Ahmad Alharbi

Background/Objectives: To evaluate the monocular and binocular visual outcomes for patients who underwent PRESBYOND Laser Blended Vision (LBV) surgery. Methods: A total of 46 patients participated in this study (mean age 47.5 yrs ± 4.7) with various refractive errors. Patients were treated using the MEL 90 excimer laser to correct their refractive errors. The patients were asked to attend follow-up sessions at intervals of 1, 3, and 6 months. A self-developed binary (Yes/No) satisfaction survey was then conducted at the end of the 6-month visit. Results: The mean preoperative spherical equivalent for the distance eyes was −0.42 ± 1.53, and for the near eyes was −0.4 ± 1.76. The mean logMAR for the uncorrected distance visual acuity after treatment and follow-up at one month, three months, and six months was 0.016, 0.037, and 0.028 (20/20 to 20/22 range), respectively. After treatment, 81% of patients achieved 20/22.5 vision or better, and 94% achieved 20/25 vision or better. For near vision, 100% of patients reached J2 print. After treatment, 97% of patients achieved 20/25 or better at distance and J2 or better at near. Patient satisfaction was 92%, with only 8% of patients reporting dissatisfaction. Conclusions: This protocol has demonstrated stable, well-tolerated, effective, and acceptable results in patients with presbyopia. The safety and efficacy of the procedure were demonstrated, with strong outcomes.

This study aimed to evaluate the static and dynamic pupil changes, and light sensitivity following a single dose of low-dose atropine at concentrations of 0.01%, 0.025%, and 0.05% over a 24 h period. Healthy young adults (20–22 years; n = 25) participated in this randomized, double-blind study. Each participant received one of three atropine concentrations in a masked fashion. Baseline mesopic and dynamic pupil sizes were measured at various post-instillation intervals (5 min, 30 min, 1 h, 2 h, 4 h, and 24 h). A minimum 48 h washout period was observed between treatments. Subjective light sensitivity was assessed using the Visual Light Sensitivity Questionnaire (VLSQ-8) at 24 h. All atropine concentrations caused significant pupil dilation (p < 0.001), with the 0.05% concentration producing the greatest dilation (peak mesopic size: 7.4 mm, p < 0.001) and the slowest recovery at 24 h (6.4 mm, p < 0.001). The dynamic pupil constriction range was most restricted with 0.05% (1.7 mm, p < 0.05), compared to 0.025% (2.2 mm) and 0.01% (2.6 mm). Subjective symptoms, including light sensitivity and glare, followed a dose-dependent pattern (p < 0.05). In 60% participants, 0.05% caused the most symptoms, while in 70% participants, 0.01% caused the least. Despite significant pupil dilation, the pupil center coordinates did not shift significantly along the horizontal or vertical axes (p > 0.05). Low-dose atropine induced dose-dependent pupil dilation and light sensitivity; 0.05% atropine caused the most pronounced effects. These findings underscore the importance of tailoring the atropine dosage to balance its efficacy and tolerability. Further studies are needed to explore the long-term impact of repeated dosing on pupillary behavior and subjective symptoms.

Purpose: This study was conducted to evaluate the accommodative response in young participants with visual impairment in comparison with visually normal participants. Methods: Fifteen participants with confirmed visual impairment and 30 visually normal participants aged 12–15 years were recruited. Accommodative response was measured using autorefractor (Grand Seiko WV500) at distances of accommodative demand of 33, 25, and 20 cm. The targets were one-line-above participant threshold acuity. The participants’ accommodative responses were compared between both groups after calibration for refractive errors and the vertex distance of the glasses. Visual acuity and refractive status were also assessed. Results: The age was not significantly different between both participant groups. The visual acuity of visually impaired patients was 6/30 to 6/240, and that of visually normal participants was 6/7.5 or better. Ten of the visually impaired patients and 29 of visually normal participants were myopic. In total, 61–73% of visually impaired patients showed an accommodative lead. Five subtypes of accommodative response were observed. In general, the accommodative inaccuracy increased with increasing accommodative demand. However, the visually normal participants largely exhibited an accommodative lag. A mild-to-moderate relationship was observed between visual acuity and accommodative response (r = 0.3–0.5, p < 0.05). Conclusion: Accommodative response in young visually impaired patients can be variable and on an individual basis. Low vision specialists should anticipate accommodative response outside the normal range. Therefore, we shall consider evaluating each patient’s accommodative response before prescribing any near addition lenses. Accommodation inaccuracy is often more complex than predicted due to increased depth of focus caused by reduced visual acuity.