An excerpt from Dr. Frangie's book, Seeing is Believing, currently in the process of being published.

The accommodating style IOLs are actually able to flex in response to the ciliary muscle contracting – in a manner similar to how a natural lens would change shape in the younger eye. Very slight motion and flexing of the lens allows the eye to gain more “power” when a patient focuses from distant to near objects.(Figure 5 A & 5 B)

A video of Crystalens implantation may be viewed at www.frangieeye.com.

The other mechanism by which an intraocular lens may replace the loss of accommodation is through multifocal optics. The multifocal system has a modified optic (lens portion of the IOL) which is able to modify the light entering the eye and focus some light for near visualization and another portion focuses the energy to allow visualization of distant images. Simply speaking, the multifocal implants, apportions the light to different focal lengths so different distances are in focus; this occurs without effort from the patient and is a totally passive system. Thus, patients do not have to worry about looking through a certain portion of their implant to see at a specific distance.

In summary, advances in cataract surgery and its outcomes have gone hand-in-hand with the evolution of intraocular lenses. The latest quantum leap in IOL technology is the introduction of presbyopic intraocular lenses. Unlike standard monofocal IOLs, these lenses restore the eye’s ability to have a range of clear vision.

Vision Screening for Young Children

Children between the ages of 3 and 5 years should be seen at least once by an eye care professional to detect the presence of amblyopia or its risk factors, according to an updated statement issued by the U.S. Preventive Services Task Force (USPSTF).  The 2011 recommendation was made following an initiative undertaken by the USPSTF to update 2004 statement offering guidelines for vision screening in young children. 

The USPSTF reviewed multiple studies that evaluated the accuracy and outcomes of preschool vision screening tests.  They also assessed the effectiveness of early detection and treatment and the harm of screening treatment. 

The researchers found that vision screening tools used to assess preschool-age children accurately detected visual impairment, such as

• refractive errors
• strabismus
• amblyopia

The task force determined that early treatment for amblyopia in children 3 to 5 years of age, including the use of cycloplegic agents, patching and eyeglasses, leads to improved visual outcomes. 

The 2004 Guidelines also recommended vision screening for children between 3 and 5 years of age;  this review reconfirmed those recommendations based on updated evidence.  According to the statement, there is "adequate evidence that early treatment for amblyopia...for children 3 to 5 years of age leads to improved visual outcomes."