The Five Myths of Monovision Correction of Presbyopia: Myth #2

In the last edition of EyeMatters, we introduced the Five Myths of Monovision Contact Lens Correction:

We addressed myth #1 in the previous edition and now we’re ready to tackle myth #2, “Fitting monovision takes less chair time than multifocal lenses.”

For anyone who has fit monovision contact lenses and tried previous multifocal corrections this statement may seem more fact than myth. What could be easier than dropping a different spherical lens onto one eye to deliver a satisfactory near correction to accompany the existing distance correction? However, chair time involves more than just fitting a lens. Since a key driver of patient satisfaction is proper management of expectations, we have to also take the time to explain what we are doing, why we are doing it, as well as accommodate follow-up visits for patients if adaptation issues arise.

In this regard, the monovision experience can be a little more complicated than it first appears. With monovision time is needed to describe the impact on stereopsis, the compromised acuity in the intermediate ranges, and the necessary alternating ocular suppression that accompanies this form of correction. These are difficult concepts to explain, and even with this knowledge, a certain percentage of patients will not adapt successfully, leading to more repeat visits and more total chair time. While it is also prudent to spend time educating patients about what to expect from multifocal lenses, describing a multifocal contact lens correction can be fairly straightforward. Not only is It a natural process for the brain to select the clearest image at any particular distance, but these lenses can be easily presented as an upgrade from multifocal spectacles which are usually well understood by patients. This more natural approach is what Bausch & Lomb PureVision^® Multi-Focal contact lenses deliver.

Additionally, the innovative PureVision Multi-Focal design has resulted in contact lenses that are much easier to fit than previous generation lenses.¹ How easy is the fitting today? In a multi-site clinical evaluation in which 158 patients were fitted with PureVision Multi-Focal contact lenses, 95% of the eye care professionals agreed that the lenses were easy to fit¹.

Finally, as patients’ age their vision capabilities also change. Many times, monovision correction patients need to be refit and have their correction continually adjusted to keep them visually comfortable. Even after all of that, with a monovision correction, there will come a point when the disparity between the distance and ADD becomes too great. At that point patients start to drop out of contact lenses altogether. In contrast, a multifocal lens correction allows you to keep the patient in the same modality over time as their ADD needs increase. And PureVision Multi-Focal lenses incorporates an increased depth of field along with additional plus in the high ADD lens thereby producing a more natural field of vision at all distances without having to resort to multiple ADD powers.

In conclusion, we should not assume that a monovision correction will automatically take less chair time. Indeed, patient satisfaction over time should drive our initial recommendations, and satisfied patients ultimately require less chair time. For expert fitting advice watch the brief video at this link www.bausch.com/multifocalfittingtips.

Please look for our discussion of Myth #3, “Patients adapt to monovision more easily than to multifocal contact lenses” in the next edition of EyeMatters. If you miss any editions of the EyeMatters series you can go to our news archives at http://www.eyematters.com/archive.asp.

Sincerely,

Mike Pier, OD

Director, Professional Relations and Practitioner Education

1. Data on file, Bausch & Lomb.

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