Key takeaways:
Contact lenses are a popular fix for poor distance vision. But most people need to also use reading glasses to help with focusing up close as they get older.
Bifocal contacts combine up-close and distance vision prescriptions into a single lens. That way you can see both near and far — without glasses.
A variety of bifocal and multifocal contact options are available. 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 your teens, 20s, and 30s. But as you get older, your visual needs change.
Everyone experiences vision changes when they reach their 40s. Presbyopia is a normal change in your eyes associated with aging. With presbyopia, your clearest, most comfortable reading distance moves 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’re 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. You can either do this by switching glasses or opting for bifocal (or multifocal) contacts or glasses.
Like bifocal glasses, bifocal (or multifocal) contact lenses combine two or more prescriptions in one lens to help with presbyopia, including:
For distance vision: One prescription helps with distance vision (for objects about six feet away or further).
For up-close vision: One prescription helps with near vision (for objects at about an arm’s length away).
For mid-distance vision: An intermediate prescription between the two can help with mid-distance vision, such as sitting at a computer.
Bifocal and multifocal lenses ensure that light from both near and far objects is focused on the retina, providing you with clear vision at multiple distances at all times. After an adjustment period, the brain adapts to the lens zones, so that you can seamlessly switch between near, middle, and far vision.
Yes, but bifocal contact lenses may not be an option for everyone. Depending on your eye shape and the type of astigmatism you have, it may be possible to combine your bifocal prescription for presbyopia with a correction for astigmatism into a single contact lens. These are called bifocal (or multifocal) toric lenses. But these specialized contact lenses can be expensive, and they won’t feel right for everyone.
Bifocal contact lenses can be a great option for people who are comfortable using contacts and want to avoid wearing any glasses. There are many options available, but they’re not right for everyone.
The benefits of bifocal contacts include:
Convenience: Using reading glasses in addition to your existing glasses or contact lenses can be annoying, especially if you’ve never needed glasses before. And taking reading glasses on and off can be bothersome.
Appearance: Bifocal and multifocal contacts are designed to help contact-lens wearers keep a glasses-free look.
Good for active lifestyles: Multifocal and bifocal contacts may be a good option for people who do lots of sports or physical activities that involve goggles and helmets.
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The disadvantage of bifocal contacts include:
Trial and error: Because of the sophisticated technology involved with these lenses, it might take several tries to find a pair that’s comfortable for you.
Time to adapt: It often takes time for your brain to adjust to having multiple prescriptions and zones in one lens.
Visual symptoms: Some people experience glare, halos, or difficulty seeing in low-light conditions. You may also notice that your distance vision isn’t quite as sharp as with contact lenses designed for distance-only vision.
Cost: Bifocal or multifocal lenses are typically more expensive than single-vision lenses.
Not suitable for everyone: For people with complex or strong prescriptions, or severe astigmatism, it may not be possible to combine different corrections into one lens.
You’ll want to be patient as you test-drive different types of bifocal or 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. (You can read more about this workaround in the monovision section below.)
Many types of bifocal and multifocal contact lenses are available from various manufacturers. Most have options for soft, rigid, and hybrid materials. Each option has different features.
Here are some types of bifocal and multifocal contact lenses you could encounter.
Here’s what to know about segmented contact lenses:
How they work: These 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. Since all contact lenses naturally shift around on the surface of your eye as you blink, the zones can move. Often, segmented contacts are weighted or shaped on the bottom to help keep them in place.
Trifocal option: Trifocal segmented lenses are also available. With trifocals, you can add a third zone to help you see clearly at an intermediate (middle) distance.
Material: Generally available as rigid gas permeable (RGP) lenses (known as hard contact lenses) which can be helpful if you need a very strong correction for your distance vision.
Downsides: Like with bifocal glasses, you’ll need to look downward when you read, which can sometimes be an annoyance.
Here’s what to know about concentric contact lenses:
How they work: Concentric contacts contain distance and up-close prescription zones arranged in alternating rings, like a target. Sometimes, rings of intermediate strength are also included. This allows you to see both close-up and distant objects clearly at the same time. Because of this, they’re also called simultaneous vision bifocal lenses. Most of the time, these contacts are designed with your distance prescription in the center of the lens. These are called “center-distance” lenses. (And “center-near” lenses put your up-close prescription in the middle.)
Materials: Concentric multifocal lenses are available as either hard or soft contact lenses.
Downsides: Because concentric multifocal lenses offer the advantage of giving you both near and far vision all the time, they can make depth perception tricky. Some people might never see as clearly with concentric lenses as they do with glasses or regular contact lenses.
Here’s what to know about aspheric multifocal contact lenses:
How they work: Aspheric multifocal lenses are designed so that their strength changes gradually from the center out to the edges. Typically, these 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 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). These lenses give your eyes a range of focal strengths all the time. This approach is similar to the way progressive eyeglasses work.
Materials: Aspheric multifocal contacts come as either soft or hard lenses.
Downsides: Just like with progressives, there can be an adaptation period. This means it can take time for the brain to adjust to the multiple focal points, and some people never fully adapt. Some people also experience problems with glare and halos in their vision at night or in dim lighting. This can make nighttime driving a problem.
Yes, contact lenses are safe and effective if you’re 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 shouldn’t 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.
“Your eyecare provider will take careful measurements to ensure that the contact lenses are the correct power and fit for your specific eyes,” notes Dr. David Meyer, an optometrist at the Moran Eye Center in Salt Lake City, Utah. “Keep in mind that contact lenses are medical devices and careful evaluation is critical to provide a healthy fit and optimal vision.”
Most opticians offer trial lenses to help you decide if they work for you. Check whether this is part of their service, so you can try before you buy.
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 you have some other options, too, that may allow you to continue to be glasses-free, if that matters to you.
Reading glasses (also called readers) 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. Progressive eyeglasses provide all the benefits of bifocals but look just like regular glasses.
An inexpensive workaround for contact lens wearers is to get basic, single-strength contacts and 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, but for others this can be a very effective method to provide clear vision.
If you’re looking for a way to avoid glasses altogether, but you can’t find contacts that work for you, 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.
Bifocal or 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 and want the option of going glasses-free. A variety of different types are available, including bifocal, aspheric multifocal, and single-vision contacts with monovision. But these options don’t come cheap and may take some getting used to. 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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Gurnani, B., et al. (2023). Contact lenses for presbyopia. StatPearls.
Mukamal, R. (2024). Corneal inlays: A surgical alternative to reading glasses. American Academy of Ophthalmology.
Shovlin, J. P. (2003). Monovision vs. multifocal: Which would you choose? Review of Optometry.
University of Utah Health. (n.d.) David A. Meyer, OD, FAAO.