Multifocal contact lenses represent a significant opportunity for vision care practitioners today. There is a growing unmet need due to an increasing number of presbyopic patients who need help with near vision.
Thankfully, as multifocal technology continues to improve, our ability to meet that need improves, as well.
For many long-time contact lens wearers, presbyopia can be especially frustrating. Patients who have enjoyed clear distance vision in contact lenses for years eventually begin struggling with near vision. These vision changes create an opportunity to introduce today’s multifocal contact lens technologies and support those patients with continued contact lens wear.
At Louisville Eye Center, our multifocal practice has developed largely from our established patient base. Over the years, I have developed an approach centered on identifying the right patients, setting appropriate expectations, and supporting them throughout the fitting process. This has helped our office to become a top prescriber of Menicon multifocal contact lenses.
We have implemented several best practices at Louisville Eye Center that have consistently supported our successful multifocal contact lens practice.
Identify Opportunities
Success with multifocal contact lenses starts with listening to patients. While they may not ask specifically about multifocal contact lenses, patients will often mention their functional vision challenges during routine eye exams, such as difficulty seeing menus in dimly lit restaurants. Those conversations create an opportunity to discuss multifocals.
In my experience, patients tend to have the greatest success once they begin recognizing that they need help with near vision. Early/pre-presbyopes, in particular, can be excellent candidates because they often gain meaningful near vision with little sacrifice in distance clarity.
Setting expectations is the key to patient satisfaction. My philosophy is simple: under promise and overdeliver.
Refine the Conversation
During conversations with my patients, the language we use also matters. Rather than immediately describing these as “bifocal contact lenses,” I often use terms such as “dual-focus” or “reading-boost” lenses.
Softening the language helps patients focus on the benefits instead of the presbyopia label and can set aside potential negative experiences with older technologies.
Set Realistic Expectations
Setting expectations is the key to patient satisfaction. My philosophy is simple: under promise and overdeliver.
I explain that eyeglass lenses have plenty of room for separate distance and near prescriptions, while a contact lens is smaller. Thus, the larger the reading zone in a contact lens, the more it can affect distance vision, and vice versa.
From there, I help patients choose a visual strategy that best matches their lifestyle. For most patients, I recommend prioritizing good distance vision, computer vision, and everyday near tasks while using readers only for very small print. Others may choose to maximize near vision or find a compromise between distance and near. Giving patients ownership of the decision helps create realistic expectations.
Talk About New Technology
For patients who first tried multifocal contact lenses several years ago and were not satisfied, I explain that while no lens is perfect, today’s designs are noticeably better than what many patients experienced 5 to 10 years ago. Then, I encourage them to try today’s technology. For example, I have found that Menicon’s innovative multifocal optics have consistently delivered excellent results for my patients. This lens design enables me to add plus power in the distance prescription to enhance near vision without compromising distance acuity, offering greater flexibility when fitting a wide range of patients.
I also believe strongly in utilizing samples. This is a low-pressure strategy that is particularly effective for demonstrating the value of multifocals for patients. We provide the samples with very little pressure, then follow up within a week to ask about the patient’s experience. Patients then fall into one of three categories: they’re ready to finalize the prescription, they decide multifocal contact lenses are not meaningfully better for them, or they’re close and simply need some refinement. Having a defined follow-up process helps convert successful trials into long-term successes.
I explain that while no lens is perfect, today’s designs are noticeably better than what many patients experienced 5 to 10 years ago.
Explain Additional Benefits
While many patients initially focus on the visual benefits of multifocals, they quickly appreciate the lifestyle and aesthetic benefits, as well. Not having to wear glasses provides both convenience and an appearance boost.
Multifocals also provide flexibility. Some patients wear them every day, while others prefer them for work, exercise, vacations, or social occasions. Plus, wearers can combine monthly and daily disposable modalities depending on their activities and day-to-day scenarios.
When a presbyopic patient who has historically worn reading glasses attends a social event without them, friends and family notice. Those conversations naturally generate word-of-mouth referrals.
Address Dry Eye for Success
Ocular surface stability plays a major role in multifocal success because dry eye conditions directly impact visual performance. If a patient experiences dryness in a monthly lens, lubricating drops may be an appropriate first step.
For patients experiencing dry eye symptoms, I often recommend switching to daily disposable lenses, which are frequently better tolerated. In these cases, it is very convenient to have a daily disposable lens with optics that are identical to its monthly counterpart.
Conclusion
Growing a multifocal practice starts with recognizing opportunities during routine exams, setting realistic expectations, and guiding patients toward the strategy that best fits their needs. Advances in multifocal technology combined with thoughtful patient education allow practices to retain more patients in contact lenses while naturally growing their contact lens business.
Aaron McNulty, OD, FAAO, is a comprehensive optometrist at Louisville Eye Center in Louisville, Kentucky, where he emphasizes ocular disease and specialty contact lenses. He is president of the Kentucky Optometric Association, a fellow of the American Academy of Optometry, and a diplomate of the American Board of Optometry. Dr. McNulty was named the 2023 Kentucky Optometrist of the Year. A graduate of the Indiana University School of Optometry, Dr. McNulty lectures nationally about the treatment of eye diseases and laser surgery in eye care.