| Options for Better Reading Vision | |
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Current Presbyopia Management Options Progressives:
Also known as "no line bifocals." These glasses have 3 zones of clear vision: the top is for driving, the middle is for a computer or intermediate zone, and the bottom is for reading. These give you the best overall daily functional vision. The main complaint is distorted side vision. Newer lens technology called "wavefront analysis" eliminates a great deal of this side distortion. There are many brands of progressives and one brand does not "fit all." Your eye doctor or knowledgeable optician can help you with your decision. If you routinely look at very small things up close or work on a computer for long periods of time, you may also benefit from having a second pair of glasses called an Office Lens.
Lined Bifocals:
The top is for driving and bottom is for reading. These give you a wider area for reading but some patients find that the line annoys them. Eventually most will need another power added to this lens thus changing it to a lined "trifocal." Cosmetically, this is not as desirable as a progressive since you can see the lines.
Reading Glasses:
Known as a "single vision lens." You only wear them for reading. When you need to see something far away, you will need to either look over them (and wear your glasses more down on your nose), remove them, or wear them on top of your head. This can be quite frustrating since you always need to look for the glasses when you want to read something (not convenient for cell phones when you're driving!). This type of lens however is good for those of us who read for long periods of time or who routinely look at small numbers or contracts all day.Office Lenses:
This is a "reversed progressive." It's a great supplemental option for the standard progressive wearer or those who are new to presbyopia and don't want to wear standard reading glasses. It still has 3 zones of clear vision like the progressive mentioned above, but the reading and computer areas are much wider and thus provide more comfort while doing those tasks. Compared to plain reading glasses, you will be able to walk around wearing these and not need to wear them on your nose.Computer Lenses:
A lined bifocal in which the top of the lens has an intermediate computer distance power and the bottom has your reading power. This is a specific use lens and you won't be able to see to drive in it.Contact Lenses:
If you already wear contacts, over-the-counter reading glasses over your contacts will provide the best reading and distance vision. Thanks to technological advances we now have multifocal (or bifocal) lenses available in both soft and rigid gas permeable materials as well as monovision. Multifocal or monovision lenses allow you to see both far and near, but almost always will blur either or both of those distances to some extent as compared to glasses (progressives) or your regular contacts.
Monovision:
Standard contacts in which your dominant eye is fit for driving and the non-dominant eye is fit for reading. Your brain will learn to ignore the reading eye while driving and vice versa. Drawback: some patients feel a little off-balance; eventually it will be difficult to get both a computer distance and reading distance in focus with your "reading eye." Overall: a good option for those who are unsuccessful with multifocals.
Multifocal Contact Lenses:
The power in these lenses is arranged in a "bull's eye" target. The center of the lens contains your reading power and the outer ring contains your distance power. Now these are available for our patients with astigmatism. After an adaptation period your brain learns how to ignore the power that it currently does not need. The optics are enhanced by our natural pupil fluctuations: when we look far away our pupils tend to be larger and we thus look more through the outer ring of the lens; our pupils get smaller naturally when we read so we are using more of the inner ring. Drawback: we tend to experience halos at night when driving. Some distances never seem clear. Overall: if successful, these can reduce your dependency on glasses up to 75% of the time. Multifocal rigid gas permeable contacts ("RGP") provide better vision than the soft multifocal lenses.
Refractive Surgery:
LASIK will correct your distance vision only. You will still need reading glasses. If you are currently near-sighted (myopic) and enjoy the convenience of removing your glasses or contacts for reading, this will totally disappear after LASIK. Near-sighted individuals have a natural "bifocal"/magnification in their own eyes that is removed with LASIK.The only procedure currently which can allow you to focus both far and near at the same time are intraocular lens implants. These are commonly referred to in the media as CrystaLens or ReZoom refractive lens implants. This is an invasive surgery which carries with it the risks of retinal detachment, inflammation, and infection. Insurance will not cover these unless you have significant cataracts.
