In just two years, the number of presbyopes in the United States is expected to climb to 120 + million. While the list of treatment options for presbyopic patients continues to expand, soft multifocal contact lenses remain a top request by our patients.
Today’s multifocal contact designs are much improved from earlier generations, in part because the latest lenses are comprised of upgraded materials that don’t dry out by the end of the day.
Many of today’s popular multifocal soft contacts feature center-near designs, with the near focal power located in the middle of the lens and distance in the periphery. Some available center-near designs include: Bausch & Lomb’s Ultra for Presbyopia and Biotrue OneDay for Presbyopia; Alcon’s Air Optix Aqua Multifocal and Dailies Total1 Multifocal and Aqua Comfort Dailies Multifocal; Johnson & Johnson Vision’s 1-Day Acuvue Moist Multifocal; and CooperVision’s Biofinity Multifocal and Clariti’s 1 day Multifocal (with the center-near design option).
Other soft multifocal lenses are based on a center-distance design. Here, the distance power is in the middle of the lens and the near power is on the periphery. Common lenses with these designs include CooperVision’s Biofinity Multifocal (with the center-distance design option) and NaturalVue Multifocal 1 Day from Visioneering Technologies.
The biggest difference among all these lenses has to do with the emphasis on near or distance, as some perform better up close and some better at distance. We can choose what lens best suits the needs of each specific patient depending on their visual demands and their daily visual needs.
Patient personalities and setting appropriate expectations also come into play when considering a fit for soft multifocal contacts. Listening to the patient’s needs and expectations is the most valuable indicator of success when fitting multifocal contact lenses. We believe all presbyopic patients should be informed of the multifocal options including when contact lenses can be appropriate. The best candidates are highly motivated patients, early presbyopes, and hyperopes are generally great candidates.
The most successful patients are the ones who will benchmark their vision through a multifocal contact lens against their uncorrected vision or judge visual function against their distance only contact lenses. We tell patients that their vision with a multifocal lens is going to be way better compared with their naked eye, but it’s not going to approach what they would get with updated glasses. It’s also important to remember the goal of using a multifocal lens is not to get the patient crystal clear vision, but functional vision.
Overall, soft multifocal contact lenses have come a long way since their introduction, and we encourage our patients to try these new materials and designs in presbyopic multifocal contact lenses.
Torrey Carlson, O.D.