B&L Ultra for Presbyopia Fitting Guide: A Comprehensive Overview (Updated 02/18/2026)

This guide details fitting Bausch + Lomb’s Ultra for Presbyopia lenses, addressing the growing need for presbyopia correction․ Many patients currently lack suitable contact lens options․

The expanded parameter availability enhances fitting success, while this resource aims to equip practitioners with the knowledge for optimal patient outcomes and satisfaction․

Understanding Presbyopia and Contact Lens Correction Options

Presbyopia, the age-related loss of near focusing ability, typically becomes noticeable around age 40․ It’s a natural physiological change, not a disease, impacting the lens’s flexibility and reducing its capacity to accommodate for close-up vision․ Consequently, individuals experience difficulty with tasks like reading, sewing, or using digital devices․

Contact lenses offer viable solutions for presbyopia correction, moving beyond traditional reading glasses․ Multifocal contact lenses, featuring concentric zones of differing power, provide clear vision at multiple distances․ Alternatively, monovision correction utilizes one lens for distance vision and another for near vision, allowing the brain to adapt and select the appropriate image․

However, a significant portion of presbyopic patients don’t receive contact lens correction, highlighting an unmet need․ Fitting challenges, patient adaptation, and lens availability contribute to this gap․ The B&L Ultra for Presbyopia lens aims to address these issues with its innovative design and expanded parameter range, offering practitioners a more effective tool for successful presbyopia management․ Understanding these options is crucial for personalized patient care․

The B&L Ultra for Presbyopia Lens Design

The B&L Ultra for Presbyopia lens utilizes a unique center-distance design, incorporating a central zone dedicated to distance vision․ This contrasts with traditional concentric multifocal designs․ Surrounding this central zone are seamlessly blended intermediate and near power zones, facilitating smooth transitions between viewing distances․

This design philosophy aims to minimize off-axis aberrations and maximize visual clarity at all focal lengths․ The lens material, silicone hydrogel, promotes high oxygen permeability, crucial for corneal health during extended wear․ Furthermore, MoistureSeal technology helps maintain lens hydration, enhancing comfort throughout the day․

The lens geometry is optimized to reduce haloes and glare, common complaints with some multifocal designs․ Its aspheric optical design further contributes to sharper vision and reduced distortion․ The B&L Ultra for Presbyopia is engineered to provide a comfortable and visually superior experience for presbyopic contact lens wearers, addressing common fitting challenges․

Available Parameters and Range

The B&L Ultra for Presbyopia lenses are currently available in a comprehensive range of parameters to facilitate successful fits for a diverse patient population․ Power ranges span from +1․00D to +6․00D, addressing a significant portion of presbyopic corrections․

Cylinder corrections are offered up to -2․75D, accommodating a substantial number of astigmatic presbyopes․ Base curves are available in 8․4mm and 8․6mm, providing options for varying corneal curvatures․ Diameter options include 14․2mm, ensuring optimal lens centration and comfort․

The addition power ranges from +0․75D to +2․50D in 0․25D steps, allowing for precise near vision correction․ Recent expansions have broadened these parameters, increasing the likelihood of finding a suitable fit․ Practitioners should consult the latest B&L parameter guide for the most up-to-date availability information, as parameters are subject to change․

Patient Selection Criteria

Ideal candidates for B&L Ultra for Presbyopia lenses are individuals experiencing the onset of presbyopia, typically around age 40, and seeking comfortable vision correction without relying solely on spectacles․ A stable refraction is crucial; changes within the last six months should be minimal for predictable fitting success․

Patients should exhibit sufficient tear film quality and quantity to ensure lens comfort and prevent dryness; Those with severe dry eye disease may require pre-treatment or alternative correction methods․ Corneal health is paramount; significant irregularities or active corneal disease contraindicate contact lens wear․

Motivation and dexterity are key factors․ Patients must be able to handle and care for contact lenses properly․ A thorough case history should identify any systemic conditions or medications that could impact contact lens wear․ Finally, realistic expectations regarding vision correction are essential for patient satisfaction․

Initial Patient Consultation & Case History

The initial consultation is paramount for successful B&L Ultra for Presbyopia fitting․ Begin by discussing the patient’s visual needs and lifestyle, specifically focusing on near and intermediate vision demands․ Understand their current spectacle prescription and any dissatisfaction with their current vision correction․

A comprehensive case history should detail ocular health, including any history of dry eye, allergies, or corneal disease․ Systemic health information is also vital, noting any conditions like diabetes or autoimmune diseases, and current medications․ Previous contact lens experience – success, failures, and reasons for discontinuation – provides valuable insight․

Inquire about occupational and recreational activities to determine specific visual requirements at different distances․ Assess the patient’s motivation and ability to handle contact lenses․ Finally, manage expectations by explaining the fitting process and potential outcomes, emphasizing that adaptation may be required․

Refraction for Presbyopia: Distance & Near

Accurate refraction is crucial for B&L Ultra for Presbyopia fitting․ Begin with a thorough distance refraction, cyclopleging if necessary, to establish the best possible distance correction․ Subsequently, perform a near refraction, ideally at the patient’s typical reading distance – typically 40cm, but confirm this․

Consider using dynamic retinoscopy or automated refraction to aid in determining the near add power․ Monocular refraction is recommended to accurately assess each eye’s refractive error․ Record both distance and near spherical equivalent refractions meticulously․

Evaluate binocular vision function, including accommodative amplitude and facility․ Assess phoria at both distance and near․ A significant phoria may influence contact lens selection․ Finally, document any discrepancies between subjective and objective refraction findings, as these can guide trial lens selection and subsequent refinement․

Keratometry and Corneal Topography Assessment

Prior to fitting B&L Ultra for Presbyopia lenses, a comprehensive corneal assessment is essential․ Perform keratometry to determine the central corneal curvature and astigmatism․ Record both horizontal and vertical readings․ Modern keratometers provide reliable measurements, but manual keratometry can be used as a secondary check․

Corneal topography provides a detailed map of the corneal surface, revealing irregularities or abnormalities that may impact lens fit and visual performance․ Look for signs of keratoconus, pellucid marginal degeneration, or other corneal distortions․ Topography is particularly valuable for patients with astigmatism or irregular corneas․

Analyze the topography maps for corneal eccentricity and asymmetry․ These parameters can help predict lens centration and movement․ Document all findings, including corneal diameter, and any noteworthy features․ This data informs trial lens selection and helps anticipate potential fitting challenges․

Trial Lens Selection: Starting Points

Initiating the trial lens fitting with B&L Ultra for Presbyopia requires a strategic approach․ Begin with the patient’s dominant eye refraction․ For established contact lens wearers, start with the current lens parameters as a baseline, adjusting for presbyopia․

If the patient is new to contact lenses, utilize the distance refraction and add a +1․00D to +1․50D for near correction as a starting point․ Consider the patient’s lifestyle and visual demands․ Active individuals may benefit from a monovision or modified monovision approach․

Select trial lenses with a similar base curve and diameter to the patient’s existing lenses, if applicable․ Ensure adequate lens coverage and centration․ Have a range of powers available, including both spherical and toric options, to facilitate accurate refinement․ Document all initial trial lens parameters carefully․

Diagnostic Fitting: Initial Over-Refraction

Following trial lens insertion, perform a thorough over-refraction․ This crucial step assesses the lens’s impact on the patient’s visual acuity and refractive error․ Begin with distance vision, then progress to intermediate and near distances․

Utilize a phoropter or retinoscopy to refine the power, cylinder, and axis as needed․ Pay close attention to the patient’s subjective responses․ Ask about clarity, comfort, and any visual disturbances․ Note any discrepancies between the predicted refraction and the actual over-refraction․

Record the over-refraction results meticulously for each eye and distance․ This data will guide subsequent adjustments and refinements․ If significant discrepancies exist, re-evaluate the initial lens selection and consider alternative parameters․ A precise over-refraction is fundamental to achieving optimal visual performance․

Assessing Visual Performance: Distance, Intermediate & Near

After the initial over-refraction, comprehensively evaluate visual performance at all relevant distances․ Begin with distance acuity using a standard eye chart, ensuring optimal clarity and minimizing aberrations․ Transition to intermediate vision, simulating computer use or dashboard viewing, typically around 40-50cm․

Assess near vision at a typical reading distance (30-40cm) with appropriate reading material․ Encourage the patient to perform tasks they routinely undertake at each distance․ Inquire about any difficulties, such as blurriness, ghosting, or reduced contrast sensitivity․

Utilize dynamic visual tasks, like reading while moving their head, to simulate real-world scenarios․ Record best-corrected visual acuity at each distance, alongside subjective feedback․ This holistic assessment informs refinement and ensures the lenses meet the patient’s lifestyle demands, maximizing visual comfort and functionality․

Subjective Refinement Techniques

Refinement hinges on patient feedback․ Employ a technique of ‘plus/minus’ spherical changes, starting with small increments (+/- 0․25D), asking the patient to compare vision with and without the change at all distances․ Focus on clarity and comfort․

Consider monocular refinement, especially if residual astigmatism exists or binocularity is compromised․ Utilize a fogging technique to balance near addition; reduce addition until slight blur at distance, then increase until comfortable near vision․

Explore intermediate power adjustments if needed, often a compromise between distance and near․ Encourage prolonged wear during the trial period to assess dynamic performance․ Document all changes and the patient’s responses meticulously․ Remember, successful refinement prioritizes the patient’s visual needs and lifestyle, not just objective measurements;

Addressing Common Fitting Challenges

A frequent challenge is patient adaptation to multifocal designs․ Emphasize the adjustment period and realistic expectations․ If distance vision is compromised, slightly reduce the near add power or consider a modified monovision approach, prioritizing the patient’s primary visual task․

For patients struggling with near vision, a small increase in add power may help, but avoid over-plus, which can induce distance blur․ If complaints involve intermediate distances, explore adjustments to the lens design or consider a separate pair of reading glasses for specific tasks․

Dry eye is a common comorbidity; ensure adequate lubrication before and during the fitting process․ Address any underlying tear film deficiencies․ Finally, remember that not all patients are suitable candidates; be prepared to discuss alternative correction options if fitting proves unsuccessful․

Troubleshooting: Haloes, Glare & Ghosting

Haloes, glare, and ghosting are potential side effects with multifocal contact lenses, often stemming from light scatter․ First, confirm the lens is properly centered and fitting well; decentration exacerbates these issues․ A thorough refraction, including under dim illumination, is crucial to rule out residual refractive error․

If the fit is optimal, consider reducing the add power slightly․ Higher add powers can increase light scatter․ Evaluate the patient’s pupil size; larger pupils may experience more symptoms․ Lens material and design also play a role – discuss alternative options if symptoms persist․

Educate patients about these potential effects and their transient nature․ Advise against nighttime driving if symptoms are severe․ If issues continue, explore monovision or alternative correction methods, prioritizing patient safety and visual comfort․

Monitoring Lens Fit & Long-Term Management

Regular follow-up appointments are vital for long-term success with B&L Ultra for Presbyopia lenses․ Schedule initial check-ups at one week, one month, and then every six months to assess lens fit, vision quality, and ocular health․ Monitor for any changes in corneal physiology or lens deposits․

Patient feedback is paramount․ Inquire about any fluctuations in vision, comfort levels, or difficulties with daily activities․ Address any concerns promptly, adjusting the lens parameters or care regimen as needed․ Remind patients about proper lens hygiene and handling techniques․

Presbyopia progresses over time, necessitating periodic refraction updates․ Be prepared to modify the lens power or design to maintain optimal vision at all distances․ Document all changes and patient responses meticulously to track long-term outcomes and personalize care․

Lens Care & Hygiene Recommendations

Emphasize the importance of diligent lens care to patients fitted with B&L Ultra for Presbyopia․ Recommend a comprehensive lens care regimen, including daily cleaning with a multi-purpose solution specifically designed for silicone hydrogel lenses․ Avoid the use of tap water or saliva for rinsing․

Instruct patients to thoroughly rub and rinse lenses to remove debris and deposits․ Proper handwashing with soap and water before handling lenses is crucial․ Cases should be regularly cleaned and air-dried to prevent microbial contamination․ Replace lens cases every three months․

Discourage extended wear unless specifically prescribed and monitored․ Educate patients on recognizing signs of infection or inflammation, such as redness, pain, or blurred vision, and advise immediate removal of lenses and professional evaluation․ Reinforce adherence to the prescribed replacement schedule․

Patient Education: Expectations & Compliance

Successful B&L Ultra for Presbyopia fitting hinges on realistic patient expectations․ Clearly explain that these lenses offer improved vision at multiple distances, but may not provide the same crispness as glasses, particularly in challenging conditions․

Discuss the adaptation period, emphasizing that it may take time for the brain to adjust to the new visual experience․ Encourage consistent wear to facilitate this adaptation․ Highlight the importance of following the prescribed wearing schedule and lens care instructions meticulously․

Address potential challenges like haloes or glare, explaining they often diminish with adaptation․ Stress the need for regular follow-up appointments to monitor progress and address any concerns․ Emphasize that compliance with lens care and wearing schedules directly impacts lens health and visual comfort․

Expanding Parameters & Future Developments

Bausch + Lomb’s recent expansion of parameters for the Ultra for Presbyopia lens signifies a commitment to broader patient applicability․ This includes increased availability in higher powers and additional base curve options, addressing a wider range of prescriptions and corneal characteristics․

Future developments are likely to focus on further refining the lens design to optimize visual performance and comfort․ Research into novel materials and aspheric designs may yield lenses with enhanced intermediate vision and reduced visual aberrations․

We anticipate potential advancements in personalized lens designs, leveraging corneal topography data for customized solutions․ Exploring digital tools for improved fitting predictability and remote monitoring are also areas of ongoing investigation․ Continued innovation will aim to minimize fitting challenges and maximize patient satisfaction with presbyopic contact lens correction․

Resources & Further Training

To support practitioners in successfully fitting Bausch + Lomb’s Ultra for Presbyopia lenses, a comprehensive suite of resources is readily available․ These include detailed fitting guides, case studies illustrating successful fitting strategies, and online educational modules․

Bausch + Lomb offers professional training programs, both online and in-person, designed to enhance skills in presbyopia assessment and contact lens fitting․ These programs cover topics such as advanced refraction techniques, corneal topography interpretation, and troubleshooting common fitting challenges․

Practitioners can access dedicated support from Bausch + Lomb’s clinical specialists for personalized guidance and assistance with complex cases․ Regular updates on product enhancements and new research findings will be communicated via email and professional channels․ Staying informed ensures optimal patient care and fitting success with the Ultra for Presbyopia lens․