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Hyperopia and Presbyopia Progression

For and about anyone having difficulty seeing near/reading.

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Carrie 17 Nov 2017, 13:20

Soundmanpt - Danielle hasn't said in detail what her vision is like without glasses just they make her eyes feel more comfortable. I presumed her comment about needing stronger glasses in the spring was based on what her optician said a few weeks ago. Maybe she has found that her current prescription isn't quite strong enough for her any more, I don't know. I think Vicky will probably get her eyes tested around the same time as Danielle.

I have got an idea I want to try with Danielle. I have dug out one of my old pairs of glasses from a few years ago. I'm pretty sure that the prescription in them is L+2.00 and R+2.50. I am going to ask Danielle if she wants to try them as they are only slightly stronger than her own glasses.

Danielle and Vicky are coming over tomorrow.


Weirdeyes 17 Nov 2017, 08:31

Lou

What I mean by helping me is that my eyes never crossed when I was a kid. I've heard that crossing eyes is more likely to cause amblyopia than a difference between your eyes. I think since my eyes were lined up my brain could still used my left eye for depth perception even though it was pretty blurry and undetailed compared to my right eye. Getting corrected kind of messed things up and caused CI. I don't think I remember CI as a kid, but I did remember issues seeing my computer screen and seeing some details far away.


Plus Tony 17 Nov 2017, 06:39

Hi Younglady,

Good to hear that it is going better with the glasses.

I'm not sure that taking breaks from wearing your glasses will help in the long run. If your eyes are going to change they'll do it anyway whether you wear the glasses or not but there is no getting over the fact that when you take them off things will not look as clear as you think they looked before you started wearing them.

Whether you wear them all the time is ultimately up to you. It isn't going to do you any harm to take them off now and then if you feel more comfortable in certain situations but from my own experience I just find it easier to put them on in the morning and forget about them. If you decide not to wear them you may find that the period between taking them off and discomfort starting gets shorter though (but there may be days when you can manage just fine).

When I first got glasses it was a real effort not to snatch them off my face if I met someone who hadn't seen we wearing them before. The funny thing is I'd always liked the idea of wearing glasses but was quite self conscious about actually wearing them. So when I finally bit the bullet I worked myself up to the point where I decided that the best thing to do was just to wear them immediately and keep them on. Initially it was hard but I forced myself to leave them on even if I felt a bit uncomfortable. There is an inevitable sense of "everyones looking at me because I'm wearing glasses" but I reckon I got over that after about 3 weeks by which time I felt good about wearing them and was so happy not to have any headaches. I got lots of positive comments from female friends too which for an average guy in his early 40s was a definite bonus! I'm actually overdue for my eye test now and I'm definitely going to buy a new pair this year even if my prescription doesn't change so hopefully I might get a few more positive comments - we live in hope :-)

Just one thing I meant to mention to you before. You said you were a stay at home Mum. I don't know how old your children are but get their eyes tested as early as you can. Don't wait for school vision screening. Eyesight issues are often hereditary so getting them checked out early is sensible. Take care.


Lou 17 Nov 2017, 03:16

Hi Weirdeyes

I am not sure what you mean about convergence insufficiency possibly helping you as a child, or helping you to avoid amblyopia. Since you have a significant difference between your two eyes, I would have thought that convergence insufficiency could have encouraged you more greatly to use just one eye. I suppose it would depend on whether both or one eye tends to drift outwards at near. If your stronger eye drifted out, I suppose that it could encourage you to use your weaker eye, but I imagine that your weaker eye would be the one likely to drift out, especially if a difficulty focusing at near owing to being long sighted, was a contributory factor in developing convergence insufficiency in the first place.

My convergence insufficiency was not diagnosed until my mid 30s, when I was struggling to keep the two images fused together whilst reading music.

I had however been told at my first optician's eye test at age twenty that my eyesight was borderline (I have no idea of my rx at the time) and my eye tracking was very poor. The optician was very surprised that I was able to read at all. I could and I can. He wanted to refer me to an eye specialist. He really scared me, and I said that I didn't want to be referred as I could see ok.

Although I passed all school eye screening tests, I noticed at aged seven that there was something not right about my close vision. Everything looked slightly out of focus, words seem to jump around on the page and I used to lose my place a lot. I was however a good reader and did well academically. When we tested our own close and distance vision in science when I was around 11, the starting point for testing our close vision, was 10cm, and the idea was to move in the text gradually closer. I couldn't see the text at the starting point. I never have been able to read particularly close. For as long as I remember, when I look closely in a mirror (without glasses since I have worn them), I can see my right eye squinting. This is my eye with the stronger prescription, although my prescription for each eye is very small.

Anyway, when it finally got to the stage that I was only using my left eye to read music, I went to the opticians. I was diagnosed as having very mild long sighted astigmatism in both eyes, and referred to an orthoptist, who diagnosed convergence insufficiency and referred me to a specialist regarding my eye tracking. The specialist said that I have eye tracking issues consistent with being dyslexic, but I have no signs of being dyslexic. She said that it is definitely a developmental condition, because I also have weak thumbs and mild coordination issues with my hands. I hold a pen strangely and am not particularly dexterous. For example, I find things like peeling potatoes difficult, but I play the flute and trumpet, touch type and have no obvious difficulties, so it is obviously very mild. I never did get a diagnosis owing to a change in the NHS funding system, and funding being withdrawn for those aged 14. I could have continued privately but there seemed no point, as apart from playing ball sports (and believe me I have always been absolutely terrible), my eye tracking issues are not bothering me.

Eye exercise for convergence insufficiency have improved it to the point that my eyes rarely drift, and I can manage it myself with regular breaks from close work. Regarding the cause of my convergence insufficiency, a previous optician said that all the muscles that move my eyes are weak, and I would have been born this way. I am not sure about this, as I read at a later date, that the same muscles are responsible for both focusing and eye movements.

My guess is that I was significantly long sighted as a child. In my late teens/early twenties I started using computers for the first time, and studying business administration for two years, I spend most of my time doing close work and looking at computer screens. Quite a few of my friends became near sighted at that time, and I noticed a change in my vision from having really good distance vision to ok distance vision, and no longer seeming to struggle as much at near. My guess is that I became less long sighted at this point.

I however don't really know, as although I noticed issues with my close vision as a child, and presumably also had convergence insufficiency, since as long as I can remember, I've occasionally seen double at near and have been able to quickly fuse it, it only became a problem in my 30s. Since I don't yet have a reading add at nearly 44, it wasn't linked to presbyopia either. I presume it was owing to starting to do a lot more orchestral trumpet playing, and spending whole days at a time reading sheet music.

Anyway, I've gone on for far too long about myself, when I'm meaning to try to help you. I don't know what is going on with your eyes, but I feel that rather than guess, that it is the time to find a good optician, and see an orthoptist/eye specialist if possible. Even if you can't solve all your issues, hopefully greater understanding will help you to manage them more successfully.

I really hope that some of this will help.

Take care

Lou


Weirdeyes 16 Nov 2017, 12:08

Sorry about that. My latest prescription is R+0.75 -0.75 L+4.24 -1.50. I really do think convergence insufficiency was caused by not wearing glasses as a child. I did a lot of close work and I avoided having crossed eyes. I also think my depth perception was good for what my prescription is. I could still watch 3D movies and no one could really identify me as having poor depth perception. But I did do terribly with ball sports and people often accused me of being careless and clumsy. So this convergence insufficiency helped me out in my childhood and I think it also helped me avoid amblyopia. But now it's just throwing off my ODs. If I had crossed eyes I would have gotten glasses at a young age. I only got glasses when I was eleven and they were the extremely weak prescription of R 0.00 L +1.25.


 16 Nov 2017, 11:27

Hi Weirdeyes

Regarding your latest prescription, I presume that it is

+0.75,-0.75 and +4.50, -1.25, as you posted on 7th November. Although you do mention previous prescriptions in your earlier posts, to save me searching, can you please confirm whether your astigmatism correction is similar in the older

+1.75 and +4.25 prescription you are trying. If so, and your distance vision is improving in your right eye with wearing +1.25, it would suggest that you do have latent hyperopia.

With regards to convergence insufficiency being a response to not having enough plus, rather than it being as simple at this, I have a feeling that having insufficient plus especially during childhood, could be a contributory factor in developing convergence insufficiency.

Take care

Lou


Weirdeyes 16 Nov 2017, 11:17

When I wear the +1.25 glasses for all distances I do notice my distance gets a bit clearer.


Weirdeyes 16 Nov 2017, 09:09

Lou

At the moment I do wear +1.25 ish reading glasses over my contacts for reading. After I wore them for a while I did notice my distance vision through my +1.75 glasses was more clear. I just find those reading glasses lower the contrast for whatever reason. Maybe they're poor quality. I'm thinking of either buying an over the counter pair I like or just ordering one on zenni along with some full strength reading glasses. One problem with my +1.75 glasses is that my left eye was only corrected to +4.25. It was my request since having my 3D difference corrected feels weird. But I actually have more equal vision and depth perception when it's fully corrected, so now I think that's correct despite the weird sensations. One issues I noticed with my +1.75 and +4.25 rx is that things actually look bigger through the right eye. I believe I was overminusing myself. As counterintuitive this is to optometrists I suspect my convergence insufficiency is a response to not having enough plus. When I cover my right eye it seems like my left eye actually turns outwards. I think someone on YouTube had the same experience as me. She had latent hyperopia and also got labeled with convergence issues.


 16 Nov 2017, 03:05

Hi Weirdeyes:

Re.:

Lou

Yeah. I believe I do have some latent hyperopia and serious eye strain. I just don't know of any good ODs for that. The one I currently go to overminuses. I also had some issues where my left eye was underplussed compared to my right, so that probably caused issues as well. I told my mom my issues and she understood. So she gave me one of her weaker readers to wear over my contacts. The distance is obviously pretty blurred, but my close up vision and depth perception is way better. I think that's a sign of latent hyperopia rather than needing an add at a young age. I think I'll temporarily wear some kind of add until my eye strain improves. It may be a one time thing, but I noticed my double vision was pretty much gone as well. Something fishy is going on.

Regarding your current OD over minusing, without meaning to risk offending you, is he/she over minusing or are you subjectively over minusing yourself?

When I last had my eyes tested, my optician felt that I may have been previously been over plussed. I was completely happy with my 2012 prescription of

R: +0.50 Sph -0.50 Cyl Axis 90

L: +0.25 Sph -0.25 Cyl Axis 80

I went for a routine eye exam in 2014, and they put my prescription up to:

R: +0.75 Sph -0.75 Cyl Axis 90

L: +0.50 Sph -0.50 Cyl Axis 80

I didn't think that this was right, so I went back for a re-test. When I was shown both my old and new prescriptions without knowing which was which, I chose my new one.

I still continued to think it was wrong, and went for another test around five months later. The optician thought that my prescription was too good and that because my eyes were not having to work to focus, they were not working to correct my convergence insufficiency. He added a small amount of prism to my right eye and fine tuned the axis of each eye to 92 and 83 respectively.

Four or five months later, I was convinced that my right prescription was either too strong for distance or the prism was causing me problems for driving, as I kept finding that I was focusing on the heater elements of my car windscreen, making my distance vision blurred.

They reduced my right eye prescription and removed the prism. i.e.

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.50 Sph -0.50 Cyl Axis 83

Another four or five months later, and I was convinced that my left eye prescription also needed reducing. The optician didn't agree and changed the left eye axis to 88.

I still didn't think my prescription was right, and went back again, probably 6 months or so later. I saw a very good optician this time. She used retinoscopy to determine my prescription, as if I was unable to communicate. She agreed that my 2012 prescription was right for me, and gave me:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.25 Sph -0.25 Cyl Axis 85*

* She went in the middle of the two previous axis readings as I couldn't tell the difference between 83 and 88 with a -0.25 cylinder.

She remarked that she didn't know why I was so worried as I was very easy to test, and consistently chose the same lens each time, which agreed with her retinoscopy findings.

If this is the case, I simply cannot understand why when my 2012 prescription worked well for me for two years, and is working well for me again, that I consistently seemed to be choosing one step higher in eye exams.

Although she wondered if I had been over plussed, and had put a note on my record that this must not be done in the future, I know that on the one occasion I went in for simply a retest, which consisted of simply comparing viewing an eye chart with both my old and new prescription, it was me who chose the new one out of the two, which ultimately turned out to be wrong.

At least some of it must have been me. Whatever happened my subjective choice and the opticians objective choice now agree, and are what worked for me well in the past, and I will be very wary of any future increases to my distance prescription.

I can only advise that you ask around for recommendations of a good optician, and ask whether you can email him/her in advance of your appointment, so that you have a chance to clearly explain in advance, all the problems which you are having. This is what I did, and the optician already understood my issues before even meeting me.

Eye strain is probably a major factor in your case. If your eyes are so strained, they are probably not relaxing enough during your eye examinations, and you are probably choosing too little plus. I know that you have already had a dilated exam, but I believe that you could do with another in combination with a really understanding optician.

If you are only 21 and really struggling at near, you possibly are uncorrected. I was once given a reading add of +0.50, and I did also get a pair of reading glasses. Talk about restrictive, they didn't even cover the distance to my lap top screen, which is only the length of my arms away, and were useless to me, who rarely reads particularly close, and I was around 42 at the time, so twice your age. This time I was given the option of a +0.25 add, but the optician didn't recommend it, as I can read fine with my distance prescription.

If you are not finding a reading add restrictive at only 21, then you possibly do need more plus, but I would guess also for distance rather than just for reading.

I hope that some of this will help. Don't give up, it can be sorted, it is just a case of finding an understanding optician.

I have one possible self help remedy, which I would like other more experienced posters on here to confirm is ethical/advisable, before you try it if you think it is a good idea, and that is to try wearing a a pair of +1.00 reading glasses over your contact lenses full-time for around a month, other than when you are driving or in a situation (such as a university lecture) when you need good distance vision. Your distance vision will start off blurred, but if your do have latent hyperopia in one or both eyes, the distance vision in one or both eyes should start to improve as your eyes become less strained. If it never does or does to only a certain degree, you can determine that you either have none or less than +1.00 latent hyperopia respectively.

Even better would be to discuss the possibility of having latent hyperopia with a good optician, and if they agree that it is likely, doing something like the above in association with the optician.

Best wishes

Lou


Soundmanpt 15 Nov 2017, 14:51

Carrie

Maybe Danielle has finally realized that her eyesight isn't improving like she hoped. I'm sure now whenever she takes her glasses off everything is noticeably more blurry to her. Also because she has been wearing her glasses so much in the past few months she should be starting to feel more comfortable wearing her glasses now. Remember for you and Vickie it was much easier for you to become comfortable wearing glasses because you both wanted to wear glasses. Danielle clearly hasn't been as comfortable wearing glasses. Her worse fears were becoming dependent on her glasses and like it or not that is exactly what has happened to her. She really can't function as well anymore without her glasses for not only reading but also for things like driving her car. Bases her comment to her friend she must already be noticing that her glasses aren't quite as strong as they need to be now if she thinks she is going to need stronger glasses in the spring. I'm really surprised that Vickie sin't getting the urge to get her eyes checked in hopes that she will need stronger glasses as well.


Cactus Jack 15 Nov 2017, 09:52

Pat,

You did not mention your age or your wife's age. Typically, Presbyopia does not become a problem until the late 30s or early 40s. However, that is not a hard and fast rule. Everyone is different and has different visual needs.

Presbyopia is normally caused by the slow stiffening of the transparent protein that makes up the Crystalline Lens. Your Ciliary Muscles and Crystalline Lenses are the active part of the "Auto-Focus" system in your eyes. While the stiffening of the Crystalline Lenses is the primary cause of Presbyopia, the secondary cause is reconditioning of the Ciliary Muscles. For their very tiny size, they are the strongest and best conditioned muscles in the body. When you wear reading glasses to help you focus, you relieve your Ciliary Muscles of some of their work load. and that helps them become weaker.

Wearing the reading glasses is not particularly harmful, but they will speed the onset of the symptoms of Presbyopiar sooner than they will, inevitably, naturally occur.

The key for deciding when to wear readers or not wear readers is visual comfort when reading. The time difference between the readers being optional and naturally mandatory is probably just a few months. If you have any underlying Hyperopia, it will happen faster.

If you or your wife has not had an eye exam recently, it would be a good idea to get an exam to establish a base line and also check for lurking diseases whose presence is often first discovered during eye exams.

C.


Weirdeyes 15 Nov 2017, 09:16

Lou

Yeah. I believe I do have some latent hyperopia and serious eye strain. I just don't know of any good ODs for that. The one I currently go to overminuses. I also had some issues where my left eye was underplussed compared to my right, so that probably caused issues as well. I told my mom my issues and she understood. So she gave me one of her weaker readers to wear over my contacts. The distance is obviously pretty blurred, but my close up vision and depth perception is way better. I think that's a sign of latent hyperopia rather than needing an add at a young age. I think I'll temporarily wear some kind of add until my eye strain improves. It may be a one time thing, but I noticed my double vision was pretty much gone as well. Something fishy is going on.


Pat 15 Nov 2017, 08:06

My wife got glasses for close about a month ago, and is getting used to wearing them more and more, mostly for reading. She says her reading is much more comfortable. When she first got them I tried them but they didn't do anything for me. She got a spare pair, and has encouraged me to use them for reading, which I have. While at first they made no difference in my close vision when I put them on, if I wear them for a longer time (20 min?) I do notice a difference when I take them off. Small print blurs a bit until my eyes re-adjust and then I can see ok. (For reference she says that when she takes hers off the small print does not clear up.) She likes to see me wearing them, but will I do irreversible harm if I continue wear these glasses?


Lou 15 Nov 2017, 06:13

Hi Weirdeyes

I'm in the UK, and I don't know if there is a minimum age limit to buy ready readers, but an adult could definitely buy them. If however you don't mind me saying, I feel that since you are only 21, that it would be better for you to visit an optician, getting a second opinion if necessary. You say that you feel that your existing prescription is not strong enough. Do you mean overall or just for reading? I personally feel that a 21 year old who is long sighted for distance shouldn't really need an additional reading prescription, and it could be a sign of latent hyperopia artificially reducing their distance prescription. If I remember correctly however, you have already considered this and have had a dilated eye exam. Possibly the dilation agent wasn't sufficient, and your eyes could relax sufficiently with a stronger distance prescription to see clearly in the distance, over time. My understanding is that once all latent hyperopia is corrected, long sighted eyes cannot relax any further, and too much plus will then result in blurred distance vision, as it will effectively make the person myopic. Therefore if your eyes were able to gradually relax into a stronger distance prescription, this would be evidence that you do have more hyperopia left to correct.

If I was in your situation, I would ask for recommendations from friends/family of the name of an optician in which they have a lot of confidence, and ask them to check both your near and distance vision, and if you do need a stronger prescription for near, whether they feel that it is just a case in helping your eyes to relax into this prescription full-time, or whether you do need a reading addition.

I hope that this will help.

Best wishes

Lou


Weirdeyes 14 Nov 2017, 19:13

How can I discretely buy some over the counter glasses? I'm 21 and I just don't think my hyperopia prescription is strong enough. My OD doesn't believe me. I'm thinking of buying some glasses that are +1.25 or +1.50 to wear over my contacts for close up work. Is it normal for 21 year olds to buy readers?


Carrie 13 Nov 2017, 14:07

I think my friend Danielle has admitted that she does need her glasses full time. We were in town at the weekend and a colleague of hers came over to say hello. She noticed that Danielle was wearing glasses and commented that she thought Danielle only wore glasses occasionally and mainly for work. Danielle told her that she was sort of correct and that she used to only wear glasses for reading and close up but her eyesight has got worse and she now wears glasses or contacts all the time. She also told her colleague that she might need a stronger prescription in the spring.

It was interesting to hear her talk about her glasses without saying that full time wearing was a temporary thing. It was also interesting to hear her tell her colleague that she might need stronger glasses next year.


Soundmanpt 13 Nov 2017, 13:55

Younglady

Yes you're going to get more reliant on your glasses if you wear them all the time like you were told, but the upside is that you won't be bothered by headaches. Wearing your glasses full time isn't going to make your eyesight any worse if that is your fear.


Lou 13 Nov 2017, 06:33

Hi Onlooker

My suggestion would be for your wife to get a second opinion.

If it comes out much the same again, she could query with the optician why they she is comfortable with +1.50 readers. It could be simply down to her preferring to read further away, and the optician not taking this into consideration.

I hope that this will help.

Best wishes

Lou


OnLooker 13 Nov 2017, 04:54

Thanks all for your reactions.

The thing is that she is not convinced the optometrist gets it right that she needs +2.75 for close up as she feels she is fine with +1.5 readers. She tried +2.00 readers and says they seem too strong.


Younglady 13 Nov 2017, 03:43

Hi Tony,

Yes, feeling a lot better. But I'm not sure if I should have time away from using them as to prevent becoming too reliant? But, no headaches or eye pain when wearing them. Only come back after not using after a few hours.

Thank you.


Plus Tony 11 Nov 2017, 23:50

Hi Younglady,

It can seem like that but it is basically just your eye muscles relaxing. Effectively they're saying thanks for the extra help. Your vision hasn't changed it is just that your eyes aren't as strained having to do all the work.

How are you getting on with your glasses? Headaches gone I hope?


Younglady 11 Nov 2017, 23:06

Hi all,

Sorry just another question if that's ok? Does wearing glasses all day make your sight worse? Eg... do you rely on them more? I feel like my sight has got worse but might be my imagination. Thanks.


Willy 09 Nov 2017, 10:57

OnLooker -- Just to pull the reins in a bit, just because your wife has been given a distance prescription, does not necessarily mean that it would be illegal to drive without glasses. Plus prescriptions work a bit differently from minus (for myopia). A -1 distance prescription would be definitely necessary for driving but I'm guessing your wife is still able to compensate well enough at distance so that she does not yet really need the +1 to see clearly at distance. But that will come...


Soundmanpt 08 Nov 2017, 16:13

OnLooker

At her eye exam the doctor must have found that she doesn't just need glasses for seeing close up, but also for seeing distances. Now the doctor has reduced her to a little weaker prescription but he clearly wants her to wear her glasses for distance as well as reading. She would be much better off getting the progressives with the weaker distance prescription because her eyes would be much more able to adjust to the weaker distance prescription then something stronger. Like the others have said, at first her distance vision might still be slightly blurry but after wearing her glasses for a week or so her eyes will adjust to them. I assume that your wife still drives? Because she has been told by a doctor that she needs glasses for distances if she continues to drive without glasses she is breaking the law.


Charlie_Delta 08 Nov 2017, 13:34

OnLooker,

Cactus Jack did a superb job breaking this all down. Of everything he said, though, this is the simplest line he wrote to sum it all up:

"The Add of +1.75 in the reading segment of your wife's prescription corrects her Presbyopia AFTER the underlying Hyperopia is corrected and you are right that the total is +2.75."

Reason she's been struggling with close-up vision, simply put, is because she was wearing, effectively, +0.50 strength reading glasses. Given her age, and your both having learned she's slightly hyperopic in general (a general refractive error that isn't related to aging of the eye), she's effectively canceling-out the intended strength of her reading glasses by one diopter (+1.00).

This nonsense happened to me earlier in the year. What I can tell you is that an additional +0.50 added to my own refractive error (also +1.00) makes everything blurry at distance, but +1.00 makes everything almost shockingly clear.

If she DOES opt to correct for distance, the second most important line Jack wrote about concerns "latent hyperopia." I experienced this -- the Rx went up another +0.50 a few months later, and a bit of astigmatism emerged. I filled that Rx and honestly am not sure I've ever seen this clearly before. It was worth it. Hope that helps!

Charlie_Delta


Willy 08 Nov 2017, 12:22

OnLooker -- You may want to encourage your wife to rethink her reluctance to get bifocals or progressives. From her prescription and age (i.e. her relative youth) I would think it very likely she will have another change or two in the next couple of years (both distance and near) to the point where some distance correction is really necessary, for comfort at least if not clarity/safety/driving. Bifocals and progressives are easier to get used to at lower prescriptions. Let us know how it goes.


Cactus Jack 08 Nov 2017, 09:37

OnLooker,

If your wife does start wearing +1.00 for distance, it is likely that her distance vision will initially be blurry. Over a week or so, her distance vision will clear as her very likely Latent Hyperopia gradually resolves. This may happen several time, depending on how much Latent Hyperopia she has, but it will ultimately settle down and there will be very few prescription changes after that.

C.


Cactus Jack 08 Nov 2017, 09:31

OnLooker,

Presbyopia and its causes!

There are really two factors in the onset of Presbyopia. The primary factor is the very slow stiffening of the Crystalline Lenses. The other factor is the very rapid de-conditioing of the very tiny Ciliary Muscles that squeeze the Crystalline Lenses to increase their PLUS power for focusing close.

For their size, the Ciliary Muscles are the strongest muscles in the body, because the work constantly to focus the images as you look at things at different distances. Wearing reading glasses of any type is actually a two edged sword. They let you focus close again, but at the same time, they do some of the work for the Ciliary Muscles. If you don't exercise a muscle, it gets weak. That can happen very quickly. When the Ciliary Muscles get weak, they have more trouble squeezing the stiff Crystalline Lenses and your Presbyopia seems to suddenly require more correction than it did.

It happens to almost everyone and there is nothing you can do about it except get stronger glasses until you reach your limit. That is why OTC readers are typically offered powers from about +1.00 to +3.50 or +3.75. Many people go thru all the powers.

You are not really doing your wife any favors by not ordering bifocals for both distance and reading. As you get older, Presbyopia reduces your Accommodation Amplitude. At 43, she is very fortunate to have much Accommodation left.

There are 3 formulas that are used to calculate estimated Accommodation Amplitude.

Minimum Amplitude 15 - (0.25 * age in years) 15 - (0.25 * 43) = 4.25 diopters

Average Amplitude 18.5 - (0.30 * 43 ) = 5.6 diopters

Maximum Amplitude 25 - (0.40 * 43) = 7.8 diopters

Remember everyone is different and those are just estimates or averages.

In your wife's case, she is using up some of her precious Accommodation Amplitude to correct her +1.00 measured Hyperopia and an unknown amount of Latent Hyperopia. The rest is what she has to focus close using her internal resources. Those resources will be disappearing faster than anyone wishes and she will need more focusing help. Don't be surprised when that happens.

C.


OnLooker 08 Nov 2017, 08:47

Cactus Jack

Thanks a lot for all this explanation.

Well her age is 43, and no she could not wear her +1.5 readers for distance. We are talking of close up vision, like reading especially. For now she opted not to have glasses for distance so she will just have glasses the reading prescription which the optometrist lowered to 2.25 to allow her some distance vision which the 2.75 would not allow.

She is puzzled by the fact that her +1.5 readers were working fine and that all of a sudden she is told she needs +2.75. What is the explanation for that, if any?


OnLooker 08 Nov 2017, 08:47

Cactus Jack

Thanks a lot for all this explanation.

Well her age is 43, and no she could not wear her +1.5 readers for distance. We are talking of close up vision, like reading especially. For now she opted not to have glasses for distance so she will just have glasses the reading prescription which the optometrist lowered to 2.25 to allow her some distance vision which the 2.75 would not allow.

She is puzzled by the fact that her +1.5 readers were working fine and that all of a sudden she is told she needs +2.75. What is the explanation for that, if any?


Mike 08 Nov 2017, 07:39

Weirdeyes

I find this Red Green chart to be easy to tell if you need more or less + or - Just need to open it on a big enough screen that you can view from 10 feet away or more.

http://www.digitaleyechart.com/graphics/Chart_redgreen.jpg

I messed around with a few pairs of old glasses, and I could tell the difference right away. With +0.5 the green was a little sharper, with +1.0 they are the same in the morning and the red is a little sharper when I tested at the end of the day.


Cactus Jack 08 Nov 2017, 07:25

OnLooker,

It appears that your wife has two separate, common, problems. The separate problems have different causes, but both require correction with PLUS lenses. Unless you really understand Optics and Vision work, the two together, can be very confusing.

Hyperopia or Farsightedness is the fundamental problem. Hyperopia is typically caused by a mismatch between the TOTAL PLUS power of her eye's lens system and the size or length her eyeball. She may also have some Latent or Hidden Hyperopia. It is very common for a person who has had Hyperopia for a long time to also have some Latent Hyperopia.

You did not mention her age, but I strongly suspect she also has the second problem. Presbyopia creeping up on her.

The first problem, Low Hyperopia, is corrected by the Sphere +1.00 component in her prescription. Hyperopia is typically caused by the eyeball not growing quite enough from childhood to adulthood. Hyperopia is unique among the different types of refractive errors because it is the ONLY refractive error that can be corrected internally using some of their built in focusing power that is normally used for focusing close, when you are young, provided Presbyopia has NOT limited that ability. Often the person with Hyperopia is not even aware that they are internally correcting it. They just think that they have exceptional distance vision. However, at some point, usually in their late 30s or early 40s (not a hard and fast rule because varies with the genetics of the individual and can even happen in the teens) Presbyopia rears its ugly head and their ability to correct their Hyperopia and also focus close, begins to diminish.

Presbyopia is the gradual stiffening of the gelatin dessert like protein that makes up the Crystalline Lenses. The Crystalline Lenses and Ciliary Muscles are the active part of your Auto-Focus system. it actually starts in childhood, but usually does not become a nuisance until the 30s or 40s. The Add of +1.75 in the reading segment of your wife's prescription corrects her Presbyopia AFTER the underlying Hyperopia is corrected and you are right that the total is +2.75.

I suspect that your wife has been wearing the +1.50 reading glasses for both distance and reading and if she tried to wear +2.00 or +2.75 for distance, they would be too strong because things in the distance would be blurry. With glasses that are that strong for DISTANCE, she would actually have become Myopic, but she would probably be OK for reading.

Confused Yet?

If not let me add a little bit to the confusion. Your wife's prescription will probably change a bit over the next couple of months. There are two culprits. Latent Hyperopia and increasing Presbyopia. The good news is that this new prescription is pretty close to the limit on how much her prescription will increase.

Latent or Hidden Hyperopia is caused by a person using their Ciliary Muscles and Crystalline Lenses to correct their Hyperopia for a long period of time, sometimes years. The Ciliary Muscles get used to doing that correction and have a lot of trouble relaxing. Imagine that you held even a small weight at arms length for month or years. After some time, you would have trouble lowering your arm because your arm muscles would have trouble relaxing. The same thing happens to your Ciliary Muscles in your eye. When you get glasses that initially only correct part of your Hyperopia, your Ciliary Muscles will gradually begin to relax and the distance Sphere correction will need to be increased a bit to make up for the extra PLUS the Crystalline Lenses are no longer suppling. It can sometimes take months and 2 or 3 prescription changes (increases) to resolve all of the Hyperopia. At the same time, Presbyopia is increasing and the Ciliary Muscles are probably getting weaker, which will require an increase in the Add. The good news again is that the Sphere increase will probably not exceed an additional +2.00 and the Add will probably not exceed +3.00 unless your wife likes to do some very close work or read in bed. At some point your Auto-Focus system can no longer help with focusing (it happens to almost everyone) and the amount of focusing help you need is strictly related to the distance to the object, AFTER the underlying Hyperopia is completely corrected. The formula is easy to understand and use. If you like to work in inches, divide the distance from your eyes to the object and divide it into 40. If you like cm, divide the distance into 100. The result is the required PLUS power to focus at that distance.

I know all this seems very complex, but in some ways dealing with these complex changes is like eating an Elephant. One bite at a time.

C.


OnLooker 08 Nov 2017, 01:33

Hi all

My wife has just had an eye exam. She has been struggling with close up vision for some time and used to wear +1.5 readers especially for reading. At the optometrist's it turned out that she needs a +2.75 for close up. Her prescription reads Sphere : +1 Add: +1.75

Can someone explain why she has been fine with jus +1.5 readers and that whenever she did try +2,5 or even +2 she found those too strong??


Weirdeyes 08 Nov 2017, 01:04

I got a pretty bad headache today. Not sure if it's eye strain or just a headache.


Weirdeyes 07 Nov 2017, 18:48

I just got my new trial lenses. They are +0.75,-0.75 and +4.50, -1.25. When I tried the red green test on my iPhone I did see the green side better, but I don't know if that means much since I was focusing up close.


Soundmanpt 07 Nov 2017, 10:07

Younglady

You can certainly try wearing contacts if you want but I think you will find that it isn't as simple as you seem to think it will be to wear them. You seem to think you simply stick them on your eyes and forget about them. First of all you're going to need to be fitted with special contacts because of your astigmatisms. They are called "toric lenses" and they cost about 4 times more than contacts that correct nearsightedness. Also in many cases they really aren't very comfortable to wear. They are weighted so they won't spin around on your eyes. But they do tend to rock back and forth and that will cause things to look out of focus to you until resettle in position on your eyes. Contacts must be cleaned every night and you can't get by with only wearing contacts. You will still need glasses so your eyes can get a break from the contacts at least one to 2 days a week. I think in the long run it is much easier to wear glasses because you do simply put them on and go.


NNVisitor 06 Nov 2017, 21:29

Younglady

Contact lenses can correct astigmatism in two ways at the same time. The natural tear layer of the eye together with the prescription of the lens can correct the astigmatism. The contact lens specialist will examine the cornea of each eye to decide which contact lenses work best. Depending on the shape of the cornea some or all of the astigmatism is corrected by properly fitted contact lenses. For many people it can be partly by the lens and partly by the natural tear layer under the contact lens working together to provide the visual correction. If you see better with glasses you should be able to see better with contact lenses which offer more peripheral vision than eyeglasses are able to do.


Lou 06 Nov 2017, 04:39

Hi Younglady

Re:

Hi,

Lou- I guess I kinda have to now, I can't cope with severe headaches constantly. I don't think frames is really an issue, it is just the fact of having to wear them. I'd prefer contacts that I could "forget" about. Thanks for your help Lou. Good luck, what instruments do you play?

I fully understand and you are very welcome. I don't see anything wrong with inquiring about contact lenses

I play trumpet in orchestras and cornet in a brass band.

Take care

Lou


Lou 06 Nov 2017, 04:39

Hi Younglady

Re:

Hi,

Lou- I guess I kinda have to now, I can't cope with severe headaches constantly. I don't think frames is really an issue, it is just the fact of having to wear them. I'd prefer contacts that I could "forget" about. Thanks for your help Lou. Good luck, what instruments do you play?

I fully understand and you are very welcome. I don't see anything wrong with inquiring about contact lenses

I play trumpet in orchestras and cornet in a brass band.

Take care

Lou


Weirdeyes 05 Nov 2017, 17:51

Younglady

You never know what your full prescription will be. My first optometrist never warned me I'd need +3.00 or +4.00. He said I had a mild prescription I only needed for reading probably to make me and my parents feel better. But looking back on things I think he did know I'd be around that prescription. When I had +1.75 in my left eye he told me to start wearing them full time. Since I made a bad frame choice I was very stubborn about wearing them. I was also stubborn about wearing them because they hardly made any difference. But I did get good results from wearing both of my glasses at the same time. I should have told my eye doctor that. But on my next exam with a different doctor I got about the same prescription anyways. So don't be stubborn like me and wear your glasses when you feel the need. Even if you feel your prescription is mild. That doesn't mean your vision problems are actually mild.


Younglady 05 Nov 2017, 15:40

Hi,

Lou- I guess I kinda have to now, I can't cope with severe headaches constantly. I don't think frames is really an issue, it is just the fact of having to wear them. I'd prefer contacts that I could "forget" about. Thanks for your help Lou. Good luck, what instruments do you play?

Weirdeyes- your story sounds similar but more severe. The optometrist said my right eye needs further correction so you're probably correct on that too. Ahhhh....

Thanks


Weirdeyes 05 Nov 2017, 14:13

Younglady

Mainly because your prescription is pretty low and your left eye is -0.50 cyl which might be high enough for you to notice, but not enough for contact lenses to correct. But I strongly suspect both the sphere and cylinder correction will get stronger. When I got my first glasses I was R 0.00 and L+1.25. Pretty weak glasses. But my optometrist knew I didn't just have a mild vision problem. My left eye noticeably didn't see as well as my right eye and I'm guessing it was around 20/50. It was like things were shrunken. So the 20/40 line looked like the 20/10 line through my left eye. My left eye was considered lazy. Eventually I got -0.50 cyl in both eyes and +3.00 ish in my left eye, that was when I was about 13. My left eye could still only see 20/30. Right now my prescription is R +0.75,-0.75 L +4.25, -1.50. Both my eyes can now be corrected to 20/20. So there might be a chance you can get better correction in your right eye one day.


Lou 05 Nov 2017, 13:06

Hi again Younglady

No, your realise that you were simply being reluctant regarding wearing your glasses, and that they are stopping your headaches, are you now planning on wearing them full-time?

If so, if you don't mind me asking, did you spend the time choosing a pair that you really liked, or were you originally planning on only wearing them for driving, so chose a reasonably priced pair which wouldn't have been your choice if you expected to wear them all the time.

If the latter, and you have the money to hand to change your glasses, I feel that you are more likely to feel comfortable wearing glasses, if you have a frame that you are happy wearing.

Take care

Lou


NNVisitor 05 Nov 2017, 09:40

Younglady

If you decide to get contact lenses you will need to go to a qualified contact lens specialist. If you know people who wear contact lenses you can ask them if they know of one that they have confidence in them. You can also contact your optometrist office and ask them. Fitting contact lenses is different than fitting glasses as your cornea's shape will be examined. Both gas permeable and soft lenses are used for astigmatism. You should inquire about which would give you the best vision. If you do get contact lenses there will be an adaptation period with a timetable for the hours of use per day just to adapt to them. I have worn gas permeable lenses for over thirty years. In the adaptation period one can feel them on the eyes. With regular daily wear most of the day there may be an awareness that they are on the eyes. For me I feel them when I put them on my eyes then I typically don't even feel them. Not everyone's experience is the same however millions of people wear contact lenses. It's one option for dealing with vision correction and of course it enables people to see clearly without wearing glasses.


Soundmanpt 05 Nov 2017, 09:01

Younglady

I'm glad you wore your glasses as suggested by a number of us and that you didn't have any "hassles" Even better you were headaches free until later that evening when you took your glasses and the headache returned. If you look back to Nov 2 2017 21:09 you will see I tried to tell you then that your headaches was due to your astigmatisms and I think proves it. So now that you have found out that by wearing your glasses full time will keep you from getting headaches do you plan on wearing your glasses full time now?


Lou 05 Nov 2017, 03:15

Hi Younglady

A randomn search result from Google to explain Convergence Insufficiency:

https://www.aapos.org/terms/conditions/38

All the best

Lou


Younglady 04 Nov 2017, 21:50

Weirdeyes- Can I ask why?


Weirdeyes 04 Nov 2017, 21:28

Younglady

With your current prescription I don't think you're a great candidate for contact lenses.


Younglady 04 Nov 2017, 15:08

Thank you all,

I actually wore them all day yesterday without any hassles. I felt good by the end of the day which is a surprise as I usually get a headache by lunchtime. I stopped wearing before dinner and within a couple of hours my eyes were hurting again. So, yes you're all correct and I'm just being reluctant.

Lou - can I ask what is convergence insufficiency?

I think I'll look into contacts but then I need to face the optometrist again!

Sorry for being a pain but I appreciate your understanding.


Carrie 04 Nov 2017, 09:22

Younglady

My first prescription was +0.75 in one eye and +1.00 in the other. I got that in September 2010 when I was 17. Distances were slightly blurry with my glasses at first but within a few weeks I noticed I could see distances with them without a blur and wore my glasses all the time by choice not because I needed to. By the early part of 2011 I noticed that all distances were better with glasses. When I got my eyes tested in that autumn I got a stronger prescription and was told that I should wear my glasses for distance as well as close up but the optician wasn't surprised that I was going to wear them all the time. It was at that eye test, I think, that I discovered that I had latent hyperopia and there was a possibility of needing stronger glasses in the future. That prediction came true and my prescription has gradually been increased. I got the astigmatism correction for the first time a couple of years ago and that got increased slightly at the following eye test.

I feel I have actually needed glasses all the time since I first got them, it just took a little while to realise. With that first prescription it was just more comfortable to wear my glasses all the time as they didn't make a huge difference.


NNVisitor 04 Nov 2017, 09:05

Younglady

I had a girlfriend years ago who got glasses because she was having headaches which the glasses relieved. She was farsighted and I don't know whether she had astigmatism. If your glasses relieve your headaches then the headaches are related to visual strain. You can try and see if they alleviate the headaches. Eye strain and tired eyes is different from eye pain. When you say eye pain did you mean discomfort and perhaps some burning? If so the glasses may relieve it but you can only find out by wearing the glasses to see if that makes it go away.

Eye pain is really painful and if that's the case you need to see a doctor about it to find out the cause.


Lou 04 Nov 2017, 05:16

Hi Younglady

Fair enough that you probably wouldn't wear glasses in my case.

If you feel that your glasses are stupid, is it a case of you not really liking your frame style. Have you considered looking around for a pair that you feel really suit you. I've worn glasses for years, everyone has seen me in them, and I think the frames I have chosen suit me. I only started to feel really comfortable with wearing glasses once I started to understand what frame styles suit me.

Regarding you not understanding the other thing I mentioned, I'm not sure what particular thing you mean. If you post again quoting what you'd like me to clarify, I'll try to explain what I mean.

I'm not sure about holding books close or tilting your head, sorry.

The consequences of not wearing your glasses for anything other than driving are what you are already experiencing, pain behind the eyes and headaches.

My uncorrected eye sight does not give me headaches, but eye pain and burning.

The reason that someone with stronger lenses only requires them for certain activities is possibly owing to them having no or less astigmatism. If you were just long-sighted, you may possibly find that you'd only need glasses for reading. You however have astigmatism, which blurs your vision at all distances.

Also different people have different levels of blur tolerance. My mum has two prescriptions, one for driving/tv and the other for reading. Since she likes to knit in front of the tv, she has bifocals. Since her glasses work for driving the car and reading, it would make sense that they would improve her vision for distances in between. Why then does she not wear hers all the time, personal preference I presume, and she either doesn't get the eye burning I experience, or it doesn't bother her.

Additionally, how visually sensitive a person is probably important. My optician says that I notice very tiny differences. A person like me who notices a tiny amount of blur and wants to see as well as possible all the time, is going to subconsciously give themselves eye strain by trying to correct the image all the time, whereas somebody who doesn't notice or care about the difference, will not subconsciously keep trying to sharpen the focus. This is probably the same thing as blur tolerance, with in my opinion, blur tolerance being how much you are able to tolerate blur, and visual sensitivity also encompassing additional aspects such as eye strain.

If it has been recommended that you wear glasses all the time, you can see better with them at all distances and get eye pain/headaches without, I feel that you should find a frame style you really like and wear them.

Take care

Lou


NNVisitor 03 Nov 2017, 22:20

Younglady

It's unclear why you are getting eye pain and why you are getting headaches. You can make an appointment with a doctor to get an opinion and a referral to a specialist physician. The eye pain may or may not be occuring due to your vision. Your headaches may or may not be related to your eyesight.

I need to bring things close to read but I am very nearsighted plus I have astigmatism. I understand that you are somewhat farsighted with astigmatism as well. Another option for you if you really don't like wearing glasses is to get contact lenses. You'd need to get them fitted and then learn how to insert and remove them. Also how to care for them using the proper solution(s) as different types of contact lenses have different care regimens. It's totally up to you what you do. You will not harm your eyes by not wearing your glasses when you are not driving. If it is your vision that's causing your headaches then glasses or contact lenses should solve that problem. I've never had headaches due to my vision. I had headaches due to other causes including stress. Your headaches could be caused by stress too but for your own benefit and peace of mind it certainly is a good idea to see a doctor so that you can find out why you are having the headaches and eye pain and to find a solution.


Soundmanpt 03 Nov 2017, 17:01

Younglady

I hat to tell you, but you're sounding more like a grade school girl getting her first glasses. You don't sound like a young mother in her 30's. You're an adult. You're certainly not showing yourself as a very good example to your kids if they even have to wear glasses. Apparently you have had your glasses already for a short time and so far you have only wore them for driving. I'm glad you're at least doing that. There are no glasses police so if you don't want to wear your glasses, then don't. Just understand that your eyesight isn't going to be nearly as good and you can expect frequent headaches. If the headaches are better than being seen wearing then continue doing that.Not wearing your glasses ins't going to cause your eyesight to get worse because that could happen no matter if you wear your glasses or not.

I'm sure you probably know a number of people that wear glasses and wear them full time. You should talk to some of them and ask them how they became full time glasses wearers od any other questions you want answers to.


Younglady 03 Nov 2017, 16:28

Thanks,

Lou- I understand that reading music sheets would be very difficult. However, I probably wouldn't wear glasses but I'm not in your situation.

Apparently, I don't pass the driving assessment requirements without these stupid glasses so I'm stuck; I think. I don't understand what the other thing was that you mentioned.

Someone (Weirdeyes)? mentioned holding a book really close, and I actually do that ALL the time! So that's interesting to me. I thought it was a bad habit. I have always tilted me head slightly too, which I was constantly told off about during school and growing up. Now, I think it's all related? But maybe not.

Just so I know... what are the consequences for not wearing them? Future... worse eyes?

Why does someone with stronger lenses, only required to wear for certain activities? The more I wear them, the more I need them?

Cheers


Lou 03 Nov 2017, 04:17

And to add to my previous post, since I only have a small prescription I don't know, but I would imagine that whether to prescribe glasses and for what, depends less on the actual prescription than the difference in visual acuity between without and with glasses, and the patient's life style and symptoms. Obviously glasses would need to be prescribed if needed to meet the visual standard for driving. I suppose there is also a common sense approach, and glasses are going to be prescribed for a prescription over a certain level whatever the patient's life style and symptoms, but that in the case of small prescriptions it depends on the patient. I have 6/6 (equivalent to 20/20) vision without glasses. If people knew, they would probably query why I chose to wear glasses which correct my vision to 6/5 + 1 in each eye, which equates to one more line on the test chart, plus one letter from the line below. The answer is that I am very visually sensitive, I differ from somebody whose eyes/visual system are only able to be corrected to 6/6, by having eyes/a visual system which are capable of seeing at 6/5 and are not owing to a correctable refractive error, which I not only notice but gives me eye strain, and that since I am an orchestral musician who has to read often small music with multiple parts on one stave in often poor lighting conditions, and do a lot of long distance night driving, my lifestyle makes glasses useful. If I was less visually sensitive and had a different lifestyle, I probably wouldn't wear glasses.

All the best

Lou


Lou 03 Nov 2017, 04:02

Hi Younglady

I understand exactly what you mean. I'll give you a little history about myself. My prescription is tiny:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.25 Sph -0.25 Cyl Axis 85

I also have convergence insufficiency, in my case owing to the muscles that converge the eyes being weak. Not only do I find it difficult to converge my eyes fully, but I find it hard to keep my eyes converged, and they want to drift out. I originally had prism in my glasses to correct this, and after a fairly long period of eye exercises I was able to go without the prism, but I kept the rest of my prescription because I found it useful.

My whole prescription is for astigmatism, and written in positive cylinder form is:

R: Plano Sph +0.50 Cyl Axis 2

L: Plano Sph +0.25 Cyl Axis 175

I find that this prescription helps me equally at all distances. My optician says that I am extremely visually sensitive, and I always choose the exact same lens for each eye, however many times she shows them to me, and that my choice agrees with her objective refraction of what she would choose for me if I was unable to communicate.

For years, I wore my glasses for music, long distance and night-time driving, sometimes tv, reading and the computer. Because I found that they improve my vision at all distances, I used to notice the difference once I put them on, and then wear them for the rest of the day, with the result that I wore them all the time some days after doing something which resulted in me wearing them in the first place, and not at all on other days.

I did this for years, but recently starting experiencing two issues, the first was that my glasses sometimes seemed too strong when putting them on for the first time later in the day, when they seemed great when worn for the first time during the morning. My optician said that this is owing to the difference between my eyes being relaxed in the mornings and strained later in the day. I additionally was getting very bad eye strain when not wearing my glasses, burning like a red hot poker being through the middle of my eyes, and headaches.

She recommended putting my glasses on as soon as I wake up in the morning and leaving them on all day. It has had two positive results, firstly no more eye burning or headaches, and my glasses now seem the right prescription throughout the day rather than too strong when wearing them for the first time in the evening.

The more consistent vision with my glasses has definitely been worth it, and no more eye strain a big bonus.

I really hope that this help. Obviously it is up to you, but since your prescription is higher than mine, I can fully understand why you are getting pain behind the eyes, and since you are also getting headaches, I would suggest trying your glasses from the moment you get up until you go to bed (obviously not in the shower lol) for a couple of weeks, and seeing what happens with regards to your vision, eye strain and headaches. I have a feeling that your vision will be more comfortable and your eye strain and headaches will either disappear or be greatly reduced.

And you are at all unusual at seeing better in the distance with plus lenses. This is just the nature of your refractive error and pretty common. The difference is that whereas people with myopia cannot use their eye muscles to focus over their refractive error, depending on the type and magnitude of their refractive error and their age, people with hyperopia can to varying extents, and their glasses allow their eyes to relax.

Since I have astigmatism, I notice a difference in vision with and without my glasses. I know people with similarly small prescriptions to me, but just a small plus sphere and no astigmatism, and they report that they don't notice a difference in vision, only in comfort and that their eyes feel more relaxed.

Since you also have astigmatism and say that you can see better with your glasses at all distances, I believe that it makes sense to wear them, especially if your are getting eye strain and headaches without.

Take care

Lou


Younglady 03 Nov 2017, 01:04

Thank you all for chatting with me. Thank you for your understanding. It's obviously a little bit difficult for me to get my head around it and I don't want my friends to know either.

Does anyone else suffer from headaches due to longsightedness/ astigmatism? Pain behind eyes?

Is there a standard measurement for when glasses are really necessary? Eg. When you reach .5 or 1.0 or 2.0 etc?

I've probably asked too many questions now, so please ignore me if you wish.

Once again,

Thanks.


Younglady 03 Nov 2017, 00:28

Hi Carrie,

Do you remember when you needed to start wearing them full time?

My script is heaps lower than yours - around 1.00 plus astigmatism. This is why I'm surprised that I need to even use them! I have more trouble with distance than reading. (I currently use for driving only). My right eye is often troubled and occasionally has a slight turn. Besides that, I just get headaches and eye pain. But clearly only a minor script compared to others, which is so confusing.


Carrie 02 Nov 2017, 23:47

Younglady

I wear glasses full time my prescription is L+3.25 and R+3.75 and -0.50 L&R for astigmatism). As you can see I am more long/far sighted than you. I need to wear my glasses full time mainly because of my longsightedness. The small astigmatism correction does sharpen things a bit more. I can see without my glasses but it makes my eyes feel uncomfortable, I can't read anything at normal reading distance and far distances are a bit fuzzy.

One of my cousins also wears glasses full time for longsightedness. Her prescription is similar to mine but with no astigmatism correction. My friend Danielle has fairly recently began wearing her glasses full time and she is around +2.00. Both my cousin and Danielle were reluctant to go full time but soon noticed the benefits of doing so (although Danielle is hopeful that she might be able to go back to just needing glasses for reading and close work, eventuly. I don't think that will happen)

Any, just embrace your need for glasses and wear them with pride. Wearing glasses is really fasbionable now.


Soundmanpt 02 Nov 2017, 21:09

Younglady

Yes your astigmatisms aren't all that bad but it doesn't take much to effect your eyes. And yes i'm very sure if you wear your glasses you will find that your headaches problem will be gone. Astigmatisms usually don't get very strong and yes they can get a bit worse or get a little bit better. But most of the time it depends on how good the doctor can get the correct amount prescribed to you. It is far more difficult to prescribe an accurate prescription for astigmatisms than being farsighted or nearsighted.No one can force you to wear your glasses. But if you were told to wear them when driving that is the one exception of course. Otherwise you don't have to wear your glasses but you would be rather foolish not to if wearing glasses keeps you from getting headaches. Right now you're clearly not used to wearing glasses and that does take a little getting used to. But I think after you wear your glasses for a couple weeks you're going to start to hardly notice that you're even wearing glasses. Like I said before, even wearing glasses full time you're still going to be able to see quite well without your glasses. But not as good as with your glasses on.


Younglady 02 Nov 2017, 18:30

Thank you very much for your replies.

Isn't my astigmatism minor? I think I've had it for as long as I can remember. Usually, does it improve or get worse with age?

Is pain behind my eyes and headaches related to this long sightedness? It seems to go away when wearing glasses. I actually hate glasses, hate being reliant on something. But, I do see better and easier with them. Ahhhh...


Soundmanpt 02 Nov 2017, 10:26

Younglady

You were told to wear your glasses full time not so much because of your SPH (+1.25 / +1.00) but because of your CYL (-1.00 / -.50) If you only needed SPH correction then you would only need your glasses for things close up like you're thinking. However you have more than enough astigmatism to cause you to need your glasses for all distances. Also you mentioned headaches. That's due also to your astigmatisms which i'm sure by wearing your glasses full you shouldn't be bothered by anymore headaches. For now your eyesight might still be good enough that you could pass the driver's vision test without glasses. but as your eyes continue to adjust to your glasses you're not going to be able to see as well without your glasses. Even after your eyes are fully adjusted to your glasses your eyesight isn't going to be all that bad, but you're sure to see everything more clearly with your glasses and the added bonus is that you won't be bothered by those frequent headaches anymore.


Plus Tony 02 Nov 2017, 04:39

Hi Younglady

Your prescription is not strong but you may well benefit from using your glasses for more than just driving.

You have a small amount of hyperopia (long/far sightedness) and some astigmatism. The hyperopia is probably less significant at your age than the astigmatism. Astigmatism means that instead of your eyes being shaped like tennis balls they are more like rugby or American footballs. That is a bit of an exaggeration of course but it is how astigmatism is often explained. Basically your eyes are not perfectly spherical. The annoying thing about astigmatism is that it affects vision at all distances. The cylinder part of your prescription is to correct the astigmatism. It is more complex than the sphere correction because you will notice that as well as the power required to correct it there is another number at the end. This is the angle of your astigmatism.

People always assume that plus lenses are just for reading. This is because everyone eventually develops a condition called presbyopia which is the hardening of the ciliary muscles that control focussing. This tends to happen from your early 40s onwards and is unavoidable. The solution is plus lenses used for close tasks.

Hyperopia is different but the solution is the same. The unique thing about it is that is the only form of refractive error that you can correct without glasses or contact lenses. Most hyperopia is caused by the eyeball being too short so that light focuses behind the retina instead of on the retina. Now because the brain doesn't like the image with which it is being presented it engages your ciliary muscles to try to pull the image into focus which, up to a point, it can. Where that point lies depends on a number of factors including age, degree of hyperopia, working environment etc.

Some people live with what is known as latent hyperopia for years without wearing glasses then suddenly their muscles start to tighten, headaches begin and they go for an eye test and discover that they are long sighted. Sometimes this doesn't happen until people go to the optician and assume they just need reading glasses.

Given the astigmatism you should certainly use your glasses when driving but I think it would be worth trying them full time for a couple of weeks to see what you think. You may well find that your eyes feel fresher as a result. Working in the home, I am sure you are constantly switching between tasks that require good close and distant vision so you might find that the glasses help.

Another possibility (although it seems less likely in your case) is that you have some latent hyperopia that has not yet come out. If that was the case your eye doctor (or optometrist if you are in Europe) would probably have asked you to come back in 6 months for a check up and that would explain why full time wear was suggested.

Does your lazy eye turn at all? If so that would be another reason for suggesting full time wear.

I get quite frustrated by eye care professionals not explaining themselves clearly. All too often they just give you a piece of paper and send you off to get glasses made. If you are lucky they might tell you when to use your glasses but more often than not (especially in the UK) they don't.

I would advise you to absorb the information that you get on here, try your glasses full time for a while and then if you still have unanswered questions go back to your eye care professional and ask.


Younglady 02 Nov 2017, 03:11

Hi again,

I'm early 30's and currently at home with young children. This script is fairly new, a few months old. Honestly, I haven't been using them except for driving.

Thanks!

(Is this script usual? Unusual? Bad/ good? My right eye isn't correct 100% but it's the best it can be I think). Why the + for long distance? Would I require to wear these all the time like I've been told to?

I really appreciate your help and understanding.


Plus Tony 02 Nov 2017, 02:35

I think if your prescription is written with positive cylinder notation it becomes:

+0.25 +1.00 35

+0.50 +0.50 160


Cactus Jack 02 Nov 2017, 02:34

Younglady,

You may email me at cactusjack1928@hotmail.com.


Plus Tony 02 Nov 2017, 02:31

Younglady

I should have added that astigmatism (cylinder) correction can be written as either a + or - but the result in terms of the lens is the same. Some eye care professionals use what is known as positive cylinder notation and others use negative. Don't ask me why though! Cactus Jack is the best person to explain the maths.


Plus Tony 02 Nov 2017, 02:27

Younglady

Sorry, A few more questions...

How long have you had this prescription?

How old are you?

Are you studying/working?

My impression is that whatever was done to treat your lazy eye as a child was relatively successful because you only have a difference of 0.25 in the sphere correction between your two eyes.


Younglady 02 Nov 2017, 02:14

Thank you Tony, Weirdeyes and Jack,

My lens aren't bad, in my opinion. Actually could be stronger but since I only wear for driving; they are fine.

R: sp +1.25, C -.1.00 axis 125

L: sp +1.00, C, -.50 axis 70

I had a lazy eye (right eye) as a child. I get frequent headaches (almost daily), my eyes often hurt / get sore. Distance and near are blurred. I just don't understand why long sighted would need to wear glasses all the time? Usually people have a negative script for near sighted. I seem to have a positive sphere but negative cylinder?

Apparently it would be illegal to drive without them?! Honestly, I'm just confused and I don't understand.

Thanks


Plus Tony 02 Nov 2017, 00:18

Younglady

There isn't anything odd about having to wear a + prescription for distances. Lots of us here wear + glasses for distance. Whether you need + or - just depends on the exact nature of your refractive error. The terms farsighted and longsighted which are the common terms used to describe the condition that requires us to wear + glasses (hyperopia is the 'official' term) is a little misleading because people assume that if you are farsighted you only need glasses to see things close up because you can see fine in the distance. However it is a bit more complicated than that because if a hyperope doesn't wear glasses the eye muscles have to work overtime to make everything sharp. Once we wear glasses the muscles relax, eyestrain goes away and after a period of adaptation to get used to it we get sharp vision at all distances.

Now that is a very brief and basic explanation. Please post your full prescription, age etc as Cactus Jack suggested and he will be able to provide you with a more comprehensive answer.

It is true that wearing plus glasses is less common for young people than minus but I prefer to think of it as membership of a more exclusive club. You have nothing to fear!


Weirdeyes 01 Nov 2017, 23:59

Younglady

After a certain point astigmatism causes issues with distance vision at any script. Even if your script is 0 or plus. Since objects up close take up more space on the retina you're less likely to notice up close vision being blurry. A common sign of astigmatism is holding reading material more close than average.


Younglady 01 Nov 2017, 23:27

Hi,

If you would prefer me to just post here I will. Thank you


Younglady 01 Nov 2017, 23:09

Can I email you instead?


Younglady 01 Nov 2017, 23:09

Can I email you instead?


Younglady 01 Nov 2017, 23:09

Can I email you instead?


Cactus Jack 01 Nov 2017, 21:19

Younglady,

What you described is rather common. I'd be happy to help you understand your vision, but I need your complete prescription.

C


Younglady 01 Nov 2017, 21:09

Hi,

Can anyone please explain why I would need to wear a +script for long distances? People have said it's weird and not common? I also have astigmatism. I'd appreciate some feedback please, as I'm confused and not sure if I want to wear them. (Legally - apparently I must to drive, so I do).

Yes, they make both near and far clear etc... but it's odd and I don't like being odd.

Please talk to me!

Thank you very much!!!


Younglady 01 Nov 2017, 20:26

Hi,

Can anyone please explain why I would need to wear a +script for long distances? People have said it's weird and not common? I also have astigmatism. I'd appreciate some feedback please, as I'm confused and not sure if I want to wear them. (Legally - apparently I must to drive, so I do).

Yes, they make both near and far clear etc... but it's odd and I don't like being odd.

Please talk to me!

Thank you very much!!!


Cactus Jack 01 Nov 2017, 06:30

A quick calculation for OTC lens power to focus at a particular distance is to divide the distance into either 40 for inches or 100 for cm. The 40 inches is not exactly 1 meter but it is close enough.

40 / 28 = 1.43

Try +1.25 or +1.50 over your glasses and see which you like the best.

These days it is not uncommon for teens to need some focusing help for the tiny text on smartphones.

Latent Hyperopia is caused by the Ciliary Muscles having difficulty relaxing. As Latent Hyperopia resolves or reduces, the Sphere PLUS for distance in glasses or contacts will INCREASE. That is why when people with uncorrected Hyperopia (along with some latent or Hidden Hyperopia) often need a +Sphere INCREASE when they start wearing glasses. If the +Sphere DECREASES, that means that either your eyeballs suddenly grew longer (not very likely) or your Ciliary Muscles and Crystalline Lenses suddenly took over some of the focusing workload (pretty likely).

The actual cylinder component in a prescription changes very slowly because it is usually related to stress on the cornea, but changes in the refracted cylinder and axis are very common. The primary reason is that the Axis portion of the exam is VERY subjective because it requires the patient to judge relative blurriness of two images. I suggest reading that portion of "How to Study for an Eye Exam" on how to "fine tune" the Axis of a prescription. Most ECPs will appreciate your active participation.

C.


Weirdeyes 31 Oct 2017, 21:31

How do I get over the embarrassment of trying on over the counter readers as a 21 year old? I think I could definitely use some when I use the computer since my vision goes out of focus a lot even when I'm wearing my prescription. I also suspect I have some latent hyperopia. I don't really believe I'm only +0.75, -0.75 and +4.25, -1.50. Over my current +1.25, -0.75 and +4.00, -1.25 contacts I seem to enjoy my +1.25, -0.75 glasses for helping me see my computer screen. My computer is around 28 inches away. I think the cyl is throwing me off. I'm thinking of sneaking my mom's over the counter readers and doing some more testing. Does this add even seem right for that distance?


Carrie 30 Oct 2017, 14:23

I don't think the answers I gave Danielle will give her false hope. I was trying to be neutral and I did say that she should continue wearing her glasses all the time.

I think she will accept her need for full time glasses or contacts eventually. I think she is starting to realise her eyesight isn't improving and the relief her glasses give her eyes is likely to be a sign for her. Saying she is stubborn is an understatement 😄! She is very independent! She left home as soon as she was old enough.

As I have said before she looks good in glasses and she knows it. This is also helped by the high quality fashionable frames she has which suit her very well.


NNVisitor 29 Oct 2017, 20:05

Carrie

Danielle strongly believes that her eyes may get better. She also does not want to believe that she is completely dependant on wearing glasses or contact lenses all the time. This gives her a sense that she is in control and there is hope for her eyesight improving. She so strongly believes this and will keep doing what she's doing and will refuse to believe otherwise. She wound up putting her glasses back on because it got to be too much and she wanted relief.


Soundmanpt 29 Oct 2017, 12:33

Ca

I have to say Danielle is one stubborn and determined young lady. She is so against wearing glasses for some reason even though her partner wears glasses full time and her best friends, you and Gemma, wear your glasses full time. Does she think that her partner or that you and Gemma are not as attractive because all of you wear glasses? She keeps testing her eyes trying to see if she can go without her glasses and she has tried this before without much luck. Wearing glasses isn't going to somehow improve her eyesight when she takes them off. By going without her glasses all she is doing is straining her eyes until she is so uncomfortable that she has to put her glasses back on. You're a very good friend but when she asked you about her eyesight ever improving you honestly should have told her the truth. You know her eyesight isn't ever going to improve. She is going to be wearing either glasses or contacts for the rest of her life unless she has the money to afford lasik and even then her eyesight will only be perfect for a few years before she would be back wearing glasses again. You answer is only giving her false hopes. Tell her the truth based on your own eyes. Ever since you started wearing glasses has your eyesight ever improved without your glasses? Even her partner Vickie who she knows really didn't need glasses but ever since she started wearing glasses her eyesight has slowly deteriorated to the point where she now really does need her glasses. her eyesight will never be perfect again.


Carrie 29 Oct 2017, 05:09

I saw my friend Danielle yesterday. She wasn't wearing her glasses at first so I presumed she was wearing contacts. After about an hour or so she pulled a glasses case out of her bag, opened it and put her glasses on. I asked her why she wasn't wearing them earlier and she said she was seeing how long she could go without them. She could feel her eyes beginning to get slightly uncomfortable so put her glasses on to see if that would stop it, which it did. She seemed a little annoyed by that saying it had only been a couple of hours since she took her glasses off. She said she tries going without glasses or contacts every few days to see if her eyesight is improving, but it isn't. I think she is finally realising that she is probably going to need glasses or contacts all the time for the rest of her life and not just for a few months. She actually admitted that since wearing glasses or contacts full time and taking regular eye breaks at work her eyes feel more comfortable than they have done for a few years. She doesn't understand why she needs her glasses all the time when there's a woman at her work with glasses that look stronger than hers but she only needs them for reading. I told Danielle that everyone is different so that just because they have a stronger prescription it doesn't mean they need glasses all the time. I do but her colleague doesn't. I also reminded her of another of her colleagues she has told me about before who is a similar age to Danielle and has glasses with a very similar prescription to Danielle's that she wears all the time.

A bit later she asked me "Do you think my eyesight will ever improve?" I replied "I don't know, but it isn't improving at the moment. Just keep wearing your glasses or contacts like the optician recommended and then see what they say at your next appointment." I was careful not to say her sight might improve, because I doubt very much if it will, and I didn't say it wouldn't improve because it probably won't.


Lou 27 Oct 2017, 01:57

Hi Weirdeyes

Maybe. I agree that getting the balance right will help. All I can suggest is getting a second opinion, ideally dilated.

Good luck with solving this.

Lou


Weirdeyes 26 Oct 2017, 09:36

Lou

Or maybe my left eye is undercorrected. Either way I think getting the balance right will help my eyes relax more.


Lou 26 Oct 2017, 09:25

Hi Weirdeyes

It sounds like your right eye may have previously been over corrected. Hopefully your new prescription is correct, which will allow you to feel a lot more comfortable.

Best wishes

Lou


Weirdeyes 26 Oct 2017, 08:16

Lou

I'm thinking my eyes actually have 3.00 or 3.25 difference and my other prescriptions weren't correcting for that. So once I get properly corrected for my difference my eyes will feel less weird and my prescription can maybe increase a bit or at least stay equal. I think I remember my left eye prescription being around +4.75 on a dialated exam.


Lou 26 Oct 2017, 05:55

Hi Weirdeyes

Have you had your new prescription filled yet? If I remember correctly, you didn't have your previous prescription with R: R +1.00 Sph -0.75 Cyl filled. I fully appreciate that since your right eye prescription is going down whereas your left eye prescription is remaining pretty stable, that your difference between your eyes is currently increasing, and that this is something which has been concerning you. I'm not sure why this is happening. When you say that it tenses up, do you mean your right or left eye? You might have previously said, but have you had a dilated exam recently. I ask, because I am wondering whether you could possibly have latent hyperopia in your right eye, causing your prescription to artificially decrease. If so, I have no idea why it would occur in only one eye. If you were going without glasses a lot, which I don't believe you are, you could be straining your stronger right eye because it is compensating for your weaker left eye. You say that, "Once I get both eyes to have the same amount they might be able to truly relax.", but I don't think that you are likely to end up with the same prescription in both eyes, or do you mean once you get both eyes corrected so that you have equal visual acuity in both eyes? Regarding the latter, did your optician give your correctly visual acuity for each eye. If not, I think that it may be useful to telephone them and ask, as if one eye can be corrected more than the other, this may be the cause of your difficulties, as your best correction is giving you unequal vision between your two yes. If your corrected visual acuity is the same for both eyes with your new prescription and you haven't yet had it filled, I would suggest trying your new prescription, as I personally don't think it matters (although contact lenses rather than glasses would stop the discrepancy in size between the images from each eye) if the prescriptions for each eye are very different, as long as the corrected visual acuity is much the same. I hope that this will be of some help.

Best wishes

Lou


Weirdeyes 25 Oct 2017, 17:46

I think I know what might be throwing off my prescription. My left eye is underplussed compared to my right eye, so it kind of tenses up. Once I get both eyes to have the same amount they might be able to truly relax.


Weirdeyes 24 Oct 2017, 16:59

I just got my new prescription. The right eye prescription got reduced again, with not much change to my left eye. It's R +0.75, -0.75 166 L+ 4.25, -1.50 16 Prism: 1 BI. I'm still thinking of buying some readers on zenni. If I make my add +1.00 my glasses will be about the same as the glasses I use right now in the house. I'm thinking of trying a +1.25 add instead. With my current distance prescription I do have some issues with sewing.


Travis 22 Oct 2017, 14:22

Cactus, thanks for another detailed response to my questions. I am very grateful for the help.

I have an exam scheduled for between Christmas and New Years and definitely plan on mentioning all this to my ecp and discuss the potential need for full time bifocals.

The idea of glasses online is intriguing, but with me going at end of December, I may hold off for now.

Thanks for the advice about potential issues with pd with the otc readers.

Decided this am, that for now was really going to only use late at night at home or when at home doing intense close work for length of time.


Cactus Jack 22 Oct 2017, 13:48

Travis,

If the +1.00s over your regular glasses make close focusing easier and more comfortable, all it will do is perhaps speed up the onset of Presbyopia slightly. You are already having some of the symptoms of Presbyopia so it won't make much difference. Be aware that as time goes on, you will need more than +1.00.

There is a potential problem with wearing OTC readers over your -6.00 glasses. As prescriptions get higher, the accuracy of your Pupillary Distance (PD) becomes more important. The best possible Visual Acuity occurs when the Central Axis of Vision passes through the Optical Center (OC) of your glasses lenses. Normally, your PD is measured while you are looking straight ahead. When you focus close, your eyes have to converge, which shifts your axes of vision inward, away from the OC. When a person needs bifocals, the PD is decreased for the reading segment and is typically shown as what appears to be a fraction. For example: 65/62. That means that the PD is 65 mm for distance and 62mm for focusing close.

OTC readers have an average PD that is reduced some, depending on the + power in the highest quality readers. Normally, for a person who only needs readers, but probably not an ideal PD for a person who needs around -6 in their glasses. That might explain what you noticed when you tried different reading power. You had the right idea when you tried different power readers to find the power (and PD) that worked the best under those circumstances. You may need to shop around to find the best for you.

The ideal thing is to discuss the problem with your ECP at your next exam and consider getting bifocals.

If you want to have a little fun with your friends who gave you the +1.00 glasses as a joke, Tell them how much you appreciate the gift. You had not realized that you were beginning to have trouble focusing close and you tried them over your regular glasses. The difference and reading comfort is amazing and you strongly suggest that they should get a pair for themselves (if they don't already have bifocals) and try them. (It doesn't hurt to embellish the truth a little.)

Soundmanpt is right by suggesting an earlier pair of glasses with a weaker prescription, but that is impossible. However, if you are interested, we can help you order some inexpensive glasses from an online retailer, such as Zenni, with a slightly weaker prescription to use as reading glasses.

C.


Travis 21 Oct 2017, 14:03

Thanks Cactus and Soundman for your responses

Soundman- Your suggestion sounds like a great idea. Unfortunately, i only have 2 pair of glasses in my current rx. The rest I gave to charity as my rx changed over time.

Cactus-So, if i am reading you correctly. If I find the +1s worth having on, that's not an issue just beware that some otc readers don't have the best quality right.

And, for both of you, actually have plans for an exam scheduled in that after Christmas period, so about 2 months more to go


Soundmanpt 21 Oct 2017, 13:15

Travis

When you wear the +1.00 glasses over the top of your -6.00 glasses in effect all you're doing is wearing -5.00 glasses. really anytime you're going ot be reading for a long time, an hour or more, if yo have any old glasses that have a weaker prescription -4.75 or -5.25 whatever you should wear them instead of your -6.00 glasses. Your eyes don't need your -6.00 for seeing up close they need them for seeing distances.


CactusJjack 21 Oct 2017, 11:17

Travis,

If you measure the distance from your eyes to the computer display and divide it into 40 if you like to use inches or into 100 if you prefer cm, it will give you the required power to focus at that distance. The +1.00s will probably work for a pretty good while, but then you may need to go up a bit,

I am twice your age and have worn lined trifocals for many years. I prefer lined over no-line because of the larger visual field without distortion. I no longer have any ability to focus so I need +2.50 for reading and +1.25 in the intermediate segment for the computer. I also have some single vision prescription reading glasses with a +3.00 add. I use them for reading in bed.

One of the things you need to watch with very inexpensive OTC reading glasses is optical quality. Some are good and a good value, but some are not.

One thing you might want to consider if you use the computer a lot is some clip-on magnifiers (similar to clip on sunglasses). Rx-safety.com offers some reasonably priced, high quality clip on magnifiers in powers from +1.00 to +5.00 for about $15 or sometimes less with a promo code.

Have you ever ordered glasses online?

C.


Travis 21 Oct 2017, 10:34

Whoops about blank post.

Thank you Cactus for the quick reply. I work as an assistant store manager at a retail outlet. As for close work, I wouldn't say I do a ton other than on days when I have to do pricing changes.

Only issue before this is an occasional tiredness in my eyes later at night if I had been doing a lot of close work throughout the day.

I went to the grocery store this morning and came across one of those over the counter displays of readers. I tried a couple different pairs just to see what the vision was like through them. They actually had +1s there as well and I found that I really only noticed a difference through the +1s. When I tried them on at the store, it was like the print jumped up at me. I wasn't sure what to make of that especially when 1.25 was not nearly as good. The pair was only $5 so I bought them. I admit Cactus have them on as typing this to you


Travis 21 Oct 2017, 10:20


Cactus Jack 21 Oct 2017, 09:16

Travis,

Presbyopia is creeping up on you as it does for about 99% of the human population on the planet. However, the idea that 40 is the magic age where it begins to become a nuisance is a myth. When it becomes a nuisance and you require some focusing help varies, with your individual genetics and your visual environment. Generally, people who are myopic seem to need focusing help later than people who are hyperopic. These days, the tiny text on smartphones often causes problemsforn teens with undetected hyperopia. It is no longer rare to see teens wearing bifocals.

Wearing the +1.00 readers over your -6.00 glasses will make it easier to read, but there is a potential downside. Presbyopia is actually caused by the gradual stiffening of the protein that makes up your Crystalline Lenses. It actually starts in childhood, but typically does not cause a problem until the late 30s or early 40s (exceptions noted above). As the Crystalline Lenses get stiffer, your Ciliary Muscles have more and more trouble squeezing the Crystalline Lenses to increase their PLUS power for close focusing. For their size (tiny), they are the strongest muscles in the body, but they need exercise to maintain their strength. Which brings us to the downside of any form of reading help. Readers, bifocals, and progressives take over some of the Ciliary Muscle's work load. That tends to cause them to become de-conditioned, which means that they need more PLUS help, which helps them get more de-conditioned, etc. This process continues until the readers or bifocal or trifocal or progressive Add reaches somewhere round +2.50 to +3.50. The actual amount you needs depends on the focal distance for the task at hand. Sir Isaac Newton's basic optical formula: Lens power = 1 meter, 100 cm, 1000 mm or 39.37 inches (use 40) divided by the Focal Distance applies here.

For example, if you like to read at 40 cm or 16 inches, you need +2.50 from somewhere. It does not matter if the +2.50 is totally or partially supplied internally by your Ciliary Muscles and Crystalline Lenses or externally with glasses, it still takes a total of +2.50 to focus at that distance. At some point, you will not be able to supply any of the focusing power you need and there is nothing you can do

about it, All wearing readers, bifocals, etc will do at this point is speed the process that will inevitably occur. If you do a lot of close work, you may find that the additional comfort is worth the downside.

Sorry to be so long winded, I hope this helps you understand the natural process that is occurring. If you have more questions about the pro and cons of different ways to solve the problem, please feel free to ask.

May I ask your occupation and how much close work you do?

C.


Travis 21 Oct 2017, 08:13

Hi everyone,

I just turned 40 and for a joke some friends of mine got me a pair of reading glasses for my birthday. I already wear glasses for nearsightedness around -6. I can still read fine, but I noticed when I tried these glasses on in front of my regular glasses that reading was easier and more comfortable.

So my question is does that mean I need bifocals? I mean I can still read fine with just my regular glasses just a bit of difference I noticed with the readers makes me wonder. I looked and the readers say +1.00 on the side of the frame.

Thanks for all your help!


Weirdeyes 20 Oct 2017, 13:02

Mike

Yeah. I do mean single vision glasses that are +1.00 stronger than my prescription. I normally wear contact lenses, so I'm thinking of trying some +1.00 over the counter reading glasses at the pharmacy. I mainly notice my right eye fluctuating, but maybe my left eye does as well. With eye drops my prescription for my right eye was +1.75, -0.75. I didn't notice much of a change in vision besides not being able to see up close. My left eye has gotten readings of about +4.75, -1.50 on autorefractors at times. I've heard those drops don't fully relax your eyes if they're incredibly strained. I think my eyes do qualify as very strained. I'm way too much of an iPhone addict. I'll see what my eye doctor will have to say. One my last appointment he actually did prescribe a +1.00 add. But it was optional.


Lou 20 Oct 2017, 04:33

Hi NNVisitor

Thank you very much for the explanation. My optician suggested wearing my glasses full-time in June, and I have been following her advice. Although my prescription is very small, and I don't really need glasses full-time, I can see better at all distances whilst wearing them, and find that it is working better for me. I'm not having to continually adjust between wearing glasses and not wearing glasses, I'm not getting eye strain from not wearing my glasses, and my vision seems a lot more consistent and comfortable.

I agree totally with your explanation that it all about what the brain gets used to the eyes seeing. As an example, I've been putting on my glasses as soon as I get up for months, and this morning I went downstairs first, noticed things looked slightly blurred and went back upstairs for my glasses. Prior to wearing my glasses full-time, I'd notice the difference when I put my glasses on for the first time and things would then look slightly blurred when I took them off, making me want to keep them on, but I wouldn't come downstairs first thing and feel that my vision was blurred. In reality, I know that my eye sight is absolutely no different to it was previously (as confirmed by looking over to the calendar and seeing that I could read it as well as I did previously without glasses), I've just got used to the better vision with my glasses and now consider it to be normal.

Thanks again

Lou


NNVisitor 19 Oct 2017, 09:59

Lou

When you only wear your glasses some of the time and after a long time without them on you put them on they seem to strong is because your brain has adapted to how things look without your glasses on. I'm nearsighted and as a child mostly did not wear my glasses so when I put them on they seemed too strong with the correct prescription. This has to do with how our brains visualize the images out eyes send it. The brain then interprets what is normal vision or something quite different and then decides eroniously that the glasses are too strong. Prople who wear their glasses every day all day long will consider the image they get as normal. That's how our perception works.


Mike 19 Oct 2017, 09:29

Weirdeyes, I am assuming when you say readers with a +1.00 add your meaning single vision glasses made in your prescription just +1 stronger, not bi focal . I did the same thing a couple of years ago, I ordered some online +1.00 stronger than my prescription mainly for computer use. Over the last 2 years my sphere has increased in plus, (as my plus increased, the fluctuation in my distance vision throughout the day decreased) now I use +0.5 added to my prescription for computer use. I would first suggest experimenting with some over the counter readers, if you have easy access to them, and multiple powers. Simply just where them over your glasses while reading to simulate what it does for your close vision. Also check each eye individually, since you may not need the same increase for each to get the best vision given the difference you already have you can order them accordingly.

Does your vision fluctuate in both eyes or just one?

Do you notice most after looking at your phone / computer?


Weirdeyes 18 Oct 2017, 14:00

Mike

Maybe it's that. I'm thinking getting some cheap readers on zenni with a +1.00 add.


Mike 18 Oct 2017, 10:59

Weirdeyes, From my personal experience with fluctuating vision, It has always been from a combination doing a lot of close work and not have enough plus correction. After doing extensive close work, my distance vision would be poor for hours or until the next day. The fix at the time, (now I know was wrong) was to prescribe less plus, to help with the distance, but just gave me more eye strain and the fluctuation in vision was even worse. I don't have the difference between my eyes like you, but I would suspect that you right eye does all the close work, and your inducing some myopia or just less hyperopia.


Weirdeyes 13 Oct 2017, 00:28

Could my fluctuating vision be related to incorrect astigmatism axis a bit? My weaker glasses have an axis that is closer to 160, while my stronger prescription is around 180. I think my 180 axis is way better. I also just started meditating and I seem to prefer my old glasses now. While the weaker glasses seem to have better distance vision, the axis is messing everything up. Hopefully my new axis will be closer to 180 again.


Lou 11 Oct 2017, 01:39

Hi Carrie

I fully agree that Danielle's eye sight isn't likely to improve with her wearing her glasse/contacts full-time.

Since I've been wearing my glasses full-time (around three months now), I've stopped feeling so tired, and I haven't experienced aching burning eyes.

I've however only found that my eye sight has improved with my glasses. When I used to wear my glasses intermittently, I'd find that especially if I put my glasses on first thing later in the day, that they would sometimes seem too strong, probably owing to my eyes not fully relaxing with my glasses after straining all day without. Now my glasses give and retain the same noticeable improvement in vision all day long, that I always noticed when I previously put them on for the first time in the morning, before the eye strain had chance to start.

I therefore imagine that it will be the same for Danielle, and that the improvement in her eye comfort will continue only for as long as she wears her glasses/contacts full-time.

Best wishes

Lou


Soundmanpt 10 Oct 2017, 08:39

Carrie

Even though Danielle doesn't enjoy wearing glasses as much as you and Vickie, she does at least do as she is told to. I'm sure those mini breaks are helping her eyes feel less strained and tired out. That should make her feel a bit better. The opticians are wanting her to continue wearing her glasses /contacts because she really does need to be wearing her glasses full time now. She no longer just needs them for seeing up close but for distance as well. She needs to understand that her eyesight isn't going to improve. It should stablize at some point, but it isn't going to somehow improve so she doesn't need her glasses for distance anymore. Carrie you have been wearing glasses full time for a long time now, since you started wearing your first very weak glasses which you barely even needed has your eyes ever improved or your need for glasses lessened? The optician are going to check her eyes at her next exam to see if she needs her glasses made stronger for seeing close. Her best option if she doesn't want her distance vision to worsen is bifocals (progressives) because that way they keep her distance prescription where it is now and only make her reading add stronger. If she stays with single vision glasses she will either need 2 pairs of glasses which I think would be a pain to deal with or one pair and allow her eyes to adjust to the stronger prescription for distance meaning her distance vision will seem even worse than it is now without her glasses.


Carrie 09 Oct 2017, 10:49

Just a little update on my friend Danielle. She's still wearing her glasses or contacts full time (her optician recommended she did this until her next eye test when she went for a check up to make sure she was suffering from nothing more serious than tired and stressed eyes. She wasn't going to have an eye test until around March but was concerned about her eyes feeling tired so booked the early test). She has also continued taking regular eye breaks at work. This seems to be working as she doesn't feel so tired in the evenings and her eyes also feel a lot less tired. She had had hoped to see an improvement in her distance vision and possibly her near vision without glasses as she has been wearing her glasses or contacts all day every day for several weeks (she started a few weeks before the recent eye test when the optician said to continue). She said there was no noticeable improvement. I pointed out that it was probably still a bit early to notice any improvement. I didn't tell her, but I'm not sure if her vision is going to improve. So long as she continues to take regular eye breaks I would expect her eyes should remain feeling stress free, though.


Maurice 05 Oct 2017, 17:48

Plus Tony, just wanted to check-in and see how your eyesight is going. Are you still in single vision glasses or have you graduated to multi-focal lenses? Take care Sir and look forward to hearing about your eye exam.


Lou 27 Sep 2017, 04:47

Hi again Charlie

I asked Specsavers what material they use for their standard single vision lenses via the Ask the Optician feature on their website. They replied as follows:

Specsavers standard single vision lenses are made of a plastic polymer, often called CR39. This material is used worldwide in producing prescription lenses.

I therefore am already wearing glasses with lenses made from CR39.

Take care

Lou


Lou 26 Sep 2017, 10:38

Dear Charlie

Thank you very much for your post. I'm not sure whether I'm the same way with sound. I'm a musician and have a good ear for tone, intonation and other performance aspects such as style and articulation. Since my ears are tuned to these, I'm probably less bothered by the quality of the recording as long as it is good enough. I'm pretty sure however that I would be able to hear the difference between very good and average speakers.

I'm not sure what lenses I have in my glasses, whatever Specsavers use for their standard single vision lenses. I have a feeling that they are polycarbonate. Whatever they are, all but my first pair of glasses have come from Specsavers, so I have no comparison.

Next time I change my glasses, I'll have a look into CR39.

Thank you very much for your kind suggestion.

Best wishes

Lou


Charlie_Delta 26 Sep 2017, 09:43

Dear Lou,

I think your visual "sensitiveness" is probably very similar to myself. I'm the same way with sound and imagine you are as well. There are those who can't really hear much difference of a fine recording through a $10,000 pair of 3-way B&W bookshelf speakers through a beautiful tube amplifier, to a $100 pair amplified by a crappy consumer-grade amp. (I don't own a pair, by my god are they gorgeous sounding!)

I'm of the breed -- for better or worse -- who can see a difference from CR39 plastic (better ABBE value/better optics) vs. polycarbonate lenses; the only material used from companies like Ace & Tate and Warby Parker. Edges aren't as sharp; usually the result of chromatic aberration. It's so subtle that I presume 99%+ users of this material would never notice, but I personally see the difference and tend to be annoyed by it.

Given your low prescription, I suggest you go with CR39. Added bonus; it's the cheapest option available!

Charlie


Eastern England? 25 Sep 2017, 15:48

For Carrie's benefit: England is the big lump of an island that sits above the rest of mainland Europe


Carrie 25 Sep 2017, 12:00

We went to Danielle's house on Saturday. She had decided to wear her contacts that day. I told her that I had been reading up about bifocals and other options. She was quite interested to hear about no-line bifocals/vari-focals. She didn't know about them until then and thought they might be a good option if she does need a little stronger prescription for work. I also suggested that glasses to wear over her contacts or a separate pair of work glasses to wear instead of her regular glasses might be more comfortable as they would give a much larger area to look through. She decided to try an experiment and got out a pair of glasses with her first prescription in (about +1.00, perhaps slightly more in one eye. She couldn't remember exactly). She also got out a pair with +0.50 in that Vicky used to wear. She put her +1.00s on first and sat in front of her own desktop computer and looked at a web page that contained some quite small text. She admitted it was perhaps a tiny bit sharper with those glasses over her contacts than just contacts but she could still read it with just contacts. Anything beyond the screen was out of focus. She then tried Vicky's old 0.50s and the result was similar to the +1.00s except things beyond the monitor were only slightly out of focus and she could sit back from the monitor a bit more and still read the text. She seemed a bit concerned that wearing +1.00 or +0.50 over her contacts was better than just contacts. She then tried my glasses on for a laugh and unsurprisingly she couldn't see anything. She can't see much with my glasses on without her contacts in anyway (my prescription is L+3.25 and R+3.75 and -0.50 L&R for astigmatism). I also reminded her that she might get a slightly stronger prescription for all distances if she can see the distance chart clearly. While she can't do it at the moment I said if she can relax her eyes she might be able to do it and then avoid bifocals. If she's lucky she might not need any changes.

Danielle said "If I still have to wear glasses all the time after my next eye test I would rather have a slightly stronger prescription than bifocals even without the line. Extra glasses would be a pain in the arse." She is definitely going to follow her optician's advice to cut the stress on her eyes. She is still hopeful she will be able to wear her glasses less.


 25 Sep 2017, 04:42

Is Eastern England the part of the country that contains the burgs of Lower Uncton and Upper Uncton?


Lou 25 Sep 2017, 02:07

Hi Soundmanpt

Although not specifically saying so, I think you are meaning that since as far as I understand you cannot induce hyperopia by wearing additional plus, that whether or not Danielle's eyes would adjust for distance with a stronger prescription, would depend solely on the extent of any latent hyperopia she has, with her eyes being able to adjust only up until the point all latent hyperopia has been corrected, with any further plus only blurring her distance vision.

I would have thought that unmasking and correcting all latent hyperopia would lead to greater visual comfort. If I understand correctly, you are suggesting in Danielle's case that since she doesn't want to wear glasses for distance any more than she absolutely needs to, it would be better that any latent hyperopia she has stays masked. In my opinion, the flip side to this for someone already in their thirties and with a job that is visually demanding at near, is probably needing a reading addition sooner than they would otherwise have done, and the reading addition probably being stronger owing to the distance prescription being lower that ultimately needed.

For me personally, rather than keep taking glasses on and off, and switching between a distance prescription for driving, and near prescription, which results in blurred distance vision every time I looked up, I'd rather wear one prescription all the time, to have as natural vision as possible, up until the time I needed a reading add over and above my full distance prescription, but we are all different, and Danielle has to do what it right for her.

Hi Carrie

Sounds like we do live in the same part of England as me. I don't blame you for not naming the town where you live. I wouldn't either.

Best wishes to you both

Lou


Carrie 24 Sep 2017, 16:44

I put eastern England as I thought it would be easier for non British readers to work out my general location. I probably don't live too far from Lou as eastern England is the same as East Anglia. There are British people who don't know where East Anglia is. For reference, if you look at a map of Britain it's the big lump of England just above London that sticks out in the sea towards mainland Europe.

I am not going to say exactly where I live, not even the county.

I will post about my chat with Danielle later today or Tuesday. It's coming up to 12:45am on Monday here and I'm and I've got to get back in bed without waking Gemma. I only got out to go to the toilet and then I had a quick look at Eyescene on my Hudl tablet.


Eastern England? 24 Sep 2017, 15:53

I have never heard anyone writing in fluent idiomatic English using the phrase "eastern England" to describe where they live in the UK...


Soundmanpt 24 Sep 2017, 10:59

I went back and reread Carrie's post from Sept 18th. Carrie said that when the doctor checked Danielle's eyes she put in stronger lenses and Danielle said that there wasn't much difference when looking at the closeup eye chart. But the smaller letters were slightly clearer with the stronger lenses. But her distance vision was a bit blurred with those lenses.

This is the reason they are suggesting that she should consider either getting 2 pairs of glasses, one for when she is at work doing close up things and the other pairs away from work for driving, watching TV or shopping. The other option is progressives or bifocals. Danielle's eyes are most likely fine with her current glasses for seeing things at a distance. Her problem is due to the type of work she does which is taking a toll on her eyes. So clearly needs a small increase now for her close up work, but no increase for distance. By putting her in bifocals or progressives they can leave her wearing the same prescription for distance and increase her close vision with the add. Now a 3rd option is to simply let her continue wearing single vision glasses and give her the necessary increase. At first, just like when she has gotten other increases, her distance vision will be slightly blurry but she is still young enough that her eyes would likely adjust after she wore them a while, But doing this will only make her even more dependent on her glasses than she is now. They know she doesn't want to wear glasses full time so they are trying to give her options so her distance vision doesn't get any worse. I'm sure the idea of wearing bifocals / progressives doesn't sound right since she isn't old enough to be needing bifocals, but this will really keep her distance vision from getting any worse. Because of the type of work she does her close vision could continue to change for a while yet.Yes the reading add in progressives is pretty small but she is young and I don't think she would have much trouble getting used to using progressives rather quickly.


Obsessed 24 Sep 2017, 06:51

@Aging Max:

OMG you and Manny together in glasses: that's gotta be such a delight! :-) Hot!


Weirdeyes 23 Sep 2017, 21:27

Miku

My right eye is +1.00 -0.75 and my left eye is +4.25 -1.50. Without my glasses I can see okay. I just struggle a lot with the computer and fail all depth perception tests. I prefer to wear my glasses fulltime because I'll get headaches and even weirder vision if I don't. Some people with my prescription claim to be blind without their glasses. I don't really understand that.


Lou 23 Sep 2017, 15:41

Sorry, for the double post. I was sure I hadn't clicked submit twice. Weird!


Lou 23 Sep 2017, 15:39

Hi Miku

I'll give you a bit of history and try to be brief. I noticed that my close up vision wasn't right around 7 years old. Text seemed to move around on the page, and I couldn't see particularly close. I was however a good reader, school eye tests didn't bring up anything, and my mum and dad never took me to the opticians.

When I was at college, I had a fair bit of eye strain, the same issue of text moving around, and found reading small parts of sheet music difficult (I'm a musician). Went for an eye test. Optician was from overseas and didn't speak very good English, and basically scared me by saying that my eye tracking was so poor, he was surprised I could read at all, and that he wanted to refer me to an eye specialist. He also said that my eyesight was borderline. I just wanted to get out of the opticians, so lied and said that I could read fine.

I struggled on until 2010, when aged 36, I was finding that I could no longer fuse images well enough to read with both eyes together.

I was diagnosed with convergence insufficiency and referred to an Orthoptist for eye exercises, who also referred me to an eye tracking specialist. I had had a couple of appointments with the eye tracking specialist when I had to postpone owing to my previous marriage failing. When I telephoned to re-appoint, funding had been withdrawn for people over 14, so I never got as far as a diagnosis. The conclusion so far was that I had eye tracking issues usually associated with dyslexia but showed no signs of dyslexia. Probably owing to years of sight reading music, the specialist found that my eye tracking issues only affect me three dimensionally and cause me no issues with reading. It is not that bad, I drive a car, but I am terrible at ball sports, just cannot seem to line up the bat and ball.

Anyway, I started wearing glasses for mild long-sighted astigmatism at the time I was diagnosed with convergence insufficiency, originally with prism, which I no longer have after eye exercises. I haven't done eye exercises for years, and my convergence isn't great, but good enough that I can manage without prism.

I don't generally read without glasses as I wear them full-time, but I can read without glasses. I can't read particularly close up probably owing to my convergence insufficiency, the focus isn't overly great and I get eye strain, but I can read ok.

Probably because I don't think that I've ever had great close up vision, it doesn't bother me particularly that my close up vision isn't overly sharp, whereas I cannot stand my intermediate or distance vision being even slightly blurred, hence why I wear a very small distance prescription full-time, and get very bad eye strain without glasses. I was very surprised by the difference in reading the near chart when the optician added an extra +0.25, but have decided to stick to my distance prescription for now.

Sorry this is rather wordy, but hopefully it answered what you asked.

Take care

Lou


Lou 23 Sep 2017, 15:39

Hi Miku

I'll give you a bit of history and try to be brief. I noticed that my close up vision wasn't right around 7 years old. Text seemed to move around on the page, and I couldn't see particularly close. I was however a good reader, school eye tests didn't bring up anything, and my mum and dad never took me to the opticians.

When I was at college, I had a fair bit of eye strain, the same issue of text moving around, and found reading small parts of sheet music difficult (I'm a musician). Went for an eye test. Optician was from overseas and didn't speak very good English, and basically scared me by saying that my eye tracking was so poor, he was surprised I could read at all, and that he wanted to refer me to an eye specialist. He also said that my eyesight was borderline. I just wanted to get out of the opticians, so lied and said that I could read fine.

I struggled on until 2010, when aged 36, I was finding that I could no longer fuse images well enough to read with both eyes together.

I was diagnosed with convergence insufficiency and referred to an Orthoptist for eye exercises, who also referred me to an eye tracking specialist. I had had a couple of appointments with the eye tracking specialist when I had to postpone owing to my previous marriage failing. When I telephoned to re-appoint, funding had been withdrawn for people over 14, so I never got as far as a diagnosis. The conclusion so far was that I had eye tracking issues usually associated with dyslexia but showed no signs of dyslexia. Probably owing to years of sight reading music, the specialist found that my eye tracking issues only affect me three dimensionally and cause me no issues with reading. It is not that bad, I drive a car, but I am terrible at ball sports, just cannot seem to line up the bat and ball.

Anyway, I started wearing glasses for mild long-sighted astigmatism at the time I was diagnosed with convergence insufficiency, originally with prism, which I no longer have after eye exercises. I haven't done eye exercises for years, and my convergence isn't great, but good enough that I can manage without prism.

I don't generally read without glasses as I wear them full-time, but I can read without glasses. I can't read particularly close up probably owing to my convergence insufficiency, the focus isn't overly great and I get eye strain, but I can read ok.

Probably because I don't think that I've ever had great close up vision, it doesn't bother me particularly that my close up vision isn't overly sharp, whereas I cannot stand my intermediate or distance vision being even slightly blurred, hence why I wear a very small distance prescription full-time, and get very bad eye strain without glasses. I was very surprised by the difference in reading the near chart when the optician added an extra +0.25, but have decided to stick to my distance prescription for now.

Sorry this is rather wordy, but hopefully it answered what you asked.

Take care

Lou


Miku 23 Sep 2017, 13:27

Lou and Carrie,

I hope you don't mind my intrusion in this conversation. I have been reading Carrie's input for a while now, so my question is for Lou, as I am a low hyperope myself. Since you don't need a reading add yet, may I ask how easy it is for you to read close uo without any glasses at all (if you ever do that)? Also, when did you start needing or wearing correction (sometimes the two do not coincide?

Thanks,

M


Lou 23 Sep 2017, 03:23

Sorry last post was from me. Forgot to input my ES Nickname.


 23 Sep 2017, 03:22

Hi Carrie

Thanks very much for your reply. I'm based in East Anglia.

I understand regarding Danielle not knowing what power lenses the optician tried on her.

I'm not surprised that she doesn't want bifocals or separate glasses for work, whilst she is still in her 30s, especially when she is finding that she can read just fine with her current prescription. You say that she was shocked to find out how much better her distance vision is with glasses. I have a feeling that rather than needing a stronger prescription for work that her eye strain was merely an indication that she is now needing to wear her glasses full-time. My prescription is tiny, but my very small amount of astigmatism was causing me eye strain without glasses, which went when I started wearing them full-time.

Regarding no-line bifocals, are you referring to progressives (varifocals) rather than blended bifocals?

I'm still wearing single vision glasses at 43, but my husband who is 59, wears varifocals. He did initially find the narrower field of intermediate vision annoying, and now has a separate pair of glasses for the computer.

If she does actually need a bit more plus for distance, as you say, that would help for close up too, without blurring her distance vision.

Having a chat with her tomorrow sounds a great idea. Regarding you having a change of prescription around aged 40, I coming up 44 and still hanging on in regards to needing a reading add, so hopefully you'll be the same.

Take care

Lou


Carrie 22 Sep 2017, 10:21

Lou - I am in eastern England.

I don't know what power lenses the optician tried on Danielle and I don't suppose Danielle knows either. Maybe she was tried with +0.75 or +1.00 and the optician told her it was only slightly stronger either to not alarm Danielle or that in the optician's opinion that is only slightly stronger.

She desperately doesn't want bifocals while she's still in her 30s. She doesn't really want separate glasses for work either. It dawned on her that she would need 2 different pairs of work glasses if she wanted to wear contacts sometimes. She would need a weaker prescription to wear over her contacts and the full stronger prescription to wear instead of her main glasses. She says she can read just fine with her current prescription. I think she was shocked to find out how much better her distance vision is with glasses.

I meant to tell Danielle about no-line bifocals as she might not be aware of them and just imagines the lined type. If/when she does need bifocals she might be happier with the no-line type.

Personally I think she would find it more comfortable to wear separate single vision glasses as that would give her a larger field of view than bifocals especially if she is looking at computer screens. She could keep her work glasses at work so she doesn't need to carry them around all the time.

As you say, she might actually need a bit more plus for distances and that would help for close up too.

My distance vision without glasses is worse now than a few years ago, it's not terrible. Danielle can see distances without glasses better than me.

I'll have a chat to her tomorrow to help her get her head around all the future possible options for glasses and contacts. I don't want to sound too knowledgeable but then I have worn glasses longer than her with a stronger prescription too. I'll pretend I've been doing research for her and me, as I will also almost certainly need a change of prescription once I get to my late 30s - early 40s


gerry 22 Sep 2017, 05:25

Julia where have you gone, i was enjoying our contact you seemed a really nice lady, you are very attractive wrote lovely mails, loved your high magnification glasses, they did not distract from your attractiveness, in fact the type of frames you choose wherever fashionable. If you have lost my email address here it is arnoldmartinjock@hotmail.com. I would love to be in touch with other eye scene fans. Take care all


Lou 22 Sep 2017, 04:45

Hi Carrie

I'm not sure where you are based, but I am a little confused regarding the advice given to Danielle. You say that the optician suggested that he could give her a slightly stronger prescription for work, but that if this continued to blur her distance vision, she would need bifocals or separate glasses. What doesn't make sense to me, is that at least in my part of the world, bifocals are not available with an add less than +0.75. This seems more than a slightly stronger prescription to me. Since Danielle said that she could notice only a small difference with tiny letters at near with the stronger prescription, wouldn't +0.50 or even +0.25 be sufficient to reduce eye strain at near but be less likely to blur her distance vision?

Additionally not to think that I know more than a qualified optician (which obviously I do not, nowhere near in fact), regarding prescribing slightly more plus than required for distance to reduce eye strain at near, or prescribing reading additions for younger people who are long sighted, I would have thought that the extra plus would lead to an unnecessary deconditioning of the ciliary muscles, and that it would be more prudent to prescribe the amount needed to adequately correct distance vision, no less and no more. Although the optician said that Danielle doesn't need to change her distance glasses, is it possible that she objectively needs a slightly stronger distance prescription although she is reading the distance chart fine with her existing distance prescription, that would reduce eyestrain at near and prevent the need for a reading add until she is in her 40s?

Best wishes

Lou


Soundmanpt 21 Sep 2017, 14:25

Plus Tony

The reason your friend keeps her glasses on when sleeping is because without her glasses all her dreams would be blurry. So with her glasses her dreams will all be nice and clear.

Seriously no matter style of glasses she wears I can't imagine lying on them can't feel very comfortable. Without any doubt she has been very lucky she hasn't woke up to broken glasses. I'm sure it's going to happen at some point. Good thig she has a backup pair.


Plus Tony 21 Sep 2017, 10:00

Carrie

Danielle's comment about getting her money's worth out of her glasses reminded me of a friend who likes wearing her specs so much that she regularly falls asleep wearing them. It is a miracle that they are still in one piece but she certainly gets her money's worth too! Fortunately she has a spare pair in case anything ever does go wrong.


Cactus Jack 20 Sep 2017, 22:02

Charlie_Delta,

A solution you might want to consider is Mono-Vision with contacts.

The way that works is that you wear a contact lens on one eye for distance and a contact lens on the other eye for reading or the distance to you computer display.

It takes a little getting used to, but your brain will select the sharpest image for what ever you are doing and use that image as it s primary source of visual information and supplement that with whatever information it can gather from the other image.

I opted for Mono-vision when I had cataract surgery and it works fine for me. I can function without glasses, but I wear glasses for precision work where I need the best vision. I also have some single vision reading glasses that I wear when I have a lot of reading to do.

Just some ideas to consider. Might be better than the multi-focal contacts.

C.


Charlie_Delta 20 Sep 2017, 15:26

SC,

Many thanks for responding. I think you’ve hit the nail on the head in terms of cause/effect. Since I posted this, a cheap pair of progressive glasses arrived from Zenni, filled with my most-recent Rx (written about two months ago). As was the case about four months ago, my vision at distance is clearer in the intermediate zone. This came as a surprise. Indeed it validates your theory on what's going on.

This situation is different however form the symptom I inquired about previously; intermittent defocus at distance. In those cases, the blur I experience at distance is much more significant. I looked into this online and believe these particular events are “spasms of accommodation.” They're probably quite common occurrences amidst the emergence of presbyopia. I’ve experienced these events both when focusing from near to far as well as vise versa. Happened most recently this past weekend after a four-hour workout on my road bike with single vision glasses for distant. After the workout, I wasn’t able to see my phone or dashboard. I do believe that available electrolytes/vitamins/minerals, diet, sleep, hydration, blood sugar etc. play a role in our eyes’ ability to accommodate, but so does presbyopia of course.

I’ve avoided spending substantial money on top-of-the line fames and progressive lenses, I think smartly, due to this ongoing emergence of latent hyperopia. At work (currently a military school), I just wear multifocal contacts. They're a poor compromise to optimal vision but seem to get the job done for seeing up close. Distant vision through them is unacceptably poor with a medium add (Air Optix Aqua MF). I’m a stickler on good optics but think I’ll stick with this routine until the prescription stabilizes. Hopefully that's soon. Cheers


Carrie 19 Sep 2017, 10:51

Soundmanpt - I'm sure Danielle wouldn't have done any driving without glasses. Vicky would have driven if necessary.

I sure Danielle will take the optician's advice and take more eye breaks at work. She admitted that she often spent hours looking at her screen at work without looking away. She also said that one advantage her glasses have, apart from helping her to focus, is that everything is slightly magnified which is very useful for fine detail.

She was glad she didn't need new glasses. She was also glad to find out that her eyes are healthy and there was no health reasons for aching eyes, just eyestrain.

She is in her early 30s so probably doesn't have much or any accommodation which would explain her getting more and more reliant on her glasses. Maybe presbyopia is beginning to creep in.

She joked that she is getting her money's worth out of her glasses by wearing them all the time.


Soundmanpt 18 Sep 2017, 17:54

Carrie

I'm sure Danielle and Vickie both probably was ready for a much needed rest from work. I don't think Vickie's job put all that much strain on her eyes. Plus i'm sure she is probably looking up quite bit as well so her eyes aren't constantly only looking at small print for long hours. All the changing from looking at something close up to something at a distance is really very healthy for her eyes. Doing that her eyes are always changing focus distance. Danielle is likely often looking at very detailed things most of the day. The optician gave her very good advice. The best thing she can aside from quitting her job is to make a point every 30 minutes or so to look away at something at a rather long distance and try and focus her eyes on that for a few minutes. The main thing is so her eyes are changing focus. Also it has been proven when your eyes get "transfixed" at staring at close distance for long periods of time you also tend to not blink as often as you should this is important because that is what moistens the eyes and keeps them from feeling dry. Doing all this will help but in the end she is still going to need to be wearing her glasses full time. She should be at least happy that her eyes haven't changed enough yet that she needs her glasses changed. Actually ever since she really started wearing her glasses full time she seems to need her glasses a good bit more for distance now than she used, but that is to be expected. I hope doing the breaks will help enough so she won't need stronger glasses for work. Even though she didn't notice much difference with seeing close up with the stronger lenses in the refractor the added power would be enough to relax her eyes and her eyes most likely because she is still young would adjust to the stronger prescription for distance as well. But you know what that means don't you? Once her eyes adjust to the stronger glasses she will for sure be told she needs to wear her glasses all the time. I know you said before she went on holiday she was hoping to maybe even drive without her glasses while on break. I wonder if she in fact did that on Thursday or Friday since she was bragging about not putting her glasses on until around mid day on those days? She really isn't happy about having to wear her glasses for driving. She made that clear by asking if he might one day be able to only need her glasses for reading. If she was told that she MUST wear her glasses for driving it was because without her glasses her vision is 20/40 or even worse. The only way she might have avoided needing to wear glasses for distance was pretty much back when she first started wearing glasses. if she had gotten bifocals then she might not need her glasses for distance now. By wearing glasses as much as she was and even more now her eyes adjusted to seeing distance with her glasses. But had she got bifocals with clear (no prescription) in the top segment (the distance part) there would have been no prescription for her eyes to adjust to for distance. Only her reading add. When she has gotten new glasses it wasn't because she needed stronger lenses to see things at a distance. She needed them stronger to see small print. Her eyes have only continued to adjust to her glasses. But the opticians are thinking her eyes maybe reaching a point where they won't be able to adjust anymore.


Carrie 18 Sep 2017, 12:16

My friends Danielle and Vicky came back from their holiday on Friday evening. We met up with them on Saturday in town. Danielle had an opticians appointment as she wanted to check there wasn't anything else affecting her eyesight. She said her eyes do feel less tired after the holiday and on Thursday and Friday she managed to get to about half way through the day before she felt she had to put her glasses on. I don't know what she said to the attractive 30ish woman who greeted her in the opticians shop but to me it was clear she fancied Danielle. (I don't know how Danielle does it - gay/bi women almost fall at her feet!) After Danielle's eye test she told us what she was told. Her prescription doesn't need to be changed just yet but would probably be better off wearing her glasses or contacts most of the time for now. She needs to take more short breaks at work for her eyes by just looking at a distant object or out of a window for a couple of minutes. If she still gets tired eyes at work even with regular eye breaks he will give her a slightly stronger prescription to use at work. During the lens flipping part of the eye test the optician tried the slightly stronger lenses on Danielle. She said they were fine at normal reading distance but couldn't notice much difference compared to her glasses, perhaps slightly clearer for the smallest letters on the close up eye chart. The stronger lenses made the distance eye chart a bit blurry. The optician told her that if he did give her the stronger prescription at her next eye test she would need bifocals or separate glasses if she still couldn't see the distance eye chart properly with the stronger prescription. Her distance vision with glasses is fine but without glasses it's below the legal minimum for driving. Trying to read without glasses should be avoided. She said she asked the optician if she would eventually be able to go back to only needing glasses for just reading instead of all the time. The optician told her that although it was down to her to judge when she needed to wear her glasses at the very least she must wear them for driving. As she gets older her distance vision might not get worse but probably won't get get much or any better. Her close up vision is likely to get worse. Bifocals or separate reading glasses are fairly likely within the next 10 years even if she doesn't require them at her next eye test.

She wasn't exactly pleased to hear she she should wear her glasses full time but hopes that this combined with resting her eyes more at work might mean she can eventually go back to just wearing them for reading and driving. She's determined that she won't need bifocals or reading glasses for a few more years - at least until she's in her 40s.

She is going to wear her glasses or contacts full time but will try going without either until her eyes start to feel strained once a week.


SC 18 Sep 2017, 09:14

Charlie_Delta

I recognise many of the issues you are describing.

Distance fuzzy after close work

This seems to be that your overall reading correction is insufficient such that you are putting your eyes under too much strain. I had and still have this - a key indicator that I need to get an eye test. It is almost that your eyes are straining to add so much plus and they can't relax. It isn't a couple of minutes - I have had it last an hour easily where there is nothing I can do to get distance focus. I can confirm that if you increase the reading correction this problem seems to go away. Most likely given your age, it is the distance that needs to increase rather than the add - it was the same for me - they key thing is that the Rx for reading is higher

Rapid changes in prescription

Yes - but I've really only had this with progressives. When I first starting wearing for hours each day it took only 4-6 weeks to find myself looking through the intermediate part for distance. The result was that I went from:

-0.25 Add 1.5

to 0.00 Add 1.5 in 18 months

and to +0.75 Add 1.75 in 4 months

So for me, a trip to the optician is mostly a problem with distance following close-up work which results in the distance Rx going up so that the Reading Rx goes up and this fixes the problem.

I'm now +1.75 Add 2.25 - I still have the problem which tells me that I'll probably need higher - just that it isn't a big enough problem to justify the expense


Lou 18 Sep 2017, 05:40

Hi Weirdeyes

I'm not sure why autorefraction showed you at one point needing +2.25 in your right eye, or how accurate autorefraction typically is. I haven't looked into an autorefractor for years, presumably because they have my current prescripton as a starting point. My optician used retinoscopy to objectively determine my prescription, and it agreed with my subjective preferences.

I can understand why you wouldn't want your right eye to become nearsighted since you already have a big difference between you eyes and a reasonable plus prescription in your left, but if it is the appearance of your eyes through glasses which you are concerned about, I wouldn't have thought that a small minus prescription would look particularly different to a small plus prescription, and I think that you would be unlikely to develop a significant minus prescription in your right eye, which would be sufficient for most people to notice that your prescription for that eye was minus. Hopefully your eyes will stabilise soon, or at least any change will be in the same direction for both eyes.

Take care

Lou


Weirdeyes 18 Sep 2017, 03:00

Lou

My autorefraction results at one point said I needed +2.25 in my right eye. Maybe the prescription just naturally reduced. At this point I think my right eye is +1.00. It also seems like my astigmatism axis is changing. My old glasses don't seem to have the best close up vision either even though they have more plus. My left eye seems to fluctuate, but not as much. Sometimes it looks like my left eye needs +4.75, but most of the time it's +4.25. I'm due for an eye test soon. Even though Cactus Jack told me not to worry, I'm still worried my right eye might go nearsighted. At one point my prescription in my right eye was plano with -0.50 cyl. So it was kind of nearsighted.


Lou 18 Sep 2017, 01:52

Hi Weirdeyes

Re.

Lou

I think with my convergence insufficiency my eyes have a tendency to converge to compensate. That makes my eyes want less plus than I need and causes my fluctuating vision. I think my right eye is maybe +1.75 or +1.50, but it ends up preferring +1.00.

If you you (and anyone else reading), doesn't mind a bit of a my eye history, I'm wondering whether my experience may be of any help to you.

I wasn't diagnosed with Convergence Insufficiency until aged 35, but am pretty sure that I had it as a child. It is difficult to know for certain, as I was diagnosed with an eye tracking disorder at aged 20, which I was in the middle of being assessed for again at aged 35, when I had to cancel my appointments owing to my marriage failing, and when I went to resume, funding had been withdrawn for those over the age of 14. All I found out, was that I have eye tracking consistent with dyslexia, but that I am not dyslexic.

Anyway, as a child, although a good reader, I never thought that text looked particularly clear, I could never read particularly close, I used to lose my place a lot, and text used to swing to the right and back again. My parents never took me to an optician, as they themselves didn't wear glasses at that time, and I never said anything. Basic school screening did not find anything.

When I was at college aged 20, I decided to have my eyes tested, as I was finding reading uncomfortable. I found the experience quite stressful as I couldn't understand the optician, who was from overseas and didn't seem to speak English very well. He said that my eyesight was borderline, that my eye tracking was very poor, and that he was surprised I could read at all. He wanted to refer me to an eye specialist. I was scared by what he was saying, didn't feel able to ask for clarification and just wanted to get out of there, so said that I could see fine.

I started orchestral trumpet playing after college, and found that I struggled with small parts and notes close together, especially when there was more than one line of music on the same stave. I also had difficulties with reading long lines of numbers, such as in bar codes, specifically in knowing how many there were of a number such as 0, if several appeared consecutively, as my eyes would swing right and back again as I tried to read the numbers.

With music, I would suddenly come to something I couldn't make out at speed, my eyes would swing to the right, then come back again. By that time I would have lost my place. Sometimes I would pan out completely and find myself looking at the whole page.

I put up with this until at age 35, I found that I just couldn't fuse the images with both eyes together, and was having to use one eye. I finally found the courage to visit an optician.

My first prescription was R and L +0.25 Sph -0.25 Cyl with 0.25 Add and 2.5 Base In prism.

I couldn't get used to the prism, so it was reduced to 1.25 Base In Prism, and I was referred to an Orthoptist. I still couldn't get used to the prism and never wore my glasses, but my optician would not reduce it further. I admit that I then did a naughty. I photocopied my prescription which was simply on white paper, tippexed out the prism, and took it to a different optician.

These glasses seemed ok but not righ,t and I wanted to try a pair without the +0.25 add. I was also getting eye strain at the end of the day, and wondered whether my distance prescription would help. I had my distance prescription made up and found it better or all distances, than my glasses with a +0.25 add.

When I next had my eyes tested (2012), the optician gave me:

R: +0.50 Sph -0.50 Cyl 90

L: +0.25 Sph -0.25 Cyl 80

This prescription was very good, but I did notice the fluctuations in my distance vision, which I mentioned previously.

I was totally happy with this prescription, but it was changed at my 2014 eye test to:

R: +0.75 Sph -0.75 Cyl 95

L: +0.50 Sph -0.50 Cyl 80

I wasn't happy and this prescription seemed wrong. Whereas circles seem slightly wider than high without glasses, and perfectly round with my old prescription, they seemed taller than wide with this new prescription, and this just did not change.

I went back for a re-test and they found the same prescription. It still seemed wrong.

I went back again, the optician felt that it was right, but that his opinion (I know consider it to be wrong) was that my eyes were corrected so well that there was nothing left to correct, and since my eyes were not having to work to correct my vision, they were also not working to correct my convergence sufficiency. He said that there were two choices, to go back to my 2012 prescription, or as he recommended owing to me being 40 at the time, to keep to my new prescription and add +0.50 base in prism to my right lens, as my right eye was the one drifting out.

Since I wore the same prescription for driving, I found that since the prism was effectively replicating my right eye turning in, that it tended to trick me into focusing up close on rain spots on the windscreen. I still also felt that my right eye prescription was too strong for distance.

I went for another test, and my prescription was reduced to the following, and the prism removed:

R:+0.50 Sph -0.50 Cyl 92

L:+0.50 Sph -0.50 Cyl 83

A few months later, I felt that my left eye prescription was too strong. I went back to the optician, and they thought it was fine. I didn't agree, and felt that it was giving me poor vision on my left hand side when driving at night.

After getting out my 2012 glasses (prescription as higher up) and finding them a lot better, I went back again last February and saw a really good optician (one of the directors).

She agreed that my 2012 prescription was better for me. I asked her if I was now under prescribed and was simply happier this way, but she said no, and that her objective refraction had found the same. She said that she felt that previous opticians had been bumping up my plus, despite me keep returning saying that I was unhappy with my prescription, and has put a note on my file saying that this is not to be done with me.

I didn't ask her why they would bump up the plus. Maybe it is owing to my age, that I have convergence insufficiency and this is a prescribing guideline for people with convergence insufficiency, or maybe the optician wasn't choosing to bump up my plus, but I was subjectively choosing more plus during the test, which the optician then prescribed, since they were going along with my choices. If the last suggestion, maybe she has put a note on my file along the lines of requesting that future opticians go with the objective refraction even if I subjectively prefer more plus.

Whatever, the return to my 2012 prescription worked and my inconsistent distance vision later in the day, which I had also noticed back in 2012, has finally gone after three months of wearing my glasses full-time.

This very long rant, is my way of saying that I am wondering whether convergence insufficiency is not causing you to prefer more minus, hence why your plus prescription is decreasing, rather that it may have been previously bumping up the plus, and this lower plus prescription is more accurate.

I am pretty sure since I was happy with my prescription in 2012, only happy once I had returned to my 2012 prescription in 2017, and was unhappy with all interim prescriptions, finding circles taller than wide which never went away, that my prescription had really been stable since 2012, and the interim increases were not right.

I really hope that this will help someone now my five year difficulty in getting the right prescription appears to be finally over

Best wishes

Lou


Weirdeyes 17 Sep 2017, 17:24

Lou

I think with my convergence insufficiency my eyes have a tendency to converge to compensate. That makes my eyes want less plus than I need and causes my fluctuating vision. I think my right eye is maybe +1.75 or +1.50, but it ends up preferring +1.00.


Lou 17 Sep 2017, 16:12

Hi again

I've been giving this some thought, to see if I can be of any help to people experiencing fluctuating distance vision.

Fluctuating distance vision was driving me crazy too, and was really starting to get me down. I just couldn't understand why I was intermittently experiencing it in the evenings, and only knew that it occurred far less often when I had been wearing my glasses all day.

I am British and asked about this via the Ask the Optician section of the Specsavers website.

The Optician advised that for many people, the refraction of the eye alters very slightly during the day, owing to factors such as tiredness, light level (which causes the pupil size to alter) and the eye very slightly changing shape as the day progresses. He said that you could find a very slight change in prescription between an eye test in the morning and one later in the day.

I decided to book an appointment for a re-test as late as possible in the day. My prescription was identical to my eye test four months previously, and my optician advised that when she did an objective refraction like she would with somebody unable to communicate, that she would prescribe exactly the same as I had chosen during the subjective part of the exam.

She said that I am very visually sensitive, and always chose exactly the same lens for each eye, however many she tried, and that the severe eye strain I suffer from without glasses is owing to my natural vision being like a lens I like less during the test, whereas my vision with my glasses is with the lens I most like. She demonstrated it by lifting her own glasses up and down, and describing it as a lens I like versus a lens I don't, and said that I will always suffer eye strain even though my uncorrected vision is 6/6 (compared to 6/5 + 1 with glasses), because I am noticing the difference and trying to correct for it.

She suggested full-time wear and advised that she had also told me that four months earlier at my last test. I honestly don't remember her saying that. She also advised putting my glasses on the minute I wake and wearing them through to when I go to bed.

Hating the eye strain, which was resulting in my convergence insufficiency starting again, and hoping that wearing glasses full-time would stop my inconsistent distance vision later in the day, as it already happened less often when I had worn my glasses all day, I followed her advice.

My eye strain disappeared almost immediately, and although my inconsistent distance vision had almost disappeared by the end of the first week, only now almost three months later, have I had absolutely no signs of it for over a week. It seems to have taken an absolute age to disappear!

I am convinced that out of the factors suggested by the Optician via the Ask the Optician service, that tiredness was the cause in my case, and that preventing my eyes from getting so tired is what is stopping inconsistent distance vision from occurring later in the day.

Rather than convergence insufficiency causing this, I'm wondering whether convergence insufficiency simply causes the eyes to be more tired, and that it is then the tiredness rather than the convergence insufficiency which results in the inconsistent distance vision. I really don't know, only that in my case, inconsistently wearing glasses was causing inconsistent distance vision later in the day.

Hopefully this long rant will help someone.

Best wishes

Lou


Cactus Jack 17 Sep 2017, 13:04

Charlie_Delta,

The good news is that it won't take 15 years for your vision to stabilize. Less than 2 is more likely. Remember, suggested intervals is just that, suggestions. You get to look at your vision problems every waking hour. YOU are the best judge of when you need to see your ECP, the calendar has almost nothing to do with it.

Remember, you can order quality glasses, in most prescriptions, inexpensively, online. Let us know if we can help.

C.


Lou 17 Sep 2017, 12:59

Hi Weirdeyes

Re:

Lou

I wear glasses full time, but I still experience fluctuations. I think convergence insufficiency makes my eyes go more minus at times. It's driving me crazy.

I fully understand. Fluctuating vision is really annoying. I have convergence insufficiency too. I did loads of eye exercises to get rid of prism originally (I believe I had 1.5 base in in each eye, reduced from the 2.5 I couldn't get used to), which I hated, as I felt that I was wearing blinkers.

A couple of prescriptions ago, I had 0.5 base in prism in just my right lens, but since I didn't wear my glasses full-time then, I found I had to adjust to it every time I wore my glasses, and I found that I needed it some times and not others. Given a choice at my next eye examination, I chose to get rid of it. My optician suggested starting eye exercises again at my last eye test, as my convergence was pretty poor, but since wearing my glasses full-time and not suffering eye strain, it seems better again. Basically I find that I can compensate for my convergence insufficiency most of the time.

I'm not sure whether eye strain owing to convergence insufficiency causes fluctuating distance vision.

Best wishes

Lou


Lou 17 Sep 2017, 12:59

Hi Weirdeyes

Re:

Lou

I wear glasses full time, but I still experience fluctuations. I think convergence insufficiency makes my eyes go more minus at times. It's driving me crazy.

I fully understand. Fluctuating vision is really annoying. I have convergence insufficiency too. I did loads of eye exercises to get rid of prism originally (I believe I had 1.5 base in in each eye, reduced from the 2.5 I couldn't get used to), which I hated, as I felt that I was wearing blinkers.

A couple of prescriptions ago, I had 0.5 base in prism in just my right lens, but since I didn't wear my glasses full-time then, I found I had to adjust to it every time I wore my glasses, and I found that I needed it some times and not others. Given a choice at my next eye examination, I chose to get rid of it. My optician suggested starting eye exercises again at my last eye test, as my convergence was pretty poor, but since wearing my glasses full-time and not suffering eye strain, it seems better again. Basically I find that I can compensate for my convergence insufficiency most of the time.

I'm not sure whether eye strain owing to convergence insufficiency causes fluctuating distance vision.

Best wishes

Lou


Weirdeyes 17 Sep 2017, 11:54

Lou

I wear glasses full time, but I still experience fluctuations. I think convergence insufficiency makes my eyes go more minus at times. It's driving me crazy.


Lou 17 Sep 2017, 11:16

Hi Charlie-Delta

I know what you mean by fluctuating distance vision. My prescription is tiny (R: +0.50 Sph -0.50 Cyl Axis 92, L: +0.25 Sph -0.25 Cyl Axis 85). I'm an orchestral musician and found that glasses made sight-reading easier. I never however could cope with taking them on and off. Once I had worn them, things looked annoyingly slightly out of focus without them, and I would get eye strain. Since my glasses help with all distances, I used to only wear them on orchestra rehearsal days, and put them on for the first time when I left the house to drive to the rehearsal venue, which is often later in the day.

I went back to see my optician in June, after experiencing two annoying things, bad eye strain when not wearing my glasses (my eyes were burning and really aching), and inconsistent vision with my glasses later in the day. If I put them on for the first time in the morning, my distance vision would always be significantly better than without glasses,but if I put them on for the first time later in the day, particularly in the evening, my distance vision would vary between being significantly better with glasses like in the mornings, to little difference, to sometimes even worse than without glasses.

Owing to me being very visually sensitive and also having convergence insufficiency (which after eye exercises I can manage most of the time without prism (which I've worn previously) and an eye tracking disorder, considering the amount of eye strain I was experiencing, my optician recommended wearing my glasses full-time from the minute I wake up.

I've followed her advice and the fluctuations in my distance vision later in the day, have really decreased. It is now only when I am really tired, do I find that my distance vision is slightly better later in the day without glasses.

My understanding is that although I have a plus sphere in negative cylinder notation, that really my entire prescription is for astigmatism, as my prescription is plano sph and +0.50 and +0.25 cylinder respectively in plus cylinder notation. Obviously this however equates to a lens for each eye which varies between plano and plus, and presumably owing to straining all day to try to correct my small amount of astigmatism (which I understand to not actually be possible, because the eye cannot self correct for astigmatism owing to the two points of focus), the result was that I was ending up with too much plus later in the day.

Wearing my glasses all day has had the joint effect of not only preventing eye strain but stopping my glasses from seeming to have too much plus later in the day.

Therefore if you are not already wearing your distance glasses full-time, it may be worth a try to see if this reduces the fluctuation in your distance vision.

Take care

Lou


Charlie_Delta 17 Sep 2017, 10:05

Lou and Cactus Jack,

I’ve succumb to the reality that I’m in the midst of rapidly changing eyes, and therefore; a silver bullet for correction through lenses isn’t achievable until things stabilize more. Basically, two things are going on: a longer-term manifestation of so-called “latent hyperopia,” and a daily fluctuation in distance acuity. My last post/inquiry was motivated by driving for an hour, around dusk on a highway, after being awake and working since 3:00AM. My eyes defocused a lot when looking out into infinity (and when the did that, it’s wasn’t a little bit of defocus but rather a significant amount). My hunch is that everything from sleep to hydration to diet (vitamins/minerals etc.) to exhaustion influence daily fluctuations like this, particularly for an emerging hyperope. It sucks!

One thing is for certain: the myope has it much better presumably, as these sort of daily fluctuations, as I understand it to be, anyway, don’t really happen. Myopic eyes seem to be able to enjoy a pretty “absolute” refraction -- whatever Rx is determined by the ECP (assuming it’s accurate) is a silver bullet for the most part.

I’d be first in line for a laser treatment to do away with the need for glasses/contacts, but common sense tells me I’m be stuck using contacts/glasses until my focus muscles relax and presbyopia has run its course. That could be a while – 15 years maybe. If I eventually go that route, I’d rather be corrected in both eyes to see at near without correction because (a) I do a ton of work up close, and (b) I’m not a fan of the appearance of plus glasses.

In December, I plan to have a properly dilated eye exam at the University of Pennsylvania. They’ve taken photos of my retina for 15+ years due to a harmless/hereditary condition commonly known as “optic nerve cupping.” Could become an issue if the surrounding tissue thins (hence photos every two years). I’m two years overdue for another set of photos and will request a refraction while me eyes are dilated. All that really would tell me is how much latent hyperopia is in there – I don’t think it’d influence my prescription much, because un-dilated, I can’t accept +0.50 more for distance at present. The random defocus issue at distance is intermittent and I probably have to live with this annoyance for the time being. Agree?

Charlie

ps: Cactus, we've chatted on here in the past and I do have an ADD (+1.50). Near Rx is OD +2.50 sph, OS +2.00 -0.25 axis 175 and I generally require that to work on a computer now.


Weirdeyes 16 Sep 2017, 11:17

Cactus Jack

My eyes haven't been dialated in a while. I am pretty close to my true prescription.


Cactus Jack 16 Sep 2017, 07:51

Weirdeyes,

First of all, your eyes are NOT particularly weird. Your two eyes develop independently as a 3 diopter difference is not anything to get excited about. A few years ago, I had a neighbor who had about 5 or 6 diopters difference. His right eye was about -2 to -3 and his left eye was about +3.00. He wore glasses. I did not know him well enough to discuss it in detail.

Are your eye exams, dilated?

C.


Lou 16 Sep 2017, 01:50

Hi Charlie_Delta

When you say:

Things at distance are out of focus (by a lot, it seems) after looking at something up-close w/ single-vision glasses for distance. I can concentrate and bring everything into focus, seemingly without much effort, but the default to blur is happening on increasing regularity now.

If you don't mind me asking for clarification, are you saying that if you look at something close with your distance glasses rather than reading glasses, then look into the distance, everything is initially blurred then clears.

If so, then I would say that rather than latent hyperopia, this is caused by a delay in the eyes switching from close to distance, and is a symptom of Presbyopia.

I'm coming up 44, and have noticed this exact same issue for the last year. I presume that it in my case it is the start of presbyopia. I currently only have distance glasses and my optician said that there isn't really any need yet for a different prescription for reading, although she could give me an extra +0.25.

Since you also have reading glasses, I think that in your case, it is just an indication that you need to switch to your reading glasses for close work.

I hope that this will help.

Lou


Weirdeyes 15 Sep 2017, 17:35

Cactus Jack

Why is the prescription in my right eye dropping while the left eye is more stable? It's getting pretty annoying. I don't want my eyes to get more lopsided. Could this be caused by spending too much time on my iPhone? I also find it challenging to get a well balanced prescription. Could that be causing the annoying fluctuations as well?


Cactus Jack 15 Sep 2017, 15:54

Charlie_Delta,

What you are experiencing is common. Presbyopia itself is caused by the Crystalline Lenses becoming stiff and hard to focus. That also means that after the Ciliary Muscles succeed in increasing the PLUS power of the Crystalline Lenses for close focusing, they are also slow to relax, which they must do for distance vision. While the Crystalline Lenses are focused for close work, you are actually Myopic.

One of the things that cause people with Hyperopia AND Presbyopia to get confused is that both are corrected with PLUS lenses, but for different reasons.

I would urge you to consider getting a dilated (wet) exam. Be sure and try to NOT do much close work, prior to the exam. Typically, the dilating agents that are used these days are not very persistent and wear off in just a few hours. All the dilating agents do is temporarily paralyze the Ciliary Muscles. They have no effect on the Crystalline Lenses. You want your Crystalline Lenses to be as relaxed (minimum PLUS power) as possible for the distance part of the exam to hopefully need another prescription change very soon.

You are not going to like this part.

It is time to consider an Add to help you focus close for reading or using the computer. There are many possible solutions. Bifocals, trifocals, progressives, mono-vision, and even multi-focal Intra-Ocular Lenses. Your visual environment is very important in choosing which solution is the best. In some instances, progressives are nice for social occasions and bifocals or trifocals are better for a wide field of focus with little or no distortion. The solution there is two pair of glasses.

Be sure and tell the examiner about your visual environment and all the problems you are having with your vision. This is no time to let vanity get in the way of good vision.

If you are getting a dialed exam, your near vision is checked before the dilated part of the exam. If your Ciliary Muscles are paralyzed, you can't focus close anyway. It is very likely that you will try to focus on the small text, try to no work too hard on that, because not having enough Add for the task, will cause you to need an increase sooner than you typically would.

Hope this helps some. Feel free to ask more questions here or in a private message if you want to discuss your situation in more detail.

C.


Charlie_Delta 15 Sep 2017, 14:41

Have others on here required more than one correction within 6-9 months due to latent hyperopia? I’m again struggling at distance – seems to be getting progressively more annoying. Things at distance are out of focus (by a lot, it seems) after looking at something up-close w/ single-vision glasses for distance. I can concentrate and bring everything into focus, seemingly without much effort, but the default to blur is happening on increasing regularity now. My last eye exam was due to similar symptoms and. This was a few months after first being prescribed glasses (40 y/o). The distance script went up +.5 in each eye. What is interesting however is that my initial prescription, reading glasses, is only +.5 more in each eye (L +1.0, R +1.5) and those are more fuzzy at distance my current distance Rx (L +0.5 / R +1.0). FWIW, the last visit did uncover slight astigmatism in left eye, but its too negligible I think to even mention (-0.25).

I’m not a Greatful Dead fan by any means but concur in their “what a long, strange trip it’s been” line when it comes to my vision experience in the past seven months!


Cactus Jack 15 Sep 2017, 09:28

Weirdeyes,

There is a relationship between focusing and convergence, but I doubt it could cause Latent Hyperopia. Latent Hyperopia is typically caused by using your Ciliary Muscles to internally correct Hyperopia for a long time, often years.

It is extremely unlikely that you will become nearsighted.

C.


Weirdeyes 15 Sep 2017, 02:34

Can convergence insufficiency create latent hyperopia? I mainly notice it in my right eye. It used to be be +1.75 with -0.75 cyl. It went down to +1.25 and later on +1.00. My eyes don't feel relaxed. My left eye has kind of fluctuated between +4.25 and +4.00. It's more stable for some reason. I'm scared my right eye will be nearsighted one day. My most recent ECP suggested prism. I just don't want to be dependent on prism. I love wearing contact lenses. Especially with my uneven eyes.


Soundmanpt 11 Sep 2017, 09:48

Carrie

One thing for sure, Danielle is one very determined young lady.She just doesn't want to accept that she needs to be wearing her lasses full time now. Her eyes don't feel as tired since she started wearing her glasses full time because her eyes aren't straining as much so her eyes are more relaxed. A reduced workload helps a bit as well but it's mostly because she has been wearing her glasses full time. Being on holiday for a week is not only good for her eyes but she is probably mentally ready for a break as well. She has been wearing her glasses full time for a good while already so her eyes should be pretty dependent on her glasses by now so I wonder how well she is going to be able to see without her glasses anymore. If she wants to read a book she is going to need her glasses that's for sure, if she wants to watch TV I think she is going to find out rather quickly her eyes aren't going to very comfortable doing that if she is even able to see the TV very well without her glasses. And since she was told that she needs to wear her glasses when she drives she shouldn't even try driving without her glasses. I don't know what the laws are in the UK but here in the US if your told by your optometrist that you need to wear glasses for driving that over seeds what your driver's license may have as restrictions. In other words if you were able to pass the drivers vision test but 6 months later you had your eyes examined an were told you need to wear glasses to drive that is considered the law. But regardless of what the law is in the UK I really hope if she is driving she wears her glasses. Otherwise if she wants to glasses free all week that's up to her. But no matter what she does over this week once she is back at work I think she will be back wearing her glasses full time again anyway.She sure feels different about wearing glasses than her lovely mate Vickie.


Carrie 11 Sep 2017, 06:22

My friend Danielle is still wearing her glasses full time (around +2). She said her eyes don't feel so tired but isn't sure if that is because she has been wearing her glasses all the time or that her workload has reduced. She is on holiday this week so she is hoping that the break will help her eyes and she can go back to wearing glasses mainly for reading and working. She'd like to not need her glasses for driving and watching tv but has a feeling that won't happen. She accepts that she will always need glasses for reading and working. She would never get surgery. She occasionally wears contact lenses.


Aging Max 08 Sep 2017, 17:08

What a surprise last evening. After dinner, Manny got ready to read a book and to my shock and delight, he pulled out a pair of glasses. He had never given me any hint that he was going to have his eyes examined. He told me that the doctor said his eyes had reached the point they could use some assist with close-up work. Left eye +1.00 and Right eye +1.25. The glasses are dark framed half-rims. Rock n' roll. Glasses now rule the household of Manny and Max.


Aging Max 31 Aug 2017, 07:16

Thanks for the suggestions. Let's see if I can get Manny to the eye doc.


Cactus Jack 30 Aug 2017, 05:18

PhillinEngland,

Sometimes, the server is slow and often people click more than once on the Submit button. The clue that your submission is acceptable, is that the Submit button changes to Reverse Video - White letters on a BLUE background. When that occurs, your submission is in the queue and you just need to be a bit patient and wait for the server to respond. It is rare for it to take more than 10-15 seconds, but it can seem like forever. It is worse than waiting for a traffic signal to turn Green, when you are in a hurry.

C.


PhillinEngland 30 Aug 2017, 00:36

Sorry about the double post!


PhillinEngland 30 Aug 2017, 00:34

Cactus Jack

I agree with every word you said, and you said it much more succinctly than I ever could!

I am now very much "converted" and I see (no pun intended) the benefits of having a regular, quality eye test.

My previous post was really to pass on my experience of how stubborn I was in resisting an eye test. I really can be a stubborn bugger especially if my darling wife gets on my case. There was a fair bit of denial involved too: acknowledging my deteriorating vision was like accepting the aging process and the fact that I was aging. In the end it was my poor visual acuity and me deciding something needed doing that got me through the optometrist's door.

It's a very fine line between trying to persuade someone of what's in their best interests and their perception of being nagged (in my experience).


PhillinEngland 30 Aug 2017, 00:34

Cactus Jack

I agree with every word you said, and you said it much more succinctly than I ever could!

I am now very much "converted" and I see (no pun intended) the benefits of having a regular, quality eye test.

My previous post was really to pass on my experience of how stubborn I was in resisting an eye test. I really can be a stubborn bugger especially if my darling wife gets on my case. There was a fair bit of denial involved too: acknowledging my deteriorating vision was like accepting the aging process and the fact that I was aging. In the end it was my poor visual acuity and me deciding something needed doing that got me through the optometrist's door.

It's a very fine line between trying to persuade someone of what's in their best interests and their perception of being nagged (in my experience).


Cactus Jack 29 Aug 2017, 19:12

PhillinEngland,

A quality eye exam, particularly one with dilation (sometimes called a “wet exam), does a lot more than just check your vision, The eyes are a window into the body and often High Blood Pressure, Diabetes, and other non-eye diseases are first detected on an eye exam. Also, internal eye pressures are checked for early detection of Glaucoma.

Most people think think they have good vision, even if they don’t. Vision actually occurs in the brain, the eyes are merely biological cameras. The brain has amazing image processing ability, IF it knows what something is supposed to look like.

That said, it is probably best to not be too forceful in mentioning much about your vision with your glasses. Manny, might view it as you trying to “force” him to get an eye exam. Often that causes a person to “dig in their heels” and delay getting an eye exam on their own. It is OK to answer questions about vision with your glasses, but don't volunteer much.

If you need a couple of prescription changes and he asks about that, you can just mention that you have what is called Latent or Hidden Hyperopia in addition to Presbyopia and it might take a few changes to completely correct your vision. It is just the nature of the beast.

C.


PhillinEngland 29 Aug 2017, 14:59

Aging Max,

I too stubbornly refused to have an eye test until my near vision was so poor that I could barely do my job. I eventually went and got prescribed reading glasses which were a great help until my vision deteriorated further and following a further eye test a couple of months ago I now wear glasses full time.

I guess Manny will know himself, like I did, when he needs to do something about his vision. Probably best to just drop subtle hints if you notice him struggling to read small print.

Regards,

Phill.


Aging Max 29 Aug 2017, 12:41

Much appreciate the comments about latent hyperopia that helped me better understand my need for glasses and why I should wear the glasses full-time. My partner, Manuel, has just turned 40 and I have been encouraging him to have an eye examination. Manny has not seen an eye doctor since high school and my thinking is a check-up would make good sense. So far, no success in convincing him to have those eyes looked at-----tells me there is nothing wrong with his vision. That may be----but he is at the age when many start wearing reading glasses. Any advice out there that night help me to persuade Manny.


Soundmanpt 28 Aug 2017, 11:15

Mike

The fact that she is using her reading glasses more and more when she is reading means her eyes are less and less comfortable trying to read small print anymore without glasses. She may not be dependent to the point where she is wearing glasses full time but the fact that she has bought 2 extra pairs means she doesn't like trying to read without glasses anymore and having the extra pairs she has them close by at all times. Even though she says they don't make much of a difference when she first puts them on i'm sure she would struggle if she didn't put them on. Not surprising that after she wears them a while reading and then takes them off the words are a blur. That's because her eye were adjusted to seeing with her glasses on. She hasn't had her glasses long enough but soon those same words are going to be as blurry even before she puts on her glasses to read. Have you asked her how her vision is with her glasses for distance? At this point I think she is going say that things at a distance is more blurry with her glasses.

As for you Mike wearing a pair of her glasses shouldn't effect your actual eyesight. All they are doing for you is enlarging the words which makes it easier to read. After a wearing them a while your eyes get used to them and and taking them off will make things blurry until your eyes refocuses. As long as you're able to pickup that same book later on and you're able to read it without any problem without glasses you should be fine.


Mike 28 Aug 2017, 07:27

Just an update on my wife's new reading glasses. She really likes the clear close vision with them, and is using them more and more. She certainly is not dependent on them, but they make reading so much more comfortable for her that she bought 2 extra pairs. She said they don't make so much of difference when she puts them on, but if she is like reading a book for a while and then takes them off all the print is a blur. I sometimes wear a spare pair of hers. Close really looks great but distance is an uncomfortable blur. If my vision blurs when I take them off, like hers, does that indicate a change in my vision?


Prismatic 28 Aug 2017, 06:09

Jan - thank you for your detailed reply and apologies for the delay in replying. With regards to my own situation unfortunately I am told that I do not require glasses (yet - although presbyopia is starting slowly). However I still hope that I may have some latent hyperopia as I am able to 'relax' my eyes and see blurry at all distances as well as some double vision when i do this but nothing has ever been picked up at a test. I have never had a wet examination but am due another test in a few months so who knows.

I have also started noticing that I have some double vision after waking up especially when i'm looking at my phone so there may be something there.


Jan 23 Aug 2017, 02:30

Prismatic,

I wore glasses full time before getting prisms. My whole glasses history always related to problems with reading. I started getting glasses at the end of high school (starting with .05 and 0.75), before moving up to +2 in each eye. I had been pretty much full time after the first increase to 1.0, because I got an astigmatism prescription of -1. After getting used to that, I had trouble doing anything meaningful without glasses.

Over the years my distance script reduced, while my astigmatism increased (to 2 dptr), and my ECP suspected that I was about to become nearsighted. In my early thirties my reading troubles got intense again. My ECP suggested that I was too young to have reading support, but he found out that my eyes would slight cross when looking at near objects, and he prescribed 2 prisms total (but put it only in one lens). As you can guess, it didn't take me long to get used to it. About a year later, another ECP found what I had long suspected, latent hyperopia, leading to a script of +2 and +2.5 again, while increasing my prism to 4BO in total. This was the most comfortable I had ever seen (once my hyperopia had fully relaxed), but since then I had trouble doing anything without glasses. While I could still look straight without glasses, I cannot focus on anything and cannot hold that for long (as soon as stop controlling eye muscles, double vision set in). I had tried an old pair of sun glasses that had my regular prescription, but had to give up soon because of double vision. Contact lenses were no longer an option since then (I tended to use them for sports, but they never really worked for me because of the astigmatism.) I wonder whether an earlier detection of the latent hyperopia would have kept me from getting prisms in the first place (or at least later). That said, my astigmatism had made me full-time wearer long before I got prisms.

Since wearing my current prescription of 3BO on both sides, putting on my glasses is the first thing I do (else I get strong eye muscle pain). If I relax my eyes, my deviation is way stronger than the 6BO total (as reported in my earlier mail), but part of it is compensated by my + script. I think over time I have accepted that I depend on glasses, but since the prisms there are no exceptions and I am aware that there is no going back (uncorrected activites such as swimming are tricky). My near glasses with 10 prisms are thicker and my eye turn is quite noticeable, so I only use them for near work. For any human interaction I swap to my normal glasses. However, when working too near, I get the 'spasms' of double vision (as described by Kris) with my regular glasses.

I hope that gives you an overview of my history. Are you wearing any prism correction, and what is your history/experience?


Glassesforeveryone 19 Aug 2017, 05:46

I have prism, 3 BO each eye. I started at 1 BO left eye and it has progressed slowly over the years. At my last test it remained unchanged.

I do get a juddering feeling of my eyes trying to get back to fusion when I am tired. If I drink I struggle with double vision, but most days it is very manageable.

My distance vision is pretty stable and my add is going up steadily. I don't think it is enough to be honest, but you don't want to rush into big prescriptions for reading.

I'm not sure where my eyesight will end up, but I don't really like the idea of a visible squint, so quite happy that the prism seems stable and works most of the time.


Prismatic  19 Aug 2017, 01:20

I find the whole adaptation and eventual dependency on plus lenses and prisms fascinating so enjoy reading posts on this thread (although I still live in hope that there will eventually be a dedicated Prism thread on ES!).

Jan - may I ask what you prescription history is? Were you a full time wearer before you got the prisms and why/how did you get them in the first place?


Mr Jules 18 Aug 2017, 23:18

Before 40, I had perfect vision. But then presbyopia started and I began with +1.00 reading glasses. A few years later, my distance vision also needed correcting. I adapted to progressive lenses well and all day wear. My eyesight stabilised.

But eyesight has now worsened again. My reglazed progressive are distance +2.00 , with a +2.25 add and atigmatism axis of 165 in the right eye.

I'm struggling to adjust to the new distance part of the progressive lenses. I really have to train the eyes to look dead ahead on the target distance object. Close up and middle parts of the lenses is great. I am trying to avoid switching to my spair of single vision glasses : I have ones for distance and ones for reading.

One thing I have noticed is that I can feel a bit dizzy when walking without my glasses. I realise that I can't function without my glasses now.. It's my decling distance vision which has been harder to adjust to.


Kris 17 Aug 2017, 18:57

Aging Max,

I found it took me a couple of weeks to adapt to my plus prescription when I first started wearing glasses (as an adult). Initially I felt like the prescription wasn't quite right, but then I got used to the prescription. If it doesn't improve after a few weeks go see your ECP. My optometrist has been very good at tweaking my prescription and twice has had to change it after only a short period of time (initially when he intentionally under prescribed my distance prescription, and again when I was prescribed prism). I found that after a couple of weeks of wearing glasses, I couldn't understand how I functioned without them for so long.

Jan,

The spasm I was describing is exactly what you described, a flickering between images. Usually when reading, and more likely when I'm tired. I had this flickering quite frequently before wearing prism, but never really tied it in to me needing prism. I spent a long time in denial about my double vision issues and find that it's usually only when my prescription has been adjusted, that I become fully aware of the issues I'm having.

When I first filled my current prescription, my vision quickly reset to single vision if I saw double. Now it takes a little more conscious effort, I find doing the prism test seems to make things worse and it's harder to fuse images once I've allowed my eyes to fully drift. Measurements I've taken in the past show my need being somewhere between 30 and 40 pdptr, but I know most people don't need fully corrected to resolve double vision issues. With my current lenses the prism test indicates a 10-14 pdptr need (on top of what is already in my lenses).

Like you, I'd like to stay with my current prescription as long as possible, but it's a balance with managing current symptoms. I have reading glasses as well, and I'm considering seeing if I can just increase the prism in those rather than in both sets of lenses. It would be interesting to know if, once I reach a certain prescription, I will stabilize and not need further increases or if I will continue to need more and more prism.

I was definitely reluctant to start wearing prism, but cannot function without them now. I do hate when I have to go without, as I feel very self conscious about my eye turning in. I thought that I would just need a small prism prescription and be fine, so am unsettled to have gone up so quickly (and potentially need a further increase after only a couple of years. I felt like others on this site were much, much worse in their prism need than I was, but now feel like I need more prism than I expected.

I struggle with being dependent on prism, although I know it's no different than needing glasses in general. I know I should probably make an eye appointment to be properly treated, but I am so reluctant to admit I'm still having issues. I'm hoping maybe things will improve (I may have magical thinking here). At some point I will have to go in and see my ECP, I guess.


Kris 17 Aug 2017, 18:56

Aging Max,

I found it took me a couple of weeks to adapt to my plus prescription when I first started wearing glasses (as an adult). Initially I felt like the prescription wasn't quite right, but then I got used to the prescription. If it doesn't improve after a few weeks go see your ECP. My optometrist has been very good at tweaking my prescription and twice has had to change it after only a short period of time (initially when he intentionally under prescribed my distance prescription, and again when I was prescribed prism). I found that after a couple of weeks of wearing glasses, I couldn't understand how I functioned without them for so long.

Jan,

The spasm I was describing is exactly what you described, a flickering between images. Usually when reading, and more likely when I'm tired. I had this flickering quite frequently before wearing prism, but never really tied it in to me needing prism. I spent a long time in denial about my double vision issues and find that it's usually only when my prescription has been adjusted, that I become fully aware of the issues I'm having.

When I first filled my current prescription, my vision quickly reset to single vision if I saw double. Now it takes a little more conscious effort, I find doing the prism test seems to make things worse and it's harder to fuse images once I've allowed my eyes to fully drift. Measurements I've taken in the past show my need being somewhere between 30 and 40 pdptr, but I know most people don't need fully corrected to resolve double vision issues. With my current lenses the prism test indicates a 10-14 pdptr need (on top of what is already in my lenses).

Like you, I'd like to stay with my current prescription as long as possible, but it's a balance with managing current symptoms. I have reading glasses as well, and I'm considering seeing if I can just increase the prism in those rather than in both sets of lenses. It would be interesting to know if, once I reach a certain prescription, I will stabilize and not need further increases or if I will continue to need more and more prism.

I was definitely reluctant to start wearing prism, but cannot function without them now. I do hate when I have to go without, as I feel very self conscious about my eye turning in. I thought that I would just need a small prism prescription and be fine, so am unsettled to have gone up so quickly (and potentially need a further increase after only a couple of years. I felt like others on this site were much, much worse in their prism need than I was, but now feel like I need more prism than I expected.

I struggle with being dependent on prism, although I know it's no different than needing glasses in general. I know I should probably make an eye appointment to be properly treated, but I am so reluctant to admit I'm still having issues. I'm hoping maybe things will improve (I may have magical thinking here). At some point I will have to go in and see my ECP, I guess.


Aging Max 17 Aug 2017, 14:58

OK, I have been wearing these + lenses for a little over week----wearing them all my waking hours. Except for some ribbing at work about old eyes and still working on my fuzzy vision during night driving----the adjustment is going ok. I am assuming that as my eyes adjust, the distant vision will eventually become clearer and sharper. The good news is that my eyes no longer tire so quickly when doing my work now that I wear glasses.


Jan 17 Aug 2017, 14:30

Kris,

I am glad to read about your experience. I recall when you started to wear prism glasses and got used to them.

Even though I never had evident strabismus when I was young, I had been wearing prism glasses for a few years now, with my latest prescription of 4BO both sides, but my current glasses have 3BO.

You mentioned that you have a sudden spasm of double vision when reading. Is it like a quick shifting between both images (flickering sensation)?

It took me while to figure it out, but it happens when I move my book/phone too close.

I felt that ECPs are not really helpful when determining the optimal prism correction, and they can't, since they only see you once anyway. So in some respect I took matter into my own hand. I tried the prism test many many times in different circumstances and measured values between 20-30 pdptr - highly dependent on my state of fatigue, but in any case definitely more than the prescribed 4BO per eye.

Since I fear the constant increase (well, I don't actually feat it but am rather annoyed when my eyes start drifting off again), I ordered reading glasses with 5BO on both sides and now switch between my regular glasses for distances and temporary reading, and the reading glasses for prolonged near vision. Even though the switch can sometimes be a bit challenging, I got quite used to it and hope that this approach will keep my prescription stable for a longer period. It is also nice to appreciate the stronger prism when you need it, instead of wearing it constantly. That said, I sometimes get double vision at distance, but this is expected, since I am undercorrected. I guess it basically depends on me, how long I wait until I fill my distance script. I am very tempted at times though...

A bit long post, but reading your experience, I felt like sharing mine.

But I would really like to know more about what you described as a spasm of double vision ...


Kris 16 Aug 2017, 10:40

Hi Cactus,

Thanks for your response. I should clarify about pushing my glasses up. I actually push them up to look out closer to the bottoms of the lens, presumably where I have a slightly higher add than where I usually look out of the lenses. It's not to have the glasses closer to my eyes, but rather to adjust where in the lens I'm looking out.

I'm 46 and already have an Add of 2.5, and I find it hard to believe I already need more. I do read with things about 30cm away, I've always liked to have books pretty close to my face. At this point, I don't know if some of the symptoms I'm having are related to trying to compensate for my strabismus issues or whether there is also a need to increase my add.

Is it true that prism demand will constantly increase or is that a myth? If prism demand increases constantly I would rather put off an eye exam to avoid going up too quickly but if there will be a firm end point where I will not need more prism I may consider going in for an eye exam. Do most people needing prism usually settle out and only need occassional increases. I don't like that I went to the 5 BO within a year of starting to wear prism and hate the thought that I might need an increase only a year later.


Cactus Jack 16 Aug 2017, 06:29

Kris,

Sorry to be slow in responding. I have been thinking about your situation since you posted and it is a little confusing.

The prism test results would indicate between 10 and 13.3 total diopters at the time of the test. Did you do the test when you were fresh or fatigued?

What is your typical reading distance? You said that you pushed your glasses closer to help you focus close. That is also a bit confusing. With a relatively low prescription, Vertex Distance (VD) effects are negligible and with a PLUS prescription, reducing the VD, actually makes your glasses slightly LESS effective.

The only thing I can thing of is your PD with your eyes turned slightly inward and the location of the Optical Center (sweet spot) of your glasses when using the close focusing zone of your progressives.

5 BO in each eye corrects about 2.85 angular degrees of turn in. It shifts the PD about 1.5 mm (about 0.3 mm per prism diopter) at the back surface of the glasses lens, but that changes with the VD (it is a trigonometry function).

That is one of the reasons higher prism glasses can be hard to fit, particularly with higher prescriptions than you have. Progressives, with a narrow transition corridor, complicate the situation also.

I would like to offer a low cost experiment of trying some low cost, single vision reading glasses from Zenni, but I need to know your preferred reading distance.

BTW, few people notice prism eye displacement in your glasses with 10 BO or less, particularly with PLUS lenses. They might notice a slightly thicker outside edge of the lens, but it is much less noticeable in plus lenses than it is in minus lenses which already have thicker outside edges.

C.


Kris 15 Aug 2017, 15:09

I've posted here before about my issues with double vision and coming to terms with needing and using prism. I've been wearing glasses for hyperopia for 7 years and have been wearing progressives for 6. Two years ago I started with prism initially with 2 BO in each eye and within a couple of months I went up to 4 BO. Last year my prism was increased to 5 BO. My current prescription is L 0.75, 5 BO, ADD 2.5, and R 1.50 cyl -0.5, 5 BO, ADD 2.5. This prescription was great but recently I've found myself pushing up my glasses to see at near and I will have quick "spasms" of double vision, where my eye almost seems to spasm and I see double, but can correct it back to single vision. It's starting to happen more frequently, but is easy to correct back to single vision. I can feel my right eye drifting occassionally, especially when I'm tired.

Cactus, I've done your prism test and at 3 meters images can be 30-40 cm apart, but I can fuse them.

My question for those who wear prism is this: When do you go in for eye checks? Do you put up with some double vision even with prism or do you not have any issues with your current prescription. My lenses are quite expensive and I'm not sure if I should pay for an eye exam or not. Is it better to put up with mild double vision symptoms or to have the correct prism prescription. My issue is that I'm usually unaware of how bad things have gotten with my vision until I get my new lenses and see what a difference they make in day to day function.

I've heard it said that prism need keeps going up. Is this true or will it settle out as it gets closer to my total prism need? I'm afraid of going up on prism too quickly and ultimately needing more prism than if I wait until my symptoms are more pronounced, but I'm not sure this is really how it works.


Cactus Jack 15 Aug 2017, 14:12

Aging Max,

There is really no way to predict because everyone is different. Correcting your Hyperopia and Latent Hyperopia will delay the need somewhat.

Everyone has a different Accommodation Amplitude, that depends on their age, genetic makeup, and visual environment. There is even a formula that can be used to estimate - not very accurately - your Accommodation Amplitude (AA). It is average 18.5 - (0.30 * patient age in years) with the minimum amplitude of accommodation as 15 - (0.25 * age in years), and the maximum as 25 - (0.40 * age in years).

Lets say that at 35 you have 8 diopters of AA and you used up 4 diopters correcting your Hyperopia, internally. That would mean that you had 4 diopters available for focusing as close as 25 cm or 10 inches, assuming your Ciliary Muscles were in good condition.

By correcting your Hyperopia externally, that would free up all 8 diopters of AA, but you have to keep your Ciliary muscles in good condition.

If you do a lot of close work, particularly if you have some Astigmatism, you may find that the strain and discomfort is not worth it and / or that after doing a lot of close work your eyes have trouble relaxing for clear distance vision. At that point, it is time to "bit the bullet" and get some bifocals.

It really is your decision about how to deal with the problem. Comfort and convenience is the key.

C.


Aging Max 15 Aug 2017, 03:34

Thank you Cactus for the good information. Just wondering how long before bifocals/progressives become a reality for Max----by the time I am 40?


Lou 12 Aug 2017, 08:56

Hi Mike

Something relevant I believe is whether although prescribed for reading and close work, your wife's prescription shows +1.25 as a distance prescription, or whether she has a zero or negligible distance prescription with a reading addition. If with her permission you post her full prescription, it will be possible to distinguish between the two.

Since she is only 32, it may very well be that she is long-sighted (has hyperopia) rather than that she has presbyopia which needs a reading addition. If she is long-sighted and +1.25 was the lens which gave her the best correction for her distance vision, then although she may only need her glasses for reading/close work, theoretically they could be worn for all distances. They may not make much difference to her distance vision, but should relax her eyes and make her vision more comfortable. If she is not having any problems with her distance vision, or experiencing any discomfort or eye strain at distances other than near, wearing her glasses for reading/close work only sounds sensible.

If her prescription has a +1.25 reading addition, and can only be worn for close work as it would blur her distance vision, for the reasons explained already, if I was her, I'd personally wear my glasses only when strictly necessary, very small print, poor light, when I was very tired etc., to avoid unnecessarily deconditioning of my ciliary muscles, but obviously the choice is hers, and she must do what is right for her.

I'm 43 and wear a very small prescription for long-sighted astigmatism full-time owing to bad eye strain. My optician said that she could give me a little stronger prescription for close work, but has advised against it, until strictly necessary.

Although my glasses for astigmatism do slightly improve my close up vision, my understanding is since they give me so called normal vision, my ciliary muscles work a so called normal amount as if I had a zero prescription, so I am not really deconditioning my ciliary muscles. This seems to be a case, as before wearing my glasses full-time, I never read with them, as I didn't want to weaken my ciliary muscles by reading with even a very small amount of plus prescription. Since wearing my glasses full-time, I have found that I can read just as well without them as I did previously. Maybe this is in part owing to the fact that my prescription is only very small.

I hope that this will help.


Cactus Jack 12 Aug 2017, 08:47

Aging Max,

Yep! Latent Hyperopia. You have it. Happens to most people who have uncorrected Hyperopia or Farsightedness.

Hyperopia is the ONLY eye condition that YOU can correct internally. When you correct your Hyperopia internally, your Ciliary Muscles and Crystalline Lenses are Adding the extra PLUS you need. Over time, your Ciliary Muscles become so accustomed to squeezing your Crystalline Lenses that they have trouble relaxing.

When Presbyopia creeps up on you to the point where your Crystalline Lenses get stiff, you initially have trouble focusing close. When you get an eye exam for reading glasses to help, Hyperopia is sometimes revealed, as it was in your exam.

Normally, your Ciliary Muscles are fully related for distance, but they have been stressed for so long that they simply cannot relax during an eye exam, even if your eyes are dilated.

When you start wearing PLUS glasses, your Ciliary Muscles will slowly relax, sometimes it can take weeks or months to fully relax. As they relax, your distance vision will improve, but you may need a prescription change as that occurs. Also, as the relaxation occurs, it makes more accommodation range available for close focusing purposes, but that won't last. Presbyopia will be creeping up, gradually robbing you of your focusing ability. At some point, you will probably need a bit more PLUS in your glasses for distance AND focusing help for intermediate and close distances.

At that point, depending on your visual environment, you may need progressives, bifocals, or trifocals.

C.


Aging Max 12 Aug 2017, 08:10

Mike, I am a year older than you and recently had my eyes examined because I felt that my eyes were tiring quickly when reading on the computer, phone, etc. The trip to the eye doctor brought me glasses, R+1.25 and L+1.50. Not only for reading but to be worn full-time. The doctor said that I was farsighted and probably should have been wearing glasses before age 35. I am trying to be diligent and wear full-time, but it is a little of an adjustment. Like you, I can tell a difference up close with print being bolder. For me, at a distance---still adapting and slowly overcoming the initial fuzziness. Latent hyperopia?


Soundmanpt 11 Aug 2017, 16:10

mike

Even though your wife's prescription is rather weak now that she will be wearing her glasses when she reads or does other close work it won't take very long before she won't be able to read small print at all without her glasses anymore. So she better keep track of where she last had her glasses she will be needing them much more than she does now. She may even need a stronger prescription in a few months time as well.


Cactus Jack 11 Aug 2017, 12:48

Mike,

It all depends on some things you can and cannot control. The thing you cannot control is Presbyopia. It ultimately affects almost everyone on this planet at one time or another.

Presbyopia is the gradual stiffening of the Crystalline Lenses over time. It actually starts in childhood, but does not typically become a problem until the 30s or 40s, but it can become a problem at any age.

The Crystalline Lenses are the variable focus lenses in your eyes. They, along with the very tiny Ciliary Muscles inside your eyes, are the optically active part of your auto-focus system.

Vision actually occurs in the brain. The eyes are merely biological cameras and they work very much like a high end digital camera. For a person with "normal" distance vision, your auto-focus system uses the Ciliary Muscles to increase the already high PLUS power of the Crystalline Lenses, by squeezing them to make them "fatter" and thereby increase their power. How much they increase the power depends strictly on the distance involved using a formula developed by Sir Isaac Newton, of gravity fame, over 300 years ago. The formula is 100 cm divided by the target distance, if you prefer metric or 40 inches divided by the target distance. 40 is not exactly 1 meter, but it is close enough for this purpose.

To focus at a typical reading distance of 40 cm or 16 inches requires +2.50 diopters of additional PLUS in the eyes optical system. It can be supplied internally or externally or a combination of both. In your wife's case, with the readers, +1.25 is being supplied by the readers and +1.25 is being supplied internally.

Now to the part you can control. For their size, the Ciliary Muscles are the strongest muscles in the body. Normally they get plenty of exercise, but like all muscles in the body, if you don't exercise them, they get weaker. Presbyopia is very slow, but the Ciliary Muscles get weak very quickly. That means that wearing the readers is a two edged sword. They make focusing to read possible, but they also do some or ultimately all of the work for the Ciliary Muscles.

Are they doing harm if you wear them? Not really, but they can speed up the process of de-conditioning your Ciliary Muscles, which will happen anyway, when they can no longer squeeze your Crystalline Lenses enough to focus close.

You will ultimately need some focusing help. They will make reading more comfortable, but they will soon go from being optional to being necessary a bit sooner that will happen naturally.

People who need close focusing help at an earlier age than typica,l are people who have Hyperopia or what is called Latent (hidden) Hyperopia. It is possible that your wife has some Latent Hyperopia. The tiny text on smartphones has tended to reveal teens that have Hyperopia at earlier ages that is typical. I don't have time to explain it right now. Let me know if you are interested.

Hope this helps.

C.


Mike 11 Aug 2017, 07:04

Happy to find this site. My wife and I have never worn glasses, but she decided we should both have an exam. She is 32, I am 34. She complained about her close vision and was prescribed +1.25 for reading. He says I don't need glasses yet. Wife got hers and says they make small print larger and bolder and reading is more comfortable. I tried them, and found that for me small print is also bolder and larger. Is there a downside to me using her glasses? Will it long term have an effect on my vision?


AndrewL 10 Aug 2017, 04:00

Hi,

I am 52 and had a recent eye exam.

The prescription was:

L: +1

R: +1 -0.75 X 81

Add: +1.50

One year ago, I had my first eye test after many years and the prescription was:

L: +0.75

R: +0.50

Add: +1

I have never worn glasses in the past as I had not noticed vision problems. This last year I have got OTC readers of +1.5 for reading and also +0.75 for computer use. I ocasionally wear glasses for reading (in low light and for small print) and when I am very tired for computer use. I tested the computer glasses (+0.75) for distance and I could see perfectly from the Left eye at least but they did not make any difference from being bare-eyed especially for driving. Moreover, night-driving with the +0.75 glasses yielded signs of glaring vision around night lights.

Based on the above, what do you think is the best to do accoreding to distance vision (I certainly need glasses for reading small print).


Soundmanpt 03 Aug 2017, 08:07

mel

In looking at what you wrote down as your 2 recent prescriptions they both seem to be more for reading than distance. Now it could be that because your 2017 prescription now has more astigmatism included the doctor wants you to wear your glasses for both distance as well as reading. Astigmatisms effects your eyesight at all distances.


mel 03 Aug 2017, 07:57

I have had a mild prescription for longsightedness with slight astigmatism for a few years now.

My two most recent prescriptions are:

2017

L: +1.25/ -0.50 x 160

R: +1.00/ -0.25 x 60

2015

L: +1.25

R: +1.25/ -0.50 x 60

Both of the above prescriptions were provided by different opticians.I have a few questions:

a) The 2017 prescription was written for distance while the 2015 one was written for reading. The numbers look fairly similar so I am curious what the difference is wth these two prescriptions.

b) Under the VA column, there is 2B+5P written. What does this mean?


Xplore 02 Aug 2017, 01:10

So, I gave in and got some +1.00 readers to try and what a difference! Thinking of ordering some nicer ones online - Thanks


Cactus Jack 01 Aug 2017, 20:16

Rubydubes,

There is nothing like having the ability to focus thoughtlessly and effortlessly, as you could when you were young, but there are some pretty good substitutes.

There are three factors involved in apparent Presbyopia progression.

1. The slow resolution of Latent Hyperopia

2. The slow actual progression of Presbyopia

and

3. The rapid de-conditioning of the Ciliary Muscles because the Add is doing some of their work for them.

All of these factors work together to your detriment, but there is not much you can do about it, except refine your tools.

One important factor in visual comfort as we get older, is a reduction in tear production. When you combine that with a reduced blink rate, reading for long periods can get uncomfortable. You might consider getting some lubricating artificial tears. After trying several, I prefer the type based on a 0.5% solution of Carboxymethylcellulose Sodium. I don't recall where you live, but in the US a major brand is Refresh Plus. You may be able to find a less expensive store brand that has the same ingredients.

You might also want to consider ordering a pair of prescription single vision reading glasses. I like to read in bed and I pair that is a bit stronger than the reading segment in my regular glasses. Because of my age and having had cataract surgery, I have no accommodation, the Add in my glasses is strictly based on the focus distance. You still have some accommodation, but that will probably go away sooner than you would like. After your distance vision is corrected, the amount of PLUS required to focus at a particular distance is determined strictly by the laws of Optics. If you have some accommodation, some of that PLUS can be supplied internally, but the balance has to be supplied externally.

Progressives are really great at hiding the fact that you need focusing help, but they are optical compromises. There are some extremely good progressives such as Varilux, Rodenstock and Zeiss, but they are rather expensive.

In my opinion, as strange as it seems, trifocals are optically closer to natural vision because of their wider and distortion free fields of vision. I am sure there will be some disagreement, but that is OK. I suggest that you don't knock it until you try it.

I would suggest that you try wearing some +2.00 or maybe +2.50 OTC reading glasses over your regular glasses when want to read for a long time. You will need to look thru the distance part of your regular glasses while you are trying them. You don't need to spend much money for the OTC readers. The optical quality is not particularly good, but is is OK for this test. Very inexpensive OTC readers sold by some of the "dollar" stores are certainly adequate.

If you find that you can read comfortably with the OTC readers over your glasses, we can help you order some low cost reading glasses from one to the online retailers.

I hope this helps, If you have more questions, please ask.

C.


Rubydubes 01 Aug 2017, 12:28

In a follow up to my posts a few month back re: presbyopia progression and it's compounding effect with hyperopia - I wanted to pose another question Cactus Jack (or someone else that could help).

In the past two months I have been wearing my first pair of progressives, my prescription is as follows:

Right +4.5 -1.25 Add +1.5 BO .5

Left +2.25 -.25 Add +1.5 BO .5

While I find that the progressives are good for most tasks, I still find that if I have to read for long stretches or do a lot of writing I still get the same eyestrain and fatigue as I did before this updated prescription. I really don't like the fact that I can't sit down and read for as long as I want without feeling uncomfortable.

Are progressives limiting in their near focus abilities or is it just me? Nothing feels as good as my natural ability to focus at all distances before presbyopia set in....is this generally the case for everyone?

This whole RLE thing is starting to become more and more appealing.....


Cactus Jack 31 Jul 2017, 14:38

Charlie_Delta,

Could I ask you to contact me privately at cactusjack1928@hotmail.com

Have a question or two unrelated to vision.

It may not be very long before you consider trifocals. Curiously, lined trifocals are less noticeable for both you and others because the change from distance, to intermediate, to close is smaller than the change from distance to close.

C.


Charlie_Delta 31 Jul 2017, 12:02

Uncle Sam has delivered government-issued bifocals to my mailbox, the result of a three-month Army school I’m soon to attend (I’m in the reserves). One requirement is “two pair of Army-issued glasses” on the packing list, which is amusing because nobody really wears them after Army Basic Training. Yet they are required, and I was required to be seen by an Army optometrist to get this sorted out. Takeaways:

1. Manifestation of latent hyperopia caused an increase in both distance and near Rx in a matter of 90 days. Indeed, Cactus Jack’s frequent “don’t be surprised” warnings should be listened to, IMO especially if you’re a mid-aged and first-time glasses wearer due to hyperopia/presbyopia. A half diopter doesn’t sound like much of anything until you see the pencil-sharp results at all distances.

2. Bifocals are *glorious* in terms of functional use. These are the wide type (35 mm “flat top”), which really DO yield superbly-wide field of view for up-close work. I terribly dislike the appearance of a line in the lens, though see why bifocals are strongly advocated on this site. I’m not ready to make this leap but have been sufficiently teased by the optimal performance of bifocals.

3. Because the course I’m attending will have a constant and high demand for focusing from distance to up-close (powerpoint slides to computer display 20” away), I think I’ll try contact lenses for distance-only, and single vision glasses for up-close. I don’t think a progressive lens is practical to do both.

My progression has gone like this..

March; first Rx, for reading-only (due to headaches and focus issues, age 40).

OS: +1.00

OD: +1.50

April; fitted for multifocal contacts and also issued progressive glasses Rx of same values:

OS: plano

OD: +0.50

ADD: +1.50 (“medium” multifocal contact lens ADD)

July; noticed things got fuzzy again. Eyescene provoked me to get a re-test with presumption latent hyperopia was manifesting. It was. New/current Rx:

OS: +0.50

OD: +1.00

ADD: +1.75*

They sent government-issued computer bifocals to my door (lol) of the following Rx: OS +1.25 OD +1.75 ADD +0.75 and a pair of distance plus full-near bifocals with the correct ADD. A call to the OD’s office confirms the computer bifocal ADD was mis-entered.

In spite the dorkiness of Army-issued specs (especially the computer bifocals which in addition to a dorky frame have lenses extruding behind the back of the frame), life in “high def” has returned and I find myself wanting to go drive around for no reason. Everything is pencil-sharp!!

At +1.75 ADD though, I fear I’m reaching the high side of what’s practical for progressives, maybe even bifocals. Think I’ll settle for contacts for distance, glasses for near and a decent pair of progressive glasses with high-quality lenses for when I need a break from contacts. Multifocal contacts do work but aren’t optimal -- and I’m a clear-vision perfectionist!

Charlie


PhillinEngland 29 Jul 2017, 14:50

Cactus Jack,

If I'd have worn glasses earlier my life may well have taken a different path, I may never have met my wife....... you can see where this is going. I have very few regrets!

I've ordered online a couple of pairs of single vision glasses for distance, one pair with dark brown tinted lenses for sunglasses and the other pair just with the anti-reflective coating. It cost me a total of £30 for both pairs including shipping from Goggles4u. My old reading glasses suffice for computer work but are a little weak for reading so I may well take you up on the offer of a reading prescription sometime soon.

Phill.


Cactus Jack 28 Jul 2017, 18:00

PhillinEngland,

It is sad that with your family history of Hyperopia, the problem was not identified and solved sooner.

The important thing is that you have comfortable vision in all situations. You might find it useful to order some inexpensive prescription reading glasses from an on line retailer like Zenni (there are several in the UK, if you find yourself needing to read a lot. We can help you with a reading prescription if you decide to order a pair.

Let us know if you have any more questions.

C.


PhillinEngland 28 Jul 2017, 16:33

Hi Cactus Jack, thanks for the reply and the welcome!

I wish I'd found this site before my visit to the optometrist, I may well have chosen less expensive lenses or have gone for bi or trifocals instead. I am getting used to my varifocals now although I am already becoming aware of their limitations in certain circumstances.

My family has a history of hyperopia and I'm the only one in my family I know of who hasn't had glasses from a young age.

I now wonder, with what I've read about latent hyperopia, if it was responsible for some problems I experienced at school. I was a bright kid but I could never concentrate on text for long periods of time and if forced to do so I got an overwhelming feeling of rising tension, agitation and anxiety. I left school at 16; I just couldn't bear the thought of more school! I was also never been able to sit down with a book, I tried but always felt like launching the book across the room after a page or so!


Cactus Jack 28 Jul 2017, 15:46

PhillinEngland,

Welcome.

Probably both. Latent Hyperopia involves the Ciliary Muscles having difficulty relaxing and Presbyopia involves the Crystalline Lens. Your Ciliary Muscles and Crystalline Lenses work together as your Auto-Focus system that allows you to focus close and also internally correct Hyperopia.

As an FYI, it is difficult to predict when Latent Hyperopia is fully resolved, the only real clue is that your + Sphere stops increasing. Also, don't be too surprised if your Add also increases a bit more. If you have been following the posts here, you probably understand that the Add increase will stop and become absolutely related to focus distance.

Depending on your visual environment and needs, you may find, at some point, that trifocals are more useful than varifocals if you need a wide visual field at intermediate distances. Some people have both trifocals and varifocals for work and social occasions.

C.


PhillinEngland 28 Jul 2017, 15:25

Hi there, 1st time posting on here although I have read quite a bit recently.

I'm a 50yo male from England, factory worker who'd never felt the need for an eye test until last year. I went and saw an optometrist and ended up with reading glasses. I found myself wearing the glasses more and more and was getting regular headaches so decided it was time for another eye test. I visited the optometrists again and it was recommended I got some varifocals, these arrived last week and I'm now wearing them all the time and my vision and headaches are much improved.

Here are the two prescriptions (about 15 months apart).

od +0.25 -0.5 165 add +1.5

os pl -0.25 5 add +1.5

od +1.25 -0.75 165 add +1.75

os +0.75 -0.5 175 add +1.75

I was wondering if the change in my prescription was due to latent hyperopia becoming manifest due to my increasing presbyopia or just due to increasing presbyopia?


Brett 27 Jul 2017, 20:46

EyeTri, its too bad when they mess with a prescription that was clearly working when the decision is based on perceived ideas of what the average person would need and not what the refraction showed or what the patient has already been using successfully.


Cactus Jack 26 Jul 2017, 10:10

WWatson,

Were you wearing the OTC readers OVER your regular glasses while looking thru the distance segment?

If you were not, I would expect you to get headaches because you are forcing your Ciliary Muscles to do work they are not used to doing.

Strengthening your Ciliary Muscles in like lifting weights at the Gym. You don't start with a heavy weight, you start with a fairly light weight and lots of repetitions.

If you would prefer to wear go ahead and get glasses to help you focus close There is no real reason to try to strengthen your Ciliary Muscles. It is possible that your Ciliary Muscles are not causing the problem, but Presbyopia or other things are in fact, causing the problem. it does happen and there is no reason to put yourself thru the discomfort.

If you are having trouble using your Laptop with your glasses, your +2.00 Add makes it difficult to get by with the lower cost progressives. The optical problem is that the transition from your distance segment to the +2.00 segment has to happen over a very short distance. That makes it difficult to find a "sweet spot" where the Laptop is in focus and the field of view is wide enough to enable you to comfortably see much of the display.

If you use the laptop a lot. you might find trifocals a more useful solution. Progressives are nice, but most people who have been wearing progressives and have to switch to trifocals, don't regret it and wish they had done it sooner.

C.


WWatson 26 Jul 2017, 09:33

Cactus Jack and Soundmanpt

Thank you for your input.

I did try your suggestion to look through the "non-add"-Part of my glasses while doing close work. It does strain my eyes a lot and I could feel a headache coming, so I stopped.

Is that me already becoming dependant on the near add or is that normal?


CactusJjack 25 Jul 2017, 15:07

WWatson,

You could have some presbyopia issues even at 26, but I suspect you are also experiencing what happens when a mildly Myopic person does not wear their glasses while focusing close. It occurs pretty often.

Being mildly Myopic is like having built in reading glasses. That means that your Ciliary Muscles don't have to work as hard to focus your Crystalline Lenses. Your Ciliary Muscles and Crystalline Lenses are the Active elements in your Auto-Focus System. Your Ciliary Muscles are tiny. They are inside your eyes and their job is to squeeze your Crystalline Lenses to increase their PLUS power. For their size, they are the strongest muscles in the body. When they don't get enough exercise, they get weak and have difficulty doing their job.

The ideal thing is to re-condition your Ciliary Muscles, but that can take some time. The way you do it its to just wear your glasses full time and use the reading segment as little as possible while focusing close. However that may not be practical at first, for using your laptop.

It may be difficult to find the +1.00 OTC glasses Soundmanpt suggested. It depends on where you live. Usually the lowest power I find where I live is +1.25.

Another possibility is clip on +1.00 magnifiers. rx-safety.com offers clip on magnifiers in powers from +1.00 to +5.00.

Hopefully, you will be able to strengthen your Ciliary Muscles and solve the problem. However, if that does not work to your satisfaction, you might need to consider trifocals rather than progressives. The field of view in both the near segment is much larger and distortion free.

C.


EyeTri 25 Jul 2017, 14:36

Brett,

I had a similar experience with an optometrist quite a few years ago. I got my first bifocals when I was 31. About 8 years later I was working a long term field assignment in another state when I thought that I needed an eye exam as it had been a few years since I'd had one. By now my prescription (still bifocal) was +1.75 SPH for both eyes with an add of +2.50 (also a little cyl/axis in the left eye). When the optometrist finished he said that I needed an increase to +2.00 SPH, but he said that a 39 year old person should not have a +2.50 add. He said I should be able to get by with an add of +2.00. I tried to use this prescription for about two weeks and went back and told him I really struggled with that +2.00 add and wanted my +2.50 add back. He gave it to me and I got new lenses at no charge. About 2 years later I got my first trifocals and the rest is history.


Soundmanpt 25 Jul 2017, 13:57

WWatson

When you got your glasses 2 years ago your glasses were for distance and being on the weaker side you probably only really needed them for things like driving, watching TV, at the movies, sporting events and concerts. They really weren't meant for reading. In fact they actually made reading more difficult for you. When you were only say reading a book or doing anything that required close vision you should have taken your glasses off.

With progressives you just have to learn where the "sweet" spot is for reading things like your laptop. At first this can be tricky to find. Your head should be almost facing straight ahead with your eyes looking down through the add segment of your glasses. You can get separate glasses for reading but it would be best for you to simply learn how to use your progressives. Your "real" add is really very little actually. You have several options if you want separate glasses. You can go on line and order a pair of glasses from anyone of a number of places. One I suggest is Zenni (zennioptical.com) If you do that you want to order:

OD +.50 -.25 79

OS +.75 -.50 165

Or you might first try and find some over the counter readers and look for a pair with +1.00 power (both eyes)

and try them before buying them.


WWatson 25 Jul 2017, 10:11

Hi.

Two years ago I got my first glasses with -1.00 and -0.75, which I wore only ocasionally.

Howeverhave noticed that I have trouble reading while wearing distance glasses, but since I hardly ever wore them I didn't bother too much. I was due for an eyetest anywaay thre weeks ago so I went.

Affter I told the doc about my experience with reading while wearing my distance glasses, he tested my near vision as well - something had not done the last time.

The result was that I appearently need an add in my glasses. My new rx is:

OD -1.50 -0.25 79 ADD +2.00

OS -1.25 -0.50 165 ADD +2.00

I was told that appearently the add will have to be increased within a few months. Also, I was recommended to wear the glasses fulltime.

Well I did get them last week and they indeed are amazing. Using my phone is really easy and my eyes feel super relaxed now. The only problem I have is with my laptop as I can't seem to find the right way to look through the lenses and have to tilt my head a lot. I got progressives although not the really expensive ones as I was told I would be back in a few months anyway. Now I am wondering if I need to buy separate computer glasses but I have no idea which prescription they should be.

Now the thing is, I am only 26y old. What do you think about this - is this normal? And, should I wear those glasses all the time? I do like them but the idea of being dependant on them sort of puts me off.

W.


Brett 24 Jul 2017, 09:28

Cactus,

Thanks for the reply. I knew from all my time on here, that it wasn't uncommon even if it wasn't the norm to have a strong add at that age. Was definitely surprised that a DOCTOR would be getting making it sound like "worst he's ever seen" and would have a better "bed side" manner about it. Oh well. She's been going there well over a decade, and has had some issues before with what I'd call lazy doctors not really asking enough questions or doing a thorough lifestyle inquiry as to what she really needed. It is a big practice, but depending on which doctor you get that day it does seem to have issues.


Cactus Jack 23 Jul 2017, 20:39

Brett,

The idea that a person does NOT need focusing help until beyond their late 30w or early 40s is a myth. There can be many reasons. Presbyopia and / or Ciliary Muscle weakness. People with Hyperopia seem to need an Add at earlier ages than people with Myopia. Of course, today, the tiny text on smartphones is revealing focusing difficulties at very young ages.

I had natural mono vision in childhood, but it was not discovered until I was 14. My eyes really did not like working as a team when I got glasses. The result was that I had to get bifocals when I was 20 in University and trifocals when I was 30 with a near add of +1.75.

I was doing work that involved large drawings and could not read the text at the top of the drawings thru the distance part of my glasses. It was difficult to explain why I was on the drafting table trying to read the text with my bifocals. The solution was trifocals, but the ECP commented that I was too young to need trifocals. He reluctantly prescribed them, but I never used him again.

Glasses are just tools and you do what you need to do to see well under all circumstances. Never mind the conventional thinking.

I think I would consider changing ECPs.

C.


Brett 23 Jul 2017, 17:19

Wife went for an exam this weekend, not so much because she was having issues but because she knew our insurance would cover a free pair. In fact her prescription didn't change so she was happy about that, but it sounds like the Doctor was kind of a inadvertently a jerk a bit... Told her he had never seen anyone so young (32) that needed a 2.50 add and then also tried very hard to talk her into getting progressives over trifocals, all for cosmetic reasons. It didn't really bother her, but it was enough to make her tell me about it when she came out of the exam room, and then asked me if I would prefer for her have to progressives. I told her no, she knows I like watching her use her segments, but I said I wanted her to get what she wanted, and she said that she definitely wants trifocals so we picked out some nice frames. They are pretty current style: the thicker metal cat eye that at first glance almost like they would/should be plastic frames but aren't, and then getting thinner around the bottom of the lens. In kind of a black/gunmetal color. I did also for the first time in a few years, see her prescription as they gave her a copy because we were talking about maybe getting another pair for her online, and surprisingly the clerk out front quickly made sure we had a copy. And again, there were no changes this time. All I know is when she first started having intermediate troubles and going from bi's/progressives to trifocals about 6 years ago or so her add was +2.00

OD +2.25, -1.50, 10, +2.50

OS +2.25, -1.00, 60, +2.50


Cactus Jack 23 Jul 2017, 07:24

Mish,

Last post was for you. Spell checker got me again.

C.


Cactus Jack 23 Jul 2017, 07:23

Miss,

What you are experiencing is normal. Presbyopia, itself, happens very slowly, but as I have explained many time, most recently for Xplore, that there are 3 factors involved in the progression of Presbyopia.

The factor that happens the fastest is the de-conditioning or weakening of the Ciliary Muscles (focusing muscles). They are very tiny, but for their size, they are the strongest muscles in the body.

If you read a lot, progressives are not always the best choice for vision comfort. You may need to try some other options, depending on your visual environment.

If you could tell us a bit more, we might be able to offer suggestions.

1. Where you live?

2. Your Occupation?

3. Do you use a computer or read from a phone or tablet very much?

4. Do you like to read in bed?

You can easily calculate the PLUS you need to focus at various distances by dividing the focus distance into 100 if you prefer cm or into 40 if you prefer inches.

You may be able to supply some of the required PLUS, internally, but that will change over time. Just expect that to happen, until your add reaches +2.50 or maybe +3.00 unless you like to work on wristwatches. When you no longer have the ability to internally focus, the ADD is strictly related to the focus distance. It happens to all of us humans, with very rare exceptions.

C.


Mish 23 Jul 2017, 01:28

Hello,

I have never had to wear glasses until about 2 years ago. I had my eyes checked because I was getting headaches, and was given a prescription for glasses and told I would benefit from wearing them full time. The prescription was R +.25 cylinder 0 and L +.75 cylinder -.25 x 165. I wore them off and on but I didn't feel like they did much for me. I found that by the time I went for my next annual eye exam, that I was starting to wear them more and more. At that exam the doctor told me it was time for bifocals, so I got progressives with the following rx, R +.25 cylinder 0 add +1.50, L +.75 cylinder -.25 x 165 add +1.50. I got these glasses and was not able to adjust to them and only wore them when I was really tired and wanted to read or do close work. Again I was getting headaches frequently, but couldn't get used to my glasses so a friend recommended I order some online with a lower add. I ordered some new glasses with bigger frames and a +1.00 add. I received them about 2 to 3 months ago and once I wore them they felt fairly comfortable and my headaches seemed to go away. I have worn them almost full time since then. Now I've got headaches again even when wearing these new glasses, so I pulled out my glasses with the +1.50 add and they don't seem any stronger than the +1.00 glasses. I'm going to try wearing them and see if the headaches go away. I'm wondering if this sounds like a normal progression for someone to go through or is there something bigger going on? Seems like my vision is slipping away quickly, especially for someone who has never ever needed any correction until a couple of years ago. By the way I am 46 years old.


NNVisitor 21 Jul 2017, 12:06

Xplore

I'd like to mention a few things. If your eyes feel dry with the contact lenses in wear them less hours each day. Make sure you care for them in accordance with the instructions you were given. If they get dry reading without the contact lenses in blink more often as often we blink less when reading. Blinking should help lubricate your eyes. Take little breaks from reading. From twenty seconds to a few minutes per brake. Make sure to have brighter lighting for reading as it will induce less eyestrain and may also make print more clear.

When I was your age I had developed a difficulty to read small print with my contact lenses in. The opthalmologist suggested the following. He said get a newspaper page and go to a store that sells readers and try some on to see which power makes the print clear on the newspaper page. For me then it was +1.50. It may be different for you. He also said he could test my reading and write out a prescription for reading glasses if I didn't mind spending more by filling the prescription for reading glasses at an optical store.


NNVisitor 21 Jul 2017, 12:06

Xplore

I'd like to mention a few things. If your eyes feel dry with the contact lenses in wear them less hours each day. Make sure you care for them in accordance with the instructions you were given. If they get dry reading without the contact lenses in blink more often as often we blink less when reading. Blinking should help lubricate your eyes. Take little breaks from reading. From twenty seconds to a few minutes per brake. Make sure to have brighter lighting for reading as it will induce less eyestrain and may also make print more clear.

When I was your age I had developed a difficulty to read small print with my contact lenses in. The opthalmologist suggested the following. He said get a newspaper page and go to a store that sells readers and try some on to see which power makes the print clear on the newspaper page. For me then it was +1.50. It may be different for you. He also said he could test my reading and write out a prescription for reading glasses if I didn't mind spending more by filling the prescription for reading glasses at an optical store.


Cactus Jack 21 Jul 2017, 08:17

Xplore,

You posted

Left +3.75 SPH -0.25 CYL. 25 AXIS

Right +3.50 SPH. 0.50 CYL. 170 AXIS

The lack of a sign on the Right CYL caused my confusion.

As an FYI, Optometrists typically use - Cylinder and MDs typically use + Cylinder. It really does not matter because lens makers use a simple math procedure to convert from + Cylinder to - Cylinder and make the glasses.

The purpose of your contact lenses (or glasses) is to correct your distance refractive error to as close to 0.00 as possible. Everything else starts from there.

As I mentioned, Presbyopia actually starts in childhood, but typically does not become a problem until the late 30s or early 40s. When Presbyopia starts causing problems it will seem to happen very fast.

I would try some Over-the-Counter reading glasses. The stores that sell them typically have powers from +1.25 to +3.50 in 0.25 steps. You can usually try different powers in the store. but usually the stores are brightly lit, which may cause you to choose a lower power than you really need for your situation.

Before you go looking for the reading glasses, measure your typical reading distance when you are reading your iPad in bed (it is usually less than your typical reading distance), then do a little math. If your measurement was in cm, divide the distance you measured into 100 cm. If your measurement was in inches, divide the distance into 40. The result is the lens power in diopters required to focus at that distance.

Let me give you an example. I also like to read my iPad in bed. I typically hold it at about 30 cm or 12 inches. Using the formula above, that means that I need 40/12=+3.33 to focus at that distance. That +3.33 has to come from somewhere or what you see will be out of focus.

When you were young, your Ciliary Muscles and Crystalline lenses easily supplied that, but now they can't do it anymore, so you need some additional external PLUS. If you have completely lost your ability to focus, which will ultimately happen, you would need +3.25 or +3.50 glasses to wear over your contacts. You can't buy +3.33, but that isn't a problem because you would just move the iPad a small amount to for the best focus.

It is likely that you can still supply some of the PLUS you need to read at your preferred distance. There is really no way for me to tell exactly where to start. Ideally, you want to start as low as you comfortably can. Frankly, you could start with OTC glasses in the +3.00 range, but you want your Ciliary Muscles and Crystalline Lenses to do as much of the work as they comfortably can, to keep your Ciliary Muscles strong. The hard reality is that your Ciliary Muscles will get weaker fairly fast. What that means is that you can start with glasses in the +1.50 range, but you will soon need stronger reading glasses. That is why I suggested getting the lowest cost readers you can find.

You mentioned headaches when you read with your iPad. The headaches are a common symptom caused by your Ciliary Muscles straining to focus your Crystalline Lenses. You need to give them some help. Speaking from experience, the usual pattern is to start with a low Plus in the +1.50 range. It will increase to the +2.50 to +3.00 range. At some point, you may find that reading power is such that you have trouble focusing at intermediate distances (computer displays for example). That problem can be solved best with trifocals. Progressives can sometimes help, but their field of view is often too small to be very useful at intermediate distances if you do it a lot.

Hope this helps some.

May I ask where you live?

C.


Xplore 21 Jul 2017, 06:57

Cactus Jack,

I've checked and the SPH is definately plus and the CYL is minus. Do you think that my eyes could have got that noticeably worse that quickly? What power reading glasses do you think

I should try?


Cactus Jack 21 Jul 2017, 02:14

Xplore,

Your contact lens prescription is a compromise Sphere only prescription to avoid using Toxic contact lenses to correct your mild Astigmatism. I would suggest that you check the glasses Cylinder correction for the sign on the Cylinder power. They should be the same sign. An optical prescription can be written with either + Cylinder or - Cylinder, but they are typically the same sign for each eye.

As prescriptions go, yours is a moderate PLUS for Hyperopia. Prescriptions can go much higher depending on the cause of the Hyperopia.

Both Hyperopia and Myopia are caused by a mismatch between the total PLUS power of the eye's lens system and the size or length of the eyeball. In a typical eye, the total PLUS power of the eye's lens system is about +59 diopters and the distance from the Crystalline Lens is about 17 mm. The most common cause of Hyperopia is the failure of the eyeball to grow quite enough in the childhood and teen years. The amounts are tiny about 0.3 mm per diopter. In your case, your eyeballs are probably about 1.3 mm too short and you need some external PLUS to move the focus point up a very little bit.

Incidentally, Hyperopia is the ONLY refractive error that you can correct internally using some of the power of your Auto-focus system, which consist of the Crystalline Lens and the Ciliary Muscles. Unfortunately, at 46 Presbyopia is probably creeping up on you, gradually robing you of the ability to focus close to read the small text on an iPhone or iPad.

There is only one solution, you need some extra PLUS to help you focus. There are several ways to get the extra PLUS.

The most common solution, if you wore glasses is Bifocals or Progressives. With contacts, you can get some OTC reading glasses or they make multi-focal contact lenses, but you may find them awkward for reading in bed. You can even get Bifocal Glasses with no prescription in the distance pard and additional PLUS in the reading part.

Another solution is what is called Mono Vision. That is where you wear two different powers of contact lenses. Usually your actual prescription in your dominant eye and say + 2.00 to +3.00 more in your other eye. Your brain will select the image from your clearest eye without your even being aware that it is doing it.

None of these are probably very appealing, but unfortunately, that is the way it works as you get older. You can deny all you want to, but human beings have been dealing with the loss of focusing ability for a long long time. As I said earlier, welcome to the senior citizens club.

If you wear contacts full time, I suggest some OTC readers for extended periods of reading as an initial low cost solution. OTC readers don't have to cost much. If you live in the US, you might find some in the $.99 stores for just a dollar or two. They are not optically wonderful, but they will do. Be aware that once your start wearing external PLUS help, the need will increase faster than you think, but it will probably never get more than about +3.00 or +3.50 unless you take up wrist watch repair.

If you wore glasses, I might also suggest some clip on magnifiers. They work great.

If any of this is a vanity issue, please be aware that no one really cares if you need vision correction. Any comments are no different than getting a different hair style or new shoes. If you want to read a humorous, well written saga about a new glasses wearer, check out Macrae's Story on the Vision and Specs website.

C.


Xplore 20 Jul 2017, 22:41

Cactus Jack

Thanks for this, my prescription for actual glasses is a little different from contacts, which I think is normal. For glasses it reads

Left +3.75 SPH -0.25 CYL. 25 AXIS

Right +3.50 SPH. 0.50 CYL. 170 AXIS

Is this considered a weak prescription? I have seen on here plus numbers in the high teens and low twenties? I do wear the lenses all the time tho. Like I said I am now having real trouble reading and using phone etc. My job means that contact lenses are ideal, so I am looking for a

Solution that works with them.

Thanks


Cactus Jack 20 Jul 2017, 11:14

Xplore,

Oops, sorry about that. The spell checker is too efficient and I did not catch it.

C.


Cactus Jack 20 Jul 2017, 11:11

Explore,

The ability to focus close can appear to change rapidly. There are likely 3 factors at work in your situation.

1. The primary issue is Presbyopia, which is the gradual stiffening of the protein that makes up your Crystalline Lenses. It actually starts in childhood, but typically does not become a nuisance until the late 30s or early 40s. It sounds like you are fortunate that you have not needed close focusing help until now, but Presbyopia is rearing its ugly head.

2. Rapid reconditioning of your Ciliary Muscles. That will happen when you start wearing bifocals or progressives, but probably not very much yet.

3. Operating in low light conditions, such as you described. Even though with your iPhone or iPad, you are looking into a fairly weak light source (I also like to read in bed using my iPad.). The low light conditions cause your pupils to open up which has the same optical effect as a photographer taking pictures in low light conditions. High end cameras have a lens adjustment, called the "f" stop which controls the Iris opening in the lens. There is a phenomenon called "depth of field" or "range of useful focus" that is usually quite broad when the lens opening is small and much narrower when the Iris is open wide. The same thing happens when you pupils contract in bright light and open up in low light conditions.

The point of all this is that you need some close focusing help. Welcome to the club. It happens to nearly everyone.

Try some Over-the-Counter readers in the +1.00 to +1.50 range over your regular glasses and see if that helps. Also, get some artificial tears with lubricant. That will help with the dry eyes.

You can expect the amount of Plus you need for reading help to increase over a few months. However it will not go beyond the amount of plus indicated by the formula 100 cm / focus distance in cm or 40 inches / reading distance in inches.

I am a few years older than you are and have been wearing bifocals and trifocals for many years. I also have a pair of single vision reading glasses that are effectively my distance prescription adjusted with a +3.00 add for reading in bed.

If you can supply your complete prescription, we can help you order some inexpensive reading glasses with what ever Add you prefer.

I also use generic equivalent to "Refresh Plus" Lubricant Eye Drops. They are a 0.5% solution of Carboxymethylcellulose Sodium and they work great for me.

You may also experience some changes in your distance prescription, if your Hyperopia includes some Latent Hyperopia. That happens to a lot of people also.

Please let us know how we can help.

C.


Xplore 20 Jul 2017, 08:01

Ok, so I have a question, how quickly can a reading prescription change? I wear plus contact lenses, +4.00 L and +3.75 R but recently, well actually only over the last few weeks I have been noticing more headaches and dry eyes, this has coincided with using an iPad and iPhone more, often at night in darkness, so the only light comes from

The screen. I last had a check up about 4 months ago and nothing was mentioned so wonder if it's time for 'readers', by the way I am 46.


Greg 18 Jul 2017, 07:45

Thanks Plus Tony. Keep us posted on your presbyopic progress. Many thanks!


Plus Tony 12 Jul 2017, 10:25

Hi Greg

Not yet but I suspect it will be this year (although I thought that last year). Thanks for asking. Next eye test due in September.


NNVisitor 11 Jul 2017, 23:40

I've actually noticed a lot of people who wear bifocals. I've also noticed a lot of people with myopia glasses who simply take off their glasses to read.


john 11 Jul 2017, 20:09

Alix, I have both lined and progressives . I use lined all the time and progressives never anymore. The progressives bend everything when you move your head back and forth .I wore them for around 3 weeks constantly and went back to lined.You will take a few days to get use to your bifocals and then there is no going back-there addictive.


Maxim 11 Jul 2017, 16:25

amendment to Cactus Jacks remark:

I have got both, progressives and lined bifocals.

The lined bifocals have not only a distortion free reading field - what I felt, there is much distortion to the right and to the left in the distance vision field (with progressive lenses), and the distance vision is nearly distortion free in the lined bifocals.

For me, I prefer the lined bifocals absolutely when driving, as the distortion in the progressives means very much irritation to me.


Greg 11 Jul 2017, 14:35

Mr. Plus Tony, just checking to see if you are still wearing single vision lens or have "graduated" to multi-focals.


Cactus Jack 10 Jul 2017, 17:43

Alix,

Lined Bifocals will give you a distortion free reading segment. Progressives tend to introduce distortion in the transition zones.

C.


Alix 10 Jul 2017, 16:12

Well guys, thanks for the inputs so far. I am thinking going to go for the bifocals. From looking here, seems like lined bifocals aren't bad just not the most appealing cosmetically. However, i will admit think the lined kinda of appeal to me. Think gonna go for a bigger frame as well than normal. Something that adds to them.


NNVisitor 08 Jul 2017, 21:35

Alix

Zenni Optical (online) has a huge frame selection and their prices are very resonable. Cheap prices especially compared to most bricks and mortar stores. You do need to know your PD before you order. Your current glasses will show the size of the frames either on the arm or the bridge. You may need a magnifying glass just to read those numbers. You can either order some bifocals online or if you prefer just reading glasses. For those subtract the add from your current glasses which at +1.25 add would be -5.75. If you go this route you will need to switch glasses when you read. With bifocals there's no switching.


Andrew 08 Jul 2017, 13:54

Alix,

Yes.


Charlie_Delta 08 Jul 2017, 10:57

Welp, “latent hyperopia” is a thing, apparently. Over the course of 3.5 months, +0.50 increase in both eyes for distance and +0.50 increase to the ADD since the preliminary appointment in March (ADD increase was caught about three months ago however, when I had a contact lens fitting through a different optometrist). The OD felt my prescription will be generally stable from this point forward but offered to take another look in three months or so.

I’d like to invest in a good pair of frames/progressive lenses (painfully expensive) but remain on the fence to do so if latent hyperopia might be continuing to manifest. Certainly don’t want to pre-purchase lenses in another 3-4 months. Any golden rule to this? I am not noticing further changes in vision, but can't be certain either.


Cactus Jack 07 Jul 2017, 20:19

Alix,

Presbyopia typically becomes a nuisance around 40, but it varies considerably by individual and their visual environment. Presbyopia is primarily caused by gradual stiffening of the protein that makes up your Crystalline Lens. A secondary and also important factor is the de-condidioning of your Ciliary Muscles. The two of them are the active part of your Auto-Focus system. For their size, the Ciliary Muscles are the strongest muscles in the body, but they can get de-conditioned very rapidly. It is this de-conditioning process that causes focusing problems to seem to progress very rapidly, once you start wearing bifocals, progressives or other close focusing aids.

At some point, you WILL need some reading and close focusing help. It is almost inevitable. However, when you decide to "bite the bullet" is pretty much up to you.

You should consider ordering glasses, with an Add, on line. Just remember that the amount of Add you need will likely increase as your Ciliary Muscles loose their tone. However, the amount of add you need will likely not increase beyond about +2.50 or +3.00 unless you do a lot of very close work.

Another possibility is to simply get some over the counter reading glasses and wear them over your regular glasses (in private of course). Another possibility is Clip on Magnifiers offered by RX Safety Glasses. They offer powers from +1.00 to +5.00 if I remember right and are pretty handy.

By the way, the actual amount of PLUS reading help needed to focus at any distance is easily calculated. if you like to use cm.: Divide the measured target distance into 100. If you like to use Inches: Divide the measured distance i to 40 (it is not exact, but close enough). The result is the lens power in diopters.

Just remember that lenses typically come in 0.25 diopter increments.

You can order glasses with an Add of +1.25. They will help and your Crystalline Lenses can supply the other +1.25 needed to focus at 40 cm or 16 inches for typical reading distance.

The reason it is easier to focus in bright light is an effect known to photographers, called Depth of Field. When the camera lens opening is very small in bright light, things are in focus over a wider range of distances. The same thing happens in your eyes when your pupils contract in bright light. At night, your pupils open up to let in more light and your range of useful focus (Depth of Field) decreases and you have trouble focusing.

C.


Alix 07 Jul 2017, 19:13

Hi guys,

Came across this and was wondering when do you know it's time to get an add in your glasses. Just had an exam a couple months ago and was given the option of a 1.25 add but turned it down. Now I am wondering whether i should order some bifocals online. Just turned 40 and eyes are -7 in each eye. Do ok, but notice at night that eyes get a bit tired. Thanks!


Plus Tony 07 Jul 2017, 05:08

Carrie

I was interested to read your post about how you experience dizziness for a few seconds when you put your glasses on or take them off. Is that something that you have always experienced or is it something that you've noticed more as your prescription has got a bit stronger or is it maybe because of the little bit of astigmatism correction?

Your point about growing up is very true. Those of us who are longsighted can struggle on for a long time but now that I've had glasses for a couple of years I really wish I'd had them for longer. I share your enthusiasm not just for being able to see better but for the way that wearing glasses all the time makes me feel. I would feel really strange now if I wasn't wearing my specs. I also really like it when I have to renew photo ID cards now and I can update the picture to one with glasses. I guess a lot of people would see it as a disadvantage but the 'real me' is the one with glasses.

I'm sure that one day Danielle will finally give in but I suppose the most important thing is that she can see clearly when she feels she needs to!


Cactus Jack 05 Jul 2017, 18:41

Guest,

The multiple posts are typically the result of clicking on "Submit" several times. Sometimes the server is slow. If the Submit button changes to White Letters on a Blue background, your submission has been accepted, but it may take a few seconds for it to appear.

You might investigate Clip on Magnifiers offered by RXSafety Glasses. I believe they offer powers up to +5.00. They are relatively inexpensive and I find them quite useful.

C.


Roy 05 Jul 2017, 06:40

Guest,

If your need -4 dioptres to correct your myopia and then wear +2 for reading this is effectively increasing your myopia to -6 and giving you clear vision at a distance of about 6 1/2 inches. Typically opticians will only prescribe a maximum reading add of +3.5 which corresponds to a clear vision reading distance of about 11 1/4 inches.

I am 70 years old and also do electronics work. At my last eye test my optician confirmed that I have effectively zero acmmodation left, but still did not want to prescribe an add higher than 3.5. I bought some glasses online with an add of 5.0 and find these much more comfortable for close work such as electronics and reading small text on phones etc, although I am happy with 3.5 for general reading. There are times when even the add of 5.0 seems not quite enough and I would imagine that +6 as you have could be ideal for intricate close work.

As we put more and more demands on our eyes I think there will be more demand for higher "adds" to help with presbyopia and I would not be surprised to see these becoming more easily available.


Guest 05 Jul 2017, 03:56

I've noticed recently that I'm struggling to see close up whilst working on repairing electronics stuff. I have -4 both eyes for distance and have had to remove my glasses now for several years to do close work but now I find I still cant see to do some close soldering jobs. I've found that wearing +2 reading glasses is actually perfect for me for these tasks and also better for reading small text on my iphone. I was just wondering why I need so much + power (by the way I'm aged 63), it seems a lot or is this perfectly normal?


Guest 05 Jul 2017, 03:56

I've noticed recently that I'm struggling to see close up whilst working on repairing electronics stuff. I have -4 both eyes for distance and have had to remove my glasses now for several years to do close work but now I find I still cant see to do some close soldering jobs. I've found that wearing +2 reading glasses is actually perfect for me for these tasks and also better for reading small text on my iphone. I was just wondering why I need so much + power (by the way I'm aged 63), it seems a lot or is this perfectly normal?


Guest 05 Jul 2017, 03:56

I've noticed recently that I'm struggling to see close up whilst working on repairing electronics stuff. I have -4 both eyes for distance and have had to remove my glasses now for several years to do close work but now I find I still cant see to do some close soldering jobs. I've found that wearing +2 reading glasses is actually perfect for me for these tasks and also better for reading small text on my iphone. I was just wondering why I need so much + power (by the way I'm aged 63), it seems a lot or is this perfectly normal?


Soundmanpt 04 Jul 2017, 10:01

Carrie

I completely agree with you that Danielle's job at the very least exposed her need for glasses. The type of work a graphic designer does is very detailed. Doing that 8 hours or more a day 5 days a week would strain anyone's eyes badly. That eyestrain was why her eyes felt so tired by the end of the day. Her eyes were over worked. I'm sure her eyes even burned at times besides being bloodshot. There wasn't anything she could possibly do to prevent her from needing glasses. By trying your glasses on and looking at something such as her phone or even a table menu she quickly noticed that it was much easier for her to see small print wearing your glasses. That's because the lenses of your glasses are much like magnifying glasses. So they made reading small print much easier for her. I'm sure she was surprised at how well she could see wearing your glasses. Of course your glasses wasn't necessary for her to see distance so she probably wasn't able to see distance very well wearing your glasses. There is no way of knowing when Danielle started to need glasses, but it is very possible that she still had 20/20 eyesight when she started at her job. But it is also possible that she may have had a slight need even before that. I get the idea that you seem to think that from the time you get your first glasses prescribed to you that the doctor already knows what your final full prescription will be but only gives you a small part of it over time. The doctor can assume that from year to year your eyes are going to be changing but even they can't predict by how much. Way back when you got your first glasses, they were only +.75 / +1.00 and that was all your eyes needed at the time to allow you to see small print perfect and relax your eyes from eyestrain if you were doing much close work. That's the same with Danielle. Her doctor only gave her what her eyes needed to bring her eyesight back to perfect with her glasses. Recently Danielle's eyes hasn't really changed much at all but she seems to be needing her glasses more with each passing day. That's because her eyes are much more comfortable when she wears her glasses now. Her eyes miss not having them on now. She is losing the ability to hold focus without her glasses. When she has her glasses off she has to work at holding focus and that can't be comfortable for her. As for Vicky I shouldn't have used the term "wrecked" in regards to what she has done to her eyes because she can still she pretty well without her glasses. If I recall Vicky had gotten her eyes checked several times over the years and she always had perfect eyesight. When she first started wearing Danielle's backup pair you may recall that she could see fine to do her job which called for her to be able to check people out at a cash register and read receipts. Danielle's glasses were weak enough that she could easily read small print wearing her glasses because they actually made the small print slightly bigger and easier to read than without glasses. But like you know when she looked at anything in the distance it was too blurry for her to see very much so she would often have to take the off if she needed to see at a distance. But the more she wore Danielle's glasses the more her eyes were adjusting to them. And when Daniele want her glasses back they went on line and ordered Vicky a pair of glasses slightly weaker than Danielle's glasses and those worked much better for her because now sh wa able to see distance as well as close up. So it is impossible to know if Vicky would be needing glasses today if she hadn't wore Danielle's glasses? At the very least she pushed things trying to cause her to need glasses. Have a great day!


Carrie 03 Jul 2017, 12:41

Soundmanpt - I think it was Danielle's job that made her realise that she did need glasses rather than it being the cause of needing glasses. She had been aware for a while that her eyes felt tired after work but thought it was normal. It was trying my glasses on and seeing clearer made her get her eyes checked. If she had good eyesight to start with I would have thought her eyes would stay "20 20" or even become slightly short/nearsighted. Obviously I don't know for sure but I think she's always needed her current prescription but had good accommodation and her optician took her half way with her first prescription so she could adjust gradually. I'm pretty much the same and I'm sure I wouldn't have been able to cope with my full prescription straight away as even now I feel a little dizzy for a few seconds when I put my glasses on or take them off. I definitely need my glasses all the time as my close up vision without glasses is terrible now (although I can strain to read but it's hard work) and my distance vision isn't too bad it's much more comfortable with glasses. In fact I am sure I can see far better now at all distances with glasses than I could for some time before I got my first glasses. I probably should have got glasses at school!

It probably is sort of to do with growing up - when you are young your eyes can accommodate easily then as you get older your eyes can't do it so easily. Some people's eyes can accommodate for more years than other people's eyes. Mine and Danielle's held out for longer than Gemma's.

Danielle doesn't have a problem with how she looks in her glasses - she looks good and she knows it! She didn't mind too much needing them for reading but now she's at the point where she could wear them all the time and is approaching the point where she should wear them all the time she's not so happy. She is a very independent woman and maybe feels that she is losing some of that independence by depending on glasses or contacts.

I know Danielle has always thought it strange that Vicky wants to wear glasses but if it makes Vicky happy then so be it. I don't think Vicky "wrecked" her eyes. She probably had good accommodation to wear Danielle's first glasses but probably already had low hyperopia rather than Danielle's glasses causing it. At her last eye test Vicky's hyperopia went down and her astigmatism went up.

I'm sure Vicky does have a glasses fetish but I will let her confess if she wants to rather than me asking her. I wonder if she's thinking the same thing about me?😄


Charlie_Delta 29 Jun 2017, 14:29

Rubydunes,

Glad to hear you're seeing clearly now! If I were you though, I'd hold off on considering RLE for at least five years. Lots of exciting innovation going on right now w/ topical solutions aimed to reverse/eliminate presbyopia. I also went down a rabbit hole last night and learned that there's *very* strong evidence that the cilliary muscle doesn't atrophy, as many scholars hypothesized for centuries. It just weakens because it doesn't have a use after the lens hardens. That said, a lens that suddenly became smooshy again, haha, may very well promote the eye muscles to re-strengthen. Crazy cool if that turns out to be proven in the near future.

Though it's important to note that only about 1/3 of all drug trials make it past Phase III in the U.S., I want to share this link with you, which includes a presentation and slide deck by Encore Vision; a boutique company (recently sold) that existed for a decade for a single mission: to cure presbyopia with a topical solution:

http://ois.net/topical-treatments-for-presbyopia/

...and note the substance this company created isn't really a drug in the sense of it being a foreign compound to the body. To the contrary, it's simply a compound consisting entirely of a chemistry already produced by the crystalline lens. I look forward to following where this goes. Also, FWIW, Encore Vision was purchased by Novartis for a huge sum of money ($465 million USD) just after this presentation was made.

Sage advise and points well taken on everything you mention.

Cheers,

Charlie


Ruby dunes 29 Jun 2017, 12:59

Charlie- Delta,

My new progressives are wonderful. I really hate the fact I need them, but after a few week or so of wearing them my brain surely loves them! Of course. The more I wear them the less I can get by without them and like you have become a full spectator in the demise of my natural vision ! The upside of this is that it is correctable and it is not pathological ( trust me, I too have second guessed what I was told and have had three full exams with retina imaging,etc) .

I still sorting out contacts. Multi-focal contacts are a complete bust for me- lots of ghosting, poor distance vision , etc. my best bet this far is a pair of single vision using a toric in my weaker eye to also correct the astigmatism. They are great for outdoors and when I don't need a lot of power for up close But the glasses still reign supreme! My next visit is to a specify contacts guy who apparently is amazing at finding the perfect contacts for you. We will see .

If it makes you feel any better, one optometrist I visited mentioned the beginning of presbyopia is the worst for latent hyperopia bc there is this period of gradual relaxation of those over-taxed muscles and it makes it all seem so dramatic in terms of change- remember, this is just a refractive error.

I am going to discuss rle exchange with an opthamologist in a few months but more so to gain I do for down the road. As long as my glasses are ok I won't risk anything irreversible unless I have to.

I am beginning to think that a big part of why this is so troublesome has a lot more to do with vanity and the psychological aspect than it does the actual condition of the eyes. No one likes things out of their control and it is also a stark reminder that time marches on!!

If you are also a bit probe to over-analyzing things and a bit of anxiety like me then this whole thing becomes a lot worse than it is!!!

Look at children with huge prescriptions- they just get I with it and don't think twice. I think we could both stand to learn from that !!! ;)


Lou 29 Jun 2017, 11:13

Hi

I had my eye test today. Apparently I am very easy to test because I am very definite which test lens I like best, and always come back to the same one, however many options I'm given. My optician also said that I choose exactly the same as she would suggest from her side, if I had been unable to communicate. My near vision is still ok, and I don't need an add yet. Apparently there is nothing to suggest that I have latent hyperopia, rather that I am visually very sensitive, know exactly what lens gives me the best vision, and by wearing my glasses intermittently, I am basically doing the same as switching being the lens I like and one which is less sharp, and I'm getting eye strain a result. Since I get eye strain if I don't wear my glasses at all, and none when I do wear them, my optician has suggested wearing my glasses full-time, and putting them on first thing in the morning, so that there is no switching between glasses and no glasses.

She also said that my convergence was poor, and recommended restarting my 2010 eye exercises.

Anyway, my prescription is unchanged at:

R: +0.50 Sphere -0.50 Cylinder Axis 92

L: +0.25 Sphere -0.25 Cylinder Axis 85.

All the best

Lou


Soundmanpt 29 Jun 2017, 10:14

Carrie

I know you really enjoyed being able to talk to Danielle about eyesight and glasses. But at the same time you had to be careful not to sound like you know too much about the subject as well. You're probably the perfect person to encourage Danielle about giving in to wearing her glasses full time because you wear your glasses full time with complete confidence. She clearly still doesn't have total confidence in her looks wearing glasses to just go full time glasses and be done with it. She can't stop herself from becoming more and more dependent on her glasses which she is slowly starting to realize. Things change in 5 years and many times even sooner than that. So she may have still had perfect eyesight 5 years ago and you Carrie had perfect eyesight 7 years ago, or so. But you don't anymore and neither does she. Could be nothing more than a part of growing up or in her case job related, doing so much close detailed work is sure to that at least some toll on the eyes. But we all need to work so if it means wearing glasses so you can continue doing your job, you wear glasses. Your advice to her about it being better for her to simply wear her glasses rather than waiting until her eyes are tired or strained and the putting them on is very silly. She has already admitted that she can't read small print anymore without her glasses and she can't see distance very well anymore with her glasses so what does that really leave that she can see without glasses? Not much. But if she is only sitting talking with you and others and she is more comfortable going without her glasses that's fine. But she just won't be able to anything at a distance clearly or anything close up. Of course you could do the same thing if you wanted to. You're still able to see okay without your glasses but you are fine with keeping your glasses so if you do need to see something you will be able to see it perfectly and have to be pulling your glasses out and putting them on. The point is she already does need to be wearing her glasses full time but she just doesn't want to accept it yet. I wonder what she thinks of Vicky purposely wrecking her eyesight just so she can wear glasses full time and Danielle is trying so hard to not need to wear her glasses. Vicky is the one I think would be interesting for you to get into a chat about eyes and glasses because i'm pretty sure she has at least a partial glasses fetish.


Lou 29 Jun 2017, 04:51

Hi Rubydubes

Thank you very much for your helpful reply, which is really appreciated.

I'm not sure what it going on, but at least in my case, either the sphere or cylinder of my prescription decreases at the day progresses, more so if I don't wear my glasses all day.

Best wishes

Lou


Carrie 28 Jun 2017, 13:54

I was chatting with my friend Danielle and we actually got on to the subject of eyesight. She said she finds it hard to get her head around the fact she needs her glasses so much now when 5 years ago she didn't have glasses at all and then when she got her first ones the same year she only needed them for reading. She is also wondering if her sight will get worse as she feels her current glasses are a lot stronger than her first ones. I told her that judging by the fact that she didn't need a new prescription at her last eye test and only a tiny increase at the one before she probably won't need a stronger prescription next time. I reminded her that the same thing happened to me, and that my prescription also seems to have stopped increasing after several increases, although my prescription is a little higher than hers and I need my glasses all the time. I said I had done a bit of research and told that our opticians had most likely given us gradually stronger prescriptions so we could adjust to our final prescriptions. I also told her that her eyes, like mine, had probably been straining for quite a while before getting glasses and hadn't got worse exactly but just relaxed/stopped straining. Then I advised her that in my opinion she shouldn't fight tired eyes or eyestrain and put her glasses on if she felt her eyes were tired or strained and it would be better if she put her glasses on before it happened. She said her eyes seem to get tired more often now and only she gets eyestrain if she tries to read without glasses for more than a few seconds or concentrates on distant objects without glasses like driving or watching tv. Wearing them for watching tv is a relatively new thing for her. I actually asked her why she doesn't just wear her glasses all the time if she needs them so much. She replied that she doesn't get eyestrain when she isn't concentrating on anything so doesn't wear her glasses then. She admits she does need her glasses more now for all distances than she did 6 months ago and is preparing herself for getting to the point when she does need her glasses all the time but will continue to avoid it for now.


Charlie_Delta 28 Jun 2017, 11:06

Rubydubs,

How are your new glasses treating you? I absolutely wouldn’t rule out surgery after things stabilize – will be interested to hear what you learn in the event you’re considering this route still.

Recently, I’ve had a good bit of fury/anxiety with what seems to be a drastic change in visual acuity – of the degree I became worried there might be some sort of pathological root cause.

On a whim, I opened up this thread (goes back a decade or more) and searched the words “months” and “increased." I'm now less concerned of something pathological as I have no symptoms other than intensifying blurring at distance and near; particularly in my dominant right eye which has been significant -- everything blurry at all distances without correction. As of right now, I think it’s just a case of sudden and significant latent hyperopia. The sudden-ness is a cause for a little concern though, still.

I hate the double-edge sword aspect of this. Glasses for computer removed major headaches, a necessity, but soon after shifting to multifocal contacts most of the time, my naked eye vision has gone right down the toilet. The computer glasses went from being a godsend to being required OVER the contacts just to get work done. Without contacts in, those glasses went from a blur point just beyond my desk, to the other end of the couch if I was laying down, to the TV across the room, then into the other room, and now to a point where I see at far distance much better with them on than off (+1.50 right, +1.00 left). I don’t think I can drive anymore without correction.

This all happened in 3.5 months, and now if I’m home alone without contacts in, I need to wear the backup pair of those glasses upside down OVER the usual pair just to use a laptop. Obviously what started as a headache relief silver bullet has become a major headache in the figurative sense -- and honestly scary in a certain sense. I wasn’t planning to have my eyes tested in March and end up not seeing a damn thing in the shower a few months later. Like so many others have stated, it also feels like my eyes have gotten much weaker (especially in the eye requiring more correction) – like focusing muscles just want to stay relaxed now (and oftentimes do). Makes me feel like I’m ruining myself but there really isn’t a viable workaround other than a prescription boost.

Will be scheduling another appointment as it’s become quite evident a change in Rx is required and I can't really put this off anymore. I have no idea when latent-manifest process will settle down or stop but hopefully the majority of the emergence of latent hyperopia is past me now. I’ve become more at east after reading similar stories on here -- very thankful for this thread.

Charlie


Rubydubes 27 Jun 2017, 16:03

Hi Lou-

If it helps any, I have had similar experience (although with a much greater prescripton) which became very noticable when I hit around 43 as well (I am almost 45).

I have always been farsighted and had a hefty prescription my whole life but managed to get by without glasses from about age 10-40 without any issues. Since my early forties my reliance on glasses became here and there to finally full-time (which I really don`t like!). Currently my prescription is:

R: +4.5 -1.00 ADD +1.5

L +2.25 -.25 ADD +1.5

There is also a small amount of prism in my glasses as well.

I think what is happening with latent hyperopia is that unlike non-hyperopic people, presbyopia does not just affect our ability for close up but also our ability to focus at a distance and oftentimes everything inbetween.

At least for myself, the strong muscles that were able to compensate for the hyperopia become weakened using the glasses which ultimately ends up revealing the extent of our true hyperopia. It`s like we are stripped of a super-power (flexible lens and strong muscles) that we never realized we were having to use to correct a problem. The onset and progression of presbyopia is really quite alarming and the changes can feel quite dramatic. I myself, am looking forward to it all stabilizing!

I have read that hyperopia can fluctuate during the day.

Hope this helps some. There are lots of us around the same age getting the double-whammy of presbyopia!


Lou 27 Jun 2017, 14:43

Hi Mike

It does help, thank you very much.

Your response was much appreciated.

Take care

Lou


Mike 27 Jun 2017, 12:09

Lou, Your situation is very similar to what I was dealing with a few years ago. As it turned out I had some latent Hyperopia or technically it was induced Myopia since at the time I had small amount of negative sphere. After going to new eye doctor, a small local practice with what I learned from this site I was better able to explain my situation. I left with a low + prescription similar to your current one. It has increased by about +.25 per year over the past few years, but unless I do a lot of really close work, I no longer have my vision change over the course of the day. Hope this helps.


Lou 27 Jun 2017, 09:39

Hi

Regarding my original post (copied below), I have my eye examination scheduled for Thursday 29th June, and I am hoping to gain some insight from the knowledgeable folks on here before I go.

I'm not sure whether my prescription is fine, and this is just a demonstration of an eye prescription changing slightly throughout the day owing to light levels, pupil size, eye shape owing to weight of eye lids etc., whether this is a suggestion that I could have latent hyperopia (which could explain why I suffer from a lot of eye strain without my very small prescription, why I seem more long sighted in the mornings, and less so at night, especially on days when I haven't already worn my glasses, and feel that I have been staring intently to focus for a lot of the day, and may explain why I developed convergence insufficiency with only a very small prescription), or whether this suggests that I have either too much cylinder or sphere in my prescription.

If it is just a case of me having either too much cylinder or sphere, which please do you think is most likely to be the case?

Many Thanks

Lou

Brief history: Felt that close up vision was not that great even as a child, but nothing picked up during school eye screening. Had first opticians appointment at 21. Was told that eyesight was borderline (have no idea of prescription) and that I should see an eye specialist regarding eye tracking issues. I was scared to see the eye specialist, so said I could see ok. I'm a musician and always struggled with small print and multiple parts on one stave. By the time I was 36, was finding that I was panning out when reading music, the music wasn't exactly double, but I was having to fuse the two images together, and it got to the stage that I was having to enlarge parts and use one eye. I finally visited an optician, was diagnosed with convergence insufficiency and later an eye tracking disorder. Was given a small prescription of +0.25 Sph -0.25 Cyl (Axis 90 for right eye and 80 for left eye) with prism. I can't remember how much, but it was intolerable and I managed to reduce it completely through eye exercises. My prescription has altered through the years from:

R: +0.50 Sph -0.50 Cyl Axis 90

L: +0.25 Sph -0.25 Cyl Axis 80

up to:

R: +0.75 Sph -0.75 Cyl Axis 92

L: +0.50 Sph -0.25 Cyl Axis 83

down to:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.50 Sph -0.50 Cyl Axis 83

down further to:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.25 Sph -0.25 Cyl Axis 85

Although my prescription is going down, my eye strain and need for glasses seems to be going up, with intermittent variable vision in my right eye between earlier and later in the day.

Earlier in the day, my glasses make a noticeable significant improvement to the vision in my right eye.

Later in the day, often I get the same noticeable improvement to the vision in my right eye as earlier in the day, but sometimes although my vision is different with my glasses to without, I cannot make my mind up whether it is better or worse, and sometimes it is worse. At these times, although it is harder to focus, I can sometimes see the calendar on the opposite wall of my kitchen, more sharply with finer lines to the letters, with my glasses on upside down, so that I am looking through my +0.25 Sph -0.25 Cyl Axis 83 left lenses with my right eye.

If I don't wear my glasses, even if I haven't done any close work, I get eye strain, burning and headaches, which go when I wear my glasses.

But especially if I haven't already worn my glasses, my right eye prescription sometimes seems too strong in the evenings, but good in the mornings.

I've scheduled another eye exam, and would please like some advice as to what is going on.

I'm 43


NNVisitor 25 Jun 2017, 11:13

Someone has integrated part of what I wrote with a misleading introduction.

I've never suggested that wearing prescribed eyeglasses makes someone's eyesight worse.


 25 Jun 2017, 10:18

I think your wearing your glasses full time made your vision worse. I mostly did not wear my glasses as a child and my eyes got worse. When I finally wore my glasses full time my vision still got worse for several years and then stopped getting worse.


Lou 24 Jun 2017, 05:10

Thank you very much for your response. I don't believe that I do have any further uncorrected astigmatism, but have scheduled an eye exam for next week.

I have previously had a reading prescription with an add of +0.50 but I never wore them, although they were better for reading, as I found them so restrictive, and not even any good for my lap top which I view at a reasonably close distance (less than arms length) since I am typing on a keyboard obviously attached to the screen.

Last time, the optician took the add off my prescription, as I only wore my distance prescription, and said that I also couldn't tolerate the fact that my reading prescription had such a restrictive range of vision. I suppose my reading glasses met their requirement of being good for reading, but I use a lap top more than I read.

My idea is to go with progressives when I need a reading prescription and an intermediate prescription, which I don't feel I yet need owing to my near add only previously being +0.50.

I don't work, but am an amateur musician, doing a lot of orchestral playing. I play trumpet, and view music at a distance of around 1 metre. The consensus with my husband and band colleagues, is that most people have an add 0.75 smaller for music distance than for reading, which makes mine still zero.

I'm 43

My full prescription is:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.25 Sph -0.25 Cyl Axis 85

I'm a mother and homemaker, who does a fair amount of computer work. I drive, including fairly long distances at night for orchestra gigs and rehearsals.

I wear my glasses full time on orchestra days, and ad hoc on other days.

I don't read that much, as I don't find the time.

I find reading with my glasses on better but still not great. Without a doubt I could probably do with a reading prescription, but cannot stand the small range of focus. I can still read ok, even pretty small print on a smart phone, but I need good light to read small print on food boxes and in the tv guide. Numbers are worse than letters, as you can obviously read a work without seeing each letter in detail.

I find mid distance vision harder than close up for some reason. My guess is that I have can use my accommodation for close vision, but cannot internally correct for my admittedly small amount of astigmatism at intermediate and distances.

I find my glasses most useful for 1m - distance.

Many Thanks in advance


 23 Jun 2017, 19:17

It may be that you have some uncorrected astigmatism or could benefit from a reading prescription that is not quite as strong as your distance script. If you are able to share your age, full prescription and occupation and how you use your eyes (e.g. do you do a lot of computer work, driving, reading etc.) there are some good people here who will, I am sure, be delighted to offer suggestions.

How do you find reading with your glasses on?


Lou 23 Jun 2017, 08:10

Brief history: Felt that close up vision was not that great even as a child, but nothing picked up during school eye screening. Had first opticians appointment at 21. Was told that eyesight was borderline (have no idea of prescription) and that I should see an eye specialist regarding eye tracking issues. I was scared to see the eye specialist, so said I could see ok. I'm a musician and always struggled with small print and multiple parts on one stave. By the time I was 36, was finding that I was panning out when reading music, the music wasn't exactly double, but I was having to fuse the two images together, and it got to the stage that I was having to enlarge parts and use one eye. I finally visited an optician, was diagnosed with convergence insufficiency and later an eye tracking disorder. Was given a small prescription of +0.25 Sph -0.25 Cyl (Axis 90 for right eye and 80 for left eye) with prism. I can't remember how much, but it was intolerable and I managed to reduce it completely through eye exercises. My prescription has altered through the years from:

R: +0.50 Sph -0.50 Cyl Axis 90

L: +0.25 Sph -0.25 Cyl Axis 80

up to:

R: +0.75 Sph -0.75 Cyl Axis 92

L: +0.50 Sph -0.25 Cyl Axis 83

down to:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.50 Sph -0.50 Cyl Axis 83

down further to:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.25 Sph -0.25 Cyl Axis 85

Although my prescription is going down, my eye strain and need for glasses seems to be going up, with intermittent variable vision in my right eye between earlier and later in the day.

Earlier in the day, my glasses make a noticeable significant improvement to the vision in my right eye.

Later in the day, often I get the same noticeable improvement to the vision in my right eye as earlier in the day, but sometimes although my vision is different with my glasses to without, I cannot make my mind up whether it is better or worse, and sometimes it is worse. At these times, although it is harder to focus, I can sometimes see the calendar on the opposite wall of my kitchen, more sharply with finer lines to the letters, with my glasses on upside down, so that I am looking through my +0.25 Sph -0.25 Cyl Axis 83 left lenses with my right eye.

If I don't wear my glasses, even if I haven't done any close work, I get eye strain, burning and headaches, which go when I wear my glasses.

But especially if I haven't already worn my glasses, my right eye prescription sometimes seems too strong in the evenings, but good in the mornings.

I've scheduled another eye exam, and would please like some advice as to what is going on.

I'm 43


cactus Jack 22 Jun 2017, 08:23

Mike,

The tiny text on Smartphones and Tablets, has revealed that many teens have Hyperopia and the onset of Presbyopia, long before it typically occurs. It is not unusual to find Hyperopic teens, who are addicted, to their phones, with bifocals or progressives in their + glasses.

C.


Mike 22 Jun 2017, 07:04

Cactus Jack

Thanks again for the detailed explanation. When this all started it was a mystery. Then the ol Google found this site for me and after a bunch of reading it all made sense. Unfortunately that wasn't until a couple of years ago. Now when I think back to when I was doing electric repair if I had been using + power glasses a lot of years of never having comfortable vision could have been prevented. (Probably my own fault for never wearing the +1 glasses when I was a kid)... So when I was in my 20's (-power glasses) my experience was in the morning I could see perfectly fine, and if I put my glasses on right away when I got up as suggested then, everything was overly sharp, actually hard to describe the feeling, it wasn't comfortable, but by the end of the day I needed them to drive home from work. When I got my first +.25 glasses and put them on, it was late in the day, and they actually made things worse, first thing I thought was how can this help. After a few days though my fluctuating vision was almost non existent. Now after 3 years I have had a few small increases each year and everything is very comfortable. Another thing a lot of farsighted people on here have mentioned was the ability to blur or relax or un focus, I have been able to do this my whole life. Interestingly now with what I think is close to my full correction it is almost impossible now. However I can still do it without any correction. I just wanted to share my experience, maybe it will help someone in their 20's so they don't have to wait for presbyopia to come into play to figure it all out. I would imagine with smart phones and tablets a lot of folks are doing the same type of close work I did years ago...


Cactus Jack 21 Jun 2017, 15:42

Mike,

There are two kinds of Myopia and two kinds of Hyperopia. Axial or True Myopia AND True Hyperopia is caused by a mismatch between the length of the eyeball and the total optical power of the eye’s lens system. The important factor is the distance from the Crystalline Lens to the Retina and how much the eyeball grows from childhood to the early to mid 20s. Typical numbers are 17 mm from the Crystalline Lens to the Retina and about +59 total diopters in the eye’s lens system. Sir Isaac Newton’s most fundamental principle and formula of optics, defines this.

Pseudo or False Myopia and Latent Hyperopia are actually the same thing, just on different sides of 0.00 refractive error. The cause of both is the Ciliary Muscles having difficulty fully relaxing. If your Ciliary Muscles cannot fully relax, your Crystalline Lenses will probably have more PLUS than they should and that makes you temporarily nearsighted. In this case “temporary” can be a very long time.

Remember, glasses correct or neutralize refractive error. If you need +1 glasses, that means that your eyes are actually -1. Most young people can easily use their accommodative power to correct the -1 by using their Ciliary Muscles and Crystalline Lenses to add a little extra PLUS, internally, to correct it. When you focused close at young age, your Ciliary Muscles could add the +1 to make distant things clear and an additional +2.50 to let you focus at 16 inches or 40 cm for reading. If you do that for a long time, the Ciliary Muscles get used to holding that position and have trouble relaxing. You then have Pseudo Myopia and are mildly Myopic or Nearsighted. It can exist for years thru many eye exams. Then, Presbyopia creeps up on you and your Crystalline Lenses get stiff. That stiffness makes focusing close require extra work by the Ciliary Muscles and you find you can’t do it. Your Ciliary Muscles gradually relax and you need less MINUS or more PLUS (same thing) in your glasses to maintain properly focused vision.

Hope this helps.

C.


Cactus Jack 21 Jun 2017, 10:15

Mike,

What you have experienced is not unusual. I will try to explain what is going on when I have a little more time.

C.


Charlie_Delta 21 Jun 2017, 09:20

Mike, it’s interesting that you went from +1 to -1 in 12 yrs, then back to a farsighted script. TY for sharing. Indeed the Nat’l Optometric Assn. should award Captain Jack some sort of Lifetime Achievement plaque, haha… he’s probably more competent than 99% of their membership! This decade-plus hyperopia/presbyopia thread/discussion in particular has been hugely helpful learn through others.

Cactus Jack,

I’ll have to find that post I referenced. Maybe you were referring to a friend of yours. I recall “amateur radio” in the post. I should set up a Charlie_Delta email address, at which point I’d be happy to send along a hello and thank you for your contributions here. ps: sorry for typos in previous post. Easy to forget there's not "edit" button after submitting on here.


Mike 20 Jun 2017, 06:57

The recent post from Charlie_Delta and Matt are very similar to the vision issues I started having a few years ago. When I think back to when I was around 12 years old I was prescribed around +1 glasses, not sure the exact prescription, but never really wore them much. Then skip ahead about 12 years, after tech school and doing electronic board level repair for a few years I was prescribed glasses in the -0.5 range and eventually stabilized at right eye -1.00 -1 110 Left -1.25 -.05 120. It stayed right around that for the next 14 years then at age 38 I started to become less nearsighted and wore glasses less and less, (I never was a full time wearer). For a couple years I only had astigmatism correction and no sphere correction, now 4 years later Im at Right +1.00 -0.75 118 Left +0.75 -0.5 115, still no add for close work however I also have glasses +.50 stronger for computer work. If I do a lot of close work I still struggle with inducing some myopia, (mainly if I don't use my stronger glasses) this whole presbyopia thing is sure taking its time to completely manifest itself. Needless to say for the last 2 years I have become a full time wearer and actually enjoyed more relaxed vision. Cactus Jack helped a couple years ago with some suggestions and also explained exactly what is happening. Thanks to people on this board I have learned a lot about how vision works.


Cactus Jack 19 Jun 2017, 09:16

Charlie_Delta,

I don't remember posting anything about Ham Radio. I was extremely interested in Ham Radio in my early teens, but could never master Morse code even at 5 WPM to get a novice license. A neighbor had a really nice setup with a 1 KW transmitter and an incredible receiver that could fish a signal from static. SSB was just getting started and I spent many hours there, drooling. All I ever had was a Hallicrafter receiver loaned to my by my favorite Uncle, who had been a naval radio operator in WW2

instead, I got a First Class Radio Telephone license because of my interest in broadcast Radio and TV.

Lots more to tell, but rather than bore people who are interested in vision and optics, may I suggest that you contact me at cactusjack1928@hotmail.com

C.


Charlie_Delta 19 Jun 2017, 08:50

Cactus Jack, (warning: useless post to others)

As I stumble on so many of your posts amidst trying to better understand my own situation, you’ve routinely reminded me kind of chap who’d CRAVE amateur radio as a hobby. I base this on your EE career, fascination with science, discourse with strangers from around the world and so on. At any rate, I was doing some reading last night and stumbled on a post of yours revealing that, voila; you’re a ham radio operator. You’d probably get a kick out of knowing that I was a huge DXer/contester in the late 1990s (until I women and beer in college occupied my free time ;). Today, I miss this hobby. In high school, I used to contact King Hussain of Jourdan (an avid ham), astronauts on-board the Space Shuttle Discovery, DXpeditions i.e. 3YOPI, and many emergencies where our work became vital (I was not active after about 1999). Pre consumerist/household use of the internet, I trust you’ll agree: this was the most incredible, borderline magical hobby on the planet.

Anyway, Jack, I have to tell you, after I stumbled on your reference to being an active ham, it subsequently dawned on me that I hope you’re telling the truth that you (a) are in fact from Houston and (b) were *never* an ECP. Otherwise, I'd have to assume you're my good friend's father and that would be awkward. One of my very good friend’s fathers, age 79, spent a good portion of his career as an electrical engineer (Columbia grad, as I recall) who worked extensively with optics. He was also a very active DXer (in “3” land) and remains very active at church w/ his wife. I trust you’re two different folks, though, as my friend’s parents live in FL and NJ. You’ll find this particularly interesting though: my friend's dad aborted a very successful career in electrical engineering to become an ophthalmologist – a CRAZY bold move with a spouse, three kids and a mortgage (and maybe also college debt?) – especially given his age and the behavior of your generation to generally stick with career/employer for a lifetime. I forget the story on how the family pulled this off. What I do know is that this guy had an explosively successful private practice which fueled his ham radio hobby (he still does an annual DXpedition to a Caribbean island). LOL, if you’re not the same darn person, you surely both hit it off!

73,

Charlie


Slit 14 Jun 2017, 21:31

Is there a higher prevalence of hyperopia (diagnosed in age group between 10 and 30 years of age) in the northern Europe + Germany & Poland?

In South Asia & East Asia I see very few cases of hyperopia (judging by the lack of usage of eyeglasses with + rx.) but one may see many individuals wearing glasses with + rx in Northern Europe, Germany & Poland.

What are your views and are there any scientific research on this?


Matt 13 Jun 2017, 15:01

Thanks CJ. No worries, I am wearing my glasses full-time and will continue to do so. My near-point vision is pretty bad without glasses and my distant vision is more comfortable with the correction.


Cactus Jack 13 Jun 2017, 07:15

Matt,

Farsightedness or Hyperopia Is the ONLY refractive error that you can correct internally using part of the power of your Auto-Focus system (Ciliary Muscles and Crystalline Lenses). Children have amazing focusing power that is gradually lost over the years until it becomes difficult or impossible because of Presbyopia.

You CAN NOT internally correct Nearsightedness or Astigmatism. The equipment to do that is simply not there.

You might be able to scrape by on the eye test for a drivers license renewal if your farsightedness is not too great by squinting, but why. Many states will let you drive with uncorrected 20/40 vision.

You can fight Presbyopia, but I can guarantee that you won't win and your vision will likely be uncomfortable while you try. If you haven't read it, I suggest Macrae's Story on the Vision and Spex site. The saga is a bit long, but it is well written and funny in spots by a man who is going thru a similar situation. Remember, It occurred over several months.

Vanity is a very powerful force, but if you need vision correction, you need to "bite-the-bullet", get some glasses, and get on with your life. You have lots of life to live and wearing glasses is not much different than wearing shoes. Except in rare instances, where you HAVE to wear shoes, they really are optional. However, they sure do make walking on sharp rocks more comfortable. Your choice!

C.


Matt 12 Jun 2017, 18:20

Good to hear from you Charlie_Delta. Liked hearing your farsighted story from 3rd grade. Interestingly enough, I had my eyes checked at age 14 and the doctor told my father that I had "some farsightedness" but would not recommend glasses. That was the last time I went to an eye doctor until a few weeks back.

In August, I will need to renew my driver's license. Am wondering if I should try to "pass" without glasses or just give in to the fact that hyperopia is doing a job on my distant vision. Will keep you posted.


Charlie_Delta 12 Jun 2017, 09:04

I should also mention that opportunity is available RIGHT NOW in the USA to participate in topical (eyedrop) drug trials to stop/reverse presbyopia. Novartis isn't alone in the race. The federal government hosts/regulates this process (to include registration to participate) at www.clinicaltrials.gov. Search "presbyopia" then scroll down to find topical solution trials presbyopia that are actively recruiting. Open those various links (again, many companies involved now) to see geographic locations to participate, by state. Maybe there's an OD in your neighborhood. I'd drive a reasonable distance to participate in the Novartis one.

... or maybe not. I mean, what the heck happens between the end of the trial and the possibility of some miracle drug reaching the marketplace? LOL, it'd be comparable to some poor guy involved in the Viagra trials in the 90s? He goes through the Fountain of Youth until the plug gets pulled. Hehehe, many frustrated spouses I'm sure!


Charlie_Delta 12 Jun 2017, 08:31

AN EYE DROP TO STOP OR REVERSE PRESBYOPIA?

CJ was likely referring to my post about pharmaceutical headway in reversing presbyopia. Novartis spent around $500-million last year to acquire Fort Worth, Texas-based Encore Vision, the later of which was a boutique pharma innovator that operated exclusively for over a decade on developing a daily eye drop solution for presbyopia. Initial trials are very encouraging! Press release below, and extensive publications on highlights of Encore's EV06 drug trials on the open internet -- I've enjoyed doing down that rabbit hole. (suggest including "EV06" in your search queries)

Imagine how many BILLIONS of dollars would be produced if such a drug reaches the open market!?!?! Of note however: Encore Vision's EV06 isn't exactly a presbyopia cure. The critical sentence in Novartis acquisition press release is as follows:

"EV06 showed a statistical significant difference to placebo in distant corrected near vision at all time points measured (from day 8); at day 90, 82% of participants treated with EV06 had 20/40 near vision (or 0.30 LogMAR) versus 48% in the placebo group."

https://www.novartis.com/news/media-releases/novartis-bolsters-ophthalmology-pipeline-through-acquisition-encore-vision-inc


Charlie_Delta 12 Jun 2017, 08:12

Matt,

Sorry for delay responding. In my case, no, I don’t think I struggled with eye strain my whole life. However, I think I always had short episodes of everything blurry at distance after a long period of seeing up close (computer, reading etc.). But I can’t be certain – maybe this emerged as an apparent nuisance only within the past few years (where I know for certain eyestrain for up close work was unbearable at times, too). And like you, I never thought to have my eyes tested. Never once did it occurred to me that chronic daily headaches of the past 3-4 years might be the result of eye strain. What an idiot I was!

I will say this though; when my third grade glass had our eyes tested at school, my sister and I were referred to an optometrist and both of us ended up with glasses for mild farsightedness. But never wore them, nor had any benefit experienced by wearing them. For over three decades, I assumed the optometrist was a crook who was out out to make a buck on my parents. Now, I believe the OD was probably legitimate in her farsighted diagnosis, but nevertheless wrong to prescribe glasses.

Re: contacts, here’s my take on multifocals: they are probably spectacular AFTER one’s natural focusing ability is essentially completely gone (presbyopia progressed to its stopping point). In my case, I can still focus in bright light up to about a 12”-14” in front of me (though with a lot of eye strain after a short while). Wearing multifocal contacts, my brain tends to “select” the distance power (rather than the up-close ADD power) which induces strain. This sounds really strange, but forcing my eyes to relax or “blur on command” while wearing multifocal contacts DOES result in the up-close “ADD” lens power coming into sharp clarity, and then everything is fine – eyes are relaxed and living is easy. So, my hunch is that multifocal contacts are of most benefit to someone who’s presbyopia has reached the end point, as in this case the brain has only one very clear image to “select.”

I’ll be interested in hearing if your prescription changes in the coming months. I think it’s actually quite common for people in our predicament.


Rubydubes 10 Jun 2017, 19:12

Cactus Jack,

Best of luck as you remodel your kitchen! At 79 you seem to have an incredibly interesting array of things to keep you young.

Thank you again for taking the time to reply, you have been incredibly informative and helpful!

Let us know how your kitchen works out.

Rubydubes


Cactus Jack 10 Jun 2017, 18:44

I don't remember if I have posted this link lately. It is a good paper on The Eye that some members may find interesting http://www.lhup.edu/~dsimanek/scenario/labman3/eye.htm

C.


Cactus Jack 10 Jun 2017, 18:41

Matt,

Not really crazy, once you understand what is going on. The body ages, it is in our genes. The neat thing is that we have learned to do something about most things that happen, up to a point. Someday, it may be possible to prevent Presbyopia (literally, Old Eyes). If you are a Star Trek fan, you may recall that in one of the movies, Captain Kirk got reading glasses because he was allergic to the drug that prevented Presbyopia. You may not have to wait that long. I saw a recent post that something was in clinical testing that reversed Presbyopia. Unfortunately, I have been so busy these past few weeks that I have not followed up on it.

Life expectancy is increasing. I'm 79 and can do pretty much anything I want to, but of course I don't particularly want to do some things, anymore. I've been there, done that, and got the T-shirt. Instead, I am finding new adventures and I am not done yet. I typically don't buy green Bananas because I might not be around for them to get ripe, but I might decide to go somewhere tomorrow, and be on an airplane the next day, unless I decide to wait for a cheaper fare.

Be patient and stay tuned, there is lots more to learn.

Rubydubes,

Please be patient and don't commit for anything in a big hurry. Somethings are NOT reversible. You need an ECP who has a creative mindset and you need to do some relatively inexpensive testing before you commit to LASIK. You can experiment with a low power sphere only disposable contact lens for just a few dollars and if it doesn't help, you are not out much.

One of the reasons the situation is bothering you so much is that up until now, you have probably been able to compensate for the difference more easily and now you need some help.

I am going to be very busy for the next few weeks. I am learning how to remodel a Kitchen (mine) while still working on Organs. I am thinking of taking up Juggling in my spare time. It seems like I am already getting some practice.

C.


Matt 10 Jun 2017, 05:46

Thanks CJ for your elaboration on hyperopia----very helpful to me. Seriously, all of this seems a little crazy to me. I reach age 42 and it is if someone just cut-off my near-point vision. Oh well, aging brings it "joys".


Rubydubes 08 Jun 2017, 12:34

Thank you Cactus Jack, this was my same concern.

I am in Canada and got my prescription from a small, independent that seemed to know more than the average OD. I have gone to 3 different optometrists and they all provided the same prescription ( interestingly single vision), but this was the first who mentioned I had issues with binocular vision... Vertical trophia?? I spent over $2000 on progressive lens and sunglasses. Not sure if I have been duped !

I think my issues all come down to the difference in lens power between the eyes. Funny, I have had the same disparity between my eyes my whole life but my trouble with glasses is now quite evident bc I have to wear them all the time and worse under fluorescent lights all day.

I booked an appt with someone who specializes is more complicated contact lens prescriptions and hoping I can figure out a solution to not deal with the glasses constantly. I wonder of LASIK could be done to get eyes to same refractive power even if it meant I still needed glasses for so e things....


Cactus Jack 08 Jun 2017, 11:51

Rubydubes,

It depends on where you had the glasses made and where you live. Some chains will provide a prescription that is intentionally "corrupted" so you will have trouble getting glasses from another vendor. In this case It is likely that your actual prescription is 1.5 Prism Diopters (indicated by a tiny triangle in a superscript. it is often mistaken for a tiny circle, which is the degree symbol), Base Out (BO), if the outside edge of your glasses is thicker than the inside edge (not always easy to tell in Plus lenses).

I suspect the mistake was intentional.

1.5 diopters in each eye is really not very much. You may actually need more prism for the best comfort. Prism is typically not very noticeable until you get up close to 10 in each and then only by "OOs".

C.


Rubydubes 08 Jun 2017, 10:10

Thank you for your response Cactus Jack.

My prism is indeed .51 in each eye. I believe it is BO (Base OUT). On my actual eye glass prescription I left he office with it indicated 1.5BO, but on the actual card I received with my glasses which outlines the prescription put in it is indeed .51 for each eye.

Not sure why it would be put in if so little?


Cactus Jack 08 Jun 2017, 09:48

Matt,

I don't mean to butt in, but unless you have a significant complicating factor such as Astigmatism and need Cylinder correction, or the Hyperopia is significant enough to cause your eyes to turn inward when you try to focus, most children do not notice that they have Hyperopia.

In fact most children are born with Hyperopia but have incredible focusing ability to compensate for it, once they learn how to do it. It typically takes about a month for a baby to learn to see pretty well. The reason they have Hyperopia is that a baby's eyeballs are small and the laws of optics say that it takes a lot of PLUS to focus things on the Retina, a very short distance from the lenses in the eye. Fortunately, most children can so easily compensate for it that they are not even aware that are doing it.

Also, children have no frame of reference for what good vision looks like and they think that whatever they see is as good as it gets and they adapt to it.

Vision actually occurs in the brain. The eyes are merely biological cameras. If the brain knows what something is supposed to look like, it can correct a blurry or distorted image. The brain can even do images with your eyes shut. Ever had a dream?

C.


Cactus Jack 08 Jun 2017, 09:33

Rubydubes,

I need a little more information about your prescxiption.

You posted:

R +4.5 -1.25 82(AXIS) Prism .51 Add 1.50

L +2.25 -.25 110(AXIS) pRISM .51 Add 1.50

Prism should include the direction, Base Out, In, Up or Down.

I don't think .51 is a valid prism value. Some ECPs might prescribe in .5 increments, such as Prism 2.5 BO, but .5 prism diopters is not much. You would be having real problems with your Eye Position Control System (EPCS) if it could not deal with 0.5 prism diopters of error. Please check the prescription more closely.

The difference in the Sphere prescription will cause different size images on your Retinas. You may be having trouble dealing with that.

If you can wear Contact lenses, You might be able to wear a Sphere ONLY contact lens on one eye to equalize the Sphere value in your eyes. That would get the image sizes closer. You would still need glasses for the rest of your prescription.

I don't remember if you have mentioned where you live, but One day disposable Sphere only contact lenses are very inexpensive in most places, they are thin and comfortable, and you don't have to deal with many care issues.

Please let me know what you think of these ideas.

C.


Matt 08 Jun 2017, 03:39

Charlie, just wondering since you have latent hyperopia, did you have problems with your vision when you were younger. I have latent hyperopia and the eye doctor said that I should have been wearing glasses for the hyperopia long ago. I now look back and recall times of eyestrain, etc., but for some reason, I just never thought about getting my eyes examined. Lived a life of denial or maybe vanity I guess.

Am 3 weeks into my new world of glasses and continue the full-time wear. Thinking that after summer, I might check into contacts----hopefully my eyes/prescription will be stabilized by September.


Rubydubes 07 Jun 2017, 14:52

So for those of you that have followed this post recently, I mentioned that I had a new prescription coming for my first pair of progressives with prism and I mentioned I would let you know how they were.

My prescription is as follows:

R +4.5 -1.25 82(AXIS) Prism .51 Add 1.50

L +2.25 -.25 110(AXIS) pRISM .51 Add 1.50

I have worn them now for 3 days and while vision is clear, it just feels weird! I know this is likely due to the adjusting to both progressive and prism field of vision - either way I hope that sensation of feeling like I have artifical vision improves. Perhaps it is the prism in the glasses that makes me feel like my eyes want to go to their natural resting place but can`t....like they are stuck! Has anyone with prism experienced this when adjusting? I feel like I want to take them off when I get home from work, but the alternative is just blurred vision. My other issue is aneisekonia (uncomfortable symptoms of the brain receiving two different image sizes due to large difference in power between eyes). I have contacts that seem to solve that problem but then don`t account for the issues of clear close vision or helping to keep my eyes foccussing in the same direction (which apparently the prism is supposed to do). The end result seems to be no perfect solution which seems a bit daunting and leaves me wondering if I should continue to drive my OD crazy trialing contacts or if I should keep working at tweaking my glasses. Either of which I am sure makes me a nightmare of a customer!

I am wondering if Cactus Jack with his wealth of knowledge might help to either validate or dispel a theory I might have re: aneiskonia. When I wear my glasses with the 2.25 D difference between the two if always feels somewhat ~off~. I can`t really explain what it is exactly but things look more normal (although blurred) when I take them off. I tried a special type of lens called the SHAW lens (you can google them) which are for prescriptions such as mine whereby the technology is such that it creates a lens that equalizes the image size so your brain is not having to reconcile competing images. They were horrible and could not adapt. Anyhow, my weak eye is considered amblyopic and best corrected only gets me so far. I have always had and always will have poor vision in that eye. My thought is since bumping up the power in that eye only really makes a crisper bad image, I wonder if overall it would help if that power was actually reduced in that eye to reduce the power disparity. It might be flawed logic, but considering I had the same prescription my whole life (more or less minus the add) and I got by without glasses at all pretty much until a few years ago, that my brain knows how to work out it`s vision without trying to improve the bad eye. All I know for sure is that figuring out the right prescription is like the story of Goldilocks.

On the other hand maybe it`s just me and I need to accept that having perfect vision on all fronts is unrealistic?

Thoughts welcomed.....


SC 02 Jun 2017, 09:40

Charlie_Delta,

Interesting about being able to go out of focus. I've always been able to do this - sort of fade out instead of being focussed on an object. I'm sure this is a clear sign of latent hyperopia.

I can't do it anymore with glasses on. I guess this means that I'm at, or almost at, my full distance Rx and so there is no more to fade out because the glasses fully correct.

As you say it is a shocking journey into bluriness. In the last year of so I've lost the ability to see the bedside clock that I've had for 20 yrs - now I have to plug my phone in and use the clock on that but the brightness is a pain - and if I put it further away then I can't see it either.

Nobody warns you about this - my short sighted friends think it is funny that my vision is as bad or worse than theirs has always been


Charlie_Delta 02 Jun 2017, 09:11

Cactus, Kris and Rubydubs,

Glad I'm not alone -- thanks for all the insight (and Kris and Rubydubs; particularly the commiseration!! ;).

Cactus Jack,

Your friend’s use of the word “elixir” reminds me of some rather interesting pharma trials going on for presbyopia. This Novartis acquisition will intrigue you, presumably. Maybe a miracle drop for presbyopia is, in fact, a strong possibility in the near future.

http://www.star-telegram.com/news/business/article128907504.html

Eyedrops to cure/reverse presbyopia; sign me up!! IOL on the other hand.. no thanks. I’d do this ONLY if I had cataracts as you did, but otherwise would not. One of the two guys I share a house with on Capitol Hill, age 39, got IOLs two months ago, followed by LASIK less than a month ago – a $10K out-of-pocket expense in all, to do without glasses. He had severe myopia paired with severe astigmatism. After the IOL surgery (which de described as you did) he had another procedure six weeks later that required all sorts of laser incisions on the white part of the eye, to make it spherical... then LASIK. He says he's close to 20/20 now, to which I reminded “…and just in time for presbyopia!”

You asked where I locale/occupation. In a nutshell, I represent a certain “heavy industry” prevalent in your area to Congress. Also serve a public affairs officer in the National Guard (live and work in DC). I’m on a computer most of the day. Active in sports otherwise -- low-grade amateur competitive cycling in particular.

Thanks for the sage advice. Though I haven’t worried myself sick JUST yet, it’s nevertheless been a particularly unexpected encounter to (a) discover I need glasses for more than reading, and (b) to now notice changes even after three months vision correction. I do understand the prescription will stabilize, but more than a little frustrated at times. I'm sure that will pass but as others have said, I too am not giving-in without a fight! ;)

My "latent hyperopia" questions root to some of these changes I've been noticing. I see distant objects significantly better now in the middle/lower-middle area of the progressive lens. More recently, a new issue is emerging whereby I can’t see close after doing things for long periods of time where my eyes are looking into the distance (driving, cycling workouts etc.) unless I’m looking through the very bottom/reading part of the progressive lens AND the object itself is around 12” further away than usual. Already mentioned that my computer glasses, which initially were a godsend, are now a little blurry. I have to assume that these abrupt changes are largely result of some latent hyperopia emerging. Doubt more than 1D, but enough to really annoy me.

Although it feels nuts to go back to the eye doc after 90 days of filling a prescription, this might be in order relatively soon. I agree it's not worth the discomfort.


Kris 01 Jun 2017, 18:36

Cactus,

Did a second test after I had a couple of drinks with friends (don't judge, I figured this would be my most relaxed vision). Images from three meters away drifted 60-66 cm apart or about 20-22 diopters. Images easily moved to within 10 diopters of one another then I had to more consciously work to fuse images (although I was able to). I will need to take a break from this test as I find it hard afterwards to maintain fusion and feel more eyestrain. It's like once my eyes have permission to relax, they don't want to work so hard to maintain fusion. I'm finding right now that when I look up from my computer, I see double and have to work to fuse the images. Thanks for your input.

When other people wearing prism do this test in their current prescription how much deviation do they find they have?


Kris 01 Jun 2017, 13:39

HI Cactus,

I have just tried the prism test with moderate fatigue and would say the image rests somewhere between 30-40 cm at 3 meters away. The second image seems to move a bit and will move further apart, but it feels a little bit forced. I'd say the image was mostly around 35 cm which would make it almost a 12 prism diopter difference in images if I've done it right. Will post rested testing on the weekend (don't expect I'll be rested before then, but may retest after I've gone for a walk. The current test was done after reading and speaking with people (so short to mid-distance focusing).


Cactus Jack 01 Jun 2017, 09:21

Kris,

Yes, it is normal because ECPs typically under correct prism correction if you have Esophoria and your Eye Position Control System (ECPS) has the ability to control your eye movements. If you have Esotropia where your EPCS has very limited ability to control movement, full prism correction is often necessary.

I suspect you have some Esophoria. When you relax and are not particularly looking anything, your eyes may drift inward some. When it becomes a nuisance or you have trouble fusing, you may need some more prism to help.

I don't want to get to technical here and please remember that I AM NOT and Eye Care Professional. My background is Electronic Engineering and Computers. My knowledge and experience comes from studying and analyzing my own vision problems.

It seems to me that the EPCS is what is called, in engineering terms, an Open Loop Servo System (OLSS). Those types of systems do not know the exact position of the thing they are controlling, but rely on results. In this case your EPCS tries to match sharp vertical edges in the two images for horizontal fusion and sharp horizontal edges for vertical fusion. The snag is that they have to be within the control range of the EPCS. Fundamentally, with Esophoria, the prism in the glasses just have to get the two images within the control range and the EPCS will do the rest.

I also have Esophoria and I most notice images breaking fusion when I am not looking at anything or when I have nothing to see that is within fusion range. It is particularly noticeable at night, in dimly lit areas without any lights (e.g. a dark room).

You can test your need for prism correction at home. I will post a "Simple Prism Test" I developed several years ago, below. You might find it helpful.

Accommodative effort can cause your eyes to try to turn inward because of the inter connection between your EPCS and your Focus Control System. If you have Esophoria, it is important to have full correction for Hyperopia and Presbyopia. if you like to read closer than 40 cm or 16 inches, you might need a bit more PLUS in your Add. Also, your Sphere correction should be checked.

Here is the Simple Prism Test:

SIMPLE PRISM TEST

It is not hard to measure the amount of prism it would take for full correction. All it takes is some adding machine or cash register tape, a marking pen, some painters or masking tape (ideally with very weak "stick-um" for easy removal) and something to measure distances.

It is a little easier to work with metric measurements, but you can do it also with inches and feet. You just have to do a little more math for conversions between the two.

This test is based on the definition of 1 prism diopter as: "That amount of prism that will deflect a ray of light 1 cm at a distance of 1 meter (100 cm)".

Ideally, this test is done without any prism correction in your glasses, but you need to be able to see some calibration marks on the adding machine tape with reasonable clarity. If you can't see the marks without glasses, you can still do the test, but you must account for the prism in the glasses.

1. Select a fairly blank wall that you can attach the calibrated adding machine tape to, using the painters or masking tape.

2. Decide where you will stand or sit while doing the test. Between 3 and 4 meters or 10 and 14 feet works best. Measure the distance from that location to the wall selected in Step 1.

3. Calculate how much displacement 1 prism diopter represents at the distance measured in Step 2.

4. Using the marker, mark the adding machine tape with major divisions 5x the distance calculated in Step 3 and optional minor tick marks at 1 prism diopter intervals. The marks need to be big enough to see easily from the distance in Step 2. You might want to identify the major divisions as 0, 5, 10 etc. Note: Some large bold markers will bleed through the adding machine tape and permanently mark the surface you are using as temporary backing for the adding machine tape. Test and take appropriate precautions to prevent damage by the marker ink.

5. Attach the adding machine tape, stretched out horizontally, to the wall selected in Step 1.

6. On another short piece of adding machine tape mark an arrow lengthwise and attach that piece of tape to the wall, vertically, so the arrow is pointing at 0.

You are ready to do the test.

7 Place yourself at the location selected in Step 2, let your eyes relax so you see double and note where the "0" arrow appears to point in the displaced image. Try this test several times during the day and at varying degrees of fatigue. Make a note of your results.

8. If you are wearing glasses with prism, adjust the readings in Step 7 for the total prism in the glasses.

This test will work with horizontal prism (Base Out or Base In) or vertical prism (Base Up or Base Down) by the placement of the long tape and short tape. Often both horizontal and vertical prism exist at the same time.

Note: It is sometimes difficult, if small amounts of prism are involved, to tell if the prism correction needs to be Base Out or In, Up or Down. You may be able to tell by noticing which way the images are displaced when you block the eyes alternately. For example, if you cover the right eye and the image from the left eye is on the left, you probably need more Base Out.

Please Let me know if you have any questions and if this works for you.

C.


Kris 31 May 2017, 21:17

Thanks Cactus. Is it normal to still experience double vision occasionally, even with prism? I don't want to go up too quickly, but am not sure if there will be a natural endpoint or if the more it's increased the more my prism demand will continue to rise. I used to be able to fuse for short periods with my non-prism glasses, but not anymore. I can fuse when I see double with my current script, but am more aware of working to fuse. There seems to be more art than science to prescribing prism and my ECP won't disclose what my full correction might be.

I posted my prescription in a previous post but I'll repost it. My left eye is 0.75 5 BO, right eye is 1.5, cyl -0.5, 5BO ADD 2.5. I'm 46 and have definitely lost much of my ability to accommodate in the last year and a half. Does this affect prism demand or is it a separate issue?


Cactus Jack 31 May 2017, 20:30

Kris,

I really need to write some more about the interrelationship between Hyperopia, Presbyopia, and the need for Prism. I don't have much time right now, but this may help some.

What you are experiencing is pretty common. The culprit on the turn in problem is the interconnection in your brain between the Focus Control System (FCS) and your Eye Position Control System (EPCS) (my names). The interconnection is what causes your eyes go automatically converge when focusing close. If that did not occur you would see double when you focused close. It also seems to be a two way interconnection, but the reverse direction seems weaker. Converging your eyes may trigger the focus response. There can be problems associated with this interconnection. You can have over convergence problems and under convergence problem and the strength of the connection can vary with individuals.

The systems do not know why you are trying to use your Ciliary Muscles. You may really be focusing close or you may be trying to compensate for Hyperopia, or straying to overcome Presbyopia. The results are the same, your eyes converge. That is why the first clue that a child is having trouble focusing close or has more than normal Hyperopia is that often their eyes try to cross or turn inward. Many times just fitting them with Plus glasses for their Hyperopia will solve the excess convergence problem.

5 BO is not really very much. Other than edge thickness, it is barely noticeable by others. I have what is called esophoria. My eyes would like to turn inward and I wear 7/7 BO most of the time. However, when I am tired, I need more because I can't fuse images with just 7/7 BO. Esophoria in layman's terms means that I can fuse images with effort, if they are within a certain range. However, there are times when I need much more prism. I have had a type of muscle surgery that briefly solved the problem, but it did not work. I have glasses with different amounts of prism. The highest is 23/23 BO. With those, it is pretty obvious that I am cross eyed.

If you get fairly small frames, you can go up to about 10/10 without it being very noticeable. The amount of turn in is 0.57 angular degrees per prism diopter.

C.


Kris 31 May 2017, 17:23

Rubydubes and Charlie Delta, you are both describing the same experiences I had when I was first told I needed progressive lenses. I was 38 and believed that I would absolutely not need them until I was into my 40's. My denial was high and I experienced a year of bad vision because of this denial. You cannot fight this, I know- I tried. I've learned that I am really good at ignoring my eye symptoms and don't realize how uncomfortable I was until I upgraded my lens prescription. I tried to go without glasses, but as I'm sure you'll realize it does not stop the progression of presbyopia and I was only more uncomfortable without glasses.

I've come to terms with my presbyopia, but really struggled with wearing prism. I think I posted a fair bit a couple of years ago about whether or not I should see my ECP about my double vision. I claimed it was mild, but in retrospect it was not. When I finally started wearing prism full time I realized just how uncomortable my vision was before hand. I started reading a lot more, something I did not realize was related to my vision and had far fewer headaches. Even knowing this, I struggle with when I should report my symptoms to my ECP. I'm experiencing occasional double vision and am not sure how much I should put up with before getting my eyes retested. I hate the idea of needing a lot of prism (is 5BO in each eye a moderate prism prescription?) but given how much my eye turns in when my glasses are off, I suspect that I am no where near my endpoint for prism prescription.

Other prism wearers- do you occassionally have double vision with your prism script? Is it something I need to worry about? I know I have some eye fatigue if I do a lot of close work, but not sure if that is related to my prism needs or to my loss of accommodation.


Cactus Jack 31 May 2017, 16:47

Charlie_Delta,

You really need to get over this. You will worry yourself sick, unnecessarily. Welcome to 40 and there is not a damn thing you can do about it, except get some glasses and keep changing the prescription until your vision stabilizes. Once it does, it will stay the same for years. You and BILLIONS of others have experienced it. Plus lenses were invented hundreds of years ago to enable people to still function after about 40. The only ones who could function were those that were nearsighted because they effectively have built in reading glasses. The price they paid was that they could not see distant things clearly. That led to the invention of Minus lenses. Then Ben Franklin combined the two and invented Bifocals.

Fortunately, we have a huge number of tools to help solve the problem, but one thing to remember is that there ain't nothing as good as the real thing. Someday, there might be, but not yet.

You did the test right, but the number you got might not be accurate in practice. Your Ciliary Muscles were rested and relaxed, which gave you more range. Try the test again when you have been working all day and your Ciliary Muscles are fatigued and see what you get.

Latent Hyperopia is very common. Dilation might help reveal it, but typically if you have been compensating for years with Hyperopia, the dilating agents that are used today don't last long enough to completely relax the Ciliary Muscles. As a doctor friend of mine said, "That requires the elixir of time".

Sometimes even teenagers discover that they actually have Latent Hyperopia. The 15 year old son of a friend discovered that reading the tiny text on his cell phone was difficult to read and texting gave him headaches. Low Plus glasses with Cylinder correction for Astigmatism solved that, for a while. I saw him last week, now 18. His prescription had obviously had more Plus, but because he had plenty of accommodation range his vision was excellent at all distances and reading tiny text on his phone was effortless. Why did he need more Plus in his glasses? Latent Hyperopia, but by now it is probably completely resolved and he just has his natural Hyperopia that needs correcting.

I don't think you have mentioned where you live. I live in Houston, Texas. One of the local Ophthalmologists is advertising elective Multi-focal Intra Ocular Lenses (IOLs) for those who really, really, really (my words) dread the thought of bifocals or trifocals. This will probably scare the crap out of you, but Installing the Multi-focal lenses involves the same exact surgery as for Cataracts. The upside of the surgery is that it is good for the rest of your life and you will NEVER have Cataracts to deal with. Cataracts are the clouding of the Crystalline Lenses. Many people develop Cataracts and in most instances today the removal of the clouded Crystalline Lens and installation of an IOL takes about 10 minutes per eye.

By the way, I had to have Cataracts removed and single focus IOLs installed with what is called Mono-vision in 2001, when I was 62. One eye is set for Distance and the other is set for about 20 - 25 inches. The surgery was the nearest thing to a non-event, I have ever experienced. I was scared to death before the first surgery, but the surgery was really not traumatic and the recovery was so fast that my first question when I saw the surgeon the next day to check his work was, "When can we do the other eye"? "Two Weeks"! i still need glasses for precision vision, but my vision with glasses is better than 20/20 with them. I can legally drive without glasses. By the way, after my vision stabilized, after the Cataract surgery, my Sphere and Cylinder have not changed for 17 years.

Multi-focal IOLs or Contacts are not for everyone. May I ask where you live and your occupation?

Did I sent you the link for the article on "The Eye"? You might find it interesting.

C.


Rubydubes 31 May 2017, 16:34

Charlie,

I think from all I have read and learned is that if you were farsighted to begin with (case in point, you were prescibed plus glasses as a child) then at about age 40ish it will begin to present itself.

As you know, hyperopia is the only refractive error that we have the ability to compensate for....until a certain point. I liken it to losing a superpower! I have been able to compensate for a prescription of +3.75 and +1.75 with astigmatism my whole life. Apparently, my muscles worked extremely hard for this to happen and I was blissfully unaware.

The issue is that once you begin to use glasses it allows you muscles to relax to their natural state, where they really want to be and this is why you feel that you are in that blur now without glasses. For us with hyperopia the presbyopia is only one part of it; its not just the stiffening of the lens it is also the weakening of those unusually strong muscles that were working overtime without us knowing it that result is poorer vision.

I struggle with this as well as I want to hold onto any focusing power I have but the glasses end up doing the job of the muscles. Its like never exercising your legs but wanting to run. I actually find that my eyesight without glasses improves if I purposely try not to wear them for a few hours a day and I really want to ask my dr. if there is any merit in trying to do this.

I have read all about amplitude of accommodation and have gone done that same rabbit hole! ;) 3.5 reserve at about age 40 sounds about right.

I guess it just is what it is. It sure is a slap in the face when it comes upon you as a surprise. I would be completely ok with just needing reading glasses, but glasses for everything....well, that is another story.

I am going to an opthamologist and going to get advice on everything from refractive surgery to rle.

Not going down without a fight! ;)


Charlie_Delta 31 May 2017, 15:36

Lately, I've noticed that with glasses off, my eyes occasionally let go of focus on objects at near – similar if not identical to a young lad intentionally “blurring” the eyes into a relaxed state, on command. I’m experiencing this unintentionally, which really worries me. Does this signal a permanent loss of a natural focusing ability?

Coupled with this concern, I notice my single vision computer glasses, first picked up 70-80 days ago (super mild script -- OD sph +1.50 OS sph +1.00) no longer provides the jaw-dropping HD experience that they did initially. It seems like a lot is changing abruptly, which makes me wonder if I perhaps raced into vision correction too aggressively. Before I started vision correction earlier this year, I'm positive I could focus on close objects better than I can right now.

Last night, I got in a rabbit hole concerning accommodative reserve (aka accommodative amplitude). I left glasses off this morning and actually measured this value as coffee was brewing. I used a mechanical ruler with (tiny millimeter markings) as a on object focus on, and a tape measure. Holding the ruler first to my eyes and moving it out slowly, I can't see a damn thing until 11 inches. 11" = 0.279 meters. 1/.28 = 3.58 diopters of focusing power remaining, if I did that right (I’m age 40).

FWIW, when I was in the third grade, I was issued glasses for farsightedness, but never once wore them. Very mild prescription as I recall, either +0.75 or +0.50 (or one-each in each eye). I always just assumed the OD was an idiot because I could see fine without glasses. Really wish that were the case these days too ;).

I’d be curious to know how common Latent Hyperopia is in general, and if any known trends exist concerning when it becomes manifest. This term is used often in this thread. For curiosity sake, I may as well ask my OD if presence of this is known at this time (I presume she'd have to do a dilated refraction).

Still learning… still on edge! Thanks for all the great posts too. Learned so much about things like prism corrections which I never knew existed.

Charlie


Charlie_Delta 31 May 2017, 14:07

SC,

Just want to clarify that my last post was totally in the spirit of a self-deprecating nut-job in denial (me!). Hopefully you got the humor and a good laugh instead of a led balloon! I’ve did a lot of research in this thread and find your posts extremely informative and helpful.

It’s been kind of shocking to go from no glasses ever in my life, just a few months ago, to leaving an eye appointment w/ a bifocal prescription. Vision stuff was never on my mind in the past, though now it's a topic I'm considerably more aware (and informed) of.

Charlie


Brian 31 May 2017, 09:12

Rubydubes, I started having double vision when reading when the prism was 1st prescribed I think I was 31 at the time. The 1st prism was 2 BI in each eye. I had an issue with my right eye drifting out for years prior to that, but I didn't notice the double vision issues until I got into my 30's. Hope that helps.


Rubydubes 31 May 2017, 03:28

Sorry I did not post my name on my last post.

My prescription is as follows:

OD: +4.5 -1.0 ADD 1.5 BO(Prism) .5

OS: +2.25 -.5 ADD 1.5 BO(prism) .5

I am more curious as to why for the first time I am being prescribed prism and the concern over dependance and increase.

Thank you!

Rubydubes


Cactus Jack 30 May 2017, 21:14

Anon Poster,

I would urge you to use a nickname so we may direct our answers to the correct poster.

It would be extremely helpful if you would post your complete prescription. Vertical prism does not increase significantly over time as horizontal prism often does. Eye Care Professionals (ECPs) are typically trained to under correct prism because of the tendency for it to increase. Some of the increase is caused by not fully correcting it in the first place.

Prism, Hyperopia, and Presbyopia can interact and cause double vision, but it is usually manifest as the need for Base Out (BO) or Base In (BI) prism rather than Base UP (BU) or Base Down (BD) prism.

C.


 30 May 2017, 16:33

Can I ask those of you who use prism , did you all notice double vision all the time? Is that why is was prescribed?

My new prescription will have .5 prism in each lens. I don't have double vision per se, but if I focus on something close everything in the background becomes somewhat doubled but I am told that is a natural phenomena - physiological diplopia . I think I only notice it now bc I am very aware of all my vision changes after turning 40. I am reluctant to have prism put in my glasses if I do to really need it bc it seems as though it may be. Slippery slope ( although maybe a more comfortable one!).I I am told I have ( and have always have had) a vertical trophia which is the rationale for prism.

Can anyone explain why the onset of presbyopia seems to unleash all of these other binocular vision issues as well?? Seems like there are a few of us who had lazy eyes as children who now after 40 have a whole bunch of issues happening- not just being able to read up close!


Brian 30 May 2017, 14:49

Roy...I live in the USA but my eye doc said the same thing in regards to 10 being about the max prism I'd likely be able to get in a pair of glasses so she has been concerned about my dependency increasing. She had suggested surgery but I'd like to use that as a last resort due to additional complications it could create. She had said doing whatever test she did that I'd likely be even more comfortable with 8 in each eye but she did not want to over prescribe. I've noticed a big improvement with the 7 over the 6 so I've been happy with the new prescription.


mattp 30 May 2017, 06:55

Hi All--

Let me tell you a bit about my prism correction with reading glasses.

My RX is -4.00; add 2.75; prism 1.5 base in; trifocals. I'm 70. About 15 years ago, as my add reached the higher numbers, my left eye kept turning out when I tried to read. I was able to hold it in and focus on the text, but eyestain was becoming a problem. That is when the eye doc prescribed the prism, and it solved the problem; my left eye stayed focused.

There have been two minor problems with this prism RX:

First, the eye doc did not want the prism correction in the distance portion of my glasses, saying that would ensure the prism would keep increasing and I didn't really need it for distance. Unfortunately, prism correction can not be added to the reading section only of progressives; thus I had to give up progressives and switch to trifocals; the prism is in the lower two sections, not the upper distance section. The adjustment to trifocals took a while, but now I love them--clear vision wherever I look.

Second, I used to be able to take my glasses off to read. No longer. The prism has not increased, but I am totally dependent on it for reading. That left eye swings right out without correction.


Roy 30 May 2017, 04:05

Anonymous Poster 29 May 11:04

Prism is noticeable in glasses but how noticeable depends on the strength of the prism, the direction of the base and also whether it is combined with correction for myopia or hyperopia. The lens will be thicker in the direction of the base and thinner on the opposite edge.

I have low myopia in my right eye and medium myopia in my right. Without the prism my right lens would be around 2.5mm thick at the edges and the left eye around 5mm. The vertical prism makes the right lens slightly thicker at the bottom and the left lens slightly thicker at the top but my lens height is quite small (28mm) and this is hardly noticeable, perhaps 0.5 to 1mm increase.

The main change in appearance comes from the 12 base-out prism that I have. This increases the thickness at the outer edge of both lenses to around 12mm. (with 1.67 index plastic). I would have expected the left lens to be thicker than the right because of the higher myopia but, apparently, the lens makers elect to put more of the prism in the right lens and less in the left (but still totaling 24 dioptres) to equalise the two lens thicknesses. Both my lenses are wafer-thin at the inner edges (around 1mm).

In addition to increasing the lens thicknesses at the outer edge the base-out prism also increases the "cut-in" a lot but it does not change the minification of the eye at all.

Brian

My eyes have always adapted easily to the increases in my prism. Most of the sharp increases have come in the last ten years and therefore when I have been wearing progressives. Of course the increases have been applied only when I have been experiencing double-vision again and needed the extra strength, so my eye strain and double-vision are relieved instantly by the stronger prism. I would almost say my eyes adapt too easily to the extra prism and then want more and I have read information that says this can happen.

One problem I do have is finding an optician (I live in the UK) who seems confident prescribing prism. At my last two eye tests (at two different opticians) they only had prisms up to 10 dioptres available. They had to hold additional prisms in front of my existing glasses to get new prism values for me. Making the glasses also seems to be difficult. They always take three or four weeks minimum and sometimes have to be re-made when the re-glazing cannot be done correctly. I typically pay £300 to £400 for progressive lenses and £200 to £250 single vision (both excluding frames).

To finish on a positive note my vision is OK with my glasses and there is nothing I cannot do. I still manage to go the recommended two year interval between eye tests. The cosmetic appearance of the glasses with thick lenses is of no concern to me.


Brian 29 May 2017, 14:23

I've had similar prism increases..my last exam in March increased my prism to 7 BI in each eye. I started at 2BI in each eye back in 2010...had yearly increases to 5BI stabilized for a few years went to 6 BI last year and now 7BI this year. I'm also approaching an age where I'll likely need progressive lenses soon I'll be 39 in a few months. At my eye test in 2016 I could see tge J1 line in my near test but could only see J2 line this year...Im not sure how that equates to when progressives are usually prescribed...on a daily basis I don't have any issues seeing up close but do notice having to adjust more at times reading in dim light. My eye doc said ill likely need them in a few years. How hard is it to adjust to progressives with a stronger prism?


Kris 29 May 2017, 13:54

Rubydubes, you describe similar symptoms to what I've had. I got my first prism prescription when I was 44, but had been wearing progressives for 5 years by then. My ECP initially prescribed 2 BO each lens, but it wasn't enough and I went up to 4 BO each eye within a month. My ECP knew my need was higher than the 2BO, but was hoping it would be enough to settle my vision. It only seemed to make me need more though. Last year I went up to 5BO and my ECP seemed concerned about how much prism I needed so soon after starting to wear prism. I too was reluctant to start in with prisms and was concerned about the predicted increasing need over time. However, the improvement in my vision and decrease in eye fatigue have made it worthwhile. I've asked for an ophthalmology referral, but my ECP doesn't think it will be that useful for me but I would like a second opinion. I'm not sure if my previous eye surgery is an indicator of less successful outcomes or if it's a general thing for people with my strabismus history.

I'm in a job where I attend presentations a few times a week and, before prisms, found that focusing on the PowerPoint slides was when I was most aware of my double vision. I think that focusing on one point for a length of time really made the double vision more obvious. I often found myself covering my right eye or closing my eyes during presentations. It is much, much better now. However, in the last few weeks I've noticed that I'm occassionally seeing double and have had more eyestrain in the past couple of months. I was trying to wait until next year for my next eye exam because I haven't gone a year without a prescription change and would really like to have stable vision and not be spending so much money on lenses.

I had issues with blurry distance vision before getting progressives. I thought it was because my distance prescription was too high, but it was because my lens was working so hard to accommodate at near, that it was unable to relax so I could see clearly at distance. This became clear when I started wearing progressives and my distance vision improved. It was only in the last couple of years that I really stopped being able to function without my glasses. I used to get up and only put on my glasses after I'd made coffee and showered, but now I reach for them as soon as I open my eyes. Going even a few minutes is uncomfortable for me now. I'm really aware of how bad my vision is without glasses when I'm in the shower and cannot read any of the labels (even the larger print) on the bottles in the shower.

When do you get your new lenses? It would be interesting to hear how your experience compares to mine.

Cactus, your input is always valuable, although you've been able to explain prism for me before. I did your prism test recently and standing three meters away, and with my current prescription and relaxing my eyes, the image would drift 30-40 cm apart, although I could work to fuse the image. Is this normal or an indicator I should consider an eye exam before next year?


 29 May 2017, 11:04

Roy,

Could you tell me if presence or increase of prism in glasses is noticeable?


Roy 29 May 2017, 09:27

I thought I would share my thoughts on my presbyopia (combined with myopia and strabismus). I have just turned 70 and my prescription is now:-

Right eye -1.50, -1.00 @ 88, prism 3 down & 12 out

Left eye -4.25, -1.00 @ 80, prism 2 up & 12 out

Add 3.50.

I asked the optician how much accommodation I had left and he said it was effectively zero and certainly less than 0.25 dioptre. I am sure this must be true. I notice that even to focus clearly on something around 2 metres away I have to raise my head a touch to look through the intermediate section of my progressives.

My progressives are OK for, say, reading prices in the grocery shop but I am much more comfortable wearing single vision glasses for any sustained close up tasks. I think this is because the strong prism correction limits the type of progressive lens I can have to the more basic types. I have ended up with four pairs of single vision glasses with adds of 1.5, 2.25, 3.5 and 5.0 for different types of close-up work and all are getting regular use.

Regarding Kris's question about how the amount of prism correction needed progresses, my vertical prism need was diagnosed around age 15 and has remained more or less constant at 3 down/2 up ever since.

The horizontal prism came much later around my mid forties. It was fairly stable at around 3 - 4 out (for each eye) for over ten years but then increased steadily to the current value of 12/12. Before my last test I was 11/11. During the test I said I was more comfortable with 13 or 14 but the optician would only give me 12/12 as I was reaching the limit of correction that is possible, and there is a tendency for the eyes to get used to the prism correction and want more. It's just about enough to fix the double vision I was starting to get with 11/11.


Matt 29 May 2017, 08:49

Great reading the adventures of other presbyopes. Been wearing my glasses full-time for over 2 weeks now. Life is good. Seeing clearly both near point and at a distance. Charlie, I still may check out m/f contacts.


Rubydubes 29 May 2017, 03:47

Kris, Charlie and SC,

Thanks for sharing your similar stores of the presbyopia/hyperopia progreson.

Kris, I understand what you mean about the eye turn (essentially muscle weakness). I also find that my weak eye feels weaker in my 40's. While I never had surgery as a child, I was patched to strengthen the eye. I remember as a child wanting to watch tv with one eye closed because it was more comfortable, and now - while not that bad, there are times when closing my weak eye provides some relief. I have a new pair of progressives coming in shortly and it will be the first time I will have prism in them (.51 in each eye). I am not sure what to expect but am a little concerned as I am told that once you get used to prism you require more and more. I am almost 45 and am pretty much in glasses fill time and it has been really hard to accept. This time last year I could get by being outside for almost anything without glasses and now it requires a whole lot of hard focus without them to get by and it can only be sustained for short periods. The problem is my glasses (which I have had for almost 3 years) almost feel to strong when I am outside in the sun, but for indoors I am ok. I am hoping my first pair of progressives I am awaiting solve this problem. I have booked an appt with an opthamologist as well to discuss any surgical options for my prescription but it is complicated . Moderate,amblyopic hyperopia + astigmatism so I don;t hold out much luck. I really just want comfortable vision at every distance without headaches everyday!

Perhaps Cactus Jack could chime in if he had a moment to discuss the following:

- effect of prism and the likelihood of increase

- the benefits of rle surgery for hyperopic/presbyopic problems.

Rubydubes


Kris 27 May 2017, 18:57

Matt, Ruby Dues and Charlie Delta, I have been there too. Like others have posted, Cactus Jack has been very helpful when I've posted before and is certainly a wealth of information. He's helped me understand what is going on in my vision and what I may expect as I get older.

I'm now 46 and became a fulltime glasses wearer at 38 (from a no-time glasses wearer). When my ECP first assessed me he too told me that I should have been wearing glasses well before that visit. I had some issues getting the initial script right and my ECP thought I needed progressives within a couple of months of becoming a glasses wearer. It took me a year to accept the truth that presbyopia was rearing it's ugly head, but getting progressives made things so much better. I lost my ability to read my phone (with a lot of effort) without glasses about a year and a half ago and am now at the point that I have to guess which bottle is which in the shower because I can't read the labels without my glasses.

My current prescription is L 0.75, 5 BO, ADD 2.5, and R 1.50 cyl -0.5, 5 BO, ADD 2.5. My presbyopia symptoms initially manifested with a lot of eye fatigue and issues focusing on distant objects if I did close work for any length of time. I was never really aware that I was having a hard time with close work, but when I started wearing progressives, things improved significantly.

I had childhood strabismus that was treated with surgery and glasses. Before wearing glasses I was having issues with depth perception and seeing double but it improved with hyperopia correction. Unfortunately the double vision became an issue I couldn't manage with just the hyperopia correction about 2 years ago. Until that time, I would only occassionally see double but it became more and more of an issue in my 40's. I was experiencing a lot of eyestrain and fatigue and the prism has helped that. I really resisted wearing prism as it meant I could no longer wear contacts, but I don't regret my decision. I am very dependent on prism now and am unable to fuse images if I take my glasses off or if I wear my old glasses without prism in the lenses. My right eye turns in when I take my glasses off and I try to relax my vision and not focus if I have my glasses off so others are less likely to notice (I don't know how well that works though).

My vision is still not perfect and I still occassionally see double, but it is much less of an issue than it used to be. I've noticed recently that I'm starting to see double more than I had since my prism increase a year ago (from 4 to 5 BO in each lens). It's not problematic, but now has me wondering when I should get my eyes examined again (it's been a year). I would be interested in hearing on the prism prescription has changed for people who have had prism for awhile. I know that there is a lot of art in prescribing prism and my ECP will ask for my input on whether I think I need it increased or not. I would like to leave it as is, but am not sure if that is the best decision.


Charlie_Delta 24 May 2017, 08:40

SC,

In honor of your chosen nickname, I send to you my knee-jerk reaction to your stark warning (thank you for this) as spoken by the Honorable Gentleman of South Carolina's Second District:

https://www.youtube.com/watch?v=h3thOPw7etI

Rubydues,

I find it fascinating that the human eye can accommodate a prescription like yours up to about age 40. You've had a purdy heavy script, I must say. DITTO sentiment on Cactus Jack. What a godsend! He's the only resource I’ve discovered who is (a) willing and (b) effective at explaining what the hell’s going on with my sudden change in vision. I’m right at age 40 (can’t tell if you’re 40 or 45) and though I can still force my eyes to focus even very small text up about 12 inches, it isn't easy and after a short stretch of time causes a pretty bad headache and just stops being able tot focus at all. Like you though, I’m very much on edge about total dependency on glasses -- even though it's only a matter of time.

By wearing glasses, are we accelerating the natural declination of our eyes’ ability to accommodate/focus? I suppose I won’t give a damn after the day comes whereby I literally can’t focus on *anything* at arm's length, but that day isn't right now and I sure don't want it to come sooner than it has to.

Let us know how you like progressive lenses. The super cheap-ass ones I got through Zenni do out-perform multifocal contacts. Everything is super sharp now, at all distances. As example, I can no see every nuance on a slice of pizza I’m in the middle of eating, then glance at a TV across the room and back to said slice of pizza without any delay in focusing. They're awful for computer work, though.

And regarding hyper-vigilance with changing eyes, weaker eye, pondering vision in general; I share in this with you and think it's probably very common for people around our age to experience. I mean, hey, we’re losing the ability of a *major* sensory device to function as it has for a lifetime without some sort of device. Not to mention, plus lenses (progressive no less) make me now feel genuinely unworthy to hop inside a mosh pit or or doing a few keg stands at the village fraternity house. But, then again, there's THIS guy:

https://www.youtube.com/watch?v=PXGo33jm3os

Charlie


SC 23 May 2017, 08:44

Matt, Rubydues &others,

I think you will be shocked at what happens as you get towards 50. In your early 40s the I expect terms like comfort and HD but going forwards you will probably miss one line of the eye chart each year. This is irrespective of whether your Rx increases - even if it stays the same things will get worse without glasses.

+2.5 will likely mean the whole chart will be illegible.

Having to get glasses was never the biggest surprise - seeing my vision get worse and worse without them was totally unexpected.

Check out the vision simulators such as http://www.wolframalpha.com/

This give a reasonable view of what you can expect to come.


 20 May 2017, 05:33

https://www.youtube.com/watch?v=4Opt4y2KZ5U


Matt 20 May 2017, 05:08

Thanks Charlie for your words about vision, glasses and presbyopia. I have been wearing my glasses full-time for over a week now and all is going well. Both distant and near-point vision are remarkably clear and crisp. No doubt that I should have been wearing glasses before now----just did not want to give-in to a sign of getting older----but it is really great to see items on my phone very CLEARLY and no longer be squinting, wishing for brighter lighting, or longer arms. Also, the prescription for distance is working well.

Charlie, though I am a few years older than you, there is no doubt now that I would have benefitted from glasses at age 40.

Jack, appreciate you sharing the postings. Always good to hear of others "aging eyes" experience.


rubydues 19 May 2017, 03:59

Charlie-

If it`s any consolation I am going through the EXACT same thing as you ( add a few diopters!).

I have always been farsighted (hyperopic) and as a child wore very strong lenses and was actually patched because of a weak eye. To this day the weak eye remains weak. The funny thing is through my later childhood, teens, 20s and 30s I rarely wore my glasses. As far as I was concerned I had perfect vision. I only remember needing them when I got tired, but got through universtiy without any need for corrective help (my prescription I think was somewhere is the range of (OS: +1.75 -.5 OD+3.75 -1.25). It was interesting when people put my glasses on and felt like they were going to have a seizure and asked how I could possibly get by without wearing them. I often wondered too, but figured I had just grown out of my condition.

Fast forward to 40....little did I know that all these years I was actually growing INTO my prescription! In the last 5 years I have come to discover and presbyopia and hyperopia are a ugly combination! I went from only every wearing my glasses when I wanted to, to NEEDING my glasses now for almost everything, and I HATE IT! ;)

I can still get by outside doing things like yard work or biking, running, etc. without having to have my glasses but life it a lot easier with them. Like you, I have had a hard time accepting this and find myself forcing myself to go without my glasses for certain stretches just to keep those muscles strong. I am not sure it is a worthwhile test!

I actually though something was seriously wrong with my eyes and went down a month rabbit hole of going to about 6 different optometrists to understand what is going on. I can say that not one of them explained this combination more accurately than Cactus Jack.

Like you, I have also had little luck with contacts. I have tried single lens, multi-focal, toric, etc. each has an element of compromise that I do not like. There also has not been one optometrist who can explain why this is.....and I like to know WHY!

Currently, I await my first pair of progressive lenses that arrive next week with the following prescription:

OS: +4.5 -1.25 Add 1.5 BO 1.5

OD: +2.5 -.-5 Add 1.5 BO 1.5

Clearly, I have the added challenge of having a significant difference in lens power, which also has never been a problem until recently which I never noticed before. AS I get older for the first time I realize how my weak eye seems to affect my overall vision . Perhaps it is because now I am very much paying attention to how I see whereas before I never gave it a thought.

Anyhow, all that to say you are not alone as you transition accepting the hyperopia/presbyopia mix!!

Rubydues


Cactus Jack 18 May 2017, 16:44

Charlie_Delta,

Glad you found the Macrae "saga" informative. It does get long at one reading, but remember that it actually occurred over several months.

One thing I don't think has been mentioned, is that vision actually occurs in the brain. Your eyes are merely biological cameras.

The brain has amazing ability to correct images IF it knows what something is supposed to look like. In fact the brain can create images without any input from your eyes. Ever had a dream or any form of hallucination?

It appears that the brain can develop and store different image processing "programs" and can load the appropriate one as necessary rather quickly. If you have a significant change in vision, it may take a few days or weeks to develop a new program to deal with the changed situation.

Often, new glasses wearers complain that their glasses have made their vision worse. Not really. What happens is that your brain has had years of experience with what you considered "normal" vision. Internal vision correction usually takes a lot of work and effort on the part of your brain. When you wear vision correction, the delivered images are already corrected optically and your brain has a lot less work to do. Once your brain has discovered its workload is less with vision correction, it really does not want to go back to the old way.

Think of glasses or contacts as labor saving tools. Also, keep your sense of humor.

C.


Charlie_Delta 18 May 2017, 12:52

Thanks Jack,

The amateur science/tech geek in me has enjoyed learning about all-things optics and the physiology behind presbyopia/hyperopia – and also; what to anticipate. It's been a lot to adjust to, both physically and psychologically, but also comforting to realize I’m not alone and that other's experiences are very similar (if not identical) to my own.

Macrae’s story points out a TON of relatable "firsts." I must stay, sifting through a “Little House on the Prairie” manuscript was a doozie, but I did gain from many takeaways. Like him, the disappearance of chronic DAILY headaches has been the biggest win of all for me, by far. I think the differential between my right and left eye had a lot to do with that. I also can relate to his comment about the appearance of lights in the dark, for example headlights in oncoming traffic. I just assumed my entire life that *everyone* saw headlights with a streaks radiating in all directions. It was absolutely MIND-BLOWING to me that glasses made that terrible annoyance disappear (making nighttime driving much safer probably, too).

Less enjoyable, I also experience something else that others have written about: dependency. Now, taking glasses off after several hours at the office makes everything significantly more-blurry at near distances (compared to prior to wearing lenses). I am NOT a fan of this and wasn't warned it might happen. That said, it's the lesser of many evils (and life in ultra HD has been truly awesome).

Just by learning from you, Jack, the blurryness I see without glasses is unfortunately becoming less of a temporary effect that gets better with a little bit of time. The obvious giveaways (like Macrae) are particularly apparent early morning with things like the bedside clock or shampoo bottle in shower. This signals to me that in a pretty short order, the ciliary muscles in my eyes are starting to relax. In addition to dependency, the other adverse impact appears to be a rapid change in required prescription to have a maximum benefit of vision correction.

Observations:

* I see better at far distance within the intermediate area of the lens.

* The ADD needs a slight boost. I hold an aspirin bottle past 1-foot to read tiny print.

* My corrected near-accommodation ability is weaker in my right eye than left by 4” or 10cm (I was crazy enough to take the tape measure out of the junk drawer to actually measure this with said aspirin bottle)

Based on the above, I flipped my single-vision computer glasses upside-down, covered left eye, and looked through the weaker of the two lenses (+1.00) to see through right. Result was an extremely slight of blur at infinity. My progressive glasses Rx for right eye is currently +0.50 sph, but I think it's closer to +0.75. Left eye might still be plano.

To climb out of this rabbit hole, my main point is that for people in my predicament, it doesn't make sense to spend and arm and a leg on progressive glasses until the adjustment/acclimation phase is through. In my case, I'm still in the middle of it I think.

I do need to buy a back-up pair of glasses however, and will probably buy the same rimless frames I previously bought on Zenni, but this time around I plan to add +0.25 to right eye sphere power and another +0.25 to the ADD of both lenses. My thinking is that this pair will become the everyday pair. As I see it, a quarter-diopter adjustment is too miniscule to really do harm anyway.

If the above method works, perhaps I just wait on going back to the eye doctor until I’m past 12 months from the previous visit, and make adjustments on the script of these $67 glasses every 4 months or so.


Cactus Jack 17 May 2017, 14:35

Charlie_Delta and Matt,

I would like to suggest that you take a look at Macrae's Story on the Vision and Spex site, Fantasy and True Stories thread.

It is a well written, funny, and classic series of posts by one of our members coming to grips with the fact that he needs glasses.

Here is a link that might work.

http://www.vision-and-spex.com/fantasy-and-true-stories-about-vision-glasses-f7.html

C.


Charlie_Delta 17 May 2017, 13:37

Matt,

If it makes you feel any better man; I’m two years younger than you with the exact same thing going on. The situation kind of sucks, but I’d take glasses ANY day over crappy vision. I’d take note of the point Cactus Jack made to you, that it’s very possible – maybe even more likely than not – that your prescription will change in the coming months. I’ve personally noticed changes happening in 60 days, and I also agree w/ Jack that it’s not worth putting up with discomfort or sub-par vision after you’ve made the plunge to wear lenses full-time. My plan is to have another vision test around the six month point from starting to wear contacts (that’s when the contact supply runs out), and probably will buy a good pair of glasses and properly fitted lenses at that point in time. Best of luck!

Charlie


Matt 17 May 2017, 09:01

Thanks for the contact lens information Charlie.

Much appreciated. After my presbyopia settles

down, I may check out CL mutifocals. For now,

Just trying to adjust to my old eyes and wearing

Glasses for the first time


Charlie_Delta 16 May 2017, 08:01

Cactus Jack,

Thanks a ton for the unabridged overview. Very much appreciated, albeit also sobering as I come to grips with a likely decline in vision acuity in my years ahead. Spexfan; TY as well. I’m less than enthused to become dependent on lenses and would MUCH rather preserve my focusing ability, but realize based on your and others’ experiences, and Jack’s posts, that progression of presbyopia will probably exacerbate existing hyperopia, thereby impacting distance vision too (“latent hyperopia” – I’m learning, slowly!)

Jack, Re: your Zenni recommendation, turns out I was one step ahead of you. A few weeks ago I bought a rather cheap pair of progressive glasses by using the Rx prescribed by my optometrist. My thinking was that if I hated the lens design (regardless of wrong “seg-height” or “canal wideness”) I probably won’t buy expensive/properly fitted progressive lens glasses. At any rate, the Zenni order has arrived and I was able to immediately adjust. Remarkable improvement over multifocal contacts, so there you go, Matt! Progressive lenses absolutely outperform multifocal contacts, which leaves me in a somewhat annoying crossroads as I prefer not to wear glasses (especially w/ “plus” lenses) full time. Above all, I *do* want perfect vision though, so this decision is being forced on me apparently.

There was also a discovery with this Zenni experiment concerning my distance prescription: I notice that I can see things at far distance much better through the intermediate part of the lens. At first I though this was just magnification of image, but after experimenting a little while in a stationary position, I can see letters on a sign 300’ away that I cannot see through the top part of the glasses. Curious what you all suggest I should do: go back to the eye doc, or try and improve the script myself at next Zenni order. My hope is that this is just a preliminary snafu and not a case of rapidly changing eyes after 60 days. If the latter is the case, it makes no sense to buy expensive frames and lenses until things stabilize. Damnit, getting old SUCKS!

Charlie


Cactus Jack 15 May 2017, 19:13

Charlie_Delta,

What you are experiencing IS typical of a person who is Hyperopic (farsighted) and Presbyopia is becoming a nuisance.

What is happening is a bit complex and very mysterious if you do not understand optics or how the eye works.

People who have Hyperopia, as you do, have a rough time when Presbyopia starts creeping up on you and you start needing glasses, initially to help you focus close, and ultimately for both distance and close.

Many people who have mild to moderate Hyperopia are not even aware that they do. The reason for this is that Hyperopia is the ONLY refractive error that you can correct internally, using some of the resources of your auto-focus system (your Ciliary Muscles and Crystalline Lenses).

One of the things that often happens to people with Hyperopia is they develop what is called Latent or Hidden Hyperopia. Latent Hyperopia occurs when the Ciliary Muscles get so used to squeezing the Crystalline Lenses to compensate for Hyperopia, that they have difficulty relaxing to allow the Crystalline Lenses to return to minimal PLUS power for distance. The Ciliary Muscles are like any other muscle. If they maintain a position for a long time, it can be hard to relax the muscle. Then along comes Presbyopia to complicate the situation.

Presbyopia, which is the gradual stiffening of the protein that makes up the Crystalline Lens. When you are born, your Crystalline Lenses have the consistence of freshly made gelatin dessert. You Ciliary Muscles have no difficulty squeezing your Crystalline Lenses to focus very close. From childhood to adulthood, your Crystalline Lenses gradually get stiffer until along about the late 30s or early 40s, the lenses get so stiff that the Ciliary Muscles have trouble squeezing the lenses.

Incidentally, Presbyopia often affects people with Hyperopia at an earlier age than those with Myopia. That is because a person with uncorrected Hyperopia is using some of their Accommodation Range to add the extra PLUS needed to see distant objects clearly, which reduces the amount of Accommodation available for focusing close.

The symptoms of Presbyopia becoming a nuisance usually start with apparent need for the arms to be longer. Then the need for low power reading glasses. This need will likely increase until it reaches about +2.50 or +3.00. It strictly depends on how close you like to read and the size of the text. Phone books used to be the culprit that drove people to get some PLUS help. Today, it is Smartphones.

There is also something else going on. For their size, the Ciliary Muscles are the strongest muscles in the body. Like all muscles they need exercise. Before you get close focusing help, the Ciliary Muscles got plenty of exercise. When you get reading glasses, the amount of exercise the Ciliary Muscles get is reduced. That causes them to loose their conditioning and get weaker. That is why the reading glasses power or the Add power will increase very fast, however, it will never increase beyond about +3.00 unless you like to read close.

Getting PLUS glasses for distance can start another slow process if you have developed some Latent Hyperopia. Your Ciliary Muscles will start relaxing and your Crystalline Lenses will begin to also relax, reducing their PLUS power. That means that the missing PLUS has to be supplied externally. The relaxation process can take months if you have been hyperopic for a long time, but it will ultimately stop and your prescription will be stable for many years. It is nearly impossible to tell exactly how much Latent Hyperopia a person has or how long it will take for it to resolve. Just rest assured that it will.

Frequent glasses changes are one of the reasons we suggest ordering glasses on line, at least until your prescription stabilizes.

Hope this helps some.

C.


spexfan 15 May 2017, 16:08

Hi all.

Posted about this earlier in the year, but regarding the recent comments:

Am currently +1.75/+1.5 with +2.25 add. Started wearing progressives fulltime about 3 years ago, aged 44. Have noticed the this really helped my eyes relax and also led to about an extra +2.5 in power for near since then. Also discovered I needed the distance rx to see anything clearly in the distance. So once you start with the near add, I think you'll find things move quickly.

My experiences with the multifocal contacts are similar to yours. If I wear them regularly/daily, my cognitive system adjusts and I get pretty good vision, slightly compromised both near and far, but definitely acceptable. Not ideal for long periods of reading though. But often forget I'm wearing them. However it's hard to switch between the glasses and contacts as the glasses give much better,pin-sharp vision at all distances. So mostly I save the contacts for public situations where I can't be bothered having the 'you wear glasses?' conversation.

Planning to have an eyetest in the next few weeks to see where I'm at, feel like I might need an extra .25 near and maybe distance also. Have been enjoying the whole presbyopia thing, but I'm a glasses fetishist, so not the average patient I guess!


Charlie_Delta 14 May 2017, 10:27

Hi Matt,

Re: glasses adjustment, I can only speak to wearing contacts all day, and/or removing them to instead wear single-vision glasses for computer work (not my full near Rx). To the latter, I’ve had a lot of “I didn’t know you wore glasses” comments at the office, to which I reply laughing “either did I.” Re: multifocal contacts; my experience has been that my single vision glasses absolutely outperform the contacts for computer work, but that contact are generally acceptable for most things. …and as mentioned, I’ve become increasingly dependent on requiring some sort of lens for doing close-up things lately, so maybe my eye muscles are relaxing for the first time (requiring lenses now). Whatever the cause, it does seem my prescription is changing a little; so I’m holding off on purchasing progressives until I have another refraction done in another few months or so.

I’d compare multifocal contacts to racing a car in all-season tires on a race car (better DOES exist), so they’re a trade-off of sorts. If you or anyone wants to try multifocal contacts, my suggestion is to NOT do what I did, by trying them without (a) having progressive glasses and (b) never having wore contacts before. This is because there are actually THREE separate adjustments to endure. The first two are physical adjustments that involve trial-and-error adjustment, those being contact lens size/type/manufacturer, and secondly being the multifocal CL prescription for refraction (which can be different from a progressive glasses script). The third adjustment is neurological, and in the contact lens world, this particular adjustment ONLY applies to the multifocal type. Basically your retina suddenly is receiving both a clear and a blurry image at simultaneously, and has to try and ignore the blurry one. Miraculously, it does! ..just not overnight, which puts your brain in hyperdrive for many days. Day-1 was screwy awful. Days 2, 3, 4 got dramatically better, and speed at focusing near-to-far-to-near continued improving for three weeks.

The problem a MF CL trial is that it’s impractical to do so if you require doing near-distance work with optical clarity. I ended up using them only for a few hours a day at first, because they were hampering my ability to get work done at the office.

If they exist; plano contact lenses (no prescription at all) would be a cool way to get one of the three adjustments out of the way early on (the physical lens fitting). You could do that one while wearing progressive glasses. Doing all three adjustments at the same time without backup progressive glasses was nuts and I can’t believe I actually did that. On the bright side, the trial and error process was free for me, and in my case, stuck with the preliminary prescription and lens: Air Optix monthly Multifocal.

My intent is to drop some real money fairly soon on a locally-fitted, high-end pair of progressives (probably a rimless frame from Lindberg). I think my prescription is still changing though as commented in my last post, so I may hold off a little while and have another refraction before doing so. Hope that helps.. Cheers!


Ved 13 May 2017, 22:18

I can command my eyes to be blurry at near distances. I have read here that its farsightedness. How can my eyes stay blurry? So i can wear glasses than having headaches while reading, thanks


Matt 13 May 2017, 17:11

Charlie, thanks for sharing your experience. After 3 days of having glasses, I am still working to get used to wearing them and keeping them on my face full-time. How long did it take you to get where you were comfortable in glasses? Also, how you you like the multi-focal contacts? Do they work better than glasses? Thanks for your guidance.


Charlie_Delta 13 May 2017, 13:47

Informative thread here! I'm age 40 and fall in the same predicament outlined by Matt in his recent post. I've never had vision correction of any kind before about two months ago. I'm now in multifocal contacts all day long and recently have required glasses on my face (when the contacts aren't in) for doing just about anything up close. My OD said I'm slightly hyperopic in my right eye (+0.50) and presbyopic: +1.50 ADD for glasses and +2.00 for multifocal contacts.

Relevant to Cactus's recent post, I'm noticing some unexpected changes lately and these I wasn't really warned about. Cactus,

You responded just below (to Matt's post) that "it is also very common for there to be a need for some prescription changes both for distance and for reading over the next few months or maybe a year."

This explains a lot. Though I never bought reading glasses at full Rx, I did use computer glasses at Rx (+1.50 right / +1.00 left) before MF contacts, and still use those at times I want perfect vision at computer monitor distance. My frustration is that in only two months, I can no longer use those for early morning or late at night reading etc in low light (two months ago however, they great for this). I have two pair at that Rx and as a simple test, wearing one pair over the other is a substantial improvement in spite the right/left Rx imbalance. My concern is that too much ADD is going on at my age. This doesn't seem normal, especially all of the sudden. Any thoughts on that?

I'll also say that the little +0.50 boost to my right eye has been a mind-blowing life-changer for far distance clarity, and the biggest unexpected find of all; I've been cured of daily chronic headaches. Hadn't the slightest clue the root cause of those was vision strain. Voila! Killed two birds with one stone!

Cheers,

Charlie Delta


Soundmanpt 12 May 2017, 07:58

guest

You're +2.00 readers are probably helping you because something is better than nothing, but you have a fairly decent amount of astigmatisms in both eyes (that's the -1.25 / -1.00 under CYL) Astigmatisms effects your eyesight at all distances which of course includes your near vision. So I get the feeling that the readers are maybe only for reading in bed at night? So for only reading maybe an hour the readers may work okay, but you probably should have gotten +2.25 or even +2.50 for that. But chances are if you were using the readers for much longer your eye would start to feel very tired.

Do you already have bifocals? You have enough of a distance prescription that driving without full correction would be unwise.


guest 12 May 2017, 05:43

I am very slightly short sighted, RE -1.25, -1.25 x 175, LE -1.25, -1.0 x 60, (ADD +3.50 both eyes). I find that +2.0 ready reader glasses work fine for close work.

Would there be any benefit in getting proper prescription reading glasses, ie with the Cyl correction included. What difference would it make?

Thanks in advance!


Matt 11 May 2017, 19:00

Thanks NN and CJ for the information. This morning I picked up my glasses--progressives--and started my new adventure. Wore them at work this afternoon---received a few compliments and some ribbing about "old eyes". Since picking them up, I have worn them full-time and both distance and near vision seem very good. Just need to discipline myself to wear for full-time use and not just a readers.


Cactus Jack 10 May 2017, 18:58

Matt,

Don't worry about it. It is very common for a person, who is mildly farsighted (hyperopic), to not realize that they need vision correction. Hyperopia is the ONLY refractive error that you can correct internally, using your Ciliary Muscles and Crystalline Lenses (your auto-focus system), to supply the extra PLUS you need - often without your being aware that you are doing it. Most people notice it when Presbyopia finally creeps up on them, as in your case.

Hyperopia, Latent Hyperopia, and Presbyopia can be hard to understand if you don't understand the optics of the eye and how vision works. All three require PLUS correction even though they have three different causes.

It is also very common for there to be a need for some prescription changes both for distance and for reading over the next few months or maybe a year. Don't be surprised if it occurs. The key thing is to NOT deny that it is occurring and don't put us with discomfort. A key thing to remember is that the changes WILL stop and your prescription will be very stable for many years. There is no way to tell when or where the PLUS for distance will stop, but the Add will stop between +2.50 (40 cm or 16 inches)and +3.50 (28 cm or 11 inches)depending on how close you like to hold things when you read. At some point, you may need an intermediate lens (trifocals) to help you focus on things, such as a computer display, that is about 60 cm (26 inches)away.

C.


NNVisitor 10 May 2017, 12:44

Matt

Your eye muscles were helping you see things close up. That's why you weren't aware.


Matt 10 May 2017, 11:46

Hi,

Just got my eyes examined and was a little surprised by the outcome. I am 42 years old and had started to struggle a little bit when reading small print and trying to read up close in dimmer light. After a little period of denial, finally visited the eye doctor. Yes, presbyopia has arrived: +1.25 needed for reading. The big surprise ---- I am also farsighted. Right eye +.75 and left eye +1.25 The doctor said that I should have been wearing glasses before now. Any others had this experience? Why had I not had eye trouble previously? Trying to get used to wearing these glasses full speed.


Maurice 29 Mar 2017, 12:24

Plus Tony, good to hear from you. Glad the single vision lenses are still doing their job. Keep us posted when you graduate to multifocal lenses. Thanks, Maurice


Plus Tony 23 Mar 2017, 11:14

Hello Maurice

Not yet. I'm still wearing my single vision prescription 100% of the time but there has been so sign of any deterioration in my vision. I know that I can handle a bit of extra plus for distance from my own experiments and although I have been tempted to self prescribe I have stuck to my official prescription for now partly because I am very fond of the glasses that I usually wear. Remarkably even though I've been wearing specs full time for over 18 months I still encounter people who haven't seen me wearing them and who ask all the standard questions which I still quite enjoy. I would be happy to have an increase but I'm prepared to be patient.


Maurice 22 Mar 2017, 12:47

Plus Tony, hope that you are seeing well. Just wondering if you had yet "graduated" to bifocals/progressives?


hooked 13 Mar 2017, 15:37

Thanks for your Explanation.

No, it is clear for me that a doctor doesn't Support any efforts in getting more myopic or hyperopic and I don't Support that, too. But I read some links and maybe there are some People who want to stay with their used-to refraction error. In any case you usually need glasses after the Operation (may it be reading glasses or some small shortsightedness) hence there may be not so much a difference.


Cactus Jack 13 Mar 2017, 10:08

Hooked,

I am not an Eye Care Professional (ECP), but an Amateur in the original French sense as a person who studies or learns a subject out of Love of Knowledge. Most of what i have leaned about vision is in trying to solve my own vision problems when I could not get satisfying answers from my ECOs.

My background is Electronic Engineering and Computer to solve Industrial problems. I have done quite a bit of industrial teaching and have a reputation as a pretty good explainer.

Most Eye Surgeons will offer choices when deciding what IOLs to install during Cataract Surgery. However, they try to get close to 6/6 or 20/20 vision. I am 79 and had Cataract Surgery in 2001. I opted for Mono-vision where one eye is close to 0.00 and the other is about -1.50. Mono-vision allows me to function without my glasses, but I wear trifocals when I need really good vision.

Most Eye Surgeons will install IOLs that let you remain Myopic or Hyperopic, IF you have a very good reason. The reason most of them became doctors is that they want to help people have better lives. They are psychologically disposed to try to make things "better". Some will install IOLs that make a person more Myopic or Hyperopic, but there usually needs to be a confirmed diagnosis of BIID (Body Integrity Identity Disorder)

These days, few people have the old type Cataract Surgery where the Crystalline Lens and Capsule are completely removed. There has to be a medical reason for not replacing the Crystalline Lens with an IOL. If the Crystalline Lens and Capsule is completely removed, the surgery goes from a fairly easy, low risk, Outpatient procedure to a serious, risky, surgery that often requires weeks or months for recovery. it becomes necessary to wear very high PLUS glasses which severely limit peripheral vision.

Before you wish very high PLUS glasses on another person, you need to get some experience wearing them. You can do that by doing some GOC with some high minus contacts and appropriate high PLUS glasses.

C.


hooked 13 Mar 2017, 07:43

Thank you for that excellent explanation. I didn't know these details.

I was just wondering because I always thought hyperopia won't increase when getting older.

Are you an expert?

You mentioned cataract surgery and you mentioned one can choose the final prescription.

Do you think (or know any studies) that there are some people which won't be corrected to zero diopters but prefer to stay myopic/hyperopic?


Cactus Jack 10 Mar 2017, 08:07

hooked,

The amount of her increase is very small, in the overall scheme of things. It is interesting that at age 20 her prescription was approximately +6. it decreased over the years and then started increasing at an age where Presbyopia becomes a factor. Her distance prescription is almost where it was at age 20.

The laws of Optical Physics are NOT variable and the tissue that makes up the eyeball, while not a rigid a bone, it is pretty dense and stiff. 1/2 diopter change is really tiny and the cause could be anywhere. Could the eyeball have shrunk 0.15 mm, sure, but it is more likely that there was a tiny change in the eye's lens system.

The eye's lens system actually consists of 4 PLUS lenses, but we only typically think of the Cornea and the Crystalline Lenses. The other two lenses are actually liquids. The Aqueous Humor (AH), between the Cornea and the Crystalline Lens, and the Vitreous Humor (VH), inside the eyeball, between the Crystalline Lens and the Retina. The AH does not contribute much PLUS and the VH contributes more. The Index of Refraction of the Humors can change as ones blood chemistry changes. The Humors seem to be particularly sensitive to Blood Glucose (BG) levels, that is why people with Diabetes experience vision changes as their BG changes. Often, Diabetics who do not have good BG control will have several pairs of glasses with different Sphere prescriptions so they can pick the pair that gives them the best vision at any particular time.

Typically, the changes are much more than your wife is experiencing and the changes occur at different times of the day, rather than over years.

It looks to me like your wife's vision has been very stable for years, I don't think you should expect much of an increase or change in the future, other than her Add, unless she likes to do a lot of very close work. It looks to me like she might still have some accommodation, available, but not a lot. There might be a little "trading" of PLUS between here Sphere correction and her Add. None of this is anything to get excited about.

At some point she may need Cataract Surgery and at that time, she can select what prescription she would like from that point forward.

Here is a link to a paper entitled "The Eye" you might find interesting:

http://www.lhup.edu/~dsimanek/scenario/labman3/eye.htm

C.


hooked 10 Mar 2017, 05:26

What I can tell you. My wife's optometrist told her it is quite normal to have an increase in hyperopia starting from age 40.

Even if Cactus Jack gave an explanation I'm wondering why hyperopia increases because that would mean that the eyeballs become shorter. And I can't find any reason for that.

@Cactus Jack: I don't agree completely with your theory. My wife wears glasses all the time hence the muscles can relax and the eyes were dilated to get the amount of latent hyperopia, too. Hence I assume this increase is not due to some "uncorrected" latent hyperopia. But maybe I'm wrong.


spexfan 09 Mar 2017, 23:50

Am fascinated by the rx increases of hooks' partner ie. she seems to have gained about +3.5 diopters total since presbyopia started at 40....but +1.5 of that went to her distance rx over time.

I've always been hoping to increase my + distance rx since I got multifocals. Just got a +.25 distance increase at my last exam which was slightly blurry at first but is very clear 3 months later. I've gained a total of +2.5 since I started wearing multifocals (since about 10 years ago...I'm 47 now.) but +2.25 of that went to the add.

Maybe I've got a bit a few distance rx increases ahead?! Would be curious to hear more from hooked or others with similar situations. FYI I am currently +1.5/+1.75 add +2.25.


Cactus Jack 07 Mar 2017, 11:10

Hooked,

Your wife likely had some Latent Hyperopia along with her actual Hyperopia, but there is really no way to tell, now. True Hyperopia is caused by a mismatch between the total PLUS optical power of the eye's lens system and the distance from the Crystalline Lens to the Retina. The typical cause is that the eyeball did not grow quite enough in adolescence. The distances involved are small, only about 0.3 mm per diopter.

Hyperopia is the only refractive error that can be corrected internally using one's Ciliary Muscles and Crystalline Lenses. Often without a person even being aware that they are doing it. Over time, the Ciliary Muscle gets used to the constant correction and has difficulty relaxing. When that happens, the condition is called Latent Hyperopia. That typically works until Presbyopia begins to become a factor and an Add is needed. As the Add increases, and takes over the focusing workload, the Ciliary Muscles begins to relax and more PLUS is needed for distance vision along with more PLUS for close focusing help.

C.


hooked 07 Mar 2017, 08:42

I had some spare time and read this thread form the beginning.

It is still quite interesting.

10 years ago I wrote that presbyopia sets in. I was 41 at that time. Now I need reading glasses and even for things far away glasses may help (for the right eye, the left one is still fine).

And then an update on my wife's progression of hyperopia and presbyopia.

Age 20: + 6 (average, for OL subtract 0.5, for OD add 0.5)

Age 25: + 5.5

Age 30: + 5

Age 40: + 5.5 ADD + 1

Age 45: + 5.75 ADD +1.5

Age 48: + 6 ADD 2

Age 51: + 6.5 ADD 2

I always thought hyperopia won't increase but it might be the case.

I must admit (we're kind of a fetish side) I like that her farsightedness increases.

And there is a big difference in magnification and cut-out (as the opposite to cut-in) between the + 6 and the + 6.5 glasses. But this might also be due to the different kind of frames.


Cactus Jack 02 Mar 2017, 08:37

BB1,

The difference is only 1.75 diopters, it just happens that your Right eye is a bit nearsighted (-1.00) and the Left Eye is a bit farsighted (+0.75). Nothing to get excited about except that it affects your depth perception and 3-D vision and makes you vision system work harder than it should have to. You are probably doing close work with with your Right Eye and distance with your Left.

You really should get glasses and wear them full time for about 2 weeks before deciding how often to wear them. I think you will be amazed at how comfortable it is to have both eyes working as a team, rather than independently.

Vision actually occurs in the brain. Your eyes are merely biological cameras. You brain has been working overtime to correct your vision. It is better to correct your vision optically and relieve your brain of the extra work. You may think, after wearing your glasses for 2 weeks, that the glasses have made your vision worse. That is not true, all that has happened is that your brain has learned to work with high quality images and has set aside the image processing algorithm it has been using. You can force it to go back to the old algorithm by not wearing your glasses, but it will probably complain.

In some ways, glasses or contacts are just labor saving tools. Most of us are "hooked" on things that make us comfortable or save work. Could you become "dependent" on your glasses? Yes. I am pretty dependent on clothes and shoes because I don't have fur or hard surfaces on my feet to protect them from stones in the walkway. I am also dependent on my glasses because I like seeing comfortably and well.

May I ask your age and where you live?

C.


BB1 02 Mar 2017, 06:30

Cactus Jack

I didnt know its pretty common. Most people i know who wear specs are nearsighted in both eyes. I was just diagnosed w/ antimetropia. My prescription is OD -1.0 OS +0.75. My eyesight is somewhat fine, I just have difficulty driving at night, and occ headaches.

Should i get glasses? And if i should, should i wear it full time?

-BB1


Cactus Jack 02 Mar 2017, 05:56

BB1,

It is fairly common. What makes it rare is if there is a large difference. It its more rare for the eyes to have exactly the same prescription. Differences of 1 to 3 diopters are pretty common, but usually they are on the same side of 0.00, but they don't have to be.

Eyeball growth is usually at the heart of any Refractive Error and nothing requires that the eyeballs grow at the same rate. The actual cause of Myopia or Hyperopia is a mismatch between the total optical power of the eye's lens system and the distance from the back of the Crystalline Lens to the Retina. In an adult eyeball of about 25 mm diameter, because the eye's lens system is inset, the distance is about 17 mm and the total power is about +59 diopters. If you do the math, it is about 0.3 mm per diopter.

The most common problem, caused by a big difference or a difference on opposite sides of 0.00, is the difference in image size on the Retinas. That can cause symptoms of double vision, that typically cannot be corrected by prism in the glasses.

May I ask your prescription and the problems you are having?

C.


BB1 02 Mar 2017, 01:59

anyone here have antimetropia / 1 eye nearsighted and 1 eye farsighted?


Cactus Jack 20 Feb 2017, 23:30

spexfan,

It takes a little explaining, but I think I can help you understand how the test works.

The first thing you have to remember is that corrective lenses are just that. They have the opposite sign of the actual refractive error. To keep the numbers straight, I call the reverse of the glasses your "Eye Power" or EP. For prescriptions below about +/- 4.00 your glasses power and your EP will be the same but with different signs.

Because you are Hyperopic, your EP is -1.75R/-1.50L A person who is Myopic will have a + EP corrected by - lenses.

The only purpose of the + reading glasses is to move the point where the text just gets fuzzy around the edges to an easily measured range of less than arms length.

However, you don't want it too close, because it actually gets harder to measure the distance accurately, which causes errors. The test is crude enough without encouraging errors. if I suspect or know that a person has a pretty low refractive error, I suggest +1.50 or +1.75. Because you are Hyperopic with a known prescription and Presbyopia. We have to modify the test slightly.

You should do the test with your glasses on, which should correct you to about 0.00 for distance.

Theoretically, you could do the test using your reading Add, but I think it would be easier and more accurate to wear readers over your glasses.

The math is not difficult to understand, but you have to remember what I talked about in the first paragraph and understand the fundamental formula in optics.

Lens power = 100 cm or 39.37 inches / focal distance.

or

Focal Distance = 100 cm / Lens power

Step 1 is to calculate the Focal Distance of the OTC readers you will be using.

lets say that you are using +1.75 readers. The Focal Distance is 100 cm / 1.75 = 57 cm.

If a person is significantly Hyperopic or Myopic you have to adjust the OTC reader power, which may be difficult or do the test with their glasses on and the OTC readers over them.

When you do the test, the difference in the measured focal distance and 57 cm is the refractive error or EP. If the measured focal distance is MORE than the calculated focal distance, their EP is (-) MINUS and they likely need more PLUS to correct it. If the measured focal distance is LESS than the calculated focal distance of the readers, their EP is (+) PLUS and they likely need more MINUS to correct it.

The amout is easily calculated by dividing the difference between the calculated and the measured distance into 100 cm.

Hope this helps. Review what I told Fubius and see if it makes sense. He got some funny results on the second test and I am still trying to figure out what is going on. I hope he responds soon with answers to my questions.

Let me know if you need more help.

C.


spexfan 20 Feb 2017, 20:49

Cactus, could you explain the formula you've applied to calculate Faubius' hyperopia? ie. the plus power lens/legible distance/under-or-over correction?

I'm wearing +1.75R/+1.5L with a 2.25 add and am curious to know how I'd tolerate a little extra plus power. Would be interested in doing some experiments.

Thanks!


Cactus Jack 20 Feb 2017, 15:35

Faubius,

Sorry about repeatedly getting your name wrong. The spell checker is changing it and I didn't catch it. Spell checkers are great, sometimes, but other times they are a nuisance.

C.


Cactus Jack 20 Feb 2017, 01:58

Fabius,

Post below is for you. Sorry about the typo.

C.


Cactus Jack 19 Feb 2017, 16:14

Fabius,

I am a little confused by the results of your second test.

The first test with the +2.00 reading glasses indicated that you may be a bit hyperopic. The +2.00 glasses were OK, and the 58 cm results indicate that. If you had a 0.00 prescription the distance should have been 50 cm with the +2.00 glasses. 58 cm indicates that your refractive error, early in the morning is about +1.75 (100/58 = 1.72) with the +2.00 glasses. The difference is about -0.25. When dealing with eye prescriptions, you have to remember that the glasses or contact prescription is the reverse sign of the actual refractive error in the eyes. -0.25 in your eyes means that you need +0.25 to correct it. In other words, mild Hyperopia.

However, based on your 2nd test results, after a day of close work, I thing there is something going on that we have not identified. That is not to say that it is serious, we just need to figure out what is going on so you can describe it to the Optician.

Were you wearing the +2.00 glasses for the 2nd test?

I would have expected that after a day of close work, you might be temporarily a bit Myopic. If so, and you were wearing the +2.00 glasses, I would have expected the fuzziness to start at a closer distance than 50 cm, not 77 cm. If you were NOT wearing the +2.00 glasses and got 77 cm, it just means that you have some temporary "Pseudo" or false Myopia which is easy to address.

C.

I may ask you to do some other tests.

C.


Faubius 18 Feb 2017, 03:09

Cactus Jack

i've done the test procedures you described,unfortunately i had to use a +2 pair because i didn't find the one you asked for,i hope it's not a problem.

However with test procedure 1,the fuzziness was between 57cm and 59cm for an average distance of 58cm.This test was in the morning at 8.am inside home with a good sunlight not too bright as you suggested.

And test procedure 2,which was more hard to measure since the fuzziness started beyond my full arms lenght,so take in count that maybe ther's a slight margin of error,anyway in this case the fuzziness was between 75cm and 78cm for an average distance of 77cm.This test was done at 7.pm with artificial light settled at medium level and after doing extensive close work.

i also casually noticed that my eyes are not the same since my left eye during the misurations had an average difference with my right eye of around 10cm.

I hope i've provided enough datas,what does all that mean?

P.S.I also tried to look around the web to test my eyesight for near with some eye charts and it happens that i could read around half of it in most cases,i don't know if it's important just wanted to add more informations


 17 Feb 2017, 15:56

Faubius,HOW TO STUDY FOR AN EYE EXAM

An eye exam is not like an exam that you might take in school and there is really no way to study for it. However, you can prepare for it and learn about your role in the exam. The best eye exams are a team effort between you and the Examiner. Part of the preparation is to learn what to expect, particularly if this is your first eye exam.

One important thing you need to keep in mind is that the Examiner has no way to experience what you are seeing. He/she has to depend on your answers to questions.

There are two parts to an eye exam. The first part is the Objective part. This part consists of:

1. Taking a Visual History where you describe your vision and the kinds of problems you are having.

2. Checking the internal pressure in your eyes for symptoms of Glaucoma. This is one of the very few parts of an eye exam that is even mildly uncomfortable and the discomfort only lasts for a few seconds. There are two basic ways to do the pressure test.

A. Using a special instrument to lightly touch your Cornea. Not to worry here. Before doing this type of test a drop of mild anesthetic will make sure you don’t even feel it.

B. There is a new type instrument that uses a puff of air directed against your cornea. No anesthetic is required, but the puff will startle you. The puff of air is harmless and there are huge benefits. Detecting Glaucoma early, before it can do damage can save your eyesight.

3. The examiner will also get a preliminary estimate of your refractive error by using an Auto-Refractor or manually by using a small hand held instrument called an Ophthalmoscope or Retinoscope.

The Auto-Refractor is a relatively new instrument that was developed in conjunction with NASA to check Astronauts vision in space. You look into the machine with each eye individually where you will see a scene or a pattern. The machine will adjust its internal lenses to focus the image you see on your retina. The Auto-Refractor only takes a few seconds for each eye and it then prints out your estimated prescription.

Some Examiners prefer to use manual methods that have been used for many years. Using an Ophthalmoscope or Retinoscope and a Trial Lens set or a Phoropter (a fancy machine with a built in lens set), the Examiner will look into your eyes and select the lenses that allow him to see your retina, most clearly.

The object of this part of the exam is to get a starting place for the Subjective part of the exam where you have to describe what you see.

Typically the Subjective part of the exam starts with the Right Eye shutter open and the Left Eye shutter closed.

Step 1 is typically determining the cylinder and axis of any Astigmatism correction you need. This is actually the hardest part of the exam because you will be asked to judge relative blurriness of two images rather than the sharpness of an image.

You will be shown a line of text and a supplemental lens will be rotated into place. This lens is a cylinder lens that is mounted on a 45 degree pivot and can be flopped back an forth to bracket a trial axis or orientation of the long axis of the cylinder lens. The thing that is confusing about this test is that the straight lines (strokes) of the letters will alternate in clarity as the lens is flipped back and forth depending on their direction. I suggest concentrating on an “O” if possible. Depending on your answers, the examiner will adjust the axis knob unit the image you see is equally blurry with the supplemental lens 45 degrees each side of the selected axis.

At this point the Examiner will probably swing the supplemental lens out of the way and may change the cylinder power while asking you which lens in clearer.

For your first exam, you may be uncomfortable asking the Examiner to let you fine tune the Cylinder Axis, but I have found that most will appreciate your wanting to actively participate. The way that works is that he will place your hand on the Axis control knob. This time, you move it back and forth a few degrees looking for the sharpest image. It is a bit like “Fine Tuning” an old Analog TV set or moving the tuning knob on an analog AM radio for the best signal.

The next step is determining the Sphere correction. This is an easy part of the exam because all you have to do is pick the sharpest image, but there is a tricky part. Your auto-focus mechanism will try to help, if it gets a chance. The Examiner has a couple of ways to minimize the action of your ciliary muscles and crystalline lenses.

The Examiner can, in effect, sneak up on your Sphere prescription or he can use drops to Dilate your eyes. Lets talk about sneaking up on your prescription first. There are actually 4 lenses in your eye’s lens system. All of them are PLUS lenses and the total power is about +56 to +60 diopters. The only variable focus lens is the crystalline lens whose PLUS power is controlled by your ciliary muscles. For distance, your Crystalline lens is fully relaxed and has somewhere around +15 diopters. When you focus to read, your Ciliary Muscles squeeze the Crystalline lens to increase its PLUS power by the amount necessary to focus which depends on the distance to the object.

This will take a little thought to get your mind around, but if you are nearsighted, your lens system has too much PLUS for the distance from the lens system to your retina and you need MINUS lenses to neutralize some of that excess PLUS power. You ONLY have the ability to increase the PLUS power of your lens system. You have NO ability to reduce the PLUS power of your Crystalline lenses more that fully relaxed.

To try to keep your Ciliary Muscles and Crystalline lenses from getting in the act, the examiner will start with NOT ENOUGH MINUS or TOO MUCH PLUS (same thing) and gradually increase the MINUS one or two steps at a time, while reducing the size of the line you are asked to read. He will not tell you what power lens or what line you are looking at. Eventually, he will reach the 20/20 line and a lens power that lets you read it with no mistakes.

He will then follow the same procedure with your Left Eye.

When he has completed both eyes, he will open the shutters and you may see two images. This part of the test is to check your muscle balance using some prisms. He will probably ask you to tell him when the two images are aligned horizontally and then vertically. While the images are separated, you have an important check to make. Compare the sharpness of the two images. If they are not equally sharp, be sure and tell the Examiner which image is clearer. If there is a difference, he will likely reduce the sharpness of the clearest image until they match. The important thing at this point is that they match. That lack of sharpness will be corrected in the next phase with both eyes working together.

Next he will fuse the images so both eyes are working together and repeat the Sphere procedure by gradually increasing the MINUS or decreasing the PLUS until you see the smallest line of letters very clearly.

That pretty much completes the exam except for checking your near vision with a small chart about 14 to 16 inches from you.

Many people, who wear glasses, actually look forward to eye exams. Once you have become accustomed to having very good vision, you will probably find anything less, unacceptable. Many times, after the exam, it will be suggested that you get another exam some time in the future. Note that I used the word “suggested”. it is NOT a Command. If your detect a problem or if your vision seems uncomfortable, please don’t wait until the “suggested” date to seek an appointment to get your vision checked.

Let me know if you have more questions

C.


Cactus Jack 17 Feb 2017, 15:54

Faubius,

I would like to suggest two things. There is a relatively easy test you can do at home to get an idea of your vision. The test is a practical application of the principles of optics codified by Sir Isaac Newton around 1700.

You will only need 3 things to do the test.

1. A pair of Over-the-Counter (OTC) Reading Glasses of +1.50 or + 1.75 power. These glasses will cause some artificial Myopia to make the test easier to do and more accurate and get the distance where the letters just become fuzzy around the edges into an easily measured range

2. A measuring tape that can measure about 100 cm.

3. A book or newspaper with average small print. (The target)

Test Procedure 1: Morning test when you are fresh.

In good, but not BRIGHT light, put on the Reading Glasses.

1.Hold the book or newspaper about 30 cm from your face and gradually move the Target away from your face until the text just starts to get fuzzy around the edges.

2. Note the distance from your face

3. Repeat steps 1 and 2, Three times and average the results.

4. Tell me the results.

Test Procedure 2:

1.Repeat Test Procedure 1 when you have been doing extensive close work.

2. Tell me the results.

Be sure and tell me th power of the glasses and when the test was performed.

Also, I suggest you read "How to Study for and Eye Exam", which follows in the next post.

C.


Faubius 17 Feb 2017, 14:54

Hello i'm a 22 year old guy from Italy,i found this website while searching informations about glasses and vision.

In the last months i've noticed that my vision is not perfect anymore,at first i thought it was caused by allergies or tired eyes since i started to work in front of a computer screen for many hours at day.

But now i'm thinking that maybe i have hyperopia because the symptoms i'm actually having are:when i start to read a book/journal or at the screen of the computer/tablet/smartphone my vision is perfectly clear but after 1/2 minutes it gets really blurry to the point i can barely make out the letters even if they're quite big,and when i look far it's still blurry(only for some minutes and for small things),although blinking and squinting very much and putting things a bit far,help in reducing a bit the blurriness to a manageable level it still give me a lot of eye strain and headaches.

I wanted to hear your opinion about it before booking an eye test to the optician,my last eye test was 10 years ago and at that time i had perfect vision so maybe something changed,i don't even remember what happens during the eye test so if you could give me informations about it,it would be great

So what's your opinion?Do i have hyperopia?Am i going to get glasses?

P.S. Sorry for my bad English,i should've studied it more in high school


Catwoman 12 Feb 2017, 10:28

Cactus Jack:

Thank you for the wealth of information. I had no idea of "true and false" myopia or anything about the crystalline lenses and celery muscles. :)

The 2 pairs of cateyes that I wear on the weekend do have progressive lenses, while the 5 pairs I wear the rest of the week are regular bifocals. I use the computer all the time at work, and I have plenty of light in my office. I have not noticed any problem with reading the screen, home or away. At home I read more close-up, mainly newspapers and magazines, quite often during commercials of TV programs, so the multi-vision (as opposed to single-vision) lenses help.

For very small print I may take my glasses off and look at it a few inches away, as not even my +2.75 add can do the trick. The same applies for when I apply makeup or eye shadow (only for special occasions anymore).


Cactus Jack 11 Feb 2017, 11:19

Catwoman,

You probably have a combination of True, Axial Myopia and False, Pseudo Myopia, they can add together. Pseudo Myopia can decrease, but Axial Myopia generally does not. Both Presbyopia and Pseudo Myopia are related to the Ciliary Muscles and the Crystalline Lenses. Your add has been increasing as your Crystalline Lenses get stiffer and your Ciliary Muscles get weaker.

Your distance prescription may decrease some, but probably not down to 0.00 and your add will probably not increase much more, unless you like to focus very close. At some point your add will be strictly related to the distance from your eyes to what you are wanting for focus on. You may need a different power add to be able to use a computer and read with the same pair of glasses. That is whey they make progressives and trifocals.

C.


Catwoman 11 Feb 2017, 10:33

When I was 38, I got my first bifocals, at +1.50. A few years later, it was up to +2.00, then to +2.50, and last summer +2.75. With my myopia seemingly decreasing, maybe some year the numbers will balance out, except of course for the astigmatism that has been a family bane.


Cactus Jack 03 Feb 2017, 10:14

Russ,

I suspect both your distance and add will need changing. Don't be surprised if this process takes several weeks or months to completely stabilize. You might check with your ECP about their policy on prescription changes. Some will remake glasses for prescription changes, free,

only within 90 days. Others offer more time or won't remake them free unless it is an error on their part.

Once your vision has stabilized, the changes will probably be small and infrequent. The primary change will be in Cylinder and Axis, but that can be minimized by using the technique for "Fine Tuning) the Axis, outlined in "How to Study for an Eye Exam"

C.


Russ 02 Feb 2017, 15:52

Thanks for the info CJ. Latent hyperopia sounds like my distance problem. I have been wearing my glasses full-time in order for my eyes to adjust, accommodate, etc. to the vision correction. Will see how quickly my add needs an increase.


Cactus Jack 31 Jan 2017, 10:07

Russ,

It would have been very rare for you to have noticed your farsightedness. Hyperopia or farsightedness is the ONLY refractive error that you can correct internally, using your Ciliary Muscles and Crystalline Lenses. Particularly, since you did not mention any Astigmatism correction (Cylinder and Axis).

Presbyopia, which is the gradual stiffening of the transparent protein that makes up your Crystalline Lens, is gradually catching up with you. That happens to almost everyone by the time they get to 40, though it can happen at any age. It depends on your genes.

There are two kinds of Hyperopia. One is caused by a mismatch between the length of your eyeball and the total PLUS power of your eye's lens system. Typically, it is caused by the failure of the eyeball to grow quite long enough by about 0.3 mm per diopter. It is considered permanent.

The other type of Hyperopia is called Latent Hyperopia. It is caused by the Ciliary Muscles and Crystalline lenses not fully relaxing for distance. Once you start wearing external PLUS lenses, to correct your Hyperopia and bifocals to correct your Presbyopia, your Ciliary Muscles will gradually relax and your will need more external PLUS for distance and your Add will increase. However, your Add will never be more than about +2.50 pr +3.00, unless you need to focus very close. Once your Hyperopia is corrected, you can calculate the amount of Add you need by measuring the distance from your eyes to the visual target and dividing that into 1 meter. The result is the Add power.

C.


Russ 31 Jan 2017, 05:28

I am 43 years old and was having difficulty seeing the text on my phone. Went to the eye doctor and came out totally surprised. I did need assistance for close-up work, but the doctor told me that I needed glasses for distance and probably had needed them for years. My prescription is +1.50 add +1.25 and +1.75 add +1.25. I have gotten the glasses and am getting used to wearing them all the time. Question-----should I have noticed the "farsightedness" related to distance???

Anyway, wearing glasses is pretty cool.


Plus Tony 23 Jan 2017, 14:30

Cactus Jack

Thanks for your advice which I have passed on. My friend was slightly taken aback when I suggested that she should see a pediatric opthamologist but I explained the rationale as you explained it here and she understood the logic. It will be interesting to see whether she is able to arrange an appointment through the NHS or whether she will have to go private. I suspect the latter.

Incidentally she says that she doesn't feel any additional strain at near but of course that doesn't necessarily mean that presbyopia isn't starting to make an appearance.

Thanks again


John S 21 Jan 2017, 17:26

CJ, I completely agree. I think there might be a few more increases to come. Hopefully his eyes will stabilize soon. I don't think his add will go up again. I think the doctor probably increased it because he asked him to see closer. You know how teenagers are addicted to their phones.

A few months after he got his glasses he was doing better in school. But part of the improvement was due to a few threats from his parents. I'm sure his glasses played a part of it also.

He wore his old glasses most of the time, but his new ones stay on him. I will post a picture of his glasses on V & S. Before anyone asks, no pictures of him wearing them.


Cactus Jack 21 Jan 2017, 15:41

John S.,

Your friend's 12 YO son is a good example of Latent Hyperopia in action and the fact that it can occur at a very early age. He probably has had Hyperopia for a long time and his visual environment finally caught up with him. I have a hunch that he may not be through with increases in his Plus for distance. Once his Hyperopia has been fully resolved and corrected, he may have enough Accommodation range available to not need an Add of +2.00. One of the things that will work against him is the tiny text on Smart Phones.

The clue that he really needed glasses was the discomfort when reading. I have an 8 YO great nephew that had behavioral problems when he was around 4 or 5. Hated to do anything that involved focusing close. My brother, his grandfather, finally put the clues together and insisted that he get his eyes checked. Turned out he had Hyperopia and Astigmatism and close focusing was very uncomfortable. At first he rebelled at wearing glasses, but quickly discovered the difference. He is now in the 3rd grade and a very different child. Turns out he is rather smart and I alerted his grandfather and his father that the problem would be keeping him challenged as he plays catch up and experiences the joy of discovery.

Your friend may experience something similar as his son begins to take advantage of comfortable close vision. You might suggest a followup check in a few months and suggest looking into some low cost spares from Zenni.

Times surely have have changed when a 12 YO wearing bifocals and having prescription reading glasses is no big deal to his friends and class mates.

C.


John S 21 Jan 2017, 11:21

My friend’s son that got his first glasses 6 months ago stepped on his glasses. His glasses didn’t feel as strong as they used to, so when he went in to get his glasses fixed he got a checkup. His new glasses are: R +1.50, L +1.75 -0.25 X 118, Add +2.00. Without his glasses his distance vision is 20/40, and his close vision is 20/200.

He got bifocals this time. He said the stronger lenses made a big difference. He really likes them.

A couple of his friends asked him about his new glasses. They said they were cool because they had a line. How things have changed.


Newspex 20 Jan 2017, 11:03

Hi John S,

Thanks for coming back to me - I got L+1.25 R+1.00 -0.25 about 10 years ago when I was 39.

I have been wearing L+0.5 ADD +1.5 R+0.25 -0.25 ADD +1.5

These work fine apart from when I remove then and look in the distance as I mentioned.


Newspex 20 Jan 2017, 11:03

Hi John S,

Thanks for coming back to me - I got L+1.25 R+1.00 -0.25 about 10 years ago when I was 39.

I have been wearing L+0.5 ADD +1.5 R+0.25 -0.25 ADD +1.5

These work fine apart from when I remove then and look in the distance as I mentioned.


John S 19 Jan 2017, 19:18

Newspex,

Since you not received your answer, I will jump in.

Your reading muscles are relaxing more since you have increased your correction. They have been compensating to keep your distance vision clear. When you give the muscles a break by using the correct reading power, they get used to it, and don't want to work to give you the extra power you need to correct your distance vision. Basically, you should also be wearing distance correction in addition to reading.

What power were your old glasses, and what are you wearing now?


Cactus Jack 19 Jan 2017, 13:21

Plus Tony,

There could be several things going on. The interactions between the focus control system and the eye position control system are complex. At 39 in addition to her other issues, I suspect Presbyopia is also getting into the act.

Prism might help some, but there is no way to offer suggestions other than to suggest that she should see a Pediatric Ophthalmologist. They specialize in children's eye misalignment problems and also see adults with eye misalignment problems.

C.


Plus Tony 19 Jan 2017, 12:26

I got into a conversation the other day with a fellow hyperope with a prescription just a little stronger than my own (she is L +1.50, R + 2.50) and is 39 years old. She was first prescribed glasses as an adult about 3 years ago and now wears her glasses full time. She is in good general health and has excellent vision with glasses although she is very much reliant on her left eye.

She had previously worn glasses as a child and was patched for a lazy eye. She stopped wearing glasses at about the age of 9 or 10 when she was told her lazy eye could not be improved further. When she removes her glasses her right eye tends to turn in. She said that she had noticed recently that her right eye sometimes turns in while she is wearing her glasses although it seems to be intermittent. She wondered whether this could be corrected by prism. I said that I wasn't sure. She mentioned that at her last eye test the optometrist had said that her right eye was corrected as much as it could be so I assume that adding plus would not help to stop the turn.

I seem to remember reading (probably here) that while prism can correct certain eye position issues it doesn't help with amblyopia. Is that correct? I suggested that she should discuss it with her optometrist which she said she would.


John S 16 Jan 2017, 12:24

Soundmanpt,

Please re-read what Newspex posted. I think you missed when he took he glasses off, his distance vision was blurry.


Soundmanpt 16 Jan 2017, 10:53

Newspex

Your eyes are still adjusting to the change in your prescription which is very normal. The same thing likely happened with your previous glasses when you first got them but as your eyes adjusted you didn't have the blur anymore.


Newspex 16 Jan 2017, 10:47

I have recently upgraded my reading/ pc glasses, but I have noticed that

after wearing them for a prolonged spell they make distance vision blurry for about 10 minutes when I remove them.

The old pair didn't seem to do it.


Cactus Jack 15 Jan 2017, 18:46

Jay,

Sometimes the ES server does not respond very quickly. If the background of the Submit button turns BLUE when you click on it, your post is acceptable. You don't need to click again. Multiple posts are usually caused by the server being slow to respond your first click. If the Submit button turns Blue, just be patient and the server will retrieve your post when it can. It rarely take more than 30 seconds.

C.


Jackson 15 Jan 2017, 16:48

Jay,

Yes, they are just reading glasses.


Jay 15 Jan 2017, 15:49

My apologies. I was having trouble posting.


Jay 15 Jan 2017, 15:45

Just getting reading glasses, Jackson?


Jay 15 Jan 2017, 15:45

Just getting reading glasses, Jackson?


Jay 15 Jan 2017, 15:45

Just getting reading glasses, Jackson?


Jay 15 Jan 2017, 15:45

Just getting reading glasses, Jackson?


Jay 15 Jan 2017, 15:45

Just getting reading glasses, Jackson?


Jay 15 Jan 2017, 15:45

Just getting reading glasses, Jackson?


Jay 15 Jan 2017, 15:44

Just getting reading glasses, Jackson?


Jackson 13 Jan 2017, 16:03

Seems my age has finally caught up to me. I was having a little trouble reading the paper, so I decided to get my eyes checked, and turns out my intuition was correct. I am getting my glasses later today.


Cactus Jack 11 Jan 2017, 18:26

There are two kinds of Hyperopia and two kinds of Myopia. True Hyperopia and Myopia are typically caused by a mismatch between the length of the eyeball and the total optical power of your eye's lens system. After your eyeballs stop growing, usually in your late teens or early 20s. The don't change size (length) very much. The critical thing here is the distance from the back of the Crystalline Lens to the Retina. The eyeballs like most other body parts don't shrink much after they have grown. They would have to shrink for for true Myopia, where the eyeball is too long, to turn into Hyperopia where the eyeball is too short.

I suspect you may have had False Myopia on top of True Hyperopia. They can occur together because False or Pseudo Myopia (ctually the same thing as Latent Hyperopia is caused by the Ciliary Muscles and Crystalline Lenses not fully relaxing back to their high PLUS power. The way it is supposed to work, if you don't need correction) is that the Ciliary Muscles and Crystalline Lenses are fully relaxed (at minimum PLUS power for distance. If you focus close your Ciliary Muscles squeeze the Crystalline Lenses and increase their Plus power by an amount determined by Sir Isaac Newton's most fundamental optical formula. Lens Power = 1 meter / Focal Distance. In practice that means to focus at a typical reading distance of 40 cm or 16 inches, you need +2.50 internally using your Ciliary Muscles and Crystalline Lenses or externally from glasses. If your Ciliary Muscles don't fully relax for any reason, you have False Myopia or if you are actually farsighted and need the extra Plus for distance, you have Latent Hyperopia.

If you have False Myopia, when you start wearing glasses with an Add, often your Ciliary Muscles gradually relax over time and you become less and less Myopic. If you are actually Hyperopic, you finally need Plus glasses for distance.

You did not mention your prescription for Myopia or present prescription for Hyperopia. That would help understand what has happened. It is really pretty common.

C.


john 11 Jan 2017, 02:27

Bailey.- Yes it happened to me.I had myopia all my life like you and when I got bifocals I slowly went to hyperopia .There was a year where I needed no distance correction except for my astigmatism .I am older than you and now have trifocals which happens when your add goes to plus 2.00 or more.Eye Drs don't like to predict what is going to happen because everybody is different .It may not happen to you but it could. Hope this helps.


Soundmanpt 11 Nov 2016, 08:53

Dan

Thanks for the update of your fiancee's recent eye exam. You and others were expecting that in the 3 years since she got her last glasses and considering her own comments to you about her vision that she almost certainly would be needing an increase in her glasses. She even said that when she doesn't wear her glasses when she is on her computer that her eyes don't focus well and it had become much more difficult trying to read small print without her glasses and even with her glasses small print was blurry. It did seem like she was almost certain to be getting stronger glasses. But instead she no longer has any plus in her new prescription. Now she only has astigmatisms. A bit more in her right eye than her left eye which is actually nearly perfect now. So please provide us with further updates once she gets her new glasses as to how she gets along wearing them. The good news for you is that since she is so used to wearing glasses already she will most likely continue wearing them even though she only barely needs them.


Dan 11 Nov 2016, 06:19

Realized I never posted my fiancée's new prescription (see discussion in September on this thread). Some had speculated (including myself) that she would need more plus. In fact, she just needed more astigmasitn correction. New prescription

OD 0.00 -1.00x95

OS 0.00 -0.25 x 45

My prescription remained quite boring, -1.75 ( up from -1.50)


Michael 30 Oct 2016, 11:19

swap- I liked it when you said you wished your girl friend would wear her glasses 24/7. I know what you are saying but I don't think you really mean 24/7. I don't think it would be a good idea for her to wear them when either showering or sleeping.But it might not be a bad idea if she wore them most of the rest of the time.If she did she might stop having headaches.


Michael 30 Oct 2016, 08:59

swap- You are welcome. I am trying to advise you as best as I can and let us know if we can be of any more assistance.


swap 30 Oct 2016, 08:14

THANKS Michael


Michael 30 Oct 2016, 07:56

swap-The headaches are a clue I think that your girl friend needs to wear her glasses more than she is if not full time. The first thing I would suggest is have her get an eye exam ASAP. I have a feeling she may have some astigmatism and that is why she is getting headaches and eye pain which I guess is getting worse.I am almost certain she needs an updated script and it might be a good idea if that is the case for her to wear it full time.

Does she wear her glasses all the time when driving?She definitely needs to do that. I don't know what the laws are in the state you live in but in the majority of them you have to periodically pass an eye exam to renew your driver's license and I have serious doubts your girl friend would be able to without correction. If her uncorrected vision is less than 20/40 I don't think she could pass a DMV vision screening in any state without wearing her glasses

I am assuming she wears her glasses in class for lectures and to read the board.Am I right? And how about for studying? If she gets headaches when using the computer I am guessing she does when reading books and doing homework as well.

But it can be a pain to keep on putting your glasses on and taking them off. Does your girl friend do that? It makes me very nervous when I see somebody do that. If you are constantly putting them on and taking them off you are probably just better off leaving them on. Plus you are less apt to either lose or break them if you keep them on your face.

And if your girl friend does go for an eye exam have her ask either the doctor or optician for advice as to when she should wear her glasses. It is my experience that most of them don't give you advice unless you ask. That has always been a pet peeve of mine.They don't seem to offer advice even to first time wearers.The optician usually just hands you the glasses and sends you on your way.

But if you want your girl friend to wear her glasses more tell her how good she looks in them. And I am sure she looks great.Encourage her but don't push her or it will have the opposite effect. But she will come around because at some point being able to see well becomes more important than vanity. And I don't think she enjoys getting headaches. My guess is if she wears her glasses that will alleviate that problem. But she does need to go for an eye exam and get an updated script. My guess is she needs a stronger prescription and she may have some astigmatism as well even if she didn't before.


swap 30 Oct 2016, 07:19

Michael- thanks for your reply friend

She is still student.

She uses glasses to see distant objects only when necessary, also she wears them for computer because she said working on computer without glasses gives her headache. Now a days she is constantly complaining about headache and eyes pain, ,,,

But now a days she is wearing it frequently as compared to past. And I really would like to see her wearing glasses 24×7. I think if her prescription increased she will use it. When I forced her to wear glasses she wears for few minutes again remove it when I ask why don't you wear them all times she replied I use when I need to read number plates and sign boards and to drive


Michael 30 Oct 2016, 06:22

swap- Does your girl friend work or is she still in school? As Cactus Jack said if you can give us your girl friend's full script we would be able to help you more. Her myopia appears to be pretty mild but we don't know whether or not she has any astigmatism. Based on the info you gave us I would say it would benefit your girl friend to wear glasses for distance activities if she wants to see well. Like movies, concerts and sporting events and maybe for TV too. But especially for driving. I doubt she would be able to pass a DMV vision screening but not 100% sure.But she should wear her glasses whenever she drives especially at night or when the weather is inclement. Driving at night without glasses would have to be difficult for her.

Astigmatism can affect both your distance and near vision. Even a small amount. If your girl friend does have some astigmatism unless it is a very small amount she might find her vision more comfortable if she wears her glasses full time. Does she get any headaches? If she does that may be a clue that she should be wearing her glasses. I am a little surprised that she does wear her glasses at least occasionally when working on the computer if she is just myopic with a relatively mild script.

Yes it is definitely possible if not probable that your girl friend's vision has gotten worse. Is she planning to go for another eye exam? It seems that she is not going to be able to avoid wearing glasses at least some of the time. I guess your goal is to have your girl friend wear glasses full time. Am I right? But if her script got up to -3 or -4 for both eyes that should do it for sure unless she is very stubborn. At some point though being able to see will take priority over vanity.

But don't try to push your girl friend into wearing her glasses more because it will likely have the exact opposite effect. She will have to decide herself.


Michael 30 Oct 2016, 05:16

Why do people have duplicate posts? Bailey has his or her post here five times. Maybe when somebody posts for the first time the person is uncertain how to do it. But shouldn't the moderator remove duplicate posts? It does cause a lot of clutter in the thread.


swap 30 Oct 2016, 04:29

Cactus jack

Sorry for my 3 posts and thanks for your reply,

She is 21 years old now

Her mom wears glasses with minus prescription

And her prescription as I know -1.25 for both eyes, ,,,

Maybe this information would be helpful for you


Cactus Jack 30 Oct 2016, 01:31

sawp,

ONE post on ONE thread is enough. As it happens, your GF has Myopia or nearsightesness, there may also be some Astigmatism, so all three of your posts are on the wrong threads. The Vision thread might have been a good one.

The biggest factor in Myopia is genetics. Do any of her close relatives also wear Minus glasses. The next most important thing is her age. Lastly, her visual environment is very important. What is her occupation?

Also, her complete prescription is very helpful in predicting future increases in Myopia.

C.


swap 29 Oct 2016, 21:05

Since childhood I like girls wearing glasses, ,

My girlfriend had prescription of -0.75 for both eyes before 2 years. She never wear glasses, she didn't like it. One and half years passed her prescription increased up to -1.25 for both eyes. Still she doesn't want to wear glasses, ,, she just wears it occasionally for driving, or working on computer. She can't see long signs. Can't read distant words, nameplates. Now again she complaining about eyes. Does it mean her prescription increased? Are there any chances of increasing her prescription further upto -3, -4 (I wish so)?

Please guide if anyone has knowledge


Bailey 23 Oct 2016, 21:45

Hello Cactus Jack,

I see that you've helped a lot of people understand vision and vision problems. I was wondering if you could help me as well.

I'm wondering if I am gradually turning from being mildly nearsighted to going farsighted.

I'm a 38-year old real estate broker, but I first began wearing glasses when I was 23. These were for fairly mild myopia, and I was quite stable at -1.50 in both eyes. (Very slight astigmatism of -0.25 as well, but I won't dwell on this since it is fairly constant.)

When I was maybe 28 or 29, my left eye slightly increased to -1.75, but at my next eye exam it reverted back to -1.50.

Then, at 32, the slow decline began: My right eye dropped to -1.25. In 2013, when I was 35, my left eye dropped from -1.50 to -1.25, and my right eye dropped from -1.25 to -1.00.

One thing to note: Even when I first began wearing glasses, I always found it more comfortable to take them off when I read. For this reason contact lenses never really worked very well for me. For the last three years at least, I simply have not been able to read without taking them off.

I just had a new exam in August of this year, and here is my new prescription:

R -0.75 -0.25 135 add +1.50

L -1.00 -0.25 110 add +1.50

So you can see that my nearsightedness has decreased further, and I now have a reading addition. I'm actually relieved to get the extra reading help because I knew it was overdue. However I cannot believe how the myopia continues to drop. It's certainly nice, but I wonder where I'm going.

Is it possible that I drift toward hyperopia? Any idea on the rate at which this could happen, given my age? What kind of physiological mechanism could cause the eyeball to shrink?

I asked my eye doctor about becoming hyperopic, and she was not very clear. Instead she focused on my emerging presbyopia. She said, "It's certainly possible, but right now we should look out for increases in your reading."

Thanks for your help, and if anyone else has any personal experience, please share!


Bailey 23 Oct 2016, 21:44

Hello Cactus Jack,

I see that you've helped a lot of people understand vision and vision problems. I was wondering if you could help me as well.

I'm wondering if I am gradually turning from being mildly nearsighted to going farsighted.

I'm a 38-year old real estate broker, but I first began wearing glasses when I was 23. These were for fairly mild myopia, and I was quite stable at -1.50 in both eyes. (Very slight astigmatism of -0.25 as well, but I won't dwell on this since it is fairly constant.)

When I was maybe 28 or 29, my left eye slightly increased to -1.75, but at my next eye exam it reverted back to -1.50.

Then, at 32, the slow decline began: My right eye dropped to -1.25. In 2013, when I was 35, my left eye dropped from -1.50 to -1.25, and my right eye dropped from -1.25 to -1.00.

One thing to note: Even when I first began wearing glasses, I always found it more comfortable to take them off when I read. For this reason contact lenses never really worked very well for me. For the last three years at least, I simply have not been able to read without taking them off.

I just had a new exam in August of this year, and here is my new prescription:

R -0.75 -0.25 135 add +1.50

L -1.00 -0.25 110 add +1.50

So you can see that my nearsightedness has decreased further, and I now have a reading addition. I'm actually relieved to get the extra reading help because I knew it was overdue. However I cannot believe how the myopia continues to drop. It's certainly nice, but I wonder where I'm going.

Is it possible that I drift toward hyperopia? Any idea on the rate at which this could happen, given my age? What kind of physiological mechanism could cause the eyeball to shrink?

I asked my eye doctor about becoming hyperopic, and she was not very clear. Instead she focused on my emerging presbyopia. She said, "It's certainly possible, but right now we should look out for increases in your reading."

Thanks for your help, and if anyone else has any personal experience, please share!


Bailey 23 Oct 2016, 21:44

Hello Cactus Jack,

I see that you've helped a lot of people understand vision and vision problems. I was wondering if you could help me as well.

I'm wondering if I am gradually turning from being mildly nearsighted to going farsighted.

I'm a 38-year old real estate broker, but I first began wearing glasses when I was 23. These were for fairly mild myopia, and I was quite stable at -1.50 in both eyes. (Very slight astigmatism of -0.25 as well, but I won't dwell on this since it is fairly constant.)

When I was maybe 28 or 29, my left eye slightly increased to -1.75, but at my next eye exam it reverted back to -1.50.

Then, at 32, the slow decline began: My right eye dropped to -1.25. In 2013, when I was 35, my left eye dropped from -1.50 to -1.25, and my right eye dropped from -1.25 to -1.00.

One thing to note: Even when I first began wearing glasses, I always found it more comfortable to take them off when I read. For this reason contact lenses never really worked very well for me. For the last three years at least, I simply have not been able to read without taking them off.

I just had a new exam in August of this year, and here is my new prescription:

R -0.75 -0.25 135 add +1.50

L -1.00 -0.25 110 add +1.50

So you can see that my nearsightedness has decreased further, and I now have a reading addition. I'm actually relieved to get the extra reading help because I knew it was overdue. However I cannot believe how the myopia continues to drop. It's certainly nice, but I wonder where I'm going.

Is it possible that I drift toward hyperopia? Any idea on the rate at which this could happen, given my age? What kind of physiological mechanism could cause the eyeball to shrink?

I asked my eye doctor about becoming hyperopic, and she was not very clear. Instead she focused on my emerging presbyopia. She said, "It's certainly possible, but right now we should look out for increases in your reading."

Thanks for your help, and if anyone else has any personal experience, please share!


Bailey 23 Oct 2016, 21:43

Hello Cactus Jack,

I see that you've helped a lot of people understand vision and vision problems. I was wondering if you could help me as well.

I'm wondering if I am gradually turning from being mildly nearsighted to going farsighted.

I'm a 38-year old real estate broker, but I first began wearing glasses when I was 23. These were for fairly mild myopia, and I was quite stable at -1.50 in both eyes. (Very slight astigmatism of -0.25 as well, but I won't dwell on this since it is fairly constant.)

When I was maybe 28 or 29, my left eye slightly increased to -1.75, but at my next eye exam it reverted back to -1.50.

Then, at 32, the slow decline began: My right eye dropped to -1.25. In 2013, when I was 35, my left eye dropped from -1.50 to -1.25, and my right eye dropped from -1.25 to -1.00.

One thing to note: Even when I first began wearing glasses, I always found it more comfortable to take them off when I read. For this reason contact lenses never really worked very well for me. For the last three years at least, I simply have not been able to read without taking them off.

I just had a new exam in August of this year, and here is my new prescription:

R -0.75 -0.25 135 add +1.50

L -1.00 -0.25 110 add +1.50

So you can see that my nearsightedness has decreased further, and I now have a reading addition. I'm actually relieved to get the extra reading help because I knew it was overdue. However I cannot believe how the myopia continues to drop. It's certainly nice, but I wonder where I'm going.

Is it possible that I drift toward hyperopia? Any idea on the rate at which this could happen, given my age? What kind of physiological mechanism could cause the eyeball to shrink?

I asked my eye doctor about becoming hyperopic, and she was not very clear. Instead she focused on my emerging presbyopia. She said, "It's certainly possible, but right now we should look out for increases in your reading."

Thanks for your help, and if anyone else has any personal experience, please share!


Bailey 23 Oct 2016, 21:42

Hello Cactus Jack,

I see that you've helped a lot of people understand vision and vision problems. I was wondering if you could help me as well.

I'm wondering if I am gradually turning from being mildly nearsighted to going farsighted.

I'm a 38-year old real estate broker, but I first began wearing glasses when I was 23. These were for fairly mild myopia, and I was quite stable at -1.50 in both eyes. (Very slight astigmatism of -0.25 as well, but I won't dwell on this since it is fairly constant.)

When I was maybe 28 or 29, my left eye slightly increased to -1.75, but at my next eye exam it reverted back to -1.50.

Then, at 32, the slow decline began: My right eye dropped to -1.25. In 2013, when I was 35, my left eye dropped from -1.50 to -1.25, and my right eye dropped from -1.25 to -1.00.

One thing to note: Even when I first began wearing glasses, I always found it more comfortable to take them off when I read. For this reason contact lenses never really worked very well for me. For the last three years at least, I simply have not been able to read without taking them off.

I just had a new exam in August of this year, and here is my new prescription:

R -0.75 -0.25 135 add +1.50

L -1.00 -0.25 110 add +1.50

So you can see that my nearsightedness has decreased further, and I now have a reading addition. I'm actually relieved to get the extra reading help because I knew it was overdue. However I cannot believe how the myopia continues to drop. It's certainly nice, but I wonder where I'm going.

Is it possible that I drift toward hyperopia? Any idea on the rate at which this could happen, given my age? What kind of physiological mechanism could cause the eyeball to shrink?

I asked my eye doctor about becoming hyperopic, and she was not very clear. Instead she focused on my emerging presbyopia. She said, "It's certainly possible, but right now we should look out for increases in your reading."

Thanks for your help, and if anyone else has any personal experience, please share!


Cactus Jack 13 Oct 2016, 21:43

Guest,

It is very unlikely. You haven't provided enough information to offer a good answers to your questions. Here are a few questions:

1. Do you presently wear glasses or contacts?

2. What is the complete prescription?

3. What is your occupation?

4. Where do you live>

I may have more questions after you answer those.

C.


Guest 13 Oct 2016, 13:25

Hello all. I have a question I can't find an answer for anywhere in net. I'm in my 20s and I'm mildly farsighted. Is it true farsightedness can turn into nearsightedness? Or will my farsightedness just increase? was told by a friend that farsightedness doesn't increase while you're in your 20s but it can become myopia. Is that true? Seemed odd to me.


Kris 08 Oct 2016, 22:40

Like lenses,

The conversation with my ECP before I started using prism was about when I would need it, not if. I thought I could put it off for several years, but he basically informed me that he was waiting for me to admit I had a problem. He made sure I understood that I wouldn't be able to go back once I started. I was surprised that I went up on my prescription as quickly as I did and hope it doesn't mean I'll end up needing a large prism prescription in the future. I didn't think my symptoms were too bad before prism, but in looking back I now realize I had more issues with double vision than I was willing to admit. I also had a lot of eye strain that has improved. I'm glad to hear you've been able to avoid them.

I don't know what material my lenses are, but the prism isn't really noticeable in the frames I wear. The outer edge is definitely thicker than the inner, but you have be looking for it to notice. They aren't Heavy either.

Overall, I'm much more comfortable than I was before I started wearing prism. If I were to be totally honest, I still have some eye strain when I'm doing a lot of computer work and do feel like my eyes are working to maintain fusion. So far though, no real issues with double vision, so I won't be rushing back to my ECP.


Likelenses 08 Oct 2016, 20:53

Kris

Unlike you,I am very myopic at -10.5 for each eye,and can only see 20/30 due to the minified distance images.

Four years ago at my exam.,my optometrist discovered a small muscle imbalance,and asked if I ever experienced any double vision.I said that after extended close work,that I did.

He said that I could benefit from some prism,but that he thought it would be better if I did not get it at this time.

Even though I am totally dependent on my minus lenses,he felt that if he gave me a prism,that it would most certainly need to be increased,and that if I can tolerate the slight double vision,that I would be better off taking more frequent breaks from close work.

He said as other here have pointed out,that when you begin to use prism lenses,that they most certainly need to be increased several times,and he was not able to predict how strong they ultimately would become.

So far the more frequent breaks seem to minimize the double vision,


Kris 07 Oct 2016, 17:53

I did the prism test a couple of times. With my current prism lenses I had 72cm between images at 3 meters. With my old lenses, without prism and with my current cyl prescription (I think they are 0.25 diopter stronger in both eyes) the distance between images was 130-135 cm at 3 meters. I tried to wear the old glasses for awhile today as, when I first put them on, I didn't think things were too bad. I managed to only wear them for a few minutes before the double vision and headache became too much. I didn't doubt it but I am definitely dependent on prism now.

I understand the issue with adapting to prism. I found my current lenses a little jarring when I first got them. Things were a little distorted and almost too 3D (if that makes sense). I've alway had issues adapting to new prescriptions, including a couple of weeks of seasickness when I first went full time with glasses, and again when I got progressives (not long after the initial glasses were prescribed).

Between my esotropia, hyperopia and impending (and now full blown) presbyopia I think I've had uncomfortable vision for a very long time. It took me a long time to even discuss my issues with double vision with my ECP and, even now, I'm not always sure what I should ignore and what I should report. Hearing others experiences with prism helps me to gauge where I'm at in managing my own issues.


Cactus Jack 07 Oct 2016, 13:15

Kris,

I think you need to do the test with full Sphere and Cylinder correction to keep the blurred images or compensation effort to focus from skewing the amount of displacement. If the glasses without prism have the approximate Sphere and Cylinder correct of your latest glasses, they should be OK. I think you can do the test with your latest 5/5/ BO (total 10) as long as you understand that the BO prism in your glasses will reduce the displacement by the appropriate amount for the distance to the target.

Most ECPs in the US will correct up to 50% of the measured prism. However, there is an adjustment process associated with prism correction that can cause some problems until your brain learns to deal with the displacement. Sometimes significant changes in prism correction can cause the symptoms of motion sickness or be difficult to tolerate both optically and psychologically. You mentioned the psychological aspects of prism in an earlier post about having to get your mind around the fact that you needed prism correction.

At some point, you will probably want to consult a Pediatric Ophthalmologist about muscle surgery to reduce the amount of prism you need to fuse images. Don't be put off by the name. Their primary practice is correcting Strabismus problems in children, but they also help adults.

C.


Kris 07 Oct 2016, 11:11

Cactus,

I did the prism test with an old pair of glasses without prism correction. Should I be doing it bare eyed? Is there a percentage of total prism needed that ECPs tend to aim for when prescribing prism? For example, eyes deviate by 40 dioptres, and will prescribe for 20% of total deviation.


Cactus Jack 07 Oct 2016, 07:51

Kris,

Typically, you should do the test without correction, but a person with Hyperopia probably needs to do the test with glasses. The reason for this is that there is a connection between the focus control system and the eye positioning system that causes the eyes to converge when they you try to focus. That can affect the results of the test. However, if you have prism correction, you need to make allowance for the prism in the glasses. Your total of 10 prism diopters Base Out, will compensate for 10 cm at 1 meter or 30 cm at 3 meters and your PLUS sphere will minimize the focus response, but there will probably still be some at 3 meters.

I suspect you have a very strong connection between your Focus Control System (FCS) and your Eye Positioning System (EPS). Almost any focusing effort will trigger the convergence response.

The Eye Positioning System has a number of external inputs in addition to the FCS inputs. In engineering terms, it is an Open Loop Servo System. Two very important inputs are the images delivered by your eyes. My personal observations are that the EPS tries to match sharp vertical edges using the Lateral (left and right) Muscles and sharp horizontal edges for the up and down muscles. If the images are not sharp and clear, it makes it more difficult to control the positioning muscles to keep the images fused. In most instances, if the image inputs are good, you really don't need full prism correction. All the the prisms have to do is get the images into a "capture range" and your EPS will do the rest, without conscious effort.

The exception to that occurs when the EPS simply cannot control the eye positioning muscles beyond a certain point as a result of crania nerve problems or damage or impairment to the brain functions that involve the EPS.

C.


Kris 06 Oct 2016, 21:39

Cactus,

I've done the prism test before. Originally, before I started wearing prism I was measuring images 75-80 cm apart when I stood 3 meters away. Once I started wearing prism I discovered that the images were 100-105 cm apart. I haven't measured, but I'd say they are at least 110-120 cm apart now (definitely farther, based on landmarks on the wall). I may get a chance to measure this weekend.

I was very reluctant to get prism in the first place and am still reluctant to go up more than I am at now. I sometimes find myself closing one eye if I'm tired or getting eye fatigue if I do close work for a long period of time. I spent a long time ignoring my double vision, and normalizing it. I find it hard now to know what I should accept as normal and when I should report symptoms and consider accepting an increase in prism. I find the testing subjective, especially, as you said as ECPs tend to want to prescribe as little prism as possible. My ECP didn't seem surprised at all when I had to go up for a third time in the 9 months since I first started wearing prism. He won't say what his expectations are, but indicated that he was waiting for me to admit I needed it when he first prescribed prism last year.

I find that since wearing prism, it is almost like my right eye is getting weaker. It used to only drift in when tired and would stay centered with my glasses off unlesss I really tried to focus on something close. Now it drifts in as soon as my glasses are off, and it is hard to get it to not turn in, even if I relax my eyes and let everything go blurry. Is it possible that it will turn in even more, the longer I wear prism?


Cactus Jack 06 Oct 2016, 19:55

Kris,

The color fringing goes with prism. Prisms bend light rays and the amount of bending is a function of the wavelength (color) of the light rays. You can also get color fringing with very strong lenses.

The reason for this gets a bit esoteric, but lenses are actually act like a very large number of infinitely thin prisms arranged in a circle. Plus lenses have the Apex of the prisms at the edge of the lens and the Base of the prism in the center. Minus lenses have their prisms arranged with the Apex in the center and the base at the edges.

You did not mention what lens material you got in your glasses, but you might try some CR-39, next time you order glasses. It has the best optical properties of all plastic lens materials.

It sounds like you have some Fatigue Esophoria. You could probably use more BO prism. Your eye positioning muscles are having to work to maintain fusion. Those muscles, like any other muscles get tired and you have trouble maintaining fusion when you are tired and let your concentration drift. When that happens, your eyes converge and you see double for distance. The reason you experience less tendency to converge for close work is that close work, itself, requires convergence, and that eases the positioning muscle work load.

Have you tried the Simple Prism Test that I posted on the Vision and Spex website?

You might find it interesting and perhaps a little scary. The test uses the optical principles codified by Sir Isaac Newton and it works very well if you follow the instructions. You my discover that you need more prism correction than you imagined. ECPs are typically very reluctant to prescribe full prism correction, for good reason. Fortunately, few people with Esophoria actually need full correction. That is one of the reasons ECPs prism increases are given, sparingly. There are a few others.

C.


Kris 06 Oct 2016, 15:34

Thanks Cactus,

I found that when I first got my current lenses images were quite distorted with the outer lines of objects appearing to bend in and with the colour effect I described before. I'm back to squares and rectangles looking like squares and rectangles but 5 months after getting these lenses, I'm still getting the strange colour effect (although more diminished).

I have to admit that I was really surprised to need as much prism as I do as quickly as I did. It seemed like others who've posted here moved up in their prism needs quite gradually. When I first posted here, I actually thought that I was a bit of a hypochondriac when it came to my eyes and that I likely only needed a minute amount of prism compared to others.

My vision has been comfortable with the 5BO, but I do notice my eyes working to stay fused. I don't let my eyes relax, but today when I did, I still had significant double vision when looking into the distance. I've never really seen double at near, it's more of an issue of the level of eye strain I experience to maintain fusion at near distances. If I do a lot of near work, I get eye fatigue and dry eyes. For now though, it's tolerable.

I've read a bit about other's experiences with prism, but would like to know how their experience compares to mine. How long has is taken people to stabilize in their prism needs?


Cactus Jack 05 Oct 2016, 07:30

Slit,

Probably not. More likely, the examiner is looking for Muscle Imbalance problems.

C.


Slit 05 Oct 2016, 01:53

Hi, I have seen some doctors do a test by holding a pen in front of the eyes of the patient, asking the patient to focus on it and then covering one eye, after that another etc.

Is this a test to identify hyperopia?


Cactus Jack 04 Oct 2016, 23:49

Kris,

Regarding the color fringing. One of the things prisms are used for is splitting the spectrum of white light into its component colors. Red is at one end of the spectrum and Blue is at the other.

If you cover one eye and look at a source of moderate White light, an outside window in a dim room, for example, you may notice that the blue fringe is on one side of the window and the red fringe is on the other side. Now, if you cover the other eye the Blue and Red fringes will be on opposite sides of the window. If you then look at the window with both eyes, the fringing will likely be substantially reduced.

Vision actually occurs in the brain and your brain will combine the images into a composite 3 D image an you may not notice any fringing at all.

I have worn much more than 5 BO in each eye for many years. I have noticed an extremely interesting phenomenon when I look at signs with Yellow LEDs. LEDs emit only one very pure (one wavelength) color of light. Yellow LEDs actually have two LEDs inside, very close to each other. One is Red and the other is Green. The result is Yellow for a person who does not wear prism. For me, I see a Red LED and a Green LED, That are far enough apart to appear as two. This is caused by the prism bending the Red light by a different amount than the Green light. When I look at a Yellow incandescent light, I only see one color, Yellow.

It is very likely that you will need more prism, but the important thing is to wear enough prism to not see double. The Eye Position Control System is amazing. It primarily uses the images from each eye to determine how to control the 3 muscle pairs on each eye to fuse the two images into one composite image. It does not have to have full prism correction to work. It only needs enough help to get the images close enough to be able to figure out what signals it needs to send to the muscles and fuse the images. It helps if the images are in comfortable focus. There is an interconnect between the Focus Control System and the Eye Position System that causes the eyes to converge with focusing effort. The strength of the interconnect can be very high in some people and focusing effort without their glasses can cause their eyes to converge or cross. That is probably what happens without your glasses.

Do not be too concerned about someone noticing that your eyes are slightly converged with your glasses. The amount of pupil displacement is really tiny, even with much more than 5 BO. Pupil displacement is about 0.1 mm per prism diopter. What people may notice is that the ouster edges of your glasses are a bit thicker than the inside edges, but they really have to be paying attention.

Let me know if I can be of more help.

C.


John S 04 Oct 2016, 22:44

Maxim, I don't know what your definition of very young is, but just because someone is young doesn't mean they have don't have a problem with accommodation. You must have seen a teenager with bifocals before. Just tonight I saw a ~14 year old kid in Walmart wearing bifocals. I would say his distance rx was -1.00/-0.25. Maybe a +1.50 add.

This past July, my friend's 12 year old son asked me if he could try my glasses. He put them on and said, I told my parents I needed glasses. I asked him why he thought he needed glasses. He said that he could see faraway fine, he just needed glasses for reading. Sometimes when he was reading he got light headed, and he couldn't see small text. I guess he wasn't persistent enough for his parents to believe that he needed glasses.

I told him to look through the bottom of my glasses at some really small print. I could tell he was trying to figure out how the progressives worked. His expression said everything. I could tell they really made a difference.

A few days later I brought over a reading vision card. He said he could make out the 20/25 line. But with my glasses he could easily read the bottom line. He wore them the rest of the evening. When I was getting ready to leave, he gave me back my glasses. He was really surprised when he took them off. He said everything was really blurry without them. I gave him the reading card. He tried as hard as he could to focus, but he said it didn't make any difference. He could just make out the 20/100 line. I told his parents he wasn't making up his vision problems. You need to take him to get glasses.

The next day he started wearing his Dad's progressives until he got glasses. They weren't strong enough, but they were better then nothing.

His rx was +0.75/+1.25 -0.75, add +1.75. He was already used to wearing his Dad's progressives, so he got progressives. He put them on, and they stayed on. He really likes them. He also got a single vision pair just for reading.

He is kind of small for his age. We were at a party, he had just gotten his glasses the day before. He has blue Nike semi-rimless frames. A lady said I like your son's glasses, they look good on him. His parents told her they had distance and reading in them. She said she really needed to get progressives too. She has to take her glasses off to read.

He his addicted to his tablet. If he is using it for more than a few minutes, he takes his progressives off and puts on his reading glasses. He puts on his reading glasses so he doesn't have to look down to see the screen. And he can see the whole screen without moving his head. He learned pretty fast.

After he had his glasses for a few weeks, he really got used to them. He said when he takes his glasses off his distance vision is a little blurry, but there is no way he can read anything. Everything close was a total blur. Wearing glasses is part of his life now. It doesn't bother him at all that he has to wear them. He actually likes wearing them.


Kris 04 Oct 2016, 21:38

I posted last year, when I was trying to decide whether I should see my optometrist to see if I needed prism. He seemed to be waiting for when I would come to my senses and accept that I needed the prism and started me with 2 BO each eye. Vision was better for a few days, but I noticed that I was still seeing double at times and I went back about a month later and he had to go up to 4 BO each eye. Needless to say, I probably needed to do this sooner, as I had a real decrease in eye fatigue and found reading much more enjoyable. I went back this spring for a checkup and at that time he went to 5BO each eye. My current prescription is R +1.5, -0.5 Add 2.5 5BO and L +1.0, Add 2.5 5BO.

My vision seems pretty stable right now, and the only issue I have with the prism is that when I see red and blue images, they appear 3D even though they aren't supposed to be. The effect has faded, but is still there. Has anyone else had this experience? Will it go away?

Since starting to wear prism, I went from not necessarily putting my glasses on right away, to reaching for them as soon as I open my eyes. I have no ability to fuse images with glasses off and my right eye instantly turns in and seems less and less able to have it look straight ahead (even if I unfocused my eyes). Cosmetically I hate taking my glasses off in public because of this.

I hope that I don't need more prism over time, but it sounds like I may. Is it possible I've hit on the right amount of prism so early after wearing them and won't need to go up?


Cactus Jack 04 Oct 2016, 19:22

Hyperopia and Presbyopia are hard for most people to understand, unless they understand the laws of optics and how the eyes work. If a person needs +6.00 glasses, it means that the optical power of their eyes are about -6.50 because of Vertex Distance effects in the glasses.

The typical reason a person is Hyperopic is that their eyeballs did not grow enough from childhood to adulthood. Though it could also be caused by the total optical power of their eye's lens system is LESS than the required amount of PLUS needed to focus distant (or close images) on their Retinas. The typical adult eyeball is about 25 mm in diameter, but because of the way the eye is constructed, the lens system is inset so that the typical distance between the back of the Crystalline Lens and the Retina is about 17 mm. That means that the total optical power of the eye's lens system needs to be about +59 diopters. If the eyeball is smaller than 25 mm so that the Retina is close to the Crystalline Lens, more PLUS is needed to focus distant images. The extra PLUS can come from the Crystalline Lens, External Lenses, Contact Lenses, or ICLs. The distances involved in both Hyperopia and Myopia are small. Only about 0.3 mm per diopter.

The math for calculating the focal distance of a lens is pretty easy:

Focal Distance = 1 meter / Lens Power in Diopters.

It is pretty easy to deal with if the lens is a PLUS lens. For example

1 meter or 100 cm / + 6.00 = 16.66 cm.

It become much harder to deal with if the eye has a MINUS power, as in Hyperopia.

100 cm / -6.00 = -16.66 cm, which really isn't possible and is called a virtual or imaginary distance because the light rays diverge rather than converge as with a PLUS lens. The focal distance of a strong MINUS lens is a considerable distance beyond Alpha Centauri (4 light years away) and really beyond the edge of the universe. In this case some internal or external PLUS can work wonders to help a person focus at reasonable distances and also for close.

If you are interested in the structure of the eye and its optics, here is a link to a fairly easy to understand paper on "The Eye".

http://www.lhup.edu/~dsimanek/scenario/labman3/eye.htm

C.


Maxim 04 Oct 2016, 16:42

Carrie writes: "I have a little difficulty with distances and much more difficulty with close up and reading."

I was at +4.00 approx. on both eyes, and I must say, I had a very difficult near vision (honestly, it's difficult to distinguish knife, fork and spoon on the table (!!)), but also distance vision without glasses is nearly impossible - you cannot recognise a person's face in the same room, on 3, 4 or 5 meters (10-15 feet) distance, you cannot see your teacher's face, you cannot read on the blackboard, you cannot read the license plate of a car - distance vision is very difficult indeed!

You can try a simulation of the +6.00 effect, when you borrow a pair of -6.00 glasses, and wear them for half an hour - that's your friend's experience without glasses!


Maxim 04 Oct 2016, 16:31

I agree with Carrie. When you are at +6.00, far things are for your eyes, if a person without correction need looks at reading distance.

When you're very young, you can accomodate, but in your 20s the eyes get tired through accomodation, and in a minute you can only accomodate for 5 or 10 seconds (just as an estimate), and the rest of every minute, your distance vision is blurry. So, when you start wearing the 'plussies', vision stabilizes, but there is no way back, you loose the capacity to accomodate for the near vision.

But in the 20s, and with the +6.00 lenses, you are able to accommodate for near vision - that means, you don't need bifocals.

When this person is in the fourties or fifties, he or she will need +6.00 as a basic correction plus a +2.00 or +2.50 for near vision, usually in bifocals or varifocals.


Carrie 04 Oct 2016, 15:35

DNBursky I am also in my 20s with a prescription that is about half the strength of your friend's. I have a little difficulty with distances and much more difficulty with close up and reading. I also have a tiny correction for astigmatism. I could get around without glasses but my eyes feel uncomfortable without them. I can't really explain the technical reasons why your friend can't see distances clearly without glasses, others here can do that if you are interested, but I would imagine that their eyes would feel very uncomfortable without glasses.


DNBursky 04 Oct 2016, 04:33

I have a friend in his 20's who's farsighted. He says he can't see distances or close things. He's +6. I would think close things would be difficult, not far things. Any thoughts?

David


Robert 30 Sep 2016, 07:27

Not sure what to do so I googled and found this site. My wife was going for her eye exam and asked me to drive her. When she finished she suggested I go in. I have no vision problems but went in anyways. After distance and close exam dr suggests I get glasses for close, +1.00. So I get them and have been trying them when I read. Without them I can read ok, but then when I take them off print goes blurry. So I am not sure why I was prescribed if I see ok without them before wearing them but not after.When I put them on they do make the print a bit bolder. My wife has worn her glasses for years (I think like-3.75) and I can't see much at all with hers.)

How can I tell if or when I should use them?


William 29 Sep 2016, 06:31

Andrew,

Why didn't you get progressives so you would only have to deal with one pair of glasses and have clear vision at all distances?


Andrew L. 28 Sep 2016, 10:51

One month ago I was diagnosed for the first time with very slight Hyperopia: R:+0.75, L:+0.50 and some Add: +1 for Presbyopia (at 51 y.o.).

Still I can function bare-eyed even for reading (except little print at dim light).

However, when I put my readers on, after taking them off, everything close up is blurry.

At distance I can only see minor difference in reading small letters (e.g. fine print on a projector shows slightly "more crispy" with my +0.75 glasses on) but other than that I really don't see any difference bare-eyed. Still, when I wear my distance glasses, everything is clear but putting them on and off is like nothing changed.

Is there any benefit you think at bothering with any distance correction or I should just use my readers?

Is it likely that my distance correction increases in the future? (Note that when I tried to wear my +1.50 readers at distance, faces at more than 5 meters from me started looking blurry).


 20 Sep 2016, 10:06

Nope. I have to go against the consensus. I think likelenses is simply a straight up asshole.


Obsessed 20 Sep 2016, 06:53

Amy Dory,

why don't you start by linking to your pics with glasses :-)


 20 Sep 2016, 04:30

Likelenses finally admits he's a racist.

well, I am not surprised.


Likelenses 19 Sep 2016, 20:34

19 Sep 2016, 19:03 Taco Boy

I will tell you that I am proud to be in the quickly growing Trump basket of deplorables.


 19 Sep 2016, 19:03

to the always rude LikeLenses: before you callously continue to attack others, i think you should answer first.

how about telling us whether you are a fucknut, dumbass, stupid shit, ass crack, asshole, fucking retard, or some old ass horny bathroom boy masturbator?

I'm guessing you're all of the above, taco boy.


Likelenses 19 Sep 2016, 18:38

Amy Dory

Opps ,meant Bambi.


Likelenses 19 Sep 2016, 18:36

Amy Dory

You appear to be new here.

Please tell us a bit about yourself. Are you a GWG,and if so are you a Myopic Chick,or a Hyperopic Bammbi,or even yourself a Bifocal Babe?


Cactus Jack 19 Sep 2016, 14:36

Dan,

Thanks. I suspect that she may have a bit of Latent Hyperopia, which is common in people who are mildly Hyperopic or farsighted. She may need a slightly stronger Sphere prescription and a change in Cylinder and Axis. A low Add is possible, but it depends on her visual environment and how much really close work she does. People with Hyperopia sometimes need some close focusing help, sooner than the Mythical 40. Teens with Hyperopia and Smartphones are most vulnerable because of the very tiny text.

Do you think she might be interested in reading the piece I wrote "How to Study for an Eye Exam"?

C.


Dan 19 Sep 2016, 13:43

CJ,

She is 27.


Dan 19 Sep 2016, 13:43

I also realized I said "strong prescription". Meant to say "stronger"


Dan 19 Sep 2016, 13:42

CJ,

She is 27.


Amy Dory 19 Sep 2016, 03:22

"bifocal babe?" oh i get it. you believe in the fetish objectivation of women. pretty rude and calloius comment. we aren't people anymore. shouldn't he see her as a woman first instead of a "bifocal babe?" as a woman, i put this overly fetishistic comment in the same category of "oh you got a black one!" and other stupid racist comments. grow up likelenses.


Likelenses 18 Sep 2016, 10:23

Dan

It sounds to me that you will be with a bifocal babe after next week,


Cactus Jack 18 Sep 2016, 07:58

Dan,

May I ask your fiancé's age?

C.


Dan 17 Sep 2016, 04:03

My fiancé has had glasses for 3 years or so with a minor plus prescription and astigmatism that she wears when on the computer. She has her annual exam this coming week and she is excited to get new frames for the first time in 3 years.

She also mentioned to me that she really notices when she doesn't wear her glasses on the computer that her eyes don't focus well. She also said that small print is getting hard to read without the glasses and is sometimes blurry with them on. Sounds like a strong prescription is in her future. I'll keep you posted.


Obsessed 16 Sep 2016, 00:22

Mark, you are one lucky man! Wow! You are what I want to be an never will be (without lasic) since I'm mildly nearsighted. Just wait for a couple of years and you will be totally dependent!

Something for you to look forward to:

I am currently vacationing in Crete. At our beach, there is this gorgeous German dad in his early fifties. He has what you will probably end up with: bifocals with about +3 for distance and a delightful add for reading. Yesterday, he fell and smashed his glasses so that one of the earpieces fell off. For 24 hours now, he has been walking around holding on to his glasses at all times. Hasn't removed them even for a minute. 1000% dependence.


Cactus Jack 08 Sep 2016, 13:46

Mark,

Oops again. I guess I am loosing it. The last post was from me. I get to concentrating on what I need to write and get ahead of myself.

Good luck. Let me know what you decide to do and how it works for you.

May I as where you live?

C.


Cactus Mark 08 Sep 2016, 13:42

Mark,

It is nearly impossible to predict when your Ciliary Muscles will be fully relaxed, what your ultimate distance prescription will be, or when you will no longer be able to contribute any accommodation to focus close without your glasses. It depends on too many factors that are difficult or impossible to measure.

For most purposes you are NOW pretty much dependent on your glasses Your distance prescription may increase a little if your Ciliary Muscles and Crystalline Lenses are NOT fully relaxed for distance, but your actual Hyperopia is limited by the laws of optics. Hyperopia is caused by a mismatch between the Total PLUS power of your eye's lens system and the length of your eyeball. Typically, Hyperopia is caused by your eyeballs not growing quite enough as you grew from childhood to adulthood. The result is that distant images actually focus behind your Retinas and you need a bit of extra PLUS to move the focus up to the plane of the Retina. This extra PLUS can come from two sources. Your Ciliary Muscles and Crystalline Lenses can add the extra PLUS without your even being aware that you are doing it, or you can use external lenses. There is no known way to cause your eyeballs to grow to decrease your Hyperopia, once your genes have stopped the growth process, or to cause them to shrink to increase your Hyperopia.

The biggest thing that occurs to change your vision, as you reach adulthood, is Presbyopia. Presbyopia is the gradual stiffening of the protein that makes up your Crystalline Lenses. It actually starts in childhood, but typically does not become a problem until you are older. When you are very young, your Crystalline Lenses have the consistency of fresh gelatin dessert. Your Ciliary Muscles can easily squeeze your Crystalline Lenses to increase their PLUS power enough to enable you to effortlessly focus very close. However as you get older, your Crystalline Lenses get stiffer until finally your Ciliary Muscles can no longer provide the extra PLUS you need to overcome Hyperopia or focus close. When that happens, you need external PLUS to help you focus.

There is a secondary factor in Presbyopia that is sometimes overlooked. The strength of your Ciliary Muscles. For their size, they are the strongest muscles in the body, but like all muscles, they can easily get out of condition and loose their strength. When you wear external PLUS, for any reason, you reduce the amount of exercise your Ciliary Muscles get and you need more external PLUS to help you focus. This de-conditioning process occurs much faster than stiffening of the Crystalline Lens, but the effect is the same. Your need for external PLUS, particularly for focusing close can happen much faster than most people expect.

In your situation, I suspect that you can still provide SOME of the extra PLUS you need to focus close. You already have the tools you need to speed the de-conditioning process.

1. Wear your glasses full time.

2. Get the +4.00 prescription reading glasses and use them when you need to do a lot of reading. (If you can, I suggest ordering inexpensive glasses from an online retailer)

3. Consider ordering some prescription reading glasses with Sphere +4.50 for really close reading.

4. Consider ordering some prescription glasses with Sphere +1.75 for distance and keep other elements unchanged. That will automatically give you a slightly higher absolute values in the reading segment.

5. Consciously decide to not try to focus and depend on your glasses to do the work for you.

6. Strongly consider getting trifocals with the intermediate segment set for your typical eye to display distance and wear them.

If you work at it, I suspect you can be extremely dependent on your glasses in just a few months to the point where the first thing you do when you wake up is put on your glasses so you read you clock or see your face clearly in your bathroom mirror.

C.


Mark 08 Sep 2016, 08:07

Thanks Cactus Jack for the information. Given that currently my reading glass prescription is +4.0, how will the strength increase in the long run. I am 36 now.

Also roughly how long will it take me to get completely dependent on glasses.


Cactus Jack 07 Sep 2016, 12:42

Oops,

Last post to Mark was from me.

Cactus


 07 Sep 2016, 12:39

Mark,

Your reading glasses prescription for a reading distance of about 40 cm or 16 inches:

Right eye :: Sph +4.00 Cyl -0.5 Axis 35

Left eye :: Sph +4.00 Cyl -0.5 Axis 150

The procedure is easy. The ADD is a Sphere correction that is in ADDition to your fundamental Sphere correction. You should always use your Cylinder and Axis correction exactly as written. Depending on your visual environment you may at some point need a bit more than +2.50 for close focusing. For example, I like to read in bed and my reading glasses are my basic sphere prescription +3.00 for a reading distance of 33 cm or 13 inches.

The formula for calculating lens power to focus at a particular distance is 100 cm or 39.37 inches / focal distance = lens power.

If you decide that you would like some computer glasses, measure the distance from your eyes to the display and let me know and I will help, if you need it.

C.


Mark 07 Sep 2016, 07:33

Thanks Cactus Jack for your valuable feedback.My complete prescription is as mentioned below

Right eye :: Sph +1.5 Cyl -0.5 Axis 35

Left eye :: Sph +1.5 Cyl -0.5 Axis 150

Add +2.5 for both eyes.

My lenses are regular progressives with index 1.5.

Also if I get reading glasses what would me my reading glass strength.


Cactus Jack 06 Sep 2016, 10:24

Mark,

What you have described is a classic case of Latent Hyperopia with onset of Presbyopia.

You are very close to achieving your wish. All you need to do is just wear your glasses from the time you wake up until you go to bed at night. If you use the computer a lot, you may find trifocals to be extremely helpful for focusing clearly at typical display distances.

The ideal situation for distance is that your glasses allow your Ciliary Muscles and Crystalline Lenses to fully relax. It is difficult to determine when that has occurred except by gradually increasing your distance PLUS until your distance vision DOES NOT clear up.

If you will provide your complete prescription and where you live, we may be able to offer some suggestions on relatively inexpensive ways to determine when you have gone as far as you can with your distance prescription. For now, I would not suggest increasing your Add.

C.


Mark 06 Sep 2016, 08:30

Hi my name is Mark and I am 36 years old. I work on computers through out the day. Since last 1 year I noticed that my near vision is blurry especially if I hold things close to my eyes(approx 30cm) I can't read. If I move them further away from my eyes it gets clear. So that pretty much excited me as I always wanted to wear glasses but unfortunately I never needed one. So I got myself a pair of reading glasses +1.5 and my near vision was crisp and clear but distance was blurry. I continued with it for 2 months and then got myself a pair of progressives of strength Sphere R and L +1.0 with an Add of +1.5. Initially it was difficult to adjust as the distance was blurry but the near vision was clear. But it became okay after a few days of continuous wear.

Last month I began to notice that I am having trouble seeing at night without glasses. So I got a good deal and ordered another pair of glasses with the following prescription. Sphere R and L +1.5 with an Add of +2.5. I have now adjusted with the new pair of glasses and can see clearly with them both near and far. But if I don't wear my glasses my vision is still okay and I am not yet dependent on them. So my question is how can I make myself completely dependent on glasses?


 04 Sep 2016, 12:37

CactusJack,

Thank you so much! I'm heading to the store now to pick up a few pairs to try.

-Melisa


Cactus Jack 04 Sep 2016, 12:00

MelisaS,

Welcome to the mysterious world of Hyperopia and Presbyopia. Hyperopia is the ONLY refractive error you can correct internally using your Ciliary Muscles and Crystalline Lenses (your auto-focus system). That works until Presbyopia catches up with you.

Before you decide to order glasses in your actual prescription, I suggest that you do some inexpensive experiments with Over-the-Counter (OTC) reading glasses. To actually have the effect of a +1.25 Add, you would need to get +1.75 readers. The reason for this is the +0.50 Sphere correction you need to correct your Hyperopia.

I would suggest starting with some inexpensive +1.50 readers and see how they work for you in practice.

You didn't mention where you live, but here in the US there are many stores that offer items around US$1.00. Surprisingly, they offer reasonable quality reading glasses in various powers at very low cost.

One thing you need to be aware of is that your Sphere and Add are very likely to increase over the next few months. The reason for this is that you probably have some Latent (hidden) Hyperopia. Latent Hyperopia is fairly common in people who have Hyperopia. It is caused by the Ciliary Muscles having difficulty relaxing fully for distance, after years of internally correcting Hyperopia. As your Ciliary Muscles relax, you will need more external PLUS correction to compensate.

Dealing with Hyperopia and Presbyopia in your visual environment can be a little frustrating. There are solutions that you may not particularly care for, but they work.

C.


MelisaS 04 Sep 2016, 09:32

Hi,

I'm 37 and sit at a computer for 8+ hours a day and had never needed glasses. Also, I work at a nonprofit in finance so I'm often looking at finer print papers. I've noticed thing haven't been as clear as they used to be. I even thought it might be time for a new monitor. After suffering headaches and intermittent blurry vision I decided to get my eyes checked. The doctor's summary says I have "HYPEROPIA, BOTH EYES - Primary and PRESBYOPIA (AGE RELATED VISION DIFFICULTY)"

My prescription is -

Sphere Cylinder Add

Right +0.5 Sphere +1.25

Left +0.5 Sphere +1.25

I'm trying to figure out if I should just get some cheap reading glasses (at +1.25 I assume) or order my exact prescription from an online site. I'm concerned about being able to see clearly because I often look close up at paperwork, maybe 25in at monitor and up at people while explaining/going over reports while sitting at my desk. I could be overthinking all of this. Any guidance would be so appreciated.


Carlos, Jr. 02 Sep 2016, 11:20

Andrew L. Try the progressives. The reality is you are going to end up wearing glasses full-time. No more bare-eyes.


Andrew L. 31 Aug 2016, 09:55

DS,

Thanks for your idea. I am aware of monovision.

But monovision would be awful for me to "sacrifice" one eye if I can see almost perfectly at distance bare-eyed and just miss +1 for close vision with distance correction.

Still, I feel I can see perfectly at distance and only at 3-10m I think I see the finest details slightly more focussed with glasses. I cannot understand what +0.75 distance correction can serve me. On the other hand, wearing the +0.75 for distance does not create any blur at all for the left eye (and is very slightly messy for the right eye at night).


DS 29 Aug 2016, 19:52

Andrew L.,

Another option is monovision. I don't know which eye is dominant, but could do something like a +0.50 or +0.75 contact lens in the left eye for distance and a little help with the monitor and a +1.50 or +1.75 lens in the right eye for reading. I like to "just" over-plus the distance eye and "just" under-plus the reading eye to minimize the balance difference as a compromise.

Monovision takes some adaptation. Some love it. Some hate it. Worth discussing with your doctor.

This may get you through most days without needing glasses except for critical tasks. Glasses for critical distance and near could be useful with monovision.


Andrew L. 29 Aug 2016, 11:15

Few days after having being diagnosed (first prescription in my life at 51 y.o.) with L.+0.75, R.+0.50, Add +1 (No astigmatism) I still haven't decided on what type of glasses/contact lenses is better for me.

I have to examine various alternatives:

1) Progressives (I do not like lined bifocals): This might be ideal but they are very expensive and also I heard that once you get used to wearing them you find it hard to go bare-eyed at medium and long-distance tasks.

2) Progressive Contact Lenses: Do they cause you the same problems as progressive glasses? That is to say you cannot easily go bare-eyed after getting used to wearing them? With this alternative I will keep going bare-eyed as up to now.

3) Single vision contact lenses at +0.75 each and use +1 Readers only when necessary for fine print. This is similar to what I am doing now. I am using for computer (and occasionally for distance tasks such as watching TV) a pair of +0.75 each and when required to read fine print (or in dim light) another pair of readers which are +1.50).

4) Just the +1.50 readers and ignore any distance prescription. Still, the +0.75 provides me better vision for computer than the +1.50 or bare-eyed.

Any opinion is useful to hear. I prefer to be bare-eyed and non-dependent on correction as much as possible. Still take into account that I feel my distance vision to be prefect bare-eyed whether tasks such as watching TV provide me better vision with the +0.75 only to magnify things and make me see clearer just the finest details.


Cactus jack 26 Aug 2016, 23:21

SocialWizYeahRight,

It would have been helpful, if you had provided your complete prescription, but I think I can help you understand a bit about vision. What you are experiencing is not all that unusual. Because you posted on the Hyperopia and Presbyopia Progression thread, I assume that you have Hyperopia and need PLUS glasses for comfortable distance vision. Both Hyperopia and Myopia are caused by a mismatch between the total power of your eye's lens system and the length of your eyeball from back of your Crystalline Lenses to your Retina. Your eyeballs are a bit too short for the power of your eyes len's system.

First lets talk about your glasses. You mentioned that there is a difference between the prescription for you two eyes. The object of your distance prescription is to bring both your eyes to near 0.00 each. That means that the same amount of focusing effort will be required to focus closer than 6 meters or 20 feet, which is considered to be Distance for our purposes.

The eye is an amazing biological camera that must obey the laws of optical physics. It works very much like a modern digital camera. It has a lens system that has 3 fixed focus lenses and 1 variable focus lens. They are all very strong PLUS lenses with a total power of about +59 diopters for distance, which is necessary to focus rays of light from distant objects on the Retina. In an Emmetropic (no Hyperopia or Myopia) the distance from the back of the Crystalline Lens to the Retina is about 17 mm. A Hyperopic eye is less than that and a Myopic eye is more than that. It turns out that the distance error is about 0.3 mm per diopter of Refractive Error.

To focus closer than 6 meters or 20 feet, the Ciliary Muscles and Crystalline Lenses (your auto-focus system) have to add some additional PLUS for you to be able to focus close. The amount of additional PLUS you need to focus close depends on the focusing distance. The formula for how much additional PLUS you need was developed by Sir Isaac Newton (of gravity fame) about 300 years ago. It is:

100 cm / Focal Distance = Lens Power in Diopters

or in your case

100 / 45 = approximately +2.25 diopters

which isn't bad for a 30 year old with some Hyperopia.

Do you have some Presbyopia? Yes, almost everyone does, unless you are VERY young.

Presbyopia is the gradual stiffening of the protein that makes up your Crystalline Lenses. It actually starts in childhood, but typically does not become a problem until much later in life.

There are a couple of formulas that are used to estimate Accommodation Amplitude. They are not considered very accurate. The average is 18.5 - (0.30 * patient age in years), minimum is 15 - (0.25 * age in years), and the maximum is 25 - (0.40 * age in years). At 30, the minimum amplitude of accommodation is 15 - (0.25 * 30) or +7.50. That means that you should be able to focus, with effort at about 13 cm. The questions is, why only 45 to 47 cm?

There are 3 possibilities.

1. As you mentioned, early onset of Presbyopia.

2. Ciliary Muscles out of condition.

3. Latent (Hidden) Hyperopia. That you are correcting internally by using some of your Accommodation Amplitude (Ciliary Muscles and Crystalline Lenses)

or perhaps a combination of the above.

The important thing to understand that it really is nothing to get excited about, particularly if you have significant Hyperopia. You can extend your practical Accommodation Range with supplemental PLUS lenses a reading glasses, bifocals, trifocals, or progressives. It is a myth that a person does not need close focusing help until 40. It can happen at any age depending on your refractive error and your visual environment. These days, Smartphones and Tablets, with tiny text, are creating a visual environment that is revealing Hyperopia at an early age and causing teens to need bifocals to prevent headaches.

I hope this helps. Let me know if you have more questions or don't understand any of the above. I have a few,

1. What is your complete prescription?

2. How long have you worn glasses?

3. Where do you live? (country)

C.


SocialWizYeahRight 26 Aug 2016, 17:31

I have a question. I'm 30, I wear glasses and my Rx is correct. I've known for some time though that I can't seem to be able to focus very close, with or without glasses. I measured recently the distance of my closest focusing point to be around 45-47cm. Seems to be roughly the same with both eyes, which each have a very different Rx. My corrected vision is good enough though that I can read very fine print at that distance. Again, I'm 30; is this premature presbyopia, or is this normal? Is there a chart for what is the usual progression of the closest focusing point distance as we age?

P.S. putting readers over my glasses gives me ability to focus very close, of course.


Soundmanpt 25 Aug 2016, 11:43

Andres L

So the actual prescription you got is very nearly exactly what I suggested to you. So what she is saying is that glasses are optional. If you want to wear glasses that you can wear and not be putting on and taking off then get bifocals with the prescription she prescribed for you. Otherwise just get single vision glasses that you may want to wear at times just to relax your eyes.


Andrew L. 25 Aug 2016, 09:12

I eventually found an available doctor appointment and have my eyes tested today.

So I got my first prescription in my life (at 51 y.o.)

Right:+0.50 0 x0

Left: +0.75 0 x0

Add: +1 for both eyes.

When the doctor tested m in the automatic refractor, she said she found a negligible astigmatism of +0.25 for each eye but in the subjective test the astigmatism was making my vision more blurry; hence she said is better to ignore it.

She said that my reading prescription may increase by +1 in the future but not much more than this and my distance prescription might either remain stable or increase till the +1.50 maximum (up to +0.75 from now).

She said that if I can see with the +0.75 glasses (both eyes) well even for most close tasks, to wear them and use the +1.50 for dim light and too small text reading. She said that I shouldn't bother for wearing my glasses at distance but if I find it crisper I can wear them (she mentioned driving at night but I explained to her that at night my vision now is slightly better bare-eyed).

She said that I will definitely need to wear glasses for distance if my prescription becomes +1.25 or higher.

She also said that wearing my +0.75 glasses more often for distance may relax my eyes.

P.S. By the way she told me she had latent hyperopia of +2.00 that was manifested when she was approaching 40 y.o. but she said that in her case almost the entire hyperopia was manifested at once.


Andrew L. 22 Aug 2016, 09:38

Just a quick update:

After wearing the +0.75 for about 5-6 hours per day I found out the following:

1) When driving at far distance I notice no strain or dizziness or worst acuity with glasses on except at night where one eye seems to be a click clearer without glasses at far distances. Still at long distance I feel I can see perfectly bare-eyed.

2) At medium-distances (e.g. watching TV at 3-10 meter distance) I see that with glasses on very small letters and details seem "more colorful" and "crystal clear" with glasses on (especially with the one eye). Still, I think I can see TV "almost perfectly" bare-eyed but when I put the +0.75 on I can see the "finest of the finest" detail I could not see clearly bare-eyed.

3) Close up things look rather blurred bare-eyed (esecially when I put glasses off). However, with the +0.75 I can see most of the things except the smallest or dimmest letters for which I need about +1.5 to see at the clearest detail.

I took a distance on-line test and found my eyes between 20/30 and 20/40 bare-eyed acuity (few months ago they used to be near 20/20) and about 20/20 with the +0.75 on. Still with the +1.5 on my acuity was between 20/40 and 20/50.

I am planning to go to an ophalmologist beginning of September (after the holidays).

Any feedback is useful.

P.S. After wearing the +0.75 for some time (for distance mainly) and then getting bare-eyed and refreshing my eyes, I found that my eyes are very relaxed and my bare-eyed vision (even close-up) is improved compared to the "before glasses" days where struggling to see close-up caused me tension.


Cactus Jack 19 Aug 2016, 17:09

Andrew L.,

I don't believe you understand Optics or how your eyes work. It has been over 20 years since you have had an eye exam and you really need to get one, even if you see well.

You are approaching the age where several silent diseases begin to appear. The eyes are windows into the body and often some of the silent diseases are spotted by a skilled examiner.

If you get a prescription, please do not order glasses until we have a chance to explain your prescription to you.

At 51, it is not surprising that the +1.50 glasses help with close focusing, but the +0.75 may not be needed for distance vision. The need for PLUS glasses for distance vision as we get older, IS NOT automatic.

There is a fairly simple eye test you can do at home, using the +1.50 glasses, if you are interested. All you need is the glasses, a ruler or tape measure and a book or newspaper.

C.


Andrew L. 19 Aug 2016, 07:26

Soundmanpt,

I have no problem ordering bi-focals or having to swich on/off with glasses or even to have 2 pairs one for close and one for distance.

I just enquire that based on your experience with this issue if I can see better at 6-10 meter distance with +0,75 than bare-eyed this means that I may need low plus for distance as well?

Still to repeat that with +0,75 I have no real blurriness (after 2 days) but I get eye-strain after wearing them for distances and get relief after removing them.


Soundmanpt 19 Aug 2016, 07:18

Andrew L

First of all your statement isn't accurate, not everyone past a certain age needs an add. You're not going to find bifocals in the over the counter rack. So that means if you prefer bifocals you can probably get them by going to your ECP (eye care professional) Or you can always go on line and order bifocals with the distance part being +.75 with a slightly stronger reading add. Otherwise if you intend on wearing glasses full time so your not doing the on and off thing constantly and you have already found out that the +.75 glasses are too weak to be enough help to you fro close work and +1.50 glasses work best then you just need to wear them full time and give your eyes a chance to adjust to them. It seems your being a bit too impatient.


Andrew L. 19 Aug 2016, 00:05

This morning I wore the +0,75 driving in the motorway and everything looked clear fine except the eyestrain (that has gone when I removed the glasses).

How is it possible to adjust with the +1,5 at all distances since everyone (due to presbyopia) after a certain age needs an ADD for reading only?


Soundmanpt 18 Aug 2016, 23:25

Andrew L

If your distance eyesight is fine without glasses then at least for the time being you might just want to wear your +1.50 over the counter readers when you need to see things close up. Now if you don't like the idea of doing the on and off thing and would prefer to just wear glasses full time then clearly the +.75 glasses are not the strength you need to be wearing since they don't seem to providing your eyes the same good vision as the +1.50 glasses for reading. If you just keep wearing your +1.50 glasses your eyes should slowly start to adjust to them for all distances. Just put those +.75 glasses in drawers and forget you even have them. They aren't what you need. Actually it really wouldn't be a bad idea for you to get your eyes examined because you may also have astigmatisms that need correction. That way you also will find out the exact prescription you need to be wearing.


Andrew L. 18 Aug 2016, 23:12

Hi,

This is my first post to ES.

I am 51 and have never worn glasses before. When I was 30 I had an eye-test and was told that my vision (near and distance) was very good.

These last years I noticed ithat I needed to squint in order to see close up things clearly especially in dim light. I understood thiis is due to presbyopia and got recently OTC readers +1,5D.

With +1,5 my near vision was OK but further to the 3 meters things were blurrier than bare-eyed and got eyestrain.

I also got a pair of +0,75D to see if this could improve my mid-range or distance vision than bare-eyed (near vision was clearer with +1,5 than with +0,75). What I noticed was the following: Wearing the +0,75 for some hours, everything up to the 6m long was clearer with the glasses on and even up to the 10m long everything was clear in focus. However, ater the 10m long, while I could see everything with the +0,75 on fairly clearly, wearing the glasses for some hours. caused me some eyestrain. When I removed the +0,75 eyestrain was vanished but my sight for up to 6m distance was not as crisp as with +0,75 (long distance seemsed to be perfect bare-eyeed).

I am planning to keep wearing the +0,75 for some hours a day as this does not blur my vision at distance although it causes some eyestrain. Do you think that my eyes will adjust and feel better with the distance correction over time than bare-eyed?

Is it natural to be able to see clearer at mid-range (up to 6m and even up to 10m) with the +0,75 on but further far to experience this strain (although not too blurred vision)?

What should I expect for my prescription epsecially in the distance part over time (due to summer holidays I did not visit a doctor yet).


Soundmanpt 18 Aug 2016, 09:56

Colette

I also was diagnosised with type 2 diabetes about 7 years ago. I am now 68 and i only require reading glasses but I am still able to read small print without glasses as long as the lighting is pretty good. I only take a small ill twice a day that is only 4mgs. I had the readers well before I was found to have diabetes. Cactus Jack's advice as always is dead on .

i think it is very possible that once your blood sugar levels are good you may go back to be short sighted again.

Some one I knew about 12 years ago went through a rather crazy thing. She was an optican and her company had just started doing lasik. Being an employee and one that wore glasses she was given the opportunity to get lasik at no cost to her because they wanted her to tell patients how great it was. Anyway she got it doen and was thrilled with the results. She like many had better than perfect eyesight. Bujt after about 6 months or so I was in visiting with her and she was in a very nasty mood and and I quickly noticed she had glasses cases and contacts in front her and was putting them in her own bag to take home. I asked her about those things thinking maybe they were for a friend and she was just dropping them off. But she went into a tirade about how terrible the results of lasik was. She told me that she was now back to needing glasses full time. She was so mad that she even quit her job. A few months later I found her back working at her old job again and she told me what had happened. Not long after she quit her job she was driving somewhere and without any warning she suddenly was unable to see. She pulled off the road and called her bf for help. They got her to a doctor and they found that she had diabetes and her blood sugar level dropped suddenly and caused her to almost be blind. Once they got her on medication and her blood sugar was back to normal she found out that her eyesight was back being perfect again and she didn't need glasses or contacts and the lasik was not the problem. So don't be surprised if there might be some changes in your vision once everything is back under control.


Cactus Jack 18 Aug 2016, 08:41

Colette,

It is very difficult to predict where your eyes will stabilize and the Type 2 diabetes makes it harder.

We typically think of two main lenses in the eye, the Cornea and the Crystalline Lens, but there are actually four. The other two are the Aqueous Humor and the Vitreous Humor. The power of the Humors is related to their Index of Refraction (IR) and Blood Glucose (BG) levels can affect their refractive power and your Sphere prescription.

The first step is to get your BG levels under control. A few questions:

1. Do you check your BG levels?

2. Typically, what do they run?

3. Do you know your A1c number?

4. Are you taking any medications to help control it.

BTW, I have had Type 2 diabetes since it was accidentally discovered when I was 30. I am 78 now and have been doing a pretty good job of managing it for nearly 50 years. So far, without retinal damage. The important thing is to manage it. It is deadly (literally) to ignore it or abuse it.

C.


Colette  18 Aug 2016, 08:20

When I was a child, I was slightly near sighted. I wore my glasses most of the time. I lost them the first year in college and I never replaced them. I didn't have the best vision, but I always took the subway/bus so I didn't need to drive. I didn't go out much in college, I was pretty much a reclusive nerd playing video games and doing IT work.

Recently, I received a diagnosis of T2 diabetes. I'm very active and fit so the doctor was pretty surprised. As part of this diagnosis, she recommended that I have my eyes checked. It was a big surprise to me that the eye exam showed I was slightly longsighted. I questioned the eye doctor and he said that sometimes elevated blood sugar can really change your rx. Other than that, my eyes looked pretty healthy and he said I should receive more frequent eye exams due to my trouble with high blood sugar.

Here's the rx progression:

2004 - 14 years old

OD -0.75 -0.50 x095

OS -0.75 -0.75 x075

2008 - 18 years old

OD -1.25 -0.50 x095

OS -1.00 -0.75 x075

2016 - 26 years old

OD +0.75 -0.50 x098

OS +0.75 -0.75 x072

Does anyone know if my eyes will go back once my blood sugar stabilizes? Will I continue to get more longsighted as I get older?


Mr Jules 15 Aug 2016, 15:21

DS, my own shift has been about 0.5 D every 2 years. From previous experience, it has taken a few days to adjust to stronger lenses, but that visual distortion does pass.

Lately, I've struggled with smaller print, and so recently, I got some cheap +4.00 glasses from eBay. Compared with my existing prescription +3.25 lenses, print was now clear again. And so it was time for another eye test.

Now I've got my new prescription, I'm looking forward to wearing my frames re-glazed to my new +3.75 reading strength. I've opted for thin lenses since the lenses in the cheap +4.00 glasses are thick.

I prefer spending money on prescription reading glasses. Over the counter reading glasses are visually clumsy.

Over the years, I've wondered about my facial appearance with stronger reading glasses. With my first pair of glasses, you could hardly see the lens strength. But now, you can clearly see that I wear stronger reading glasses. But change has been gradual and trouble free.


DS 15 Aug 2016, 13:52

It is common to under-prescribe/not prescribe for hyperopia, but less likely to "miss." Remember that the prescription may not exactly represent what you "are." It's the correction you are going to get.

0.50D shift over a couple of years-- quite common. 1D shift over a couple of years, less common, but "not uncommon." A real and natural 1 D shift in 3 months? Uncommon.


Mr Jules 15 Aug 2016, 12:09

SC, that's a rapid move to progressives. Did you adjust to them ok ?

Needing glasses for reading was fine and understandable. But I did not expect my distance vision would then need correcting, too.


SC 15 Aug 2016, 11:16

DS,

I think it is very common to miss hyperopia at tests.

The most obvious symptom is early need for reading help but despite this it took me several years to be diagnosed and then more years for the prescription to develop.

2009 -0.25

2010 0.00

2011 +0.75

2013 +1.00

2015 +1.50

My progression has been very similar to Mr Jules readers to full-time progressives in 2 years.

My wife, however, has been consistently diagnosed with hyperopia during the same period with the same optometrist, again with progression (+0.25, +0.5, +1.0) although she doesn't have glasses for distance

So unless they do some kind of dilation it seems it can be difficult to detect and I've asked about dilation and they only do it if they want a good look rather than to test for hyperopia (in UK). Of course being cynical it could be just to sell you new progressives every 18 months


Mr Jules 15 Aug 2016, 10:24

Presbyopia has been rapid for me.

When I was 41, I had got my first pair of reading glasses. They were +1.00 lenses, which I wore now and again.

By 43, my prescription has increased to +2.25 for reading. And they were now essential for reading and computer.

By 44, I was now starting to have problems with my distance vision, too. Following an eye test, the optician suggested varifocals/progressives. Instead, I got a pair of +1.50 prescription single vision glasses which I wore most of the time. They corrected my distance vision and I could just about read with them, too. This worked for about a year.

A year later when I was 45, my eyesight had changed again. I finally decided to wear varifocals/progressives. I had no trouble adjusting to varifocals/progressives. And I was now happily wearing glasses full time.

In 4 years, I'd gone from occasionally wearing +1.00 reading glasses, to full time varifocals.

I'm 49, just had my latest eye test and the 'add' has increased to +2.25. Distance unchanged at +1.50. Getting my single vision reading glasses reglazed to +3.75 lenses. I'll get my varifocals reglazed at a later date.


DS 14 Aug 2016, 22:24

CJ,

The only note I have is that Sparky's add did not reduce significantly with the sphere increase. He "should" have wanted/needed close to the higher total plus back in May.

I think there might be a combination of things going on with the first 3 being the keys--

1) First doc missed some hyperopia (possible, but less common once presbyopia is manifesting),

2) Sparky didn't have "clear enough" preferences in the first exam at near, additionally with some reticence by doc to prescribe an unnaturally high add with respect to the age, to get to a sufficient total near plus (albeit with a non-optimal prescription). [When a patient hesitates the lower add usually prevails.]

3) The second doc addressing the complaint with a hammer and prescribing more add than necessary.

4) Sparky having benefit of the add from the May exam was better prepared for the redo in terms of choosing and in reduced eyestrain.


Cactus Jack 14 Aug 2016, 19:10

Sparky,

I would like to suggest the possibility of Latent (or Hidden) Hyperopia. Hyperopia is the ONLY refractive error that you can correct internally. You do this by using your Ciliary Muscles and Crystalline Lenses to add the extra PLUS you need, to focus clearly. Often, people do this with out even being aware. If you have been correcting some Hyperopia internally, for a long time, it can take weeks or months for your Ciliary Muscles to fully relax. When they do, you need more external PLUS, particularly if Presbyopia is beginning to limit your accommodation.

If you have some Latent Hyperopia, an increase of +1.00 is not really very much, and your Left eye won't look bug eyed. It is pretty common for people with Latent Hyperopia to need a couple of prescription changes while the Ciliary Muscle relax. Once that has occurred, your distance prescription will be very stable in the future. However, you will have some increases in your Add as Presbyopia continues to progress, but there is a limit to how much Add you ultimately need. It is strictly a function of your focus distance and will probably never exceed +2.50 to +3.00 unless you need to focus very close for some reason.

What you are experiencing is pretty common, which explains the name of this thread. Did the examiner do a dilated exam, where get use drops to help relax you focusing muscles?

DS - Please feel free to correct or amplify.

C.


DS 14 Aug 2016, 16:32

Sparky,

No, it is not common for that sudden of a change. But, more history is needed (previous prescription, from how long ago?) to really comment on what happened or is going on.

A key part of prescribing is discussion with the patient to try to match needs. Sounds like there was a "miss" for whatever reason.

I agree with Soundmanpt that you should refer back to your original doctor unless you have reason to have lost confidence. Besides potentially saving you money, it is valuable to the doctor to get the feedback.


Soundmanpt 14 Aug 2016, 11:37

Sparky

Sorry I honestly missed seeing your question when you posted it. First of all I think it is a mistake when you have a problem like you seemed to have by not returning to the same doctor and letting him / her re-examine your eyes. Since it was only in May that you got your eye exam and glasses that is very close to being within the time limits when nearly every doctor will not charge for any change that mat need to be made to your glasses. Going off to another doctor has lead you the the question you now have. Did your eyes really change by that much in such a short time, did the other doctor under correct your eyes, is this doctor over correcting you? So is it possible that your eyes changed by that much? Yes it is possible, but now your looking to be paying double for everything and if you get new glases based on this new prescription maybe they will be fine and maybe not. If it were me I would be calling the doctor you saw in May and not mention anything about your recent exam and tell them the issues your having. They should or at might do a re exam at no charge and change your glasses at no cost which I think would be the better option. As for as the "bug eye" thing you may need to have a high index lens for your left eye so it is closer to being the same thickness as the right lens. Hope this helped in some way.


Sparky 14 Aug 2016, 11:05

It seems no 9ne wants to reply to my issues.!.I guess you guys only reply to who constantly Post!


Sparky 12 Aug 2016, 23:42

Hi all.I got multifocal lenses.in may this year.left +2.25 right.+ 1.50.add +1.been having some difficulty again for a few weeks. I went to a new optician. New script left.+3.25.right +2.25.add+1.25.is it common for eyes to change so fast.I am 39 yo.will my left eye look bug eyed.


Sparky 12 Aug 2016, 23:42

Hi all.I got multifocal lenses.in may this year.left +2.25 right.+ 1.50.add +1.been having some difficulty again for a few weeks. I went to a new optician. New script left.+3.25.right +2.25.add+1.25.is it common for eyes to change so fast.I am 39 yo.will my left eye look bug eyed.


Greg 12 Aug 2016, 04:32

Mr. Plus Tony, just checking to see how you are adjusting to the need for bifocals.


Mr Jules 11 Aug 2016, 15:56

Cactus Jack, thank you for your advice. Currently have a pair of single vision prescription reading glasses at the old +3.25 prescription. Intend to get them reglazed with +3.75 lenses.

Most of the time, I wear my varifocals. But I don't find the varifocals suitable when I'm using a computer monitor. Instead, I prefer my single vision reading glasses.

For info, my new prescription reads:

Right: sphere +1.50, cylinder -0.50, axis 155

Left: sphere +1.50, cylinder -0.50, axis 20

Reading addition +2.25


Cactus Jack 11 Aug 2016, 10:19

Mr. Jules,

Single vision reading glasses are great, if you need to do a lot of reading. It may be cheaper to just order some +3.75 ((+1.50) + (+2.25)) glasses from an online retailer, such as Zenni. You don't need a fancy or expensive frame.

Also, you might find the Clip-On Magnifiers from Rx-Safety Glasses, useful, particularly for computer use.

C.


Mr Jules 11 Aug 2016, 07:55

Thank you for your advice. It all makes sense to me.

My +1.50 distance vision has remained stable for the last 4 years. The changes have been with the addition for reading.

New progressive lenses are expensive, so I'll stick with my current pair of glasses for the time being.

I also have another pair of single vision reading glasses, and I think I'll have these reglazed with new prescription strength. I can manage with my current varifocals glasses, but it would be good to have my single vision reading glasses reglazed.


 11 Aug 2016, 06:58

Mr Jules,

Your Sphere +1.50 distance vision prescription will likely be stable for many years, unless you develop cataracts or other eye problems. Your Add will likely increase some as you completely loose the ability to contribute internal PLUS for focusing. How much it will increase and where it will stop depends on your close focusing and reading distance preferences. The amount of PLUS Add you need is strictly governed by this formula:

Lens Power = 1 meter (100 cm, 1000 mm, or 39.39 inches) / Focus Distance

For example: To focus at a typical reading distance of 40 cm or 16 inches requires

100 cm / 40 cm = +2.50 or 39.37 / 16 inches = +2.50

That +2.50 has to come from somewhere. Right now, your Add provides +2.25 and you can still contribute the additional +0.25, internally, but that will ultimately go away and the necessary Add you need, will have to be in your glasses.

C.


Mr Jules 11 Aug 2016, 06:05

Just had my 2 yearly eyesight test. Distance unchanged at +1.50 for each eye. But addition has increased from +1.75 t +2.25.

Perfect eyesight until I was 40. Then an eyesight text lead to +1.00 reading glasses. Things changed. By 45, I was wearing varifocals all the time. Adjusting to full time varifocals was absolutely fine. Can't imagine my face without glasses, now.

Now I'm 49, I wondering if I can expect further changes to my eyesight.


Michael 17 Jul 2016, 20:22

chinese soup-The distance script could be almost anything.It would be impossible for me or anybody else to guess. Whatever it is you take that number and to it add the reading add to get the total reading RX of 2.75. My guess is your friend has some kind of a distance script but I can't be 100% sure.


chinese soup 17 Jul 2016, 19:42

Hi guys, no the reading Rx alone is +2.75. For readers. What I'm trying to figure, out is what the breadown of the Rx would be likely to be for the new progressives. He started wearing glasses for reading at 43, but had been complaining prior to that.


chinese soup 17 Jul 2016, 19:42

Hi guys, no the reading Rx alone is +2.75. For readers. What I'm trying to figure, out is what the breadown of the Rx would be likely to be for the new progressives. He started wearing glasses for reading at 43, but had been complaining prior to that.


Michael 16 Jul 2016, 12:35

John S- Thank you for clarifying things. I reread his post and responded to him again. Yes he was probably referring to the complete reading RX and not just the add. And I think the add by age is just a guideline. If you are over 40 and are getting an eye exam for the first time the doctor may go by age to try to figure out the appropriate add. But as you said there are always exceptions. But if you went just by age I would guess a 1.75 add would be probably about right for somebody who is 47 years old.


Michael 16 Jul 2016, 12:25

chinese soup- Are you talking reading glasses that are +2.75? If a person got progressives the add of 2.75 would be added to whatever the distance script is. If the distance script for instance is +1.00 the 2.75 would be added to that. So if a person bought readers they would need 3.75. I am still confused about exactly what you are asking and may be confusing myself because I am afraid I may not be explaining this very well. But for somebody who has bifocals or progressive almost never will they have an add of more than 3.00 added to their distance script.A 47 year old I doubt would ever need a 2.75 add though I guess it is possible. Everybody's eyes are different. I am 63 years old and my reading add is 2.50 for my progressives.


John S 16 Jul 2016, 12:16

Michael,

He did not say reading add, he said reading rx. If he is using a +2.75 for 18", he would most likely have a distance rx also. So it is an impossible question to answer since the distance rx is used as a baseline, and the reading rx is added to that.

If you used his age as the only determining factor, the add would be about a +1.75 for 16". Believe it if you want, but the age rule does not apply to several people I know, and myself.


Michael 16 Jul 2016, 11:52

A 2.75 reading add?That sounds very high to me especially for someone who is 47 years old. Usually people who need reading glasses start out with 1.00 or 1.25 and it gradually goes up until they are in their 50's and all the elasticity in their eyes is gone. But even then usually it is not more than 2.50 unless the person likes to hold their reading material very close. And even if that is the case most people will never need an add of more than 3.00.


chinese soup 16 Jul 2016, 10:23

Going to ask you experts an impossible question. If a man of 47 has a full reading prescription of +2.75, and starts to wear progessives, having not worn glasses for anything other than reading/computer before, what is the likely breakdon of the Rx?

I know that requires a bit of guessing, but I assume there is a pattern in there somewhere.

Do your best, I have faith in you!


John S 15 Jul 2016, 10:50

His eyes must have been screaming for glasses for a long time. The few weeks that he was wearing his Dad's, he had become completely dependent on them to see anything close.

Before he started wearing glasses, he could see close pretty well, but he said he would get light headed when he was reading. I don't think a kid could make that up.

He is basically wearing a +2.50 for reading. Without his glasses, he said anything close is a total blur. With his glasses, he can see the smallest of print.


 15 Jul 2016, 10:36

Cruising this board and see that a bunch of people wrote that at -1.00 some people go full time, and by -1.50 most are full time. At what prescription do most presbyopes lose their ability to read without glasses. I just got +1.25's and think I can still ok without them. Will I lose that ability? After how long?


Michael 15 Jul 2016, 10:05

John S- A lot of times parents don't listen to their kids even though they should. I guess his parents thought he wanted glasses because they were cool and a lot of his friends had them and not because he needed them. But it is amazing how quickly his eyes adapted to the progressives and he quickly figured out how to use them when many adults have a lot of problems getting used to them.Even though I got used to mine pretty quickly. But when he goes back to school he may have trouble finding another schoolmate who wears progressives. That may be a challenge.


Michael 15 Jul 2016, 09:54

Soundmanpt-Good point about the demand these days on young people's eyes. And progressives are appealing because nobody will know they are really bifocals unless you tell them. Some people still associate bifocals with old people. So progressives are much more appealing to wear. People who wear lined bifocals I can pick up on it right away even if the line isn't that visible. I got my first pair of glasses when I was 9 years old and for a long time got away without wearing them much. If they had computers and smartphones when I was growing up it would have been much harder for me to avoid wearing my glasses.


John S 15 Jul 2016, 09:33

I should give the rest of the story.

When I was over, he wanted to try on my glasses. When he put them on he said, I told my parents I needed glasses. So I asked him what the deal was. Then he told me about his reading problems. So his Dad said to try on his glasses, and he didn't want to give them back. I don't know why he didn't try wearing his Dad's before he asked me. His Dad also had reading glasses, so he let his son keep wearing his progressives.

His parents said that he had mentioned a few times about getting glasses over the past year or so, but he never said why he wanted them. I guess he wasn't persistent enough, so his parents just thought he was being a kid and wanted to be like his friends that had glasses. They don't think that anymore.

You are right about him adapting to progressives. The kid absolutely loves them. He thinks his glasses are really cool. He understands what he has to do to see, and doesn't complain about needing to wear them at all. It ended up being about 3 weeks before he got his glasses, so wearing his Dad's for all that time probably helped a lot.

I told him he would probably be the only kid in his school that had progressives. Now that he knows what progressives are, he is pretty sure that he had tried on a another kid's glasses that were progressives when they were swapping glasses around at school.

I'm sure he'll be asking about progressives when he starts school again to see if anyone else has them.


Soundmanpt 15 Jul 2016, 08:14

Michael

Yes years ago when you were talking about bifocals, progressives weren't even being made yet, you knew you were talking about someone that was likely over 60 years old. But in recent years bifocals, and even more so progressives are not nearly as uncommon as you might think for young people anymore. The increase of young people, the 20ish age group, getting progressives has been increasing quite a bit. I have several good friends that are opticians and they have all seen a fair share of young people needing progressives. The doctors seem to believe that it's due to how much young people's eyes are being exposed to everyday. As if computers didn't already have an impact on the eye industry years ago now look at how many more things the eyes are looking at such as I-Phones and all the texting has to be effecting the eyes at some point. The eyes are seeing more small print than they can handle anymore. I have come across several young people that were barely 20 and wearing progressives. One was a very attractive young lady working at a toy store at the mall.


Michael 15 Jul 2016, 07:48

John S- Yes he might have gotten a deal with the second pair of glasses. I know places sometimes offer a second pair of glasses at a discounted price or maybe even for free. And you may be right as to the reason he decided to get a pair of reading glasses to go along with the progressives instead of two pair of progressives or maybe a pair of progressives and a pair of sunglasses. But it is unbelievable how quickly he adapted to wearing glasses.People often have trouble adapting to single vision glasses if they never wore glasses before never mind progressives or bifocals. Probably the key is to put them on and keep them on instead of doing the on and off thing. If you keep on putting them on and taking them off it will be more difficult to get adjusted to them. Several people here have offered a suggestion in the past when you get glasses for the first time to wear them full time for two weeks and then decide after that how much you want to wear them.


John S 15 Jul 2016, 07:15

Michael,

I wouldn't say it is rare, it is just less common. When I was his age, I had the same prescription that he has without any astigmatism.

I guess he got them as an extra pair in case something happened to his main glasses, or maybe a discount deal. By the time he got his eyes checked, he had been wearing his Dad's glasses long enough to know that he wasn't going to be able, or didn't want to try to read without glasses.

I didn't ask him why he switched glasses. I bet it was to widen his field of vision to see the pages, or just so he didn't have keep looking down through the reading area.

I have never seen someone take to progressives as fast as he did. I don't think it took him more than 15 minutes to get used to his Dad's progressives, and they weren't even strong enough for him.


Michael 15 Jul 2016, 02:11

John S- How unusual is it for somebody that young to need either bifocals or progressives?I would guess it is pretty rare. And I am curious about one thing. What was the purpose of him getting both progressives and reading glasses?Not sure I have heard of anybody doing that before although I have heard of people getting two pair of glasses one for distance and one for reading. And he seems to have gotten used to the progressives very easily when some adults have trouble getting used to either bifocals or progressives.


John S 15 Jul 2016, 01:04

A friend of mine's 12 year old son had been complaining for a while that reading bothered him. He vision didn't seem very bad. He could see some pretty small print. It didn't seem like he really needed glasses, but he didn't like to read.

A few weeks ago he started wearing his Dad's progressives. They were pretty weak. He wore them on and off for a few days, and then they were glued to his face. It turns out his son did need glasses. His son's rx was: R +0.75, L +1.25, -0.75, X 115, Add +1.75.

The kid was really happy when he got his glasses today. They were noticeably stronger than his Dad's glasses were. He liked his Dad's progressives, so he got progressives, and a pair just for reading.

He put on his progressives, and said his distance vision was kind of blurry. Being farsighted, that made sense with new glasses. But he still liked his glasses better.

He had worn his new progressives most of the day. I asked him how his vision was. He said his distance vision was better with his glasses on. Then he tried reading a business card without his glasses. He said he couldn't see it. It was really blurry, so he put his glasses back on.

He started reading a gaming magazine, and took his progressives off, and put on his reading glasses. He is a pretty smart kid to have figured that out in just a few hours.

He doesn't care about vanity. He just wants to be able to see, so he has no problem with wearing his glasses. A few of us could probably learn something from him.


newglasses 15 Jun 2016, 01:29

Bifocal Sandy: are you still around? Would you be so kind and update us on your current rx?

Thanks and best,

newglasses


Soundmanpt 14 Jun 2016, 08:55

Carrie

Nice that the 4 of you were able to get together. I thought that your cousin probably had at some point met Danielle and Vicky. I'm sure the difference Vicky is noticing now between Danielle's glasses and her own glasses is the astigmatism correction she has in her glasses now. A -.25 CYL isn't much but it is enough to sharpen things up for her. I'm sure she has to be thrilled now that shes wearing her very own glasses. Nice that Danielle even put on her glasses so she wasn't the only one not wearing glasses at the table. Do you think that she might be starting to not mind wearing her glasses? I know you have said that she is okay with wearing her glasses but she just doesn't want to become dependent on needing them. But she seems to be starting to wear them more and more often as of late. Even more strange since her partner loves wearing glasses and wears her glasses constantly. You would think that seeing how good Vicky looks wearing her glasses she would be encouraged to wear hers all the time as well. Gemma has a bit of sense of humor since she offered to take her glasses off so Daniele wouldn't be the only one not wearing glasses. But she cautioned that no one change seats. I'm sure your right that Gemma even without her glasses would still be able to tell if anyone were to move. But she is nearsighted enough that you would all look blurry to her without her glasses.


Carrie 14 Jun 2016, 05:24

Soundmanpt - my cousin has met Vicky and Danielle a few times and really likes them both. She did notice Vicky had different glasses and thought they looked nice on her. Vicky said she can see in HD now.

Danielle did put her own glasses on for a few minutes so she wasn't the only person in the room not wearing glasses she said. Gemma offered to take her glasses off in sympathy for Danielle and joked that nobody was to change places because she wouldn't be able to tell. (We weren't sitting that far apart that Gemma wouldn't be able to see bare eyed)


Soundmanpt 13 Jun 2016, 11:12

Carrie

Something else about wearing your cousin's glasses. I'm pretty sure that when you wear her glasses you most likely put them on first thing when you chose which glasses you plan to wear that day. And once you choose her glasses you wear the the full day and right up until your going to bed. Getting up the next day if you choose to wear a pair of your own glasses i really doubt your eyes notice any difference at all from having wore her glasses the day before. But if you were wear her glasses most of the day and then decide to switch to your own glasses later in the day then I think you would notice the difference right away because your eyes would still be adjusted to her glasses so your glasses would almost certainly feel a bit weaker. Given some time your eyes will of course readjust to your own glasses. But none of this is doing any harm to your eyes so if you like wearing her glasses then go ahead and wear them as your everyday glasses if you want.


Soundmanpt 11 Jun 2016, 08:12

Carrie

Actually your eyes are now slightly more comfortable wearing your cousin's previous glasses then you own glasses. Your not doing any harm by wearing hers because your eyes most likely have changed by at least that much since you got your current glasses. Part of that extra +.50 your eyes are probably using to makeup for the lack of having your -.25 astigmatism correction in them. If either you or Vicky were to decide you wanted to wear contacts which we know that isn't going to happen, the contacts you would be given wouldn't even have any astigmatism correction in them. They would simply ignore it. But since you both wear glasses and have a small need for astigmatism correction they will include it in your glasses. It makes sense that when you first started wearing your cousin's glasses that when you first put them on your eyes noticed the slight increase, but as you know your eyes were able to easily make the small adjustment to them and within just a few minutes they felt perfect to your eyes. But the more your wearing her glasses i'm sure your going to notice you own glasses being just a tiny bit weaker, but maybe not enough to bother you. So when you were with your cousin, Danielle and Vicky and you asked to try her current glasses again this time her glasses didn't feel nearly as strong as they did when you last tried them. That's because now your eyes are only needing to adjust to another extra +.50 over your cousin's previous glasses. In other words it's a smaller step for your eyes. In fact it is pretty much the same as what Vicky needed to do when she started wearing glasses. Her eye weren't at all able to handle or adjust to Danielle's first glasses when she tried wearing them. But by going down to +.50 glasses her eyes were able to adjust to them and before long her glasses were completely comfortable for seeing at all distances. Then going back to Daniele's glasses with her eyes already adjusted to her +.50 it was much easier this time for her eyes to adjust to +1.00. That is much like what your doing now. You now could probably wear your cousin's current glasses without any problem if you wanted to. As long as your eyes aren't bothering you which thye don't seem to be and you have your cousin's glasses to wear if they do become more comfortable to your eyes then I don't see any reason to get an eye exam when you have pretty well corrected your own eyes. Of course you might consider getting another pair of glasses in the same prescription as your cousin's glasses only be sure to add in your astigmatism correction. With you switching glasses with your cousin in front of Danielle and Vicky did they make any comments about their glasses? Did your cousin notice that Vicky was wearing new glasses or did they not know each other? Did Vicky say anything about her glasses since she has her own now?


Carrie 11 Jun 2016, 02:58

I've been wearing my cousin's previous glasses quite a lot recently and I seem to have got completely used to them (they are +0.5 stronger in both eyes than my current prescription). I don't actually notice the difference between the two prescriptions any more. It used to take a short while to adjust to my cousin's glasses and once I had them on it took a moment to see clearly going from reading to distance. Now I adjust immediately and there's no delay focusing from reading to distance, just like my own glasses. I don't know if I can see any better with them but there's no feeling of eyestrain. I'm not sure how much effect my small astigmatism correction in my glasses has but it is hard to tell if I would see better if I had it combined with the slightly stronger + prescription.

My cousin came over yesterday evening (Danielle and Vicky also came over) and I mentioned that I had got used to her old glasses. She said maybe I actually need that prescription. I then asked if I could try the glasses she has now (+1.00 stronger than mine). So she passed me the glasses she was wearing and put her old ones on. When I put her stronger glasses on it wasn't as bad as the first time I tried them on a few months ago when she first got them and after a couple of minutes I could see pretty well. Of course it could be that I have good accommodation rather than me needing +.50 or even +1.00 stronger glasses. I might get my eyes tested this year even though I'm not due until next year. I'm in no hurry as I can see just fine with my current glasses.


Soundmanpt 08 Jun 2016, 09:38

Louise

In looking at your prescription from last year compared to your new prescription there really hasn't been much change at all. Your right eye only had a +.25 change in CYl (astigmatism) which is the smallest you could possibly get. Your left eye only needed the smallest increase of +.25 for SPH (distance) that is possible and that is the same case for your CYL. And even your reading segment only went up by +.25. Very minor increases across the board. The main thing that has changed is that you now need prisms in your glasses. That 2 BO (base out) is very little as well. But what that means is your eyes aren't converging as they should. This change is something that you now need to do as you have been instructed and start wearing your glasses full time now. Your glasses now aren't going to just be to correct your eyesight but now they are going to be pulling your eye in the correct position so they are aligned as they should be. The reason your getting headaches is because your eyes aren't able to converge. Your glasses are going to solve that for you but only if you keep them on all the time now.


Louise 08 Jun 2016, 09:12

Hi, I posted on here about a year ago. I got a prescription for varifocals after wearing +1.25 off the shelf readers for a while. I got the glasses but haven't quite gone full time except at work and when driving but admit i can see better with them. The prescription was

R +1 -0.5 140

L +0.75 -0.25 65

ADD +1.5

i found I've been getting headaches and struggling to focus at work etc even with my glasses on. I assumed I might need a change in prescription and booked a test and the prescription is

R +1 -0.75 130

L +1 -0.5 60

ADD +1.75

but the biggest surprise is they did another test with some dot and lights to line up and said I need some prism in my glasses too which should stop the headaches. It says 2 BO and i have to get checked in 6 months.

I'm getting new frames and waiting for the glasses to be made up. They seemed to think i was full time in the glasses i've got and said i'll get used to the new ones fairly quickly.

Will i have to wear them all the time? all this seems a big jump from no glasses a few years ago.I'm 43.


Cactus Jack 07 Jun 2016, 23:14

Landon,

Cycloplegic Refraction is the correct name. Sorry about that. Senior moment, I guess. I seem to be having more of those lately.

If the ECP does not believe that your Ciliary Muscles / Crystalline Lenses can interfere with the accuracy of the refraction, there is no need to do it for that purpose. As you reach the age where people begin to develop health issues that can damage the Retina, a dilated exam is worth considering if only to establish a base line. If you have any known medical conditions that can affect the Retina, a dilated exam and perhaps a visual fields test is definitely worth considering.

C.


Landon 07 Jun 2016, 19:54

Cactus Jack,

Thanks for that. I've had my eyes dilated before, but it was always AFTER the refraction. I was poking around the internet, and I think the term is "cycloplegic refraction." (???)

I once casually asked about this to my optometrist, and he replied that it wasn't necessary for me. I am a little hyperopic having had LASIK like Jens' wife.

I wonder when a dilated exam is recommended, aside from young children.


Cactus Jack 06 Jun 2016, 20:52

Jens & Landon,

The technical name IS Dilated Exam. It is sometimes called a "Wet" exam. The Dilating Agent does two things:

1. It causes the Iris (pupil) to open wide which gives a better view of the Retina to check its condition. I get a Dilated Exam periodically to check my Retinas for damage from Diabetes. So far, so good. While your pupils are dilated, you have no defense against bright light so you will need dark glasses in bright light until the Agent wears off in about 4 to 6 hours depending on the Agent that is used,

2. The Dilating Agent also paralyzes your ciliary muscles which prevents them from helping with the refraction process by supplying compensating PLUS, internally. A third benefit is that with the pupils wide open, your depth of field is at a minimum. Your pupils act like the iris in a high end camera lens where the depth of field (range of useful focus increases as the Iris adjustment (f stop) is closed down in bright light. You experience the same thing in bright light, you pupils close down and you can often see better. It is the same effect as the "pin hole" effect the you look through a tiny hole. Depth of field effects are also the reason that people who need correction have more difficulty seeing clearly in low light conditions.

Because the Dilating Agent paralyzes the Ciliary Muscles. Many examiners will do a preliminary refraction before dilation to check your Accommodation and ability to focus close. Then, they will administer a mild anesthetic to keep the Dilating Agent from stinging a little. The may also do a pressure check for Glaucoma after administering the anesthetic. Then they will administer a drop of the Dilating Agent in each eye and give you a tissue to blot the excess and ask you to go to a waiting area for about 20 minutes.

At first nothing will happen, but you may notice that the room lights seem to be getting brighter and you are loosing your ability to focus if you normally have plenty of accommodation. If you wear bifocals or trifocals, you may not notice much of this effect because you can't focus much anyway. You may also notice a slight haze that seems to go along with dilation. Not to worry, everything will go back to normal when the agent wears off.

After about 20 minutes, you will be called back in the examining room for a distance refraction. With your Ciliary Muscles paralyzed, they cannot use your Crystalline Lenses to affect the results of the exam. However, if you have long term Pseudo Myopia or Latent Hyperopia, the dilating agent MAY NOT be able to fully relax your Ciliary Muscles and Crystalline Lenses, fully. If you have been compensating for Hyperopia or Myopic Over Correction for years, the dilating agent won't be able to undo that condition in just a few minutes, but it might be able to do enough to give you and the examiner a clue that you have Latent Hyperopia or Pseudo Myopia and get the process started to fully relax your Ciliary Muscles and Crystalline Lenses.

The most important benefit of a Dilated Exam is the better view of the Retina. Many diseases are first recognized during an eye exam. Ideally, they are discovered at a very early stage when management is relatively easy, long before they affect vision.

I would like to invite DS and ECPs to comment on the above. As I have stated repeatedly, I am not an ECP. I am an Amateur in the original French sense of one who studies a subject out of love. I seem to be pretty good explainer for non professional people. If I make a mistakes, I would appreciate comments. My primary goal is helping members understand how this stuff works.

BTW, people with Axial Myopia typically do not need dilation to relax their Ciliary Muscles and Crystalline Lenses because the nature of the "beast" is such that they are typically fully relaxed unless they are reading with their glasses or have some Pseudo Myopia.

C.


Landon 06 Jun 2016, 19:50

I had the same question as Jens about the technical name for a dilated eye exam and whether it would be a good idea. (My story is very similar to Jens wife's.)


Ricky 06 Jun 2016, 09:19

Hi this is Ricky..i am 36 years of age. Of late i have begun to notice that if i hold things close to my eyes its difficult to read. Since i like glasses i got my self a pair of progressive glasses with strength of L and R eye +1.0 with a add of +1.5. I have been wearing these glasses for 4-5 hours in a day and i can see very clearly with them. My question is how soon will i be completely dependent on the glasses?


Jens 30 May 2016, 14:56

DS,

Thanks indeed for the drugstore reader trial suggestion for distance vision. We may have to resort to that method if all else fails. Your caution on add power is also helpful.

She will try to see an O.D. later this week.

*****

Cactus Jack,

In addition to my question about how to request a dilated exam, and whether it could result in a too-strong Rx, here is another:

You use the term *latent hyperopia*, but does this really apply in this situation?

(a post-LASIK case with an internally myopic eye)


DS 30 May 2016, 14:05

Jens,

Your wife's astigmatism is practically negligible, and she is in the range where she can experiment to find what powers she prefers by trying on drug store readers. They tend to start at +1.00 and will go high enough to cover her distance + add since she is still early into presbyopia.

She should choose the highest power that allows her to see distance clearly and comfortably. Then, she can choose the total power she prefers for reading and the ADD computed as the difference between the two powers.

The astigmatism and quarter-diopter (between eyes) adjustments can be included if wanting to order some multifocals.

I would be careful to not increase the add more than necessary. +1.50 is a high add for age 41. With a prescription such as the following, note that the total reading power would still be more than her current +1.5/+1.75 glasses:

OD +1.00 -0.25 x 90 ADD +1.00

OS +1.25 -0.25 x 110 ADD +1.00

A lower ADD will maintain the widest transition zone (and lower off-corridor distortions) between distance and near in progressive lenses, too, which will make adaptation easier.


Jens 29 May 2016, 16:15

Cactus Jack,

Thanks for reading, and for your response. We live in Southern California, southeast of Los Angeles.

She does not have any of the diseases you mention, nor did her single pregnancy eight years ago seem to affect her vision at the time.

You suggest a dilated exam and thanks for that. I agree that this is a better approach than the Zenni trial option.

From my experience as a patient, an O.D. will perform a dilation for an extra fee, and does this *after* performing the refraction.

How do we request a dilated exam the way you describe it? Is there a specific term or phrase to use?

Is there a risk that a dilated exam will yield a distance Rx too strong for her autofocus-prone eyes to handle on a daily basis?

Thanks again, and my apologies for such a lengthy post earlier!


Cactus Jack 29 May 2016, 14:35

Jens,

May I ask where you live? It could affect my answer.

It appears that your wife's vision is pretty much stabilized and has very little, if any Latent Hyperopia. If that is the case her distance Sphere correction will probably not change much, but it is likely that her Presbyopia has not reached its end point where accommodation is no longer possible.

My first thought is to suggest a dilated exam to make sure her Ciliary Muscles and Crystalline Lenses are as relaxed as possible for the distance Sphere part of the exam.

The amount of Add she needs is strictly a function of the laws of optics that relate focal distance to lens power and how much extra PLUS she is able to contribute. Once you have those numbers you can go from there. It is very likely that her Distance Sphere, Cylinder and Axis correction will be stable, but the Add may increase depending on her accommodation and how close she needs to focus. If there is much change in the distance Sphere, it needs to be investigated. There are several conditions that can affect refraction. The most common is diabetes, followed by Blood Pressure and Glaucoma. They are often first discovered on an Eye Exam, while they can still be managed with little inconvenience or effort.

It is tempting to try to chase a prescription with low cost glasses from Zenni or other online retailer, but I think a dilated exam would be better to establishing a starting point.

C.


Jens 29 May 2016, 11:58

Hello,

Cactus Jack, I have seen your helpful explanatory posts and advice to others, and I was wondering if you could do the same for me--my wife actually.

Quick summary:

She is having trouble getting a comfortable, clear prescription for mild hyperopia + presbyopia following LASIK to correct myopia some years ago. The difficulty in Rx determination could be primarily due to optometrist incapability, but even in this case, a prompt to any eye examiner could help lead things in the right direction.

We had a discussion together to see how we should proceed. I told her that I would try to find some information online.

Aim:

My wife is a financial advisor who travels around a fair bit to meet clients and make presentations. She requires comfortable, clear vision moving from distance to near and vice versa. She now wants to be able to wear glasses continuously throughout the workday by default, for a consistent professional appearance. She doesn't like the hassle of on-off glasses wear (which makes her feel old), nor does she want the hassle of contacts. The latter factor was why she had LASIK in the first place.

More detail (trying to be reasonable concise though):

My wife became myopic around 15 which increased eventually to roughly -3.75 or so. She wore glasses, then contact lenses, regularly until she had the LASIK procedure in 2005 (age 30). At her follow-up she was told that there was a slight overcorrection, but she had no symptoms or complaints, and decided with her ophthalmologist to leave her eyes alone. In fact her eyes probably enjoyed the extra sharpness. Her O.D. actually suggested very weak OTC reading glasses to relax her eyes, but she didn't feel the need and never bothered.

In her late 30s, almost 39, she really began to have headaches while on her laptop or otherwise reading. She had an eye exam and was prescribed a new Rx:

R +1.50 -0.25 090

L +1.75 -0.25 110

The O.D. told her that these were primarily for reading, and for distance when her eyes were tired. She could wear them for distance as well, but didn't need to. This was fine with her, though she could not quite adjust to this Rx for distance. She could still walk around wearing them at home or her office, but for example, I remember her saying that she would have to lower her glasses at a coffee shop so that the board menu was a little clearer.

I suspect that this Rx was the result of maximal use of the technique I think you describe--where the examiner makes the eyes very tired by forcing the eye muscles to work very hard to focus, then applying plus lenses and working down the power. The problem in her case, it seems, was that her eyes' "natural state" could not quite accept the prescribed strength, because her eyes would auto-focus more than anticipated.

Two years later, she is now 41, and needs the glasses more urgently for close work. In fact, she has been having headaches even with the glasses on. For several months she has been wearing her glasses fairly continuously throughout the workday, she says. At distance, she can tolerate the strength better than earlier, but it is probably still slightly strong. She travels a fair bit for work, so after driving a while things look fairly clear.

Last week she decided on her own that it was time for an eye exam, this time with a different O.D. Her new Rx:

+0.50 R -0.25 090

+0.75 L -0.25 110

add +1.00 both eyes

She knew intuitively that this didn't seem right, because the eye examiner spent very little time in Rx determination. An assembly-line experience, she says. She had to wait a while with the pre-exam information in front of her, and the distance Rx written was the same as that measured by autorefractor. (She knows what that is!)

One obvious red flag: the total reading Rx was exactly the same as before, which would not address her worsening symptoms at near. The other problem, she says, is that she thinks the distance Rx is a little less than what she could use. That is because sometimes when her eyes are very tired the lenses that are +1.00 stronger work pretty well.

It seems like the two eye examiners took opposite approaches: the earlier one too aggressive, but the more recent one too lax.

My sub-amateur guess is that a "midpoint" Rx for distance with a slightly stronger near add would serve her better. Something like:

R +1.00 -0.25 090

L +1.25 -0.25 110

add +1.50 for both eyes

I was wondering what you think, Cactus Jack, on how to proceed, as you are a far more accomplished amateur. In particular, how could she "prompt" a new optometrist to help her get a more comfortable and accurate presciption? I was actually thinking of trying out an online order with the "midpoint" Rx to see if it works for her.

Thanks for your help!


RR 13 May 2016, 17:16

Nice videos

https://www.youtube.com/watch?v=cM3aWvq8ZBU

https://www.youtube.com/watch?v=mpBwz-pAg1U

https://vimeo.com/129145610


 10 May 2016, 19:26

I believe that he is from Transylvania.


All 10 May 2016, 12:40

Hi Igor! it looks strange, but I like the crosseyed. What country are you from?


Carlos, Jr 10 May 2016, 12:26

Plus Tony, I think you'll appreciate wearing bifocals. Let us know how it goes.


Brian 10 May 2016, 11:44

Cactus, The thickness doesn't bother me that much to worry about wearing glasses over contacts. Especially if I need them all the time. It would be one thing if I could get away with only needing the prism glasses to read, but with amount of prism I need, I'm pretty sure I'd have double vision all the time without the prism being there.


Cactus Jack 10 May 2016, 07:14

Igor,

May I ask the following questions?

1. What is your complete prescription?

2. Your age?

3. Your occupation?

4. Where do you live?

C.


Cactus Jack 10 May 2016, 07:09

Brian,

There are two factors that are affecting the inside thickness of the lenses in your glasses. One is the inside edge thickness caused by correcting your Myopia and the other is the BI prism in your glasses.

Here is an idea you may not have considered, GOC. You could correct most of your myopia with Contact Lenses and correct your Exophoria and possibly any Astigmatism with prism and cylinder in your glasses.

C.


Igor 10 May 2016, 01:38

Hi guys,

I have a similar experience. I have been wearing prism correction on top off my usual correction for 3 years now, and am at 3BO per eye which is not much.

I have to wear my glasses FT because of high astigmatism, so I didn't notice the change at first, but some time ago I tried using my old sunnies without prism correction (but regular prescription) for driving, but could not keep my eyes straight anymore. My weak eye constantly drifted off towards the nose. Anyway, since then I had more an more situations where I could not bring my eyes into alignment and have stopped trying since because of headaches. It's easier to just close one eye or let it drift to the nose. (I find it easier to handle when the double images are further apart.)

I have slowly come to terms that I am now permanently crosseyed (but not visible to others), which means that my old glasses are useless, and that I should buy a spare pair. I did the CJ's prism test posted multiple times and probably require at least an additional 10dpt, but I neither have the funds nor the willingness to go for an eye exam that will probably lead to glasses that make me appear crosseyed.

Anyway, I am wondering if I should buy glasses with an additional 1 or two dpt per eye (to increase the comfort a bit, since I can easily make them drift off with glasses but can also maintain fusion), since I am ordering it anyway. Will I be able to switch between my old and new glasses, or will my eyes not allow that and require the stronger ones permanently? Any insight is welcome.


Brian 08 May 2016, 19:00

Kris...I've had similar issues with prism..I'm 37..mine is based in not base out...I started at 2BI in each eye back in 2010..saw yearly increases to 5BI in 2013...I thought it had stabilized because I did not need increases in 2014 or 2015 but when I went for my yearly exam in March I saw another increase to 6BI in each eye...My optometrist said it might be possible that I could need surgery in the future but I was OK for now..like you I am dependant on them all the time or I see double...My distance script is -6.00 in one eye and -5.00 in the other eye...before I needed prism I was able to wear contacts but since getting the prism I can not wear them anymore...The insides of my lenses are pretty thick now with the large amount of prism I need but my vision is comfortable with them.


Kris 08 May 2016, 16:46

I'm now 45 and have been wearing progressives for 6 years. I had childhood strabismus and I posted last summer about my issues with double vision and my debate about whether or not I could manage without prism. I initially started with prism in computer glasses, but eventually went full time. I had been stable with 4BO in each eye.

I went back to my ECP recently because I wanted to get a new pair of glasses in case my current ones break. Because I hadn't had an eye exam in almost a year, I booked an exam, expecting that things were stable. However, the ECP indicated that I needed more prism and that the strength of my distance vision lenses could be decreased. I now have a prescription of L +0.75 add 2.75 5BO, R 1.5, cyl -0.5, add 2.75, 5BO.

I'm surprised that within a year of starting to wear prism I am needing 5BO both eyes. Does it prism need usually stabilize quickly or should I expect that it will go up again in the future?

Before wearing prism I used to sometimes putter around in the morning without glasses, but now I reach for them as soon as I wake up. As well, I can't even read the large print on shampoo bottles anymore, so struggle more to sort out if I've grabbed shampoo or conditioner in the shower. I noticed on my eye exam that when the ECP used his machine to see how the new prescription worked when I used both eyes the images were really far apart. Last year I saw double with this, but could fuse the images. The ECP had to make some adjustments to the machine so that I could fuse the images. My vision is more comfortable since starting to wear prism, but I'm surprised at how much I need.


Plus Tony 05 May 2016, 12:11

Cactus Jack

Thank you for your guidance. I am going to carry out the test you suggested at the weekend and will report back on the results.


John S 05 May 2016, 10:22

Until I was in my late 30s my rx was around +1.25, add +2.00. Before I totally lost my accommodation, it was uncomfortable to read without my glasses, but I could usually do it. But the second I put my glasses on and used the reading seg, I lost all my accommodation for about 60 seconds. It was just like someone turned a switch off. Even my distance vision was blurry.


SC 05 May 2016, 06:48

Carrie,

Thanks for the insight into your 'crappy' vision. I didn't start with a distance Rx until my mid 40s and so always assumed that plus lenses for young people were more about comfort and headache relief rather than being unable to see!

If my Rx is stable (getting there at age 51) then at age 40 I could still see small print without glasses so could accommodate +1.75 (distance) & +3.00 (small print) so +4.75.

Interesting at about half that age, you can't see your phone with +2.50 (distance from memory) & +2.50 (phone @40cm) so +5.00.

Maybe you have some way to go on your distance Rx because I'd expect your accommodation to be twice as good as mine was at 40. Do your eyes 'recover' after a while - ie if you didn't wear glasses for 15 mins then would your close vision be better? I went through a period where I could see distance in the morning before putting glasses on but not in the evening after wearing them


Soundmanpt 01 May 2016, 10:57

Carrie

In part you could be somewhat correct about the first place you went to get your eyes examined. He very well might have just thought you were just another teenage girl just wanting glasses for fashion. But i'm pretty sure he did give your eyes a complete and thoural examination. If he did anything like you suggest I think he probably did want to fit you with glasses to make you happy since you came in expecting to get glasses. Doctors would rather write you a weak prescription than tell you that there is nothing wrong with your eyes. But if you had really needed anything stronger than what you got I don't think he would have had any problem prescribing you as such. You have to remember until you tried on some of those OTC readers you thought your eyesight was completely perfect. Chances are the OTC glasses you tried on that make small print nice and clear was only +1.00. Your glasses worked just fine for you for seeing close but if they had been stronger it would have been that much harder for your eyes to have adjusted to them for distance. By the time you went for your 2nd eye exam your eyes were completely adjusted to seeing everything with your glasses. When you first got your eyes tested i'm sure you didn't have any problem with seeing the eye chart. Now this time your going in almost certainly wearing your glasses so that already told them that you were likely wearing your glasses full time and then when they took your glasses away from you and you had to try making out the letters on the eye chart it wasn't nearly as clear as it was the first time you got your eyes tested. That would also explain why you were told that you only needed your glasses fro reading after your first eye exam. Carrie I am in no way lecturing you because I totally get it that you were very happy to be wearing glasses full time and didn't have any problem at all with being told that you now needed to wear your glasses full time because you now needed them in order to see distances as well as close up. Your at least nearing the age where your eyes should soon start becoming stable. You have all of your prescriptions so all you need to do is keep a list of when you got your eyes exams and how much change each time. If the increases are getting smaller and remember to take into account how long it is between each eye exam as well.


Cactus Jack 01 May 2016, 08:34

Plus Tony,

A couple of comments and suggestions.

The fact that one eye needs a +1.00 lens and the other a +2.00 lens does not mean that one eye is "weaker" than the other, There is just a difference in the Refractive Error. Typically, Hyperopia is caused by insufficient eyeball growth when you were young. The controlling factor is your genes. The amount of insufficient growth is very small, about 0.3 mm per diopter. The eyes are independent entities. They tend to track pretty closely, but it is rare to have exactly the same prescription in each eye. Sometimes the difference is large and there can be situation where one eye is Hyperopic and the other is Myopic. That can cause all kinds of Fusion problems because of the difference in image sizes on the Retinas.

When you will need some close focusing help is primarily a function of your Accommodation Range and the condition of your Ciliary Muscles. You can get an idea of your Accommodation Range by doing a slightly modified "Book Test" that I suggest for estimating distance prescription.

1. With your glasses on, hold a book or newspaper at your typical reading distance of 14 to 16 inches (36 to 40 cm) and gradually move it toward your eyes until the text just begins to get a little fuzzy. Try not to strain to focus close.

2. Measure the distance.

3. Do steps 1 and 2 three times and average the distance

4. Tell me the average distance and I will estimate your Accommodation Range.

If you do a lot of reading and it seems like your eyes are getting tired of focusing close, you may want to try some Over the Counter +1.00 or +1.25 reading glasses over your glasses. If that makes reading easier and more comfortable, you might want to consider asking your ECP for an Add or order some bifocals or progressives from an online retailer.

C.


Carrie 01 May 2016, 03:33

I seem to remember that the first optician I went to didn't seem that interested in my eyesight. He probabably thought I was just another teenager wanting to get some weak glasses to wear mainly for fashion. He probably should have given me a stronger prescription. My second eye test was with a different optician and I think it was that eye test or my third one it was suggested I wore my glasses for distances and not just reading. I was wearing my glasses full time anyway. I think that's when it was noticed that I had latent hyperopia and so my prescription has been steadily increased. I must be close to my full + prescription now.


Plus Tony 01 May 2016, 02:55

On Thursday it was 7 months since I got my first glasses at age 43 with a prescription of +1.00, +2.00. I started wearing them full time immediately as the optician emphasised that it was a distance prescription even though I was not told to wear them all the time. A bit like Carrie when she woke up with her glasses still on and found she coild see the TV ok I decided to put mine on first thing in the morning and took them off only after switching off the bedside light. Distances were clear and sharp almost immediately and I still only remove them when I absolutely have to. Although my right eye is weaker than my left I have good binocular vision and my depth perception is so much better than it used to be. My only regret is not getting glasses sooner. My vision is still pretty good at all distances and I can't decide whether to wait for another test or go for a check now (like June did after about 6 months). I remember she said that she didn't notice that she needed extra distance power when she got her bifocals so I am tempted to go and find out. I'd be interested to know what my fellow members of the eyescene 'plus wearers' branch would do. About a month ago I was convinced it was time for bifocals but now I'm not 100% sure.


Soundmanpt 30 Apr 2016, 19:19

Carrie

The way you seem to be wearing them should be fine and not cause you any problem with your eyes getting too adjusted to the stronger script in your cousin's glasses. You just don't want to wear them as your everyday glasses until your ready to go full time with a stronger prescription. Sounds like when you get around to ordering a pair on line might be the perfect time to start wearing her glasses full time along with whatever you get online. You still might be able to wear your current glasses but I am sure once your used to the stronger prescription you will notice the difference between your current glasses and your cousins, and the on line glasses. Things just won't seem as sharp and clear to you with your weaker glasses. Your right, it really doesn't seem like it has already been nearly 6 years since you got your first pair of glasses. In fact I had some time on this rainy, stormy day so I was curious as to when you first came in here. So I wasn't sure which thread you might have first used but I took a wild guess and went to "New Glasses" and went back to January 2010. Sure enough it seems like your first post was on September 17th 2010. Apparently you had only very recently gotten your glasses and you of course went on to tell how you were just trying on OTC readers just for fun to see how you looked in them and you noticed that the print was darker and more crisp with some of them. Somethings I had forgotten from back then. You didn't buy the readers but you did go for an eye exam and was prescribed glasses fro reading. Once you got your glasses you were determined to wear them all the time but your distance vision with your glasses wasn't very good even though you tried your best to wear them. But I forgot that you fell asleep with your glasses on while you were in bed reading. When you woke up the next morning and turned your TV on you still had your glasses only now you were able to see your TV perfectly with your glasses on. You found out that by putting your glasses on first thing in the morning for some reason your eyes didn't seem to have any problem seeing distances perfectly with your glasses on. I had forgotten about that. It seemed odd reading about what you said about your bf liking how you looked wearing glasses and he even helped you pick them out. Actually considering that you have been wearing glasses for 6 years now your prescription isn't bad at all. Your eyes have gotten worse of course but your increases have been very reasonable. Your cousin got got her first glasses a good while after you got yours and she needs a full diopter more than you wear and your college friend has stronger glasses as well. So I agree your far from being blind without your glasses. You mostly can't see to read any small print and your distance is blurry but still not so terrible that you can't see well enough to use the loo in the middle of the night without your glasses. Am I right?

The idea of starting a glasses wardrobe I am sure you would be the perfect person for that because I think you would even enjoy wearing glasses even more if you had a nice big collection to pick from everyday and maybe even like Melissa change several times a day even. But really until your eyes get stable it might not be worth getting too many yet. Now if you really start looking ta glasses on line as you plan to do, you can still buy about 5 pairs for under $100.00 without much effort from places like Zenni and Eye Buy Direct. They both have a nice large selection for under $20.00 a pair. That should be considerably less than what one you pay for one pair at a brick and mortor store. I don't expect that your astigmatism will change much in the coming years. In fact don't be surprised if it even goes away completely at your next eye exam. That happens more than you think. Look at it this way your cousin's glasses doesn't have any astigmatism correction and even if she did it wouldn't match yours anyway and you not having any problem wearing her glasses without the astigmatism. But if you do decide to order glasses on line I would include your astigmatism as well as the axis anyway. I really liked how you described your eyesight. You said your vision isn't terrible, it's just not very good. A bit on the crappy side. But somehow I think if you had the choice of still having perfect vision or keeping needing the glasses your wearing, you would say you want to keep your glasses. Just for when you have some time you might enjoy reading your posts back when you first got your glasses. As it turned out I was the first one to respond to you back then and we had some long posts from then on. I guess that includes this one. haha!


Maxim 30 Apr 2016, 06:37

Glasses from 6.99 Euros, postage limited to 5.99 Euros, a total of approx. 13,00 Euros, that looks good!

Try this - more or less for weak prescriptions:

http://www.polette.com/eu/ for Europe, or

http://www.polette.com/en/ for the US,

http://www.lusinealunettes.com/fr/ for French-speaking people,

I'll try it soon, only have to wait for a new refraction (eye test).


Carrie 30 Apr 2016, 01:37

Soundmanpt - I do occasionally wear my cousin's glasses. I don't really notice much difference until I take them off after wearing them for a few hours/all day then everything is a bit fuzzier than it usually is when I take my glasses off for a minute or 2 then it gradually goes back to how I normally see without my glasses. I have said before that I am not blind without glasses but there is no doubt I need them full time. Just 6 years ago I didn't even know I needed glasses!

I haven't ordered any new glasses online yet because I simply haven't got round to it but I will and I will order them with the same prescription as the glasses my cousin loaned/gave me. I think I might start building up a glasses wardrobe, like Melyssa, so I can change frames more frequently! I won't get lots straight away as I want to wait until my prescription has stabilised. I have a feel I might be given more + in my next prescription if I can see with my cousin's glasses. But as they are only +0.50 stronger than my own prescription it could just be accomodation. Then there's the astigmatism correction that I got for the first time with my current prescription. It's very small at the moment and I'm not sure how much difference it makes but there's a chance that could increase too. I will include the astigmatism part of my prescription when I order new glasses with the slightly higher +. I have read on Eyescene that it's best to leave the astigmatism correction as it is when ordering stronger glasses, which is exactly what I will do.

I might have a browse through some sites later.

I deliberately tried to read my phone without my glasses on just now. Absolutely no chance! Couldn't read a thing! If I strained I could make out the word "SAMSUNG" (the phone make) printed just above the top of the screen. I can read the numbers on the tv remote control in our bedroom without glasses but that's only because the numbers are larger than on a phone screen. There'd be no point trying to watch the tv without my glasses on because that would be annoyingly slightly out of focus and I certainly wouldn't be able to read any captions or the end of show credits.

I still wouldn't say my vision is terrible it's just not very good. A bit on the crappy side! ;-)


Soundmanpt 29 Apr 2016, 10:07

Carrie

A couple of months ago you had found that your eyesight was slightly better with your cousins previous glasses when you and her were trying on each others glasses. They were not as strong as her new glasses but they were a little stronger than your glasses and you were able to see perfect with them. She let you borrow them, and really they were useless to her anymore anyway. I warned you that by wearing her glasses as your day to day glasses that your eyes would easily adjust to them and then your own glasses would seem too weak for your eyes. At the time you were thinking about going on line and ordering a pair of glasses a little stronger than your current glasses. Are you still considering doing that? Do wear your cousin's glasses every so often just for a change and different look? You should be able to wear her glasses a couple days a week to work or for fun if want and they shouldn't have any permanent effect on your eyes. Actually by doing that it should help you decide if you see better with her glasses or not. Then you could order a pair on line in the same prescription as your cousin's glasses. and have 2 pairs to wear.


LT Lurker 20 Apr 2016, 20:56

I don't know if anyone has seen this research paper on accommodation, but it does appear to throw current thinking off the usual course with how much accommodative amplitude is required in reserve.

http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802015000400225


Soundmanpt 24 Mar 2016, 13:45

Carrie

So I was really not far off when I said that I though Danielle's glasses were somewhere around -1.50 or -1.75, but what I didn't remember was that her prescription was slightly different from one eye to the other. So if Vickie is maybe planning on wearing Danielle's current glasses when she gets new ones that might be a small problem for her. Really it would be so much easier if her glasses were just +1.50 for both eyes. Now your right that this is considerably much based on Vickie's last eye exam when she was prescribed +.50 glasses. But several things enter into this. First of all before Vickie started wearing +.50 glasses her eyesight had always been perfect. So clearly her wearing +.50 glasses full time effected her eyes. Now for the past few months she has been wearing Danielle's previous glasses and seeing perfectly with them. So I seriously doubt that if she were to get her eyes examined today she would still be at +.50 anymore. She is much more likely to be at +.75 or even +1.00 already. You might recall that when Vickie decided to start wearing Danielle's glasses again she had her own +.50 glasses close by when she needed them so she could change. But as soon as she was able to wear Danielle's glasses full time without any problem you have not seen Vickie wear her own pair of +.50 since. I'm sure she now feels alike they are too weak and she can't see as well with them anymore. She has even commented that now when she takes off her glasses (Danielle's) she can really see a difference, meaning things are more blurry I would assume. I could be wrong but since she has been wearing Danielle's glasses and switching between them she probably hasn't wore her own glasses even once anymore. I don't thing Danielle is due or planning on going anytime soon to get her eyes examined she is going to have even more time wearing +1.00 glasses. So she would only be talking about going up again another +0.50 / +.75. So that isn't nearly as bad as going from +.50 to +1.50 / +1.75 which is a sizable difference which I agree her eyes probably couldn't do. But by going up in steps that really makes the change much easier on her eyes. Of course we don't even know that she even has any thoughts about going any stronger. But you have to wonder if she sees Danielle's previous glasses just sitting there gathering dust if she maybe tempted to want to wear them even if she isn't thinking about it now. I don't recall if Danielle got 2 pairs of glasses the last time or just the one. If she only got one pair maybe Vickie likes having 2 pairs to switch between rather than only having one pair to wear.

I didn't mean to scare you with my warning about your wearing your cousin's glasses as your own full time glasses. Like I said before i am very sure your cousin won't have any sue for those glasses anymore since they are too weak to be of much benefit to her. She really should consider starting to get 2 pairs of glasses now since she really can't get by very well without glasses anymore. Like you she needs to go on line and at least buy a cheap pair just as a backup in case something were to happen to her current glasses. You already do seem to get 2 pairs when you get glasses which is the same for you because you can't really do much without your glasses anymore either. I mean you already know that doing your job at work would be nearly impossible for you and you can't see to drive so you couldn't even drive to work. Anyway wearing your cousin's glasses every 4 th day or so is fine but daily would probably cause you to need her stronger glasses and your glasses would not feel strong enough. So as soon as you indicated that you were planning on wearing your own glasses I knew I needed to warn you that might not be a good idea. Now of course if you get a pair on line with the same prescription as your cousin's glasses then if you want you can start wearing the on line glasses and your cousin's and not worry about your current glasses anymore. Have you checked out (zennioptical.com) or (eyebuydirect.com) they are both one that I have used and highly recommend. The prices are very good and the quality good as well.


Carrie 24 Mar 2016, 11:26

Soundmanpt - I have just checked back to some of my posts from last year to see what Danielle's current prescription is. She is +1.50 in one eye and +1.75 in the other. Maybe Vicky could handle that prescription but it is +1.00 & +1.25 stronger than her real prescription and I found my cousin's current glasses a bit too strong for me at +1.00 stronger than my current prescription.

I have been wearing my cousin's previous glasses all week but after reading what you have suggested I have now changed to my own glasses and won't wear my cousin's for a few days. I would like to find some frames online that are similar to my "Carrie" frames that I could get +3.00 and +3.50 put in.

Even before I started wearing my cousin's previous glasses I noticed that my vision without glasses was worse than when I got my current prescription. I could still get around without glasses but I wouldn't dream of driving without them.

Have to stop now as Gemma has nearly finished cooking our tea and I'm really hungry after spending all day at work surrounded by Hot Cross Buns and Easter Eggs and not being able to eat any!


Soundmanpt 24 Mar 2016, 08:46

Carrie

I agree with you i'm sure that Vickie loves wearing her glasses and wants that to be her look now. She is probably a lot like you and loves hearing someone describe her as as the girl with glasses when they describe her. I'm sure she smiles at that now. We probably won't find out if Vickie is interested in wearing stronger glasses until Danielle gets her eyes checked again. If Danielle gets an increase, which she likely will, she will be getting new glasses again and that will mean her current glasses will be available to Vickie if she chooses to try and wear them. I don't remember what you said Danielle's current prescription is but it seems like it was either +1.50 or +1.75 for both eyes. Now we all know that Vickie's eyes couldn't handle Danielle's +1.00 when she first tried wearing them because they were too strong for her, but after wearing her +.50 for a while when she again tried wearing Danielle's glasses they hardly bothered her at all and she is doing dine wearing them now. So now that her eyes seem completely adjusted to her +1.00 glasses going up another +.50 or +.75 may not be so hard for her if she wants to be wearing stronger glasses. My guess is that she will at least try to wear them. I am sure she has probably tried on Danielle's current glasses quite a bit already. So she may already know that her eyes can handle her stronger glasses when Danielle gets new ones. If you feel real daring you might even want to ask her if she has tried Danielle's glasses? Which of course you know she has and how well she could see with them?

If you still like your own glasses and want to be able to wear them for another year or more you better be careful not to wear your cousin's glasses too often. The more you wear her glasses the more your eyes are going to adjust to them and your own glasses will start to feel on the weak side. Are you currently wearing her glasses on a daily basis now? You probably shouldn't wear them more than once every 4 days or so. I'm pretty sure whatever glasses you put on when you start your day is the glasses you wear all day. So wearing her glasses every 4th day your eyes shouldn't get too adjusted to them. You just don't your own glasses to start to feel too weak. If her glasses are already that comfortable to you now you may find that in about 6 months or so you might need to actually start wearing hers full time anyway if you intend to not get your eyes checked this year. Of course like you already commented you could always go on line and order a pair of glasses in the same rx as your cousin's glasses if you wanted to.


Sajil 24 Mar 2016, 01:52

Thanks CJ


Cactus Jack 23 Mar 2016, 21:33

Sajil,

1. There is no way to predict, at this point, if your wife has any Hyperopia or Latent Hyperopia. A prescription increase or decrease (in to the - range) is not a given.

2. Any increase in her Add will depend on the amount of Presbyopia progression, the amount of Ciliary Muscle de-conditioning she experiences, and her preferred reading distance. Generally, a person's Add will never exceed +2.50 or +3.00, unless they like to read close in bed or have hobbies that involve very close work. The amount of +Add you need is governed by the laws of optics and is strictly related to focus distance. For example, to focus at 40 cm or 16 inches requires +2.50, period. The total amount can be divided between glasses and your Crystalline Lens, If you have enough Accommodation Range available to supply it.

3. I can almost be certain that it will change, either in power or axis. Determining the amount of Cylinder and the Axis is the most subjective part of an eye exam and the accuracy of the numbers depends very much on the skill of the patient. I urge you to Go to the Vision thread and look for my 2 posts on 27 December 2015 on "How to Study for an Eye Exam". I explained a procedure I use during an eye exam to fine tune my Cylinder and Axis correction. It might be helpful if your wife would review the procedure before her next exam.

C.


Sajil 23 Mar 2016, 19:42

Thanks CJ for your valuable information.

I am not going to order glasses on line.

Base on your experience, could you tell me

1. at next check up, will my wife get sphere correction (+0.50, +0.75 or +1.00)?. Currently sphere correction is 0.00

2. How much power will add to reading. Will it reach ADD +2.0 since it is now ADD +1.25

3. Will Astigmatism increase or decrease? About 5 years back, she has only Astigmatism -0.75 Cyl Axis 90 on both eyes.


Carrie 23 Mar 2016, 14:15

Soundmanpt - I will try to ask Vicky how well she sees first thing in the morning. She wants to wear glasses and likes wearing them. I wouldn't be surprised if she wanted to wear a stronger prescription but I think she is probably wearing as strong as she can manage.

My cousin's glasses do fit me. I just had to bend the ear pieces down a bit as my cousin's head must be a bit bigger than mine. Probably to fit in her bigger brain - she's cleverer than me. :-D I wasn't planning on getting my eyes tested this year. I don't know how long I will keep wearing my cousin's glasses as I really love my own pairs and I haven't had them that long.


Soundmanpt 22 Mar 2016, 09:50

Carrie

So if Vickie is wearing both of Danielle's old glasses that means that it wasn't the frame of one of Danielle's glasses that Vickie liked and wanted to wear. But she just wanted to wear glasses it would seem. To bad that they were too strong for her eyes and she couldn't wear them right away like she wanted. But it worked out well anyway because Danielle was wanting her own glasses back to wear and ordering Vickie a pair with +.50 lenses was perfect for her eyes to adjust to. They clearly weakened her eyes enough that when Danielle had to get an increase she was ready to try again wearing her old +1.00 glasses. Now her eyes were much more able to adjust to them and she had to extremely happy. I think when she says that her glasses are now much more obvious I assume that she means to her because everything is much more blurry now when she takes them off. She can't mean obvious to others because no one could tell by looking at her glasses that they are any stronger than her +.50's were. Hard to say how much these glasses are effecting her real vision. Clearly after wearing her glasses for long hours everyday i'm sure that when she takes her glasses off she can't see very well anymore but I wonder if she leaves her glasses off for a while if her eyesight slowly tries to return to normal? She seems pretty open about talking about her glasses you might want to ask her how well she can see when she first wakes up in the morning before she puts her glasses on?


Sajil 22 Mar 2016, 09:43

Thanks CJ for your valuable information.

I am not going to order glasses on line.

Base on your experience, could you tell me

1. at next check up, will my wife get sphere correction (+0.50, +0.75 or +1.00)?. Currently sphere correction is 0.00

2. How much power will add to reading. Will it reach ADD +2.0 since it is now ADD +1.25

3. Will Astigmatism increase or decrease? About 5 years back, she has only Astigmatism -0.75 Cyl Axis 90 on both eyes.


Soundmanpt 22 Mar 2016, 09:16

Carrie

I know you only asked to borrow your cousin's previous glasses but i'm sure she isn't going to be wanting them back. Now that she her new glasses and her eyes are now fully adjusted to them her previous glasses are pretty useless to her now. Even though they are only a little weaker than her current glasses they would feel much weaker to her now. You know that from your own glasses. Once you have gotten new glasses and your eyes adjust your previous glasses just seem far too weak to wear anymore. You didn't say if your wearing your cousin's glasses on a daily basis or just every so often, but if your wearing them all the time it won't be long before your own glasses are going to feel too weak for your eyes. I'm sure it didn't take much for your eyes to adjust to her glasses. Like you say they are only +.50 stronger than your own glasses. The only thing your eyes really needed to adjust to was distance which as you know you have to when you get new glasses that were prescribed to you. Does her glasses fit you pretty well? Now that you have her glasses to wear you should be able to hold off with getting your eyes examined a while longer now don't you think?


Cactus Jack 22 Mar 2016, 07:34

Sajil,

Sphere only glasses will not work for your wife. Even though her prescription seems low, her Astigmatism is enough to cause problems with reading text, without correction. You cannot appreciate the problems Astigmatism can cause, unless you have some yourself.

If you order glasses online, DO NOT try to help her by ordering different Sphere, Cylinder or Axis than what is specified by her official prescription. She may find it useful to have a small increase in the Add over time or to get some Single Vision glasses with +1.25 or + 1.50 Sphere and her Cylinder and Axis, but no Add for the computer. You can determine the actual Sphere by measuring the distance from her eyes to the Display and dividing that into 100 cm or 39.37 inches, depending on the units of measure you prefer.

Please feel free to ask for help if you are not clear on how to order glasses online.

C.


Carrie 22 Mar 2016, 06:37

Soundmanpt - to answer one of your questions from a few days ago, Vicky wears either of Danielle's old glasses. She seems quite comfortable with the +1.00 prescription and shows no sign of any difficulty seeing distances clearly despite her own prescription being +0.50. I suppose if I can see clearly with glasses that are +0.50 stronger than my prescription then so can she. I don't know if she wants stronger glasses but she is happy that the +1.00 prescription is more obvious than +0.50. She says she feels she actually needs them much more now and can see everything clearer if she wears them all the time. She feels a bit dizzy for a moment when she takes them off. Obviously I don't know if she can see better with the glasses but she has been wearing them long enough to get fully used to them.


Carrie 22 Mar 2016, 06:09

My cousin has lent me her previous glasses. I said I wanted to try a different style but still wanted to be able to see and I should be fine with them as they are only slightly stronger than my current prescription and I wouldn't be surprised if I got a stronger prescription at my next eye test.

It took me less than an hour to get used to them, although looking up from reading distance to far distance takes a couple of seconds to get fully focused. There is no delay with my glasses. At +3.00 and +3.50 my cousin's glasses are exactly +0.50 stronger than mine (her new glasses are +3.50 and +4.00, a whole +1.00 stronger than mine).

Off to work soon. Doing an afternoon and evening shift. :-(


Sajil 21 Mar 2016, 18:21

Thanks CJ,

Most of the time, she uses glasses for Computer and a little for the paper work at the office. That is why I think, still she can manage to see the news papers without glasses at Home.

Before getting her eyes checked, I have ordered +1.0 reading glasses online. But it was not comfortable for her. But when I check the magnification efect, +1.0 glasses has more magnification effect than her current prescription glasses. Is my observation correct?

Thanks

Sajil


Cactus Jack 21 Mar 2016, 16:17

Sajil,

Your wife is at the age were Presbyopia becomes a problem. The will probably have increasing difficulty reading without some help.

There are two elements in your wife's prescription. Astigmatism, as indicated by the Cylinder and Axis correction and the +1.25 Add. She has no Sphere correction for distance as indicated by the PLANO. The +1.25 Add is actually a Sphere correction to help her focus close. It is likely that the Add will increase to around +2.50 to +3.00, depending on how close she likes to read, over the next year of so.

She might be able to get by with some over-the-counter reading glasses, but they do not correct her astigmatism.

Her prescription is one that you can order from an on line retailer such as Zenni at considerable savings. If you want to do that, we can help you.

C.


Sajil 21 Mar 2016, 08:51

CJ and all,

Correct prescription of my wife is as follows

Left Eye PLANO,-1.0 Cyl Axis 90, Add +1.25

Right Eye PLANO,-0.75 Cyl Axis 90, Add + 1.25

She wears glasses at the office full time and still she can manage to see the small prints on papers without glasses at home. How long she can manage to see the news papers without the glasses? She is now 41 years of age and got the glasses last month.

One more thing, as per the prescription above, can she use reading glasses of +1.25 for reading and close works? What is the difference between reading glasses and above prescription? Will that reading glasses have more magnifying effect?


Soundmanpt 21 Mar 2016, 08:27

doug

It is impossible to predict how long before she won't be able to read without them because a lot depends on how much close work she does. The more close work she does, the more she is going to be wearing her glasses which will effect how long before he can't read without them. But based on what you say she already seems to finding it harder and harder to do without them. Remember it wasn't that long ago that she thought her eyes were fine and she wasn't wearing glasses. Trust me if they weren't helping her I really doubt she would be wearing so much. She is even making sure to have them close by when she isn't doing any close work such as driving and watching TV. She has them up in her hair so they are at hand to put on. I think if she were trying with very small print she would find it nearly impossible now without her glasses. As far as her wearing her glasses full time that may take awhile. Her glasses are weak enough that if she were to start trying to keep them on even when she isn't reading her eyes would soon start to adjust to them and she would be able to drive and watch TV wearing her glasses. She might only want to do that because it would be much more convient if she were wearing them all the time. If your wanting her to start wearing her glasses all the time I suggest that you complement your wife on how nice she looks wearing glasses.


Sajil 21 Mar 2016, 08:25

Thanks. CJ. My wife has only cylindrical correction. So, spherical correction is Plano as you said.


doug 21 Mar 2016, 07:55

Thanks for your response CJ. Your wrote "it won't be long before she won't be able to read without them". Is that a matter of weeks? Months? Is everyone different? She does wear them often (reading, eating, cooking) but puts them in her hair to drive or watch TV.


Cactus Jack 21 Mar 2016, 07:43

Sajil,

The prescription you provided is not clear. Prescriptions in the standard format are:

Sphere, Cylinder and Axis (they always go together), and ADD

It appears that the 1st number is Sphere, but it could be Cylinder because of the apparent axis number of 90 degrees. Cylinder and Axis are important because they correct Astigmatism which affects vision at all distances. It is possible to need Astigmatism correction without needing Sphere correction. However, if no Sphere correction is needed, Sphere is usually listed as Plano, 0.00 or NA.

We cannot answer your questions very accurately without a complete prescription.

C.


Sajil 21 Mar 2016, 03:44

Hi,

My wife recently got her eyes checked and doctor prescribed progressive lenses. Her prescription is shown below

Left Eye -1.0 Cyl Axis 90 Add +1.25

Right Eye -0.75 Cyl Axis 90 Add + 1.25

She wears glasses at the office full time and still she can manage to see the small prints on papers without glasses at home. How long she can manage to see the news papers without the glasses? She is now 41 years of age and got the glasses last month.

One more thing, as per the prescription above, can she use reading glasses of +1.25 for reading and close works? What is the difference between reading glasses and above prescription? Will that reading glasses have more magnifying effect?


Soundmanpt 18 Mar 2016, 15:23

Doug

Sorry I just now noticed your comment back on March 11th. Anyway let me try and answer your questions as best as I can. In answer to questions #1 #2 and #3 She has already found that her glasses are indeed a benefit to her since she is seeing the letters bigger and bolder and reading is now more comfortable with her glasses on. Now as too if she should wear them full time or not is really going to be up to her for now. Here is what you can expect to happen. Since she likes that her glasses really do help her she is going to want to wear them anytime she is reading or doing anything close. It won't take long at all before she won't be able to read any small print without her glasses and then it becomes the hunting game of where did she last leave her glasses? So she may decide that wearing them is the better answer the she knows where they are at all times. Her prescription is weak so her eyes won't have to work very hard to adjust to them for everything else. And no she of course she wasn't "hustled" she clearly needs her glasses. If she didn't need them I doubt she would bother with wearing them. Right now she is still able to read without them but that won't last very long now.

There is no way way to predict if you would be prescribed glasses or not. I guess you could use a magic ball or something. If you don't trust them then don't go. Your not doing any harm to your eys even if you do need glasses by holding off until you yourself know that you need them.


spexfan 18 Mar 2016, 14:48

SC

Yes, I wear progressives. I prefer the extra plus to be set up a bit higher in the frame than normal so I can access it more readily. So I guess I do inadvertently use some of the intermediate zone sometimes for distance, definitely for watching TV. I tried tilting up to use some extra power with driving and it looks quite good, especially in my weaker right eye.

What is your current age and rx?

And does anyone ever use multifocal contacts. I've had quite a bit of success with Dailies multifocal contacts.


Soundmanpt 13 Mar 2016, 08:58

Carrie

I think you now know enough about wearing glasses and how things tend to go that you must know that Danielle is fighting a losing battle. She is about the same as your cousin was with her glasses and your cousin wasn't seeming to be putting nearly as much of a strain on her eyes as Danielle is with her type of work. Your a keen observer to notice the red marks on her nose and your right that means she had only taken her glasses off recently and she had been wearing them a good while for the marks to still be showing. I know she is trying hard not to become dependent on her glasses, but she must be very close to it anyway since it seems when she isn't wearing her glasses they seem to be perched on top of her head now quite a bit. Her prescription will almost certainly increase at her next eye exam and if she isn't wearing her glasses full time by then she probably will after that increase. With her finding out that her co worker has the exact same prescription as she does except just in opposite eyes and she wears her glasses full time it has to make Danielle at least consider thinking that she maybe should be wearing hers full time now as well. With this little chat about glasses in front of Vicky, did Vicky say anything about her own wearing of glasses? You have now seen Vicky quite a few times since she started wearing Danielle's previous glasses and I know Danielle had 2 pairs. So does Vicky only choose to wear one of the pairs or does she seem to switch between the 2 pairs? So I wonder if when the time comes and Danielle gets an increase if Vicky will start wearing Danielle's current glasses or if she is happy enough with the glasses she has and doesn't want to make her eyes any worse?


Carrie 12 Mar 2016, 20:21

We met up with our friends Danielle and her girlfriend (who I will now on refer to as Vicky. It's not her real name as that is unusual and distinctive). Danielle had her glasses on top of her head but had obviously been wearing them quite recently and for some time as I could see the tell-tale red marks on her nose. A bit later we were chatting away and Danielle mentioned that a woman at work had said to her she was surprised that she didn't wear her glasses all the time as their glasses looked very similar in prescription. Danielle said the woman at work, who is a couple of years older than her, wears glasses all the time. Danielle said "I asked her what her prescription was and when she told me I thought it sounded familiar. It was familiar because it's the same as mine just in opposite eyes!". Danielle said that the woman said that she presumed that when Danielle got contacts it was because she needed them or glasses all the time. Danielle said she told the woman that she just chooses not to wear her glasses all the time even though she could.


Soundmanpt 11 Mar 2016, 17:15

Carrie

It's funny as much as you enjoy wearing your glasses your cousin is completely different about wearing her glasses and even worse since she had to start wearing them full time which she really didn't want to happen. But even though she doesn't like it she really can't function very well anymore without her glasses. I'm sure you have tried to convince her that she looks very attractive wearing glasses and that wearing glasses isn't the worst thing that could ever happen to her. Sounds like you were having fun trying on not only her new glasses but even some of her previous ones as well? It's always interesting how she first got glasses a good while after you had your glasses and now her glasses are +1.00 stronger than your glasses. Even stranger since you you went straight to full time wear as soon as you got your first weak glasses and have been full time ever since and your cousin avoided wearing her glasses as much as she possibly could and now she has the stronger glasses as a result. Anyway when you were trying on some her glasses you mentioned that her previous glasses are L +3.00 and R +3.50 and that is exactly what your considering ordering on line for yourself. Why don't you first just borrow your cousin's glasses long enough to be sure that the prescription works well for you, but I am sure your eyes shouldn't have any problem with adjusting to them since they would only be +.50 stronger than your current glasses. Trust me in a few weeks those glasses will be close to useless to your cousin anyway, but she might still want them as a backup just in case something were to happen to her glasses so you probably would still want to go online and order a pair for yourself once you know you like that prescription.


Plus Tony 11 Mar 2016, 13:00

Doug

I suspect that your wife has latent hyperopia (long sightedness) rather than early presbyopia. Everyone is different but I would suggest that she wears her glasses all the time for a week or two. If at the end of that time her distance vision with glasses is nice and sharp she should continue with full time wear. If not she should probably use her glasses only for close work.


Doug 11 Mar 2016, 04:52

My wife was has an optical benefit that was expiring so went for an exam for kicks. He gave her a prescription of +1.25 and told her it will help with her close vision but she can wear them all the time if she wants. She got a very hot pair of glasses, which she doesn't really think she needs, but says they do make print bolder and easier to read. She says although she was told she can wear them all the time, distance is blurry. I tried them on, and can verify what she says...close is a bit more vivid but distance blurry. Four questions...

1. Should she wear them at all?

2. Should she try to wear them all the time despite the distance blurriness?

3. What's the chance that if I go for an exam I will be prescribed despite the fact I can see ok..no problems or strain, last exam about 2 years ago.

4. Any chance she was "hustled"?

We are both 37.

Thanks


Likelenses 11 Mar 2016, 01:30

Carrie

After reading your post regarding wearing your cousins glasses,I am now convinced that you will soon be in bifocals.


Cactus Jack 10 Mar 2016, 19:40

J.D.,

I need some more information to offer suggestions.

1. Your age?

2. Your complete prescription?

3. How long have your worn vision correction.

It sounds like you are in sales or client relations of some sort.

I am working on a response for spexfan that you might find useful. I have been extremely busy this week and have not had time or energy to finish my response. I have a couple of ideas that might help, but I need the answers above.

You probably should get a dilated exam. The ECP probably used the technique, but you were not aware that he/she was doing it. The technique is to start with a trial lens that has much more PLUS than was indicated in the Objective part of the exam. The excess PLUS actually causes you to be Optically Myopic so the chart is very blurry. Then the excess PLUS is gradually reduced until you can read either the 20/20 line or the 20/15 line. This technique will not normally trigger an accommodation response (where you add some PLUS internally, unless you do it intentionally or inadvertently.

I strongly suspect that you may be trying to help which leads to an incorrect prescription. I also have several other things I would like to suggest after I receive your answers.

I am going to be pretty busy over the weekend, but I think I can give you a little homework.

C.


J.D. 10 Mar 2016, 18:52

Hi, I am copying and pasting from a recent post by Cactus Jack.

"If that is not available, your ECP knows how to overcome most of your accommodation response, but try NOT to "help" the ECP by trying to focus."

I am honestly having trouble finding an ECP that is skilled in this procedure. It is quite frustrating, as I would like to get a new pair of glasses. I have tried a couple of ECPs recently and they keep undercorrecting me, even messing up with the astigmatism part. Headaches are the result. Because my work involves frequent transitions between near and distance vision, with travel to meet clients, I need a solid, comfortable, and stylish full-time pair to wear.

Part of it is me, because after these experiences I have become so wired and excited and nervous that I can't sleep properly the night before an eye exam, and I am almost too "hyperactive" during it--which makes the accommodative response even stronger than usual.

I am this close to "adjusting" scanned copy of my previous prescription to what I think it now should be. I have a specific frame style that I want from a cute local optical shop--online vendors just won't work for me.

Where I am, every ECP seems to have graduated from the same SoCal optometry school. I don't know if their training is poor, or if I am just getting a series of young and inexperienced ODs.

Your suggestions are welcome.


Weirdeyes 10 Mar 2016, 18:22

Carrie

It probably is your real prescription. That prescription would make sense for you. Especially because you have so much trouble reading without your glasses at your age. My right eye pretty much has no problems reading without glasses. It's around +1.00-+1.50. My left eye does struggle quite a bit to read stuff without glasses. It's around +4.00-+4.50.


Carrie 10 Mar 2016, 15:53

I popped in to see my cousin earlier. It's the first time I've seen her since she got her new glasses. She has got used to the slightly stronger prescription. She had a copy of her prescription which says L +3.50 and R +4.00. She said her optician said this was +0.50 higher than her previous prescription. She said she didn't notice much difference between her old and new prescriptions and put her previous glasses on to compare. She said her new glasses just sharpened things up a bit more than the previous ones. She is still fed up that she has to wear glasses full time. She let me try her new glasses on. As they are exactly +1.00 stronger than mine everything was a bit fuzzy except for reading distance which was fine. If I concentrated hard I could force my eyes to focus. I tried on her previous glasses and there was much less blur. I kept them on for a few minutes and by then I could almost see perfectly through them. My cousin dug out her previous glasses to them which were +2.75 in both lenses. She put them on and said they seemed quite weak now but seemed quite strong when she first got them. I tried them on and unsurprisingly I could see perfectly with them as one lens is only +0.25 stronger and the other is only +0.25 weaker than in my glasses.

After trying my cousin's previous glasses I am tempted to order glasses online with +3.00 and +3.50 as the prescription as I am sure I could see perfectly through them after half an hour. I don't know if this is a sign of a future prescription for me or just good accomodation as I am still relatively young.


SC 09 Mar 2016, 11:58

Spexfan,

I've seen hyperopia develop since my 40s. I assume with your 'Add' that you are wearing progressives?

The progressive lens design has lots of interesting bits - the distance part of my lens (my Rx is almost identical to yours) has intermediate adds of +0.25 & +0.5 right next to it.

My experience has been that I've always been able to tell that I will need a stronger distance Rx when I catch myself using these intermediate sections - typically I find myself tilting my head and looking through another bit of the lens. For me this isn't all the time, just when I'm tired, and is often not repeated at the eye test: for example I knew from 2011 that I would need +1.5 because I found myself looking through the intermediate segment but it would take another 4 years for this to be recognised at the eyetest.

At the moment I really don't have any hard evidence that I need stronger - I suspect +0.25 but it looks like I'm beginning to stabilise.

So before you ask for anything stronger then make sure you need it - just see whether you can focus using other parts of the progressive lens


spexfan 08 Mar 2016, 22:29

Cactus Jack, thanks, and ust to make sure I understand you correctly,....So if I got a little extra for distance, would my eyes continue to de-condition and adjust, or does adjustment stop at a certain point ie. would further deconditioning or relaxing the ciliary muscles ever allow me to wear more plus for distance than my current refractive error indicates?

Anyone else have any experience with distance plus rx increases in middle age?


Cactus Jack 08 Mar 2016, 21:46

spexfan,

Please don't try to get more PLUS than you actually need. It will have the effect of making you effectively slightly Myopic.

C.


Cactus Jack 08 Mar 2016, 21:44

spexfan,

What you are experiencing is pretty common with hyperopes. The +1.25/+1.50 prescription you have been wearing for distance was, up until recently, pretty easily corrected by your Ciliary Muscles and Crystalline Lenses. The Add of +1.50 indicated that you still had about +1.00 to +1.50 of accommodation left to make up the +2.50 to +3.00 required for focusing close.

Now, you are up to an Add of +2.25. That means that Presbyopia and Ciliary Muscle de-conditioning has reduced your Accommodation Range to maybe +0.50 and you can no longer use your Crystalline Lenses to clear up your Distance Vision. That is pretty much the way it works.

I urge you to request a dilated or wet exam to get the most accurate prescription. If that is not available, your ECP knows how to overcome most of your accommodation response, but try NOT to "help" the ECP by trying to focus. Try to keep your eyes relaxed and let the lenses do the work. With luck, this prescription will last for a very long time.

C.


spexfan 08 Mar 2016, 16:58

Currently wearing +1.25/+1.5 with a tiny bit of cyl and a +2.25 ADD. Fulltime. Have had a mild plus rx all my adult life but was able to function without until a few years ago, hence an ADD of +1.5 which was prescribed in my early forties, gradually increasing to +2.25. I'm currently aged 46.

I've noticed that my *distance* vision in particular has really deteriorated this past year. I definitely get a noticeable blur watching tv or driving without glasses, this was never the case before.

So I'm curious to hear people's experiences with plus distance rx increases in middle age. I think I'm going to ask my OD for a +0.5 increase at my annual exam mid-year. Would be great to eventually have +3.0 or something similar (this would be a dream come true as I've always had a fetish for some real glasses dependence...I've had to play around with GOC until now!!)

Thoughts anyone?


Lurker 29 Feb 2016, 13:52

Carrie...

I was told I could use some help for close work, and was able to get +1.25 contacts which I often use. I found over time that while my close vision with my contact-less eye is ok-fair, I cannot read with my "contact" eye alone. My left eye close vision is all a blur. So I have effect mono-vision. I wonder if I never wore the contact if I would still be able to read without glasses!


Carrie 29 Feb 2016, 12:07

Soundmanpt - She's a bit funny like that. She's got really nice frames that weren't cheap which she looks rather hot in. Her prescription makes distances "HD" as well enabling her to see close up (She can't read her phone without glasses and said she would be "totally screwed", as she put it, at work now without glasses). She doesn't need to wear glasses full time yet but she could but chooses not to. I think she's holding off until she needs to wear glasses or contacts full time and probably hoping she will never need to. I think I've said before that she doesn't mind wearing glasses she just doesn't want to be dependant on them all the time. She's already concerned how much she needs them now. She will occasionally wear her glasses all day if her eyes feel tired or if she just wants a different look.


Soundmanpt 29 Feb 2016, 10:00

Carrie

That's right I forgot about your friend from college. She pretty much did the very same thing as Danielle didn't she? In her case as I recall she would often have her glasses up in her hair when they weren't needed. Funny how people don't seem to understand that by wearing contacts full time it is really the same thing as wearing glasses full time. So it would seem that you pretty much expected the same thing would happen to Danielle when she got her contacts that happened with your college friend? I totally agree with you that Danielle is far more likely to be wearing bifocals before you. In fact based on the fact that she now appears to need at least a weak prescription for her distance she could already be at that point. Her main need is still going to be for close up work which being a graphic designer is very detailed so she is working her eyes quite a bit all the time doing that. But I don't think she has completely ruined her distance vision by wearing contacts but her distance isn't perfect anymore and she will likely need a weak prescription for that now. So depending on how much change she has in her close vision at her next exam will determine if they just recommend her new glasses with a small increase and suggest that she wear them all the time or if they might feel she needs much weaker for distance then they may recommend bifocals to her. That should totally freak her out don't you think?


Carrie 28 Feb 2016, 10:46

I haven't told Danielle about my friend at college who got contacts for the sort of reason and eventually found she couldn't go without contacts or glasses full time. Danielle may be close to needing full time correction but while she can get away choosing to wear correction or not she will. Being 30 she is that much closer to the sort of age when age related vision problems start. I wouldn't be surprised if she goes full time in the next 10 years and gets bifocals before I do.


Soundmanpt 28 Feb 2016, 09:48

Carrie

She may think that she has caught it just in time not cause her any problems but she is probably wrong in her thinking. I don't think she really understood that when she decided to get contacts that in her case they weren't what her eyes really needed. At least if she was really trying to not let her eyes get any worse. Her plan at the time sounded easy enough, but she didn't realize that contacts take much more care and time than glasses do. I really do get what she was thinking. She just figured that by wearing contacts at work all day would be better than constantly putting on and taking off her glasses all day. But she is young and enjoys going out with co workers and meeting others after work for drinks and chatting, but as she has found out not so easy to care for her contacts properly if she removed them before leaving work. So she would usually just leave her lenses on and go out. Also she probably even forgot to take them off because by now her eyes were completely adjusted to them and she was seeing perfectly wearing them. I'm sure she does need her glasses now much more than she did before she got her contacts. Something she probably doesn't want to hear is that she really should be wearing her glasses now for driving. The damage is done, she now needs her glasses for seeing things at a distance as well as for seeing up close. Her eyes are feeling like they they have been working really hard after driving because is unable to see as well now without correction. Her eyes feel tired because she is straining trying to see and that is very tiring. Whenever it's time for her to get her eyes examined again she should expect not to be able to see the eye chart nearly as well as he has in her past exams. She is most likely going to be told that she needs to start wearing her glasses more often including driving and maybe even full time. The only bad thing about happening is that if she is told that she needs to wear her glasses full time she might just decide to wear contacts all the time to avoid wearing glasses.

How's her partner the coffee shop girl doing with her glasses these days? Since her eyes were able to adjust to Danielle's previous glasses this time around much easier than when she first was trying to wear them and she said that her distance with the now was fine I wonder how her distance vision is without her glasses now?


Carrie 28 Feb 2016, 05:11

My friend Danielle said to me that she thinks she stopped wearing contacts instead of her reading glasses just in time as she thinks she would have to wear them or glasses all the time if she continued wearing the contacts for another couple of months. Now she is back wearing her reading glasses she wears them for shorter periods than the contacts. Because it was a bit awkward and fiddly to take the contacts out she often wore them well into the evening after work. She has forgotten that she was wearing her glasses a couple of times and has still been wearing them when she got home. She has noticed that she feels she needs her glasses even more than before she started using contacts. She hasn't been wearing them for driving (apart from when she hadn't taken them off after work) but thinks she probably should as her eyes feel like they have been working really hard after driving.


Cactus Jack 26 Feb 2016, 23:50

Eric,

Happens to a lot of people. Hyperopia is the ONLY eye condition that you can correct yourself by using part of the accommodation power of your Ciliary Muscles and Crystalline Lenses to correct. Often, you do the correction without even being aware that you are doing it.

That works until Presbyopia gradually eliminates your ability to do that by making your Crystalline Lenses so stiff that your Ciliary Muscles have trouble increasing their PLUS power. Once that starts happening and you need an ADD to help you focus close, your Ciliary Muscles will no longer have to work as hard to make your eyes focus and they will become weaker - like any muscle you are not using as much as you did before. When that happens you will probably need a bit more PLUS in your glasses for distance and most certainly, you will need more PLUS in your ADD.

Don't get excited when that happens. It WILL NOT continue to increase, but will soon stop. There is no way to tell what your ultimate prescription will be for distance, but your reading ADD will not exceed +2.50 to +3.50 depending on how close you like to hold things when you read.

C.


Eric 26 Feb 2016, 13:50

I have been having trouble reading the print on my phone. Am 42 years old, so thought the time had come for my first pair of glasses. Went to the eye doc and got somewhat of a shock. Instead of receiving a prescription for reading glasses, I am now wearing glasses full-time. Apparently, I am farsighted, along with begin presbyopic, and need glasses FT. First time I had heard anything about being farsighted.

OD: +1.00 add +1.25

OS: +1.25 add +1.25

Just getting used to this glasses wearing gig----guess they will be on my face from here on.


Cactus Jack 19 Feb 2016, 13:00

Lance,

If your wife likes to read a lot or do other close things, a pair of single vision reading glasses are a good idea, You can order an inexpensive pair online with excellent optical quality. We can help you if decide you want to do that.

C.


Lance 19 Feb 2016, 09:01

So yesterday my wife had her exam. Her distance part of her prescription didn't change but she did get her near add bumped up to +1.75.

The interesting thing is the doctor also told her that she should get a single vision pair of reading glasses as well.

-.75 -2.25 70

-1.25 -1.25 100

add 1.75

Not even 10 years ago she had -2.00 sphere in each eye. Its interesting that as she gets older she is shifting towards being less myopic (she's 44) and more astigmatism.


Soundmanpt 18 Feb 2016, 10:30

Jane

Hang in there. It's very normal that things are going to be blurry at first for distance with your glasses, but you should slowly start to see improvement as your eyes continue to adjust to your prescription. How is your close vision with your glasses? I would think that your eyes are adjusting pretty well for reading by now with your glasses.


Cactus Jack 18 Feb 2016, 09:58

PlusWearer,

If you ordered glasses with only prism (no Sphere or Cylinder), you would need to specify a PD to keep from confusing the people making the glasses.

Sphere or Cylinder does NOT affect the adjustment for Prism, but the higher the prescription, the greater the optical effect of the PD not being right.

C.


PlusWearer 18 Feb 2016, 03:07

Hi Cactus Jack,

If prisms don't have an optical centre per se, theoretically the PD wouldn't matter if I ordered glasses without spherical or cylindrical correction?

Are spherical/cyl. values something to take into account when calculating the PD displacement based on prism dioptres? So far I have only concerned with the prism values (i.e. reduction by 0.3mm per prism dptr.) and was satisfied with the result.

In my experience with brick and mortar opticians has been moderate in terms of accuracy, since they usually used the total PD. I suspect that this is not accurate in my case, so I will refine it a bit.

Thank you for your insightful advice!


Cactus Jack 17 Feb 2016, 18:17

PlusWeare,

That seems right. Ideally you want the central axis of vision to impinge on the back of the lens at the optical center.

A couple of points. Pure Prism has no optical center, but the lens incorporation the prism does if it has any Sphere or Cylinder. You may need to try to list the PD separately for each eye rather than a total. I've had lots of problems with that.

C.


PlusWearer 17 Feb 2016, 17:44

Hi Cactus Jack,

thank you very much. That should be easy then. Yes, I have a minimal amount of prism (4BO per side), but I will probably increase it to 5BO to make it more comfortable without becoming visible (and will adjust the PD accordingly).

One minor question: If I look through the left lens and see sharper when looking slightly to the left (as opposed to the center), this implies that the left PD is too large, correct?

Thank you!

PlusWearer


Cactus Jack 17 Feb 2016, 09:32

PlusWearer,

PD adjustment for Prism is an overall effect on the glasses. The only exception to that is what are called Slab Off glasses where there are different amounts of prism in the distance and near segments.

You did not mention Prism in your original request, what do you have in mind?

C.


PlusWearer 17 Feb 2016, 04:57

Hi Cactus Jack and specs4ever,

Thank you very much for your help. Thank you for your detailed elaboration, Cactus Jack. I will use 3mm reduction.

Can I assume that the PD correction for prism glasses (Prentice's rule) is the same for distance and near?

Thanks,

PlusWearer


Jane 16 Feb 2016, 15:23

Soundmanpt

I hooe you're right because so far my fistnce vision is really blurry with my glasses on.


Soundmanpt 16 Feb 2016, 08:27

Jane

I would expect that by the end of that week wearing your glasses full time your eyes will have adjusted quite bit if not completely and you should be able to see at all distances pretty well. By then your glasses should even feel much more comfortable on and you might even almost forget that you're wearing glasses. Remember to start your days by putting your glasses on as soon as you get out of bed. You want your eyes to start seeing with correction as soon as your eyes are open.


specs4ever 16 Feb 2016, 07:50

Hi plus wearer. For the pd of the bifocal segment - which in progressives is generally the entire area, they usually decrease the distance pd by 3mm. Hope this helps.


Cactus Jack 16 Feb 2016, 07:49

PlusWearer,

The idea that a person does not need reading help until 40 or more, is a Myth. Everyone is different. It seems fairly common for people who are Hyperopic to need close focusing help sooner than people who are Myopic. A big factor these days is how much close focusing we do compared to say 20 years ago. The culprit is Presbyopia combined with the use of Computers and more particularly the small text on SmartPhones and Tablets. Even teenagers sometimes need bifocals or progressives to relieve the strain.

Typically, PD for near is 3 mm less than PD for distance. When you read or focus close your eyes converge. The amount of convergence is a function of focus distance and is unrelated to the amount of ADD or the power of the reading glasses. The reduced PD helps keep the Optical Center of the lens or segment close to the Central Axis of Vision for each eye when focusing close.

C.


PlusWearer 16 Feb 2016, 01:32

Hi everyone,

I had ordered glasses from Zenni with additional plus (+0.75) to reduce my strain when reading or doing close work, which works great. I wear those as an alternative to my regular correction (around sph +2) for a year now. The issue is that I got used to them and have trouble reading close without them. I would like to order a pair that has the additional extra plus built in, so I can have this support on any everyday basis, not only for specific tasks. However, my ECP thinks I am too young (35) to warrant combined distance/near glasses.

I nevertheless would like to try my luck with progressive glasses (since they are not noticeable to the untrained eye).

My question:

Since my ECP doesn't want to help me, is there any technique to determine (or at least estimate) the PD for near vision (e.g. a simple test), so I can give this a try?

Thanks!


Likelenses 15 Feb 2016, 16:59

Jane

Advanced education really takes a toll on ones vision.


Jane 15 Feb 2016, 15:31

C

Thank you so much for you excellent description. I am working on my MBA, I got my BBA last year. I have taken what you and soundmapt have said, and will start wearing my glasses all the time for a week and see how I feel about them afterwards.


Cactus Jack 15 Feb 2016, 13:01

Jane,

I did not ask what you are studying. The detailed explanation of why I said what I said, involves Math, Optical Physics, and the Physiology of the Eye. I have explained all this, many times, on this and other threads. Please feel free to do some research on your own.

I will try to be brief, but the explanation is not simple.

Hyperopia and Latent Hyperopia - Two different causes with one effect and one solution. Also both can be present in one eye and their effects are additive.

Hyperopia is caused by the eyeball not having grown enough for the Total PLUS power of the eye’s lens system. This causes images to focus behind the Retina. PLUS lenses are required to move the focus up to the Retina. This can be done using external lenses or the internal Crystalline Lens. Hyperopia is considered Permanent after the eyeball stops naturally growing in the late teens or early 20s.

Latent Hyperopia is caused by the Crystalline Lens (and the Ciliary Muscles) internally correcting Hyperopia for a long time. The Ciliary Muscles can become so used to squeezing the Crystalline Lenses to provide the extra PLUS to correct Hyperopia that they cannot relax very rapidly. When you start wearing external PLUS correction, your Ciliary Muscles can gradually relax. Initially, you have too much PLUS which makes distant images blurry, but as the Ciliary Muscles relax, your Crystalline Lenses supply less and less PLUS and your distance vision clears up. How long? No way to predict, but IF you have Latent Hyperopia, the more you wear your external PLUS glasses, the quicker it will occur. Expect weeks if you are lucky, but months are not unheard of. Without your glasses you use your Ciliary Muscles and Crystalline Lenses to correct Hyperopia and nothing is accomplished.

Exophoria is a subset of Strabismus. Strabismus is a general medical name for problems with the Eye Positioning System, sometimes called muscle imbalance. The name Exophoria is a compound term. The first part describes which direction of the deviation. Exo = Outward, Eso = Inward, Hyper = Upward, and Hypo = Downward. The last part describes the permanence. Tropia = All the time and Phoria = Some of the time.

There are 6 muscles in 3 opposing pairs for each eye. The muscle pairs control movement up-down, left-right, and oblique. Ideally, your eyes should point in the same direction for distance vision and converge when you look at something close. There is NEVER a requirement for your eyes to diverge. However, during your eye exam the examiner discovered that your eyes would like to diverge even when looking straight ahead. You can overcome this tendency to diverge with effort, but that takes energy to keep from seeing double. Base IN prism can correct for this divergence, optically.

To complicate things, there is an interconnection in your brain between the Focus Control System and your Eye Positioning System. The act of focusing close, causes your eyes to converge to avoid double vision. When you use your Ciliary Muscles and Crystalline Lenses to correct Hyperopia your eyes sometimes try to converge. When you correct your Hyperopia with external lenses, sometimes, a tendency of your eyes to diverge is revealed, thus the Base IN prism to keep you from seeing double.

The only know way to ultimately diagnose and correct Latent Hyperopia is to start wearing external PLUS lenses and see what happens to your distance vision with glasses. If it starts clearing up, you have some Latent Hyperopia, if it does not, you didn’t, but it is likely that you had and have some true Hyperopia that needs correction, full time.

C.


Soundmanpt 15 Feb 2016, 11:51

Jane

It looks as if you recently joined the glasses wearing club. Always nice to see new members. I have a feeling the fact that you now have glasses to wear is still somewhat surprising to you if not shocking. I will try and not step on any toes with Cactus jack who is without a doubt our expert in here. You have had your glasses for about a month now and you're still not sure if you should be wearing them full time or just for reading. It really helps when you get glasses and you're trying to adjust to them to make a point of putting your glasses on as soon as you wake up to start your day. This is when your eyes are their freshest and well rested. Then try not to be taking them off. The fact that your distance vision is blurry is very normal with a prescription like yours, but the more and longer you're able to keep your glasses on the faster your eyes will adjust to them. Of course if you need to drive someplace and distance is blurry then take your glasses off for driving until your eyes start to adjust to your glasses for distance and then wear your glasses to drive. I assume that your glasses are already helpful with things like reading and seeing other close things. It is difficult to predict how long before your distance becomes clear with your glasses. Maybe a week or two or maybe even slightly longer. Everyone is different in that. But you should start to see intermediate distance getting better and further away which is telling you that your eyes are adjusting slowly as they should be.

So you apparently weren't having any noticeable vision problems before your friend went and got her eyes examined and gave you that small hand held eye chart which you were just sort of playing with until you noticed that you couldn't see it so well. otherwise if not for that you didn't have any plans on getting your eyes checked. So you were at least thinking that you might be getting glasses when you went for your appointment? Was your friend surprised that you got glasses too. She seems okay with wearing her glasses full time are you going to be okay with wearing your glasses full time as well?

I have told this before but I will try and make it as short as possible this time. The young lady that used to cut my hair was about your age and she told me that sh had gone for an eye exam and she was surprised to be told that she needed glasses because she wasn't having any kind of vision problem. The doctor told her that it was very common at her age that she didn't notice any problem but he told her she could hold off getting glasses but she should expect that she will at some point need glasses. She decided to hold off. The place she was working closed up and I had to find a new place to get my haircuts at. About a month ago I was out shopping and this young lady comes over and says hi to me. At first I didn't even recognize her. You get used to seeing people in certain places and away form there you may not recognize them, but she also looked a bit different because she was wearing glasses and her hair was a different color. She pointed out the fact that she was now wearing glasses. She said she got them about 6 months ago because she was starting to have problems reading or seeing anything small. She siad at first she planned on just wearing them for close things but it wasn't very long until she was never taking them off anymore and now she needs them for pretty much everything.


Jane 15 Feb 2016, 09:47

C

Thank you so much for your input. Right off the bat you said I should be wearing my glasses all the time, could you please elaborate on the reasons why. Also, in explaining my prescription you said that I have exophoria, could you please go a little bit more into detail on what exactly that is? My next question is about latent hyperopia, how is that different from regular hyperopia? Also on this you said that if i have some my distance vision with my glasses on should be blurry, which it is so I guess I do have latent hyperopia. Later on you said that it should clear up, so I'm wondering how long does it usually take to clear up?

Now to answer your question the reason I just want to get my eyes checked was because friend of mine had recently gotten her stripes and had this little handheld chart to test her vision chart and while just messing around I decided to check test my eyes, and I was surprised at the fact that I could not read all of it even when holding it as far away from my face as I could with my arms.


Cactus Jack 14 Feb 2016, 22:01

Jane,

Let me format your prescription for you. The first row is for the Right Eye, sometimes designated OD, for Oculus Dexter (latin). The second row is for the Left Eye, sometimes OS for Oculus Sinister.

OD Sphere +1.75, Cylinder -0.25, Axis 130, Prism 2, Base IN

OS Sphere +2,25, Cylinder None, Axis None, Prism 2, Base IN

At your age, that is a prescription for Hyperopia or Farsightedness with a very small bit of Prism correction of Exophoria (eyes wanting to diverge)

A quick answer is that you should probably wear your glasses full time.

However, you should be aware that it is likely that you also have some Latent or Hidden Hyperopia that may take a while to resolve.

Of all the refractive errors, Hyperopia and the things that go along with it are the hardest to understand. One of the reasons that people with Hyperopia have trouble understanding that they really need glasses is that Hyperopia is the ONLY refractive error that they can correct internally, using part of their Auto-Focus System's Accommodation Range. You didn't mention and I did not ask about what symptoms prompted you to get an eye exam. These days, the most often manifest symptom is having to strain to read the tiny text on SmartPhones or headaches when doing close work.

You may be experiencing a decided improvement in comfort when you read, along with blurry distance vision when you wear your glasses. If you have some Latent Hyperopia, your distance vision should slowly clear up with your glasses. It is possible that you will need a Sphere increase in a few months. All these things are common and you are not any different than millions of other young people who discover that they need PLUS glasses and sometimes even Bifocals because of difficulty reading their SmartPhones and Tablets.

The important thing to remember is that you vision should be comfortable at all distances. Glasses are simply tools and they are really no different than wearing shoes to protect your feet or a coat to keep warm.

If your distance vision is blurry, you probably shouldn't wear your glasses while driving until your distance vision clears up.

C.


Likelenses 14 Feb 2016, 21:53

Jane

That is a strong prescription for a first one.

I believe that it is a prescription for bifocals,which of course would be for full time wear.


Jane 14 Feb 2016, 20:38

C,

I am sorry I missed the second part of number four, typically I spend about 8-9 hours reading non screen material everyday.


Jane 14 Feb 2016, 20:36

C

Thank you for responding. As far as I know, my prescriptuon is what is in the sheet my docotor gave.

1. The first row reads +1.75, -0.25, 130, 2 and in. The second row does not have anything in two of the columns. It reads +2.25, nothing, nothing, 2 and in.

2. I am 21 years old

3. I am a full time student and I work front desk at a hotel.

4. I spend a lot of time at a computer. I use it for school, and I am almost constantly on a computer at work.


Cactus Jack 14 Feb 2016, 20:03

Sorry, the last post for Jane was from me.

C.


 14 Feb 2016, 20:02

Jane,

- for distance and + for close is not necessarily true. It depends on your underlying refractive error and if you have Myopia or Hyperopia which are sometimes mixed in with Presbyopia.

Could you provide a bit of information.

1. Your complete Prescription

2. Your age (we won't tell).

3. Your occupation

4. How much work you do with a computer and how much reading you do.

Wearing glasses is a lot like wearing shoes. One size and style DOES NOT fit all.

I will probably have a few more questions after you answer those.

C.


Jane 14 Feb 2016, 18:33

Just got my first pair of glasses about a month ago. I am confused on when and how much I should be wearing them, could someone help me out with this. I do not know much about glasses but I do know - glasses are far away and + glasses are for close or reading. My glasses are + glasses. My question comes from the fact that I have a friend who also has + glasses, but she wears hers all the time. So should I be wearing mine all the time?


Soundmanpt 07 Feb 2016, 10:12

Carrie

I'm sure that when Danielle was telling you that she is not going to wear her contacts anymore because she feels like she is becoming more dependent on needing correction full time. Of course you couldn't say a word but you and I both chatted about how wearing contacts is nearly the same as wearing glasses full time because like her, you tend to put them on before you leave home for work in the morning and they remain on until at least when she got back home that evening. But if she was not going home from work and was maybe meeting up with people or even going shopping she was still wearing her lenses. So her eyes were now not only using her lenses for seeing things close up at her job but she was seeing distances with her prescription as well. So it would make sense that her eyes are getting more and more adjusted to seeing distance with her lenses on. She's how noticing that her distance vision isn't as good anymore without her contacts or glasses as it used to be. And completely unlike her gf who would like nothing better than to be completely dependent on her glasses Danielle doesn't feel the same way at all. It could be that its too late because now her eyes are always going to see a bit better at a distance if she is wearing her glasses. Actually even though I know she really doesn't want to wear glasses full time, even though she has admitted that she is okay wearing glasses, she is probably going to find that she is wearing her glasses nearly full time anyway and might soon just stop taking them off altogether. My guess is that she will very soon get tired of putting on and taking off her glasses so much. Also her job working in graphic arts she needs to be able to see detail so her glasses will likely be on 95% of while she is at work and now that she sees distances not just as good but even better it makes little sense other than vanity for her to be taking her glasses off very much. It will be interesting now to see when you all 4 get together if she is wearing glasses or not. If distance is even slightly better now with glasses she really should now be wearing her glasses when she is driving.


Carrie 07 Feb 2016, 04:52

My friend Danielle happened to mention last night that she was going to stop using contacts as she felt she was becoming more dependant on them. She has been wearing them at work instead of her reading glasses but quite often doesn't take them out until a few hours after finishing work. She can see distances very slightly better with her glasses or contacts but not enough, according to her, to justify wearing them full time. But she has found that wearing the contacts so much that she sometimes has to put her glasses on when she takes her contacts out so she can see properly. I suggested that maybe she does actually need her glasses or contacts full time and that she could just wear her contacts when she didn't want to wear her glasses. She said maybe she did need her glasses or contacts more but she was going to try just using her glasses when she needs them for now.


Carrie 07 Feb 2016, 03:59

Soundmanpt My cousin went for the eye test only because it had been a year since her last one. She hadn't noticed any changes in her vision. I wouldn't tell her that she is highly likely to need full time correction for the rest of her life. She accepts she needs her glasses for now but is hopeful that one day her prescription will go down and she'll only need them for reading or even not at all. Since she's been full time she has had nice frames and does look good in them. I have shown her various makeup for glasses YouTube videos and she has taken advice from them.

She is still shocked that in just a few years she has gone from finding she needed reading glasses to needing stronger glasses full time. Like me, she can get around without glasses for a short time. She has given up trying to go without them for longer periods as it strains her eyes.

Likelenses Interesting you think we will both have bifocals by 30. I think my cousin is borderline needing them as she was close to getting them last year but maybe her optician is going to wait a bit longer to see if she does need them. I have never been offered bifocals but if I did get them I would get the no-line type. I'm not against having them but I admit I am a little bit vain, which is the reason I would go for no-line ones.


Likelenses 07 Feb 2016, 01:03

Carrie

http://www.optometriceyesitenc.com/eye-conditions/hyperopia/

The last paragraph at this site states," 3. Bifocal Glasses – Many people are surprised to see a young person wearing bifocal glasses, but this is a really effective treatment for moderate levels of hyperopia in young patients. The bifocal takes the stress out of focusing up close and strongly enhances a young persons ability to see up close and far away. During the general eye examination, a prescription is always given to the patient, and bifocal glasses are an excellent option for treating a hyperopic patient."


Likelenses 07 Feb 2016, 00:06

Carrie

Since you and your cousin began wearing plus glasses at a relatively young age,it is probable that both of you will be in bifocals early,most likely before you are 30.


Soundmanpt 06 Feb 2016, 08:21

Carrie

So I assume your cousin only went to get her eyes examined because it was time for her annual eye exam and not because she was having any problems with her eyesight? It's good that she only needs a small increase and it must mean that her eyes are pretty stable now. Between you and me I always question if you're not having any issues with your eyesight and only going in because it has been a year since your last eye exam when they tell you that you need slight or small increase if you really do need an increase or if they just see a golden chance to sell a pair of glasses that may not be needed? If you were to go on line today and order a pair of glasses from Zenni or one of the other fine on line shops and increase your glasses by +.50 more than your current glasses are you wouldn't have one problem with them and be seeing slightly better as well. I'm sure you very well know that there is no chance that your cousin's eyesight is ever going to somehow start to improve. But I assume you just don't want to burst her balloon by telling her that she is going to be wearing glasses form now on. She has at least accepted that she has to wear her glasses full time if she wants to see but she still clearly isn't happy about it. Too bad i'm sure she probably really cute wearing her glasses. She still must like how she looks wearing glasses which is odd after this long. Maybe she needs to go and get a professional makeover done. I good makeup artists can really show her ways to enhance her eyes with her glasses on.


Carrie 06 Feb 2016, 05:47

Just been to see my cousin. She had her eyes tested this morning and only needs a small increase in her prescription and much to her relief she doesn't need bifocals or separate reading glasses - yet. Like last time, she hoped her prescription would go down and she'd get closer to not needing glasses full time. I don't think she will ever not need glasses full time. She is going to get her new glasses in a few days.


Cactus Jack 03 Feb 2016, 19:00

Willem.

I am interpreting what you listed as your prescription as:

OD (Right Eye) Sphere 0.00, Cylinder -0.50 Axis 160 Add +1.25

OS (Left Eye) Sphere 0.00, Cylinder -0.25 Axis 005 Add +1.25

If that is correct, it appears to be a prescription for bifocals or progressives. It also could have been made as prescription single vision reading glasses asL

OD (Right Eye) Sphere +1.25, Cylinder -0.50 Axis 160

OS (Left Eye) Sphere +1.25, Cylinder -0.25 Axis 005

If it was made in a bifocal the distance segment would only have very mild Astigmatism correction (Cylinder and Axis) and a comfortable reading segment.

If it was made as single vision reading glasses it would have the reading prescription over the entire lens.

Based on what you said, they are pure single vision glasses and what your coworker said, may not be applicable. The problem with Latent Hyperopia is that it is Hidden and it is very difficult to diagnose except by observing your Sphere prescription changes over time. If you do have some Latent Hyperopia, it will be manifest by very slow clearing of your distance vision through the glasses. However if you do not have any form of Hyperopia (which is very likely) your blurry distance vision through your glasses WILL NOT clear up.

It is very likely that the Add or Reading prescription will increase over time to the +2.50 to +3.00 range as Presbyopia continues to develop and reach an end point. That will make distance vision through the reading part of the glasses even blurrier. At some point, depending on your visual environment, it may become inconvenient to remove your glasses to see distance, clearly and you may find bifocals, trifocals or progressive lenses to be useful.

If you don't have any Hyperopia, you cannot induce it or affect it by wearing more PLUS than you need.

C.


Willem 03 Feb 2016, 08:04

Thanks CJ for your repsonse to my Jan 28 post...

prescription says - -.50 160 +1.25 and - -.25 5 +1.25.

Reading is very comfortable with them, until I take them off. Distance is blurry so I don't use them for distance. If you remember...I told you my co-worker told me to wear them all the time assuring me that the distance blur will go away. Will I then NEED them for driving etc, whereas I don't now? Thanks!


Prismatic 03 Feb 2016, 07:05

SC and Mike,

I thank you for your replies. Mike - I wear near correction anytime I need to do an up-close task that isn't mundane (eating, dishes etc.). I too can keep my eyes from changing if I limit the near vision tasks, but unless I am on a road trip and driving all day, that is more or less impossible. As a health-care provider and university educator, my life and job are very near task demanding (which is probably part of my problem). Mid-range near (computer at arms length) doesn't seem to affect it as much as very near tasks (reading, knitting). It seems that my progressives make the problem worse than if I am using single vision reading glasses or computer distance (+1 add). Anyway, I have worn said new glasses FT for 3 days now. After being at work all day yesterday my left eye was fuzzy for distance and had to switch to old glasses to drive home. I am going to give it a few more days and go back to the Dr. I am sure he thinks I am crazy. I think the frustrating part is I don't need glasses for distance (See below), but I hate the on/off game of reading glasses. Plus, the prism keeps my eyes happy when doing distance tasks that require focus (lectures, driving, TV, movies). Therefore, if I need to have it, I want to be able to see well.

SC - I don't think I have that much latent hyperopia (I suppose it's possible, but I doubt it). I have had multiple dilated thorough exams over the years. I had lasik 14 years ago to remove an astigmatism (cylinder) of about -2.5 with pretty much no sphere (+/- 0.25). More recently I had an issue with my retina that required a thorough workup (luckily ended up being nothing more than inflammation that went away). I could tell I was a bit more hyperopic while dilated but not much. Right now the +2 add gets me to about 11-18 inches, which is exactly where I like it. It is a hefty add for a person my age, have had it for about 5 years now. But whatever it takes to get the job done.

I will keep you posted.


SC 02 Feb 2016, 15:00

Prismatic,

I agree with Mike. Pseudo myopia induced because your eyes are straining too much on close up. Big add for a 39yo so I guess you have a lot of latent hyperopia to come out yet.

I've had these symptoms before I got glasses and after when I needed more help reading. Increasing the add will help but in your case it looks like it is distance that really needs to go up - maybe you should be +2,75 add +1,00


Mike 02 Feb 2016, 07:38

Prismatic

I have had very similar issues with my vision getting worse as the day goes on. I am 40 years old and this has been challenging for the last 3 years or more. Funny thing is I always thought I was myopic and had a perscription for that up until 2 weeks ago. I posted details of my latest exam here on 1/27. Basically I have found by limiting the amount of accommodation I have to do I can stop my vision from changing as the day goes on. However, the only way to do this is use + power lenses for near work or don't look at anything close. I would think with your +2 add on your current glasses you should have good results if you use them for your close works. Unfortunately I don't think there is anyway to prevent your vision from fluctuating if you only use glasses part time, because anytime you take them off you will have to use accommodation to correct your distance vision, and this will induce some myopia until you get to the age that your ciliary muscles can no longer help.


Prismatic 01 Feb 2016, 08:01

Had my yearly exam the other day.

Old Rx: R -0.25 , -0.25, 87, 3.5 BI prism, Add 2.0

L +0.5, -0.5, 90, 3.5 BI prism, Add 2.0

New Rx: R Plano, -0.5, 83, 3.5 BI, Add 2.0

L +0.75, -0.5, 84, 3.5 BI, Add 2.0

As I have gotten older (age 39) and more presbyopic, I suspect I have some latent hyperopia, as my Left eye has gradually gone from a sphere of plano to + 0.75 over the course of several years. Even with my last prescription though I noticed I could see well with my left eye in the distance in the morning, but by the afternoon my vision without glasses was better than with them. I have been a mostly part-time distance glasses wearer (at work, or driving - need the prism) and stick to using my computer/near glasses at home. When I picked up my new glasses the left eye was considerably blurrier, but I wore them all afternoon. This morning, as suspected, the left eye is sharp with the new prescription. From all of you out there in this similar boat, how can I just get my left eye to stop this afternoon/evening pseudo myopia of probably -0.5 diopters (estimated). I get it, my eye wants to be perfect without glasses, and does a good job by the end of the day, but this doesn't help with the overall near vision or distance vision with my glasses since I need the prism. Does anyone have any good advice (other than wearing my new glasses 24/7 for the next several weeks) to get this to happen?


Buzz 30 Jan 2016, 08:55

Hi all, i have been wearing my glasses full time for a few wks now and i can say that i am fully adjusted to it. My distance vision with and without glasses are pretty much the same now. I just notices that even with the glasses on i can "relax my eyes" again and near stuff becomes blurry again. What does that mean? Do you guys think i need more plus power in my glasses or that i have latent hyperopia?

Thanks again


Cactus Jack 28 Jan 2016, 21:15

Willem,

You really have not provided enough information to be able to offer any response.

You mentioned your age, but you did not mention anything about your complete actual prescription or your visual history such as what prompted you to get an exam.

At 36, you are probably beginning to experience the effects of Presbyopia and need a little close focusing help with PLUS lenses. The idea that you don't need close focusing help until you are 40 is a myth. Some people experience close focusing problems even in their teens. There are other eye conditions conditions that require PLUS lenses for correction. That may have been what prompted your co-worker's comments and those comments may not be applicable to your situation.

Many people who begin to experience problems with Presbyopia also have Hyperopia and what is called Latent or Hidden Hyperopia. If you have True Hyperopia you will ultimately always need PLUS corrective lenses for both Distance and Close. If you also have some Latent Hyperopia, Your initial distance vision will be blurry, but that will gradually improve as your Ciliary Muscles and Crystalline Lenses relax.

Presbyopia, Hyperopia, and Latent Hyperopia are extremely confusing unless you understand basic optics and how your eye's work. The hardest thing to understand is how 3 different eye conditions all have the same solution. The amount of PLUS can vary with the conditions and sometimes if all three conditions are present there will be several prescription changes until everything is resolved. Ultimately, you may need bifocals or trifocals.

We can help you understand what is happening, but we will need to ask a lot of questions and ask for you to do some simple tests.

Please let us know your complete prescription and more about why you decided to get an eye exam.

C.


Willem 28 Jan 2016, 16:52

I picked up my new glasses yesterday and have some questions about when to wear them. The dr told me to wear them for help reading, and I understand that, as distance is all blurry. When I told that to a co-worker she said that if I wear them all the time I will adjust to them and be able to wear them all day and see close and far clearly. I tried that for the rest of the day, but was really put off by the distance blur..anything past like 3 feet. She assured me that this will clear up by itself given time. If I try that and my eyes adjust, will I be able to see distance clearly without glasses, as I can now, or will I NEED to wear them all the time. I don't even NEED to use them now for reading. I am 36 and use the computer a lot. Is there a "typical" progression once you start wearing glasses?


Cactus Jack 28 Jan 2016, 01:57

Thank you Mike,

I really appreciate the feedback and the report of good results. Please give us an update after you have worn them for a few days in different visual situations. I am particularly glad that you felt comfortable discussing your visual experiences with your ECP.

Glasses are just tools to help you see comfortably and function with less effort. I fully understand that there are limits on what insurance plans will spend on exams. You were very smart to read the fine print (with your glasses?) and discover that it would pay for one exam during a Calendar Year rather than a year between exams. I don't know what an exam costs where you live, but if you are not seeing well and your eyes are bothering you, the out of pocket cost of an exam is pretty small. The cost of new glasses can be pretty significant, but often you can get some amazingly high quality glasses at online retailers, as you did, unless your prescription is very complex.

I think you did good all the way around and I am glad I could be of some help.

C.


Mike 27 Jan 2016, 21:54

Cactus Jack

I wanted to follow up with you on our post from a few weeks ago. So I took your advice of "if your having vision problems why wait" I checked my vision insurance and after the 1st of the year I could go for the exam anytime I didn't need to wait a full year since my last exam as I thought. So it was a week after using the +1.25 readers anytime I was on the computer or any close work, I felt a substantial improvement, my eyes felt relaxed. I actually quit using my glasses full time because I felt they made things worse, but still used them under the readers for the close work because the astigmatism correction made everything much sharper. At this point I decided it was best to go in right away, I made an appointment, explained my situation and what I had been doing and the improvements so far. The auto refactor gave a R +.50 -1.25 L +.25 -.50 I didn't ask the axis, the subjective test yielded R +.25 -1.25 120 L +.25 -.75 105. Then he did something that they have never done before and put drops in my eyes and did the part with the light and the scope thing (I'm to lazy and tired to google the spelling and nomenclature right now so I hope calling it a scope thing is ok) anyway after that he suggested R +.75 -1.25 120 L +.50 -.75 105 and that is what he wrote the prescription for. We talked about an add for bi focal's but considering with my job I pretty much sit at the computer most of the day, and don't need to take the readers on and off, and he estimated I would need about +1 to +1.5 sphere within the next year or less ( as he said my sphere power will double) anyway at that point we could revisit bi focals or if I had issues he was very open to making it right at anytime. I ordered a pair of glasses online (took some time to get) and finally got them this afternoon. My distance vision was slightly blurred at first, after only a few hours it is now the same or slightly better than without my glasses ( my visual acuity without correction for distance with both eyes open was 20-25 ish). Now with my new glasses my overall vision is excellent and especial from 0 - 15 feet is HD quality. Excited to start tomorrow with fresh eyes in the morning. Big Thanks to Cactus Jack for all the information and Help!


Soundmanpt 27 Jan 2016, 12:51

Marie

I understand your frustration with all the comments and suggestions etc. which I was a part of as well. I'm truly hoping that with the change in lenses your going to get the vision your wanting and no more headaches. Clearly all you want to be able to do is get up, put your glasses on, wear them all day and see perfect for distance as well as close up and at the end of the day take your glasses of and go to bed without ever even a sign of a headache. I do hope you come back in a few weeks after you have had some time with your glasses and let us know how thing are going with your eyes and glasses. Good luck!


Mike 26 Jan 2016, 11:00

Marie, I followed your post from the beginning. It was nice that you shared your experience. It really helps others that first discover they have hyperopia or have had it for most of their life and how difficult it is to get the right correction the first time. My wife went back to the ECP 4 times 2 different places before she had lenses that were comfortable. The good thing with my wifes issues were that the ECP's were very willing to help and replaced her lenses every time at no cost.

I am having a similar experience, I posted here a few weeks ago, with the onset of Presbyopia, and some hidden hyperopia, but that is another story that I plan to post a follow up to once its all figured out.


Marie 26 Jan 2016, 02:10

Well this is getting quite detailed. I think I'll bow out here. Thanks for the discussion, guys, it's been fun. :)

Jordan: Sorry about the confusion. An optician in my country is a certified, highly educated ECP comparable to a specialist nurse. They are responsible for referrals to specialists and doctors. Their screenings are not just subjective refractions. I'm not particularly worried, but I agree it was a good idea to get things checked out! :) Thanks for all your feedback, it certainly has given me food for thought.

Cactus jack: Hello, and thanks for your words. I'm NOT a helicopter pilot, but I did try to become one. These days I'm a high school teacher/student of history and linguistics! Not quite the same, I'm afraid. Sorry about the confusion. I might just e-mail you, though I hope it wouldn't be an imposition.


Jordan 25 Jan 2016, 22:42

Correction acknowledged regarding the nationality error. Apologies to Marie.


Likelenses 25 Jan 2016, 20:21

Jordan

It appears to me that in your quest to convince Marie that she does not really need glasses,that you have overlooked the fact of the subjective part of an eye exam.

Marie has had two of them now,with only a small difference in prescription.Therefore the need for correction has been established not only by the two different doctors objective methods,but most importantly Marie's own subjective results.

Also in your rather lengthy posts,you erred in two areas.1. you thought she is Canadian,when she herself twice said she is Scandinavian.2. You also missed her meaning in her reply to me regarding the word optician.She was referring to the optician,as one who dispenses glasses,as she said something about their return policy.


Jordan 25 Jan 2016, 18:16

Hi Marie,

My apologies for any mischaracterization or misunderstanding of your visual state or general well-being. This is a very strong risk of double-blind communication over the internet. I may not have read your posts carefully enough, and/or you are now describing your symptoms in greater detail. I also did not know how many years this has been going on.

If you read my earlier post again, you will notice that I was not explicitly advocating a LASIK re-do, but rather a consultation, to get a more fine-tuned assessment. Now that I am reading that your symptoms are serious, all the more reason to address the issue more seriously. I will now modify my suggestion accordingly:

Go to an eye center or clinic associated with a medical school (i.e., department of ophthalmology), where you can find a specialist who is willing to take you seriously and work with you to address all outstanding issues in a systematic fashion. This is clearly not a job for the average street-corner or shopping-plaza ECP.

(I am not quite sure in which country you live, as you use the term "optician," yet you sound fairly North American in your style. My understanding is that in both Canada and the USA, an optometrist is what an optician would be in the United Kingdom. I thought I saw metric use in your posts, which would lead me to believe you are Canadian.)

As LASIK has now been around for a few decades, there are likely to be academically inclined clinicians who have studied its effects in patients, and who can take on complex cases. On the other hand, there could be things going on with your eyes that are completely unrelated to the effects your LASIK procedure.

If your case requires someone of greater stature than your average ECP, it is certainly beyond the scope of the individuals who participate here. Please tell what course you decide to take, but then I think it's probably best for you to allow the most highly qualified professionals handle the matter. That means not taking advice here. There is enough confusion already!

There are some similarities between your experience and mine, but that does not mean I truly know how you see, or what symptoms you experience. My sincerest apologies once again. The others here are far too motivated by the desire to encourage people, young women in particular, to wear glasses full-time to make any objective recommendations. You may need corrective lenses after all, but it's not our call. Nor should it be.

All the best,

Jordan


Cactus Jack 25 Jan 2016, 17:45

Marie,

I have avoided this fray so far. This will probably be the only time I offer my thoughts. I believe you mentioned that you are a Helicopter Pilot. I never flew Helicopters, but I flew fixed wing General Aviation airplanes from the time I was 17 until I could no longer pass the medical, when I was in my 60s.

Part of the problem is that you are behind the power curve as it relates to your vision. In some way it is like the student pilot who, after an accident, wrote in his report that he had run out of airspeed, altitude and ideas, all at the same time.

You need to land, rethink the situation, analyze what went wrong, make a plan, test your theories, and complete the mission. I think you can do that without bending anything.

I think I understand what is happening to your vision and I would be willing to offer suggestions, but not in an open forum. If you are interested, please contact me privately at cactusjack1928@hotmail.com.

C.


Marie 25 Jan 2016, 16:50

Hey guys, I feel like I've kidnapped this entire thing. That wasn't my intention, I was just feeling a bit frustrated. Sorry about that, and thanks for your replies!

KL: Well, to be fair, I've no clue what's going on, either. :P Differing opinions all round at this point! Yay for Scandinavians. ;)

Jordan: I appreciate your reply, but I'm not certain I agree with you (but then I've been a bit all over the place trying to figure this out, so I can understand what you mean about me moving too fast. Sorry about that.) You present some logical options and considerations, but you conclude I've gone "far beyond being "positive" about glasses," and that chances are I wont notice headaches if I'm occupied? That's a little unfair. I've been trying that for the last three years. Last week I had to go lie down because I went grocery shopping and it gave me a headache from shifting focus and reading labels. I'm having double vision up close, but _ I thought everyone did_, and the astigmatism once I tried on the new lenses was noticeable. I'm sure you know how these things sneak up on you.

Surgery is problematic; For one thing my pupils are too large and the chances of more severe after effects than the ones I've got are massive. I'm not risking it, wouldn't have done it again if I could go back, either. For another it'd be like using a sledgehammer to crack a nut.

How can I be sure the optician is right this time? I'm not, but I don't have a lot to lose by being positive (I accommodate just fine, you're right about that). :)

Sorry, that was all about me again. =/ Please post your own experiences when or if you feel like it, but don't exhaust yourself on my behalf. I appreciate the effort and the intentions, but it's not worth it if it's just getting you riled up. Thanks for your reply and the food for thought.

Soundmanpt: She didn't recommend them, but then I did explain to her a week ago that I didn't want them (she was present the last time, but didn't do the test). We agreed then that if these glasses didn't work out I'd come back and we'd figure out a way to make them work with single strength lenses - and she did. It was like she dropped the salesperson-act this time... You're right, the floor felt slanted like the first time I got glasses for astigmatism, so I'm expecting a bit of a ride from that the first couple of days. Things looked pretty awesome with them on (and I thought they were perfect before), so I'm optimistic. :)


KL 25 Jan 2016, 15:00

Marie,

I can't believe how many opinions you have been getting, the fascinating part being that not only are they contradicting each other (which, really - everyone has an opinion, so that part isn't surprising), some are also contradicting what you've already explained about your issues.

Is the below about right?

You had Lasik about 6 years ago, and were fine for 3 years after that.

Currently, you're getting eyestrain and headaches frequently without glasses, at all distances.

You don't want to do the off and on (reading glasses) thing 50 billion times a day.

Your current glasses were intended for reading, yet your distance vision with them is good enough to be driving for hours - and no headache.

Your most recent prescription has more astigmatism and less sphere than what's currently in your glasses.

Throwing some logic at this, I come up with the following:

No glasses is not a viable option

Reading glasses is not a viable option

Which leaves:

Go with the glasses full time.

Hopefully the latest prescription will be more accurate. Best of luck, no matter what you decide. (And greetings from a fellow Scandinavian!)


Jordan 25 Jan 2016, 14:15

Hi Marie,

I had a really detailed post planned for you yesterday evening, but now you're making it difficult to keep up. I think you've gone far beyond being "positive" about glasses.

Let's go back to the basics. You are demanding a degree of perfection from your visual clarity and visual comfort that is probably impossible to achieve. You already know that the LASIK-induced changes to your cornea and your untouched internal eye are effectively opposing each other. Given your young age and ability to accommodate, your eyes' desire for visual clarity will win out. Remember that vision should be effortlessly clear. You can easily achieve this without vision correction. If you have slight headaches, they will probably disappear over time, or remain as background noise that you will learn to tolerate. For reading and close work, vision correction can mitigate headaches and eyestrain, which makes glasses particularly useful for a student like you while undertaking those activities.

Now it seems also that you are demanding a nearly impossible degree of perfection, a perfectly fixed number, with your prescription. I would claim that what you can actually get is a range--a range that you can find comfortable and clear. Can you be really sure that your second opinion is correct, versus the first? Can you be really sure that you have a higher level of astigmatism than you thought earlier?

The reading that an optometrist will get will certainly depend on his or her skill, but it may also vary on changes in your vision, which occur not just day to day, but intraday as well. If your eyes are tired, or you haven't slept too well, you may get a higher reading than otherwise. Low hyperopia is difficult to measure, particularly so in "our" cases.

Mild astigmatism is difficult to gauge as well, more so for the angles. (In my case, the angles effectively cancel each other out.) In these mild cases, the optometrist may, appropriately, not fully correct the astigmatism but dial it back a step, because the complete correction may be too difficult for the patient to adjust. This is particularly true in cases like yours, where the patient does not need full-time wear.

You can get your eyes checked and rechecked, without the aid of your current prescription, and you can get different readings each time. If your eyes get used to a particular Rx, then an eye exam will eventually reflect that. As mentioned, a very thorough eye exam in which your eyes are given a workout will yield a stronger prescription than otherwise. Obviously a less thorough, quick exam will do the opposite, particularly given your age and eye condition. Eventually, though, a prescription has to work for you.

I think you can easily adjust to wearing glasses for long periods of reading and studying, then taking them off otherwise. Millions of natural hyperopes do the same. Yes, there is a jarring effect when you take them off, but you will recover fast. Take a walk, go on a run, go to a yoga class or coffee, chat with a friend, run some errands. Chances are, you will not notice the headaches if you are mind is occupied with other things. Much of this phenomenon is probably in your mind, and eventually you will get used to the changes and move seamlessly between the two worlds (glasses vs. no glasses).

Did you notice that the prescription in your right eye, the dominant one, is the same with both eye exams? I think that's what I read: +0.75 both times. If this is correct, then how does it change your distance vision? (You shouldn't be too bothered with your left eye in isolation; what matters is your binocular vision.) If it was fuzzy before, it likely still will be so. Now, I understand there is an astigmatism component that could be greater than thought, but are you really sure? Does it really make a difference in your vision? Is it just an artifact?

Your LASIK result probably falls under an acceptable range for the vast majority of people, both in terms of the hyperopia as well as the astigmatism. Most patients in your case can tolerate small degree of both and see clearly and comfortably. I have actually read that small levels of astigmatism can actually help sharpen vision in some patients. You need to consult ECPs on this matter, particularly those experienced with post-LASIK patients, rather than the characters who post here.

In fact, the best course of action for you might be to return to the ophthalmologist who did your procedure. This office will have all your records, and they will do as thorough an examination as possible, far beyond what a typical optometrist would do. Just tell them that you are considering an enhancement of your LASIK, and let them go from there. (In fact, this course of action might be the best option for you, if you really want to eliminate all your symptoms. You just have to keep in mind the unintended consequences. In fact, being slightly nearsighted has enormous advantages, particularly as you get older. I see that with my husband.) As a second choice, you can go to another LASIK place instead.

In either case, you can back out if you decide that another round of surgery is not right for you. But you will get a definitive gauge of your vision, in a narrower, more defined range, and you will get a prescription that is honed to your desire for clear and comfortable vision. I would suspect that they will still recommend glasses primarily for near work, and no glasses for distance, except in special circumstances (examples: seeing an IMAX movie, maybe a long drive at night). That's because your eyes will naturally gravitate to the clearest option.

If you really want to fight your eyes as they function now, and you are not interested in more surgery, then contact lenses are an option as well. This will force your eyes to adjust to the prescribed correction for distance, since you cannot easily take them off at will. (I looked into contacts once, but luckily my optometrist talked me out of it, because she knew that I could see fine bare-eyed. It was a vanity issue.) The other issue is that sometimes contacts can be difficult to fit because of LASIK-induced changes to the cornea.

The other issue you were grappling with was multifocal lenses. In case you are lured into that direction once again, let me offer some caution. Because your eyes can see well without correction in the first place, and you could presumably read well with a hypothetical weaker distance Rx, it would be difficult for you to force yourself to use the correct portion of the lens.

If you are a student, then this problem is even more pronounced, since are you are doing near work for long periods, and you would naturally prefer having a full frame of vision. Unless you use the add properly, you wouldn't get the benefit, and your distance vision afterward with glasses would be blurry. (Trust me, when you eventually really need bifocals, you will know it, and you will automatically adjust your head accordingly.)

Well, I'm a little exhausted now. I have not delved too much into my own experiences, because I wanted to keep the focus on you. Maybe another time. Meanwhile, let me know what you think. I hope there is food for thought here.

Take care,

Jordan


Soundmanpt 25 Jan 2016, 10:22

Marie

I am really glad that you were able to get in and be that did the right thing by really starting over with you as if you were walking into there store for the first time. Even better that you examined by a different doctor as well. Now of course the real test will be when you get your glasses. I assume you don't have them yet since they are remaking the lenses? Interesting that this doctor seems to think the SPH previously was a bit too strong but that you have more astigmatism than the other doctor found. Even though you won't know much until you get your glasses back I already agree with this doctor's diagnosis. The reason I think she is right is because of the headache problem you have been having both with and without your glasses being on. In most cases astigmatisms are far more likely to cause headaches than being near or farsighted. But not if it really was only -.25 in each eye. Now with it being -.75 that is certainly more than enough to cause headache pain. This time when you get your glasses you may still need to do a little bit of adjusting to them due mostly to the astigmatisms but after only a short time your glasses should begin to feel very comfortable for distance as well as close up. So I assume that this doctor didn't recommend progressives to you like the first doctor did? For the record Jordan is correct I am not a doctor and never claimed to be one, but it was in fact a doctor that had first recommended you get progressives, not me. Because of his recommendation it seemed he clearly felt that you needed glasses with a different distance prescription than what you needed for seeing close up. Because of that it really isn't possible to make single vision glasses do both properly. Anyway it seems like the store you went to is doing their best to work with you and that is exactly what they should do. They know if your not pleased with your glasses or their service your not going to say many nice things about them to others. And of course they had reason to charge you since you now have a completely different prescription for your glasses. I'm sure your going to continue to let us know how you get along when you get your glasses back. remember you have enough astigmatism that you may feel like the floor is slated and even a little bit dizzy at first.


Marie 25 Jan 2016, 04:41

Long post again, sorry about that.

I went back and got things sorted. :)

Another optician re-tested me, and then ordered new lenses.

R: +0.75 (-0.75 astigmatism) and L: +0.5 (-0.75 astigmatism)

The old one was R: +1.25 (-0.25) and L: +0.75 (-0.25), which might explain why the glasses haven't been optimal.

Still not a high prescription or anything, but I'm hopeful it'll make a difference.

The optician this time was very professional and thorough. She explained that the likelihood of my eyes feeling "perfect" with or without glasses is small "on top of the lasik." I've got some visual disturbances ("visual snow") that make it hard to see the minor differences between images, so I struggle a bit with some aspects of the tests.

She referred me to an orthoptist, and she seemed pretty confident it'd work out. They didn't charge for anything, either.

Jordan:

Please feel free to share your thoughts when you've got the time, I'm still interested in reading them. :)

I just want to make it clear I'm not expecting a diagnosis from anyone, that's not why I came here. This has been a great place to vent frustrations and get advice - even if you don't agree with some of it. I think you'll probably agree that our situation is pretty complicated, and getting glasses fitted can be fiddly. Still, pushing on without glasses when you need them doesn't fix anything, either.

At this point I've made the choice to be positive about the glasses, because I honestly can't be bothered feeling bitter about the whole lasik experience. ;)

Soundmanpt:

It's not a significant squint, but it accounts for why I feel motion sickness from close-up work - which is great, because I thought it was in my head. Thought I was going loopy.

Exercises combined with glasses that fix whatever refraction error I have should clear it up, or at least get it to a point I can live with. :)

It's a relief to know I'm not struggling with close-up work because I'm going significantly presbyopic at 28, and she agreed I don't need progressives. Good stuff.

Likelenses:

Thankfully it can be sorted without them - something my wallet certainly appreciates. :)


Jordan 24 Jan 2016, 19:24

Hi Marie,

I was about to at least begin a response, then perhaps continue tomorrow. It however looks like you are interacting with multiple people whose aims may not be aligned with your best interests. (I have followed this site for a long time, and I am not at all surprised that we are seeing advocacy for full-time wear, multifocals, and now prism.) The participants here are, moreover, not eyecare professionals who can make a diagnosis properly, nor are they patients who have experienced what you have. All this can lead to great confusion and conflicts of interest.

I am not an ECP either, but least I have experience as a patient undergoing the same procedure and resultant effects over many, many years, and I have had nearly the same symptoms as you have, but now obviously affected by getting older.

It isn't easy to get "our" type of prescriptions exactly right, but there probably isn't a rigid exact correction to be made in the first place, thanks to the ability to accommodate. There really is no perfect solution to your problem, and I don't know how big of a problem it is in the first place. Human beings have a remarkable ability to adjust to new situations. Maybe you just need a little extra time, but I think you'll get there.

I was about to outline a few scenarios for you, but I really need to go now. Please let me know if you want to hear me out, and I will get back to you probably tomorrow. Please also note that I must ignore other people's posts on this matter.

Thanks,

Jordan


Soundmanpt 24 Jan 2016, 18:15

Marie

Your test with the pen is interesting. When you did that test was that with or without glasses or both? Since they made your glasses based on being for reading they should have measured your PD for close up and if they didn't that could be a part of your problem. It does almost sound like they need to check your eyes to see if you may indeed need some prism added if your left eye seems to turn out a bit. Of course that would be on the doctor for not catching that. I think you need to call as soon as tomorrow and see about getting things checked out. It could be that your left eye turns out when your tired or in this case over working your eyes by trying to adjust to your glasses. Unless you feel like your making progress with your glasses as they are I don't see any point in going another week or even longer depending on when you can in to be seen. At this point I think they need to treat things as if your a new patient by starting with doing a complete and comprehensive eye exam and going from there by checking your glasses to be sure that a mistake wasn't made at the lab. If they are professional about this their main interest should be in fitting you with glasses that work perfectly for you. Your not dealing with anything close to a strong prescription from the numbers you have provided. Your glasses are not all that much stronger than what they feel you need for distance and for reading they should be dead on. So if things were right your eyes should have been able to adjust to them easily within a weeks time.


Likelenses 24 Jan 2016, 16:49

Marie

Sounds now like some hefty prism is in your near future.


Marie 24 Jan 2016, 12:16

Hey guys, so. Thanks for that, Soundmanpt, both you and Jordan have some good points. :) There's no point in forcing myself to wear glasses that don't work, no matter the reason!

I do have a distance prescription. It's +0.5 and +0.75 in addition to the astigmatism (I think). Not a lot, and with that my eyes relax just fine. I'm not myopic - I managed 1.2 (left) and 1(right) uncorrected visus. :)

I still suspect the optician didn't do his job properly and check for convergence issues.

Holding a pen away from my nose, for instance, I can't focus properly on it until it's pretty far away. If I look at the top of my laptop screen I know logically it's a straight, smooth edge, and I can see that if I close one eye, but with both it's somehow hard to focus.

I feel carsick when knitting or reading (have done for years), and the left eye seems to turn a tiny bit out? It would explain why the glasses aren't doing the trick, I guess, and why reading or sewing makes it feel like something's tugging on my eyes and giving me headaches.

Pretty sure it's not all in my head (had to take a picture to prove it to myself, but having shown it to a couple friends they agree something's up), but seeing as the optician didn't pick up on it I'm feeling uncertain. Never had any issues as a kid, either.

Sorry for nattering on about this, and thanks for your patience. ^^


Soundmanpt 24 Jan 2016, 09:57

Jordan

I pretty much agree with you 100% and you should know since you yourself had lasik. The only difference is that apparently when Marie was examined they must have found that she had at least a small distance prescription. I would hate to think they would be recommending her progressives if she only has -.25 for her astigmatisms since that would seem unnecessary for sure. But too be honest if Marie would prefer to just be able to wear her glasses full time so she isn't doing the on and off thing all day long even if she didn't have any need at all for a prescription in the upper segment of her glasses and only had the reading add she would benefit from having progressives anyway. It seems clear she is really struggling with wearing her glasses full time, or trying to, which are clearly stronger than she needs for her distance and adjusting to them for that but then not being able to read small print with them. in her case it seems her eyes maybe at least more sensitive than others might be. Something she can't help. But she seems to even not be able to wear them just for reading because she gets headaches without them. For this reason it is hard to believe that her only need for glasses for distance is just the -.25 she has for astigmatisms. It almost sounds like she maybe slightly nearsighted again. I think she really need to get some clarification about exactly what she really needs her glasses for.


Marie 24 Jan 2016, 02:47

Jordan:

Oh, and sorry, I forgot to reply to the last part of your post. Please do post your own experiences, I'd be interested to read them! :)

To answer your question, though, I'm right eye dominant.


Marie 24 Jan 2016, 02:43

Hey Jordan

Great to hear from someone with sort of the same experience! :)

You're absolutely right in the things you write, this could all be caused by my eyes being able to adjust to - but not needing - the glasses. That's definitely true for distance - I really don't need them. My eyes didn't change shape, they didn't shrink, there is a limit to how much the surgeon overcorrected me, etc. :) Agreed!

On the other hand, I'm definitely not imagining the headaches. Most likely I was overcorrected to +.50 and +.75 (not unheard of, I've got friends with the same problem), and I'm just one of those people who are sensitive enough that such a tiny prescription gives me headaches even if I'm young enough to accommodate it easily. The fact that I spent half my day doing very detailed close-up work, and the rest of it studying probably doesn't help.

I don't really mind wearing or not wearing glasses, but putting them on and taking them off is setting off the same headaches as not wearing them, and keeping them on doesn't. I've always been like that. If I put them on to begin with, I might as well stick the day out. I know this site is all for wearing glasses, which is fine, I'm just mostly interested in not getting headaches. No one is making me wear my glasses apart from me!

As for the bifocals - I didn't actually buy them for pretty much exactly the reasons you wrote, and I'm not going to any time soon (I just got frustrated last night). I don't need bifocals, I just need to get these glasses adjusted for my right eye (which is causing the majority of the problems), and I'm pretty sure things will settle down just fine.

Ever the optimist!

Thanks for your thoughts on this! :)


Jordan 23 Jan 2016, 16:47

Hi Marie,

I've been following your story the past few days, and I think it's time for me to chime in, because I've gone through a similar phenomenon. Yes, myopia, followed by LASIK with a slight overcorrection resulting in hyperopia. I'm also presbyopic now and wear multifocal lenses now, so you can that I'm older, well into my 40s. As a result, I have a fair amount of experience with this flavor of hyperopia, as well as with optometrists trying to correct it accordingly. (It hasn't always been easy.)

I'll start with the basics: Keep in mind that LASIK altered only your cornea. Internally, your eye remains myopic, with gradual changes over time as a result of physiological processes. Your LASIK-induced overcorrection is like wearing contact lenses that are a bit too strong. Now, many myopes like having a little extra correction than they need, because their vision is even sharper.

Clearly, you can easily accommodate for the overcorrection: nearsighted eyes are very good at doing this, as long as the extra power is to high. As such, I'm not at all surprised that you don't adjust easily to your hyperopic prescription with regard to your distance vision. But don't forget that many hyperopes, often younger ones, have the same difficulty. They may wear their glasses for extended reading, studying, etc., but they can't adjust for distance, or they don't feel the need to. This is very common and normal, and is the the essence of being a true hyperope: distance vision is clear, near vision benefits from correction. (Note the opposite case with myopia. It's why many myopes take off their glasses to read, right? You might remember that, pre-LASIK, you could see super-well up close without correction, if the object was close enough.)

Please keep in mind that vast majority of people on this site are motivated by the desire to encourage women, particularly young women, to wear eyeglasses full time, so they will advise accordingly, no matter the extenuating circumstances. I am trying to help you find clear, comfortable vision. Normally, people who wear glasses full time find a benefit in doing so, in terms of their visual clarity and visual comfort. You don't seem to fall in this category.

Based on your own experiences you share, I am guessing that you really don't need glasses for distance. Someday you might. As you say yourself, your astigmatism is minimal. Your hyperopia is mild and you can easily accommodate for it. I would urge you to self-examine whether any feelings of discomfort you have going about your day without glasses are psychological, or are motivated by your intrigue with them. When you take them off, you might feel discomfort for a few minutes, but your eyes should adjust very easily, based on your own reporting. Just as innumerable native hyperopic eyes do.

So, how did you get the prescription? Your eyecare professional gave your eyes a workout to make them very tired and relaxed to uncover the hyperopia. The prescription you got was in essence an idealized set of numbers, one that does not reflect your everyday visual experiences. It's essentially a near and perhaps middle distance prescription. In other words, you could benefit from near vision correction to reduce eyestrain and headache symptoms, but you probably can go without them as well, at least for short periods. Just as those same native hyperopic eyes do.

Unless you have a specific occupational need, I seriously doubt you need multifocals. Don't worry, you will eventually. Unfortunately, many optometry practices are motivated in part by the extra profits they can make in selling progressive lenses. They can claim that they simply addressing your symptoms. People on this site will suggest progressive glasses for other reasons: it is a natural progession of the interest described above. You are lucky nobody here suggested you wear lined bifocals.

I'd be happy to describe my own experiences over the years, if you want to hear them, but I'll ask you one thing for now: do you know which of your eyes is the dominant one? There are many simple tests you can find online that can help you find the answer.


Marie 23 Jan 2016, 10:31

Soundmanpt:

Yeah, sorry, I usually operate in cm (in which case I'm at least 60/70 cm away from the screen. :P)!

It's pretty dumb. When I focus on the distance with the glasses, everything close goes very blurry. I _can_ bring things back into focus (and make the distance go blurry, obviously), but it's straining my eyes. If I take them off distance is relatively clear, but anything within 5-6 meters is increasingly blurry the closer it gets (and worse if I relax my eyes the way they seem to want to).

No, I used a Scandinavian chain. :) I appreciate the suggestion to order from zenni, but there's a similar online shop in my country that has a full refund policy within 3 months (and free shipping). I'm going to talk to the place I bought the glasses first and see what they suggest, and whether they have any options within a reasonable price range. At this point I don't even care if they suggest bifocals, so long as they work, and I can afford them.

Worst case scenario I'll get the prescription on these glasses (which were expensive, and so I'm going to wear them until they fall apart) adjusted for distance and such (which was straining my eyes before I got the glasses, too), and buy a pair for reading and then switch between them.

Still, it's only been a week. I'll give it another week before I decide what to do, I might still have some adjusting left in me.

Thanks for your help. :)


Soundmanpt 22 Jan 2016, 18:31

Marie

Your sure having a tough time of it aren't you? It seems like if you get one thing working pretty good something else isn't as good anymore. If you were able to drive with your glasses on for a couple of hours without any problem that means that your eyes were able to focus like you want them to with your glasses on. Taking your glasses off after wearing them that long for distance it makes sense that you wouldn't be able to see very well up close because your eyes were adjusted for seeing distances. But you should have been able to see up close with your glasses on. You commented that you were having trouble seeing your laptop from only a foot away. Actually that is a little too close anyway. Your eyes should be more like 18" to 20" away from your laptop and maybe even a little further if necessary.

By any chance did you get your glasses from Lenscrafter's? I know that they tend to be quite expensive for glasses. So what your saying even though they have a remake policy they don't have a refund policy. So your probably right that exchanging your lenses for progressives would still cost you way too much. Your glasses are stronger than they need to be for distance, so what is happening is that once your eyes adjust to them for distance like today when you were able to drive with them for a couple hours, then when you want to see something close up they are a little bit too weak. To be honest I don't know what they can do to fix your problem aside from telling you that you simply may need to only wear them for reading and that means taking them off and on 50,000 times a day which I don't blame you for not wanting to do. But I urge you to be sure to not leave that store without getting a copy of your full prescription for progressives. If you get that I am positive that you can a really nice pair of progressives on line for less than $60.00. Then if they will remake your lenses just for reading let them do that and you can have them for times when you might be doing a lot of close work or maybe if you like to read in bed having just readers in your full prescription would be nice. Then during the day you can wear your progressives so you have your distance correction for things like driving. Just so you know Zenni does have a partial refund policy. So if for any reason you got glasses from them and didn't like them, which isn't likely to happen, you can return them and get 50% of what you paid for them. So if you paid $60.00 for progressives and for any reason didn't like them you would get back $30.00. So not really a bad risk and I don't think you would be wanting to return them anyway.


Marie 22 Jan 2016, 14:02

Soundmanpt:

Oh, and from what I understand, the prescription I posted earlier is what he wanted to give me as an add (because I opted for single lenses)...


Marie 22 Jan 2016, 13:29

Soundmanpt:

I remember my first glasses very well! it was a neat experience, for sure. Wish it was that easy now - and that I'd never fiddled with my eyes to begin with. ^^

The shop has a policy where I can switch the lenses/glasses within 180 days, but I can't get my money back and go somewhere with reasonable prices. I didn't actually know their prices before I went in, or I wouldn't have committed to them.

I don't know how strong lenses I actually need for distance, because I suspect I've been accommodating a lot. I went for a long drive today, and now when I take off my glasses I can't see _anything_ up close. If I put them on things are still blurry up to about 3 feet away, and then they're crystal clear up until about 10 feet away. They're not bad in the distance now, either, considering I drove for about two hours with them on without a hitch.

Right now I'm having trouble reading the font on my laptop screen, which is about a foot away from my face - while wearing my glasses!

In the span of a day I've gone from taking off my glasses and things up close looking crystal clear to having to strain like hell to get them into focus at all. Tried on a pair of readers, and at about +1.5 (on top of my regular glasses) things up close start to come into focus.

I'm clearly going to have to go back and get it checked out, but I'm feeling a little freaked out. Starting to understand why people think their vision got worse from wearing glasses!


Soundmanpt 22 Jan 2016, 08:09

Marie

With your having been down the road both ways with your eyes I don't know how well you remember when you first got your glasses when you were nearsighted but i'm sure it was so much easier for your eyes to adjust to your glasses. Back then your glasses should have almost felt natural to your eyes. Now your like you know your working very hard forcing your eyes to adjust and function at a distance with your glasses. You are clearly frustrated that your eyes are still blurry for distance with your glasses but your eyes have adjusted some since you started wearing them so with constant full time wear your eyes will slowly give to your glasses. It makes sense that your left eye seems to have pretty well adjusted to your glasses. Your right eye has a little bit stronger prescription so that is why it is taking longer for the blur to go away in that eye. Would I be correct to assume that now when you take your glasses off after having them on for awhile your distance vision is more blurry than it was before you got your glasses. The fact that you find yourself squinting without your glasses indicates that your eyes are being changed. It's too bad that you weren't able to get progressives because with a slightly weaker prescription for your distance by now your eyes would have likely already adjusted. To be honest I am not happy with the shop that you got your glasses from. I don't know what part of the world you live in but here in the US many if not most of the optical shops offer a 90 day trial period with your glasses and during that time if for any reason even if you decide you don't like the color of the frame you can return them for a different pair. So they should have at least been willing to exchange your lenses for progressive lenses with you only paying the upgrade to progressives and deducted the price of your single vision lenses. But $800.00 seems way out of line for a pair of progressive glasses unless you wanted the best designer frame. I still wish I could convince you to check out go on line for your progressives because I am sure they would be so much easier on your eyes to adjust to. My fear is that after a few months your likely to find that your glasses are too weak for seeing small print and your going to need new glasses or new lenses as a result. So staying with single vision glasses you will be forcing your eyes to adjust again to even stronger glasses for distance. Remember your eyes don't really need your glasses to be very strong for distance, you mostly need glasses for seeing close. By any chance did they also provide you with a copy of what your prescription would be for progressives?


Marie 22 Jan 2016, 06:34

Likelenses:

Yeah, you're probably right, but I went to an optician who wont give me my money back so I can go somewhere they charge a reasonable price for them, and they want me to shell out about 800$ for progressive lenses.

I'm a history/linguistics student, so that's not going to happen. Next time I'll be sure to go somewhere else!

In other words - I'll just have to make this work. Haha!


Weirdeyes 22 Jan 2016, 01:37

When I was eleven I got my first glasses. I was considered amblyopic because they couldn't fully correct my left eye. At that time I had no cylinder in my glasses. I don't know how good the best corrected vision in my left eye was back then. Eventually I got glasses that had a -0.50 cylinder in both eyes. They corrected my left eye to 20/30.

When I was sixteen I got my first glasses that could fully correct my left eye. The cylinder was -1.25. I never really patched. Is it possible that I never had amblyopia to begin with and just lacked cylinder? 1.25-0.50=0.75. 0.75 astigmatism is about 20/30 vision.


Likelenses 21 Jan 2016, 19:24

Marie

It sounds as though you could benefit from bifocals.


Marie 21 Jan 2016, 13:28

Finally managed to scrounge up the prescription.

Right eye: SPH +1.25, CYL -0.25, AXE 90

Left eye: SPH +0.75, CYL -0.25, AXE 90

I've been wearing my glasses pretty much full time since Saturday, and while distance things have gotten clearer, they're still a little blurry, particularly in my right eye. If I read and look up, things in the distance look more blurry until my eyes adjust after a couple of seconds. I've also noticed there's some distortion around lights whether or not I wear the glasses, like they're smudged upwards (like a ghost image from lasik, maybe, but I don't know).

At the same time, if I take my glasses off I notice I'm squinting within a minute. I've also noticed that I can "relax" my eyes when I'm not wearing them, and everything up close (if I relax them enough everything in the distance as well) blurs, and putting on the glasses helps the blur up close, but not in the distance.

Conclusion: Eyes are _weird_.

Getting a little doubtful that the distance will clear up, in which case I'll be stuck taking off and putting the glasses on about 50 000 times a day.

Any thoughts? I'm pretty grateful for any help or feedback you guys have got. ^^

-M


Marie 19 Jan 2016, 12:52

Soundmanpt:

As a helicopter pilot.. Yeah. :) I wanted to go the military route, in which case it was required. Didn't end up doing that.

And yep, I usually keep a copy of the Rx around, I just forgot to get it printed this time around. Going back tomorrow to pick it up, and then I'll probably have a billion questions about it after, haha!

My vision had been stable since I was 14 at the time I got lasik. I got them checked regularly, and there had been no change in prescription. The regular checkups after lasik only went on for a year, and at that point I had no problems at all. No scar tissue, no dry eyes or starbursts to speak of. I do recall the surgeon saying that if my prescription had been any higher, they wouldn't have gone through with the surgery, because my pupils were (are) huge. They asked me if I was a drug addict, and whether my night vision was good (it's pretty crap).

Not needing glasses for driving, wearing cheap sunglasses, going to the cinema or in the rain without them - brilliant! Loved it. Didn't miss the winter fogged lenses, either. Fortunately, my new glasses look pretty great, and the headaches were pretty bad, so that helps! :P

I think they gave me the stronger glasses meant for reading. He wanted to sell me progressive glasses, and when I opted for single strength I got the ones meant for reading. I assume that's why I'm struggling to adapt to them for distance until my eyes relax properly - which I'm hoping it will, considering the test was only for manifested hyperopia.

Thank you for your advice, I'm feeling slightly more hopeful the glasses will work out now (which I really wasn't before).


Soundmanpt 19 Jan 2016, 10:31

Marie

This is just a suggestion but now that your back wearing glasses it would be with your best interest to always ask for a copy of your prescription. It's just good to have in case you ever wanted to order rx sunglasses on line or maybe even a spare pair in case you were break or somehow lose your current glasses. It also helps us to better answer your vision questions for you. You understand that the reason they don't often just give it to you without asking is because they realize that as long as they have your prescription they are pretty sure you will be forced to come back to them for your glasses.

That's interesting that to be an EMT on a helicopter you can't wear glasses. I am going to make a point to check and see if that same rule applies here. I'm not sure why wearing glasses would be an issue. I can only assume the idea that your glasses could come off in turbulence maybe? At any rate i'm sorry that you didn't end up getting that job. You clearly must have wanted it pretty badly otherwise I get the idea you were fine with wearing glasses and would not have gotten lasik. It was not unreasonable that your eyes were stable at 23 but I maybe misunderstood you to say that they were stable at 14. I now think you must have meant that you first got glasses when you were 14 which would make sense. Like I said after lasik I would not be surprised that your vision was slightly better than perfect which is pretty common. How nice was it to wake up and be able to see perfectly across the room without your glasses? Being able to wear regular sunglasses. Not having to try and keep rain off your glasses and so many other things. But at the same time did you kind of miss not wearing glasses as well? I know several people that got lasik and loved it but also admitted they actually missed wearing their glasses. Were you required to get your eyes checked every year in order to keep up the warranty in case you ever needed or wanted a "touch-up" done. So it was 3 years later when your eyes changed a bit for the first time since lasik. Not enough for you to even get glasses for (+.50 -.25 / +.25 -.25) Now at +1.25 / +.75 with the same -.25 astigmatism in bot eyes you were getting headaches. Your prescription is not very strong so if they felt like you needed something a little bit weaker for distance than you need for reading I assume they were only going to give you +.50 or for distance. But since you opted for single vision glasses I wonder if they maybe gave you glasses a little bit weaker than you really need for reading so your glasses wouldn't feel too strong for distance. Nearly everyone usually finds that after having their glasses for a few months that they need something a little stronger for reading small print. Your eyes seem to be adjusting very well to your glasses and that slight blur your seeing should be less and less each day now until it is completely gone and your able to see perfect with your glasses. The best thing to do is pretty much what you have been doing. Wear your glasses full time. Put them on when you get up and don't take them off until you go to bed. Besides you already said you hate taking them off and putting them on and taking them off again thing anyway. So just keep them on. You seem comfortable wearing glasses again anyway. I think your distance is going to be great with your glasses but you may need an increase in your close vision in a few months. it will be up to you at that time if you want to stay with single vision glasses which will cause your eyes to wear stronger glasses than you need for your distance so you can get your glasses strong enough for close work or give in to getting bifocals which would allow your distance to be unchanged and just increase your reading area.


Marie 18 Jan 2016, 23:39

Likelenses: I'll have to check the prescription I didn't get printed out, because I don't even know what I have now!

Soundmanpt: Thanks for your reply. :)

The point of the lasik was to not need glasses. However weak the prescription was, -2.25 and -1.75 was enough to need glasses, even if I wasn't blind as a bat! Not fighter pilot - I wanted to work as an EMT helicopter... Thing. Can't remember the term in English, but perfect vision was required. You'd have to ask the surgeon (major university hospital, not a quack) why I was stable at 23. I'm not sure if my eyesight has gotten worse these past couple of years, or if I've just been accommodating a little.

My eyes don't feel like they're working very hard to see distance. They don't ache, nothing looks warped or weird. It's just a little bit blurry, but not enough to need glasses had this been my regular vision. What's killing me is taking the glasses off, putting them on, taking them off etc. Switching is giving me a headache and eyestrain, while keeping them on makes things slightly blurry, but comfortable. The optician wanted me to have + strength for distance anyway, but not as much as I do now.

I don't mind the glasses. I didn't get rid of them because of a deep seated hatred of them, but because I needed perfect vision, and couldn't tolerate contacts (which wouldn't have worked anyway).

Besides - no point crying over spilt milk.


Likelenses 18 Jan 2016, 17:00

Marie

It sounds to me like you need some prism in those glasses.


Soundmanpt 18 Jan 2016, 16:09

Marie

Interesting that your eyes were already stable at 14 years old. Most often the eyes don't become stable until your early to mid twenties and I was a little curious why you would have even wanted to bother with getting lasik with what is considered a pretty weak prescription. May I ask what type of job you were interested in which required you to have perfect or very good vision? Was contacts also out of the question as well? In the US abut the only type of think that requires perfect eyesight is being a fighter pilot. It seems as if they wanted you to get either bifocals or progressives for your glasses? But you seemed to feel like you only needed glasses for reading up close. Did they feel like you had a need for glasses for seeing distances as well or was it just because of your astigmatisms? You opted for single vision glasses because of the expense that bifocals are. You have had your glasses for 3 days now and seem to be adjusting to them rather well if you already able to drive with them without any problem. But it sounds like you only able to do that by working your eyes quite hard which makes sense if you didn't really need glasses for distance and your forcing your eyes to adjust to a prescription for distance now. Your eyes must be cooperating if your now able to see better at a distance with your glasses than without them in only 3 days.

For what its worth if you are interested in giving bifocals or progressives a try, you can get very nice ones on line from Zenni Optical (zennioptical.com) for around $55.00. I think I know what they meant when they said your "pupils were too close together" and yes I think by getting single vision glasses could be why when you take off your glasses now you can't seem to get your eyes to focus on up close anymore. Your eyes are in fact adjusting to your glasses which is good but is also the reason your eyes don't want to focus anymore. When you got your glasses and you sat down the optician used a device that looked like a view finder that he looked through at your eyes. He was measuring your pupil distance or the PD (the distance between your pupils) Since you decide on getting single vision glasses they measured your eyes for distance but if you had gotten rhe bifocals or progressives they would have also measure your eyes for close up as well meaning when you read your eyes go closer together than when your looking at distance. So now when your reading your eyes are being spread apart more than before you got your glasses.

The good news is that your eyes seem to be adjusting well to your glasses and your getting more and more comfortable with your glasses you should be able to wear them full time for all distances. But you had 6 years of not needing to wear glasses and you really seem okay with wearing glasses again.


Marie 18 Jan 2016, 13:39

Wow, that was quick!

My eyesight wasn't terrible, although the astigmatism was pretty significant. I'd been stable since I was 14, which was over the limit the surgeon operated with in my country. I had my reasons for getting the surgery - although I probably wouldn't have done it again. I wanted to go into a line of work that required good vision. Didn't end up in that line of work, but that's all water under the bridge. I could go back and get them to fix it, but I don't want to risk the extra side effects and infections, etc. :)

The glasses I got were prescribed as reading glasses (probably because I told them that's when I was having trouble, I got flustered). I was recommended bifocals or progressive lenses, but as they're so goddamned expensive, I opted for single strength. At this point I can see pretty much everything just fine for distance (can drive fine, went to the movies yesterday, and this morning the left eye actually felt better WITH the glasses than without, etc), but I'm lacking the crystal clear feeling I get without them for the most part.

I was having headaches when I was at just +0.25 and +0.50. The jump seems significant, you know? My eyes are definitely working hard to adjust to the glasses, although the headaches are already easing up. I'm really just wondering how long it'll take at this point.

Uhm, and before I get too self-conscious to post this, I'm just going to ask... When I take the glasses off I get the feeling I can't get my eyes to join together to focus up close. Am I adjusting to the glasses, or is that what the optician meant by "pupils too close together"? x)

Many thanks, sorry for the rambling...


Soundmanpt 18 Jan 2016, 12:59

Marie

I can only answer some of your questions. So you had lasik when you were about 22 years old and I assume that your eyes had been stable for between 12 and 18 prior to getting the surgery? Your eyesight wasn't all that bad and your left eye was almost not enough to even do lasik on. But you didn't provide what your astigmatism numbers were which might have played a part as well. It is very common for them to over correct your eyes to the point where most everyone comes out seeing considerably better than 20/20. In most cases at least 20/15 or even 20/10 is common. They do this because after a couple years your eyes will slowly reverse a slight bit getting you closer to 20/20. But also with lasik which they should have told you normally means that you may need to start needing reading glasses much sooner than normal. Now I don't think that means by 25 or even 28 but it would seem like that is the case for you. So you have reached the point where as you say you bit the bullet and got glasses, but you at least like your glasses and don't seem to mind wearing them. It seems you have been wearing trying to get your eyes to adjust to them. Its' jut a lot different from the days when you were nearsighted and you eyes easily adjusted to your glasses for distance. ow your glasses are fine for close up but your distance is blurry with them. But at the same time you say that without them your getting headaches so by keeping the on for distance as well as for reading your eyes should slowly adjust to them for all distance which it seems is what you really want anyway.


Marie 18 Jan 2016, 11:43

Hey. :)

Lots of people here who know more about hyperopia than I do, so I thought I'd see if any of you had any clever ideas on what the heck is going on with my eyes!

About 6 years ago I has lasik surgery on my eyes. I was myopic, and had some astigmatism (-1.25 (L), and -2.25 (R), but I can't find the papers describing the astigmatism -.-). After the surgery my eyes were fine for a few years. About 3 years ago I started getting strained when reading - much the same way I used to feel while reading with my glasses on before surgery - and got my eyes checked. Not bad, just +0.5 (R) and +0.25 (L), and a touch of astigmatism (basically nothing, -.25 both sides).

Went back now because I've been getting pretty bad headaches for a few months, even while outside or shopping or such, and not actually reading or doing up-close work. My new prescription (I forgot to get it printed, will do that tomorrow -.-) is something like +1.25 (R) and +0.75 (L) with the same astigmatism (-0.25 both sides), so I bit the bullet and got glasses. Love them, they look great, very comfortable for up-close work. Don't mind having to wear glasses again, either, just.. Curious about what's up.

I've been wearing them for 3 days, and things have been getting gradually clearer. My distance vision is perfect (120%, the optician said), and on my left eye I'm getting closer to that with the glasses on (in fact, earlier today I noticed things were clearer with the glasses on on my left side, which I suppose means I'm getting used to them). My RIGHT side, however, still looks like I've wrapped the glasses in saran wrap if I close my left eye.

If it helps, I can see _perfectly_ without the glasses, although the slight astigmatism tends to make lights a bit funky at night. I can thread a needle just fine, I can read fine print, I just get _really bad_ headaches. Lately without reading, too. So far, wearing the glasses, they're gone (unless I take them off, in which case the world tilts sideways and looks flat).

Here's what I'm wondering:

- Is this presbyopia or hyperopia? I have a feeling it's hyperopia after having been overcorrected in surgery. I'm only 28, and the glasses are getting gradually clearer for distance.

- The optician said my, "pupils get very close together when I do up-close work," what does that mean? I'm confused.

- Should I ( or CAN I) wear the glasses full time? Taking them off constantly is giving me a headache. What'll happen if I wear them all the time?

Thanks for any help! Please let me know if I'm in the wrong place...


Cactus Jack 13 Jan 2016, 19:21

Adam,

If you order glasses with a +3.50 add, your vision through the reading segment will be quite good as long as the object / text you are viewing is closer than about 28 cm or 11 inches. Beyond that distance, things will get very blurry, very quickly.

The stronger ADD will not directly make your vision worse for distance, but it may reduce the need for accommodation. That, in turn, will reduce the exercise your Ciliary Muscles get when you focus to read and that will help your Ciliary Muscles get weaker.

All this depends on how you use the +3.50 segment. You may find that instead of bifocals, you really need trifocals with the intermediate segment power chosen for the distance to your computer display. If you want the glasses for reading, you might find that single vision reading glasses are more suitable.

When you get into higher ADD glasses, you need to think of the functionality of the glasses and decide on the power based on what you plan to do with them and the distance from your eyes to the target. You apparently still have some Accommodation left if you can read at typical reading distances with a +1.50 ADD. Reading at 40 cm or 16 inches requires +2.50. Your glasses supply +1.50 and your Ciliary Muscles and Crystalline Lenses supply the other +1.00. At 43, you cannot expect to be able to do that much longer. BTW, having an ADD in your glasses generally does not affect your distance prescription in any bad way and in some situations where there is still some Latent Hyperopia. an ADD can encourage more rapid relaxation of your Ciliary Muscles and Crystalline Lenses.

C.


Weirdeyes 13 Jan 2016, 13:57

Apparently progressives don't work with my prescription because of the large different between my eyes. I really don't want to wear bifocals.


Weirdeyes 13 Jan 2016, 13:53

Soundmanpt

I actually do wear glasses fulltime. The right eye actually descreased by .25 and the left eye increased by .25 and the cylinder in the left eye also had an increase by .25. Not enough of a change to update glasses. My sister actually only wears her add for close up and a bit of distance sometimes. Her distance rx is too weak to be worth it.


Soundmanpt 13 Jan 2016, 10:15

Weirdeyes

So based on your comment below you already must have glasses for distance since you said you didn't update your glasses. So when they tested your eyes did they say if you needed an increase for distance? I assume you only wear your glasses when you feel you need them and not full time.

It seems like the optometrists are checking near vision closer now than they used to with younger patients. It is getting more and more common for younger eyes, like you and your sister, now needing bifocals even before you turn 20. Your sister is only 16 and she already has a an add. The eyes are subject to so much more strain due to all of the devices everyone now uses. All that texting and constantly being on some type of computer is taking a toll on the eyes.

You could go out and buy a weak pair of weak over the counter readers to use around the house but chances are a while your eyes would find it even harder you see small print at other times because your eyes have gotten used to the added help. At some point I think you and your sister will benefit by going ahead and getting bifocals are since your both so young progressives which doesn't have a line on the lenses and no one will know your wearing bifocals. I know of several the same age as you that wear progressives on a daily basis and love them.


Adam 13 Jan 2016, 06:19

Cactus Jack,

I'm 43 years old hyperope with a little bit ambloypia in my left eye.

My current RX:

R: +2,0/-0,5 add 1,50

L: +3,50 add 1,50

I love to wear my glasses.I like to see the effect of magnification, looking in the mirror. Maybe its a kind of fetisch? ...but it doesn't matter.

I'd like to order glasses for very close works with an add +3,50.

Could you tell me please if I have to do that. They will +2.00 stronger, than in my current readers! How I will see in them?

Could so strong readers make my eyesight worse?...ever i wish to have stronger rx.

I have allergic problems with my eyes, and I can't wear contacts, so GOC is not for me.

Thanks in advance for Your help.

Best regards

Adam


Weirdeyes 13 Jan 2016, 00:56

Likelenses

I think actual bifocals are overkill.


Likelenses 12 Jan 2016, 23:23

Weirdeyes

You really need to get the bifocals.

By your next exam you will need them for certain,so it will be easier to adjust to them now.


Weirdeyes 12 Jan 2016, 21:58

If I get reading glasses will I become dependent on them? I only want to wear them at home when I'm on my phone a lot or studying.


Sarah 12 Jan 2016, 15:01

My boyfriend and I just picked up our new glasses together. He has not worn them yet. He is set on only wearing them as needed. I told him to start when reading at home.


Mike 12 Jan 2016, 08:10

CJ mentioned rx-safety.com , I was checking out their site and seen stick on bi focals, they look pretty cool. http://www.rx-safety.com/magnifying-products/stick-on-bifocals/stick-on-bifocal-lenses-hy-stkon.html

Has anyone ever used these?


Cactus Jack 12 Jan 2016, 07:54

Weirdeyes,

Sorry about that. Apple spell checker got me and I didn't catch it. It is way too smart for my own good.

C.


Cactus Jack 12 Jan 2016, 07:50

Weirdoes,

Yes, I think you would find an Add or prescription reading glasses very useful.

Presbyopia actually starts in childhood, but used to not become much of a nuisance until mid 30s or early 40s. SmartPhones and Computers have changed all that and it is fairly common for teens, particularly those with Hyperopia, to need some focusing help long before the reach their mid 30s.

There are several ways to get a little more PLUS to help focus close.

1. A bifocal or progressive Add. (most expensive and probably most convenient)

2. PLUS Over the Counter (OTC) reading glasses over your regular glasses.

3. PLUS Clip on "Magnifiers" (reading glasses) that clip on to your regular glasses like Clip on Sunglasses.

2 and 3 are not very expensive and not as convenient as 1. 2 is easy to find in many retail stores. 3 it available online in several different powers from Rx Safety Glasses (www.rx-safety.com) in New Jersey, USA. Look under Reading and Magnifying for Clip On Magnifiers.

C.


Weirdeyes 12 Jan 2016, 01:47

During my most recent eye exam I had an optional +1.00 add. They actually tested my distance and close up vision. They've never tested my close up vision before. I'm only 19, so I feel weird about having an add at my age. I felt better when I found out my 16 year old sister has an optional add as well.

I also spend a lot of time on my phone and computer. I didn't update my glasses because there wasn't any meaningful change in my prescription.

I've been thinking of getting a seperate pair of reading glasses to use at home. I get a lot of eyestrain headaches and my distance vision is occasionally more blurry than normal. Do you think they'd be worth it? I'm farsighted and I wear glasses fulltime.


Cactus Jack 11 Jan 2016, 10:19

James 2,

This is the wrong thread because your girl friend has Myopia, dominated by Astigmatism in her Right eye.

It is impossible to suggest how much Base IN prism correction she may need to correct her misalignment or even if Base IN prism would be appropriate for her. It may be desirable to consult with a specialist, such as a Pediatric Ophthalmologist, to determine if muscle surgery might be more appropriate.

C.


james 2 11 Jan 2016, 08:39

Hi

My girl friend prescription is R -1.25 -2.50 180 L -1.00 Only. Her right eye still turns OUT even with this new prescription. Would a prism in the right eye help and if so how much do you think?

many thanks


Cactus Jack 10 Jan 2016, 14:19

Buzz,

IF you had developed Presbyopia or some other condition that affected your ability to focus close, then your assumptions would be correct. However, at 19, you should have plenty of Accommodation Range or Amplitude to be able to focus close AFTER your distance vision has been corrected. In fact, you should have MORE ability to focus close AFTER your Hyperopia is fully corrected and your Ciliary Muscles are fully relaxed for Distance.

C.


Cactus Jack 10 Jan 2016, 14:19

Buzz,

IF you had developed Presbyopia or some other condition that affected your ability to focus close, then your assumptions would be correct. However, at 19, you should have plenty of Accommodation Range or Amplitude to be able to focus close AFTER your distance vision has been corrected. In fact, you should have MORE ability to focus close AFTER your Hyperopia is fully corrected and your Ciliary Muscles are fully relaxed for Distance.

C.


Buzz 10 Jan 2016, 09:45

Cactus jack and Val

Thanks for aswering my questions. What is the effect of full relaxation of my ciliary muscles? I read that relaxed muscles=distance vision clearer, does it mean that because i have farsightedness more relaxed muscles=more blurry near vision?


Cactus Jack 10 Jan 2016, 08:53

Buzz,

What Val said is exactly right. You have Hyperopia and you are using some of your Accommodation to correct it, internally, making your Ciliary Muscles and Crystalline Lenses work extra hard to produce the additional PLUS you need to focus distant objects, clearly. The way your eyes are supposed to work Is that the Ciliary Muscles and Crystalline Lenses are fully relaxed for distance and the only time they need to work is to focus close.

Ideally, your glasses should have enough PLUS so that your eyes are relaxed for distance and you have your full Accommodative Range available for focusing close.

You should wear your glasses full time to help your Ciliary Muscles and Crystalline Lenses relax. However, full relaxation may take a few weeks or a month or more. Don't be surprised if you need a bit more PLUS in your glasses. The fact that you can consciously "relax" your eyes probably means that you don't have very much Latent or Hidden Hyperopia to work through., but you ned to do it. If you do not, you will probably experience the first effects of Presbyopia than you ordinarily would.

May I ask if you text on a SmartPhone or use a Tablet very much. Close focusing to read the tiny text, often reveals Hyperopia and the onset of Presbyopia even in teens. Presbyopia, which is the gradual stiffening of the Crystalline Lenses, happens to almost everyone, It actually starts in childhood, but typically does not become a nuisance until the mid 30s to early 40s. It is happening sooner because of the amount of close focusing made necessary by modern hand held technology.

C.


Cactus Jack 10 Jan 2016, 08:28

Joey,

When you were wearing the +1.25 glasses over your regular glasses, three things were happening. Your regular glasses corrected the difference between your two eyes and ideally corrected their refractive error to 0.00 in each eye. Then the +1.25 helped you a bit to focus close and reduce the focusing effort.

I suspect that you don't have very much knowledge about Optics and how lenses work. I would suggest that if you can find the time. you might want to do a little reading on the subject. When you wore the +1.25 glasses over your regular glasses, Your distance vision should have been a bit blurry, but your close vision should have been clear and a bit more comfortable. If your distance vision had been clear when you wore the +1.25 glasses, it would have meant that you had some uncorrected Hyperopia.

All that is good news, but the fact that you see better with one eye than the other means that you may have some residual uncorrected hyperopia or myopia. It is really too soon to tell. You need to wear your glasses full time for several more weeks and then I may be able to suggest some simple tests to identify any remaining refractive error.

If you experience discomfort when reading with your regular glasses, I suggest that you consider getting your own +1.25 or +1.50 reading glasses or clip-on magnifiers to wear when you are doing a lot of reading or work on the computer.

You may think you have perfect vision with your glasses, but you don't really. If there is a difference in the shapes of the two images, your brain will select the best image as the primary source and pretty much ignore the other eye. What you really want is for both eyes to be equally clear so the brain can easily and effectively combine them into a 3D image so you have good depth perception.

C.


Joey 10 Jan 2016, 07:38

Hi cactus jack, i tried your suggestion of wearing additional plus lenses. I just borrowed a pair or +1.25 and my near vision is comfartable with it but i cannot see far away with,though i havent had the chance of wearing it for a long time. What does this experiment mean? Im wearing my true glasses for a few days now and i think i adjusted already although my right eye still see a little blurrier than the left for distance (i test it often by closing my r eye), but with both eyes open i think i do have perfect vision already.


val 10 Jan 2016, 05:27

Actually is "decreases" not "increases".


Val 10 Jan 2016, 05:24

Buzz, what you experience is a privilege that only us hyperopes can have. You can see without glasses because you have good accommodation in your eyes. When you are not wearing your glasses, your eyes can adapt the focus to see clearly. Actually the brain is forcing the inner lens to focus. You are young so the effort is not so big.

By "relaxing" your eyes you are reversing the effect of the accommodation. The eye increases optical power like when wearing your glasses. But without the glasses, the image will be blurry.

So, what you say, that "relaxing" your eyes would not make near things blurry anymore, it means that you are now fully corrected when wearing your glasses.

If your prescription is new, maybe you have to wait a few weeks for you eyes to adapt and maybe after that you will also have some power left to "relax".


Buzz 10 Jan 2016, 04:29

Cactus Jack,

Hello im 19 y/o. I can "relax" my eyes since i was 10 or 11 i think. Relaxing my eyes would make near things blurry. When im wearing my glasses, "relaxing" my eyes would not make near things blurry anymore. I can still see without my glasses but i like wearing them because i can tolerate reading longer with it.

What can i do to make my eyes stay in a relax state? because i think my distance vision with the glasses on would be better if it stays in a relaxed state (Or my assumption is wrong?)

The optician also said to wear it full time, but as what i said i can see without them on? Do you think i should wear it full time?

Can anyone else experience what im talking about? I read this forum searching for someone who experiences the same thing i am but i havent found a post about it.

I havent been wearing my glasses full time because im afraid people will think my prescription is too low and prob too young for someone who needs reading glasses.


Buzz 10 Jan 2016, 04:28

Cactus Jack,

Hello im 19 y/o. I can "relax" my eyes since i was 10 or 11 i think. Relaxing my eyes would make near things blurry. When im wearing my glasses, "relaxing" my eyes would not make near things blurry anymore. I can still see without my glasses but i like wearing them because i can tolerate reading longer with it.

What can i do to make my eyes stay in a relax state? because i think my distance vision with the glasses on would be better if it stays in a relaxed state (Or my assumption is wrong?)

The optician also said to wear it full time, but as what i said i can see without them on? Do you think i should wear it full time?

Can anyone else experience what im talking about? I read this forum searching for someone who experiences the same thing i am but i havent found a post about it.

I havent been wearing my glasses full time because im afraid people will think my prescription is too low and prob too young for someone who needs reading glasses.


Cactus Jack 09 Jan 2016, 23:37

Mike,

You are welcome. I have been amazed at the number of people with Hyperopia and the beginnings of Presbyopia who have been posting questions lately. I am happy to have been of help.

Let me know if there is anything else I can help you with.

C.


Mike 09 Jan 2016, 20:52

Cactus Jack,

Thanks again for all the information.

The only reason i'm waiting for my exam is because my insurance pays for it (once a year), a really good thing is i have learned a lot about how the eye works so i can work with them to troubleshoot my issues much better.

I am in the US.

Funny thing is after using the readers for just a couple days my eyes feel so much more relaxed, and it is hard to look at a computer screen or smart phone without them now.


Maurice 09 Jan 2016, 13:58

My mistake Plus Tony. I started waering glasses at age 48 and that is when I found out that I not only had presbyopia, but hyperopia. I should have been wearing glasses much, much earlier. Went from no glasses to FT wear. Am 51 now and the doctor recently told me I had a cataract on my right eye. No surgery yet, but will happen over the next few years. Middle-age plays havoc with vision and eyes. But at least there are solutions.


Cactus Jack 09 Jan 2016, 12:40

Buzz,

You didn't mention your age. It is important, but not the only factor. It is very likely that you are experiencing the effects of Hyperopia and the gradual onset of Presbyopia.

Hyperopia is the ONLY eye condition that you can correct, internally, using your Ciliary Muscles and Crystalline Lenses to Add the necessary PLUS you need to be able to focus. Often without your even being aware that you are doing it. There are several factors that make internal correction possible.

1. The Hyperopia needs to be pretty low.

2. You can't have much Astigmatism.

3. You need to have plenty of Accommodation Range still available. In other words, Presbyopia cannot have progressed too far.

Almost everyone has Presbyopia, which is the gradual stiffening of the transparent protein that makes up the Crystalline Lens. It actually starts in childhood, but typically does not become a nuisance until the mid 30s or early 40s, UNLESS there are other factors that make Presbyopia manifest itself at an earlier age. Uncorrected Hyperopia and the need to focus very close (e.g. tiny text on Smartphones) can even cause Teenagers to need focusing help.

You might want to consider a dilated eye exam to help reveal the magnitude of your Hyperopia. The typically used dilating agents will help your Ciliary Muscles (focusing muscles) relax, but they are very short acting and often they are not able to fully relax your Ciliary Muscles. That is particularly true if you have some Latent or Hidden Hyperopia.

C.


Buzz 09 Jan 2016, 08:45

Hello, im a long time reader of this blog. I was just prescribed with +0.75 glasses, only for the r eye and plano on the left. Few yrs ago i discovered that near vision is blurred when i relax my eyes although it comes back to clear after i focus again. Is that a symptom of farsightedness? And im still having a hard time with my new glasses, although near vision is clear i think it affects my distance vision a bit. I can still drive and see far things although i little bit blurry than usual. Is that normal or my thing of "relaxing my eyes" affected the refraction process and my optician prob gave me a wrong prescription?


Plus Tony 09 Jan 2016, 06:45

Maurice

I think you must be confusing me with someone else. Thankfully I have not had to have cataract surgery. I just have ordinary hyperopia. I have been wearing specs full time since getting my first prescription at the end of September last year.

Still enjoying the way I see and the way I look with glasses and feeling much happier and more confident as a result. I surprised myself with how quickly I got over any concerns about the reactions of people seeing me in specs. Another thing that I have noticed is how many more people in the 30-45 age range seem to be wearing plus prescriptions full time now. Maybe it was always like that but it certainly adds to my feeling of confidence.

My distance vision without correction is still acceptable but i just can't see the point of taking glasses on and off all the time when I can see perfectly at all distances with them on. Another thing I have noticed is that I don't fiddle with my specs anymore and they stay much cleaner as a result. I guess that is just part of the process of getting used to full time wear.


Maurice 09 Jan 2016, 05:50

Plus Tony, any updates on your recent cataract surgery?


Cactus Jack 08 Jan 2016, 09:31

Mike,

That is great news, you are on the way to to solving your vision problems and being able to describe the symptoms on your next eye exam. If you are having problems, why do you need to wait to get an exam?

It would be very helpful to know where you live (country) as it will affect my suggestions.

You will soon be needing either bifocals or trifocals. You may be tempted to consider progressives. Progressives are fine for some people and social occasions, but they may not offer the wide, constant power visual field that bifocals and trifocals provide and most practicing engineers prefer. Another possibility is clip on magnifiers (reading glasses). They are available from Rx Safety Glasses in New Jersey, USA in a wide range of powers. They are not very expensive and more convenient than wearing readers over your glasses. They clip onto your regular glasses like "flip-up" sunglasses. Let me know if you are interested and I will offer a detailed suggestions about what to order.

Yes you need to get over the phobia about putting anything in your eyes. Artificial Tears chemically match your natural tears and they don't sting. I don't what may be available in your area. I really like the brand "Refresh Plus Lubricant Eye Drops" it is available in the US in small bottles with about 1 ounce or 30 ml of solution. It is also available in individual small single use containers with about 8 to 10 drops of solution.

C.


Mike 08 Jan 2016, 06:33

Thanks Cactus Jack and SC for the replies.

Yesterday I picked up some +1.25 readers and used them all day on the computer. My eyes felt great all day, and at the end of the day I could even see as good if not better than when I get up in the morning. I didn't get eye drops, only because I have a very hard time putting anything in my eyes. I would be nice to get over that phobia. I have my annual exam coming up within a few months it will be interesting to see what they find. Thanks Again!

Mike


Mike 08 Jan 2016, 06:33

Thanks Cactus Jack and SC for the replies.

Yesterday I picked up some +1.25 readers and used them all day on the computer. My eyes felt great all day, and at the end of the day I could even see as good if not better than when I get up in the morning. I didn't get eye drops, only because I have a very hard time putting anything in my eyes. I would be nice to get over that phobia. I have my annual exam coming up within a few months it will be interesting to see what they find. Thanks Again!

Mike


SC 08 Jan 2016, 05:11

Mike,

I used to have these symptoms and the cause seems to be exactly as CJ describes. I was using so much accommodation to read close up that I was becoming temporarily short sighted for distance. Eventually close-up started to go, but at my first eye test I was prescribed low minus (-0.25) for distance and a reading add.

I spotted the pattern that straining with close-up affected my distance vision and always wore glasses for reading. Then when I would get towards the end of life for the prescription the symptoms would recur even when wearing glasses (I could still read fine, but after reading my distance would be off) and that was the trigger for me to go get an increase.

Eventually, the reason for the strain became clear when my distance started adapting to the middle part of the progressive and it became obvious I was hyperopic. Since then I've still had the symptoms and used that to identify the need for a new eye test but now I don't have much accommodation left anyway.

I was prescribed -0.25 @44yo and I'm now +1.5. I would guess that you will be going in a similar direction


Cactus Jack 07 Jan 2016, 20:56

Sarah,

I did not answer your last question, but Julian explained it very well. He really needs to wear his glasses full time at least for the first 2 weeks and then he can decide for himself when to wear them. The reason for the 2 weeks is to give his brain time to reprogram itself and learn how to process much higher quality images from his eyes.

As Julian suggests he probably won't do that initially, but you should not try to force him or make a big deal out of his wearing the glasses or not wearing them. One thing that will likely occur is that at some point, he will decide that the glasses have made his vision worse. That really is not true. All that has happened is that his brain has stopped trying to improve the crappy images his eyes were delivering before he got the glasses. His glasses are now doing the hard work and with his glasses his eyes are delivering high quality images to his brain and very little image processing is required.

C.


Cactus Jack 06 Jan 2016, 22:40

Mike,

Yes it is possible to have both Pseudo Myopia and Latent Hyperopia because they are two names for the same exact phenomenon. Both involve the Ciliary Muscles and Crystalline Lenses and the name that gets attached depends on the underlying Myopia or Hyperopia. In both instances the Ciliary Muscles and Crystalline lenses are having trouble relaxing back to their minimal PLUS power for distance. Curiously, Presbyopia, the generally age related stiffening of the Crystalline Lens AND the Ciliary Muscles becoming weak or having trouble relaxing, can play a role in both.

The symptoms of Pseudo Myopia can occur in a person about your age, who has some corrected Myopia for distance, but uses their Ciliary Muscles and Crystalline Lenses to focus close for long periods. Because the Crystalline Lenses are becoming stiff, the Ciliary Muscles have to work extra hard to squeeze the Crystalline Lenses to produce the extra PLUS you need to focus close. When you stop reading, your stiff Crystalline lenses are very slow to relax and the extra PLUS persists, sometimes for hours, and the extra PLUS does make you more Myopic.

The symptoms of Latent or Hidden Hyperopia can occur at almost any age if a person is Hyperopic. Hyperopia is the ONLY refractive error that you can correct internally, using your Ciliary Muscles and Crystalline lenses to provide the extra PLUS a person with Hyperopia needs to focus clearly for distance and even supply more PLUS to be able to focus close. This means that the Ciliary Muscles are under constant strain and like any muscles, the Ciliary Muscles can take a “set” and sometimes even cramp to the point where they cannot easily relax. If they have been Hyperopic for many years, it can take weeks or months of wearing PLUS glasses for their Ciliary Muscles to relax.

I think you have the classic symptoms of a person with low Myopia who is developing Presbyopia. Presbyopia actually starts in childhood, but typically does not become a nuisance until the late 30s or early 40s. I have two suggestions. One is related to Presbyopia and the other is related to another condition that can develop called Dry Eye.

As an experiment, I would suggest getting a pair of Over-the-Counter (OTC) in the +1.25 or +1.50 power readers and try wearing them OVER your regular glasses when you read or use the computer. See if that helps relieve the soreness and also reduce the apparent increase in your Myopia after a long period of close work.

The other suggestion is to get some Artificial Tears with lubricant and instill one or two drops in each eye every few hours. Also try to consciously blink more often. Blink rates often go down when you work with a computer display or read. Blinking will help you produce more natural tears and spread them your Corneas. You Corneas have no blood supply and they must get oxygen from the air and moisture, lubricant and nutrients from tears.

Please let me know if you try either or both of these suggestions and the results. Please don’t let vanity get in the way of finding a solution. If the OTC glasses help, that opens a pathway to several possible solutions.

As an engineer, you are a problem solver. My background is also Electronic and Computer Engineering. However, I had/have more complex vision problems than you do, but in some ways they were similar. I won't go into the reasons why, but I had to start wearing bifocals at 20 and trifocals at 30 to provide comfortable vision at all distances. Never regretted using glasses to solve the problems for even a nanosecond.

C.


Mike 06 Jan 2016, 21:20

Just read that post and that sounds a lot like my symptoms, what I can't figure out is how my vision is pretty much perfect in the morning accept the astigmatism part. I have even tried my wifes glasses that are +0.75 and in the morning I can see clearly. At night not so much. My guess is that I loose about a dopter throughout the day. If don't do any close work, I don't seem to have any problems...


Likelenses 06 Jan 2016, 20:52

Mike

The time of that post was 1800


Likelenses 06 Jan 2016, 20:50

Mike

Your situation sounds like one that I posted about on 08 Dec 2015 in the New Glasses thread.

Sounds like you have much more myopia that they gave you glasses for.


Mike 06 Jan 2016, 11:27

This is a great blog of information. The recent post on Pseudo Myopia and Latent Hyperopia really got me thinking. For the last 3 years I have been experiencing sore eyes after close work and my distance vision degrades as the day goes on. Im 40 years old, and have been doing close work for my entire career, I started out doing electronic board repair, and am currently an engineer. 2 years ago I went for my first eye exam (ever), I explained my issues, after the exam they explained I had astigmatism and said it was not a lot but would cause the issues I had.

OD Sphere Plano, Cylinder -1.00, Axis 108

OS Sphere -0.25, Cylinder -0.50, Axis 120

I got the glasses and they did help sharpen things up a lot but I still got sore eyes and worse distance vision by the end of the day.

A year later, at my next exam, I explained the same concerns, they said your astigmatism is slightly worse and you are a little more nearsighted.

OD Sphere -0.25, Cylinder -1.25, Axis 105

OS Sphere -0.50, Cylinder -0.50, Axis 120

When i put the glasses on the first time they felt too strong, and made my eyes sore even faster while on the computer. Long story short I found it more comfortable to use my old glasses for driving and nothing at work. My questions here are is it possible that I have some Pseudo Myopia and Latent Hyperopia, and is there any way to know without a dilated exam? At first I just thought it was Presbyopia, however I can still read really close, like 6 inches? Any thoughts are appreciated. Thanks!


Julian 06 Jan 2016, 02:44

Sarah: I suggest you don't urge your boyfriend to wear his glasses any more than he wants to. When he discovers how comfortable his vision is, far and near, when he's wearing them, it will be easy for him to forget to take them off and you'll see him wearing them more until he becomes the full-time wearer he needs to be.


Hoerbie 06 Jan 2016, 01:20

Sarah,

didn't your ECP say something to his prescription and wearing glasses to him?

I don't think that it is only a prescription for reading, but that your boyfriend will have to wear his glasses fulltime, if he wants relaxed vision and relaxed eyes.

For a first prescription his prism values are not low, so I think he has big need for vision help, and should give his glasses a full try.

Greets from Hoerbie, another farsighted prism wearer, who started with nearly the same prescription


Sarah 05 Jan 2016, 21:32

Cactus Jack,

He does not seem to want to want to wear glasses any longer than he needs to, seems like he will wait it out. Do you have any idea when and or how much he should be wearing his glasses when they come?

~Sarah


Brucieboy 05 Jan 2016, 13:28

Cactus Jack

Thanks for the explanation. That makes a lot of sense regarding her first pair of multifocals. She'll definitely have a much needed increase in her reading add. She'll no doubt have to go fulltime once the eyes relax into the higher script too.


Cactus Jack 05 Jan 2016, 10:51

Sarah,

Your boyfriend might find some Over-the-Counter Reading glasses very useful, even for distance vision and even more useful for doing close work, until his prescription glasses are ready. Also, the plus glasses would help him get a head start on the relaxation of his Ciliary Muscles.

If you can get him to do it, I would suggest first trying some +1.00 or +1.25, but +1.50 or +1.75 would be closer to his actual prescription and might ease his headaches when reading.

C.


Cactus Jack 05 Jan 2016, 09:47

Joey,

The short answer is YES, it could decrease. It depends on the cause of the myopia in that eye.

There are two different types of myopia with two different causes.

Axial or True Myopia is caused by the eyeball having grown too much for the total power of your eye's lens system. Typically, Axial Myopia is permanent because the eyeball can't "ungrow" once it has grown to a particular size and length. Axial Myopia can increase if the eyeball grows some more, but a 24, the odds are that your genes won't let that happen.

Pseudo or False Myopia and Latent or Hidden Hyperopia have the same cause, the temporary inability of the Ciliary Muscles and Crystalline Lenses to fully relax back to their minimal PLUS power for distance. The Ciliary Muscles and Crystalline Lenses are part of your Auto-Focus System. Hyperopia is the ONLY type of refractive error that you can correct internally using your Auto-Focus system to add the needed extra PLUS. As I mentioned before, while your eyes are actually independent entities, the Auto-Focus system tends to apply the same correction to both eyes. If one eye has grown a bit more than the other, the extra PLUS will make the longer eye more Myopic. If the extra PLUS is required for a long time, the Ciliary Muscles get used to holding that position and have difficulty relaxing. Like any muscles, if they have to hold a position for a long time, the muscles under tension will have trouble relaxing. BTW, you may notice this more with many other muscles, as you get older.

As your Ciliary Muscles relax, your Crystalline Lenses will also relax and your Myopic eye will get less Myopic and need LESS MINUS for correction and your Hyperopic eye will need MORE external PLUS for correction.

One thing that may be causing some confusion is that you are used to dealing with + and - numbers that represent value changes for Profit and Loss. Lens powers are specified using + numbers for Convergent lenses and - numbers for Divergent lenses. The + and - have nothing to do with the absolute power of the lens, that is specified by the number itself, which specifies the amount of Convergence (+) or the amount of Divergence (-) the lenses have.

I hope this helps. It takes a bit of thinking to get your mind around these concepts.

C.


Sarah 05 Jan 2016, 09:10

Cactus Jack,

We will find out how he feels towards his glasses in about 2 weeks. I'll keep you up to dat! Thanks for all your help.

~Sarah


Cactus Jack 05 Jan 2016, 09:02

Sarah,

I was just curious if he had ordered the glasses. Mostly, because of his initial denial and reluctance to get an exam.

I want to congratulate you. You did a good job of overcoming his objections. You obviously care for him and realized that he was having vision problems and that they were close to affecting his academic performance. Both of you are engaged in studying and preparing yourselves for professional careers where comfortable, effortless, high quality vision is very important.

It will be interesting to hear what he thinks about wearing glasses and his reactions to wearing them. It is typically more difficult for people with his prescription to adapt to having their vision corrected, mostly because they do not understand how the optical system in their eyes work.

From an engineering point of view, vision is amazing and the more you learn about the cleverness of the systems involved and how they work together to make vision possible, the more you wonder about how it happened.

Please keep us informed.

C.


Sarah 05 Jan 2016, 00:15

Cactus Jack,

Sorry for the typo it is + in both. Thank you for your explanation, they are the best! Yes, he has ordered his glasses already, why do you ask?

~Sarah


Joey 04 Jan 2016, 23:38

Cactus Jack

Thanks for explaining farsightedness and my prescription. But i dont understand what is pseudomyopia? Does it mean that the prescription in my right eye could decrease?


Cactus Jack 04 Jan 2016, 22:45

Brucieboy,

They often under prescribe, but not for commercial reasons. Vision actually occurs in the brain, the eyes are merely biological cameras. It a person reaches their mid 40s having never worn glasses, getting full correction can be a bit traumatic because the brain has to reprogram itself and learn that it does not have to work as hard to provide good images. Think of it as a bit like weightlifting at the gym. You do not start building your muscles by lifting the heaviest weights.

Once Presbyopia starts and you start requiring reading help, the amount of help you need will increase fairly rapidly as the Ciliary Muscles get out of condition and the Crystalline Lenses get stiffer and harder to focus. However, the amount of reading help you ultimately need depends on how close you need to be able to focus. Typical reading distance of 40 cm or 16 inches requires +2.50, If you like to read closer, it could go up to +3.00 or even +3.50 if you like to read in bed (as I do).

You can assure your wife that she is not alone. Several Billion other people have experienced the same problem and wondered the same thing.

C.


Cactus Jack 04 Jan 2016, 22:29

Sarah,

I believe there may be a typo in the Cylinder correction specified in the prescription you posted for your boyfriend. I have written it in a standard arrangement.

OD Sphere +1.50, Cylinder ?0.25, Axis 140 Prism 3 BO

OS Sphere +1.25, Cylinder ?0.50, Axis 105 Prism 3 BO 2 BU

I put a question mark infant of the Cylinder correction because one of the signs is wrong. Typically, Ophthalmologists use + Cylinder and Optometrists and Opticians use - Cylinder, but that is not a hard and fast rule. However, you never see mixed Cylinder in one prescription. You need to check the prescription and make sure about the sign on the Cylinder.

Now about Prism. It appears that your boyfriend eyes are turned inward slightly and has a bit of vertical mis-alignment also. Prism is same as the prisms you saw in Middle school, except the amount required to correct the slight inward turning of his eyes is MUCH smaller. The prisms you saw in middle school would probably be in the 50 to 60 diopter range and in this instance he has been prescribed 3 Prism Diopters, Base Out in each eye and 2 Prism Diopters Base Up in his left eye. The Base of the prism is the side opposite the Apex or point. A ray of light passing through the prism is bent toward the Base.

What that means from a practical point of view is that the outer edges of his lenses will be a little bit thicker and the inner edges will be a little bit thinner than if there was no prism. Also the upper edge of his Left lens will be a little thicker than the bottom edge. The edges of PLUS lenses are pretty thin anyway so it will not be very noticeable unless you know exactly what to look for.

Will he need more PLUS in his glasses? Probably, but not by very much. Hyperopia is very different from Myopia. It is possible that he has had Hyperopia for a very long time and may have some Latent or Hidden Hyperopia. It sometimes takes a while for that to resolve itself after getting PLUS glasses. It is caused by the Ciliary Muscles becoming so used to correction Hyperopia that they have trouble relaxing. As they relax, his plus prescription will probably increase by +1 or +2 diopters,

It is also possible that he may need a bit more Base Out prism, but again, not very much. It depends on the cause of the tendency for his eyes to turn inward. Sometimes the tendency of the eyes to turn inward or cross is caused by the correction effort for Hyperopia. If the glasses correct his Hyperopia, it is possible that the inward turning will resolve and additional prism will not be required. Everyone is different and there is no way to predict future prescriptions with any accuracy.

BTW, Prism correction of 10 diopters or less is very hard to spot except by Eye Care Professionals (ECPs) Often, ECPs will not fully correct prism in first glasses.

Did he order glasses?

C.


Brucieboy 04 Jan 2016, 20:39

My wife had been complaining about the font on the TV screen for a couple of years. In addition since she was about 44 reading DVD covers was becoming difficult under low light. So at 46 she went for her first eye test.She has a small degree of astigmatism and is slightly shortsighted.The optician noted a degree of presbyopia also.She was given multifocals with a +.75 add. She also picked up a 2nd pair of single vision glasses for driving. She uses these a lot for night driving. With these on she was unable to read normal print.The thing she now finds after just 12 months and now 47 is that even with the multifocals she's struggling to read fine print.She's a bit annoyed that maybe that is a normal occurence? My first reading glasses at a similar age,were +1.00.At 49 I've jumped to +2.50. They are a bit strong for her but she says she can read fine print easily and any print in low light. As a result she keeps my 2nd pair always handy.Do Optometrists have a habit of underprescribing? Particularly first glasses,just for commercial reasons. Anyone experienced that before?


Sarah 04 Jan 2016, 19:10

Cactus Jack,

What exactly are prism and base? What and how do they correct what they are supposed to correct? Will the prism numbers go up like my sephere numbers do? Also, does hyperopia get worse with time like myopia? Are the prism going to be like a triangular prism from middle school sciense classes added to his lenses?

~Sarah


Sarah 04 Jan 2016, 19:05

Cactus Jack,

Thank you for the response. His prescription is:

O.D. +1.5/-0.25/140 and then he has a prism column it is 3 next is a base column it says out

O.S. +1.25/+0.5/105 and then this eye has two prism columns and two base columns the first prsim one says 3 the first base one says out the second prism says 2 and the base column after it says up.

~Sarah


Cactus Jack 04 Jan 2016, 18:31

Sarah,

Farsightedness or Hyperopia actually requires correction for both Far and Near. However, Hyperopia is the ONLY condition that you can correct internally, using your Ciliary Muscles and Crystalline Lenses. The correction strategy depends on several factors, but the most important factor is how much Hyperopia your boyfriend has.

Generally, misalignment causes double vision, but it also depends on how much misalignment and the nature of the misalignment. It is not uncommon for uncorrected Hyperopia to cause the eyes to converge or turn inward, but not always. If the misalignment is small, the eye positioning system can correct the problem, but it takes effort. If the misalignment is large, prism is often required.

In both cases, uncorrected Hyperopia and Strabismus (general term for misalignment) can cause headaches or other symptoms of strain.

If possible, it would be very helpful if you could post his complete prescription.

C.


 04 Jan 2016, 17:29

it's not his eyes that are misaligned. its his head. he should just keep tilting his head sideways and the eyes will eventually line up.


Sarah 04 Jan 2016, 17:01

Cactus Jack,

I went to get my new glassss today and took my boyfriend with me. Turned out my glasses were too weak, so they had to reexamine my eyes. My boyfriend sat in during the exam, and somehow I managed to make him get his eyes examined too. We were correct, he is farsighted and needs glasses. Since he is farsighted he really inly needs to wear them to read, right? The doctor also said his eyes are missaligned? What exactly does that cause vision wise? I never noticed it before, but now I see it.

~Sarah


Cactus Jack 04 Jan 2016, 16:00

KennethWest,

Thank you for the update. I was a bit concerned. It is hard to believe that you have had your glasses for only 5 or 6 days and seem to be over most of the psychological "humps" about wearing glasses. You are experiencing what most new glasses wearers do when they discover what they have been missing.

People who are Myopic have a slightly different experience because there isn't much of a "getting used to seeing well" period wth MINUS glasses. You put them on and things that were out of focus are suddenly in focus.

People with Hyperopia and Presbyopia experience the sudden ability to focus close with their glasses, but often distance vision is blurry with their glasses. Fortunately, that will clear up over days and sometimes weeks.

I think you are doing amazingly well. Keep up the good work. I think you will feel much more secure having a spare pair of glasses. The big problem will be where to keep them.

Hope you have a wonderful, clear eyed, 2016.

C.


KennethWest 04 Jan 2016, 11:54

Cactus Jack,

Sorry for the wait I was really busy. I did get my glasses back as soon as I realized I left them at my grandparent's (about 30 mins into my drive). I bought a spare pair a few minutes ago. They should be ready in about 2 hours. Thank you for the idea. I have had my glasses for all of a minute out my life and they seem as necessary as a shirt now. My vision without them (both far, and especialy near) seem so bad without them now that I have a prespective on how I should be seeing.

Kenneth


Cactus Jack 03 Jan 2016, 14:13

Joey,

I will try to answer your questions in the order you posted them.

1. Your prescription is very mild, but the difference makes it significant and you should wear your glasses full time.

2. It is very likely that your prescription will change some, The fact that one eye is mildly nearsighted and the other is a bit farsighted, complicates things. Your nearsighted eye may get a little more nearsighted, but probably not much. However, I suspect ate your +1.00 eye may have some Latent or Hidden Hyperopia.

Hyperopia is the ONLY eye condition that you have the ability to correct, internally using your Ciliary Muscles and Crystalline Lenses, often without your even being aware that you are doing it. After possibly years of correcting your Hyperopia, it can take weeks or sometimes months for your Ciliary Muscles to relax. As they relax, you will need more PLUS in your distance prescription. At this point, there is no way to tell just how much they need to relax.

Next Post

3. Yes, in fact what you are experiencing is a pretty strong clue that you may have some Latent or Hidden additional Hyperopia. Without your glasses, it is very likely that you are using your Ciliary Muscles and Crystalline Lenses to correct your Hyperopia in your Left eye. Initially, when you wear your glasses your Hyperopia is being corrected TWICE. Once by your internal lenses and again by your glasses. It takes a while for you to stop the internal correction and let your glasses do the work. When you get full correction, you will probably experience this again.

A few thoughts, from a long way away, Houston, Texas.

While your eyes are two separate entities, Your focus control system in your brain typically tries to apply the same close focus correction to both eyes simultaneously. The amount of focus correction your Right eye needs is very different from the focus correction your Left eye needs. That is probably the source of your headaches..

I would like to suggest another experiment. Get some +1.50 Over-the-Counter OTC reading glasses. Try wearing them OVER your glasses when you read or perhaps use the computer. Your eyes are not used to working together as a team and you possibly need some focusing help. I experienced something similar when I got my first glasses at 14. My prescription was -1.50 in one eye and 0.00 (plano) in the other. I was reading with the -1.50 and using the 0.00 eye for distance. When I got in University, I started having headaches when I did a lot of studying. The solution was bifocals.

Because of my age when I go my first glasses, my Myopia increased in both eyes, to about -4.50 and -2.75, but the difference remained almost constant. Everyone is different, but I suspect that at 24, once your Latent Hyperopia is resolved, your prescription will be very stable. It is possible that you have some Pseudo Myopia in your Right eye. It is actually the same thing as Latent Hyperopia, but on the other side of 0.00.

I don't know what glasses cost in Manilla, but you may be able to order glasses from an online retailer. We can teach you how, if you are interested.

C.


Joey 03 Jan 2016, 12:24

Cactus Jack

I noticed that when i have the glasses on it takes time for me to adjust seeing things that are far is that normal for people who wears plus lenses?


Joey 03 Jan 2016, 12:13

Cactus Jack

Hi, im 24, student, studying business. I live in manila. Is my prescription significant that i Should wear my glasses full time? I have been wearing my glasses since i got them, im still having headaches though. And last question, is there a chance will my prescription increase after a few months/yrs?


Joey 03 Jan 2016, 12:12

Cactus Jack

Hi, im 24, student, studying business. I live in manila. Is my prescription significant that i Should wear my glasses full time? I have been wearing my glasses since i got them, im still having headaches though. And last question, is there a chance will my prescription increase after a few months/yrs?


Cactus Jack 03 Jan 2016, 11:04

Joey,

A difference of 1.50 is nothing to be concerned about, Nearsightedness (Myopia) and Farsightedness (Hyperopia) are both caused by a mismatch between the Total PLUS power of your eye's lens system (usually about +55 to + 60 diopters) and the distance from the back of the Crystalline Lens and your Retina (usually about 17 mm in adults). The key factor here is how much your eyeballs grew from birth to now, rather than the total PLUS power of your eye's lens system. The eyes do not necessarily grow at the same rate and your nearsighted eye grew a tiny bit too much and your farsighted eye didn't grow quite enough. BTW the distance error is only about 0.3 mm per diopter so your -0.50 eye is about 0.15 mm too long and your +1.00 eye is about 0.3 mm too short.

Vision occurs in the brain. Your eyes are merely biological cameras. You did not mention your age, which is important, but I suspect your brain has many years of experience dealing with the difference and you probably used your Left Eye (OS) for distance and your Right Eye (OD) for focusing close, without your even being aware that you were doing it. Your eyes are not used to working as a team and the corrective lenses forced them to do that and the result, in your case, was dizziness. The dizziness was probably caused by a slight difference in the apparent rate of motion each corrected eye detected when you moved your head. You just seem to be hypersensitive to the small difference. It is actually a very mild form of motion sickness. Motion sickness us typically caused by a mismatch between the motion you SEE and the motion you FEEL wth your semicircular canals in your ears.

How long does it take to adjust to your glasses? Probably just a few more days. Your brain has to re-program itself to the higher quality images and the differences it is sensing. As an experiment, you might try some over-the-counter motion sickness pills for a few days. I suspect it is tempting to NOT wear your glasses, but you need to wear them as much as possible to help with the adaptation process. It would be good if you had some glasses with your full correction that you could start wearing as soon as you get adapt to these glasses.

May I ask a few questions? The answers will help with our suggestions.

1. Your age?

2. Your occupation?

3. Your visual environment? Do you do a lot of close focusing?

4. Where do you live? (country)

5. Do you have your complete prescription?

C.


Joey 03 Jan 2016, 09:54

Hi, i went for an eye exam yesterday and the results were

OD: -0.5 and Os+1.0. But the optometrist just gave me OD: -0.25 and OS+0.5 because i got dizzy with the first prescription and said that i should come back after a few months to repeat the eye exam.

Is this really possible to have both nearsightedness and farsightedness? My actual complain before going to the eye doctor was headache and having difficulty driving at night. Starting to wear the glasses full time and im still having a bit of an adjustment issue. How many days will it take me to adjust to the glasses? Sorry i got so many questions its my first time to wear glasses


Cactus Jack 02 Jan 2016, 09:54

Emma,

You are very fortunate to only need some close focusing help at 36. Many people in professions that require long hours of reading and study have at least some kind of vision problems that require correction.

Not to worry, all you have is the early symptoms of Presbyopia. Presbyopia gradually creeps up on probably 99.9999% of the population as they get older.

Presbyopia actually starts in childhood. It is the gradual thickening of the transparent protein that make up your Crystalline Lenses. Your Crystalline Lenses along with their associated Ciliary Muscles comprise your "Auto-Focus" system. When you are young, your Crystalline Lenses have the consistency of Gelatin Dessert and your Ciliary Muscles can easily squeeze your Crystalline Lenses to increase their PLUS power from a relaxed (distance) power of approximately +15 to as much as +30 for focusing close. That is why you see young children reading or coloring with the book just 6 or 8 inches from their face. This focusing ability is called your Accommodation Range. As you get older your Accommodation Range is gradually reduced by Presbyopia and at some point it will become a problem when your Ciliary Muscles and Crystalline Lenses can no longer provide all the PLUS necessary to focus close.

In the past, focusing problems did not usually become apparent until around the mid 30s to early 40s., But, these days the tiny text on SmartPhones and Tablets have revealed the onset of Presbyopia at much earlier ages, even teens are needing focusing help, particularly is some of their Accommodation Range is being used up by internal correction of Hyperopia.

The amount of PLUS power to focus at any distance is determined by the laws of Optics, which were codified by Sir Isaac Newton around 1700. If you have NO refractive error (0.00) for distance,which you apparently do , the amount of additional PLUS you need to focus at any distance less than Infinity (20 feet or 6 meters for practical purposes) is easily calculated by this formula:

Lens Power = 1 meter or 100 cm or 1000 mm or 39.37 inches, divided by the desired focus distance (same units of measure)

To focus at a typical reading distance of 40 cm or 16 inches, the numbers are:

100 cm / 40 cm = +2.50.

To focus closer will require more +, farther away, less +, but the PLUS has to come from somewhere. If Presbyopia has not reared it head, your Ciliary Muscles and Crystalline Lenses can easily provide ALL of the extra PLUS. However, If Presbyopia or weakness of the Ciliary Muscles are present, you may only be able supply part of the extra PLUS internally and the rest must be supplied externally by Reading Glasses or in some instances bifocals, trifocals, or progressive lenses. The amount of external PLUS you will ultimately need is strictly controlled by how much you can supply internally and your focusing distance. If at some point, you can no longer supply ANY of the extra PLUS you need to focus close, it MUST be supplied externally. It is very rare for the external amount to exceed +3.50, which will allow you to focus at about 29 cm or 11 inches (eg reading in bed, perhaps).

Even though you do not presently need any distance correction, you may find that "functional" bifocals or progressive glasses with 0.00 lens power for distance with a reading segment of +1.00 to be very useful to allow you to quickly switch from distance to close if the +1.00 readers become a nuisance.

You probably have a question about how soon you will need more than +1.00. The answer, regrettably is, sooner than you think. Presbyopia itself progresses pretty slowly, but unfortunately, your Ciliary Muscles will become de-conditioned pretty quickly. For their size, your Ciliary Muscles are the strongest muscles in the body and normally they get plenty of exercise. However, glasses to help you focus close do some of their work for them and that reduces the amount of exercise they get.

The result is that you will likely need gradual increases in the PLUS help, until it reaches +2.50, +2.75, or +3.00.

Sorry for the long winded explanation, but I thought it would be useful for you to understand how this stuff works so you know what to expect. Just remember that you are not alone. Billions of people have experienced this and more will experience this in the future until a way is found to keep the Crystalline Lenses a flexible as fresh Gelatin Dessert or the laws of Optical Physics get changed. So far we have been unable to discuss the later with anyone of importance.

C.


Soundmanpt 02 Jan 2016, 09:26

Emma

Considering how much close work you must do and all the close work it took to become a lawyer I think your eyes have held up very well. If anything now that you have glasses you should even have more of that "I want to be taken even more seriously now" look. As you know your glasses are on the weak side but just as you are finding out they are relaxing your eyes and helping to reduce eye strain. It is hard to predict how much your eyes will change in the coming years, but chances are you will likely need an increase within a year. So far do you try and only wear your glasses when your doing close work and take them off for seeing at a distance or are you trying to just adjust to them so you can wear them full time? If your only trying to wear them when doing close work I would think that your doing a lot of on an off with your glasses? In your case you might be wise to have a pair of progressives (bifocals) made with just your reading prescription in the bottom segment and clear in the top for your distance. That way you can wear you can keep your glasses on all the time and not be taking them on and off.


Emma 02 Jan 2016, 04:36

I am 36 year old lawyer and having been suffering for eyestrain when reading and blurriness when looking at my phone. I went for an eyetest a few days ago and was prescribed +1 reading glasses. I have got a couple of pairs , some tortoiseshell half frames and some rimless ovals. My eyes feel much more relaxed when wearing glasses, but I am worried how bad my eyes might get.


Cactus Jack 01 Jan 2016, 21:30

KennethWest,

If you have not done so, you seriously need to go get your glasses. Also, you need to order some spare prescription glasses as soon as possible. I think we tried to alert you to at least some of the things to expect, but I have to admit that it is happening faster than expected. Did you pay any attention at all to what we wrote about Hyperopia and Presbyopia?

Until you can get some spare prescription glasses, I urge you to get some Over the Counter Reading Glasses either +2.25 or +2.50 for distance (try different powers) and +3.50 for close (try several for that also).

I don't recall where you live, but you may be able to order some low cost spare glasses from an online retailer like Zenni Optical. You probably have everything you need to order except your Pupillary Distance (PD). It is not hard to measure, but because of your prescription, you may need some help. We can help you if you want us to.

C.


KennethWest 01 Jan 2016, 19:41

It's unbelievable how bad my eyesight seems without my glasses now. I left then at my grandparent's. I had to squint so much and reading (my phone) was imposible without zooming in.

Kenneth


KennethWest 31 Dec 2015, 17:05

Cacatus Jack,

Will do. Thank you for all your help. Just got my daughter and myself ready. We are about head over to the great grandparent's house.

Happy new years all.

Kenneth


Cactus Jack 31 Dec 2015, 11:40

KennethWest,

You might also tell them that you have learned a lot more about vision and optics than you really wanted to know. That should get a laugh.

C.


Cactus Jack 31 Dec 2015, 11:37

KennethWest,

Yes. Just do it. There will be some comments, but that will be all over in a few minutes. If there is any comment about the power and/or the bifocals, just tell them that everyone is amazed that you were able to get by without glasses for all these years, as farsighted as you are.

There will be some requests to try your glasses. Let them, but alert them that they will probably find them very blurry for distance, but very close things should be a lot clearer. That will help defuse any comments. If they find that they can see pretty well with them, they need an eye exam.

Try to make a joke of it and try to laugh at yourself if you can, about being in denial for so long. That also defuses a lot of remarks.

Best wishes,

C.


KennethWest 31 Dec 2015, 09:38

Planing on wearing my glasses all day again today. It is going to be a little difficult. I see my daughter today. Tonight as per West family tradition we go to my grandparent's house to kick in the new year. I am nervous about wearing my glasses infront of all my family. Any tips?

Kenneth


Likelenses 30 Dec 2015, 23:35

KennethWest

Wow! have been following your posts,and agree that your first prescription is massive.

Full time wear is a given.


John S 30 Dec 2015, 22:30

Kenneth,

Your RX in a minus cylinder:

R: +2.25

L: +3.50, -0.50 X 50

Add +1.50

You have a small amount of astigmatism (cylinder correction) in your left eye only. Your left eye needs more plus correction than the right eye.


John S 30 Dec 2015, 22:19

I thought you were talking about the distance chart. The reading lens would help seeing close, but it is too strong to see distance, hence the reason for two different lenses.

In time it will become a natural habit to be able to judge when use the different lenses.

The movie projector is a great analogy. Each time the projector is moved a different distance from the screen, it must be refocused. That's you. The top lens sees 10-20 feet, the reading lens focuses at 16-20 inches. Outside of those distances using bifocal lenses, you are in no man's land.

CJ and I agree on most things. We come from similar backgrounds. But we have always had differing opinions on the lenses we prefer. I prefer progressive lenses, he prefers lined lenses. Both have their good and bad points. I believe a person that wears lined lenses for a long time, will have more of a problem changing to progressive lenses, than a first time wearer would. As usual, I am the exception to the rule. I wore lined lenses for 15 years, and went to progressives and never looked back. If you want to get into that discussion, let me know. If you think I am on the soap box now, I can really let loose.

Most people 35-40 start with a +1.00 of +1.25 lens only for reading. Their distance correction is so small, they don't worry about it. In your case, you are starting with about a +3.00 just for distance, and then a +1.50 reading add on top of that. It is called a reading add, because it adds to the positive strength of the lens. +3.00 and +1.50 = +4.50 for reading. That is a decent amount of power. I wasn't kidding when I said it will take a while to get used to that power. But it's not like you really have a choice. Go with the flow.

Like CJ says, glasses are just a tool that will make your life easier. Let the lenses do their thing, and don't fight it. Yes, you are stuck with them. It would have been so much easier if your vision problems were caught while you were a kid. Kids adapt much easier to a big change.

In NY state, part of the vision screening at schools was to use glasses with +2.00 lenses. The child is encouraged to read the distance chart. If they can, the parents are notified they needed to have their eyes checked. A person with normal vision would not be able to read the eye chart with +2.00 lenses. Kenneth probably would have said the chart looked better with the plus lenses. The usual vision screening is great for nearsighted people. It is about useless for younger farsighted people without using a method like that.

Normally a nearsighted person's RX increases somewhat because the eye grows longer in length. A farsighted person's eye is too short. It is really hard for a body part to grow shorter, so you have had this vision problem since childhood. But your accommodation muscles were so strong, they were able to compensate for it. They have run out of steam, so now you need external lenses to take over and do the work.

Please let me know if any of this makes sense.


KennethWest 30 Dec 2015, 20:59

John S,

It appears my last post did not go through correctly. What I had said was thag I could not read all of the card with my distance lens, so I understand why I have an add. It really helps. It enlargens things more than the top. The top does too, though. This whole knowing when and how to transition seems confusing.

Kenneth


 30 Dec 2015, 18:55


John S 30 Dec 2015, 17:31

Ok, that all makes sense. It is important you wear your glasses all the time. That will accomplish two things...

Getting used to the distance rx. Your distance vision will keep getting clearer the more you wear them. If you are part time, it is going to take a lot longer.

You need to get used to the bifocal segment. Stairs are one of the hardest things to get used to. You naturally look down to see close, so you need to try to look around the bifocal until you get used to using stairs. You do not have a strong add, so that will not be that hard.

Since you started out with strong lenses, things look a lot larger than before. After a while, that sensation will feel very natural. You will actually dislike taking your glasses off, because things will be blurry, and much smaller.

Your prescription will get worse, at least your reading add will. Your distance will probably go up some also.

Did you say that you could not read the 20/20 line with lenses?

I will post your RX in a minus cylinder tonight. Then you can compare your RX with the other postings. Most RXs are written in a minus cylinder. Your RX was written in a plus cylinder.

In a few weeks, you should be pretty well used to them.


Jamie37 30 Dec 2015, 17:08

Oh most certainly I do. I am quite nearsighted around -6 with another -3 in astig so a totally different set of vision issues then you except for the fact neither of us can see well without correction.

Tend to currently rotate between big black wayfarer frames and semi-rimless


KennethWest 30 Dec 2015, 17:05

Jamie37,

I see. Do you already have glasses?

Kenneth


Jamie37 30 Dec 2015, 17:01

Actually I am 38 now and am a proverbial long-time user/follower here. And, so of course interested in how things have progressed for you etc. And, can only imagine how stunning you must look in the new bifocals.


KennetyWest 30 Dec 2015, 16:55

Oh, okay. Thank you. Hopefully my experience can help you and/or anyone else. Is 37 your age?

Kenneth


Jamie37 30 Dec 2015, 16:50

Not yet Kenneth, although me and the doc did discuss bifocals at my last exam. I am thinking a likely scenario at next exam in late spring that I will be given a rx for bifocals then.

Enjoy reading your journey through thi


KennethWest 30 Dec 2015, 16:48

Jamie37,

Thry are the normal lined ones. Do you wear bifocals too?

Kenneth


Jamie37 30 Dec 2015, 16:39

So Kenneth, did you get progressives or regular lined bifocals


KennethWest 30 Dec 2015, 15:32

John s,

Yes, the put drops in. I am not sure what he was.

Cactus Jack,

Further away was blurry, it is super clear (through the top) for upto about 10-15 feet (just a guesstimate). Through the bottom it is only super clear until about 1.5 to 2 feet. Past those numbers it is blurry in the respective sections of the lens.

Thank you for all the tips. I almost tripped going down stairs in the mall and at a curb getting when I walked out.

The doctor mentioned during the exam that if I get to +2 he would strobgly reccomend me getting trifocals

Kenneth


Cactus Jack 30 Dec 2015, 14:22

KennethWest,

I am not the least surprised. In fact, If you look back through the conversations, it is pretty much what we expected. You are going to pay a little price for waiting so long. Typically, we suggest wearing First Glasses full time for 10 days to 2 weeks, but it may take a little longer for you to get used to your glasses, but the best way is to just wear them as much as possible.

The bifocals will take a little getting used to. The actual prescription in the bifocal segment is:

R +3.75

L +4.50, +0.50, 140 (The last two numbers are Cylinder and Axis to correct mild Astigmatism)

The additional PLUS helps you focus to read small text. You will soon get used to using the bifocal segment to help you focus. When you get to the point where you need +2.00 or more to focus close, you might find Trifocals with an intermediate power useful for the computer between the distance power and reading power.

Be careful going down stairs or stepping off curbs (kerbs?) because they ARE NOT where you think they are. If you are descending stairs, hold on to the handrail until you get used to wearing bifocals.

Will your prescription change? YES, probably sooner than 1 year. It is very likely that your Distance prescription will increase and the Reading ADD will Increase. You need to ask what their policy is if you need a prescription change. Some will remake glasses for a period of time at no charge, some will not.

Is your prescription high for first glasses? YES. It is amazing that you could function for this long, without correction.

Question: Is your distance vision a little fuzzy?

If so, it should start clearing up in a few days of wearing your glasses.

C.


John S 30 Dec 2015, 14:05

Kenneth,

Did the doctor put drops in when he determined your prescription? Was the doctor an optometrist or an ophthalmologist?


KennethWest 30 Dec 2015, 13:48

Just picked up my glasses. The whole bifocal thing seems confusing. When I had to read the hand held card that tests the glasses I had to switch to looking out the bottom to see the bottom. My prescription is R: +2.25 add +1.5 L:+3.00, +0.50, 140, add 1.50. Also, I forgot to mention this earlier the docor told me I should come back in in about a year or when/if I experience new vision problems. In the appointment we shortly discussed trifocals. How long does it typically take to get used to glasses? How long for bifocals? Do you think my eyes will change within one year? Is my prescription really high for first glasses. The lady that gave me my glasses was pretty surprised that thry were my first. Saying I have a third time maybe second time prescription.

Kenneth


Cactus Jack 30 Dec 2015, 13:46

KennethWest,

I am not clear when, in the exam, you had trouble reading the last two lines of the Snellen Chart.

The Snellen Chart is simply a way to conveniently measure Visual Acuity. If it was a full sized printed chart the last 3 lines are 20/20, 20/15, and 20/10. If it was a projected or video generated chart it is hard to tell which line you are seeing though some charts have the line clearly identified.

The 20/20 line is considered "normal" vision based on a large percentage of the population who function without vision correction. A few people have 20/15 vision and a very few people have 20/10 vision, but they are rare.

There are many factors that can affect a persons Best Corrected Visual Acuity (BCVA). The most obvious one is inaccuracy of the glasses prescription, but sometimes there are problems with the beginning of Cataracts forming in the Crystalline Lense or Retinal problems, just to mention two more.

Sometimes, it is just best to NOT give a person full correction in their first glasses, if the correction is significant. Your brain has years of experience dealing with your refractive errors and it can take a while for your brain to learn to deal with better quality images. If the total correction needed is to great, it makes it harder to function while the brain is in the leaning process.

In some ways it is like lifting weights at the gym. You don't build muscles by starting with the heaviest weights available.

We really need your full prescription to be able to offer suggestions.

C.


KL 30 Dec 2015, 09:25

KennethWest,

Messing up on the Snellen chart might have been due to hyperopia, but it could also be astigmatism - or a combination of both. Knowing your full prescription might make one or the other more likely. Was there a big difference between your eyes when you looked at the chart? If it was significantly worse in the eye with astigmatism, that’s probably the main problem.

A higher than 'usual' first prescription does mean that you would have benefited from glasses earlier, but your prescription is what it is. You didn't make it worse by not getting glasses earlier. Your vision without glasses will not get better, and your prescription will not decrease.

As for when you'll need to wear your glasses, no one can really know how you see or give you hard and fast rules (with the notable exception of driving and other safety issues). But from the sounds of it, you might well find you'll want to wear them all the time. Time will tell.


KennethWest 30 Dec 2015, 08:55

Cactus Jack,

I had trouble eeading the last two lines. Managed to say stuf for the last one, but had yo admit defeat on the 20/20.

Kenneth


Cactus Jack 30 Dec 2015, 08:33

KennethWest,

How did you mess up?

C.


KennethWest 30 Dec 2015, 08:26

I have not gotten them yet. What ajout me messing up on the snellen chart? I asked that in my previous post too.

Kenneth


Cactus Jack 30 Dec 2015, 08:18

KennethWest,

Have you picked up your glasses. yet? You need to ask for a copy of your prescription. You are entitled to it and one of the first things you need to learn is to put a copy in your wallet and keep it with you.

I am not surprised, if you look back through the conversations, I think we were pretty close in analyzing your vision even with the limited information we had.

The most important thing to get through your head is that what you are discovering is essentially what MILLIONS of other people who reach your age and have undiagnosed and uncorrected Hyperopia along with the beginnings of Presbyopia. We need to have some more conversations after you get your glasses and we know your complete prescription. Every element of the prescription is important.

Here are the answers to your questions:

Also, I remember my number were much higher than what I have seen most people here state their first prescription are, is that bad?

NO! It is just what is. Your prescription is like your Shoe size or Clothing size. The key is a comfortable fit.

Does it have to do with me being long overdue for glasses?

Not really. However, being "overdue" with Hyperopia makes it much more likely that you have some Latent Hyperopia that will take some time to fully resolve and likely some prescription changes.

Did I worsen my eyes by not noticing earlier?

Not really. I think it will take a few days, but you will realize what you have been missing and wish you had done this sooner.

Will my vision be able to get better?

Without your glasses, NO! In fact, you will initially think your glasses have made your vision worse. Also, it is common for Hyperopes with New Glasses to have slightly blurry distance vision which will improve over a few days or a week. This is a sure sign that you have/had some Latent or Hidden Hyperopia in addition to the Hyperopia revealed during the eye exam.

Or is it sort of like a no rewind zone?

NO! It doesn't work that way.

When will I need to wear my glasses?

It depends on your prescription, but you should probably wear your glasses ever waking hour for at least two weeks and then decide when you want to wear them. Vision actually occurs in the brain and the eyes are merely biological cameras. Your brain has been doing as much image correction as it can for a long time. It has to learn that it no longer needs to apply any correction to the high quality images it is now receiving.

How often?

See above. However, depending on your prescription, you may not want to drive with your glasses until your distance vision begins to clear up. You are the only one who can make that judgement.

We need to talk about his more, after you get your glasses and have your complete prescription.

C.


John S 29 Dec 2015, 23:26

Kenneth,

Welcome to the club. Sounds like you had the same problems I had, around the same age. You just didn't realize you had vision problems until later. Early on my vision problems bothered me more, so I got glasses.

Don't forget to post your prescription.


KennetgWest 29 Dec 2015, 23:16

Sorry for the long post. I tend to ramble when I am nervous. It's like my brain cannot stop my mouth (or in this case my hands).

Sorry,

Kenneth


KennethWest 29 Dec 2015, 23:11

Cactus Jack,

I do not remember the exact prescrition, but I remember the greater details. My doctor was sort of confusing, but it might have just been all this vison stuff coming at me all of a sudden.Turns out my eyes are plenty messed up (especialy my right eye). I have hyperopia, the doctor thinks I have probably had it for a very long time, grade school days, but was able to mask it and accomedate. So apparently I have had problems with my vision for longer than I thought. He also said it is likely I had gotten comfertable in my own blur. Untill it got really bad and/or until presbyopia made it's early entery. Turns out I also have astigmatisim in my right eye. I messed up on the snellen chart, but I have hyperopia, not myopia, is this like what KL said it was "too close," closer than my near point? The precription he put in to help me focus the parts I missed did not however make much of a difference up close on the card, so I will be needing extra plus to see close. Basically, I need bifocals. Also, I remembr my number were much higher than what I have seen most people here state their first prescription are, is that bad? Does it have to do with me being long overdue for glasses? Did I worsen my eyes by not noticing earlier? Will my vision be able to get better? Or is it sort of like a no rewind zone? When will I need to wear my glasses? How often?

Sorry for all the questions. Thank you in advance.

Excuse my big thumbs for typos,

Kenneth


Cactus Jack 29 Dec 2015, 21:34

KennethWest,

After all our conversations, I am really looking forward to finding out the results of your Eye Exam. I am sure you are going to have more questions after you get your glasses and knowing the prescription will help us offer appropriate suggestions. Up until now any suggestions we could offer were speculative. Now we can be more specific.

Being apprehensive about wearing glasses is common and normal. Hopefully, the benefits will outweigh any initial apprehension and you will soon be past all that.

C.


KennethWest 29 Dec 2015, 18:32

Looks like I'm going to have to pick up my first pair of glasses in the morning. By the time my appointment was over the glasses place was about an hour away from closing, so they said my glasses should be ready tomorrow morning. I have to admit I am a bit nervous about getting/ wearing them.

Kenneth


KennethWest 29 Dec 2015, 13:32

KL,

Okay, that makes sense. I think I will have problem with the latter. Will gind out for sure in about an hour.

Kenneth


KL 29 Dec 2015, 09:51

KennethWest,

If you're nearsighted, distance is blurred because it's too far away - past your 'far point', which is the farthest thing you can see clearly. Minus lenses move the far point to infinity so you can see distance clearly.

If you're farsighted, distance is blurred because it's *too close* - closer than your near point (closest thing you can focus on), which is already past infinity. Plus lenses bring the near point closer.


Cactus Jack 28 Dec 2015, 23:50

KennethWest,

This is a lousy way to try to teach Optical Physics, there is nothing like a Physics lab with an optical bench to allow you to see how lenses bend light rays to focus them and how they converge to a focus and diverge beyond focus. This will be very a very brief summary, but here goes.

Have you ever had occasion to focus a microscope, telescope, slide or movie projector? If you have, you may recall that there is only ONE place where the image is perfectly focused, but it is blurry on either side of that perfect place. Something similar happens in the optics of the eye.

If you have Myopia, distant objects are blurry and external - lenses can bring them into focus. Close objects may be in focus without correction, but it depends on how much Myopia and the distance to the object.

If you have Hyperopia. distant objects may be blurry and there are two ways to bring them into focus. Where Myopia required (-) lenses for correction, Hyperopia requires (+) lenses for correction. I mentioned that there are two ways to correct Hyperopia and which you use depends on several factors. Option 1 is to supply the extra (+) needed to focus by using your internal Crystalline Lenses, which are part of your Auto-Focus system, provided your Hyperopia is not too great and Presbyopia has not reduced your ability to focus by very much. Option 2, If you have a lot of Hyperopia or Presbyopia has made using your internal Crystalline Lenses for the extra (+) impossible, the only solution is external (+) lenses. One of the downsides of Hyperopia is that it will tend to affect your ability to focus close before it affects your ability to focus for distance.

The neat thing about Option 1 is that there is no cost involved and often you are not even aware that you are correcting your Hyperopia internally. However that good thing will not go on forever and at some point Presbyopia will gradually take away your Accommodation and you will need some external (+) lenses to focus for both near and far and ultimately bifocals.

Incidentally, people with Myopia also loose their focusing ability to Presbyopia and will need bifocals. It just does not seem to happen as as soon as it does with Hyperopes.

C.


John S 28 Dec 2015, 21:26

Kenneth,

My initial prescription at 13 was:

R +1.00 (hyperopia)

L +1.00

Add +1.75 (accommodation)

At 60 it is now:

R +1.00 -0.75 X 95 (hyperopia & astigmatism)

L +1.25 -0.50 X 75

Add +2.50 (my accommodation problem is now moot, taken over by presbyopia)

Both prescriptions (adds) were set for the average 16" reading distance. Around 30, I developed some astigmatism. My add started to creep up in my mid 30s.

I wear a +3.50 or +4.00 add in progressive lenses. That is a 11"-12" reading distance. I wear a stronger add so that I can focus closer for working with electronics. Since I was 20, I have worn a stronger add. A stronger add also feels more comfortable to me. I can say with some certainty, your arms will never be too short with a strong add. A few doctors will use a tape measure to determine the distance you like to read at. That works out very well.

If you use a computer a lot, glasses dedicated for that use are a good idea. You need to specify the distance from your screen so you get the correct lenses. They do not replace glasses for reading.

Some people normally wear bifocals or progressives, and wear single vision lenses when they are using their computer. That is a pretty good combination.


KennethWest 28 Dec 2015, 20:04

Cactus Jack,

Okay, thanks it makes a little bit more sense, but I think you missed one point of my question, why/ how would + glasses help someone see far I thought that is what the - did?

Sorry for all the confusion,

Kenneth


Cactus Jack 28 Dec 2015, 18:49

KennethWest,

Young farsighted people can get away with NOT wearing the PLUS glasses they actually need, provided their Hyperopia is not very high or complicated by Astigmatism. Often without their being aware of it, the use their "Auto Focus" system to let them see distance clearly, but it requires constant effort and energy.

At some point it catches up with them and they discover that they need some focusing help. The tiny text on SmartPhones and Tablets are famous for revealing Hyperopia even in young people. The solution is some PLUS glasses for both distance and close work. Extra PLUS is not needed for reading or most close work because they can use their Auto Focus system to take care of the extra plus.

If a person needs some additional PLUS to focus close, you have to get bifocals, trifocals, progressives or a separate pair of reading glasses.

Lets say that a person needs +2.00 correction for comfortable distance vision and likes to read at 16 inches or 40 cm, but can no longer use his Auto Focus System because Presbyopia makes that impossible. It turns out that Sir Isaac Newton's optics formula says it takes an extra +2.50 to focus at that distance.

If the person decides to get bifocals the most of his glasses would be +2.00 for distance, but there would be an area (called a segment) near the bottom of the lens for reading. It would have what is called an ADD of +2.50. The ADD means that its PLUS is in addition to the distance PLUS. Therefore, the optical power of the reading segment would be +4.50 and the person could use the reading segment by just lowering his eyes as typically occurs when they read. In some instances a person may need a very large field of vision for viewing close objects (e.g. reading X-Rays), In those instances a pair of single vision glasses with the whole lens with +4.50 may be desirable.

I am 78 and I wear Trifocals so I can see clearly at all distances, but have pair of single vision glasses with the power of the reading segment in my Trifocals. I use them for reading in bed. They are great for that, but because of the significant PLUS ADD for focusing close, everything beyond their focus distance is very blurry and almost useless for anything else.

C.


Cactus Jack 28 Dec 2015, 18:49

KennethWest,

Young farsighted people can get away with NOT wearing the PLUS glasses they actually need, provided their Hyperopia is not very high or complicated by Astigmatism. Often without their being aware of it, the use their "Auto Focus" system to let them see distance clearly, but it requires constant effort and energy.

At some point it catches up with them and they discover that they need some focusing help. The tiny text on SmartPhones and Tablets are famous for revealing Hyperopia even in young people. The solution is some PLUS glasses for both distance and close work. Extra PLUS is not needed for reading or most close work because they can use their Auto Focus system to take care of the extra plus.

If a person needs some additional PLUS to focus close, you have to get bifocals, trifocals, progressives or a separate pair of reading glasses.

Lets say that a person needs +2.00 correction for comfortable distance vision and likes to read at 16 inches or 40 cm, but can no longer use his Auto Focus System because Presbyopia makes that impossible. It turns out that Sir Isaac Newton's optics formula says it takes an extra +2.50 to focus at that distance.

If the person decides to get bifocals the most of his glasses would be +2.00 for distance, but there would be an area (called a segment) near the bottom of the lens for reading. It would have what is called an ADD of +2.50. The ADD means that its PLUS is in addition to the distance PLUS. Therefore, the optical power of the reading segment would be +4.50 and the person could use the reading segment by just lowering his eyes as typically occurs when they read. In some instances a person may need a very large field of vision for viewing close objects (e.g. reading X-Rays), In those instances a pair of single vision glasses with the whole lens with +4.50 may be desirable.

I am 78 and I wear Trifocals so I can see clearly at all distances, but have pair of single vision glasses with the power of the reading segment in my Trifocals. I use them for reading in bed. They are great for that, but because of the significant PLUS ADD for focusing close, everything beyond their focus distance is very blurry and almost useless for anything else.

C.


KennethWest 28 Dec 2015, 17:56

Cactus Jack,

Thabk you so much for all the help. One last question, I have been reading som posts on here. Howcome people farsighted people (+) wear there glasses all the time arent +lenses for close work like reading only? How could someone have an add when they already have plus lenses? Why not just add it into the lens as a whole? I understand - bifocals, but not + ones.

Thank you,

Kenneth


Cactus Jack 28 Dec 2015, 17:04

KennethWest,

I don't think you are being rude, I think you want to understand how this stuff works and I want to help. You may actually be overthinking this. The optics of vision are really pretty easy to understand. Hyperopia and Presbyopia are two different things with two different causes, but only ONE solution, though sometimes there are two solutions built into ONE lens.

Hyperopia - almost every baby is born with Hyperopia because of optical physics and the physical size of their heads and eyeballs. Fortunately, we have the ability to grow out of it in many instances, but your genes are in charge of how that happens.

Johns Hopkins University did some research on Nanothalmia several years ago. Nanothalmia occurs when the eyeballs do not grow and develop normally. The result is extreme Hyperopia. There was some evidence and a theory was developed that there is an eyeball specific growth hormone that is produced by the Retina when processing out-of-focus images and possibly by the stress of focusing. The ultimate control of this hormone production is your genes. Typically, your genes cut off the production of this hormone in your late teens or early 20s.

However, if hormone production is cut off early, before the eyeball has grown enough, the result is Hyperopia. If the cut off is late and the eyeball grows too much the result is Myopia or nearsightedness. As of the last news bulletin I saw several years ago, the hormone has not been isolated or identified, however there is empirical evidence that it exists. It is fairly common that women, who are significantly Myopic have a tendency to become more Myopic if they become pregnant, even after their vision had been stable for years.

It is certainly possible that you have some residual Hyperopia, but it has been masked by your Accommodation without your being aware of it. Hyperopia is the ONLY type of Refractive Error that you can correct internally using your Ciliary Muscles and Crystalline Lenses. However, while you can definitely correct Hyperopia, you cannot correct it indefinitely because Presbyopia rears its ugly head.

As I have mentioned before, Presbyopia is the gradual stiffening of the protein in your Crystalline Lenses and it actually starts in early childhood. The Accommodation Range (AR) of most children is huge. Most have the ability to Accommodate as much as +18 diopters of the relaxed distance state. That is why young children can effortlessly focus at 6 to 8 inches while reading or coloring on the floor even with a lot of Hyperopia remaining. However, as Presbyopia progresses, Accommodation Range is reduced (there is even a formula for that) and at some point it will limit your focusing ability. Typically, in the Emmetropic eye that needs NO correction for distance, Presbyopia does not become a nuisance until around 40. In the Myopic eye, Presbyopia usually becomes a nuisance a bit later, but in the Hyperopic eye, it happens earlier. In fact, one of the clues that a person has some Latent or Hidden Hyperopia is that they start having focusing problem at an earlier age than is typical.

The reason for this is that the Latent Hyperope has used up some of his Accommodation Range correcting his Hyperopia which leaves less for focusing to read.

Often, if the Latent Hyperopia is corrected with some PLUS glasses, it will free up your Accommodation for focusing close, at least for a few more years. After correction, when you will need some additional close focusing help depends on your visual environment and how much focusing ability you have left.

Hyperopia, Latent Hyperopia, and Presbyopia are strange beasts, but the strangest of all is Latent Hyperopia is the strangest of all. Latent Hyperopia occurs when the Ciliary Muscles and Crystalline Lenses have become so used to correcting Hyperopia that they can no longer easily relax. If you have had uncorrected Hyperopia for many years, it can take weeks or months for them to fully relax and restore your full available Accommodation Range. If you have Latent Hyperopia, you will probably get a prescription for PLUS glasses to correct your apparent Hyperopia. When you start wearing them, your distance vision may be a bit blurry, but after a few days or weeks that will clear up as your Ciliary Muscles and Crystalline lenses gradually relax. At that point, you should get another exam and possible get some glasses with a bit more PLUS and go through the same process. Depending on how much Latent Hyperopia you have, the total process can take some time.

Unfortunately, there is not way to estimate how much Latent Hyperopia or actual Hyperopia you have, until everything is fully relaxed. There is also no way to predict if you will need bifocals. You may need bifocals or progressives or reading glasses to help the process along. The keys are comfort and functionality.

If you get an exam and a prescription, remember that you don't have to get the prescription filled immediately. If you want to talk about it before taking action, please feel free to ask for an explanation of what it means.

C.


DS 28 Dec 2015, 16:11

Kenneth,

Babies are born hyperopic and grow, ideally, into emmetropia (focus at infinity in the fully relaxed state).

The aging process starts just as early, and the focusing ability available to overcome being farsighted is also constantly reducing. This is what causes eventually becomes presbyopia, when you no longer can make the transition from far to near with natural accommodation.

While young, there is a lot of extra focusing power available to overcome some hyperopia, as long as it doesn't require so much to cause the eyes to turn in so much to cause double vision. At age 34, you have likely hit the point along the ever-worsening presbyopia line where you need more accommodation than you have comfortably available to focus near.

You probably aren't technically "prebyopic" yet as, with only single-vision lenses, you'll likely be able to see both far and at normal reading distances. That label will come when you need additional help for close that would cause distance vision to blur, requiring bifocals.


KennethWest 28 Dec 2015, 13:37

Iforgot to add this at thr end of my last post, but I had to cancel my plans of getting my eyes checked today. Hopefully I can get them checked tomorrow after work.


KennethWest 28 Dec 2015, 13:31

Cactus Jack,

Okay, that really clarifies things. Earlier you had said you think I have both, why? In this last post you said hyperopia is developed during childhood (I'm 34), if that is true howcome I just started having problems? Let's say your initial post is correct if I have both will they add the corrections needed for both problems together into one number or will I need bifocals?

Not trying to sound rude. Sorry if it has come off like that,I just want to understand.

My best,

Kenneth


Cactus Jack 28 Dec 2015, 13:01

KennethWest & John S,

A small correction. Accommodation involves the Ciliary Muscles and Crystalline Lenses. Until Presbyopia or weak Ciliary Muscles make it difficult or impossible, the Ciliary Muscles squeeze the Crystalline Lenses to increase their PLUS power. The increased PLUS will move the focus point up to the retina.

Kenneth,

Hyperopia is generally caused by the eyeball not growing enough during childhood and adolescence. Most babies are born with substantial Hyperopia because their head must be small enough to pass through the birth canal and their eyeballs have to fit in their small eye sockets. Fortunately, most babies are born with very flexible Crystalline Lenses (made of a transparent protein with the consistent of gelatin dessert). It typically takes about a month for a newborn to learn how to use their Ciliary Muscles to make use of their excellent Accommodation potential. As the child grows their head and eyeballs grow. The growth is believed to be triggered by an eyeball growth hormone produced by the retina, but genetics are in charge of the production of the growth hormone. If there is not enough production, Hyperopia results and supplemental PLUS lenses are required. If there is too much production, Myopia results and supplemental MINUS lenses are required..

Presbyopia is something completely different. It is the gradual stiffening of the protein in the Crystalline Lenses. It finally gets so stiff that the Ciliary Muscles can no longer squeeze the Crystalline Lenses to increase their PLUS power and external PLUS lenses are required to enable close focusing.

Both Hyperopia and Presbyopia require PLUS lenses, but for different reasons. If both Hyperopia and Presbyopia are present, their effects are additive.

The amounts of PLUS correction required for Hyperopia is usually less than +6.00, but can be very high, if the Crystalline Lenses have been removed, as in Cataract Surgery before the development of Intra Ocular Lenses. The correction for Presbyopia correction, on the other hand, depends on how much extra PLUS the Ciliary Muscles and Crystalline Lenses can provide and the focus distance involved. Even if Presbyopia prevents any accommodation, the reading Add will probably be less than +3.50 diopters for someone who needs help focusing at a distance of 28 cm or 11 inches.

Here is a link to a paper discussing The Eye, that you might find interesting.

http://www.lhup.edu/~dsimanek/scenario/labman3/eye.htm

C.


KennethWest 28 Dec 2015, 04:37

John S,

Thank you for the explanation. You said you have both, what is your prescription? Would it be the same as person with just one of the problems?

Sincerly,

Kenneth


John S 28 Dec 2015, 00:56

Kenneth,

I hope you don't mind my 2 cents.

The lens can be the same to correct both vision errors, but the causes are completely different.

Hyperopia is basically caused by the eye being too short. That causes the image to focus behind the retina. For a sharply focused image, the image needs to strike directly on the retina.

Presbyopia symptoms can be caused by several things:

The lens in the eye is getting stiff or hard. This starts occurring after childhood, but it is not usually noticed until the mid 30s to mid 40s. There is supposed to be an automatic action called accommodation, that occurs between the brain and the eye muscles to lengthen the eye, to temporarily cause the focus point to move closer. It occurs very fast, and usually not noticed. When the lens become stiff, the muscles can no longer squeeze the lens to cause it to lengthen. Then the minimum focus distance moves closer to 20 feet, unless myopia or hyperopia is also present.

A breakdown in that automatic action, due to a chemical imbalance (blood sugar, or some types of medications).

It can also be caused by weak cilary eye muscles, or a communication problem between the brain and eye. Those are usually classified as an accommodation problem.

I have had both hyperopia and accommodative insufficiency since I was kid. (Google is your friend)

Hyperopia and presbyopia can have the same end effect. They usually show first as blurry close vision (intermittently, or constant), headaches, tiredness, or red/sore eyes. It can be a combination of any of those.

To find out which you have, or both, your distance vision needs to be corrected first (if needed). Hyperopia can be masked by your cilary muscles, and sometimes be hard to detect without a dilated exam. Because of your age, dilation will probably not be necessary, but still could be helpful.

If you can focus at 20 feet looking through a plus lens, you are hyperoptic. If you want to do this test yourself, find a set of readers that are a +1.00. Wear them for at least 15 minutes to relax your muscles. Then compare your distance vision (20 feet) with and without them. If your distance vision looks the same, or is better with the lenses, you are hyperoptic. If your distance vision is worse with lenses, you are probably not hyperoptic. Then the cause of your problem would probably be presbyopia or accommodation.

If you have presbyopia or an accommodation problem in your case, both of them would require a plus lens to correct. You can use the same readers to see if you get any comfort or vision improvement by wearing them only for seeing close. Your distance vision will be blurred while your are wearing them.

It is always a good idea to get an eye exam, even if you find the root cause yourself. You want to prescription to be correct, and there are eye diseases that can only be determined by an exam. Lenses are only part of an eye exam.

The eye has been said to be a window to see into the body. There are many diseases not related to the eye that can be determined by looking into the eye.

Many younger people do not even realize that they are hyperoptic, or that they have an accommodation problem until later in life.

Be aware that astigmatism can cause varied effects also. You can have that in to addition to any other vision error. That is for another discussion.

John


KennethWest 27 Dec 2015, 22:21

Cactus Jack,

Aren't both hperopia and presbyopia just different terms for farsightedness?

Your study guide was really helpful. Thanks for it. I promise to keep you guys posted. Wish me luck on my exam.

Regards,

Kenneth


Cactus Jack 27 Dec 2015, 20:58

Sarah,

I am working on some suggestions along that line, but I think if you try to force glasses on him, it will backfire. I really think he needs some vision help, but it needs to be his idea. I think it would be best if he got an eye exam, mostly to find out if he has any astigmatism, but it is doubtful he would go along with that idea, at this stage.

You might do a little scouting to find what is available in Over-the-Counter (OTC) reading glasses. Don't buy anything yet, but what you are looking for is +1.00 in a nice looking frame. +1.00 is typically hard to find, but failing that, +1.25 or +1.50 would be OK.

C.


Cactus Jack 27 Dec 2015, 20:44

KennethWest,

I was tempted to suggest a dilated exam, but that will temporarily affect your ability to focus close and if you are in fact Hyperopic, it will also affect your distance vision. The dilating agents typically take 5 to 8 hours to wear off, so you should schedule a dilated exam late in the day, when you go home after the exam.

C.


Cactus Jack 27 Dec 2015, 20:37

KennethWest,

I suspect you may be a bit hyperopic and presbyopia is creeping up on you. It typically happens a bit earlier in hyperopes, You might find the piece I wrote useful if you have not had an eye exam in a long time. It is on the Vision thread and called "HOW TO STUDY FOR AN EYE EXAM".

Please be let us know the results of the exam.

C.


KennethWest 27 Dec 2015, 14:18

Just to clarify I am still in my residency (thought it might be important).


KennethTWest 27 Dec 2015, 13:49

Hi,

My name is Kenneth I am a 34 year old medical oncologist (from reading previous post I figured you guys would want to know my age and occupation). Until recently I have never had any vision problems. When I was in high school I would wear my then girlfriend's glasses sometimes just for fun, but other than that I have never worn glasses. Now for about two months I have realized it is getting sort of harder to focus when reading, like my arms are no longer long enough to be able to read (even with my arms fully stretched in front of me the word are blurry). I plan on stopping in at our local mall's walk in optometrist's office tomorrow before work. Any thoughts, suggestions, tips, or words of advise for tomorrow or just my overall situation? Is there anything I should do to get ready for the exam?

Take care,

Kenneth


Sarah 27 Dec 2015, 08:40

I saw how low this has gotten in the recent post section, and thought I would bring it up because this is really important to me. I want to help my boyfriend, and it sounded like Cacutus Jack had something insightful coming up. I was thinking I should just buy a pair of readers and put them on him when he is reading so he can see he needs them, Does that soubd good? If I do that, what prescription should I get?

~Sarah


Sarah 26 Dec 2015, 12:24

Cactus Jack,

Just noticed your question what year of college he is in, sorry I read overr it last time. He is on his second year, and if you were wondering I am on my first.

~Sarah


Sarah 25 Dec 2015, 15:57

Cactus Jack,

I found them, and was reading it earlier. I am an 18 year old chemical engineering and business administration student. Cost is not the issue, I think he is just ignoring the problem cause I think he is sort of afraid of needing glasses.

~Sarah


Cactus Jack 25 Dec 2015, 14:47

Sarah,

If he is 19, farsighted, majoring in a subject as visually intense as Mechanical Engineering (first year?), and having headaches when he reads, he really should not put off finding the solution to his problem. He can buy headache medicine by the case, but that is not the answer.

People who want to study Engineering are fundamentally Problem Solvers. I know. I am one.

My background is Electronic Engineering and Computer, and my curiosity about a personal "unsolvable" vision problem is what caused me to learn about vision and optics. I found the solution to my problem and my ECP said that I ought to be teaching at Optometry school. I don't think your boyfriend's problem is very complex or hard to solve.

Most engineering types are naturally curious. Maybe a different approach would cause his "curiosity bump" to itch a little. I am toying with an idea that might help get him past a glasses "hang up". May I ask a few questions about you?

1. Your age?

2. Are you also in school?

3. If so, what are you studying?

4. Where do you live (country)?

5. Is cost of an exam or glasses an issue?

If you are uncomfortable discussing any of this online, please feel free to contact me privately at cactusjack1928@hotmail.com.

If you have time, please read the Macrae saga I mentioned. it is well written and funny. I think Macrae and your boyfriend are kindred spirits and reading his glasses adventure will help you understand the problem. Let me know if you have trouble finding it on the True and Fantasy Stories thread on the Vision and Spex website.

C.


Sarah 25 Dec 2015, 11:41

Cactus Jack,

Yes, I do wear glasses, I just had my last check up and am now waiting for my first double digit lensed glasses to come in (for myopia and astigmatism). As far as my boyfriend, yes he is definitely a keeper! Yes. He is in school he is studying to be a mechanical engineer with a minor in business administration.

~Sarah


Cactus Jack 25 Dec 2015, 09:08

Sarah,

It is very likely that he is farsighted and what is happening is much more common these days that it was even 20 years ago. The medical term for farsightedness is Hyperopia. It is the ONLY refractive error that a person can correct by using their internal resources, without their even being aware that they are doing it. That makes it hard for a person with low to moderate Hyperopia, unless it is complicated by Astigmatism, to understand that they may need some help. In some cases, being a little Hyperopic is like a being a slightly over corrected Myope. Their vision seems to be exceptional and they often brag about how well they see things in the distance.

The idea that a person does not need focusing help until their 40s is a myth. You need help when you need it and if you have some uncorrected Hyperopia you may need it a lot sooner than 40. The reason is really simple if you understand a bit about optics and how the eyes work. The culprit is Presbyopia, which is the gradual stiffening of the Crystalline Lens (the focusing lens in the eye) as you get older. Presbyopia actually starts in childhood, but it typically does not become a problem until around 40. Most babies are born with very significant Hyperopia. That is because their eyeballs have to be small to fit in their small eye sockets. Of course, their heads are small so it can pass through the birth canal. Fortunately, most babies have extremely flexible Crystalline Lenses to compensate for the Hyperopia, but it takes about a month after birth for them to learn how to use their Ciliary Muscles to focus their eyes. As the child and their eyes grow, they become gradually less Hyperopic, but if the eyeball growth stops too soon, they wind up with Hyperopia.

Hidden or Latent Hyperopia is more common that previously believed because it is often revealed by trouble reading the tiny text on SmartPhones and Tablets.

Your boyfriend seriously needs an Eye Exam, but there is probably a vanity issue involved. Yes, males have vanity also and it can often be worse than female vanity. There is likely no way to force him to get an eye exam, but you are right with your recognizing the symptoms. If you try to force him to get an exam, he will likely just dig his heals in. He needs to decide for himself, but that probably won't happen unless his discomfort exceeds his vanity.

A couple of questions:

1. Do you wear vision correction?

2. Is he presently in school of any sort?

4. If so, what is he studying?

3. Is he a 'keeper'?

You might find it useful and entertaining to read Macrae's Story on the Vision and Spex website.

C.


Sarah 25 Dec 2015, 00:43

Cactus Jack,

Thank you for replying. My boyfriend is 19 years old. You said he needs vision help, do you agree with me in the sense that he is most likely farsighted and needs reading glasses?

~Sarah


Cactus Jack 24 Dec 2015, 21:10

Sarah,

Your bf probably needs some help with his vision. How old is he..

C.


Sarah 24 Dec 2015, 17:46

Hey, I have a question, my boyfriend has been complaining of headaches and I have noticed that they mainly originate when he reads. By now he noticeably struggles with reading especialy small print, and I see him holding his menues, books and phine further away to focus. I think he is farsighted and needs glasses. I brought it up a few times, but he blows me off and blames my observations on just being tiered, sick or on bad lighting. I hate to see him struggling, but he is not my child so I cannot just force him to go to the eyedoctors. What do you guys think, does he need glasses, or am I just paranoid like he says? If you think he does need to get his eyes checked how do yoh suppose I get him to go?

Knowing him with all his pride I think he is just having trouble coming to terms with what he is obviously noticing cause he thinks only older people are farsighted.

~Sarah


Joey 14 Dec 2015, 19:09

My right eye is -4.75 and my left eye is -1.5. Me left eye has a bunch of astigmatism. Add 1.75.


Cactus Jack 13 Dec 2015, 17:10

Joey,

Once Presbyopia gets to the point where you need some close focusing help, it can appear to progress pretty rapidly. However, there is a limit to how far it can go.

Presbyopia, which is the gradual stiffening of your Crystalline Lens (your focusing lens), actually starts in childhood, It usually does not become a nuisance until around 40, but these days with tiny text on Smartphones and Tablets, even some teens are needing close focusing help.

The stiffening of the Crystalline Lens happens very slowly, but the Ciliary Muscles which, for their size, are the strongest muscles in the body, get out of condition very quickly. Unfortunately, when you get to the point where the Ciliary Muscles can't squeeze the Crystalline Lenses to increase their PLUS power for focusing close, you need some external help (glasses). The external help relieves the Ciliary Muscles of some of their work load and the focusing system goes into a downward spiral where the Ciliary Muscles get weaker as the Crystalline Lenses get harder to squeeze and you need a stronger reading prescription. The good news is that your reading prescription will never go over +3.00 unless you like or need to focus closer than 33 cm or 13 inches.

May I ask your complete prescription?

C.


Joey 13 Dec 2015, 14:14

I have worn glasses as long as I can remember. I had a lazy eye and did the patch for several years. Not sure how that worked, got contacts in high school. Got married,and had two boys, both needed glasses before they went to school. Just turned 42 and went to the eye dr...of course my 6 yr old grandson needs glasses, but I need bifocals. Two days, eyesight is amazing . When I put contacss in I can't see anything closer than 12". Weird how my eyesight has gotten so much worse in a short period of time


Joey 13 Dec 2015, 14:14

I have worn glasses as long as I can remember. I had a lazy eye and did the patch for several years. Not sure how that worked, got contacts in high school. Got married,and had two boys, both needed glasses before they went to school. Just turned 42 and went to the eye dr...of course my 6 yr old grandson needs glasses, but I need bifocals. Two days, eyesight is amazing . When I put contacss in I can't see anything closer than 12". Weird how my eyesight has gotten so much worse in a short period of time


Soundmanpt 12 Dec 2015, 20:36

Kristen

It's really great to hear from you and that your eyes seem to have pretty much adjusted to your glasses for nearly everything. Even your distance seems to be getting better and better with your glasses for driving at night. It makes perfect sense that your more comfortable wearing your glasses than they are without them. That's because your eyes are now using the +.50 prescription in your glasses which is why it's easier now to focus with your glasses on. That's exactly what your glasses should be doing, making it just slightly better with your glasses. Sp that little bit of difference you notice is the +.50 in your glasses doing what it should be doing. So you should still be more than able to see everything just like you you did before you got your glasses only now your glasses are making it easier on your eyes.

Carrie's friend the "server" is different than you because when she started wearing glasses her vision was perfect. She wasn't prescribed glasses at least not at first. Her gf Danielle, had been prescribed glasses, +1.00's, and when she got her glasses she took advantage of a 2 for one deal so she got 2 pairs of glasses for the price of one. The "server girl" it seems just wanted to wear glasses so she borrowed one of Danielle's glasses to start wearing as her own. But as it turned out they were just a little bit tot strong for her eyes and she was never able to adjust to them. Danielle i'm pretty sure by then was also wanting her other pair of glasses back to wear herself. They decided to go on line and order a pair of glasses for "server girl" in a weaker strength. They picked out a pair and had them made with +.50 lenses. These glasses was much easier for her to adjust to and she never had any problem wearing them and seeing fine. At some point Danielle needed an increase in her own glasses so she made an appointment to get her eyes examined for new glasses. Her gf (server girl) decided to get her eyes examined at the same time and she was prescribed +.50 glasses which of course she already had been wearing. So her vision most likely changed as a result of her wearing glasses that were not prescribed to her. Your case is completely different because you were prescribed glasses by an optometrist, Now he may have called them "booster" glasses or whatever but the truth is you were prescribed glasses because he felt like your eyes were a little weak and needed a little help, or "boost" if you will. So all you have been doing is getting your eyes to adjust to the glasses the doctor prescribed to you. You not ruining your eyes by wearing your glasses. So yes she had to of weakened her eyes a little bit if she went from having perfect vision to being prescribed +.50 glasses. Now that she is wearing Danielle's +1.00 glasses chances are she will find that if she gets her eyes examined in the next few months she will be prescribed +1.00 glasses as a result of her own doing. Now it's hard to predict what your next eye exam will determine. It is possible your eyes won't change at all or you may need a slight increase, but if you do it won't be because your wearing glasses. It will be because of the amount of close work you do and eye strain. But your glasses are doing a good job of reducing eye strain now because your wearing glasses.


Carrie 12 Dec 2015, 16:43

Kristen - good to hear you have got used to your glasses

I don't know if my friend has weakened her eyes. She has a prescription, like you, for +0.50 which she can see perfectly with. She can see fine with her girlfriend's old +1.00 glasses. She says although she can't see any better it's certainly no worse than with the weaker glasses. She can see well without glasses but likes how she looks in them and likes that her "new" glasses look more real than the +0.50s because the prescription is stronger. She can read/see close up without glasses but with glasses everything is really clear and her eyes don't get tired from being on her phone for long periods.

In my opinion, I don't think you will do any harm to your eyes. If you like wearing glasses and want to wear them all the time then it's good you can see all distances as good or better than without glasses.


Kristen 12 Dec 2015, 12:32

Plus Tony, Soundmanpt, Carrie

I have cntinued to wear my glasses all of the time as you recommended. I am seeing fantastically with them on now. It is no longer comfortable to not be wearing them. I can see everything without them but it is easier to focus with them on. I think that my vision is clearer up close and at mid-distance while wearing them now. Distance waffles between clearer with them on or clearer without my glasses. It is pretty close either way.

I am concerned with something that Soundmanpt wrote to Carrie about her "server" friend. You stated that wearing my. "booster" prescription was tolerable the adaption of her vision and that she was therefore using the "power of the lenses" which "weakened her eyes". Am I weakening my eyesight by wearing my booster glasses? On 11/11, you indicated that wearing my glasses would not ruin my vision. It sounds wearing her glasses over time with the same prescription as mine has weakened her vision.

I love wearing glasses finally but do not want to do harm to my eyesight.


Plus Tony 12 Dec 2015, 07:03

Kristen

How are you getting on with your glasses? I tried some of the online tests but I found it difficult to make any useful judgements from them. I think when you get down to the smallest lines the distance between eyes and screen becomes more critical and it is tricky to ensure that screen size and distance from the screen are spot on.

The best test for me is whether I can see better with glasses than without. In my case there is no question that everything is better with than without but I appreciate that in your case the benefits may be more marginal.


Soundmanpt 08 Dec 2015, 17:08

Carrie

I completely understand privacy so of course I would never expect for you or anyone else to ever use anyone's last name but not sure how using a first name could be of any problem. It just seems funny all the time to keep referring to her as "the server girl at the coffee shop"

I only asked about which glasses she was wearing because before she was wearing Danielle's spare pair and it made me wonder if it she started wearing Danielle's previous glasses because she really liked the ones she started off wearing? But based on what you say she is now wearing the glasses that Danielle was using as her primary glasses. Lastly I wonder if she asked Danielle for her previous glasses when Danielle got her new ones or if Danielle just gave her previous glasses to her thinking she might want to wear them. Which she did of course. I know of course these are things you can never ask but only hope things come out in conversations. So you don't get to see Danielle wearing her glasses as much as you would like since she got contacts but at least now you are seeing her gf wearing glasses full time. Which one looks better wearing glasses, Danielle or her gf?


Carrie 08 Dec 2015, 14:33

Soundmanpt

I don't use her name for privacy reasons. I might give her name at some point in the future as I don't like referring to her as "the server" - she's more than that, but I need to think about it. I don't want my exact area to be identified. Maybe it's just me being paranoid.

I've only seen her wearing what used to be Danielle's main pair but I presume she could use either pair. They look better than the +0.5s and those looked nice on her anyway.


Soundmanpt 08 Dec 2015, 12:38

Carrie

You mentioned being with Gemma as well as Danielle and her gf the server from the coffee shop over the weekend. First of all is there any reason why you can't use the servers first name instead of calling her the "server from the coffee shop"? Anyway now that the server has started wearing Danielle's previous glasses and has 2 pairs to choose from, is she switching between them match the outfit she is wearing that day or is she sticking with just one of them? Have you seen her in both pairs? Does she look better in one than the other or are they both nice looking on her? She didn't seem to have hardly any problem with her eyes adjusting to them this time. Poor girl worked so hard before trying to get her eyes to adjust to the prescription so she could see with them but they were just too strong for her eyes. Danielle's idea of ordering her a pair of glasses with a weaker prescription was the perfect solution. Danielle got her spare pair of glasses back to wear herself and her gf got glasses that her eyes were much more able to adjust to. With the weaker lenses her eyes were not rejecting the prescription anymore and instead was using the power of the lenses. This of course weakened her eyes and her glasses now were providing her with good vision for close up as well as distances. With her eyes now a bit weaker than they were when she tried wearing Daniele's glasses the first time her eyes are much more receptive to the slightly stronger prescription this time. You of course should know very well just how well she is able to see without glasses since her glasses are nearly exactly the same as your first glasses. You already said that she commented that things are more blurry now when she takes her glasses off.


Cactus Jack 03 Dec 2015, 08:07

Robert,

cactusjack1928@hotmail.com

Very busy for the next few days. Reply may delayed, slightly.

C.


Robert 03 Dec 2015, 03:27

Cactus

I have a few questions regarding prisms, would it be possible to email you to ask advice?

Thanks


Cactus Jack 02 Dec 2015, 22:16

Jay,

That is good. Many older former Myopes discover that they don't need as much Minus as they did when they were younger.

Since your ECP has not noticed the beginnings of Cataract formation, I suspect your vision will be very stable for distance, but you may need increasing Add until it reaches about +2.50 or +3.00, depending on how close you like to read.

Regular Eye Exams are a must because your eyes are a window into your body. Often health problems that develop as we get older are first discovered during an eye exam. The earlier developing health problems are discovered, the easier they are to manage, so you can live life to the fullest.

C.


Jay 02 Dec 2015, 21:40

Hi Cactus Jack. I get regular eye exams and there is no sign of cataracts. First glasses for distance were at 30 and they were a low minus. Add came at 40. Morphing from minus lenses for distance to low plus came in late 40s/early 50s. Late 50s now.


Jay 02 Dec 2015, 21:40

Hi Cactus Jack. I get regular eye exams and there is no sign of cataracts. First glasses for distance were at 30 and they were a low minus. Add came at 40. Morphing from minus lenses for distance to low plus came in late 40s/early 50s. Late 50s now.


Cactus Jack 02 Dec 2015, 21:35

Jay,

May I ask your age?

A couple of things some to mind. It is possible that your Myopia was actually Pseudo Myopia, which is the same thing as Latent Hyperopia, but it is just on the other side of 0.00. As Presbyopia began to rear its head, your Ciliary Muscles and Crystalline Lenses my not have been able to maintain the excess PLUS, which is the cause of Pseudo Myopia and Latent Hyperopia.

Another possibility is that you are developing Cataracts. Has your ECP mentioned anything like that?

C.


Jay 02 Dec 2015, 21:05

I had something even odder happen, Willie. I was wearing glasses for distance that were about a -3 or -4. As near vision faded, I morphed into low plus for distance with axis and cyl correction...and of course the add for up close.


Cactus Jack 02 Dec 2015, 19:00

Willie,

Common! Happens all the time. Don't be concerned.

Many people in your situation have some Latent or Hidden Hyperopia that can take some time to resolve, maybe months. Don't be surprised if your distance PLUS prescription in creases some and your Add also increases some. Your distance prescription will probably not increase more than +1 or +1.50 diopters and your Add will probably not go beyond +2.50 or +3.00 depending your your preferred reading distance.

If you would like, we can teach you how to order inexpensive glasses on line. It is really easy.

Welcome to the Hyperopia/Presbyopia club. It has millions of members, all over the world.

May I ask your occupation?

C.


Willie 02 Dec 2015, 18:04

OK, at age 48, I finally gave in and had my eyes examined. My close-up vision was on fast-fade. During the examination, I also found out that I was farsighted and probably could have used glasses much, much earlier. The prescription is OS +1.00 add +1.50 and OD +1.25 add +1.50. Wow, from no glasses to wearing glasses full-time. Not what I expected, but after 2 weeks in the glasses, all is sharp and clear. Any others had this experience?


Soundmanpt 30 Nov 2015, 10:22

Kristen

You have only been wearing your glasses for less than a month and your eyes are only first now getting completely adjusted to them. So testing your eyes now is really much too soon. Maybe after wearing your glasses for a few more months you may want to see want effect your glasses has made to your near vision as well as your distance vision. You know it makes a difference the time of day you test your eyes. This even includes going to an optometrist for an eye exam. You are more likely to be given a stronger prescription if you go for an eye exam on a Friday after work then if you go before work on a Monday morning. So if you tried this test in the morning your results since your eyes are still adjusting to glasses would be slightly different than if you did it later in the day after you had your glasses on all day. I am not at all surprised that you were able to read your I-Pad both with and without your glasses. But even so you still said that doing the near test was slightly more comfortable wearing your glasses. That makes sense because your glasses are mostly to reduce eye strain so without your glasses your eyes were actually straining a bit to focus. You seemed surprised and disappointed that it wasn't blurry without your glasses. Maybe if your eyes were more tired later in the the day the words might have been a bit more fuzzy? Back on 16 Nov 2015 17:25 you commented "I took my glasses off after work to remove makeup and shower and my eyes did not like it" I assume that you meant that things were somewhat blurry? At any rate your glasses do make a difference in your vision. Your glasses aren't strong enough to ever make things very blurry but they do make a difference. Remember a month ago you weren't even able to wear them hardly at all. Now your wearing wearing them full time and I am sure they are relaxing your eyes quite a bit at work now and your last report seemed like your now able to wear them comfortably driving at night.


Kristen 29 Nov 2015, 19:36

Ben, Plus Tony, and Soundmanpt

I have only done the near test in normal light so far. I was able to read the N.4 line and all of the above lines with both of my eyes, left eye, and right eye with my glasses on and without wearing my glasses. I held my IPad at normal reading distance for that test. I hope that is how I was supposed to take the near test. The near test was easy either way but it was slightly more comfortable while wearing my glasses. I was surprised that I could read all of those lines clearly without my glasses on. I thought the lines would be blurry when I tried to read them based on being prescribed glasses for reading and using the computer. My glasses really don't "boost" my vision and I am wondering if I really need them. I have been wearing them all of the time.

Is that the Snellan test you wanted the results for? I don't know which test is for astigmatism or how to take it. I also do not see anything listed for distance vision.


Soundmanpt 26 Nov 2015, 16:47

Kristen

Most all of the apps that I have come across for testing your vision really aren't very accurate and considering that your prescription is only +.50 those tests may not even be able to determine any difference between your vision with and without your glasses. Also remember you have only been wearing glasses for just a couple days more than 2 weeks and your eyes are just now getting to where they are completely adjusted to your glasses for all distances. So it is really too soon to be trying to test your eyes anyway. Go back and read what you posted on "09 Nov 2015 19:23" and compare that with what you just posted on "24 Nov 2015 21:05" Your last line you say "I have felt really comfortable wearing my glasses at all times the past two days" And even before that you were pretty happy that driving at night had improved so much that you had no problem seeing with your glasses on even on an unfamiliar road. I'm sure when you put your glasses on in the morning now it doesn't take your eyes hardly anytime to adjust to your glasses? Even though i'm sure your able to see small print without your glasses it's now easier with your glasses and it should since this is what you were told your glasses were for in the first place. Your eyes are simply enjoying the benefit of the added help that your glasses now provide to relax your eyes. And there is very little doubt just how much you like wearing glasses now. As much as you enjoy wearing glasses is there anything that you have learned about glasses that you didn't know or anything that glasses seem to get in the way of? Of course you mentioned the rain on your windshield of your car when you were driving at night causing you to lose focus a bit but of course that same rain gets on your glasses and you either have to wipe your glasses or try and see through the raindrops. Something you have never had to worry about before you started wearing glasses. The first few days i'm sure you spent cleaning your glasses quite a bit due to finger prints and smears some by you and more by your friends and co workers that insisted on trying them. But now that your more sued to your glasses and most everyone has seen you wearing glasses that should be much better now.


Plus Tony 25 Nov 2015, 11:45

Kristen

I'm afraid I'm not an expert on the various eye test apps and I'm travelling today so I'm not in the best environment to try them out but I'll have a go and let you know how I get on.

I'm absolutely delighted that you're doing so well with your glasses. I knew you'd get there. It is such a good feeling when your glasses start to work as you want them to so congratulations for persevering and I hope you're enjoying being a full time wearer. Obviously I'm biased but I think there is something a little bit special about being a full time plus wearer. Take care.


Ben 25 Nov 2015, 10:35

Kristen,

You should take the snellen test with both your glasses on and off. You should also take an astigmatism test.


Ben 25 Nov 2015, 10:35

Kristen,

You should take the snellen test with both your glasses on and off. You should also take an astigmatism test.


Kristen 24 Nov 2015, 21:17

Also, please let me know on each of the tests that I should be taking if I should only take it with my glasses on, or only without my glasses, or should I try taking the tests doing them wearing and then not wearing my glasses. I am excited about this app but I am clueless about using it to generate information.


Kristen 24 Nov 2015, 21:05

Ben, Likelenses, Soundmanpt, Cactus Jack, Plus Tony, and Carrie,

Thank you for letting me know about this app. I am excited to find out more about my eyesight and share it. I downloaded the app but I can't seem to find the directions on how to use it. I also noticed there a lot of different options for various tests. Can someone please explain this app and let me know about the tests I should be getting information about.

What did you mean by "I corrected acuity"? I would also love to hear your results if you test yourselves with this app. I would really also like to hear how Carrie's friend with the same prescription as me tests.

I have felt really comfortable wearing my glasses at all times the past two days.


Ben 23 Nov 2015, 05:40

Kristen,

If you are wondering how well you see with and without your glasses you can find many online eye tests that test for visual acuity. You can also download the app eyesnellen as well and test your vision. I'm curious what your corrected and I corrected acuity is in both good light and low light conditions. Let us know! Thanks!

Ben


Kristen 22 Nov 2015, 20:25

Likelenses, Cactus Jack, and Soundmanpt

I think that I am still making progress while wearing my glasses. I have been increasingly comfortable when driving at night wearing them. I had no problems at all tonight on unfamiliar roads. My vision still goes in and out on occasion if I have to remove my glasses. It happened the other night when I was tired too. Today, there was no problem though.

I did experience some difficulty when I was driving in the rain the other day. I kept focusing on the raindrops that were falling on my windshield instead of the road. I had to fight that repeatedly. This never happened to me when when I have driven without glasses.

I am curious on how well I can see with my glasses on for distance now. I know that I have incredible distance vision without my glasses. I am not sure what it is but the eye doctor said that I tested as well as any patient that he has ever seen in all of his years. People at work,my family, and friends know that about me and I think that is why I get so much flack for wearing my glasses all of the time. I really love having and wearing my glasses though.


Carlos, Jr 21 Nov 2015, 13:33

Mel, I would go ahead with the +1.75 strength.

I'm 6 months, the ''contributors' on this site will

Be telling you that it is time for bifocals


Cactus Jack 20 Nov 2015, 08:38

Mel,

What you experienced is exactly what is expected, given the symptoms you stated. We need a bit more information. The most important bit is your age. Were there any other parts to your prescription, other than you needed some close focusing help, as indicated by the +1.25 or +1.75?

C.


Mel 20 Nov 2015, 06:35

I got tired when reading a lot so decided for an eye exam. Near the end she put a card on a stick in front of me but I couldn't really read the smallest lines. She clicked a bunch until I could read them. Then she clicked 2 more times. I could see better with each click. When she removed the stick everything was a blur. Then the judgement came. I need glasses for close! She said I can get +1.25's that will help me focus close, and guesses that 6+ months out will become dependent on them and possibly want stronger glasses, or I could go for stronger now, I think +1.75 that could make me dependent even within a month, but will let me hold that prescription longer. Also with the +1.75 distance will be even more blurry if I look out. What should I get?


Soundmanpt 19 Nov 2015, 11:52

Kristen

The more comfortable and relaxed that your eyes feel it makes sense that your vision is really good with your glasses now. By putting your glasses on at the start of each day and keeping them on the rest of the day your eyes have adjusted quite a bit since you started wearing them. So it is understandable that by having them on all day that by the time your driving home after work your eyes are actually being helped by the prescription in your glasses. You were right in not taking them off to compare because your eyes would have lost focus and went back to your normal vision. Then been blurry when you put your glasses back on. This way your eyes stayed in focus with your glasses and you had your best drive home yet wearing your glasses. But this still shows that your that your eyes are clearly adjusting to your glasses more all the time. Only you and your eyes know how long before your able to see perfectly driving with your glasses after dark. But your probably not far off with it being less than a week now.

At one point early on I also thought you might do better with glasses with -.50 lenses since it is, for most people, much easier if you have perfect or near perfect vision to see with a weak prescription for distance, but the fact that your optometrist even pointed out the fact that you have "acute distance vision" tells me that when you were asked to read the 20/20 line but you must have also been able to read the letters on the 20/15 line as well which is slightly better than perfect vision. That is really good but it also can cause you to be slightly farsighted which I can only assume is what he saw in your eyes. This is why he prescribed you with +.50 glasses. So in your case I think you would have more of a problem trying to adjust to -.50 and even more of a problem with -1.00 glasses. But if your ever really curious to try a pair of -.50 let me know and I will be happy to send to a nice pair. I have about 10 pairs or so which Zenni no longer stocks so they are useless as samples for me. I would be happy to mail you one to try. This was why I was asking you about some of your friends glasses that you borrowed to wear. Of course the ones with astigmatism correct were of no use to you. But the ones that were for distance was what I was interested in how well you were able to see with any of those glasses. But not surprising form what you said they were too strong for your eyes. But if your friends hardly ever wore them and they must not have been very strong, but I can see where they might seem that way for you. Were you ever able to wear any of their glasses very long? As badly as you wanted to wear glasses i'm surprised you never asked any of your friends for a pair of their old glasses that they longer wore or that they never offered you a pair. Yeah the fake glasses are fine but not good when your forced to admit they are fake to people you know. But I am sure you enjoyed being far enough away so you could wear them where no one would know you. It seems that you have wanted to wear glasses for quite a long while? So have to be over joyed finally having a pair of real glasses and now being able to wear them full time. Your glasses sound really nice, Oakley glasses are not cheap so I can see why your happy that your now wearing them.


Cactus Jack 18 Nov 2015, 22:47

Likeliness, Kristen, Soundmanpt,

I have not been following this thread closely, but I was wondering if Kristen might not benefit from doing the "home" refraction test using some OTC readers of known PLUS power, say +1.50 or +1.75, and measuring the distance where small text just begins to get fuzzy. That might give you an idea of her actual refractive error.

C.


Likelenses 18 Nov 2015, 22:28

Kristen

Minus power glasses are for nearsightedness,and plus are for farsightedness.

If a normal sighted of slightly farsighted person puts on weak minus glasses of -1.00 or less, they have incredibly sharp distant vision,especially in the dark.

The fact that you have had difficulty using plus glasses after dark leads me to believe that you either have perfect vision without glasses,or that you are slightly nearsighted.

If you want to, you could return to the eye doctor that prescribed your glasses,and tell them that you do not see real well in the dark for night driving,and that the glasses that they prescribed seem to make it worse.

With that,I am willing to bet that they would prescribe you a weak minus prescription.

You are still young enough that you could wear that prescription all the time.

There should be no charge for a reexamination,and the new lenses.

The other thing that you could do is go to an online optical site such as Zenni,and order a pair of glasses with a weak minus,and see how you like them.


Kristen 18 Nov 2015, 19:27

That was my post below. I forgot to put my name on it.


 18 Nov 2015, 19:25

Like lenses, Soundmanpt

My vision with my glasses is really good at the minute. It was better than it has been while driving in the dark on the way home tonight. I didn't take them off while I was driving to compare because I was afraid that my eyes would adjust to normal and it would be blurrier when I put my glasses back on. I think I will be fine by the end of this second week like the woman that Carrie wrote me about.

What is the difference between my +0.50 glasses and wearing a -1.00 pair of glasses for distance and driving at night? I know the numbers and the signs are different but how would it be different? This was the prescription (+0.50) that my doctor issued.

I pretended that my fake glasses were real. I never lied about them though. It was embarrassing when I had to come clean. I loved wearing them when I was pretty sure that no one would know me.

Most of the glasses that I borrowed were for people who wore them to see faraway or said they had astigmatism. Some were way too strong. I had trouble seeing with them on. It was fun to wear glasses that were not very strong but my friends that had those often did not wear or have them with them.

My glasses are all plastic, black, and are made by Oakley. I would call them semi-hipster. I wanted hipster frames but I want to be taken seriously at work. They were a compromise. I love them and enjoy wearing them. I have real glasses.


Soundmanpt 17 Nov 2015, 10:02

Kristen

Well today makes a full week that you have been wearing glasses full time and I think you doing terrific. Your experience on Saturday when you went driving and you were seeing very clearly until you happened to remember that you had your glasses on and then your eyes didn't want to see as well, but still not all that bad either. Why did this happen? Well not only are your eyes getting more adjusted to seeing distances, which they are, but your now so used to having you glasses on that you never gave it a thought as you drove off. Your eyes were totally relaxed and so they were using the prescription of they glasses. Problem is as soon as you remembered that you were wearing your glasses that relaxed feeling went away but not completely. I'm sure your much more comfortable wearing glasses now then you were last Wednesday. It helps that your now seeing clearly at work and now that all your co-workers have seen you wearing glasses your not getting near as many comments about your glasses. So it makes sense that you sometimes forget that your even wearing glasses now.

You may recall commenting that you had your glasses for 3 weeks and they didn't really seem to do much of anything? Now you have been wearing glasses for just one week but now when you take your glasses off your eyes feel uncomfortable. Like on Friday when you came home from work after wearing your glasses all day. So your eyes were adjusted to your glasses when you got home. You took your glasses off to remove your makeup and shower and your eyes didn't like it. That was because your eyes were used to that added "boost" from your glasses. But while you were showering your eyes had the chance to re adjust to your normal vision. When you were done showering and you put your glasses back on at first your vision wasn't very good. But rather quickly your eyes adjusted and you were seeing clearly with your glasses again.

Your right that your not quite there yet but look how far you have come in just one week. Your now able to see everything you need to see at work with your glasses on and your eyes should even feel more relaxed than if you weren't wearing glasses. Your intermediate distance is now quite good and based on your driving experience on Saturday even driving is starting to get better with your glasses, at least during the daytime. So you only need your night vision vision to improve with your glasses which will happen. If you want to push it along some you should wait until the evening rush is over and then go out driving after dark. This is the best way to get your eyes to adjust.

When you were wearing your "fake glasses" what did you say when someone asked you about your glasses? Did you admit that they were fake or did you try and convince them that you had some sort of need for them? When you borrowed your friends glasses did she say what she needed her glasses for? How well could you see with them? Did you ever consider asking her for an old pair of her glasses, or were they too strong for you? I guess that explains why you love wearing your glasses so much now. By the way what do your glasses look like? Are they a full plastic frame, semi-rimless, cat eye, or hipster (like the bigger Ray-Ban style)


Likelenses 17 Nov 2015, 00:16

Kristen

Since you are still unable to see clearly at night with plus glasses,indicates to me that your you are not farsighted at all,but either have perfect vision,or are slightly nearsighted.

In either case you would benefit greatly by ordering a pair of online minus glasses,for full time wear.

I am sure that your eyes could handle -1.00 for each eye,but if you wanted to start out with less that would be Ok also.

In either case you will have incredible clarity for distance,especially at night.

You most likely will have little to no period of getting used to minus lenses.

Worth a try at online prices.


Kristen 16 Nov 2015, 17:25

Plus Tony, Soundmanpt, SC, and Carrie

OMG, what fantastic support. Thank you all. I have continued to wear my glasses all of the time. I was driving on Saturday and was seeing very clearly until I noticed that I was seeing really clearly. I still saw fairly well but I am not sure why my eyesight changed after I noticed how well I was seeing. There have been times that I forgot that I was wearing my glasses and my vision has been outstanding.

Also, Saturday, yesterday, and today when I did remove my glasses, my eyes felt uncomfortable. I took my glasses off after work to remove my make-up and shower and my eyes did not like it. They did adjust and get color table while I was in the shower. Since my shower, I am not seeing as well with my glasses on as I was prior to the shower. I think that they are adjusting again though. I just looked up at the television and they have definitely adjusted.

I am not there yet. I still feel uncomfortable while driving in the dark with my glasses on. My distance vision is incredible without glasses and I can see way better at night than anyone that I know. There have been several occasions recently before I got glasses that I was a passenger with a friend who could not see well on a dark night or a rainy night and I ended up taking the wheel of their car upon their request. I hope that eventually my night vision with glasses does improve.

It is really helpful to hear that Carrie and Plus Tony have gone through this. It was incredibly interesting that one of your friends has the same prescription that I do. It would so love to share experiences with her. It sounds like we have a lot in common and similar struggles. I hope that she might post on here or contact me. Thank you for sharing that Carrie. She was the first person that I have known that has also been prescribed booster glasses and has tried to wear them all of the time.

I am hoping that I am in the one-third that SC has referenced and will be successful. I love wearing my real glasses. It beats wearing the my old fakes and being allowed to wear my friends' glasses from time to time.

Thank you for being my support group.


Carrie 16 Nov 2015, 08:47

Kristen - keep going with wearing your glasses full time as you will soon be able to see distances clearly. My first glasses were slightly stronger than yours but I got used to them quite quickly once I realised I could see distances if I put them on as soon as I woke up in the morning and kept them on. As it turned out my eyesight was much worse than I had realised - my prescription is now +2.50 and +3.00 with a tiny correction for astigmatism in both eyes. It seems I was gradually given stronger prescriptions so it was less of a shock to the system. I started out wearing glasses full time because I wanted to and I could. I now feel I actually need to wear them full time because my eyes feel uncomfortable without them and they give me clear vision at all distances. My need for stronger prescriptions had nothing to do with wearing my glasses full time but did help me get used to the stronger prescription each time. Especially useful when I was told my prescription was for distances and not just for reading and when my eyes felt tired.

A friend of mine wanted to wear glasses like a lot of the students do that come in to the coffee shop where she works. She didn't want fake ones so she used her girlfriend's spare reading glasses at first but found they were a little too strong for her to see across the room clearly. She then bought glasses from an online store with +0.50 for both eyes. She wore them full time and was able to see everything clearly in less than two weeks, if I remember correctly. Earlier this year she got her eyes tested and was given a prescription the same as the glasses she bought online. She asked the optician if she would harm her eyes by wearing her glasses full time. They said she didn't need to wear glasses full time but wouldn't do any harm if she did. She continues to wear the +0.50s full time, all day, every day even out of work. She wants to go back to wearing her girlfriend's glasses as she feels the +0.50 prescription is barely noticeable. Her girlfriend has let her have both pairs of her first glasses as she got new ones with a stronger prescription earlier this year. She says she can now see further than she could before with her girlfriend's old glasses, which are +1.00 in both eyes, but still not perfectly. She is going to wear the +1.00 glasses as much as possible at home until her eyes start to feel a bit strained and then put the +0.50s back on. She will do that until she can see as good as she can with the +0.5s and then wear the +1.00s full time.

She could easily go without glasses at all, although the +0.50 prescription would help with long periods of reading. She only wears glasses because she wants to and is happy that they look real because of the very slight prescription in the lenses. She will be happier if she can get used to the slightly stronger prescription in her girlfriend's old glasses.


SC 16 Nov 2015, 02:13

Kristen,

You may never adjust to seeing distance. Unlike minus lenses where your eyes can work harder to see through them, you can only focus clearly through plus lenses if you are long sighted.

Given that you are not short sighted then you have about a 1/3 chance of being long sighted. This is very difficult to detect and most people do not realise until their 40s.

With a +0.5 lens you should be able to focus up to 2 metres (6ft6in). If you can focus beyond 2 metres then you MUST be long sighted.

If you are long sighted then you will eventually need to wear glasses for distance - probably at first for headaches and eye strain but ultimately to focus clearly - ie you won't be able to see without them but that will not happen for many years and will depend on how long sighted you are


Soundmanpt 15 Nov 2015, 08:50

Kristen

Your eyes are adjusting just about the way I expected they would. it was only last Tuesday that you were hardly ever even wearing your glasses. You had gotten them 3 weeks before but having never worn glasses before you weren't used to wearing glasses and it didn't help that when you did try and wear them you didn't notice any difference in your close vision with them on and your computer across the desk was slightly blurry with them on and of course your distance vision was also blurry with them. All this made sense because of the type of prescription you were given. But on Wednesday you decided to make an effort to wear your glasses because you actually like your glasses and wanted to be able to wear them and you had even been told how nice they look on you. You have wore them full time since then. But in just those few days your close vision is good, your now able to see your computer clearly and your intermediate distance vision is now good as well. With your intermediate vision now being clear that actually means that you over all distance vision has to be improved as well. So your eyes are adjusting and I have to think now when your driving those road signs that were quite blurry to you on Wednesday are not quite as blurry now? Without a doubt your night vision will be the last to clear up. It is really hard to predict exactly when everything will become clear at all distances with your glasses but I think it is safe to say that it should only be days and not weeks based on the progress you have already made. Over the weekend I hope you able to do things that had you outside where your eyes were being forced to see distances. The more of that you do the faster the distance blur will be gone. Keep the updates coming.


Plus Tony 14 Nov 2015, 16:58

Kristen

It sounds like you are getting there. It is difficult to predict how long it will take but you are making progress. A few days ago I think you were worried that you wouldn't be able to adapt at all and now you could say you are two thirds of the way towards your target!

The reason it is difficult to predict is of course because we are all different. When I was about your age I knew a girl who had -0.5 in each eye and never took her glasses off. I have a colleague at work who is -3.00 and she refuses to wear glasses at all even though she wouldn't recognise me if she walked past me on the street but she gets through the day somehow. With plus prescriptions it is even more difficult to predict when people will wear their glasses and what they see when they do or don't wear them. What I've noticed during my brief career as a full time wearer is that a lot of younger people with mild plus prescriptions are wearing their glasses all day than I had previously realised. I suspect there are at least two reasons for this. First, wearing glasses is now cool in a way that it wasn't maybe 10 years ago. Second I suspect that a lot of people take the same view as me that if it is possible to get used to seeing at all distances with the glasses on it is just easier to put them on in the morning and leave them on rather than whipping them on and off all the time.

Another good thing in a world where strangers don't really talk is that sometimes people with glasses do. It was raining heavily yesterday and after I dashed into a cafe for lunch the bespectacled girl who served me said she was giving me an extra napkin so I could wipe the spots of rain off my lenses. She laughed and said "we have the same issue". This led to a minute or two of chat and reciprocal frame admiration. I don't think anyone would ever have given me an extra napkin to wipe the spots of rain off my face...so there is a bit of solidarity among those of us who see the world through lenses.

If I had to guess I'd say that by this time next week you'll be seeing everything more or less perfectly but it may happen quicker or it may take a bit longer.

One thing that I did to get used to wearing mine was to put them on before switching on the light in the morning and taking them off straight after switching off the light at night. That way the only time I don't wear them is when I'm in the shower or cleaning them so my eyes got used to the fact that having glasses on was the normal state. I tried as hard as I could to resist the temptation to take them off to compare my vision with and without (although admittedly it was very tempting). I really wish that I'd got glasses before now because I feel so much more confident and happy that I feel like a new person. I don't know if you want to feel like a new person or not but anyway keep going because you're doing really well!


Kristen 14 Nov 2015, 14:21

Soundmanpt

I have continued to wear my booster glasses all of the time. I love wearing them but I still do not see as well in the distance with them on. You are right about that. However, I do see fine in the intermediate distance with them on now and also up close still. Do you have any idea how long it will be before I see as well in the distance with my glasses on?


Soundmanpt 14 Nov 2015, 10:30

Kristen

So I assuming that Friday probably went a little bit better than either Thursday or Wednesday? With it being the weekend and I assume your not working but I hope that your continuing to wear your glasses. Now the more things that your doing where your needing to see more things in the distance the more that will help with adjusting to your glasses for distance which it seems is the only thing that still was a little bit blurry with your glasses.


Soundmanpt 12 Nov 2015, 21:06

Kristen

So it sounds like wearing your glasses today was somewhat better than it was on Wednesday? I'm sure you felt better about wearing glasses as you were driving to work today compared to yesterday? It makes sense that driving home after dark is still a bit more difficult, but if you think about it even without glasses it is common that driving after dark is always going to be a bit more difficult than during the daytime. That will improve as your eyes continue to adjust. Were you surprised that tonight you while you were watching television you were able to read the print at the bottom of the screen without any problem with your glasses on and last night you couldn't? Your not imagining that your eyes are starting to adjust because they clearly are. You should expect more improvement again tomorrow as well. It's nice that your still getting complements on your glasses but it's too bad that some are still suggesting that your going to get dependent or even ruin your eyesight by wearing them. All you can do is continue to tell them that your glasses really help to relax your eyes and helps to eliminate eyestrain and that you can see just fine without them. After a bit they will let up with their concerns and stop questioning you. And don't be afraid to tell them that you really don't mind wearing glasses and kind of like wearing them. That should also help.


Kristen 12 Nov 2015, 18:07

Plus Tony, Soundmanpt,

I have worn my glasses all day again. I wore them to drive this morning and I was fine with them on. I wore them at work all day. People were surprised that I was wearing them again today. More compliments and warnings. It was dark when I drove home tonight with them on. That is not as easy as it is to drive with them on during the day. I am glad that I know the roads. I wore them into the grocery store on the way home. That was fine. I have worn them since I got home and am watching television now. I can see the television fine and could read the moving print at the bottom of the screen during the news without a problem.

Can I see better in the distance without them still? Yes, I can. I can see pretty well with them on though today. I will definitely be weary no them all day tomorrow.

However, if I take them off for a minute or two, it is blurry when I put them on again for a while. It takes a while for my eyes to readjust to them. It also takes a while to adjust to seeing different distances clearly with my glasses on. I think I was adjusting a little better than yesterday but I might be just imagining it because I want it to be better.


Soundmanpt 12 Nov 2015, 10:49

Kristen

I think your going to find that wearing your glasses today is going to be even easier than it was yesterday as your getting used to having your glasses on and your eyes are adjusting as well. My guess is that it will be easier for you to see with your glasses today than it was yesterday. Your eyes are going to adjust to the close work that you do first and your distance won't be far behind. Short distances like watching TV should soon start to clear up and then longer distances will follow.


Kristen 11 Nov 2015, 19:05

Plus Tony, Soundmanpt

I appreciate your advice. It is good to hear that wearing my glasses all day will not ruin my eyesight or make me dependent on them. I have worn them while exercising and watching television tonight. I can see the screen fine but I can see it better without my glasses. I have kept them on though. I will wear them all day long tomorrow too.


Soundmanpt 11 Nov 2015, 18:46

Kristen

Well all in all it seems like you had a pretty good "first day" wearing glasses. Just like I said your +.50 glasses is not anywhere near being strong enough to blur your vision to the point where you wouldn't be able to see to drive safely. By wearing your glasses all day today your not going to feel nearly as self conscious tomorrow when you wear them. It's understandable that your co-workers would question your wearing your glasses all day today since this is the first time you have really wore them since you got them. If anyone asks you tomorrow simply tell them that your eyes were bothering you so you thought it would be a good idea to wear your glasses since that was what you really got them for. Actually you really wouldn't be stretching the truth very much because the real purpose of your glasses is to relax your eyes from eyestrain. That is what the doctor meant by "booster" glasses. Your +.50 prescription glasses is far too weak to ever make you dependent on them even if you were to decide to wear them full time. And they aren't going to ruin your eyesight either.

Tell the truth as your work day was nearing be done weren't you feeling much more comfortable actually wearing your glasses for the first time since you got them? Trust me tomorrow will even be better than today was as your eyes adjust a bit more. Enjoy wearing your glasses!


Plus Tony 11 Nov 2015, 17:14

Kristen

Congratulations. I think today you took the first step towards being able to enjoy wearing your glasses whenever you want to. Like most of the people who post here I'm not an eyecare professional. I'm just an enthusiastic amateur who now loves wearing glasses. I definitely need glasses but as I said earlier I don't technically need them all the time but it feels good so I wear them all the time. It took a little while before I could see perfectly at all distances but now that I've got used to it I can't imagine not wearing them. I like the way I look and the way I see and as a relatively shy person I feel much more confident especially now that nearly everyone has seen me wearing them. Only today I saw a woman who works at my favourite coffee place for the first time since getting them as she has been away and she told me she thought I really suited them and that I should definitely wear them. She isn't a glasses wearer herself but as she is around my age you never know...

However like you I was concerned that I could be damaging my eyes by wearing them full time. So over the last few weeks I've asked 3 different optometrists at different opticians (while asking about different lenses and coatings etc) whether I could be damaging my sight. All have said no and that I should wear them as much as I feel comfortable with and that whether I wear them or not it won't affect my vision. Obviously at my "advanced age" I know that my eyes are going to get a bit worse naturally but that will happen whether I wear glasses or not.

I think you can be sure that you won't damage your eyes if you wear them most of the time. You may start to notice a little blur at near distances when you take them off buy that is just because your eye muscles are telling you that they appreciate a little help. At your age though any blur probably won't last more than a few seconds.

The most important thing is that you have a real prescription and you clearly want to wear them so go for it! I'm sure you look great, you'll get lots of compliments and as you have a plus prescription people will be able to see your eyes a little more clearly too which is a bonus. Let us know how the rest of the week goes.


Kristen 11 Nov 2015, 16:22

Soundmanpt, Likelenses, and Plus Tony

I have worn my glasses all day today. I wore them to drive to work and I could not see as well but I still felt safe enough to keep them on. I kept them on at work all day and felt a little self conscious. My co-workers complimented me while at the same time questioned why I was wearing my glasses all day and warnied me that I will become dependent and ruin my eyesight. They are well aware that I have great vision and that these are just booster glasses. We had that conversation a few weeks ago when I first got my glasses. I also wore them the drive home a little while ago. It was more difficult for me to drive in the dark with them on. I wanted to take them off several times but I did keep them on. I am still wearing them now.

I enjoy wearing my glasses. Will I ruin my eyesight by wearing them too much? Will I become dependent on them? I am not sure how I feel about that. If my glasses don't ruin my eyesight and they will not make me dependent, I will wear them for the remainder of the week all of the time to try and adjust to them.

Plus Tony, I will be 25 in Februrary.


Plus Tony 11 Nov 2015, 12:12

Kristen

How did you get on? I'm sorry that I only saw your post now. My advice would've been to wear your glasses all day but to take care when driving and take them off if you were in any way concerned about your safety. Forgive me if you've already posted this and I've missed it but how old are you (if you don't mind me asking!)? That will have an effect on how quickly you adapt to the prescription. I'm 43 so I think my eyes were definitely ready for some plus. If you are younger I suspect it may take a little longer.

For me I knew that the only way I would become a full time wearer was if I got on with it straight away and didn't put it off. You may still be in two minds about how much you want to wear your glasses but even if you wear them full time for a week you aren't going to change your eyes. My distance vision is more or less still perfect without specs and my close vision is far from useless but the key difference I've found for the last six weeks is that I haven't had a single headache or felt any eyestrain. That issue may not apply to you. Anyway I hope you are having a successful day!


Soundmanpt 11 Nov 2015, 00:11

Kristen

That's what you need to do so your eyes can adjust to them. If you do that I think you will find that even by the end of the day your eyes will be more adjusted to them and the blur will not be as noticeable. Do that for a few days straight and I think the blur will soon be completely gone.

You should be able to see well enough to drive safely with your glasses on because I doubt that the blur is so bad that you can't see well enough to drive. But of course if you really don't feel safe keeping them on then by all means take them off. By afternoon or evening if you have had your glasses on all day your eyes should be adjusted enough that driving should not be any problem. If you do get a headache during the day take your glasses off for a few minutes to rest your eyes, but put them back on after a small break.

Actually what Likelenses is suggesting isn't really a bad idea if you find it too hard to adjust to your glasses. It is much easier to adjust to minus glasses if you don't really need them than plus glasses. But since you have "acute distance vision" you probably should only get -.50 or maybe -.75 but -1.00 might be a bit too strong for your eyes. But since you have already bought your glasses that you know doubt must like the way they look I think with a bit of determination you should be able to adjust to them.

Just so you know if you had gone in and was complaining that you were having trouble seeing when you are driving at night you would have gotten a prescription for glasses with -.50 lenses and and been told to get the AR coating (anti-reflective) even if you have acute distant vision. Doctors call this "night blindness" and they have no way to test your eyes for this but they know that -.50 won't cause you any harm and it has been found to work for people with this condition. My best friend's wife has this very thing. During the day she is fine and can see perfectly, but once it gets dark she needs her glasses to drive. She has had them for several years. So if need be you can always go on line and order a pair of glasses with the -.50 and the AR coating. Zenni has very nice looking glasses and well over 800 to choose from for under $20.00.


Likelenses 10 Nov 2015, 22:04

Kristen

Since your prescription is so small,and you probably do not need it at all,I would suggest that you order a pair of -1.00 glasses online.

You would enjoy wearing those much better.

Your distance vision will be incredible with them on.


Kristen 10 Nov 2015, 16:32

Soundmanpt,

I will try to wear them all day tomorrow. Should I even wear them when I drive?


Soundmanpt 10 Nov 2015, 12:19

Kristen

I looked back in "New Glasses" and found your first post where you stopped in while at the mall and got your eyes examined because for one reason you said it had been years since you last had an eye exam and I think you went in hoping that you might need glasses. I say that because you were even trying frames on before while you were waiting. Also you mentioned that you like trying on other peoples glasses and even fake ones. so you were clearly hoping that you might need glasses. Now to be honest with you, which I think you even knew, you really didn't need glasses even if you eyes suggested a +.50 prescription. In most cases the doctor would only recommend glasses to you if you were complaining about having some problems with your eyes such as burning or feeling some eyestrain. Like you say the weakest plus glasses you can buy over the counter is, well you only found +1.25's, but some places do carry +1.00's. The reason they only go that low is because anything less than that they know isn't really necessary because they would be so weak. So the fact that you don't seem to notice any difference in your near vision is very understandable because the difference is so slight. And as for the blur you get when you try wearing them for distance well that is because just as you were told you have "acute distance vision" meaning your eyesight is perfect for distance. and even such a small amount of prescription your sure to notice. But you just need to make up your mind if you want to wear glasses or not. Remember he wouldn't have given you a prescription if he felt like the were going to damage your vision. If you like the idea of wearing glasses then you need to just start keeping them on even if you don't notice any difference in your vision. And if you start keeping them on your eyes eyes will rather quickly adjust to them for distance as well. A +.50 prescription can't possibly make things that blurry for your distance because they are really that weak,but their real and not fake glasses.


Kristen 09 Nov 2015, 19:23

Hi Plus Tony, Soundmanpt, and Jill,

I am coming up on three weeks since I was prescribed my +0.50 booster glasses. I am proud that I finally have real glasses but do not get to wear them much. My glasses blur my distance vision. I am supposed to wear them for computer work and reading but they really do not make any difference there. I like to wear them but I can't find a reason to yet.


Melyssa 28 Oct 2015, 04:47

Leanna,

I am unable to wear contacts, and I did not enjoy wearing glasses until 20 years after starting, when I bought my first pair of drop-temples. I have 15 pairs of drop-temples and 16 pairs of cat's-eyes, my other favorite style, in my current collection. And it helps to have had the same prescription for the past 23 years.

Of course, if I had perfect vision I would not wear glasses at all, not even planos like some people do.

And I can blame heredity for my referee-like vision, as my parents and grandparents wore glasses.


Leanna 27 Oct 2015, 12:38

Melyssa

Wow, 50 pairs of glasses? I got only 4 pairs and a prescription sunglasses. But I also wear contacts, sometimes they are just more convenient than the glasses.

My boyfriend is not that into this glasses-thing, though. All of his family members had bad eyesight, so the glasses for him is just an object, which helps to see. In my family I was the only one with glasses (later my mother got reading glasses, but that's all), so maybe that's the reason of my whole enquiry.


Likelenses 26 Oct 2015, 20:18

Leanna and Melyssa

Nearsighted women are my cup of tea.

I thicker,and larger the lenses,the better.


Melyssa 26 Oct 2015, 04:48

Leanna,

I feel the same way about men. I never dated one with a plus prescription though. My husband is at -8.25, and he likes seeing me in my nearly 50 pairs of big, bold, and beautiful glasses.

Both of us knew early on that we preferred glasses wearers of the opposite sex, and we certainly achieved our goal. :)

And for the record, had any guy I dated told me to ditch my glasses and get contacts, I would have ditched him.


Leanna 25 Oct 2015, 08:32

Likelenses

Yes, I have to admit, I have a thing for guys in glasses. I thought I prefer minus lenses, but plus lenses can be very nice, too. (And I'm sorry to say that, but it's kinda arousing, if someone can see distance well with them.)

I only had one shortsighted boyfriend though, who had been wearing contact most of the time. I broke up with him before this trendy hipster-glasses era, now he's probably wearing black rimmed frames all the time, and he's probably looking very handsome in them.

But I really like my current boyfriend's glasses as well (right: +1.0 left: +0.75 with some astigmatism). The interesting thing is, that he was mildly shortsighted, when I first met him about 12 years ago. He was only one of friend's friend, so I didn't really pay attention, but I got some photos from those parties, and I can say that his prescription was -1.0 or weaker, but it was definitely minus. 5 years ago we met again (and falling in love). At that time he's got a very mild plus prescription, I think it was actually weaker than his current glasses. Unfortunately he's not really talks about his glasses or his eyesight, so I don't want to push it, he only says that his eyes are messed up. But at least he can still see without glasses, unlike me. I'm shortsighted (right: -3.0, left: -2.5), cannot really see without my glasses or contacts.


Likelenses 17 Oct 2015, 13:53

Hannah

Very nice glasses you have there Hannah.

I love the chunky inner portion in the rimless frame.


Hannah 17 Oct 2015, 11:48

I got glasses about 7 years ago, I'm slightly farsighted but also have a prism in my glasses. I'm 37 now, when I first got glasses, I just wore them for reading, but with the prism increasing, now at 4.5BI in each eye I have to wear them all the time. Here is what my glasses look like. http://hannahg7.imgur.com/all/


new bifocals 15 Oct 2015, 19:30

I posted back here in july and got first pair of glasses (non readers) and three months later i am full time completely........and love wearing glasses....I was fearful of wearing as a kid because thought it was nerdy ( and i was nerdy enough).......feel great wearing them


Ricky 13 Oct 2015, 08:48

I will like to go for Multifocal contact lenses. My current glasses prescription is OD, OS +1 with an add of +1.25.

What will be my contact lens prescription? Any suggestions or feedback on the multifocal lenses most welcome.

Thanks

Ricky


Plus Tony 06 Oct 2015, 15:30

Ricky. I was recently prescribed L +1.00, R + 2.00. I do not yet have an add but I expect to be getting one in a couple of years at most. I am actually a bit older than you so the fact that I didn't need extra close power was a surprise but it just shows that we are all different. However I quickly realised that after wearing full time for a week I can see great at all distances and I don't have any strain with close work anymore.

I decided to wear full time as someone made a good point on here that taking glasses on and off all the time can make you look older. It is also very inconvenient and a good way to scratch the lenses. You don't need to worry about ruining your eyes by wearing your glasses. If I take mine off my distance vision is still fine. It is just a lot more comfortable at all distances with glasses now. The other thing is that with progressives nobody will notice that you have an add anyway.

You will also find that you get a lot of nice compliments from people if you wear them. My confidence has been greatly boosted by positive comments including one from a young lady young enough to be my daughter who told me I looked 5 years younger! When you've hit 40 comments like that are worth their weight in gold!

You need to make your own choice of course but wearing as much as possible for a week or two will give you the chance to make an objective judgement about whether they work for you both in terms of vision and lifestyle.


Likelenses 06 Oct 2015, 14:02

Leanna

It sounds like you like guys in glasses.

Do you like to see them in minus lenses,or plus?

Do you wear glasses,and if so what is the prescription?


Leanna 06 Oct 2015, 11:15

Ricky,

Don't be depressed :)

And wear your glasses full time if you feel like you need them. My boyfriend (he is 36 years old) also needs plus glasses (almost the same strength as you have, but without the add), and I find it very sexy, if he wears them for distance. Unfortunately he wears them only 50-60% of the time, mostly at work, not at home...


Cactus Jack 06 Oct 2015, 09:52

Ricky,

No need to be depressed. The idea that a person does not need closer focusing help until they are at least 40 is a myth. Presbyopia often begins to be a nuisance earlier in people who are Hyperopic or Long Sighted or Far Sighted (all the same thing) than people who are Myopic or Short Sighted or Near Sighted)

Presbyopia actually begins in childhood, but typically does not become a problem until some time in the 30s when you begin to notice that your arms are too short.

There is also a very interesting phenomenon occurring, where teen agers are needing bifocals or progressives far earlier than expected. It often turns out that they are a bit Hyperopic and the tiny text on Smartphones or Tablets revealed that they were having close focusing problems.

I also suspect that you may have some Latent or Hidden Hyperopia. Hyperopia is the only refractive error that you can correct internally, using some of the Accommodation (auto-focus) resources of your Ciliary Muscles and Crystalline Lenses. It is likely that you have been internally correcting your Hyperopia and your Ciliary Muscles may have difficulty relaxing. It is very common and often hard to detect on an eye exam. The best way to determine if you have Latent Hyperopia is to wear your glasses full time for at least two weeks and then make a decision on how often you want to wear them. You may begin to feel like your glasses have made your vision worse, but that is not really true. Vision actually occurs in the brain. Your eyes are merely biological cameras and your brain has been used to correcting your vision. That takes a lot of energy and effort. If your glasses are correcting the images that your eyes send to your brain, Its workload is reduced and you may find that your brain (and you) prefer wearing your glasses. Think of glasses is simply labor saving, comfort producing, tools.

If you have some Latent Hyperopia, don't be surprised if you need a new prescription in a few months. That is also very common. That may happen as your Ciliary Muscles learn to relax, Ideally, If you have Latent Hyperopia, you want that to be resolved as soon as possible. The reason is that you have likely been using some of your remaining accommodation for correcting your Hyperopia, which takes away some of your close focusing ability. If you can fully correct your Hyperopia with some additional Plus Sphere in your glasses for distance, you may be able to avoid increases in the reading portion of your glasses for several more years.

C.


Ricky 06 Oct 2015, 08:54

Hi all,

I was prescribed my first pair of glasses recently and they turn out to be progressives. I am 35 years of age.I am already depressed since I have to wear progressives so early. The prescription I have is OD, OS +1 with an add of +1.25. So can anyone please let me know how often should I wear them? Will i get dependent on the glasses?As of now I can still manage without my glasses but I have to hold things at a distance to read.

Thanks

Ricky


LT Lurker 28 Sep 2015, 22:29

SC - My wife was doing the same anything upto 1.25m, although not in the supermarket.

She since, due to the blurring, has backed off using them and uses them for computer only when doing figures, reading and needlework etc.

She can see without at PC just not very comfortably- at 47 she is beginning the presbyope slide which I believe by 50 will be full blown.

It seems maybe your wife has done something very similar!

Cheers

LTL


SC 28 Sep 2015, 10:43

LT Lurker,

I think she can see OK - uses for PC 60-70cm and reading 40cm and supermarket shopping (80-100cm).

The problem with the new glasses is the blur after wearing - I assume this is because +2.5 is +1 distance + 1.5 close up - ie her eyes have to relax completely to see computer @66cm and they then don't recover immediately.


LT Lurker 25 Sep 2015, 12:52

SC When you say anything within 80cm, is that a recent occurrence from wearing the +2.50s or has your wife gradually reached that as a comfortable near point in the last few years.

Can she not see at all within that distance?


LT Lurker 25 Sep 2015, 12:52

SC When you say anything within 80cm, is that a recent occurrence from wearing the +2.50s or has your wife gradually reached that as a comfortable near point in the last few years.

Can she not see at all within that distance?


LTLurker 23 Sep 2015, 12:22

SC-That is what you read about time after time, the transition to progressives and the reliability that comes with it.

Looking back at previous posts and those who get progressives are full time in a few days!


SC 23 Sep 2015, 11:20

LT Lurker,

Yes she wears for PC & reading. I would say everything up to 80cm.

She wore glasses occasionally for long-sight from age 14 to about 21 (about the time I first met her) but stopped soon afterwards. I can't remember what the lenses were like but they were not strong so I guess less than +1.

She thinks that by the next test in 2 yrs she will have progressives - I think it may be sooner than that. I don't think that she will mind wearing for distance, eg driving, and reading - she says she has them on almost all the time at work - but I guess she'll be shocked at what happens to her vision without glasses and will not be happy with needing them full-time


LTLurker 22 Sep 2015, 21:21

SC- Sorry I meant to ask does your wife wear her specs for reading or PC as well ?


LT Lurker 22 Sep 2015, 04:03

SC, I would say my wife is right there behind yours, she has a 1.5 ADD but only + 0.25 for distance although 8 years ago age 39 she had +1.25 and +1 as a distance prescription to use for reading.

She, like your wife has said that she does not like the effect of wearing her new +1.75 readers even though she can see at some distance with them.

It's when she takes them off she does not like "everything blurry".

I tried to say this is normal, but she was not listening.

She said she didn't need them for the computer so she stopped wearing them about a month or two ago. They have been making an appearance again recently at the PC and not just for books.

I guess clear and comfortable vision is preferable, but to my wife this is at the expense of her "excellent" distance vision, which as a latent hyperope is probably true.

I think she was explained all this by first Optom who did a full and careful refraction, the second Optom just used the auto refractor which missed all her latent H and so she left "not needing glasses" despite headaches, excessive blinking, photophobia watering eyes, small pupils in fact almost all symptoms of latent H.

Finally Optom 3, stuck her on the autorefractor and gave her her latest rx.

She has never been dilated. So she is at least 1.25 which will mean full time sometime down the road. I think a gradual transition is the best way phasing in various activities until it's easier to wear or impossible to be without. 50 is 2 1/2 years away for my wife so I suspect more frequent wear by then.


LT Lurker 22 Sep 2015, 04:03

SC, I would say my wife is right there behind yours, she has a 1.5 ADD but only + 0.25 for distance although 8 years ago age 39 she had +1.25 and +1 as a distance prescription to use for reading.

She, like your wife has said that she does not like the effect of wearing her new +1.75 readers even though she can see at some distance with them.

It's when she takes them off she does not like "everything blurry".

I tried to say this is normal, but she was not listening.

She said she didn't need them for the computer so she stopped wearing them about a month or two ago. They have been making an appearance again recently at the PC and not just for books.

I guess clear and comfortable vision is preferable, but to my wife this is at the expense of her "excellent" distance vision, which as a latent hyperope is probably true.

I think she was explained all this by first Optom who did a full and careful refraction, the second Optom just used the auto refractor which missed all her latent H and so she left "not needing glasses" despite headaches, excessive blinking, photophobia watering eyes, small pupils in fact almost all symptoms of latent H.

Finally Optom 3, stuck her on the autorefractor and gave her her latest rx.

She has never been dilated. So she is at least 1.25 which will mean full time sometime down the road. I think a gradual transition is the best way phasing in various activities until it's easier to wear or impossible to be without. 50 is 2 1/2 years away for my wife so I suspect more frequent wear by then.


SC 21 Sep 2015, 03:07

Vanessa,

Wearing glasses full-time makes you feel younger than wearing reading glasses. Reading glasses are age-related as everyone knows - full-time glasses are just for people who need glasses and are not age-related.

Very few people would know that the glasses are varifocals/progressives - I certainly never noticed them in other people before I got them


SC 21 Sep 2015, 03:04

LT Lurker,

I'm not sure my wife always has a problem with TV credits, maybe just when tired, and I don't think there are any issues with driving. I think she is just holding off until she is over 50 as a target.

I've already heard that the new glasses (+2.5 reading Rx) are 'ruining her eyes' and she can't see distance afterwards. I've explained that this is because her eyes are being forced to relax and take some time to recover/squeeze the plus again when she takes them off.

I'm not bothered whether she wears glasses or not - I know that she will end up full time because +1.0 distance Rx is simply not optional long term.

I can see the advantage of not wearing - her closeup is much better than mine: +1.5 add @49, I'm +2.25 @50 so my eyes are 2-3 years 'older' than hers. The distance is no comparison - her Rx is the same as my previous Rx(+1, I'm now +1.5) and I can't focus without glasses whereas she can see fine. So not wearing plus lenses certainly preserves your vision for longer by keeping the cilliary muscles working but won't change the end game. The convenience of wearing glasses all the time rather than handing things to your husband (me) because putting reading glasses on takes too long and too much effort is not lost on her!


Val 20 Sep 2015, 05:32

Vanessa, if you don't like wearing glasses with magnifying lenses, you can talk with your eye doctor and make a glasses and contacts combination, also called GOC (Glasses over conctacts).

Your prescription:

Sphere Cylinder

L +1.75 -1.25 x 110 add +0.75

R +1.25 -1.25 x 80 add +0.75

But with a GOC combination, you can wear contacts with a prescription = sphere+add, like this:

L +2.5 (=1.75+0.75)

R +2 (=1.25+0.75)

Wearing contacts with this prescription will make your eyes virtually myopic.

Glasses prescription

L -0.75 -1.25 x 110 add +0.75

R -0.75 -1.25 x 80 add +0.75

The cylinder part remains unchanged, and you will still need an add, but will actually be 0.0 power (= -0.75+0.75)


Likelenses 19 Sep 2015, 21:46

Vanessa,

From the prescription that you stated,you definitely should have been wearing a distance prescription.

And now you need help for near also.

Welcome to the life of the bespectacled.


George1968 19 Sep 2015, 10:13

Vanessa,

You can't be forced to wear your glasses. On the other hand, not wearing them won't get away from the fact you need progressives. You also know that you can't avoid reading glasses. So, you could just get reading glasses at a drugstore and try to manage,

But, you are just punting on the real issue -- that your eyes have a number of things going on. Your eyes are straining, and need to be relaxed already. Once relaxed, you are likely to need a slightly stronger prescription near, particularly the add. Finally, you have astigmatism that affects things near and far.

Bottomline is that you can go another year or so with just reading glasses, but likely with more eyestrain and headaches as a cost. Eventually, your vision will have you surrender.

Wearing glasses is not going to make you look older. Get a stylish frame, and you will likely look more like 31. Nothing screams older than demonstrating that your arms are no longer long enough for you to see.


cutter 19 Sep 2015, 09:20

Thank you Cactus Jack!

Telling me of “build-in plus glasses” that shortsighted people are likely to have when they remove their glasses, you gave me a novel perspective to explain what my wife does, and which risk she would face if she take them off more often than the strict necessary. According to you, when she’ll squint, while wearing glasses, to focus a very close object she cannot keep farer (e.g. her hair’s ends), I’ll not suggest to take glasses on, in order to no deconditioning her crystalline and ciliary muscles faster. If I well understood, this could prevent (better: delay) the moment she will forced to adds in any circumstances.

In the meanwhile, I guess it is a “myth” what she told me, namely that even in her early twenties to focus small objects while wearing glasses (at that time glasses were less strong than her current ones), she needed to keep them at a distance that was more than the standard, say 20-25cm instead of 10-15, and that in any case she were more comfortable in removing glasses especially for prolonged very close work.

Is there any formula to calculate how the minimum focus distance of a person (with and without glasses) varies based on her sphere RX (no astigmatism)?

Thank you also for the advice to be careful in talking about varifocals with her, unless she brings up the topic on her own, to not be counter-productive. Nonetheless, after your explanation I am worrying she could become to take off her glasses even more often (especially with her new RX) , so damaging her accommodation ability sooner. Is there any symptoms I should look at to become stubborn in asking her wearing varifocals?

Finally, what should I expect if she started wearing contact lenses? Problems in close work would increase or rather diminish for her?


Soundmanpt 19 Sep 2015, 08:01

Vanessa

First of all everything "Carrie" has already told you is dead on. There is nothing wrong with looking and feeling like your 31, but you have to remember that your eyes are still 41 and they need help. And at 41 it is not at all unusual to start to not just need glasses but bifocals. However you might be surprised at how many young people in their late teens and early twenties now wear bifocals or progressives. There is little doubt the amount of time everyone is spending on so many devices with very small type as well as images has taken its toll on eyesight. But that's the world we live in now. You said the glasses you have had are about the same prescription as your new ones except for the add and you only wear them while at home. The truth is based on what you say you should have been wearing them far more often than that. If you have been driving without glasses you were putting yourself at risk as well as others because your vision without glasses is well past the limits for safe driving. The +1.75 / +1.25 isn't so bad but when you add in your astigmatisms of -1.25 for both eyes it is considerably worse. Astigmatisms blurs your vision for all distances. (the 110 and 80 means nothing to you as they are not power values) The add they prescribed you is the weakest they could go with and I am quite sure they just first want you to get used to using bifocals (progressives) so they are making the from from your distance to your near as small as possible. There is no doubt since you far from happy about needing to wear glasses full time now that you don't want a lined bifocal. If you get progressives no one will ever know unless you tell them. Your glasses will look nearly the same as your current glasses aside from a different frame. So your eyes shouldn't look any different either as only the very lower segment of your lenses will have the add. Your prescription isn't that strong to cause your eyes to look much larger than they look without glasses. Besides if you have nice eyes your glasses may even enhance your eyes and make them look even nicer. People of all ages wear plus glasses which is what your glasses are so you shouldn't look at plus glasses as something only "granny's wear. I really don't think Carrie is by any means close to being considered a granny. She is instead a very confident young woman that has no problem wearing glasses. So just pick out the perfect glasses that really suits your youngish looks and start making it a habit that when you get up in the morning the first thing you do is put your glasses on and keep them on until you to bed that night. You will be amazed at how much better your eyes are going to feel when you start doing that.

One thing when you get your progressives and start wearing them be very careful when you are going up and down steps as well as even curbs because even with the weakest add it can still cause you to see the curb or step as being closer to your face than it really is. And wearing heels only makes it worse. The best thing you can do is look straight ahead of you and don't look down. The first day or so as your eyes are adjusting to them you may even want to take them off when your on steps. But put them right back on so your eyes can continue to adjust to them.


Curt 19 Sep 2015, 07:25

Vanessa: Dont get too worked up over this. Lots of folks wear glasses, and they do not scream granny! Very, very few people can notice no-line bifocals; that's why they are so popular. You have a fair amount of astigmatism and a small distance correction...I bet you will see much better at all distances if you get this prescription made into glasses. Pick out a frame that compliments your face and give them a try for a week or two. If you don't like them, there are no glasses police that will force you to wear them. For what it's worth, I got bifocals at 27!


Carrie 19 Sep 2015, 05:28

Vanessa - I suggest you get your prescription made, go for the no line bifocals if you are worried about the line, and wear them full time. I don't think the lenses will magnify that much and anyway your eyes will be more noticeable than any small wrinkles you might have. You could get separate reading and distance glasses but putting on and taking off glasses would be more noticeable than just wearing them all the time.

You might look 31 but your eyes aren't and they can't take the strain anymore. You will very quickly notice the benefit of the distance part of the prescription especially with the astigmatism correction (did you have that in your previous prescription? If you did I'm surprised you're not already wearing glasses full time.). Your vision will be very clear and your eyes won't feel tired at the end of the day.

If you choose a stylish frame you can still look 10 years younger.

I'm about 20 years younger than you but my prescription is stronger than yours L+2.50 -0.25 and R+3.00 -0.25 and I need them all the time. I need them because I am long sighted (hyperopic) rather than age related (presbyopic). I think your need for new glasses is a bit of both. If people ask about your glasses you can say you've had glasses for ages but your eyes have got a little worse which is why you need them all the time. This is perfectly true and you don't have to even mention they are bifocals/varifocals. You never know some of your glasses wearing friends and colleagues that are around your age might also be wearing varifocals and you didn't realise. Actually it's not uncommon for younger people to need bifocals - it's not just an age thing. My cousin is a bit younger than me and her prescription is a bit stronger than mine and at her last eyetest she was told she was on the virge of needing bifocals. If you look on YouTube you will find videos of girls much younger than you that have had to get bifocals.

If, or more likely when, I need bifocals I will get varifocals so there is a gradual change from the distance part to the reading part.


Vanessa 19 Sep 2015, 03:03

Today is not a good day. I went for a eye test because they don't make phones any bigger that a iPhone 6 plus. I have held off wearing glass as long as I could but I think it is becoming noticeable to people that I need glasses. I am 41 years old and take a lot of pride in maintaining my youthful appearance. I would like to think I look 31. I got the shock of all shocks today....Bifocals!!! I have always had glasses but would only use them at home. I managed at work where I use a computer for 3-4 hours a day. My eyes have been taking a little bit of strain but my vanity has always won. I do not know what my old rx was but my new is L +1.75.-1.25 x 110 add +0.75 R+1.25 -1.25 x 80 add +0.75. I immediately asked about contact lenses options but was told that it would be best to get used to the new bifocal glasses as this can take a while and come back in a few months time as there are a lot of things happening in my prescription. I do not consider myself having that bad eyes. I can see a lot better than my husband who wears contacts of -1.25 and -0.75 although he is a bit dramatic over his bad vision. I have always avoided glasses as they magnify my eyes and any fine wrinkles I have around them. The glasses are the basically the same strength as my previous pair except that there is the extra reading strength. Will this noticeably magnify my wrinkles. I have not committed to buying the glasses yet. It is obviously not a option to go with the bifocals with the line, but will the no line type be visible to anybody. I guess this is all kind of pointless because line or no line wearing glasses that look like reading glasses all the time just screams granny all over it. Is it really going to be necessary for me to wear these glasses most of the time or is am still going to be able to manage without them. Bifocals seems like the end of the line for me.....and I'm only 41!!!!


Kris 18 Sep 2015, 18:48

Thanks Cactus,

I find the prism works well for me and have been reading a lot more since using them, as it turns out eyestrain was a side effect of the my esotropia I hadn't appreciated. I don't know why, but I find that I have more issues with near vision with my progressive lenses (hard to make out fine print) but not with my readers (even though my prescription for the near portion of my progressives is 0.75 dioptres higher than my readers).

I have been attending a conference for the last few days (lots of listening and staring at powerpoint presentations in medium to large rooms) and, for the first time since going full-time with prisms, I slipped into double vision and could not regain fusion until I left the presentation. Presentations have always been the most problematic for my double vision and are the test for how well the prisms are working. I hope it's just fatigue and not a sign I'm going to need more prism. I'm not going to worry too much and hope it goes away.

Your analogy about vision and the open loop servo system is an interesting one and I certainly notice that both relaxing too much and focusing too hard can lead to double vision. It's like I have a visual sweet spot that I have to stay in to avoid diplopia. With the prism, it's like that sweet spot is bigger than without prism, but it still has it's limits. My insurerer will pay for new glasses and lenses next year and my plan it to get my eyes retested then so that I can get a second pair of glasses. My hope is that things remain stable in the interim.


Cactus Jack 17 Sep 2015, 18:49

Kris,

I apologize for taking so long to get back to you. I missed your question about prism on my first reading.

What you are experiencing seems to be typical and similar to what I have experienced. Often, the amount of prism you need is affected by three things. Fatigue, focusing effort, and the amount of separation of the two images.

The eye positioning system, which controls the 3 muscle pairs on each eye, is very similar to what an engineer would call an Open Loop Servo System. Unlike a Closed Loop Servo System, such as you find on a Computer Controlled Milling Machine where the control computer knows EXACTLY where the tool is with extreme precision and even the size of the tool. The Eye Positioning System (EPS) only knows generally where the eyes are pointing (eyes closed) and it must depend on the relative displacement of the two images, delivered to the Visual Cortex, to have any idea where the eyes are pointing and direct the eye positioning muscles to bring the images together and fuse them. If there is too much separation and I try to fuse the images, the EPS will often make the wrong decision and move the images farther apart.

To complicate matters, there is a connection between the Focus Control System and the EPS so that focusing effort causes the eyes to converge. This is particularly problematic for people with uncorrected Hyperopia because the effort to focus distant images will trigger the convergence response and cause their eyes to turn inward. The strength of this connection varies with individuals and the convergence response can often be overcome by concentration and training.

Fatigue is often the big variable because it often requires continuous effort to overcome the convergence and you get tired of doing that and tired after a long day.

Sometimes, when I am well rested, I can fuse images without prism help. But most of the time, I wake up seeing double and can solve the problem with 7/7 BO for most of the day. On rare occasions, when it is very late and I am very tired, I can't keep the images fused at all, with my highest prism glasses, a combination which is an effective 32/32 BO. That is a serious clue to turn off the light and go to sleep. It will be better tomorrow.

Everyone is different and your hyperopia is a factor. The idea is to have comfortable vision under all conditions. My suggestion is to wear the lowest amount of prism you can that helps you keep the images fused with the least conscious effort on your part and don't worry about it.

I am very happy to hear that 4/4 BO is working for you. It may need to increase a bit later, but remember all you have to do is get the images in range where the EPS can do its job, you probably don't need full prism correction, all the time.

BTW, one of the things that drives me nuts is to look at a pattern that repeats, horizontally. I have some wall paper that has a repeating pattern of symbols about 4 inches (10 cm) apart that I try to avoid looking at. I can be doing fine with my 7/7 BO, but if I look at the wall paper when I am tired, my eyes will break fusion and start converging with out stopping until it would require the 32/32 BO to fuse the image. It is very disconcerting. Replacing that wallpaper is very high on my to do list. I am tired of it anyway.

C.


LT Lurker 17 Sep 2015, 17:50

SC,Your post was very interesting, concerning your wife and her slower need for dependency than yourself.

Has your wife had difficulty for a while with the TV credits?

Also how I wonder how is your wife's vision for say driving at night?

From what I have read recently it seems that there can be a considerable amount of accommodative tone still in play quite late into the 40s and even early 50s masking some quite significant latent hyperopia.

This is evidenced by the work of Finnish ophthalmologist Kaisu Viikari, who has through her long career documented many cases to support this.


Cactus Jack 17 Sep 2015, 14:25

cutter,

Your wife is already wearing Reading Glasses. They are very strong and they are built in. All people who are myopic have built in reading glasses. In your wife's case, the reading glasses are for reading at about 14-15 cm. When she reads at that distance without her regular glasses, the text will appear to be very large and clear.

When she is wearing her glasses, they corrects her vision so that ideally her focus distance is 'infinity' or, as a more practical number, about 6 meters or 20 feet. An ADD would be like wearing glasses with less MINUS.

When she reads or focuses close without her glasses, it is very likely that her Ciliary Muscles and Crystalline Lenses are fully relaxed. The effect of doing that is the same as wearing strong reading glasses, which tend to de-condition the Ciliary Muscles and make it more likely that she will loose her ability to focus without external help, sooner.

You need to be very careful about discussing this with your wife. It is counter-productive and will get you in trouble. It is very likely that her mind is made up and you should not try to confuse her with the facts. She is probably not interested.

C.


cutter 16 Sep 2015, 10:25

@Cactus Jack

Thus, according to your experience, my shortsighted wife should move to adds, or bi-/multi-focals, or any other stuffs that help her for close work, isn't it?

This is exactly what I told her, but she believes I am exaggerating: "For very close vision, I have ever seen better without glasses, even when I was 20!" she said: "And now in 99% of cases I am still comfortable with my glasses on, with no true need to take them off".

What can I do in the next months to delicately monitor her acuity over time, without explicitly hint at presbyopia? Do you have any triks to suggest me?

Probably, she is also worried that, moving to bifocals, her eyes would relax faster so making her more and more dependent from adds, until the point in few years she would not able to see well even bareeyed (when she stays at bed she usually check the smartphone without glasses for minutes).

Is this a possibility for a myope (LE -6.50 RE -7.00), as she is?


Cactus Jack 15 Sep 2015, 20:21

cutter,

Presbyopia is gradually creeping up on her. The idea that a person does not need focusing help until 40 is a myth. It varies with the individual. As with almost anything else related to the body, your genes and your visual environment have a lot to do with when you need focusing help.

Presbyopia actually starts in childhood, but typically does not become noticeable until the mid to late 30s. There is an interesting phenomenon, people who need + glasses often need focusing help at an earlier age than people who need - glasses, but that is NOT a hard and fast rule.

Unfortunately, many Eye Care Professionals believe the myth and won't suggest bifocals, particularly for women, until well after 40, because of vanity issues.

Suggest that she try some Over-the-Counter reading glasses over her regular glasses and see if that makes any difference.

C.


cutter 15 Sep 2015, 15:17

My 36 y.o. wife wears minus glasses since childhood. She is in the range of -6.50 with no astigmatism, still needing small increases (an additional -0.25 or -0.50) every 2-3 years.

Recently, I have noticed some symptoms of her troubles in close view:

- when she tries to focus on a very close object (e.g. her humerous) she looks under the glasses and often winks eyes and wrinkles her nose

- her best reading distance for smallest fonts (e.g. the power of a phone charger as written on it) is not less than 25 centimeters

- when we hugs and I ask her to look in my eyes, she must move her head 10 centimeters behind to focus me

Are these starting symptoms of a need for by-/multi-focals?

She is not worried about them as they have (supposedly) characterized her whole glasses wearer's life. Actually in her last eye check, the doctor told her there is no need for byfocals without checking her close acuity.

But I am not so sure, especially now that she is going to use more powerful minus glasses (around -7). What is it happening? At which age, for Mediterranean persons with her RX, byfocals are typically required?


Kris 01 Sep 2015, 18:36

It's been a couple of months since I started wearing prism lenses (4 bo each eye) and I can say that my vision is much more comfortable in them than without. As I've said before, I was really reluctant to do this, but part of me now wishes I'd stopped denying my problems with double vision earlier. Initially, I had issues with things looking rhomboid rather than square when using the near part of my prescription, but that is no longer noticeable. Although, if I try, I can see double it no longer automatically happens if I relax my eyes. It is very rare that I see double now.

The downside of wearing prism is the fact that I had to give up contacts (definitely not a surprise to me or anyone on this site). As well, I noticed that my eye pulled inwards with the glasses off and I could even feel it turning in with my eyes closed. My right eye used to turn in only when I was trying to focus on something near when I took my glasses off but now almost always turns in as soon as my glasses come off.

I repeated Cactus Jack's prism test recently and using an old pair of glasses without prism the deviation between images was 110-115 cm at a distance of 3m. Under the same conditions before I started wearing prism the deviation was around 70-75 cm. I was surprised (and a little alarmed) at the difference. Deviation with the prism is about 65-70 cm. I don't like this. This is almost the same deviation I had before I started wearing prism although I was much more symptomatic at that time. Is this normal to see more deviation once prisms are prescribed? So far I'm nor showing any signs that I need more and this may be all I need right?


Cactus Jack 01 Sep 2015, 17:15

SC,

Your wife has a prescription for Bifocals or Progressives. The +1.00 is for distance and the +1.50 Add is to help focus closer for reading or using the computer. She has a bit of Hyperopia and also some Presbyopia.

If she does not want to get Bifocals or Progressives right now, she may be able to get by with some +1.00 Over the Counter (OTC) "readers" for distance and some +2.50 OTC "readers" for closer focusing. The +1.00 for distance is probably pretty stable, but may increase slightly to say +1.25 or +1.50. It is likely that the close-up readers will need to increase up to +3.50 or maybe a little higher, depend on how close she needs to focus. It is all normal as we get older, but don't be too surprised if Vanity and Denial rear their heads. That is normal too.

C.


SC 01 Sep 2015, 11:31

My wife pickup up her new glasses last week. She now has +2.5 readers.

I was surprised when I saw her prescription card saying she was now +1 add 1.5 in both eyes. I asked whether they had mentioned wearing glasses for distance and she said no but she is expecting to next time (2 years). I know she seems to struggle with the credits at the end of TV programmes (fuzzy) but other than that I assume distance is OK.

She's 49 and has worn readers for the last 4 years - has always had a distance prescription of +0.5 but never filled it.

Interesting that when my distance Rx was +1 I was already completely dependent


delighted 27 Aug 2015, 04:39

Today I was informed to bring in my glasses in order to replace the old +1.75dpt lenses with the new progressive ones. Of course I did and for the last two hours since I picked them up again I'm in awe.

They're fantastic. I didn't even notice the add until I sat down and consciously read a newspaper. There I can notice that if I don't look straight enough through the lenses there is some slight distortion. But if I look at the computer screen the corridor or whatever you want to call this is just about as wide as a A4 format, I can read an open doc on the computer and have no distortion if I look straight.

Looking at distance with the +2.25dpt segment is still a bit foggy. I need a few seconds until things at far clear up. But up close everything is crystal clear. I think that the additional +0.75dpt for up-close were absolutely necessary. If I make the math I'm also a bit surprised (not really, but I don't find any other word for it). Up close basically I'm a +3.00dpt now. That is rather strong for my age, I'd say (36). But since I'm a natural hyperope no real surprise there.

I do feel though that something is happening in/behind/around my eyes - it feels like my muscles already started to let go, they are relaxing (they might not want to, but what choice do they have, hehehehe).

What I notice most is that if I take my glasses of everything is out of focus. That was not the case before, at least not to that extent.

Also, if I look at my reflection in the mirror I notice my eyes now being a lot more magnified. There is a noticable cut-out which is wider at the bottom of the glasses. I don't mind it at all. I actually think it makes me more handsome :-) but also more vulnerable/soft.

I haven't worn my glasses full time before, I wore them most of the time. I think this has changed now. I don't think that I will be able to see without my glasses once my eyes have settled in and have grown accustomed to the stronger prescription. I'll give an update in a week's time if you're interested.

Best regards,

delighted


delighted 21 Aug 2015, 07:26

Funny how life goes. I had always wanted to wear glasses, eventually got a pair prescribed years ago for mild hyperopia. Over the years I had a few small increases and got stuck at +1.75dpt with some astigmatism appr. half a year ago. Back then the ecp told me that he would prescribe me +0.25dpt extra (+0.25 stronger than my actual prescription) because I had told him that my eyes felt tired during work and while reading.

Apparently the extra +0.25 set something in motion. Today I went back because my eyes felt tired and guess what: I was prescribed an increase of +0.5dpt. So now I'll be at +2.25dpt, lucky me, love it. But not enough, I thought that I would also mention that I happended to fall asleep while reading recently so the ecp suggested an extra +0.75 dpt for reading - thus my first varifocals! I could not be happier. I had not even thought about needing an add. He told me that he'll order the new lenses and will give me a call to replace my existing +1.75dpt with the new lenses next week. I'm so excited. It already felt great to have the +2.25dpt in the trial frame and the +0.75dpt for close up. I wonder how it will be when I can collect the glasses and put them on for the first time. I'm 36 years old by the way. I certainly hope that my rx will increase a bit more over time. But I just had to share the news with people who can probably appreciate and imagine how happy I feel right now. I can hardly wait until the ecp calls me to bring in my current glasses. He told me that it'll take about an hour to grind the new lenses into the frame once the lenses have arrived. Happy weekend


miku 08 Aug 2015, 04:56

I am 23, svensont. And I live in the UK


svensont 08 Aug 2015, 03:46

Miku, what is your age and where are you from?


miku 08 Aug 2015, 01:33

Hi all,

I've been wearing my glasses mostly full-time for about a month now. It is fascinating how I have adapted to them and how clear they make things now. The only annoying thing is that I cannot go around without having them, anymore. Quite frustrating at times, knowing that a month ago I was able to read and drive without them.

M


Owlish 20 Jul 2015, 03:45

Cactus Jack, I just need to send some appreciation your way for the wonderfully clear explanation you just gave to Jonathan and for all the teaching you have given to so many people here over the years. I think we all learn from your posts as I certainly have so, keep up the great work CJ! and thanks.


Jonathan 19 Jul 2015, 18:33

Thanks Cactus for the explanation. I have been wearing readers since I was 43. Had my eyes checked about 3 months ago and was increased from +1.25 to +1.50 readers. Thought it was interesting, and a little baffling, that my son and I now wear the same prescription. I do understand that presbyopia will continue to march forward and that stronger glasses are on the way. Much appreciate the good explanation.


Cactus Jack 19 Jul 2015, 06:08

Jonathan,

Welcome to the mysterious world of Vision. Your son has hyperopia and you have Presbyopia. Two different problems with two different causes, but the same solution.

Hyperopia or farsightedness or long sightedness is typically caused by a mismatch between the length of the eyeball and the total PLUS power of the eye's lens system. Your son's eyeballs are about 0.5 mm too short for distant objects to focus properly on the retina. Of all the refractive errors, hyperopia is the ONLY one that can be corrected internally by use of a persons ciliary muscles (focus muscles) and crystalline lenses. However, that means that the eye's focus muscles have to do extra work to see clearly in the distance, work even harder to focus close to read, and word still harder to read the tiny text on a smartphone or tablet. That extra work often means headaches and extra fatigue.

It is also possible that he may have a bit of Latent or Hidden Hyperopia where the eye muscles have become so used to having to focus to see clearly in the distance that it take weeks or months to relax fully. That means that in a few months he may need glasses with a bit more PLUS in them to see comfortably at all distances. Be aware that this can happen and don't be reluctant to have him return to his Eye Care Professional (ECP)before the suggested time for a re-check. Many ECPs offer to remake glasses if a prescription changes within a certain time period at reduced cost.

You have Presbyopia, literally "Old Eyes" where your crystalline lenses have gradually become so stiff that your ciliary muscles can no longer make them focus at close distances. Your distance vision is apparently pretty close to what is called "normal" or 20/20 or 6/6 depending on where you live. That means that the length of your eyeballs are pretty close to "just right" for distance vision.

The amount of extra plus you need to focus at any distance closer than about 6 meters or 20 feet is easily calculated by using a formula developed by Sir Isaac Newto, of gravity fame, around 1700. The formula states that

Focal Distance = 1 meter or 100 cm or 39.37 inches divided by lens power in diopters

In other words to focus at a reading distance of 40 cm or 16 inches, you need an extra +2.50. The fact that you can read at 40 cm with +1.50 reading glasses means that your ciliary muscles and crystalline lenses can still provide +1.00 to read, but I can almost assure you that that will change. Before long you will probably need +2.00, +2.50, or even a bit stronger, depending on how close you like to read. Rest assured that it will probably never exceed +3.50 unless you need to do extremely close work like watch repair.

I hope this helps. It may seem a bit complex, but it is all normal and not in the least surprising. You may be able to get along OK with Over-the-Counter reading glasses, but you should strongly consider an eye exam to make sure that all is well otherwise. Many apparently unrelated health problems are discovered during eye exams. Many are "silent killers" that if caught early are easily managed.

If you have more questions, please ask.

C.


Jonathan 19 Jul 2015, 04:51

A question about farsightedness. My 17-year old son was complaining about his eyes and vision, so we took him for an eye appointment. It turns put that he is farsighted and needs to wear glasses full-time. Each eye is +1.50. He is slowly getting used to wearing the glasses. Interestingly enough, his prescription is the same as the prescription of my reading glasses. He is 17---I am 45--but he is able to see clearly at a distance with the glasses----I can only see close-up with the +1.50.


Kris 11 Jul 2015, 21:22

I have been wearing my new prism prescription for a couple of days and it is definitely an improvement. It is much easier to maintain single vision. I occasionally see double, but it quickly corrects back to single vision without effort. I needed a couple of days to adapt to the prescription and still find that I get a little thrown if I move my head too quickly. One thing I noticed is that when I looked at square objects through the near vision part of my lenses, they could look rhomboid, but that is starting to settle. I am struggling a bit with finding the sweet spot in the near vision portion of the lenses, but expect that that will improve too.

The outer ends of the lenses are thicker than I expected. I wear plastic frames and the lenses are thicker than the frames. They are by no means huge but I don't like the idea of the prism being really noticeable, especially if I have to go up any more in the prescription. I hope it won't limit the types of frames I can wear.

I tried for a long time to avoid using prisms, and am still getting used to the idea that I am now in them (probably for life, but we'll see what the ophthalmologist has to say). I am still getting used to the idea that I can no longer consider using contacts (although with the deterioration in my near vision in the last year, they weren't as convenient as they used to be). I am going to try to wear contacts again, more out of curiosity of what I will experience than any other reason. I have noticed an improvement in eyestrain and I am reading more since using prism. I still get eyestrain but not nearly as bad.

Since going full time with prism my right eye (the weaker one) waters a lot, especially at night . I can feel it pulling in when my glasses are off, even with my eyes closed. It feels a little like the eye muscles are resetting themselves with the prism. I find it automatically turns in as soon as I take my glasses off, whereas before it would stay straight as long as I didn't try to focus my eyes. I don't like that my eye turning in is almost automatic now when I don't have glasses on, and it turns in enough to be noticeable to others. With glasses though it's not noticeable. I am hopeful that with my current prescription I will be good for awhile and I will now have some time to get used to the whole prism thing. I'm realizing I had more issues with double vision than I was willing to acknowledge and it was definitely impacting my daily life. I don't love having to wear prism and was very reluctant to acknowledge to my ECP that I was having issues (chose not to mention it at the last couple of eye exams I had) but appreciate that they are helpful to me. For whatever reason I've struggled more with this than having to wear progressives.


Carlos, Jr 08 Jul 2015, 10:20

New Bifocals, how are you doing with your new glasses? Wearing them full-time? Join the crowd---I also went to the eye doctor for reading glasses and was told that I had farsightedness, in addition to the presbyopia. Went from no glasses to full-time wear. It happens.


Soundmanpt 04 Jul 2015, 14:36

Kris

Good to hear back from you and tanks for the update. I know you said that it could be a couple weeks before your new lenses come in so there not late. And as long as they didn't need to take your glasses form you and you at least have them to wear they are still better than not having any glasses with prisms in them. But you can tell that the prisms need to be more when your talking with someone and start to lose focus or your straining to hold single vision. Needless to say forcing your eyes like that is a big part why you and your eyes feel tired. I'm not sure why your bothering with your old glasses that don't have prisms anymore? One thing I know you found out is that your eyes need the prisms and they can't really function very well without it anymore. This is the same thing with your contacts. I know you hate to give them up but if thing are blurry now when you try and wear them your eyes aren't going to be very comfortable anyway. But you played tennis wearing your glasses. I'm guessing that was a first time for you to wear glasses playing tennis considering that was a concern for you if you couldn't wear contacts anymore. Well now you know you can indeed play tennis ant wear glasses and I am guessing you did rather well playing? It really helps that your much more sued to having your glasses on now which means it is easier to do things now wearing glasses than it used to be. Tennis is a visual sport that requires very good hand/eye coordination and even with wearing glasses for the first time and playing tennis you must have very good hand/eye coordination? But now that your not likely to be buying anymore contacts as soon as you see that everything is good when your new lenses come in you probably would find getting a pair of glasses, I suggest on line, in single vision for tennis and other things where you don't need close vision. There was probably several times while you were playing tennis that your eyes happened to focus through the add segment of your glasses and of course that would be cause for you to misjudge exactly where the ball is. Zenni odes offer glasses with prisms up to I believe 5 for an added $9.00. So you good get nice sturdy glasses, for sports, for under $30.00.

There is no way anyone can tell if this change in your glasses will be the last one for a long time or not. But you know the prisms in your glasses now isn't enough and wasn't from day one. But for sure with the new lenses it should be enough that you won't be forcing your eyes to hold focus. And that alone should make your glasses even more comfortable than thye already are.


Kris 04 Jul 2015, 13:22

I'm still waiting for my new prism lenses to come in, but they should be here any day now. I've questioned whether or not I needed to go up on the prism so soon after starting to wear them as, for the most part, I've been pretty comfortable in my current lenses with 2 BO each eye. However, I've noticed that when I'm talking to someone for a long period of time I start to have issues staying focused on them and start to have troubles with blurring. I also noticed that when my eyes were tired, I struggled to maintain single vision. I've tried wearing my old glasses without prism to keep my eye muscles working, but find it uncomfortable and am not sure I understand the point if I'm going to be a full-time prism wearer. Does not using prism really keep the eye muscles strengthened or does it just lead to more eyestrain?

I think I've given up on contacts. I find that I can't wait to change back into my glasses and was taking out my lenses as soon as my game was over, whereas before I would be comfortable in them post-game (as long as I didn't have to read). I don't get instant double vision like others have described, but find my vision blurrier than before I started with prism. I wore my glasses to my game this week and didn't find it as awkward as I expected to play wearing glasses vs contacts. I am looking forward to getting my new lenses and hope that I will have comfortable vision for a long time with the new prism.


miku 03 Jul 2015, 11:51

Hi Cactus Jack,

This particular pair that I've been wearing is around +1.00/+1.25 (RIGHT) and +1.75 (LEFT).

I've kept comparing images with/without glasses and I can tell the difference. But as I woke up this morning, my vision was nice and crisp again with no correction!


Cactus Jack 03 Jul 2015, 11:33

Hi Julian,

I thought it had been posted, but I was not sure exactly where and was too lazy to look very hard. I wanted to be sure and give you credit for the original work in compiling the posts. All I did was a little editing.

It was fun to read it again. History continues to repeat itself when Presbyopia creeps up on Latent Hyperopes and they discover how their vision really works. Hopefully, they can face the trials and tribulations of correcting Latent Hyperopia with the same good humor Macrae did.

C.


Julian 03 Jul 2015, 11:05

Cactus: Macrae's story was already on Vision & Spex where I posted it in 2013. As it's quite a big file and your editing makes it easier to read I'm going to delete the old one.


Cactus Jack 03 Jul 2015, 11:04

Miku,

What is your prescription?

C.


miku 03 Jul 2015, 09:53

Hi all,

I finally started to wear my glasses every day after work. That makes for some good 5-7 hours of more or less full-time correction.

It's an awesome feeling! I'm curious to follow the de-conditioning of my ciliary muscles.


Cactus Cack 02 Jul 2015, 12:51

New Bifocal,

It is on the Fantasy and True Stories thread.

C.


Cactus Jack 02 Jul 2015, 12:48

New Bifocal,

Vanity is often an issue with new glasses wearers or glasses wearers who have a significant change in their correction needs.

Some years ago, one of our members, Macrae, wrote a series of about 50 very well written and often humorous posts about his experiences with having to get glasses and then progressives at 40. Julian compiled the posts into "Macrae's Story". The series of posts is too long for posting here. I have edited the story slightly and posted it on the Vision and Spex site.

http://www.vision-and-spex.com/

I hope you find it enjoyable and helpful.

C.


Veteran progressive wearer 02 Jul 2015, 10:18

Actually, the best advice I was given for adjusting to progressive lenses is to point your nose where you want to see. It really works!


Soundmanpt 02 Jul 2015, 09:52

New Bifocals

So I am guessing that your quite shocked when you went for your eye exam that you needed bifocals? Since you felt that you still had good vision what prompted you to get your eyes examined since you had only been wearing OTC readers for a while without any problem? Am I right in thinking that you only wore your OTC readers for close things such as reading and not for distance? The next surprise must have been when it was suggested to you that you needed to wear your new bifocals full time because you have a rather strong prescription? Then even making a point that you shouldn't be driving without glasses now. Based on your prescription I have to agree with what they told you. You have quite a good bit of astigmatisms in both eyes. Astigmatisms effects your vision for all distances so I am sure once your eyes adjust to your glasses your going to be surprised at how much better your distance is going to be as well as your close vision. I am in total agreement with Cactus Jack that at first your distance with your new glasses is going to take some getting used to and you will probably find your distance to be somewhat blurry at first. This very normal considering your prescription. Besides the blur you likely may feel like the floor is moving and the room is spinning and a headache could also be in the offering at first. Probably not what you wanted to hear but at least if you know ahead of time it may help you. But just as Cactus Jack said you just have to make a point of as soon as you open your eyes each morning you put you glasses on and don't take them off until your going to bed for the night. Trying to adjust to them by only wearing them a short time each day is not the answer and will take much too long. You will be surprised at how fast your eyes will become more and more comfortable wearing your glasses and the blur will soon be gone and your vision will be perfect with your glasses at all distances. You didn't say if your getting lined bifocals or progressives but either one is about the same idea. The first thing your going to have to learn is that when you want to read something you will need to look through the bottom segment of your glasses. So you need to learn to move your eyes down and not your head. And of course when your looking at something in the distance you should be able to look straight ahead and see perfect that way. You don't need or want to tilt your back to look at something through the lower segment of your glasses. The first few days after getting your glasses and your needing to drive somewhere you may need to decide if your eyes have adjusted well enough to leave them on to drive or if you feel your able to see better without your glasses still. That all depends on how fast your eyes adjust to them. Of course it would be best if your able to keep them on for driving as long as the blur is gone or nearly gone. Lastly you need to be extremely careful on curbs and steps. Many people new to bifocals have taken some nasty falls because they misjudged where the steps were. Going up or down steps you don't ant ever look down jsut straight ahead of you and you'll be fine. Of course high heels makes it even more of a danger.

Come back after you get your bifocals and let us know how it is going.


New Bifocal 02 Jul 2015, 03:02

Cactus, I guess I really do not have a choice.......I ll need glasses to drive as well as to read. Remember being so fearful that i would need them as a school student.........and it has finally come to fruition!


New Bifocal 02 Jul 2015, 03:02

Cactus, I guess I really do not have a choice.......I ll need glasses to drive as well as to read. Remember being so fearful that i would need them as a school student.........and it has finally come to fruition!


Cactus Jack 30 Jun 2015, 15:18

New Bifocals,

Welcome to to the "club". The best thing to do is just "bite the bullet" get the glasses and wear them. Almost every person on the planet goes through this process, eventually. In a few weeks, you will wonder why you waited so long to do something that is essentially no different than getting a new pair of more comfortable shoes or a tool to make your work easier and more productive.

C.


new bifocals 30 Jun 2015, 15:08

i am 55. was always fearful of needing glasses, so might be difficult to get used to. There is definitely difference in vision, but seemed to be going along quite fine with the otc readers


Cactus Jack 30 Jun 2015, 14:23

New Bifocals,

Your experience is typical of a person with low Hyperopia. It is possible that you also have some hidden or what is called Latent Hyperopia. If so you may need a small prescription increase in a few months.

You may experience some initial burring of your distance vision that should clear up very quickly. The best way to get used to the new prescription is to wear your glasses full time from the time you wake until you go to bed. In about two weeks you will not notice them, until you take them off. Expect some comments from friends and family for a few days, but by then everyone will be used to your wearing glasses all the time. From then on, people will only notice frame changes.

May I ask your age?

C.


new bifocals 30 Jun 2015, 14:10

have only worn OTC readers.........always thought i had good vision and went for an exam and dr. gave me

+1.50 -1.00 axis 97 add +2.00

+1.50 - 1.25 axis 85 add +2.00

She said i should wear full time and that this was a fairly strong prescription. Also that I should probably not drive without them. I was usiong +2.00 readers and thought all was fine. Any comments on this and how long it will take me to get used to new glasses?


new bifocals 30 Jun 2015, 14:09

have only worn OTC readers.........always thought i had good vision and went for an exam and dr. gave me

+1.50 -1.00 axis 97 add +2.00

+1.50 - 1.25 axis 85 add +2.00

She said i should wear full time and that this was a fairly strong prescription. Also that I should probably not drive without them. I was usiong +2.00 readers and thought all was fine. Any comments on this and how long it will take me to get used to new glasses?


Weirdeyes 28 Jun 2015, 22:22

I've been experiencing some eyestrain headaches and fluctuating vision. My glasses used to be +1.75, but they were too strong and they were changed to +1.25. Recently they were changed again to +1.00 with 1.5 base in prism, but he added a separate reading prescription that is +2.00 with prism(don't know the number).

At the moment I manage my eyestrain by wearing my +1.25 glasses when I'm going out and want good distance vision and my +1.75 glasses at home. I also get headaches from the +1.25 glasses once in a while. That is usually fixed by wearing my stronger glasses.

Should I bother filling out my add? I'm only nineteen and I still live with parents. It would be kind of nice to have reading glasses for when I have a headache, but they'll probably be very thick.


sarag 28 Jun 2015, 14:51

June 2012 prescription:

OD Plano

OS +.25 -.75 55

March 2013 prescription:

OD -.25 -.25 120

OS +.25 -1.00 55

ADD 1.00 (first add)

Distance has stayed about the same, but the add has gone up to 1.50 in 2014 and 1.75 this spring.

This week, after a minor cold all week, but plenty of sleep, I find myself searching for the very bottom of the add in my progressives. I'm sure I'd be happy with a 2.00 add or maybe even a bit more. Things are blurred but readable without correction still, but I'm not sure how readable they will be by next year. My near vision is always worse when sick, but usually a precursor of things to come. Hopefully I can be back to full health and my usual add needs soon.

I just ordered a slightly higher pair of reading glasses to enjoy next time I'm sick, or in a few months when my need for add is higher.

I appreciate all those who share here and though I'd give a quick update myself.


Kris  23 Jun 2015, 17:37

Prismatic and Soundmanpt,

My ECP is not charging me with the replacement. I am replacing my progressives. I will still have my readers with 2 prism (which I think will be fine for the time being). My ECP had suggested I try a distance only lens, but I didn't see the point as I am constantly switching between distance and close work and it didn't seem practical or necessary to have another pair of glasses. I should get them end of next week or the week after.

I am looking forward to having more comfortable vision, but am worried I set my expectations too high. I never expected to not have double vision, but did expect it would be easier to maintain single vision. I tried hard to avoid this, but based on what my apparent prism need is guess that there was no way I was not going to end up having prism. I'm optimistic that the new lenses will hold me for awhile as it sounds like things do stabilize once you hit on the right amount of prism.


Prismatic 23 Jun 2015, 11:43

Hi Kris,

What you are describing seems like normal progression into the world of prism. I think ECP's are reluctant to go down the prism road and they want you to know that there is no return so you don't come back to them complaining that they didn't warn you. With that said, if your eyes need prism, they need it. Clearly having additional prism in your lenses showed increased comfort. A normal eye would reject that much prism, instead you accepted it. As far as needing more down the road, the answer is probably. I started at 1.5 per eye, went back after 1 month because I didn't feel it was enough and was bumped to 2.5 per eye. I am now at 3.5 per eye and seem stable. I can still separate images with prism but it is definitely easier to maintain with than without. I was told I could handle as much as 6-7 per eye (12-14 total). I think the answer for how much they tend to give you is the least amount to keep the symptoms away, but they also want you happy and able to function. You were right to go back and have a re-evaluation. You might as well not have to pay for new lenses again if you feel that you need a change and they will remake them within a certain amount of time. Did you get progressives with prism or did you stick with just a separate distance and reading pair?


Soundmanpt 23 Jun 2015, 09:33

Kris

It seems to me that your ECP is doing a very good job of working with you and taking good care of your eyes. And your input is certainly a help as well. Increasing the prisms to 4 BO is exactly what I thought would happen. It is always best to too little than too much. If you had continued to wear the 2 BO I think you would have found that it would get harder and harder for your eyes to stay focused with one image and not drift into double vision if you relaxed your eyes at all. I doubt that very many ever find the first try with prisms so good that it lasts for several years.

You didn't say but should I assume that there was no charge for making the change in your glasses? When will you get the new lenses put into your glasses? You should be excited to see if your going to be able to relax your eyes without them seeing double. Of course do let us know when you get them.


Kris  22 Jun 2015, 14:22

I called my ECP this morning and was able to get in to see him today. I explained that I still have eyestrain and that I feel like I am working to not see double. He was reluctant to change my prescription, but did some testing to see if I needed a change. He had me stare at the letter chart and tried a lens in front of one eye to see if I felt any improvement. As I stared at the letters I did find that they would start to move apart and I had to work to not see double. The lens he tried seemed to help, but not by a lot.

My ECP tried to say that he thought I may be just getting used to using my right eye again, but I really didn't think that was what I was experiencing. I know I've been using my right eye more since wearing glasses and the symptoms I had before getting prism improved with the prism but weren't resolved. He tried two different lenses in front of my eyes to see which one was better. One seemed much more comfortable (turned out to be the higher of the two prisms he was trying) and I seemed to be able to maintain single vision without a lot of extra effort. Based on this my ECP is ordering new lenses with 4 BO each eye.

Based on what people have written about their experiences, I thought the 2 BO would help for a few years before needing an increase, so am surprised that I've needed a change right away. I'm hoping the current script will remain stable for awhile. If all goes well, I plan on ordering some single vision lenses for sports. I was able to wear contacts last week, but if I'm honest, I couldn't wait to take them out and start wearing glasses again which doesn't bode well for being able to continue wear them.

Part of me wonders if I should have tried with the 2 BO for longer before seeing my ECP, but I really didn't think the discomfort I was having was going to improve and want to feel comfortable. Should I have waited? I understand that I need to still engage my eye muscles, and know there is a balance between relying on prism and working the muscles. One of the strange things I've noticed about these eye exams is that, event with only using prism for a few minutes during the exam, I seem to be more uncomfortable for the rest of the day.


Soundmanpt 21 Jun 2015, 03:32

Kris

Well clearly the idea of going full time with your prism glasses is the best for your eyes. I'm sure he probably went with just a small amount to see how your eyes would react and to allow your eyes to adjust to them. The prisms is working but needs to be increased because you don't want your eyes to be slipping into double vision and you shouldn't have to force your eyes to work to keep a single image. By upping the prisms a bit should stop your eyes from seeing double as long as your wearing your glasses. But without your glasses your eyes will rather quickly see double. For this reason your contacts will become useless to you because they won't keep the double vision away.


Kris  20 Jun 2015, 19:05

When I went back to my ECP after using prism for near vision, he noted that I could go up to 4 prism bo from 2 in my computer glasses based on testing then. However, because I was having issues with motion sickness, we both thought going full-time would be my best option. I'm guessing he stayed at 2 bo each eye because he was concerned about how I'd adapt to them. I suspect he will suggest a similar change to my prism this time as he did with the computer lenses.

He keeps warning me that I can't change my mind on this, once I start wearing them but I don't really understand how there can be a choice on this. I'm guessing that even if there is an increase, I may still see double occasionally. Right now I find it easy to slip into double vision, but the difference is that I can re-fuse images without too much effort. Is re-fusing images something that will get harder to do as I adapt to using prism? The prism doesn't seem to stop my eyes from seeing double, just makes it easier to correct it when it happens. I can tell my eyes are working to maintain a single image. Yesterday, after the presentation I attended, I had dry, watery eyes.

I usually don't have problems seeing my ECP so will post once I've had an appointment.


Soundmanpt 20 Jun 2015, 14:32

Carrie

That was about what I thought you you might need for as an increase. Actually for being nearly 2 years since your last increase I think your eyes held up very well. But this is going to be your first time needing astigmatism correction in your glasses. It's the smallest amount you could possibly get, but even being small the effect may surprise you. So if you quickly feel like the room is spinning and your even slightly dizzy you can blame it on newly developed astigmatisms. But the good news IF you have those issues it won't last very long and as soon as your eyes adjust to your glasses it will not happen again. Its just really strange that it only happens when you first get astigmatisms and from then on you never notice it. And again you may or may not get that effect but now if you do you will know why and that your glasses were not made wrong. With hour glasses on were you able to see and read the 20/20 line of the eye chart or was it a little bit too blurry? I'm just curious if you needed any increase for distance or if you just needed an increase for your near vision? I think the part you enjoy most is trying on new frames even if getting new glasses is expensive. But even though your trying on frames at the mortar shops you really should consider ordering glasses on line. The savings is incredible and the quality every bit as good. If you need any help in about making sure they fit there are several of us in here that can guide you. Oh and something else that is kind of cool that Zenni and several others offer is where you can post your picture and try on the frames that way. Because the prices are so low you can afford to get 5 or 6 pairs for less than what one will cost at a local hop.


Carrie 20 Jun 2015, 11:24

As I suspected I did get a new prescription after my eye test today. A small increase of +0.50 in both eyes. No mention of bifocals or separate reading glasses (I didn't expect there to be). One small surprise was that they have now given me a small astigmatism correction of -0.25 in both eyes.

I still haven't chosen my new frames but I did see a few possibilities today. I love glasses shopping with Gemma as not only does she help me pick out frames and give an honest opinion of what she thinks of them on me, she can't resist trying on some frames herself. Because she's shortsighted she doesn't bother trying to get close enough to a mirror to see herself in the frames she just takes a selfie and looks at that instead. I can see myself in the mirror but I also take a selfie if I want a close-up view. I just can't force myself to focus that close for very long without my glasses on. Anyway, a photo is more accurate as that is how you look to everyone whereas a mirror shows everything back to front.


Cactus Jack 20 Jun 2015, 09:24

Kris,

The 3 meter distance is pretty handy because all you have to do is divide the separation distance in cm. by 3 to get the equivalent prism diopters.

The numbers you got are reasonable when you consider the fatigue factors.

Your first post of 19 Jun 2015, 18:42

Fatigued

Without prism at 3 meters- between 95-102 cm = approx 32 to 34 total prism diopters.

With 2 bo prism each eye, 3 meters -about 70 cm = approx. 23 total prism diopters, uncorrected. The actual turn in was 27 diopters, but the glasses took care of 4 diopters leaving 23 uncorrected. As you have discovered, the amount of prism is usually somewhat variable as the Eye Positioning System tries to fuse the images. A little help can go a long way.

Your 2nd post of 20 Jun 2015, 06:16

When you were rested.

With prism and distance correction- 56-58cm = approx 19 diopters uncorrected out of approx 23 total.

Without prism but with distance correction 72-75 cm = approx 24 to 25 diopters.

The difference fatigue makes is pretty significant also, the beneficial effects of some BO help in the glasses, Less fatigue.

I am very tempted to suggest trying 5 to 7 BO in each eye and compare results. As I have mentioned, I have significantly more fatigue convergence than you do, but get by most of the day with 7 BO in each eye. It works until very late. One other suggestion, if you do a lot of close reading (I do a lot in bed) consider some reading glasses w/o prism to keep your ciliary muscles relaxed. Reading close forces your eyes to converge, but you don't want want to force them to over converge with BO prism unless you have double vision when reading. To test this idea, you can wear some OTC readers over your no prism glasses. You might need to try several different powers to compare results.

C.


Kris  20 Jun 2015, 06:16

Prism test this morning (rested).

With prism and distance correction- 56-58cm

Without prism but with distance correction 72-75 cm.

Both from 3 meters aways.


Kris 19 Jun 2015, 18:43

Forgot to mention that both tests were with distance correction.


Kris 19 Jun 2015, 18:42

Cactus

Fatigued assessment of double vision is as follows.

Without prism at 3 meters- between 95-102 cm (It drifts farther apart than this, but usually settles around here)

With 2 bo prism each eye, 3 meters -about 70 cm.

When I last checked distance without prism (before I got prism) was usually about 75 cm (up to 90 if really tired).

Will report on rested results tomorrow.


Cactus Jack 19 Jun 2015, 16:43

Kris,

You really need to see a Pediatric Ophthalmologist who specializes in Strabismus Correction before making a decision about muscle surgery. I have heard of muscle surgery in people as old as their 70s.

Your OCP is pretty much parroting the "party line" and repeating his training. Depending or your situation, there may only be TWO possible solutions. Wearing as much prism as you need to not see double - that may not be full correction.

Or, surgical correction.

In both instances what corrects the problem today, may not correct it in a few years. I have been down this road and I can tell you that denial will not solve the problem. I have been measured as needing over 70 total diopters of BO prism when I am very tired. However, most of the time, I can do quite well with much less.

Even if only one eye is turing inward, it may be possible to split the total correction between your two eyes so it is not particularly noticeable.

I believe you have done the simple prism test I posted on Vision and Spex. What sort of numbers have you been getting. That is a clue to your full correction. As a practical matter, you may not need that much correction. All you want to do is get the images close enough for your Eye Positioning System to take over and fuse the images. If in general you eyes want to turn inward. your Eye Positioning System needs a scene with a few prominent vertical edges or lines. If the images are pretty close to being fused, your brain will analyze the positioning error and match up the two images using the vertical lines as a reference and target. You won't even be aware that it is happening. The only thing that gives me a fit is looking at something like wallpaper with a very repetitive pattern of objects or vertical lines, even with my prism glasses. To use an engineering term, my Eye Positioning System may "lock on" incorrectly to the pattern and act like it has the two images fused when it does not. I know to just look at something close without a pattern and work my way to the wallpaper. I can do it very quickly and maintain fusion without thinking about it.

May I suggest that you do the prism test again when you are fresh and when you are fatigued. Let me know the results and then we can strategize.

C.


Kris 19 Jun 2015, 15:49

Thanks Soundmanpt and Brian,

I tried calling to make an appointment with my OCP but they were closed today. My OCP keeps warning me that going with prism means that I am committed for life and I guess that has me cautious about pursuing it. I really thought it wasn't too much of a problem, but have been reading so much more since getting prism. I attended a meeting today that had a long presentation and found that I had dry eyes afterwards. I also relaxed a little to much at one point and started seeing double again. It is different than before as I was able to fuse images again, but I find I'm confused as to what is acceptable prism correction, no double vision or being able to refuse images when I do see double. Although I am more comfortable, I honestly expected more relief than I am experiencing.

My eye definitely turns in without glasses (probably about a 1/4 inch between edge of the pupil and the corner of my eye). With glasses it can still turn in, but it's much less noticeable (I think it probably turns in about a 1/4 of an inch). I don't want to have a noticeable eye turn, but feel like I may just have to accept this as part of having comfortable vision. Since using prisms, I've notice a pulling feeling in my right eye when I wake in the morning (sometimes even before I open my eyes). It only settles once I put my glasses on. I noticed this same sensation when i first started wearing glasses. Then I think it was because I was starting to use my eye more and the muscles were being used more.

My OCP has really left it up to me to decide how much prism I want (although he wanted to start low so that I adapted to the prism). Other than a little motion sickness at the end of the day (which is improving), I think I've adapted fairly well. I don't have a good sense of whether I should just go with full correction or if there is some advantage to making my eyes work a little to maintain fusion. I do feel that it should be easier to maintain fusion than I am currently experiencing. I find it strange that this is being left up to me to decide when I have no say in what the other parts of my lens prescription are.

Soundmanpt, why do you think I won't be a candidate for eye surgery? I did have eye surgery as a kid, I don't know if this changes my options now.


Brian 19 Jun 2015, 08:21

Kris, I was kind of the same way as you, I never had regular eye exams when I was younger.. I remember at my regular doctor check ups, the doctor saying something about depth perception issues when I looked into a machine and took these tests to to determine if something was in or out of the sandbox.. I should have had glasses sooner than I got them and the 2nd time I went to the eye doctor after getting my initial pair of glasses, they asked me about my right eye being lazy and if I had problem keeping my place with reading etc.. issues I always had when I was younger. They held out giving me prisms for a while and like you started with 2 prisms in each eye, but my issue is the opposite of yours, mine is base in since my eye wanders out.. I was slowly increased to 5 BI in each eye have been steady in the prism department over the last few years.


Soundmanpt 19 Jun 2015, 07:41

Kris

Now that your getting much more comfortable wearing your glasses all the time your eyes are more adjusted now as well. Prism correction takes longer for the eyes to fully adjust to because there actually pulling on your eyes so they are aligned properly. After a while that process will be much quicker. If your still needing to work to keep your eyes focused with your glasses on you probably need a bit more prism added to your glasses. Your doctor did the right thing by starting you off with lowest amount possible with the intention of increasing it after your eye have had a chance to get used to the prisms. I suspect that he will increase it to around 5 bo when you go back. That should be enough for a good long while then. You said that you tend to have been holding back with your eyes way more than you should have been. You don't want to hold off very long with calling your optometrist to let him know that you have to work to keep from seeing double with your glasses on. Like I said nearly every optical location remakes your glasses free of charge if the doctor writes a new prescription. I doubt that you will need anything else changed in your glasses.

Just so you know it your certainly not the only one that pushes things off when it comes to their eyes. In fact I think most people do that. I'm sure when you were having trouble with being able to only read for a short time you kept thinking that it would somehow go away and you would be fine in a day or two. You would be surprised at how poor some people's eyes get before they decide to get an eye exam.

Honestly I think your going to find that eye surgery isn't an option anymore. Your probably going to be told that your best, and only, option is glasses.


hoffide 18 Jun 2015, 20:04

so see 12 prisms base out of, but I need a total of 40 prisms, therefore the prism sheet:

https://www.flickr.com/photos/68727704@N06/?


Kris 18 Jun 2015, 19:30

Thanks Soundmanpt,

I'm definitely more comfortable with the prism, but still find it easy to see double if I relax my eyes. It is much easier to bring the images back together, but I do wonder how much prism I'm going to end up needing as time goes on. I think part of my issue is that I don't really know what comfortable vision should feel like as I seem to have a history of acknowledging very late in the game that I'm having problems. I only had my eyes examined when I first needed to wear glasses after I realized I could no longer tolerate more than 20-30 minutes reading/using a computer at a time and was increasing font size on my computer to read.

I only realized that I should be asking about my double vision when I started to read other eyesceners writing about their experiences with prism. Lots of people seemed to need prism without having double vision. I realized I had been ignoring my double vision issues and was compensating by covering my eye or closing my eyes when they were bothering me and it never occurred to me that I really needed prism correction. I think I am really good at denying my eye issues. I am more comfortable now, but it's hard to see if I am completely comfortable or just not as uncomfortable with my current lens correction.

I have asked my OCP about eye surgery and he was very discouraging. He didn't think it would help, but I am not sure if I trust his opinion or not. I have asked to see an ophthalmologist but they are quite busy in my area, so am not sure when I might get an appointment. I'm not a big fan of surgery, but would like to know what my options are. Anyone know how useful eye surgery is?

2 base out in each lens seems like a really low prism prescription, so I feel like it shouldn't be too much of an issue wearing contacts, but I don't have a good feel about what the range is for prism lenses.


SC 18 Jun 2015, 11:53

Louise,

You made the right decision.

I have to manage your expectations - you needed reading glasses and now a distance prescription @42 - I was just 46 when I got a distance prescription and I needed that first pair of reader around 42.

I'm now +1.50 for distance so I'd expect you end up slightly higher than me. You will need them full-time - for your own convenience, for your own comfort and, I'm afraid to say, for necessity. You don't have to rush in and wear full-time now but don't be in denial as you will end up needing to, particularly as presbyopia really kicks in.

On a more positive note, don't feel old. When I got varifocals I felt younger - I was no longer someone who needed reading glasses because I was getting old and having to fumble about in my pocket before I could read something (just like my grandparents did). Now I was just someone who wore glasses, like many others, and I was always able to see - only someone with an interest would know that you have varifocals and that they are age-related. For example my sister in law was moaning that she now needed glasses all the time and she had never noticed that I had varifocals too.

My wife wears glasses for reading and even she is beginning to realise that having them in front of your eyes all the time is the most convenient solution to the eyesight problem!

Good luck


Soundmanpt 18 Jun 2015, 06:41

Louise

Your decision to get varifocals is the best decision you could have made and once you get them I am sure you will agree. Unlike when you first got your readers and you would look up to see something with them on and things in the distance was blurry, now when you look up from reading everything is going to be crystal clear.

At first as your getting used to them you may have to remember that if your reading something you only need to move your eyes down and not your head. You will be surprised at how fast you learn to do that and then you will be doing it without even thinking about it anymore. It will just be a natural reaction.

I do want to remind you that while your getting used to your new glasses be very careful stepping up and down on curbs and even more careful on steps. You may have learned already with your reading glasses that anything on the floor appears much closer than they actually are.

Now like I said before just because your getting varifocals doesn't mean that you need to wear them full time. So if you want to wear them much the same way as you have been wearing your readers that is totally okay to do. But you really do need to start wearing your glasses when your driving. Your distance without your glasses isn't all that bad but your going to find that they will make a difference in how well you see things at a distance now. But it is very possible that you may quickly find that your glasses are very comfortable and that you enjoy seeing everything perfect so you could end up wearing them full time as a result. I imagine they told you that your glasses would be ready in about a week? So just be sure that they fit them so they are very comfortable on your nose and behind your ears.

Your new glasses should be good for a year, but you might need an increase in the reading area at that point. Your distance probably won't change much if at all.


Soundmanpt 18 Jun 2015, 06:14

Kris

Nice to hear from you. I know you have been very reluctant about wearing glasses with prisms but your eyes clearly need the prisms. So your decision to go full time with the prism glasses is best if you don't want double vision. Your already seeing the results in your meeting and you didn't have any double vision issues to deal with and that is only after wearing them a few days. If you continue to feel like even with your glasses on that your eyes are still wanting to see double images you may need to see your optometrists because it could be that you need a little more prism in your glasses. But first see if its just your eyes adjusting to them. You have only had your glasses a short time so if they do need changing most places will make the change at no cost to you within a certain time frame of a few months.

I think you better enjoy your days being able to wear contacts because they may be coming to an end soon. Right now your eyes aren't fully adjusted to your glasses but once they are you probably won't be able to use contacts anymore. I know that was a big concern to you with going full time with your prism glasses because of the sports your active in. But wearing glasses shouldn't stop you from being able to do your sports. You need to get a sports strap that attaches to the ear pieces of your glasses and goes under your hair so it isn't even seen but it keeps your glasses in place and not be falling off. Also if you happen to sweat a bit when playing sports getting sweat in your eyes with glasses on isn't very comfortable. So they sell many really nice looking sweat bands that work very well with keeping sweat from running into your eyes.


Louise 18 Jun 2015, 02:48

Thanks to Soundmanpt and SC for your replies. I went back to the optical place yesterday lunch time and a took a friend from work to help me choose frames. I found some nice ones in a red-brown plastic and I've ordered them with varifocal lenses, a mid range option cos I was advised not to get the cheap ones but also that it would be unwise to spend a lot cos i should get my vision checked again in a year. After the way its changed in the last year or two I hope there's not much more though. I've gone from no glasses to needing varifocals. Now i feel old. I'm looking forward to getting them now the decision on frames and lenses is done but i don't know yet how much i'll wear them or if my husband wil