contact lens management
Good News for Presbyopes
Metro Optics' progressive GP lens is a great alternative to offer baby boomers.

For most baby boomers, the devastating health effects of aging and the reality of living on a fixed income in retirement are looming in the not-too-distant future. Presbyopia is the present day reminder of what is to come.

It's no wonder that baby boomers are searching for ways to deal with presbyopia that won't remind them of that aging process. One group of emerging presbyopes is wearing single vision GP contact lenses. These patients are excellent candidates for Metro Optics' Metro Progressive Base contact lens.

Fitting is easy

The Metro Progressive Base contact lens

The Metro Progressive Base lens is a GP lens that has an aspheric back surface design that puts a distance power in the center of the lens and near correction in the periphery of the lens for simultaneous viewing of both distance and near objects. It can be made in any GP material. You can fit the lens with relative ease and without a specialized fitting set.

Start from a well fitting single vision lens. Pick a lens diameter around 9.5 mm; this lens can be from a fitting set or from the patient's previous contact lens. Take its base curve and simply order the Metro Progressive Base 1.25 diopters steeper. Then, compensate for this change in base curve by adding ­1.25 to the distance power of the lens. Metro Optics has expert consultants available to assist in designing or modifying lenses.

Work with them

Emerging presbyopes are generally motivated, but they often expect miracles and don't like surprises. Managing a patient's expectations early leads to greater satisfaction, so warn the patient that it may take two weeks or more to fully adapt. It's also best to suggest that the patient avoid driving at night in the new lenses until they have adapted to wearing them.

Getting it just right

At the slit lamp, look for a well-centered lens with minimal movement. The fluorescein tear pattern should show a mild edge lift, alignment mid-peripherally and a central pooling area of about 1 mm. The absence of a central pool implies that the lens is too loose and won't provide as much add power as a snug fit. However, as with all tight-fitting contact lenses, corneal warpage can occur.

I recommend fine-tuning the power of the contact lenses with loose trial lenses in normal light. If distance vision needs improving, then consider modifying the power of the dominant eye first. It's best to have the patient live with a little distance blur for a week or so, because they often start by using the intermediate power of the lens for distance viewing and slowly learn to use the distance power. If near is less than desired, start by adding more plus to the non-dominant eye and leaving the dominant eye alone. Distance and near vision should be 20/30 or better in each eye and 20/20 OU after adaptation.

Last thoughts

The Metro Progressive Base contact lens has an effective add power of up to 2.00D in its standard design. When a patient progresses into needing a higher add power, then you can use an enhanced progressive design. Also, for patient's needing higher add powers, the Metro Seg translating bifocal may be a good alternative. Visit www.metro-optics.com to learn more.

DR. COLDIRON IS IN PRIVATE PRACTICE IN AUSTIN, TEXAS. SHE'S A PAST PRESIDENT OF THE CENTRAL TEXAS OPTOMETRIC SOCIETY, AND IS A MEMBER OF THE AMERICAN OPTOMETRIC ASSOCIATION. E-MAIL HER AT DRC@FARWESTOPTICAL.COM.