Some things in life are just guaranteed to happen: you will pay taxes, you will likely get food poisoning once or twice, and eventually, you will die. It might sound like we are being a “Debbie Downer,” but it is true … and another sad fact of life is that as we get older, our vision is likely to drop in quality. Presbyopia, the gradual loss of your eye’s ability to focus on nearby objects, is a common side effect of aging.
Presbyopia is enjoying something of a “moment in the sun” recently and has frequently dominated discussion at both ophthalmology and optometry webinars. The 5th Oracles of Eye Innovation webinar, streamed on March 2, 2021, provided some examples of how optometrists are using new technologies to diagnose and treat presbyopia. We often talk about cool optometry at COOKIE and this event hit the mark.
After all, is anything cooler than lasers?
Dr. Robert Ang, a senior consultant at the Asian Eye Institute in Manila, Philippines, presented his work on laser scleral microporation (LSM) and its first human trial results. He said LSM is designed to reduce scleral biomechanical stiffness, and improve both ciliary muscle forces on the lens as well as lens shape changes. LSM is designed with presbyopia in mind and involves uncross-linking of scleral myofibrils, restoring the mechanical efficiency of the accommodation mechanism, and improving biomechanical mobility.
Patients selected for the first human studio were aged 48 and over, had a reading add rate of +1.50 D and an astigmatism of no more than 1.0 D. The results were stark, with Dr. Ang reporting improved visual acuity across all distances, with an average improvement of 0.3 logMAR. Dr. Ang concluded that LSM is a “safe and effective procedure for restoring visual performance.”
Well, maybe ray guns…
Presbyopia is by its nature, a condition that requires long-term patient follow-up and cross-referencing with other conditions. This makes RayPRO particularly valuable as a free mobile and web-based digital platform that proactively collects information for patients. Developed by Rayner (Worthing, England), RayPRO was originally designed for cataract surgeons but has applicability in presbyopia treatment and by optometrists.
RayPRO works by registering patients for up to three years and routinely sends them confidential questionnaires which ask about their satisfaction, spectacle independence, dysphotopsia, and follow-up procedures. Clinicians are then able to see their “patient score,” which Rayner reports is beneficial as it “provides real-time professional insights, and supports accreditation and clinical studies.” The RayPRO includes a Rasch constructed near visual acuity questionnaire which can differentiate between presbyopic corrections.
Editor’s Note: The Oracles of Eye Innovation webinar was held on March 2, 2021. Reporting for this story took place during the event.