Retinal Physician Article Submission Guidelines-Prescribing for Astigmatism and Presbyopia


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Article Date: 2/1/2012

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Today's Multifocal Opportunity

Today's Multifocal Opportunity

To grow your practice with a new generation of presbyopes, use the next generation of multifocal contact lenses.

Contributing authors: Victoria Dzurinko, OD, FAAO, Thomas G. Quinn, OD, MS, FAAO, Jill Woods, BSc(Hons), MCOptom

Presbyopes are projected to be the single largest group of potential contact lens wearers by 2018 (28% of all potential lens wearers or approximately 13.5 million people).1 That makes fitting the next-generation multifocal contact lenses a smart way for practitioners to get ahead of their competition and grow their practices.

Historically, contact lens usage has shown a drop off around age 45, when many patients begin to need multifocal correction for presbyopia (Figure 1). Overall, the multifocal contact lens market is underdeveloped compared to spectacles.2

Figure 1. Contact Lens Usage by Age7

But advanced technologies are already helping to change those numbers. Today, next-generation silicone hydrogel multifocal contact lenses give us the ability to provide patients with functional, comfortable binocular vision that monovision correction can't deliver. We can avoid the negative impacts of monovision and adjust prescriptions easily over time. We may even get patients on board more easily, since the idea of multifocal lenses is easier to grasp than a monovision approach. We can keep patients in contact lenses when presbyopic changes occur and keep new patients out of reading glasses.

Fortunately, as people are aging, the contact lens industry is responding. Already deep into the wave of aging Baby Boomers, we're now seeing Generation Xers age into their presbyopic years, and these are people who grew up with the comfort and convenience of soft contact lenses. Air Optix Aqua Multifocal contact lenses offer that same comfort and convenience to help these patients continue to enjoy clear vision at near, intermediate and far distances. Among many ECPs, this lens is now the first choice for presbyopia correction — one that will keep many patients functional, comfortable and happy in contact lenses.

SHIFTING AWAY FROM MONOVISION

Patients are demanding. They expect great things from technology, including the technology in their contact lenses. So when a patient in his 40s tells you he can't read up close, what's the best modality to recommend for excellent vision, comfort and satisfaction?

If the patient wears contact lenses, you might start by pushing the plus a half-diopter in one eye. But age-related presbyopia progresses. If you keep pushing plus, you'll have the patient in monovision. It's a convenient choice that turns into a slippery slope. As you push the plus, the difference between the two prescriptions will start to negatively affect depth perception,3 intermediate vision4 and night driving.5

These effects of monovision can impact patients' quality of life. Activities such as watching TV, using a computer and driving dominate most of the hours in a day for most people. Also, any active pursuits are likely to be impacted by issues with depth perception. These activities and pursuits occur during a significant portion of people's waking hours.

You can bypass the issues of poor depth perception and reduced vision for computers and driving that come with monovision, by making multifocal contact lenses your first choice for presbyopes. It's easy to get them adapted to multifocal contact lenses and easy to change the prescription as the presbyopia advances. And consider this: About 7 out of 10 patients prefer multifocals over monovision.6

CHOOSING THE BETTER OPTION

In the past, monovision was fitted in preference to multifocals because older multifocal designs didn't deliver the distance vision patients desired. The next-generation Air Optix Aqua Multifocal contact lens has a Precision Profile design, which has a smooth transition between the near, intermediate and far zones of the lens (Figure 2). This design offsets loss of accommodation by extending the depth of focus. All three ADD designs offer smooth transition from the center near zone. These lenses have a proven aspheric back surface design for optimal centration and fitting.

Figure 2. Precision Profile Design

Figure 2. Air Optix Aqua Multifocal lenses have a Precision Profile design, with a smooth transition between the near, intermediate and far zones of the lens.

The lenses also provide a constant ADD effect regardless of the patient's distance prescription, resulting in predictable, consistent clinical results with efficient chair time. They have one base curve (8.6) and one diameter (14.2), with distance power ranges from +6.00D to –10.00D in 0.25D steps, and three levels of ADD.

Air Optix Aqua Multifocal lenses are made of breathable (Dk/t 138 @ −3.00D), moisture-retaining, deposit-resistant lotrafilcon B, the same comfortable material used in the Air Optix Aqua single-vision lens.

What's more, studies have shown that although monovision performance is often better than multifocal lenses in a clinical setting, patients prefer multifocals to monovision in practical activities and “real world” settings.3-6 Monovision's challenge to binocularity and limitations with regard to intermediate distance are likely responsible for this. Finally, we have an option that gives our presbyopic patients the clear near, intermediate and distance vision they expect.

FREEDOM AFTER 45

Does contact lens usage need to drop off around age 45? Do presbyopes need to be in eyeglasses? The answer to both questions is “No,” and doctors are beginning to communicate this to their patients. The catalyst is the next generation of lenses such as Air Optix Aqua Multifocal contact lenses.

When you help your presbyopic patients continue enjoying the freedom of contact lenses and their youthful no-glasses appearance, it's a victory for you. This is a practice-building technology. The results are excellent, and the chair time is efficient. Instead of monvision and its attendant issues, you can give patients clear-at-all-distances, comfortable vision with Air Optix Aqua Multifocal contact lenses to meet their high expectations. CLS

REFERENCES
1. Studebaker J. Soft multifocals: practice growth opportunity. Contact Lens Spectrum; June 2009. Available at: www.clspectrum.com/article.aspx?article=103013; last accessed Nov. 28, 2011).
2. Morgan PB, Efron N, Woods CA. An international survey of contact lens prescribing for presbyopia. Clin Exp Optom 2011;94:87-92.
3. Gupta N, Naroo SA, Wolffsohn JS. Visual comparison of multifocal contact lens to monovision. Optom Vis Sci 2009;86:E98 –E105.
4. Situ P, Du Toit R, Fonn D, Simpson T. Successful monovision contact lens wearers refitted with bifocal contact lenses. Eye Contact Lens 2003;29:181-184.
5. Woods J, Woods CA, Fonn D. Early symptomatic presbyopes — What correction works best? Eye Contact Lens 2009;35:221-226.
6. Richdale K, Mitchell GL, Zadnik K. Comparison of multifocal and monovision soft contact lens corrections in patients with low-astigmatic presbyopia. Optom Vis Sci 2006;83:266-273.
7. Air Optix Aqua Multifocal Lenses product detail aid; 2006.


Contact Lens Spectrum, Issue: February 2012, page(s): 2 3

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