Eyeglasses vs Contacts vs LASIK: Pros, Cons & Who Is a Candidate?

Eyeglasses, contacts, or LASIK — how do you know what’s right for you? There are a lot of different options for vision correction these days, so it can be tough to know the best option for your situation.

Eyeglasses are the most common type of vision correction. That’s because they’re affordable, easy to maintain, and can be removed or adjusted as needed. However, some people find them cumbersome to wear regularly, particularly those who play sports or are more active.

Contacts offer many of the same benefits as eyeglasses, and they offer more freedom for active individuals. They’re also affordable and easy to maintain and wear. However, some wearers complain that they’re uncomfortable or cause eye scratchiness or dryness.

LASIK is a more long-term solution. It is designed to provide clear and crisp vision, often without the need to wear eyeglasses or contacts. It’s more expensive than glasses and contacts, and it may not be the right answer for everyone.

How you choose to improve your vision will ultimately depend on your lifestyle, eye care needs, and budget.

How the Cornea Works

The cornea is the clear, transparent front layer of the eye that aids in focusing light onto the retina. You can liken its function to how a camera lens transmits light to produce an image. To do this, the cornea refracts or bends the beams to create visual acuity.

To be more specific, the cornea is the eye’s outer round and clear structure that covers the pupil (the round opening of the eye) and the iris (the colored portion of the eye). The cornea directs the rays of light into the eye, so they can settle at the back of the retina. The lens of the eye sits behind the iris.

If the cornea is not correctly shaped, the retina’s image is distorted or blurred. This causes a refractive error, which may result in only seeing things close to you or far away clearly.

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Refractive Errors

Myopia, hyperopia, and astigmatism are the three most common forms of refractive errors. 

Myopic people, or people who are nearsighted, have trouble seeing at a distance. They see better when things or people are closer — thus, the term nearsighted. They can see objects or people near them.

Farsighted people have hyperopia, or trouble seeing things or people close to them. They have an easier time seeing things in the distance or “far” away from them.

If you’re nearsighted or farsighted, you may have astigmatism as well. Astigmatism represents a flaw in the curvature of the lens or cornea of the eye. This will blur the vision.

Eyeglasses to Correct Vision

Eyeglasses represent the most common type of eyewear used to correct vision problems. They are made of a frame that holds two pieces of plastic or glass, which have been ground into lenses to correct visual refractive errors. These errors include myopia (nearsightedness) or hyperopia (farsightedness). 

They may also be used to correct astigmatism, or an irregularly shaped cornea. The glasses work by increasing or reducing the focusing power of the eye’s lens and cornea.

Types of Eyeglasses

Eyeglasses may be made for single-vision use or as bifocals or trifocals. Single vision lenses help you see close or far away, while bifocals are made for reading and distance viewing, depending on which part of the lenses you look through. Trifocal lenses feature intermediate lens, distance lens, and near vision correction in one pair of lenses.

Progressive lenses are used in bifocal or trifocal glasses, but they do not have a dividing line between the distance and near vision sections. This may make them more difficult to wear for a small percent (about 10 percent) of the population.

Eyeglass Prescriptions

The power of the prescription lens for eyeglasses is measured in diopters. This measurement shows the amount of power required for focusing images onto the retina. 

When you read an eyeglass prescription, you’ll see two abbreviations:

• OD or (oculus dexter) or RE refers to the right eye.
• OS (oculus sinister) or LE refers to the left eye.

An eyeglass prescription may include the following:

• The sphere, or the amount of nearsightedness or farsightedness
• The cylinder, or the level of astigmatism
• The axis, or the measure of the astigmatism in degrees

Bifocal lenses increase the power of the lens. The measurement is included on the prescription as “add” to indicate the lens’ strength.

Types of Eyeglass Lenses

The types of eyeglass lenses used to correct vision problems come in three main shapes, depending on how they’re used.

• Concave lenses: These lenses are thinner in the center and the diopter numbers are marked with a minus symbol. They are used to correct myopia or nearsightedness.
• Convex lenses: These lenses are thick in the center like a magnifier. They use a plus symbol for the diopters. Convex lenses correct hyperopia or nearsightedness.
• Cylindrical lenses: These curve in one direction more than in the other. They are made to correct astigmatism.

Pros of Eyeglasses

Eyeglasses are preferred by some people for the following reasons:

• Eyeglasses may be more affordable because they don’t have to be replaced as often.
• Eyeglasses come in stylish frames. Many people find them fashionable and fun to wear.
• People who wear glasses normally do not have to worry about getting an eye infection or dry eyes like people who wear contacts.

Cons of Eyeglasses

Eyeglasses also come with certain drawbacks, primarily the following:

• Eyeglasses tend to fog up, especially in cold weather.
• You may have peripheral vision problems, as eyeglasses sit further away from the eyes.
• While eyeglasses are easier to maintain, an unadjusted frame or scratched lens can cause problems with comfort.

Who Is a Good Candidate for Eyeglasses?

If you’re budget-conscious or have sensitive eyes, you may be a good candidate for eyeglasses. If contacts tend to irritate your eyes, you’re better off wearing eyeglasses. This is also true if your prescription makes you a poor candidate for LASIK.

Contacts for Vision Correction

Contacts are thin, curved lenses that sit directly on the cornea of the eye. They correct vision by changing the way light enters the eye. 

Contacts are a popular choice for people who don’t want to wear glasses, who are active, or who wish to have a more natural appearance. 

Types of Contact Lenses

Contact lenses include soft or daily replacement lenses, rigid gas permeable lenses, and extended wear contacts.

Soft Contact Lenses

Soft contact lenses are made of flexible plastics, allowing oxygen to pass through to the cornea. 

Disposable or Replacement Scheduled Contacts

Most wearers of soft contacts are given a prescription for a frequent replacement schedule. The FDA defines “disposable” as being used once before discarded. Therefore, a new pair of lenses is scheduled daily.

Some contact lens sellers define soft contacts as disposable, but the lenses are not planned for frequent replacement. Instead, they are prescribed for a specific wearing period (7 days to a month) before they are discarded. 

You should always disinfect and clean your lenses properly before they are reinserted. Otherwise, you increase the risk of an eye infection.

Rigid Gas Permeable Lenses

Rigid gas permeable (RGP) lenses are FDA-approved for overnight wear. RGPs are considered more durable than soft lenses and resist deposit buildups. They also provide the wearer with clearer vision. In addition, they are easier to manage and less prone to tearing. 

Because RGPs are not as comfortable as soft contacts, it may take several weeks to get used to wearing them. By comparison, soft contacts take a couple days to get used to.

Extended Wear Contacts

You can wear extended wear contacts overnight or continuously from six nights to a month at a time. 

These lenses are usually soft contacts, although some RGPs are designed for overnight wear. You should rest your eyes, without the lenses, at least one night when the contacts are scheduled for removal.

The length for continuous wear depends on the type of lens and your eye doctor’s assessment of your tolerance for overnight wear.

Pros of Contacts

The benefits to wearing contacts include the following:

• Contacts provide a wider field of vision than eyeglasses since they sit directly on the eye.
• Contacts can be worn during sports and other activities where glasses may prove to be cumbersome or uncomfortable.
• Contacts do not fog up like glasses can, making them ideal for cold weather or humid conditions.
• Contacts can be removed and put away at the end of the day, so your eyes get a break from wearing them.

Cons of Contacts

Contacts may also have some drawbacks, such as these:

• They can be uncomfortable, especially when first placed in the eye. 
• It may take some time to get used to the feel of them. 
• If they are not properly cleaned, they can cause infections. 
• They can dry out your eyes and make them more susceptible to irritation and redness.
• If you suffer from allergies, pollen can settle behind the lens, causing itchiness or scratchiness.
• Contacts need to be replaced periodically.
• They may be easily lost or damaged.

Who Is a Good Candidate for Contacts? 

Most people who regularly wear glasses are good candidates for contact lenses. This includes people with nearsightedness, farsightedness, and astigmatism.

If you have severe allergies or get frequent eye infections, contacts may not be the best choice for you.

LASIK

LASIK is an acronym that stands for laser-assisted in situ keratomileusis. It is used to change the cornea’s shape using an excimer laser in order to correct vision. 

A surgeon cuts a flap into the cornea, which is folded back, revealing the stroma, or the cornea’s mid-section. Pulses from the laser vaporize part of the stroma before the flap is replaced. Other methods are used as well. 

This surgery is used to correct refractive errors. A refractive error occurs when the eye does not bend or refract light as it should.

Therefore, LASIK is a type of refractive surgery that corrects the vision by restructuring the cornea. LASIK can correct nearsightedness, farsightedness, and astigmatism. 

LASIK boasts incredibly high success rates. The majority of people who have had LASIK experienced significant improvement in their vision. Some even say they can see better than when they had normal vision, which in most cases is usually 20/20.

How Does ‘Perfect Vision’ Tie into LASIK Outcomes?

We often think of 20/20 vision as the gold standard. To understand these numbers, you have to know what they represent. 

The first number reveals what you can see when you stand at a distance of 20 feet compared to an average person. The second number is the distance at which someone with “normal” vision can see. For example, if your vision is 20/10, it means that if you stand at 20 feet, you’ll see what an average person sees at 10 feet. So, in essence, you have “better than [average] perfect vision.”

That is why some people, after LASIK surgery, may comment that they see better than they did when they had “normal” vision.

On the other hand, if you’re diagnosed with 20/50 vision, you have worse than average vision. What you see at 20 feet is what an average person could see at 50 feet.

LASIK Associated Risks

LASIK is widely considered to be a safe procedure. As with any surgery, there are some risks involved, however. These include the following:

• Dry eyes: This is a common side effect of LASIK surgery. Your eyes may feel dry and irritated for the first few weeks after the procedure. This usually goes away with time.

• Glare and halos: You may notice increased glare and halos around lights for the first few months after LASIK surgery. This usually goes away as your eyes heal.

• Undercorrection or overcorrection: In some cases, the surgery may not achieve the desired results. This may require additional surgery to correct, often referred to as a LASIK enhancement.

Pros of LASIK

The pros for choosing LASIK are numerous, as the surgery can literally change your life. For example, people who have shied away from sports in the past may be more likely to take part in these activities. LASIK may also lead you to even reconsider your career. 

Other advantages include the following:

• LASIK provides a permanent solution to correct your vision long term.
• The procedure has a high success rate, with most patients achieving 20/20 vision or better after the surgery. The vast majority of patients express satisfaction. In fact, LASIK has the highest satisfaction rate of any elective surgery. 
• LASIK is painless and quick. It is done on an outpatient basis.
• The surgery takes under 30 minutes, on average.
• The recovery period is also fast, with most patients resuming their daily activities in a day or two. However, full healing does take longer and lasts about three to six months.
• The vision correction procedure is more affordable than other options, especially when you compare it to the long-term costs of wearing contacts or eyeglasses.
• Medicaid may pay to correct refractive errors or LASIK if a refractive error is severe. Also, patients (children or adolescents) who cannot wear eyeglasses or contacts because of physical limitations may be eligible for LASIK coverage.

Cons of LASIK

LASIK comes with some potential cons as well, such as these:

• Not everyone is eligible for LASIK. If your corneas are too thin, you can’t get the procedure, but other surgical options may be available to you.
• While the cost of LASIK can be offset by the savings on ongoing costs of contacts or eyeglasses, it is still expensive upfront. Both fear and affordability are reasons people cite for delaying the surgery.
• Regular health insurance will not pay for LASIK, as it is not considered a necessary procedure. Unless the refractive injury is considered severe, health plans normally don’t pay for the procedure.
• Some patients may not tolerate the requirements associated with the surgery. For example, during the surgery, the doctor will ask you to stare at a light. This light is used for focusing once the laser is in use. If you cannot fulfill this request, you won’t be able to go through with the process.
• LASIK will not prevent future vision deterioration. If you get vision corrected with LASIK, you may still experience age-related farsightedness (presbyopia) later in life.

Who Is a Candidate for LASIK?

LASIK surgery is a safe and effective way to improve your vision. It is important to consult with an experienced eye surgeon to find out if you are a candidate for the procedure. Whether or not you meet the criteria for surgery will depend on the following:

• Your overall health
• Your age
• Your lifestyle, such as whether you smoke 
• Your vision health
• The prescription strength of your eyeglasses
• The thickness of your cornea

Most people who are over 18 years old who have stable vision are good candidates for LASIK. If you have any health problems or conditions that could affect the healing process, you may not be eligible for the procedure. 

When Surgery Is Not Recommended

Besides thin corneas, some patients may not be able to undergo LASIK because they have corneal disease. Also, if too much corneal tissue is removed from a thin cornea, it can lead to the development of iatrogenic keratectasia. 

While rare, this condition can develop after LASIK surgery. This can happen as early as one week after the procedure, or it may be delayed up to several years. The condition presents itself with progressive myopia, fluctuating vision problems, irregular astigmatism, and difficulties with scotopic vision, also known as night vision. While photopic vision defines daytime vision, scotopic refers to seeing at night.

This is incredibly rare, so it is highly unlikely to occur for most people. Overall, the risk of complications with LASIK is very low.

Surgical Alternatives

For those who have corneas that are too thin, some doctors recommend alternative surgical options, such as photorefractive keratectomy (PRK) or phakic IOL 

During the surgery for phakic IOL, phakic lenses, made of silicone or plastic, are permanently inserted into the eye, so the patient does not need to depend on eyeglasses or contacts. During the implant procedure, the lenses are added without removing the natural lens. A small incision is made in the front part of the eye before the insertion is made — just behind the iris.

In some cases, your eye doctor may discuss one of the above alternative options. However, they may not recommend them if you can easily tolerate wearing contacts.

Which Is the Best Choice?

What you choose for vision correction is highly dependent on your overall health, eye health, age, lifestyle, and budget. Weigh all the benefits and drawbacks when deciding whether to wear eyeglasses or contacts or pursue LASIK. 

Discuss your concerns with your eye doctor before you decide on the best vision correction option for you. They’ll likely make a professional recommendation based on your prescription and goals. MyVision.org offers many resources to help answer questions about LASIK surgery, including how to find the best surgeon and what questions to ask before your procedure. Consulting with an eye care professional prior to undergoing LASIK will ensure all your questions are answered, and you have all the instructions and directions you need to set yourself up for a successful procedure. We can help you find a highly rated LASIK surgeon near you.

References

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2. Eye Diseases & Conditions: Refractive Error. Prevent Blindness.

3. How to Choose Eyeglasses for Vision Correction. (February 2020). American Academy of Ophthalmology.

4. What Is a Diopter? (November 2022). All the Science.

5. Eyeglasses and Contact Lenses: Lenses for correcting or improving vision. (2022) University of Rochester Medical Center.

6. Contact Lenses. (July 2019). National Eye Institute.

7. Types of Contact Lenses. U.S. Food & Drug Administration.

8. LASIK. U.S. Food & Drug Administration.

9. What Is the LASIK Success Rate? (August 2022). American Refractive Surgery Council.

10. What Should I Expect Before, During, and After Surgery? U.S. Food & Drug Administration.

11. Vision and Hearing Screening Services for Children and Adolescents. (2014). Medicaid.

12. The 25th Anniversary of Laser Vision Correction in the United States. (March 2021). Clinical Ophthalmology.

13. Iatrogenic Keratectasia: A Review. (April 2015). National Center for Biotechnology Information.

14. What Is Photorefractive Keratectomy (PRK)? (November 2022). American Academy of Ophthalmology.

15. What Are Phakic Lenses? U.S. Food & Drug Administration.

16. Extremely Thin Corneas. (May 2013). Cataract & Refractive Surgery Today.