Multifocal Contact Lenses Have Advantages vs. Monovision – Just when he thought it could not get better!

7th March, 2010 - Posted by Dr. S. Barry Eiden - 6 Comments

Jim had not been seen at our practice for over three years but he decided to travel the 35 miles (in the Chicago area that is very far!) to be seen at our practice in order to obtain what he found to be superior eye care when compared to what he experienced in his neighborhood during his last two annual eye examinations.

Jim has been wearing contact lenses for many years and ever since he noticed his near vision deteriorating he began to wear monovision contact lenses (one lens fit to provide far vision and the other eye’s contact lens fit to provide near vision). This is by far the most common method to address the age related deterioration of near vision called “presbyopia”. It requires no special type of contact lens, is no more complicated to fit than traditional lenses, and is generally accepted visually by over 60% of patients. However, it is not the optimal way to correct vision and results in a loss of binocular vision (two eyes working together). Jim, now 58 years old,  reported that the near contact lens power had to be increased over the past few years to continue to provide him with clear near vision. He did state however that he could tell that the two eyes were becoming more imbalanced. He specifically noticed a problem with mid-range vision (store shelves, computer work, etc.).

Our solution to his problem was to fit Jim in a new form of multifocal contact lens. This lens provides multiple focus points such that the imbalance between the two eyes that Jim was experiencing with monovision was dramatically reduced. With his new multifocal contacts his dominant distance vision eye was still sharp and clear for far away objects but  now had crystal clear intermediate mid-range vision and fairly clear near vision. His habitual non-dominant eye that he wore a near contact lens on was again still able to maintain clear vision for near point, but once again he now could get very sharp vision at mid-range and his distance vision was dramatically improved in this eye compared to his former monovision contact lenses.

Bifocal gas permeable contact lens Aspheric multifocal contact lens design

There are many designs of multifocal lenses now available (soft, rigid gas permeable, hybrid combination lenses, and even for those with keratoconus or those requiring large diameter scleralcontact lenses). Almost all patients are able to be successfully fit in multifocal contact lenses of one sort or another. Monovision contact lens wear is now a last option for our contact lens wearers. Why would anyone not want to have clear binocular vision vs. monovision? I can’t think of why.

Why is it that most doctors still only fit monovision? Primarily because the fitting of multifocal contact lenses is more complex and takes greater experience and expertise on the part of the doctor. In addition, the time involved in fitting multifocal contacts is greater than monovision. To be honest, it is more of an effort on the doctor’s part and those with limited experience have significantly lower success rates. So, they tend to stay with what is easiest and most comfortable, and that is monovision fitting. However, there are more and more eye care practitioners who have embraced multifocal contact lens fitting and present this as the initial option of choice to their patients.

Make sure your eye doctor presents you with all options available for multifocal contact lenses and prescribes for you what is best for your individual case.

For more information on multifocal contact lenses, please visit our website and our section on contact lens specialty services at: www.nsvc.com

6 Comments

Robert Wichers

March 20th, 2013 at 6:53 am    


I am 52 years old and never had to wear glasses or contacts. I went to a very experienced contact professional in NYC where she just specializes in all contacts. I have an astigmatism so she has been patiently trying to fit me with the Coopervision Toric Progressive lens contacts. We have tried several trials and my eyes still see all blurry in them. Somehow my eyes are blurring all the rings together. She now suggested we try the Coopervision toric monovision contacts as an option. We are in the process of trying to get a good fit. Based on your article am I going backwards in time to Monovision contacts and will I be able to see the computer screen. Now I’m so depressed and confused. Any insight…thanks Rob

Dr. S. Barry Eiden

March 21st, 2013 at 11:56 am    


Robert:

Fitting a multifocal toric case like yours is one of the most complex of cases with a lower success rate vs. other cases. The Cooper ProClear Toric Multifocal is the ONLY toric multifocal disposable lens on the market, however there are many “custom” design soft toric multifocals manufactured by smaller custom laboratories that are either annual replacement, or can be done for semi-annual or quarterly replacement. One of those designs might work if you are appropriate for less frequent lens replacement. Of course other options also exist such as gas permeable multifocal designs and hybrid lens multifocal designs. So, in summary there are other options to consider before “backing” into monovision. Discuss with your doctor. Good luck!

Adriana

August 1st, 2013 at 4:26 pm    


I recently was presented with monovision option after 25 years of glasses. I am one week into adjustment and near vision is very compromised. No other options were presented. I suspect I was offered was was easiest for the (young) doc, not what might be best for me in the long run.

How do I find an experienced multifocal practitioner in Atlanta?

researching contacts

October 1st, 2013 at 8:24 am    


@Robert – I’m not sure if this helps but I have a severe astigmatism and the Acuview soft lenses for astigmatism worked well for me (though I haven’t tried cooper lenses).

Dr. S. Barry Eiden

October 25th, 2013 at 6:16 pm    


sorry for the delay in response, one idea is to contact a respected multifocal laboratory in the area. In Atlanta you can contact XCell contact lens labs

Dr. S. Barry Eiden

October 25th, 2013 at 6:27 pm    


Unfortunately Acuview lenses for astigmatism (either Oasys or Advance for astigmatism designs) are not multifocals, the only toric disposable multifocal currently available is the ProClear Toric Multifocal from Cooper Labs, although the word within the profession is that Biofinity Toric Multifocal will be coming to market within the next year.

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