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Medical Forum / General / Vision / December 2005Progressive contacts, is this the best I can expect?
Here I am at 56 (female), tired of fishing out my reading glasses to read the dinner menu, the sports program, etc. Distant vision without correction is excellent. So, after years of wearing reading glasses and at one point bifocals (during college), I decided to give progressive contacts a try. Currently left eye at +1.00 and right eye at +1.50 - Focus Dailies progressives. Close up and intermediate vision is good (With the initial prescription which was just a trifle stronger it was excellent.) but I'm struggling with distant vision. Using them at sporting events or driving is a problem. I expected and have difficulty at night but was hoping for better results in other conditions. Reading very fine print is difficult but satisfactory for reading normal text. Intermediate vision is excellent. I purchased a one month supply and am a little more than half way through those. Coupled with the trial contacts provided by my optometrist, I have worn these contacts for about one month. I've been told my eyes and brain will adjust. I want to give this a fair chance but at what point do I conclude it's just not working? Is this about the best I can expect? Are there other contact alternatives that I might want to ask my optometrist about before throwing in the towel? I really hate to go to bifocal or progressive glasses. I've have bifocal glasses before and really hated using them to read newspapers, play the piano, work at the computer, tasks like painting the porch which requires close and intermediate looking up, or when shopping and trying to view the bottom shelves. At what point do I give it up and buy the little cord to hang my reading glasses around my neck? > Here I am at 56 (female), tired of fishing out my reading glasses to read > the dinner menu, the sports program, etc. Distant vision without correction > is excellent. So, after years of wearing reading glasses Getting old is not fun. :-( I think it is just personal preference. I wouldn't choose these contacts myself. I'm perfectly happy with reading glasses. My wife, on the other hand, has given them up. She got progressives, and after a few months, adjusted to them to where she wears nothing else. I'm 55, and have been wearing reading glasses, first prescription and then OTC, for many years.  SignatureDan Abel dabel@sonic.net Petaluma, California, USA I dont like contacts, besides them drying and irritating my eyes, I dont see very well from near. You could try monovision but not everyone likes it. Another option is actually make both eyes slightly myopic then you wont need glasses except for driving. I am happy wearing contacts that do not fully correct my myopia so I can still see reading material and distance vision is only slightly blurry. However im much happier just sticking to glasses, my eyes thank me plus I just lift my glasses to read > In article > <ifZjf.53182$Tf5.41750@newsread1.mlpsca01.us.to.verio.net>, [quoted text clipped - 15 lines] > 55, and have been wearing reading glasses, first > prescription and then OTC, for many years. How about translating bifocal contacts? I believe someone even makes a soft one. No compromise on vision. You will still have the problem of having to tilt your head down to see the bottom shelf at the store but you won't have to put on and take off readers all the time. -Quick there are a few things you can do. First drop the script in your dominant eye by 0.25D and increase the script in the non-dominant eye by 0.25D. Second, get focus daily spheres for the dominant eye. The options here are using these (modified monovision) either full time, which means that you will do all the computer work with your non-dominant eye, or using the modified monovision on weekends when you don't read as much and want good distance vision, and the 2 multifocals during the week for work. good luck. dr grant in general you should expect some compromises when you try bifocal contacts. when you get distance clear, typically near is not strong enough. and when you get near clear, then distance is blurry (as you report). see your doctor. one approach is to strengthen one eye for distance and let the other be stronger for near. this is called modified monovision which is what dr. grant (CatmanX) suggested. works fine for a lot of people. the trick is to spend a lot of time trying different options that your doctor gives you. just go into the process realizing the combined distance plus near vision that you get will not be as sharp as you were getting without the bifocal contacts-- i.e. you must accept "good enough" and not perfect. > in general you should expect some compromises when you > try bifocal contacts. when you get distance clear, > typically near is not strong enough. and when you get > near clear, then distance is blurry (as you report). This more applies to simultaneous vision bifocals and not to translating bifocals right? I didn't do well with the simultaneous vision solutions. Apparently I don't do well at rejecting the out of focus image(s). I then rejected the compromises of a monovision (and modified monovision) solution. ...look left at the intersection and it was blurry. Then there is generally the "soft" vision inherant with soft contacts (they sure were comfortable though). > the trick is to spend a lot of time trying different > options that your doctor gives you. just go into the > process realizing the combined distance plus near vision > that you get will not be as sharp as you were getting > without the bifocal contacts-- i.e. you must accept "good > enough" and not perfect. No. There are other options (maybe with different compromises). I find RGPs to give me much sharper vision. My OD and myself are in the process of fitting RGP translating trifocals. I'm confident this will be the best solution for me once we get the rotation, fit, and tweak the RXs (Rx for each segment is independent so it takes a good bit of tweaking). *lots* of adjustments in fitting these things. Pros: no compromise on vision much easier to handle less expensive if you don't lose or break them Cons: -Some head positioning at times for translation -Less comfort (maybe we just don't have the fit right yet). -more expensive if you lose or break them -Quick If a patient can accept RGPs from a comfort standpoint, then translating bifocals are the best solutions. But thats a big if. In my practice the majority of patients (estimate 80%) reject gas perms outright because they cannot tolerate the feeling and they have no stomach to try to adapt. The entire field of fitting multifocal/bifocal contacts is problematic for the practitioner. ========== >> in general you should expect some compromises when you >> try bifocal contacts. when you get distance clear, [quoted text clipped - 38 lines] > > -Quick > I purchased a one month supply and am a little more than half way through > those. Coupled with the trial contacts provided by my optometrist, I have > worn these contacts for about one month. I've been told my eyes and brain > will adjust. I want to give this a fair chance but at what point do I > conclude it's just not working? I reckon if your brain hasn't adjusted within the first few days then it never will. To me getting used to multifocal or monovision contacts is not so much 'adaptation' but more learning to accept the compromise. In other words accepting in your own mind that the excellent distance vision you're used to will have to be partially 'sacrificed' in order to give you some near vision. This is more of a 'realisation' than a 'getting used to' issue. I really hate to go to bifocal or > progressive glasses. I've have bifocal glasses before and really hated > using them to read newspapers, play the piano, work at the computer, tasks > like painting the porch which requires close and intermediate looking up, or > when shopping and trying to view the bottom shelves. You shouldn't judge progressive glasses by your bad experience with bifocal glasses. Progressive are MUCH better than bifocals for music, computer, painting, shopping, etc. They do need to be fitted very precisely to work properly, but if you can find someone to do this for you they might be a great solution. Dom >> I purchased a one month supply and am a little more than half way through >> those. Coupled with the trial contacts provided by my optometrist, I [quoted text clipped - 11 lines] > near vision. This is more of a 'realisation' than a 'getting used to' > issue. Exactly. Well stated IMHO. Contact companies like to phrase this as "adaptation" as if the process is similar to accepting a prescription change. In reality, its more "acceptance" of a visual compromise. When I fit my patients in multifocals, we have a little talk about this up front so as to manage their expectations. Afterwards, I think that I successfully fit the majority of them. After all, presbyopia is all about "acceptance" anyway. > Exactly. Well stated IMHO. Contact companies like to phrase this as > "adaptation" as if the process is similar to accepting a prescription > change. In reality, its more "acceptance" of a visual compromise. I agree with this assessment. I think a lot of it has to do with expectations. I am wearing monovision contacts and get excellent distance and near vision and adapted very quickly. I was also very motivated to have it work. If I think about it, I do notice that my right eye is blurry for near and my left for distance, but for the most part I don't even notice it. I think this is large part to "acceptance". If I had unrealistic expectation, I don't think I would have been able to adapt. > When I fit my patients in multifocals, we have a little talk about this up > front so as to manage their expectations. Afterwards, I think that I > successfully fit the majority of them. After all, presbyopia is all about > "acceptance" anyway. Before my OD fit me, we discussed expectations and I suspect that if I was unwilling to accept compromises, he would have suggested other options. In the future, I hope to try multifocals, but am waiting until silicone hydrogel come out in multifocals. Colin >> Exactly. Well stated IMHO. Contact companies like to >> phrase this as "adaptation" as if the process is similar [quoted text clipped - 22 lines] > to try multifocals, but am waiting until silicone > hydrogel come out in multifocals. I wasn't so lucky with the first OD I went to. (I think he was only interested with the "quick fit for soft lenses".) I expressed the desire to try RGPs and he wouldn't really consider it. I think it's both acceptance and adaptation. Best analogy I can think of is walking into a room that smells bad. If you stay there you have accepted it. If some time later you don't notice it any more you have adapted. I agree that most people wouldn't tolerate the adaptation period without having their expectations set. My initial disappointment was discovering that, even though we're in the steam age, it's not just a matter of money to get perfectly functioning eyes again... -Quick > Using them at sporting events or driving is > a problem. I expected and have difficulty at night but was hoping for > better results in other conditions. Reading very fine print is difficult > but satisfactory for reading normal text. Intermediate vision is excellent. You might want to try the Baush and Laumb Softlens Multifocals. I can see distant very well and fine print. The dominent eye is presciibed for best distant vision and high power reading. My other eye for high power reading but slightly weaker on the distant vision. It works. We had to try several trial lenes to come up with the good result. SignatureCharles |
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