Presbyopia and the aging eye: Existing refractive approaches and their potential impact on dry eye signs and symptoms

Lafosse, Edouard; Wolffsohn, James S.; Talens‐Estarelles, Cristian; García‐Lázaro, Santiago

doi:10.1016/j.clae.2019.08.005

Cited by 23 publications

(21 citation statements)

References 148 publications

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“…Unfortunately, conditions such as dry eye are more common in this group of patients, 50 which is an additional hurdle that may promote contact lens dropout in presbyopic patients. 51 Again, as described above, early treatment may promote additional years of comfortable contact lens use. 9 Nevertheless, at every state of a contact lens wearer's life, they should be offered an alternative contact lens option if they are struggling or if they have dropped out of lenses because research suggests that they may be able to resume contact lens wearer if they are given additional opportunities.…”

Section: Combatting Contact Lens Dropoutmentioning

confidence: 98%

<p>A Review of Contact Lens Dropout</p>

Pucker¹,

Tichenor

2020

OPTO

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Purpose: Contact lens (CL) dropout is likely a major factor contributing to the near stagnant growth in the CL market. The purpose of this review is to summarize the current state of knowledge related to the frequency of CL dropout and the factors associated with it. Methods: PubMed.gov was searched on or before March 22, 2020, with the terms "contact lens" with "dropout" or "cessation" or "disruption" or "discomfort". Pertinent articles were collected. The references from these articles were likewise searched to identify additional relevant articles. Only manuscripts written in English were included. No study design or date exclusions were imposed on this review. Results: This literature review found that CL dropout was frequent across developed countries, with a CL dropout frequency that ranged between 12.0% and 27.4% (pooled mean = 21.7%). The top cited reason for CL dropout in established CL wearers was discomfort, while vision was the top reason in neophyte CL wearers. If given the chance, CL dropouts are often able to successfully resume CL wear up to 74% of the time. While the literature is mixed with regard to factors promoting CL dropout, meibomian gland dysfunction appears to promote CL dropout. Conclusion: CL dropout is a frequently encountered condition that may be curtailed by early detection, patient education, alterative CL options, or early treatment of underlying ocular surface diseases such as meibomian gland dysfunction.

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Section: Combatting Contact Lens Dropoutmentioning

confidence: 98%

<p>A Review of Contact Lens Dropout</p>

Pucker¹,

Tichenor

2020

OPTO

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“…60 Surgical correction strategies for presbyopia may also disrupt the corneal epithelium and ocular surface, which can impact outcomes and exacerbate dryness in the aging presbyopic eye. 72 In terms of laser surgery, monovision or multifocal laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) can be used to remove corneal tissue and reshape the cornea to reduce the need for reading glasses in presbyopic individuals (Table 1). Monovision laser vision correction, in which one eye is optically corrected for distance and the other eye for near vision, often results in reduced binocular visual acuity and stereopsis.…”

Section: Corneal Procedures For Presbyopiamentioning

confidence: 99%

Section: Presbyopic Treatment Optionsmentioning

confidence: 99%

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Presbyopia – A Review of Current Treatment Options and Emerging Therapies

Katz¹,

Karpecki²,

Dorca³

et al. 2021

OPTH

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Presbyopia is a common age-related vision disorder characterized by a progressive inability to focus on near objects. If uncorrected or under-corrected, presbyopia can significantly impact patients' quality of life. Presbyopia represents an area of considerable unmet need due to its rising prevalence worldwide as the population ages, the high proportion of under-treated individuals in some parts of the world, and the limitations of currently available corrective methods. Progressive or bifocal spectacles are associated with peripheral blur, a restricted visual field and impaired depth perception, which have been linked to an increased risk of falls in the elderly. Contact lens options can be difficult to maintain due to the development of age-related dry eye symptoms and reduced manual dexterity. Other corrective methods involve surgical interventions that modify the optics of the cornea, replace the crystalline lens, or attempt to restore active accommodation. While patients undergoing surgery report satisfactory outcomes post-operatively, many of them eventually require reading glasses. Non-invasive therapies with novel mechanisms of action are currently being investigated; these include miotic agents and UNR844, a lipoic acid choline ester. In this narrative review, available evidence on presbyopia prevalence, quality of life impact and risk factors are described, with a focus on observational studies in nonclinical settings. The diagnosis pathway and patient journey in presbyopia are outlined, and various treatment options are analyzed. The data reviewed herein reveals significant gaps in the provision of vision correction for this common condition, with a paucity of effective, non-invasive treatment options broadly accessible to presbyopic individuals.

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“…Visual decline related to normal aging contributes to disability and reduces health span (Owsley 2011; 2016). Hardening (presbyopia; Lafosse et al, 2020) and clouding (cataracts; Asbell et al, 2005) of the lens are common optical consequences of aging that can seriously impair visual function. The development of devices and procedures (eg.…”

Section: Introductionmentioning

confidence: 99%

Treatment of age-related visual impairment with a mitochondrial therapeutic

Alam

Douglas

Prusky

2020

Preprint

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Age-related visual decline and disease due to neural dysfunction are major sources of disability that have resisted effective treatment. In light of evidence that visual impairment and mitochondrial dysfunction advance with age, we characterized age-related decline of spatial visual function in mice, and investigated whether improving mitochondrial function could treat it. Impaired photopic acuity measured with a virtual opto-kinetic system emerged near 18 months, and declined to ∼40% below normal by 34 months. Daily application of the synthetic peptide SS-31, which has high selectivity for mitochondrial membranes that contain cardiolipin, and promotes efficient electron transfer, was able to mitigate visual decline from 18 months. Daily application from 24 months, when acuity was reduced by ∼16%, reversed visual decline and normalized function within 2 months; recovered function that persisted for at least 3 months after treatment was withdrawn. A single treatment at 24 months also delayed subsequent visual decline. Daily application from 32 months took longer to affect change, but enabled substantial improvement within 2 months. The effects of age and SS-31 treatment on contrast sensitivity was similar to those on acuity, systemic and eye drop applications of SS-31 had comparable effects, scotopic spatial visual function was largely unaffected by age or treatment, and altered function was independent of variation in optical clarity. These data indicate that SS-31 treatment adaptively alters the aging visual system, and provide a rationale to investigate whether mitochondrial dysfunction is a treatable pathophysiology of human visual aging and age-related visual disease.TRANSLATIONAL IMPACTClinical issueAge-related visual impairment is a major source of disability. Aging invariably leads to optical dysfunction related to inflexibility (presbyopia) or clouding (cataracts) of the lens, and neural dysfunction; each of which compromises the ability to resolve detail (acuity) and differences in luminance (contrast sensitivity) in visual scenes. Age is also a predisposition to develop blinding visual diseases that have a neurological origin, such as glaucoma, diabetic retinopathy, and age-related macular degeneration. Whereas, age-related optical problems can often be corrected with eyewear or surgical lens replacement, we lack sufficient understanding of the natural course of visual aging and the neural processes that regulate it to effectively treat age-related visual dysfunction and disease linked to neural dysfunction.ResultsMitochondria are cellular organelles that enable energy metabolism, and essential cellular signaling processes. Mitochondrial function declines with age in the visual system and is linked with the development of age-related visual disease. Here, the authors present evidence that improving mitochondrial function can treat age-related visual decline. They report that a loss of acuity emerged in mice near 18 months (early old age) and declined with age until 34 months (extreme old age) when it was reduced by ∼60%. Daily administration of the mitochondria-acting peptide, SS-31, from 18 months largely prevented subsequent age-related visual decline. Application from 24 months, when moderate visual impairment was present, led to complete recovery of visual acuity within 2 months, which persisted for at least 3 months after SS-31 was withdrawn. A single dose at 24 months was also able to delay visual decline. Moreover, 2 months of SS-31 administration from 32 months, after much more severe visual dysfunction was manifest, substantially improved function by 34 months.Implications and future directionsThe study reveals that spatial measures of visuomotor function can identify age-related visual decline in mice that is largely preventable and reversible early in its course, by treatment with a mitochondrial-acting peptide. That visual dysfunction late in life is partially reversible with the peptide, also indicates that treating mitochondrial dysfunction has the potential to provide a benefit at any age. In addition, that restored function endured after the peptide was withdrawn indicates that improving mitochondrial function elicits long-lasting beneficial changes in the aging visual system. By linking mitochondrial dysfunction with visual aging, the data also suggests that improving mitochondrial function is a promising approach for treating age-related visual disease.

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Presbyopia and the aging eye: Existing refractive approaches and their potential impact on dry eye signs and symptoms

Cited by 23 publications

References 148 publications

<p>A Review of Contact Lens Dropout</p>

<p>A Review of Contact Lens Dropout</p>

Presbyopia – A Review of Current Treatment Options and Emerging Therapies

Treatment of age-related visual impairment with a mitochondrial therapeutic

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