Vision with different presbyopia corrections simulated with a portable binocular visual simulator

PLoS One. 2019 Aug 20;14(8):e0221144. doi: 10.1371/journal.pone.0221144. eCollection 2019.

Abstract

Presbyopes can choose today among different corrections to provide them with functional vision at far and near, and the outcomes and patient satisfaction depend on the selection. In this study, we present a binocular and portable vision simulator, based on temporal multiplexing of two synchronized tunable lenses allowing see-through and programmable visual simulations of presbyopic corrections. Seventeen binocular corrections were tested: 3 Monofocal (Far, Intermediate, Near), 4 Simultaneous Vision (bifocal, trifocal), 2 Monovision (far and near in either eye) and 8 Modified Monovision corrections (Simultaneous vision in one eye, Monofocal in the other eye). Perceived visual quality was assessed through the simulated corrections in 8 cyclopleged subjects who viewed a composite realistic visual scene with high contrast letters and a landscape at far (4 m) and a high contrast text at intermediate (66 cm) and near (33 cm) distances. Perceptual scores were obtained on a scale of 0 to 5 (low to high perceived quality). Perceptual preference was assessed by judging 36 random image pairs (6 repetitions) viewed through 9 binocular presbyopic corrections using two-interval forced choice procedures. The average score, across far and near distances, was the highest for Monovision (4.4±0.3), followed by Modified Monovision (3.4±0.1), Simultaneous Vision (3.0±0.1) and Monofocal corrections (2.9±0.2). However, the mean difference between far and near was lower for Simultaneous Vision and Monovision (0.4±0.1 PS) than Modified Monovision (1.8±0.7) or monofocal corrections (3.3±1.5). A strong significant correlation was found between the perceptual scores and the percentages of energy in focus, for each correction and distance (R = 0.64, p<0.0001). Multivariate ANOVA revealed significant influence of observation distances (p<10-9) and patients (p = 0.01) on Perceptual Score. In conclusion, we have developed a binocular portable vision simulator that can simulate rapidly and non-invasively different combinations of presbyopic corrections. This tool has applications in systematic clinical evaluation of presbyopia corrections.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Humans
  • Male
  • Middle Aged
  • Presbyopia / diagnosis*
  • Presbyopia / therapy
  • Telescopes*
  • Vision Tests / instrumentation*
  • Young Adult

Grants and funding

This work was supported by: European Research Council under the European Union's Seventh Framework Programme FP7/2007-2013, ERC Grant Agreement nº ERC-AdG-294099, Spanish Government grant FIS2014-56643-R to SM; ISCIII DTS16/00127 to CD; Spanish Government grant FIS2017-84753-R to CD and SM; and by 7th Framework Programme of the European Community through the Marie Curie Initial Training Network OpAL (PITN-GA-2010-264605) to AR.