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Current Opinion in Ophthalmology Jul 2021Presbyopia is the normal progressive loss of accommodation, which leads to the inability to focus clearly on objects located at different distances. Some of the accepted... (Review)
Review
PURPOSE OF REVIEW
Presbyopia is the normal progressive loss of accommodation, which leads to the inability to focus clearly on objects located at different distances. Some of the accepted methods for treating this condition are glasses, contact lenses, and surgery. Pharmacological treatments are a new and promising noninvasive option for dealing with presbyopia. The aim of this review is to provide an update on some recent advances in this field.
RECENT FINDINGS
Currently, there are three different strategies for the pharmacological treatment of presbyopia. The first one aims to produce miosis and increase depth of focus through a pinhole effect, therefore improving uncorrected near visual acuity. The second one tries to restore the elasticity the lens has lost due to aging. Finally, the third strategy is based on rehabilitating accommodation; which is to say, in a binocular way, allowing for good vision at all distances.
SUMMARY
Pharmacological treatments are a new alternative that expands the diversity of existing strategies for treating presbyopia. These treatments are based on the instillation of eyedrops with different compositions, which vary according to the different strategies. Many of these developments will most likely be on the market in the next few years. If the process of patient selection is done properly, any one of these three strategies can be used successfully.
Topics: Accommodation, Ocular; Humans; Ophthalmic Solutions; Practice Guidelines as Topic; Presbyopia; Visual Acuity
PubMed: 33973905
DOI: 10.1097/ICU.0000000000000770 -
Journal of Refractive Surgery... Oct 2022To compare objective measurements of accommodation and pseudoaccommodation in phakic and pseudo-phakic eyes using ray-tracing aberrometry.
PURPOSE
To compare objective measurements of accommodation and pseudoaccommodation in phakic and pseudo-phakic eyes using ray-tracing aberrometry.
METHODS
Patients with normal and hyperprolate corneas (post-hyperopic laser in situ keratomileusis) who underwent cataract surgery from March 2018 to October 2019 at the Medical University of South Carolina were examined and received either a diffractive intraocular lens (IOL) with an echelette design (Tecnis ZXR00 Symfony; Johnson & Johnson Vision), a monofocal IOL with negative spherical aberration (Tecnis ZCB00; Johnson & Johnson Vision), or an aberration-free IOL (MX60E; Bausch & Lomb). The control groups consisted of young and presbyopic phakic patients. Ray-tracing wavefront analysis was performed 1 to 3 months postoperatively. Objective ray-tracing metrics of accommodation and pseudoaccommodation included the effective range of focus, sphere shift accommodation, and depth of focus.
RESULTS
Sixty-two eyes received a Tecnis ZCB00, 39 a MX60E, and 43 a Tecnic ZXR00 Symfony IOL; furthermore, 20 young phakic eyes and 19 presbyopic eyes were included in this study. The effective range of focus and sphere shift accommodation in the young control group were statistically larger than in the presbyopic group ( = .005 and < .001, respectively). There was no difference in effective range of focus, sphere shift accommodation, and pseudoaccommodations between the different IOL groups. The young control group had the highest visual Strehl optical transfer function for near and distant targets (0.64 ± 0.24 and 0.56 ± 0.19, respectively), whereas the aberration-free IOL in the MX60E hyperprolate cornea group presented the lowest visual Strehl optical transfer function value for near (0.49 ± 0.19).
CONCLUSIONS
Ray-tracing aberrometry can objectively assess accommodative amplitude in phakic eyes and pseudoaccommodation (depth of focus) in pseudophakic eyes. .
Topics: Aberrometry; Accommodation, Ocular; Humans; Lens Implantation, Intraocular; Lenses, Intraocular; Phacoemulsification; Pseudophakia
PubMed: 36214353
DOI: 10.3928/1081597X-20220830-02 -
Journal of the Optical Society of... Jun 2022Multifocal contact lenses are increasingly popular interventions for controlling myopia. This study presents the short-term effects of multifocal contact lenses on...
Multifocal contact lenses are increasingly popular interventions for controlling myopia. This study presents the short-term effects of multifocal contact lenses on foveal and peripheral vision. The MiSight contact lenses designed to inhibit myopia progression and the 1-Day Acuvue Moist contact lenses designed for presbyopia were investigated. The MiSight produced similar foveal results to spectacles despite the increased astigmatism and coma. The MiSight also reduced the low-contrast resolution acuity in the periphery, despite no clear change in relative peripheral refraction. When compared with spectacles, Acuvue Moist decreased accommodative response and reduced foveal high- and low-contrast resolution acuity, whereas peripheral thresholds were more similar to those of spectacles. The most likely treatment property for myopia control by the MiSight is the contrast reduction in the peripheral visual field and the changed accommodation.
Topics: Accommodation, Ocular; Contact Lenses; Eyeglasses; Humans; Myopia; Visual Acuity
PubMed: 36215526
DOI: 10.1364/JOSAA.450195 -
Optometry and Vision Science : Official... Jul 2021The popularity of competitive video game play is growing rapidly. Little is known about the ocular characteristics of esports participants. Refractive error and...
SIGNIFICANCE
The popularity of competitive video game play is growing rapidly. Little is known about the ocular characteristics of esports participants. Refractive error and binocular measures in young adult gamers were similar to population norms. However, tear breakup time was lower, and accommodative lag was higher.
PURPOSE
In a recent report, very young video game players were found to have greater levels of refractive error and heterophoria and reduced stereopsis. The purpose of this study was to assess the visual and ocular characteristics of a group of recreational esports athletes to determine if the findings in young children were similar to findings in a group of young adult video game players.
METHODS
Vision tests were performed on 36 college students during a video game combine event. Testing included high- and low-contrast visual acuity, autorefraction at distance and at 33 cm, stereoacuity, near heterophoria, and tear breakup time. Participants also indicated their level or rank in the game Overwatch.
RESULTS
Fifteen participants were myopic, and 21 did not wear vision correction. The mean local stereopsis was 31.9 seconds. The mean of the esophoric value was 3.2 prism diopters, and the mean of the exophoric value was 5.7 prism diopters. The mean lag of accommodation was 0.81 D. The mean tear breakup time was 5.8 seconds. Average hours of play did not differ between those who wore vision correction and those who did not. There were no significant relationships between the hours of play and the ocular findings.
CONCLUSIONS
The prevalence of refractive error and the mean heterophoria were similar to population norms, and the mean stereoacuity was normal. However, accommodative lag was slightly higher, and the tear breakup time was lower than expected. Differences in these latter values were also noted between high- and low-level Overwatch players.
Topics: Accommodation, Ocular; Child; Child, Preschool; Humans; Myopia; Refractive Errors; Strabismus; Visual Acuity; Young Adult
PubMed: 34328456
DOI: 10.1097/OPX.0000000000001725 -
Asia-Pacific Journal of Ophthalmology... 2017With an explosive increase in the worldwide prevalence of presbyopia, development of an accommodating intraocular lens (IOL) with expansive accommodative amplitude... (Review)
Review
With an explosive increase in the worldwide prevalence of presbyopia, development of an accommodating intraocular lens (IOL) with expansive accommodative amplitude remains the holy grail in lens-based refractive surgery. A dynamic change in the dioptric power of the eye can be accomplished by various strategies alone or in combination, including changes in the position, shape, or refractive index of a single- or dual- optic IOL. This article reviews the cumulative advances in these various lens designs, along with clinical outcomes and complications of those that have been implanted. The challenges that remain in each cat-egory are also highlighted.
Topics: Accommodation, Ocular; Humans; Lenses, Intraocular; Optics and Photonics; Postoperative Period; Presbyopia; Prosthesis Design
PubMed: 28650131
DOI: 10.22608/APO.2017198 -
Journal of Cataract and Refractive... Mar 2015
Topics: Accommodation, Ocular; Anterior Eye Segment; Diagnostic Techniques, Ophthalmological; Humans; Presbyopia
PubMed: 25804576
DOI: 10.1016/j.jcrs.2015.02.003 -
Clinical & Experimental Optometry May 2024Concussion, which is usually associated with head injuries, has received considerable attention in recent years because of its possible long-term cognitive and visual... (Review)
Review
Concussion, which is usually associated with head injuries, has received considerable attention in recent years because of its possible long-term cognitive and visual consequences. The review summarised the mild traumatic brain injury literature. Pupillary dynamics, which are primarily mediated by the autonomic nervous system, play an important function in regulating the amount of light entering the eye, but they can be dramatically impacted after a concussion. This can result in aberrant pupillary responses, which may have ramifications for light sensitivity, a common post-concussion symptom. In concussed individuals, accommodation and vergence - the visual processes responsible for focusing on near and distant objects - might be interrupted, potentially leading to fuzzy vision, eyestrain, and difficulty with tasks that require precise visual coordination. Understanding the delicate interplay between these three components of vision in the setting of concussions is critical for creating more targeted diagnostic and rehabilitative techniques, ultimately enhancing the quality of life for those who have had head injuries.
Topics: Humans; Accommodation, Ocular; Brain Concussion; Convergence, Ocular; Pupil
PubMed: 38325849
DOI: 10.1080/08164622.2024.2311692 -
Clinical & Experimental Optometry Jan 2020Peripheral image quality influences several aspects of human vision. Apart from off-axis visual functions, the manipulation of peripheral optical errors is widely used... (Review)
Review
Peripheral image quality influences several aspects of human vision. Apart from off-axis visual functions, the manipulation of peripheral optical errors is widely used in myopia control interventions. This, together with recent technological advancements enabling the measurement of peripheral errors, has inspired many studies concerning off-axis optical aberrations. However, direct comparison between these studies is often not straightforward. To enable between-study comparisons and to summarise the current state of knowledge, this review presents population data analysed using a consistent approach from 16 studies on peripheral ocular optical quality (in total over 2,400 eyes). The presented data include refractive errors and higher order monochromatic aberrations expressed as Zernike co-efficients (reported in a subset of the studies) over the horizontal visual field. Additionally, modulation transfer functions, describing the monochromatic image quality, are calculated using individual wavefront data from three studies. The analysed data show that optical errors increase with increasing eccentricity as expected from theoretical modelling. Compared to emmetropes, myopes tend to have more hypermetropic relative peripheral refraction over the horizontal field and worse image quality in the near-periphery of the nasal visual field. The modulation transfer functions depend considerably on pupil shape (for angles larger than 30°) and to some extent, the number of Zernike terms included. Moreover, modulation transfer functions calculated from the average Zernike co-efficients of a cohort are artificially inflated compared to the average of individual modulation transfer functions from the same cohort. The data collated in this review are important for the design of ocular corrections and the development and assessment of optical eye models.
Topics: Accommodation, Ocular; Corneal Wavefront Aberration; Emmetropia; Humans; Refraction, Ocular; Refractive Errors; Visual Fields
PubMed: 31382321
DOI: 10.1111/cxo.12943 -
Insight (American Society of Ophthalmic...
Review
Topics: Accommodation, Ocular; Humans; Presbyopia; Quality of Life; Risk Factors; Visual Acuity
PubMed: 30074720
DOI: No ID Found -
Ophthalmic & Physiological Optics : the... Jul 2023Individuals with different types of intermittent exotropia (IXT) may use neurally coupled accommodation and vergence responses differently from those without exotropia...
PURPOSE
Individuals with different types of intermittent exotropia (IXT) may use neurally coupled accommodation and vergence responses differently from those without exotropia to achieve eye alignment. This study examined the relationship between simultaneously recorded accommodation and vergence responses in children and young adults with a range of types of IXT while aligned and deviated.
METHODS
Responses of 29 participants with IXT (4-31 years) and 24 age-matched controls were recorded using simultaneous eye-tracking and eccentric photorefraction while they watched a movie in binocular or monocular viewing at varying viewing distances. Gradient response AC/A ratios and fusional vergence ranges were also assessed. Eight participants had divergence or pseudo-divergence excess type IXT, 5 had convergence insufficiency and 16 had basic IXT.
RESULTS
Control and IXT participants accommodated similarly both in monocular and binocular-aligned conditions to visual targets at 80 and 33 cm. When deviated in binocular viewing, most participants with IXT exhibited changes in accommodation <0.5D relative to alignment. Gradient response AC/A ratios were similar for control [0.56 MA/D (IQR: 0.51 MA/D)] and IXT participants [0.42 MA/D (0.54 MA/D); p = 0.60]. IXT participants showed larger vergence to accommodation ratios with changes from distance to near fixation [1.19 MA/D (1.45 MA/D)] than control participants [0.78 MA/D (0.60 MA/D); p = 0.02], especially among IXT participants with divergence or pseudo-divergence excess. Participants with IXT exhibited typical fusional divergence ranges beyond their dissociated position [8.86 Δ (7.10 Δ)] and typical fusional convergence ranges from alignment [18 Δ (15.75 Δ)].
CONCLUSIONS
This study suggests that control of IXT is typically neither driven by accommodative convergence alone nor associated with over-accommodation secondary to fusional convergence efforts. These simultaneous measurements confirmed that proximal vergence contributed significantly to IXT control, particularly for divergence or pseudo-divergence excess type IXT. For IXT participants in this study, achieving eye alignment did not conflict with having clear vision.
Topics: Child; Young Adult; Humans; Exotropia; Vision, Binocular; Convergence, Ocular; Accommodation, Ocular; Strabismus; Chronic Disease
PubMed: 36692334
DOI: 10.1111/opo.13093