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Multifocals for Presbyopia and other conditions

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Presby Tony 27 Feb 2018, 13:26

Thanks for the info and advice, spexfan and Charlie_Delta. I have purchased Air Optix multifocals and been wearing them pretty much full-time for the last week. So far, so good. Trying to get used to the lenses.

spexfan 22 Feb 2018, 17:56

I use Dailies AquaComfort plus MF. They're +1.75 with a MED add. I agree with the comments below. Distance vision is not as good as I'd like. However I do find that my vision improves with them as they settle in, takes about an hour, and then continues to improve slightly throughout the day/night, I think it's because the brain adjusts to reading the image that the contacts produce (the optics of MF contacts are more complicated than standard MF glasses)

That being said, they are still never as good for distance as glasses. I did note, however (and my OD has heard this from other patients) that it's easier to adapt if you mostly wear the contacts. I guess switching between glasses and contacts all the time makes it hard to adapt to the compromised distance vision as your brain is always switching back and forth.

I've used them quite happily for driving and meetings. Would only really find the distance blur a problem and night and even then, I find that if I've worn them all day it doesn't really matter. Sometimes I even forget I'm wearing them late in the day.

So a tenatative thumbs up from me. Different brands are different also. see if your OD will do a free trial with the Dailies.

Charlie_Delta 22 Feb 2018, 15:21

Presby Tony,

I've tried them (Air Optix Aqua MF) and discovered that although my near near vision was quite good, this came at the cost of unacceptably poor distance vision. I mentioned this to my ECP some months ago she recommended trying same brand but with "low" ADD power -- she game me a trial pair in same brand. The outcome was expected: this did drastically improve distance vision (but still not perfect), but headaches resumed for near work due to insufficient ADD. I wear MF contacts w/ medium ADD for nights on the town, but that's about it. I can't even read road signs at distance in them in. I'm on my last pair of those and plan to try dailies MF's going forward because I wear them infrequently.

I suppose I could try a different brand (e.g. Biofinity) but doubt I'd be overly "wowed" in terms of performance. It's a shame, because MF contacts definitely would be my preferred means of vision correction over any other option. BTW, I learned that for testing purposes, the cheapest option is to by contacts from the UK and have them mailed to me. You can buy monthly contacts at sites such as Lenstore in 3-month supplies (3 pair), which I think is the most economical means of giving them a try.

I posted on GOC thread recently that I plan to try something wonky just before I return to my civilian job (currently attending a 5 month military course in connection with my service in the Army reserves). My colleagues haven't seen me in glasses and I'll make no bones about the fact that I'm not a fan of sporting plus lenses. My plan is to try single vision contacts Rx'ed for my full-near correction, then progressive glasses on top for distance (Rx equal to add power). I'm struggling again at near but have been too busy with school to get back to the eye doc. Probably will do that in the coming months as I'm nearly certain the prescription has changed.

Hope that helps.



Presby Tony 01 Feb 2018, 13:46

Just want to check and see if anyone here had had experience with multi-focal contact lenses. Not too long ago, I was prescribed progressive lens glasses and having been wearing them full-time. Just for some change now and then, have been thinking contacts might be be good.

Jose 18 Nov 2017, 00:18

Plus Tony, was wondering if you have "graduated" to bifocals

Cactus Jack 11 Nov 2017, 17:48


From your prescription, it appears that your vision problems are caused primarily by Astigmatism and Presbyopia. I understand about neck issues and multi-focal glasses. Your issues may be different, but I may be able to offer some suggestion that worked for me.

I can suggest some things that might helpful, but first I need more information about your visual environment.

1. What is your occupation?

2. Do you read quite a bit. If so what kind of reading and about how far is it from your eyes to the target?

3. Do you use a computer much? How far is it from your eyes to the computer display?

4. Do you use a smartphone much? How do you use it?


Lance 11 Nov 2017, 11:28

I've had progressives for over 4 years now but lately I can't seem to tolerate them lately. I'm 42 with a prescription of

PL -2.00 83

PL -1.50 83

Add +2.00

When I was a kid I had a bad neck injury. As I've grown older its started to bother me again over the past few month. I am finding that the progressives put a strain on my neck and are causing horrible headaches.

I am also getting vertigo sometimes when I wear them.

If I use my computer glasses, sunglasses or a pair of single vision for distance then I have less issues with my neck.

Could it be possible that I may not be able to wear multifocal lenses anymore? Will have have to just carry multiple glasses with me from now on?

Maurice 31 Jul 2017, 15:00

Plus Tony, hope all is well with your eyes and vision. Have you noticed any signs of presbyopia yet?

Plus T 28 Nov 2016, 14:40

Am headed to another optometrist to confirm that I do not need an add.

Maurice 04 Nov 2016, 18:34

Guest, I think that you will really like wearing bifocals. I have been very pleased since I started wearing multi-focal lenses. Let me know how you are adjusting to the new glasses.

Guest 02 Nov 2016, 15:18

Just got back from my appointment. My distance prescriptionbis not 1.25 stronger in both eyes, my astigmatism is 0.5 and 1.00 higher, and now I have a reading add of +1.00.

Guest 01 Nov 2016, 22:23

Tomorrow I will have a long overdue eye exam. I anticipate that I need a strongee prescription, as it has been about 5 1/2 years since I had my last appointment. Also belive there is a likely chance I will come out of there with bifocals because mist of my co-workers and former classmates have been getting prescribed bifocals. Not quite sure hiw I feel about going to the eye doctor after all these years. I used to love getting my eyes examined, loved when the the doctor would put the big glasses infront if me. I was also always so nervous and quesy during the exams. Wonder if I will indeed end up with bifocals, and if so how I will adjust to them.

eyescene 29 Oct 2016, 21:04

Since childhood I like girls wearing glasses, ,

My girlfriend had prescription of -0.75 for both eyes before 2 years. She never wear glasses, she didn't like it. One and half years passed her prescription increased up to -1.25 for both eyes. Still she doesn't want to wear glasses, ,, she just wears it occasionally for driving, or working on computer. She can't see long signs. Can't read distant words, nameplates. Now again she complaining about eyes. Does it mean her prescription increased? Are there any chances of increasing her prescription further upto -3, -4 (because I wish so) ?

If anyone knows please guide

Michael 28 Oct 2016, 16:49

Plus Tony- Given your age I would guess that much of your hyperopia is absolute and probably has a lot to do with the optometrist keeping your distance script the same even though you said you could see well with the slightly stronger lenses.

Michael 28 Oct 2016, 16:31

Plus Tony- I was able to open up the link. It is a Word document and don't have Word installed on my computer, only Microsoft Works which is a generic watered down version of Word but installed Microsoft Word Viewer on my computer a while back so I can open up any Word document without Word being installed. So some people here may have difficulty opening up the document if they don't have Word installed on their computer.

But getting back to the document it was a little confusing to me but the thing I most got out of it was there is a difference between myopes and hyperopes as far as prescribing lenses. For hyperopes you want to prescribe the lowest amount of plus for the person to see clearly at distances and for myopes it is the exact opposite. And accommodation is a huge factor.The more accommodation you have the less plus you will need.And since you haven't appeared to become presbyopic yet it makes sense that the doctor wanted to give you the least amount of plus possible to see distances clearly. Also some of these terms like total hyperopia, absolute hyperopia and manifest hyperopia can be very confusing.

I think this article explains why some hyperopes especially when they get older need glasses for both distance and reading whereas younger hyperopes would only maybe need glasses for reading or possibly get by without wearing glasses at all because their accommodation is still very good.

Now what Cactus Jack told me a few years ago when I wrote to him about Chris makes sense based on this article. Chris and I are hyperopic, presbyopic and have astigmatism. I was trying to figure out which one of us sees better without glasses. Cactus Jack said it was impossible to tell based on the script. If we both were myopic instead then you can tell more easily. It all has to do with accommodation I guess.

But Chris told me she could barely read any letters on the chart and the doctor did say she should be wearing glasses full time and definitely for driving so that tells me her vision is not good. But you can't put a number on it like 20/40, 20/60 or 20/100. I have lived with her for a long time and just by personal observation know she doesn't see very well without glasses. And Cactus Jack did tell me most people with her script would wear it full time. Her left eye is worse than her right eye so her right eye may be her primary vision source so that may help her a bit especially when driving.

Do you have any idea what your distance vision is uncorrected? But for someone like Chris based on her script there is no way to gauge what she can see and what she can't so you can't take my script and her script and compare them even though both of us have hyperopia, presbyopia and astigmatism.

I think you might have to be a Rhodes scholar to understand that article fully. It is pretty complicated. But I am trying to learn more and more about vision and optics.

Unless I am interpreting this wrong once you develop presbyopia and need a reading add it is likely your distance script will go up at least a little as well.

Plus Tony 28 Oct 2016, 13:20

Thanks to everyone who has posted in response to my recent eye exam. I have been doing some research on the net and found an interesting document that may explain to some extent why I can see well with stronger lenses but the optometrist didn't want to prescribe them. It appears to be a set of notes about Optometric Procedures from a lecture or tutorial about prescribing

I hope this link works,d.ZGg

If I have read it correctly the example on Absolute Hyperopia could be similar to my situation. I would be interested to know what others make of it.

Maurice 27 Oct 2016, 13:26

Plus Tony, good to read your update. I see that it has generated a good number of opinions and theories. Most interesting. Enjoy the glasses wearing my friend. Co

Michael 27 Oct 2016, 12:57

Plus Tony-I had a bunch of misconceptions about dilation that I think Cactus Jack cleared up. I will be very interested in how he responds to your questions. Now it makes a little more sense that when you asked the optometrist about a dilated exam he said it wasn't necessary. You are 20 years younger than I am and presbyopia hasn't set in yet so I have no idea if a dilated exam would have any benefit at all for you. I will leave it up to Cactus Jack to answer that.

What I don't understand is why you were able to see distances clearly with the stronger lenses. That is why I guess you assumed you would be needing a stronger prescription. And why would the doctor under correct you? So you thought you could see better with +1.25 than +1.00 for your left eye yet he decided to stick with +1.00? I don't get it. I will be waiting to read Cactus Jack's response.

Michael 27 Oct 2016, 12:37

Cactus Jack- Thank you so much for your explanation about dilation. Now I think I understand it much better. For your info I am 63 years old so I would say my presbyopia is advanced but am in pretty good health now. A couple of years ago I did deal with prostate cancer and had both surgery and radiation but now my PSA is negligible and has been that way for the past two years.I get a blood test and see my urologist every 6 months.

So I might be right that ophthalmologists tend to give dilated exams more often than optometrists do.Am I right that an ophthalmologist is a medical doctor and an optometrist isn't?And only an ophthalmologist can do surgery.

My ophthalmologist told me she does a dilated exam for all of her patients when they are getting a routine eye exam. I guess it is because she wants to check the health of the patient's eyes and has nothing to do with prescriptions especially for someone my age. But I can see where you are coming from when you say there is probably no good reason to do a dilation.

But I am not going to fight my ophthalmologist on that. Insurance pays for my eye exam so if she wants to do a dilation it is fine by me.But my roommate Chris has always had problems with eye doctors doing a dilation because she has very sensitive eyes that can't tolerate the drops. So thank goodness she doesn't go to my doctor or else there would be an issue.

Michael 27 Oct 2016, 09:16

Plus Tony-Likelenses idea might be a good one. I remember what the optometrist my mother and I went to when I was a little boy would say. You should get used to your glasses in two weeks maximum. But if for some reason you don't call and make an appointment for a free retest. Just say you don't think you are seeing as well as you should with your glasses. And I think I read here that the time of the day you have your eye test can make a difference. I can see how doing excessive reading that day and waiting until late afternoon can make a difference. Your eyes will be more tired and not only might you be able to get a higher distance prescription you might also be able to get a reading add.

Or if you don't want to do that you can also try another optometrist.

But going to doctors and thinking I am a number is something I have dealt with in the past but not necessarily with eye doctors. Their number one goal often is profits and they try to see as many patients as possible on a given day and don't devote enough time to each one.You feel rushed and that the doctor doesn't care. I have dealt with foot problems for a number of years and went to this doctor who was in a university medical center because doctors in private practice could not help me. I went several times and each time I had to wait 2 to 3 hours past the time of my scheduled appointment to see this doctor and he didn't show any concern gave me no more than 10 minutes of his time and sent me on my way. He was supposed to be this great doctor but he didn't help me either but my biggest pet peeve was I don't think he wanted to help me. So you can figure why after a few visits I never went back there.What a waste of time.

And speaking of eye doctors who don't give their patients enough time Chris went to one several times before this year when she decided to switch. I never went there myself and it is probably good. Because she had an eye exam and picked out frames for glasses and was done in a half hour. How is that possible? I have read that a thorough eye exam should take no less than 45 minutes. And mine usually take longer than that.

But the place Chris went to never liked her so that might have been a factor in them spending so little time with her. She always gave them a hard time. She wouldn't ever let them dilate her pupils because she said she doesn't like it because it blurs her vision. But Chris' vision is blurred as it is but that is another story. She kept on breaking her glasses and blamed them even though I don't think it was their fault. She was costing them money because the glasses were repaired at no cost to her.And she kept on telling them they sell cheap glasses.Her lenses for some reason kept on popping out. And one time she insisted that they send them out to the lab to get them fixed instead of doing it there and they complied.But the problem I think was Chris and the way she handled her glasses.She kept them loose in her purse, hanging from her shirt or on top of her head. No wonder they broke. But she is doing much better with her new ones probably because she is wearing them a lot more.

And the last time she went there she accused them of overcharging her. She thought it was 20.00 for both the exam and glasses but it was 20.00 for the exam and 20.00 for the glasses with insurance covering the rest. What she said didn't sound right to me so I said to her check with work to make sure you know what the insurance covers. But Miss Know It All of course didn't do it and made herself look like a fool. She was yelling and swearing at them on the phone and it turned out they were right and she was wrong. And we moved since the last time she went there and they didn't know her new address so there was no way they could send her a letter asking for the 20.00 she owed them.

I am sure they wrote it off. Much too small to turn over to a collection agency. No wonder she didn't want to go back there this year. And Chris was one customer I don't think they minded losing because all she did was gave them a hard time and she was costing them money. And those things might have been a factor in them wanting to get her in and out so quickly. And the last couple of times she went there they told her that her eyes didn't change at all which might have been the case but given what I know about Chris' relationship with them it does make me suspicious and makes me wonder how thorough of an eye exam they gave her.

But this year she went to a place that actually spent some time with her and the doctor laid it on the line to her letting her know she should be wearing her glasses full time.

But Chris got a very expensive pair of glasses this year and had to pay quite a bit out of pocket. But counting what insurance paid they cost about 800.00 I think. I know Chris has expensive tastes but doesn't have much money which makes no sense does it? But she bought the glasses from the private optometrist she went to. I question if that is a conflict of interest. I don't think eye doctors make a lot of money giving eye exams so that is why they also sell glasses. That is where they make most of their money. The doctor also wanted her to buy sunglasses from him but Chris didn't have the money to do that. So it is to the doctor's benefit to sell somebody the most expensive frame and lenses they have.

I don't have that issue. My ophthalmologist doesn't sell glasses even though there is an optical shop in the building separate from her practice. So I can fill my script anyplace and prefer to go to a local optical shop. I told Chris that even though her doctor sells glasses she does not have to buy them there and can go anyplace to have her script filled. But once again she does not listen to me. I am trying to save her some money and I do think you pay more when you buy them directly from the doctor. Why do you think a lot of people buy glasses from places like Zenni Optical? But I tried to buy sunglasses for her from there and it didn't work out. If she ever bought sunglasses from the eye doctor it probably would have cost her a lot of money. Maybe 500.00 or so.

I wonder why Chris thinks the non prescription sunglasses help her when driving. Honestly I don't get it. But no doubt it is in her head. If you have something in your mind no matter how stupid it is you actually can convince yourself it is true. Especially when the person is Chris.

I have no clue why a doctor would under correct you. It would be different if somebody had a very high first script or a huge increase. Is the N6 line the 20/20 line? Did you read it easily and did you make any mistakes? I think they allow one or two mistakes in a line or else you aren't credited for being able to read it. But sometimes if you make a mistake or two in a line they will list your vision as being able to read that line but with a minus sign next to it.

I don't think Chris has a vanity issue about wearing glasses because everybody she knows has seen her wear glasses by now even if they didn't before her latest eye exam. But for some reason she has this hangup about wearing glasses for driving. I have no clue why.And saying she didn't like the frame was a cop out because the frame for the drugstore sunglasses she wears was much poorer quality than anything they sell at Zenni Optical and don't look great on her. And if you are wearing them mostly for driving and very few people will see them is it really that important how they look? And since I was paying for them I wanted to stick with the 6.95 frames from Zenni.

Good point about Chris being a danger to animals, children and not being able to read signs warning drivers of temporary hazards.Not sure there is anything I could do. I have already suggested to her on numerous occasions to wear her glasses for driving but she won't listen. Expensive sunglasses would probably be the answer but neither of us can afford them. But her eyes seem to be ultra sensitive to light. I drive without sunglasses and have few problems. The only time I have an issue is when we are approaching sunset and the sun is very low in the sky.

Chris had car issues a couple of weeks ago and I brought her to and from work a few days and she wasn't wearing her glasses in the car and she kept on telling me to go right on red when there was a sign no right on red at an intersection. Which tells me she can't see road signs at all.

The only thing I can think of is call up her eye doctor and tell him Chris is driving without corrective lenses and if DMV would be able to do anything if he notified them. But my guess is no. At least not in CT. But yes I do wish there could be something done when people are driving who have impaired vision. They are at risk both to themselves and other people as well as animals.

I will send some glasses police from the UK to check up on you and make sure they are women between the ages of 35 and 45 and of course they have to be wearing glasses.

Chris looks very good in her glasses and seems OK with wearing them now but not for driving. Does that make any sense to you? This seems to be a problem that has no solution at least one that either Chris or I can afford. If I had more money I would offer to buy her a pair of more expensive sunglasses that she might actually be willing to wear.

Possibly your optometrist doesn't do dilated exams because it takes too long.Maybe that is making you think your doctor is more interested in getting people in and out quickly than anything else. But a lot of doctors not just eye doctors don't like their patients to ask a lot of questions. But I am a person who likes to ask questions so I can gain knowledge. Not sure why that is the case but I don't think some doctors like answering questions maybe because it takes too much time and the second reason is they may think the patient doesn't trust the doctor. Some of them might have inferiority complexes. But a lot of doctors are not good at explaining things so then you have to ask questions.

Plus Tony 27 Oct 2016, 07:36

Cactus Jack

Your reply to Michael about dilation was very interesting. I had been under the impression that dilation would reveal the full extent of both manifest and latent hyperopia.

If I have understood your post correctly you are saying that a dilated eye exam will not necessarily reveal latent hyperopia. As I've posted below I was surprised not to get an increase at my eye exam as I had been able to resolve distances clearly with stronger lenses. I had also thought that it would be sensible to get as much of my hyperopia corrected as possible before presbyopia sets in. With your comments about latent hyperopia in mind do you think there is actually any benefit in me asking for a dilated exam?

Cactus Jack 27 Oct 2016, 06:05


You recently asked a question about dilation during an eye exam.

The Dilation agent does two things:

1. It paralyzes the Ciliary Muscles so they cannot attempt to add focusing PlUS internally. This can result in a more accurate prescription if a person is Hyperopic. Dilation might help a little in improving the accuracy of the prescription if a person has Latent Hyperopia, However, the effects of the dilating agent are usually not strong enough and wear off too quickly to have much effect on long standing Latent Hyperopia.

Dilation is of little value, for prescription purposes, if a person has well advanced Presbyopia. Once the Ciliary Muscles can no longer affect the PLUS power of the Crystalline Lenses, there is no refractive benefit to paralyzing them.

2. The Dilating Agent also paralyzes the muscles that control the Iris or Pupil of the eye. That causes the Pupil to open wide which makes it easier for the ECP to inspect the whole of the Retina and the interior health of the eyes. That is the primary reason Ophthalmologists regularly use Dilating Agents. Refractions are not the primary function of their medical practice.

Opticians and Optometrists are not allowed to use Dilating Agents in some countries. That used to be the case in the US (Texas for sure), but that has changed. Often Opticians and Optometrists are the first to notice other health problems during an exam. Your eyes are windows into your body and the effects of many silent killers or vision destroyers are first noticed on a routine eye exam. If an anomaly is noticed during the objective part of the exam, they may suggest dilation to get a better view and help them make a decision about referring the patient to an Ophthalmologist or Medical Doctor for treatment.

If you are in your 60s, with fully advanced Presbyopia and in known good health or receiving regular medical care, there is probably no good reason to do a dilation.


Likelenses 26 Oct 2016, 21:40

Plus Tony

This may be of some help to you.

A lady that I knew a few years back, and have lost contact with was in her forties, and already in bifocals. She had been wearing them about two years, and felt that she needed an increase for both distance, and near. At her exam. she was told that her present prescription was fine. As I recall it was maybe + .75 with -.25 cyl. per eye, and an add of +1.25.

She thought about it, and called the optometrist after about two weeks, and complained, and demanded another exam.

The exam was scheduled in the late afternoon, so she got up and spent about four hours reading, then drove to the exam., arriving about one hour early.She remained in her car, and read a newspaper for that hour, then went in for the exam.She even read from a magazine in the waiting area, until she was called into the exam. room

This exam resulted in as I recall, a +1.00 increase for distance,and a + .50 more in the add.

She was very happy with the new prescription for both distance, and near.

It was a chain optical, and they did not charge her for the exam.

Plus Tony 26 Oct 2016, 12:51


Thanks for your reply which made me smile and wince in equal measure!

Soundmanpt's glasses police are welcome to visit me anytime (especially if they are female, aged between 35 and 45 and, obviously, permanently bespectacled themselves!).

I think Chris is very lucky to have a friend like you to look out for her and at least she is taking some of your advice but I agree that non-prescription sunglasses aren't going to help her when she is driving. Never mind going somewhere she isn't familiar with, what about animals, children and signs warning of temporary hazards. Reading your post makes me want to get involved with an organisation that promotes the importance of good sight for driving!

The thing is that I have no particular issue with my sight with my current glasses. It is just curiosity because I suspect most longsighted folk are under corrected (especially here in the UK) and it seems strange to me that I can resolve distances with stronger lenses and yet their testing didn't reveal that. The eye test I had yesterday was probably functionally satisfactory but I didn't feel that the optometrist was interested in much more than getting me in and out and on to the next patient. For example they did not do an auto refractor test (the machine that estimates your prescription objectively). This is probably my own fault for visiting a chain optician rather than a smaller independent (in the UK eye tests are generally undertaken by Optometrists working in the optical store while some of the staff may be qualified Dispensing Opticians but most are just sales assistants with little optical training). At the point in the test where the optometrist tried a +1.25 lens on my left eye he gave me about 15 seconds to look through it, which isn't much in a darkened room and even though I could see better with it he decided it wasn't necessary. The near vision test was done with a card and I could actually see OK down to the N6 line.

Eye tests are not generally expensive in the UK and virtually every chain optician always has an offer on that means that they cost no more than £20. Eye tests are generally not covered by insurance although they are actually free up in Scotland (largely due to a more progressive government). I think I may be prepared to spend more to go to a smaller local optician who might charge more but might listen to my concerns with more interest. If the result is the same then no problem but if I have more latent hyperopia then I'd prefer to have it corrected before presbyopia sets in (which it will undoubtedly in the next couple of years). One reason for this is that I've picked up three frames over the course of the year (one I found at a market and two from clearance stores) and I don't want to get lenses put in any of them until I'm 100% certain that my prescription is as good as it can get. I know that it may sound like I'm complaining about nothing (and that may prove to be the case) but it occurs to me that a slightly stronger prescription could result in even more relaxed and comfortable vision.

Keep trying with Chris. I hope she will come to realise the wisdom of your words. If it is a vanity issue she should realise that there isn't a woman on the planet whose attractiveness isn't enhanced by a nice pair of glasses!

Michael 26 Oct 2016, 10:15

Plus Tony-I wonder why they said a dilated exam was not necessary. What would have happened if you insisted on it?I think I told you before that it seems to me ophthalmologists favor dilated exams more than optometrists do but not sure it is the case and if it is the reason why.But I am sure I read someplace that some people think dilated exams give a more accurate prescription.

I have no idea why I thought you had an add but 44 was the age I got my first one I think. Yours is coming probably sooner rather than later. Maybe after your next eye exam?

Are you having problems reading small print with your glasses? One way maybe to get an add is to tell the doctor you are. How did the doctor test your near vision? By seeing if you could read the 20/20 line on the near vision chart with your glasses?

I think everybody is a little apprehensive about wearing glasses full time for the first time but you did very well. You made up your mind to do it and did it. Which is the best way.There are a lot of benefits to wearing glasses full time that have been discussed here many times.Besides having comfortable vision all the time you don't have to worry about misplacing them and the chances of them breaking is a lot less.

There is a misconception that far sighted people just need glasses for reading. Which is often the case but as a person gets older the eyes lose more and more elasticity so even distance vision can start becoming blurred.

You mentioned Carrie. It is so true that young people can sometimes overcome hyperopia and avoid wearing glasses especially if their prescription is mild because of their accommodation.But as they get older especially if their prescription increases it becomes more and more difficult to do so.

Your accommodation still has to be pretty good if you could see distance clearly using stronger readers without an adjustment period. You could go to another optometrist and ask for a dilated exam but I don't think any insurance plan will pay for more than one eye exam a year. So you would have to pay it all out of pocket. But if you did that my guess is your script would not be much different or at least it shouldn't be.If it is there is another issue.You would then have to decide which prescription is more accurate.

Boy do you hit home when talking about people driving without glasses who couldn't pass a DMV vision screening test without them. It is even worse in a few states in the United States. I live in CT and once you get your license you never have to pass another eye test ever again. So most drivers only have to pass one eye test in their life and that would be when they first got their driver's license.

This is my roommate Chris. She was told by her doctor this last time she needs to wear her glasses full time. But she won't wear them for driving at least during the daytime because she insists on wearing cheap non prescription sunglasses that do nothing to improve her vision. But besides for that she is wearing her glasses most of the time so I don't get it. Yesterday for instance she got home from work and didn't have her glasses on which is typical for Chris. But shortly after she got home and changed her clothes on went the glasses and they stayed on most of the rest of the night. She even went to the grocery store with her boyfriend and kept her glasses on even though he drove.

And it seems when she goes out at night she is wearing her glasses more and more even if she isn't driving. Now mornings are kind of dark so I hope at least she is wearing them driving to work. Sunglasses sure wouldn't help her then. I usually am up when she leaves for work at 7 in the morning but I can't give her the impression I am checking up on her. Even though I would be.

I am not sure what the issue is. I tried ordering her sunglasses from Zenni but Chris didn't like them because they were not designer frames. She drives me crazy being so fussy. She told me she needs sunglasses to drive because of the glare and thought I found a solution so I give up trying to help her.

It is because of people like Chris that I wish the state of CT would find the money to have periodic eye exams for drivers. CT many years ago did pass a law but they didn't have the funds to implement it so they appealed the law years later. I remember all the issues they had before passing the law. Originally they were going to target people past a certain age but our state legislators thought that was discrimination so they were going to do everybody on every other renewal which would be every 12 years.

I like it when you said you are now officially required to wear glasses full time. Maybe I should have the glasses police check up on you to make sure you are doing so. Soundmanpt often joked around about that.

I have a much better chance of winning the Powerball jackpot than Chris asking DMV to put an optical restriction on her driver's license. But that would be the only way she would do it and I am not 100% sure she would even do it then. Unfortunately people often will not do anything unless they are required to by law.

And I know for a fact that she is driving without prescription glasses and can't see road signs at all. She even admitted that to me. But she told me she doesn't need to read road signs because she knows where she is going.But what happens if for some reason she has to take a detour? Then what? And whenever she has to go someplace for the first time she always gets lost.No wonder because she can't see. I would say driving when it is either dark out or the weather is inclement would be almost impossible for her to do now without correction so I would hope at least she is wearing her glasses then.But she should be wearing prescription glasses whenever she drives. Day or night.The doctor was shocked she wasn't doing so and she still isn't doing it.

Plus Tony 26 Oct 2016, 06:41


I went to the same optometrist as last year but unfortunately despite my request to see the same person that didn't happen. I asked if a dilated exam might be sensible and they said they didn't think it was necessary. Not sure why you thought I already had an add (but I thought it might be coming as I'm 44).

I have worn my glasses constantly since the day they were prescribed. Last year the optometrist said nothing but the dispenser seemed to assume that I'd be wearing them full time during the fitting (although she didn't actually say anything). I wanted to wear them full time anyway (although I was nervous about becoming a full time wearer - people's reactions etc.) and it was explained to me back then that it was a distance prescription rather than just for reading (but that was as far as it went). I walked out of the shop wearing them and decided that the only way to become a full time wearer was to start as I meant to go on. I told everyone I met that it was essential that I wear them all day every day and to be honest after a few weeks of realising the benefits of good comfortable vision that was the truth anyway. However I knew that if I took them on and off all the time I could quite easily backslide into not wearing them so I literally put them on before I switch on the light in the morning and take them off when I switch off the light at night. One only has to look at instagram etc to see people in their 30s/40s (mainly plus wearers) who say they have been told they need glasses all the time and after 2 or 3 days the glasses are never seen again...

As you know I agree with you wholeheartedly that optometrists and eye doctors should be required to give clear wearing instructions. To be honest I think that any mature adult who has hyperopia but is not yet presbyopic should be told to wear their glasses all the time anyway as the benefits are enormous. Never mind clear sight and lack of headaches etc but you can't lose your glasses if you are wearing them! Another thing that bothers me (and why I think optometrists should be clearer) is that in the UK once you have passed your driving test you do not have to do anything special to renew your licence until you are over 70. If you need discover you need glasses for driving after you have passed your test it is up to you to notify the DVLA so they can add that requirement to your licence. I dread to think how many people (both plus and minus) should be wearing glasses for driving but don’t.

I know that younger people who are longsighted (like Carrie, who posts regularly here) could probably get away without wearing any correction due to their greater powers of accommodation but one only has to read Carrie's history to see how happy and confident she has become with glasses even though (or possibly because) her prescription has steadily increased over the years, to recognise the benefits of wearing plus glasses full time. One positive thing I have noticed is that more young hyperopes with very mild prescriptions are either being told to or choosing to wear their glasses full time (especially in mainland Europe where I suspect eye care professionals may offer more precise instructions). I had a discussion with one young woman I met through work who started wearing plus glasses about 6 months ago. Her prescription is only +0.75 in each eye but she had the good sense to ask when she should wear them and her optician said ‘all the time if you want to see well and avoid headaches’. She has followed that advice and although she can see fine without them she says she enjoys wearing them and noted that when it is windy things don’t blow into her eyes! She also noted that she feels more professional when wearing them and that they suit her casual style as well. On the odd occasion when she has forgotten to put them on in the morning she said she felt naked without them. As she is nearly 20 years younger I’m sure that what she sees bare eyed is much sharper than me as her eye muscles will still retain much more elasticity than mine but it is good that she realises the benefits.

I know I could just order any prescription online (indeed I did order an extra pair online in my current prescription) but I'm very curious to know to what extent I may be under corrected and if I am I'd like the opportunity to see if I could cope with my full power. If +1.00, +2.00 is really the ‘full story’ then so be it. At the end of the day at least I have the pleasure of knowing not only that I enjoy wearing glasses but that as of yesterday I’m ‘officially’ required to do so!

Carlos, Jr 26 Oct 2016, 04:40

Plus Tony, thanks for the update. Glad you were able to have your vision checked. Be patient sir, the addition of an "add" will be coming your way. As time rolls by, presbyopia will necessitate multifocals/bifocals. There is no escape from this reality.

Michael 26 Oct 2016, 04:08

Plus Tony- Why did I think you already had a reading add? How old are you? Were you given a dilated exam?I think you said you wanted one this time and would ask specifically for it. The other option other than going to another optometrist would be to order glasses online and this way you could get any prescription you want. No astigmatism?Many of us here have used Zenni Optical. Soundmanpt among others has always recommended them.

And it is unusual to be told by an optometrist or optician when to wear your glasses without asking but it does happen. Chris was told by her doctor this year to wear her glasses full time and that never happened before even though her prescription hasn't changed much in her last few eye exams. But this year she went to a different optometrist.Did you go to a different doctor this time? Some doctors do under correct for a variety of reasons.And wearing your glasses full time will not make your vision worse even though you might think it does.

I guess studying for your eye exam didn't accomplish what you wanted it to.

Plus Tony 26 Oct 2016, 02:10

One positive was that the optometrist did at least say that I should be wearing my glasses full time (without me having to ask!). Hardly anyone I have met over the last year has suggested that I shouldn't be wearing them full time but I do remember a couple of people who've trotted out the lines "do you really need to wear them all day" or "they'll make your eyes worse". Self evidently the latter has been proved not to be the case (unfortunately)!

Plus Tony 26 Oct 2016, 02:01

Maurice, Carlos Jr,

I had my eye test last night and the result was not what I expected at all.

As you guys know I have been wearing my current (first) prescription of L +1.00 and R +2.00 full time for 13 months. You could count the amount of time I haven't worn my glasses in minutes rather than hours during that period. Based on the fact that I tried some over the counter readers with slightly stronger prescriptions and found that I could see clearly at distance with +2.00, +2.50 I was very surprised by the outcome of the test which was... exactly the same as last year.

The optometrist tried a +1.25 for my left eye but concluded that my vision was better with +1.00. He also said that I didn't need a reading add.

On one hand I'm pleased that my vision is apparently stable but I'm slightly disappointed not to have got a stronger prescription as I still suspect that I have some uncorrected hyperopia. I'm still seeing well but I am going to think about going to a different optician and possibly say that I got my first glasses when I was abroad and the optician recommended returning for a dilated exam because they hadn't given me my full correction as it was a first prescription. Obviously there is no guarantee that this would produce a different result but I would certainly like to ensure that any latent hyperopia is fully corrected before I reach the stage of requiring a reading add.

I would value any feedback from the more knowledgable members of the community about what a sensible next step might be.

Carlos, Jr 21 Oct 2016, 14:58

Plus Tony, see well on the 25th

Plus Tony 21 Oct 2016, 06:43

Carlos Jr.

Tuesday 25th is now 'glasses day"

Hopefully it'll be third time lucky as I had to cancel my rearranged appointment which should have been this Tuesday due to 'flu!

Carlos, Jr 20 Oct 2016, 19:29

Hey Plus Tony. Just wondering if there were any updates on your vision correction.

Plus Tony 05 Oct 2016, 12:36

Carlos Jr and Maurice,

Sadly "Glasses Day" had to be postponed due to my optometrist being unwell. I haven't rescheduled yet due to pressure of work. I am keen to see the same optometrist as last time so it may take a week or two to get a convenient appointment. I'll post news when I have it.

Carlos, Jr 04 Oct 2016, 18:40

Hey Plus Tony, just checking to see how your recent "glasses day" went.

Has presbyopia struck?

Maurice 24 Aug 2016, 16:13

Great to hear from you Plus Tony. Sounds like you played it right by putting your glasses on full-time. You are right---too many people look at glasses for hyperopia as a akin to reading glasses/presbyopia.

I found out that I had hyperopia when I went to the doctor for help with presbyopia. Ended up with a plus prescription for distance and an add for near. Have been a full-time wearer ever since I first wore glasses.

Look forward to hearing about the results on September 28.

Plus Tony 24 Aug 2016, 11:48

Last para should have read:

I'll let you know what happens on 28 September but if anyone reading this around the age of 35+ has just been prescribed glasses for hyperopia for the first time my advice is simple. 1. Choose a nice frame. 2. Get your prescription filled. 3. Put them on your nose and leave them there. Your world will be a better place.

Maybe some evidence there that the varifocals will soon be necessary!

Plus Tony 24 Aug 2016, 11:46

Hi Maurice

Apologies for the delay in replying. I haven't got varifocals yet but I have booked an eye test for 28 September which is 'glasses day', i.e. exactly one year since I got my glasses.

I still see pretty well with my single vision lenses and although I was tempted to return after 6 months I thought I would wait exactly a year. I am already a little bit excited and as you can imagine I'm wondering whether I'll get some extra plus for distance, whether I may have developed some astigmatism and of course whether I'll be getting an add for close work.

I've enjoyed wearing glasses so much that I'm looking forward to it with the same anticipation as a child waiting for Christmas! I have kept a note in my diary since day one of my glasses wearing career to spur me on. You may recall that I've been full time since day one and I've kept a note of exactly how long I've worn them each day (which is easy because apart from when I'm in the shower I'm wearing them), who I've met that day who hasn't seen me in specs before and any comments they might have made.

Deciding to go full time immediately was the best decision I have ever made. I know that some people may disagree with that decision but telling people that I needed them constantly made the process of adjustment easier for me and ensured that I didn't follow in the footsteps of so many people who are prescribed glasses for the first time and don't wear them. I can think of several people around my age and a bit younger who were prescribed glasses for hyperopia (as opposed to presbyopia) or astigmatism and who simply gave up after a few days because they didn't understand how the lenses were helping their eyes. Their loss. I don't have headaches or eyestrain anymore. They're probably still reaching for the paracetamol...

If only they had persevered they would have realised that the benefits are not just visual. I feel better than I ever have. I'm more relaxed and confident and I enjoy life more than ever. Glasses open up conversational possibilities. I think it is much easier for a person wearing glasses to complement a complete stranger with glasses (if the circumstances are appropriate) than for a bare eyed person to do so.

I'll let you know what happens on 28 September but if anyone reading around around the age of 35+ this has just been prescribed glasses for hyperopia for the first time my advice is simple. 1. Choose a nice frame. 2. Get your prescription filled. 3. Put them on your nose and leave them there. Your world will be a better place.

Maurice 19 Jul 2016, 18:29

Hi Plus Tony, just wondering how you are doing with the bifocals.

Carlos, Jr 25 May 2016, 03:55

Plus Tony, I think you will appreciate wearing bifocals/progressives. Look forward to hearing more.

Plus Tony 24 May 2016, 14:25

Hi Carlos Jr.

I haven't got bifocals yet. I've been so busy with work that I haven't had time to carry out the self tests that Cactus Jack kindly suggested. I am doing OK with my single vision lenses most of the time but I am excited to find out what my next test will bring. You may remember that June (who got her first glasses around the same time as me) got an increase for distance and a reading add when she went back after about 6 months. It will be 8 months with glasses for me at the end of this month so I will try Cactus Jack's tests and decide whether I should have another test. Since getting my glasses I have worn them all day every day and I've been very happy with the result. It has made such a big difference that I cannot imagine life without them now. Thanks for your interest. I'll let you know how things progress.

Carlos, Jr 24 May 2016, 04:39

Hey Plus Tony, just wanted to check and see how your adjustment to wearing bifocals is going. Hope all is well

Michael 26 Apr 2016, 08:44

Catherine- I think you are correct but I will let others here confirm that. In your first example to get the reading power the sphere and add together equal +1.00. In your second example the person would need a slightly lower minus script to read in this case -8.00. That is why slightly nearsighted people when presbyopia begins to set in can read without their glasses for at least a while. Being nearsighted in effect gives you built in reading glasses. It is kind of confusing but I think you pretty much have the idea. A myope with a -2.00 sphere in effect has +2.00 readers built in. And as long as the nearsightedness isn't too severe myopes when presbyopia begins to set in can't read with their glasses but are able to do so when they take their glasses off. So myopes can often delay getting bifocals or progressive lenses longer than either normal or farsighted people. If I have confused you I apologize because I might not have done a great job in trying to explain this.

Cactus Jack 26 Apr 2016, 08:15


You have it right. An Add just indicated the power of the add. The absolute power in the reading segment of bifocals or progressives is the algebraic sum of the distance power of the lens and the Add. The distance power of the lens ideally corrects a persons refractive error to 0.00 and the Add helps by doing some or all of the PLUS power required to focus close. In practical terms, the absolute power of the reading segment is not important to the person wearing the glasses, only the relative power.

The power of the Add is primarily related to the focus distance and how much of the required PLUS the person can supply through accommodation. For example. the most basic law of optics says that to focus at a typical reading distance of 16 inches or 40 cm requires +2.50 diopters. If you can supply +0.50 internally, you only need an external Add of +2.00 in your glasses to focus at 16 inches or 40 cm. If you can no longer supply the +0.50, you will need an Add of +2.50.


Catherine 26 Apr 2016, 07:50

Question about progressives. Is this correct thinking?

a mild myope say with -1 distance and +2 reading add will

will see the equivalent magnification of +1 readers when looking through the reading portion of progressives.

a severe myope say -10 with the same +2 add. When they look through the reading portion they won't see any noticeable magnification as they are still being corrected with an effective -8 lens.

astigmaphile 20 Apr 2016, 18:38

Lasik is a filthy word on this website.

 20 Apr 2016, 13:03

Tell her about Lasik, Carrie.

Carrie 20 Apr 2016, 11:03

Soundmanpt - I didn't give her any advice as I don't know anyone with bifocals and it would sound strange if I gave her advice I read on here. I think her optician gave her advice anyway. She hasn't worn contacts at work for ages so I have had the pleasure of seeing her in glasses regularly. If her distance prescription was weaker she probably wouldn't need bifocals yet. If she had any older glasses with a weaker prescription she might have tried using them whilst on the computer but I think she would have found changing over glasses a real pain. She was surprised she needed a slightly stronger distance prescription but does like how everything is in super HD now.

She first noticed her eyesight wasn't perfect at school but somehow managed to get through school without getting glasses. She got her eyes tested when she wanted to start driving lessons at 17. Unsurprisingly she was told she must wear glasses for driving. Her eyes gradually got worse and she gave in to wearing glasses full time at 20 but probably should have been full time from the first prescription. Her eyes got a little worse before they stopped changing in her mid 20s. They haven't changed at all until this most recent eye test. She started wearing contacts a few months after going full time with her glasses and gradually wore contacts more and until she only wore her glasses for a short period just before bed each evening.

Because, more recently, she got fed up with the fiddling about with contacts she had no intention of going back to them and is now even less likely to do so.

Soundmanpt 19 Apr 2016, 10:13


You did remember to warn your manager about being very careful when she is going up and down steps until her eyes get fully adjusted to wearing bifocals. Looking down for a while is going to make everything seem much closer to her than it really is. This includes roadside curbs as well. It is even worse if she happens to wear heels. But even though she wasn't very happy about needing bifocals it seems that she is already seeing the benefits they provide her eyes. It has to make going to work for you even more enjoyable seeing her wearing glasses all the time now? I remember some time ago you said how attractive your manager was and I think you were disappointed that she always wore contacts and you would have much preferred to see her wearing her glasses more often. Well I think you got your wish. They do make contacts that are bifocals but now that she is wearing glasses and seems comfortable with wearing them I doubt she will bother ever trying them. So she just joins some of the others that you work with that now wear glasses . Enjoy your eye candy.

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