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Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. What we have learnt from 30 years living with positive dysphotopsia after intraocular lens implantation?: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1917997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology (Imqo-oftalmar), Vithas Medimar International Hospital, Alicante, Spain
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Wolffsohn JS, Davies LN. Presbyopia: Effectiveness of correction strategies. Prog Retin Eye Res 2018; 68:124-143. [PMID: 30244049 DOI: 10.1016/j.preteyeres.2018.09.004] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 01/04/2023]
Abstract
Presbyopia is a global problem affecting over a billion people worldwide. The prevalence of unmanaged presbyopia is as high as 50% of those over 50 years of age in developing world populations, due to a lack of awareness and accessibility to affordable treatment, and is even as high as 34% in developed countries. Definitions of presbyopia are inconsistent and varied, so we propose a redefinition that states "presbyopia occurs when the physiologically normal age-related reduction in the eye's focusing range reaches a point, when optimally corrected for distance vision, that the clarity of vision at near is insufficient to satisfy an individual's requirements". Strategies for correcting presbyopia include separate optical devices located in front of the visual system (reading glasses) or a change in the direction of gaze to view through optical zones of different optical powers (bifocal, trifocal or progressive addition spectacle lenses), monovision (with contact lenses, intraocular lenses, laser refractive surgery and corneal collagen shrinkage), simultaneous images (with contact lenses, intraocular lenses and corneal inlays), pinhole depth of focus expansion (with intraocular lenses, corneal inlays and pharmaceuticals), crystalline lens softening (with lasers or pharmaceuticals) or restored dynamics (with 'accommodating' intraocular lenses, scleral expansion techniques and ciliary muscle electrostimulation); these strategies may be applied differently to the two eyes to optimise the range of clear focus for an individual's task requirements and minimise adverse visual effects. However, none fully overcome presbyopia in all patients. While the restoration of natural accommodation or an equivalent remains elusive, guidance is given on presbyopic correction evaluation techniques.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK.
| | - Leon N Davies
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, B4 7ET, UK
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Su B, Zhang B, Huang J, Xie W, Wu Z, Lin M, Chen Z, Wu H, Jiang J, Lu F. The effect of transient glare on shape discrimination threshold in myopic adults. Clin Exp Optom 2017; 101:220-224. [PMID: 29076561 DOI: 10.1111/cxo.12616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 04/17/2017] [Accepted: 06/16/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The aim was to evaluate the effect of transient glare on shape discrimination threshold (SDT) in myopic adults. METHODS A total of 162 myopic subjects were enrolled. Of these, 121 had low to mid myopia (-1.00 D to -6.00 D) and 41 had high myopia (-6.13 D to -10.25 D). All subjects had corrected visual acuity of 6/6 or better, and only data for the right eye were included in the study. SDTs were measured with circular D4 (fourth derivative of Gaussian) radial frequency patterns with a radial frequency of four, peak spatial frequency of three cpds, and mean radius of 1.5 degrees. SDTs were measured under two conditions, with and without the presence of transient glare while the stimulus was displayed (duration = 500 ms). RESULTS Without transient glare, SDTs were not different between the low-mid (23.84 ± 6.02 arcsec) and high myopia groups (25.17 ± 5.98 arcsec, p = 0.16, Mann-Whitney test). With transient glare, SDTs in all subjects became significantly higher (p < 0.001, Wilcoxon signed-rank test). SDTs in the high myopia group (55.53 ± 18.59 arcsec) became significantly higher than those in the low to mid myopia group (47.55 ± 15.06 arcsec, p = 0.014, Mann-Whitney test). The increments were significantly higher in the high myopia group (28.94 arcsec versus 20.88 arcsec, p = 0.031, Mann-Whitney test). Multiple regression showed that SDTs with glare were significantly associated with SDTs without glare (p < 0.001) and the presence of high myopia (p = 0.015). CONCLUSIONS Transient glare significantly increased SDTs in all myopic subjects, with the increment in subjects with high myopia being significantly larger than those in subjects with low to mid myopia.
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Affiliation(s)
- Binbin Su
- Optometry Department, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Davie, Florida, USA
| | - Junping Huang
- Optometry Department, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wen Xie
- Optometry Department, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhenyu Wu
- Department of Ophthalmology, Zhejiang Hospital, Hangzhou, Zhejiang, China
| | - Meng Lin
- Optometry Department, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zheyi Chen
- Optometry Department, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haoran Wu
- Optometry Department, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jun Jiang
- Optometry Department, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fan Lu
- Optometry Department, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Buckhurst PJ, Naroo SA, Davies LN, Shah S, Drew T, Wolffsohn JS. Assessment of dysphotopsia in pseudophakic subjects with multifocal intraocular lenses. BMJ Open Ophthalmol 2017; 1:e000064. [PMID: 29354708 PMCID: PMC5721632 DOI: 10.1136/bmjophth-2016-000064] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 05/04/2017] [Accepted: 05/07/2017] [Indexed: 11/03/2022] Open
Abstract
Aim To better understand the phenomenon of dysphotopsia in patients implanted with multifocal intraocular lenses (IOLs). Methods Forty-five patients (aged 61.8±8.9 years) implanted bilaterally with Tecnis ZM900 (diffractive multifocal), Lentis Mplus MF30 (segmented refractive multifocal) or Softec-1 (monofocal) IOLs (each n=15) 4-6 months previously and who had achieved a good surgical outcome were examined. Each reported their dysphotopsia symptoms subjectively, identified its form (EyeVisPod illustrations), quantified retinal straylight (C-Quant) and halo perception (Aston halometer). Retinal straylight and halometry was repeated by a second masked clinician to determine interobserver repeatability. Results Subjective dysphotopsia ratings were able to differentiate Tecnis ZM900 from Lentis Mplus MF30 (p<0.001), but not Lentis Mplus MF30 from groups implanted with Softec-1 (p=0.290). Straylight was similar between the monofocal and multifocal IOL designs (p=0.664). ZM900 IOLs demonstrated a uniform increase in dysphotopsia in comparison with the monofocal IOL (p<0.001) as measured with the halometer, whereas sectorial refractive multifocal IOLs demonstrated a localised increase in dysphotopsia over the inferior visual field. Intraobserver repeatability was good for the straylight (intraclass correlation coefficients (ICC)=0.77) and halometry (ICC=0.89). There was no significant correlation between the subjective dysphotopsia severity and the straylight (p=0.503) or halometry (p>0.10) quantification or between straylight and the halo area (p>0.30). Conclusions Multifocal IOLs induce symptoms of dysphotopsia. Straylight did not differentiate between IOL designs, however halometry identified clear differences in light scatter due to the IOL optics. Whereas, subjective rating of overall dysphotopsia are not strongly associated with straylight or halo perception, the halometry polar diagram reflected the subjective descriptions of dysphotopsia.
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Affiliation(s)
| | - Shehzad A Naroo
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
| | - Leon N Davies
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
| | - Sunil Shah
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK.,Midland Eye, Ophthalmology, Solihull, UK
| | - Tom Drew
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
| | - James S Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK
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Ferreira-Neves H, Macedo-de-Araújo R, Rico-Del-Viejo L, da-Silva AC, Queirós A, González-Méijome JM. Validation of a method to measure light distortion surrounding a source of glare. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:75002. [PMID: 26146877 DOI: 10.1117/1.jbo.20.7.075002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/04/2015] [Indexed: 06/04/2023]
Abstract
Our objective was to validate a new device dedicated to measure the light disturbances surrounding bright sources of light under different sources of potential variability. Twenty subjects were involved in the study. Light distortion was measured using an experimental prototype (light distortion analyzer, CEORLab, University of Minho, Portugal) comprising twenty-four LED arrays panel at 2 m. Sources of variability included: intrasession and intersession repeated measures, pupil size (3 versus 6 mm), defocus (+0.50 ) correction for the working distance, angular resolution (15 deg versus 30 deg), temporal stimuli presentation, and pupil size. Size, shape, location, and irregularity parameters have been obtained. At a low speed of presentation of the stimuli, changes in angular resolution did not have an effect on the results of the parameters measured. Results did not change with pupil size. Intensity of the central glare source significantly influenced the outcomes. Examination time was reduced by 30% when a 30 deg angular resolution was explored instead of 15 deg. Measurements were fast and repeatable under the same experimental conditions. Size and shape parameters showed the highest consistency, whereas location and irregularity parameters showed lower consistency. The system was sensitive to changes in the intensity of the central glare source but not to pupil changes in this sample of healthy subjects
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Puell MC, Pérez-Carrasco MJ, Palomo-Alvarez C, Antona B, Barrio A. Relationship between halo size and forward light scatter. Br J Ophthalmol 2014; 98:1389-92. [PMID: 24814964 DOI: 10.1136/bjophthalmol-2014-304872] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE To determine the relationship between the size of a halo induced by a glare source and forward scatter or visual acuity (VA) in healthy eyes. METHOD Measurements were made in the right eyes of 51 healthy individuals of mean age 29.3 ± 7.5 years. Halo radius was measured using the Vision Monitor and low luminance (1 cd/m(2)) optotypes presented at a distance of 2.5 m. The visual angle subtended by the radius of the halo was calculated in minutes of arc (arc min). Forward scatter or, straylight, was measured using the compensation comparison technique. Best-corrected distance VA was measured using high contrast (HC) (96%) and low contrast (LC) (10%) Bailey-Lovie logMAR letter charts under photopic (85 cd/m(2)) and mesopic (0.15 cd/m(2)) luminance conditions. RESULTS Mean halo radius was 202 ± 43 arc min (3.4 ± 0.7°) and mean retinal straylight was 0.95 ± 0.12 log units. Mean photopic distance HC-VA and LC-VA were -0.02 ± 0.06 and 0.12 ± 0.09 logMAR, respectively. Mean mesopic distance HC-VA and LC-VA were 0.35 ± 0.11 and 0.74 ± 0.11 logMAR, respectively. Forward stepwise regression analysis revealed that halo radius was significantly correlated with straylight (r=0.45) and mesopic LC-VA (r=0.48), but not with photopic HC-VA and/or LC-VA and mesopic HC-VA. CONCLUSIONS In healthy eyes, the larger the halo size induced by a given glare source, the greater the forward-scatter (straylight) and worse the mesopic LC-VA. Halo size seems to be independent of photopic HC-VA or LC-VA and mesopic HC-VA.
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Affiliation(s)
- María C Puell
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - María J Pérez-Carrasco
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Catalina Palomo-Alvarez
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Beatriz Antona
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Barrio
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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