|Proclear 1 day multifocal from CooperVision utilizes technology which allows the lens to form hydrogen bonds with water to naturally resist dryness.|
Three steps to successful fits for multifocal contact lenses, plus tips to reduce chair time.
When I used to see a presbyopic contact lens patient on my schedule, all I could imagine was the amount of time I would spend fitting this patient and multiple follow-up visits. Now that I have found a simple approach that can work for everyone, I look forward to prescribing new contact lens technologies for presbyopes.
The first thing I do is get comfortable with the latest multifocal lenses by fitting some of my staff, family or even myself and select two or three lens designs for the office. I have found there is no need for anything other than daily disposables for most presbyopes. Most are also dry eye patients, or spend their days in front of a computer screen, and the moisture and clean, non-deposited lens that is a function of the modality make lenses an option for them. That said, there are some non-daily modalities for patients with unusual or high astigmatism, such as Duette Progressive from Synergeyes and Astera from Alden Optical, that are easy to fit.
Next, it’s critical to assess a patient’s visual needs at work and play. With daily disposables, it’s easy to mix and match weekday lenses in one power with weekend lenses in another power. After I finish the refraction, I think about powers and lenses I might try on the patient. Then, the patient is taken to our contact lens room and fit with lenses. Lenses are dispensed for five to seven days of wear with a return visit in one week.
At the follow-up, I talk to patients about expectations of the lenses and fees. People will pay for dailies once they understand that technology costs money. I stress to the patient that there are no solutions to buy and the lenses remain sterile in the pack for up to a few years.
REDUCING CHAIR TIME
In my office, my first choice is Cooper-Vision’s Proclear 1 day multifocal because there is only one add power to think about and the lens works 85% to 90% of the time. In patients with higher add powers, I consider Alcon’s DAILIES AquaComfort PLUS Multifocal, since it has multiple add powers. In patients with more dry eye symptoms than average, I may choose the 1-DAY ACUVUE MOIST Brand MULTIFOCAL from Johnson & Johnson Vision Care.
If the patient returns because they need a power change, I have my staff use spherical loose lenses over the contacts to see if they can increase distance or near to their needs. We use a Snellen chart in the hallway for distance testing and their mobile phone for functional near testing. Since my staff is attending to the patient, I don’t have to use more chair time and I can stop by between patients to see the final outcome.
Further utilizing staff for follow-up, I reduce chair time even more and efficiently fit presbyopes with the latest technology in lenses.
Carol Deitz-Bertke, OD, is in private practice in Edgewood, KY.
WHERE TO FIND IT:
800.451.3937 | alcon.com
800.253.3669 | aldenoptical.com
800.341.2020 | coopervision.com
Johnson & Johnson Vision Care, Inc.
800.843.2020 | ACUVUEProfessional.com
800.SEE.2012 | synergeyes.com