I recently attended one of our Optometry Times webinars, “Increasing your successful multifocal fits,” presented by our Editorial Advisory Board member David Geffen, OD, FAAO. David is one of the sharpest ODs I know, and his mastery of the subject matter was evident. I consider myself to be up to speed on this topic and was amazed at what I didn’t know! The webinar is available on our website (http://www.modernmedicine.com/webinars#eyecare).
After the presentation, I wondered: with all the outstanding multifocal options for our contact lens patients, why in the world would anyone still choose monovision as a primary selection? Monovision is an antiquated technology dating back at least to the 1960s1 and goes against almost every tenet we’ve been taught regarding binocular vision. At its inception, it was the only method we had to keep our presbyopic patients in their contact lenses. Not a week goes by where I don’t see a patient wearing this modality. Many come to my office on the recommendation of a family member or friend who raved about their improved vision after I fitted them with multifocals.
I understand the attraction of monovision, especially in a busy practice: it requires no special lens, fitting is no more complicated than traditional lenses, and monovision is generally accepted visually by over 70 percent of patients.2 Likewise, some practitioners shy away from multifocal contacts due to a perceived complexity of the fit and increased chair time involved with multifocal contact lens correction.
Not saying that monovision doesn’t have a place in our armamentarium. It still does, albeit for those few rare cases when I just can’t get them comfortable in a multifocal. I am also a firm subscriber to grandma’s old adage: if it ain’t broke, Ernie, don’t fix it. In most cases, I’d say yes, but not when it comes to monovison. Many patients have simply gone along with that modality. They may not be aware of other options. That’s where we come in.
Let’s face it: today’s presbyopes aren’t our grandparents. Baby boomers are more active with more visual demands and more disposable income to spend on what they want. This cohort is growing and is seriously underserved regarding presbyopic correction.3 These patients want the absolute best vision correction we have to offer, do not want to compromise their vision, and are willing to pay for the better technology. Today, that means multifocal contact lenses.
So, if you haven’t given multifocal contact lenses a whirl lately, consider them. These new soft multifocal designs have resulted in increased success rates and patient satisfaction versus monovision.3 Your patients will really appreciate your efforts at bringing them the latest in contact lens technology.
1. Fonda G. Presbyopia corrected with single vision spectacles or corneal lenses in preference to bifocal corneal lenses. Trans Ophthalmol Soc Aust. 1966:25;70-80.
2. Westin E, Wick B, Harrist RB. Factors influencing success of monovision contact lens fitting: survey of contact lens diplomates. Optometry. 2000 Dec;71(12):757–63.
3. Bennett ES. Contact lens correction of presbyopia. Clin Exp Optom. 2008 May;91(3):265-78.