Common problems with multifocal lenses or progressive lenses

For a lot of people the shift from standing distance glasses to needing something for both distance and reading can be daunting.  You might have heard problems from friends or family that had problems getting used to their multifocal lenses.  It should be understood that the term multifocal lenses and progressive lenses are used interchangeably.  If someone describes a progressive lens it is also a multifocal lens and vice versa.  We use the term multifocal as the lens works for both distance, intermediate (computer) and reading so it has multi-focal lengths.

Common problems with multifocals start with:

Is the prescription correct? 

Who measured your eyes for the prescription was it your optometrist or ophthalmologist?  How old is the prescription?  Is there a chance your eyes have changed from when they were measured?

Are the lenses fitting in the right spot?

A good spectacle prescription is only a part of getting a multifocal lens correct.  If the lens position is even a few millimetres off then you will struggle to adapt to the lens and it won’t work properly.  Sometimes the spectacle frame didn’t fit well before the measurements were taken and after the lens is fitted to you the multifocal lens position is now incorrect.  Unfortunately that means the lens will need to be remade to suit the new frame position.

If we assume the spectacle prescription is correct and the lens position was measured correctly what are some common adaptation symptoms with muiltifocals?

I don’t see as well out to the side of my vision with these multifocals

Yes, the way a multifocal lens is designed leads to some distortion of your side vision.  That means you may have to turn your head more to look behind you particularly when reversing the car.  This is something that you will get used to by moving your head more or adapting how you use your eyes.  You can spend more for better and better multifocal lens technology that minimises that distortion but all multifocal lenses have it.  It is just part of how they work.

I can only see a few words clearly at a time

With a multifocal lens there is a coridoor of clear vision that runs from the top of the lens (distance) through the middle of the lens (intermediate) to the bottom (reading).  This coridoor varies in length and width depending on the design of multifocal lens chosen.  With newer and more advanced multifocal lens designs (more expensive) you will find the width of the clear vision zones to be larger.  Even with the largest reading area and most advanced lenses there is still a limit to how wide your vision is.  Try looking at  one word and without moving your eyes see how far either side of that word is clear with your current reading glasses.  Then try it with your multifocal lens.

When using a multifocal lens it is best to point your nose at what you want to look at.  If you are finding that the reading or computer zone is too small it may be that you need special reading or computer glasses where the entire lens is focussed for the screen or up close.  That means you would need a separate pair of glasses for this but they would be customised exactly for what you want.

The ground seems to be in a different place or I feel taller than before

Because the bottom of the multifocal lens is stronger for reading that magnifies the bottom area of your vision causing some people to feel like the ground has shifted or they have grown longer legs.  For most people this will pass within a few days of getting their multifocals.  Rarely some people never get used to it and need to stay with separate distance and reading glasses.  This is more common if you suffer from migraines, car sickness or light sensitivity.

I feel like I have to tilt my head backwards to see clearly in the distance

This may be because the lens centres have been set too low or the prescription is not strong enough in the distance.  I would make a time to discuss this with your optometrist.

I have to tilt my head in towards my chest to see clearly in the distance

This happens if the lens centre is too high meaning that in the normal head position you are looking through the intermediate (computer) or reading section of the lens.  Sometimes the frame can be adjusted to lower the lenses and improve the vision considerably.  Other times the lens needs to be remade to be placed in the correct position.

I find the reading area very small

Sometimes the frame curvature on your face is too flat meaning that both eyes are not looking perpendicular to the lenses.  That means that we need to curve the frame on your face (dihedral angle/wrap angle) to improve your binocular vision and improve the apparent width of the reading zone.

I am having lots of problems with my multifocals they just aren’t working

If you have been successfully wearing multifocals before then it is likely there is something wrong with either the fitting or prescription of the lens.  If you haven’t worn multifocal lenses before it may be an adaptation issue but it is worth discussing with your optometrist.







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