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Multifocal contact lenses: another paradigm shift in optometric practice
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![Michael D. DePaolis, OD, FAAO [photo]](images/commonart/depaolis.jpg)
Change is inevitable. This is true in every aspect of medicine, and eye care is no exception. What begins as a concept is deemed theoretically possible, is validated by clinical trials and eventually becomes a reality in the marketplace. It is often this sequence of events that leads to changes in practice patterns and, occasionally, results in a paradigm shift.
Shifting paradigms in optometry
Indeed, optometry has seen its share of paradigm shifts. We've witnessed bifocal eyeglasses give way to progressive-addition multifocals. We've also watched laser vision correction antiquate radial keratotomy. Therapeutically, we've seen topical fluoroquinolones replace earlier-generation antibiotics. And, most recently, prostaglandin analogs have assumed the role as first-line therapy in managing glaucoma. While each of these changes didn't happen overnight – and are still not unequivocal mandates – they do represent paradigm shifts. Paradigm shifts that have had huge implications in patient care.
Presbyopic contact lens correction is yet another example of a practice pattern long overdue for change. While distance vision contact lenses in conjunction with reading glasses are functional, they are anything but convenient. And although monovision has endured for nearly three decades, it is not an inherently intuitive concept and has certain limitations as well. So we continue our search for a better presbyopic contact lens option – one that provides functional vision at all distances, good stereopsis and convenience. As change is inevitable, our search continues to be a worthy endeavor.
More functional multifocals
Arguably, today's bifocal and multifocal contact lenses are far more functional than their predecessors. We have a variety of gas-permeable designs, each precisely crafted in a wide range of parameters. Likewise, soft lens manufacturers provide us with numerous designs in the most contemporary materials and with the convenience of disposability. With so many viable options – and the poetic license to prescribe creatively – it is understandable why practitioners are finding these lenses so successful. Successful in that these lenses can be efficiently prescribed and provide clear, comfortable, binocular vision. Successful in that multifocal contact lenses are supplanting monovision as a first-line approach to presbyopia in many practices. And, quite possibly, successful enough to result in yet another paradigm shift in optometry.