Contact Lens Options for People Over 40

Adjusting to Presbyopia

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Around age 40, many people begin to shop around for reading glasses to help with presbyopia. This condition typically starts around this time and impacts the eyes' ability to focus when looking at something close-up.

But these glasses, as well as bifocal, trifocal, or no-line progressive multifocal eyeglasses, are not your only options. Contact lenses can be a solution for those over 40 who are having trouble doing things like reading a menu or a book.

This article describes different contact lens options and combinations to consider.

different contact lens options and combinations

Verywell / Brianna Gilmartin

Contact Lenses With Reading Glasses

If you already wear contact lenses for distance vision, you may do so because you feel they are more comfortable, practical, or you just prefer the way they look.

If that's the case, wearing glasses in addition to your contacts may not sound all that appealing. However, this is generally the best way to obtain the clearest vision at all distances.

Contact lenses are prescribed to correct your distance vision in full. Reading glasses can be put on when you need clearer vision at close range.

Pros
  • This delivers the clearest, sharpest vision for every task.

  • People with occupations requiring precise vision usually do better with this method.

  • Athletes tend to enjoy this method to maximize their distance vision.

Cons
  • You must put on and take off your reading glasses every time you wish to see clearly at distance.

  • In effect, you must always have your reading glasses handy.

If you feel the cons outweigh the pros, there are a few contact lens options that can consider.

Monovision Contact Lenses

In monovision, one contact lens is worn for distance (if needed) and another one is worn for up-close vision.

The distance contact lens is usually worn in your dominant eye. Everyone has a dominant eye that they primarily use when looking at distant objects, though they don't realize it.

Wearing a near-focused contact lens in the non-dominant eye doesn't seem to create difficulty in adapting to this vision correction.

Pros
  • Near vision seems to be slightly clearer with monovision because each eye is fit with single-vision (one prescription) lens strength.

  • When finding a comfortable lens, your healthcare provider has a wide selection of lens materials, sizes, and shapes. (Monovision is a power adjustment, not a specific brand.)

  • The adjustment period is quick.

Cons
  • Some people notice slightly decreased distance or driving vision, especially at night.

  • Depth perception is slightly decreased while wearing monovision contacts. This may be a problem for people who enjoy sports, such as golf and tennis.

  • Professional or leisure pilots cannot wear monovision contacts. They may cause a certain area of vision to be slightly blurred.

Bifocal or Multifocal Contact Lenses

Bifocal or multifocal contact lenses aim to create more natural vision. Both eyes can be corrected for distance vision and near vision. They can also correct for near vision only, if you don't need any distance correction.

Multifocal lenses are available in several different types, including rigid gas permeable, hybrid hard/soft, and regular soft contact lenses. Depending on the manufacturer, they all work a little differently.

Some of the rigid lenses are designed more like a lined flat-top bifocal eyeglass lens and move around on your eye. When you look down to read, they move up slightly so your line of sight is lined up with the near segment.

Other lenses do not usually move around on the eye. Called aspheric designs, these gradually and smoothly increase in power from the center to the periphery of the lens.

Some of these lenses have near vision power in the middle of the lens and distance power in the periphery, or vice versa. These contact lenses work more like a no-line progressive spectacle lens and are sometimes dependent on the size of your pupils.

Other lenses may be concentrically designed. Concentric designs have alternating rings of distance and near power. These are similar to having two lenses, one distance and one near, blended together.

It will take some time for your eyes to adjust to bifocal contact lenses. After a little while, your eyes will learn to differentiate between the different prescriptions. They'll begin to use the proper prescription for the proper distance.

Pros
  • Multifocal lenses minimally decrease depth perception, if at all.

  • If fit correctly, you will not have to wear eyeglasses over your contact lenses for most of your daily activities.

Cons
  • If distance vision is extremely clear, near vision sometimes suffers. If near vision is clear, distance or intermediate vision may be less than expected.


  • You may see "ghost images" or doubling of images. This usually happens when wearing the lenses for the first time.

  • Contrast sensitivity is sometimes a problem while wearing multifocal lenses. Some people will be able to read the 20/20 line but say it doesn’t appear "crisp."

Summary

Around age 40, you may begin to develop presbyopia, making it hard for your eyes to focus on close objects. If you'd like to wear contact lenses with presbyopia, there are options available—not to mention many places to buy your contacts online.

If you already wear contact lenses, you can still use them along with reading glasses when you need to see something close.

With monovision, you can wear one contact in your non-dominant eye to correct your up-close vision. If you need distance vision correction, you'll wear a contact in your dominant eye with a different prescription.

Another option includes bifocal or multifocal contact lenses. These are designed more like bifocal eyeglasses, making it possible to see both near and far with both eyes.

A Word From Verywell

Your opthalmologist or optometrist will help you decide on one of the above methods based on your needs. Fitting presbyopic contact lenses depends on many factors including your flexibility, lifestyle, prescription, and your eye’s anatomy and physiology.

Optometric healthcare providers and ophthalmologists who fit contact lenses quickly learn that one lens type does not work for everyone. Fitting contact lenses to correct presbyopia requires a little science and a little art on behalf of the practitioner, as well as some patience from you.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Negishi K, Ayaki M, Kawashima M, Tsubota K. Sleep and subjective happiness between the ages 40 and 59 in relation to presbyopia and dry eyePLoS One. 2021;16(4):e0250087. doi:10.1371/journal.pone.0250087

  2. Alvarez TL, Kim EH, Granger-Donetti B. Adaptation to Progressive Additive Lenses: Potential Factors to Consider. Sci Rep. 2017;7(1):2529. doi:10.1038/s41598-017-02851-5

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.