The range of ocular movements decreases with aging

Purpose: To determine whether normal maximum versions change as a function of age. Methods: One hundred twenty-four healthy subjects without a ny history of strabismus, ocular or periocular surgery, or major illness were examined to confirm visual acuity better than 20/60 in each eye and the absence of strabismus. Maximum sustained elevation, depression, dextroversion, and levoversion were quantified by using a standardized lateral version light-reflex (LVR) test. Results, Subjects ranged in age from 23 to 84 years. All LVR measurements were converted into degrees of eye rotation assuming standard globe size. For each maximal gaze position, the regression line (whether determined directly or scaled against historical normal values) was formed by plotting the LVR measurements versus age had a negative slope significantly different than zero (P =.0001 for all). Depression had a significantly smaller decrease in LVR measurement with age (-0.5% per year) than elevation (-1% per year, P =.0001), adduction (-0.3% per year, P=.0001), or abduction (-0.7% per year, P=.0017). Elevation had the largest decrease in LVR measurement with age compared with depression and abduction (P =.003). Conclusion: As measured by LVR, the maximum versions into extremes of gaze decrease by an average of 0.5% to 1.0% per year of life between the third and ninth decade. The version least affected and most affected by age is depression and elevation, respectively Age should be considered when assessing versions for evidence of rectus muscle overaction and underaction.