Over 40 and can't read with my contacts, what can I do?

More middle-aged and older adults are wearing soft contacts than ever.

And one of the biggest reasons they decrease or stop wearing contacts is the difficulty they face reading with their contacts after presbyopia begins to set in around the early 40’s.

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 read to eventually even having a meal is blurred. As I am going through this problem myself, it is very frustrating to stare at something up close and have it be blurry regardless of what I do.

So there are three basic choices a contact lens wearer can do to aid their reading while still wearing contact lenses.

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 vision is clear near and far. However, they need to be with you, not left in the car or at work, and oftentimes people end up just wearing readers all day since it is just that much clearer.

Monovision

This fitting technique can be used with any type of contact lens. The brand of lenses you are currently wearing can often be used to fit you with monovision. Your dominant eye is determined. Then the non-dominant eye prescription is adjusted to compensate to make it a reading contact lens. So once fitted you have one eye for distance and the other for reading. Yes, it sounds really crazy, but it actually works quite well. Your brain initially has to adjust to using each eye individually to obtain the sharpest vision, but once this is achieved, year-to-year adjustments can be made to the reading eye to allow comfortable distance and reading vision for many years.

Monovision fits are not always successful. Some people just cannot adjust to it regardless of motivation or desire. It seems to work best when someone has had some difficulty with reading and they are noticing more and more that they need their readers. At that point, they can appreciate the ability to read and their brain seems to adapt more readily. When I wear my contacts this is the option I have used for myself.

Multifocal Contacts

Another option is multifocal contact lenses. Most every major manufacturer of soft contact lenses has some type of disposable multifocal lens available. They do not work like multifocal glasses. They use a technique called simultaneous viewing where you are actually looking through all the powers at once.

To visualize this, imagine a vinyl record with the label in the center and the various tracks extending outward. Most of the lenses are made with the strongest reading power located in the center where the label would be, then each ring further out gradually becomes weaker until you reach your full distance power. So essentially you are looking “around” the reading part for distance then through the center for reading. It works, sort of.

Multifocal lenses work better on younger patients, say 40-50 years old, for help with reading. There is no adaptation period to these lenses like monovision. What you see is what you get. But if you have any significant amount of astigmatism or if you wear a toric contact that corrects for astigmatism, multifocal lenses are not for you. And because the reading is central in the lens, if you make it too strong for reading then you blur the distance vision too much, so oftentimes a multifocal lens wearer after age 50 faces a dilemma to either wear reading glasses to boost their reading needs or change to monovision.

Conclusion

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. But some options may better serve you at a certain point in your life or career than others. So while you happily wore contacts from your teens into 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.

Article contributed by Eugene Schoener O.D.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ

Here are 11 bad things that can happen if you don’t wear and care for your contact lenses properly.

1) Sleeping in your contacts. This is the No. 1 risk factor for corneal ulcers, which can lead to severe vision loss and the need for a corneal transplant. Your cornea needs oxygen from the atmosphere because it has no blood vessels. The cornea is already somewhat deprived of oxygen when you have your eyes closed all night, and adding a contact on top of that stresses the cornea out from lack of oxygen. You don’t need to see when you are sleeping. Take your contacts out!!!! I promise your dreams will still look the same.

2) Swimming in your contacts. Salt, fresh or pool water all have their individual issues with either bacteria or chemicals that can leach into your contacts. If you absolutely need to wear them to be safe in the water, then take them out as soon as you are done and clean and disinfect them.

3) Using tap water to clean contacts. Tap water is not sterile. See No. 2.

4) Using your contacts past their replacement schedule. The three main schedules now are daily, two weeks and monthly. Dailies are just that – use them one time then throw them away; they are not designed to be removed and re-used. Two-week contacts are designed to be thrown away after two weeks because they get protein buildup on them that doesn’t come off with regular cleaning. Monthly replacement contacts need to have both daily cleaning and weekly enzymatic cleaning to take the protein buildup off. Using your lenses outside of these schedules and maintenance increases the risk of infection and irritation.

5) Getting contacts from an unlicensed source. Costume shops and novelty stores sometimes illegally sell lenses. If you didn’t get the fit of the lenses checked by an eye doctor, they could cause serious damage if they don’t fit correctly.

6) Wearing contacts past their expiration date. You can’t be sure of the sterility of the contact past its expiration date. As cheap as contacts are now, don’t take the risk with an expired one.

7) Topping off your contact lens case solution instead of changing it. This is a really bad idea. Old disinfecting solution no longer kills the bacteria and can lead to resistant bacteria growing in your case and on your lenses that even fresh disinfecting solution may not kill. Throw out the solution in the case EVERY DAY!

8) Not properly washing your hands before inserting or removing contacts. It should be self-evident why this is a problem.

9) Not rubbing your contact lens when cleaning even with a “no rub” solution. Rubbing the lens helps get the bacteria off. Is the three seconds it takes to rub the lens really that hard? “No rub” should never have made it to market.

10) Sticking your contacts in your mouth to wet them. Yes people actually do this. Do you know the number of bacteria that reside in the human mouth? Don’t do it.

11) Not having a backup pair of glasses. This is one of my biggest pet peeves with contact lens wearers. In my 25 years of being an eye doctor, the people who consistently get in the biggest trouble with their contacts are the ones who sleep in them and don’t have a backup pair of glasses. So when an eye is red and irritated they keep sticking that contact lens in because it is the only way they can see. BAD IDEA. If your eye is red and irritated don’t stick the contact back in; it’s worst thing you can do!

Article contributed by Dr. Brian Wnorowski, M.D.

The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ