Name of the Procedure:

Bifocal Segment Width Over 28 mm (HCPCS Procedure Code V2219)

Summary

Bifocal segment width over 28 mm refers to corrective lenses with a bifocal segment wider than 28 millimeters. These lenses help individuals with presbyopia, a condition where near vision deteriorates due to aging, by providing a wider field of view for close-up tasks.

Purpose

Medical Conditions:

• Presbyopia
• Complex vision issues needing a larger bifocal area

Goals/Outcomes:

• Enhanced near vision
• Reduced eye strain during close-up activities

Indications

• Difficulty reading or doing close-up work
• Patient needs clearer vision for activities like sewing or reading instruments
• Preference for larger bifocal segments to meet specific visual demands

Preparation

• Eye examination to determine bifocal prescription
• Measure for proper fit on eyeglasses
• Discuss lifestyle needs with the optometrist to determine appropriateness

Procedure Description

1. Eye Examination: Assess vision and determine the bifocal prescription.
2. Lens Selection: Choose lenses with a segment width over 28 mm.
3. Lens Fitting: Optometrist measures and fits the lenses into the selected frame.
4. Lens Fabrication: Lenses are custom-made at an optical lab.
5. Fitting: Optometrist ensures lenses are correctly aligned in the frame and fit comfortably on the face.

Tools:

• Auto-refractor
• Phoropter
• Lensometer

Anesthesia or Sedation:

• Not applicable

Duration

• Eye exam: Typically 30-60 minutes
• Lens fabrication: 1-2 weeks
• Final fitting: 15-30 minutes

Setting

• Optometrist's office
• Optical retail store

Personnel

• Optometrist
• Optical technician
• Eyewear specialist

Risks and Complications

• Initial discomfort or adaptation period
• Distorted vision if lenses are improperly fitted
• Headaches or eye strain from improperly aligned lenses

Benefits

• Improved near vision for reading and close-up tasks
• Enhanced comfort and reduced strain
• Immediate benefits upon adaptation, usually within a few days

Recovery

• Adaptation period typically takes a few days to a week
• Follow-up appointment if discomfort persists or vision needs adjustment

Alternatives

• Single vision reading glasses
• Progressive lenses with no visible bifocal line
• Contact lenses designed for presbyopia
• Pros: No line, adjustable vision ranges
• Cons: May require a longer adaptation period, can be more expensive

Patient Experience

• Initial adjustment to larger bifocal segments but generally comfortable after a few days
• Possible mild headache or eye strain during adaptation
• Clear vision for both near and distant tasks after adaptation
• Regular cleaning and care of lenses required