Presbyopic cl

1. CONTACT LENS FOR
PRESBYOPES
OPTOM FASLU MUHAMMED

2.  A large % of population needs correction for
Presbyopia
 100 million presbyopes in india & 10 million
adding every year
PRESBYOPIA

3.  It’s a part of normal ageing process,where the
eye loses its ability to easily focus on near objects
 So, need near correction.

4.  Single Vision Reading Glasses,Bifocals,Trifocals
OR Multifocal With Contact Lenses On The Eye
There Are 2 Options to Correct Near Vision With
Spectacle Over Contact lens
CORRECTING OPTIONS

5.  OPTION 1: Fit CL For Distance; Don’t
Overcorrect
* Determine Near Addition Over CL On Trial Frame
*Prescribe Reading Glass Over CL

6.  OPTION 2 : Ideal For Pt’s Who Do
Near/Intermediate Work All Day
*Give near add on CL
*Give Minus Power For Distance In The Form Of
Spectacles For Driving And Other Distance Task

7.  Highly motivated
 Those who have adequate tear film & no lid
disease/ abnormality
 Whose jobs don’t require fine va
 Affordability
PATIENT SELECTION

8.  MONOVISION CORRECTION
 ALTERNATING/TRANSLATING VISION LENSES
 SIMULTANEOUS VISION LENSES
CL PRESBYOPIA CORRECTION

9. Eye Dominance Test

10.  Equipment required: your arms and hands, and an
object about 10 feet (3 meters) away
 Procedure: Extend both arms in front of your body and place
the hands together so as to make a small triangle between your
thumbs and the first knuckle (see image). With both of your eyes
open, look through the triangle and focus on a specific small
object. Close your left eye. If the object remains in view, you are
right eye dominant. If your hands appear to move off the object
and move to the left, then you are left eye dominant.

12.  ONE EYE IS CORRECTED FOR DISTANCE
VISION OTHER EYE FOR NEAR VISION
 IT’S THE EASIEST & AN EFFECTIVE MEANS
OF CORRECTING PRESBYOPIA
 SUCCESS RATE IS AS HIGH AS 70%
MONOVISION

14.  The visual system can suppress the central focus
image thus enable the object of interest to be
seen clearly .
PRINCIPLE

15.  Determine the distance & near corescription
 Determine the dominant and non-dominant eye
 Fit The Dominant With The Distance POWER
Prescrptn And Non Dominant Eye For Near Power
Prescrptn
FITTING PROCEDURE

16.  EG:-4.00 DSPH (OU)
ADD +1.50 DSPH (OU)
Dominant Eye With -4.00 DSPH(DISTANCE) & Non
Dominant With -2.50 DSPH (NEAR )

17.  Use disposable lens and give an office trial.
Record BVA for distance and near
 Don’t attempt uniocular VA now
 The eye with near power’ll read less for distance
and eye with distance power’ll read less for near

18.  Explain fitting technique now
 Some pt’s may need sum adaptatn time & may be
dissatisfied with reduction of stereopsis
 Follow up,and fit the final lens

19.  Adaptation time-atleast 2 wks
 Advise-continue normal activities if possible
 No night driving
 Don’t compare eyes
 Set pt’s expectations
 Educate visual improvement overtime
TIPS-MONOCULAR VN FITTING

20.  Translating Vision types
Like executive type bifocal spectacle lens
Pt when look down gaze lower lid lifts the near
segments up, towards the pupil /the visual axis thus
the pt see clear for near
 Popular in RGP
 Near and far can’t be seen clearly same time
BIFOCAL/MULTIFOCAL CL

24.  Sharp near/far vision
 When it works well,it’s very successful
 Works Better In Rgp & Less Successful/Common
In Scl
ADVANTAGES

25.  Takes longer in adaptation
 Comfort is less due to thick design
 Dependence on eye -lens relationship
DISADVANTAGES

26.  Distance & near images focused on retina
simultaneously
 Brain’ll be select/concentrate on one /other will be
ignored
 Like looking via net across the window @ distance
object
SIMULTANEOUS VN

27. Sharp near and far vision
DISADVNTGES
 Compromised intermediate vision
 Ghosting(doubling) is sometimes a
problem
ADVNTGES

28. 1.CONCENTRIC DESIGN
Concentric segment show sharp demarcation b/w
distance and near powers
2 TYPES
Center near
Center distance
3 TYPES

29. 2.Diffractive bifocal
Made up of concentric rings, Something like a
fresnel prism
Higher the addition more no; of rings

30. 3.Aspheric Designs
Prog.Addition type of lens formed with alteration in
ant. & Post. Curvature of lens
Power is uniformly increase/decreases in
periphery due to asphericity

32.  One eye is fitted with distance correction and
other eye is bifocal lens
 Improves binocularity & stereo acuity which may
be reduced in mono Vn
 Tried in pt’s who are sensitive to distance vn
MODIFIED MONO VISION

33.  High myopes
 Pts with busy schedules
 Dry eyes
 Flat corneas
 Laxity of lower lid
 High astigmatism
 External ocular disease / abnormality
UNSUCCESSFUL CL FITTING
-PRESBYOPES

35. THANK YOUUUU