Biotrue ONEday for Presbyopia from Bausch + Lomb
mimics the lipid layer of tear film to maintain moisture.
1-Day ACUVUE Moist brand Multifocal for Presbyopia matches the optical design to the pupil size.
Alcon’s DAILIES AquaComfort PLUS Multifocal provides Blink-Activated Moisture Technology.

Do you play sports? Do you hunt? Do you travel often? Pose these questions to your patients and you may find good candidates for daily disposable multifocals.

Our patients with presbyopia lead demanding lifestyles and need functional vision at all ranges””but they are less willing to compromise than ever before. We are fortunate to live in a time when the technological advances in multifocal lenses are exploding, providing us with another way to stay ahead of the curve and distinguish ourselves from big box and online competitors: recommending daily disposable multifocal contact lenses to presbyopes and those who might not have realized they were an option.

A person’s visual demands during the week can be vastly different than over the weekend. Between the work-up with my technician and the examination, I can develop an idea of what the patient requires for both work and play. In some, patients are currently wearing contact lenses part-time, making it a great starting point for discussing the daily disposable modality.  Here are four demographics with varying visual demands:

1. Active presbyopes. Patients who play sports, especially golf, tennis and racquetball, need more than just good distance vision. These sports require clear vision at multiple distances. I often ask patients if they are having trouble seeing the tennis ball when they are serving, and I constantly ask golfers if they would like to read their scorecard and also be able to track the ball off the tee. The other key factor in sports is the importance of depth perception in order to be competitive.

2. Frequent travelers. Patients on the move, whether for business or pleasure, enjoy the convenience of disposables because they do not have to pack solution and cases (much appreciated in these days of luggage fees.) Personally, I enjoy the health of a daily disposable especially when flying regularly due to the dry environment on planes.

3. Hunters. Everyday glasses are inconvenient when waiting in a deer stand for hours, but most hunters will admit to not owning prescription safety glasses for hunting.

4. LASIK patients with presbyopia. Sure, not for everyday, but these patients would probably appreciate not having to reach for their readers on special occasions. Plus, dryness is one of the most common post-refractive side effects. In my practice, patients who have worn contacts post-surgery have been amazed at the difference between their lenses before surgery and the comfort of daily disposables after.

Much to the dismay of my technician, I personally prescribe all of the following five daily disposable multifocals. I find that no one multifocal is best in comfort or vision on every patient. Every eye is different, and all of these lenses have major advantages compared to previous technologies.

1-DAY ACUVUE MOIST Brand MULTIFOCAL: Johnson and Johnson Vision Care, Inc. has patented an aspheric center-near design contact lens that matches the variations in pupil sizes according to age and refractive error. This makes sense, because as we age, the pupil gets smaller. (A diminishing pupil creates an issue with the concentric circle design of multifocal lenses, which has less room for all of the different refractive powers.) Additionally, this lens is built on the 1-DAY ACUVUE MOIST brand platform and offers UV protection.

clariti 1 day multifocal: CooperVision’s newest multifocal is a silicone hydrogel (SiHy) lens. Compared to hydrogel contact lenses, silicone hydrogels allow more oxygen to pass through the cornea throughout the day. This line includes a full family of SiHy daily disposables with a sphere, toric and multifocal lens, plus it provides UV protection.

Proclear 1 day multifocal: This near center design hydrogel multifocal lens from CooperVision features a single power profile designed to preserve distance vision and limit visual compromise. As presbyopes age, a near boost is added to the non-dominant eye. The Proclear family features a unique lens technology that naturally attracts water to keep lenses feeling hydrated throughout the day.

DAILIES AquaComfort PLUS Multifocal: These contact lenses offer Alcon’s patented Precision Profile Design for sharper vision and Blink-Activated Moisture Technology for all-day comfort. This DAILIES line also offers a full family of products, which allows for easy upgrade as the patient ages.

Biotrue ONEday for Presbyopia: This lens from Bausch + Lomb combines the material of Biotrue ONEday, which maintains 98% of its moisture for up to 16 hours, with the company’s 3-Zone Progressive multifocal design for clear, comfortable vision up close, at a distance and everywhere in between.

With all these lenses in our arsenal, why aren’t more practitioners prescribing them? I can only imagine the reason is because fitting multifocals might seem difficult. Monovision is quick and easy, and we are constantly trying to maximize the number of patients we see in a day. But I have actually been taking the opposite approach with my multifocal patients.

The first evaluation is always the most time-consuming, so I take that valuable chair time to properly set realistic expectations and make sure this is the right kind of patient. That is the key to success with any multifocal lens. Honestly, all presbyopic patients want to see the way they did in their twenties. I remind them that this will not happen with either glasses or contacts, but I can get them functional vision at all distances without having to rely on glasses.

Remember, the time-consuming part is only in the beginning. Take the time up front, and after you identify the best brand for the patient, each subsequent year requires just a small tweak. I find that patients are so appreciative of trying to get it right in as many lenses as it takes that they and their families become lifelong patients. And this patient loyalty is another way we can separate ourselves as practitioners.

Brooke Kaplan, OD, is in private practice in Mountain Brook, AL.


Alcon Laboratories
800.451.3937 | alcon.com

Bausch + Lomb
800.828.9030 | bausch.com

CooperVision, Inc.
800.341.2020 | coopervision.com

Johnson & Johnson Vision Care, Inc.
800-843-2020 | ACUVUEProfessional.com


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