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.
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