For people with the following vision problems, can you provide
information on what options optometrists typically, or can plausibly,
recommend? (I recognize that you can't offer specific medical advice.
I'm concerned that the optometrist may not have time to thoroughly
discuss all the options. Knowing them ahead of time will help me with
my discussion/decision.)

Overview:
- I have moderate myopia (nearsightedness).
- I have increasing presbyopia ("old age eyes", I'm currently 45 years old).
- I work with computers for a living.
- I currently have glasses with just myopia correction.

More details:
- My nearsighted clear focus extends far enough to, and I nearly
always do, read without glasses, by holding reading materials just a
little closer than most people do. My understanding (?) is that
presbyopia shouldn't ever apply to this situation since this distance
is "virtual infinity" for me. Is this understanding correct?
- My presbyopia has progressed far enough that I nearly always need to
remove or lift up my current glasses to read smaller print.
- Without glasses on, computer screens are a little too far away to
easily read, due to myopia.
- With current glasses on, computer screens are close enough that eye
strain is starting to become more noticeable, due to slowly increasing
presbyopia.

Needs:
- I need a fairly large field of clear vision at the distance for computer work.
- I'd prefer not to have to remove my glasses every time I need to
read something up close.
- But I also need distance vision for driving and other activities.
- I'm willing to consider two pairs of glasses as an option.
- I'm not willing to use contact lenses.

Are progressive lens now the norm for bifocal/trifocal needs? If not, what is?

One possibility I can think of is two pairs of glasses with
progressive changes for the following corrections:
- First pair used mainly for computer work, with a large center field
of view for computer work, a narrower field at the top for distance,
and a narrower field at the bottom for close-up work.
- A second pair of glasses with a larger top portion for
distance/driving, and progressive changes in the bottom portion for
computer and close-up work.
Is such an approach practical for vision and for lens making? Do any
existing resources discuss such an approach? Would optometrists
typically be familiar with such an approach?

I've heard of glasses where the prescription is notably different for
each eye. Is this commonly done?

Are there other typical and/or plausible options for my situation?
What are the main advantages and disadvantages of each of the various
options?

Thank you for your help.

---

Clarification of Question by philroy-ga on 10 Apr 2005 13:28 PDT

Laser eye surgery would probably not be a good idea. I've already had
it done twice:

- I had RK done on my left eye in 1987. It worked generally well,
though it gave me mild glare and halo effect so I chose not to have my
right eye done. I was able to skip wearing glasses for much of the day
for awhile, taking advantage of the differing focus in each eye.
However, (as has been discovered since as not uncommon), my RK caused
progressive hyperopia (farsightedness distinct from presbyopia), which
gave me increasing eyestrain to see things at middle distance.
Correcting that with glasses would have involved a left lens for
hyperopia and a right lens for myopia, and the eye doctor confirmed
that a difference in lenses that great would cause headaches.

- So I got LASIK surgery for farsightedness, also on my left eye, in
2002. But the LASIK overshot and brought my left eye back to mildly
nearsighted, and also added some slight blurriness (later tentatively
diagnosed as "irregular astigmatism") not correctable with glasses.
:-( Well at least it got both eyes nearer to each other in vision, so
that the difference between the two glasses lenses is small.

Some of the material in this answer may be of interest to you:

http://www.answers.google.com/answers/threadview?id=349080

pinkfreud-ga, thanks for your comment. You posted before I had a
chance to clarify that I had already had laser surgery! I'll still
follow up on the reference you provided. Thanks again.

Here's a personal perspective.

My husband earns his living working with computers. He is extremely
myopic, and mildly presbyopic. He tried two types of progressive
lenses, and found them unsatisfactory. He dislikes contact lenses, and
does not wish to undergo surgery, so he decided to ask the optometrist
for three separate prescriptions. He now has three pairs of
eyeglasses: one optimized for distance (such as driving an
automobile), one for the typical distance from his eyes to a computer
monitor, and one for reading. This works out well for him, except for
the nuisance of having to swap glasses several times during the day.

Like my husband, I am also extremely myopic and mildly presbyopic.
Progressive lenses suit me fine, and I use my progressive eyeglasses
for everything except very close work such as sewing.

Here's an interesting article about lenses for presbyopic computer users:

http://www.visioncareproducts.com/34/len_comp.html

Pink, thanks. The article is quite helpful. I might print it out and
take it with me to the eye doctor appt.