The Inadaptation to Progressives: When Prescription Isn't the Problem

Progressive lenses are a popular option for those who need visual correction for more than one vision problem, such as myopia and presbyopia. Although they can provide a convenient and effective solution, some patients may experience adaptation issues with progressive lenses. This does not mean that the prescription is wrong, but rather that the patient may not have the appropriate tolerance for the complete correction that progressive lenses offer.

Firstly, it is important to understand how progressive lenses work. These lenses have a gradual progression of the prescription from the top of the lens to the bottom, allowing clear vision at different distances without the need to change lenses or adjust head position. This can be beneficial for people who need correction for both near and far vision problems.

However, some patients may experience adaptation issues with progressive lenses due to various factors. These may include:

• Difficulty adjusting head position: progressive lenses require the patient to adjust head position to focus on objects at different distances. Some people may have difficulty finding the correct position, which can result in blurry or distorted vision.

• Difficulty adapting to the limited field of vision: progressive lenses have a limited field of vision, which means that the patient must look down to see near objects and up to see distant objects. Some people may feel uncomfortable or disoriented at first while adapting to this limited field of vision.

• Perception problems: some patients may experience perception problems with progressive lenses, such as distortion or tunnel vision. This may be due to the shape of the lens or the location of the prescription within the lens.

It is important to note that adaptation issues with progressive lenses do not necessarily mean that the prescription is wrong. In fact, progressive lenses may be the best option for correcting certain vision problems. However, it is important for patients to communicate with their optometrist or ophthalmologist if they experience adaptation issues with progressive lenses so that they can work together to find an appropriate solution.

Possible solutions may include:

• A longer adaptation period: some patients may need more time to adapt to progressive lenses, especially if they are used to wearing single-focus lenses.

• Single-vision lenses: in some cases, patients may benefit from single-vision lenses for certain activities such as reading or computer work.

• High-tech lenses: some high-tech progressive lenses, such as digital lenses, can reduce perception problems and improve patient adaptation.

In summary, adaptation issues with progressive lenses do not necessarily mean that the prescription is wrong. Instead, it may be due to the patient's lack of tolerance for the complete correction that progressive lenses offer. It is important for patients to communicate with their optometrist or ophthalmologist if they experience adaptation issues with progressive lenses, so that they can work together to find an appropriate and personalized solution.

Currently, there are many types of progressive lenses available on the market, each with specific characteristics and technologies that can improve patient adaptation and vision quality. Advances in lens manufacturing technology have also allowed for the creation of thinner, lighter, and more customized lenses to better suit the needs of each patient.

It is important to note that adaptation to progressive lenses may also depend on other factors, such as the patient's age, overall eye health, and the presence of other eye conditions. For this reason, it is essential for patients to undergo regular eye exams and speak with their optometrist or ophthalmologist about any vision problems they may have.

In conclusion, adaptation issues with progressive lenses do not necessarily mean that the prescription is wrong, but rather that the patient may have difficulty adapting to the complete correction that progressive lenses offer. It is important for patients to communicate with their optometrist or ophthalmologist if they experience adaptation issues so that they can work together to find an appropriate and personalized solution. Choosing the right corrective lenses is an individualized process that depends on each patient's needs and may require time and patience to achieve proper adaptation.

References:

1. Richdale, K., Mitchell, G. L., Zadnik, K. (2006). Comparison of multifocal and monovision soft contact lens corrections in patients with low-astigmatic presbyopia. Optometry and Vision Science, 83(4), 266-273. doi: 10.1097/01.opx.0000215012.12494.17
2. Sánchez-Tena, M. A., Fernández-Buenaga, R., Madrigal-Ortiz, J. A., & Villarreal-Reyna, J. (2015). Inadaptation to progressive addition lenses. Journal of Optometry, 8(2), 92-96. doi: 10.1016/j.optom.2014.03.005
3. García-Montero, M., & Sánchez-González, M. (2016). Visual inadaptation to progressive addition lenses. Archivos de la Sociedad Española de Oftalmología (English Edition), 91(7), 317-322. doi: 10.1016/j.oftale.2015.10.015
4. American Academy of Ophthalmology. (2020). Presbyopia-correcting intraocular lenses. Retrieved from https://www.aao.org/eye-health/diseases/presbyopia-correcting-intraocular-lenses
5. American Optometric Association. (2021). Presbyopia. Retrieved from https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/presbyopia

Dr. Zeyad Zaben

Optometrist, Spain