IT IS WELL KNOWN that no one presbyopic contact lens is perfect for everyone. It is important to understand the variables to maximize success with this demanding group of contact lens wearers. Even the small details can make a big difference in a successful fit to prevent contact lens dropout.
Achieving the Multifocal Effect
Practitioners know that presbyopes have lost a percentage of their accommodation system, so how does the contact lens replace what those patients don’t have any longer?
Options include simultaneous vision with center-near or center-distance, extended depth of focus, and more advanced designs. It is important to understand the designs available when selecting a lens for a patient. This can help eyecare professionals describe how the lenses work, so their patients can understand how they differ from their previous lenses and the need to adapt and adjust to the new ones to achieve the best outcomes.
For example, find an image on the internet of an eye wearing a contact lens (Figure 1) and describe what the contact lens is designed to accomplish. Next, discuss how a change in power profile provides vision at distance, near, and intermediate. Practitioners can also explain that presbyopic eyes require lenses that focus at different distances because their eyes are not able to switch between distances on their own anymore. The patient may not report 100% perfect vision at all distances initially, but a careful fit, coupled with the patient’s willingness to learn to use the lenses, will help them achieve their visual needs. This helps set the stage for long-term success and helps the provider choose the design that best suits the patient’s visual needs.
The Fit Guide
Understanding the fitting guide is critical to mastering the fitting process for each unique lens design, and learning how to use it is time well spent. These guides have been developed based on many patient encounters and will help maximize your success. The information they provide helps the eyecare professional select the most appropriate initial diagnostic lens for each patient’s unique prescription from the start.
Additionally, the fitting guides provide troubleshooting techniques that help fine-tune the powers during the fitting process. Some of those techniques may even be surprising, with all the potential variables to change. Whether your patients are asking for an improvement in their distance or near vision, look over the fitting guide and make sure you are on the right path before wasting time by guessing or using fitting suggestions based on a different lens design.
These are just a couple of important variables to consider when fitting multifocal contact lenses for the presbyopic population. These patients are known to be underserved, and fitting patients with presbyopia is rewarding and also a growth opportunity for most practices. Although fitting multifocal contact lenses can be demanding at times and can also take a little more time to achieve success, it can also be very rewarding—and successful patients are great advocates for your care and practice. Start with the basics—the design and how to fit a patient with this technology—to maximize the growth of your practice.