A corrective lens is a transmissive optical device that is worn on the eye to improve visual perception. The most common use is to treat refractive errors: myopia, hypermetropia, astigmatism, and presbyopia. Glasses or "spectacles" are worn on the face a short distance in front of the eye. Contact lenses are worn directly on the surface of the eye. Intraocular lenses are surgically implanted most commonly after cataract removal but can be used for purely refractive purposes.
Prescription of corrective lenses
Corrective lenses are typically prescribed by an ophthalmologist or an optometrist. The prescription consists of all the specifications necessary to make the lens. Prescriptions typically include the power specifications of each lens (for each eye). Strengths are generally prescribed in quarter-diopter steps (0.25 D), because most people cannot generally distinguish between smaller increments (e.g., eighth-diopter steps / 0.125 D). The use of improper corrective lenses may not be helpful and can even exacerbate binocular vision disorders. Eyecare professionals (optometrists and ophthalmologists) are trained to determine the specific corrective lenses that will provide the clearest, most comfortable, and most efficient vision, avoiding double vision and maximizing binocularity.
Over-the-counter correction Ready-made single-vision reading glasses go by many names, including over-the-counter glasses, ready readers, cheaters, magnifiers, non-prescription readers, or generic readers. They are designed to lessen the focusing burden of near work, such as reading. They are typically sold in retail locations such as pharmacies and grocery stores but are also available in book stores and clothing retailers. They are available in common reading prescriptions with strengths ranging from +0.75 to +3.50 diopters. While these "magnifiers" do indeed make the image of the viewed object bigger, their main advantage comes from focusing the image, not magnification.
These glasses are not tailored to a person's individual needs. A difference in refractive error between the eyes or the presence of astigmatism will not be accounted for. People with little to no need for correction in the distance may find off-the-shelf glasses work quite well for seeing better during near vision tasks. But if the person has a significant need for distance correction, it is less likely that the over-the-counter glasses will be perfectly effective. Although such glasses are generally considered safe, an individual prescription, as determined by an ophthalmologist or optometrist and made by a qualified optician, usually results in better visual correction and fewer headaches and visual discomfort. Another criticism of over-the-counter glasses is that they may alleviate symptoms, causing a person to forgo the other benefits of routine vision exams, such as early diagnosis of chronic disease.
Self-selected corrective lenses Although lenses are normally prescribed by optometrists or ophthalmologists, there is evidence from developing countries that allowing people to select lenses for themselves produces good results in the majority of cases and is less than a tenth of the cost of prescription lenses.
Lens types
Single vision
Single vision lenses correct for only one distance. If they correct for far distance, the person must accommodate to see up close. If the person cannot accommodate, they may need a separate correction for near distances, or else use a multifocal lens (see below).
Reading glasses are single vision lenses designed for near work and include over the counter glasses. They come in two main styles: full frames, in which the entire lens is made in the reading prescription, and half-eyes, style glasses that sit lower down on the nose. Full frame readers must be removed to see distance clearly, while the distance can be clearly viewed over the top of half-eye readers.
Bifocal
A bifocal is a lens with two sections, separated by a line (see image to the right). Generally, the upper part of the lens is used for distance vision, while the lower segment is used for near vision. The area of the lens that caters to near vision is called the add segment. There are many different shapes, sizes, and positions for the add segment, such as rounded bifocals and D segment bifocals, that are selected for functional differences as well as the visual demands of the patient. Bifocals allow people with presbyopia to see clearly at distance and near without having to remove the glasses, which would be required with single vision correction.
Trifocal Trifocal lenses are similar to bifocals, except that the two focal areas are separated by a third area (with intermediate focus correction) in the middle. This segment corrects the wearer's vision for intermediate distances roughly at arms' length, e.g. computer distance. This lens type has two segment lines, dividing the three different correcting segments.
Progressive Progressive addition or varifocal lenses provide a smooth transition from distance correction to near correction, eliminating segment lines and allowing clear vision at all distances, including intermediate (roughly arms' length). The lack of any abrupt change in power and the uniform appearance of the lens gives rise to the name "no-line bifocal".
Multifocal Multifocal contact lenses (e.g. bifocals or progressives) are comparable to spectacles with bifocals or progressive lenses because they have multiple focal points. Multifocal contact lenses are typically designed for constant viewing through the center of the lens, but some designs do incorporate a shift in lens position to view through the reading power (similar to bifocal glasses).
Adjustable focus The power or focal length of adjustable or variable focus can be changed to suit the needs of the wearer. A typical application of such a lens is to refocus the correction allowing clear vision at any distance. Unlike with bifocals, near-vision correction is achieved over the entire field of view, in any direction. Switching between distance and near vision is accomplished by re-adjusting the lens, instead of by tilting and/or rotating the head. The need for constant adjustment when the person's attention switches to an object at a different distance is a design challenge of such a lens. Manual adjustment is more cumbersome than bifocals or similar lenses. Automated systems require electronic systems, power supplies, and sensors that increase the cost, size, and weight of the correction.
Plano A corrective lens with a power of zero is called a plano lens. These lenses are used when one or both eyes do not require correction of a refractive error. Some people with good natural eyesight like to wear eyeglasses as a style accessory, or want to change the appearance of their eyes using novelty contact lenses.
Lens optical profile
Although corrective lenses can be produced in many different profiles, the most common is ophthalmic or convex-concave. In an ophthalmic lens, both the front and back surfaces have a positive radius, resulting in a positive/convergent front surface and a negative/divergent back surface. The difference in curvature between the front and rear surface leads to the corrective power of the lens. In hyperopia a convergent lens is needed; therefore, the convergent front surface overpowers the divergent back surface. For myopia the opposite is true: the divergent back surface is greater in magnitude than the convergent front surface. To correct for presbyopia, the lens, or section of the lens, must be more convergent or less divergent than the person's distance lens.
The base curve (usually determined from the profile of the front surface of an ophthalmic lens) can be changed to result in the best optic and cosmetic characteristics across the entire surface of the lens. Optometrists may choose to specify a particular base curve when prescribing a corrective lens for either of these reasons. A multitude of mathematical formulas and professional clinical experience has allowed optometrists and lens designers to determine standard base curves that are ideal for most people. As a result, the front surface curve is more standardized and the characteristics that generate a person's unique prescription are typically derived from the geometry of the back surface of the lens.
Bifocals and trifocals Bifocals and trifocals result in a more complex lens profile, compounding multiple surfaces. The main lens is composed of a typical ophthalmic lens. Thus the base curve defines the front surface of the main part of the lens while the back surface geometry is changed to achieve the desired distance power. The "bifocal" is a third spherical segment, called an add segment, found on the front surface of the lens. Steeper and more convergent than the base curve, the add segment combines with the back surface to deliver the person's near correction. Early manufacturing techniques fused a separate lens to the front surface, but modern processes cut all the geometry into a single piece of lens material. There are many locations, profiles, and sizes of add segments typically referred to as segment type. Some "seg type" examples include Flat top, Kryptok, Orthogon, Tillyer Executive, and Ultex A. Trifocals contain two add segments to achieve a lens that corrects the person's vision for three distinct distances.
The optical center of the add segment may be placed on the lens surface or may hang off into an empty space near the lens surface. Although the surface profile of a bifocal segment is spherical, it is often trimmed to have straight edges so that it is contained within a small region of the overall lens surface.
Progressive lens The progressive addition lens (PAL, also commonly called a no-line or varifocal lens) eliminates the line in bi/tri-focals and is very complex in its profile. PALs are a continuously variable parametric surface that begins using one spherical surface base curve and ends at another, with the radius of curvature continuously varying as the transition is made from one surface to the other. This shift in curvature results in different powers being delivered from different locations on the lens.
Vertex distance Vertex distance is the space between the front of the eye and the back surface of the lens. In glasses with powers beyond ±4.00D, the vertex distance can affect the effective power of the glasses. A shorter vertex distance can expand the field of view, but if the vertex distance is too small, the eyelashes will come into contact with the back of the lens, smudging the lens and causing annoyance for the wearer. A skilled frame stylist will help the wearer select a good balance of fashionable frame size with good vertex distance to achieve ideal aesthetics and field of view. The average vertex distance in a pair of glasses is 12-14mm. A contact lens is placed directly on the eye and thus has a vertex distance of zero.
Refractive index
In the UK and the US, the refractive index is generally specified concerning the yellow He-d Fraunhofer line, commonly abbreviated as nd. Lens materials are classified by their refractive index, as follows: Normal index: 1.48 ≤ < 1.54 Mid-index: 1.54 ≤ < 1.60 High-index: 1.60 ≤ < 1.74 Very high index: 1.76 ≤
This is a general classification. Often for marketing purposes, materials with values that are at or above 1.60 can be referred to as "high-index". Likewise, Trivex and other borderline normal / mid-index materials may be referred to as mid-index.
Advantages of higher indices Thinner, sometimes lighter lenses (See below). Improved UV protection over CR-39 and glass lenses.
Disadvantages of increased indices Lower Abbe number, meaning, amongst other things, increased chromatic aberration. Poorer light transmission and increased backside and inner-surface reflections (see Fresnel reflection equation), increasing the importance of anti-reflective coating.