Ah, presbyopia…the visual bane of my advancing adulthood. On the surface, understanding presbyopia and its effects seems straightforward. However, to truly understand and appreciate the complexity of presbyopia, one must dive deeper. Enter Presbyopia: Origins, Effects, and Treatment.
Going well beyond the surface, the authors of this book set a goal of thoroughly explaining presbyopia; not an easy task, it turns out. But they succeed in revealing what is known about presbyopia in astounding, but necessary, detail. Using the expertise of nearly 60 scientists and clinicians, the chapters cover topics such as the physiology and behavior of the accommodation system, cues for accommodation, optical and related changes in the aging eye, role of the ciliary muscle and zonula in accommodation and presbyopia, theories of presbyopia (yes, there’s more than one), and, perhaps most interestingly, methods for presbyopia correction.
With regard to presbyopia correction, there is heavy emphasis on surgical methodologies. This, however, is not an unwelcome emphasis. Spectacle and contact lens treatments are reasonably well known, and although there may be further advancements in spectacles and contact lenses, the greatest strides are being made in the surgical arena. The advancements laid out in these chapters are truly amazing, described in ample detail and include pertinent research findings. Several of the procedures described would have been pure science fiction a few years ago, such as lens refilling and femtosecond laser photodisruption of the crystalline lens for restoring accommodation. Could a cure for presbyopia be around the corner?
An appreciated aspect to this book is the amount of space devoted to evaluating the effectiveness of presbyopia correction. As we all know, it’s wonderful to hear about new treatments for presbyopia, but one must also be armed with the ability to evaluate its effectiveness. Described within this portion of the book are subjective, behavioral, and objective methods, as well as the instrumentation available for performing the evaluation. Some of the computational aspects of these chapters may be deeper than the average practitioner may want to delve into but provides the needed information to understand that effectiveness can be a matter of opinion and/or method of analysis.
All in all, this is a very comprehensive review of the current knowledge about presbyopia and its treatment. For those interested, it is well worth the read.
Robert B. Greer