Occasionally, when patients have difficulty at near (generally those who require more reading time or have to sustain long periods of reading), I will try the Proclear N (CooperVision) for the non-dominant eye. The balanced vision-distance and near-keeps most patients happy over a long period of time. This approach seems to work well for a wide range of add power needs. As higher add powers are needed, I’ll under-correct myopes in the non-dominant eye, and then eventually switch to the high add power (at times requiring under-correction). In most cases, I will opt for either Bausch+Lomb’s or CIBA Vision’s multifocal lens and start with a low add power in order to only slightly affect distance vision. Some patients are essentially emmmetropic, but as presbyopia sets in, they become totally annoyed that their once-perfect vision has been violated by the creeping age factor. I will often reach for an aspheric multifocal hydrogel or silicone hydrogel design. Some report a sudden difficulty seeing things they could see last month, while others struggle for months until they arrive for their annual examination-but all seek relief from their near frustrations.
Most patients who present with presbyopia seek independence from their reading glasses, and the majority of them are currently using contact lenses. Joseph Shovlin, O.D., Clinical Editor, RCCL. simultaneous designs? And, what about presbyopes with astigmatism? To help navigate the maze of multifocal contact lenses, we’ve asked Joseph Shovlin O.D., clinical editor of Review of Cornea and Contact Lenses (RCCL) and other regular RCCL contributors to share experiences with their “go-to” presbyopic lenses. Additionally, there are many other factors to consider when fitting presbyopic lenses: Should you stick with monovision or opt for multifocals? Which patients would benefit from translating vs. A thorough history and lifestyle assessment are essential in pairing a lens with a patient. While there are a multitude of presbyopic lens options on the market, one lens modality does not fit all, and certain lenses can better serve certain patients. Whether the presbyope in your chair is someone who has successfully worn contact lenses for years or someone who’s never needed vision correction, this patient has come to you during a transitional time, and what you say and do during the initial visit can have an impact on that patient’s chances of multifocal lens wear success. So, how do you handle your patients’ mid-life crisis, one that stems from the decline of their near vision? On the flip side are those patients who have never required vision correction and are suddenly reaching for readers to be able to decipher the buttons on their cell phones and keyboards. These patients may get discouraged and feel as though they have to trade in their lenses for reading glasses. While patients have enjoyed the quality-of-life benefits contact lenses provide, many experience a decrease in acuity as presbyopia begins to impair their ability to function when performing near tasks.
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