As experienced optometrists, we recognize the significance of tailoring multifocal contact lens prescriptions to suit each patient's unique visual requirements. One effective approach involves starting with the vertex adjusted power based on the manifest refraction. If necessary, we adjust the power in the non-dominant eye to optimize near vision. When starting I use this chart as a guide for fitting the ADD power according to age and eye dominance. Chart of Add power based on age (Try to keep the Dominant ADD as low as possible) Age: 40-44, ADD for Dominant Eye: Low, ADD for Non-Dominant Eye: Low Age: 45-49, ADD for Dominant Eye: Low, ADD for Non-Dominant Eye: Medium Age: 50-54, ADD for Dominant Eye: Low or Medium, ADD for Non-Dominant Eye: High Age: 55-60+, ADD for Dominant Eye: Medium or High, ADD for Non-Dominant Eye: High I recommend over-refracting with loose lenses, gradually increasing by +0.25 diopters at a time in the non-dominant eye while having the patient keep both eyes open until achieving the best possible near vision. Once the optimal binocular near visual acuity is determined in the non-dominant eye, hold that selected loose lens over it while checking distant vision. (For instance, if the non-dominant eye requires +0.50DS for optimal near vision, hold the +0.50 loose lens over that eye while checking binocular distance visual acuity). This step ensures that the added plus power does not significantly compromise distance vision. If distance vision is compromised, consider reducing the plus power and educate the patient that a slight monovision approach may be necessary to achieve the best possible clarity. This meticulous approach allows for precise fine-tuning of the prescription, ensuring maximum visual acuity and patient satisfaction. It's worth noting that this method is beneficial even for patients with low astigmatism. By considering the overall spherical equivalent power required for both distance and near vision, outstanding results can still be achieved with multifocal contact lenses. This comprehensive approach ensures that each patient receives personalized care tailored to their specific visual needs, leading to enhanced satisfaction and success with multifocal lenses.