Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

Corneal ulcers are more prevalent in older adults primarily due to which physiological change?

1. prevalence of high blood pressure in the elderly

2. sudden fall

3. slack of regular eye exams

4. decreased tear production

The correct answer is: decreased tear production

Decreased tear production is the primary physiological change in older adults that contributes to a higher prevalence of corneal ulcers. As individuals age, the production of tears often diminishes due to age-related changes in lacrimal gland function and hormonal shifts. This reduction in tear quantity leads to dry eyes, which create an environment where the cornea can become more vulnerable to injury, infection, and ulceration. Tears are essential for maintaining corneal health, providing moisture, nourishment, and protection against pathogens. When tear production is insufficient, the cornea may not receive the necessary hydration and protective elements it requires, increasing the risk of developing corneal abrasions or ulcers. While aspects such as high blood pressure, accidents resulting in falls, and insufficient eye care may be relevant factors in the overall health of older adults, they do not directly lead to the physiological changes that predispose the cornea to ulceration as significantly as decreased tear production does. The impact of dry eyes makes it the most relevant choice in understanding the prevalence of corneal ulcers in the aging population.