A 75-Year-Old Man Comes to the Office Due to a 2-Year

A 75-year-old man comes to the office due to a 2-year history of slowly worsening vision in both eyes.  The symptoms are worse at night and the patient has stopped driving at night due to excessive glare from oncoming headlights.  He has worked his entire life as a farmer and continues to drive tractors and other farm equipment during the day without difficulty.  Medical history is unremarkable.  Ocular examination shows loss of the red reflex and poor visualization of retinal detail.  Acuity testing shows 20/100 vision in both eyes; visual field testing is normal.  Which of the following is the most likely etiologic factor for this patient's eye condition?

A) Accumulation of sorbitol in the lens
B) Age-related oxidative injury
C) Decreased collagen fibril production
D) Ischemia and neovascularization
E) Loss of lens distensibility

Correct Answer:

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