prescribing for presbyopia
Investment = Presbyopic Soft Lens Success
BY CRAIG W. NORMAN, FCLSA

Often, colleagues tell me they are unhappy with the level of success in their presbyopic contact lens practice, especially with soft lenses. Others are extremely satisfied with their outcomes and view fitting presbyopes as a terrific growth opportunity.

What's the difference here? Product availability is the same for both practitioner types. Fitting techniques should be similar. Plus, even though we like to think, "our patients are different," they are very similar throughout North America.

You Get Out What You Put In

After much discussion with these colleagues, I believe the biggest difference is investment ­ in time, staff training and tools to increase patient satisfaction with these products. To successfully fit presbyopic contact lenses, you must first be sure that you are committed to this portion of the practice. Ask yourself, "Am I ready to commit to the time, effort and financial obligation it takes to make fitting bifocal and multifocal contact lenses successful?"

Time

The time component of this investment is learning the products available in this category and when to properly use them. Today, several two-week disposable hydrogel lenses for presbyopes are on the market. Learn their differences and what parameters are available. Discover if more than one add power exists. Define for yourself which optical design each lens employs. Decide if the product works better for distance, reading or intermediate vision. Are there any nuances to the fitting process of each lens that will increase success? Which type of patient is best indicated for each design? Can I combine brands by choosing one that is better for distance and another that has reading advantages? Knowing these characteristics will increase success through choosing the right lens for the patient.

Staff Training

Next, pass this information to everyone in your office ­ often. I recently overheard a new employee in our practice tell a patient that we have bifocal soft lenses available but, "they don't work." When asked why she said this she sheepishly stated, "That's what we always said where I worked before." Ensure that all staff have a positive attitude towards this lens modality, and patients will begin to feel the same way.

Describe product differences to the staff. For some reason, all bifocal soft lenses seem to be lumped together, while in actuality they are quite different from one brand to another. Teach staff how to answer questions on the telephone and in the examination room. You and your staff members should wear bifocal soft contact lenses when indicated.

Diagnostic Lenses

Ensure that your diagnostic lenses remain well stocked, as small parameter changes can have a big impact in presbyopic soft lens fitting. Many manufacturers provide trial lenses at no charge, but some might require an initial purchase of a trial set to begin using the products.

Finally, proactively tell your patients about bifocal contact lenses.We begin the discussion with patients before they actually need bifocal lenses. Also, we inform monovision patients that bifocals will most likely provide better vision for their situation in the future.

Craig W. Norman is Director of the Contact Lens Section at the South Bend Clinic in South Bend, Indiana. He is a fellow of the Contact Lens Society of America and an advisor to the RGP Lens Institute.