Cargando…

Prescription of near addition and its relation to accommodative reserve in presbyopia - The dichotomy between theory and practice

PURPOSE: To study the relationship between the amplitude of accommodation (AA) measured by the Royal Air Force (RAF) rule and near addition (NA) prescribed in presbyopic patients to assess how far practice is different from theoretical recommendations. METHODS: Patients, aged 40 to 60 years with bes...

Descripción completa

Detalles Bibliográficos
Autores principales: Deepu, Susmi, Kujur, Evon Selina, Horo, Saban, Priyanka, Nancy, Selvin, Satheesh Solomon T, Kuriakose, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374824/
https://www.ncbi.nlm.nih.gov/pubmed/34146010
http://dx.doi.org/10.4103/ijo.IJO_3160_20
_version_ 1783740198799015936
author Deepu, Susmi
Kujur, Evon Selina
Horo, Saban
Priyanka, Nancy
Selvin, Satheesh Solomon T
Kuriakose, Thomas
author_facet Deepu, Susmi
Kujur, Evon Selina
Horo, Saban
Priyanka, Nancy
Selvin, Satheesh Solomon T
Kuriakose, Thomas
author_sort Deepu, Susmi
collection PubMed
description PURPOSE: To study the relationship between the amplitude of accommodation (AA) measured by the Royal Air Force (RAF) rule and near addition (NA) prescribed in presbyopic patients to assess how far practice is different from theoretical recommendations. METHODS: Patients, aged 40 to 60 years with best corrected vision of 6/6 N5 were included in this cross sectional observational study. AA was measured using the RAF rule. Refined with near Duochrome chart, the NA was given with the chart at 40 cm. Accommodative reserve was calculated from the measured AA, NA required and the calculated additional accommodation expended by the patient for reading. The percentage of reserve was calculated with and without the correction for depth-of-field. RESULTS: A total of 130 patients were studied. In the patients above 50 years of age, the negative correlation of AA with age was - 0.298 (P = 0.065) and AA and NA was - 0.365 (P = 0.002) was weak. Among the patients aged between 40 and 50 years, the negative correlation of AA with Age and NA were strong; - 0.853 (P < 0.0001) and - 0.823 (P < 0.0001) respectively. When prescribing glasses, 62.01% (CI 58.78 to 65.23) and 90.93% (CI 62.50 to 119.37) of the AA was found to be kept in reserve for patients below and above 50 years of age respectively. CONCLUSION: Accommodative reserve kept in our study patients when prescribing NA was two to three times the theoretical recommendation. High percentage of accommodation kept in reserve suggest that the measured AA is not activated normally and require higher NA and one should not rely on patient’s ability to generate accommodative power especially in patients over 50 years.
format Online
Article
Text
id pubmed-8374824
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Wolters Kluwer - Medknow
record_format MEDLINE/PubMed
spelling pubmed-83748242021-08-25 Prescription of near addition and its relation to accommodative reserve in presbyopia - The dichotomy between theory and practice Deepu, Susmi Kujur, Evon Selina Horo, Saban Priyanka, Nancy Selvin, Satheesh Solomon T Kuriakose, Thomas Indian J Ophthalmol Original Article PURPOSE: To study the relationship between the amplitude of accommodation (AA) measured by the Royal Air Force (RAF) rule and near addition (NA) prescribed in presbyopic patients to assess how far practice is different from theoretical recommendations. METHODS: Patients, aged 40 to 60 years with best corrected vision of 6/6 N5 were included in this cross sectional observational study. AA was measured using the RAF rule. Refined with near Duochrome chart, the NA was given with the chart at 40 cm. Accommodative reserve was calculated from the measured AA, NA required and the calculated additional accommodation expended by the patient for reading. The percentage of reserve was calculated with and without the correction for depth-of-field. RESULTS: A total of 130 patients were studied. In the patients above 50 years of age, the negative correlation of AA with age was - 0.298 (P = 0.065) and AA and NA was - 0.365 (P = 0.002) was weak. Among the patients aged between 40 and 50 years, the negative correlation of AA with Age and NA were strong; - 0.853 (P < 0.0001) and - 0.823 (P < 0.0001) respectively. When prescribing glasses, 62.01% (CI 58.78 to 65.23) and 90.93% (CI 62.50 to 119.37) of the AA was found to be kept in reserve for patients below and above 50 years of age respectively. CONCLUSION: Accommodative reserve kept in our study patients when prescribing NA was two to three times the theoretical recommendation. High percentage of accommodation kept in reserve suggest that the measured AA is not activated normally and require higher NA and one should not rely on patient’s ability to generate accommodative power especially in patients over 50 years. Wolters Kluwer - Medknow 2021-07 2021-06-18 /pmc/articles/PMC8374824/ /pubmed/34146010 http://dx.doi.org/10.4103/ijo.IJO_3160_20 Text en Copyright: © 2021 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Deepu, Susmi
Kujur, Evon Selina
Horo, Saban
Priyanka, Nancy
Selvin, Satheesh Solomon T
Kuriakose, Thomas
Prescription of near addition and its relation to accommodative reserve in presbyopia - The dichotomy between theory and practice
title Prescription of near addition and its relation to accommodative reserve in presbyopia - The dichotomy between theory and practice
title_full Prescription of near addition and its relation to accommodative reserve in presbyopia - The dichotomy between theory and practice
title_fullStr Prescription of near addition and its relation to accommodative reserve in presbyopia - The dichotomy between theory and practice
title_full_unstemmed Prescription of near addition and its relation to accommodative reserve in presbyopia - The dichotomy between theory and practice
title_short Prescription of near addition and its relation to accommodative reserve in presbyopia - The dichotomy between theory and practice
title_sort prescription of near addition and its relation to accommodative reserve in presbyopia - the dichotomy between theory and practice
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8374824/
https://www.ncbi.nlm.nih.gov/pubmed/34146010
http://dx.doi.org/10.4103/ijo.IJO_3160_20
work_keys_str_mv AT deepususmi prescriptionofnearadditionanditsrelationtoaccommodativereserveinpresbyopiathedichotomybetweentheoryandpractice
AT kujurevonselina prescriptionofnearadditionanditsrelationtoaccommodativereserveinpresbyopiathedichotomybetweentheoryandpractice
AT horosaban prescriptionofnearadditionanditsrelationtoaccommodativereserveinpresbyopiathedichotomybetweentheoryandpractice
AT priyankanancy prescriptionofnearadditionanditsrelationtoaccommodativereserveinpresbyopiathedichotomybetweentheoryandpractice
AT selvinsatheeshsolomont prescriptionofnearadditionanditsrelationtoaccommodativereserveinpresbyopiathedichotomybetweentheoryandpractice
AT kuriakosethomas prescriptionofnearadditionanditsrelationtoaccommodativereserveinpresbyopiathedichotomybetweentheoryandpractice