• List the common age-related changes in ocular function.
• Discuss the common causes of vision problems in older adults.
• Techniques for preventing and treating visual loss.
• Know the signs of, and treatments for common eye disorders in older persons.
• Be able to correlate visual impairment in older adults with functional impairment and the effects on quality of life.
• Know the indicators for the effective management of impaired vision in vulnerable elders.
• Be familiar with low vision rehabilitation.

Angela R. Curtis, PhD
Managing Editor
Assistant Professor, Geriatric Education Manager
Division of Gerontology, Geriatrics and Palliative Care

Erum Jadoon, MD
Assistant Professor, Division of Gerontology, Geriatrics and Palliative Care

Dawn K. DeCarlo, OD, MS
Associate Professor of Ophthalmology,
Director, UAB Center for Low Vision Rehabilitation

Mark W. Swanson, OD, MSPH
Associate Professor
Chief, Ocular Disease, Low Vision, and Geriatric Vision Services

University of Alabama at Birmingham
Birmingham, Alabama

The faculty has no commercial affiliations to disclose.

Because of the nature of preliminary studies, some products mentioned are unlabeled and investigational. Dosages, indications, and methods of use of drugs mentioned in this publication may reflect the experience of the authors, clinical literature, or other resources. Therefore, please see the full prescribing information before using any licensed product mentioned.

The University of Alabama School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of Alabama School of Medicine designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The boards of nursing in many states, including Alabama, recognize Category 1 continuing medical education courses as acceptable activities for the renewal of license to practice nursing.

Vision impairment is common in older adults and increases with age. Population-based studies report functional visual impairment in 4% to 7% of persons aged 71-74, 16% of persons aged 80 and older, and 39% of persons aged 90 and older. [1,2,3]. Studies estimate that between 27-59% of nursing home residents are visually impaired and 5-11% are legally blind. The National Nursing Home Survey used reports by nursing staff to determine whether residents had impaired vision. [4] Using data from the National Nursing Home Survey, Dey estimated that 364,000 (26%) of the 1.4 million nursing home residents in the United States age 65 and over have visual impairments.[5] These numbers are expected only to grow over the coming years.

Functional vision problems can be secondary to age-related changes as well as disease states commonly affecting the eye. Together or on their own, these problems result in visual disability that not only threaten an older person’s ability to live independently, but also impose significant risk for new events, such as falls.

Vision impairment has serious consequences for older adults. These individuals are more likely to have limited physiological reserve and have a high prevalence of chronic disease. Vision impairment adds to this burden and significantly affects quality of life. There is an abundant literature linking vision impairment to poorer quality of life in older adults, some of which can be summarized as : [6,7]

• Increased risk of 5-year mortality
• Increased risk of nursing home placement
• Increased length of hospital stay (by up to two days)
• Increased risk of falls
• Increased risk of hip fracture
• Increased risk of clinical depression (up to 50%)
• Increased risk of social isolation