Multifocal contact lenses have been touted continuously by manufacturers as the next “holy grail” of contact lens opportunities. With fanfare and hoopla. multifocals are heavily promoted to eye care providers. Granted, the population is greying and the pool of potential patients is expanding rather than contracting.
But the shine of multifocal soft lenses has not outlasted the promises from the manufacturers. Rather than buttressing the sagging profit margins of eye care proiders, it has become a shy partner in the business of eye care. Although every lens manufacturer trumpets their lens as the best in the market, the reality is that no one brand or design has captured the market. In fact, I would venture to guess that its promise has been less than fulfilled.
What will bring back the luster of multifocal lenses? What will bring back the disillusioned doctors and the disappointed patients? First, the price of multifocals has to fall even more. With spherical contacts so much cheaper, there is little reason to gamble chair time on a product that rarely achieves 50% success rate on any random spherical presbyopic patient. With a price reduction, patients need not gamble on whether a multifocal will work full time as a replacement for spectacles.
Second, multifocal may work best in fulfilling other clinical objectives. Although myopia control has not been proven clinically, its use in children might make it a suitable alternative to penalization by atropine. Its quite possible that such a niche could be an opportunity (Walline et. al., 2011 and Llorente-Guillemot et al, 2011 and Ferrer-Blasco T, 2011), their adoption by eligible patients is still significantly less than that of a single vision spherical contact lens patient.
Lastly, both the material and the availabe parameters need to be upgraded. Because presbyopic contact lens cases are more variable than simple spheres, it is important to have a ready lens that might fit the patient. This includes toric multifocals. The lack of cylindrical correction presumes that no presbyope ever has astigmatism, a prospect that is ill-conceived.
In summary, multifocal lens success is elusive for both the doctor and the manufacturer. However, a serious initiative to improve lens material, availability of parameters and price points may improve this segment of the market.
Walline JJ, Lindsley K, Vedula SS, Cotter SA, Mutti DO, Twelker JD. “Interventions to slow progression of myopia in children. “Cochrane Database Syst Rev. 2011 Dec 7;12:CD004916.
Ferrer-Blasco T, Madrid-Costa D.”Stereoacuity with balanced presbyopic contact lenses.
“. Clin Exp Optom. 2011 Jan;94(1):76-81. doi: 10.1111/j.1444-0938.2010.00530.x. Epub 2010 Oct 6.
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