The VEPRO trial: a cross-over randomised controlled trial comparing 2 progressive lenses for patients with presbyopia

BCLA CLEAR Presbyopia: Management with contact lenses and spectacles

This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.

A simple clinical test for perception of progressive addition lens peripheral image blur. A pilot study

Purpose

To introduce a simple method for subjective perception of progressive addition lens (PAL) peripheral image blur (PIB). The amounts of PIB induced by traditional PAL trial lenses (plano distant PAL, TPAL) and prescription PAL (FPAL) were also evaluated.

Methods

Subjects wearing the PALs adjusted their heads laterally to view the fixation target for PIB perception. 38 subjects were randomized and recruited from the Eye’ni optical shop. Outcomes were assessed by the high-contrast visual acuity chart (LogMAR scale), and by subjectively indicating the magnitude of PIB on a scale of 0 to 10 (10 is extremely blur) using astigmatism-sensitive optotype (Polatest^®, Carl Zeiss Vision, Germany).

Results

Visual acuities (mean ± SD) at the central and temporal fixations were measured at 0 ± 0.03 and 0.2 ± 0.04 with FPAL, and 0 ± 0.03 and 0.1 ± 0.03 with TPAL respectively. Significantly lower visual acuities were found with the temporal fixation than with the central fixation in both PALs (p < 0.001). And significant even reduction at the temporal fixation with FPAL than with TPAL was observed (p < 0.001). For subjective measures of PIB using astigmatism-sensitive optotype, the average score of FPAL (7.4 ± 0.8, ranged 5–9) was found statistically higher than that of TPAL (6.7 ± 0.8, ranged 4–8) (p < 0.01).

Conclusions

Our proposed simple clinical method appears to facilitate PAL peripheral image blur demonstration, which may help potential PAL wearers to effectively experience the peripheral PAL image blur. Opticians may caution the potential PAL wearers that prescription PAL may induce more peripheral image blur than that with the traditional distant plano PAL trial lenses.