Q&A on Bifocal Eyeglasses,
Progressive Lenses and
Q: Why don't optical outlets explain to people that progressive addition lenses have huge areas to the right and the left of the focal points that give poor sight? It is not good for long or short distances. H.K., Nebraska
A: Progressive lenses have limited areas of "soft focus" in the periphery of the lenses to the left and right of the intermediate viewing zone, in particular. This is unavoidable when creating line-free progressive lenses. But over the years, new manufacturing technology has made these areas less noticeable.
Despite this minor limitation of progressive lenses, most people with presbyopia find progressives are more comfortable and provide more natural-feeling vision than bifocals or trifocals. Line-free progressive lenses also provide a more youthful appearance, which is another reason they are so popular.
For best results, be sure to have your progressive lenses fitted by an experienced optician. Proper eye measurements, frame selection and frame adjustments are essential to maximize your comfort with these lenses. Also, there are many progressive lens designs available, and some may be more comfortable for you than others, based on your specific visual needs. Ask your optometrist, ophthalmologist or optician for details. Dr. Heiting
Q: I just got my new glasses from my optician. They're fine except that in my right eye, where the bifocal line is, I'm getting a reflected image (upside down) of the TV screen. This is my third pair of bifocals, and I've never experienced anything like this problem before. Any opinions? My prescription is 8/11 diopters (8 in my right eye where the reflected image occurs). J.R., New York
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A: Go back to your optician. He or she probably can adjust your glasses to eliminate the reflection problem. If not, perhaps you need an anti-reflective coating, which I recommend with your prescription anyway. Dr. Dubow
Q: I wear trifocal lenses. I can read fine without glasses. Can I get bifocal lenses for distance and computer distance instead of trifocals for distance, computer distance and reading? I'm 57 and my eyes are healthy. J.F., Michigan
A: Bifocals and trifocals are a convenience to help people see at multiple distances without taking their glasses on and off constantly.
Sure, you can get bifocal lenses where the top is for far away and the bottom is for computer distance. But unless you hold your reading at the same distance from your eyes as your computer screen, they won't work for close up very well.
Your lenses must be prescribed to focus at the distances you use, and bifocals can only be made to focus at two different distances. Trifocals, on the other hand, focus at three distances.
You may want to consider progressive lenses that focus at almost 20 distances in a smooth transition from the center to the bottom of the lenses. And go ahead and read without your glasses if it feels comfortable to do so it won't hurt a thing! Dr. Dubow
[Read about computer glasses.]
Q: What kind of glasses do I need to play golf? The light hurts my eyes, and my current bifocals either get in the way, or if they are made smaller, I cannot see to read.
I have tried progressive lenses, but they do not help. What do you suggest, besides wearing several pairs or quitting golf? A.H., Texas
A: Tough question! What's your handicap? Never mind...
It sounds to me as though you'd be better off with more than one pair of glasses to handle all your vision needs. You may want to consider golf glasses with photochromic lenses and a bifocal that's big enough to read the score card but small enough so that it won't interfere with your swing.
Why not have multiple pairs of eyeglasses? You don't wear just one pair of shoes, right? Dr. Dubow
Q: I just heard about a new lens called Zeiss. Can you explain the benefits for bifocal wearers like myself? M.A., Louisiana
A: I assume you are referring to Zeiss progressive addition lenses. There are a number of very high-quality brands of progressives available to patients who need bifocals, Zeiss being one of them.
Progressives, in my opinion (as both a prescriber and a wearer!), offer much more natural and usable vision than bifocals or trifocals. With perhaps as many as 20 focal points (as compared with three in a trifocal), progressives allow you to pretty much see comfortably at most distances without excessive head movement. Most of my patients over age 40 wear progressives and are very happy. Dr. Dubow
Q: I have bifocals that I don't wear because of the line. If I look straight ahead, the line is in the middle of my vision. I get dizzy going up and down stairs when I wear them. Because I am on Medicaid, I can't get the blended bifocal. I don't drive or operate machinery. Why do I have to have a bifocal? K.R., Wisconsin
A: Bifocals usually are prescribed for those of us over the age of 40 who have lost their ability to focus on close work. They are a convenience, but are not necessary if your lifestyle needs can be met with single vision glasses.
It sounds to me like your bifocals may be too high. Go back to where you got them and ask to have the bifocal heights checked. This may solve your problem. Dr. Dubow
Q: I currently have bifocal lenses which are called "blended," which means that they have the distance correction in the largest portion of the lens and the reading correction in a small, curved section at the bottom of the lens. There is no visible line on the lens. Is this lens still available? B.B., Alabama
A: Yup, blended lenses are indeed still available. But why would you want them? Progressive addition lenses are far better and more practical. Blended lenses have their widest measurement very near the bottom of the lens, making them difficult to use properly especially when you're on a computer. Try out progressives... you'll love them! Dr. Dubow
I work on a computer most of the day, but I also am a musician, and I need be able to read music on a stand that is about 28 inches away. I have a separate pair of glasses for playing, but when I look at the conductor and back again, the sheet music is blurred. Would bifocal contacts work, and will I still need to tilt my head back (like I must do now with my progressive eyeglass lenses) to read the music? E.K., Toronto
A: Bifocal or multifocal contact lenses may be a good solution for when you play music. When properly prescribed for your specific needs, these premium contacts should enable you to see both the conductor and your music without unusual head movements or the need to tilt your head back.
Another option is to wear eyeglasses with special progressive lenses called office progressives or near variable focus (NVF) lenses. These lenses have larger viewing zones than regular progressive lenses for seeing objects up close and at arm's length (like your music).
Though some NVF progressives are designed for intermediate and near viewing only, others have a small distance zone that would enable you to see your conductor clearly. You may find that NVF progressive lenses also are more comfortable than your current progressive lenses for your computer work.
Examples of near variable focus progressive lenses include Zeiss Gradal RD and Shamir Office. These lenses are designed for indoor vision only and should not be worn for driving. Ask your eye care professional for details. Dr. Heiting
Q: I had my eyes examined by a doctor, and he said I needed reading glasses strength 1.25. But because my eyes were even, I could buy them over the counter. Is this true, or should I get real prescription glasses? Lori, Massachusetts
A: There are pros and cons to buying over-the-counter reading glasses. They can have flaws and distortions in their lenses, which may cause eye strain and fatigue. They also (obviously) won't fit as well as glasses that are measured and fitted specifically for your face. If the whole lens is for reading, they will blur your distance vision, and you'll have to take them off to see far away.
Prescription lenses can be more functional and easier to wear. They can be progressive, meaning that they change in strength from the center to the bottom, giving you more focal range from intermediate to close distances.
Although over-the-counter reading glasses will not damage your eyes or your vision, it is essential that you continue to have your eyes examined regularly to check for diseases such as glaucoma and diabetes, which can cause blindness. Dr. Dubow
Q: I am 67 years old and use strong reading glasses, about +3.0. Is there a material that allows for lenses with this characteristic that aren't so thick and heavy? I have plastic lenses, but they are thick and relatively heavy. Thanks. J.P., Mississippi
A: Suffer no more! Ask your optical provider for either high-index or polycarbonate aspheric lenses. Keep your frames as small as possible, and make sure the lenses are fairly symmetrical as well. You'll love it! Dr. Dubow
[Page updated May 2010]
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