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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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2
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Qiu D, Liao Y, Wang Y, Liu K, Jin C, Du F. Impact of Refractive Status on Presbyopia Progression among Patients with Presbyopia. Graefes Arch Clin Exp Ophthalmol 2024; 262:2695-2701. [PMID: 38512509 DOI: 10.1007/s00417-024-06455-4] [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: 07/18/2023] [Revised: 03/03/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE To explore the impact of refractive status on presbyopia progression among patients with presbyopia. METHODS This retrospective observational study included patients with presbyopia who visited the Seventh Affiliated Hospital of Sun Yat-sen University and Shenzhen Polytechnic Medical College between May 2018 and August 2022. The amplitude of accommodation (AMP) and near addition power (ADD) at 6 months and 1 year were collected. RESULTS A total of 103 patients with presbyopia were included in this study: 42 patients with myopia, 23 patients with emmetropia, and 38 patients with hyperopia. There were significant differences in ΔAMP(6-month) and ΔADD(6-month) among patients with different refractive statuses, and the values of emmetropic patients and hyperopic patients were higher than in myopic patients (all P < 0.001). The ΔAMP(1-year) and ΔADD(1-year) of hyperopic patients were significantly higher than in emmetropic patients and myopic patients (all P < 0.001). The ΔADD(1-year) of emmetropic patients was greater than in myopic patients (P = 0.045), but there were no significant differences in ΔAMP(1-year) between patients with emmetropia and myopia (P = 0.090). CONCLUSIONS The progression of presbyopia in hyperopic patients was relatively more significant than for emmetropia, followed by myopia. The prescription of presbyopia glasses might need to be replaced more frequently in patients with hyperopia.
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Affiliation(s)
- Dongrong Qiu
- Optometry Technology Major, College of Medical Technology and Nursing, Shenzhen Polytechnic University, Shenzhen, 518000, China
| | - Youfen Liao
- Department of Ophthalmology, The Eighth Affiliated Hospital Sun Yat-Sen University, Shenzhen, 518000, China
| | - Ying Wang
- Optometry Technology Major, College of Medical Technology and Nursing, Shenzhen Polytechnic University, Shenzhen, 518000, China
| | - Keyou Liu
- Optometry Technology Major, College of Medical Technology and Nursing, Shenzhen Polytechnic University, Shenzhen, 518000, China
| | - Chenhui Jin
- Optometry Technology Major, College of Medical Technology and Nursing, Shenzhen Polytechnic University, Shenzhen, 518000, China
| | - Fangfang Du
- Department of Ophthalmology, The Seventh Affiliated Hospital Sun Yat-Sen University, Shenzhen, 518000, China.
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3
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Guthrie SE, Luensmann D, Woods J, Vega J, Orsborn G. Relationships Between Success Factors in Daily Disposable Multifocal Contact Lenses. CLINICAL OPTOMETRY 2024; 16:157-167. [PMID: 39050806 PMCID: PMC11268754 DOI: 10.2147/opto.s462723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024]
Abstract
Purpose To explore links between subjective comfort and vision in habitual multifocal soft contact lens (MFCL) wearers when refit with daily disposable MFCLs, to determine which factors are relevant for success with MFCLs and evaluate consistency between MFCLs of different designs. Patients and Methods This work examined subjective measures in a randomised, participant masked, bilateral wear crossover study at five optometry practices. Fifty-eight habitual MFCL wearers wore stenfilcon A multifocal (stenA-MF; CooperVision Inc) and delefilcon A multifocal (delA-MF; Alcon) for two-weeks. Subjective ratings included satisfaction with comfort and vision and agreement questions. Results Agreement with "I would like to wear this MFCL in the future" was taken to indicate success with each MFCL; agreement was significantly higher with stenA-MF. There was strong correlation between agreement responses for "I would like to wear this MFCL in the future" and "MFCL met my needs for vision" with both lenses (p<0.01). However, it was only with stenA-MF, which had higher agreement responses to both statements (p<0.05), that responses to these two statements correlated with satisfaction with end-of-day (EOD) comfort (p<0.01). These differences in correlations between the two lenses are seemingly driven by greater satisfaction with stenA-MF for near and intermediate vision (p<0.05). Conclusion Subjective vision and comfort were only correlated when vision met the needs of most participants. Meeting participants' needs for vision correlated strongly with wanting to wear a MFCL. Results indicate that meeting vision needs is more important than meeting comfort needs when influencing whether presbyopic patients continue wearing MFCLs.
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Affiliation(s)
- Sarah E Guthrie
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Doerte Luensmann
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Jose Vega
- CooperVision Incorporated, San Ramon, CA, USA
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Smith SL, Maldonado-Codina C, Morgan PB, Read ML. Gaze and behavioural metrics in the refractive correction of presbyopia. Ophthalmic Physiol Opt 2024; 44:774-786. [PMID: 38578134 DOI: 10.1111/opo.13310] [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: 11/15/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE To investigate gaze and behavioural metrics at different viewing distances with multifocal contact lenses (MFCLs), single vision contact lenses (SVCLs) and progressive addition lenses (PALs). METHODS Fifteen presbyopic contact lens wearers participated over five separate study visits. At each visit, participants were randomly assigned to wear one of five refractive corrections: habitual PAL spectacles, delefilcon A (Alcon Inc.) MFCLs and three separate pairs of delefilcon A single vision lenses worn as distance, intermediate and near corrections. Participants wore a Pupil Core headset to record eye and head movements while performing three visual tasks: reading, visual search and scene observation. Data were investigated using linear regression and post-hoc testing. Parameters of interest included gaze (fixation duration, head movement) and behavioural (reading speed, reading accuracy, visual search time) metrics. RESULTS Reading speed in SVCLs was significantly faster than in MFCLs and PAL spectacles (F = 16.3, p < 0.0001). Refractive correction worn did not influence visual search times (F = 0.16, p = 0.85). Fixation duration was significantly affected by the type of visual task (F = 60.2, p < 0.001), and an interaction effect was observed between viewing distance and refractive correction (F = 4.3, p = 0.002). There was significantly more horizontal and vertical head movement (F = 3.2, p = 0.01 and F = 3.3, p = 0.01, respectively) during visual search tasks when wearing PAL spectacles compared to SVCLs or MFCLs. CONCLUSION This work showed that the type of refractive correction affects behavioural metrics such as reading speed and gaze behaviour by affecting horizontal and vertical head movements. The findings of this study suggest that under certain conditions, wearers of MFCLs make fewer head movements compared to PAL spectacles. Gaze behaviour metrics offer a new approach to compare and understand contact lens and spectacle performance, with potential applications including peripheral optical designs for myopia management.
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Affiliation(s)
- Sarah L Smith
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Michael L Read
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Zeri F, Di Vizio A, Lucia S, Berchicci M, Bianco V, Pitzalis S, Tavazzi S, Naroo SA, Di Russo F. Cortical dynamics in visual areas induced by the first use of multifocal contact lenses in presbyopes. Cont Lens Anterior Eye 2024; 47:102137. [PMID: 38485618 DOI: 10.1016/j.clae.2024.102137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/19/2024] [Accepted: 03/06/2024] [Indexed: 05/20/2024]
Abstract
A common non-spectacle strategy to correct presbyopia is to provide simultaneous images with multifocal optical designs. Understanding the neuroadaptation mechanisms behind multifocal devices usage would have important clinical implications, such as predicting whether patients will be able to tolerate multifocal optics. The aim of this study was to evaluate the brain correlates during the initial wear of multifocal contact lenses (CLs) using high-density visual evoked potential (VEP) measures. Fifteen presbyopes (mean age 51.8 ± 2.6 years) who had previously not used multifocal CLs were enrolled. VEP measures were achieved while participants looked at arrays of 0.5 logMAR Sloan letters in three different optical conditions arranged with CLs: monofocal condition with the optical power appropriate for the distance viewing; multifocal correction with medium addition; and multifocal correction with low addition. An ANOVA for repeated measures showed that the amplitude of the C1 and N1 components significantly dropped with both multifocal low and medium addition CL conditions compared to monofocal CLs. The P1 and P2 components showed opposite behavior with an increase in amplitudes for multifocal compared to monofocal conditions. VEP data indicated that multifocal presbyopia corrections produce a loss of feedforward activity in the primary visual cortex that is compensated by extra feedback activity in extrastriate areas only, in both early and late visual processing.
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Affiliation(s)
- Fabrizio Zeri
- Department of Materials Science. University of Milano-Bicocca, Milan, Italy; COMiB Research Centre in Optics and Optometry. University of Milano-Bicocca, Milan, Italy; College of Health and Life Sciences. Aston University, Birmingham, UK.
| | - Assunta Di Vizio
- COMiB Research Centre in Optics and Optometry. University of Milano-Bicocca, Milan, Italy; Department of Science, Roma Tre University, Rome, Italy
| | - Stefania Lucia
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Marika Berchicci
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy; Department of Psychological, Humanistic and Territorial Sciences, University "G. d'Annunzio", Chieti-Pescara, Italy
| | - Valentina Bianco
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sabrina Pitzalis
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy; IRCCS Santa Lucia Foundation Rome, Italy
| | - Silvia Tavazzi
- Department of Materials Science. University of Milano-Bicocca, Milan, Italy; COMiB Research Centre in Optics and Optometry. University of Milano-Bicocca, Milan, Italy
| | - Shehzad A Naroo
- College of Health and Life Sciences. Aston University, Birmingham, UK
| | - 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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Onyszkiewicz M, Hilmers J, Rejdak R, Zrenner E, Straßer T. Effects of Miosis on the Visual Acuity Space under Varying Conditions of Contrast and Ambient Luminance in Presbyopia. J Clin Med 2024; 13:1209. [PMID: 38592033 PMCID: PMC10931829 DOI: 10.3390/jcm13051209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye's ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal or lens based), and, more recently, the FDA-approved topical administration of 1.25% pilocarpine. While prior research has demonstrated the efficacy of daily pilocarpine eye drop application in enhancing near visual acuity by increasing the depth of focus leveraging the pinhole effect, limited knowledge exists regarding its influence on visual acuity under varying conditions of contrast and ambient luminance. Methods: This study aims to investigate the impact of these variables on visual acuity, employing the VA-CAL test, among 11 emmetropic and 11 presbyopic volunteers who reported subjective difficulties with near vision. This study includes evaluations under natural conditions with a pinhole occluder (diameter of 2 mm), and subsequent administration of 1% pilocarpine (Pilomann, Bausch + Lomb, Laval, Canada). Results: The VA-CAL results demonstrate the expected, statistically significant effects of contrast and ambient luminance on visual acuity in both emmetropic and presbyopic volunteers. Furthermore, in emmetropic individuals, the application of pilocarpine resulted in a statistically significant reduction in visual acuity. In contrast, presbyopes did not exhibit statistically significant differences in the visual acuity space under either the pinhole or pilocarpine conditions when compared to natural conditions. Conclusions: The pharmacological treatment of presbyopia with pilocarpine eye drops, intended to enhance near vision, does not adversely affect visual acuity in presbyopes. This suggests that pilocarpine may offer a viable alternative for individuals averse to wearing corrective eyewear.
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Affiliation(s)
- Maksymilian Onyszkiewicz
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany; (M.O.); (E.Z.)
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Julian Hilmers
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany; (M.O.); (E.Z.)
- STZ Eyetrial, University Eye Hospital Tuebingen, 72076 Tuebingen, Germany;
| | - Robert Rejdak
- STZ Eyetrial, University Eye Hospital Tuebingen, 72076 Tuebingen, Germany;
| | - Eberhart Zrenner
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany; (M.O.); (E.Z.)
- University Eye Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Torsten Straßer
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany; (M.O.); (E.Z.)
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland
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Sauer Y, Künstle DE, Wichmann FA, Wahl S. An objective measurement approach to quantify the perceived distortions of spectacle lenses. Sci Rep 2024; 14:3967. [PMID: 38368485 PMCID: PMC10874444 DOI: 10.1038/s41598-024-54368-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/12/2024] [Indexed: 02/19/2024] Open
Abstract
The eye's natural aging influences our ability to focus on close objects. Without optical correction, all adults will suffer from blurry close vision starting in their 40s. In effect, different optical corrections are necessary for near and far vision. Current state-of-the-art glasses offer a gradual change of correction across the field of view for any distance-using Progressive Addition Lenses (PALs). However, an inevitable side effect of PALs is geometric distortion, which causes the swim effect, a phenomenon of unstable perception of the environment leading to discomfort for many wearers. Unfortunately, little is known about the relationship between lens distortions and their perceptual effects, that is, between the complex physical distortions on the one hand and their subjective severity on the other. We show that perceived distortion can be measured as a psychophysical scaling function using a VR experiment with accurately simulated PAL distortions. Despite the multi-dimensional space of physical distortions, the measured perception is well represented as a 1D scaling function; distortions are perceived less with negative far correction, suggesting an advantage for short-sighted people. Beyond that, our results successfully demonstrate that psychophysical scaling with ordinal embedding methods can investigate complex perceptual phenomena like lens distortions that affect geometry, stereo, and motion perception. Our approach provides a new perspective on lens design based on modeling visual processing that could be applied beyond distortions. We anticipate that future PAL designs could be improved using our method to minimize subjectively discomforting distortions rather than merely optimizing physical parameters.
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Affiliation(s)
- Yannick Sauer
- University of Tübingen, Tübingen, Germany.
- Carl Zeiss Vision International GmbH, Aalen, Germany.
| | - David-Elias Künstle
- University of Tübingen, Tübingen, Germany.
- Tübingen AI Center, Tübingen, Germany.
| | | | - Siegfried Wahl
- University of Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Aalen, Germany
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Privado-Aroco A, Valdes-Soria G, Romaguera M, Serramito M, Carracedo G. Visual Quality Assessment and Comparison of Monofocal and Multifocal Scleral Lens Designs: A Pilot Study. Eye Contact Lens 2024; 50:35-40. [PMID: 38124285 DOI: 10.1097/icl.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To compare visual quality, contrast sensitivity, stereopsis, subjective vision, and comfort between monofocal and multifocal scleral lens (SL) designs. METHODS An experimental, cross over and short-term pilot study has been performed. Nineteen presbyopic patients (51.9±3.8 years) with regular corneas participated voluntarily in the study and Onefit MED monofocal and multifocal SL designs were fitted bilaterally. Subjective vision and comfort, contrast sensitivity function, stereopsis, high- and low-contrast visual acuity (VA) at 4 m and 40 cm under photopic and mesopic conditions, and defocus curves were measured. Data analysis was performed with nonparametric tests. P<0.05 was considered as statistically significant. RESULTS Mean addition power of the prescribed lenses was 1.72±0.38 diopters. Multifocal design showed a statistically significant improvement for intermediate and near vision in the defocus curve under photopic and mesopic conditions (P<0.05), however, worsening in stereopsis (P<0.05) and contrast sensitivity for high spatial frequencies (P<0.05). Distance visual acuity (VA) showed significantly lower values under mesopic conditions for high- and low-contrast tests (P<0.05), and on low-contrast test under photopic conditions (P<0.001) with the multifocal design. CONCLUSION Multifocal SLs showed better visual performance at intermediate and near distances without compromising distance vision under photopic conditions for a high-contrast test when compared with monofocal design.
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Affiliation(s)
- Ana Privado-Aroco
- Department of Optometry and Vision (A.P.-A., G.V.-S., M.R., M.S., G.C.), Faculty of Optics and Optometry, Complutense University of Madrid, Spain; and Ocupharm Research Group (A.P.-A., G.V.-S., M.R., M.S., G.C.), Faculty of Optics and Optometry, Complutense University of Madrid, Spain
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Garcia-Porta N, Gómez-Varela AI, Arines-Piferrer J. Visual performance of new affordable and auto-adherent lenses for presbyopia correction. Ophthalmic Physiol Opt 2024; 44:78-82. [PMID: 37888774 DOI: 10.1111/opo.13241] [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: 07/28/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023]
Abstract
Presbyopia is a visual condition that affects all of us, evolving with time, reducing the range of accommodation and the ability to work at near. Reading glasses, bifocals or multifocal lenses are the most common solutions. In this work, we demonstrate the near visual performance of new elastomeric auto-adherent lenses developed for the correction of presbyopia. Visual acuity and contrast sensitivity were measured in 10 presbyopic subjects. The results showed that wearing either conventional trial ophthalmic lenses or the new elastomeric lenses provided similar visual quality. These elastomeric lenses can be placed in, or removed from the distance-vision spectacles of the wearers, providing an affordable solution for correcting presbyopia at its clinical onset, which might be especially useful in subjects with different refractive error in each eye and for those with astigmatism.
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Affiliation(s)
- Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Santiago, Spain
- Institute of Materials (iMATUS) of the University of Santiago de Compostela, Santiago, Spain
| | - Ana I Gómez-Varela
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Santiago, Spain
- Institute of Materials (iMATUS) of the University of Santiago de Compostela, Santiago, Spain
| | - Justo Arines-Piferrer
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Santiago, Spain
- Institute of Materials (iMATUS) of the University of Santiago de Compostela, Santiago, Spain
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10
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Garcia Espinilla O, Sanchez I, Martin R. Intrasession repeatability and agreement of a new method to measure the foveal fixation axis. PeerJ 2023; 11:e14942. [PMID: 36860763 PMCID: PMC9969851 DOI: 10.7717/peerj.14942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/01/2023] [Indexed: 02/26/2023] Open
Abstract
Purpose Ophthalmic lens adaptation, particularly with progressive addition lenses, requires accurate measurements of the patient nasopupillary distance (NPD) and interpupillary distance (IPD), which are usually collected using the pupil centre as a reference. However, differences between the pupil centre and visual or foveal axis could induce some subsidiary effects of correcting lenses. This study aimed to assess the intrasession repeatability of a new prototype (Ergofocus®; Lentitech, Barakaldo, Spain) that can measure the foveal fixation axis (FFA) distance and assess the agreement with the NPD measurements collected using a traditional method (frame ruler). Methods The FFA at far and near distances was measured three consecutive times in 39 healthy volunteers to determine the intrasession repeatability according to the British Standards Institute and International Organization for Standardization. Additionally, the FFA and NPD (standard frame ruler) were measured in 71 healthy volunteers and compared using Bland-Altman analysis. Two blinded experienced practitioners conducted each FFA and NPD measurement. Results The FFA measurements showed acceptable repeatability at far distances (right eye (RE): Sw = 1.16 ± 0.76 mm and coefficient of variation (CV) = 3.92 ± 2.51%; left eye (LE) Sw = 1.11 ± 0.79 mm and CV = 3.76 ± 2.51%) and at near distances (RE: Sw = 0.97 ± 0.85 mm and CV = 3.52 ± 3.02%; LE: Sw = 1.17 ± 0.96 mm and CV = 4.54 ± 3.72%). Additionally, agreement with the NPD showed large differences at far distances (RE: -2.15 ± 2.34, LoA = -6.73 to 2.43 mm (P < 0.001); LE: -0.61 ± 2.62, LoA = -5.75 to 4.53 mm (P = 0.052)) and near distances (RE: -3.08 ± 2.80, LoA -8.57 to 2.42 mm (P < 0.001); LE: -2.97 ± 3.97, LoA: -10.75 to 4.80 mm (P < 0.001)). Conclusions FFA measurements showed clinically acceptable repeatability at both far and near distances. Agreement with the NPD measured using a standard frame ruler showed significant differences, suggesting that both measurements are not interchangeable in clinical practice to prescribe and center ophthalmic lenses. Further research is necessary to assess the impact of FFA measurement in ophthalmic lens prescriptions.
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Affiliation(s)
- Oscar Garcia Espinilla
- Optometry Research Group, IOBA Eye Institute, School of Optometry, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain
| | - Irene Sanchez
- Optometry Research Group, IOBA Eye Institute, School of Optometry, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain
| | - Raul Martin
- Optometry Research Group, IOBA Eye Institute, School of Optometry, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Castilla y Leon, Spain,Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Castilla y Leon, Spain
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Rizzo GC, Di Vizio A, Versaci F, Przekoracka K, Tavazzi S, Zeri F. Centration assessment of an extended depth of focus contact lens for myopic progression control. Cont Lens Anterior Eye 2023; 46:101533. [PMID: 34753686 DOI: 10.1016/j.clae.2021.101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/24/2021] [Accepted: 10/21/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE To evaluate the accuracy and the inter and intra-observer reliability of the centration assessment of extended depth of focus (EDOF) contact lenses (CL) using corneal topography. METHOD EDOF soft CLs (Mylo, Mark'Ennovy) were fitted on thirty-three myopic students (25 females), aged 19-28 years (22.7 ± 2.0 years). For any EDOF CL, a topography over the CL and a slit lamp (SL) digital picture were taken in random order. For the topographic images, the position of the EDOF CL centre, with respect to the pupil centre, was detected by two different practitioners (one newly graduated and one with more than 20 years of clinical experience respectively) and repeated after 15 days. This measurement was compared to the one taken through the SL, considered as the gold standard, and assessed using the instrument software. RESULTS EDOF CLs resulted decentred inferiorly and temporally ranging, in the case of slit lamp assessment, between -0.27 ± 0.19 and 0.22 ± 0.23 mm horizontally and between -0.12 ± 0.31 and -0.17 ± 0.34 mm vertically, for the right and left eye respectively. The accuracy of the topographic assessment in determining EDOF CL centration was found to be very good compared to the SL assessment. No differences were found for the left eye, whereas in the right eye, a less temporally decentred position of the CL was detected by the topographical method (p < 0.05). However, this difference appeared clinically negligible (0.14 ± 0.22 mm). Inter-observer reliability (the differences between the two practitioners in assessing the EDOF centre) resulted significant only for the vertical coordinates of the centre position (p < 0.05). Concerning intra-observer reliability, better coefficient of precision and reliability between measurements within the same session were achieved by the more experienced practitioner, as well as a better level of the intraclass correlation coefficient in test-retest. CONCLUSION The centration of the EDOF CL investigated in this study can be accurately detected by a corneal topography performed over CLs. Inter-observer reliability resulted good whereas the intra-observer reliability resulted partially affected by the level of clinical experience of the practitioner.
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Affiliation(s)
- Giulia Carlotta Rizzo
- University of Milano-Bicocca, Department of Materials Science, Milan, Italy; University of Milano-Bicocca, COMiB Research Centre in Optics and Optometry, Milan, Italy
| | - Assunta Di Vizio
- Degree Course in Optics and Optometry, Department of Sciences. Roma TRE University, Rome, Italy
| | - Francesco Versaci
- R&D Department, Costruzione Strumenti Oftalmici (CSO), Florence, Italy
| | - Katarzyna Przekoracka
- Laboratory of Bionics and Experimental Medical Biology, Department of Bionics and Bioimpendance, University of Medical Sciences, Poznań, Poland; Laboratory of Vision Science and Optometry, Faculty of Physics, Adam Mickiewicz University, Poznań, Poland
| | - Silvia Tavazzi
- University of Milano-Bicocca, Department of Materials Science, Milan, Italy; University of Milano-Bicocca, COMiB Research Centre in Optics and Optometry, Milan, Italy
| | - Fabrizio Zeri
- University of Milano-Bicocca, Department of Materials Science, Milan, Italy; University of Milano-Bicocca, COMiB Research Centre in Optics and Optometry, Milan, Italy; College of Health and Life Sciences, Aston University, Birmingham, UK.
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Findley A, Sharma G, Bentley S, Arbuckle R, Patalano F, Naujoks C, Kommineni J, Tyagi N, Lehane A, Wolffsohn JS, Chiva-Razavi S. Comparison of Literature Review, Social Media Listening, and Qualitative Interview Research Methods in Generating Patient-Reported Symptom and Functional Impact Concepts of Presbyopia. Ophthalmol Ther 2023; 12:501-516. [PMID: 36502495 PMCID: PMC9834465 DOI: 10.1007/s40123-022-00620-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION To compare the insights obtained about the experience of individuals with presbyopia (age-related impaired near vision) across three different sources of qualitative data: a structured targeted literature review, a social media listening (SML) review, and qualitative concept elicitation (CE) interviews with individuals with presbyopia and healthcare professionals (HCPs). The number of concepts identified, depth of data, cost and time implications, and value of the patient insights generated were explored and compared for each method. METHODS Keyword searches in bibliographic databases and review of abstracts identified 120 relevant publications; in-depth targeted literature review of the qualitative studies identified key symptoms/functioning concepts. SML was conducted using publicly accessible social media sources with focus on ophthalmologic diseases using a pre-defined search string. Relevant posts from individuals with presbyopia (n = 270) were analysed and key concepts identified. Semi-structured CE interviews were conducted with individuals with presbyopia (US n = 30, Germany n = 10, France n = 10), and HCPs (US = 3, France n = 2, Germany n = 1, Japan n = 1) who were experienced in treating presbyopia. Verbatim transcripts were coded using thematic analysis. A conceptual model summarised concepts identified across sources RESULTS: Out of the total of 158 concepts identified across the three sources, qualitative CE interviews yielded the highest number of concepts (n = 151/158, 96%), with SML yielding a third of the concepts (n = 51/158, 32%) and the literature review yielding the fewest concepts (n = 33/158, 21%). Qualitative CE interviews provided greater depth of data than SML and literature reviews. SML and literature reviews were less costly and quicker to run than qualitative CE interviews and also were less burdensome for participants. CONCLUSION Qualitative CE interviews are considered the gold standard in providing greater depth of understanding of the patient experience, and more robust data. However, research requirements, budget, and available time should be considered when choosing the most appropriate research method. More time and cost-effective SML and literature review methods can be used to supplement qualitative CE interview data and provide early identification of measurement concepts. More research and regulatory guidance into less traditional qualitative methods, however, are needed to increase the value of SML and literature review data.
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Affiliation(s)
- Amy Findley
- Adelphi Values Patient-Centered Outcomes, Bollington, Cheshire, UK.
| | - Garima Sharma
- Novartis Business Services (NBS) CONEXTS, Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - Sarah Bentley
- Adelphi Values Patient-Centered Outcomes, Bollington, Cheshire, UK
| | - Rob Arbuckle
- Adelphi Values Patient-Centered Outcomes, Bollington, Cheshire, UK
| | | | | | - Jyothi Kommineni
- Novartis Business Services (NBS) CONEXTS, Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - Nishith Tyagi
- Novartis Business Services (NBS) CONEXTS, Novartis Healthcare Pvt. Ltd., Hyderabad, India
| | - Asha Lehane
- Adelphi Values Patient-Centered Outcomes, Bollington, Cheshire, UK
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Agarwala R, Lukashova Sanz O, Seitz IP, Reichel FF, Wahl S. Evaluation of a liquid membrane-based tunable lens and a solid-state LIDAR camera feedback system for presbyopia. BIOMEDICAL OPTICS EXPRESS 2022; 13:5849-5859. [PMID: 36733729 PMCID: PMC9872906 DOI: 10.1364/boe.471190] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 05/30/2023]
Abstract
Presbyopia is an age-related loss of accommodation ability of the eye which affects individuals in their late 40s or early 50s. Presbyopia reduces the ability of a person to focus on closer objects at will. In this study, we assessed electronically tunable lenses for their aberration properties as well as for their use as correction lenses. The tunable lenses were evaluated in healthy subjects with cycloplegia by measuring visual acuity and contrast sensitivity for their use in presbyopia correction. Furthermore, we have developed and demonstrated the feasibility of a feedback mechanism for the operation of tunable lenses using a portable solid-state LIDAR camera with a processing time of 40 ± 5 ms.
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Affiliation(s)
- Rajat Agarwala
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, Tuebingen, 72076, Germany
| | - Olga Lukashova Sanz
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, Tuebingen, 72076, Germany
- Carl Zeiss Vision International GmbH, Turnstr. 27, Aalen, 73430, Germany
| | - Immanuel P. Seitz
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, Tuebingen, 72076, Germany
- Carl Zeiss Vision International GmbH, Turnstr. 27, Aalen, 73430, Germany
| | - Felix F. Reichel
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, Tuebingen, 72076, Germany
- University Eye Hospital, Centre for Ophthalmology, University Hospital Tübingen, Tübingen, Germany
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University of Tuebingen, Elfriede-Aulhorn-Str. 7, Tuebingen, 72076, Germany
- Carl Zeiss Vision International GmbH, Turnstr. 27, Aalen, 73430, Germany
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14
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Ma Q, Chen M, Li D, Zhou R, Du Y, Yin S, Chen B, Wang H, Jiang J, Guan Z, Qiu K. Potential productivity loss from uncorrected and under-corrected presbyopia in low- and middle-income countries: A life table modeling study. Front Public Health 2022; 10:983423. [PMID: 36304252 PMCID: PMC9592832 DOI: 10.3389/fpubh.2022.983423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/23/2022] [Indexed: 01/25/2023] Open
Abstract
Objective To estimate the burden of potential productivity losses due to uncorrected and under-corrected presbyopia in LMICs among the working-age population in both the cross-sectional and longitudinal manner. Methods We extracted data for the prevalence of presbyopia from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019. Data for the gross domestic product (GDP) per capita were extracted from the World Bank database and Central Intelligence Agency's World Factbook. We introduced life table models to construct age cohorts (in 5-year age groups) of the working-age population (aged from 40 to 64 years old) in LMICs, with simulated follow-up until 65 years old in people with and without uncorrected presbyopia. The differences in productivity-adjusted life years (PALYs) lived and productivity between these two cohorts were calculated. The potential productivity loss was estimated based on GDP per capita. The WHO standard 3% annual discount rate was applied to all years of life and PALYs lived. Results In 2019, there were 238.40 million (95% confidence interval [CI]: 150.92-346.78 million) uncorrected and under-corrected presbyopia cases in LMICs, resulting in 54.13 billion (current US dollars) (95% confidence interval [CI]: 34.34-79.02 billion) potential productivity losses. With simulated follow-up until retirement, those with uncorrected and under-corrected presbyopia were predicted to experience an additional loss of 155 million PALYs (an average loss of 0.7 PALYs per case), which was equivalent to a total loss of US$ 315 billion (an average loss of US$ 1453.72 per person). Conclusions Our findings highlight the considerable productivity losses due to uncorrected and under-corrected presbyopia in LMICs, especially in a longitudinal manner. There is a great need for the development of enabling eye care policies and programs to create access to eye care services, and more healthcare investment in the correction of presbyopia in the working-age population in LMICs. This study could provide evidences for some potential health-related strategies for socio-economic development.
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15
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Fernández J, Alfonso Sánchez JF, Nieradzik M, Valcárcel B, Burguera N, Kapp A. Visual performance, safety and patient satisfaction after bilateral implantation of a trifocal intraocular lens in presbyopic patients without cataract. BMC Ophthalmol 2022; 22:341. [PMID: 35948879 PMCID: PMC9364506 DOI: 10.1186/s12886-022-02556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background The aim was to evaluate the safety and efficacy of a trifocal intraocular lens (IOL) for the correction of presbyopia and to assess patient satisfaction. Methods Records from three centres were reviewed to select presbyopic patients having undergone bilateral refractive lens exchange and implantation of the AT LISA tri 839MP multifocal IOL. Postoperatively, monocular and binocular distance, intermediate and near visual acuities, corrected and uncorrected, and subjective refraction were measured. Patients also completed a quality of life questionnaire. Safety evaluation included IOL stability and postoperative complications. Results 72 eyes (36 patients) were analysed. No clinically significant difference between pre- and postoperative corrected distance visual acuity (CDVA) was found for monocular or binocular measurements. Mean postoperative monocular CDVA was 0.02 ± 0.04 logMAR. Mean refractive values all improved statistically significantly compared with preoperative baseline (p ≤ 0.0064). Overall, 82.4% of eyes had spherical equivalent within ± 0.5 D and 97.1% within ± 1.0 D of emmetropia with a mean accuracy of -0.10 ± 0.41 D. Spectacle independence for distance, intermediate and near visual acuity was 87.5%, 84.4% and 78.1% respectively, and 78.1% of patients were satisfied with their postoperative, spectacle-free vision. Eight eyes received Nd:YAG laser treatment. No other IOL-related safety issues were reported. Conclusion AT LISA tri 839MP multifocal IOL bilaterally implanted in presbyopic patients provided excellent distance, intermediate and near visual outcomes with very accurate correction of refraction. These results were associated with a high level of spectacle independence and patient satisfaction. Trial registration Trial registered on https://clinicaltrials.gov/ under the identification NCT03790592 (31/12/2018).
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Affiliation(s)
- Joaquín Fernández
- Qvision, Department of Ophthalmology of VITHAS Almería Hospital, 04120, Almería, Spain.
| | - José F Alfonso Sánchez
- Fernández-Vega Ophthalmological Institute, Av. Doctores Fernández Vega, 34, 33012, Oviedo, Asturias, Spain
| | - Mark Nieradzik
- Augenzentrum Michelfeld, Daimlerstraße 60, 74545, Michelfeld, Germany
| | - Beatriz Valcárcel
- Fernández-Vega Ophthalmological Institute, Av. Doctores Fernández Vega, 34, 33012, Oviedo, Asturias, Spain
| | - Noemí Burguera
- Qvision, Department of Ophthalmology of VITHAS Almería Hospital, 04120, Almería, Spain
| | - Alexander Kapp
- Augenzentrum Michelfeld, Daimlerstraße 60, 74545, Michelfeld, Germany
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16
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Elmadina AEM. Progressive addition lenses wearers’ visual satisfaction among Saudi population. AFRICAN VISION AND EYE HEALTH 2022; 81. [DOI: 10.4102/aveh.v81i1.733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
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17
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Brujic M, Kruger P, Todd J, Barnes E, Wuttke M, Perna F, Aliò J. Living with presbyopia: experiences from a virtual roundtable dialogue among impacted individuals and healthcare professionals. BMC Ophthalmol 2022; 22:204. [PMID: 35513787 PMCID: PMC9074271 DOI: 10.1186/s12886-022-02432-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Presbyopia is a common progressive vision disorder characterised by an inability to focus on near objects. The emergence of newer treatment options in addition to spectacles or contact lenses highlights the importance of assessing patient/user preferences. METHODS People with presbyopia and healthcare professionals (HCPs) took part in a moderated, structured discussion of specific questions on a virtual advisory-board platform. The objective was to better understand unmet needs and the experience of living with the condition. Closed and open questions were included. RESULTS Nine individuals (age 40 to 70 years) with presbyopia participated, from Australia, China, France, Italy, Ireland, Japan and the US. One ophthalmologist and one optometrist represented the perspective of HCPs. Over two weeks, 621 posts were entered on the platform. There was widespread agreement that the often stated association between age and presbyopia was unfortunate. Some participants had developed presbyopia at 30-45 years of age. What is more, the association with age was seen as implying a natural process, reducing the incentive to treat. Instead there was a call for an action-oriented view of presbyopia as a condition which may be effectively treated in the future. All participants experienced dealing with presbyopia as burdensome, affecting quality of life to varying degrees. When considering new treatments, convenience was the most important factor. The option to administer drops when needed was considered favourable, but short-acting treatments may not reduce inconvenience compared with spectacles. Participants viewed a therapy that targets the underlying cause of the condition favourably compared with symptomatic treatment. Side effects would severely reduce the appeal of drops. For clinical trials in presbyopia, patient-reported outcomes should be mandatory and need adequately to capture quality of life. Studies in presbyopia must be designed to minimise the inconvenience to participants in order to counter the risk of high drop-out rates. CONCLUSIONS The interactive format provided insights into living with presbyopia, particularly the negative impact on quality of life, subjects' openness to new therapies, and the need to move away from considering the condition an unavoidable and intractable consequence of ageing.
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Affiliation(s)
- Mile Brujic
- Premier Vision Group, Bowling Green, OH, USA
| | | | | | | | | | | | - Jorge Aliò
- Universidad Miguel Hernández and Vissum Miranza, C/ Cabañal, 1, 03016, Alicante, Spain.
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18
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Zhu Y, Zhong Y, Fu Y. The effects of premium intraocular lenses on presbyopia treatments. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100042. [PMID: 37846220 PMCID: PMC10577869 DOI: 10.1016/j.aopr.2022.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/28/2022] [Accepted: 02/20/2022] [Indexed: 10/18/2023]
Abstract
Background Presbyopia has become a global disease affecting the world's aging population. Among various treatments, cataract extraction and intraocular lens (IOL) implantation have become the most popular and common methods of presbyopia correction. During the twentieth century, IOLs have underwent significant innovation and advancements to meet the patients' high demands for functional vision at all distances. Main Text To meet the increasing needs for excellent near and intermediate vision for daily activities, some premium IOLs with more than one focus have been developed, for example, the refractive MfIOLs, diffractive MfIOLs, extended depth of field (EDOF) IOLs, and accommodating IOLs (AIOLs) were introduced to meet this need. In addition, the add-on MfIOLs have been explored as promising supplementary IOLs for pseudophakic presbyopia. When selecting the MfIOLs, the IOLs' features, patients' characteristics, preoperative eye conditions, and treatment expectations should be considered. Conclusions In this review, we focus on the multifocal IOLs (MfIOLs) commonly used for presbyopia correction and systematically summarized their optical designs and clinical outcomes. More evidence-based studies are required to provide guidelines for MfIOL selection, provide maximum visual benefits, and develop personalized visual solutions in the future.
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Affiliation(s)
- Yanan Zhu
- Corresponding author. Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, Zhejiang Province, China.
| | | | - Yanyan Fu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China
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Labiris G, Panagiotopoulou EK, Ntonti P. Development and Validation of a Lighting Facility for the Objective Assessment of the Visual Performance of Presbyopic Patients in a Series of Activities of Daily Living. Cureus 2022; 14:e24548. [PMID: 35651385 PMCID: PMC9138179 DOI: 10.7759/cureus.24548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction The primary objective of this study is to develop and validate an experimental lighting facility that allows the evaluation of near and intermediate vision in different user-defined illuminance levels. Methods This is a prospective, randomized, controlled study. Normophakic patients populated three validation groups (VGs) according to their binocular uncorrected near visual acuity (UNVA): a) VG1, 0.0-0.1 logMAR; b) VG2, 0.4 logMAR; and c) VG3, 0.7 logMAR. All participants addressed 10 near and intermediate activities of daily life (ADLs) in the three following lighting settings: 1) 25 foot candles (fc)/3000 kelvins (K), 2) 50 fc/4000 K, and 3) 75 fc/6000 K. Results Thirty patients in each group performed all ADLs in the three lighting settings. VG1 demonstrated the best ADL scores in all ADLs and lighting settings, followed by the VG2. VG3 presented the worst scores. ADLs using printed material showed significant differences among the three lighting settings for all study groups, while ADLs using screens or needing manual dexterity demonstrated no significant differences except for the Screwdriver Test (ST) in VG1. All ADL scores demonstrated a high correlation with UNVA in all lighting settings (p < 0.001). Conclusion This is the first study that validates a lighting facility for comparative studies in patients with different near vision capacities performing a series of ADLs.
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Affiliation(s)
- Georgios Labiris
- Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, GRC
| | | | - Panagiota Ntonti
- Department of Ophthalmology, University Hospital of Alexandroupolis, Alexandroupolis, GRC
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Assessment of a New Trifocal Diffractive Corneal Inlay for Presbyopia Correction Using an Adaptive Optics Visual Simulator. PHOTONICS 2022. [DOI: 10.3390/photonics9030135] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this work, we analyze a proposal of a new intracorneal diffractive lens for presbyopia correction that could allow good, distance, intermediate and near vision. By using an adaptive optics visual simulator, we study the influence of two factors in the inlay performance: the spherical aberration (SA) and the potential errors of in thickness, induced in the manufacturing process. We show that the inlay through-the-focus imaging performance can be customized with the SA value, favoring either distance–intermediate or intermediate–near vision. Moreover, we found that with thickness variations of 10%, the inlay still maintains its trifocal nature.
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Bentley S, Findley A, Chiva-Razavi S, Naujoks C, Patalano F, Johnson C, Arbuckle R, Wolffsohn JS. Understanding the visual function symptoms and associated functional impacts of phakic presbyopia. J Patient Rep Outcomes 2021; 5:114. [PMID: 34731344 PMCID: PMC8566618 DOI: 10.1186/s41687-021-00383-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 10/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Presbyopia is defined as the age-related deterioration in the ability to focus on close objects, causing difficulty with near vision tasks. The study aim was to understand the lived experience of phakic presbyopia and identify all relevant visual function symptoms and associated functional impacts. METHODS Fifty individuals with clinician-confirmed phakic presbyopia (US n = 30, France n = 10, Germany n = 10) and seven healthcare professionals (HCPs) participated in in-depth, face-to-face, qualitative concept elicitation interviews. Verbatim transcripts were analyzed using thematic analysis methods. RESULTS Visual function symptoms reported by participants with phakic presbyopia were categorized as: primary near vision functioning symptoms (impaired near visual acuity, n = 50/50, 100%; difficulty with near vision in dim light, n = 42/50, 84%; difficulty focusing at close distances, n = 30/50, 60%; difficulty seeing things when glare is present, n = 30/50, 60%) and secondary symptoms (eye strain, n = 37/50, 74%; dry eyes, n = 35/50, 70%; headaches, n = 30/50, 60%). Proximal impacts on functional vision included difficulty reading in near vision (n = 49/50, 98%, including printed text and handwriting), seeing objects in near vision n = 48/50, 96%, and performing activities of daily living that require near vision (n = 49/50, 98%, including using a smartphone or computer). Distal impacts on functional vision included emotional, work, financial and social impacts. HCP interviews supported participant findings. CONCLUSION Findings provide a comprehensive understanding of the lived experience of phakic presbyopia which informed the development of a presbyopia conceptual model and patient-reported outcome assessments of vision correction independence and near vision functioning. The sample did not include those whose vision cannot be adequately corrected with lenses or surgery.
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22
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Chang DH, Waring GO, Hom M, Barnett M. Presbyopia Treatments by Mechanism of Action: A New Classification System Based on a Review of the Literature. Clin Ophthalmol 2021; 15:3733-3745. [PMID: 34522079 PMCID: PMC8432361 DOI: 10.2147/opth.s318065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/08/2021] [Indexed: 01/07/2023] Open
Abstract
Presbyopia, a loss of accommodative ability associated with aging, is a significant cause of vision impairment globally. At the clinical level, it is a frustrating and difficult issue that negatively impacts patients’ quality of life. Less appreciated is the fact that loss of accommodative ability and its current treatments methods may present safety concerns, for example, increasing the risk of falls. Therefore, a more complete understanding of treatment options with respect to how they relate to the natural ability of the eye is needed to improve decision making and to aid clinicians in individualizing treatment options. This article reviews the options for expanding functional through focus—a term coined to describe the ability of the eye to see at all distances with minimal latency—by how they vary the refractive power over time, across the visual field, between eyes, or across a range of distances. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/HZw7qvIu6pw
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Affiliation(s)
| | | | | | - Melissa Barnett
- University of California, Davis Eye Center, Sacramento, CA, USA
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Monterano Mesquita G, Patel D, Chang YC, Cabot F, Ruggeri M, Yoo SH, Ho A, Parel JMA, Manns F. In vivo measurement of the attenuation coefficient of the sclera and ciliary muscle. BIOMEDICAL OPTICS EXPRESS 2021; 12:5089-5106. [PMID: 34513244 PMCID: PMC8407821 DOI: 10.1364/boe.427286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
We acquired 1325 nm OCT images of the sclera and ciliary muscle of human subjects. The attenuation coefficients of the sclera and ciliary muscle were determined from a curve fit of the average intensity profile of about 100 A-lines in a region of interest after correction for the effect of beam geometry, using a single scattering model. The average scleral attenuation coefficient was 4.13 ± 1.42 mm-1 with an age-related decrease that was near the threshold for statistical significance (p = 0.053). The average ciliary muscle attenuation coefficient was 1.72 ± 0.88 mm-1, but this value may be an underestimation due to contributions from multiple scattering. Overall, the results suggest that inter-individual variations in scleral attenuation contribute to variability in the quality of transscleral OCT images of the ciliary muscle and the outcome of transscleral laser therapies.
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Affiliation(s)
- Gabrielle Monterano Mesquita
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Disha Patel
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Yu-Cherng Chang
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Florence Cabot
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Sonia H. Yoo
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
| | - Arthur Ho
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
- Brien Holden Vision Institute, Sydney, NSW 2052, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2033, Australia
| | - Jean-Marie A. Parel
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
- Brien Holden Vision Institute, Sydney, NSW 2052, Australia
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL 33146, USA
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Improvement of Presbyopia Using a Mixture of Traditional Chinese Herbal Medicines, Including Cassiae Semen, Wolfberry, and Dendrobium huoshanense. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9902211. [PMID: 34354761 PMCID: PMC8331274 DOI: 10.1155/2021/9902211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/29/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023]
Abstract
Background Presbyopia is a primary cause of a decline in near vision. In this study, we developed a new mixed herbal medicine to retard presbyopic progression and increase the amplitude of accommodation (AA), which is beneficial for near vision. Methods A total of 400 participants between the ages of 45 and 70 years were recruited. We designed the mixed herbal drug to include Cassiae Semen (200 mg), wolfberry (200 mg), and Dendrobium huoshanense (DD) (40 mg) in one capsule. In experiment 1, the recruited subjects were directed to perform a push-up test to measure their AA; this was then converted to the additional diopters of reading glasses. In experiment 2, 240 subjects took three capsules daily for six months and then stopped medical therapy for a six-month follow-up. In experiment 3, 160 subjects were randomly categorized into four groups: a placebo group, low-dose group (LDG) (1 capsule daily), middle-dose group (MDG) (two capsules daily), and high-dose group (HDG) (three capsules daily). The 160 volunteers took different doses for six months and then stopped treatment, accompanied by another six-month follow-up. In experiments 2 and 3, the change in AA, uncorrected far visual acuity (UFVA), and uncorrected near visual acuity (UNVA) were recorded each month for one year. Results In experiment 1, AA was found to decrease with age and a great deal of additional power was needed in older individuals. In experiment 2, the mean AA reached a maximum value of 2.1D (P < 0.05) after six months, while the UNVA improved by about two to three lines of a Jaeger chart in most of the subjects. At nine months, all the means decreased slightly to 2.0 D (P < 0.05). This meant that the mixed herbal medicine could still maintain AA for another three months because the herbal therapy was stopped at the seventh month. In experiment 3, the maximal AA was 2.8D, 2.9D, and 3.2D (P < 0.05) in the LDG, MDG, and HDG after six-month treatments, respectively. Experiment 3 showed that AA gain occurred in a dose-dependent manner; the higher the dose, the greater the AA value. Conclusion Only two studies on the use of herbal drugs for presbyopia have been reported in PubMed. In our study, we found that taking a mixed herbal drug caused an excellent gain in AA. This is the first study to report that the characteristics of the new herbal regimen could retard and even ameliorate presbyopia.
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Karkhanis MU, Ghosh C, Banerjee A, Hasan N, Likhite R, Ghosh T, Kim H, Mastrangelo CH. Correcting Presbyopia With Autofocusing Liquid-Lens Eyeglasses. IEEE Trans Biomed Eng 2021; 69:390-400. [PMID: 34232861 DOI: 10.1109/tbme.2021.3094964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Presbyopia, an age-related ocular disorder, is characterized by the loss in the accommodative abilities of the human eye. Conventional methods of correcting presbyopia divide the field of view, thereby resulting in significant vision impairment. We demonstrate the design, assembly and evaluation of autofocusing eyeglasses for restoration of accommodation without dividing the field of view. METHODS The adaptive optics eyeglasses comprise of two variable-focus liquid lenses, a time-of-flight range sensor and low-power, dual microprocessor control electronics, housed within an ergonomic frame. Subject-specific accommodation deficiency models were utilized to demonstrate high-fidelity accommodative correction. The abilities of this system to reduce accommodation deficiency, its power consumption, response time, optical performance and MTF were evaluated. RESULTS Average corrected accommodation deficiencies for 5 subjects ranged from -0.021 D to 0.016 D. Each accommodation correction calculation was performed in ∼67 ms which consumed 4.86 mJ of energy. The optical resolution of the system was 10.5 cycles/degree, and featured a restorative accommodative range of 4.3 D. This system was capable of running for up to 19 hours between charge cycles and weighed ∼132 g. CONCLUSION The design, assembly and performance of an autofocusing eyeglasses system to restore accommodation in presbyopes has been demonstrated. SIGNIFICANCE The new autofocusing eyeglasses system presented in this article has the potential to restore pre-presbyopic levels of accommodation in subjects diagnosed with presbyopia.
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Abstract
Presbyopia is an age-related condition that affects approximately 1.8 billion people worldwide. Strategies to correct presbyopia include both nonsurgical and surgical approaches. Although eye care providers assume that multifocal spectacles and monovision have lower risks than surgical interventions, there is evidence to suggest that the use of these nonsurgical approaches in the older population increases the risk for trips and falls. Each year, fall-related injuries and deaths are reported in a substantial portion of the population, both globally and in the United States. Previous studies have shown a link between visual acuity, contrast sensitivity, stereoacuity, and visual field impairments and falls. More recent mechanistic and epidemiological studies have shown that multifocal spectacles and monovision can increase the risk for falls as well. Although evidence on the financial burden of falls related to multifocal spectacles or monovision is limited, total direct medical costs related to falls associated with multifocal spectacles are estimated to be approximately $11 billion annually in the United States. Therefore, it is important that eye care providers consider the risk for falls associated with multifocal spectacles and monovision when making decisions on the best strategy for correcting presbyopia in older adults. [J Refract Surg. 2021;37(6 Suppl):S12-S16.].
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Katz JA, Karpecki PM, Dorca A, Chiva-Razavi S, Floyd H, Barnes E, Wuttke M, Donnenfeld E. Presbyopia - A Review of Current Treatment Options and Emerging Therapies. Clin Ophthalmol 2021; 15:2167-2178. [PMID: 34079215 PMCID: PMC8163965 DOI: 10.2147/opth.s259011] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/11/2021] [Indexed: 01/07/2023] Open
Abstract
Presbyopia is a common age-related vision disorder characterized by a progressive inability to focus on near objects. If uncorrected or under-corrected, presbyopia can significantly impact patients' quality of life. Presbyopia represents an area of considerable unmet need due to its rising prevalence worldwide as the population ages, the high proportion of under-treated individuals in some parts of the world, and the limitations of currently available corrective methods. Progressive or bifocal spectacles are associated with peripheral blur, a restricted visual field and impaired depth perception, which have been linked to an increased risk of falls in the elderly. Contact lens options can be difficult to maintain due to the development of age-related dry eye symptoms and reduced manual dexterity. Other corrective methods involve surgical interventions that modify the optics of the cornea, replace the crystalline lens, or attempt to restore active accommodation. While patients undergoing surgery report satisfactory outcomes post-operatively, many of them eventually require reading glasses. Non-invasive therapies with novel mechanisms of action are currently being investigated; these include miotic agents and UNR844, a lipoic acid choline ester. In this narrative review, available evidence on presbyopia prevalence, quality of life impact and risk factors are described, with a focus on observational studies in non-clinical settings. The diagnosis pathway and patient journey in presbyopia are outlined, and various treatment options are analyzed. The data reviewed herein reveals significant gaps in the provision of vision correction for this common condition, with a paucity of effective, non-invasive treatment options broadly accessible to presbyopic individuals.
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Affiliation(s)
- James A Katz
- The Midwest Center for Sight, Des Plaines, IL, USA
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Vedhakrishnan S, Vinas M, Aissati S, Marcos S. Vision with spatial light modulator simulating multifocal contact lenses in an adaptive optics system. BIOMEDICAL OPTICS EXPRESS 2021; 12:2859-2872. [PMID: 34123507 PMCID: PMC8176799 DOI: 10.1364/boe.419680] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/12/2021] [Accepted: 03/23/2021] [Indexed: 05/06/2023]
Abstract
Visual simulators are useful tools to provide patients experience of multifocal vision prior to treatment. In this study, commercially available center-near aspheric multifocal contact lenses (MCLs) of low, medium, and high additions were mapped on a spatial light modulator (SLM) and validated on a bench. Through focus visual acuity (TFVA) was measured in subjects through the SLM and real MCLs on the eye. A correlation metric revealed statistically significant shape similarity between TFVA curves with real and simulated MCLs. A Bland-Altman analysis showed differences within confidence intervals of ±0.01 logMAR for LowAdd/MediumAdd and ±0.06 logMAR for HighAdd. Visual performance with simulated MCLs outperformed real MCLs by ∼20%. In conclusion, SLM captures the profile of center-near MCLs and reproduces vision with real MCLs, revealing that the MCL profile and its interactions with the eye's optics (and not fitting aspects) account for the majority of the contributions to visual performance with MCLs.
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Affiliation(s)
- Shrilekha Vedhakrishnan
- Instituto de Optica “Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Maria Vinas
- Instituto de Optica “Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Sara Aissati
- Instituto de Optica “Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Susana Marcos
- Instituto de Optica “Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
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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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Papas EB. Contact lens technology to 2020 and beyond: a review of recent patent literature. Clin Exp Optom 2021; 100:529-536. [DOI: 10.1111/cxo.12596] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/16/2017] [Accepted: 07/05/2017] [Indexed: 12/28/2022] Open
Affiliation(s)
- Eric B Papas
- School of Optometry and Vision Science,The University of New South Wales, Kensington, New South Wales, Australia,
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Hutchins B, Huntjens B. Patients' attitudes and beliefs to presbyopia and its correction. JOURNAL OF OPTOMETRY 2021; 14:127-132. [PMID: 32241701 PMCID: PMC8093526 DOI: 10.1016/j.optom.2020.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Presbyopia is the gradual inability to focus near objects with age. This study explores patients' attitudes and beliefs towards presbyopia including preferred modes of near refractive correction. METHODS In the United Kingdom, twenty-four volunteers completed an online questionnaire and attended a structured, recorded focus group. Participants' age ranged between 36 and 48 years, representing a pre-presbyopic and a presbyopic population. Attitudes and beliefs about presbyopia, its significance, and opinions about current refractive correction including multifocal contact lenses were transcribed and coded using content analysis for overarching themes and patterns. RESULTS Six participants (25%) were already wearing a near visual correction while 18 (75%) were not. Five key primary themes with clear inter-participant similarities were identified as 'age-related' (75%), 'acceptance' (50%), clear lack of 'familiarity with the word presbyopia' (65%), a mixed/ reluctant attitude 'towards (multifocal) contact lenses' (62.5%), and 'comfort and convenience' of a presbyopic correction (79%) whereby cost is of less importance. CONCLUSION The need for a reading correction was perceived as a sign of age. Spectacles were the most preferred mode of near vision correction, while comfort and convenience were seen as more important than cost. Patient education about presbyopia is lacking. Multifocal contact lenses are not necessarily the preferred visual correction even if the patient already wears contact lenses for distance.
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Affiliation(s)
- Brooke Hutchins
- Centre for Applied Vision Research, City, University of London, London, UK
| | - Byki Huntjens
- Centre for Applied Vision Research, City, University of London, London, UK.
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Vincent SJ, Cho P, Chan KY, Fadel D, Ghorbani-Mojarrad N, González-Méijome JM, Johnson L, Kang P, Michaud L, Simard P, Jones L. CLEAR - Orthokeratology. Cont Lens Anterior Eye 2021; 44:240-269. [DOI: 10.1016/j.clae.2021.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
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Talens-Estarelles C, García-Del Valle AM, García-Lázaro S. Impact of the pupil size - central optical zone diameter relationship on visual performance in aspheric multifocal contact lenses. Cont Lens Anterior Eye 2021; 45:101440. [PMID: 33814283 DOI: 10.1016/j.clae.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/16/2021] [Accepted: 03/22/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine the impact of different central optical zone diameters (COZDs), obtained from pupil size, on the visual performance of presbyopic subjects fitted with centre-distance simultaneous-image multifocal contact lenses (SIMCLs). METHODS Thirty-two presbyopic volunteers, between 45-58 years of age, participated in this prospective, controlled, double-blind study. Subjects were fitted with 5 centre-distance SIMCLs of variable COZD, determined from the measurement of pupil size under photopic light conditions and corresponding to 60, 70, 80, 90 and 100 % of pupil diameter. Subjects visual performance was evaluated through the measurement of distance, intermediate and near visual acuity (VA), "visual functional range" (VFR) obtained from the VA Defocus Curve (VADC) and Contrast Sensitivity Function (CSF), using a third-generation retina display iPad. RESULTS Statistically significant differences were obtained for both distance (p = 0.01) and intermediate (p = 0.001) VA amongst designs. Best results were obtained with 80 % and 90 % COZDs compared to 60 %. No significant differences in VFR (p > 0.05) were obtained amongst the different COZDs. 90 and 100 % COZDs offered statistically significant better results at 6 and 18 cycles per degree (cpd) in the CSF, compared to the 60 and 70 % designs. CONCLUSIONS SIMCLs with COZDs of 80-90 % and of 90-100% of photopic pupil diameter offered better distance and intermediate VA, without a decline in near performance, and superior contrast sensitivity at medium and high spatial frequencies respectively, compared to lower COZD designs.
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Affiliation(s)
- C Talens-Estarelles
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | | | - S García-Lázaro
- Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain.
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Barcala X, Vinas M, Romero M, Gambra E, Mendez-Gonzalez JL, Marcos S, Dorronsoro C. Multifocal acceptance score to evaluate vision: MAS-2EV. Sci Rep 2021; 11:1397. [PMID: 33446794 PMCID: PMC7809428 DOI: 10.1038/s41598-021-81059-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022] Open
Abstract
We present a new metric (Multifocal Acceptance Score, MAS-2EV) to evaluate vision with presbyopic corrections. The MAS-2EV is based on a set of images representing natural visual scenes at day and night conditions projected in far and near displays, and a near stereo target. Subjects view and score the images through different binocular corrections (monofocal corrections at far; bifocal corrections; monovision and modified monovision) administered with soft contact lenses (in cyclopleged young subjects) or with a binocular simultaneous vision simulator (in presbyopic and cyclopleged young subjects). MAS-2EV scores are visually represented in the form of polygons, and quantified using different metrics: overall visual quality, visual degradation at far, visual benefit at near, near stereo benefit, visual imbalance near-far, overall visual imbalance and a combined overall performance metric. We have found that the MAS-2EV has sufficient repeatability and sensitivity to allow differentiation across corrections with only two repetitions, and the duration of the psychophysical task (3 min for subject/condition/correction) makes it useable in the clinic. We found that in most subjects binocular bifocal corrections produce the lowest visual imbalance, and the highest near stereo benefit. 46.67% of the subjects ranked binocular bifocal corrections first, and 46.67% of the subjects ranked monovision first. MAS-2EV, particularly in combination with visual simulators, can be applied to select prospective presbyopic corrections in patients prior to contact lens fitting or intraocular lens implantation.
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Affiliation(s)
| | - Maria Vinas
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Mercedes Romero
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | | | | | - Susana Marcos
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Carlos Dorronsoro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
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Vincent M, Marin G, Legras R. Subjective Evaluation of Defocus and Astigmatism Combinations Using Image Simulation in Presbyopes. Optom Vis Sci 2021; 98:73-80. [PMID: 33394934 DOI: 10.1097/opx.0000000000001627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
SIGNIFICANCE Image simulation is a useful and efficient tool to explore the impact of defocus and astigmatism combinations on visual acuity and image quality score when accommodation is taken into account. PURPOSE The goal of this experiment was to determine if a simulation is able to predict visual acuity and image quality score (IQS) with defocus and astigmatism combinations in presbyopes. METHODS We measured visual acuity and IQS in five defocus and astigmatism combinations in either real or simulated conditions. In real conditions, the subjects viewed a stimulus through an ophthalmic lens or a deformable mirror. In simulated conditions, subjects viewed images of the same stimulus with simulated blur. The amounts of defocus and astigmatism combinations of a progressive addition lens in near vision were generated through a static correction of the subject's aberrations. We simulated three levels of accommodation: subject could not accommodate (FOC0), subject could accommodate to the less hyperopic focal point (FOC1), or subject could accommodate to the circle of least confusion (FOC2). RESULTS Visual acuity or IQS did not differ between mirror and progressive addition lens conditions. Visual acuity measured in real blur conditions differed significantly from that in FOC0 simulated blur condition but were similar to that in FOC1 and FOC2 simulated blur conditions. Image quality score obtained in real conditions were between scores measured with the FOC0 and FOC1 simulated conditions, suggesting that the subjects were able to produce a low level of accommodation. CONCLUSIONS Accommodation may play a role when comparing optical and simulated defocus and astigmatism combinations. Presbyopic subjects are able to produce a low level of accommodation that may counterbalance a part of the deleterious effect of the astigmatism on image quality. Simulation remains a useful tool if the correct accommodation state is taken into account.
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Affiliation(s)
- Marc Vincent
- Laboratoire Lumière, Matière et Interfaces, CNRS, ENS Paris-Saclay, CentraleSupelec, Université Paris-Saclay, Orsay, France
| | - Gildas Marin
- Essilor International, Research and Development, Vision Science Department, Créteil, France
| | - Richard Legras
- Laboratoire Lumière, Matière et Interfaces, CNRS, ENS Paris-Saclay, CentraleSupelec, Université Paris-Saclay, Orsay, France
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Mawatari G, Uchida S, Nao-i N. Base Curve of Progressive Addition Lenses Influences Clear Vision and Stereopsis Area. CLINICAL OPTOMETRY 2020; 12:223-230. [PMID: 33364869 PMCID: PMC7751720 DOI: 10.2147/opto.s282326] [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: 09/16/2020] [Accepted: 11/17/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE Progressive addition lenses (PAL) are effective, particularly for middle-aged and elderly people who require reading spectacles. However, with PALs, peripheral vision may be distorted and blurred because of both the lateral bending of the surface and the effect of unequal bending of the light coming from an off-axis location in the tangential and sagittal directions, which may lead to a decrease in the quality of vision. Till date, no evaluation of PALs has been reported with regard to peripheral and binocular vision. We investigated the influence of high-base-curve PAL on the visual function of binocular vision using a synoptophore. METHODS The subjects were seven males and 13 females aged 50-79 years with a best-corrected visual acuity of decimal visual acuity (1.0) or higher in both eyes and addition power of 1.50-2.50 diopters as the inclusion criteria. The study design was a two-group, two-period crossover trial. Using a synoptophore, the subjective clear vision area of monocular vision and stereopsis area of binocular vision were measured while wearing conventional-base curve PAL (4-curve) and high-base-curve PAL (8-curve). HOYALUX RF SPORT 1.6 lenses (HOYA Corporation, Tokyo, Japan) were used for the test PALs. RESULTS The clear vision area of monocular vision was significantly wider when wearing the 8-curve PAL on the temporal side of the right eye (P = 0.02), and on the temporal side of the left eye (P = 0.01). The stereopsis area of binocular vision was significantly wider in all directions when wearing the 8-curve PAL: right (P = 0.02); left (P = 0.03); right 15° upward (P = 0.02); and left 15° upward (P = 0.02). CONCLUSION It was clarified that, compared to 4-curve PAL, clear vision and stereopsis areas are wider when wearing 8-curve PAL.
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Affiliation(s)
- Go Mawatari
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Saeko Uchida
- Department of Orthoptics and Visual Sciences, Kyusyu University of Health and Welfare, Nobeoka, Miyazaki, Japan
| | - Nobuhisa Nao-i
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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Jamali A, Bryant D, Bhowmick AK, Bos PJ. Large area liquid crystal lenses for correction of presbyopia. OPTICS EXPRESS 2020; 28:33982-33993. [PMID: 33182876 DOI: 10.1364/oe.408770] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
Presbyopia is the failure of the eye lens to accommodate. The widely used presbyopia correction method involves wearing bi/trifocal or progressive glasses, which limits the field of view due to division of lens area into sections of different optical power. A large aperture focus tunable liquid crystal lens has the potential to correct human eye accommodation failure and provide a wide field of view. In this paper, we present characterization and demonstration of a segmented phase profile liquid crystal lens, which has the characteristics of a large area (diameter: 20 mm), being flat and thin (<2 mm), and having continuous focus tunability (1.5 D to 0 D), fast response time (<500 ms), low operating voltage (<5 V), and on-axis diffraction-limited performance (for a 5mm aperture). Considering all these properties, our lens provides performance details of an approach for presbyopia correction. We have tested the minimum resolution and visual acuity of 20 subjects using the designed lens and compared the results with a reference glass lens of the same optical power.
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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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Wolffsohn JS, Leteneux-Pantais C, Chiva-Razavi S, Bentley S, Johnson C, Findley A, Tolley C, Arbuckle R, Kommineni J, Tyagi N. Social Media Listening to Understand the Lived Experience of Presbyopia: Systematic Search and Content Analysis Study. J Med Internet Res 2020; 22:e18306. [PMID: 32955443 PMCID: PMC7536603 DOI: 10.2196/18306] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/05/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Presbyopia is defined as the age-related deterioration of near vision over time which is experienced in over 80% of people aged 40 years or older. Individuals with presbyopia have difficulty with tasks that rely on near vision. It is not currently possible to stop or reverse the aging process that causes presbyopia; generally, it is corrected with glasses, contact lenses, surgery, or the use of a magnifying glass. OBJECTIVE This study aimed to explore how individuals used social media to describe their experience of presbyopia with regard to the symptoms experienced and the impacts of presbyopia on their quality of life. METHODS Social media sources including Twitter, forums, blogs, and news outlets were searched using a predefined search string relating to symptoms and impacts of presbyopia. The data that were downloaded, based on the keywords, underwent manual review to identify relevant data points. Relevant posts were further manually analyzed through a process of data tagging, categorization, and clustering. Key themes relating to symptoms, impacts, treatment, and lived experiences were identified. RESULTS A total of 4456 social media posts related to presbyopia were identified between May 2017 and August 2017. Using a random sampling methodology, we selected 2229 (50.0%) posts for manual review, with 1470 (65.9%) of these 2229 posts identified as relevant to the study objectives. Twitter was the most commonly used channel for discussions on presbyopia compared to forums and blogs. The majority of relevant posts originated in Spain (559/1470, 38.0%) and the United States (426/1470, 29.0%). Of the relevant posts, 270/1470 (18.4%) were categorized as posts written by individuals who have presbyopia, of which 37 of the 270 posts (13.7%) discussed symptoms. On social media, individuals with presbyopia most frequently reported experiencing difficulty reading small print (24/37, 64.9%), difficulty focusing on near objects (15/37, 40.5%), eye strain (12/37, 32.4%), headaches (9/37, 24.3%), and blurred vision (8/37, 21.6%). 81 of the 270 posts (30.0%) discussed impacts of presbyopia-emotional burden (57/81, 70.4%), functional or daily living impacts (46/81, 56.8%), such as difficulty reading (46/81, 56.8%) and using electronic devices (21/81, 25.9%), and impacts on work (3/81, 3.7%). CONCLUSIONS Findings from this social media listening study provided insight into how people with presbyopia discuss their condition online and highlight the impact of presbyopia on individuals' quality of life. The social media listening methodology can be used to generate insights into the lived experience of a condition, but it is recommended that this research be combined with prospective qualitative research for added rigor and for confirmation of the relevance of the findings.
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Affiliation(s)
- James S Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | | | | | - Sarah Bentley
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Chloe Johnson
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Amy Findley
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Chloe Tolley
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Rob Arbuckle
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, United Kingdom
| | - Jyothi Kommineni
- Novartis Business Services, Product Lifecycle Services, Hyderabad, India
| | - Nishith Tyagi
- Novartis Business Services, Product Lifecycle Services, Hyderabad, India
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Hossain P, Barbara R. The future of refractive surgery: presbyopia treatment, can we dispense with our glasses? Eye (Lond) 2020; 35:359-361. [PMID: 32895499 DOI: 10.1038/s41433-020-01172-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/07/2020] [Accepted: 08/25/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Parwez Hossain
- Southampton Eye Unit, University Hospitals Southampton, Southampton, UK. .,Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Ramez Barbara
- Southampton Eye Unit, University Hospitals Southampton, Southampton, UK.,Birmingham Midlands Eye Centre, Birmingham, UK
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Grzybowski A, Markeviciute A, Zemaitiene R. A Review of Pharmacological Presbyopia Treatment. Asia Pac J Ophthalmol (Phila) 2020; 9:226-233. [PMID: 32511122 PMCID: PMC7299227 DOI: 10.1097/apo.0000000000000297] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/02/2020] [Indexed: 11/25/2022] Open
Abstract
Presbyopia reduces an individual's ability to perform visual tasks at near distances. It is a global problem, affecting over a billion people worldwide. Contact lenses, glasses, refractive surgery, and intraocular lens surgery are the main modalities in presbyopia treatment, although they all have some disadvantages. Thus, there is an increasing need for effective, easy-to-use, and noninvasive approaches for treating presbyopia while not limiting patients' daily activities. Pharmacological presbyopia treatment as an alternative method has been under investigation in recent years. We reviewed all relevant articles using the keywords "presbyopia," "presbyopia treatment," "pharmacological presbyopia treatment," and "presbyopic corrections" from 2010 to February 9, 2020, and summarized the main results of clinical trials, investigating the drops used for presbyopia treatment.
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Affiliation(s)
| | - Agne Markeviciute
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Reda Zemaitiene
- Department of Ophthalmology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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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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Riau AK, Liu YC, Yam GH, Mehta JS. Stromal keratophakia: Corneal inlay implantation. Prog Retin Eye Res 2020; 75:100780. [DOI: 10.1016/j.preteyeres.2019.100780] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 07/28/2019] [Accepted: 09/02/2019] [Indexed: 12/31/2022]
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Zeri F, Di Vizio A, Guida M, Rotondi A, Tavazzi S, Naroo SA. Accuracy, inter-observer and intra-observer reliability in topography assessment of multifocal contact lens centration. Cont Lens Anterior Eye 2020; 43:448-457. [PMID: 32088134 DOI: 10.1016/j.clae.2020.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 02/09/2020] [Accepted: 02/12/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the accuracy and reliability (inter and intra-observer) of a method to assess multifocal contact lenses (MCLs) centration using a corneal topography unit. METHOD Daily-disposable MCLs (Fusion 1 day Presbyo) were fitted on both eyes of the subjects. For each lens fit a slit lamp digital picture and videokeratograph image were taken in a rapid but randomised sequence. Photo-editing software was used to assess the position of the MCL centre with respect to pupil centre as taken from the slit lamp photograph. The position of the MCL centre was automatically detected as the point of maximum curvature from the videokeratography. Three further manual and qualitative procedures to detect MCL centre, comparing a template of CLs optic zones to the videokeratographic image were performed by 4 practitioners using 3 different algorithms to represent the topographic map. Each manual reading was repeated 3 times. RESULTS Twenty-two subjects (11 males) aged 22.8 ± 1.9 years (range 20.8-27.0 years) were recruited. The accuracy of the 4 topographic assessments in determining the centre coordinates of the MCL with respect to SL assessment was good: no differences were found in the left eyes and although in the right eyes a more temporal and superior position of MCLs was determined (paired t-test, p < 0.05) the difference was clinically negligible (0.16 ± 0.36 mm horizontally, 0.23 ± 0.48 vertically). Amongst the 4 practitioners one-way Anova for repeated measures showed no differences for any of the 3 manual assessments. Intra-class correlation coefficient was calculated among the 3 readings for each manual procedure and was very good (between 0.75 and 0.98) in 3 practitioners and moderate (between 0.49 and 0.92) in the fourth. CONCLUSIONS The assessment of MCL centration by performing corneal topography over the MCL is an accurate method. Furthermore, inter and intra-practitioner reliability showed by manual procedures appeared very good.
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Affiliation(s)
- Fabrizio Zeri
- University of Milano Bicocca, Department of Materials Science, via R. Cozzi 55, I-20125 Milan, Italy; University of Milano Bicocca, COMiB Research Centre in Optics and Optometry, via R. Cozzi 55, I-20125 Milan, Italy; School of Life and Health Sciences, Aston University, Birmingham, UK.
| | - Assunta Di Vizio
- Degree Course in Optics and Optometry, Department of Sciences, Roma TRE University, Rome, Italy
| | - Maurizio Guida
- Degree Course in Optics and Optometry, Department of Sciences, Roma TRE University, Rome, Italy
| | - Anastasia Rotondi
- Degree Course in Optics and Optometry, Department of Sciences, Roma TRE University, Rome, Italy
| | - Silvia Tavazzi
- University of Milano Bicocca, Department of Materials Science, via R. Cozzi 55, I-20125 Milan, Italy; University of Milano Bicocca, COMiB Research Centre in Optics and Optometry, via R. Cozzi 55, I-20125 Milan, Italy
| | - Shehzad A Naroo
- School of Life and Health Sciences, Aston University, Birmingham, UK
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Sivardeen A, McAlinden C, Wolffsohn JS. Presbyopic correction use and its impact on quality of vision symptoms. JOURNAL OF OPTOMETRY 2020; 13:29-34. [PMID: 30935816 PMCID: PMC6951833 DOI: 10.1016/j.optom.2018.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 11/07/2018] [Accepted: 12/28/2018] [Indexed: 05/09/2023]
Abstract
AIM To assess real-world adoption of presbyopic correction and its impact on quality of vision. METHOD The use of visual corrections by 529 sequential patients (aged 36 years to 85 years, 50.4% female) attending 4 optometric practices in diverse areas across London were surveyed by interview and completed the quality of vision (QoV) questionnaire to evaluate visual symptoms. RESULTS Over half of the population (54.7%) managed without glasses at least some of the time, while between 30 and 40% wore distance, reading and progressive spectacles with those using Progressive Addition Lenses wearing them over 80% of the time, while those wearing reading spectacles only approximately 25% of the time. Age, sex and driving frequency had no effect of QoV (p>0.05), whereas the distance of the task significantly impacted QoV (p<0.01). In all QoV metrics, regardless of the far, intermediate or near blur assessment, QoV was rated higher by patients whose main tasks were far focused (n=231, 43.9%), than those who principally conduct intermediate tasks (n=165, 31.4%) and worse still for those whose main tasks were near (n=130, 24.7%), regardless of the form of correction. CONCLUSION Majority of tasks are in the distance and these had a higher QoV than intermediate tasks with near focused tasks being even worse. It is important to discuss with patients the principal distance of the tasks they generally perform and the forms of presbyopic correction used from the outset.
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Affiliation(s)
- Ahmed Sivardeen
- Ophthalmic Research Group, Aston University, Birmingham, UK; Specsavers, New Malden, London, UK
| | - Colm McAlinden
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK; Wenzhou Medical University, Wenzhou, China; Flinders University, Adelaide, Australia
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Almutairi MS, Altoaimi BH, Bradley A. Impact of monovision on dynamic accommodation of early presbyopes. Ophthalmic Physiol Opt 2019; 40:47-59. [PMID: 31879995 DOI: 10.1111/opo.12660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/24/2019] [Accepted: 11/29/2019] [Indexed: 01/13/2023]
Abstract
PURPOSE To examine the impact of monovision on dynamic changes in accommodation, pupil responses, spherical aberration and resultant image quality in early presbyopes. METHODS Refractive state, pupil size and spherical aberration levels were monitored in nine early presbyopes who exhibited some accommodation (40-50 years, mean = 42 ± 2.37 years) using a Shack-Hartmann aberrometer as a binocularly viewed stimulus stepped closer (from 2 m to 40 cm), or farther (from 40 cm to 2 m). Comparison data from two fully presbyopic (i.e. non-accommodating) subjects (ages 46 and 61 years) and two young adults (ages 26 and 29 years) were also collected. Each subject was fit with four different refractive strategies: (1) both eyes corrected for 2 m, (2) both eyes corrected for 40 cm, (3) monovision with the measured right eye corrected for 2 m and, (4) monovision with the right eye corrected for 40 cm. Monochromatic image quality was quantified using the AreaMTF metric. RESULTS When fit with monovision, the largest number of early presbyopes produce an accommodative response dominated by the right eye correction (distance or near) as the stimulus is abruptly changed from the retinal conjugate plane of one eye to that of the other eye. However, the accommodative responses in some early presbyopes were always dominated by the distance corrected eye, the near corrected eye, or by convergence. When the stimulus approached, the near corrected eye experienced high image quality only if there was no accommodative response. However, reduced image quality was observed if an accommodative response was initiated. Neither accommodation nor pupil response latencies were longer with monovision corrections compared with bilateral distance corrections (p > 0.05). In the early presbyopes, spherical aberration was reduced during near viewing, but primarily due to pupil miosis and not lens shape changes. CONCLUSION As the stimulus was abruptly changed from the retinal conjugate plane of the distance corrected eye to that of the near corrected eye, most early presbyopes fit with monovision accommodated, which resulted in a decline, not an increase in image quality in the near corrected eye. These results reveal a non-optimal accommodative strategy in early presbyopes fit with monovision.
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Affiliation(s)
- Meznah S Almutairi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.,School of Optometry, Indiana University, Bloomington, USA
| | - Basal H Altoaimi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Arthur Bradley
- School of Optometry, Indiana University, Bloomington, USA
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Montés-Micó R, Charman WN. Pharmacological Strategies for Presbyopia Correction. J Refract Surg 2019; 35:803-814. [DOI: 10.3928/1081597x-20191010-04] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/10/2019] [Indexed: 11/20/2022]
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48
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Factors That Influence the Success of Contact Lens Fitting in Presbyopes: A Multicentric Survey. Eye Contact Lens 2019; 45:382-389. [DOI: 10.1097/icl.0000000000000606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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49
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Radhakrishnan A, Pascual D, Marcos S, Dorronsoro C. Vision with different presbyopia corrections simulated with a portable binocular visual simulator. PLoS One 2019; 14:e0221144. [PMID: 31430328 PMCID: PMC6701771 DOI: 10.1371/journal.pone.0221144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/31/2019] [Indexed: 11/18/2022] Open
Abstract
Presbyopes can choose today among different corrections to provide them with functional vision at far and near, and the outcomes and patient satisfaction depend on the selection. In this study, we present a binocular and portable vision simulator, based on temporal multiplexing of two synchronized tunable lenses allowing see-through and programmable visual simulations of presbyopic corrections. Seventeen binocular corrections were tested: 3 Monofocal (Far, Intermediate, Near), 4 Simultaneous Vision (bifocal, trifocal), 2 Monovision (far and near in either eye) and 8 Modified Monovision corrections (Simultaneous vision in one eye, Monofocal in the other eye). Perceived visual quality was assessed through the simulated corrections in 8 cyclopleged subjects who viewed a composite realistic visual scene with high contrast letters and a landscape at far (4 m) and a high contrast text at intermediate (66 cm) and near (33 cm) distances. Perceptual scores were obtained on a scale of 0 to 5 (low to high perceived quality). Perceptual preference was assessed by judging 36 random image pairs (6 repetitions) viewed through 9 binocular presbyopic corrections using two-interval forced choice procedures. The average score, across far and near distances, was the highest for Monovision (4.4±0.3), followed by Modified Monovision (3.4±0.1), Simultaneous Vision (3.0±0.1) and Monofocal corrections (2.9±0.2). However, the mean difference between far and near was lower for Simultaneous Vision and Monovision (0.4±0.1 PS) than Modified Monovision (1.8±0.7) or monofocal corrections (3.3±1.5). A strong significant correlation was found between the perceptual scores and the percentages of energy in focus, for each correction and distance (R = 0.64, p<0.0001). Multivariate ANOVA revealed significant influence of observation distances (p<10-9) and patients (p = 0.01) on Perceptual Score. In conclusion, we have developed a binocular portable vision simulator that can simulate rapidly and non-invasively different combinations of presbyopic corrections. This tool has applications in systematic clinical evaluation of presbyopia corrections.
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Affiliation(s)
- Aiswaryah Radhakrishnan
- Laboratory of Visual Optics and Biophotonics, Instituto de Óptica, IO-CSIC, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Daniel Pascual
- Laboratory of Visual Optics and Biophotonics, Instituto de Óptica, IO-CSIC, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Susana Marcos
- Laboratory of Visual Optics and Biophotonics, Instituto de Óptica, IO-CSIC, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Carlos Dorronsoro
- Laboratory of Visual Optics and Biophotonics, Instituto de Óptica, IO-CSIC, Consejo Superior de Investigaciones Científicas, Madrid, Spain
- * E-mail:
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Lafosse E, Wolffsohn JS, Talens-Estarelles C, García-Lázaro S. Presbyopia and the aging eye: Existing refractive approaches and their potential impact on dry eye signs and symptoms. Cont Lens Anterior Eye 2019; 43:103-114. [PMID: 31445772 DOI: 10.1016/j.clae.2019.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 01/18/2023]
Abstract
Every part of the human body is subject to aging, including the eye. An increased prevalence of dry eye disease with age is widely acknowledged. Aging threatens ocular surface homeostasis, altering the normal functioning of the lacrimal functional unit and potentially leading to signs and symptoms of dry eye. Additional age-related processes take place within the crystalline lens, leading to presbyopia and cataractogenesis. Correction strategies for presbyopia and cataracts may directly or indirectly challenge the ocular surface. Contact lenses disturb the normal structure of the tear film and can interact negatively with the ocular surface, further deteriorating an already unbalanced tear film in presbyopes, however, newer contact lens designs can overcome some of these issues. Moreover, cataract and corneal refractive surgeries sever corneal nerves and disrupt the corneal epithelium and ocular surface, which can influence surgical outcomes and aggravate dryness symptoms in older age groups. This review summarises the current understanding of how the invasive nature of contact lens wear and cataract and refractive surgery influence signs and symptoms of ocular dryness in an aging population.
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Affiliation(s)
- E Lafosse
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain; Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - J S Wolffsohn
- Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - C Talens-Estarelles
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain
| | - S García-Lázaro
- Optometry Research Group, Department of Optics & Optometry & Vision Sciences, University of Valencia, Valencia, Spain.
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