Article Date: 2/1/2008

Practice Early Intervention

Practice Early Intervention

Why deny emerging presbyopes binocular vision at distance, intermediate and near? Find out about a multifocal contact lens made just for them.

BY EARL SANDLER, O.D.

Have you reached statistical overload when it comes to the baby boomer generation? Here's a number that may grab your attention again: According to data gathered by MetLife in 2005, the estimated annual spending power of the baby boomers in North America is more than $2 trillion.

What's more, according to trendwatching.com and Shopper Vision, baby boomers are neither frugal nor set in their ways, and they spend more time considering new products and brands. They engage in more activities than previous generations, including work, leisure and learning. As eyecare practitioners, we can capitalize on this demographic phenomenon by delivering better vision-correcting options.

Now that we know who the baby boomers are and what they want, our first order of business should be to capture the emerging presbyope before he or she is lost to readers or bifocals or even monovision. Here's the approach I recommend.

More Than an Age

The biggest opportunity lies with patients who are already in our care. The new Biomedics EP lens from CooperVision enables us to deliver the clear, natural vision that these patients want. Review your records for these prime candidates:

1. Spectacle-wearing emerging presbyopes with near vision symptoms who have never worn contact lenses. Offering soft multifocal contact lenses to these patients is another way of differentiating your practice from others. Present the Biomedics EP in a positive and enthusiastic manner, and you'll be pleasantly surprised at how many of these patients will succeed. Definitely use the diagnostic fitting set, which will demonstrate the excellent comfort and vision that these lenses provide that will impress these first timers.

2. Current single-vision soft lens wearers with near vision symptoms in this age group, including those wearing monovision. These patients often are unaware of their contact lens options. As you know, monovision has limitations. For example, some of these patients may be sensitive to blur and imbalance. They may have difficulty with night vision, or they may need eyeglasses for certain activities. I generally fit these patients directly into the Biomedics EP. You will find that current monovision wearers are excited to learn about this new technology, which will allow them to see clearly with both eyes at all distances.

Fitting Ease

The Biomedics EP lens is as simple to fit as a spherical contact lens but offers the advantages and performance of a multifocal. The lens has a center spherical distance zone with a progressive aspheric zone that provides excellent intermediate and near vision. There is no need to determine eye dominance when fitting this lens. In my experience, the lens provides exceptional vision at all distances, as well as all-day comfort and easy adaptation.

I've found that emerging presbyopes may be more prone to dry eyes. Biomedics EP, made from omafilcon A material, provides a wettable lens that may decrease lens dehydration. This allows for better movement when blinking and helps to avoid reduced comfort and visual clarity related to contact lens dry eye. Generally, patients with more than 1.00D of cylinder and/or an add of above 1.25D may not be ideal candidates for this lens. I usually recommend the Proclear Multifocal or Proclear Multifocal Toric for these patients.

Patient Education Starts With Questions

To increase your success rate with the Biomedics EP lens, ask patients specific questions about their visual demands, work environment, computer viewing distance, hobbies and sports, and then listen to their expectations, wants and needs. Then present this lens in a positive manner with benefits tied into each patient's lifestyle.

Patients need to know up front that this new visual system will not mimic the visual freedom of a 20-year-old emmetrope. They must have realistic expectations and understand that there may be times when reading glasses may be necessary. This way, patients have a clear understanding of what can be achieved, and they'll be less likely to chase after perfect vision.

Another key point is to reassure patients that adapting to this lens is easier than adapting to multifocal spectacles because they don't have to find the "sweet spot" as they do with multifocal spectacles. Ease of adaptation is a key factor that will motivate patients to try the Biomedics EP lens.

Plant the Seed Early

Think about the potential market for all existing lens wearers who will become emerging presbyopes and would prefer to remain in contact lenses. I think it's very important to prepare your patients and mention treatment options before presbyopia surfaces. I like to plant the seed and create awareness about multifocal contact lenses by telling patients how we can use them to handle near-vision problems down the road. When patients return to your office with the onset of near-vision symptoms, they'll remember this conversation and be more open to trying this new technology.

Support Success at All Levels

To achieve success in your practice, you need to fit and market multifocal contact lenses appropriately to patients. I recommend you have educational material on multifocal contact lenses in your reception area. Be sure to educate all staff members about the lenses as well.

As we all know, word of mouth is the ultimate marketing tool because it can help establish your practice as a presbyopic contact lens specialty practice, leading to larger patient volume and profitability. The baby boomer generation wants to remain active and free from the need for spectacles while participating in their favorite activities. The combination of wealth, health and longer life gives them a new phase of life. Baby boomers want to 'have their time again,' by chasing personal fulfillment, feeling young and having great vision correction at all distances. In my opinion, there's no better way to offer it to them than with the Biomedics EP multifocal contact lens.

Wide Array of Multifocal Choices

In this supplement, we have clearly identified three different levels of presbyopia and how contact lens practitioners can address these patients' needs with a wide array of choices. In these cases, we chose from the CooperVision family of multifocals for emerging to advanced cases, including the presbyopic astigmat.


Dr. Sandler is in group private practice at Carmel Mountain Vision Care in San Diego, Calif.

Biomedics EP in Action

Russell, a 43-year-old software engineer, came to our office for his yearly eye examination. His previous ocular and medical history was unremarkable. He was in excellent health, taking no medicines and not allergic to any medicines. He complained that he couldn't see clearly at near, especially while working on his computer with his current contact lenses. He was wearing:

OD: Proclear sphere 8.6/14.2/ –3.25
OS: Proclear sphere 8.6/14.2/ –3.75

External examination of the lids and adnexae was normal. Anterior segment evaluation using slit lamp biomicroscopy was unremarkable. Fundus evaluation revealed healthy optic nerve head, macula, retinal vasculature and periphery.
Manifest refraction was:
OD: –3.25 –0.50 × 180 20/20 Add +1.25 20/20
OS: –3.75 –0.50 × 180 20/20 Add +1.25 20/20

We refitted Russell with:
OD: Biomedics EP 8.7 / 14.4/ –3.25
OS: Biomedics EP 8.7 / 14.4/ –3.75

Visual acuity with the new diagnostic lenses was 20/20 at distance and near. The lenses were well centered with excellent movement to blink and excursion. We instructed Russell to use his new contact lenses for 1 week.
At his 1-week progress evaluation, the patient's vision was 20/20 at distance and near. The lenses were well centered with excellent movement to blink and excursion. Russell reported he was very happy with the comfort of the lenses and could see clearly and comfortably while reading, working on his computer and driving.



Optometric Management, Issue: February 2008