Specs: Do I Really Need…

When it comes to buying glasses, there are a TON of options.  Whether you’re new to buying specs, or an old pro, it can be difficult to determine what you really need.  Sometimes your doctor or the optician will may make suggestions, but what if they don’t?
In this post, I’ll dive into some common glasses options and try to provide some doctoral advice on what you do (and don’t) need.  Let’s get started!


I pretty vividly remember a speaker coming in during optometry school and lecturing on the benefits of transitions and why we need to promote them to every patient.  At the end, as with all such lectures, we were polled on our likelihood to suggest these lenses at the end of an exam.  My vote? Not at all likely.
I don’t believe in promoting products that I personally will not wear.
But, for the sake of discussion in a spirit of fairness, here are the pros and cons:
  • Pro: You’ve got built in sunglasses, which are supposed to protect the eyes.  Hello 2 for 1?
  • Con: They’re getting better, but they struggle in the cold (#OhioWintersSuck), often don’t change in vehicles, and are an up-charge.
The story?  Some patients love them (ie my mom, who has worn transistions as long as I can remember).  Some patients hate them (ie me, who put transitions in a pair of glasses during optometry school and wore them literally once – I couldn’t stand looking like a backwards 90s kid).
Takeaway?  If you want to try them, great! If you don’t, great! Don’t feel like you have to, but I am obligated to inform you that a good pair of sunglasses promotes better ocular health.

Anti-Reflective Coating

As an OD, I, once again, have first hand experience with the difference that AR-Coating makes.  My primary pair of specs (aka the pair without transitions) doesn’t have AR-Coating.  I don’t notice it 100% of the time (mainly because I typically wear them for maybe 10 minutes/day), but the reflections are miserable.
Though I rarely wear the other pair which has one of the best AR-coatings, I never notice reflections with these.
Takeaway: 10/10 would recommend.

High Index Lenses

The need for high index lenses is entirely dependent on your prescription.  If you’re less than a +/-4.00 and have minimal astigmatism, don’t spend the extra.  If your prescription is higher and you wear your glasses frequently/all the time, go high-index.  The difference in weight will be noticeable.
Takeaway: For high prescriptions, use high index.

Blue Blockers

In theory, blue-blockers have not been definitively proven to have an effect on vision/eyestrain/etc, especially considering that natural light produces significantly more blue light than screens.
However, I personally am a huge fan of blue-blockers.  Regardless of study results, I generally appreciate reduced eyestrain when using blue-blocking lenses, and I know many others that report the same improvement.
From there, blue-blocking lenses are definitely not a necessity, however, I would be inclined to suggest them (as well as improved ocular habits) for patients with ocular complaints secondary to excessive screen-time.

Progressive Lenses

Progressive lenses, or no-line bifocals, could really be a post of their own (and probably will at some point.) For now though, let’s stick with the basics.  These line-free lenses aim to provide clear vision at all distances – far, intermediate, and near, with a transition zone that adds progressively more power as needed.
  • Pro: They’re bifocals, but without the line!
  • Pro: Clear vision at (theoretically) all distances.
  • Con: Putting variable powers into one lens makes for a lot of “peripheral distortions” – or blurry/unusable vision when you’re not looking through the center.
  • Con: Some people have a really hard time adjusting to them (normally those who are more likely to move their eyes than their head for tasks).  I normally tell patients to give a new pair of progressives 2 weeks for adjustment, but this isn’t always enough.
Takeaway: Progressives are not a requirement.  It never hurts to give them a try, but they’re definitely not for everyone.  If you try them and can’t adjust, don’t be afraid to go back and ask for something different.  I know plenty of patients who are perfectly happy in a lined bifocal (or trifocal…)  The key? Find what works for you.

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