What Are Multifocal and Bifocal Contact Lenses?

Multifocal and bifocal contact lenses are designed for people with presbyopia who have trouble focusing on close-up objects. They work by combining correction for distance and near vision into the same contact lens. Multifocal lenses have improved significantly in recent years due to better technology. If you’ve thought about ditching your reading glasses in favor of contact lenses for reading, you may be able to find some multifocals that work for you.

What is presbyopia?

At some point in time, everyone starts to have difficulty focusing on close-up objects. It often begins with having to stretch out your arms to see reading material more clearly, or having trouble seeing small print on a menu in a dimly lit restaurant. This process is called presbyopia. It affects everyone eventually, but most people start to have symptoms at some point around their 40th to 45th birthday.

Presbyopia can be a frustrating problem, and tends to come up rather quickly. It also can be a bit depressing when it starts, because it is one of the first unavoidable aging changes to affect the body, and no one likes the idea of aging.

What can you do about presbyopia?

With presbyopia, people who have had perfect vision all their lives start to find that using over the counter reading glasses, or “cheaters”, makes reading much clearer and more comfortable. People who already wear glasses to correct nearsightedness often find that they need to take off their glasses or look under them to see to read, but then they can’t see far away.

Fortunately, there are lots of great options to correct presbyopia. Some people only need to wear glasses for reading and don’t mind putting them on for that. Other people need correction for both far away and up close and choose to wear bifocal, trifocal or progressive no-line glasses.

Many people may have been told in the past that contact lenses could not correct their presbyopia, but recent advances in contact lens technology have provided a wealth of new viable options.

Quiet moment by window light

Options for correcting presbyopia with contact lenses

1. Alternate between contacts and reading glasses

There are three main options for correcting presbyopia with contact lenses. The first is to correct distance vision with the contacts and wear reading glasses over the contacts for reading. This works well, but it is inconvenient to always have to pull out reading glasses when you want to see something close up.

2. Monovision

The second option is to do what is called monovision. Monovision means that you wear a contact lens in one eye to correct the distance vision and a contact lens in the other eye to correct the near vision. That sounds kind of crazy, but the brain actually adapts to this system quite well by tuning out the image from the eye that you are not using.

3. Wear multifocal / bifocal contacts

The third option to correct presbyopia is to use bifocal or multifocal contact lenses. A true bifocal lens only has two different strengths to provide correction at two different focal points (usually distance and reading). Multifocal contact lenses have several different strengths to correct multiple focal points. The terms bifocal and multifocal are usually used interchangeably. Bifocal and multifocal contact lenses are now available in many different designs and materials that provide excellent vision at all distances without having to use glasses.

Simultaneous vision

Simultaneous vision lenses have correction for distance, near and sometimes intermediate range vision, and your brain learns to use whatever correction is needed to provide clear vision wherever you are looking. Simultaneous vision lenses come in concentric optic and aspheric optic designs.

Concentric

Concentric style lenses are designed with concentric rings of alternating distance and near corrections, resembling a bull’s eye pattern.

Concentric Multifocal Contact Lens

Aspheric

Aspheric lenses have a more blended transition between the different corrections, similar to progressive glasses lenses. Most of the newest and most popular soft disposable lenses on the market utilize different variations of aspheric lens designs.

Aspheric Multifocal Contact Lens

Translating (alternating)

Translating or alternating bifocals and multifocals actually shift on the eye so that you are looking through a different part of the lens to read than at a distance. This works by having a truncated or flat bottom edge that catches on the lower eyelid so that when you look down the lens moves upward. This design is more common in rigid gas permeable (RGP) lens materials than soft lenses.

Translating Multifocal Contact Lens

Soft disposable lenses are the most popular types of bifocal and multifocal lenses on the market due to their comfort, relatively low cost, and availability in a wide range of materials. Multifocal soft lenses are now available from most of the major contact lens manufacturers including Vistakon (the makers of the Acuvue Brand lenses), Alcon, CooperVision and Bausch and Lomb.

Disposable multifocal lenses are available in different replacement schedules including daily disposable, 2 week replacement and monthly replacement.

Are there disadvantages to bifocal and multifocal lenses?

  • Bifocal and multifocal contact lenses work very well for many people, but some find that their vision may not be perfect at both distance and near. In this case, it is important to find the best compromise to provide the most useful vision for each individual. For example, someone who drives a semi-truck would want to maximize distance vision with a little bit of near, reading vision. Someone who spends twelve hours a day on the computer might need more help with near vision with some compromise at distance.
  • It helps to start using multifocal lenses early in the process of presbyopia. It is easier to adjust to them when you first start having difficulty with near vision than it is when you need much stronger correction for reading.
  • People who have a lot of astigmatism may have more difficulty with bifocal and multifocal lenses. There are multifocal lenses available that correct astigmatism, but they tend to be a little more complex to fit.
  • Lighting is critical with multifocal lenses. These lenses provide much better vision when there is abundant light. In dim lighting, reading might be more difficult.
  • People who suffer from dry eyes may have more difficulty wearing contact lenses, and dry eyes are more common in people over 40 years old. Some people need to be treated for dry eye to get their eyes healthy before wearing contacts.

The goal with multifocal contact lenses is to provide clear, comfortable vision at all distances, but there may still be times when you need to wear glasses.

There are a lot of great contact lens options for people who need extra correction to see to read. Your eye doctor can help you find the perfect lenses for you.

Updated Jul 21st, 2015

Read These Too