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Medical Forum / General / Vision / July 2004Soft multifocals?
Has anyone here (practitioner or patient) had success (wearing and/or prescribing) with soft multifocal lenses? Which brands have worked best? How does success rate of multifocal fitting compare with that of monovision fitting? > Has anyone here (practitioner or patient) had success (wearing and/or > prescribing) with soft multifocal lenses? Yes. > Which brands have worked best? How does success rate of multifocal fitting > compare with that of monovision fitting? It is not possible to answer on your question wich brands works best in a induvidual. The second part is (for me) easier to answer. Succes rate in multifocal softlenses about 60 to 70 % Succes rate when using monovision about 90 % Both after explaining the minus and plus of the systems. Did you know eyecareprofessionals use combination's of both systems? Jan (normally Dutch spoken) > It is not possible to answer on your question wich brands works best in a > induvidual. Of course not. I meant in general, which types have had the best success with a larger number of people. (Of course no answer here could say which would be best for an individual.) Regarding your statistics about success of multifocals vs. monovision, may I ask where those numbers come from? From your practice (if you are a practitioner)? If not, has there been a survey of practitioners about this, that you read? URL? > > Has anyone here (practitioner or patient) had success (wearing and/or > > prescribing) with soft multifocal lenses? [quoted text clipped - 15 lines] > > Jan (normally Dutch spoken) I don't know about those numbers, Jan. The monovision numbers seem way off, and, of course, statistics without defining the parameters are pretty useless in any event. But to answer the original poster's query: I've had excellent success with just three of the dozen or so soft multifocals, a very little success with "disposable" multifocals and no longer even attempt to fit them. My current lenses of choice are: Blanchard Quattro, (which I'm wearing now) Unilens (a similar design but in a plastic I don't use) Ocu-Ease Ocuflex Plus (also similar but with cusomizable optic zones) and if you need torics, Acuity One/Optic-Centre Ultravue. My success rate is pretty much 100%, defined by patients who I've selected to be good candidates, who were trial fitted, liked them and then purchased them for continued use. My monovision success rate is 100%, again with patients selected likely to be successful (are naturally not binocular or have one eye very strongly distance dominant.) If you switched those patients, the success rates would be near zero for both groups. There's another fitting design that uses a distance-dominant lens and a near-dominant lens. Basically, a modified monovision, offering some reasonable binocular vision processing and is a nice alternative to straight monovision. --LB  SignatureDr. Larry Bickford, O.D. Family Practice Eye Health & Vision Care The Eyecare Connection http://www.eyecarecontacts.com larrydoc at eye-care-contacts dot com (remove -) Thanks a lot for all the info, Larry! Of the four designs you mention, are any good for extended wear, or are they all for daily use only? > > > Has anyone here (practitioner or patient) had success (wearing and/or > > > prescribing) with soft multifocal lenses? [quoted text clipped - 45 lines] > > --LB > Thanks a lot for all the info, Larry! > > Of the four designs you mention, are any good for extended wear, or are they > all for daily use only? It is my opinion, and that of many other practitioners, that the only lenses suitable for overnight use are those with DKs over 80 and, as of the moment, there are no SOFT multifocals in that type of material. I understand that B&L's Purevision lens may be available in multifocal shortly in the UK and EU countries. There is another soft multifocal (daily wear) that I did not mention as I have no experience with it (not avail in USA) but looks, on paper, promising: Proclear mutlifocal. Coming to the USA this fall. --LB > > Succes rate in multifocal softlenses about 60 to 70 % > > Succes rate when using monovision about 90 % [quoted text clipped - 3 lines] > off, and, of course, statistics without defining the parameters are > pretty useless in any event. There you have a point Larry! These numbers came out short after the trialperiods whith highly motivated clients who must be good (technicaly) candidates also. The clients who continue after the trial period offcourse are 100% successfull in both systems but I suppose this is not what the OP is asking for. What where your numbers here Larry? > But to answer the original poster's query: > My success rate is pretty much 100%, defined by patients who I've [quoted text clipped - 4 lines] > dominant.) If you switched those patients, the success rates would be > near zero for both groups. What percentage did continue to wear one of those systems after one year Larry ? Jan (normally Dutch spoken) > Dr. Larry Bickford, O.D. > Family Practice Eye Health & Vision Care > > The Eyecare Connection > http://www.eyecarecontacts.com > larrydoc at eye-care-contacts dot com (remove -) > These numbers came out short after the trialperiods whith highly motivated > clients who must be good (technicaly) candidates also. For those who recognize the phrase "highly motivated", I am not Otis. Jan (normally Dutch spoken) > Has anyone here (practitioner or patient) had success (wearing and/or > prescribing) with soft multifocal lenses? Yes > Which brands have worked best? How does success rate of multifocal fitting > compare with that of monovision fitting? It is not possible to answer on your question which brands works best in a individual. The second part is (for me) easier to answer. Success rate in multifocal softlenses about 60 to 70 % Success rate when using monovision about 90 % Both after explaining the minus and plus of the systems. Did you know eyecareprofessionals use combination's of both systems? Jan (normally Dutch spoken) > Has anyone here (practitioner or patient) had success (wearing and/or > prescribing) with soft multifocal lenses? > > Which brands have worked best? How does success rate of multifocal > fitting compare with that of monovision fitting? I am not an eyecare professional, but myopic and presybyopic. I have worn multifocal and progressives for many years and prefer them to monovision lenses. Recently, I have gone through a search of the best designs, with help of several on the board and as much info as I could pull from the internet (trying to filter out advertising spiel), and have decided to go with the Johnson & Johnson Definity. Your local lab won't carry it, they are made at J&J lab in Roanoke, VA. Besides the Definity, other brands that appear worth consideration are the Shamir Genesis, and the Varilux/Essilor Comfort or Panamic. There are apparently some good lenses from Zeiss and Rodenstock, but they are out of my price range. The Definity will cost more than the Comfort which would be the least expensive one in my list. Do a Google search for links for any of these. My Definity's were ordered Friday and should be here sometime late this week. Looking forward to trying them. Currently, I am wearing Essilor Naturals, but the prescription is out of date. SignatureDennis Roark denro@sio.NOSPAMmidco.net Starting Points: http://sio.midco.net/denro/www Thanks for the detailed reply, but you are discussing something else, multifocal spectacles, whereas I was asking about contact lenses. Looking back at my original post, I see I forgot the word "contact", so I see how it could have been misunderstood, although the word "soft" could have given a clue, that I wasn't discussing eyeglasses. I do see a lot of posts on this board asking about progressive eyeglasses, so you might want to post the info you give below in a different thread. P.S. Now I'm curious, in looking again at your post, you don't mention Seiko. What do you think of them? I have Seiko progressives. They seem OK. I cannot compare them to others, however, 1) as they are the only progressive eyeglasses I have ever had, I haven't tried any others, and 2) I hardly wear them anyhow, as I wear contact lenses most of the time. > > Has anyone here (practitioner or patient) had success (wearing and/or > > prescribing) with soft multifocal lenses? [quoted text clipped - 18 lines] > Currently, I am wearing Essilor Naturals, but the prescription is out of > date. > Thanks for the detailed reply, but you are discussing something else, > multifocal spectacles, whereas I was asking about contact lenses. > > Looking back at my original post, I see I forgot the word "contact", > so I see how it could have been misunderstood, although the word > "soft" could have given a clue, that I wasn't discussing eyeglasses. Sorry I misinterpreted your question. BTW, "soft" can refer to the design of a progressive spectacle, which are often categorized as "hard" or "soft" mostly depending on the rapidity of the transitions between far, intermediate, and near. Soft give a better intermediate zone, but usually has more peripheral astigmatism. The way the progressive spectacle works is that as you look down, where you would normally read or work on the computer, you are looking through the lower, intermediate or near presciption on the lens. Of course, multifocal contacts cannot work this way because as you look down the contact naturally moves with your eye. I understand that the mechanism for the contacts is more the presenting to the eye always two images, one in focus for distance and the other in focus for near. Then the brain is supposed to more or less sort out the two images and ignore the more out of focus one. This has always seemed to me a rather bad compromise, hence my preference for progressives spectacles than multifocus (perhaps should be called "double-focus, double-image") contacts. These criticisms are more of a theoretical nature, but enough to have me steer well clear of the multifocal contacts; and these comments may well start a war in this newsgroup by the defenders of the contacts. SignatureDennis Roark denro@sio.NOSPAMmidco.net Starting Points: http://sio.midco.net/denro/www > Sorry I misinterpreted your question. BTW, "soft" can refer to the > design of a progressive spectacle, which are often categorized as > "hard" or "soft" mostly depending on the rapidity of the transitions > between far, intermediate, and near. Soft give a better intermediate > zone, but usually has more peripheral astigmatism. As there are many more surface geometries now available, the terms "soft" and "hard" for PALs are pretty much archaic. > The way the progressive spectacle works is that as you look down, where > you would normally read or work on the computer, you are looking through > the lower, intermediate or near presciption on the lens. Of course, > multifocal contacts cannot work this way because as you look down the > contact naturally moves with your eye. Not necessarily. Some multifocal and bifocal contact lens designs are translating----that is designed to "translate" or move up upon downward gaze so the wearer looks through the bottom segment of the lens, much like a standard segmented bifocal spectacle lens. Some of the contacts are true translating segmented lenses and others progressively translating, just like PAL spectacle lenses. There are even a couple of lenses that incorporate both methodologies. >I understand that the mechanism > for the contacts is more the presenting to the eye always two images, > one in focus for distance and the other in focus for near. Then the > brain is supposed to more or less sort out the two images and ignore the > more out of focus one. That is just one of the possible designs. > This has always seemed to me a rather bad > compromise, hence my preference for progressives spectacles than [quoted text clipped - 3 lines] > comments may well start a war in this newsgroup by the defenders of the > contacts. No, not a war, just facts based on current, not ancient technology. --LB SignatureDr. Larry Bickford, O.D. Family Practice Eye Health & Vision Care The Eyecare Connection http://www.eyecarecontacts.com larrydoc at eye-care-contacts dot com (remove -) |
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