Most American adults will struggle with a visual acuity issue at some point. It is typically a refractive error like astigmatism or nearsightedness, but sometimes, it’s a more serious condition like cataracts. (Learn More)

There is a wide range of approaches to changing how light is refracted onto your retina. (Learn More) Many nonsurgical options, like glasses, work for most people. Some people prefer devices like orthokeratology corneal reshaping lenses. (Learn More)

Surgical options to manage vision issues are improving all the time. They are more often being at least partially covered by vision insurance. (Learn More)

Regardless of why your eyesight is changing, you should get regular eye exams to follow the condition’s progression and then decide what approach you want for your visual acuity — either nonsurgical or surgical. This decision will be based on your visual health and the cost. (Learn More)

patient receiving cataract surgery

Vision Correction

Millions of people all over the world struggle with vision impairment of some type. About 11 million people in the United States, ages 12 and older, could get improved vision via refractive correction, according to the Centers for Disease Control and Prevention (CDC).

Myopia, or nearsightedness, is the most common form of visual impairment, but other types of eye conditions (like farsightedness, astigmatism, diabetic retinopathy, cataracts, and glaucoma) can cause poor or low vision. About 3.3 million Americans, ages 40 and older, are legally blind. Eye diseases related to middle age are the most common cause of low vision and blindness.

Treating these eye conditions involves both nonsurgical options, like glasses and contact lenses, and surgical options ranging from laser in-situ keratomileusis (LASIK) to cataract removal surgery and artificial lens implants. There are several options depending on the condition you are diagnosed with and how serious it is.

Getting regular eye exams is the best way to have your eyes diagnosed and treated for any condition that is causing low vision, blurry vision, double vision, floaters, and other eye problems.

Types of Vision Correction

There are many conditions that can cause blurry, double, or distorted vision. The most common causes are refractive errors like myopia (nearsightedness), farsightedness (hyperopia or presbyopia), and astigmatism. However, underlying conditions like glaucoma and cataracts may also lead to vision problems, and these conditions require different types of treatment.

Nonsurgical Vision Correction

  • Eye drops: If you have chronic dry eye but few other vision problems, you man using eyedropmay find that your vision becomes blurry or distorted because you do not have enough tears to keep your eyes focused. Using over-the-counter eye drops can help. You can get recommendations from your optometrist for specific brands or obtain a prescription for more effective eye drops.
  • Glasses: For hundreds of years, glasses have been the primary way of managing eye problems, especially refractive errors like nearsightedness or farsightedness. Prescription lenses are still the leading method of managing refractive errors, including complex problems that require both near and far vision correction.

    Types of glasses include:

    • Single-vision glasses. These are standard glasses designed to treat a single refractive error, like astigmatism, hyperopia, or myopia. Single-vision reading glasses treat presbyopia, a type of farsightedness that develops in middle age.

      With typical single-vision glasses, you must wear them all the time to get good visual clarity. Reading glasses are typically taken on and off, as they are often used just for close-up work like reading, sewing, or using a computer.

    • Bifocals. These glasses correct for two types of refractive errors. The main one is corrected at the top and center of the lens, while the bottom portion corrects for the secondary refractive error, typically presbyopia.
    • Trifocals. Like bifocals, trifocals correct a primary refractive error, along with a secondary and tertiary error. This could be myopia, astigmatism, and presbyopia, or it could be another combination of visual acuity issues.
    • Progressive lenses. These lenses are designed to correct multiple refractive errors, like bifocals and trifocals, but they do not have a sharp break between the different types of lenses. Instead, there is a smooth transition between the different areas of the lens. It can take some time for your mind to learn to use these lenses.

      Progressive lenses are less obvious than standard bifocals and trifocals. As a result, many people are getting these lenses as they manage presbyopia along with a primary refractive error like myopia.

If you have a diagnosed refractive error, your vision insurance will cover much of the cost of your glasses. Typically, frames and lenses are around $100 to $150, but some designer frames may cost $200 or more on their own. Some new companies that sell glasses mostly online offer rebates or reimbursements if you purchase with them.

  • Contact lenses: Although glasses come in several styles, many people who need vision correction do not want to wear them. Contact lenses were invented to treat myopia, hyperopia, and, in some cases, astigmatism, so you can see clearly without wearing a device on your face.

    These lenses are prescription-strength clear plastic discs. Most of these are soft lenses, which are more gas-permeable, so they are better for your eyes.

    Older contact lenses and some types of medically necessary contacts are hard lenses. These devices float on the tear film that covers your cornea, reshaping it enough to improve how light refracts onto your retina.

    Most vision insurance plans in the U.S. offer some coverage of contact lenses to manage your refractive error. Typically, this is an allotment, which often covers a year’s supply of contacts.

    A one-year supply of contact lenses could be as cheap as $175, although some lenses run as high as $1,400 for that supply. Many vision insurance plans offer to cover either glasses or contacts, so you may need to pay for one of these options out of pocket if you need to update both.

colored contacts

  • Corneal reshaping/ortho-K: Corneal reshaping is a system that forces your cornea into a shape that refracts light more clearly onto your retina. The most famous system for this is called ortho-K, or orthokeratology. You wear reverse geometry contact lenses overnight, which reshapes your cornea for several hours.

    Typically, the results last all day, although you may develop blurry vision at night before bed. It is similar to wearing a retainer at night after you have braces.

    Reported costs for ortho-K range from $500 to $1,000 per eye, which is lower than many surgical options. Ortho-K is not likely to be covered by your vision insurance, so this cost may come entirely out of pocket, unlike glasses or contact lenses.

Surgical Vision Correction

  • Laser in-situ keratomileusis (LASIK): This is a laser-guided form of corrective surgery that reduces your refractive error, allowing you to achieve 20/40 visual acuity or better. People who are good LASIK candidates heal within a few days, often return to work the next day, and can see clearly without visual aids like glasses or contacts.

    Using a map of your cornea as a guide, either a microkeratome or laser will create a small incision in your cornea. Then, a second laser removes part of the corneal tissue to reshape the front of your eye.

    Nine out of 10 patients achieve between 20/20 and 20/40 vision, with most people being happy with the improvements to their eyesight. Many people develop presbyopia in middle age, so you may find that you need glasses again at some point later in life, even if you have successful LASIK surgery.

    LASIK typically costs about $1,500 to $3,000 per eye, out of pocket. While few vision insurance plans cover this cosmetic procedure, more insurance plans are partnering with LASIK providers to offer discounts on this cost.

laser eye surgery

  • Other refractive surgeries: While LASIK is the most popular and familiar form of refractive eye surgery, there are many other types that may work better for you, depending on your cornea’s health, your refractive error, and any underlying conditions.

    Some other forms of refractive surgery include:

    • Photorefractive keratectomy (PRK). This procedure also uses an excimer laser like LASIK, but it works specifically for mild myopia.
    • Radial keratectomy (RK). Small incisions are made around the cornea to reshape it, which works best for mild myopia.
    • Astigmatic keratectomy (AK). Like with RK, a series of incisions reshapes the cornea. This procedure is designed specifically for astigmatism
    • Other types of LASIK. Wavefront LASIK, LASEK, and EpiLasik use various combinations of microkeratomes and guided lasers to improve on standard LASIK outcomes
  • Intracorneal ring segments: These are implanted into the cornea to adjust its shape, reducing mild myopia and improving how light is refracted onto the retina.
  • Permanent contact lenses: Phakic intraocular lenses (IOLs) or permanent contacts are lenses added to the front or back of your natural lens, adjusting its shape and improving how light refracts onto your retina so you get a clearer image.

    Unlike many surgical vision improvements, this operation can correct a high degree of refractive error. It is also good for people who have thin corneas, struggle with dry eye, or are otherwise not good LASIK candidates.

    If something goes wrong, the lenses can be surgically removed. Other forms of refractive surgery cannot be undone.

    woman with cataract

  • Cataract surgery: Cataracts are spots of cloudiness or darkness that indicate proteins in the lens of your eye are damaged.There is no medical treatment to slow down the progression of cataract development once this begins, but typically, this condition takes decades to significantly impair your vision.

    Once your vision is low enough that you cannot see clearly, even with glasses, your optometrist or ophthalmologist may recommend surgery to remove the damaged, cloudy lens. This lens will then be replaced with an intraocular lens (IOL). This will often be a monovision lens, but you might upgrade to a progressive lens so you can get near and far vision correction in the same eye.

    Since most people who need cataract surgery are older adults, Medicare is one of the leading methods of paying for this procedure. This vision surgery is considered medically necessary, unlike most other vision procedures, so standard health insurance will cover much of the cost.

Vision Correction Requires Regular Eye Exams

To determine how you can best correct your vision problems, work with an optometrist or ophthalmologist to get a diagnosis and prescription. Getting regular eye exams (at least every two years if your vision is good and not changing, but sometimes once per year or more) will help you manage any visual acuity issues, get updated prescriptions for glasses or contacts, and decide if you want surgery to improve your vision. Cost will often be a factor, but it’s important to first determine whether you meet the requirements for some types of surgery.

 

References

Common Eye Disorders. (September 2015). Centers for Disease Control and Prevention (CDC).

How to Choose Eyeglasses for Vision Correction. (February 2020). American Academy of Ophthalmology (AAO).

Eight Great Ways to Save on the Cost of Eyeglasses. (December 2016). Consumer Reports.

Contact Lenses for Vision Correction. (May 2019). American Academy of Ophthalmology (AAO).

How Much Are Contacts? Acuvue.

Seven Things You Didn’t Know About Ortho-K. (September 2018). Healio, Primary Care Optometry News.

What Does Orthokeratology (Ortho-K) Cost? (2018). iSee.

The Basics of LASIK Eye Surgery. (August 2012). Federal Trade Commission (FTC) Consumer Information.

LASIK Cost – How Much Is LASIK? QualSight.

Types of Eye Surgery for Refractive Errors. University of Rochester Medical Center.

Alternative Refractive Surgery Procedures. (September 2017). American Academy of Ophthalmology (AAO).

Types of Eye Surgery for Refractive Errors. University of Rochester Medical Center.

Phakic Intraocular Lenses (IOLs) or Implantable Contact Lenses (IOLs). Kellogg Eye Center, Michigan Medicine.

What Are Cataracts? (October 2019). American Academy of Ophthalmology (AAO).

Cataract Surgery. (September 2019). American Academy of Ophthalmology (AAO).

Procedure Price Lookup: Extracapsular Cataract Removal. Medicare.gov.