Multifocal Contact Lenses

-Case Presentation

Abdul Majid Visharam

CL Clinic
Navasuja Sankara Nethralaya
About multifocals
 Multi focal Lenses
Translating /Alternating
Simultaneous
 Simultaneous
Concentric
Diffractive
Aspheric
 Case report 1

 42 yrs old male / sales officer

 Old contact lens wearer

 C/o difficulty in near vn with present CL

 PGP (6 months)
Od: -4.00 -0.50 X180
Os: -4.75 DS
 Case report 1
 Vn with Rx
Od: 6/6-, N6 @ 40
Os: 6/6, N6 @ 40

 Flash : Od: -4.50 DS

Os; -4.75 DS
 Acceptance :
Od: -4.50 DS (6/6+)
Os: -5.00 DS (6/6+)

 Add : Ou: +1.25 DS (N6)

 Case report 1
 Keratometry :
OD: 43.25 @ 20 OS: 43.50 @ 180
43.50 @ 110 44.00 @ 90

 Options : Reading glass over CL / Multifocal CL

 Preference - Multifocal CLs

 Trial lenses ordered

Od: 8.5/ -4.25/ Low Add
Os: 8.5/ -4.75/ Low Add
 Case report 1
 Vn with Trial multifocal
Od: 6/5 ; N6 @ 40cm
Os: 6/5 ; N6 @ 40cm

 Assessement :
Good fit, Adequate movement,
360deg.coverage

 No complaints of glare & ghost images

 Patient comfortable with clear vision

 Case report 2

 49 yr old female / works with computers

 New to contact lens wear
 C/o headache and glare with PC
 PGP (6 months)
Od : -0.25 -0.50 X150
Os : - 0.25 -0.50 X20
Add : OU : +1.50DS
 Case report 2
 Vn with Rx
Od : 6/6, N6 @ 40
Os : 6/6, N6 @ 40

 Flash : Od : Plano -0.50 x160

Os : +0.25 -0.50 x40
 Acceptance :
Od : Plano -0.25 x160 (6/6)
Os : Plano -0.50 x 60 (6/6)

 Add : Ou : +1.75 DS (N6) @ 40

 Case report 2
 Keratometry :
OD: 43.00 @ 180 OS: 43.50 @ 160
43.50 @ 90 43.75 @ 70

 Options : Progressive specs / Multifocal CL

 Preference - Multifocal CLs

 Trial lenses :
Od: 8.5/ Plano / High Add
Os: 8.5/ -0.25 / High Add
 Case report 2
 C/o blurred vn for both dist. & near after
15min. Of adaptation.

 Vision :
Od: 6/12 ; N6 @ 40cm
Os: 6/6 ; N8 @ 40cm

 Assessement :
Good fit, Adequate movement,
360deg.coverage
 Case report 2
 Distance vn not clear – Alter Dominant eye rx

Add -0.25DS to distance rx (or)

Change to Low Add

 Near vn not clear – Alter Non-dominant eye rx

Add +0.25DS to distance rx (or)

Change to High Add

 Case report 2

 Trial lenses :
Od: 8.5/ -0.25 / Low Add
Os: 8.5/ Plano / High Add

 After adaptation
patient was comfortable
clear dist. & near vision
no glare / ghost images
 Case report 2

 Vision with trial lenses :

Od: 6/6 ; N6 @ 40cm

Os: 6/6 ; N6 @ 40cm