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      Vision and Aging

      1
      Annual Review of Vision Science
      Annual Reviews

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          Abstract

          Research on aging and vision has increased dramatically over the past few decades. Changes in our visual capacities in later adulthood have the potential to impact our ability to perform common everyday visual tasks such as recognizing objects, reading, engaging in mobility activities, and driving, thus influencing the quality of our life and well-being. Here, we discuss several common visual problems in older adults that cause performance problems in the visual tasks of everyday living and when exacerbated are related to the development of common eye conditions and diseases of aging.

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          Aging and vision.

          Given the increasing size of the older adult population in many countries, there is a pressing need to identify the nature of aging-related vision impairments, their underlying mechanisms, and how they impact older adults' performance of everyday visual tasks. The results of this research can then be used to develop and evaluate interventions to slow or reverse aging-related declines in vision, thereby improving quality of life. Here we summarize salient developments in research on aging and vision over the past 25 years, focusing on spatial contrast sensitivity, vision under low luminance, temporal sensitivity and motion perception, and visual processing speed. Copyright © 2010 Elsevier Ltd. All rights reserved.
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            Dark adaptation and the retinoid cycle of vision.

            Following exposure of our eye to very intense illumination, we experience a greatly elevated visual threshold, that takes tens of minutes to return completely to normal. The slowness of this phenomenon of "dark adaptation" has been studied for many decades, yet is still not fully understood. Here we review the biochemical and physical processes involved in eliminating the products of light absorption from the photoreceptor outer segment, in recycling the released retinoid to its original isomeric form as 11-cis retinal, and in regenerating the visual pigment rhodopsin. Then we analyse the time-course of three aspects of human dark adaptation: the recovery of psychophysical threshold, the recovery of rod photoreceptor circulating current, and the regeneration of rhodopsin. We begin with normal human subjects, and then analyse the recovery in several retinal disorders, including Oguchi disease, vitamin A deficiency, fundus albipunctatus, Bothnia dystrophy and Stargardt disease. We review a large body of evidence showing that the time-course of human dark adaptation and pigment regeneration is determined by the local concentration of 11-cis retinal, and that after a large bleach the recovery is limited by the rate at which 11-cis retinal is delivered to opsin in the bleached rod outer segments. We present a mathematical model that successfully describes a wide range of results in human and other mammals. The theoretical analysis provides a simple means of estimating the relative concentration of free 11-cis retinal in the retina/RPE, in disorders exhibiting slowed dark adaptation, from analysis of psychophysical measurements of threshold recovery or from analysis of pigment regeneration kinetics.
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              Visual processing impairment and risk of motor vehicle crash among older adults.

              Motor vehicle crash risk in older drivers has been associated with visual acuity loss, but only weakly so, suggesting other factors contribute. The useful field of view is a measure that reflects decline in visual sensory function, slowed visual processing speed, and impaired visual attention skills. To identify whether measures of visual processing ability, including the useful field of view test, are associated with crash involvement by older drivers. Prospective cohort study with 3 years of follow-up, 1990-1993. Ophthalmology clinic assessment of community-based sample. A total of 294 drivers aged 55 to 87 years at enrollment. Motor vehicle crash occurrence. Older drivers with a 40% or greater impairment in the useful field of view were 2.2 times (95% confidence interval, 1.2-4.1) more likely to incur a crash during 3 years of follow-up, after adjusting for age, sex, race, chronic medical conditions, mental status, and days driven per week. This association was primarily mediated by difficulty in dividing attention under brief target durations. Reduction in the useful field of view increases crash risk in older drivers. Given the relatively high prevalence of visual processing impairment among the elderly, visual dysfunction and eye disease deserve further examination as causes of motor vehicle crashes and injury.
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                Author and article information

                Journal
                Annual Review of Vision Science
                Annu. Rev. Vis. Sci.
                Annual Reviews
                2374-4642
                2374-4650
                October 14 2016
                October 14 2016
                : 2
                : 1
                : 255-271
                Affiliations
                [1 ]Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Alabama 35294; email:
                Article
                10.1146/annurev-vision-111815-114550
                28532355
                048fc06c-5055-42be-9cd8-af7d0dee22c8
                © 2016
                History

                Geriatric medicine,Medicine,Neurology,Anatomy & Physiology,Health & Social care,Public health

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