The College of Optometrists

Whats the best advise to give to px??

Rx: RE +0.75/-0.25x180 6/5

LE Balance (+1.00)6/60 NIPH

Reading Add +1.00 N4 (RE) Age:47yrs

Px wants varifocal CLs,does not want to wear specs at work at all!!

(Px had cosmetic squint surgery 20 yrs ago, no problems)

All CLs parameters normal,no CL contraindications.

Px coming to see me in few days time.

I was thinking of offerring:

RE: Multifocal CL, and

LE: SV CL ( To aid peripheral vision)

What other options should I be considering??

(P.S. Palfi resolved my consistent over- plus Rx)

Many thanx

apple1 - thanks - happy to be of service. this is really going for it - c/ls for presbyopia work best with two equal eyes. So yr idea may not be very successful for reading.

The LE could be over plussed by +1.50 without her noticing, I dare say. You could try a daily multifocal to try first - focus make one. If it works to some extent - then try the soflens multifocal and push the plus. This lens works better than the daily lens. It all depends on compromise.

She should have glasses and a day off per week at least. It is tough if she does not like it - but you must not let her be irresponsible - 'cos that means you take all the responsibilty. Explain to her that you don't care about next week - it is how will her eyes be in ten years that you care about. Explain to her that long term wear slowly weakens the eye and speeds up aging.

She won't like that! I get them to sign a paper saying that they will look after their eyes properly. why not?

In my expereience, low hyperopes don't like the impact that multifocal CLs have on DV clarity. Looking at the Rx, I might expect them to see 6/9, maybe 6/6 unaided. With a multi CL, this would not necessarily improve, may even worsen, which does not help with motivation/compliance. Might not be very comfy for VDU worker. You might find SV CL would be sufficient as plus lens reduces accommodative demand. Hyperopes need less reading add then, especially if you can saturate the plus for DV.

may 02 2003 the aging eye contact lenese for the over 40's by OT. You ca nget it from the OT website. Read it - it will answer yr questions :palf

Thanx Palfi....but having trouble opening the file from OT website...says " file too long to open"...

okay - look in this weeks optician mag - all abt varifocal cls. On monday phone ot and ask for copy of the article - they will give it free if you ask nicely :-)

You might want to try a RGP bifocal lens with a segment at the bottom which is pushed in front of the pupil by the lids when the Px looks down. With this you ain't relying on the Px's binocular summation to give them good vision at distance and near which is the basis of most soft CL multifocal. Rubbish for a VDU at eyelevel tho.