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Fitting of spectacles, except for aphakia; bifocal

CPT4 code

Name of the Procedure:

Fitting of Spectacles, except for aphakia; bifocal
Common Name: Bifocal glasses fitting
Technical/Medical Terms: Presbyopic correction, Bifocal lens fitting

Summary

This procedure involves fitting a pair of bifocal spectacles designed to correct presbyopia, a common age-related condition that affects near and distance vision. The glasses have two distinct optical powers, allowing wearers to see clearly at different distances.

Purpose

Medical Condition or Problem: Presbyopia or other vision issues that require both near and distance correction.
Goals/Expected Outcomes: To provide improved vision for activities requiring both near and distant focus, such as reading and driving, in a single pair of glasses.

Indications

Symptoms or Conditions: Blurred near vision, difficulty focusing on nearby objects, headaches or eye strain when reading.
Patient Criteria: Typically older adults diagnosed with presbyopia or individuals with refractive errors needing bifocal lenses.

Preparation

Pre-procedure Instructions: No specific preparation required for the patient.
Diagnostic Tests/Assessments: Routine eye examination, vision tests (refraction tests, near vision assessment).

Procedure Description

  1. Eye Examination: The optometrist conducts a comprehensive eye exam to determine the patient's precise prescription.
  2. Lens Selection: Based on the prescription, the optometrist selects the bifocal lens types.
  3. Frame Selection and Fitting: The patient selects the frame for their bifocals, and precise measurements of the eyes and face are taken to ensure proper fit.
  4. Lens Placement: The bifocal lenses are prepared and placed in the frame, incorporating the specific areas for distance and near vision.
  5. Adjustment and Alignment: Final adjustments are made to the glasses to ensure optimal comfort and vision.

Tools/Equipment Used: Phoropter for refraction, lensometers, PD rulers for pupillary distance measurement.
Anesthesia/Sedation: Not applicable.

Duration

The entire process typically takes about 1 to 2 hours, mainly for eye examination and frame selection.

Setting

Optometry clinic or optical store.

Personnel

Healthcare Professionals Involved: Optometrist, optician.

Risks and Complications

Common Risks: Initial discomfort while adjusting to bifocals, mild headache, or eye strain.
Rare Risks: Incorrect prescription, poorly fitted glasses, leading to persistent discomfort or vision issues.
Management: Follow-up appointments for adjustments, possible lens replacement.

Benefits

Expected Benefits: Clear vision for both near and distant tasks, reduction in eye strain, and improved quality of life.
Timeframe for Benefits: Most patients adjust to bifocals within a few days to weeks.

Recovery

Post-procedure Care: Regular use of glasses as prescribed, possible follow-up visits for adjustments.
Expected Recovery Time: Adjustment period usually ranges from a few days to a few weeks.
Restrictions/Follow-up: Minimal restrictions; follow-up if experiencing significant issues.

Alternatives

Other Treatment Options: Progressive lenses (no visible line), separate pairs of reading and distance glasses, contact lenses or surgical options like LASIK.
Pros and Cons of Alternatives: Progressive lenses offer a gradual transition between prescriptions but might be more expensive. Multiple pairs of glasses can be inconvenient.

Patient Experience

During the Procedure: No discomfort during the fitting process.
After the Procedure: Patients may experience mild discomfort as they adapt to new lenses, including slight headaches or visual distortions.
Pain Management and Comfort Measures: Inform the optometrist if discomfort persists; consider short breaks during initial wear periods.

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