The most frequent changes of the anterior eye observed in senescence include changes in refraction which may be toward the hyperopic or the myopic side and a diminished tear secretion which may lead to the sicca syndrome. The corneal endothelium often shows degenerative changes which may lead to a decompensation of the cornea and corneal edema. A senile cataract is a frequent finding in older people as is chronic open angle glaucoma. One of the most serious senile changes is macular degeneration which may lead to extremely poor central vision though the peripheral vision may still be satisfactory. A similar effect has the less frequently seen anterior ischemic optic neuropathy.