Presbyopia isn't just for Presbyterians.
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It has been observed that, after radial keratotomy (RK), uncorrected residual hyperopes may have better visual acuity than expected and that some presbyopes, corrected only for distance, have adequate near-vision. We offer a possible explanation for these observations by showing that the increased spherical aberration after RK may produce a second focus 1.5 diopters or more in front of the principal focus of the eye.
Although presbyopes represent a large and growing fraction of the population, only 2% of them have tried bifocal contact lens correction. Bifocal contact lenses have in the past been notorious for the chair time they required and for low success rates. But now the picture is beginning to change. The growing number of new and innovative lens designs is expanding the fitter's options and greatly increasing the chances of success. Success, however, depends on the fitter being able to select an appropriate lens for each patient. This paper reviews contact lens options available for presbyopic patients and discusses the patients for whom specific lens designs are most advantageous.
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Twenty one presbyopes of 48 years old and over (considered as emmetropes or light ametropes), and a young aphakik patient wearing contact lenses, working before visualization screens, were equipped with semi-framed Varilux 2. The correction of their Intermediary Vision was made precisely on the upper edged level of the frame; the correction of their Near Vision was made by an addition of strength reduced by half when compared to the usual graduation. This specific equipment was compared to the classical system of their choice, manufactured at the same time and offering the same strength in Near Vision. This comparative study resulted in the following conclusions which were in most cases: a "normalization" of the distance to the working screen, an improved distinctness of characters in the intermediate and near distances, a very definite improvement of the vertical scanning when alternating between the keyboard and the screen, and of the horizontal scanning when alternating between the keyboard, or the screen, and the documents, an obvious diminution of the time of tiredness, and less stiffness of the neck in its usual working position, the proposed progressive half spectacles remained essentially a working tool, but most participants of this study used them for spare time activities, large professional categories (musicians, painters, etc.), including ours, might benefit from them. The possible benefits obtained from their use by aviators will be published separately. These half-framed progressive spectacles seemed to be the best optical complement to propose to aphakic patients wearing contact lenses and to the pseudophakics.
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