One thing that struck me while working on our special 125th anniversary issue—published last month—is just how pivotal optometrists were in the development of contact lenses. There’s an entire story about it in that issue (“Contact Lenses: A Perfect Fit for Optometry,” July 2016). Decades of achievement came at the hands of ODs. 

Optometrists were integral to the process of developing the materials, designs and fitting principles that made contact lenses a reality. They started contact lens-themed conferences, as well as study groups to educate each other. When problems arose—and they did quite often in the early days—ODs got to work figuring out the causes and devising a path forward. Discomfort, lens flexure, hypoxia and edema, CLARE, GPC, ulcers and infiltrates, solution reactions—all these setbacks, and more, were essentially conquered by optometrists. Hardly anything was too tough to tackle.

Except multifocals. Only 2% of optometrists perform more than two multifocal fits per week, according to one industry study. 

Are the designs at fault? The doctors who are successful with multifocals say no, they’re better than ever and easy to use if you follow the fitting guidelines.

Are patients disinterested? Again, the answer is no. Surveys and anecdotal experiences find that presbyopes welcome an alternative that would give them better vision and a younger appearance than they have with the dreaded reading glasses.

Are the economics of multifocal lens prescribing a turn-off? I’ll bet many ODs continue to think so, but the doctors who set fees commensurate with their expertise and the value of the service provided do great with these lenses. Fitting multifocals brings in recurring revenue, boosts referrals and creates one more driver of patient loyalty.

But still the perception problem persists, and multifocals languish.

It’s because of this disconnect between perception and reality that we devoted our 40th annual contact lens report to multifocals. We asked ODs who have made this modality a marquee item in their practices for their best tips and insights. In a series packed with good advice, two quotes bear repeating:

“I think we are reactionary when it comes to our presbyopes,” said Mile Brujic, OD, in the practice-building article on p. 46. “We often feel that if we make a recommendation or offer a solution, and the patient says, ‘No, I’m not interested,’ we should simply stop offering it to all our other patients unless a patient comes in and specifically asks for it.” 

In the same article, Julie DeKinder, OD, said that she encourages patients to let her do a trial fit “by telling them they really have nothing to lose. If the multifocal works, that is great for them.” If not, “they can always go back to their current modality.” Invest a little chair time and see if it doesn’t start to pay off, she advises. Even those who pass on it will appreciate the opportunity to try. And as the saying goes, you miss 100% of the shots you don’t take.