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Title: Effects of progressive addition lens wear on digital work in pre-presbyopes
Authors: Kee, CS 
Leung, TW 
Kan, KH 
Lam, CHI 
Issue Date: 2018
Source: Optometry and vision science, May 2018, v. 95, no. 5, p. 457-467
Abstract: SIGNIFICANCE: Growing popularity of handheld digital devices imposes significant challenges to our visual system and clinical management. This study aimed to determine the effects of lens design on parameters that may influence the refractive management of pre-presbyopic adult computer users. PURPOSE: To determine the effects of wearing conventional single-vision lenses (SVL) versus progressive addition lenses (PAL) on the working distance and refractive status.
Methods: Adult computer users, recruited from two age cohorts (18 to 25 years, n = 19; 30 to 40 years, n = 45), were prescribed SVLs and PALs designed for use with handheld digital devices. For each lens type, the working distance and refractive shift (post-task - pre-task) were measured immediately after lens delivery (T0) and after 1 month of lens wear (T1). Working distances were recorded with an automatic ultrasound device while the participants were playing a video game. Refractive status through the subjects' glasses was measured before (pre-task) and after playing the game (post-task). Questionnaires assessing the frequencies of 10 digital work-related visual symptoms were conducted for both lens types at T1.
Results: Switching from SVL to PAL increased the working distance in both cohorts (mean SEM = 1.88 +/- 0.60 cm; P = .002) and induced a small but significant positive refractive shift (+0.08 +/- 0.04 D, P = .021) in the older cohort at T1. In the younger cohort, the changes in working distance due to the switching lens design were correlated with myopic error (r = +0.66, P = .002). In the older cohort, the changes in refractive shift due to switching lens design were correlated with amplitude of accommodation at both time points (r for T0 and T1 = -0.32 and -0.30, respectively; both P < .05). Progressive addition lens was rated as causing less increased sensitivity to light compared with SVL.
Conclusions: Switching from SVL to PAL increased the working distance and induced a positive refractive shift in the majority of pre-presbyopic adults.
Publisher: Lippincott Williams & Wilkins
Journal: Optometry and vision science 
ISSN: 1040-5488
EISSN: 1538-9235
DOI: 10.1097/OPX.0000000000001211
Rights: Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Optometry. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
The following publication Kee, C. S., Leung, T. W., Kan, K. H., & Lam, C. H. I. (2018). Effects of Progressive Addition Lens Wear on Digital Work in Pre-presbyopes. Optometry and Vision Science, 95(5), 457-467 is available at
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