BCLA CLEAR presbyopia: Mechanism and optics

Abstract

With over a billion adults worldwide currently affected, presbyopia remains a ubiquitous, global problem. Despite over a century of study, the precise mechanism of ocular accommodation and presbyopia progression remains a topic of debate. Accordingly, this narrative review outlines the lenticular and extralenticular components of accommodation together with the impact of age on the accommodative apparatus, neural control of accommodation, models of accommodation, the impact of presbyopia on retinal image quality, and both historic and contemporary theories of presbyopia.

Keywords: Accommodation; Amplitude of accommodation; Ciliary muscle; Crystalline lens; Depth of focus; Presbyopia; Zonules.