Multifocal Contact Lenses
Are you over 40? If so, you may want to consider wearing multifocal contact lenses.
So it's no surprise that many people 40 and older prefer contact lenses over glasses for their active lifestyles.
Once we reach our mid-40s, presbyopia makes it difficult to focus on near objects. Reading glasses used to be the only option available to contact lens wearers who wanted to read a menu or do other everyday tasks that require good near vision.
But today, a number of multifocal contact lens options are available for you to consider. Multifocal contacts offer the best of both worlds: no glasses, along with good near and distance vision.
Some multifocal contact lenses have a bifocal design with two distinct lens powers — one for your distance vision and one for near. Others have a multifocal design somewhat like progressive eyeglass lenses, with a gradual change in lens power for a natural visual transition from distance to close-up. [Read our article on How To Choose The Best Reading Glasses Power.]
Multifocal contacts are available in both soft and rigid gas permeable (RGP or GP) lens materials and are designed for daily wear or extended (overnight) wear. Soft multifocal lenses can be comfortably worn on a part-time basis, so they're great for weekends and other occasions if you prefer not to wear them on an all-day, every day schedule.
For the ultimate in convenience, one-day disposable soft multifocal lenses allow you to discard the lenses at the end of a single day of wear, so there's no hassle with lens care.
In many cases, GP multifocal contact lenses provide sharper vision than soft multifocal contacts. But because of their rigid nature, GP multifocal contacts require some adaptation and are more comfortable if you condition your eyes by wearing the lenses every day.
Hybrid multifocal contacts are an exciting new alternative. These lenses provide the clarity of gas permeable lenses and the comfort and easy adaptation of soft lenses.
Multifocal Contact Lens Designs
There are two basic types of multifocal contact lens designs: simultaneous vision designs and segmented designs.
Simultaneous Vision Designs. In this type of multifocal design, different zones of the lens are designated for far and near (and sometimes intermediate) vision. Depending on the object being viewed, the wearer's visual system determines the region(s) of the lens that provide the sharpest vision.
There are two types of simultaneous vision designs:
- Concentric multifocal contact lenses. These multifocal contacts have a primary viewing zone in the center of the lens, surrounded by concentric rings of near and distance powers. The central viewing zone usually is for viewing distant objects (called a center-distance design), but center-near designs also are available. In some cases, a center-distance design is used for the wearer's dominant eye and a center-near design is used for the non-dominant eye.
- Aspheric multifocal contact lenses. These multifocal contacts are similar to concentric multifocal lenses, but instead of having discrete rings of distance and near power surrounding the center of the lens, the multifocal lens power gradually changes from distance to near (or near to distance) from the center to the periphery of the lens. In this regard, aspheric multifocal contact lenses are designed somewhat like progressive eyeglass lenses.
A segmented bifocal GP lens stays in place when your eye moves, enabling your pupil to be aligned with the distance or near power.
Segmented Multifocal Designs. Segmented multifocal contact lenses have a design that's very similar to bifocal and trifocal eyeglass lenses. These lenses have a zone for distance vision in the upper and central zones of the lens, with a zone for near vision in the lower half of the lens. The distance and near zones are separated by a visible line in the lenses.
Segmented multifocal contact lenses are made of rigid gas permeable (GP) contact lens material. These lenses are smaller in diameter than soft contact lenses and rest on a layer of tears above the margin of your lower eyelid. When your gaze shifts downward for reading or seeing near objects, a segmented multifocal contact lens stays in place, allowing you to see through the lower, near-correction part of the lens (see illustration).
Segmented trifocal GP contact lenses — which include a small, ribbon-shaped segment for intermediate vision between the distance and near zones — also are available.
Segmented multifocal contact lenses sometimes are called translating multifocal contacts or alternating multifocal lenses.
In the past, soft multifocal contact lenses could not correct astigmatism. If you had astigmatism, your only choice in multifocal contact lenses was rigid gas permeable lenses.
Today, soft multifocal contacts can also correct astigmatism by using a toric lens design. The lenses achieve the proper rotational positioning on the eye by means of unequal thickness zones in the lens to create a prism ballast effect (similar to that on a translating GP multifocal).
Hybrid multifocal contact lenses also correct most types of astigmatism.
Until you have a contact lens fitting, there's no way to know for sure if you'll be able to successfully adapt to wearing multifocal contact lenses. If multifocal lenses aren't comfortable or don't give you adequate vision, a monovision contact lens fitting may be a good alternative.
Monovision uses your dominant eye for distance vision and the non-dominant eye for near vision. Right-handed people tend to be right-eye dominant and left-handed folks left-eye dominant. But your eye care professional will perform testing to make that determination.
Usually, single vision contact lenses are used for monovision. One advantage here is that single vision lenses are less costly to replace, lowering your annual contact lens expenses.
But in some cases, better results can be achieved using a single vision lens on the dominant eye for distance vision and a multifocal lens on the other eye for intermediate and near vision.
What If Multifocal Contacts Don't Work Out?
If your multifocal contact lenses don't work out for you, your eye care professional can return most brands to the manufacturer for a refund. So if you're an unsuccessful wearer, you can usually receive a full or partial refund of the material costs of your contact lens fitting fee.
But part of your contact lens fitting fee involves the time and services your eye doctor or contact lens fitter provides during the fitting and follow-up visits. This portion of your overall fitting fee usually is not refundable.
To increase your chances of success with multifocal contact lenses, it's important to manage your expectations. These lenses usually won't be able to match the clarity you get with bifocal or progressive eyeglass lenses. It's also very likely you will still need single vision eyeglasses or reading glasses for specific tasks like driving at night or reading small print.
But it's reasonable to expect multifocal contact lenses to give you very acceptable vision for 80 percent of your daily activities, and without the need for supplemental eyeglasses.
New Daily Disposable Multifocal Contacts Available
July 2015 — Johnson & Johnson Vision Care announced a new daily disposable contact lens with an aspheric center-near design that the company says closely matches the optical design to the wearer's pupil size for better vision.
The 1-Day Acuvue Moist Multifocal comes in 61 distance powers from +6.00D to -9.00D and three add powers, to give contact lens fitters lots of options to fit people with various needs.
The lens's back curve design helps keep the lens centered over the pupil, with the aspheric center mimicking the natural shape of the eye's surface. Such stability can help the complex front-surface optics do their job in delivering clear vision at various distances.
For comfort, a wetting agent is embedded in the lens material. And the 1-Day Acuvue Moist Multifocal blocks about 82 percent of UVA and 97 percent of UVB rays. (But sunglasses are still required for complete UV protection outdoors, since the contact lens doesn't cover the entire eye).
An inside-out mark and visibility tint are also included, and the lenses come in 30- and 90-packs.
About the Reviewer: Gary Heiting, OD, is senior editor of AllAboutVision.com. Dr. Heiting has more than 25 years of experience as an eye care provider, health educator and consultant to the eyewear industry. His special interests include contact lenses, nutrition and preventive vision care. Connect with Dr. Heiting via Google+.
Page updated September 2017