THE POSTER SESSION at this year’s Global Specialty Lens Symposium was incredibly robust, with 160 research and clinical case report/series posters presented. Highlighted here are some of the notable posters covering contact lens management of presbyopia.
• Setting Expectations for High and Pathologic Myopic Presbyopes: Multifocal GP Fitting Overview (Pfeifer and Keh, 2023) This fascinating case series highlighted the unique visual struggles of those who have high myopia. Higher myopes are noted to struggle with increased aberrations and poor quality of vision. It has been found that there is a greater distribution of refractive power across the pupil in myopic eyes (Gupta et al, 2016).
These cases highlight the importance of discussing and understanding patients’ goals to better fulfill their unique visual demands. It also featured the optical benefits that rigid GP contact lenses provide, particularly multifocal rigid GP lenses. In addition to the optical benefits of GP multifocal lenses, the authors noted that the lenses’ custom nature allows them to correct a nearly unlimited range of conditions in addition to presbyopia.
Though eyecare professionals (ECPs) can provide patients who have high myopia with multifocal options, don’t forget that single-vision GP lenses also can correct high myopia. Rigid GPs optimize distance vision and inherently correct corneal astigmatism with a recommendation of over-spectacles to maximize success in presbyopic patients.
As outlined in the poster, the benefits of multifocal GP lenses include high oxygen permeability, excellent optics, aberration correction, and cost.
• How to Turn Your Aberrations From Zero to Hero: The Use of Wavefront-Guided Extended Depth-of-Focus Scleral Lenses to Improve Quality of Life for a Presbyopic Patient with Keratoconus (Feng, 2023) This case highlighted the visual and quality-of-life improvements that scleral contact lenses provide for patients who have keratoconus. It also detailed some of the potential visual limitations of scleral lenses, such as patient complaints of ghosting and shadowing of images.
The reason for this visual limitation of scleral lenses reportedly is that even though patients who have keratoconus are known to have greater amounts of higher-order aberrations (HOAs) and that scleral lenses can mask most HOAs, residual HOAs can come from posterior cornea, crystalline lens, or scleral lens decentration.
Aberrometry can be performed over a well-fitted scleral lens to optimize distance vision, then additional amounts of negative spherical aberration can be incorporated to increase depth of focus for the improvement of near visual acuity and performance. This results in a highly customized wavefront-guided scleral lens that improves the patient’s visual performance distance and near, to include improving driving at night as well as limiting the need for reading glasses over the scleral lenses. CLS
- Pfeifer T, Keh S. Setting Expectations for High and Pathologic Myopic Presbyopes Multifocal GP Fitting Overview. Poster presented at the 2023 Global Specialty Lens Symposium, Las Vegas. January 2023.
- Gupta V, Gupta S, Chaudhuri Z. Diplopia in high myopia. Expert review of ophthalmology. 2016;11:191-200.
- Feng K. How to Turn Your Aberrations From Zero to Hero: The Use of Wavefront Guided Extended Depth of Focus Scleral Lenses to Improve Quality of Life for a Presbyopic Patient with Keratoconus. Poster presented at the 2023 Global Specialty Lens Symposium, Las Vegas. January 2023.