Transition Gen X Patients to Multifocal CLs in 3 Easy Steps

The emerging presbyopes of Generation X are natural customers for multifocal contact lenses. They are often lifelong CL wearers, and a captive audience. Since you’ve already earned their loyalty and trust, it’s easier to recommend and sell new technologies. But even those who have never worn glasses (like functional emmetropes) can benefit from multifocal CLs.

These patients likely don’t know they’re emerging presbyopes. They may have started to wear drugstore reading glasses, getting headaches, or dealing with fatigued, watery eyes. These patients may present with complaints of discomfort or just general frustration about visual changes they’re beginning to notice, but they are also usually anxious to remain glasses-free. They have a need, but likely aren’t aware of how you can help.

Offer to fit them with multifocals, and see if their symptoms resolve. Unless you introduce them to the available technology, they’ll assume they’re stuck with those dollar store reading glasses.

Your emerging presbyope patients who are used to regular contact lenses are usually able to transition successfully to multifocals. But building a winning multifocal strategy in your practice means actively recommending these products—don’t wait for patients to inquire on their own. Below, three simple steps to keep aging patients in the contact lenses they know and love:


Based on their attitude towards aging (hint: they don’t like it), Gen X patients tend to ignore small changes in their vision. They may not bring up symptoms like eyestrain or headaches. Asking the right questions ensures you’ll uncover details of their visual lives at home, work, and play, along with opportunities to present multifocal CL options:

  • Do they do close work?
  • Do they use a computer all day?
  • What are their hobbies?
  • What about intermediate vision?

Fitting multifocal CLs is undeniably tricky, cautions Phyllis Rakow, a presenter at SECO 2016 and director of contact lens services for The Princeton Eye Group. Solid screening will prevent a myriad of problems down the line. Below, her criteria, shared with attendees during her SECO presentation:

Good Candidate Not a Candidate
  • Healthy ocular surface
  • Unaddressed dry eyes
  • Realistic expectations
  • Poor tear film
  • Good motivation
  • Minimal distance Rx
  • Distance Rx over 0.75 D
  • High add powers
  • Current CL wearer
  • Poor motivation
  • Dislikes glasses
  • High astigmatism
  • Needs vision at intermediate range
  • No dry eye problems
  • Hyperopic or high myopic Rx


Experts agree that good communication is key to multifocal CL success. Part of that is setting expectations and explaining the limits of CLs. First, explain presbyopia to the patient, ideally using a poster or eye model. Then, explain the design of the CLs, and their limitations. Patients need to know that with CLs, you’re compressing their Rx from a spectacle lens to lens smaller than a dime, notes Rakow.

ECPs know that achieving 20/20 vision with multifocal CLs is often impossible. But patients are used to a full range of vision and expect to retain that no matter what their modality, adds David Kading, OD, who also spoke about contact lenses at the SECO conference. To remedy this conflict, he advises “fitting the patient, not the prescription.” Here’s how:

  • Ensure patients have reasonable expectations about multifocal CL wear. It is always best to under promise and over deliver.
  •  Ask patients if they are willing to accept a CL that meets about 80% of their visual needs.
  • Explain that the goal is to reduce the need for glasses, not eliminate it. Ask the patient if they are willing to occasionally use reading glasses.
  • Ask patients to specify exactly what they wish they could see better; during the fitting, be sure to draw attention to what the patient can see, versus what they can’t.


Gen X patients—and really, nearly all patients—are busy people with busy lives. They demand quality and convenience. That’s why it’s imperative to show patients how a multifocal CL can help make their lives easier, their vision better, and their eyes more comfortable.

If a patient hasn’t yet considered multifocal CLs, chances are they’re suffering physically from eye fatigue related to close work. Tell the patient how much better they will feel when their eyes are relaxed, not strained.

Focus on expressing the benefits of the lens to the patient—not just the features. It’s easy for ECPs to get wrapped up in the technology behind the newest CLs (features), but patients just want to know how the lenses will help them (benefits). Emphasize that contact lenses may be worn full- or part-time, depending on individual needs.

A Trial Run

Patients appreciate the opportunity to experience products versus just receiving education about them, says Mile Brujic, OD, FAAO, also a presenter at SECO2016.

TIP: Optometrists who allow patients to try multifocal contact lenses will sell more of them.

Invite presbyopic patients to wear a trial pair of lenses while browsing for frames, then assess their vision using targets in your practice. Encourage them to walk around the office, look out a window, pick up a magazine, check their phone, and get a real-world feel for the lenses. Then ask an open-ended question like ‘So, what do you think?’

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