Presbyopia, contact lenses, and the practice team

In practice, Johnson & Johnson professional affairs consultant Faye McDearmid has observed the growing ageing population curve reflected in patients over the age of 45 presenting in her independent practice.

“Many in this older group are first-time contact lens wearers, motivated by the need for vision correction that fits with their daily lives,” McDearmid shared.

However, for practices, the challenge is not just clinical. Advances in contact lens technology mean there are more options than ever to meet patient needs, and a focus on clear communication, team confidence, and reconsidering long-held assumptions with patients is required.

Education is key in this and can be supported by the whole practice team, McDearmid told OT.

Drawing on her own experiences in practice, McDearmid emphasised that the entire team plays a vital role in the patient journey, from initial conversations and sharing first-hand experiences through to the final fitting.

Every team member can help create a positive, informed experience, particularly when introducing new contact lenses, the optometrist said.

McDearmid’s own journey with contact lenses started at 11-years-old. She was struggling with short-sightedness, particularly during equestrian sports, and glasses were not practical. Contact lenses changed that, not just in terms of vision, but confidence and performance.

Her own experience continues to shape how McDearmid practises today, and she strives for contact lenses to be spoken about by all staff to all patients.

“How do patients know what’s possible if nobody tells them?” she asked.

Discussing contact lenses through the patient journey is increasingly relevant as patient demographics evolve, and as emerging presbyopes look for solutions that align with both their vision needs and their lifestyles, and new products are released.

Bringing the practice team with you

With people living longer, staying active, and expecting more from their vision, presbyopia is no longer a passive stage.

When it comes to fitting contact lenses for presbyopia, success does not rest solely with the practitioner. “It’s a team effort,” McDearmid said.

“It’s the collective confidence of the whole team that results in a patient considering contact lenses in the first place,” McDearmid emphasised.

When it comes to multifocal and multifocal toric contact lens conversations with patients, McDearmid said that every touchpoint matters. From reception to pre-testing, each team member has a role in normalising contact lenses as an option, “especially for emerging presbyopes who might have never considered them,” she said.

“A well-informed team can introduce the idea early, reinforce key messages, and build patient curiosity before I see them for a more clinical conversation,” she said.

Keeping the whole team informed and confident is therefore key, in particular when new products become available and are introduced in practice.

McDearmid ensures that her team receives regular updates on new products, as well as simple messaging that everyone can adapt and use. This is done through a range of in-practice training, as well as support from sales representatives.

“I learn so much from contact lens reps coming in to practice too,” McDearmid said.

For McDearmid, practice teams should be mindful that patients will not necessarily ask if they are interested in contact lenses, and it is important for the team to play a role in talking about and recommending them.

“Patients may assume they aren’t suitable for lenses – they may have tried them years ago and dropped out, but a lot has changed,” McDearmid emphasised.

She added that a team that is also able to share its own experiences with contact lenses can be impactful, noting that patients respond positively and that these experiences help the team feel comfortable talking about contact lenses.

McDearmid highlighted that a small shift in language when the team is talking to patients can make a significant difference. Rather than asking, “Are you interested in contact lenses?”, they will say, “There’s a new option that fully corrects your vision –something we couldn’t offer before. Can I tell you more?”

When the entire team feels comfortable discussing contact lenses, patients are far more likely to engage, she emphasised.

When OT spoke to McDearmid, she had been fitting Johnson & Johnson’s newly launched ACUVUE® OASYS MAX 1-Day MULTIFOCAL for ASTIGMATISM for a few weeks and was able to reflect on introducing the new lens in practice with her team and with patients.

Myth: Multifocal toric contact lenses are hard to fit for presbyopic patients

Faye says… “This is one of the most persistent misconceptions among practitioners. However, the process isn’t harder, it comes down to understanding the lens, the eye, and what the patient wants. I follow four steps to support fitting multifocal contact lenses that I encourage others to follow: understand how the lens works, match it to the patient’s visual needs, set and manage realistic expectations for the patient, and follow the fitting guide. The final step will help minimise fitting attempts. Tools like ACUVUE® Simplifit calculator help remove the guesswork.”

Myth: Fitting presbyopic patients with astigmatism with contact lenses comes with a compromise

Faye says… “Historically, this was often true, but with new contact lenses, such as ACUVUE® OASYS MAX 1-Day MULTIFOCAL for ASTIGMATISM, available, this is changing.

“With modern multifocal toric designs patients who were ‘making do’ before are now seeing better than ever. Now that technology has advanced more patients can benefit from contact lenses, and practitioners and the practice team will play a vital role in re-educating patients about this.”

Myth: My patients will not pay for premium lenses

Faye says… “This assumption can limit patient outcomes and practice growth, and patients can’t choose what they’re never offered. Rather than pre-judging affordability, in practice we present all the suitable options available to a patient and explain the benefits. Then, we let the patient decide. When you discuss prices transparently as a range, based on wear frequency and modality, patients often surprise you. In my experience, patients are offended when they aren’t offered the best available options. This approach can also be supported by the practice team. By being able to confidently communicate the options and value of contact lenses, they can help normalise premium lenses as part of everyday eye care.”

Myth: Multifocal toric contact lenses are only for niche patients

Faye says… “Around half of presbyopic patients have clinically significant astigmatism, so, in reality, this category is far from niche. That’s a substantial portion of patients, many of whom may have previously been told that contact lenses weren’t suitable for them. This isn’t occasional, it’s everyday practice.”

Myth: Patients will not like the tint

Faye says… “Practitioner concern doesn’t always reflect patient reality. I flag the tint as something to explain to patients, but not something to worry about. In my experience, a patient may be curious, but no one has rejected a lens because of it. I mention it when discussing the blue-violet light filter. It’s only an issue if you ignore it. If you explain it, it becomes a positive.”