Research Review: <br>Pupil Size and Multifocal Lens Performance</br>
-
By
-
Alex Hui, OD, PhD, FAAO
-
September 1, 2026
-
5 min
Clinical Report: Pupil Size and Multifocal Lens Performance
Overview
This review examines the impact of pupil size on the performance of multifocal contact lenses (MFCLs), noting that variations in pupil size can influence visual acuity and contrast sensitivity. High-contrast acuity is comparable across different pupil sizes, while low-contrast performance shows a decline, particularly with larger pupils.
Background
Understanding the relationship between pupil size and multifocal lens performance is crucial for optimizing visual outcomes in presbyopic patients. Variability in pupil size can alter the effective refractive power of MFCLs, impacting the distribution of vision across distance, intermediate, and near tasks.
Data Highlights
No numerical data available in the source material.
Key Findings
- Variation in pupil size affects the performance of multifocal contact lenses (MFCLs) due to changes in the refractive power profile.
- High-contrast distance visual acuity with MFCLs is comparable to single vision lenses across pupil sizes from 3 mm to 6 mm.
- Low-contrast visual acuity shows a significant decrease of up to 2 lines between 3-mm and 6-mm pupils when using MFCLs, as reported in some studies.
- Contrast sensitivity function (CSF) is impacted by pupil size, with a decrease in CSF area under larger pupil conditions.
- Visual satisfaction with MFCLs correlates with pupillary dynamics.
- Manipulation of pupil size through tints can enlarge pupils but may not improve distance visual acuity if light transmission is reduced.
Clinical Implications
Clinicians should consider pupil size when fitting multifocal contact lenses, as it can influence visual performance.
Conclusion
Pupil size is a factor in the performance of multifocal contact lenses, affecting visual acuity.
Related Resources & Content
- Cardona G, López S, J Optom, 2016 -- Pupil diameter, working distance and illumination during habitual tasks.
- Papadatou E, et al, Int J Ophthalmol, 2017 -- Objective assessment of the effect of pupil size upon the power distribution of multifocal contact lenses.
- Dolce JC, et al, Optom Vis Sci, 2025 -- The effect of pupil size on visual performance with center-distance soft multifocal contact lenses.
- Phatak NR, et al, Clin Optom (Auckl), 2025 -- Vision performance of a 3-zone progressive™ design kalifilcon a silicone hydrogel multifocal contact lens is not influenced by pupil size.
- Martinez-Plaza J, et al, 2026 -- Study on multifocal contact lenses and pupil size.
- Contact Lens Spectrum — PRESCRIBING FOR PRESBYOPIA
- Contact Lens Spectrum — Research Review: Pre-Presbyopes and Multifocal Contact Lenses
- contact lens spectrum — Research Review: Pre-Presbyopes and Multifocal Contact Lenses
- contact lens spectrum — Prescribing for Presbyopia: <br>Pupils, Aberrations, and Miotic Impact</br>
- Prescribing for Presbyopia
- Research Review: Pre-Presbyopes and Multifocal Contact Lenses
- International consensuses and guidelines on multifocal intraocular lenses (IOLs) by the Academy of Asia-Pacific Professors of Ophthalmology (AAPPO) - ScienceDirect
- Impact of ocular aberrations and pupil diameter on vision with four daily multifocal contact lenses - PubMed
Based on findings from:
Research Review: <br>Pupil Size and Multifocal Lens Performance</br>
Alex Hui, OD, PhD, FAAO. Contact Lens Spectrum, 2026.
https://www.clspectrum.com/issues/2026/september-october/research-review
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
