Follow these three steps, so presbyopes can enjoy the benefits of these lenses

Loss of accommodative function is a challenging condition for the patient, as well as for the optometrist. For our part, prescribing the right multifocal contact lens depends on the patient’s visual, physiological, and emotional changes surrounding this inevitable, but unwelcome, part of aging.

Given the patient characteristics of presbyopes, here, I share tips for improving success with multifocal contact lens prescribing. (See “Millennial Presbyopes Pending,” p.66.)

1 UNDERSTAND DESIGN DIFFERENCES

While it may not be possible to empirically determine which multifocal contact lens design will work best for a given individual, it’s important we understand the differences among designs, so that, should a different contact lens be needed, a meaningful change is made. Communicating this to presbyopic patients at the outset is also important, as this population is known for having high expectations and can, therefore, be particular.

As a brief, yet important reminder, the three most common multifocal contact lens designs are center near aspheric, distance, or near centered concentric (often containing a blended intermediate zone), and extended depth of focus. These designs are available in multiple materials and replacement schedules.

While daily disposable contact lenses may be the first choice for comfort, health, and convenience, let’s also keep in mind that custom contact lens designs are now easier than ever to fit, while providing a wide range of options for optic zone diameters, adds, and cylinder correction.

2 KEEP IT POSITIVE

When presenting multifocal contact lenses, we should avoid words such as “compromise,” “limitations,” and “trade-off,” as they all have negative connotations.

Instead, let’s emphasize the goal of these important contact lenses: “to optically restore as much flexibility to the visual system as possible.” Or, more simply, “to reduce dependency on reading glasses.” Of course, to the point made in the first step, we want to set realistic expectations as well:

“Auxiliary glasses may be necessary in certain challenging conditions, such as for driving at night, or reading in very low light.”

3 USE A TEAM APPROACH

I find that training and enlisting my staff to use brief but engaging messaging at each patient touchpoint is key to getting patients who could benefit from multifocal contact lenses to buy in.

For example, during pre-testing, my technician may ask a current CL wearer about any changes in vision since the last visit.

If the patient acknowledges difficulty with near tasks, he will then say, “I will pass that on to the doctor. I know we have contact lenses that can help with that.”

Equally important is our administrative staff’s knowledge of multifocal contact lenses. They, too, must be equipped to answer basic questions regarding the benefits of the technology, such as whether patients can expect either no or less spectacle wear.

Finally, there’s no better way to make your staff enthusiastic promoters of multifocal contact lenses than to fit them, too! OM

MILLENNIAL PRESBYOPES PENDING

Millennials, the oldest of whom were born in the early 1980s are predicted to comprise the largest segment of the presbyopic patient population.¹ These children of baby boomers currently comprise the second largest population that wears contact lenses,² which should facilitate their transition to multifocal contact lenses.

REFERENCES

1. Statista. Resident population in the United States in 2021, by generation (in millions) https://www.statista.com/statistics/797321/us-population-by-generation/#main-content . Accessed August 23, 2022.
2. Statista. Share of adult consumers who currently wear contact lenses in the United States in 2017, by age group. https://www.statista.com/statistics/734801/adult-wearing-contact-lenses-age-group/ . Accessed August 23, 2022.

DR. RESNICK is president and managing partner at Drs. Farkas, Kassalow, Resnick, and Associates, a contact lens and anterior segment specialty practice in New York. She is a diplomate in the Cornea, Contact Lens, and Refractive Technology section of the AAO, a diplomate of the ABO, and a fellow of the Scleral Lens Education Society.