Multifocal and Monovision Lenses: Convenient, But Are They Putting You at Risk?
Find out how multifocal and monovision lenses might be impacting your balance, depth perception, and overall safety.
When it comes to correcting both near and far vision, multifocal and monovision lenses are popular choices. They seem super convenient—one pair of glasses that can handle all your visual needs. But here’s something you might not know: these lenses come with hidden risks. They can distort your depth perception and affect your spatial awareness, which actually increases your chances of trips and falls!
Let’s take a closer look at how these lenses can impact your vision and what you can do to protect yourself.
Multifocal Lenses: Convenient but Risky
Multifocal lenses, like progressive lenses, are designed with multiple zones to help you see clearly at various distances—whether you're reading a book, working on your laptop, or looking into the distance. However, these different zones can distort depth perception.
Imagine this: you’re looking through the lower part of your glasses to read something, and then you shift to walking or looking down at stairs. It becomes easy to misjudge distances, which can lead to a misstep and even injury. Simple activities like walking on uneven ground can become challenging because your vision is constantly adjusting between different zones.
Monovision: A Disruption to Depth Perception
Monovision lenses are another commonly used solution, especially for people with presbyopia. With monovision, one eye is corrected for distance vision while the other is corrected for near vision. While this might seem like an ideal way to avoid switching between glasses, it can be highly problematic from a movement and body alignment standpoint. Monovision almost always disrupts how your eyes work together, affecting your binocular vision and reducing accurate depth perception.
For tasks that require precise vision—like climbing stairs, driving, or even walking outside—monovision can create confusion in the brain. With one eye focusing on something close while the other eye focuses on something far, the eyes (and thus the brain) struggle to sync up properly. This mismatch increases the risk of tripping or losing balance.
Often, people don’t even notice the impact when they first start using monovision lenses. However, in my clinic, I frequently see individuals who’ve used monovision correction long-term experience issues like disrupted balance, altered gait, and chronic pain, especially in the neck or shoulders. They’ve often explored numerous treatments without success, only to discover that addressing this visual imbalance finally brings relief.
Why Fall Prevention Is Important for Everyone
Falls aren’t just a concern for older adults—they’re a risk for anyone using lenses that can distort depth perception and spatial awareness. Whether you’re navigating stairs, walking outside, or simply moving around at home, clear and consistent vision is essential for avoiding trips and falls. Single-vision lenses allow your brain to focus without constantly adjusting between zones, which helps you move more safely and confidently.
The Safer Alternative: Single-Vision Lenses for Different Tasks
If this sounds overwhelming, don’t worry—single-vision lenses offer a simple, effective solution. They provide clear, undistorted vision at specific distances, allowing for consistent depth perception and spatial awareness tailored to different activities. Here’s a recommended setup:
One pair for distance vision (walking, driving, outdoor activities)
One pair for close-up work (reading, using your phone)
One pair for intermediate vision (computer work, desk tasks)
By using dedicated glasses for each activity, you reduce the visual confusion that multifocal or monovision lenses can cause, making it easier to navigate your environment with clarity and peace of mind.
The Safer Alternative: Single-Vision Lenses for Different Tasks
If this all sounds a bit overwhelming, don’t worry—there’s a simple solution that can help: single-vision lenses for specific activities. Here’s why this approach works so well:
Consistent Vision for Each Task: Single-vision lenses provide clear, undistorted vision for specific distances, making it easier to maintain accurate depth perception and spatial awareness whether you’re reading, walking, or working at a computer.
Separate Glasses for Different Needs: Having specific glasses for different activities ensures your vision is perfectly suited to each task. Here’s a basic setup:
One pair for distance vision (walking, driving, outdoor activities)
One pair for close-up work (reading, using your phone)
One pair for intermediate vision (working on a computer or doing desk work)
By dedicating specific glasses to each activity, you reduce the visual confusion caused by multifocal or monovision lenses, allowing you to move through your environment safely and confidently.
Why You Should See a Behavioral Optometrist
If you’re using multifocal or monovision lenses, I strongly recommend seeing a behavioral optometrist rather than a standard optometrist. Behavioral optometrists focus on how your eyes work together (binocular vision) and can prescribe lenses that support your body’s movement and function as a whole.
Long-term use of monovision can make it hard for your eyes to work together properly, as each eye has been focusing on different distances. Behavioral optometrists are experts in identifying these issues and can ensure your prescription aligns with your body’s needs—not just your visual needs. This is especially helpful if you have postural or alignment challenges.
Behavioral optometrists hold specialized certifications from organizations like the Optometric Extension Program Foundation (OEPF), College of Optometrists in Vision Development (COVD), Neuro-Optometric Rehabilitation Association (NORA), and Optometric Vision Development and Rehabilitation Association (OVDRA). These certifications equip them to evaluate how vision impacts balance, depth perception, and coordination, crucial for achieving a balanced, functional body. To locate a certified behavioral optometrist, check the following directories:
I also had the privilege of co-presenting a lecture with Dr. Daniella Rutner, OD through OEPF, titled "Interdisciplinary Care Between Postural Restoration & Functional Behavioral Optometry & Dentistry." This course explores how integrating Postural Restoration (PRI) techniques with functional behavioral optometry and dentistry leads to more comprehensive patient care by addressing asymmetry and aligning the visual and oral systems with the body. You can find more information on our approach and this lecture here.
Making the Switch
Using multiple pairs of glasses may seem like a hassle compared to multifocals or monovision, but the safety benefits far outweigh the inconvenience. Having a pair for walking or driving, another for reading, and a third for computer work helps ensure your vision remains clear and accurate, reducing the chance of falls or missteps.
If you’re currently using multifocal or monovision lenses and notice issues with balance or depth perception, consider talking to a behavioral optometrist about switching to single-vision lenses. A tailored approach can help you feel safe, supported, and clear-headed, while reducing your risk of falls.
For more information, check out the full study on fall risks associated with multifocal lenses here.
Switching to single-vision glasses might just be the small but significant change you need to enhance your comfort and safety. If you’ve experienced any challenges with your current lenses, it might be time to consider a new approach.
Keep Learning,
❤️ Aleena
References:
Chang DH. Multifocal Spectacle and Monovision Treatment of Presbyopia and Falls in the Elderly. J Refract Surg. 2021 Jun;37(S1):S12-S16. doi: 10.3928/1081597X-20210408-02. Epub 2021 Jun 1. PMID: 34170766.
Smith, T. (2010). Failure of Adaptation to Multifocal Lenses: Longitudinal Evidence and Implications on Falling. ACRM. Retrieved from https://files.r2d2.center/BIFOCAL-Smith-2010-ACRM-Failure-of-Adaptation-to-Multifocal-Lenses-Longitudina-Evidence-and-Implications-on-Falling.pdf.