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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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Abstract
The incidence of visual impairment greatly increases with age. Diabetic retinopathy, senile cataracts, senile macular degeneration and glaucoma are the leading causes of blindness in elderly persons. Environmental modifications, such as levels of illumination and reduction of glare, can enhance an individual's ability to function in society. The nursing home population needs to pay attention to environmental factors as well as standardization of procedures for vision assessment. Much work is needed to develop programs to properly screen and treat the visual problems in elderly persons.
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Affiliation(s)
- A.R. Morse
- The Jewish Guild for the Blind, New York, NY 10023
| | - R. Silberman
- Hunter College of CUNY, Dept. of Special Education, New York, NY 10023
| | - E. Trief
- Early Intervention, The Jewish Guild for the Blind, 15 West 65th Street, New York, NY 10023
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Hsieh MC, Hong LY, Wang EMY, Chao WC, Yang CC, Su LC. Effect of correlated colour temperature and illuminance levels on user's visual perception under LED lighting in Taiwan. ERGONOMICS 2020; 63:175-190. [PMID: 31782686 DOI: 10.1080/00140139.2019.1699964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
This study aimed to utilise the characteristics of light-emitting diode (LED) lighting, including the adjustable correlated colour temperature (CCT) and illuminance levels, to evaluate the effects of various CCT and illuminance level combinations on visual perception and their patterns under different lighting conditions. Five white light balances with different CCTs were created together with four levels of illuminance. Based on the patterns of visual perception, when the CCT increased with the illuminance levels, the participants' visual perception changed from dim, boring, and sleepy to intense, vivid, energetic, and bright. As the CCT decreased, the participants gradually perceived the lighting as warm and relaxing. As illuminance levels increased, dim and unpleasant feelings progressively changed to bright and pleasant ones. The study attempted to identify lighting combinations that can respond to different psychological needs and can be used as a guide in the future design of lighting equipment. Practitioner summary: Appropriate lighting conditions could aid individuals in increasing the quality of life. This study conducted an experiment to evaluate the effects of various correlated colour temperature and illuminance level combinations on visual perception by using LED lighting. The results showed the effect of the different lighting combinations on the visual perception of the participants. Abbreviation: LED: light-emitting diode; CCT: correlated colour temperature; K: Kelvin; lx: Lux; CIE: Commission Internationale de l'Eclairage; ANSI: American National Standards Institute.
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Affiliation(s)
- Min-Chih Hsieh
- Department of Industrial Engineering, University of Shanghai for Science and Technology, Shanghai, China
- Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu, Taiwan (R.O.C)
| | - Li-Ying Hong
- Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu, Taiwan (R.O.C)
| | - Eric Min-Yang Wang
- Department of Industrial Engineering and Engineering Management, National Tsing Hua University, Hsinchu, Taiwan (R.O.C)
| | - Wei-Cheng Chao
- Electronic and Optoelectronic System Research Laboratory, Industrial Technology Research Institute, Hsinchu, Taiwan (R.O.C)
| | - Chi-Chin Yang
- Electronic and Optoelectronic System Research Laboratory, Industrial Technology Research Institute, Hsinchu, Taiwan (R.O.C)
| | - Li-Chi Su
- Electronic and Optoelectronic System Research Laboratory, Industrial Technology Research Institute, Hsinchu, Taiwan (R.O.C)
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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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Affiliation(s)
- W Neil Charman
- Biology, Medicine and Health, University of Manchester, Manchester, UK
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Nioi A, Roe J, Gow A, McNair D, Aspinall P. Seasonal Differences in Light Exposure and the Associations With Health and Well-Being in Older Adults: An Exploratory Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2017; 10:64-79. [PMID: 29056090 PMCID: PMC5656103 DOI: 10.1177/1937586717697650] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This article reports summer verses winter seasonal variations across a suite of blue light, illuminance levels and health and well-being indicators. BACKGROUND The quality of lighting in care homes has been assessed previously, yet seasonal comparisons and the associations with sleep quality are limited. This exploratory study investigates light exposure in two seasons to determine the changes over time and the associations with health and well-being. METHODS In a repeated measures design, 16 older people (aged 72-99 years) living in a care home had their personal light exposure and sleep/wake patterns monitored for 4 days. Cognitive ability, mental well-being, daytime physical activity, and visual function were assessed. Mean light levels at preset times across the day, duration in light exposure over 1,000 lux, and sleep parameters were computed. Statistical investigations included correlations exploring associations and paired means tests to detect the changes between seasons. RESULTS The mean morning illuminance level in summer was 466 lux and 65 lux in winter. Duration in bright light over 1,000 lux was 46 min in summer and 3 min in winter. Light measures were significantly higher in summer. There was no statistical difference in sleep quality parameters between seasons, but there were significant difference in daytime physical activity level (i.e., this was higher in summer). CONCLUSION The findings indicate low level of light exposures experienced in both seasons, with exposure levels being particularly low in winter. This provides new insights into the limited amount of light older people receive independent of season and the possible impacts on sleep and daytime physical activity level.
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Affiliation(s)
- Amanda Nioi
- Department of Human Health, School of Engineering and Physical Science, Heriot-Watt University, Edinburgh, UK
- School of Energy, Geoscience, Infrastructure and Society, Heriot-Watt University, Edinburgh, UK
| | - Jenny Roe
- Center for Design and Health, School of Architecture, University of Virginia, Charlottesville, VA, USA
- Stockholm Environment Institute, University of York, York, UK
| | - Alan Gow
- School of Management and Languages, Heriot-Watt University, Edinburgh, UK
- Centre for Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - David McNair
- Dementia Centre, Hammond Care, Sydney, Australia
| | - Peter Aspinall
- School of Energy, Geoscience, Infrastructure and Society, Heriot-Watt University, Edinburgh, UK
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Van Hoof J, Kort HS. Supportive living environments: A first concept of a dwelling designed for older adults with dementia. DEMENTIA 2009. [DOI: 10.1177/1471301209103276] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The vast majority of older adults want to remain living independently at home, with or without a sufficient amount of professional home care, even when overall health is starting to decline. The ageing of society and the increase in the number of very old elders goes together with an increase in the number of people with dementia. About two thirds of the diagnosed people in the Netherlands live at home. Dementia has severe implications to the quality of daily life, in particular to independent functioning. This sets extra demands to living environments. Older adults with dementia and their partners ask for living environments that support independence, compensate for declining vitality, and lower the burden of family care. For this purpose, a first concept of a design for a dementia dwelling is presented in this paper, which incorporates modifications in terms of architecture, interior design, the indoor environment, and technological solutions. These design features were derived from literature search and focus group sessions. Current design guidelines are frequently based on practical experience only, and therefore, more systematic field research should be carried out to find evidence for the various design modifications. Also, it needs to be studied how the design features of the dementia dwelling can be incorporated into the existing housing stock.
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Affiliation(s)
- Joost Van Hoof
- Hogeschool Utrecht University of Applied Sciences, The
Netherlands,
| | - Helianthe S.M. Kort
- Hogeschool Utrecht University of Applied Sciences, and
Vilans, The Netherlands,
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Van Someren EJW, Riemersma RF, Swaab DF. Functional plasticity of the circadian timing system in old age: light exposure. PROGRESS IN BRAIN RESEARCH 2002; 138:205-31. [PMID: 12432772 DOI: 10.1016/s0079-6123(02)38080-4] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Eus J W Van Someren
- Graduate School Neuroscience Amsterdam, Netherlands Institute for Brain Research, Meibergdreef 33, 1105 AZ Amsterdam, The Netherlands.
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Abstract
The incidence of disturbed sleep is strongly increased in healthy and demented elderly. Age-related alterations in the circadian timing system appear to contribute strongly to these problems. With increasing age, a lack of input to the suprachiasmatic nucleus (SCN), the biological clock of the brain, may accelerate de-activation of neurons involved in the generation of 24-h rhythm or output of this rhythm. This process appears to be reversible, since supplementation of stimuli that impinge on the SCN can re-activate these neurons and ameliorate disturbances in the sleep-wake rhythm.
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Teresi JA, Holmes D, Ory MG. The therapeutic design of environments for people with dementia: further reflections and recent findings from the National Institute on Aging Collaborative studies of Dementia special care units. THE GERONTOLOGIST 2000; 40:417-21. [PMID: 10961030 DOI: 10.1093/geront/40.4.417] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J A Teresi
- Hebrew Home for the Aged, Research Division, Riverdale, NY 10471, USA.
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Charness N, Dijkstra K. Age, luminance, and print legibility in homes, offices, and public places. HUMAN FACTORS 1999; 41:173-193. [PMID: 10422530 DOI: 10.1518/001872099779591204] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Field studies were conducted in homes, offices, and public places with younger and older adults to determine how legibility performance (in a proofreading and phone book search) changes with age and luminance. Homes and public places generally exhibited much lower than recommended luminance values for reading. Older adults had higher light levels in their homes than did younger adults at reading locations. Older adults performed less quickly than did younger adults on most legibility tasks. Adding light helped younger and older adults equally for most legibility tasks (in homes and public places), though increased luminance differentially improved the performance of older office workers. In response to feedback about low light levels, nearly 60% of building managers in public places indicated in a 6-month follow-up that they had improved lighting or were planning to do so. Actual or potential applications of this work include setting luminance guidelines for adults and identifying barriers to lighting changes.
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Affiliation(s)
- N Charness
- Psychology Department, Florida State University, Tallahassee 32306-1270, USA.
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Abstract
Aging is associated with a variety of decremental visual changes, including reductions in retinal illuminance, color discrimination, static and dynamic acuity, near focus, contrast sensitivity, smooth and saccadic eye movements, visual field, visual search, and the ability to see in and recover from glare. Laboratory research, field studies, and self-report data all indicate that many older persons experience significant difficulty in carrying out tasks that depend on these visual functions. It is also increasingly clear that older observer's performance in finding, extracting, and using visual information can be enhanced significantly by designing task environments to minimize the effects of visual deficits. Recent research indicates that optical simulation of visual loss and contrast sensitivity testing, used in conjunction with image processing, may be very powerful tools for designing displays for the elderly and others with diminished spatial vision. These developments are reviewed, and general guidelines for creating ergonomically correct visual task environments for older observers are offered.
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Affiliation(s)
- D W Kline
- Department of Psychology, University of Calgary, Alberta, Canada
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14
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Genhart MJ, Kelly KA, Coursey RD, Datiles M, Rosenthal NE. Effects of bright light on mood in normal elderly women. Psychiatry Res 1993; 47:87-97. [PMID: 8516421 DOI: 10.1016/0165-1781(93)90058-o] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Reduced light appears to be a key factor in seasonal affective disorder (SAD). This study asks whether the reduced levels of light experienced by elderly persons might result in depression and other SAD symptoms, and how normal elderly persons might respond to bright light interventions similar to those used to treat SAD. In interviews with 140 senior citizens, we found virtually no seasonal variation in mood and behavior and very little depressed affect. Seventeen of these seniors who had good mental and physical health, with no major eye problems, participated in a crossover study of the effects of bright light on both positive and negative affect and sleep. Although sleep did not appear to be affected, the bright light intervention tended to make these normal elderly persons feel worse--more irritable, anxious, and agitated. These findings confirm earlier reports that bright light is not beneficial for normal individuals who are unaffected by seasonal changes.
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Affiliation(s)
- M J Genhart
- Adolescent Day Treatment Center, California Pacific Medical Center, San Francisco
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15
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Kelly JS. Visual impairment among older people. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 1993; 2:110-6. [PMID: 8448423 DOI: 10.12968/bjon.1993.2.2.110] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Visual impairment is the most age-related disability, with older people forming the majority of the visually disabled population. This article re-examines the nature of visual impairment among older people and points to a key role for nurses in identification and intervention.
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Abstract
1. Nurses need to be aware of the effects of artificial lights on the aged because the aged spend a greater amount of time under these lights than do younger people. 2. Although the aged require more light than younger people to see, bright lights may cause glare. The use of indirect lighting is recommended to reduce problems with glare. 3. The aged see best under artificial lighting that simulates natural sunlight. 4. Nurses who work in institutional settings should be sensitive to the need for individualized light-dark cycles.
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Abstract
Recently, it has been reported that melatonin administration extends the lifespan of mice, a finding which supports previous research on the effects of pinealectomy and pineal extract administration. The prolongation of lifespan by melatonin has been interpreted in favour of an upregulation of the immune system as well as due to anti-stress properties of melatonin acting via the brain opioid system. In this paper we offer an alternative explanation of melatonin's anti-aging effect: the circadian pacemaker system has a diminished amplitude with age as indexed by a decrease in circulating melatonin levels. Stability of the circadian system correlates with its amplitude and loss of circadian amplitude produces lability which, in turn, leads to internal temporal disorder. Internal temporal disorder may be a precursor of disease states. Exogenous melatonin increases the amplitude of the circadian pacemaker system by feedback onto that system. The hypothalamic suprachiasmatic nuclei are thought to be the mammalian biological clock in the brain and have high concentrations of melatonin receptors. Therefore, melatonin administration in pharmacological doses may prevent aging symptoms by acting at the level of the circadian pacemaker's amplitude.
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Affiliation(s)
- S M Armstrong
- Psychology Department, La Trobe University, Bundoora, Victoria, Australia
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Andreasen ME, Conley DM. Let the sun shine in. Geriatr Nurs 1987; 8:174-7. [PMID: 3649324 DOI: 10.1016/s0197-4572(87)80214-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
Performance standards of dental task and ambient lighting systems were presented. Twelve brands of commercial dental lights were tested for compliance with ISO draft specifications. Technical results were presented and recommendations made to assist the dentist in selection of an optimal light system.
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Fozard JL. Person-environment relationships in adulthood: implications for human factors engineering. HUMAN FACTORS 1981; 23:7-27. [PMID: 7014417 DOI: 10.1177/001872088102300103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Environments for aging and the aged are best designed if human factors engineers incorporate a developmental view of adulthood in their planning. Accordingly, environments for living should be designed to accommodate the transitions between stages of adult life as well as the periods of stability. The optimal human factors interventions involve both psychosocial and physical aspects of the environment and include changing people through psychological intervention. Examples of human factors engineering for aging in perception, learning, and memory, as well as work, leisure, and health, illustrate areas that require successively more complicated plans for intervention.
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