Nutrient requirements for optimum health and function of aging physiological systems often are
quite distinct from those required for young ones. Recognition and understanding of the special
nutrition problems of the aged are being intensively researched and tested, especially due to the
increases in the elderly in the general population. In developed countries, economic restrictions and
physical inactivity during aging can significantly reduce food intakes, contributing to nutritional
stresses and needs. Many disease entities and cancers are found with higher frequency in the aged.
Although cataract surgery has been performed
for many centuries, technological advances now
provide us with the opportunity to afford our
patients vision more similar to the pre-cataract
state than ever before. Advanced instrumentation
and surgical techniques allow our patients to
expect excellent uncorrected vision within 24 h
of surgery. In addition, newer multifocal and
accommodating intraocular lens (IOLs) offer the possibility of distance, near, and intermediate
vision without glasses [2, 23, 32]....
This book is part of a series of ophthalmic monographs, written for ophthalmologists in training and
general ophthalmologists wishing to update their knowledge in specialised areas. The emphasis of
each is to combine clinical experience with the current knowledge of the underlying disease processes.
Each monograph provides an up to date, very clinical and practical approach to the subject so that
the reader can readily use the information in everyday clinical practice.
The format of the book has not changed but some of the chapters have been expanded.
For example, there is now a section dealing with the eye complications of acquired
immune deficiency syndrome (AIDS). This problem barely existed at the time of the first
edition. Cataract surgery has changed a great deal in this short time and is becoming
one of the commonest major surgical procedures to be performed in a hospital. The
management of glaucoma has also changed with the introduction of a range of new medications.
In this context, the term dizziness is being used to describe disturbed ambulation. There may be mild associated lightheadedness, particularly with impaired sensation from the feet or poor vision; this is known as multiple-sensory-defect dizziness and occurs in elderly individuals who complain of dizziness only when walking. Decreased position sense (secondary to neuropathy or myelopathy) and poor vision (from cataracts or retinal degeneration) create an overreliance on the aging vestibular apparatus.
The Physicians’ Health Study II, which included more than 14,000 male physicians aged 50
or older, found that neither vitamin E nor vitamin C supplements reduced the risk of major
cardiovascular events (heart attack, stroke, or death from cardiovascular disease), cancer,
or cataracts. In fact, vitamin E supplements were associated with an increased risk of
hemorrhagic stroke in this study.
a-Crystallin is the principal lens protein which, in addition to its structural
role, also acts as a molecular chaperone, to prevent aggregation and preci-pitation of other lens proteins. One of its two subunits,aB-crystallin, is
also expressed in many nonlenticular tissues, and a natural missense muta-tion, R120G, has been associated with cataract and desmin-related myopa-