The first time I noticed it was in a dimly lit restaurant. I grabbed for the candle on the table thinking, “Gee, the type on this menu is awfully small.” In the next few weeks I found the same thing happening when I read the newspaper or sought ingredients on a package label in the market. Menus continued to be challenging in all kinds of lighting and I needed to go online, using my large computer screen, to read instruction manuals. My annual trip to the eye doctor confirmed it: I had presbyopia, the formal name for the age-related vision loss that affects almost 100 percent of men and women over the age of 45. The eye’s crystalline lens loses its ability to bring close objects into clear focus.
Nooooo! I had given up glasses for good when I switched to contact lenses when I was a nearsighted 12-year-old, and 33 years later there was no way I was giving in to bifocals or reading glasses. My ophthalmologist empathized, and offered me a few options to cope with my vanity as my eyes’ crystalline lenses were losing their ability to bring close objects into focus.
1. Monovision: In this technique, you wear one contact lens to treat near vision in one eye, and if needed, a lens in the other eye that solves for distance. The two eyes work together to allow you fairly normal vision.
Pros: If you can adjust to monovision, it can be a pretty perfect solution. “Watch this,” my friend Elizabeth said one day, holding a newspaper a normal distance from her face and rattling off the fine print. “I used to have to hold my arms out all the way.”
Cons: Some people find it takes a while to adjust to their new contact lens prescription, and some never get comfortable with it. Others find that the lack of 20/20 vision — one contact will always undercorrect — can be an issue when driving at night or participating in sports where you need to see a reasonable distance, like tennis or golf. (One solution is that for certain activities, substitute your monovision lenses for lenses that get you to 20/20 vision, and keep a pair of reading glasses handy in case you need to pull over and read something.)
2. Bifocal or Multifocal Lenses: In option A, alternating bifocal lenses allow your pupil to alternate between two power segments (distance and nearby) when you look up or down. For example, if you look down to read the instructions on the new vibrator you just bought, the lower segment will make the words larger and clearer.
In Option B, simultaneous bifocal lenses let you look at both distance and near powers at the same time. These are generally “progressive” lenses, and are quickly gaining popularity.
Pros: Many people love their progressives, finding they seamlessly let them shift from near to far vision with few or no problems.
Cons: Some people can’t adjust to the lenses, and others find they work better for close vision than they do for far vision.
3. Surgical Monovision: If you are having surgery to correct your vision, talk to your doctor about whether you are a candidate for a surgical version of monovision, in which your non-dominant eye will be left slightly nearsighted, to let you read close up.
Here’s where I wound up: After trying monovision and progressive lenses, I opted for monovision. I had no trouble getting my eyes to work together, and find that if monovision isn’t perfect when I play tennis, I can easily swap out the undercorrected lens for a stronger one before I hit the court.
I tried several different progressive types and prescriptions, and found that while they were great for near vision, I couldn’t get them to work as well as monovision for distance vision. For me, this meant I couldn’t read the street sign on the next corner.
Our advice is to go talk with your ophthalmologist or optometrist. Many will be able to offer you demo lenses that you can try out, and counsel you about surgical alternatives.
By the way, we’re not knocking reading glasses. In fact, we think there are plenty of sexy frames on the market these days.
Which option are you using to cure presbyopia? Let us know.
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