Getting optimal vision with or without bifocals

September 13, 2007 9:12 AM

Can I get by without bifocals, or am I fooling myself? I hate my Bausch and Lomb multi-focal soft lenses, but have hopes that glasses can be made to work.

I got multifocal contact lenses because I started having problems reading very small print. I adjusted to them very quickly, and was fairly pleased at first because I thought this was the right solution, even though I was aware that my vision wasn't all it could be. My distance vision is somewhat worse with multi-focals and reading small print is still a challenge. For example, I had a hard time reading the feature articles in this month's GQ with my contacts in. When I browse the web, I can usually read all but the smallest font alright with my old glasses (which corrected myopia only), but keep pumping up the font size in Firefox when I wear my multi-focal contacts. And when I read for pleasure at night, or have to read small print medicine bottles, I do best with no correction at all.

I could try a slightly higher magnification (I have low magnification, not high, on my current set of contacts), but I don't know if that will make enough of a difference. And anyway, my distance vision is still compromised in multi-focals.

What I'm considering is switching back to standard contact lenses for my myopia (-4.25 right, -6.5 left) and using a pair of cheap magnifying glasses from the drugstore for reading small print on the fly when I wear my contacts during the day. (GQ result: super-crisp!). I could them get a set of real bifocal glasses to use for distance vision or reading as needed.

So, are there any solutions I'm missing? Are you satisfied with your multi-focal contact lenses? It's possible that I may need a new prescription because my presbyopia has worsened after a year, but given how well I can read small print with my naked eyes versus contacts, I'm doubtful of that.

posted by rosemere to health & fitness (10 answers total)

I've had multi-focals for about 4 years, now. I just went to the high-resolution lenses, and it made a pretty big difference. I have 20/20 vision for reading and for distance. I really like the lenses. They're more comfortable than my old type. I hated reading glasses and could never adjust to them. YMMV.
posted by clarkstonian at 9:26 AM on September 13, 2007

I have regular contacts and bifocal - without the lines - glasses. At home I wear the glasses and I love them, but for some reason I have trouble driving, particularly at night, in them. So during the day I wear my regular old contacts (-8.00, both eyes) and reading glasses. I mean I wear the magnifying reading glasses all day at the computer, and for pretty much everything I do at work and around the house, as I'm finding I can't see anything otherwise. All this has happened in the last 6 months, too, sigh. However. Generally, this solution - which is pretty much the one you're proposing - is working for me. I just have to be sure I have a pair of reading glasses on me at all times, which is kind of a pain, but you get used to it.
posted by mygothlaundry at 10:00 AM on September 13, 2007

I have a "monovision" contact lens setup, with a distance lens in my left eye and a close up lens in my right. My doctor didn't feel that soft lens bifocals were very good. It takes a while to get used to, of course, and not everyone does. It's at least worth trying.
posted by tommasz at 11:58 AM on September 13, 2007

Second monovision
posted by A189Nut at 4:18 PM on September 13, 2007

Well, I wasn't totally off base with my original idea, it seems, and maybe just cranking the power of the lenses may help. But monovision people, your ideas intrigue me and I would like to subscribe to your newsletter.

I adapted pretty easy to these multifocal contacts, so I could probably adapt to monovision as well. But do you notice anything odd about your vision even after you adjust? Are you conscious of switching from one eye to another? My left eye is dominant, but it also has the worst myopia, so should it be the one that wears the distance lens? And do you find your depth perception suffers?
posted by rosemere at 4:34 PM on September 13, 2007

I have this exact same problem and I've talked to several other people with it as well. I tried monovision too. My eye doctor told me some people just can't do monovision because the the brain won't connect the pictures. I tried it and it just gave me headaches and blurry vision.

I've also tried many different combinations of bifocal contacts. If we get the prescription so that I can read small print, then I can't read highway signs very well and vice versa. I've finally compromised so that I can function for most daily tasks and only use my reading glasses for the smallest of print. If I know I'm going to be doing a lot of tedious work with small print, which doesn't happen very often, or if I'm reading at home just for pleasure, I leave my contacts out. It's not a perfect solution, but it's the best I've been able to find for now after much trying.
posted by rcavett at 9:29 PM on September 13, 2007

You have to experiment to figure out which eye gets which lens (and, as mentioned above, you may not succeed). I did notice the difference at first, but that faded over time. Same with having to move my head slightly when reading or driving. It becomes automatic and no one seems to notice.
posted by tommasz at 6:36 AM on September 14, 2007

Try my "manual bifocal" method: I work on a computer all day. I wear contact lenses with enough correction to see the monitor (-2.50/-3.00). I can use these lenses for everything except reading tiny print in low light (for which I keep a cheap pair of reading glasses), and for driving, watching movies, or television across the room. For that I wear my "driving glasses" over my contacts. These glasses bring my prescription up to full distance vision (another -4.00 or so). I only have to wear them when I need to see far away. Most of the day my contacts alone are fine, and when I take the contacts out I can read anything no matter how small.
posted by Joleta at 2:38 PM on September 14, 2007

Is there something wrong with wearing glasses instead of contacts? Do you have an aversion -- as in, hate taking them off when putting on shades, fear losing them, think you look like a, um, geek? My spouse, who is legally blind, has glasses that are coke-bottle thick and contacts, too. He used to be vain about not being seen in public with his glasses (they make his eyes look HUGE!), but in recent years comfort took precedence over vanity. He's also in the public eye (no pun intended), and folks are very nice about not jerking him around regarding his dorky glasses. NOT that you'd have that problem, but I wonder why you don't take the comfort route. And please don't think I'm being a wiseguysmartypants. Just curious.
posted by Smalltown Girl at 7:21 PM on September 15, 2007

Coming back late ...

I've gotten the same brand of multifocal lenses with high power lenses, and while they are better for reading, I find the increased degeneration in my distance vision to be incredibly annoying. Not the solution for me, I'm afraid.

Smalltown Girl, I do wear glasses, but I really prefer the convenience of contacts and have worn them most of the time for over 25 years. I'm getting a new pair soon (with truly nifty frames) and can't decide if I just want to go for myopia correction (switching to no glasses or reading glasses as needed) or some kind of progressive.

Joleta, I'm not sure why you need three sets of glasses. Why not your driving glasses for driving and the computer, and the reading glasses for reading?

rcavett, your contact lens solution seems best for me, too. Maybe multifocal lenses work well enough for some people, but I find they've been a royal pain.

Thanks to all!
posted by rosemere at 12:34 AM on November 22, 2007