KEEPING PRESBYOPES IN CONTACT LENSES

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To do so, educate your patient and take advantage of the materials available.

Patients who are likely to give up contact lens wear represent one of the greatest opportunities in our practices. Contact lens usage drops off dramatically after age 45 due to comfort and vision issues, even though today’s contact lens technology means they do not have to sacrifice vision or comfort while wearing contact lenses. Also, many patients are unaware of the opportunities that exist for them. If we can successfully provide these patients with clear, crisp, comfortable vision that matches their changing needs, our practices will benefit greatly.

Multifocal wearers have traditionally been thought of as time consuming patients who take a lot of chair time. I welcome these patients, however, and ask every presbyopic patient about contact lens wear. Many of these patients have never considered themselves a candidate for contact lenses and are thrilled with the option of even part time freedom from spectacle wear.

One of the best ways to ensure success is proper patient selection and clear cut expectations. I often tell patients that “if I can get you happy 80% of the time, that is a 100% success in my book.” I also let them know that multifocal lenses may not work for them in every situation, but that does not mean they are a failure. Having the option for sports, social occasions and as an option for everyday use can be just as great.

We are very fortunate to have many different lenses available, all with different designs and materials.

ALCON
The AIR OPTIX AQUA Multifocal lens provides patients with a monthly lens offering crisp vision, comfort and wettability, and high oxygen transmission. The Precison Profile Design gives clear vision at all distances, and the lens is available in powers of +6.00D to -10.00D and low (to +1.25D), medium (+1.50D to +2.00D) and high (+2.25D to +2.50D) add powers.

DAILIES AquaComfort Plus Multifocal One-Day Contact Lenses, made of nefilcon A, also feature Precision Profile Design. A consistent add power also decreases fit time and improves performance at all distances. This lens is available from +6.00D to -10.00D with low (to +1.25D), medium(+1.50D to +2.00D) and high (+2.25D to +2.50D) add powers.

The DAILIES TOTAL1 Multifocal is a water gradient contact lens for presbyopes. This lens features the Precision Profile Design, which allows for clear vision at all distances, and a smooth transition from center near to intermediate and far. Like the DAILIES AquaComfort Plus Multifocal, this lens is available in powers of +6.00D to -10.00D low (to +1.25D), medium (+1.50D to +2.00D) and high (+2.25D to +2.50D) add powers.

The 1-DAY ACUVUE MOIST Brand MULTIFOCAL from Johnson & Johnson Vision features a permanently embedded wetting agent.

JOHNSON & JOHNSON
The 1-DAY ACUVUE MOIST Brand MULTIFOCAL from Johnson & Johnson Vision features pupil optimization, which closely matches the optical design to the pupil size according to age and refractive power for built-in precision and consistent performance, and LACREON Technology, which permanently embeds a wetting agent in the lens material for improved comfort. They are available in powers of +6.00D to -9.00D (0.25D steps) and three ranges of add powers: low (+0.75D to +1.25D), medium (+1.50D to +1.75D) and high (+2.00D to +2.50D).

The ACUVUE OASYS FOR PRESBYOPIA lens combines HYDRACLEAR PLUS technology, which balances increased oxygen transmissibity of the senofilcon A silicone hydrogel material with a higher volume of wetting agent, for greater lubricity, and the STEREO PRECISION TECHNOLOGY, which works with the eye’s natural function to provide balanced near, intermediate and distance vision across variable lighting conditions. With 98% of the oxygen available reaching the eye, and increased lubricity, patients wearing this lens find they have better comfort in challenging environments. The ACUVUE OASYS FOR PRESBYOPIA is available in three add powers from +6.00D to -9.00D (0.25D steps) with three add powers: low (+1.25D), medium (+1.75D) and high (+2.50D).

Proclear 1 day multifocal is an aspheric center near design that allows for vision at all distances.

COOPERVISION
CooperVision’s clariti 1 day multifocal lens combines exceptional vision for early to late presbyopes, the ease of a daily disposable lens and the comfort and breathability of a silicone hydrogel lens. I’ve found that fitting this lens only requires an extra five minutes vs. the clariti 1 day. This lens also features WetLoc Technology to keep the surface continuously moist, UVA and UVB protection, and 100%

corneal oxygen consumption. The clariti 1 day multifocal is available from +5.00D to -6.00D (0.25D) steps and two ranges of powers: low (up to +2.25D) and high (+2.50D to +3.00D).

Proclear 1 day multifocal is an aspheric, center near design that allows for vision at all distances. The Proclear material can help with dry eye discomfort, as the molecular chemistry of the lenses and PC Technology keep the lenses hydrated and clean all day. The single power profile keeps distance vision sharp, optimizes near and intermediate vision and maintains binocularity. This lens is available from +6.00D to -10.00D (0.25D steps, 0.50D steps after -6.00D), and can accommodate add powers to +2.50.

The Biofinity multifocal is a lens that has a low modulus, high Dk value (128) and is naturally wettable. It is approved for daily and extended wear up to six nights/seven days. It is available from +6.00D to -8.00D and in add powers of +1.00D to +2.50D.

The Bausch + Lomb ULTRA for Presbyopia combines Moisture Seal Technology with a 3-Zone Progressive Design.

BAUSCH + LOMB
The Bausch + Lomb ULTRA for Presbyopia combines Moisture Seal Technology with a 3-Zone Progressive Design. The combination of these technologies provides patients exceptional comfort and clear vision at near, far, and in-between. Bausch + Lomb ULTRA for Presbyopia also provides consistent add power across the powers for an easy, predictable fit. This lens is available in powers of +6.00D to -10.00D (0.25D steps) and with low (+0.75D to +1.50D) and high (+1.75D to +2.50D) add powers.
Biotrue ONEday for Presbyopia contact lenses combine the bio-inspired Surface Active Technology with Bausch + Lomb’s 3-Zone Progressive design. The lenses have an extremely high water content and maintain 98% of their moisture for a full 16 hours. The multifocal design offers patients comfortable vision across all distances and is available in powers of +6.00D to -9.00D (0.25D steps), including plano, and with low (+0.75D to +1.50D) and high (+1.75D to +2.50D) add powers.

MORE CHOICES
There are more choices then ever for our presbyopic contact lens wearers. We have the option of daily disposable lenses, traditional two-week lenses, and monthly replacement lenses that are approved for extended wear. The newer designs and detailed fitting guides decrease chair time and improve fitting success, making it easier than ever for eyecare practitioners to add multifocal contact lenses into their practice.

Jennifer L. Stewart, OD, is a partner at Norwalk Eye Care, in Norwalk, CT. She is also the co-founder and chief optometric officer at Performance 20/20, a sports and performance vision clinic, in Stamford, CT.

WHERE TO FIND IT:
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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