Quantification of ghosting produced with presbyopic contact lens correction

The defocused portion of the image obtained in wearers of bifocal and multifocal contact lenses often appears as a "ghost." Relatively few methods exist to quantify the ghosting perceived with lenses. The purpose of this study is to validate and implement a questionnaire to help patients quantify the ghost images perceived with bifocal or multifocal corrections.

Ten subjects viewed simulated bifocal vision images displayed on a monitor. Images contained a focused and a defocused (ghost) component of a specific dimension (direction, position offset, intensity, and focus). Using a test card, the subjects identified the ghosting dimension level displayed on the monitor. An additional 54 presbyopic subjects wearing a multifocal correction monocularly viewed a well-focused stimulus and then compared the perceived image to that of the other well-corrected eye looking at the ghosting test card to quantify their visual experience of the 4 proposed ghosting dimensions.

Regardless of ghost letter size and orientation, subject responses were within 1 rating unit of expected on >95% of all trials for all 4 dimensions when asked to directly match a single dimension of ghosting. With bifocal images containing random amounts of these 4 dimensions most response errors were also within ± 1 unit. In presbyopes wearing a multifocal lens, the focus dimension was most strongly associated with overall ratings of ghosting.

The subjects can accurately and reliably report on ghost intensity, focus, direction and position offset, and well-focused ghosts are most correlated with the overall perceptual saliency of ghosting.