Description

The significance of presbyopia will be self-evident to all optometrists. As is pointed out by Weale1 in a recent major review on the epidemiology of refractive errors and presbyopia, the risk of falling prey to the condition of being unable to focus on near-by-objects, such as the printed page, is 100%. While some optometrists might argue that their familiarity with the problem of  presbyopia reduces the requirement for continuing education on this issue, as editors of this journal, we have learnt that no topic, however familiar, stands still over time, in terms of our understanding of both matters physiological and clinical. Such a prevalent visual problem, and one so intimately linked to the role of the optometrist, merits a feature issue.

This issue opens with an authoritative guest editorial from Professor Robert Weale, who has contributed so much over so many years on the ageing of the human eye and visual system. Henri Obstfled provides an historical perspective on presbyopia, discussing the recognition of this condition as distinct from ametropia, the early understanding of mechanisms and the evolution of optical correction. David Adams discusses ageing and accommodation, reviewing the physiology of accommodation and the theories on the aetiology of presbyopia. The feature issue then moves to matters of management, with Colin Fowler presenting an update on progressive lens design and Stephen Golding reviewing the spectacle lens choices in an article on dispensing and presbyopia. Finally, Judith Morris discusses the management of presbyopia without spectacles. Although primarily about contact lens management options for presbyopia, Morris reminds us about intraocular lens options in presbyopia, introducing us to the attractive concept of replacing the hardened crystalline lens with a synthetic pliable lens that could potentially return us to our youth, as least as far as accommodation is concerned! A note of caution needs to be sounded in this regard, however, as Robert Weale reminds us in the conclusion to his guest editorial.

1. Weale RA. Epidemiology of refractive errors and presbyopia. Surv Ophthalmol 2003, 48: 515-543.