reader and industry forum
GP Multifocals: A Useful Tool for Presbyopes
BY CHRIS A. SMILEY, OD
Recent improvements in soft multifocal contact lens technologies are a welcome resource in helping us meet the vision demands of our presbyopic patients. While these lenses provide acceptable vision to many patients, there remains a large group of patients who do not achieve acceptable vision with the soft multifocal contact lens technologies.
We have all found ourselves challenged at one time or another by some of these presbyopic patients, particularly those who have astigmatism. Can you recall the last patient(s) for whom you have adjusted the distance, near, and add power so many times that you start running your lens selection in circles? There is no need to be ashamed; we have all been there with our visually demanding presbyopic patients.
Consider a GP Design
Fortunately, there is a secret tool to help us get out of this "soft contact lens rut." The irony is that most of us already know about it. Unfortunately, some of us just forget to use it, and others have not tried it for one reason or another. The next time you have a challenging presbyopic contact lens fit, consider using one of the newer aspheric GP multifocal lens designs.
Success rates with most GP multifocal lenses are extremely high, particularly in patients who have mild-to-moderate amounts of astigmatism. Patients who have a history GP contact lens wear are the best candidates. However, don't be afraid to try them on patients who are new to GP lenses.
Managing the Fitting Process
Setting realistic comfort expectations is critical for success with new GP patients. It is best to avoid describing the initial GP lens sensation as painful, irritating, or in any way involving the eyeball itself. I explain that GP lenses will cause mild lens awareness stemming from the eyelids blinking over the lens. The eyelids eventually adapt to blinking over something new, and the sensation goes away. Current GP wearers frequently report a significant improvement in lens comfort when switched to aspheric GP multifocal lenses.
As with any multifocal lens modality, it is important to discuss vision expectations with each patient. I explain in general terms that GP multifocal lenses will enable them to see well enough to drive a car, use a computer, use a cellular phone, and read the newspaper. I am honest in explaining that in some cases patients may be able to read ultra fine print such as medicine bottles, but that it is not always possible. I mention that our goal is to meet 98 percent of their vision needs throughout the day. The great news is that today's GP multifocal lens designs can consistently achieve that goal.
Getting started with fitting GP multifocal lenses is as easy as calling your laboratory with a patient's keratometry readings, refraction, and add power. Many practitioners are surprised that the first pair of lenses works perfectly when ordered this way. On occasion, a minor adjustment may be necessary to maximize lens fit or prescription. A lab consultant can be an invaluable resource especially when you are new to fitting this modality.
Diversify Your Toolbox
As cliché as it sounds, the best contact lens practitioners are the ones who have many tools in their toolbox. Whether you are a veteran or a rookie contact lens practitioner, the best way to avoid the "soft multifocal lens rut" is to add GP multifocal lens designs to your toolbox. The hardest part of fitting GP multifocal contact lenses may just be remembering to get started. CLS
Dr. Smiley is a graduate of The Ohio State University and the owner of a two-location private practice in Columbus, Ohio. He has served as a clinical investigator for both Bausch & Lomb and Blanchard Contact Lens. He can be reached via e-mail at firstname.lastname@example.org.