Hyperopic Presbyopes and Contact Lenses

[LandLord]

Seeing more hyperopic presbyopes who want multifocal contacts but can't see to put them on. Any tips that have worked for you?

[drk]

Good question.

You could try flourescein dye during training sessions. I oftentime insert the lenses myself, instill a little benoxinate and fluorescein combo, and they are numb and the lenses are visible for the training session.

Long-term, I don't know what to say. Some have to put on their glasses to position the contact lens, then take them off before insertion.

[obxeyeguy]

My favorite type of cl patient. ;) They will take at least 3 visits of tweeking the Rx because "things just don't look clear", but they will take them and order a 3 month supply. Each time they will come in personaly to re-order and let you know that the "vision is just not right", and want to see the Doc again, N/C of course. "It's good in the daytime, but about 7:00pm I can't see the computer as well".

I refer most of them to the Doc down the street, before I go through that.

[Dinz]

That's a good tip to add a bit of color for training sessions.
I assume that you are dispensing these colored trials to these patients. Any issues with these contacts because I've had some soft lenses warp, permanently stain and shrivel up by adding Fluress.

[LandLord]

I agree, adding flourescein is a good idea. Some cases, it just seems hopeless if they can't see the lens on their finger. I guess a yellow blur is better than a clear blur!!

[fjpod]

Definately use a magnifying mirror with a lot of light. Have them look into the mirror to see the lens and their eye relative to each other. Also, start by putting the lenses in for the patient and having the patient remove only one, then re-insert. This way, they can see with the other eye because the correction is in place. Repeat one eye at a time until they get it.

[LandLord]

I like that as well. Maybe add both techniques for a double whammy

[drk]

I find the fluorescein leaches out in 24 hours or so.

[jimrask]

Most of my clients in this case wear their glasses until just before putting on the first lens.
I also have one who uses make-up glasses (I don't find it very practical). (this is what I mean: )