Lots of contact lens patients start to lose interest in contacts when Presbyopia (a loss of ability to focus the eyes on near objects) starts to take away their up-close vision. But wait! There are now excellent MULTIFOCAL CONTACTS available that allow patients over age 40 to wear contacts and be able to see both far away, up close, and at the intermediate distance so crucial for computer users.
Since our Seattle patients live in an urban area, pretty much all of us are computer users at some level. But that intermediate distance is also key for lots of other things, such as seeing the person across the table from you. I would like to state that I would be doing a disservice to the profession of optometry if I did not mention that fitting multifocal contacts is a difficult skill. Not all patients will be successful (for example, patients with more than one diopter of astigmatism need expensive specialty lenses). But for a large majority of patients in their 40s and beyond, multifocal contacts can be a real game changer.
Whenever I fit patients in multifocals, I like to discuss the 80% rule with them. This rule is really about setting expectations at the right level. Basically it boils down to this: if you expect perfection in multifocal contacts, we should not even try them. They are not perfect. If we get to a point where the patient is happy 80% (or more) of the time, and does not need supplemental reading glasses, then that is a successful fit. There is always some level of compromise. That being said, they are WAY better than the products we had just a handful of years ago. Things got much better when the Air Optix Multifocal and Biofinity Multifocal were released. It is a good day and age to need multifocals; modern contact lens technology is impressive.
Often when one of the doctors at Cannon EyeCare in Seattle fits a patient in Multifocals, they can see 20/20 in the distance, and 20/20 or close to that up close. But they often tell us that their vision is not perfect. They can see the street sign about as early as anybody else in the car, but there is a little fuzziness to it. Patients tell us it is almost like a shadow or ghost image next to the letters. But many of them also say their vision is “awesome” because they can see everything they need to see, all day long, without pulling out reading glasses.
On the other hand, these same contact lens patients who are in their 40s, 50s, 60s, even 70s can typically see their phone and printed material without readers. Again the 80% rule says that if you are happy 80% of the time, and able to do 80% of the things you’d like to be able to do without putting on readers, then that is a successful fit.
Sometimes I’ll have patients come in and tell me that they are happy 90% of the time with their contacts. When that happens, I am over the moon, super excited about the success of the fit. I am really good at fitting these lenses. When I have patients come in telling me that they are 80 to 90 % happy with their contacts, that is a really successful fit. Again, if you expect perfection, we should not even try.
Like most types of contacts, multifocals are now available in monthly replacement and daily disposable modalities. Dailies may make good sense for you if you are new to contacts, or only wear them a few times a week. Often monthlies make more sense for daily wearers.
One final note: these lenses require good lighting to perform up close. You can therefore expect them to underperform in your favorite dimly lit Italian restaurant.
Sincerely, Dr. Mark Cannon, optometrist @ Cannon EyeCare (at Market Optical) in Seattle, Washington