Abstract
Dysfunctional lens syndrome (DLS) is a term coined to describe the natural aging changes in the crystalline lens. Different alterations in the refractive properties and transparency of the lens are produced during the development of presbyopia and cataract, such as changes in internal high order aberrations or an increase in ocular forward scattering, with a potentially significant impact on clinical measures, including visual acuity and contrast sensitivity. Objective technologies have emerged to solve the limits of current methods for the grading of the lens aging, which have been linked to the DLS term. However, there is still not a gold standard or evidence-based clinical guidelines around these new technologies despite multiple research studies have correlated their results with conventional methods such as visual acuity or the lens opacification system (LOCS), with more scientific background around the ocular scattering index (OSI) and Scheimpflug densitometry. In either case, DLS is not a new evidence-based concept that leads to new knowledge about crystalline lens aging but it is a nomenclature change of two existing terms, presbyopia and cataracts. Therefore, this term should be used with caution in the scientific peer-reviewed literature.
Highlights
Dysfunctional lens syndrome (DLS) describes the natural lens changes in the crystalline lens and has been helpful in educating patients, staff, and doctors about these changes for years [1]. e crystalline lens aging from presbyopia to cataracts is coined in a single term which includes three stages. e stage 1 has been popularly suggested [1, 2] from 42 to 50 years old and corresponds to the term of presbyopia, when accommodation has been lost but light scatter remains relatively limited
Presbyopia can, start before the age of forty and the light can scatter after sixty [4]. e DLS, is not a new evidence-based concept that leads to new knowledge about crystalline lens aging, but it is a nomenclature change of two existing terms, presbyopia and cataracts
Donaldson et al [11] rigorously described the physiological optics of the crystalline lens and the development of cataract, suggesting future possible treatments based on functionality changes at the cellular level
Summary
Different alterations in the refractive properties and transparency of the lens are produced during the development of presbyopia and cataract, such as changes in internal high order aberrations or an increase in ocular forward scattering, with a potentially significant impact on clinical measures, including visual acuity and contrast sensitivity. There is still not a gold standard or evidence-based clinical guidelines around these new technologies despite multiple research studies have correlated their results with conventional methods such as visual acuity or the lens opacification system (LOCS), with more scientific background around the ocular scattering index (OSI) and Scheimpflug densitometry. DLS is not a new evidence-based concept that leads to new knowledge about crystalline lens aging but it is a nomenclature change of two existing terms, presbyopia and cataracts. DLS is not a new evidence-based concept that leads to new knowledge about crystalline lens aging but it is a nomenclature change of two existing terms, presbyopia and cataracts. erefore, this term should be used with caution in the scientific peer-reviewed literature
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