What are the Best Contact Lenses for Reading?

Monovision vs. Multifocal Contact Lenses

Monovision contact lenses are the use of a different prescription of lenses in each eye. Monovision contacts is a technique that is used to correct farsightedness in patients who are over the age of 40 and who also have presbyopia, which is a condition that causes difficulty focusing on close objects. Monovision involves correcting one eye for distance vision and the other eye for close-up vision. This allows the patient to see both distant and close objects clearly without the need for glasses or contact lenses.

How Monovision Contact Lenses Work

One eye (usually the dominant eye) is corrected for distance vision and the other for near vision. This requires some testing in the office to determine which eye is best suited for each type of lens.

It usually takes at least 1 to 2 weeks to adapt to monovision. The vision will continue to improve as the lenses are worn. At first it is possible to notice shadowing of images especially when reading and a slightly strange visual sensation that will improve over time.

As the brain and the visual system learn to adapt to the new vision correction, the monovision patient feels more and more natural with the correction. Most patients adapt well and feel very natural with monovision contact lenses, especially in younger patients with presbyopia.

While monovision is generally well-tolerated, it can take some time to get used to, as your brain needs to adjust to your two eyes focusing on different things. This can lead to some changes in depth perception and require extra caution when driving or performing other activities that rely on this sense. Monovision may be a good option if you're equally engaged in tasks that require both near and far vision and you don't mind the trade-off of having one eye for distance and one for near.

Benefits of Monovision Contact Lenses for reading

Far and away the biggest benefit of monovision contact lenses is that they provide crisp clear vision, superior clarity over multifocal lenses, for both near and far tasks. Another benefit of monovision lenses is that they are available in a wide range of brands and materials, while multifocal lenses have far fewer options. This is especially important for long time contact lens wearers who have found a contact lens that they absolutely love but it is not available in multifocal design. Another benefit of monovision contact lenses is the price, as multifocal lenses tend to be higher priced.

One major downside of this option is that it reduces the ability to use both eyes simultaneously, which does affect depth perception to some degree. Depth perception is the visual ability to perceive the world in three dimensions, coupled with the ability to gauge how far away an object is. In general reducing depth perception is not the best option, however some people find monovision contacts comfortable and have used it for years.

It is important to note that monovision lenses are not generally recommended for people who use distance vision for prolonged periods of time. Furthermore monovision lenses become harder to adapt to as the prescription changes, which is generally why they are only a good option for people with earlier stages of presbyopia.

Bifocal or Progressive Contact Lenses and Reading

Bifocal and Progressive Contact Lenses are some of the best contact lenses available for those who need help with their reading vision. These types of lenses are designed with two or more prescriptions in one lens, allowing wearers to see clearly at both near and far distances. The bifocal portion of the prescription provides clear vision for activities such as reading and close-up tasks while the rest of the lens allows for clear distance vision. Multifocal lenses work similarly but may cause more disruption in vision due to the multiple powers within one contact lens. Bifocal and Progressive Contact Lenses provide a clearer, more comfortable vision experience compared to multifocal lenses by giving you sharper images than multifocal lenses can offer.

Scleral lenses for Presbyopia

One of the benefits of scleral lenses is that they stay in place better, they reduce dryness, and they provide a new optical surface, it is for this reason that scleral lenses have become an extremely popular choice.

For patients that have corneal irregularities or severe dry eye, scleral lenses are an incredible, often life changing contact lens. However for patients that have presbyopia, scleral lenses are also available in multifocal design. The challenge with scleral lenses in a multifocal design is that they vault over the eye and this can impact the quality of vision due to the design of multifocal lenses requiring them to be centered on the pupillary axis. Thankfully there are many new designs that improve on the visual outcome of scleral lenses in multifocal design, although fittings may require a few more visits than a standard scleral lens fit.

Another option for patients with presbyopia that choose scleral lenses is for a monovision option, where one eye is for near and the other for far. This solves the challenges in multifocal design, and may improve clarity for reading, however as noted in the monovision section above, this design also has its own set of difficulties.

If you are a scleral lens wearer or are considering scleral lenses for presbyopia due to having keratoconus, corneal conditions, severe dry eye, or for other reasons, it is best to schedule an appointment for scleral lenses for a complete evaluation and discussion. Since scleral lenses are much more customized than traditional contact lenses, specific guidance is important from an eye doctor that specializes in contact lenses. Learn more about scleral lenses.

The best contact lenses for reading for children

As noted above there are two categories of children that can benefit from contact lenses, both near and farsighted children can benefit from contact lenses, however the specific needs of each group is very different.  Typically contact lenses are a fantastic option for children starting from the age of 8 years old, although maturity is more important than age. Kids tend to prefer contact lenses over glasses and multiple studies have shown that contacts are well tolerated in kids. For any patient contact lenses can pose additional risks if instructions are not followed, which is why maturity is an important consideration.

Hyperopia or farsighted children and contact lenses

For kids with hyperopia contact lenses can be a great option. There are a wide range of modalities from daily disposable lenses (ideal due to minimal upkeep) all the way to hard contacts and scleral lenses. Generally a bifocal or multifocal contact lens in daily disposable, is recommended. However in some cases, for example where the child also has high astigmatism other lens designs such as rigid gas permeable lenses or toric lenses may be recommended.

Another great option for farsighted kids is called orthoK or orthokeratology. These lenses address hyperopia as well as astigmatism, and result in crisp and clear vision for reading. These lenses are only worn while sleeping, and gently reshape the eye, leaving the child with crisp and clear vision all day, without the need for glasses or contact lenses. It goes without saying that these lenses are extremely popular with kids, as they enjoy not needing to wear glasses or contacts, great vision, and not having to worry about corrective lenses during sports. OrthoK lenses are widely prescribed to kids around the world with great success, although the cost of orthok lenses is higher than other modalities.

If your child is having trouble with reading with their contact lenses, discuss the best options with an optometrist that specializes in contact lenses.

Myopia or nearsighted children and contact lenses

For children with myopia the most important element is to slow down the progression of the condition. So while you may be considering whether your child should wear glasses or contact lenses, or perhaps they have tried contact lenses but are not getting the best vision, contact lenses are far superior to glasses as they prevent serious complications later in life. This is critical because for every diopter of change in prescription the risks for severe vision threatening eye disease increases significantly.

For every diopter change:

• 30% increase in risk of retinal detachment
• 67% increase in risk for myopic maculopathy
• 20% increase of risk for open angle glaucoma
• 20% increase of risk for posterior subcapsular cataract

There are two contact lens modalities used for myopia management, soft multifocal contact lenses and OrthoK night time lenses.

OrthoK Night time Contact Lenses are an extremely successful option for kids with nearsightedness, and have the benefit of only being worn while sleeping. While both the MiSight and OrthoK lenses are excellent options for myopia management, orthoK lenses will generally have better visual clarity for reading.

Soft multifocal lenses for myopia management include the MiSight® 1 day, which is the only FDA-approved soft contact lens proven to slow the progression of myopia (nearsightedness) in children, aged 8-12 at the initiation of treatment. The 3 year clinical trial found that best corrected acuity with MiSight 1 day was within one letter for the dual focus lens and the control (single vision) lens at distance and near.

Advantages & Disadvantages of Wearing Contacts for Reading

There are many advantages to wearing contact lenses for reading, as well as some potential disadvantages:

Advantages of contact lenses for reading:

• Convenience of not needing to use reading glasses
• Preferred by many over reading glasses which have a psychological effect on some
• Contact lens designs such as scleral lenses improve comfort and vision dramatically for those with corneal conditions and dry eye
• Contact lenses for myopia management such as multifocal lenses and orthkeratology lenses are vital for reducing risk of severe eye disease
• OrthoK lenses can improve quality of life by leaving the wearer glasses and contact lens free all day without the need for surgery
• OrthoK lenses can reduce the risk of sports related injuries and are much easier for athletes, swimmers, or very active people

Disadvantages of contact lenses for reading:

• Contact lenses may not provide the sharpest vision for every patient, and may require trying different types before finding a lens that is best suited for you
• Contact lenses require maturity and following instructions to reduce the risks of infection and complications
• Contact lenses that provide you the best vision may be more costly than glasses or reading glasses
• Some modalities of contact lenses may lead to discomfort such as dryness or irritation