Alternatives to Progressive Lens

Nearly all human beings begin to experience problems reading at or inside arm's length in their mid-40s. This results from a reduction in flexibility of the lens in the eye. The lens loses its ability to focus for different distances. In order to cope with this problem, a person will need to use one of many available options to improve their near vision. Progressive lenses are one option, but many more exist.

Line Bifocals or Trifocals

• One of the most commonly used alternatives to progressive lenses, also known as no-line bifocals, are line bifocals or trifocals. A line bifocal has a distance prescription at the top of the lens. The reading portion of the lens is delineated by a straight horizontal line usually set at the level of the lower eyelid. The reading portion is generally prescribed for a reading distance of 16 inches. This type of lens can leave out intermediate distances such as a computer screen. If a line bifocal does not allow for clear viewing of a computer monitor, a line trifocal can be used. The line trifocal has a 7- or 8-millimeter-tall segment on top of the bifocal line that is generally set for a reading distance of 26 inches.

  Another option is a round bifocal. The top of the round bifocal is also fit level with the lower eyelid. It is in the shape of a half circle. The round segment bifocal tends to be less noticeable cosmetically. Unfortunately, it is not available in a trifocal design.

Contact Lenses

• Soft bifocal contact lenses are typically designed with a near zone and a distance zone that the patient looks through simultaneously. This can cause the vision to appear a little blurry, but people are generally able to adapt to this different way of seeing. Another option is monovision. This is where one eye is fit with a contact lens for distance, and the other eye is fit with a contact lens for near. With monovision, both distances are corrected when both eyes are open. This can take a considerable amount of time to adapt to. Many people choose to be fit with contact lenses for their distance vision only. When these people need to read, they simply put a pair of reading glasses on over their contact lenses. Whether any of these options work for any one person depends on several factors. The patient should discuss all contact lens options thoroughly with her optometrist or ophthalmologist.

Surgical Options

• Laser surgery can be performed to induce monovision, where one eye sees distance and the other sees near. Conductive keratoplasty is a laser procedure that makes it easier for a person to read at or inside arms length. If this procedure is done, the person will generally need distance glasses afterward. Another option can be done when cataract surgery is performed; the human lens can be replaced with a multifocal lens implant. These premium lens implants will generally leave a person able to drive and to read without the help of glasses or contact lenses.