seeing many types of blind through a new lens?
May 23, 2010 8:07 PM   Subscribe

Can I get contacts if I have presbyopia (needing progressives) AND astigmatism?

I have always worn glasses instead of contacts, and only now recently have switched to progressives and I like them. I'm looking for contacts just for occasional use.

Assume I know nothing about contacts. Hard? Soft? Semi permeable? eh?

From looking at other threads that addressed the question of astigmatism OR progressives, it looks like I should find an optician which specializes in contact lenses. How do I find such a person? I know I'm going to have to leave my small town to do that, but that makes it even harder to find.

Bonus for recommendations of such optometrists in Edmonton, Calgary, Ottawa, Montreal or Vancouver (cities I'm likely to be in).
Personal experience and recommendations welcome.
posted by kch to Health & Fitness (7 answers total) 2 users marked this as a favorite
I'm not sure about the combination but you're correct in that finding someone who specialises in this stuff is a good idea. Do you have an optometrist in your small town that you like (not for contacts, just in general)? Or even one you've used somewhere else that you liked? Ring and ask for a recommendation. It's like any profession, people already in it tend to know who's good and who's bad and what you're looking for is specialist enough that they'll understand why you want a referral. If not an optometrist try asking your doctor, I've had good results getting a referral that way too (I just rang the practise and asked the nurse behind reception). Otherwise word of mouth is also good so hopefully someone else can give you something more specific.
posted by shelleycat at 8:13 PM on May 23, 2010

What you're looking for are "multifocal toric contact lenses." Cooper Vision has one such brand.
posted by fairytale of los angeles at 9:00 PM on May 23, 2010

something else to check out: I was told that the problem with progressive contact lenses is that every time you blink, the lens shifts and since the prescription is different in different regions, things can blurry until the lens settles back into position.
posted by metahawk at 10:32 PM on May 23, 2010

There is another method of dealing with presbyopia for contact wearers that would get around the issue of astigmatism. In addition to having multi-focal lenses, you can have a different perscription in each eye – one for close and one for far. Each would have it's correct toric.

I'm told that the brain adapts to this and you don't notice the eyes switching focus from near to far after a bit, however you lose depth perception. You can definitely try the multifocal torics first, but just letting you know there is another option.

As metahawk notes, progressives contact lenses have "sweet spots" that move when you blink. Add to this that toric lenses are "weighted" on the bottom so that they tend to orient in a specific way, but that also can be moved around by blinking.

The good news is that most optometrists who specialise in these types of lenses will let you try a bunch until you find something you like.
posted by qwip at 2:58 AM on May 24, 2010

I have the setup qwip describes (7 years now). It took me only a couple of days to get fully used to having different correction in each eye. As part of fitting you will have to find out which eye works best for closeup and which for distance. For me closeup is my right eye. I find that I tend to shift my head a little to the left to read and look at my computer monitor but it's very slight and others probably won't notice you doing it. I just got a new presciption and my right eye has actually gone + so the difference between my two lenses is now fairly large. Even so, it took only an hour or so to adjust to the new prescription.

My lenses are Cooper Vision Frequency Toric 55. They fit my eyes best with regards to the proper rotation for handling my astigmatism. Other brands (I forget which ones now) didn't work as well. Your optometrist will help you determine the brand that works best for you. Keeping them moist is key since the rotation doesn't work as well if your eyes are dry.

I had gas-permeable hard lenses, but I can't recommend them. While they provided excellent vision (they're essentially custom-made for each eye), I always knew I had them in. The difference between them and soft lenses just wasn't worth the lack of comfort. Still, they are a viable alternative if you can't tolerate the monovision setup.
posted by tommasz at 8:42 AM on May 24, 2010

I am currently dealing with this. I have astigmatism in both eyes. Additionally, one eye is near-sighted and the other is far-sighted and now I have presbyopia. I got my first pair of progressives 2 years ago and they worked great. Aside from an unsuccessful attempt to use contacts 30 years ago, I've worn glasses since I was 5. Call it a mid-life crisis, but I got a bee in my bonnet about not wanting to wear glasses anymore.

So here's the deal. Since I naturally have one eye that is near-sided and one eye far-sided, we went the different prescription in each eye route. My optometrist never even suggested progressive contacts (at first I thought that maybe they weren't available for astigmatism, but I've since discovered that they are; they are just a lot more expensive). I've been trying various pairs of trial contacts since my initial appointment in late March. They've tweaked the prescription once and also switched me from whatever brand they initially prescribed to Acuvue Oasys for astigmatism. Just today, we decided that this prescription and brand combo is the one that works for me. All total, I had 5 follow-up appointments and a total of 4 different pairs of trial contacts. This was all covered in my initial $180 co-pay. My doctor did say that I had a particularly challenging prescription, so you may not need to have so many appointments to find your ideal pair of contacts.

Note that if you and your optometrist decide to go the one prescription each lens route, switching back and forth between your contacts and your glasses with progressive lenses may not be possible, at least until you have put in substantial time with your contacts and your brain has adapted. My doctor had me stop using my glasses entirely so that I my brain could adapt to the contacts more readily and that seemed to work.

I love being free of glasses for the first time in 30 years, but here are some of the cons:

It seems that if you have astigmatism and presbyopia, there is going to be a bit more compromise. If they up the prescription for far-sightedness, then I lose some ability to see small print. If they up the prescription to correct the near-sightedness, then it's a little harder for me to make out things in the distance. And in either case, middle distance can loose a little clarity. Don't get me wrong, my contact lens prescription allows me to comfortably work on my computer, see a movie, walk around, read street signs, basically live my life reading and seeing what I need to, but the correction isn't quite as good as it was with my glasses. But for me right now, I'm enjoying life without glasses, and I presume contacts will continue to improve.
posted by kaybdc at 10:05 AM on May 24, 2010

Response by poster: Thank you all! Hmmm, lots to think about and try. What is clear is that this isn't going to be a straightforward process. But at least now I know what to look for and some ideas to get started. I'm not marking any best answers because they all are providing an important piece for me to follow up on. I'll post back if I get something back before the thread is closed.
posted by kch at 5:14 PM on May 30, 2010

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