Low Vision in the Geriatric Population: Rehabilitation and Management

Older persons represent the fastest growing segment of individuals with visual impairments in industrialized countries. This population is expected to grow dramatically in the coming years. This article discusses the common agerelated changes in vision and the most prevalent visual impairments associated with aging, and the resulting functional implications. It includes information for health care professionals about preparing an older person to benefit from low‐vision rehabilitation services, environmental evaluations and modifications, and orientation to the environment. The importance of functional assessment and instruction in the use of visual skills and vision devices is stressed. The article also emphasizes the need for teamwork to provide a full scope of rehabilitation services to older adults with low vision, and the importance of support by family members and caregivers to maximize coping, adjustment, independence and quality of life.

[1]  B. Cooper,et al.  The use of the Lanthony New Color Test in determining the effects of aging on color vision. , 1991, Journal of gerontology.

[2]  S. Van Zandt,et al.  The Role of Support Groups in Adjusting to Visual Impairment in Old Age , 1994 .

[3]  I L Bailey,et al.  New Design Principles for Visual Acuity Letter Charts* , 1976, American journal of optometry and physiological optics.

[4]  J. Brabyn,et al.  Seeing into old age: vision function beyond acuity. , 1999, Optometry and vision science : official publication of the American Academy of Optometry.

[5]  Newell Sw,et al.  Nursing home glaucoma and visual acuity screening results in western Oklahoma. , 1985 .

[6]  R. W. Young Solar radiation and age-related macular degeneration. , 1988, Survey of ophthalmology.

[7]  M. Sloane,et al.  Visual processing impairment and risk of motor vehicle crash among older adults. , 1998, JAMA.

[8]  D. Whitaker,et al.  Factors affecting light-adapted pupil size in normal human subjects. , 1994, Investigative ophthalmology & visual science.

[9]  M A Leinhaas,et al.  Low vision: how to assess and treat its emotional impact. , 1994, Geriatrics.

[10]  Gunilla Haegerstrom-Portnoy,et al.  Age changes in the optical density of human ocular media , 1993 .

[11]  V C Smith,et al.  Aging of the human lens. , 1987, Applied optics.

[12]  S. Valluri Gradual painless visual loss: anterior segment causes. , 1999, Clinics in geriatric medicine.

[13]  A. Eisner,et al.  Sensitivities in older eyes with good acuity: cross-sectional norms. , 1987, Investigative ophthalmology & visual science.

[14]  C. Curcio,et al.  Aging of the human photoreceptor mosaic: evidence for selective vulnerability of rods in central retina. , 1993, Investigative ophthalmology & visual science.

[15]  J. Horwitz,et al.  Aging-related cataract: laboratory investigation and clinical management. , 1985, Annals of internal medicine.

[16]  R F Fisher,et al.  Presbyopia and the changes with age in the human crystalline lens , 1973, The Journal of physiology.

[17]  P. D. Spear,et al.  Neural bases of visual deficits during aging , 1993, Vision Research.

[18]  E F Cook,et al.  Development of the Activities of Daily Vision Scale: A Measure of Visual Functional Status , 1992, Medical care.

[19]  A. Dodds,et al.  Psychological Factors in Acquired Visual Impairment: The Development of a Scale of Adjustment , 1991 .

[20]  P Darzins,et al.  Sun exposure and age-related macular degeneration. An Australian case-control study. , 1997, Ophthalmology.

[21]  K Knoblauch,et al.  Age and illuminance effects in the Farnsworth-Munsell 100-hue test. , 1987, Applied optics.

[22]  Denis G. Pelli,et al.  THE DESIGN OF A NEW LETTER CHART FOR MEASURING CONTRAST SENSITIVITY , 1988 .

[23]  K. Ball,et al.  A Preliminary Assessment of the Medical and Functional Factors Associated with Vehicle Crashes by Older Adults , 1998, Journal of the American Geriatrics Society.

[24]  C. Owsley,et al.  Relationship between visual sensitivity and target localization in older adults , 1995, Vision Research.

[25]  Richard G. Domey,et al.  Threshold and Rate of Dark Adaptation as Functions of Aǵe and Time1 , 1960 .

[26]  C. Owsley,et al.  The useful field of view test: a new technique for evaluating age-related declines in visual function. , 1993, Journal of the American Optometric Association.

[27]  B. Blasch,et al.  Outcome assessment of the rehabilitation of the visually impaired. , 1999, Journal of rehabilitation research and development.

[28]  Allan G. Dodds,et al.  Motivation reconsidered: the importance of self-efficacy in rehabilitation , 1989 .

[29]  M. Warren Providing low vision rehabilitation services with occupational therapy and ophthalmology: a program description. , 1995, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[30]  Gregory L. Goodrich,et al.  Training Eccentric Viewing , 1977 .

[31]  M. Bullimore,et al.  A New Test for the Evaluation of Disability Glare , 1991, Optometry and vision science : official publication of the American Academy of Optometry.

[32]  W. Applegate,et al.  Impact of cataract surgery with lens implantation on vision and physical function in elderly patients. , 1987, JAMA.

[33]  Ra Schuchard,et al.  Preferred retinal locus. A review with applications in low vision rehabilitation , 1994 .

[34]  M. Hersen,et al.  Assertiveness, Depression, and Social Support in Older Visually Impaired Adults , 1995 .

[35]  G. Rubin,et al.  Fixation patterns and reading rates in eyes with central scotomas from advanced atrophic age-related macular degeneration and Stargardt disease. , 1996, Ophthalmology.

[36]  J. Marshall,et al.  Convolution in human rods: an ageing process. , 1979, The British journal of ophthalmology.

[37]  S. West,et al.  Epidemiology of risk factors for age-related cataract. , 1995, Survey of ophthalmology.

[38]  R. Kendrick Gradual painless visual loss: glaucoma. , 1999, Clinics in geriatric medicine.

[39]  S. Whittaker,et al.  Scanning characters and reading with a central scotoma. , 1985, American journal of optometry and physiological optics.

[40]  S. Whittaker,et al.  Visual Requirements for Reading , 1993, Optometry and vision science : official publication of the American Academy of Optometry.

[41]  J. Werner,et al.  Light, vision, and aging. , 1990, Optometry and vision science : official publication of the American Academy of Optometry.

[42]  J S Sunness,et al.  Scanning laser ophthalmoscopic analysis of the pattern of visual loss in age-related geographic atrophy of the macula. , 1995, American journal of ophthalmology.

[43]  Gale R. Watson,et al.  National Survey of the Impact of Low Vision Device Use among Veterans , 1997, Optometry and vision science : official publication of the American Academy of Optometry.

[44]  W. De l'aune,et al.  Reaching Visually Impaired Elders in Long-term Care: A Self-study Curriculum for Care Providers , 1995 .