Presbyopia

Multifocal Contact Lenses: The Second-Chance Success Story

Photo Credit: iStock

Why “I tried those once” shouldn’t end the multifocal conversation

By Dana DeVito, OD

March 6, 2026

It’s not uncommon for patients to walk into the exam room with a clear stance on multifocal contact lenses. I’ve heard it all, from “I tried those once” to “They didn’t work for me.” For many clinicians, that statement can feel like the end of the conversation. But in today’s contact lens landscape, I believe it should actually be the beginning.

In my experience, most patients who abandon multifocal lenses don’t do so because the concept is flawed. They give up because expectations weren’t properly set, adaptation wasn’t supported or the technology simply wasn’t where it is today. With advancements in optics, materials and daily disposable designs, many former “multifocal failures” are now some of our happiest and most loyal contact lens wearers.

WHY PATIENTS GIVE UP TOO SOON

When patients struggle with multifocal lenses, expectations are often the primary issue. Many presbyopes are accustomed to the crisp clarity of progressive spectacles and assume multifocal contact lenses will deliver the same experience immediately. What’s often missing from the conversation is the need for a short adaptation period, during which the visual system learns to integrate near, intermediate and distance vision. Without that context, frustration can set in quickly.

Older multifocal designs also contributed to early dropout. Rigid transition zones, increased glare or halos and inconsistent comfort made success harder to achieve. Limited parameter options and fewer customization strategies further constrained outcomes.

Practitioner confidence plays a role as well. Multifocal fittings require time and experience, and patients can sense hesitation. Education for both the patient and the clinician is often the difference between success and abandonment.

WHAT’S CHANGED IN MULTIFOCAL TECHNOLOGY

Today’s multifocal lenses are fundamentally different from those many patients tried years ago. Advances such as extended depth of focus (EDOF) and refined aspheric optics allow for smoother transitions between focal points with less visual disruption. These designs have largely eliminated the “all-or-nothing” feel that characterized earlier multifocals.

Materials have evolved just as significantly. Modern silicone hydrogel lenses provide higher oxygen permeability and improved moisture retention, which is especially important for presbyopic patients prone to dryness. Daily disposable multifocals further enhance comfort by eliminating deposit buildup and variability associated with reusable lenses.

Customization has expanded as well. A broader range of add powers, center-near and center-distance designs and pupil-optimized fitting strategies allow clinicians to tailor the lens to the patient rather than forcing adaptation in the other direction.

Photo courtesy of Vision Source Naperville | DeVito Eye Care

WHY DAILY MULTIFOCALS DESERVE A SECOND LOOK

Daily disposable multifocal lenses have been a game changer in my practice, particularly for patients who struggled in the past. Starting each day with a fresh, sterile lens improves hygiene and reduces issues related to allergens and protein deposits.

From a troubleshooting standpoint, dailies simplify follow-up visits. When patients experience blur, it’s easier to determine whether the issue is prescription-related rather than lens degradation. That clarity builds confidence for both the patient and the practitioner.

Several daily multifocal options now offer excellent wettability and breathability to support all-day comfort. Lenses such as CooperVision’s MyDay® multifocal, along with offerings from other manufacturers, have helped raise expectations for what patients can experience with multifocal contacts.

REINTRODUCING MULTIFOCALS AFTER A BAD EXPERIENCE

When reintroducing multifocals to patients with a negative history, empathy and education are essential. I begin by acknowledging their past frustration and explaining how today’s lenses differ from what they may have tried previously. A thorough assessment—updating the spectacle prescription, evaluating ocular surface health and identifying factors such as dry eye, early cataracts or astigmatism—sets the foundation for success.

I follow the fitting guide closely, refine prescriptions in-office when needed and encourage patients to wear the lenses consistently for at least a week to allow for adaptation in real-world conditions. I also emphasize that multifocals are not an all-or-nothing decision. Framing the trial as an opportunity rather than a risk helps patients remain open-minded.

THE BUSINESS CASE FOR GIVING MULTIFOCALS ANOTHER SHOT

From a practice perspective, successfully fitting multifocal contact lenses can significantly impact retention and lifetime value. Presbyopic patients tend to be highly loyal when satisfied and often become strong sources of word-of-mouth referrals. While multifocal fittings may require more chair time initially, they frequently result in fewer problem visits once the right solution is in place.

Modern fitting tools, including app-based guides and refined add power steps, have streamlined the process compared to earlier trial-and-error approaches. Daily multifocals also encourage compliance and consistent reordering, supporting both patient health and practice revenue.

I purchased this practice in March 2025, and it was only open 1.5 days per week with an average of two patients per day. Now, the office is open five to six days per week, averaging six patients per day. My patient population is growing alongside my contact lens fittings. Comparing sales from the previous year in 2024 to 2025, I’ve seen growth across multiple brands and products. My multifocal fits with CooperVision have seen a 31% increase over 2024. My dollar amount of sales with Bausch+Lomb, particularly the INFUSE line of products, has tripled in that same time frame.

STARTING SMALL AND BUILDING CONFIDENCE

For clinicians hesitant to revisit multifocals, my advice is simple: start small. Choose one daily multifocal lens, invest time in understanding its fitting philosophy and offer trials to a handful of motivated presbyopic patients. Each successful fit builds confidence and reinforces that multifocals don’t have to be complicated.

Ultimately, offering modern multifocal contact lenses signals to patients that your practice is evolving alongside them. Past frustrations—whether yours or your patients’—don’t define what’s possible today. With the technology now available, giving multifocal contact lenses another shot is often well worth it.

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