Refractive errors are common vision problems. Multifocal contact lenses can help if you develop presbyopia along with more than one other refractive error — most often, myopia and astigmatism together. (Learn More)

There are a few types of multifocal contact lenses based on where the powers are located on the lens itself, which determines how your pupil adjusts to see at different distances. (Learn More) Bifocals are a type of multifocal lens, but there are other types that may work better for you. (Learn More)

While there are many great reasons to try multifocal contact lenses, there are some downsides to consider too. (Learn More) Price can be a factor as well.

Ultimately, the best way to decide whether to get multifocal contact lenses is to work with your eye doctor. (Learn More)

Multifocal Contact Lenses Correct Multiple Refractive Errors

Close-up Of Young Man Holding Contact Lens On Finger

Contact lenses are plastic devices that rest on top of your cornea and correct a refractive error. If you have a refractive error, you may have myopia (nearsightedness), astigmatism, hyperopia (farsightedness), or presbyopia (age-related farsightedness).

Many people have more than one refractive error. For example, myopia and astigmatism together are very common. There are several methods for managing refractive errors, and soft contact lenses are among the most common devices.

As you age, you are likely to develop presbyopia with other refractive errors. It is common for people in middle age or older adulthood to have myopia, presbyopia, and astigmatism. Often, this means you end up wearing a set of contacts to correct your existing refractive error and then wearing reading glasses when you need to for up-close work. Your optometrist may recommend bifocals or multifocal lens glasses for times when you need to consistently correct all refractive errors. However, you may not want to wear glasses again, and instead, you want to stick with contact lenses.

Multifocal contact lenses allow you to see near, medium, and far distances with better visual acuity and less juggling of other devices, like wearing contacts and also wearing reading glasses. They are not for everyone, but they can be very helpful for some people who have more than one refractive error.

How Do Multifocal Contact Lenses Work?

Any type of contact lens that has two or more “powers,” or prescriptions, is a multifocal contact lens. Bifocal lenses are the most familiar to most people, but there are other forms of multifocal lenses, including trifocals and progressive lenses.

Wearing multifocal lenses allows you to alternate between multiple activities. For example, you can look at the GPS on your phone while you are stopped and then read road signs while you drive.

There are different sections in multifocal lenses for different prescription powers. Famously, bifocal lenses in glasses have a top section for your dominant refractive error, like myopia, and a bottom section for presbyopia treatment. These are clearly divided sections. Bifocal contact lenses sometimes work the same way.

More people wanted smoother transitions between these visual areas, especially if they have more than two powers in their glasses or contact lenses. This led to new types of multifocal lenses for glasses and contacts. Some of these include:

  • Segmented, which look like traditional bifocal or trifocal lenses in glasses, featuring clearly divided areas for focus.
  • Progressive, which transition seamlessly from one area to another in your vision.
  • Concentric, which have rings of vision correction rather than sections from top to bottom. These can feel better for contact lens wearers.

Most people who use contacts get soft contact lenses, but if you have specific eye conditions, you may ask about hard gas permeable multifocal contact lenses. These are rarely used, however. Most optometrists and ophthalmologists recommend soft contacts, as they allow better oxygen flow for the health of your cornea.

You can get daily disposable lenses, month-long lenses, and some other in-between options. If you wear contact lenses for a month, your doctor will recommend that you wear them no more than 16 hours per day and dispose of them when the month is up.

Bifocal vs. Multifocal Contact Lenses

Bifocal contacts are a type of multifocal lenses, but they work better for specific people compared to other multifocal lenses. There are specific reasons you may choose bifocals or other types of multifocal lenses.

  • Bifocals: If you recently developed presbyopia, but have worn contact lenses to correct one refractive error like myopia or astigmatism for much of your life, bifocal contact lenses can work well for you. You are already used to wearing contacts, but you need two powers for better visual clarity rather than just one.
  • Multifocals: Myopia, astigmatism, and presbyopia together are common in older adults. If you have more than two refractive errors, bifocals probably do not offer enough visual correction. Instead, you can get progressive multifocal contacts or concentric multifocal contacts, so you can adjust your vision to a different distance with a different lens power quickly and easily.

You may not be a good candidate for contact lenses at all if you have chronic dry eye. This condition is common in people who have worn contact lenses for years, and it becomes worse in people once they enter middle age. You may find that your eyes’ health improves if you wear multifocal glasses or trifocal glasses rather than wearing contact lenses most of the time.

Talk to your optometrist about multifocal vs. bifocal contact lenses. You will need to undergo a special contact lens fitting for either type of lenses. This includes discussing your daily habits with your optometrist or ophthalmologist. They will then use this information to determine how often you need to access more than one lens power so you can see well.

One concern for multifocal lenses that is less of a concern for single power or bifocal lenses is pupil size. Multifocal lenses tend to be the concentric type, meaning the different powers in the lens radiate out from the center of the lens to the outer edges. The prescription powers on these lenses must be within the pupil’s range of adjustment in contacts, but contacts move in the eyes, which can put them off-center. This can be especially true as the pupil adjusts to intense light changes — moving from bright outdoor light into a dark room, for example.

If the lens shifts too much, the eye will be uncomfortable as it attempts to adjust. It is important for your optometrist or ophthalmologist to consider these issues while fitting you for multifocal contacts. Also, expect to go through an adjustment period before you fully judge how these lenses work for you.

The Pros & Cons of Wearing Multifocal Contact Lensescontact solution

Having access to a variety of methods of visual correction means that more people can have improved visual clarity in the way that works best for them. There are some great benefits to wearing multifocal contacts, but there are some downsides too.

  • Pros: If you have enjoyed wearing contact lenses and do not want the weight or poor peripheral vision that come from glasses, you are likely a good candidate for multifocal lenses. You should also have healthy eyes, which your optometrist or ophthalmologist can measure.

    You are also a good candidate for multifocal lenses if your distance vision correction does not exceed 1 diopter for astigmatism. However, you can still try multifocal contact lenses if your astigmatism is greater than that. It may take a little more adjustment time to learn to use them.

    If you need several powers because you consistently switch between ranges of vision throughout the day, multifocal lenses are convenient.

  • Cons: Middle-aged and older adults are at higher risk for chronic dry eye, so wearing contact lenses of any type can be uncomfortable. This includes multifocal lenses. It may be better for your eye health to wear glasses instead.

    The adjustment period can take some time as well, even if you normally wear contact lenses. You have to train your brain to use the different powers on these lenses, which might not quickly make sense. Instead, you might try to wear reading glasses or multifocal glasses first, and then try wearing multifocal contact lenses once your mind understands the basic process of switching between powers.

It is important for practitioners to inform their patients who are interested in multifocal contact lenses that they will not get perfect, complete visual acuity. They will not have 20/20 vision when they wear these lenses.

Instead, they will get improved visual clarity at different distances when they focus. This means other objects in the world may be blurry. For example, while you read, you use up-close vision; it can take a moment for your eyes to refocus when looking into the distance. This can be frustrating for some people.

Talk to Your Eye Doctor Before You Decide on Multifocal Contact Lenses

Multifocal contact lenses are more expensive than single-power contacts, but with a prescription from your optometrist or ophthalmologist, your vision insurance should help to offset that cost.

If you are interested in these lenses because they are convenient and can help you with presbyopia correction on top of other refractive error correction, talk to your eye doctor. They can advise whether they think these lenses would be a good solution for your vision issues and your lifestyle.

If you decide to move forward with them, work with your doctor to get the right fit and to understand any side effects. They can give you tips on how to best adjust to your lenses.

 

References

Refractive Errors. (July 2019). National Eye Institute (NEI).

Contact Lens Types. (May 2019). American Academy of Ophthalmology (AAO).

Other Types of Contact Lenses. (July 2019). National Eye Institute (NEI).

How Do Bifocal and Multifocal Contact Lenses Work? (November 2015). VSP Individual Vision Plans.

Nine Habits for Multifocal Contact Lens Fitting Success. (August 2017). Optometry Times.

Determining Multifocal Parameters for a Better Fit. (August 2016). Review of Optometry.

Identifying Good Multifocal Candidates. Bausch + Lomb.