Q & A on Bifocal Eyeglasses, Progressive Lenses and Reading Glasses

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: Good ones do! And, in fact, the better quality progressive addition lenses are great for almost all distances. They use a "soft" design that makes them much more acceptable and comfortable. You get what you pay for! — Dr. Dubow

[Read our article on progressive lenses.]

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

A: Go back to your optician. He or she can probably adjust your glasses to eliminate the glare problem. If not, perhaps you need an antireflection coating, which I recommend with your prescription anyway. — Dr. Dubow

[Read more about anti-reflective coatings.]

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 glasses 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 more about progressive lenses.]

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 playing 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 a photochangeable tint 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

[Read more about photochromic tints or special-use multifocal lenses.]

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 40 wear progressives and are very happy. — Dr. Dubow

[Read more about progressive lenses.]
 

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 up and down stairs when I wear them. Because I am on Title 19, 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 are usually 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

[Read more about bifocal lenses.]

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

[Read more about progressive lenses.]

Q: I bought new progressive lenses in October 1999. I have returned to my optometrist twice because my vision is blurred. I just can't seem to get the focus right. What do I do now? The optometrist has rechecked the prescription and says nothing is wrong. — A.W.

A: It is likely that your progressive lenses are positioned incorrectly in front of your eyes. Ask your optometrist to put the little plastic markers on your lenses and double-check their positioning — both side to side and up and down.

Also, ask your optometrist to measure the distance between your eyes monocularly (from the center of your nose to the center of each eye individually) to make sure your lenses are spaced correctly. Progressive lenses are fantastic when properly fitted. I wear them myself... not that I'm old enough to need them... — Dr. Dubow

[Read more about progressive lenses.]

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 eyestrain 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 watch for diseases such as glaucoma and diabetes, which can cause blindness. — Dr. Dubow

[Read more about reading glasses.]

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