Presbyopia Contact Lens Options
Your reading vision is starting to annoy you enough that you’ve decided to do something about it.
But… you don’t want to wear glasses.
What are your contact lens options for presbyopia (presbyopia = farsightedness, or difficulty with reading, that hits most people in their 40s)?
Or can you even do contacts? Let’s start with that…
Are contacts an options for presbyopia?
Yes, contacts are an option for presbyopia. The more difficult question is which contact option is best to correct your declining reading vision.
The challenge with contacts is when you correct your reading, it focuses your eyes up close, so the distance vision is worse. If you’re saying, “I see great far away. I don’t need help there.” The best way to understand the challenge with contact is to put on over-the-counter reading glasses. It will help relax your eyes up-close, but look far away and everything is blurrier than when you take the glasses off.
So the question is: How do I correct my reading vision with contacts without making the distance worse?
Contact options to improve presbyopia or blurry reading vision
There are 3 ways contacts lenses can help free you from glasses even though presbyopia is creeping in your life:
- multifocal contact lenses
- monovision contact lenses
- distance contacts with occassional glasses for reading
Multifocal Contact Lenses
Multifocal contact lenses, also called presbyopia contacts, are the most modern option for correcting your reading vision.
These lenses are called multifocal because they have multiple prescriptions in one lens. This allows you to see both far away and up close (remember, even if you already see well far away, putting a reading prescription on your eye makes things worse, so you need a “nothing” prescription for far away).
In theory, these contacts are perfect. You put one in each eye, and you can see at all distances until you take them out. No problems.
The reality is the technology to give you both distance vision and reading vision isn’t perfect.
Biggest advantages of multifocal lenses:
- you don’t need glasses at all (in most cases)
- you have good depth perception (compared to monovision)
- you can see far away and close in either eye (this can be important when doing things like changing lanes in a car)
Biggest drawbacks of multifocal lenses:
- can have more glare or halos
- vision may not be quite as clear (compared to if you just tried to correct reading or distance)
- cost a little more than standard contacts
- not available in colored lenses
Okay, so 3 “big” advantages vs 4 “big” drawbacks… not sounding so great. In my opinion, multifocal contacts are still the best option for most presbyopic patients. The advantages outweigh the drawbacks for many people. Check out our page on multifocal contacts for more general information, best lenses, and details on the pros and cons.
Monovision Contact Lenses
Monovision is a contact lens option where you wear a lens for reading in one eye, and in the other eye, you wear a lens for distance (or no lens at all if you already see well at distance).
This doesn’t require a special contact lens. You just need your eye doctor to determine your distance and near prescriptions and which eye is dominant.
Biggest advantages of monovision contacts:
- you don’t need glasses at all (in most cases)
- no glare or halos that can come with multifocals
- less expensive (only need a standard lens, and may only need one lens)
Biggest drawbacks of monovision contacts:
- lose some depth perception
- blurry vision to one side of vision
- later stages of presbyopia may be difficult to get both intermediate (computer) and very close (fine print) clear
Many patients adapt to the drawbacks of monovision just fine and love it. I don’t think “losing” one eye for each distance is ideal, but still think this can be a good option for the right person. Check out our page on monovision contacts for more general information, whether or not you’d be a candidate and details on the pros and cons.
Distance Contacts and Wearing Reading Glasses When Needed
Another option is to wear contacts that make your distance vision the best it can be, and then when you need to read, you put on reading glasses.
Typically, this option is best for people with myopia (unable to see far away without glasses) and presbyopia.
This can be a good option for people who spend long periods on certain tasks. Maybe they’re playing a sport or running, and they only need to throw on reading glasses to occasionally look at their phone.
Advantages of wearing distance contacts and using readers:
- best distance vision of any of the options
- inexpensive because you can buy over-the-counter readers
Drawbacks of wearing distance contacts and using readers
- you have to carry glasses with you
- changing from reading to looking far away can be constant on and off with glasses
You can check our article “Can I wear readers with contacts?” for more pros and cons, as well as what power readers you’ll need.
Blend of multifocal and monovision
The options above can be blended. This is best to work on with your eye doctor because the possibilities are endless and can be customized to your lifestyle.
An example might be someone who wants contacts for outdoor days but also the rare look to check in on their phone. If this is you, you might like a distance contact in one eye, and a mild multifocal in the other eye. This is called blended or modified monovision.
Another more common example is just a slight preference in one eye for distance in the multifocal and the other eye has a stronger reading multifocal. This allows both eyes to do distance and reading, so you don’t lose depth perception but still has a little bit of a monovision feel.
If you’ve tried monovision and multifocal contacts and had no success so far, you might ask your doctor about this option.
What contacts are best for presbyopia?
There’s no one size fits all option that is best for presbyopia, but I prefer multifocal contacts for most people. It’s the least sacrifice. You don’t have to worry about reading. You don’t lose your depth perception. And you can see distance and far away no matter if you look left or right.
As for specific brand recommendations? We may review the brands at some point, but for now, this would be best to discuss with your eye doctor.