Abstract
Purpose :
To define and demonstrate a clinical metric quantifying individual acceptance of presbyopic corrections, useful for prospective users of multifocal lenses.
Methods :
MAS is defined as a multi-component vector, comprising stereoscopic vision and 6 Perceptual Scores (PS; 0 to 10) of image quality, at far & near vision, and overall across distances, of day & night multi-stimuli. Stimuli comprised street visual scenes (including a night driving scene with real glare introduced by LEDs) for far –presented in a UHD HDR 3D Monitor at 4 m- and typical reading/cell phone screenshots at near –iPad Retina display at adjustable reading distance–. Random dot stereograms with E-letters (size: 10-35 arcmin; disparity: 1-7 arcmin) were used to test stereoscopic vision at far. MAS is numerically summarized in its modulus (|MAS|), and graphically represented as a polygon with the vector components as vertices. 3 young presbyopic subjects (43 - 46 yo), long-term monofocal soft contact lens (CL) users, evaluated 7 corrections through CLs (Alcon Dailies Monofocal or Multifocal) and parallel corrections through a binocular simultaneous vision simulator (SimVis) using temporal multiplexing (Dorronsoro et al. Optica 2016): 1) Binocular Monof-far; 2) Binocular Multif; Monovision: 3) Monof-far in dominant eye (DE); 4) Monof-near in DE; Modified Monovision: 5) Multif+Monof-far in DE; 6) Multif in DE+Monof-far; 7) Multif in DE+Monof-near.
Results :
|MAS| varied across subjects and corrections (|9.8| to |4.6| for S1; |10| to |7.3| for S2 and |8.7| to |5.2| for S3, but was consistent across SimVis and real CLs, with PS within ±1 in comparable conditions. MAS polygons show strong lateral symmetry, indicating high auto-consistency and low influence of day/night factor. Highest PS (9.7±0.9) were provided for Binocular Monof-far at far and lowest for Multif in DE+Monof-near (6.7±2.2) at far. The highest overall PS were obtained for Binocular Monof-far (9.0) and Multif+Monof-far (8.5). The highest |MAS| was achieved for Binocular Monof-far (S1, |9.8|), Multif+Monof-far in DE (S2, |10|) and Multif in DE+Monof-far (S3, |8.7|). Stereovision was largely degraded with monovision. The entire test (7 corrections) was performed in 20-30 minutes with SimVis and 40-75 min with CLs.
Conclusions :
MAS is a sensitive metric to evaluate vision and compare across contact lens presbyopic corrections. In combination with SimVis, it reduces drastically chair time to select optimal presbyopic corrections.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.