Progression Of Presbyopia Research Articles

Ultrasound biomicroscopy of the aging rhesus monkey ciliary region.

Ultrasound biomicroscopy of the living rhesus monkey ocular ciliary region was undertaken to identify age-dependent changes that might relate to the progression of presbyopia. Monkeys were anesthetized and pharmacologically cyclopleged, the eyelids were held open with a lid speculum, and sutures were placed beneath the medial and lateral rectus muscles. Ultrasound biomicroscopy imaging of the nasal and temporal quadrants of the eye were performed, and the live images were recorded to videotape. Subsequent image analysis was performed to obtain objective morphometric measurements of the ciliary body region. The ciliary body inner radius of curvature, outer radius of curvature, inner arc length, area, thickness, perimeter, zonular fiber length, and circumlental space were measured. Zonular space was calculated. The circumlental space decreased with increasing age in the temporal quadrant. The other morphologic measurements were not significantly correlated with age or body weight. Most morphologic measurements were significantly different comparing temporal vs. nasal quadrants. Bifurcation of the posterior zonular fibers was frequently observed. Although temporal circumlental space was the only measurement found to change with age, ultrasound biomicroscopy of the living rhesus ciliary region did identify distinct nasal vs. temporal asymmetries, which may reflect anatomical requirements for convergence-associated accommodation.

What we know and understand about presbyopia

The major theories for presbyopia are reviewed. These date from the very earliest hypotheses to current ideas and encompass both rheological (mechanical or elastic) and optical factors. Experimental findings are presented to support or refute the theories. The onset and rate of progression of presbyopia is shown to have multifactorial influences and a substantial contribution comes from an age-related change in the refractive index gradient of the lens cortex. (Clin Exp Optom 1993; 76: 3: 83–90)