Presbyopia correction using multifocal contact lenses (through the example of Biofinity Multifocal)

Proper presbyopia correction has become increasingly relevant for clinical practice in recent years. This problem arises from both the population ageing as a whole and the need for a higher vision quality that directly affects the quality of patients’ life. There are many factors that require comfortable and high-quality vision correction with soft contact lenses, such as active sports, the desire not to change usual activities and feel younger, the reluctance to use extra reading glasses and glasses in general. We have to look for soft contact lenses with the wettest surface, lenses that can maintain tear film for as long as possible due to following reasons: disruption of eye surface’s wetting; dry eye syndrome, that sometimes arise with age; medicine use, one of the side effects of which is usually the reduction of tear production. The review provides recommendations for the fitting of multifocal contact lenses through the example of Biofinity Multifocal with different designs: distance-center and near-center. Conclusion: It is possible not only to achieve high vision quality at all distances in patients, but also to maintain their accustomed lifestyle and to minimize their astenopic complaints with the help of proper presbyopia correction.

Prevalence of Refractive Error and Need for Corrective Lenses in Medically Underserved Residents of Tijuana, Mexico

PurposeThe population of Tijuana, Mexico is growing rapidly, with a current official population estimate of 1.7 million. Nearly 80,000 people migrate to Tijuana each year, resulting in the rise of neighborhoods with substandard housing, lack of services and inadequate access to health care, including eye care. This study describes refractive errors and the need for corrective lenses among participants attending free clinics in these neighborhoods where they received free eye exams and glasses during January 2016. Methods: This is a retrospective observational chart review of de-identified data collected from intake forms that were filled out for each participant at the clinics. Subjects were self-selected in response to announcements in the neighborhoods where clinics were conducted. Subjects with presenting uncorrected visual acuity 20/30 OU or worse were examined with an autorefractor to measure spherical refractive error. Either prescription or reading glasses were then distributed to participants who had refractive errors. Epi Info, an open source program provided by the CDC, was used to analyze demographic, visual acuity and refractive error data. Results: Presenting visual acuity was evaluated in 1209 people. Of these patients, 70% had a visual acuity of 20/30 or worse. Only 23% of these patients had glasses. Among the patients who were given refractions, 13% had clinically significant myopia (−0.75 D or worse in at least one eye). In participants 20 years old and younger, only 8% had clinically significant myopia. Clinically significant hyperopia (+0.75 D or worse in at least one eye) was detected in 25% of participants. Astigmatism (−1.5 D or worse in at least one eye) was present in 18% of participants. Prescription glasses were given to 542 participants and 396 of these people received their first glasses. Reading glasses were given to 386 people. Among students only 15% presented at the clinics with glasses, while it was determined that 56% of student participants needed glasses. Conclusion: The high levels of uncorrected refractive error in this study suggest limited access to affordable eye care in neighborhoods where clinics were conducted. Prevalence of myopia among adolescents and young adults is increasing in many parts of the world. In contrast, a relatively high prevalence of hyperopia was observed in this age group in Tijuana. The data demonstrate an urgent need for eye care and correction of refractive error in the study group.

Optometric Management of Sports-related Post-concussion Visual Symptoms in Teenagers with Vision Therapy: A Case Series

Background: Sports-related concussions are among the most common causes of mild traumatic brain injury (mTBI) in children and young adults. Post-concussion visual problems include: changes in refractive status, binocularity, accommodation, ocular motility, visual processing, and vestibular-visual interaction. Modifications to the traditional optometric exam, use of prisms, lenses, binasal occlusion, tints, filters, and a sequence of in-office vision therapy (VT) can successfully rehabilitate the visual symptoms and improve the quality of life (QoL) for this very unique patient population. Case Reports: 1) A 14 year old male presented with a history of a concussion from soccer. His symptoms included headaches, decreased concentration, difficulty copying form the board and difficulty transitioning from near to far activities. Clinical testing revealed an accommodative and oculomotor dysfunction (OMD). He was prescribed BU yoked prism glasses and vision therapy. 2) A 16 year old female presented with a history of two sports-related concussions from cheerleading. Her symptoms included headaches, blurry vision at near and difficulty keeping her place when reading. Clinical observation revealed OMD and accommodative insufficiency. She was prescribed reading glasses to relieve visual stress when reading while she completed vision therapy. 3) A 19 year old female presented with a history of multiple sports concussions while playing collegiate soccer, which resulted in headaches that became worse when reading, decreased reading stamina and difficulty keeping her place when reading. Clinical observation revealed accommodative insufficiency, binocular dysfunction and OMD. She was prescribed reading glasses and vision therapy. Conclusion: This case series outlines the exam procedures and therapy techniques used to manage three teenagers with postconcussive visual disorders. Symptoms such as blurred vision, headaches and difficulty reading can profoundly affect activities of daily living (ADLs). Optometric examinations and management through the use of prisms, tints, reading glasses, and in-office vision therapy can successfully resolve these visual complaints. Each patient described completed 10-12 sessions of in-office vision therapy [over a span of four to eight months], with home re-enforcement, and graduated with marked improvement of their visual signs and symptoms.