Accommodation and presbyopia: the ciliary neuromuscular view

Abstract

Presbyopia (literally, "old eye"), the age-related loss of the ability to accommodate, is the most common ocular affliction in the world. Although the lens no doubt has a major role in presbyopia, altered lens function could be in part secondary to extralenticular age-related changes, such as loss of ciliary body forward movement. Centripetal ciliary muscle movement does not seem to decrease significantly with age. Loss of elasticity of the ciliary muscle posterior attachments may be an important factor contributing to presbyopia. Even if loss of ciliary muscle mobility is not causally related to presbyopia, it may limit the performance of putatively accommodating intraocular lenses now being developed by academic and industrial groups.