What I have learned
Fitting for presbyopia
Optometrist at Leightons Opticians in St Albans, Indie Grewal, and 50-year-old school teacher, Carol Girdlestone, tell OT about their experience treating presbyopia with multifocal contact lenses
How has presbyopia affected your day-to-day life?
Carol Girdlestone (CG): I found that my reading vision was starting to become difficult in my early forties. I became more reliant on my spectacles to read as I got older. That reliance became frustrating as I was constantly looking for my spectacles, or continually having to put them on and off throughout the day.
When were contact lenses first introduced as an option to you?
CG: I’ve been seeing my optometrist, Indie Grewal, for eye examinations since 2014, and he introduced the idea of contact lenses at the first exam. Initially, I wasn’t keen on the idea of putting something in my eye.
A year later, Indie fitted me with some trial multifocal contact lenses, which he considered to be a serious contender of vision correction as I needed different prescription spectacles depending on what activities I was doing. Although I could see the advantage of contact lenses, I had a phobia about fiddling with my eyes. I drifted towards wearing spectacles constantly, which I found quite frustrating, having gotten to my mid-forties without needing any help with my vision.
What concerns did you have about wearing contact lenses?
CG: Although Indie explained the benefits, putting something in my eyes every day filled me with dread. I think the biggest barrier was inserting and removing them – what would happen if I couldn’t get them out? Indie and his team were very patient and put me at ease by helping me through the process and answering any questions I had regarding contact lenses.
What advice was given to you?
CG: When an expert tells you that something is good or better for you, you have to listen to the advice offered. Indie allowed me to trial some lenses for a whole day last year. If I wasn’t convinced at the beginning of that day, I certainly was by the end. I found I couldn’t feel the lenses and could see as well as I could in my spectacles.
"It has been said that 60 is the new 40. Many presbyopes are fitter and more active than they were a generation ago"
How have you found the contact lenses in day-to-day life?
CG: As soon as I put them in, I forget they are there and I have perfect vision at all distances. Contact lenses have made me feel happier and more confident. They help without me even thinking about them. I can now drive and see the dials and the sat-nav in the car. They help a lot at school where, as a teacher, I view children’s work from varying distances. I can’t think of any drawbacks, apart from wishing I’d tried them earlier.
What advice or options did you offer Carol?
Indie Grewal (IG): I’m keen to mention the option on multifocal contact lenses to every patient, if appropriate. Many don’t know that contact lenses can help with presbyopia. Patients need to be advised that multifocal contact lenses are an option for both full and part-time wear and are an equally important option as spectacles.
Did she raise any concerns about wearing contact lenses, and how did you help alleviate her worries?
IG: Carol was initially concerned about wearing contact lenses, especially the application and removal of the lenses. This concern can be the main reason many neophtyes don’t even trial multifocal contact lenses. Once convinced to trial multifocal contact lenses, risk-free and under supervision, many patients are happy to try them, many with surprising results.
What would you say to practitioners who might shy away from recommending contact lenses to treat presbyopic patients?
IG: It has been said that 60 is the new 40. Many presbyopes are fitter and more active than they were a generation ago. Many of these presbyopes also have a desire to look more like their children than their parents. Spectacles, for many patients, are a reminder of their advancing years.
Both materials and multifocal technology have changed significantly in the past few years. With improvements in multifocal design, the fitting process has been significantly simplified. The more recent introduction of daily disposable multifocal contact lenses means that they can be offered as part of a visual wardrobe, giving patients freedom from their spectacles.
My confidence in the materials and multifocal technology has also allowed me to happily provide patients with the option to trial multifocal contact lenses for a whole day. This enables patients to try them at work, while at lunch with friends or pursuing their favourite hobbies.
The idea of multifocal contact lenses can by introduced at the end of any eye examination as an aid to dispensing spectacles, thus reinforcing the message that contact lenses are another visual option open to many of today’s busy presbyopes.