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.

Step 1.
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.

Step 2.
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.

Step 3.
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.

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.


Alcon Laboratories
800.451.3937 |

Alden Optical
800.253.3669 |

CooperVision, Inc.
800.341.2020 |

Johnson & Johnson Vision Care, Inc.
800.843.2020 |

Synergeyes Inc.
800.SEE.2012 |


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