progressive contact lenses

**Sheryl** · 08-03-2006, 10:02 AM

I was just fitted for progressive contact lenses, and I'm thrilled with them. The progressive eye glasses are okay, but the progressive contacts are like magic! The quality of vision is like it was before I needed glasses at all. I can see near, far, and everything in the middle. I don't have to think about what part of the lens I'm looking through - it just works. Magic!

I didn't know they made multifocal contacts until I saw a contact lens specialist yesterday. I don't have a question here - just sharing my experience.

**llal98@aol.com** · 08-03-2006, 11:13 AM

What kind did you get? I've tried several brands of the soft multifocal lenses and none of them gave me great vision.

**Dave Nelson** · 08-03-2006, 12:15 PM

Sheryl, thanks for sharing your story with us. llal, asking what kind work so well for Sheryl may not translate into what kind may work for you. Add power, residual astigmatism, and other factors play a greater role in determining the success of multi-focal contact lenses. I'm not saying don't ask, just don't run to the nearest contact lens fitter and say you want brand x contacts because they work for Sheryl.

**llal98@aol.com** · 08-03-2006, 12:28 PM

Oh, yes, I realize. I was just wondering if maybe there's something new available that would be worth looking into.

**Sheryl** · 08-03-2006, 01:39 PM

They are Bausch & Lomb PureVision Multifocal lenses. They are made of the same material (silicone, I think) as my previous lenses (CIBA Vision Focus Night & Day). These are good for me because my eyes tend to be dry and they are very permeable.

The lenses I'm wearing now give me perfect distance vision, and the ability to see near but with some strain (a 1.00 or 1.25 reading glass over the lenses takes away the strain). I want near vision with no glasses, so the optician is sending me a new left lens. There will be some decrement in far vision to pay for that - haven't seen how much yet (she's mailing the lens).

It is SO COOL to be able to wear normal sized watches again when I'm wearing contacts. I'd started wearing giant dials because I couldn't see my dress watches without reading glasses. And I can read packages in the grocery store, menus in restaurants... It is glorious. It will be even more glorious with the new left lens, I think.

**chip anderson** · 08-03-2006, 02:18 PM

Sharron:
Just for the record, I made my first multifocal contact lenses in 1958 and they had been around quite a while before I got in the industry.
Most doctors have denied that multifocal lenses existed because they either didn't want to work that hard, or were not skilled enough to fit them and unwilling to refer this work out to a competent contact lens fitter.
Now that disposable soft contact lenses are available in multifocals, many doctors will attempt them as the skill levels and time involved are negligable. One doesn't loose much in money or time if they don't work.

Chip

**Sheryl** · 08-03-2006, 02:50 PM

Years ago, my father had what he called "bifocal contacts" - not sure if they were multifocal (or even bifocal), and he's been dead for 10 years so I can't ask. As I recall, he had one contact for near vision and one for far. That's essentially what I have, but (from what I can tell), each lens is a progressive that starts and ends at a different point. Maybe that's my imagination, but that's what appears to be happening.

My right eye does the main work for distance and is corrected perfectly for distance. I can see close with my right eye, but not as close as with my left eye. My left eye is less clear for distance but more clear for near vision. Somehow my brain sorts all this out. It's the most naturally correct vision I've had since I started needing reading glasses.

I got the lenses from a contact lens specialist recommended by my opthamologist. He said that if I wanted bifocal contacts, she was the one I should see. (She's in New York.)

**Sheryl** · 08-03-2006, 02:57 PM

Chip,

How are contact lenses made? My impression as a customer is that they are just ordered from a lab, but you said you made them. What does the contact lens specialist do besides stay on top of current developments and resell what a lab makes? Or maybe I have this wrong.

**chip anderson** · 08-03-2006, 04:17 PM

Sherrl:
One eye for near and one eye for distance is called "monovision" it is neither progressive or a bi-focal. It deprives the patient of depth preception and the ability to see at one place or another if one lens is lost. It is inexpensive (cost the same as single vision lenses) and easy to fit.
Bifocal contact lenses give one depth preception and the ability to see both near and distance with either eye and both eyes together at both near and far. There are now many types of these in both rigid and soft. Most rigid lenses are custom made (usually in a lab.)

In the days when I made lenses we turned them on a lathe and polished and edged them. Now most are molded.

Chip

**Sheryl** · 08-03-2006, 04:51 PM

My lenses are multifocal, but at the same time the left lens is more for near vision and the right lens more for distance. They seem to be a combination of what you're talking about. Both lenses are progressive, but the starting and ending points are different. Have you heard of this? My understanding is that my myopia and presbyopia (did I get that word right?) can't be fully corrected in a single teeny contact lens, so each lens takes it part way.

**Ory** · 08-03-2006, 05:29 PM

Originally Posted by Sheryl

My lenses are multifocal, but at the same time the left lens is more for near vision and the right lens more for distance. They seem to be a combination of what you're talking about. Both lenses are progressive, but the starting and ending points are different. Have you heard of this? My understanding is that my myopia and presbyopia (did I get that word right?) can't be fully corrected in a single teeny contact lens, so each lens takes it part way.

You are doing what is called modified monovision. It is not as much of a compromise on depth perception as regular monovision is.

**llal98@aol.com** · 08-03-2006, 06:20 PM

Sheryl, can you let me know who you went to? I'm in New York too, and I've been looking for a really good contact lens specialist.

Thanks,
Ann

**chip anderson** · 08-03-2006, 06:35 PM

Sheryl: You been lied too, bifocal contact lenses can correct both near and far vision "all the way." What you have is just one way of addressing the problem. Even "lined trifocal" lenses are possible.

**Happylady** · 08-03-2006, 08:32 PM

Well I tried the multifocal Pure Vision and went back to my mono vision. They gave me good room distance vision but my very far distance was not as good as with my mono vision and my close vision was not as good either.

It just shows that different things work for different people.

**Sheryl** · 08-03-2006, 09:44 PM

Originally Posted by chip anderson

Sheryl: You been lied too, bifocal contact lenses can correct both near and far vision "all the way." What you have is just one way of addressing the problem. Even "lined trifocal" lenses are possible.

Nobody "lied" to me. Geesh. As I said, I was making a guess that this is why she approached it this way.

If this isn't the reason, then what is? Why do it this way when it could be done all the way within each lens? There must be some advantage or why would she do it?

**Sheryl** · 08-03-2006, 09:50 PM

Originally Posted by Happylady

Well I tried the multifocal Pure Vision and went back to my mono vision. They gave me good room distance vision but my very far distance was not as good as with my mono vision and my close vision was not as good either.

Perhaps this is why the contact lens specialist I went to is using the approach of relying on one eye more for far vision and the other more for near vision. My distance vision is perfectly corrected right now, and I can see near but with strain, as I said. The new left lens she is mailing to me will improve my near vision at the expense of the far, but I'm not sure how much the far vision will deteriorate. Not very much, I don't think. I expect I'll still be able to drive, but we'll see!

I can live with wearing reading glasses over the contacts for extended close work, but I'd trade 20/15 far vision (which is what I correct to) to 20/30 or 20/40 if I could toss the reading glasses.

**Happylady** · 08-04-2006, 11:46 AM

Originally Posted by chip anderson

Sherrl:
One eye for near and one eye for distance is called "monovision" it is neither progressive or a bi-focal. It deprives the patient of depth preception and the ability to see at one place or another if one lens is lost. It is inexpensive (cost the same as single vision lenses) and easy to fit.
Bifocal contact lenses give one depth preception and the ability to see both near and distance with either eye and both eyes together at both near and far. There are now many types of these in both rigid and soft. Most rigid lenses are custom made (usually in a lab.)

In the days when I made lenses we turned them on a lathe and polished and edged them. Now most are molded.

Chip

I wear mono visiona and my depth perception is just fine. Yes, it is slightly better with two distance lenses but it is still good with the mono vision.

I have tried many multifocal lenses and none give me as a good a distance correction as my mono vision. It is true that if I lost my right contact my distance would be blurry but my distance correction is only a -2.25 so it isn't a huge concern. I also carry a pair of glasses in my car just in case.

**Sheryl** · 08-04-2006, 12:25 PM

I'd like to understand why the two eyes have different ranges meant to combine for full range, instead of putting the full range in both eyes equally (as Chip said could be done). There must be a reason she did it this way. Maybe I should ask her.

**chip anderson** · 08-04-2006, 01:26 PM

Sheryl:
I didn't say it should not be done this way. It's just one way of doing things. Some companies, intentially market thier lenses this way as a fitting "method". It's just that other methods are available. What ever you and your practioner get to work for you is good.
I have just had too many "precribers" tell patient's that bifocal and trifocal contact lenses: "They don't make 'em." or "They don't work." If the _._._. doesn't want to do this work for whatever reason, It would seem to his and his patient's benefit to refer this to an independent optician, he wouldn't loose a patient and the patient would be well served. But perhaps it's a case of his ego saying: "If I can't do it, there's nobody better than me, so no one can do it."
Of course this is silly as the independent optician does not have the knowledge or capability or doing most of what the O.M.D. or O.D. does and a lot of us don't even want to do.

Chip

**Ory** · 08-04-2006, 01:50 PM

Originally Posted by Sheryl

I'd like to understand why the two eyes have different ranges meant to combine for full range, instead of putting the full range in both eyes equally (as Chip said could be done). There must be a reason she did it this way. Maybe I should ask her.

The lenses you have use a method called simultaneous vision. Essentially they are designed to let you see both near and far at the same time. I don't have the info with me right now but I believe they are designed in the following way: The centre of the lens is for reading and then after a couple of millimetres it gradually changes the power to your distance power.

The reason you may have trouble getting sharp distance and near at the same time in both lenses is that making a large change in power compresses a large power change in a small area. By making one eye skewed for distance and one for near we can have a smaller overall power change per lens and hence make the vision sharper.

What Chip is describing I assume is a translating RGP, a hard lens with obvious distance and near parts to it. The reading part can be as strong as the prescriber wants. When you look down the lens slides upward and you look through the lower (reading) part of the lens. A soft lens like you are wearing will not move in this way and that is why we must use simultaneous vision.

Hope this explains things a little better.

**Sheryl** · 08-04-2006, 03:40 PM

Thanks very much for the explanation, Ory. That's just what I was wondering about.

**Sheryl** · 08-05-2006, 04:20 PM

I got the new left contact lens in the mail just now. I'm typing this message with no reading glasses on. I can see the computer, and so far I don't think I'm getting a headache.

The contact lens specialist I went to told me that my distance vision would be worse with the near vision better corrected, but I can't detect a difference. If I cover my right eye things are blurry far, but with both eyes open I seem to be looking only through my right eye.

When I first became myopic (decades ago), my right eye got very bad while my left eye had nearly perfect vision for a long time. At one point I was in vision training because my eyes were not working together quite right - I'd gotten so used to only looking out of my right eye. Maybe my brain is just used to suppressing blurriness in my left eye - I don't know. But this is working well for me. So far, anyway. I've only had the new lens in for about 20 minutes.