When we reach the age where we need help reading at near, what options do we have? Well, there are several and the answer for you is individual. Occupation, lifestyle, hobbies, visual demands, ocular health, personality, and expectations all need to be taken into account.
Glasses are an option. Some people need to have multiple pairs depending on the activity they are doing (reading, computer/piano, driving, etc). Other people don’t have the time or lifestyle or even the personality to keep track of multiple pairs of glasses so bifocals or progressive addition lenses may be their best option. We all try and get a single pair of glasses to meet the majority of life’s challenges. Contact lenses are another option.
Monovision Contacts @ BA Eyesite
Monovision: One contact is focused for distance while the other is set for near. This takes some training of the brain to adjust to this set-up and for some, it may take a few days to a few weeks. Monovision was the only good option in contact lenses about eleven years ago. This technique is still used because it does work for most and if there is a significant amount of astigmatism present then often this is the best option.
Bifocal contacts: These are great for most people who don’t have astigmatism over a diopter. They preserve depth perception and help with night vision difficulties experienced with monovision. I am always surprised when I have monovision patient, and I ask them if they have ever tried the bifocal/multifocal lenses. Their answer is almost always no my last doctor never discussed them or had me try them. This technology is so much more advanced than it once was and when you have a good candidate the option should at least be presented to the patient.
Bifocals for Astigmatism: There are a few soft lenses that address both astigmatism and presbyopia. Cost factors and fitting difficulty often leads to these patients being placed in monovision lenses or reading glasses being fit over distance contact lens correction.
RGP: Hard lenses offer varying designs based upon patient needs and eyelid position and tightness.
LASIK: This is an option as well. If a patient has been successful in monovision contacts, their LASIK can be customized to give them that vision.
One of the biggest obstacles of monovision is training the brain to interpret what is it seeing and reconciling the distance and near being seen by only one or the other eye. After this is accomplished, some patients noticed a sacrifice of depth perception and night vision. This is an older option but it can be effective in helping our presbyopia patients avoid much of the need to reading glasses.
Dr. Matthew Ozment
Optometrist, Broken Arrow OK