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EYE ADVICE: Professional Papers


(ii) Pseudophakes and ATR Corneal Changes

Mr A.C.   Age 69 Right eye has IOL.

Ophtahlmologist  Rx:     R) +1.50/-1.00*70   L) +2.75/-0.75*100.

My subjective result after eye closure to relax eyes,

                    R) +1.50/-0.25*65   L) +2.75/-0.25*105.

A more ATR cylindrical lens was used in the right eye for half a minute to stimulate PMA: +1.50/-1.50*75. Immediately after wearing the inducing lens the subjective result was R) +1.50/-0.75*82.5.

A noticeable ATR cylindrical increase is produced in the subjective result when PMA is stimulated by the inducing cylinder. Upon relaxation, the subjective cylinder power is reduced. Fluctuations of 1D in the cylinder power are not uncommon even in pseudophakes. Uncorrected pseudophakes who engage in significant close work, would be expected to develop increasing ATR astigmatism over time. To prevent this, these patients should be encouraged to wear the full correction when reading. 

These findings are in agreement with Yamanaka's work (1961) on observed changes in the corneal toricity upon atropinisation. One of the reasons for slight fluctuations in keratometer readings would be related to PMA effects on the cornea.






Paper 1 - Meridional (Astigmatic) Accommodation  Abstract

Physiology of Meridional Accommodation (A) Ciliary Muscle Action and Innervations
(B) Corneal Changes due to Ciliary Muscle Action
(C) Theory of Initiation of Meridional Accommodation

Clinical Implications of Meridional Accommodation


(A) Astigmatic Changes Related to WTR Corneal Toricity (i) Latent Astigmatism
(ii) Primary Accommodative Astigmatism (PAA)       (B) Reflex or 2°PMA and Induced ATR Astigmatic Changes
(C) Eye Preference and Meridional Accommodation (i) 1° PMA and Eye Preference
(ii) 2° PMA and Eye Preference (D) Proactive Prescribing for Presbyopia (i) Phakic Presbyopes
(ii) Pseudophakes and ATR Corneal Changes (E) Refractive Techniques and MA (i) Balancing Meridional Accommodation
(ii) Binocular Test of Cylinder Power (F) Further Clinical Subject Areas and Meridional Accommodation (i) Preventing Induced Oblique Astigmatism in Children
(ii) Low Vision
(iii) Keratoconus
(iv) Hard Contact Lenses
(v) PRK and PARK (Photorefractive Astigmatic Keratectomy)



Paper 2 - Common Chronic (Infective) Conjunctivitis and Nasal Rinsing

Paper 3 - Primary Open-Angle Glaucoma

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