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Multifocal contact lenses: the presbyopian cure?
Old 02-26-2008, 12:45 AM   #1
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Multifocal contact lenses: the presbyopian cure?

This is a long story of despair and desperation, sinking into a pit of frustration with no hope of recovery. Indulge me in helping some of you to understand the victim's mindset before you can appreciate my discovery that salvation may be at hand. The rest of you can tell me if it really is at hand.

Spouse grew up with terrible vision and coke-bottle classes. My eyes weren't as bad yet since the age of three I wore glasses for 30 years, too. I'd occasionally considered contact lenses but in my early 30s my eyes changed to the point where I could read without glasses. Hallelujah!

Spouse, however, continued with nosemarks and sore ears from the 1970s fashionable big-lensed frames. About 25 years ago she tried wearing soft contacts and she finally discovered orthokeratotomy through the naval aviator's grapevine. Once her eyeballs were reshaped to about 20/50 she continued to wear prescription gas-permeable lenses. She had problems back then with the lenses popping out, trapping dirt/eyelashes, and wandering around under her eyelids. But she said it was worth it to be able to see the way to the bathroom in the middle of the night without fumbling for her glasses. Over the last five years the gas-permeable lenses have become much healthier, need little or no cleaning, and she's had far fewer problems. Hallelujah!

I was glad that I didn't have to wear glasses or contact lenses and she was glad that she didn't have to wear glasses. Life was good enough that neither of us would ever consider paying a laser-wielding quack doctor to hack on perfectly good eyeballs. And then... a few years ago we were involuntarily converted to presbyopians.

As some long-term board members are aware, I'm not taking this well. One of my childhood memories is of my father's rampages around the house grumbling "Where the #$%^ are my @#$^ing reading glasses?!?" when he'd forgotten that all the while they were pushed up on top of his head. I had decided that I would never be "one of those people" whose eyes would ever get that bad and I couldn't imagine that I'd ever need reading glasses for the rest of my life like my father. This Freudian complex is also one heckuva reminder of impending mortality. Ick.

I think a special corner of hell should be reserved for the opticians who label the strength of reading glasses in tiny two-point font on the frames where (1) the numbers keep wearing off, and (2) you need reading glasses to see how strong your reading glasses are. However for the last few years I've bitched, moaned, and whined dutifully acquired reading glasses, carrying cases, magnifying glasses, reading lights, and the rest of the crap presbyopian paraphernalia.

Before it happened to her, spouse snickered behind her contacts for the first few years of my misery coping-- although at least she had the decency to do it quietly. But then last year the same presbyopian phenomenon blitzed her and in a matter of months she was upgrading from 1.25s to 1.75s. She still had trouble remembering to leave the house with her "visual aids" and she'd get busted publicly putting papers on the floor to read or borrowing other people's glasses. Ick.

I've settled out around 2.00 but I've heard that it's just gonna get worse. I've researched RPK & LASIK but I'm squeamish concerned about the risks and waiting for the next miracle surgical cure. The problem is that now I can't focus on my dinner plate or the refrigerator shelves, I keep dropping my glasses in the yard or sitting on them, I keep bobbing my head around the frames to look at distant objects, and I'm always scratching the lenses. I occasionally screw up paperwork or labels because I'm too pigheaded much in a hurry to put my glasses back on to check. And, yes, I've started roaming the house, muttering & looking for the glasses I have stashed in every room, only to find the "wrong" pair on my head.

I'm so deep in denial that I can no longer read the car's numbers on the odometer, and the other drivers are I'm lucky that I have the speedometer display color-coded & memorized. I hit rock bottom a couple months ago when I was getting a duplicate driver's license and the clerk handed me the form while saying "Verify, read, & sign". I didn't know if I'd still keep a full license if they saw me whip out my reading glasses-- so I asked to use the water fountain, scampered around the corner, and took care of it in the waiting room. I'm pretty sure they thought I was illiterate, but at least they thought I could see! However my luck is about to run out-- I have to get an eye exam with my next license renewal in just eight months.

I've been glumly waiting for surfer's cataracts to appear so that I have an imperative to get artificial lens implants. Spouse, meanwhile, was going through her presbyopian adjustment with less drama trauma. She quietly decided to investigate bifocals and eventually found Costco's multifocal contacts. She had an exam a couple weeks ago, paid $285, and picked them up this morning. I haven't been paying much attention because I don't wear contact lenses and I didn't see how this could apply to me.

Spouse returned from Costco, burst into the house, did a Flying Springsteen across the room, and shouted "Hallelujah, I can SEE!" She says her eyes immediately adjusted to the multifocal gas-permeable lenses and her entire body relaxed in relief. She's wearing pretty much the same contacts she's worn for the last 20 years only now they're multifocal, her face doesn't squinch up to focus, and she doesn't have to wear reading glasses. She's spent the whole day gathering her glasses for Goodwill while spontaneously breaking out into song & dance and shouting "Hallelujah!!" Her latest affront has been telling me that she actually read the recipe card while making dinner. I can honestly say that it's been decades since I've found her so annoying.

Well, I'm not as stupid as I've been and I'm finally "seeing" my own light. I have an appointment with the Costco optometrist next week, and with their concurrence I'll be learning how to wear gas-permeable multifocals.

Heck, I've spent over $300 on reading glasses in the last five years. And I can wear goggles over contacts when I'm surfing. I'm not ready to confront surgery and I may never be ready, but I think I can handle contacts.

For those of you who've suggested contacts to me before, I apologize-- and this time I'm really gonna do something about it.

Anyone else have any problems or advice with multifocal contacts?
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Old 02-26-2008, 03:30 AM   #2
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I have tried them twice but for me they do not work. I may try again.
Good luck!
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Old 02-26-2008, 03:51 AM   #3
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I have used them. There are several patents and a couple of different approach. I have been told that some type of Multi-focals work better than others. Mine are SofLens Multifocal by Bausch and Lomb. This type/brand works well for me. These look like a dot in the center of the lense (but the power graduates)

DW had the type that has concentric rings radiating out from the center. They did not work well for her. She has almost a year supply just sitting there. I guess after using them for a month or so, she decided she did not like them. She uses them occasionally.

I am near sighted. My vision is not very bad. I can read just fine, have a little problem with distances. I needed to get the multifocal because I could not read with my single vision contact lenses in... to much eye strain.

My multifocal contacts work fine but they are not perfect. I noticed one small problem, a very small (slight) shadow on small text around the letter. I can tell the difference when I have them out. I was told this is very common.

You will probably be sold a single pair to wear for a week or two and see how they work out. I did this and had to tune the prescription a bit in one eye. Then another week of trying it. I ordered a bunch.

Lately, I have reverted back to single vision glasses. I only wear them for certain distance activities like driving.
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Old 02-26-2008, 04:29 AM   #4
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No experience with multifocals, but I've been wearing contact lenses since the early '80's w/o problems. Uncorrected, my right eye can't see the big "E" at the top of the chart but is correctable to 20/15. Go figure. With contacts in I use reading glasses.

Let us know how the multifocals turn out for you.
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Old 02-26-2008, 06:48 AM   #5
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If contacts and glasses are both bothersome for you, it is possible to ask your doctor for the lens replacement surgery even if you don't have cataracts. I had one cataract, and had the surgery on both eyes for a couple of reasons: 1) doc said eventually the other eye would probably develop a cataract, and 2) the balance between the surgically corrected eye and the mechanically corrected eye (glasses/contacts) would not be very good. As far as my vision goes, its the best thing I ever did. The surgery is painless (scary to start with for the squeemish, but not bad), recovery is quick, and the results have been great. I got the ReStor lens, but somewhere on another thread ReZoom was mentioned as a good brand and that ReStor in one eye with ReZoom in the other could be helpful to cover all lighting situations. (ReStor works by having concentric rings in the lens with different powers). The only problems that I have had are mid-range (think reading a GPS in the car at 2.5 feet or price stickers in the store at 2-5 feet), and low light reading (think reading a menu in a candlelit restaurant). For these situations I have a pair of progressive bifocals (multifocals) that I use (rarely).

The problem will be paying for them, your insurance won't if you don't have cataracts. For mine, I had to pay $500 per eye because the ReStor were more than the insurance would pay. If I did not have insurance or paid for non-cataract lens replacement, the price would have been $2500 per eye. This was in 2005.

....for what its worth....

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Old 02-26-2008, 10:39 AM   #6
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Bifocal Contact Lenses For Presbyopia: A Complete Guide to Bifocals - AllAboutVision.com

Bifocal contact lenses have been around for many years, but until recently they weren't very popular. Older bifocal designs didn't satisfy many people, leading to frustration among wearers and prescribers alike.


Today, new technology has produced more successful designs, as well as a greater variety of designs. So if one design doesn't work for you, another might. Your doctor may also try these related techniques:
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Old 02-26-2008, 01:23 PM   #7
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Since I was about ten years old, my uncorrected vision was about as bad as it could get with severe astigmatism in the left eye. I wore hard contacts from the age of 16 and switched to the gas permeable hard contacts at about age 38. I preferred wearing contacts, even though they were very uncomfortable, to my glasses as the lenses in the glasses were thick and I couldn't wear anything but the larger frames to accommodate the curved lenses. In my 40s, I used monovision contacts, with one prescription for distance and the other lens for reading. It worked ok, but it threw my depth perception off. Multifocal contacts weren't an option for me as I couldn't wear the soft contacts in the first place due to the level of astigmatism.

After researching the topic for several years, I finally got up my nerve to have lasik surgery five years ago. I went to Canada to have the procedure done by the most experienced surgeon, the guy who introduced lasik to North America. Overnight my vision went from 20/400 to 20/15 and my astigmatism was completely eliminated. I had the option of having one eye corrected for near vision and the other for distance -- again, monovision -- but elected to have both corrected for the distance vision. So now I do have to wear 1.0 readers, particularly when my eyes are tired, but the lasik surgery literally changed my life. Not a day goes by that I don't marvel at what this surgery has done to improve my vision.
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Old 02-26-2008, 01:59 PM   #8
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I wore monovision contacts for years before I got the lenses implanted .I tried the bifocal contacts and did not have any luck with them but no problem with monovision ( one eye for close and one eye for distance ) . A few years ago I went to have lasix surgery but since I was developing cataracts they would not do it . Two years later I had cataract surgery and monovision implants .What a pleasure to not have to bother with glasses .
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Old 02-26-2008, 04:05 PM   #9
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i never tried bifocal contacts but i tried the bifocal glasses & hated them. i also tried differing strength contacts (one eye for distance, the other for close-up). i couldn't tell the difference between a cop & a taxi and the way i drive, well, i need very good vision.

my contacts now are perfect for both long distance and midrange. i work on the computer best with contacts on. when i want to read (not on computer) for a short time i use cheaters over the contacts and when i want to read for extended periods i take the contacts out.
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Old 02-26-2008, 04:11 PM   #10
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If you (or your father) have/had a tendency to leave your glasses pushed up on your head, why not look there first?
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Old 02-27-2008, 12:59 PM   #11
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I've tried progressive bifocals twice (glasses not contacts), but both times there just wasn't a large enough area devoted to the reading prescription. I had to keep the current line of text at the absolute bottom of the lens or only a portion of the line could be in focus at one time. I wonder if these types of glasses work for the general public only because most people don't read much.
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Old 02-27-2008, 01:07 PM   #12
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Quote:
Originally Posted by TromboneAl View Post
I've tried progressive bifocals twice (glasses not contacts), but both times there just wasn't a large enough area devoted to the reading prescription. I had to keep the current line of text at the absolute bottom of the lens or only a portion of the line could be in focus at one time. I wonder if these types of glasses work for the general public only because most people don't read much.
I wore progresive lenses for years before I got my implants and I read constantly .
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Old 02-27-2008, 01:49 PM   #13
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Quote:
Originally Posted by TromboneAl View Post
I've tried progressive bifocals twice (glasses not contacts), but both times there just wasn't a large enough area devoted to the reading prescription. I had to keep the current line of text at the absolute bottom of the lens or only a portion of the line could be in focus at one time. I wonder if these types of glasses work for the general public only because most people don't read much.
I have worn progressive lense glasses for years, read a lot, and have the following observations:

1. When I first started wearing progressive lenses I had verilux lenses (which at the time were the best) and the reading strength was very low. Excellent results. BTW, fashion then was for fairly large size lense glasses (not those huge ones, though). Also, I learned to "point my nose" at what I was reading. Also, the doc suggested that I train myself to blink as I switched from distant objects to those close up. Worked...eventually my brain adjusted and the transition became normal, but the blinking did help.

2. Next pair had stronger reading RX and the size of the lense in my new glasses remained about the same. I was already used to pointing my nose at what I was reading, but now I had to be careful to position the reading material stratigically so I could focus. Still OK.

3. Next pair of glasses had a little stronger reading RX, but fashion was calling for smaller lenses in the glasses. That's when the fun reallly started. The reading portion of the lense is at the very bottom of the smaller lense, and if the lense is too shallow (measuring in the direction of eyebrow toward cheek, there is no viable space for the reading portion of a progressive lense. The Doc and I went round and round about this...me claiming that there must be something wrong with the lense because I used to be able to read across an 8.5" page without too much movement of my head, while now it is a challenge to read a across a paper back book. That's when he said something...probably out of frustration with me...that really explained a lot to me. He said that the stronger the reading RX, the smaller the reading area would be on the lense. So, I found a reasonably fashionable pair of glasses and have been OK. I am considering having a pair of glasses made that has my reading RX in the whole lense for when I am reading for an extended period of time...I like to read in bed and it is awkward trying to position my head on the pillow and keep my glasses in the right position to see the text.

4. I have allergies pretty bad and have to put drops in my eyes to keep them from itching. I also have dry eyes. I have not tried contacts in years...last attempt was unsuccessful. I have not had the courage to try it again. My RX is not severe, but I have an astigmatism and have no tolerance for the normal plus or minus of most lenses. So I am probably going to have to wear glasses until some whiz-bang procedure comes along. Sigh.
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Old 02-27-2008, 02:05 PM   #14
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I just went the whole route with contacts and bifocals. It was years before there were contacts I could wear to correct my astigmatism, they worked fine until I reached the age I needed reading glasses. Until a year ago drug store readers over my contacts were great (and condoned by my dr) for reading and computer work. This past year things have changed and I need a stronger script for reading, I tried the progressive (no line) bifocals, made me sick, dizzy and were just impossible for me to wear. I did my best but after 2 months I gave in and had them make that pair into regular bifocals, they're fine for reading but I cannot adjust my computer chair or monitor enough to not put strain on my neck. The next step was to have a pair of reading glasses made for computer work, so far they are fine except I'm constantly changing glasses every time I get up from my desk. Now I carry three pair with me, bifocals, distance and reading, it's frustrating as all heck but not enough for me to subject myself to lasers or surgery.
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Old 02-27-2008, 09:41 PM   #15
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Both my DW and I have the bifocal lens done by a Costco opthomologist. My wife had two colleagues in the office try but finally my doc had to intervene to get it right. Fitting Bifocal lens are as much art as science. It is good that your DW doc got it right the first thing. My lens are Golden Eye. I have no problem with them and they work fine for all general use except when the light is real low or there is limited contrast--then it is out with the readers.
Definitely makes reading the speedometer easier as well as seeing the number you are putting in your cell.
I am about to have Cataract surgery so will soon no longer need contacts but am glad I paid the premium for the bifocal lens
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Old 02-29-2008, 02:08 PM   #16
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I started wearing monovision gas permeable contacts ~17 years ago. I have night driving glasses which have a neutral lens for my distance eye and correction to provide better distance vision for my close/reading eye. I experience a few seconds of out of focus close vision when I first put the glasses on. I wear progressive glasses when I take my contacts out. A few years ago I tried bifocal contacts to no avail. My optometrist allowed me 4 fittings and I could never get satisfaction. I am sticking with monovision as I nervous about eye surgery.
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Old 02-29-2008, 03:16 PM   #17
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Recently I went up to a 2.75 correction for reading. For some reason, this has made the progressive glasses less useful for me. I have always kept a pair of reading glasses for extended reading, but I needed the progressive lenses for quick reads, and for computer work, and so I can read the speedometer in the car. The new prescription is great for close up work and for reading glasses and is great at a distance, but somehow I got shorted on the middle distance vision. I am concerned that I am going to have to get computer glasses too. Yuck.

I thought about mucking around with my prescription and guessing on what I would use for the computer and ordering a pair of those 8.00 glasses from www.zennioptical.com. I got readers from them for 8.00 plus five bucks shipping and they work great. (I learned from them that you make a reading glasses prescription by deducting the amount of your close vision prescription from you long vision and narrowing the pupillary distance by 2 or 3mm) I am wondering if I changed the strength of my readers by maybe .25 or .5 and increasing the PD if they would work for computer glasses. Anyone know? Any secret optometrists on the board?
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Old 02-29-2008, 05:58 PM   #18
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One option for those who have problems with computers: get a big monitor. I recently started using my 40" 1080p HDTV as a computer monitor on my desk. I found that I naturally sat further back, and so my eyes feel less strained. It also helps to have a deep desk so you can place it far away.
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Old 02-29-2008, 10:04 PM   #19
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Al, thanks for the link to that article. It's hard to find "objective" comparisons among the various vision systems. Spouse thinks she has the concentric lenses but even she couldn't find a handy spec sheet. We'll learn more at the optometrist next week.

Quote:
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Recently I went up to a 2.75 correction for reading. For some reason, this has made the progressive glasses less useful for me. I have always kept a pair of reading glasses for extended reading, but I needed the progressive lenses for quick reads, and for computer work, and so I can read the speedometer in the car. The new prescription is great for close up work and for reading glasses and is great at a distance, but somehow I got shorted on the middle distance vision. I am concerned that I am going to have to get computer glasses too. Yuck.
You're livin' my nightmare, so I guess it's time to find out about contacts while I'm still mostly in the high 1s.

I have a 21" monitor and sit about three feet away from it with the text set on the default size. I use 1.75s for that with no problem and for almost everything else. However when I'm reading a book or magazine, especially with a font size smaller than 10 points, then I need 2.00s and brighter light. If I accidentally wear the 2.00s with the computer monitor, it's too blurry.

It might be worth talking to Costco or your local drugstore about buying a pair or two of their various lens strengths, taking them home to try overnight, and returning the extras the next day.
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Old 03-01-2008, 03:31 AM   #20
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Don't fear surgery.

I had congenital cataracts along with some astigmatism. Was told repeatedly that surgery to remove the catatracts was not an option, since these types of cataracts are placed differently in the eye. Corrected vision was never better than 20/60, while uncorrected was 20/80 or so - inside and with proper lighting, but one eye was maybe 20/200 at best. Hated glasses, didn't wear them because they didn't do much good.

Generally stumbled around blindly all of the time.

With age, eyes became less flexible. Lost ability to drive at night and was loosing ability to drive in bright sun (I live in FL) and when moving from shade to light or the other way around, I couldn't see squat. It was pretty scary asking my 8 year old to tell me whether a car was coming before I pulled into traffic or when 6 to read the medicine bottle at 2 am to know if the dose was 1 or 2 tsp.

New surgical techniques and now cataracts are gone!!!!! (doc said it was the hardest surgery he had ever done - one of the lenses is gerry-rigged into place). Vision uncorrected is now 20/25 and I could wear glasses to get the last bit of improvement (but I don't bother). I walked around for 1 year amazed at what I could see and how different everything looked.

I was terrified of the surgery, did my bad eye first, since I figure I wouldn't loose anything anyway if it went badly. My only regret is that the surgical techniques were not available sooner.
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