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    Managing astigmats when they hit presybopia

    Many options allow patients to remain in contact lenses


    This explanation helps patients understand where they are in the process, how much of the accommodative system they have lost, and how much they have remaining, enabling them to track their own personal rate of change. 


    The system of 10 units can also be used to clarify how a pair of progressive lenses is a linear system, while a soft multifocal contact lens is typically designed in a circular pattern. Explaining the differences in glasses and contact lens designs is key to clarifying how these products work as well as understanding why starting earlier in the presbyopic process prevents the frustration that so many feel with progressive glasses (See Figures 1A and 1B).

    The most important part in communication is the need to start early to achieve greater success with these fits. Patients with a lower add amount typically have an easier time adapting to both progressives and soft multifocal lenses as compared to those more mature presbyopic patients with much higher adds.

    Fitting fees

    After years of education, countless hours of practicing on each other, years of continuing education, and years of experience, we are valuable professionals and deserve to be paid well for the knowledge we have and the services we provide. I don’t shy away from discussing fees and costs in my practice. We have open and honest conversations of prices and are proud of the quality of service we provide for those fees.

    I approach explaining any service that has an additional fee is the same manner with no fear. I explain the process, what will be received, the time it will take, my expectations of the outcomes, and the cost for the service. Then I wait. If the patient agrees to the cost, we move forward with the service at that time or at a separate visit, time depending. Money does not have to be an uncomfortable topic. ODs can calmly and confidently explain the value and benefits of the service we are providing, giving patients the choice to choose. Don’t give your services away for free.

    Bringing it together

    Our contact lens patients have not thought of an age when they want to stop wearing their lenses. It is our job to make sure that they never have to give up on a luxury to which they have become accustomed. Presbyopia should not be a limiting factor in their contact lens success. Being able to keep your astigmatic patients in their lenses as they age will keep your patients happy, help them to remain functional while feeling young, and will ultimately help you grow your practice.

    Read more on toric contact lenses by visiting our Toric Contact Lens Resource Center

    Shalu Pal, BSc, OD, FAAO
    Dr. Pal earned her Doctor of Optometry degree from Southern California College of Optometry and completed a cornea, contact lens, and ...


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    Optometry Times A/V