In a myopic patient, is the proximal point closer when using glasses or contact lenses?

• A. Closer in glasses
• B. Closer in contact lenses
• C. Same distance
• D. Indeterminate

Answer: (A)

The proximal point (the near point) is the closest distance at which an object can be seen clearly with accommodation. In myopia, correcting with spectacles introduces a vertex distance, so the minus lenses diverge light before it reaches the eye. To view a near object through these spectacles, the eye must work harder to increase accommodation. Because the eye has a finite accommodative range, this extra demand makes the limit of clear vision occur at a closer distance when wearing glasses. With contact lenses, the correction sits directly on the cornea, so the near-task accommodative demand is reduced, making the closest clearly seen distance not as close as with spectacles. Thus the proximal point is closer when using glasses.