As the worldwide population continues to age, presbyopia affects nearly 80% of individuals between the ages of 45 and 55.1 Current data on presbyopes suggest this population has visual needs that traditional contact lens options aren’t meeting. In optometric patients over the age of 40, the drop-out rate for wearing contact lenses is 24%.2 One of the primary reasons for contact lens discontinuation is discomfort, something that at least half of contact lens wearers have reported experiencing to some degree for a length of time.3 On the other hand, up to 57% of patients who stop wearing their contact lenses within the first year of their prescription don’t tell their doctor that they’ve done so,4 because they don’t believe a remedy exists.5 Even so, data indicate that presbyopes still prefer contact lenses at the same rate as non-presbyopes.2
A NEW MULTIFOCAL MODEL TO MEET THE NEED
To meet this demand, Alcon is launching the TOTAL30® Multifocal contact lenses, the newest monthly replacement in its TOTAL® family of products, which includes TOTAL30®, TOTAL30® for Astigmatism, DAILIES TOTAL1®, DAILIES TOTAL1® Multifocal, and DAILIES TOTAL1® for Astigmatism. The TOTAL30® Multifocal contact lens meets presbyopes’ range of visual needs with clear, uninterrupted vision, and it feels like nothing on the eye, even at day 30.6,7 This lens will launch nationally in the US in February 2024.
Herein, three optometric practice owners describe how this new multifocal contact lens option is providing an opportunity to educate their presbyopic patients about solutions to their previously unmet needs.
COMFORT: THE BIGGEST COMPLAINT
Eye care practitioners are used to hearing complaints about contact lens discomfort with traditional lens materials. Patients tend to use language like “dryness,” and “fatigue” to describe their symptoms, which often get worse throughout the day.3 Lifestyle circumstances can contribute to the discomfort to some extent—the more time patients spend using digital devices, the less they blink, which exacerbates dryness.
TOTAL® contact lenses are the only lenses on the market with the unique biphasic Water Gradient material that provides a cushion of almost 100% water at the surface of the lens (Figure 1). This technology combats “digital dryness” by minimizing interaction with the delicate tissues of the eye.8 The Water Gradient technology in the TOTAL30® line of lenses remains functional for a full 30 days of wear and care, thanks to the CELLIGENT® technology.8-10
Figure 1. The Alcon Water Gradient contact lenses are made with an ultra-soft hydrophilic surface gel that has a water content of nearly 100%, as well as a silica-based polymer that serves as the permanent core of the contact lens.
Dr. Crooker: When I first started to promote multifocal contact lenses, I often found that the eyesight of people in their early-to-mid 40s was beginning to change, but they resisted the stigma of aging that they associated with wearing readers. I told them about the range of vision the multifocal contact lenses could provide for their daily activities, freeing them from the need for readers.
I frequently hear presbyopic patients complain of vision problems while exercising. Often, their distance vision is good, but they want intermediate vision if they’re jogging or riding a bike, or a greater ability to read their metrics if they’re on a Peloton, treadmill, or other gym equipment. At the same time, they want to see their surroundings clearly. Glasses are inconvenient for these activities.
Dr. Glover: My ideal patient for the TOTAL30® Multifocal contact lens is anyone who is a first-time wearer of contacts with presbyopia. In my practice, most contact lens wearers are in the 40+ club, but not everybody wants a daily disposable contact lens. To now have a monthly replacement option with Water Gradient technology allows me to offer patients an innovative solution, regardless of replacement schedule.
Dr. Wademan: In my practice, the best candidates for a monthly replacement multifocal contact lens are those who are mid-40s and older. They have the beginning signs of presbyopia, they rely on reading glasses over their contacts, and many are interested in a new multifocal option. Also, with so many people now spending significant time on digital screens, technology that provides all-day comfort is crucial.
For patients who suffer from contact lens discomfort, the Water Gradient technology in the Alcon TOTAL® family of contact lenses is game-changing. I tell my patients who use these lenses to expect to get through their day without even thinking about their eyes.
CONVERSATIONS TO CONVERSIONS
The TOTAL30® monthly replacement contact lens family introduced innovation to a category that was overdue. The most recent launch of TOTAL30® Multifocal provides a clear and comfortable lens-wearing experience for presbyopic patients and enables practitioners to capitalize on the growing multifocal contact lens market.6,7,11 As with any contact lens, the key to patient adoption is the provider-patient conversation.
Dr. Glover: I start talking to patients about multifocal correction options when they’re in their late 30s. I like to plant the seed early, so when their vision starts to change, it’s not a surprise.
Dr. Wademan: My staff and I continuously educate our patients about new contact lens technologies in the lane, at the front desk, and in pretest areas. We also use different display monitors in the office to mention new technology. Patients can tend to ignore mild symptoms of eyestrain, eye fatigue, and difficulty focusing on smaller print size because they can “get by.” Often times, these same patients don’t know better contact lenses exist.
THE IMPACT OF THE TOTAL® FAMILY OF CONTACT LENSES ON PRACTICES
The availability of a contact lens that provides both multifocal vision and exceptional comfort has the potential to spur practice growth among presbyopic patients.
Dr. Glover: The DAILIES TOTAL1® and TOTAL30® contact lenses have been strong practice-builders for my clinic because of the level of comfort and performance they impart, thanks to the Water Gradient technology and the PRECISION PROFILE® optical design of the multifocal lenses.7 Patients are able to enjoy sharp, clear vision throughout the day.6
The DAILIES TOTAL1® contact lens has been my most popular model for the past few years, but there will always be patients who prefer a monthly reusable option or who need a multifocal contact lens. For the latter population, I’m looking forward to offering the TOTAL30® Multifocal contact lens.
1. Zebardast N, Friedman DS, Vitale S. The prevalence and demographic associations of presenting near-vision impairment among adults living in the United States. Am J Ophthalmol. 2017;174(2):134-144.
2. Rueff EM, Bailey MD. Presbyopic and non-presbyopic contact lens opinions and vision correction preferences. Cont Lens Anterior Eye. 2017;40(5):323-328.
3. Nichols JJ, Wilcox MOP, Bron AJ, et al. TFOS International Workshop on Contact Lens Discomfort: Executive summary. Invest Ophthalmol Vis Sci. 2013;54:TFOS7-TFOS13.
4. Sulley A, Young G, Hunt C, et al. Retention rates in new contact lens wearers. Eye Contact Lens. 2018;44(Suppl1):S273-S282.
5. TOTAL30 Unmet Needs Survey. Alcon Laboratories, Inc.
6. Baker K, Merchea M. Impact of pupil diameter on multifocal contact lens vision. Poster presented at: American Academy of Optometry Annual Conference; November 9, 2018; San Antonio, TX.
7. In a clinical study wherein patients used AOSEPT solution for nightly cleaning, disinfecting, and storing; Alcon data on file, 2021.
8. Shi X, Cantu-Crouch D, Sharma V, et al. Surface characterization of a silicone hydrogel contact lens having bioinspired 2-methacryloyloxyethyl phosphorylcholine polymer layer in hydrated state. Colloids Surf B: Biointerfaces. 2021;199:111539.
9. Surface property analysis of lehfilcon A lenses out of pack and after 30 days of wear; Alcon data on file, 2020.
10. Surface observations of lehfilcon A contact lens and human cornea using scanning transmissions electron microscopy; Alcon data on file, 2020.
11. Internal estimate based on 3rd party data. Alcon Capital Markets Day.
Jessica Crooker, OD
Owner, Scituate Harbor Vision Source
jcrooker@visionsource.com
Financial disclosures: Paid consultant (Alcon)
Darryl Glover, OD
Optometrist at MyEyeDr., Raleigh, North Carolina
Cofounder of Black EyeCare Perspective
Cofounder of the Defocus Media podcast
drdarrylglover@gmail.com
Financial disclosures: Defocus Media Partners: Alcon Labs, Iveric Bio, EssilorLuxottica, Heidelberg
Engineering, Lumenis, Johnson & Johnson Vision, Transitions Optical
Jennifer Wademan, OD
Owner and Optometrist, Bidwell Optometry, Folsom, California
docjen@hotmail.com; Instagram @drjenwademan
Financial disclosure: Alcon Labs, Zeiss Vision Care