Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PRESBYOPIA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources

Prismatic effects of spherical ophthalmic lenses.

Exact prismatic effects were calculated for stock spectacle lenses (-6 D to +10 D) and trial refracting set lenses (-10 D to +10 D) using a range of visual field eccentricities on the 0.30 m Goldmann perimeter, and on the 1- and 2-m tangent screens. Slightly larger prismatic effects were found for the tangent screens than the perimeter, but the difference in results for the two tangent screen distances was negligible. For low power ophthalmic lenses (-2 D +2 D), the prismatic effects were smaller than the variation in apparent target eccentricity caused by variation in patient fixation distance. Paraxial estimates of prismatic effects using both thick and thin lens theory were calculated, but found to become more inaccurate as target eccentricity increased. Data are presented which can be used by clinicians to predict the alteration in the size of kinetic perimetric isopters when ophthalmic lenses are used to correct patient defocus resulting from ametropia or presbyopia.

Eyeglasses↗

Image evaluation of ophthalmic devices.

Methods used in the ophthalmic industry to evaluate the optical image quality of correcting lenses have remained the same over many years. This is especially true for single-vision ophthalmic lenses. With the development of new optical designs and materials for correcting refractive errors and presbyopia, new procedures for evaluating lens performance are being explored. One such method is the measurement of the modulation transfer function. Over the last 2 years, we have been measuring modulation transfer functions on a variety of single-vision and bifocal contact lenses, progressive addition spectacle lenses, holographic-diffractive lenses, and intraocular lenses. In this article, the modulation transfer function procedure and its application and results from one study on safety goggles will be presented and discussed.

Eye Protective Devices↗

Is accommodative amplitude correlated with lens fluorescence?

We found a correlation between accommodative amplitude and lens fluorescence in a small population of subjects of nearly the same age. This supports the hypothesis that aging changes of the lens, including presbyopia, are related to lens growth.

Accommodation, Ocular↗

Factors influencing hand/eye synchronicity in the computer age.

In using a computer, the relation of vision to hand/finger actuated keyboard usage in performing fine motor-coordinated functions is influenced by the physical location, size, and collective placement of the keys. Traditional nonprehensile flat/rectangular keyboard applications usually require a high and nearly constant level of visual attention. Biometrically shaped keyboards would allow for prehensile hand-posturing, thus affording better tactile familiarity with the keys, requiring less intense and less constant level of visual attention to the task, and providing a greater measure of freedom from having to visualize the key(s). Workpace and related physiological changes, aging, onset of monocularization (intermittent lapsing of binocularity for near vision) that accompanies presbyopia, tool colors, and background contrast are factors affecting constancy of visual attention to task performance. Capitas extension, excessive excyclotorsion, and repetitive strain injuries (such as carpal tunnel syndrome) are common and debilitating concomitants to computer usage. These problems can be remedied by improved keyboard design. The salutary role of mnemonics in minimizing visual dependency is discussed.

Accommodation, Ocular↗

Evaluation of vision services delivered by a mobile eye clinic in Costa Rica.

A number of private voluntary organizations provide mobile eye services to underserved populations in the developing world. This paper seeks to determine what segment of the population makes use of mobile vision clinics and whether the clinics are identifying significant eye conditions previously undetected by local eye care providers. The population studied were those attending the 1989 vision screening project conducted in rural Costa Rica by members of Volunteer Optometric Services to Humanity (VOSH). Sources of data include patient records of clinic attendees (N = 1530), patient interviews, and Costa Rican census data. Most of the clinic attendees were female (56.9%), over 35 years of age, and literate (71.1%). The three most commonly stated occupation categories were (1) housewife; (2) agriculture, forestry, or fishery worker; and (3) student. Over one-half reported having had a previous eye examination. Presbyopia and low hyperopia were the predominant refractive conditions encountered. Over one-third of patients presented with visual acuities 6/15 (20/50) or worse, and one-third of this group had never had an eye examination. Three-quarters of the patients required prescription lenses and over 20% had cataract. The dispensing of presbyopic corrections to first time patients is clearly the most valuable service provided by the clinics. Teaming up with mobile cataract camps may improve the access to surgical care for patients with cataract. It is important that mobile vision projects target future efforts toward those likely to be missed by conventional screenings.

Adolescent↗

Age-related changes in human ciliary muscle.

PURPOSE: To examine the role of the ciliary muscle in accommodation and presbyopia. METHODS: Sixteen pairs of eyes from donors aged 1 to 107 years were treated with atropine or pilocarpine and then processed for light microscopy. Seven pairs were analyzed for treatment effects, including morphometric measurements of muscle dimensions, muscle fiber group area, and the percentage of connective tissue. RESULTS: The ciliary muscle shortened in length in response to drug treatment at all ages. The ciliary muscle of older subjects contained greater amounts of connective tissue and was shorter, wider and the internal apical edge moved forward. CONCLUSIONS: This study confirms previous reports that the human ciliary muscle retains its ability to contract throughout the lifespan. However, the ciliary muscle also displayed age-related changes, which may be partly accounted for by the forces exerted from the aging lens and zonules.

Accommodation, Ocular↗

The thickness of the aging human lens obtained from corrected Scheimpflug images.

Commonly, measurements of lens thickness are performed using A-scan ultrasonography or slitlamp Scheimpflug photography. Both techniques have their drawbacks in the study of presbyopia: ultrasonography requires the velocity of sound in the lens which may change with age, whereas Scheimpflug photography requires knowing the refractive index of the lens to enable correction of the photographs for the distortion due to the refraction of the cornea and lens. By combining Scheimpflug photography and axial optical eye-length measurements, we were able to individually correct the Scheimpflug images for distortion and calculate the refractive index and thickness of the human lens. Lens thickness of 90 subjects ranging in age between 16 and 65 years was measured, and an average increase of 24 microm/year was found. This value is consistent with ultrasonographic measurements assuming an age-independent velocity of sound in the lens of 1641 m/s. The posterior lens surface recedes from the cornea with age, and this backward movement does not differ significantly from the forward movement of the anterior lens surface.

Adolescent↗

What are the visual benefits of eyelid squinting?

PURPOSE: We propose that eyelid squint can reduce the impact of several conditions known to cause eyestrain such as uncorrected refractive error, accommodative dysfunction, presbyopia, and glare. Clinicians commonly accept that squint improves visual acuity (VA) in the presence of refractive error, and even though the benefit of eyelid squint in bright light seems self-evident, data are not available to support either benefit. The purpose of this study was to measure the effect of eyelid squint on VA in the presence of refractive blur and on visual field sensitivity. METHODS: Nineteen subjects with optimal refractive correction were tested, with and without squinting, as follows: (1) distance VA with induced refractive errors of +0.50, +1.00, +2.00, +3.00, +1.00 -1.00 x 90, and +1.00 -1.00 x 180; (2) near VA with induced refractive errors of -1.00 x 90 and -1.00 x 180; and (3) central and peripheral threshold visual fields with a Humphrey Field Analyzer. Differences in visual acuity between squinting and nonsquinting were tested for significance with repeated-measures analysis of variance, and differences in visual fields were tested using mixed model analysis of variance with repeated measures. RESULTS: Eyelid squint significantly improved (p < 00.016) distance VA measurements for 1.00 to 3.00 D of induced myopia. The squint-induced VA improvement increased from 0.06 logarithm of the minimum angle of resolution for 1.00 D to 0.24 logarithm of the minimum angle of resolution for 3.00 D of myopia. Eyelid squint also significantly reduced visual field sensitivity below the horizontal meridian by an average of 1.4 dB, by 1.6 dB on the horizontal meridian, and with increasing reductions in the vertical field up to 11.6 dB for measurements 40 degrees above fixation. This pattern of decreased superior field sensitivity would decrease visual discomfort from overhead glare. CONCLUSIONS: The results provide empirical support that eyelid squint improves visual acuity for subjects with refractive error and reduces glare in the superior visual field.

Adult↗

Refractive cataract surgery.

Cataract surgery is the most commonly performed refractive procedure in the world today. Improvements in the calculation of intraocular lens power and design have allowed complete spherical correction of preexisting refractive error with intraocular lens implantation. Advances in incision construction have improved the refractive results of cataract surgery by minimizing surgically induced astigmatism. Astigmatism and pseudophakic presbyopia continue as the primary indications for spectacle correction following cataract surgery. Improvements in the technique of correcting preexisting astigmatism with cataract surgery have improved the uncorrected visual outcome of cataract surgery. The application of these advances in technology over the past year has demonstrated that full refractive correction of the cataract patient is now possible.

Astigmatism↗

Quantitative assessment of the anterior segment using ultrasound biomicroscopy.

The development of ocular imaging devices has progressed rapidly during the past 10 years. Ultrasound biomicroscopy has revolutionized the evaluation of the anterior segment of the eye. The qualitative information gathered using this technology has contributed to our understanding of the pathophysiology of angle-closure glaucoma, pigmentary glaucoma, and a variety of other anterior segment disorders. However, the area of quantitative analysis of ultrasound biomicroscopic images remains largely to be developed. This review describes the role of ultrasound biomicroscopy in the measurement of the anatomic structures and their configurations within the anterior segment. Included are previously published and established methods as well as methods in their early stages of development. Application of quantitative image analysis techniques should yield significant information about mechanisms of appositional angle closure, dynamic functions of the iris, accommodation, and presbyopia.

Anterior Eye Segment↗

Refractive lens exchange with a multifocal intraocular lens.

Refractive lens exchange with a multifocal intraocular lens is becoming a more popular method of refractive surgery in the presbyopic patient. The limitations of keratorefractive surgery have led to a resurgence of lens exchange surgery for patients with prescriptions outside the limits of corneal refractive procedures, in addition to patients with routine refractive errors requesting a surgical procedure to achieve emmetropia and also address presbyopia. Side effects of multifocal technology including unwanted photic phenomena and deterioration in contrast sensitivity are being further defined and evaluated to better assess the effects of these intraocular lenses on functional vision and patient satisfaction. Attention to detail in regards to proper patient selection, preoperative measurements, intraoperative technique, and postoperative management will ultimately result in excellent outcomes and improved patient acceptance of this effective technique.

Device Removal↗

Refractive lens exchange as a refractive surgery modality.

PURPOSE OF REVIEW: Refractive lens exchange is becoming a more popular method of refractive surgery in the presbyopic patient. The limitations of keratorefractive surgery have led to a resurgence of lens exchange surgery for patients with prescriptions outside the limits of corneal refractive procedures, in addition to patients with routine refractive errors requesting a surgical procedure to achieve emmetropia and also address presbyopia. A review of the recent literature was performed to determine recent advances in this surgical procedure. RECENT FINDINGS: New multifocal and accommodative lens technology should enhance patient satisfaction. In addition, newer lens extraction techniques using microincisions and new phacoemulsification technology will enhance the safety of this procedure, ultimately allowing refractive lens exchanges to be performed through two microincisions as future lens technologies become available. SUMMARY: Attention to detail in regard to proper patient selection, preoperative measurements, intraoperative technique, and postoperative management has resulted in excellent outcomes and improved patient acceptance of this effective technique.

Humans↗

Multifocal intraocular lenses.

PURPOSE OF REVIEW: Multifocal intraocular lenses (IOLs) are growing in popularity among patients and surgeons, and opened the way to refractive lens exchange. Still they are not used routinely in cataract surgery, for reasons probably connected to the frequently observed reduction in contrast sensitivity. Recent papers with clinical study outcomes can help in understanding the advantages and the limits of multifocal IOLs. RECENT FINDINGS: Emerging from every published study, both refractive and diffractive multifocal IOLs usually provide good near visual acuity with distance correction. As many multifocal IOLs are distance-dominant, near vision can be improved by correcting for near the distance focus. The near contrast sensitivity thus obtained is similar to that of monofocal IOLs. Multifocal IOLs have been employed with success in complicated cataract surgery and in trauma cases, with the same outcome as in normal cataract cases. Presbyopic lens exchange remains controversial, with a high success rate in original ametropic eyes, but limited success in original emmetropic eyes. Secondary procedures to improve the refractive outcome are usually of little efficacy in improving patient satisfaction. A new anterior chamber phakic multifocal IOL has been designed to correct presbyopia and small refractive errors. The first clinical results indicate high patient satisfaction, with 7.3% explantation rate. SUMMARY: Multifocal IOLs can be more widely used after cataract surgery, but should be used with caution in almost emmetropic eyes with little or no cataract. Refractive lens exchange with multifocal IOL is especially worthwhile in hyperopic eyes. The new phakic multifocal IOL adds the concept of reversibility to presbyopic lens exchange.

Humans↗

Phakic intraocular lenses.

PURPOSE OF REVIEW: Laser in-situ keratomileusis has been tremendously successful in treating patients with mild and moderate ametropias. For patients with high degrees of refractive error, however, phakic intraocular lenses provide superior quality of vision without the risk of corneal ectasia. Early international results, as well as United States Food and Drug Administration clinical trials, have demonstrated the early safety and efficacy of phakic intraocular lenses. Nevertheless, long-term corneal endothelium cell density and crystalline lens clarity remain a concern. RECENT FINDINGS: Several new studies demonstrate the superior visual outcomes of phakic intraocular lenses over laser in-situ keratomileusis in patients with moderate and high myopia, particularly in the areas of visual quality and contrast sensitivity. New anterior segment imaging and measurement technologies have provided valuable information about in-vivo structure and function, with and without phakic lens implants. More is being learned about long-term endothelial cell stability and cataract formation, particularly in relation to implant positioning. New applications of phakic intraocular lenses in presbyopia and in other conditions are being explored. SUMMARY: Once plagued by complications and marginal outcomes, improved designs of phakic intraocular lenses are providing increasing safety and efficacy for the correction of severe ametropias. Long-term concerns with endothelial cell loss remain, but recent data suggest stabilization with time. Proper sizing and positioning are important and increasingly achievable with new imaging modalities. With continued research and experience, phakic intraocular lenses are becoming an invaluable addition to the mainstream refractive surgery armamentarium.

Humans↗

Effects of an educational seminar on rejection demographics in patients presenting for laser in situ keratomileusis.

PURPOSE: To evaluate the effectiveness of an educational seminar as an initial screening tool for patients interested in laser in situ keratomileusis (LASIK) and to determine the incidence of and reasons for patients not being candidates for the procedure. METHODS: A retrospective review of the medical charts of 438 consecutive patients, half of whom attended an educational seminar, and half of whom did not. All patients underwent ophthalmic evaluations as candidates for LASIK. The reasons for patients not proving to be good candidates were determined. RESULTS: Thirteen percent of all patients examined were found not to be suitable candidates for LASIK. There was no difference in rejection rates between patients who had attended a seminar and those who had been screened and educated over the telephone by a skilled technician. The principal reasons for rejection were, in decreasing order of frequency: cataract, presbyopia, abnormal corneal curvature, insufficient corneal thickness, unstable refraction, large pupil, irregular astigmatism, anterior basement membrane dystrophy, previous corneal surgery, uncontrollable dry eye, and previously undiagnosed ocular malignancy. CONCLUSIONS: Patients educated through group seminars or individually by trained technicians over the telephone still present for consideration for LASIK with unidentified ocular problems that make them poor surgical candidates. This occurs at a rate of 13%. The majority of the patients required a careful evaluation to uncover the abnormalities.

Attitude of Health Personnel↗

Kersley lecture: eye believe in contact lenses: contact lenses and/or refractive surgery.

PURPOSE: Media publicity has made patients increasingly aware that surgical vision correction is available. This article gives an overview on refractive surgery and contact lenses. METHODS: Contact lens and refractive surgery possibilities are highlighted for patients with myopia, hyperopia, astigmatism, presbyopia, aphakia, and keratoconus. Therapeutic, pediatric, and cosmetic indications are discussed. RESULTS: Refractive surgery is beneficial for low refractive errors. The use of contact lenses is mandatory in cases of monovision and strabismus before refractive surgery and beneficial for therapeutic use postoperatively. CONCLUSION: Although many patients are always best corrected with contact lenses, only the right synergism of contact lenses and refractive surgery will benefit patients.

Contact Lenses↗

Ocular vergence under natural conditions. II. Gaze shifts between real targets differing in distance and direction.

Horizontal binocular eye movements of three subjects were recorded with the scleral sensor coil--revolving magnetic field technique during voluntary shifts of gaze between pairs of stationary, real, continuously visible targets. The target pairs were located either along the median plane (requiring symmetrical vergence), or on either side of the median plane (requiring asymmetrical vergence). Symmetrical vergence was primarily smooth, but it was often assisted by small, disjunctive saccades. Peak vergence speeds were very high; they increased from about 50 degrees s-1 for vergence changes of 5 degrees to between 150 and 200 degrees s-1 for vergence changes of 34 degrees. Differences between convergence and divergence were idiosyncratic. Asymmetrical vergence, requiring a vergence of 11 degrees combined with a version of 45 degrees, was largely saccadic. Unequal saccades mediated virtually all (95%) of the vergence required in the divergent direction, whereas 75% of the vergence required in the convergent direction was mediated by unequal saccades, with the remaining convergence mediated by smooth vergence, following completion of the saccades. Peak divergence speeds during these saccades were very high (180 degrees s-1 for a change of vergence of 11 degrees); much faster than the smooth, symmetrical vergence change of comparable size (14 degrees). Peak convergent saccadic speeds were about 20% lower. This difference in peak speed was caused by an initial, transient divergence, observed at the beginning of all horizontal saccades. The waveform of disjunctive saccades did not have the same shape as the waveform of conjugate saccades of similar size. The smaller saccade of the disjunctive pair was stretched out in time so as to have the same duration as its larger, companion saccade. These results permitted the conclusion that the subsystems controlling saccades and vergence are not independent. Vergence responses were relatively slow and incomplete with monocular viewing, which excluded disparity as a cue. Monocularly stimulated vergence decreased as a function of the increasing presbyopia of our three subjects. Subjects were able to generate some vergence in darkness towards previously seen and remembered targets. Such responses, however, were slow, irregular and evanescent. In conclusion, vergence shifts between targets, which provided all natural cues to distance, were fast and accurate; they appeared adequate to provide effective binocular vision under natural conditions. This result could not have been expected on the basis of previous observations, all of which had been made with severely reduced cues to depth.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

Sensitivity analysis of the stimulus-response function of a static nonlinear accommodation model.

The effect of parameter variation of a nonlinear static feedback control model of the accommodation system was investigated. Simulations of a MATLAB/SIMULINK model showed a nonlinear relationship between stimulus and response in which the response curve was above the 1:1 line in the region to the left of the crossover and below the 1:1 line in the region to the right of the crossover. At the crossover, the response curve exhibited an inflection that was constant and equal to the tonic accommodation value (ABIAS). Sensitivity analysis showed that increasing depth of focus (deadspace range between +/- DSP) increased the separation between the boundary lines of the deadspace region, with a larger separation associated with late-onset myopia and congenital nystagmus. Increasing accommodative controller gain (ACG) increased the slope of the function on either side of the deadspace, with lower ACG values corresponding to lower slopes that indicated an amblyopic deficit. Increasing ABIAS increased the accommodative level at the inflection region. In addition, the saturation level of the accommodative response decreased with increasing age, while the slope remained the same, which was consistent with the Hess-Gullstrand theory of presbyopia. The accuracy and relative simplicity of the model indicated that it could serve as a basis for further comprehensive investigation of the basic and clinical aspects of the accommodation system.

Accommodation, Ocular↗