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1、Presbyopia:NearrefractionandmanagementJingjingXuWenzhouMedicalUniversity2015-11-11?Presbyopia:–Greek:oldeyesPresbyopia?Definition:reductioninaccommodativeabilityoccurringnormallywithageandnecessitatingapluslensadditionforsatisfactoryseeingatnear.?Epidemiologist:everyonegetpr
2、esbyopia?EtiologyPresbyopia?Sometimesquantitativelydefinedbyanamplitudeofaccommodationoflessthan5Dorbytherecessionofthenearpointofaccommodationbeyond20cmWhy5D??Absolutepresbyopia–Emmetrope–Myope–hyperope?Borderlinepresbyopia–Slow–NeedplusbutrejectsEtiologyofpresbyopia?Helmho
3、ltz(1855):gradualhardeningorsclerosisofthecrystallinelenssubstance?Doners(1864):weakeningoftheciliarybody?Fincham(1973):newfibersareaddedtothecortexofthelensthroughoutlifecompressingandhardeningthenuclearfibersWhatisthechiefcomplaintofthepresbyope?Myarmistooshort!Onsetandpro
4、gressionofpresbyopia?Amp.Acc<5.0D?36-50AmplitudeofaccommodationAgeDonders’Duane’sHofstetter’sHofstetter’stableTableMinimummaximum355.56.56.2511404.55.55.09.0453.53.53.757.0502.53.02.55.0Accommodationvsage(EmsleyafterDuane)12108642AccommodationMonocularAmplitudeof1-0D94101520
5、2530354045506070AgeTheonsetofsymptomsofpresbyopiavarieswith?Refractivetype–Hyperopes:early–Myopes:later?Usageofeyes?Thephysicalattributesofpatient?Geographiclocationofthepatient?medicationsTheonsetofsymptomsofpresbyopiavarieswith?Refractivetype?Usageofeyes–Detailedclosework:
6、earlynoticethechanges?Thephysicalattributesofpatient?Geographiclocationofthepatient?medicationsTheonsetofsymptomsofpresbyopiavarieswith?Refractivetype?Usageofeyes?Thephysicalattributesofpatient–Talllongarmedguys:later?Geographiclocationofthepatient?medicationsTheonsetofsympt
7、omsofpresbyopiavarieswith?Refractivetype?Usageofeyes?Thephysicalattributesofpatient?Geographiclocationofthepatient–Equatorvsloweraltitudes?medicationsTheonsetofsymptomsofpresbyopiavarieswith?Refractivetype?Usageofeyes?Thephysicalattributesofpatient?Geographiclocationofthepat
8、ient?Medications–Insulin,anti-anxietyagents,anti-depressants,anti-psychotic
