AAO 2025: The rise of presbyopia research

AnnMarie Hipsley, PDT, PhD, founder of ACE Vision Group spoke to the group's advances in ocular biomechanics and vision science. The central theme was moving beyond a lens-centric approach to vision, historically the foundation of presbyopia research, towards a systems-level understanding that encompasses the dynamic interplay between the eye’s biomechanical components.

Hipsley emphasized the multi-faceted nature of dynamic range of focus, underscoring the roles of accommodation, pseudo-accommodation, higher order aberrations, sphericity, and especially pupil dynamics. Recent technological developments, such as sophisticated imaging systems—dynamic OCT, UVM, and real-time wavefront aberrometry—enable comprehensive measurement of how these interrelated elements contribute to vision, providing new insight into ocular function.

A significant part of the team’s work involves expanding research from the lens to include the pupil and sclera, using cutting-edge AI-driven simulations. Dan Goldberg’s groundbreaking animated visualizations made the complex interrelationship of zonular pathways and the Bruchs membrane more accessible, enabling further advancements using the Virtual Eye Simulation Analyzer (VESA). Through VESA and physics-based modeling, custom virtual reality eyes and AI-enabled virtual clinical trials can be constructed, enhancing visualization, diagnostics, and future therapy development for conditions like presbyopia.

The meeting highlighted the importance of restoring the eye’s natural elasticity and balance—hallmarks of youthful vision. By integrating AI and new biometrics, the team aims to pioneer innovative presbyopia treatments that prioritize not just returning vision but also restoring complete physiological function. Ultimately, their research aspires to reduce the global burden of presbyopia, opening up transformative possibilities for comprehensive, system-level eye care.