Case study #1
Celeste Martins, 59, senior administrator, was prescribed glasses for presbyopia in her mid-to-late 40s, with her first glasses being standard reading spectacles. After turning 50, and a subsequent deterioration of eyesight, the optician graduated Martins to varifocals. ‘Within approximately four years, anything I tried to read was blurry and illegible. My glasses very quickly became essential to my life and hobbies. My hobbies are reading and walking, following a GPS route on my phone, both of which require me to wear glasses,’ she
says.
However, there was only one pair of glasses out of three varifocals that Martins was able to get used to immediately over the years. She says: ‘My initial standard glasses were easy to adapt to but when I moved to varifocals it became much harder to adapt. All my prescriptions have always suited my visual needs but when I transitioned to varifocals, I have always found it hard to feel comfortable using them, especially while using my monitor screen at work.’
With a former pair, which Martins used for the past two-and-a-half years, Martins was not able to see the top of her monitor screen for work and despite returning to the optician for adjustments, there were very little improvements as she continued to struggle to see the whole of the screen unless manually adjusting them herself.
Two weeks ago, Martins received an eye exam and told the optician about previous issues with the varifocals. ‘I was prescribed adjusted lenses that are now larger in height, which the optician described as “deeper”, to accommodate the whole screen, and made the temple tighter so they don’t fall down my nose as much,’ she says. ‘When I returned for a follow-up to check the fit, the optician also adjusted the arms to help straighten the glasses as one side was lower on my face than the other side.’
Case study #2
Chris Bennett, 61, editor-in-chief at Optician, noticed the onset of presbyopia over 10 years ago while using orthokeratology (ortho-k) contact lenses, which he wore overnight to correct short-sightedness. As this is supposed to overcorrect short-sightedness throughout the day, Bennett was shocked to find that he struggled to read some work during a train journey across London.
‘Obviously, that was my light bulb moment when I thought, “Oh, something’s going on here. I can’t read things up close, I must be getting to that stage where I’m presbyopic, and I’m going to need to deal with that”,’ he says.
Since then, Bennett has tried various forms of presbyopia solutions, including single-vision, multifocal glasses and contact lenses. After being caught out without any vision correction during a cycling race of over 100 miles, which required reading a small map and his Garmin watch, Bennett became highly aware of the need to better cater his presbyopia solutions to his lifestyle activities.
‘There’s definitely an art of tailoring the lenses to the needs of the wearer. I’ve had multifocal contact lenses as well as multifocal and varifocal spectacle lenses that I could use for cycling. The kind of varifocals or multifocals that I would wear for office work and proofreading at work are totally different from ones that I would want when I’m on a bike, gardening or doing something outside, because my distance and near work needs are different,’ he says.
When getting fitted for multifocal contact lenses, the optician also recommended Bennett to get two sets: one with a stronger positive add for office work, and one with a less positive add for outside sports activities.
From Bennett’s experience trying to make glasses fit his needs, compromise was key: ‘I would encourage wearers to take a flexible approach to presbyopia, and don’t expect that you’re going to get one product that is going to solve all your problems at distance vision and near vision. There’s always a little bit of a compromise to be had, depending on whether it’s more important for you to see in the distance or more important for you to see up close.’
Bennett emphasises that he has been surprised, especially in recent years, about how easy the adaptation is, and highlights that the improvement in lens designs has made a big difference for him, compared to those of 10-15 years ago.
‘The designs were much harsher; you could hold the lens up and you could see the different areas where you looked through the lens. But if I hold up any of the varifocals I’ve got at the moment, there are very smooth transitions between the distance, intermediate and near areas,’ he says.
Bennett has experienced a very slow progression and has worn his current glasses for four or five years. A recent eye exam resulted in a suggestion to increase lens strengths, but the change in vision wasn’t strong enough to be urgent.
Case study #3
Martin Patchett, 67, commercial property consultant and building surveyor, needs reading glasses and varifocals. He started using them around 10-12 years ago after noticing he was having difficulty reading road signs, with low lighting and during outdoor sports as near vision became blurry.
‘The driving compelled me to get tested, because I didn’t like driving at night without being able to see properly. At first, I’d only use them for driving or if in a low-light room but I’ve gradually got into the habit of keeping them on because it’s too much of a hassle to take them
on and off all the time,’ he says.
For lifestyle needs, he uses varifocals for driving, office and building surveying work and reading. He uses reading spectacles or sunglasses with +2.00 diopters of magnification to assist in activities such as sailing and riding motorbikes.
As a building surveyor, Patchett says his varifocals are needed daily for assessments, measuring buildings and reading notes during meetings. He has two pairs of varifocals and insures his glasses as a precaution after losing them once: ‘After making a £250 mistake, I’m very conscious about how expensive they are if you damage them or break them or lose them,’ he adds.
He previously used motorbike-recommended sunglasses to ride his motorbike and for fixing things that require near vision during sailing. These are sports wrap-around sunglasses with high-impact lenses and a magnified section in the bottom half for reading the dashboard and close-up road signs. He said: ‘If you’re on the bike, all you want to do is see the instruments, you look down a bit. And if you’re on the boat, all you do is change your head [angle] a little bit.’
Patchett also keeps fold-up map reading glasses in a special case for practicality and safety to use while navigating on the boat.
Presbyopia progression remains slow, with only a small decrease in visual acuity, following yearly check ups.
Case study #4
Debbie Martin, 57, civil worker, was initially prescribed visual display unit glasses to alleviate digital eye strain, before the onset of presbyopia started in 2008. She says: ‘I could no longer read properly and kept holding the paper further away and, after regular check-ups, my prescription was amended as my eyes worsened as I got older.’
Then, single vision glasses were prescribed, Martin explains: ‘I couldn’t get on with varifocals, and luckily, I haven’t gotten to the stage that I need them. I was recommended to have them, but the optician said it wasn’t essential. And I was quite happy with single vision glasses as my long-range vision is fine.
‘I use them for my job and everyday things, even for preparing food, cooking, doing intricate things in gardening, I wear them simply for comfort so I don’t have to constantly strain to see,’ she adds.
Martin had to be reexamined as she received the wrong prescription a couple years ago during a regular check-up at a high street multiple due to a severe miscalculation, and the glasses kept breaking too - ‘You get what you pay for,’ she remarked. Despite the optician fixing the prescription and lenses, Martin felt the trust was lost and decided to move to another optical practice last year for her next examination.
As Martin’s prescription takes into account a very weak astigmatism in one eye, she prefers thicker frames, instead of rimless glasses, so she doesn’t have to worry about thinning the suspended lens.
When choosing frames, she always takes one of her daughters with her as she relies heavily on their second opinion: ‘I have to go with someone to tell me whether they’re okay or not. I have trouble because I’ve got a small face and all frames often seem huge, so I need to have them small and a certain shape. I respect a family relative to tell me whether they look right, rather than a member of staff.’
