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Patients prescribed pilocarpine ophthalmic solution are advised to be cautious when driving at night, but studies evaluating the effects of pilocarpine hydrochloride ophthalmic solution 1.25% (pilo), approved to treat presbyopia, on driving at night are lacking. This double-masked, crossover, phase 3b study evaluated night-driving performance with pilo or the placebo once daily. Forty-three adults (40–55 years) with presbyopia impacting daily activities and mesopic, high-contrast, binocular distance-corrected near vision 6/12–6/30 were randomised to bilateral treatment with pilo followed by placebo or placebo followed by pilo (with a ≥7-day washout between interventions). Night-driving performance was evaluated at twilight at a closed-circuit course. Primary efficacy endpoint: overall composite night-driving performance Z score at the end of the 7–14-day intervention period, 1 hour post-instillation. Pilo was considered non-inferior if the lower limit of the 95% confidence interval (CI) for the least squares mean difference (LSMD, pilo minus placebo) was >–0.25. Other efficacy endpoints: individual components of the night-driving performance test (hazard avoidance rate; road sign recognition rate and distance; pedestrians recognition distance; overall driving and lane-keeping times) and night-driving experience questionnaire. Safety included treatment-emergent adverse events (TEAEs). The mean overall composite Z scores were −0.121 (pilo) and 0.118 (placebo). The LSMD (pilo minus placebo) was −0.224 (95% CI, −0.346, −0.103), with 3 of the 7 individual tasks being significantly better with the placebo. The questionnaire did not reveal significant differences between pilo and the placebo. There were no serious or severe TEAEs and no TEAE-related discontinuations. The most common ocular TEAEs were headache and visual impairment with pilo (both 27.9%), and dry eye (7.0%) with the placebo. The overall performance of night driving was inferior with pilo, compared with placebo. The study findings are consistent with the current class labelling and provide evidence to inform regulators and assist clinicians considering prescribing pilo to adults who seek treatment of presbyopia symptoms and drive at night. ClinicalTrials.gov identifier: NCT04837482. [ABSTRACT FROM AUTHOR]

Background: This study investigated patients' awareness of presbyopia and its management approaches and their preferred methods for near vision correction. Methods: In Saudi Arabia, 785 participants (aged between 35 and 60 years) completed a structured survey online, consisting of hard copies and direct interviews. The survey consisted of twenty-eight items divided into three parts. It was designed to record participants' awareness of and preferences for presbyopia and its refractive corrections. Nonparametric tests and descriptive analyses were conducted to analyse participants' responses. Result: Approximately half of the participants had difficulty with near vision activities, such as reading newspapers or using mobile phones. Among all the participants, 76% were not aware of presbyopia. The prevalence of uncorrected presbyopia was 48% of the 785. The majority (82%) felt that spectacles were acceptable for correction of presbyopia. Most reported that they did not experience social stigma when using reading spectacles (87% of participants). When asked if they were aware of management approaches other than spectacles, 72% responded with not at all. Most participants had no earlier knowledge of the use of multifocal contact lenses or eye drops for presbyopia correction (67% and 82%, respectively). In the present study, some tendencies to use corrective approaches to presbyopia other than spectacles were noted. Finally, participants' age, sex, region, education, and income had a statistically significant impact on essential parts of their responses (p < 0.05). Conclusion: Presbyopia is a highly prevalent age-related ocular disorder, and a significant percentage of cases are uncorrected due to a lack of awareness or reluctance to wear spectacles. More efficient health education about presbyopia and its corrective alternatives is urgently needed. [ABSTRACT FROM AUTHOR]

Abstract Background This study investigated patients’ awareness of presbyopia and its management approaches and their preferred methods for near vision correction. Methods In Saudi Arabia, 785 participants (aged between 35 and 60 years) completed a structured survey online, consisting of hard copies and direct interviews. The survey consisted of twenty-eight items divided into three parts. It was designed to record participants’ awareness of and preferences for presbyopia and its refractive corrections. Nonparametric tests and descriptive analyses were conducted to analyse participants’ responses. Result Approximately half of the participants had difficulty with near vision activities, such as reading newspapers or using mobile phones. Among all the participants, 76% were not aware of presbyopia. The prevalence of uncorrected presbyopia was 48% of the 785. The majority (82%) felt that spectacles were acceptable for correction of presbyopia. Most reported that they did not experience social stigma when using reading spectacles (87% of participants). When asked if they were aware of management approaches other than spectacles, 72% responded with not at all. Most participants had no earlier knowledge of the use of multifocal contact lenses or eye drops for presbyopia correction (67% and 82%, respectively). In the present study, some tendencies to use corrective approaches to presbyopia other than spectacles were noted. Finally, participants’ age, sex, region, education, and income had a statistically significant impact on essential parts of their responses (p

Abstract Background The aim of this study is to evaluate near and distance visual acuity (VA) and their correlation with the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) outcomes in patients with diabetic macular edema (DME) and macular edema due to retinal vein occlusion (RVO) treated with aflibercept. Methods In this prospective study, we included 87 eyes of patients diagnosed with DME (n = 61) and RVO (n = 26), who received aflibercept treatment and were followed until the 8th injection. Near VA was examined on the 1st, 2nd, 3rd, 4th, 6th, and 8th injection, and patients completed the NEI VFQ-25 on the 1st, 4th, and 8th aflibercept injection. Results The mean near VA at baseline in all eyes was 0.89 ± 0.12 logMAR. With every administration, there was a statistically significant improvement; on the 4th (0.70 ± 0.19; p = 0.000) and the 8th application (0.60 ± 0.19; p = 0.000). At baseline, the mean NEI VFQ-25 total score was 71 ± 14%, and improved to 81 ± 13% (p = 0.000) on the 8th injection. The most significant score gain was recorded in the near VA subscale (+ 20 ± 14%, p = 0.000). There was no statistically significant difference between DME and RVO group in the questionnaire or near VA outcomes. Conclusion Aflibercept treatment resulted in a remarkable improvement of near vision by 4 lines of logMAR optotype after the 8th application. The near vision questionnaire subscale, initially scoring the lowest, exhibited the greatest gain during the treatment period. This underscores the importance of near vision and reading ability for patients with DME and RVO.

Background: Idiopathic epiretinal membrane (ERM) often leads to visual symptoms such as metamorphopsia and decreased central vision. This study aimed to evaluate functional, structural, and microvascular characteristics in patients with different stages of idiopathic ERM who were candidates for surgery, with a focus on identifying potential indicators for surgical timing. Methods: A retrospective cohort study was conducted on consecutive patients with unilateral idiopathic ERM who were candidates for surgery. Patients underwent comprehensive ophthalmological assessments, including OCT grading, reading performance evaluation, and OCT angiography. Data analysis included comparisons between different ERM stages for functional, structural, and microvascular parameters. Results: A total of 44 eyes were included, classified into four ERM stages according to the Govetto grading system. Functional parameters, including distance and near visual acuity, worsened significantly with higher ERM stages, particularly in the transition from Stage 3 to Stage 4. Structural assessments revealed significant increases in central macular thickness (CMT) from Stage 3 to Stage 4. No significant differences were observed in microvascular features across different ERM stages. Conclusions: This study highlights the significant functional and anatomical impact of OCT staging in idiopathic ERM, particularly during the transition from Stage 3 to Stage 4, characterized by notable reductions in visual acuity and increases in CMT. These findings underscore the importance of considering both functional and structural parameters in surgical decision-making for ERM management. However, further research with larger cohorts is needed to confirm these observations and inform clinical practice. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to evaluate near and distance visual acuity (VA) and their correlation with the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) outcomes in patients with diabetic macular edema (DME) and macular edema due to retinal vein occlusion (RVO) treated with aflibercept. Methods: In this prospective study, we included 87 eyes of patients diagnosed with DME (n = 61) and RVO (n = 26), who received aflibercept treatment and were followed until the 8th injection. Near VA was examined on the 1st, 2nd, 3rd, 4th, 6th, and 8th injection, and patients completed the NEI VFQ-25 on the 1st, 4th, and 8th aflibercept injection. Results: The mean near VA at baseline in all eyes was 0.89 ± 0.12 logMAR. With every administration, there was a statistically significant improvement; on the 4th (0.70 ± 0.19; p = 0.000) and the 8th application (0.60 ± 0.19; p = 0.000). At baseline, the mean NEI VFQ-25 total score was 71 ± 14%, and improved to 81 ± 13% (p = 0.000) on the 8th injection. The most significant score gain was recorded in the near VA subscale (+ 20 ± 14%, p = 0.000). There was no statistically significant difference between DME and RVO group in the questionnaire or near VA outcomes. Conclusion: Aflibercept treatment resulted in a remarkable improvement of near vision by 4 lines of logMAR optotype after the 8th application. The near vision questionnaire subscale, initially scoring the lowest, exhibited the greatest gain during the treatment period. This underscores the importance of near vision and reading ability for patients with DME and RVO. [ABSTRACT FROM AUTHOR]

The diffusion of virtual reality urges to solve the problem of vergence-accommodation conflict arising when viewing stereoscopic displays, which causes visual stress. We addressed this issue with an approach based on reducing ocular convergence effort. In virtual environments, vergence can be controlled by manipulating the binocular separation of the virtual cameras. Using this technique, we implemented two quasi-3D conditions characterized by binocular image separations intermediate between 3D (stereoscopic) and 2D (monoscopic). In a first experiment, focused on perceptual aspects, ten participants performed a visuo-manual pursuit task while wearing a head-mounted display (HMD) in head-constrained (non-immersive) condition for an overall exposure time of ~ 7 min. Passing from 3D to quasi-3D and 2D conditions, progressively resulted in a decrease of vergence eye movements—both mean convergence angle (static vergence) and vergence excursion (dynamic vergence)—and an increase of hand pursuit spatial error, with the target perceived further from the observer and larger. Decreased static and dynamic vergence predicted decreases in asthenopia trial-wise. In a second experiment, focused on tolerance aspects, fourteen participants performed a detection task in near-vision while wearing an HMD in head-free (immersive) condition for an overall exposure time of ~ 20 min. Passing from 3D to quasi-3D and 2D conditions, there was a general decrease of both subjective and objective visual stress indicators (ocular convergence discomfort ratings, cyber-sickness symptoms and skin conductance level). Decreased static and dynamic vergence predicted the decrease in these indicators. Remarkably, skin conductance level predicted all subjective symptoms, both trial-wise and session-wise, suggesting that it could become an objective replacement of visual stress self-reports. We conclude that relieving convergence effort by reducing binocular image separation in virtual environments can be a simple and effective way to decrease visual stress caused by stereoscopic HMDs. The negative side-effect—worsening of spatial vision—arguably would become unnoticed or compensated over time. This initial proof-of-concept study should be extended by future large-scale studies testing additional environments, tasks, displays, users, and exposure times. [ABSTRACT FROM AUTHOR]

Objective: To compare the visual performance of two presbyopia-correcting intraocular lenses (IOLs) that combine both bifocal and extended depth-of-focus profiles, Artis® Symbiose® Plus (Symbiose Plus; Cristalens Industrie, Lannion, France) and Tecnis® Synergy® (Synergy; Johnson & Johnson Vision, Santa Ana, CA, USA). Methods: The medical records of patients with cataract bilaterally implanted with either Symbiose Plus or Synergy between January 2022 and January 2023 were assessed. The principal measures of postoperative findings included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near (40 and 33 cm) visual acuity (UNVA), objective optical quality (OOQ) parameters, distance-corrected defocus curve analysis, and surveys of subjective satisfaction. Results: Total of 96 eyes from 48 patients were enrolled. Each group was equally composed of 24 patients, 48 eyes. There were no significant differences between the two groups on baseline characteristics. Both IOLs displayed excellent binocular UDVA, CDVA, and UNVA (40 and 33 cm) with no statistical difference (p = 0.467(UDVA), p = 0.584(CDVA), p = 0.096(40-cm UNVA), and p = 0.621(33-cm UNVA)). However, with regard to UIVA, the Synergy group showed significantly superior results (p < 0.001). In contrast, the Symbiose Plus group showed significantly better results on OOQ parameters and patient-reported quality of vision survey outcomes (both p < 0.001). Conclusions: Both IOLs provided a decent continuous range of vision from near to far distance. [ABSTRACT FROM AUTHOR]

Background: Idiopathic epiretinal membrane (ERM) often leads to visual symptoms such as metamorphopsia and decreased central vision. This study aimed to evaluate functional, structural, and microvascular characteristics in patients with different stages of idiopathic ERM who were candidates for surgery, with a focus on identifying potential indicators for surgical timing. Methods: A retrospective cohort study was conducted on consecutive patients with unilateral idiopathic ERM who were candidates for surgery. Patients underwent comprehensive ophthalmological assessments, including OCT grading, reading performance evaluation, and OCT angiography. Data analysis included comparisons between different ERM stages for functional, structural, and microvascular parameters. Results: A total of 44 eyes were included, classified into four ERM stages according to the Govetto grading system. Functional parameters, including distance and near visual acuity, worsened significantly with higher ERM stages, particularly in the transition from Stage 3 to Stage 4. Structural assessments revealed significant increases in central macular thickness (CMT) from Stage 3 to Stage 4. No significant differences were observed in microvascular features across different ERM stages. Conclusions: This study highlights the significant functional and anatomical impact of OCT staging in idiopathic ERM, particularly during the transition from Stage 3 to Stage 4, characterized by notable reductions in visual acuity and increases in CMT. These findings underscore the importance of considering both functional and structural parameters in surgical decision-making for ERM management. However, further research with larger cohorts is needed to confirm these observations and inform clinical practice.

Reversed-contrast testing is easy to perform via electronic devices and may improve reading performance and the quality of life of most glaucoma patients. Electronic devices are becoming increasing popularity and most devices have easily adjustable contrast settings. This study investigated near vision acuity and preference between the standard visual acuity chart (black text on white background) and a reversed-contrast chart (white text on black background) in glaucoma patients with decreasing contrast sensitivity. This cross-sectional study evaluated 177 eyes of 177 patients from a single glaucoma clinic. The better eye of primary glaucoma patients (visual acuity of 6/20 or better) was evaluated. Patients with any other condition affecting visual acuity or reading performance were excluded. Near visual acuity was measured using a device with an anti-glare screen at 40 cm distance for both standard and reversed-contrast charts. Glaucoma patients had a significantly better average near visual acuity using the reversed-contrast chart than using the standard chart (median best-corrected visual acuity, LogMAR = 0.12; interquartile range = 0.18 vs median best-corrected visual acuity, LogMAR = 0.2; interquartile range = 0.26; respectively; P < 0.01), with more prominent differences in the advanced glaucoma group (median best-corrected visual acuity of reversed contrast chart: median best-corrected visual acuity of standard chart = 0.12:0.2, 0.12:0.13, and 0.18:0.22 in the early, moderate, and severe groups, respectively, P < 0.01 in early and severe group and P = 0.02 in moderate group). One hundred and nine (109) out of 177 patients (61.58%) preferred the reversed contrast version. Reversed contrast materials may improve the reading performance and quality of life of patients with glaucoma, especially those with severe disease. [ABSTRACT FROM AUTHOR]

This study aimed to translate the Convergence Insufficiency Symptom Survey (CISS) into the Italian language and assess psychometric properties of the translated questionnaire (CISS_I). The CISS_I was arranged according to guidelines for a comprehensive multistep methodologic process for translating, adapting, and validating psychometric instruments in health care research. The CISS_I questionnaire was administered to 103 volunteers (21.8 ± 2.2 years), students in higher education, at two different times. A complete optometric evaluation was performed including subjective refraction, best corrected visual acuity, near point of convergence, prism fusional ranges to blur, diplopia and recovery, TNO stereo test and prism cover test for measurement of heterophoria. The performance of the CISS_I in terms of validity showed some points of weakness. Sensitivity was 42%, specificity was 74%, positive predictive value was 27% and negative predictive value was 85%. The area under the ROC curve was 0.672. On the contrary, the results showed good internal consistency of the CISS_I (Cronbach's alpha - α=0.89) and good test-retest reliability (ICC = 0.92). Rasch analysis showed good model fit (all items, except one, with infit and outfit mean square between 0.7 and 1.3), good measurement precision (person separation = 2.66) and good targeting –0,81 logits but also some evidence of multidimensionality. The CISS_I showed some point of weakness in terms of validity but also good psychometric properties and has been shown to be applicable to an Italian speaking population to quantify the visual discomfort associated with near vision in higher education students. The results show that high CISS_I score is not necessarily linked to convergence insufficiency, while low scores can exclude the presence of this anomaly. The CISS_I can help in interpreting and monitoring convergence insufficiency symptoms in already identified subjects, but it is not suitable for screening a general population of young adults. [ABSTRACT FROM AUTHOR]

Lee Jerome Briones,1 James Paul Gomez,2 Edgar Felipe Leuenberger1– 3 1Department of Ophthalmology, University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines; 2Department of Ophthalmology, Asian Eye Institute, Makati City, Philippines; 3Department of Ophthalmology, Ospital ng Makati, Makati City, PhilippinesCorrespondence: Lee Jerome Briones, Department of Ophthalmology, University of the East Ramon Magsaysay Memorial Medical Center Inc, 64 Aurora Boulevard, Quezon City, 1113, Philippines, Tel +639178271894, Email jerome.briones@gmail.comPurpose: This study aimed to determine if near visual acuity measurements using a Philippine peso bill are comparable to a standard Jaeger chart.Study Design: This is a cross-sectional study comparing the near visual acuity measurements of a Philippine peso bill and a Jaeger chart among sixty subjects.Methods: LogMAR scores from the two methods were analyzed using Wilcoxon Mann–Whitney test. The relationship of the logMAR scores between these methods was determined using Spearman rank order correlation. The Bland-Altman plot was used to determine the comparability between quantitative measurements for near visual acuity using the standard Jaeger chart (reference) and the Philippine peso bill.Results: There were no significant differences in the proportion of Jaeger scores and mean logMAR equivalents between the two methods (p > 0.05). The scatter plot diagram shows a positive upward trend with a very strong and significant correlation between logMAR scores of Jaeger chart and Philippine peso bill methods (r = 0.9258, p < 0.0001). With a concordance correlation coefficient of 0.9505, there is a high agreement between these two measures. The Philippine peso bill overestimates the Jaeger chart visual acuity by 0.04 logMAR units. We suspect that the contrast between the background color and the serial numbers of the peso bill may have brought about this outcome.Conclusion: The Philippine peso bill may be used as an alternative measuring tool for near visual acuity. However, there is a tendency to overestimate the scores obtained using the Philippine peso bill. Future studies are recommended to validate the results in a tele-ophthalmology setting.Keywords: Jaeger chart, near vision, near visual acuity testing, telemedicine, tele-ophthalmology

Abstract Background Recently, a new presbyopia-correcting intraocular lens (IOL) that combines extended depth-of-focus and bifocal profiles (ZFR00: Tecnis® Synergy®, Johnson & Johnson Vision, Santa Ana, CA, USA) has been established and several studies have been reported. We attempted to compare the performance with a standard IOL (ZCB00: Tecnis® monofocal, Johnson & Johnson Vision, Santa Ana, CA, USA) manufactured using the same material from the same company, which has been extensively used worldwide. Methods The medical records of patients undergoing cataract surgery with ZCB00 or ZFR00 implantation between March 2021 and September 2021 and with available 3-month visit data were reviewed. Uncorrected near, intermediate, and distance visual acuity (VA), corrected distance VA, and optical quality were the main outcome measures. Results This study included forty-six patients (64 eyes), with twenty-one patients (32 eyes) implanted with ZCB00 and twenty-five patients (32 eyes) implanted with ZFR00. The average age of the patients was 66.0 ± 10.1 (range: 40 to 82) and 65.1 ± 4.7 (range: 59 to 77) years in the ZCB00 and ZFR00 groups, respectively. The preoperative characteristics did not differ significantly between the two groups. Compared to the ZCB00 group, the ZFR00 group demonstrated significantly superior intermediate and near VA (p

Introduction : The objective of this prospective study was to evaluate the effects of intraocular macular lens implantation and visual rehabilitation on the quality of life of patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Methods: Patients with bilaterally decreased near vision (not better than 0.3 logMAR with the best correction), pseudophakia, were included in the project. The Scharioth macula lens (SML) was implanted into the patients' better-seeing eye. Intensive visual rehabilitation of the ability to perform nearby activities was performed for 20 consecutive postoperative days. All subjects were examined before and after SML implantation ophthalmologically. The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was administered before and 6 months after surgery. Results: Twenty eligible patients with mean age 81 years (63 to 92 years) were included in the project: 7 males and 13 females. Nineteen of them completed the 6-month follow-up. Near uncorrected visual acuity was 1.321 ± 0.208 logMAR before SML implantation and improved to 0.547 ± 0.210 logMAR after 6 months (dz = − 2.846, p < 0.001, BF10 = 3.29E + 07). In the composite score of the NEI VFQ-25, there was an improvement in the general score and the specific domains related to the implantation. Participants reported fewer difficulties in performing near activities (dz = 0.91, p = 0.001, BF10 = 39.718) and upturns in mental health symptoms related to vision (dz = 0.62, p =.014, BF10 = 3.937). Conclusion: SML implantation, followed by appropriate rehabilitation, improved near vision and increased the quality of life of visually handicapped patients with AMD in our project. [ABSTRACT FROM AUTHOR]

PurposeTo analyze the objective and subjective visual performances of a new hybrid refractive/aspheric extended depth of focus (EDOF) intraocular lens (IOL).MethodsIn this monocentric prospective study patients with bilateral cataracts underwent cataract surgery and were implanted with a Lucidis IOL (SAV-IOL SA, Neuchâtel, Switzerland) in both eyes, 1 week apart from each other. At 3 months from implantation postoperative evaluations included monocular and binocular uncorrected and distance-corrected distant (4 m), intermediate (80 cm, 67 cm) and near (40 cm) visual acuities (UDVA/DCVA, UI80-67VA/DCI80-67VA, UNVA/DCNVA), binocular defocus curves, halometry, contrast sensitivity and objective quality-of-vision measurements. Also, patients were also asked to complete the national eye institute refractive error quality of life (NEI-RQL-42) questionnaire.ResultsTwenty-five patients (50 eyes) were included. The mean postoperative binocular UDVA, UI80VA, UI67VA and UNVA were-0.02 ± 0.13, 0.05 ± 0.09, 0.05 ± 0.08 and 0.03 ± 0.1 LogMar, and did not significantly differ from their corrected counterparts. On binocular defocus curves a VA ≥0.05LogMar was found between +0.50 and − 2.50 D of vergence, whereas the mean distance from the central stimulus on halometry was 1.23 ± 0.01. Mean ocular and corneal radical mean square at 4 mm were 0.31 ± 0.28 and 0.19 ± 0.07, respectively; whereas the mean Strehl ratio was 0.2 ± 0.09.ConclusionLucidis IOLs demonstrated excellent visual performances, especially at close distances while maintain good quality of vision, contrast sensitivity, and overall patient-satisfaction.

Purpose: To characterize accommodative function in secondary school children in year 9 and year 13 and assess the possible relationship between daily working conditions (number of near work hours and distances) and accommodation variables related to accommodative excess. Methods: This was a prospective study. Participants were 43 subjects who were first examined in year 9 and then again when they were in year 13. The accommodation variables measured in each session were as follows: accommodation amplitude (AA), accommodative response (AR), monocular and binocular accommodation flexibility (MAF and BAF), negative relative accommodation (NRA), and positive relative accommodation (PRA). Other data recorded were the number of hours spent working at near vision tasks and the distances used for these tasks. Participants were classified as those with accommodation variables within the normal range (NA) and those with variables suggesting accommodative excess (AE). Results: Several accommodative function variables were below normative values in both year 9 and year 13. The number of subjects classified as having AE went from 27.9% in year 9 to 58.1% in year 13 according to AR (p < 0.005) and from 23.3 to 46.5% according to MAF (p = 0.024). More near work was reported in year 13 (44.6 h/week) than year 9 (32.7 h/week) (p < 0.001). It emerged that subjects in year 13 spent more hours working at near if they had AE than if they were assigned to the NA group. No differences were detected in near work distances used by subjects in the NA and AE groups in both years. Conclusions: In both school years, values outside the norm were detected in several accommodative function measures. Also, devoting more hours to near work was linked to a greater extent of accommodative excess. We would therefore recommend regular accommodative function assessment in secondary school children. [ABSTRACT FROM AUTHOR]

Plain English Summary Presbyopia is worsening of the ability to focus on close objects due to ageing. The objective of this study was to understand the lived experience of presbyopia, specifically to identify the visual symptoms experienced, and how these affect a person’s daily life. Fifty people with presbyopia (from the US n = 30, France n = 10 and Germany n = 10) took part in a face-to-face interview. The interviews took place in three separate rounds. Seven HCPs who specialize in presbyopia also took part in a telephone interview. The key visual symptoms that were reported by people with presbyopia included difficulty seeing close up, difficulty seeing close up in dim light, difficulty focusing at close distances, and difficulty seeing things close up when there is glare. Additional symptoms reported as a result of the key visual symptoms included eye strain, dry eyes and headaches. People with presbyopia reported that these symptoms caused them difficulty to read close up (both printed text and handwriting) and difficulty to see objects in near vision. As a result, people with presbyopia reported a number of other difficulties in their daily living (including using a smartphone or computer), as well as impacts on emotional, work, financial and social aspects of their life. HCPs supported these findings. This study provided an in-depth understanding of the lived experience of presbyopia. The findings supported development of a model of the key symptoms and impacts of presbyopia, and contributed to the development of a questionnaire measuring the ability to do near vision activities.

Background: Recently, a new presbyopia-correcting intraocular lens (IOL) that combines extended depth-of-focus and bifocal profiles (ZFR00: Tecnis® Synergy®, Johnson & Johnson Vision, Santa Ana, CA, USA) has been established and several studies have been reported. We attempted to compare the performance with a standard IOL (ZCB00: Tecnis® monofocal, Johnson & Johnson Vision, Santa Ana, CA, USA) manufactured using the same material from the same company, which has been extensively used worldwide.Methods: The medical records of patients undergoing cataract surgery with ZCB00 or ZFR00 implantation between March 2021 and September 2021 and with available 3-month visit data were reviewed. Uncorrected near, intermediate, and distance visual acuity (VA), corrected distance VA, and optical quality were the main outcome measures.Results: This study included forty-six patients (64 eyes), with twenty-one patients (32 eyes) implanted with ZCB00 and twenty-five patients (32 eyes) implanted with ZFR00. The average age of the patients was 66.0 ± 10.1 (range: 40 to 82) and 65.1 ± 4.7 (range: 59 to 77) years in the ZCB00 and ZFR00 groups, respectively. The preoperative characteristics did not differ significantly between the two groups. Compared to the ZCB00 group, the ZFR00 group demonstrated significantly superior intermediate and near VA (p < 0.001) at 3 months postoperatively. The ZFR00 group showed significantly lower objective measured optical quality than that in the ZCB00 group.Conclusions: The ZFR00 exhibited a continuous range of vision and a smooth defocus curve, while the ZCB00 provided superior objective optical quality. [ABSTRACT FROM AUTHOR]

PURPOSE: Although multifocal intraocular lenses (IOLs) are effective methods of dealing with surgical presbyopia, there are associated limitations (cost, technique, and patient‑reported symptoms). Given their scalability challenge (due to economic factors), it is imperative to explore alternative low‑cost and sustainable solutions to achieve good near vision postcataract surgery. This study aimed to determine the proportion of and the factors associated with good near vision in patients following cataract surgery with monofocal IOL implantation. METHODS: We conducted a hospital‑based cross‑sectional study at a tertiary eye hospital in southern India from September 2019 to January 2020. Inclusion criteria: Uncomplicated postcataract surgery cases with monofocal IOL at least 30 days ago. Exclusion criteria: patients with any ocular condition (other than refractive errors) that could decrease the vision with best‑corrected distance visual acuity < 0.18 Logarithm of the Minimum Angle of Resolution (LogMAR) units. Data collection: we assessed near vision (at 40 cm distance by using near vision card with Early Treatment of Diabetic Retinopathy Study format), distance visual acuity (uncorrected and best‑corrected), refractive error (amount and type), type of astigmatism, pupil size, axial length, and contrast sensitivity. We considered a near vision of 0.2 LogMAR units or better as good near vision. RESULTS: Of the 82 patients (82 eyes), 71 (86.59%) had good near vision. Multiple logistic regression analysis found found that the presence of myopia or myopic astigmatism was significantly associated with good near vision (adjusted odds ratio: 72.63; 95% confidence interval: 1.02–5193.5, p = 0.049). CONCLUSION: About eight of every ten participants had good near vision postcataract surgery with monofocal IOL implantation. Myopia/myopic astigmatism was associated with good near vision. [ABSTRACT FROM AUTHOR]

Exercise for presbyopia is theoretically ineffective. However, some studies have reported favorable subject responses, although the reasons were not detected. We investigated one such presbyopic exercise. Twenty-three volunteers (48.5 ± 5.0 years) viewed near (30-40 cm) and far (>5 m) points back and forth 20 times in one set and repeated this four times daily. After 2 months, the accommodation or near visual acuity did not improve. The pupillary size under accommodative stimulation decreased significantly (p = 0.04) from 4.03 ± 0.84 to 3.75 ± 0.98 mm, and the convergence amounts increased significantly (p = 0.03) from 0.71 ± 0.25 to 0.98 ± 0.46 mm. The overall satisfaction with the near vision improved significantly (p = 0.02). The changes in the pupillary sizes and convergence amounts did not differ between subjects with improved satisfaction (positive group) and those without improvement (negative group) (p = 0.50 and p = 0.94, respectively). The pupillary size after exercise was significantly (p = 0.04) smaller in the positive group (3.19 ± 0.82) than in the negative group (4.08 ± 0.94). In conclusion, the exercise for presbyopia was fundamentally ineffective to improve accommodation, however, it strengthened miosis while viewing near and might improve satisfaction for near vision. (Clinical Trial Registration number: UMIN000023561). [ABSTRACT FROM AUTHOR]

Background: Presbyopia is defined as the age-related deterioration in the ability to focus on close objects, causing difficulty with near vision tasks. The study aim was to understand the lived experience of phakic presbyopia and identify all relevant visual function symptoms and associated functional impacts. Methods: Fifty individuals with clinician-confirmed phakic presbyopia (US n = 30, France n = 10, Germany n = 10) and seven healthcare professionals (HCPs) participated in in-depth, face-to-face, qualitative concept elicitation interviews. Verbatim transcripts were analyzed using thematic analysis methods. Results: Visual function symptoms reported by participants with phakic presbyopia were categorized as: primary near vision functioning symptoms (impaired near visual acuity, n = 50/50, 100%; difficulty with near vision in dim light, n = 42/50, 84%; difficulty focusing at close distances, n = 30/50, 60%; difficulty seeing things when glare is present, n = 30/50, 60%) and secondary symptoms (eye strain, n = 37/50, 74%; dry eyes, n = 35/50, 70%; headaches, n = 30/50, 60%). Proximal impacts on functional vision included difficulty reading in near vision (n = 49/50, 98%, including printed text and handwriting), seeing objects in near vision n = 48/50, 96%, and performing activities of daily living that require near vision (n = 49/50, 98%, including using a smartphone or computer). Distal impacts on functional vision included emotional, work, financial and social impacts. HCP interviews supported participant findings. Conclusion: Findings provide a comprehensive understanding of the lived experience of phakic presbyopia which informed the development of a presbyopia conceptual model and patient-reported outcome assessments of vision correction independence and near vision functioning. The sample did not include those whose vision cannot be adequately corrected with lenses or surgery. Plain English Summary: Presbyopia is worsening of the ability to focus on close objects due to ageing. The objective of this study was to understand the lived experience of presbyopia, specifically to identify the visual symptoms experienced, and how these affect a person's daily life. Fifty people with presbyopia (from the US n = 30, France n = 10 and Germany n = 10) took part in a face-to-face interview. The interviews took place in three separate rounds. Seven HCPs who specialize in presbyopia also took part in a telephone interview. The key visual symptoms that were reported by people with presbyopia included difficulty seeing close up, difficulty seeing close up in dim light, difficulty focusing at close distances, and difficulty seeing things close up when there is glare. Additional symptoms reported as a result of the key visual symptoms included eye strain, dry eyes and headaches. People with presbyopia reported that these symptoms caused them difficulty to read close up (both printed text and handwriting) and difficulty to see objects in near vision. As a result, people with presbyopia reported a number of other difficulties in their daily living (including using a smartphone or computer), as well as impacts on emotional, work, financial and social aspects of their life. HCPs supported these findings. This study provided an in-depth understanding of the lived experience of presbyopia. The findings supported development of a model of the key symptoms and impacts of presbyopia, and contributed to the development of a questionnaire measuring the ability to do near vision activities. [ABSTRACT FROM AUTHOR]

Abstract Purpose To evaluate the clinical and visual outcomes, quality of near vision and the influence of photic phenomena in patients bilaterally implanted with a new Precizon Presbyopic multifocal intraocular lens (IOL). Methods In this prospective consecutive case series, 20 eyes of 10 patients were included (mean age 63.80 ± 12.55 years). Uncorrected and corrected visual acuity (far, intermediate and near), subjective refraction, binocular defocus curve, contrast sensitivity (CSV-1000) and quality of vision and satisfaction questionnaires were measured. The follow-up was 12 months after surgery. Results At 12 months after surgery, uncorrected distance visual acuity (UDVA) improved with surgery (p = 0.001) with a value of 0.08 ± 0.08 logMAR. Uncorrected near visual acuity (UNVA) was 0.22 ± 0.12 logMAR and distance corrected near visual acuity (DCNVA) was 0.16 ± 0.13 logMAR. Intermediate distance visual acuity (UIVA) was 0.22 ± 0.10 logMAR. Contrast sensitivity outcomes were similar to normal population in photopic conditions and slightly reduced in mesopic conditions of lighting. Defocus curve showed that this multifocal IOL was able to provide a visual acuity (VA) equal or better to 0.16 logMAR between defocus levels of + 1.00 to − 2.50 D. Good patient satisfaction was obtained in quality of vision and satisfaction questionnaires outcomes. Conclusions The Precizon Presbyopic NVA IOL (OPHTEC BV) provides good visual outcomes. This multifocal IOL provides a high percentage of spectacle independence due to good VA at far, intermediate and near distances and satisfactory contrast sensitivity. High patient satisfaction was observed in quality of vision and satisfaction questionnaires with a low percentage of patients manifesting photic phenomena.

AIM: To evaluate clinical outcomes of unilateral implantation of a diffractive multifocal intraocular lens (IOL) in patients with contralateral monofocal IOL. METHODS: Twenty-two patients who already had implantation of a monofocal IOL in unilateral eye underwent implantation of a diffractive multifocal IOL in contralateral eye were enrolled. After 1, 6, and 12mo, uncorrected and distant corrected distant visual acuity (UCDVA and DCDVA), uncorrected and distant corrected intermediate-visual acuity (UCIVA and DCIVA), uncorrected and distant corrected near visual acuity (UCNVA and DCNVA), and contrast sensitivity were obtained. Halo/glare symptoms, spectacle dependence, and patient satisfaction were also evaluated. RESULTS: The mean age was 67.86±7.25y and the average interval between two IOL implantations was 645.82±878.44d. At 1mo, binocular UCDVA was lower than 0.20 logMAR in 76% of patients (mean 0.12±0.13 logMAR), which increased to 90% by 6 and 12mo. The binocular UCDVA was significantly better than the monocular results (P

Pharmacological treatment of presbyopia-spectacle free senescence Therefore, it is of interest to estimate improvement of near vision with 0.5%pilocarpine drops in presbyopic patients. It was a cross-sectional observational study done at tertiary care centre history, comprehensive eye examination, including distant visual acuity distant and near vision, IOP. 1 drop of 0.5%Pilocarpine eye-drops was instilled in both eyes in Patients with full distant vision and impaired near vision, near vision was checked after 2hours. Among 55 participants, 48% were males and 52% were females. Mean age of patients was 44.8 years. Out of 55 patients 58% patients showed improvement of 1 line after instilling drops, 41% patients showed no improvement. Topical 0.5%pilocarpine in treatment of near vision is attractive option for patients and would increase compliance with minimal side effects., Competing Interests: There are no conflicts of interest., (© 2024 Biomedical Informatics.)

Purpose: Using raytracing simulation to study the effect of corneal imaging metrics for different aperture sizes as a function of object distances with different schematic model eyes. Methods: This raytracing simulation determined the best focus (with the least root‐mean‐square (rms) ray scatter) and the best wavefront focus (with least rms wavefront error) for four schematic model eyes (Liou‐Brennan (LBME), Atchison (ATCHME), Gullstrand (GULLME) and Navarro (NAVME)) with 4 aperture sizes (2–5 mm) and 30 object distances in a logscale from 10 cm to 10 m plus infinity. For each configuration, 10,000 rays were traced through the cornea, and the aperture stop was located at the lens front apex plane as described in the model eyes. The wavefront was decomposed into Zernike components to extract the spherical aberration term. Results: The focal distance with respect to the corneal front apex increases from around 31 mm for objects at infinity to around 40 mm for objects at 10 cm. The best (wavefront) focus was systematically closer to the cornea compared with the paraxial focus, and the overestimation of focal length with the paraxial focus was larger for large aperture sizes and small object distances. The rms ray scatter and wavefront error were both systematically larger with large aperture and small object sizes. At best focus the rms wavefront error was systematically larger, and the rms ray scatter was systematically smaller compared to the best wavefront focus. Spherical aberration varied more with GULLME than with LBME or NAVME, and increased strongly at smaller object distances. Conclusions: The imaging properties of the cornea, especially spherical aberration, increase strongly as the object distance decreases. This effect should be considered, especially when considering aberration correcting lenses for near vision such as multifocal or enhanced depth of focus lenses. [ABSTRACT FROM AUTHOR]

The aim of this cross-sectional observational study was to measure habitual viewing distance with smartphones in individuals of different ages, and to identify factors influencing viewing distance. Gender, reading position, forearm length, ametropia, correction modality, and near vision quality were investigated as factors affecting viewing distance. Participants were asked to read a typical text message on their own smartphone, while sitting and standing. A total of 233 subjects (129 females and 104 males), aged from 16 to 90 years old, were included and divided in two groups: 131 non-presbyopes (median 21.1, range 16 − 39), and 102 presbyopes (median 54.5, range 42 − 90). Mean viewing distance was 36.1 ± 7.2 cm while sitting, and 37.4 ± 6.8 cm while standing (P < 0.05), and 36.8 +/- 6.6 cm overall. The average viewing distance was 35.0 ± 6.4 cm in non-presbyopes, and 39.0 ± 6.1 cm in presbyopes (P < 0.05). The average viewing distance was 34.7 ± 6.2 cm in females, and 38.2 ± 6.3 cm in males (P < 0.001). Significant differences between males and females were observed, due to the different average body size between the two gender groups. Average viewing distance with smartphones in presbyopes matched approximately to the typical near reading distance of 40 cm. In the non-presbyopic group, the accommodative demand when reading a smartphone was slightly higher than in the presbyopic group. High variability was observed in both age groups, without a statistically significant correlation with other assessed factors as reading position, ametropia, correction modality, and near vision quality. [ABSTRACT FROM AUTHOR]

Presbyopia is the gradual inability to focus near objects with age. This study explores patients' attitudes and beliefs towards presbyopia including preferred modes of near refractive correction. In the United Kingdom, twenty-four volunteers completed an online questionnaire and attended a structured, recorded focus group. Participants' age ranged between 36 and 48 years, representing a pre-presbyopic and a presbyopic population. Attitudes and beliefs about presbyopia, its significance, and opinions about current refractive correction including multifocal contact lenses were transcribed and coded using content analysis for overarching themes and patterns. Six participants (25%) were already wearing a near visual correction while 18 (75%) were not. Five key primary themes with clear inter-participant similarities were identified as 'age-related' (75%), 'acceptance' (50%), clear lack of 'familiarity with the word presbyopia' (65%), a mixed/ reluctant attitude 'towards (multifocal) contact lenses' (62.5%), and 'comfort and convenience' of a presbyopic correction (79%) whereby cost is of less importance. The need for a reading correction was perceived as a sign of age. Spectacles were the most preferred mode of near vision correction, while comfort and convenience were seen as more important than cost. Patient education about presbyopia is lacking. Multifocal contact lenses are not necessarily the preferred visual correction even if the patient already wears contact lenses for distance. [ABSTRACT FROM AUTHOR]

Abstract Introduction To report the outcomes in near vision, optical quality and pupil diameter of a new pharmacological therapy (FOV tears) for presbyopia. Methods This was a prospective, consecutive, interventional, non-comparative clinical study in which 117 presbyopic patients were given one drop of the novel therapy (FOV tears) in each eye, followed 2 h after the instillation of the eye drop by an evaluation of the binocular uncorrected near visual acuity (UNVA) and uncorrected distance visual acuity. The objective scatter index and pupil diameter under photopic and scotopic conditions before and after instillation were also assessed. The patients were divided into two groups according to their age, with group 1 patients being 41 and 50 years old and group 2 patients, between 51 and 65 years old. Results The mean age of the patients was 50.2 years. The mean UNVA before the use of the eye drop was 0.35 LogMAR, which improved to 0.16 LogMAR at 2 h after the use of the eye drop (p = 0.000). Nine patients did not show an improvement in UNVA, but no patient showed a loss of lines. Fourteen patients (11.9%) reported headaches as a side effect of the therapy. Conclusion This pharmacological therapy improved near vision by one or more lines (mean improvement 0.18 lines) in 92.3% of the patients at 2 h following the instillation of the eye drops. The group with the youngest patients gained more lines than the group with the oldest patients.

Introduction: Age-related macular degeneration (AMD) requires continuous visual acuity (VA) monitoring, increasing the burden on the health care system. Self-measurement VA tests are available on various devices. However, none of them have been based on an internationally validated benchmark chart, such as that of the Early Treatment Diabetic Retinopathy Study (ETDRS). The goal of this study was to assess the reliability of two digitized ETDRS charts adapted to two electronic devices for self-measurement of VA., Material and Methods: A prospective, single-center, 1:1 randomized, two-arm, parallel group trial was conducted. The main objective was to compare VA variation as conventionally measured on a 4-m ETDRS chart versus self-measured with digitized ETDRS charts in patients treated for AMD. At each visit, conventional measurement and patient self-measurement, either on a computer at 80-cm (arm 1) or on a tablet at 40-cm (arm 2), were performed., Results: Eighty patients were included (25 men, 55 women, mean age 81.3±7.4 years). No significant differences were observed between VA variation, conventionally measured and self-measured on a computer (arm 1; P=0.914) or tablet (arm 2; P=0.913)., Conclusion: These results confirm the reliability of these two methods for self-measurement of VA, and will lead to the development of a wider "telemedicine" project extended to self-measurement of VA in various pathologies., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)