Contact lenses are a popular fix for poor distance vision, but most of us need to add reading glasses to help with focusing up close as we get older.
Bifocal contacts combine up close and distance vision prescriptions into a single lens so that you can see both near and far — without glasses.
Many different bifocal and multifocal contact options are available, so you might need to try several types before you find a pair that works for you.
Contact lenses can be a convenient and attractive way to avoid glasses in our teens, 20s, and 30s. But as we get older, our visual needs change.
All of us experience vision changes when we reach our 40s. Presbyopia is a normal condition that causes your clearest, most comfortable reading distance to move further and further away from you over time. As this happens, it becomes increasingly difficult to focus up close.
If you already wear glasses or contacts for distance vision (that is, if you are nearsighted and have “minus” power glasses or contacts), presbyopia will cause you to need help with up close vision, too. And that means you’ll need to switch between two different prescriptions — one for near, and one for far — depending on what you need to see.
Multifocal and bifocal contacts solve this problem by combining two or more prescriptions in a single contact lens. Similar to bifocal eyeglasses, these specialized contacts can give you both up close and distance vision all the time — without glasses.
For many contact lens wearers, the most straightforward solution as you get older is to keep your regular contacts and put on a pair of reading glasses when you need to focus on something up close. But reading glasses can be an unwelcome addition, especially if you’ve never needed glasses before. And taking reading glasses on and off all the time can be annoying.
Bifocal and multifocal contacts are designed to help contact lens wearers avoid reading glasses.
Bifocal contacts are a specific type of multifocal contacts. While bifocals contain exactly two different prescription strengths in each lens, multifocal contacts can contain two, three, or many different strengths.
Many different types of bifocal and multifocal contact lenses are available from different manufacturing companies. Each has different features, and some have sophisticated technology that can add an extra cost. Here are some types you could encounter.
Segmented bifocal contacts are the most similar to old-fashioned bifocal glasses. Each lens is designed with two zones: an upper zone to give you clear distance vision and a lower zone for seeing up close, with a sharp distinction in between.
These contacts are generally available as rigid gas permeable (RGP) lenses, which can be helpful if you need a very strong correction for your distance vision.
Trifocal segmented lenses, which add a third zone to help you see clearly at a middle distance, are also available.
In general, segmented contacts, like bifocal glasses, expect you to look downward when you read, which can sometimes be an annoyance. And, since all contact lenses naturally shift around on the surface of your eye as you blink, the zones can move. Often, these contacts are weighted or shaped on the bottom to help keep them in place.
Concentric contacts contain distance and up close prescription zones arranged in rings, like a target. In each lens, rings of distance and near strength alternate out from the center. Sometimes, rings of intermediate strength are also included.
Concentric multifocal contacts allow you to see both close-up and distant objects clearly at the same time. Because of this, they are also called simultaneous vision bifocal lenses.
Most of the time, concentric multifocal contacts are designed with your distance prescription in the center of the lens. These are called “center-distance” lenses. “Center-near” lenses put your up close prescription in the middle.
Although concentric multifocal lenses offer the advantage of giving you both near and far vision all the time, they can make depth perception tricky. And some people might never see as clearly with concentric lenses as they do with glasses or regular contact lenses.
Concentric multifocal lenses are available as either RGP or soft contact lenses.
Aspheric multifocal lenses are designed so that their strength changes gradually from the center out to the edges. These lenses give your eyes a range of focal strengths all the time.
Typically, aspheric multifocal contacts are made with your distance prescription in the middle, your up close prescription around the perimeter, and a gradual transition in between. The in-between zone is useful: It can give you clear vision for tasks in the middle distance, such as working at a computer screen, seeing the dashboard of your car, or playing the piano.
If you’ve shopped around for bifocal glasses, you’ll know this gradually-changing-strength approach is similar to the way progressive eyeglasses work.
Aspheric multifocal contacts come as either soft or RGP lenses.
An inexpensive work-around for contact lens wearers is to get basic, single-strength contacts but to use a different prescription in each eye. This is called monovision.
The idea with monovision is to help one eye (usually your dominant eye) see clearly at a distance while the other eye has a lens to help you see clearly up close. Monovision can give you very sharp vision but, since each eye works independently, you’ll lose some depth perception. Some people have trouble getting used to this arrangement.
Bifocal contact lenses can be a great option for people who are comfortable using contacts and who want to avoid any kind of glasses. There are many options available, but they are not right for everyone. And because of the sophisticated technology involved with these lenses, it might take several tries to find a pair that is comfortable for you.
You’ll want to be patient as you test-drive different types of multifocal contacts. Working closely with your eye care specialist is important. Pay careful attention to what works well and what bothers you about each pair. Everyone has different preferences, and sometimes a creative solution — like using a “center-distance” lens in one eye and a “center-near” lens in the other — can be the answer.
Contact lenses can be safe and effective if you are careful about following instructions and taking good care of them. Like all contact lenses, bifocal and multifocal contacts require careful fitting by a professional.
It’s important to point out that contact lens users can develop serious problems, including severe infections and permanent eye damage. These complications are especially likely when contacts are used incorrectly. Contact lenses should never be borrowed or shared, and single-use lenses should not be reused. If you start to have pain or other problems when wearing contact lenses, stop using them and see an eye doctor as soon as possible.
You’ll want to have your contact lenses fitted by an experienced eye care professional. Optometrists are trained to measure your eyes and prescribe contact lenses. Many ophthalmology offices also offer this service.
Reading glasses are the easiest way to improve your up close vision if you already wear contact lenses for distance. If you don’t like readers but you don’t mind wearing glasses all the time, bifocal or progressive eyeglasses could do the trick. Progressives provide all the benefits of bifocals but look just like regular glasses.
If you’re looking for a way to avoid glasses altogether but you can’t find contacts you like, some surgical options are available. People who need cataract surgery can have multifocal lenses implanted inside their eyes. Occasionally, refractive surgery, like LASIK or corneal inlays, are an appropriate choice.
Multifocal contact lenses can be a convenient choice for people who already wear contacts but also need reading glasses, or for those who wear bifocal glasses but want the option of going glasses-free. A number of different types are available, including bifocal, aspheric multifocal, and single-vision contacts with monovision. An optometrist or ophthalmologist who specializes in contact lenses can help you find the best lenses for your eyes and lifestyle.
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Healthwise. (2020). Bifocal contact lenses. University of Michigan Health.
Heiting, G., et al. (2022). A consumer guide to bifocal and multifocal contact lenses. All About Vision.
Kollbaum, P. (2010). Simultaneous vision: The science behind the art. Contact Lens Spectrum.
Mukamal, R. (2022). Corneal inlays: A surgical alternative to reading glasses. American Academy of Ophthalmology.
Shovlin, J. P., et al. (2003). Monovision vs. multifocal: Which would you choose? Review of Optometry.
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