We’ve often heard about the opportunity that presbyopic patients can bring to the contact lens market. I agree that there are many new presbyopes interested in wearing contact lenses. The challenge is that the success rates may be lower, which can ultimately drain your energy throughout a long day of patient care. Even though there are many new multifocal designs entering the market, having realistic expectations for everyone is important to ultimately increase the number of presbyopic contact lens wearers in your practice.

Presbyopes may be some of the most challenging contact lens fits. There is a technical component, which is different with each multifocal design. Experience and using the fitting guides will help overcome this. Each lens is designed differently, and small changes and adjustments can make a big difference in the overall visual success of each lens.

The other component is the mental challenge. Multifocal contact lenses can test your perseverance and energy throughout the day. Follow these steps to help keep the momentum in your practice and build on the tremendous opportunity that presbyopes can provide.

Four Steps to Mental Success

1. Put yourself in their shoes. Mentally take a step back and think about their perspective. Managing expectations can be difficult. Many patients are hoping for their vision to be restored to pre-presbyopia or are comparing the vision with contact lenses to what they experience through their spectacles.
   It is important for them to understand the differences between single-vision contact lenses and multifocal contact lenses. Use whatever analogy works best for you; I describe their vision in terms of grades in school: “After presbyopia starts, we slowly lose the ability to focus up close. My expectations with multifocal contact lenses are to achieve B+ or A– vision in the distance and B or B– vision up close. Single-vision lenses often provide A+ vision in the distance and C– or D vision up close.”
   You can help your patients understand the visual expectations by setting the stage up front.
2. Listen to what is most important. We cannot provide perfect vision at every distance with multifocal contact lenses. Focus instead on what is most important to your patients. Listen to what their visual needs are, and customize the lenses depending on those needs.
   We now live in a much more visually demanding digital world. Expect this, and be ready to address it visually. Many patients prefer to see best at the computer and are OK with losing a little bit of sharpness in the distance.
3. Utilize the newest technologies. Multifocal lenses are difficult enough to fit, let alone using an older technology lens. Presbyopic patients want to see better and are often willing to spend a little extra to achieve that with contact lenses. Offer them the newest and best technology.
   Our responsibility as eyecare providers is to continually educate ourselves about new technologies. There are many new lens designs in a variety of different modalities to meet your patients’ visual needs.
4. Keep it positive, but force the decision. After following the fitting guide and making necessary power optimization changes, let patients make the final decision. For those having a hard time committing to a multifocal contact lens, allow them to try one lens that is near enhanced and one lens that is distance enhanced. I don’t even schedule them back, but rather tell them to call in and order which lens they prefer after wearing each for a few days in their normal visual world.

Keep Your Momentum Going

Be aware of your emerging presbyopes, and prepare your mental energy when handling these contact lens fits. Understand their perspective, and proactively address their expectations. There is a wave of new multifocal contact lens technology. Be ready to adopt, offer, and actively embrace these options to grow your presbyopic contact lens business. CLS