Traditionally, monovision has been considered the simplest method of presbyopic contact lens correction. Despite recent advances in multifocal contact lens technologies, monovision remains a common mode of presbyopic lens correction in the U.S. today. However, as practitioners are gaining first hand experience with more advanced multifocal lens designs there has been a steady shift away from the traditional approach. Over the next several weeks, we will explore why these fitting practices are changing. Specifically, we will challenge the validity of five common myths driving the use of monovision over multifocal lenses for presbyopic contact lens corrections.
"Monovision is the Best Place to Start for Emerging Presbyopes" is a myth because the status quo may not be the best for everyone. Many patients, for example, use computers at home or work and therefore have intense intermediate visual needs that cannot be met with monovision. It's not uncommon for monovision patients to resort to glasses for certain sports, or computer work because of this limitation.
Your current spherical contact lens patients are possibly the best candidates for a multifocal lens correction. Over the years, these patients have relied on their contact lenses to help them maintain their binocular functionality. Night vision and depth perception are dependent on binocular vision. So why must these patients give up their lenses to maintain this functionality at the onset of presbyopia? The answer, of course, is they don't. And as their eye care practitioners we know they would most likely prefer to stay in their lenses. With the right multifocal contact lens design, you can give your presbyopic patients the opportunity to stay in contact lenses to achieve great visual acuity while maintaining natural, binocular vision.
In a comparative evaluation with 275 contact lens patients a significant percentage of the satisfied monovision patients preferred the Bausch & Lomb Multi-Focal lens for near vision, distance vision, and overall (see chart below). In fact, 73% of the satisfied monovision patients planned on continuing in the Bausch & Lomb Multi-Focal lens and not in their previous monovision correction. When practitioners were asked which lens they preferred, the response was Bausch & Lomb Multi-Focal lenses for all of their previously successful monovision wearers.*
These findings suggest that the natural binocular vision provided by a multifocal lens is preferable to visual compromises inherent in a monovision correction. This also suggests that the Bausch + Lomb Multi-Focal contact lens should be used as the fit of choice for presbyopic patients while monovision be relegated for use as a back-up.
*Data on file, Bausch & Lomb, Inc.