editor’s perspective

We Should Be Fitting More Multifocal Lenses

BY JASON J. NICHOLS, OD, MPH, PHD, FAAO

Looking at the “2013 Annual Report” and “International Prescribing” articles published in our January 2014 issue, I think it is important to take note of a few disheartening statistics. It’s not surprising that the bulk of our contact lens fits are in the spherical and toric lens categories. Even so, an optimistic estimate of the number of multifocal lens fits compared to all contact lens fits on a global basis is only about 12%. More surprisingly, indicators of multifocal prescribing habits in the United States suggest that perhaps only 9% to 10% of U.S. soft contact lens fits are multifocals. Considering that there are approximately 35 million soft lens wearers in the United States, this means that only about 3 to 4 million of them wear multifocals. Yet, presbyopia is a ubiquitous and highly prevalent condition, growing in society year after year as baby boomers age.

Given that presbyopic patients make up a significant portion of our patient population, it seems obvious that these percentages should be much higher. Yet, they aren’t, although we have seen some upward trends in multifocal fitting in the last few years. There are perhaps many reasons why this might be; in particular, I traditionally hear that visual compromise is the primary reason for lack of success. However, I believe that many of us have given up on multifocals for all the wrong reasons. Today, we have new technologies in this category that should allow for successful fitting in most of our presbyopic patients. Likewise, although currently an off-label use, multifocals can be used for myopia control in our children and teens as well. Look for more information on this very important discussion in the coming months ahead.