AAOpt 2024: Multifocal contact lenses for all ages

Erin Tomiyama, OD, PhD, FAAO, an assistant professor at SCCO Marshall B Ketchum University, discusses her AAOpt 2024 presentation, "Multifocal Contact Lenses for All Ages." The talk covers a range of topics, including fitting multifocal lenses for pediatric myopia management, young adults with binocular vision issues, emerging presbyopia, and presbyopic patients using scleral contact lenses. Tomiyama explains that when fitting young children in contact lenses, the primary challenge is ensuring good quality of vision, as multifocal lenses can sometimes cause blurred distance vision due to the add power. For older patients, the fitting process varies depending on the lens type, with soft multifocal lenses and GP multifocals presenting their own unique challenges.

Regarding myopia management, Tomiyama follows the evidence-based approach of the BLINK study, which suggests that a higher add power in a center-distance design is more effective in slowing myopia progression. He emphasizes the importance of following the fitting guides provided by lens companies and using reliable tests, such as the plus lens method, to determine eye dominance. Managing patient expectations is crucial, especially for presbyopic patients transitioning to multifocals. Tomiyama shares a personal success story about his mother, who was initially unhappy with her distance-focused lens but found greater satisfaction with a lens more tailored to her near-vision needs.

Tomiyama concludes by emphasizing the role of multifocals in practice, highlighting that there is no age limit for fitting these lenses. Multifocals can be beneficial for slowing myopia progression in children and managing eyestrain in young adults in the digital era. He emphasizes the importance of individualized fitting based on patient needs and preferences to ensure successful outcomes.