Clinical Scorecard: Clinical Pearls to Become a Soft Multifocal Expert

At a Glance

Key Highlights

• Soft multifocal lenses have been available since the mid-1980s.
• Only 9% of adults in the multifocal age range received recommendations for contact lenses.
• Modern multifocal designs use aspheric center-near designs to reduce visual compromise.
• Accurate refraction is critical for successful multifocal lens fitting.
• The red/green balance test is an effective method for achieving maximum plus refraction.

Guideline-Based Recommendations

Diagnosis

• Assess visual demands and lifestyle of the patient.
• Gather key examination data: best refraction, sensory ocular dominance, functional add at near.

Management

• Follow manufacturer-specific fitting guides for lens selection.
• Use aspheric designs to minimize visual compromise.

Monitoring & Follow-up

• Evaluate patient comfort and vision post-fitting.
• Adjust lens parameters based on patient feedback.

Risks

• Over-minusing at distance can lead to higher add power and increased visual compromise.
• Errors in examination data can significantly affect fitting outcomes.

Patient & Prescribing Data

Adults over 40, particularly those with presbyopia.

Utilize the red/green test for optimal refraction and fitting of multifocal lenses.

Clinical Best Practices

• Perform refractions in ambient lighting to account for pupil size.
• Use the red/green balance test monocularly for accurate maximum plus refraction.
• Understand the optical design of each multifocal lens to optimize fitting.

References

• Clinical Pearls to Become a Soft Multifocal Expert