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Baur ID, Mueller A, Labuz G, Naujokaitis T, Auffarth GU, Khoramnia R. Refractive Lens Exchange: A Review. Klin Monbl Augenheilkd 2024; 241:893-904. [PMID: 39146574 DOI: 10.1055/a-2346-4428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
In recent decades, technical advancements in lens surgery have considerably improved safety and refractive outcomes. This has led to a much broader range of indications for refractive lens exchange (RLE). Effective restoration of uncorrected distance and near visual acuity is possible with modern presbyopia correcting intraocular lenses (IOLs). Hyperopic patients who are fully presbyopic were identified as ideal candidates for RLE. For myopic patients, an increased risk of retinal detachment has been reported, which leads to a higher threshold to perform RLE in this patient group. The most frequent postoperative complications include posterior capsular opacification, deviation from the target refraction and cystoid macular edema. Thus, adequate planning of surgery, careful patient selection, as well as comprehensive counseling are crucial for successful RLE.
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Affiliation(s)
| | - Arthur Mueller
- Department of Ophthalmology, University Hospital Augsburg, Germany
| | - Grzegorz Labuz
- International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Germany
| | - Tadas Naujokaitis
- International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Germany
| | - Gerd U Auffarth
- International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Germany
| | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC) and David J Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University Hospital Heidelberg, Germany
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Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, Kollbaum P, Marcotte-Collard R, Montani G, Plainis S, Richdale K, Simard P, Wolffsohn JS. BCLA CLEAR presbyopia: Mechanism and optics. Cont Lens Anterior Eye 2024; 47:102185. [PMID: 38796331 DOI: 10.1016/j.clae.2024.102185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2024]
Abstract
With over a billion adults worldwide currently affected, presbyopia remains a ubiquitous, global problem. Despite over a century of study, the precise mechanism of ocular accommodation and presbyopia progression remains a topic of debate. Accordingly, this narrative review outlines the lenticular and extralenticular components of accommodation together with the impact of age on the accommodative apparatus, neural control of accommodation, models of accommodation, the impact of presbyopia on retinal image quality, and both historic and contemporary theories of presbyopia.
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Affiliation(s)
- Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK.
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Fiona Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Jose J Estevez
- Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, Australia; Flinders Centre for Ophthalmology, Eye and Vision Research, Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Safal Khanal
- Department of Optometry and Vision Science, The University of Alabama at Birmingham, USA
| | | | | | | | - Sotiris Plainis
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK; Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | | | - Patrick Simard
- School of Optometry, Universite de Montreal, Montreal, Quebec, Canada
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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Mahmood M, Day M, Seidel D, Cameron LA. The effect of multifocal contact lenses on the dynamic accommodation step response. Ophthalmic Physiol Opt 2024; 44:321-333. [PMID: 38303152 DOI: 10.1111/opo.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE To measure the dynamic accommodation response (AR) to step stimuli with and without multifocal contact lenses (MFCLs), in emmetropes and myopes. METHODS Twenty-two adult subjects viewed alternating distance (0.25D) and near (3D) Maltese crosses placed in free space, through two contact lens types: single vision (SVCL) or centre-distance multifocal (MFCL; +2.50D add). The AR level was measured along with near to far (N-F) and far to near (F-N) step response characteristics: percentage of correct responses, magnitude, latency, peak velocity and duration of step response. RESULTS There was no difference between N-F and F-N responses, or between refractive groups in any aspect of the accommodation step response dynamics. The percentage of correct responses was unaffected by contact lens type. Through MFCLs, subjects demonstrated smaller magnitude, longer latency, shorter duration and slower peak velocity steps than through SVCLs. When viewing the near target, the AR through MFCLs was significantly lower than through SVCLs. When viewing the distance target with the MFCL, the focal points from rays travelling through the distance and near zones were approximately 0.004D behind and 2.50D in front of the retina, respectively. When viewing the near target, the respective values were approximately 1.89D behind and 0.61D in front of the retina. CONCLUSION The defocus error required for accommodation control appears not to be solely derived from the distance zone of the MFCL. This results in reduced performance in response to abruptly changing vergence stimuli; however, these errors were small and unlikely to impact everyday visual tasks. There was a decrease in ocular accommodation during near tasks, which has previously been correlated with a reduced myopic treatment response through these lenses. With MFCLs, the estimated dioptric myopic defocus was the largest when viewing a distant stimulus, supporting the hypothesis that the outdoors provides a beneficial visual environment to reduce myopia progression.
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Affiliation(s)
- Mubeen Mahmood
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Mhairi Day
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dirk Seidel
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lorraine A Cameron
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
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Plainis S, Panagopoulou S, Charman WN. Longitudinal changes in objective accommodative response, pupil size and spherical aberration: A case study. Ophthalmic Physiol Opt 2024; 44:168-176. [PMID: 37966110 DOI: 10.1111/opo.13250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Previous transverse and a handful of longitudinal studies have shown that the slope of the static accommodation response/stimulus curve declines as complete presbyopia is approached. Changes in pupillary miosis and ocular spherical aberration (SA) are also evident. This study further investigated longitudinal changes in the relationships between the monocular static accommodative response, pupil diameter and SA of a single adult. METHODS A wavefront analysing system, the Complete Ophthalmic Analysis System, was used in conjunction with a Badal optometer to allow continuous recording of the aberration structure of the dominant eye in a low myope for a range of accommodative demands (-0.83 to 7.63 D) over a period of 17 years until the age of 50. Monocular accommodative response was calculated as the equivalent refraction minimising wavefront error. The associated longitudinal changes in pupil size and SA with accommodation were also recorded. RESULTS A decrease in accommodation response with age was found at almost all target vergences, with the changes being greatest for higher vergences. In addition, although absolute pupil diameter decreased with age, the rate of change in pupil diameter with accommodative stimulus remained approximately constant with age. Pupil constriction occurred for near stimuli even in full presbyopia. SA changed linearly with the accommodation response at all ages. CONCLUSIONS The objective amplitude of accommodation declined linearly with age as complete presbyopia was approached, while the slope of the response/stimulus curve also fell. It was hypothesised that the retinal image blur associated with the larger lags of accommodation at higher accommodative stimuli was reduced by pupil constriction and the resulting lower levels of SA.
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Affiliation(s)
- Sotiris Plainis
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Rethymno, Greece
- Optometry & Vision Science Research Group, Aston University School of Life and Health Sciences, Birmingham, UK
| | - Sophia Panagopoulou
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Rethymno, Greece
| | - W Neil Charman
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Ozhan FO, Aygun U, Sahin A, Urey H. Dynamic accommodation measurement using Purkinje reflections and machine learning. Sci Rep 2023; 13:21625. [PMID: 38062067 PMCID: PMC10703819 DOI: 10.1038/s41598-023-47572-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
Quantifying eye movement is important for diagnosing various neurological and ocular diseases as well as AR/VR displays. We developed a simple setup for real-time dynamic gaze tracking and accommodation measurements based on Purkinje reflections, which are the reflections from front and back surfaces of the cornea and the eye lens. We used an accurate eye model in ZEMAX to simulate the Purkinje reflection positions at different focus distances of the eye, which matched the experimental data. A neural network was trained to simultaneously predict vergence and accommodation using data collected from 9 subjects. We demonstrated that the use of Purkinje reflection coordinates in machine learning resulted in precise estimation. The proposed system accurately predicted the accommodation with an accuracy better than 0.22 D using subject's own data and 0.40 D using other subjects' data with two-point calibration in tests performed with 9 subjects in our setup.
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Affiliation(s)
- Faik Ozan Ozhan
- Department of Electrical and Electronics Engineering, Koç University, 34450, Istanbul, Turkey
| | - Ugur Aygun
- Department of Electrical and Electronics Engineering, Koç University, 34450, Istanbul, Turkey
| | - Afsun Sahin
- Koç University Translational Medicine Research Center (KUTTAM), 34450, Istanbul, Turkey
- School of Medicine, Koç University, 34450, Istanbul, Turkey
| | - Hakan Urey
- Department of Electrical and Electronics Engineering, Koç University, 34450, Istanbul, Turkey.
- Koç University Translational Medicine Research Center (KUTTAM), 34450, Istanbul, Turkey.
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Espinosa J, Archid K, Pérez J, Perales E. Using a video-based eye tracker to analyse the binocular near-reflex dynamics response. Ophthalmic Physiol Opt 2023; 43:1540-1549. [PMID: 37470168 DOI: 10.1111/opo.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE This study presents a novel video-based eye-tracking system for analysing the dynamics of the binocular near-reflex response. The system enables the simultaneous measurement of convergence, divergence and pupillary size during accommodation and disaccommodation to aid the comprehensive understanding of the three-component near-reflex. METHODS A high-speed (90 Hz) video-based eye tracker was used to capture changes in eye gaze and pupil radius in 15 participants in response to altering stimulus conditions. An offline analysis involved separating the gaze vector components and pupil radius, which were fitted to a hyperbolic tangent function to characterise the dynamics of the near-reflex process. RESULTS Significant differences in the temporal parameters of the pupil radius were observed between the near-to-far and far-to-near vision changes, with faster miosis compared with mydriasis. Additionally, differences in response times were found between gaze angle components, with longer convergence times compared to changes in the vertical direction (saccades). The steady-state values of the gaze components and pupil radius were in line with theoretical expectations and previous reports. CONCLUSIONS The proposed system provides a non-invasive, portable and cost-effective method for evaluating near-reflex dynamics under natural viewing conditions using a video-based eye tracker. The sampling rate ensures the accurate assessment of vergence eye movements and pupillary dynamics. By simultaneously measuring eye convergence, divergence and pupil size, the system offers a more comprehensive assessment of the near-reflex response. This makes it a valuable tool for clinical diagnosis, research studies and investigating the effects of near work on the visual system.
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Affiliation(s)
- Julián Espinosa
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
- Instituto Universitario de Física, Aplicada a las Ciencias y las Tecnologías, Universidad de Alicante, Alicante, Spain
| | - Kauzar Archid
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
| | - Jorge Pérez
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
- Instituto Universitario de Física, Aplicada a las Ciencias y las Tecnologías, Universidad de Alicante, Alicante, Spain
| | - Esther Perales
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
- Instituto Universitario de Física, Aplicada a las Ciencias y las Tecnologías, Universidad de Alicante, Alicante, Spain
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Roorda A, Tiruveedhula P, Naseri A, Rhee P, Clarke M. FIAT: A Device for Objective, Optical Measures of Accommodation in Phakic and Pseudophakic Eyes. Transl Vis Sci Technol 2023; 12:9. [PMID: 36607622 PMCID: PMC9836010 DOI: 10.1167/tvst.12.1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose To present FIAT, a novel optical instrument and analysis package that is designed to elicit and optically record accommodation in human eyes. Methods FIAT employs a Shack-Hartmann wavefront sensor and a retro-illumination pupil camera that records from a single eye at video rates. It is effective at eliciting accommodation by offering the subject a full-field binocular view of an alternating distant target and a near-eye display. FIAT analysis software computes wave aberrations for each video frame over full- or subpupil sizes and computes accommodative dynamics and accommodative range. Results The system is validated by showing accurate refraction measurements in model eyes and human eyes with trial lenses. Robust accommodative responses are shown for young eyes, and a lack of accommodative response is shown for a known presbyopes. Accommodative stimulus-response curves from five phakic subjects over a range of ages show expected results. Results from two individuals with monofocal intraocular lenses are shown. Conclusions FIAT is an effective instrument for making accurate, objective measures of accommodation in phakic and pseudophakic eyes. Translational Relevance We present a device that can play an important role in the development and testing of accommodating intraocular lenses.
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Affiliation(s)
- Austin Roorda
- University of California at Berkeley, Berkeley, CA, USA
| | | | - Ayman Naseri
- ForSight VISION6, Inc. South San Francisco, CA, USA,University of California, San Francisco, San Francisco, CA, USA
| | - Paul Rhee
- ForSight VISION6, Inc. South San Francisco, CA, USA
| | - Matt Clarke
- ForSight VISION6, Inc. South San Francisco, CA, USA
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Haddad JS, Gouvea L, Ambrósio R, Waring GO, Rocha KM. Ray-tracing Analysis of Accommodation and Pseudoaccommodation in Phakic and Pseudophakic Eyes. J Refract Surg 2022; 38:661-667. [DOI: 10.3928/1081597x-20220830-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Ahmed M, Shefali MK, Husain L, Khondaker M, Alauddin M, Hossain MA, Kabir AKMN, Whitestone N, Cherwek DH, Congdon N, Patnaik JL. Vision Impairment and Productivity Among Female Garment Workers in Bangladesh: A Cohort Study. Asia Pac J Ophthalmol (Phila) 2022; 11:79-84. [PMID: 35030134 DOI: 10.1097/apo.0000000000000485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To assess the prevalence of near and correctable distance visual impairment among screened participants in the garment industry and to explore associations with income, age, and urban versus rural residence. METHODS Vision screenings were conducted at 4 garment factories, 2 urban and 2 rural locations during September and October 2019. Distance vision impairment was the presence of uncorrected vision of <6/12 in either eye, correctable to ≥6/7.5 with distance refraction. Near vision impairment was defined as 1 or more of the following: 1) either eye with presenting near vision 6/12 in the same eye; 2) having been prescribed near add spectacle power in examination records; and/or 3) clinical diagnosis of presbyopia at the time of screening. Demographic information and monthly income were self-reported by questionnaire completion. RESULTS Among 915 participating workers (100% female, 18 to 70 years), 29.2% (n = 267) and 26.8% (n = 245) had correctable distance and near vision impairment respectively. Prevalence of near vision impairment was significantly higher among rural residents (34.2%, n = 160), compared to urban (19.0%, n = 85, P < 0.0001) with the largest differences in the 35 to 39 (68.2% vs 44.2%, P = 0.0019) and 40+ (85.9 vs 48.9%, P < 0.0001) year age ranges. Prevalence of near vision impairment was already high among urban (20.4%, n = 20) and rural (23.0%, n = 17) workers aged 30 to 34 years. In simple linear regression models, participants with near vision impairment earned $13.3 [standard error (SE) 2.44, P < 0.0001] less per month than those without, while urban residents earned $40.6 (SE 1.74, P < 0.0001) more than rural dwellers. In the final multivariate linear model, both near vision impairment ($6.51 lower monthly earnings, SE 1.84, P = 0.0004) and urban residence ($43.2 higher monthly earnings, SE 2.39, P < 0.0001) remained significantly associated with income. CONCLUSIONS This study found high rates of near vision impairment among female garment workers, particularly rural dwellers, and at a younger age than expected. The high prevalence and association between near vision impairment and lower income suggest that focusing on industries with a high proportion of female workers, such as readymade garments, may be effective in addressing gender disparities in vision impairment and its economic impact.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Nathan Congdon
- Orbis International, New York, NY, US
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jennifer L Patnaik
- Orbis International, New York, NY, US
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, US
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Kang JW, Chun YS, Moon NJ. A comparison of accommodation and ocular discomfort change according to display size of smart devices. BMC Ophthalmol 2021; 21:44. [PMID: 33461518 PMCID: PMC7814593 DOI: 10.1186/s12886-020-01789-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 12/22/2020] [Indexed: 12/01/2022] Open
Abstract
Background To evaluate the change of accommodation and ocular discomfort according to the display size, using quantitative measurements of accommodation and ocular discomfort through subjective and objective metrics. Methods Forty six subjects without any ophthalmic disease history were asked to watch the documentary movie, using two different sizes of smart devices; smartphones and tablets. Before and after using devices, the near point accommodation (NPA) and the near point convergence (NPC) were measured, and objective accommodation was measured using an auto refractometer/keratometer. The subjective ocular discomfort was assessed through a survey. Results Both devices showed a decrease in post-use NPA and NPC, and the change after use of the smartphone was significantly severe, 1.8 and 2.5 folds respectively, compared to tablet (p = 0.044, p = 0.033, respectively). Neither smartphone nor tablet showed significant changes in the accommodative response induced by dynamic accommodative stimulus of auto refractometer/keratometer (p = 0.240 and p = 0.199, respectively). Subjects showed a more severe increase in ocular discomfort after using smartphones (p = 0.035) and reported feeling tired even with shorter use times (p = 0.012). Conclusions Both devices showed significant decreases in NPA and NPC, and the larger changes were seen when using the small display smartphone. Even within 20minutes of using, subjects start to feel ocular discomfort, and it was more severe and faster after smartphones than tablets. Therefore, the smaller the display size, the greater the adverse impact on eyes, and thus, appropriate display size will need to be selected depending on the time and purpose of use.
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Affiliation(s)
- Jeong Woo Kang
- Department of Ophthalmology, Airforce 16th Fighter Wing Medical Squadrone, Yecheon, Gyeongsangbuk-Do, South Korea
| | - Yeoun Sook Chun
- Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, 06974, Seoul, South Korea
| | - Nam Ju Moon
- Department of Ophthalmology, College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, 06974, Seoul, South Korea.
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Haddad JS, Gouvea L, Ferreira JL, Ambrósio R, Waring GO, Rocha KM. Impact of a Chromatic Aberration-Correcting Intraocular Lens on Automated Refraction. J Refract Surg 2020; 36:334-339. [DOI: 10.3928/1081597x-20200403-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/02/2020] [Indexed: 11/20/2022]
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Weng CC, Hwang DK, Liu CJL. Repeatability of the amplitude of accommodation measured by a new generation autorefractor. PLoS One 2020; 15:e0224733. [PMID: 31986151 PMCID: PMC6984687 DOI: 10.1371/journal.pone.0224733] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/21/2019] [Indexed: 11/18/2022] Open
Abstract
Significance This is the first study to validate the repeatability of objective measurements of amplitude of accommodation (AA) using the TONOREF III (NIDEK Co., Ltd., Japan), which can measure the AA in 30 seconds. Purpose To evaluate the repeatability of objective measurements of AA using the TONOREF III and explored the association between objectively measured AA and factors, including age, sex, spherical equivalent, baseline pupil size and pupil size change during accommodation. Methods This cross-sectional study recruited 35 healthy subjects aged 26 to 52 years. The Bland-Altman method and intraclass correlation coefficients (ICCs) were used to assess the repeatability of TONOREF III measurements. The relationships between AA and age, sex, baseline pupil size, changes in pupil size (ΔPS) during accommodation were analyzed using linear regression for univariate and multivariate analysis. Results The mean difference in AA (ΔAA) between two sessions of TONOREF III measurements was 0.23 D (95% CI: -1.07 to +1.53 D), while no significant correlation was found between the mean and ΔAA (p = .14). The ICCs of the TONOREF III was 0.96. Age, sex, and ΔPS during accommodation were significant factors affecting the AA in multivariate analysis. Conclusions The repeatability of objective AA measurements using the TONOREF III was good. Measuring AA using the TONOREFTM III in clinical practice is feasible.
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Affiliation(s)
- Chang-Chi Weng
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - De-Kuang Hwang
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
- * E-mail: (DKH); (JLL)
| | - Catherine Jui-Ling Liu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
- * E-mail: (DKH); (JLL)
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Almutairi MS, Altoaimi BH, Bradley A. Impact of monovision on dynamic accommodation of early presbyopes. Ophthalmic Physiol Opt 2019; 40:47-59. [PMID: 31879995 DOI: 10.1111/opo.12660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/24/2019] [Accepted: 11/29/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE To examine the impact of monovision on dynamic changes in accommodation, pupil responses, spherical aberration and resultant image quality in early presbyopes. METHODS Refractive state, pupil size and spherical aberration levels were monitored in nine early presbyopes who exhibited some accommodation (40-50 years, mean = 42 ± 2.37 years) using a Shack-Hartmann aberrometer as a binocularly viewed stimulus stepped closer (from 2 m to 40 cm), or farther (from 40 cm to 2 m). Comparison data from two fully presbyopic (i.e. non-accommodating) subjects (ages 46 and 61 years) and two young adults (ages 26 and 29 years) were also collected. Each subject was fit with four different refractive strategies: (1) both eyes corrected for 2 m, (2) both eyes corrected for 40 cm, (3) monovision with the measured right eye corrected for 2 m and, (4) monovision with the right eye corrected for 40 cm. Monochromatic image quality was quantified using the AreaMTF metric. RESULTS When fit with monovision, the largest number of early presbyopes produce an accommodative response dominated by the right eye correction (distance or near) as the stimulus is abruptly changed from the retinal conjugate plane of one eye to that of the other eye. However, the accommodative responses in some early presbyopes were always dominated by the distance corrected eye, the near corrected eye, or by convergence. When the stimulus approached, the near corrected eye experienced high image quality only if there was no accommodative response. However, reduced image quality was observed if an accommodative response was initiated. Neither accommodation nor pupil response latencies were longer with monovision corrections compared with bilateral distance corrections (p > 0.05). In the early presbyopes, spherical aberration was reduced during near viewing, but primarily due to pupil miosis and not lens shape changes. CONCLUSION As the stimulus was abruptly changed from the retinal conjugate plane of the distance corrected eye to that of the near corrected eye, most early presbyopes fit with monovision accommodated, which resulted in a decline, not an increase in image quality in the near corrected eye. These results reveal a non-optimal accommodative strategy in early presbyopes fit with monovision.
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Affiliation(s)
- Meznah S Almutairi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,School of Optometry, Indiana University, Bloomington, USA
| | - Basal H Altoaimi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Arthur Bradley
- School of Optometry, Indiana University, Bloomington, USA
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Palomino-Bautista C, Sánchez-Jean R, Carmona-González D, Piñero DP, Molina-Martín A. Subjective and objective depth of field measures in pseudophakic eyes: comparison between extended depth of focus, trifocal and bifocal intraocular lenses. Int Ophthalmol 2019; 40:351-359. [DOI: 10.1007/s10792-019-01186-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/23/2019] [Indexed: 11/28/2022]
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Kumar M, Shetty R, Dutta D, Rao HL, Jayadev C, Atchison DA. Effects of a semi-scleral contact lens on refraction and higher order aberrations. Cont Lens Anterior Eye 2019; 42:670-674. [PMID: 31230973 DOI: 10.1016/j.clae.2019.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/23/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate effects of Rose K2 XL semi-scleral contact lenses (Menicon Co.) on visual acuity and higher-order aberrations in eyes with irregular corneas. METHODS One hundred and twelve eyes of 84 patients fitted with Rose K2 XL lenses were analysed. Participants were in 4 clinical groups: keratoconus, intra-corneal ring segments, radial keratotomy, and penetrating keratoplasty. Corrected distance visual acuity and ocular aberrations were determined before lens wear and 60 min into lens wear. The i-Trace aberrometer was used to determine aberrations at 4.5 mm pupil size. RESULTS There were 55, 22, 19 and 16 eyes in keratoconus, intra-corneal ring segments, radial keratotomy and penetrating keratoplasty groups, respectively. Before lens wear, eyes had poor corrected distance vision acuity (mean and standard deviation +0.55 ± 0.33 logMAR), high negative spherical equivalent refraction (-6.4 ± 3.7 D), high cylindrical errors (4.5 ± 2.2 D), large higher-order root-mean-squared (HO-RMS) aberration (1.5 ± 1.3 μm) and large higher-order aberration components. Cylinder was particular high for the penetrating keratoplasty group (mean 5.9 ± 2.5 D), root-mean-squared third-order coma was lowest for the radial keratotomy group (0.7 ± 1.0 μm), and fourth-order spherical aberration was highly negative for the intra-corneal ring segment group (co-efficient -0.4 ± 0.7 μm). With lens wear, the values changed considerably. Corrected distance visual acuity improved by 0.51 ± 0.31 logMAR, cylinder decreased by 3.6 ± 2.1 D, HO-RMS aberration reduced by 1.1 ± 1.2 μm, and higher-order aberration components decreased considerably. Magnitudes of group changes reflected the magnitudes before lens wear. CONCLUSIONS Rose K2 XL semi-scleral contact lenses were effective in improving vision and reducing ocular aberrations for eyes with irregular corneas.
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Affiliation(s)
- Mukesh Kumar
- Cornea and Refractive Department, Narayana Nethralaya, Bangalore, India.
| | - Rohit Shetty
- Cornea and Refractive Department, Narayana Nethralaya, Bangalore, India
| | - Debarun Dutta
- School of Optometry and Vision Science, The University of New Wales, Sydney, New South Wales, Australia
| | - Harsha L Rao
- Cornea and Refractive Department, Narayana Nethralaya, Bangalore, India
| | - Chaitra Jayadev
- Cornea and Refractive Department, Narayana Nethralaya, Bangalore, India
| | - David A Atchison
- Institute of Health & Biomedical Innovation and School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove Q 4059 Australia
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Vargas V, Radner W, Allan BD, Reinstein DZ, Burkhard Dick H, Alió JL. Methods for the study of near, intermediate vision, and accommodation: an overview of subjective and objective approaches. Surv Ophthalmol 2019; 64:90-100. [DOI: 10.1016/j.survophthal.2018.08.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 08/02/2018] [Accepted: 08/06/2018] [Indexed: 11/26/2022]
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Mathebula SD, Ntsoane MD, Makgaba NT, Landela KL. Comparison of the amplitude of accommodation determined subjectively and objectively in South African university students. AFRICAN VISION AND EYE HEALTH 2018. [DOI: 10.4102/aveh.v77i1.437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Historically, two clinical methods have been used for measuring the amplitude of accommodation, which are the push-up and minus lens methods. However, it has been documented that the push-up method overestimates amplitude of accommodation, while the minus lens method underestimates it.Aim: The purpose of this study was to compare subjective and objective procedures for determining the monocular amplitude of accommodation in young optometry students.Setting: The study was conducted in the optometry clinic at the university.Methods: Amplitude of accommodation was measured on 45 optometry students (17 males and 28 females, whose ages ranged from 21 to 27 years) using the push-up, push-down, minus lens, modified dynamic retinoscopy and Pascal dynamic retinoscopy methods. Data were collected by three different examiners in this study. One examiner measured all the subjective tests, while another examiner measured the modified dynamic retinoscopy. The third examiner measured the Pascal heterodynamic retinoscopy.Results: The highest amplitude of accommodation was obtained using the push-up method (10.23 ± 1.67 D), while the minus lens method gave the lowest subjective finding (8.43 ± 1.68 D). However, the subjective methods generally produced comparable results. Both retinoscopic methods showed the lowest mean amplitude of accommodation of approximately 6.50 ± 1.40 D. However, there was a high correlation between the various methods.Conclusion: The push-up and push-down methods overestimate the true amplitude of accommodation because of the relative magnification, while the minus lens method creates an abnormal viewing environment in which the target is stationary but the stimulus becomes increasingly minified. Subjective amplitude of accommodation is an inadequate measure to assess any true accommodation because it fails to differentiate between passive depth of focus and an active accommodative power change in the eye. Therefore, subjective measurement of the amplitude of accommodation may suggest that accommodation is present when it is not. Further research is needed to further validate dynamic retinoscopy as the optimal or best possible routine clinical method to assess the true amplitude of accommodation.
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Reliability of Ocular Aberration Measurements in Children with Moderate and Low Myopia under Scotopic Conditions. J Ophthalmol 2018; 2018:2043718. [PMID: 29607213 PMCID: PMC5828559 DOI: 10.1155/2018/2043718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/19/2017] [Accepted: 11/30/2017] [Indexed: 11/17/2022] Open
Abstract
Purpose To investigate the reliability of ocular aberration measurement in myopic children under scotopic conditions and to validate the mathematical Zernike pupil scaling-down technique. Methods Ocular aberrations of 45 myopic children were examined under scotopic conditions via iTrace aberrometer. The intra- and intersession repeatability was evaluated for both the measured values with the true pupil sizes and the estimated ones that were determined by scaling down the pupil sizes to the largest integer value across all measurements. Results The intra- and intersession difference of clinically measured aberration was generally insignificant, and the ICCs for each aberration component exhibited good to excellent reliability (ICCs > 0.4). Similar results were found for the estimated aberration using the scaling-down technique. Although the majority of the estimated Zernike components were comparable with the corresponding measured one, the estimated values of defocus, coma, and the corresponding total aberrations were found significantly smaller than the measured values (all P < 0.01). Conclusions The ocular aberration measurements in myopic children under the circumstances described are reliable. The scaling-down technique is a useful option for comparing the results obtained from different pupil sizes, but the estimated Zernike coefficients were not always comparable with the corresponding measured values.
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Reindel W, Zhang L, Chinn J, Rah M. Evaluation of binocular function among pre- and early-presbyopes with asthenopia. CLINICAL OPTOMETRY 2018; 10:1-8. [PMID: 30214336 PMCID: PMC6095559 DOI: 10.2147/opto.s151294] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Individuals approaching presbyopia may exhibit ocular symptoms as they contend with visual demands of near work, coupled with natural age-related changes in accommodation. Therefore, accommodation and vergence of 30- to 40-year-old, myopic, soft contact lens wearing subjects with symptoms of asthenopia and no history of using multifocal lenses were evaluated. PATIENTS AND METHODS In this prospective, observational study, 253 subjects with asthenopia were evaluated by 25 qualified practitioners, each at a different clinical site. Subjects were 30-40 years in age, had symptoms of soreness, eyestrain, tired eyes, or headaches with near work, regularly performed 2-3 consecutive hours of near work, and were undiagnosed with presbyopia. Amplitude of accommodation (AC) and near point convergence (NPC) were measured with a Royal Air Force binocular gauge. Triplicate push up and push down AC and NPC measures were recorded, and average AC values were compared to those calculated using the Hofstetter formula (HF). RESULTS The average AC push up/push down value was significantly better than the HF prediction for this age range (8.04±3.09 vs 6.23±0.80 D), although 22.5% of subjects had mean AC below their HF value (5.36±0.99 D). The average NPC push up/push down value was 12.0±4.69 cm. The mean binocular AC value using the push up measure was significantly better than the push down measure (8.5±3.4 vs 7.6±3.0 D). The mean NPC value using the push up measure was significantly worse than the push down measure (13.0±5.0 vs 11.0±4.7 cm). The most frequent primary diagnosis was ill-sustained accommodation (54%), followed by accommodative insufficiency (18%), and accommodative infacility (12%). CONCLUSION Based upon a standardized assessment of accommodation and vergence, ill-sustained accommodation was the most frequent diagnosis among this population.
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Almutairi MS, Altoaimi BH, Bradley A. Accommodation and pupil behaviour of binocularly viewing early presbyopes. Ophthalmic Physiol Opt 2017; 37:128-140. [DOI: 10.1111/opo.12356] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 01/04/2017] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Arthur Bradley
- School of Optometry; Indiana University; Bloomington USA
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Glasser A, Hilmantel G, Calogero D, MacRae S, Masket S, Stark W, Holladay JT, Rorer E, Tarver ME, Nguyen T, Eydelman ME. Special Report: American Academy of Ophthalmology Task Force Recommendations for Test Methods to Assess Accommodation Produced by Intraocular Lenses. Ophthalmology 2017; 124:134-139. [DOI: 10.1016/j.ophtha.2016.09.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 09/26/2016] [Indexed: 11/28/2022] Open
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Momeni-Moghaddam H, Kundart J, Askarizadeh F. Comparing measurement techniques of accommodative amplitudes. Indian J Ophthalmol 2016; 62:683-7. [PMID: 25005195 PMCID: PMC4131318 DOI: 10.4103/0301-4738.126990] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim and Background: This study was designed to compare four standard procedures, for determining the monocular accommodative amplitudes. Materials and Methods: Fifty-two students participated in this analytical-descriptive study. Accommodative amplitudes were measured using four common clinical techniques, namely: Push-up, push-down, minus lens, and modified push-up. Results: The highest amplitude was obtained using the push-up method (11.21 ± 1.85 D), while the minus lens technique gave the lowest finding (9.31 ± 1.61 D). A repeated-measures Analysis of Variance (ANOVA) showed a significant difference between these methods (P < 0.05), further analysis showed that this difference was only between the minus lens and other the three methods (the push-up (P < 0.001), the push-down (P < 0.001) and the modified push-up (P < 0.001)). The highest and the lowest mean difference was related to the push-up with the minus lens, and the push-down with the modified push-up, while the highest and the lowest 95% limits of agreement were related to the push-up with the modified push-up and the push-up with the push-down methods. There was almost a perfect agreement between the push-up and the push-down method, whereas, a poor agreement was present between the modified push-up and the minus lens technique, and a fair agreement existed between the other pairs. Conclusions: The quick and easy assessment of the amplitude using the push-up and the push-down methods compared to other methods, and the obtained perfect agreement between these two methods can further emphasize their use as a routine procedure in the clinic, especially if a combination of the two techniques is used to offset their slight over- and underestimation.
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Kang DW, Eom YS, Rhim JW, Kang SY, Kim HM, Song JS. Evaluation of Objective Accommodation Power in Different Age Groups Using an Auto Accommodation Refractometer. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.1.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dong Wan Kang
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Young Sub Eom
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jay Won Rhim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Su Yeon Kang
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Hyo Myung Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Shetty R, Negalur N, Kurian M, Shroff R. Preclinical cataract masquerading as post-LASIK regression. Oman J Ophthalmol 2016; 9:157-159. [PMID: 27843230 PMCID: PMC5084498 DOI: 10.4103/0974-620x.192270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The purpose of this case report is to bring forth a rare clinical scenario where preclinical cataract mimics post-LASIK regression and to describe the role of aberrometry in detecting higher order aberrations (HOAs) and early lens changes. A 36-year-old female presented with blurring of vision since 1 year after having undergone an uneventful LASIK surgery 3 years prior. Corneal topography and aberrometry were within normal limits. Although the lens was morphologically normal on slit lamp examination, increased HOAs and lenticular density were detected. Since there were no cataractous changes, the patient was advised regular follow-up. A year later, the patient had developed lenticular changes along with a further increase in aberrations and worsening of scatter on densitometry. Increase in aberrations and lenticular density may serve as a marker for cataract development before clinically detectable lenticular changes. This report shows how preclinical cataract can mimic post-LASIK regression with a change in spherical and cylindrical power of the eye. This could result in patients undergoing re-correction in eyes where the primary pathology is in the lens.
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Affiliation(s)
- Rohit Shetty
- Cataract, Refractive and Cornea Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Nikhil Negalur
- Cataract, Refractive and Cornea Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Mathew Kurian
- Cataract, Refractive and Cornea Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Rushad Shroff
- Cataract, Refractive and Cornea Services, Narayana Nethralaya, Bengaluru, Karnataka, India
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Abstract
PURPOSE To evaluate changes of accommodative power in phakic eyes after uneventful pars plana vitrectomy (PPV) in patients aged younger than 45 years without presbyopia. METHODS We investigated patients aged younger than 45 years who underwent PPV without crystalline lens extraction because of vitreoretinal disorders. Twelve weeks after vitrectomy, the near point of accommodation, high-frequency component of accommodative microfluctuation, axial length, and anterior chamber depth of vitrectomized and contralateral nonvitrectomized eyes were examined. RESULTS Ten eyes of 10 patients were included. The average patient age was 39.8 (±4.3) years. None experienced cataract progression in the vitrectomized eye up to 12 weeks after surgery. Near point of accommodation was significantly lower in the vitrectomized eye than in the opposite eye at 12 weeks after vitrectomy (5.23 [±1.39] diopters vs. 5.91 [±1.83] diopters, p < 0.001). The high-frequency components in the vitrectomized eyes were significantly greater than those in the contralateral eyes (p = 0.01). However, anterior chamber depth and axial length were similar in value to the preoperative observations. CONCLUSIONS Uneventful PPV in relatively young patients without presbyopia reduced accommodative power during the early postoperative period with no cataract progression.
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Gabriel C, Klaproth OK, Titke C, Baumeister M, Bühren J, Kohnen T. Repeatability of topographic and aberrometric measurements at different accommodative states using a combined topographer and open-view aberrometer. J Cataract Refract Surg 2015; 41:806-11. [PMID: 25840305 DOI: 10.1016/j.jcrs.2014.07.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/30/2014] [Accepted: 07/10/2014] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the repeatability of corneal first-surface aberrations and aberrometric measurements of a combined aberrometer-topographer (iTrace Visual Function Analyzer) for 5 accommodative stimuli. SETTING Department of Ophthalmology, Goethe-University, Frankfurt, Germany. DESIGN Prospective case series. METHODS Eyes of young adults with low to moderate myopia or hyperopia were examined in 2 measurement series comprising 3 corneal topography measurements and wavefront measurements focusing on targets at 5 distances (0.4, 0.5, 0.6, 1.0, and 4.0 m). Repeatability was analyzed using the standard deviation (SD) within 6 measurements and the coefficient of repeatability (CoR) by Bland-Altman analysis of the means of the 2 measurement series. RESULTS Fifty eyes (50 subjects) were evaluated. The lowest calculated mean SD/CoR measurements using the aberrometer function at 5 target distances were 0.07 μm/0.14 μm for total ocular aberrations root mean square (RMS), 0.07 μm/0.16 μm for lower-order aberrations (LOAs) RMS, 0.03 μm/0.66 μm for higher-order aberrations (HOAs) RMS, 0.10 diopter (D)/0.22 D for sphere, 0.08 D/0.13 D for cylinder, and 0.09 D/0.21 D for the spherical equivalent (SE). Repeatability of the total RMS, LOAs RMS, sphere, and SE measurements improved with increasing target distance (P < .01 for aberrometric values; P < .03 for refractive values). Measurement reproducibility using the corneal topographer showed mean SDs/CoRs of 0.19 μm/0.41 μm for total RMS, 0.19 μm/0.39 μm for LOAs RMS, and 0.08 μm/0.23 μm for HOAs RMS. CONCLUSION The aberrometer showed satisfactory results for measurement repeatability at all target distances and declining repeatability with increasing accommodation effort. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Claudia Gabriel
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | | | - Christine Titke
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | - Martin Baumeister
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | - Jens Bühren
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | - Thomas Kohnen
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany.
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Ramasubramanian V, Glasser A. Can Ultrasound Biomicroscopy Be Used to Predict Accommodation Accurately? J Refract Surg 2015; 31:266-73. [DOI: 10.3928/1081597x-20150319-06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 01/30/2015] [Indexed: 11/20/2022]
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Abstract
PURPOSE To measure the accommodative response in unsighted or profoundly vision impaired (PVI) eyes when accommodation is elicited in the fellow, sighted eye. METHODS Eighty-eight unilaterally PVI subjects (UPS) and 97 bilaterally sighted subjects (BSS) (10 to 45 years) were enrolled. Subjects had clear ocular media for auto-refraction and could steadily fixate targets with the sighted eye. For BSS, a long-pass filter was placed in front of one eye to simulate unilateral blindness. Both eyes were measured with a Shin-Nippon auto-refractor while fixating a 4/40 letter at 4 m and then an N8 letter at 40 cm and at 33 cm. Accommodation was calculated as the difference between distance and near refraction. RESULTS Only subjects with repeatable alignment between measurements were included in the analyses (64 UPS, 95 BSS). Results were analyzed using t test and a generalized linear mixed model including age, sightedness, distance spherical equivalent, and accommodation as factors. The t test found no significant difference between eyes for UPS (p = 0.981 at 40 cm and p = 0.663 at 33 cm). For BSS, the sighting eye produced statistically significant but only slightly greater amounts of accommodation than the filtered eye (0.098 diopters [D], p = 0.002 at 40 cm and 0.189 D, p < 0.001 at 33 cm). The generalized linear mixed model found no difference between BSS and UPS in terms of difference in accommodation between eyes (p = 0.128 at 40 cm and p = 0.157 at 33 cm). CONCLUSIONS The PVI eyes of unilaterally PVI individuals display similar accommodative response to their fellow, sighted eyes when accommodation is elicited by near target of up to 3 D to the fellow eye. However, the difference in accommodative response between PVI and fellow, sighted eye is related to the amount of accommodation elicited.
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Vasudevan B, Flores M, Gaib S. Objective and subjective visual performance of multifocal contact lenses: Pilot study. Cont Lens Anterior Eye 2014; 37:168-74. [DOI: 10.1016/j.clae.2013.09.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 09/17/2013] [Accepted: 09/28/2013] [Indexed: 10/26/2022]
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Detorakis ET, Karavitaki A, Stojanovic N, Kontadakis G, Pallikaris IG. Anterior chamber angle evaluation with ultrasound biomicroscopy and optical coherence tomography in eyes implanted with a Crystalens. Int Ophthalmol 2013; 34:781-6. [PMID: 24166704 DOI: 10.1007/s10792-013-9872-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Accepted: 10/13/2013] [Indexed: 11/27/2022]
Abstract
This study employs optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM) imaging as well as optical aberrometry to examine correlations between the anterior chamber angle aperture and visual acuity for near vision as well as coma along the horizontal and vertical axes in eyes implanted with an accommodative intraocular lens (Crystalens). A retrospective comparative consecutive case series of 22 eyes of 11 patients (5 males) uneventfully implanted with a Crystalens. Eyes with signs of posterior capsular opacification were excluded. All eyes were examined with 40 MHz UBM (Ellex Eyecubed) and spectral-domain OCT (Zeiss Visante). The angle aperture along the horizontal and vertical meridians was recorded based on the software of the systems. The coma root mean square (RMS) scores for the horizontal and vertical meridians were also recorded with the iTrace aberrometer. The anterior chamber angle was significantly wider along the horizontal axis compared with the vertical axis by UBM (46.37° and 44.20°, respectively) and by OCT (46.79° and 43.58°, respectively) (p = 0.02 in both cases, paired-samples t test). The correlations between the logMAR-converted Jaeger near vision score and the horizontal or vertical angle apertures was not statistically significant. Horizontal coma RMS was significantly inversely correlated with the horizontal angle aperture (r = -0.45, p = 0.03 and r = -0.39, p = 0.04 by OCT and UBM, respectively). Measurement of the horizontal angle aperture by the modalities used may represent an anatomical and clinical predictor of the optical aberrations induced by the Crystalens.
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Affiliation(s)
- Efstathios T Detorakis
- Department of Ophthalmology, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece,
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Nemeth G, Lipecz A, Szalai E, Berta A, Modis L. Accommodation in phakic and pseudophakic eyes measured with subjective and objective methods. J Cataract Refract Surg 2013; 39:1534-42. [DOI: 10.1016/j.jcrs.2013.04.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 04/09/2013] [Accepted: 04/09/2013] [Indexed: 10/26/2022]
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Aldaba M, Vilaseca M, Arjona M, Pujol J. Age-related changes in accommodation measured with a double-pass system. Ophthalmic Physiol Opt 2013; 33:508-15. [PMID: 23448348 DOI: 10.1111/opo.12038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 01/07/2013] [Indexed: 11/28/2022]
Abstract
PURPOSE To measure the accommodative response in a wide age range population using the retinal image quality assessments provided by a double-pass system. METHODS The accommodative response was measured using a custom-built double-pass setup in 84 patients from 15 to 55 years of age. Patients were classified in four groups (A: 15-25 year old; B: 26-35; C: 36-45; D: 46-55). Accommodation was stimulated from 0 to 5 dioptres (D) with the push up method using an open field fixation test. The total accommodative response in the stimulated range, the accommodative stimulus-response curve, the slope and the progression of optical quality with accommodation were measured. RESULTS The total accommodation obtained in groups A and B was high, with a mean value of 4 D or higher, whereas values in older individuals were significantly lower. The accommodative stimulus-response curve and the slope were also high with a sudden decrease in patients over 35 years of age. The optical quality of the eye during accommodation did not change significantly. CONCLUSIONS Participants aged 15-35 years showed a good accommodative response. Thereafter, a significant decrease of the response in the total accommodation, stimulus response curve and slope was observed. The younger groups showed a larger accommodative response than previously published.
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Affiliation(s)
- Mikel Aldaba
- Centre for Sensors, Instruments, and Systems Development (CD6), Universitat Politecnica de Catalunya (UPC), Barcelona, Spain.
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Benozzi G, Leiro J, Facal S, Perez C, Benozzi J, Orman B. Developmental changes in accommodation evidenced by an ultrabiomicroscopy procedure in patients of different ages. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2013; 2:8-13. [PMID: 24600634 PMCID: PMC3939763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
We demonstrate that changes in the behaviour of the contractile ciliary muscle accompanied by augmented rigidity of the lens are the most important aspects in the loss of accommodation. With ultrabiomicroscopy (UBM), we demonstrated that the performance of the ciliary muscle is diminished and accompanied by rigidity of the lens. Both lens thickness and trabecular-ciliary process distance (TCPD) were the parameters that showed major alterations with the loss of accommodation in patients of different ages. The results indicated that the differences between these parameters in farsightedness and nearsightedness in the different groups of patients were positively correlated.
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Affiliation(s)
- Giovanna Benozzi
- Centro de Investigación Avanzada para la Presbicia (C.I.A.P.) . Ciudad Autónoma de Buenos Aires, Republic of Argentina., Pharmacology Unit, School of Dentistry, Buenos Aires University. Ciudad Autónoma de Buenos Aires, Republic of Argentina
| | - Juliana Leiro
- Centro de Investigación Avanzada para la Presbicia (C.I.A.P.) . Ciudad Autónoma de Buenos Aires, Republic of Argentina
| | - Sonia Facal
- Centro de Investigación Avanzada para la Presbicia (C.I.A.P.) . Ciudad Autónoma de Buenos Aires, Republic of Argentina
| | - Cristian Perez
- Centro de Investigación Avanzada para la Presbicia (C.I.A.P.) . Ciudad Autónoma de Buenos Aires, Republic of Argentina
| | - Jorge Benozzi
- Centro de Investigación Avanzada para la Presbicia (C.I.A.P.) . Ciudad Autónoma de Buenos Aires, Republic of Argentina
| | - Betina Orman
- Pharmacology Unit, School of Dentistry, Buenos Aires University. Ciudad Autónoma de Buenos Aires, Republic of Argentina
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Aldaba M, Vilaseca M, Díaz-Doutón F, Arjona M, Pujol J. Measuring the accommodative response with a double-pass system: Comparison with the Hartmann-Shack technique. Vision Res 2012; 62:26-34. [DOI: 10.1016/j.visres.2012.03.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 03/14/2012] [Accepted: 03/20/2012] [Indexed: 10/28/2022]
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Kothari M, Balankhe S, Paralkar S, Nar D, Bhagat S, Ranade S. Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children. Indian J Ophthalmol 2012; 60:109-14. [PMID: 22446905 PMCID: PMC3339069 DOI: 10.4103/0301-4738.94051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim: To describe and compare dynamic distance direct ophthalmoscopy (DDDO) with dynamic retinoscopy (DR) in assessment of accommodation in children. Materials and Methods: This prospective observational study had four components. Component 1: to understand the characteristic digital images of DDDO. Component 2: to compare DDDO with DR for detection of accommodative defects in children (1–16 years). Component 3: to compare DDDO with DR for the detection of completeness of pharmacologically induced cycloplegia in children (5–16 years) and Component 4: to assess which one of the two techniques was more sensitive to detect onset of cycloplegia after instillation of 1% cyclopentolate eye drops. Results: Component 1: image analysis of DDDO on two subjects (7 years and 35 years) demonstrated superior pupillary crescent that progressively disappeared with increasing accommodation. Concurrently an inferior crescent appeared that became bigger in size with increasing accommodation. Component 2: the prevalence of defects in accommodation was 3.3% (33/1000 children). Three had unilateral accommodation failure. Sensitivity of DDDO was 94%, specificity 100%, positive predictive value 100%, negative predictive value 99%, and clinical agreement (kappa) 0.97. Component 3: in the detection of completeness of pharmacologically induced cycloplegia (n=30), the sensitivity of DDDO was 94%, specificity 96%, positive predictive value 97%, negative predictive value 93% and kappa 0.9. DR had two false positives. DDDO had one false negative. Component 4: DDDO detected onset of pharmacologically induced cycloplegia 5 min earlier than DR (n=5). Conclusion: DDDO is a novel, simple, clinical and reliable method to assess accommodation in young children. This test can assess the accommodative response of both eyes simultaneously.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology, Pediatric Neuroophthalmology and Adult Strabismus of Jyotirmay Eye Clinic, Thane, Maharashtra, India.
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Li YJ, Choi JA, Kim H, Yu SY, Joo CK. Changes in ocular wavefront aberrations and retinal image quality with objective accommodation. J Cataract Refract Surg 2011; 37:835-41. [DOI: 10.1016/j.jcrs.2010.11.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 11/23/2010] [Accepted: 11/23/2010] [Indexed: 10/18/2022]
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Win-Hall DM, Houser J, Glasser A. Static and dynamic accommodation measured using the WAM-5500 Autorefractor. Optom Vis Sci 2011; 87:873-82. [PMID: 20852450 DOI: 10.1097/opx.0b013e3181f6f98f] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study was undertaken to compare static and dynamic accommodation measurements using the Grand Seiko WR-5500 (WAM) in young, phakic subjects. METHODS Fifteen subjects, aged 20 to 28 years (23.8 ± 0.58 years; mean ± SD years) participated. Accommodation was stimulated with printed text presented at various distances. In static mode, three measurements were taken for each stimulus amplitude. In dynamic mode, 5-Hz recordings were started, and subjects alternately looked through a transparent near chart and focused on a letter chart at 6 m for 5 seconds and then focused on the near letter chart for 5 seconds for a total of 30 seconds. After smoothing the raw data, the highest three individual values recorded in each 5-s interval of focusing at near were averaged for each stimulus amplitude. Analysis of variance and Bland-Altman analysis were used to compare the static and dynamic measurements. A calibration was performed with +3.00 to -10.00 D trial lenses behind an infrared filter, in 1.00 D steps in 5 of the 15 subjects. RESULTS Stimulus-response graphs from static and dynamic modes were not significantly different in the lower stimulus range (<5.00 D, p = 0.93), but differed significantly for the higher stimulus amplitudes (p = 0.0027). One of the 15 subjects showed a significant difference between the static and dynamic modes. Corresponding pupil diameter could be recorded along with the accommodation responses for the subjects, and pupil diameter decreased with increasing stimulus demand. Calibration curves for static and dynamic measurements were not significantly different from the 1:1 line or from each other (p = 0.32). CONCLUSIONS Slight differences between the dynamically and statically recorded response amplitudes were identified. This is attributed to differences in the accommodative responses in this population and not to the instrument performance. Dynamic measurement of accommodation and pupil constriction potentially provides additional useful information on the accommodative response other than simply the response amplitude.
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Affiliation(s)
- Dorothy M Win-Hall
- College of Optometry, University of Houston, Houston, Texas 77204-2020, USA
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Win-Hall DM, Glasser A. Objective accommodation measurements in pseudophakic subjects using an autorefractor and an aberrometer. J Cataract Refract Surg 2009; 35:282-90. [PMID: 19185244 DOI: 10.1016/j.jcrs.2008.10.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 10/15/2008] [Accepted: 10/17/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare objective measures of accommodation with the WR-5100K autorefractor and iTrace aberrometer to subjective push-down and defocus tests in normal phakic subjects and pseudophakic subjects with standard monofocal intraocular lenses (IOLs). SETTING University of Houston, College of Optometry, Houston, Texas, USA. METHODS The push-down test and defocus curves were used to stimulate and measure accommodation subjectively in pseudophakic subjects. For objective testing, a near target was pushed up and refraction measured objectively. For comparison, the same objective measurements were performed in phakic subjects. Calibration tests were performed with soft contact lenses in phakic subjects with varying refractive error and in pseudophakic subjects. RESULTS Fifteen phakic subjects (mean age 28.9 years+/-5.52 [SD]) and 10 pseudophakic subjects (mean age 66.2+/-11.23 years) participated. Subjectively measured accommodative amplitude in the pseudophakic group was 3.28+/-1.11 diopters (D) in the right eye and 3.64+/-1.38 D in the left eye. Defocus curves in the pseudophakic group had a range of 2.00 D for distance-corrected visual acuity of 20/40 or better. Objective measurements in the pseudophakic group were 0.11+/-0.50 D with the autorefractor and 0.10+/-0.47 D with the aberrometer. Contact lens calibrations showed good agreement with the 1:1 line. CONCLUSIONS The subjective tests overestimated accommodative amplitude relative to the objective measures. The autorefractor and aberrometer were accurate, reliable, and appropriate for objective accommodation measurements in pseudophakes. Objective accommodation measurements such as these can be used to evaluate the performance of accommodating IOLs.
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Cleary G, Spalton DJ, Patel PM, Lin PF, Marshall J. Diagnostic accuracy and variability of autorefraction by the Tracey Visual Function Analyzer and the Shin-Nippon NVision-K 5001 in relation to subjective refraction. Ophthalmic Physiol Opt 2009; 29:173-81. [DOI: 10.1111/j.1475-1313.2008.00627.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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López-Gil N, Fernández-Sánchez V, Thibos LN, Montés-Micó R. Objective Amplitude of Accommodation Computed from Optical Quality Metrics Applied to Wavefront Outcomes. JOURNAL OF OPTOMETRY 2009; 2:223-234. [PMCID: PMC3974290 DOI: 10.3921/joptom.2009.223] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2009] [Revised: 11/02/2009] [Accepted: 11/18/2009] [Indexed: 06/03/2023]
Abstract
Purpose We studied the accuracy and precision of 32 objective wavefront methods for finding the amplitude of accommodation obtained in 180 eyes. Methods Ocular accommodation was stimulated with 0.5 D steps in target vergence spanning the full range of accommodation for each subject. Subjective monocular amplitude of accommodation was measured using two clinical methods, using negative lenses and with a custom Badal optometer. Results Both subjective methods gave similar results. Results obtained from the Badal optometer where used to test the accuracy of the objective methods. All objective methods showed lower amplitude of accommodation that the subjective ones by an amount that varied from 0.2 to 1.1 D depending on the method. The precision in this prediction also varied between subjects, with an average standard error of the mean of 0.1 D that decreased with age. Conclusions Depth of field increases subjective of amplitude of accommodation overestimating the objective amplitude obtained with all the metrics used. The change in the negative direction of spherical aberration during accommodation increases the amplitude of accommodation by an amount that varies with age.
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Affiliation(s)
| | | | | | - Robert Montés-Micó
- Grupo de Investigación en Optometría (GIO), University of Valencia, Spain
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