Progression Of Presbyopia Research Articles

Near Add Power of Glaucoma Patients with Early Presbyopia.

Purpose: Glaucoma medication may accelerate the progression of presbyopia. The aim of this study was to compare presbyopia between controls and patients with glaucoma in their 40s. Methods: This was a cross-sectional study of bilateral phakic participants aged between 40 and 49, which included controls (n = 114, mean age 46.1 ± 2.7 y) and patients with primary open-angle glaucoma (n = 105, 46.4 ± 2.7 y) who had been using FP receptor agonists, beta blockers, and carbonic anhydrase inhibitors for at least six months. We compared the near add power between the two groups. Results: The mean near add power and the prevalence of symptomatic presbyopia (near add power ≥ 1.50 D) were 1.16 ± 0.74 D and 42.1% for controls and 1.77 ± 0.71 D (p < 0.01) and 79.0% (p < 0.01) for glaucoma patients, respectively. The odds ratio (OR) and confidence interval for symptomatic presbyopia were associated with age (1.36, 1.21-1.52), ganglion cell complex thickness (0.96, 0.94-0.99), presence of glaucoma (6.19, 3.13-12.23), and number of glaucoma medications (4.26, 2.42-7.43). Among medications, only FP receptor agonists (5.79, 2.68-12.32) produced significant results. Survival analysis showed that glaucoma patients reached the threshold of a near add power of +1.50 D significantly sooner than controls (p < 0.05; log-rank test). Conclusions: Glaucoma patients, especially those using FP receptor agonists, had higher near add power than controls.

Presbyopia, Dry Eye, and Retinal Thickness in the Middle-Aged Population: Focusing on Sex Differences.

Risk factors for presbyopia have not been fully determined although previous studies suggested presbyopia was associate with age, dry eye, and retinal ganglion cell complex thickness (GCC). We accessed these signs and common ocular symptoms in the middle-aged population focusing on sex differences when women have drastic hormonal change. This cohort study consecutively enrolled 2743 patients aged 36-45 years (n=1000), 46-55 years (n=1000), and 56-65 years (n=743). All underwent ocular surface tests and had near add power and GCC measured. Common ocular symptoms were asked using questionnaire. Among female participants, visual symptoms (eye strain and photophobia) were more prevalent in the age group 46-55, whereas non-visual symptoms (dryness, irritation, and pain) were not. We identified symptomatic presbyopia (near add power ≥ 1.5D) in 14.4%, 73.8%, and 97.8%, positive corneal staining in 29.1%, 23.8%, and 23.9%, and a mean GCC of 98.2 μm, 105.3 μm, and 89.6 μm in the age groups 36-45, 46-55, and 56-65, respectively. Mean tear break-up time were 3.3, 3.5, and 3.3 seconds, respectively. Results indicated a large progression of presbyopia (P<0.01) from the period of 36-45 years onward and significantly increased GCC (P<0.01) in women of age group 46-55. No notable tendency was observed in symptoms and GCC for male participants. Visual symptoms in women were worse between 46 and 55 years than before or after these ages. The increase of symptomatic presbyopia and GCC may be contributing to visual symptoms in addition to menopausal transition symptoms in this age group.

BCLA CLEAR presbyopia: Mechanism and optics

With over a billion adults worldwide currently affected, presbyopia remains a ubiquitous, global problem. Despite over a century of study, the precise mechanism of ocular accommodation and presbyopia progression remains a topic of debate. Accordingly, this narrative review outlines the lenticular and extralenticular components of accommodation together with the impact of age on the accommodative apparatus, neural control of accommodation, models of accommodation, the impact of presbyopia on retinal image quality, and both historic and contemporary theories of presbyopia.

Impact of Refractive Status on Presbyopia Progression among Patients with Presbyopia.

To explore the impact of refractive status on presbyopia progression among patients with presbyopia. This retrospective observational study included patients with presbyopia who visited the Seventh Affiliated Hospital of Sun Yat-sen University and Shenzhen Polytechnic Medical College between May 2018 and August 2022. The amplitude of accommodation (AMP) and near addition power (ADD) at 6 months and 1 year were collected. A total of 103 patients with presbyopia were included in this study: 42 patients with myopia, 23 patients with emmetropia, and 38 patients with hyperopia. There were significant differences in ΔAMP(6-month) and ΔADD(6-month) among patients with different refractive statuses, and the values of emmetropic patients and hyperopic patients were higher than in myopic patients (all P < 0.001). The ΔAMP(1-year) and ΔADD(1-year) of hyperopic patients were significantly higher than in emmetropic patients and myopic patients (all P < 0.001). The ΔADD(1-year) of emmetropic patients was greater than in myopic patients (P = 0.045), but there were no significant differences in ΔAMP(1-year) between patients with emmetropia and myopia (P = 0.090). The progression of presbyopia in hyperopic patients was relatively more significant than for emmetropia, followed by myopia. The prescription of presbyopia glasses might need to be replaced more frequently in patients with hyperopia.

Анализ поражений глаз у больных сахарным диабетом 2 типа, перенесших пневмонию, вызванную новой коронавирусной инфекцией COVID-19

Purpose. Аnalysis of eye lesions in type 2 diabetes mellitus patients after pneumonia caused by the new coronavirus infection (COVID-19) in the Voronezh Regional Diabetes Center during 6 months. Material and methods. 70 patients with type 2 diabetes mellitus (140 eyes): group 1 (n = 35, 70 eyes): patients after pneumonia of 1–3 degrees of severity caused by COVID-19; group 2 (n = 35, 70 eyes): patients with diabetes mellitus without a pneumonia. All patients underwent a standard ophthalmological examination and Norn's test. The 1st examination in group 1 was carried out 1–2 months before COVID-19, the 2nd examination was 6 months after discharge from the hospital, the patients of group 2 were delayed with an interval of 6 months. Results. 45.7 % of patients in group 1 showed progression of presbyopia which required replacement of glasses versus 25.7 % in group 2. Signs of dry eye syndrome were found in 25.7 % of patients in group 1 and in 11.4 % of patients in group 2. The number of cases of dry eye syndrome increased after treatment with COVID-19 from 11.4 % (8 eyes) to 25.7 % (18 eyes) in group 1, 55.5 % of them (10 eyes) had symptoms of conjunctivitis during the manifestation COVID-19. The progression of the stage of diabetic retinopathy in patients of group 2 was observed in 2.9 % of patients and was absent in group 1. Conclusion. Diabetes mellitus patients after the new coronavirus infection (COVID-19) show the progression of presbyopia and signs of dry eye syndrome 2 times more often. There was no case of onset or progression of diabetic retinopathy after COVID-19. Keywords: diabetes mellitus, diabetic retinopathy, dry eye syndrome, presbyopia, new coronavirus infection

Starting Time of Presbyopic Eyeglasses Wear and Lifestyle

PurposePresbyopia is a serious burden in the aged population, however, the factors affecting its progression have not been fully determined. The aim of this study was to explore the association between the time of starting to wear presbyopic eyeglasses and lifestyle, in participants aged from 40 to 59 years.MethodsWe selected the sample to be representative of sex and age for the age group 40 to 59 years. Participants completed a web-based survey on presbyopia-related questions, symptomatic dry eye, sleep habits, Pittsburgh Sleep Quality Index, subjective happiness scale (SHS), and other lifestyle-related questions including marital status, income, screen time, sun exposure, family history of myopia, and the frequency of regular visits to medical services.ResultsWe found 529 participants (26.5%) used near correction, with a mean age for first near correction of 47.8±4.8 years. An earlier commencement of near correction correlated with hyperopia (P = 0.013), late wake-up time (P = 0.010), a poor subjective sleep quality score (P = 0.019), and a low annual income score (P = 0.025), after adjusting for age and sex. Stratification by income demonstrated the low-income group exhibited more dry eye, later wake-up time, longer sleep latency, longer sleep duration, worse sleep efficacy, lower SHS score, and a higher prevalence of living alone compared with the high-income group. The usage of corrective devices did not differ between the two groups.ConclusionsThe current study suggests a healthy sleep habit may delay the need for near correction, in addition to myopia. Shift work and circadian rhythm disruption might exacerbate presbyopia progression.

Short Tear Breakup Time Could Exacerbate the Progression of Presbyopia in Women.

Purpose The contributory factors and symptoms for presbyopia progression have not been fully determined. The purpose of the study was to compare presbyopia progression in subjects with short and normal tear breakup time and to explore the severity of common ocular symptoms associated with presbyopia progression. Method We conducted a clinic-based, retrospective, cross-sectional study. Inclusion criteria were bilateral phakic patients aged 40–69 years with best-corrected distance visual acuity better than 20/30, and exclusion criteria were the use of glaucoma eye drops, any disease affecting vision, or history of ocular surgery. We measured the binocular near add power and compared the results using Kaplan-Meier analysis. Association between near add power and ocular symptoms was explored. Results There were 1411 participants (mean age of 50.1 years). There were no significant differences in age, intraocular pressure, spherical equivalent, astigmatism, or anisometropia between the sexes. Kaplan-Meier analysis indicated that women with short tear breakup time reached the endpoint (near add power of +3.00 D) significantly earlier than those with normal tear breakup time (P = 0.043; Cox-Mantel test). Eye fatigue was most severe in the group with an add power of 1.25-2.00 D. Near add power was correlated with hyperopia, astigmatic errors, and anisometropia. Conclusions This study suggests an exacerbation of presbyopia progression in women with short tear breakup time. Eye fatigue was most severe in those with an add power of 1.25-2.00 D.

Presbyopia progression during the pandemic of COVID-19: Accelerated senescence?

Presbyopia progression during the pandemic of COVID-19: Accelerated senescence?

Presbyopia developed earlier during the COVID-19 pandemic.

PurposeThe aim of this cohort study was to evaluate the development and progression of presbyopia and the status of dry eye-related symptoms from 2017 to 2020, to assess the impact of the COVID-19 pandemic.MethodsNear add power at 30 cm was measured in 339 participants aged between 40 and 55 from 2017 to 2021 at Japanese eye clinics. Regression analysis of near add power and age was analyzed to compare 2017 with later years up to the pandemic. The prevalence of dry eye-related signs and six common symptoms were compared.ResultsThe number and mean age (y) of participants were 183 (48.6±4.1) in 2017, 46 (51.3±7.5) in 2019, and 110 (49.2±3.7) in 2020–21, respectively. The mean progression rate of near add power (D/y) was 0.13 for 2017, 0.09 for 2019 (P = 0.028, vs 2017), and 0.08 for 2020–21 (P<0.001, vs 2017). The slope (rate of presbyopia progression) became flatter from 2017 to 2021 and the estimated near add power at the age of 40 increased from 2017 to 2020–2021, implicating presbyopia developed earlier and worsened during the study period. The 2017 values were comparable with previous studies described in 1922 and 2019. The standardized correlation coefficient between age and near add power was 0.816 for 2017, 0.671 for 2019 (P = 0.084, vs 2017), and 0.572 for 2020–21 (P<0.001, vs 2017). Multiple regression analysis revealed age and COVID-19 pandemic were significantly correlated with near add power. The prevalence of dryness irritation, and pain was greater in 2020–21 than in 2017 with no difference in the prevalence of eye fatigue, blurring, and photophobia. There was no difference in the prevalence of short tear break-up time and positive corneal staining among 2017, 2019 and 2020–21.ConclusionEstimated presbyopia developed earlier and progressed slower from 2017 to 2021, the COVID-19 pandemic. Stress and rapid digitalization related to strict infection control and quarantine might be contributing factors.

The Effects of Presbyopia on Performance Vision

Presbyopia has been a condition that eye doctors have largely diagnosed based on age or clinical testing. Although the effects of presbyopia are typically very predictable in a clinical setting; its effects on real-world visual performance are far less predictable and relatively poorly understood. With more and more Baby Boomers and Gen X maintaining an active lifestyle, performance vision becomes a priority. This article aims to explore what is known about how visual performance can be maximized despite the progressionof presbyopia and identifies areas where research is needed.

Sleep and subjective happiness between the ages 40 and 59 in relation to presbyopia and dry eye.

PurposeThe aim of this study was to explore the status of quality of life between the ages 40–59 in relation to presbyopia and dry eye.MethodsNear add power and preferred contact lens power were examined in 219 participants at three clinics. 2000 participants completed a web-based survey on presbyopic symptoms, symptomatic dry eye, sleep quality, and subjective happiness.ResultsMean preferred corrected visual acuity was less than 20/20 in women (vs men, P<0.01) who were more often prescribed under-corrected contact lenses, whereas men preferred full correction. According to the annual progression rate of near add power in men (0.1468D/year), the estimated difference in presbyopia progression between men and women was 0.75 years in the right eye, and 1.69 years in the left eye, implying men might suffer presbyopia earlier than women due to higher myopic power of daily use contact lenses. The web-based survey revealed that men reported lower subjective happiness than women (P<0.001) and earlier onset of presbyopic symptoms by 1.1–1.7 years (P<0.05). Men received their first reading glasses 0.8 years earlier than women (P = 0.066). Multiple regression analysis demonstrated that awareness of presbyopic symptoms, visual burden, and dry eyes were significantly correlated with poor sleep quality and subjective happiness.ConclusionPresbyopia and dry eye were significantly associated with sleep quality and subjective happiness in middle-adulthood.

Reversible Photoalignment of Liquid Crystals: a Path toward the Creation of Rewritable Lenses

In this work, we describe a new reversible photoalignment effect for the director in nematic liquid crystals that provides an approach for the creation of lenses whose optical power can be recorded and erased. The possibility of creating a rewritable lens has very important practical implications, for example, in the ophthalmic lens industry. A rewritable ophthalmic lens could be a convenient solution for patients whose compensation needs change over time due to age-related physiological changes, such as the onset and progression of presbyopia. Using rewritable lenses, small lens power corrections could be implemented through a rewriting procedure on the mounted lens without resurfacing or manufacturing and mounting a new lens. More generally, this new effect multiple potential applications in the creation of rewritable optical systems, such as reconfigurable optical networks, index-tunable antireflective coatings and optically rewritable phase gratings.

Normative patterns and factors associated with presbyopia progression in a multiethnic Asian population: the Singapore Epidemiology of Eye Diseases Study

Background/AimTo investigate normative patterns and factors associated with presbyopia progression in a multiethnic Asian population.MethodsMalay, Indian and Chinese participants aged 40–80 years who had baseline and 6-year follow-up examinations with...

Latanoprost could exacerbate the progression of presbyopia

PurposeProstaglandin analogues (PG) reduce intra-ocular pressure by enhancing uveoscleral flow at the ciliary body, which controls accommodation via the ciliary muscle. We investigated the effect of PG on accommodation and presbyopia progression in glaucoma patients.MethodsWe conducted a clinic-based, retrospective, cross-sectional study. Inclusion criteria were bilateral phakic patients aged 40–69 years with best corrected visual acuity better than 20/30. Exclusion criteria were any disease affecting vision other than glaucoma and history of ocular surgery. Subjects with no prescription or vision-affecting disease served as controls (n = 260). The glaucoma patients were prescribed eye drops containing 0.005% latanoprost for more than six months (n = 23). We measured the binocular near add power at a distance of 30 cm in both groups and compared the results using Kaplan-Meier analysis.ResultsThe mean age (± SD) of the control subjects was 51.5 ± 5.2 years and 39% were male. Similarly, the glaucoma patients had a mean age of 51.0 ± 7.2 years and 39% were male. There were no significant differences in age, gender, intra-ocular pressure, spherical equivalent, astigmatism, or anisometropia between groups. Survival analysis indicated that the glaucoma patients in this study reached the endpoint (near add power of +3.00 D) significantly earlier than control patients (P = 0.0001; generalized Wilcoxon test).ConclusionsExacerbation of presbyopia progression in glaucoma patients is a potential side effect of latanoprost eyedrops.

Prevalence and incidence of presbyopia in urban Southern China

AimsTo investigate the prevalence and incidence of presbyopia in an urban Chinese population.Methods1817 subjects aged ≥35 years were identified by random cluster sampling in Yuexiu District, Guangzhou, China, at baseline...

Suppression of presbyopia progression with pirenoxine eye drops: experiments on rats and non-blinded, randomized clinical trial of efficacy

Various methods can correct presbyopia, but all require devices or surgeries. Recently, supplements or warming devices to relieve presbyopic symptoms have been developed, but no eye drops have been developed. We screened certain compounds possibly related to lens degeneration and identified pirenoxine, which has been used for cataracts, as a possible new pharmacologic treatment for presbyopia. We first researched the anti-presbyopic activity of pirenoxine in rats. The lens elasticity significantly (p = 0.028) increased with exposure to tobacco smoke for 12 days, and pirenoxine eye drops significantly (p < 0.001) suppressed lens hardening, which causes presbyopia in humans. In a parallel randomized controlled clinical study of the subjects in their fifth decade of life, the objective accommodative amplitude (AA) decreased significantly (p < 0.01) by 0.16 diopter (D) in the control group, and there was no detectable change in the treatment group after a 6-month treatment period, suggesting that pirenoxine eye drops might prevent progression of presbyopia. Subjects in their sixth decade of life, in whom the AA was already nearly 0 D, did not show similar results. Pirenoxine eye drops might be a new and the first pharmacologic treatment for preventing progression of presbyopia.

A Near Visual Acuity Test for Dentists.

Unimpaired near vision is crucial in dentistry, but appropriate visual tests at dental working distance are not publicly available. The aim of this study was to validate a novel visual triage test for dentists that is easy to use and freely available. The near visual acuity at 300 mm of 106 dental professionals (aged 21-65 years) was assessed with 1) a validated near visual test for scientific purposes miniaturized on a microfilm; 2) an experimental test using a US $5 bill, in which the first five words of each line in the Lincoln Memorial frieze had to be read under a dental operating light. The Spearman rank correlation coefficient of 0.784 revealed a strong correlation between the two tests (p<0.0001). The ability to read six or more words in the memorial frieze meant there was a 94% chance of having a validated near visual acuity greater than or equal to the median score of the dentists tested. If none of the words could be read, the chance of having a near visual acuity below the median of the peer group was 89%. The influence of the dentists' age and experience on their visual performance reported in former studies was corroborated with this new test. The US $5 bill offers a simple and easily available near visual test to rank individuals' near vision relative to that of other dentists and to recognize the progression of presbyopia with increasing age.

Apparent Progression of Presbyopia After Laser In Situ Keratomileusis in Patients With Early Presbyopia

To assess the effect of laser insitu keratomileusis (LASIK) on near visual function in presbyopic patients. Retrospective cohort study. Fifty-three eyes of 40 patients 45 years of age and older who had undergone LASIK for high myopia (-6 diopters [D] and over) were included. The minimal add powers for obtaining the best-corrected near visual acuity (add powers) were measured preoperatively and 3months postoperatively, and the correlations with the powers corrected by LASIK, corneal higher-order aberrations (HOAs), ocular HOAs, and patient ages were evaluated using univariate analysis. Factors correlated with the changes in add powers were evaluated further by multivariate analysis. The mean ± standard deviation patient age was 50.0 ± 4.1 years; the power corrected by LASIK was-7.56 ± 1.06 D. The mean add power was 1.80 ± 0.60 D preoperatively, which increased significantly (P< .001) to 2.18 ± 0.69 D postoperatively. Significant correlations with the increased add powers were detected with age (P= .01) and the power corrected by LASIK (P= .04) but not with corneal and ocular HOAs (P> .05). Multivariate analysis showed that only age was correlated significantly (P= .01). The percentage of eyes with increased add powers of 0.5 D or more was 60.4%, which was significantly (P= .02) higher in younger patients. This study verified the apparent progression of presbyopia after LASIK and the importance of obtaining informed consent from patients, especially those with early presbyopia.

Long-term reproducibility of Edinger–Westphal stimulated accommodation in rhesus monkeys

If longitudinal studies of accommodation or accommodation restoration procedures are undertaken in rhesus monkeys, the methods used to induce and measure accommodation must remain reproducible over the study period. Stimulation of the Edinger–Westphal (EW) nucleus in anesthetized rhesus monkeys is a valuable method to understand various aspects of accommodation. A prior study showed reproducibility of EW-stimulated accommodation over 14 months after chronic electrode implantation. However, reproducibility over a period longer than this has not been investigated and therefore remains unknown. To address this, accommodation stimulation experiments in four eyes of two rhesus monkeys (13.7 and 13.8 years old) were evaluated over a period of 68 months. Carbachol iontophoresis stimulated accommodation was first measured with a Hartinger coincidence refractometer (HCR) two weeks before electrode implantation to determine maximum accommodative amplitudes. EW stimulus-response curves were initially measured with the HCR one month after electrode implantation and then repeated at least six times for each eye in the following 60 months. At 64 months, carbachol iontophoresis induced accommodation was measured again. At 68 months, EW stimulus-response curves were measured with an HCR and photorefraction every week over four consecutive weeks to evaluate the short-term reproducibility over one month. In the four eyes studied, long-term EW-stimulated accommodation decreased by 7.00 D, 3.33 D, 4.63 D, and 2.03 D, whereas carbachol stimulated accommodation increased by 0.18 D–0.49 D over the same time period. The short-term reproducibility of maximum EW-stimulated accommodation (standard deviations) over a period of four weeks at 68 months after electrode implantation was 0.48 D, 0.79 D, 0.55 D and 0.39 D in the four eyes. Since the long-term decrease in EW-stimulated accommodation is not matched by similar decreases in carbachol iontophoresis stimulated accommodation, the decline in accommodation cannot be due to the progression of presbyopia but is likely to result from variability in EW electrode position. Therefore, EW-stimulated accommodation in anesthetized monkeys is not appropriate for long-term longitudinal studies of age-related loss of accommodation or accommodation restoration procedures.

A retrospective study on presbyopia onset and progression in a Hispanic population

This study evaluates differences in age and presbyopia progression between an ethnic Hispanic and a non-Hispanic patient population. 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. 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). 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.