Considering many changes that take place in our bodies as part of the normal aging process, one of the most predictable and often considered signs of middle age is the onset of presbyopia. This is a widespread, progressive disadvantage of the ability to keep the eyes focused at a close reading distance. The onset age is usually from the late ’30s to the early 40s. There are exceptional exceptions, and some people manage to keep up until the 50s. Ultimately, however, we all have to accept this increasingly apparent complexity. This problem can be especially troubling for those with contact lenses fixed by now. After more than 32 years of helping patients, family, and friends cope with this change, I would like to offer some simple observations and suggestions for keeping contact lenses as an active option. These observations are related to those who wear hard and soft contact lenses, but now the majority of those affected have probably been wearing soft contacts since the 70’s or 80’s.
Deceptive – pretty simple
Most contact lens wearers, especially those involved in recreational or competitive sports, are strongly advised to stay with their current distance correction lenses and only for visual purposes. Use cheap, commercially available reading glasses. Reading help in the early stages of presbyopia is usually only needed for specific situations, such as low light in restaurants and theaters or tiny printed details, such as maps and medicine bottles. As reading problems get deeper, other options, such as multifocal contact lenses, can be explored with age. The use of plain reading glasses maintains good distance vision from older contact lenses and efficiently provides close-up vision. As the presbyopia deepens, readers will need more vital forces, and different troops will be required for different working distances. Reading a 16-inch book requires a more robust reading lens than working on a 22-inch computer monitor. Scammers are everywhere, and it can be a fun fashion item. They are also available in the design of protective glasses and sunglasses.
Monovision – History Revised.
Old photographs of historical figures wearing monoculars reflect the vision correction that is still widely used today, especially those wearing contact lenses. As a result of the prolonged absence of available multifocal contact lens options, patients and their ophthalmologists began looking for ways to treat presbyopia without ugly reading glasses. Correcting vision for distance in one eye and reading in the other eye is called monovision. This ancient technique is straightforward to try, especially with modern soft contact lenses, but most patients who try it do not tolerate it. Monovision will interfere with normal telescopic vision and visual understanding, and perception of depth. People who can accept imbalances perform surprisingly well over many years. Monovision should never be used by people who need maximum distance vision and binoculars, such as commercial drivers, pilots, or, more precisely, professionals involved in near-depth work. A simple trial in an ophthalmologist’s office can determine if this application is valid or not.
Multifocal contact lenses – get there slowly.
Multifocal contacts have been available in complex contact lens designs for over fifty years. Still, until the recent explosion of availability in soft lens configurations, they have been a viable option for a large population of emerging press biopsy. All major soft contact lens Canada makers have entered the multi-focal market. Lenses are available in a variety of materials, both traditional everyday wearers and new, oxygen-permeable silicone materials. Multifocal lens options are now available to even the rudest patients. Virtually all new multifocal designs use a feature called simultaneous vision, in which the eye sees from both the distance and proximity of the lens at all times. Different companies test different combinations and arrangements of the two optical zones, but there are significant similarities in all the designs. In practice, this means that two separate power zones inevitably get in the way of each other.
Visual acuity when driving at night
The most common problem reported by my patients is a significant decrease in visual acuity when driving at night, with an alarming amount of light flashing around. This results in an extended, dark-sloping bridge that allows more light to enter the two opposite zones of the contact lens. Some patients are better able to cope than others. I have had some significant success using a modern form of monovision, with only a distance lens on one eye and two focal points on the other. Includes fitting multifocal contact lenses.