Aphakic Reading Adds: An Error in Traditional Teaching

It is traditionally taught in opthalmic optics that the “effective” bifocal add is greater than the prescribed add in aphakic spectacles. Because the reading segment is fabricated on the front surface of the lens, the added back vertex power is significantly greater than the prescribed add. It is taught that the effective power should be measured at the back surface. The authors explain informally why the effective add is, in truth, exactly equal to the prescribed add and not equal to the difference in back vertex power between the top and bottom segments. Practitioners who prescribe spectacles by the traditional teaching may leave their aphakic patients with suboptimal reading vision.