Multifocal and bifocal contact lenses have been around since the late 1940s. There are a large number of great designs in both GP and soft materials. The fitting guides for each lens are straightforward, and every lab has consultants to help if it is needed. With all of the availability, why are we reluctant to use multifocal or bifocal designs? According to the Annual Report in the January 2017 issue (Nichols, 2017), only 13% of patients on average are fit or refit into a multifocal design.

Some practitioners point to the increased time it takes to fit bifocal/multifocal contact lenses as the main reason why they do not prescribe them. Granted, these more complex designs do require more visits to finalize the prescription compared to single-vision lenses. That is why the professional fees are (or should be) higher for multifocal lenses.

These extra visits give practitioners the opportunity to reinforce reasonable expectations for bifocal and multifocal designs. This can help increase success rates. Also, spending extra time to fine-tune the vision increases the patient bond with the practitioner and practice. These patients tend to be very loyal to the practice, and they refer more people to the office.


A busy office and practitioner sometimes can result in poor communication about potential vision correction options. Patients may not be made aware of multifocal (or, for that matter, any) contact lens availability. It really is in patients’ best interest to be informed about all possible choices for their situation.

The solution is simple. Front office staff and technicians in the office should be encouraged to discuss the various options before the eyecare practitioner sees the patient. Once patients are aware that contact lenses to correct presbyopia exist, their interest can be gauged.

If they wish to pursue contact lenses, it is a simple matter to re-appoint them for the extra care. This approach decreases the potential for practitioners to feel pressured to get it all done at one visit. Also, it reinforces to patients that contact lens care is not part of their well patient examination. This opens the door to discuss the higher fees associated with multifocal contact lenses, much of which is justified by the extra time it takes to refine vision with these specialty lenses.

Embrace the Trend

Practitioners need to embrace bifocal and multifocal contact lens technology. It is changing at a rapid pace, and the design improvements are fantastic. The baby boomers are already presbyopic, and there are millions of them. Plus, their children are also now approaching that fateful age when reading becomes more challenging. That creates a vast potential for practice growth. Technical staff can be trained and empowered to do much of the work of lens placement, application and removal training, and reviewing patient expectations versus reality. Then practitioners can check in, do a review, and decide what the next step should be. This approach is efficient, and patients are well cared for. What are you waiting for? CLS

For references, please visit and click on document #263.