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Journal of Ophthalmology
Volume 2018, Article ID 4318405, 10 pages
Review Article

From Presbyopia to Cataracts: A Critical Review on Dysfunctional Lens Syndrome

1Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120 Almería, Spain
2Department of Ophthalmology, Torrecárdenas Hospital Complex, 04009 Almería, Spain
3Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
4Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante, Spain

Correspondence should be addressed to David P. Piñero;

Received 12 February 2018; Accepted 5 June 2018; Published 27 June 2018

Academic Editor: Antonio Queiros

Copyright © 2018 Joaquín Fernández et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Dysfunctional lens syndrome (DLS) is a term coined to describe the natural aging changes in the crystalline lens. Different alterations in the refractive properties and transparency of the lens are produced during the development of presbyopia and cataract, such as changes in internal high order aberrations or an increase in ocular forward scattering, with a potentially significant impact on clinical measures, including visual acuity and contrast sensitivity. Objective technologies have emerged to solve the limits of current methods for the grading of the lens aging, which have been linked to the DLS term. However, there is still not a gold standard or evidence-based clinical guidelines around these new technologies despite multiple research studies have correlated their results with conventional methods such as visual acuity or the lens opacification system (LOCS), with more scientific background around the ocular scattering index (OSI) and Scheimpflug densitometry. In either case, DLS is not a new evidence-based concept that leads to new knowledge about crystalline lens aging but it is a nomenclature change of two existing terms, presbyopia and cataracts. Therefore, this term should be used with caution in the scientific peer-reviewed literature.