RESEARCH PAPER Visual performance comparison between contact lens-based pinhole and simultaneous vision contact lenses Clin Exp Optom 2013; 96: 46–52 DOI:10.1111/j.1444-0938.2012.00791.x Santiago García-Lázaro* PhD César Albarrán-Diego* MSc Teresa Ferrer-Blasco* PhD Hema Radhakrishnan † PhD Robert Montés-Micó* PhD * Optometry Research Group, Optics Department, University of Valencia, Valencia, Spain † Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom E-mail: santiago.garcia-lazaro@uv.es Background: The aim was to evaluate the visual performance provided with a contact lens-based pinhole design against a simultaneous vision multifocal contact lens. Methods: In a cross-over study at the University of Valencia, 22 presbyopic patients were evaluated using an artificial pupil fitted on the non-dominant eye and the simultaneous vision PureVision Multifocal contact lenses. After one month of contact lens wear, binocular distance visual acuity (BDVA), binocular near visual acuity (BNVA), defocus curve, binocular distance contrast sensitivity, binocular near contrast sensitivity, and stereoacuity were measured, under photopic conditions (85 cd/m 2 ). In addition, bin- ocular distance visual acuity and binocular distance contrast sensitivity were examined under mesopic conditions (5 cd/m 2 ). Results: Mean binocular distance visual acuity for pinhole and PureVision Multifocal were 0.02  0.04 and 0.01  0.04 logMAR under photopic conditions and 0.16  0.06 and 0.12  0.04 logMAR for binocular near visual acuity under mesopic conditions, respectively. No statistically significant differences were found between both types of lenses at distance for both lighting levels and intermediate distances (p > 0.05). There was a significant difference at near vision under photopic conditions (p = 0.03). Bin- ocular distance contrast sensitivity revealed statistically significant differences between the pinhole system and PureVision Multifocal for six and 12 cpd (cycles per degree) spatial frequencies at the two luminance levels, while for near vision, differences were also significant for 18 cpd. Stereoacuity was better with PureVision Multifocal (127  49.3 seconds of arc) compared with the pinhole lens (220.2  32.3 seconds of arc, p = 0.004). Conclusion: Pinhole and PureVision Multifocal contact lenses provide good binocular vision for distance and functional intermediate vision. Although it was better with the PureVision Multifocal, near vision was not satisfactory for either of the two contact lens options. Submitted: 7 December 2011 Revised: 29 December 2011 Accepted for publication: 29 April 2012 Key words: bifocals contact lenses, contact lenses, presbyopia, stereopsis The age-dependent loss of the ability to accommodate, named presbyopia, is pri- marily attributed to a decrease in lens elas- ticity. 1 Other possible causal factors for presbyopia include the increase in equato- rial diameter of the lens, loss of elasticity of Bruch’s membrane and reduced mobil- ity of the ciliary muscle. 2 Presbyopia usually begins between ages 38 and 45 and the prevalence is virtually 100 per cent by ages 50 to 52 years. 3 Many presbyopic patients believe the loss of accommoda- CLINICAL AND EXPERIMENTAL OPTOMETRY Clinical and Experimental Optometry 96.1 January 2013 © 2012 The Authors 46 Clinical and Experimental Optometry © 2012 Optometrists Association Australia