8. Acknowledge the impact of the tear film
Considering the complex optics of a multifocal design, the tear film is more important than ever to maintain clarity and consistency. For a contact lens wearer, tear film becomes divided. Patients over age 40 may already have underlying tear film deficiencies.
Any build-up on the lens will further decrease its wettability, inducing visual disturbance and frequent blinking. For these reasons, use daily disposable multifocal contact lenses whenever possible.
Explain to patients the potential consequence to their comfort, vision, and ocular surface and be firm in your recommendation of daily disposables. If that’s not possible, be adamant about recommending a peroxide system for daily use.
Always be aggressive in implementing treatment for underlying ocular surface problems before fitting a patient with multifocal contact lenses, and see him more frequently to monitor for changes and ensure compliance.
Don’t overthink the complexity of a multifocal contact lens fit. If you are considerate and direct in your presentation on the first visit, it will establish realistic expectations and have a dynamic impact in improving patient satisfaction in a timely manner.
Don’t overthink the lens choice. Choose a successful go-to lens and learn the fitting nuances well.
Don’t ignore the impact of tear film. Treat first, then proceed in a watchful manner.
Finally, don’t underestimate the influence satisfied multifocal contact lens patients can have on your practice. These patients will be incredibly loyal and can be a great referral source.
1. Oculus. Oculus Vissard 3D. Available at: http://www.oculus.de/de/produkte/refraktion/vissard-3d/highlights/. Accessed 8/21/17.