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    5 reasons to upgrade patients from monovision to multifocals

    Although multifocal contact lenses have existed since 1938,1 it wasn’t until the 1990s that multifocal designs advanced enough for widespread use by eyecare practitioners.

    Given that multifocal contact lenses have almost 80 years of existence, why does monovision persist as a treatment of choice for many presbyopes even if they are good candidates for multifocals?

    Why monovision persists

    One explanation is there is no clear-cut evidence-based conclusion on which modality is superior.

    A study of presbyopic contact lens corrections by Arthur Back in 1992 concluded that monovision provided superior visual performance.2 In 2006, Rajagopalan concluded visual performance with multifocal correction was superior to monovision.3 However, Gupta’s 2009 study found monovision superior on objective visual acuity tests, but that superiority was not supported by subjective patient ratings.4

    Another explanation may be practitioner perception that fitting monovision requires less chair time than fitting multifocals.5

    Many optometrists use the “if it aint broke, don’t fix it” excuse for not fitting multifocals. It is time for ODs to get comfortable with multifocal contact lenses and the opportunity they provide our practices as well as the ability they give us to meet modern patient demands.

    Here are five reasons why.

    Related: Top multifocal contact lens tips

    1. It really is an upgrade

    With the demands that our technology places upon near and intermediate vision, modern life is hard on presbyopes.

    A third of Generation Xers and a quarter of baby boomers spend nine hours a day on digital devices.6 Plus, blink rates can decrease as much as 66 percent when using a digital device, according to a literature review conducted by Marjorie Rah, OD, PhD, making comfort as much a factor as fatigue.7-9

    Technology has also helped make our current multifocal lens options the best we have ever had. Advances in lens design deliver better vision at distance and near. Material designs have brought comfort and visual stability to the forefront, allowing us to successfully fit more patients. Early bifocal designs did not have the fit success that we now enjoy with modern designs and materials, often with the first trial lens.

    Technology upgrades can be as much of a marketing tool as a patient care option. In its most basic form, upgrading patients to new technology shows you and your practice stay on top of advances—not just the status quo.

    Some 97 percent of patients want know about or try new technology.8 Not upgrading your patients is no longer “if it ain't broke, don't fix it.” We are actively ignoring patient desires and falling behind. If your patients find they have friends who visit a doctor “who has these ‘new’ contact lenses for seeing near and far,” your patients perceive that you do not offer such lenses and are behind the times.

    Kristopher A. May, OD, FAAO
    Dr. May serves as adjunct and guest faculty at Southern College of Optometry. Previously, he was center director for West Tennessee Eye ...

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