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Medical Forum / General / Vision / January 2009Ciba Focus Progressives vs B & L Purevision multifocals
I have been wearing Focus Progressives for about 5 years. I wore no prescription glasses before that but used reading glasses as necessary. I opted for contacts when the presbyopia was forcing me to have constant correction at about 59 years of age. I think it took me longer than average for my brain to sort out the clearest image from the simultaneous choices given it. In about two weeks I could read everything close and far. I have a +1.75 left and +1.5 right correction, btw. I noticed everything was improving and at about six weeks I was totally satisfied. I wanted to try Purevision and my eye doctor got me a pair of trial lenses. I had two immediate "wows" - one good and on bad. First, the near vision was even better than the Ciba Focus Progressives, but, secondly, distant was so bad, I could not read road signs over about 50' away. After a follow up exam, he lowered each by one notch. +1.5 and +1.25. This helped some, but the distant vision is still too blurry. So, my question is: do they use such different methods of correction that my brain is having a difficult time adjusting or re-adjusting? Like center-near on one and not the other, or aspheric design on one and concentric ring on the other? I guess I should wear them for a couple of weeks before I give up. Right now, I only tried them one day, and went back to my Ciba lenses. TIA for any advice. marc The precise dioptric value of contacts is different on different eyes, and it's notoriously muzzy with aspheric designs. The only way to really tell what's best is to overrefract - eg measure for glasses with the contacts in place. Ideally, you'd measure zero. In practice, we often find a quarter- or half-diopter variance between glasses and contacts, and between one brand of contact to another. They're both center-near aspheric designs, so distance vision will vary with pupil size. Both lenses come with a range of adds, and some people exhibit different choices for distance when we change the near add value. What happens if you go to the drugstore and put on a pair of +150 or +175 reading glasses? Is it blurry far away? -MT, OD >I have been wearing Focus Progressives for about 5 years. I wore no >prescription glasses before that but used reading glasses as necessary. I [quoted text clipped - 26 lines] > > marc Thanks so much for the reply. I tried the B&L for 3 days and went back to my OD for a follow up check. I really can't see how I can keep them. I have to strain to get part of the 20/25 line, and I had 20/20 with the CIBA's. Out in the world, I couldn't read many signs within a half of a block (depending on the size, of course). I can see the same ones clearly with the Focus Progressives. One advantage the B&L had was that, what I call, the near-immediate distance was clearer. About 5 to 7 feet. This comes into play when someone asks me about some on their computer screen while they are seated at their computer. I couldn't read much with CIBA and could see that better with the B&L. Oh well. It's all a matter of trade offs. I still opt for contacts over eye glasses. They are just more convenient for me, even though eye glasses give crisp vision. I will keep the Focus Progressives. marc > The precise dioptric value of contacts is different on different eyes, and > it's notoriously muzzy with aspheric designs. The only way to really tell [quoted text clipped - 44 lines] >> >> marc > One advantage the B&L had was that, what I call, the near-immediate > distance was clearer. About 5 to 7 feet. Maybe. Or maybe you were just over-plussed in the B&L. Can't tell. -MT The Purevision lenses would probably be better for your eyes--as being silicon hydrogel, let more oxygen in. I'm surprised that Purevision is still the only si-hy multifocal available. With an increasing number of si-hy regular lenses available, even a few now in toric versions, why still only one multifocal version? For instance--Ciba has two silicon hydrogel lenses out--Focus Night and Day (I believe still the highest oxygen transmissibility (dk/t) available),and AirOptix. (Also now, Airoptix Aqua, so perhaps three.) Airoptix now available in toric as well. Why not multifocal? One would think that with the phenomenon of the aging baby-boomers, there would be an increase in multifocal models available, new multifocal technologies, etc. but unfortunately that does not seem to be the case, at least as of now. >I have been wearing Focus Progressives for about 5 years. I wore no >prescription glasses before that but used reading glasses as necessary. I [quoted text clipped - 24 lines] > > TIA for any advice. If I had problems like that I would go for glasses! Thanks for the input, but I don't want glasses. I get almost as good as vision as with glasses with the CIBA's without scratched lenses, dirty lenses, misplaced glasses, sat on frames, etc. I don't think I ever want the 'advantage' of glasses. I will stay with Focus Progressives and occasionally try other similar products to see how they work for me. B&L didn't pass the test. >>I have been wearing Focus Progressives for about 5 years. I wore no >>prescription glasses before that but used reading glasses as necessary. I [quoted text clipped - 26 lines] >> > If I had problems like that I would go for glasses! > Thanks for the input, but I don't want glasses. I get almost as good as > vision as with glasses with the CIBA's without scratched lenses, dirty [quoted text clipped - 36 lines] > > - Show quoted text - Getting good distance and good near with a MF contact lens requires a little compromise. Did your doctor try modified mono vision, using the multifocal in both eyes but optimizing one for distance and one for near? I find good success with the B&Lwhen fitting older presbyopes by using a low add in the dominant eye and a high add in the near eye. Worth a try. Dr Judy Getting good distance and good near with a MF contact lens requires a little compromise. Did your doctor try modified mono vision, using the multifocal in both eyes but optimizing one for distance and one for near? I find good success with the B&Lwhen fitting older presbyopes by using a low add in the dominant eye and a high add in the near eye. Worth a try. Dr Judy ----------------- Hi Dr. Judy, Is the high add really high enough for older presbyopes? I am 56, myopic and presbyopic. I tried the PV MFs once. I think both were high add, but did not give me good enough near vision from the add. We had to keep lowering the power of the myopia prescription on the left eye, so that I could finally read with them, but it was lowered so much, that it was not really much different from regular monovision, except less clear distance vision. I wish they would come out with more types of Si-hy multifocals. Does anyone here know, if anything new will be coming out in the near future? > Getting good distance and good near with a MF contact lens requires a > little compromise. Did your doctor try modified mono vision, using [quoted text clipped - 20 lines] > I wish they would come out with more types of Si-hy multifocals. Does anyone > here know, if anything new will be coming out in the near future? I believe that both Ciba and Vistakon have multifocals in the works. Have you ever considered trying GP lenses? >1) I believe that both Ciba and Vistakon have multifocals in the works. >2) Have you ever considered trying GP lenses? 1) Do you have any idea when they might be coming out? Any info about them on the web? 2) I wore GP lenses for most of my adult life. I only changed to softs (only si-hys) a few years ago. So yes, I could wear GPs, which I understand have some better characteristics for vision. However, I have become used to the comfort of the softs now, and the convenience of EW. (I take out the lenses and clean them overnight once per week, as well as changing the lenses each month.) Also, peripheral vision is better with softs, due to the larger lenses. Also, with GPs, more than once, for instance on a windy day, a lens would fall out of my eye, and I couldn't find it. Then I would have to wear glasses for weeks, while waiting for a new lens. With the softs, besides not falling out, they are so easily replaceable if need be. Do you think GP multifocals are better? Which kinds in particular? > I have been wearing Focus Progressives for about 5 years. I wore no > prescription glasses before that but used reading glasses as necessary. I [quoted text clipped - 26 lines] > > marc I have not tried the Ciba Focus Progressives, but it was my understanding that the add power was low, maybe about +0.75. The Purevision is available in 2 adds, "low" and "high." In general, the quality of the distance vision is inversely related to the value of the add. So, my question is what add were you wearing in the Purevision? At 59 years, you probably need the "high" add. I usually try to compensate for this by using a low add in the dominant eye, FWIW. |
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