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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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Affiliation(s)
- W Neil Charman
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
E‐mail:
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Abstract
SIGNIFICANCE The effect of predictability in changes of time, magnitude, and direction of the accommodation demand on the accommodation response latency and its magnitude are insignificant, which suggests that repetitive accommodative tasks such as the clinical accommodative facility test may not be influenced by potential anticipation effects. PURPOSE The purpose of this study was to investigate the effect of stimulus' time, magnitude, and direction predictability, as well as their interactions, on accommodation latency and response magnitude. METHODS Monocular accommodative response and latency were measured in 12 young subjects for nine different conditions where the stimulus accommodative demand changed several times in a steplike fashion for a period of 120 seconds. Each change in accommodative demand could have different time duration (i.e., 1, 2, or 3 seconds), magnitude (1, 2, or 3 diopters), and/or direction (i.e., accommodation or disaccommodation). All conditions were created permuting the factors of time, magnitude, and direction with two levels each: random and not random. The baseline condition was a step signal from 0 to 2 diopters persisting for 2 seconds in both accommodative demands. After each condition, subjects were asked to provide a score from 1 to 5 in their perceived predictability. RESULTS Friedman test conducted on the perceived predictability of each condition resulted in statistically significant differences between the nine conditions (χ = 56.57, P < .01). However, repeated-measures analysis of variance applied to latency and accommodative response magnitude did not show significant differences (P > .05). In addition, no correlation was found between the perceived predictability scores and both latency and accommodative response magnitudes between the most predictable and the most unpredictable conditions. CONCLUSIONS Subjects were able to perceptually notice whether the stimulus was predictable or not, although our results indicate no significant effect of stimuli predictability on either the accommodation latency or its magnitude.
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Charman WN. Non-surgical treatment options for presbyopia. EXPERT REVIEW OF OPHTHALMOLOGY 2018. [DOI: 10.1080/17469899.2018.1506330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- W. Neil Charman
- Faculty of Biology, Medicine and Health, University of Manchester, M13 9PL, Manchester, UK
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Szostek N, Buckhurst H, Purslow C, Drew T, Collinson A, Buckhurst P. Validation of Novel Metrics from the Accommodative Dynamic Profile. Vision (Basel) 2018; 2:vision2030034. [PMID: 31735897 PMCID: PMC6836212 DOI: 10.3390/vision2030034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/03/2018] [Accepted: 08/13/2018] [Indexed: 11/16/2022] Open
Abstract
Objective and subjective methods of assessing time taken for accommodative change (ToAC) include accommodative dynamics (AD) and accommodative facility (AF). This study investigates the validity of novel metrics derived from the AD-profile and explores their relationship with AF. AD were assessed using a modified open-field autorefractor in 43 healthy adults. Non-linear regression curves were fitted to the data to derive: latency-of-accommodation (nLoA) and -disaccomodation (nLoD), Time-for-accommodation (ToA) and -disaccommodation (ToD), and objective-ToAC (oToAC). Latencies were also calculated through visual inspection of the AD data as in previous studies (pLoA and pLoD). AF was used to assess subjective-ToAC. Statistical analysis explored the relationships between the AD-metrics and AF. Subjects were assessed on three visits to examine intra- and inter-observer repeatability. nLoA and nLoD were greater than pLoA (p = 0.001) and pLoD (p = 0.004) respectively. nLoA and nLoD also demonstrated greater intra- and inter-observer repeatability than pLoA and pLoD. AF demonstrated a moderate, inverse correlation with ToA (p = 0.02), ToD (p = 0.007), and oToAC (p = 0.007). ToD was the single best accommodative predictor of AF (p = 0.011). The novel method for deriving latency was more repeatable, but not interchangeable with the techniques used in previous studies. ToD was the most repeatable metric with the greatest association with AF.
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Affiliation(s)
- Nicola Szostek
- Eye and Vision Research Group, School of Health Professions, University of Plymouth, Plymouth PL4 8AA, UK
- Correspondence:
| | - Hetal Buckhurst
- Eye and Vision Research Group, School of Health Professions, University of Plymouth, Plymouth PL4 8AA, UK
| | - Christine Purslow
- School of Optometry and Vision Sciences, Cardiff University, Cardiff CF24 4HQ, UK
| | - Thomas Drew
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham B4 7ET, UK
| | - Avril Collinson
- Eye and Vision Research Group, School of Health Professions, University of Plymouth, Plymouth PL4 8AA, UK
| | - Phillip Buckhurst
- Eye and Vision Research Group, School of Health Professions, University of Plymouth, Plymouth PL4 8AA, UK
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Padmanaban N, Konrad R, Stramer T, Cooper EA, Wetzstein G. Optimizing virtual reality for all users through gaze-contingent and adaptive focus displays. Proc Natl Acad Sci U S A 2017; 114:2183-2188. [PMID: 28193871 PMCID: PMC5338519 DOI: 10.1073/pnas.1617251114] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
From the desktop to the laptop to the mobile device, personal computing platforms evolve over time. Moving forward, wearable computing is widely expected to be integral to consumer electronics and beyond. The primary interface between a wearable computer and a user is often a near-eye display. However, current generation near-eye displays suffer from multiple limitations: they are unable to provide fully natural visual cues and comfortable viewing experiences for all users. At their core, many of the issues with near-eye displays are caused by limitations in conventional optics. Current displays cannot reproduce the changes in focus that accompany natural vision, and they cannot support users with uncorrected refractive errors. With two prototype near-eye displays, we show how these issues can be overcome using display modes that adapt to the user via computational optics. By using focus-tunable lenses, mechanically actuated displays, and mobile gaze-tracking technology, these displays can be tailored to correct common refractive errors and provide natural focus cues by dynamically updating the system based on where a user looks in a virtual scene. Indeed, the opportunities afforded by recent advances in computational optics open up the possibility of creating a computing platform in which some users may experience better quality vision in the virtual world than in the real one.
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Affiliation(s)
- Nitish Padmanaban
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305
| | - Robert Konrad
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305
| | - Tal Stramer
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305
| | - Emily A Cooper
- Department of Psychological & Brain Sciences, Dartmouth College, Hanover, NH 03755
| | - Gordon Wetzstein
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305;
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Ruggeri M, Uhlhorn SR, De Freitas C, Ho A, Manns F, Parel JM. Imaging and full-length biometry of the eye during accommodation using spectral domain OCT with an optical switch. BIOMEDICAL OPTICS EXPRESS 2012; 3:1506-20. [PMID: 22808424 PMCID: PMC3395477 DOI: 10.1364/boe.3.001506] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 05/21/2012] [Accepted: 06/01/2012] [Indexed: 05/20/2023]
Abstract
An optical switch was implemented in the reference arm of an extended depth SD-OCT system to sequentially acquire OCT images at different depths into the eye ranging from the cornea to the retina. A custom-made accommodation module was coupled with the delivery of the OCT system to provide controlled step stimuli of accommodation and disaccommodation that preserve ocular alignment. The changes in the lens shape were imaged and ocular distances were dynamically measured during accommodation and disaccommodation. The system is capable of dynamic in vivo imaging of the entire anterior segment and eye-length measurement during accommodation in real-time.
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Affiliation(s)
- Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute,
University of Miami Miller School of Medicine, 1638 NW 10th Ave. Miami, FL 33136,
USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical
Engineering, University of Miami, College of Engineering, Coral Gables, FL,33146
USA
| | - Stephen R. Uhlhorn
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute,
University of Miami Miller School of Medicine, 1638 NW 10th Ave. Miami, FL 33136,
USA
| | - Carolina De Freitas
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute,
University of Miami Miller School of Medicine, 1638 NW 10th Ave. Miami, FL 33136,
USA
| | - Arthur Ho
- Brien Holden Vision Institute, Sydney, NSW,
Australia
- Vision Cooperative Research Centre, Sydney, NSW,
Australia
- School of Optometry & Vision Science, University of New South
Wales, Australia
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute,
University of Miami Miller School of Medicine, 1638 NW 10th Ave. Miami, FL 33136,
USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical
Engineering, University of Miami, College of Engineering, Coral Gables, FL,33146
USA
| | - Jean-Marie Parel
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute,
University of Miami Miller School of Medicine, 1638 NW 10th Ave. Miami, FL 33136,
USA
- Biomedical Optics and Laser Laboratory, Department of Biomedical
Engineering, University of Miami, College of Engineering, Coral Gables, FL,33146
USA
- Vision Cooperative Research Centre, Sydney, NSW,
Australia
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Beirão M, Matos E, Beirâo I, Costa PPE, Torres P. Anticipation of presbyopia in Portuguese familial amyloidosis ATTR V30M. Amyloid 2011; 18:92-7. [PMID: 21591979 DOI: 10.3109/13506129.2011.576719] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of this study was to evaluate if Portuguese patients with familial amyloidosis, liver transplanted and not, have an earlier development of presbyopia compared with a normal population and its relation with the presence or the absence of anterior capsule opacification of the lens. This study was performed to evaluate if Portuguese patients with familial amyloidosis and in a blood donors population (control group). Three hundred and fifty-six subjects, 144 amyloidotic patients and 212 healthy individuals, were evaluated for the need of plus lenses for normal near reading (Jaeger chart 1 at 33 cm). In familial amyloidosis patients, the value of the add-power was related to age, liver transplantation status, and presence of visible anterior capsule opacification of the lens. In both groups, the value of add-power was positively correlated with age (r=0.91; P<0.005). Familial amyloidosis patients require more add-power than control individuals of similar age, and need to use reading glasses at earlier ages. The age of onset of presbyopia in familial amyloidosis patients was significantly lower than in control individuals (32 years vs. 42 years). Adjusting for age, no significant difference was observed in add-power values between liver transplanted and not transplanted amyloidotic patients, suggesting that liver transplantation has no influence on presbyopia evolution in these patients. Familial amyloidosis patients had an earlier onset of presbyopia, probably related to amyloid deposition on the anterior capsule of the lens, which is not halted by liver transplantation.
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Affiliation(s)
- Melo Beirão
- Opthalmology, Centro Hospitalar do Porto, Porto, Portugal.
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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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Pheasant R, Horoshenkov K, Watts G, Barrett B. The acoustic and visual factors influencing the construction of tranquil space in urban and rural environments tranquil spaces-quiet places? THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2008; 123:1446-1457. [PMID: 18345834 DOI: 10.1121/1.2831735] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Prior to this work no structured mechanism existed in the UK to evaluate the tranquillity of open spaces with respect to the characteristics of both acoustic and visual stimuli. This is largely due to the fact that within the context of "tranquil" environments, little is known about the interaction of the audio-visual modalities and how they combine to lead to the perception of tranquillity. This paper presents the findings of a study in which visual and acoustic data, captured from 11 English rural and urban landscapes, were used by 44 volunteers to make subjective assessments of both their perceived tranquillity of a location, and the loudness of five generic soundscape components. The results were then analyzed alongside objective measurements taken in the laboratory. It was found that the maximum sound pressure level (L(Amax)) and the percentage of natural features present at a location were the key factors influencing tranquillity. Engineering formulas for the tranquillity as a function of the noise level and proportion of the natural features are proposed.
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Affiliation(s)
- Robert Pheasant
- School of Engineering, Design and Technology, University of Bradford, Bradford, West Yorkshire, BD7 1DP, United Kingdom
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Equatorial Lens Growth Predicts the Age-related Decline in Accommodative Amplitude That Results in Presbyopia and the Increase in Intraocular Pressure That Occurs With Age. Clin Ophthalmol 2008; 48:1-8. [DOI: 10.1097/iio.0b013e31815eb836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Age related changes in accommodative dynamics in humans: response to Dr. Schachar's letter. Vision Res 2007; 48:316-8. [PMID: 17964631 DOI: 10.1016/j.visres.2007.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Sehl M, Sawhney R, Naeim A. Physiologic aspects of aging: impact on cancer management and decision making, part II. Cancer J 2006; 11:461-73. [PMID: 16393480 DOI: 10.1097/00130404-200511000-00005] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this second article of our two-part review, we focus on age-associated physiologic changes involving the nervous, endocrine, hematologic, immune, and musculoskeletal systems, with close attention to the interconnected nature of these systems. There is a well-known connection between the neuroendocrine and immune systems via the hypothalamic-pituitary-adrenal axis and via interaction by means of cytokines, hormones, and neurotransmitters. These changes may lead to a loss of integration and resiliency with age, thus decreasing the ability of the elderly patient with cancer to adapt to stressful circumstances. Prominent changes include decline in memory and cognition, and increased susceptibility to peripheral neuropathy. Hematologic and immune changes like reduced bone marrow reserve and increased susceptibility to infections have far reaching implications for cancer care in the elderly. Gradual decline in hormone levels, and changes in muscle and body composition, can lead to functional decline and frailty. Use of the clinical interventions suggested in this article, along with an appreciation of the interplay of these age-related physiologic changes and their consequences, allows oncology professionals to customize therapy and minimize side effects in the geriatric oncology patient.
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Affiliation(s)
- Mary Sehl
- Division of Hematology-Oncology and Geriatrics, David Geffen School of Medicine, University of California, Los Angeles, California 90095-1687, USA
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