BCLA CLEAR presbyopia: Management with scleral techniques, lens softening, pharmaceutical and nutritional therapies

Abstract

The aging eye undergoes the same progressive crosslinking which occurs throughout the body, resulting in increased rigidity of ocular connective tissues including the lens and the sclera which impact ocular functions. This offers the potential for a scleral treatment that is based on restoring normal biomechanical movements. Laser Scleral Microporation is a laser therapy that evaporates fractional areas of crosslinked tissues in the sclera, reducing ocular rigidity over critical anatomical zones of the accommodation apparatus, restoring the natural dynamic range of focus of the eye. Although controversial and challenged, an alternative theory for presbyopia is Schachar's theory that suggests a reduction in the space between the ciliary processes and the crystalline lens. Widening of this space with expansion bands has been shown to aid near vision in people with presbyopia, a technique that has been used in the past but seems to be obsolete now. The use of drugs has been used in the treatment of presbyopia, either to cause pupil miosis to increase depth of focus, or an alteration in refractive error (to induce myopia in one eye to create monovision). Drugs and laser ablation of the crystalline lens have been used with the aim of softening the hardened lens. Poor nutrition and excess exposure to ultraviolet light have been implicated in the onset of presbyopia. Dietary nutritional supplements, lifestyle changes have also been shown to improve accommodation and the question arises whether these could be harnessed in a treatment for presbyopia as well.

Publication DOI: https://doi.org/10.1016/j.clae.2024.102191
Divisions: College of Health & Life Sciences > School of Optometry > Optometry
College of Health & Life Sciences > School of Optometry > Optometry & Vision Science Research Group (OVSRG)
College of Health & Life Sciences > School of Optometry > Vision, Hearing and Language
College of Health & Life Sciences
Aston University (General)
Funding Information: BCLA CLEAR Presbyopia was facilitated by the BCLA, with financial support by way of educational grants for collaboration, publication and dissemination provided by Alcon, Bausch + Lomb, CooperVision, EssilorLuxottica, and Johnson & Johnson Vision.
Additional Information: Copyright © 2024 The Author(s). Published by Elsevier Ltd on behalf of British Contact Lens Association. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/).
Uncontrolled Keywords: Lens, miosis,Nutrition,Pharmaceutical,Presbyopia,Sclera,Ophthalmology,Optometry
Publication ISSN: 1476-5411
Last Modified: 04 Dec 2024 17:22
Date Deposited: 16 Jul 2024 17:41
Full Text Link:
Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://www.sci ... 367048424000833 (Publisher URL)
PURE Output Type: Article
Published Date: 2024-06-29
Published Online Date: 2024-06-29
Accepted Date: 2024-05-20
Authors: Naroo, Shehzad A. (ORCID Profile 0000-0002-6373-7187)
Woods, Craig A.
Gil-Cazorla, Raquel (ORCID Profile 0000-0003-0855-8554)
Ang, Robert E.
Collazos, Mariana
Eperjesi, Frank
Guillon, Michel
Hipsley, AnnMarie
Jackson, Mitchell A.
Price, Edwin R.
Wolffsohn, James S. (ORCID Profile 0000-0003-4673-8927)

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