RIGID GAS PERMEABLE

CONTACT LENS DESIGNS

Module 2.5

121
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 SPONSORS

Development and delivery of contact lens education by IACLE is supported

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Supporters

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 Published in Australia by
The International Association of Contact Lens Educators
First Edition 1997
The International Association of Contact Lens Educators 1996
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, without the prior
permission, in writing, of:
The International Association of Contact Lens Educators
IACLE Secretariat,
PO Box 656
Kensington NSW 1465
Australia
Email: [email protected]

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 CONTRIBUTORS

Rigid Gas Permeable Contact Lens Designs:

Lewis Williams, AQIT(Optom), MOptom, PhD

For a complete list of acknowledgements please see

our website: www.iacle.org

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 RGP LENSES DESIGN

• Essential for optimizing response

• High Dk materials make design
more forgiving

Does Design Matter?

Design issues can never be ignored because design can be used to optimize the ocular
response both on an individual basis and for the population at large. However, as RGP
material technology has advanced, RGP materials are now much more forgiving in
terms of the precision and finesse of fit required. This is due partially to the generally
lower rigidity of modern RGP lens materials.

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 RGP LENS DESIRABLE PROPERTIES

• Optimal design
• Material
- high Dk
- wettability
- deposit resistance
- stability
- ease of manufacture

Desirable Properties
The desirable properties of an RGP lens are:
Optimal design.
Design is the cornerstone of any contact lens fitting. As materials have improved, the
demands on the prescriber have lessened. However they almost certainly will never be
eliminated, even when topography measuring systems are interfaced to design and
manufacturing systems.
Material.
Dk. The minimum requirements for daily wear (DW) and extended wear (EW) can be
met by some RGP materials.
Wettability. For both optical regularity and lubricity reasons, a wettable material
which will retain a regular tear film is essential for satisfactory ongoing RGP lens
wear.
Deposit resistance. A deposited lens is not only potentially uncomfortable but the
wettability and the regularity of the pre-lens tear film may also be adversely affected.
Stability. In the interests of maintaining the parameters of the lens, and therefore lens
behaviour, the lens material must be stable. This enables it to resist changes to its
chemistry and properties over time, regardless of its environment or treatment.

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Ease of manufacture.
Manufacturing difficulties with a particular material can be a barrier to its usage. If special
handling or treatment is required, laboratories may resist using it. Alternatively, if the material
is treated conventionally, an unreliable product may result.

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 DESIRED FITTING

• Moderate edge width and clearance

• Central and mid-peripheral alignment
• Smooth movement
• Centration

Desired Fitting
Moderate edge width and clearance. A balance needs to be struck between the volume
of the tear fluid reservoir at the lens edge and the edge ‘stand-off’ which can adversely
affect comfort.
Central and mid-peripheral alignment. In general, modern RGP fitting philosophies
are based on alignment with the cornea.
Smooth movement. Lens movement is essential to disperse metabolic and cellular
wastes from under the lens. Excess movement can create visual and comfort
disturbances. A balance of factors affected by movement will help define the optimal
movement characteristics of a fitting.
Adequate centration. A decentred lens can cause visual anomalies particularly during
lowered illumination. Comfort may also be compromised. Since movement is
required, this movement should be symmetrical about a central location.

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 DESIRED PERFORMANCE

• Comfortable
• Clear vision
• Adequate wearing time
• Minimal ocular response
• Normal facial appearance

Desired Performance
A properly performing lens should:
Be comfortable.
Provide clear vision which is equal to or better than the vision provided by spectacle
lenses.
Enable adequate wearing time. Patient should be able to wear the lenses during
waking hours - an acceptable time is approximately 8-14 hours per day.
Provoke minimal ocular response - lenses usually affect ocular function but the affect
should not be clinically detectable.
Not affect head posture or ocular appearance such as narrowing of the palpebral
aperture or blepharospasm.

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9
 KEY DESIGN FEATURES

• Back surface design

• Back optic zone diameter
• Front surface design
• Lens thickness
• Edge configuration
• Lens diameter

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 LENS PARAMETERS

ISO TERMINOLOGY

International Organization for Standardization (ISO) terminology is used throughout

this lecture.

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 LENS PARAMETERS

tpj2
tpj1 r2
r1
Back Parameters
tc r0
ra0 Front Parameters

ra1

Simple Tricurve Lens

Lens Parameters: Front and Back Radii and Thicknesses

Simple Tricurve Lens
The lens parameters, their standardized names and their standardized symbols are
included in this diagram.
r0 = Back Optic Zone Radius
r1 = Back Peripheral Radius (First)
r2 = Back Peripheral Radius (Second)
ra0 = Front Optic Zone Radius
ra1 = Front Peripheral Radius (First)
tc = Geometric Centre Thickness
tp|1 = Peripheral Junction Thickness (First)
tp|2 = Peripheral Junction Thickness (Second)

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 LENS PARAMETERS

Ø0
Ø1 Øa0
Øt

tEA

tER

Lens Parameters: Diameters and Edge Thicknesses

This diagram shows the relevant diameters along with the two types of edge thickness
defined in the ISO standard.
0 = Back Optic Zone Diameter
o0 = Front Optic Zone Diameter
1 = Back Peripheral Zone Diameter
T = Total Diameter
tER = Radial Edge Thickness
tEA = Axial Edge Thickness

Miscellaneous (not shown on slide)

Fv´ = Back Vertex Power
Fv = Front Vertex Power

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 BACK SURFACE

• Controls Lens/Cornea Interaction

Centration
• Affects
Movement

The Back Surface

Back surface design (shape) is the major factor in controlling the lens/cornea
interaction. This interaction largely controls the clinical behaviour of a lens which is
usually described as the ‘fit’.
This lens/cornea interaction affects the centration of the lens as well as lens movement.
Since lens ‘fit’ is more than just the result of a lens being steeper, flatter or aligned
with the cornea, the back surface design outside the back central optic zone is also
relevant to final lens behaviour.

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 MULTICURVE DESIGNS

r2 Spherical back
r1
surface curves
r0
c0 c1 c2
Centres of curvature on
axis of symmetry

Simple Tricurve

Multicurve Design
This diagram illustrates a series of spherical (i.e. shapes based on a circle) back curves
which will ultimately be blended to form a smooth continuous curve. Importantly,
because spherical surfaces are the result of the use of a conventional lathe, the centres
of curvature of each of these spherical curves lies on the axis of symmetry of the lens
(which is also the optic axis of such a lens).

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 CONTINUOUS NON-SPHERICAL DESIGN

• Single continuous curve

• Approximates cornea’s shape
• Aspheric
• Shape usually derived from conic sections
• More than one conic section can be
combined to form a compound continuous
curve

Continuous Non-Spherical Design

Surface designs (front or back) don’t have to be limited to designs based on a circle.
The concept of the cornea not being spherical has been accepted for more than a
century (Senff, 1846).
The attraction of a continuous single curve which more nearly approximates the
cornea’s actual shape is obvious. Such surface designs are referred to as ‘aspheric’
and represent a deliberate attempt to improve on designs which are ‘spherical’. (The
term ‘spheric’ is not normally used but is still correct.)
The family of curves from which such surface shapes can be derived, which also
includes a first-order approximation to the shape of the cornea, is called conic sections.
Conic sections can be combined to form compound continuous curves. Combinations
of conic and non-conic sections have also been used. The advent of computers and
computer-aided manufacturing means that very complex continuous curves are
possible.

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16
 RELEVANT CONIC SECTIONS

Parabola e=1
Ellipse e=0.5
Circle e=0
(0,0)

r0 = 7.80 mm

Conic Sections
This diagram shows all conic sections. In this series the circle is considered a special
case. The hyperbola has been rarely used in RGP or PMMA lenses and it is believed
that no current lens designs incorporate such a shape. The solid formed by the rotation
of a conic section about its major axis is called a conicoid. The conicoid resulting
from the special case of the circle is a sphere hence the term spherical.

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 FIRST TRUE ASPHERIC HARD LENS
DESIGN
(Feinbloom, 1961)

• Ellipsoidal, PMMA, Spheres and Torics

• Invented manufacturing equipment as well
• Developments by Volk followed. Volk
became the most prolific aspheric
proponent (1961 - 1987)

First True Aspheric Hard Lens Design

The first true aspheric hard lens design was by Feinbloom in 1961. His lens was
ellipsoidal and could be fabricated as a lens with either a spherical or a toric Rx.
Because the shapes could not be generated by contemporary equipment, Feinbloom
also invented fabrication machinery for the generation of his lens designs. His
pioneering work was quickly followed by the work of Volk and Neefe. The former
then went on to become the greatest proponent of aspheric lenses for contact lenses
and virtually all other clinical purposes (e.g. field lenses for indirect ophthalmoscopy).

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 ASPHERIC DESIGNS

• Regular non-spherical back surface

curves
• Often a continuous curve
• Centres of curvature off axis of symmetry

Aspheric Designs
Aspheric lenses incorporate regular non-spherical curves whose centres of curvature
appear to be off the axis of symmetry (cf. spherical lens designs whose centres of
curvature appear to be on the axis of symmetry).
Surfaces, especially back surfaces, are often a continuous curve as opposed to surfaces
formed by blending discrete curves.

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 ASPHERIC SURFACES CIRCLE vs ELLIPSE

Circle
e = 0.9

r0 = 7.80 mm
Aperture = 10.5mm

Aspheric Surfaces
Despite the dramatic diagrams used to illustrate aspheric surfaces and curves which
appear in textbooks, the shape differences are anything but dramatic. This diagram
compares a circle and an ellipse. Despite the ellipse’s larger than normal eccentricity
(0.9 versus 0.4 to 0.6), and the use of a larger than practical diameter, the difference,
especially over a more realistic aperture of say 8 mm, in fact remains quite small.

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 BACK SURFACE DESIGN FREEDOM

• Spherical or aspheric
• Single or multiple curves
• Fitting relationship

Back Surface Design: Design Freedom

While back surface design is somewhat limited by the fact that it must relate to the
corneal shape in an acceptable way, there is still some freedom as to the final overall
shape. The possibilities are:
A spherical or aspheric shape.
Single or multiple curve design.
Fitting relationships which broadly fall into the following categories:
steeper than the cornea
aligned with the cornea
flatter than the cornea.

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 BACK SURFACE DESIGN CLINICAL
CONSIDERATIONS

• Central fluorescein pattern

• Corneal curvature changes
• Vision

Back Surface Design: Clinical Considerations

Central fluorescein pattern.
The use of sodium fluorescein is a sensitive technique for comparing the cornea’s
shape to that of a trial contact lens by highlighting the differences between them.
Corneal curvature changes.
When a fitting relationship other than alignment is chosen, the possibility that the lens
may alter the corneal curvature and/or shape needs to be considered.
Lens adherence.
Virtually all EW RGP wearers will show an episode of lens adherence at some time
and it is still not clear what, if anything, can be done to eliminate the occurrence.
Vision.
If the corneal shape is normal and regular, the tear lens power, and its influence on the
final BVP required, is directly influenced by the BOZR chosen.
If the cornea is irregular, keratoconic or highly astigmatic, the overall back surface
shape, as well as the BOZR, may influence the vision outcome.

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 BACK SURFACE DESIGN FLUORESCEIN
PATTERN

Ideal
Aspheric

Spherical BOZD
BOZD

Fluorescein Pattern
The fluorescein pattern observed under an RGP lens depends on its back surface
shape. The diagrams, representing cross-sectional traces of tear lens thickness under
rigid lenses, show the expected patterns from two possibilities.
An aspheric shape ideally aligns with the cornea. As a result, little or no fluorescein is
seen anywhere except at the lens edge. The latter is due to the tear reservoir/meniscus
deliberately formed at the lens edge.
A spherical BOZD shows the effect of a spherical curve not aligning with the aspheric
cornea. The bull’s-eye appearance refers to the concentric bright band (ring of
fluorescence) surrounding the dark centre (absence of fluorescence) which results.
This effect is much less pronounced with a small BOZD) even when the BOZR is
altered to compensate for the change in sagittal height.

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Diagram of the Three Main Fitting Philosophies
Flatter.
Aligned.
Steeper.

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 BACK OPTIC ZONE RADIUS

• Aspheric
- better alignment
- more difficult to manufacture
- difficult to verify
- more decentration

• Spherical
- better vision
- better centration

Back Optic Zone Radius:

Aspheric:
better alignment. Cornea is aspheric and better approximations to its shape can be
achieved with aspheric back surface designs.
difficult to manufacture. While the difference between spherical and aspheric lenses is
now smaller due to the wide usage of CNC lathes, it is still slightly more difficult to
produce aspheric lenses by non-molding techniques. Molding aspherics is only more
difficult at the start-up stage when master tools are being fabricated.
difficult to verify. Since current instruments are designed for spherical optics and
curves, aspherics represent a challenge to both the industry and practitioners.
Spherical:
studies have shown that spherical surface shapes generally produce superior vision
quality (see slide 25).

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 CORNEAL CURVATURE CHANGES
EFFECT OF FITTING PHILOSOPHIES
(n=11)

SPHERICAL ASPHERIC

Kh -0.26 + 0.49 D -0.19 + 0.51 D

Kv -0.61 + 0.47 D -0.20 + 0.47 D

p<0.001
Negative = a flattening

Corneal Curvature Changes: Effect of Design

In a study of back surface designs, the changes in horizontal and vertical corneal
meridians were compared. The greatest changes (flattening) occurred with spherical
lenses in the vertical meridian. The horizontal meridian with spherical lenses, and both
meridians with aspheric lenses, changed by lesser amounts.

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 EFFECT OF FITTING PHILOSOPHIES
Spherical Back Surface Design

Kh Kv

Steep +0.04 (0.42 D)* -0.15 (0.54 D)*

Align -0.03 (0.43 D)* -0.23 (0.52 D)*
Flat -0.13 (0.39 D)* -0.32 (0.59 D)*

p<0.001 p<0.003
*mean (sd)

Corneal Curvature Changes: Effect of Fitting Philosophies (Spherical Back

Surfaces)
The changes in corneal curvature (horizontal and vertical) induced by lenses with
spherical BOZRs and fitted according to the three fitting philosophies, were compared
in a CCLRU study.
This table shows that the vertical meridian is generally more affected regardless of the
fitting philosophy used (steeper, aligned, flatter). Somewhat paradoxically, even with
a steep lens, the vertical meridian still flattened slightly (–0.15 but with a substantial
SD). Only in the horizontal meridian with a steep fit was a curvature increase
recorded. Even then it was only slight, albeit with a significant SD. The data also
suggests that flatter fits are more effective at altering corneal curvature. This may also
be relevant to lens adherence.

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 BEARING RELATION RANGE
Adherence Incidence
0.3

Overall
0.2
incidence

0.1

0
STEEP ALIGNED FLAT

Bearing Rotation Range

Lens Adherence: Bearing Relation Range

When the relationship between RGP lens adherence (lens binding to the cornea) and
the fitting relationship is examined, it appears that when the lens is fitted steeper than
K, the incidence of adherence is lower but still not zero. While adherence with
‘aligned’ and ‘flatter’ fits differs little, there is a tendency for the flatter fits to result in
a greater incidence of adherence.

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 RIGID LENS DESIGNS
(Cornish, 1987)
Vision lost (letters lost)
0

Low -2
-3
Contrast -5
Low
-7
Illumination
-10

-13
-15
SPH ELL SPH PARAB
-ELL

Rigid Lens Design and Vision Quality

The effect of back surface shape on vision quality is demonstrated in this graph. While
spherical and elliptical shapes produced little loss of quality, a combination of them
resulted in a greater decrease in vision. For manufacturing convenience, RGP lenses
with aspheric back surface designs often have spherical front surfaces, a combination
this graph suggests is undesirable. The parabolic surface shape performed poorly.

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 VISION EFFECT OF BOZD

BOZD
(Ø0)

formed by light
passing through
lens periphery

Vision Effect of Back Optic Zone Diameter

The effects on vision of a BOZD (0) which is smaller than the entrance pupil size
(the image of the anatomical pupil formed by the optics of the cornea and anterior
chamber) are illustrated in this diagram. Once the BOZD is exceeded by the entrance
pupil diameter, light is refracted by the optic zone, the first curve junction and the lens
periphery. In this circumstance, vision quality, including image contrast, is decreased.

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 BACK OPTIC ZONE RADIUS SUMMARY

• K changes according to fitting

relationship
• Steep fitting lenses
- less adherence?
• Larger optic diameter
- better vision but poorer alignment

Optimal Back Surface Design: Summary

Assuming the lens back surface design is spherical and an alignment fitting is sought,
the following summarizes the optimum fluorescein fitting pattern of a centred RGP
contact lens resting on a spherical cornea:
Alignment or a very slight tendency towards apical clearance over the central 7 – 8
mm.
Mid-peripheral alignment about 1 – 2 mm wide.
Edge clearance about 0.5 mm wide.
An obvious tear meniscus at the lens edge.
The actual dimensions (pattern widths) depend on:
Total lens diameter (TD).
Corneal topography (toricity, p-value and regularity).
Actual lens back surface design (including BOZD, etc.).

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31
 BACK SURFACE MID-PERIPHERY
DESIGN FREEDOM

• Width
• Radius
• Shape
• Number of curves

Back Surface Mid-Periphery

Design Freedom:
Width. The width of the curve(s).
Radius. The radius/radii of the curve(s).
Shape. The shape or form of the surface, i.e. conical, spherical, aspheric.
Number of curves.

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 BACK SURFACE MID-PERIPHERY

Requirement:
• Align the flattening cornea

Affects:
• Tear flow
• Stability of the fit
• Corneal mid-peripheral shape
• Centration

Back Mid-Periphery
Requirement:
Should align flattening cornea.
Since the cornea flattens peripherally, the lens secondary and peripheral zones must
have curves which are flatter than the BOZR, preferably flattening progressively. This
can be achieved by a series of flattening blended spherical curves, or by a continuous
aspheric curve such as an ellipsoid or a paraboloid which would match the corneal
shape.
Affects:
Stability of fit.
If the mid-peripheral curves are significantly flatter than this corneal region, excessive
clearance, an unstable fit and excessive movement will result.
Tear flow.
This area of the lens can cause a restriction of tear flow if the bearing area is localized
(narrow) by sealing off the back optic zone region. This is also likely to produce a
tight fit and entrapment of debris or air bubbles within the optic zone area.
Corneal peripheral shape.
As with the central region, corneal shape can be affected by the lens fitting
relationship. Harsh and localized bearing on the mid-peripheral band may cause

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corneal indentation.
Centration.
If the mid-peripheral zone is flatter than the cornea resulting in excessive edge lift, the lens is
more likely to decentre.

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 BACK SURFACE DESIGN
CENTRAL FIT AND MID-PERIPHERY (MP)

Steep centre Tight MP

Aligned
or flat centre { Moderate to flat
MP clearance

Central Fit and Mid-Periphery

A steep central fit may produce a tight mid-peripheral fit unless multiple curves are
used and the optic zone diameter is reduced.
An aligned or flat central fit can result in moderate or excessive mid-peripheral
clearance.

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 Radial edge clearance
and Radial edge lift

Axial
AEL Axial TLT Edge
Clearance
Edge
Lift
Cornea
Lens BOZR
Extended

Axial Edge Lift, Radial Edge Lift, Tear Layer Thickness

This diagram illustrates the terms Axial and Radial Edge Lift and Clearance as well as
the Tear Layer Thickness (TLT). While this diagram refers to the lens edge, the
concept of the ‘extension’ of the base curve (BOZR) to form a reference surface
applies to all lens zones, i.e. central, mid-peripheral, peripheral and edge zones. Note
that the term ‘lift’ refers to a lens and not the lens/cornea fitting relationship. The
terms axial and radial clearance are used to describe the distance between the lens and
the cornea for each of the lens zones.

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 TRICURVE LENS DESIGN

Curve Radius Diameter

Central BOZR BOZD (TD-1.4)

2nd BOZR + 0.8 BOZD + 0.6
Peripheral BOZR + 2.5 BOZD + 1.4

Tricurve Lens Design

This typical, simple tricurve design (i.e. optic and two additional curves) shows that
the second curve has a radius 0.80 mm flatter than the BOZR for a width of 0.30 mm.
The optic zone has a diameter 1.4 mm less than the total diameter (TD) of the lens.
Many variations of this design are used. However, the principle of progressively
flatter curves over discrete widths is common to all. This allows the mid-peripheral
curve to either align with the flattening paracentral region of the cornea or have
minimal clearance over this zone. Interestingly, the ISO draft standard deals only in
zone diameters whereas manufacturers prefer to deal in zone widths. Diameters are
presented here.

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36
 BACK SURFACE PERIPHERY
DESIGN FREEDOM

• Width
• Radius/lift
• Shape
• Number of curves

Back Surface Periphery

Design Freedom:
Width.
The width of the peripheral curves.
Radius/lift. The flatter a peripheral curve is in relation to the cornea, the greater will
be the edge stand-off. It can be measured axially or radially as shown in slide 31.
Shape. The shape or form of the surface, i.e. spherical, aspheric.
Number of curves.
Either a single continuous curve, or multiple curves blended into a smooth surface,
may be used as the back peripheral design.

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 BACK SURFACE PERIPHERY

Peripheral (or edge) curve:

Radius - 2.50 mm flatter than BOZR

Width - 0.30 to 0.50 mm

Blend final mid-peripheral and

peripheral curves

Back Surface Periphery

In order to optimise this section of lens design, the peripheral curve, regardless of its
form (spherical or aspheric), should be flatter than the corneal radius in order to have
corneal clearance. The clearance when observed with fluorescein should appear as a
band with its intensity increasing towards the periphery.
An almost ideal fluorescein fitting pattern is presented in slide 39 It demonstrates the
little or no fluorescein pattern under the central and mid-peripheral zones of the lens
indicating corneal alignment, the edge clearance desired, the tear meniscus at the lens
edge and good lens centration.

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Back surface periphery affects:
Fluorescein pattern at the periphery of the lens, e.g. a flat and wide peripheral curve will result
in excessive edge clearance producing a bright band of fluorescein.
Centration is usually compromised by excessive edge clearance.
Tear exchange is greater with a wide and flat peripheral curve.
Excessive edge clearance will result in an unstable fit with excessive lens movement.
3 & 9 o’clock staining may result from excessive or inadequate edge clearance.

38
BACK SURFACE PERIPHERY

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39
 BACK SURFACE PERIPHERY

Affects:
• Peripheral fluorescein appearance
• Centration
• Tear exchange
• Lens fit
• 3 & 9 staining

Back Surface Periphery

In order to optimise this section of lens design, the peripheral curve, regardless of its
form (spherical or aspheric), should be flatter than the corneal radius in order to have
corneal clearance. The clearance when observed with fluorescein should appear as a
band with its intensity increasing towards the periphery.
An almost ideal fluorescein fitting pattern is presented in slide 39. It demonstrates the
little or no fluorescein pattern under the central and mid-peripheral zones of the lens
indicating corneal alignment, the edge clearance desired, the tear meniscus at the lens
edge and good lens centration.

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Back surface periphery affects:
Fluorescein pattern at the periphery of the lens, e.g. a flat and wide peripheral curve will result
in excessive edge clearance producing a bright band of fluorescein.
Centration is usually compromised by excessive edge clearance.
Tear exchange is greater with a wide and flat peripheral curve.
Excessive edge clearance will result in an unstable fit with excessive lens movement.
3 & 9 o’clock staining may result from excessive or inadequate edge clearance.

40
 EDGE WIDTH AND TEAR RESERVOIR

WIDE NARROW
edge edge

Excessive reservoir Inadequate reservoir

loose fit tight fit

Edge Width and Tear Reservoir

This diagram shows the competing issues involved in selecting edge widths. While a
wide edge will increase the volume of tears stored in the edge reservoir, the stability of
lens fit may be adversely affected. A balance between these forces is required.

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 EDGE CONFIGURATION DESIGN

• Position of apex
• Roundness
• Blend of junctions
• Thickness

Edge Configuration
Design Freedom:
Position of apex. The apex of the edge profile can be biased towards the back or front
or remain central.
The edge of the lens should not exhibit any ‘high’ points.
Blend of Junctions.
The topography of the lens just inside the lens edge influences the edge profile,
thickness, junction angles etc. The blend from the final peripheral curve to the edge
finish is critical to what edge design is possible.
Thickness.
This is difficult to quantify because of the multitude of ways it can be measured.
Traditionally the radial thickness at some point a fixed distance in from the edge apex
is used.
The distance and the tools used to measure thickness vary greatly. A precision
profilometer is an alternative to this technique but such devices are uncommon,
expensive and not widely accepted at this time.

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42
 EDGE CONFIGURATION

Affects:
• Comfort
• Durability
• Tear meniscus

Edge Configuration
Edge Configuration can affect:
Comfort.
Generally the thinner, rounder and smoother the better. It has been shown when the
edge apex is biased towards the back of the lens, the comfort is optimized (La Hood,
1988)
Durability.
Making a lens too thin creates a risk of lens fragility. Making it too thick may
influence comfort adversely.
Tear meniscus.
The edge clearance, apex location and material wettability largely define the tear
meniscus at the lens edge.

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 EDGE SHAPE vs COMFORT
(La Hood, 1988)

• RGP lenses with rounded and square

posterior edge profiles are more
comfortable
• Comfort is determined by interaction of
lens edge with the lid

Edge Shape versus Comfort

As a result of studies of comfort versus edge shape it was found that:
RGP lenses with rounded and square posterior edge profiles are more comfortable.
This suggests that as long as the apex is not biased towards the anterior surface, the
actual shape is less significant.
Comfort is determined by the interaction of lens edge with the lid and to a lesser extent
the interaction of the lens with the cornea. However when the lids are manually
retracted, the wearer of an RGP lens usually reports decreased sensation from the lens.

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 RGP EDGE SHAPE vs COMFORT
(La Hood, 1988a)
Cannot be felt
10

0
Painful Square Square Round Round
Square Round Square Round

RGP Edge Shape versus Comfort

This graph shows the comfort ratings found for each of the edge profiles trialed in the
study. A depiction of each profile appears above the relevant bar on the graph.

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 EDGE CONFIGURATION COMFORT
vs APEX LOCATION
(Osborn et al. 1988)

Posterior Centre Anterior

Comfort level:
Centre > Posterior > Anterior

Comfort versus Apex Location

In a detailed study of custom fitted lenses, Orsborn found a centrally located edge apex
was more comfortable than either a posterior or anterior location. An anterior location
was the least comfortable.

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 EDGE CONFIGURATION COMFORT
vs APEX LOCATION

#34 #23

Edge Thickness

Edge Thickness

Apex Apex
BOZR BOZR

Edge lift Edge lift

Numerical Edge Analysis

With a high precision profilometer, numerical data on the actual edge shape can be
achieved. While applicable to clinical practice, the real role of such an instrument is in
manufacturing, lens design and quality assurance/control.
Lens #34 Lens #23
Edge thickness 0.1 mm 142.2 m 145.9 m
Edge thickness 0.5 mm 189.3 m 194.3 m
Edge lift 112.2 m 113.5 m
Edge taper 73.3% 73.1%
Apex position 43.7% 51.9%
cent.-ant. central
Radius anterior 34.3 m 46.4 m
Radius apex 22.7 m 34.5 m
Radius posterior 56.5 m 43.0 m

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 IDEAL FITTING

Centre - aligned
Mid-periphery - align/min. clearance
Pheripheral curve - 0.3-0.5 mm wide
AEL - 75-100µm clearance

Ideal Fitting
Based on the foregoing, the ideal fit of an RGP can now be described.
Centrally the lens should align with the cornea.
The mid-periphery should be aligned with the cornea or have minimal clearance from
it. Excessive bearing pressure in this region may restrict tear flow under the lens
and/or affect the cornea itself.
The peripheral curve, which is usually 0.3 to
0.5 mm wide, should result in an axial edge lift of approximately 0.10 mm. This lift is
dependent on the other back surface parameters as well.

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 LENS THICKNESS

Determined by:
• Rigidity
• Permeability
• Back vertex power

Lens Thickness
Lens thickness is largely determined by:
Rigidity of the lens material. Lenses made from less rigid materials need to be made
thicker when fitted to an astigmatic cornea if they are to resist becoming toric
themselves by conformance.
Permeability. As some highly permeable materials are more flexible, lens thickness
may have to be increased compared with less permeable materials.
Back vertex power (BVP). BVP is a significant determinant of lens thickness,
especially in the optical zone.

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 LENS THICKNESS CONSIDERATIONS

• ‘On-eye’ lens flexure

• Correction of corneal astigmatism
• Dk/t

Lens Thickness
Considerations:
‘On-eye’ lens flexure.
A lens needs to be thick enough to resist flexure while being thin enough to deliver the
potential physiological benefits inherent in higher Dk materials.
Some materials show a direct relationship between Dk and flexibility, i.e. the higher
the Dk the greater the flexibility. This often means in practice that any gains from
increasing the Dk are offset by the need for a thicker lens having an acceptable level of
flexure, i.e. Dk/t does not increase by as much as is suggested by the increase in the
Dk of the material used. However, Cornish et al ., (1991) found that over the Dk
range 0 – 140, Dk and flexibility were independent properties. Therefore, at least for
the materials tested, the oxygen transmissibility can be increased without the need to
increase lens thickness to maintain the level of lens rigidity desired.
Correction of astigmatism.
The dominant use of RGPs in many practices is for the correction of corneal
astigmatism with a spherical lens. If the lens flexes on an astigmatic cornea, then less
than the 90% of astigmatism (which is normally corrected by such lenses) will be
corrected.
Dk/t.

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Since Dk/t is a measure of the oxygen transmission through the lens, t is an important
determinant of oxygen availability especially for low to moderate Dk materials.

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 Dk/t of various materials at standard power
(-3.00 D) and centre thicknesses (tc)

tc(µm) Dk/tc
Quantum ll 150 94
Breath ‘O’ HCL 170 80
Equalens ll 150 77

Dk/t of Various Materials at Standard Power and Centre Thickness

Historically, the contact lens industry has used
–3.00 D as a standard BVP. Each material requires a characteristic thickness to resist
clinically significant flexure on a toric cornea. This table shows typical thicknesses for
some common materials along with the resultant Dk/tc. The table clearly shows that
high Dk values are not the final arbiter of oxygen conditions under a lens.

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 ‘ON-EYE’ FLEXURE vs tc
CORNEAL Cyl = 1.82 + 0.74 D

Flexure (D)
2.0

1.5

1.0

0.5

0.0
0 20 40 60 80 100 120 140 160 180

tc (µm)

‘On-Eye’ Flexure versus tc

This graph shows the lens flexure which occurs at varying lens thicknesses when fitted
to a population of astigmatic corneas whose toricity was
1.82  0.74 D. From the data, it can be surmised that a thickness of >0.16 mm is
required to resist flexure of a clinically significant level.

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 FLEXURE & LENS POWER

FSK (DC) (Harris & Appelquist. 1974)

2
K cyl 3.00 DC
1.5 K cyl 0.00 DC

0.5

-0.5
0 -2.00 -4.00 -6.00 -8.00 -10.00
Back Vertex Power (D)

Flexure and Lens Power

Because of the effect BVP has on overall lens thickness, it too is a clinical
consideration. This graph shows the effect BVP has on lens flexure on a 3.00 D
corneal cylinder. Obviously there is no effect when a lens is placed on a spherical
cornea.

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 FLEXURE, LENS THICKNESS & CORNEAL CYL

FSK (DC) (after Harris & Chu, 1972)

3
6.12 D Cyl
4.00 D Cyl
Spherical
2

0
0.08 0.10 0.12 0.14 0.16 0.18 0.20 0.22
Thickness (mm)

Flexure, Lens Thickness and Corneal Cylinder

This composite graph clearly shows the effect progressively increasing corneal
cylinder has on lens flexure in situ. The material used was PMMA. It shows that
about 0.16 mm centre thickness is required to resist flexure on the larger cylinders.
Interestingly, in the case of the 6.12 D cylinder, even 0.22 mm thickness still exhibited
an 0.50 D flexure.

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 FLEXURE, LENS MATERIAL & THICKNESS

FSK (DC)
1.5
16 eyes,
with-the-rule astigmatism,
1.25 to 4.25 D
1

0.5

Polycon
PMMA
0
0.05 0.1 0.15 0.2
Thickness (mm)

Flexure, Lens Material and Thickness

This graph shows the flexure differences which can be attributed to the physical
property differences of materials. The more flexible PolyconTM material needs to be
thicker to resist on-eye flexure.

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 FRONT SURFACE DESIGN

Controlled by:
• BVP
Design Freedom:
• FOZD
• Front peripheral curves
• Their radii and widths

Front Surface Design

The front surface of the lens and the thickness profile is largely controlled by the BVP
required and whether the front surface is spherical or aspherical.
The only options that may be exercised are:
FOZD.
This is usually made large enough to accommodate most pupil (entrance pupil) sizes
without resulting in an excessive mid-peripheral thickness. In higher powers, the
FOZD may be reduced slightly as a compromise between mid-peripheral thickness and
the effects a large pupil size may have on vision.
Number of peripheral curves on the front surface, their radii and widths.

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 FRONT SURFACE DESIGN

Affects:
• Vision
• Lid interaction
- comfort
- movement
- centration

Thickness Profile/FS Design

The front surface design affects:
Vision.
Apart from FOZD versus pupil size issues, there is also the question of the ‘form’ of
the lens. While it is desirable that a lens be of ‘best form’ design, contact lenses do not
offer this freedom because their form is dictated by corneal shape. Spherical or
aspheric shapes also differ in their vision quality with spherical probably performing a
little better (see slide 25).
Lid interaction. This in turn will influence comfort, movement and centration. The
profile thickness of the lens will also affect lid interaction.

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 LENTICULATION

Affects:
• Centre thickness
• Lens mass
• O2 transmission
• Comfort

Lenticulation
Lenticulation affects:
Centre thickness.
In plus lenses only.
Lens mass.
This is true for all lenses.
O2 transmission.
This is true for all lens types. It is especially true for the optic zones of plus lenses,
and for the effects on average lens thickness of all lens types.

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58
 FRONT OPTIC DIAMETER

FOZD

Lenticulation defines the FOZD of a lens. Unlike most soft lenses, the FOZD does not
necessarily define the practical optical zone diameter on RGP lenses, and often the
BOZD is smaller than the FOZD.

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 JUNCTION ANGLE & THICKNESS

Junction
Junction
thickness angle
FPR
(tpj1)
(ra1)

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JUNCTION ANGLE & THICKNESS

Affects
• Comfort
• Lens movement
• Centration
• Lens bulk

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 INTERACTION with LID

Minus Wedge
carrier shape

Interaction with Lid

Sometimes, outcomes which are generally considered undesirable can be harnessed for
the benefit of the wearer. If a combination of lid interaction and gravity result in
excess movement and inferior decentration, a so-called minus carrier can be
incorporated into the design of the front surface’s periphery to try to use the upper lid
as a lens elevator. A blink will then raise the lens rather than displace it inferiorly.
A variation of this theme is the Korb ‘lid attachment’ fitting philosophy. This uses a
thinner lens design (to decrease lens mass) and a modification of the edge design
(especially the front surface) in the outer 1 mm to provide a broader band of contact
with the upper lid. The lens is fitted flatter (flattest K + 0.15 - 0.70, average +0.25)
than usual in diameters which are towards the smaller end (8.6 - 9.4 mm) of the normal
range. The intention is for the lens to be ‘attached’ to, and move with, the upper lid.

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 THICKNESS PROFILE

Minus
carrier

Wedge
shape

Thickness Profile
This is a diagrammatic representation of two possible edge profiles, one a conventional
type, the other a ‘minus carrier’ aimed at lens elevation on blinking.

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 DIAMETER

Determined by:
• Corneal diameter of population
(stock lenses)
• HVID of patient
• Inter-palpebral aperture
• Lens power (minus/plus)

Lens Diameter (Total Diameter, TD, ØT)

Lens diameter (total diameter or ØT) is determined by:
Corneal diameter (or HVID) of the population when stock lenses are involved.
HVID of the patient when a custom fitting is being pursued.
Lens power (BVP) (plus and minus).
When it is likely that the lens will decentre (high plus: gravity and lid interaction, high
minus: lid interaction and some gravity) it may be necessary to increase total diameter
in the interests of a larger FOZD/BOZD. This is to ensure that a useful amount of the
optic zone covers the pupil.

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 LENS DIAMETER

Affects:
• Centre of gravity
• Stability
• Option to have larger BOZD/FOZD
• Comfort
• 3 & 9 staining

Lens Diameter
Lens diameter affects:
Centre of gravity.
This is shown diagrammatically in slides 68.
Stability.
In general the fit of larger lenses is more stable because the locating forces are highly
dependent (direct relationship) on the lens circumference, and larger lenses have less
corneal space available in which to move.
The option to have a larger BOZD/FOZD.
Comfort.
3 & 9 o’clock staining.
If an area is susceptible to desiccation staining, one possible solution is to cover it with
the lens by increasing the lens diameter until this is achieved.

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 LENS DIAMETER and COMFORT

Lens Diameter and Comfort

Better comfort with larger TD?
There is a theory that because a larger lens diameter places more of the lens edge under
the lids while they are in their resting position, the overall comfort of an RGP lens is
enhanced.
While this is a factor in the greater comfort of soft lenses, the contribution of larger
RGP lens diameters to comfort has only recently been demonstrated. Williams-Lyn et
al., (1993) showed that larger diameter (10 mm versus 9.5 and 9.0 mm) RGP lenses
were more comfortable. (They also showed that steeper fitting lenses were less
comfortable).

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 CENTRE of GRAVITY PLUS LENS

C of G C of G

Thicker Thinner

Centre of Gravity: Plus Lenses

This diagram illustrates the effect lens design, especially the lens periphery and lens
diameter, can have on the location of the centre of gravity of plus lenses. The more
anterior the centre of gravity
(C of G) is located, the less stable will be the fit because of the greater mislocation
force (rotational moment) produced by gravity.

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 CENTRE of GRAVITY MINUS LENS

C of G C of G

Small Large

Centre of Gravity: Minus Lenses

This diagram illustrates the effect lens design, lens diameter and overall thickness
profile can have on the location of the centre of gravity of minus lenses. The more
anterior the centre of gravity is located, the less stable will be the fit because of the
greater mislocation force (rotational moment) produced by gravity. Further, the
contribution of the greater lens mass resulting from a larger diameter cannot be ignored
as it is also a mislocating force.

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 OTHER DESIGN ISSUES

Tints
• Handling
• Aid to colour defectives
Lens Markings
• For ‘piggyback’ fits

Other Design Issues

Tints:
Handling.
Tints are usually incorporated to improve the visibility of a lens during handling. RGP
lens tints are usually not effective as cosmetic tints because considerably less than the
whole of the iris is covered by the average lens. Lens movement may make this
shortcoming even more apparent.
For colour defectives.
Lenses such as the X-Chrom (Zeltzer, 1971) or the JLS lens (Schlanger, 1985) are
used by colour defectives to help overcome their confusion of colours. Their function
is to introduce a brightness difference to assist in colour differentiation. They are
uncommon.
Special edge design.
In those rare cases in which a ‘piggy-back’ RGP/soft lens combination is to be used,
the RGP ‘rider’ lens may be edge finished to facilitate its ‘fit’ in the recess machined
in the front of the soft ‘carrier’ lens.
Lens Markings.
Lens data such as BOZR, TD, the intended eye (R or L), the base of any prism
incorporated, the cylinder axis, the 6 o’clock lens position, manufacturing data such as

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company logo, batch #, series, etc. can all be engraved or laser marked on an RGP lens’s front
surface.
Markings may be alphanumeric or a series of dots, lines or depressions.
Many manufacturers choose not to mark lenses because they have reservations about the
adverse effects such markings may have on lens durability or its susceptibility to deposits.

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 OTHER DESIGN ISSUES

Tints
• Engraved or laser etched
- Lens parameters
- Axis, prism base, R or L
- Manufacturing data
- Alphanumeric, dot or line coding

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 ROLE OF MANUFACTURER

Accurately reproduce what was ordered

• Dimensions
• Power
• Edge shape
• Blending
Manufacture with craftsmanship

Role of the Manufacturer

A manufacturer is expected to reproduce the lens order accurately. The expectations
are:
Dimensions.
Power (BVP).
Edge shape.
This lecture has dealt with this issue in some detail and its importance should now be
apparent.
Blending.
Apart from this as a design issue, it is also affected by the level of ‘craftmanship’
applied to the lens finishing steps.
Craftmanship should be demonstrated by a manufacturer at all stages of lens creation
and it should be one of the practitioner’s criteria for selection of a manufacturer once a
design has been chosen.

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 ROLE OF MANUFACTURER

RGPs delivered to practitioner should be

in best possible condition, including:
• Thorough post-manufacturer cleaning
with recommended solvent and/or
cleaner
• Soaking in wetting solution

The manufacturer should deliver to the practitioner a cleaned, accurate and

appropriately stored RGP lens. For initial comfort and microbiological reasons, the
lens should ideally be delivered in an RGP storage solution.

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 DESIGNS FOR THE 90s

• Iso-pressure
• Aberration controlled
• Torics
• Bifocals
• EW
• Disposable

Designs for the 90s

Iso-pressure. A design which will apply a uniform ‘benign’ pressure to the whole of
the corneal area covered by the lens.
Aberration-controlled design which will minimize the lens-induced aberrations. This
may not be achievable since contact lenses offer designers few degrees of freedom.
Since shape cannot be altered significantly, it is probable that a variable refractive
index across a lens is one of the few possibilities. Results to date have not been
encouraging.
Torics.
Torics and bitorics, which have been available for decades, are relatively reliable
products which will improve as manufacturing technology becomes more advanced.
Bifocals.
Translating implanted-segment bifocals appear to be the most successful type of
contact lens bifocal and this will probably continue.
Extended Wear (EW).
Generally, the oxygen transmissibility (Dk/t) of RGP lenses is significantly greater
than that of hydrogels. Currently, the only materials which could satisfy the Holden-
Mertz criteria are RGPs. Successful extended wear is more likely to involve RGP
materials than the current hydrogels. New hydrogels being developed may reach the

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criteria.
Disposable.
AS RGP materials have become more sophisticated, they have tended to exhibit some of the
deposit/spoilage characteristics of hydrogels. Protein treatments are now required for a
significant number of wearers. Like hydrogels, disposing of the lens is one solution to this
problem. Higher manufacturing costs are currently a barrier to disposability.

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 THANK YOU

Feedback on errors, omissions, or suggestions for

improvement are invited. Please contact us at:
[email protected]

See the following slides explaining the symbols,

abbreviations, and acronyms used in the IACLE
Contact Lens Course

CLICK to return
Table of Contents
to the first slide

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SYMBOLS

75
ABBREVIATIONS

76
ACRONYMS

77
ACRONYMS

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