What Are Progressive Lenses? Getting Used to Them and What to Look Out For

The short answer to what progressive lenses are: they are glasses lenses that combine distance, intermediate and near vision in one lens, with no line in between. They are used by people who would otherwise have to take their glasses off and on to see close up, or carry two separate pairs. They take some getting used to at first; knowing what to expect during this time makes adapting easier.

What are progressive lenses?

A progressive lens is a glasses lens whose power changes gradually from top to bottom, combining distance, intermediate and near vision in one lens. The top part of the lens is for distance, the middle for intermediate distance and the bottom for near. There is no visible line between the zones as there is on a bifocal lens; from the outside the lens looks like one piece. They are also known as varifocal or multifocal lenses.

Because the power changes without steps, focus shifts from far to near as you lower your gaze through the lens. In everyday use the zones work like this:

This design lets you look at a sign across the street, the screen on your desk and the book in your hand with the same glasses. On the other hand, not every point of the lens shows every distance clearly: to see clearly you need to look through the right part. This is why progressive lenses take some getting used to.

Who are progressive lenses for?

Progressive lenses are mostly used by people with presbyopia, that is, people who find it harder to see close up as they get older. Presbyopia is the increasing difficulty of focusing on near objects as the eye's lens gradually loses its flexibility, and it usually starts in your 40s. It is not a disease but a natural change that comes with age; even so, it is diagnosed by an ophthalmologist.

Progressive lenses are not the only option for presbyopia. Single vision reading glasses made only for near, or bifocal lenses, can also be used; you can see the differences in the table below.

A prescription for progressive lenses includes an ADD (addition) value besides the distance values. ADD is the power added to the distance prescription for near vision. You can find the meaning of the abbreviations on a prescription in our article how to read a glasses prescription.

What is the difference between single vision, bifocal and progressive lenses?

The difference between the three lens types is how many distances the lens corrects and how the transition between zones works. A single vision lens is made for one distance. A bifocal lens separates the distance and near zones with a visible line. A progressive lens combines three distances with a gradual transition and no line.

Which lens type suits you depends on your prescription and on which distances you look at most during the day. You can discuss this with your ophthalmologist during the examination.

What are the limits of progressive lenses?

The main limit of progressive lenses is that the clear field of vision does not cover the whole lens. The gradual change in power causes blur in the side areas of the lens; this is a result of the lens design and does not disappear completely. The limits worth knowing are:

1. Blur and a sense of swimming can occur at the edges of the lens.
2. The intermediate and near zones are narrower than the distance zone; you need to turn your head when looking at a wide screen or a newspaper page.
3. Looking at a near object above you, such as a label on a high shelf, is difficult, because the top of the lens is for distance.
4. They take time to get used to and are not comfortable without correct centring.

If you work at a screen all day or do close work for long periods, telling your ophthalmologist about it at the examination helps them assess the prescription and the lens type for your use.

How long does it take to get used to progressive lenses?

How long it takes to adapt to progressive lenses varies from person to person; for most people it takes between a few days and a few weeks. During this time you learn which part of the lens to look through for which distance, and your head and eye movements adjust to the new lens. People wearing progressive lenses for the first time may notice the process more.

Factors that can affect how long it takes include:

• The ADD value in the prescription: the higher the value, the greater the difference in power between the zones.
• Having worn progressive or bifocal lenses before.
• How long the glasses are worn during the day.
• How the frame sits on the face and how the lens is centred.

What might you notice in the first days?

In the first days you may notice the following; for most people they lessen as they adapt:

• Blur when looking through the side edges of the lens.
• A sense of the image swimming when you turn your head quickly.
• The floor and steps looking blurred when you look down.
• Needing to move your head slightly to find the clear zone when reading or looking at a screen.

What makes it easier to get used to progressive lenses?

The main habit that makes adapting easier is wearing the glasses regularly all day from the first day. The steps below help you use the zones of the lens correctly:

1. Wear the glasses all day. Switching between your old glasses and the new ones can slow down adapting.
2. Turn your head towards what you look at. If you look to the side with only your eyes, you enter the blurred edge of the lens; point your nose at what you are looking at.
3. Lower your eyes to read. Rather than tilting your head forward, direct your gaze to the bottom of the lens; move your chin slightly until the text is clear.
4. Look at a screen through the middle of the lens. A computer screen is at intermediate distance; move your head slightly up and down to find the clear point.
5. Take your time on stairs. Steps look blurred through the bottom of the lens; tilt your head forward to look through the top part, and hold the handrail in the first days.
6. Keep the frame in position. If the glasses slide down your nose, the zones shift too. The optician adjusts the frame.

In the first days, take your time at the kerb and when driving too; avoid sudden head movements until you feel comfortable.

What should you look out for with progressive lenses?

The decisive point with progressive lenses is that the lens is centred correctly in front of the eye. Because the clear zones are arranged in a narrow area, the lens has to be fitted in the frame so that it lines up with your pupil. Two lenses made to the same prescription will not be equally comfortable if they are centred differently. Two measurements are used for centring:

• Pupillary distance (PD): the distance between the two pupils.
• Fitting height: the height of the pupil above the bottom edge of the lens fitted in the frame.

These measurements concern how the lens is positioned in the frame; they do not determine the prescription, which comes from the ophthalmologist. Because the fitting height varies from frame to frame, it is measured with the chosen frame on your face.

Other points to look out for are:

• An up-to-date prescription. The lens is made to the current prescription written by the ophthalmologist.
• Lens height of the frame. The lens needs to be tall enough for the three zones to fit; in frames with very shallow lenses there may not be room for the near zone. You can find how frame sizes are read in our article on glasses for your face shape.
• How the frame sits on the face. A frame that slides or sits crooked shifts the zones relative to your eyes.
• Coatings. Coatings such as anti-reflective coating can also be applied to progressive lenses; you can read what they do in our article lens coatings explained.

What if you cannot get used to progressive lenses?

If you cannot adapt after a few weeks despite wearing the glasses regularly, you should go back to your optician and your ophthalmologist. The cause can be how the frame sits, how the lens is centred or the prescription itself; you are not expected to tell these apart on your own. The order to follow is:

1. The optician checks how the frame sits on your face and how the lens is centred, and adjusts the frame if needed.
2. If the problem continues, the ophthalmologist reassesses the prescription.
3. If your ophthalmologist considers it necessary, they may suggest a different solution.

When you go to the optician, say in which situation you struggle most: reading, at a screen or walking. This information makes it easier to find the source of the problem.