title: Factors influencing success of monovision contact lens fitting: survey of contact lens diplomates.
abstract: BACKGROUND
  Contact lenses are frequently fitted so that one eye is focused for distance and the other for near (monovision) in order to reduce the dependence of presbyopic patients on bifocal spectacle correction.
  
  
  METHODS
  We surveyed Diplomates in the Cornea and Contact Lens section of the American Academy of Optometry (N = 179) regarding their estimates of success with monovision fitting and factors influencing their perception of success. Results were statistically analyzed to determine the fitting philosophies of responders estimating that they achieve high success rates (HSRs) and low success rates (LSRs), respectively.
  
  
  RESULTS
  Completed surveys were returned by 98 Diplomates (54.8%), who estimated an overall success rate of approximately 71.7% with monovision; 50.5% "totally successful" (wear monovision correction full-time without problems or need for additional correction) and 21.2% "successful" (wear monovision full-time, but experience some symptoms of blur or other discomfort, may wear over-correction at times for driving or detailed near work). Sighting dominance was the most frequently used method to determine the distant eye, followed by the plus-lens test. The HSR group tended to be more likely to take occupational factors into account when deciding which eye to use for the distance lens, and they used more flexibility in determining the near-add power. The LSR group discontinued monovision sooner than the HSR group, who continued treatment for longer than 4 weeks during the adaptation period much more often for all add ranges.
  
  
  CONCLUSIONS
  Practitioners who regard monovision treatment as very successful have somewhat different fitting philosophies than those who regard monovision as unsuccessful. Implementation of highly successful practitioners' fitting techniques may increase success with monovision contact lens fitting.
authors.affiliation: University of Houston, College of Optometry, Texas 77204-6052, USA.
authors.forename: E
authors.initials: E
authors.lastname: Westin
authors.forename: B
authors.initials: B
authors.lastname: Wick
authors.forename: R B
authors.initials: RB
authors.lastname: Harrist
mesh_terms: D000221:Adaptation, Ocular; D000328:Adult; D003261:Contact Lenses; D006306:Health Surveys; D006801:Humans; D009907:Optometry / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011305:Presbyopia / Q000534:rehabilitation*; D055656:Prescriptions / Q000706:statistics & numerical data; D017755:Prosthesis Fitting; D011795:Surveys and Questionnaires; D016896:Treatment Outcome