Prescribing for Presbyopia
Presbyopes and Daily Disposable Lenses
BY THOMAS G. QUINN, OD, MS, FAAO
If you are not fitting many of your presbyopic patients with daily disposable contact lenses, I would argue that you should be. Following are the reasons why.
Why Daily Disposable Lenses for Presbyopes?
Safety Chalmers et al (2012) suggest that applying a fresh lens every day reduces the risk of ocular inflammation by 12.5 times versus re-wearing a lens. That’s a big enough number to consider recommending daily disposables for all patients, but presbyopes are a particularly attractive group for a few reasons. Perhaps most compelling is that common changes in tear quality over time make them more prone to lens drying and surface deposits, both often leading to problems with vision, comfort, and safety.
On-the-Go Lifestyle Daily disposables also align with the multi-faceted, on-the-go lifestyle of this population. Having the freedom to simply discard the lenses after wear offers real value, and many in this group have the financial resources to take advantage of this convenience.
Occasional Wear Opportunity Perhaps one of the most overlooked opportunities in contact lenses is fitting patients for occasional wear. In particular, presbyopes have a host of visual demands associated with a variety of activities that could benefit from an equally varied array of corrective options. For example, many presbyopes are happy to wear their glasses to work, but love the freedom that contact lenses provide for exercise and social events.
Occasional wear also means less cost. Expense is a commonly cited reason for not pursuing the daily disposable option. Efron (2013) found that wearing daily disposable lenses on an occasional wear basis can actually be less costly than purchasing two-week or monthly replacement lenses.
Multiple Design Options The natural synergy between presbyopia and daily disposability has resulted in an array of options.
Alcon retired its Focus Dailies Progressives in 2014, but offers the Dailies AquaComfort Plus Multifocal, built on the same optical platform as its monthly Air Optix Aqua Multifocal lens.
Bausch + Lomb released Biotrue Oneday for Presbyopia last year in the low add power. Built on the same optical platform as its PureVision2 for Presbyopia, plans are to release the high add power in the third quarter of 2015 and to expand the distance power range from +6.00D to –9.00D.
In addition to Proclear 1 Day Multifocal, CooperVision also now offers the silicone hydrogel Clariti 1 Day Multifocal in both a low and high add option.
Johnson and Johnson Vision Care, Inc. will soon introduce 1-Day Acuvue Moist Brand Multifocal. A center-near design lens, it will incorporate zone size changes with changes in add and distance power to adjust for pupil size changes that can occur over time and with refractive error.
Visioneering Technologies, Inc., introduced its NaturalVue Multifocal 1 Day lens in March. Currently the only center-distance daily disposable on the market, it is designed to offer an extended depth of focus while employing a single add power that generates up to 3.00D of equivalent near power.
The Perfect Match
Improved safety and convenience make daily disposables an excellent tool, particularly for presbyopic lens wearers. Let them know about this wonderful option. CLS
For references, please visit www.clspectrum.com/references and click on document #234.
Dr. Quinn is in group practice in Athens, Ohio. He is an advisor to the GP Lens Institute and an area manager for Vision Source. He is an advisor or consultant to Alcon and B+L, has received research funding from Alcon, AMO, Allergan, and B+L, and has received lecture or authorship honoraria from Alcon, B+L, CooperVision, GPLI, SynergEyes, and STAPLE program. You can reach him at email@example.com.