ESCRS - PO1010 - Clinical Strategies For Successful Evaluation Of The Presbyopic Patient

Clinical Strategies For Successful Evaluation Of The Presbyopic Patient

Published 2023 - 41st Congress of the ESCRS

Reference: PO1010 | Type: Free paper | DOI: 10.82333/yfth-am63

Authors: James A Katz* 1 , AnnMarie Hipsley 2 , Tracy Schroeder Swartz 3 , Mariana Collazos 4

1ophthalmology,The Midwest Center for Sight, Des Plaines, IL,United States, 2ophthalmology,AceVision Group,Silver Lake,United States, 3ophthalmology,Southeast Eye Specialists,Huntsville,United States, 4ophthalmology,Panama Eye Center,Panamá,Panama

Purpose

To review objective and subjective assessment methods of the presbyopic disease state.  Objective methods include static and dynamic aberrometry, dysfunctional lens syndrome, ocular scatter index (OSI), and biomicroscopy, while subjective methods include visual acuity, refractive add power, and stereopsis.   

Setting

Panama Eye Center, Panamá, Panama

Methods

Assessment of presbyopia included wavefront aberrometry using static ray-tracing and dynamic Hartmann-Schack aberrometry. The dysfunctional lens Index (DLI) was measured using the iTrace and ocular scatter was measured using the HD Analyzer.  Lens evaluation was performed with biomicroscopy.  Visual acuity was measured at 4m, 60cm and 40 cm using ETDRS cards at 85-90 cd/m2 unaided and distance corrected.  Manifest refraction at 40 cm determined the refractive add power.  

Results

Aberrometry using static and dynamic techniques demonstrated depth of focus curve changes at near:  myopic spherical shift compared to distance and widened curves. DLI mildly correlated to OSI, and Add power mildly correlated to age.  Distance-corrected near visual acuity (DCNVA) fell with age. Comprehensive results will be presented.

Conclusions

Presbyopia is the manifestation of aging and is associated with objective signs such as lens changes, smaller pupil size, lower DLI and increased OSI as well as subjective signs of reduced DCNVA.  Presbyopia is difficult to assess and dynamic aberrometry may demonstrate the active dynamic range of focus response better than other methods.