Erdinest Nir, London Naomi, Morad Yair
Department of Ophthalmology, Hadassah-Hebrew University Medical Center.
Private clinic, Jerusalem, Israel.
Harefuah. 2020 Dec;159(12):892-897.
Several significant visual changes can occur during human aging. These include decreased visual acuity and binocular function, contraction of visual fields, presbyopia, dry eye, decreased contrast sensitivity, decreased dark adaptation, delayed glare recovery, change in color vision and decreased visual processing speed. The most common physical changes are decreased pupil size, decreased retinal luminance, changes in inter- and intracellular connections, both intra-retinal and connections to the cortex .There are changes both in quantity and physical location of various cells, such as photoreceptors ganglion and bipolar retinal cells, as well as changes in clarity of media such as the crystalline lens, all of which in turn cause the resulting visual changes. Among adversely affected tasks are near work such as reading and computer work, driving, maneuvering through crowded or unfamiliar surroundings, locating desired objects surrounded by clutter and even decreased balance ability that may cause falling. Some of the changes can be reversed or at least slowed, but some processes cannot be stopped. Some of the options at our disposal to help the patient can vary from early prevention, using single or a combination of external devices such as optical devices and various forms of medical treatments, surgical and other. Although the visual system is affected by other senses, vision also affects other systems in the body. The objective here is to isolate specifically visual-related changes that can occur as healthy people age and thereby expand the vocabulary and dialogue between health care providers with ophthalmologists and optometrists for ultimate better patient care. The following review attempts to present a brief current update of the accumulated data describing various physiological visual changes that can occur with aging in generally healthy individuals and in this article, disregards the effects of ocular diseases, even if they are usually associated with age.
在人类衰老过程中会出现一些显著的视觉变化。这些变化包括视力下降、双眼功能减退、视野缩小、老花眼、干眼症、对比敏感度降低、暗适应能力下降、眩光恢复延迟、色觉改变以及视觉处理速度减慢。最常见的身体变化是瞳孔缩小、视网膜亮度降低、视网膜内和细胞间连接的变化(包括视网膜内连接以及与皮层的连接)。各种细胞(如光感受器、神经节细胞和视网膜双极细胞)的数量和物理位置都会发生变化,晶状体等介质的透明度也会改变,所有这些反过来都会导致视觉变化。受负面影响的任务包括近距离工作(如阅读和电脑操作)、驾驶、在拥挤或不熟悉的环境中行动、在杂乱环境中找到所需物品,甚至平衡能力下降可能导致跌倒。有些变化可以逆转或至少减缓,但有些过程无法停止。我们可以采取的帮助患者的一些方法包括早期预防,使用单一或多种外部设备(如光学设备)以及各种形式的医学治疗、手术等。虽然视觉系统会受到其他感官的影响,但视觉也会影响身体的其他系统。这里的目的是专门分离出随着健康人年龄增长可能出现的与视觉相关的变化,从而扩大医疗保健提供者与眼科医生和验光师之间的词汇量和对话,以最终实现更好的患者护理。以下综述试图简要介绍目前积累的数据,描述一般健康个体衰老过程中可能发生的各种生理性视觉变化,并且在本文中,忽略眼部疾病的影响,即使它们通常与年龄相关。