Low vision is the term used to describe reduced eyesight – either blurred vision (usually 20/70 or worse) or an incomplete field of view – that cannot be fully corrected with eyeglasses, contact lenses or eye surgery. The primary causes of low vision are eye diseases, such as macular degeneration, glaucoma and diabetic retinopathy. But low vision also can be inherited or caused by an eye or brain injury.
A person with low vision is not blind: they have some useful sight. But the degree of their visual impairment can make daily tasks, such as reading and driving, difficult or impossible.
Though children as well as adults can be visually impaired, low vision is mostly a problem that afflicts seniors. Vision loss after a lifetime of good eyesight can be very traumatic, leading to frustration and depression.
Many people who develop eye problems that cause low vision lose their jobs. According to the U.S. Census Bureau’s American Community Survey of 2010, the employment rate for visually disabled Americans ages 21-64 (working age) was only 37.2 percent, and the full-time/full-year employment rate was only 24 percent.
Not being able to drive safely, read quickly, or easily see images on a television or computer screen can cause people with low vision to feel shut off from the world. They may be unable to get around town independently, earn a living or even shop for food and other necessities. Some visually impaired people become completely dependent on friends and relatives, while others suffer alone.
Thankfully, in many cases, people with impaired vision can be helped by low vision devices, which include eyeglass-mounted magnifiers, handheld magnifiers and telescopes, and stand-alone magnifiers. There are many ingenious low vision devices and strategies that can help visually impaired individuals get the most out of their remaining sight and, in many cases, continue to live independently.
If you have hazy or blurred vision, light sensitivity, loss of peripheral vision, night blindness, a need for more light than before, unusual floaters or spots, or difficulty reading, your first step is to see an eyecare professional for a complete exam. These could be the first signs of a serious eye disease such as macular degeneration, glaucoma, or retinitis pigmentosa. Or, they could mean you are developing a cataract that needs removal. Whatever the case, it’s wise to take action before further vision loss occurs.
If your eye doctor finds you have vision loss that cannot be corrected with eyewear, medical treatment or surgery, you will be referred to a low vision specialist. Usually an optometrist, a low vision specialist can evaluate the degree and type of vision loss you have, prescribe appropriate low vision aids, and help you learn how to use them.
The low vision specialist can also recommend non-optical adaptive devices, such as large-print publications, audio books, special light fixtures and signature guides for signing checks and documents. If necessary, your eye doctor or low vision specialist can also refer you to a counselor to help you cope with your loss of vision.
Contact lenses can offer several benefits over other forms of vision correction for kids. But a common question many parents have is: “When is my child old enough to wear contact lenses?”
Physically, your child’s eyes can tolerate contact lenses at a very young age. In fact, some babies are fitted with contact lenses due to eye conditions present at birth. And in a recent study that involved fitting nearsighted children ages 8-11 with one-day disposable contact lenses, 90% had no trouble applying or removing the contacts without assistance from their parents.
A Matter of Maturity
The important question to ask yourself is whether your child is mature enough to insert, remove and take care of their contact lenses. How they handle other responsibilities at home will give you a clue. If your child has poor grooming habits and needs frequent reminders to perform everyday chores, they may not be ready for the responsibility of wearing and caring for contact lenses. But if they are conscientious and handle these things well, they may be excellent candidates for contact lens wear, regardless of their age.
Contact Lenses for Sports
Many kids are active in sports. Contact lenses offer several advantages over glasses for these activities. Contacts don’t fog up, get streaked with perspiration or get knocked off like glasses can. They also provide better peripheral vision than glasses, which is important for nearly every sport. There are even contact lenses with special tints to help your child see the ball easier.
For sports, soft contact lenses are usually the best choice. They are larger and fit closer to the eye than rigid gas permeable (GP) lenses, so there’s virtually no chance they will dislodge or get knocked off during competition.
If your young son or daughter is nearsighted, rigid gas permeable (GP) contacts may be a good choice. GP lenses are more durable and often provide sharper vision than soft contacts.
A modified technique of fitting gas permeable lenses — called orthokeratology or “ortho-k” — can reverse myopia temporarily. Kids put their ortho-K lenses in at night and wear them while they’re sleeping. In the morning, when the lenses are removed, nearsighted kids should be able to see clearly without lenses of any kind.
Researchers also are finding that multifocal soft contact lenses may be effective for myopia control. Multifocal contacts are special lenses that have different powers in different zones of the lens.
Building Self-Esteem with Contact Lenses
Contact lenses can do wonders for some children’s self-esteem. Many kids don’t like the way they look in glasses and become overly self-conscious about their appearance because of them. Wearing contact lenses can often elevate how they feel about themselves and improve their self-confidence. Sometimes, even school performance and participation in social activities improve after kids switch to contact lenses.
Glasses Are Still Required
If your child chooses to wear contact lenses, they still need an up-to-date pair of eyeglasses. Contact lenses worn on a daily basis should be removed at least an hour before bedtime to allow the eyes to breathe. Also, there will be times when your child may want to wear their glasses instead of contact lenses. And contact lenses should be removed immediately anytime they cause discomfort or eye redness.
Don’t Push Contacts on Your Kids
Motivation is often the most important factor in determining whether your son or daughter will be a successful contact lens wearer. If you wear contact lenses yourself and love them, that still doesn’t mean they are the right choice for your child. Some children like wearing glasses and have no desire to wear contact lenses.
Sometimes it’s just a matter of timing. Often, a child may feel they don’t want contacts, but a year or two later, they do.
Bifocal and multifocal contact lenses are designed to give you good vision when you reach your 40s. Beginning at this age, you may need to hold reading material – like a menu or newspaper – farther from your eyes to see it clearly. This condition is called “presbyopia.”
Bifocal and multifocal contact lenses are available in both soft and rigid gas permeable (GP) materials.
Bifocals, Multifocals – What’s the Difference?
Bifocal contacts lenses (like bifocal eyeglass lenses) have two powers – one for seeing clearly far away and one for seeing clearly up close. Multifocal contact lenses, like progressive eyeglass lenses, have a range of powers for seeing clearly far away, up close and everywhere in between. (“Multifocal” is also used as a catch-all term for all lenses with more than one power, including bifocals.)
Types of Multifocal Contact Lenses
Based on design, there are basically two types of multifocal contact lenses:
Simultaneous vision lenses. With these lenses, both distance and near zones of the lens are in front of your pupil at the same time. Although this might sound unworkable, after a short period of time your visual system learns to use the power you need and ignore the other lens power(s), depending on what you are looking at. Simultaneous vision lenses are the most popular type of multifocal contact lens. They are nearly always soft lenses and are available in two designs:
Concentric ring designs – These are bifocal lenses with either the distance or near power in the center of the lens, with alternating rings of distance and near powers surrounding it.
Aspheric designs – These are progressive-style multifocal lenses, with many powers blended across the lens surface. Some aspheric lenses have the distance power in the center of the lens; others have the near power in the center.
Alternating vision (or translating) lenses. These are GP multifocal lenses that are designed like bifocal eyeglass lenses. The top part of the lens has the distance power, and the bottom part of the lens contains the near power. When you look straight ahead, your eye is looking through the distance part of the lens. When you look down, your lower lid holds the lens in place while your pupil moves (translates) into the near zone of the lens for reading.
Will Multifocal Contact Lenses Work for Me?
Most people who try multifocal contact lenses are happy with them. But some compromises may be necessary when you wear these lenses. For example, your distance vision with multifocal contact lenses may not seem clear enough, or you may have trouble with glare at night or not being able to see small print.
In some cases, a person with presbyopia may prefer monovision or modified monovision. Both of these fitting strategies use single vision lenses – that is, lenses that each have only one power – instead of multifocals.
In monovision, you wear a single vision contact lens on one eye for your distance vision and a single vision contact lens on the other eye that has a prescription for your near vision. In modified monovision, you wear a single vision “distance lens” on one eye and a multifocal contact lens on the other eye to help you see better up close.
To determine the best contact lenses for your vision needs when you reach “bifocal age,” call our office for a consultation.