Abstract:
A contact lens is fitted to a cornea of a patient&#39;s eye to gradually alter the patient&#39;s cornea during continued wear to reshape the cornea to reduce the hyperopia and/or presbyopia condition. The contact lens has a plurality of zones that includes one or two optical zones, a plateau zone, a fitting zone, an alignment zone and a peripheral zone. The one or more optical zones are utilized to redistribute cornea tissue to cause the cornea to have a steepened central portion surrounded by a flat mid-peripheral ring The plateau zone helps steepening the central cornea by two ways: a positive molding effect of pushing the cornea tissue inward to pile up and a negative molding effect to flatten the mid-peripheral cornea for enhancing.

Description:
RELATED APPLICATION 
   The present application is a continuation of a Patent Cooperation Treaty International application, filed on Aug. 6, 2003, to the United States Receiving Office, with International Application No. PCT/US03/24624, which claims priority from a U.S. application, filed on Aug. 7, 2002, Ser. No. 10/214,652, now U.S. Pat. No. 6,652,095. This prior U.S. application, Ser. No. 10/214,652, is a continuation-in-part of a U.S. application, Ser. No. 09/715,964, filed Nov. 17, 2000, now U.S. Pat. No. 6,543,897. The entire disclosure of the PCT and US applications are incorporated by this reference as if set forth fully herein. 

   BACKGROUND OF THE INVENTION 
   1. Field of the Invention 
   The present invention relates to contact lenses that are used in treating hyperopia and presbyopia, and more particularly, to contact lenses that are shaped to provide gradual altering of the patient&#39;s cornea during continued wear to reshape the cornea to reduce the hyperopic and presbyopic condition. 
   2. Description of the Related Art 
   Many people experience difficulties with their vision due to a number of possible conditions. The most common vision problem is a condition known as myopia or nearsightedness. Myopia is a common condition where an eye cannot focus on far-away objects because the cornea of the eye is curved too steeply (i.e., where the radius of curvature of the cornea is smaller than normal) to provide adequate focusing at the retina of the eye. Another condition is known as hyperopia or farsightedness. With hyperopia, the eye cannot focus on both far and near objects because the curvature of the cornea of the eye is too flat (i.e., where the radius of curvature of the cornea is larger than normal)to provide adequate focusing at the retina of the eye. Hyperopia is common among young children. Severe hyperopia will induce lazy eye or amblyopia in childhood. Mild or moderate hyperopia is tolerable and insidious in young ages but will cause reading problems in older age. Another common problem is astigmatism, where unequal curvature of one or more refractive surfaces of the cornea prevents light rays from focusing clearly at one point on the retina, resulting in blurred vision. Presbyopia is the most common vision problem in adults 40 years and older. It does not matter whether they are emmetropic, myopic or hyperopic in far vision, the middle-aged population over 40 years old will begin to experience difficulty in focusing on close objects, due to the loss of flexibility of the eye&#39;s crystalline lens. Presbyopia may occur and complicate other refractive problems such as hyperopia, myopia or astigmatism. 
   Hyperopia and presbyopia are both conditions for which no entirely suitable permanent treatment has been developed. The conventional way is to wear a pair of heavy convex glasses. One approach to correcting hyperopia is through laser surgical reshaping of the cornea. However, such surgical procedures have not been entirely safe and there have been less favorable vision outcome for the hyperopia surgery than that of myopia surgery. 
   Another approach to treating some or all of these conditions is to alter the corneal shape by wearing contact lenses which are designed to continually exert pressure on selected locations of the cornea to gradually force or mold the cornea into the desired normal corneal curvature. A retainer lens is then worn on a part-time basis to prevent the cornea from returning to its previously deformed shape. This method of treatment is commonly referred to as orthokeratology (referred to herein as “ortho-k”). The success of any treatment by ortho-k is dependent upon the shape and structure of the contact lens. For example, conventional contact lenses with a longer central radius of curvature than the central radius of the cornea are known to change the shape of the cornea by compressing the surface at its apex. This reshaped cornea has a lengthened radius of curvature in its central zone, which serves to improve myopia. Although it has been well known to treat myopia using modem Ortho-K lenses to reshape the cornea, treating hyperopia or presbyopia using Ortho-K lenses has been met with uncertain outcome and results. 
   Ortho-k has been performed in some form or another since the early 1970s. There are three factors that impact the effectiveness and desirability of ortho-k procedures and lenses. The first factor is the time. needed to achieve a desired visual correction. Unfortunately, the time needed to achieve a desired visual correction using conventional ortho-k techniques and lenses has been a serious problem, since it will take several months, or even years, for small amount of hyperopia to be reduced. The second factor is the amount of hyperopia that can be corrected using ortho-k. Conventional ortho-k techniques and lenses were limited to a reduction of no more than about one diopter of hyperopia. The third factor is the amount of time that the correction would “hold” before degrading (known as the “maintenance period”). Conventional ortho-k techniques and lenses provide variable length for the maintenance period. To prolong this maintenance period, a patient would have to wear a retainer lens. 
   Some patients have been fitted with a series of progressively steeper regular RGP lenses to treat hyperopia. The lens diameter was small (7–8 mm) and the base curve steeper than the central cornea curvature. Lenses would need to be replaced upon the showing of some effect, while the results are usually minimal and unpredictable. The lenses sometimes became tightened to cause adverse effect. 
   U.S. Pat. No. 5,963,297 to Reim and U.S. Pat. No. 5,349,395, No. 4,952,045, No. 5,191,365, No. 6,010,219 to Stoyan disclose Ortho-k lens designs for myopia reduction. There has been no lens specifically designed for increasing the curvature power of the cornea for hyperopia reduction. Orthokeratology for the presbyopia has never been addressed or mentioned before, largely because it was thought that no lens could mold a cornea into dual shapes for clearing up near, as well as far, vision simultaneously. The conventional way to treat a myopic, and yet presbyopic, person by Ortho-k is either to sacrifice the far vision of both eyes (under-corrected) or to sacrifice monocular far vision (Mono-vision). Both ways make it hard to be accepted by most of the patients. 
   Notwithstanding the improvements provided by modern Orthokeratology for myopia, there remains a need for a contact lens that can be used for effective ortho-k of hyperopia and/or presbyopia. 
   SUMMARY OF THE INVENTION 
   It is an object of the present invention to provide an ortho-k contact lens that provides effective reduction of hyperopia and/or presbyopia. 
   It is another object of the present invention to provide an ortho-k contact lens that provides a shorter correction time. 
   It is yet another object of the present invention to provide an ortho-k contact lens that provides a longer maintenance period. 
   The objects of the present invention may be achieved by providing an apparatus and method for correcting a hyperopia and/or presbyopia condition in a patient&#39;s eye. In accordance with a method of the present invention, a contact lens is fitted to a cornea of a patient&#39;s eye, the contact lens having a plurality of zones that includes a optical zone, a Plateau zone, a fitting zone, an Alignment zone and the peripheral zone . The Plateau zone is carefully created to flatten the mid-peripheral cornea curvature to cause the cornea to have a flattened mid-peripheral portion surrounding the central steeper cornea zone. The flatter mid-peripheral plateau zone works together with the steeper optical zone to enhance the steepening of the central cornea to reduce hyperopia. The concept of “flattening the mid-peripheral cornea to enhance the steepening of the central cornea for effective hyperopia reduction” is totally different from that of the conventional method by “squeezing the cornea tissue inward and piling up to steepen the central cornea for hyperopia reduction”. We define the new concepts to be a “dual molding” for hyperopia and/or presbyopia reduction. 
   In accordance with an apparatus of the present invention, a contact lens is provided having a base curve portion of the lens, a plateau curve portion of the lens circumscribing and coupled to the base curve portion, a fitting curve portion of the lens circumscribing and coupled to the plateau curve portion, and an alignment curve portion of the lens circumscribing and coupled to the fitting curve portion, and a peripheral curve portion of the lens circumscribing and coupled to the alignment curve portion. 
   The goal of this type of lenses is to mold the cornea into a shape of central steepening just like a hummock on top of a plateau. The overall diameter of the central optical zone could be varied or divided for different purposes of correcting hyperopia or presbyopia. 
   For treating the hyperopic person, the base curve should preferably be steeper than the central cornea curvature. The optical zone should be wide enough for better far vision. It is also preferred to keep the plateau zone as narrow as possible to prevent it from inducing ghost imaging due to the flattened mid-peripheral area. 
   For treating the presbyopic person, the optical zone should be divided into two portions. The central zone should be designed to be very small for the purpose of near vision to prevent it from hindering the far vision. The outer optical zone then should be much wider to mold the juxta-central cornea area into a flatter zone to clear up far vision (reducing myopia, hyperopia, or astigmatism if any). 

   
     BRIEF DESCRIPTION OF THE DRAWINGS 
       FIG. 1  is a side schematic outline view of an ortho-k contact lens according to the present invention in use with a cornea of a patient&#39;s eye. 
       FIG. 2  is a front planar view of the ortho-k contact lens according to one embodiment of the present invention for hyperopia correction. 
       FIG. 3  is a side sectional view of the ortho-k contact lens of  FIG. 2 . 
       FIG. 4  is a front planar view of the ortho-k contact lens according to another embodiment of the present invention for presbyopia correction in a myopic person. 
       FIG. 5  is a side sectional view of the ortho-k contact lens of  FIG. 4 . 
       FIG. 6  is a front planar view of the ortho-k contact lens according to one embodiment of the present invention for presbyopia correction in a hyperopic person. 
       FIG. 7  is a side sectional view of the ortho-k contact lens of  FIG. 6 . 
   

   DESCRIPTION OF THE PREFERRED EMBODIMENTS 
   The following detailed description is of the best presently contemplated modes of carrying out the invention. This description is not to be taken in a limiting sense, but is made merely for the purpose of illustrating general principles of embodiments of the invention. The scope of the invention is best defined by the appended claims. 
     FIGS. 1–3  illustrate an ortho-k contact lens  10  according to one embodiment of the present invention. As shown in  FIG. 1 , the contact lens  10  is a dual geometric contact lens that is adapted to be worn over the cornea  12  of a patient&#39;s eye  14 . The contact lens  10  has five correction zones, listed from the center of the lens  10  to the outer periphery: an optical zone  20 , a plateau zone  22 , a fitting zone  24 , an alignment zone  26 , and a peripheral zone  28 . 
   Optical Zone 
   Referring to  FIGS. 2 and 3 , the optical zone  20  has a curvature that is defined by the base curve  30 . The optical zone  20  forms a suitable space for molding tissue to a region substantially centered at the apical center of the cornea  12 , and is responsible for the corrective steepening or increasing in the radius of curvature of the central cornea during treatment. The radius of curvature of the base curve  30  is smaller than a measured curvature of a central portion of the cornea  12  for treatment of hyperopia, thus creating a central tenting up area  32 . The tent-up area  32  provides a suitable space for piling the cornea tissue up during vision correction. 
   The optical zone in the invention may be divided into two portions for the treatment of presbyopia coupled with hyperopia. A tiny inner additive optical curve  30   b  defined by inner additive optical zone  20   b  is steeper (shorter radii) than the consecutive outer base curve  31   b  by 1–4 Diopters. The outer base curve  31   b  defined by the outer optical zone  21   b  is steeper (shorter radii) than the central curvature of the cornea  12  by 1–15 diopters. The tented-up spacing under the outer optical zone  21   b  causes the cornea molding to form a steeper juxta-central portion of the cornea  12  for correcting hyperopia, and the even steeper inner optical zone  20   b  causes the formation of even steeper curvature of the central portion of the cornea  12  for correcting presbyopia. The inner optical zone  20   b  is preferably kept small enough to prevent it from hindering the far vision and the size is usually from 0.5 to 1.5 mm. As can be appreciated by those skilled in the art, the pupil of human eyes will constrict for near reading (so called “near reflex”) and dilate when looking into the distance. Since the tiny central blurred image will be neglected when looking into far distance, we can create a tiny (0.1–1.5 mm) steeper inner optical zone  20   a ,  20   b  coupled with a wider (1.5–4.0 mm) and flatter outer optical zone  21   a ,  21   b  to treat the far and near vision simultaneously in one lens. 
   The steeper inner optical zone  20   a  of  FIG. 6  can also be incorporated into a single reverse geometric Ortho-K lens to treat coexisting presbyopia and myopia simultaneously. In this situation, the inner base curve  30   a , defining the inner optical zone  20   a , is made 1–4 diopters (hereinafter “D”) steeper than the outer base curve  31   a , defining the outer optical zone  21   a , to mold the central portion of the cornea  12  into a steeper curvature for reading. The outer optical zone  21   a  and outer base curve  31   a  is determined according to the principle of optical zone/curvature of the reverse geometric ortho-K lenses for proper myopia reduction. The incorporated inner optical zone  20   a  has an inner base curvature  30   a  that is 1–4 D steeper (shorter radius) than the consecutive outer base curve  31   a  of outer optical zone  21   a . The inner additive base curve  30   a  is not necessarily steeper (shorter radius), but is preferably flatter (longer radius) than the curvature of the central portion of the cornea  12 , except when the myopic power is mild and numerically smaller than that of the presbyopic additive power which in turn could be same as, or slightly steeper (shorter radii) than, the curvature of the  central portion of the cornea  12 . The outer base curve  31   a , functioning like the central optical zone/base curve of a reverse geometric Ortho-K lens for myopia reduction, is flatter (larger radius) than the central portion of the cornea  12  by 1–30 D, and is designed to compress the juxta-central portion of the cornea  12  for proper myopia reduction. 
   There could be a substitution for dividing the optical zones for presbyopia reduction, by creating an aspheric base curve with positive eccentricity (e-value), so that the curvature of the inner portion of base curve  30  will be substantially steeper than that of the outer portion of the base curve  30 . The curvatures flatten (elongate) continuously from the lens center to the edge of optical zone  20  due to the eccentricity (e-value). That will then mold the cornea into a shape of a steeper central portion for the near vision and a flatter juxta-central portion for the far vision. 
   In one embodiment of the present invention, the diameter of the optical zone  20  ranges from 3 mm to 8 mm, and the inner optical zone  20   a ,  20   b  ranges from 0.5 mm to 1.5 mm, the outer optical zone  21   a ,  21   b  ranges from 1.0 mm to 4.0 mm, and the radii of the curvature for the base curve  30  and the inner base curve  30   a ,  30   b  and the outer base curve  31   a ,  31   b  ranges from 15.0 mm to 5.0 mm. 
   Plateau Zone  22   
   Referring to  FIGS. 2 ,  3 ,  4  and  5 , the Plateau zone  22  has a radius of curvature defined by a predefined plateau curve  34 , which is longer (i.e., flatter) than the radius of curvature associated with the base curve  30  or outer base curve  30   a . On the lens  10   a  for the reduction of myopia coupled with presbyopia, the flatter plateau zone in lens  10   a  merges with the flatter outer optical zone  31   a  and can be looked upon as a continuous and gradual-flattening curve with positive e-value. 
   This longer radius of curvature of the plateau zone  22  defines a plateau curvature  34  that is flatter (longer radius) than the measured curvature of the central portion of the cornea  12  and the measured curvature of the portion of the cornea  12  circumscribing the central portion of the cornea  12 . As mentioned above, the plateau zone  22  functions as a primary compression force to the mid-peripheral cornea region substantially surrounding the apical central cornea between the inner and outer optical zones  20 ,  21   a ,  21   b  and the fitting zone  24 . 
   The plateau zone  22  is preferably kept as narrow as possible, so that it can function as a compression zone for mid-peripheral cornea flattening. The flattened mid-peripheral cornea will in turn enhance the central cornea  12  for further steepening. The molding technique is named “dual molding” which includes a positive molding for central cornea steepening and a negative molding for mid-peripheral cornea flattening. The lens design can also be named a “dual geometric lens” which include a positive geometric zone and a negative geometric zone for the steeper optical zone and flatter plateau zone respectively. A narrow flattened mid-peripheral cornea area coupled with a large steepened central and juxta-central cornea area will prevent the person from being bothered by ghost image in far vision. 
   As can now be appreciated, the plateau zone  22  performs three primary functions. First, the provision of the plateau zone  22  allows an effective compression on mid-peripheral cornea to push the cornea tissue inward, which in turn steepens the cornea curvature of the central portion of the cornea  12 . This represents the positive molding component of the “dual molding”. The compression force exerted by the flatter plateau zone  22  on mid-peripheral cornea portion will be far more effective for tissue molding than the compression force by traditional method of a series of steeper regular RGP. The compression force by a steep fit regular RGP is exerted on more peripheral cornea and is more tangential to the compressed area, so that most of the molded tissue will pile up at mid-peripheral area instead of the central area to cause an adverse effect. 
   Second, the plateau zone  22  functions as a compression zone for the effective flattening of the mid-peripheral area surrounding the steepened central cornea area  12 . Forming a plateau shape on the mid-peripheral area of the cornea  12  by the compression force of plateau zone  22  will in turn enhance the steepening effect of the central cornea. The negative molding component of “dual molding” flattens the mid-peripheral cornea  12  and effectively enhances the positive molding of steepening the central and juxta-central portion of the cornea  12 . The flatter plateau zone will also prevent the cornea tissue, which is squeezed inward by the alignment zone  26  (described later), from piling up at the mid-peripheral area. Piling up of the cornea tissue on the mid-peripheral area would have adversely flattened the central cornea curvature and increased the hyperopia, instead of reducing it. This is one of the problems that conventional orthokeratology frequently encountered. 
   Third, the flat plateau curve  34  of the plateau zone  22  reserves more room for the vertical height of the fitting zone  24  so that the fitting curve  36  can be fitted much steeper than the plateau curve  34 . This allows the fitting curve  36  to form a space for proper tear circulation and a room for tissue molding before connecting to the alignment zone  26  (described later). 
   In one embodiment of the present invention, the diameter of the plateau zone  22  ranges from 0.1 mm to 2.0 mm. The radius of curvature for the plateau curve  34  is flatter (longer radius) than the central base curve  30  or outer base curve  31   b  by 3–60 diopters, and is usually between 8–25 diopters. In lens  10   a , the plateau zone  22  and plateau curve  34  merges with the outer optical zone  21   a  and outer base curve  31   a , respectively. 
   Although the present invention illustrates the provision of one plateau curve  34 , it is also possible to provide the contact lens  10  with two or more plateau zones and curves as well as substitute the zone with an aspheric curve of a positive e value, or even merge with zone  21   a  or zone  21   b  to form a continuously flatter curvature next to the inner optical zone  20   a  or  20   b . For a positive e-value, the value could be so large as to make the plateau zone become convex, i.e. minus in power, as can be appreciated by those skilled in the art. 
   Fitting Zone  24   
   Referring to  FIGS. 2 and 3 , the fitting zone  24  of lens  10  has a radius of curvature defined by a fitting curve  36  with the radius of curvature being less than (i.e., shorter than) the radius of curvature associated with the plateau curves  34 . Since the plateau zone and curve in lens  10   a  (shown in  FIGS. 4 and 5 ) merge with the outer optical zone  21   a  and outer base curve  31   a , the plateau curve  34  in lens  10   a  can then be looked upon as having the same definition of outer optical zone  21   a  and outer base curve  31   a  for lens  10   a  shown in  FIGS. 4 and 5 . This shorter radius of curvature of the fitting zone  24  yields a fitting curvature  36  that is much steeper than the plateau curve  34 . Although the fitting curve  36  is much steeper (smaller radius) than the plateau curves  34 , the curvature  36  may not necessarily be steeper than the measured curvature of the central portion of the cornea  12 , or the measured curvature of the portion of the cornea  12  circumscribing the central portion of the cornea  12 . 
   The fitting zone  24  acts as a transition region between the plateau zone(s)  22  and the alignment zone  26 . The fitting zone  24  brings the posterior surface of the contact lens  10  to a bearing relationship on the mid-peripheral portion of the cornea  12  under the plateau zone  22 , and provides compression force on the plateau zone  22 , thereby compressing the mid-peripheral portion of the cornea  12 , for dual molding of the cornea  12 . In one embodiment of the present invention, the width of the fitting zone  24  ranges from 0.1 mm to 2.0 mm, the radius of curvature for the fitting curve  36  is 5–30 diopters steeper than the plateau curve  34 , and is 15 diopters flatter to 15 diopters steeper than the base curve. 
   At this time, it should be noted that a lens can be calculated from the view point of saggital depth. A saggital depth calculation translates the component curvatures and each width for a lens into a simple factor known as the saggital depth. A saggital depth will be measured from the center of a lens to the denoted width, and will also define the slope of an area on a lens. In other words, the angles A 1 , A 2 , A 3  and A 4  illustrated in  FIG. 3  can be calculated as the “saggital depth/zone width” and can be considered to be a slope ratio, which can be defined as the vertical height/zone width. Since a dual geometric lens has multiple curvatures, we have to calculate the vertical height of each zone and add them up. Here, the summation of (i) vertical height of the optical zone  20 , (ii) the vertical height of the plateau zone  22  , and (iii) the vertical height of the fitting zone  24  should be equal to the height of the original cornea with the same zone width (i.e., the 3 total zones) plus 10 microns (this additional 10 microns is an allowance made to prevent the lens  10  from bearing on the cornea  12 ). This is the underlying principle of saggital depth calculation. A more detailed explanation of saggital depth calculation is provided in ADVANCED CL FITTING, PART SEVEN, TRENDS IN MODERN ORTHOKERATOLOGY, Optician, No. 5645, Vol. 215, Apr. 3, 1996, pages 20–24, whose entire disclosure is incorporated by this reference as though fully set forth herein. 
   Alignment Zone  26   
   Referring to  FIGS. 2 and 3 , the alignment zone  26  is designed to provide and maintain centration of the lens  10  by having a radius of curvature that is either the same as, or slightly longer than the central curvature of the cornea  12  (i.e., to match the peripheral cornea). A predefined alignment curve  38  defines the curvature of the alignment zone  26 , which is almost the same as the measured curvature of the portion of the cornea  12  circumscribing the central portion of the cornea  12 . 
   The alignment zone  26  creates a large bearing area  40  in a region corresponding with the portion of the cornea  12  where a centering force is created that maintains the optical zone  20  substantially at the apical center of the cornea  12 . The alignment zone  26  further produces a secondary compressive force in the large bearing area  40  that cooperates with the primary compressive force from the plateau curve to flatten the mid-peripheral portion of the cornea  12  contributes to the negative molding component of the dual molding for hyperopia and/or presbyopia reduction during vision correction. 
   The alignment curve  38  is determined by mean K (also known as KM). In other words: 
   a. (Vertical KM+Horizontal KM)/2. 
   The central mean K in turn will be recalculated to estimate the mid-peripheral radius of curvature according to the eccentricity (e-value) of a cornea to match the point that the alignment zone  26  contacts the cornea  12 . This calculation method enjoys two benefits over known methods. First, this calculation method can be used for both toric (astigmatic) or non-toric corneas. Corneas with the same horizontal central KM do not mean they should be fitted with the same ortho-k lens. The vertical curvature could be different (astigmatic or toric cornea), the e-value could also be different, and they should be considered as different corneas. Second, by considering the e-value of a normal cornea, the peripheral attachment of the alignment zone  26  will be improved. 
   The associated alignment curve  38  creates a bearing zone over a large surface area of the cornea  12 , which is helpful in aligning the lens  10  at the apex of the cornea  12 . In one embodiment of the present invention, the width of the alignment zone  26  ranges from 0.1 mm to 5.0 mm (depending on the fitting characteristics desired and the particular shape factors of the cornea  12 ), the radius of curvature for the alignment curve  38  is 1–30 diopters steeper than the plateau curve  34 , and the alignment curve  38  is also about 1–25 diopters less steep (i.e., flatter) than the fitting curve  36 . 
   Alternatively, the alignment zone  26  can be segmented into multiple curves and any combination of any shapes or curves, as long as sufficient bearing area is maintained. 
   Peripheral Zone  28   
   The peripheral zone  28  is designed with a radius of curvature longer than that of the cornea  12 , yielding a curvature less than a measured curvature of a portion of the cornea  12  circumscribing the central portion of the cornea  12  that corresponds to the alignment zone  26 . The peripheral zone  28  has its surface contour defined by a predefined peripheral curve  42  which has a curvature that nearly parallels the portion of the cornea  12  underneath it, but is flatter than the cornea  12 . The peripheral zone  28  promotes tear flow under the contact lens  10  by taking advantage of a tear pumping action created when the individual blinks the eyelid. This tear flow allows constant lubrication and oxygenation of the lens-cornea interface and results in a more comfortable and wearable lens  10 . 
   Additionally, the peripheral zone  28  is designed to create a slight edge lift which allows easy contact lens removal from the cornea  12 . In one embodiment of the present invention, the width of the peripheral zone  28  ranges from 0.1 mm to 2.0 mm, the radius of curvature for the peripheral curve  42  is 0–15 diopters greater (flatter) than the plateau curve  34 , and is also about 1–35 diopters greater(longer radii) than the fitting curve  36 , or the alignment curve  38 . The peripheral curvature should be carefully calculated according to the aforementioned saggital theory to achieve an edge lift of 100–120 microns. An overly-large edge lift may induce a reverse suction force to create air bubbles under the lens  10 , while an overly-small edge lift may reduce tear circulation and cause lens seal-off. 
   The different radii used to define the base curve  30 , the plateau curve  34 , the fitting curve  36 , the alignment curve  38  and the peripheral curve  42  are calculated after careful examination of the patient&#39;s eye and the associated ocular tissue. The corneal curvature must be measured, the proper contact lens power defined, and the anticipated physiological response to the contact lens  10  must be determined. An individual skilled in the examination techniques of the ocular system is typically capable of performing these tasks. 
   As explained above, the provision of one or more plateau zones  22  offers dual molding force to facilitate the steepening of the central portion of the cornea  12  for hyperopia and/or presbyopia correction. The invention of a tiny and steeper inner optical zone  30   a , 30   b  open up a new era of correcting dual refraction errors of presbyopia coupled with hyperopia, or presbyopia coupled with myopia simultaneously in one lens. The present invention enables treatment of dual refractive problems in one lens by dual molding force from a dual geometric lens. A typical dual geometric lens will have consecutive curvatures featuring interlaced steep-flat-steep-flat curvatures from the central portion outward. Of course, there can be additional zones or eccentricity (e-value) incorporated into the basic components as previously mentioned. 
   For example, the contact lens  10  of the present invention can achieve a reduction of hyperopia up to 2.0–10.0 diopters with a shorter wearing time (e.g., 6–10 hours a day for initial wearing, and 4–8 hours a day to maintain) and longer maintenance period (e.g., 1–7 days after the lens  10  is removed). 
   EXAMPLE 1 
   A contact lens having the following dimensions was provided for a AA0786 patient: 
   &lt;Right eye&gt; 
   KM: 43.375 D(7.78 mm)@H, 44.5 D(7.85 mm) @V 
   Refraction: +2.00–0.75@130 (hyperopia +2.00D astigmatism 0.75D axis  130 ) 
   optical zone  20 : width 4.0 mm, radius of curvature 7.25 mm 
   plateau zone  22 : width 1.1 mm, radius of curvature 9.79 mm 
   fitting zone  24 : width 0.5 mm, radius of curvature 6.57 mm 
   alignment zone  26 : width 1.2 mm, radius of curvature 7.85 mm 
   peripheral zone  28 : width 0.4 mm, radius of curvature 11.30 mm 
   &lt;Left Eye&gt; 
   KM:43.375 D(7.78 mm) @H, 44.5 D(7.85 mm)@V 
   Refraction: +3.00–1.00@40 (hyperopia +3.00 D and astigmatism 1.00 D axis 40 degree) 
   optical zone  20 : width 4.0 mm, radius of curvature 7.16 mm 
   plateau zone  22 : width 1.1 mm, radius of curvature 9.85 mm 
   fitting zone  24 : width 0.5 mm, radius of curvature 6.59 mm 
   alignment zone  26 : width 1.2 mm, radius of curvature 7.85 mm 
   peripheral zone  28 : width 0.4 mm, radius of curvature 11.30 mm 
   The contact lenses were worn by the patient for 7 day, at 7–8 hours a day. 
   After this correction period, the patient experienced a hyperopia and astigmatism reduction to zero power. This is equivalent to a hyperopia reduction of +1.75 D for the right eye and +2.50 D (spherical equivalent) for the left eye. The maintenance period (of nearly zero power) lasted for all awakening hours with a 5–7 hour maintenance night wearing. The topography of the cornea is well-centered and has a definite boundary of a hummock-on-plateau shape to support an efficient reduction in hyperopia. This case has been followed for 3 months with no side effects. 
   EXAMPLE 2 
   A contact lens having the following dimensions was provided for a AA0751 patient: 
   &lt;Right Eye&gt; 
   KM: 42.25(7.99 mm), 43.125(7.83 mm) 
   Refraction: −3.00–0.50@90 (myopia −3.00 D astigmatism 0.50D axis 90 degree) 
   With Presbyopic Near addition of +1.50D, corrected to 20/20 at 40 cm 
   (Since the right eye is the sighting eye for far, we designed a reverse geometric lens for right eye to correct her myopia only) 
   optical zone: width 5.6 mm, radius of curvature 8.89 mm 
   fitting zone : width 0.8 mm, radius of curvature 7.04 mm 
   alignment zone: width 1.5 mm, radius of curvature 8.03 mm 
   peripheral zone: width 0.4 mm, radius of curvature 11.80 mm 
   &lt;Left Eye&gt; 
   KM:42.00 D(8.04 mm))42.65 D(7.91 mm) 
   Refraction: −3.00–0.50@75 (myopia −3.00 D and astigmatism 0.50D axis 75 degree) 
   With presbyopic near addition of +1.50 D, corrected to 20/20 at 40 cm 
   (We corrected her left eye for myopia as well as presbyopia simultaneously) 
   inner optical zone  20   a : width 1.0 mm, radius of curvature 8.50 mm 
   outer optical zone  21   a : width 2.50 mm, radius of curvature 8.83 mm 
   plateau zone  22 : none (merged with outer optical zone  21   a ) 
   fitting zone  24 : width 0.6 mm, radius of curvature 6.85 mm 
   alignment zone  26 : width 1.5 mm, radius of curvature 8.07 mm 
   peripheral zone  28 : width 0.4 mm, radius of curvature 11.90 mm 
   The contact lenses were worn by the patient for 7 day, at 7–8 hours a day. 
   After this correction period, the patient experienced a myopia and astigmatism reduction to zero power for both eyes. The far vision was 20/20 on right eye and 20/25+ on left eye. The near vision was 20/40 on right eye but was 20/20 on left eye. The patient enjoyed the simultaneous improvement of far and near visions. There are two reasons for correcting monocular presbyopia on left eye instead of on both eyes, first is for comparing the far and near vision between both eyes for demonstration, second is to preserve a clearer far vision for her occupational requirement. We learn from this case that the influence on far vision by the incorporation of tiny inner central optical zone  20   a  is minimal (one line decrease only). On the other hand, the quality of the near vision will be much improved (from 20/40 on right to 20/20 on left eye) by the incorporation of inner optical zone  20   a . There should have been no problem fitting both eyes with dual geometric lenses if the requirement for far vision was not so critical. Otherwise we should correct the non dominant eye (left eye in this case) for reading and maintain a better far vision for the dominant sighing eye (right eye in this case). 
   The maintenance period (of nearly zero power) lasted for all awakening hours with a 5–7 hour maintenance night wearing. The topography of the cornea is well-centered and has a definite tiny central steeper island to support an efficient reduction in myopia and presbyopia. This case has also been followed for 3 months with no side effects. 
   It should be appreciated by those skilled in the art that the lenses described for Ortho-K may also be used as bi-focal contact lenses, which can be worn during daytime. 
   Although the present invention has been described in connection with the preferred embodiments, it will be appreciated by those skilled in the art that modifications can be made and alternatives utilized without departing from the spirit and scope of the present invention.