The AOA Contact Lens & Cornea Section (CLCS) has developed a supplement to assist doctors of optometry with the challenges of treating patients with presbyopia, the natural aging process of the eye after age 40.
Perspectives on Achieving Presbyopic Contact Lens Success—sponsored by Johnson & Johnson Inc.—the second Through the Lens supplement, is a valuable tool for doctors of optometry who may be hesitant to offer multifocal contact lenses to presbyopic patients. The supplement presents a conversation among CLCS members, addressing a wide range of issues related to providing multifocal contact lenses, including which patients make the best candidates, how to approach patients and how to manage patient expectations.
Jeffrey J. Walline, O.D., Ph.D., CLCS chair and associate dean for research at The Ohio State University, offers five tips for multifocal contact lens success.
- Talk to all presbyopic patients about multifocal contact lenses.
Everyone's eyes begin to have trouble focusing close up sometime after age 40, but most patients are unaware of their options. "All people over the age of 40 who wear glasses should know contact lenses are an option so they at least know what the possibilities are," Dr. Walline says.
Candidates for multifocal contact lens success include presbyopic patients who wear only glasses, those who wear contact lenses but wear reading glasses over them and those who are already wearing monovision contact lenses (particularly those with high computer use).
Dr. Walline recommends talking with presbyopic patients every year about their options. They may not be interested one year, but as daily activities change—or as their eyes continue to age—they may become more open to trying multifocal contact lenses. Patients also may not realize that contact lenses are much more comfortable than when they might have tried them years ago.
- Baby boomers and Generation X patients require different approaches.
Baby boomers were born between 1946 and 1964, while Gen Xers were born roughly between 1965 and 1982. Dr. Walline says that Generation X patients have often read about the latest technology and will ask doctors of optometry about their options. On the other hand, doctors will often need to bring up the subject first with baby boomers.
- Follow the product-fitting guide and become educated on different options.
Each product has its own unique fitting guide, and it's critical that doctors of optometry follow the appropriate one.
- Encourage patients to try daily disposable lenses.
For patients who wear contact lenses only two or three days a week, dailies are more cost-effective than frequent replacement contact lenses. If patients are hesitant, give them at least a one-week supply to try. They often discover they enjoy the comfort and convenience enough to switch, Dr. Walline says.
- Manage patient expectations without over-emphasizing compromised vision.
"There is no contact lens that will return your vision to what it was like when you were 16 years old," Dr. Walline says. But optometrists should make adjustments based on a patient's response, not solely the visual acuity measurement. Also, let patients know that light is their friend. They may still have difficulty reading menus in a dark restaurant, but a flashlight on a smartphone can often easily remedy the problem.
"The overall message is that multifocals are vastly improved and can take care of our patients' needs better than any other modality for presbyopic patients," Dr. Walline says. "So we should try them and gain experience with them to optimize our patients' well-being."
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