Normative Data Analysis Of Presbyopia Progression And Quality Vision Loss Using Dynamic Wavefront Aberrometry

To establish a normative curve for Dynamic Range of Focus (DRoF) measured by the WaveDyn dynamic aberrometer and compare it to existing normative curves describing near vision changes with age. This study aims to provide a comprehensive assessment of presbyopia progression by incorporating accommodative amplitude and pseudoaccommodation, offering a more precise evaluation of near visual function over time 

This study used published normative data on near vision metrics combined with newly collected measurements from an IRB-registered pilot study at the Waring Vision Institute, South Carolina, USA. The research adhered to the principles of the Declaration of Helsinki for ethical medical research involving human subjects. All participants provided informed consent before enrollment, ensuring their voluntary participation and understanding of the study’s objectives, procedures, and potential risks.  

Existing literature on age-related near vision decline was reviewed, covering accommodative amplitude, distance-corrected near visual acuity (DCNVA), and reading add power. Additionally, an IRB-approved study enrolled 20 eyes from 10 subjects (18–59 yrs, 60% male, 40% female). DRoF was measured via a dynamic aberrometer (WaveDyn, USA) to assess vision quality by age. The DRoF metric, incorporating accommodative amplitude, pseudoaccommodation, pupillary effects, depth of focus, and lenticular multifocality, was analyzed for age correlation. Regression models, including linear and power fits, compared DRoF trends with published accommodative amplitude decline curves. 

Both accommodative amplitude and DRoF declined with age, with DRoF averaging 1.3 D greater than accommodative amplitude. Linear regression (R² = 0.72–0.84) and a power curve (R² = 0.82) showed strong correlations between DRoF and age. Accommodative amplitude, measured via Visual Strehl Optical Transfer Function (VSOTF) through-focus, peaked at ~8 D in 18-year-olds and declined to <1 D by age 50, aligning with prior studies. 

Findings suggest that the WaveDyn Aberrometer effectively quantifies near vision function and presbyopia progression. The observed DRoF trend highlights the combined impact of accommodation and pseudoaccommodation on functional near vision. Further studies with larger sample sizes will refine normative DRoF curves, enhancing presbyopia assessment and management strategies.