By Susan Resnick, OD, of Drs. Farkas, Kassalow, Resnick & Associates, New York, New York
Presbyopic contact lens patients come with an array of needs. NaturalVue® Multifocal 1 Day Contact Lenses have been a boon to both our patients and practice. We began prescribing NaturalVue Multifocal 1 Day four years ago. As early adopters of new technologies, we welcomed a new and unique design that might help us to better serve the increasing number of presbyopic patients desiring contact lenses.
While there have been significant improvements in multifocal contact lens offerings, many patients still failed with aspheric and concentric designs requiring adaptation to “simultaneous vision.” NaturalVue Multifocal 1 Day features an extended depth-of-focus optical design. Therefore, it offers the opportunity to capture those patients who were previously unsuccessful, in addition to emerging presbyopes.
Of the roughly 5,000 presbyopes in our practice, 50 percent wear contact lenses. Of those, approximately 1,500 wear multifocal contact lenses. Preventing contact lens dropouts is critical to our contact lens specialty practice’s reputation and growth. With contact lens sales accounting for 30 percent of our gross revenues, we carefully select products that meet our standards for ocular health, vision and comfort.
The initial fitting visit for multifocal contact lenses typically takes about an hour. Because we work with highly trained technicians who oversee pulling the lenses and the application, the patient is only in the exam room chair for about 20 minutes. This includes discussing the options and procedures. Most of the time required is to allow the lenses to settle.
Our fitting fees for multifocals is 30 percent higher than fees for single-vision contact lenses. The fitting and sale of multifocal contact lenses generates roughly 20 percent of our annual revenues. With a proper fee schedule, and informing the patient in advance of the fees, fitting multifocal contact lenses gives an immediate and long-lasting return on investment.
No special instrumentation or added overhead cost is necessary. We rely on our autorefractor for quick review but always start with a new subjective refraction. To encourage patients to “take the plunge,” we offer a 50 percent return on the fitting fee if they are not successful. Fortunately, our success rates are high, and this rarely occurs.
MORE CHOICES, GREATER PATIENT SATISFACTION
Having more choices, particularly when the design platforms are significantly different, is the biggest factor in enabling us to fit more patients with multifocal contact lenses. Because there is no empirical way to predict perfectly which lens design or material will work for a given patient, it is not uncommon to have to try more than one design.
Presbyopes not only have changes in accommodation, but they have changes in the tear film and lid structure that can affect their ability to continue to wear contact lenses or to transition into lenses. Materials that address dry eye symptoms, optical designs that offer the most natural vision and contact lenses that handle easily allow us to best serve this population.
It helps that in addition to its many clinical advantages, the NaturalVue family of products is not available through alternative suppliers; this ensures patient loyalty
and financial opportunity.
BUILD BOND THROUGH EDUCATION
Having an advanced-technology contact lens like NaturalVue Multifocal 1 Day gives us the opportunity to educate patients about how we can help them when they notice their vision changing. I first describe the “giveaway” behaviors, such as needing more light to read, craning the neck back and moving things away to see them more clearly. Patients can easily relate to these, and it gives them a better understanding that presbyopia is common. I explain that they now have two separate prescriptions: one for distance and one for near.
I then say, in a very positive tone, “The good news is that we have contact lenses that can restore the flexibility in your focus. These lenses feel the same as your current lenses but will significantly reduce your need for reading glasses.” For emmetropes, I explain that multifocal contact lenses offer freedom from eyeglasses for activities and occasions of their choice or for full-time wear.
NOT THE SAME AS SPECTACLES
Patients who have not adapted to ophthalmic progressive lenses may be concerned about their ability to adapt to multifocal contact lenses. I explain that the adaptation is easier and shorter, and because the lens rests on the eye, there is no peripheral distortion with eye movements.
I also bring my new multifocal contact lens wearers back for a follow-up about a week later. This allows me to address any issues in a timely fashion. By letting them know this is a “work in progress,” they understand that this is a more complex process than fitting single vision lenses. We help our patients understand that while their vision is changing, we can still achieve clear and comfortable vision.
Products like NaturalVue Multifocal 1 Day enable us to make that case very easily.