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Visual impairment in adults: Refractive disorders and presbyopia

Shahzad I Mian, MD
Section Editor
Jonathan Trobe, MD
Deputy Editor
Howard Libman, MD, FACP


Refractive errors are a common, correctable cause of impaired vision throughout the world.

The normal eye creates a clear image by bending (refracting) light to focus onto the retina. Refractive errors occur when a component of the eye's optical system fails to focus the optical image.

This topic will cover the epidemiology, diagnosis, and treatment of refractive errors in adults. Refractive errors in children and laser refractive treatment are discussed separately. (See "Refractive errors in children" and "Laser refractive surgery".)


The eye's ability to focus is dependent on the eye's optical system, which consists of two refractive surfaces working in tandem: the cornea and the crystalline lens (figure 1).

The cornea is the more powerful refractive element, accounting for two thirds of the eye's refractive power. The lens provides the remaining one third, for a total refractive power of 60 diopters (D). Refractive power of the eye and corrective lenses is measured in diopters, where a diopter is the reciprocal of the focal length measured in meters. The focal length is the distance from a lens to its focus or focal point.

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Literature review current through: Nov 2017. | This topic last updated: Feb 17, 2017.
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