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Markoulli M, Fricke TR, Arvind A, Frick KD, Hart KM, Joshi MR, Kandel H, Filipe Macedo A, Makrynioti D, Retallic N, Garcia-Porta N, Shrestha G, Wolffsohn JS. BCLA CLEAR Presbyopia: Epidemiology and impact. Cont Lens Anterior Eye 2024; 47:102157. [PMID: 38594155 DOI: 10.1016/j.clae.2024.102157] [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: 04/11/2024]
Abstract
The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people. This prevalence was projected to stabilise at 24.1% in 2030 due to increasing myopia, but to affect more people (2.1 billion) due to population dynamics. Factors affecting the prevalence of presbyopia include age, geographic location, urban versus rural location, sex, and, to a lesser extent, socioeconomic status, literacy and education, health literacy and inequality. Risk factors for early onset of presbyopia included environmental factors, nutrition, near demands, refractive error, accommodative dysfunction, medications, certain health conditions and sleep. Presbyopia was found to impact on quality-of-life, in particular quality of vision, labour force participation, work productivity and financial burden, mental health, social wellbeing and physical health. Current understanding makes it clear that presbyopia is a very common age-related condition that has significant impacts on both patient-reported outcome measures and economics. However, there are complexities in defining presbyopia for epidemiological and impact studies. Standardisation of definitions will assist future synthesis, pattern analysis and sense-making between studies.
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Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | - Timothy R Fricke
- School of Optometry and Vision Science, UNSW Sydney, Australia; Department of Optometry and Vision Science, University of Melbourne, Australia; National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | - Anitha Arvind
- Department of Optometry, School of Medical and Allied Sciences, GD Goenka University, India
| | - Kevin D Frick
- Johns Hopkins Carey Business School, USA; Johns Hopkins Bloomberg School of Public Health Departments of International Health and Health Policy and Management, USA; Johns Hopkins School of Medicine, Department of Ophthalmology, USA
| | - Kerryn M Hart
- School of Medicine, Faculty of Health, Deakin University, Australia; Member Support and Optometry Advancement, Optometry Australia, Australia
| | - Mahesh R Joshi
- School of Health Professions, University of Plymouth, United Kingdom
| | - Himal Kandel
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Eye Hospital, Australia
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Sweden; Centre of Physics of Minho and Porto Universities, School of Sciences, University of Minho, Braga, Portugal
| | | | - Neil Retallic
- Specsavers Optical Group, La Villiaze, St. Andrew's, Guernsey, United Kingdom; School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | - Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Spain; Institute of Materials (iMATUS) of the University of Santiago de Compostela, Spain
| | - Gauri Shrestha
- Optometry Department, BPK Centre for Ophthalmic Studies, Institute of Medicine, Nepal
| | - James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
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Morgan PB, Efron N, Papas E, Barnett M, Carnt N, Dutta D, Hepworth A, Little JA, Nagra M, Pult H, Schweizer H, Shen Lee B, Subbaraman LN, Sulley A, Thompson A, Webster A, Markoulli M. BCLA CLEAR Presbyopia: Management with contact lenses and spectacles. Cont Lens Anterior Eye 2024; 47:102158. [PMID: 38631935 DOI: 10.1016/j.clae.2024.102158] [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: 04/19/2024]
Abstract
This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.
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Affiliation(s)
- Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom.
| | - Nathan Efron
- Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Eric Papas
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Nicole Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Debarun Dutta
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - Andy Hepworth
- EssilorLuxottica Europe North, Bristol, United Kingdom
| | - Julie-Anne Little
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
| | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Young Street, Cambridge, United Kingdom
| | - Heiko Pult
- Dr Heiko Pult - Optometry and Vision Research, Weinheim, Germany
| | - Helmer Schweizer
- CEO Helmer Schweizer Consulting Group (HSCG), Bassersdorf, Switzerland
| | - Bridgitte Shen Lee
- Vision Optique and Ocular Aesthetics dba Ocular Clinical Trials, Houston, TX, United States
| | | | - Anna Sulley
- CooperVision International Ltd, Chandlers Ford, United Kingdom
| | | | | | - Maria Markoulli
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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3
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Wolffsohn JS, Berkow D, Chan KY, Chaurasiya SK, Fadel D, Haddad M, Imane T, Jones L, Sheppard AL, Vianya-Estopa M, Walsh K, Woods J, Zeri F, Morgan PB. BCLA CLEAR Presbyopia: Evaluation and diagnosis. Cont Lens Anterior Eye 2024; 47:102156. [PMID: 38641525 DOI: 10.1016/j.clae.2024.102156] [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: 04/21/2024]
Abstract
It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.
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Affiliation(s)
- James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom.
| | - David Berkow
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Ka Yin Chan
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Suraj K Chaurasiya
- Department of Contact Lens and Anterior Segment, CL Gupta Eye Institute, Moradabad, India; Department of Optometry and Vision Science, CL Gupta Eye Institute, Moradabad, India
| | - Daddi Fadel
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Mera Haddad
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Tarib Imane
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, United States
| | - Lyndon Jones
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong; Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Amy L Sheppard
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marta Vianya-Estopa
- Vision and Hearing Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karen Walsh
- CooperVision Inc., San Ramon, CA, United States
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fabrizio Zeri
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom; University of Milano-Bicocca, Department of Materials Science, Milan, Italy
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom
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Haddad MF, Abdo N, Bakkar MM. Public Awareness, Knowledge of Presbyopia and Compliance to Eye Examination in Jordan. CLINICAL OPTOMETRY 2024; 16:191-199. [PMID: 39100731 PMCID: PMC11296362 DOI: 10.2147/opto.s467933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024]
Abstract
Purpose To assess public awareness and knowledge about presbyopia and their compliance to ocular examination in Jordan. Patients and Methods A cross-sectional survey was designed to interview people in different provinces of Jordan. Socio-demographic data such as age, gender and level of education and region was reported. The first part of the questionnaire assessed awareness of presbyopia in terms of the need for spectacles with age, age of onset, possible causes of presbyopia and methods of presbyopia management. The second part of the questionnaire evaluated compliance of the participants with ocular examination in terms of frequency and motive to do general eye check, intraocular pressure (IOP), fundus exam and visual acuity. Results A total of 802 participants (232 males, 570 females) with an average age of 28 (±11.6) completed the questionnaire. Most participants (84.2%) knew that glasses are needed for near vision as age increases, and 62.8% estimated the age at which spectacles are required (40 years or older). Over half understood that presbyopia is correctable and progressive. Age significantly influenced knowledge about the need for near vision spectacles, and whether presbyopia is preventable and progressive (both p < 0.05). Females were more knowledgeable about these aspects. The frequency of eye examinations, particularly fundus exams and IOP tests, was significantly influenced by age but not by education. Gender only significantly affected the frequency of vision checks (p = 0.01), with females being more likely to adhere to them. Conclusion This study demonstrated a good level of awareness and knowledge about presbyopia among Jordanians, especially those over 40 and females. Regular eye check-ups were more common among young participants and females. Addressing misconceptions about presbyopia's preventability and promoting regular eye exams are crucial for early diagnosis and management of presbyopia and other serious eye conditions.
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Affiliation(s)
- Mera F Haddad
- Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Nour Abdo
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - May M Bakkar
- Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Kim DY, Ahn H, Lee S, Jun I, Seo KY, Kim SY, Kim TI. Efficacy of a new refractive multifocal contact lens for presbyopia. Sci Rep 2024; 14:8878. [PMID: 38632261 PMCID: PMC11024154 DOI: 10.1038/s41598-024-55918-5] [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: 06/06/2023] [Accepted: 02/28/2024] [Indexed: 04/19/2024] Open
Abstract
This prospective single-arm study aimed to evaluate the clinical efficacy and safety of a refractive multifocal contact lens for the correction of presbyopia in 22 patients. The participants underwent clinical examinations before and 1 week after wearing a refractive multifocal contact lens (OptaCon ZOOM). The primary endpoints were the corrected distance visual acuity (CDVA) and distance-corrected near visual acuity (DCNVA). Defocus curve, contrast sensitivity, and ocular surface disease index (OSDI) were analyzed. A slit-lamp examination was performed for safety analysis. Contact lens comfort and patient satisfaction were assessed using a questionnaire. No significant difference in CDVA was observed before and 1 week after refractive multifocal contact lens use (p = 0.127), whereas DCNVA was significantly improved after 1 week (p < 0.001). The contrast sensitivity was not significantly affected at any spatial frequency under mesopic or photopic conditions. OSDI was significantly increased (p = 0.023). The patient-reported satisfaction scores were 96.2, 91.9, and 85.0 out of 100 at far, intermediate, and near distances, respectively. No significant adverse events were observed. Refractive multifocal contact lenses improved near vision while maintaining distance vision in presbyopic patients, without compromising contrast sensitivity. The study results suggest that OptaCon ZOOM can be considered safe and effective for the correction of presbyopia.
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Affiliation(s)
- Do Young Kim
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
- Siloam Eye Hospital, Seoul, Republic of Korea
| | - Hyunmin Ahn
- Eyejun Ophthalmic Clinic, Seoul, Republic of Korea
| | - Sukyung Lee
- Yonsei Plus Eye Center, Seongnam, Republic of Korea
| | - Ikhyun Jun
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | | | - Tae-Im Kim
- Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
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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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7
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Knaus KR, Hipsley A, Blemker SS. A new look at an old problem: 3D modeling of accommodation reveals how age-related biomechanical changes contribute to dysfunction in presbyopia. Biomech Model Mechanobiol 2024; 23:193-205. [PMID: 37733144 DOI: 10.1007/s10237-023-01767-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/17/2023] [Indexed: 09/22/2023]
Abstract
Presbyopia is an age-related ocular disorder where accommodative ability declines so that an individual's focusing range is insufficient to provide visual clarity for near and distance vision tasks without corrective measures. With age, the eye exhibits changes in biomechanical properties of many components involved in accommodation, including the lens, sclera, and ciliary muscle. Changes occur at different rates, affecting accommodative biomechanics differently, but individual contributions to presbyopia are unknown. We used a finite element model (FEM) of the accommodative mechanism to simulate age-related changes in lens stiffness, scleral stiffness, and ciliary contraction to predict differences in accommodative function. The FEM predicts how ciliary muscle action leads to lens displacement by initializing a tensioned unaccommodated lens (Phase 0) then simulating ciliary muscle contraction in accommodation (Phase 1). Model inputs were calibrated to replicate experimentally measured lens and ciliary muscle in 30-year-old eyes. Predictions of accommodative lens deformation were verified with additional imaging studies. Model variations were created with altered lens component stiffnesses, scleral stiffness, or ciliary muscle section activations, representing fifteen-year incremental age-related changes. Model variations predict significant changes in accommodative function with age-related biomechanical property changes. Lens changes only significantly altered lens thickening with advanced age (46% decrease at 75 years old) while sclera changes produced progressive dysfunction with increasing age (23%, 36%, 49% decrease at 45, 60, and 75 years old). Ciliary muscle changes effected lens position modulation. Model predictions identified potential mechanisms of presbyopia that likely work in combination to reduce accommodative function and could indicate effectiveness of treatment strategies and their dependency on patient age or relative ocular mechanical properties.
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Affiliation(s)
- Katherine R Knaus
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | | | - Silvia S Blemker
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
- Department of Ophthalmology, University of Virginia, 415 Lane Road, MR5 Room 2133, Box 800759, Charlottesville, VA, USA.
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8
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Meyer D, Rickert M, Reed O, Joret P, Kollbaum P. Clinical Comparison of High-resolution and Standard Refractions and Prescriptions. Optom Vis Sci 2023; 100:751-760. [PMID: 37861987 DOI: 10.1097/opx.0000000000002076] [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: 10/21/2023] Open
Abstract
SIGNIFICANCE Recently, novel refraction technology allows subjective refractions to be performed with a higher-resolution. It is unclear, however, if these benefits are noticed and appreciated by the patient during the examination and after dispensing. PURPOSE This study investigated benefits and drawbacks of high-resolution refraction technology over standard, specifically in terms of the refraction, glasses prescription, and participant's perceptions of the technology. METHODS Sixty progressive-addition-lens wearers (aged 35 to 70 years) and 60 single-vision wearers (18 years or older) were randomized to a high-resolution refraction (Vision-R 800; Essilor Instruments, Dallas, TX; essilorinstrumentsusa.com ) and standard refraction in a 2-week crossover dispensing design. Refractive results were converted to M, J0, and J45 and analyzed using multivariate t tests. Bayesian estimation was used to analyze differences between refraction type and age group for subjective outcomes. RESULTS Differences in refractive error between the two refractions were small, and none differed statistically ( P > .05) or clinically (e.g., <0.25 D) in either subgroup. Visual acuities at distance and near were better than 0.00 logMAR; none of the mean differences between the refractions reached statistical or clinical (e.g., <0.10 D) significance. Participants significantly preferred the high-resolution refraction for its quickness and efficiency, improved comfort, and less stress. Bayesian analysis indicated a 76% probability that participants had higher confidence in the high-resolution refraction, 93% probability that they would seek it out for their care, and 94% probability that they would recommend an optometrist using this technology. CONCLUSIONS Refractive and acuity endpoints were similar with the high-resolution and standard refraction. Participants, however, perceived several key benefits of the high-resolution refraction and prescription for their care, the care of their friends/family, and the practice itself.
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Affiliation(s)
| | - Martin Rickert
- Indiana University, School of Optometry, Bloomington, Indiana
| | - Olivia Reed
- Indiana University, School of Optometry, Bloomington, Indiana
| | | | - Pete Kollbaum
- Indiana University, School of Optometry, Bloomington, Indiana
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9
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Rueff EM. Visual discomfort and contact lens wear: A review. Cont Lens Anterior Eye 2023; 46:101872. [PMID: 37277259 DOI: 10.1016/j.clae.2023.101872] [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: 02/22/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Abstract
The purpose of this manuscript is to describe how vision influences contact lens discomfort and review the evidence supporting the hypothesis that contact lens discomfort can be caused by vision and vision-related disorders. Contact lens discomfort is a misunderstood and difficult to manage clinical condition. Most treatments and strategies aimed at alleviating discomfort focus on optimizing the contact lens fit and its relationship with the ocular surface, but these strategies commonly fail at relieving discomfort symptoms. Many vision and vision-related disorders share symptoms with those reported by uncomfortable contact lens wearers. This paper will review evidence and literature that describes how these vision and vision-related disorders may influence comfort in contact lens wearers. Acknowledging how vision influences contact lens discomfort will improve future research intended to better understand the condition, allow for more effective clinical management, and reduce rates of discontinuation.
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Affiliation(s)
- Erin M Rueff
- The Southern California College of Optometry at Marshall B Ketchum University, 2575 Yorba Linda Blvd, Fullerton, CA 92831, USA.
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10
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Parekh D, Asokan R, Purkait S, Iqbal A. Multifocal versus modified monovision corrections: A non-dispensing comparison of visual assessment in presbyopic neophytes. Indian J Ophthalmol 2023; 71:1837-1842. [PMID: 37203039 PMCID: PMC10391403 DOI: 10.4103/ijo.ijo_2027_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To compare the visual performance of two simultaneous-vision soft multifocal contact lenses and to compare multifocal contact lens and its modified monovision counterpart in presbyopic neophytes. Methods A double-masked, prospective, comparative study was conducted on 19 participants fitted with soft PureVision2 multifocal (PVMF) and clariti multifocal (CMF) lenses in random order. High- and low-contrast distance visual acuity, near visual acuity, stereopsis, contrast sensitivity, and glare acuity were measured. The measurements were conducted using multifocal and modified monovision design with one brand and then repeated with another brand of lens. Results High-contrast distance visual acuity showed a significant difference between CMF (0.00 [-0.10-0.04]) and PureVision2 modified monovision (PVMMV; -0.10 [-0.14-0.00]) correction (P = 0.003) and also between CMF and clariti modified monovision (CMMV; -0.10 [-0.20-0.00]) correction (P = 0.002). Both modified monovision lenses outperformed CMF. The current study did not show any statistically significant difference between contact lens corrections for low-contrast visual acuity, near visual acuity, and contrast sensitivity (P > 0.01). Stereopsis at near distance was significantly lower with both modified monovision (PVMMV: 70 [50-85]; P = 0.007, CMMV: 70 [70-100]; P = 0.006) and with CMF (50 [40-70]; P = 0.005) when compared to spectacles (50 [30-70]). Glare acuity was significantly lower with multifocal (PVMF: 0.46 [0.40-0.50]; P = 0.001, CMF: 0.40 [0.40-0.46]; P = 0.007) compared with spectacles (0.40 [0.30-0.40]), but no significant difference was noted between the multifocal contact lenses (P = 0.033). Conclusion Modified monovision provided superior high-contrast vision compared to multifocal correction. Multifocal corrections performed better for stereopsis when compared to modified monovision. In parameters like low-contrast visual acuity, near acuity, and contrast sensitivity, both the corrections performed similarly. Both multifocal designs showed comparable visual performances.
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Affiliation(s)
- Dhruval Parekh
- Department of Contact Lens and Occupational Optometry Services, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Rashima Asokan
- Department of Contact Lens and Occupational Optometry Services, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Sutapa Purkait
- Department of Contact Lens and Occupational Optometry Services, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
| | - Asif Iqbal
- Department of Contact Lens and Occupational Optometry Services, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, Tamil Nadu, India
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11
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Gurnani B, Kaur K. Commentary: Leap forward in presbyopia management - Correcting beyond spectacles. Indian J Ophthalmol 2023; 71:1843-1844. [PMID: 37203041 PMCID: PMC10391491 DOI: 10.4103/ijo.ijo_803_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Bharat Gurnani
- Cornea and Refractive Services, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-Kund, Chitrakoot, Madhya Pradesh, India
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12
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Martínez-Pérez C, Villa-Collar C, Santodomingo-Rubido J, Shinde L, Thite N, Wolffsohn JS. Opportunities and threats to contact lens practice in Spain. JOURNAL OF OPTOMETRY 2023; 16:116-127. [PMID: 35821106 PMCID: PMC10104793 DOI: 10.1016/j.optom.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/21/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE An international survey evaluated the opportunities and threats related to contact lens practice reported by eye care professionals worldwide. This study reports on the results specifically found in Spain and how these compare with those from other regions of the world. METHODS A questionnaire was distributed to eye care practitioners around the world through professional associations. The questionnaire consisted of 9, 5 and 12 questions about opportunities, interventions, and potential threats related to contact lens practice, respectively. RESULTS A total of 2,408 responses were obtained from practitioners worldwide, of which 436 responses were obtained from Spanish practitioners. Spain was found among the regions with the highest perception of opportunities (median: 6.5/10) along with Australasia, North America, Europe, and South America. Spanish (median: 7.3/10), along with South American practitioners, also reported the highest perception of threats. Continuously updating of knowledge/skills, recommending contact lens wearing options to potential patients, creating an efficient recall system for follow-up examinations and being competent in managing contact lens-related complications were reported as important interventions for contact lens practice growth by Spanish eye care practitioners. CONCLUSIONS Spain is one of the regions in the world with the highest perception of both opportunities and threats regarding future contact lens practice. As such, Spanish practitioners consider it important to continuously update knowledge/skills and to recommend and educate patients on the benefits of contact lens wear. Online sales were found to be one of the most important concerns reported by both Spanish and eye care practitioners worldwide.
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Affiliation(s)
- Clara Martínez-Pérez
- Department of Pharmacy, Biotechnology, Nutrition, Optics and Optometry, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | - César Villa-Collar
- Department of Pharmacy, Biotechnology, Nutrition, Optics and Optometry, Faculty of Biomedical and Health Sciences, European University of Madrid, Madrid, Spain
| | | | | | - Nilesh Thite
- International Association of Contact Lens Educators, Pune, India
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13
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Ntonti P, Bakirtzis M, Delibasis K, Seimenis I, Tsinopoulos I, Labiris G. Impact of personality on the decision process and on satisfaction rates in pseudophakic presbyopic correction. J Cataract Refract Surg 2022; 48:1433-1439. [PMID: 35862830 DOI: 10.1097/j.jcrs.0000000000001021] [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] [Received: 06/23/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To explore the impact of personality on the decision process and satisfaction rates in pseudophakic presbyopic correction. SETTING Department of Ophthalmology, University Hospital of Alexandroupolis, Greece. DESIGN Prospective, comparative study. METHODS A consistent consultation was conducted in patients with cataract that explained the benefits and the drawbacks of bilateral trifocal correction, which was offered at no extra cost. In all participants, personality was evaluated by The Traits Personality Questionnaire 5. Data modeling with decision trees and multiple regression analysis identified the contributions of personality traits to the decision process and postoperative satisfaction. RESULTS Of 120 participants (60 men and 60 women), 81 (67.5%, 24 men, 57 women) selected premium correction. In men, low neuroticism and high extraversion were the primary personality contributors for selecting premium surgery. In women, all personality traits contributed to the selection process. Women were more demanding in the expected postoperative distant acuity than men (0.1 vs 0.2 logMAR) to present high satisfaction. For both men and women, openness to experience, conscientiousness, and extraversion are primary contributors for optimal satisfaction rates. CONCLUSIONS Men and women demonstrate differences in the selection process for premium pseudophakic surgery and differences in the expected postoperative visual acuity. It seems that the personality of the patient plays a significant role in the perceived outcome after premium surgery.
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Affiliation(s)
- Panagiota Ntonti
- From the Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, Greece (Ntonti, Bakirtzis, Labiris); Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, Greece (Delibasis); Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Seimenis); Second Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece (Tsinopoulos)
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14
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McParland M, Walsh K, Comoroda D, Sulley A. Wearer Experience and Eye Care Professional Acceptance with a 1 Day Multifocal Contact Lens. CLINICAL OPTOMETRY 2022; 14:223-235. [PMID: 36444271 PMCID: PMC9700463 DOI: 10.2147/opto.s375133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE A large observational survey was undertaken to determine eye care professional (ECP) and patient experience of stenfilcon A multifocal soft contact lens (MyDay multifocal) when prescribed in a real-world setting. METHODS A total of 196 ECPs from eleven countries fit up to ten presbyopes with stenfilcon A multifocal. Data were collected on fit success at the initial visit, patient satisfaction with comfort, vision at distance, intermediate, and near, overall vision, overall satisfaction, and handling at the initial and follow-up visits after 1-2 weeks of wear. ECPs completed questionnaires on multifocal fitting experience and expectations before and after the fitting period. RESULTS A total of 196 pre-fitting and 141 post-fitting ECP surveys were collected. A total of 1505 initial fits (mean age 53.4, range 38 to 81 years, 73% female, 27% neophytes) and 1440 follow-up visits were completed. The mean distance vision contact lens prescription was -1.32DS (range -12.00DS to +8.00DS) with Add powers: Low 56%, Medium 24%, and High 21%. At the follow-up visit 77% (n=1108) of trials were successful. Mean patient satisfaction ratings (1-10 scale, where 1 is not at all satisfied, and 10 extremely satisfied) at the initial visit were higher than eight out of ten for comfort, vision, and overall satisfaction, and were not significantly different after 1-2 weeks of wear. Stenfilcon A multifocal was preferred by 66% of patients over their habitual correction. In most cases mean satisfaction scores and the proportion of patients highly satisfied were not significantly different between myopes and hyperopes, across Add range, between new and habitual wearers, and wearers of frequently replaced and 1 day contact lenses. CONCLUSION ECPs in real-world clinical settings found stenfilcon A multifocal contact lenses easy to fit to a wide range of patients, with a high fit success rate and high levels of patient satisfaction for overall comfort, vision, satisfaction, and handling.
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Affiliation(s)
| | - Karen Walsh
- Coopervision, Inc. Professional Affairs, San Ramon, CA, USA
| | - Daniel Comoroda
- Lumanity (Formerly Cello Health Insight), Insight Department, Bethesda, MD, USA
| | - Anna Sulley
- Coopervision, Inc. Medical Affairs, San Ramon, CA, USA
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15
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Walsh K, Jones L, Moody K. Addressing common myths and misconceptions in soft contact lens practice. Clin Exp Optom 2021; 105:459-473. [PMID: 34886744 DOI: 10.1080/08164622.2021.2003693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Advances in contact lens technology over the past 50 years since the commercialisation of the first soft lenses in 1971 have been incredible, with significant changes in contact lens materials, frequency of replacement, care systems and lens designs occurring. However, despite the widespread availability of contact lenses, penetration rates for those who need vision correction remain in the low single digits and many practitioners seem to hold on to concepts around the potential value of contact lenses that appear based in the dim and distant past and are certainly no longer valid today. This review addresses 10 common 'myths and misconceptions' around soft contact lenses using an evidence-based approach that can hopefully dispel some of these incorrect assumptions.
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Affiliation(s)
- Karen Walsh
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada.,Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Shatin, Hong Kong
| | - Kurt Moody
- Johnson & Johnson Vision, Jacksonville, Florida, USA
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16
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Park WC, Kim CH, Jin SW. Clinical performance of presbyopia correction with a multifocal corneoscleral lens. Int J Ophthalmol 2021; 14:529-535. [PMID: 33875943 DOI: 10.18240/ijo.2021.04.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 08/24/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the clinical performance of a multifocal corneoscleral lens for the presbyopia correction. METHODS A prospective clinical trial of the Onefit™ A multifocal corneoscleral lens was conducted with 40 participants with presbyopia. At 4wk of continuous wear of the corneoscleral lens, changes in the distance, intermediate, and near visual acuity (VA) were evaluated. The safety of the corneoscleral lens, central corneal thickness (CCT), corneal endothelial cell count, binocular stereopsis, tear film break-up time (BUT), corneal staining, corneal edema, corneal neovascularization (NV), and conjunctival hyperemia were examined. In addition, a subjective questionnaire addressing satisfaction (rated from 1 to 5 points) and discomfort (rated from 1 to 5 points) was administered. RESULTS Forty participants were enrolled in this study. Six participants were excluded because of poor compliance with lens fitting (n=2) and loss to follow-up (n=4). The mean age of the participants was 53.0±4.9y. At 4wk of continuous wear of the corneoscleral lens, the best corrected far, intermediate, and near VA was 0.08±0.11, 0.10±0.12, and 0.10±0.12 logMAR, respectively. These results were significant improvements over the baseline uncorrected VA (far: P=0.004; intermediate: P=0.004; near: P=0.002). CCT, corneal endothelial cell count, binocular stereopsis, BUT, corneal staining, corneal edema, corneal NV, and conjunctival hyperemia were not significantly different between baseline and after corneoscleral lens use. The average satisfaction scores for fit sensation; corrected far, intermediate, and near VA; and ease of handling were 4.1, 3.4, 3.6, 3.5, and 3.4, respectively. The average discomfort scores for dryness, irritation, foreign body sensation, redness, fogging, and halo were 1.7, 1.8, 1.5, 1.7, 1.7, and 1.3, respectively. CONCLUSION Far, intermediate, and near VA are improved in presbyopic patients with the multifocal corneoscleral lens compared to uncorrected baseline VA, without adverse ocular effects. This evidence supports the safety and effectiveness of presbyopia correction with multifocal corneoscleral lenses.
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Affiliation(s)
- Woo Chan Park
- Department of Ophthalmology, Dong-A University College of Medicine, Busan 49201, Republic of Korea
| | - Chae Hoon Kim
- Department of Ophthalmology, Dong-A University College of Medicine, Busan 49201, Republic of Korea
| | - Sang Wook Jin
- Department of Ophthalmology, Dong-A University College of Medicine, Busan 49201, Republic of Korea
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17
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Ferrer‐blasco T, Madrid‐costa D. Stereoacuity with balanced presbyopic contact lenses. Clin Exp Optom 2021; 94:76-81. [DOI: 10.1111/j.1444-0938.2010.00530.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Teresa Ferrer‐blasco
- Optometry Research Group (GIO), Optics Department, University of Valencia, Spain
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18
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Richdale K, Cox I, Kollbaum P, Bullimore MA, Bakaraju RC, Gifford P, Plainis S, McKenney C, Newman S, Tomiyama ES, Morgan PB. CLEAR – Contact lens optics. Cont Lens Anterior Eye 2021; 44:220-239. [DOI: 10.1016/j.clae.2021.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/27/2022]
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19
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Wolffsohn JS, Dumbleton K, Huntjens B, Kandel H, Koh S, Kunnen CME, Nagra M, Pult H, Sulley AL, Vianya-Estopa M, Walsh K, Wong S, Stapleton F. CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye 2021; 44:368-397. [PMID: 33775383 DOI: 10.1016/j.clae.2021.02.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022]
Abstract
Evidence-based contact lens -->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patient. This reports reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as -->minimising risks of lens wear through encouraging compliance) and an aftercare routine.
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Affiliation(s)
| | - Kathy Dumbleton
- School of Optometry, University of California, Berkeley, CA, USA
| | - Byki Huntjens
- Division of Optometry and Visual Sciences at City, University of London, London, UK
| | - Himal Kandel
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Shizuka Koh
- Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Japan
| | | | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Cambridge, UK
| | - Heiko Pult
- Optometry and Vision Research, Weinheim, Germany
| | | | - Marta Vianya-Estopa
- Department of Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Karen Walsh
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Stephanie Wong
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
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20
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Vinas M, Aissati S, Gonzalez-Ramos AM, Romero M, Sawides L, Akondi V, Gambra E, Dorronsoro C, Karkkainen T, Nankivil D, Marcos S. Optical and Visual Quality With Physical and Visually Simulated Presbyopic Multifocal Contact Lenses. Transl Vis Sci Technol 2020; 9:20. [PMID: 33005478 PMCID: PMC7509762 DOI: 10.1167/tvst.9.10.20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose As multifocal contact lenses (MCLs) expand as a solution for presbyopia correction, a better understanding of their optical and visual performance becomes essential. Also, providing subjects with the experience of multifocal vision before contact lens fitting becomes critical, both to systematically test different multifocal designs and to optimize selection in the clinic. In this study, we evaluated the ability of a simultaneous vision visual simulator (SimVis) to represent MCLs. Methods Through focus (TF) optical and visual quality with a center-near aspheric MCL (low, medium and high near adds) were measured using a multichannel polychromatic Adaptive Optics visual simulator equipped with double-pass, SimVis (temporal multiplexing), and psychophysical channels to allow measurements on-bench and in vivo. On bench TF optical quality of SimVis-simulated MCLs was obtained from double-pass (DP) images and images of an E-stimulus using artificial eyes. Ten presbyopic subjects were fitted with the MCL. Visual acuity (VA) and DP retinal images were measured TF in a 4.00 D range with the MCL on eye, and through SimVis simulations of the same MCLs on the same subjects. Results TF optical (on bench and in vivo) and visual (in vivo) quality measurements captured the expected broadening of the curves with increasing add. Root mean square difference between real and SimVis-simulated lens was 0.031/0.025 (low add), 0.025/0.015 (medium add), 0.019/0.011 (high add), for TF DP and TF LogMAR VA, respectively. A shape similarity metric shows high statistical values (lag κ = 0), rho = 0.811/0.895 (low add), 0.792/0.944 (medium add), and 0.861/0.915 (high add) for TF DP/LogMAR VA, respectively. Conclusions MCLs theoretically and effectively expand the depth of focus. A novel simulator, SimVis, captured the through-focus optical and visual performance of the MCL in most of the subjects. Visual simulators allow subjects to experience vision with multifocal lenses prior to testing them on-eye. Translational Relevance Simultaneous visual simulators allow subjects to experience multifocal vision non-invasively. We demonstrated equivalency between real multifocal contact lenses and SimVis-simulated lenses. The results suggest that SimVis is a suitable technique to aid selection of presbyopic corrections in the contactology practice.
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Affiliation(s)
- Maria Vinas
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
| | - Sara Aissati
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
| | | | - Mercedes Romero
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
| | | | - Vyas Akondi
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain.,Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | | | - Carlos Dorronsoro
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain.,EyesVision, Madrid, Spain
| | - Thomas Karkkainen
- Johnson & Johnson Vision, Inc., Research & Development, Jacksonville, FL, USA
| | - Derek Nankivil
- Johnson & Johnson Vision, Inc., Research & Development, Jacksonville, FL, USA
| | - Susana Marcos
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
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21
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Visual quality of juvenile myopes wearing multifocal soft contact lenses. EYE AND VISION 2020; 7:41. [PMID: 32699804 PMCID: PMC7368986 DOI: 10.1186/s40662-020-00204-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/16/2020] [Indexed: 12/20/2022]
Abstract
Background It is unclear whether multifocal soft contact lenses (MFSCLs) affect visual quality when they are used for myopia control in juvenile myopes. The aim of this study was, therefore, to investigate the effect of MFSCLs on visual quality among juvenile myopia subjects. Methods In a prospective, intervention study, thirty-three juvenile myopes were enrolled. Visual perception was assessed by a quality of vision (QoV) questionnaire with spectacles at baseline and after 1 month of MFSCL wear. At the one-month visit, the high (96%) contrast distance visual acuity (distance HCVA) and low (10%) contrast distance visual acuity (distance LCVA) were measured with single vision spectacle lenses, single vision soft contact lenses (SVSCLs) and MFSCLs in a random order. Wavefront aberrations were measured with SVSCLs, with MFSCLs, and without any correction. Results Neither distance HCVA (p > 0.05) nor distance LCVA (p > 0.05) revealed any significant difference between MFSCLs, SVSCLs and single vision spectacle lenses. The overall score (the sum of ten symptoms) of the QoV questionnaire did not show a statistically significant difference between spectacles at baseline and after 1 month of MFSCL wear (p = 0.357). The results showed that the frequency (p < 0.001), severity (p = 0.001) and bothersome degree (p = 0.016) of halos were significantly worse when wearing MFSCLs than when wearing single vision spectacle lenses. In contrast, the bothersome degree caused by focusing difficulty (p = 0.046) and the frequency of difficulty in judging distance or depth perception (p = 0.046) were better when wearing MFSCLs than when wearing single vision spectacle lenses. Compared with the naked eye, MFSCLs increased the total aberrations (p < 0.001), higher-order aberrations (p < 0.001), trefoil (p = 0.023), coma aberrations (p < 0.001) and spherical aberrations (SA) (p < 0.001). Compared with the SVSCLs, MFSCLs increased the total aberrations (p < 0.001), higher-order aberrations (p < 0.001), coma aberrations (p < 0.001) and SA (p < 0.001). The direction of SA was more positive (p < 0.001) with the MFSCLs and more negative (p = 0.001) with the SVSCLs compared with the naked eye. Conclusions Wearing MFSCLs can provide satisfactory corrected visual acuity (both distance HCVA and distance LCVA). Although the lenses increased the aberrations, such as total aberrations and higher-order aberrations, there were few adverse effects on the distance HCVA, distance LCVA and visual perception after 1 month of MFSCL use. Trial registration Chinese Clinical Trial Registry: ChiCTR-OOC-17012103. Registered 23 July 2017, http://www.chictr.org.cn/usercenter.aspx
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22
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Sharma G, Chiva-Razavi S, Viriato D, Naujoks C, Patalano F, Bentley S, Findley A, Johnson C, Arbuckle R, Wolffsohn J. Patient-reported outcome measures in presbyopia: a literature review. BMJ Open Ophthalmol 2020; 5:e000453. [PMID: 32685693 PMCID: PMC7359053 DOI: 10.1136/bmjophth-2020-000453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/18/2020] [Accepted: 06/12/2020] [Indexed: 12/02/2022] Open
Abstract
Presbyopia is the age-related loss of near-distance focusing ability. The aim of this study was to identify patient-reported outcome measures (PROMs) used in clinical trials and quality-of-life studies conducted in individuals with presbyopia and to assess their suitability for use in individuals with phakic presbyopia. Literature searches were performed in Medline and Embase up until October 2017. Specific search terms were used to identify presbyopia studies that included a PROM. All clinical trials with PROM-supported endpoints in presbyopia were identified on ClinicalTrials.gov. Further searches were conducted to retrieve articles documenting the development and psychometric evaluation of the PROMs identified. A total of 703 records were identified; 120 were selected for full-text review. Twenty-one clinical trials employed PROMs to support a primary or secondary endpoint. In total, 13 PROMs were identified; a further 23 publications pertaining to the development and validation of these measures were retrieved. Most PROMs were developed prior to release of the Food and Drug Administration (FDA) 2009 patient-reported outcome guidance and did not satisfy regulatory standards. The Near Activity Visual Questionnaire (NAVQ) was identified as the most appropriate for assessing near-vision functioning in presbyopia. While the NAVQ was developed in line with the FDA guidance, the items do not reflect changes in technology that have occurred since the questionnaire was developed in 2008 (eg, the increase in smartphone use), and the measure was not validated in a purely phakic presbyopia sample. Further research is ongoing to refine the NAVQ to support trial endpoints related to changes in near-vision functioning associated with phakic presbyopia.
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Affiliation(s)
| | | | | | | | | | - Sarah Bentley
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
| | - Amy Findley
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
| | - Chloe Johnson
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
| | - Rob Arbuckle
- Adelphi Values Patient-Centered Outcomes, Bollington, UK
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23
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Bifocal and Multifocal Contact Lenses for Presbyopia and Myopia Control. J Ophthalmol 2020; 2020:8067657. [PMID: 32318285 PMCID: PMC7152962 DOI: 10.1155/2020/8067657] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/10/2020] [Accepted: 02/24/2020] [Indexed: 02/07/2023] Open
Abstract
Bifocal and multifocal optical devices are intended to get images into focus from objects placed at different distances from the observer. Spectacles, contact lenses, and intraocular lenses can meet the requirements to provide such a solution. Contact lenses provide unique characteristics as a platform for implementing bifocality and multifocality. Compared to spectacles, they are closer to the eye, providing a wider field of view, less distortion, and their use is more consistent as they are not so easily removed along the day. In addition, contact lenses are also minimally invasive, can be easily exchangeable, and, therefore, suitable for conditions in which surgical procedures are not indicated. Contact lenses can remain centered with the eye despite eye movements, providing the possibility for simultaneous imaging from different object distances. The main current indications for bifocal and multifocal contact lenses include presbyopia correction in adult population and myopia control in children. Considering the large numbers of potential candidates for optical correction of presbyopia and the demographic trends in myopia, the potential impact of contact lenses for presbyopia and myopia applications is undoubtedly tremendous. However, the ocular characteristics and expectations vary significantly between young and older candidates and impose different challenges in fitting bifocal and multifocal contact lenses for the correction of presbyopia and myopia control. This review presents the recent developments in material platforms, optical designs, simulated visual performance, and the clinical performance assessment of bifocal and multifocal contact lenses for presbyopia correction and/or myopia progression control.
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Park HM, Ryu YU, Park IJ, Chu BS. Can Tinted Lenses Be Used to Manipulate Pupil Size and Visual Performance When Wearing Multifocal Contact Lenses? CLINICAL OPTOMETRY 2020; 12:27-35. [PMID: 32184694 PMCID: PMC7062197 DOI: 10.2147/opto.s245715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 02/21/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The purpose of this study is to investigate the effect of wearing neutral density (ND) filters with different transmittance levels over multifocal contact lenses (MTF CLs) on pupil size, visual functions and the dynamic accommodative response under daylight conditions in early presbyopes. METHODS Seventeen individuals aged between 40 and 48 years (mean age 42.35±2.62 years) were recruited to participate in this study. This study involved a repeated-measures design with two within-subject factors: optical condition (which had five levels), and fixation distance (which had three levels). The five optical conditions were no correction (baseline), MTF CL wear, MTF CL wear + 0.3 ND filter (transmission [Tv]=48.38%), MTF CL wear + 0.6 ND filter (Tv=27.12%) and MTF CL wear + 0.9 ND filter (Tv=14.58%). The three fixation distances were 3 m, 40 cm and 20 cm. Outcome measures were pupil size, the measured accommodative response (optical aid + physiological accommodation), distance visual acuity (VA), near VA and contrast sensitivity (CS). RESULTS There was no effect of optical condition on the accommodative response; however, there was a significant effect of fixation distance. (Accommodative response was 0.44±0.29, 1.83±0.37 and 4.03±0.46 D for fixation distances of 3 m, 40 cm and 20 cm, respectively; p<0.05.) There was a significant effect of optical condition (p<0.05) and of fixation distance on pupil size variation (5.13±0.90 mm for 3 m, 4.71±0.92 mm for 40 cm and 4.11±1.04 mm for 20 cm; p<0.05). Optical condition had a significant effect on distance VA, near VA and CS (p<0.05). Compared to the reduction in distance VA, near VA was relatively small (two-letter reduction with 0.9 ND) and unlikely to be clinically significant. CONCLUSION This study demonstrated that in a group of adults with early presbyopia, the use of ND filters enlarged pupil size. However, the combination of enlarged pupils and MTF CL did not improve distance vision, and if transmittance was reduced by 50% it resulted in decrements in vision and CS. MTF CL designs which incorporate tints, or tints that vary in darkness in response to ultraviolet exposure, should consider these findings.
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Affiliation(s)
- Hyung Min Park
- School of Optometry and Vision Science, Daegu Catholic University, Gyeongsan-si, Republic of Korea
| | - Young Uk Ryu
- Department of Physical Therapy, Daegu Catholic University, Gyeongsan-si, Republic of Korea
| | - Inn-Jee Park
- School of Optometry and Vision Science, Daegu Catholic University, Gyeongsan-si, Republic of Korea
| | - Byoung Sun Chu
- School of Optometry and Vision Science, Daegu Catholic University, Gyeongsan-si, Republic of Korea
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Merchea M, Evans D, Kannarr S, Miller J, Kaplan M, Nixon L. Assessing a modified fitting approach for improved multifocal contact lens fitting. Cont Lens Anterior Eye 2019; 42:540-545. [DOI: 10.1016/j.clae.2019.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
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Combined Effect of Ocular and Multifocal Contact Lens Induced Aberrations on Visual Performance: Center-Distance Versus Center-Near Design. Eye Contact Lens 2018; 44 Suppl 1:S131-S137. [PMID: 28060146 DOI: 10.1097/icl.0000000000000355] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the combined effects of inherent ocular aberrations and induced aberrations with a multifocal soft contact lens (MFCL) after 15 days of lens wear in presbyopic participants and their influence on visual performance at distance and near under high and low contrast conditions. METHODS Forty presbyopic participants (mean age, 48.7±3.4) presenting a mean addition of 1.53±0.58 D were fitted with Biofinity Multifocal (CooperVision) and included in the study. Measurements comprised distance and near monocular high (100%) and low contrast (10%) logMAR visual acuity (VA). Ocular aberrations were obtained with Hartmann-Shack aberrometer (IRX3, Imagine Eyes) and analyzed for 2 mm and maximum round natural pupil. RESULTS Distance VA was significantly higher in dominant eye, whereas near VA was significantly better in the non-dominant eye (P<0.05 in all conditions). For a 2-mm pupil in the dominant eye fitted with MFCL, spherical-like aberration significantly increased (P=0.027) so as higher-order aberrations (HOA) (P=0.002). A significant increase was also observed in spherical-like aberrations (P=0.001), coma-like aberrations (P=0.006) and HOA (P=0.004) in non-dominant eye. For the maximum round natural pupil size, a significant decrease in vertical coma was observed (P=0.018) in dominant eye, whereas a significant increase in spherical-like (P<0.001) and coma-like aberrations (P=0.007) was observed in non-dominant eye. A negative significant correlation was found between vertical coma and high contrast VA (Rho=-0.405, P=0.011) in dominant eye; whereas in non-dominant eye, a significant correlation was found between induced secondary astigmatism and distance VA under high (Rho=0.556, P<0.001) and low contrast (Rho=0.448, P=0.005). CONCLUSIONS On-eye visual performance of MFSCL is dependent on the high-order aberrations induced by dominant and non-dominant design coupled with the wearer's inherent aberrations.
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Comparison of Extended Depth-of-Focus Prototype Contact Lenses With the 1-Day ACUVUE MOIST MULTIFOCAL After One Week of Wear. Eye Contact Lens 2018; 44 Suppl 2:S157-S163. [DOI: 10.1097/icl.0000000000000430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Zeri F, Naroo SA, Zoccolotti P, De Luca M. Pattern of reading eye movements during monovision contact lens wear in presbyopes. Sci Rep 2018; 8:15574. [PMID: 30349058 PMCID: PMC6197269 DOI: 10.1038/s41598-018-33934-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 09/26/2018] [Indexed: 11/12/2022] Open
Abstract
Monovision can be used as a method to correct presbyopia with contact lenses (CL) but its effect on reading behavior is still poorly understood. In this study eye movements (EM) were recorded in fifteen presbyopic participants, naïve to monovision, whilst they read arrays of words, non-words, and text passages to assess whether monovision affected their reading. Three conditions were compared, using daily disposable CLs: baseline (near correction in both eyes), conventional monovision (distance correction in the dominant eye, near correction in the non-dominant eye), and crossed monovision (the reversal of conventional monovision). Behavioral measures (reading speed and accuracy) and EM parameters (single fixation duration, number of fixations, dwell time per item, percentage of regressions, and percentage of skipped items) were analyzed. When reading passages, no differences in behavioral and EM measures were seen in any comparison of the three conditions. The number of fixations and dwell time significantly increased for both monovision and crossed monovision with respect to baseline only with word and non-word arrays. It appears that monovision did not appreciably alter visual processing when reading meaningful texts but some limited stress of the EM pattern was observed only with arrays of unrelated or meaningless items under monovision, which require the reader to have more in-depth controlled visual processing.
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Affiliation(s)
- Fabrizio Zeri
- Ophthalmic Research Group. School of Life and Health Sciences, Aston University, Birmingham, B4 7ET, United Kingdom. .,University of Milano Bicocca, Department of Materials Science, 20125, Milan, Italy.
| | - Shehzad A Naroo
- Ophthalmic Research Group. School of Life and Health Sciences, Aston University, Birmingham, B4 7ET, United Kingdom
| | - Pierluigi Zoccolotti
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Rome, 00179, Italy.,Department of Psychology, Sapienza University, Rome, 00176, Italy
| | - Maria De Luca
- Neuropsychology Unit, IRCCS Fondazione Santa Lucia, Rome, 00179, Italy
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Wolffsohn JS, Davies LN. Presbyopia: Effectiveness of correction strategies. Prog Retin Eye Res 2018; 68:124-143. [PMID: 30244049 DOI: 10.1016/j.preteyeres.2018.09.004] [Citation(s) in RCA: 148] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 01/04/2023]
Abstract
Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
| | - Leon N Davies
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK
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Trivizki O, Smadja D, Mimouni M, Levinger S, Levinger E. Bioptics for high hyperopia with combined multifocal intraocular lens implantation and excimer ablation in young patients. Eur J Ophthalmol 2018; 29:426-430. [PMID: 30175611 DOI: 10.1177/1120672118797281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To analyze the visual and refractive outcome of the bioptics procedure combining multifocal intraocular lens implantation and excimer laser surgery in young patients with high hyperopic eyes not suitable for a single surgical procedure. METHODS This retrospective case series included 10 eyes of five patients (age range 18-30 years) with high hyperopia (spherical equivalent +8.51 ± 0.85 diopters (D)). They had been treated with serial multifocal intraocular lens implantation followed 6 weeks later by laser in situ keratomileusis for residual hyperopia. Uncorrected distance visual acuity, uncorrected near visual acuity, corrected distance visual acuity, corrected near visual acuity, and manifest refraction were evaluated before surgeries, after multifocal intraocular lens implantation, and 3 months post laser in situ keratomileusis. RESULTS No patients were lost to follow-up (6 months). The mean spherical equivalent decreased to +2.05 ± 1.33 D after multifocal intraocular lens implantation and to -0.10 ± 0.58 D after the laser in situ keratomileusis procedure. Success of the procedures was determined by uncorrected visual acuity. LogMAR uncorrected distance visual acuity improved by a total of more than six lines from 1.05 ± 0.18 LogMAR to 0.46 ± 0.12 LogMAR post multifocal intraocular lens implantation and to 0.15 ± 0.06 LogMAR after both surgeries. The LogMAR uncorrected near visual acuity increased by 0.81 ± 0.82 LogMAR after lens implantation due to loss of accommodation, and all eyes reached a LogMAR of 0 at 1 month postoperatively following laser in situ keratomileusis. CONCLUSIONS A bioptics approach involving multifocal intraocular lens followed 6 weeks later by a laser in situ keratomileusis procedure for the correction of very high hyperopia enabled the resolution of the residual refractive error in young very high hyperopic patients.
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Affiliation(s)
- Omer Trivizki
- 1 Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Smadja
- 1 Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,3 Enaim Refractive Surgery Center, Jerusalem, Israel
| | - Michael Mimouni
- 4 Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel.,5 Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Eliya Levinger
- 1 Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,3 Enaim Refractive Surgery Center, Jerusalem, Israel
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Sanchez I, Ortiz-Toquero S, Blanco M, Martin R. A new method to analyse the effect of multifocal contact lenses on visual function. Cont Lens Anterior Eye 2018; 41:169-174. [DOI: 10.1016/j.clae.2017.11.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 10/16/2017] [Accepted: 11/30/2017] [Indexed: 11/17/2022]
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Fernandes P, Amorim-de-Sousa A, Queirós A, Escandón-Garcia S, McAlinden C, González-Méijome JM. Light disturbance with multifocal contact lens and monovision for presbyopia. Cont Lens Anterior Eye 2018; 41:393-399. [PMID: 29576438 DOI: 10.1016/j.clae.2018.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 02/07/2018] [Accepted: 03/18/2018] [Indexed: 12/11/2022]
Abstract
Dysphotopsia affects a significant number of patients, particularly after visual correction with multifocal optical designs. PURPOSE Evaluate light distortion (LD) in two modalities of contact lens (CL) wear: multifocal (MF) and monofocal (MV). METHODS This was a randomized, double-masked, crossover study involving 20 presbyopic patients. Patients were randomized first into either MF or MV for 15 days of use with a 1 week wash-out period between each lens type. The LD was evaluated with the Light Distortion Analyzer (LDA, University of Minho) under monocular and binocular conditions. The light distortion index (LDI, %), among other parameters were analyzed. Subjective quality of vision was assessed with the Quality of Vision (QoV). RESULTS The LD showed an increase in all parameters in both CL modalities being significant for MV in the non-dominant eye (p < 0.030, for all LD parameters). For the MF, there was also a significant increase in LDI (p = 0.016) and in BFCrad (p = 0.022) in the non-dominant eye. After 15 days of MF lens wear, there was a significant decrease in all LD parameters (p < 0.002) in the dominant eye. Binocularly, a significant improvement from 1 to 15 days was observed for LDI (p = 0.009) and BFCrad (p = 0.0013) with MF. The QoV questionnaire showed no significant changes with neither CL. CONCLUSIONS Adaptation to light disturbances induced by MF CL is more effective compared to MV. Practitioners will have greater success if they prepare their patients for the adaptation required as their vision will get better and have less of an issue with light disturbance.
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Affiliation(s)
- Paulo Fernandes
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal.
| | - Ana Amorim-de-Sousa
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
| | - António Queirós
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
| | - Santiago Escandón-Garcia
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
| | - Colm McAlinden
- University Hospitals Bristol, NHS Foundation Trust, Bristol, UK
| | - José Manuel González-Méijome
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
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Bakaraju RC, Ehrmann K, Ho A. Extended depth of focus contact lenses vs. two commercial multifocals: Part 1. Optical performance evaluation via computed through-focus retinal image quality metrics. JOURNAL OF OPTOMETRY 2018; 11:10-20. [PMID: 28606456 PMCID: PMC5777930 DOI: 10.1016/j.optom.2017.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/12/2017] [Accepted: 04/21/2017] [Indexed: 05/20/2023]
Abstract
PURPOSE To compare the computed optical performance of prototype lenses designed using deliberate manipulation of higher-order spherical aberrations to extend depth-of-focus (EDOF) with two commercial multifocals. METHODS Emmetropic, presbyopic, schematic eyes were coupled with prototype EDOF and commercial multifocal lenses (Acuvue Oasys for presbyopia, AOP, Johnson & Johnson & Air Optix Aqua multifocal, AOMF, Alcon). For each test configuration, the through-focus retinal image quality (TFRIQ) values were computed over 21 vergences, ranging from -0.50 to 2.00D, in 0.125D steps. Analysis was performed considering eyes with three different inherent aberration profiles: five different pupils and five different lens decentration levels. RESULTS Except the LOW design, the AOP lenses offered 'bifocal' like TFRIQ performance. Lens performance was relatively independent to pupil and aberrations but not centration. Contrastingly, AOMF demonstrated distance centric performance, most dominant in LOW followed by MED and HIGH designs. AOMF lenses were the most sensitive to pupil, aberrations and centration. The prototypes demonstrated a 'lift-off' in the TFRIQ performance, particularly at intermediate and near, without trading performance at distance. When compared with AOP and AOMF, EDOF lenses demonstrated reduced sensitivity to pupil, aberrations and centration. CONCLUSION With the through focus retinal image quality as the gauge of optical performance, we demonstrated that the prototype EDOF designs were less susceptible to variations in pupil, inherent ocular aberrations and decentration, compared to the commercial designs. To ascertain whether these incremental improvements translate to a clinically palpable outcome requires investigation through human trials.
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Affiliation(s)
- Ravi C Bakaraju
- Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.
| | - Klaus Ehrmann
- Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Arthur Ho
- Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Patient-reported Outcomes for Assessment of Quality of Life in Refractive Error: A Systematic Review. Optom Vis Sci 2017; 94:1102-1119. [PMID: 29095758 DOI: 10.1097/opx.0000000000001143] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This review has identified the best existing patient-reported outcome (PRO) instruments in refractive error. The article highlights the limitations of the existing instruments and discusses the way forward. PURPOSE A systematic review was conducted to identify the types of PROs used in refractive error, to determine the quality of the existing PRO instruments in terms of their psychometric properties, and to determine the limitations in the content of the existing PRO instruments. METHODS Articles describing a PRO instrument measuring 1 or more domains of quality of life in people with refractive error were identified by electronic searches on the MEDLINE, PubMed, Scopus, Web of Science, and Cochrane databases. The information on content development, psychometric properties, validity, reliability, and responsiveness of those PRO instruments was extracted from the selected articles. The analysis was done based on a comprehensive set of assessment criteria. RESULTS One hundred forty-eight articles describing 47 PRO instruments in refractive error were included in the review. Most of the articles (99 [66.9%]) used refractive error-specific PRO instruments. The PRO instruments comprised 19 refractive, 12 vision but nonrefractive, and 16 generic PRO instruments. Only 17 PRO instruments were validated in refractive error populations; six of them were developed using Rasch analysis. None of the PRO instruments has items across all domains of quality of life. The Quality of Life Impact of Refractive Correction, the Quality of Vision, and the Contact Lens Impact on Quality of Life have comparatively better quality with some limitations, compared with the other PRO instruments. CONCLUSIONS This review describes the PRO instruments and informs the choice of an appropriate measure in refractive error. We identified need of a comprehensive and scientifically robust refractive error-specific PRO instrument. Item banking and computer-adaptive testing system can be the way to provide such an instrument.
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Zeri F, Berchicci M, Naroo SA, Pitzalis S, Di Russo F. Immediate cortical adaptation in visual and non-visual areas functions induced by monovision. J Physiol 2017; 596:253-266. [PMID: 29071723 DOI: 10.1113/jp274896] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/18/2017] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Monovision is an optical correction for presbyopes that consists of correcting one eye for far distance and the other for near distance, creating a superimposition of an in-focus with a blurred image. Brain adaptation to monovision was studied in unexperienced observers by measuring visual evoked potentials from 64-channels. The first clear effect of monovision on visual evoked potentials was the C1 amplitude reduction, indicating that the unilateral blurring induced by monovision reduces feed-forward activity in primary visual area. Monovision led also to an increased amplitude of the P1 and pP1 components, with the latter originating in prefrontal regions. This effect probably works as an attentional compensatory activity used to compensate for the degraded V1 signal. ABSTRACT A common and often successful option to correct presbyopia with contact lenses is monovision. This is an unbalanced correction across the two eyes where one eye is corrected for far vision and the other eye is corrected for near vision. Monovision is therefore a form of acquired anisometropia that causes a superimposition of an in-focus image with a blurred image. In spite of this visual anisometropia, monovision has been successfully used for many decadesl however the brain mechanism supporting monovision is not well understood. The present study aimed to measure the visual evoked potentials with a high-density electrode array (64-channel) in a group of presbyopes and to provide a detailed spatiotemporal analysis of the cortical activity after a short period of adaptation to monovision with contact lenses. When compared with a balanced eye near correction, monovision produced both a clear reduction of the earliest visual evoked potential components, the C1 and the N1, and an amplitude increase of the P1 and pP1. These results indicate that the unilateral blurring induced by wearing monovision contact lenses reduces feed-forward activity in the primary visual area and feedback activity in extrastriate areas (C1 and N1 reduction). Interestingly, other brain activities in both extrastriate visual areas (the P1 component) and in the anterior insula (the pP1 component) appear to compensate for this dysfunction, increasing their activity during monovision. These changes confirm the presence of fluid brain adaptation in visual and non-visual areas during monocular interferences.
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Affiliation(s)
- Fabrizio Zeri
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Marika Berchicci
- Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Rome, Italy
| | - Shehzad A Naroo
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Sabrina Pitzalis
- Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Rome, Italy.,IRCCS Santa Lucia Foundation Rome, Italy
| | - Francesco Di Russo
- Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Rome, Italy.,IRCCS Santa Lucia Foundation Rome, Italy
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Wahl S, Fornoff L, Ochakovski GA, Ohlendorf A. Disability glare in soft multifocal contact lenses. Cont Lens Anterior Eye 2017; 41:175-179. [PMID: 29017826 DOI: 10.1016/j.clae.2017.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 08/24/2017] [Accepted: 10/04/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE The study investigated the effect of the design of multifocal contact lenses on the sensitivity to contrast and disability glare. METHODS Contrast sensitivity was measured in 16 young adults (mean age: 25.5±2.5years) at a distance of 2m under two conditions: no-glare and glare. Two designs (Center Near and Center Distance) of the Biofinity soft contact lens were used to simulate correction for presbyopes, while a correction with single vision trial lenses and contact lenses acted as controls. RESULTS The design of the used multifocal contact lenses had a significant influence on the log area under the curve of the contrast sensitivity function (AUC-CSF). Compared to the spectacle lens correction, the AUC-CSF was significantly reduced, in case CS was measured with the Center Near design lens, under the no-glare (p<0.001) and the glare condition (p: p<0.001). In case of the Center Distance design contact lens, the AUC-CSF was significantly smaller in case CS was tested under glare (p=0.001). Disability glare (DG) was depending on the spatial frequency and the design of the multifocal lens, while the Center Distance design produced higher amounts of DG (p<0.001), compared to the other used corrections. CONCLUSION The optical design of a multifocal contact lenses has a significant impact on the contrast sensitivity as well as the disability glare. In order to dispense the best correction in terms of contact lenses, the sensitivity to contrast under no-glare and glare conditions should be tested a medium spatial frequencies.
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Affiliation(s)
- Siegfried Wahl
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany; Carl Zeiss Vision International GmbH, Turnstrasse 27, 73430 Aalen, Germany.
| | - Luise Fornoff
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany; University of Applied Sciences Aalen, Anton-Huber-Straße 23, 73430 Aalen, Germany
| | - G Alex Ochakovski
- University Eye Hospital, Centre for Ophthalmology, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany
| | - Arne Ohlendorf
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Elfriede-Aulhorn-Straße 7, 72076 Tuebingen, Germany; Carl Zeiss Vision International GmbH, Turnstrasse 27, 73430 Aalen, Germany
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Abstract
PURPOSE To determine why presbyopic patients discontinue contact lens wear and describe their opinions of comfort and visual quality with contact lenses. METHODS A survey assessing current age, gender, contact lens material/design, and opinions of contact lens comfort and visual quality was mailed to 2400 presbyopic patients (age 40 years and older) that have had eye exams in the Ohio State University College of Optometry's Contact Lens Services over the last 4 years. RESULTS A total of 496 surveys were analyzed. The mean age of survey respondents was 57 ± 9 years, and 68% of the sample was female. Permanent discontinuation of contact lens wear was reported by 15%. No association was found between contact lens discontinuation and age (p = 0.7), gender (p = 0.2), age of beginning contact lens wear (p = 0.1), or contact lens material (p = 0.1). Poor vision (38%), discomfort (34%), convenience (20%), and cost (6%) were the primary reported reasons for discontinuation. There was no difference between the proportion of subjects reporting "poor vision" as their primary discontinuation reason and those reporting "discomfort" (p = 0.7). Discontinued wearers had a worse overall opinion of their distance (p = 0.03), intermediate (p = 0.01), and near vision (p = 0.002) compared to subjects who were still wearing their contact lenses. CONCLUSIONS Discomfort has been reported as the primary reason for contact lens discontinuation. In this presbyopic population, dissatisfaction with vision and discomfort were reported equally as often as primary reasons for discontinuation. As well, subjects who ceased contact lens wear had worse overall opinions of their vision at all distances than current contact lens wearers. The results of this survey suggest that presbyopes have unique demands and opinions related to contact lens wear.
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El Ameen A, Majzoub S, Pisella PJ. [The search for electrophysiological predictors of visual comfort after presbyopia correction with contact lenses]. J Fr Ophtalmol 2017; 40:257-263. [PMID: 28343723 DOI: 10.1016/j.jfo.2016.10.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/08/2016] [Accepted: 10/14/2016] [Indexed: 10/19/2022]
Abstract
Starting at 40 years of age, prespyopia affects a quarter of the world population. Many techniques of presbyopia surgery have emerged in recent years. The purpose of this study was to compare monovision and multifocality and to identify clinical and electrophysiological predictive markers of visual comfort for each correction available in clinical practice. Ten presbyopic patients participated in this study. Patients received monovision and multifocal correction using contact lenses for three weeks each in a random order. A clinical evaluation (visual acuity, TNO test, binocular contrast sensitivity and quality of vision questionnaires) and an electrophysiological evaluation (monocular and binocular pattern VEP with multiple spatial frequencies: 60, 30 and 15') were performed before and after each correction modality. The P100 was significantly wider and slightly earlier after binocular compared to monocular stimulation at T0. The TNO stereopsis score decreased significantly after correction. No other significant differences, either on clinical or electrophysiological criteria, were found between the two modes of correction. Several significant correlations were found between the stereoacuity difference depending upon correction and evoked potentials by binocular pattern at T0. The larger the stereoacuity difference (better stereoacuity with multifocal compensation), the longer the latency of the P100 using 60' checks (R=0.82; P=0.004) and the greater the amplitude of the N75 using 30' (R=0.652; P=0.04). Our study found no differences between the 2 types of correction, but it highlights a benefit of VEP used in current practice and measurement of the P100 wave, the best indicator of stereopsis and the most consistent, to predict visual comfort after compensation presbyopia.
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Affiliation(s)
- A El Ameen
- Service d'ophtalmologie, CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France.
| | - S Majzoub
- Service d'ophtalmologie, CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - P-J Pisella
- Service d'ophtalmologie, CHRU Bretonneau de Tours, 2, boulevard Tonnellé, 37000 Tours, France
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Labiris G, Ntonti P, Patsiamanidi M, Sideroudi H, Georgantzoglou K, Kozobolis VP. Evaluation of activities of daily living following pseudophakic presbyopic correction. EYE AND VISION 2017; 4:2. [PMID: 28116335 PMCID: PMC5244730 DOI: 10.1186/s40662-016-0067-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 12/29/2016] [Indexed: 11/13/2022]
Abstract
Background Pseudophakic presbyopic correction is among the prevalent methods for regaining near vision capacity. The purpose of this study is to compare the impact of pseudophakic monovision correction and multifocal lens implantation on the performance in a series of activities of daily living (ADL) of presbyopic patients. Methods An ADL research framework (10 ADLs) was constructed and validated in a sample of patients divided into three validation groups according to their near visual acuity. Sixty-two participants that underwent mini-monovision (MoG) cataract extraction and 60 that underwent bilateral multifocal lenses implantation (MfG) populated study groups and addressed the ADLs. Binocular uncorrected distant (BdUVA) and near (BnUVA) visual acuity were associated with ADL scores and with subjective satisfaction using the VF-14 questionnaire. Results Test-retest reliability [all Intraclass Correlations Coefficients (ICC) >0.90] and construct validity (all p < 0.05) tests indicated sufficient psychometric performance of the ADL framework. Both study groups presented comparable mean ADL scores (p = 0.07) however, MoG patients had lower performance in demanding ADLs (p = 0.02). ADL scores demonstrated significant correlation with BnUVA (r2 = −0.67, p < 0.01) VF-14 scores (r2 = 0.53, p < 0.01). Conclusions Both methods provide sufficient near vision capacity for the majority of activities of daily living. However, only multifocal lens implantation can address demanding near vision tasks. Trial registration ClinicalTrials.gov Identifier: NCT02431156.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis, Greece.,Eye Institute of Thrace, Alexandroupolis, Greece
| | - Panagiota Ntonti
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis, Greece
| | - Maria Patsiamanidi
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis, Greece
| | | | | | - Vassilios P Kozobolis
- Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis, Greece.,Eye Institute of Thrace, Alexandroupolis, Greece
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Tilia D, Munro A, Chung J, Sha J, Delaney S, Kho D, Thomas V, Ehrmann K, Bakaraju RC. Short-term comparison between extended depth-of-focus prototype contact lenses and a commercially-available center-near multifocal. JOURNAL OF OPTOMETRY 2017; 10:14-25. [PMID: 27161603 PMCID: PMC5219826 DOI: 10.1016/j.optom.2016.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 05/29/2023]
Abstract
PURPOSE To compare the visual performance of prototype contact lenses which extend depth-of-focus (EDOF) by deliberate manipulation of multiple higher-order spherical aberration terms and a commercially-available center-near lens (AIR OPTIX Aqua Multifocal, AOMF). METHODS This was a prospective, cross-over, randomized, single-masked (participant), short-term clinical trial where 52 participants (age 45-70 years) were stratified as low, medium or high presbyopes and wore EDOF and AOMF on different days. Objective measures comprised high and low contrast visual acuity (HCVA/LCVA, logMAR), and contrast sensitivity (log units) at 6m; HCVA at 70cm, 50cm and 40cm and stereopsis (seconds of arc) at 40cm. HCVA at 70cm, 50cm and 40cm were measured as "comfortable acuity" rather than conventional resolution acuity. Subjective measures comprised clarity-of-vision and ghosting at distance, intermediate and near, overall vision satisfaction and ocular comfort (1-10 numeric rating scale) and lens purchase (yes/no response). Statistical analysis included repeated measures ANOVA, paired t-tests and McNemar's test. RESULTS Significant differences between lens types were independent of strata (p≥0.119). EDOF was significantly better than AOMF for HCVA at 40cm (0.42±0.18 vs. 0.48±0.22, p=0.024), stereopsis (98±88 vs. 141±114, p<0.001), clarity-of-vision at intermediate (8.5±1.6 vs. 7.7±1.9, p=0.006) and near (7.3±2.5 vs. 6.2±2.5, p=0.005), lack-of-ghosting (p=0.012), overall vision satisfaction (7.5±1.7 vs. 6.4±2.2, p<0.001) and ocular comfort (9.0±1.0 vs. 8.3±1.7, p=0.002). Significantly more participants chose to only-purchase EDOF (33% vs. 6%, p=0.003).). There were no significant differences between lens types for any objective measure at 6m or clarity-of-vision at distance (p≥0.356). CONCLUSIONS EDOF provides better intermediate and near vision performance in presbyopes than AOMF with no difference for distance vision during short-term wear.
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Affiliation(s)
- Daniel Tilia
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia; School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Anna Munro
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia
| | - Jiyoon Chung
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia
| | - Jennifer Sha
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia
| | - Shona Delaney
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia
| | - Danny Kho
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia
| | - Varghese Thomas
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia
| | - Klaus Ehrmann
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia; School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Ravi Chandra Bakaraju
- The Brien Holden Vision Institute, Sydney, NSW 2052, Australia; School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW 2052, Australia.
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Pérez-Prados R, Piñero DP, Pérez-Cambrodí RJ, Madrid-Costa D. Soft multifocal simultaneous image contact lenses: a review. Clin Exp Optom 2016; 100:107-127. [PMID: 27800638 DOI: 10.1111/cxo.12488] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/27/2016] [Accepted: 06/12/2016] [Indexed: 11/30/2022] Open
Abstract
Soft multifocal simultaneous image contact lenses have boomed in recent years due to the growing number of presbyopic patients demanding visual solutions, allowing them to maintain their current standard of living. The concept of 'simultaneous image' is based on blur interpretation and/or blur tolerance of superimposed multiple images on the retina formed by various powers of a contact lens. This is the basis for a specific type of multifocal contact lens developed for the compensation of presbyopia. Manufacturers have released a great variety of soft simultaneous image lens designs to meet different patient needs but their fitting is still unsatisfactory in some cases. Some presbyopes discontinue wearing contact lenses due to some limitations in visual quality and comfort that can be overcome with an appropriate contact lens selection based on a comprehensive pre-fitting evaluation. This paper aims to review the different types of soft multifocal contact lenses that are currently available for presbyopic correction and to define the steps and factors crucial for their fitting, such as pupil, aberrations, accommodation and centring. A discussion about useful tools to achieve a customised fitting leading to a successful outcome, such as the defocus curve, power profile and questionnaires, is performed.
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Affiliation(s)
- Roque Pérez-Prados
- Centro Óptico Benalúa, Alicante, Spain.,Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology (Oftalmar), Medimar International Hospital, Alicante, Spain.,Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
| | - Rafael J Pérez-Cambrodí
- Department of Ophthalmology (Oftalmar), Medimar International Hospital, Alicante, Spain.,Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
| | - David Madrid-Costa
- Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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Sivardeen A, Laughton D, Wolffsohn JS. Investigating the utility of clinical assessments to predict success with presbyopic contact lens correction. Cont Lens Anterior Eye 2016; 39:322-30. [DOI: 10.1016/j.clae.2016.05.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 05/07/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
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Abstract
PURPOSE To assess the performance of four commercially available silicone hydrogel multifocal monthly contact lens designs against monovision. METHODS A double-masked randomized crossover trial of Air Optix Aqua multifocal, PureVision 2 for Presbyopia, Acuvue OASYS for Presbyopia, Biofinity multifocal, and monovision with Biofinity contact lenses was conducted on 35 presbyopes (54.3 ± 6.2 years). After 4 weeks of wear, visual performance was quantified by high- and low-contrast visual acuity under photopic and mesopic conditions, reading speed, defocus curves, stereopsis, halometry, aberrometry, Near Activity Visual Questionnaire rating, and subjective quality of vision scoring. Bulbar, limbal, and palpebral hyperemia and corneal staining were graded to monitor the impact of each contact lens on ocular physiology. RESULTS High-contrast photopic visual acuity (p = 0.102), reading speed (F = 1.082, p = 0.368), and aberrometry (F = 0.855, p = 0.493) were not significantly different between presbyopic lens options. Defocus curve profiles (p < 0.001), stereopsis (p < 0.001), halometry (F = 4.101, p = 0.004), Near Activity Visual Questionnaire (F = 3.730, p = 0.007), quality of vision (p = 0.002), bulbar hyperemia (p = 0.020), and palpebral hyperemia (p = 0.012) differed significantly between lens types, with the Biofinity multifocal lens design principal (center-distance lens was fitted to the dominant eye and a center-near lens to the nondominant eye) typically outperforming the other lenses. CONCLUSIONS Although ocular aberration variation between individuals largely masks the differences in optics between current multifocal contact lens designs, certain design strategies can outperform monovision, even in early presbyopes.
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Imbeau L, Majzoub S, Thillay A, Bonnet-Brilhault F, Pisella PJ, Batty M. Presbyopia compensation: looking for cortical predictors. Br J Ophthalmol 2016; 101:223-226. [PMID: 27107029 DOI: 10.1136/bjophthalmol-2015-307581] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 02/11/2016] [Accepted: 03/24/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS New surgical techniques have recently been developed in order to compensate for visual impairment and to improve visual comfort for patients with presbyopia. However, the results are still variable, depending on the correction modality used and/or the patient. The main purpose of this study was to identify predictive electrophysiological markers of postcorrection visual comfort for patients with presbyopia. METHODS Thirteen patients with presbyopia (aged between 45 and 60 years) received successive randomised presbyopia compensation with contact lenses supplying monovision (one eye corrected for distance, the other for near vision) and simultaneous vision (progressive lenses). The period for each type of correction lasted for 3 weeks, with a 2-week break without any presbyopia compensation between the two test phases. Examinations were performed at entry (T0) and after each correction modality (Tmono and Tsimult). They included testing for near and distance visual acuity, stereoacuity, binocular contrast sensitivity and electrophysiological recordings (monocular and binocular visual evoked potentials). RESULTS Follow-up showed no significant differences between the two compensation modalities for either clinical or electrophysiological criteria. However, a significant correlation was found between the difference in TNO score (monovision-simultaneous vision) and the P100 latency evoked by the binocular pattern at T0, suggesting that late P100 latency could be associated with a lesser degree of decrease in stereoacuity with monovision. CONCLUSIONS While our findings do not permit decisions regarding the superiority of one type of compensation over another, these preliminary results support using the P100 latency evoked by binocular patterns as a predictor of postcompensation stereoacuity. TRIAL REGISTRATION NUMBER NCT02444130, Pre-results.
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Affiliation(s)
- Léa Imbeau
- Service d'Ophtalmologie, Université François-Rabelais de Tours, CHRU de Tours, Tours, France
| | - Sadi Majzoub
- Service d'Ophtalmologie, Université François-Rabelais de Tours, CHRU de Tours, Tours, France
| | - Alix Thillay
- Université François-Rabelais de Tours, INSERM, Imagerie et Cerveau UMR U 930, CHRU de Tours, Centre Universitaire de PédoPsychiatrie, Tours, France
| | - Frederique Bonnet-Brilhault
- Université François-Rabelais de Tours, INSERM, Imagerie et Cerveau UMR U 930, CHRU de Tours, Centre Universitaire de PédoPsychiatrie, Tours, France
| | - Pierre-Jean Pisella
- Service d'Ophtalmologie, Université François-Rabelais de Tours, CHRU de Tours, Tours, France
| | - Magali Batty
- Université François-Rabelais de Tours, INSERM, Imagerie et Cerveau UMR U 930, CHRU de Tours, Centre Universitaire de PédoPsychiatrie, Tours, France
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Visual Performance of a Multifocal Contact Lens versus Monovision in Established Presbyopes. Optom Vis Sci 2015; 92:175-82. [PMID: 25525891 DOI: 10.1097/opx.0000000000000476] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To compare subjective and objective visual performance of the Air Optix Aqua Multifocal lens to monovision in a group of subjects requiring a medium level of reading-addition power. METHODS Fifty participants with reading additions between 1.25 and 2.00 diopters (inclusive) were randomized into a prospective, crossover clinical trial. They wore monovision and multifocals for 2 weeks in a randomized order. High- and low-contrast logMAR (logarithm of the minimum angle of resolution) acuity and stereopsis were measured at the beginning and end of each period. During each phase, participants performed specific tasks followed by subjective rating surveys and also completed satisfaction rating surveys on days 3, 7, and 12; all were transferred in real time using BlackBerry smartphones. A general rating survey was completed at the dispensing and 2-week visits. RESULTS Forty-nine participants completed the study (mean age, 52 years). Distance and near high- and low-contrast acuities were significantly better (p < 0.05) with monovision at all visits. High-contrast intermediate acuity was only better (p < 0.05) with multifocals after 2 weeks. Stereopsis was equivalent after 2 weeks, but better (p < 0.05) with multifocals at dispensing. Subjective ratings were generally equivalent between modalities although there was a trend for multifocals to be rated higher for focus changing and driving, whereas monovision tended to be rated higher for near tasks. For both corrections, the satisfaction survey showed no significant change between days 3, 7, and 12, and the general survey showed that comfort was maintained but subjective vision ratings decreased significantly over the 2 weeks. Twenty-five participants (51%) preferred multifocals, 18 (37%) preferred monovision, and the remaining 6 (12%) declared both unacceptable. CONCLUSIONS In this cohort, distance and near acuities were better with monovision, whereas the subjective ratings tended to favor the Air Optix Aqua Multifocal, with the exception of near performance. Preference was statistically similar between both corrections, with a trend toward preferring the multifocal.
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Gil-Cazorla R, Shah S, Naroo SA. A review of the surgical options for the correction of presbyopia. Br J Ophthalmol 2015; 100:62-70. [PMID: 25908836 DOI: 10.1136/bjophthalmol-2015-306663] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/04/2015] [Indexed: 11/03/2022]
Abstract
Presbyopia is an age-related eye condition where one of the signs is the reduction in the amplitude of accommodation, resulting in the loss of ability to change the eye's focus from far to near. It is the most common age-related ailments affecting everyone around their mid-40s. Methods for the correction of presbyopia include contact lens and spectacle options but the surgical correction of presbyopia still remains a significant challenge for refractive surgeons. Surgical strategies for dealing with presbyopia may be extraocular (corneal or scleral) or intraocular (removal and replacement of the crystalline lens or some type of treatment on the crystalline lens itself). There are however a number of limitations and considerations that have limited the widespread acceptance of surgical correction of presbyopia. Each surgical strategy presents its own unique set of advantages and disadvantages. For example, lens removal and replacement with an intraocular lens may not be preferable in a young patient with presbyopia without a refractive error. Similarly treatment on the crystalline lens may not be a suitable choice for a patient with early signs of cataract. This article is a review of the options available and those that are in development stages and are likely to be available in the near future for the surgical correction of presbyopia.
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Affiliation(s)
- Raquel Gil-Cazorla
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK Midland Eye, Solihull, UK
| | - Sunil Shah
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK Midland Eye, Solihull, UK Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK
| | - Shehzad A Naroo
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK
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Optical power distribution of refractive and aspheric multifocal contact lenses: Effect of pupil size. Cont Lens Anterior Eye 2015; 38:317-21. [PMID: 25899637 DOI: 10.1016/j.clae.2015.03.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 03/16/2015] [Accepted: 03/23/2015] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate the power profile within the optic zone of different designs of multifocal contact lenses (CLs) and to analyze how the effect of pupil size could impact on their optical performance. METHODS The optical power distribution within the optic zones of multifocal CLs was measured by the Nimo TR1504 (LAMBDA-X, Belgium). The multifocal CLs under study were the Acuvue Bifocal, the Acuvue Oasys for Presbyopia, the PureVision Multifocal and the PureVision 2 for Presbyopia. Each design was considered in all their available addition powers. All lenses had a nominal power of -3.0D. At the same time, three lenses of each model were considered and five consecutive readings of each lens were performed. RESULTS The results show that the PureVision Multifocal and the PureVision 2 for Presbyopia have aspheric power profiles. Both designs showed aspheric center-near designs with a smoother progression of the optical power in the PureVision 2 for Presbyopia. The Acuvue Bifocal and the Acuvue Oasys for Presbyopia are shown to have concentric alternating near and far zones. Apart from the refractive rings, the Acuvue Oasys for Presbyopia showed an increase in negative (or less positive) values toward the periphery of the lens. CONCLUSIONS Besides the refraction, the knowledge of the power profiles of multifocal CLs and the effect of pupil size on the optical distribution of these lenses could be crucial to understand the performance of these designs when they are fitted.
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Thite N, Shah U, Mehta J, Jurkus J. Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India. JOURNAL OF OPTOMETRY 2015; 8:56-61. [PMID: 25563404 PMCID: PMC4314618 DOI: 10.1016/j.optom.2014.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/30/2014] [Accepted: 11/26/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). METHOD Two focus group discussions were conducted to design questionnaires regarding the prescribing habits for multifocal contact lenses (MFCL). Questions on potential barriers and motivators were included. The questionnaires were distributed among 133 eye care practitioners across Mumbai, India. Practitioners fitting one or less patient per month with MFCL completed the survey describing potential barriers, while those who prescribed more MFCL's per month completed the survey describing enablers and motivators. RESULTS Responses from 102 practitioners were received. Most common potential barriers in prescribing MFCL were increased chair time (75%), lack of readily available trials (69%) and limitation in power range (63%). Lack of awareness among patients (90%) was the most common barrier from patients' outlook. Professional satisfaction (88%) and better business proposition (82%) were observed as main motivators while availability of the trials (84%) and correct patient selection (82%) were the major enablers. Graduate Optometrists felt dispensing MFCL did not offer a good business proposition (p=0.02). Experienced practitioners were observed to be least motivated (p=0.01) and believed that their patients found these lenses expensive (p=0.02). CONCLUSION To enhance the MFCL practice, barriers like lack of awareness and limitations in power range must be addressed. Trial lens availability may motivate practitioners to prescribe MFCL. Further probing is required to understand lack of motivation among experienced practitioners.
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Affiliation(s)
- Nilesh Thite
- International Association of Contact Lens Educators, Pune, Maharashtra, India
| | - Ukti Shah
- Dr. Doongerwala's Clinic, Mumbai, Maharashtra, India.
| | | | - Janice Jurkus
- Illinois College of Optometry, International Association of Contact Lens Educators, Chicago, IL, USA
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50
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García-Lázaro S, Ferrer-Blasco T, Madrid-Costa D, Albarrán-Diego C, Montés-Micó R. Visual Performance of Four Simultaneous-Image Multifocal Contact Lenses Under Dim and Glare Conditions. Eye Contact Lens 2015; 41:19-24. [DOI: 10.1097/icl.0000000000000060] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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