Optimize Comfort and Performance With Multifocal Contact Lenses
AT A GLANCE
- Today’s multifocal contact lenses boast superior optical designs engineered with the specific biometrics and visual needs of patients with presbyopia in mind.
- Daily disposable lenses excel at maintaining moisture and oxygen transmission, which effectively minimizes dryness and discomfort.
- A robust understanding of the optical design and the fitting process, as outlined in the guide of each lens, can substantially boost your success rates with multifocal contact lenses.
Today, presbyopic patients have a wealth of corrective lens options from which to choose.1 Although spectacles may seem like a popular choice due to their reliable performance, many patients find them lacking in aesthetics and practicality for everyday use.2 Contact lenses are an attractive alternative, promising exceptional visual quality, while maintaining the comfort and convenience of being glasses-free.
Among the various contact lens design options available for the correction of presbyopia, multifocal contact lenses stand out for their remarkable performance across all distances. Compared with those of the past, today’s multifocal contact lenses boast superior optical designs engineered with the specific biometrics and visual needs of presbyopes in mind. Multifocal contact lenses are typically made of a soft silicone hydrogel material to ensure a comfortable wearing experience.3 In recent accounts, the success rate of multifocal contact lenses is reported to be around 85%,4 with practitioners and patients expressing a strong preference for them compared with single-vision and monovision options.3,5
OPTIMIZED FOR COMFORT
Manufacturers have made great strides in their multifocal contact lens offerings, with enhanced designs and innovative ingredients that provide a comfortable wearing experience.6 For example, Acuvue Oasys Max 1-Day Multifocal lenses (Johnson & Johnson Vision) employ TearStable Technology to ensure tear film stability and all-day comfort through the distribution of wetting agents. In addition, the Total30 (Alcon) line of contact lenses is being launched. These monthly lenses incorporate Water Gradient Technology, which features a gradual transition of water content across the lens. Infuse One-Day Multifocal lenses (Bausch + Lomb) include ProBalance Technology, an innovative blend of electrolytes, osmoprotectants, and moisturizers that help maintain the tear film and ocular surface homeostasis.
In general, daily disposable multifocal contact lenses excel at maintaining moisture and oxygen transmission, which effectively minimizes dryness and discomfort. These remarkable properties establish the selection of daily multifocal contact lenses (with the exception of the Total30 line) as an excellent choice for patients with presbyopia, a population susceptible to dry eye and related conditions due to both the natural aging processes and age-related systemic diseases (see A Note on Managing Ocular Surface Disease).7
NEXT-GENERATION OPTIC DESIGNS
Multifocal contact lens manufacturers have integrated various optic designs that are optimized not only for comfort, but also for performance. For instance, the Acuvue Oasys Max 1-Day Multifocal lens incorporates Pupil Optimized Design technology, which addresses pupil size variations, and OptiBlue Light Filter, which aims to reduce exposure to blue-violet light.6 MyDay daily disposable multifocal lenses (CooperVision) feature the Binocular Progressive System, which includes a 3-ADD system to provide clear vision at all distances. The Infuse One-Day Multifocal lens seamlessly integrates the company’s 3-Zone Progressive Design, which incorporates seven biometric factors to deliver an effortless and reliable fit for most patients.
A Note on Managing Ocular Surface Disease
When managing patients with presbyopia who have comorbid conditions, including ocular surface disease (OSD), practitioners should focus first on treating and managing these conditions before considering contact lens wear. This is primarily because OSD, including dry eye and blepharitis, can disrupt the composition and integrity of the tear film, leading to added discomfort when combined with contact lenses. Additionally, contact lenses have been associated with dryness and wearer discomfort, as they split the tear film and can cause long-term alteration of tear composition.1
Once any OSD is effectively controlled, careful thought should be given to selecting a lens that maximizes comfort and minimally disrupts ocular surface homeostasis. Daily disposable silicone hydrogel multifocal lenses are especially well-suited for maintaining eye health and comfort, while preserving visual performance.
1. Walsh K, Dantam J, Luensmann D. Contact lens wear and its disruption of the tear film. Review of Cornea & Contact Lenses. June 15, 2019. Accessed September 22, 2023. www.reviewofcontactlenses.com/article/contact-lens-wear-and-its-disruption-of-the-tear-film
PERSONALIZED LENS SELECTION
Ensuring a successful lens fitting experience hinges on taking a personalized approach to meeting each patient’s individual needs. Some factors to consider during this process include ocular history, lifestyle needs, and financial flexibility, as well as your own preferences and experience with each product as the provider.
Assessment and Education
Our team initiates the contact lens assessment by gauging a patient’s interest in contact lenses. We find it valuable to rephrase and reiterate the inquiry several times during the visit, which helps us uncover patients who may not have realized that they could benefit from multifocal lenses. After the exam, I educate the patient on the available corrective options, outlining the expected visual outcomes and the overall wear experience with multifocal contact lenses.
Budget Considerations
Although daily disposable lenses provide the best comfort level for most patients, not all patients have the financial flexibility to invest in this premium option. For patients who want to wear multifocal contact lenses without straining their budget, there is a wide selection of excellent monthly and biweekly options available. These lenses have good optical designs that can deliver exceptional performance when fit correctly.
One strategy for a patient with a limited budget involves initially fitting them with a lower-cost lens option, which can then be upgraded to a higher-tier daily disposable lens from the same manufacturer. Because many lenses from the same line share common optic designs, it offers a seamless experience for patients seeking an enhanced lens option.
As a practitioner, your prior experience with a particular lens product and the associated fit guide can have a considerable effect on the success of the lens-fitting process.
A SECOND CHANCE AT CONTACT LENS WEAR
Multifocal contact lenses have seen significant improvements in both optic design and comfort. For presbyopes who have previously dropped out of contact lens wear, these innovative technologies offer a compelling opportunity to try again. Although most products in this category perform well for a broad spectrum of patients, a comprehensive understanding of each individual patient’s circumstances and the unique design of each multifocal lens product can play a pivotal role in delivering an optimized contact lens wear experience.
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