Testing the efficacy of vision training for presbyopia: alternating-distance training does not facilitate vision improvement compared to fixed-distance training

Abstract

Purpose: Current evidence demonstrates the effectiveness of vision training for presbyopia. We developed and examined a training program to test the effectiveness of alternating focal distances as a training method.

Methods: We devised a sharpness discrimination task, in which participants judged whether the stimulus was a sine- or square-wave grating, and tested in two training groups and one control group. In the alternating-distance training group (N = 8, age 49-64), participants had to alternate the fixation between a near- and far-screen. In the fixed-distance training group (N=8, age 47-65), participants fixated on the same-distance target for the whole block. Before and after the 20 training sessions, we measured the near- and far-visual acuity (VA) using the Landolt C and Early Treatment Diabetic Retinopathy Study (ETDRS) tasks and contrast sensitivity using the qCSF procedure. The control group (N=8, age 49-65) participated only in the pre- and post-tests.

Results: Both training groups showed a significant improvement between the pre- and post-tests in the Landolt C task, and the improvement sizes were not significantly different between the groups. In the ETDRS task, only the fixed-distance training group showed significant improvement, although there was no significant difference between the two groups. Neither group showed improvement in the contrast sensitivity task compared to the control group.

Conclusion: The novel sharpness discrimination task can be an effective training method for presbyopia to prevent the deterioration of VA; however, contrary to popular belief, the effect of alternating-distance training was comparable to or even weaker than that of fixed-distance training.

Keywords: Accommodation training; Eye training; Presbyopia; Visual perceptual learning; Visual psychophysics.