Enhanced Addition Contact Lens Pair for the Correction of Presbyopia, and Related Lens Pair System and Fitting Method - Patent application

Abstract

Enhanced addition contact lens pairs for the correction of presbyopia, as well as related enhanced addition contact lens pair systems and fitting methods. The optical zones of the enhanced addition contact lens pair are optimized as a binocular system so that the lens wearer experiences not only enhanced presbyopia-corrected near vision, such as that of near monocular vision, but also enhanced intermediate and distance vision. Enhanced presbyopia-corrected near vision is achieved through the central near optical zone of the central near non-dominant ocular lens, which has an add power and is optimized in diameter size based on expected pupil constriction. Enhanced intermediate distance vision through the transition optical zone in the enhanced addition contact lens pair emulates extended depth of focus (EDOF) through binocular addition and multifocality when the wearer is focusing on intermediate distance objects. Enhanced distance vision is achieved by light received through the enhanced addition contact lens pair when the wearer is focusing on distant distance objects, emulating so-called "partial monocular vision."

Description

[Technical Field]

[0001] (Priority application) This application claims the benefit of U.S. Provisional Patent Application No. 63 / 434,401, filed December 21, 2022, entitled "ENHANCED-SUMMATION CONTACT LENS PAIR FOR CORRECTION OF PRESBYOPIA, AND RELATED LENSES PAIR SYSTEMS AND FITTING METHODS," the disclosure of which is incorporated herein by reference in its entirety.

[0002] FIELD OF THE INVENTION The field of this disclosure relates to ophthalmic lenses useful for correcting presbyopia. [Background technology]

[0003] As individuals age, the eye's ability to accommodate or bend the eye's natural lens to focus on objects that are relatively close to the observer decreases. This condition is known as presbyopia. Presbyopia is the gradual loss of the eye's ability to focus on nearby objects. Similarly, in individuals whose natural lens has been removed (e.g., as a result of cataract surgery) and who have had an intraocular lens inserted as a replacement lens, there is no ability to accommodate. Presbyopia typically becomes noticeable in the early to mid-40s and continues to worsen until around age 65.

[0004] One method for correcting ocular dysaccommodative disorders is to use a monocular vision lens strategy. In monocular vision, a first monofocal lens is used to correct distance vision for the lens wearer's dominant eye. A second monofocal lens is then used to correct near vision for the lens wearer's non-dominant eye. This is illustrated in the example of FIGS. 1A and 1B. FIG. 1A illustrates monocular vision at a focus of a near object 100 (such as a book) greater than 2.5 diopters from a corrective lens pair 102: a first monofocal lens 104 ("first lens 104") for near vision correction for the lens wearer's non-dominant eye and a second monofocal lens 106 ("second lens 106") for distance vision correction for the lens wearer's dominant eye. In this example, the first lens 104 also has a +1.75 diopter add power for distance correction to correct presbyopia. FIG. 1B illustrates monocular vision at a focus of less than 0.25 diopters for a distance object 108 from a pair of corrective lenses 102. As shown in FIGS. 1A and 1B, a first lens 104 has a first power profile optimized for improved near vision. A second lens 106 has a second aspheric power profile optimized for improved distance vision. The aspheric power profile of the first lens 104 has an add paraxial power offset in diopters from the paraxial power in the second aspheric power profile of the second lens 106. This provides an add power in the first lens 104 relative to the second lens 106 to provide presbyopia correction in the first lens 104.

[0005] Thus, as shown in FIG. 1A, when an individual wearing the first lens 104 and the second lens 106 focuses on a near object, improved vision is achieved through the first lens 104 and its add power. However, as shown in FIG. 1B, when an individual wearing the first lens 104 and the second lens 106 focuses on a far object, improved vision is achieved through the second lens 106, which does not include add power. Advantages of the monocular lens pair strategy include good visual acuity and contrast for both far and near objects. Because a single-vision lens is used for each lens in the monocular lens pair, lens costs are reduced. Lens fitting is also less complicated. However, the monocular lens pair strategy is disadvantageous because it results in a loss of stereoscopic vision due to parallax between the add powers in the lenses for presbyopia. Because each lens 104, 106 in the corrective lens pair 102 is designed to achieve excellent near and far vision, respectively, the monocular may also have poorer intermediate distance vision performance.

[0006] Another known method for correcting presbyopia is to use bifocal or multifocal lenses on the patient-wearer's eyes. Multifocal lenses are designed with specific surface designs to achieve multiple optical focal lengths. Instead of multiple optical focal lengths, some multifocal lenses are designed with an extended depth of focus (EDOF), which "spreads" the focus along a wider range as a single elongated focus to improve the range of vision or depth of focus. In this regard, FIG. 2 illustrates how light received through a multifocal lens 200 designed with an extended depth of focus (EDOF) is focused over a wider range of elongated focuses 202. As shown in FIG. 2, light 204 received by the multifocal lens 200 is refracted and focused to a focal length that depends on the radial position within the multifocal lens 200. For example, the multifocal lens 200 may have an aspheric power profile. The power profile of the multifocal lens 200 is such that received light 204 is focused across an elongated focal point 202. Advantages of a multifocal lens strategy include reduced parallax in corrective power between lenses within a multifocal contact lens pair. Multifocal lenses may also have higher intermediate-distance vision performance because these lenses may have EDOFs with peak performance for objects focused at intermediate distances. However, multifocal lens designs typically trade off performance between distance, intermediate, and near vision. Therefore, the use of bifocal or multifocal lenses in both eyes may result in reduced visual acuity (i.e., image resolution) and image contrast at near vision compared to a monocular vision lens strategy.

[0007] Yet another method for treating presbyopia is to use a bifocal or multifocal lens in one eye and a single vision lens in the other eye. A drawback to using this method is the large number of lenses that must be considered to provide satisfactory vision for an individual. Summary of the Invention [Means for solving the problem]

[0008] Aspects disclosed herein include an enhanced addition contact lens pair for the correction of presbyopia. Related enhanced addition contact lens pair systems and fitting methods are also disclosed. The enhanced addition contact lens pair includes a central distance lens fitted to a patient-wearer's ("wearer's") dominant eye and a central near lens fitted to the wearer's non-dominant eye. The dominant eye is the eye that provides more signal input to the visual cortex of the individual's brain, while the non-dominant eye is the other eye that provides less signal input to the visual cortex of the individual's brain. The central distance lens and central near lens are fitted to the wearer's dominant and non-dominant eyes, respectively, based on refractive correction for distance vision. The optical zones of the enhanced addition contact lens pair are optimized and fitted to the wearer as a binocular system so that the wearer experiences enhanced presbyopia-corrected near vision, like that of near monocular vision, but also experiences enhanced intermediate distance vision and partial monocular distance vision through the multifocal effect from the lens pair.

[0009] Enhanced presbyopia-corrected near vision is achieved through a large monocular visual acuity (VA) disparity (e.g., approximately 2.5 diopters) between the dominant and non-dominant eyes of a wearer wearing a respective dominant eye central distance lens and a non-dominant eye central near lens. In the non-dominant eye central near lens, the central near optical zone of the non-dominant eye lens has a refractive correction power (if necessary) and an add power for presbyopia correction. The central near optical zone is also optimized in optical zone diameter size based on studies of constricted pupil size when a wearer focuses on near objects due to pupillary constriction. This optimized diameter of the central near optical zone provides an increased proportion of light received in the non-dominant eye pupil through the central near optical zone when the wearer focuses on near objects. Therefore, a higher monocular VA can be achieved in the non-dominant eye wearing a non-dominant eye central near lens. On the other hand, the dominant eye central distance lens has a central distance optical zone with refractive correction based on distance visual acuity. The central distance optical zone has an optical zone diameter size that can be smaller than that of the central near optical zone of the non-dominant central near lens. Therefore, when the wearer focuses on a near object due to pupil constriction, the dominant eye's pupil is only covered by the central distance optical zone of the dominant eye central distance lens. Therefore, the dominant eye wearing the central distance lens achieves a lower monocular VA than the non-dominant eye wearing the central near lens. This results in a larger monocular VA difference between the dominant and non-dominant eyes, which allows the enhanced addition lens pair to function as a monocular vision lens pair for enhanced presbyopia-corrected near vision. The individual's brain processes a higher VA focused image from light received primarily by the individual's non-dominant eye through the central near optical zone versus a significantly reduced VA image from light received by the individual's dominant eye through the central distance optical zone of the central distance dominant eye lens.

[0010] Enhanced intermediate-distance vision is achieved by binocular summation of light received through the transition optical zone in a pair of enhanced addition contact lenses when the wearer focuses on an intermediate-distance object. This emulates extended depth of focus (EDOF) through binocular summation and multifocality. At intermediate-distance vision (e.g., approximately 1.6 diopters), both the wearer's dominant eye, wearing a central distance dominant lens, and the non-dominant eye, wearing a central near non-dominant lens, use the EDOF effect from the transition optical zone of the lenses to achieve minimized monocular VA disparity, which is then summed by the wearer's brain to provide enhanced intermediate-distance vision.

[0011] Enhanced distance vision is achieved by light received through the enhanced addition contact lens pair when the wearer focuses on a distant object, emulating so-called "partial monocular vision." For distance vision, the patient's pupils dilate to a larger diameter size with a longer depth of focus in both the dominant and non-dominant eyes. Light received by the wearer's dominant and non-dominant eyes while wearing their respective central distance and near lens pairs contributes to distance vision. Because the dominant eye (wearing the dominant central distance lens) contributes more to distance vision than the non-dominant eye (wearing the non-dominant central near lens), only "weak" addition occurs for distance vision. This is defined as "partial monocular vision." Therefore, the non-dominant eye has poorer monocular image quality than the dominant eye. Therefore, "partial monocular vision" is defined as the weak binocular addition of (1) distance vision through the central distance optical zone in the dominant eye wearing a central distance lens, and (2) weak multifocality of light received through the transition optical zone of an enhanced addition contact lens, with the non-dominant eye's central near lens providing EDOF for distance vision. Because the transition optical zone of the enhanced addition contact lens pair is optimized for intermediate distance vision, the VA disparity of light received through the enhanced addition contact lens pair is greater for distance vision than for intermediate distance vision. For distance vision, the dominant eye wearing a central distance lens provides more vision correction than the weak EDOF effect provided by the non-dominant eye wearing a central near lens. This also means that the dominant eye has a smaller depth of focus (DOF) than the non-dominant eye.

[0012] In this regard, an exemplary embodiment provides a pair of enhanced addition contact lenses. The enhanced addition contact lens pair includes a central distance lens for a dominant eye of a contact lens wearer. The central distance lens comprises a central distance optical zone having a central distance zone diameter and a first power, disposed about a first optical axis, and a first transition optical zone surrounding the first central optical zone, the first transition optical zone having a first progressive power profile. The enhanced addition contact lens pair also includes a central near lens for a non-dominant eye of the contact lens wearer. The central near lens comprises a central near optical zone having a central near zone diameter and surrounding a second optical axis, the central near zone diameter having a second power that is at least +0.75 diopters of add relative to the first power, and a second transition optical zone surrounding the second central optical zone, the second transition optical zone having a second progressive power profile. The central distance zone diameter and the central near zone diameter are selected so that the contact lens pair including the central distance lens and the central near lens emulates monocular vision when the contact lens wearer is focusing on near distance objects, and the contact lens pair emulates partial monocular vision when the contact lens wearer is focusing on far distance objects. Furthermore, the first transition optical zone and the second transition optical zone are selected so that the contact lens pair emulates an EDOF lens through binocular addition when the contact lens wearer is focusing on intermediate distance objects.

[0013] In another exemplary embodiment, a strengthened addition contact lens pair is provided. The strengthened addition contact lens pair includes a central distance lens for a dominant eye of a contact lens wearer. The central distance lens comprises a central distance optical zone having a central distance zone diameter and a first power, disposed about a first optical axis, and a first transition optical zone surrounding the first central optical zone, the first transition optical zone having a first progressive power profile. The strengthened addition contact lens pair also includes a central near lens for a non-dominant eye of the contact lens wearer. The central near lens comprises a central near optical zone having a central near zone diameter targeted to an average pupil size of the population, surrounding a second optical axis, and having a second power that is an add power relative to the first power, and a second transition optical zone surrounding the second central optical zone, the second transition optical zone having a second progressive power profile.

[0014] The power profiles of the dominant eye central distance lens and the non-dominant eye central near lens can be customized based on design parameters, including pupillary constriction data and the expected spherical aberration that naturally occurs in an individual's ocular system when focusing on objects at different distances. For example, the diameter of the central near optical zone of the central near non-dominant ocular lens can be 2.6 millimeters (mm) to 4.0 mm. The diameter of the central distance optical zone of the central distance dominant ocular lens can be 1.8 mm to 3.8 mm. The power profiles of the dominant eye central distance lens and the non-dominant eye central near lens are also designed based on the desired corrective prescription for a given stock keeping unit (SKU) of lenses, as well as the desired add power for the central near optical zone of the central near non-dominant ocular lens for the correction of presbyopia.

[0015] Enhanced addition contact lens pair systems can also be provided that include multiple central near non-dominant ophthalmic lenses and central distance dominant ophthalmic lenses to provide optimal visual acuity for an individual. The enhanced addition contact lens pair system can include, for example, a central near non-dominant ophthalmic lens and a central distance dominant ophthalmic lens, including lenses with corrective prescription powers encompassing powers from -12.0 diopters to +9.0 diopters. The enhanced addition contact lens pair system can also include non-dominant ophthalmic lenses with effective add powers spanning an add power range of +0.75 diopters to +2.5 diopters, as another example for lenses made available with different add powers for a range of corrective powers. For example, an enhanced addition contact lens pair system may include a central near non-dominant ophthalmic lens including three add power profiles across the range of corrective powers provided, the three add power profiles being: (1) a non-dominant low add power profile including a central near zone diameter of 4.0 mm, a second transition optic zone having a second transition diameter of 4.0 mm to 6.0 mm, and an add power of +0.9 to +1.1 diopters; and (2) a 4.0 mm and (3) a non-dominant intermediate ADD profile including a central near diameter of 4.0 mm, a second transition optical zone having a second transition diameter of 4.0 mm to 6.0 mm, and an ADD power of +0.9 to +1.2 diopters. Above a diameter of 6.0 mm, for each of the non-dominant low ADD profile, intermediate ADD profile, and high ADD profile of the central near dominant ophthalmic lens, the lens power profile in this example is designed to correct the patient's distance refractive error, population mean ocular spherical aberration, and provide improved / optimized visual vision performance with larger pupil sizes (including the central and peripheral zones).

[0016] The enhanced addition contact lens pair system may also include a central distance dominant ophthalmic lens including three add power profiles across the range of corrective powers provided, the three add power profiles being: (1) a dominant low add power profile having a central distance zone diameter of 2.0 to 2.8 mm, the first transition optic zone having a first transition diameter greater than the central distance optic zone radius and a dominant add power of 0.1 to 0.4 diopters; and (2) a dominant medium add power profile having a central distance zone diameter of 2.4 to 3.8 mm. (2) a dominant intermediate add power profile having a first transition optical zone with a first transition radius larger than the central distance zone diameter and a dominant add power of 0.1 diopters to 0.4 diopters; and (3) a dominant high add power profile having a central distance zone diameter of 1.8 to 2.2 mm, having a first transition optical zone with a first transition radius larger than the central distance zone diameter and a dominant add power of 0.1 diopters to 0.4 diopters. Beyond the central portion of the transition zone (which may be a 1-2.2 mm diameter region), for each of the low, intermediate, and high add power profiles of the central distance dominant ophthalmic lens, the lens power profiles in this example are designed to correct the patient's distance refractive error, population mean ocular aberrations, and provide improved / optimized visual vision performance with larger pupil sizes (including the central and peripheral zones).

[0017] Other exemplary embodiments may also include an enhanced addition contact lens pair system. The enhanced addition contact lens pair system includes a plurality of central distance lenses for a contact lens wearer's dominant eye and a plurality of central near lenses for the contact lens wearer's non-dominant eye. Each of the plurality of central distance lenses may include a correction power spanning the range of refractive correction powers available for the correction of hyperopia or myopia. Each of the plurality of central near lenses may include a refractive correction power spanning the range of refractive correction powers available for the correction of hyperopia or myopia, and an add power for the correction of presbyopia. Each of the plurality of central distance lenses and the plurality of central near lenses may include any of the reference central distance lenses and reference central near lenses disclosed herein.

[0018] Other exemplary embodiments may also include a method of fitting a contact lens wearer with an enhanced addition contact lens pair of an enhanced addition contact lens pair system as described above and in the detailed description. The method may include a) selecting an add power for the contact lens wearer. The method may then include b) selecting a next enhanced addition contact lens pair for the contact lens wearer, wherein one central near lens of the plurality of central near lenses has a second power based on a refractive correction for the contact lens wearer's non-dominant eye and an add power for the contact lens wearer's presbyopia correction, and one central distance lens of the plurality of central distance lenses has a first power based on a refractive correction for the contact lens wearer's dominant eye. For example, the refractive correction for the contact lenses may be determined based on the patient's refractive correction needs when focusing on a 0.25 diopter distance object. The method may then include (c) receiving feedback from the contact lens wearer based on a perceived stereopsis based on a distance visual acuity difference between the contact lens wearer's dominant and non-dominant eyes when focusing on a distance object. The method may then include d) in response to the feedback indicating a reduction in stereopsis based on the distance visual acuity difference of the next enhanced addition contact lens pair, at least one of selecting a next central distance lens of the plurality of central distance lenses having a next first power increase for the contact lens wearer and selecting a next central near lens of the plurality of central near lenses having a next second power decrease for the contact lens wearer.

[0019] Additional features and advantages will be set forth in the detailed description that follows, and in part will become readily apparent to those skilled in the art from that description, or may be learned by practicing the embodiments described in the description and claims herein, and in the accompanying drawings.

[0020] It is to be understood that both the foregoing general description and the following detailed description are merely exemplary and are intended to provide an overview or framework for understanding the nature and character of the claims.

[0021] The accompanying drawings are included to provide a further understanding, and are incorporated in and constitute a part of this specification. The drawings illustrate one or more embodiments and, together with the description, serve to explain the principles and operation of the various embodiments. [Brief explanation of the drawings]

[0022] The above and other features and advantages of the present disclosure will be apparent from the following more particular description of preferred embodiments of the present disclosure, as illustrated in the accompanying drawings. [Figure 1A] FIG. 1 illustrates monocular vision provided by a pair of single focal lenses for near and far focused objects. [Figure 1B] FIG. 1 illustrates monocular vision provided by a pair of single focal lenses for near and far focused objects. [Figure 2] FIG. 1 is a diagram of an enhanced addition lens having an aspheric power profile that provides multifocality over different radial distances to provide an extended depth of focus (EDOF). [Figure 3] FIG. 1 is a schematic diagram of an exemplary enhanced addition contact lens pair including a central near non-dominant ocular lens and a central distance dominant ocular lens, each with optical zones optimized as a binocular system to provide excellent presbyopia-corrected near vision like that of monocular vision, but also with enhanced intermediate and distance vision through binocular addition and multifocality. [Figure 4A] FIG. 1 is a schematic diagram of an exemplary central distance dominant and central near non-dominant eye contact lens worn by a contact lens wearer, illustrating the relative diameters of the central distance and near optical zones and transition optical zones of the contact lens compared to the contact lens wearer's constricted pupil when focusing on a near object. [Figure 4B] FIG. 1 is a schematic diagram of an exemplary central distance dominant and central near non-dominant eye contact lens worn by a contact lens wearer, illustrating the relative diameters of the central distance and near optical zones and transition optical zones of the contact lenses compared to the contact lens wearer's dilated pupil when focusing on a distant object. [Figure 5] 4 illustrates exemplary sharpness and contrast improvements in distance, intermediate, and near vision for a contact lens wearer with a dominant eye-centered distance lens and a non-dominant eye-centered near lens, as in FIG. 3. [Figure 6A] FIG. 4 illustrates the enhanced presbyopia-correcting near monocular vision that a central distance lens in the dominant eye and a central near lens in the non-dominant eye, such as that of FIG. 3, can provide when a contact lens wearer of such lenses focuses on near objects. [Figure 6B] FIG. 4 illustrates partial monocular vision of distance vision by a contact lens wearer with a dominant eye-centered distance lens and a non-dominant eye-centered near lens, as in FIG. 3, when the contact lens wearer focuses on a distant object. [Figure 6C] FIG. 4 illustrates enhanced intermediate distance vision through binocular addition and multifocality by a contact lens wearer with a central dominant eye and a central near non-dominant eye lens, as in FIG. 3, when the contact lens wearer focuses on intermediate distance objects. [Figure 7] FIG. 1 illustrates conventional multifocality for higher sharpness and contrast intermediate distance vision compared to lower sharpness and contrast distance and near distance vision by a contact lens wearer of conventional central near-strengthened addition contact lenses. [Figure 8] FIG. 1 illustrates conventional monocular viewing of higher sharpness and contrast distance and near vision compared to lower sharpness and contrast intermediate vision by a contact lens wearer of conventional central near-strengthened addition contact lenses. [Figure 9]4 is a schematic diagram of the central distance-dominant eye lens and the central near-non-dominant eye lens of FIG. 3. [Figure 10A] 10 is a graph illustrating an exemplary power profile as a function of radius for a central distance dominant ophthalmic lens such as that of FIG. 9. [Figure 10B] 10 is a graph illustrating an exemplary power profile as a function of radius of a central near non-dominant eye lens such as that of FIG. 9 , and a graph illustrating a central near optical zone having a paraxial add power relative to a first power in the central distance optical zone of a central distance dominant eye lens such as that of FIG. [Figure 11] 4 is a graph illustrating exemplary visual acuity performance as a function of vergence for distance, intermediate, and near vision using a dominant eye central distance lens and a non-dominant eye central near lens, as in FIG. 3, compared to a conventional central near-powered addition lens. [Figure 12] FIG. 1 illustrates exemplary mean pupil diameter sizes and standard deviation and variability of pupil diameters based on pupil size studies of myopic and hyperopic subjects in photopic and mesopic conditions. [Figure 13A] 1 is a graph illustrating an exemplary dynamic pupil constriction model that models mean pupil diameter as a function of paraxial accommodation power. [Figure 13B] 13B is a graph illustrating an exemplary visual acuity (VA) as a function of vergence based on the dynamic pupil constriction model of FIG. 13A. [Figure 14] 4 illustrates a chart of exemplary actual add powers to the central near optical zone of a central near non-dominant ophthalmic lens such as that of FIG. 3 for correcting presbyopia in monocular vision. [Figure 15A] 4A-4C are power profiles of exemplary low, medium, and high add power profiles as a function of lens radius / diameter for a central near non-dominant eye lens such as that of FIG. 3 spanning a range of refractive correction powers to illustrate central near power profiles having paraxial low, medium, and high add powers in the central near optical zone and power profiles in the transition zone. [Figure 15B]4A-4C are power profiles of exemplary low, medium, and high add power profiles as a function of lens radius / diameter for a central near non-dominant eye lens such as that of FIG. 3 spanning a range of refractive correction powers to illustrate central near power profiles having paraxial low, medium, and high add powers in the central near optical zone and power profiles in the transition zone. [Figure 15C] 4A-4C are power profiles of exemplary low, medium, and high add power profiles as a function of lens radius / diameter for a central near non-dominant eye lens such as that of FIG. 3 spanning a range of refractive correction powers to illustrate central near power profiles having paraxial low, medium, and high add powers in the central near optical zone and power profiles in the transition zone. [Figure 15D] 4A-4C are exemplary respective low, medium, and high add power profiles as a function of lens radius / diameter for a central distance dominant ophthalmic lens such as that of FIG. 3 spanning a range of refractive correction powers. [Figure 15E] 4A-4C are exemplary respective low, medium, and high add power profiles as a function of lens radius / diameter for a central distance dominant ophthalmic lens such as that of FIG. 3 spanning a range of refractive correction powers. [Figure 15F] 4A-4C are exemplary respective low, medium, and high add power profiles as a function of lens radius / diameter for a central distance dominant ophthalmic lens such as that of FIG. 3 spanning a range of refractive correction powers. [Figure 16] 15A and 15D for a refractive correction of −3.0 diopters for various different diameters of the central near optical zone in a central near non-dominant eye lens and the central distance optical zone in a central distance dominant eye lens at pupil sizes (EPD) of 5.4, 4, and 3 millimeters (mm). [Figure 17] 1A-C are graphs illustrating exemplary binocular VA as a function of vergence between wearers for near, intermediate, and distance vision for a pair of enhanced addition contact lenses described herein compared to wearing Acuvue® presbyopic lenses with 4, 5.4, and 3 mm pupils. [Figure 18] 15B and 15E for a prescription correction of −3.0 diopters for various different diameters of the central near optical zone in a central near non-dominant eye lens and the central distance optical zone in a central distance dominant eye lens at 5.4, 4, and 3 mm pupil sizes (EPD). [Figure 19A] 1 is a graph illustrating exemplary binocular VA as a function of vergence for a pair of enhanced addition contact lenses described herein compared to wearing Acuvue® presbyopic lenses with pupils of 4, 5.4, and 3 mm. [Figure 19B] 1 is a graph illustrating exemplary binocular VA as a function of vergence for a pair of enhanced addition contact lenses described herein compared to wearing Acuvue® presbyopic lenses with pupils of 4, 5.4, and 3 mm. [Figure 19C] 1 is a graph illustrating exemplary binocular VA as a function of vergence for a pair of enhanced addition contact lenses described herein compared to wearing Acuvue® presbyopic lenses with pupils of 4, 5.4, and 3 mm. [Figure 20]15C and 15F for a prescription correction of −6.0 diopters for various different diameters of the central near optical zone in a central near non-dominant eye lens and the central distance optical zone in a central distance dominant eye lens at pupil sizes (EPD) of 5.4, 4, and 3 mm. [Figure 21A] 1 is a graph illustrating exemplary binocular VA as a function of vergence for a pair of enhanced addition contact lenses described herein compared to wearing Acuvue® presbyopic lenses with pupils of 4, 5.4, and 3 mm. [Figure 21B] 1 is a graph illustrating exemplary binocular VA as a function of vergence for a pair of enhanced addition contact lenses described herein compared to wearing Acuvue® presbyopic lenses with pupils of 4, 5.4, and 3 mm. [Figure 21C] 1 is a graph illustrating exemplary binocular VA as a function of vergence for a pair of enhanced addition contact lenses described herein compared to wearing Acuvue® presbyopic lenses with pupils of 4, 5.4, and 3 mm. [Figure 22A] 4 is a graph illustrating exemplary monocular VA as a function of vergence with large disparities in near and distance vision for an enhanced addition contact lens such as that of FIG. 3 for both the dominant and non-dominant eyes. [Figure 22B] 4 is a graph illustrating exemplary monocular VA as a function of parallax-reduced vergence in distance vision for an enhanced addition contact lens such as that of FIG. 3 for both the dominant and non-dominant eyes. [Figure 23]Graphs A-F show exemplary monocular VA as a function of vergence of the fit guide for a contact lens wearer wearing a dominant central distance lens and a non-dominant central near lens, as in FIG. 3, for both the dominant and non-dominant eyes. Graphs illustrating the reduction in disparity, which is the VA difference at distance, in VA as a function of incrementally changing refractive power for the central distance dominant lens and the central near non-dominant lens, respectively. [Figure 24] 1 is a flowchart illustrating an exemplary process for fitting a contact lens wearer with an enhanced addition contact lens pair of an enhanced addition contact lens pair system, the enhanced addition contact lens pair including a plurality of central distance dominant and central near non-dominant ophthalmic lenses, as in FIG. 3 or as otherwise described in any other aspect relating to different corrective prescriptions and effective add powers, to arrive at an optimized selection of central distance dominant and central near non-dominant ophthalmic lenses for a contact lens wearer with improved VA and near, intermediate and distance vision. DETAILED DESCRIPTION OF THE INVENTION

[0023] Aspects disclosed herein include an enhanced addition contact lens pair for the correction of presbyopia. Related enhanced addition contact lens pair systems and fitting methods are also disclosed. The enhanced addition contact lens pair includes a central distance lens fitted to a patient-wearer's ("wearer's") dominant eye and a central near lens fitted to the wearer's non-dominant eye. The dominant eye is the eye that provides more signal input to the visual cortex of the individual's brain, while the non-dominant eye is the other eye that provides less signal input to the visual cortex of the individual's brain. The central distance lens and central near lens are fitted to the wearer's dominant and non-dominant eyes, respectively, based on refractive correction for distance vision. The optical zones of the enhanced addition contact lens pair are optimized and fitted to the wearer as a binocular system so that the wearer experiences enhanced presbyopia-corrected near vision, such as near monocular vision, but also experiences enhanced intermediate and partial monocular distance vision through the multifocal effect from the lens pair.

[0024] Enhanced presbyopia-corrected near visual acuity is achieved through a large monocular visual acuity disparity (e.g., approximately 2.5 diopters) between the dominant and non-dominant eyes of a wearer wearing a respective dominant eye central distance lens and a non-dominant eye central near lens. In the non-dominant eye central near lens, the central near optical zone of the non-dominant eye lens has a refractive correction power (if necessary) and an add power for presbyopia correction. The central near optical zone is also optimized in optical zone diameter size based on studies of constricted pupil size when a wearer focuses on near objects due to pupillary constriction. This optimized diameter of the central near optical zone provides an increased proportion of light received in the non-dominant eye pupil through the central near optical zone when the wearer focuses on near objects. Therefore, a higher monocular VA can be achieved in the non-dominant eye wearing a non-dominant eye central near lens. On the other hand, the dominant eye central distance lens has a central distance optical zone with refractive correction based on distance visual acuity. The central distance optical zone has an optical zone diameter size that can be smaller than that of the central near optical zone of the non-dominant central near lens. Therefore, when the wearer focuses on a near object due to pupil constriction, the dominant eye's pupil is only covered by the central distance optical zone of the dominant eye central distance lens. Therefore, the dominant eye wearing the central distance lens achieves a lower monocular VA than the non-dominant eye wearing the central near lens. This results in a larger monocular VA difference between the dominant and non-dominant eyes, which allows the enhanced addition contact lens pair to function as a monocular vision lens pair for enhanced presbyopia-corrected near vision.

[0025] Enhanced intermediate-distance vision is achieved by binocular summation of light received through the transition optical zone in a pair of enhanced addition contact lenses when the wearer focuses on intermediate-distance objects. This emulates extended depth of focus (EDOF) through binocular summation and multifocality. At intermediate-distance vision (e.g., approximately 1.6 diopters), both the wearer's dominant eye, wearing a central distance dominant lens, and the non-dominant eye, wearing a central near non-dominant lens, use the EDOF effect from the transition optical zone of the lenses to achieve minimized monocular VA disparity, which is then summed by the wearer's brain to provide enhanced intermediate-distance vision.

[0026] Enhanced distance vision is achieved by light received through the enhanced addition contact lens pair when the wearer focuses on a distant object, emulating so-called "partial monocular vision." For distance vision, the patient's pupils dilate to a larger diameter size with a longer depth of focus in both the dominant and non-dominant eyes. Light received by the wearer's dominant and non-dominant eyes while wearing their respective central distance and near lens pairs contributes to distance vision. Because the dominant eye (wearing the dominant central distance lens) contributes more to distance vision than the non-dominant eye (wearing the non-dominant central near lens), only "weak" addition occurs for distance vision. This is defined as "partial monocular vision." Therefore, the non-dominant eye has poorer monocular image quality than the dominant eye. Therefore, "partial monocular vision" is defined as the weak binocular addition of (1) distance vision through the central distance optical zone in the dominant eye wearing a central distance lens, and (2) the weak multifocality of light received through the transition optical zone of an enhanced addition contact lens pair, with the non-dominant eye's central near lens providing the EDOF for distance vision. Because the transition optical zone of the enhanced addition contact lens pair is optimized for intermediate distance vision, the VA mismatch of light received through the enhanced addition contact lens pair is greater for distance vision than for intermediate distance vision. For distance vision, the dominant eye wearing a central distance lens provides more vision correction than the weak EDOF effect provided by the non-dominant eye wearing a central near lens. This also means that the dominant eye has a smaller depth of focus (DOF) than the non-dominant eye.

[0027] In this regard, FIG. 3 is a schematic diagram of an exemplary reinforced addition contact lens pair 300 (also referred to as "contact lens pair 300") for correcting presbyopia. The reinforced addition contact lens pair 300 includes a central distance dominant eye contact lens 302 (also referred to as "central distance lens 302") and a central near non-dominant eye contact lens 304 (also referred to as "central near lens 304") that can be worn in the respective dominant and non-dominant eyes of a contact lens wearer ("wearer"). The contact lenses 302, 304 provide multifocality with presbyopic correction for near vision. The central distance dominant eye lens 302 is designed to fit the wearer's dominant eye, and the central near lens 304 is designed to fit the wearer's non-dominant eye. The dominant eye is the eye that provides more signal input to the visual cortex of the individual's brain. The non-dominant eye is the individual's other eye that provides less signal input to the visual cortex of the individual's brain. As discussed in more detail below, the optical zones of the enhanced addition contact lens pair 300 are optimized and fitted to the wearer as a binocular system so that the wearer experiences not only enhanced presbyopia-corrected near vision as with monocular vision, but also enhanced intermediate distance vision through binocular addition and enhanced distance vision with partial monocular vision.

[0028] 3, in this embodiment, a central distance lens 302 for a contact lens wearer's dominant eye has a central distance optical zone 306 disposed about a first optical axis A1. As discussed in more detail below, the central distance optical zone 306 has a central distance zone diameter D that is optimized based on the expected pupil dilation when the wearer focuses on far-distance objects (e.g., 0.25 diopters) and intermediate-distance objects (e.g., 1.6 diopters). CFZThe central distance optical zone 306, in this example, has a first power selected to correct the refractive correction for distance vision of the wearer's dominant eye according to the prescription for the wearer's dominant eye. The central distance optical zone 306 may be spherical or have some target spherical aberration depending on the corrective first power in the central distance optical zone 306. The central distance lens 302 also includes one or more transition optical zones 308(1)-306(3), each of which has a different radius R outside the central distance optical zone 308 relative to the first optical axis A1 of the central distance lens 302. CF The central distance lens 302 includes a respective refractive correction power profile for correcting light rays ("light") passing through the central distance lens 302, which is a distance between the central distance and the first transition optical zone 308(1). For example, each transition optical zone 308(1)-308(3) may have a progressive power profile that provides the wearer with overall multifocality as a function of focused object distance. In this example, the power profiles of the first transition optical zone 308(1) and the second transition optical zone 308(2) provide a discontinuous change in power or a discontinuous derivative change at each transition to the second transition optical zone 308(2) and the third transition optical zone 308(3). Alternatively, the central distance lens 302 may have a single transition optical zone surrounding the central distance optical zone 306 and having a continuous power profile power. In this example, the first transition optical zone 308(1) surrounds the central distance optical zone 306. A second transition optical zone 308(2) surrounds the first transition optical zone 308(1). A third transition optical zone 308(3) surrounds the second transition optical zone 308(2) and extends to the lens edge 310 of the central distance lens 302. The central distance lens 302 has an overall central distance diameter D from the first optical axis A1 to the lens edge 310. CF It has.

[0029] 3, in this embodiment, the central near lens 304 for the contact lens wearer's non-dominant eye has a central near optical zone 312 disposed about a second optical axis A2. As discussed in more detail below, the central near optical zone 312 has a central near zone diameter D that is optimized based on expected pupil constriction when the wearer focuses on near distance objects (e.g., to 2.5 diopters). CNZ The central near optical zone 312, in this example, has a second power selected to correct the design refractive correction for distance vision of the wearer's non-dominant eye according to the prescription for the non-dominant eye. The central near optical zone 312 may be spherical or have some target spherical aberration depending on the correction power in the central near optical zone 312. Also, in this example, the central near optical zone 312 also has an effective add power (e.g., an add power of at least +0.75 diopters) that is added to its label power to provide correction for presbyopia in the wearer's non-dominant eye. Effective add refractive power refers to the add power to the labeled power of the lens. The add power provides the lens wearer with an effective add power for the correction of presbyopia. The central near lens 304 also includes one or more transitional optical zones 314(1)-314(3), each of which has a different radius R outside the central near optical zone 312 relative to the second optical axis A2 of the central near lens 304. CNThe central near lens 304 includes a respective corrective power profile for focusing light through the central near lens 304 at a distance equal to or greater than the distance to an object focused on by the wearer. For example, each transition optical zone 314(1)-314(3) may have a continuous progressive power profile that provides overall multifocality as a function of the distance to an object focused on by the wearer. In this example, the power profile of the first transition optical zone has a derivative change in power at each transition to the second transition optical zone 314(2). A derivative change in the power profile means that the power profile has a derivative that is not a continuous function. Alternatively, the central near lens 304 may have a single transition optical zone surrounding the central near optical zone 312 and having a continuous power profile power. In this example, the first transition optical zone 314(1) surrounds the central near optical zone 312. The second transition optical zone 314(2) surrounds the first transition optical zone 314(1). The third transition optic zone 314(3) surrounds the second transition optic zone 314(2) and extends to the lens edge 316 of the central near lens 304. The central near lens 304 has an overall central near diameter D from the second optical axis A2 to the lens edge 316. CN It has.

[0030] As will be discussed in more detail below, enhanced presbyopia-corrected near vision is achieved through a large monocular visual acuity (VA) disparity (e.g., about 2.5 diopters) in near vision between the wearer's dominant and non-dominant eyes wearing the respective central distance lens 302 and central near lens 304. As will be discussed in more detail below, the central near zone diameter D CNZ is optimized for near vision. Central near zone diameter D CNZ and its refractive correction power is designed so that when the contact lens wearer is focusing on near objects (e.g., ≧2.5 diopters), the enhanced addition contact lens pair 300 emulates monocular vision in the wearer's non-dominant eye for enhanced presbyopia-corrected near vision. The enhanced addition contact lens pair 300 has a central near zone diameter D of the central near optical zone 312 in the non-dominant eye.CNZ is specifically designed to more closely match the diameter of the wearer's pupil when constricted during near distance viewing when pupillary constriction occurs, thus emulating the wearer's monocular vision for near distance viewing. Enhanced presbyopia-corrected near vision is achieved through the central near optical zone 312 of the central near non-dominant ophthalmic lens 304 having an add power, and having a central near zone diameter D CNZ is optimized in size based on the estimated diameter size of the constricted pupil when the wearer focuses on a near object (e.g., to 2.5 diopters) due to pupil constriction. This optimized central near zone diameter D of the central near optical zone 312 CNZ provides an increased proportion of light received in the non-dominant eye pupil through the central near optical zone 312 when the wearer focuses on near objects, thereby achieving a higher monocular VA in the non-dominant eye wearing the central near lens 304.

[0031] On the other hand, the central distance zone diameter D of the central distance optical zone 306 of the central distance lens 302 CFZ is the central near optical zone D of the non-dominant central near lens 304 CNZ Therefore, due to pupil constriction, when the wearer focuses on a near object, the dominant eye's pupil is covered only by the central distance optical zone 306 of the central distance lens 302 of the dominant eye and receives light through it. Therefore, a lower monocular VA is achieved in the dominant eye wearing the central distance lens 302 than is achieved in the non-dominant eye wearing the central near lens 304. This results in a larger monocular VA difference between the dominant and non-dominant eyes, which allows the enhanced addition lens pair 300 to operate as a monocular vision lens pair for enhanced presbyopia-corrected near vision. The larger monocular VA difference between the dominant and non-dominant eyes triggers the wearer's brain to use the image in the non-dominant eye.

[0032] Additionally, as discussed in more detail below, the transition optical zones 308(1)-308(3), 314(1)-314(3) of the central distance lens 302 and the central near lens 304, respectively, are selected to emulate EDOF lenses such that the enhanced addition contact lens pair 300 provides EDOF through binocular addition and multifocality when the contact lens wearer is focusing on intermediate distance objects (e.g., 1.0-2.0 diopters, e.g., 1.6 diopters). EDOF is the creation of a single elongated focus, rather than several focuses, to enhance depth of focus. Enhanced intermediate distance vision is achieved through the binocular addition and multifocality of light received through the transition optical zones 308(1)-308(3), 314(1)-314(3) of the respective contact lenses 302, 304 of the enhanced addition contact lens pair 300 when the wearer is focusing on intermediate distance objects. For intermediate distance vision, both the wearer's dominant eye, wearing the central distance dominant eye lens 302, and the non-dominant eye, wearing the central near non-dominant eye lens 304, use the EDOF effect from the transition optical zones 308(1)-308(3), 314(1), 314(3) of lenses 302, 304, respectively, to achieve minimized monocular VA disparity rather than that summed by the wearer's brain, providing enhanced intermediate distance vision.

[0033] Additionally, as discussed in more detail below, when the lens wearer is focusing on a distant object (e.g., ≦0.25 diopters), the enhanced addition contact lens pair 300 emulates what is called “partial monocular vision.” For distance vision, the patient's pupils dilate to a larger diameter size with a longer depth of focus in both the dominant and non-dominant eyes. Light received by the wearer's dominant and non-dominant eyes while wearing the respective central distance lens 302 and central near lens 304 contributes to distance vision. Because the dominant eye wearing the dominant central distance lens 302 contributes more to distance vision than the non-dominant eye wearing the non-dominant central near lens 304, only “weak” addition occurs for distance vision. This is defined as “partial monocular vision.” As a result, the non-dominant eye has worse monocular image quality than the dominant eye. Thus, "partial monocular vision" is defined as weak binocular addition of (1) distance vision through the central distance optical zone 306 in the dominant eye wearing the dominant eye's central distance lens 302, and (2) weak multifocality of light received through the transition optical zones 308(1)-308(3), 314(1)-314(3) of the enhanced addition contact lens pair 300, where the non-dominant eye's central near lens 304 provides the EDOF for distance vision. The transition optical zones 308(1)-308(3), 314(1)-314(3) of the enhanced addition contact lens pair 300 are optimized for intermediate distance vision, resulting in a greater disparity in the VA of light received through the enhanced addition contact lens pair 300 for distance vision than for intermediate distance vision. For distance vision, the dominant eye wearing the central distance lens 302 provides more vision correction than the weak EDOF effect vision correction provided by the non-dominant eye wearing the central near lens 304. This also means that the dominant eye has a smaller depth of focus (DOF) than the non-dominant eye. However, the central distance central optical zone 306 of the central distance dominant eye lens 302 contributes to excellent distance vision through distance monocular vision.

[0034] With continued reference to FIG. 3, and with reference to FIGS. 4A-8, a more exemplary discussion of an enhanced addition contact lens pair 300 providing enhanced near, intermediate, and distance vision is provided below.

[0035] In this regard, and with continued reference to FIG. 3, as discussed above, for a pair of enhanced addition contact lenses 300 for providing enhanced near vision, the central near zone diameter D of the central near optical zone 312 (having an add power for the correction of presbyopia) is CNZ is optimized. The central near zone diameter D of the central near optical zone 312 CNZ is sized based on the estimated diameter size of the constricted pupil when the wearer focuses on a near object (e.g., at 2.5 diopters). CNZ is increased compared to conventional multifocal lenses to approximate the mean or mean diameter of an individual's pupil based on expected pupil constriction, lighting conditions, and / or as a spherical aberration that naturally occurs in the individual's ocular system when focusing on near objects to achieve good near vision, such as monocular vision. For example, as discussed in more detail below, the central near zone diameter D of the central near optical zone 312 CNZ may be sized to a diameter of 2.6-4.0 mm based on pupillary constriction studies of the average or mean diameter size of the pupil when focusing on near objects (e.g., ≥ 2.5 diopters) and based on different lighting conditions. CNZ Optimizing the central near zone diameter D of the central near lens 304 takes advantage of the fact that the pupil constricts when the eye focuses on objects at closer distances due to pupillary constriction. CNZBecause the diameter of the wearer's pupil is sized to more closely match the size of the central near optical zone 312 when focusing on near objects, there will be no, or less, light passing through the transition optical zones 314(1)-314(3) of the central near lens 304 to reach the pupil of the wearer's non-dominant eye as it passes through the central near optical zone 312. This is shown by way of example in Figure 4A, which is a schematic diagram of the dominant eye central distance contact lens 302 and non-dominant eye central near contact lens 304 of Figure 3 worn by an exemplary contact lens wearer when focusing on near objects.

[0036] As shown in FIG. 4A, when the wearer is focusing on a near object, the diameters D of the non-dominant eye pupil 400 and the dominant eye pupil 404 of the wearer's non-dominant eye 402 and dominant eye 406, respectively, are PN The central near zone diameter D of the central near optical zone 312 is CNZ The size (e.g., 2.6 to 4.0 mm) is determined based on the contraction diameter D of the wearer's non-dominant eye pupil 400 at near vision (e.g., ≥ 2.5 diopters). PN This design of the central near lens 304 provides a constricted non-dominant pupil 400 such that when the wearer focuses on near objects, all or most of the light is received through the central near optical zone 312. This allows the enhanced addition contact lens pair 300 to emulate monocular vision at near distances with higher VA and higher contrast because (1) either all or most (in this example) of the light received by the constricted non-dominant pupil 400 focusing on near objects is received through the central near optical zone 312, which corrects for near distance vision, and (2) either all or most (in this example) of the light received by the constricted dominant pupil 404 focusing on near objects is received through the central distance optical zone 306, which is corrected for distance vision. The central near optical zone 312 not only has refractive correction power for the wearer, but also has add power for presbyopia correction.

[0037] 4A, in near vision, more light is received by the constricted dominant pupil 404 through the transition zone 308 of the central distance lens 302 than by the constricted non-dominant pupil 400 through the transition zone 314 of the central near lens 304. This is due to the central near zone diameter D of the central near optical zone 312. CNZ The mean contraction diameter of the non-dominant eye pupil is D PN 1A , for example, from near distance monocular vision provided by a monocular vision lens for near vision as shown in FIG. 1A . This is because the wearer's brain will process a higher VA focused image from light received primarily by the wearer's non-dominant eye 402 through the central near optical zone 312 of the central near lens 304 rather than a reduced VA image from light received by the wearer's dominant eye 406 through the central distance optical zone 306 of the central distance lens 302.

[0038] This is also shown in Figure 5, where a wearer of the enhanced addition contact lens pair 300 experiences high VA and high contrast in images from near vision through the central near non-dominant ocular lens 304, as indicated by the high VA and contrast letters shown as "near letters" therein. This is also shown in Figure 6A, which shows the wearer focusing (e.g., at 2.5 diopters) on a near object 600 through the central distance lens 302 and central near lens 304 in the wearer's respective dominant eye 406 and non-dominant eye 402. This is contrasted with Figure 7, which shows exemplary lower VA and lower contrast for near vision, as indicated by the "near letters," for a conventional multifocal contact lens pair without a central distance dominant, central near non-dominant ocular lens design. 4A, the central distance lens 302 does not provide the wearer with high VA and high contrast images for near vision because the central distance optical zone 306 of the central near lens 304 does not have the add power provided in the central near optical zone 312 of the central near lens 302 in this example. Note that it is possible to provide some add power in the central distance optical zone 306 of the central distance lens 302, if desired. A significant VA difference between the dominant and non-dominant eyes causes the lens pair to function monocularly for near vision.

[0039] Referring now to FIG. 4B, when the wearer is focusing on a far-distance object (e.g., ≦25 diopters), the wearer's pupils 400, 404 will have a dilated pupil diameter D due to pupillary constriction. PF For distance vision, the patient's pupils dilate to a larger diameter size with a longer depth of focus in both the dominant and non-dominant eyes. The dilated pupil diameter D of the dilated pupils 400, 404 of the non-dominant eye 402 and dominant eye 406 is PF is the central near zone diameter D of the central near optical zone 312 and the central distance optical zone 306 of the central near lens 304 and the central distance lens 302, respectively. CNZ and central distance zone diameter D CFZis much greater than 0.25 diopters. Therefore, when the wearer is focusing on a distant object (e.g., ≦0.25 diopters), some light received by the dominant eye pupil 404 passes through the central distance optical zone 306 of the central distance lens 302. As previously discussed, the central distance optical zone 306 of the central distance lens 302 has a first power for vision correction at an optimized distance (e.g., 0.25 diopters). This central distance optical zone 306 provides distance correction for enhanced distance vision, such as distance monocular vision (defined as “partial monocular vision”). This is also illustrated in FIG. 5, where the wearer of the contact lens pair 300 experiences high VA and high contrast in images from distance vision through the central distance dominant eye lens 302, as indicated by the high VA and contrast letters labeled “Distance Letters” therein. This is also illustrated in Figure 6B, which shows the wearer focusing (e.g., at 0.25 diopters) on a distance object 602 through the central distance lens 302 and central near lens 304 in the wearer's respective dominant eye 406 and non-dominant eye 402. This is contrasted with Figure 7, which shows exemplary lower VA and lower contrast for distance vision, as indicated by the "distance lettering," for a conventional multifocal contact lens pair without a central distance dominant, central near non-dominant lens design.

[0040] However, as also shown in Figure 4B, when the wearer focuses on a distant object such that the dominant pupil 404 is dilated, light is also received by the dominant pupil 404 and the non-dominant pupil 400 through those transition optical zones 308, 314 of the central distance lens 302 and central near lens 304, respectively. More light is received by the dominant pupil 404 and the non-dominant pupil 400 through those transition optical zones 308, 314 of the central distance lens 302 and central near lens 304 than is received when the wearer's dominant pupil 404 and non-dominant pupil 400 are constricted while focusing on a near object. This also provides a higher VA and higher contrast image at distant distances through partial monocular vision, as previously discussed above. This is because, as discussed above, when a wearer focuses on a distant object, light is received through the central distance optical zone 306 in the form of long-distance monocular vision, while multifocal light is also received through the transition optical zones 308, 314 of the lens pair 300 in the EDOF. This light received through the central distance optical zone 306 of the central distance lens 302 and from the transition optical zones 308, 314 of the central distance lens 302 and central near lens 304 is combined by the wearer's brain to provide a summed image of enhanced distance vision to provide partial monocular vision (binocular summation). The wearer's brain can combine the higher VA and high contrast light received through the central distance optical zone 306 of the central distance lens 304 and the light in the EDOF received through the transition optical zones 308, 314 of the central distance and central near lenses 302, 304 to provide an image with high VA and contrast. This is also shown in Figure 5, where a wearer of contact lens pair 300 experiences high VA and high contrast in images from distance vision through monocular vision through central distance lens 302, as indicated by the high VA and contrast text shown as "distance text" therein.This is also shown in Figure 5, where the wearer of contact lens pair 300 experiences high VA and high contrast in images from intermediate distance vision through the EDOF provided by the multifocality of the central distance lens 302 and central near lens 304, as indicated by the high VA and high contrast text shown as "middle text" therein. This is also shown in Figures 6B and 6C, which show the wearer focusing on a distance object 602 (e.g., at 0.25 diopters) and an intermediate distance object 604 (e.g., at 1.5 diopters) through the central distance lens 302 and central near lens 304 of the wearer's respective dominant eye 406 and non-dominant eye 402, respectively. This is contrasted with FIG. 8, which shows exemplary lower VA and lower intermediate distance visual acuity contrast, as indicated by the "middle letter," for a conventional monocular lens pair strategy that does not use an enhanced addition lens or a central distance dominant enhanced addition lens, central near non-dominant enhanced addition lens design, such as that shown in enhanced addition contact lens pair 300 of FIG. 3.

[0041] Also, in the embodiment of the enhanced addition contact lens pair 300 of Figure 3, enhanced intermediate distance vision is achieved through binocular addition and multifocality based on optimizing the transition optical zones 308, 314 in both the central distance dominant eye lens 302 and the central near non-dominant eye lens 304 so that the contact lens pair 300 provides EDOF. In this regard, when the non-dominant eye 402 and dominant eye 406 shown in Figures 4A and 4B focus on an intermediate distance object, the pupils 400, 404 of both the dominant eye 402 and non-dominant eye 406 dilate to a diameter that receives a significant amount of light within the EDOF through the transition optical zones 308, 314 of both the central distance lens 302 and central near lens 304. Furthermore, when the wearer focuses at intermediate distances, the light received through these transition optical zones 308, 314 of the central distance lens 302 and central near lens 304 also has reduced parallax in VA (i.e., reduced stereopsis) to improve intermediate distance vision. This is also due, in part, to the fact that the non-dominant eye pupil 400 has a larger central near zone diameter DCNZ a larger central distance zone diameter D of the central near optical zone 312 of the central near lens 304 than is received by the central distance optical zone 306 of the central distance lens 302 having CFZ This is because the central distance lens 302 receives less light through its transition optical zone 314 due to the reduced disparity in VA of the light received by both lenses 302, 304. The size of the transition zone 308 of the central distance lens 302 is increased to allow an increased amount of light to be received through the transition zone 308 of the central distance lens 302 to further reduce the disparity in VA of the light received by both lenses 302, 304. This provides the wearer with a reduced disparity in VA of the image from the light received through the central distance lens 302 and central near lens 304 of the lens pair 300. When the wearer focuses at intermediate distances, the received light with reduced disparity in VA can be more easily summed by the wearer's brain for the higher VA to provide improved binocular summation at intermediate distances over conventional monocular vision lens pairs. The individual's brain can more easily and effectively process the sum image in the dominant eye 406 and non-dominant eye 402 with reduced disparity in VA to provide an image with improved clarity and contrast of intermediate distance objects.

[0042] This is also shown in Figure 5, where a wearer of contact lens pair 300 experiences high VA and high contrast in images from intermediate distance vision through binocular addition through central distance lens 302 and central near lens 304, as indicated by the high VA and high contrast letters shown as "middle letters" therein. Contrast this with Figure 8, which shows exemplary lower VA and lower contrast for intermediate distance vision, as indicated by the "middle letters," for a traditional monocular lens pair strategy that does not use an added lens or a central distance dominant added lens, central near non-dominant added lens design, as shown in enhanced addition contact lens pair 300 of Figure 3. As shown in Figure 5, the central distance lens 302 fitted to the dominant eye provides distance and intermediate vision correction when used alone, but does not provide near vision correction or sufficient correction. Similarly, the central near lens 304 fitted to the non-dominant eye provides near and intermediate vision correction, but does not provide distance vision correction or sufficient correction.

[0043] More exemplary details of an enhanced addition contact lens pair including a central distance dominant lens and a central near non-dominant lens, such as enhanced addition contact lens pair 300 of Figure 3, optimized and fitted to a wearer as a binocular system so that the wearer experiences excellent presbyopia-corrected near vision like that of monocular vision, but also enhanced intermediate distance vision through binocular addition and distance vision through partial monocular vision, will now be described with respect to Figures 9-22B. Figures 23A-24 will then be considered as an exemplary process of fitting an enhanced addition contact lens pair into an enhanced addition contact lens pair system including multiple enhanced addition contact lens pairs to provide a contact wearer with improved VA, and near, intermediate, and distance vision.

[0044] 10A and 10B are graphs 1000 and 1002 illustrating exemplary normalized power profiles 1004 and 1006, normalized without adding any corrective prescription, as a function of radius for the central distance-dominant ophthalmic lens 302 and the central near-non-dominant ophthalmic lens 304, respectively, of FIG. 3. Normalized power means that the lens label refractive correction power is subtracted. Note that in the actual power profile of the lens for a patent, any refractive correction power is included in the power profile. In FIG. 9, for convenience, the schematic diagram of FIG. 3 for the central distance-dominant ophthalmic lens 302 and the central near-non-dominant ophthalmic lens 304 is repeated. As shown in graph 1000 of FIG. 10A , the overall power profile 1004 (Y-axis) of the central distance lens 302 includes a central distance power profile 1008 of the central distance optical zone 306 of the central distance-dominant ophthalmic lens 302, and is shown with a radius of 0 mm to approximately 1.3 mm (or a diameter of 2.6 mm) (X-axis). The central distance power profile 1008 of the central distance optical zone 306 has a nearly spherical first power of 0 diopters that is normalized to be independent of any refractive power. In this example, the central distance optical zone 306 has a larger diameter than the central near optical zone 312 in the central near lens 304 for the reasons previously discussed above. 10A, the central distance power profile 1008 of the central distance optical zone 306 of the central distance lens 302 has a power profile with a spherical aberration (SPHA) to account for the spherical aberration that naturally occurs in an individual's ocular system when focusing on a distance object. As an example, the central distance power profile 1008 of the central distance optical zone 306 of the central distance lens 302 may have an SPHA that depends on the first power prescription or lens labeled power (Rx), as follows: a. If Rx≦-3 diopters, SPHA=0.0082 * Rx-0.0251, b. If Rx>-3 diopters, then SPHA=-0.0497.

[0045] 10A, the overall power profile 1004 of the central distance lens 302 also has a transition power profile 1010 in the transition optical zone 308 of the central distance lens 302. The transition power profile 1010 of the transition optical zone 308 has an SPHA that accounts for spherical aberrations that occur naturally within an individual's ocular system in the wearer's non-dominant eye, which affect light received from focused intermediate and far distance objects.

[0046] 10B, the overall power profile 1006 of the central near lens 304 includes a central near power profile 1012 of the central near optical zone 312 of the central distance dominant ophthalmic lens 302 with a prescription power (Y-axis) of a radius of 0 mm to approximately 2.0 mm (or 4.0 mm diameter) (X-axis). As previously discussed, the central near optical zone 312 and its central near power profile 1012 are sized in diameter to approximate the diameter of an individual's pupil when focusing on near objects due to pupillary constriction in order to provide enhanced near vision, such as monocular vision, through the central near lens 304 in the wearer's non-dominant eye. In this example, as previously discussed, the central near optical zone 312 has a larger diameter than the central distance optical zone 306 in the central distance lens 302. The central near power profile 1012 of the central near optical zone 312 has a spherical aberration (SPHA) 304 to account for the spherical aberration that occurs naturally in an individual's ocular system that affects light received from focused near distance objects. As also shown in Figure 10B, the overall power profile 1006 of the central near lens 304 also has a transition power profile 1014 in the transition optical zone 314 of the central near lens 304. The transition power profile 1014 of the transition optical zone 314 has a SPHA to account for the spherical aberration that occurs naturally in an individual's ocular system that affects light received in the wearer's non-dominant eye from focused intermediate and far distance objects. For example, the central near power profile 1012 may include a central near optical zone 312 within a 2.0 mm radius that includes a percentage of the add power and exactly over 65% depending on the SKU of the add power, and an intermediate power profile 1014 having a transition zone of 2.0 to 3.0 mm diameter that includes less than 35% of the add power, and above 6 mm diameter the transition zone is designed to correct the patient's distance vision refractive power and spherical aberration and is configured to have 0 add power.

[0047] 11 is a graph 1100 illustrating exemplary VA performance (Y-axis) as a function of vergence (D) (X-axis) across distance, intermediate, and near vision using the enhanced addition contact lens pair 300 of FIG. 3 with the central distance lens 302 in the dominant eye and the central near lens 304 in the non-dominant eye, compared to a conventional central near multifocal lens. The VA (VA) (in -10 LogMAR units) performance of the enhanced addition contact lens pair 300 is shown in VA curve 1102. The VA performance of an alternative multifocal lens pair using a central near optical zone in all lenses for both the wearer's dominant and non-dominant eyes is shown in VA curve 1104. For example, the multifocal lens pair illustrated by the VA performance in VA curve 1104 could be a 1-Day Acuvue® Moist presbyopic contact lens pair with a central near EDOF for both the dominant and non-dominant eyes. In the lens near the center of the non-dominant eye for a 1-DAY ACUVUE® Moist presbyopic contact lens pair, the majority of the add power (e.g., ≥ 65%, e.g., 88%) is within the central 2.0 mm radius of the lens, with the remainder of the add power provided at the first 3.00 mm radius of the lens. As shown by VA curves 1102 and 1104 in Figure 11, the VA at near distances (e.g., greater than 1.75 diopters) of the strengthened addition contact lens pair 300 is at least a 0.8 line improvement over the 1-DAY ACUVUE® Moist presbyopic contact lens pair. As shown by VA curves 1102 and 1104, at a near distance of 2.5 diopters, the strengthened addition contact lens pair 300 has a VA improvement of approximately 1.0 VA over the 1-DAY ACUVUE® Moist presbyopic contact lens pair. Also, as shown in VA curves 1102 and 1104 of FIG. 11, the VA at distance (e.g., <1.0 diopter) of the enhanced addition contact lens pair 300 may, in one example, not be an improvement over (or worse than) the 1-Day Acuvue® Moist presbyopic contact lens pair, since both lenses are based on providing distance vision based on the combined multifocality of light with EDOF.

[0048] As previously discussed above, the central near optical zone 312 of the central near lens 304 of FIG. 3 is designed to include a factor of an individual's mean pupil diameter based on expected pupil constriction to achieve good near-distance visual acuity, such as monocular vision. Studies were conducted on various patients in both photopic and mesopic conditions to determine metrics related to pupil diameter and pupil diameter variability when focusing on near-distance objects (e.g., at 2.5 diopters). These results are shown in Table 1200 of FIG. 12, which illustrates exemplary mean pupil diameter sizes and standard deviations and variability based on pupil size for a study of myopic and hyperopic subjects in photopic and mesopic conditions. This study, titled "Evaluation of the visual performance of a new multifocal contact lens and the impact of refractive error" by Moody et al., appeared in Contact Lens and Anterior Eye, Volume 41, Supplement 1, S24, June 1, 2016 (https: / / www.contactlensjournal.com / article / S1367-0484(18)30689-1 / fulltext), and is incorporated herein by reference in its entirety. As shown in Figure 12, the mean pupil diameter of 181 myopes studied under photopic conditions was 4.1 mm, while the mean pupil diameter of hyperopes studied under photopic conditions was 3.82 mm. Also shown in Figure 12, the mean pupil diameter of 94 hyperopes studied under mesopic conditions was 5.18 mm, while the mean pupil diameter of 181 myopes studied under mesopic conditions was 5.43 mm. As such, as discussed in more detail below, the central near diameter of the central near optical zone 312 of the central near lens 304 was selected based on multiple pupil sizes based on variations in pupil diameter that may occur in different conditions and as affected by accommodative lead / lag and lens / eye wavefront interaction refraction. For example, the central near zone diameter D of the central near optical zone 312 of the central near lens 304 CNZcan be selected to be 2.6 to 4.0 mm. Furthermore, the central near zone diameter D CNZ The central near zone diameter D can be selected to be 2.6 to 4.0 mm. CNZ can be selected differently for myope and hyperope prescriptions based on studies of pupil diameter size and variability between myopes and hyperopes, as shown, for example, in the study of Figure 12 (4.1 mm vs. 3.82 mm). Alternatively, to reduce SKU, a compromise between myope and hyperope prescriptions can be achieved by using a single diameter central near zone diameter D in the central near lens 304 for the myope and hyperope prescriptions. CNZ Pupil constriction studies can also be based on the average pupil size of a population of any size, including, for example, a population as small as one size.

[0049] FIG. 13A is a graph illustrating an exemplary dynamic pupil constriction model 1300, showing modeled mean pupil diameter (Y-axis) as a function of paraxial accommodation power (X-axis). Paraxial accommodation power is a representation of the distance at which an individual focuses on an object. Dynamic pupil constriction model 1300 illustrates modeling of mean pupil diameter as a function of paraxial accommodation power (focused distance), which can be used to determine the sizing of the central near optical zone diameter in the central near lens of the enhanced addition contact lens pair 300. As illustrated in dynamic pupil constriction model 1300, the dynamic pupil constriction model includes curves 1302, 1304, and 1306, each of which varies pupil diameter size as a function of focused distance for different dilated pupil diameters at a given focused distance. Curve 1302 shows a constricted pupil diameter of approximately 4.5 mm at a focal distance of 0 diopters. Curve 1304 shows a constricted pupil diameter of approximately 3.0 mm at a focal length of 0 diopters. Curve 1306 shows a constricted pupil diameter of approximately 6.0 mm at a focal length of 0 diopters. The pupil diameter size then constricts as the individual focuses on objects at closer distances, as shown in each of curves 1302-1306. This exemplary dynamic pupil constriction model of FIG. 13A shows a mean central near zone diameter D of the central near optical zone 312 of the central near lens 304. CNZ For example, the optimized central near zone diameter D of the central near optical zone 312 of the central near lens 304 can be used to determine CNZ To determine the size, a focused distance of 2.5 diopters can be used from the dynamic pupil constriction model 1300 used in FIG. 13A.

[0050] Figure 13B is a graph 1310 illustrating an exemplary VA as a function of vergence based on the dynamic pupil constriction model of Figure 13A. The x-axis of graph 1310 in Figure 13B is target object vergence in diopters, and the y-axis of graph 1310 is VA in -10 LogMAR units. When calculating VA, the induced pupil constriction, the interaction between lens design and ocular wavefront aberrations, and the patient's pupil size are taken into account. Details of this model are published in "Modeling the impact of spherical aberration on accommodation," Ophthalmic & Physiological Optics, 2013, Vol. 33, pp. 482-496, which is incorporated herein by reference in its entirety.

[0051] Figure 14 illustrates a chart 1400 of exemplary actual add powers to the central near optical zone of a central near non-dominant ophthalmic lens, such as the central near lens 304 of Figure 3, for correcting presbyopia in monocular vision as a function of corrective prescription. The add powers in chart 1400 were determined based on the pupillary constriction study of Figure 12, and modeling of the central near non-dominant ophthalmic lens based on the pupillary constriction accommodation model of Figure 13A and the dynamic pupillary constriction and accommodation model of Figure 13B and the determined diameter of the central near zone of the central near lens based on pupil size. 14, the add powers of low add (PRLOWN), medium add (PRMIDN), and high add (PRHIGN) central near lenses having a central near optical zone with a diameter modeled based on the expected pupil diameter when focusing on near objects are shown across corrective prescriptions of -12 diopters, -9 diopters, -3 diopters, -1 diopter, +1 diopter, +3 diopters, and +6 diopters. In this example, enhanced addition contact lens pairs are provided for three patient add power ranges: low add (e.g., the patient's add power may be 0.75, 1.0, or 1.25 diopters), medium add (e.g., the patient's add power may be 1.5 or 1.75 diopters), and high add (e.g., the patient's add power may be 2.0, 2.25, and 2.5 diopters). These choices may be based on the desire to provide an enhanced addition contact lens pair system including multiple enhanced addition contact lenses such as those in FIG. 3 for different prescription SKUs and different patient add power needs, but may be practically limited to three different effective add powers to reduce complexity in fitting the wearer and minimize the total number of SKUs.

[0052] 15A-15F are provided to further illustrate an exemplary enhanced addition contact lens pair system including a central near non-dominant ophthalmic lens pair and a central distance dominant ophthalmic lens pair offered for presbyopia and with three add powers across a prescription SKU ranging from -12 diopters to +9.0 diopters. Figures 15A-15C show exemplary respective low, medium, and high add power profiles 1500, 1502, 1504 for a central near non-dominant ophthalmic lens (labeled N-LENS) as in FIG. 3 as a function of lens radius across a range of different refractive correction powers, showing central near power profiles with paraxial low, medium, and high add powers in the central near optical zone, and power profiles in the transition zone. Figures 15D-15F show exemplary low, medium, and high add power profiles 1506, 1508, 1510 for a central distance dominant eye lens (labeled D-LENS) such as that of Figure 3 as a function of lens radius across a range of refractive correction powers, showing central near power profiles with paraxial low, medium, and high add powers in the central near optical zone, as well as power profiles in the transition zone.

[0053] As shown in the example of Figure 15A, a low ADD profile 1500 for the low ADD central near non-dominant eye includes a central near optical zone 312 with a central distance zone diameter of 4.0 mm, a transition optical zone 314 with a transition diameter of 4.0 to 6.0 mm, and an ADD power provided in the central near optical zone 312 of +0.9 to +1.1 diopters. As shown in the example of Figure 15B, an intermediate ADD profile 1502 for the intermediate ADD central near non-dominant eye includes a central near optical zone 312 with a central distance zone diameter of 4.0 mm, a transition optical zone 314 with a transition diameter of 4.0 to 6.0 mm, and an ADD power provided in the central distance optical zone of +0.9 to +1.2 diopters. As shown in the example of FIG. 15C, the high add power profile 1504 of the high add power central near non-dominant ophthalmic lens includes a central near optical zone 312 having a central distance zone diameter of 4.0 mm, a transition optical zone 314 having a transition diameter of +4.0 to +6.0 mm, and an add power provided to the central near optical zone 312 of +1.0 to +1.2 diopters.

[0054] As shown in the example of Figure 15D, a low ADD profile 1506 for a low ADD central distance dominant eye includes a central distance optic zone 306 having a central distance zone diameter of 2.0 to 2.8 mm, a transition optic zone 308 having a transition zone larger than the central distance zone diameter, and an ADD provided in the central distance optic zone of +0.1 to +0.4 diopters. As shown in the example of Figure 15E, an intermediate ADD profile 1508 for an intermediate ADD central distance dominant eye includes a central distance optic zone 306 having a central distance zone diameter of 2.2 to 2.8 mm, a transition optic zone 308 having a transition radius larger than the central distance zone diameter, and an ADD provided in the central distance optic zone 306 of +0.1 to +0.4 diopters. As shown in the example of Figure 15F, the high add power profile 1510 of a high add power central distance dominant eye lens can be designed to have an intermediate add power profile including a central distance optical zone 306 having a central distance zone diameter of 1.8 to 2.2 mm, a transition optical zone 308 having a transition radius greater than 2.0 mm, and an add power provided in the central distance optical zone of +0.1 to +0.4 diopters.

[0055] Comprising a pair of central near non-dominant ophthalmic lenses and a central distance dominant ophthalmic lens, as described above, the enhanced addition contact lens pair system may include labeled add powers within and / or including the end points of +0.75 diopters to +2.5 diopters, so that a variety of different accommodative add powers can be offered as options for the wearer.

[0056] As an example, as shown in power profiles 1500-1510 of Figures 15A-15D, the power of the respective transition optic zones 314, 308 at any given radius from the central axis of a complementary pair of low add lenses (Figures 15A and 15D), medium add lenses (Figures 15B and 15E), and high add lenses (Figures 15C and 15F) differs by less than 1.4 diopters. For example, the power of the respective transition optic zones 314, 308 at a radius of 3.0 mm from the central axis of a complementary pair of low add lenses (Figures 15A and 15D), medium add lenses (Figures 15B and 15E), and high add lenses (Figures 15C and 15F) may differ by less than 1.0 diopter. This is to minimize the parallax of refractive correction power at intermediate and far distances while also providing enhanced binocular vision through the EDOF of the lens pair. In another embodiment, the power of the respective transition optic zones 314, 308 at any given radius from the central axis of a complementary pair of low add power lenses (FIGS. 15A and 15D), intermediate add power lenses (FIGS. 15B and 15E), and high add power lenses (FIGS. 15C and 15F) differs by less than 1.3 diopters. In another embodiment, the power of the respective transition optic zones 314, 308 at any given radius from the central axis of a complementary pair of low add power lenses (FIGS. 15A and 15D), intermediate add power lenses (FIGS. 15B and 15E), and high add power lenses (FIGS. 15C and 15F) differs by less than 1.2 diopters. In another embodiment, the power of the respective transition optic zones 314, 308 at any given radius from the central axis of a complementary pair of low add lenses (FIGS. 15A and 15D), medium add lenses (FIGS. 15B and 15E), and high add lenses (FIGS. 15C and 15F) differs by less than 1.1 diopters. In another embodiment, the power of the respective transition optic zones 314, 308 at any given radius from the central axis of a complementary pair of low add lenses (FIGS. 15A and 15D), medium add lenses (FIGS. 15B and 15E), and high add lenses (FIGS. 15C and 15F) differs by less than 1.0 diopters.

[0057] To further validate the lens results and designs described above, additional studies were conducted to model the VA of an enhanced addition contact lens pair, such as enhanced addition contact lens pair 300 of FIG. 3, for different assumptions of pupil diameter when focusing on near objects. For example, as shown in chart 1600 of FIG. 16, binocular VA improvement was determined for an enhanced addition contact lens pair including a central near non-dominant eye lens with central near optical zone diameters of 5.4 mm, 4 mm, and 3 mm for effective pupil diameters (EPD) of the enhanced addition contact lens pair, such as that of FIG. 3, as worn by a patient with an exemplary corrective prescription of -3.0 diopters for a myope with an effective add power of +1.25 diopters. The binocular VA improvement shown in chart 1600 of FIG. 16 is compared to a patient wearing an equivalent 1-Day Acuvue® Moist presbyopic contact lens pair with a central near optical zone for both the dominant and non-dominant eyes. As shown in Chart 1600, improvements were determined for distance vision (F), intermediate vision (I), and near vision (N).

[0058] A negative value in chart 1600 of FIG. 16 means that the strengthened addition contact lens pair has better VA performance than the 1-DAY ACUVUE® Moist presbyopic contact lens pair. "F," "I," and "N" represent distance, intermediate, and near visual acuity, respectively. A positive value in chart 1600 of FIG. 16 means that the strengthened addition contact lens pair has lower VA performance than the 1-DAY ACUVUE® Moist presbyopic contact lens pair. Results are given in units of -10 LogMAR, where "1" represents a one-line variation. As an example, as shown in FIG. 16, with a 4mm pupil, the VA performance of the strengthened addition contact lens pair is -1.08 better than the 1-DAY ACUVUE® Moist presbyopic contact lens pair in near visual acuity, meaning that the strengthened addition contact lens pair is more than one line better in VA than the 1-DAY ACUVUE® Moist presbyopic contact lens pair.

[0059] 17A-17C are graphs 1700, 1702, and 1704 illustrating exemplary VA (Y-axis) as a function of vergence (X-axis) for an enhanced addition contact lens pair used to determine the VA improvement shown in chart 1600 of FIG. 16. Graphs 1700, 1702, and 1704 are based on determining the VA of an enhanced addition contact lens pair including a central distance dominant ocular lens and a central near non-dominant ocular lens with central near zone diameters of the central near optical zone of 5.4 mm, 4 mm, and 3 mm effective pupil diameter (EPD), respectively, compared to a comparable 1-DAY ACUVUE® Moist presbyopic contact lens pair having central near optical zones in both the dominant and non-dominant eyes for an exemplary corrective prescription of −3.0 diopters for a myope with +1.25 diopters of add. Curves 1706, 1708, 1710 in Figures 17A-17C illustrate the VA of pairs of 1-DAY ACUVUE® Moist presbyopic contact lenses with central near zone diameters of the central near optical zones of 5.4 mm, 4 mm, and 3 mm effective pupil diameters (EPD), respectively. Curves 1712, 1714, 1716 in Figures 17A-17C illustrate the VA of pairs of 1-DAY ACUVUE® Moist presbyopic contact lenses with central near zone diameters of the central near optical zones of 5.4 mm, 4 mm, and 3 mm effective pupil diameters (EPD), respectively. As shown in Figures 17A-17C, an enhanced addition contact lens pair having a central distance dominant eye lens and a central near non-dominant eye lens with a central near zone diameter of 1.5 mm has improved VA over a 1-Day Acuvue® Moist presbyopic contact lens pair for intermediate and near vision, with no or almost no compromise in VA for distance vision.

[0060] The results of another VA improvement study are shown in Chart 1800 of Figure 18. VA improvement was determined for a strengthened addition contact lens pair, such as that of Figure 3, including a central near non-dominant eye lens with central near optical zone diameters of 5.4 mm, 4 mm, and 3 mm for a central near optical zone of a strengthened addition contact lens pair of 5.4 mm, 4 mm, and 3 mm for an exemplary correction prescription of -3.0 diopters for a myope with +1.5 diopters of add. The VA improvement shown in Chart 1800 of Figure 18 is compared to a pair of 1-Day Acuvue® Moist presbyopic contact lenses with central near optical zones in both the dominant and non-dominant eyes. As shown in Chart 1800, improvement was determined for distance visual acuity (F), intermediate visual acuity (I), and near visual acuity (N).

[0061] 19A-19C are graphs 1900, 1902, and 1904 illustrating exemplary VA (Y-axis) as a function of vergence (X-axis) for an enhanced addition contact lens pair used to determine the binocular VA improvement shown in chart 1800 of FIG. 18. Graphs 1900, 1902, and 1904 are based on determining the VA of a patient wearing an enhanced addition contact lens pair such as that of FIG. 3, including a central distance dominant lens and a central near non-dominant lens with central near optical zone diameters of 5.4 mm, 4 mm, and 3 mm effective pupil diameter (EPD) for the central near optical zone, compared to a patient wearing a comparable 1-DAY ACUVUE® Moist presbyopic contact lens pair having central near optical zones in both the dominant and non-dominant eyes for an exemplary corrective prescription of −3.0 diopters for a myope with +1.5 diopters of add. A negative value in chart 1800 of Figure 18 means that the strengthened addition contact lens pair has better VA performance than that of the 1-DAY ACUVUE® Moist presbyopic contact lens pair. A positive value in chart 1800 of Figure 18 means that the strengthened addition contact lens pair has lower VA performance than that of the 1-DAY ACUVUE® Moist presbyopic contact lens pair. "F," "I," and "N" refer to distance, intermediate, and near visual acuity, respectively.

[0062] Curves 1906, 1908, 1910 in Figures 19A-19C illustrate the VA of pairs of 1-DAY ACUVUE® Moist presbyopic contact lenses with central near zone diameters of the central near optical zones of 5.4 mm, 4 mm, and 3 mm effective pupil diameters (EPD), respectively. Curves 1912, 1914, 1916 in Figures 19A-19C illustrate the VA of pairs of 1-DAY ACUVUE® Moist presbyopic contact lenses with central near zone diameters of the central near optical zones of 5.4 mm, 4 mm, and 3 mm effective pupil diameters (EPD), respectively. As shown in Figures 19A-19C, an enhanced addition contact lens pair having a central distance dominant ophthalmic lens and a central near non-dominant ophthalmic lens with a central near zone diameter of 0.01 mm has improved VA than a 1-Day Acuvue® Moist presbyopic contact lens pair for intermediate and near vision, with no or almost no compromise in VA for distance vision. As an example, as shown in Figure 18, with a 4 mm pupil, the VA performance of the enhanced addition contact lens pair is approximately 1.38 better (or more than one line better) than a 1-Day Acuvue® Moist presbyopic contact lens pair for near vision.

[0063] The results of another VA improvement study are shown in Chart 2000 of Figure 20. VA improvement was determined for a strengthened addition contact lens pair, such as that of Figure 3, including a central near non-dominant eye lens with central near optical zone diameters of 5.4 mm, 4 mm, and 3 mm for a central near optical zone of a strengthened addition contact lens pair of 5.4 mm, 4 mm, and 3 mm for an exemplary correction prescription of -6.0 diopters for a myope with +2.0 diopters of add. The VA improvement shown in Chart 2000 of Figure 20 was compared to a pair of 1-Day Acuvue® Moist presbyopic contact lenses with central near optical zones in both the dominant and non-dominant eyes. As shown in Chart 2000, improvement was determined for distance visual acuity (F), intermediate visual acuity (I), and near visual acuity (N).

[0064] Figures 21A-21C are graphs 2100, 2102, and 2104 illustrating exemplary VA (Y-axis) as a function of vergence (X-axis) for an enhanced addition contact lens pair used to determine the binocular VA improvement shown in chart 2000 of Figure 20. Graphs 2100, 2102, and 2104 are based on determining the VA of a patient wearing an enhanced addition contact lens pair such as that of Figure 3, including a central distance dominant lens and a central near non-dominant lens with central near zone diameters of central near optical zones of 5.4 mm, 4 mm, and 3 mm effective pupil diameter (EPD), compared to a patient wearing a comparable 1-DAY ACUVUE® Moist presbyopic contact lens pair having central near optical zones in both the dominant and non-dominant eyes for an exemplary correction prescription of -6.0 diopters for a myope with +2.0 diopters of add. A negative value in Chart 2000 of Figure 20 means that the strengthened addition contact lens pair has better VA performance than that of the 1-Day Acuvue® Moist Presbyopic contact lens pair. A positive value in Chart 2000 of Figure 20 means that the strengthened addition contact lens pair has lower VA performance than that of the 1-Day Acuvue® Moist Presbyopic contact lens pair. "F," "I," and "N" refer to distance, intermediate, and near visual acuity, respectively.

[0065] Curves 2106, 2108, 2110 in Figures 21A-21C illustrate the VA of pairs of 1-DAY ACUVUE® Moist presbyopic contact lenses with central near zone diameters of the central near optical zones of 5.4 mm, 4 mm, and 3 mm effective pupil diameters (EPD), respectively. Curves 2112, 2114, 2116 in Figures 21A-21C illustrate the VA of pairs of 1-DAY ACUVUE® Moist presbyopic contact lenses with central near zone diameters of the central near optical zones of 5.4 mm, 4 mm, and 3 mm effective pupil diameters (EPD), respectively. As shown in Figures 21A-21C, an enhanced addition contact lens pair having a central distance dominant ophthalmic lens and a central near non-dominant ophthalmic lens with a central near zone diameter of 1.0 mm has improved VA than a 1-Day Acuvue® Moist presbyopic contact lens pair for intermediate and near vision, with no or almost no compromise in VA for distance vision. As an example, as shown in Figure 20, with a 4 mm pupil, the VA performance of the enhanced addition contact lens pair is -0.97 better (or nearly 1 line better) in near vision than a 1-Day Acuvue® Moist presbyopic contact lens pair.

[0066] It may also be desirable to provide a contact lens wearer with a fitting procedure and guide for fitting lenses for the dominant and non-dominant eyes using an enhanced addition contact lens pair based on the design of the enhanced addition contact lens pair 300 of FIG. 3 . The enhanced addition contact lens pair can be selected from the enhanced addition contact lens pairs in the enhanced addition contact lens pair system shown in FIGS. 15A-15F based on the low, medium, and high add powers for correcting presbyopia and the corrective prescription for the wearer's eyes. Due to design differences between the central distance dominant lens and the central near non-dominant lens in the enhanced addition contact lens pair, there may be a VA disparity in the distance vision experienced by the wearer between the dominant and non-dominant eyes. This is shown in graph 2200 of FIG. 22A . Graph 2200 of FIG. 22A illustrates VA (Y-axis) as a function of vergence (X-axis) with the enhanced addition contact lens pair design described herein. Curve 2202 in Figure 22A illustrates the VA as a function of vergence for a non-dominant eye fitted with a central near lens according to the enhanced addition contact lens pair design described herein. As shown in Figure 22A, there may be a larger VA disparity 2206 between the non-dominant and dominant eyes of a lens wearer fitted with respective central near and central distance lenses according to the enhanced addition contact lens pair design described herein. However, by fitting the dominant and non-dominant eyes with respective central distance and / or central near lens powers that have variations in refractive correction power (or lens label power) that deviate from the patient's prescribed refractive correction, this VA disparity in distance vision may be reduced, as shown in graph 2208 in Figure 22B.

[0067] In this regard, curve 2210 in FIG. 22B illustrates the VA (Y-axis) as a function of vergence (X-axis) of the non-dominant eye fitted with a central near lens according to the enhanced addition contact lens pair design described herein. Curve 2212 in FIG. 22B illustrates the VA as a function of vergence of the dominant eye fitted with a central distance lens according to the enhanced addition contact lens pair design described herein. The VA disparity 2214 between the dominant and non-dominant eyes with their respective central distance and / or central near lenses is less than the VA disparity 2206 in graph 2200 of FIG. 22A. Furthermore, the spherical equivalent powers used in the central distance and central near lenses for the dominant and non-dominant eyes, respectively, can also be further reduced. The VA disparity (and / or spherical equivalent power variation from the prescription power difference) between the dominant and non-dominant eyes is a measure of binocular disparity. Due to the reduction in parallax, the enhanced addition contact lens pairs described herein are expected to maintain similar distance vision performance and near vision benefits (compared to control lenses such as the 1-Day Acuvue® Moist presbyopic contact lens pair previously discussed above).

[0068] 23A-23F are graphs 2300A-2300F illustrating fit guides for contact lens wearers wearing a central distance lens for a dominant eye and a central near lens for a non-dominant eye, as in FIG. 3, from an enhanced addition contact lens pair system such as that described in FIGS. 15A-15F by way of example. Graphs 2300A-2300F illustrate exemplary respective VA (Y-axis) 2302A-2302F, 2304A-2304F as a function of vergence (X-axis) for contact lens wearers wearing a respective central distance dominant lens and a central near non-dominant lens, as in FIG. 3. Each graph 2300A-2300F illustrates incremental fit steps in an attempt to provide the wearer with a reduction in disparity in VA. The fit guides of FIGS. 23A-23F are described in conjunction with an exemplary fit guide process 2400 of FIG. 24.

[0069] For example, as shown in graph 2300A of FIG. 23A, the first step in the fitting process 2400 shown in FIG. 24 for fitting a patient with a pair of enhanced addition contact lenses as described herein is to select the patient's add power for the contact lens wearer (block 2402 of FIG. 24). The add power of the selected central near lens may be selected from the low, medium, and high add powers described in FIGS. 15A-15F based on the wearer's age (block 2402 of FIG. 24). The next step in the fitting process 2400 is to select the patient's initial central near non-dominant and central distance dominant eye lenses based on the labeled powers of the lenses according to the patient's prescription and desired add power for each eye (block 2404 of FIG. 24). For example, the process may include selecting a central near lens from among a plurality of central near lenses in an enhanced addition contact lens pair system, such as those in FIGS. 15A-15F, for the wearer's non-dominant eye based on a corrective prescription selected to substantially correct the distance vision in the wearer's non-dominant eye (block 2406 of FIG. 24). For example, the refractive correction used to select the contact lenses in steps 2404 and 2406 may be determined based on the patient's refractive correction needs when focusing on a distance object at 0.25 diopters. The process then includes selecting a central distance lens from among a plurality of central distance lenses in an enhanced addition contact lens pair system, such as those in FIGS. 15A-15F, for the wearer's dominant eye based on a corrective prescription selected to substantially correct the distance vision in the wearer's dominant eye (block 2408 of FIG. 24).

[0070] The patient-wearer can then provide feedback to the fitting technician or physician based on their perceived stereopsis based on the distance visual acuity difference between the wearer's dominant eye fitted with the currently selected central distance lens and the wearer's non-dominant eye fitted with the currently selected central near lens (block 2410 of FIG. 24). This perceived stereopsis based on the distance visual acuity difference is a subjective measurement by the wearer based on whether the wearer's brain can effectively provide the sum of the light received by the wearer's eye fitted with the currently selected central distance lens and the wearer's dominant eye fitted with the currently selected central near lens. If the wearer's feedback indicates a reduction in stereopsis based on the distance visual acuity difference between the wearer's dominant eye fitted with the currently selected central distance lens and the wearer's non-dominant eye fitted with the currently selected central near lens (block 2412 of FIG. 24), the patient can be fitted with the next different combination of central near and distance lenses to attempt to reduce the distance visual acuity difference for their perception.

[0071] In this regard, as shown in exemplary graph 2300B of FIG. 23B, the next step in the fitting process may be, for example, selecting a next central distance dominant ocular lens with an increased corrective power (e.g., +0.5 diopters) while leaving the central near non-dominant ocular lens the same (block 2414 of FIG. 24). This may have the effect of reducing VA disparity in distance vision, as shown in graph 2300B of FIG. 23B. If the feedback from the wearer still indicates a reduction in stereopsis based on the difference in distance visual acuity between the wearer's dominant eye fitted with the currently selected central distance lens and the wearer's non-dominant eye fitted with the currently selected central near lens (block 2412 of FIG. 24), the next step may be to select the next central near non-dominant eye lens with a reduced refractive power (e.g., −0.25 diopters) while keeping the central distance dominant eye lens the same (block 2416 of FIG. 24), as shown in the exemplary graph 2300C of FIG. 23C. As shown in graph 2300C of FIG. 23C, this may have the effect of reducing the VA disparity in distance vision to a level acceptable to the wearer.

[0072] Again, if the feedback from the wearer still indicates a reduction in stereopsis based on the difference in distance visual acuity between the wearer's dominant eye fitted with the currently selected central distance lens and the wearer's non-dominant eye fitted with the currently selected central near lens (block 2412 of FIG. 24), the next step may be to select the next central near non-dominant eye lens with a further reduction in refractive correction (e.g., −0.5 diopters) while keeping the central distance non-dominant eye lens the same (block 2414 of FIG. 24), as shown in exemplary graph 2300D of FIG. 23D. This may have the effect of reducing VA disparity in distance vision to a level acceptable to the wearer, as shown in graph 2300D of FIG. 23D. If the feedback from the wearer still indicates a reduction in stereopsis based on the difference in distance visual acuity between the wearer's dominant eye fitted with the currently selected central distance lens and the wearer's non-dominant eye fitted with the currently selected central near lens (block 2412 of FIG. 24), the next step may be to select the next central distance dominant eye lens with a further increase in refractive power correction (e.g., +0.75 diopters) and the next central near non-dominant eye lens with a decrease in refractive power correction (e.g., −0.25 diopters) (block 2414 of FIG. 24), as shown in the exemplary graph 2300E of FIG. 23E. This may have the effect of reducing the VA disparity in distance vision to a level acceptable to the wearer, as shown in the graph 2300E of FIG. 23E. Again, if the feedback from the wearer still indicates a reduction in stereopsis based on the difference in distance visual acuity between the wearer's dominant eye fitted with the currently selected central distance lens and the wearer's non-dominant eye fitted with the currently selected central near lens (block 2412 of FIG. 24), the next step may be to select both of the next central near non-dominant eye lenses with a further reduction in refractive correction (e.g., −0.5 diopters) while leaving the central distance dominant eye lens the same (block 2416 of FIG. 24), as shown in exemplary graph 2300F of FIG. 23F. As shown in graph 2300F of FIG. 23F, this may have the effect of reducing the VA disparity in distance vision to a level acceptable to the wearer.As shown in graph 2300F of Figure 23F, the total difference between the diopter increase in the central distance dominant eye lens and the diopter decrease in the central near non-dominant eye lens is the same (1.0 diopter) as graph 2300E of Figure 23E, however, this may still have the effect of reducing VA disparity in distance vision to a level acceptable to the wearer.

[0073] It should be noted that while the above aspects relate to exemplary contact lens pairs, such examples are not limited to contact lenses, but may be applied to any type of lens and associated lens pair.

[0074] It is important to note that the lens designs of the present disclosure may be incorporated into any number of different contact lenses formed from any number of materials. Specifically, the lens designs of the present disclosure may be utilized in any of the contact lenses described herein, including, but not limited to, daily disposable contact lenses, rigid gas permeable contact lenses, bifocal contact lenses, toric contact lenses, and hybrid contact lenses. Additionally, while the present disclosure is described with respect to contact lenses, it is important to note that the concepts of the present disclosure may be utilized in spectacle lenses, intraocular lenses, corneal inlays, and onlays.

[0075] It is to be understood that the present disclosure is not limited to the particular aspects disclosed, and that modifications and other aspects are intended to be included within the scope of the appended claims and their equivalents. Although specific terms are employed herein, they are used in a generic and descriptive sense and not for purposes of limitation. Upon reading the following description in light of the accompanying drawings, those skilled in the art will understand the concepts of the disclosure and will recognize applications of these concepts not specifically addressed herein. The aspects set forth below represent the information necessary to enable one skilled in the art to practice the disclosure and illustrate the best modes for practicing the disclosure. It is to be understood that these concepts and applications fall within the scope of the disclosure and the appended claims. Many modifications and other embodiments of the disclosure set forth herein will come to mind to one skilled in the art to which this disclosure pertains having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. While shown and described in what is believed to be the most practical and specific aspects disclosed, modifications and other aspects are intended to be included within the scope of the appended claims. It will be apparent that deviations from the specific designs and methods described and illustrated may be suggested to those skilled in the art and may be used without departing from the spirit and scope of the present invention.

[0076] [Embodiment] (1) A pair of contact lenses, 1. A central distance lens for a contact lens wearer's dominant eye, comprising: a central distance optical zone having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye, the central distance optical zone being disposed about a first optical axis and having a first power selected to substantially correct distance vision in the dominant eye; a central distance lens comprising a first transition optical zone surrounding the first central optical zone, the first transition optical zone having a first progressive power profile; a central near lens for the non-dominant eye of the contact lens wearer, comprising: a central near optical zone having a central near zone diameter surrounding a second optical axis and having a second power selected to substantially correct distance vision in the non-dominant eye and an add power of at least +0.75 diopters relative to the first power; a second transition optical zone surrounding the second central optical zone, the second transition optical zone having a second progressive power profile; the central distance zone diameter and the central near zone diameter are selected such that a contact lens pair including the central distance lens and the central near lens emulates monocular vision when the contact lens wearer is focusing on near distance objects, and such that the contact lens pair emulates partial monocular vision when the contact lens wearer is focusing on far distance objects; A contact lens pair, wherein the first transition optical zone and the second transition optical zone are selected such that when the contact lens wearer is focusing on an intermediate distance object, the contact lens pair emulates an extended depth of focus lens through binocular addition. (2) The pair of contact lenses described in embodiment 1, wherein the central distance zone diameter is between 1.8 millimeters (mm) and 3.8 mm. (3) The pair of contact lenses described in embodiment 1, wherein the central near zone diameter is between 2.6 millimeters (mm) and 4.0 mm. (4) The central distance optical zone adjusts the spherical aberration (SPHA) depending on the first power (Rx) as follows: a. If Rx≦-3 diopters, SPHA=0.0082 * Rx-0.0251, b. If Rx>-3 diopters, then SPHA=-0.0497; A pair of contact lenses according to embodiment 1, having: (5) The pair of contact lenses of embodiment 1, wherein the first and second progressive power profiles differ by less than 1.4 diopters, less than 1.3 diopters, less than 1.2 diopters, less than 1.1 diopters, or less than 1.0 diopters at any radius from their respective first and second optical axes.

[0077] (6) the first progressive power profile includes a first continuous power profile; 2. The pair of contact lenses of embodiment 1, wherein the second progressive power profile comprises a second continuous power profile. (7) The pair of contact lenses of embodiment 1, wherein the second power profile comprises a derivative power profile. (8) The central distance lens is selected from the group consisting of: a dominant low add profile comprising a central distance zone diameter of 2.0 to 2.8 mm, wherein the first transition optic zone has a first transition radius greater than the central distance zone diameter, and wherein the dominant add power provided in the central distance zone increases radially from 0 at the lens center to +0.1 to +0.4 diopters; a dominant intermediate add power profile comprising a central distance zone diameter of 2.4 to 3.8 mm, wherein the first transition optic zone has a first transition radius greater than the central distance zone diameter, and the dominant add power provided in the central distance zone increases radially from 0 at the lens center to +0.1 to +0.4 diopters; a dominant high add profile comprising a central distance zone diameter of 1.8 to 2.2 mm, the first transition optical zone having a first transition radius greater than 2.0 mm, and the dominant add power provided in the central distance zone increasing radially from 0 at the lens center to +0.1 to +0.4 diopters. (9) The central near vision lens is selected from the group consisting of: a non-dominant low ADD profile including the central near zone diameter of 4.0 mm, wherein the second transition optical zone has a second transition diameter of 4.0 mm to 6.0 mm, and the ADD power is +0.9 to +1.1 diopters; a non-dominant intermediate add power profile including the central near diameter of 4.0 mm, wherein the second transition optical zone has a second transition diameter of 4.0 mm to 6.0 mm, and the add power is +0.9 to +1.2 diopters; a non-dominant high add power profile including the central near diameter of 4.0 mm, wherein the second transition optical zone has a second transition diameter of +4.0 mm to +6.0 mm, and the add power is +1.0 to +1.2 diopters. (10) The pair of contact lenses of embodiment 9, wherein the first transition optical zone of the central distance lens and the second transition optical zone of the central near lens differ by less than 1.4 diopters, less than 1.3 diopters, less than 1.2 diopters, less than 1.1 diopters, or less than 1.0 diopters at any radial distance from the respective first and second optical axes.

[0078] (11) at least 65% of the add power is within a radius of 2 millimeters (mm) of the second optical axis in the central near optical zone; 2. The pair of contact lenses of claim 1, wherein the remaining add power is outside the 2 mm radius of the second optical axis. (12) A pair of contact lenses according to embodiment 1, having greater visual acuity (VA) for vision focused on near objects when the visual acuity focused on intermediate or far objects is reduced compared to a pair of 1-DAY ACUVUE® Moist presbyopic contact lenses having a central near extended depth of focus (EDOF) design for both the dominant and non-dominant eyes. (13) A pair of contact lenses according to embodiment 12, having a visual acuity (VA) improvement of at least 0.8 for visual acuity focused on near objects compared to a pair of 1-Day Acuvue® Moist presbyopic contact lenses. (14) The pair of contact lenses of embodiment 1, wherein the add power provides an effective add power of less than +2.0 diopters. (15) The pair of contact lenses described in embodiment 1, wherein the second power is for correcting hyperopia.

[0079] (16) The pair of contact lenses of embodiment 1, wherein the central near zone diameter targets the average pupil size of the population. (17) The pair of contact lenses according to embodiment 16, wherein the population is 1. (18) A pair of contact lenses, 1. A central distance lens for a contact lens wearer's dominant eye, comprising: a central distance optical zone having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye, the central distance optical zone being disposed about a first optical axis and having a first power selected to substantially correct distance vision in the dominant eye; a central distance lens comprising a first transition optical zone surrounding the first central optical zone, the first transition optical zone having a first progressive power profile; a central near lens for the non-dominant eye of the contact lens wearer, comprising: a central near optical zone having a central near zone diameter targeted to an average pupil size of a population, the central near optical zone surrounding a second optical axis and having a second power selected to substantially correct distance vision in the non-dominant eye and an add power relative to the first power; a central near lens comprising a second transition optical zone surrounding the second central optical zone, the second transition optical zone having a second progressive power profile. (19) The pair of contact lenses of embodiment 18, wherein the central distance zone diameter is between 1.8 millimeters (mm) and 3.8 mm. (20) The pair of contact lenses described in embodiment 18, wherein the central near zone diameter is between 2.6 millimeters (mm) and 4.0 mm.

[0080] (21) The central distance optical zone adjusts the spherical aberration (SPHA) depending on the first power (Rx) as follows: a. If Rx≦-3 diopters, SPHA=0.0082 * Rx-0.0251, b. A pair of contact lenses according to embodiment 18, wherein when Rx>-3 diopters, SPHA=-0.0497. (22) The pair of contact lenses of embodiment 18, wherein the first and second progressive power profiles differ by less than 1.4 diopters, less than 1.3 diopters, less than 1.2 diopters, less than 1.1 diopters, or less than 1.0 diopters at any radius from their respective first and second optical axes. (23) The first progressive power profile includes a first continuous power profile, 19. The pair of contact lenses of embodiment 18, wherein the second progressive power profile comprises a second continuous power profile. (24) The pair of contact lenses according to embodiment 18, wherein the second progressive power profile comprises a derivative continuous power profile. (25) A pair of contact lenses according to embodiment 18, having greater visual acuity (VA) for vision focused on near objects when the visual acuity focused on intermediate or far objects is reduced compared to a pair of 1-DAY ACUVUE® Moist presbyopic contact lenses having a central near extended depth of focus (EDOF) design for both the dominant and non-dominant eyes.

[0081] (26) A contact lens pair system, comprising: A plurality of central distance lenses for a dominant eye of a contact lens wearer, each comprising: a central distance optical zone having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye, the central distance optical zone being disposed about a first optical axis and having a first power selected to substantially correct distance vision in the dominant eye; a plurality of central distance lenses comprising a first transition optical zone surrounding the first central optical zone, the first transition optical zone having a first progressive power profile; A plurality of central near lenses for a contact lens wearer's non-dominant eye, each comprising: a central near optical zone having a central near zone diameter surrounding a second optical axis and having a second power selected to substantially correct distance vision in the non-dominant eye, the central near optical zone having an add power of at least +0.75 diopters relative to the first power; a second transition optical zone surrounding the second central optical zone, the second transition optical zone having a second progressive power profile; the central distance zone diameter and the central near zone diameter of a contact lens pair including one central distance lens of the plurality of central distance lenses and one central near lens of the plurality of central near lenses are selected such that the contact lens pair emulates monocular vision when the contact lens wearer is viewing near distance objects and such that the contact lens pair emulates partial monocular vision when the contact lens wearer is focusing on far distance objects; A contact lens pair system, wherein the first transition optical zone and the second transition optical zone of the contact lens pair are selected such that the contact lens pair emulates an extended depth of focus lens through binocular addition when the contact lens wearer is focusing on an intermediate distance object. (27) The contact lens pair system of embodiment 26, wherein the central distance zone diameter of each of the plurality of central distance lenses is between 1.8 millimeters (mm) and 3.8 mm. (28) The contact lens pair system of embodiment 26, wherein the central near zone diameter of each of the plurality of central near lenses is between 2.6 millimeters (mm) and 4.0 mm. (29) Each of the central distance lenses of the plurality of central distance lenses is selected from the group consisting of: a dominant low add profile comprising a central distance zone diameter of 2.0 to 2.8 mm, wherein the first transition optic zone has a first transition radius greater than the central distance zone diameter, and wherein the dominant add power provided in the central distance zone increases radially from 0 at the lens center to 0.1 to 0.4 diopters; a dominant intermediate add power profile comprising a central distance zone diameter of 2.4 to 3.8 mm, wherein the first transition optic zone has a first transition radius greater than the central distance zone diameter, and the dominant add power provided in the central distance zone increases radially from 0 at the lens center to 0.1 to 0.4 diopters; 27. The contact lens pair system of claim 26, having a power profile consisting of the group consisting of: a dominant high add power profile including a central distance zone diameter of 1.8 to 2.2 mm, wherein the first transition optical zone has a first transition radius greater than 2.0 mm, and the dominant add power provided in the central distance zone increases radially from 0 at the lens center to 0.1 to 0.4 diopters. (30) Each of the central near lenses among the plurality of central near lenses is selected from the group consisting of: a non-dominant low ADD profile including the central near zone diameter of 4.0 mm, wherein the second transition optical zone has a second transition diameter of 4.0 mm to 6.0 mm, and the ADD power is +0.9 to +1.1 diopters; a non-dominant intermediate add power profile including the central near diameter of 4.0 mm, wherein the second transition optical zone has a second transition diameter of 4.0 mm to 6.0 mm, and the add power is +0.9 to +1.2 diopters; a non-dominant high add power profile including the central near diameter of 4.0 mm, wherein the second transition optical zone has a second transition diameter of +4.0 mm to +6.0 mm, and the add power is +1.0 to 1.2 diopters.

[0082] (31) A contact lens pair system as described in embodiment 26, wherein the add powers of the plurality of central near lenses include effective add powers ranging from +0.75 diopters to +1.75 diopters, including the end points. (32) The plurality of central distance lenses have a plurality of first power profiles, the plurality of central near lenses having a plurality of second power profiles; The plurality of first power profiles are based on respective refractive corrections of -9.0 diopters to +6.0 diopters, including end points; 27. A contact lens pair system as described in embodiment 26, wherein the plurality of second power profiles are based on respective refractive corrections of -9.0 diopters to +6.0 diopters, including the end points. (33) (1) each of the first transition zones of the plurality of central distance lenses has a variation of less than 1.0 diopter from other first power profiles of the plurality of first power profiles at a given radius from the first optical axis; and (2) each of the second transition zones of the plurality of central near lenses has a variation of less than 1.0 diopter from other second power profiles of the plurality of second power profiles at a given radius from the second optical axis; 33. The contact lens pair system of claim 32, wherein the contact lens pair system is at least one of: (34) A method of fitting a contact lens pair of the contact lens pair system of embodiment 25 to a contact lens wearer, comprising: a) selecting an add power for the contact lens wearer; b) selecting a next pair of contact lenses for the contact lens wearer, a central near lens of the plurality of central near lenses having a second power selected to substantially correct distance vision in the contact lens wearer's non-dominant eye and having the add power of the presbyopia correction for the contact lens wearer's non-dominant eye; and selecting a next pair of contact lenses comprising: one central distance lens of the plurality of central distance lenses having a first power selected to substantially correct distance vision in the contact lens wearer's dominant eye. (35) c) receiving feedback from the contact lens wearer based on perceived stereopsis based on the distance visual acuity difference between the contact lens wearer's dominant eye and non-dominant eye when focusing on a distance object; d) in response to the feedback indicating reduced stereopsis based on the distance visual acuity difference of the next pair of contact lenses; selecting a next central distance lens of the plurality of central distance lenses for the contact lens wearer, the next central distance lens having the first power increment; and selecting a next central near lens among the plurality of central near lenses having a next second power reduction for the contact lens wearer.

[0083] (36) The method of embodiment 35, wherein step c) includes receiving feedback from the contact lens wearer based on the perceived visual acuity of the contact lens wearer when viewing the near object based on the disparity in the next central distance lens and the next central near lens. (37) The method of embodiment 35, further comprising repeating step d) until the feedback from the contact lens wearer indicates acceptable perceived stereopsis based on the distance visual acuity difference between the contact lens wearer's dominant and non-dominant eyes when focused on the distance object. (38) The method described in embodiment 34, wherein the increase in the next first power is +0.25 diopters to +0.5 diopters. (39) The method of embodiment 34, wherein the reduction in the next second power is between -0.25 diopters and -0.5 diopters. (40) The method of embodiment 38, wherein the increase in next first power for each repetition of step d) comprises increments of next first power increase of +0.5 diopters, +0.5 diopters, +0.5 diopters, +0.75 diopters, and +0.75 diopters.

[0084] (41) The method of embodiment 40, wherein the reduction in the next second power for each repetition of step d) comprises increments of reduction in the next second power of 0 diopters, −0.25 diopters, −0.5 diopters, −0.25 diopters, and −0.5 diopters. (42) The method of embodiment 38, wherein the reduction in the next second power for each repetition of step d) comprises increments of reduction in the next second power of 0 diopters, −0.25 diopters, −0.5 diopters, −0.25 diopters, and −0.5 diopters.

Claims

1. A pair of contact lenses, 1. A central distance lens for a contact lens wearer's dominant eye, comprising: a central distance optical zone having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye, the central distance optical zone being disposed about a first optical axis and having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye; a central distance lens comprising a first transition optical zone surrounding the first central optical zone, the first transition optical zone having a first progressive power profile; a central near lens for the non-dominant eye of the contact lens wearer, comprising: a central near optical zone having a central near zone diameter surrounding a second optical axis and having a second power selected to substantially correct distance vision in the non-dominant eye and an add power of at least +0.75 diopters relative to the first power; a second transition optical zone surrounding the second central optical zone, the second transition optical zone having a second progressive power profile; the central distance zone diameter and the central near zone diameter are selected such that a contact lens pair including the central distance lens and the central near lens emulates monocular vision when the contact lens wearer is focusing on near distance objects, and such that the contact lens pair emulates partial monocular vision when the contact lens wearer is focusing on far distance objects; A contact lens pair, wherein the first transition optical zone and the second transition optical zone are selected such that when the contact lens wearer is focusing on an intermediate distance object, the contact lens pair emulates an extended depth of focus lens through binocular addition.

2. 10. The pair of contact lenses of claim 1, wherein the central distance zone diameter is between 1.8 millimeters (mm) and 3.8 mm.

3. 10. The pair of contact lenses of claim 1, wherein the central near zone diameter is between 2.6 millimeters (mm) and 4.0 mm.

4. The central distance optical zone has a spherical aberration (SPHA) that depends on the first power (Rx) as follows: If Rx≦−3 diopters, SPHA=0.0082 ＊ Rx-0.0251, b. If Rx>-3 diopters, then SPHA=-0.0497; 10. The pair of contact lenses of claim 1,

5. 10. The pair of contact lenses of claim 1, wherein the first and second progressive power profiles differ by less than 1.4 diopters, less than 1.3 diopters, less than 1.2 diopters, less than 1.1 diopters, or less than 1.0 diopters at any radius from their respective first and second optical axes.

6. the first progressive power profile comprises a first continuous power profile; The pair of contact lenses of claim 1 , wherein the second progressive power profile comprises a second continuous power profile.

7. The pair of contact lenses of claim 1 , wherein the second power profile comprises a derivative power profile.

8. The central distance lens is selected from the group consisting of: a dominant low add profile comprising a central distance zone diameter of 2.0 to 2.8 mm, the first transition optic zone having a first transition radius greater than the central distance zone diameter, the dominant add power provided in the central distance zone increasing radially from 0 at the lens center to +0.1 to +0.4 diopters; a dominant intermediate add power profile comprising a central distance zone diameter of 2.4 to 3.8 mm, the first transition optic zone having a first transition radius greater than the central distance zone diameter, the dominant intermediate add power provided in the central distance zone increasing radially from 0 at the lens center to +0.1 to +0.4 diopters; 10. The pair of contact lenses of claim 1, having a power profile consisting of the group consisting of: a dominant high add profile comprising a central distance zone diameter of 1.8 to 2.2 mm, the first transition optical zone having a first transition radius greater than 2.0 mm, and a dominant high add profile provided in the central distance zone increasing radially from 0 at the lens center to +0.1 to +0.4 diopters.

9. The central near lens is selected from the group consisting of: a non-dominant low add profile including the central near zone diameter of 4.0 mm, the second transition optic zone having a second transition diameter of 4.0 mm to 6.0 mm, and the add power being between +0.9 and +1.1 diopters; a non-dominant intermediate add power profile including the central near diameter of 4.0 mm, wherein the second transition optic zone has a second transition diameter of 4.0 mm to 6.0 mm, and the add power is between +0.9 and +1.2 diopters; 10. The pair of contact lenses of claim 8, having a power profile consisting of, or consisting essentially of: a non-dominant high ADD profile including the central near diameter of 4.0 mm, the second transition optical zone having a second transition diameter of +4.0 mm to +6.0 mm, and the ADD power being between +1.0 and +1.2 diopters.

10. 10. The pair of contact lenses of claim 9, wherein the first transition optical zone of the central distance lens and the second transition optical zone of the central near lens differ by less than 1.4 diopters, less than 1.3 diopters, less than 1.2 diopters, less than 1.1 diopters, or less than 1.0 diopters at any radial distance from the first optical axis and the second optical axis, respectively.

11. at least 65% of the add power is within a radius of 2 millimeters (mm) of the second optical axis in the central near optical zone; 2. The pair of contact lenses of claim 1, wherein the remaining add power is outside the 2 mm radius of the second optical axis.

12. 10. The pair of contact lenses of claim 1, having greater visual acuity (VA) for vision focused on near objects with reduced vision focused on intermediate or far distance objects compared to a pair of 1-Day Acuvue® Moist presbyopic contact lenses having a central near extended depth of focus (EDOF) design for both the dominant and non-dominant eyes.

13. 13. The pair of contact lenses of claim 12, having a visual acuity (VA) improvement of at least 0.8 for visual acuity focused on near objects compared to a pair of 1-Day Acuvue® Moist presbyopic contact lenses.

14. 10. The pair of contact lenses of claim 1, wherein the add power provides an effective add power of less than +2.0 diopters.

15. 10. The pair of contact lenses of claim 1, wherein the second power is for hyperopia correction.

16. 10. The pair of contact lenses of claim 1, wherein the central near zone diameter targets an average pupil size of a population.

17. 17. The pair of contact lenses of claim 16, wherein the population is one.

18. A pair of contact lenses, 1. A central distance lens for a contact lens wearer's dominant eye, comprising: a central distance optical zone having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye, the central distance optical zone being disposed about a first optical axis and having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye; a central distance lens comprising a first transition optical zone surrounding the first central optical zone, the first transition optical zone having a first progressive power profile; a central near lens for the non-dominant eye of the contact lens wearer, comprising: a central near optical zone having a central near zone diameter targeted to an average pupil size of a population, the central near optical zone surrounding a second optical axis and having a second power selected to substantially correct distance vision in the non-dominant eye and an add power relative to the first power; a central near lens comprising a second transition optical zone surrounding the second central optical zone, the second transition optical zone having a second progressive power profile.

19. 20. The pair of contact lenses of claim 18, wherein the central distance zone diameter is between 1.8 millimeters (mm) and 3.8 mm.

20. 20. The pair of contact lenses of claim 18, wherein the central near zone diameter is between 2.6 millimeters (mm) and 4.0 mm.

21. The central distance optical zone has a spherical aberration (SPHA) that depends on the first power (Rx) as follows: If Rx≦−3 diopters, SPHA=0.0082 ＊ Rx-0.0251, b. The pair of contact lenses of claim 18, having: if Rx>-3 diopters, then SPHA=-0.0497.

22. 20. The pair of contact lenses of claim 18, wherein the first and second progressive power profiles differ by less than 1.4 diopters, less than 1.3 diopters, less than 1.2 diopters, less than 1.1 diopters, or less than 1.0 diopters at any radius from their respective first and second optical axes.

23. the first progressive power profile comprises a first continuous power profile; 20. The pair of contact lenses of claim 18, wherein the second progressive power profile comprises a second continuous power profile.

24. 20. The pair of contact lenses of claim 18, wherein the second progressive power profile comprises a derivative continuous power profile.

25. 19. The pair of contact lenses of claim 18, having greater visual acuity (VA) for vision focused on near objects with reduced vision focused on intermediate or far distance objects compared to a pair of 1-DAY ACUVUE® Moist presbyopic contact lenses having a central near extended depth of focus (EDOF) design for both the dominant and non-dominant eyes.

26. 1. A contact lens system comprising: A plurality of central distance lenses for a dominant eye of a contact lens wearer, each comprising: a central distance optical zone having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye, the central distance optical zone being disposed about a first optical axis and having a central distance zone diameter and a first power selected to substantially correct distance vision in the dominant eye; a plurality of central distance lenses comprising a first transition optical zone surrounding the first central optical zone, the first transition optical zone having a first progressive power profile; A plurality of central near lenses for a contact lens wearer's non-dominant eye, each comprising: a central near optical zone having a central near zone diameter surrounding a second optical axis and having a second power selected to substantially correct distance vision in the non-dominant eye, the central near optical zone having an add power of at least +0.75 diopters relative to the first power; a second transition optical zone surrounding the second central optical zone, the second transition optical zone having a second progressive power profile; the central distance zone diameter and the central near zone diameter of a contact lens pair including one central distance lens of the plurality of central distance lenses and one central near lens of the plurality of central near lenses are selected such that the contact lens pair emulates monocular vision when the contact lens wearer is viewing near distance objects and such that the contact lens pair emulates partial monocular vision when the contact lens wearer is focusing on far distance objects; A contact lens pair system, wherein the first transition optical zone and the second transition optical zone of the contact lens pair are selected such that the contact lens pair emulates an extended depth of focus lens through binocular addition when the contact lens wearer is focusing on an intermediate distance object.

27. 27. The contact lens pair system of claim 26, wherein each of the central distance lenses has a central distance zone diameter between 1.8 millimeters (mm) and 3.8 mm.

28. 27. The contact lens pair system of claim 26, wherein each of the central near lenses has a central near zone diameter between 2.6 millimeters (mm) and 4.0 mm.

29. wherein each central distance lens of said plurality of central distance lenses is selected from the group consisting of: a dominant low add profile comprising a central distance zone diameter of 2.0 to 2.8 mm, the first transition optic zone having a first transition radius greater than the central distance zone diameter, the dominant add power provided in the central distance zone increasing radially from 0 at the lens center to 0.1 to 0.4 diopters; a dominant intermediate add power profile comprising a central distance zone diameter of 2.4 to 3.8 mm, wherein the first transition optic zone has a first transition radius greater than the central distance zone diameter, and wherein the dominant add power provided in the central distance zone increases radially from 0 at the lens center to 0.1 to 0.4 diopters; 27. The contact lens pair system of claim 26, having a power profile consisting of the group consisting of: a dominant high add profile comprising a central distance zone diameter of 1.8 to 2.2 mm, the first transition optical zone having a first transition radius greater than 2.0 mm, and a dominant high add power provided in the central distance zone increasing radially from 0 at the lens center to 0.1 to 0.4 diopters.

30. wherein each central near lens of said plurality of central near lenses is selected from the group consisting of: a non-dominant low add profile including the central near zone diameter of 4.0 mm, the second transition optic zone having a second transition diameter of 4.0 mm to 6.0 mm, and the add power being between +0.9 and +1.1 diopters; a non-dominant intermediate add power profile including the central near diameter of 4.0 mm, wherein the second transition optic zone has a second transition diameter of 4.0 mm to 6.0 mm, and the add power is between +0.9 and +1.2 diopters; a non-dominant high add profile including the central near diameter of 4.0 mm, wherein the second transition optical zone has a second transition diameter of +4.0 mm to +6.0 mm, and the add power is between +1.0 and +1.2 diopters.

31. 27. The contact lens pair system of claim 26, wherein the add powers of the plurality of central near lenses comprise effective add powers ranging from +0.75 diopters to +1.75 diopters, inclusive.

32. the plurality of central distance lenses having a plurality of first power profiles; the plurality of central near lenses having a plurality of second power profiles; the plurality of first power profiles are based on respective refractive corrections of −9.0 diopters to +6.0 diopters, including end points; 27. The contact lens pair system of claim 26, wherein the plurality of second power profiles are based on respective refractive corrections from -9.0 diopters to +6.0 diopters, inclusive of endpoints.

33. (1) each of the first transition zones of the plurality of central distance lenses has a variation of less than 1.0 diopter from other first power profiles of the plurality of first power profiles at a given radius from the first optical axis; and (2) each of the second transition zones of the plurality of central near lenses has a variation of less than 1.0 diopter from other second power profiles of the plurality of second power profiles at a given radius from the second optical axis; 33. The contact lens pair system of claim 32, wherein at least one of:

34. 26. A method of fitting a contact lens pair of the contact lens pair system of claim 25 to a contact lens wearer, comprising: a) selecting an add power for the contact lens wearer; b) selecting a next pair of contact lenses for the contact lens wearer, a central near lens of the plurality of central near lenses having a second power selected to substantially correct distance vision in the contact lens wearer's non-dominant eye and having the add power of the presbyopia correction for the contact lens wearer's non-dominant eye; and selecting a next pair of contact lenses comprising: one central distance lens of the plurality of central distance lenses having a first power selected to substantially correct distance vision in the contact lens wearer's dominant eye.

35. c) receiving feedback from the contact lens wearer based on perceived stereopsis based on the distance visual acuity difference between the contact lens wearer's dominant and non-dominant eyes when focusing on a distance object; d) in response to the feedback indicating reduced stereopsis based on the distance visual acuity difference of the next pair of contact lenses; selecting a next central distance lens of the plurality of central distance lenses having a next first power increment for the contact lens wearer; and selecting a next central near lens of the plurality of central near lenses having a next second power reduction for the contact lens wearer.

36. 36. The method of claim 35, wherein step c) comprises receiving feedback from the contact lens wearer based on the contact lens wearer's perceived visual acuity when viewing the near distance object based on the disparity in the next central distance lens and the next central near lens.

37. 36. The method of claim 35, further comprising repeating step d) until the feedback from the contact lens wearer indicates acceptable perceived stereopsis based on the distance visual acuity difference between the contact lens wearer's dominant and non-dominant eyes when focused on the distance object.

38. 35. The method of claim 34, wherein the next first power increase is between +0.25 diopters and +0.5 diopters.

39. 35. The method of claim 34, wherein the next second power decrease is between -0.25 diopters and -0.5 diopters.

40. 39. The method of claim 38, wherein the next first power increase for each repetition of step d) comprises next first power increase increments of +0.5 diopters, +0.5 diopters, +0.5 diopters, +0.75 diopters, and +0.75 diopters.

41. 41. The method of claim 40, wherein the reduction in next second power for each repetition of step d) comprises increments of reduction in next second power of 0 diopters, −0.25 diopters, −0.5 diopters, −0.25 diopters, and −0.5 diopters.

42. 39. The method of claim 38, wherein the reduction in next second power for each repetition of step d) comprises increments of next second power reduction of 0 diopters, −0.25 diopters, −0.5 diopters, −0.25 diopters, and −0.5 diopters.

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