Regarding the surgical reversal of presbyopia (SRP) surgery for presbyopia, vol 108, number 12, December 2001, 2161-2.
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Accommodation, Ocular↗
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Regarding the surgical reversal of presbyopia (SRP) surgery for presbyopia, vol 108, number 12, December 2001, 2161-2.
Explore the source record for details and available documents.
Accommodation, Ocular↗
Population-based study of presbyopia in rural Tanzania.
OBJECTIVE: To determine the prevalence of presbyopia in a rural African population. DESIGN: Cross-sectional prevalence study. PARTICIPANTS: One thousand seven hundred nine persons age 40 years and older who resided in 3 villages and randomly selected neighborhoods of Kongwa town, Tanzania. METHODS: Eligible persons were refracted and given best distance correction. Near vision was tested and corrected to the nearest 0.5 diopter. Presbyopia was defined as at least 1 line of improvement on a near visual acuity chart with an addition of a plus lens. RESULTS: A total of 61.7% of eligible participants were presbyopic. A higher prevalence of presbyopia was associated with increased age, female gender, higher educational level, and residence in town (odds ratio = 3.09; 95% confidence interval: 2.46-3.90). The odds of developing presbyopia increased 16% per year of age from age 40 to 50, but the increase was nonsignificant at 1% per year after age 50. More severe presbyopia was associated with female gender and less with education. CONCLUSIONS: This study provides the first population-based data on prevalence of presbyopia in a large, random sample of older Africans and suggests a high rate of presbyopia. Presbyopia plateaus after age 50, and it is more common in females. In addition, the 3-fold increased odds in town versus village dwellers was unexpected and suggests that research of other factors, including environmental factors, is warranted.
Adult↗
A population-based assessment of presbyopia in the state of Andhra Pradesh, south India: the Andhra Pradesh Eye Disease Study.
PURPOSE: To determine the prevalence of presbyopia in the state of Andhra Pradesh in south India. METHODS: Comprehensive ocular examinations including logMAR (logarithm of the minimum angle of resolution) distance and near (presenting and best corrected) visual acuity, slit lamp biomicroscopy of the anterior segment, and dilated posterior segment examinations were performed using a standardized protocol for subjects identified through a random cluster-sampling strategy in Andhra Pradesh. Information of difficulty in performing near tasks was collected as part of a visual function questionnaire administered to all subjects. A person was defined as having presbyopia if the person required an addition of at least 1.0 D in either eye for near vision in addition to their best corrected distance correction to improve near vision to at least N8 and if they had graded lens opacities (Lens Opacities Classification System [LOCS III] system). RESULTS: Examined in the study were 5587 subjects 30 years of age or older (mean age 47.5+/-13.0 years). The age-, gender-, and area-adjusted prevalence of presbyopia was 55.3% (95% confidence interval [CI]: 54.0-56.6). One third (n=1173; 30.0%) of the 3907 subjects with presbyopia were currently using spectacles. Of the 2734 subjects with presbyopia and not using spectacles, 528 (19.3%) had moderate to severe difficulty in reading small print, and 2085 (76.3%) had moderate to severe difficulty in recognizing small objects and performing near work, including 1057 (38.6%) subjects who were unable to manage any near work. On multivariate analysis, female sex (OR: 1.4, 95% CI: 1.1-1.8), rural residence (OR: 1.5, 95% CI: 1.2-1.8), alcohol consumption (OR: 0.8, 95% CI: 0.6-0.9), nuclear opacity of the lens greater than grade 2 LOCS III (OR: 4.8, 95% CI: 1.4-16.8), myopia (OR: 1.6, 95% CI: 1.3-2.1), and hyperopia (OR: 3.6, 95% CI: 2.7-5.2) were associated with presbyopia. CONCLUSIONS: The high prevalence of presbyopia and the stated effect on performing activities related to near vision needs to be translated into programs and strategies that specifically target presbyopia.
Activities of Daily Living↗
Impact of presbyopia on quality of life in a rural African setting.
PURPOSE: To determine the impact of uncorrected presbyopia on quality of life in rural Tanzania. DESIGN: Cross-sectional study. PARTICIPANTS: Population-based sample of 1709 village and town-dwelling adults aged 40 and older in the Kongwa district in rural Tanzania. METHODS: Subjects underwent distance and near visual acuity testing to determine presbyopia. A near vision-related quality of life questionnaire was administered by trained interviewers to determine the degree of self-rated difficulty with tasks appropriate to life in a rural African setting, and how much near vision loss contributed to this difficulty. MAIN OUTCOME MEASURES: Near vision-related quality of life. RESULTS: Complete data were available for 1564 (92%) of the subjects. The prevalence rate of presbyopia was 62%. The majority of presbyopes (94%) did not have corrective near vision glasses. Compared with nonpresbyopes, being presbyopic increased the odds of reporting some difficulty with near vision tasks by 2-fold (odds ratio [OR], 2.04; 95% confidence interval [CI]: 1.57-2.66), odds of reporting moderate difficulty by 5-fold (OR 5.01; 95% CI: 3.19-7.89), and odds of reporting high difficulty by >8-fold (OR 8.52; 95% CI 3.13-23.10). The degree of presbyopia was associated with increasing difficulty with daily tasks (P<0.0001). CONCLUSIONS: This is the first study to demonstrate that uncorrected presbyopia has a significant impact on vision-related quality of life in a rural African setting. The high prevalence of presbyopia, and increased aging of the population in developing countries, suggests that the World Health Organization's Vision 2020 refraction agenda should place greater emphasis on presbyopia.
Activities of Daily Living↗
A study of racial differences in age at onset and progression of presbyopia.
BACKGROUND: This study investigated reported differences in age at onset and progression of presbyopia between black and white patients. METHODS: The records of 692 primary care patients (242 black and 450 white), ages 35 to 55 years, who received eye examinations at the University of Alabama at Birmingham School of Optometry (December 1, 1992 and May 31, 1993), were reviewed retrospectively. Regression models were used to compare age at onset and progression of presbyopia of study subjects with respect to race. Also, the effect of socioeconomic status (SES) was assessed for a subset of 373 subjects. RESULTS: No significant differences in the age at onset or progression of presbyopia were detected between black and white patients (p > 0.05). Similarly, there were no significant differences in age at onset and progression of presbyopia with respect to socioeconomic status. CONCLUSIONS: Contrary to previous studies, the onset and progression of presbyopia of black and white patients in this study population did not differ significantly. This result suggests other factors may play a role in previously reported variation of presbyopia in black and white patients. Similarly, variations in income status did not significantly impact the onset and progression of presbyopia. Further study is needed to corroborate or refute these findings.
Adult↗
Associations of presbyopia with vision-targeted health-related quality of life.
OBJECTIVE: To evaluate the associations of presbyopia and its correction, particularly monovision optical correction, with vision-targeted health-related quality of life. METHODS: The National Eye Institute Refractive Error Quality of Life (NEI-RQL) Instrument was prospectively self-administered by subjects from 6 medical centers in the following age and correction categories: subjects with emmetropia younger than 45 years (n = 75), subjects with emmetropia aged 45 years or older (n = 38), and subjects with ametropia aged 45 years or older without monovision (n = 486) or corrected with monovision (n = 38). Differences in the 13 NEI-RQL Instrument subscale scores among subjects in the 4 groups were examined. The age of 45 years or older was used as a surrogate for presbyopia. RESULTS: A comparison of older (age > or =45 years) vs younger (age <45 years) persons with emmetropia suggests that presbyopia was associated with reduced scores in 7 of 13 subscales (P<.05). In those aged 45 years or older, correction of presbyopia with monovision was associated with statistically significantly better scores on 3 subscales (expectations, dependence on correction, and appearance) compared with single-vision correction. One subscale (dependence on correction) showed worsening scores with increasing age without adjustment for need or type of correction. Older persons with monovision correction had significantly worse scores than younger subjects with emmetropia on all subscales except suboptimal correction and appearance. CONCLUSIONS: Presbyopia is associated with worse vision-targeted health-related quality of life compared with younger subjects with emmetropia. Monovision correction of presbyopia is related to some improvements in health-related quality of life, but it is still worse than that for younger subjects with emmetropia in several areas.
Adult↗
The mechanism of presbyopia.
Accommodation in humans refers to the ability of the lens to change shape in order to bring near objects into focus. Accommodative loss begins during childhood, with symptomatic presbyopia, or presbyopia that affects one's day to day activities, striking during midlife. While symptomatic presbyopia has traditionally been treated with reading glasses or contact lenses, a number of surgical interventions and devices are being actively developed in an attempt to restore at least some level of accommodation. This is occurring at a time when the underlying cause of presbyopia remains unknown, and even the mechanism of accommodation is occasionally debated. While Helmholtz' theory regarding the mechanism of accommodation is generally accepted with regard to broad issues, additional details continue to emerge. Age-related changes in anterior segment structures associated with accommodation have been documented, often through in vitro and/or rhesus monkey studies. A review of these findings suggests that presbyopia develops very differently in humans compared to non-human primates. Focusing on non-invasive in vivo human imaging technologies, including Scheimpflug photography and high-resolution magnetic resonance imaging (MRI), the data suggest that the human uveal tract acts as a unit in response to age-related increasing lens thickness and strongly implicates lifelong lens growth as the causal factor in the development of presbyopia.
Accommodation, Ocular↗
Southeastern Asian refugees' presbyopia.
The onset and terminal stages of presbyopia, the loss of amplitude of accommodation of the eye associated with old age, of the Southeastern Asian refugees were investigated. Subjects examined in a 6-mo. period in an optometric practice are included. A +1.00 D add was used to define onset of presbyopia, and +2.00 to 2.50 D, the terminal stage. Only those age 42 yr. and below were analyzed, a total of 184 subjects. Of these 68 required a +1.00 D or larger add. chi 2 test of an obvious increase in add requirement from ages 30-34 to 35-39 yr. was significant, meaning that the onset of presbyopia begins at the age of 35 yr. Age 42 yr. was considered the most probable age to be the terminal stage. An unusual feature, presbyopia occurring below age 35 yr., was noted. Thus, the earlier onset and terminal stages of presbyopia of the Southeastern Asian refugees support the notion of the regional, ethnic, and environmental influences in the development of presbyopia.
Adolescent↗
The aetiology of presbyopia: a summary of the role of lenticular and extralenticular structures.
Presbyopia is a condition of age rather than ageing and, as such, is devolved from the lamentable situation where the normal age-related reduction in amplitude of accommodation reaches a point when the clarity of vision at near cannot be sustained for long enough to satisfy an individual's requirements. Most of our facility to accommodate has been lost by 55 years-of-age and subsequent deterioration in visual performance at near is attributable to characteristics of senescent vision familiar to the optometrist. Our understanding of the cause of presbyopia has then to be derived principally from our understanding of the mechanism of accommodation in young eyes. Hermann von Helmholtz did much to clarify these mechanisms, but despite much research in the 100 years since his death, there is still no consensus on their precise nature. This paper presents a summary of issues, past and present, which have figured in the literature on the physiology of accommodation and presbyopia, and confirms that the pathophysiology of presbyopia is likely to result from deterioration in structure and function of a number of inter-related tissues. Changes in crystalline lens dimensions with age, the associated change in geometry of zonular attachments, and changes in viscoelastic properties of the lens capsule and lens matrix would, however, appear to be the principal correlates for the onset of presbyopia. Recent models of the biomechanics of accommodation have drawn attention to the feasibility of extralenticular contributions to presbyopia and have examined properties of the elasticity and leverage provided by posterior, anterior and tensile fibre systems.(ABSTRACT TRUNCATED AT 250 WORDS)
Accommodation, Ocular↗
A retrospective study on presbyopia onset and progression in a Hispanic population.
BACKGROUND: This study evaluates differences in age and presbyopia progression between an ethnic Hispanic and a non-Hispanic patient population. METHODS: Patient records from the Optometric Center of Los Angeles were examined retrospectively from 1998 through 2001. The first part of the study compared ages at onset and progression of presbyopia as a function of ethnicity. The second part of the study compared the amplitude of accommodation for the cohort of patients to Hofstetter's expected norms. RESULTS: A total of 332 patient records were evaluated: 61% (n = 203) Hispanic and 39% (n = 129) non-Hispanic. For an add power of +0.75 D, presbyopia developed in the reviewed Hispanic population at 39.31 years of age in comparison to development in non-Hispanics at 40.22 years. Hispanics also had a similar progression of reading add power (0.105 D/year) as compared to non-Hispanics (0.097 D/year) (t= 0.798, p = 0.43). The progression of amplitude of accommodation for the Hispanic (amplitude = 11.2 - 0.132 x age) and non-Hispanic populations (amplitude = 9.72 - 0.18 x age) (t= 0.0997, p = 0.92) were comparable, but both groups show a slower decline of amplitude when compared to Hofstetter's norms (p< 0.001). CONCLUSIONS: No statistically significant difference in the age at onset and progression of presbyopia was found between Hispanic and non-Hispanic patients; however, both groups of patients have a later onset and slower progression of presbyopia when compared to Hofstetter's norms.
Adult↗
Correlation between presbyopia, age and number of births of mothers in the Kumasi area of Ghana.
There is an assumption in Ghana that motherhood has an effect on presbyopia. This study thus attempts to correlate the relationship between presbyopia, age and number of births of mothers in the Kumasi area of Ghana. The data were compiled from records of patients who attended routine eye examinations and refraction tests at the Morny Optical Centre, Kumasi, during the last quarter of 1993. Presbyopia in males and females, and those of mothers and childless female adults for particular age groups were compared. Correlations were found between age and reading additions for both sexes, and presbyopia occurs at a younger age than published. This preliminary study does not indicate any inter-dependence of births on female presbyopia. Further studies with select data may be required to confirm the above findings.
Adolescent↗
Accommodation and presbyopia: the ciliary neuromuscular view.
Presbyopia (literally, "old eye"), the age-related loss of the ability to accommodate, is the most common ocular affliction in the world. Although the lens no doubt has a major role in presbyopia, altered lens function could be in part secondary to extralenticular age-related changes, such as loss of ciliary body forward movement. Centripetal ciliary muscle movement does not seem to decrease significantly with age. Loss of elasticity of the ciliary muscle posterior attachments may be an important factor contributing to presbyopia. Even if loss of ciliary muscle mobility is not causally related to presbyopia, it may limit the performance of putatively accommodating intraocular lenses now being developed by academic and industrial groups.
Accommodation, Ocular↗
Myopic astigmatism and presbyopia trial.
PURPOSE: No prospective double-masked study has evaluated whether low astigmatism benefits or harms patients with presbyopia, whose intermediate and near vision might theoretically benefit from enhanced depth of focus provided by astigmatism. The purpose of the first Myopic Astigmatism and Presbyopia (MAP I) study was to determine whether low myopic astigmatism enhances or harms the visual acuity, stereopsis, or quality of life in patients with presbyopia. DESIGN: Prospective, randomized, double-masked, crossover design clinical trial. METHODS: Fifteen patients with presbyopia aged 45 to 68 years were recruited from an academic center population. These patients were given a baseline eye examination, including manifest refraction, Early Treatment of Diabetic Retinopathy Study (ETDRS) logarithm of minimal angle of resolution (logMAR) visual acuity at distance, intermediate, and near, accommodative amplitudes, and stereo vision. Each patient was then cycled in random order through three masked pairs of soft contact lenses. The power of each contact lens pair was calculated by the subtraction method to maintain a spherical equivalent of -0.5 diopters, while providing either no astigmatism (spherical arm, SPH), 1 diopter of with-the-rule (WTR) astigmatism, or 1 diopter of against-the-rule (ATR) astigmatism. Actual refractive errors produced were measured by masked examiner. Outcomes measured at the end of 1 week of usage of each contact lens arm were binocular (ETDRS) logMAR visual acuity at three distances (far [4 m], intermediate [1 m], and near [33cm]); near stereoacuity, using the quantitative Titmus Stereotest; and quality of life, measured using the Refractive Status and Vision Profile (RSVP), a standardized questionnaire. RESULTS: Visual acuity results across the three arms were similar. However, 1-m logMAR visual acuity was better for the spherical arm than either astigmatic arm (-0.06 SPH, +0.01 WTR, +0.02 ATR). Near (33 cm) and distance (4 m) acuities were similar across arms. Stereoacuity was better in ATR than WTR (50 vs 102 seconds, P =.01). Subjects preferred SPH slightly over the WTR astigmatic arm by the RSVP quality-of-life survey instrument (101 vs 104, P =.05). Other intergroup comparisons showed no difference in RSVP scores. CONCLUSIONS: This study has demonstrated that intermediate distance acuity and refractive quality of life are slightly better with spherical low myopic refractive error vs either astigmatic arm. Near and far distance acuity were unaffected by low myopic astigmatism compared with spherical low myopia. Near stereopsis was best in the ATR arms, but this did not produce better near visual acuity or RSVP quality of life.
Aged↗
Presbyopia: the first stage of nuclear cataract?
Presbyopia, the inability to accommodate, affects almost everyone at middle age. Recently, it has been shown that there is a massive increase in the stiffness(1) of the lens with age and, since the shape of the lens must change during accommodation, this could provide an explanation for presbyopia. In this review, we propose that presbyopia may be the earliest observable symptom of age-related nuclear (ARN) cataract. ARN cataract is a major cause of world blindness. The genesis of ARN cataract can be traced to the onset of a barrier within the lens at middle age. This barrier restricts the ability of small molecules, such as antioxidants, to penetrate into the centre of the lens leaving the proteins in this region susceptible to oxidation and post-translational modification. Major protein oxidation and colouration are the hallmarks of ARN cataract. We postulate that the onset of the barrier, and the hardening of the nucleus, are intimately linked. Specifically, we propose that progressive age-dependent hardening of the lens nucleus may be responsible for both presbyopia and ARN cataract.
Accommodation, Ocular↗
Optical surface optimization for the correction of presbyopia.
Presbyopia, the gradual loss of accommodation that accompanies aging, can be corrected by creating asphericity in the optical path of the eye. Bifocal and aspheric contact lenses, intraocular lenses, spectacle lenses, and laser refractive surgery are all widely used to alleviate the symptoms of presbyopia. These types of corrective surfaces try to concentrate vision in limited peaks over the full range of vergences. The methodology described in this paper is designed to correct presbyopia by optimizing vision over the entire target range of near to distant. A corrective surface was created by employing an iterative function minimization algorithm to optimize an optical metric. In most cases, it is possible to obtain an optical surface that will optically compensate for presbyopia.
Animals↗
[Advances in surgical management of presbyopia].
Presbyopia is age-related reduction in amplitude of accommodation and can not read comfortably. Current methods such as single-focus glasses, bifocal glasses and progressive additional lens are the most widely used for correction of presbyopia. All surgical solutions for presbyopia do not improve the physiological amplitude of accommodation. This article is an attempt to review the advances in surgical management of presbyopia.
Humans↗
Accommodation and presbyopia.
The mechanism of accommodation has been studied for at least four hundred years. The most interesting aspect of accommodation is that its time course is well in advance of other physiological functions--it begins to decline by adolescence and is lost about two-thirds of the way through the normal life span. The state of presbyopia is reached when accommodation has declined sufficiently to interfere with close tasks requiring acute vision. Presbyopia is generally considered to originate with the 'plant' of the accommodative system, either within the lens and its capsule or within their support structures. One of the lenticular theories, the Hess-Gullstrand theory, is distinguished from other theories by its claim that as age increases there is an increasing excess amount of ciliary muscle contraction beyond the ability of the lens and capsule to respond to it. For all other theories, the maximum possible amount of ciliary muscle contraction is always necessary to produce maximum accommodation, at least beyond the age at which it reaches its peak. From my review of the present understanding of the mechanisms of accommodation and the theories of the development of presbyopia, I conclude that there is overwhelming evidence against the Hess-Gullstrand theory and that it is unlikely that changes in the ciliary muscle contractility contribute significantly to the development of presbyopia.
Accommodation, Ocular↗