Presbyopia is the accommodative insufficiency to focus near objects due to reduced amplitude of accommodation. It has also been defined as failing near vision due to age-related reduction in the amplitude of accommodation or increased distance of punctum proximum.[1] Presbyopia usually sets in by the age of 40–45 years when there is a reduction in the amplitude of accommodation. Presbyopia before the age of 40 years is called premature presbyopia. Premature presbyopia can result from untreated hypermetropia, nuclear sclerosis at an early age, chronic simple glaucoma, and presenile weakness of the ciliary muscles. Every year, many presbyopics are added to the community, which has paved the way for enhanced research and novel treatment options for presbyopia.[2] The major treatment options for correcting presbyopia are spectacles, contact lenses, and surgical correction. Contact lenses have revolutionized the management of presbyopia. The varied contact lens management options are bifocals and simultaneous vision multifocal (MF) contact lenses (concentric, diffractive, and aspheric). The strategies include single-vision contact lenses with over spectacles, monovision, modified monovision, and MF contact lenses.[3] Strategies for Presbyopic Correction Monovision In this strategy, the dominant eye is fitted with a contact lens for distance and the nondominant eye is fitted with a contact lens for near vision. These lenses are easier to fit and inexpensive, and the complications related to MF, such as glare and halos, are avoided because they are not dependent on pupil size. But in this strategy, there can be a loss of stereopsis and a reduction in contrast sensitivity. The term “monovision” is a misnomer as both eyes are still working together so that a subject can see.[4] Modified monovision In this presbyopic correction strategy, the dominant eye is fitted with monofocal distance correcting lenses such as a toric or a spherical lens and the nondominant eye is fitted with an MF lens. The other strategy can be MF low add in the dominant eye for distance vision correction and MF high add in another eye for optimizing near vision. Another defined strategy is center distance MF lens design in the dominant eye and center near lens in the nondominant eye for correcting near vision.[5] Mini-monovision In the mini-monovision strategy, the dominant eye is corrected for the same distant correction, but in the nondominant eye, a less typical magnifying power is added to the near vision. Mini-monovision helps in improving the monovision strategy. The overall distance vision improves because the gap between the two eyes becomes smaller.[6] Contact Lenses Available for Presbyopic Correction Bifocals Bifocals give the advantage of two different powers in two other portions of the lens. They can be alternating or concentric and are available as rigid gas permeable contact or hydrogel lenses. The fitting strategy can be alternating or translating, and the design can be simultaneous or segmented.[7] Multifocals These lenses take care of far, intermediate, and near vision. The light enters simultaneously in these three portions, hence they are also known as simultaneous vision lenses. These lenses provide both near and distant vision simultaneously and are not dependent on the lens movement. The MF types can be concentric, aspheric, and diffractive. Among the various designs available, the most commonly used ones are simultaneous vision center–near soft contact lenses. The advantage is low incidence of ghosting and haloes, which rarely reduces the quality of vision. The various problems associated with MF lenses include the pupil size, fitting issues, lens design, surrounding illumination, and the problem of spherical aberration.[8] Park et al.,[9] in a prospective clinical trial, assessed the clinical performance of MF corneoscleral lenses in 40 patients with presbyopia. The changes in near, intermediate, and distant visual acuity (VA) were evaluated after 4 weeks of trial. The VA for far, intermediate, and near was 0.08 ± 0.11, 0.10 ± 0.12, and 0.10 ± 0.12 log of minimum angle of resolution (logMAR), respectively, which was significant compared to baseline values. The value are score which is clear in the beginning of the sentence as satisfaction score 4.1, 3.4, 3.6, 3.5, and 3.4, respectively. The discomfort scores for dryness, irritation, foreign body sensation, redness, fogging, and halo were 1.7, 1.8, 1.5, 1.7, 1.7, and 1.3, respectively. They concluded that MF lenses are safe and effective for presbyopia correction. Richdale et al.,[10] in their randomized trial, studied the visual performance and patient satisfaction with MF (Bausch & Lomb SofLens MF) and monovision (SofLens 59) lenses for 1 month in 38 patients with presbyopia. Under high contrast conditions at a distance and near, all patients achieved 20/20 binocular vision with both types of lenses. Under low contrast conditions, there was loss of less than a line of vision P value for multifocal lens (pMF) and P value for monovision (pMV) (pMF = 0.001, pMV = 0.006) at a distance. At near, under low contrast conditions, MF wearers lost five or six letters and monovision wearers lost two letters of vision (pMF < 0.001, pMV = 0.03, pMF/MV = 0.005). The average stereo acuity was reduced by 79 s of arc. Considering patient satisfaction, on National Eye Institute Refractive Error-Related Quality of Life (QoL), the patients reported worse clarity of vision (pMF = 0.01, pMV < 0.001), more symptoms (pMF = 0.09, pMV = 0.01), and an improvement in their appearance with contact lens wear (pMF < 0.001, pMV < 0.001). There was a high preference for MF contact lenses (76%) compared to monovision lenses (24%). The current study[11] by the authors is an interesting analysis, and the authors must be congratulated for the excellent concept in presbyopia management strategies. This is probably the first study evaluating modified monovision versus MF lenses, and also, the authors have compared the different brands of MF contact lenses. The take-home message from the study is that modified monovision correction performs better than MF correction in high contrast distance VA. The authors have used pure vision MF (PVMF) and clarity MF content lenses for MF correction pure vision Pure vision modified monovision (PVMMV) and clarity single-vision lenses Clarity modified monovision (CMMV) for modified monovision correction. The was no significant difference in PVMF and PVMMV for VA, contrast sensitivity, and image quality due to design difference and the difference in add power profile for low add lenses. The difference quoted is due to more additional power improvement ability (+2 D) of Clarity Multifocal IOL (CMF) lenses. In low-contrast distant VA cases, modified monovision outweighed the MF correction, but the difference was not statistically significant. The study gives insights into different presbyopia correcting strategies and is a definite add-on to the existing literature. Considering the sample size and less adaptation time of subjects, a much larger randomized clinical trial with perfect management strategies will give a better understanding and overview of this concept.