Air Optix Multifocal Fitting Guide: A Comprehensive Plan
This guide details a thorough approach to fitting Air Optix Multifocal lenses, ensuring optimal vision correction and patient comfort. It leverages advanced technology and personalized strategies.
Air Optix Multifocal lenses represent a significant advancement in presbyopia correction, offering a comfortable and high-performing solution for multifocal contact lens wearers. These monthly disposable lenses utilize Lotrafilcon B material and HydraGlyde Technology, creating a breathable lens with exceptional moisture retention – feeling like nothing even at day 30.
Designed with a unique, progressive addition power profile, Air Optix Multifocal provides a smooth transition between distance, intermediate, and near vision. This design minimizes visual disturbances and maximizes clarity at all focal points. They are available in a power range of +6.00 to -10.00, with a base curve of 8.6mm and a diameter of 14.2mm, catering to a broad range of prescriptions.
Understanding Presbyopia and Multifocal Correction
Presbyopia, the age-related loss of near focusing ability, typically begins around age 40. It occurs as the natural lens of the eye loses flexibility, making close-up tasks like reading increasingly difficult. Multifocal contact lenses address this by incorporating multiple power zones into a single lens.
These zones provide clear vision at varying distances – distance, intermediate, and near. Air Optix Multifocal lenses employ a progressive addition design, mimicking natural vision. This allows for a seamless transition between focal points, reducing the need for reading glasses. Successful multifocal correction requires careful consideration of the patient’s visual needs and lifestyle.
Patient Selection Criteria
Ideal candidates for Air Optix Multifocal lenses are presbyopic individuals seeking to reduce or eliminate their reliance on reading glasses. A stable refraction is crucial, ideally within the past year. Patients should exhibit sufficient tear film quality and quantity to ensure lens comfort and prevent dryness.
Good overall health and the ability to handle contact lens insertion, removal, and care are essential. Motivation and realistic expectations are also key factors. Patients with certain ocular conditions, such as severe dry eye or uncontrolled glaucoma, may not be suitable candidates. A thorough assessment of patient history is paramount.
Comprehensive Eye Examination
A detailed eye exam is foundational for successful Air Optix Multifocal fitting. This includes a complete patient history, assessing ocular health, and evaluating visual needs. Thoroughly assess binocular vision, including near point of convergence and accommodative amplitude. Evaluate pupil size in both light and dark conditions, as this impacts multifocal lens design.
Careful attention to tear film assessment is vital, utilizing tests like Schirmer’s or tear breakup time. Document any pre-existing ocular conditions. The examination must provide a precise baseline for lens selection and subsequent evaluation.
Refraction for Multifocal Contact Lenses
Refraction for multifocal lenses differs from single vision. Begin with a thorough distance refraction, followed by a near addition assessment. Monocular refraction is crucial to accurately determine the add power needed for near and intermediate vision. Utilize plus build-up to minimize accommodation during near refraction.
Consider performing a wet refraction to simulate contact lens wear. Record both distance and near corrections; Evaluate binocular balance at all distances. A slight under-correction of distance vision may optimize near acuity with multifocal designs. Document all refraction findings meticulously.
Keratometry and Corneal Topography
Accurate corneal measurements are vital for successful Air Optix Multifocal fitting. Keratometry establishes the corneal curvature, guiding base curve selection. Corneal topography provides a detailed map of the corneal surface, identifying irregularities like astigmatism or keratoconus.
Topography helps assess corneal health and rule out contraindications. Analyze axial maps for steep or flat areas. Evaluate corneal eccentricity and astigmatism patterns. These measurements ensure optimal lens fit and minimize complications. Document all keratometry and topography readings for future reference and comparison.
Air Optix Multifocal Lens Parameters
Understanding Air Optix Multifocal lens parameters is crucial for precise fitting. The available power range extends from +6.00D to -10.00D, accommodating a wide spectrum of prescriptions. Base curve options typically include 8.6mm, while diameter options are generally 14.2mm.
These lenses are crafted from Lotrafilcon B material, known for its high oxygen permeability. They feature HydraGlyde Technology, enhancing moisture retention and comfort throughout the day. Consider these parameters alongside patient refraction and corneal measurements to achieve optimal visual acuity and wearing experience.
Available Power Range
Air Optix Multifocal lenses offer a comprehensive power range, designed to address a diverse patient population. The sphere power spans from +6.00D to -10.00D, effectively managing both hyperopic and myopic presbyopia. Add powers are available in increments, allowing for precise customization to meet individual refractive needs.
This broad range facilitates fitting for a significant number of presbyopic patients. Careful consideration of the patient’s full refraction, including distance and near corrections, is essential when selecting the appropriate lens power. Accurate power selection maximizes visual clarity at all distances.
Base Curve and Diameter Options
Air Optix Multifocal lenses are currently available with a base curve of 8.6mm, designed to fit a wide range of corneal curvatures comfortably and effectively. The diameter is standardized at 14.2mm, promoting optimal lens centration and minimizing unwanted movement during wear.
These standardized dimensions simplify the fitting process and contribute to consistent performance. While limited in options, the 8.6mm base curve and 14.2mm diameter are engineered to provide a balance of comfort, vision, and oxygen permeability. Careful assessment of corneal topography is still recommended.
Material and Water Content (Lotrafilcon B & HydraGlyde Technology)
Air Optix Multifocal lenses are crafted from Lotrafilcon B, a silicone hydrogel material renowned for its high oxygen permeability. This allows for extended wear and promotes excellent corneal health. The lenses boast a water content of 33%, balanced to maintain comfort without compromising oxygen transmissibility.
Furthermore, HydraGlyde Technology is integrated into the lens design, creating a moisture-rich surface that resists deposits and enhances all-day comfort. This dual-action system minimizes dryness and irritation, contributing to a consistently smooth wearing experience. The material’s properties support clear vision and lens health.
Fitting Philosophy: Empirical vs. Diagnostic
The Air Optix Multifocal fitting approach offers two primary philosophies: empirical and diagnostic. Empirical fitting utilizes established algorithms and patient refraction data to predict the initial lens parameters, streamlining the process. This is suitable for straightforward presbyopic corrections.
Conversely, diagnostic fitting involves a trial lens approach, allowing for subjective refinement based on patient feedback and visual acuity assessment at various distances. This method is preferred for complex cases or when empirical results are uncertain. A combination of both approaches often yields optimal outcomes, balancing efficiency with personalized precision.
Diagnostic Lens Fitting Process
The diagnostic fitting process begins with careful initial lens selection, utilizing trial sets encompassing a range of adds and powers based on the patient’s refraction. Over-refraction is crucial, fine-tuning the lens power to maximize visual acuity at distance, intermediate, and near.
A thorough visual acuity assessment is performed at each distance, alongside subjective patient feedback regarding clarity and comfort. This iterative process allows for precise parameter adjustments. Multiple visits may be necessary to achieve optimal binocular vision and minimize visual disturbances. Careful documentation of each trial is essential for successful fitting.
Initial Lens Selection and Trial Sets
Selecting the initial diagnostic lens parameters requires a detailed understanding of the patient’s prescription, including spherical power, cylinder, and axis. Begin with a lens power close to the patient’s single vision add power. Trial sets should include a variety of adds – typically +0.75D, +1.00D, +1.25D, and +1.50D – to assess the optimal correction.
Consider the patient’s lifestyle and visual demands when choosing trial sets. Base curves and diameters should align with corneal topography measurements. Having a range of parameters available ensures a higher probability of achieving successful multifocal vision.
Over-Refraction and Visual Acuity Assessment
Following trial lens insertion, perform a thorough over-refraction to fine-tune the prescription. Assess visual acuity at distance, intermediate (approximately 40cm), and near (30-40cm) using standardized charts. Compare acuity with and without the trial lenses to quantify improvement.
Pay close attention to the patient’s subjective responses regarding clarity and comfort. A slight over-minus refraction can sometimes enhance near vision, while a slight over-plus can improve distance acuity. Document all findings meticulously, noting any discrepancies or challenges encountered during the assessment process.
Assessing Intermediate and Near Vision
Intermediate vision assessment is crucial, often overlooked, yet vital for daily tasks like computer use. Utilize a reading card held at approximately 40cm to evaluate clarity and comfort. Near vision should be tested with standard near charts at a comfortable reading distance (30-40cm).
Observe for any complaints of blurriness, distortion, or eye strain during these assessments. Ask patients to describe their typical near and intermediate activities to tailor the evaluation. Document the best corrected visual acuity at each distance, noting any add power adjustments needed for optimal performance.
Evaluating Lens Comfort and Fit
Lens comfort is paramount for successful wear. Begin with subjective patient feedback – ask about initial sensations, dryness, or any awareness of the lenses. A comfortable lens promotes compliance and positive outcomes.
Slit lamp biomicroscopy is essential to objectively assess fit. Evaluate centration, movement, and corneal clearance. Look for any signs of corneal stress, limbal injection, or conjunctival reaction. Assess the tear film quality and quantity. Document findings meticulously, noting any adjustments needed to optimize both comfort and visual performance.
Subjective Patient Feedback
Gathering detailed patient feedback is crucial. Inquire about the initial sensation upon lens insertion – is it immediately comfortable, or is there any foreign body sensation? Ask about awareness of the lens throughout the day, and if it diminishes over time.
Specifically probe for dryness, burning, or irritation. Understand their visual experience at all distances: near, intermediate, and far. Are there any haloes or glare, especially during nighttime driving? Document all responses carefully, as subjective reports guide refinement and ensure optimal satisfaction with Air Optix Multifocal lenses.
Slit Lamp Biomicroscopy Assessment
Perform a thorough slit lamp evaluation to assess overall lens fit and ocular health. Evaluate the tear film quality and quantity, noting any signs of dryness or instability. Inspect the lens position, centration, and movement with blink.
Carefully examine the cornea for any signs of hypoxia, edema, or epithelial microcysts. Assess the conjunctiva and lids for redness, swelling, or papillae. Document any abnormalities meticulously. This objective assessment, combined with subjective feedback, ensures a successful Air Optix Multifocal lens fitting.
Troubleshooting Common Fitting Challenges
Addressing fitting issues is crucial for patient satisfaction. Haloes and glare can occur, often requiring adjustments to lens power or design. Distance vision complaints may necessitate over-refraction or a change in add power.
Consider lens centration and movement; improper fit can induce aberrations. If discomfort persists, evaluate tear film and lens material compatibility. Air Optix Multifocal lenses generally perform well, but individual variations demand careful assessment and tailored solutions. Document all changes and patient responses meticulously for optimal outcomes.
Haloes and Glare Management
Haloes and glare are common with multifocal lenses, often stemming from light scattering around the lens edges. Initial management involves verifying accurate refraction and lens centration. Reducing add power or adjusting lens design parameters can minimize these effects.
Evaluate pupil size in dim light, as larger pupils increase the likelihood of these visual disturbances. Consider a different base curve or diameter if symptoms persist. HydraGlyde Technology aids comfort, but doesn’t eliminate optical phenomena. Thorough patient education regarding adaptation is vital for managing expectations.
Distance Vision Complaints
Distance vision blur with Air Optix Multifocal lenses often indicates insufficient plus power in the distance zone. Over-refraction is crucial; slightly reducing the add power can improve clarity. Ensure proper lens centration, as decentration impacts optical performance.
Assess the patient’s visual demands – extensive distance viewing may necessitate a different lens design. HydraGlyde Technology maintains moisture, but doesn’t correct refractive errors. If complaints persist, explore alternative multifocal designs or a monovision correction strategy. Thorough follow-up is essential to refine the prescription.
Refinement and Final Lens Ordering
After diagnostic lens evaluation and patient feedback, finalize the Air Optix Multifocal prescription. Confirm stable binocular vision and comfortable wear. Utilize the Alcon Multifocal Fitting Calculator for precise parameter selection, considering add power and intermediate addition.
Order lenses with the confirmed base curve and diameter. Double-check the power for each eye. Ensure accurate pupil size measurements were considered during the fitting process. Communicate clearly with the laboratory regarding any special requests. Proper documentation of the fitting process is vital for future reference and potential adjustments.
Patient Education and Lens Care
Thorough patient education is crucial for Air Optix Multifocal success. Explain the lens design and adaptation period, emphasizing potential initial adjustment challenges. Demonstrate proper insertion, removal, and cleaning techniques using approved solutions. Highlight the importance of adhering to the prescribed wearing schedule.
Stress the need for regular lens case hygiene and avoiding tap water for rinsing. Discuss signs of complications like redness, pain, or blurred vision, urging prompt contact with the practice. Provide written care instructions and emphasize compliance for optimal lens performance and ocular health.
Follow-Up Visits and Monitoring
Scheduled follow-up visits are essential to assess Air Optix Multifocal lens performance. A one-week check evaluates initial adaptation, comfort, and visual acuity at all distances. Further evaluations at one month and three months monitor long-term success and identify any emerging issues.
Assess subjective responses and refine the prescription if needed. Slit-lamp examination checks for corneal health and lens fit. Document all findings meticulously. Reinforce proper lens care and address any patient concerns. Consistent monitoring ensures optimal vision and minimizes potential complications.
Air Optix Multifocal Fitting Calculator
Alcon provides a valuable Multifocal Fitting Calculator to aid in initial lens selection. This tool utilizes patient refraction data, including spherical power, cylinder, and add power, to suggest appropriate lens parameters. It considers low, intermediate, and high add power needs, streamlining the fitting process.
The calculator recommends starting parameters, but clinical judgment remains crucial. Input accurate keratometry readings for optimal results. Utilize the calculator as a guide, always verifying the fit and vision with diagnostic lenses. It’s a powerful resource, but not a replacement for a comprehensive eye exam and careful assessment.
Comparison with Other Multifocal Contact Lenses
Air Optix Multifocal distinguishes itself with Lotrafilcon B material and HydraGlyde Technology, promoting exceptional breathability and lasting comfort throughout the month. Compared to ACUVUE Oasys Multifocal or Biofinity Multifocal, it often demonstrates superior end-of-day comfort for some patients.
Other lenses may utilize different materials or designs, impacting oxygen permeability and vision correction. Air Optix’s water gradient technology aims to maintain moisture, potentially reducing dryness. Consider patient lifestyle and visual demands when choosing between options, as individual responses vary significantly. A thorough evaluation is key.
Contraindications for Air Optix Multifocal Lenses
Air Optix Multifocal lenses aren’t suitable for all patients. Individuals with certain ocular surface diseases, like severe dry eye, may experience discomfort and should not be fitted. Those with active eye infections or allergies require resolution before lens wear.
Patients with uncontrolled diabetes or systemic conditions affecting tear production are generally poor candidates. A history of non-compliance with lens care significantly increases risk. Corneal abnormalities, such as keratoconus, may preclude successful fitting. Careful screening is crucial to ensure patient safety and optimal outcomes.
Resources and Further Information
For comprehensive support, visit the Alcon website, offering detailed product information, fitting guides, and educational materials on Air Optix Multifocal lenses. Professional resources include webinars and online training modules designed to enhance fitting expertise.
Contact Alcon’s customer service for personalized assistance with complex cases or ordering inquiries. Peer-to-peer forums and professional organizations provide valuable insights and shared experiences. Stay updated on the latest advancements through industry publications and conferences, ensuring best practices in multifocal contact lens fitting.