presbyopia and accomodative problems.pdf

Presbyopia

1. PERSONALIZED APPROACH IN PRESBYOPIA
AND ACCOMODATIVE PROBLEMS
Nanda W Anandita ,MD
RS dr SAIFUL ANWAR MALANG

2. age-related condition
the lens loses its flexibility
starts to affect people in their
early to mid-40s
progresses over time.
PRESBYOPIA
the eye's focusing ability is impaired
Accommodative Insufficiency
Accommodative Excess
Accommodative Infacility
ACCOMODATIVE PROBLEMS

4. Accommodative Insufficiency:
Difficulty in sustaining focus on close objects,
leading to eye strain and fatigue
Accommodative Excess:
The eye remains too focused for distance vision,
causing blurred distance vision after prolonged near work
Accommodative Infacility:
Sluggish or reduced ability to switch focus between near
and far objects

5. Accommodative problems
caused by various factors :
fatigue
stress
certain medications
can occur at any age

6. Aspect Traditional Treatments Personalized Treatments
Approach One-size-fits-all solutions
Customized based on patient’s specific needs
and lifestyle
Corrective Lenses
- Standard reading glasses - Bifocal
glasses
- Progressive lenses tailored to lifestyle -
Custom multifocals
Contact Lenses
- Standard monovision or bifocal
contacts
- Personalized multifocal contacts - Hybrid
designs for clarity
Surgical Options - Standard LASIK or PRK
- Customized LASIK with presby-LASIK - Lens
implants based on pupil size and dynamics
Technology Use - Basic measurements
- Advanced wavefront analysis - AI-driven
diagnostics
Patient Experience
- Limited adaptation for varied daily
tasks
- Enhanced comfort and vision across different
environments
Vision Quality
- Variable clarity, may have glare or
halos
- Improved clarity, reduced glare - Better near,
intermediate, and distance vision balance
Long-term Effectiveness - May require frequent adjustments
- Stable, long-lasting results - Reduced need for
future corrections

7. Personalized Treatments
use advanced diagnostics and
technologies to tailor solutions to
each patient.
Traditional Treatments
Generally standardized and
suitable for the average patient
it is not fully accommodate
different lifestyles or specific
visual demands.
consider individual factors such as
visual habits, occupation, and even
eye anatomy, providing more effective
and comfortable vision correction.

8. Aspect Traditional Treatments Personalized Treatments
Approach Generalized solutions, same for all patients
Tailored interventions based on individual visual
demands and habits
Corrective Lenses - Standard single-vision lenses
- Custom-designed lenses for specific tasks (e.g.,
computer use)
Bifocal/Multifocal Lenses - Basic bifocal or multifocal lenses
- Customized progressive lenses for smooth focus
transition
Vision Therapy - Standard exercises prescribed for all
- Individualized vision therapy programs focusing
on specific deficits
Use of Technology - Minimal use of diagnostic tools
- Advanced diagnostic tools like dynamic
retinoscopy, accommodative amplitude testing
Lifestyle Adjustments
- General recommendations like breaks and
lighting
- Personalized ergonomic and environmental
advice (e.g., workspace setup)
Medication
- Generalized use of eye drops or
medications
- Specific pharmacological treatment based on
detailed diagnosis
Surgical Options - Limited or no surgical options
- Investigational or customized surgical approaches
for severe cases
Patient Education - Basic guidance on eye health
- Detailed, personalized education on maintaining
accommodative function
Outcomes - Variable success; often partial relief
- Higher success rates; improved comfort and
functionality in daily tasks

9. how to prescribe near distance spectacle ?

10. Prescribe Near Distance Spectacle for Presbyopia
BEST
CORRECTED
VISUAL ACUITY
working
distance
amplitudo
accomodation
add =
1/2 AA
prescriiption