editor's perspective

I am Presbyopic and I Don't Like PALs

BY JOSEPH T. BARR, OD, MS, EDITORA
JUNE 1998

A few weekends ago, after years of denial, I suffered an acute onset of presbyopia. I put on the progressive addition lens (PAL) spectacles my staff had been trying to get me to wear for the past few years, and I wore them faithfully for a couple of weeks. My work requires careful attention to subtle contrast changes in such tasks as performing slit lamp examinations and hours of reviewing slides for our research. I don't like the PAL vision, I don't like having to aim my head all the time, and I am not a visual slob (thanks to Karla Zadnik for that term).

So now I wear a 0.75D add OS in my soft contact lenses. So far, the results are acceptable. I'm tolerating the drying symptoms to avoid wearing the spectacles most of the working day. I can see well at the computer and while reading, and adequately while driving. I like having good vision out of each eye at the appropriate distance. It does, however, remind me of my recollection of Bob Mandell's definition (daffynition) of monovision: "where each eye is blurred." But at least it's not like wearing the PALs, where I feel like both eyes are blurred. Sure, my contrast sensitivity is a little off and I need the stand magnifier more often when I sort slides, but overall, the vision is pretty good. Compromise is synonymous with presbyopia. I used to believe it; now I know it.

I like being able to wear my plano sunglasses. I enjoy listening to eyecare practitioners who tell me how their spectacle patients love PALs and how they like them for themselves. Of course they say, "you have to aim your head and there's the peripheral blur, but you'll get used to it." For now, I'd rather get used to monovision. I like to exercise about four times per week, but spectacles get in the way and sweat is a problem. Oh sure, I've already had offers to be fitted with bifocal or multifocal contact lenses, and I'll probably try them. Will I continue to wear contact lenses like I did in my youth? Only time will tell.