Ruby wrote:
Hi. I am far-sighted and have add +2.25DS.  I’m currently using 2 eyeglasses: 1 bifocal for reading and 1 with full grade lens for computer use. I use the computer almost the whole day at work. Problem is, I switch from one eyeglass to another when I have to get up from my desk because with the computer glasses, everything is blurred beyond an arm’s length. My optician has recommended progressive. But would this solve my problem, can I use the progressive for computer work?  I understand it’s the lower part of the lens that I would need for computer-distance.  Would that not strain my neck as I would have to tilt my head to use that part?  I’m supposed to buy the glasses in 2 days, so I would appreciate your advice. Thanks.

ANSWER

Hi Ruby,
Progressives would solve your problem as they actually have three different powers – distance, intermediate and near.  All distances will be clear with these lenses.  There is a different prescription for the computer than there is for reading.  With progressive lenses the top part of the lens is for distance, and then it gradually changes into an intermediate prescription and then into reading at the bottom of the lens.  The intermediate portion is part way down the lens.  Therefore to look at the computer screen you will have to look slightly down, but not all the way to the bottom of the lens.  You do need your computer monitor in the right position for progressive lenses to work optimally.  Ideally you want the top of the monitor to be at about eye level, that way you are naturally looking down at the monitor.  If your monitor is too high you will be forced to tilt your head up.  The only thing you may notice in going from a strict computer lens to progressives is that the clear area will be narrower and in one spot, versus the computer lenses, which allow clear vision for the computer through any part of the lens.
Dr. Doman

Aimee wrote:
I have worn glasses since I was 12 and fulltime since I was 31-32.I have always had 1 pair of glasses that I used for everything.2 years ago my optometrist started me on hidden bifocals.I couldnt stand them so this time when I went back in nov I told him I didnt want hidden bifocal and just wanted my normal lenses back.So I got them(or so I thought) and I cant use them on computer at night*(I always could with all my previous glasses)These make my eyes seem blurry .I have transitions glasses for the first time could that affect them?.Also when I read now I have to take them off,cant read with them.Ive never had this problem before ever.I have always had 1 pair that did it all/So I called and told them I couldnt read with them or anything.
They said bring them back and I will pay 130.00 to put hidden bifocals in!!!I dont want hidden bifocals.I have a feeling they really messed up here and I shouldnt have to pay to correct their mistake.Why all of a sudden after all these yr s cant I read with them? Which is exactly why I got them in the first time when I was 12.
TY for any help you can give,Aimee

ANSWER

Aimee,

Since you have not mentioned your current age, I will write this with the assumption you are in your 40s, the time when most everyone needs some help with focusing up close.  I will also assume that the “hidden bifocals” are progressive lenses.

By the time we all reach our 40s it becomes difficult to see print at normal reading distances.  Those who are short sighted (Myopic) can often take their glasses off to read, but this is not very convenient in many situations.  Those who are far sighted (Hyperopic) have no choice but to get reading glasses of some sort.  Help for reading comes in several versions  -  separate reading glasses, old fashioned lined bifocals, or todays Progressive lenses (also called Multifocal lenses).

There is no going back unfortunately, we have not yet found a way to restore focusing ability as you had in your 30s.  So yes, I am afraid that you will need progressive lenses from now on.

Dr. Joan Hansen, Optometrist for CAO

D. George wrote:
My optometrist has said I must have two pairs of glasses instead of bifocals.  Until now I have only used reading glasses.  I can’t understand his explanation.  Heavy accent, keeps saying it the same way!

Small town, only one optometrist.

Why would an optometrist not want me to have bifocals.

ANSWER

Dear D. George

There might be a medical or work related reason why the optometrist suggested two pairs of spectacles instead of bifocals.  Bifocals and progressive lenses do take a little bit of time to adapt to the way they work.  The progressive lenses work with the distance vision at the top of the lens, intermediate near the middle and the reading area towards the bottom of the lens.  If you look to the side the vision will be blurred so you must move your head and your eyes for the correct position.  Initially, you will do this with thought but afterwards it will become second nature.  The reason the vision is blurred at the sides is due to the change in the lens power of your prescription.  The bifocal has only two distances: far sight at the top portion of the lens and near sight in the little segment portion.  You must be careful when you change your viewing distance from far to near as you move down the lens objects will appear to jump up towards you.  If you are still keen to try bifocals/progressive lenses, then do so but keep in mind a period of adjustment to get used to the new way the lenses work.  It is sometimes easier to have one pair of spectacles rather than two.  You can also go back to two pairs if bifocals/progressive lenses do not work for you.

Joe wrote:
Several months ago after getting my eyes checked and being told I needed to wear bifocals (at 50+). I was issued computer glasses and new bifocals.

Since then I have continued to struggle with wearing the bifocals. I thought maybe it was vanity or just me being strange about all of this.

I had maintained all along that I could read fine without glasses, but now after wearing these bifocals sometimes it’s blurry to read without them.

I do understand that the concept here was that with the bifocals you can see distance and close up, but I still find (at times) that the distance of the print has to be “just so” in order to read. Oftentimes the glasses end up on the top of my head or on the counter. At work the computer glasses work best as the bifocals are useless.

I guess my biggest adjustment (or lack thereof) has been that the bottom part is almost always in my field of vision. There are times when I don’t see it, but they are few and far between. I’ve even worn my old prescription on occasion to see if I’d really like just the old fashioned glasses again.  I have not been able to come to a definitive conclusion.

I guess I’m reaching out because I just don’t know what to do. Is it worth it to try to adjust the bifocals to see if the lower part could be lowered more? Or should I just “stick to it” and try to adjust? Are “no- lines” better?  I know I had a bad experience with progressives some years ago which was discussed at my initial visit to my opticians. It was probably just an improper fitting at that time. Would progressives be better?

On one of my last visits, the optician suggested having a regular pair made for $99.  I kind of balked at that because to me, if I happen to like the “regular” glasses, the bifocals would stay in their case and I’d just be out more money! I also have been experiencing a pain in my neck on the right side.  I have been wondering if it could have been caused by looking through the bifocals.

Today I went to my opticians and explained all this again.  I end up walking out with nothing solved.

Thanks for listening to my venting! I’d appreciate your opinion and assistance.

ANSWER

Joe,
I am becoming presbyope like you and I fully understand what you mean. First of all, a bifocal pair of glasses is certainly not the best way to correct presbyopia nowadays. Modern progressive glasses are certainly more appropriate and will give you more “natural” vision. My preference is the Hoya lenses (Hoyalux ID) which is probably the best progressive lens in the market. It took me less than a minute to get use to them and I feel comfortable to see at all distances with them.  Essilor Physio 360 and Nikon Seemax are other great lenses that provide comfort and ease of use. However, they are not cheap. But it takes what it takes to see well. Cheaper progressive lenses are made from an old technology and it is not unusual to see patients struggling to get use to them for several days or weeks. For that reason, I do not prescribe them anymore. I rely on the 3 other very good, up-to-date, state-of-the art progressive lenses (Hoya, Essilor and Nikon).  For computer work, computer glasses are the best for sure. The problem with the progressive lenses is that you have to look at the inferior part and this causes neck problems. In that area, Nikon “on-line” products are probably the best.

Once prescribed, make sure to wear your glasses on a full time basis for the first few days in order to optimize the outcome. Once you are used to them, you can wear them as needed.

A last piece of advice would be to get your glasses from the professional who examined you. Optometrists know your eyes better than any other professionals and can help you to design the appropriate glasses for your need. If there is a problem, it is always easier to go back to the professional who did the exam and treatment (glasses) – If you consult 2 places they share the responsibility and you can be stuck in the middle of the battle between them.

Hoping that this will help you,
Langis Michaud
Associate professor – U de Montréal

Roy wrote:
I have a question about progressive lenses. I am 59 and have worn reading glasses for about the last ten years. I recently had my eyes tested and find that I should now have glasses for distance as well. I work and use computers for a significant part of my day. I would like to have glasses made with progressive lenses that have the top 1/2 for distance, then the next lower section (1/2 of what is left) for computer range and the bottom 1/4 for reading. Typically, I believe more space is used for the reading portion than the computer portion and I would like the portions as I have indicated above. Would this be commonly available? The optometrist that is trying to sell me glasses claims that this is not available and wants to sell me bifocal reading/computer glasses and a pair of progressive reading/distance glasses. She claims that progressive computer/reading glasses have the top portion for computer distance and progressing towards the lower reading portion. I am having a hard time believing her.
If need be, would my request be available in a tri-focal?
Thanks, Roy

ANSWER

Roy,
Your optometrist is absolutely right. The best way to address your problem is to get a reading/computer glasses for your regular work and to have a regular progressive lenses for other activities. Regular progressive lenses are limited for computer work since you will have to look at the bottom part for most of the times, which can create discomfort and neck problems. This is why computer glasses (that offer the top for computer distance with progression in the lower part to see the desktop and papers at closer distance) are designed.
Other option could be to correct your distance vision with contact lenses and to rely on computer glasses only. Or to consider multifocal contact lenses of the newest generation (Pure Vision Multifocal, Proclear EP or Acuvue Oasys for presbyopia) to correct both distance and near vision without problems with head movements and other limitations of the glasses.
A little bit later, you can also consider clear lens extraction surgery and the insertion of multifocal/bifocal implants in lieu of the natural crystalline lens in the eye. This is surgery similar to cataract surgery offering you to correct distance and near vision with the replacement of the crystalline lens (which is not contributing any more) by an implanted lens that can correct both distance and near vision.
Discuss these options with your optometrist. That is the most appropriate person to help you since they know your eyes better than anyone else.

Good luck
Langis Michaud

Jim wrote:

My age is 57. I am on my second pair of progressive eyeglasses over a four year period.  Still, these glasses give me severe eye pain/strain. My doctor says they’re the best. Should I just get lined bifocals? Many friends say they returned their progressives for lined bifocals.

ANSWER

After four years you should have adapted to your lenses. They do give the best vision since they focus at all distances.  Lined bifocals only work for far distance (like driving) and reading, but do not focus at all in the arms length (computer screen) distance. In a lined lens you would need a trifocal (two lines) to get a similar effect. I might suggest that you ask another eyeglass supplier to check your progressive eyeglasses to assure that they are sitting straight on your face.

Dr. Joan Hansen, Optometrist for CAO

Maria wrote:

I am over 60 and have been using bifocals for a few years. I need to get new glasses. I have been trying to do some research and have gone to 3 different places. Now I am confused as each one has a different kind of lenses, Physio 360, Zeiss, Shamir, Panamic, how do I know which is the best? My prescription is around -4 to -4.75.  The price is different, but I want something that gives very good vision.

Thank you, Maria

ANSWER

Hi Maria,

Thank you for your question.  It sounds like you are wearing progressive lenses or what are also referred to as invisible bifocals.  These can be extremely confusing to shop for.  There are literally hundreds of types and brands of progressive lenses.  Some of these lens designs can be 20-30 years old.  In the past few years there have been huge advancements in the world of progressive lenses.  The newest generation of progressive lenses is called free-form progressive lenses.  The biggest advantage with free-form progressive lenses is that they are customized to the individual.  In the past progressive lenses could only be made from lenses with certain pre-determined base curves, which gave sub-optimal optics.  Because free-form progressives are customized to your individual prescription and frame parameters they increase your field of view and decrease distortions in the periphery of the lens.  Distortions in the periphery of the lenses were always a disadvantage with traditional progressive lenses and contributed to adaptation problems.  To answer your question, for the best vision I would recommend free-form progressives.  There are a number of good free-form progressives on the market and it is impossible for me to say which one is the best.  Of the names you have listed above Physio 360 is made by Essilor and is a free-form progressive, Zeiss and Shamir are brand names who both make free-form progressive lenses.  Panamic is also made by Essilor, but it is not a free-form lens.  You will pay more for free-form lenses, but in my opinion the benefits outweigh the cost. I hope this helps with your decision.

Dr. Carol Doman

Robbin Ritchie wrote:

Is it true that round bifocals are not good lenses?

I am looking to purchase glasses and since the majority of lenses are not large enough to comfortably accommodate progressives, would rather not have the lines.

Could you answer to this?

ANSWER

Robbin,

Progressive lenses are the lens of choice in today’s world and there are styles of progressives that can fit in narrow frames.  The problem with Round bifocals (or any bifocal for that matter) is that you have to pick what distance you want the bifocal part to be in focus.  The top part of the lens focuses far away for driving and TV.  The bifocal part can focus either on the computer screen or reading material held in the hand, NOT on both.  Progressive lenses have a gradual change in focus so that all distances can be seen clearly, while the round bifocals cause the print to “jump” in location as soon as you cross over the line.  I would strongly suggest that you talk to your Optometrist, or glasses person, about shallow lens designs.  If you are not getting satisfactory answers, speak to some one else who is more up to date on the latest lens designs.

Dr. Joan Hansen    Optometrist
for CAO

Telya wrote:

I do not comprehend why some enterprising lens maker has not just made a real no line bifocal. I had cataract surgery and now am ready for my new progressives but I’d really just like bifocals but am so vain that I do not want the visible line.

I’ll have plano for my left, non dominant eye and a slight astigmatism correction for my right dominant eye for distance since my left eye is now 20/15. I’ll need reading glasses of about 2.25 or 2.50. I can see my computer and dashboard just fine without correction but am forced into an intermediate section to get the no lines. Just ridiculous!

Now, is Physio (not the 360) just plain Physio really a good lens? Everyone you ask has a different opinion, depending on what they sell. It’s just not fair to the customer.

Also, I do not want any of that crappy coating that will scratch or peel in a year or two.

Any advice?

ANWSER

Dear Telya,

Most people find that having a section in their glasses to provide improved intermediate vision improves their overall visual comfort. While you probably can see your computer and dashboard reasonably well, a well fitted pair of progressive lenses will probably improve your vision for these tasks.

It is impossible to pass judgement on a specific brand or lens design without considering the needs and expectations of the person who will wear the lenses. Most optometrists supply a wide range of progressive lens options, and they or their staff can discuss available options with you. A “good” lens is one that allows you to see clearly and comfortably. For most wearers, there is a variety of “good” lens options.

There are also a variety of lens coatings available, some of which stand up better in certain environments than others. If you have had problems with coatings in the past, it would probably be prudent to purchase a coating that has a two year warranty. In my experience, some patients never have problems with any coating, and some patients seem to have problems with every coating. All coatings require extra care to prevent scratching and deterioration. Again, you should probably discuss your options with your optometrist.

Dr. Smit