Evidence Based

Multifocal & Bifocal Contact Lenses

How Do Bifocal Contact Lenses Work? 

Bifocal contact lenses provide two different prescriptions in the same lens. The most common bifocal contacts are soft contacts with concentric circles of distance and near vision, like a bull's eye target. 

Presbyopia is a refractive error (vision problem) that people develop between 40 and 45 years of age. The condition results in the inability to focus clearly on small, close-up text, such as a book, restaurant menu, or newspaper. Presbyopia happens naturally as people age.

Symptoms of presbyopia include:

  • A difficult time reading small text
  • Issues focusing on close objects
  • Needing to hold reading material farther out than arm’s distance
  • Frequently straining your eyes to focus
  • Headaches

The dual prescription in bifocal contact lenses helps presbyopic patients see clearly. The lenses also eliminate the need to wear specific eyeglasses to focus on close-up objects and text. 

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Bifocal Contact Lenses vs. Multifocal Contact Lenses

The main difference between bifocal contacts and multifocal contacts is vision correction power:

  • Bifocal lenses have two prescriptions (or ‘lens powers’) in one lens so that they can correct more than one refractive error. Segmented bifocal contacts have a defined segment between the distance prescription on top and near prescription on the bottom. These are only available as rigid gas permeable (hard) lenses. Concentric bifocal lenses (available as soft or hard lenses) have either the near or distance power in the center of the lens and the opposite power in the periphery of the lens.
  • Multifocal lenses have many powers in each lens, with a gradual transition between near vision and distance vision. This is called an aspheric multifocal lens, which functions similarly to progressive eyeglasses. Another type of multifocal lens has a concentric design, with rings of alternating distance and near power, similar to a bull’s eye target. 

Only 3 percent of people with presbyopia currently wear some form of presbyopic contact lenses. This is because patients with presbyopia are commonly told that bifocal lenses are likely to fail. However, multifocal lenses won’t be successful if eye doctors do not offer them to presbyopic patients. Other people are not aware that bifocal, trifocal, and progressive contact lenses even exist. 

Types of Bifocal Contact Lenses

Multifocal and bifocal lenses are made of either soft lens materials (e.g., silicone hydrogel) or rigid gas permeable (RGP) materials, also called hard contacts. Hybrid lenses are also available. You can purchase the contacts in daily, weekly, and monthly disposable forms. 

There are two factors eye care practitioners consider during eye exams to determine the type of bifocal contact lenses a patient needs. These factors include pupil size and near prescription.  

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There are a few types of bifocal and multifocal contact lenses wearers can choose from, including:

  1. Segmented bifocal lenses are rigid gas permeable (GP) lenses that work similarly to bifocal glasses. GP lenses are hard contacts that allow oxygen to flow through the cornea. They provide a defined line of separation between presbyopia correction (below) and distance vision correction (above). Segmented bifocal contacts are also often weighted. This makes the lenses remain in place and not move around like soft lenses.  
  2. Concentric bifocal lenses, also called simultaneous vision lenses, do not have an upper and lower section. Instead, the lenses have an outer ring and inner ring. The center of the lens contains the distance vision correction, while the outer ring includes the near vision correction. Most concentric lenses provide an instant transition from one prescription to the other. 
  3. Aspheric contact lenses provide a gradual transition between close and distance vision correction. Aspheric lenses also have a longer adjustment period. 

Some popular brands of multifocal and bifocal contact lenses include Biofinity Multifocals, Air Optix, Proclear, and Acuvue. 

Pros and Cons of Multifocal and Bifocal Lenses

  • For older adults who have worn contacts most of their lives, bifocal contacts are a great alternative to bifocal eyeglass lenses. 
  • Bifocal contacts are more aesthetically pleasing than bifocal glasses.
  • They are easy to adapt to and provide superior depth perception. 
  • They are convenient (you don’t have to carry around additional eyewear).
  • Bifocal and multifocal contacts can be more expensive than other types of contacts and presbyopia treatment options.
  • They can be challenging to adapt to if you’ve never worn contacts before.
  • Reading glasses may still be necessary, depending on the severity of presbyopia. 
  • Objects may look different than they do in reality, such as appearing lower or higher.
  • Night glares and seeing shadows in low light conditions is possible.  
  • Some wearers experience reduced visual perception (contrast sensitivity).
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Alternative Contact Lenses

Bifocal contact lenses are not for everyone, especially if you have trouble wearing contacts or develop other eye conditions. If bifocal lenses don’t work for your needs, your optometrist (eye doctor) may recommend:

Normal distance contact lenses combined with reading glasses, instead of wearing a pair of bifocal contact lenses.

Monovision lenses are single-vision lenses rather than double prescription lenses. In monovision contacts, your near prescription is put in one lens, and your distance prescription is placed in the other.

Multifocal monovision lenses put a single-vision lens in one of your eyes and a multifocal lens in your other eye. 

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