Refractive changes in the elderly

Abstract

ABSTRACT.Purpose: Cross-sectional studies have consistently shown younger people to be less hyperopic than older people, but it is not known if this reflects a myopic shift from one generation to the next or a true age-related shift. Methods: We used data from three population surveys to study cohort phenomena and true age-related changes in refraction of elderly people in southern Sweden. Differences concerning the use of cycloplegics made us restrict comparisons between refractions in separate studies to persons aged 65 to74 years, in whom our measurements were considered unlikely to have been affected by accommodation. Results: An apparent increase in mean spherical equivalent as rapid as 0.6 D in 10 years was observed in our latest (and largest) cross-sectional survey. The myopic shift, from one generation to the next, was limited to 0.25 D in 25 years. This discrepancy was explained by a true age-related hyperopic shift between 55 and 70, which was confirmed in a longitudinal study of over 1000 persons followed for more than 8 years. Conclusion: A true age-related hyperopic shift between 55 and 70 does indeed exist, and should not be disregarded by anyone who is prescribing spectacles or performing surgery for refractive errors. In the long run, however, a persisting secular trend towards myopia could prove even more important.

The Association between Time Spent Outdoors and Myopia Using a Novel Biomarker of Outdoor Light Exposure

“…Study authors subsequently repeated the analysis by restricting the participants to those aged <50 years, to control for the hyperopic shift in individuals aged >50 years. 48 Interaction was evaluated with the likelihood ratio test, and results of interaction and other statistical analyses were considered significant at the P < 0.05 level. All P-values were twotailed.…”

Sixteen-year follow-up of hyperopic laser in situ keratomileusis

“…The mean age at time of surgery of our cohort was 51.6 years. Bengtsson reported a hyperopic shift of 0.6 D (0.06D per year) every 10 years between 50 and 70 years (25) , with a similar trend of hyperopic shift between 50 to 65 yrs followed by myopic drift after 65 years seen in the Blue Mountains Eye Study (26) and by Saunders (27) .…”

“…(table 1, figure 1). When evaluating long-term refractive stability, the expected natural history of physiological age-related refractive changes has to be taken into consideration (27)(28)(29) . The mean age at time of surgery of our cohort was 51.6 years.…”

“…This is of particular relevance in the case of refractive surgery, which is directed at treating natural physiological variants rather than disease processes and especially important with the correction of hyperopia, as this condition not only tends to progress with age but becomes more symptomatic with developing presbyopia (17) . However, despite millions of 5 corrections having been performed world-wide over the past two decades, studies examining the long-term follow-up of hyperopic excimer laser procedures beyond 5 years are few with none beyond 10 years (18)(19) .…”

Evaluation of Refractive Value by Skiascopy in Healthy Beagles

“…The same association between myopia and age has been detected in dogs [12] and humans [13,20]. In humans, since the thickness of the lens nucleus increases with nuclear sclerosis, which is an age-related change, so the refractive power of the lens increases, and as a result, the refractive state tends toward myopia with ageing [1,8,9]. In dogs, nuclear sclerosis becomes evident at approximately 6 years old or older [21].…”