Sharp vision - Progressive eyeglasses or multifocal contacts?

[Jude]

I am a consumer who has been somewhat confused lately about the quality of vision I should expect from contact lens vs eyeglasses. I'd been wearing Varilux Comfort with no problems, but as my prescription changed due to "aging" eyes, my new OD suggested contacts would give me as good vision as eyeglasses. The results from the several trial pairs I've worn have failed to meet good, clear vision needs and I'm thinking the glasses will work better for me. I have mild far-sightedness, minor (0.5) astigmatism in one eye, and need +2.25 reading.

Generally speaking (realizing all eyes see differently), would you say that for presbyopic consumers, the eyeglasses will give greater visual acuity?

Thanks in advance for your thoughts.

[Dave Nelson]

No soft bifocal contacts will give you vision as well as a pair of spectacles. Rigid Gas permeable may come close, but would involve a significant amount of fitting and "tuning." Unless you are highly motivated to wear contact lenses over eyeglasses, you will likely do best with spectacles, with part time contact lens wear as an option. Good luck

[Happylady]

My acuity is much better out of my glasses then my monovision contacts. I see well with my contacts, I would rate it a B but my glasses rate an A. Of course, glasses are much more of a hassle.

I tried multifocal contacts on both eyes and for me they are worse then monovision. Have you tried wearing a distance only in your dominant eye and a multifocal in your other eye? This acually works best for me. I will sometimes wear reading glasses over my contacts for very very fine print.

[chip anderson]

Acuity with bifocal contact lenses varies from patient to patient and from practioner to practioner. There are probably 27 different types of RGP/PMMA bifocal lenses.

I have had patients who see 20/10 J1. Some of these were still not happy with thier vision. Others who saw 20/40 J3 with trial lenses and thought this was wonderfull, wanted the trial lenses and would have stopped there without improvement had I allowed them to do so.

Just because you or someone else "tried them" does not indicate that you achieved optimum results. Nor does it indicate that you could have been ultimately pleased. Bifocal and Trifocal contact lens fitting calls for high skill and time investment. Most practioners just settle for the patient having monovision, call this a bifocal or tell the patient that bifocal and trifocal lenses do not exist. Very,very few would attempt a toric bifocal. But just because "my doctor doesn't recomend them" doesn't mean that it can't or shouldn't be done." It might just mean he knows he can make more money with a knife or a phoropter.

Bifocal contact lens wearers actually have depth preception and can see to drive home if one lens is lost, but who cares time is money.

Chip

[Happylady]

Chip, I actually have depth perception with my monovision contacts. I wear Night & Days and see 20/15 with my distance eye and see 20/40 to 20/50 with my near eye. I difinitely use both eyes for distance.

With both eyes togeather I see 20/15. I have tried many different bifocal contacts and have never gotten 20/15 with them.

I know many people do very well with bifocal contacts but they aren't for everyone. Just because someone perfers monovision doesn't mean they are settling. :)

[francisOD]

My 2cents on this is that no bifocal/multifocal contact lenses even with a great fitter and lots of time and money to spend will not achieve as clear vision in all distances, near, intermediate and distance as will a good pair of progressive lenses. However, there are many bifocal/multifocal lens wearers out there that are very happy with their vision...If your ultimate goal is getting the best vision, you should stick to a pair of progressive glasses done by some you trust. Good luck!!:cheers:

[Pete Hanlin]

I concur with pretty much everything said so far...

Certain types of prescriptions may actually require contacts for the best vision possible- for example, someone with anisometropia (large difference between the prescription for each eye) usually fares better with contacts. Likewise, sometimes astigmatism can be resolved with RGPs for better vision quality.

However, given your relatively slight Rx, soft contacts are probably not going to surpass your spectacle lenses in providing clear near and distance vision- in fact, the phrase often used by manufacturers of bifocal contacts is "20/Happy" vision (i.e., perhaps not the absolute sharpest possible- but good enough to make the patient who wants to avoid spectacles happy).

[chip anderson]

Note: Soft contacts are not the only contacts, just those providing the poorest vision and those requireing the least skill on the fitters part.

[Jude]

Thank you all SO much for taking the time and thought to respond to my question. Maybe a pair of monovision soft lens contacts would work for occasional wear when I don't need to see that well. But my daytime profession as an engineer (lots of computer time) and my second profession as a watercolor artist cause me to have strong demands for as good vision as I can get. I had actually suggested trying RGPs to my OD, but he said that wouldn't help me at all. I do realize, after doing some research on my own, that his statement isn't necessarily correct and that he possibly didn't want to put that much time/work into it. I have to admit my confidence in him is a bit shaky.

I'm going to go with the Varilux Physio as my eyeglass choice. And again, thanks to you all for sharing your information and sugestions.

[ziggy]

I had actually suggested trying RGPs to my OD, but he said that wouldn't help me at all. .

I would say he had no idea how to fit a RGP multifocal. About 90% of my RGP multifocal patients achive near vision at 20/25 or better. IMHO do not fall into the "mono" trap. If your optician or doc does not fit rgp multifocals then find some one who does. BTW soft multifocal lens can only be ok at best, stay away from them.