Abstract
Bifocal and multifocal optical devices are intended to get images into focus from objects placed at different distances from the observer. Spectacles, contact lenses, and intraocular lenses can meet the requirements to provide such a solution. Contact lenses provide unique characteristics as a platform for implementing bifocality and multifocality. Compared to spectacles, they are closer to the eye, providing a wider field of view, less distortion, and their use is more consistent as they are not so easily removed along the day. In addition, contact lenses are also minimally invasive, can be easily exchangeable, and, therefore, suitable for conditions in which surgical procedures are not indicated. Contact lenses can remain centered with the eye despite eye movements, providing the possibility for simultaneous imaging from different object distances. The main current indications for bifocal and multifocal contact lenses include presbyopia correction in adult population and myopia control in children. Considering the large numbers of potential candidates for optical correction of presbyopia and the demographic trends in myopia, the potential impact of contact lenses for presbyopia and myopia applications is undoubtedly tremendous. However, the ocular characteristics and expectations vary significantly between young and older candidates and impose different challenges in fitting bifocal and multifocal contact lenses for the correction of presbyopia and myopia control. This review presents the recent developments in material platforms, optical designs, simulated visual performance, and the clinical performance assessment of bifocal and multifocal contact lenses for presbyopia correction and/or myopia progression control.
Highlights
Bifocal and multifocal contact lenses (CLs) for presbyopia correction and/or myopia control can be made available in a wide variety of platforms, including rigid gas permeable (RGP) lenses of different sizes from corneal to scleral supported, soft contact lenses, and hybrid lenses [1]
We present an overview of the recent developments of bifocal and multifocal contact lens designs for the correction of presbyopia and myopia control, including the optical design of different platforms for bifocality and multifocality, computational simulations and performance assessment, and their connection with the visual performance, patient acceptance, and efficacy
Current bifocal and multifocal contact lens designs for presbyopia correction and myopia progression control are focused on providing a robust distance and near visual performance over a wide range of pupil sizes
Summary
Bifocal and multifocal contact lenses (CLs) for presbyopia correction and/or myopia control can be made available in a wide variety of platforms, including rigid gas permeable (RGP) lenses of different sizes from corneal to scleral supported, soft contact lenses, and hybrid lenses [1]. In addition to the lens optical structure, bifocality and multifocality can be achieved by reshaping the cornea with the application of CLs in the technique called orthokeratology and has been used widely for myopia correction and myopia control [2, 3] its application for presbyopia correction is still limited [4]. We present an overview of the recent developments of bifocal and multifocal contact lens designs for the correction of presbyopia and myopia control, including the optical design of different platforms for bifocality and multifocality, computational simulations and performance assessment, and their connection with the visual performance, patient acceptance, and efficacy. For further information on the performance of earlier designs for presbyopia correction [1, 9] and myopia control, including orthokeratology [10, 11], the reader must consult the abundant existing literature including several systematic reviews and meta-analyses on the former topic [12,13,14,15,16]
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