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    Letters to the editor: UPP, dry eye, and more


    Jumping into multifocal contact lens fitting

    Here's a big Amen after reading Dr. Bowling’s editorial “Embracing new contact lens technology” in the February issue. I find myself fitting more and more patients in multifocal contact lenses, even those patients with low distance refractive error.

    Traditionally, patients who are emmetropic or minimally hyperopic at distance were ones who I would very reluctantly discuss contact lenses with and then mostly to consider a monovision fit. Those patients typically use only over-the-counter reading glasses and often resist any kind of distance correction. With the multifocal technology available today, I have successfully fit this niche of patients with contact lenses.

    Of course, setting appropriate expectations is vital to achieving a successful fit. I discuss the quality of vision the patient can expect with multifocal contact lenses as compared to spectacles. I take into consideration occupation and hobbies and the patient’s goals for his vision with contact lenses. Patients who are highly motivated to wear contact lenses because they tire of keeping up with their reading glasses can successfully be fit into a multifocal.

    I recently went out on a limb and fit two patients with very low hyperopia (less than +1.00 D at distance). I was very doubtful that I would succeed. The initial lens selection yielded good distance vision but unsatisfactory near vision. An over-refraction of just +0.25 D OU yielded dramatically better near vision without compromising distance. Both patients are now happy contact lens wearers.

    By considering this subset of patients for multifocal fits, not only are you making patients happy and giving them comfortable vision, but this opens another revenue stream for your practice. Instead of those patients walking out your door and buying readers at the drugstore, they are now purchasing contact lenses. Is a multifocal contact the answer for every presbyopic patient? Certainly not. Some patients are perfectly happy with their readers, but a multifocal contact lens is an appropriate answer in more cases now than in times past. 

    Don't be afraid to try something new now and then. Unexpected success is still success.

    Neal Lovett, OD

    Baxley, GA

    Related: Embracing new contact lens technology

    Boiling down dry eye info

    I wanted to let you know how much I liked Scott Schachter’s blog “Why dry eye means poor vision” (April 11, 2015). As I told him, it was boiled down very nicely! It's a complex subject, and his article would make it easy for a patient to have a very good understanding. I'm keeping a copy. Honestly, when I saw the topic, I did not think it could be covered so succinctly, without leaving out big chunks of relevant information. I was wrong. He really did a great job.

    Dena Mintz

    Corona, CA

    Related: Why dry eye means poor vision

    Next: Move on from replacement contact lenses 


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