Do I need multifocal contacts?!
Question: I can see crystal clear for 4 feet in front of me, reading even fine print 6 inches from my face is easy, but after 4 feet things get progressively blurrier due to my myopia and astigmatism (around -1.00 SPH and CYL, each eye, at around 90 axis).
At 45 years of age, everyone wants to put me in multifocal contacts, but could I just skate by (for a few more years anyway) in single vision toric contacts correcting only for my myopia?
It seems to be so silly correcting for near vision when it is still so sharp and clear...?
Am I missing something, or is the broader definition of presbyopia not that you can't necessarily focus up close, but that single vision correction lenses will diminish your near vision?
Answers: I can see crystal clear for 4 feet in front of me, reading even fine print 6 inches from my face is easy, but after 4 feet things get progressively blurrier due to my myopia and astigmatism (around -1.00 SPH and CYL, each eye, at around 90 axis).
At 45 years of age, everyone wants to put me in multifocal contacts, but could I just skate by (for a few more years anyway) in single vision toric contacts correcting only for my myopia?
It seems to be so silly correcting for near vision when it is still so sharp and clear...?
Am I missing something, or is the broader definition of presbyopia not that you can't necessarily focus up close, but that single vision correction lenses will diminish your near vision?
You are a one dioptor myope.
If your prescription were minus one each eye, you would be able to see out to one meter perfectly clearly.
If you go out beyond one meter, lettters will start to blur. Not because the letters are too small necessarily, but because they are beyons your range.
Since you have -1.00 with a certain amount of myopic astigmatism, your range increases somewhat.
Now suppose you were to make some vertical and some horizontal lines on a piece of paper, put it on the wall and walk towards it slowly. Take off your glasses before you do this. Check one eye at a time. If you have myopic astigmatism, you will see the vertical lines come into focus. As you continue slowly towards the paper both v and h lines will become equally clear and finally the horizontal lines will become the most clear, If you approach the wall more closely everything will fuzz out and you will not be able to clear it.
The first number of meters (where the vertical lines come sharp is your focusing distance for vertical lines. Measure this distance in meters. This is your sphere power. Power is 1 divided by focal distance in meters. So if you saw clear at 1 meter, the negative power would be -1.00. Then is you measured the distance where the horizontal lines came into focus, say 67 cm., then your cylinder poiwer would -1.50 Dioptors minus 1.00 dioptor, or -.50 Dioptor.
Then your Rx in that eye would be something like -1.00 -.50 x 90.
Now getting back to your question. The people don't understand that although they may need some help for reading, that you do not. What they don't understand is that you have a built in reading situation. You can see perfectly well for reading distance, and you always will.
One man's reading glasses are another man's distance glasses. In this instance your eyes are set for reading without help.
All this is true until you put your contacts in. When you put your contacts in how is your reading vision? How is your distance vision? I would guess that you can see less perfectly for reading with them in than with nothing at all. Tell me honestly, is your near point of clear focus still 6" with your contacts on? If it is, then just go ahead and keep them in for reading. I think that if you examine things carefully you will find your near point moving out with time. Sooner or later your near point will move out to a point where you will find it difficult to read with lenses on. When this begins to happen, you will find that you need a little help for reading.
Try this. Go down to the drug store, ask for Dr. Dean Edell, and try on a pair of low powered reading glasses.
There, now. Doesn't that help?
Of course when you look at a distance your visual acuity will be somewhat compromised.
Now do you get it?
You could try mono vision contacts. Thats where one lens is corrected for distance and the other is corrected for near vision.
To be completly honest, if your able to read fine print and have clear distance vision with your current SV Toric contacts, then stay with them. Bifocal contact are hard to fit and don't work for everyone.
I will caution you that if you have been fatigued latley and or have been geting headaches, it could be from your eyes having to accomodate for your close up reading. Because you have such a mild RX, your eyes could be doing all the work for you that your glasses or contacts could be doing.
Good luck in your vision decision, Eric
It's purely down to you, though your subconscious mind gets a major vote on whether multifocal contacts are good or terrible. Not everyone likes them, even people who want them badly.
Firstly you only need to *consider* them if your near vision with the contacts on is blurred or fatigueing, for the sort of closework you do.
45 isn't a rule, it's an average (for people of European descent) Some people make it to 50 without a significant reading addition, others are in trouble at 40.
If you do lose your near vision with the distance contacts on, yes, you are presbyopic. "When the distance prescription, if present, needs to be modified for near." would do as a rough definition.of presbyopia.
Options then are:
N/V without Rx, spectacles for distance.
Multifocal spectacles.
Distance contacts with reading glasses over as required.
Monovision contacts.
Multifocal contacts.
Every one of those has advantages and disadvantages, and I've known people pick every one of them as the route that suited *them*.
Potential drawbacks of multifocal contacts, apart from the cost:
not usually any correction for astigmatism available, poor performance in dim light, glare and flare when night-driving. Vision quality may be poorer than with other corrections even if the letter reading ability on a high contrast eye chart (standard black & white one) seems the same.
Anyone who thinks multifocal contacts are *always* the answer either doesn't know the alternates or doesn't know multifocal lenses!
Toric lenses correct for astigmatism. The axis and cylinder correction is for the astigmatism. The sphere is for distance. The thing about near vision, if you need correction for near, lenses that just correct for distance and astigmatism will not help with your near vision. You might find if you are placed in lenses without the near correction, that you can't see up close. Nearsighted people can read up close without any kind of correction, but once you put glasses on or wear contacts, you can't see up close then. I am 43 and have to wear bifocal glasses and multifocal contacts.
What you are describing is an alternative to bifocal contacts- which is Mono vision, where the dominant eye wears the distance contact, and the non dominate eye is Rx'ed for near only- and yes, many many people wear contacts like this successfully- we sell them all day long!