For many older adults, vision prescription differs between eyes

November 21, 2013, Wolters Kluwer Health

Follow-up in older adults shows a high rate of anisometropia, or differing levels of visual abnormalities between eyes, reports a study in Optometry and Vision Science, official journal of the American Academy of Optometry.

"Uncorrected anisometropia is likely to lead to disturbances in binocular vision and stereopsis, which in turn may contribute to falls in the elderly," concludes the new research, led by Gunilla Haegerstrom-Portnoy, OD, PhD, FAAO, of University of California, Berkeley. They emphasize the importance of appropriate vision correction in both eyes for —especially at more advanced ages.

Study Confirms Increased Anisometropia with Aging…

The researchers analyzed vision examination results in 118 older adults followed up over 12 years—from an average age of 67 to 79 years at the end of the study. The study focused on the development of anisometropia, defined as a significant difference (one diopter or more) in prescription () between the two eyes in one of four components.

During the study period, the prevalence of anisometropia increased significantly. For each of the four prescription components, the prevalence of anisometropia approximately doubled. As the participants approached 80 years of age, 32 percent met the study definition of anisometropia.

The differences in prescription components provided some clues to the causes of aging-related anisometropia. Most cases were related to differing degrees of farsightedness (hyperopia) between eyes. Others were caused by early but unequal blurring of the lens of the eye—even though none of the older adults in the study had eye lenses that met the usual clinical definition of cataracts.

Within the age range studied, differences between eyes could begin to occur anytime, with no particular preference for any one age. In a few patients, anisometropia actually decreased during the study.

…Highlighting Need for Proper Correction in Both Eyes

Previous studies, based on cross-sectional (one-time) measurements, have suggested that the rate of anisometropia increases exponentially with aging. However, these studies provide no information on how the visual mismatch develops over time, or the specific refractive error components involved.

Dr Haegerstrom-Portnoy and coauthors cite previous studies showing that the prevalence of anisometropia in children is only two to four percent. They write, "Whatever the cause of the increase in anisometropia with aging, the fact that significant anisometropia is at least ten times more common in those over 75 years of age than in children needs to be clearly emphasized to clinicians."

Anthony Adams, OD, PhD, Editor-in-Chief of Optometry and Vision Science, comments: "For older people a lack of correction of this prescription difference between the eyes may contribute to the increased frequency of falls that, in turn, can have a severe impact on health and even life expectancy." Under current American Academy of Optometry guidelines, people over age 65 are considered a high-risk group, for whom visual examination and screening are recommended at least every two years.

Dr Adams raises special concern over the frequent use of "over-the-counter drugstore reading glasses" by older adults. He adds, "These 'dime store readers' are made to be generic, with identical focusing or magnification power in each —certainly not an ideal solution for at least 30 percent of the over-age-75 population who have differing visual requirements between eyes."

Explore further: New optical metrics can identify patients on 'fast track' to decreased vision

Related Stories

New optical metrics can identify patients on 'fast track' to decreased vision

June 24, 2013
Sophisticated new optical quality metrics can identify older adults likely to have more rapid age-related declines in vision, suggests a study, "Factors Accounting for the 4-Year Change in Acuity in Patients Between 50 and ...

New technique shows promise in restoring near vision without glasses

April 1, 2013
By middle age, most people have age-related declines in near vision (presbyopia) requiring bifocals or reading glasses. An emerging technique called hyperopic orthokeratology (OK) may provide a new alternative for restoring ...

'Preferred retinal location' may aid rehabilitation in patients with central vision loss

May 28, 2013
Perceptual learning techniques may provide a useful new approach to rehabilitation in patients with central vision loss—taking advantage of visual plasticity that persists even in old age, according to a special article ...

Review identifies risk factors for comitant strabismus

July 12, 2013
(HealthDay)—Risk factors for strabismus include low birth weight, prematurity, retinopathy of prematurity, smoking during pregnancy, anisometropia, hyperopia, and genetic factors, according to a review published online ...

In combat vets and others, high rate of vision problems after traumatic brain injury

February 4, 2013
Visual symptoms and abnormalities occur at high rates in people with traumatic brain injury (TBI)—including Iraq and Afghanistan War veterans with blast-related TBI, reports a study, "Abnormal Fixation in Individuals with ...

Recommended for you

Study advances gene therapy for glaucoma

January 16, 2018
While testing genes to treat glaucoma by reducing pressure inside the eye, University of Wisconsin-Madison scientists stumbled onto a problem: They had trouble getting efficient gene delivery to the cells that act like drains ...

New study offers added hope for patients awaiting corneal transplants

January 9, 2018
New national research led by Jonathan Lass of Case Western Reserve University School of Medicine has found that corneal donor tissue can be safely stored for 11 days before transplantation surgery to correct eye problems ...

Diabetic blindness caused and reversed "trapped" immune cells in rodent retinas

January 3, 2018
Johns Hopkins researchers have discovered a cell signaling pathway in mice that triggers vision loss in patients with diabetic retinopathy and retinal vein occlusion – diseases characterized by the closure of blood vessels ...

Ophthalmologists increasingly dissatisfied with electronic health records

December 29, 2017
Ophthalmologists' use of electronic health records (EHR) systems for storing and accessing patients' medical histories more than doubled between 2006 and 2016, while their perceptions of financial and clinical productivity ...

Higher omega-3 fatty acid intake tied to lower glaucoma risk

December 26, 2017
(HealthDay)—Increased daily intake of ω-3 fatty acids is associated with lower odds of glaucoma, but higher levels of total polyunsaturated fatty acid (PUFA) intake are associated with higher odds of developing glaucoma, ...

Protein analysis allows for treatment of eye-disease symptoms with existing drugs

December 21, 2017
Demonstrating the potential of precision health, a team led by a researcher at the Stanford University School of Medicine has matched existing drugs to errant proteins expressed by patients with a rare eye disease.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.