Changes and Diseases of the Aging Eye

We live in a visual world. Functional impairment related to the visual system has a profound effect on geriatric patients, and care providers should be alert to these changes. Vision care for the aging patient may be considered as managing symptomatic conditions and early detection of asymptomatic vision-threatening disease. The goal of vision care can be regarded as maintaining or restoring vision to a level allowing the greatest possible quality of life. Vision is often taken for granted until there is a problem, particularly with aging, as various visual changes occur in the aging eye. The pathologies associated with these changes that occur with aging affect visual function and eye comfort and eventually impact independence and well-being. A few of these changes are, unfortunately, asymptomatic until they have progressed to irreversible vision loss. The primary care provider can recognize common eye problems, support adherence and appropriate specialty involvement, and play a key role activating and coordinating person-centered considerations in care management. The functional components of the visual system most commonly affected by aging include acuity (resolution), motion detection (peripheral vision), contrast sensitivity, and night vision. These functional components can have profound effects in activities of daily living and quality of life. Educating patients regarding yearly eye examinations is an important step in maintaining general health of the eye and preventing further decline in functional impairment related to the visual system. This chapter discusses the aging eye, associated pathophysiology, and the impacts on visual independence and quality of life. We further focus on clinical manifestations, management of ocular disease, and diagnostic tools utilized in clinical settings.