3/19/2019 1 Latvian Optometry Congress 17. March 2019 Helmer Schweizer MULTIFOCAL BENEFITS AND FITTING Helmer Schweizer Head Professional Affairs Distributor Markets Alcon EMEA, Cointrin-Geneva, Switzerland Latvian Optometry Congress 17. March 2019 Helmer Schweizer Latvian Optometry Congress 17. March 2019 Helmer Schweizer Abstract The central European population is aging and the median age will still go up over the next decades. With high penetration rates among the not yet but soon to be presbyopic contact lens wearers, it is clearly time to consider the fitting of multifocal soft contact lenses as a standard procedure. Why? Just because the wearers do not want to give up on their contact lenses, just because they are now presbyope. The higher the distance correction, the more insisting they may become. Being a minus two (-2.00) myope, one for the first time enjoys a benefit: Build in reading glasses! One may, however get fed up lifting the glasses more and more often. Another target group are hyperopes, who may not warm up to the idea of having to wear glasses, even for distance or to relief them from headaches. Their dislike is similar to that of first time myope teenagers. Last not least, emmetropes or almost emmetropes do not want to show their age, by having to use half readers or alike. They will also end up putting and removing the glasses in too high a frequency. So they get fed up and look for alternatives. Multifocal contact lenses offer a lot of benefits, while may be not as equally good as multifocal or single vision (near) glasses, especially in challenging light conditions. This presentation witll review these various points of difference and and give tips for the fitting. Some wearers may use glasses for heavy near work, but will still enjoy the multifocal contact lenses in the spare time, when doing sports, travel etc. The option of a daily disposable version is then very appealing to them.
Transcript
3/19/2019
1
Latvian Optometry Congress 17. March 2019 Helmer Schweizer
MULTIFOCAL BENEFITS AND FITTING
Helmer Schweizer Head Professional Affairs Distributor Markets Alcon EMEA, Cointrin-Geneva, Switzerland
Latvian Optometry Congress 17. March 2019 Helmer Schweizer Latvian Optometry Congress 17. March 2019 Helmer Schweizer
Abstract The central European population is aging and the median age will still go up over the next decades. With high penetration rates among the not yet but soon to be presbyopic contact lens wearers, it is clearly time to consider the fitting of multifocalsoft contact lenses as a standard procedure. Why? Just because the wearers do not want to give up on their contact lenses, just because they are now presbyope. The higher the distance correction, the more insisting they may become. Being a minus two (-2.00) myope, one for the first time enjoys a benefit: Build in reading glasses! One may, however get fed up lifting the glasses more and more often.
Another target group are hyperopes, who may not warm up to the idea of having to wear glasses, even for distance or to relief them from headaches. Their dislike is similar to that of first time myope teenagers. Last not least, emmetropes or almost emmetropes do not want to show their age, by having to use half readers or alike. They will also end up putting and removing the glasses in too high a frequency. So they get fed up and look for alternatives.
Multifocal contact lenses offer a lot of benefits, while may be not as equally good as multifocal or single vision (near) glasses, especially in challenging light conditions.
This presentation witll review these various points of difference and and give tips for the fitting.
Some wearers may use glasses for heavy near work, but will still enjoy the multifocal contact lenses in the spare time, when doing sports, travel etc. The option of a daily disposable version is then very appealing to them.
3/19/2019
2
Latvian Optometry Congress 17. March 2019 Helmer Schweizer Latvian Optometry Congress 17. March 2019 Helmer Schweizer
Agenda
The opportunity
The benefits of multifocal contact lenses for the wearer
Latvian Optometry Congress 17. March 2019 Helmer Schweizer Latvian Optometry Congress 17. March 2019 Helmer Schweizer
The Opportunity
The ‘low-hanging’ fruit is:
- Keeping existing contact lens wearers in contact lenses when they become presbyope, certainly the spherical ones.
=> need to talk to them about the existence of multifocal lenses
But, also offer to all, especially emmetropes (opportunity of the occasional use):
- During the weekend, in the aerobic class, when doing sport ... The emmetropes are not ‘entrenched’ in using glasses, as e.g. myopes.=> They behave more like the first time teenage glasses wearers, most do not like them
1 CIA FACTBOOK, https://www.cia.gov/library/publications/the-world-factbook/geos/lg.html visited 22. Jan 2019
Latvian Optometry Congress 17. March 2019 Helmer Schweizer Latvian Optometry Congress 17. March 2019 Helmer Schweizer
The benefits of multifocal contact lenses Against the believe of many optometrists, especially the non presbopic ones, Multifocal glasses aren’t as perfect as these manufacturers say.
Today’s are much better than the older ones, but the are still not perfect
Latvian Optometry Congress 17. March 2019 Helmer Schweizer
When presenting multifocal / presbyopic CLs
• Be prepared to tell how simultaneous vision works / to answer the question of: How does this work?
• Do not believe or assume that multifocal spectacles do always work and have no weaknesses
– (think walking down steep stairs, lots of head movement at work or during spare time activities (dynamic vision), need for wide field of vision in intermediate and / or near
• Believe in multifocal contact lenses as a business!
Latvian Optometry Congress 17. March 2019 Helmer Schweizer Latvian Optometry Congress 17. March 2019 Helmer Schweizer
Fitting Tips
- Always make a new refraction.
- Never accept that they not need any correction for distance to not do a distance refraction. Small correction needs does not mean they need glasses for distance, but needs to be included in the determination of the multifocal lenses
- Make directional (hole) and sensitivity / sensory (+1.5) dominance tests
- When doing the eye exam with the bio-microscope, check if the pupil is centered to the cornea
Latvian Optometry Congress 17. March 2019 Helmer Schweizer Latvian Optometry Congress 17. March 2019 Helmer Schweizer
Fitting Tips
- When aiming to improve distance / far vision, always start with binocular plus!Do not expect this to be a success all the times, but be surprised it can be!
- If improved in the required distance, try the opposite one
- If no improvements, test eye by eye, again start with the needed (far or near), and then test the effect on the opposite one
- Once you found a power change that works, delivers the desired improvements, show it again and get the ‘approval’ from the wearer. The apply the new trial lenses, let them settle and again ask for a one week trial.
Latvian Optometry Congress 17. March 2019 Helmer Schweizer Latvian Optometry Congress 17. March 2019 Helmer Schweizer
Summary and conclusions
The European and also the Latvian population is ageing.
Existing contact lens users are becoming presbypic. They do want to carry on wearing lenses, if informed that multifocal contact lenses exist.
More or less emmetrope presbyopes are open for alternative corrections of presbyopia (they also ask about refractive surgery!). => need to tell that MF CL exist.
DD MF CL availability is a great tool! Occasional use / wear, different corrections for different times of the week, different activities.
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