Development Of A Presbyopia Progression Classification System Based On Age And Near Visual Acuity
Published 2022
- 40th Congress of the ESCRS
Reference: PP18.05
| Type: Free paper
| DOI:
10.82333/yx3k-4c09
Authors:
AnnMarie Hipsley* 1
, George O Waring, IV 2
, Karoline Maia Rocha 3
, Tracy Schroeder Swartz 1
1AceVision Group,Silver Lake, OH,United States, 2Waring Vision Institute,Mt. Pleasant, SC,United States, 3Ophthalmology,MUSC,Charleston, SC,United States
Purpose
To develop an objective assessment for presbyopia progression based upon age, lens evaluation and near visual function to guide treatment.
Setting
Subjects were enrolled in a feasibility study and separated into 4 categories based upon disease progression.
Methods
Patients over 40 years of age, demonstrating a loss of accommodative ability, increased reading add and decreased functional vision were enrolled. Visual acuity outcomes were assessed using the Early Diabetic Retinopathy Study (EDTRS) logMAR charts and wavefront aberrometry. Each patient was evaluated multiple times using visual acuity at near, slit lamp, and aberrometry/topography to determine DLS. Disability was measured by reading ad requirements for Visual Functional Activities of Daily Living (VFADL) as an indicator of Quality of LIfe (QOL) .
Results
We classified patients into 4 stages based on disease progression. Stage I Early Presbyopia (38-42 years): difficulty reading 20/40 (J5) or better at near using distance prescription for a length of time. Stage II Acute Presbyopia (43-48 years): reading add required to see 20/40 (J5) or better at near using distance prescription. Stage III Chronic Presbyopia (49-55 years): progressive increase of 0.25 D reading addition every year. Stage IV Stable Presbyopia (56+ years): inability to read 20/100 (J10) without full reading addition (+2.50D). These stages had good correlation with the stages in dysfunctional lens syndrome (DLS).
Conclusions
As presbyopia treatments options increase, there is clinical value in the classification, prevalence and incidence of age-related accommodation decline as it relates to decreased VFADL and QOL. Using objective data linked to the progression of presbyopia, we offer a Stages of Classification of Presbyopia as an objective to identify risk for loss of QOl, age related eye diseases as well as supporting the treatment indication by stage. . An objective measurement tool for tracking presbyopia progress based on age and near visual function was developed. This novel classification system has the potential to direct treatment interventions and identify risk factors for age-related loss of sight.