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HomemicontactHard Science, Contemporary Questions

Hard Science, Contemporary Questions

Recognition that customised visual solutions can improve patient outcomes is driving innovation in Australia, New Zealand, and around the world.

The Journal, Ophthalmic & Physiological Optics (OPO) has, for almost 100 years, addressed basic and applied questions in vision science and optometry.

It’s good to see Australia and New Zealand continuing their leading role in contact lens research, development, and practise

In the January 2019 edition of OPO, a paper by Faria-Ribeiro and Gonzalez-Meijome – Multifocal contact lenses: towards customisation?,1 – asked whether “eyes with spherical aberration (SA) that deviates significantly from the average level, underperform when fitted with a simultaneous imaging contact lens (CL) with a power profile calculated for an ‘average eye’?” Furthermore, they asked if a customised bifocal CL can improve image quality in these eyes?

It’s an interesting question and one that has been asked by several other clinicians, researchers and manufacturers, who want to know whether customised fitting, power profiles, and myopia control lead to better visual outcomes.

Following complex optical modelling, Faria-Ribeiro and Gonzalez-Meijome write that the answer to their first question is “Yes”. Furthermore, they state, “Our findings suggest that visual performance at distance and near, when wearing bifocal CLs, can be improved by using a semicustomised approach”.


In the same issue, long time contributor and editorial board member, Emeritus Professor W. Neil Charman, delivers a pertinent editorial, “Pinholes and presbyopia: solution or sideshow?2 As expected, in his typically thorough manner, Neil investigates optical issues, depth of focus, visual acuity, illuminance, and pupil size, among other things. He also considers history, presbyopia, and the consumer/industry driven goals of ‘spectacle independence’. These in part, as we know, drive the evolution and development of small aperture intraocular lenses, corneal inlays, contact lenses, and pharmacological methods.

He concludes that, “the ‘pinhole’ approach, in its many variants, is neither a complete solution for the problems of presbyopia nor an over hyped irrelevance”. He goes on to say, “it offers useful improvements in vision to the emmetropic presbyope who wishes to be spectacle free and to be able to perform distance and near visual tasks which are reasonably well lit and are not too taxing”.

Neil adds, “there is a need for more work to be carried out at lower mesopic and scotopic levels to determine whether interocular differences in retinal illuminance and imagery then become more important.”

Any presbyope knows that if it’s dimly lit, turn up the light. This is because, as Neil states, “Near vision then improves through natural pupillary miosis and increased retinal illuminance”.


In the contact lens sphere, new players are making their presence felt with a variety of customised and off the shelf options for complex eyes, myopia control, torics, and multifocals. New scleral lens options will also become available this year.

It’s good to see Australia and New Zealand continuing their leading role in contact lens research, development, and practise. We can be proud of our academics, researchers, clinicians, and pioneers who continue to set the standards and contribute to groundwork in the international contact lens arena. Our custom laboratories are well respected with lenses manufactured to a very high standard for distribution around the world. Similarly, we increasingly see international specialist lens manufacturers, technology providers, educators, and trainers getting more involved in our markets.

Some of these people will be honoured at the 17th International Cornea and Contact Lens Congress3 in Noosa, from 11–13 October 2019. The programme is shaping up well with some amazing international and local presenters, and a great industry exhibition.

Contact lenses are not the only area of eye care in which Australia and New Zealand excel. Our profession is awash with giants and shining stars in vision research, ophthalmology, optometry, software, and related technology. I’ll continue to feature some of these people and technologies in future editions.


  1. https://onlinelibrary.wiley.com/doi/epdf/10.1111/opo.12597 
  2. https://onlinelibrary.wiley.com/doi/10.1111/opo.12594
  3. www.icclc2019.com.au