Objective:

To evaluate the impact of pupil size on the performance of multifocal contact lenses (MFCLs) and visual satisfaction.

Approach:

• Variation in Pupil Size: The article discusses how pupil size varies among individuals performing the same visual tasks, affecting MFCL performance.
• Impact on Visual Acuity: Studies indicate that MFCLs perform similarly to single vision lenses in high-contrast distance visual acuity across varying pupil sizes.
• Low-Contrast Acuity and CSF: A 2-line difference in acuity was noted between 3-mm and 6-mm pupils using low-contrast charts, with a significant decrease in contrast sensitivity function (CSF) at larger pupil sizes.
• Pupillary Dynamics: Visual satisfaction with MFCLs correlates with the ability to change pupil size under different lighting conditions.
• Tinted Lenses: The use of tints to manipulate pupil size was explored, showing potential benefits for distance optics but not improving distance visual acuity.

Key Findings:

• MFCLs are reported to be comparable to single vision lenses in high-contrast visual acuity.
• Acuity decreases with larger pupil sizes when measured with low-contrast charts.
• Higher-order aberrations in MFCLs have a greater impact on visual performance with larger pupils.
• Visual satisfaction is linked to pupillary dynamics, suggesting other measures may predict MFCL acceptance better.

Limitations:

• The studies primarily focus on high-contrast visual acuity, which may not fully represent real-world visual performance.
• The impact of tinted lenses on visual acuity needs further investigation.

Sources:

• Cardona and López, 2016
• Papadatou et al, 2017
• Dolce et al, 2025
• Phatak et al, 2025
• Martinez-Plaza et al, 2026
• Park et al, 2020