Fitting multifocal contact lenses may have been historically challenging, but with new designs and straightforward fitting guides, modern multifocals have become an important part of every day contact lens practice. Dr. Bruce Lucas of Personal Care Optometry in Woodland Hills, California recently took the time to discuss his tips and tricks for fitting success with clariti® 1 day multifocal lenses.
Q: You do a lot of multifocal contact lens fitting in your practice. Why do you consider this such an important offering for your patients?
A: The presbyopic community is large and a great opportunity as contact lens patients. Many of them have worn lenses for years and now have the need for reading correction. I don’t subscribe to the vision expectations that many subscribe to. I don’t expect to compromise distance or reading vision. I am a 20/15 emmetrope who at 61 years of age was not going to give up the distance clarity I have had my whole life to avoid reading glasses. So, my expectation is that distance will be as good, or nearly as good as a SV contact lens, and that my patients will easily read print smaller than phone book size.
I have only a handful of presbyopic contact lens wearers that are in monovision. With the many lenses available to us it allows me to have a better than 90% success rate with multifocal contact lenses. My preference with any contact lens wearer is to utilize a daily modality and 73% of the contact lenses we sell are daily lenses.
Q: How has clariti 1 day multifocal impacted your practice?
A: The clariti 1 day multifocal is my first lens of choice when fitting a daily multifocal lens. The material is very comfortable with a high oxygen transmission and UV protection*. The fit is straightforward because surprisingly, the low add will work on most all presbyopes, regardless of age, and provide excellent near vision. It is rare that I have to go to the high add at all, and with one exception it has only been on the non-dominant eye.
Q: How have patients in your practice responded to clariti 1 day multifocal?
A: Patient response is the reason the clariti 1 day multifocal lens is my first choice… because it has such a high success rate. It has provided my patients all day comfort, clear white eyes, and excellent distance and reading vision.
Q: How important do you consider the silicone hydrogel material to be for your 1-day multifocal patients?
A: Any time I can fit a patient in a silicone hydrogel material it is my preference. I tell patients that many of the problems that arise after years of contact lens wear are avoidable. If we do our job by seeing patients regularly, diagnosing contact lens related problems and making adjustments, there is no reason they shouldn’t be able to wear lenses all day for 20 or 30 years if they choose. It is incumbent on us to provide them every chance to maintain healthy eyes and this starts with providing the maximum oxygen to the cornea. We should utilize silicone hydrogel lenses for virtually everyone one of our contact lens wearers. Why not provide them with the best odds for maintaining healthy lens wear for years?
Q: Which patients are the best candidates for multifocal contact lenses?
A: Virtually all of my presbyopes are candidates for multifocal contacts. I have patients of nearly every profession in them, including patients with high and detailed visual demands. Whether it is a spherical or astigmatic presbyope my expectation is the same, and I am willing to invest the time to success. It is the most rewarding patient for me.
Q: What tips or tricks can you offer practitioners for successful multifocal fitting with clariti 1 day?
A: Here are some pearls that can increase your success with not only clariti 1 day multifocals, but all of your multifocal fittings.
PEARL #1: Small prescription changes can make significant changes in the quality of vision. Don’t sell .25 difference in only one eye short. It can be the difference in a patient telling you they are doing “ok” and them saying “this is much better.”
PEARL #2: No matter how small the change you make at a follow up visit see the patient back in another week. As they adjust to change their eyes will dictate further changes on the next visit. I never assume what I’ll find at the next appointment. It will play out differently week to week, patient to patient.
PEARL #3: Invest your time with these patients. They are by far and away my biggest contact lens referral sources. I have patients who will drive as much as 2 hours from my office because of the quality of vision I can provide. Invariably they run into a contact lens wearer in monovision or reading glasses over contacts who have been told by their eye care provider that bifocal contacts don’t work that well. Or they were given bifocal trial contacts and told to try them and let them know if they want to proceed. That is destined for failure. My patients turn those stories into referrals for me.
Maximize your multifocal fitting success with clariti 1 day multifocal contact lenses.
*Warning: UV-absorbing contact lenses are not substitutes for protective UV-absorbing eyewear, such as UV-absorbing goggles or sunglasses, because they do not 'completely' cover the eye and surrounding area. Patients should continue to use UV-absorbing eyewear as directed.