Progressive spectacle lenses more likely than bifocals

SAN DIEGO — Progressive-addition lenses are more likely than bifocals to improve mobility and balance in older people, according to a poster presentation at the American Academy of Optometry meeting here.

Carol Lakkis, OD, at the University of Melbourne, in Australia, said that progressive-addition lenses (PALs) are especially beneficial in the areas of dynamic postural stability and coordinated stability. She studied 20 full-time bifocal wearers who were at least 65 years old at baseline. All participants had a distance visual acuity of 20/30 or better in each eye. They had all worn bifocal lenses for at least 1 year, and all had active lifestyles as determined by the Physical Activity Scale for the Elderly.

Patients were assigned to wear either Essilor’s Definity or Varilux Comfort PALs; participants wore one lens for 3 weeks each, with a 2-week washout period. At each follow-up, patients were measured for high- and low-contrast distance and near visual acuity, postural sway and coordinated stability and walking speed.

Dynamic postural stability was significantly better with one of the PALs compared with bifocals; coordinated stability showed significant superiority with both PALs at 3 weeks compared with bifocals. No significant differences in walking speed were found between the two lens designs.

All patients opted to continue wearing PALs at the end of the study. At 3 months follow-up, 76% were wearing PALs full time, with the remainder splitting lens use between bifocals and PALs.