Yes / Purpose: A recent randomised controlled trial indicated that providing long-term
multifocal wearers with a pair of distance single-vision spectacles for use outside
the home reduced falls risk in active older people. However, it also found that
participants disliked continually switching between using two pairs of glasses and
adherence to the intervention was poor. In this study we determined whether
intermediate addition multifocals (which could be worn most of the time inside
and outside the home and thus avoid continual switching) could provide similar
gait safety on stairs to distance single vision spectacles whilst also providing adequate
‘short-term’ reading and near vision.
Methods: Fourteen healthy long-term multifocal wearers completed stair ascent
and descent trials over a 3-step staircase wearing intermediate and full addition
bifocals and progression-addition lenses (PALs) and single-vision distance spectacles.
Gait safety/caution was assessed using foot clearance measurements (toe on
ascent, heel on descent) over the step edges and ascent and descent duration.
Binocular near visual acuity, critical print size and reading speed were measured
using Bailey-Lovie near charts and MNRead charts at 40 cm.
Results: Gait safety/caution measures were worse with full addition bifocals
and PALs compared to intermediate bifocals and PALs. The intermediate
PALs provided similar gait ascent/descent measures to those with distance single-
vision spectacles. The intermediate addition PALs also provided good
reading ability: Near word acuity and MNRead critical print size were better
with the intermediate addition PALs than with the single-vision lenses
(p < 0.0001), with a mean near visual acuity of 0.24 0.13 logMAR (~N5.5)
which is satisfactory for most near vision tasks when performed for a short
period of time.
Conclusions: The better ability to ‘spot read’ with the intermediate addition PALs
compared to single-vision spectacles suggests that elderly individuals might better
comply with the use of intermediate addition PALs outside the home. A lack of
difference in gait parameters for the intermediate addition PALs compared to distance
single-vision spectacles suggests they could be usefully used to help prevent
falls in older well-adapted full addition PAL wearers. A randomised controlled
trial to investigate the usefulness of intermediate multifocals in preventing falls
seems warranted.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/8222 |
| Date | 24 July 2015 |
| Creators | Elliott, David B., Hotchkiss, John, Scally, Andy J., Foster, Richard J., Buckley, John |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Published version |
| Rights | © 2015 The Authors, Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists. Ophthalmic & Physiological Optics 36 (2016) 60–68 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited., CC-BY |
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