Presbyopia + reading on a computer = ??????
July 19, 2023 5:02 PM   Subscribe

Do I really need a million pairs of glasses? I'm 50 and nearsighted for decades, corrected usually with contact lenses, and now dealing with presbyopia. Help me figure out my options for computer work.

I have some prescriptions glasses for distance but generally wear contact lenses as I find glasses uncomfortable on my ears for more than a few hours.

Wearing my contacts lenses or glasses, I can read books, my phone, and menus, but it's blurry and not comfortable (and I can't read pill labels at all). I have a handful of pairs of cheap drugstore reading glasses in 1.25 and 1.50 strength and keep them at work, in my purse, and stashed around the house, which works fine for reading. I don't love having to take them on and off, but I'm getting used to it.

However, I'm struggling at the computer, especially for work. I can manage reading without any corrective lenses, with contacts or distance glasses, and with contacts and reading glasses, but none of it is great, and I think the discomfort is making me avoid the computer, which I need to use for work.

Do folks really wear contacts and then have both reading glasses and mid-range/computer glasses? I would rather not wear glasses all the time except when reading. And I don't think there are glasses you can get cheaply at the store that correct for mid-range/computer vision, right?

I talked to my eye doctor last year, before the computer stuff was a problem, and I don't think I want bifocals or progressives. I also don't want to spend a ton of money on prescriptions that don't really work for me. But, I'm open to ideas here. I'm due back at the eye doctor this fall and can explore options then.

If you have solved this problem in a way that works well for you, please let me know what it is. Thanks!
posted by bluedaisy to Health & Fitness (13 answers total) 4 users marked this as a favorite
 
Unfortunately, this is really why progressives and bifocals exist. After cataract surgery in both eyes I have zero accommodation which is the end state for presbyopia. I have two pairs of glasses, a progressive set and a set of computer distance glasses. The progressive set is fine for general use. For extended computer activities the dedicated computer glasses are more comfortable.

You can get a reader/computer bifocal or progressive. It’d be custom made ($$$) and you probably wouldn’t be able to stash them everywhere.

Contacts never worked for me, so I was happy to be rid of them after the 2nd cataract surgery. But multifocal contact lenses exist. They are almost certainly going to be expensive, and I’ve never tried them but I understand that they way that they work can cause visual artifacts.
posted by doomsey at 5:15 PM on July 19, 2023 [1 favorite]


Have you tried multifocals? They're pricey, but some people find them a workable solution. The distance view for mine at night is shaky but since I don't drive, having contacts that work for both short and computer distance is practical.
posted by praemunire at 5:25 PM on July 19, 2023


The unchangeable fact that you are dealing with is that your eyes can no longer change focus. The only way to achieve focus at different distances - ie, reading, computer, distant/outside - is by using different lenses. These could be glasses or contact lenses. They could be single focus type glasses or some kind of variable focus, like bifocals or progressive lenses.

You can also have e.g. laser surgery on your eyes and change their focus. However - the focus your eyes achieve after surgery will then be the new set focus point. To achieve any other focus point, you'll still need lenses of some sort.

All that is unfortunate, but it is the reality you are dealing with now, and sometimes it helps to understand clearly the constraints.

(In fact, if you are about 50 you may well still have some ability to focus within a limited range. As you continue to age, that ability will only decrease even more. Whatever small amount of focusing ability you have now is only going to decrease. It won't increase.)

Personally I wear progressive lenses when "out and about" and doing various random things like driving or looking at the sunset. I don't really like progressives - they allow you to do "everything" to some limited degree but they are mediocre at everything (they are actually pretty good at distance viewing - but anything arms length or closer you have to get BOTH the right angle of your neck AND it is kinda sorta in focus but actually still a bit fuzzy. Good enough to, for example, read, but still more fuzzy than I would like). But if you're out on a shopping trip or walking the dog or whatever, "good enough" without horsing around with three different pairs of glasses to look at near, medium, and far things is indeed, good enough.

When working, I will typically wear computer-vision glasses all day long. These are sort of like reading glasses, but instead of being optimized for reading distance (12-18 inches?) they are optimized for computer screen distance - about 24 inches. So they are perfect for all the day-to-day computer and office work. And they are good enough for reading my phone or a book (have to hold it a bit further away than I would like and/or it is a bit fuzzier than I would like, but it works OK). They are also good enough for taking a walk outside or, for example, watching TV (not my most preferred, as everything is a bit fuzzy at this distance, but it's "good enough" though slightly irritating. I've even driven across town with them on - not my preferred way to do it but I can still read e.g. a speed limit sign and such.)

My additional advantage is, my natural/no glasses nearsightedness focuses at about 7 inches. That is perfect for reading a phone with even the very smallest font and is OK for reading books, fine print on prescriptions or food labels, etc etc etc.

Point is, my go-to is computer-distance glasses for 90% of day-to-day activities and whip them off if I need to read anything really small or microscopic. When I go outside I put on the progressives (or sometimes, my single-vision distance glasses - I actually prefer those over progressives for a lot of activities).

That is not really the most ideal solution - I'd prefer to not hassle with glasses at all, or at worst have just one pair to deal with. But it's the optimum solution I've found balancing the annoyance of wearing glasses vs not, keeping track of multiple pairs for different purposes vs not, and needing/wanting to see different things at different distances clearly.

One thing you could consider (assuming your setup is similar to mine, and indoor/office/computer work takes most of your day) is getting your contact lenses at computer distance. That is ideal for what you do 90% of the time and good enough for everything else - to read and/or do outside/distance viewing things when necessary.

You can have reading glasses and distance glasses made up that pair with the computer-distance contact lenses. 90% of the time maybe you don't even fuss with them, but when you sit down to read a book for 2 hours you whip the reading glasses out. If you're going for a 2 hour drive, you whip the distance glasses out (in fact, maybe they live in your car).

Another option would be, computer distance for your contact lenses, but then get a pair of bifocals that pair with those computer-distance contact lenses to give you reading distance (the bifocal part) and far distance (the main/large part of the bifocal lense) when you put them on.

Now you've reduced it to "no glasses" for 90% of daily activities and only one pair of glasses to fuss with for the remaining 10%.

Those are about the least fuss/least glasses wearing/least different types of glasses that I know of - if you don't want to or don't like the progressive lens option.

Another type of option that people have explored, is setting each eye to a different focal distance. So for example, you get contacts that put the left eye at distant focus and the right eye at computer focus. So now you can do both computer-distance and far-distance/outside things without needing any glasses at all. For reading distance you would probably need/want glasses (which would, ideally, have differential correction for each eye). Some people have done this, adjusted rather quickly, and so they love it. So - a possibility, that requires even fewer pairs of glasses to keep track of.

(Yet another option people have pursued is laser surgery that permanently creates one eye close or medium focus, and the other eye distant focus. Now you don't even need the contact lenses.)

FYI one thing that makes alternatives like the the ones I prefer more feasible is ordering the spare glasses/different strengths from Zenni or a similar inexpensive/online optical shop. I can order a very good pair of reading glasses for about $20 (puts the drug store glasses to shame - I honestly can't believe anyone can put up with those things), or a good pair of distance glasses for maybe $5 more (usually you want better coatings etc for the outdoor pair).

Point is, at those prices a person can afford to experiment with different glasses with different focal points. Try reading glasses and see if that works for your. Try a pair of bifocals. And so on.

When you're paying $450 for a pair of glasses at the local optometrist, you just can't afford to experiment. Those $450 glasses have to work, they have to work right, and they have to last for years.

When a (perfectly good) pair of glasses is more like $20, your perspective changes.
posted by flug at 5:45 PM on July 19, 2023 [18 favorites]


I do indeed have glasses for everything, and no glasses for some things.

I have the driving/living room glasses, which are full progressives - I use them to watch the TV that's about 15 feet away while typing answers to AskMeFi questions :) I also use these for walking around, or for driving - since sometimes when driving I need distance and other times I need to look at the map on my console.

Then I have "computer-distance" glasses I use when I'm upstairs working in my office, because there I'm never looking at anything BUT the computer screen. They really are perfect for that distance. Though it's sad that I can't just look out the window up there, the view is nice. But blurry.

I also wander around frequently without any glasses, because my nearsightedness isn't all THAT bad; I can legally drive without glasses, I can see the tv and read closed captioning without if I have to. But for perfect comfort I do need a bit of correction.

My farsightedness is also minor, but definitely present; many things I can read by moving them to the right distance, sans glasses - but then, some things I can't.

Getting old sucks. This is just one of the ways. But it beats the alternative!
posted by invincible summer at 6:37 PM on July 19, 2023 [1 favorite]


the flug story is almost exactly a version of mine.
posted by doomsey at 7:11 PM on July 19, 2023 [2 favorites]


Flugs answer is outstanding and basically what I've gone thru. For now I've stayed with contacts and various length reading glasses over the top as situation demands. Mostly I came here to say this:

Do folks really wear contacts and then have both reading glasses and mid-range/computer glasses?

Yes. And it fucking sucks. I'm miserable and sad about it almost every day for the last year since the light switch went off and I couldn't see up close anymore.
posted by chasles at 8:18 PM on July 19, 2023 [2 favorites]


On glasses hurting your ears:

This is an issue that can absolutely be addressed. A large part of it has to do with the fit and weight of your frames. The weight of the lenses should be primarily supported by your nose and if the length of the temples is off this can shift everything off. If the curve of the ends of the temple pieces is too sharp or too soft for your ear shape the same thing can happen. If the width of your bridge is off it can throw the balance wrong too. I suspect that the discomfort you get is from having never bothered much to get frames intended for the shape and size of your facial features or visited an optometrist for frame adjustments after a couple weeks of wear.

That said, even I, a person who has worn glasses since I was six whose skull literally has divots where the temple pieces of my glasses have sat as my skeleton grew, occasionally have some tenderness of the ears from my glasses. Usually this happens because I’m especially sweaty and active in a day, causing chafing and extra movement. What can help is to use some kind of stabilizer preemptively, like a sports strap, or pulling them up maybe a half an inch and holding them to my head with a hairband (or, as in these past few years, looping around a mask strap), or even nestling them into the curve of the shell of my ear so the cartilage supports them. This is all possible because my glasses fit well enough and are balanced so that they remain stable and usable despite being tilted. I only ever need to do these as a temporary measure, and after a night’s sleep my ears feel fine. When they don’t, I know I need to get my frames adjusted. I also like to put a little gold bond powder behind my ears when it’s especially muggy out.

Once you are comfortable wearing your glasses for longer periods of time, you’ll be able to tell what kinds of activities you really want different focal points for and which ones you can get away with good enough for now. If you drive, I would kindly ask you to prioritize that. For my dad, he has specific glasses for golfing because it makes his life more enjoyable (and he has a sports strap for them, and they live hooked on his clubs so he never forgets them.) I have a friend about your age who does a ton of precision craft work, likes hiking, and doesn’t drive, so she has glasses for very up close and stargazing but not mid distance.
posted by Mizu at 8:32 PM on July 19, 2023 [2 favorites]


I wear multifocal contacts most of the time (the way flug describes wearing progressives) - I also can’t tolerate glasses (i moved right into contacts when I was a nearsighted kid, wearing glasses for only a year or so). They are pretty good for a lot of things, but not perfect for distance. If I’m just going to be working from home all day, they are perfect for everything I do inside including computer work and book reading. When I first got them, they seemed really awesome because I got back a lot of the midrange vision (like the computer or the clock in my car) that I hadn’t noticed was going until it was better. So definitely give those a go if you can.

As my vision has continued to worsen though the multifocals don’t seem as awesome anymore and I’m seeing the artifacts more (distance vision is fuzzier). For long drives especially at night and for sports, I have a separate plain contact lens prescription that aren’t multifocal, just to correct distance. I can’t read my phone with those so then I have to keep a pair of reading glasses around (but again I only tolerate glasses for quick tasks). This all works pretty well for me and the hardest part is making sure to leave the house wearing the right flavor of contacts, and coming up with a safe way to store contacts (sometimes I wear one pair for only an hour and the eye doctor says it’s perfectly safe to store them to use another day - otherwise I could go through three per day). My eyes are pretty fussy with contacts and I can only tolerate a few brands - they are so expensive “plain” that the multifocals really aren’t much more $$$.

(I think there’s merit in trying to wear two different contacts as well - one to correct nearsightedness and one to correct farsightedness but this isn’t an option for me due to an old injury to one of my eyes.)
posted by Tandem Affinity at 9:47 PM on July 19, 2023


I think there’s merit in trying to wear two different contacts as well - one to correct nearsightedness and one to correct farsightedness

I forgot to mention above that a relative does this and is happy, though she, like me, is a lifetime myope in the early days of presbyopia development.
posted by praemunire at 8:34 AM on July 20, 2023


Frames with spring hinges tend to cause less ear/head pain than the ones with fixed hinges.
posted by still_wears_a_hat at 6:21 PM on July 20, 2023


When a (perfectly good) pair of glasses is more like $20, your perspective changes.

I can't emphasize this enough. Cheap glasses have changed my life. I wait for sales from the various web shops and pick up several different pairs.

Until recently I had one pair that is my real prescription (progressive) from an eye doctor, that cost $70. I recently replaced them with one where I added a notch to the "+" section of the prescription, which determines the strength of the lower "reading" area. I did this myself because you can just manipulate your prescription when you use online shops. Those two are from Liingo which is my favorite but not the cheapest.

I also have a pair of "mid-range" progressives from Zenni. I gave them my prescription but the mid-range version reduces the magnification so it works better at indoor distances. If I go outside the faraway things are a bit blurry, but these let me see everything including my computer clearly inside. These were an experiment so I chose the cheapest frames ($7) and the total was under $40.

Between those two (and removing my glasses, which for now makes phones and small screens clear) everything is good. I expect to eventually replace the midrange glasses with a true "closeup" pair for the computer as my presbyopia gets worse.

Along with those two pairs I've ordered two or three "experiments" that didn't work out, and a couple of pairs that I just didn't like the style or comfort of. But it's all cheaper than a single $500 pair from LensCrafters.

The important thing is to experiment, and give each option a week or so to get used to it, and find what works for you. For example, the "one contact for near and one for far" was one thing I tried, and I spent two weeks feeling dizzy before I gave up...
posted by mmoncur at 10:13 PM on July 20, 2023


Response by poster: Hey, everyone, thanks so much for sharing all this information. It's been tremendously helpful as I sort through options, and I'm still absorbing it all. I didn't mention that optimizing for distance with my contacts is a priority because I bike for transportation even more than I drive. I also did want to say that I have had my glasses adjusted when they weren't feeling good, and it helps, but still isn't perfect; I find myself not wanting to wear them by early or late afternoon regardless. I have bought less expensive prescriptions online so I think I will start poking around for more options that way.
posted by bluedaisy at 4:28 PM on July 24, 2023 [1 favorite]


Response by poster: Another follow up: I ended up going with multifocal contact lenses. I sacrificed some crisp distance vision in order to have a more experience with my contacts on for computer work. My eye doctor let me try many different options and commented that the right prescription can be as much art as science (meaning, the same combo won't work for everyone). I appreciate everyone's input.
posted by bluedaisy at 10:40 AM on December 18, 2023 [1 favorite]


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