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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 |