Word puzzles useful for exercising ciliary muscles in patients with accommodating IOL

Word search puzzles are an effective way for patients to exercise their ciliary muscles after crystalens accommodating IOL (eyeonics) implantation, explained Paul Koch, MD, who developed a series of six exercise booklets, each containing 14 different puzzles.

Patients are expected to complete one puzzle a day, which takes about 15 minutes, and finish each book in 2 weeks. All six booklets can be completed in 12 weeks. The first booklets have larger font sizes than the subsequent ones.

"We make patients turn in each of the booklets when they are finished, so we can monitor progress," said Dr. Koch during the American Society of Cataract and Refractive Surgery annual meeting. "You know the patients concentrate and focus on progressively smaller font sizes. They are constantly stimulating the accommodative effort."

This tool allows patients to be aware of their own progress with accommodation of this lens. It also keeps patients occupied during the 3-month postoperative period.

"As they finish each booklet, it shows that they are getting better," said Dr. Koch, founder and medical director of Koch Eye Associates in Rhode Island and Connecticut.

The booklets can be used in place of other reading materials, such as newspapers, magazines, and books. The problem associated with newspapers and some magazines is that the font size may be too small, he said.

Reading a book may not be as useful either because "it does not mean they are using their eyes to accommodate because there are limitations to reading as an accommodative exercise," Dr. Koch pointed out. "Patients don't necessarily concentrate on the words in a book and will often skim as they read. So we don't know if that works."