3-Step Guide to Fitting Success

vti header naturalvue multifocal 3-step guide to fitting success

1-2-3 See Naturally®

Follow this step-by-step approach to fitting success with NaturalVue® Multifocal Contact Lenses.

1. STARTING POWER

Refract icon

Refract to 20/15.

BCSR icon

Use the best corrected spectacle refraction (BCSR) using the full cylinder component.

Fitting red green duochrome

Use the Red/Green (Duochrome) Test for a binocular check that the patient is not overplussed (one click into the Green) for best starting point).

NaturalVue Multifocal QuickStart Calculator icon

Then enter the full spectacle refraction into the NaturalVue® Multifocal QuickStart Calculator.

Click here

2. SETTLE FOR 10 MINUTES

  • Let lenses settle 10 minutes & distance vision will begin to clear.

Remember:  During ‘settling’, the brain is actually adapting to the design of the lens.  The closer the starting lens powers, the less adaptation time that will be required.

3. EVALUATE AND ENHANCE – DISTANCE 1ST; THEN NEAR

Do NOT over-refract with the phoropter, flippers, loose trial lenses or trial frames.
Make a Diagnostice Lens Change – The 0.25D Difference:

  • To enhance DISTANCE: CHANGE THE DIAGNOSTIC LENS POWER on eye by -0.25D (up to -0.50D) in the DOMINANT eye, and -0.25D in the NON-DOMINANT eye only if needed.
  • To enhance NEAR: CHANGE THE DIAGNOSTIC LENS POWER on eye by +0.25D (up to +0.50D) in the NON-DOMINANT eye, and +0.25D in the DOMINANT eye only if needed.

Further Vision Enhancement:

For any questions or issues regarding fitting:

  • Verify best corrected spectacle refraction used
  • Use Red/Green (Duochrome) test to verify RX is not overplussed.
  • Use the NaturalVue® Multifocal QuickStart Calculator
  • Check that lenses have settled 10 minutes
ISSUE
Distance vision not clear Dominant: Change diagnostic lens -0.25 (-0.50 if needed)
Non Dominant: Change diagnostic lens -0.25 only if needed
Near vision not clear Non Dominant: Change diagnostic lens +0.25 (+0.50 if needed)
Dominant: + 0.25 only if needed
Glare, halos, vision seems "different" Dominant: Change diagnostic lens -0.25 (-0.50 if needed)
If Center Near MF wearer or monovision, advise may take 2-3 days to adapt
Issues with driving at night Dominant: Change diagnostic lens -0.25 (-0.50 if needed)
Vision is clear but feels strange, 3D effect things jumping out at them Dominant: Change diagnostic lens -0.25 (-0.50 if needed)
If Center Near MF wearer or monovision, advise may take 2-3 days to adapt
Have been adding minus and distance, still not clear Recheck that Best Corrected Spectacle Refraction is used. Duochrome is -0.25 into green and NaturalVue® QuickStart Calculator is used.
Vision fluctuating, going in and out, feels like have to stare at something to focus – signs of over minus Non Dominant: Change diagnostic lens +0.25 (+0.50 if needed)
Dominant: + 0.25 only if needed

Keep this 3-Step Guide to Fitting Success Handy in your Exam Rooms

A step-by-step approach to fitting success with NaturalVue® Multifocal Contact Lenses.
VTI_123_Fitting_Guide_US
Plus, a Fitting Guide and Enhancement Tool for your exam rooms.
VTI 123 Fitting Guide_US_Enhancement
Download these two documents as a 2-page pdf.

Presbyopia Best Practices

  • Choose motivated or symptomatic presbyopes seeking an improvement over their current vision correction.
  • For over-refractions.
    – Keep both eyes open.
    – Do not use the phoropter.
    – Use a +1.00D loose trial lens to blur the eye not being tested.
    – Over-refract up to +/-0.50 in 0.25D steps. If over-refraction is greater than this, recheck Best-Corrected Spherical Refraction.
  • For presbyopes, a 0.25D lens change can greatly impact vision. Listen to the patient. If the patient says vision is not clear, a change to on eye lens power needs to be made. Even if no over-refraction is found, make a 0.25D change in the power, one eye at a time, starting with -0.25D in dominant eye to refine distance; +0.25D in non-dominant eye to refine near.
  • Patients in monovision or center near multifocal designs may not have been using their central vision in both eyes for distance. It may take them a few days to fully adapt to this change.

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