Multifocal soft lenses are nowhere near as good as the manufacturers represent. -Charlie
Well, Charlie wrote that over a year ago and wow, have things changed!
Oh.....wait. NOT.
So I'll add a few comments to this thread:
1. Fitting not-emmetropes who are currently in CLs to multifocals is a no-brainer. Early to mid presbyopes---easy peasy. Absolute, a little harder but surely do-able. For the former almost anything fit centered or at least over the optical axis will work. For the latter you have near-center in the non-dom and distance center in the dom eye like Biofinity.
2. Fitting emmetropes new to CLs is indeed a big ask. But still do-able if you present realistic expectations. "You're distance vision is not always going to be perfect but you will be mostly, not always, free of using near specs."
3. The Big Failure either way is ignoring ATR astigmatism correction (their distance vision will always suck) and not embracing undercorrecting WTR astig in the not-dominant eye.
4. Big Failure #2 is ignoring dry ocular surface issues, especially toward the end of the day.
5. Big Failure #3 is adjusting the distance power in a 10ft room behind a photopter. You abolutley
must use hand lenses in real space (20ft+, Snellen AND actual trees with leaves. Flowers good, too.)
Back in the day (still only a few months ago) I had near 100% success rate, using primarily Alcon DT1 or BL Ultra--and trying both for comparison as their e-values are not the same), sometimes Oasys and then Biofinity MF and Definity-material custom lenses for weird astigmats and steep/large corneas.
Worth the extra time in the resulting referrals when you succeed.
That's my two cents. Bye for now.
