Vision correction for presbyopia is an ever-growing need that is only expected to increase in the future.^1,2 In the United States alone, it is estimated that nearly 112 million individuals have presbyopia, and on a global scale, it is projected that approximately 2.1 billion people will be presbyopic by 2030.³

Beyond the statistics, we know that presbyopia can adversely impact an individual’s quality of life and emotional well-being.⁴ Studies have found that patients with presbyopia feel burdened by their near vision difficulties and believe that their condition impacts their daily activities, self-esteem, and work performance.^5,6

Patients with presbyopia prefer contact lens correction when they can achieve comfort and good vision.⁷ Contact lenses also provide these patients with a dual wear correction option (both spectacles and contact lenses) that they can enjoy, for greater flexibility in their vision correction. Dual wearers can also be a practice builder for the eyecare professional.⁸ However, 53% of patients who wear soft multifocal contact lenses drop out of wear during the first year, with many lapsing within the first 2 months.⁹ This fact highlights an opportunity to better support patients with presbyopia as they begin to wear multifocal contact lenses.

Today’s multifocal contact lenses are an excellent option for new and established wearers, providing good visual performance with the added benefit of improved cosmesis and convenience compared to spectacles.¹⁰ Additionally, modern multifocal contact lenses are available in a wide range of parameters, materials, and replacement frequencies.¹⁰ In other words, no matter the patient, there is likely a multifocal contact lens for his or her specific vision and lifestyle needs.

Advance Beyond the Monovision Mindset

The use of monovision contact lenses to correct presbyopia has been around for decades, but this approach requires compromises for wearers.¹¹ These compromises include a decrease in or loss of stereopsis, diminished contrast sensitivity, and issues with glare during night driving.¹⁰ Further, monovision is more likely to be successful in patients with early presbyopia.¹² This fact, of course, narrows the potential candidate pool to those with prescriptions requiring a +1.50 D or lower add,¹¹ and may require a refit as presbyopia advances.

Conversely, numerous studies have illustrated multifocal contact lenses’ advantages over monovision.^13-15 Multifocal wearers can maintain their binocular vision with a minimal impact on their depth perception.^13-15 Additionally, multifocal contact lenses provide correction of intermediate distances with high overall success rates, even with advanced add powers.^13-15

One investigation found that patients fit with daily multifocals achieved better binocular visual acuity at all distances compared to their monovision-wearing counterparts.¹⁶

Break Perceived Barriers, Prescribe the Preferred Treatment

Despite new multifocal lens options and an increase in category growth in recent years, a 2023 global survey of contact lens prescribers found that, across all soft contact lens fits, soft multifocal lenses represented 17% of fits and refits.¹⁷ Eyecare professionals’ most common self-reported barriers to fitting soft multifocal lenses include a lack of fitting knowledge, in addition to perceived low success rates and increased fitting times.¹⁸ Countering these misconceptions, several studies have reported that successful fits only require 1 or 2 trials per eye when readily available tools, namely manufacturers’ fitting guides or online calculators, are used.^19-24

In one real-world observational survey, 89% of eyecare professionals said that a daily multifocal soft contact lens met or exceeded their expectations for overall vision performance.¹⁸ Additionally, 96% agreed the multifocal lens met or exceeded their expectations for comfort, while 84% affirmed the lens provided a high fit success rate.¹⁸

Patient perceptions should also tip the scales toward multifocal contact lens prescribing for patients with presbyopia. Time and time again, research has shown that a strong majority of patients prefer multifocals over monovision or spectacle lenses.^{25, 26}

Select the Right Lens for the Right Patient

When prescribing multifocals, lens selection should be tailored to a patient’s visual requirements.¹⁰ Eyecare professionals should consider the distance, intermediate, and near tasks in which the patient engages on a daily basis. For example, these tasks could encompass their visual needs at all distances for work, hobbies, and athletic activities.¹⁰

Other considerations should include a patient’s refractive error, level of astigmatism, age, previous contact lens wear, and motivation to wear a multifocal contact lens.¹⁰ Patients with astigmatism and presbyopia can also be ideal candidates for a toric multifocal contact lens since today’s designs provide optimal distance, intermediate, and near visual performance without compromise to their binocular vision.¹⁰

Tap Into CooperVision’s Broad Multifocal Contact Lens Portfolio

While every patient with presbyopia has unique needs, CooperVision has a multifocal contact lens to match them, with each design offering innovative technology in an unparalleled range of parameters.^27-30 The MyDay daily disposable multifocal with CooperVision’s innovative Binocular Progressive System provides an easy fit for eyecare professionals,³¹ as well as comfort and excellent vision at all ranges for wearers.^32,33 The MyDay multifocal delivers unsurpassed near and distance visual acuity compared to presbyopes’ habitual multifocal contact lenses.^34,35For eyecare professionals, MyDay multifocal’s fitting guide and the OptiExpert online calculator help to provide a high fit success rate of 98% with 2 or fewer pairs of lenses.^34,36 Notably, the 3-add multifocal system optimizes vision for all levels of presbyopia, even as the patient’s visual needs and prescription change down the road.³⁰

For monthly daily or extended wear, the Biofinity multifocal offers exceptional vision at all distances: near, intermediate, and far. Biofinity multifocal features Balanced Progressive Technology with 2 different optical designs and 4 distinct adds of up to +2.50. The Biofinity multifocal’s easy, 3-step fitting approach is based on eyecare professionals’ real-world experience, and it allows for a simplified, flexible, and individualized fitting, including the availability of both D and N options for a highly customizable fit.

Finally, the Biofinity toric multifocal, designed for patients with both presbyopia and astigmatism, combines Optimized Toric Lens Geometry with Balanced Progressive Technology. Optimized Toric Lens Geometry, which is also found in the Biofinitytoric, delivers excellent stability and predictable orientation, while Balanced Progressive Technology, also found in the Biofinity multifocal, offers wearers consistent vision performance at all distances.

Rounding out the wearing experience, the MyDay multifocal, Biofinity multifocal, and Biofinity toric multifocal offer the all-day comfort of Aquaform Technology.

Don’t Miss Out on the Multifocal Opportunity

With the number of patients with presbyopia on the rise, soft multifocal contact lenses represent a significant opportunity to grow a contact lens practice. Keep the multifocal conversation going. It’s an investment in your practice and your patients’ vision.

Michele Andrews, OD is the vice president, professional and government affairs, Americas, for CooperVision.

References

1. Care of the Patient with Presbyopia. American Optometric Association. 2011.

2. Zebardast N, Friedman DS, Vitale S. The prevalence and demographic associations of presenting near-vision impairment among adults living in the United States. Am J Ophthalmol. 2017;174:134-144.

3. Fricke TR, Tahhan N, Resnikoff S, et al. Global prevalence of presbyopia and vision impairment from uncorrected presbyopia: systematic review, meta-analysis, and modelling. Ophthalmology. 2018;125(10):1492-1499.

4. Wolffsohn JS, Davies LN, Sheppard AL. New insights in presbyopia: impact of correction strategies. BMJ Open Ophthalmol. 2023;8(1):e001122.

5. Goertz AD, Stewart WC, Burns WR, Stewart JA, Nelson LA. Review of the impact of presbyopia on quality of life in the developing and developed world. Acta Ophthalmol. 2014;92(6):497-500.

6. Wolffsohn JS, Leteneux-Pantais C, Chiva-Razavi S, et al. Social media listening to understand the lived experience of presbyopia: Systematic search and content analysis study. J Med Internet Res. 2020;22(9):e18306.

7. Rueff EM, Bailey MD. Presbyopic and non-presbyopic contact lens opinions and vision correction preferences. Cont Lens Anterior Eye. 2017;40(5):323-328.

8. Practice building. CooperVision website. Accessed February 2, 2024. https://coopervision.com/practitioner/practice-building

9. Sulley A, Young G, Hunt C. Factors in the success of new contact lens wearers. Cont Lens Anterior Eye. 2017;40(1):15-24.

10. Dumbleton K, Palombi J. Soft multifocal contact lenses: a review. Cont Lens Spectrum. 2022;37(6):34-38,40.

11. Evans BJ. Monovision: a review. Ophthalmic Physiol Opt. 2007;27(5):417-439.

12. Bennett ES. Contact lens correction of presbyopia. Clin Exp Optom. 2008;91(3):265-278

13. Woods J, Woods C, Fonn D. Visual performance of a multifocal contact lens versus monovision in established presbyopes. Optom Vis Sci. 2015;92(2):175-182.

14. Woods J, Woods CA, Fonn D. Early symptomatic presbyopes--what correction modality works best? Eye Cont Lens. 2009;35(5):221-226.

15. Pérez-Prados R, Piñero DP, Pérez-Cambrodí RJ, Madrid-Costa D. Soft simultaneous image contact lenses: a review. Clin Exp Optom. 2017;100(2):107-127.

16. Guillon M, et al. Investigation on the Influence of Presbyopia Correction on Binocular Vision Status. American Academy of Optometry Meeting Poster. 2022

17. Nichols JJ, Fisher D. Contact lenses 2023. Cont Lens Spectrum. 2024;39(1):14-16,18-19.

18. McParland M, Walsh K, Comoroda D, Sulley A. Wearer experience and eye care professional acceptance with a 1 day multifocal contact lens. Clin Optom (Auckl). 2022;14:223-235.

19. Schulze M. Multifocal Contact Lens Fitting: Clinical Pearls. Contact Lens Update. Dec. 1, 2022. https://contactlensupdate.com/2022/12/21/multifocal-contact-lens-fitting-clinical-pearls. Accessed 11/28/2023.

20. Luensmann D, Schulze MM, Woods J, Lazon de la Jara P, Vega J, Orsborn G.. Fitting success with stenfilcon: a daily disposable multifocal lenses. Cont Lens Anterior Eye. 2022;45(1):101648.

21. Bauman E. Material effect on multifocal contact lens fitting of lenses of the same optical design with the same fitting guide. Cont Lens Anterior Eye. 2018;41(Suppl 1):S60.

22. Woods J, Varikooty J, Lumb E. Validation of a multifocal contact lens online fitting app. Cont Lens Anterior Eye. 2019;42(6):e38.

23. Sulley A, et. al. Ease of Fitting Multifocal Contact Lenses. BCLA conference 2023 poster.

24. Merchea M, Evans D, Kannarr S, Miller J, Kaplan M, Nixon L. Assessing a modified fitting approach for improved multifocal contact lens fitting. Cont Lens Anterior Eye. 2019;42(5):540-545.

25. Richdale K, Mitchell GL, Zadnik K. Comparison of multifocal and monovision soft contact lens correction in patients with low-astigmatic presbyopia. Optom Vis Sci. 2006;83(5):226-273.

26. Fogt JS, Weisenberger K, Fogt N. Visual performance with multifocal contact lenses and progressive addition spectacles. Cont Lens Anterior Eye. 2022;45(4):101472.

27. CVI data on file as of May 2023 vs. leading manufacturers

28. CVI data on file 2021. Prospective, double-masked, bilateral, one-week dispensing study with clariti 1 day multifocal 3 add; with ratings from 85 to 89 out of 100; n=90 habitual MFCL wearers.

29. CVI data on file, 2021. Based on prescription option combinations (sph and add) available across all daily disposable multifocal soft lenses from CVI, JJV, B+L and Alcon in USA May 2021.

30. CVI data on file, 2020. Rx coverage database n=101,973 aged 14 to 70 years.

31.CVI data on file 2021. Global observational in-practice assessment with MyDay multifocal (US, Canada, UK, France, Italy, Benelux, Iberia, Singapore) with 196 ECPs and 1505 wearers.

32. CVI data on file 2021. Observational in-practice assessment with MyDay multifocal in US with 48 ECPs and 372 wearers,

33. CVI data on file 2021. Global observational in-practice assessment with MyDay multifocal (US, Canada, UK, France, Italy, Benelux, Iberia, Singapore) with 196 ECPs and 1440 wearers.

34. CVI data on file 2021. Prospective, subject-masked, randomized, bilateral, two-week cross-over dispensing study at 5 US sites with MyDay multifocal and the subject’s habitual, optimized multifocal contact lenses; n=58.

35. CVI data on file 2021. Prospective, subject-masked, randomized, bilateral, two-week cross-over dispensing study at 5 US sites with MyDay multifocal and the subject’s habitual, optimized multifocal contact lenses; n=58. LogMAR 0.08 vs 0.10 at dispensing; p=0.09; LogMAR 0.08 vs 0.11 at follow up; p=0.01.

36. CVI data on file 2020. Prospective, double-masked, bilateral, 1-week dispensing study with MyDay daily disposable multifocal; n=104 habitual MFCL wearers.