Multifocal Lens for Cataract Surgery
Light split between focal points, so one lens is designed to cover distance and near — and that split is also what it costs you.
- Bifocal has two focal points, trifocal three
- Haloes at night are a recognised effect
- Not suitable for every eye
Camden (Orchard)Joo ChiatClementiBedokToa PayohJurong
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What a multifocal lens is
A multifocal lens divides the light entering the eye between more than one focal point, so a single lens is designed to bring both a far object and a near one into focus.
Whichever type is implanted, how the cataract is removed does not change. A monofocal lens sends all of the light to one distance and leaves the others soft. A multifocal lens gives up some of the light at each distance in order to cover several, which is the trade at the centre of the whole decision: more of your range in focus, less light at each point of it.
It is the type most likely to reduce how often glasses are needed. It is not guaranteed to remove the need, and it does not suit every eye. Compare the lens types
How it works
The lens surface carries concentric rings or zones of different power. Light passing through them is sent to two or three focal points at once, so more than one image reaches the retina at the same time — one in focus and the others not.
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Zones of different power send light to two focal points — one on the retina, one in front of it
The brain learns to attend to the sharp image and disregard the rest. That adaptation is real and it takes time, usually weeks to a few months, which is why the first fortnight after surgery is a poor guide to the result.
It also explains both of the lens's known costs. Contrast is slightly lower than with a monofocal lens, because less light reaches each focus. And the out-of-focus light has to go somewhere, which at night is what produces rings around headlights.
Bifocal and trifocal
Both are multifocal lenses. They differ in how many distances they are built to cover.
- Bifocal
- Two focal points, far and near. A book or a phone sits inside the range it is built for; a computer screen, at arm’s length, falls between the two and often still needs glasses.
- Trifocal
- Three focal points, adding arm’s length between the other two. Designed to cover a screen as well as a book and the far distance.
Dividing light three ways rather than two covers more of your range and leaves slightly less light at each focus. Which of the two is suitable, and whether an extended depth of focus lens would serve you better than either, is a question for your surgeon once your eyes have been measured.
Haloes, glare and night driving
Rings and starbursts around headlights and street lamps are a recognised effect of splitting light between focal points, and they are reported more often with multifocal lenses than with the other types.
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A light at night
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Haloes around the same light
They are at their most noticeable in the first weeks and commonly settle over the first months as the brain adapts. They do not settle for everyone, and there is no way to know in advance which group a given person will be in.
If you drive at night for a living, or already find oncoming headlights difficult, say so before the lens is chosen. It is implanted for life, and exchanging one is a further operation.
When a multifocal lens is not offered
These are findings from the examination, not matters of preference. Any of them can rule the type out:
- Disease of the retina or optic nerve
- A multifocal lens reduces contrast sensitivity compared with a monofocal one, because the light is divided between focal points. Where the retina or optic nerve is already limiting vision, that further reduction is harder to tolerate, and dividing the light also makes the underlying disease harder to monitor — so the type is generally not offered.
- Previous laser vision correction
- A reshaped cornea makes the lens power harder to calculate and the result more likely to land slightly off target, which a multifocal design is less forgiving of.
- Significant night driving
- Rings and glare around headlights are a recognised effect of the design. Somebody who drives at night for a living should say so before choosing.
- An irregular cornea or marked dry eye
- Both scatter light before it reaches the lens, which a design that is already dividing light has less margin for.
Your eyes are measured before any of this is discussed, and the measurement is what decides the lens power in the first place. It helps to go in with questions to ask your cataract surgeon.
Not sure whether a multifocal lens suits your eyes? Talk to our friendly staff and we will arrange an examination — the lens is recommended once your eyes are measured.
Multifocal lenses and astigmatism
A multifocal lens does not correct astigmatism, and uncorrected astigmatism blurs every one of its focal points — so it matters more here than with a lens that only has to get one distance right.
A multifocal toric version has the astigmatism correction built in along one direction, which means it has to sit at an angle measured before surgery. How much astigmatism you have is one of the findings that decides whether a multifocal design is worth considering at all. How a toric lens works
Where it sits in the cost of surgery
A multifocal lens sits at the upper end of the range for cataract surgery at The Straits Eye Centre, and a multifocal toric version costs more again.
| Service | Price |
|---|---|
| Cataract surgery · per eye | |
| Cataract surgery by senior eye surgeons | $5,200–12,000 |
| MediSave withdrawal limit | up to $3,280 |
| With a Senior Eye Specialist · Camden (Orchard) and Parkway East (Joo Chiat) | |
| First consultation | $174.40 |
| Follow-up consultation | $119.90 |
| With a Senior Eye Specialist · Bedok, Clementi, Toa Payoh and Jurong | |
| First consultation | $130.80 |
| Follow-up consultation | $98.10 |
| With a Primary Eye Care Doctor · Bedok, Clementi, Toa Payoh and Jurong | |
| First consultation | $76.30 |
| Follow-up consultation | $54.50 |
Surgery figures are per eye at The Straits Eye Centre, before MediSave. Withdrawal limit subject to approval by the CPF Board. All fees shown are nett.
The lens moves the figure most; laser assistance and your insurance status move it as well. All surgeries are done by senior surgeons regardless.
The lens types are designed for different visual goals, not arranged on a scale — the one that costs more is doing more at once, which is only worth paying for if those are the things you need. What else moves the figure is set out in the breakdown of cataract surgery fees.
Who performs it
Whichever lens is chosen, the operation is the same, and our senior consultant eye surgeons perform it — more than 60 years in ophthalmology between them. Talk to us for a quick appointment.
10,000+
cataract operations, between our senior consultant eye surgeons.
99%+
cataract surgery success rate at The Straits Eye Centre.
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Dr Jayant V Iyer
Senior Consultant & Medical Director
The Straits Eye CentreMBBS · GDFM · MMed (Ophth) · FRCOphth · FAMS
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Dr Jason Lee
Senior Consultant & Medical Director
The Straits Eye CentreMBBS · BMedSc · MMed (Ophth) · FRCOphth · FAMS
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Dr Audrey Pang
Senior Consultant Eye Surgeon
The Straits Eye CentreMBBChir (Cambridge) · MMed (Singapore) · FRCOphth (London) · FAMS
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Dr Laurence Lim
Senior Consultant Eye Specialist and Vitreo-Retinal Surgeon
The Straits Eye CentreMBBS (S’pore) · MRCS (Edin) · FRCS (Edin) · FAMS
Ask whether a multifocal lens suits you
Send us a message with how you use your eyes day to day, including any night driving. We will arrange an examination, and the lens is recommended once your eyes have been measured.
Common questions
Do multifocal lenses cause haloes at night?
Haloes and glare around lights at night are a recognised effect of splitting light between focal points, and they are reported more often with multifocal lenses than with the other types. They commonly settle over the first months as the brain adapts, but they do not settle for everyone. If you drive at night for a living, say so before you choose.
Will I stop needing glasses with a multifocal lens?
It is the type most likely to reduce how often glasses are needed, and no lens is guaranteed to remove the need entirely. Some people use glasses rarely afterwards; others still reach for them for fine print or in poor light. No lens should be chosen on a promise of doing without them.
Can a multifocal lens be removed or exchanged later?
It can, but an intraocular lens is intended to stay for life and exchanging one is a further operation with its own risks, so it is done only where there is a clear reason — which occasionally includes somebody who cannot adapt to the design. This is why the choice is worth the time it takes before surgery rather than after.
Can I have a multifocal lens in one eye only?
It is sometimes done, though the two eyes then work differently and not everybody is comfortable with that. Where both eyes need surgery, a multifocal design is usually planned for both, because the benefit comes from the pair working together.
Is a multifocal lens the same as progressive glasses?
No. Progressive spectacle lenses put different powers in different parts of the lens, so you look through the right part by moving your head or eyes. A multifocal intraocular lens splits light between focal points across the whole lens, and the brain selects the image that is in focus. The two share a name and nothing else.
Does a multifocal lens correct astigmatism?
Not on its own. A multifocal toric version does, with the astigmatism correction built in along one direction, and it has to sit at a measured angle. Whether you need one is measured before surgery.