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• W2263232933 abstract "Presbyopia, the age-related loss of accommodation,is a visual condition affecting all adults over the age of 45years. In presbyopia, individuals lose the ability to focus onnearby objects, due to a lifelong growth and stiffening of theeye’s crystalline lens. This leads to poor near visual performanceand affects patients’ quality of life. The objective of this thesisis aimed towards the correction of presbyopia and can be dividedinto four aims. First, we examined thecharacteristics and limitations of currently available strategiesfor the correction of presbyopia. A natural-view wavefront sensorwas used to objectively measure the accommodative ability ofpatients implanted with an accommodative intraocular lens (IOL).Although these patients had little accommodative ability based onchanges in power, pupil miosis and higher order aberrations led toan improvement in through-focus retinal image quality in somecases. To quantify the through-focus retinal image quality ofaccommodative and multifocal IOLs directly, an adaptive optics (AO)IOL metrology system was developed. Using this system, the impactof corneal aberrations in regard to presbyopia-correcting IOLs wasassessed, providing an objective measure of through-focus retinalimage quality and practical guidelines for patientselection. To improve upon existingmultifocal designs, we investigated retinal image quality metricsfor the prediction of through-focus visual performance. Thepreferred metric was based on the fidelity of an image convolvedwith an aberrated point spread function. Using this metric, weinvestigated the potential of higher order aberrations and pupilamplitude apodization to increase the depth of focus of thepresbyopic eye. Thirdly, we investigatedmodified monovision, a novel binocular approach to presbyopiacorrection using a binocular AO vision simulator. In modifiedmonovision, different magnitudes of defocus and sphericalaberration are introduced to each eye, thereby taking advantage ofthe binocular visual system. Several experiments using thebinocular AO vision simulator found modified monovision led tosignificant improvements in through-focus visual performance,binocular summation and stereoacuity, as compared to traditionalmonovision. Finally, we addressed neuralfactors, affecting visual performance in modified monovision, suchas ocular dominance and neural plasticity. We found that pairingmodified monovision with a vision training regimen may furtherimprove visual performance beyond the limits set by optics vianeural plasticity. This opens the door to an exciting new avenue ofvision correction to accompany opticalinterventions. The research presented inthis thesis offers important guidelines for the clinical andscientific communities. Furthermore, the techniques describedherein may be applied to other fields of ophthalmology, such aschildhood myopia progression." @default.
• W2263232933 created "2016-06-24" @default.
• W2263232933 creator A5033878933 @default.
• W2263232933 date "2014-01-01" @default.
• W2263232933 modified "2023-09-28" @default.
• W2263232933 title "Overcoming Presbyopia by Manipulating the Eyes' Optics" @default.
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