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 433 records · Page 24Linked to original sources

The application of a computerised diagnostic index for ophthalmic practice.

All 2792 patients seen in my private practice between July 1989 and September 1992 and receiving a diagnosis were coded according to the International Classification of Diseases-9 (Clinical Modification), 1979. Any procedures performed were coded according to the American Medical Association Current Procedural Terminology. Patient details and codes were filed by computer using a customised database in Foxpro 2.0 software. Those with minor refractive error or presbyopia alone and those who had no abnormality were excluded from the database. The set-up and maintenance of this diagnostic index is described and the database structure is specified. A modification of the glaucoma section of ICD-9, which better suited my needs, is presented. Examples of the potential information available from such a database is described, including some analysis of this general ophthalmic practice.

Adolescent↗

Ophthalmology in proverbs and aphorisms.

After a comprehensive review of available texts and literature covering five millennia, the authors present a collection of ophthalmic proverbs and aphorisms with an examination of their applicability within current medical knowledge. A total of 74 ophthalmic proverbs and aphorisms were retrieved from 130 texts and divided into seven categories: (i) importance of vision ('The eyes, like sentinels, hold the highest place in the body'); (ii) definition of blindness and anatomical observations ('The eye is protected by the lashes, eyebrows, and orbit'); (iii) diseases of the eye such as presbyopia, sensitivity to light and dry eye ('Tear in the eye is jewel'); (iv) the eye as a window of the body; (v) vulnerability of the eye ('The eye cannot oppose an awl'); (vi) health behaviours and protection of sight ('Be gentle with two: women and eyes'), and finally; and (vii) nutrition and vision ('Carrots improve vision'). The majority of these proverbs and aphorisms can be used as a guide, not for prognosis, diagnosis or cure, but rather for ocular health promotion.

Aphorisms and Proverbs as Topic↗

Werner syndrome.

A case of Werner syndrome is reported. The patient was prematurely old, had skin atrophy, characteristic posterior subcapsular cataracts and prepubertal primary hypogonadism. Additional ocular features compatible with premature ageing included presbyopia, arcus seniles and diminished tear flow. Diabetes mellitus, poliosis, baldness and beak-like nose were not present.

Adult↗

Crystalline lens accommodation and anterior chamber depth.

Using paraxial equations, the change in dioptric power of the crystalline lens required to image objects at given distances from the eye, on the retina, is calculated. This shows that the depth of the anterior chamber affects crystalline lens accommodation more than other variables. The relationship between anterior chamber depth and presbyopia, and a possible geographical aspect, are discussed.

Accommodation, Ocular↗

Diplopia in the aged: etiology and management.

A description of diplopia, its causes, compensating mechanisms, and therapy is presented. Diplopia may be of benign origin, e.g., presbyopia or convergence insufficiency, but in the elderly it can be a warning of a severe local disorder or systemic disease. Early medical diagnosis should be a prime objective. Most of these disorders, if identified in time, can be cured or at least relieved by appropriate medical and surgical treatment.

Aged↗

Elastic constants of the human lens capsule.

1. A technique is described whereby the elasticity of the human lens capsule has been determined at birth and throughout life. This technique requires three separate determinations: (a) thickness; (b) stress and strain; (c) Poisson's ratio; (a) the capsule was clamped between accurately perforated ground glass plates and its thickness determined by noting the change in depth of focus between Latex spherules adhering to its upper and lower surfaces; (b) the undisturbed capsule was then placed in a specially designed glass distension apparatus and the relationship between volume and pressure recorded when it was distended with isotonic saline. The permeability of the capsule was also measured; (c) in some cases Poisson's ratio was determined by measuring the change of thickness of the capsule and the height to which it rose when distended with isotonic saline at different pressures. An apparatus was designed for this purpose.2. The average thickness of the anterior capsule increases from birth until about the 60th year but thereafter it decreases slightly.3. Poisson's ratio was about 0.47 for both cat and human capsule, and no significant variations with age in human capsule could be detected.4. Corrected volume pressure curves obeyed Hook's law almost to the point of capsule rupture.5. In childhood Young's Modulus of elasticity is about 6 x 10(7) dyn/cm(2) and decreases to 3 x 10(7) dyn/cm(2) at 60 and 1.5 x 10(7) dyn/cm(2) in extreme old age.6. The ultimate tensile stress was 2.3 x 10(7) dyn/cm(2) in young capsules and 0.7 x 10(7) dyn/cm(2) in old ones. The maximum percentage elongation was 29 per cent and independent of age.7. The implications of these findings are discussed in relation to(a) the mechanical properties of the lens capsule;(b) the ageing of the lens capsule and basement membranes; and(c) the decrease in elasticity of the lens capsule as a cause of presbyopia.

Aging↗

The force of contraction of the human ciliary muscle during accommodation.

1. Apparatus has been designed to alter the shape of the human lens by tensile forces applied to the zonular fibres indirectly through the ciliary body. The changes in dioptric power of the lens for monochromatic sodium light were measured at the same time. Simultaneous serial photography, and direct measurement enabled one to relate a change in shape of the lens to the change in dioptric power. Subsequently, the same lens was isolated and spun around its antero-posterior polar axis and high speed photography recorded its changing profile.2. By comparing the changes in lens profile due to zonular tension and centrifugal force respectively, the force developed in the zonule for a given change in the shape of the lens could be calculated. Changes in dioptric power associated with those of shape can thus be related directly to the force of contraction of the ciliary muscle necessary to reduce the initial tension of the zonule in the unaccommodated state.3. The force of contraction of the ciliary muscle as measured by radial force exerted through the zonule and the change in dioptric power of the lens were not linearly related. The relationship is more exactly expressed by the equation [Formula: see text] where D = amplitude of accommodation in dioptres (m(-1)), F(CB) = force of contraction of the ciliary muscle as measured by changes in tension of the zonule (N), K(df) = dioptric force coefficient and is constant for a given age (m(-1)N(-(1/2)) x 10(2.5)). This coefficient is 0.41 at 15 yr and 0.07 at 45 yr of age.4. In youth for maximum accommodation (10-12 D) the force is approximately 1.0 x 10(-2) N while to produce sufficient accommodation for near vision (3.5 D) the force is less than 0.05 x 10(-2) N.5. After the age of 30 yr the force of contraction of the ciliary muscle necessary to produce maximum accommodation rises steadily to about 50 yr of age and thereafter probably falls slightly. At about 50 yr of age the ciliary muscle is some 50% more powerful than in youth.6. Even if hypertrophy of the muscle did not occur the amplitude of accommodation would be reduced at the most by only 0.8 D of that observed at the onset of presbyopia.

Accommodation, Ocular↗

Is activated factor VII associated with retinal vein occlusion?

AIM: To determine whether a newly identified thrombophilia factor, activated factor VII (FVIIa), is associated with retinal vein occlusion (RVO). METHODS: 54 consecutive cases with RVO seen between March and September 1999 were included in the study. 22 cases had central retinal vein occlusion (CRVO) and 32 had branch retinal vein occlusion (BRVO). Ophthalmoscopic examination with detailed medical history was followed by blood analyses for liver and renal functions, cholesterol, triglycerides, complete blood count, and coagulation factors including protein C activity, free protein S, antithrombin III, fibrinogen, and factor VIIa (FVIIa). Data were compared with those of the control group, composed of 19 cases under ophthalmological follow up for refractive errors, presbyopia, or senile cataract. RESULTS: Hypertension was highly prevalent in cases with BRVO. Complete blood count, and liver and kidney function tests were within normal limits in the study group. Two cases had low protein C activity, and one had low free protein S. FVIIa levels were significantly higher in the RVO group than in the control group (p=0.0004). There was no significant difference in FVIIa levels between the CRVO and BRVO groups (p=0.51). CONCLUSION: No haematological parameter except FVIIa differed significantly from that of the control group. Elevation of FVIIa level may play a part in the pathophysiology of both CRVO and BRVO.

Adult↗

Ocular biomechanics and biotransport.

The eye transduces light, and we usually do not think of it as a biomechanical structure. Yet it is actually a pressurized, thick-walled shell that has an internal and external musculature, a remarkably complex internal vascular system, dedicated fluid production and drainage tissues, and a variety of specialized fluid and solute transport systems. Biomechanics is particularly involved in accommodation (focusing near and far), as well as in common disorders such as glaucoma, macular degeneration, myopia, and presbyopia. In this review, we give a (necessarily brief) overview of many of the interesting biomechanical aspects of the eye, concluding with a list of open problems.

Animals↗

The ageing lens.

The human lens grows by a process of epithelial cell division at its equator and the formation of generations of differentiated fibre cells. Despite the process of continuous remodelling necessary to achieve growth within a closed system, the lens can retain a high level of light transmission throughout the lifetime of the individual, with the ability to form sharp images on the retina. Continuous growth of the lens solves the problem imposed by terminal differentiation within a closed, avascular system, from which cells cannot be shed. The lens fibre tips arch over the equator to meet anteriorly and posteriorly and form branching sutures of increasing complexity. The stages of branching may create the optical zones of discontinuity seen on biomicroscopy. The lens is exposed to the cumulative effects of radiation, oxidation and postranslational modification. These later proteins and other lens molecules in such a way as to impair membrane functions and perturb protein (particularly crystallin) organisation, so that light transmission and image formation may be compromised. Damage is minimised by the presence of powerful scavenger and chaperone molecules. Progressive insolublisation of the crystallins of the lens nucleus in the first five decades of life, and the formation of higher molecular weight aggregates, may account for the decreased deformability of the lens nucleus which characterises presbyopia. Additional factors include: the progressive increase in lens mass with age, changes in the point of insertion of the lens zonules, and a shortening of the radius of curvature of the anterior surface of the lens. Also with age, there is a fall in light transmission by the lens, associated with increased light scatter, increased spectral absorption, particularly at the blue end of the spectrum, and increased lens fluorescence. A major factor responsible for the increased yellowing of the lens is the accumulation of a novel fluorogen, glutathione-3-hydroxy kynurenine glycoside, which makes a major contribution to the increasing fluorescence of the lens nucleus which occurs with age. Since this compound may also cross-link with the lens crystallins, it may contribute to the formation of high-molecular-weight aggregates and the increases in light scattering which occur with age. Focal changes of microscopic size are observed in apparently transparent, aged lenses and may be regarded as precursors of cortical cataract formation.

Aging↗

Three-dimensional arrangement of collagen fibrils in human ciliary body.

The purpose of this study is to visualize the three-dimensional arrangement of collagen fibrils in aged human ciliary body and discuss their significance. The ciliary bodies obtained from two human eyes were treated with a NaOH cell-maceration method for 7 days, then prepared conventionally for light and scanning electron microscopy. The general morphology of the collagen tissue in the ciliary body appeared almost the same as that normally observed. Cellular elements were completely removed, but collagen fibrils were well preserved. In the stroma of the ciliary body, collagen fibrils were arranged irregularly. In the areas of the radial and circular ciliary muscles, considerable numbers of collagen fiber bundles were observed running in a circular direction. A honeycomb structure was seen in the pars plana, the walls and base of which were formed by interweaving collagen fibrils. The results suggested that collagen fibrils in the aged human ciliary body may be largely involved in the presbyopia.

Aged↗

Geometrical gradients in the distribution of temperature and absorbed ultraviolet radiation in ocular tissues.

The geographical variations in the incidence of age-related ocular changes such as presbyopia and cataracts and diseases such as pterygium and droplet keratopathies have led to theories pointing to sunlight, ultraviolet radiation (UVR) exposure and ambient temperature as potential etiological factors. Some epidemiological evidence also points to an association of age-related macular degeneration to sunlight exposure. The actual distribution of sunlight exposure and the determination of temperature variations of different tissues within the anterior segment of the eye are difficult to assess. Of greatest importance are the geometrical factors that influence selective UVR exposures to different segments of the lens, cornea and retina. Studies show that the temperature of the lens and cornea varies by several degrees depending upon climate, and that the incidence of nuclear cataract incidence is greater in areas of higher ambient temperature (i.e., in the tropics). Likewise, sunlight exposure to local areas of the cornea, lens and retina varies greatly in different environments. However, epidemiological studies of the influence of environmental UVR in the development of cataract, pterygium, droplet keratopathies and age-related macular degeneration have produced surprisingly inconsistent findings. The lack of consistent results is seen to be due largely to either incomplete or erroneous estimates of outdoor UV exposure dose. Geometrical factors dominate the determination of UVR exposure of the eye. The degree of lid opening limits ocular exposure to rays entering at angles near the horizon. Clouds redistribute overhead UVR to the horizon sky. Mountains, trees and building shield the eye from direct sky exposure. Most ground surfaces reflect little UVR. The result is that highest UVR exposure occurs during light overcast where the horizon is visible and ground surface reflection is high. By contrast, exposure in a high mountain valley (lower ambient temperature) with green foliage results in a much lower ocular dose. Other findings of these studies show that retinal exposure to light and UVR in daylight occurs largely in the superior retina.

Animals↗

Accommodative ciliary body and lens function in rhesus monkeys, I: normal lens, zonule and ciliary process configuration in the iridectomized eye.

PURPOSE: The underlying causes of presbyopia, and the functional relationship between the ciliary muscle and lens during aging are unclear. In the current study, these relationships were studied in rhesus monkeys, whose accommodative apparatus and age-related loss of accommodation are similar to those in humans. METHODS: Centripetal ciliary body and lens equator movements were measured during accommodation in 28 eyes of 21 rhesus monkeys (ages, 5.7-26 years) by goniovideography. Ultrasound biomicroscopy was performed in 21 eyes of 17 monkeys. Narrowing of the angle between the anterior aspect of the ciliary body and the inner aspect of the cornea was used as a surrogate indicator of forward ciliary body movement during accommodation. RESULTS: Average centripetal ciliary body movement in older eyes (age > or =17 years, n = 16) was approximately 20% (0.09 mm) less than in young eyes (age, 6-10 years, n = 6), but not enough to explain the 60% (0.21 mm) loss in centripetal lens movement nor the 76% (10.2 D) loss in accommodative amplitude. Average forward ciliary body movement was 67% (49 degrees ) less in older (n = 11) versus young (n = 6) eyes. Maximum accommodative amplitude correlated significantly with the amplitude of centripetal lens movement (0.02 +/- 0.003 mm/D; n = 28; P < 0.001) and with forward ciliary body movement (3.34 +/- 0.54 deg/D; n = 21; P = 0.01). CONCLUSIONS: Decreased lens movement with age could be in part secondary to extralenticular age-related changes, such as loss of ciliary body forward movement. Ciliary body centripetal movement may not be the limiting component in accommodation in the older eye.

Accommodation, Ocular↗

[Prevalence of ocular diseases in a population of elderly residents of the city of Veranópolis, Brazil].

PURPOSE: To evaluate the prevalence of diseases of the eye in a population aged 80 years and above in the city of Veranópolis, Rio Grande do Sul, Brazil. METHODS: 187 elderly people were submitted to ophthalmologic tests including external inspection, ocular motility examination, visual acuity determination for near and far distance, applanation tonometry, biomicroscopy, cycloplegia, direct fundus examination and static skiascopy. RESULTS: The most prevalent disease was presbyopia in 173 (92.5%) patients, cataract in 160 (85.6%), age-related ectropion in 130 (69.5%), hypermetropia in 130 (69.5%) and age-related macular degeneration (ARMD) in 59 (31.5%) patients. 85 (45.4%) patients presented marked low vision whose main causes were cataract in 46 (54.1%) and refractive error in 16 (18.9%) of the studied population. The most prevalent complaint was due to presence of age-related ectropion. CONCLUSIONS: Common diseases as cataract and retractive error are still a challenge to ophthalmologists because these diseases remain main causes of visual deficit in old age resulting in life quality losses.

Aged, 80 and over↗

Communication and informed consent in clinical geriatrics.

Obtaining a valid informed consent from an elderly person, especially with possible senile dementia of the Alzheimer's type (SDAT), first may involve solving the practical problems of effective communication. Perceptual constraints that frequently occur in the elderly and that may interfere with communication, i.e., the sharing of information, are auditory and/or visual. The most common auditory obstacle, presbycusis (the hearing loss for pure tones due to normal aging) and other hearing impairments, may make the communication of any information about a proposed research project difficult, if not impossible, when not suspected and successfully overcome. Speech and language impediments, whether as a result of stroke or SDAT, are also common and need to be addressed if the person is to communicate his or her concerns and questions effectively with the researcher. Included in such constraints are the misunderstandings that arise from the use of confusing vocabulary, especially "medicalese." Presbyopia, cataract, and glaucoma are some of the visual constraints that may play an important role in making it difficult for the person to read the informed consent form. This article discusses these and other impediments to effective communication with SDAT elderly and makes suggestions how to obviate them.

Aged↗

Binocular rivalry alternation rate declines with age.

The effect of aging on the time of spontaneous perceptual alternation in binocular rivalry was examined in 59 subjects. An earlier study reported the change of alternation time by comparing middle-age and elderly subjects. We also observed age-related prolongation in alternation time by comparing subjects in a lower age group (20-34 years) with those in both a middle-age group (35-49 years) and a higher age group (50-64 years). Aging of visual optical functions such as presbyopia or the reduction of contrast sensitivity has an accelerating effect over age and may not be related to the age-associated monotonic prolongation of alternation time in binocular rivalry. The origin of aging in binocular rivalry is still unclear but a neural interval generator for perceptual switching is suggested.

Adult↗

Blindness and low vision in Jimma Zone, Ethopia: results of a population-based survey.

A population-based study on the prevalence of blindness and low vision was carried out in Jimma Zone, south-western Ethiopia between November 1994 and January 1995. A total of 7423 people from a sample of 8215 (90.4%) was examined. Sixty-three (0.85%) were blind (visual acuity less than 3/60 in the better eye) and 125 people (1.7%) had low vision (less than 6/18-3/60). Cataract and aphakia (52.4%), corneal opacity and phthisis bulbi (25.4%), and glaucoma (9.5%) were the major causes of blindness. Cataract (56.8%), refractive errors (28.8%), and corneal opacity (12.8%) were the major causes of low vision. Corneal opacity from trachoma was responsible for 20.6% of all blindness and 10.4% of low vision. The prevalence of visual impairment due to refractive errors was 5.1/1000 population. Almost 25% of the study population had active trachoma, and 0.9% of pre-school children had signs of vitamin A deficiency. Out of a total population of 2 million an estimated 17,000 people are blind and 34,000 have low vision (i.e., a total of 51,000 people with visual impairment). Approximately 20,000 people require cataract surgery, 52,000 require lid surgery for trichiasis, 24,000 require spectacles (excluding presbyopia), including 10,000 for significant refractive errors, half a million require treatment for active trachoma and 4,000 require glaucoma treatment. Effective and feasible eye care programs need to be established in the zone and the available ophthalmic services have to be strengthened. These may be achievable through joint efforts of the community and the Ministry of Health in collaboration with non-governmental organizations. The available eye services are briefly described and recommendations made to meet the important needs for prevention of blindness in the region.

Adolescent↗

U.S. trends in refractive surgery: 2001 International Society of Refractive Surgery Survey.

PURPOSE: To determine the trends in refractive surgery in the United States in 2001. METHODS: The 980 U.S. members of the International Society of Refractive Surgery were mailed the 2001 refractive surgery survey dealing with volumes, types, and preferences of refractive surgery performed. Questions regarding radial keratotomy, astigmatic keratotomy, photorefractive keratectomy, laser in situ keratomileusis (LASIK), laser subepithelial keratomileusis, intracorneal rings (Intacs), laser thermal keratoplasty, conductive keratoplasty, clear lens extraction, phakic intraocular lenses, and scleral expansion procedures for presbyopia were examined in the survey. Procedure preferences for low, moderate, and high myopia and hyperopia were compared with the results from the surveys of the previous 4 years. Preference for unilateral versus bilateral same-day surgery, laser type, and microkeratome choice were also compared with the survey data from previous years. Incidence and frequency of comanagement of refractive surgery patients were compared with 2000 data. RESULTS AND CONCLUSION: LASIK remains the dominant refractive surgery for refractive errors from -12.00 to +3.00 D; the VISX excimer laser and the Hansatome microkeratome are the most frequently used instruments for LASIK.

Health Care Surveys↗