Contact Lenses and the Over 40 Set

One of the biggest challenges fitting contact lenses is when a patient is over 40 and wants contacts. If you fit just the far away situation, more likely than not the patient will have problems close up. There are three ways to deal with this. The first and by far the easiest is to fit both eyes for distance and then have the patient wear a pair of reading glasses over the contacts for near. The second way is to fit one eye for reading and one eye for distance. This has been shown to work in most but not all cases. The third and most challenging way is to fit multifocal contact lenses. These lenses are geting better all the time and many different companies manuafacture them. However, they don't work on everybody. The only way to fit them is to put them on the patient and see how they adapt. More times than not, you have to try multiple pairs on the patient until one pair works. Sometimes the patient can't adapt to any of the multifocals. Then the patient has to decide if they want one eye for reading and one eye for distance or if they want both eyes for distance and reading glasses over them. I had a patient today who wants to ride a bicycle and be able to see his speedometer. He's around 50. On the third pair of contacts we tried, the patient seemed fairly content with his far and near vision. In a number of cases when the over 40 patient can wear contact lenses, they're a lot more content as compared to their glasses. This is because when successfully fitted with contacts, there is no zone of vision that the patient can't see out of.