I want to start promoting soft progressive contact lenses in my practice. Friends in another practice have stopped offering these contact lenses because of the high number of patients who complained about a lack of clear vision. Do you have any tips to avoid this?

I have fitted soft progressive contact lenses to many patients and from my experience the two most important points that come to my mind are:

Firstly, bear in mind that soft progressive contact lenses are very unlikely to provide the same visual clarity as spectacle lenses, no matter what their design. This is an important point for the practitioner to understand.

Secondly, your patients’ expectations need to be set so they too understand this. It is very important that they are not told that they will be able to replace their spectacles with soft progressive for all visual tasks. In my experience soft progressive contact lenses (or any type of multifocal contact lenses) contact lenses cannot totally replace spectacle wear. This needs to be explained from the moment the patient enquires about progressive or other types of multifocal contact lenses.

I communicate this by informing the patient that soft progressive lenses will allow them to see the menu in a well-lit restaurant and see to drive safely when the conditions are good. They will provide good vision for most everyday tasks but where there is a need to see close things clearly or driving in poor conditions there may be a need for single vision distance and/or single vision spectacles to use over the contact lenses.

Some patients will stop at this point because they cannot see the point of purchasing contact lenses and still have to use spectacles. Other patients will continue and be less likely to be disappointed when they are wearing soft progressive contact lenses because you helped them reset their expectations. They will be prepared for the reduced clarity and may even be surprised by how clear things are once they are wearing the lenses.

By approaching soft progressive lenses in this way, you can filter out many of those patients who would complain about the lack of clarity and keep those who are happy with their reduced expectations. Supplying single vision distance and/or near over spectacles also helps develop a prosperous business.