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We need to talk about multifocal contact lenses

There’s a lot to gain by supporting presbyopic patients with multifocal contact lenses and proactive, clear explanations, writes Robyn Marsden

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Robyn Marsden

Robyn Marsden

15 May 2020

We all know that presbyopia is completely natural and inevitable. But while we are comfortable with this knowledge, we often forget the experience can be worrying for our patients. It can be frustrating even. Those experiencing symptoms for the first time can be anxious; I once had a patient who thought they had experienced a stroke.

As a profession we need to be more proactive, getting on the front foot in explaining presbyopia and the options available. We are all living longer, more active lives and the vision correction solutions that we prescribe should reflect that. Presbyopia doesn’t mean that patients have to change their lifestyles.

As a profession we need to be more proactive, getting on the front foot in explaining presbyopia and the options available

Robyn Marsden, professional affairs consultant for Johnson & Johnson Vision


So, let’s consider multifocal contact lenses. In my experience, we are falling into an old-school habit by opting to prescribe glasses only, a combination of glasses and contact lenses, or monovision without considering the benefits that newer multifocal contact lenses can offer.

This is because historically, fitting multifocal contact lenses for presbyopes could be challenging. Multifocal lenses typically offered a limited number of designs, which would therefore require multiple adjustments to get the right fit for patients. But, just as varifocal glasses have evolved, so have contact lenses. For example, Acuvue Moist Multifocal contact lenses offers 183 unique designs. That means the technology has improved for a more bespoke, yet easier fit, as the complexity of finding the right design of the 183 is managed by the simple-to-use fitting guide. It also means improved chair time, so there shouldn’t be concerns in running over allocated appointment slots.

Multifocal contact lenses and glasses shouldn’t have to be an either-or choice. Most patients are best suited using both. By being proactive as eye care professionals and letting patients trial multifocal lenses, we can break down barriers and reinforce that presbyopia doesn’t mean a life change.

Robyn’s experiences of the coronavirus (COVID-19) pandemic

“Having two young children, I am currently caring for them at home while schools are closed. However, I am really proud of my friends and colleagues that are able to continue to work in practice to provide urgent and essential care. Optometrists are really standing up to support the NHS frontline workers by providing extra capacity for eye care during these unprecedented times. And, of course supporting those that need replacements for broken or lost glasses and carrying out tele-consultations to continue contact lens supply. This not only helps to allow patients to retain some normality in these times, but also helps lessen hospital admissions by reducing falls and other accidents.”

Robyn’s tips for engaging patients

Be proactive. “What I aim to do is get ahead of presbyopia by explaining it to any patients I see who are in their late 30s. When they come in for their routine eye check, I let them know that everything is looking fine, but that they may start to experience some changes in the next couple years. I say: “Just so you know, in time you may notice that seeing things close-up will become more difficult, and there is no need to be concerned as this happens to everyone.” And that when it does change, they can come in and I can help them with it. This makes it more normal. If our patients know presbyopia is inevitable and is something that happens to everyone, it becomes a much more expected and accepted condition.”

Skip the jargon. “When explaining multifocal contact lenses to patients, they may be concerned that it is complicated or won’t feel natural. You can simplify it for them with visual analogies such as looking through a window on a rainy day. If you were to look at a raindrop on a window you can see it up close in great detail. Equally, you can focus on the tree in the background and your eyes forget the raindrop is there . Multifocal contact lenses are the same; they allow your brain to correctly interpret the image you want to see without you having to do anything. The simplest way to bring the benefit of multifocal lenses to life for patients is to show them. Pop on a pair while they pick out their glasses. This alleviates a lot of the pressure on the patient and if you don’t trial, they might not understand what they could be missing.”

Ask patients about their lifestyle. “Presbyopes are more active than they ever used to be, so they are more likely to be interested in multifocal lenses as a complementary option to glasses. In fact, I have an 80-year-old patient who plays tennis on a weekly basis. If I had not shown him multifocal lenses, he may have given up the sport.”

Robyn Marsden is an optometrist and professional affairs consultant for Johnson & Johnson Vision. 

What do you prescribe for presbyopia?

  • I typically prescribe glasses

    2 14%

  • I typically suggest a combination of glasses and contact lenses, including multifocals

    10 71%

  • I typically suggest a combination of glasses and contact lenses, excluding multifocals

    2 14%

  • I offer something else

    0 0%
 

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