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Appendix B Annotated Bibliography This bibliography has been designed to provide interested individuals with a list of farther readings on the effects of aging on human visual function and the relationship of those effects to work performance. The bibliography is not intended to serve as a comprehensive list of readings in this area; rather, it serves as a mechanism to orient readers to the diverse literature comprising this area. The bibliography is divided into five major sections: (~) basic visual changes with age; (2) age charges in higher-level perceptual processes; (3) the impact of vision on work; (4) low vision and optical aids; and (5) general texts on vision and aging. The third section, compact of Vision on Work, ~ further subdivided into 3 sections: (~) employment status; (2) task performance;;a~d (3) environmental design. Each annotation briefly describes the major foci of the book or article. When the item berg annotated ~ a general text, the annotation highlights the content of the reference specifically related to work, aging, and vision. BASIC VISUAL CHANGES WITH ACE Kline, D. W., and Schieber, F. 3. 1985 Vision and aging. Pp. 290331 in J. E. Birren and K. W. Schaie, eds., Handbook of the Psychology of Aging. New York: Van Nostrand Reinhold. This chapter ~ a basic review of the changes that occur in vi- sion with aging. It includes information on changes in the eye 54

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ss and brain, visual pathologies, light sensitivity, color vision, spa- tial resolution, temporal resolution, and higher-level perceptual processes. Michaels, D. D. 1985 Visual Optics and Refraction: A Clinical Approach. St. Loum: The C. V. Mosley Company. Textbook on optics and refraction that includes a chapter on refraction of the aging eye. This chapter describes structural and functional changes of the aging eye and discusses the diagnosis and treatment of presbyopia. Also includes a chapter on prescribing low vision aide. 1986 Ocular disease in the aged. Pp. 135-167 in A. A. Rosenbloom, Jr., and M. W. Morgan, eds., Vision and Aging: General and Clinical Perspectives. New York: Professional Press Books/Fairchild Publications. Presents an overview of the aging eye and its clinical evaluation. Reviews the features of several age-related ocular diseases, includ- ing diseases of the orbit, cornea, lens, retina, and optic nerve. Also reviews the ophthalmic signs of diseases, such as arteriosclerosis, diabetes, and hypertension. National Center for Health Statistics 1978 Refractive Status and Mobility Defects of Persons 4- 7], Yea rat, United States, 1971-1972. Prepared by J. Roberts and M. Rowland. Vital and Health Statistics. Series 11, Number 206. DHEW Pub. No. (PHS) 78- 1654. Washington, D.C.: U.S. Department of Health, Education, and Welfare. Reports estunates on refraction status, maximum corrected visual acuity, and eye motility defects among the civilian non~nstitution- alized population in the United States. These estimates, based on findings from the ophthahnology examination in the Health and Nutrition Examination Survey of 1971-1972, are analyzed with respect to several demographic add socioeconomic variables. 1983 Eye Conditions and Related Need for Medical Care Among Persons 1-72 Years of Age: United States, ~971-1972. Prepared by J. GanIey and J. Roberts. Vital Health Statistics, Series 11, No. 228. DHHS

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56 Pub. No. (PHS) 83-1678. Washington, D.C.: U.S. Department of Health and Human Services. Contains estanates of the total prevalence of various types of eye abnormalities and vision decrease from abnormal conditions among the civilian noninstitutional~zed population of the United States. Based on findings from the ophthalmology examination in the National Health and Nutrition Examination Survey of 1971- 1972 and analyzed with respect to various demographic and so- cioeconom~c factors. 1984 Eye Care Vi~ts and Use of Eyeglasses or Contact Lenses, United States, 1979 and 1980. Vital and Health Statistics. Series 10, No. 145. DHHS Pub. No. (PHS) 8~1573. Washington, D.C.: U.S. Department of Health and Human Services. Presents national estunates of volume and frequency of eye care visits and types of eye care professionals seen, based on data collected in 1979 by the National Health Interview Survey. Also reports on the use of eyeglasses and contact lenses in 1979 and 1980 and on trends in corrective lenses since 1966. Weale, R. A. 1982 A Biography of the Eye: Development, Growth, Age. London: H. K. Lewd ~ Co. Ltd. Examines ocular aging in a developmental framework. Discusses ocular embryology and the properties of the infant eye. Chapters are devoted to detailed discussions of the effects of aging on the eyeball, the uveal tract, the crystalline lens, the retina, and the brain. Summarizes data on visual capabilities such as acuity, contrast sensitivity, and temporal resolution as a function of age. AGE CHANGES IN HIGlIER-I`EVEL PERCEPTUAL PROCESSES Kline, D. W., and Schieber, F. J. 1982 Visual persistence and temporal resolution. Pp. 231- 244 in R. Sekuler, D. Kline, and K. D~mukes, eds., Aging and Human Visual Function. New York: Alan R. Liss, Inc.

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57 Discusses factors contributing to the loss with age In the temporal resolving power of the visual system. Critically reviews the evi- dence suggesting that stunulus persistence effects In the nervous system account for the loss of temporal resolution. Points to one need for further research in the area. Sekuter, R., and Owsley, C. 1982 The spatial vision of older humans. Pp. 185-202 in R. Sekuler, D. Kline, and K. D~mukes, eds., Aging and Human Visual Function. New York: Alan R. Liss, Inc. Discusses measurement of the contrast sensitivity function as a method of assessing spatial vision integrity. Presents contrast sensitivity data for younger and older observers, which indicate sensitivity losses at intermediate and high- spatial frequencies for older adults. Studies relating these losses to age differences in human face perception are reported. Data on age differences in motion sensitivity are also presented. Walsh, D. A. 1982 The development of visual information processes in adulthood and old age. Pp. 2~-230 in R. Sekuler, D. KIme, and K. Dismukes, eds., Aging and Human Visual Function. New York: Alan R. Liss, Inc. Examines age differences In visual functioning in the framework of visual information processing modem. Describes these modem and the distinctions drawn between peripheral and central perceptual processes. Reviews the results of experunents demonstrating that older adults are slower than young adults in more than one stage of visual information processing. IMPACT OF VISION ON WORM Employment Status Kahne, H. 1985 Reconceiving Part-time Work: New Perspectives for Older Workers and Women. Totowa, N. J.: Rowan & AlIanheld. Discusses the demographic, economic, and societal trends that in- fluence work patterns. Finds that part-time work schedules will

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58 become increasingly unport ant in the future and suggests how cur- rently employed part-time work arrangements can be improved. Examines the interests and needs of women and older workers in part-time work and the impact of social policies and legislation on part-time work for older workers. Explores the influence of unions' and employers' opinions and policies on part-tune work structure and availability. Impacts of visual function are not con- sidered. includes an extensive bibliography on older workers and employment. National Commission for Employment Policy 1985 Older Worker Employment Comes of Age: Practice and Potential. Washington, D.C.: National Commission for Employment Policy Guide to various aspects of older worker employment. Includes discussions on who the older worker is, work arrangements for older workers, policies affecting older workers, and initiatives in the employment sector to help older workers find and retain jobs. Does not deal specifically with visual unpa~rment. U.S. Congress, Senate 1985 Health and Extended Worklife. Special Committee on Aging. Prepared by D. D. Newquist. Washington, D.C.: U.S. Government Printing Office. This document presents health status information on older per- sons as it relates to extending their work lives. Sumunarizes data from the National Center for Health Statistics and the Social Se- curity Administration on various health and disability measures of m~ddle-aged and older populations. Discusses these data In the broad context of health, aging, and work. Several areas of research need are listed. Office of Technology Assessment 1985 Technology and Aging in America. Washington, D.C.: U.S. Government Printing Office. Discusses the impact of technology on several aspects of the func- tional status of the older person, such as health, living en~riron- ments, and employment. Reviews demographic trends in the United States and considers how advances ~ technology affect employment opportunities for older workers. Discusses the costs and benefits of job retraining programs for older workers. Also dis- cusses the use of technology to improve worker health and safety

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so and to assist older workers with physical impairments. Includes an appendix that bets devices used by workers with physical or sensory deficits, including visual impairments. Paul, C. E. 1983 A Human Resource Management Perspective on WO TIC Alternatives for Older Woricera. Washington, D.C.: National Commission for Employment Policy. Survey of 25 companies known for progressive programs address- ing the needs of older workers. Discusses the forms these pros grams take, the variables that influence management's decision on whether to implement such programs, the extent to which the programs are used by older workers, and the impacts of public policies on the development of such programs. No discussion of how such programs might address visual impairments. Robinson, P. K. 1983 Organizational Strategies for Older Workers. New York: Pergamon Press. Reviews the literature on management strategies for an aging work force. Contains several annotations of references in the field as well as a recommended reading list. Robinson, P. K., I,ivingston, J. L., and Birren, J. E., eds. 1984 Aging and Technological Advances. New York: Plenum Pre - . Proceedings from a symposium sponsored by the NATO Special Program P~e} on Human Factors. Presents a broad view of the positive and negative consequences of technology for the aging. Includes chapters on labor force participation, health and stress, human factors, home and community. Several chapters consider issues relevant to the older worker's employment status. Includes a limited amount of material related specifically to technology and visual impairment ~ the aging. Root, L. S., and Zarrugh, L. H. 1983 Innovative Employment Practices for Older Americans. Washington, D.C.: National Commission for Employ- ment Policy. Analyzes a variety of program and practices initiated by com- panies to create employment options for older workers. Descrip- tions of companies were obtained from the National Older Worker

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60 Information System (NOWIS), a computerized data base. Pro- grams and practices include part-time work assignments, job train- ing/retraining, and job redesign. With rare exceptions, the pro- grarns do not address visual needs of the older worker. U.S. Congress, Senate 1985 Personnel Practices for an Aging Work Force: Private- Sector Examples. Special Committee on Aging. Pre- pared by L. S. Root and L. H. Zarrugh. Washington, D.C.: U.S. Government Printing Office. This paper is based on the National Older Worker Information System (NOWIS), a data base of practices and programs in the private sector that can benefit older workers. Discusses part-time employment practices, training programs, and job redesign ini- tiatives. Summaries of 38 company programs selected from the data base are presented. Physical redesign of the workstation to accommodate disabilities such as visual impairment is an uncom- mon practice among the sample companies. 1986 Aging America: Trends and Projections. Special Com- mittee on Aging. Washington, D.C.: U.S. Government Printing Office. This document presents a general overview of the size, growth, and geographic distribution of the older population, as well as data on its health, income, employment, housing, and social status. Task Performance Davison,P.A. 1985 Inter-relationshipe between British drivers' visual abil- ities, age and road accidents. Ophthalmic and Physio- log~cal Optics 5:195-204. An analysis is provided of 1,000 drivers' accident histories on a vi- sion screening instrument. Significant relationships were seen bet tween various accident variables and several different vision tests. Retesting drivers' vision at about age 50 was recommended. Evans, D. W., and Ginsburg, A. P. 1985 Contrast sensitivity predicts age-related differences in highway-sign discrirninability. Human Factors 23~6~: 637~42.

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61 Examines whether contrast sensitivity measurements can be used to predict aggregated differences in the ability to discriminate sim- ple highway signs. Snellen visual acuity and contrast sensitivity measures were determined for a group of younger observers (ages 19 to 30) and group of older observers (ages 55 to 793. Although vi- sual acuity was the same in the two groups, the younger observers were able to discriminate road signs at significantly greater dis- tances than the older observers. The results of the discrimination experiment correlated well with contrast sensitivity measures at 1.5 and 12 cycles per degree. Holmes, C., Tolliffe, H., Gregg, J., Cameron, I., and Blyth, R. 1958 Guide to Occupational and Other Visual Needs, Volume 1. Los Angeles: Silver I.ake L`ithographers, Inc. Presents an analysis of the visual tasks involved in several occu- pations and avocations. This cIa~ic volume was motivated to a large degree by a concern for prescribing proper lenses to give pres- byopes clear vision at multiple working distances. Each analysis describes the workstation in terms of locations of work areas and working distances. The analyses comment on the requirements for visual acuity, ocular motility, depth perception, peripheral vision, and color discrimination and also discuss other factors affecting lens prescription, such as lighting and safety. Institute of Medicine 1981 Airline Pilot Age, Health and Performance: Scientific and Medical Considerations. Washington, D.C.: Na- tional Academy Pre - . Report of the Committee to Study Scientific Evidence Relevant to Mandatory Age Retirement for Airline Pilots. Provides a com- prehensive review of information regarding how advances in age may unpact the ability of airline pilots to perform their jobs safely. The report includes a consideration of the pilot's job, safety and methodological issues, age-related health changes, perceptual and psychomotor changes with age, and alternative approaches to the evaluation of pilot proficiency. Panek, P. E., Barrett, G. V., Sterns, H. I,., and Alexander, R. A. 1977 A review of age changes in perceptual information pros cessing ability with regard to driving. Experimental Aging Research 3~6) :387-449.

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62 Reviews age-related changes in vision, hearing, and information processing abilities, such as selective attention and perceptua]- motor reaction tune, as they impact driving behavior. Includes an extensive reference list. Salthouse, T. A., and Somberg, B. L. 1982 Skilled performance: Effects of age and experience on elementary processes. Journal of Experimental Psy- chologs,: Genera' Ill(2~:17~207. Examines the effects of practice on the performance of four simple tasks by younger adults (ages I~27) and older adults (ages 62- 73~. Tasks included are signal detection, memory scanning, visual discrimination, and temporal prediction. Findings indicate that practice improves performance in both age groups, but that age differences remain. Suggests that differences between young and old in performance of simple perceptual and cognitive tasks are due to a slower overall rate of information processing. Sekuler, R. S., Kline, D., and Dismokes, K., eds. 1982 Aging and visual function of military pilots: A re- view. Aviation, Space, and Environmental Medicine 53~:747-758. Report of Working Group 55 of the Committee on Vision. Sum- mare the visual tasks of pilots and reviews the visual functions crucial to the performance of these tasks, emphasizing the effects of age on these functions. Discuses methodological obstacles to determining the effects of age on visual function and performance of visual tasks. Presents recommendations for further research. Sivak, M., Olson, P. L., and Pastalan, L. A. 1981 Effect of driver's age on nighttime legibility of highway signs. Human Factors 23~:59 64. Examines the relationship between driver's age and nighttime leg- ibility of highway signs. Findings show that the distances required to correctly read a sign for older drivers (over age 61) are 65 to 77 percent of those for younger drivers (under age 25~. Suggests that legibility standards should not be based solely on data from the young and that standard (high luminance) acuity tests may be poor predictors of nighttime visual performance.

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63 Welford, A. T. 1976 Thirty years of psychological research on age and work. Journal of Occupational Psychology 49:129-138. Historical review of research In industrial gerontology in Britain beginning in 1946. Summarizes the main ideas that emerged from this research and discusses future research needs in the area of aging and work. Environmental Design Boyce, P. R. 1981 Human Factors in Lighting. New York: MacMillan Publishing Co., Inc. Comprehensive survey of the impact of lighting conditions on people's responses. Reviews fundamentals of the quantification and production of light and basic information on vision. Examines the relationship between lighting and work. Explores people's reactions to different lighting conditions, along dimensions such as discomfort, and discusses the standards, codes, and guides for specification of lighting in different environments. Presents a brief review of the effects of age on visual performance as determined by such basic measures as visual acuity (pp. 231-248~. Guth, S. K., Eastman, A. A., and McNelm, J. F. 1956 Lighting requirements for older workers. Ruminating Engineering 30:656-660. Classic study of the eject of age on visibility levels. Observers were office and laboratory workers ranging in age from 17 to 65. Measurements of word recognition were made in illumination levels varying from 10 to 100 footcandles. Results indicate an increase in lighting requirements with increasing age. Fozard, J. L. 1981 Person-environment relationships in adulthood: Impli- cations for human factors engineering. Human Factors 23(1):7-27. Discusses designing environments for the aging and the elderly. Reviews the literature on the effects of aging on vision, hearing, the other senses, learning, memory, health, and work variables. Discusses human factors interventions for those changes that occur with age.

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64 Hakkinen, L. 1984 Vision in the elderly and its use In the social envi- ronment. Scandanav~an Journal of Social Medicine Supplement 35:~0. Study of the visual function and visual requirements of daily life in the elderly, based on data from 601 residents of Turku, Finland, age 65 and older. Reports measurements of visual functions such as best corrected visual acuity, color vision, visual field, grating acuity, and contrast sensitivity. The study also explores the re- lationship between visual functions and social data such as living arrangements and the needs for vision in daily activities. Includes a review of the literature and 303 references. Hughes, P. 1981 Lighting for the elderly: A psychobiological approach to lighting. Human Factors 23~:6~85. Reviews the literature on the role of illumination in optimizing indoor environments for the elderly, emphasizing both the impact of illurriination on vision and the photobiological effects of light. Discusses physiological changes that occur with aging and the effects of aging on visual performance. Comments on good lighting design practices for different environments, including the work environment. Kaufman, J. E., and Haynes, H., eds. 1981 lES Lighting Handbook. New York: TIlurn~nating En- gineering Society of North America. This technical handbook of light and its applications Is published in two comprehensive volumes, a reference volume and an appli- cation volume. The reference volume includes chapters on the physics of light, light and vision, the measurement of light, color, and light sources. The application volume discuses approaches to lighting design and the factors to be considered in illumunance selection, including the age of observers. Examines lighting design for various environments, such as the office, industry, residents, and roadways.

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65 LOW VISION AND OPTICAL AD)S Bailey, I. L. 1986 The optometric examination of the elderly patient. Pp. 18~209 in A. A. Rosenbloom, Jr., and M. W. Morgan, eds., Vision and Aging: General and Clinical Perepec- tives. New York: Professional Press Books/Fairchild Publications. Describes special considerations that should be taken in providing vision care to the older patient. Includes a discussion of refraction techniques and visual acuity measurements for both the normally sighted older person and the older patient with low vision. Con- siders how to prescribe various optical aids to enhance vision for patients with low vision. Damato, B. E. 1985 Oculokinetic perunetry: A sunple visual field test for use in the community. British Journal of Ophthalmol- ogy 69:927-931. A method of visual field examination is described that enables an unsupervised person to carry out self-assessment using only a pa- per test chart, a record sheet, and a pencil. It is entitled "oculoki- netic perimetry~ because it ~ the subject's eye that moves and not the test target. By providing nonophthalmic health care workers with a simple means of performing perimetry in the community, and by allowing susceptible people to carry out self-asse~ment of the visual fields at home, this test should facilitate the detec- tion and management of glaucoma, especially in underdeveloped countries. Jose,R.T.,ed. 1983 Understand;'ng Lou' Vision. New York: American Foundation for the Blind. Written for professionals in the low vision area, covering such top- ics as low vision averment and training techniques. The text, although directed at the professional, ~ sufficiently nontechnical to be appreciated by the lay person. Includes a chapter describing both optical aids for the visually unpaired as well as nonoptical forms of assistance. Selected references, including several on oh tical and nonoptical aids and on geriatric concerns in low vision, are annotated.

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68 Kirchner, C. 1985 Data on Blindness and Lima! Impairment in the U.S. New York: American Foundation for the Blind. Twenty-eight astatistical briefs" originally published ~ the .70ur- nal of Visuat Impairment and Blindness between 1978 and 1984. The chapters contain data on social, educational, and employment characteristics of visually unpaired and blind populations in the United States. Information on service delivery systems is also presented. GENERAL TEXTS ON VISION AND AGING Birren, S. E., and Schaie, K. W., ede. 1985 Handbook of the Psychology of Aging. New York: Van Nostrand Reinhold Company. Comprehensive review and excellent reference source of the litera- ture on the psychological and behavioral aspects of aging. Includes chapters on the theory and methods, biological and social ~nflu- ences on behavior, and applications of psychological knowledge to issues relevant to both the individual and society. Chapters devoted to discussions of behavioral processes cover such topics as vision and aging, speed and behavior, and problem solving. Rosenbloom, A. A., Jr., and Morgan, M. W., eds. 1986 Vision and Aging: General and Clinical Perspectives. New York: Professional Prem Booke/Fairchild Publi- cations. This general text covers a diversity of topics related to vision and aging. Considers vision care for the older adult as part of a broader physiological, psychological, and social context. Several chapters present overviews of normal and pathological ocular changes in the aged. Other chapters addrem Rues related to the delivery of health and vision care to the elderly. Sekuler, R. S., Kline, D., and Dismukes, K., eds. 1982 Aging and Human Visual Function. New York: Alan R. Hiss, Inc. A collection of papers based on a symposium sponsored by the Committee on Vision. Many aspects of the effects of age on vision are discussed. Considers, for example, changes in the lens, cataract

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67 formation, changes and such visual functions as glare sensitivity, dark adaptation, and visual field loss. Other chapters consider the impacts of aging on visual perception and information processing. Discusses, for example, spatial and temporal vision, attention, and pattern recognition. Methodological issues and the unpacts of visual changes on the life of the older person are also explored.

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- 5ECURITY CLASSIFICAl.ION OF T~lS PAGE (When D-t. En'.ted) REPORT WCUMENTATION PAGE READ INSTRUCTIONS BEFORE COMPLETING FORM 3. RECIPIENT'S CATALOG NU141lER 1. REPORT NUh413ER 2. Gove ACC EsSION NO 4. TITLE (and Subtitle) Work; Aging' and Vision: Report of a Conference S. TYPE OF REPORT ~ PERIOD COVERED Technical Report 6. PERFORMING OF4G. REPORT. t4U'4BER 7. AU Tl4OR(~) Working Group on Aging Workers and Visual Impairment 8. CONTRACT OR GRANT NUMBERED) N00014-80-C-0159 9- PERfORhIING ORGANIZATION NAME ADO ADDRESS Committee on Vision National Research Council Washington, D.C. 11. CON7RO~Li~G Of FICE NAME ANO ADDRESS . 10. PROGRAM ELEMENT. PROJECTS ruse AREA ~ WORK UNIT NUMBERS NR 201-124 Office of Naval Research Arlington, Virginia 22217-5000 14. 1~1oNlTORING AGENCY NAblE ~ AODRESS(tf dJ!ferent from Controli~nd Office) 12. REPORT DATE February 1987 13. NUMBER OF PAGES 77 1S. SECURITY CLASS. fat this report) Unclassified 15-. DECL4SSlPlCATION/ DOWNGRADING SCHEDULE _ .. 16. DISTRIBUTION STATEblENT (of reds Report) Approved for Public Release: Distribution Unlimited t7. DISTRIeUT'ON STATEMENT (of the abstract entered In Bloc* 20. 1' dltteront born Report) 1S. SUPPLEMENTARY NoTES 19. KEY WORDS (Contend@ on reverse aid. if noc@asery and identity by block number) 1 Vision Aging Visual Function Committee on Vision Ophthalmology Employment 20. ABSTRACT (Continue on r@,rera. adda `t necesa.ty and identity by block numb The aging of the human eye involves a series of changes in visual performance that can be detected readily in the healthy adult. Viewed in the context of employment, reduced visual function does not necessarily have any effect on job performance, but for some individuals it will. This report reviews what is known about changing visual functions relevant to job performance, and recommends steps that can be taken by the worker and the employer to address changing visual needs. DO , J AN '3 1473 EDITION Of ~ NOV 6S IS OBSOLETE S 19 0102- LF 01.1-5601 . . SECURITY CLASSIFICATION OF rims PAGE (When Data entered,

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