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Course
Introduction
This course covers contact lenses which are fit for the correction of
presbyopia, astigmatism, aphakia, and keratoconus. These, indeed, are
advanced techniques and require the skill and experience of the seasoned
contact lens fitter. While the study of this section by itself will
not produce an expert fitter, it will provide an introduction to and
a survey of the various lens designs and fitting procedures which are
employed. The section begins with the study of presbyopia by presenting
the various options available to the presbyopic contact lens wearer.
Among these are spectacle lenses for near vision to be worn over the
distance vision contact lenses, monovision, concentric style multifocal
contact lenses, and segment style contact lenses. The discussion of
contact lenses for the correction of astigmatism includes the fitting
of front toric, back toric, and bitoric lens designs. Lens stabilization
techniques designed to inhibit lens rotation in cylindrical and segment
multifocal lenses will be discussed. These include prism ballast, truncation,
double slab-off and posterior toric surfaces. The section on contact
lenses for the correction of aphakia will survey the various lens materials
and shapes that can be used to help the cataract patient. These will
include conventional lenticular, minus carrier lenticular (myoflange),
and single cut lenses. Emphasis will be placed on the special problems
encountered by the elderly aphakic contact lens wearer. We continue
with a discussion of keratoconus, a degenerative hereditary condition
of the cornea. The various stages of the disease will be defined and
contact lens fitting methods and philosophies designed to help improve
visual acuity will be surveyed.
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