High myopia, also known as severe nearsightedness, is a common vision condition characterized by significant difficulty seeing objects in the distance. Individuals with high myopia typically have a refractive error of -6.00 diopters or worse. This means the length of their eyeball is longer than average, causing light rays to focus in front of the retina rather than directly on it. As a result, distant objects appear blurry without corrective eyewear such as glasses or contact lenses.
Progressive lenses are a type of multifocal corrective lens used to treat presbyopia, which is age-related loss of near vision. They provide a gradient of increasing lens power, transitioning smoothly from distance correction at the top of the lens to near vision correction at the bottom. This allows the wearer to seamlessly focus on objects at all distances. Unlike bifocals which have an abrupt transition line, progressives do not have visible lines in the lenses.
For people with high myopia considering progressive lenses, the key question is whether progressives can provide sufficient distance correction while also accommodating their need for near vision support. In this article, we will explore the pros and cons of progressive lenses for high myopia and provide guidance on whether they are a good choice.
Benefits of Progressive Lenses for High Myopia
There are several potential benefits that make progressives an appealing option for those with high myopia:
– Seamless vision at all distances – With a single pair of progressives, you can focus clearly on near, intermediate, and distant objects without having to switch between separate reading and distance glasses. The graduated power allows smooth transitions.
– Less distortion than bifocals – Progressive lenses provide a much wider intermediate zone compared to old-fashioned bifocals. This results in less peripheral distortion when scanning your field of vision. There are no abrupt changes in power.
– Good aesthetics – Progressives look like regular single vision lenses with no visible line. This gives them a more attractive cosmetic appearance compared to bifocals.
– Gradual adaptation period – Wearers can slowly get used to the variable lens power in progressives, making the transition easier than going straight to bifocals or trifocals. The brain and eyes adjust over time.
For high myopes, the main advantage is convenience. Progressives combine distance and near correction into one lens. This saves you from carrying multiple pairs of eyeglasses. It also means you don’t have to tilt your head back to see through the reading portion of bifocals. The wide intermediate zone also helps avoid this problem.
Drawbacks of Progressive Lenses for High Myopia
However, there are also some disadvantages to consider with progressives:
– Smaller usable area for distance vision – To incorporate the near zone, progressive lenses have a shorter corridor for distance viewing. This can cause peripheral blurring and distortion issues. The usable area shrinks as the add power increases.
– Challenging fit and precision required – Getting the measurements right is critical for progressives to function properly. They require very precise centration and fitting to the frame. This can be difficult with high prescriptions.
– More prone to artifacts – Progressives are more complex lenses by design. This makes them more susceptible to unwanted astigmatism, distortion, and other visual artifacts, especially for stronger lens powers.
– May not provide full distance clarity – The maximum distance correction may not be adequate for very high myopia. The reading area starts to impinge on the distance zone.
– More expensive – Good quality progressives made with premium materials cost significantly more than single vision or bifocal lenses. This is especially true for high index materials needed for strong myopic prescriptions.
– Adaptation period required – It takes most wearers 2-4 weeks to get fully comfortable with progressives. Some never adapt successfully. The brain has to get used to the variable power.
– Not suitable for certain occupations/activities – Progressives may not work well for those who need very sharp, stable distance vision like pilots. The narrowed distance area can be problematic.
The main drawback is that the distance viewing zone in progressives becomes quite small and distorted with very high myopic prescriptions. The maximum achievable distance acuity may not suffice for certain individuals and occupations.
Recommendations for High Myopes
Here are some recommendations regarding progressive lenses for those with high myopia:
– Try progressives with lower add powers first – Begin with a +1.00 or +1.50 add if starting with your first progressives. Higher add powers shrink the distance viewing corridor.
– Select a design optimized for your prescription – Certain progressive lens designs work better for stronger powers. Ask your eye doctor to recommend an appropriate design.
– Choose a frame with proper dimensions – Carefully measure your frames to ensure the lenses will fit and center well. Follow your optician’s frame fitting advice.
– Give yourself time to adapt – It may take a few weeks to get fully used to progressives. Don’t get discouraged too quickly during the adjustment period.
– Ask about custom enhancement options – Additional customization like personalized corridors based on your eyewear habits can optimize progressives for your needs.
– Consider using progressives part-time – Wear them for most day-to-day tasks, but have a separate pair of single vision glasses for critical distance viewing needs.
– Evaluate vision capabilities without adaptation bias – Be honest with yourself about whether your distance vision is acceptably sharp after trying to get used to the progressives for a month.
– Weigh pros and cons relative to your priorities – Make your decision based on your vision needs, cosmetic preferences, cost considerations, and other personal factors.
The most important guidance is to independently assess your vision after giving progressives a fair tryout period. Don’t just assume you will adapt. If your distance vision is not adequately clear and comfortable with the maximum distance prescription, you may be better off sticking with single vision or bifocal lenses. Get professional help fine tuning your progressive lenses to optimize the fit and power range.
Maximizing the Performance of Progressives
If you do opt to wear progressives with high myopia, here are some tips to get the best vision performance from them:
– Choose a versatile frame size – Medium-sized frames provide a good balance of distance and near utility. Avoid extreme shapes.
– Stick with standard fitting parameters – Follow your prescriber’s recommendations for pantoscopic tilt and frame measurements.
– Keep frames properly adjusted – Regularly tighten screws and use nosepads to maintain proper alignment.
– Position your head appropriately – Align your eyes in the upper distance portion for far viewing. Lower your gaze to look through the reading zone.
– Turn your head more – Rotate your head instead of just your eyes when scanning across a wide area. This minimizes peripheral distortion.
– Give your brain feedback – As you scan your eyes across the lens, consciously register when things look clearest to reinforce brain adaptation.
– Use supplemental single vision glasses as needed – Keep a spare pair handy for situations like driving at night where maximum distance acuity is vital.
– Take advantage of outdoor visibility benefits – The wider pupils and distance gaze when outdoors can provide a better experience.
– Communicate specific issues to your eye doctor – Describe any bothersome artifacts so they can be minimized in a re-make if needed.
– Stick with it for at least a month – Persist through the adjustment period unless problems are severe. It takes time for most wearers to adapt.
With a quality progressive lens design, precise fitting parameters, realistic vision expectations, purposeful wearing habits, and patience during acclimation, high myopes can experience very good results with progressives. Work closely with your eye care provider to decide if trying them makes sense for your visual lifestyle needs and prescription level.
Case Studies on High Myopes using Progressives
Looking at specific examples can further illustrate when progressive lenses can work well for high myopia, and when limitations may arise:
Case 1
Katie is 35 years old with -8.00D of myopia and no astigmatism. She has worn single vision contact lenses since college but now finds herself needing to remove her contacts to read restaurant menus and other near material. She is considering progressive lenses to address her emerging presbyopia.
After trying a pair with a +1.50 add, Katie is very pleased. The small reading boost makes menus and her phone easy to see, while the distance area provides sharp acuity. She notices very minimal distortion in her peripheral vision. Katie adapts quickly in about 2 weeks. For most daily activities, the compromise works beautifully, and she only occasionally feels the need to swap her contacts back in for critical distance tasks.
Case 2
Alex is 43 with -10.00D of myopia and -2.50D of astigmatism. As a construction supervisor, he relies heavily on sharp distance acuity but also does paperwork on the jobsite. Bifocals have served him well for years, but he is interested in trying progressives for smoother transitions.
Alex tries a pair but ends up very frustrated. The small distance area forces him to turn his head constantly to reduce blurriness. The distortion is also more bothersome. After a month, he gives up on adapting. For his stronger myopic prescription and visually demanding occupation, Alex determines traditional bifocals still work better.
As these cases illustrate, moderate to moderately high myopia under -10.00D can often be well managed in progressives. But for very high prescriptions or situational visual needs, the limitations become more problematic. Carefully evaluating the tradeoffs is crucial when deciding whether to use progressives.
Conclusion
Progressive lenses can provide an appealing vision solution for managing presbyopia while also correcting higher degrees of myopia. For many wearers, the graduated power allows sharp sight at all ranges without switching eyeglasses. However, the compressed distance area can result in insufficient distance acuity, peripheral blurring, and adaptation difficulty for some high myopes.
Carefully considering your correction needs, lifestyle, and willingness to persevere through an adjustment period is important. Seek professional guidance in selecting an appropriate design and fit. Be honest in assessing real-world vision after a trial period. Progressives can work well for many high myopes but may not be ideal for all. Weighing the benefits against drawbacks can lead to the best choice for your individual situation.
