Aphakic Lenses

Aphakic Lenses
• Aphakic lenses are generally lenses of high plus
power and relative central thickness.
• As the power of a spectacle lens increases, the
optical and mechanical issues associated with lens
power also increase.
• For prescription powers stronger than ±4.00
diopters, the fit and design of the lens become
especially critical due to the sensitivity of these
higher powers to changes in lens design or position.
 Aphakic Lenses
• Care must be taken when fitting and
dispensing high-powered lenses in order to
ensure maximum optical performance and
visual comfort for the wearer.
 Aphakic Lenses
The following factors should be considered
when fitting and dispensing high-powered
lenses :
• Magnification and field of view
• Lens reflections
• Optical aberrations
• Vertex distance
• Lens tilt
Magnification and field of view.
• The magnification produced by plus lenses results
in a relatively small field of view through the
spectacle lens.
• This magnification also results in the unappealing
"bug-eye" effect visible to others.
• Keeping the vertex distance of the lenses as short
as possible and using a flatter, aspheric lens design
will minimize magnification and its related effects.
Lens reflections.
• The thick edges of high minus lenses produce
internal reflections, known as power rings,
which are visible to others and exacerbate
(increase) the apparent thickness of the lens.
• An anti-reflection coating will eliminate these
annoying reflections and also improve the
overall appearance of the lens.
Optical aberrations.
• High-powered lenses are subject to greater optical
aberrations in the periphery of the lens than low-
powered lenses, including
• oblique astigmatism and chromatic aberration.
• Proper base curve selection is critical in order to
ensure that the wearer enjoys a wide field of clear
vision.
• Lens materials with high Abbe values are also highly
recommended.
Vertex distance.
• As the vertex distance (or distance from the back
surface of the lens to the cornea of the eye)
changes, the power of the lens as perceived by
the wearer effectively changes as well.
• Increasing the vertex distance, for instance,
increases the effective power of a plus lens and
decreases the effective power of a minus lens.
• In some cases the examiner may note a
refracted vertex distance, which is the vertex
distance of the trial lenses used during the
examination.
• If the fitted vertex distance of the actual
frame differs from the refracted vertex
distance, the ordered powers of the lens
should be adjusted accordingly.
Lens tilt.
• Any excessive lens tilt, including pantoscopic tilt
(that is, lens tilt toward the cheek) and face-
form tilt (that is, "wrap"), will also induce a
form of oblique astigmatism due to lens tilt.
• The oblique astigmatism induced by lens tilt
can be minimized by ensuring that the optical
axis of the lens passes through the center of
rotation (C) of the eye.
• Because of differences in magnification and
thickness, plus-powered lenses and minus-
powered lenses each present unique optical
and mechanical challenges.
• Special lens designs have been devised to
address the optical and mechanical
requirements specific to high plus lenses.
 High Plus Lens Designs

• high-index lens materials as the only option for

minimizing lens thickness.
• For low to moderate plus powers, center thickness
and weight can generally be controlled satisfactorily
using high-index materials, aspheric lens designs, and
sensible frame styles.
• For higher plus powers, particularly those for post-
operative cataract patients with no crystalline lenses,
more radical lens designs may be necessary to control
thickness and weight adequately.
 High Plus Lens Designs
• Indeed, for extremely high-powered plus lenses, it
may not be possible to fabricate (create) a lens blank
beyond 50 to 60 mm in diameter using conventional
designs.
• High-index lens materials can afford some reduction
in thickness, the effects of chromatic aberration may
become intolerable to the wearer for these
prescriptions.
• However, significant thickness reduction can be
obtained by using alternative plus lens designs.
 Cont…..
• Common lens designs for high-powered plus lenses,
beyond +8.00 or +9.00 D—which are often referred to as
cataract lenses, include:
• Full field design: This is the most common single vision lens
design, and is generally what you would receive if you do
not specify a "specialty" design.
• The desired power is provided across the entire diameter
of a full field design.
• You can reduce the thickness of full field designs by using
an aspheric lens design, though this is less effective in
extremely high plus powers.
 Cont….
• Above +8.00 D, traditional spherical lens
designs will not adequately eliminate lens
aberrations in the periphery; only aspheric full
field lens designs should be used in this
prescription range.
 Aspheric design
Aspheric lenticular design:
• This is a speciality lens design that can provide significant
thickness reductions.
• The desired power is provided by a convex "bowl"—or
aperture—with a lenticular design.
• This bowl is often around 40 mm in diameter, and protrudes
(bulge out) from a much flatter carrier curve.
• The curvature of the carrier is such that when combined
with the range of back curves typically used for the
recommended prescription range, the carrier becomes
nearly plano in power.
 Aspheric design
• This near-plano carrier provides a very slim
profile compared to the full field design, since it
retains the center thickness of a 40-mm diameter
lens, regardless of the actual blank size.
• However, the vision beyond the bowl is
extremely blurred and a scotoma exists at the
junction between the bowl and the carrier.
• The bowl is also very conspicuous (noticeable,
obvious) to others.
 Aspheric design
Continuous surface and zonal aspheric designs:
• This is a category of lens designs that provides the
apparent full field of view of a full field design
(without a visible lenticular region), yet provides
much of the weight and thickness reduction of a
lenticular design.
• A continuous surface design is similar to an aspheric
lenticular with the central optical bowl "blended"
into the peripheral carrier using asphericity.
 Aspheric design
• This results in a thin, lightweight design with
the optical performance of an aspheric
lenticular.
• With a zonal aspheric design, asphericity is
exaggerated (enhanced) across the surface in
order to thin the lens profile. However, this
extreme asphericity (on the order of 4.00
diopters or more of surface astigmatism)
results in blurred vision in the periphery.
 Aspheric design
• Another optical characteristic of high-powered plus
lenses is the annular blind area, or scotoma, that is
produced in the wearer's periphery.
• Because of the high magnification produced by plus
lenses, the field of view through the lens is relatively
narrow.
• Consequently, there is a blind area surrounding the
periphery of the lens between the field of view through
the lens and the object field immediately visible outside
the lens edge (or bowl, in the case of lenticulars).
This also results in a somewhat startling "jack-in-the-
box" effect for the wearer as objects pass through the
scotoma and suddenly reappear on the other side it.
• Since the advent of intraocular lens implants,
which are artificial crystalline lens implants,
high-powered "cataract" lens designs have
become relatively scarce.
• However, several cataract lens design options
are still available through a handful of
manufacturers.
 References
• David Wilson, Steve stenersen: Practical
optical workshop, OTEN- DE, NSW TAFE
Commission, 2002
• Margaret Dowaliby: Practical Aspects of
Ophthalmic optics, Fourth edition,
Butterworth Heinemann, USA, 2001