Ocular and Refractive Considerations for the Aging Eye

BY KATHRYN RICHDALE, OD, MS, FAAO

1. Refractive astigmatism changes during adulthood at the rate of how much per decade?
a. 0.25DC
b. 0.30DC
c. 0.50DC
d. 0.62DC

2. About what percentage of patients over the age 65 has impaired vision of 20/60 or less in the better eye?
a. 5
b. 10
c. 20
d. 30

3. A tear break-up time of less than how many seconds signifies a dry eye?
a. 10
b. 15
c. 20
d. 25

4. With age the ciliary muscle decreases as much as:
a. 2mm
b. 4mm
c. 6mm
d. 8mm

5. The one “accommodating IOL” with a single optic design available in the United States allows an average eye to achieve how much add?
a. 0.50D
b. 1.00D
c. 1.50D
d. 2.00D

6. The prevalence of hyperopia over +3.00D for adults 40 years and older is about:
a. 5 percent
b. 10 percent
c. 15 percent
d. 20 percent

7. Compared to a 20-year-old, the average 60-year-old receives about what percent of light to the retina?
a. 88
b. 66
c. 44
d. 33

8. From 20 to 80 years of age, the pupil in the light and dark, respectively, decreases about:
a. 1mm to 2mm
b. 2mm to 3mm
c. 1mm to 3mm
d. 3mm to 5mm

9. Atrophy of the ciliary muscle occurs after what age?
a. 30
b. 40
c. 50
d. 60

10. The ciliary body shows an increase in connective tissue beginning in what decade of life?
a. third
b. fourth
c. fifth
d. sixth

11. From about the fourth through sixth decades of life, spherical refractive error changes by about how much per decade?
a. +0.25D
b. +0.50D
c. +0.75D
d. +1.00D

12. The loss of accommodative function is nearly complete by what age?
a. 50
b. 60
c. 70
d. 80

13. With the decline of elasticity of the eyelids with age:
a. Only the lower lid moves down
b. Only the upper lid moves down
c. Both the lower and upper lids move down
d. Neither the upper nor lower lid moves down

14. Which is the only refractive error with 100 percent incidence?
a. myopia
b. hyperopia
c. presbyopia
d. astigmatism

15. Spherical soft lenses may not provide adequate vision when astigmatism is:
a. 0.25DC
b. 0.50DC
c. 0.75DC
d. 1.00DC

16. In the seventh or eighth decade, there is noted “myopic shift” of up to about:
a. –0.30DS
b. –0.50DS
c. –0.70DS
d. –0.90DS

17. Best-corrected visual acuity is relatively stable until about what age?
a. 20
b. 30
c. 40
d. 50

18. With age:
a. Lacrimal glands increase
b. Goblet cells increase
c. Only goblet cells decrease
d. Both goblet cells and lacrimal glands decrease

19. About how much does the crystalline lens increase in thickness per year?
a. 18µm to 30µm
b. 15µm to 20µm
c. 10µm to 15µm
d. 5µm to 10µm

20. For a translating GP lens to work, the lower lid should be beneath the inferior limbus with primary fixation by no more than:
a. 1mm
b. 2mm
c. 3mm
d. 4mm


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