Over 40 and Wearing Contacts

by Jonathan Gerard O.D.

The population is getting older. People are living longer, and the demand for those looking for solutions to their reading problems with contact lenses is growing.  Presbyopia is the diminished ability of the natural lens in our eyes to focus up close on near objects.  It begins with the occasional medicine bottle being a struggle to eventually even having a meal is blurred.  It can be frustrating for people to adapt to, especially for those who never needed glasses or contact lenses previously. Luckily, with the advent of newer contact lens materials and technologies, there is something out there for practically everyone. 

Reading Glasses

Initially the use of an over the counter reader or prescription reading glass for occasional use works well for people in the early stages of presbyopia.  They are worn over distance contact lenses so there is little adjustment and clear vision near and far.   However, they need to be with you, not left in the car or at work, and often times people end up just wearing these readers all day since it is just that much clearer.  

Mono Vision

In the past, there were very few options for multifocal, or bifocal, contact lenses. Therefore, monovision was used, whereby one eye, typically the dominant eye, was corrected for distance, and the other eye (non-dominant eye) was corrected for near. The drawbacks to this practice are obvious; the eyes do not work together well as a “team,” and common complaints range from poor intermediate vision to poor night driving, headaches, etc.  As such, this method is one I tend to employ as a last measure for those who fail in multifocals, which I discuss next.

Multi Focal Contacts

Multifocals are my first line treatment for those who wish to be able to see distance and near with contact lenses. They work based on “simultaneous vision,” whereby light rays enter the eye for both distance and reading at the same time- the drawback being that the brain has to learn which light rays to “ignore.” As such, multifocals, like their older cousin monovision, are not perfect. Ideal patients for multifocal lenses are those who are able to deal with a slight compromise to their vision at both distance and near for the luxury of not having to wear reading glasses all of the time. Therefore, for those looking for perfect vision and are bothered by slight blur, multifocals will NOT be a good solution for you. However, if you are motivated and willing to accept this fact, multifocals are a great tool for relying less on those pesky reading glasses.


So in conclusion, while none of the options are perfect they all may present some level of relief in your quest to continue to wear contacts into middle age, retirement and beyond.  Some options may better serve you at a certain point in your life or career than others.  So while you happily wore contacts from a teenager till your 40’s just because you’re another year older is no reason to give them up. Talk to your Ophthalmologist or Optometrist to see what choices are best for you.