Help! Opinions with Multifocal CL's and Lenticular Astigmatism...?

At 45 years old, I just recently started with vision correction--
multifocal soft contact lenses. I have taken to them like a duck to
water, with no problems at all. I started with the ProClear
Multifocals, but disliked the D & N monovison-esque system, and found
the PC technology good for 12 hours, sometimes a little drying after
12 hours.

I am currently wearing PureVision Multifocals, and much prefer them
over the Proclear--the Purevision has crisper optics, much better
contrast and greater depth of field. I am myopic, and the Purevision
with LOW add doesn't sacrifice too much of my great near vision while
adding fantastic intermediate and decent distant. The silicone
hydrogel material is great for me, and I can easily wear them for 16+
hours with very little, if any, drying or lens awareness problems or
the need for frequent applications of re-wetting drops. I have even
slept in them a few nights. From what I have read with CL wearers, I
am very lucky in this regard...

Problem is that the Purevision Multifocals don't fully correct
(spherical correction granted) for my against-the-rule lenticular
astigmatism. My OD says it's around .75D per eye (maybe closer to
1.00D on my dominate right eye), so I am right on the border of
needing toric correction. The Purevision lenses do a decent job, but I
can still see what I would call "slight" ghosts/shadows on some text
and lights (traffic lights in particular), most notably in high
contrast situations or with thin lettering. I can read the text and
signs, but the ghosting is still there. The far distant vision is also
affected, a tad blurry (which could also be just a multifocal thing).

At the OD'S office, when she applies the handheld astigmatism
correction over the Purevisions, the ghosting on the chart almost
disappears, so I really think the problem is primarily my uncorrected
astigmatism, and not the simultaneous vision design of the CL's.

If I want crisper vision my options are pretty much Proclear
Multifocal Toric (which I hear very poor reviews about, particularly
with distance vision) with a double N design (emulating the Purevision
design of near center for both eyes); RGP's; or the new Synergeyes
coming out this spring. I am sure I would acclimate to RGP's as I am
motivated, but my biggest concern is actually losing one (I am fairly
active). The new Synergeyes hybrids sound promising, but the hydrogel
skirt only has a dk rating of 9 (yes, nine!), and I wonder how safe
that is for long hours and how comfortable they would be...

I really do like so many things about the Purevision Multifocals, and
wonder if the other options stated above with toric correction would
provide that much more clarity and if it is worth the effort to pursue
them? Being so new to vision correction and CL's, I have nothing to
compare with...? I would like to eliminate the ghosting/shadows.

My OD has been very noncommittal (and not much help) and essentially
says that with against-the-rule lenticular astigmatism, compromise is
a concept I should learn to live with...?

For what it's worth, here is my eyeglass prescription:

OD: -.75 / -.75 X 90
OS: -1.00 / -.75 X 82

 

Frankly, any other design (multifocal toric, skirted RGP) will also be
time consuming to fit, expensive and likely will still have some
ghosting. If the PVMF is good for most applications and you only
notice the ghosting in high visual demand situations, I would suggest
a pair of single vision glasses with the astigmatism correction to
wear over the contacts for driving at night and when reading very fine
print. Cheap and easy.

Judy

 

pretty good suggestion IMHO.

fitting multifocals is an exercise in finding the "20/happy" spot.
sounds like you are pretty much there and to expect even more might be
unrealistic. presbyopia just doesn't correct all that well using soft
contact lenses.