Name of the Procedure:

Sphere, Bifocal, Plano to Plus or Minus 4.00d, per Lens (HCPCS Code: V2200)

Summary

This procedure involves creating and fitting bifocal lenses with spherical power ranging from plano (0.00) to plus or minus 4.00 diopters. Bifocal lenses help individuals see clearly at both near and far distances through two distinct optical powers embedded in a single lens.

Purpose

Primary purpose is to correct presbyopia, a condition common in individuals over 40 where near vision becomes blurry.

• Goals: Improve near and distance vision, reduce the need for multiple pairs of glasses.
• Expected Outcomes: Enhanced visual acuity at varying distances, increased convenience in daily activities.

Indications

• Symptoms: Difficulty reading or seeing objects up close, eye strain when performing close-up tasks.
• Conditions: Presbyopia, myopia, hyperopia, astigmatism.
• Patient Criteria: Typically older adults who require correction for both near and distance vision within a specified diopter range.

Preparation

• Pre-Procedure Instructions: Regular eye exam to determine prescription strength, discuss any existing eye conditions with ophthalmologist.
• Diagnostic Tests: Comprehensive eye exam including refraction assessment, fundus examination, and visual acuity tests.

Procedure Description

1. Ocular Measurement: The optometrist measures the patient's current vision prescription.
2. Lens Design: The optometrist designs bifocal lenses based on the patient’s needs.
3. Lens Manufacturing: The lenses are fabricated, incorporating two distinct optical powers.
4. Fitting: The lenses are fitted into a frame selected by the patient.
5. Final Adjustments: Adjustments are made to ensure optimal vision and comfort.

• Tools Used: Phoropter, lensometer, auto-refractor, fitting frames.
• Anesthesia or Sedation: Not applicable.

Duration

The entire procedure, including eye examination and fitting, typically takes about 1-2 hours over one or more appointments.

Setting

Performed in an optometrist’s office or optical clinic.

Personnel

• Primary Professionals: Optometrist.
• Support Staff: Optical technicians, receptionists for scheduling and coordination.

Risks and Complications

• Common Risks: Initial discomfort or adaptation period to bifocal lenses.
• Rare Risks: Incorrect prescription leading to headaches, visual blur, or eye strain.
• Complications Management: Follow-up appointments for readjustments, alternative lens designs if necessary.

Benefits

• Expected Benefits: Significant improvement in both near and distance vision, convenience of a single pair of glasses for multiple vision needs.
• Realization: Benefits are typically noticed immediately upon proper fitting and adjustment.

Recovery

• Post-Procedure Care: Regular follow-up appointments to ensure correct fitting and prescription.
• Recovery Time: Most patients adapt to bifocal lenses within a few days to weeks.
• Restrictions and Follow-Up: Regular eye exams and possible adjustments.

Alternatives

• Single Vision Glasses: Separate pairs for near and distance use.
• Progressive Lenses: No visible line bifocal lenses with a gradual change in lens power.
• Contact Lenses: Multifocal contacts designed for presbyopia.
• Pros and Cons:
  • Single Vision: Inconvenient to switch between pairs.
  • Progressive Lenses: Aesthetic appeal but sometimes harder to adjust to.
  • Contact Lenses: May offer broader field of vision but require proper hygiene.

Patient Experience

• During the Procedure: Minimal discomfort; mostly involves sitting for an eye exam and trying on frames.
• After the Procedure: Period of adjustment where vision may feel slightly off; minor discomfort as eyes adapt.
• Pain Management: Not typically necessary; comfort improves as patients get accustomed to the lenses.