prescribing for presbyopia
Communicate and Demonstrate Soft Multifocal Lens Benefits
BY CRAIG W. NORMAN, FCLSA

Recently I took part in a discussion with some colleagues about how we incorporated soft multifocal/bifocal contact lenses into our practices. We also discussed success rates and patient acceptance.  One veteran practitioner (I'll call him Dr. P for pessimistic) made a comment that caused me to wonder if we practitioners, as the patient's source of eyecare information, are not our own worst enemy. Dr. P's comment was, "Once I mention to patients the potential for compromised vision, the many visits it may take to complete the fitting process and the higher costs of multifocal soft lenses, most choose single vision or monovision instead."

Was Dr. P correct in his statements? It's possible. In fact, it prompted me to take stock on how our practice manages these discussions with presbyopes to ensure that we are doing everything possible to increase each patient's chance of success.

Our office is currently undergoing a paradigm shift in that we are moving away from "selling" soft contact lenses toward "professionally fitting" them. We encourage patients to purchase their contact lenses wherever they desire provided that they are successful with those lenses. Thus, it has become even more important that we determine what category of presbyopic lenses is best suited for individual patients.

Win Your Patients Over

In our office we use three key methods to communicate and demonstrate soft multifocal lens benefits to patients.

1. Present this option to every presbyopic soft contact lens candidate. In our office we are committed to updating our patients about what's new in the contact lens field and what is available for their needs. This certainly applies to presbyopes -- in fact we may have more to discuss with these patients than we do with single-vision wearers.

We tell presbyopes about new products such as Vistakon's Acuvue Bifocal, Bausch & Lomb's SofLens Multi-Focal, CooperVision's Frequency 55 Multifocal and CIBA Vision's Focus Progressive lenses and how they may be ideal for their visual needs.

2. Diagnostic fit to demonstrate vision potential at distance and near. With our new commitment to "fit" rather than "sell" soft lenses, it has become vital that we "show and tell" the patient how soft multifocal lenses might work for them. We perform a diagnostic fitting, demonstrate two to three lens options and then determine whether the patient is suited for this modality.

3. Avoid negative descriptions of potential outcomes. You've heard it before -- prescribing bifocal and multifocal contact lenses is a more difficult and time-consuming task than prescribing spherical lenses. So what! Patients don't know that. They think we can make this option can work for them.

Don't spend your time explaining to prospective presbyopic lens wearers that these contact lenses will "compromise" their vision -- instead demonstrate how they might work (see Method #2). Patients respond much more positively when we are enthusiastic about their chances for success.

The Moral Is...

Don't be like my friend Dr. P -- give your patients the best opportunity for success from the minute you determine they may be candidates for soft multifocal contact lenses.

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.