Correcting Presbyopia – Getting Started

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  • Provide patient with all options, but emphasize bifocals
  • Assess patient motivation

Discuss with Patient:

  • Possible compromise in vision
  • May take a lens exchange and up to 6-8 weeks to fully adapt
  • Explain dynamics of the two types of GP presbyopic corrections
  • Simultaneous aspheric designs are similar to no-line spectacles
  • Translating (segmented) bifocal designs are similar to lined spectacles
  • Use topical anesthetic during the fit
  • Use diagnostic lenses when indicated
  • Apply fluorescein and a yellow filter over observation system to evaluate fitting relationship
Pattern observed without the
use of yellow filter over
observation system
Identical pattern with the
addition of yellow filter; notice
greater fluorescence

Other Considerations for Lens Selection

  • Lower adds are well suited for aspheric designs, higher add powers suited for segmented designs
  • Computer (intermediate) use is best with aspheric designs
  • Small and normal-size pupils best with aspheric designs
  • Athletes best with aspheric designs
  • Critical near vision best with segmented designs
Bottom lid below the lower
limbus (>1mm) best suited for
aspheric design
Bottom lid at the inferior
limbus is suited for either
aspheric or segmented design

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