The reality of contact lenses today in my office and yours is very different from how it could be. Sometimes it is good to imagine a world of “could be’s” in an effort to advance to where we want to be. Here are a few of my “what ifs” that I think are worth pushing toward.

Daily Disposable Lenses

What if we had daily disposable lenses in nearly every prescription (sphere, toric, and multifocal). Imagine that they could cover patients’ prescriptions all the way up to the high-minus and high-plus ranges. What if they were available in updated materials and not just outdated ones? Just think how great it would be for a patient to be able to wear them all day comfortably and throw them away daily. My patients always tell me that their lenses are far less comfortable at day 14 or 30 than they are at day one. Imagine if that could change. Thinking crazy-stupid, imagine silicone hydrogel daily disposable lenses. No way, right?


I still have patients tell me that they can’t wear lenses because they have “the stigma” or that they were told by their last fitter that they cannot wear contact lenses because of their eye shape. I really wish we could change this.

What if we had toric lenses in the daily disposable modality? What if we could fit 95% of all astigmats in daily disposable or, at minimum, two-week or monthly contact lenses? Someday, my friends, someday.


What if we had multiple options available to us in multifocal daily disposable lenses? Options that had low and high add powers in the newest materials. I would venture to guess that with that type of lens selection, we could fit most presbyopes in a lens that they could choose to wear daily or even occasionally.

Even crazier, imagine that we viewed correcting presbyopia with contact lenses differently than we do with spectacle lenses—thoughts that instead revolved around the benefits of multifocal lenses, such as freedom from glasses and a range of vision without having to move your eyes or head up and down. Imagine if we could properly discuss these options with our patients, and that they wanted them.


While we are on daily disposable lenses, imagine if we opted to fit them for patients who are not “contact lens wearers.” Rather, these patients are more like “weekend warriors” who wear lenses mainly for sports and recreational activities. If we thought of these people as having disposable income that they may choose to use on contact lenses because it makes their lives easier, it would be fantastic. But instead of this imaginary place, we look at our patients based on what they do every day rather than on occasion.

Myopia Control

What if we had reasonable options in distance-center multifocal lenses or orthokeratology that could help our young patients who are advancing in their myopia? If only.


Oops, I guess these are all available to us today. But you know what? I’m sure patients would never pay for all of these wonderful, far-off things. So, what’s the point of bringing them up today when there’s always “someday”? CLS

Dr. Kading owns the Specialty Dry Eye and Contact Lens Center in Seattle. He is the co-owner of Optometric Insights with Dr. Mile Brujic. He has received honoraria for consulting, performing research, speaking, and/or writing from Alcon Laboratories, Allergan, Bausch + Lomb, CooperVision, Johnson & Johnson Vision Care, Oculus, OptoVue, RPS Detectors, Paragon Vision Sciences, TearScience, Valeant Pharmaceuticals, Valley Contax, VSP, ZeaVision, and Zeiss. Follow him on Twitter @davekading .