Multifocal Vision Solutions

Progressive glasses

Lenses that grade from distance at the top to near at the bottom with intermediate between, with no visible line. Effective, adjustable as the prescription changes, and free of surgical risk. The compromises are a narrow reading zone, distortion at the edges, and the glasses themselves.

Multifocal contact lenses

Soft, rigid, hybrid or scleral lenses with concentric or aspheric multifocal optics, or a blended fitting with one eye nearer. Good for patients who want to be free of glasses without surgery, and a useful trial of how the brain handles multifocal vision before committing to an implant. Dry eye and astigmatism complicate the fit but rarely prevent it.

Blended vision with laser or the ICL

Setting one eye for distance and the other slightly near with LASIK, SMILE or the EVO ICL, for patients in their forties whose lens is still clear. Reversible in the sense that the balance can be adjusted, and trialed first with contact lenses. Depth perception and fine near vision are the compromises.

Lens implants

• Trifocal or full-range (for example PanOptix or Odyssey): distance, intermediate and near; the most complete independence; night halos during adaptation
• Extended depth of focus (for example Vivity or Symfony): a continuous range with fewer night effects; readers for fine print
• Enhanced monofocal (for example Eyhance): distance with improved intermediate; monofocal night vision; readers for near
• Light Adjustable Lens as blended vision at cataract surgery: monofocal clarity with the balance fine tuned after surgery

Implants are placed at Refractive Lens Exchange from the mid to late forties, or at cataract surgery, and toric versions correct astigmatism at the same time.

Matching the solution to the patient

Under 45 with a clear lens: glasses, contacts or blended laser. Over 45: lens replacement becomes the more permanent answer, with the lens type chosen from night driving, screen use, reading habits, the health of the macula and cornea, and tolerance for halos. The consultation examines and asks, and the recommendation is made for your eyes and your day.