Monovision vs. GP Bifocals:
Which Comes Out on Top?
Monovision is one option for presbyopia, but it compromises depth perception and intermediate vision.
Monovision means wearing one contact lens that corrects only distance vision in one eye, and wearing another lens that corrects only near vision in the other eye.
This used to be a popular way to correct presbyopia for contact lens wearers.
However, the introduction of new and improved multifocal contact lenses – especially those in GP lens designs – makes monovision a secondary and less preferable option.
Disadvantages of Monovision
Although monovision lets you see uninterrupted distance vision with one eye and uninterrupted near vision with the other, this option does involve compromises. They include some decrease in overall distance vision, difficulty in seeing clearly at arm’s length (such as your computer screen), and some loss of depth perception.
In addition, driving is compromised, especially at night. Glare from oncoming headlights is a common complaint, unless you wear eyeglasses simultaneously, providing distance correction for the near-corrected eye.
Multifocals: Much Better Than Monovision
Multifocal lenses provide vision correction at all distances in both eyes. Although there can be mild compromise in vision, depending on the lens design, studies in which multifocals have been directly compared with monovision the vast majority of patients prefer the multifocal option.
In one comprehensive study, published in the August 2006 issue of Optometry and Vision Science (the official publication of the American Academy of Optometry), the quality of vision was assessed and compared among participants wearing progressive addition eyeglasses, GP multifocal contact lenses, soft multifocal lenses, and monovision.
When the results of all tests were analyzed, including those for quality of distance and near vision, GP multifocal lenses performed similarly to eyeglasses, soft bifocals were next highest, and monovision performed the poorest of all four options.
Download a brochure about contacts for people over 40
I wear my GP lenses all day, from about 7 in the morning to 11 at night. I would not go back to glasses. The vision is just so good. When I can see close up and read and thread a needle, yet I can see the other side of the room, that's definitely worth it. And not having to wear cheater glasses over the contacts. Why wear contacts if you have to wear cheaters?
Frequently Asked Questions About Multifocal Contact Lenses
We've compiled some of the most frequently asked questions about multifocal and bifocal contact lenses. Click a question for the answer.
Q. What’s the difference between multifocal and bifocal contact lenses?
A. Multifocal lenses focus at a variety of distances. Bifocal lenses are a type of multifocal lens, but focus at only two distances, usually far and near.
Q. Who can wear multifocal or bifocal contact lenses?
A. You're an especially good candidate if you are already used to wearing contact lenses or if you have already adapted to bifocal, trifocal, or progressive eyeglass lenses.
But really, most people with presbyopia – even those with no contact lens experience – can wear multifocal contact lenses successfully.
Q. Am I too old or too young to wear them?
A. Usually, presbyopia begins at around age 40. If you are presbyopic and a good candidate for contact lenses, you are a potential multifocal contact lens wearer, no matter what your age.
Q. I need reading glasses, but I don't need eyewear to see far away. Am I a candidate?
A. Yes, you can get bifocal contact lenses that have just a reading zone. Many people find this more convenient and attractive than wearing reading glasses.
Q. How do I find an eye care practitioner who fits them? Should I choose an optometrist or an ophthalmologist?
A. Call your regular eye care practitioner and ask if he or she fits multifocal contact lenses. If not, use our GP Eye Care Professional Locator. This useful resource also lists each practitioner's specialty areas, including bifocal and multifocal GPs.
Even when using this locator, confirm before making an appointment that the eye care practitioner fits GP bifocals. Fitting these lenses requires special knowledge and experience, so not every practitioner does it.
Q. Is it difficult to get used to multifocal contact lenses?
A. No. If you have adapted to bifocal, trifocal, or progressive eyeglass lenses, you will already understand the basics of using translating bifocal contact lenses, in which the distance zone is straight ahead and above center, while the reading zone is lower. With simultaneous designs, your eyes will learn to focus near or far as needed.
Whatever your particular lens design, your eye care practitioner will make sure you understand how to use it. Because all types of multifocal GP lenses, when fitted properly, move little on the eye when you blink, clinical research shows they are initially more comfortable than regular GP lenses.
Q. Do they provide vision that's as good as my bifocal eyeglasses?
A. Yes. Though there may be a slight compromise with some designs as compared with glasses, GP bifocal contacts provide especially crisp vision, as compared with soft contact lenses. The rigid material of GP lenses tends to hold a more definite shape on the wearer's eye, even after a blink.
Q. Are multifocal contact lenses expensive?
A. The cost of contact lenses varies from one lens design to another, but in general they are less expensive than eyeglasses with progressive lenses. GP multifocal contact lenses, especially, are a good value because they last longer than most soft multifocal contacts.
Q. How often will I need to replace them?
A. That depends on whether you choose soft or GP multifocals.
In general, soft contact lenses become cloudy with protein deposits over time and are easy to tear; those disadvantages are somewhat remedied by disposable or planned replacement soft multifocals.
GP contact lenses are made of a more durable plastic that stays clear over time. With GP multifocals, you may need new ones only when your presbyopia progresses so that you need a stronger near vision prescription. Read a comparison of soft contacts vs. GP contact lenses.
Q. Do they require any special care?
A. Multifocal contact lenses require no more care than regular contact lenses, and they are just as easy to apply and remove from the eye. Most wearers go all day without needing to think about their contact lenses.
Wearers of bifocal or progressive eyeglasses, however, constantly feel the weight of their glasses on their nose, must remove them for periodic cleaning, and have to put up with fogging on cold days. Reading glasses, too, are often removed and replaced several times a day, and it's easy to misplace or scratch them.
Q. What if I have astigmatism?
A. Not to worry. Multifocal contact lenses come in many designs and can be prescribed for people with astigmatism. The best choice is usually GP lenses, because they hold their shape to correct astigmatism better.