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Thread: What to do when monovision CL's dont work anymore?

  1. #1
    OptiBoard Apprentice Steelerfan's Avatar
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    What to do when monovision CL's dont work anymore?

    So... it seems to be a thing in my shop lately that I'm getting these long time monovision CL wearers that can no longer make it work for close work, computer distance, and distance vision. I have tried in a trial frame to compensate for the desparity of the power correction in the conatacts with a pair of intermediate glasses over the monovision cl's. The one woman I tried it on, did not accept it. Her I ended up switching back to true distance contacts and an office progressive with plano in the top. I'm just wondering if anyone hs had success compensating for a near lens and a far lens in a reading RX over the top.

    Example: Monovision CL Rx is

    OD -4.25 (Distance)
    OS -3.50 (Near)

    Glasses Rx is:

    OD -4.25 -.25 x 085
    OS -5.25 sphere
    Add +2.25 OU

    So my first attempt was a pair of computer readers with +1.25 in the right and a -1.25 in the left. She couldn't tolerate it. Is my thought process correct?

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    That's why they make bifocal and trifocal contacts! Your skaret or something?

    Chip
    Last edited by chip anderson; 06-30-2008 at 04:54 PM. Reason: Trifocals

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    Is it November yet? Jana Lewis's Avatar
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    Quote Originally Posted by Steelerfan View Post
    So... it seems to be a thing in my shop lately that I'm getting these long time monovision CL wearers that can no longer make it work for close work, computer distance, and distance vision. I have tried in a trial frame to compensate for the desparity of the power correction in the conatacts with a pair of intermediate glasses over the monovision cl's. The one woman I tried it on, did not accept it. Her I ended up switching back to true distance contacts and an office progressive with plano in the top. I'm just wondering if anyone hs had success compensating for a near lens and a far lens in a reading RX over the top.

    Example: Monovision CL Rx is

    OD -4.25 (Distance)
    OS -3.50 (Near)

    Glasses Rx is:

    OD -4.25 -.25 x 085
    OS -5.25 sphere
    Add +2.25 OU

    So my first attempt was a pair of computer readers with +1.25 in the right and a -1.25 in the left. She couldn't tolerate it. Is my thought process correct?

    Multi-focal contacts maybe?
    Jana Lewis
    ABOC , NCLE

    A fine quotation is a diamond on the finger of a man of wit, and a pebble in the hand of a fool.
    Joseph Roux

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    If anyone ever bothered to read almost any CL contact lens fitting manual, almost all say that monovision is unsatisfactory for patients with over a +1.50 add. So why not fit multifocals to begin with, then you don't have to re-fit, just up the add when the patient ages?
    Besides anyone can fit SV lenses, especially in soft, so why not do something he won't get and discount contact lenses Inc.?

    Chip

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    Just last week I fit a patient with +1.25 OD/ +3.50 OS with no worries--her spec RX is +1.25 OU (well, a quarter astig. in one eye but who cares), with a +2.50 add. She's overjoyed, and I know she's overjoyed because she's my girlfriend and I therefore have to hear about the contacts every day. Every patient is different, is my point--but what Chip said I find generally to be true. I'd generally try multi-focal before monovision regardless of add.

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    Quote Originally Posted by chip anderson View Post
    If anyone ever bothered to read almost any CL contact lens fitting manual, almost all say that monovision is unsatisfactory for patients with over a +1.50 add. So why not fit multifocals to begin with, then you don't have to re-fit, just up the add when the patient ages?
    Besides anyone can fit SV lenses, especially in soft, so why not do something he won't get and discount contact lenses Inc.?

    Chip
    Yes, and drk agrees. MF CLs or PALS.

  7. #7
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    Have you tried multifocal contacts on these patients? Some people do well with them, but for some people like me they aren't any better then monovision. They are worth trying, though.

    I'll tell you what works for me. I wear monovision contacts and my add is +2.25. But what I do is not try to get my full reading correction in my reading contact, I under correct it by about .75 diopters.

    I recently gave multifocals another try. I wore Purevision multifocals for about 2 months. With my Purevision multifocals I still used my right eye for distance (low add) and my left eye for near (high add). I couldn't read with my right eye and my distance with my left eye was barely one line better then with monovision. Reading was not as easy as with monovision.

    Any yes, I've tried other multifocal contacts. If I can read with them the distance is blurry, if I can see distance with them the reading is blurry.

    By undercorrecting my reading with my monovision, I get good intermediate and fair distance with that eye. I can read reasonably well but if I want a little more help I just wear over the counter readers. The readers have the same power in both eyes but they work fine over the contacts.

    Sometimes a 1/4 diopter change makes a huge difference. Try adjusting the reading contact a little and see if that helps.

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