Contact lenses for presbyopia

Presbyopia is a condition where the eye gradually loses the ability to focus at a normal reading distance.  It is usually first noticed between the ages of 40 and 50 years when people find that they can no longer focus comfortably on objects closer than at arm’s length.  Presbyopia is not a disease and it affects everyone.  Presbyopia is usually corrected by reading glasses (which will make near objects clear but distant objects blurry) or multifocal glasses (which incorporate progressive lenses that provide clear vision at both distance and near).


Presbyopia can also be managed by prescription of contact lenses and many of our older patients (like me!) are discovering that the diagnosis of presbyopia does not have to mean that one is condemned to wearing spectacles for the rest of their life.  Contact lens correction of presbyopia has increased significantly over the past two decades.  A recent paper reported that 58% of contact lens patients over 45 years of age were prescribed some form of presbyopic contact lens correction with multifocal lenses (44%) being more commonly the preferred option over monovision (14%).


Monovision is where one eye is corrected for distance and the other eye is corrected for near.  The success rate with this mode of correction is high, with the main disadvantage being a slight reduction in depth perception.  Some monovision patients often require 3 contact lenses - 2 distance and 1 near - whereby they can alternate between a distance and a near contact lens in one eye, while always using a distance contact lens in the other eye.  This way they can be binocular for sporting and recreational tasks while retaining the use of monovision for work and social occasions.


Multifocal (and bifocal) contact lenses that attempt to correct distance and near vision with the same lens.  Disposable soft multifocal contact lenses utilize the simultaneous vision principle, whereby the distance and near zones of the lens are positioned over the pupil continuously.  The major problems with this type of design are patient adaptation and loss of contrast, both as a result of the simultaneous presentation of the distance and near images.  Despite this, the success rate with disposable soft multifocal contact lenses is also quite high and there are now even daily disposable multifocal lenses available that offer great convenience and excellent vision at both distance and near for patients like yours truly.


We also understand that many of our patients will be unsure if they are suitable for a presbyopic contact lens correction.  Fortunately we have access to a large range of diagnostic disposable single vision and multifocal contact lenses, and this allows our patients to trial the various presbyopic contact lens modalities to work out what option (i.e. monovision or multifocal contact lenses) – is best for them.