Question

A 60-year-old lady comes to see you with complaints of dimness of her vision.
What are the causes of reduced vision?

Hint:

The most common cause of reduced vision in older adults is cataracts, followed by macular degeneration and diabetic retinopathy. Always assess for treatable causes first, such as refractive errors or cataracts.

Answer 1

Step 1: Common Causes of Reduced Vision.
- Refractive Errors: The most common cause of reduced vision in older adults is uncorrected refractive errors (e.g., myopia, hyperopia, presbyopia, astigmatism). These can be easily corrected with glasses or contact lenses.
- Cataracts: Clouding of the lens inside the eye is a leading cause of vision loss in the elderly. Symptoms include gradual, painless vision loss and glare.
- Glaucoma: Increased intraocular pressure damages the optic nerve, leading to gradual peripheral vision loss. It is asymptomatic in the early stages and often goes unnoticed.
- Macular Degeneration: Age-related macular degeneration (AMD) leads to central vision loss, making it difficult to read or recognize faces. It is common in older adults.
- Diabetic Retinopathy: Chronic diabetes can damage blood vessels in the retina, leading to vision loss. Early stages may be asymptomatic, but it can progress to blindness.
- Retinal Disorders: Conditions like retinal detachment, diabetic macular edema, or retinal vein occlusion can cause sudden or progressive vision loss.
- Other Causes: Conditions like optic neuritis, uveitis, or brain tumors can also affect vision.

Step 2: Conclusion.
Several causes contribute to reduced vision in older adults, ranging from refractive errors to serious retinal and neurological conditions. A thorough assessment is needed to identify the cause.