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Purpose An individual's reading ability cannot be reliably predicted from his/her letter acuity, contrast sensitivity, and visual field extent. We developed a set of Chinese reading acuity charts (C-READ) to assess the reading ability of Chinese readers, based on the collective wisdom of previously published reading acuity charts, especially the MNRead and the Radner Reading Charts. Methods The C-READ consists of three charts. Each consists sixteen 12-character simplified Chinese sentences crafted from first- to third-grade textbooks. One hundred eighteen native Chinese-speaking college students (aged 22.1 ± 2.1 years) with normal or corrected to normal near vision (-0.26 ± 0.05 logMAR) were included in the study to develop the C-READ charts, to test the homogeneity of the three charts, and to validate the C-READ against the text paragraphs from the International Reading Speed Texts (IReST) with corrected and uncorrected near vision. Results The reading acuity, critical print size, and maximum reading speed for young normal native Chinese-speaking readers were 0.16 ± 0.05 logMAR, 0.24 ± 0.06 logMAR, and 273.44 ± 34.37 characters per minute (mean ± SD), respectively. The reliability test revealed no significant differences among the three C-READ charts and no significant test order effect in the three reading parameters. Regression analyses showed that the IReST reading speed could be reliably predicted by the C-READ maximum reading speed under the corrected near-vision condition (adjusted R = 0.72) and by C-READ maximum reading speed and critical print size under the uncorrected near-vision condition (adjusted R = 0.69). Conclusions The three C-READ charts are very comparable to each other, and there is no significant order effect. Reading test results can accurately predict continuous text reading performance quantified by the IReST reading speed over a wide range of refractive errors. The C-READ is a reliable and valid clinical instrument for quantifying reading performance in simplified Chinese readers.

Efforts to reduce the progression of myopia in childhood are on the rise, due to an increasing incidence of myopia worldwide and its associated sight-threatening complications. Interventions are aimed at reducing myopia in childhood and include environmental considerations, spectacles, contact lenses, and pharmacological agents. We reviewed recent literature with interventions aimed at reducing myopia progression in children and found that a number of interventions were significant in reducing the progression of myopia. Of these interventions, atropine showed the largest dose-related effect on myopia progression control. Although higher doses are associated with side effects of pupil dilatation, loss of accommodation, near vision blur, and rebound phenomenon, low-dose atropine has also been shown to provide effective myopia control with minimal side effects and rebound. To a lesser degree, bifocal soft contact lenses have also been shown to be effective in reducing the progression of myopia, though compliance is an issue. Similarly, orthokeratology lenses have also been shown to be effective in reducing axial length elongation and myopia progression, though long-term data on its rebound effects are unavailable.

Introduction Presbyopia affects people from the 4th decade of life and is characterized by accommodative loss that leads to negative effects on vision-targeted health-related quality of life. A non-invasive pharmacological treatment providing near-lenses independence would be a truly groundbreaking approach in the treatment of presbyopia. The purpose of this review is to analyze the emerging pharmacological solutions proposed to address presbyopia. Results Several ophthalmic eye drops compounds solutions have been described in peer-reviewed papers or presented in ophthalmological tabloids and congresses. Each topical treatment deals with drug combinations aimed to modify one or more factors involved in the accommodative process and have been proposed to be instilled either monocularly or binocularly. It remains unclear how much each drug in the final combined form is involved in the achievement of the outcome and contributes to it. Conclusion Despite the lack of a completely well understood mechanism, pharmacological control of presbyopia seems to be a possible and very attractive alternative for presbyopic patients. The studies mentioned in this review are to be considered pilot investigations as they involve either a small number of subjects or are single case series. Complete studies are needed to confirm which will be the more effective pharmacological compound for the treatment of presbyopia.

Background: Uncorrected near vision impairment affects the performance of near vision tasks and activities for an estimated 410 million people worldwide. Once normal vision becomes blurred or impaired, the ordinary and simple daily routines of individuals become difficult; often resulting in frustration and irritation, which is consequently reflected in their quality of life. Aim: We investigated the change of vision-related quality of life (VRQoL) following near correction among textile factory workers in South Africa. Methods: Presbyopic subjects who were 40 years and older with no other eye conditions were provided near spectacle correction. We interviewed subjects to ascertain their VRQoL scores using the National Eye Institute Visual Function Questionnaire, pre-treatment and 6 months after the provision of near corrections. Setting: The study was conducted among the textile factory workers in KwaZulu-Natal, South Africa. Results: A total of 423 textile factory workers were followed up from seven textile factories in Durban. The overall increase in VRQoL scores of 21.9 (95% CI 16.7–27) was significant ( p < 0.01). This translates to a 36.5% (95% CI 30.6–42.4) change in VRQoL. The increase was highest among participants of African origin 25.1 (95% CI 21.14–29.1), males 18.8 (95% CI 12.6–27.2), among those who had completed primary school 35.8 (95% CI 21.7–49.9) and among participants with other responsibilities (ironing and quality assurance) 21.9 (95% CI 16.7–27). Conclusion: Correcting near vision impairment improved the VRQoL scores of textile factory workers. The results showed that VRQoL scores increased significantly across levels of education and categories of responsibility

Pseudophakic presbyopic correction is among the prevalent methods for regaining near vision capacity. The purpose of this study is to compare the impact of pseudophakic monovision correction and multifocal lens implantation on the performance in a series of activities of daily living (ADL) of presbyopic patients. An ADL research framework (10 ADLs) was constructed and validated in a sample of patients divided into three validation groups according to their near visual acuity. Sixty-two participants that underwent mini-monovision (MoG) cataract extraction and 60 that underwent bilateral multifocal lenses implantation (MfG) populated study groups and addressed the ADLs. Binocular uncorrected distant (BdUVA) and near (BnUVA) visual acuity were associated with ADL scores and with subjective satisfaction using the VF-14 questionnaire. Test-retest reliability [all Intraclass Correlations Coefficients (ICC) >0.90] and construct validity (all p

PURPOSE: To evaluate monocular functional outcomes after the implantation of the AcrySof ReSTOR SN6AD2 intraocular lens (IOL) (+2.5 diopters [D] near add) (Alcon Laboratories, Inc., Fort Worth, TX) and the AcrySof ReSTOR SN6AD1 IOL (+3.0 D near add) (Alcon Laboratories, Inc.). METHODS: This prospective, comparative, nonrandomized single-blind observational study comprised 62 eyes of 62 patients that underwent phacoemulsification and implantation of a multifocal IOL: SN6AD2 (31 eyes) (+2.5 group) and SN6AD1 (31 eyes) (+3.0 group). Twelve months after surgery, monocular near (30 and 40 cm), intermediate (50, 60, and 70 cm), and distance (4 m) visual acuity were evaluated with the internal root mean square and modulation transfer function. Both parameters were evaluated at the 4- and 6-mm pupil sizes. RESULTS: No statistical differences at 4 m were found between the groups. The +2.5 group obtained better performances at all intermediate distances (50 cm, 0.23 ± 0.14 vs 0.32 ± 0.13; 60 and 70 cm, 0.21 ± 0.10 vs 0.41 ± 0.14 and 0.24 ± 0.10 vs 0.53 ± 0.17, respectively), whereas the near visual acuity was better for the +3.0 group (30 and 40 cm, 0.36 ± 0.18 vs 0.14 ± 0.09 and 0.36 ± 0.19 vs 0.17 ± 0.07, respectively). The root mean square was lower for the +2.5 group compared to the +3.0 group, whereas the modulation transfer function showed overlapping results between the two models. CONCLUSIONS: Both IOL models showed good results in distance vision; the +2.5 D IOL seemed to provide better intermediate vision than the +3.0 D IOL. For near vision, the +3.0 D model performed better than the +2.5 D model. [ J Refract Surg . 2014;30(11):754–760.]

Purpose: To develop and validate 28 short Italian sentences for the construction of the Italian version of the Radner Reading Chart to simultaneously measure near visual acuity and reading speed. Methods: 41 sentences were constructed in Italian language, following the procedure defined by Radner, to obtain ‘‘sentence optotypes’’ with comparable structure and with the same lexical and grammatical difficulty. Sentences were statistically selected and used in 211 normal, nonpresbyopic, native Italian-speaking persons. The most equally matched sentences in terms of reading speed and number of reading errors were selected. To assess the validity of the reading speed results obtained with the 28 selected short sentences, we compared the reading speed and reading errors with the average obtained by reading two long 4th-grade paragraphs (97 and 90 words) under the same conditions. Results: The overall mean reading speed of the tested persons was 189 ± 26 wpm. The 28 sentences more similar in terms of reading times were selected, achieving a coefficient of variation (the relative SD) of 2.2%. The reliability analyses yielded an overall Cronbach’s alpha coefficient of 0.98. The correlation between the short sentences and the long paragraph was high (r = 0.85, P < 0.0001). Conclusions: The 28 short single Italian sentences optotypes were highly comparable in syntactical structure, number, position, and length of words, lexical difficulty, and reading length. The resulting Italian Radner Reading Chart is precise (high consistency) and practical (short sentences) and therefore useful for research and clinical practice to simultaneously measure near reading acuity and reading speed. © 2013 Spanish General Council of Optometry. Published by Elsevier Espana, S.L.U. All rights reserved.

Purpose: To study the changes in anterior chamber depth (ACD), anterior chamber angle (ACA), and pupil diameter (PD) during accommodation. Methods: Eighty eyes of 80 subjects, aged 22 to 40 years, were included. The rotating Dual Scheimpflug and a Placido disc system (Galilei G4, Ziemer Ophthalmic Systems AG, Switzerland) was used to measure the changes in ACD, ACA, and PD during accommodation. ACD measurement was taken for the central zone and for 4 more positions, each in different orientation (nasal, superior, temporal and inferior), 4 mm away from the centre. ACA was measured for the whole eye as well for the nasal, superior, temporal, and inferior quadrants. These metrics were obtained for various accommodation stimuli, ranging from +1 D to -4 D in 1-D steps. Results: For a given position, the ACD did not vary significantly with accommodation. For the central ACD, the percentage of relative change between far and near vision was -4.11%. The ACA was significantly lower at the inferior, temporal, and superior positions. There was no change in the ACA of the whole eye and that of the nasal orientation. These two eye metrics were significantly lower in the superior-nasal than in the inferior-temporal region. At each vergence studied, the PD decreased significantly with accommodation. The relative change after the -4 D stimulus was -8.13%. Conclusion: ACA and PD varied significantly with accommodation, whereas no such variation of ACD was observed. Further, the anterior chamber was found to be asymmetrical, with the nasal-superior area becoming significantly shallower than the inferior temporal region. Objetivo: Estudar as mudanças na profundidade da câmara anterior (ACD), ângulo da câmara anterior (ACA) e diâmetro da pupila (PD) durante a acomodação. Métodos: Foram incluídos 80 olhos de 80 indivíduos com idades entre 22 e 40 anos. Um sistema rotacional de Scheimpflug duplo acoplado a um sistema de disco de Placido (Galilei G4, Ziemer Ophthalmic Systems AG, Suíça) foi usado para medir as mudanças na ACD, ACA e PD, durante a acomodação. As medidas da ACD foram consideradas na zona central e em mais 4 posições, cada uma em orientação diferente (nasal, superior, temporal e inferior), a 4 milímetros de distância do centro. O ACA do olho inteiro, assim como nos quadrantes nasal, superior, temporal e inferior foram medidos. Todos estes indicadores foram obtidos por vários estímulos acomodativos, que variaram de +1 D a -4 D em intervalos de 1 D. Resultados: A ACD não variou significativamente com acomodação para qualquer determinada orientação, sendo a percentagem de variação relativa entre longe e visão de perto -4,11% para a ACD central (onde sinal negativo representa uma diminuição na ACD). Em relação ao ACA, este diminuiu significativamente em posições inferiores, temporais e superiores. O ACA total de olho e o ACA nasal não se alterou. Estas duas métricas oculares foram significativamente menores no par nasal-superior do que no temporal-inferior. Finalmente, PD diminuiu significativamente com a acomodação em cada vergência estudada, a mudança relativa após o estímulo de -4 D foi -8,13%. Conclusão: ACA e PD variaram significativamente com a acomodação, enquanto ACD não. Além disso, a câmara anterior se mostrou alterar assimetricamente, com a área nasal-superior se tornando significativamente mais rasa do que a temporal-inferior.

We present the case of a patient who had refractive corneal inlay implantation for near vision improvement after bilateral cataract surgery. The patient had a history of bilateral cataract, and a 2-step procedure was suggested to improve her near and distance visual acuities. The first step was bilateral cataract extraction with a power target of plano intraocular lens implantation. Six months later, a refractive corneal inlay, Presbia Microlens, was implanted in the nondominant eye in the intracorneal pocket made with the femtosecond laser. No intraoperative or postoperative complications occurred. The bilateral uncorrected near visual acuity improved from less than Jaeger (J)6 to J1 and remained stable during the 2-year follow-up. The refractive corneal inlay is a safe, simple, and efficient method for improving near visual acuity in patients after cataract surgery. Financial Disclosure Dr. Pallikaris is the chair of the medical advisory board of Presbia Cooperatief U.A. No other author has a financial or proprietary interest in any material or method mentioned.

Background: The evidence of the relationship between sensorimotor function and blood glucose and their determinants in the elderly is limited in developing countries. This study investigated the relationship between sensorimotor function and blood glucose and compared the association between sensorimotor function and blood glucose and several determinants in Chinese people aged 50–74 years. Methods: A multistage stratified random cluster sampling method was used to sample 2476 individuals with a response rate of 81% in the Qingdao region. Pair-wise correlation analysis was performed to investigate the relationship between sensorimotor function and blood glucose. To display the association between the health domains and their determinants, t tests and one-way analysis of variance were used. Results: Near vision acuity showed a negative correlation with blood glucose (p

INTRODUCTION: Cataract is a highly treatable condition due to advances in cataract surgery procedures. The aim of cataract surgery is to improve visual function which in turn will improve overall quality of life. OBJECTIVE: To evaluate visual acuity and quality of life after cataract surgery. MATERIALS & METHODS: Five hundred patients having senile cataract attending the outpatient department of ophthalmology at R.L.JALAPPA Hospital between January 2011 to March 2011 were included in the study. Cataract extraction was performed using manual small incision cataract surgery (SICS) and rigid PMMA posterior chamber intraocular lenses was implanted in all patients. Visual acuity - pre & post operatively was recorded for every patient. The visual acuity was divided into grades for the purpose of statistical analysis. Quality of life was assessed by a questionnaire analyzing distant & near vision, social functions and cataract related symptoms. Each item in the questionnaire was scored and total score was calculated for each patient and graded. RESULTS: After 6 weeks postoperatively, 455(91%) subjects had BCVA of 6/18 or better, 39(7.8%) had vision lesser than 6/18 but better than 6/60 and 6(1.3%) subjects had BCVA 6/60 seller equivalent or worse. In this study pre-operative general function was 22.2 ± 3.25, social function was 5.68 ± 1.07 and visual function was 15.76 ± 1.05. Post operatively general function score was 53.05 ± 11.59, social functions was 13.35 ± 3.07 and visual function was 23.23 ± 3.18. Post-operative score was high resulting in significant improvement in quality of life (p

Accommodative dysfunction is a common oculomotor sequelae of mild traumatic brain injury (mTBI). This study evaluated a range of dynamic (objective) and static (subjective) measures of accommodation in 12 nonstrabismic individuals with mTBI and near vision-related symptoms before and after oculomotor training (OMT) and placebo (P) training (6 wk, two sessions per week, 3 h of training each). Following OMT, the dynamics of accommodation improved markedly. Clinically, there was a significant increase in the maximum accommodative amplitude both monocularly and binocularly. In addition, the near vision symptoms reduced along with improved visual attention. None of the measures were found to change significantly following P training. These results provide evidence for a significant positive effect of the accommodatively based OMT on accommodative responsivity. Such improvement is suggestive of oculomotor learning, demonstrating considerable residual brain-visual system plasticity in the adult compromised brain.

Background: “Low vision” is a term used refer to a person having a visual acuity of less than 6/18 (20/60) to light perception (LP). People with low vision can still be treated to perceive or see objects, although several limitations occur. Treatments for people with low vision include either optical or non-optical devices. This research aims to reveal visual acuity for near vision that can serve as corrective benchmark after devices for near vision are given. Methods: This is a retrospective descriptive research, using medical records from the National Eye Healthcare Center, Cicendo Eye Hospital, for the period of August 2010–September 2011 as the subject of the research. Approximately 475 patients were listed, 263 female and 212 male. The number of patients with low vision given with corrective device for near vision were 81 patients. Results: The result showed that visual acuity was corrected after corrective devices for near vision with the size of 1 – 10 M were given. Conclusions: The highest of overall corrections or improvements for near vision are the one under the category of “severe visual impairment”. Key words : low vision, optical devices, visual acuity Peningkatan Penglihatan Jarak Dekat Pada Penderita“ Low Vision” di RS Mata Nasional Cicendo 2010–2011 LatarBelakang: " Low vision " adalah istilah yang mengacu pada seseorang yang memiliki ketajaman visual kurang dari 6/18 (20/60) dengan persepsi cahaya. Orang dengan low vision masih dapat diobati untuk melihat benda meskipun dengan berbagai keterbatasan. Pengobatan terhadap penderita low vision meliputi perangkat optik atau non-optik.. Penelitian ini bertujuan untuk menggambarkan ketajaman visual penglihatan dekat yang dapat berfungsi sebagai pedoman perbaikan setelah perangkat diberikan. Metode: Penelitian ini merupakan penelitian deskriptif retrospektif dengan menggunakan rekam medis dari Pusat Mata Nasional Kesehatan, RS Mata Cicendo, periode Agustus 2010–September 2011 sebagai subjek penelitian. Sekitar 475 pasien yang terdaftar terdiri atas 263 perempuan dan 212 laki-laki, 81 diantaranya diberikan perangkat korektif untuk penglihatan dekat. Hasil: Ketajaman visual dapat diperbaiki setelah dilakukan pemberian perangkat korektif untuk penglihatan jarak dekat dengan ukuran 1–10 M. S impulan: Peningkatan penglihatan jarak dekat terbaik adalah pada kelompok low vision yang termasuk kategori “gangguan penglihatan berat”. Kata kunci: low vision , perangkat optik, ketajaman visual DOI: 10.15850/amj.v1n2.355

In this retrospective case series, we report the spectrum and outcomes of aggressive posterior retinopathy of prematurity (APROP) in infants ≥ 1500 g birth weight. Twenty-nine eyes of 15 infants are included. All infants were referred from level I or II nurseries, received supplemental unmonitored oxygen for prolonged duration (1 week) and had multiple systemic co-morbidities. Of the 29 eyes, 10 (34.5%) had zone 1 and 19 (65.5%) had posterior zone 2 disease. Twenty-five (86.2%) eyes had flat neovascularization and 4 (13.8%) eyes had brush like proliferation. We noticed large vascular loops in 10 (34.5%) eyes. After confluent laser photocoagulation, 22 (75.9%) eyes had a favorable outcome. The study concludes that APROP in heavier (≥ 1500 g birth weight) premature infants occurs mostly in posterior zone 2 with flat neovascularization and atypical features like large vascular loops. Supplemental unmonitored oxygen for prolonged duration and multiple systemic co-morbidities could be a contributing factor.

Purpose To estimate the prevalence, potential determinants, and proportion of met need for near vision impairment (NVI) correctable with refraction approximately 2 years after initial examination of a multi-country cohort. Design Population-based, prospective cohort study. Participants People aged ≥35 years examined at baseline in semi-rural (Shunyi) and urban (Guangzhou) sites in China; rural sites in Nepal (Kaski), India (Madurai), and Niger (Dosso); a semi-urban site (Durban) in South Africa; and an urban site (Los Angeles) in the United States. Methods Near visual acuity (NVA) with and without current near correction was measured at 40 cm using a logarithm of the minimum angle of resolution near vision tumbling E chart. Participants with uncorrected binocular NVA ≤20/40 were tested with plus sphere lenses to obtain best-corrected binocular NVA. Main Outcome Measures Prevalence of total NVI (defined as uncorrected NVA ≤20/40) and NVI correctable and uncorrectable to >20/40, and current spectacle wearing among those with bilateral NVA ≤20/63 improving to >20/40 with near correction (met need). Results Among 13 671 baseline participants, 10 533 (77.2%) attended the follow-up examination. The prevalence of correctable NVI increased with age from 35 to 50–60 years and then decreased at all sites. Multiple logistic regression modeling suggested that correctable NVI was not associated with gender at any site, whereas more educated persons aged >54 years were associated with a higher prevalence of correctable NVI in Nepal and India. Although near vision spectacles were provided free at baseline, wear among those who could benefit was Conclusions Prevalence of correctable NVI is greatest among persons of working age, and rates of correction are low in many settings, suggesting that strategies targeting the workplace may be needed.

The study examined the ocular health of agricultural workers in the fisheries sub sector with the aim of establishing a possible correlation between the work place hazards and their ocular health. A multi-stage random sampling (involving 683 subjects, 358 fishmongers and 325 fishers) was employed. Ocular hazards encountered at the work place included seawater, sand or dust, heat, sunrays and smoke. Exposure to these hazards were found to be associated with ocular irritation (P

Advances in intraocular lens (IOL) design have rendered cataract surgery a refractive procedure. Newer IOL types include bifocal, trifocal and extended depth of focus (EDOF) IOLs. Their basic difference nestles in the number of focal points that each lens provides, which in turn leads to different visual outcomes. Familiarity of surgeons with the various characteristics of each lens is of utmost importance for accurate IOL selection to match each patient’s needs. In this review, we aim to compare the clinical outcomes after implantation of multifocal and EDOF IOLs in terms of distance, intermediate and near vision, contrast sensitivity, and reading performance. Finally, we discuss the defocus curve and the optical and photic phenomena associated with each type of IOL.

Presbyopia is the refractive disability of an aging eye in which accommodative ability is insufficient for near vision. An estimated 1.04 billion people are impacted by presbyopia. Successful management and compensation of presbyopia can substantially improve health-related quality of life. Optical methods for managing presbyopia are well established and can provide functional near- and distance-vision to improve the symptoms of presbyopia in a noninvasive manner. However, these methods have limitations and may not be appropriate for every individual. In response to this, several surgical technologies have been explored and developed to compensate for presbyopia.

Intraocular lens (IOL) technology has evolved dramatically in recent years with various premium IOLs improving the visual outcome. Toric IOLs with toricity on their posterior surface are able to correct astigmatism but the results depend on the correct axis of placement. Multifocal IOLs have specialized optical properties that can divide light to bring it into focus at more than one point at the same time and are currently the most reliable lenses for attaining both distance and near vision. Accommodating IOLs uses the optic shift principle and depend on the strength of ciliary body for their action. Microincisional IOLs acts by minimizing the surgeon induced astigmatism. Light adjustable lenses allow non-invasive post-operative adjustment of the IOL’s refractive power. Aspheric IOLs reduce the spherical aberrations and provides better image quality and contrast. This is a rapidly evolving field and the future looks promising. *Himanshu Shekhar, Rajesh Sinha

To assess the prevalence of near vision impairment caused by uncorrected presbyopia and to determine the spectacle coverage for presbyopia in Durban, KwaZulu Natal, South Africa.A cross-sectional community-based survey was conducted to determine the prevalence of presbyopia in Durban. Eighteen clusters were randomly selected from the suburbs of Durban--Inanda, Ntuzuma, and KwaMashu. Adults over 35 years of age were enumerated through a door-to-door method using aged-based sampling. Respondents were interviewed and then underwent standardized clinical eye examinations. Spectacle coverage was determined. Applying multivariate logistic regressions, the strengths of association of presbyopia and spectacle coverage with the participants' demographic profile were determined.A total of 2764 participants were enumerated while 1939 (70.2%) were examined with a median age of 52 years (interquartile range 45, 60). The prevalence of presbyopia was 77.0% (95% confidence interval [CI] 74.3%-79.2%), significantly higher in those 50-64 years old (OR 10.2, 95% CI 5.3-19.6) and 65-79 years old (OR 10.7, 95% CI 3.2-35.6) and significantly lower in those who had secondary and higher education (p0.05). The spectacle coverage for presbyopia was 4.84% (95% CI 3.35%-6.33%), significantly higher in those who were 65-79 years old (OR 4.4, 95% CI 1.5-12.9) and 50-64 years old (OR 2.6, 95% CI 1.1-6.1).This study indicated that there is a high prevalence of presbyopia in the study area, with low spectacle coverage, and therefore suggests that uncorrected presbyopia is a major public health concern. The findings of this study may help in making recommendations for strategic planning for eye health intervention efforts.

Purpose To investigate utility (a preference-based quality of life [QoL] measure) associated with uncorrected refractive error (URE). Design Cross-sectional study. Participants A cohort of 341 consecutive patients 40 to 65 years of age with refractive error and no ocular disease impairing vision worse than 20/25 (0.1 logarithm of the minimum angle of resolution [logMAR] units) in the better eye. Without vision correction, 30 had no vision impairment, 65 had only distance vision impairment (DVI), 97 had only near vision impairment (NVI), 112 had moderate amounts of both distance and near vision impairment (DNVI), and 37 had severe impairment (distance or near worse than 20/200 [>1.0 logMAR]) in the better eye. Methods All participants underwent a comprehensive eye examination with refraction, aided and unaided visual acuity (VA) at 6 m and 40 cm, and ocular health assessment. Utilities were elicited for a number of scenarios using a standardized, face-to-face time trade-off (TTO) interview method. Main Outcome Measures The main outcome measure was TTO utility for the participant's own uncorrected vision state. Utilities ranged from 0 to 1, where 0 = death and 1 = perfect vision, and were scaled to account for comorbidities so that 1 = perfect health (adjusted utility). Results Unaided VA was 0.50±0.24 logMAR at distance in the DVI group, 0.43±0.17 logMAR at near in the NVI group, and 0.72±0.36 and 0.56±0.29 at distance and near, respectively, in the DNVI group. Adjusted utilities for the 3 groups were 0.82±0.16 in the DVI group, 0.81±0.17 in the NVI group, and 0.68±0.25 in the DNVI group. The DVI and NVI group utilities (adjusted and unadjusted) did not differ significantly ( P = 0.73 and P = 0.77, respectively). The DNVI utility was significantly worse than that of the DVI and NVI groups (adjusted and unadjusted, P Conclusions The URE is associated with measurable reductions in utility (and therefore QoL). Reductions are similar regardless of whether near or distance vision is impaired, but worse when both are impaired. The results underscore the significance of the effect of URE on QoL, particularly with respect to uncorrected presbyopia, which has been a relatively neglected area in research and policy. The utility figures in this study can be used as inputs for cost-effectiveness studies relating to URE to assist resource allocation decisions. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Purpose To report the safety and efficacy of treatment of hyperopic presbyopia with a new multifocal corneal laser in situ keratomileusis (LASIK) procedure, Supracor. Setting Mater Private Hospital, Dublin, Ireland. Design Case series. Methods Bilateral LASIK using a multifocal corneal ablation profile was performed on consecutive hyperopic presbyopic patients with a manifest refraction spherical equivalent (MRSE) of +1.00 to +3.25 diopters (D) and a maximum 0.75 D difference between the MRSE and cycloplegic refraction. All patients were followed for a minimum of 6 months postoperatively. The main outcome measures were safety, efficacy in terms of uncorrected distance visual acuity (UDVA) and uncorrected reading ability (Vocational Reading Test), predictability, stability, patient satisfaction, and functioning at 6 months. Results Forty-six eyes (23 patients) were treated. The mean binocular UDVA was 0.07 logMAR ± 0.12 (SD) at 6 months, with 91% having a binocular UDVA of 0.2 logMAR or better. Ninety-one percent had an uncorrected reading ability of N8 or better, and 93% were fully independent of reading glasses. Six percent lost 2 or more lines of corrected distance visual acuity (CDVA), with 100% maintaining a CDVA of 0.2 logMAR or better. Five patients (22%) required a retreatment in the dominant eye to enhance UDVA. Ninety-six percent were happy they had the procedure. Conclusions The procedure provided a high level of spectacle independence for near vision. The UDVA outcomes must be improved with nomogram adjustment to reduce the retreatment rate. Targeting emmetropia in the dominant eye and 0.50 D myopia in the nondominant eye may be an effective solution. Financial Disclosure Neither author has a financial or proprietary interest in any material or method mentioned.

This study compares the influence of two different types of magnification (magnifier versus large print) on crowded near vision task performance.Fifty-eight visually impaired children aged 4-8 years participated. Participants were divided in two groups, matched on age and near visual acuity (NVA): [1] the magnifier group (4-6 year olds [n = 13] and 7-8 year olds [n = 19]), and [2] the large print group (4-6 year olds [n = 12] and 7-8 year olds [n = 14]). At baseline, single and crowded Landolt C acuity were measured at 40 cm without magnification. Crowded near vision was measured again with magnification. A 90 mm diameter dome magnifier was chosen to avoid measuring the confounding effect of navigational skills. The magnifier provided 1.7x magnification and the large print provided 1.8x magnification. Performance measures: [1] NVA without magnification at 40 cm, [2] near vision with magnification, and [3] response time. Working distance was monitored.There was no difference in performance between the two types of magnification for the 4-6 year olds and the 7-8 year olds (p's = .291 and .246, respectively). Average NVA in the 4-6 year old group was 0.95 logMAR without and 0.42 logMAR with magnification (p A magnifier is equally effective as large print in improving the performance of young children with a range of visual acuities on a crowded near vision task. Visually impaired children with stronger crowding effects showed larger improvements when working with magnification.

Purpose To assess the prevalence of presbyopia, spectacles use and spectacle correction coverage for near vision among weaving communities in Prakasam district in the South Indian state of Andhra Pradesh. Methods A population based cross sectional study was conducted among a population aged ≥40 years. Distance visual acuity was assessed at 6 m. Near vision was assessed using N notation charts at a fixed distance of 40 cm. Presbyopia was defined as binocular unaided near vision

To investigate the effect of astigmatism on near vision performance.In a consecutive case series 23 eyes of 23 participants were fogged with 0 D, -0.75 D and -1.5 D of with-the-rule (WTR) and against-the-rule (ATR) astigmatism (cylindrical lenses without spherical compensation). All subjects were cyclopleged and distance corrected. Reading acuity (RAc) and speed (RS) were measured with standardised sentences, near visual acuity (NVA) was assessed using single optotypes (Snellen E), all presented on a thin film transistor display using the Salzburg Reading Desk (SRD). Data were analysed using Wilcoxon-matched-pairs test, regression analysis and Bland-Altman analysis.An increasing amount of astigmatism resulted in a decreased NVA (p=0.16 for -0.75 D, p=0.005 for -1.5 D) and RAc (p=0.002 for -0.75 D, p=0.014 for -1.5 D). WTR astigmatism caused a reduced NVA, RAc and lower RS compared with ATR astigmatism (p0.001). NVA was better than RAc with no astigmatism, -0.75 D WTR and -1.5 D WTR (p=0.03 for 0 D, p0.001 for -0.75 D, p=0.03 for -1.5 D). There was no difference between NVA and RAc for -0.75 D ATR and -1.5 D ATR (p=0.06 for -0.75 D, p=0.5 for -1.5 D).WTR astigmatism results in reduced reading parameters and NVA for -0.75 D and -1.5 D astigmatism compared with corresponding ATR astigmatism and no astigmatism added. No beneficial effect of astigmatism was detected.

Advanced technology or premium intraocular lenses have been developed to meet the patient expectations of perfect distance and near vision without the need for spectacles. Careful patient selection is critical when implanting these implants. This brief review focusses mainly on multifocal and toric IOLs and their application and limitations in patients with glaucoma. How to cite this article: Ichhpujani P, Bhartiya S, Sharma A. Premium IOLs in Glaucoma. J Current Glau Prac 2013;7(2): 54-57.

Objective To describe the possible impairment of binocular vision in primary open angle glaucoma (POAG) patients. Method A cross-sectional study was conducted on 58 glaucoma patients, 76 ocular hypertensives and 82 normal subjects. They were examined with a battery of binocular tests consisting of the measurement of phoria angles, amplitudes of fusion (AF), near point of convergence (NPC) assessment, an evaluation of suppression (Worth test), stereoacuity according to Titmus, and TNO tests. Results The patients with glaucoma showed significantly increased phoria angles, especially in near vision, compared with the ocular hypertensives and controls (p = 0.000). AF were reduced mainly in near distances compared to hypertensives and controls (p = 0.000). The NPC of glaucoma was higher than the other two groups (p = 0.000). No differences were found in the near-distance suppression test between the three groups (p = 0.682), but there were differences in the distance vision of patients with glaucoma compared to hypertensives (OR = 3.867, 95% CI; 1.260–11.862; p = 0.008) and controls (OR = 5.831, 95% CI; 2.229–15.252; p = 0.000). The stereoacuity of patients with glaucoma was reduced in both tests (p = 0.001). Conclusions POAG is mostly associated with, an increased exophoria in near vision, a decreased AF in near vision, a far-distance NPC, central suppression in far-vision, and a loss of stereoacuity. These changes do not seem to appear early as they were not observed in hypertensive patients versus controls.

Purpose To analyze simultaneous vision (distance and near) 1-year after biaspheric multifocal central presbyLASIK treatments for hyperopia and myopia with or without astigmatism. Methods Patients were treated to correct distance ametropias and alleviating presbyopic symptoms simultaneously. All patients have been treated in Presby aberration-free mode using FemtoLASIK for Sphere from -7.00 to +3.25 diopters (D), astigmatism up to 3.00 D, and addition up to +2.75 D. No eye had previous corneal refractive surgery. Preoperative corneal curvature ranged between 40 and 48 D, with pachymetry thicker than 500 μm. Preoperative corrected distance visual acuity was 0.1 logarithm of the minimum angle of resolution (logMAR) or better, with near vision of 0.2 logRAD or better with addition up to +2.50 D. Results Sixty-six eyes treated bilaterally using PresbyMAX software were reviewed. For 31 patients (94%), 1-year follow-up was completed. At 1 year, 70% of patients achieved uncorrected distance visual acuity 0.1 logMAR or better, 84% patients obtained uncorrected near visual acuity 0.1 logRAD or better, and 83% of eyes were within 0.75 D of defocus. Postoperative mean spherical equivalent refraction was -0.47 ± 0.44 D. Stability was achieved from the 6-week follow-up. Eighty-five percent of patients achieved simultaneously uncorrected distance visual acuity 0.2 logMAR or better and uncorrected near visual acuity 0.2 logRAD or better. Conclusion Patient selection and expectation management is essential to achieve patient satisfaction. Even though optically the results are predictable and good, some patients find it difficult to adapt to the compromise and others are dissatisfied by the minor loss of distance visual acuity. Certain individuals are best suited for PresbyMAX. A test with multifocal contact lenses or trial frames that creates slightly defocused images can be used to simulate postoperative visual impressions and verify patient acceptance.

PURPOSE: To identify factors that influence near vision after monofocal intraocular lens (IOL) implantation for distance vision. METHODS: A retrospective review was conducted of patients who underwent cataract surgery with monofocal IOL implantation from October 2009 to April 2010 at Samsung Medical Center. Eyes were classified as having good (⩾ J4) or poor (< J4) near vision. Factors analyzed included age, sex, intraocular lens (IOL) movement, axial length, pupil size, degree and type of astigmatism, IOL type, total aberration, and higher-order aberrations. Binary logistic regression and odds ratios with 95% confidence intervals were determined. RESULTS: This retrospective study involved 84 eyes of 84 patients. Thirty-four eyes were classified as having good near vision and 50 eyes as having poor near vision. All groups had a postoperative uncorrected visual acuity greater than 0.2 logMAR (Snellen 20/32) and a refractive error within ± 0.5 diopter of spherical equivalent. Pupil size and axial length were inversely associated with good near vision ( P = .034 and .039, respectively). A pupil size smaller than 2.6 mm and an axial length less than 23.0 mm resulted in better near vision than larger measurements after monofocal IOL implantation for distant target. CONCLUSIONS: Among the factors analyzed, small pupil size and short axial length predicted good near vision after phacoemulsification and monofocal IOL implantation.

OBJETIVO: Avaliar por deflexometria as diferentes regiões das lentes progressivas e determinar as áreas dos campos de visão intermediário e de perto. MÉTODOS: Foram incluídas vinte e duas lentes progressivas com poder +1,00 DE para longe e duas adições diferentes (adição 1,00 e 2,00, 11 de cada). Mediram-se as áreas dos campos intermediário e de perto entre as isoastigmáticas de 0,5 DC. RESULTADOS: Encontraram-se diferenças significativas entre as áreas dos campos intermediário e de perto das lentes estudadas. Entre a área do campo intermediário e a adição observou-se correlação inversa; entre a área do campo intermediário e a extensão vertical do corredor encontrou-se correlação direta. CONCLUSÃO: Com esses dados permitem-se recomendar as lentes de acordo com o campo de maior necessidade visual de cada usuário. PURPOSE: To determine near and intermediate vision areas of progressive addition lenses by means of a deflectometer. METHODS: Twenty-two progressive addition lenses with +1.00 SD far power and two different additions (add 1.00 and 2.00; eleven subjects in each addition) were studied. Near and intermediate vision areas within 0.50 CD isoastigmatic lines were determined. RESULTS: There are significant differences between near and intermediate vision areas of the studied lenses. There is also an inverse correlation between the addition and intermediate areas as well as direct relation between the vertical length of the corridor and its area. CONCLUSION: Based on those findings, progressive addition lenses can be selected to suit the wearer's visual requirements.

A hospital based descriptive cross sectional study was conducted in a girls' high school, Tarakeswar, Hooghly, West Bengal to assess the proportion of visual acuity and visual impairment among the students in a Rural High School along with its association with some socio-demographic, environmental and nutritional factors. Out of 160 students, 132 girl students of class VIII, IX, X attended the school on the day of survey. In first step Pre-designed pre-tested self administered questionnaire was filled in by the students. The second step involved eye examination, including students' visual acuity using the Snellen E chart and near vision chart. Data were tabulated in MS EXCEL 2007 and analysed by SPSS 20. Most of the students were Hindu (98.49%), Poor socio-economic class (63.64%). Education status of the fathers was mostly primary school completed (36.4%). 68.9% students had visual acuity 6/6 and 31.1% had visual acuity

PURPOSE To identify the optical needs of students with low vision studying in the integrated schools for the blind in Nepal. METHODS A total of 779 blind and vision-impaired students studying in 67 integrated schools for the blind across Nepal were examined using the World Health Organization/Prevention of Blindness Eye Examination Record for Children with Blindness and Low Vision. Glasses and low-vision devices were provided to the students with low vision who showed improvement in visual acuity up to a level that was considered sufficient for classroom learning. Follow-up on the use and maintenance of device provided was done after a year. RESULTS Almost 78% of students studying in the integrated schools for the blind were not actually blind; they had low vision. Five students were found to be wrongly enrolled. Avoidable causes of blindness were responsible for 41% of all blindness. Among 224 students who had visual acuity 1/60 or better, distance vision could be improved in 18.7% whereas near vision could be improved in 41.1% students. Optical intervention provided improved vision in 48.2% of students who were learning braille. Only 34.8% students were found to be using the devices regularly after assessment 1 year later; the most common causes for nonuse were damage or misplacement of the device. CONCLUSIONS A high proportion of students with low vision in integrated schools could benefit from optical intervention. A system of comprehensive eye examination at the time of school enrollment would allow students with low vision to use their available vision to the fullest, encourage print reading over braille, ensure appropriate placement, and promote timely adoption and proper usage of optical device.

Purpose Today, many patients who have undergone cataract surgery want to enjoy good non-spectacle corrected distant vision and nonspectacle corrected near vision with glasses independence. According to the literature, the implantation of an accommodative intraocular lens (AIOLs) can achieve the level of vision after cataract surgery. However, there is a debate regarding the true accommodative capability of the AIOLs (i.e., whether the IOLs can move forward when attempting to accommodate like the natural crystalline lens of a phakic eye). This review aims to answer the following questions: (1) Can pseudophakic eye accommodate? (2) If pseudophakic eyes can accommodate, how long does this accommodation last? (3) Is there pseudoaccommodation? Methods This is a systematic review of randomized and nonrandomized controlled trials that have compared different IOLs in accommodation using subjective and objective methods of testing accommodation. All peer reviewed randomized and nonrandomized controlled trials that compared different IOLs in accommodation were included. Results There was evidence of pseudophakic accommodation up to 12 months postoperatively for AIOLs (mostly 1CU): subjective accommodation [95% confidence interval (CI), 0.36–0.98], objective optic shift (95% CI, 0.12–0.76). However, accommodation decreased at 12 months postoperatively (95% CI, 0.55–1.00). In addition, several papers have reported evidence of pseudoaccommodation. Conclusion There is pseudophakic accommodation up to 1 year post cataract surgery, mostly 1CU AIOL. Pseudoaccommodation may coexist.

A new generation of logarithmic reading charts has sparked interest in standardized reading performance analyses. Such reading charts have been developed according to the standards of the International Council of Ophthalmology. The print size progression in these calibrated charts is in accordance with the mathematical background of EN ISO 8596. These reading charts are: the Bailey-Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the Oculus Reading Probe II, the MNREAD Charts, the SKread Charts, and the RADNER Reading Charts. The test items used for these reading charts differ among the charts and are standardized to various extents. The Bailey-Lovie Charts, MNREAD Charts, SKread Charts, and RADNER Charts are also meant to measure reading speed and allow determination of further reading parameters such as reading acuity, reading speed based on reading acuity, critical print size, reading score, and logMAR/logRAD ratio. Such calibrated reading charts have already provided valuable insights into the reading performance of patients in many research studies. They are available in many languages and thus facilitate international communication about near visual performance. In the present review article, the backgrounds of these modern reading charts are presented, and their different levels of test-item standardization are discussed. Clinical research studies are mentioned, and a discussion about the immoderately high number of reading acuity notations is included. Using the logReading Acuity Determination ([logRAD] = reading acuity equivalent of logMAR) measure for research purposes would give reading acuity its own identity as a standardized reading parameter in ophthalmology.

Presbyopia correction is mainly concerned with the goal of regaining an uncorrected reading performance. Since historic reading charts do not provide a unique standard that is applicable for the analysis of clinical and scientific reading performance, new standardized reading charts have been developed, in order to provide reading performance analyses analogous to modern single-optotype distance acuity measurements: the Bailey-Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the MNREAD Charts, and the RADNER Reading Charts. The last three are also meant to measure reading speed, thus allowing detailed analysis of the reading capabilities of the patient’s functional vision. Furthermore, these reading charts can be declared homologated, based on the standards that were published for reading charts by the Visual Function Committee of the International Council of Ophthalmology (ICO) in 1988. Many research studies have shown that by analyzing the reading performance with homologated reading charts, valuable insight into the reading performance of patients suffering from various diseases can be obtained. These reading charts have also been successfully used in presbyopia research. It therefore seems evident that homologated, standardized reading charts facilitate not only research concerning functional vision in many fields of ophthalmology but also international communication about near visual performance. Homologated reading charts are available in almost all languages and have become a valuable tool in analyzing reading performance. We argue in this review that homologated reading charts are clearly a necessity for presbyopia research.

Purpose: To compare the visual performance of prototype contact lenses designed via deliberate manipulation of higher-order spherical aberrations to extend-depth-of-focus with two commercial multifocals, after 1 week of lens wear. Methods: In a prospective, participant-masked, cross-over, randomized, 1-week dispensing clinical-trial, 43 presbyopes [age: 42–63 years] each wore AIROPTIX Aqua multifocal (AOMF), ACUVUE OASYS for presbyopia (AOP) and extended-depth-of-focus prototypes (EDOF) appropriate to their add requirements. Measurements comprised high-contrast-visual-acuity (HCVA) at 6 m, 70 cm, 50 cm and 40 cm; low-contrast-visual-acuity (LCVA) and contrast-sensitivity (CS) at 6 m and stereopsis at 40 cm. A self-administered questionnaire on a numeric-rating-scale (1–10) assessed subjective visual performance comprising clarity-of-vision and lack-of-ghosting at various distances during day/night-viewing conditions and overall-vision-satisfaction. Results: EDOF was significantly better than AOMF and AOP for HCVA averaged across distances (p ≤ 0.038); significantly worse than AOMF for LCVA (p = 0.021) and significantly worse than AOMF for CS in medium and high add-groups (p = 0.006). None of these differences were clinically significant (≤2 letters). EDOF was significantly better than AOMF and AOP for mean stereoacuity (36 and 13 seconds-of-arc, respectively: p ≤ 0.05). For clarity-of-vision, EDOF was significantly better than AOP at all distances and AOMF at intermediate and near (p ≤ 0.028). For lack-of-ghosting averaged across distances, EDOF was significantly better than AOP (p

PURPOSE To investigate the degree of visual acuity in workers with intellectual disabilities and the impact of vision on their working conditions. METHODS We recruited 224 workers (mean age 43.77 years, SD ± 12.96; range, 19-72 years) from a workshop for those with intellectual disabilities, to participate in a vision examination program. The assessment consisted of objective refraction, visual acuity, ocular motility, near-point of convergence, cover/uncover test, stereo acuity and colour perception. Individuals with vision deficits were fitted with spectacles following the screening program. RESULTS Within the past three years, 38.9 per cent of the participants received eye care, 14.3 per cent of participants had not received eye care in more than three years, and 6.7 per cent had not received any eye care. As many as 39.7 per cent of participants did not know whether they had ever received eye care. Entering visual acuity for far vision was 0.52 dec (-0.29 logMAR) and 0.42 dec (-0.38 logMAR) for near vision. Only 14.9 per cent, 11 of all participants aged ≥50 years, owned spectacles for near vision before the examination. After subjective determination of refraction, best corrected visual acuity for far vision was 0.61 dec (-0.22 logMAR) and 0.56 dec (-0.25 logMAR) for near vision (in both cases with p < 0.001). After the examination, 44.6 per cent (33) of all workers aged ≥50 years received a recommendation for reading or bifocal spectacles. In 46 per cent of workers, the threshold of stereopsis was higher than 63 arc seconds, and some form of colour vision deficiency was measured in 12.5 per cent of participants. CONCLUSIONS Workers with intellectual disabilities are often unaware of their visual deficits. We found that some of their abnormalities can be solved by appropriate optical means and that they could benefit from regular eye care. These workers should be encouraged to be tested and to improve their vision with appropriate lenses.

ummary An increasing demand of spectacle independence after cataract surgery or clear lens extraction has greatly stimulated the development of multifocal intraocular lenses (MIOLs). Optical design has played an essential role in this progress. Based on the principle of simultaneous vision, MIOLs overcome the loss of accommodation by providing at least two primary powers intended for distance and near vision. Diffraction-based MIOLs have proved better optical performance than multizonal refractive MIOLs and accommodative IOLs. Some new designs of diffractive MIOLs attempt to direct light either to an intermediate focus location or to an extended focal segment for an improved visual acuity at intermediate distances. Although the patient primarily perceives the focused image, they can also experience disturbing visual phenomena, such as halos and glare. The optical imaging performance of MIOLs, as referred to some quality metrics, is assessed using in-vitro as well as in-vivo testing methods. This work reviews the objective imaging quality of a variety of MIOLs measured in an optical bench and compares the experimental results with those obtained in the clinical practice.

With the growing population of the elderly people, designers of the human-machine interface must consider their psychophysiological characteristics. Three groups of subjects with a mean age of 21.0, 38.5 and 61.5 years, participated in the experiments. First they were examined by the perimeter. Then their near vision were measured by the Landolt ring test. Finally a Chinese character choosing task was done. The senile group had a marked decrease of light sensitivity and also a decline of near vision. For the 9-point font, there was no significant difference among three groups. However, for the 6-point font, the senile group reacted slowly. In the future, for the sake of the aged people, it would be of great importance to work out the critical and optimal font sizes under different light conditions. To obtain this goal, more experiments should be done and more subjects should be involved.

To assess uncorrected and corrected distance and near binocular visual acuity (VA) and the use of corrective lenses in U.S. Army Active Duty, Guard, and Reserve Soldiers.A descriptive statistical analysis of VA group data from the U.S. Army Vision Readiness Classification Screening system was performed. Data pulls from June 2012 to January 2015 were compared.In January 2015, 62.3% of Soldiers had an uncorrected binocular distance VA of 20/20, 21.2% of Soldiers were worse than 20/40, and 41.4% of Soldiers wore corrective eyewear for distance vision. With correction, 92.5% had a binocular distance VA of 20/20 and 1.4% were worse than 20/40. In January 2015, 32.6% of Soldiers age45 had an uncorrected binocular near VA of 20/20, 28.4% of Soldiers age45 were worse than 20/40, and 61.9% of Soldiers age45 wore corrective eyewear for near vision. With correction, 74.6% had a binocular near VA of 20/20 and 3.0% were worse than 20/40. Data for both years were similar, although there were differences between individual service components.In comparison to the U.S. adult population, U.S. Army Soldiers have better uncorrected and corrected vision and are less likely to wear vision correction.

Purpose To determine why presbyopic patients discontinue contact lens wear and describe their opinions of comfort and visual quality with contact lenses. Methods A survey assessing current age, gender, contact lens material/design, and opinions of contact lens comfort and visual quality was mailed to 2400 presbyopic patients (age 40 years and older) that have had eye exams in the Ohio State University College of Optometry's Contact Lens Services over the last 4 years. Results A total of 496 surveys were analyzed. The mean age of survey respondents was 57 ± 9 years, and 68% of the sample was female. Permanent discontinuation of contact lens wear was reported by 15%. No association was found between contact lens discontinuation and age (p = 0.7), gender (p = 0.2), age of beginning contact lens wear (p = 0.1), or contact lens material (p = 0.1). Poor vision (38%), discomfort (34%), convenience (20%), and cost (6%) were the primary reported reasons for discontinuation. There was no difference between the proportion of subjects reporting "poor vision" as their primary discontinuation reason and those reporting "discomfort" (p = 0.7). Discontinued wearers had a worse overall opinion of their distance (p = 0.03), intermediate (p = 0.01), and near vision (p = 0.002) compared to subjects who were still wearing their contact lenses. Conclusions Discomfort has been reported as the primary reason for contact lens discontinuation. In this presbyopic population, dissatisfaction with vision and discomfort were reported equally as often as primary reasons for discontinuation. As well, subjects who ceased contact lens wear had worse overall opinions of their vision at all distances than current contact lens wearers. The results of this survey suggest that presbyopes have unique demands and opinions related to contact lens wear.

Purpose To evaluate how multiple-zone multifocal designs maximize optical performance of modified monovision corrections. Setting Midwestern University, Chicago College of Optometry, Downers Grove, Illinois, USA. Design Experimental study. Methods Optical performance under monovision conditions combining monofocal, bifocal, trifocal, and designs with spherical aberration was evaluated using computer simulations of the visual Strehl ratio based on the optical transfer function in relation to the optical quality provided by design (limiting performance at best focus), through-focus performance of design (evaluating real multifocal usability), and difference between images on each eye (limiting tolerance for monovision corrections). Results Monovision corrections with bifocal or trifocal patterns for near vision offered higher optical performance (larger area under values of the visual Strehl ratio and larger range of acceptable vision through-focus) than an aspheric design. A bifocal design with 1.5 diopters (D) of addition and centered through-focus between 2.0 D and 3.5 D had the best range above threshold (3.98 D) for a monofocal design (centered at 0 D, distance vision) combined with a bifocal design. The largest optical disparity was achieved with 2 monofocal designs (1 centered at 0 D, 1 centered at 4.0 D). Conclusions Bifocal and trifocal combinations produced higher optical quality (5%) and through-focus performance (35%) than spherical aberration designs. For any given amount of tolerable optical disparity in presbyopia, a combination of monofocal and bifocal/trifocal designs offered better optical performance than a spherical aberration design. Bifocal and trifocal designs can be implemented in laser in situ keratomileusis equipment to improve conventional monovision and will soon be available in new multifocal contact and intraocular lenses. Financial Disclosure The author has no financial or proprietary interest in any material or method mentioned.

Purpose: Uncorrected presbyopia (near vision impairment) is prevalent in approximately 517 million people worldwide; this prevalence ranges from 30% to 80% in Africa. Good near vision is needed for a range of tasks; therefore, uncorrected presbyopia can negatively affect the quality of life of individuals, impact families and society, and potentially have negative implications on employment and labour work productivity. This study aimed to determine the impact of near vision correction on the work productivity of clothing factory workers. Methods: We conducted a cross-sectional study and sampled all workers who were aged 40 years and older and who performed near vision tasks (e.g. machinist, cutter, zip sewer, clothing pressers and quality controllers) in seven clothing factories. We included workers who were employed for at least 3 months and whose uncorrected near visual acuity could be improved and corrected to better than 6/9 with spectacle correction. Workers were provided with near vision spectacles, and changes in their work productivity were evaluated after 6 months, using the factories’ output records as an indicator for measurement. Results: The final sample comprised 268 individuals, with 56% of African origin ( n = 151) and 49% ( n = 115) Indian origin. There were mainly females (94%) in the sample, and the average age was 48 years (± 5.5 years, range 40–62 years). The overall post-correction mean production score (70.5 [SD ± 19.9]) was significantly higher than the overall pre-correction mean production score (67.0 [SD ±20.3]) ( p < 0.001). The average change in production score was 3.5 (95% confidence interval [CI] 2.7–4.3), and the percent difference was 6.4% (95% CI 5.2–7.7). The increase in work productivity was significant for individuals of African ( p < 0.001) and Indian origins ( p < 0.001) but not for those of mixed race ( p = 0.364; n = 2). Post-correction, the production scores of women increased significantly by 6.6% (95% CI 5.3–7.9) ( p < 0.001). Significant increases in production scores were recorded for machinists, clothing pressers and quality controllers. Conclusion: Significant changes in work productivity among the workers with presbyopic correction were recorded. The clothing industry served as a favourable setting to examine changes in work productivity, obtaining reliable scores of output. This study was used as an exploratory investigation, and the results will be used to inform a randomised-controlled study that will provide stronger validation for the hypothesis that near vision correction impacts work productivity

The aim of this study was to investigate the outcome in near vision and the best-corrected visual acuity in patients with wet, age-related macular degeneration treated with aflibercept in a fixed bimonthly regimen in an ordinary clinical setting.The study was a retrospective, nonrandomized consecutive case series including 85 patients with wet, age-related macular degeneration followed for 18 months. During the first year all the patients received aflibercept injections in a fixed regimen at the following time points: Month 0, 1, 2, 4, 6, 8, 10, and 12. From Month 12 to Month 18, patients were treated with a treat and extend algorithm.The median near visual acuity improved from 12 points (95% confidence interval [CI] 10.5-13.4) at baseline to 5 points both at Month 12 (95% CI 3.8-6.2) and at Month 18 (95% CI 3.6-6.4) (P0.0001). At the 18-month visit, 58% (42/73) of the patients had a near visual acuity of at least 5 points compared with 7% (6/85) (P0.0001) at baseline. Best-corrected visual acuity improved from 60.9 letters (Snellen 20/63) (95% CI 58.4-63.4) at baseline to 68.1 letters (20/40) (95% CI 65.3-70.9) (P0.001) at Month 12 and 69.6 letters (20/40) (95% CI 66.7-72.5) (P0.001) at Month 18.Significant improvements were found in near vision and best-corrected visual acuity. The improvement in near vision was comparably greater than the change in best-corrected visual acuity. Monitoring near vision can contribute additional information when managing the patient with wet, age-related macular degeneration.

Background Chinese traditional “eye exercises of acupoints” have been advocated as a compulsory measure to reduce visual symptoms, as well as to retard the development of refractive error, among Chinese students for decades. The exercises are comprised of a 5-min, bilateral eye acupoint self-massage. This study evaluated the possible effect of these eye exercises among Chinese rural students. Methods Eight hundred thirty-six students (437 males, 52.3 %), aged 10.6 ± 2.5 (range 6–17) years from the Handan Offspring Myopia Study (HOMS) who completed the eye exercises and vision questionnaire, the convergence insufficiency symptom survey (CISS) questionnaire, and had a cycloplegic refraction were included in this study. Results 121 (14.5 %) students (64 males, 52.9 %) performed the eye exercises of acupoints in school. The multiple odds ratio (OR) and 95 % confidence interval (CI) for those having a “serious attitude” towards performing the eye exercises (0.12, 0.03–0.49) demonstrated a protective effect for myopia, after adjusting for the children’s age, gender, average parental refractive error, and the time spent on near work and outdoor activity. The more frequently, and the more seriously, the students performed the eye exercises each week, the less likely was their chance of being myopic (OR, 95 % CI: 0.17, 0.03–0.99), after adjusting for the same confounders. However, neither the “seriousness of attitude” of performing the eye exercises (multiple β coefficients: -1.58, p = 0.23), nor other related aspects of these eye exercises, were found to be associated with the CISS score in this sample. Conclusions The traditional eye exercises of acupoints appeared to have a modest protective effect on myopia among these Chinese rural students aged 6–17 years. However, no association between the eye exercises and near vision symptoms was found. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-1289-4) contains supplementary material, which is available to authorized users.

Purpose.To compare near, intermediate, and distance vision and quality of vision, when refractive rotational multifocal intraocular lenses with 3.0 diopters or diffractive multifocal intraocular lenses with 2.5 diopters near addition are implanted.Methods.41 eyes of 41 patients in whom rotational +3.0 diopters near addition IOLs were implanted and 30 eyes of 30 patients in whom diffractive +2.5 diopters near addition IOLs were implanted after cataract surgery were reviewed. Uncorrected and corrected distance visual acuity, intermediate visual acuity, near visual acuity, and patient satisfaction were evaluated 6 months later.Results. The corrected and uncorrected distance visual acuity were the same between both groups (p=0.50andp=0.509, resp.). The uncorrected intermediate and corrected intermediate and near vision acuities were better in the +2.5 near vision added intraocular lens implanted group (p=0.049,p=0.005, andp=0.001, resp.) and the uncorrected near vision acuity was better in the +3.0 near vision added intraocular lens implanted group (p=0.001). The patient satisfactions of both groups were similar.Conclusion. The +2.5 diopters near addition could be a better choice in younger patients with more distance and intermediate visual requirements (driving, outdoor activities), whereas the + 3.0 diopters should be considered for patients with more near vision correction (reading).

We present a technique that uses a near-point string to demonstrate the anticipated near point of multifocal and accommodating intraocular lenses (IOLs). Beads are placed on the string at distances corresponding to the near points for diffractive and accommodating IOLs. The string is held up to the patient's eye to demonstrate where each of the IOLs is likely to provide the best near vision. Financial Disclosure None of the authors has a financial or proprietary interest in any material or method mentioned.

Aim. To examine subscale and total scores of NEI-VFQ questionnaire of type 2 diabetes patients at different diabetic retinopathy (DRP) stages.Methods. A total number of 201 patients have been included. Prior to ophthalmological examination all patients participated in the NEI-VFQ questionnaire. The patients were divided into 5 groups according to the International Clinical Diabetic Retinopathy Disease Severity Scale (ICDRS).Results. The diabetes duration in general health scores (p=0.029); the stage (p=0.011); and clinically significant macular edema (CSME) (p=0.019) in general vision were found to be the most efficient factors. In near vision activities the most efficient factors were near vision acuity (NVA) (p=0.0001) and DRP stage (p=0.020). EDTRS visual acuity was found to be the most efficient factor in vision specific role difficulties (p=0.034) and dependency (p=0.011) whereas Snellen visual acuity was found to be among the most effective factors in distance activities (DA) (p=0.014) and total scores (p=0.026).Discussion. Difference was based not on the diabetes duration, clinically significant cataract (CSCat), CSME presence, and DRP stage but on thevisual acuitylevels of the better seeing eye of the patients.

Purpose To evaluate distance, intermediate, and near vision after bilateral implantation of a diffractive aspheric trifocal intraocular lens (IOL). Methods This study enrolled 204 eyes of 102 patients who had bilateral implantation of the AT LISA tri 839MP IOL. Monocular and binocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (4 meters), monocular and binocular uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) (30, 40 centimeters), binocular uncorrected intermediate visual acuity (UIVA) and distance-corrected intermediate visual acuity (DCIVA) (50, 60, 70 centimeters), the defocus curve, and binocular photopic and mesopic contrast sensitivity with and without glare were evaluated over 6 months. Results No statistically significant differences in visual acuity outcomes between follow-up visits were found at any distance evaluated (p>0.05). Six months postoperatively, the mean monocular UDVA and UNVA were comparable to preoperative CDVA and DCNVA, respectively. All patients achieved a binocular CDVA of 20/25 or better. The mean binocular DCIVA ranged from 0.11 ± 0.11 (70 cm) to 0.07 ± 0.11 logMAR (50 cm). The mean binocular DCNVA was 20/25 or better in nearly 87% of patients. The defocus curve showed a wide range of useful vision, with no statistically significant differences in visual acuity at intermediate distances (p = 0.151). Mesopic contrast sensitivity was lower than under photopic conditions, particularly at medium and high spatial frequencies (pConclusions Bilateral implantation of this trifocal IOL provides good visual outcomes at far, intermediate, and near distances, being an effective solution to reduce spectacle dependence after lensectomy.