By Thomas P. Arnold, OD, FSLS
August 19, 2020
It is an axiom that your patients grow old with you. That is certainly true as I prepare to enter my 37th year of practice. Thus, many of my patients, possibly close to a majority, are affected by presbyopia (“old eyes”). Fortunately, I have a multifocal lens that serves these patients so well that many are able to avoid having to carry reading glasses or wear progressive eyeglasses all of the time.
The contact lens making such a positive difference in my patients’ lives, while helping me to build my practice, is NaturalVue® Multifocal 1 Day Contact Lenses.
A Practice-Differentiating Lens
I first discovered NaturalVue MF 1 day lenses over three years ago quite by accident.
I was tasked with presenting a talk on the latest innovations in multifocal lenses at the Cornea, Contact Lens and Contemporary Vision meeting in Houston. In the process of preparing my talk, I stumbled across the NaturalVue.
The concept and design were totally unique and unknown to me at the time. I was so impressed that I included a short video on the lens in my presentation. NaturalVue MF has advantages including a material with a solid reputation for comfort and durability, easy handling and a UV blocker, which patients appreciate. The base curve and overall diameter give the lens a good sagittal depth, which accommodates a variety of corneal curvatures.
Slightly More Chair Time, But Greater Per-Patient Revenue
Multifocal patients may require a little more chair time, primarily due to the need for additional information about their condition and our strategy for addressing it. Selecting the appropriate prescription of the NaturalVue Multifocal is easy with the help of the NaturalVue calculator. Simply input the spectacle prescription, select the dominant eye and hit “Enter.” Information is also provided for tweaking the Rx to enhance either distance or near vision. I have found it to be very accurate.
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Our fees are commensurate with the level of skill that we provide, as well as our access to the latest technologies. In our tier system of fees, ranging from Levels 1 -4 for both new and established patients, soft multifocal lenses are priced at Level 3. Scleral lenses occupy their own category. The NaturalVue Multifocal is definitely a profit center in our practice. Multifocal contact lens evaluations may contribute 15-25 percent of our contact lens revenues.
Give Presbyopic Patients a Chance to Comfortably Maintain Their Look & Style
We know that many established contact lens wearers do not want to give up their contacts as their near vision declines. And in our culture, which places a premium on youthful appearance, they certainly don’t want to wear “Granny” glasses. Many are receptive to the idea of multifocal lenses, especially in the single-use mode.
Myopic patients are a natural and easy fit in that they will accept less minus in the non-dominant eye (creating a low-level monovision situation). With the NaturalVue MF worn in both eyes, their reading vision is far superior to traditional monovision while maintaining clear distance vision. The step-up to new technology is an easy transition and a solid way to increase revenue.
Easy Transition for Single-Vision CL Wearers
Having a best-in-class lens with a unique, extended-depth-of-focus design is helpful in transitioning current contact lens wearers into a lens that will address their needs at near, intermediate and far. The design has no abrupt image jumps so that the patient can easily transition from reading material to the computer to across the room or office. The change in focus is so smooth that it is seamless to the patient. Adaptation is facilitated and occurs in a short period of time, sometimes even before the conclusion of the visit.
The NaturalVue MF lens is our preferred lens for young myopes who show evidence or risk of myopic progression. The high plus power that is generated in the periphery yields an effective myopic defocus. This has been shown to be an important factor in reducing progression. New wearers are often not even aware that they are wearing a multifocal, and parents are reassured that their child is receiving the latest technology.
Take Time to Educate Your Patients
With patients entering presbyopia, we always take the time to explain the thickening of the crystalline lens that comes with age (I call it the “birthday” issue). We go into the action of the ciliary muscle and how the lens does not flex like it once did. This leads to a need for more “plus” power at near.
I sometimes give the example of the racks of reading glasses found at the drug store in the various powers of increasing strength. I explain that we can now incorporate this reading power right into their contact lens. The added benefit of a daily disposable lens makes this an attractive option for busy adults. The fact that each lens is fresh and clean each day, which reduces the chance of infection, is a big plus to many patients.
We discuss that adjusting to anything new may take time, so we urge the patient to “be gentle with themselves.” They are reminded to keep both eyes open as best vision is obtained binocularly. I urge them to go about their business and try to “forget about the contacts.” Many adapt quickly to this design, but I caution that it may take a few days or even a week.
We schedule the first progress visit no sooner than 10-14 days after beginning wear. This gives the new wearer time to get used to the lenses in a variety of environments and tasks. In this way, unnecessary power adjustments are avoided. We advise our myopic patients in the same fashion as hyperopes; however, in my experience, hyperopes may take longer to adapt and need more reassurance.
With the right support, and the right lens, we ensure our presbyopic patients can comfortably enjoy all the advantages of contact-lens wear.
This information may describe uses for multifocal contact lenses that have not been approved or cleared by the FDA for use in the United States.