Difficulty seeing up close with contact lenses is a common and often frustrating issue. This can make everyday tasks, such as reading or using a smartphone, challenging. While perplexing, especially if distance vision remains clear, there are physiological reasons behind this change. Understanding why this happens is the first step toward finding effective solutions.
Understanding Presbyopia
The primary reason for difficulty seeing up close with contacts is presbyopia, a natural, age-related condition. This condition typically begins around age 40. Presbyopia occurs because the eye’s natural lens, located behind the iris, gradually loses flexibility. In younger eyes, this lens is soft and pliable, readily changing shape to focus light for clear vision at varying distances.
Over time, the lens becomes more rigid, reducing its ability to “accommodate” or adjust focus for close work. Consequently, light from near objects focuses behind the retina instead of directly on it, leading to blurred near vision. Symptoms often include needing to hold reading material farther away, eye strain, and headaches.
Single-vision contact lenses are designed to correct vision for a single distance, usually far vision. These lenses do not compensate for the natural loss of flexibility in the eye’s lens caused by presbyopia. Therefore, while single-vision contacts may provide excellent distance vision, they do not address the eye’s diminished capacity to focus on close objects.
Contact Lens Options for Near Vision
Several contact lens options are specifically designed to address presbyopia and improve near vision. Two common approaches are multifocal and monovision contact lenses.
Multifocal contact lenses contain multiple prescription strengths within a single lens, allowing for clear vision at near, intermediate, and far distances. These lenses work by having different power zones, similar to progressive eyeglasses, but they function differently because the lens moves with the eye. Some designs have concentric rings of power, while others have a gradual change in power from the center to the edge. This design allows the brain to instinctively select the appropriate power for the distance being viewed.
Monovision contact lenses correct one eye for distance vision and the other eye for near vision. Typically, the dominant eye is corrected for distance, and the non-dominant eye is corrected for near. The brain then learns to adapt and combine these two images, allowing for functional vision at both distances. While monovision can reduce the need for reading glasses, some individuals may experience a compromise in depth perception or struggle with adaptation.
Other Contributing Factors
While presbyopia is the primary culprit, other factors can also contribute to difficulty seeing up close with contact lenses.
Outdated or Incorrect Prescription
An outdated or incorrect prescription is a common issue, as vision changes over time. If the contact lens prescription no longer accurately matches the eye’s current needs, it can lead to blurry vision at any distance, including close-up. This can result in eye strain or headaches.
Dry Eyes
Dry eyes can significantly impact vision clarity with contacts. When the tear film is unstable or insufficient, it can cause fluctuating or blurry vision, making it hard to maintain a clear focus, particularly during tasks requiring sustained near vision. Symptoms often include a gritty sensation, redness, and discomfort, which can worsen with contact lens wear.
Astigmatism
Astigmatism, a common refractive error caused by an irregularly shaped cornea or lens, can also lead to blurry or distorted vision at all distances if uncorrected. Standard contact lenses may not fully address astigmatism, leading to persistent blur, especially for detailed near work. Specialized toric contact lenses are designed to correct astigmatism by having different powers in specific meridians and maintaining a stable position on the eye.
Contact Lens Fit
Issues with the contact lens fit can cause inconsistent vision. If a lens is too tight or too loose, it can shift on the eye, leading to fluctuating or blurry vision. A poorly fitting lens can also cause discomfort, redness, and irritation, impacting visual clarity. Regular eye exams are important to ensure the contact lenses continue to fit properly as the eye’s shape can change over time.
When to Seek Professional Advice
If you are experiencing persistent difficulty seeing up close with contact lenses, consulting an eye care professional is important. An optometrist or ophthalmologist can perform a comprehensive eye examination to diagnose the underlying cause of your vision changes. This examination can determine if presbyopia, an outdated prescription, dry eyes, or astigmatism is contributing to the problem.
A professional can recommend suitable contact lens options, such as multifocal or monovision lenses, tailored to your visual needs and lifestyle. They can also provide guidance on managing conditions like dry eyes or ensure your contact lenses fit properly. Attempting to self-diagnose or adjust your contact lenses without professional guidance is not recommended, as it can lead to discomfort or potentially serious eye health issues. Regular eye check-ups are key to maintaining clear and comfortable vision with contact lenses.