Article Date: 10/1/2013

Achieve Multifocal CL Success
vision wear
VISION CARE & WEAR

Achieve Multifocal CL Success

Start by creating a rewarding fitting experience for you and your patients.

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JASON R. MILLER, O.D., M.B.A., F.A.A.O.

In addition to meeting visual demands and exceeding patient expectations, successfully providing multifocal contact lenses to your patients increases the number of referrals to your practice, as satisfied patients are sure to spread the word.

Here are some tips for a rewarding multifocal fitting experience for both you and your patients.

Explain the technology.

Some patients may be hesitant to try multifocals based on what they’ve heard or experienced from older multifocal technology.

To overcome these negative perceptions, explain that recent soft, disposable multifocal designs have improved. Inform patients that the fitting process is smoother, and tell them the lenses provide clearer vision than earlier designs.

Define success.

Part of the fitting process is educating the patient about what we consider “success.” This means different things to different people: freedom from reading glasses, the ability to read a book sans reading glasses or the ability to perform a favorite hobby. With different visual demands for every patient, make sure to elicit primary visual tasks and address them.

In addition, as texting and e-mail become the new medium for conversations, a new nearpoint card we can use is the patient’s cell phone. During the overrefraction, ask the patient to read his/her cell phone screen.

A new near-point card we can use is the patient’s cell phone.

Determine your primary lens.

It is important to fully understand all the designs and be ready to describe their benefits to your patients.

I recommend conducting your own in-office study by fitting your friends and family with multiple lenses. This helps determine your first-line lens, as well as your fallback design. Take their feedback, and learn from it.

Consider modified multifocals.

Eyecare professionals are changing their fitting trends, but these trends still lag behind patient preferences. An important statistic: A total of 76% of patients report that they prefer multifocal contact lenses vs. monovision contact lenses consistently in multiple studies.1,2 There may be times when you have to modify the multifocal lenses to achieve patients’ visual desires.

For example, I may let the patient know I am going to provide a little extra distance in the dominant eye and little extra near in his/her non-dominant eye. This usually results in a +0.25/+0.50 addition to help his/her near vision in the non-dominant eye. This is not the same as monovision with a single vision prescription but may prove to be the best endpoint in some patients.

Reach a common ground.

As many patients continue to demand better options to correct their vision and maintain their active lifestyles, eyecare practitioners are in a position to fit and prescribe the perfect contact lens for each situation. Follow the above tips, and embrace multifocal contact lenses for your presbyopic patients. OM

1. Benjamin WJ. Comparing multifocals and mono-vision. Contact Lens Spect. 2007 Jul:22(7): Accessed online September 14, 2013. http://www.clspectrum.com/article.aspx?article=100637.

2. Richdale K, Mitchell GL, Zadnik K. Comparison of multifocal and monovision soft contact lens corrections in patients with low-astigmatic presbyopia. Optom Vis Sci 2006 May;83(5):266-73.


DR. MILLER IS A PARTNER IN A PRIVATE PRACTICE IN POWELL, OHIO, AND IS AN ADJUNCT FACULTY MEMBER FOR THE OHIO STATE UNIVERSITY COLLEGE OF OPTOMETRY. SEND COMMENTS TO OPTOMETRICMANAGEMENT@GMAIL.COM.



Optometric Management, Volume: 48 , Issue: October 2013, page(s): 56