Managing patient expectations is one of the most important components to a patient being successful with multifocal contact lenses. It is important for the doctor to discuss any visual goals that the patient may have. I always have the patient state one or two visual goals and document their goals in the chart so that I can follow up with them at their progress visit and confirm that the lenses are performing just as I had discussed. In the event that the patient does not have realistic expectations, I discuss what is or is not a realistic visual outcome.
Another factor that is important to mention to the patient is the importance of good, direct light. I like to use the analogy of a professional basketball player running down the court in baseball cleats. Sure, the ball player will be able to play ball, but is going to be limited to how well he can perform because of his equipment. In this sense, multifocal lenses aren't any different. The multifocal lenses will always perform best in good direct lighting. If a patient's vision isn't as good as it should be, my recommendation to them is to always assess their surroundings to determine whether or not lighting is the issue. I also discuss at the dispense of the lenses that it may be necessary to make some adjustments to their work environment such as having a good, direct light at their work station. It is amazing how this very simple 30 second discussion can make a difference when a patient finds themselves in environments with dim lighting.
It is also beneficial to let the patient know that vision typically gets a little bit better after wearing the lenses for a couple of days. A dramatic improvement is generally not seen, but it is very common for vision to become more crisp after wearing the multifocal technology for a couple of days.