Bifocal Contact Lenses: A Consumer Guide

Bifocal contact lenses are for people suffering from presbyopia or astigmatism. Each bifocal lens must be customized to each patient’s needs. A doctor’s method of fitting can either be monovision or multifocal, and they can choose from silicone hydrogel, soft, or GP lens materials.

In the past, lenses had to fit quite loosely in the eye in order for the lens to shift upward in down-gaze.

What Are the Categories of Bifocal Contact Lenses?

There are two categories of bifocal lenses: translating and simultaneous. Each lens has multiple designs.

Translating or alternating bifocal lenses allow your pupil to alternate between two power segments when you look either upward or downward. Usually the distance power is the upper segment and the near power is the lower segment. For example, if you glance downward to read the newspaper, the lower segment will make the words larger and clearer.

Simultaneous bifocal lenses enable you to look at both distance and near powers at the same time, and these have become increasingly popular in recent years. There are two basic designs a patient can be fitted with; aspheric or concentric.

Aspheric lenses have the different powers blended throughout the lens. They are “progressive” and simultaneous lenses, and the center can be designed for either distance or near power.

Concentric lenses feature a central prescription of near or far power, and are surrounded by a ring or multiple rings of the opposite power. If there are multiple rings, then they alternate between the near and distance prescriptions. Concentric lenses can be made of either soft or GP materials, and location of powers will vary from patient to patient.

GP (gas permeable) lenses are smaller and ride on your eye just above the lower lid, so when you look down the lens stays in place.

What is Monovision?

Monovision is an alternative to bifocal contact lenses. The idea is that one eye is a little better for distance, and the other eye is better for near vision. Doctors simply fit each eye accordingly, as the dominant eye is always fitted for distance. Monovision allows a constant clarity in each eye and requires less chair time than bifocal fits. Monovision can be extremely helpful when fitting hyperopic patients, astigmatic patients, and patients who aren’t good multifocal candidates.

One of the biggest drawbacks to monovision is it can lead to a loss in depth perception. Another negative feature to monovision is the fact that each eye works separately and not together like normal eyes would. LASIK can be performed with a correction for monovision, and monovision is also used for conductive keratoplasty.

Astigmatism and Bifocal Contact Lenses — Are They For You?

People who suffer from astigmatism generally have trouble wearing a soft bifocal lens because most patients are too sensitive to handle the two extreme power segments in each lens. Bifocals carry a cylinder of 1.00D, but most patients can’t even handle half of that.

So if you’re a patient with presbyopia and have a significant amount of astigmatism, you should consider bringing up one of these options to your doctor if they haven’t already:

• Use a toric single vision soft contact lens on the dominant eye, and a multifocal on the non-dominant eye.
• If only the non-dominant eye exhibits blurriness, try using a multifocal soft lens in both eyes, or try a toric, single-vision lens in the non-dominant eye.
• Avoid very thin disposable-type bifocal soft lenses and use thicker front-surface aspheric lenses instead.
• Consider a soft bifocal lens that also includes a toric correction.

What Are My Options for Bifocal Contact Lens Material?

A patient has three options in lens material: GP, hydrogel, or silicone hydrogel. Gas permeable designed bifocal lenses are the newest technology, and can be made of hard or soft material.

Silicone hydrogel is a material that allows a significant amount of oxygen to pass through the lens to reach the eye. These contact lenses are becoming increasingly popular with patients and doctors. Experts expect they will soon take over traditional hydrogel soft contact lenses.

Are Bifocal Contact Lenses Right for You?

Good candidates for bifocal lenses should have a healthy tear system, a cornea that’s in good shape, a normal blinking rate, and the ability to wear them during most waking hours with comfort.

The fittings for these lenses can be long and drawn out, so it’s important that you are prepared mentally for this process. You may need to try or test out different bifocal contact lens designs before finding the one that’s right for you, but most practitioners have free trial lenses to help you through this process.

Good bifocal and multifocal soft lens candidates are people who:

• Require a near Rx of more than +0.75D.
• Are dissatisfied with monovision.
• Have visual demands that require them to see objects simultaneously over large viewing distances such as driving, computer use and reading.
• Want a more appealing alternative to glasses without undergoing refractive surgery.

Advantages vs. Disadvantages of Bifocal Contact Lenses

Some of the advantages of bifocals are good vision at all distances, not carrying around two pairs of glasses, and not having to search for glasses simply to read. Patients report feeling “free” of their heavy glasses, and are able to enjoy activities such as sports more easily. The new generation of soft bifocal and multifocal contact lenses have provided acceptable results for many present and future lens wearers, so people who once thought they could never benefit from contact lenses now have a second chance.

How Much Do Bifocal Contact Lenses Cost?

Depending on which contact lens you choose, you could spend hundreds of dollars annually just for the lenses. Most brands offer a box of four for approximately $50–$100, but those only last a month.

Doctors usually provide free trial lenses until you figure out which lens is right for you, but keep in mind that’s not including doctor visits for fitting, adjusting, and follow-ups.

How Do I Care For My Bifocal Contact Lenses?

If you’re using disposable bifocal lenses, caring for your lenses couldn’t be easier. You simply follow the instructions that came with the lenses and wear them daily, weekly, or monthly.

In the past, GP users were told by doctors to rinse the lenses in tap water. Today this is strongly discouraged because of the microorganisms in tap water.

You should always wash your hands thoroughly before handling your lenses to prevent damage, scratching, etc., and always store your lenses in fresh solution, in a clean case.