Can I use a multifocal lens if I have macular degeneration or glaucoma?

Key Takeaways

• Multifocal lenses may reduce the need for glasses, but they’re not ideal for patients with retinal or optic nerve issues, such as Macular Degeneration or Glaucoma.
• Patients in early stages of Macular Degeneration may benefit from Extended Depth of Focus (EDOF) lenses like Vivity, while monofocal lenses are preferred in advanced stages due to better contrast and fewer visual side effects.
• Patients with advanced Glaucoma should avoid multifocal lenses. EDOF or monofocal lenses provide safer and more reliable outcomes.
• Setting realistic expectations is essential—discuss potential issues like glare, halos, and reduced contrast when considering multifocal lenses.

Are Multifocal Lenses Safe for Macular Degeneration or Glaucoma?

If you have Macular Degeneration or Glaucoma and are preparing for cataract surgery, you might be wondering whether a multifocal lens is right for you. After years of performing cataract surgery, I can tell you this decision depends heavily on the health of your retina and optic nerve. While multifocal lenses offer the appeal of reducing glasses use, they aren’t the best option for every patient—especially those with underlying eye conditions.

Macular Degeneration: What You Should Know

Macular Degeneration affects the central retina, making it harder to see fine details. During cataract surgery, I use a gentler technique to minimize inflammation and stress on the eye—such as using reduced Phaco power and delicate chopping methods. This helps protect the retina and preserve existing vision.

When it comes to lens selection:

• Early-stage Macular Degeneration: I may recommend an EDOF lens like Vivity. These lenses offer a broader range of vision while maintaining contrast sensitivity and minimizing side effects like halos.
• Moderate to advanced stages: I avoid both multifocal and EDOF lenses. Instead, I recommend monofocal lenses, which provide better contrast and are more dependable, especially in low-light situations.

I also avoid lenses with diffractive rings, which can reduce contrast sensitivity—something already compromised in Macular Degeneration patients.

Glaucoma Considerations

Glaucoma damages the optic nerve and often involves increased intraocular pressure. In advanced stages, this significantly impacts the ability of the eye to process visual information—especially with lenses that split light, like multifocals.

In my experience:

• Mild Glaucoma: EDOF lenses may be an option, especially ring-free models like Vivity.
• Advanced Glaucoma: I recommend avoiding multifocal lenses altogether. Monofocal or ring-free EDOF lenses are safer and more reliable.

Visual Outcomes and Risks

Patients with mild Macular Degeneration may have mixed results with multifocal lenses. While some achieve good distance and near vision, others report glare, halos, or poor contrast—especially in low-light conditions. These drawbacks can outweigh the benefits in patients with compromised retinal or optic nerve health.

In glaucoma cases, I find the visual quality loss from multifocal lenses to be less of a concern in early stages, but I still avoid them in advanced cases. For both conditions, EDOF lenses like Vivity—especially those without rings—offer a more dependable and patient-friendly option.

Patient Expectations and Lens Counseling

When I sit down with patients who have Macular Degeneration or Glaucoma, I focus on transparency and education. While multifocal lenses can reduce glasses dependency, they come with trade-offs—especially in patients with preexisting eye conditions.

That’s why I always discuss the full range of options, including monofocal and EDOF lenses. These alternatives often provide a better balance between visual clarity, comfort, and long-term eye health. Most importantly, I want my patients to make informed choices based on realistic expectations—not just marketing promises.

Final Thoughts

Multifocal lenses are not a one-size-fits-all solution. If you have Macular Degeneration or Glaucoma, the safest and most effective path is to select a lens that respects your eye’s current condition. The goal isn’t just freedom from glasses—it’s achieving the best vision possible for years to come.

If you’re unsure which lens is right for you, consult a cataract surgeon with experience in treating patients with retinal and optic nerve conditions. The right lens can make all the difference in your outcome.