Prescribing for Presbyopia

Many Chances for Success With GPs for Presbyopia

BY CRAIG W. NORMAN, FCLSA

I recently returned from The Ohio State University, where the Gas Permeable Lens Institute, the educational arm of the Contact lens Manufacturers Association (CLMA), held its annual Cornea and Contact Lens Resident Symposium. This four-day event offered great lecturers, but more importantly, the attendees had the opportunity to evaluate and/or fit GP and hybrid lens wearers. I commend the CLMA for this effort, and I’m sure that the current residents do as well.

Presbyopic Fitting Session

Of the many topics covered, the Presbyopic Fitting Session really grabbed my attention. In advance of this session, eight GP lens manufacturers were given pertinent ocular data to determine the initial presbyopic lenses for eight patients. The designs were then calculated per their product fitting guides, resulting in various multifocal/bifocal/trifocal lenses depending on each patient’s add power, prescription, lid structure, previous wear, etc.

Groups of three to four residents then proceeded to try as many as five to six of these different lens designs on their assigned patient and finally had to choose which pair they would dispense.

The outcomes were fascinating: six fitting stations resulted in six different designs being chosen by the residents and patients—although in some cases, more than one GP presbyopic lens type could have been an option.

Many Good Options Available

What does this mean? Obviously, this is a very small sample size, and the lens fits were not evaluated over a long-term basis, but my sense of what transpired here is exactly what I’ve thought for years. Namely, there is not just one really good GP presbyopic design available, but rather there are many and when chosen for appropriate patients and fit properly, they all have a high chance of being very successful.

Experience Builds Confidence

At the end of the meeting, one of the attendees told me, “This was a great experience that gave me the confidence boost I need at this early point in my career.” Her statement really got me thinking. I think the key word that she said was “confidence.”

If you read this column often, you know that I’m a proponent of GP lens designs for presbyopes. They unfortunately still have a relatively low market penetration compared to soft lens designs. They provide sharp vision, are easily customized for any add power, and provide wearers with many years of satisfied use.

Why, then, are they not prescribed more often? Possibly, it’s the aforementioned confidence factor, and here’s the conundrum. You can only feel self-assured using a device or technique by gaining experience, but you can only gain experience by using the device or technique.

So my suggestion is this. For your next potential presbyopic contact lens candidate, try GP multifocals/bifocals. Follow the fitting guide, order some lenses, and refine a pair enough to dispense. Then, try it again, and again. Become confident with these lenses, and satisfaction will be achieved—from both the patients’ perspective and from yours. CLS

Craig Norman is Director of Research, Michigan College of Optometry at Ferris State University. He is a fellow of the Contact Lens Society of America and is an advisor to the GP Lens Institute. You can reach him at CraigNorman@ferris.edu.