Presbyopia: An outstanding and global opportunity for early detection of pre-frailty and frailty states

Depto. de Optometría y VisiónUnidad Docente de Inmunología, Oftalmología y ORLFac. de Óptica y OptometríaTRUEEuropean Union's Horizon 2020 programmeUniversidad Complutense de Madrid (España)Banco Santander (España)pu

Innovación docente en Prácticas de la asignatura Optometría V del Grado en Óptica y Optometría de la UCM

El desarrollo de las prácticas de esta asignatura tiene un componente teórico previo a la ejecución práctica y, en consecuencia, el uso de material en video que favorezcan un aprendizaje on-line activo, autónomo y colaborativo es de vital importancia en conceptos claves. Además, la resolución de casos clínicos a través de cuestiones auto-evaluativas fomenta el aprendizaje clínico basado en el desarrollo de las consultas optométricas con este tipo de pacientes

Effects of Blink Rate on Tear Film Optical Quality Dynamics with Different Soft Contact Lenses

Objective. The aim of this study was to investigate tear film optical quality dynamics for four types of silicone hydrogel contact lenses (SHCLs) for daily wear over a 15-day period and for different blink rate (BR) patterns. Methods. A prospective randomized, double-blind, cross-over pilot study including four SHCLs (A: lotrafilcon B (Air Optix plus HydraGlyde, Alcon Laboratories); B: samfilcon A (Ultra, Bausch & Lomb); C: comfilcon A (Biofinity, CooperVision); and D: filcom V3 (Blu:gen, Mark’Ennovy)). Serial measurements of Objective Scatter Index (OSI) using the HD Analyzer (Visiometrics S.L., Terrassa, Spain) were taken at different blinking patterns: blinking every 2.5 seconds (high BRs) and every 9 seconds (low BRs). They were performed during the first visit before CL insertion (baseline), after 20 minutes of CL wear (Day 1), and during the last visit after 8 hours of CL wear on day 15 of use (Day 15). Results. Normal young healthy subjects were recruited and fitted with the four lenses. For low BRs, the mean OSI value increased over time for all CLs and the slope of the curve also increased for all CLs, except for CL D. However, for high BRs, the mean OSI value increased only for CLs B and C and the slope of the curve did not change over time for any of them. Conclusions. These results suggest that the tear film optical quality dynamics after wearing SCHLs for 15 days seems to undergo a slight deterioration only for lowest BR

Repeatability of Noninvasive Keratograph 5M Measurements Associated With Contact Lens Wear

Objetive: To assess the intrarater repeatability of the measurements of tear meniscus height (TMH), noninvasive keratograph tear break-up time (NIKBUTs), and ocular redness measurements obtained with the Keratograph 5M (K5M) in a sample of soft silicone hydrogel contact lens (CL) wearers over 15 days. Methods: Prospective study over two consecutive weeks. Three measurements of TMH, NIKBUTs (NIKBUT first and NIKBUT average), and ocular redness were obtained in different sessions; the first day (baseline, at 8 hr of wear, and after lens removal) and the last day of wear-15th day (at 8 hr of wear and after lens removal). The repeatability of measurements were assessed by two intraclass correlation coefficient (ICC) forms; single measurement [ICC (2,1)] and multiple measurements (k=3) [ICC (2, k)]. Results: Sixty-four eyes were analyzed. The repeatability of baseline TMH [ICC (2,1) greater than 0.90; coefficient of repeatability (CR)=0.06 mm] and after and during CL wear [ICC (2,k) greater than 0.90; CR≤0.07 mm] were excellent. The repeatability of baseline NIKBUT average [ICC (2,k)=0.89 (0.82-0.93); CR=6.07 sec] was maintained after CL removal but was poorer during CL wear. The repeatability of baseline NIKBUT first [ICC (2,k) =0.80 (0.69-0.87); CR=8.74 sec] was maintained after CL removal and during CL wear at moderate-good level. Conclusions: Intrarater repeatability of TMH, NIKBUTs, and ocular redness performed by K5M after CL wear remains stable when three measurements are performed. However, intrarater repeatability during CL wear decreased only for NIKBUT average and was not affected by time of use (15 days)

The role of clinical diagnosis criteria on the frequency of accommodative insufficiency

AIM: To estimate and compare the frequency of accommodative insufficiency (AI) within the same clinical population sample depending on the type of clinical criteria used for diagnosis. Comparing the frequency within the same population would help to minimize bias due to sampling or methodological variability. METHODS: Retrospective study of 205 medical records of symptomatic subjects free of any organic cause and symptoms persisting despite optical compensation evaluated. Based on the most commonly clinical diagnostics criteria found in the literature, four diagnostics criteria were established for AI (I, II, III and IV) based on subjective accommodative tests: monocular accommodative amplitude two or more diopters below Hofstetter’s minimum value [15-(0.25×age)] (I, II, III, IV); failing monocular accommodative facility with minus lens, establishing the cut-off in 0 cycles per minute (cpm) (I) and in 6 cpm (II, III); failing binocular accommodative facility with minus lens, establishing the cut-off in 0 cpm (I) and in 3 cpm (II). RESULTS: The proportion of AI (95%CI) for criteria I, II, III and IV were 1.95% (0.04%-3.86%), 2.93% (0.31%-4.57%), 6.34% (1.90%-7.85%) and 41.95% (35.14%-48.76%) respectively, with a statistically significant difference shown between these values (χ2=226.7, P<0.001). A pairwise multiple comparison revealed that the proportion of AI detected for criterion IV was significantly greater than the proportion for the rest of the criteria (P-adjusted<0.05 in all cases). CONCLUSION: The prevalence of cases of AI within the same clinical population varies with the clinical diagnostic criteria selected. The variation is statistically significant when considering the monocular accommodative amplitude as the only clinical diagnostic sign

Aplicación de un programa informatizado para emitir informes clínicos en la asignatura de Clínica Optométrica I

El objetivo es optimizar el uso de un programa informático de registro y almacenamiento de datos clínicos y la creación de una nueva herramienta para generar informes clínicos. Los informes clínicos forman parte de la evaluación del alumno

PhDAY 2020 -FOO (Facultad de Óptica y Optometría)

Por cuarto año consecutivo los doctorandos de la Facultad de Óptica y Optometría de la Universidad Complutense de Madrid cuentan con un congreso propio organizado por y para ellos, el 4º PhDAY- FOO. Se trata de un congreso gratuito abierto en la que estos jóvenes científicos podrán presentar sus investigaciones al resto de sus compañeros predoctorales y a toda la comunidad universitaria que quiera disfrutar de este evento. Apunta en tu agenda: el 15 de octubre de 2020. En esta ocasión será un Congreso On-line para evitar que la incertidumbre asociada a la pandemia Covid-19 pudiera condicionar su celebración

A multiple approach to presbyopia : optical correction and molecular implicactions

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Óptica y Optometría, leída el 23-03-2023La presbicia es una condición fisiológica que conlleva una pérdida progresiva de la capacidad de acomodación del ojo, dificultando las tareas próximas con el paso de los años. La corrección óptica multifocal, mediante lentes de contacto (LCs) y lentes intraoculares (LIOs) multifocales,es actualmente la opción más común para solventar los problemas visuales de la presbicia, demostrando altas tasas de independencia de gafas. En este contexto, la investigación en el ámbito de diseños para corregir la presbicia está en avance, con nuevos diseños para extender el rango de distancias en las que la visión sea nítida (extended depth-of-focus, EDOF).En cuanto a las LCs, los factores principales que afectan al éxito de la adaptación son la visión y la comodidad durante el porte, los cuales son calificados como igual de importantes por los usuarios. Además, la integridad de la superficie ocular debería tenerse en cuenta antes, durante y después del proceso de adaptación, al igual que la repetibilidad de los dispositivos utilizados para su evaluación. En cuanto a las LIOs para corregir la presbicia, su función visual y calidad óptica han sido ampliamente estudiadas. Sin embargo, ciertos factores, bien relativos al individuo (cirugías corneales previas) o al propio procedimiento quirúrgico (error refractivo residual, descentramiento de la LIO, rotación o inclinación) deben tenerse en cuenta a la hora de evaluarla calidad óptica, ya que podrían ser de gran ayuda en la práctica clínica para satisfacer las necesidades individuales de cada sujeto...Presbyopia is a physiological condition leading to a progressive decline of the ability of the eye to focus, thus making close-up work worsen over time. Multifocal optical correction, either by multifocal contact lenses (CLs) or intraocular lenses (IOLs), is currently the most common option to provide good vision at various distances, showing high rates of spectacle independence.In this context, new designs are being developed aiming to extend the range of distances with satisfactory vision (extended depth of focus; EDOF). Regarding CLs, the main factors affecting fitting success are vision and comfort, which are rated by wearers as equally important. Moreover, ocular surface integrity should also be taken into account before, during and after CL fitting process, along with the repeatability of the devices used for its evaluation. Regarding presbyopia-correcting IOLs, their visual and optical performance has been widely assessed. However, several factors related to both the patient (previous surgeries) and the surgical procedure itself (residual refractive error, lens decentration, rotation and tilt) should be taken into consideration when evaluating IOL's optical quality, since they might be useful in clinical practice to meet the needs of each individual...Fac. de Óptica y OptometríaTRUEunpu

Visual function, ocular surface integrity and symptomatology of a new extended depth-of-focus and a conventional multifocal contact lens

Purpose: To evaluate visual function, ocular surface integrity and dry eye symptoms with an extended depth-of-focus (EDOF) design and a conventional multifocal (MF) contact lens (CL) after 15 days of wear. Methods: A crossover single mask randomised clinical trial was conducted including 30 presbyopes who used an EDOF and a conventional MF CL (Biofinity MF) for 15 days each. Defocus curves, depth-of-focus range, contrast sensitivity (CS) under photopic and mesopic conditions (with and without glare) and subjective perception of halos and glare were evaluated. The ocular surface was evaluated through non-invasive Keratograph tear breakup time (NIKBUT), averaged tear breakup time (NIKBUT-avg), tear meniscus height (TMH), bulbar and limbal redness, and conjunctival and corneal staining. Dry eye symptoms were assessed with the OSDI questionnaire. Results: No statistically significant differences were found for defocus curves or depth-of-focus between the two CLs (both p > 0.05). Subjective perception of halos and glare was not significantly different between CLs. Statistically significant differences were observed for CS under mesopic conditions for low spatial frequencies (p = 0.008). None of the CL produced significant changes in NIKBUT, NIKBUT-avg, TMH or redness. No change in conjunctival staining was observed in 76.7 % and 73.3 % of participants for EDOF and Biofinity MF, respectively. No change in corneal staining was observed in 86.7 % and 83.3 % of participants for EDOF and Biofinity MF, respectively. No changes were observed in the symptomatology measured with OSDI questionnaire (p > 0.05). Conclusions: Both CL for presbyopia offer good visual quality, preserve the ocular surface integrity and provide the patient with similar symptomatology levels after 15 days of lens wear