An evaluation of estimation methods for determining addition in presbyopes

Abstract

All the methods used displayed similar behavior and provided a tentative addition close to the final addition. The coefficient of agreements (COA) detected suggests that every tentative addition should be adjusted according to the particular needs of the patient.

Evaluating three different methods of determining addition in presbyopia

“…Under-corrected or uncorrected presbyopia can lead to considerable visual disability and have a negative influence on the quality of life. [6] Near additions are usually refined according to the subject's favorite in terms of image clarity and a comfortable working distance. [13] In the current study, it was aimed to investigate the difference between the addition values determined by three methods.…”

“…[16] In addition, subjective measurements overestimate the real amount of amplitude of accommodation particularly in the presbyopic population, possibly because of the increased depth of focus due to smaller pupil diameter. [11] The amplitude of accommodation provides a more precise suggestion of accommodative status of patients and range of clear vision,[6] although “push-up” method is not always applicable, especially for patients with communication problems. [17] Dynamic retinoscopy (DR), an alternative method, provides a rapid objective measure of accommodation.…”

“…Therefore it is necessary to provide the weakest and most proper addition measured for each eye separately, in order to establish a correlation between accommodation and convergence. [6] Patient's habitual working distance is a fundamental factor to determine a precise and suitable correction. According to a classic rule for optical correction of presbyopia, patients should use up to half of their amplitude of accommodation.…”

“…According to a classic rule for optical correction of presbyopia, patients should use up to half of their amplitude of accommodation. [6] Calculation based on the amplitude of accommodation is more accurate compared with subjective refraction. [7] Age-related near addition values have shown a difference compared with the amplitude of accommodation measurements due to inter-individual differences;[8] however, some studies proved that age-expected addition might be more precise compared with ones estimated by the amplitude of accommodation.…”

“…Goss et al[10] applied dynamic retinoscopy (DR) to determine the reading addition in presbyopia and showed that this method could provide the best near addition and comfort for non-presbyopes. Bittencourt et al[6] compared four methods for determining addition: One-half amplitude accommodation with minus lenses; one-third accommodative demand with the positive lens; balanced range of accommodation with minus and positive lenses and crossed cylinder test with initial myopization. The results revealed that all methods estimated the comparable and almost similar near additions.…”