Contact Lenses For Presbyopia

Spectacles are not the only option for giving you both distance and near vision! If you are over 40 years old and have been wearing reading glasses, progressive or bifocal spectacles, this does not mean you cannot wear a pair of contact lenses. These are perfect for when you want to be able to do the things you enjoy in life without the hassle of having to wear a frame on your face. There are two primary options for presbyopic contact lens wear: multifocal contact lenses and monovision (or blended) contact lenses. Soft disposable contact lenses or rigid gas permeable lenses are both available in these options. Your optometrist will advise which is best for your situation.

Contact Lens Options for Presbyopia:

Multifocal Contact Lenses (simultaneous vision)

With these lenses your eyes are focused for both distance and near vision at the same time; your brain figures out which image it needs to concentrate on and it ignores the other. In this way, the eyes are working naturally together. The clarity of your vision will never be as sharp as with your spectacles due to slight ‘ghosting’ of images, but the majority of patients find these lenses allow them to do ~90% of the visual tasks in their life with ~90% of the visual quality. In various studies these lenses have been shown to offer patients better ‘real-world’ vision compared to monovision contact lenses. Multifocals are typically only available in a monthly modality, but do exist in a daily modality for occasional use.

CAPTION: The design of a typical soft multifocal contact lens.

Monovision Contact Lenses (blended vision)

With monovision, one of your eyes is corrected for distance and the other is corrected for near vision. In this way the eyes do not work together as naturally; however, the visual quality of the eyes tends to be superior in the examination room compared to multifocals. Monovision also allows significant astigmatism to be corrected better than multifocals. Because monovision contact lenses are no different to standard lenses, just with the powers adjusted, your habitual lenses can be used without a refit being required. Daily lenses can also be used for convenience. In patients with good distance vision, you may just need a lens in one eye to improve your vision for near tasks.

Orthokeratology for Presbyopia

Orthokeratology or 'ortho-k' lenses (overnight corneal reshaping lenses) can be designed to give distance and near vision in a manner similar to monovision, Due to the nature of how ortho-k lenses reshape the cornea, they have more of a multi-focal effect than standard soft lenses. Like monovision, if you normally see well in the distance you may just need a single ortho-k lens worn overnight in one eye to give you better vision for near tasks throughout the day.