Very few people walk into an opticians saying, “I’d love a pair of varifocals.”
They usually arrive after several months of increasingly elaborate denial. Restaurant menus have become harder to read, the phone is held at a distance previously reserved for suspicious parcels and, for reasons nobody can explain, every pub and restaurant has apparently decided to replace its lighting with a single candle at the other end of the room.
Reading glasses begin multiplying around the house. There is a pair by the bed, one in the kitchen, another at work and at least three more currently hiding somewhere important. Eventually, changing glasses every time you look from the television to your phone becomes more irritating than admitting it might be time for a varifocal.
For a lot of people, they are brilliant. One pair can cover driving, walking around, shopping, reading a menu and checking a message without the constant administrative burden of finding the correct spectacles.
When varifocals work well, you stop thinking about them. When they don’t, they become an expensive ornament in a drawer while the owner tells everybody, “I just couldn’t get on with them.”
The explanation they were probably given is that varifocals take time to adapt to, which is true, but not quite the whole truth.
Adaptation means becoming used to how the lens works. The distance vision sits towards the top, the reading power develops lower down and the areas between them cover everything in between. Your eyes and head gradually learn where to look without you having to think about it, much like you stopped consciously considering where every pedal was after learning to drive.
It does not mean spending three months tolerating blur, nausea or a staircase that appears to have developed opinions about where its steps ought to be.
A well-made varifocal should give clear vision. There will always be some softer vision towards the sides because of the way the changing powers are produced, but you should not be constantly hunting for a tiny usable patch in the middle or lifting and lowering your head like a pigeon on New Street.
If that is still happening after a reasonable period, there is probably something worth investigating. The prescription might need checking, the measurements may be wrong, the frame could be sitting somewhere different from where it was measured, or the lens design may simply be a poor match for the person wearing it.
The difficulty is that “varifocal” describes an enormous category of lenses rather than one product. It is a bit like saying you tried shoes once and did not like them.
Every varifocal has to blend a distance prescription into a reading prescription while controlling the unwanted distortion created during that change. There are different ways of doing this, and every design makes choices about where to place the clearest areas and how to distribute the softer vision around them.
Some designs favour generous distance vision. Others provide more room for reading or intermediate tasks. Some are easier to adapt to, while more advanced lenses can be tailored in extraordinary detail around the wearer and the frame.
That means two people with the same prescription can have very different experiences, and the most expensive option is not automatically the right one. A lens should be chosen around what the person actually spends their time doing rather than where it sits on a price list.
This is where expectations can go slightly wrong.
A modern everyday varifocal is designed to move through ordinary life. It can take somebody from driving to shopping, cooking, reading and looking across a room without changing glasses. To achieve that range, it has to divide a fairly small lens between distance, intermediate and near vision.
It cannot give every distance the entire lens at once. Physics, rather inconsiderately, refuses to negotiate.
Somebody who works for eight hours across two large monitors, paperwork and video meetings may technically be able to use an everyday varifocal for all of it, but that does not mean it is the most comfortable tool for the job. They may find themselves turning their head repeatedly, raising their chin or trying to view a wide screen through an intermediate area that was designed for much more general use.
An occupational lens can be far better in that situation. It gives up long-distance vision to create much wider and more comfortable areas for computer and reading distances. You would not drive in it, but indoors it can make an enormous difference.
That does not mean choosing between occupational lenses and varifocals forever. Plenty of people use a varifocal for everyday life and a separate occupational pair for work or hobbies. Asking one pair of glasses to cover every possible activity can result in something that performs several jobs adequately while being excellent at none of them.
Before choosing a lens, the useful question is what you actually look at all day.
The position of the varifocal matters just as much as its design. These lenses are calculated to work from a particular place in front of each eye, and moving them away from that position changes how they behave.
The fitting height decides where the progression and reading area sit. If it is too low, reading may involve lifting the chin and dropping the eyes until you resemble somebody trying to examine the underside of their own eyebrows. If it is too high, the near power may intrude when you are trying to look further away.
The horizontal position matters too. Each eye should naturally look through the intended part of its lens. If those positions are wrong, the wearer has to keep searching for clear vision rather than simply looking at whatever they wanted to see.
Modern individualised lenses can also use measurements such as the distance between the eye and lens, the angle of the frame and the amount it curves around the face. These sound like minor details because the numbers involved are small, but varifocals are precise pieces of optics and small errors can create very noticeable irritation.
The frame therefore cannot be treated as a decorative container chosen before the serious lens conversation begins. It needs enough depth for the design, must fit securely and should sit in a stable, sensible position. A frame that slides down the nose throughout the day takes the carefully positioned lens design with it.
At Doctor Oculus, Rodenstock is our main lens partner because I genuinely believe they make some of the best lenses available. Their more advanced designs allow us to tailor the optics around the prescription, the frame, its wearing position and the way the person uses their vision.
That technology is valuable, but only when the information needed to use it has actually been gathered. Ordering an individually optimised lens and then supplying generic measurements rather misses the point. It is like having a suit made to measure but telling the tailor to use the dimensions of an average man they met several years ago.
The lens brand cannot rescue poor dispensing. The clever bit is deciding which design makes sense, configuring it properly, measuring it accurately and fitting the finished glasses so they remain where they were intended to be.
People who have struggled with varifocals often arrive expecting to be told that they need a miraculous premium lens costing twice as much as the last one. A more advanced design will genuinely help, but quite often the problem is more ordinary. The old frame was unsuitable, the measurements were inaccurate, the glasses were never properly adjusted or the lens had been chosen without asking enough questions about what the wearer needed it to do.
There are also people for whom a varifocal is simply not the best answer. Somebody with one very specific visual task may be happier with a dedicated pair, while another person may prefer switching between distance and reading glasses and feel no desire whatsoever to stop. There is no prize for wearing varifocals, and forcing them onto somebody because they have reached a particular birthday is not clever dispensing.
It may sound like a bit of a marketing tag line but my approach at Doctor Oculus is that we do not begin with a lens. We begin with the person.
I want to know what they do during the day, where their current glasses fail, what they enjoyed about previous pairs and what they expect the new ones to achieve. Then we can decide whether a varifocal makes sense, which design suits them, what frame will allow it to work and how the whole thing should be measured.
The best compliment anybody can give a varifocal is not that it is technologically advanced, individually optimised or reassuringly expensive.
It is that they forgot they were wearing it.