Article

PRESCRIBING FOR PRESBYOPIA

MULTIFOCAL LENS USE FOR PRESBYOPIA

The management of presbyopia with contact lenses presents many challenges. Some of the more significant challenges become increasingly apparent when analyzing the reasons that patients cite for discontinuing contact lens wear.

The two most commonly cited reasons are contact lens discomfort and unsatisfactory vision (Young, 2014; Richdale et al, 2007; Dumbleton et al, 2013). In addition, the number of lapsed wearers increases in frequency as patients age (Richdale et al, 2007; Dumbleton et al, 2013). There are many factors that can influence patient comfort with contact lenses, such as contact lens material characteristics, lens design, and lens fit. Once these have been optimized, there are several additional recommendation that practitioners can propose to enhance successful contact lens wear, including switching patients to a daily disposable (single use) replacement modality.

In analyzing the use of daily disposable contact lenses, statistics vary widely around the world. In Finland and Denmark, 70% of soft lenses prescribed are daily disposable contact lenses (Morgan et al, 2019). Compare this to the 12% and 4% prescribing rate for daily disposable contact lenses in the Netherlands and in Mexico, respectively (Morgan et al, 2019).

Multifocal Options

Daily disposable lenses have steadily increased in use over the last decade. Now there are more daily disposable multifocal contact lens options available. This may be an additional tool that practitioners can use to help those patients who have struggled in soft lenses due to comfort and/or vision to be successful.

One of the initial categories to look out for in clinical practice consists of those patients who wear lenses part time (≥ three days per week); this currently encompasses approximately 8% of contact lens wearers worldwide (Morgan et al, 2019). It is those patients who may be struggling with contact lenses and may only be wearing them part time. This wear schedule may be due to a multitude of different reasons. Therefore, providing them with a new contact lens each day for the management of their ametropia and presbyopia may increase their use and success.

Presbyopia Needs

When looking at soft contact lens use across the globe in patients who have presbyopia (> 45 years of age), 46% are fitted with multifocal lens designs and 9% are prescribed monovision (Morgan et al, 2019). This shows the variety by which patients and practitioners prefer certain types of visual correction.

Interestingly, the Contact Lens Spectrum 2018 Annual Report stated that “when the Contact Lens Spectrum readers were asked which soft lens categories they anticipated using more of in 2019, 62% indicated daily disposables (versus 58% in 2018), followed by multifocals (34% in both 2017 and 2018), torics (3% versus 5% in 2018), and cosmetic lenses (1% versus 3% in 2018)” (Nichols and Fisher, 2019).

In Conclusion

Eyecare practitioners have demonstrated their excitement for daily disposable and multifocal contact lenses. In addition, as manufacturers provide increasingly innovative and variable multifocal contact lens design choices and replacement modalities, patients and practitioners are both able to capitalize on this and enhance comfort, vision, and contact lens success. CLS

For references, please visit www.clspectrum.com/references and click on document #283.