Vol 32 No 1 Original Article PDF

Monovision soft contact lenses versus reading glasses among early emmetropic presbyopes

Gabriel Bunagan, MD, Ruben Lim Bon Siong, MD, Leda Tolentino, MSc, Irwin Cua, MD

Objectives
This study determined the effectiveness and acceptance of monovision contact lenses compared with reading glasses for early emmetropic presbyopes.

Methods
Fifty participants, 36 to 45 years old, with early emmetropic prebyopia were enrolled and randomized to two groups. Group 1 used monovision contact lens for 2 weeks on an extended-wear basis, while Group 2 used bilateral reading glasses for 2 weeks. Participants were then crossed over to the other group for another two weeks. Acceptance rate, binocular distance and near visual acuity (log MAR), stereoacuity, contrast sensitivity, and quality-of-life evaluation (VF-14) were measured at the end of 2 weeks after each intervention. Adverse events and complications were also noted. Chi-square, one-way analysis of variance (ANOVA), paired t-test, and Pearson correlation were used to analyze differences.

Results
Fifty patients (33 females and 17 males) with a mean age of 41 were enrolled into the study. Nineteen (38%) fully accepted the use of monovision contact lens while 22 (44%) moderately accepted it. Nine patients did not accept monovision, with 33% citing difficulty with focusing as the most common reason. Age and amount of plus power were statistically significant variables affecting monovision acceptance, with younger age and lower plus power favoring acceptance. Monovision showed poorer binocular distance and near visual acuity values and a significant decrease in contrast sensitivity and stereoacuity (p < 0.01). One case of eye redness and another of foreign-body sensation were reported with soft-contactlens use.

Conclusions
Use of monovision soft contact lens to improve near vision among early emmetropic presbyopes is an effective alternative to reading glasses. Younger presbyopes and lower plus power are favorable factors for monovision acceptance. Reading glasses are superior to monovision contact lenses in terms of visual acuity, quality of vision, and quality of life.

Keywords: Presbyopia, Monovision, Contact lens, Reading glasses