Near, Intermediate and Distance Vision Assessment after Intraocular Lens Implantation: A Review

In recent decades, the widespread use of digital technologies, increased life expectancy, and sustained professional and social activity among older adults have significantly raised expectations for visual performance at multiple working distances. In patients with presbyopia and age-related cataract undergoing intraocular lens (IOL) implantation, the assessment of visual function at far, intermediate, and near distances has therefore become increasingly important. However, in clinical practice and scientific research there is still no single standardized approach to determining the metric values of these distances. This narrative review analyzes Russian and international publications, regulatory documents, professional guidelines, and manufacturer data related to the assessment of visual acuity at far, intermediate, and near distances. The review demonstrates that distance visual acuity is evaluated at varying test distances ranging to 6 m. Intermediate viewing distance shows the greatest variability, ranging from 50 to 80 cm across studies, largely reflecting differences in visual tasks and typical distances to digital devices. Near visual acuity is most commonly assessed at distances of 33–40 cm. Special attention is given to defocus curves as an adjunctive method for evaluating depth of focus and functional visual performance in pseudophakic patients. The limitations of interpreting defocus curves without direct correlation to real-distance visual acuity measurements are discussed. The need for unification of approaches to assessing vision at an intermediate distance in domestic ophthalmology and the feasibility of using a distance of 66 cm as clinically significant, functionally justified and the most universal seems relevant today.

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