Toric multifocal contact lens an option for those who may have ruled out contact lens wear

Here, the author answers questions about a contact lens, based on firsthand experience with it.

Please describe the lens and what makes it unique.

CooperVision Biofinity toric multifocal is a contact lens that features optimized toric lens geometry and balanced progressive technology with over 205,000 parameters. The toric lens geometry features a unique back-surface curvature, a large optic zone and an optimized ballast toric design for stability and consistent vision. The balanced progressive technology features a central zone that is either distance or near, an intermediate progressive zone and a peripheral zone that is either distance or near.

For whom is it indicated?

This lens is indicated for any presbyopic patient who has clinically significant astigmatism (cylinder greater than 0.75 D in either or both eyes), provided there are no contraindications to contact lens wear.

How long have you been prescribing the lens? What percentage of your patients utilize the product? And what, if any, feedback have you gotten from them on the lens?

I have been prescribing this lens since February 2020. During the pandemic, our presbyopic patient population has made up a lower percentage of our overall patients. As a result, about 5% of our total patients are in this lens. The feedback I have received has been positive. Our practice followed the first 10 patients fit with this lens. All 10 rated the initial comfort at 10/10 and their overall vision at 9/10 or higher.

How do you discuss the lens with the patient?

I will say: “There is a lens that can correct both your distance and near vision. It is called a multifocal toric because it corrects your astigmatism as well. With this lens, you can step out of the house and live your life with very little to no dependence on reading glasses.”

What chair time is involved in fitting this lens? Do you have any tips for fitting the lens?

This lens involves relatively little chair time. Once the patient puts the lenses in, I perform a slit lamp evaluation, then let the patient neuro-adapt for about 10 minutes. Next, I assess VA and discuss any feedback or questions the patient may have. This process takes about 15 minutes.

Based on a clinical evaluation, Biofinity toric multifocal was successful for 93% of initial fits, and I personally find this to be accurate for my patients as well.

I strongly recommend following the fit guide or using the newly updated OptiExpert app, as it can be tricky to try to accurately correct so many variables (astigmatism, add and center-near vs. center-distance profile) on one’s own.

Case study

I recently fit the lens in a 60-year-old female, who is a tennis buddy of mine. She was tired of wearing her glasses while on the court. Her prescription is -1.00 -1.75 x 110 OD and -1.00 -1.75 x 170 OS, with a +2.50 add. Having never worn contact lenses, she assumed they would not correct her astigmatism or her presbyopia. I fit her with -1.00 -1.75 x 110 +2.50 center distance OD and -1.00 -1.75 x 170 +2.50 center near OS. When she returned to the office for her fitting, she picked up insertion and removal of the lens very quickly — a clear indication of her motivation. A slit lamp examination showed an excellent fit. Good centration and movement were both noted, with excellent stability (less than 5° of rotation). She reported great distance, intermediate and near vision upon initial insertion. I followed up with her a week later, and she was happy with the lens, having used it for both tennis and work, as a psychiatrist. OM

DR. CHIMA practices in Cleveland, Ohio at a Pearle Vision multi-location franchise, for which he also serves on an Optometric Advisory Board. He is a member of the Cleveland Optometric Association Board. Dr. Chima also works as a consultant for Optometric Insights, a career-coaching company for optometry students.