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Hyperopia and Presbyopia Progression

For and about anyone having difficulty seeing near/reading.

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Soundmanpt 25 Oct 2014, 17:12

Catherine

Its all about genes and since you and your husband both wear glasses it is very probable that your kids will be needing glasses if they don't already. In kids it is much harder to determine farsightedness because they can get by much easier than adults can with not seeing well close up.

The girl that cuts my hair was told that she farsighted and at this point she doesn't have any problem with her eyes, but she did admit that if she is reading for along stretch say a book after a while her eyes do start to get tired and the letters of words begin to blur. I told her that she will probably notice with each passing year that her reading time will become less and less. I warned her that she may not want to take a desk job where she is doing much close work because she probably would be needing glasses even sooner. She laughed and said her optometrist told her the very same thing. Sadly she doesn't have any desire to start wearing glasses until she really needs them. I tried to convince her to get some +1.00 readers but she didn't like that idea at all.

At any rate it would be a very good idea to get your kids eyes examined even if they aren't showing any signs of needing glasses. It's just good eye health.


Catherine 25 Oct 2014, 12:05

I had an eye exam the other day and the doctor was great. My distance glasses stayed the same at +1.75 -.5 (both eyes) and I was saying that I still have issues with my phone or the computer even with my contacts on so he checked my near vision and said I could wear +1.00 over my contacts for extended near tasks. Seems like an easy fix but I never liked people seeing me in glasses so we'll see if I get the nerve to wear the reading glasses. But what was interesting was that he asked if my husband was nearsighted or farsighted and I said he was nearsighted (-4.5) but had had lasik. He went on to say that if my husband was farsighted we should have our kids in so he could do a thorough exam to see if they are also farsighted as it is not always easy to detect. He thought it would be a good idea to have them in for an exam anyway because he would be able to predict by where they are now whether they could become farsighted or nearsighted...I had never heard of that before?


Melyssa 24 Oct 2014, 04:37

Another one bites the dust -- no, not me, but my dental hygienist, who is in her upper 40s age-wise. Yesterday was the first time I had ever seen her wear glasses -- they were half-glasses, like the ones I use with my regular glasses for reading. Hers were red, and they did work very well because she did not make me bleed while working on my lovely choppers. :)


Cactus Jack 02 Oct 2014, 19:06

MCI,

I would suggest that you are looking at the need to wear glasses, the wrong way. Glasses are just tools to help you function more efficiently and comfortably. Those of us who need reading glasses, bifocals, trifocals, or progressives understand what you are experiencing, but let me assure you that you will soon appreciate the valuable service your glasses are doing for you.

Consider that you are somewhat dependent on other tools, but you probably don't think much about them.

Shoes are tools to keep the rocks from hurting your feet. The primary purpose of clothing is a tool to keep you warm in cool weather. Hammers are just tools to let you drive nails with minimal pain to your hand. Obviously, Shoes and Clothing have other ancillary functions, but they may not be necessary or even appreciated in certain situations.

If there is a vanity issue involved, maybe we can help with that also.

C.


MCI 02 Oct 2014, 15:05

Cactus Jack, thank you for the clear explanation.

I don't worry too much, and I don't mind to use glasses. But I feel a bit frustrated of being so dependent on them, not being capable of reading anything without glasses


Cactus Jack 30 Sep 2014, 23:07

MCI,

Welcome to the "joys" of presbyopia and all the things that go with it. Presbyopia itself is caused by stiffening of the crystalline lenses. Over time, your crystalline lenses will become so stiff that your ciliary muscles cannot increase their PLUS power to focus close. However, there is another effect that you are experiencing.

For their size, your ciliary muscles are the strongest muscles in the body, but like all muscles it you don't use them, they get out of condition. The +0.5 sphere in your prescription means that you have a little hyperopia. The function of the sphere and cylinder distance correction in your glasses is to correct your hyperopia to 0.00 or no refractive error. The +1.50 add has another purpose entirely.

When you were young, your crystalline lenses had the consistency of gelatin dessert and your ciliary muscles could easily squeeze your crystalline lenses and cause them to provide the extra PLUS you needed to correct your hyperopia, but also effortlessly focus close for reading or any other close task. After your hyperopia was corrected, the amount of extra PLUS you needed to to focus close was strictly related to the focus distance involved. This relationship is described by the most fundamental formula of optics developed by Sir Isaac Newton of gravity fame around 1700. The formula is pretty simple: Lens power in diopters = 1 meter, 100 cm or 1000 mm / Focal Distance in meters, cm or mm as appropriate. If you like to use inches, 39.37 inches = 1 meter.

To focus at a normal reading distance of 40 cm or 16 inches requires +2.50. That +2.50 has to come from somewhere. The Add in your glasses provided +1.50 and you were able to supply the extra +1.00 internally using your ciliary muscles and crystalline lenses for a total of +2.50. When you wear higher plus glasses, for reading, your ciliary muscles can relax and let the glasses to the work, but that quickly leads to de-conditioning. It is a vicious circle and it will ultimately lead to a full time need for either bifocals or trifocals to provide the needed PLUS, externally. Frankly, there is not much you can do about it. It happens to almost everyone.

I can offer you a little comfort. The amount of PLUS you will need will depend on your preferred focus distance, nothing else, after your hyperopia is corrected. If you like to read closer than 40 cm or 16 inches, you may need a +3.00 or +3.50 Add, but it is very rare for the Add to go higher than that unless you like to work on mechanical watches. You may find that +1.25 or +1.50 is very handy for using a computer and there are some tricky ways to do that.

Again, what you are experiencing is normal and the best thing is to not worry about it, but just get the glasses you need to function comfortably in all situations. I you have more questions, we will be happy to help.

C.


MCI 30 Sep 2014, 17:43

Tired of putting the glasses on and off I decided to move to multifocals at the beginning of this year (I was using occupational glasses before) Short time after, I became fully dependent on them for reading. (Before I could still read the text at the mobile with a bit of effort but now I can’t anymore). I understand eyes can relax getting used to the glasses, but I was already using them full time (10-12 hours/day) for close work (reading and computer) and I didn’t expect my close vision changes. I don’t understand it can have changed because of the new glasses.

I’m now struggling a bit with the very small printer. Last weekend I was using the readers of a friend. They were +2.5D, what is ~0.5D stronger than my prescription for close (my prescription in January was: OD:sph +0.50 cyl -0.50 OS:sph +0.5 cyl -0.25 Add +1.5). When I put them I feel them stronger than mine, but after some time I feel very comfortable for reading, for computer distance was not so good but it was not too bad either. I continued using them for the full weekend (to read and computing only). Can our eyes relax and get used to stronger prescriptions? Or perhaps my vision has really worsen? An increase of +0.5D looks perhaps too much change for 9 months, and an addition of +2.0D looks also a bit high for my age (I turned to 47 recently). Do you have any hint?

I don’t know if it’s worth to get my eyes checked again.


Carlos, Jr. 26 Sep 2014, 18:03

Hi Slit, great news about you being prescribed progressives. Let us know how the adjustment goes.


Cactus Jack 24 Sep 2014, 08:16

Sydneycider,

cactusjack1928@hotmail.com

C.


Sydneycider 24 Sep 2014, 03:09

Hi Cactus Jack,

What is your email?

Cheers,

C


Sydneycider 24 Sep 2014, 03:09

Hi Cactus Jack,

What is your email?

Cheers,

C


LT Lurker 04 Sep 2014, 00:21

Oh to the last anonymous post....perhaps your pious personality may do better on another site. One that shapes your dull and uninteresting character into an even more politically correct clone drone.


 03 Sep 2014, 22:15

Well, L.T. Lurker, perhaps 46 is old enough for her to make her own decisions as to when she wears, or doesn't wear her glasses... notwithstanding your fetish, of course.


LT Lurker 03 Sep 2014, 19:36

My wife has been back wearing her glasses for a year or so and then all of sudden she stops and complains they are "no good" as they give her a worse headache than not wearing them also she complains that when she looks around it makes her dizzy and uncomfortable although straight ahead at a screen is fine.

Rx is R+1.25 L +1.00 CYL -0.25

Although she had a test 1 year ago which she didn't fill of

R+0.25 CYL -0.25 L+0.25 CYL -0.25 ADD +1

She is 46


Carlos, Jr. 03 Sep 2014, 18:17

My glasses-averse boss is at it again. Not wearing his glasses for the past few weeks and using a magnifying glass to read items on the computer monitor. Sounds like glasses would be a much easier solution.


Maurice 29 Aug 2014, 12:18

Slit, how long have you worn glasses for hyperopia. Are you full-time or just for close-up work?


Grant 21 Aug 2014, 06:57

Slit - I can see pretty well in the distance with my glasses although it is a little clearer with them off. Is it normal at 35 to feel I need to wear my glasses for most prolonged near task since they are so weak?


Slit 21 Aug 2014, 04:32

Grant,

when you wear the regular reading glasses do you find the distant vision blurry?

given that your present reading glasses are not much powerful, you might even get adapted to wearing them full time. (initially it will be blurry in distances with them on, but if you practice wearing it in a safe manner avoiding driving with them etc, you will find them helping both distant and close vision).

However if you absolutely hate wearing glasses in public, and also if you can afford, multifocal contact lenses are a good option.

Other advantage is you are still 35, so getting used to the multifocal contact lenses earlier in life will be helpful when you have higher prescriptions as you grow older...


Grant 20 Aug 2014, 21:16

I have glasses for reading L +1.5, R +1.75. The machine (autorefractor, I think?) gave a prescription of L +.25, R +.5. I wear my reading glasses all day at work then take them off but in the last year I find that looking at my phone or doing anything up close causes strain and headaches pretty quickly. It has been 3 years since my last exam and I am 35 years old. I am wondering if I could wear bifocal contacts so that I do not have to always have my glasses handy....is that possible with my prescription? I am really self conscious about my glasses and I know my prescription is weak so I am really nervous about going for an exam and asking about contacts.


Weirdeyes 01 Aug 2014, 22:47

I'm 18. I do look at my iphone for hours because of boredom. I recently got glasses in my new prescription. I get some headaches from them, but I notice slightly clearer distance vision.


LT Lurker 01 Aug 2014, 22:34

Hi Weird Eyes,

Very interesting post there.Did you have a full cycloplegic test? Also how old are you?

I say this because I recently read an article on lasik where the surgeon concerned specialized in clients who were hyperopic presbyopes, ie persons of 40 -55 or so who had had great eyesight but found that presbyopia had reduced the quality of their vision at both near and far.

A lot of information suggests that there is no real need to cycloplege a 45+ year old, however this particular surgeon insists it essential as time is money and he does not wish to keep wasting it doing the so called "enhancements".

This means he aims to identify the full amount of latent hyperopia and his results show that he often finds as much as 2D of hyperopia as the eye muscles are so tense that they have this much locked up and he has to use increased amounts of the atropine to ensure he gets a complete picture.

So when you say that your prescription was lowered as a result of tense muscles I suggest that it is because you might have a good amount of latent hyperopia going undetected and all sorts of things can affect this from various pharmaceuticals to plain old sugar as well as looking at a PC all day without glasses or too weak glasses.


Weirdeyes 28 Jul 2014, 01:31

I keep on noticing that my vision fluctuates. I sometimes see fine with my glasses, but I sometimes get slightly blurred distance vision. My eyes happened to be tense when I got tested, so my prescription got lowered a bit. Today my vision is more relaxed and my distance vision is fine with my glasses.


Carlos 02 Jun 2014, 13:31

Looks like my 49-year old boss has finally resigned himself to a life of wearing glasses. Though he has had glasses for months, we saw him using a magnifying glass, stretching out his arms, squinting when he read close-up. But, suddenly, during the past two week, he has gone to glasses full-time. I guess he finally came to the conclusion that he just could not see.


Cactus Jack 01 Jun 2014, 15:02

Dude,

Yes! Even that small amount means that her ciliary muscles and crystalline lenses are having to work to see distance clearly and harder than normal to focus close. If she finds that her vision is more comfortable with +0.25 glasses, it is not for us to pass judgment on what makes another person comfortable. It would be like me saying that I would like it better if you were wearing shoes that were 1/2 size smaller than what is comfortable.

C.


Dude 01 Jun 2014, 14:29

Hi, I'm curious my cousin is a 25 years old girl, who wears +.25 glasses full-time, when she's not wearing her glasses, she squints a lot and has headaches. Should a little prescription such as this, make any difference in her eyesight?


don-boy 29 May 2014, 18:59

hi wife went for new glasses with complaint of poor vision near,int, and far was given od+2.75-0.75x080 os+3.00-0.75x080 add+2.00 autorefraction od+3.50-0.75x080 os+3.75-1.00x080 old rx od+2.75-0.75x080 os+3.00-0.50x089 add 1.50

old autorefraction od+3.00-0.75x097 os+3.25-0.75x085

question is autorefraction went up +050 but new distance rx stayed same thanks

=

=


Julian 26 May 2014, 02:21

okay: don't know why you bothered.


okay 25 May 2014, 18:22

Let me try again...

http://www.youtube.com/watch?v=imW392e6XR0

http://www.youtube.com/watch?v=4Y1iErgBrDQ


okay 25 May 2014, 18:15

Looks like celebrities are not immune...

https://www.youtube.com/watch?v=imW392e6XR0

https://www.youtube.com/watch?v=4Y1iErgBrDQ


Weirdeyes 07 May 2014, 03:31

I think my visual discomfort has to do with being tense, having sinus problems or eye strain. Even though I've worn my glasses fulltime for two years I still have trouble relaxing my eyes. When my eyes get very tense I start to get slightly blurry distance vision or lowered contrast.

It seems like it's way easier for Carrie to relax her eyes even though she's not much older than me. She also seems way more dependent on her glasses. It's still very easy for me to read without my glasses even though my prescription is higher than Carrie's.


John S 02 May 2014, 01:02

Dan,

The test is called a Fused Cross Cylinder Test. I think I have only had the test once or twice. I have not made an effort to read enough about it and retain the info to understand how it actually works.

This is from a document on how to measure accommodation.

"1. Ask the patient to report which lines are sharper or most distinct, the lines going up and down or the lines going across.

2. If the patient reports that the vertical lines are sharper than the horizontal lines before any lenses have been added, reduce the illumination. If the patient then reports that the horizontal lines are sharper or that the two sets of lines appear equal, proceed to step 4. Otherwise, proceed to step 3.

3. If the patient continues to report that the vertical lines are sharper with reduced illumination, flip the JCC axes so that the red dots (minus cylinder axis) are now along the horizontal meridian and again ask patient which lines are sharper.

a. If the patient then reports that the vertical lines are still sharper, stop the procedure and record “vertical preference.”

b. If the patient reports that the horizontal lines are sharper, record “lead of accommodation,” “minus add indicated,” or “minus projection.”

4. If the patient reports that the horizontal lines are sharper or that the two sets of lines appear equal, add plus lenses binocularly, +0.25D at a time, until the patient reports that the vertical lines are sharper.

5. Reduce the plus power binocularly until equality in the sharpness of the lines is produced. If equality is not reached, stop at the highest plus lens through which the patient reports that the horizontal lines are sharper."

I also found an optometrist explaining the test-

"If you're overminused/uncorrected hyperopic/presbyopic/overaccommodator, the verticals will seem clearer. If you're normal (due to +0.50 lag in accommodation)/underminused/underaccommodator, the horizontals will seem clearer.

It's a "sneaky" test that patients can't overthink and therefore screw up."

The way I read it, in your case you will most likely see the horizontal lines darker when the test is started if your minus distance rx is set into the phoropter. That indicates you need more plus to accommodate for near. Plus is added until the vertical lines seem darker. If you delay your response when you see vertical lines get darker for a few lens changes, more plus should be added showing a need for a higher reading add.

I found a blog with some good info on accomodation problems with kids. Since you're not 35-40 yet, it can apply to you.

I really like the paragraph starting with "Then I like to demonstrate".

http://eyedolatry.blogspot.com/2012/01/accommodative-insufficiency-guide-for.html

I hope this helps.


Dan 01 May 2014, 15:09

Question about the cross cylinder test for near vision. I know this has been discussed on here before but can't seem to find the relevant info.

As I have mentioned in the past, I sometimes wear bifocals or reading glasses over contacts. At my next appointment, if they do the cross cylinder test with the horizontal and vertical liens for close work, what is the best way to go about that if I wanted to get a slightly stronger add?


Marg 29 Apr 2014, 14:21

I asked my optician today if I should have the prisms in my plus 9 reading glasses and he said YES I do not like very small frames can u tell be how much thicker the 5 out prims will make the lens Thanks


Aubrac 28 Apr 2014, 03:48

Marg

Base out prism is used to correct over convergence which can most often happen when reading but also at any other time. This can result in one or both eyes turning inward and give rise to double vision, eyestrain, and headaches.

The extra thickness will be at the outer edge but actual thickness will depend on the frame size of the lens but at 5 degrees should not make too much difference.

I think you will find the prism makes reading easier but at +9.00 your optician may not think them necessary.

Have you experienced any vision problems or headaches? Many people who get a prism correction do find it makes vision much more comfortable and with less strain.


Carlos 27 Apr 2014, 08:07

Got my first pair of glasses yesterday. Had been having some difficulty reading items on my phone. To my surprise, discovered that I probably should have been wearing glasses a lot earlier than this. Apparently, I am farsighted, along with being presbyopia.

Left eye is+1.25 add +1.25

Right eye is +1.50 add + 1.25

Anyway, am getting used to not only wearing glasses, but wearing glasses full-time.


Marg  27 Apr 2014, 07:37

I forgot to say I also wear plus 9glasses for reading should I get prisms in these as well and how thick would they be

Thanks


Marg 27 Apr 2014, 06:26

Hi

I wear plus 6 lens with no cyl or axis correction for distance I have now been told I need 5 out prisms will this be a lot thicker now.also where will the extra thickness be will it be in the middle or. To one side also I always wear cr 39 lens much clear vision many thanks


Cactus Jack 27 Apr 2014, 02:19

Ty ty,

You've got it!

C.


Ty ty 26 Apr 2014, 21:59

I have been reading about eye exercises and all and how they are supposed to relax your ciliary muscles which will in turn improve your vision and less dependency on glasses. However if you are farsighted, wouldnt that relax your muscles into being more farsighted?


LTLurker 26 Apr 2014, 18:57

I neglected to consider that the glasses would not get tired!


LT Lurker 26 Apr 2014, 17:52

Hi SC, That is the bit I don't understand, if you read prescribing philosophies in various books and papers they suggest that to do close work comfortably you require 1/2 the total amplitude of accommodation in reserve

o One-half amplitude in reserve

 Determine ½ amplitude of accommodation and accommodative stimulus (determined by working distance)

 What do you have to give them so that ½ of their amps plus the patient’s add= stimulus?

The above info pulled from a university text is what is confusing me.

LTL


SC 26 Apr 2014, 13:10

LT Lurker

Not sure I agree with your maths.

@33cm (small print) you need +3.0D plus distance

So for PH wife:

With current glasses (RE +0.75, Add +1.50):

Total needed +3.75D

Glasses provide +2.25

Remainder +1.5 to be provided by accommodation.

This is nothing special as my wife has +1.5 add @48yo

This is also my reasoning that variations in distance Rx not an issue. If LE is trule +1.0 and glasses currently +0.25 the available +1.5 will cover the difference albeit I suspect reading will become more difficult.

In my eye tests, each eye tested separately for distance but often together for reading so may be it would not be picked up.


Jamie32 26 Apr 2014, 12:03

Yeah Dan,

I see what you mean

BTW, am wearing my bifocals to type this to you:)

Think I'll be a full time bifocal wearer after next eye exam!


choch 26 Apr 2014, 11:54

Would it be viable to ask an optician to prescribe a +2.00 contact as well as glasses -2.00 stronger than I officially need to induce a little bit more dependency while wearing the contacts? I have been having a lot of trouble reading recently even with just my extremely low myopia and I am pretty self conscious about the thought of needing readers before age 30. Bifocals too. Id like it to keep it more of a secret and honestly even with the new lenses bifocals are fairly obvious for a number of reasons. It would be nice to just take glasses off and be able to read again. Would an optician buy into this if asked about it? Has anyone here ever tried this?


Dan 26 Apr 2014, 11:03

Jamie,

Haha...we'll see how long I can hold out. It took smaller font on a different computer for some of my issues to really present themselves it seems. I have an appointment in August. We'll see how dependent I have become on reading glasses by then!


Jamie32 26 Apr 2014, 10:28

Hey Dan,

Thanks for the update. Yeah, read a post that more younger people needing the extra help up close way earlier than ever before due to our digital world.

Now, just how long before you become a full time wearer of progressives:) Of course, this coming from Eyescene's slowest ever realizer/accepter of his own actual need for a little extra help up close, lol


LT Lurker 25 Apr 2014, 23:16

I think that the situation with Puzzled Husbands wife is fascinating.

SC& CJ have both proposed quite acceptably that as there was in the past 1D of Hyperopia found then that will re appear at some later date as it is currently being corrected by accommodation.

So this means that PH's wife has to find with current specs at least +.75D to clear distance, then she has an additional help of + 2D for near.

So it is my understanding that in order to see clearly and comfortably at near, at say 14" (35cms), then she must have 5.75 D of accommodation still available.

This is (please correct me if I am wrong)formulated as follows -

3.5D required to see at 14" with an additional 3.5D to see without tiring.

So the +2 add makes up deficit.

The thing is,is that this goes against the generally held and accepted Donders rule of expected amplitudes accommodation, as PH's wife is 46 and Donders states that only 3.5D is available for a 45 year old.

So with PH's wifes prescription for near we can question Donders as - if she wishes to read at near she has correction +0.25 for the distance in one eye and +2D for near in both meaning prolonged near work she will need 7D less 2D for her lenses, so her accommodation will need to be 5D ....at least 1.5D more than Donders says she can have.

So why Donders is so well held I don't know.

Hofstetters’ formulas shown below however give us a better impression on what is going on with PH's wife.

i. Minimum expected amplitude = 15 – 0.25 (age)

ii. Average expected amplitude = 18.5 – 0.30 (age)

iii. Maximum expected amplitude = 25 – 0.40 (age)

The average expected gives her 4.7D whilst the maximum will give her 6.6D... so the originally found Hyperopia could exist latently with this formula.

Additionally I have read an article by a lasik surgeon who specialises in "baby boomers" and correcting their sudden need for glasses after a life of both great near and distant vision (some able to see 20/10)

He insists ALL patients over 45 (most of his client base btw) have a cycloplegic refraction, because many of his presbyopic hyperopes are found to have a significant amount of latent hyperopia even at around 50 years of age and the last thing he wanted was to have clients rocking up for an "adjustment" (he doesn't want to see them again).

So the evidence is there and it could be that as PH's wife has been given varifocals for the simple reason that the optician knows that distance correction will increase and that it is better to be used to varifocals than to have a hard time adjusting.

I should finally mention that my partner was in a similar situation to PH's wife ...

33 +0.75 L +0.5 R

39 +1.25 L

+1.0 -0.25CYL r

45 +0.25 -0.25 CYL ADD+1.00 L

+0.25 -0.25 CYL ADD+1.00 R

She has not filled the final prescription and wears her previous script for reading and PC,I know also, although she denies this, that she can see with this for distance.

Finally the prescribing philosophy that is held with low latent hyperopes who emerge in the late 30s/40s that only part of the full correction be given as a near correction.

I presume that PH, your wife wears her varifocals all the time?

I await with interest the views of the more learned posters on this site as I am keen to learn more about the strange phenomenon of accommodation and it's bearing on hyperopia and presbyopia.

LTL


Dan 25 Apr 2014, 16:57

I've posted on here several times and figured I'd give an update!

Been wearing my -1.25 contacts all the time, as I have for the past few years (sorry all glasses fans!). As I've mentioned before, I've toyed around with bifocals and reading glasses from time to time over the last few years but never consistently used any. That may be changing. I recently got a new position at work which requires lots of work in Excel. Also received a new computer which has great resolution but the font seems quite tiny. I started getting headaches so decided to try the reading glasses again...and wouldn't you know! No more headaches. Looks like I may be moving more toward reading glasses regularly for close work. It's amazing what the computers have done to us! :) I am nearly 25.


Cactus Jack 25 Apr 2014, 16:01

New Wearer,

Obviously, the optician you visited did not do a very good job. If you could provide a bit more information, we might be able to offer suggestions. You may have provided the requested information before, but it is impossible to remember the details of every post.

1. Your age?

2. Where you live?

3. Most recent complete prescription with approximate date?

4. Complete prior prescription with approximate date?

5. Did you visit an independent optician or an optical chain?

Even without the above information, I think you need to visit a different Eye Care Professional, but before you do that, you need to do a bit of planning. We can help with that.

C.


New Wearer 25 Apr 2014, 12:30

Hi everyone. I posted on new glasses a while back about getting new glasses.

I've been getting persistent headaches, neck ache and eye strain as well as double vision.

I went to the opticians today. They didn't even check my eye alignment (new optician). There was no lining up as per before and no cover test.

I am convinced I need stronger prism correction but this optician didn't even check.

I need stronger glasses he says, but only mildly so.

I don't think that will fix my problems!


SC 25 Apr 2014, 07:39

Puzzled Husband,

Looking at the Rx you list for your wife. Then you can make some assumptions:

- the +0.75/+1.00 that has been prescribed in the past will be the minimum distance in the long run as CJ says it doesn't get better

- an add of +1.5 (as in the 45yo Rx) suggests there must still be another +1.5 internal accommodation to handle small print and so small changes in distance Rx will not be a problem

- as the add increases due to accommodation reduction then the distance Rx will become much more sensitive and the true Rx will begin to appear


John S 24 Apr 2014, 22:26

In my 40s, my distance rx dropped to +0.25/+0.50 from +1.00/+1.25. I had the +1.00 rx since I was 13.

By the time I hit 50, I was back to my same old rx. I never understood why.

As far as different exam results go, I had better results wearing stronger lenses before the exam. Wearing an intermediate distance rx while driving seemed to shift the rx a little more positive. I guess the lenses were causing my eyes to relax to try to make my vision clearer.


SC 24 Apr 2014, 10:11

Ennis, PH

I have little faith in individual eye tests as being an accurate indicator of hyperopia. So much depends on the day and what you have been doing. The best approach is self-assessment particularly the intermediate segment of progressive lenses.

In my personal experience, I find that if I drive a long way, say 200 miles, then my eyes get tired and they will accept a stronger prescription, but driving that distance before an eye test is a little incovenient! Using the reading add then my brain seems to realise that it is for short distance and will not relax, but the intermediate seems to relax easily.

My previous Rx ws +0.75 Int Add +0.75, Read Add +1.50. I found that the intermediate (+1.5) focus distance increased to 3 metres over about 6 months and was OK for distance after the tired driving. so I knew I needed +1.5 for distance, but when my eyes were tested I could not see through them!!!

So I got +1.0 Int add +1.25, read add +2.00. I was told by the optician that I'd have to get used to using the intermediate for the computer (as opposed to reading segment). Within 2 weeks I was using the reading add again, and the intermediate had quickly stretched to 2 metres.

So now I need at least +1.75, and having tried on my mum's +2.25, probably +2.25 as they seemed ideal.

This would mean my progression would be:

-0.25 at 44yo

0.00 at 45.5yo

+0.75 at 46yo

+1.00 at 48yo

?+2.25 at 49yo

So I wouldn't read too much into individual tests. I got my mum to dig out her Rx (as she didn't know) and she brought out a stack going back 20 years. Interesting that she added the final +0.5 sphere between ages 55 and 61 which I thought was very late


Ennis 23 Apr 2014, 21:34

My guesses regarding the Puzzled Husband (PH) conundrum:

Because PH's wife has had relatively low hyperopia, there was more room for error in determining the right prescription. As Cactus Jack mentioned, it is hard to get a mild prescription right. The good thing is that most people can tolerate a small range of power. Plus, there is also the day-to-day (or more frequent) variability he mentioned.

Earlier, PH's wife probably had more tolerance for prescription variability and, perhaps, more tolerance for a stronger prescription than what she really needed. Now that she is older, her eyes accommodate less and cannot tolerate a prescription that is either too strong or too weak.

It is still possible that her hyperopia will increase in the future. For now, though, her presbyopia is becoming manifest.

I would be interested in hearing what others might think.


hooked 23 Apr 2014, 05:03

@Puzzled Husband

My wife is a rather strong hyperope with a refraction of +5/+5.5 from the age of 20 until 45. Before 20 it decreased slightly.

Since then (She is 48 now) the RX increased to +5.5/+6 .

Her doctor told that such an increase is quite normal during that age which fits to your theory/understandings. Usually one can expect an increase up to 1 diopter.

This increase goes together with the onset presbyopia. At the age of 45 my wife had an add of max. +0.5 while now it is +2 AFAIR.


Cactus Jack 22 Apr 2014, 19:37

Puzzled Husband,

Thanks, it may be related to the phenomenon known as Second Sight, when the crystalline lens begins to swell as a result of changes in the protein molecules that make up the lens. Swelling would increase the + power of the crystalline lens and reduce the need for external correction. Ultimately, the protein changes and the crystalline lens becomes clouded with a cataract, think what happens to egg white when you cook it, and the lens must be removed and replaced. Usually, Second Sight is enough of a change that older people who have acceptable distance vision, but need +2.50 or +3.00 for focusing close, can get by pretty well in bright light, without much correction. However, when that happens, it usually means that it won't be long before cataracts manifest themselves.

Small changes, such as your wife has experienced, is usually just normal variance. One thing that can cause short term changes in vision is Blood Glucose (BG) levels. The Aqueous Humor is a thin fluid between the Conrea and the Crystalline Lens. The Vitreous Humor is a thick gel between the crystalline lens and the retina. Changes in Blood Glucose levels can cause the Index of Refraction of the Humors to change and that can cause vision changes. For a person without Diabetes, BG levels average around 80 when fasting and as high as 160 to 180 after a high carb or high fat meal and that can affect eyesight by a fraction of a diopter in sphere. The Islets in the Pancreas produce Insulin to bring down the BG level or the liver dumps some Glycogen in the blood to raise the BG level. Most people don't notice the small changes. When working right, BG control is very fast and fully automatic. The system's ability to keep BG in the proper range for good health and proper functioning is truly amazing.

Again thanks for the link. As I have said many times, I am not an ECP. My background is Electronics and Computers. I am an Amateur in the original French sense in that I have studied vision and optics out of love of the subject, motivated by vision problems that the average ECP, had trouble explaining or correcting to my satisfaction. Also, I have a reputation as being a pretty good explainer and problem solver, once I understand the exact nature of the problem. Hopefully, the link will increase my knowledge.

You provided excellent detailed information in your first post. I will study the link and get back to you. In the meantime, I don't think you or your wife should be very worried.

C.


Puzzled Husband 22 Apr 2014, 18:36

My assumption was not based on my own theories but on the following academic article which concluded: "In the longitudinal study,

it was found that almost all hyperopic and emmetropic eyes showed an age-related hyperopic shift"

The authors concluded that: "that when healthy myopic, hyperopic, or

emmetropic eyes shift in the hyperopic direction, it is because of an age-related decrease in the gradient index of the lens"

http://onlinelibrary.wiley.com/store/10.1111/j.1444-0938.1999.tb06654.x/asset/j.1444-0938.1999.tb06654.x.pdf;jsessionid=0EA645549AC61102E30B37D6C4385B72.f04t02?v=1&t=hubrpzfb&s=0525090a319cb9bd74557678523d08db82a7e9db

Perhaps I've taught you something for a change! ;-)


cactus jack 22 Apr 2014, 17:35

Puzzled Husband,

I would suggest that you have misinterpreted the research findings or the finding are flawed. More likely you misinterpreted the research and are reaching conclusions that you desire, rather than understanding what is happening.

Hyperopia and presbyopia are the two most difficult vision problems to understand because they are caused by two different problems that have the same solution.

Hyperopia is caused by a mismatch between the total optical power of the eye's lens system and the length (size) of the eyeball from the back of the crystalline lens and the retina. Presbyopia is caused by a gradual stiffening of the crystalline lens with age.

Based on the prescriptions you provided, your wife has almost no Hyperopia as indicated by the sphere correction (1st number) and a tiny bit of astigmatism and your wife's prescription has been amazingly stable over the years. The early prescriptions may have been used to assist dealing with her visual environment at that time, but her recent prescriptions just indicated a reasonable onset of Presbyopia

Refraction results, particularly where low refractive errors are involved, are very subjective and your refractive error can change some throughout the day and sometimes from hour to hour depending on what you have been doing.

For a person's true hyperopia to decrease, the eyeball would either have to shrink - not very likely considering the tissue that the eye is made of - or if there is an increase, it is likely that the person had Latent Hyperopia component to their Hyperopia and it is gradually resolving.

I urge you read some of the many explanations of Hyperopia, Latent Hyperopia, and Presbyopia on this and related threads.

Incidentally, some of the dimensions and optical powers involved are very interesting. The total optical power of the eye's lens system is between 50 and 60 diopters. The distance from the back of the eye's lenses system is about 17 mm. Length variant is about 0.3 mm per diopter of error. There are 4 lenses in the eye's lens system. 3 lenses; the cornea, aqueous humor, and vitreous humor are all fixed focus. The crystalline lens is variable focus. The crystalline lens, the ciliary muscles and the focus control system in the brain make up the auto-focus mechanism of the eyes.

Rather than write a tutorial to fit your post, the explanations are already here, but you may have to look some and think some. May I ask you to review what has been written and ask questions about what you don't understand. Here is a clue, nothing in the prescriptions you posted are unusual.

C.


Puzzled Husband 22 Apr 2014, 13:06

I had always been led to believe that hyperopia usually increases with age, an assumption which has been backed up by solid scientific research.

I was therefore relishing my wife (a very mild hyperope) becoming more reliant on her glasses for distance as she got older. However she seems to be bucking the trend as evidenced by her eye test results over the past ?? years:

1994 (age 27) - advised to wear for reading when tired

R +0.25

L +0.25

2001 (age 34) - advised to wear for reading

R Plano add +1.00

L Plano add +1.00

2002 (age 35) - advised to wear full-time

R +0.50 -0.50

L +0.75 -0.25

2004 (age 37) - advised to continue wearing full-time

R +0.50 -0.50

L +0.75 -0.50

2007 (age 40) - advised to continue to wear full-time

R +0.75 -0.50

L +0.50 -0.25

2009 (age 42) - advised to wear for reading only!

R +0.75 -0.50 add +0.50

L +0.25 add +0.50

2009 (age 42.5) - advised to wear varifocals (different optician)

R +0.75 -0.50 add +1.25

L +0.50 add+1.25

2011 (age 44) - advised to wear varifocals

R +0.75 -0.75 add +1.25

L +1.00 add +1.25

2013 (age 45) - advised to wear varifocals

R +0.75 -0.50 add +1.50

L +0.25 add +1.50

2014 (age 46) - advised "no clinical change, continue with current varifocals)

R: +0.25 -0.50 add +2.00

L: Plano add+ +2.00

I thought you might be interested to see the progression (or lack of!) in her prescription - I just wish she was following the clinical norm! Instead her distance vision seems to be improving rather than getting worse - which is a shame!

She had been for a run on the morning of her test and was rather red in the face afterwards - could raised blood pressure make someone more myopic perhaps?


Soundmanpt 22 Apr 2014, 12:04

Lena

It seems that your eyes are changing some. If you got your first glasses when you were 18 and I assume the prescription you got was the +.75 -.25 then? Now it is +1.25 with some astigmatism. Not a huge change but certainly enough that you should notice the difference more. When you got your first glasses did you go straight to full time wear or just as you needed them? If your not wearing your glasses full time then I suggest that you do that. Like "Svesort" said you can't induce hyperopia, but constant wear should help some. Also being only 20 you can always order your glasses on-line and increase the +1.25 a bit higher because your eyes shouldn't have any problem tolerating a little more power. Not that this will actually change your real prescription but it will make your glasses look stronger which it sounds like what your wanting?


svensont 22 Apr 2014, 01:45

Lena,

Measure the new distance. Try wearing this combo as often and as long as possible. I believe that after few days the distance will increase significantly


Lena 21 Apr 2014, 19:28

Svensont

At first putting the +2s over I could see the computer clearly (the text of this website) until about 45cms. Within 10 or minutes this distance increased slightly.


svensont 21 Apr 2014, 17:32

Lena,

You can check if your eyes can relax more. Buy over the counter reading glasses, lets say +2D and wear them over your glasses. Measure the distance from your eyes to a small print until it becomes blurry. Then after some time measure it again. If it will increase, it means you have more hyperopia.

It may take more time, just try wearing that combo as long as you can, and after few hours or days you will know the answer. This method will turn off your accommodation, so your ciliary muscles will start relaxing (if they can, because hyperopia cannot be induced).

Let us know about the results, how is the maximal distance you can read in that combo changing.


Lena 21 Apr 2014, 16:51

Svensont

- What was the reason to get glasses?

Poor distance vision at night, initially.

- How long have you been wearing glasses?

2 yrs

- Your previous prescriptions?

+0.75, -0.5 each eye

- Have you got a dilated eye exam?

No

Thanks


svensont 21 Apr 2014, 09:22

Lena,

It all depends, if you have some latent hyperopia then your prescription can be higher. We need more details:

- What was the reason to get glasses?

- How long have you been wearing glasses?

- Your previous prescriptions?

- Have you got a dilated eye exam?


Cactus Jack 21 Apr 2014, 08:54

Weirdeyes,

It sounds like you are working with your eye care professionals to help you with your problems. There have been several instances over the years where people were having mysterious eye comfort problems and it took some detective work to identify the problem. Three possibilities come to mind that might be worth considering:

1. Dry eye problems, caused by insufficient tearing action, very low humidity, In one very unusual case, the individuals eye lids were not completely closing when they were asleep.

2. Allergies causing itchy eyes. Typically allergy problems are caused by pollen in the spring, but can also be caused by pets and other environmental factors.

3. Early onset of the symptoms of presbyopia. Your comment about your iPhone brought that to mind. The tiny text on smartphones and tablets has resulted in teen agers experiencing the symptoms of presbyopia years earlier than that ordinarily would. This happens more often to teens with unidentified and uncorrected hyperopia. The idea that you don’t need close focusing help until 40 is a myth.

Presbyopia actually starts in childhood and you gradually loose your ability to focus close as you get older. It typically does not become a problem until a person gets to 30 or 40, but people with hyperopia tend to experience it earlier and often need a low add bifocal much earlier than is typical. All those myths and rules were developed long before iPhones were even dreamed about. Back when the smallest text was newsprint, or worst of all, the phone book, many a phone book had a magnifying glass nearby. These days, it is not unusual to see a teen looking through her/his bifocals to read the text on their smartphone.

I would suggest that you need to do a bit of detective work. When you start noticing the discomfort, try to write down what you were doing just prior to the onset of the discomfort, the environment, and time of day. It may take a few weeks of notes for an identifiable pattern to become apparent. If you can see a pattern, you can probably solve the problem. Remember, your Eye Care Professional (ECP) gets to see you for just a few minutes, but you get to experience the problem for hours or days. The better you can describe the problem and circumstances to your ECP, the better chance you have of getting him/her to help you solve it.

You did not mention in what part of Canada you live, but it has been an exceptionally cold winter in parts of Canada and the northern US. Cold weather is often accompanied by extremely low humidity both indoors and out. Could that be a factor?

Keep in the back of your mind that what you are experiencing is really not all that weird and the solution may not involve optics at all.

Please let us know what you discover. You have to be the detective. Remember, all we can do is be a long distance Coach, sometimes from many thousands of Km away.

C.


Lena 21 Apr 2014, 08:30

Hi,

I am +1.25 farsighted with some mild astigmatism. Is there any way that I can get progressively more farsighted or get a stronger prescription by the time of my next eye exam? I am 20.


LT Lurker 20 Apr 2014, 20:37

Thanks CJ for a superb explanation. I am guessing that in the case of a latent hyperope they could have a lot of ability to move focus nearer by using the un-relaxed cilliary muscles and once presbyopia kicks in these cilliary muscles have to start relaxing?

Thanks LTL


Weirdeyes 20 Apr 2014, 19:42

1. Am I correct in assuming that you are still a student?

Yes, but not full time. I have chronic fatigue symptoms.

2. Do you have to do a lot of reading?

No, but I use my iphone a lot.

3. May I ask your favorite subjects?

I don't really have any.

4. Have you had any science, math, or physics courses?

Not really.

5. If you have studied any science or physics, did you study anything about optics?

No, but I learned about optics while browsing this website and a few others.

6. Do any of your parents, grandparents or other close relatives have to wear Plus glasses or Minus glasses full time?

My mom wore +5.00 glasses before LASIK and my dad just has low minus glasses with about the same amount of astigmatism as me.

7. May I ask your gender?

Female

8. Would you like to understand more about optics and vision?

Ok

9. Do you happen to recall your glasses prescription prior to this one?

R +0.25, -0.50 L +3.50, -0.50

10. Do you recall any discussion about amblyopia?

When I had my previous prescription they thought I had it, but when they increased my astigmatism correction they discovered that I don't have amblyopia.

11. While wearing your glasses, if you compare your vision with each eye individually, is it pretty much equally clear?

Yes


Cactus Jack 20 Apr 2014, 19:05

Weirdeyes,

Thank you for your answers. They help.

First of all, your eyes are not very weird, you happen to be a bit hyperopic and have a bit of astigmatism. None of this is particularly unusual, it just seems that way to you and perhaps to your classmates. The only thing that is even a little bit unusual is the difference in the prescription between your Right eye and your Left eye you provided (R +1.75, -0.75 L +4.25, -1.25) and that is only a difference of 2.50 diopters. There is nothing that says that your two eyes have to track together and it is actually rare to have exactly the same prescription in both eyes.

Could I ask a few more questions?

1. Am I correct in assuming that you are still a student?

2. Do you have to do a lot of reading?

3. May I ask your favorite subjects?

4. Have you had any science, math, or physics courses?

5. If you have studied any science or physics, did you study anything about optics?

6. Do any of your parents, grandparents or other close relatives have to wear Plus glasses or Minus glasses full time?

7. May I ask your gender?

8. Would you like to understand more about optics and vision?

9. Do you happen to recall your glasses prescription prior to this one?

10. Do you recall any discussion about amblyopia?

11. While wearing your glasses, if you compare your vision with each eye individually, is it pretty much equally clear?

Sorry to be a pain with the questions, but as I said hyperopia causes lots of different problems compared to myopia and sometimes is it hard to figure out what is causing visual discomfort.

C.


Weirdeyes 20 Apr 2014, 13:01

1. Your age?

17

2. Your occupation?

Unemployed

3. Where do you live (country)?

Canada

4. Does your Right Eye or Left Eye feel differently when you are feeling strain.

They usually feel different whether I have strain or not.

5. Do you have any problems with double vision with or without your glasses.

Sometimes I notice double vision without my glasses. When I first got my glasses I noticed double vision when I moved my head.

6. How long have you worn vision correction?

Since I was eleven.

7. How is your distance vision with your glasses?

Good

8. How is your near vision with your glasses?

Good


Cactus Jack 20 Apr 2014, 10:19

Weirdeyes,

The typical reason a post gets no response is that there is not enough information to offer reasonable suggestions or the symptom descriptions are almost meaningless.

Hyperopia is probably the most difficult to deal with because it can have a variety of symptoms and effects and much more information is needed to understand and explain what may be happening.

Here are a few questions that would help:

1. Your age?

2. Your occupation?

3. Where do you live (country)?

4. Does your Right Eye or Left Eye feel differently when you are feeling strain.

5. Do you have any problems with double vision with or without your glasses.

6. How long have you worn vision correction?

7. How is your distance vision with your glasses?

8. How is your near vision with your glasses?

Just to mention a few. There could be more questions based on your answers.

One thing that comes to mind is that there is enough difference between the sphere correction to cause a noticeable difference in image size on your retinas. It could be that your brain is ignoring the image from one of your eyes and overworking the other. At this point there is no way to know and even with all the information you can offer, you may need to consult an ECP.

C.


Weirdeyes 20 Apr 2014, 08:06

I'm reposting this because I got no replies.

I've been noticing some weird eye strain that I get whether I'm wearing my glasses or not. When I have this eye strain I can see okay with or without glasses. My prescription is R +1.75, -0.75 L +4.25, -1.25. I've been wearing this prescription full time for two years, but sometimes it seems pointless when I get that weird strained feeling.


Soundmanpt 19 Apr 2014, 14:41

Carrie

It was just a matter of time before your cousin was bound to give up telling herself she didn't to wear her glasses full time. It never was a question of if but rather a question of when. Now of course she is finding out what you have been telling her, that is just so much easier to wear them all the time and be done with it.

Now as for the little girl working at the coffee shop, if she still can actually see distances perfect without her glasses it won't be long before she won't be able to anymore. Of course she may not want to admit it to anyone. Now of course since her glasses are probably pretty weak she will be able to see distances okay, just not perfect. Pretty much like you when you started wearing glasses and you could see distance pretty good without your glasses but you could see distance better with them.


Carrie 19 Apr 2014, 13:43

My cousin has finally given in to wearing glasses full time. She's spent the last few months since getting her new prescription denying to herself and everyone else that she should wear them all the time despite her optician saying she would be better off wearing her glasses full time. At first her new glasses made distances worse but this changed one she had got used to them. She would wear them at college and at home (to stop her parents nagging her to wear them) and, as they did actually improve her distance vision, for driving but would avoid wearing them anywhere else unless she really needed to. In the last couple of weeks her eyes have felt more tired and in the last few days has reluctantly began wearing her glasses all the time. She admits that her eyes do feel better for it.

Me and Gemma took her into town for some retail therapy today and called in at our favourite coffee shop. Danielle was in there waiting for our friend to finish her shift serving in the shop. As soon as Danielle saw us I could tell she fancied my cousin! Our server friend came over to sit with us when she finished still wearing the glasses she doesn't really need. I looked around the table and noticed that Danielle was now wearing her glasses (looking sexy in them) as she was messaging someone on her phone. At that point every person on that table was wearing glasses! The only one with minus prescription glasses was my Gemma, the rest of us were wearing plus prescriptions of varying strengths. So she was sort of the odd one out. My cousin pointed out that she was the odd one out as she was the only straight one out of the 5 of us. Danielle suggested that her girlfriend could also be the odd one out as she was the only one of us who didn't need the glasses she was wearing! You can't have 3 odd ones out! Ha Ha!

We chatted for ages and my cousin cheered up.


Cactus Jack 19 Apr 2014, 01:27

LT Lurker,

You can get a pretty good idea of your accommodative amplitude by judicious application of our favorite one of Sir Isaac Newton’s optical formulas to the numbers you provided.

You can get a good clue that you still have pretty good accommodation for your age by noticing that you only have a prescribed add of +1.50. That means you have +1.00 to +1.50 of comfortable accommodation remaining to read at 40 to 33 cm.

If you wear a -2.50 contact on one eye, you can focus pretty easily at 30 cm. Lens Power = 100 cm / 30 cm or +3.33 of accommodation without much effort and 100 cm / 22 cm = +4.50 if you work at it.

To focus the uncorrected eye at 12 cm requires 100 / 12 = +8.33 from somewhere. +2.50 of that comes automatically from your uncorrected myopia. The remainder of +5.83 has to come from your ciliary muscles and crystalline lenses.

Do not assume that your two eyes have to respond to accommodation requirements equally. They are independent entities and your ciliary muscle strength may not be equal and presbyopia effects may also not be equal.

Naturally, these are all SWAGs

C.


LT Lurker 18 Apr 2014, 23:32

Hi All,

I have been trying to work out my accommodative amplitude.

I am 47 and wear a -2.50 contact lens in my left eye and I am uncorrected in the right (-2.50) as well.

My prescription for glasses is L-2.5 R-2.5 ADD +1.5 - I don't have bi or multifocals as I do ok with either monovision or my single vision glasses .

I have been trying the push up method -moving a sheet of small text along a ruler and the text blurs at 30cms with the corrected eye.Although I can see the same text clearly nearer in if I kind of refocus and is clear at 22cms

The uncorrected eye is 12cm -

How am I able to refocus to 22cms at age 47 when I have a +1.5 ADD?

Thanks LTL


Soundmanpt 28 Mar 2014, 12:13

James

Well your wife has had her glasses now for about 10 days how is she doing with them? If shes been wearing them full time her eyes should be adjusted to them and they should feel comfortable for her now. When she takes them off her distance should be slightly blurry and not as clear. Has she managed to learn how to use the add when she is reading or doing other close work yet?


Soundmanpt 28 Mar 2014, 11:26

PaulZ

When and when you don't choose to wear your glasses is totally up to you and your wife.

And I promise not yo call the "glasses police" on you or her. This time I will just let you off with a warning. lol


PaulZ 25 Mar 2014, 21:01

Your response is true in some cases however my comment was based on the majority. Yes I know of a few that wear progressives and don't wear their glasses full time. For most though either the distance vision or the close vision continues to change requiring glasses to be worn more often if not full time.

As far as astigmatisms go generally speaking most doctors recommend full time wear at -.75 or -1.00 for sure. Like anything this doesn't mean the patient always does what is recommended.

Soundmanpt,

I'm sorry but my statements are true, period. I worded them carefully enough, without using any specific numbers, to make them so.

You cannot take your personal observations and project on those onto a general population; I doubt there are many surveys on the link between having progressive lenses and wearing glasses all the time. On the topic of astigmatism (there is no such thing as "astigmatisms"), again, we have two eyes, not one, so people can vary in their tolerance.

For example, I can tell you that I have -0.50 R and -0.75 L of astigmatism with nearsightedness in progressive lenses myself, and I frequently take my glasses off while at my desk. My wife is now normally full time (plus with a little astigmatism in progressives). But she, too, takes her glasses off sometimes when we go for a walk, relax on the sofa, etc. Are you going to call the full time police on us?

My point is, you are not an optometrist and neither am I, and we have to be respectful of personal choices--particularly in these mild correction cases.


Soundmanpt 25 Mar 2014, 10:05

PaulZ

Your response is true in some cases however my comment was based on the majority. Yes I know of a few that wear progressives and don't wear their glasses full time. For most though either the distance vision or the close vision continues to change requiring glasses to be worn more often if not full time.

As far as astigmatisms go generally speaking most doctors recommend full time wear at -.75 or -1.00 for sure. Like anything this doesn't mean the patient always does what is recommended.


Weirdeyes 25 Mar 2014, 08:30

I've been noticing some weird eye strain that I get whether I'm wearing my glasses or not. When I have this eye strain I can see okay with or without glasses. My prescription is R +1.75, -0.75 L +4.25, -1.25. I've been wearing this prescription full time for two years, but sometimes it seems pointless when I get that weird strained feeling.


PaulZ 18 Mar 2014, 22:52

Soundmanpt, I read your posts here and appreciate your helping others, but I have to correct a couple of points you constantly make:

(1) Just because someone has been prescribed multifocal or progressive lenses does NOT mean the person is compelled

to wear glasses full time.

(2) Just because someone has mild astigmatism does NOT mean the person is compelled to wear glasses all the time.

Believe me, I learned about this the hard way: My wife was long ago prescribed a mild prescription similar to James's wife, though with a little distance plus as well. It was her first prescription, and I was excitedly looking forward to her wearing them full time. I, too, relied on the internet and textbooks, and made the same assumptions as you have. I am nearsighted, so clearly I didn't know what it was like to have a prescription like hers.

Well, my wife was really not wearing the glasses as much as I expected, and she didn't seem to really need them all that much either. To make a long story short, our optometrist corrected me in front of my annoyed wife and suggested that I let my wife decide when and if she needed them. She really scoffed at the idea of going by a textbook.

She explained: Many people can go without a mild correction (especially plus) without realizing it. It doesn't matter whether the prescription has an ADD. Many people can tolerate mild levels of astigmatism as well, without realizing it (including some soft lens wearers). Many people can still read without their reading correction if they so choose. What multifocal lenses do is give the patient the OPTION of wearing them anytime. That notion is quite different from mandatory wear.

Really, almost any adult can figure out when to wear his or her glasses. If not wearing them is dangerous or harmful (say, when driving), then certainly an eye care professional will let the patient know, and suggest wearing them. (Kids, and perhaps the elderly, are obviously a different story.) Otherwise, it's better to let the patient decide, because the patient can figure it out.

Anyway, after that embarrassing moment, I left my wife alone. It took a few years, and just a few small prescription increases, before she really went full time. Patience prevailed.


Carrie 17 Mar 2014, 19:03

Soundmanpt - Thank you for asking after me. Just been busy, really. Also, don't want to lie to Gemma about what I was looking at if she asks so I tend not to look at eyescene if she isn't occupied doing something. I have been having a quick look at the posts but haven't had time to post anything myself.


Soundmanpt 17 Mar 2014, 12:17

James

I was just thinking yesterday that they should be calling soon to tell you that both you and your wife's glasses were ready to be picked up. You have been down this road many times, but this was all new for your wife being fitted with glasses. Did the optician explain anything to your wife about her glasses or did she ask any questions? They should have warned her to be very careful on steps until she gets used to her glasses. Did they have her read a card with various size sentences on it to test how well she could see with the add? Was any recommendations made about when she should wear them? It of course would have been a big help if they suggested that she wear them full time. Actually she really does need to even though she doesn't have any SPH so she isn't nearsighted, but her CYL is at the point that most doctors want their patients to wear their glasses full time.

I'm sure she was surprised at how much better she was able to see the TV with her new glasses. She has been watching TV and never had any idea it wasn't as clear and sharp as it should have been. She will find the same thing when she is driving. Even though she could see okay before, now everything is going to be even more intense with her glasses.

Of course the more she wears them the more comfortable she is going to get wearing them. But it makes sense the more she finds how they improve her vision the better for you and her.


James 17 Mar 2014, 02:05

So we finally picked up our new glasses and my wife was amazed at the difference in the television. She kept saying, "I know I have a little script, but man they make a difference."That was music to my ears. She's worn them watching our normal Sunday night shows so hopefully the novelty will not wear off.


James 16 Mar 2014, 22:54

So we finally picked up our new glasses and my wife was amazed at the difference in the television. She kept saying, "I know I have a little script, but man they make a difference."That was music to my ears. She's worn them watching our normal Sunday night shows so hopefully the novelty will not wear off.


Soundmanpt 16 Mar 2014, 11:28

Carrie

It has been several weeks since you last posted any comments? I hope all is well with you?


LT Lurker 12 Mar 2014, 05:57

My wife, after some time of trying hard not to wear her glasses has relented and now wears them regularly.

She sometimes tries to go with out but after a while she is popping them on her face.

She is trying hard not to look through the lenses for any distance work but sometimes she forgets herself and I catch her looking at objects across the room or outside.

I know she can see clearly with them as she states everything is extremely blurry - She has called out detailed info whilst only looking through her glasses ....and then realises and quickly whips them off!

I reckon a year or so she'll be full time.


Soundmanpt 06 Mar 2014, 15:35

James

She was willing yesterday, but the real question will come when she actually has to start wearing them how willing she will be? I think most would say it is much easier to go from part time wear and have a gradual progression to full time wear. It's a much bigger step going from never wearing glasses at all to wearing them full time. For her right now i'm sure she feels like she can see just fine. But that first day she gets her glasses and wears them she will not it that when she takes them off her vision is going to be more blurry than before she got her glasses. Somehow your going to have to convince her that this is normal and that her eyes are just adjusting to them. Hopefully the very first day she will get lots of complements which should help a lot.

When she was picking out her frame with your friends mom was there any recommendations about wearing them full time?


James 06 Mar 2014, 14:51

My wife and I went yesterday to get fitted for our new glasses. She was a very willing participant and seemed happy with the look. We should get them in about a week


DC 03 Mar 2014, 05:57

I was wondering of anybosy can help me

My wife is finally succumming to having to wear glasses and I have just had a chance to see the latest prescription, Can you advise me of her progression to full time varifocals

distance

Left sph cyl -100 Axis 015

Right sph cyl -50 Axis 170

near

Left +1.75

Right +1.75

Vdu

Left +1.25

Right+1.25

She is in her late 40's and is taking this badly even if I reassure her that she looks great, just would love to see her fulltime

Thanks


Soundmanpt 02 Mar 2014, 15:09

Likelenses

These young ladies you described are just complete opposites. The one that was wearing SPH -1.50 CYL -3.00 clearly doesn't like wearing glasses and probably even less in front of a guy she was on a date with. She know doubt is uncomfortable wearing glasses and feel she is more attractive without glasses. Did you ever try and tell her when she did have them on briefly that she looked good with glasses? It may have helped, sometimes just an acceptance can make a big difference. For her by taking her glasses off she was saying this is what I really look like. my guess is she really liked you and she was trying to make an impression on you.

The other young lady is the one I would want to date. This is just a guess but she may have one of those girls that always wanted glasses and never needed them. But if she continued to insist that she needed glasses and it could be when she got to driving that if she made a claim about poor vision at night whil driving that will almost always trigger a doctor to prescribe glasses fro driving at night. So that may have provided her with her first rx of only -.50 in both eyes and again with constant badgering that her glasses aren't strong enough she could have convinced different doctors to give her the smallest increases possible and now they are refusing because they can tell she doesn't need an increase and probably is over corrected. She probably has convinced herself that her glasses aren't strong enough and she actually believes it herself. If she has been twice in 2 years and she wasn't given an increase her eyes are completely stable and she won't find a doctor to go any further with over correcting.

If you still know her you need to get her into this forum i think she belongs.


astigmaphile 02 Mar 2014, 14:11

Likelenses,

The woman with -1.50sph/-3.00 cyl had alot more reason to keep her glasses on than someone with just -.75/ -1.00 sph only.Sometimes I don't understand peoples behavior.


Likelenses 01 Mar 2014, 22:23

Revolver and astigmaphile

Yes blur interpretation is interesting

I at one time dated a girl that had really strong astigmatism correction,perhaps -3.00 cyl.,along with about -1.50 sphere. When I would pick her up for a date she would be bare eyed, but would put the glasses on to walk out of her apartment.As soon as she sat down in my car,off they came,but as soon as I began driving on they went.When we got to the date destination off they came until we were inside,and on again they went.This type of thing went on all evening,no matter where we went. Watching TV with her was interesting also. On for the program,but if she got up to leave the room,or wanted to talk,off they came.The hinges on the glasses were so loose that they would flop around.

Another girl that I later dated had a very mild minus Rx,around -.75.-1.00,with no cyl.,and she wore her glasses constantly.If she took them off for any reason,even if to only clean them,she would squint very hard.Even when the glasses were new she would squint through them.She would complain how bad her vision was especially at night,while wearing glasses.She had two eye exams in the two years that we dated and never needed an increase.If we went to a movie she always wanted to sit near the front because she said she could not see well.She said she did not like to participate in sports because she couldn't see well.


astigmaphile 28 Feb 2014, 18:07

Revolver,

I am 0.00/=2.50 in my left eye and can easily read the 20/70 line. My right eye is 0.00/+1.25 and is 20/30 or 20/40. Do I just have damned good blur interpretation?


Soundmanpt 28 Feb 2014, 15:18

James

Just a suggestion when you both go back to have your glasses fitted when they come in. If your wife doesn't ask maybe you should say something about this being your wife's first glasses and just say something about adjusting to wearing glasses and that you have heard that getting adjusted to glasses with astigmatisms is harder than if you are just nearsighted? By the way this is true, for many astigmatisms can cause the room to spin and dizziness which is very common, but the fear for you is if that happens she may decide not to wear them.

Likelenses is very right that usually most doctors want you to wear your glasses full time once your astigmatisms are at -.75 or above.

Maybe another way is that after you both make your selections for glasses and this woman your going to be working with has a chance to see her prescription you could call her before your glasses come in and let her know that these are your wife's first glasses and that your afraid she is going to be reluctant to wear them as she should and that it would help if she would make a a point to recommend that she wear them full time because of her astigmatisms so her eyes can adjust.

Did you happen to ask your wife what the doctor suggested to her about when she should wear them> I can't imagine that she didn't ask that question already so maybe see what she says her doctor recommended.


Revolver 28 Feb 2014, 13:32

Likelenses: the operative words in your recent post were "optometry books", so they can teach and the O.D. can preach, but it's a matter of the subjective interpretation by the wearer.

Case in point, I had a girlfriend back in the 80's who was prescribed OD plano/-1.25 x 172 and OS plano/-1.75 x 180. Her unaided VA was 20/100 OU, with that rx she was corrected to 20/20 OU. She had a very attractive pair of large plastic frames, but would not be caught dead wearing them, she put them on once for me and then I never saw them again. And horror of all horrors, she drove without them.

The docs call this good blur interpretation. My opinion was it was pure vanity.


James 28 Feb 2014, 09:24

Thanks for the responses. I was a little disappointed in the weakness of the perscription. I guess since she never really complained about poor vision I should have expected it to be weak. My hope is that when she gets the glasses she is amazed at the clarity and decides that she wants to wear them often. As someone who has never worn glasses or understands what it really means to be blind w/o glasses, she may think she is really blind without them. What is the likeliness of an increase going forward? I guess whether she's full-time, part-time or whatever now, I'm sure I'll be able to look forward to full-time eventually like almost all of us. I'm also hoping the fact that I have always worn glasses full-time since the day we met 12 years ago that she may embrace wearing them as well. She has always been very involved in picking out my glasses,so I'm looking forward to the same with her on Wednesday. Btw, I'm getting new glasses too so we'll be helping each other.


Likelenses 27 Feb 2014, 20:14

James

Most books on optometry teach doctors that if the astigmatism is .75 or greater in the better eye,that the glasses should be worn full time.

Since she is at that point,and that her right eye is at 1.00, I think that if she wears the glasses for a few days that she will be very uncomfortable ,and will not see distant things very well without them.Additionally if she uses them for extended periods of near work,she will find distant things quite blurred.

I think that you can look forward to having a full time GWG!


Soundmanpt 27 Feb 2014, 19:15

James

It will be up to her about what type of glasses she decides on. But since she isn't crazy about getting glasses in the first place I would think she will want progressives since there is no line for anyone to see and with such a weak prescription they will appear to only be single vision glasses.

I think if she asks about when she should wear them they might suggest full time because even though her astigmatisms isn't very bad they do cause her vision to be less than perfect at all distances. Generally when bifocals are prescribed they are for full time wear.


Soundmanpt 27 Feb 2014, 19:10

James

Well your wife's prescription is interesting. On the good side because the prescription is so weak she shouldn't have much trouble adjusting to them, but then again the fact that she has never wore glasses before and that she hardly needs them she may feel like she really doesn't need them. Since her distance part of her prescription is blank or "plano" in the SPH space that means she is able to see the 20/20 line on the eye chart. However she does have a fair amount of astigmatisms (CYL) and that will effect her vision slightly for seeing distances and even though she can read the 20/20 line without correction with her glasses it will be much sharper and clearer for her. Astigmatisms effect vision at all distances, so if she does as she said and wears her glasses full time she will quickly find them comfortable to her eyes for everything even though her sight isn't bad at all. The reading add is actually as weak as they can make it. So once again she is able to read now fine but just like the upper segment of her glasses the more she wears them the more she will find they make reading easier.

Since your looking forward to seeing her wearing glasses full time the biggest problem maybe just be the fact that her need for glasses isn't too much so she may feel like she can see just fine without them and sadly for you she is right. Remember for her not only does her eyes have to get comfortable wearing them but she has to get comfortable with learning to wear glasses. She isn't use to having anything on her nose, or behind her ears full time not to mention just getting used to looking through 2 little pieces of plastic in front of her eyes and now if that isn't enough learning how to use progressives. You will have to be very patient with her once she gets them.


James 27 Feb 2014, 15:56

My wife finally brought home a copy of her script :

OD sph: PL cyl: -1.00 axis: 080 add: +0.75

OS sph: PL cyl: -0.75 axis: 090 add: +0.75

We are going to get it filled next Tuesday. What kind of improvement in her vision can my wife expect? How often should she wear them? Will it be difficult to adjust to this prescription? Will she notice a big difference? Will they prescribe bifocals? varifocals? progressives?

What do you guys think?


Bob 27 Feb 2014, 15:43

Hi Cactus Jack,

yes, I think I understand the problem with the astigmatism.

Thank you for the explanation for the night conditions; good analogy.

I am a software engineer and live in NZ.

I had been living in (continental) Europe and just came back from there. One difference I recall (and that could make the difference) is that the ECP tested without dimming the surrounding light, while over here testing usually occurs in the dark room. That might have led to the different results.

I was thinking about the nearpoint as an indicator for the right prescription values - but this idea may be totally off. When using my old glasses I have the near point at around 28-30cm depending on situation, with the new prescription it lies at pretty much 20cm, which gives me very comfortable near vision, particularly when reading in bed.

Thanks for all your explanations!

Bob


Cactus Jack 27 Feb 2014, 10:48

Bob,

Astigmatism is NOT the direct cause of your eyes trying to turn inward. It is a very INDIRECT and more subtle cause. Astigmatism is typically caused by the front surface of the cornea having an uneven curvature sort of like the shape of a section of an American Football. Ideally, the cornea should be shaped like a section from the side of a perfect sphere. It can only be corrected by a cylinder and axis component in the lenses of glasses, contact lenses, or refractive surgery. You have no internal ability to correct astigmatism, but your brain does not know that. The only tools it has to adjust focus ares your ciliary muscles and crystalline lenses. When it tries to use those tools it triggers the convergence response and that causes your eye(s) to turn inward.

The reason you have more trouble at night is the same reason professional photographers have to be more careful about lens focus in low light conditions than bright light. It is a phenomenon called "Depth of Field" or range of useful focus. In bright light, your pupil closes down to reduce the amount of light reaching your retina just like the photographer increases the "f" stop on his lens to make the Iris opening on his camera lens, smaller. In both your eyes and in the camera that increases the range of useful focus. In low light your pupils open up to let in more light and the focus gets more critical.We can't tell for sure at this point if you need more PLUS or less PLUS to focus clearly in low light, but I suspect it is a little bit less. However, less plus would slow the resolution of your Latent Hyperopia.

A month is probably not long enough to resolve a situation that took years to develop. Ideally, you should get a new prescription, to balance your vision, but it is likely a bit too soon for that and your Eye Care Professional (ECP) would not want to change your prescription this quickly. I suggest waiting another month to see how your vision improves. I may be able to suggest a simple test to estimate the cause of the blurriness in your left eye. Remember that your two eyes are more independent than most people think and they respond differently to their visual environment.

May I as where you live and your occupation?

C.


Bob 27 Feb 2014, 06:06

Hi Cactus Jack,

yes, sorry I forgot to mention the amount of the increase. The increase was around 0.75 for each eye (not sure about the exact values). That was the strongest jump I ever had, and this within a year. And yes, initially things were quite blurry, but close distance was a real surprise (forgot that one has fingerprints ;)). However, now distance is clearing up. Only the left side is still a bit blurry but I can compensate this well when using both eyes. However, I still struggle a bit at night (if that makes sense). In daylight my vision is much more comfortable. The increase was about a month ago. Should the ciliary muscles be relaxed by now or can I expect a further improvement?

But coming back to the original point: Your suggestion that the astigmatism might be the actual reason for the turning sounds convincing. I indeed have to put quite some effort to read small writing because of the constant blur, which bothers me more at close distance. Thank you for this insight. Also, the idea with the projecting clock is great.

Again, thank you very much!

Bob


Cactus Jack 26 Feb 2014, 16:38

Bob,

Because you didn't provide your previous prescription, I can comment on the change and all I can do is speculate on what is going on. Here is what I think.

You have a low to moderate hyperopia prescription, possibly with some Latent (hidden) additional Hyperopia lurking in the background. Your prescription is complicated by significant astigmatism and likely some true or perhaps what I will call some Pseudo Presbyopia with a little Esophoria, thrown in for good measure.

Given all that, the symptoms you related are pretty typical of a person of your age, in your situation. With the exception of the astigmatism, all the things i mentioned sort of go together. The astigmatism just makes trying to correct your hyperopia using your ciliary muscles and crystalline lenses, impossible and when you try very hard, your eye or most likely, both eyes, try to converge or turn inward. Your left eye just turns in more. This inward turning is because of the interconnection in your brain between the focus control system and your eye positioning system. The connection between those systems works both ways and when you try to add some PLUS using your ciliary muscles and crystalline lenses, your eyes converge and vice versa. The strength of the interconnection varies with the individual and yours seems to be pretty strong.

The only way you can avoid that is wearing your glasses and letting them do the work. You might also consider some toric contacts that can be safely worn for for extended periods (overnight), but they have risks of there own and are not inexpensive. Another possibility is refractive surgery for both your hyperopia and astigmatism, but you don't want to consider that until all of your latent hyperopia has been resolved. You might also try one of those clocks that project the time on the ceiling so you don't have to focus close to read it.

I believe the first thing you need to do is try to resolve your Latent Hyperopia and then work on the other items. Unfortunately, a dilated exam will help to discover your actual hyperopia by relaxing your ciliary muscles, but that often does not fully relax them, it just does not last long enough. The best technique is to wear a bit more PLUS sphere correction than you need to see distant objects clearly. Initially, distant objects may be blurry, but if, over a few weeks of full time wear, they clear up, it is a sure sign that you had some latent hyperopia. The next step is to increase the sphere PLUS again and wait for the distance blur to clear up. At some point, the distance blur will not clear and it is time to back off on the PLUS until distant objects are clear and that prescription will probably be stable for years.

Unfortunately, there is a side effect that you may not like. Your ciliary muscles will probably become de-conditioned and you may need to wear bifocals or progressives sooner than you expected, but there are ways to exercise them and restore some accommodation. However, conditioning the ciliary muscles will not have any effect on the steady progress of Presbyopia. Presbyopia is most likely inevitable and most people with hyperopia seem to need close focusing help earlier than the mythical 40.

Hope this helps.

C.


Bob 26 Feb 2014, 06:57

Hi guys,

I recently had a change in my prescription:

L +2.5, -1.75

R +2, -1.5

I also wear 2 prism BO in each eye.

Now when I focus at an object without glasses (e.g. clock after waking up) it has gotten a lot harder to focus on close objects. (In this situation I generally only use my right eye as the left one is too blurry, despite the low prescription.)

However, when I do so, my left eye seems to turn in towards the nose, and not just a bit, but pretty much totally crosses (way more than the deviation I have with prisms). I didn't have that problem before and I am just wondering if that is normal. I read about this before, but I thought this would only happen with strong prescriptions, not weak ones as mine.

Can I do anything to avoid that? If I force my eyes to focus together, everything is too blurry.

Is that a reason to be concerned, or do other people have a similar problem?

If of relevance, my age is 33 and I am pretty sure I didn't have that problem before.

Greetings!


 26 Feb 2014, 04:41

Cactus jack

My wife is finally succumming to having to wear glasses and I have just had a chance to see the latest prescription, Can you advise me of her progression to full time varifocals

distance

Left sph cyl -100 Axis 015

Right sph cyl -50 Axis 170

near

Left +1.75

Right +1.75

Vdu

Left +1.25

Right+1.25

She is in her late 40's and is taking this badly even if I reassure her that she looks great, just would love to see her fulltime

Thanks


Cactus Jack 25 Feb 2014, 10:43

Helen,

I am not sure what measurement system you like to use (Metric or English), but I will use Metric in what follows simply because it is easier work with. Just remember that 1 meter is 39.37 inches.

You have a pretty good idea of how the optics of the eye work. Actually, the numbers do bear a mathematical relationship to their prescription, it just is not obvious. The mathematics of optics were discovered by Sir Isaac Newton, of gravity fame, around 1700. It was he that developed the formula that is the basis of almost all optical calculations. The formula fundamentally says that the optical power of a lens is equal to 1 meter (or 100 cm or 1000 mm) divided by distance at which parallel rays of light from a distant object will converge to a point. If you have ever used a magnifying glass (PLUS lens) to focus the sun's rays to set something on fire, you have used Sir Isaac's formula. In math shorthand the formula is: Lens Power in diopters = 100 cm / Focus Distance in cm. That formula can be algebraically rearranged to: Focus Distance = 100 cm / Lens Power in Diopters.

Everything related to vision correction starts with the determination of a person's refractive error, generally by using trial lenses to discover which lenses will correct their distance vision refractive error to 0.00 using external lenses that NEUTRALIZE or CANCEL OUT the error. That means that if your eyes have too much PLUS (myopia), you need MINUS lenses to neutralize it or if your eye have too little PLUS (hyperopia), you need PLUS lenses to supplement that which you already have or can generate, using your internal crystalline lenses. The object is to sharply focus light rays from distant objects, very shapely on the retina. Notice the emphasis on PLUS lens power in your eyes. That is because each eye has 4 lenses with a total power of between +50 and +60 diopters to focus distant images on the retina, which is typically only about 12-16 mm behind the eye's lens system. Once, the required correction for distance has been determined, everything from there is simply math using Sir Isaac's formula.

For example, if you want to focus on a book or newspaper that is typically about 40 cm or 16 inches away from your eyes, you will need +2.50 of additional PLUS from some source. ( Lens Power = 100 cm / 40 cm +2.50). The key point is "from some source". If your ciliary muscles and crystalline lenses can supply it internally, then that will be good enough. If they can't, it MUST be supplied by glasses or contact lenses. The rules of optical physics apply, no matter what. Distances less than 6 meters (20 feet), but more than 40 cm or 16 inches will require LESS plus. To focus and distances closer than 40 cm or 16 inches will require MORE plus.

When you see that a prescription includes an ADD, that just means that the reading segment ADDs that much PLUS power to your basic distance prescription. You can calculate the ABSOLUTE optical power of the reading segment by simply adding the distance sphere correction to the ADD. For example, if you need a sphere correction of +1.00 to see clearly for distance, your reading segment will be (+1.00) + (+2.50) = +3.50. If you wanted to get some prescription single vision reading glasses you would just need to get some +3.50 readers to have the same optical power as the reading segment of bifocals or progressives. If a person was myopic the power of their reading segment might be something like this: (-2.00) + (2.50) = +0.50.

If a person still has some accommodation available to help out with focusing close, the reading ADD will be less than +2.50 by what ever amount of PLUS they can contribute internally.

If you like to focus closer than 40 cm, your ADD will be more than +2.50. To determine the ADD to focus at any distance, just divide the distance in cm into 100 cm and that will give you the answer.

People order glasses with prescriptions that are different than those prescribed in examinations for a lot of reasons, but Sir Isaac's formulas are the basis of all optical prescriptions.

C.


Helen 25 Feb 2014, 04:08

Hello Cactus Jack

Thank you for the reply and as I understand it the role of my glasses is to let my Ciliary muscles relax and take on their role. I guess this means that like any muscle if its not used it will loose its strength hence your suggestion about full time wear. The consequence being my distance vision will eventually become slightly blurry all the time without glasses. I have read a lot of stuff on the internet about glasses making vision worse so I was keen to find out exactly what was happening so thank you for clearing that myth up. One other question if you don't mind, I have read elsewhere on the internet about someone talking about the lens strength of their glasses. How did they arrive at a number which bore no relation to the numbers on their prescription?


James 24 Feb 2014, 20:32

My wife has dragged her feet on getting her script, but she is set to finally get it on Wednesday. Then she can go into my friend's mom's store and get her bifocals. I'll share her script when I see it on Wednesday.


Cactus Jack 24 Feb 2014, 08:13

Helen,

I suspect what is going on is that you may have a bit of Latent Hypeopia or Hyperopia that has not been correct and you still have a very small amount of accommodation. You glasses allow your ciliary muscles and crystalline lenses to relax for distance, which is what you want to occur. When you take off your glasses, your ciliary muscles try to use your crystalline lenses to add the plus you need to see clearly in the distance, but it takes time and a lot of effort and strain to do it, thus the headaches.

Hyperopia, where you need plus lenses to see clearly in the distance, is unique because you have the internal ability to use your ciliary muscles and crystalline lenses to correct it. However, presbyopia gradually takes that ability away. When you get Hyperopia, Presbyopia, and glasses trying to work together to solve a problem is can sometimes be like the old saying that "too many cooks spoil the broth". Sometimes they work together and sometimes they work at cross purposes and the results are often confusing.

The best solution is to wear your glasses all the time and avoid the blurriness and headaches. Be aware that your distance prescription may not be quite through changing and you may need a bit more plus before it stabilizes. If you vision is not comfortable, don't put off a visit to your optician until some arbitrary time. There is nothing to be gained by waiting.

C.


Helen 24 Feb 2014, 07:08

Hello Cactus Jack,Thank you for replying. I was first prescribed readers only when I was 41, and this followed until this last prescription when my Optician said my distance vision needed a 'boost'. My current prescription says Right eye Sph+.75 Cyl -.50 axis 75 Add +2.75

Left eye Sph +.75 Cyl -.50 axis 100 add +2.75.

My previous prescription was Sph+.25 Cyl -.50 axis 75 Add +2.25. Left eye Sph +.25 Cyl -.50 axis 100 add +2.25.I am now 49.


Cactus Jack 24 Feb 2014, 06:48

Helen,

The symptoms you posted are typical when a person has a combination of hyperopia and presbyopia and has just begun to need correction for both. I could probably give you a more definitive answer if you could provide your complete prescription and your approximate age.

If you review some of the earlier posts on this thread, I think you will find others who have had or are having similar symptoms.

C.


Helen 24 Feb 2014, 06:37

Hello everyone,I am curious about some of the changes with my eyesight. I recently got my first pair of progressives after only having readers for several years before. I am finding that after wearing them for a a few hours if I take them off my distance vision is slightly blurry this however does clear after a while although if I don't wear my glasses again I will tend to get a headache which will be resolved by putting my glasses back on again. I have also noticed that the longer I wear my glasses the longer it takes for the distance vision blurriness to resolve.


Cactus Jack 21 Feb 2014, 12:18

Lucas,

Sorry to be slow in answering your questions. Been very busy on another project.

You vision can change through the day for many reasons and it is sometimes very hard to understand what is happening with so many variables. The key is to gather clues over several days and if possible keep detailed notes.

In some situations, you vision can even be affected by what you eat and your overall health. For example, blood glucose levels can affect the Index of Refraction of the Aqueous Humor and Vitreous Humor in your eyes and change your prescription. People with poorly controlled diabetes often have to have several different pairs of glasses and have to pick the pair that gives them the best vision for what they are doing. I did not mention that to scare you, but it does happen and is sometimes a clue that there are other health problems.

Another thing that can happen is that after a day of doing close work, your ciliary muscles and crystalline lenses may be slow to relax and you notice a difference between being tired and fully rested in the morning. If you have Latent Hyperopia, that is fundamentally caused by the ciliary muscles and crystalline lenses having trouble relaxing.

Please make some notes on your symptoms over a couple of days. If you have the weekend off, it is likely that your visual environment will be considerably different than a typical workday. That may help provide some clues as to what is going on.

Please remember that no one, including your ECP, can see what you see. Everyone involved can only rely on what you tell them. The more accurate and detailed your description, the better chance there is of getting to the bottom of the problem and getting it fixed.

C.


Soundmanpt 20 Feb 2014, 20:09

Carrie

Your correct in not saying anything. that would probably only make her rebel even more and as you know her eyes aren't going to get any better so as her eyes get worse she will soon not have any choice but to wear them no matter how much she hates the idea. Once she finally comes around and starts wearing them she will be fine with wearing them full time.

Probably the best thing is when she does start wearing them more often is to not say anything, not even a complement because she won't want to be reminded that she is wearing them.


Carrie 20 Feb 2014, 19:19

Soundmanpt

I'm afraid my cousin is being very stubborn and doesn't wear her glasses unless she is reading or with her or my parents. I'm not going to say anything to her or to our parents. It's her choice and I think she will wear her glasses more when she's ready and when she wants to. I'm not going to gain anything by saying something.


Lucas 20 Feb 2014, 09:27

Hi again,

A quick question. Last night, I could see perfectly well from close with the glasses on and they clearly helped my near vision. however this morning, I see better with them off. Is this due to how tired my eyes are in the evning and me able to compensate for my latent hyperopia in the morning? Should i keep them on even if my vision is worse with them?

Thanks


Cactus Jack 19 Feb 2014, 19:54

Lucas,

it is possible, but there is no way to predict WHEN you may need a change to your prescription. The point I was trying to make is that your visual comfort and clarity of vision are the things that should cause you to consider getting a vision check up, not an arbitrarily selected date.

I have seen visitors to ES, over the years, who obviously needed a prescription change in their glasses, but the ECP had said to come back in 6 months, 1 year, or even 2 years and they thought that they could not go back until the proper time. If you decide that your visual comfort is not what it should be, thats the time to get a check up. If you are doing fine at 6 months, wait a while. If things don't seem right at 4 months, check into it. You are the only one who can judge if you are not seeing as well as you should.

C.


Lucas 19 Feb 2014, 18:22

Do you mean I could need an increase sooner than in 6months?


Cactus Jack 19 Feb 2014, 17:41

Lucas,

Sounds like a good plan, at least for the short term. Don't let the calendar govern your actions. Your visual comfort and visual clarity should be the deciding factors until everything stabilizes. If you have any other questions, don't hesitate to ask.

C.


Lucas 19 Feb 2014, 17:33

Ill be wearing them all the time at work from now on anyways. I imagine ill need to go back in 6 months for a prescription increase as my eyes have accustomed


Cactus Jack 19 Feb 2014, 17:27

Lucas,

It may take more than an evening for your distance vision to clear up. It depends on the prescription in the glasses, your actual prescription, and how much Latent Hyperopia you have. That is one of the reasons Hyperopia and Latent Hyperopia are so hard to deal with. High levels of Latent Hyperopia can take weeks and months to fully resolve.

Please keep us updated on how you are doing with your glasses.

C.


Lucas 19 Feb 2014, 17:18

I picked up my glasses with my new prescription. So far, distance is a tiny bit blurry but i will wear them all evening and see if it adjusts


Soundmanpt 19 Feb 2014, 16:40

Carrie

Is your cousin coming to terms with wearing her glasses full time now?

Don't forget to check in soon at the coffee shop to see how she is doing now that she has her own weaker glasses to wear.


Soundmanpt 19 Feb 2014, 15:14

James

You said your wife "freaked out at being told she needs bifocals" Did she say if she has been having any problems with seeing signs in the distance or maybe problems when she is reading? If she honestly was surprised that she needs glasses that should mean her prescription for both distance and close will be on the weak side which should make it easier for her eyes to adjust to them.

Hopefully while there fitting her glasses for her they will give her advice as well. For instance while her eyes are adjusting to them she needs to be very careful going up and coming down steps as her depth perseption will be off a bit.

It is hard to say if she will need a minus on the top or a plus. it could be either way for her. If she does much close work or computer work then it could very well be that she needs a little minus for her distance. i guess you be finding out in a short while?


James 19 Feb 2014, 09:15

I had a good talk with my wife yesterday, and she's totally on board with the glasses. I told her that a friend's mom works at a local optical shop where they sell fashionable frames, and I would contact my friend to see a good time for her to go in. I'm also excited because that means she needs to go back to the place where she had the exam and get the script. I'm interested to see what it's going to be. I would imagine that it's going to be a + perscription with a bit of an add.


Soundmanpt 18 Feb 2014, 14:50

James

I'm sure your doctor is probably very capable. If he examined your daughter's eyes and feel she isn't ready for glasses yet then there is no rush to put her in glasses. Chances are by next year her eyes will have changed and she will need glasses. Hard to predict about your other daughters as that depends if they got your genes or your wife's genes. Since your wife is 38 and first now is needing glasses your daughters may not need glasses until later on as well. But of course it makes sense to get them all annual eye exams to know if and when they may need glasses.

Your right in your approach since your 8 year old knows that mom was told she needs glasses if she doesn't follow through now and get her glasses and wear them it will be very hard when the daughters start to need glasses to make them wear them if mom puts it off. So your right she needs to set an example for them. And as you know once starts wearing glasses she will soon find it hard to be without them anymore.

Of course you know when she gets her glasses you need to convince her that she looks good wearing them. But when she starts wearing them and her friends and family see her wearing them they will give her lots of complements which will really help her confidence.


James 18 Feb 2014, 09:22

My wife knew I was just kidding. We have that kind of relationship. My daughters know that she was perscribed glasses so my angle to get her to wear them is that we know at least one of them will need glasses someday (probably all of them with my eyesight) so she needs to set the example and wear them.


James 18 Feb 2014, 04:33

I live in a suburb of Chicago. Should I be more concerned about my daughter? I trust my optician. I've been seeing him for at least 15 years for myself.


Julian 18 Feb 2014, 03:35

James: seems to me that if your wife hasn't already chosen her frames you might tell her you want to help her with the choice because you think right glasses will make her even more gorgeous - if anything could!


Soundmanpt 18 Feb 2014, 01:59

James

Cactus jack is right. The worst thing you could ever do is poke fun at her or tease her about needing bifocals. Trust me if you do you might never see her wearing any kind of glasses.

This is a big step for her to not only be getting her first glasses but bifocals on top of it. You will be much better off by doing some mild encouraging by pointing out that they will probably help her see things better and that age has nothing ot do with needing bifocals and point out that she can get progressives and no one except he will know they are for distance as well as close up.


Cactus Jack 17 Feb 2014, 22:57

James,

I strongly suggest that you DO NOT joke with your wife about needing glasses or bifocals. She is having the denial reaction almost any woman will have to the news she received. It just confirms her worst fear, that she is going to get older. If you continue, she will dig in her heels and it will be years before she does anything about getting glasses, no matter how badly she needs them.

Instead, comfort her and re-assure her that it is her decision and no matter what she decides you will still love and cherish her. You might explain that the reason you found it funny is that you never have had a choice about wearing glasses. You are nearsighted and can't see much beyond your nose without your glasses. People who are significantly nearsighted, as you are, can sometimes avoid wearing bifocals or progressives for a bit longer than the average person, but you will also need bifocals pretty soon (unless you already have them).

Also, explain to her that your biggest concern is that she be able to see comfortably at all distances no matter if it takes glasses to do it and you will support her decision.

You also need to dig a little deeper into your daughter's situation and find out exactly what kind of vision difficulties your daughter is having.and why she did not pass the school vision test. You may also need a 2nd opinion from a another Eye Care Professional.

May I ask where you live?

C.


James 17 Feb 2014, 22:32

My wife took my 8yr old daughter for an eye exam today. My daughter failed her eye test at school but the Dr. said today that she has a weak muscle in her eye that caused her to fail but she doesn't need glasses at this time. My 38yr old wife, though, also had an exam also and was told she has near and far issues and would need bifocals. As you can imagine, she is freaking out. She's never worn glasses and definitely doesn't seem ready to either. I, on the other hand, wear glasses full-time (-6.00) in each eye. Not sure what wifey is gonna do, but I'm excited about the idea of seeing her in glasses. I'm also enjoying calling her grandma bc of the bifocals, haha. On a day when I expected my daughter to need glasses, I get the nice surprise abt my wife instead!!


Soundmanpt 16 Feb 2014, 11:40

Kate

I think the word "bifocals" really tends to scare people much more than it should I can only assume that for years it seemed something that only old people were prescribed to wear. But not anymore. You would be surprised at how many late teens and early 20's are now wearing bifocals. I too agree with Cactus Jack and Likelense as well that bifocals / progressives is the best option for you. Progressives is probably the better choice since there is no line to be seen and only you know your wearing them for both distance as well as seeing close. Also progressives offer a mid section that works well on the computer. As stated you probably need less than -1.00 for distance but even such a small amount will make a difference in how you see things at a distance. And your distance isn't likely to change much over time. Your nearsightedness is probably due to all the computer work you do which is very common. The nice thing is that your glasses should stay on the weak side for both distance as well as close up.

Wearing progressives will mean you won't be putting on and taking off your glasses all the time. You would probably get comfortable just wearing them all the time.


Kate 16 Feb 2014, 10:13

Bifocals? Really? Could it be that I am overprescribed for my reading prescription? I could strictly only wear them when reading but I hate drawing attention to them with all the on and off. I can still read without them but it is increasingly difficult and I don't think I could work the entire day without wearing them due to the eye strain and headaches. Maybe I will book an appointment at a different eye doctor...the last place I went seemed to be annoyed to have to give eye exams and were less than helpful.


Lucas 16 Feb 2014, 09:07

Hi thanks for all the info,

What ill probably do is wear these all the time in 6 months and then go back and see if I should have a stronger prescripiton now that im used to wearing glasses for distance and close


John S 16 Feb 2014, 02:43

Lucas,

You know that extended close work causes you discomfort. In some cases it is difficult to get a doctor to prescribe a "decent" reading prescription to a younger person.

You did not help the situation by saying you had a distance problem, when you really have a reading problem. Then you come out of the exam with an even weaker prescription.

I will repeat what C.J. said, you need to establish a baseline. You need to know what your distance prescription is. The only sure way to find that out is with a dilated exam. Your real distance prescription can easily be masked by the intervention of your accommodation muscles. The dilation procedure should paralyze the muscles and get them out of the way to reveal the amount of distance correction needed (if any). This may be an trial and error process to find out what is really going on. If you go in for another exam, measure the average distance between your forehead and the monitor, so your reading distance can be set to that.

At this point, there is not a lot of information to determine the problem.

Some possibilities - Latent hyperopia, a stronger distance prescription that may take a while to overcome to the distance blur.

An accommodation problem, with or without hyperopia. A possible distance prescription with a stronger reading prescription. When I was a teenager that was my problem, I had hyperopia and accommodative insufficiency (AI).

Eye teaming problems, where both eyes do not work together. Google the term, there are a lot of problems that can fall into that category.

An eye doctor that specializes in pediatric optometry is your best bet to get to the root of the problem. They are used to dealing with convergence and accommodation problems.


Likelenses 16 Feb 2014, 01:13

Kate

I agree with Cactus Jack,that there is a good possibility that you are now slightly nearsighted from all of the computer work that you do.

Many adults are becoming nearsighted in later years,and it is called adult onset myopia.The good news is that the distance prescription never gets really strong,but you will need to wear the glasses full time.I would guess that your new distance prescription will be about -1.00,and within a few years top out at -2.50 or so.And and as Cactus Jack said they will be bifocals.


Cactus Jack 15 Feb 2014, 23:41

Kate,

You need an eye exam. In bright light, your pupils close down like the "f" stop adjustment on a professional camera. This increases the Depth or Field or Range of Useful Focus of the lens. The same thing happens in your eyes. In low light conditions your pupils open up and that reduces your range of useful focus. The range gets narrow and distant things go out of focus. After a day of work, you may be a little nearsighted or need a prescription change. Be sure and tell the examiner all your symptoms you may need to consider bifocals or progressives to see comfortably for both distance and close because you are at an age where presbyopia can begin to manifest itself. The idea the you don't need focusing help until your 40s is a myth. Everyone is different and your visual situation is unique to you. Please don't put off an exam. Nothing will be gained by delaying.

C.


Cactus Jack 15 Feb 2014, 23:28

Lucas,

Hyperopia is much harder to refract, because you have the internal ability to compensate for quite a bit by using your ciliary muscles and crystalline lenses, which make up the autofocus portion of your eyes. Normally for distance, your ciliary muscles and crystalline lenses should be fully relaxed and to focus close, the ciliary muscles squeeze your crystalline lenses to add the necessary additional PLUS to focus closer than about 20 feet. When a person has hyperopia (needs PLUS glasses for distance) but does not wear them, the ciliary muscles and crystalline lenses can compensate without your even being aware of it and over time they can get so accustomed to adding that additional plus that they are unable to fully relax. That is what is called Latent or hidden Hyperopia.

Also, your autofocus system can become very sensitive to the need to focus and that makes it difficult to correctly refract a person who has Latent Hyperopia. To try to identify how much hyperopia you have, the examiner will start with trial lenses that have more PLUS (same thing as increasing the MINUS) than you need to correct your apparent hyperopia and gradually reduce the amount of plus until your can read the 20/20 line without effort. As a test, the examiner will often go beyond the 20/20 point by one or two steps and your autofocus system will correct the focus internally and you will see a bit sharper image which is the same phenomenon that people experience by wearing glasses with a slightly stronger MINUS prescription or in your case, less plus than you really need.

It is possible to prevent your autofocus mechanism from helping by using a dilating agent to temporarily paralyze the ciliary muscles. I would urge you to consider getting a dilated exam. Some states allow Optometrists to use dilating agents, but other states only allow Ophthalmologists to use them. A dilated exam takes a bit longer than a non-dilated exam because it takes about 20-30 minutes for most dilating agents to work. In addition to paralyzing your ciliary muscles the dilating agent will also relax your pupil. The effects will gradually wear off over 5-6 hours and during that time, you will not be able to focus very well or read and you will not be able to deal with bright lights. The examiners are well aware of this and they usually provide disposable high density sun glasses to help you get home. I have had many dilated exams and I try to schedule them so that I can go from the exam to home. There is no pain or other discomfort associated with a dilated exam. The dilating agent may sting a little, but most examiners will use a mild anesthetic drop before using the dilating drop, so you don't feel the sting.

A dilated exam is the first step in correcting your hyperopia, but unfortunately it will usually not detect much Latent Hyperopia. The dilation process simply does not last long enough for the ciliary muscles and crystalline lenses to fully relax. It can take weeks or months for Latent Hyperopia to be fully resolved. Which is understandable when you consider that it took years for it to develop.

If Latent Hyperopia is suspected or confirmed, the solution is to prescribe glasses with several steps too much plus and perhaps possibly a temporary prescription for bifocals, trifocals or progressives is a person is young. The idea is to create a condition where the crystalline lenses can relax. Initially, distance vision will be a little blurry, but as the Latent Hyperopia resolves, the distance vision will clear up and more accommodation will be available for close work. That may take a few weeks and a prescription change to again add a bit more plus may be necessary to complete the process. Once the Latent Hyperopia is resolved, you will probably need a prescription for plus glasses or contacts for distance, but if your ciliary muscles and crystalline lenses recover their full accommodation range, you may find that you can work for long periods at the computer in comfort. It is possible that you may find that some computer glasses add a bit of comfort, but one thing your should do when doing close work is to blink frequently and look up about every 10 minutes for a few seconds at a distant object to give your ciliary muscles and crystalline lenses a chance to relax a bit.

This has been a bit longwinded, but I hope this will help you understand what is going on and what can be done about it. One thing to remember is that you are not the only person to experience these kinds of problems. Hyperopia and Latent Hyperopia are pretty common. The reason I asked about the Smartphone and Tablet is that they tend to reveal that even some teens have Latent Hyperopia and require early help to read the tiny text. What is happening is early revelation of presbyopia. Presbyopia actually starts in childhood, but does not become a problem until the late 30s or early 40s. It is common for people with Hyperopia to begin to have problems with presbyopia earlier than people with myopia because they have been using part of their accommodation to correct their hyperopia instead of using it to focus close.

C.


Kate 15 Feb 2014, 22:03

Hi all. I have reading glasses, +1.5 L +1.75 R. In the last year or so, when I am tired or have a headache I tend to wear them all daylong since I spend the majority of the day in front of a computer. It seems that on days that are sunny my distance vision is not blurry at all but on cloudy days my distance vision is a little blurry. Is there a reason why that would be? I am due for an exam since it has been 2.5 years since my last one. I am 35 years old.


Lucas 15 Feb 2014, 21:06

Hi Cactus Jack,

to answer your questions in order:

1) From memory it was +1.00 in the right eye and +0.5 in the left eye

2) I have never had a dilated exam

3) I have recently graduated and started work where I spend all day on the computer. This is where I realized that my eyes would be extremely tired in the afternoon, much more so than as a student.

4) I do not use a phone a lot for texting

5) I do not own a tablet

6) US

7) No one in my family wears plus glasses for distance


Cactus Jack 15 Feb 2014, 20:57

Lucas,

Based on the very limited information you provided, I suspect that you have some Hyperopia along with perhaps some Latent Hyperopia to go along with it. At your age, you have plenty of accommodation and you can easily use your accommodation to compensate for your hyperopia, but it takes effort and is ultimately very tiring. Also, it can cause problems in an eye exam. Here are a few questions that might help us offer some suggestions:

1. What was your complete prescription before your most recent exam?

2. Have you ever had a dilated or "wet" eye exam?

3. What is your occupation. If you are a student, your course of study?

4. Do you use a Smartphone much for texting?

5. Do you use a Tablet?

6. Where do you live - Country?

7. Do either of your patents or any grandparents need Plus glasses for distance? It is likely that they need reading glasses or bifocals for close work.

C.


Lucas 15 Feb 2014, 15:47

Any thoughts?


 13 Feb 2014, 19:48

Lucas, she's an inadequite practitioner, because she doesn't have the communication skills to make up for your lack there of. Good luck being Mr. McGoo.


Lucas 13 Feb 2014, 17:59

Additionnaly, most of the eye test focused on me testing my distance vision with them, even though its mostly been reading problems. She also realized that for any lenses she would put, my eyes were always trying to adjust to them and in the end, id have a hard time telling which lens was best


Lucas 13 Feb 2014, 17:57

Hi,

I went for a new eye exam following really tired eyes at work and got a decrease in my prescription but told to wear them all day at work and for tv and distance. My prescription went down to +0.5 and -0.25 160 in the right eye and plano in the left. The doctor asked me how much i wore my old pair and i had told her only when my eyes were tired because i couldnt see well in the distance with them. She asked me if i would wear them more if my distance was clear with them to which i said yes. Am i correct in assuming that she is tryign to get me to wear them all the time and progressively get to my real hyperopia prescription?

PS i am now 23


Cactus Jack 12 Feb 2014, 13:19

IndoorSighted,

Of all the refractive problems, Astigmatism is the most difficult to understand. Your prescription:

OD: Sphere -1.50, Cylinder -1.75 x 94

OS: Sphere -2.25, Cylinder -1.25 x 76

indicates that you have significant astigmatism in both eyes, perhaps the dominant factor in your right eye.

Astigmatism typically affects the Cornea which provides a significant portion of the eye’s total optical power. The actual cause of Astigmatism is unknown, but the effects cause the front surface of the cornea to be curved more steeply in one direction (axis) than it is in the axis that is at 90 degrees from the long axis of the cylinder. To help visualize the effects of astigmatism, imagine that your cornea is shaped more like an American Football than like a section from the side of a perfect sphere like a soccer ball. The result is that it has more plus power in one direction than at 90 degrees to that direction.

In your right eye, its power is +1.75 diopters more (this will be very confusing) in the 004 axis than in the 094 axis. It is corrected by a cylindrical lens with -1.75 oriented, by convention, with the long axis of the cylinder at 94 degrees or approximately in the vertical directions. By convention, cylinder axis are measured from 0 degrees Horizontal in a counter-clockwise direction looking at the patient, through 90 degrees Vertical around to 180 degrees. Cylinder axis are always designated as less than 180 degrees.

Because astigmatism affects only the fixed focus cornea, it does not change with focus distance and therefore needs to be corrected only ONCE and it is good for all distances. If you read any of the posts on the GOC thread, you may notice that participants are cautioned to NEVER adjust the cylinder and axis in the glasses prescription while the sphere prescription is changed massively.

Note: There are two ways to designate cylinder correction. Ophthalmologists typically use + cylinder and Optometrists, Opticians, and Lens Makers typically use - cylinder. The use of + cylinder will make the overall prescription look radically different. However there is a simple formula for converting + cylinder to - cylinder and lens makers apply the formula to + cylinder prescriptions and make the lenses using - cylinder. The optical results are identical no matter how the original prescription was written.

Under Correction or Over Correction - Please do not confuse the Snellen Fraction 20/20 or 6/6 etc. for the optical power of the eye or any lens system. Other things can affect Visual Acuity than just refractive error. The Snellen Fraction is just a convenient way of saying that this person sees at 20 feet with a person with “normal” vision sees at 30 feet, 100 feet etc. It is very loosely related to refractive error, but refractive error can be on either side of 0.00, which is the goal of vision correction for distance. A person can need a +0.50 corrective lens or a -0.50 corrective lens and have say 20/40 vision in either instance. The BIG difference is that a person who needs +0.50 MAY be able to correct his vision internally using some of the accommodative power of the crystalline lenses and ciliary muscles, but a person who needs -0.50 CAN NOT.

Over Correction or under correction are relative terms related to the sphere correction. Its meaning can vary depending on which side of 0.00 the prescription is on. Increasing PLUS is the SAME THING as decreasing MINUS and vice versa. The object of ALL vision correction is to correct a persons refractive error to 0.00 for distance (defined as 20 feet or 6 meters) and then determine if a PLUS ADD or PLUS sphere adjustment is necessary to REDUCE the focal distance to some preferred or required value. The primary reason for needing an ADD or increased PLUS in sphere is that the ciliary muscles and crystalline lenses can no longer add the increased PLUS required, internally. The reason the ciliary muscles can no longer do it usually starts with presbyopia, but can be a change in visual needs such a acquiring a Smartphone or taking up watch making. In ALL instances, Sir Isaac Newton’s formula for calculating focal distances apply. Another principle to remember is that ALL sphere refractive errors are caused by a mismatch between the total power of the eye’s lens system and the distance from the back of the crystalline lens and the retina. In all cases of myopia, hyperopia, or presbyopia, it is caused by: Myopia, too much PLUS, Hyperopia, too little PLUS, and Presbyopia, not enough PLUS to focus close, for the distance to the retina.

In your case, an ADD reduces your MINUS sphere distance correction and if strong enough will change the absolute power of the reading lens lens to a PLUS value. For example, if you got a +2.50 ADD, your prescription in the reading segment would be:

OD: Sphere +1.00, Cylinder -1.75 x 94

OS: Sphere +0.25, Cylinder -1.25 x 76

Mr. Walker discusses his experiences with myopia. He may have experienced the effects of Pseudo or false myopia in addition to his Axial or true myopia. They have two different causes, but have the same symptoms and the same correction. Axial or true myopia is caused by the eyeball having grown too much and it is NOT reversible. It would require that the eyeball un-grow or shrink. Pseudo or false myopia is actually the same phenomenon as Latent Hyperopia, just on a different side of 0.00. It is caused by the ciliary muscles and crystalline lenses being unable to fully relax back to their minimum PLUS state. Pseudo myopia IS reversible, but it can take weeks or months for it to occur. IF it is present, wearing LESS MINUS can encourage the ciliary muscles and crystalline lenses to relax and distance vision will be improved. The big problem is determining how much of a person’s total myopia is caused by Pseudo Myopia. Dilating agents used for “wet” exams typically do not fully relax the ciliary muscles and crystalline lenses to be able to eliminate Pseudo Myopia as part of the total Myopia.

Super-Focus glasses are just the latest version of a type of glasses that have been around for a long time. They were originally invented by a man in England (I think) to help people in 3rd world countries that had little or no ability to access eye care. They weren’t perfect because they could not correct astigmatism, but they were cheap if mass produced and allowed people to adjust them to their needs. Any time you relieve the ciliary muscles of some of their workload, you are contributing to their de-conditioning.

You can do the same thing your optician suggested by trying some Over the Counter readers. The only thing is that they usually start at +1.00 or more and go up to about +3.50. Your optician can start with +0.25.

C.


IndoorSighted 11 Feb 2014, 22:51

Cactus Jack,

You wrote:

"A very significant factor in correcting your vision is your Cylinder correction for astigmatism. ... The need for sphere correction is usually caused by a mismatch between the total optical power of the eyes's lens system and the length of the eyeball. The need for cylinder correction is generally caused by uneven curvature of the front surface of the cornea and it typically affects Visual Acuity at all distances.

It is particularly noticeable when reading text."

So,

I am curious about why the Cylinder correction does not need to be adjusted for ones reading prescription (Optos just add the ADD to your distance prescription), as I would assume that as the text gets closer to ones eyes the distortions of ones astigmatism would become more noticeable. I am assuming that it is harder to find the right correction for one's astigmatism when viewing text at a distance v.s. viewing text close up... and thus the astig. correction value used in ones distance prescription would not be quite correct for ones reading prescription... but this is an assumption of mine)?

Also,

can you talk a bit more about the de-conditioning of the ciliary muscles effect when an ADD is used. I mean, if your distance prescription is *under*-corrected (to say 20/30 or 20/40) will this also cause a de-conditioning of the ciliary muscles? As I understand it, an ADD is just under-correcting your [sphere value] distance prescription.

And,

John Walker at this link- https://www.fourmilab.ch/documents/health/myopia/ -talks about his experiences as a myop. and his thoughts on under-correcting a near-sighted prescription. It would be interesting to me to hear your thoughts on what he has written at this link, above.

Finally,

do you have any familiarity/comments on the super-focus glasses ( https://superfocus.com/the-superfocus-technology ), as I am thinking of trying them at some point. And will using something like them also result in de-conditioning of the ciliary muscles and thus increasingly reduce ones accommodation ability?

Thanks for all your feedback and input!

Best regards,

I.S.

P.S. My optician wants me to come in and... I think she said "Trial" some prescription ADDs to see what I prefer in a more real situation. Something about putting +(sphere) lenses over-top my current distance prescription glasses to see what I like for a reading prescription, I think.


Cactus Jack 08 Feb 2014, 15:03

Very Progressive,

Please measure your preferred normal reading distance and if you like to read in bed or while lying down, please measure those distances also. At some point, either because of presbyopia, de-conditioning of the ciliary muscles, or both, you will not have much useful accommodation left. It eventually happens to almost everyone. When that happens, Sir Isaac Newton's formulas that relate focus distance to lens power is the sole determinant of the ADD needed for focusing at a particular distance.

For example, +2.50 is the add needed to read at 40 cm or 16 inches. If you like to read at closer distances, you will need more add, but probably not much more. Except where there are other problems, such as extreme hyperopia (double digits), +3.50 is about the upper limit people need in an add. +3.50 lets you focus at 28.5 cm or 11 inches.

The formula is simple. Divide the distance into 100 cm or 39.37 inches and the result will be the add lens power needed to focus at that distance. If you want to calculate the sphere prescription needed for single vision reading glasses, you need to start with the complete prescription for distance and algebraically add the calculated reading distance ADD to the sphere correction in the glasses, the cylinder and axis is carried over to the reading glasses prescription WITHOUT any alteration.

You can also use the above to calculate the add or the sphere prescription for computer glasses by measuring the distance from your eyes to the display.

C.


Very Progressive 08 Feb 2014, 14:45

Can anyone tell me what reading add I might end up with when presbyopia stops progressing. I am 53 now and have been wearing +2.50 for 2 yrs.

Thanks!


Crystal Veil 07 Feb 2014, 17:08

peps,

the thumb rule for opticians used to be (for people with perfect eyesight at long distance): +1.00 add at age 45, +2.00 add at age 52, +3.00 at age 60. But there are lots of individual variations to this. Some get it earlier, others later. Some people are a bit shortsighted in one eye and they don't bother about getting glasses for that. So having several co-workers in their early fifties without glasses is not strange although there are many, many people like yourself who need progressives in their mid forties.


peps 07 Feb 2014, 16:50

Hi

I have used glasses occasionally since the university for working at the computer. I had +0.5D sph, -0.5D cyl in both eyes. Due to the presbyopia I became dependent on them for close and intermediate work in the last year. I have an add=+1.5D (perhaps now iy could be 1.75) and I'm using multifocals. I'm 46 y/o. My friends of my age doesn't need glasses, I imagine that my extra +0.5D of hyperopia makes it worse for me. But I have also several work mates 53-55 y/o and no one seems to need glasses. I'm wondering at which add (assuming you don't have other problems appart from presbyopia) people becomes dependent on glasses for close vision. Do you have any idea?


Likelenses 04 Feb 2014, 21:20

Carrie

This is most likely what your prescription will look like in the future,before the bifocals kick in.

http://www.youtube.com/watch?v=h8f6uG0fv74


Cactus Jack 04 Feb 2014, 09:24

IndoorSighted,

You asked a specific question and I answered it. You cannot extrapolate that specific answer to formulate a general principle.

A calculation, using the basic formula of optical physics, is NEVER a substitute for a professional eye exam, but it explains the relationship between focus distance and lens power. You CAN use the formula to adjust your sphere correction if you understand how it works. It is regularly used to determine ADD powers for intermediate or close work AFTER the distance sphere correction is determined in an exam. It is also helpful to understand the relationship between the DISTANCE sphere, the ADD, and the ABSOLUTE SPHERE POWER of the reading or intermediate segments of glasses if you want to translate that to special bifocals, single vision glasses, or trifocals where the intermediate segment provides sharp focus at a particular working distance. It is really not difficult, it just takes a little algebraic addition where the + and - signs are observed.

Two rules are very important. One, you can only adjust the sphere for a particular purpose, never the cylinder or axis. Two, a +1.00 lens focuses at 1 meter (39.37 inches) and a +2.00 lens focuses at 0.5 meters (~20 inches). Those will keep you on track.

A very significant factor in correcting your vision is your Cylinder correction for astigmatism. Sphere correction is fairly easy to understand, but cylinder correction is more difficult. The need for sphere correction is usually caused by a mismatch between the total optical power of the eyes's lens system and the length of the eyeball. The need for cylinder correction is generally caused by uneven curvature of the front surface of the cornea and it typically affects Visual Acuity at all distances. It is particularly noticeable when reading text.

For the best optical performance, a lens of a particular sphere power can only focus at one point. Bifocals and Trifocals have discrete segments that focus at specific distances, when your eye's auto-focus mechanism (ciliary muscles and crystalline lenses) begins to fail because of presbyopia. Progressives, multi-focal contacts and multi-focal IOLs offer compromise solutions, but the price is usually reduced optical performance and narrow fields of view with low distortion. The trade off between optical performance and vanity or convenience depends on the preferences of the wearer.

You can get bifocals with almost any combination of sphere powers for various purposes. For example you can get the "distance" segment for focusing on a computer display and the "reading" segment for focusing on the keyboard, by selecting the appropriate lens powers. Frankly, I like trifocals because of their sharpness, utility and convenience. I also have single vision glasses for specific purposes like reading in bed.

You have a real dilemma and optical physics is getting in the way of your desires. Someday, there may be a way of restoring your crystalline lenses to their youthful flexibility, but not yet. One very interesting possibility has recently come available. Elective surgery (identical to cataract surgery) to install multi-focal IOLs in place of your natural crystalline lenses. It has very low risk as surgeries go, gives you reasonably good vision a most distances, and avoids the need for future cataract surgery. The biggest snag is that it is expensive and not or only partially covered by most health insurance because it is elective. The other factor to consider is that if you don't like the results because even the best multi-focal IOLs are compromises, you can't change your mind, ever. Actually, you can, but you might not like the cost in money, risk, and available options.

The key factors in selecting ADDs or Sphere powers is the working distance involved and your remaining accommodation. Be prepared for an apparent rapid increase in presbyopia after you get an ADD. It is caused by de-conditioning of the ciliary muscles with their reduced workload when they have external help..

C.


IndoorSighted 04 Feb 2014, 03:46

Hey Cactus Jack,

so first thanks for the help! Been busy, so haven't had time to reply.

But are you saying that just using the focus distance formula to adjust my 20/20 distance prescription (+0.25 diopter to Sphere) will give me the same prescription as if I went to the Optometrist to correct my vision to 20/30 instead of 20/20 (or moved the reading chart to 13.3 feet, instead of 20 feet, and had the Opto. correct my vision so I could see the 20/20 text line at this closer distance)? If so, that's an awesome and surprisingly simple formula!

Also, I have been reading about near (LDDV) and far points (min and max points where things are in focus) and was wondering how those points might be related to one's distance prescription.

Btw,

I found my real prescription but it probably doesn't make a difference. It is:

OD: -1.50 S, -1.75 C, 094 Axis

OS: -2.25 S, -1.25 C, 076 Axis

The opto wants to give me a +1.5 add, but I didn't want to get progressives. What I wanted was to find a prescription that would give me either near and intermediate (reading/computer/TV) OR intermediate and far (computer/distance) corrected vision with a single vision prescription, with my only slightly presbyopic eyes.

Any suggestions on what I can do?

Thanks,

ID.


Likelenses 04 Feb 2014, 03:12

Carrie

I guess that I never knew you prescription history ,and age until your most recent posts.

With where you are today,do you realize that you could be at+ 6.00,or 8.00 with a + 2.75 bifocal,by the time that you are thirty.


Carrie 04 Feb 2014, 01:55

Like me, she probably doesn't know if her latent hyperopia is fully corrected yet. She seems better at being able to cope without her glasses than me. Maybe it's because she is younger than me. I think she is still a little shocked and upset that her new glasses seem a lot stronger than her old ones. As I have said before, she is very stubborn so telling her she should do something will only maker her want to do the opposite which is why it went down the sympathetic route!


Soundmanpt 03 Feb 2014, 18:45

Carrie

You handled things perfectly with your cousin. Your right if you had given any advice at all about how she should keep her glasses on so her eyes adjust to them etc. etc. She probably would consider you a nagger as well and she seems to have enough of them already with the families pushing her to wear her glasses. Besides even though she is trying hard to not get dependent on wearing her glasses it will happen. Her new glasses are stronger than yours so I am sure you are very aware of her need for glasses now. As you have watched how her eyes have changed in a very short time. You were wearing glasses for a good while before she even got her first pair. Her intentions then was to only wear them if she happened to think about it for reading close up. Unlike you she had no interest at all in wanting to wear glasses anymore than she really had to, but you watched as she seemed to be needing them for more and more things and i'm sure you were pretty surprised when she started wearing them for driving. So she can try and hold off the inevitable but she is going to be more and more dependent on her glasses. You and I both know she never ever had any intentions of wearing them for driving but when she found that she was starting to have trouble seeing to drive she had no choice but to give in and wear her glasses since they cleared her vision up so she was able to see and read the signs along the road. She will soon get tired of putting on and taking off her glasses constantly. And as her vision deteriorates even more she will be wearing them more and more until they are on constantly. But for now if she feels she can resist it there is no harm in her trying. She has proven she is smart enough to know that she now needs them for driving so I think as things come up that she needs them for, reluctently, she will wear them.


Carrie 03 Feb 2014, 16:00

Soundmanpt - I saw my cousin yesterday. She was wearing her new glasses when she answered the door but took them off as soon as we got to her room. I asked why she took them off. She said it's still slightly blurry in the distance with her new glasses but better than it was. The main reason she took them off was that she doesn't want to get dependant on them but always keeps them on in front of her parents (and my parents) so she doesn't get nagged for not wearing them all the time. She now wishes she hadn't told her parents that the optician said she would probably be better off wearing them full time. She accepts that she really can't do without them for reading and they do help for distances when she's tired but just doesn't want to wear them all the time. I wasn't going to add to the nagging so I told her I sympathised with her and that it was, of course, entirely up to her how much she wore her glasses away from the family and that her eyes would very quickly let her know if they needed a bit of help! We soon got chatting about other things not related to glasses or eyesight.


Carrie 03 Feb 2014, 15:35

Bobby - I was in a shop when I noticed the display of ready-made reading glasses (I think a lot of people call them Over the Counter Glasses). I thought I would try some on just to see what I looked like in them as I liked wearing fake glasses when I was younger. I didn't even realise I needed glasses at that point. I just happened to notice that the text on the card you use to work out the power of the glasses you need seemed much darker and very clear when I was wearing one of the pairs of glasses. I could have bought a pair but none of them really suited me, which isn't surprising as they are not designed for young people. I thought I would get my eyes tested to check if I did actually need glasses. I did need them. My prescription was L +0.75 and R +1.00 and they were for reading. I wanted to wear them all the time but it was too blurry until I woke up one morning and realised I was still wearing my glasses and I could see across my room clearly. I was 17 then and I am now 20 and my prescription is now L+2.00 R+2.50 as it turned out I have latent hyperopia and the optician has been gradually taking me up to my full strength prescription. I don't know if I've got there yet. With my current prescription I really feel I do need my glasses all the time whereas with my previous prescriptions I could have got away with just using them mainly for reading but my eyes just felt so much more comfortable when I wore my glasses full time.

2010 was a very memorable year for me. I discovered I needed glasses. Got glasses. A few months later, at a Christmas party, I made another discovery - I was attracted to women. I had my first kiss with a woman (who also wore glasses). I am still with the short-sighted and shy beauty I met that night.


BOBBY 02 Feb 2014, 10:44

Carrie,

I've read some older posts and found out that you have started wearing glasses with a prescription similar to mine, but slightly weaker. Sorry if you have already written about it, but could you tell us what made you have your eyes checked in the first place?

Cheers


Carrie 01 Feb 2014, 15:51

Soundmanpt - I haven't actually seen her very recently. I have spoken to her but didn't bring up the subject of glasses. I'll try and see her tomorrow.

It seems ages since we went to the coffee shop. January is a long month if you don't earn much money! We've been saving. We've both got some spending money now so hopefully we'll go soon. Like with my cousin, I have chatted to our coffee shop friends on the phone but didn't mention glasses.

Sorry for the lack of news. I will post a message when I have seen any of the ladies.


Soundmanpt 01 Feb 2014, 14:06

Carrie

Have you seen your cousin since she has had her new glasses fro a few days? By now I am pretty sure her eyes have made the needed adjustment for seeing distances. I'm sure she hates the idea of having to wear them full time but the more she wears them she will get more and more comfortable wearing them. Plus the fact that she really won't be able to see much without them anymore she will have no choice but to accept them as her look from now on. It helps that her bf is very supportive of her wearing glasses as well. I'm sure you have already told her that she looks nice with them.

She had to know that when she started needing them for things like driving that her eyes were getting worse and she needed them for more than reading a book.

I still hope you find your way past the coffee shop soon to check on the Danielle's gf to see how she is doing with the glasses that Danielle got for her. Because they have to be much more comfortable than Danielle's glasses and that she picked them out she probably wears them even more often now.


Betty B 31 Jan 2014, 12:55

Cactus Jack

Thanks very much for that. I have actually got single vision readers in my current prescription. I can't think why I didn't mention that! I think it was because I was aware of posts where people were using OTC readers for similar tests.

I will probably get an eye exam in a couple of months so will let you know the results.


Cactus Jack 31 Jan 2014, 08:37

Betty B.

Using your results and Sir Isaac Newtons formula here is what we get:

Lens Power = 100 cm / 32 cm = +3.125 for distance.

If you did not need more plus sphere correction in your glasses you should have had a result of approximately 28.57 cm. so it is likely that you could use +0.37 more sphere in your glasses. Typically, 0.37 is pretty special (more expensive) and glasses are made in 0.25 diopter increments. I am estimating that your new distance prescription in sphere will be +0.25 or +0.50 stronger. Using +0.50 it would be:

OD Right Eye Sphere +2.50, cylinder +0.25

OS Left Eye Sphere +2.75, cylinder +1.25

The second test was to determine your accommodation range.

It appears that you have about +3.00 with your existing distance glasses.

Lens Power = 100 / 32.75 = +3.05

But, based on the distance test you need a bit more + for distance. If you had that additional plus, you probably would have been able to accommodate up to about 28 cm.

I suspect that your +1.00 add would still work, but I think you would find that a bit more plus in the add would be more comfortable, say an add of +1.50.

With the astigmatism in your Left Eye, I would suggest that prescription single vision reading glasses would be more comfortable that the OTC readers. After you get an eye exam and a new prescription, we can tell you how to order some inexpensive prescription readers, online for about US$15 to 20 from Zenni or other online optician.

Please understand that all of the above and the tests are very crude estimates and your exam results may vary. We call them SWAGs, Sophisticated Wild A** Guesses. Please check out the Astigmatism thread for my post on ways to improve the accuracy of the cylinder and axis.

Please let me know the results of any eye exam. I am very curious to find out how good my guesses were.

C.


Betty B 31 Jan 2014, 03:34

Hi Cactus Jack

I did the tests. On the first test, the average distance was 32cm and on the second one (through the distance part) the average distance was 32.75 cm.


Cactus Jack 30 Jan 2014, 22:06

Betty B.,

Sorry to be so slow getting back with you. Thanks for the reminder. One of the reason it has taken so long is that I had to think some about your situation so the test I offer will hopefully give you a fairly accurate estimate of the changes, but please remember that it is likely that some of the changes will be so small it is difficult to measure.

It is possible that you have or had a bit of latent hyperopia for your last exam and the +1.00 add has done 2 things in addition to assisting your ability to focus close. One, the +1.00 helped your ciliary muscles and crystalline lenses to relax a bit more, reducing your latent hyperopia. Two, the add may have encouraged your ciliary muscles to loose a bit of their conditioning - not necessarily a good thing, but unfortunately an inevitable and unavoidable result of wearing a prescription with an add.

You can use your +3.50 readers to estimate your distance change, but the distances involved are very small and hard to determine accurately. +1.75 or +2.00 might be easier to measure accurately because they will be larger.

To calculate the optical powers involved, we will use Sir Isaac Newton’f formulas to determine lens powers and related focal distances. We start with the assumption that your present glasses correct your relaxed distance refractive error to 0.00. That is probably not true, but we may be able to estimate the true refractive error and estimate the amount of sphere change that will provide accurate correction.

You will need normal lighting for all tests:

1. A book or newspaper with typical sized print.

2. Something to measure distances less that 1 meter or 3 feet with good accuracy.

3. Your prescription glasses and the +3.50 OTC readers.

For this test you should wear your prescription glasses with your +3.50 readers over them and look thru the distance part of your prescription glasses.

Step 1. Hold the book or newspaper (target) far enough away from you that the text is fuzzy.

Step 2. Slowly move the target toward you until the text just becomes sharp and clear and not fuzzy at the edges.

Step 3. Measure the distance from your eyes to where this occurs.

Step 4. Repeat Steps 1thru 3, three times and average the results.

Let me know the results.

If your distance prescription is correct (0.00 error) the focus distance with the +3.50 readers should be 11.25 inches or 28.57 cm. If your sphere prescription is too weak, it will focus farther away and we can calculate an estimate of the change. If it is too strong, it will focus closer. You can help the accuracy by using weaker readers that will move the focus distance away from you and expand the distances involved and make the error easier to determine. Just remember that this test is VERY crude and it cannot replace the actual exam, preferably dilated.

Close vision is a bit harder to determine, but does not need the OTC readers.

The normal amount of add required to read at 40 cm or 15.75 inches is +2.50. The add can come from your crystalline lenses, external lenses (add) or a combination of both. Right now you have an external add of +1.00 and to read at the above distance, your crystalline lenses have to produce an extra +1.50 to focus. As they crystalline lenses and ciliary muscles gradually loose their ability to produce the additional plus, you will need more external plus. We can get an idea of how much plus you can produce internally with the following test.

You will need:

1. The book or newspaper above.

2. Something to measure distances above.

3. Your prescription glasses.

For this test you will wear only your prescription glasses. Look thru the distance part of your glasses if possible. If you cannot focus clearly on the target, look thru the close up part of your glasses. The purpose is to estimate your accommodation range.

Step 1. Hold the target at arms length if you can read the text looking thru the distance part of your glasses.

Step 2. Slowly move the target toward you until the text become fuzz around the edges.

Step 3. Measure the distance from your eyes to where this occurred.

Step 4. Repeat Steps 1 thru 3, 4 times and average the results.

Let me know the distance where the text became fuzzy and if the distance was thru the distance or the reading part of your glasses.

C.


Likelenses 30 Jan 2014, 20:22

Newtoglasses

I am glad to hear that the progressives are working out better for you. I thought that you would like them better,than the on,and off thingy.

Your Rx in the progressives is just a tad stronger.The right eye is plano,or zero power for distance,and the left eye is +.25 for distance,which is the minimum that would be prescribed. The reading portion on each eye is +.25 more for each eye than the earlier Rx. So for reading you have a total Rx of +1.25 in your Rt,and a total of +1.50 in your Lt.The astigmatism correction in each eye is the same as your earlier Rx.

As the term progressive implies,the power of each lense is increasingly stronger as your eye looks farther downward through the lense.So at about the mid point,which is actually lower than the lense center,your power would be +.625 for your Rt.,and +.75 for your Lt.When on your computer you will find the mid point most comfortable,and the lowest part of the lense most beneficial for reading books,papers, etc.

When your eyes are really tired you may find the distance part helpful for TV,driving,sporting events,or other distance viewing.However you probably should not wear them for distance full time,as they will cause you to not see as clearly without them in time.

BTW ,quit sending that cold Canadian air across the lake to Ohio.


Lyall 30 Jan 2014, 18:55

Hi Newtoglasses,

It seems you do have almost the same progression as me.

I can see quite clearly through my single vision lenses but I can see very well without, although I am getting more headaches when I watch TV or drive.

If I am a passenger I feel motion sickness very quickly, which I have been told can be a symptom of farsightedness.

I am not getting the varifocals yet as I am ok using my old glasses and as Soundmapt kindly pointed out the prescription is the same (almost)


Betty B 30 Jan 2014, 18:08

Hi Cactus Jack

Glad you're back. I posted on 10th and 11th Jan and just wanted to remind you I'm here! Thank you!


Soundmanpt 30 Jan 2014, 12:59

IndoorSighted

I don't think you can get the results your wanting with any form of single vision glasses. If your trying to get glasses that will provide your eyes relief while your on the computer but at the same time allow you to see distance objects such as your TV while wearing your glasses this won't happen.

I suggest if you feel the need for glasses close up you would be much better off ordering progressives on line. In your case since your vision is perfect for distance the top portion would be plano (non prescription) but you would have a mid section that is useful for seeing your computer screen which is usually further away that say a book would be. The add section (bottom) would be the strongest part and just enough to give your eyes relief or ease eye strain probably only a +1.00 would be best for that. These progressives should provide you with your same great distance vision as well as helping with close up things.


Cactus Jack 30 Jan 2014, 12:51

IndoorSighted,

There is no direct relationship between the Snellen Fraction (20/20, 20/30, etc) and a glasses prescription. There is an approximation, but you don't need that to determine what glasses power you need to focus at a particular distance.

All you need is the focus distance formula developed by Sir Isaac Newton, of gravity fame, about 300 years ago. The formula is:

Focal Distance = 1 meter (in its various forms) / Lens Power in diopters.

Using simple algebra rules you can change the terms to:

Lens Power = 1 meter / Focal distance.

In all cases, Focal distance and 1 meter or its equal must be in the same units of measure.

The distance prescription is intended to correct vision to 20/20 or more accurately to a refractive error of 0.00. You seem to like working with feet so lets use that.

1 meter = 39.37 inches or 3.28 feet

Using the formula above.

Lens Power = 3.28/13.3 = +0.246 or +0.25 diopters

Using your prescription example of:

OD: -2.00, -0.50, 090

OS: -2.50, -0.75, 084

Glasses to focus at 13.3 feet would have +0.25 added to the sphere;

OD: -1,75, -0.50, 090

OS: -2.25, -0.75, 084

This is the same procedure used to determine the power of single vision reading glasses or the absolute power of the add in progressives or bifocals to focus at desired focus distances.

Hope this helps.

C.


IndoorSighted 30 Jan 2014, 04:29

Hi,

I have a question about how to convert a single vision 20/20 prescription into one that would give me 20/20 vision at say 13.3 feet instead of 20 feet?

Since I forget my exact 20/20 prescription, let us use this as an example

OD: -2.00, -0.50, 090

OS: -2.50, -0.75, 084

I am guessing that 20/20 vision at 13.3' would be 13.3/20 vision or

13.3*(20/13.3) / 20*(20/13.3) vision == 20/30 vision.

But I still don't know how to convert my OD/OS prescription to give me 20/30 *corrected* vision (if that is indeed the same as 20/20 vision at 13').

Thanks,

Indoor.

p.s. basically I am trying to determine my computer glasses prescription and hoping that I can read and watch TV with these glasses too.


Newtoglasses 30 Jan 2014, 00:11

Likelenses:

So, here's my update...to answer your question.

After only a week with my new glasses for reading and slight astigmatism correction, I became tired of the on and off routine in addition to feeling slight distortion when reading and having trouble adjusting to distance vision with my glasses...all too blurry. I know that the blur likely would have disappeared with a little persistence of just wearing them full-time but the distortion had me concerned whether the Rx was correct and I wasn't ready to alter my current 20/15 distance vision by forcing my eyes to adjust to my glasses when my distance vision was fine! Keeping in mind as well that my eye dr. didn't spend any time explaining anything to me regarding my astigmatism. This was my first time needing glasses...ever!

After second guessing my prescription, I called his office for a re-test. I was hoping to get a different doctor there but was told that he needed to do the re-evaluation. I got a same day appointment and as I suspected, his results were exactly the same. Even if they were different, I didn't expect him to admit an error.

I addressed the fact that the optician at the eye glasses store told me that I had a slight astigmatism and he nodded. He didn't elaborate much more other than saying it was a correction in my prescription.

My complaints about distortion were explained as me needing to get used to my prescription but the on and off routine was normal for someone wearing reading glasses. He offered to write me an additional prescription for Progressives which I now have and have been wearing on and off for almost a week. I must admit, I much prefer wearing my Progressive lenses almost full-time for ease and comfort of having clear vision at all distances and my headaches are suddenly gone. My eyes are so much more relaxed. No more eye strain!! The adjustment period with Progressives was quite easy for me (likely because my prescription is quite mild). I also have my single vision reading glasses for times when I'm going to be focusing up-close for long periods of time or reading at night. With my single vision glasses though, I do feel my eyes getting a little fatigued after a long time reading or on the computer at the end of a long day...even with my glasses. Is this normal?

My prescriptions are as follows:

Single Vision:

OD: +1.00, -0.25, 090

OS: +1.25, -0.50, 084

Progressives:

OD: PL, -0.25, 090 ADD +1.25

OS: +0.25, -0.50, 084. ADD +1.25

Is second (new) prescription virtually the same or is the Progressive strength a little bit stronger?

Slowly, I'm getting more accustomed to wearing glasses and the benefits far outweigh the eye strain up-close. The vanity issue...well, I'm slowly working on that!


Soundmanpt 23 Jan 2014, 19:46

Lyall

Wearing what you have is really not that far off from what was prescribed really. The +.25 in each eye for SPH is hardly nothing so really the very small astigmatisms is the only real difference and that is really weak so it shouldn't be noticeable to you either.


Lyall 23 Jan 2014, 19:13

Thank you for the replies, I did not get the new glasses as I decided I would go back to my old ones which were

R +1.25 L+1.00 - They have offered some relief for reading and computer.

I don't know why the prescription seems so much more complicated.


Likelenses 22 Jan 2014, 20:02

Newtoglasses

We chatted a week or so ago.

Did you get a retest?


Soundmanpt 22 Jan 2014, 18:53

Lyall

I am not sure why when you were asked about headaches you replied "no"? The whole purpose of getting any kind of an exam is to be completely honest and open with the doctors. I understand that before going for the eye exam you might want to blame the headaches on the medicine you were taking, but I would think at the first mention by your eye doctor about headaches would have made the light bulb go off in your head.

Somethings you didn't comment on and is very important is since you got your glasses have you been wearing them most all the time or even better full time? You should first try wearing your glasses enough so your eyes get adjusted to them and see if that makes the headaches go away. If after doing this for about a week or 10 days then if the headaches are stiil going on call your doctor and see if they want you to come back. My guess is they won't, but they will probably suggest just what i have suggested to you. I am sure you wouldn't have been given a differnt prescription if you had told your doctor about the headaches, but he / she may have gave you different recommendations about how much you need to wear them.


Newtoglasses 22 Jan 2014, 15:13

Hi Lyall,

Is this your first prescription for glasses or did you have something before...stronger or weaker? Your Rx is similar to mine and headaches were always a big compliant I had, especially while reading, working on the computer or focusing up-close for long periods of time. I never really associated it to my vision until I got glasses with a mild prescription and now it all makes sense...who knew! :). It's amazing how a slight adjustment can make a world of difference!

I did suffer a full day with a constant pounding headache during one of the first days I was trying to adjust to my new glasses but after that, it's been great...and no more headaches!

Maybe a re-test with your eye dr. would be a good idea...speaking from experience (which I have very little yet).

Let us know how it goes...


Lyall 22 Jan 2014, 02:49

Hi I just came across this site and wondered if I should have a retest.I was on strong meds for a year or so and this I thought caused headaches.

I went for an exam and was prescribed a different prescription.

It is now R SPH +0.25 CYL -0.25 ADD 1.0

L SPH +0.25 CYL -0.25 ADD 1.0

I was asked about headaches but I said I did not get them as I thought it due to the meds.

I have not been taking the meds and seem to get headaches after any continued "looking" including driving tv and computers also reading is hard.

Should I re contact my eye doc and tell her about the headaches?

Thanks

Lyall


Julian 21 Jan 2014, 02:58

Astigmaphile; you might say that; I couldn't possibly comment ::)


astigmaphile 20 Jan 2014, 21:57

Specsavers?


Julian 20 Jan 2014, 18:12

Actually, Juicebox, if you mean the company I have in mind, their ads are the best thing about them, and I don't think their name is particularly suitable.


Juicebox 20 Jan 2014, 16:29

Newtoglasses, (and Julian indirectly I guess!)

I second Julian's comment about not going to a chain. My experience with a certain company that keep saying I should have gone to them, were not the most useful. When I first got glasses they handed them to me to put on, adjusted them and then I was out of the door. My sister on the other hand goes to one at home and when I went with her the other day while she was back from uni, I was shocked by how long they took. I should have brought a book! So I will definitely be going there for my next exam in February.


Julian 20 Jan 2014, 16:13

Newtoglasses:

The other thing I meant to say in my last post: you are likely to get better service and lower prices from a 'family' or 'private' optician than from a chain.


Carrie 20 Jan 2014, 15:30

My cousin got her new glasses the other day. I can tell by looking at them as she's wearing them that they are stronger than her old glasses. She's not happy that she's supposed to wear them all the time. She's been complaining that she can see in the distance better without them and reading seems the same as with her old glasses. I told her she probably needs to get used to them. I tried them on and I could see fine with my right eye but it was slightly fuzzy with my left eye. My prescription is L+2.00 R+2.50 and hers is +2.75 in both eyes. Gemma was so nice and said my cousins eyes looked pretty being slightly magnified by her glasses and she is as good looking with her glasses as she is without. "The boyfriend really likes the glasses!" my cousin added, sounding a little happier.


Julian 20 Jan 2014, 06:53

Newtoglasses

some other thoughts: if you do decide to get tested again I think you should find another optometrist as the first one doesn't seem to have been very helpful; and you also need to find another optician who will fit your glasses properly - actually you could do that first. And before you think about bifocals you could try wearing your properly adjusted glasses full time to get used to them (I think I suggested that over on vision-and spex). All in all you don't seem to have had very good treatment so far.


Likelenses 19 Jan 2014, 23:37

Newtoglasses

After chatting with you a few days ago,I have a thought for you.

If you do get a re exam.and whatever the outcome may be, you could have a pair of either lined bifocals,or progressives made up,with no prescription ( called plano lenses )in the top portion,and your reading Rx in the lower. This would solve the annoying problem that you are having when you either have to look up in the distance,or remove your glasses.


Newtoglasses 19 Jan 2014, 13:30

Neko: you didn't mention it but does your prescription have a correction for an astigmatism as well or just the one plus number for each eye.

I'm confused...because this is all new to me and our prescriptions are very similar. Why were you prescribed a plus prescription if you were having difficulty seeing in the distance. I had trouble focusing up close and was given almost the same prescription.

Thanks...


Newtoglasses 19 Jan 2014, 13:26

Soundmanpt: thank you for your advice. I will admit, I thought it was strange too...that my glasses were not fitted properly to my face but just handed to me and asked how they felt. More discomforting though was the fact that my eye dr. didn't inform me that I had an astigmatism. Perhaps because it is so small and maybe insignificant to him? Either way, he just said to wear them for reading and computer work. I've been finding the on and off game to be annoying. It's amazing how much you look down and then up into the distance so many times each day!! I never realized that before. Sometimes I just get lazy and look up with my glasses on and surprisingly, the distance is looking a little less blurry after just a week with glasses. I may make another appt. to get him to re-check my prescription...as things up close still seem a touch distorted. Perhaps the astigmatism correction though that I need to get used to??

I will send you an email in the next few days to the email address you gave me.

Thanks again for your help!


varifocals 19 Jan 2014, 12:16

Aubrac.

Select Specs are good.

I have used them several times.


Cactus Jack 19 Jan 2014, 11:49

Betty B.,

I have not forgotten about you. My out of town trip was a working one and the job proved to take more time than was originally planned. I am leaving again, tomorrow for another week and will hopefully be back for a while, next weekend.

C.


Aubrac 19 Jan 2014, 06:41

Happy

Glasses4Eyes will make up lenses with prism up to 3 degrees and may go higher if you ask them. I have had three pairs of glasses (plus and minus) reglazed with prisms with no problem - they are cheap and reliable.

There is 'SelectSpecs' in Westgate on Sea, Kent. They claim to make the cheapest glasses in the world starting at £6 for a complete pair but have not tried them yet.

Good luck.


Soundmanpt 18 Jan 2014, 12:46

Happy

Zenni is international so they ship to the UK without any problem. Your not going to find a store that you can go into and buy minus glasses except in Asia.


freddy 18 Jan 2014, 12:42

hi,i am doing goc for 5 years and just ordered -16.25 glasses with 5 base in prisms if i wear them all the time will my eyes become used to them that i need them all the time,thanks


Happy 18 Jan 2014, 10:47

Thanks for the replies!

I am based in the uk so does anyone have the links for uk stores?


Soundmanpt 17 Jan 2014, 12:10

Happy

I forgot you asked about an on line retailer that does prism glasses. Zenni (zennioptical.com) goes up to 5 and the additional charge is less than $10.00 as i recall.


Aubrac 17 Jan 2014, 07:17

Newtoglasses

It doesn't sound as though your optical people have not really explained things or taken much care. As Soundmanpt said, fit is very important for both comfort and vision. It is surprising how many people have one ear slightly lower/higher than the other, and unless the frame is adjusted accordingly, they will always feel a bit wonky, also one eye will not be looking through the correct part of the lens.

Happy

It depends where you are. I am in the UK and know only two online retailers who will make lenses with up to 3 degrees prism without a prescription. Suggest you try base out prism as base in may make you feel slightly cross-eyed. In any case prism at this level is not really addictive, only when you get to more than 5 degrees could you start to rely on it if worn continuously.


Soundmanpt 16 Jan 2014, 22:44

Post at 16:45 was not posted by me. Most likely Ralph or Gus or whoever he is.


Neko 16 Jan 2014, 17:47

Hi all,

I've been prescripted my first glasses about a month ago because the optometrist noticed I could see better the distant chart with correction, that is :

OD : +0.5

OS : +0.75

By daylight, my vision with my new glasses is HD clear at all distances. At home, I can see quite better on computer or TV screen.

However, by night, distances are a little blurry with them on.

How can you explain this ? Will that get better with time ?


Soundmanpt  16 Jan 2014, 16:45

I admit, crossing the line, in my previous post. I'm a perv, okay?


Soundmanpt 16 Jan 2014, 12:23

Newtoglasses

We chatted yesterday over on "Lenschat" I am surprised that the optician only handed you your new glasses and merely asked you how they felt. She / he did not do a proper fitting and for a new wearer that is very important. The optician should have put your glasses on you so they could see how easily they slipped on behind your ears and then once on made sure that they didn't rub to tight on the backs of your ears. And of course that they weren't too looses which would cause them to slip down your nose. Never fun having to push your glasses back up all the time. Then a good check to see how they fit on your nose. Again they shouldn't be so tight to create dark red spots on your nose. If your glasses aren't totally comfortable you won't want to wear them them even when you need to be wearing them. The last check is the "shake" test. The optician should have had you look down and shake your head from side to side and then look back straight. If your glasses were adjusted right they should have stayed in place, if they slipped down then they were too loose and needed more adjusting.

In the coming days if your glasses hurt in anyway or they slip down then you need to return to them and have someone that knows better adjust them for you.

Don't forget to e-mail me when you get a chance.


newtoglasses 16 Jan 2014, 05:51

Hi everyone,

I am new on here and sourced out this site because just yesterday I was prescribed glasses for the very first time...the optometrist says just for reading (for now). I am a 45 year old female and up until now have never needed to rely on glasses to see anything. Lucky, I guess that my vision has been so good up until my mid-40's. For the past couple of years, I have noticed my up-close vision slowly getting worse. The fine print in the back of an aspirin bottle, the tiny fine print at the bottom of a document or even the font on my iPhone (which I was constantly having to enlarge to read more easily). Since it had been over 10 years since my last eye exam, I figured it was time to go. My distance vision seems to be fine...I have no difficulty seeing things far away (or at least I don't think so) and I could still manage reading up-close...albeit with a little bit of extra focusing on my part. It always seemed to take me a few minutes to re-adjust my focus from reading to distance vision and vice-versa. In addition, I have experienced some nasty headaches in the recent past and my eyes get extremely tired in the evening hours after spending an hour or more on the computer. I also don't have much of an attention span for reading...likely because I get so tired from straining to read much at all. But it all seemed 'normal' to me and what I was used to as it all happened slowly and gradually.

Maybe it came as a little shock to me yesterday when the Optometrist handed me a prescription for reading glasses...or maybe not! I think I knew it was coming, eventually!

Knowing how much I procrastinate, I decided to just go for it and fill my prescription right away at the Optical store right next door to his office. After waiting an hour, my new glasses were ready. A little nervous, I will admit! The woman in the store merely handed them to me and asked me to put them on, asked me how they felt (which I don't really know because I wasn't sure what to expect at this point) and gave me my receipt and a copy of my prescription. I'm not sure what I should have expected but it was quick and I was ready to go. Having a closer look at the copy of my prescription now (with my glasses on), I noticed that my prescription has both a plus number and a minus number in it and I am a little confused. I also forgot to mention that the Optometrist didn't explain anything to me except that I should wear my new glasses while reading and while on the computer...that's all he said! He didn't explain the prescription numbers to me and what they meant, nor the detailed findings of his examination. I do notice a little bit of a 'distorted' feeling while wearing my glasses...although my close up vision is great now! My computer vision may not be as sharp as I would like and the 'distorted' feeling is a little more noticeable when looking at my computer screen.

My prescription is as follows:

OD: +1.00 (sphere), -.25 (cylinder), 090 (axis)

OS: +1.25 (sphere), -.50 (cylinder), 084 (axis)

Can anyone help me understand what my prescription means, why I have a plus and an minus prescription for reading and why I'm feeling a little distorted while wearing them? Also, should I be wearing them just for reading or more often than that? I'm finding taking them on and off to be a bit of a nuisance already.

Any help or feedback would be greatly appreciated.

Thanks.


Happy 14 Jan 2014, 19:24

Hi all. First time poster.

Currently have r +1.5 and l+1.25 farsighted and find glasses make vision more comfortable, but they are not essential. Interested in trying some prism lenses and was wondering what you would recommend in terms of base in and base out. Also what strength to start with? Don't mind if eyes get hooked as some posts suggest.

Also where could I get such lenses put in with no official prescription?

Thanks in advance for any help


Betty B 11 Jan 2014, 06:48

Thanks Cactus Jack. I've had a prescription for hyperopia since I was about 20. It has gradually increased.

I am happy to wait a week! I live in Manchester, UK.


Cactus Jack 11 Jan 2014, 00:50

Betty B,

You did not mention if your current prescription was your first prescription for hyperopia. It is possible that you may have some latent (hidden) hyperopia that is gradually resolving. It is likely they you will need additional plus for distance and perhaps a bit more add.

There a very crude, but relatively simple test you can do with your present progressives and the OTC +3.50 readers to get an idea of how much more + you may need for clear distance vision. It would actually be easier with OTC readers with less plus, but if you are careful you can do it with the +3.50 readers.

Unfortunately, I will be going out of town for a week starting tomorrow, Sunday. If you can wait that long, I will be happy to try to help you when I return.

May I ask where you live?

C.


Betty B 10 Jan 2014, 23:24

I am 44 and at my last eye test 9 months ago got an add for the first time (R sph +2.00 cyl +0.25 L sph +2.25 cyl +1.25 Add +1.00).The distance was a slight increase. I know I need a bit more add already and possibly more plus for distance. Is there an easy test I can do at home to get some idea how much? I have varifocals and readers (my proper prescription and also some +3.50 over the counter readers). Thanks.


Soundmanpt 04 Jan 2014, 13:53

Carrie

I am not at all surprised by your cousin's results and I can tell you weren't either. Really I have to think she also must have expected she was going to be told she needs to start wearing her glasses full time as well. She had had to be noticing that her vision was getting worse and was already causing her to wear them way more than she expected to ever need them. Even though she isn't happy about it now wearing them full time and with an even stronger prescription she soon will be more comfortable wearing her glasses than she will be when she takes them off. Since her new prescription is very close to yours and even slightly more you will know just about how much she is able to see without her glasses.

By the way since you got your increase I assume you don't get to wear your college friends contacts that she gave you a supply of anymore? I'm sure like your previous glasses they are now too weak to be of much good to you. Your cousin will find that after she gets her new glasses and her eyes adjust to them her current glasses will be of no use to her either.


Carrie 04 Jan 2014, 12:22

We (me and my girlfriend Gemma) went to see my cousin at lunchtime today. She was wearing her glasses and was not as cheerful as she usually is. She said over the last few weeks she has found she has needed her glasses more and more because her eyes have felt more tired. Her parents and her boyfriend have been nagging her to get her eyes tested again. She went this morning. She said she was given a stronger prescription, which she wasn't too surprised about as I had told her a while ago what latent hyperopia meant. What she was a little upset about was that she was told she would probably be better off if she wears the new prescription full time and wears her current glasses full time until her new ones are ready. Her new prescription is +2.75 for both eyes. That's a +1 increase from her current one. The optician said to get her eyes tested again in a year, or sooner if she has any problems.

I'm not surprised that she should wear glasses full time as at her last eye test she was told she should wear her glasses for distances and not just for reading. Her new prescription is stronger than mine (L+2.00 R+2.50). Her new glasses will be ready in 7-10 days.

I think "You will probably be better off wearing them full time" is the optician's gentle way of saying to patients that aren't full time wearers "You really should wear them full time". It doesn't sound quite so dramatic.

Obviously I was very supportive to her as she is family and she we are like good friends anyway. She soon managed to change the subject away from glasses and talk about something else. Her eyesight is a subject she doesn't like to talk very much about.


Cactus Jack 18 Dec 2013, 14:21

Good news,

Julian has recovered and posted posted Macrae's true story on the Vision and Spex site. It is on the Fantasy and True Stories thread. It is a bit long, but worth your time if you have recently discovered that your "perfect" vision isn't quite as perfect as you thought, your arms have become too short, or you are worried about what others think of your having to wear glasses.

C.


Cactus Jack 15 Dec 2013, 22:06

Aging slowly,

If your distance vision was 0.00 the +1.50 readers should have started getting fuzzy at about 26 inches. This analysis is going to seem rather convoluted, but it appears that you may need about +0.25 as a distance prescription and I would not be surprised if you didn't need a bit more + for reading.

The result of the test suggests that your have effectively about +1.30 of correction with the +1.50 glasses. Using Sir Isaac Newton's formula 39.37" (1 meter) / 30" = +1.31 or pretty close to +1.25. During the test, your eyes provided approximately -0.25 of additional refractive error, which would be corrected or neutralized by +0.25 glasses for distance.

You could have some uncorrected astigmatism that this test would not uncover and that could affect the results. This test is very crude when small refractive errors are involved and my analysis could easily be off. Please let me know your new prescription. Be sure and tell the examiner that your distance vision does not seem very sharp.

C.


Aging slowly 15 Dec 2013, 19:59

I did your test a few times and the blur seems to come in at about 30". What does that mean? For distance I feel that my left eye is a bit clearer than my right eye. Thanks!


FrequencyF 15 Dec 2013, 17:05

Went to dinner today with my wife's family and wore my glasses. Still getting used to people seeing me in them. Got quite a few compliments and got into conversation with my sister in law about how her prescription has changed.

I haven't't really had the glasses off my face since I got them. I am surprised how easily I have got used to them and how comfortable my eyes are when wearing them


Cactus Jack 14 Dec 2013, 23:43

Aging slowly,

There is a crude test you can do that might give you a clue of about what to expect for a distance prescription.

You will need a book or newspaper with typical small print, your +1.50 reading glasses, and a tape measure up to about 6 feet or 2 meters. Either inches or cm can be used for the calculation.

Try to do this test fairly soon after you wake up in the morning and before you have done much reading or close work.

In moderate light:

1. Put on your reading glasses.

2. Try to relax your eyes as much a possible.

3. Slowly move the book or newspaper away from you until the text just becomes fuzzy around the edges,

4. Measure the distance.

5 Repeat 1 thru 4, 3 times and average the distance

6. Tell us the result.

This test will only estimate needed sphere correction for distance which may be significantly affected by astigmatism and other vision factors. I will explain what the results mean when you provide them.

C.


Aging slowly 14 Dec 2013, 23:23

I have been wearing +1.50 reading glasses for a couple of years now, and think I am not seeing distance as clearly as I used to. I booked an exam for next week, and expect that I will be told I need bi-focals. Is there any way to know if I will be prescribed a plus or a minus?


Cactus Jack 14 Dec 2013, 15:23

FrequencyF,

Many of our newly bespectacled hyperopic members experience what you are experiencing. One member, Macrae, posted a very funny series that recounted his adventures with getting glasses. You might find them both interesting and educational. If I remember right the adventure started in 2007, but I have mislaid the exact date and thread.

Another member, Julian, collected the individual posts into a Saga and perhaps, if he still has them, he will share them with us again. This time, I will try not to loose them. Macrae's story is a classic hyperope's adventure into the world of vision correction.

The best thing to do is wear your glasses full time for a few days. My experience, having worn glasses for about 60 years, is that people do not notice the lenses, only the frames. Wearing glasses has about the same effect as changing your hair cut style. You get a few comments, but after a day or so, nothing.

C.


FrequencyF 14 Dec 2013, 13:21

Soundmanpt / Cactus Jack

Thanks for the advice. I guess I just have to get used the feeling of Glasses on my face which is a bit strange when I'm not used to it. Not much sun in the UK so never really wear sunglasses either.

I've been wearing them quite a lot but still feel a bit self conscious when out in public . My wife is a full time glasses wearer and is supportive which helps.

I'm 35 and just didn't expect to need glasses for a few years yet.


Soundmanpt 14 Dec 2013, 12:23

FrequencyF

Seeing distances a bit blurry is with the prescription you were given is quite normal and your eyes will get adjusted and the blur will soon go away. As your optometrist suggested the more you wear them the sooner that blur will disappear. Wearing them less often will take much longer for your eyes to get adjusted to them completely.

Getting glasses for the first time can take some getting used to. How they feel on your nose, behind your ears and learning to see looking through 2 pieces of plastic. But hang in there after a couple of weeks you will hardly notice your wearing them.


Cactus Jack 14 Dec 2013, 11:28

FrequencyF,

Welcome. You definitely have some hyperopia and probably a bit of Latent Hyperopia (Hidden Hyperopia) to go with it. You didn't mention your age, but a little bit of presbyopia may also be creeping up on you. It happens and that is probably what caused your headaches and discomfort.

You didn't ask, but fogging simply means that the optician started with substantially too much plus and gradually reduced it until you could see reasonably clearly for distance. Almost everyone has the ability to correct some hyperopia by using their accommodation powers to correct it, but that ability does not last forever and at some point, you need external help.

Two things are likely to happen. One, your distance vision will clear up as your ciliary muscles and crystalline lenses relax and the Latent Hyperopia slowly resolves itself. Two, you will probably need an increase in your plus sphere sooner than you think. That is actually a good thing because the more of your hyperopia is corrected externally, the more accommodation range (auto-focusing ability) you recover. It may take 2 or 3 sphere prescription changes to fully resolve the Latent Hyperopia.

A third thing that will happen is that presbyopia WILL get to the point that you need an add to help you focus close. Again, this happens to about 99% of the people on this planet. It is caused by the gradual stiffening of the protein that makes up your crystalline lenses that actually started in childhood. At some point, the crystalline lenses will get so stiff that the ciliary muscles (the strongest muscles in the body for their size) simply are no longer strong enough to squeeze the crystalline lenses to allow you to focus close without help. The idea that presbyopia does not become a problem until 40 is a myth. It can happen much sooner or very rarely later depending on your genetic makeup. People with hyperopia often develop presbyopia earlier than people with myopia.

One last point, don't get excited if the cylinder (2nd number) and axis (3rd number) change on future prescriptions. Those numbers correct astigmatism. Astigmatism is caused by uneven curvature of the front surface of the cornea and it tends to change very very slowly. The problem is that the test is very subjective and depends to some extent on YOUR ability to judge relative blurriness rather than sharpness. Frankly, it is not easy to do, but there are a few things you can do to improve the accuracy of the results. Let us know before your next exam and we can give you some tips on how.

Hope all this is helpful. Please visit often and let us know how you are doing. Many people with hyperopia are discouraged when they first get glasses because quite a few thought they had perfect or better than perfect vision. Vision should be the best it can be and comfortable. Glasses are just tools to that end. Vision actually occurs in the brain. The eyes are simply biological cameras and your brain has to learn how to process the new, clearer images. The more you wear your glasses, the sooner that will occur. One last thing to be aware of, once your brain gets used to having clear images delivered effortlessly, it will likely rebel and complain if it gets images that are not near perfect. Guess how it lets you know it is unhappy. You may not like its methods.

C.


FrequencyF 14 Dec 2013, 08:21

I went to the opticians recently as I was getting a lot of eyestrain on the computer in work especially in the afternoon, text going out of focus and my eyes feeling really tired. Never needed glasses before

During the eye test the optician said he was fogging my eyes?

My prescription was

RIGHT EYE

SPHERE CYL AXIS

DIST +1.25 -0.75 110

LEFT EYE

SPHERE CYL AXIS

DIST +1.25 -0.50 90

I was told that the glasses should help with my computer work and also distance (which i didn't think I had a problem with). He said I could wear them all the time if I wanted or for reading, computer, driving and cinema etc when i felt i needed to.

I got my glasses on thursday. They are great for the computer and my eyes feel really relaxed even when watching the TV with them. My only problem seems to be a slight blur when looking at things at a distance. Is this normal and should this clear up?


Cactus jack 13 Dec 2013, 06:39

Annabel,

Latent Hyperopia (LH) is certainly a possibility. Unfortunately, if a person has had LH for many years, it is often very hard to fully diagnose even with a dilated exam. Most modern dilating agents are designed to work quickly and dissipate quickly and the ciliary muscles and crystalline lenses just don't have time to fully relax.

It can take weeks or months for a severe case of LH to fully resolve itself because the ciliary muscles and crystalline lenses can be very slow to relax after years of internally correcting hyperopia. The usual clue that LH has been at work is that the need for additional plus correction occurs much faster than expected after getting a stronger plus correction and usually a reading add. Often if LH is suspected, an ECP will prescribe a bit more plus than what is really needed at that time. The result is that initially distance vision will be a little blurry, but if distance vision improves significantly in a week or so, it is a pretty good clue that LH is involved. Typically, another slightly blurry plus prescription will be prescribed to see if that soon clears up also. At some point the increases in plus will not have much effect and most of the LH will be gone. Hopefully, during this process, the ciliary muscles will get enough exercise to stay in good condition and provide excellent accommodation range.

C.


Cactus Jack 13 Dec 2013, 06:18

Aubrac,

A need for an increase is certainly a possibility and her reluctance is not an unreasonable reaction. She knows something is not right, but doesn't want to deal with it. As a medical professional (dental) she knows deep inside that ignoring a problem is not a good idea. Few things associated with reduced visual acuity, get better on their own.

There could be other things going on such as cataract or perhaps some macular issues. It might be a good idea for her to see an ophthalmologist for a dilated retinal exam. Hopefully, there will be nothing that a slightly stronger prescription won't fix, but if there is a developing problem the sooner it is addressed, the better.

C.


Aubrac 13 Dec 2013, 04:44

Just posted an update on my wife and should have added that yesterday she was looking at a video on her phone holding a pair of +5 glasses (origin unknown but maybe were her mum's or a pair she wore as a kid)in front of the screen to watch - definite sign of an increase needed.

She has also started taking 'Visionace' eye nutrition tablets but think these may only possibly help eye health rather than make any change in prescription.


Aubrac 13 Dec 2013, 04:00

My wife has been wearing her progressives pretty much full time for over a year. I don't know the exact prescription but reckon they are about +2 with a +1.5/2.00 add and some cylinder correction.

Just lately she has been looking through the lower lens portion for distance, and the other day when looking out of the window spent about five minutes with her head back looking at things - I know she needs an increase for reading and maybe time for an upping of her distance correction.

Her optician has sent her a letter about getting a test but I think she is a bit reluctant to face the increase.

Any way we'll see!!


Soundmanpt 12 Dec 2013, 19:11

Lance

Glad you and your wife got your glasses and like them. Not uncommon at all for her, and you, to feel like your swimming as your eyes are adjusting to progressives, but the best thing you can do is to do just like she is doing and that is to stick it out. The more she wears them the more she is adjusting even if she doesn't think so. I'm sure she is fine as for seeing distances, but when she goes to read something closeup is where trying to locate the proper spot for her eyes to look isn't as natural.


Annabel 12 Dec 2013, 16:59

Thanks Cactus.

Clip on readers aren't particularly appealing. I am somewhat vain in that respect! I am also against any type of lined bifocals.

My ECP has thus far been quite helpful - prescribing a reading add at 30 is not exactly common place from what I understand. He also willingly prescribed prism, though said he thought I needed more but he refused to prescribe it likening it to eating chocolate. He has talked of a hospital referral although I'm not sure what they could do other than check the physical health of my eyes. I suspect my issues are neurological in origin.

He has also talked of prescribing several pairs of glasses with different strengths so I can choose which one works best at any particular time.

I think this might be quite good, although I have enough trouble being bothered to use my readers. I never seem have them to hand when I need them.

I wonder if I have some degree of latent hyperopia? What would be the signs of this?

I guess I will see what he says next week, but it would be good to find something that helps.

Annabel


Cactus Jack 12 Dec 2013, 16:14

Annabel,

Varifocals or Progressives may be tempting and may be OK with a low add. You should also consider trifocals if you need a wider intermediate segment for the computer and a stronger reading segment. Remember that glasses are simply tools to help you see clearly and comfortably. I wear trifocals, but also use clip-on magnifiers when I have to do a lot of computer work. They enable me to focus clearly on the computer display using the distance portion of my glasses with out tilting my head. Let me know if you find the clip-ons interesting.

Your ECP may be reluctant to prescribe varifocals, progressives, or most particularly trifocals for a young woman of 31, but if he/she doesn't seem to understand your special vision problems, you need to see a different ECP.

One thing you might do before the exam is measure the distance from your normal working position to the computer display and take it with you. That will help determine the power needed in the intermediate portion of your glasses.

C.


Lance 12 Dec 2013, 14:27

So the wife and my glasses finally came in. The glasses seem great but as expected there is an adjustment period. Driving was ok but the computer and watching TV from the couch has been the biggest challenges so far.

My wife is having a harder time adjusting. Last night was a little rough be she toughed it out. This morning was better but she still feels like she's swimming in them. She said it was fine until she remembered that she got new glasses, then the disorientation started.

She also tried out her readers last night and she is ecstatic with them though she knows that she needs to stick with the progressives to begin with.

Lance


Annabel 12 Dec 2013, 14:02

Hi

I am 31 year old female. My current glasses prescription is:

R: +0.75 -0.5 x 90

L: +0.75 -0.5 x 75

Add: 0.5

Prism: 1.5D base out, left eye

I wear the distance prescription full time, and I have reading glasses for occasional use but I always forget to use them.

I am having massive problems with my vision, partly because I suffer from fibromyalgia and thyroid trouble which affects my eyes. They burn and feel sore and tired all the time. I cannot focus on anything properly at any distance. I seem to live in a constant slight blur. Over the past few months I've noticed things in the distance becoming progressively more blurry (e.g. guide on TV screen). I think my accommodation mechanism has really stopped working and I'm being over corrected for distance, yet possibly under corrected for intermediate and close work, definitely with my 'distance' prescription. I am a teacher and spend many many hours a day reading and looking at a computer screen.

I last had an exam in February but have booked another one for next week. I am quite worried what is going to happen. What do you think my options are with my prescription and health problems? Would I really benefit from varifocals of some kind?

Annabel


Soundmanpt 26 Nov 2013, 12:52

Lance

It may not be a concern anyway. I asked Zenni once since they don't use a prescribed measurement for the sight height of the bifocal how they are able to do it and if they have many returns because of it and she told me very few returns and that was before they started asking where you normally wear your glasses on your nose.

You are both going to be working with your first progressives so after you have both been wearing your glasses for a little while there are ways to tell if the bifocals are positioned about right. If the add is too high you will find that your dipping your head to look in the distance and if the add is too low you will be raising your head too much to read things close. You should be able to look straight ahead when your looking in the distance without the add in the way.

Don't you thnk that just finding out you need an add has made you more aware of it then before? Kind of like being put into you mind.


Lance 26 Nov 2013, 12:19

We both ordered plastic frames. Both her and I don't like nose pads but I didn't think that it might be easier to adjust them. Thats good to know for the future.

Since I am now aware of my near issues I find it really annoying. I was driving my son to an appointment today and noticed that the dash wasn't clear. I really hadn't noticed I had a problem until I was tested. Sure the the phone would get blurry but I thought that it was just normal.


Soundmanpt 25 Nov 2013, 23:18

Lance

I don't know if this is the first time you have ordered from Zenni but they are very good at delivering on schedule or even sooner.

What type of frame did your wife get? I hope that she got a frame that has the adjustable nose pads? With progressives that helps so if they need to be adjusted so her vision is seeing through her lenses at the right point. Plastic frames with the molded nose pad are nice but not much can be done to adjust the level of the add. One thing they added recently which was a good idea was where they ask you about where you position your glasses on your nose. Since your wife has been wearing glasses for some time i'm sure she knows what feels comfortable on her nose and how her glasses sit on her nose so that should really help as well.


Lance 24 Nov 2013, 20:32

I thought it might have to do with the frame but I tried at bunch of different ones with the same result. The one I chose were a full frame acetate so I don't think thats it.

And yes we made sure we got the anti-reflective coatings.

My wife actually said "I can't wait until they show up" tonight at dinner as she struggled with the menu.


Soundmanpt 24 Nov 2013, 13:29

Lance

By the way I hope you both added the AR coatings on your glasses. You only really need the cheaper one as that seems fine and it is only a $4.95 option, but it really helps in cutting glare.


Soundmanpt 24 Nov 2013, 13:27

Lance it could be because of the type of frame you picked out. If yours is a rimless or semi rimless that could be the reason. Remember just because they suggest using that lens you can order as you wish. I orde from them all the time and they sometimes will recommend the 1.61 lens for some of my orders and I know if they will look good or not with just the 1.57, which is still in the included price, and they turn out fine. But a lot depends on the frame. For example if your wife is getting a frame that has a wide temple and is a plastic full frame then that could be why they didn't recommend she go to the 1.61 lenses. I have ordered many glasses from them with single vision prescriptions of -4.50 and only got the 1.57 lenses and they look great.


Lance 24 Nov 2013, 13:05

Now this was strange

We decided to order for zenni and we both picked out some nice frames.

When it came time to put in her order they recommended the 1.57 progressives which seemed about right.

Then we put in mine and it said that I should get the 1.61 progressives which were a lot more expensive (thats not the issue). If I ordered single vision it said I could use the 1.50 lenses.

I was just wondering why I would need the higher index lenses? Our astigmatism is almost the same and my sphere is considerably lower.

Doing a little research and the 1.61 are aspheric and cut down on distortions - Could the low sphere combined with the moderate astigmatism warrant this? Or is it due to the angle of the astigmatism?

I checked with other online sites and they all recommended similar lenses for our prescriptions.

I ordered the 1.61 anyway I am just wondering why.


Soundmanpt 23 Nov 2013, 14:54

Lance

Good to hear. Now when they come in the fun of learning how to use the add segment. It just takes time to learn to not look down when you need to read something, but instead to just move your eyes downward and trying to find what they call the "sweet" spot of the add. The best way to start off is by reading magazines while watching the TV.

Even though she's getting a pair of single vision reading glasses she should try to avoid using them for now and work on adjusting to her progressives. Even in bed which iwhat she wanted the single vision ones for. But the more she wears her progressives the easier it will get and of course that goes for you as well.


Lance 22 Nov 2013, 23:45

She finally ordered some tonight - She really hasn't been avoiding it - more like just too busy and thats a good excuse but now she has no choice (plus since I've been prescribed she would feel hypocritical if she didn't get hers)

She also talked to the doc and got a single vision reading pair so that she can have them by the bed. She likes the idea of having a full frame in a reading prescription.


Soundmanpt 22 Nov 2013, 19:55

Lance

It would seem your wife is trying to avoid getting her progressives? It has been several weeks since she got her eyes examined, I would have thought by now she was wearing them and already pretty used to them? Now that you also need an add do you think she will finally give in and order her glasses when you order yours?

The good thing is that her distant vision didn't change at all so like her doctor suggested she probably should continue to wear her current single vision glasses for driving until she is really used to using the add in her new glasses. Again please remind her about being very careful at first when she going up or down steps. And that goes for you as well. That add makes everything appear much closer than they are. The secret is don't look down. Wearing heels makes it even more of a challenge, for her not you. lol


Lance 22 Nov 2013, 14:40

Since my wife found out she needed progressives (which she hasn't ordered yet) she has urged me to get my eyes checked. She noticed I was struggling a little with the phone (I'm 38). So I decided to bite the bullet and get my eyes checked. I wear glasses but haven't had my eyes checked in almost 3 years.

The exam was fine - this doctor was very nice and explained every step as she worked on my prescription.

After she made a slight adjustment to my distance she placed the near vision card in front of me and told me to read the lowest line. There was 6 lines and I could only clearly see down to the third (and even that wasn't perfect). As soon as I said that she replied.

"I guess you're getting bifocals"

A few clicks later and I couldn't believe the difference. I could see all the lines perfectly. She added a little more add and it made things a lot clearer.

my previous prescription was

-.5 -2.00 82

pl -1.50 90

I came out with the following prescription

-.25 -1.75 80

+.25 -1.25 80

ADD +1.50

There was also a Prescription Note: Opposing Signs (which I assume is due to one eye being plus and the other being minus)

So I guess the wife and I can be in the progressives club together.


Soundmanpt 09 Nov 2013, 14:01

Lance

I would bet that your wife finding out her friend at work has been wearing progressives since her 20's helped a lot. So since your wife had no idea until she was told she had to know that her own glasses wouldn't look any different than they look now. In fact if she really didn't want any questions when she got them she could have just had her new prescription put into her current glasses and there would not have been any comments about new glasses.

I think the best thing they could have done was to call progressives, progressives. As I recall when they first came out they were called no-line bifocals, but because of how many people considered bifocals something only old people ever got the idea to call them progressives came about. A much better name.

I think also just upgrading from single vision glasses that your wife has been wearing since her teens to progressives is not as big of a deal as it would be if she was just getting her first glasses.


Lance 08 Nov 2013, 18:25

I think that she finally realized that there was no getting around it. One of her friends told her to get her eyes checked because the constant arm stretching made her look older. She has worn glasses since her teens but has had trouble with near vision since her mid thirties. She fought it as long as she could (wanted to hold out to at least the spring) but there was no way she could hang on until then. Even at dinner after her exam she was struggling with the menu.

I also told her that no one will know they are progressives unless she tells them. It also didn't hurt that one of her co-workers admitted that she has had progressives since she was in her early 20's and that it wasn't that big of a deal.

With the advent of no-line bifocal technology a lot of the stigma goes away. I'm sure there are a lot of people out there with multi-focals but because there is no visible line no one will ever notice.


Soundmanpt 08 Nov 2013, 11:06

Lance

Good to hear that your wife is not objecting to her need for progressives. For women getting their first bifocals (progressives) often is mistaken as a sign of age, but she really seems to be more interested in being able to see small print now.

Besides letting her eyes get adjusted to them before she wears them to drive with she also needs to be very careful when she is wearing them and going up and down steps. And even more careful if she is wearing heels. The add often causes steps to appear much closer than they really are resulting in some nasty falls. At first since her prescription isn't very strong she probably should just take them off when she is going up or down steps until she gets used to them. Progressives do take some getting used to but she seems to have the right additude so she should do fine.

Keep us updated as to how she is doing once she gets her glasses.


Lance 08 Nov 2013, 09:17

A quick update on my wife. She went to the eye doctor last night. After the auto-refraction the Dr. came in and said that she would be going home with a bifocal prescription. They placed the lenses in front of her to show her the difference and she couldn't believe the change.

Her distance script didn't change nor did her astigmatism. The only change was her add which is a surprisingly high +1.75

I was expecting her to be a little upset but she seemed OK by it. The only thing she didn't like was the Dr kept referring to them as bifocals so she made the Dr call them progressives.

The doctor recommended that she use her regular glasses for driving just until she gets used to the progressives.

We are going to pick out new glasses this weekend.


svensont 03 Nov 2013, 17:05

In the post from 15 Jul 2013, newglasses has mentioned something about 2/3 rule. I have found an article about it:

"The wide spectrum of philosophies concerning appropriate treatment ranges

from providing minimal plus lenses that may alleviate symptoms to prescribing

full plus correction to relax accommodation. The middle position of prescribing

one-half to twothirds of plus lens power takes into account the relationship of

latent hyperopia to manifest hyperopia and is a reasonable approach for many

patients. Clinicians may base prescription decisions on the power required

to provide optimal visual acuity and normal accommodative and binocular function.

Patients often become quite dependent upon this correction."

source: http://www.aoa.org/documents/CPG-16.pdf

page 16


Ralph Tyko 01 Nov 2013, 23:49

Sorry, Jack, not John.

I did, indeed mean you. Will contact you soon. I've spent the past six hours, soaking up your advice about a subject that interests me, greatly... the aging eye.


Cactus Jack 01 Nov 2013, 23:28

Ralph Tyko,

Was your post intended for me? I think I am the only Cactus on this forum except in those instances when someone is poking fun (I hope) or ridicule in my direction by corrupting my nom de web.

If it is for me, I am honored by your request. I would like to know more and would ask that you contact me privately at

cactusjack1928@hotmail.com

C.


Ralph Tyko 01 Nov 2013, 21:37

Cactus John,

I'd love it if you would guest on my show.

http://www.youtube.com/channel/UCiQUY00KIKj9RFo2Ruqg4Cg


Cactus Jack 01 Nov 2013, 18:28

Lance,

The odds of solving the problem by just lowering the sphere to help her read are pretty slim. Lowering her distance sphere correction will likely affect her distance vision unless her myopia has a significant Pseudo Myopia component. The most dominant factor in her present glasses is the astigmatism which affects vision at all distances.

The problem she is having is presbyopia and the solution for that is a PLUS add in some form, progressives, bifocals, or reading glasses. The add will effectively lower the -1.25 sphere in the reading segment to something nearer 0.00 or perhaps lower into the plus side depending on how much add is prescribed. Ultimately, she will need an add in the +2.50 to +3.00 range, but probably not yet. However, don't be surprised if that happens more quickly that she believes is possible for reasons I have explained on numerous previous occasions.

C.


Lance 01 Nov 2013, 18:04

So it looks like my wife is finally taking the plunge and getting progressives.

For the past 3 years she has been struggling with reading but it has all come to a head in the past month. Her grandmother passed away and they asked her to read a letter from the Grandchildren. She declined and announced to the whole room that she couldn't read the type and needed progressives.

She even said that her students have been beginning to bug her about getting an eye exam since she struggles reading in the classroom.

Last night I went to show her some Halloween pics I took and she said that she couldn't see the LCD screen clearly. Right then and there she declared she was going to get an exam this week. She called today and they had space for her tomorrow but we have a football game to go to so the next spot was next Thursday.

She will be 42 in a week and her current prescription is

-1.25 -1.75 x 100

-1.25 -1.00 x 70

Is there any chance she escapes progressives and they just lower her sphere? About 8 years ago she was as high as -2 and -1.75 but each exam they have lowered it a bit.Could that be the case again?

She struggles mightily with her phone and most near work so I'm guessing she will be coming home with an add of some sorts.It seems that the past 6 months she just turned the corner and her near vision has given out.


specs4ever 30 Oct 2013, 10:14

Willard - I was naturally in your position with one eye being used for distance and the other for close up for most of my life. Now I am in my late 60's I have been having trouble with binocular vision and I have had to do some vision therapy to get my eyes to work together again. My doctor didn't think it was possible for me to get my eyes back to working together, but I believe I have managed.


WIllard 30 Oct 2013, 09:42

A few months back I was prescribed +1.25 readers. They are good but fuzz up distance. I want to get +1.25 contacts to help me for close in my left eye, and go bare in my right eye. Is there any danger or downside in doing this? Advantages to this? Thanks!


OnLooker 22 Oct 2013, 05:11

Thanks CJ for the inputs but one thing i omitted to say was that she wasn't wearing her +1 glasses!!


SC 16 Oct 2013, 05:04

LT Lurker,

I have a lot of empathy with your wife's situation. My current Rx is for +1 hyperopis, but I suspect +1.5 would be more accurate, so possibly my situation was worse than your wife.

I knew I needed reading glasses at 42, but held out until 44. I had already started taking decisions based on what I could see - ie not buying a smart phone for fear I wouldn't be able to read it.

I guess I could have carried on quite easily - you can read almost anything under the glare of a 100W bulb, and if you can't read a book in bed because you are too tired to focus then there is always the next night. My dad was very proud of not wearing glasses until he was nearly 60 but he used various magnifying devices in the interim!

I took a personal decision at 44, my wife was shocked when I came home with glasses as she thought I'd never give in. I guess your wife is going to be at the same point in the next 12 months but may not make the same decision.

Once she gives in to reading then the rest will follow quickly, but I guess she could hold out for several years if really determined and willing to sacrifice things.


Peter7 14 Oct 2013, 12:10

Cactus Jack,

It was more out of curiosity, I had never had an eye exam actually. I mean I do use a smart-phone, but I'm not buried in it per se, meaning most of the time it's off or in my pocket. I used it when I need to, I don't conduct actual business on it.

Thanks again.


Cactus Jack 14 Oct 2013, 11:34

Peter7,

I really don't think you have much to worry about. Your visual environment does not involve much close work and potential eye strain that would cause you to have trouble focusing close, any time soon.

Most people who need bifocals at a young age often have much more uncorrected hyperopia than you do, spend a lot of time reading tiny text on smartphones, or have other problems that affect their ability to use their internal auto-focus system. You just don't fit the typical profile.

One thing, I don't think you ever said what prompted you to get an eye exam in the first place.

C.


Peter7 14 Oct 2013, 11:11

Cactus Jack,

I guess I'm worried about bifocals because previous posters my age went from no glasses to reading glasses, to bifocals in less than 2 years. That's all, or because my job doesn't involve a computer, will that effect the length of time between my current glasses and when bifocals will be needed?

Thanks


Cactus Jack 14 Oct 2013, 08:56

Peter7,

Probably not much worse. Astigmatism is typically caused by uneven curvature of the front surface of the cornea where the curve is steeper in one direction than it is in another. The cornea should be curved like a slice off the side of a glass golf ball. However, if a person has astigmatism, the cornea is shaped more like a slice from the side of an American Football.

Astigmatism can change over time, but it usually changes very very slowly. Usually, prescription changes for astigmatism are changes in axis, caused mostly by the lack of experience and skill by the patient during the part of the exam where the axis is being "bracketed", rather than by actual changes. That part is early in the exam where the examiner uses a supplemental lens that he/she can flip back and forth while adjusting the axis angle. You have to judge relative blurriness between the two axis angles. It is hard to do if you have no experience and most ECPs don't take the time to tell you what to look for.

The problem is that astigmatism actually means that the eye focuses at two different distances depending on the cylinder power and the axis angle of your astigmatism. The effect is most noticeable when reading text. Letters that have straight lines (called strokes) that run in different directions will not focus at the same time. For example an "E" has 3 horizontal strokes and 1 vertical stroke. With astigmatism, the horizontal lines might be in focus at say 40 cm or 16 inches while the vertical lines are a bit blurry. If you moved the text to 35 cm or 14 inches the situation might be reversed. The net effect is that reading text with uncorrected astigmatism can be very fatiguing because the eyes and brain have no ability to resolve the problem without external help, but they try, anyway. If you don't have to do much reading, astigmatism affects the clarity of small objects, but that is not as problematic as it might be if a person reads a lot.

One technique that works for me, in the astigmatism part of an eye exam, is to concentrate on an "O" if possible, because it has no straight lines.

I think you may be concerned about things that probably won't happen, at least for several years as you approach mid 30s to 40s. Your sphere correction may increase a little, but I suspect that after that it will be stable for many years. However, you should get a through eye exam every year or two. The eyes are windows into the body. As we age, many things can happen to us that do not affect vision directly, but are often detected first during an eye exam. High blood pressure and diabetes are often detected there before you have noticed any problems or they have caused any real damage.

C.


Peter7 14 Oct 2013, 07:14

Cactus Jack,

Can my astigmatism get worse over time? -0.50 and -0.25 hardly seem noticeable, just as the +1.25 and +0.75 don't seem noticeable either.


Cactus Jack 14 Oct 2013, 07:03

OnLooker,

She was straining to focus close and probably is getting very close to needing some supplemental help in the form of bifocals, a higher plus reader, or maybe a clip-on, flip-up magnifier/reader. I find clip on magnifiers to be inexpensive, extremely useful tools for people who wear prescription glasses and just occasionally need some close focusing help. Also, a needle threader for her sewing kit would not be a bad idea either.

The reason her eye(s) tried to turn inward when straining to focus is because there is an interconnection in the brain between the focus control and the convergence control. Focusing close to read (or thread needles) causes a convergence response to turn the eyes inward. If your eyes don't turn inward to focus close, you will see double. The interconnection works both ways. The strength of the interconnection varies among different people.

The reason she has to strain so much to focus very close is that presbyopia is creeping up on her.

Check out:

http://www.rx-safety.com/store/index.php?cPath=45_80&osCsid=nd0l6022asna66pm9iujgre151

for clip-on flip-up magnifier/readers. They are available in 12 different powers up to +5.00 for about US$15.00 and well worth it.

C.


OnLooker 14 Oct 2013, 06:34

My wife, 40,(a +1 hyperope, dating back to more than 3 years without eye tests)was threading a needle and i noticed her right eye was importantly turning in while she kept on struggling to do that, she did manage after several tries. What does this imply??


Cactus Jack 14 Oct 2013, 01:06

Peter7,

Yes. Wearing your glasses full time, means that you are not using your focusing power for distance which makes it all available for closer work. That should stave off the need for bifocals. However, remember that everyone is different. Some people who need a low Plus prescription in sphere (1st number) also have some Latent or hidden hyperopia. If you do, you may need a little more Plus in your next prescription, but it probably will not be very much more.

You may experience some prescription changes in your cylinder (2nd number) and axis (3rd number) over time, but that is nothing to get concerned about. Determining how much cylinder and axis is very subjective and depends a lot on your ability to judge relative blurriness. When you decide you need another eye exam, let us know and we will tell you how to fine tune the axis. It is easy and most Eye Care Professionals (ECPs) will let you do it and even encourage it, if you ask before the exam starts.

Please let us know how you get on with your glasses. Right now you can't tell much difference wearing or not wearing your glasses. In a few weeks, you will notice a difference. Initially, you may think that the glasses made your vision worse. That is not true. Vision actually occurs in the brain and your eyes are merely biological cameras. Your brain has been doing extra work correcting your vision. As your brain gets used to having sharp and clear images to work with, instead of slightly blurry ones it will decide that it prefers the sharp images and let you know that it prefers them.

C.


peter7 13 Oct 2013, 22:58

Cactus Jack,

I'm a chef. I use the computer about 15-20 minutes a day at work.

At home though, between phone and computer, about 2 hours a day.So I can actually stave off bifocals by wearing my glasses full-time? I guess I've read about others my age getting bifocals right away on here.

Peter7


peter7 13 Oct 2013, 21:40

Cactus Jack,

I'm a chef. I use the computer about 15-20 minutes a day at work.

At home though, between phone and computer, about 2 hours a day.So I can actually stave off bifocals by wearing my glasses full-time? I guess I've read about others my age getting bifocals right away on here.

Peter7


Cactus Jack 13 Oct 2013, 14:45

Peter7,

Thank you for the information. Your prescription indicates that you have mild hyperopia and probably could benefit from wearing your glasses most of the time because it would allow your ciliary muscles and crystalline lenses to be used primarily for their intended purpose - focusing close.

Your hyperopia means that there is a small mismatch between the relaxed power of your eye's lens system and the length of your eyeballs. Your eyeballs are a mm or so too short and you need a little extra plus (the first number in your prescription) to focus images sharply on your retinas. Unlike people who have myopia or near sightedness, who need less plus (minus lenses) you have a choice, you can use some of your accommodation (internal focusing power) to add the extra plus or you can do it externally, with glasses or contact lenses. The snag with using some of your accommodation power to focus for distance when you should not have to, is that it uses up some of your focusing power that you need for reading or using a computer. Right now, that is probably not a problem and it may not be a problem for a few more years until your presbyopia gradually robs you of your internal focusing power. Notice that I said YOUR presbyopia. Unless you are in a very small group of people (less than 1% of the population, you are gradually developing presbyopia and you have been since childhood. If you don't correct your mild hyperopia using external means, you will probably need focusing help in your mid-30s. If you wear external plus glasses for distance, you might not need bifocals or reading glasses until maybe 40. By the way, those numbers are a guess because no one really knows when a person will actually need close focusing help. It is typically around 40, but often sooner for people with hyperopia and later for people with myopia.

The thing that will probably cause you the most discomfort is astigmatism as indicated by the 2nd number (cylinder) correction and the 3rd number which is the direction of the long axis of your cylinder correction. Astigmatism is usually caused by uneven curvature of the front surface of the cornea. Astigmatism causes blurry vision at all distances (most noticeable when reading text or distant signs) and you have no way to correct astigmatism except by using external lenses. The general effect of uncorrected astigmatism is fatigue when doing close work such a reading or using the computer.

Astigmatism and the onset of presbyopia is very noticeable if you need to read the tiny text on smartphones or tablets. Even teenagers are getting bifocals these days to help them use their smartphones.

I hope this explanation helps you understand more about how your vision works. If you have more questions, please ask.

One thing I forgot to ask is your occupation. Do you have to do a lot of reading or spend a lot of time using the computer?

C.


Peter7 13 Oct 2013, 14:08

Cactus Jack,

I'm 28. I went for my exam in mid August. I could see at all distances with the glasses without minimal distortion. I don't wear them full-time, maybe about fifty percent of the time.

Thanks


Cactus Jack 13 Oct 2013, 05:21

Peter7,

Some questions to help answer your questions:

1. May I ask your age? That is an important factor in the onset of Presbyopia and the requirement for help in focusing close.

2. Why did you get an exam for glasses?

3. Do you wear them full time?

4. When you first got your glasses, was your distance vision a little blurry with them and it has now cleared up?

C.


Peter7 13 Oct 2013, 02:51

It has been almost two months now since I got glasses;

R +1.25 -0.50 90 L +0.75 -0.25 60. I find I can see at all distances now clearly with them on, as well as without them. Should I be worried about bifocals in the soon to be or near future?


LT Lurker 11 Oct 2013, 23:46

SC,I am intrigued as to where my wife will end up.

She can't drive long distances without a headache, she is unable to watch a full sports game(which she enjoys) without a headache.

So I think the hyperopia is there, but how long for it to emerge is a anybody's guess.

I am going with another year or two before she becomes pretty dependent.

Cheers

LTL


SC 07 Oct 2013, 07:49

LT Lurker,

I would think she will have to give in and use them for reading. I had progressives 0 add +1.50 (previously -0.25 add +1.5). These were the first glasses which I always had to wear when using the computer - as a consequence, my reading quickly adjusted. Within 2 months my eyes found the intermediate lens for distance, within 4 months I could no longer read fine print through the add.

So I had to get +0.75 add +1.5 - that is an example of how quickly things can change. If your wife actually uses them for reading/computer on almost every occasion then I would expect +1 add +1.25 within 6 months


LT Lurker 04 Oct 2013, 22:04

SC-It is the amplitude of accommodation which interests me most.

I am 47 and wear -2.50 in both eyes. I am also wearing the same in conatct lenses which means I am over corrected by 0.25.

I can read,albeit uncomfortably at 19cm - but at 24cms I can read without strain.

Therefore if Duanes method is applied means I should have only 2.4D available.

Instead I have what appears to be 4.16 -5.1D at 47 which is pretty much in line with Hofstetter proposes.

The AOA suggest that Hofstetter is the "probable".

So if this is the case then my wife could have a fair bit a hidden H.

I would think that the optician may have said to my wife something along the lines of ...."sooner or later you will be needing full time multi/bifocals which can take time to get used to, so I am prescribing you with them now as the transition to them is much easier with a lower prescription"

I keep asking myself that if there is no/negligable hyperopia at all then why prescribe multifocals?

If he was looking to make a sale he could have just gone with the 0.25 increase and the astigmatism that appears in both eyes.

I think he was being professional, but my wife just opted for keeping the same.


SC 04 Oct 2013, 13:44

LT Lurker,

I guess she is really struggling - perhaps there is +1D hyperopia, and she only has around +1.75 to use normally, and is really over-straining to get the other +0.5, say, that is the minimum you can cope with.

If she does give in and use for reading - which I guess is the most likely option - then I guess there would a be a few years before distance became a problem - my estimate is when watching TV without glasses becomes the same effort as normal reading with glasses is when distance becomes an issue. So assuming your TV is 4m away, and hyperopia is +1D, then she needs +1.25. If she uses glasses and her add reaches +1.5 (normally around 47-48) then Tv would be more effort than reading.


LT Lurker 03 Oct 2013, 19:11

SC,It all does seem odd to me, but the amount of strain is significant, everyday she has a "banging headache" by about 1pm and this she blames on Tamoxifen.

After reading for 15mins say an article on an ipad at about 40cm she rubs her eyes in a vigorous fashion, every time!

Reading a book in bed for more than 10 mins normally ends up with her asleep, she doesn't read much any more when before she would read for hours!

She does play Candy Crush which I don't think you need to concentrate on too much, not having played myself.

Working on a PC she does an hour and then goes off for a while and there is a lot of eye rubbing here too.

I am wondering if the optician just gave her what is manifest and as she told him there were no symptoms he just corrected her absolute distance error, which wasn't there previously as she was able to do 20/15.

She is a conundrum for sure, but I think perhaps she may have more than 3.5D accommodation, all will be revealed with the passage of time


SC 03 Oct 2013, 12:11

LT Lurker,

Accommodation depends on what formula you use. The one that works best in my experience is:

18.5 - age/3 (there are others that are 18.5-age*0.3) which gives accomm at 45 of 3.5D

The problem is that you can't really keep this level up, so someone who really gives their eyes an optical workout (ie doesn't wear correction when they need it) is usually around 75% (or +2.6D)

This would mean that if there is no hyperopia (and there is at least +0.25) then your wife would be unable to read small print and would be struggling with normal print (+2.5D = 40cm, +2.6-0.25 = 42cm) but it would be possible.

If she really has +1 hyperopia then she has very good accommodation. Normally this would be masked by a higher add - ie the rx is 0 add +2 when it should be +1 add +1 but that doesn't seem to be the case here.

In my case at 45, I was 0 add +1.5. Now I'm +1 add +2. This means at 45 my effective add was only +0.5, but I wouldn't have been able to read much without correction unlike your wife.


LT Lurker 03 Oct 2013, 07:27

Hi SC,

I do find it odd that 6 years ago there was hyperopia - and now it is not prescribed.

She would have played down the headaches and tiredness, and basically lied!

Silly I know but its all part of the denial.

I know she can see clearly at a good distance with her glasses as she has read signs and stuff on tv etc.

I was wondering if the optician recognised the need at some point for a full time correction and gave her a small distance correction with a reading add to get her used to using multi/bifocals.

She may have a lot of accommodation left - upto 6 or 7 D according to some scales.

Time will tell, but it is very bizarre as the symptoms are becoming more visible, yet she attributes these to other things!


SC 03 Oct 2013, 04:54

LT Lurker,

So your wife had a distance Rx 6 years ago but now essentially has a Reading Rx now. I doubt whether the hyperopia would fix itself, so it is either still there or it never existed.

Whilst you still have accommodation it is very difficult to test - opticians tend to ask whether you can read the distance line (6/6) and if you can then all is OK - it is really up the patient to mention headaches or tiredness and then the red/green is usually done and will find some hyperopia.

I would generally guess that someone having a problem with reading that at least warranted a visit to the opticians aged 39 would be hiding at least +2 latent hyperopia but maybe it was triggered by other things - bad lighting etc.

It is possible that there is still latent hyperopia - there seems to be a lot of cases of +1.5 appearing after 45yo, but equally there may be none. The +0.25 is small - my wife has +0.5 and manages without correction for distance, so if that is a true measure than I suspect she will never need a distance correction


LT Lurker 01 Oct 2013, 18:25

Hi Cactus,

The initial prescription had the numbers in the sph column-

She could seem to see ok into the distance with them,however she has really been in denial and only uses them when very tired,often preferring to fall asleep.

In addition she does get a fair bit of strain which she would have played down on the test.

She is 45


Soundmanpt 01 Oct 2013, 12:10

Carrie

Sounds like your eyes are adjusting pretty well to your new glasses. Each day now when you put your glasses on you should notice that it is taking less and less time for your eyes to see distance perfect with them and soon you will be able to put them on and not see any blur in the distance at all.

But it seems from your cousin's reactions with your glasses on she didn't have any problem seeing even better with your glasses on in the distance than her own glasses. She seems to be needing glasses more and more for distance than she does for reading. If you remember she started wearing her glasses for driving recently as well as other things besides reading. A big step considering she doesn't even want to wear glasses. It would sure seem her next visit she will be getting a stronger prescription than yours.

Oh and I am really glad your so happy with your selection of frames this time. Always nice when everyone else is telling you that as well.


Cactus Jack 01 Oct 2013, 10:53

L T Lurker,

Her future prescriptions depend on her age, how much Latent Hyperopia she has, and how much Presbyopia has progressed. Right now, we don't know enough to even guess. It would not be much of a surprise if her distance sphere remained pretty stable, maybe increasing to the +1.00 range, but it is very likely that her reading add will increase to the +2.50 to +3.00 range over the next few years.

May I ask her age and when she wears her glasses with the approximate +1.00 prescription for distance or close work. How is her distance vision with the +1.00 glasses?

C.


LT Lurker 01 Oct 2013, 01:49

Thanks Cactus,

I was wondering if she would over the next few years start heading towards the +1.25 and +1.00 for distance.

Is this probable in your view?

Cheers LTL


Cactus Jack 30 Sep 2013, 22:48

L T Lurker,

I forgot to mention that the difference in the cylinder axis is of little consequence when the cylinder is very low. Determining low cylinder and axis is very subjective on the patient's part and if she had had another exam a few hours later, the cylinder and axis numbers would probably be slightly different.

C.


Cactus Jack 30 Sep 2013, 22:43

L T Lurker,

The new prescription is for bifocals or progressives.

The reading add is very close to her old single vision prescription. In absolute prescription terms, the reading add is:

R +1.25 -0.25 35

L +1.25 -0.25 15

If she wore the old glasses for distance and for close, the new prescription would be clearer for distance, but seem the same or nearly so for close.

The thought of bifocals or progressives may be abhorrent and result in thinking about a very long river in Egypt instead. The name of the river is sometimes spelled "denial".

C.


LT Lurker 30 Sep 2013, 20:46

Sph Cyl Axis ADD

R +0.25 -0.25 35 +1.00

L +0.25 -0.25 15 +1.00

Hi Cactus,

This was what she got instead, but is sticking with the old

Cheers

LTL


Carrie 30 Sep 2013, 17:30

Not fully adjusted to the new prescription yet. Distances are still a little bit blurry for a few hours from when I put them on. I soon forget about it and it clears up eventually. I had lots of compliments at work today. Everybody says the new frames really suit me. Slightly more casual than my rimless glasses and slightly smarter than my large black ones.


Soundmanpt 30 Sep 2013, 11:07

Carrie

I agree that since you will likely be getting a new prescription in 6 months no real need to have the second pair made at this time. But at some point because you liked your rimless pair you may want to just update the lenses. Even though as you say it really is only the temples (arms) and bridge (across the nose) there is still value in having that. It of course is still considered the frame. Another interesting thing about having a rimless frame is that your not limited to getting the same shape lenses made or even the same size as you have in them now. The optical shop you go to should have a nice selection of lenses that you can have made into your prescription.

I'm thinking you were in no way surprised that your cousin would be able to see so well with your glasses were you? Little doubt that she will be needing stronger glasses at her next exam. Now that she has found that she could see so well with your glasses on she has to realize that she needs an increase herself. At least even though she is still trying very hard to resist wear her glasses full time she is wearing them much more often now. She has hit that point where once she puts her glasses on she doesn't want to take them off. Just like your college friend she will get to where it is much easier just to put her glasses on at the start of the day and stop working so hard at avoiding wearing them. And with a little stronger prescription she will find it even more difficult to see without her glasses.

Are you pretty well adjusted to your new glasses? They are probably nice and comfortable already.


Cactus jack 30 Sep 2013, 00:30

L T Lurker,

Maybe it was written with + cylinder. The prescriptions will look different but be optically the same.

C.


LT Lurker 29 Sep 2013, 22:33

My wife just had a test at Specsavers, she came out saying she had fine distance vision and healthy eyes but she did need near help when tired.

She also said the prescription was no stronger or weaker than her existing rx from 2006, just written differently.

She was offered new glasses but decided not to as she still has the specs from before.

I was wondering what the rx was, if it was basically the same but written differently, as she didn't get a copy ?

L+1.25

R+1.00 -0.25 x 170

was from 2006 - interim she was told by another optometerist 3 years ago she didn't need glasses.


Carrie 29 Sep 2013, 06:58

I will keep both the rimless and the large black ones as spares. I don't think I'll put new lenses in either of them. Not much point for the rimless ones as there's only the 2 arms and the piece that joins the lenses together with the nose pads attached. I'll probably hold off getting another new pair until I get the eye test in 6 months.

My cousin likes my new glasses. Like everyone else who has commented on them she said they are pretty. She tried them on and they felt very comfortable. I asked her how well she could see with them on. She said reading seemed better than with her own glasses and distances seemed about the same as with her glasses. She got her own glasses out to compare and confirmed that reading was better with mine and was slightly surprised that she could see a distant object slightly clearer with mine than with her glasses. As she was comparing the 2 pairs of glasses she suddenly realised that mine were stronger than hers. She was slightly disappointed that she could see better with my stronger glasses. She was hoping that her sight would get better or at least stay the same. I reminded her that her optician told her she has latent hyperopia, which is what an optician said I have. I said she is very likely to get a stronger prescription if she can see better with my new glasses. She said she now sometimes forgets she's wearing her glasses and often finds herself wearing them all day. She tries to resist wearing them much at weekends except when she absolutely needs to but it's difficult as once she puts them on she doesn't want to take them off again. I told her there's no point fighting it and if her eyes are even a little tired she should put her glasses on whatever the time or the day. She still had my glasses on at this point and my eyes were starting to ache so I asked for my glasses back. She immediately put her own glasses on and kept them on for the rest of the evening. I didn't mention glasses any more. I think she is getting even closer to wearing her glasses full time but still denying to herself that she should.


Soundmanpt 28 Sep 2013, 13:15

Carrie

Glad to hear that you found some new glasses that you like. It sounds like they fit what you were looking for. So lets hope people now will realize that the are real and not fake glasses.

Most every frame is able to have new lenses replaced. Since you only got the one pair this time but still like your rimless glasses you should keep that pair in case you ever want to get the lenses switched out. I agree with just getting the one pair since it seems like you maybe getting another increase in 6 months.

Your eyes seemed to be fine with the increase right away.

Yeah nice idea to test your cousin's vision with your new glasses to see how she reacts to the prescription. Like you her distance vision may be a bit blurry with them but I think she will find they are perfect for her close vision.


Carrie 28 Sep 2013, 12:02

I got my new glasses today. Me and Gemma looked in 3 different places and found some frames I liked in an opticians shop that is independent or part of a small chain, I don't really know. The frames were almost exactly what I was after - smaller than my black ones and tortoiseshell colour. I asked if it was possible to put new lenses in them if my prescription changes. I was told that it is. The best thing was that they make your glasses in about an hour!

The assistant that fitted my glasses was very good looking but didn't wear glasses. She put my glasses on my face to check the parts that go over the ears. She took them off to bend them a bit and just as she was going to put them back on my face she brushed my hair back over my ears! It felt incredible and I just looked ahead without showing any reaction.

I looked around with my new glasses on and everything seemed fine - about the same as with my black glasses. Just the far distance was a little out of focus. I could tell the prescription was a little stronger, especially in my right eye. Reading did seem clearer with the new prescription.

Gemma thinks I look much prettier with the new glasses than my black ones. She says they do exactly what I wanted - they make me look older and my eyes are more noticeable because of the lighter colour even though they are a bit smaller than my black ones.

We went for a walk after we left the opticians as I wanted to do as much looking at distances as possible to get used to the new prescription as soon as possible.

We're back home (in our flat) now and Gemma is fiddling around in the kitchen.

I showed my Mum and Dad my new look and they both said the new glasses are much prettier than the black ones and more mature but still fun.

My cousin is coming over later and I hope she'll try my new glasses on. I won't tell her that they are a stronger prescription until after she's tried them on. I want to get her reaction to how she sees with them on. I'm sure she'll get a stronger prescription at her next eye test.


Asdoo 27 Sep 2013, 09:08

A similar thing happened to me. When I was nine I got my eyes tested. I remember that my distance vision was slightly blurry and I had a bit of eyestrain. I also had poor depth perception that caused problems when I tried to catch balls. I actually wanted to get glasses, but I didn't get them for some reason.

When I was eleven I got my eyes tested and I ended up with glasses. They were R: plano L: +1.25. The optometrist said that my left eye was lazy. I quickly noticed that they didn't really help me. After a few changes in optometrists my prescription became R: sph +1.75 cyl -0.75 L sph+4.25 cyl -1.25. This optometrist said that my left eye was NOT lazy. He just explained that the other optometrists didn't correct the astigmatism correctly.


Dolphinology 27 Sep 2013, 04:13

LTLurker, I was 18 and I had symptoms of blurred distance vision and even more trouble close up. I don't know why the machine didn't pick this up?


Soundmanpt 26 Sep 2013, 14:24

SC

Yes I agree that if they are doing incruments they tend to try to be at around 50% each time.

I was only suggesting the idea of bifocals to hr because they should be more comfortable than forcing her eyes to accommodate an even stronger prescription for distance that she doesn't really need. Your right at her young age her eyes can adjust in a short time. It was only meant as an option.


SC 26 Sep 2013, 14:00

Carrie,

The only reason I know for staging an increase is the difficulty in adjusting for image size if the rx is different for both eyes.

If the optician is deliberately delaying an increase then it is common for the first increment to be 50%.

So, for example if your true rx was +2.5 & +3.5 then staging it may keep the eyes on one image. I was surprised about your comment on "seeing better" as reality is you are just replacing accommodation with external lenses so apart from some magnification ai wouldn't expect much difference. At your age you should have no probs with accommodation and wouldn't expect bifocals until somewhere between 37 & 42 yo

To be honest I have no idea how they figure out hyperopia without a dilated exam (I was given a minus rx 2yrs before I realised I needed a plus one!). So the 6 months may be just in case they got it wrong and you haven't adjusted.


LTLurker 26 Sep 2013, 09:03

Hi Dolphynology,

That's bizarre,how old were you when that was done and were you asymptomatic?

Regards LTL


Dolphinology 26 Sep 2013, 06:42

LT Lurker,

Interesting that you ask. I had the balloon test and got a prescription of 0.00, both eyes. In the exam conducted by the physical optometrist (not a machine), I ended up with a full time prescription to correct my hyperopia and astigmatism.


LT Lurker 26 Sep 2013, 02:46

Any thoughts anyone on how effective the Big Balloon Autorefractor test is for diagnosing hyperopia, and particularly latent heyperopia?


juicebox 25 Sep 2013, 18:04

Carrie,

did you see the link I posted for you to the tortoiseshell and aqua glasses? they're from the specsavers petite range. if not i can repost it for you


Carrie 25 Sep 2013, 14:01

I actually don't mind if they are male or female. If they are good looking and they brush the hair over my ears it just makes the feeling even more intense. Weirdly I still like it if the person isn't remotely fanciable, just not as much. It would be funny if they got just as aroused as me. I know if I was doing what they do I would.

The increase in my right eye is the same as the increase for my right eye last time. The increase for my left eye is only +0.25 less than the increase I got for that eye last time. That last increase was definitely noticeable for me even though I adjusted to it fairly quickly. I think some people on Eyescene thought that a +0.75 increase was a lot. I got my eyes tested at a different place last time so I'm guessing different opticians have different opinions. I spoke to someone at work who has had their eyes tested at the same store I did and they think the optician is just doing what is best for me rather than trying to make money. The optician may have worked out I couldn't take the full prescription in one go. I remember another place I went to, it may have been at my last eyetest, mentioned something about putting new lenses in existing frames. I would probably do that if/when I get another increase. I'm not necessarily going to buy glasses from Specsavers this time or next time so all they'll get out of me is the eyetest charge next time unless they have another voucher for a free test again like this time. I will certainly have a good look at what Specsavers have got at the weekend, so they might get my money. But I will also be checking out other opticians stores.


Soundmanpt 24 Sep 2013, 15:08

Carrie

I forgot the other part of your post.

So you tend to get aroused when the opticians are adjusting your glasses. An optician friend of mine told me she how she always gets aroused when anyone is adjusting her glasses or if they are removing her glasses. So that seems very common.

Now since you still find men attractive and you never have said anything about if you feel your more attracted to men wearing glasses or if it doesn't matter? So is it a nice looking guy or a hot looking woman optician adjusting your glasses that turns you on or both?


Soundmanpt 24 Sep 2013, 15:00

Carrie

Asking about bifocals was just just a thought since your actual distant vision seems pretty good even with full time wear and your prescription getting increasingly stronger. But I agree with you, if they are planning on having you back in after 6 months I can only guess that they intend to increase your prescription again. But as long as you feel your eyes can tolerate a bigger increase it doesn't make sense to do your increases at such a small pace. Just remember their your eyes and you have every right to question if that is what they are planning and even request your full increase now. It's very strange that they are doing this now when the change you had from your first glasses to your current glasses was quite a bit more than they want to give you now. And you didn't have any trouble getting used to your current glasses right from day one you never once complained that they felt even a tiny bit strong. I don't even remember any problems with your distance so your eyes must have had very little problem getting used to them. So before you spend money on new glasses that will likely only be good for 6 months i would ask at least.


Carrie 24 Sep 2013, 13:32

Soundmanpt - I don't really want bifocals and I know I'll adjust fairly quickly to the new prescription. I hope they are not spreading out the increase so they can get more money out of me for new lenses next year.

Lazysiow - That could have been very embarrassing! I get very aroused and all weak at the knees if someone gently brushes my hair over my ears with their fingers if they've taken glasses of my face. It's a bit awkward when it's a good looking assistant in an opticians shop and they are sitting right in front of you looking you right in the face. I just try to think of something else and not look at the assistant.


lazysiow 23 Sep 2013, 23:41

You're probably not the only one who gets turned on by eye exams around here, there are ASMR videos on youtube for that too (but most are from people just pretending to be eye doctors)

Before I got used to wearing glasses I would get pretty turned on by ladies putting them on me. My first pair I had to wonder if the lady noticed I was sporting a massive hardon afterwards as I got up to look in the mirror. If she did she kept it to herself lol


Soundmanpt 23 Sep 2013, 19:27

Carrie

It does seem like they will want to increase your prescription again in 6 months, but curious since they didn't really increase you even as much as you got at your last exam. If their concerned that your eyes may have too much trouble seeing distances if they made your glasses any stronger I would think they would just suggest bifocals to you. If you are still able to see good enough without your glasses that only the bottom line was unreadable it would make a lot more sense to give you a weaker prescription for distances and increase your reading area. If you don't have any problem with getting bifocals (progressives) you might even ask them if they think you would be better off that way. I think some doctors are just a bit afraid to suggest bifocals to someone your age.


Carrie 23 Sep 2013, 15:37

I have a feeling they are increasing my prescription gradually. I felt I got used to my last increase fairly quickly but maybe the optician thinks a big increase would be difficult for me to adjust to so is giving me a bit now and probably a bit more in 6 months. They did test me for distances with and without glasses. Couldn't read the bottom line without glasses and the rest wasn't too clear. I had trouble concentrating because I get turned on by having my eyes tested. I even forgot I wasn't feeling very well!

At least this time I controlled my potty mouth when they did the air puff (I swore last time. I don't get turned on by that part).

I'll probably go glasses shopping at the weekend.

I am feeling better now (thankyou) as I slept most of today (I took the day off work). Gemma wanted to stay and look after me but I made her go to work - for her benefit (I get grumpy when I'm ill or tired - not nice to be around). It's so boring being sick so I'm glad I was asleep.


 23 Sep 2013, 07:51

Sorry, wrong nickname. That's "Diaperfan" not "Hyperfan".


Hyperfan 22 Sep 2013, 18:36

Oh, poor Carrie, you forget to tell us abour Gemma your lesbian girlfriend about this in increase !

I will be unable to sleep if i dont know about Gema (my lesbian girlfiend) advice !

So dramatic.


Soundmanpt 22 Sep 2013, 13:31

Carrie

Sorry to hear your under the weather. Hope you get to feeling better soon.

I was wondering if and when you were going to get around to getting your eyes checked. So now that you have your new prescription i'm sure you will be looking even harder now for new frames. Do you plan on getting 2 new pairs again? I know you enjoy being able to try them on but you might want to consider getting one pair at a local shop and a second pair from Zenni. You like your rimless pair and Zenni has many of those with every possible shape of lenses to pick from that would cost you about $30.00.

Your increase wasn't too much considering it has been more than a year since you last had your eyes tested. Did they test your distance vision with and without your glasses. Were you able to read the 20/20 (perfect)line with your glasses still or was that too blurry? Of course without your glasses should have been much harder than the last time you had your eyes examined? Interesting that they want you back in 6 months. They must feel that your eyes are changing enough to warrant it even though the increase isn't that much.


Carrie 22 Sep 2013, 06:52

Got my eyes tested yesterday even though I was feeling a bit ill but I put extra makeup on so I looked normal and Gemma was with me to make sure I was all right.

As I suspected I needed a new prescription due to my latent hyperopia. Got another +0.50 for my left eye and another +0.75 for my right eye. My prescription is now left +2.00 and right +2.50. I was told I will see much better with the new prescription but distances may be a little blurry for a few days. The optician wants me to go back in 6 months.

I haven't chosen my new frames yet but I will do soon, so for now I am still wearing my glasses with +1.50 and +1.75.

The fresh air yesterday helped a bit. Still not feeling great today but at least I have my girlfriend with me which does make me feel better (she's making me some breakfast at the moment). (we've had a busy week moving our stuff into the flat built on to my parents house so maybe I just got a bit too tired out to fight off a bug)


Cactus Jack 16 Sep 2013, 14:16

Dan,

I didn't quite answer the question you asked. If you had +0.75 as an internal source, that would indicate that you would need the opposite of the +0.75 or an external -0.75 to neutralize or cancel out the +0.75 and give you a refractive error of 0.00 for distance.

C.


Cactus Jack 16 Sep 2013, 14:12

Dan,

To focus light rays at 50 cm requires +2.00 from either an internal or external source or both. If you were wearing a +1.25 external source, the only choice for the other +0.75 is internal. There are two possibilities. A mismatch between the total optical power of the eye's lens system and the length of the eyeball between the back of the crystalline lens and the retina, or the crystalline lens as the only potentially variable element in the optical system.

Remember, the discussion with Lucas was based on the fact that his +0.75 glasses were intended to help him focus close and he wanted to also have clear distance vision with them. That is not optically possible unless something is going on with his ciliary muscles and crystalline lenses that we know nothing about.

Why do you ask the question?

C.


Dan 16 Sep 2013, 12:30

CJ,

So if I did the same test and also got 50cm but was wearing +1.25 glasses while doing it instead of +0.75, what would that say about my need for distance prescription?


Dan 16 Sep 2013, 12:30

CJ,

So if I did the same test and also got 50cm but was wearing +1.25 glasses while doing it instead of +0.75, what would that say about my need for distance prescription?


Cactus Jack 15 Sep 2013, 23:05

Lucas,

Remember that the 50 cm focal distance with the glasses means that the total refractive error under those conditions was +2.00, but you don't know why. The test is pretty crude, but if the only factor was the +0.75 glasses, the distance where the text became fuzzy should have been around 133 cm.

Let me know if I can be of any more help. If you wish to contact me privately, Cactus' email address is cactusjack1928@hotmail.com


Lucas 15 Sep 2013, 22:55

Hi that makes sense, although I did get multiple exams in the past few years all leading to a similar prescription. Perhaps I did the book test wrong as I was having trouble determining when it would be considered blurry. I will keep using my glasses for reading and computer solely. Thank you for the answers.


Cactus Jack 15 Sep 2013, 22:48

Lucas,

That is a good question. It may be that your stated symptoms misled the examiner or your eyes were different a year ago. Things can can change at 22 and it is common for students who do a lot of close work can develop vision problems. Low hyperopia or Low True Myopia combined with Pseudo Myopia or Latent Hyperopia can cause interesting (in the Chinese sense) refractive results. The Chinese expression "may you live in interesting times, is a curse".

Also, time of day and what you had been doing prior to the exam can affect results.

Many people discover that they could use some help in the vision department in university. When I was in school, there were a few people in their late teens and early 20 who wore bifocals in lectures so they could read the board and their notes with ease. One guy I knew had bifocals with no prescription in the distance part and about +1.50 in the reading segment. The name for glasses like that are functional bifocals. He really didn't need +1.50 for reading his notes, but it caused much less fatigue than having to completely shift focus as he switched from reading the board to reading his notes. The problem he ran into was finding an ECP that would prescribe bifocals for a 20 YO. It is not a hard today with all the tiny text devices, but there are still some ECPs around who were programed to not prescribe bifocals for people under 40.

I would like to suggest that a dilated or "wet" exam might be useful, but you need to understand that the mild agents used might not fully relax your ciliary muscles and crystalline lenses. The kind of ECP you need to see for a dilated exam depends on where you live. Some states allow Optometrists to dilate eyes and others only allow MDs (Ophthalmologists) to do them.

Any thoughts?


Lucas 15 Sep 2013, 22:19

That makes sense, but in that case, why wasnt I given - glasses?


Cactus Jack 15 Sep 2013, 22:17

Lucas,

The short answer is NO. Let me explain why using Sir Isaac Newton's discovery back around 1700.

The 50 cm distance indicates that with your +0.75, your refractive error is +2.00 100 cm / 50 cm focal distance = +2.00. The glasses supplied +0.75 and your eyes supplied the other +1.25 for a total of +2.00. If all that is right, you have +1.25 built in and are actually mildly nearsighted and require approximately -1.25 for good distance vision.

It is possible that you are either a bit truly nearsighted or have developed some Pseudo Myopia.

The small amount of astigmatism has a different cause and it can mess with your vision at ALL distances so it needs correction, no matter what other conditions exist.

Does any of this make sense to you?


Lucas 15 Sep 2013, 22:03

I got the glasses a while back as I got tired when reading and spending time on the computer. Is there anyway id get accustomed to waering them for distance


Cactus Jack 15 Sep 2013, 22:03

Lucas,

Interesting. Two questions:

1. Why did you get the glasses.

2. Have you ever previously worn glasses for distance vision or for reading.


lucas 15 Sep 2013, 22:00

That distance is about 50 cm


lucas 15 Sep 2013, 21:59

That distance is about 50 cm


Cactus Jack 15 Sep 2013, 21:54

Lucas,

What you need to do is find out at what distance ordinary book sized text just begins to get fuzzy. To do that, with your glasses, start with the text sharp and clear in good light and gradually move the text or yourself away until the text begins to get a little fuzzy around the edges. You can use a computer as long as the text size is about the same as the text in a book.

Measure the distance form your eyes to the text.

Do it three times and average the distance.

Let me know the distance.

If the distance is more than you can conveniently measure, let me know.


Lucas 15 Sep 2013, 21:48

What do I need to do?


Cactus Jack 15 Sep 2013, 21:47

Lucas,

That makes more sense. Could you do a simple test to get an idea of how effectively they are doing their job? You will need something to measure a meter or two.


Lucas 15 Sep 2013, 21:44

They were prescriped for reading and computer use, but I am tired of having to take them on and off to see far I was hoping I could wear them all the time


Cactus Jack 15 Sep 2013, 21:42

Lucas,

Something doesn't seem right here. Were the glasses prescribed for reading or computer use rather than distance?


Lucas 15 Sep 2013, 21:38

From memory, the prescription is +0.75, -0.5 in each eye


Lucas 15 Sep 2013, 21:38

From memory, the prescription is +0.75, -0.5 in each eye


Cactus Jack 15 Sep 2013, 21:35

Lucas,

A few days is rarely long enough for any Latent Hyperopia to be revealed. It usually takes weeks or months depending on how far Presbyopia has progressed and the actual amount of hyperopia present.

What is the prescription of the glasses you are wearing for reading or using the computer.

C.


Lucas 15 Sep 2013, 21:27

Yes I have and have been following this website for a while so im pretty familiar with the workings of the eye. I was thinking it would take a while for my eyes to stop accomodating for the hyperopia and was wondering how long that usually takes


Lucas 15 Sep 2013, 21:27

Yes I have and have been following this website for a while so im pretty familiar with the workings of the eye. I was thinking it would take a while for my eyes to stop accomodating for the hyperopia and was wondering how long that usually takes


Cactus Jack 15 Sep 2013, 21:25

Lucas,

Have you studied any physics or studied the optical structure of the eye?

C.


Lucas 15 Sep 2013, 20:14

Hi Cactus jack,

Im am 22, a student, who spends most of his day on the computer or reading. My latest prescription is about a year old of if i remember correctly +0.75 hyperopia and +0.5 astigmatism in each eye living in the united-states. Ive now been wearing them all day for 2 days and distance hasnt immproved.

Thank you for any help.


Cactus Jack 15 Sep 2013, 19:53

Lucas,

I apologize if we have conversed before and you have previously answered my questions. Unfortunately, I can't keep track of everyone's prescriptions so I need to ask you to refresh my memory about your situation. I think I need to help you understand how your vision works and help you understand what is possible, what is not and why. It sounds like you may be trying to do something that is very difficult or not possible because the laws of optical physics and the structure of the eye will not let you do.

I need to ask a few questions so I can answer clearly:

1. What is your age?

2. Your occupation?

3. Your most recent complete prescription and its approximate age?

4. The prescription in the glasses you are wearing that prompted the question?

5. Where do you live (country, state or province)?

6. Do you do much close work?

Thanks,

C.


Lucas 15 Sep 2013, 12:55

From other people's experience, I thought that my eyes would naturally adjust to the distance vision and would eventually see better with them on. Is that not correct?


Lucas 15 Sep 2013, 12:55

From other people's experience, I thought that my eyes would naturally adjust to the distance vision and would eventually see better with them on. Is that not correct?


varifocals 15 Sep 2013, 12:48

Lucas.

The way it works is that you should have blurry vision, depending on the lens strength. I have the same thing & I have varifiocal glasses


Lucas 15 Sep 2013, 12:26

Also,

Once im used to wearing them for all distances, can I go back to wearing them only when needed, and my distance vision will be clear with them on. Or will I need to keep wearing them in order to keep my distance vision clear with them on.

Thanks


Lucas 15 Sep 2013, 11:47

Hi all,

I've been wearing my glasses full time for the past two days to try to clear my distance vision. My close vision and intermediate vision (up to a few meters) is now perfect but I still havent adjusted to seeing distance vision, 10, 15 meters. How long does it usually take? Thank you


NYC O^O 08 Sep 2013, 08:29

My wife has been wearing reading contact lenses in both eyes for over a year now. She needs +2.00 for distance in both eyes, with +1.75 more for reading, and could not adjust to progressive glasses. He eye md suggested contact lenses, right distance and left near. That made her feel off balanced. I have a -1.25 distance Rx. She tried reading contacts in both eyes +4.00's and found she was more comfortable than monovision. She felt the distance blur was no worse than going with no correction for her and found my distance glasses worked well enough to give her distance vision while she wore both near contacts. As she spends most of the day looking at screens or on an I-phone, she has been very happy with both near contacts. Her eye md has since given her a distance Rx of -1.50 glasses both eyes to wear with the reading contacts.

One of her best friends has been wearing a mild distance pair of glasses for years, is actually a high myope of about -9.00 and goes with contacts most of the time and uses the over correction to sharpen her distance when needed. I only realized that she was a high myope when one evening at the theater she switched to the stronger pair when her contacts acted up. Both pairs have the same frame. This may also have been how my wife decided do both contacts for reading.


lazysiow 07 Sep 2013, 13:06

I've always thought a good alternative to bifocals would be to wear the add prescription as contacts and then over minused glasses over them to cancel things out. That way you can just take your glasses off to read

Any ideas as to why that doesnt happen more often?


Soundmanpt 06 Sep 2013, 09:25

Cactus Jack

Funny this came up. The other night I was at the local mall and I stopped to have a pretzel and soft drink. Across from where I was sitting was a hair place to get your hair done. There was 3 young laddies in there and since it was only about an hour from closing time they didn't have any customers. One of them must have gotten a text or something on her I-Phone and she was sharing it with the other 2 girls. One of them when she was trying to see it took it from the one girl and held it about 3 inches from her eyes to read. But when the other 2 wanted to see it they held it at a more normal distance. This whet on a while and as each new text came in the one girl would take it hold it very close to her eyes each time. When I finished my pretzel I took one of my sheets I give out about getting glasses on line and went in to the desk and gave it to one of the other 2 that didn't seem to have any problem and told her it was for the girl that was holding her I-Phone so close. That girl was close enough that she heard what I said and she spoke up and replied that she didn't think she needed glasses and that her vision was all right. The other girls then came back and called her out about how she is guilty of holding her phone really close. She acted like she didn't even know she was doing it. I left as they continued to talk about it.


Cactus Jack 05 Sep 2013, 14:36

Aubrac,

I suspect your step-daughter may have some vision problems that have not been diagnosed. At her age, she probably has excellent accommodation and can focus close easily. However, that cannot help with anything, but latent hyperopia. Sometimes people with astigmatism will hold something with fine print, very close to make text appear larger on the retina and make it easier to decipher If, for example, there is some astigmatic blur. Also, if there is a tendency to over-converge it might make the images easier to fuse. Don’t overlook latent hyperopia and / or possible esophoria. More things have a genetic component than just myopia.

Being able to discern the letters and numbers on an automobile number plate is not much of an eye exam. Has she had an eye exam anytime recently?

C.


Aubrac 05 Sep 2013, 05:38

Cactus Jack

Many thanks for that CJ, they look really useful.

Maybe I could have your advice on something - my step-daughter is 17 and has just started driving. She must have ok distance vision as she can read the test number plate, however she always holds books about six inches away and even closer with her phone. Before her mum had glasses she also did the same thing but what I don't understand is that if there is a need for plus lenses, I would have thought they would hold books farther away and not closer.

Any ideas?


Cactus Jack 04 Sep 2013, 08:19

Aubrac,

You might check out this link.

http://www.rx-safety.com/store/index.php?cPath=45_80&osCsid=afk2opph1p557ekd5ltn7jo627

it is to the clip-on magnifier (readers) page at Rx Safety Glasses. I have found their inexpensive clip-on readers to be very useful for a lot of applications. They are available in powers from +1 to +5. I like them much better than wearing OTC readers over my regular glasses.

C.


Aubrac 04 Sep 2013, 05:27

An update on my wife's glasses wearing which is a bit confusing these days.

She had new glasses about nine months ago. A nice Silhouette rimless frame with quite big varifocal lenses of about +2 with +2 add. Before the add she used to carry a +3 magnifying glass in her bag for reading things like restaurant menus.

The magnifier has disappeared but she has some old-looking nerdy glasses of about +4/+5 she uses for very small print over her varifocals. These glasses look like the ones I've seen in photos that she wore until age 12/13 as she had glasses from age four to correct strabismus.

A couple of weeks ago I found a nice pair of tortoiseshell specs on the table that are OTC +3 readers, and which I have seen her wearing over her varifocals at the computer. The unusual thing is that for the last few days she has gone full time with the OTC readers.

Maybe she now needs more distance correction and finds the readers more comfortable although they would not correct her -0.75 axis 130 cylinder need.

A bit of a merry go round of strange combinations, and hopefully I can get her to a really good optometrist who can sort out a correct prescription for her.


Cactus Jack 04 Sep 2013, 00:01

Sam,

Thank you for your answers. With your background, you will have no problem with the technical side of this.

At this point, I do not know what your actual prescription is, but I suspect you may have a small amount of latent hyperopia. You can do a simple test that will give us an idea if that is correct. The +1.50 contacts make you a little myopic as indicated by the blurry distance vision. Here is the test procedure to be performed when you get home after wearing the contacts all day. Your ciliary muscles and crystalline lenses should be fairly relaxed:

1. Using a news paper or book with similar sized text and something to measure with, start with the text at a comfortable reading distance and;

2. Slowly move the text away from you until you notice the the smallest text is just beginning to get fuzzy around the edges.

3. Measure the distance from your eyes to the text.

4. Do steps 1 thru 3 again, three times and average the distances.

You can use Sir Isaac Newton's formula by dividing the distance you measured into either 100 cm or 39.37 inches depending on which units of measure you are using to determine the refractive power of your eyes with the +1.50 contacts, at that instant in time.

Please let me know what you measure and we can go from there.

As far as how long it will take to induce presbyopia, we can't tell for sure, but let me explain what has to happen. Presbyopia or "old eyes" actually starts in childhood, but typically does not become a problem until around 40, but it can become a problem sooner than that under the right circumstances. Presbyopia is caused by the crystalline lens becoming gradually stiffer and harder to focus over time. When you are very young, your crystalline lenses have the consistency of gelatin dessert and they are very easy for the ciliary muscles to squeeze and increase their power to focus close. As you get older, depending on your genetic makeup, your crystalline lenses ultimately get so stiff that the ciliary muscles just cannot squeeze them enough to focus. There are three other factors that affect when presbyopia becomes a problem; your visual environment, any latent hyperopia that is using up some of your accommodation to correct, and the conditioning or strength of your ciliary muscles.

For their size, the ciliary muscles are the strongest muscles in the body because they normally get plenty of exercise. However, like all muscles they can easily get out of condition and loose their strength. When that happens, usually as a result of wearing external plus lenses to help you focus close, the need more reading help will seem to cascade very rapidly until it reaches its limit that is determined strictly by your preferred reading distance and any residual refractive error. If you want to induce presbyopia, all you have to do is decondition your ciliary muscles by letting external lenses do all their work for them.

Lets see if we can get a better idea of your present refractive error (if any) with the above test.

C.


Sam 03 Sep 2013, 21:08

Thanks for the reply cactus jack. Given below are the answers

1.I live in India.

2.i am a software engineer who spends long hours in front of computers.

3. I am an engineer.

4. Yes I had training in contact lens usage.

5. I wear them after waking up and remove them before going to bed.

6. I would like to wear a prescription between +1.5 to +3.0

Okay going through your post I understand that this process of wearing +1.5 contacts will make me presbyopic. How long will this process take.


Cactus Jack 03 Sep 2013, 09:12

Sam,

I have some disappointing news for you. It is not possible to make yourself hyperopic. Your eyes and your body just don't work that way. The short answer to your question of "how long will it take for my eyes to become completely dependent on the lens." is: "forever". However, that does NOT mean that you can't wear almost any power glasses, if that is what you want. You just need to go about it in the right way.

It is possible that you are already mildly hyperopic. Many people are, who think they have perfect vision, they just don't know that they have some hyperopia. Often, the hyperopia is hidden and it even has a name, Latent Hyperopia. If that is actually your situation, all the +1.50 contacts will do, is reveal it, but they cannot increase it.

To understand why, it helps if you understand a little about optics and how the eye works. It actually is not difficult or all that complicated, but it does involve a little math at the add, subtract, multiply and divide level. The simple math will also help you understand how you wear almost any power vision correction you want to.

May I ask a few questions? Some may seem a little strange, but they will help me, help you.

1. Where do you live (country)?

2. What is your occupation?

3. What is your educational background?

4. Have you had any training in hygiene and how to care for your contact lenses?

5. How long do you wear your hd 2 contact lenses before taking them out and cleaning them?

6. If you could choose, what would you like your glasses prescription to be?

By the way, the optical term for what you are wanting to do is to "Induce Hyperopia". In this instance, "Induce" means "to cause". While it is impossible to Induce Hyperopia, It is possible to Induce Presbyopia, which you may be inadvertently doing, and under limited circumstances, Induce Myopia if you are young enough.

I look forward to hearing from you.

C.


Sam 03 Sep 2013, 02:55

Hi All,

I am 33 years old. I eyesight is perfect. I want to make myself hyperoic. So I from yesterday I am wearing baush and lomb pure vision hd 2 contacts of strength+1.5. After wearing the contacts my near vison is good but the distance is a bit blurry. Once I remove the lenses everything becomes clear again in a few minutes. My question is how long will it take for my eyes to become completely dependent on the lens.

Thanks

Sam


Maurice 22 Aug 2013, 06:54

Thanks for the comments. Not sure that I am ready to go back seeking a stronger prescription, but will see what blurriness comes my way in the next months. When I first got the glasses, I tried to just wear them for reading,but taking glasses on and off was too much hassle for me, along with trying to remember where I left them. Decided full-time wear was the better way to go. Glad to know this has not worsened my eyesight.


Kris 21 Aug 2013, 22:32

Cactus Jack,

Thanks for your help. I'm going to see how the new prescription is working, then try ordering some glasses. I'm hopeful that things will improve with the new prescription.

Maurice,

Welcome to the club! I had an experience similar to yours when I was first prescribed glasses. It seemed like once my eyes relaxed, they really relaxed and I had my prescription increased within a month of first starting to wear glasses. My optometrist replaced my lenses free of charge at that time. Does your optometrist offer free adjustments on your prescription? If so it would be worth being retested to ensure you have the right lenses.


Cactus Jack 21 Aug 2013, 21:55

Maurice,

The glasses did not make your eyes worse, they just revealed what is known as latent hyperopia. Millions of people have experienced what you are experiencing and have had similar reactions.

You asked if your glasses were too strong. Actually, they are not quite strong enough, but probably only by a small amount.

There are 4 different common refractive problems.

1. Myopia or Nearsightedness where distant things are blurry and depending on the magnitude of the myopia, near things may be very clear. Myopia is corrected by - sphere correction.

2. Astigmatism, which is caused by uneven curvature of the front surface of the cornea. It is corrected by + or - cylinder and axis in the prescription.

3. Hyperopia or Farsightedness where distant things are blurry and near things are often more blurry. Hyperopia is corrected two ways. You have the ability to correct low to moderate hyperopia internally by using some of the Plus power of the auto-focus mechanism in your eyes, often without your even being aware that you are doing it. The auto-focus mechanism consists of two elements. Your crystalline lenses and your ciliary muscles which squeeze the crystalline lenses to increase their + power to focus close or correct your hyperopia. Alternatively, the ciliary muscles relax ideally relax for focus for distance.

4. Presbyopia or literally "old eyes" where with age the crystalline lenses gradually change from the consistency of gelatin dessert, in childhood. to rather stiff as we get older. As the crystalline lenses get stiffer they become harder to squeeze and much slower to relax. Presbyopia is corrected by + lenses for focusing close when the ciliary muscles can no longer increase the plus power of the crystalline lenses to let you focus close.

You are "enjoying" the symptoms of Latent or Hidden Hyperopia combined with Presbyopia. It is highly likely that you have had mild hyperopia for many years and your ciliary muscles and crystalline lenses have, in effect, taken a "set". When you got your glasses, the sphere correction fixed the hyperopia that existed at the time of the exam and the add, proved PART of the extra plus you needed to focus close. The glasses have taken over some of the work load of your ciliary muscles and have allowed your crystalline lenses to slowly relax. The result is that you need a bit more + for distance, probably somewhere between +0.50 and +1.00 and probably as much as +0.50 more in the add.

That was the bad news, the good news is that you are probably almost to the point where your prescription will stabilize for many years. The distance sphere won't change much at all and your add will be determined by the distances you like to read or if you use the computer a lot, you might find that you need an intermediate lens for that distance. (trifocals or progressives) The actual power of the add is determined mathematically using formulas discovered by Sir Isaac Newton about 300 years ago.

I hope this helps. There is really nothing to be very concerned about and welcome to the forum. If you have more questions, please ask.

C.


Maurice 21 Aug 2013, 19:53

About 6 weeks ago, I gave up the charade and admitted that my 48 year-old eyes needed glasses. I must say that I was surprised,when the doctor prescribed multifocals:

Right: +1.00 add +2.00

Left: + .75 add. +2.00

Since getting the glasses, I have been a pretty full-time wearer and have noticed that my vision without glasses has gotten even worse. Now, without glasses, I can barely make out letters and numbers up close. Have also noticed some fuzziness with my distant vision when going bare-eyed. Did I worsen my vision with full-time wear? Maybe these glasses are too,strong?


Cactus Jack 21 Aug 2013, 09:47

Kris,

If you decide you want to get some single vision reading glasses, Here is the prescription. Right eye is usually listed first:

OD (Right Eye) Sphere +4.00, Cylinder -0.50, Axis 75

OS (Left Eye) Sphere +3.25

All you need is your near PD. If you get a chance to see your PD, it may be listed as what appears to be a fraction. For example 63/60. The 63 is your distance PD and 60 is your near PD. The difference is because your eyes converge when you focus on something close. Near PD is typically 3 to 4 mm less than the Distance PD.

If you don't know your PD, you can measure it with a mm ruler and a bathroom mirror provided you can see the mm marks on the ruler in the mirror without your glasses. If you can't, you may need to get someone to help you. It is really easy. Ask and we will tell you how.

C.


Kris 20 Aug 2013, 18:22

Had my eye exam today. Ended up with just a tweak to my current prescription. New prescription is Left eye 1.25, Right eye 2.00 Cyl -0.5 axis 75 with 2.00 add for both eyes. Not sure how much this will improve my current vision, but worth a try to see if headaches improve. Won't get the new glasses for a bit so will have to wait and see if the change is worth it. Really didn't think there was going to be a change to my distance vision at all and really thought I had selected the same correction as I have now during the testing. Was surprised that there was any change. Now I just have to hold out until the new glasses are available.


Cactus Jack 19 Aug 2013, 23:13

Kris,

It is really easy to measure your PD. All you need is a ruler with mm markings and a bathroom mirror or a mm ruler and a friend to help. You can do it by yourself if you can focus well enough to see the calibration marks on the ruler while looking in the mirror and holding the ruler. The idea is to measure the distance from the center of your nose to the center of each pupil individually and add the numbers together. There are a few additional details we can help you with depending on your ability to measure solo or if you have a friend who can help. Just let us know.

Three reasons you don't notice.

1. The change is slow

2. Vision occurs in the brain, the eyes are merely biological cameras.

3. The brain can fix image problems if it knows what something is supposed to look like.

People with hyperopia and presbyopia tend to develop headaches and other symptoms because they are straining to focus. I had low to moderate myopia and my need for new glasses developed over months and one morning I would wake up, put on my glasses, and my distance vision was blurry. The day before, it seemed fine. I guess my brain finally decided that it had done enough image correction and effectively said, "Get some new glasses, Ace."

C.


Kris 19 Aug 2013, 22:50

I was thinking about getting some readers. Will see my script is after my exam and will look into it. I can't figure out how to calculate PD so that has stopped me from ordering online in the past.

Random thought: why is it that I don't notice my vision changing until after I start to get physical symptoms like dry eyes and headache. Am I that out of tune with what's going on with myself?


Cactus Jack 19 Aug 2013, 21:27

Kris,

One more thought. If you like to read a lot, as I do, you may find an inexpensive pair of single vision prescription reading glasses extremely useful and comfortable. Prescription reading glasses are essentially the absolute optical power of your distance prescription and your ADD combined. You can order single vision reading glasses on line from an online retailer like Zenni Optical for less than US$15.00 including shipping. If you decide you would like to do that, let us know and we will help you with the prescription and with the order details.

C.


Cactus Jack 19 Aug 2013, 21:20

Kris,

It depends on how you define worse. I can almost guarantee that your prescription will change some over the next year or so, but after that, it will probably be very stable. If you like to read close, you may find that trifocals are a better solution for intermediate distances than progressives. When you get to the point where you prefer +2.50 to +3.25 for the reading add, the transition corridor with progressives gets very short and narrow. You might find that you prefer the wider and possibly taller intermediate segment that is fixed focus all over. There is no need to rush it. You will know when you need to do something different. Just don't be reluctant to take action if something doesn't seem right, just because a certain arbitrary amount of calendar time has not elapsed.

C.


Kris 19 Aug 2013, 20:23

Thanks Cactus Jack and SC,

After speaking to my insurance provider to sort out coverage I made an appointment for an eye exam this week. I am not 100% sure my issues are related to vision changes but thought I should rule it out. I live in Canada and am in a job where I am off and on a computer through the day and also do some reading. I wouldn't say that I have sustained close work, but depends on the day.

My symptoms now are similar to when I first started wearing glasses (as an adult, I don't count the ones I wore until I was 8). It was like once I started to wear glasses, my eyes gave out. My original prescription only partially corrected my farsightedness and I needed to increase my script within a couple of months of getting my first pair of glasses. Even with those (single vision) I was having problems with blurred distance vision and my eye doc suggested progressives which I resisted until the next year. He told me I should have been wearing glasses for close work for years but turns out I am really good at ignoring the signs. I haven't been having any problems with this prescription but there seems to be a change recently. I have occasional double vision, usually at middle distances. I have spoken to my eye doc about it and he feels that I may need prism at some point, but for now I'm avoiding since I wear contacts for sport and am not sure how well I'd do moving back and forth from the prism. LIke you CJ I am a close reader, so I suspect that is part of why my current add is where it is at. With the strabismus, can I expect that to get worse as I age, or will it be relatively stable?

Will post once I see my ECP.


John S 19 Aug 2013, 17:43

Julian,

I wouldn't be too sure. But I hope you are 100% right!

What would a person that didn't know any better do? Just put up with headaches and strain because the doctor told them they didn't need glasses?

My Dad had bifocals, that is how I figured out I needed some plus for distance, and some extra power for reading. When the second doctor wrote the rx, it was identical to the rx on my Dad's rx card.

I didn't give the doctor any starting point, because I did not bring Dad's glasses into the exam. When the exam was over, I had the same bifocal rx.


Julian 19 Aug 2013, 16:25

John S: OK, point taken. My experience was better than yours - and then of course I was 40. You have told your story before and I ought to have remembered it, but I hope that happened a long time ago and there are no such idiots of ECPs still in practice.


SC 19 Aug 2013, 04:51

Kris,

+1.75 ADD at 42yo is quite high (I would have expected +1.0) and so it seems likely that if you are having trouble it is that you under-prescribed for distance and increasing the ADD would be a temporary alleviation.

I guess your first Rx was for reading only at 38yo, and then the distance Rx has been introduced. Difficulty reading at 38yo would indicate a distance Rx higher than +2.0 in your best eye - ie you were experiencing difficulty in reading because most of your available plus power (accommodation) was being spent on enabling you to focus at distance such that there wasn't enough to spare for close-up.

It isn't unusual for the distance Rx to fully develop - ie your eyes need +2.0 but in tests they only show as +1, +1.5 or even nil - this is what CJ refers to as Latent Hyperopia - the problem is there but your eyes are self correcting while they still can. I've been waiting almost 5yrs for mine to be fully realised

So maybe you need something like +2 Add +1 & +2.5 add +1, although it is not so easy to go backwards with an ADD.

From my experience, ECPs rarely look at age unless it stands out (ie you are very young). When I first got glasses at 44 but said I had had a problem since 41/42, this didn't seem to ring any alarm bells about hyperopia (I was prescribed -0.25 for distance!) and yet it seems likely that I will indeed need +1.25/+1.5 or slightly higher for distance as an age of 41/42 would suggest


Cactus Jack 18 Aug 2013, 23:42

Kris,

The problems you are having point to the need for an eye exam. There is nothing to be gained by waiting, other than headaches and discomfort. The idea that you have to wait a specific time between exams is simple not true. You need to see an Eye Care Professional (ECP) when your vision is no longer comfortable and effortless.

To help you understand what may be going on let me try this explanation.

There is a connection in your brain between the eye positioning system and the focus control system. The act of trying to focus on something close causes your eyes to try to converge and vice versa. The strength of this connection varies with individuals and if a person has hyperopia and a strong connection, tries to correct their distance vision with their ciliary muscles and crystalline lenses (sometimes without realizing it), the act of focusing is sensed by the brain as trying to look at something close and the eyes will turn inward or converge. Sometimes, base out prism is prescribed if the over convergence is significant, but other times the problem can be corrected by using plus lenses to correct the hyperopia and bifocals to minimize the over convergence when focusing close for reading.

It is not uncommon for there to be some changes in a prescription like yours and the change can happen pretty fast because there are three things occurring that tend to combine and exacerbate the problem.

1. You may have had some latent hyperopia and it has taken a while for your ciliary muscles and crystalline lenses to relax. When this happens, you will need an increase in your distance plus.

2. it is very probable that your presbyopia is increasing and your crystalline lenses is becoming stiffer and harder for the ciliary muscles to squeeze to add the plus you need for focusing close internally. The harder the ciliary muscles have to work the stronger the convergence signal and your eye try to turn inward.

3. For their size, the ciliary muscles are the hardest working and strongest muscles in the body, but like all muscles if some of their workload is eased, by bifocals, progressives, etc. They get de-conditioned and loose some of their strength. This means that they have trouble squeezing the stiff crystalline lenses.

Put all those together and you need stronger glasses for distance and stronger add for close work. It is also possible that you may need some base out prism if double vision develops.

How strong will your glasses need to be? At this point, it is hard to tell how much plus you will ultimately need for distance, but probably not more than +3 or so. The ultimate need for ADD will depend on how much close work you do. For example, to focus at 16 inches or 40 cm, which is typical reading distance, requires +2.50 more than your distance prescription, period. Right now, your add provides +1.75 and your ciliary muscles and crystalline lenses supply the other +0.75. As that ability to supply plus internally fades, you will need more ADD, but it will not ever be more than +2.50 unless you like or need to read closer than 16 inches or 40 cm. I like to read in bed with the book a bit closer than that, so I have a +3.00 ADD. Nothing magic, just the rules of optics discovered by Sir Isaac Newton a bit over 300 years ago.

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

May I ask where you live and your occupation?

C.


Kris 18 Aug 2013, 21:11

I'm 42 and have been in glasses for 4 years, the last three with progressives. My current prescription is Right eye 1.5 Add 1.75, Left eye 1.0 Add 1.75. I was also treated for strabismus as a kid. My last eye exam was a little less than a year ago and vision was stable then. I haven't noticed any vision changes but have had a lot of headaches in the last couple of months. I'm starting to wonder if it is my vision and if I need another eye exam. Also noticed my right eye turning in today with glasses on (the right eye turns in all the time now if I take my glasses off- never used to be so obvious). If I have the right prescription should my eye be turning in (my strabismus is due to my right eye being weaker than my left)? I've only had my current Add for 2 years, it seems early to need a change. How often can I expect to need new prescriptions?


John S 18 Aug 2013, 20:39

Julian,

I respectfully disagree with you.

When I was a teenager, a doctor sent me out of his office not being to see the reading chart without straining. I made him well aware of my vision problems.

His exact words were, "that is the best your vision will get". To that I replied, "if I wear my Dad's reading glasses, I could read fine". He said, "don't wear his glasses". There was no reasoning with him. The optician apologized, and said he was pretty set in his ways. I should go to another doctor.

So I went to another doctor. I just told him I had problems reading, nothing about the other exam. He said I needed a +1.00 for distance, and a +1.50 add. He said it was no big deal, other kids needed to wear bifocals for reading too. He acted like my problem was nothing out of the ordinary.

The 2 doctors couldn't have been any more different in their thinking.


Julian 18 Aug 2013, 15:20

Peter7: you'll know it's time for bifocals when your optometrist tells you so. It is common sense to have your eyes checked every year or two. In my experience, when I was 40 and went for my test he said something that began 'The time is rapidly approaching...' and when that happens you may already be noticing some problems with close vision.

Don't worry: wearing glasses doesn't hurt, as long as they fit properly!


Cactus Jack 18 Aug 2013, 15:00

Peter7,

I think wearing glasses full time will be optional for at least a few more years, in your situation. My suggestion of wearing them full time for about 2 weeks was offered for two reasons. The most important one was to let you get used to wearing glasses so when to wear them will be truly optional (in other words, you won't intentionally avoid them) and you can always choose to wear them or not, depending on the situation. Because of the potential for steaming up in the kitchen, they could wind up being a nuisance. If that happens, and you like the corrected vision, you might want to consider contacts. The secondary reason was to try to get an idea if you actually have some latent hyperopia. There likely is at least a little.

Remember, with the exception of possibly needing glasses to legally drive, it is always your choice of if or when to wear vision correction.

C.


Al 18 Aug 2013, 14:36

@Peter7

It depends. There's no general rule, in case there's some latent hyperopia besides the manifest part, you'll get you bifocals sooner, but if it's close to your full prescription, I think it will be stable for the next 8-10 years until the typical age when presbyopia becomes evident. For example, with the prescription like yours, I only wear glasses for prolonged close work in order to prevent pseudo-myopia caused by an accomodative strain.


Peter7 18 Aug 2013, 12:52

Will I be resigned to wearing these glasses fulltime? And how will I know when bifocals are needed? It just seems that once the glasses are worn, bifocals come very quickly after.


Al 18 Aug 2013, 06:08

@Peter7

Any astigmatism below 1.00 diopter is considered to be a normal condition. Moreover, many people find it more comfortable to leave such an astigmatism uncorrected (I don't, though).


Cactus Jack 17 Aug 2013, 09:19

Peter7,

Many people who are mildly hyperopic have vision that is better than 20/20. 20/20 is really NOT perfect vision. It is what is considered "typical" or "normal" vision in a large percentage of the population who do not need vision correction. 20/15 is a bit better and a few people have 20/10 vision. Those numbers are what are called the Snellen Fraction. It is a measure of Visual Acuity (VA) and in your case, it means that you can discern the letters on a Snellen Chart at 20 feet that most people have to be at 15 feet from the chart to read.

You have excellent VA, probably because your retina is doing its job very well, but your ciliary muscles and crystalline lenses are having to work harder than they should to focus mages on your retina. The glasses will relieve them of that extra work and more importantly fix the astigmatism that they simply can't correct.

My suggestion is to wear them full time for 2 weeks and then make a decision as to how often to wear them. If distance vision is initially a little bit fuzzy and begins improving with the glasses, it is a sure sign that you have some latent hyperopia that will ultimately need correcting to make your close work easier by giving you back some of the accommodation range you are using to correct your hyperopia.

C.


Peter7 16 Aug 2013, 23:26

Cactus Jack,

Should I just wear them fulltime, even watching television, I don't have a car as I live in the city of Chicago and take public transportation everywhere, so I don't need them for driving. The odd thing is that the optometrist told me I had 20/15 vision. I did choose really cool metallic blue Puma frames.

Thanks Again,

Peter


Cactus Jack 16 Aug 2013, 14:04

Peter7,

I suspect you will find the glasses to be very comfortable. Initially, you may find your distance vision a little fuzzy, but if you have some latent hyperopia it will clear up in a few weeks. You will probably find them very helpful at intermediate and close distances and they may help reduce end of day fatigue. Please let us know how you get on with them. You may feel a bit reluctant to wear them in public, but the best solution to that is to wear them as much as possible for about 2 weeks. There may be some comments, but within days, people will get used to seeing them and that will be the end of that. BTW, people don't notice the lenses in your glasses, they notice the frames and once they get used to seeing you wearing glasses, the only comments you will get occur when you change frames.

C.


Peter7 16 Aug 2013, 13:07

Cactus Jack,

I use a computer daily, I'm a chef, so I do a lot of close work.


Cactus Jack 16 Aug 2013, 12:52

Peter7,

Maybe. It is not unusual for people who are hyperopic to need bifocals, progressives, or multi-focals a bit sooner than is typical. Your visual environment can be a factor, but your genetic make up is an even bigger factor. The tiny text on Smartphones and Tablets is causing many teens to need what are technically called functional bifocals with an add in the +1.00 to +1.50 range. If they also have astigmatism, which affects vision at all distances, can exacerbate the problem by making the small text even harder to read. Unlike hyperopia, no one has any internal ability to correct astigmatism, but the brain does not know that and tries to fix the problem, which causes headaches and excessive fatigue.

May I ask a couple of questions?

1. Your occupation?

2. Do you do a lot of computer or close focusing work?

C.


Peter7 16 Aug 2013, 12:28

Cactus Jack,

Thank you for the information, does this mean that bifocals or multi-focal lenses are not too far off in the future for me?

Thanks


Cactus Jack 16 Aug 2013, 11:04

Peter7,

You will probably need some adjustment to your prescription sooner than you think. There are two things that can cause a person to need a + sphere correction (the first number in your prescription). The most common one in your age range is called hyperopia or far or longsightedness. As you get older, presbyopia comes into play. Unfortunately, at this point, you probably don't have enough information to know exactly what is going on because both can cause you to need help with + sphere glasses.

The thing that makes the diagnosis tricky is that you have the built in ability to correct hyperopia by using the "auto-focus" mechanism in your eyes called your crystalline lenses and ciliary muscles. The primary purpose of the ciliary muscles and crystalline lenses is to allow you to focus close. In most young children, the auto-focus mechanism has incredible range, which is why you see young children focusing effortlessly at very close distances. That is because when you are born, the crystalline lenses have the consistency of gelatin dessert. As you get older the crystalline lenses become gradually stiffer and hard for the ciliary muscles to squeeze and increase their optical power. This effect is called "presbyopia" or literally "old eyes" and why people need reading glasses when they get older.

However, the idea that you don't get presbyopia until your 40s is a myth. As mentioned above, presbyopia actually begins in childhood, but usually does not become a nuisance until around 40, but it can happen sooner if a person already has hyperopia and is using some of their focusing power to internally correct hyperopia.

There is also a phenomenon called "latent hyperopia". That is caused by your ciliary muscles and crystalline lenses becoming so used to correcting hyperopia that they cannot easily relax. It can take weeks or months to fully relax and during that time, your sphere prescription will gradually increase, but usually not more than a few + diopters. Sometimes this relaxation process can reveal an early onset of presbyopia where you need + glasses to help you focus closer.

The point of all this is that what is happening to you is very common and nothing to get very excited about. It has happened to billions of people around the world and you can read about a lot of on this and similar threads of this forum.

To talk a little technical about vision. Hyperopia (+ sphere (1st number)) or myopia (- sphere) are generally caused by a mismatch between the total + power of your eye's lens system and the length of your eyeball. + means that your eyeballs are a little (a few mm) too short and - means that your eyeballs are too long. Astigmatism is generally related to uneven curvature of the front surface of your cornea. It is corrected by the 2nd and 3rd numbers in a prescription. The 2nd number is the power of the cylinder correction (can be + or - depending on the preferences of the examiner) and the 3rd number is the axis or direction of the long axis of the cylinder correction. By convention, 0 degrees is horizontal and the numbers increase counter clockwise (looking at the patient) through 90 degrees (vertical) to 180 degrees. Numbers above 180 are never used. Each eye develops independently and it is usual for the prescriptions (particularly astigmatism) for each eye to be different.

I hope this helps.

C.


Peter7 16 Aug 2013, 01:57

I recently have been prescribed glasses to wear as needed, I'm 28 years old and I am wondering how much worse my eyes will get over time; the prescription is as follows:

R- +1.25 -0.50 90

L- +0.75 -0.25 60

Also, is it normal to have astigmatism in both eyes?

Thanks


Soundmanpt 15 Aug 2013, 09:38

Alexandria

Your experiment with your glasses and contacts gave some interesting results. You may need a small increase for your distance but it looks like your close vision needs an increase now. Slit maybe right, you very well may be better off going to progressives soon. At least your test seemed to prove that a stronger reading prescription with a little less for distance allowed you to focus when you looked up and slid your glasses down.

I'm pretty sure your doctor is thinking that your eyes are still changing quite a bit. You probably really should try and keep your 6 month appointment. You may even ask your doctor if they think bifocals, progressives, would benefit you at this time.


Alexandria 13 Aug 2013, 17:38

Slit,

I have contacts which are slightly stronger than my normal prescription (see below). I am experimenting right now, but the funny thing is that I can see quite well in the distance with my glasses over my contacts! Admittedly it is a little blurrier, but not too bad... I can see fine to read with my glasses over contacts, and then if I pull the glasses down to look into the distance it's clear.


Slit 13 Aug 2013, 13:54

Alexandria,

+1.75 was just an example figure... it is only by a real eye test you can figure out the distance vision component and the near vision component separately for your glasses...


Slit 13 Aug 2013, 13:53

Alexandria,

Do you have a pair of contact lenses with your prescription?

If so, you can try out about +1 off the shelf reading glasses above them while reading and look above them at the power point presentation. when you do this test if your eyes react fine, then it is an indication that your ultimate prescriptions is something like:

+1.75 {any cylinders} add +1 or add +0.5


Alexandria 13 Aug 2013, 04:44

Slit,

The issue with a bifocal or progressives for me would be that I need the +1.25/-0.75 CYL to see in the distance normally... If it were any less I'd probably feel more eyestrain just in general day-to-day activities.


slit 13 Aug 2013, 03:40

Hi alexandria,

You are describing a common case of accommodation. The eye changes it's focal length every time we look at things at different distances. So when you look at something near you (30 - 40cm away) the eyes have made a higher effort and focused at that length. When trying to look at a far away thing, eyes will have to relax the muscles.

Including myself, many of ours eyes do not react as fast as we expect. So when it becomes quite necessary to switch focus between near and far within a short time (especially in the classroom) the best solution is progressive bifocals. It seamlessly changes focus from near to far (provided that lens is of high quality and the practitioner has fitted the lens well).

Some practitioners are reluctant to provide these lenses to younger people but you can insist on it describing the challenges you have in the classroom and how it affects by disturbing your concentration on lessons.


Carrie 13 Aug 2013, 01:13

Soundmanpt - I sure my cousin would be better off going full time now and she probably knows she would. Her optician sort of suggested it when he said she could wear her glasses full time and asked her if she wanted to try contacts. I know that she said the optician said she can get away with not wearing her glasses full time for now and I think that's why she isn't. She's holding off for as long as she can but probably just delaying the inevitable. She is denying to herself that she needs her glasses most,if not all, of the time.

Overcoming denial will lead to good things. She will be able to see better all the time. I overcame a different denial - I always unconsciously denied to myself that I was gay/bi but when I met Gemma I finally admitted to myself that I fancied girls, and the rest is history.


Alexandria 13 Aug 2013, 01:04

Thanks again Soundmanpt.

I just have one other question. I can see perfectly at a distance with my current prescription (see below). But in lectures at uni, I will stare at my screen for about 10 minutes without any trouble, but then look up at the PowerPoint after this time and have to squint to make the writing to come into focus. If i'm not reading beforehand, the distance is clear. What does this mean? Thank you.


Soundmanpt 12 Aug 2013, 19:35

Alexandria

I am not very good with attaching links but I can tell you where you can check out about nearly 775 that are semi-rimless. but since I am not sure what size frame best fits your face, and really since you wear the bigger style Ray-Bans you don't really know what would be a good fit for you for a more classy look style frame. But when your ready I can probably give you some suggestions on how you can find out what a good size would be.

But go on line to "zennioptical.com" and in the upper left corner you will see a search bar. Put in some of these numbers and see what you think. Remember this is just a very small sampling. #212321, #396616, #732021, #719221, #599921, #755717, #733821, #755221.

If you want to see more of the semi rimless go to half frame glasses and click on that.


Alexandria 12 Aug 2013, 19:02

Soundmanpt

Thanks for your suggestions. I'm hoping to book an appointment sometime within the next couple of months if I have time. It is coincidental that I want stronger glasses but I think that my eyesight is actually getting worse as time goes on anyway. I currently wear Ray-Ban frames (as are popular with young people where I live) and am not sure that I'm aware of the semi-rimless ones you are referring to. Would you be able to provide a link? Thank you.


Soundmanpt 12 Aug 2013, 16:18

Carrie

Like i'm sure you can easily tell, your cousin's eyes are getting worse. I'm sure she isn't too happy about that, since unlike you she really doesn't want to have to depend on only being able to see with her glasses. The uncomfortable feeling she is referring to is not being able to see much without her glasses. As you very well know now the more she wears them the more she will need them. Maybe she will get your point when you told her that your eyes feel uncomfortable when your not wearing your glasses and that is why you wear your glasses all the time. With that comment you did everything but tell outright that she needs to start wearing her glasses full time now. Her eyes are uncomfortable because she is straining them way too much trying to see.


Carrie 12 Aug 2013, 14:58

I had a bit of a surprise at work today. My cousin came in to do some food shopping and she was wearing her glasses even though it was only early afternoon and not evening. She said her eyes started to feel slightly uncomfortable around late morning so she put her glasses on to see if that made the feeling go away. It did, so she wore them for an hour or so and then took her glasses off but the feeling came back after a few minutes so she decided to wear her glasses for the rest of the day. She wasn't particularly happy about needing to wear her glasses. I told her that my eyes always feel uncomfortable if I'm not wearing my glasses that's one of the reasons I wear them all the time. She looked slightly worried when I said that. Then one of my colleagues asked if we were related. I told her we were cousins. My colleague said "I thought there was a family resemblance. It's the face features and the glasses." I said "Yeah, we've got the same features as our Nan when she was our age" and, pointing to my cousin I added "and she's also picked up the same bad eyesight gene from our Nan as I did!"


Soundmanpt 12 Aug 2013, 10:44

Alexandria

Your doctor's recommendation was correct for your first glasses. I'm sure the plus part of your prescription made reading and doing other close work a little easier. The astigmatism was enough to sharpen up your vision at all distances once your eyes adjusted to them. And of course once your eyes adjusted to them your vision was better with your glasses than without them at all distances, close, far and in between.

It wasn't too uncommon for your doctor to want you to come back after having your first glasses for about 6 months since he/she likely thought that as your eyes relaxed you would need an increase. but then it is more common for them to have you back after a year. This makes me think he/she must think your eyes are still changing and that you will need another increase then. So I think there is a very good chance you will be needing +1.75 by next month, but since they want you to return, you probably should. It would be different if you were only going in on your own because your hoping to get an increase. Do you feel like your vision is still very good and sharp with your glasses or do you feel like they need to be stronger?

The big bold thick framed glasses are nice and can be worn for nearly everything, but like you say, I don't think they work well with short skirts and heels etc. Better put a more dressy look. After you get your eyes checked you may want to consider getting a nicer more dressy pair for social things if you don't feel like putting on contacts. I suggest something completely different from what your daily glasses look like. Something like a semi rimless pair is nice and it shows off your lenses very nicely as well.


Alexandria 11 Aug 2013, 17:26

Hi Soundmanpt,

When I first got glasses, I was not told that I needed them for reading specifically. The dr. said that I could wear them whenever I felt it was necessary - driving at night was an example he used. When I got an increase in May, she said she wanted to see me again in six months and my prescription sheet says that the prescription is only valid for six months. I don't like to wear glasses sometimes socially and even some days because they don't always match my outfits. I have big, thick frames that suit mostly everything I wear but they're not so good with short skirts, formal dresses, evening wear etc.


Soundmanpt 11 Aug 2013, 10:30

Alexandria

Well your left eye managed to change in just the short time between when you got you current glasses and your contacts. Your right eye stayed the same but as you can see you got a very slight increase in the power (SPH) as well as your astigmatism. So when you got your contacts your left eye was already slightly under corrected with your glasses.

When you got your first glasses as long as you didn't try to do something to be prescribed glasses, then I am quite sure he felt like after your eyes had a chance to relax and adjust to the prescription that they might need to be a little stronger. Optometrists tend to never over prescribe. You said you only went to get your eyes examined hoping you might need glasses, but were you surprised that you needed a plus prescription for close up or would you have been happier needing them for distance? But really because of your astigmatisms your glasses are useful for all distances.

When you got your glasses in May, did he say he wanted to see you again after 6 months or were you only planning on going hoping for an increase? In most cases they like to see you after a year.

You seem to enjoy wearing your glasses and must prefer how you look wearing them, so I am curious why you don't want to wear your glasses socially? Now I certainly understand that contacts are a better option for playing certain sports and tennis is one of them. Your first glasses were weak enough that you were able to see well enough to play tennis and attend social outings without your glasses,but with a little stronger prescription and distance now being better with glasses than without, playing tennis with glasses is harder than with contacts.


Carrie 11 Aug 2013, 05:27

My cousin is far less outgoing than me and feels intimidated by doctors and dentists.

The optician clearly wants her to wear glasses full time but my cousin doesn't want to and can't see a reason to do it. It sounds like a compromise and wearing them for distances and when tired will make her realise how much she needs them.

At the moment she can see distances slightly better than me when we both take our glasses off. When she puts her glasses on she can see distances as good as I can when I have my glasses on. For both of us this is better than without glasses. I think she'll eventually see better than me until I get a new prescription. She has commented on how her vision goes from clear to slightly blurry when she takes her glasses off when looking around. I know this difference is going to be more noticeable when she has got fully adjusted to her glasses as it happened to me.

Surely it's only a matter of time before she realises that she is being stubborn and gives in to full time wear. She will want to get new frames if she needs her glasses full time as she thinks her current frames are a bit boring and when she got her glasses she said she would have got more fashionable frames if she had to wear glasses all the time but got cheaper frames as (at the time) her glasses were for reading.


svensont 11 Aug 2013, 05:01

Alexandria,

You can try ordering contact lenses with 0.5 sph without cylinder and wear that with your glasses. Do this for a few days/weeks and see what will happen.


Alexandria 10 Aug 2013, 20:52

Thanks for your insight Soundmanpt.

I got my contacts a couple of weeks after I got my most recent glasses. I'm not sure if I will go back for the six monthly exam or wait until it has been about a year, because perhaps the longer I wait, the more my eyes will ease into the current prescription and the stronger my next prescription will be? Do you think the dr. asked me back in six months to increase the prescription or decrease it? And yes, I would still like to wear contacts socially and for sports. I play a lot of tennis.


Soundmanpt 10 Aug 2013, 20:41

Alexandria

Okay, that does tell me something. The fact that he wanted you to be re examined after only 6 months tells me he expected that your eyes were likely to change as your eyes adjusted to seeing with glasses. And they did.

Did you happen to get your contacts sometime after you got your recent glasses? He did prescribe you with toric lenses and even increased your prescription slightly.

Remember just look at this exam as just finding out if your eyes are changing on their own or if their has been no change, my guess is there has probably been some change, but I can't tell you by how much and if it will only be your SPH or if your astigmatisms may still be adjusting and changing? But it really doesn't matter because you can go on line and order whatever you want your glasses to be, and there are a few places that you can order your contacts from as well on line that doesn't require a doctor's approval. I assume you may still want to wear contacts for special occasions and sports? Just curious what sports do you play?


Alexandria 10 Aug 2013, 20:19

Soundmanpt,

My latest prescription was only valid for six months b/c the optician was not sure of its accuracy and wanted to check again. I am not sure why this was the case (do you have any ideas).

My contact lenses are stronger than my glasses. I went to a different optician, and kept choosing "green" over "red" in one of the tests, which I heard means that they add more plus. The RX on my contacts is as follows:

R: +1.25, -0.75, 10

L: +1.50, -0.75, 180

I got my eyes checked because I was hoping that I needed glasses. I went back because, while I could see fine with the first prescription, I thought I could benefit from more. The first prescription didn't seem to make much of a difference compared to when I first got them, and I wanted an increase to feel the crispness again.


Soundmanpt 10 Aug 2013, 20:11

Alexandria

Truthfully, I think you have done pretty well in such a short time. You have gone from no glasses to being prescribed full time wear in only about 15 months time and already wearing your second prescription. So you maybe pushing it a bit since you have only been wearing your current prescription for about 4 months. But coming in so soon for an exam you maybe able to convince your doctor that you feel you need your glasses made stronger. I'm sure when you got your glasses you were probably told to return again after about a year?

You said when you got your recent glasses you also got contacts as well. Because of your astigmatisms I am curious what the rx is on your contacts? Your one is just at the point where they sometimes just increase your SPH meaning that eye would be +1.50 for contacts or they will put you in toric contacts and include the astigmatism correction. The other eye with only -.50 CYL I would think he/she would just increase the power of your SPH also to +1.50?

When you were 17 and you got your first glasses, did you get your eyes checked because you really thought you needed glasses or were you just hoping you did? So then when you went back again after only 7 or 8 months were you going because you thought your glasses were really not strong enough or were you hoping to get an increase? The reason I am asking these questions is so there is something to compare with. So tell the truth, do you really feel that your not seeing as well as you were when you first got your glasses, or are you seeing fine but just want your glasses a little stronger? In other words how does this trip to get your eyes examined compare to your Feb.visit?

But I urge you to not try cheating in anyway because if you get caught then it will be harder than ever to get prescribed glasses stronger from now on.


Alexandria 10 Aug 2013, 20:08

EDIT:

Hi Soundmanpt,

I have been wearing glasses since I was 17 (May 2012) at which time I was prescribed a very mild prescription:

R: +0.75, -0.50, forgotten axis

L: +0.75, -0.50, forgotten axis (I had, and still have, oblique astigmatism)

In February 2013 (18 years), I went to get an eye exam hoping for a stronger prescription. I complained about poor distance vision and came out with this prescription:

R: +1.25, -0.75 x 180

L: +1.25, -0.5 x 9

I have always worn them as much as I can. With my first pair, I didn't make a fuss when I didn't wear them socially/for sports because I knew they were weak. With my second prescription, I was told to wear them full time so I got contacts and now always have some form of correction. I would love another increase like the one that occurred between May and February.

Also, I bought a +2 pair of OTC readers to wear. When wearing them, I can see the computer screen clearly (40 - 50 cm away). The far distance is noticeably blurrier, but I can see the middle ground quite well and can still wear these readers to drive. It's more smaller text on the other side of the room that is hard to make out. I have never worn the +2 lenses for more than a few hours at a time (I live in a house with lots of other family members and can't risk being caught without my proper glasses on). Do you think there is a possibility that I could be prescribed +2 glasses for FT wear and over a week or two of constant use, ease into them until my distance vision is as clear as it is with my +1.25 pair?


Alexandria 10 Aug 2013, 18:02

Hi Soundmanpt,

I have been wearing glasses since I was 17 (May 2012) at which time I was prescribed a very mild prescription:

R: +0.75, -0.50, forgotten axis

L: +0.75, -0.50, forgotten axis (I had, and still have, oblique astigmatism)

In February 2013 (18 years), I went to get an eye exam hoping for a stronger prescription. I complained about poor distance vision and came out with this prescription:

R: +1.25, -0.75 x 180

L: +1.25, -0.5 x 9

I have always worn them as much as I can. With my first pair, I didn't make a fuss when I didn't wear them socially/for sports because I knew they were weak. With my second prescription, I was told to wear them full time so I got contacts and now always have some form of correction. I would love another increase like the one that occurred between May and February.


Soundmanpt 10 Aug 2013, 11:40

Carrie

Your cousin needs to learn not to be afraid to ask questions when she is in any doctor if she doesn't know what they are telling her. In other words she needs to be a better patient. Somehow I don't think I need to give you that advice as I think if your doctor said something that you didn't exactly know what he/she meant you would ask. Based on her doctor's recommendations with her recent eye exam she was pretty much told that she really needs to start wearing her glasses full time now. Being told that she needs to start wearing them now for seeing distance and for reading an other close things doesn't leave much that she can see without her glasses. I guess maybe she would have gotten it better if the doctor had said she didn't need them when she's sleeping. I only hope that her need now is enough that she may slowly start to wear them full time without any pushing from you. Like you say she is just trying so hard not have to give into wearing them, but at least she knows that her vision isn't good enough anymore to be driving without her glasses which is probably part of the reason she purchased a pair of prescription sunglasses. About all you can do is just point out that wearing glasses full time isn't that big of deal.


Soundmanpt 10 Aug 2013, 11:22

Alexandria

First off going to a discount or high volume optical store or department as opposed to going to say Pearle or Lenscrafters should not make a difference in the outcome of the prescription your given. The doctors in these stores are nearly all independent optometrist and very often work at more than one company. So the same doctor that you may see at Wal-Mart Vision Center could well also work for Pearle as well.

Several things you didn't mention that may make a difference in the outcome of your coming exam, is how long have you been wearing glasses? I assume you where your current glasses full time, when did you start wearing them full time? Your wanting and asking for advice on how you might be able to encourage your doctor to give you a stronger prescription. Really I think there is a very good chance you will be needing stronger glasses without you doing anything. By no means don't try and fake or claim you can't see something that you really can see. After all the whole purpose of getting your eyes examined is to see if your vision has changed and by how much. Once you leave the doctor's office and what you decide to order for glasses is totally up to you. I think it is at least possible that your eyes very well may have changed to where you really do need +1.75 now. But if your prescribed something less than like Cactus Jack advised you, there is nothing to stop you from going on line to Zenni (zennioptical.com) and ordering whatever prescription you want. But like Cactus Jack also advised only change the SPH numbers and leave the CYL and Axis as what the doctor has prescribed.

When you get your exam we would be interested to see the results.


Alexandria 09 Aug 2013, 23:58

Hi Cactus Jack,

Thanks for your advice. I just want stronger plus glasses because I feel I could use the strength and I like the way thick plus glasses look. I would not want to get the lenses thinned.


Carrie 09 Aug 2013, 15:01

Like me, it turns out my cousin has latent hyperopia. She was thinking about what the optician had told her during the eye test asked if I knew what the optician meant by "latex hypy ropier". I couldn't stop myself laughing when she said that. She didn't find it so funny. I explained that she must have misheard what he said and told her what it meant. She looked horrified when I said it was possible she would need a stronger prescription eventually, probably when she goes for the check up next year. She was going to ask the optician what he meant but the way he said it she got the impression she should know what he meant so she didn't ask him.


Cactus jack 09 Aug 2013, 09:24

Alexandria,

It is pretty hard to increase a plus prescription during an exam unless there is a real requirement such as latent or hidden hyperopia that is gradually resolving. The reason has to do with optical physics and how the optics of the eye works.

Hyperopia is usually caused by a mismatch between the length (size) of the eyeball and the total plus power of the eye's lens system. In the case of hyperopia, the eyeball is too short for the power of the lenses and the image focuses behind the retina. External plus is required to move the focus point up to the plane of the retina. Unlike, myopia, you can use part of the auto-focus system's (ciliary muscles and crystalline lenses to add the extra plus needed to focus clearly at distance without your even being aware of it. Unfortunately, that uses up some of the focus range you would normally need to focus close for reading, using the computer, and reading the small text on a tablet or cell phone. That results in the symptoms of early onset presbyopia. Those symptoms are often headaches and fatigue when doing a lot of close focusing, or the arms being too short and text being too small to be able to hold at a comfortable reading distance.

During a non-diated eye exam, the examiner will typically start the subjective (2nd part) part of the exam by setting up the phorpter or trial lens frame with substantially more PLUS (or less MINUS) than was indicated by the objective part of the exam, then gradually reduce the plus (or increase the minus) until you can read the 20/20 or 6/6 line on the chart. A person who would like more minus in their glasses can sometimes fake it by using their accommodation (auto-focus mechanism) to add some plus internally to compensate for the extra minus, but a person who would like more plus simply cannot relax their ciliary muscle and crystalline lenses beyond fully relaxed, it just does not work that way. The total power of your eye's lens system is around +40 in 3 fixed power lenses and 1 variable power lens. All glasses or contact lenses do is add to the +40 if a person is hyperopic PLUS lenses or neutralize some of the +40 if a person is myopic.

Presbyopia occurs when the ciliary muscles cannot squeeze the crystalline lenses enough to add plus power for focusing close and external plus is required as reading glasses, bifocals, or progressives.

It would be very helpful if you could tell me why you would like more plus in your glasses. All reasons are valid, including that you just want to wear stronger glasses, lots of people do. We can offer several solution, but we need to understand your problems and desires.

BTW, the idea that you do not need focusing help until you are around 40 is a myth. You need it when you need it. More and more young people are discovering hyperopia and early onset of presbyopia because of the tiny text on cell phones and tablets and wearing bifocals or progressives to help.

C.


Alexandria 08 Aug 2013, 23:39

Cactus Jack,

Thank you for your advice. I will order a dummy pair of Zenni. Is there any way I can increase my actual prescription at the examination though?

Thank you.


Cactus Jack 08 Aug 2013, 23:06

Alexandria, the easiest way of all is to simply order glasses on line with the prescription you want. If you want to try +1.75 glasses, order this prescription:

R: +1.75, -0.75 x 180

L: +1.75, -0.50 x 009

Many of us have used Zenni Optical with good success. I suggest ordering some inexpensive frames and lenses, maybe with an Anti-reflective coating for trial purposes and if you like them order a nicer frame and perhaps thin lenses if you want them.

One thing you need to be aware of is that you may find that initially, the +1.75 glasses will cause you to have somewhat blurry distance vision because the extra +0.50 actually makes you a bit nearsighted. However, if you have some latent hyperopia it may clear up in a few weeks as your ciliary muscles and crystalline lenses relax. If you do not have any latent hyperopia, distance vision will remain blurry. If your distance vision clears up, you may want to try a bit more plus sphere. Notice that the cylinder and axis were copied exactly. Never try to adjust the cylinder and axis. All that will do it cause problems such as headaches and fatigue.

You will find that the extra plus will make reading and close work a little easier.

C.


Alexandria 08 Aug 2013, 21:16

Hi,

How can I get a stronger prescription next time I have an eye exam? I was given this prescription in February:

R: +1.25, -0.75 x 180

L: +1.25, -0.5 x 9

I know I could have a 'wet' examination, but they do not tend to do those with 19 year olds at the optician I visit. I tend to go to budget, chain opticians as I feel they are more likely to give me a stronger prescription (which is what I want) just to sell me a new pair of glasses. I am hoping to get a stronger plus lens (at least +1.75) to wear full time, so if you have any tips that'd be great.

Also, at what plus strength do people usually start getting their lenses thinned?


Carrie 08 Aug 2013, 17:48

She definitely went. She wouldn't lie. My thinking is that she probably made it quite clear she didn't want to wear her glasses all the time but admitted they did make distances a little clearer. She told me she told the optician that she had been studying without her glasses and only put them on when she couldn't stand the eye strain any more. She thought she might be able to "cure" herself by forcing her eyes to read without glasses. The optician said that the eyestrain was causing the headaches and eyeaches. Because she is young her eye muscles can cope with focussing at most distances but they very quickly get tired trying to focus her eyes at close distance. Wearing her glasses will help them relax. Because she hasn't been wearing her glasses much she still isn't fully used to them but she will notice distances will be even clearer in a week or so if she continues to wear them for driving. He was pleased to hear she has prescription sunglasses and that she wears them for driving and not just for reading in bright sunshine.

I popped round earlier this evening and she was doing as the optician suggested and was wearing her glasses. She said watching the tv with her glasses on didn't make a huge difference but she did feel her eyes were more relaxed and she didn't feel so tired.

I asked her if she knew why the optician wanted to see her again so soon as he said "in the new year". She queried that this morning and was told there was nothing to worry about he just wants to check her vision again when she's fully used to her glasses and has been wearing them when she should for a few months. It doesn't have to be January and late winter early spring would be fine.

I think the optician will suggest she wears her glasses full time when she sees him next year. That's if she isn't already wearing them full time. I'm not going to suggest going full time in case she does her stubborn thing and hardly wears her glasses again. I will keep an eye on her as I think she is hiding the fact she is worried about how much she now needs her glasses for less than a year since getting them. I don't want her getting stressed or upset. She's not going blind or anything or the optician would have been much more concerned.


Soundmanpt 07 Aug 2013, 15:47

Carrie

I wonder if she really went. It's funny that her doctor would suggest wearing them more now for distances as well as for reading and if her eyes feel tired. Doesn't that pretty much sound like all the time? If your not reading chances are your looking in the distance. And then to even be told she shouldn't even make an attempt to try and read anything without her glasses. Also a little strange that she is to come back after the first of the year. That is only about 4 months away now. If she really had her eyes examined it doesn't make since if there was no change that she would be told to come back so soon.

So at least it gives her a good reason to start wearing her glasses much more. So I wonder if she will get the idea that she was told she really needs to wear them full time now?


Carrie 07 Aug 2013, 15:15

Hi Soundmanpt

I spoke to my cousin on Tuesday but I didn't get a chance to post here as some friends came over and we ended up chatting and drinking until way past midnight. It was hard getting up for work this morning! I had to have a little sleep when I got home after work today!

My cousin didn't get a new prescription but was told to wear her glasses more and for distances now, not just for reading. She should also wear her glasses when her eyes are tired or are likely to be tired - so she should wear them in the evenings. She should wear her glasses as soon as she reads something rather than straining her eyes and then putting her glasses on. She could wear her glasses all the time but can get away with not doing so, for now. She was asked if she wanted contacts but she said no. It's quite possible she will need glasses all the time "sooner or later".

She was advised to have another eye test in the new year.

To me it sounds like the optician is keen for her to start wearing glasses full time but is aware that she doesn't really want to so is breaking her in gently. It also sounds like she got a slight telling off for not wearing her glasses enough!


Soundmanpt 07 Aug 2013, 11:22

Carrie

I assume your cousin didn't get back to you with the results from her eye exam on Monday? Little doubt she got an increase and very possible she was told she needs to wear them full time now. Very little doubt that she is in denial, but she is fighting a battle she can't win. But as you have found she is now having nearly as much trouble seeing distances without her glasses as she has with reading without them. I hope she doesn't freak out if the doctor were to suggest bifocals to her. A lot depends on how much she needs glasses for distance now compared to what she needs for reading.


Tulip 07 Aug 2013, 09:56

Just got back from the eyedoctor's with a new prescription:

L +1.25 -0.75 94 add +2.00

R +1.25 -0.75 93 add +2.00

Two and halve years ago:

L +0.50 -0.50 60 add +1.50

R +0.75 -0.50 80 add +1.50

So I have gone up. YEAH!


Carrie 03 Aug 2013, 14:52

Yes I should have seen how far she can actually see. I think she is in denial of how much she really needs them. I don't know much about astigmatism and I don't know if she has it as she doesn't know her prescription. As I've said before she's not embarrassed to wear glasses but would rather not. She was hoping to wear her glasses less now she's on her summer holiday from college. I didn't think she'd be able to as she struggles to read her phone without her glasses. Anything more than a short text message and she has to put her glasses on. She says she feels like an old lady when she does that. I wouldn't be surprised if she gets a stronger prescription. Maybe the headaches come from a combination of needing a stronger prescription and trying to go without glasses when she should have been wearing them. She still starts to read stuff without her glasses on and then only puts them on when she can't strain any more. I expect I'll find out on Monday sometime.


Soundmanpt 03 Aug 2013, 14:14

Carrie

I think your cousin is just being reluctant to admit that she really is finding that she needs her glasses almost as much now for seeing distance as she does for reading. When you were talking with her about getting her eyes checked you should have asked her to take her glasses off and read some signs in the distance. Are you sure your cousin didn't maybe also have some astigmatism when she got her glasses? The headaches sure sound like how astigmatisms react. At any rate she will be getting a stronger prescription and likely be told she needs to start wearing her glasses full time.

Do you agree that this is likely to happen?


Carrie 03 Aug 2013, 10:28

I was with my cousin earlier today and she was wearing her glasses the whole time. She said she was wearing them because she got a slight headache not long after getting up and one of the things her optician said when she got her glasses is that if she didn't wear her glasses when she should she could get eyestrain headaches. Even though she wasn't reading anything she put her glasses on and the headache went away soon after. I asked her if that had happened before. She said it has happened a few times over the last couple of weeks at different times of day and she has ended up wearing her glasses the rest of the day. I suggested she goes to her optician to check everything is ok. I told her she might need a new prescription. She didn't like the sound of a new prescription and didn't really want to go to the optician less than a year after getting glasses but she reluctantly accepted she should get her eyes checked. She managed to get an appointment on Monday.


Clare 31 Jul 2013, 15:22

Soundmanpt - no this is a colleague, the other is a friend who I haven't yet had the opportunity to discuss it with. I don't want to launch into the conversation and nothing has led me to be able to start it yet.

Matt - you're right, had she not made a point of telling people I maybe wouldn't have noticed. I'm not yet in the market for progressives, though I no doubt will be in future as my contacts wearing time is now much reduced. Because of that its interesting to observe how others get on.


Sydneycider 31 Jul 2013, 07:14

I often wonder how Snowman26 is getting on. anyone any idea?


Sydneycider 31 Jul 2013, 07:14

I often wonder how Snowman26 is getting on. anyone any idea?


Matt 29 Jul 2013, 21:11

Hi Clare, sorry for not responding to your questions from last week sooner.

You can find my description of my girlfriend's predicament and prescription in the Multifocals thread, posted back on June 4 I think. She's 25 with minus 3 or something thereabouts (cannot remember exactly right now).

And, regarding your question about moving her head, yes I noticed that as well. In fact last week we were doing some shopping for ourselves, so when I was done with my purchase, I went to meet her at the makeup counter. I could see both her and the saleslady who was probably twice her age, move their heads up to get a better look at things. Most people, I think, wouldn't notice as much as us.

Are you preparing for the move into progressive lenses yourself?


Guest 29 Jul 2013, 13:03

Just to add to my last post, I do realise that the advice was to experiment with readers over contacts but I didn't have that option the other day because I needed to take my contacts out. But wondered if it suggests I need at least +3.50 for reading (and does the fact I can see well with +3.50 further than normal reading distance mean I need more than that?)


Guest 29 Jul 2013, 12:58

I posted a few days ago and said I would experiment with over the counter readers. I ended up having to experiment immediately as I had to stay away overnight unexpectedly and didn't have my glasses with me. So I got +3.50 readers which is slightly more than my current prescription but I wanted them to last as an emergency pair a bit longer (and also to experiment). I can read small print much better with them (than my multifocal contacts or current glasses) and can see clearly for about 40" before things start getting blurry. Not sure what that means though....


Ozgirl 27 Jul 2013, 08:58

I have been wearing reading glasses for the past 5 years. In December last year, there was a significant change in vision to the right eye. Subsequently found to have an ocular melanoma. Have had radiation in that eye and have lost central vision, rendering it pretty useless Question relates to the healthy eye. Since I have pretty much become reliant on it, my prescription has changed from +2.75 for reading to now +1.50 with a +2.50 add. Wearing full time. This is the second change in 6 months. Optician wants me to come back in 3 months for a further check as she is concerned that my vision is worse than it should be for someone my age and the changes in prescription. I am 45.

Any thought or comments? How worried should I be that I am on a rapid descent to regular increases in prescription. Is there anything I can do to slow/stop it?


Cactus Jack 26 Jul 2013, 20:47

Lucas,

I don't think so. Dilating agents paralyze the ciliary muscles and the muscles that control the pupil opening, but the modern ones wear off very quickly and are not persistent.

I am wondering if you could have some other problems that are manifesting themselves as temporary inability to focus without concentration and effort when you first wake up. I frankly have not heard of that.

My first inclination would be to suspect latent hyperopia and early onset of presbyopia, I don't have enough of your visual history to even make a comment in that regard. Often, people with hyperopia self correct using their ciliary muscles and crystalline lenses without their even being aware of it. That works until presbyopia starts creeping up on them. Surprisingly, sometimes hyperopia can be so well hidden that simple dilation will not fully reveal it, which is why, when hyperopia is revealed and plus glasses are prescribed both for distance and reading, it can take weeks or months for the ciliary muscles and crystalline lenses to fully relax and the true degree of hyperopia is revealed. Incidentally, hyperopia is the only eye condition that the eye can correct without external help. Myopia and astigmatism always require external correction of some sort.

By the way, I am not an eye care professional, but an amateur in the original French sense of one who studies a subject out of love. I seem to be a pretty good explainer. Fortunately, we have several member ECPs and hopefully they will offer a better explanation of the cause of the mystery.

May I ask where you live?

C.


Lucas 26 Jul 2013, 19:31

They are prescription with astigmatism and a +0.50 reading add. Is there any chance it could be similar to what happens during a dilated exam and my eyes are unable to focus for the first few minutes of the day?


Cactus Jack 26 Jul 2013, 16:17

Lucas,

I don't think it is uncommon to wake up and be marginally functional. Some people can spring out of bed and be hitting on all cylinders almost instantly. I fit in the former category. At 75, having had cataract surgery and and wearing trifocals, I can't wake up and read my computer screen easily. In my case is it seems to be that I don't get good tear production in my sleep (tight eyelids I think) and I seem to have a film over my eyes when I wake up. I can quickly solve the problem with a drop or two of Artificial Tears in each eye and a few blinks. If you decide to try the Artificial Tears, get a good brand with lubricant. If you have a Wal-Mart, I like their Equate brand it is cheaper than some of the heavily advertised brand and works well. Some brands are a thin gel rather than a liquid. The gel does not clear as rapidly as the liquid and I like things to clear up NOW, not in a few minutes.

You might try the Artificial Tears and see how they work. Please let me know if that helps. There could be something else going on, but I suggest trying the simple solution first.

Are your reading glasses prescription or over-the-counter? May I ask the prescription or power if you know it?

C.


Lucas 26 Jul 2013, 13:29

I am 22


Cactus Jack 26 Jul 2013, 13:19

Lucas,

What is your age?

C.


Lucas 26 Jul 2013, 12:09

I've noticed recently that I have trouble reading in the morning as I wake up. The first few minutes after I wake up, im completly uanble to read a computer screen and it takes me about 4 or 5 mintues till im wide awake to be able to. I have glasses for reading that I rarely wear as i usually dont feel the need to. Has anyone noticed that before?


Cactus Jack 25 Jul 2013, 09:20

Guest,

Yes, once presbyopia reaches the point where you need some reading help. It will often SEEM to progress very rapidly. This rapid onset is not caused by presbyopia itself, but by the fact that providing the close focusing assistance with the Add relieves the ciliary muscles of some of their workload.

The ciliary muscles and the crystalline lenses in your eyes are the action elements in your auto-focus system. Presbyopia is the gradual stiffening of the crystalline lenses as you get older. When you are very young, your crystalline lenses are very flexible and have the approximate consistency of gelatin dessert and you have incredible focusing ability. As you get older your focusing range gradually decreases until you simply cannot focus close. In the case of uncorrected hyperopes, they are at a disadvantage if they do not wear external correction for distance, part of their focusing power will be used up correcting for their hyperopia to see clearly at distance, leaving less for focusing close. For their size, the ciliary muscles are the strongest, hardest working muscles in the body. Their job is to squeeze the crystalline lenses from their relaxed state for distance to increase their plus power for close focusing. At some point, your crystalline lenses become so stiff that the ciliary muscles can no longer increase their plus power to focus and the strain causes headaches and discomfort. The solution is external plus lenses to help out in the form of reading glasses, bifocals glasses or bifocal contacts.

Like all muscles in the body, if you don't fully exercise your ciliary muscles, they begin to loose their strength. When that happens, you WILL need more plus to help with focusing close, you also might need a little more plus for distance, but that is incidental. One comfort in all this is that the Add will not increase beyond that required for the focus distance. That amount is determined by simple formulas developed by Sir Isaac Newton, of gravity fame, over 300 years ago. Some specific numbers are +2.50 is required to focus at a typical reading distance of 16 inches or 40 cm. Closer requires a bit more plus, but it is rare that a person might need +3.50 except there the need to focus REALLY close.

You might ask, why only a +1.00 Add for reading? That is because your ciliary muscles and crystalline lenses were able to provide the +1.50 needed for the +2.50 internally, but that ability will fade and there is little that you or anyone else can do about it except increase the external Add power.

I hope this helps.

C.

P.S. Unlike Hyperopia, your eyes have no ability to correct Astigmatism. It must be corrected externally or by refractive surgery.


Guest 25 Jul 2013, 01:50

Thanks Cactus Jack. I am female and 42. Could I need more Add in just 4 months? I wanted to avoid readers over the contacts as that was the point of getting multi-focal contacts but will experiment.


Cactus Jack 25 Jul 2013, 01:23

Guest,

Probably no harm. You did not provide the prescription for your old glasses, but I suspect, based on your new glasses prescription, you probably have some cylinder correction in the Right lens of your old glasses. Your contacts have a compromised sphere correction to avoid having to deal with a toric contact in your Right eye so wearing the glasses over the contacts you wind up having a bit of a mystery correction. The nature of astigmatism (which is corrected by cylinder) affects vision at all distances, but it particularly makes reading much more fatiguing than it needs to be.

It is certainly possible that you need more add for comfortable reading.

You might experiment with some Over-the-counter readers over your contacts.

May I ask your age and gender?

C.


guest 24 Jul 2013, 17:15

Hi

I've just recently got multifocal contacts which are better than before but not great for small print ('small' to me now - probably wouldn't have thought it was that small 3 years ago...). I'm reading an annotated book at the moment so much more smallish print than normal and I put my glasses on top which meant I had to hold book closer but was so much clearer and more comfortable. My questions are: am I doing my eyes any harm by doing this (occassionally) and/or does it mean that my contact lens prescription isn't strong enough (I got it about 4 months ago)?

My recent contact lens prescription is R:+2.75, L:+2.00. There's no note of the Add but presume it's +1.00 as that's my new glasses prescription?

New glasses prescription (which not got yet) is R: +2.25, cyl +1.25, Add +1.00 and L: +2.00, cyl 0.25 and Add +1.00.

And I think the prescription of my old glasses (the ones I was wearing on top of contacts and which really helped) is same as before but without the Add.

Thanks.


Carrie 24 Jul 2013, 16:13

Soundmanpt - Had a great evening with Danielle and "the server" (sorry, but she will remain nameless here) in the pub garden yesterday. We drank a little too much wine (I hope we didn't annoy the other customers). It was nice to see them away from the coffee shop. "The sever" wasn't wearing Danielle's glasses. I did manage to ask if she still wore them in the shop. She said not so much now most of the students have gone home for the summer but does put them on out of habit sometimes. She can see perfectly without them which she proved by reading something I could just about read with my glasses on. Danielle could read it perfectly with her glasses but not without them. She can't see very far with them.

This was over a few minutes and we soon went on to talk about other things. She actually checked out a male customer, who I have to admit was attractive (there's still a little bit of a straight girl inside me somewhere!). He was wearing some plastic framed glasses that looked like designer ones but I couldn't tell which. Danielle and Gemma just didn't see the attraction!


Alex 24 Jul 2013, 09:40

thanks, CJ for your advises.

I'll be very thankful for optometrist's opinions on my post.

(Revolver, Soundmanpt, or other of our ECP members)

Here it is the copy below:

I have the question:

I have noticed red eyes, right eye turning in and squinting of my gf in the evenings and she mentioned the eyesight worsening.

Her glasses were with sph +5.5 and cyl. -2, not sure about axes, ask it is important. Her age is 30.

After optometrist visit she has

OS: +6 cyl -3 axis 5, OD: +6 cyl -2,5 axis 180

on the NO relaxing pupil in autorefracometr.

(dry test, NO dilated crystalline)

The optometrist made her glasses +4,5 cyl -2.5 and +4 cyl -2.

She has 0.8 sight with these glasses on both eyes.

Now she can see better with her new glasses but she mention about some tension in the evenings and I see the same with her eye turning.

The eyedoctor said that if she will use full correction glasses she can't have proper glasses after several years because of constant strengthening of prescription.

It sounds nonsence for me.

Could you comment this situation and recomend the way to solve it.

What do you think, which diagnostics she should done and how to calculate the proper glasses power for comfort and good eyesight.


Soundmanpt 23 Jul 2013, 21:11

Clare

Is this the same young lady you were talking about recently wondering why she had suddenly started wearing her glasses full time instead of contacts? They make bifocal contacts but they can be much too tricky to deal with.

I assume you finally got a good chance to talk to her about her change to glasses?


Clare 23 Jul 2013, 21:01

Matt - my colleague recently told us she got progressives, we wouldn't know probably if she hadn't said. Now that she has said i think the movement of her head tomget things into focus is noticeable. Do you notice that with your girlfriend?

My colleague has a moderate minus prescription. She's very pleased with them but said that stairs were difficult at the start, do you know what your girlfriend's prescription is?


Matt 23 Jul 2013, 20:37

A quick update regarding my girlfriend's early entry into the progressive lens world:

Well, after a slightly long wait, her new glasses were ready the first week of July. I went with her to get them. The first thing she did was to look at them to see how the lenses looked, before the optician put them on her face. Satisfied, she then tried them on and adjusted instantly. There were warnings from the optician about stairs, dizziness, etc., but really it was no problem at all. We walked out into the shopping center where she tested the warnings about stairs. She learned fast.

In fact, what she told me was that she did not even notice anything different when walking around or even driving, yet it was intuitive to use the lower part for reading. The next day she tested out her new vision for reading a menu when we went to a very dimly lit restaurant, comparing the new glasses with the old ones without going under the candle. She was amazed at the difference.

However the real benefit is that she can read and study without it being a chore like it was earlier. So, all in all, a great result, and the premium personalized lenses I think were worth it.


Neil 23 Jul 2013, 00:43

@SaraG

Well, the combination of desktop web pages in tiny fonts on a smartphone that you have to hold close--that's definitely going to take a toll. If instead you read old-fashioned books and magazines, your experience may be rather different.

I am actually curious how smartphone use will evolve as the most active users get older. I guess the devices themselves will change.


Soundmanpt 22 Jul 2013, 21:31

Carrie

I know that many people only have the bigger glasses like yours and have nothing to switch to. But many of the ones that have ordered that style of glasses from me have also gotten a 2nd and 3rd pair. They look at the bigger Ray Ban style as a fun pair of glasses and wear the others for work and other social things where they want to look a bit more proper. I have to admit the are still very popular with many people.

But its good that your getting so many comments on your rimless glasses and better still that the comments are all good. At least there not asking if there real or not, so now they at last know you really do need glasses. lol

I look forward to your report about tomorrow nights dinner with Danielle and her server girlfriend.


Soundmanpt 22 Jul 2013, 21:09

SaraG

That is a great idea and the best way to get the prescription that will work the best for you. And since that is what you are using so much of the day there is not a better way to work it out.

Others that have much the same problem should do the same thing if that is at all an issue for you.


SaraG 22 Jul 2013, 19:31

Neil, thanks for the thoughts. Much of my reading is on my smartphone, too often in little fonts because many places don't have a mobile site. I'm thinking of loading up some samples to bring to my next vision test so I can compare against a "real" example. Since much of my reading is "on the run" on my smartphone, I would think of that as typical use for me. As far as reading habits go, it's hard to tell. I'm only just beginning to read for any length of time again now that our kids are a bit bigger. For a while, reading was a pretty limited, short-duration activity.


Neil 22 Jul 2013, 15:07

@SaraG

One thing to consider about previously nearsighted post-LASIK patients is that habits and adaptations from the days of nearsightedness can remain (besides the important fact that the internal structure of the eye maintains the characteristics of myopia). Especially significant is the tendency hold things closer to read than farsighted or normal-sighted people would. This might apply to you, and might help explain your need for a stronger reading prescription if you like to read relatively close.

Another consideration is that reading on electronic devices like phones with all their graphics spread over millions of pixels might stress the eyes more than old-fashioned black-on-white print materials. So here again a stronger prescription might be in order. On the other hand, backlit devices obviously emit light, so reading is easier than, say, reading the small print on a printed phonebook page or medicine label.

(I don't know how these considerations work against each other...maybe Cactus Jack could offer his typically sage insight on this and related matters.)

Bottom line: In a typical near vision test the examiner tests the patient using very well lit, black-on-white print at 16 inches. This model could be rather different from your usual reading preferences.


Carrie 22 Jul 2013, 13:13

Soundmanpt - Danielle and "the server" are coming over tomorrow (Tuesday) evening so I will try to ask about the glasses.

My rimless glasses certainly make me look more grown up even if I don't feel it ! Ha ha! They are obviously real and I've had some really lovely comments from people that normally only see me in my large plastic glasses. The comments are like "Your glasses are really pretty" "You look much prettier in those glasses" "I can actually see your face now!". Someone actually said I look older and more mature (in a good way) in my rimless glasses. Even Gemma said that she thinks I look better in the rimless ones but the large ones do look good and suit my personality. Other people have said that not seeing me in my large glasses will take some getting used to as every time they see a girl with large glasses they think of me. When I asked another one of my friends what he thought about my glasses he asked if my other glasses looked normal sized on other people and just looked big on me because I'm so small. He nearly got a punch in the balls for being so cheeky! I'm giving up with my large plastic frames until the weather cools down. They are much heavier than my rimless ones and it does get annoying when the slide down my nose all the time. It's not going to get any better with a new prescription because that's going to be stronger without a doubt so that means slightly heavier. That's another reason I'm looking for smaller frames. I'm pretty sure I'll go for another rimless pair too.


SaraG 21 Jul 2013, 21:12

Nichole, on your note about trying single vision readers for a longer time, that is what I've been doing recently. The 1.00, my prescribed add, work for a while, but then I tire out before long. With the 1.50s, I never felt like I hit that wall or like I was working to read. At the very least, I have the option to do any serious reading with those now, which does diminish the urgency some.


SaraG 21 Jul 2013, 18:53

Thanks guys. My progressives are the nicer ones from our local independent optometrist. The single vision readers I order online. Sadly, when given the choice when getting the prescription, I chose the lower of the two adds offered. I do regret that extra .25 now. I was so close to ready for it, I should have just gone for it. Oh well.

Nicole, I see your point about age and optometrists being hesitant to prescribe more add. The optometrist I want to switch to for other reasons happens to be close to my age and also with progressives, so I think she'll be sympathetic.


Nichole 21 Jul 2013, 17:10

Thanks, Soundmanpt.

Fortunately mine is strictly a spare pair. I find the expensive frame + lenses from my doctor's office much better, in every respect. But, SaraG and others might find your insights useful.

Also SaraG, I just remembered that you are quite a bit younger than I am (44), so it might be a little harder to convince your doctor that you need much more strength at near...I would bet that with good quality progressive lenses, +1.25 at most would suffice. The best test would be with SV lenses when reading for longer periods.


Soundmanpt 21 Jul 2013, 16:58

Oops! that should said "2 millimeters lower for lined bifocals"


Soundmanpt 21 Jul 2013, 16:56

Nichole

I can only answer for Zenni as that is who I use nearly 100% these days when ordering glasses for people. I was curious about how they are able to sell bifocals and progressives without having the sight height 9the measurement where the add is)? The young lady i talked with was very nice and told me that they use one number for progressives, which I sadly didn't write down, and another number, 2 millimeters higher as I recall, for lined bifocals. In other words the same position for everyone.

So my suggestion to the people I deal with and am ordering bifocals or progressives for is to ignore plastic frames because there is little you can do to adjust the height of the frame on your face to make them work if their off. Instead i recommend they look for a frame that has adjustable nose pads so you have some leeway in moving the glasses up and down.

Other than that you could order your glasses and increase the add a bit by say maybe +.50 more, this should put a little more power in your sight area?

Lastly if you know they wont work Zenni will return 50% of the cost to you without question if you return them within a few weeks. So if you pay $50.00 for your glasses you would be out $25.00, but it may worth the gamble compared to what a local shop will cost you.

Hope that helped!


Nichole 21 Jul 2013, 16:16

SaraG,

Am having a similar dilemma about insurance. Around last Halloween I got a new prescription distance + add and am feeling I could use slightly more strength. But, I think I can wait three more months. Have to keep in mind that ODs tend to be trained to keep adds to a minimum.

I would however also say that the quality of the progressive lens design may be an influence here. Maybe others like Soundmanpt would know better.

It's possible that with the cheaper online providers, the lens doesn't reach its full add power until very far down the lens, and it's uncomfortable to move your eyes that far down. Plus, the reading corridor is more narrow in the first place.

(I ordered a cheap imported online version as a spare and at least that's what I found compared with my regular, more expensive glasses from my doctor's office.)

In that scenario, you might not really need quite as much strength as you think.


SaraG 21 Jul 2013, 07:09

A quick update. I picked up a few single vision glasses online with a few different add strengths over my distance prescription. It is nice to be able to pick the best strength for me for what I am doing. Slightly less for long work on the computer and more for other reading. I got such a headache yesterday when we were away most of the day and I was doing lots of reading on my phone with just my usual progressives. This morning I've done the same with +1.50 instead of the +1.00 in the progressives and there is no strain, headache, etc. even after a few hours! Obviously my prescription has changed or is changing. I hope I can make it to 2014 when the next round of insurance is available. I do wonder what my prescription will be by then and if I will l move past the +1.50s for regular use. So far I can still read without the add, but I sure do notice the strain much more and more quickly. If it weren't for a cost issue with the insurance, I wouldn't mind moving to even more add sooner. It is kind of a neat feeling. It's like my world gets smaller, more intimate, and much more relaxed when I slip on my stronger readers and am just focused close and further out starts to blur. Most of all, though, I'd love a more stable prescription. I expect I'll have to wait a while for that.


Soundmanpt 20 Jul 2013, 21:19

Carrie

I knew there was something else. About your rimless glasses being more comfy in the summer time. Like you have found they are much lighter weight and only the nose pads rest on you nose. Your bigger and heavier plastic ones not only does the plastic nose pieces rest on your nose but a good part of the inside part of the frame sits on your nose as well. This causes your nose to sweat a bit and then your glasses don't want to stay up like they should. Besides your rimless glasses should look much more real as well so you probably never get asked if there real or not? Do you feel like they make you more grown up? lol


Soundmanpt 20 Jul 2013, 21:13

Carrie

That sounds like a good idea and your probably right the idea of wine in the garden is much better than trying to chat at her job with her working. If she isn't wearing Danielle's glasses you should still approach the matter by asking her if she is still wearing glasses at the coffee shop since she did say it was because of her clients coming in wearing glasses that prompted her into wearing glasses. If she says that she stopped wearing them because they were a little too strong and she couldn't see distance very well with them, that would be a perfect time to let her try your first pair since they are pretty weak. Then it would be up to you if you choose to let her borrow them or not.


Carrie 20 Jul 2013, 17:29

I just haven't had a chance to get to the coffee shop. I have chatted to Danielle and the server by text but not face to face. I'm going to invite them over to see me soon rather than me going to the coffee shop. I think the thought of a sunny pub garden and a couple of bottles of wine will certainly tempt them over! It will be interesting to see if the server still wears Danielle's spare reading glasses when she isn't serving at the coffee shop.

I've been wearing my rimless glasses quite a lot recently due to the very warm weather we've been having here in the UK (we're not used to having nice weather for so many days in a row! Ha ha!) They are much lighter than my large plastic ones and have small nose pads. The plastic frames sit directly on my nose down both sides on on top, which makes my nose get a bit sweaty and itchy.


Soundmanpt 20 Jul 2013, 13:24

Carrie

Yes it would be a good idea for Gemma to order her sunglasses at the same time as you order yours since its only a couple of months until you plan on getting your eyes examined. I can already tell you that your optician wont be able to predict how much your eyes may change in the coming years. He/she will only be able to tell you what your eyes will need at the time of your exam. But really there isn't any reason to buy expensive rx sunglasses because unlike your regular glasses you wear them much less.

Yep! Those super big over the glasses sunglasses were pretty ugly. I often found them in with the donated glasses and my mom loved them so I brought them home to her. She must have had a dozen or more of them when she died.

I think your exactly right about your cousin, she is probably trying to avoid becoming dependent on her glasses, but she at least admits she is needing them more often now. Not sure how much she wears sunglasses normally but if she wears them often and she is now going to wear her prescription ones, she will be wearing them for driving as well. and she was already wearing glasses for night driving so if she gets used to them driving during the day she will soon be wearing her regular glasses even more. Her eyes are changing and she probably needs her prescription changed before long. Her next exam shh will find that unlike when she got her current glasses and was able to see the eye chart perfectly without them now it will be much more blurry without her glasses and she will probably be told she needs to wear them for distance besides close up.

Still waiting for a report on that attractive little coffee shop server? You look like you need to have a coffee!


Revolver 17 Jul 2013, 12:50

Sounder, that's exactly what happened. Her day job was as a food and cocktail server so she did very little close work. Probably a case of latent hyperopia that didn't manifest itself until returning to school.

She made no bones about it, she was wearing her glasses because of how much they helped, both at near point and after a few days, at distance as well. Maybe she secretly liked wearing them, her frame choice was excellent for her features and coloring and the plus lenses dramatically enhanced blue eyes. The only concern was when she reached her full rx that the lenses would be "bulgy".


Soundmanpt 16 Jul 2013, 16:41

Revolver

Thanks for the clarification, I kinda thought that was what you meant but wasn't sure since it could have been either way if her eyes hadn't adjusted to seeing distance with them yet.

Her comment that she should have gotten glasses much sooner is interesting because it sounds like it wasn't until she was doing a fair amount of close work with evening classes at the university that she found that her eyes were straining? If before that she was not doing a lot of close work and using her eyes mostly for distance she would not have any idea that she needed glasses. The fact that her eyes were still at 20/20 for distance without glasses would not give any clue that anything was wrong until she really started with a lot of studying.

She seems to fine with everything that has happened to her and will be happening in the future even. When she got her glasses she seemed to plan on only wearing them for reading but not sure why she decided to wear them for everything in such a short time.


Ancient One 16 Jul 2013, 16:20

Yes, this always funny Cacti man. I see people who say legally blind without glasses, but not. No such thing. Legally blind mean with glasses people can't see better 20/200. It not measure of eyesight without glasses.


Cactus Jack 16 Jul 2013, 14:02

I believe that "legally blind" is often used without knowing the real meaning of the term. It does NOT mean that a person cannot see. There are some additional parameters that cause a person to be "legally blind", but the ones we would be most familiar with are Best CORRECTED Visual Acuity (BCVA) of 20/200 or 6/60 or less. The fact that a persons vision is 20/200 or 6/60 without correction does not make them "legally blind". When I got my first glasses about 60 years ago, my vision without glasses was 20/200. I knew the top letter was a big "E" on the Snellen Chart, but it was anything clear. My first Rx was -1.50 with some cylinder, and voila, my vision with glasses was better than 20/20.

C.


Revolver 16 Jul 2013, 13:37

Lazy, no sadder than a very young person getting a fairly strong minus for their first correction and by high school topping out at -5.00 or so. Either way, it's a fact of life, and the tragedy would be if lenses couldn't correct it. She admits she should've had glasses a long time ago and would've had a better quality of life if she had.

Soundman, sorry I wasn't clearer about that, when she pulled them down and looked at a distance she said things were a lot better with them on now, but they weren't the first week or so. At first the were wonderful for reading and the computer but distance was slightly blurred.


lazysiow 16 Jul 2013, 10:39

Revolver - I cant help but feel so bad for that young lady. Shes going to go from 20/20 to being basically legally blind when she gets used to her glasses, does she know this? is she going to be happy about it?

I can't say I would espec if shes in the prime of her life. People like us will find that attractive but not for everyone?


Soundmanpt 16 Jul 2013, 10:36

Revolver

I assume you meant that when she pulled her glasses down that her distance was now blurry and she was able to see distance better with her glasses now? Or was she saying she could still see distance better without her glasses?


Neil 15 Jul 2013, 15:59

I've heard of a 2/3rd rule for presbyopia correction (maintain some accommodation in reserve), but not for hyperopia correction. There could be a misunderstanding or misstatement happening here.


Revolver 15 Jul 2013, 13:07

It would seem that CJ is spot on with his analysis for 2006, can only add that the 2/3ds rule is new to me. I do know that in the higher plusses when diagnosed for the first time ECP's will definitely prescribed less than what the wet refraction says simply because the distance blur is sometimes overwhelming and people will avoid their glasses because of it until the glasses are a total necessity.

That approach seems to work, here's an anecdotal piece of evidence, know a delightful 23 year old female, very attractive young blonde, who showed up wearing her first glasses. They had a fairly substantial plus for a first pair being worn all the time as opposed to reading only, and she was very chatty about them. She had gotten an exam (wet) because of increasing difficulty doing her part time university studies. She was +2.75 in one eye and +3.00 in the other but said she had another exam scheduled in 6 months where the rx was expected to be +3.50 and +3.75, and the ECP also told her in a year she would be able to get her final rx which would be +4.50 and +4.75.

She had short blonde hair and perfect facial features, and had smallish dark blue plastic semi-rimless frames that just looked gorgeous. She said that she was only going to wear them for reading but then in a few days was wearing them full time, while we were chatting she pulled them down and looked in the distance and remarked that she really could see much better in the distance now. She also said that during the refraction before dilation she had no problem with 20/20 at distance, but after dilation the entire chart was a blur and she was amazed when the rx was place in the phoropter, everything was perfect.

So, 2/3d's? Not necessarily, that's not to say it doesn't exist but that may just be the technique employed by one or more ECP's. Don't know for sure.


Cactus Jack 15 Jul 2013, 07:52

newglasses (since 2006),

Welcome to the forum. You should be around 34 now and if I interpret your post correctly your current prescription is somewhere around +1.50 in both eyes for distance and you have been prescribed an add of +1.00. As a 34 year old mild hyperope, it is very likely that your vision is quite stable and the only thing you will have to contend with in the future is presbyopia, which is creeping up on you as it does for almost everyone.

The idea that you don't need close focusing help until 40 is not correct. Presbyopia actually starts in childhood, but does not usually become a problem until the 30s or 40s. However, your genetic make up has a lot to do with when it becomes a problem as does your visual environment. Curiously, people with hyperopia (like you) tend to experience problems with presbyopia earlier that people with myopia. Part of the problem is that a surprising amount of hyperopia, unlike myopia or nearsightedness, can be corrected by your internal ciliary muscles and crystalline lenses (your auto-focus mechanism) without your even being aware of it. That works until presbyopia begins to limit your accommodation and it becomes difficult or uncomfortable to focus close or it even takes excessive effort to focus distant objects clearly.

Even though they are caused by two different things, the solution for both hyperopia and presbyopia is the same, external plus lenses. Because of the principles of optics, discovered a bit over 300 years ago by Sir Isaac Newton (of gravity fame), different plus powers are required to focus clearly for distance and for near. Near requires more plus power than distance thus different glasses for each or bifocals or trifocals or progressives for all distances. When presbyopia makes focusing close nearly impossible.

It is likely that your distance prescription will not change much for many years, however your add will gradually increase to around +2.50 and stop unless you have a need to focus closer than the typical 16 inches or 40 cm to read. Sometimes the add will increase more rapidly than you expect, not because presbyopia is increasing rapidly, but because your ciliary muscles are becoming de-conditioned. For their size, your ciliary muscles are the strongest, hardest working muscles in the body. Their job is to squeeze the crystalline lenses and increase their plus power to focus close. The add (or reading glasses for that matter) decrease the amount of work they have to do and like all muscles that don't get much exercise, they gradually loose conditioning (strength) and have difficulty squeezing increasingly stiff crystalline lenses because of presbyopia.

I hope this helps. If you have more questions, it would be very helpful if you could include your COMPLETE prescription.

Anyone heard of the "2/3 rule" mentioned in the post?

C.


newglasses (since 2006) 15 Jul 2013, 02:01

I have a question. In 2006 I was prescribed glasses for the first time. Back then I was 27 years old. I had a dilated exam. Since then my rx only increased 0.5 dpt.

Recently I read somewhere that if dilated doctors use to prescribe only 2/3 of the full prescription which would be correct considering my increase of 0.5 from +1.00 back in 2006. But over last x-mas break I went to my annual exam and was dilated again (as always). My ecp told me that my new prescription would be quite close to the results of the dilated exams...I was too nervous to ask what my actual prescription would be but I know that I still accommodate quite well and therefore I suspect that the 1.5 dpt is still not my final prescription, I simply cannot tolerate more at the moment, I reckon - that would be my question: could it be that my dilated rx would still be a bit higher? Is the 2/3-rule I read somewhere applicable here or is this something that's just nonsense?

Additionally to my new rx I was prescribed an add of +1.00 dpt which I love. I had myself some reading glasses made but will opt for bifocals towards the end of the year because I'm tired of carrying two glasses around.

Best

newglasses


Cactus Jack 14 Jul 2013, 12:33

Alex,

I am not sure it is nonsense, but it is confusing. Generally, auto refractors are not considered to be the final word on prescriptions. They usually just offer a starting point and time saver during an exam.

You did not mention if the exam was a cycloplegic or dilated exam (same thing, also sometimes called a "wet" exam). You have to be careful in identifying an exam as a dilated exam just because "drops" are used in the eyes. Sometimes "drops" are used to slightly anesthesize the cornea if an instrument that touches the cornea is used to measure internal pressure. Those "drops" work immediately and have no effect on vision. The "drops" used for dilation of the pupils and paralysis of the ciliary muscles take 20 to 30 minutes to work. They prevent the pupils from compensating for bright light and also prevent focusing action by the ciliary muscles. Dilated exams are most often used to improve the accuracy of the distance + prescriptions for people with hyperopia to try to at least partially relax the ciliary muscles and crystalline lenses.

Many Eye Care Professionals (ECP) are trained to under correct myopia, in an effort to slow progression, particularly in younger people. However, I don't understand the benefit to a 30 year old with significant hyperopia. If some additional latent hyperopia was diagnosed, there might be bit of additional + sphere in the distance prescription to encourage the ciliary muscles to relax.

The changes in the cylinder power are also confusing, the axis changes are not very important for discussion purposes, but accurate axis angles are very important in the glasses prescription with her cylinder power. The determination of the cylinder axis is VERY subjective and depends to some extent on the skill of the patient in determining relative blurriness as the ECP tries to bracket the actual axis. I usually ask the ECP to let me fine tune the axis slightly after he/she has it identified. If the ECP understands the highly subjective nature of that part of the exam, they are very happy to let me do it because they have no way of seeing what I am seeing.

Finally, I think your GF needs to see another ECP, perhaps an ophthalmologist or a pediatric ophthalmologist. The fact that she is having some turn in when she is tired tends to indicate to me that she may be under corrected and when she tries to correct using her ciliary muscles and crystalline lenses, the internal connection between her focusing and converging mechanism comes into play and tries to over converge her eyes particularly when focusing close. She may in fact benefit from some prism in her glasses.

Please remember that I am NOT an Eye Care Professional, but an amateur in the original French sense of one who studies and learns a subject out of love of it. I would appreciate it if Revolver, Soundmanpt, or other of our ECP members would comment.

C.


Alex 14 Jul 2013, 05:55

Hello CJ,

I have the question:

I have noticed red eyes, right eye turning in and squinting of my gf in the evenings and she mentioned the eyesight worsening.

Her glasses were with sph +5.5 and cyl. -2, not sure about axes, ask it is important. Her age is 30.

After optometrist visit she has

OS: +6 cyl -3 axis 5, OD: +6 cyl -2,5 axis 180

on the NO relaxing pupil in autorefracometr.

The optometrist made her glasses +4,5 cyl -2.5 and +4 cyl -2.

She has 0.8 sight with these glasses on both eyes.

Now she can see better with her new glasses but she mention about some tension in the evenings and I see the same with her eye turning.

The eyedoctor said that if she will use full correction glasses she can't have proper glasses after several years because of constant strengthening of prescription.

It sounds nonsence for me.

Could you comment this situation and recomend the way to solve it.

What do you think, which diagnostics she should done and how to calculate the proper glasses power for comfort and good eyesight.


JOMA Oz 10 Jul 2013, 20:58

Thanks CJ. Appreciate your assistance :)


Cactus Jack 10 Jul 2013, 11:26

JOMA Oz,

If the +1.00 add is comfortable, it should not be harmful and certainly not dangerous. Lens blanks with reading segments less than +1.00 are not normally stocked in high volume operations because prescriptions with an add less than +1.00 is uncommon.

C.


Cactus Jack 10 Jul 2013, 11:20

CarlyM,

I would suggest the following prescription for computer glasses with a reading segment.

R +1.50, -0.75 010 Add +1.00

L +1.00, -1.25 165 Add +1.00

What I have done is algebraically add +2.50 to your distance sphere correction to focus at 16 inches with an add of +1.00 in the reading segment to focus at 12 inches. You will need to provide a PD that has been adjusted slightly. Do you know the PD for your regular glasses? It should be two numbers, one for distance and one for reading, around 60 mm.

I would suggest considering a 28 mm Flat Top Bifocal or if you can get it, a 35 mm Flat Top Bifocal for a wider field of view in the reading segment. From your post, you are used to progressives, so you know their limitations. In this prescription the transition from the main computer prescription to the reading prescription is only +1.00 so it should be a bit better than the transition in your regular glasses.

I hope this is helpful. Please let us know if you have more questions or if you feel that the above will not meet your needs.

C.


JOMA Oz 09 Jul 2013, 23:56

Is it a problem (issue/danger) for me to wear a lens with ADD+1.00 when my script is actually ADD+0.50? They are my first lens ever, but made cheaply overseas (and hence script is out). Or, should I have the lens replaced? Thanks :)


CarlyM 09 Jul 2013, 22:54

Here are my answers:

1. Is your present distance prescription satisfactory? Yes

2. What is your working distance from your eyes to the computer when using it? around 16 inches

3. What is your preferred reading distance when you are reading? about 12 inches

4. Do you often read in bed? no

5. Would you consider lined bifocal computer glasses where the top part of the glasses were designed for the distance to the computer display and the reading segment designed for the working distance if you need to refer to a document? I would prefer progressives that accomplish the same thing if possible otherwise, yes lined bifocals would work

6. If you refer to a document while working with the computer, what is the distance from your eyes to the document? around 12 inches

7. Do you need to see distant text or objects while wearing the computer glasses? No

I spend about 8-10 hours a day on the computer and it's just really difficult looking through 3 sections :)


Cactus Jack 09 Jul 2013, 22:45

CarlyM,

Revised question 7.

7. Do you need to see distant text or objects clearly while wearing the computer glasses?

C.


Cactus Jack 09 Jul 2013, 22:42

CarlyM,

It sounds like presbyopia has pretty much run its course and your reading ADD and intermediate prescriptions will be pretty much based on Sir Isaac's famous formulas for optics. I need to ask a few questions and request some measurements. Please don't guess, you do not seem to have much accommodation amplitude remaining to compensate for distance errors so we need to be as accurate as possible.

1. Is your present distance prescription satisfactory?

2. What is your working distance from your eyes to the computer when using it?

3. What is your preferred reading distance when you are reading?

4. Do you often read in bed?

5. Would you consider lined bifocal computer glasses where the top part of the glasses were designed for the distance to the computer display and the reading segment designed for the working distance if you need to refer to a document?

6. If you refer to a document while working with the computer, what is the distance from your eyes to the document?

7. Do you need to see distant text or objects while wearing the computer glasses?

Baseed on your answers, I may have some more questions.

C.


CarlyM 09 Jul 2013, 22:22

I have always worn glasses for distance/astigmatism. 14 years ago I started wearing progressive lenses with a reading prescription. The reading prescription gets stronger every year. Until recently I was able to take my glasses off and read but not anymore. It is really hard to wear distance contacts with progressive reading glasses over them or just plain progressives with the full prescription and see every distance clearly because sections are so small. Just not enough room in the lenses -the mid & reading is so small. Drives me crazy . . .

I would like to order a pair of computer glasses so I have a larger range for computer distance and reading but I have no idea how to figure out the prescription. Here's my full prescription - any suggestions would be appreciated on how to convert for computer/reading prescription.

R -1.00 -.75 010 add +3.50

L -1.50 -1.25 165 add +3.50


Clare 09 Jul 2013, 15:35

guest - do you have a prescription for a particular brand of contact lenses from an optician? A friend of mine, who did have an optician's prescription (we are in the UK) chose to buy lenses on the internet, the first problem she encountered was veins growing into her eyes and now she can't wear contacts at all. Just a friendly word of warning - don't wear contacts without proper care from a professional.


guest 09 Jul 2013, 10:44

I am thinking of trying to order some oasys contacts for presbyopia without prescription.

I have already had a fitting for lenses a couple of years ago but they were not very succesfull but I know these match my fit.

I only have a small script so my question is do I need to adjust my contact script to compensate the glasses script ?

Also the add comes in low ,med and high .Which would match my script best.

right + .75 -0.25 x 100 add + 2

left + .25 add + 2


Soundmanpt 04 Jul 2013, 17:28

Or just go on line and order a pair for about $40.00. But I do suggest picking out a semi-rimless frame or rimless or something that has adjustable nose pads so if they need any adjusting you have some play to work with. A plastic frame with plastic nose parts can't be adjusted very well.


DWV 04 Jul 2013, 16:40

I'm going to suggest trying "computer bifocals". They can be quite cheap, even in a brick-and-mortar store. For example, take a used frame into a Walmart optical, ask for new lenses with no frills, and the price may be only $60. Bifocals made with the intermediate prescription in the main part of the lens will give a much larger useful area than any progressive lens at any price. If you don't have an old pair of glasses to reuse, visit thrift stores: there's often a basket full of used glasses (and sunglasses, and reading glasses) for as little as a buck each.


SC 01 Jul 2013, 09:36

SaraG,

Seeing 1m with a +1 add is what you'd expect. My vision varies day to day by at least +0.5 so you may be in the same position.

I find the difference is most asily observed in the intermediate part of the lens, for example and add of +1.5 has an intermediate of +0.75 (usually) which you should be able to see up to 1.33m away (2m in the case of a +1.00 add), but I can often have days where I see 3-4m.

So I suggest that you just keep checking to see how far you can focus to see whether there is any latent hyperopia


SaraG 30 Jun 2013, 22:57

I haven't gotten many comments. For several years before LASIK I wore contacts, so they may not even remember I had it.


Nichole 30 Jun 2013, 21:42

SaraG,

Have you had family and friends ask you (when they first see you in glasses again) "Didn't you have LASIK?"--or something like that?

I'm asking because my cousin seems to have the same type of experience as you, though she is a few years older, and now just started wearing glasses again. Recently at a family gathering several people ask about it.


Jose 28 Jun 2013, 04:45

Slit, what age were you when you began wearing plus lenses?


Slit 27 Jun 2013, 22:16

Hi SaraG,

Well that sounds good. Wish you best with health and everything around. : KIT!


SaraG 27 Jun 2013, 11:48

Slit, I didn't notice anything before spring 2012.


Slit 27 Jun 2013, 08:48

SaraG, sorry form my side also for misspelling your name :)

Ok, so awaiting to know how it goes.

After LASIK, until 2012 did you have any signs of difficulty in focusing up close, such as news papers with small print/dim light menu etc?

I have a friend who had LASIK for -6 myopia few years ago, now she sometimes pushes away the news papers to arms length to read, unconsciously - it happens just automatically when she gets a news paper in hand! When asked about her she said it is just normally happening by habit and comfortable that way...

Any similar experience?


SaraG 26 Jun 2013, 09:21

SC, I tried again just now and with the 1.00 over my distance I can see to about three feet. I do know I could see further to about 5 feet with them the other day when I felt like I needed additional help for reading.


SC 26 Jun 2013, 07:52

SaraG,

I noticed in one of your posts that you said you could see to 5 feet (150cm) with +1.25 readers. Is this so?

+1.25 has a focal point of 80cm, so if you can see beyond 80cm it means that you have mild hyperopia (around +0.6 by this measure). That would be consistent with the headaches and the reading needs and it is not too surprising that the dilated exam didn't find it.

So your add of +1 on -0.25 distance Rx, is net +0.75, and if you are +0.6 then it is really of little help for reading if you need +0.6 for distance alone.

So just increasing the add may not be the best solution (it will just decondition the muscles) and you may try more scientific approaches- how far can you see through the intermediate and reading sections of your progrssives for example as these will indicate whether you are hyperopic. Once you have a better view about distance then the close up is just a natural consequence of how far way you hold the thing you want to read


SaraG 25 Jun 2013, 23:30

Slit, sorry for mistyping your name.


SaraG 25 Jun 2013, 22:56

Silt,

Yes. This is my plan. And really, most nights I am fine with the current Rx, just not when super exhausted. Now for my last favorite part of glasses- waiting for new ones to arrive.


Slit 25 Jun 2013, 22:09

Thanks "anonymous 25 Jun 2013, 11:30"

PS: May I know who this is?

@SarahG: As far as what I can observe from your postings, you are comfortable with the existing progressive glasses for most activities, but need extra correction only wen reading at night/ when you are tired or sick etc... am I correct?

In that case perhaps you can continue to wear existing progressives for a while (delaying a further cash out flow) and just have some +2 or +2.5 kind of readers for reading at home at night etc.

What do you think SarahG?


Soundmanpt 25 Jun 2013, 13:49

FionaA

I would suggest going on-line and getting your progressives that way. Cactus Jack and myself agree that Zenni is very good and the price is very inexpensive. I have placed a good number of orders for progressives from there and they have been great. There is a huge selection that would cost you less than %50.00 and that also includes an AR coating. I do recommend that you pick out a frame that has the adjustable nose pads so if the add needs some minor adjustment it can be easily done by adjusting the nose pads so you can raise or lower the add segment. The plastic frames are nice and they probably would be fine but just to be sure being able to make a slight adjustment is maybe better.

The site is "zennioptical.com"

A warning I always give to anyone getting their first bifocals or progressives is to be very careful going up or coming down stairs while wearing them as they tend to make things appear much closer than they are. And wearing heels make it even a bigger challenge.


 25 Jun 2013, 11:30

Slit.

I agree with your advice to Fiona A.

I have varifocals ( pregressives) & the sesign continues to improve.


SaraG 25 Jun 2013, 08:38

Thanks of all of you who prompted me to learn more about accomodation issues. From my online research, it seems my increased issues when sick, exhausted, stressed are expected with accomodative insufficiency and just using what help I need when I need it makes sense. It's nice to see my symptoms match with a known situation, and to know that next time I'm down and just want to curl up and sleep/read, like I do when I'm sick, I'll be able to do so comfortably.


Slit 25 Jun 2013, 06:25

So FionaA is the lady who used to wear a lower plus precriptuon for reading earlier, then received reading add recently. Am I correct?

Then there was another Fiona who asked about at what strength the glasses look noticeably strong. Am I correct?

So, regarding FionaA, it seems like you try to decide whether to get progressives or not? If the money is not a constrainnt, it sounds like a good idea. Mainly because, having normal reading glasses at work will make you uncomfortable if you have to slide them down every time you wany to look at distance, if you have normal bifocals, you will have to strain the neck while trying to look at computer screen through lower portion of lens. Butnif there is a good quality pair of progressives, distance, near and far all covered seamlessly.

In terms of vanity side also, Someone with interest about glasses and lenses only can notice the slight bend inthe image through lens. I think lately there are many who wear progressives that not many average people notice.

Considering all these, if I was in your situation, progressives will be the choice (as long as I can afford it).

Regarding the increase of rx by +1 for near, i can see nothing un-natural. +2.25 seems to be a quite legit reading prescription for someone in 30s with previous years of hyperopia. Today's visual needs are mych difference and I wear the +1.25 much more than my parents wear due to smart phone and tablet usage. (I wake up, take tablet in hand when going to make my tea and morning reading is a must for me while sipping the tea. Then again while I'm on public transport I read heavily, resulting a high work load on eyes and accomodation)

So FionaA, if you can afford financially, I would suggest adopting progressive glasses and gain all the benefits.

Note: Do not get demotivated by the initial familiarization phase. The effort is worth it.


FionaA 25 Jun 2013, 03:46

I notice that another Fiona has posted recently so I will change my nickname. I finally got my eyes tested again and my eyes have changed a bit.

Old script. Right -0.25. -0.5. Add +1.25

Left. +.25. -.25. Add+1.25

New script. Right. -0.25. -0.75. Add +2.25

Left. +0.75. -0.25. Add +2.25

She also said that I need +1.50 for computer. I now need to decide what to do re. progressives. At the moment I use my single vision reading glasses for the computer buy closer things are becoming harder to see.

Should I be concerned about the increase in the add as it seems rather large?


Neil 24 Jun 2013, 15:17

@SaraG

A colleague at work is one of the post-LASIK people I know. He has progressive lenses with a very slight apparent plus distance Rx and usually wears them at the office, but not consistently. His story:

He is 41 IIRC and, after getting tested a few months ago, was somewhat astonished that he had "new" vision correction needs, and told us his tale that day.

He said he had the option of getting an "enhancement" with monovision, but was not too sure about becoming nearsighted again.

Recently at a meeting he didn't have them on, and someone else casually asked about their absence. "My eyes really fluctuate. Sometimes I need them, sometimes I don't."

So, what you are experiencing may be not be unusual. But, if you have concerns, maybe go back to your doctor.


lazysiow 24 Jun 2013, 13:20

Only if you use them constantly SaraG


SaraG 24 Jun 2013, 09:31

Today my vision feels better, but I remembered that there were other days, usually when tired or sick, I think, that I didn't feel like the current 1.00 ADD was enough. Maybe my vision just varies enough that I only need the extra add sometimes. I'm thinking if that's the case, maybe ordering a stronger pair to use just on those days if I want to go read. I certainly wouldn't have been up for reading much yesterday with my normal prescription. Since I'm already wearing glasses full time, I don't really care what the prescription is as long as things feel pretty crisp. That said, I feel like I should keep the near focus I have while I still can. I know that's just a matter of time, and wonder if using the extra help occasionally will accelerate the accomodation loss much. I know some of you have mentioned either you or your partner's needs seem to fluctuate as well. Do you have any insights?


Soundmanpt 24 Jun 2013, 00:26

The reason her doctor didn't suggest a "touch-up" which is what they call a redo is because her vision isn't considered to be bad enough to have it done again. It may have changed some but as far as I know in order to get a "touch-up" your vision had to be worse than -1.25 and honestly I am not sure where the cylinder came into play with that.


Neil 24 Jun 2013, 00:07

@John S

Thanks. I knew you would have a good explanation.

Just to reiterate:

As a post-LASIK patient, she was nearsighted IIRC, and per my understanding, internally her eyes function that way. I don't think latent hyperopia is a factor.

Might be good to wait a year and see what happens. Sometimes we just like the extra power but don't really need it yet.


John S 23 Jun 2013, 22:41

The last post was from me.


 23 Jun 2013, 22:39

SaraG,

The astigmatism in the left eye is enough to cause a problem at any distance if you don't wear some type of lens to correct for it. I doubt you have latent hyperopia since you had a dilated exam.

Reading - You can have poor accommodation at any age. Compared to most younger people, I needed a lot more correction for my accommodation problem. I tend to be more biased toward throwing as much plus as possible to elevate the symptoms. I know for many people that is not needed and can cause "addiction" to the extra power. The extra power can be quite comforting. Your eyes no longer need to supply the power for reading, they can rest normally at a distance state. By the time you are in your 50s, that extra power is not optional, so you are just getting used to it sooner.

I think most people that do not fall into the normal age for presbyopia symptoms with accommodation problems fall into four categories:

1. A reading add is needed, but not prescribed.

2. A functional reading add is prescribed (+0.75 to +1.25), and works well.

3. A functional reading add is prescribed, but a stronger add is needed for comfort.

4. A stronger reading add is prescribed (+1.50 to +2.00), and works well.

The problem is figuring out what category you fall into. By your explanation, I would say number 2 or 3. By rough calculations, it appears an add of +1.75 or +2.00 would put your reading distance at 16". As Neil said, that is a normal distance for reading.

If stronger readers feel good, wear them. You can always order a pair online with your complete reading prescription so you don't have to wear contacts to read.


Neil 23 Jun 2013, 16:31

Just to add, SaraG, I think you will get great explanations from Cactus Jack, and from John S (if around).

But, on the surface, it looks like you had a thorough eye exam if you got dilating drops. Some doctors just don't like to explain.


Neil 23 Jun 2013, 16:10

SaraG, thanks for that.

So your doctor didn't bring up a LASIK re-do?

As far as reading goes, +1.00 sounds plausible considering your age. I say that because some doctors wouldn't even contemplate giving you a reading add in the first place.

Another question:

Do you still like holding things fairly close to read (like most myopes naturally would)?

How close do you like to hold your iPhone?

I think your personal disposition and comfort level with reading distance would be an important factor.

Most optometrists are trained to correct for ~16 inches. But if you like to hold at ~12 inches, that would imply a slightly stronger reading Rx. But, I really doubt that you would want to effectively double your reading Rx right now.


SaraG 23 Jun 2013, 15:23

Thanks, Neil. I found that without fulltime wear I am prone to headaches. I can get away without glasses for a run or while swimming, but not the whole day. With small kids, just wearing them is easier than on and off. I don't really mind. The contact correction isn't as good, but nice for hiking, skiing, etc.

Im not sure what trade off makes sense for the reading prrscription. Mostly, I'm curious what's up and haven't found an optometrist who doesn't make me feel rushed and who explains things like I had long ago before many moves in the interim.


Neil 23 Jun 2013, 15:10

@SaraG

I've actually known a number of people who now need reading glasses many years after LASIK. I know one person who is more or less full time who reversed course from myopia to hyperopia (mentioned that one in the sightings section IIRC).

May I ask about the full time correction, as your Rx doesn't seem that strong. Though, I understand that the astigmatism in one eye may be difficult to tolerate.

Did your doctor suggest going full time?

Also, did your doctor suggest a LASIK re-do?

I'm asking because post-LASIK patients tend not to be enthusiastic about wearing glasses full time--that's why they had it in the first place.

The one person I know who is a more of a full time wearer didn't like toric contacts, and she was leery about LASIK again because her eyes kept changing.

As far as increasing the reading Rx, you can do that, but you will fast-forward what will happen naturally over time.

Personally, I think that the best thing is to find the reading distance that you are comfortable with, tell the optometrist, and let him or her adjust your Rx accordingly.

Others can comment better, though.


SaraG 23 Jun 2013, 12:26

I'm a long time lurker. I am 36 and had LASIK to correct myopia and astigmatism about ten years ago. My vision was 20/20 after that. In early 2012, I noticed serious headaches, especially after long sessions at the computer. I'm a stay at home mom, so those are rare unless I'm doing taxes, etc. I am on my iPhone much of the day.

June 2012 prescription:

OD Plano

OS +.25 -.75 55

March 2013 prescription:

OD -.25 -.25 120

OS +.25 -1.00 55

ADD 1.00

I currently have progressives I wear full time and single vision readers with the reading prescription. I also have 1.25 drug store readers to wear over distance only toric contacts I wear occasionally.

Today I was reading in bed and tried the 1.25s over the reading glasses and found it much easier and not over strong at all. I was comfortable with the text at about 14". With just the prescripion readers, I can see well to about 5 feet. Distance is blurry with either way, obviously more so with the stronger plus.

Does this sound like presbyopia? Latent hyperopia? Should I order a pair in the stronger prescription online? Will that make the progressives useless and I'll need to replace those? The exams both were with dialating drops, fwiw. Is this a really fast progression and/or am I just more sensitive to strain/blur than most?


astigmaphile 22 Jun 2013, 09:26

LT Lurker,

I got my first glasses in junior high in the 1950s. I realize years later that the optometrist undercorrected me. I assume that it was about the same as a 2005 prescription that I never filled. The astigmatic part of that was .50 left and 1.25 right. By then I was presbyopic and the + sphere part was 1.50 left and .50 right.

When I had cataract surgery on my left eye in January 2011, they found out that my left eye was +3.00 astigmatic. The only explanation was that my lens was astigmatic , as well, and cancelled most of the corneal astigmatism.


Al 22 Jun 2013, 07:20

@Rick33

The explanation is pretty simple: unlike myopia, low-to-medium unastigmatic hyperopia doesn't affect quality of your vision since it's naturally fully corrected by extra muscular effort at younger ages, thus many young hyperopes just don't know their actual refraction in a relaxed state.


LT Lurker 19 Jun 2013, 22:54

astigmaphile,that's interesting, so at what age did you get your first correction and what was it?


astigmaphile 16 Jun 2013, 18:02

When I was young and had excellent accommodation it corrected my low end hyperopia. That did not become obvious until presbyopia set in. I actually am compound hyperopic astigmatism in both eyes.

On the post your prescription thread I have seen many myopes who are astigmatic, as well.


Cactus Jack 16 Jun 2013, 13:56

Rick33,

Hyperopia (plus glasses) and Myopia (minus glasses) are both caused by a mismatch between the total optical power of the eye's lens system and the length of the eyeball. Astigmatism is generally caused by uneven curvature of the front surface of the cornea. There is no physiological connection between Astigmatism and either Hyperopia or Myopia.

I believe you came to an incorrect conclusion based on a data sample that was too small or incorrect.

There are many people who are Hyperopic, but do not wear glasses because they can use their internal ciliary muscles and crystalline lenses to correct their Hyperopia. Astigmatism CANNOT be corrected without external lenses (glasses or contacts) or refractive surgery. It is very likely that ONLY those younger Hyperopes who also have Astigmatism have visual symptoms that are annoying enough to cause them to seek a solution.

Older Hyperopes often wait until Presbyopia (which is a stiffening of the crystalline lens, generally with age) makes internal correction impossible.

C.


Carrie 16 Jun 2013, 04:32

I have a plus prescription and I don't have astigmatism.


Rick33 15 Jun 2013, 23:54

Hi,

Long time lurker, now a poster! Just wondering why plus glasses and astigmatism always seem to go hand in hand, whereas this does not seem to be the case with myopic people?

Everyone I've met who is hyperopic (including myself) usually has some degree of astigmatism, but I know lots of myopic people without any astigmatism.

Thanks!


Lucas 12 Jun 2013, 09:24

Dan, I have found that has happened to quite a few people who get glasses during college, and when the prescription is not strong enough to make a difference, they end up sitting at the bottom of the bag. They initially wear them, and after being unable to deal with the blur in the distance, give up on using them. I know that is my case.


Dan 12 Jun 2013, 08:48

I had posted at least a year ago about a friend of mine (she is 21 now) who got glasses 2 years ago for reading. her eyes were getting tired with all the close work in college. I have never found at the prescription from her but was able to try them on once and from what I remember cant be any more than +1.0. Probably more like +0.5. She says there is no astigmatism correction but Im not 100% sure on that.

Anyway, two years after she first got them she really doesnt wear them any more than she had although she did say that after a day of wearing them in front of a computer it took a few minutes for everythinf to come into focus when she took them off. She has told me she cant see distance with them.

I'm somewhat surprised that she hasn't found more dependence with them after 2 years. Or maybe her eyes just haven't gotten any worse and only nned a little help.


Aubrac 11 Jun 2013, 09:51

I was browsing through a stack of old photos taken when my wife was a child.

At about age 3 there are the first photos of her wearing glasses although between 4 and 5 she is not wearing glasses, and in these there is very noticeable 'squint' or turning in of her right eye, but she may have just taken them off for the picture.

Subsequent photos show her always in glasses from about age 6 to 12 and then no glasses from teenage years onwards. My question is how easy is it for a child who has been wearing about +4 lenses for six or more years, to suddenly stop wearing them.

I know young people have great powers of accommodation but would have thought that six years of constant wear would have lessened this ability.

For those who have not seen my earlier posts, latent hyperopia reared its head about twenty years later and she is now FT wearing varifocals.


Yellow22 10 Jun 2013, 00:21

Is it possible to mess with the auto refractor? I go to my local specsavers, and there is a mandatory auto refraction before seeing the doctor. I am hypermetropic and astigmatic myself, but is it possible to get a higher reading on the auto refractor by relaxing my eyes (I think everyone can do it, you know how you can make everything go blurry)?


Cactus jack 07 Jun 2013, 11:30

Don,

The key point in your post is your age. 43 is a typical age for presbyopia to become a problem. All presbyopia (literally, old eyes) means is that part of your eye's auto-focus mechanism is not functioning as well as it used to and you need help to focus close. +1.25 is a typical first reading glasses prescription, but you need to be aware that you will likely need a stronger reading prescription within a few months. There are two reasons that you will need to get stronger glasses. 1. Your crystalline lenses, which are gradually becoming stiffer and harder to focus. 2. Your ciliary muscles, which squeeze the crystalline lenses to increase their power will fairly rapidly begin to become de-conditioned as you provide more focusing help with your reading glasses. Unfortunately, there is really nothing you can do about either 1 or 2.

There is a bit of good news. While your reading prescription will increase, it will never go beyond around +2.50 to +3.25. The amount of plus you need to focus at typical reading distances can be calculated by dividing the focus distance into either 100 cm or 39.37 inches, depending on the units you like. If you like to read at 40 cm or 16 inches, it takes +2.50. If you like to read closer it will require a bit more plus. When you were young, your ciliary muscles and crystalline lenses provided the extra plus you need to focus close without any conscious effort on your part. Now, if you read at 40 cm or 16 inches, your reading glasses provide the extra +1.25 and your crystalline lenses provide the rest. Ultimately, the amount of plus your ciliary muscles and crystalline lenses can provide will diminish and you will need stronger readers.

The other visual effects you described are typical and nothing to get excited about. Welcome to the club.

C.


varifocals 07 Jun 2013, 10:31

Hi Don.

As a wearer of + glasses for nearly 10 years I found your experiences interesting & I can relate to it.

I have found your left/right focussing odd as something is odd there & I have not had this experience.

I dont find +1.50 too bad provided it is for reading. What should happen is that close up work should be sharp & yes the distance will be a little blurry, but I assume close up vision & maybe associated headaches started it. It did me. It is possible as things progress you may find, even without glasses that as well as distance reading is hard, or impossible without then glasseswhich are dual focus kick in. These are known as bi focals or progressives, which is what I have. They are not a problem & you soon get used to them & I wear full time. +3.25/ +5.75, the latter being for close work. In addition, at my last test I gor a pair of +4.25 which I use simply for computer use & they are really great. But, initially when I take them off, its blurry. So really its not an escience & depends upon the individual.


Don 07 Jun 2013, 09:26

Seems my questions got lost in the furry of other posts...can someone with experience give me an idea of what to expect with my new glasses?

I just got my first pair of readers. They are +1.25. Lots of questions that I forgot to ask the Dr who prescribed them but seemed to be a bit rushed.

1. Is this a "normal" prescription for a first pair?

2. When I put them on and look towards the left things seem to shift towards the right. When I look to the right they seem to shift towards the left. Is that normal?

3. They don't make a big difference in clarity when I put them on but when I take them off after wearing for a while everything close goes blurry. If I then put them back on everything close really pops in to focus with intense colors, blacker blacks etc. Is that normal? After using them for a will I lose my ability to see close without them? or will my ability to focus close diminish with stronger glasses?

4. Everything in the distance is a blur with the glasses on. Do I have to be careful to take them off when not reading...will they have a long term effect on my distance vision if I wear them more for just seeing close?

5. Any way to know how long this prescription will "last"? I want to buy at least a couple of pair to have around, but if I will soon need stronger I don't want to throw money away. How often would a prescription last for a 43 year old?

Just trying to understand these and know what to expect.

Thanks.


svensont 06 Jun 2013, 03:40

DeCoder93,

I can't tell you if your eyes will relax to 2D or more, you can just experiment and watch the results or do a dilated eye test, then you will know for sure.

The relaxation is a process and may take days/weeks or months. You can do the simple test, just measure the distance from each eye to a place when the text starts to become blurry. Wear the +3D more, measure after few hours. It is possible that after few days of doing it you will see some improvements. In my case I could see better always a day after I was wearing the glasses long enough.


Cactus Jack 06 Jun 2013, 00:33

Matthew,

Absolutely! I think after you have worn the glasses for a week or two, you will wonder why you even asked the question. You will probably reach for them first thing when you wake up and they will be the last thing you take off when you go to bed. You might not like them at first because your brain needs to do a little re-programming. Vision actually occurs in the brain and the eyes are merely biological cameras. Your brain is very good an correcting images if it knows what something is supposed to look like, but it takes lots of work. Once your brain discovers that your glasses are really labor saving devices, it will let you know is some often unsubtle ways that it is not happy if you don't wear your glasses. At first, you may think the glasses have made your vision worse, but they really have not, your brain has discovered that with the glasses, the extra work is not required and it quits doing it. You can force it to go back to work by not wearing the glasses for a week or so, but your brain will not be happy and it will make very sure that you are not happy either.

It is actually more difficult for hyperopes to get used to their glasses than myopes, but the end result is worth it. Many of us have been down this road and we can help. All you need to do is ask. Let us know when you get your glasses.

C.


Matthew 06 Jun 2013, 00:09

Thanks for your help Cactus Jack!

So my prescription is one that will help at every distance? And most people with this prescription would wear ft?


Cactus Jack 06 Jun 2013, 00:03

Matthew,

Absolutely justified! Without the correction of a prescription like that, most people would find extensive visual activity uncomfortable and fatiguing. That is not the way it is supposed to be. Your visual system was designed or evolved (take your choice) to capture images clearly and effortlessly at all distances. In your case and millions of others, it is not quite perfect. Exactly why, we don't know except to say that it is probably that your eyeballs needed to grow about 1 more mm thatn they did and your corneas are probably under some tension in one axis, but again we don't know exactly why. The result is some hyperopia and astigmatism.

No one on this planet has the right to pass judgement or deny you the right to comfortable, effortless vision. If someone wants to pass judgement on that, perhaps you should be able to decide if they are wearing the correct shoe size or if they should be permitted to wear shoes at all. The fact that the rocks hurt their feet, or that you get headaches without your glasses is not important, right? Same principle.

Anyone who thinks that a certain level of refractive error is necessary to justify correction, simply does not know what they are talking about and generally one small notch above stupid.

Strongly worded post follows.

C.


Matthew 05 Jun 2013, 23:05

I know that it is up to the wearer how often they choose to wear their glasses, but from an objective point of view, is my full time wear of this prescription justified or is it a bit too weak to normally be considered for full time wear?

Right: SPH +1.25, CYL -0.75 AXIS can't remember

Left: SPH +1.25, CYL -0.50 AXIS can't remember


Cactus Jack 05 Jun 2013, 22:05

Fiona,

Someone who knows what to look for would know at a glance if you are near or farsighted. The average person would only know that your glasses are not fake and pay attention to the frames rather than the lenses.

C.


Cactus Jack 05 Jun 2013, 21:59

Fiona,

First of all if you wear +1.25 full time and see distant signs and objects with them clearly, you are hyperopoic or farsighted not nearsighted. People who are nearsighted have to wear minus (-) glasses or contacts.

There are a number of clues to a prescription. Plus glasses are ticker in the center and usually thin on the edges. If the lenses are large enough that you can see through them really distant objects will often either be blurry or if you and the distant objects are far enough away, they will be either blurry or sometimes inverted, minified, and clear. Plus glasses DO NOT have "power rings" or "cut in" where the side of the face through the lenses is inside the actual side of the face outside the lens. Minus lenses do.

With +1.25 lenses, some of the effects are hard to see at reasonable distances (arms reach) however, you may be able to see some of them with +3.00 or more OTC readers.

May I ask your age, occupation, and where you live. If you are in school or have some good contacts there, you could have a lot of fun at an optical bench in a physics lab. Seeing the optical effects of different types of lenses with different powers in a controlled setting is fascinating. You can duplicate the experiments Sir Isaac Newton did when he was developing the optical formulas around 1700. We still use the same formulas today.

C.


Fiona 05 Jun 2013, 20:04

Cactus Jack,

I currently wear +1.25's ft and wonder if anyone can tell if I am near/farsighted? How can you tell the strength of someone's prescription just by looking, esp. when it is a relatively weak one like mine?


Cactus Jack 05 Jun 2013, 19:58

Fiona,

I don't know the answer to your question about the eyes looking obviously larger. Probably around +4 or +5 for the average observer, though an experienced OO could probably detect a +1.00 prescription using different clues that just the eyes appearing larger. The eyes never look blurry to others even with very high plus glasses such as the lenticulars like they used to have to wear after cataract surgery. Those can sometimes be more than +20.

May I ask the reasons for your questions?

C.


DeCoder93 05 Jun 2013, 19:50

svensont

yes everything was crystal clear at all distances with +1.5D. I don't know how to get my muscles to relax enough for +3. I tried wearing cheap +3 readers all day and while I could see to read, the TV was blurry in them. Do you think I could get my eye muscles to relax to see around +2D or +2.5D at least?


svensont 05 Jun 2013, 19:45

DeCoder93,

Do you see perfectly clear through the +1.5D glasses? Will you wear them full time? If you would like to get stronger glasses, I think you can wear the +3D and watch if your eyes are relaxing more.


Fiona 05 Jun 2013, 17:57

Cactus Jack

At what prescription do the eyes of the glasses wearer start to look noticeably bigger and blurrier to onlookers?


Cactus Jack 05 Jun 2013, 14:38

Fiona,

CR-39 lenses should be fine for a +2.00 prescription. They will make your eyes look a little larger, but any lens material, including high index (thin) will do that.

A plus lens is thin at the edges. You may see a little blurring at the edges, but others do not. If it becomes a problem, investigate "aspheric" lenses, but try the CR-39 first. They are much less expensive and they should be OK.

C.


Fiona 05 Jun 2013, 03:32

At what prescription strength is it a good idea to consider thinner lenses than are standard? I have +2 ft wear but have not got the specs made up yet. Will this prescription enlarge my eyes, and make the edges of the lenses look blurry to others when I move my head? I like a bigger, fuller frame due to my face shape.


svensont 05 Jun 2013, 02:50

DeCoder93,

Your vision looks like it is perfect because you can probably read all the letters on the wall without a glasses, but you are a hyperope and the 1.5D can help you. If you experienced a headache, eyestrain and other symptoms they can disappear now.

Your prescription probably can go up in the next eye test. To know your final prescription you should get a dilated eye exam.


svensont 05 Jun 2013, 02:44

Matthew,

It is not that your eyes are getting shorter. You are latent hyperope which means that your cilliary muscles are used to supply you necessary plus power to see clearly and this position in normal for them (spasm). It is the same but on the other side like being a pseudomyope, when your eyes are delivering too much plus and you need minus lenses to see clearly.

So only your cilliary muscles are relaxing and not supplying the additional plus power and that is why your prescription is getting stronger.

Just read many posts in this thread and you will understand laten hyperopia more


DeCoder93 05 Jun 2013, 02:38

Just had eye exam this morning upon your advice, and have a question. Before seeing the doctor I was told to look through the auto refractor. The result of the auto refractor was 0.00 for both eyes. My vision was perfect, according to the machine. But then doctor looked at my eyes, had me read chart on wall etc. and gave me +1.50D prescription for fulltime wear. Why is this? Do I need glasses or was the doctor just trying to give me a prescription since my vision is actually perfect?


Matthew 05 Jun 2013, 02:32

svensont, you previously identified my latent hyperopia, but I was wondering how/why it had gotten worse between the two prescription changes when people say that hyperopia cannot get worse because the eye cannot grow shorter? thanks


svensont 05 Jun 2013, 02:30

Matthew,

You are a latent hyperope and your eyes are relaxing, that's why you can see through +1.5D glasses


svensont 05 Jun 2013, 02:29

DeCoder93,

You can order glasses on zennioptical.com and choose index you want


Matthew 05 Jun 2013, 02:09

Can anyone tell me why the following has occurred:

First prescription at 16 -

Right: SPH +0.75, CYL -0.50 AXIS can't remember

Left: SPH +0.75, CYL -0.50 AXIS can't remember (I have oblique astigmatism)

At this point, my father's +1.50D readers seemed reasonably clear for near distance, but far distance (much beyond a metre) everything was a blur.

Within a year I got my second prescription -

Right: SPH +1.25, CYL -0.75 AXIS can't remember

Left: SPH +1.25, CYL -0.50 AXIS can't remember

Now, the +1.50D readers are crystal clear at every distance (save for the distortion from my astigmatism)- I could wear them full time if I wanted to (but I would never).

Has my eyesight really deteriorated that much in one year? Will it continue?


DeCoder93 04 Jun 2013, 22:03

Can you get low index lenses at eye glass dispensing store to make the lenses thicker rather than thinner? if so ,how?


svensont 04 Jun 2013, 18:13

DeCoder93,

If you like the +3D glasses you can try to wear them more. I suppose that your eyes will relax more.

Based on my experience, after few hours in them each day you should start to notice the difference, especially on the second and third day. Give it a try


DeCoder93 04 Jun 2013, 17:57

I have only been wearing the +3 glasses for about an hour at a time while I study over the past week - not much at all. I will have to find a tape measure before I accurately measure the distance. I feel like my eyes can relax with +3D but far distance is blurry.


svensont 04 Jun 2013, 17:43

DeCoder93,

How long have you been wearing the +3D glasses? For days, weeks? How long per day?

This 1.25D of hyperopia is just an estimate. Better estimate would be done if you could measure the distance by a ruler from each eye 3 times and average the results.

If you could get 1.25D prescription and see well in the distance then it is up on you when you wanna wear them, probably you will just like wearing them full time


DeCoder93 04 Jun 2013, 17:38

If I am 1.25 hyperope, should I wear glasses all the time? And no I have not had an eye test before but kind of like +3 lens. Can I wear +1.25 all the time or just for reading? I am 19.


svensont 04 Jun 2013, 17:06

DeCoder93,

Try to measure the distance with a ruler. If it will be 55cm then that means that you probably are a 1.25D hyperope.

How long have you been wearing the glasses? Have you ever had an eye test?

I'm not an expert but I think that the pain you experienced means that your cilliary muscles were in relaxed state and had to squeeze when you took your glasses off. They are weak and getting weaker by wearing the plus lenses.

If you wanna wear plus lenses you should go for an eye test. I'm sure you will get a plus prescription.


DeCoder93 04 Jun 2013, 15:35

Yes Aredent just curious. I am male student who suffers blurry vision but like hyperopia lenses so would like to tolerate +3D


Don 04 Jun 2013, 14:43

Hey.

I just got my first pair of readers. They are +1.25. Lots of questions that I forgot to ask the Dr who prescribed them but seemed to be a bit rushed.

1. Is this a "normal" prescription for a first pair?

2. When I put them on and look towards the left things seem to shift towards the right. When I look to the right they seem to shift towards the left. Is that normal?

3. They don't make a big difference in clarity when I put them on but when I take them off after wearing for a while everything close goes blurry. If I then put them back on everything close really pops in to focus with intense colors, blacker blacks etc. Is that normal? After using them for a will I lose my ability to see close without them? or will my ability to focus close diminish with stronger glasses?

4. Everything in the distance is a blur with the glasses on. Do I have to be careful to take them off when not reading...will they have a long term effect on my distance vision if I wear them more for just seeing close?

5. Any way to know how long this prescription will "last"? I want to buy at least a couple of pair to have around, but if I will soon need stronger I don't want to throw money away. How often would a prescription last for a 43 year old?

Just trying to understand these and know what to expect.

Thanks.


Aredent 04 Jun 2013, 11:20

DeCoder93

What purpose did you have in trying +3 glasses on your eyes in the first place? Were you just curious how they would work or what? What kind of work you do, maybe glasses will benefit you? Are you male or female?


svensont 04 Jun 2013, 10:31

DeCoder93,

You should measure the distance, not guess. But if it is around 55cm it means that you are 1.25D in plus


 04 Jun 2013, 08:42

I just did the test svensont, and I could hold my laptop at arm's length - probably 55cm around - and read small font clearly with +3D lenses. What does this mean?

ADDITION: I read with my laptop about 30cm away and +3D has always been clear. Just then I took the +3D lenses off and it took my eyes about 10 seconds to adjust back to no correction. It was somewhat painful to take my glasses off, as the screen was such a blur and I was squinting awkwardly to try and focus - it hurt my eyes so I put them back on quickly and everything came back into focus.


DeCoder93 04 Jun 2013, 08:40

I just did the test svensont, and I could hold my laptop at arm's length - probably 55cm around - and read small font clearly with +3D lenses. What does this mean?


svensont 04 Jun 2013, 08:23

DeCoder93,

Wear the glasses, read in them etc and measure the distance wearing them. If you take them off you will see perfect so you can't measure anything.


DeCoder93 04 Jun 2013, 08:12

svensont do i leave glasses on after 30 minutes to measure distance or take off after 30 minutes then measure distance


svensont 04 Jun 2013, 07:29

DeCoder93,

Wear the glasses for 30min and measure the maximum distance from your eyes to a small print until it becomes blurry. Then tell us the result. If you have normal eyesight then you should see up to 33cm or 13" clearly and everything beyond should be blurry.


svensont 04 Jun 2013, 06:42

Matthew,

If you can see 35-40cm in glasses over contacts it means that the glasses works effectively as 2.5D or 2.75, so you can increase you prescription by 0.25D or 0.5D and still see clearly or slightly blurry


DeCoder93 04 Jun 2013, 03:23

Hi, I am 19 year old and, just wondering if it is good or bad that I can see to read clearly through +3D readers? The distance is blurry but I can clearly see the computer/books on my desk. Would I be slightly hyperopic for this to occur or can people with normal vision see to read through +3D as well?


John S 04 Jun 2013, 01:04

There is really no way to tell. That is why it is good to get the exam.

There were some prior posts earlier this year by Snowman26. The last post details his problems on 4/16/13. I believe he went from no rx to a +5 in 4 months. I don't know if he has had a wet exam yet. He was not thrilled at all that his rx climbed that high. And it is probably not done climbing.

His accommodation muscles had hidden his hyperopia until he could not deal with it anymore due to headaches.

In my case, I had conscious control over my muscles, I could relax them fully. I knew what my real rx was without being dilated. I don't think there are too many people that could do that.

My initial rx at 13 was +1.00, add +2.00. At 57, now my normal rx is +1.25 -0.50, add +2.50. Not really an increase, it works out to be the same.


Matthew 04 Jun 2013, 00:30

Sounds good John S. What should I expect my undialated prescription. To be if a normal exam gave me +1.25? Could it be much higher than that?


John S 04 Jun 2013, 00:27

Matthew,

The exam should not be an all day event, it should only hold you up a few hours. Bring sunglasses...

The other side effect will be, you will get to experience what your vision will be like when you need your strongest prescription. Since the drug will temporarily paralyze your muscles into a fully distant state, the power you need for full correction should never be higher than during the exam. You will not have any added power for reading, what you will see is probably be close to your vision when you are in your 50s.

Most people don't like it because they can't read (unless they are nearsighted). But I think it was kind of cool to completely lose the ability focus for a few hours. It was like a look into the future.


fiona  03 Jun 2013, 23:09

Can anyone hazard a guess as to how many diopters of hyperopia this might be?

http://www.last.fm/music/Aldous+Huxley/+images/57802043


Matthew 03 Jun 2013, 23:08

Cactus Jack,

Thanks for your explanation of astigmatism, I'll be sure to ask next exam. The last exam I had, the astigmatism component did not include letters, rather, just a series of dots and I was asked to chose the clearer of multiple lenses. I chose the ones that made the dots look more ovular to increase my astigmatism prescription.

John S,

I'm not hesitant to have a wet exam, it's just that I am self-sufficient in terms of transport and cannot have someone else to drive me or do my tasks for a day while my pupils are dilated so I'd rather avoid it if possible. I totally understand you otherwise :) I'll just keep overcorrecting as far as is possible. I think that I have further to go than my current prescription (+1.25), because it seems a little weak. Any more techniques you have surrounding the examination (like overcorrecting nearer to the day, talking about computer distance) etc. would be much appreciated.


John S 03 Jun 2013, 22:35

Matthew,

Having an incorrect cylinder correction will make you have blurry vision at all distances, it is not something you want to do. You don't want to play that game. You have to take my word for it.

The sphere correction is a different story. If you know what works best for you, you can tweak it some.

I am hyperoptic also. I liked my distance rx correct, but I craved the added plus for reading. It made everything bigger and it caused my eyes to relax. Read about AI in my previous posts.

I am curious to know why you do not want a wet exam. It will give you an idea of your real rx, then have a reference point. Then you can set a goal to get to it by over correction. The doctor may even just prescribe the full rx if you say you can deal with the blurry distance until you get used to the stronger lenses.

Once you reach the maximum plus rx, you can't go any further. People that have myopia can try to cause the lenses in their eyes to grow longer and need a stronger minus rx. To get a stronger plus rx, your eyes need to become shorter, that is pretty hard to do. You are stuck with what you have.

The only control you have over the situation is to try to cause to accommodation muscles to fully relax to so you will need the maximum correction. That will happen faster by over correction. After that happens your rx will probably be pretty stable.

Do you get my drift?


Cactus Jack 03 Jun 2013, 22:17

Matthew,

To put in my 2 cents, astigmatism is totally unrelated to hyperopia. Hyperopia is caused by a mismatch between the total optical power of your eye's lens system and the length of your eyeball. Astigmatism is usually caused by the uneven curvature of the front surface of your cornea. You want that to be as accurate as possible and no mater what you do the sphere portion of your Rx, if you are smart you will EXACTLY duplicate the cylinder and axis correction in any prescription you alter.

The accuracy of your cylinder and axis correction to some extent depend on your skill during the subjective part of the examination where the examiner is trying to bracket the axis and you are trying to compare relative degrees of blurriness. Letters with straight lines can be confusing because as the examiner flips the lenses back and forth, straight lines will often appear sharp and then blurry in an alternating fashion. If possible, I urge you to concentrate on an "O" if possible. Also, you may ask the examiner if you can "fine tune" the axis after he/she has finished. Often they will place your hand on the axis knob and you can turn the knob back and forth by a small amount for, at that point, the sharpest image.

C.


Matthew 03 Jun 2013, 21:41

John S - great advice.

I have also noticed the added plus feeling on a sunny day. When I go for walks in my glasses and it's bright out (I live in CA, so it's sunny most of the time), I feel the sun very strongly on my eyes. Why is this? And what is wrong with lying about astigmatism correction? I like the feeling of being slightly overcorrected, especially when driving.


John S 03 Jun 2013, 20:55

Matthew,

Just go in for an exam, and say you want to get a second pair of glasses for use for computer and reading. Your eyes get tired after you study for a while. If you wear your glasses over your contacts the increased power helps you read easier. Mention that you keep your laptop about 16"-18" away from you. So you would like your reading glasses set for that distance.

Wear your glasses over your contacts as much as you can before the exam to relax your eyes. Usually a sunny day will get you a little more plus.

A lot of the rx forms have a spot for a computer rx, it is not uncommon. So it should not be much of a problem to get a computer rx. Then if you want to wear them for distance, you have your increased rx.

I would not lie about the astigmatism correction, that can get you a pretty bad rx.


Matthew 03 Jun 2013, 19:06

Thanks so much svensont - just the kind of advice I was looking for. With +3 readers over my contacts I can see to read at bout 35-40cm at most. What does this indicate? Hopefully I can keep increasing the distance.


svensont 03 Jun 2013, 18:47

Matthew,

Maybe you can try to buy OTC reading glasses, +3D and wear them over your contacts. Try to read in them being slightly beyond the point you see clearly/the blur begins. After some time you should start to see clearly, then again, increase the distance to be in the point of blur/clear vision. Wear the combination as much as possible before your eye exam and maybe you can get stronger prescription then.

When I was experimenting with plus glasses, I bought +2D reading glasses. At first, the blur was from 60cm, after 15min it was from 65cm. Then I got intrigued by this and decided to wear them more. So I was seating 75cm from the computer display and after 30min I started to see the letters clearly (but quite foggy). The next day I saw the display crystal clear from 75cm. At the end I could see clearly from 85cm, the next day it was 1m, and finally about 1.25m and I couldn't go further.


Matthew 03 Jun 2013, 18:06

Thanks svensont.

I currently have contact lenses with a slightly stronger prescription than my glasses (both eyes have -0.75 astigmatism, and I the right eye is up to +1.50 sphere). Since I have contacts, my optometrist really thinks I need ft wear due to my hyperopia but probably more because of my astigmatism (things look a bit distorted/hazy without my glasses, esp. when tired). I can see in the distance with my glasses over my contacts (see below post for glasses prescription), so if you add them together I can see reasonably well with about +2.75D which is quite strong for a teenager who only got glasses about a year ago? I would like this kind of prescription from an optometrist for ft wear. Is there anything I can do in the exam to get this result besides having a wet exam?


svensont 03 Jun 2013, 17:49

Matthew,

You can order glasses with stronger sphere, say +0.5 to +1 more and wear them full time. This in theory should make you myopic and it might be hard to walk in the blur. If you can't see clearly after few days/weeks then you probably can't do more. The best if you could make a dilated eye test, this should reveal if you have any latent hyperopia.

You can also order glasses with +2 more sphere power and use them for close tasks. Make tests - measure the distance from your eyes to a place when the blur begins at the beginning and after some days/weeks of using the glasses. This should let your eyes to relax, if they can. The disadvantage can be that you can create the symptoms of pseudo-presbyopia.


Matthew 03 Jun 2013, 16:05

Cactus Jack,

Thanks for your response. If I have latent hyperopia, is there any way I can get a stronger prescription in the exam? I'm not too keen for GOC. I just like thick plus lenses, and feel that my eyes can adapt.

Would I be able to see through my +1.25 lenses in the distance if I were not truly hyperopic to some degree? Because my near and distance vision is fine with them. Could this mean that I could get a stronger RX if I say that near tasks are an issue (I am a student, so this is true towards the end of the night with all the reading).

I would just like to bump up my prescription at least to +2.00

Thanks


John S 03 Jun 2013, 13:18

Eric,

If your accommodation muscles are weak, you need to compensate for the lack of muscle action by adding more plus for close work, not distance. The accommodation muscles come into play a lot more for reading than distance. But I would stay with the wet exam rx for distance.

As you increase the reading add, the focus distance decreases, and the focusing range also decreases (you have to stay closer the center point for clear vision). The normal center of focus distance usually prescribed is 40 cm. That can vary due to doctor preference, and the patient's needs. It is a very good starting point.

I agree that the symptoms you have described seem to point to an accommodation problem. Since the muscles are not cooperating, try adding enough external plus for reading to cause them to no longer need to work. Eventually they will probably get even weaker. There will be not be any accommodative focusing lag if there is no muscle action. With no muscle action the reading add should be a +2.50 for 40cm. Most younger people cannot accept that much. I was the exception to the rule.

The downfall is you have trained them not to work, so you will always need some type of reading correction into addition to the distance rx. Progressives or bifocals would be the best choices. For extended close work, standard SV lenses set for the distance you work at.

Have any of the doctors tried a stronger reading correction to see if there is any improvement?

It will be trial and error to find out what works best for you.


Eric 03 Jun 2013, 11:44

Hoerbie:

I can only say yes to the top question. Im very sensitive to light, a sunny day without sunglasses can often result in headache. Candles in my field of vision will be the end of the day. But that is probably a symptom for hyperopia as well?

Actually I have been to both an Orthoptist and Optician who claimed to be good at prism correction. I visited the optician first and he said that I should buy glasses with prism correction, so I did. After months of trying to adapt I gave up. A few months later I got in to an Orthoptist who did not see any reason for prism correction.

John:

Im familiar with those terms, and belive that both my optician and orthoptist have checked me for that. What I have been told is that I have weak accommodation muscles, but shouldnt that get better by increasing my rx?

I will definitely try stronger reading glasses. Do you think I should try an increase in lenses eventually as well? Maybe increase +0.25 to see if I can adapt to that and so on. Even though I now have the rx that the wet exam detected.


 03 Jun 2013, 11:36

http://www.fccfreeradio.com/?page_id=7874


Cactus Jack 03 Jun 2013, 08:50

Matthew,

You need to read up on how the optics of the eyes work. Latent Hyperopia is caused by the eye's ability to correct hyperopia using the ciliary muscle and crystalline lenses. After perhaps years of doing this correction, it becomes very hard for the ciliary muscles and crystalline lenses to relax fully. However, once the crystalline lenses are fully relaxed, that is it. They cannot relax further.

Hyperopia itself is usually caused by the eyeballs not growing quite as much as they should. The result is that the eyeball is too short for the very high plus power of the cornea and crystalline lenses and the images actually focus behind the retina. The additional plus provided by either the crystalline lenses or contacts or glasses move the focus point up to the plane of the retina. To actually increase hyperopia, it would be necessary for the eye ball to shrink, but there is no physiological process that causes that. If the eyeballs are going to change size, they can only grow which, if they grow too much, causes myopia.

Once your ciliary muscles and crystalline lenses are fully relaxed, additional external plus will only cause you to have the symptoms of myopia where distant objects are out of focus and blurry.

I suspect you are right that you developed latent hyperopia, but once you have solved that problem, additional plus in your glasses will just make your distance vision worse and will not cause an actual increase in your hyperopia. From that point on, if you want to wear higher plus glasses, you will need to consider GOC.

C.


Matthew 03 Jun 2013, 08:13

Hi all,

I have been a reader of eyescene for some time but have never posted. I'm an 17 year old male with some hyperopia and astigmatism, and I am really wanting to get stronger prescriptions as much as possible.

I first got glasses at 16, with the prescription:

Right: SPH +0.75, CYL -0.50 AXIS can't remember

Left: SPH +0.75, CYL -0.50 AXIS can't remember (I have oblique astigmatism)

I was told that I should wear them for close tasks, but not to be surprised if I found I liked to wear my glasses all the time due to the mild astigmatism correction. I wore them all day everyday. Within a under a year, I went to get my eyes re-tested and managed to make my prescription jump to the lenses which I wear now, that are:

Right: SPH +1.25, CYL -0.75 AXIS can't remember

Left: SPH +1.25, CYL -0.50 AXIS can't remember

I was instructed to wear glasses all the time, but this was at a big, commercial chain optometrist who quite frankly, just seemed to want to sell me some glasses. Which I suppose was lucky, since I am wanting to increase my prescription :) I lied during the test, but not beyond what was reasonable. I chose the green instead of red (something that I learned off eye scene before the test) and when the optometrist did the astigmatism test with the circle of dots, I chose the more distorted options. Nevertheless, when the optometrist did the cross check and put the final prescription in the trial frames, I could read all the lines. So while I exaggerated my vision problems, it was still found that I could see better with this prescription than without anything. I think that since I am getting used to looking through plus lenses, I am able to handle more and more plus, but I am unsure of the accuracy behind this. Perhaps I may be very latently hyperopic?

Is anyone able to tell me how I can keep my prescription going up? Have I been doing it consciously or am I actually hyperopic/astigmatic but it's just coming up in my late teens?

Thank you


Hoerbie 03 Jun 2013, 02:58

Eric,

your story sounds like mine. Questions:

-Do you squint a lot, if the sun is shining strong?

-Do you close one eye sometimes to see better? Please try to read with one eye, can you focus better?

-As a kid did you have problems in writing correct words or reading, oder did you have problems in fast ball games and school sport?

-If you see two objects, do you have problems in telling, which object is nearer?

The more questions you answer with yes, maybe you have some esophoria and need a prism correction, it has helped me a lot.

Problem is, that a lot of eyedocs and opticians are not familar with this problems, and a lot of them try to help only with reading-add, where prism could be the better solution.


John S 03 Jun 2013, 02:30

Eric,

If OTC reading glasses are available where you live, I would try getting a pair of +1.50 or +1.75. You will not be able to see distance while wearing them, so just look over the top to see distance. See if that relaxes you reading muscles, to get rid of the accommodation lag (switch faster between near and far).

You could also wear +3.25 or +3.50 bare-eyed, that would give you a break from your contacts. The problem with that is you don't have a way to have the correct distance correction.

Hopefully you get the idea of what to do. The stronger lens you use, the closer your viewing distance will be, and the less range you will have between too close and too far for clear focus. The stronger the lens that you can deal with for reading, the more relief you will give to your accommodation muscles.

When I was your age, I needed a +1.00 for distance, and an additional +2.00 for reading. The problem I had is called accommodative insufficiency.

What made my case unique was, most kids that have AI, also have a problem with eye convergence, I did not. I noticed my eyesight problem when I was 12-13.

I think you will learn a lot by searching those terms. Please report back with your results.


Eric 03 Jun 2013, 01:42

Im a male.


Eric 03 Jun 2013, 01:40

There is no history of diabetes in my family, and I do belive that I've been tested for diabetes for a few years back.

The funny thing John is that I sometimes feel that I am seeing great at all distances, but other times having a hard time to focus at distance. It could also be hard to just focus at my son when he is 4-5 meters away. This is especially a problem after close work. Thats way I still use the +0.75 glasses because I feel that ease the situation.

Insufficient tears, allergies or low humidity could be a reason. I did use Air Optix Night & Day in several years. Those you use 24/7 over a month. But for a year back my optician discovered that I had developed something he called GPC (Giant Pupillary Conjunctivitis). He recommended that I switch lenses to 1-day or month lenses.

Most of the 1-day lenses gave me dry and uncomfortable eyes during the day, but I've found one type that I like. That is Acuve TruEye. Since these lenses are very expensive I'm now using Acuve Oasys which I use during the day for a period of two weeks before I toss them. Since I got the new prescription I have been trying both of the two types. And I have had the impression of that things have been better with the 1-day TruEye lenses, but also been telling myself that this is only imagination.

Sitting in front of a screen for to long (1-2 hours+) gives me bad vision no matter what lenses I use. So I've learned to minimize my screen time as much as possible. I also should inform of that I have different types of allergies, such as gras, some wood sorts, cat and dog. But this dont bother me much, since it's a light version and I have meds for it. It is though high allergi season in Norway now.

Anyway, after I got the new rx things have been feeling much better at close distance. I can have my son up close without feeling the urge to close my eyes. And that is a big relief. But the symptoms is still there. Especially that I get blurry vision after a period of reading. And I do belive that I'm good at taking both small og long breakes during the studying.


slit 03 Jun 2013, 00:22

Re: eric's case

I'm just wondering if there can be changes in vision based on hormonal changes, body fluid activity etc. I guess Eric has not mentioned his/her gender though.

Anyone knowledgeable about this please enlighten us if the body changes such as monthly menstrual cycle etc affect vision?


Soundmanpt 02 Jun 2013, 23:18

Presby

I tend to agree with you that it is somewhat exaggerated, but it does at least give at least some insight about someones vision needs even though it is not perfect. Not sure why they couldn't get it a bit closer.


Cactus Jack 02 Jun 2013, 21:23

Eric,

Like John S, I am concerned about the changes in your vision you mentioned in your post. There can be a number of causes including diabetes, but there can also be some much less serious causes such as insufficient tears, allergies, very low humidity, etc. I would like to suggest that you consider ordering some low cost glasses on line and try wearing them for a while. You have almost enough information to order from Zenni Optical and we can help you with the rest. I think you need to experiment a little to isolate the problem and the cheapest way to do it is on line. Many of us use Zenni because their quality seems to be very good and their prices for simple prescriptions and inexpensive frames can be as low as about US$7,00 plus shipping.

Please do not try to order any glasses yet, we need to chat a little more before you do that.

One question about diabetes. Is there any history of diabetes in your family?

By the way, if you would like to contact me privately, my email is cactusjack1928@hotmail.com

C.


Presby 02 Jun 2013, 19:55

Soundhampt. i used the german simulator and it seems the simulator vison is much worse than what I actually see. Prescriptionj is +1.00 -.50 axis 90 add 1.75

+1.25 -.50 axis 75 add 1.75

I can still operate without glasses if I desire, meanwhile my partner at -3.00 -3.50 with a similar add is hopeless without glasses


John S 02 Jun 2013, 17:12

I should have said, That can cause a shift in your rx.


 02 Jun 2013, 17:09

Eric,

Everything is based on your distance rx. If that is ok, it is a lot easier to determine the reading add. Can you see distance ok the new +1.75 lenses? Do you also notice a difference in your distance vision changing during the day, or just close vision?

There is always a possibility that there is another underlying problem. Have you been checked for Diabetes? That can cause a shift is your rx.

C.J. is correct about have your eyes dilated. Sometimes it takes a couple of doses before your muscles will fully relax.


Eric 02 Jun 2013, 10:57

First of all, thank you for a good response.

1. Full time student, studying to become an electrical engineer (got two years left from a masters degree)

2. Live in Trondheim in Norway.

I am very interested in any suggestions you might have.

About the adaption to the new lenses my hope is that things will get better during the summer school break. The vacation starts on wednesday. The strange thing about the new lenses is that I have good and bad days. Some days are more comfortable and clear then others. It can also vary during the day.

Would you recommend me to continue with these lenses (in that case with or without the reading glasses?) or should I switch to glasses which would correct my astigmatisme as well?

And what should I do when I eventually have adapted to this prescription?

Again Jack, I'm very grateful for your advice and help.


Cactus Jack 02 Jun 2013, 08:22

Eric,

You probably have more hyperopia than indicated by your recent dilated (wet) eye exam. Please don't get me wrong, you did the right thing by getting a wet exam.

The problem is that you have been using your ciliary muscles and crystalline lenses to compensate for your hyperopia for so long that they they have become somewhat fixed and have difficulty relaxing. While a wet exam is very helpful in that regard, the 20 to 30 minutes it takes for the dilating agent to work is simply not long enough for full relaxation. Full relaxation can take weeks or months of wearing glasses or contacts with adequate plus sphere. It is common for newly discovered hyperopes to be given a bit more plus than they need at the moment to speed the process. You may have read posts where a person with hyperopia gets new glasses and initially, their distance vision is blurry. Then over a few weeks it clears up as the ciliary muscles and crystalline lenses gradually relax.

I think you are also having two additional problems that are confusing and complicating the situation. The most obvious of the two is uncorrected astigmatism, which is corrected by the cylinder and axis part of your prescription. I agree with your Eye Care Professional that the small amount of astigmatism you have is generally not worth trying to correct with toric contacts. They would probably be more trouble than they are worth. However, in your situation, even very small amounts of uncorrected astigmatism often cause surprising discomfort. The reason is that while you CAN correct significant amounts of hyperopia using your ciliary muscles and crystalline lenses, you have absolutely NO ability to correct astigmatism without external help. Uncorrected astigmatism makes it impossible for your eyes to focus properly, but unfortunately your brain does not know that and it constantly tries to focus the slightly blurry images on your retina. The fact that you have a significant reading workload, makes the problem that much worse.

The other problem I think you are having is that your ciliary muscles are having trouble responding to focusing commands from your brain. I know this sounds strange, but the clue is that your are finding the reading glasses over your contacts to be helpful. The problem may be that your ciliary muscles are so used to using part of their focus range to correct your vision that they have not had enough exercise to stay in condition. For their size, the ciliary muscles are the strongest, hardest working muscles in the body, but like all muscles they need to be exercised throughout their full range of motion. You could also be developing early presbyopia. The notion that presbyopia does not develop until after 40 is a myth. Presbyopia, which is the stiffening of the crystalline lenses, actually starts in childhood, but typically does not become a problem until the late 30s or 40s, but it can happen at any age. Often, hyperopes seem to develop presbyopia earlier than is typical.

I have some suggestions that you might find helpful, if you are interested. Before offering them, I need the answers to a few more questions.

1. What are you studying and are you doing post graduate work?

2. Where do you live?

C.


Eric 02 Jun 2013, 06:24

Hi,

I've been reading in this thread for a long time. And I am very glad I found it, it has providing me much information. Thank you all.

I have for many years trying to get a grip of what my problem is. And after visiting many opticians complaining about tired eyes, headaches, and eye strain while doing close work I think I have found the answer - latent hyperopia. Blurry vision at distance after close work is also a frequently situation.

I am a 24 year old student, with a very hectic day being a parent to a 1 year old on top of very demanding studies. I have been complaining about my symptoms since I was 15-16 years old.

The last 7 years I've been using contacts with +1.00 correction on both eyes. And the last 5 years reading glasses on top of that with +0.75 to ease my symptoms while working with my studies.

After getting a wet exam at an eye doctor recently he found the following:

R +1.75 -0.50 171

L +1.75 -0.25 14

I am now using contact lenses with +1.75 and I have been doing so for over a month now. I use the reading glasses (+0.75) on top when doing near work but I still have the symptoms. I also experience some blur from time to time on middle distance.

It's though important to mention that I am in the middle of a period with many exams at school and a period where my eyes have to work a lot.

So my question is, how long should it take for my eyes to adjust to this new prescripton? Do you think I have even more plus in my eyes than the wet exam can uncover?

My optician also says that I have a astigmatisme of -0.25 on both eyes (even though my wet exam said somthing different) and that it is so little that it is not worth correcting with lenses/glasses.


Nicky D 02 Jun 2013, 05:27

Cactus Jack and Soundmanpt

Thanks very much for your replies - really interesting. I tried those simulators which are great, tho it seems like her vision is much worse than I expected.


Soundmanpt 02 Jun 2013, 01:13

I was a little surprised that when I told several doctor friends about those simulators they were not aware of them but now they use them to show parents just what their son or daughters eyesight is like after an eye exam. It is very helpful when they are getting their first glasses.


Soundmanpt 02 Jun 2013, 01:07

Cactus Jack and Nicky D.

I know of 2 that are pretty easy to use and your correct one of them is in German but still should work rather easy. You may want to change it depending where your at to be 20/20 or just leave set at 6/6.

optiker.@/simulator/

and the other one is:

billauer.co,il/simulator

(you will then click on "blur simulator, what you see without your glasses"

These are both pretty good and should at least give you a pretty good idea of what her vision is like without her glasses.


Cactus Jack 01 Jun 2013, 16:52

Nicky D,

She could probably watch TV for a short time without glasses, but frankly it would be a lot of work to keep images in focus. She would actually be primarily using only her right eye because it has the least astigmatism. It would take a great deal of work to read for more than just a few minutes and the smaller the text, the harder it is for her to read.

Vision actually occurs in the brain and the eyes are merely biological cameras. The brain wants to use the images from both eyes to construct a sharp 3-D image, but if one of the images is substantially better than the other, it will select the best image and ignore the other, blurry image.

It is very difficult to try to explain how the eyes and optics (optical physics) work in a few short sentences to a person without a technical background. At one time, there was a website in Austria, if I remember right, that would show images of what a person sees who needs glasses. The site was in German, but it was pretty easy to work and in that case, a picture was worth 10,000 words. If that site still exists, perhaps another member can help out with a link.

If you REALLY want to get a better idea of her vision without glasses and are willing to spend a small amount of money, we can tell you how. Glasses and contact lenses cancel out or neutralize a person's refractive error to where their prescription with glasses is as close to 0.00 as possible. If your refractive error is actually 0.00 (frankly doubtful) you could order some very low cost glasses with the opposite prescription. If she were nearsighted, you could get an idea of how she sees without glasses by trying on a pair of over the counter reading glasses, but that won't work if a person is farsighted as is your GF.

In your own situation and at your age, it would be a good idea to consider an eye exam, even if you are not having any apparent vision problems. A good eye exam does more than just check your vision. The eyes are "windows" into the body and many "silent" or hidden health problems are first discovered during an eye exam while they are still easily managed and before they have done any permanent damage. A through eye exam, preferably by an ophthalmologist is well worth the money for the peace of mind, but an exam by an independent optometrist or optician is almost as good.

Please let us know if we can help with any of this.

C.


Nicky D 01 Jun 2013, 07:54

Cactus Jack,

Thanks for that. So how well could she read or watch tv without glasses/contacts? If she doesn't have her contacts in,she sometimes watches tv for a bit without glasses but then usually puts them on. I don't think I've seen her reading without them.

You asked about me. I am 37. I am a bar manager. I think my eyesight is pretty good but I admit I haven't ever had a proper eye test at an optician (just at school!).


Cactus Jack 31 May 2013, 23:32

Nicky D.,

It is very difficult to describe how another person sees without their glasses or contacts to another person. The +2.00 and +2.25 are called the sphere correction. The + means that she is farsighted and distant objects will tend to be a little small and blurry, The closer things are, the blurrier they get. She probably has the ability, at least for a few more years to use some of her built in close focusing ability to clear up some of that and the add offers a little more help in focusing close.

The thing that messes up clarity of vision at all distances is her astigmatism as indicated by the Cylinder correction. The +0.25 in the Right eye only messes it up a little, but the +1.25 in the Left eye is pretty significant and is probably the cause of her comment about her vision in her left eye. Unless there is some other problem, she should be able to see well with glasses, but maybe not so well with contacts for her left eye unless they are torics and maybe not so well even with them. Torics are not for everyone with astigmatism and are often hard to prescribe and fit.

At 42, her vision should be stable, but over time she may need an increase in her + sphere, but maybe not very much. She will almost certainly need and increase in the add as she develops more presbyopia, but it probably will not exceed +2.50 unless she likes to do a lot of close focusing.

May I as you a few questions?

1. Your age?

2. Your occupation?

3. Do you need or wear vision correction?

4. If you do, what is your prescription?

5. If you don't, when was your last eye exam?

C.


Nicky D 31 May 2013, 21:43

Hi

Can you tell me how well/badly my girlfriend sees? Her latest prescription is R +2.00, Cyl +0.25, Add +1.00 and L +2.25, cyl +1.25, Add +1.00.

She said this was an increase on her last prescription (I think by about +0.25 or 0.5 and the Add bit was new). How much worse her eyesight likely to get? She is 42.

Also, she says her vision in her left eye has always been bad even with her contacts/glasses. Why would this be?

I don't mind, i'm just really interested but don't want to ask too many questions about it as haven't known her that long!


Cactus Jack 20 May 2013, 10:27

Malley,

I am very glad you decided to get an eye exam. When a person has only a small amount of refractive error, it is very difficult to estimate that error using the crude tests we suggested. In your situation, you have two separate problems one with your distance vision and the other with close vision, but the small distance vision problem contributes a bit to your close vision problem.

Almost everyone in your situation thinks they have "perfect" distance vision simply because they have no way to make any comparison. Usually, the way they discover that their distance vision is not as good as it could be is that they start having problems with reading, using the computer, or more often these days, reading tiny text on cell phones or tablets. The reason is really simple, if you understand how vision works.

Vision actually occurs in the brain. The eyes are merely biological cameras. The brain has amazing image creation, processing, and correction capabilities IF it knows what something is supposed to look like. Proof of this capability occurs whenever you dream. You brain creates images with your eyes closed. Even people who have large refractive errors and have blurry vision without correction dream in sharp images. The problem with uncorrected small refractive errors is that they make the brain have to work harder to process the images so you see "clearly".

Right now, you could probably get by with just wearing some +1.25 OTC readers. They would help with your close vision, but do nothing to help with your basic refractive errors. However, you do seem to have "early" onset presbyopia and it will almost certainly increase, probably faster than you expect as you gradually loose the ability to contribute focusing power using your ciliary muscles and crystalline lenses. However, as I mentioned in my previous posts, it will never go higher than +2.50 to +3.50 depending on how close you like to read.

OTC readers are not the best solution because they do not relieve your brain of the extra visual workload for both distance and close vision. If you decide to get glasses that correct your refractive error for distance you need to know that you will likely experience another common phenomenon. You will think the glasses have suddenly made your distance vision worse without your glasses, but that will not happen instantly. It will take a few days or maybe a week. Your initial reaction to the glasses will probably be that your vision is better with the glasses, but not by much. The reason for this is that your brain will still be correcting the slightly fuzzy images from your eyes without your glasses. If you wear your glasses pretty much full time for a week or so, your brain will discover that the extra work is no longer necessary and when you take off your glasses, your distance vision will appear fuzzy without them. If you stop wearing your glasses, your brain will go back to work correcting the images, but it may take a few days and it may deliver some complaints with headaches. Essentially, the glasses will have become labor saving tools and you will prefer wearing them to not wearing them.

Will you become dependent? It depends on your definition of dependency. It is very unlikely that you will ever become absolutely dependent on glasses for useful distance vision. Your distance vision has likely pretty much stabilized, but it could change a little over time. What will change is your ability to focus close without some external help. That has already begun, but at least the amount of help you will ultimately need is limited.

It is very common for people to become "dependent" on tools that make work easier and more productive. Some years ago, I bought an inexpensive cordless electric screwdriver thinking that it might be handy to have. I quickly discovered that it was a much better way to drive screws than using a standard screwdriver. Now, I keep it charged and ready for even the simplest task. I still know how to use a regular screwdriver, but I much prefer the cordless electric. I guess I have become "dependent" because I LIKE not having to work a hard to install a screw. Same thing with glasses. You may come to LIKE seeing effortlessly by wearing glasses.

A couple of questions and comments:

1. Have you ordered any glasses?

If you have not, you might want to consider ordering some inexpensive glasses online. We will help you if you want to try them.

2. Where do you live?

That can affect the total cost. Depending on the frame you select, shipping can cost almost as much as the glasses with neither one being very expensive. Ultimately, I think you will want to get either bifocals or progressives, but prescription glasses for distance and for reading can sometimes be very handy, particularly if the cost is low. Many of us like Zenni Optical. Quality is good and the cost is very reasonable.

Please let us know how we can help.

C.


Malley 20 May 2013, 08:49

I took your advice and went for an exam. I told the whole story to the Dr, and she did the thing with me looking at the letters through the lenses. To me they didn't make much of a difference. She then did the same with the close up small print card. She says I can use some help for close AND far! The far is -.50 -.25 180 and -.25 -.25 020. For close she said she shows +1.25. Not sure what that all means. She said I could go for 1 pair distance and 1 pair close, or bifocal. Seems strange to me as I thought my vision was ok. Can I use otc readers? Will I eventually NEED these to see clearly? She said to come back in 6 months.


Cactus Jack 08 May 2013, 12:41

OnLooker,

Time, tide, and presbyopia wait for no man - or woman!

I saw an ad the other day for sewing needles with a very tricky eye arrangement that allowed for automatic threading, possibly even with your eyes closed. The eye is sort of a maze like arrangement with a slot in the side. You just slide the thread up the side of the needle, the thread enters the slot, gets captured in the maze, and winds up in the eye of the needle. I would not tell her about it. It would be a nice gesture, but the plus focusing help has other benefits than just needle threading.

I saw the needles on line, but they may not be as totally useful as the ad said. There is nothing to keep the slot from capturing one or two of the threads of the cloth being sewn as it goes through the cloth. Maybe not the proverbial "better mouse trap" for the presbyopic sewing set.

C.


Cactus Jack 08 May 2013, 12:21

Malley,

Please remember that these are crude tests that are only estimates.

It appears that you have little or no astigmatism. You may have a little refractive error, but this test of simulating a little myopia by using the reading glasses of a known power is just not that accurate. If you had no refractive error, the print should have just become fuzzy around 31.5 inches, but the difference between that and what you measured is nothing to get excited about.

You are beginning to develop a little presbyopia, which is not in the least surprising. The clue here is that with the +1.25 readers, the text was fuzzy closer than 16 inches. With 0.00 (NO) refractive error, it requires +2.50 to focus at 16 inches. The glasses supplied +1.25 and you effortlessly supplied the other +1.25. However, If you were still able to effortlessly supply +2.50 to read at 16 inches, the text should have been clearer a bit closer than 16 inches, 10.5 inches to be exact.

With the developing presbyopia, your ciliary muscles are having to work harder to focus. The +1.25 readers do some of their work for them and when you wear them, to read, the ciliary muscles can relax some. For their size, your ciliary muscles are the strongest, hardest working muscles in the body. You are not weakening your eyes, but by doing some of their work for them, the glasses can help the ciliary muscles become de-conditioned. The effect of that is that presbyopia will APPEAR to progress more rapidly, but it actually is not. Presbyopia only affects the crystalline lenses and it actually started many years ago, but it is just becoming noticeable. The practical effect of all this is that your arms will gradually grow too short and/or you will need more reading help with stronger reading glasses. However, for practical purposes, you will never need more than about +3.25 unless you like to read or focus very close.

You could have a little latent hyperopia which is easily masked and corrected by your ciliary muscles and crystalline lens, but presbyopia will ultimately reveal that also.

If you have not had an eye exam in the past few years, I would suggest considering a dilated (sometimes called a wet exam) by an ophthalmologist only for the purpose of establishing a base line of your eye health. You are approaching an age where health problems often begin to appear that are easily "nipped in the bud". Because the eyes are windows into the body, lurking health problems in other parts of the body are often detected during an eye exam. The only disadvantage to a dilated eye exam is that you will not be able to focus close for several hours after the exam. Everything will return to normal after the dilating agent wears off.

Hope this helps,

C.


OnLooker 08 May 2013, 10:58

I loved a moment and i wanted to share it with you people:

My wife, eventhough a +1 with proper prescription glasses has always managed to make it without glasses for close up work like reading or threading a needle unless she is tired or reading for too long. Yesterday she was about to thread a needle and she, out of the blue, called on our daughter to do it for her and then she looed at me and asked for my +1.5 readers! She pu them on to do it and kept them while she was sewing... I think we're there (by the way she's 39).


Malley 08 May 2013, 08:40

I was away for a few days, and just now had time to try to do this. I don't think the astigmatism test shows any. If I did it right, print came in to focus about 16" and out at 30".

When I put her glasses on, again, they really don't make any difference in my close clarity. But when I take them off IF they are on for at least 15 minutes or so print is still readable but noticeably fuzzy. Am I unnecessarily weakening my eyes?


Cactus Jack 02 May 2013, 23:24

Malley,

There are several elements involved in how well you see, but the most important ones are near or far sightedness for distance (your sphere correction), astigmatism ( your cylinder and axis correction), and presbyopia (the Add if any in a prescription). Perfect vision is very rare, but often the need for correction is so slight that while not perfect, it is good enough. With a couple of simple tests we can get a pretty good idea of how well you actually see and can make suggestions if an eye exam would be worthwhile.

The first test needs to be done on your computer for astigmatism. This test will not determine your actual astigmatism, but it will show if astigmatism is present.

1. Do a Google Search for Astigmatism Test.

2. Choose one of the tests and following the instructions. The test consists of a series of closely spaced lines of equal width and blackness that run in different directions. If you do not have any astigmatism, the line will appear equally black. If you have astigmatism, some lines will appear very clear and black and others will appear a little fuzzy and somewhat gray.

3. An eye exam is required to determine your actual astigmatism and the corrective cylinder and axis.

Astigmatism messes up your ability to read text and see small objects clearly at all distances.

The second test is to determine if you could use some distance or near vision correction. Svensont described the basic test, and I will describe it again in slightly different words.

For this test, you need some non prescription reading glasses of known power. I typically suggest +1.50, but your wife's +1.25s will work if they ARE NOT prescription or do not have any cylinder correction in them for astigmatism. I suggest doing this test first thing in the morning before you done any significant reading so your ciliary muscles will be as relaxed as possible.

The purpose of the test is to use the glasses to make you a little nearsighted by a known amount and then measure the amount of nearsightedness actually produced by the reading glasses. You will need the reading glasses, a newspaper or book will typical small print, and a rule or tape measure that is at least 1 meter or 36 inches long.

1. in normal room lighting, put on the reading glasses and hold the book or newspaper about 12 inches or 30 cm from your face.

2. Slowly move the book or newspaper away from your face. It is possible that the text will start a little blurry, get clear and then start getting fuzzy again.

3. Measure the distance where you just begin to detect the text getting fuzzy around the edges.

4. Repeat the test 3 times and average the distance.

Tell us the results of these tests and we can make suggestions regarding additional tests to better define your visual situation. If there is any part of these tests that you do not understand or cannot do, please let us know.

We need the results of these tests to determine if you have a small amount of myopia, a little hyperperopia - with the possibility of some latent hyperopia or some astigmatism. We may also get some clues if there is a bit of lurking presbyopia.

C.


svensont 02 May 2013, 09:55

Malley,

You can do a simple test. 1.25D glasses will have the effect as being a 1.25D myope, which means that everything beyond 0.8m or 31.5 inch will be blurred. Put on the glasses and measure the distance where the text in a newspaper starts to be blurred. Repeat this test after wearing the glasses for 1/2-1h.

We will know then if your eyes are starting to relax and an approximation of your refractivity error.


Malley 02 May 2013, 09:44

No, distance is all fuzzy.


svensont 02 May 2013, 09:17

Malley,

Have you seen an improvement in your distance vision after wearing the glasses for 1/2 hour? Or maybe do you see clear the distance with them?

If you saw a difference after only 1/2 hour and in only 1.25D glasses, then I think stronger glasses would make bigger difference.


Malley 02 May 2013, 09:11

Cactus..what tests do you suggest?


Malley 02 May 2013, 09:10

Interesting responses.

I never have worn glasses, nor felt the need for them,but have always been intrigued by them. I am in outside sales.

When I tried my wife's, that are +1.25 I only used them for a few minutes. They really didn't make much of a difference at all. Per what Svensont suggested I tried them for about 1/2 hour this morning, even forgetting that I was wearing them. When I took them off I could still read OK, but not quite as clearly. Does that mean they did relax the muscle? What if I used stronger glasses..would that have made a bigger difference?


Cactus Jack 01 May 2013, 20:32

Malley,

The spell checker is working to well. The word reconditioned should be de-conditioned in my earlier post.

C.


Cactus Jack 01 May 2013, 20:29

Malley,

Presbyopia is much easier to "induce" than myopia, but before we talk about that, lets talk about presbyopia itself.

The term presbyopia means "old eyes". Presbyopia is the inability to use your crystalline lenses to focus close. It is usually caused by the protein, that make up the crystalline lenses in your eyes, becoming so stiff that the ciliary muscles can no longer squeeze the lenses and increase their optical power to allow you to focus closer than about 20 feet or 6 meters. Presbyopia can also be caused by the problems with the ciliary muscles or their control system.

The idea that presbyopia doesn't happen until around 40 is a myth. Combinations of presbyopia and hyperopia (far or long sightedness) can create interesting vision problems and often cause early onset of presbyopia and myopia or nearsightedness can often delayed onset of presbyopia.

Inducing presbyopia is very easy. Just let or cause your ciliary muscles become weak and reconditioned. The ciliary muscles are very tiny muscles in your eyes that can adjust the focusing power of your crystalline lenses. The crystalline lenses and ciliary muscles make up the auto-focus part of your eyes. For their size, the ciliary muscles are the strongest, hardest working muscles in the body.

All you have to do to cause "presbyopia" is wear glasses that do the focusing for close so your ciliary muscles do little of no work. You can start by wearing reading glasses as often as you can when reading or using the computer. If you have perfect 20/20 or 6/6 vision for distance (frankly doubtful), you can calculate the power of the glasses you need to focus at various distances by using the formula 39.37 inches / distance from your eyes to the target in inches or 100/ cm if you prefer metric. The result will be the lens power you need to focus at that distance. For example, if you like to read at 16 inches or 40 cm, you need +2.50 glasses to make sure your ciliary muscles don't have to focus. If you like to read closer, you will need stronger lenses of say +2.75 or +3.00. If you work at it, you can decondition your ciliary muscles in a few months and soon get to the point where you will need them to focus close. Ultimately, you will probably need bifocals, trifocals, or progressive lenses in your glasses for full time wear.

svensont made some excellent comments and between his and the above you may get an idea of what is involved. Here are a couple of questions that may help us provide more specific suggestions.

1. Do you presently wear any vision correction?

2. Have you had an eye exam, recently?

3. What is your occupation?

We can suggest some simple tests to get an idea of your vision. If you want to try them, please let us know.

C.


svensont 01 May 2013, 19:35

Malley,

If you have some latent hyperopia, then by wearing reading glasses your eyes will start to relax and after some time you should see clearly through them and become dependent on them.

If you are not a latent hyperope, then by wearing reading glasses you will cause cilliary muscle deconditioning, which will create the effect of pseudo presbyopia, so you will need glasses for close. The fastest way to achieve that is to wear 2.5D glasses, that should turn off your accomodation.

You can make a test, wear reading glasses with known power and measure the distance when the text is starting to get blurry. Wear the glasses for 20-60 min or longer and repeat the test. Then calculate 1/distance in m to know the diopters. You should see if your eyes are starting to relax.

What power are your wife's glasses?


Malley 01 May 2013, 18:49

I read about induced myopia and how hard it can be to do, but what about presbyopia. I am 32 and my wife just got reading glasses, likely brought on by her smart phone usage. I tried her glasses although I don't need them for close, but they do make the print clearer. If I wear them will I become dependent on them? If so, how long would that take? If I wear them all the time will I become dependent on them full time?


lazysiow 30 Apr 2013, 14:27

useful red/green chart for testing. The colours should be about the same but if you see green better you need stronger plus for reading, and red is for minus

http://imageshack.us/photo/my-images/51/visionexpress.png/


Soundmanpt 30 Apr 2013, 10:59

fiona

In looking back I found your post from when you got your glasses and you were actually prescribed a weak prescription for bifocals. But understandably you only got single vision glasses since your distance part was very slight. According to you it was only -.25 and +.25 which actually cancels each other out with some cyl and you did have that in the glasses you ordered. It looks like now you will be needing an increase for distance as well as your reading add increase. Full time wear will likely be recommended when you get your new glasses.


SC 29 Apr 2013, 23:59

LT Lurker,

I don't know my wife's current Rx. She has mild hyperopia but only has a reading Rx - at a guess I'd say +0.25 in one eye, +0.5 in the other add +1 - so really +1.25/+1.5 reading glasses. Seems to have no problem with distance or middle distance.

Interesting that your wife has headaches - I never had headaches until I got a distance Rx!!! When I got the glasses, I tried to carry on wearing them as I would reading glasses, but within 2 weeks the headaches were terrible and was forced to wear all the time, even though they really made no difference to distance vision.

This lasted about 9 months. Now I no longer have to wear them full-time, I don't get headaches, but I just can't see!


fiona 29 Apr 2013, 10:11

I haven't posted recently but have been gradually noticing that my reading glasses don't always seem to be strong enough for me any more. They are great for the computer but basically don't work too well for anything closer or smaller. I am going to book an eye test when I can find time as I am pretty sure I need more help for reading. I am also struggling to do things like watch tv, which is a few metres from where I sit - I don't know if that distance classifies as middle distance but I don't seem to be able to see it clearly with either my distance or reading glasses.

I seem to have become a lot more dependent on my glasses compared to when I first got them. Things like: the keyboard; preparing and eating food; washing dishes and putting on makeup are all a blur without my glasses now. The other day I tried to thread a needle but had to give up as I couldn't see the eye of the needle or the end of the thread no matter how hard I tried to focus.

What worries me is that I haven't even had these reading glasses for a whole year yet, although the optometrist did say that my eyes could get worse. I just wasn't expecting it to happen so quickly.


Soundmanpt 28 Apr 2013, 08:55

LT Lurker

I really doubt that an ECP would write a prescription for your wife to get glasses and then turn around and tell her that she didn't really need to wear them? Sounds more like he / she told her that she didn't really need to wear them all the time. Something like only hearing what she wanted to hear. And of course something else she likely ignored was that when she was told to return in a year or two is usually followed up with unless you are having difficulty. Meaning if your getting headaches and your glasses don't seem strong enough you should return even sooner. Now of course her eyes have no doubt gotten somewhat worse to where she probably should be wearing her glasses much more often and they now probably need changing as well.

You said she does at least have an eye appointment made. She won't be hearing that "she doesn't need to wear them" on this trip.


Cactus Jack 28 Apr 2013, 07:25

LT Lurker,

Vanity and denial are very powerful forces. They can overcome a lot of pain. The idea that her vision has changed or she needs to wear her glasses is not even in the realm of possibility, because the ECP said she didn't HAVE to wear them and also said he/she wanted to see her in a year or so. That means 2014 or preferably 2015 doesn't it? It is very likely that the ECP would get very upset if she showed up even hours before the specifically authorized time. The very last thing you want to do is upset your ECP.

It is very important to understand that her vision is NOT causing her headaches. They are obviously being caused by a deficiency of Acetaminophen, Ibuprofen, or Aspirin which is easily corrected.

Her mind is made up. It is best not to try to confuse her with the facts. You might be able to get quantity discounts is you buy by the case.

C.


Cactus jack 28 Apr 2013, 06:39

Carlos,

Like many others, you are a bit farsighted with enough astigmatism to be noticeable if you do a lot of reading or work a lot with a computer display of some sort. I suspect that you may also have what is called latent hyperopia (farsightedness) which means that it is possible that a significant part of your hyperopia is still hidden.

Hyperopia is generally caused by a mismatch between the length of your eyeball and the total power of your eye's lens system. In the case, your eyeball is just a little bit too short. Nearsightedness or myopia is caused by the eyeball being a little bit too long. Unlike myopia, you have the internal ability to correct quite a bit of hyperopia by using some of the resources in your auto-focus mechanism which consists of your ciliary muscles and your crystalline lenses. That takes place without your even being aware of it, until presbyopia starts creeping up on you, just as it does for almost everyone else.

The idea that presbyopia is no factor until around 40 is a myth. Presbyopia is caused by the gradual stiffening of the gelatin like protein that makes up your crystalline lenses. Most children have crystalline lenses that have the consistency of gelatin dessert and the ciliary muscles can easily provide +10 diopters or more of accommodation (focusing) range, which is why you often see young children effortlessly reading or coloring with the book very close to their face. As you get older, the protein of the crystalline lens gets stiffer and harder to focus, the result is that your accommodation range gets reduced. If you have hyperopia, some of the available accommodation range gets used up in correcting the hyperopia, which leaves less available for focusing close.

If your ciliary muscles and crystalline lenses have to constantly add extra plus to enable you to focus even at distance and often have done so for years, they get to the point where it is very difficult for them to relax.

It is possible that you have reached the point where your ciliary muscles can no longer easily squeeze your crystalline lenses to supply the extra plus you need and you need external help. However, you need to be aware that it may take weeks or months for your ciliary muscles and crystalline lenses to fully relax. Your glasses provide the extra plus you need to focus properly and the more you wear them, the faster that relaxation will occur. It is very likely that you will need more plus in your glasses in what seems to be a very short time, once the process starts, but rest assured that it will stabilize. Also, don't be too surprised if you need focusing help for close work sooner than you think. It often happens to people with latent hyperopia.

The mild astigmatism you have, as indicated by the 2nd and 3rd numbers is caused by slightly uneven curvature of the front surface of your cornea. The problem with astigmatism is that affects your ability to focus at ALL distances and you have no way to correct it internally, it must be corrected using external lenses or sometimes by surgical procedures in severe cases. Astigmatism changes very slowly, if at all, but low astigmatism is very hard to refract accurately because the exam for astigmatism requires your participation. I am working on some tips to help you help the examiner get it right.

I hope you find this long winded explanation useful. Just remember that millions of others have experienced similar effects and the very best solution is to wear your glasses full time and if you begin to notice any changes, see your Eye Care Professional for a new prescription. You might also want to learn how to order low cost glasses on line. Depending on where you live, the savings can be substantial and you will probably go through several pairs of glasses over the next few years. Also, look back through the many posts on the Hyperopia and Presbyopia related threads.

C.


LT Lurker 28 Apr 2013, 02:10

Hi SC, more interesting information, did you mention your wifes prescription?

My wife is experiencing headaches every day and is taking painkillers, she has said she is going to schedule an appointment pretty soon rather than leave it until the end of the year.

She has a prescription for which she was advised two years ago that she could do without her glasses if she really wanted to and she has done.

Now it looks as if she will have to give in as she says the headaches are extremely painful.


Carlos 27 Apr 2013, 06:31

OD: +1.00, cyl -.25, axis 160

OS: +1.00, cyl -.50, axis 15

Thanks for any explanations--Carlos


Cactus Jack 26 Apr 2013, 21:39

Carlos,

It wold be helpful if you could provide your complete prescription.

C.


Carlos 26 Apr 2013, 21:25

Got a little surprise last week. Had been having some difficulties focusing ----thought maybe I was a little nearsighted. Went to the eye doctor and came away with a plus lens prescription. Apparently the focus problems were caused by farsightedness. Am 32 years old and have never worn glasses---sort of intrigued as to why farsightedness would now show up. Am supposed to wear the glasses full-time.


Melyssa 26 Apr 2013, 12:34

Revolver,

How did you know the readers (black only) were dollar-store ones? And red drop-temples are so Wednesday; it's large, sky-blue top-temples at this moment. :)


Revolver 26 Apr 2013, 12:25

Gee, Melyssa, you are making quite a fashion statement. Would love to see you wearing your red drop temples (or any other in your collection) with dollar store halfeyes! LOL.


SC 24 Apr 2013, 19:52

Clare,

Seems to vary but age is not on his side. It went in this order for me:

fine print / dimly lit (almost immediately)

bedtime reading (almost immediately)

writing (you can't stretch your arms to write!) [6 months]

reading books [9 months]

computer [18 months]

If I wore the glasses for reading or writing then I'd have to wear them for computer and I'd also use them for the computer when tired (and I'd also adjust the resolution so I didn't have to wear them!). Gave in at next prescription.

My wife has worn for just over 18 months and has just turned 47. She is more of a reluctant wearer (doesn't want to be dependent) but she rarely reads without, and I notice that after 12 months they are on for IPAD, writing texts, but occassionaly will read a magazine for 10 mins without


Melyssa 24 Apr 2013, 10:35

Cactus Jack,

Thank you for the explanation. Actually, some of the screens (mainframe work) have dark backgrounds, while for web work I have white backgrounds. Either way, I see just fine in the red drop-temples I have on now. :)


Cactus Jack 24 Apr 2013, 10:27

Melyssa,

Another factor when you are using a computer, is that you are looking into a light source which is bright enough to cause the pupils to contract some and improve your "depth of field". Almost all other visual activities use reflected light, which is of lower intensity by the time it reaches your eyes, but it still can be bright, such as in your office environment.

C.


Melyssa 24 Apr 2013, 06:54

Ever since I obtained reading glasses, I have needed them only at home, reading in not-so-bright light. At work, on the computer, I have never needed readers as (1) I have good overhead lighting, and (B) being of high rank I have a window cubicle. This is why I use half-readers in conjunction with whatever regular glasses I'm wearing when reading at home (and to save zillions of dollars on bicycle-focals).


Cactus Jack 23 Apr 2013, 15:38

Clare and Andrew,

In bright light, your pupil closes down to regulate the amount of light entering the eye. This has the same effect as closing down the iris (selecting a higher f stop) on a high end camera lens or looking through a pin hole or a button hole. The smaller aperture reduces the total light and at the same time in increases the depth of field (range of useful focus) of the image on the retina. The practical effect of the brighter light is to focus an otherwise out of focus image, without the use of a supplemental lens.

You may have noticed that eye exams are done with reduced lighting, The idea here is that the low light level will cause the pupils to open up and the refracted prescription will be more accurate than if the exam were done in very bright light. Low light helps, but nothing opens up the pupils and relaxes the ciliary muscles more than dilating drops.

C.


Andrew 23 Apr 2013, 15:08

That's where you first start to notice the onset of presbyopia, Clare. I'm sure someone can explain the physics behind it, but I know I have reached the stage where I need reading glasses over my contacts in "normal" light, but do not need them if what I am looking at has full sunlight on it.


Clare 23 Apr 2013, 14:49

Handsome guy at work is 48 and just got prescribed first plus Rx for 'reading in low light'. Not heard of that before. He seems to read fine in daylight so how long do you think before he's no longer able to do that?


SC 22 Apr 2013, 10:12

LT Lurker,

Yes held out for 2 years. I remember reading a book that had a page for each day of the year. Near vision was deteriorating so that I had to give up some time in May!

I can't focus at any distance. This means I can't read anything small as the multiple images just overlap and my brain can't make it out - this is true of road signs, eg mileage signs on motorway or small print when reading.

If I squint and wait then eventually I'll squeeze more plus and read better at distance and text on a PC, but small print is out

If I wear distance Rx only, then I can read much more effectively - just as you describe your friend, but small print would be very difficult unless there is a bright light source.

Because of progressives, then you get used to working with the lenses - ie I should be able to still squeeze +1.5 - I must be able to do that to read fine print with glasses on!!, yet that is more than my distance Rx and I can't persuade my eyes/brain to squeeze that out for distance.

As CJ has pointed out, the auto-focus and image processing have also switched off. This mans that if I look at, say 2m without glasses it is blury, but after a few seconds it will come into better focus (not sharp or clear, but just enough for the brain to say that is OK, if I turn away, look at my watch, and then look back I'm back at the 2m object I'm back to square one - completely out of focus. This is how it works with text - with natural objects such as nature or faces I seem to be able to do nothing to add plus - no persuading at all

So this means that +0.75 distance Rx seems bad. I guess coming from having clear distance vision, the loss of acuity is intolerable so I wear the glasses and marvel at the people on this site who go without at higher plus or minus Rx


LT Lurker 21 Apr 2013, 21:16

Hi SC, That is very interesting, so you held out for a couple of years before wearing specs?

What can you read now and from how near?

I ask as I was watching someone I know who is mid 50s reading (without her specs)small text on a packet.

She was seemingly concentrating very hard but she was able to see the ingredients at about 40cm - When she works she does wear reading spex.But if she wants to, she can see but it appears to be a considerable effort to remain in focus.

I being myopic and doing monovision don't really get the out of focus problem.Except perhaps for very late in the day when I am staring at a screen.


SC 20 Apr 2013, 03:41

Smudgeur, LT Lurker,

I'm 48 and like most other latent hyperopes started with presbyopia first. With the hindsight of Eyescene, I guess the fact I was struggling with small print at 42 is really an alarm bell that something more than presbyopia is involved.

I found out about the hyperopia accidentally - I had varifocals because I needed to see near and far at the same time, even though the distance was effectively plano. However within 8 weeks of getting them I'd adjusted to the intermediate lens. So I could see fine in the morning and when tired at the end could only see through the intermediate.

This was confirmed at the eye test (even though I could still read parts of 20/15) unaided.

2.5 years later and visual acuity is very different - lost the ability to see unaided to a large extent, but still the same prescription. As I said lots of variation based on what I do - too much straining for close seems to prevent the eyes from relaxing and I have to wait before I can see distance again (better bare eyed!), too much fixed distance and the eyes seem to relax further and I find it frightening to tilt my head and look threough the intermediate and see things better! TV never really an issue because it is nearer (4 metres) and even HD is really quite low resolution compared to real-world so you don't notice the difference.

So as to your question, +1 at 45 being final - I got to 46 with no distance Rx, so I don't see 45 as a strong rule. My mum is over +2 distance but I don't remember her having a distance Rx until after 45/46.

So genetics is a useful guide, and I think that when you first struggle to read (not headaches, but really can't see). I think my Mum gave in around 40 yo and got glasses, I know I had a problem by 41/42 but didn't give in until 44. My rule of thumb therefore is 1/3 for each year under 45 you needed glasses - so I'm expecting around +1.3 (approx)


John S 18 Apr 2013, 11:51

Snowman,

At birth most people are hyperoptic. Up to the age of 3-4, the grows in length to zero that hyperopia out. If the process works correctly, most should end up with a rx less than +1.00. If the process continues, you end up with myopia because the eye grows past the zero point and becomes too long.

If the growth stops too early, you are hyperoptic. The accommodation (reading) muscles compensate for the error for as long as possible by constantly forcing the eye to stretch in length. The stronger the rx, the earlier it will bother you. I am a bit surprised that you had been able to deal with it for that long without any hints. Most of the time it would have been detected by your early teens.

If it was me, I would schedule an dilated exam (drops) sooner then later. If for nothing else, just for curiosity. Except for the astigmatism correction that could change, you would then have a good idea of your final sphere (+) correction. The drops temporarily paralyze the accommodation muscles from adding any additional plus power, thus being able to determine the rx required for total correction.


Julian 17 Apr 2013, 09:29

Snowman 26: a word of warning. I can understand why you've opted for contacts as glasses in your strong plus prescription would make you look 'bug-eyed' - but you ought to have been warned that you can't rely on contacts all day every day. Wear them too much of the time for too long and you can damage your corneas; and apart from that there's the danger of getting an eye infection and not being able to put them in. Without correction you'd be up the creek without a paddle, so you really do need to have a pair of glasses in your current prescription as a backup, not only in case of emergencies but also to rest your eyes when no one's looking, in the evening and at weekends say - but actually it makes sense to let people see you in glasses from time to time, so that if you have to wear them for a while it doesn't cause so much comment. I wouldn't have mentioned it, but you write as if you don't have glasses to fall back on.


Cactus Jack 16 Apr 2013, 22:15

Snowman26,

Welcome back, it is good to hear from you.

In looking back to our posts in January, I must say that your accommodation had really masked your hyperopia more than we thought at the time. I wish I could tell you that you were finally past the latent hyperopia, but unfortunately I can't say for sure. I think you are probably very close. It is good that you are able to successfully wear toric contacts, there are many people who don't have that choice and are stuck with plus glasses that are not very good, optically.

I think the suggestion that you should get another dilated exam is a good one. If you can, try to get it done early in the day and take the rest of the day off to recover. A small tip, you may not be able to wear your contacts for several hours until everything wears off. If you have some glasses that are close to the +5.50 prescription with the cylinder, you will probably be able to see distance fairly well with them while you are recovering, but it is highly doubtful that you will be able to focus close because part of the function of the dilating drops is to paralyze your ciliary muscles. However, if you need to focus close for using the computer or reading, you can wear some OTC plus readers to do the close focusing for you. In this case, the power you need will depend on the focus distance. If it turns out that you need some more plus for distance, because of some residual latent hyperopia, you may need stronger readers that the calculations would indicate. If you want some help with the calculations, let us know. They are really easy if you know the focus distance.

If you get in a situation where you need glasses in addition to contacts, you should consider what are called aspheric lenses to minimize distortion. Plus glasses lenses, more so than minus lenses, tend to have increased distortion as the power increases.

At some point, presbyopia will catch up with you and you will need some additional focusing help. For some reason, people with significant hyperopia, need focusing help sooner than the typical age of around 40 for people who need no vision correction. Surprisingly, people who need to wear minus glasses often develop a need for focusing help even later than people who do not need vision correction.

Don't be surprised when it happens. That is probably why the doctor mentioned the possibility of bifocals. There is such a thing as bifocal contacts, but I don't know if they are available in toric contact lenses.

One thing to remember is that you can get creative with vision correction in ways that some Eye Care Professionals don't think about.

For example, if you get to the point where you need bifocals, trifocals, or progressives and you can't get the prescription you need in contacts, you can do something like Glasses Over Contacts (GOC) that you may read about here. However, in your case, you could use relatively inexpensive Sphere Only contact to correct or even slightly over correct, the Sphere part of your prescription and the wear low power plus or even low power minus glasses with cylinder to correct the remainder of your sphere error and all of your astigmatism. These glasses could also contain the reading, intermediate, or progressive part of your prescription that might be difficult or awkward to correct if your primary sphere correct was in the medium plus range.

Anyway, just some thought and ideas. The really important thing is to see well and see comfortably. There are lots of tools to help you do that. If we can help or you would like to experiment a little, let us know. If done carefully, it can be done inexpensively.

C.


Snowman26 16 Apr 2013, 19:11

I had posted back in January about receiving a glasses diagnosis that I thought was too extreme. I had not returned to this site because the link was gone when I cleared my web history, however, I found it after some googling am returning to tell you that you were mostly correct about the condition that I am experiencing.

I have confirmed that I am dealing with latent hyperopia and have probably had it for some time but was able to mostly strain and overwork my eyes to not know it. I did not like the thought of getting glasses, but they do seem to have helped with headaches and some dizziness. It was hard getting used to how they enlarge things and make lines look slightly distorted. I am wearing contacts now because of this and how they make my eyes look large and the reaction of others.

The first glasses I received took a few weeks to adjust to, but then I found that things were more clear with than without. I’d still take them off at the bar and social activities after work, but lost them somewhere so I decided to try the second pair as the eye doctor recommended. It was the same with these except it was not as easy to adjust to having them off after wearing the stronger ones at work, so I ended up keeping them on most of the time.

Everything was fine until about 3 weeks or so ago and had some headaches starting again towards the end of the day for several days in a row. Since it wasn’t the flu or a cold, I wondered if it was the vision again so I went for a retest. Sure enough there had been another change to my prescription but got more astigmatism and stronger farsightedness correction.

I decided to try contacts because I didn’t like how big my eyes look with glasses on, and all but 2 or 3 people who have asked to try my glasses said that they were getting sea sick or that they couldn’t see at all and I am a little self consions about that.

So my contacts are the same for both eyes and say +5.50 -1.25 100. I’m hoping that my vision does not deteriorate more. I find it hard to adjust after taking them out at night, but sometimes in the morning I can go a few hours before feeling off balance (hard feeling to describe). Its difficult to understand how I went from feeling like I had good vision last year to now feeling nearly dependent on contacts. The doctor did want to do another thorough test with the drops next time but said that I could wait 6 months or a year if I had no other problems. I know you had said before that there were other people with my symptoms but has anyone ever heard of this strong a prescription in less than a year? I see others with close, but all at once?

Thanks for your advice.


hooked 16 Apr 2013, 01:51

@Smudgeur

The values for my wife (age 47) follow more the rules.

Last year she got new glasses with a changed prescription (from +5 to +5.5) after 20 years of nearly the same RX. She went for a new test last week and prescription went up half a diopter to +6. The optometrist told her this is not unusual in this age that the longsightedness raises. This may last for five years until it stabilizes again.


Smudgeur 14 Apr 2013, 13:07

Thanks SC - it's interesting to hear that from a hyperope's perspective. May I ask how old you are?

I assumed my wife would settle at +1.00 as she's 45 now - however it would appear to be swinging about a fair bit. (up +0.50 a year ago and now down +0.75). I'm also interested in how her reading will be affected in her left eye as her net reading prescription was +2.25 and is now +1.75 in that eye - I'd have thought that her eye may not like that too much, although as her add is up +0.25 in her right eye maybe she'll switch to monovision (reading in her right eye and distance in her left)

Any further thoughts SC, Cactus Jack or any other knowledgeable readers?


LT Lurker 12 Apr 2013, 17:41

Hey SC, That as Andrea has said is great info.

The idea that a hyperope can go and drive for miles without any discomfort is not altogether true as with watching TV etc, tiredness will set in soon enough.

Can I ask how old you are?

Regards

LTL


andrea 09 Apr 2013, 20:00

SC, thanks for your wonderful explanation. Something like this happened to me, and after some aggravation, I finally convinced my optometrist to increase my prescription back to where it was.


SC 09 Apr 2013, 06:10

Smudgeur,

The only explanation I can give is that there is a lot of variability on a day to day basis with latent hyperopes.

The last time I had my eyes tested, I could see better through a reduced Rx (+0.5) than I could through my existing Rx (+0.75). I put this down to having done a lot of close work immediately before and I had induced some psuedo myopia

The week before, I had been driving, eyes focused on distance, tired after a few hundred miles and I could see through the intermediate segment (+1.5)

So I guess that ultimately I'll need +1.5 but in the mean time it is mostly too strong. Even if I try to look through +1.5 for a few hours, my eyes do not relax. I guess they would after a few weeks but I'm not prepared to do that and not see in the intervening period.

So really for your wife it is probably down to the day of the test- the original +1 was perhaps on a super-relaxed day and it has rarely been acheived since (ie really they are too strong), and the +0.25 was on a psuedo-myopic day and may not be enough going forward.

Children, teens etc seem to be able to adjust in a short-time. Hardened hyperopes seem to take years. I've spent 4 years with +1.25 or +1.5 in front of my eyes (either as reading or intermediate segment) and I've still not relaxed to see throught it (on a regular basis)


Melyssa 05 Apr 2013, 06:36

"Ask Doctor K" on reading glasses: http://newssun.suntimes.com/lifestyles/komaroff/17652360-423/many-options-for-reading-glasses.html


Andrew 30 Mar 2013, 16:22

No idea at all, but see you at Wembley! UTB!


Smudgeur 30 Mar 2013, 11:11

Update....

My wife went for an eye test this morning, latest RX:

R: +0.75 -0.50 080

L: +0.25 ---- ----

Add: +1.50

Significant drop for distance in the left eye (lower than it was 3.5 years ago) - at her age (45) that seems a bit odd to me. The optometrist told her that she could get away with plano, but she was worried about dropping by so much in one go.

Any thoughts on the possible reasons behind this?

I assumed that latent hyperopia was being uncovered as she became more presbyopic but it would appear not.

Any thoughts from those with knowledge would be much appreciated!


Smudgeur 29 Mar 2013, 18:07

The missus (45 years old) has been in varifocals for 3.5 years now. Current RX

R +0.75 -0.75 090

L +1.00 ---- ----

Add +1.25

She has recently been complaining that her distance vision is not clear in her left eye (OK with both together). She tried her old glasses on and said that the distance vision in her left eye was slightly better with these (though not perfect), previous RX

R: +0.75 -0.50 090

L: +0.50 ---- ----

Add: +1.25

Is it typical for hyperopia to improve once one gets into their 40s? I assumed it would be going the other way? If not else what else is most likely to have changed in the last 18 months? She says that her reading vision is fine.


svensont 25 Mar 2013, 06:38

Pete,

What you decided to do? Have you ordered your glasses?


lazysiow 13 Mar 2013, 15:57

My right eye seems to now need an increase very fast. Gone are the years of "I don't really need glasses". The prescription bumps are now coming blazingly fast. Tried putting an old pair's +0.25 lens over it and amazed at how much difference it made.

I miss the days when I had some distance blur but use the computer and do most things fine. Now I can hardly read the screen without the damn things no thanks to my right eye's astigmatism. On the other hand my distance has cleared up except for the astigmatism, but I preferred the other way.

Currently +0.75 in each eye, but once the left eye gets worse too, there'll be no more winging it I'm guessing.


svensont 13 Mar 2013, 12:22

Pete,

You can make a simple test, tell us the minimum distance you can read each eye a small print, then we can estimate how many diopters you have left.

I think that you can wear -2D/-3D glasses without problem, so it would help induce myopia if you would increase sphere a little more.

Maybe start with first pair:

L,R: -1 -0.5cyl 3BI

second pair:

L,R: -2 -0.5cyl 5BI

People might be affraid of prism because it will make them totally dependent on glasses, they can't wear contacts. Maybe they don't know what to expect.


yogi 13 Mar 2013, 11:24

how about PRISM DEPENDENCY

seems to cover people who already have or need a prism correction and those among this comunity who for whatever reason are trying to create a need for prism

advice and suggestions from fellow followers could advise those new to prism

anyway thanks for reading bye


Cactus Jack 13 Mar 2013, 11:16

varifocals,

There are several fixed focus lenses and one variable focus lens in the eye's lens system. The crystalline lens is the variable focus lens. If the crystalline lenses and their associated ciliary muscles can do their job, they provide an autofocus mechanism to allow a person to focus at closer distances.

Cataracts affect the crystalline lenses. Cataract surgery involves removal of the crystalline lenses and most often, but not always, replacement with an Intraocular Lens (IOL). The IOL most often used is fixed focus and most often, the chosen lens power will be to correct any myopia or hyperopia and provide the best possible distance vision. Sometimes the lens powers are chosen to make one eye focused for distance and the other for reading, called mono vision. There are other IOL options that offer multi-focal IOLs, but the additional cost of these options over the cost of standard fixed focus iOLs must be payed by the patient.

Often, after cataract surgery, a patients vision is only close to 20/20 or 6/6. This is because IOLs are only available in 0.50 diopter increments and the process of determining the actual power of the IOLs is not exact. Also, IOLs usually do not affect astigmatism. The end result is that many people still need glasses for some visual tasks after cataract surgery, but it is likely that major refractive errors can be substantially corrected by careful selection of the IOL power.

C.


Cactus Jack 13 Mar 2013, 10:32

Big Lurker,

"Induced Prism" has a special meaning in the optical industry. It means to "create" prism correction in lenses by relocating the Optical Center of a lens to bend the light rays slightly and create the effect of prism. The amount of "Induced Prism" depends on several factors, but typically it is not very large. Higher values of prism involve grinding an actual prism component into the lens.

We need to find a name that won't be the same as one already in use in the industry. Suggestions anyone?

C.


varifocals 13 Mar 2013, 10:12

Its odd but I now know, fromm meeting people, several myopies who have had lens implants for cataract operations.

They are all long sighted & cant read un aided.


big lurker 13 Mar 2013, 08:42

Good question Pete. maybe there should be a "Induced Prism" thread as well. Seems like there has been increased interest in that recently.

From what Cactus Jack has said it seems it is far more easy and quicker to induce prism correction than to induce myopia. So for those that have the desire to wear glasses full time this may be an easy answer.

Not much has been mentioned about "prisms" through the years until recently but like someone pointed out there have been posts about how quickly some have become dependent on glasses in a rather short time. The tales of Daffy and Larissa and even more so Larissa's friend that had perfect vision but started wearing some of Larissa's old glasses very quickly became dependent on glasses.


Pete 13 Mar 2013, 04:18

Good morning!

If I will adopt to first prism and later increase BI should I increase sphere as well?

Is it possible to predict how much I can increase prism?

And why so many people who desire glasses full time are afraid of prism?

Sorry, right now I am not sure whether I should sill post it here or in "induced myopia"


John S 12 Mar 2013, 12:49

You would have a tough time causing your eyes to become shorter to induce more hyperopia.

When inducing myopia, the constant effort of accommodation can cause the eye to grow longer, thus becoming more myopic.

Although you cannot induce hyperopia, you can bring it out of hiding. If you are hyperoptic, by the time you are in your 40s, it will start to show up(if not sooner). The accommodation muscles can hide a lot of hyperopia depending on your age. Your could wear just a little stronger plus rx to try to relax the muscles. Until or if your muscles relax, your distance vision will be slightly blurry.

If I wanted to have the symptoms of presbyopia, starting with my distance rx, I would add a little plus (.25 or .50). Then use a reading add in a bifocal. I think the combination of the 2 RXs, would force the accommodation muscles to relax faster then just using a distance rx only. The muscles would not have to work, so they should begin to relax. This could cause dependence on a reading lens sooner than it would normally happen naturally. Using a distance rx only, you would still need muscle action to focus for close things, therefore still exercising the muscles.


varifocals 12 Mar 2013, 12:13

svensont.

I always had the impression that it was not possible to increase the dependance on plus lens through inducement because of the eye muscles.

Myopia yes.

I know someone who has done a first rate job that was by increasing contact lens & is -14.50!

So I await cataract lens implants for the future.

Even here I know several myopies who have had cataract ops & are now long sighted & cant read unaided.


svensont 12 Mar 2013, 12:02

Pete,

I think you can try minus lenses if they will not cause you problems with reading close distances. I have read an interesting method in http://books.google.pl/books?id=CgC8ZKTA3Y4C&printsec=frontcover&hl=pl#v=onepage&q&f=false

If you are a hyperope you can try wearing stronger and stronger minus glasses until you will be able to see good without glasses, but if you push it too far, then you'll become myopic.

I suggest BI because as I read in older posts it is causing dependence on glasses sooner and it seems permanent. BO is like when you read something, your eyes are converging, so it's natural. You need to wear much stronger BO to make yourself dependent (I think start from 6 BO each eye).

Maybe you have more hyperopia, you can make a dilated eyetest to get to know.


Pete 12 Mar 2013, 11:37

Thanks svensont..

I am afraid I have a small hyperopia. Do you think I can still try minus lenses? If it will work can it delay hyperopia in the future?

Could you tell me please wyh you suggest BI not BO?

And one more thing. I am in my 30's. Is it not to late for me?


svensont 12 Mar 2013, 11:36

It all begins here (17 Dec 2001):

http://eyescene.net/bbs/threads/12.html

and is continued there (from the beginning):

http://eyescene.net/bbs/threads/25.html

You can use search tool ctrl+f and just read posts from Daffy and Larissa


 12 Mar 2013, 11:05

svensont

any chance of telling as where the posts from daffy /larissa can be found

which thread and dates

thanks


svensont 12 Mar 2013, 09:59

Pete,

I think if you will start wearing minus glasses with prism full-time you may create some pseudo myopia, but I don't know how is it related with BI prism. I know that Larissa's friend couldn't focus properly after few days with her glasses and on an eyetest she was prescribed minus glasses with prism, even she has had perfect eyesight before.

You may find BI glasses very comfortable, like a relax.

If you are not latent hyperope then you will not see clearly distance in your glasses, so it doesn't make sense.

Let us know what you decided to do.


Pete 12 Mar 2013, 09:42

Will I become permanentry -1D sphere or is it better to try +1D? I prefer myopia if I have a choice...


svensont 12 Mar 2013, 06:18

Pete,

If you would like to have the real need for glasses you can start wearing something like:

-1 -0.5cyl 3BI

Based on posts from Daffy and Larissa's friend after a few days, maybe weeks you should not be able to function normally without your glasses.

You can also try to order glasses with more plus sphere and use them as much as you can, it is possible that your eyes will start to relax if you are latent hyperope.


Pete 12 Mar 2013, 05:48

I posted here about a year ago. After complaining about my vision I was prescribed my first glasses Sph+0.5 Cyl-0.5 .

Initially when i used them on my computer I could notice verry small difference but right now the reading with or without glasses is almost the same. (it is not a big difference anyway).

As I am still willing to have more serious prescription I am wondering if adding a prism could help?

I am aware from different posts prism can be permanent. I just dream bo become real full-time-wearer.

I'll be grateful for any sugestion.

Pete


Cactus Jack 11 Mar 2013, 11:32

Bert

It is likely that you and your co-worker have are experiencing the effects of Latent Hyperopia. Your description fits the scenario almost exactly. It would be helpful if you could provide some ages and complete prescriptions.

C.


Bert 11 Mar 2013, 09:55

I just had an exam, after a very long time, because I didn't think my far vision was so clear. After a fairly long exam he prescribed some reading glasses. He said that if I read a long time my muscles might cramp and that can cause blurry distance vision that can clear up after a while and that reading glasses would likely stop that. So I got the glasses yesterday and wore them while reading, but didn't notice much of a difference. They made the print just a bit clearer although before putting them on I could see just fine.

When I went to work this morning I proudly showed off my new glasses and explained that I don't really need them, that they just help a bit actually for my distance vision after intense close work. A colleague told me she started with weak reading glasses she thought she didn't really need and enjoyed wearing them, but over the next 3 months or so as her eyes adjusted to them them she grew so dependent on them she couldn't read without them. Within about 6 months she noticed such a difference she went for another exam and was given an increase. She says if I don't need to wear the glasses to see, not to start unless I want to get hooked. She went from no glasses to glasses to wear as she wanted to needing them in 6 months. Then her Dr suggested a small + for distance to make her distance vision clearer, which it didn't really. Within a few weeks her distance vision was clear (which it was before she got the distance added to her readers)but, gain she found she lost her clear distance vision without glasses. She now credits her Dr for her need for full time glasses. I don't know if that is fair, and I know everyone is different, but I don't want to hasten dependency on glasses. How do I know if she is right, and determine what to do for myself.


SC 11 Mar 2013, 07:45

Neil,

I think +1 is an acceptable add but it depends on your distance prescription.

If you are -Rx then the add is probably irrelevant as you can get the necessary extra plus by removing glasses

If yu are +Rx or even no distance Rx then +1 may mean the difference between able to read fine print or not.

My experience is that people finally give in and get reading glasses at +1.25 but realise they haven't been able to read properly for a year or two


Neil 10 Mar 2013, 17:57

When my optometrist first prescribed me an add, even she suggested that +0.75 or +1 is often not noticeable enough to make a difference. You might not even use the right part of the lens for the intended task and it would be a waste of money. I wonder if people here agree.


Aubrac 10 Mar 2013, 05:23

OnLooker

Sounds like the often encountered 'denial'. At a similar age my wife went through this, peering at newsprint, increasing computer print font sizes, and generally magnifying everything 150%.

It wont last forever. Plus one doesn't make that much difference, try substituting +2.00 and she really will notice a change, find things a lot easier, and possibly use them more.


OnLooker 05 Mar 2013, 04:54

My wife, 39, is not wearing her +1 glasses but in rare occasions when reading a book for a long time. On the laptop she keeps on squinting and sometimes pushing the screen away. I see her rub her eyes very often too. At night she says her eyes are very tired. She only wears them if i just give them to her otherwise she doesn't. I tend not to do this often! In fact i just let her rather struggle to see hoping she will tunr into full time wearer.


Cactus Jack 16 Feb 2013, 16:49

Neil,

A dilated or "wet" exam involves the use of "drops" of dilating agents in the eyes. There are several different agents that temporarily paralyze the ciliary muscles in the eye and also the muscles that control the iris. Usually, the agent chosen is one that acts quickly (20 minutes) and wears off quickly (4 to 6 hours). Curiously, eye color can affect how quickly the agent works and how quickly it wears off.

There are two reasons for a wet exam. The most common one is for people with hyperopia. Hyperopia is unique because almost all hyperopes have the built in ability to correct their hyperopia by using their ciliary muscles and crystalline lenses to add plus power to their eye's internal lens system to correct their refractive error. Often they make the correction without conscious effort on their part. During an eye exam, this internal correction means that the examiner will often have difficulty determining their actual refractive error. The use of dilating agents to paralyze the ciliary muscles can sometimes help the examiner get closer to the actual prescription, but not always. If the patient has significant latent hyperopia where the eye muscles and crystalline lenses simply cannot relax in the 20 to 30 minutes required for dilation, it will help, but may not fully relax the crystalline lenses. Significant latent hyperopia can tale weeks or months to fully relax.

The other common reason for a dilated exam is to open up the iris to allow full examination of the retina or other internal structures of the eye. Many diseases (e.g. diabetes) cause retinal damage and being able to examine the internal structures are very important in preventing or treating conditions that can destroy vision.

People who are myopic rarely need dilation for determining their prescription because their ciliary muscles and crystalline lenses are usually fully relaxed. The only exception are those situations where pseudo myopia is suspected which is identical to latent hyperopia except on the other side of 0.00.

C.


Neil 16 Feb 2013, 15:15

@Cactus Jack

From your post below RE a dilated or wet exam, what specifically does that mean?

I am asking because my optometrist is rigorous in performing a dilation for each visit,

but at least in my case this occurs AFTER the refraction. My understanding based on her explanation is that this is to look at the back of the eye.

Thanks in advance.


LT Lurker 10 Feb 2013, 17:23

http://www.ophthalmologymanagement.com/articleviewer.aspx?articleid=85553

The first contributor to this article actually seems to nail where I believe my wife is.


LT Lurker 08 Feb 2013, 18:23

Hi

Soundmapt - My wife's last optometrist has, now we learn, got a poor reputation around town and there is an alternative ,also non-chain here, which is where she says she will go. They apparently take 45mins to 1 hr.

I think 2-3 years ago she was comfortable with the struggle but now the presbyopia is emerging and she is happy to give in...she may just hang in a bit longer!

CJ - I was thinking a wet refraction may be in order as I think my wife may have good accommodation but also have some Latent Hyperopia which was not previously corrected with her initial optometerist as my wife initially mentioned she had a script of +1.75 but on receipt of her rx it was only +1.25 +1 -0.75

She can read up quite close (25-30cms) and does this with the "use it or lose it" maxim in mind for a very short time (say 2 minutes) but after this she is struggling...blinking every second watery eyes a severe frown and also some unusual straining noises!

After this she pushes out to 40cms or for a long read 50cms.

I have read of cases where 45/6/7 year olds go and get a massive +2 distance correction for the first time and I believe this to be due to higher than anticipated accommodation.

I am convinced the first optometrist was correct and did a very thorough refraction...as has been said hyperopia does not lie, but if you are cocky and incompetent it can surely be missed.


Soundmanpt 06 Feb 2013, 18:23

Cactus Jack

You know i didn't think about that. I will tell her she should find out what drops the doctor used so in the future she can warn the doctors about what happened to her as well as the drops used. I will try and get her to provide the name of the product used as that may help. She was just there on Friday as she was getting fitted for colored prescription contacts. She has to go back to get the trials as they had to order them for her. That will be a perfect time for her to get that information.

I plan on seeing her tomorrow night so I will tell her. i'm sure she wouldn't want that to ever happen again as it could be dangerous.


john 06 Feb 2013, 17:29

I had the same experience passing out after eye drops about 20 years ago.I got all the way through the eye exam and passed out while paying.I ended up in a regular drs. office up the hallway.I guess i was alergic to the drops.I never found out what they were but was told they were a faster acting drop that was new.It was discovred i had high blood pressure and bifocals were on the way.


Clare 06 Feb 2013, 16:14

I agree with Cactus Jack - go for the independent rather than a chain. I've left a major UK independent who I felt didn't much care for solving my contact lens issues whereas I'm getting a much better service from an independent.


Cactus Jack 06 Feb 2013, 13:24

Soundmanpt,

I have never heard of that either, but anything is possible. She may have been allergic to either something in either the anesthetic drops that are often administered before the dilating drops or the agent the doctor used.

I would suggest that your friend find out exactly the drops were used so she can be aware of her sensitivity to those medications.

Allergies can sometimes cause sudden, strange, and sometimes fatal reactions. For example there are some people who are so allergic to peanuts that the mere odor will cause Anaphylactic shock. It is possible that she experienced something similar. I suggest looking up Anaphylactic shock to review some of the causes and effects.

C.


Curt 06 Feb 2013, 11:36

I wonder if he was an old-school doctor who still uses atropine to dilate the eyes. Atropine has a lot of side effects besides paralyzing the ciliary muscles.


Soundmanpt 06 Feb 2013, 08:50

I am directing this at Cactus Jack, but anyone that may have known anyone that this may have happened to I would be interested to hear about.

Last night I went to visit a friend, she had told me several weeks ago and even asked about suggestions on where she could best use her insurance at to get her eyes examined. She told me that she had been out with her bf and she was surprised that he was able to read a sign in the distance that she could not make out anything on it. She admitted that she hasn't had an eye exam since maybe when she started high school and that was about 8 years ago. Any way she related how it went. The doctor put drops in her eyes to dialate them and within a few short minutes she began to feel very dizzy and proceeded to blackout. When she woke up the doctor told her she was only out a few seconds. She said he appeared to be in his mid 60's so she assumes he has been a doctor for a good many years. He told her that she was only the 3rd patient he has ever had to react that way. I have never heard of this happening and I am very curious what is in the process that would cause that? I even called an optician friend on my way home to ask if she had ever heard of that happening and she was as shocked as I was. aside from that everything else went as she expected and she was given her first prescription for glasses which she already had but of course still too shy to wear them.


Likelenses 06 Feb 2013, 00:26

LT Lurker

With the headaches related to distance viewing, and the sensitivity to sunlight,don't be surprised if she gets a small minus prescription for distance,along with a bifocal,for full time wear.


Cactus Jack 05 Feb 2013, 22:54

LT Lurker,

Consider an independent ECP rather than a chain. Also, consider a dilated or wet exam if possible. Between 40 and 50 it is a really good idea to get a very through eye exam. In addition to presbyopia, there are lots of other things that can begin to develop such as glaucoma, cataracts, and retinal problems. Almost all can be managed with excellent long term results if caught early. The bright sunlight sensitivity should be investigated, but be careful how you broach that subject. As stubborn as she is and as comforting as she finds denial, she might decide to do nothing.

Ideally, a very through eye exam will just result in a very accurate prescription and a report of excellent eye health. There is great comfort in knowing exactly what, if anything, is going on so it can be managed. I have had type 2 diabetes for about 45 years and have managed it diligently. I get a retinal exam every 6 months or so. Of all the eye exams, they are the most uncomfortable because of the bright light used to illuminate the retina while dilated. But the report that, so far I have no retinal damage, make the management effort and the brief discomfort, all worthwhile.

C.


Soundmanpt 05 Feb 2013, 20:47

LT Lurker

Well if that happens again and they rush her out in 10 minutes you should ask for the manager and request your money back and let them know that you have some knowledge about eye examines and that it isn't possible to do a proper refraction in such a short time.

Maybe even see if you can find some references before you go there about the quality of service the doctor provides.

You can even ask when your calling about making an appointment how long the exam will take, if they say 20 minutes or less I suggest you call another location.


LT Lurker 05 Feb 2013, 15:34

Hi Soundmapt,

I guess my wife will probably not want to admit that she gets headaches from driving and watching TV - The original optometrist took nearly 1 hour doing a proper refraction whilst the last "idiot" she saw took 10 minutes and basically did a quick VA test and an even quicker auto-refraction.

The same "idiot" did an eyetest for me and I wasover prescribed with the same 10 minute test.

She has said she is going somewhere else this time so I hope that they will do a proper job - they just need to see her blinking to realise there is a problem.


Soundmanpt 03 Feb 2013, 12:52

LT Lurker

Well of course if she is straining now to see distance then it no doubt she should be wearing glasses for that as well as for reading. I think the doctor wanted her to just wear her glasses and at first her distant vision my seem off better within a short time that would clear up and she would be able to see perfect for reading and distance.

But she may be better off just getting bifocals and be done with it. That way they can put a weak prescription to clear up her distance and give her the add she knows she already needs. Either way she will be wearing glasses full time after her exam or at least she will be told to.


LT Lurker 02 Feb 2013, 21:45

Hi Aubrac,

Initially they were for reading but she was told that she the distance vision would become clear in due course.

I think that she still has good distance vision without but it is not without strain.

I think bifocals will be a shock, but she is going for a test in a month or two.


LT Lurker 02 Feb 2013, 21:25

Hi Aubrac,

Initially they were for reading but she was told that she the distance vision would become clear in due course.

I think that she still has good distance vision without but it is not without strain.

I think bifocals will be a shock, but she is going for a test in a month or two.


Gus 02 Feb 2013, 09:06

fuuny show.

http://www.fccfreeradio.com/?page_id=7874


Aubrac 02 Feb 2013, 05:52

LT Lurker

Did your wife get glasses for general use or just as readers?

She may well need bifocals but might find that a bit scary, so best just to get along to the optometrist and see what happens.

My wife (see earlier post) got her varifocals a couple of months ago and has been been wearing them FT since - I think maybe the optician told her to go FT or she would not otherwise get used to them.

She seems quite at ease tiling her head back to read and when she did this in a bookshop, was the first time I realised she had varifocals.


LT Lurker 01 Feb 2013, 21:41

Quite bizarrely out of the blue my wife proclaimed that she may need to start "phasing in" wearing of her glasses.

She said she had noticed quite a bit of strain recently and had found it hard focusing on threading a needle.

Her Rx from about 6 years ago (39) being

L+1.25 R +1.0 -0.25 axis 170

She had decided not to wear them when a new optometrist told her she could get by without.

Now she is not able to read for more than about 20 minutes,when years ago she would read for 2 hours.

She has trouble staying awake when watching TV especially sports (which she likes)

She blinks incessantly as well as needing sunglasses on days without sun and does a lot of eye rubbing.

I am wondering when she says phase in she know she needs to go full time or whether she will suddenly need bifocals


SC 21 Jan 2013, 03:44

Aubrac,

I wouldn't worry about the apparently excessive add - it is just whatever is handly - I usually pop anoyher pair over the top which gives an add around +4 but I don't need that - just easiest solution when doing somthing fiddly like changing a plug on a cable.

If you wife, as you have posted previously work +4 then it seems possible she still needs the +4 for distance and an add - at 44 I would guess this would be 1.25-1.5. So when you are seeing here put +4 glasses over her progressives or use the +3 magnifier then maybe she is just looking through the top of the lense and still only getting +5 to +6 which would be relatively close to +4 add +1.5


Aubrac 20 Jan 2013, 03:16

My wife wore glasses from about age seven to eleven because she had a 'lazy right eye'.

Now I don't know for sure her new prescription but as previous distance was +1.75 I think now she is maybe +2 to +2.5. Her reading add from the magnification and cutout I would say is about +2.5.

My wife has exotropia (I think that's the right word) which means whenever she reads small print and rarely but on some occasions at distance, her right eye turns severely to the centre.

I used to be fascinated when I was in the dentist's chair and she was doing some work on the gnashers, seeing her right eye turned in all the time.

I know also the turning of the eye does give her double vision at times. Getting back to the her prescription, she often wears a pair of about +4 glasses over her varifocal glasses for small print, which would give her the equivalent of about a +6/+7 add, which might be needed to prevent double vision, and read small print with both eyes.


Carrie 19 Jan 2013, 17:12

I forgot to say that she's not embarrassed to wear glasses she just finds them inconvenient. As I said in an earlier post if she had to wear them all the time she would have got got more fashionable (and probably more expensive) frames and would wear them. As she doesn't need them all the time she only wears them when she needs them (even if it means struggling). Her frames aren't unfashionable just simple. She has got used to them now - they don't make her dizzy when she puts them on now.


Carrie 19 Jan 2013, 16:53

Soundmanpt

My cousin is VERY stubborn (more than me!) and I have no intention of suggesting she wears her glasses more or even full time as I would be wasting my time. She will only wear her glasses when she absolutely needs them. If she thinks she can get by without wearing them she will. I think she was a bit surprised that her boyfriend liked her wearing glasses so much. She also seemed slightly annoyed by it (despite the good sex). I'm not going to keep going on about glasses to her as she will think it's weird.


Aubrac 19 Jan 2013, 16:30

Cactus Jack

I will ask my friend what correction she needed after her cataract surgery and if she has noticed any change in her distance and reading needs.

The point I was really interested in is that I assumed, rightly or wrongly, that with IOL implants after surgery, vision would be fixed, i.e. it could not change in terms of any plus or minus needs. And so I was surprised that she has had plus changes for both distance and close vision.

Not to confuse issues, it is my wife who has varifocals about +2 with +2 add and who still needs about a further +3 add for small print, which she gets from wearing an additional pair of glasses over her own.

This made me wonder if a plus 5 to plus 7 add is possible with varifocals


Soundmanpt 19 Jan 2013, 15:04

Carrie

Your cousin may prefer to have perfect vision but the truth is she doesn't have perfect vision anymore. At least not for close up. Her distance vision may be still be perfect and if she doesn't like wearing glasses she can certainly not wear them for driving and seeing for other distant things. As you should remember when you got your first glasses your distance vision was till perfect too. You probably would have a very hard time convincing her to wear her glasses full time because of that blur. You already had a desire to wear glasses even before you found out that you actually needed them. Because of that desire you wore your new glasses full time right away and the blur for distance vision soon went away and you were soon able to see perfect with your glasses for distance as well as close up. All that said, she still should try getting more used to at least putting them on when she needs to see close instead of straining to read something. If she does much close work then she might be better off letting her eyes adjust to them for all distances instead of doing a lot of the on / off thing. She can fight it but her eyes will probably still change and she will need stronger glasses within a year or so and it be be even harder for her to read anything without them.


Carrie 19 Jan 2013, 06:09

My cousin does like to see clearly but she'd rather have perfect eyesight than rely on glasses. I would suggest contacts but I don't think she'd go for them especially as she doesn't need them or glasses full time.


Cactus Jack 18 Jan 2013, 20:21

Aubrac,

We really do not have enough solid information to be able to understand what has happened to your friend after she had cataract surgery. To my knowledge, IOLs are fixed focus lenses, though some are fixed focus with 2 or 3 different power in the lens, like a bifocal or trifocal lens or perhaps a progressive focus lens. The effect of the lens, for the wearer, may be variable focus, but the lens itself was made with 2 or 3 different FIXED powers.

It is possible that the original intent was mono vision with one eye set for distance and the other set to focus closer. Mono vision is sometimes done with two different powers of contact lenses or, if the myopia is just right for reading without glasses, only one contact lens for distance is used. However, some people cannot tolerate mono vision and it is possible that she wound up needing bifocals glasses. Selecting lens powers for IOLs is not an exact science. Firstly, they are available in only 0.50 increments and secondly, the measurements of the eye are amazingly accurate considering the structure of the eye, but not exact. A fraction of a mm error in measuring the lenses and length of the eye can easily mean a less than perfect result.

For the right price, you can get bifocal lenses made with any powers you want. However, a requirement for a +6 bifocal add would be unusual unless a person had serious vision problems. If I remember right, our friend 4 Eyes, from Brazil wore something like +32 distance with a +6 add. A +6 add would normally mean that the reading segment would focus at 16.6 cm or about 6.5 inches. The depth of field (range of useful focus) would be very narrow. If I remember right, your wife is a dentist and a high add might be useful for some of her work, but I think some clip on magnifiers or the magnifiers made for close work with prism to assist in convergence might be eve more useful,

There are companies that offer specialty glasses for various professions. RX Safety Glasses in New Jersey comes to mind as a source here in the US. http://www.rx-safety.com , but I am certain that there are sources in the UK for specialty glasses.


Soundmanpt 18 Jan 2013, 18:17

Carrie

So were you not curious why your cousin still refuses to at least wear her glasses when she needs them? Seems like she gave 2 really good reasons why she now be over joyed about wearing them.


Asdoo 18 Jan 2013, 15:37

Aubrac

I think your wife needs an increase in her distance script. +6 adds do not exist unless you are visually impaired.


Aubrac 18 Jan 2013, 14:59

Cactus Jack

Thank you for your welcome, and glad to be back.

I saw my friend after she had had the IOL insertion in one eye, and at that time, she was pleased with the distance correction it gave her (of about -4.00) and could read well with monovision.

I did not see her again for some months after the second eye was operated on and she was then wearing bifocals which seemed plano with a reading add. Some while later her glasses had a definite + correction of about +2.00 and a reading add.

I have seen adverts for IOL that can cure, if that is the right word, presbyopia, and wonder if there are different types of IOL that can allow a degree of accommodation.

I would have thought that in my friends case, her IOL was fixed and therefore there would not be any further change in her reading prescription, and I wonder why this is not the case.

I will ask her next time we meet what rx changes she has needed since her cataract operations.

By the way, do you know if there is a limit to the reading add in multifocals? Because as I said in an earlier post my wife could possibly use a +6.00 add to her +2.00 distance prescription.


Carrie 18 Jan 2013, 14:14

I was at my cousin's house the other earlier this week. She wanted to show me something on her laptop. As she was looking at the screen she sort of squinted at it for a short while without her reading glasses and then sighed as she put them on. She still doesn't like wearing them but struggles to read without them despite trying. She said to me that there was only 2 good things about wearing her glasses. 1 was that she can actually see to read clearly and the other good thing is that her boyfriend REALLY likes her in glasses. She said she tried a "sexy secretary" act with him for a laugh and she had the best sex she's ever had!


John S 15 Jan 2013, 08:05

LT,

Correct. It was just uncomfortable. I could deal with it, but it was a lot easier looking at something and not thinking about focusing on it(as long as I looked through the correct part of the lens).

I tried my first progressives in the early 80s with a +2.00 add. I don't think they were fitted very well. I did not use them a lot. I tried another pair around 1990 with a +3.00 add. I was about 35 then. They worked very well. It took me no time to get used to the placement of the add. It became second nature for me to know exactly where to look for the correct focus. I didn't have to find the "sweet spot". I already knew where it was for the distance of the object I was looking at. There are many variables that go into the correct fitting of a progressive. A bad fit will turn someone off real fast from wearing them.

As I got older the focus kept moving further away like a normal person with presbyopia.


LT Lurker 15 Jan 2013, 02:50

John S,Interesting !

So if you had wanted to you could have gone bare eyed to your mid forties.Did you,when you lost the ability to do this, was it the near vision that went quickly or both near and far?

Cheers

LTL


John S 14 Jan 2013, 07:14

LT,

That is the interesting part, I never got headaches. It was just took an effort to cause my eyes to focus.

My eyes needed a +1 to correct for distance, so it took an effort just for that. It didn't seem to make a lot of difference what I was focusing on. When I made the effort to focus for distance, my near vision was in focus. I just had to cause the focusing action to occur. I could focus at 8" or infinity, it took the same amount of effort. As I got closer to 40, my lenses became stiffer and I started to see a limit on the distance I could accommodate. Of course, we all know where it went from there - no accommodation. I mean NONE.

So my problem was not stiff lenses, it was a problem with the usually automatic muscle action requiring manual intervention for them to operate. But I had usually had complete conscious control over the muscles. It was kind of like an sci-fi show, I thought about it, and then it happened. I just needed to cause the accommodation action, then all distances were in focus.

I believe my problem might have been hereditary. My Dad wore reading glasses when he was a teenager, and then stopped wearing them until he was in his mid 40s. When my Dad did get reading glasses again, they were the same as my first rx - +1.00, add +1.50. That in itself would lend you to believe it was hereditary. My Mom wore a mild plus ~+.50 for reading during her college years while at nursing school. The combination of the both may have attributed to the problem.


LT Lurker 14 Jan 2013, 02:16

John S - Interestingly you said at the end of your most recent post that were able to force accommodation into your mid 40s.

How long were you able to this before headache ? Could you read at 35"- 40" whilst doing this?

Cheers

LTL


Cactus jack 13 Jan 2013, 22:45

Aubrac,

Welcome back. We missed you.

Cataracts can develop at any age, even before birth. Cataract are the general name for a set of problems with the crystalline lenses. The most common form of cataracts is a clouding of the lens (imagine what happens to an egg white when you cook it, both the egg white and the crystalline lens are proteins), but there are other types. Almost all can be corrected by IOLs.

Most cataract surgery today involves emulsifying the crystalline lens through a tiny (3 mm) incision in the side of the cornea and replacing the lens with an Intra Ocular Lens (IOL) of plastic. The lens is flexible so it can be rolled up and inserted through a small tube that will fit through the incision. Body heat causes the lens to assume its normal shape. The lens is actually fixed focus, but it is possible to make IOLs with multiple fixed focus areas like a bifocal or trifocal or even a progressive lens. There is a lot of research into various way to make the IOLs and I have heard radio ads that offer multi-focal IOLs BEFORE cataract development to correct presbyopia. I have been surprised that I have not heard of the availability of an IOL that has the characteristics of a young person’s crystalline lens so the ciliary muscles can focus it like they did the natural crystalline lens. The fact that I have not heard of such an IOL doesn’t mean anything.

When I had my cataract surgery, the very best visual acuity and the lowest cost, involved using a single focus lens. Typically, if the patient wants a multi-focal lens, and the cataract surgery is paid for by insurance in some form, the patient must pay the difference and I suspect the VA may be better with the newer lenses, but I also still suspect that the eye surgeon chooses the candidates for multi-focal lenses, carefully. If the patient winds up unhappy, the cost of doing something different under warranty, can be significant.

IOLs are available, in 0.50 diopter increments, in a broad range of + powers to correct both myopia and hyperopia.

The power of the IOLs cannot be changed by the ciliary muscles (yet?) so they produce the ultimate form of artificial presbyopia. That does not mean that the prescription after cataract surgery does not change. The eye surgeon tries to get as close as possible to the target prescription, but the ultrasound measurements of the eye and the availability of IOLs in 0.50 increments can cause the best laid plans to go astray. Also, there can be changes in the composition of the humors and it is not unusual for the prescription for older people to change some, if the eyeball shrinks a little. Lots of things shrink a little as we get older.

One question I would ask would be was the target Rx the same in both eyes or was the idea to create mono-vision?

C.


John S 13 Jan 2013, 13:00

SC,

You are correct, no formula worked for my problem. I know my case is in the minority, but it should not be discounted. I believe Ben and Jared also had a similar problem. To bump up my old posts again...

When I was 13, I first realized that needed glasses. Without trying to focus, distance had a slight blur, reading was non-existent.

The first time I tried on my Dad's glasses, distance was really bad. Then I looked at a book and it was in focus. I wore them for a few minutes. When I took them off the book was a blur. I could not focus on it, I was really scared. In about 30-60 seconds, I was able to start to read again.

I started as a "closet" wearer. I wore my Dad's spare SV +2.50 glasses sometimes in my room while doing homework and reading magazines, maybe 3-4 hours a week. I did that for 4 years. My room was in the basement, so I could usually hear someone coming down the stairs. I would take them off and hide them. I almost told them a few times, but then I didn't. Thinking back, I should have made sure I got caught wearing them. My parents' would have taken me to the eye doctor, and the game would have been over.

In a few months, I realized that strength of lenses determined the focus distance. I needed a little power for distance, and more power for reading. Glasses are in style now, they weren't then. I knew I needed bifocals, that made the decision even harder.

When I got my driver's license at 17, I went on my own to get glasses. I guess the doctor was in his 60s. He gave me a distance rx of +1.00. He refused to give me a reading rx. He told me that he could not make my reading vision any better. I knew that was not the truth, he did not want to give me that stronger reading power. Arguing did no good, I left the office pretty pissed. Being my first eye exam, I mistakenly thought I would be able to get glasses so I could read. I did not understand why I couldn't get reading glasses.

I waited a month and I went to another doctor. I think he was 28-30. I told him I had to strain really hard to read. After checking my distance, he used a Jackson fused cross cylinder test for my near vision. He said I needed bifocals. I was farsighted and had an accommodation problem. My rx was: +1.00, add +1.50.

Having my own glasses, I wore them more often. I realized in a short time that I could use a little more add. My reading distance was about 18" to 22". During the next checkup I asked him to increase the add to about 15"-16". He did, and I got a +2.00 add. That worked great until I was about 30. By then, I needed another boost. The add increased to a +2.50.

I had always worked in electronics. For normal reading the new add worked perfect, but I could still use a stronger add my electronics work. I got a stronger pair of bifocals for use at work. My distance had finally changed a little, and that took 15 years. My new rx was: +1.25, +1.25 -0.50 X 90, add +3.00. I had a few ups and downs in my distance rx until I reached about 52. Since then I have worn progressives full time +1.25 -0.50 X 95, +1.00 -0.50 X 68, add +3.50. They work fine for everyday use. If I sit at my computer for an extended time, I will use an SV pair with a +1.25 add. The monitor distance is 33" away.

Until I reached my mid 40s, I could still force accommodation.


Cactus jack 13 Jan 2013, 07:59

SC,

I think, but honestly don't know, that genetics plays a very large role in the molecular structure of the crystalline lenses and the rate at which that structure changes over time. Also, diet and medications (self prescribed or professionally prescribed) may have an effect. I am not sure anyone know exactly what causes presbyopia itself to occur or what specific changes are involved. Obviously, something is changing to reduce flexibility. Same thing with cataracts in their various forms, something is changing to affect the transparency of the proteins.

I think you are exactly right about keeping the ciliary muscles exercised to prolong their ability to squeeze the crystalline lenses. As I have mentioned on other threads, I think going without glasses is a really long term dumb idea if you are myopic. If your prescription is just right, your ciliary muscles never have to do anything and they will atrophy like any other unused muscle. I also suspect that the focus control system in your brain will also forget how to even make them try. Use it or loose it applies to a lot of things and recent research on brain function has found evidence that the brain can re-arrange its resources as it needs, even into old age.

C.


SC 13 Jan 2013, 06:44

LT Lurker

Just saw your earlier post of accomm formulae. I think the formulae are just approximations and can't be used to explain variances. As you say Donders seems high but for some people I know still not high enough! Hofstetters is just too linear.

A key factor seems to be visual exercise - if you are a corrected hyperope, or a myope with an add, or a myope who takes their glasses off to read then you seem to have lower accommodation. If you are a myope who always reads through the glasses, or better still a contact-lens myope then you can have super-human accommodation (ie can read through minus lenses into their 50s)

I tried to come up with a forumula based on myself, friends and family (by guessing rx) and the only thing I could conclude was that if you needed an add before 45 then either you were a psuedo myope or a latent hyperope and one day (perhaps several years later) your distance Rx would change accordingly.

As CJ would say - everyone is different, and if you see John S posts then he cleary not subscribing to any formula!


Val 12 Jan 2013, 16:07

Julian, you could post the Macrae saga on Vision and Spex.

Maybe Bobby didn't get your email...


Aubrac 10 Jan 2013, 12:29

I have a friend who's partner wore glasses since her teens and had a scrip of about -4.00. Her daughters also wear glasses with maybe lower scrips of -2 and -3.

She had an operation a year or two ago for cataracts and at age 60 was quite indignant that this should happen so young.

However, her lens implant corrected her short-sight and whenever I saw them she was bare-eyed and was ok for distance and it seemed reading.

About six months later she was wearing glasses, plano distance and maybe less than +2 add, but when I saw them last week she has low plus for distance and about +2 reading add.

Maybe this is aged related presbyopia kicking in and perhaps CJ could add a sage comment on this.

I must add that because I am so fascinated by prescriptions, eye conditions, etc, that I perhaps find it more difficult to enter a general conversation about this than other people do.


Cactus Jack 05 Jan 2013, 21:37

Snowman26,

Julian sent me the Macrae Saga file and it was a delight to re-read Macrae's well written and humorous adventures in the world of wearing glasses.

If you would like me to forward it to you, please contact me privately at cactusjack1928@hotmail.com

C.


Cactus Jack 05 Jan 2013, 10:39

Thanks Julian,

I was pretty sure you had created a file of the saga and I think you might have even sent me a copy. Unfortunately, with the evolution and replacement of computers I lost it. I think you can send it via cactusjack1928@hotmail.com If hotmail won't allow attachments we'll figure out something else via direct email.

Cactus


Julian 05 Jan 2013, 01:57

Hi Cactus and Snowman26. I actually edited the whole Macrae saga into a file (112K). It began in 2007 and ran right through 2008 with a couple of posts in 2009. IMHO it made and makes great reading. I sent it to Bobby once suggesting it could be posted as a non-fiction story, but I never heard anything back - for some reason emails that Bobby sends never reach me - so I don't know if he got it. But I can easily send it to either of you if you like. One piece of fiction that's very informative is a story called 'A learning curve' - it's at http://bobbylaurel.blogspot.cz/2012/09/a-learning-curve.html

Snowman, you write as if you see your need for glasses as a life sentence. Look at it another way: the life sentence is to the headaches that took you to the doctor in the first place, and the bad vision that hasn't quite hit you yet. The glasses are the cure, the remission, the relief. Get them, wear them (yes, full time) and enjoy them. You won't regret it!


Jamie32 04 Jan 2013, 20:41

Snowman 26, welcome to the club of glasses wearers. Looking forward to hearing more about the journey!


Cactus Jack 04 Jan 2013, 16:39

Snowman26 & Julian,

The file search took a little longer than it should, but at least it is still there. I believe the gentleman's name is Macrae and I believe the adventure started in September or 2008. The actual thread has not come to me yet.

C.


Cactus Jack 04 Jan 2013, 16:31

Snoman26,

The prescriptions confirmed my suspicions. I've got some good news and some bad news.

The good news firs. it is unlikely, at your age, that your actual hyperopia will change much, but it will probably seem like it has. As hard as it may be to believe, your reading, studying, and close work with computers may have had the effect of reducing your actual hyperopia by stimulating your eyeball growth when you were young.

As I mentioned, I am not an Eye Care Professional, I am 75 and semi-retired. My background is Electronic Engineering and Computer Design and Applications for specialized industrial purposes. When I went to school, computers were laboratory curiosities. The same year I graduated from High School, Thomas Watson of IBM stated that he thought there might be a market for 12 computers in the world. He was off by a few orders of magnitude. I had to teach myself about computers and using them to solve problems. I developed a need to wear fairly high Base Out prism glasses because my eyes would like to be crossed. I am fundamentally a problem solver and I was not satisfied with the answers I was getting from Eye Care Professionals as to why I could not see 20/20 wearing prism glasses and I saw 20/20 or better with glasses without prism - just double. My problem solving instinct took over and I learned all I could about vision and how it worked. I discovered that it was not as mysterious as the ECPs implied and the Optics I had leaned in Physics was equally applicable to the optics of vision and the math was no more difficult than basic algebra and trig.

Back to your questions. You need to get your mind around this. You are NOT going to BECOME dependent on vision correction, you already are and have been for years. Up until now you have been able to correct your vision using your built ciliary muscles and crystalline lenses. However, Presbyopia is slowly robbing you of that ability.

One thing that happens when your ciliary muscles and crystalline lenses have to constantly compensate for your hyperopia is that they, in effect, "take a set" and cannot fully relax for distance vision. Remember my reference to Latent or Hidden Hyperopia? Hyperopes frequently require a series of increasing + sphere prescriptions (the 1st number) over several months until your ciliary muscles and crystalline lenses fully relax. You may find that your distance vision is fuzzy with your first prescription. Your distance vision will gradually clear up over a few weeks and your close vision will become much more comfortable. At some point your should switch to occasionally wearing the 2nd prescription, at first for reading and the computer and then, if possible for distance. Again, initially your distance vision may be fuzzy, but that should gradually clear up. Hopefully, your distance vision will not fully clear up as your ciliary muscles and crystalline lenses relax. At that point, you need another dilated exam an that will probably be your long term sphere prescription.

There is a small risk of de-conditioning your ciliary muscles by letting the 2nd prescription glasses do their work for them for close work. For their size, the ciliary muscles are the strongest, hardest working muscles in the body, but they can, like all muscles loose their tone and conditioning pretty quickly. When that happens the symptoms of Presbyopia will appear to have increased suddenly, when it actually has not.

Wearing the correct distance prescription will relieve your ciliary muscles and crystalline lenses of work that is really not their job. Their job is to add + power to your eye's lens system to allow you to focus closer than infinity (technically), but practically closer than 20 feet. That is where the 20/20 Visual Acuity fraction came from. It means that you can see at 20 feet, what a person with "normal" vision can see at 20 feet. Normal in this case is what 80% of the population can see at 20 feet. The actual vision limit depends on the number of rods and cones (pixels) in your retina - typically around 120 million - and is around 20/15. Some animals and birds have much better visual acuity than most human beings.

Most people like to read at distances from about 11 inches to 18 inches with the average being close to 16 inches. The amount of plus that the ciliary muscles/crystalline lenses need to supply is only +2.50 to focus at 16 inches. 11 inches takes about +3.50. When presbyopia finally makes it impossible for the ciliary muscles to focus the crystalline lenses, you WILL need bifocals with that amount of ADD for reading and possible an intermediate trifocal segment of about half the reading ADD. People who have hyperopia tend to need bifocals at an earlier age than people who have myopia. Needing bifocals or trifocals is not the end of the world and many people try to delay wearing them far too long. Almost universally when they get them, they wonder why they waited so long.

Presbyopia tends to come on gradually and often first bifocals have an ADD of around +1.25. What that means is that you can still internally supply +1.25 of the +2.50 to focus at 16 inches.

I sincerely hope these long winded explanations help. One thing that will probably happen is that VANITY will rear its head (yes, men can be VAIN also) and you may be concerned about what others will say about your glasses. Remember, glasses are simply a tool to help you see better and you wear them for YOUR benefit, not for the benefit of others. With glasses, most people only notice the frames. There may be a few comments after you get your glasses, but that only lasts a day or two. After that, the only comments you might get is if you change frames. People rarely notice changes in your prescription.

Several years ago, there were a series of very humorous posts by someone, like yourself, who was shocked to learn that he needed glasses. He has exceptional writing talents and his adventures becoming a full time glasses wearer kept us all laughing with him for several months. I'll see if I can find the posts and direct you to them.

One of the problems with being 75 is that your internal file storage system probably needs de-fraging and it sometimes takes a while to recall a particular reference. Julian, if you are following this discussion, I think that you made a point of saving that wonderful series of posts. Can you help me out here?

C.


Snowman26 04 Jan 2013, 14:12

Thank you for the explanation. Its good to know I'm not the only one this has ever happened to. I was just concerned that wearing strong glasses, or starting off wearing them all the time, would make me need them forever, but it sounds like from your explanation that I already need them, but can get by without them. Do I understand this right?

The first prescription says

OD +2.25 -0.75 100

OS +2.50 -0.75 105

The second one is

OD +3.75 -0.75 100

OS +4.00 -0.75 105

I am 26 and live in the northeast USA. I work as an IT project manager. You probably cant tell without examining me yourself, but could any of this be caused by a computer screen making my eyes bad? Should I request a larger screen from my employer to stop this. Will my eyes continue to need stronger glasses?


Cactus Jack 04 Jan 2013, 07:05

Snowman26,

You will probably be surprised to learn that thousands, if not millions of people, all over the world, have experienced something similar to your experience. A few, like yourself, have discovered this and another website, with almost the same membership, both are dedicated to the discussing vision problems and their solutions. Whenever possible the members try to share their knowledge and experiences to promote education and understanding. Most are not Eye Care Professionals (ECP). A few, like myself, are Amateurs in the original French meaning of a person who studies a subject for the love of it. My background is Electronic Engineering and Computers and my optical knowledge comes primarily from finding solutions to my own vision problems.

Many first posts are by people, like yourself, who have been "blindsided" by the discovery that their "perfect" or "better than perfect" vision, really isn't as perfect as they thought (or bragged about) and their confusion and frustration are obvious. We can help you learn about vision and how it works. We can also tell you how to get the most out of an eye exam with the best possible prescription.

Speaking of eye exams, your exam appears to have been a very thorough one. What occurred is very typical for a first eye exam of a person with Latent or Hidden Hyperopia and the creeping onset of Presbyopia.

The biological camera we call the eye and its image processing and control system in the brain is one of the most fascinating features of complex life on Earth. Of all the things that can happen to this incredible vision system, the combination of Hyperopia and Presbyopia is the most complex and difficult to accurately diagnose and prescribe during an eye examination.

The problem is that your vision system, in particular, is too clever and efficient for your own good. During the part of the exam for Hyperopia, the auto-focusing mechanism in your eye and brain, which has masked your hyperopia for most of your 26 years, fights the examiner by automatically compensating for the different corrective lenses (the 1 or 2 part) he tries. The solution for him is to put some drops in your eyes that do two things. For normal exam purposes, the drops paralyze the ciliary muscles that are instructed by the focus control in your brain to change the power of your crystalline lens. The second thing the drops to is dilate or open the iris or pupil, the light intensity control part of the eye. Dilating the pupil of the eye contributes slightly to the accuracy of the exam, but it is most useful in permitting complete examination of the retina. The eyes are the only windows into the body and many diseases affect the retina before any other symptoms appear. Often, a through eye exam is the source of the early clues that something else (high blood pressure and diabetes come to mind) needs attention and prompt treatment.

The problem for you, as a patient, is that the drops take a few hours to wear off and until they wear off you can't focus close to read and if you have hyperopia, you can't focus for distance, either. On top of that, bright light is murder because your pupils cannot close down to block the light. Hopefully, they gave you some very dark sunglasses to help with the too bright light, but the sunglasses can't do anything for your blurry vision. If you recall how blurry your distance vision was with the drops, that will give you an idea of the extra work your ciliary muscles and crystalline lenses have been having to do to provide clear distance vision for your and how much more work they have to do for you to focus close.

To face facts, you have been subjected to a psychological shock that you never imagined possible. Fortunately, there are easy, though mildly inconvenient, solutions. The lens system in your eyes needs some external help with supplemental + lenses. How much + is indicated by those prescriptions I asked for. There are three common solutions, each with their own advantages and inconveniences. Glasses are the most obvious, also there are contact lenses, and even some surgical procedures that can correct hyperopia and, if necessary, presbyopia. The good news is that if your hyperopia is corrected, it may be a few more years until you need correction for presbyopia.

None of this is the "End of the world" and many, if not all, of us have "Been there, done that and, in our case, got the glasses" and survived handily. We are here to help and look forward to your questions.

May I ask where you live and your occupation, it will help us offer suggested solutions.

C.


Cactus Jack 03 Jan 2013, 22:53

post deleted at authors request


Snowman26 03 Jan 2013, 19:12

I found this website and had some questions about a recent examination and recommendation to wear glasses full time. I was recently refered to have an eye test after complaining to my family doctor about headaches. I have never had trouble with my eyes so I put this off for several months, but when nothing else helped the headaches, I decided to schedule a check up at a place at the mall.

During the exam, the doctor seemed puzzled and it was if he was questioning my answers to the which is better 1 or 2 questions. When I thought everything was done, he said that he detected quite a bit of variability in my answers and what the computer told him. He recommended placing drops in my eyes to get a better reading. I was quite nervous that he had found something serious, so I allowed this, not knowing that the next 6 hours or longer would be terribly annoying and unpleasant. Within about 10 minutes of the drops, I could no longer focus on anything, and even the mall lights were incredibly bright and painful.

It seemed like the doctor repeated the entire exam over with the computer thing and the 1 or 2 questions, and when it was over he said that my eyes were healthy, but I would need a very strong prescription for glasses, perhaps even need bifocals, once I got used to them.

Is this a normal occurrence for someone who is 26? I have never had problems with my eyes before and can see better than some of my friends. Do I need to get a second opinion from another doctor? Should I really wear these all the time going from not needing glasses at all? I was given 2 prescriptions, one to wear at first for 4-6 weeks, then another to “grow in to”. The store had a 2 pairs for $99 deal, so I ordered glasses, but I’m concerned that this might make my eyes worse and wind up needing glasses forever.

Help and advise are appreciated


Cactus Jack 30 Dec 2012, 20:01

LT Lurker,

It sounds like an interesting project. Hopefully, you will get some useful responses.

One thing that may skew the data significantly is the amount of latent hyperopia and other vision problems being revealed by the myriad of hand held devices with small displays. These displays expose hyperopia, presbyopia and weak ciliary muscles, years before they commonly affected close vision in the past.

It will be interesting where this leads. As younger and younger children are exposed to reading tiny text and focusing on tiny images, it may be an opportunity to prove or disprove environmental factors in the development and progression of myopia.

C.


LT Lurker 30 Dec 2012, 17:07

Cactus Jack,

I am interested in the various anticipated amounts of accommodative amplitude AC/A available in the 30s and 40s and how they vary quite wildly.

Donders scale has the lowest expected whilst Hofstetters formula suggests much more is available.

I was hoping to take a survey to see who is closest as many eye care professionals seem to use Donders scale which if compared to Hofstetter would be wildly inaccurate.

Hofstetter's maximum at 45 was a huge 7D

So it really is a question of what is your Age and Accommodative Amplitude.

I was also interested in how many hyperopes had this higher amount of Accommodative Amplitude as there seems to be a large amount of people getting relatively strong RXs into their late 40s for a first prescription.


Cactus Jack 29 Dec 2012, 07:32

LTLurker,

I am having trouble understanding the purpose of your question.

There are factors, other than hyperopia/presbyopia that can affect visual acuity at any distance. - astigmatism for instance.

From the information you provided, you have -2.25 of myopia, which is like having permanent built in reading glasses of +2.25. That means that your distance vision gets blurry beyond about 45 cm (17.7 inches). If you can read at 15 cm with some comfort, that requires +6.66 diopters of total focusing power. All that means is that at 45, you still have about 4.50 diopters of accommodation range - the difference between +2.25 and +6.66. That is good, but not uncommon for myopes, who seem to develop presbyopia at a slower rate than hyperopes. However, no matter what the cause of a persons refractive error, genetics play a bigger role in the development of presbyopia than age alone and conditioning of the ciliary muscles plays a significant role in the apparent progression of presbyopia. Weak ciliary muscles can't squeeze stiffening crystalline lenses as well as strong ones. If you read wearing -2.25 glasses, you are exercising your ciliary muscles. If you take your glasses off to read, you are not.

May I ask your point and purpose? Understanding that may help you get some responses.

C.


LTLurker 28 Dec 2012, 21:00

Here's a question for all you presbyopes/hyperopes...what distance can read a newspaper from - uncorrected?

Please state 1.age 2. prescription 3.duration possible.

I'm 45 -2.25 15cms I seem comfortable for a while!

Cheers

LTL


Cactus Jack 14 Dec 2012, 22:46

AJ,

You need to face reality, you are not far from needing correction for both distance and near vision. That is nothing to be ashamed or worried about it is just nature taking its normal course. Your significant astigmatism does limit your options to either toric contact lenses for distance and OTC (sphere only) reading glasses or multifocal glasses of some sort. I think, depending on your visual environment, that you would find bifocals comfortable and useful. Progressives are also an option, but as your bifocal add power increases they often become marginally satisfactory because of the very limited size of the transition zone between distance and near focus powers.

There are actually two things going on with your vision, both are presbyopia related. One thing is that your crystalline lenses are becoming gradually stiffer and harder for your ciliary muscles to make focus close. The other thing is that your ciliary muscles are becoming de-conditioned. Both things happen so frequently, that "typical" is a very good descriptive word.

If your eyes are properly corrected for distance (I am not 100% sure that your distance glasses offer full correction for distance, but they are probably close), the glasses you had made up provided in effect an add of +1.25 for close work. The +1.25 was just right for focusing at 80 cm (31 inches), but the laws of optics apply all the time, every time, no mater what your age, and that meant that for focusing at any distance closer than that, you needed a bit more plus.

Your ciliary muscles and crystalline lenses can easily supply the small amount of extra plus you need, but that is going to change. In fact the change is already underway. The increase in the stiffness of your crystalline lenses happens pretty slowly, but while the ciliary muscles are the strongest muscles in the body for their size, like all muscles they can become de-conditioned very rapidly and become weakened. When you use any plus help for focusing, you are relieving your ciliary muscles of some of their work load and helping them loose some of their strength and that is what you are experiencing. The net effect of all this is for you to feel like your presbyopia is increasing more rapidly than it actually is. One thing to remember is that it WILL NOT increase much more. Typically, the add winds up around +2.50 (40 cm or 16 inches) unless you like to read very close or do some close work.

I mentioned earlier that I was not sure your glasses prescription was exactly right. The fact that your distance vision with the +1.25 glasses seems to be getting better indicates to me that you may have had a little bit of latent hyperopia or pseudo myopia (actually the same thing, what it is called depends on which side of 0.00 you are on). The cause is that your ciliary muscles and crystalline lenses get used to maintaining some small amount of focusing power instead of fully relaxing. By wearing the +1.25 glasses you have helped them relax and the result will be a more accurate correction.

Three suggestions:

1. Wear your +1.25 glasses to the exam and tell the examiner that you got the glasses to help you with the computer and reading. Initially, you found your distance vision a little bit blurry, but it seems to be clearing up. If he asks where you got them, tell him from an out of town store.

2. Consider a dilated or "wet" exam if it is available.

3. Your astigmatism is a significant part of your prescription. Check out my posts on the Astigmatism thread about fine tuning the axis of your prescription.

Please let me know if there is any part of this you don't fully understand or any part that doesn't make sense.

Three questions to help me answer your questions better:

1. Where do you live? (country and state or province)

2. What is your occupation?

3. Did your education include any math and/or physics?

C.

P.S. Your wife's thoughts are pretty close, but you may be happier with bifocals for work rather than progressives.


Cactus Jack 14 Dec 2012, 12:46

AJ,

You didn't hurt your eyes. In fact you did a good job of solving your problem in spite of your ECPs mindset. You need focusing help when you need it, not when some myth (that is all it is) says that you absolutely don't need it until you are 40 of better.

I will try to explain more a bit later on exactly what has taken place and offer some suggestions about you next eye exam. Here is the first suggestion, find another ECP.

C.


AJ 14 Dec 2012, 09:07

I have had glasses since I was 18 - (38 now). The prescription has stayed pretty stable going as high as -1.00 (mid 20's) (both eyes) in sphere and has now dropped as I have aged to:

-.25 -2.00 83

pL -1.50 90

I noticed that I was having trouble up close and on the computer so I went to the Dr a year ago. He said that it was too soon for progressives/bifocals even though I was getting severe eye strain.

After dealing with that for a while I decided to try something. Since I have hig-ish astigmatism OTC readers do not work and wearing another pair of glasses overtop of my existing ones isn't practical.

I saw a promotion online for a free pair of glasses so I decided to make my own readers. I ordered a pair with the following prescription.

+1.00 -2.00 83

+1.25 -1.30 90

I just added +1.25 to my existing prescription.

I got them about a month ago and wow what a difference for up close/intermediate. Distance is blurry after about 20ft but has slowly been getting better. On the computer and reading its like my eyes have finally relaxed.

The problem is now I can't seem to read/use computer comfortably without them. If I try to even use my phone - I can still see it but Its blurry at first and then I can feel my eyes straining to focus.

Have I damaged my eyes? My wife says that my eyes just prefer these glasses for up close and this is just proof that I need progressives and that the Dr. messed up.

I am not due for an exam for a month or two - should I continue to use these? Does this mean progressives are forgone conclusion? Switching back and forth is really annoying.


John S 07 Dec 2012, 22:25

William,

Sorry, I did not read your post thoroughly. Wear them at little as possible if you want the minimum rx.


Cactus Jack 07 Dec 2012, 11:03

William,

You didn't mention any ages. Always important when discussing hyperopia and presbyopia progression.

C.


John S 07 Dec 2012, 10:57

William,

If you wear them as much as possible before the exam (including the weekend), that could cause your eyes to relax a little more. You might end up with a small increase in your rx, or it may not make any difference. It is certainly worth a try.


William 07 Dec 2012, 10:51

Thanks Soundmanpt.

I have worn mine sparingly, and I presume that is why I can still do some reading without help.

She got some foxy looking glasses and started wearing them for almost all close work. She likes wearing them and sometimes even wears them for distance..something I can't do cause it makes things too blurry. When I told her I am going for another exam she said she thinks she is ready for one also.


Soundmanpt 07 Dec 2012, 10:41

William

I would say it is always best if your not wanting much of an increase to go for your exam as early in the day as possible and certainly not after you have been doing much close work.

In regards to your work colleague it is hard to say why she wasn't prescribed glasses the first time she went. It could be if she is on the young side the doctor may have felt she didn't need a reading prescription yet? Also I wonder if she mentioned that she had tried your glasses and found that they helped her? Also as you said it could be that her first visit she may have only showed a very slight need (+.50) and after 6 months her eyes have changed some? Did she get glasses and how often does she wear them? Like yourself, she too will likely need an increase in a year or less.


William 07 Dec 2012, 10:06

About a year ago I was prescribed readers that are +1.25's. They didn't make much difference at first, and I can still read without them, although over the year I read much more clearly with them. I find more and more now, that if I pick up for example a newspaper, I can read without too much difficulty without my glasses. But after reading a bit and I take them off I can't read anything..all I see is a blur.

I have an exam scheduled for Monday. Should I wear the glasses during the day to relax my eyes, or go without them as much as possible. Although I expect an increase in strength, I would like to minimize the increase so as to delay becoming completely dependent on them.

On a separate note, a colleague of mine tried on my readers not long after I got them, and liked the improvement in her close vision. She went for an exam, and was told her vision was ok, but told to come back in 6 months. She went back 6 months later, and was prescribed +1.00 for close. Why didn't she get them 1st time through..did her vision change that much in 6 months?


LongTallSighted 20 Nov 2012, 08:55

I'm confused. I always read here that when you get glasses for hyperopia in your late 30s that progression is fairly swift.

I got my eyes tested yesterday a year after first prescription:

L: +.5 -.25 180 base in 1

R: +.5 -.25 180

Add .5

This is identical to my previous prescription. What confuses me more is that I saw what the auto refractor print out said:

L: +1.25 -.5

R: +.75 -.5

Any ideas why the prescription hasn't changed. My eyes *feel* worse than a year ago.


Soundmanpt 16 Nov 2012, 12:00

Carrie

I almost forgot what you said about your friend from college. That's right she is still wearing her first glasses isn't she? She got glasses not long after you got your first pair so I think it may even be more than a year. She is way past due, but she must feel like her glasses are still good or else she is just putting it off. Maybe when you and Gemma get together with her on a girls night out you can point out Gemma's new glasses and mention about your cousin getting glasses and ask her when she is due to get her eyes checked? You can even remind her that she got her glasses about the same time you got yours and you have since gone and got new glasses months ago already. It never hurts to give someone a gentle nudge to get them moving.


Soundmanpt 16 Nov 2012, 11:46

Carrie

Since her glasses are very similar to your prescription I think in a very short time her vision for reading will be much the same as yours is. Of course right now she just finds wearing her glasses more comfortable for reading as it makes it much easier. Right now she is probably still able to read pretty well without them but that will get harder and harder for her soon. But since she is determined to not want to wear them for anything more than close work her distance vision should remain good without glasses unless she gets to where she hates doing the on off thing all the time and she decides to just keep them on. You were lucky because your first glasses were weak enough that wearing them full time was much easier as distance was only slightly blurry for you and your eyes soon adjusted to where the blur went away. This worked well for you since you wanted to wear your glasses full time anyway. Your cousin's glasses are stronger than yours were and even if she wanted to wear them full time it would take some getting used to before the blur would go away. You will just have to see how her vision changes over the next year.


Carrie 16 Nov 2012, 08:32

She did say that when she takes her glasses off it goes out of focus for a few moments. I know what it's like as when I take my glasses off text is very blurry and then I can force my eyes to focus but that is very tiring on my eyes. I expect my cousin will get to that stage soon.

I don't just wear my glasses all the time because I want to but because they make things HD clear at distances as well as close up. I know everyone is different but I'd be surprised if she didn't find distances are slightly better with her glasses on eventually.

She's around the same age I was when I first got glasses but she's got a stronger prescription than I had. I don't think she would ever wear contacts as she's more squeamish than me and I'm still amazed that I ever got a contact lens in my eye never mind still occasionally use them.

I haven't seen my college friend for a while as she got a place at a university not far away and also wants to spend a lot of time with her girlfriend who treats her far better than her last boyfriend. We still speak to each other on the phone but with me working full time but not always "normal" hours and her university work it's been difficult to find a time to meet up. She and her girlfriend want to have a "girly night out" with me and Gemma when we do find the right time. I haven't asked her about her glasses as she might think that was a bit strange but it's 2 years since she got glasses so she must be due for an eye test.


Soundmanpt 16 Nov 2012, 00:37

Carrie

I think she may be surprised with only wearing her glasses for reading and even being young she may soon find that reading will become more and more difficult without them. So she probably will be able to hold off wearing them except for reading but she will find it annoying to constantly be taking them off and putting them on. Remember her prescription also must be about the same as your college friend and she too tried very hard to avoid wearing her glasses but she was soon either wearing them or she had them on top of her head. Even that soon lead her to try contacts. Now as you know she has gone to full time wear just like you. But unlike you she didn't have the same desire to wear glasses like you did. She likely be able to do as she wants for a while but as you know by next year this time she will be needing stronger glasses. For now wearing them as was suggested for a few days full time won't cause her to need them full time that quickly, only if she were to decide to continue to wear them would cause that. Her doctor just wants her eyes to get more adjusted to them and relax her eyes from the strain she has been giving them.


Carrie 15 Nov 2012, 19:55

Soundmanpt - I think you are right about the strength of my cousin's glasses. She got them on Tuesday and I went round to see her yesterday (Thursday) after work. She still doesn't know her prescription but it must be very close to my prescription as I can see perfectly well with her glasses and she's the same with mine. She says her eyes do feel so much more relaxed when she reads with them on but she feels a little bit dizzy for a few minutes when she puts them on. I said I thought it's probably because she's not used to them yet and she's still adjusting to straining her eyes for so long. She said although her glasses make reading more comfortable and clearer they make seeing boards and screens at college worse. Not really bad just slightly out of focus. She said the opticians suggested wearing her glasses as much as possible for a few days so she can get used to them quicker. She's reluctant to do this because she thinks she will need them all the time like me. I told her that I wore my first glasses all the time mainly because I wanted to. She rightly pointed out that I need to wear my glasses all the time now. I tried to reassure her by telling her that even if she got stronger glasses in the future she might not need them all the time. She wasn't totally convinced.

Her frames are fairly simple dark metal rectangular. She didn't see much point getting trendy frames as she won't be wearing them much. She would have got some if she did need glasses all the time. She does look nice in them. Sometimes simple works better than highly fashionable.

I know she will wear her glasses for reading but I doubt if she'll wear them any more than absolutely necessary.


Carrie 09 Nov 2012, 19:30

Soundmanpt - My cousin is at 6th Form college, the same one I went to. She takes her studies much more seriously than I did and will almost certainly do better than me. Lots of reading required which is why she wants to be able to see perfectly. She probably wouldn't have got her eyes tested if she wasn't doing so much reading.


Cactus Jack 08 Nov 2012, 19:27

hyperope.

The test is pretty simple and it will work for low to moderate hyperopes.

First, lets explore the optics of hyperopia or farsightedness. Axial or true hyperopia means that with the ciliary muscles and crystalline lenses fully relaxed, the eyes focus somewhere beyond infinity. A friend, who has to wear strong plus glasses asked me where his eyes focused and my answer was about the star Alpha Centauri which is about 4 light years away. Normally, plus glasses for distance are intended to bring the focus to infinity, which for our purposes is 20 feet or 6 meters. The idea of this test is to try to bring the relaxed focus to a distance we can deal with handily and easily measure where small text goes out of focus. Astigmatism can mess up the results a bit, but all we are trying to do is get and idea of where small print ACTUALLY gets noticeably blurry and compare that number to where it SHOULD get blurry.

If you wear plus glasses for distance, you will probably need those glasses and some reading glasses with a known Rx. Over-the-counter readers will work fine for this purpose if you know the Rx. You will also need a book or newspaper with typical text and a way to measure up to about 1 meter or 3 feet fairly accurately.

With known reading correction, in comfortably bright light. Hold the book or newspaper where small print is clearly in focus. Slowly move the book or newspaper away from you until you notice even the slightest blur or fuzz of the text. Measure the distance from your eyes and write this number down. Do it 3 times and average the results,

The next step is to figure out where the text SHOULD go out of focus.

Where the text SHOULD go out of focus depends on the strength of the readers or the power of the add. You can calculate where the text should go out of focus by dividing the Reading Rx or Add into either 100 cm or 39.37 inches depending on the measurements you like to use. For example, if power of the add or the OTC readers is +2.00, 2.00 divided into 100 cm = 50 cm or 2.00 into 39.37 = 19.68 inches or just under 19 3/4 inches.

If the ACTUAL distance where the text got noticeably fuzzed (or more fuzzed) is say 60 cm or 23.6 inches (a bit over 23 1/2 inches) you need to divide the ACTUAL distance into either 100 cm or 39,37 to get your apparent Add. In this instance, it would be +1.66. Hmmm! The add is +2.00 and the fuzz point should be 50 cm or 19.6 inches. That means the +2.00 UNDER corrected my actual hyperopia by +0.33 diopters. If the ACTUAL fuzz distance was less than what it should have been, then the add OVER corrected my hyperopia by the calculated amount.

Latent hyperopia complicates the issue because the ciliary muscles are probably not fully relaxed and the crystalline lenses are adding some plus to correct some of the hyperopia. You may be able to minimize the amount of plus being added by doing the test right after you wake up or wearing OTC readers over your distance glasses that are strong enough to make your distance vision fuzzy for as long as possible before the test.

This may be a little confusing, so if you need help performing the test, or interpreting the results, please contact me with specific information about your vision and your complete Rx.

C.


hyperope 08 Nov 2012, 05:10

@Cactus Jack:

You wrote to Lucas: There is a pretty simple test that you can do to get an idea of your actual hyperopia. It takes about 5 minutes and all you need is a book or a newspaper with normal sized print, something to measure distances of 100 to 150 cm or 3 to 4 feet, and your glasses.

Let me know if you want to try it and I will tell you how to do the test.

Could you explain how this works? I'm hyperopic but think that there might be some more hyperopia hidden.


Soundmanpt 07 Nov 2012, 18:20

Carrie

Good to see your not modest at all. lol But i'm sure your right that she will look very nice with her new glasses. I don't think you will have much luck convincing her to wear her glasses except for reading and I wouldn't want to bet she will even bother to wear them then unless she is doing a fair amount of close work and she feels her eyes are straining. Does she have a job or is she in school where she does much close work?


Carrie 07 Nov 2012, 15:46

She was told they were for reading. I think she would have horrified to be told to wear them all the time! I'll probably go and see her soon after she gets her glasses. She doesn't live very far from me. I expect she will look stunning in her glasses - well she is related to me ;-) !


Soundmanpt 07 Nov 2012, 09:43

Carrie

That makes sense, I was wondering since I know you don't have any problem letting others try your glasses. Certainly no surprise that she was prescribed glasses. Did she say if she was told to wear them full time or just for reading? My guess is she will try and only wear them for reading as she isn't as thrilled about wearing glasses like you are. Sounds a bit like your college friend when she got her glasses, she too avoided wearing them as much as possible but the more her eyes got used to them the harder it got to read anything without them.

I assume you will be looking forward to seeing your cousin after she gets her glasses so you can compare them to yours. When you see her you should have your old pair with you to see if she can tell the difference between her glasses and your 2 pairs. My guess is hers will about the same strength as your current ones are.


Carrie 06 Nov 2012, 19:05

Soundmanpt - I should have said that I was talking to my cousin on the phone. I would have certainly let her try my glasses on if I'd been with her.

She emailed me this evening to say she'd been for her eye test and did need glasses. She picked out her frames and her glasses will be ready next week. She said she's not looking forward to getting glasses but is looking forward to reading without eyestrain. She doesn't know her prescription.


Cactus Jack 05 Nov 2012, 22:14

Lucas,

It is likely that +1.25 is a bit more plus than you need for distance at this time. When you wear your glasses for distance, they actually make you slightly nearsighted. Part of the problem is that you really don't know how much true hyperopia you have and there may be no really easy way to find out exactly, even with an eye exam. The reason is that a person of your age and no hyperopia (0.00 Rx) can typically change focus from fully relaxed to say +2.50 for reading at 40 cm or 16 inches and relax again for distance in a fraction of a second. A person with latent hyperopia (and we are not sure you have any) might have a semi-fixed accommodation bias of say +1.00 to correct his hyperopia and be able to accommodate a further +2.50 (total of +3.50) to read at 40 cm or 16 inches very quickly and relax back to +1.00 very quickly for distance. However, the ciliary muscles are so used to adding the +1.00, maybe for years, that that is where the relaxation stops.

One way to get an idea of a persons true hyperopia is to get a dilated or "wet" exam. For those exams, drops are put in the eyes that temporarily paralyze the ciliary muscles and prevent accommodation. However, while that may reveal some latent hyperopia, the agents used are not strong enough or long lasting enough to fully relax the ciliary muscles and crystalline lenses of a long term latent hype rope. But, it is better than nothing. If you get a dilated exam, it will probably take 3 to 5 hours for your pupils to close up and accommodation to return to normal. There are some pretty strong agents that take days to wear off, but you REALLY would not like those so most ECPs won't use them except in very rare instances.

There is a pretty simple test that you can do to get an idea of your actual hyperopia. It takes about 5 minutes and all you need is a book or a newspaper with normal sized print, something to measure distances of 100 to 150 cm or 3 to 4 feet, and your glasses.

Let me know if you want to try it and I will tell you how to do the test.

Also, it would be helpful if you had your actual complete glasses Rx.

Could I as where you live (country and region, state or province) and your major in college?

That may affect my suggestions.

C.


Lucas 05 Nov 2012, 19:01

I have tried to wear them full time a few times but after a few hours the blur was too annoying and too much. I might give it another shot again


Cactus Jack 05 Nov 2012, 18:11

Lucas,

I thought so. Low hyperopes and latent hyperopes often think they have perfect vision without correction and they are right. What they usually don't understand is that they have the built in ability to self correct hyperopia.

Both hyperopia and myopia are caused by a mismatch between the optical power of the eye's lens system and the length of their eyeball. The eye's lens system has 3 fixed focus lenses (cornea, aqueous humor, and vitreous humor) and one variable focus lens (crystalline lens). If the eyeball is too long for the lens system's relaxed power, you have too much plus in your lens system and distant images focus in front of the retinal and you need minus lenses to move the focal plane back to the retina. If your eyeball is too short for the lens system's relaxed power, distant images will focus behind the retina and you need more plus to move the focal plane forward to the retina. Incidentally, the distances involved are about 0.5 mm per diopter.

Myopes are stuck with their problem and require external lenses to fix their problem for distance, but if the myopia is less than about -3.00 they have built in reading glasses which are great for close work. In some ways, hyperopes are lucky. If the hyperopia is not too high and if presbyopia has not become a real nuisance yet, they can use their ciliary muscles and crystalline lenses to fix their distance problem without even being aware that they are doing it. Fundamentally, that is what you are doing. This works pretty well until presbyopia starts creeping up on you and you are faced with a very high close up visual workload which is why college students often need some reading help and teens need reading help with the tiny text on mobile devices.

You probably think you are too young to have presbyopia problems. Wrong! Presbyopia actually begins in very early childhood, but most children are born with very high accommodation. They can typically focus effortlessly for hours at 6-8 inches (15-20 cm), but as they get older, their crystalline lenses become stiffer and harder to focus. The idea that you do not need focusing help until 40 is a myth. When presbyopia becomes a nuisance depends on your genetics more than anything else coupled with how much close work you are doing.

As a low hype rope, your ciliary muscles really never have a chance to relax, even for distance. As I said in my previous post, the ciliary muscles are the strongest and hardest working muscles in the body for their size, but they still get tired. I think that you are primarily experiencing fatigue problems made worse by your astigmatism.

I think you should start seriously start thinking of full time distance correction which will let your ciliary muscles relax for distance and free up some of your accommodation for focusing close. One thing you need to be aware of is that you probably have some latent hyperopia which occurs when your ciliary muscles have been correcting your hyperopia for so long that the have trouble fully relaxing. This means that when you start wearing plus glasses full time, you may initially have blurry distance vision that will gradually clear up as your ciliary muscles relax. Some times it requires a couple of increases in your distance Rx over a few months for your ciliary muscles to fully relax.

You may be tempted to delay distance correction, but all that will do is make it harder for your eyes to fully relax in the future and probably mean an earlier need for bifocals. To delay the need for bifocals as long as possible, you need to relax your ciliary muscles for distance and keep them in condition by using them for normal accommodation rather that using up their available accommodation range for correcting your distance vision.

BTW, your super sharp distance vision is optically the same as a myope who is slightly over corrected. Some people find super sharp distance vision stimulating.

C.


Lucas 05 Nov 2012, 16:55

I am farsighted, have had the glasses for about two years now, and only wear them occasionally, when I feel the need for them. I was told to only wear them while reading and that I had perfect distance vision. I have the best distance vision of almost anyone I know, often being able to read things many cant. I just am surprised at how sometimes they'll seem so useful while I can go weeks without them


Cactus Jack 05 Nov 2012, 16:17

Lucas,

You really didn't provide enough information to answer your question. I suspect you are a bit hyperopic (farsighted) and your ciliary muscles are having to work extra hard to focus close for reading and using the computer without some help. The ciliary muscles, which are the strongest and hardest working muscles in the body for their size, are what are doing the work to focus your crystalline lenses. Like all muscles, they can get fatigued and and even have spasms. Even the small amount of astigmatism complicates things, because at your age, you should be able to compensate for a little hyperopia, you have no ability to compensate for astigmatism without external correction.

You didn't mention any suggestions from the ECP regarding when you should wear your glasses. May I ask how well you see distant signs and text with and without your glasses?

C.


Lucas 05 Nov 2012, 13:23

I am 21, in college


Cactus Jack 05 Nov 2012, 13:22

Lucas,

What is your age?

C.


Lucas 05 Nov 2012, 11:14

I have a question concerning the use of my glasses. They are about +1.25 with 0.50 of astigmatism correction if I remember correctly. What I am wondering about is why they seem to help so much on certain days and then I can go a week without feeling the need for them. Is this because eyestrain depends on the activity over the day. Somedays they will be a life saver and other will barely make a difference

thanks


Soundmanpt 05 Nov 2012, 10:53

Carrie

If she has been feeling eye strain for a few years but it has reached a point of concern for her now she will likely be given a prescription stronger than your first glasses and probably closer to your current ones. The doctor may start her off with something a bit weaker and have her return in 6 months or so. A lot depends on how strained her eyes are. But it doesn't sound like she will be wearing glasses full time unless the doctor recommends it.

Did you not have her try your glasses just to see if they made any difference? I'm quite sure your previous glasses would have been of some help to her, but probably weaker than she will need.


Carrie 05 Nov 2012, 05:19

It looks like the Hyperopia gene in my family is picking out the females only. One of my cousins on my Mum's side of the family is pretty sure she needs reading glasses. She's a bit younger than me and is still at college. She says for a few years now she has felt tired after doing a lot of reading and more recently has had to really concentrate on what she's reading to keep it in focus. If she wasn't doing so much studying she probably wouldn't have noticed. She's worried that her work will be affected if she can't see properly. She doesn't want glasses and hopes that it's just a temporary problem but feels it's inevitable she will need them. I pointed out to her that glasses are fashionable and lots of people wear them. I reminded her that I've worn glasses for over 2 years now. She said "I know, but you're really confident and outgoing and you wanted to wear glasses. I'm the opposite." So I said "You are like Gemma, probably more confident than she is, but she got glasses when she found she needed them even though she didn't want them and wore them even though she was afraid of being bullied for wearing them. She doesn't mind wearing glasses now."

My cousin has booked an eye test for Tuesday afternoon.


John S 30 Oct 2012, 12:21

My area lost power due to the hurricane yesterday. Today, I stopped by my neighbors to see if they were ok.

One of them is 38-39. He had a pair of ~+1.25 (a guess) glasses on the top of his head. His job is repairing lawn equipment, and related stuff. He said he was just sticking around the house today and was reading.

Over the last few years when he had come by, he had made some comments that he couldn't see close things anymore. And the usual actions followed, holding something at arm's length, etc.

He is a stubborn person (more than me). I was really surprised to see him give in and get glasses. I am pretty sure he is not 40 yet. (I asked his age a couple times after he mentioned about his eyesight problem)

I certainly did not expect to see him with glasses.


Julian 26 Oct 2012, 11:13

...as we would normally expect.


Melyssa 26 Oct 2012, 09:46

Julian,

They were minus, as were those of everyone who wore glasses in our group back then.


Julian 26 Oct 2012, 09:42

Interesting, Melyssa. Can you remember whether his lenses were minus or plus?


Melyssa 26 Oct 2012, 06:51

SC,

In the “olden days” of school, I remember a handsome boy in my class who was about the same height as I was, and who had perfect vision. Over the summer, things changed, as I had to look way up to see him, and he was wearing glasses. So his height went up and his vision went down. As for myself, my increases in height and in the strength of my glasses were gradual, except for a two-diopter jump at age 27, long after I had reached my maximum height of 5’10” sans heels.


SC 26 Oct 2012, 05:01

I noticed another pattern when I was at school many years ago, particularely amongst the girls

Girls who were tall early, ie they had almost finished growing by the time they were 11/12 yo seemed to become myopic later - almost as if their body had stopped growing but their eyes continued.

Conversely those who seemed to have a late growing spurt seem (now) to be more likely to be hyperopic -again the body woke up and grew but the eyes didn't keep up.

I couldn't see the blackboard from the back of the class when I was about 11 so I guess I was myopic but had a big growth spurt from 14-16 - by 16 I could read the bottom line. Now I'm hyperopic.

Tbis may be the same answer as 'genetic' as I have a friend who was reasonably small at 18 but continued to 6'5" and his son has done exactly the same - both are mildly hyperopic!

Did you have a period of growth around the 14-16 age?


Carrie 24 Oct 2012, 14:40

Thankyou Cactus Jack.

Looks like Hyperopia did skip a generation in my family and landed on me. I suppose it could also be a coincidence. Being short is definitely inherited - my nan and my mum are short and so am I! The human body is a mysterious thing.


Cactus Jack 22 Oct 2012, 17:53

Carrie,

There is abundant evidence that there are strong genetic factors in both hyperopia and myopia. Often, the genetic factors skip a generation, but basically, they follow the rules for passing on genes. If both parents are hyperopic or myopic, it is highly likely that any children will also be hyperopic or myopic, but there are enough exceptions to the rules to make it interesting.

There may be some genetic factors in presbyopia which affect early or late onset of presbyopia, but they seem to have very limited involvement in the need for reading help.

As we learn more about the human genome and the role of various genes and chromosomes we may be able to ultimately control development of hyperopia or myopia.

C.


Carrie 22 Oct 2012, 16:33

I'm sure someone has asked this before, but is it possible than sight problems are inherited? I think I got my long sightedness from my nan. I was talking to her on Saturday and she, like my mum, said I looked better with my rimless glasses rather than my big plastic framed glasses (both her and my mum have said this a few times before!) I asked her when she first glasses and she said she couldn't remember exactly but she was about my age and wore them all the time straight away probably because the optician said she should. She thought she was going to get reading glasses but was not happy that she had to wear them all the time as she didn't want them and thought the boys wouldn't be interested in her. But she did wear them and a few years later she was married with my mum arriving a couple of years after that, so her glasses didn't put off my granddad! She doesn't remember her prescription as it was a long time ago but she's sure it wasn't much different to what it is now - but she can't remember her current prescription. I think her prescription is probably slightly stronger than mine as I can see through her glasses ok but it's slightly blurry.

My mum had perfect eyesight until she was nearly 50 and then got reading glasses.


Jose 21 Oct 2012, 20:13

Slit, how are you enjoying your bifocals?


Cactus Jack 21 Oct 2012, 10:30

Phillip,

It is likely that you had some pseudo myopia along with your true or axial myopia. Pseudo myopia is the same phenomenon as latent hyperopia in that it is produced by the crystalline lenses and ciliary muscles, just on the other side of 0.00 Rx. True myopia is caused by a mismatch between the length of your eyeball and the total relaxed plus power of your eye's lens system.

Like latent hyperopia, pseudo myopia is the result of constant over accommodation for clear distance vision over a long time and it can take a while for the crystalline lenses and ciliary muscles to fully relax to their minimum plus power. As they relax, less minus is required to focus distant images on the retina.

In add department, once presbyopia has fully developed and you no longer have much, if any, accommodation left, the amount of add you need is strictly governed by the focus distance as explained by Sir Isaac Newton's formula: Lens Power = 100 cm (or 39.37 inches) / Focus Distance in cm or inches, as appropriate. +2.75 focuses at about 36 cm (14 inches). +3.00 would focus at about 3 cm (1 inch) closer.

If you would like a bit more add, just ask for it on your next exam, but be aware that you will need to hold reading material a little bit closer. It is not uncommon when your add gets above +2.00 to +2.50 to start having some trouble if you do much work with a computer. That happens because most computer displays are not at the same distance from your eyes as a book or other reading. Many people find tri-focals or bifocal computer glasses, with the distance Rx set for focus at the display distance and the add a small amount more to focus at reading distance, very useful. Varifocals or progressives could theoretically work, but often the "sweet spot" for the computer distance it is so small as to be marginally useful, if you use the computer a lot.

C.


Philip 21 Oct 2012, 09:54

Mark, Not at all! If anything I seem to need to wear my glasses more now than ever. I don't know whether having gone fulltime (except for computer, reading etc) has made me less tolerant of blur. Or whether age makes it harder to squint one's way around myopia. I think that the -4.00 rx was a bit of over-prescription, though I loved wearing it. When I got there (at around 45) I thought that I would go on increasing to -5.00 or so. But over the last 10 years I have gradually come down by 0.25 or so at each test. My sphere rx is now completely cancelled out by my add! I am hoping for a teeny bit of "real" reading plus next time.


Mark 21 Oct 2012, 05:23

Philip

Do you notice much difference in your vision without glasses with your -2.75 compared to when it was -4?


Cactus Jack 20 Oct 2012, 11:56

varifocals,

Presbyopia actually begins in childhood but does not typically begin to cause difficulty with accommodation until the 30s and 40s. One of the first clues that presbyopia was near at hand was reading numbers in the telephone directory. That was then and this is now. Small, hand held devices with small displays and tiny text do not cause the early onset of presbyopia, but the need to focus extremely close for longer periods reveals it sooner than in the past.

This leads to headaches and visual discomfort, which leads to the need for focusing help that is more conveniently available than single vision readers. Bifocals and varifocals (progressives) with a moderate add are the simple solution.

Small hand held devices are helping to eliminate the "age" myth that you do not need reading help until you are at least 40. You need help when you need it in your visual environment.

C.


varifocals 20 Oct 2012, 05:04

Bi- focals etc.

There seems to be a trend now for younger people getting bi- focala/ varifocals.

On a glasses site, a while back there were 4 young ladies, all about 24/5 of age who had them.


Philip 20 Oct 2012, 04:38

Fran, I can tell! Not from looking at the lenses but, having had varifocals myself for nearly 15 years, I know how one lowers the eyes to read. I think that a woman looks so lovely doing it! Getting an add is nothing to be ashamed of: it's just part of the myope's journey. In my case it was followed by a gradual decrease in my distance rx (from -4 to -2.75). And nowadays, it's not even a sign of having reached "a certain age": many younger myopes (and hyperopes) wear bi- or vari-focals. Just enjoy wearing them and looking good!


Fran 20 Oct 2012, 04:05

I just wondered if its possible for people generally to tell if someone's lenses are varifocals?

A couple of my friends have commented that I don't take my glasses off to read anymore, I suppose that's a big giveaway for people who know me and I've been open that I now have varifocals. The two who commented have them too.

Other than that, can people tell? I know the giveaway is moving the head to get things into focus and I don't think I do that noticeably.

My prescription is -3 in one eye and -2.50 in the other with a +1.50 for reading.


 19 Oct 2012, 09:20

Hey Soundmanpt,

Reading your response to "Question"...would that cause a permanent change? If their eyes adjust to clearer distance vision with the +1.00's will it be necessary to continue with them or will regular vision likely return if they stop wearing them. Would even stronger + lenses be needed later? Would the +1.00's cause sooner dependence for close up too? Thanks.


Soundmanpt 18 Oct 2012, 10:41

Question

If your only interested in wearing weak or mild plus glasses your eyes should be able to tolerate a +1.00 prescription without much trouble. They should just make reading material appear slightly larger. Your distant vision may be slightly blurry at first, but after a couple days of wearing them everything should come into focus as well. Of course the best way to find out is to purchase a pair of readers in the +1.00 prescription anywhere they sell over the counter readers.

I have come across several young ladies in last couple of years that admitted to me that they were wearing over the counter readers for fashion sake.

Of course it really would be a good idea to first get your eyes examined to see if you maybe need glasses and don't know it. However if you have had an eye check within the past year then there is no need.


Asdoo 18 Oct 2012, 01:59

question

No it isn't possible to induce latent hyperopia. It is possible to have it without knowing it.


question 17 Oct 2012, 23:18

Is it possible to induce latent-hyperopia?

If not in longer run maybe it is possible temporary (without drops or other medicine). +1 or 1.5 would be perfect result.


Bryan 08 Oct 2012, 23:30

Thanks to all for their responses, especially to Cactus Jack. Actually, I had the number off, it's actually +1.50, and they are strictly for reading. When picking them up, my wife took a look and immediately wondered if this was a strong prescription. The optician actually took a look at her chart (must have been checking her DOB) and said it was completely normal, nothing to worry about. From everything I have learned here, it seems like there are no fixed ages on when things should or shouldn't happen.


OnLooker 08 Oct 2012, 03:15

It's actually a mixture, atropine is only part of it but it is still there. I have asked the doctore about blurry vision, he said that was quite normal we just need to mnoitor that it doesn't become incapacitating... For now she seems to have adapted to the dosage and has trouble focusing very close up as well as difficulty with small print or tiny stuff.


M 07 Oct 2012, 21:27

OnLooker I'm curious about your wife's use of atropine. When prescribed for oral use, atropine is usually in tablet form, but you mentioned "drops" - that seems strange. You should be aware that blurry vision as a side effect of atropine taken orally should be reported to the physician if it persists - it can be a sign of overdose.


Kris 07 Oct 2012, 21:00

I'm 42 and I've been in progressives for three years and glasses for four years (had a year of denial before I accepted the add). My current prescription is L +1.00 add 1.5, R +1.75 add 1.5. I've been pretty comfortable in this prescription and could get by for short periods of time without glasses. This fall I've noticed a significant decline and am starting to feel a bit of eye strain, even with glasses. I, until recently, could quickly check my phone for messages without the glasses but now can only read at arms length. It seems like my vision seems stable for most of the year but each fall I notice what seems like a sudden decline. Do others feel like their vision plateaus then drops rather then gradually declining. I wasn't planning on havIng an eye exam by now feel that it might be necessary.


Mr Jules 07 Oct 2012, 10:28

SC, I would agree with the comments about accommodation dropping below +2.50.

When my reading prescription was +1.75, I could just about read without glasses. I'm now +3.25, and absolutely depend on my reading glasses.


SC 06 Oct 2012, 23:06

Bryan,

+1.75 at 44/45 is more than you would expect for a 1st Rx. Most people eventually give-in when their accommodation drops below +2.5 - they've already lost the ability to read fine print (except in bright light) and they are starting to stretch arms to read- eg +2.25 accom to read - ie approaching 45cm rather than the usual 40cm. This level of presbyopia would normally result in something like +1.25

Do you know the actual Rx? ie is it written as SPH +0.5 ADD +1.25 which means you need +1.75 for reading, but there is also a distance element

It would seem likely that you will end up with a distance Rx within the next few years, with your wife's probably being slightly higher than yours. Maybe her eyes are already relaxing and hence the earlier dependency

My wife has a similar Rx - she has +0.25 & +0.5 add 1.25 @45yo - so one eye has +1.75 and the other +1.5 and she can still read without glasses (not fine print) after more than 1 yr of wearing. This continues to puzzle me!


Cactus Jack 05 Oct 2012, 21:10

Bryan,

Everyone is different and presbyopia develops at different rates. Presbyopia is a thickening and stiffening of the protein that makes up the crystalline lenses. Generally, the rate of thickening is governed by genetics. However, there is a secondary factor that can be quite significant. That is the strength and conditioning of the ciliary muscles. For their size, they are the strongest muscles in the body, but like all muscles the level of conditioning can vary greatly between individuals. I suspect your biceps are stronger than your wife's and it may be that your visual environment has caused your ciliary muscles to be stronger.

Assuming that both of you have 0.00 refractive error for distance, the amount of plus required to focus at any close distance is governed by the formula developed by Sir Isaac Newton over 300 years ago. Lens Power=100 cm/focus distance in cm or 39.37/ focus distance in inches. If you work the formula, you will find that to focus at a typical reading distance of 40 cm or 16 inches, you need a +2.50 lens, period. The fact that you both need +1.75 for reading means that you both can still supply +0.75 diopters of accommodation to focus at 40 cm or 16 inches, but is says noting about how much effort your ciliary muscles are having to expend to accomplish the task. If your ciliary muscles are in better condition than your wife's, you can focus with less conscious effort than she can, just as you can probably lift a heavier object than she can. In either case it is normal and nothing to get into a discussion over. If you do, you will probably live to regret it.

The whole idea of wearing vision correction is comfortable vision for the individual in their environment. Nothing more and nothing less. She may like the comfort provided by the glasses and you may think that is macho thing to be able to focus without your glasses to help. Don't brag too much, presbyopia will win in the end and there is nothing you or anyone else can do about it.

C.


Bryan 05 Oct 2012, 19:47

Interesting site. About six months ago my wife and I both decided get our eyes checked and face up to the fact we needed reading glasses after popping way too many headache pills. My wife is 44 and I am 45. AFAIK we have the same prescription +1.75 and for now neither of us need glasses for distance. Since then what I have found is that I CAN read without my glasses, but after a little while the headaches become so strong that I have to put them on. My wife's case is a little different--she says she CAN'T read without them and puts them on whenever she is texting, reading, etc. Now I don't know if she literally cannot read or if this is a question of whether she is willing to make her eyes focus.

I am just asking the experts here if there is a difference here between her case and mine, and if maybe she she needs stronger glasses. Intuitively I would think that someone who can't read up close would need a stronger prescription than someone who can, but I don't know if presbyopia manifests itself in different ways in different people. Thanks in advance for your explanations!


OnLooker 04 Oct 2012, 08:18

Following up on my latest post, i think Atropine has started affecting my wife's vision as yesterday she *was squinting like hell at times in front of the computer screen. Then she told me there's something wrong with my eyes, it's the computer i guess!! She's by the way not aware that atropine causes such a side effect! Had she known she would have stopped the treatment which is quite important at this stage. My wish is that this episode will lead her to wear her spex more often!!!


OnLooker 02 Oct 2012, 05:44

My wife has been prescribed Atropine drops through oral route for a condition that has nothing to do with eyes and vision. Reading the leaflet, i discovered oral atropine may cause the same effects as in eye drops but with less impact. It does cause blurred vision, mydriasis and accommodation problems. My wife being a +1 hyperope in full denial of her needing glasses, i hope this will make her more glasses dependent and more frequent wearer. Wait and see!


Mr Jules 01 Oct 2012, 15:53

SC,

Thanks for your advice and comments.

When at work, I switch to my +3.25 reading glasses. On the few days, I've forgotten to bring in my reading glasses, after a while, my eyes do strain when sitting in front of a monitor wearing my +1.75 distance glasses.

After the next eye test, I'll probably keep a separate pair of single vision reading glasses for reading and monitor.


SC 01 Oct 2012, 04:33

Mr Jules

Progressives are easy to adjust to - it will only take hours or a few days at most. They are a compromise however. Reading while seated is fine, in bed I have to use OTC readers as other have said.

Computers are interesting - I use a laptop because then it is like reading - I have to look down to see it. If you use a monitor at a longer distance then it can be more problematic. Do you use +3.25 or +1.75 for using a computer? If you use +1.75 then you will be OK as you can look through the top - the biggest part of the lens, if you use +3.25, then you would have to tip your head back (to use the bottom of the lens) and you will get neck ache.

I tend to find that even with a laptop is use the middle part of the lens without realising - this is difficult to use intially (it is really very small in my glasses) but you get used to it but you can't move your head so much.

I could never carry two pairs about, so I use the progressives and live with them. However at home I use OTC readers for bed-time and older/weaker OTC readers for computer.

There are still tasks I struggle with - I have to look at other peoples computers, eg 1m away and that is difficult. Your eyes get lazy and although you should be able to see through the top of the lens, the initial reaction of your eyes is to 'want' the middle part and that is too small to find and scan something that far away. Not sure I'd want Trifocals but I guess that is the answer.

My add is the same as yours (+1.5), my distance Rx is lower than yours but you become dependent just the same!!


Mr Jules 30 Sep 2012, 14:46

Fran,

Thanks for your words of encouragement ! Pretty much made up my mind to get varifocals. Especially now that I really can't use my distance glasses (+1.75) to read with any longer. The add is now +1.50 and I'm certain it'll increase at my next eye test.


Fran 30 Sep 2012, 13:23

Mr Jules

I have a nearsightedprescription and have recently got my first varifocals prescription and I am pleased with them. I used to have to take my glasses off to read which I always thought was okay but I am finding th varifocals more convenient so I'd recommend them without doubt. I found them very easy to get used to which was a surprise as everything I read says they're difficult to acclimatise to even though I on,y wear them at the weekend so I'd say go for it, I don't think you'll regret it.


varifocals 30 Sep 2012, 10:37

Mr Jules.

I can manage but with a struggle so the simple answer if yes but not for much longer.

Lots of opticians have gadgets like cameras which enable you to choose frames from the screen.

For those with bad vision they are a godsend, especially for plus wearers.

My next test is December & I feel i will have an increase.

No big deal though.

Some people like the magnified blue eyes!!


Mr Jules 30 Sep 2012, 09:34

Yes, I am now all set for varifocals at my next eye test.

Your eyesight is worse than mine. Been wearing glasses for 4 years and started off with +1.00. Now I am +1.75/+3.25. So perhaps I have little way to go before my eyesight stabilises.

Out of interest, can see yourself in the mirror without your glasses ? I ask this because I wonder how you choose new frames at the opticians ?


varifocals. 30 Sep 2012, 09:26

Mr jules.

The simpleanswer is I got used to varifocals very quickly.

My first pair were bi focals which have the dividing line.

Varifocals does not have this so not only to they look better but are easier to use.

I used to have cronic headaches due to eye strain & that was the start of my glasses journey.

Ok I am now dependant, but that is no big deal as I far prefer comfort.

there is no point in fighting it.

I have had glasses now for 10 years & am +3.25/ 5.75 not too bad & I also have a %.75 pair of readers.

So dont worry.

The stores have deals on varifocal glasses too.


Mr Jules 30 Sep 2012, 09:16

Varifocals, thanks for your comments.

Agree with you. For reading, totally dependent. For distance, find the eyestrain/blur unpleasant. So glasses are worn all day.

How long does it take to get used to varifocals ?

When I get varifocals, I'll also keep a separate single vision reading pair for computer work.


varifocals 30 Sep 2012, 09:09

Yes Mr Jules, varifocals will do the trick but is handy also to have a pair of readers if you read in bed.

This wasrecommended to me as the full frame vision for just reading is better.

I too am totally dependant now but it does not worry me at all.

I prefer comfort rather than eye strain.


Mr Jules 30 Sep 2012, 08:59

For those who are finding their prescription changes almost annually, consider having just the lenses changes rather buying new glasses. Here in the UK, I use http://www.ciliaryblue.com with a pair of new lenses costing about 25 pounds (about 40 dollars).

Over the last 3 years, my eyesight has changed. Back in Spring 2010, I was wearing +1.75 reading glasses and I could just about manage to read with them.

Now my last (Feb 2012) prescription for reading is +3.25. Just recently, I've start wearing OTC +3.50 reading glasses which I find are better. Now at the stage where I'm completely dependent on my reading glasses for anything close up.

I now also have a distance prescription +1.75 and distance separate glasses. Again, I'm starting to find dependency creeping in here too.

So over the last 18 months, I've drifted to full time glass wearing. It doesn't bother me at all. What does bother me is that I can no longer use my +1.75 distance glasses to read with. At my next eyesight test, I will go for varifocals. The novelty of switching between distance and reading glasses has well and truly worn off !


Soundmanpt 27 Sep 2012, 17:21

Fran

So long as you able to take off your glasses and read without eye strain then if you feel more comfortable reading without glasses then by all means continue to do so.

Also glad you had no problem with getting used to going up and down stairs with your glasses as that can sometimes be a dangerous area for bifocal and progressive wearers. It could be due to the fact that you are used to doing mono vision that made it easier.

Maybe as long as no one knows your wearing progressives you should just keep it to yourself unless someone should ask you about your glasses and you want to let them know what your wearing.

But I thought you would quickly find that being able to leave your glasses on is so much better than taking them off all the time to read something.


Fran 27 Sep 2012, 14:42

Hi Philip

I agree that reading is slightly nicer with the lenses although I can easily read without if fairly close. I think if I was doing a lot of reading I might still take them off, maybe that's because I'm still new to progressives?

I've not worn these at work but some friends who came to the house weren't surprised to see me wearing glasses as I often do at the weekend but they did comment on the new glasses. Of course they didn't know they are progressives. In fact I'm not sure that any of my friends wear progressives so it isn't yet something we discuss!


Philip 27 Sep 2012, 02:25

Fran, No, I keep them on to read. The new prescription means that the only correction in the reading area of the lenses is my bit of cylinder. If anything print is marginally clearer with glasses. Your frames sound nice-have you had any positive reaction to your appearing more in glasses? Have you worn them at work?


Fran 26 Sep 2012, 14:15

Hi Soundmanpt

You're right, I was quite happy looking under or taking off my glasses but once having to wear glasses in the office made me realise that it was a nuisance as I couldn't see the PC screen with or without glasses. If that happens again I know that won't be a problem. I can see well without my glasses but it seems the print is slightly crisper with them. Having worn these throughout the weekend and evenings this week I'm finding them a very acceptable alternative to contacts. I'm not experiencing the issues with stairs at all, is that because my prescription isn't high enought?

Hi Philip

I'm not sure I've thought about whether I like how I look with varifocals, I probably think more about how I look in glasses which is okay. I have a black and cream Karen Millen frame which I think is very stylish. So from having progressives you're now back to taking off glasses to read, is that irritating for you at all? I'm rather liking not having to!


philip 26 Sep 2012, 08:09

Fran, It is astonishing how similar our vision is! I'm now -2.75 with cylinder of -0.50 in one eye and -0.25 in the other.I had an add like you at your age but it is now 2.75. You may find that your distance rx comes down a bit in the coming years and that your add increases. I have reached the point where the clearest vision for reading comes without glasses. Do you enjoy how you look in the varifocals? What frames do you have?


Soundmanpt 25 Sep 2012, 19:23

Fran

Glad to hear your not having any trouble getting used to your new glasses. Sometimes it can be hard to break old habits, like looking under the frame to read. But I think like your finding even though you were able to do that with your old single vision glasses without much trouble now actually having the add will make it even easier. I think as time goes by you may find it at the least more of a strain to read without your glasses. Your doctor must of felt that you were at a point where progressives were going to make reading easier for you.

So also glad to hear no miscues going up or down steps. You do see why I warned you though?

Also from what i remember it was sometimes a bigger problem when someone wanted to go from lined bifocals to progressives. But generally speaking I don't recall too many having much trouble going from single vision glasses to progressives except in some cases where they thought the floor was at their waist.


Fran 25 Sep 2012, 13:57

Just a quick update in case anyone is interested!

I've spent most of the weekend wearing my new glasses and am surprised how easy it has been to get used to them. I am looking under them less now and actually find I like the quality of the print through the glasses, its just I've been used to looking underneath for a while. I think I'm still getting used to where to look but find its only a small change in position of the eyes. I was told its easier to get used to progressives before the prescription difference is too big. Interestingly they look less strong than my other glasses even though the distance is the same. I presume that's because the prescription gets smaller as it goes down the lenses?


Cameron 23 Sep 2012, 17:43

Wow, thanks again!

What happened was, after my exam I wasn't going to get new glasses and just use my old prescription. But as it turned out, I dropped them and they became damaged, so I got new ones in the new prescription. Very little difference, they give great vision.

Before reading your post, I had thought that maybe my distance would continue going down as my reading increases, but now I see that it doesn't work that way.


Cactus Jack 23 Sep 2012, 13:59

Cameron,

Hyperopia tends to be very stable over long periods of time because for it to increase or decrease, it would be necessary for the eyeball to shrink (which is nearly impossible) or grow (which it does not do much beyond 25 - except in rare instances). Often, what many people think of as increasing hyperopia is actually latent hyperopia, which is hyperopia that has been corrected internally, for a long time, buy the ciliary muscles and crystalline lenses. Latent hyperopia usually becomes apparent when presbyopia, which is stiffening of the crystalline lenses because of age or genetics, rears its head and the ciliary muscles and crystalline lenses can no longer compensate and add the needed plus to correct the hyperopia and can no longer focus enough to allow reading at "normal" distances. The fix for both hyperopia and presbyopia is the same, external plus lenses. The hyperopia means that you need an external plus lens to see distance clearly and it will appear to increase as the crystalline lenses gradually loose their ability to compensate. That plus also helps provide some of the plus you need to focus close without straining. Also, that plus may buy you a little time in the close focusing department, but ultimately, presbyopia will get you and you will need more external plus for close focusing ONLY. The amount of reading add WILL gradually increase as your crystalline lenses get stiffer AND your ciliary muscles become de-conditioned.

Normally, the ciliary muscles are the strongest in your body for their size because they work constantly as long as you are awake to keep images in focus on your retinas. However, like all muscles, they can become de-conditioned with surprising speed. As they become de-conditioned, you will need more reading and close focusing help. The amount of help you need will stop increasing when the add reaches around +2.50 unless you have need to focus clearly at distances closer than 16 inches or 40 cm. From that point on, the amount of add you need is almost strictly based on focus distance.

Right now, for reading, your crystalline lenses can supply some, but not all the plus you need to focus close. If a person's distance vision is fully corrected, the amount of extra plus you need to focus at 16 inches or 40 cm IS +2.50 PERIOD. It can come from either the crystalline lenses, external lenses, or a combination thereof. The amount of extra plus is determined by the laws of optics discovered by Sir Isaac Newton a bit over 300 years ago and is a mathematical certainty. Your distance Rx went down a little and your reading add went up by the same amount. Hmmm, Newton's discoveries must still be in effect. I doubt you will notice much difference between the Rx. Your crystalline lenses can still make any small adjustments they need to to provide clear distance vision.

Sounds like you are doing just fine, visually.

C.


Cameron 23 Sep 2012, 13:16

Thank you, Cactus Jack!

The reason I was asking, is that I thought vision (hyperopia and presbyopia) just gets worse and worse over time if you are 40 plus like me.

Just trying to remember . . . I think my optometrist was saying something about the eyes not being able to adjust as well, as the lenses stiffen over time. So the eyes can't adjust if there is not enough power, but they can't adjust if there is too much power either. I don't know if this is quite right.

Cammie


Cactus Jack 23 Sep 2012, 08:57

Cameron,

Noting to get concerned about. Just small differences in measurements, mostly. Eye Exams are very subjective. The examiner cannot see what you see, only what you tell him or her, you see. Also, it is likely that you do not speak or understand precisely the same language. If you had another exam, later the same day, by a different examiner, the Rx could easily slightly different or perhaps the same as your last Rx.

C.


lazysiow 23 Sep 2012, 04:45

Pete - it could take a week to a month just to get used to them and about the same time when your eyes will want them for anything close up afterwards


Cameron 23 Sep 2012, 01:41

I recently got a new glasses prescription which is, +1.00 -0.50 180 R, +1.00 -0.75 180 L, add +1.50. My old prescription from June 2010 was +1.25 -0.50 180 R, +1.25 -0.50 180 L, add +1.25. I just turned 42. So it seems like 0.25 of my distance prescription and reading add swapped places. I don't remember my doctor's explanation. Is this strange or unusual? Just wondering what is going on. Thanks, Cammie


Fran 21 Sep 2012, 16:09

Hi Soundmanpt

I'm aware that looking under the frames means I have to move my head more. I think its not a good look! I'm hoping that once I get the hang of these glasses moving my head to get close things into focus won't be so obvious. Why do you think that once I get used to the add I won't be able to read much without my glasses? I'd always heard that nearsighted people can read without glasses. Thanks.


Soundmanpt 21 Sep 2012, 15:28

Fran

Well since you have only had your glasses for about a day I guess it is a little soon to ask if you find it easier now to not have to take off your glasses to read something? But it seems your cheating anyway by looking under them instead of through the lower part of the lenses. It shouldn't be too long until your eyes adjust to using the add and then you won't have the option of being able to read much without your glasses anyway.

Glad to hear your being careful on the steps. I'm sure you notice when you look down through your glasses everything looks much closer than it really is?

Glad to hear you got your glasses and it won't take long to adjust to them as your already finding out.


Fran 21 Sep 2012, 14:55

Just an update for those who were interested. I picked up my new glasses yesterday and am quite impressed. The only thing I find is that I'm still looking under the frames, I've got so used to it I think it's become a habit. I am going to spend the weekend getting used to them and will be careful of stairs. I went for varilux and did a lot of research so wondered if there would be blurry at the sides but am impressed at the quality.


Pete 21 Sep 2012, 09:28

I was having some trouble reading smaller print so I went for an eye exam. Not unexpectedly I was prescribed glasses for close work. They are +1.25's and he said I could buy them anywhere. He also said that as I wear them I would gradually get used to them and eventually not be able to read without them. I bought a couple pairs. On first trying them I was a bit dizzy, but within a short time I could see how print looks a bit closer and bigger and blacker. I am now wondering if this is a typical first prescription strength. More importantly, I am wondering how long it will be until I can't really focus close without them..is it weeks? months? years?


philip 21 Sep 2012, 08:35

Rach, I'd go for varifocals next time if I were you. It's good to have optimum correction for distance, mid and close vision. Just make sure you get good quality lenses or you'll end up feeling 'drunk'! You'll never be a myope but you have a nice rx and I'm sure you look good in glasses. What frames did you get?


Rach 21 Sep 2012, 05:33

I had my eye test this week and got a new Rx. My old Rx was:

OD: +1 -0.5 x 85

OS: +0.75 -0.25 x 80 (can't exactly rememeber axis for this Rx)

My new Rx is:

OD: +0.75 -0.75 x 95

OS: +0.50 -0.75 x 70

I am 30 and have several underlying health conditions (underactive thyroid being one) which are affecting my eyes and focusing ability. The optom said that I have very slow accommodation and severe sensitivity to light, and that I should get tinted/reaction lenses. My pupils were not behaving normally he said. I pretty much stopped driving ages ago because I feel unsafe and unable to react quickly to things going on around me. This is so very frustrating.

He also said that I seem to need two prescriptions, one for distance, one for near but beacuse of my age he said he was giving me one Rx something in between the two. My distance Rx was

+0.5/+0.25 for right and left respectively I think. He didn't say exactly what my reading requirement was but I think he showed me +1.25 and +1 for right and left respectively. This made reading the card easier, but the wall chart was fuzzy.

He also said to have at least an annual check from now on because he was anticipating some changes. He commented on my jump in cyl too. He told me to wear glasses for all close work and computers and at least for night driving, but basically as much or as little as I wanted the rest of the time. Up to now, I had been wearing full time anyway, as it is much more comfortable.

Any comments on what maybe going on for me and if I should really have been prescribed varifocals, or two pairs of glasses, one for distance and one for near work? Am I going to have big increases in the future? I am somewhat OO and a wannabe myope, I realise there is no chance, but i'm not keen on the look of plus lenses so I hope I don't end up with a particularly strong Rx!!

Thanks :-)


varifocals 21 Sep 2012, 04:38

We seem to have a large increase in children with plus lens now, some young 7 quite strong too.

The future progression will be interesting.


Cactus jack 20 Sep 2012, 23:07

Jim H.,

I can understand why she would have trouble getting her mind around the fact that she might need external reading help at her age. It is possible that if she gets her hyperopia fully corrected, she may be able to get by for some time yet. However, remember that around 40 is average age that presbyopia starts rearing its head, but he distribution seems to be something of a bell curve where a few people need reading help at a comparatively young age and others can read handily into the senior years. Genetics seems to play a big role as does one's visual environment. Visual environment seems to be playing a much bigger role these days among teens trying to read tiny text on smartphones and other small devices. The are discovering that some early plus help can work wonders.

C.


Carrie 20 Sep 2012, 22:57

Is there a chance the same will happen to me that's happening to Jim H's wife?

As most of you probably know, I'm 19 and I feel I'm dependant on my glasses at +1.75 and +1.50. Looking back at Jim's posts from earlier this year his wife's prescription was only +0.25 stronger than mine. When I got my eyes tested last year the optician didn't say anything about the possibility of my prescription getting stronger in the future. I thought the increase of +0.75 in each eye I got then would be the only one. Considering I only got my first glasses the year before it was a bit of pain to need a new prescription but a great excuse to get new frames.

As I've mentioned before, I'm not bothered if my prescription goes up a little bit but it looks like I could be heading for a few increases in the coming years if my eyes are like Jim's wife's.

I know eyesight is very important but I could really do without the expense of another pair of glasses every year or less! I've cut back on a lot of things to help me save for a deposit on a flat :-(. Every penny counts, so even cheap glasses will eat up much needed money.


Jim H 20 Sep 2012, 21:41

Thanks CJ. She just turned 27. It will be interesting to see what her eyes will do with stronger, full time correction.


Cactus Jack 20 Sep 2012, 20:10

Jim H.,

It sounds like your wife has very significant latent hyperopia and that she had been hyperopic without correction for a long time. I suspect her ciliary muscles and crystalline lenses are relaxing VERY slowly.

I don't recall your wife's age, but presbyopia can play a significant role in the rate at which the crystalline lenses relax. I suspect that is will not be long before it becomes hard for her to read without external help. However, getting plus correction will mean that more accommodation is available for focusing close. Also, the plus correction will mean that her ciliary muscles do not have to work as hard to compensate for both the hyperopia and focusing close. Both factors will be at work over the next several months. Her crystalline lenses will be becoming stiffer and the ciliary muscles will be getting gradually weaker. However, there is no way to predict when it will become inconvenient and annoying enough to do something about it.

C.


Cactus Jack 20 Sep 2012, 19:58

Andre,

She might try some +3.25 or +3.50 readers over her glasses in bed to see if they are comfortable. I suspect it is likely that you will be the only one who sees the unusual arrangement. Hopefully, her vanity does not extend to the bedroom.

One rule that seems to be applicable here is never push an add or reading glasses if she is fighting it. It is incredibly counter productive. Do you by any chance have any form of reading assistance?

C.


Andre 20 Sep 2012, 15:37

Cactus I suggested the OTCs over her regular glasses but she thinks that would be silly so I think the plan is for her to use the magnifier for a bit and then she'll probably have to break down and get her eyes tested once she figures out that lugging around a magnifier everywhere isn't practical or attractive.

I'm sure after a while she will probably struggle without it to read her phone or laptop and that will cause her to take the next step.

She did try +1.25 OTCs once but found that they "pulled" her eyes. Her doc said that OTCs probably wouldn't work for her because of her astigmatism.

She is the type of person that can't stand any blur in her vision so I'm sure she will just have to bite the bullet soon and see the doctor.

I think she's just trying to hold off due to the stigma of needing an Add. Thankfully she could get progressives and no one would notice. One of her friends admitted the other day that she has had an add for over 20 years and that might help set her mind at ease a bit.


Jim H 20 Sep 2012, 14:10

Hello. I posted here back in February about my wife getting an increase in her prescription to relieve her eye strain. She has been wearing the new lenses about 90% of the time, and commented that she is starting to feel dependent on them. I suggested she gets prescription sunglasses, but she wanted to get another eye exam first because she is still having daily eyestrain.

Today she got another new prescription:

R +2.50 -0.75 x 171

L +2.25 -0.50 x 174

The doctor did some other tests on her to check her eye health, and everything seems fine. But he wants her back in December because it will probably go up again. He told her she was seeing well with stronger lenses, but needs to 'expose the prescription in your eyes'.

New lenses for cost and no charge from the doc! She wishes she had him younger because she realized that shes needed stronger glasses for a while.

Wondering, what is the max jump to give at once for farsightedness. If she gets new lenses in December, that will be 4 sets of lenses in the same glasses in 1 year.

How bad will her eyes get? Will she need bifocals once her eyes fully relax?

Thanks


Cactus Jack 20 Sep 2012, 10:53

Andre,

Your wife might fine OTC readers worn over her regular glasses to be helpful until she can get either new glasses with an add or Rx reading glasses. If she got some +3.25 OTC readers they would give her an effective reading add of +2.00. If the +2.00 add is too much initially, you can reduce the power of the OTC readers accordingly. By wearing OTC readers over her regular glasses, the regular glasses correct her significant astigmatism.

If she likes to read in bed (as I do) single vision Rx reading glasses are great. For reading in bed, she might need a bit more plus than she does for ordinary reading. In my case at least, I like to hold the book closer in bed than is usual.

If she or you would like to order some inexpensive Rx reading glasses online, we can help. We just need her actual complete Rx and her preferred reading distance in bed if that is where she wants to use them primarily.

C.


Andre 20 Sep 2012, 10:03

So the other day my wife (40) who wear glasses full time (low myope -1.25 both eyes with moderate astigmatism -2.00 and -1.50) was running around the house looking for her checkbook. I started to help her and asked what she needed it for. She said that it didn't matter and that we just needed to find it.

After we found it I asked again whats it for and she said it was for the book service at her school. I thought she might be getting something for our son and asked her what she was buying. She got all embarrassed and told me not to laugh. She was buying a LED magnifier to help her read. OTC readers are out of the question due to her astigmatism.

Her last exam was a year ago and the Dr said she didn't need an add but I think now at her next one she will have no choice. Probably for the last 5 years she's had a little issue with near vision but has been able to deal with it by removing her glasses. Lately she won't even read in bed because it makes her too tired too quick.

So I think after a while she's going to find it will just be easier to get an Add. I think she will find the magnifier helpful yet clumsy but then probably won't be able to read without it.


Asdoo 12 Sep 2012, 16:31

Carrie

You often need more than one prescription change to get to your full prescription. It took me four changes to get to my current prescription. My very first prescription was R 0 L +1.25.


Carrie 12 Sep 2012, 05:45

As much as I like glasses I don't really want my prescription to get much stronger. I'm only 19 with a prescription of +1.50 and +1.75. Very simple prescription and not very strong but I really need them. With my glasses on my vision is perfect. I can get really close, much closer than normal reading distance, and it's still in focus. I can see distances without glasses but my eyes start to feel strained and it's perfect with glasses on. When my girlfriend gets her new glasses we are going to see who can see clearly furthest. I sure I don't need bifocals as I know someone who is a little older than me and they are more long sighted than me and they don't have bifocals.

I know that I got stronger glasses last year but I thought that was me just being bumped up to my full prescription.


Varifocals 12 Sep 2012, 04:19

CARRIE.

I started off the same as you.

initially eye strain/ headaches. Then i got my first pair of glasses which I found I still have, interesting to wear now, useless!!

I now have varifocal plus lens +3.25/ 5.75 so my close vision is hopeless without my glasses which I wearfull time.

I am happy with that. An rx in a way is just a number, comfort & clarity are most important

As well as the varifocals I have a pair of perscription readers, which I find are great, but when I take them off, the vision is quite a big blur, amazing really.


Asdoo 11 Sep 2012, 17:15

Carrie

I can still read uncorrected without strain for a few minutes. I can even read uncorrected with my left eye if I strain a lot. My prescription is R +1.75 -0.75 L +4.25 -1.25. I think your prescription will increase even though you see "perfectly" with your glasses.


Carrie 11 Sep 2012, 08:35

I don't think my eyes are getting any worse as I can see perfectly with my glasses on. It may have something to do with how tired I am but today, just out of curiosity, I tried reading without my glasses. I couldn't! I used a tv listings magazine (if you are in the UK it was the Radio Times). The front cover was no problem but when I turned to the pages with the main channels on that's when I had real trouble. I could see the programme titles as they were in bold letters on a white background, but they were very soft round the edges, if you know what I mean, and had to strain a little to read it. The description part below the programme title was incredibly difficult. I could only read it by really straining. Below that in smaller letters still was the cast list. The programme I was reading about was Dr Who and I know that the first 2 names in the cast list are Matt Smith and Karen Gillan - I just couldn't read that bit at all. I could tell that there was something there but I couldn't focus on it. Below that, in even smaller text was the names of the writer, producer and director - I didn't know that was there until I put my glasses back on!

As I wear my glasses full time I hadn't noticed any changes. 6 months ago I probably could have read the cast list if I strained. My distance vision without glasses seems slightly worse than it used to be. I know since I've had glasses my uncorrected sight seems to have good days and bad days. It seems it is having more bad days now and is making me realise how much I actually do need my glasses now. More than ever.


Philip 07 Sep 2012, 08:29

I have always been a myope but since I was 50 my distance rx has been slowly decreasing. I did hit -4.00 sphere about 10 years ago but I am now (at 57) -2.75 sphere in both eyes, with -0.25 of cylinder in one eye and -0.50 in the other. That new rx gives me 6/5 vision and is really clear. My add has also increased and is now +2.75. Does anyone know whether it is likely to increase any further (or indeed with my distance correction may reduce further)? I must admit that I am intrigued by the possibility that I may soon need a bit of "real" plus for reading! I would love a pair of weak readers!


lentilux 07 Sep 2012, 08:03

I have a prescription of +14.5 dpt and therefore need rather special lenses...ergo lentilux as nickname


varifocals 07 Sep 2012, 07:08

Lentilux

I have got varifocal plus lens from select specs who are based in Ramsgate & are good & cheap.

I have also had pair of reflectorlite glassesfrom them for sunny weather 7 they are fine.


lentilux 07 Sep 2012, 03:53

Does anybody of you know if there is an online-store which produces plus-lentilux glasses?

thanks


Soundmanpt 05 Sep 2012, 23:33

Fran

I think that was a good decision and I think you will soon find you will like the convience of not having to remove your glasses to read something.

Something i always remind people about when they gt their first bifocals, progressives or varifocals, be very careful going up or down steps until you get use to them. Many people have taken some bad falls because of not being able to judge the proper distance when they look down.


Fran 05 Sep 2012, 23:16

Just an update to say I decided to take my optician's advice and ordered the varifocals. Having done that I agree it will be nice not to have to take off my glasses to read, although it will also be strange as that's what I've generally always done even when I could read with glasses. What will be strange is not needing to take them off at all throughout the day on the rare occasion that I wear them to work.


Julian 03 Sep 2012, 02:15

Philip: I agree with you about good quality varifocal lenses. I've never had Zeiss; the best I've had, I think, were Rodenstock, better I think than the Nikon lenses I'm wearing as I type. This is where online retailers can let you down, unfortunately.


Crystal Veil 31 Aug 2012, 10:42

Marco,

I have s similar prescription as your son. Over the years I have had 100.000's of prescription glasses through my hands and my estimate is that only 1% of those had a major difference like that, with a + and a - lens. There are more people with glasses of -3 and -6, perhaps another 2%. I had an arrangement to do a photo shoot with a well known model in Dublin who has + 2.50 and +5.50 but this had to be postponed. No doubt it will be an interesting experience. Opticians often prescribe contact lenses when the difference exceeds three diopters.


Marco 31 Aug 2012, 06:43

Just wanted to get some insight on the following experience with my 13-year-old son. We recently took him to the eye doctor because he was squinting when looking at a distance. He was found to be nearsighted in one eye: -1.50, but farsighted in the other eye: +1.75. Is this something that happens frequently? Just wondering why we had not noticed eye problems with him sooner. His previous eye checks were only at school.


Philip 27 Aug 2012, 04:16

Fran, I've never had contacts, though I am tempted to give them a shot as I've always quite fancied donning some half-moon readers! I do often struggle bare-eyed though I wear my current rimless varifocals for the majority of the timne now. I really do think you'd like varifocals. I suppoe one does have to look down a bit to read but it's less obvious than reading under one's frames! And after a while one just gets used to them. I don't think most people would notice that one wasn't wearing single vision lenses. If I were yoiu I'd give them a try: after all it's an excuse for some new frames. But I really would encourage you to splash out for Zeiss lenses which are brilliant. A friend of mine got some after wearing standard lenses and described it as like having gone HD!


Soundmanpt 26 Aug 2012, 14:22

Fran

Okay! That now makes more sense to me. So he isn't wanting to replace your contacts with progressives but instead just thinks it would be more comfortable for you if you didn't have to keep taking your single vision glasses off and on. That does make some sense because it would be much easier if you could just keep them on and be taking them off to read. Of course as you know the more you take them off and put them on tends to make them loose and some times even get out of shape. Yes and as long as you can still read without your glasses then it is up to you if you want to continue on that way or get a pair of progressives. Again since you only paln on wearing them around the house mainly it might be best to just get a cheap pair on line or wait until a local store has a sale. Remember you don't have to buy your glasses where you get your eyes examined, so you can ask for a copy of your prescription and take it where ever you wish.


Fran 26 Aug 2012, 13:09

Hi Soundmanpt

Yes same optician but I had a contact lens check up and 2 yearly vision test at the same time. The contacts were no change and it was only when we were discussing my vision with glasses that he said I should consider progressives. I generally tend to wear my glasses at home at the weekend and in the evening so don't think that he was suggesting that I wear progressives instead of my contacts. What was a surprise was that he thought I might need progressives when, to me, it seems normal to take my glasses off to read.

Hi Phil

Do you mean you sometimes go without glasses - I presume then you wear contacts? I can get by with looking under my glasses as they are a shallow frame but do you think there's any real benefit in not having to take them off? Apart from anything I have visions of people doing the dipping duck impression as they move their head to get the right bit of the lens! Is that the same with progressives?


Phil 26 Aug 2012, 11:40

Fran, You have virtually the same distance rx as me: I'm -3.25 in both eyes. I don't always wear my glasses and can read perfectly bare-eyed. But the glasses I have are varifocals. I find them great: when I am wearing them I can read clearly without taking them off. They are useful when one needs clear distance vision for something (like the theatre) but wants to be able to read too (like the programme). I first got an add (of +1.50) at 43 and now a dozen years later I'm at +2.50. What I would say though is that to get good vision with them my experience is that one needs to buy expensive lenses like Zeiss. When I was once tempted to get some of Vision Express's cheaper options they were awful: I felt permanently drunk (even when I hadn't touched a drop)!


Soundmanpt 26 Aug 2012, 11:25

Fran

I assume it is the same doctor that prescribed you the mono vision contacts that is suggesting progressive glasses? Well of course the biggest difference is that you would now be using both eyes for distance and both eyes for close up as to only using one eye as you have been doing. Did your prescription change at all when he/she made this recommendation? Your vision is really not very bad at all so I am not sure what the reason would be unless they feel your eyes aren't tolerating the contacts as well as they should be. But I would think they would have said something to you if that was the case. From what you said it doesn't sound like you over wear your contacts because you mentioned wearing your single vision glasses.


Fran 26 Aug 2012, 10:16

Hi Soundmapt

I'm doing mono vision contacts right now, wearing one -3 and one -1.50 which work fine. Would other contacts be better than these?

My full prescription is this

Right eye -3 -0.50 x140 add +1.50

Left eye -2.50 add +1.50

Am I really going to get any benefits from progressives?


Soundmanpt 26 Aug 2012, 09:54

Fran

First off welcome! Your doctor has a much bigger advantage than we do because he has examined your eyes. But my guess is he must feel like your vision has reached a point where you maybe need an add. At 47 it is very common for most to start to need help for their close up vision. Now I am not sure why he wouldn't recommend either bifocal contacts or mono vision contacts as well by using 2 different prescriptions instead of only one contact. That is a question you could certainly ask him or her. But it seems clear they feel you need some correction for your near vision. The cost difference between single vision glasses and progressives is not quite as bad as it once was. Often times they even have sales where they include progressives at the same price as single vision lenses. One thing you should do if you didn't already do it is ask for a copy of your prescription. Post it here and they may help myself and others make suggestions to you.

Also another way you can really keep the cost down would be to go on line and purchase your progressives that way. For around $50.00 - $75.00 you can get some very nice ones from "zennioptical.com"


Fran 26 Aug 2012, 09:24

Hi, this is my first post on an online forum and I was pleased to find this one.

I have a distance prescription for myopia. I wear contacts and have done mono vision for 2 years. Yesterday I went to a yearly check up and my optician said I might consider progressives. I don't wear glassess that often, just at home, not at work, I think they're expensive so not sure of its worth it. When I wear glasses I take them off if I need to read, or look underneath, and I can still use the computer owith my glasses which are -2.50 and -3.

Am I being cynical by thinking the optician may be wanting to sell me progressives because they're a bit of a money spinner for them, or would I really get some benefit from them. I'm 47. Thanks!


r 23 Aug 2012, 19:17

I was in that same situation last November with OD +0.50 -0.25 OS +0.25 -0.50. I was getting headaches after playing poker for more than an hour or so, and went in for an exam. I still have a single-vision Rx, OD +0.75 OS +0.75 -0.50 (with axis rotated by about 60 degrees), and the headaches went away. A few weeks later, I went to Vegas and had the best 24-hour span of playing poker in my life.


Soundmanpt 23 Aug 2012, 10:26

Uncertain Racoon

The advice given by Julian is dead on. In your comments you yourself have given all the reasons why you have reached the point where your eyes are telling you they need help. If watching TV and driving seem to bring on headaches that is because you need to focus to see for both activities and your straining badly to try and focus and after a short time after working your eyes hard a headache will come. Looking off at scenery where you don't have to focus near as much probably bothers your eyes less because seeing the leaves on a tree is not that important. And as you say your close vision is only good for so long and it also becomes more difficult for you. Bottom line is that you should be wearing glasses for reading at all times and your distance vision is not nearly as good as you want to think it is. I think if you tell the doctor everything you have said in here, and of course you should tell him or her as they can't completely help you if you don't tell them everything, you will either be prescribed glasses for full time wear or bifocals which would also be for full time wear. In the end you will be much more comfortable wearing glasses than straining as much as you are now.


Julian 23 Aug 2012, 04:16

U.R.: you won't like this and you won't agree, but what you say convinces me that for sheer comfort you'd be better off wearing glasses full time. You have good distance vision - but TV and driving give you headaches. This is because you are using your focussing power to see things in the distance and not just close up. You can see close up, but with strain. All this is typical of a latent hyperope. There's a story called 'A Learning Curve' on Bobby's site that illustrates what I mean. You might like to read it at http://bobbygoc.sweb.cz/migstories/a_learning_curve.htm


Uncertain Racoon 22 Aug 2012, 17:46

Hi Julian,

Thanks for your encouragement.I am due a test as it has been 2 years or so.I may well see a different eyedoc, as my last test was pretty quick and seemed like I was not getting her full attention.

I still have very good distance vision although TV and driving can produce a bit of a headache and I can still read for quite a while and I am just a little bit opposed to making myself dependent whilst I can work around and still actually see up close albeit with a bit of strain

PS - I am a 44 yo female


Julian 22 Aug 2012, 05:35

Uncertain Racoon: Honestly, you're worried about being dependent on glasses - what's wrong with that? It seems to me you already are, except that you're struggling without them. I'll bet everybody who sees you holding your book at arm's length thinks, 'Why doesn't (s)he wear glasses?' (You haven't mentioned whether you're male or female, not that it matters.) And you want to keep bifocals at bay - why? What's wrong with wearing bifocals if they help you to see? ECPs can be fools: your headaches might be caused by stress; then again your visual problems might be caused by too much sex, but neither is likely!

First step is to start wearing the glasses you've got, and if you still have trouble with near work get new ones properly prescribed by a competent optometrist - that's probably better than off-the-shelf readers as there's some cylinder in your 2007 Rx. Then enjoy the clear vision without eyestrain!


Uncertain Racoon 21 Aug 2012, 21:11

Also I moved location a few years ago and saw an ECP who said I could get away without glasses for another couple of years and just to wear them when I was tired.

She said my prscription was a bit too strong.

I do get headaches buts she said this could be stress.


lentifan 21 Aug 2012, 18:48

Uncertain Racoon

You are right to be concerned at 44 that time will catch up with you. Because it will! Why should you be different from everyone else?

What to do? The simplest and cheapest solution is to get a pair of off-the-shelf readers from any shop. You try them out at the stand and select the power which suits. Then you wear them when you are reading. You will be surprised how much more comfortable it will be. You just have to remember always to take them with you.

A better idea would be to get another vision test. Your prescription is likely to have changed in 5 years. See whether you only need correction for reading or for distance too.


Uncertain Racoon 21 Aug 2012, 17:21

I was reading back on posts and am not sure what to do.

When I was 39 - 5 years ago I got a prescription for glasses which I was told I would need occasionally.

L+1 Cyl -0.25 R+125

I have not worn them for a year or two as I am worried I will become dependent on them.

I can still see quite close up 25cms albeit not for long, I really want to keep bifocals at bay but I am experiencing some degree of strain and I am told I blink very rapidly and frequently.

I can read in the evening for about an hour but the book has to be about 40cms or so away and I need to put it under a lamp sometimes.

I am now 44 and concerned time will suddenly catch up on me!


SC 09 Aug 2012, 01:35

Arah,

I tend to agree with you. It may result in more cost - more frequent changes and earlier need for expensive progressives but I'm happy to let it progress gradually.

I've had 3 prescriptions:

-0.25,add +1.5 (20 months)

0.00, add +1.5 (6 months)

+0.75, add +1.5 (20 months and still going)

The first one was probably too difficult to spot the hyperopia. The second one, the optician should have known with the symptoms I gave that I needed +0.5 at least in the distance - I adjusted to the intermediate lens in the new glasses and so needed to change (both glasses and optician!). The 3rd one is just coming to the end - the intermediate is almost clear for distance and I am starting to blink a little through the distance Rx


Arah 08 Aug 2012, 20:30

I went through a similar experience as Fiona and Liz in my mid-30s--a slow revealing of hyperopia and presbyopia in my eyes--and I have to say that it is probably best to let it happen naturally, get regular eye exams, and get whatever prescription gives clear, comfortable vision at the time of each exam. The first time I went to an optometrist (as an adult), he did the whole dilated exam thing and gave me such a strong prescription that I simply could not adjust. After a month of misery (uncomfortable either with or without the new glasses), I finally went to a different eye doctor who fitted me in progressive lenses with a weakish prescription to allow my eyes to adjust to them and increased it six months later. Since then I have obviously had more increases (I'm 41 now), but I'm afraid I don't agree with the idea that it is important to go with a strong, single vision plus prescription just for the sake of it. I think most eye doctors want their patients to have as much visual clarity and comfort as possible, and I agree with that idea.


SC 08 Aug 2012, 10:59

Fiona

If my own experience is anything to go by, I don't have too much faith in the distance part of the prescription. I too was diagnosed with -0.25 distance Rx the first time (44yo). Hyperopia is caused by the eyeball being too short and it's an unlikely thing to shrink in adulthood, so mostly you have it all your adult life without knowing - certainly in my case - as the eye just squeezes the lens all by itself.

The reading prescription is just the distance + the add - hence the two lenses are different. So if you take the eye with -0.25 + 1.25 = +1.00. The -0.25 part is meant to take you eyeball to the correct length, then the +1.25 is designed to focus up to 80cm away. The weakest lens that can focus at 120cm is +0.83 so somehow the +1.00 lens has only +0.83 effect, so your myopic eye is in fact hyperopic to +0.17 - ie it takes +0.17 of the lens to get it to the right eyeball length.

if you take the +1.5 lens, then this time the hyperopia must be +1.5-0.83 = +0.62, so I could rewite your prescription (already) as

+0.17 Add +0.83

+0.62 Add +0.83

So it does seem likely that your difficulty reading (without glasses) is caused by your eyeballs being too short (Hyperopia or far-sighted) exascerbated by the fact you are now in your mid-30s.

You have a choice. You can go back to the optician and ask for a dilated (relaxed muscle) test. No doubt you'll come out with a moderate single-vision prescription (+1 to +2) designed to be worn at all distances (driving tv and reading/computer) - no separate reading glasses.

Or you can just let things adjust gradually, I'm guessing that you will be able to see further and further, and conversely you will suffer a little temp distance blur when you take them off, and eventually you'll struggle to read even with them - it took me 18 months. At that point the eye test will note that you can see distance through them, so you will have +1.25 for distance and an add of +1, say, and go for progressives or bi-focals

Sorry for the long post


varifocals 08 Aug 2012, 10:54

Very progressive

my perscription does not specifically mention computers yet works fine anyway

Viz +3.25 - 2.00 90 right eye

+3.25 - 2.50 95 left eye

add. +2.50

would be totally uselss without these to read.

In addition I have a pair +5.75 full frames glasses which I have on at the moment for the computer. These give me a distance blurr when I look up.

I have used the readers a lot for book reading & have found, that initially I take them off there is very blurry vision


very progressive 08 Aug 2012, 09:17

Fiona,

Doesn't your rx indicate that you are myopic in your right eye and hyperopic in your left eye?


very progressive 08 Aug 2012, 09:15

Varifocals,

Do you know if a prescription for computer glasses would be written the same as for my regular progressives, with only a notation at the bottom stating that computer lenses should be made?


fiona 08 Aug 2012, 08:15

With my reading glasses,I can definitely focus on things further away than 80cm. I can move about 120cm away from my computer and still clearly see the text. Does that suggest that I am hyperopic? The script for my reading glasses is actually different for each eye (I am assuming that is because I have a slight distance prescription of +0.25 for left eye and - 0.25 for right eye). My reading glasses are +1.50 +0.25 x 120 (left) and + 1.00 -0.50 x 70 (right). I am a bit confused as to why i have a minus prescription for my right eye yet you seem to think that I am long-sighted. When I do near work for a while, my distance vision is blurry when I look up. After a while, my distance vision in my left eye clears up but the right one is permanently blurry.


varifocals 08 Aug 2012, 06:49

Very Progressive.

Yes this may well happen that you will get a blurry distance but as time goes on your eyes should adjust as mine have done. I also have a pair of pescription readers which are helpful.

i am +3.25/ +5.75 & the varifocals( progressives) are good


very progressive 06 Aug 2012, 18:46

I just received a prescription from my Dr for computer glasses. I will be using progressives. The tech wrote the prescription(based on the Drs instructions) and it is written exactly the same as my regular progressives with the exception of a notation at the bottom "please make computer progressive". Is this correct? I was under the understanding that the distance portion woud be written at about 1/2 of my 2.50 add? The Dr informed me that my vision would be very blurred when I stepped away from the computer or tried to look into the distance.


SC 06 Aug 2012, 07:25

John S,

It seems as you get older the slower your eyes adjust. I had progressives with essentially plano distance Rx. It took 20 months for my eyes to see distance clearly through the intermediate lens. Since my last Rx, I'm coming close to the point again, so 3.5 years to adjust to +1.5 for distance.

I always notice the gradual adjustment first on the how far I can see through intermediate lens. I have a +1.5 add, so the intermediate is +0.75 and so should be good for 1.3 meters but even after about 7 months, I could see it stretching to 2m & sometimes 3m, but not everyday!!

So for Fiona & Liz, there would seem to be a reasonable probability, because of your age, that you are undiagnosed hyperopes (far sighted) and will eventually need plus lenses (as you have just been prescribed) for distance. The first sign will be that you can see further with your glasses on than the power of the lens would suggest.

For Add +1.25 the focal point is 80cm - if you can focus on something greater than 80cm away with your reading glasses then that would indicate emerging hyperopia.

For Add +1.5, the focal point is 66cm - again being able to focus further away would indicate hyperopia.

I would expect very gradual change, eg 80cm becomes 100cm in 4 months time. It was around that for me, but you are younger so you may adjust faster


Philip 06 Aug 2012, 04:30

Liz, The blue half-framed pair sound a cool choice! What others did you get? It seems from your age that you may have some latent hyperopia. I suspect that you may eventually end up needing a bit of help with your distance vision too.


Liz 06 Aug 2012, 02:41

I have been suffering for eye strain for a while and on Friday at lunch time went for a eye test.

I couldn’t read the bottom two lines of the reading card and I was prescribed +1.5 reading glasses. I was a bit surprised since I am only 36. I chose three pairs and picked them up after work. On Saturday I went to the theatre with a friend. When I looked at the programme in the poor light the text was a blurry mess, so I slipped on my blue plastic half frame glasses. The difference was huge, the text looked crisp and bold. My friend wanted to know all about my glasses and to try them on.


John S 04 Aug 2012, 12:40

SC,

I'm not sure if it is laziness, or they are just not in tune with all the scenarios that are out in the real world. You are right, if the person cannot accept the correction right away when looking at the distance chart, the problem may go uncorrected. Some ECPs will fog the distance with a +2, and ask the person to concentrate for a few minutes and try to pick out any letters to reveal hyperopia. But again, it takes more time to let someone sit in the chair while you could be starting another exam. Something I don't know if you are aware of, in New York during school eye screenings, they will put +2 glasses on a kid and ask the kid to read the distance chart. If the kid can read the chart, they will notify the parents to have his eyes checked.

My problem is certainly not the norm, but I am proof it can happen. I really believe my problem was hereditary. My Dad had the exact problem I had when he was kid. From what I understand, he needed reading glasses only.

For me fogging was not necessary, I could relax my muscles at will. And that is what I wanted correction for. My issue was, some ECPs did not believe that could happen. I think I have taught a few that it can, and they are now friends.


SC 04 Aug 2012, 04:34

John S,

I didn't explain myself well. Whilst I accept that some (like you) have accommodation problems from a young age, the common scenario for someone in their mid-30s neading help with close up is latent hyperopia becoming a problem due to onset of presbyopia. In the individual case, it is not clear whether this is due to early onset presbyopia (ie accommodation is a problem) or more moderate hyperopia (accommodation is good, just no longer enough).

So a +2 latent hyperope, who is prescribed +1.5 add and no distance rx (as the hyperopia is undiagnosed), will likely need a +1 distance Rx, and a +1.5 add (they never go down!) at the next test - hence early need for multi-focals

Whereas a wet test, may reveal the need for +1.5 distance Rx and no add and may continue like that for 5-10 years as single vision.

So they laziness of the ECP to try and detect hyperopia lines their pockets with the revenue from multi-focal lenses that also seem to result in more rapid changes (I have never managed to last 2 years!)


Soundmanpt 03 Aug 2012, 14:06

fiona

Good to hear you are finding the glasses helpful. So I assume you only got single vision with the necessary astigmatism correction and +1.25 for your sph? I think since there is a good chance your vision may change in a few months and your distance rx is very slight these glasses should work well for you. It sounds like you plan on wearing them often. Right now I your distance vision is probably a little blurry with them on, but after you wear them more that should clear up as your eyes adjust to them more and you should be able to very good at all distances wearing them.

Enjoy your new clear vision.


fiona 03 Aug 2012, 07:03

I got my reading glasses today. They make things so much clearer! I am wearing them as I type this and I can't believe how in focus the screen is. When I take them off, the print goes very blurry and doesn't come back into focus for ages and even then I can only focus if I really strain my eyes. I can see that I will use these glasses heaps.


John S 30 Jul 2012, 15:46

SC,

I missed your comment at then end about wearing distance only. That is completely true. I thought you were saying, wearing a progressive lens would speed up the progression compared to a SV reading lens. You are correct.

The reading correction will help speed up the dependency process, because the muscles can relax more when reading. Wearing the reading rx full time will really speed it up.

At the end, whether it be sooner or later, you will have same rx when the muscles fully relax. The only thing that changes is the amount of time it takes for the process to run it's course.


John S 30 Jul 2012, 15:29

SC,

I don't really agree.

Situation: A person wears a reading correction in a single vision lens, and wears them ~full time (except for driving). The add is less than +2.50. That would cause dependency faster, because the muscles are trying to relax further so they can see at a distance while using the stronger reading rx. That would then cause a shift to a more positive distance rx, and in effect increasing the reading rx. That would keep occurring until the muscles relaxed fully. Then the distance and reading rxs should be somewhat stable.

Wearing a bifocal type rx, you are not trying to force the muscles to relax as much to see distance. You are correcting only for the current state of the muscles. I would think the progression would be slower. This assumes the add had not yet reached +2.50. If the add is at +2.50, the sphere rx should be stable.

Any comments?


Slit 30 Jul 2012, 12:57

Hi Fiona!

As John says it is not a very high add. (in fact as a +1.75 person i see no difference between a window pane and a +1 lens!) so 1.25 is a very starting level.

I noticed you ordered single vision glasses for the time being. Not a bad idea until the Rx stabilize. But you will find it much easier to start off with progressive lenses now rather than later.


John S 30 Jul 2012, 09:46

Fiona,

The add is at the low end of the scale. You cannot go by age, even though many doctors use age as a rule. +1.25 will certainly make a difference, but over years it will increase as your muscles relax and presbyopia takes a hold. It will probably top out at +2.50.

The more you wear glasses, the faster the muscles will get used the correction and want it. The reading correction may be just an option for years, there is no way to tell. If the doctor gives you a "wet exam", that is an exam while your eyes are dialated, the doctor can get an rough idea of your future distance rx. But there still is not a good way to determine how fast increases will happen. Most of the rx changes will be in your 40s. It was nice your doctor cared enough to bring it to your attention, some would not have. Stick with that doctor.

Try your new glasses full time for at least a few weeks and check back. I think you will like them.


fiona 30 Jul 2012, 06:05

Add is +1.25 (forgot to give it in my last post).


fiona 30 Jul 2012, 03:45

I have a couple of questions if anyone has the time and expertise or personal experience to answer them:

1.Is the add I was prescribed strong for someone my age (I'm 35)?

2. How dependent do you think I am likely to become on my reading glasses and how quickly do you think I will need stronger correction?

Thank you.


SC 30 Jul 2012, 01:46

There seem to be a number of posters with 'early onset presbyopia'. In all probability is this more likely to be driven by hyperopia. Hyperopia seems to be so difficult to diagnose - my first Rx at 44 was minus for distance and yet I'm a hyperope now.

It has still taken a long time for my muscles to relax and only now I'm approaching +1.25/+1.5 for distance. I'm working on the principle that if I first struggled with close up when I was 41 then that would indicate hyperopia of around +1.5 and each 3 years is another +1. So if someone struggles around their mid-30s with close up, then although they will initially be prescribed an Rx for reading, it would seem more likely they will be a +3 hyperope that just isn't showing any sign of relaxing.

I'm not sure the ECPs care too much - the reading add will force you into expensive varifocals much more quickly than single vision distance will.


varifocals 29 Jul 2012, 09:38

hi Katie forgot to post varifocals


 29 Jul 2012, 09:32

Hi Katie.

What you have experienced is very common as I have done exactly the same.

I found my initial glasses in a case in the garage, boy so weak & useless now.

Yes close up to start with, & distance blur which gradually clears & in time you need new glasses for reading & close up especially for computers.

I wear all the time & had a shock at 0705 in the morning, when there was banging on the door & I left my glasses in the bathroom.

It was a parcel for next door & the signing block was a blur.

That dependancy I suppose & at the same time on a jaunt to london with my son to Olympic was staggered that i could not see the station map clearly on the seat opposite.

Yes optics are interesting, dont let it worry you.

I am +3.25/+ 5.75 varifocals so thats not too bad.


Katie Me 29 Jul 2012, 07:50

I too started initially with +1.75 for reading and PC (work) use. After the first week I was wearing them for reading/PC and taking them off for everything but. I noticed that I started to slide them a little down my nose so that they are there when I need it...then realised I look like a granny when I walked into the bathroom. That was it for me. I wore them all the time. I put up with the distance blur, but it was only I that knew. I didn't want to get bifocals or progressives as the held tilt would bother me.

After about 2 months, I started to notice that I could see at all distances. I thought this was way cool. about 2 months after that, I noticed that distance was fine, but near needed more help. So I got stronger glasses. I'm on +2.25. I kept them on all the time even though I could not see far clearly. After about 2 months again I saw clearly all distances. I've been with that Rx for more than a year now. I feel great, even though I cannot see comfortably without them any longer.


Carrie 29 Jul 2012, 06:58

Michelle

I have the same prescription as you. When I had my eyes tested last year my optician was going to suggest I wore my glasses for distances and not just reading but I was already wearing my first, weaker glasses, full time and planned to do the same with my new glasses. This was out of choice, I didn't need to wear them full time then.

I wouldn't say I was totally dependant on glasses now but almost dependant. They do make everything clearer at all distances (It's like the difference between HD and non-HD tv but more noticeable - maybe like someone who is slightly short sighted and the difference between with or without their glasses when looking at distances)and my eyes feel more relaxed. Not only do I want to wear my glasses all the time, they make life easier and more comfortable so I feel I should wear them all the time. My eyes feel funny without glasses and it's very difficult to read without them, I don't know how you managed to not wear them at work Michelle. Seeing distances with your glasses might take a few days of wearing them all day. Try putting them on as soon as you wake up and before you open the curtains or switch the light on so your eyes don't focus on anything before you put your glasses on. That's what I did. Even if you don't want to wear them all the time it could be useful at times to be able to see distances clearly while wearing your glasses. It was for me when I was taking notes at college. Also you don't have to pull your glasses down your nose like a granny! You're a long way off from that age!

Maybe I wouldn't be so dependant on them if I hadn't chosen to wear them all the time but I don't know or care. I like how I look in glasses. I want to wear glasses. I can see better at all distances with them on. I might as well wear them all the time.


michelle 29 Jul 2012, 06:11

Soundmapt, Willy, thanks for your replies. It has been quite few years since my last exam but was able to find my prescription; 1.50, 1.75 both numbers are plus and it says wear as needed. Besides my workstation, i checked my vision as i looked out the window and most signs were readable but not as clear as without glasses. I wore my glasses at work most of the time the rest of the week, but I felt like it took a while for my eyes to come back into focus after taking my glasses off which is a little unsettling at first. Will i eventually not be able to focus without glasses? I will schedule an exam to check my prescription and ask how often to wear my glasses and will post the results. Thanks for your comments.


Varifocals. 28 Jul 2012, 07:03

I have found I prefer dependency to strain & discomfort.

glasses, remember, can make some people look & feel better.


fiona 28 Jul 2012, 02:25

John S

Thank you for replying to my post. The information that you gave was really helpful - I have googled it now that I know what the test is called.

I can't wait for my new glasses to be ready as I am so sick of squinting to see up close and my current glasses don't help much at all). I have been having problems for ages but last time I had my eyes tested (early 2011) even though I mentioned my near vision problems, they didn't even test it (probably thought I was too young). I was glad that this time I got a different optometrist who listened to my problems. It will be interesting to see how dependent I become on them and if my eyes get worse. I suppose only time will tell.


Cactus Jack 27 Jul 2012, 20:41

Neil,

I think almost any technique is OK as long as the ECP will listen to the patient and work toward maximum visual comfort in the patient's visual environment. Unfortunately, too many ECPs were "programed" to do things a certain way and to ignore the needs of the patient. A prime example is the refusal to fit bifocals or reading glasses unless you are 40 years or more old.

Some ECPs have forgotten that they look at your problems for 15-20 minutes and you get to look at them every waking hour. Everyone's needs are different. If we all had perfect vision or all needed the same Rx, they would not have a profession.

C.


Neil 27 Jul 2012, 19:59

@John S

Thanks for your response. To answer your questions, I turned 45 a few months ago, distance Rx is -1.50 -1.25 045 (R) -1.50 -1.00 175 (L). Earlier reading add was +1.75 from last exam just over a year ago, initial new add was +1.50; after complaining it was bumped back up to +1.75.

Funny thing is that checking age tables via Google, my add should be +1.25! (My wife is even more ahead on this count, but she's a hyperope.) Besides fused cross cylinder, I think another technique optometrists use is NRA/PRA or negative relative accommodation/positive relative accommodation. But I think too many just flip through lenses and ask what looks good.

BTW, I know Cactus Jack is a technical expert here, so I wonder what his views are on the various diagnostic techniques for near vision.


John S 27 Jul 2012, 18:06

Neil,

Very good questions, it appears you are correct. Usually the most plus (or least minus) is prescribed for distance, the opposite for near vision. Sometimes you can press the examiner into giving you more of an add (or the correct add), if you convince them you need or want the higher add, and that you have had it before, and you are happy with it. I think they are partially scared of a redo.

As far as "age tables", you have really hit a sore spot there. When I was 17, I needed at +2.00 add for reading. Not a convergence issue, that is what I needed. My reading muscles were almost relaxed by then. I don't see that listed on the age chart. The answer is, none or maybe a +1.00. Right...A +1.00 for me was like almost a piece of clear glass. Please tell me your rx, and the add before and after you complained, and how old you are.

I think the way the age tables should work is, whatever the table lists for your age should be a minimum, not average or maximum. Mind you, this is only an opinion of a slightly educated layman.

So what should you expect, just what they are taught. Maximum distance plus and minimum near. Although, my ECP friend told me one of the most important tools in his office is a small tape measure. He asks patients where they need to see for close work. He has got his stuff together.

I think, everyone of any age that comes for an exam should be given the Fused Cross Cylinder test. This would bring up a lot of accommodation problems that a person does not know that have, or does not know how to explain the problem correctly during an exam.


Neil 27 Jul 2012, 01:04

@John S

Thank you for bringing up the cross cylinder test. In fact I was planning to ask, exactly what is/are the most reliable means for properly diagnosing and correcting near vision and accommodation?

The reason I ask is that I recently had to get an eye exam and new glasses while away, after breaking my pair, so I was seeing a different optometrist than usual. When I saw the Rx after the exam, I found everything identical to my usual Rx except for a lower add. I suppose it would not have been such a big deal, but I thought I should tell him what correction I am used to. After my explanation he revised the Rx as I requested.

As you note, Google is your friend, so I was looking up all the various approaches ODs use to check near vision. Besides cross cylinder, there are a bunch of ways to prescribe, including simple age tables!

It seems that there is no clear standard, and as a result Rxs could turn out differently depending on the doctor's approach. I suppose some ODs might feel that reading adds should be as little as possible to keep the ciliary muscles working well whereas other ODs might feel that patients should have the most comfortable vision possible. I would imagine that manually adding plus (what I just experienced at my exam) to see what the patient likes best can yield varying results, especially for those with some accommodation remaining, as I certainly have. Sometimes my eyes are more tired than other times.

Any insight on what we patients should expect?


John S 26 Jul 2012, 10:57

Fiona,

That is called a fused cross cylinder test (Google is your friend). It is a way to determine a accommodation muscle problem(accommodative insufficiency). I know a little about the subject since I had the problem before I was a teenager. For someone with that type of problem, it actually may work better than using a near reading chart. I think it may show the more accurately how much external power you need by causing the reading muscles to relax further. If your distance vision is corrected, or does not need correction, and you are experiencing headaches, blurry near vision, or tired eyes, and have not yet reached your late 30s when reading you may have weak accommodation muscles. I believe it is really under diagnosed, and some doctors don't think it is a real problem, so they don't correct for it. When I was 17, I went get glasses. I could not read the near chart, and the doctor refused to give me a reading prescription. He would only give me a distance rx.

By the time you are in your 50s, the muscles can't really function much anymore because the lens in your eye starts to harden. Then the muscles cannot change the power of the your lens to give the extra power you need for focusing close.

But before that, your muscles normally can supply the needed power for reading till you are 35-40. If they cannot not, plus power is added in your glasses. That just takes the place of the muscles supplying the power.

It also could be a hardening of the lens (presbyopia), that could be happening earlier than usual.

In your case, it could really be either one. You are at that age. When you back for a checkup, ask the doctor which he-she thinks it is.

I hope this helps you understand a little more.


Willy 26 Jul 2012, 07:12

Michelle -- As Soundmanpt says, if it has been more than a year since your last exam, then given you have experienced an increase in your need to wear your glasses, even if spurred primarily by work enviroinment factors, I would schedule an exam. I am guessing from your description that your prescription is around +1.00, give or take. Perhaps a small increase is in order. Your eyes sound like mine were around your age; I had mild reading glasses primarily for comfort, but once I hit 40 the near vision really started going downhill, so I now (since age 46 I think) wear progressives full time. YMMV, of course....


fiona 26 Jul 2012, 07:11

I just got a new prescription and for the first time (and only in my mid thirties), it has an add. I think I knew was coming as I have been having considerable trouble with close up work. My prescription is:

Right: -0.25 -0.5 x 170 Add +1.25

Left: +0.25 -0.25 x120 Add +1.25

The rest of my prescription was the same as last time and I only really need it because of the astigmatism. At the moment,I am just having a pair of single vision reading glasses made up as the optometrist suggested that my near vision could get worse in the next 6 months or so.

I had to do this test that had vertical and horizontal lines that started off with the horizontal lines being clearer and I had to say when the vertical ones became clearer. It took lots of lens changes before this happened and she was quite surprised by how long it took. Can anyone explain what this was testing? Thanks.


Soundmanpt 25 Jul 2012, 23:27

Michelle

First off it sounds like you have had your glasses for quite a good while? Any idea when you were prescribed those glasses? Also what is the prescription in them? By any chance did you try them at a greater distance, like outside looking at a street sign down the road? But I would say if it has been more than a couple of years you really should get your eyes checked. When you do it would be a good idea to ask the doctor, not the optician as to what he/she suggests for when and how much you should wear them. Without a doubt you should be wearing them at your computer and also for any casual reading you may do beside at work. Aside for that you may find they work well for many other tasks as well.


Michelle 25 Jul 2012, 20:48

I have had glasses for years but never really wore them as I felt that other people would think they were too weak to bother. After a recent computer upgrade that must have reset some settings making the text on the screen appear smaller I spent all morning straining to focus which caused a terrible headache. There weren't many co-workers in the office today so I finally gave in walked a block back to my car in the parking garage to get my glasses. What a relief! My headache went away in no time. Now to get the courage to wear them every day at work. I new this day would come but I didnt expect it to be at 34, however I was able to find a setting to increase the text size later in the day so maybe that will buy some more time! What I found interesting though was that everything in my space was much clearer, not just the computer screen, even the calender and other items posted on my wall 3 feet away were clearer with glasses than without.Has anyone had a similar experience...maybe it is time for another exam?


lazysiow 19 Jul 2012, 00:33

I've been using a +0.5 prescription for computer/general use a lot now, not fulltime but year I got a bump to +0.75 for reading but was still recommended to use the +0.5 for most things "Since its good that your eyes have to work a bit".

Lately though, intermediate has cleared up a lot to the point where my eyes are really irritated if I'm not wearing them indoors. Distance is still blurry and the +0.75's are too strong after awhile for most things but I'm wondering if at this point I should go full time with the +0.5's. It would be nice to have a solution that in the end relaxes my eyes 100% of the time instead of on a situational basis.

How long does someone take to eventually go full time from their reading prescription?


Cactus Jack 18 Jul 2012, 22:23

Jess,

It is not unusual for moderately nearsighted people (myopes) to need reading help a bit later than 40 and for farsighted people to need help a bit earlier. At some point you will need an add unless you are one of those very rare people who do not develop presbyopia (exceptionally good genes). With your Rx, an add just reduces the Sphere Rx for your reading segment and ultimately, the amount of add you need is determined by your focus distance. In most people, it does not get beyond +2.50 unless you do very close work or (like me) like to read in bed. I like to read in bed with the book or Kindle about 10 inches from my eyes. For that, I have a pair of single vision readers with the equivalent of my distance Rx with a +3.25 add as the Rx. Works great.

Enjoy while you can.

C.


Jess 18 Jul 2012, 20:28

Maybe I am lucky, but I just had a checkup, and, at age 46, still can do without an add. My optometrist simply said, "You are seeing well at all distances with your prescription, in fact we can take it down a step." (He meant 0.25 diopters.) In the right eye I'm now -5.25 -0.75 130, in the left it's -5.00 -0.5 110. I did not want to bring up the issue of bifocals, so let me ask here: Am I lucky, or is there still time for this to happen? Maybe it will not proceed to the same degree as it would if starting at an earlier age?


Dieter 16 Jul 2012, 20:33

Clare, it will be something like about -1.25 to -1.50 less than full script. It is very important to first determine the dominant eye which is the one that will keep full script. The exercise is not terribly necessary though as a good eye doc should work with the patient with complimentary trial lenses to determine what is comfortable. The doc should be aware that fitting the prescription is partially trial-and-error and that not everyone will achieve success. I would suggest that your friend start by booking an appointment rather than try to self-diagnose.


Clare 16 Jul 2012, 14:25

Soundmanpt, Cactus and experienced others -

What would be the minimum under correction for someone of 46? My friend wears contacts like me and her prescription is -2.50 and -3. Like some of my colleagues at work she's interested in doing mono vision, how much would it be likely that they'd prescribe for that age? She will get her eyes properly tested for it but wondered if she could try some older contacts - that depends of course what the *average* reduction would be based on her age doesn't it?


varifocals 13 Jul 2012, 12:04

I have had glasses for 9 years now which have had an effect on both near& close vision. Intially low rx just for reading then bi focals for near & distane vistion then changing to varifocals ( progressives ) which look better as the line goes.As reading gets more difficult then there is an increase for that despite a slight increase for distance although distance is slightly blurry, but over time it goes. I also have a perscription pair of glasses +5.75 at the moment which are great for simple reading. However I have found when I take them off for a tea break, the distance, as already mentioned by another person is a blur. A wierd sensation. My distance is now +3.25 not too strong but I wear my glasses full time.


Soundmanpt 13 Jul 2012, 10:48

Holly

Your first post back on July 5th (3:49) you said "I was having trouble with my distance vision after doing near work" The need for readers alone should not have been causing this to happen. I have seen this happen where someone may have astigmatism issues but your astigmatism is so weak I am sure that is not the case. But it sounds like when your distance vision was tested you didn't have any problem seeing it. And you asked your doctor and he/she said you only needed your glasses for close work? Since you got your glasses do you still find when you take them off after reading for a while that your distance vision isn't as clear as it should be? It is normal for your distance vision to be blurry with your glasses unless you wear them full time and after a week or two your eyes will adjust to them at all distances without any blur. The other option you were given is also something you may want to look into. You didn't say what type of work you do or how much you wear your glasses now but if your job has you doing much close work and taking them on and off is a hassle you may be better off getting a nice pair of progressives. this would give you clear vision for your distance as there would likely be nothing more than your slight astigmatism correction in the upper segment, but it would be nice to have a mid range which is a little weaker than your readers and of course the add which would be your full reading prescription. It would be worth asking your doctor about and allow you to wear your glasses all the time if you chose to or at least not be doing as much on and off.


Holly 13 Jul 2012, 08:00

Willy - Unfortunately I do not have a copy of the prescription as they didn't give it to me. I suppose I should have asked. But I know they are "single vision" lenses and there was never any mention of an add.


Willy 10 Jul 2012, 08:21

Holly -- did your eye doctor give you your prescription in writing? If so, perhaps you would not mind sharing the details. For example, while your glasses are +2, the prescription may read something like OD +1, OS +1, ADD +1. This would mean that you are somewhat farsighted and not merely presbyopic, which would not be uncommon for someone needing +2 reading glasses in their 30s.


Holly 10 Jul 2012, 05:24

As far as I know, the glasses are for reading, or that's what I was told anyway and my distance vision is fine. When I look at things in the distance through my glasses, it's pretty blurry.

As far as friends and family go, some of them thought that it was a strong prescription and no-one else who has reading glasses started out this strong.


Jose 09 Jul 2012, 22:15

Holly, have you considered bifocals?


John S 09 Jul 2012, 18:27

Willy,

I was wondering the same thing. It could be she needs to correction for distance, and the reading gets fixed wearing the distance rx. Only time will tell.

Holly, how well can you see distance wearing your glasses?


Willy 09 Jul 2012, 12:06

Not to add confusion to Holly's tale, but is it certain that all of the +2 is for near and none for distance?


Slit 08 Jul 2012, 21:23

Hi Holly,

Actually it is a common phenomena that lenses look a bit too strong at +2. If you do not mind wearing glasses full time, you can check the option of making a progressive lens with upper portion zero powered and the lower portion +2 powered.

What was the reaction about your glasses wearing from spouse / family / friends etc? Was it a surprise?


Holly 06 Jul 2012, 22:59

I have just been reading the Vision thread and noticed that another Holly has been posting. My apologies for using the same name.


Holly 06 Jul 2012, 22:56

Thank you to Cactus Jack and the anonymous poster for replying to my questions.


Varifocals 06 Jul 2012, 08:56

I have both perscription & readers & it is the reading bit that isinteresting.

I am + 5.75 at the moment. The impact on distance vision is interesting. I have been reading a really good book for a long period & when I take the glasses off the distance is a massive blur. After a while it reverts back to the normal blur,

Strange eh


Cactus Jack 05 Jul 2012, 08:17

Holly,

All that has happened is that presbyopia had become a nuisance a little sooner than is typical, but it is nothing to get excited about. Some people need reading help in their teens and 20s, others don't need help until their 50s. The idea that you don't need reading help until 40 is a myth.

There are two things at work here. Presbyopia causes your crystalline lenses (focusing lenses) to become stiff as you get older which slows down their ability to change focus both from far to near AND near to far. The solution is to wear external plus lenses to help you focus close (reading glasses or an add if you wear glasses for distance). The second thing that is at work is that wearing reading glasses takes some of the work load off your ciliary muscles (focusing muscles) in your eyes.

For their size, the ciliary muscles are the strongest and hardest working muscles in the body. However, like all muscles, if they don't have to work as hard, they begin to loose some of their strength and conditioning pretty rapidly, which makes it harder to focus and the solution there is a bit more plus in the reading glasses.

The question about how strong will the readers or the add get is very common. The answer depends on your near vision requirements. The laws of optics provide a simple fixed mathematical relationship between the plus power required to focus close and the distance. Lens power = 100 divided by the distance in cm or lens power = 39.37 divided by the distance in inches depending on what you like to work with. In practice, this works out so that to focus at a normal reading distance of 40 cm or 16 inches, you need an extra +2.50 to focus. To focus closer (for reading very fine print, maybe), you need a bit more plus. For the computer, you may need a bit less.

Why just +2.00 reading glasses? Your crystalline lenses and ciliary muscles are still able to supply a little of the plus focusing power you need to focus at 40 cm or 16 inches, but that can change pretty fast. Many people start with a reading Rx of +1.25 or +1.50 and need an increase within a couple of months. Your Eye Care Professional, probably saved you the cost of some new glasses within 6 months or so by prescribing the +2.00 readers. Unless you need to do some very close work (or read in bed) you may never need more than +2.50.

One thing to consider is that with only 0.25 diopters of astigmatism, you may be able to use off the shelf reading glasses for quite some time, but prescription readers are generally of higher optical quality.

Hope this helps.

C.


 05 Jul 2012, 06:23

Hi Holly.

I dont thing +2 is too strong as you may have been masking the problem with the long arm syndrome.

Many of us have traveled the same journey.Ignore the comments some people like the magnified eyes.


Holly 05 Jul 2012, 03:49

I have just recently started wearing reading glasses. I was having trouble with my distance vision after doing near work and then could not refocus on the near work when I tried to look back at it unless I moved it further away, so I went for an eye test. I was prescribed glasses for reading and apparently have some slight astigmatism in my right eye too. My prescription is +2 in both eyes with +0.25 for the astigmatism in the right eye. I chose metal frames and the lenses stick out a bit at the back of the frames. Several people have commented that my glasses look quite strong. Does anyone here have an opinion as to whether +2 is a strong first prescription for reading glasses and how quickly is it likely to change? Even after only having them for a month or so, I seem to be unable to go without them for close up work. By the way, I am 35.


Melyssa 25 Jun 2012, 14:44

I cannot vouch for the paper itself, being that I am in the U.S., but I must be one of the lucky women not to have needed an add in my prescription until I was 48, even though I was not so fortunate to have to start wearing glasses 40 years earlier. I do have my reading material (but not the computer screen) relatively close most of the time.


Glassesforeveryone 25 Jun 2012, 12:58

Thanks Asdoo,

That means a lot. I've been meaning to write some more for ages but never get the time, but the fact that anyone likes the old stories might just give me the push I need!


Asdoo 25 Jun 2012, 03:42

Glassesforeveryone

I know this is off topic, but I love your story "The Definition of Cool." I could totally relate to Sarah.


Glassesforeveryone 25 Jun 2012, 01:35

Terrible paper, interesting article: http://www.dailymail.co.uk/news/article-2164039/Women-s-eyesight-suffering-hold-books-closely.html


Asdoo 17 Jun 2012, 16:36

Oops I forgot that you said she already got glasses.


Asdoo 17 Jun 2012, 16:35

Dan

That is a very low prescription. The right eye is the lowest prescription possible and the left eye is only one increment higher. Most people with that prescription don't bother getting glasses. If your friend wants get glasses she should buy them cheaply online.


Dan 17 Jun 2012, 07:26

Was chatting with a friend of mine the other day who just got glasses (she is 21) for reading. She thought she needed distance glasses but came away with some for reading. I asked her prescription and she said it was OD +0.25 -0.25 x 75 and OS +0.50 -0.25 x 95.

My question is would this make much difference and I guess she doesn't need distance correction like she thought?


LT Lurker  27 May 2012, 18:15

Sorry Soundmapt that was primarily directed towards you!


LT Lurker 27 May 2012, 18:14

The situation is that it is all about vanity.Her optometerist told her that she did not need glasses on the basis that she had good VA near and distant and actually lied when she was asked about any headaches or strain.

As she was asymptomatic and had good VA the test took about 10 minutes on a Friday PM, as soon as she was out the door the store closed and the staff left as well!

That was nearly 2 years ago, she can now only read or sew for a limited time and if she does read for longer holds the paper or book a fair way out, although for a very short time she seems to get to about 25-30cms, but is soon pushed out.

From extensive reading the watershed is 45 and it is here that any significant existing hyperopia is unable to be easily dealt with and it seems, from forums like this, that there is a glut of people talking about "never needing glasses, but now I wear bifocals".These people are the low hyperopes like my wife and at 44 years and 5 months time is running out and I think it will be bifocals when she finally succumbs in the next year or so!


Soundmanpt 27 May 2012, 11:56

LT Lurker

I assume she has glasses but she just refuses to wear them? Well it could be since she has what she claims to be better than perfect vision for distance, which if she has even a small amount of astigmatism isn't quite true, she doesn't like the fact that wearing her glasses her distant vision is not as clear and sharp as without. If she were to wear her glasses full time her eyes would adjust for distance with them as well. Just a suggestion but she would likely benefit from progressives. She could get them with only her astigmatism correction in the top and her reading correction in the bottom and with the mid range should even work well for seeing the computer screen better. That way she could wear them as much as she likes or not at if she didn't want to, but she wouldn't see blur when she looks up at a distance.


LT Lurker 26 May 2012, 19:07

Onlooker - an interesting development for you.My wife is a +1.25 hyperope with minor astigmatism and at 44 is really struggling to do close stuff,she is extremely stubborn and knows that she will be in glasses soon enough although she is holding out for as long as she can.She refuses to accept the correlation between having very good distance vision and hyperopia. For her The fact she can focus probably better than 20/20 at distance is the sole way to determine good or bad vision.

Headaches are attributed to other things and eye rubbing is due to hairs in her eyes!

Denial, but she is not finding things easy.Recently we went away and she took a book to read, but could only read for about 20-30 mins max at a time, and the bulk of this reading was over 50cms away!

She has been off the computer for a week or so and her job demands a bit of screen work, upto we went away she was really struggling but I think upon her return this struggle will be unbearable.

Anyhow she is due a test in September and has already said she wants to go to a different optometerist as the last one told her she need not wear glasses, based on my wife telling her she had no eyestrain or headaches!

Maybe she will just give in like Onlookers wife appears to have done!


OnLooker 26 May 2012, 06:39

My wife, 38, officially +1 hyperope with some astigmatism, seldom weras her glasses. yesterday, she managed to thread a needle without glasses but when she started sowing she asked for her glasses. The first time she does so!


Astra 21 May 2012, 13:30

Re: Cactus Jack 21 May

No worries. I am interested about the effect for all 3 conditions.

I have myopia.

My elder relatives mostly have emmetropia. They managed to maintain without the need of plus add until age 60-70. But they are not much informed about ciliary muscles. And their age group (55-85) is prone to eye problems.


Cactus Jack 21 May 2012, 06:09

Astra,

My post on 19 May was a very quick and marginally satisfactory answer. I have been traveling and very busy for the last two weeks. I should be home by Wednesday and will try to provide a better explanation. Extreme Ciliary muscle de-conditioning can have the same apparent effect as late term presbyopia, but the causes of the de-conditioning and ways to avoid / delay it vary with Myopia, Hyperopia, and Emmetropia.

C.


çactus Jack 19 May 2012, 13:39

Astra,

Exercise them and delay an add as long as possible.

C.


Astra 17 May 2012, 02:36

Cactus Jack ,

How to keep ciliary muscles in good condition ?


Cactus Jack 16 May 2012, 08:32

Brett,

Sorry about getting the age wrong, but what I said still applies. Genetics rules and there is no way you can control that. Ultimately, you will need some close focusing help and typically, people with 20/15 or 20/10 vision are slightly hyperopic. Right now, you can easily compensate by using some of your accommodation. Often that can lead to an earlier onset of presbyopia problems.

One of the tricks is to try to keep your ciliary muscles in good condition. The ciliary muscles, for their size, are the strongest muscles in the body because they are in constant use adjusting the focus of your eyes. Like all muscles, they can become de-conditioned rapidly and when presbyopia become such a nuisance that you need some external help, it will seem to progress very rapidly. However, beyond a certain point, the apparent progression will stop and from that point the laws of optics will apply and the amount of help you need will depend strictly on your fundamental Rx and the focus distance. The lens power to focus at a certain distance is 100cm. (1 meter) / the focus distance in cm = lens power. For example, to focus at a typical reading distance of 40 cm 100/40=+2.50.

C.


Brett 15 May 2012, 22:40

Thanks Cactus. I'm afraid though you maybe proved the doctor's point about "earlier than most". . . I'm only 30. I haven't actually noticed the problems yet with blurry distance vision after prolonged close. If anything, since he's mentioned I've been consciously trying to notice any changes and perhaps a couple times going from far to near has taken longer than it should. He told me I wouldn't need an exam again for 3 years.


Cactus Jack 14 May 2012, 07:22

Brett,

From your posts, I believe you must be about 38 now and it probably won't be too long until presbyopia starts creeping up on you. Presbyopia can become a nuisance at any age, it depends on your genetics, but for much of the population it occurs around 40. The first symptoms are that you tend to hold things farther away to read. Very small text such as offered by phones and tablets just reveal the problem sooner.

Your distance Rx at 38 is probably very stable. However, you can experience the effects of what is called pseudo myopia when you read of focus close for extended periods. Pseudo myopia is caused by the crystalline lens being slow to relax. The crystalline lenses along with the ciliary muscles that squeeze them are the "auto-focus" mechanism in your eyes that allow you to focus close. Presbyopia is the gradual stiffening of the crystalline lenses with age and they ultimately get so stiff that the ciliary muscles can't squeeze them enough to focus close and you need some external help - glasses. This stiffening makes them hard to squeeze and slow to relax once the are focused close.

Fortunately, pseudo myopia is not permanent and the blurry distance vision after a lot of close work will gradually disappear. How long it takes depends of how far the presbyopia has progressed. Usually, it is just a few minutes.

Ultimately, you will completely loose the ability to focus close and you will need some form of multifocal lenses to allow you to see comfortably at all distances. So far the only known way to avoid this is don't get any older. Speaking as a 74 YO, trifocals are a pretty good alternative to the obvious way of completely avoiding aging.

C.


Cactus Jack 14 May 2012, 06:57

Stingray,

Just leave off the add and that is the Rx for single vision distance glasses.

C.


Cactus Jack 14 May 2012, 06:55

Stingray,

I have been out of town for several days and am playing catch-up. I misunderstood your post. Single vision glasses mean that they have one lens power in the lens. You could get single vision glasses with your distance Rx or get single vision glasses with your reading Rx (Your distance Rx plus the add). Alternatively you could get mono vision glasses with your distance Rx in one lens and your reading Rx in the other. It might take a little getting used to, but many people do that to avoid bifocals. With mono vision, your brain will switch which eye it is using by selecting the eye with the sharpest image. Mono vision tends to degrade your depth perception, but your brain is pretty clever at filling in the details of what you see. It just has to learn how.

Bifocals and progressives fundamentally accomplish the same thing using different methods. They provide two different usable lens powers in the same lens. Progressives do it by making a gradual transition from the distance Rx to the reading Rx using, as you said, a transitions zone. Lower cost progressives typically have a narrow transition zone. More expensive progressives provide a wider, more optically correct, transition zone, but in both cases, the transition zone will have a little distortion at the edges.

The marketing people tend to imply (without mentioning the forbidden words) that progressives have trifocal or multifocal effects. Theoretically, that would make the transition zone potentially useful for computer use, but usually the "sweet spot" in the transition zone is so small that it is not comfortable for extended computer use for most people.

I hope this explanation is helpful.

C.


Brett 12 May 2012, 21:40

Thanks Soundman. I know I read so much on here, and from my own observations (mainly of co-workers on the office side at that) that extended computer work seems to cause issues and makes a lot of people nearsighted or more nearsighted. That was kind of the whole reason I went and what I wanted to ask him about. The doc didn't seem to "buy into" my theory of that, and maybe he can tell I'm not at risk of that. But he brushed right over it in the discussion. I haven't noticed any eyestrain or anything yet, or what he's talking about trouble focusing from far to near earlier than most. I suppose if I did start noticing the eyestrain and wore computer glasses, I might grow more dependent on +prescription earlier. For now I'll just try to make sure I don't spend anymore time than I have to sitting at the desk. I don't do much texting or smart phone apps either.


Soundmanpt 12 May 2012, 11:18

Oops! Sorry about sending that twice.


Soundmanpt 12 May 2012, 11:18

Brett

I will leave the technical answer to Cactus Jack or someone else. But I think you should be fine. The good part is that your not going to be doing close up work all day, but only a small part of it. Like you already know the most important thing is not to get too transfixed on staring at the screen. This causes your eyes not to blink as often as they should. Just make a point every so often, say every 30 minutes or so, look away from the screen and maybe out a window or something in the distance. Of course good lighting which should not be much of a problem in most modern offices these days.


Soundmanpt 12 May 2012, 11:16

Brett

I will leave the technical answer to Cactus Jack or someone else. But I think you should be fine. The good part is that your not going to be doing close up work all day, but only a small part of it. Like you already know the most important thing is not to get too transfixed on staring at the screen. This causes your eyes not to blink as often as they should. Just make a point every so often, say every 30 minutes or so, look away from the screen and maybe out a window or something in the distance. Of course good lighting which should not be much of a problem in most modern offices these days.


Brett 12 May 2012, 09:11

Thanks Astra. I'm not sure this is severe, as nobody ever mentioned surgery. What happened I basically walked into the end of a 2x4 in a dark shop. It had been cut off on an end and I got a thick splinter cut into my eye. The only concern at present seemed to be that it may lead to stiffening of some eye muscles.

My main concern is the fact that I do much more desk work now and I know from reading on here that seems to maybe lead to some sort of eyestrain /vision problem. I would rather if I did need glasses need them for reading and not distance. I'm assuming that wearing reading glasses/computer would probably protect my distance vision. I'm curious though if that would in my case allow the muscles to stiffen/relax sooner.

I tried mentioning this to the doc and he kind of brushed it off and said I'm too young for reading glasses. Which kind of surprised me since right after he examined my wife, who is younger than me, and has had an add for about a decade.


Astra 12 May 2012, 04:36

A large number of surgical procedures can be performed on eyes; many of the ones involving scar tissue fall under the heading of vitrectomy. This type of surgery involves the physical insertion of microsurgical tools to either alter the fluids in the eye or to physically peel scar tissue off the light sensitive parts of the eye.

In cases where the scar tissue is floating freely in the eye, a surgeon may decide to completely or partially drain the intraocular fluid. Because this surgery can have significant side effects, it is only done is cases in which floating scar tissue is significantly impeding vision. Often this procedure will involve the injection of air or gas into the eye to maintain the eye's pressure while the fluid is drained. When the fluid including the scar tissue is completely removed the eye refills itself quickly with fluid.

In cases where the unhealthy tissue is firmly attached to part of the eye, the surgeon may make use of a variety of tiny tools in a procedure called membranectomy. These tools may include forceps (tiny tweezers) and small hooks. Sometimes the technique of visco-dissection, which involves separating the scar tissue from healthy tissue with a powerful, focused spray of fluid, may also be used. If the scar tissue is attached to the lens of the eye, the lens itself may be removed in a procedure called lensectomy.

Side Effects

While these types of surgery are often successful, they have a history of significant side effects. Some patents may suffer retinal detachment after surgery. More commonly, patients may develop a cataract due to bleeding in the as a result of surgery. Overall, however, most people who undergo vitrectomy are able to recover most of their vision.

In some extreme cases, scar tissue in the eye may be a result of serious damage. In these cases, even if surgery were to remove the scar tissue, the eye would still be too damaged to allow normal vision.


Brett 12 May 2012, 02:43

Wife and I went to the eye doc last week. I hadn't had a "real" exam since maybe 2004 when I got injured on deployment and was referred to a specialist when we returned. I get snellen/wall chart twice a year for work physical and for the Reserves physical. I'm always 20/10 or 20/15 depending how far into the 20/10 I get. This was no exception, and I got 20/15 left, 20/10 right. Doc mentioned my eyes are healthy for a 30 year old, but I do have some scar tissue on my right eye that may result in stiffening of muscles sooner than most, and I mentioned I took a promotion in Feb. that puts me at a desk for about a 1/3rd of my time at work reading reports on a computer. He said not to worry, and there wasn't anything I could do for my eyes other than take breaks? Any thoughts, especially soundman or cactus? I haven't had any problems, but would like to preserve my distance vision at all costs.

Also, wife got a new Rx, sphere was increased +.50 in each eye. Add and cylinder stayed the same. She picked out new frames and continued with trifocals. They are black, plastic and similar to the styles in the 1950's or 1960's, bigger than any pair I've seen her with. I think she's kind of like "us". Even though I wasn't prescribed glasses, she was wanting me to try on frames and saying how sexy I looked with certain frames and how she wished I got an Rx. LoL.


DWV 11 May 2012, 01:23

If you just get distance glasses with no add, you'll be uncomfortable reading (except maybe under very bright light) or using the computer. Even watching TV may be fatiguing depending on how close you sit. (2 m (6.5 feet) needs 0.5 diopters of accomodation, so I got myself TV glasses with an add of 0.5.)

There are these things called trifocals: take an old frame into a Walmart Vision store and for $100 you can get 7x28 trifocal lenses put in. That's more expensive than progressive lenses from China, but considerably less than most other brick & mortar opticians will charge. And the fitting will (in my experience) be done by a qualified optician in a white coat. And you'll have wide zones of clear vision at near, intermediate, and distance. Hardly anyone you meet will gasp in horror and point at the only slightly visible lines on the lenses.


Stingray 09 May 2012, 11:02

Cactus Jack: I am not looking for reading glasses, but glasses to wear for distant vision in addition to reading with them. I am not crazy about my

Chinese glasses which seem to have a very narrow channel in the transition lenses. What I wanted to know is how would I see with this prescription written as a single vision lens without the add. Thanks


Cactus Jack 08 May 2012, 18:41

Stingray,

It sounds like you want some Rx single vision readers. The Rx for them would be:

OD +4.75 –2.00 axis 100

OS +4.50 –0.75 axis 085

If you don't have your near PD, measure you distance PD using a mm rule and a bathroom mirror and subtract 4 mm.

I just algebraically added the +2.50 to the distance sphere and did not change the cylinder or axis.

C.


Stingray 08 May 2012, 18:12

I asked this question before, but got no response. So here goes again. My current prescription is:

OD +2.25 –2.00 axis 100

OS +2.00 –0.75 axis 085

Add +2.50

My current glasses are progressive lenses. Why can’t I just get a prescription for single vision lenses with a rx in each eye for +2.50 along with the correction for astigmatism? Would that work?


approaching middle age 04 May 2012, 17:04

My wife has worn glasses for 20+ years, but wears them off and on. She's +1.25 -1.00 in each eye. With that plus prescription, will she be proned to presbyopia creeping in earlier than normal? She's currently 33.


Asdoo 29 Apr 2012, 18:00

I think the reason why my rxs aren't that accurate is because I have horrible communication skills due to ASD. This also causes problems at regular doctors. My communication skills aren't even good enough for you to understand my posts.


Asdoo 29 Apr 2012, 16:33

I don't think that rx is very accurate. When I look at the stars bare eyed with my right eye the stars look clear. When I look at the stars with a +1.50 lens they get a bit blurred. When I look at the neighbors house with the +1.50 lens I don't notice much of a difference. I think the rx for my right eye should be higher than sph +0.25 cyl -0.50. I feel like my right eye is doing more effort than my left eye when I wear the +3.25 contact lens in the left eye. I've been noticing my left eye drifts outward when I'm tired.


Cactus Jack 29 Apr 2012, 15:57

Asdoo,

Sorry, I misread your Rx.

Your Rx for your right eye is very low and other than the astigmatism, you could easily accommodate the slight hyperopia for distance which is why you are able to see the stars pretty well with your right eye. The hyperopia in your left eye is significant in that for clear distance vision your ciliary muscles and crystalline lenses have to produce +3.50 of accommodation and to read at 16 inches or 40 cm, they need to produce +6.00 of accommodation. If the accommodation in your right eye is tracking the accommodation in your left eye, when you try to focus for distance with your left eye, your tight eye actually becomes myopic to around -3.50 or -6.00 if you focus to read. I doubt it is exactly those amounts, but with the difference, it is very hard for your brain to correctly focus both eyes at the same time. Which can significantly affect your depth perception.

Because of the difference in your glasses Rx, there is a significant difference between image sizes on the retinas which can also cause problems. This difference is caused by the vertex distance of your glasses, but because vertex distance of contact lenses is zero, they don't have the problem. Contact lenses are the best solution for you, but you did not say why you were unable to wear them.

Glasses are better than nothing. Do you still have the broken glasses? Are the lenses broken or just the frames?

C.


Asdoo 29 Apr 2012, 13:17

I live in Canada. Do both my eyes have moderate hyperopia or just my left eye? My first rx at 11 was 0 for my right eye and +1.25 for my left eye if that helps.


Cactus Jack 29 Apr 2012, 12:40

Asdoo,

From your description of your symptoms and your Rx, it appears that you have moderate hyperopia and probably some additional latent or hidden hyperopia. It is also possible that you have been under corrected.

You have the ability to use your ciliary muscles and crystalline lenses to correct some of your hyperopia by using your available accommodation. You may be beginning to have trouble supplying the additional accommodation needed to focus. However, if your hyperopia were fully corrected, that may solve that problem. The fact that your hyperopia is not the same in both eyes means that it requires different focusing effort in each eye to compensate for the difference which makes the task even harder.

You did not mention where you live, so I cannot comment on 15 year olds getting an eye exam without parental permission. However, when you get an eye exam for your situation you should request a dilated exam and you should not make any effort to accommodate or focus during the exam. Even with that, it is likely that you have been accommodating to correct your hyperopia for so long that your ciliary muscles and crystalline lenses will not be fully relaxed for the exam. It could take several weeks for them to relax after you get a new Rx and later require some additional plus sphere.

You really should get an exam as soon as possible because not wearing the best correction possible WILL NOT improve your vision, but it can cause other problems such as strabisums (esophoria) as your eyes strain to focus properly.

Hopefully, the examiner will strongly suggest that you should get a check up a few months after getting a new Rx to see if a change is needed.

C.


Asdoo 28 Apr 2012, 01:19

I feel like I have some "pseudoanisometropia". My right eye feels "pushed into my head". Once in a while my left eye feels "pushed into my head". What can I do to get an accurate as possible rx as possible for the eye exam.


Asdoo 28 Apr 2012, 00:46

I forgot to mention that when I try my +1.50 and +3.25 combo my depth perception improves.


Asdoo 28 Apr 2012, 00:43

At the moment I wear +3.25 in my left eye and nothing in my right eye. My glasses are R sph: +0.25 cyl: -0.50 L sph: +3.50 cyl: -0.50. I forgot the axis While this rx reduces eyestrain it feels like the right eye "needs more". I've experimented with my mom's +1.50 readers. When I look into the distance with my left eye closed it only looks a little blurred. As I've experimented more with this I've noticed the vision becoming clearer. At the moment if I try this looking up at the sky I notice the stars are blurry, but my neighbor's house almost looks perfect. As I've done this more I've noticed the stars getting a bit clearer. When I try wearing my glasses with a +1.50 added to my right eye it feels like my left eye "doesn't have enough". I've bugged my parents about an eye exam because I don't think 15 year olds can get an eye exam alone. So far my dad says he'll take me to one "some time in may".


Cactus jack 27 Apr 2012, 23:42

Asdoo,

It would help if you posted the Rx for your contacts or glasses.

C.


Asdoo 27 Apr 2012, 23:02

Can eyestrain "pile up"? I haven't been able to wear my contact lenses for a while. My glasses are broken so I can't wear them either. When I first stopped wearing my contact lenses I got mild headaches about ten minutes after I did close work and at the end of the day. Closing my eyes and rubbing my eyebrows would usually fix get rid of it. My eyestrain headaches have been getting worse. Now after a few minutes I get horrible headaches when I do things like close work, practicing piano and watching a movie. In order to get rid of the headache I have to lie down and close my eyes for a few minutes. I'm 15 if it helps.


Cruiser 25 Apr 2012, 09:37

Hey Andre I have pretty much traveled the road you are on. You went from no add to +1.75 with your new exam, and Cactus in his response suggests that is good to allow your muscles to relax. Like you I was able to read ok without glasses but had more trouble close with the higher distance script.

It took a while for me to get used to my new reading script (mine is +1.50)but within a month or so close was clearer and blacker. Problem now is I can't read without them. It took about a month to go from reading without glasses to needing them for anything small and close (Blackberry, newsprint, ingredients etc.) Given a choice I think I would have preferred a much smaller add if that would have put off total dependence for a year.


John S 24 Apr 2012, 16:29

Andre,

How did explain to the doctor your problem? Did you say the other doctor would not give you the right rx, or that you used two different pairs?

I'm glad it all worked out in the end.

If you typed the rx correctly, it appears the new doctor raised the cylinder in your left eye quite a bit.


Cactus Jack 24 Apr 2012, 13:25

Andre,

Many ECPs seem to be trained to under correct. It may be related to the "First do no harm" medical oath. Some believe that full correction may be doing harm. Either that or by under correcting, they get to see you more often.

Don't be too excited about needing bifocals at 36. It is not that unusual. Actually you have be wearing bifocals for some time, just not in the same pair of glasses where they are more convenient.

Typically, it is people who are hyperopic that develop presbyopia early, but it can also happen to myopes. In your case, it is the astigmatism in your Rx that is the big factor for needing correction. I do not know if there is a strong connection between cylinder and early onset of presbyopia. My suspicion is, that it is not.

Please let us know how your get on with your new glasses.

C.


Andre 24 Apr 2012, 12:18

So I went to a new doctor after calling the original one (she was no help) and got the following script

-1.00 -2.25 82 add +1.75

-.75 -2.00 90 add +1.75

Haven't got them yet but will let you know how it works out. I am a little weird-ed out by getting multifocals at 36.

For now I will use my current pair as reading glasses and my old pair for distance.

Now what's interesting is my wife (40 yrs old) tried on my current pair (the one with hardly and sphere correction) Our Astigmatism is almost the same yet her Sphere is -1.25 in each eye. Anyway she tried them on and said that she could read perfectly with them on. She had been having trouble recently with near vision - She has to take her glasses off to read or increase the font size on her kindle. She said that my glasses were like magnifiers for her. She couldn't see distance at all but up close was near perfect. So its safe to say that multifocals are in her future.

Her past few visits to the eye doctor have seen her sphere decrease. When I met her it was -2.00 in each eye. She too has noticed that distance is not as clear as it used to be but just thought that was a normal part of getting older.

Are Doctors deliberately decreasing sphere as we age to avoid prescribing multifocals as long as possible? With the advent of progressives you'd thnk they would be prescribing them earlier since it means a happier patient with clearer vision.


Andrew 23 Apr 2012, 14:36

The other thing with the reading chart is not to sit with it on your lap but to pick it up to simulate where you might hold a book to read in bed or while lying in the bath, as this will require more plus power as well.


Astra 23 Apr 2012, 02:54

Cactus Jack,

note that the article is suggesting a factor influencing presbyopia. It does not mean the traditional theory is incorrect.

It describes a mechanism for accelerating the aging process .

The article :

when focus on watching the text on the smart-phone screen or computer games, the number of per minute blink only about five times , compared to the usual 15-20 times, this is a lot less. When blink less, lacrimal gland secretion is reduced, resulting in reactive oxygen species lead to presbyopia.


John S 21 Apr 2012, 19:25

Andre,

Your wife is correct. If there ever was a question that had an built-in answer...

The doctor reduced your distance rx. Now you can't see well for distance. Now your near appears to be ok. Another doctor that does not listen to the patient. I feel sorry for anyone with a unusual visual problem going to her office. Too young for a reading add, why do kids have them?

Definitely go to a different doctor. You are not going to get anywhere with that one. Optometrists usually are better at getting rxs right. The exam is usually cheaper also. You cannot go by the price of the exam. That will tell you nothing about the end result.

You have 2 choices.

1. Go to the doctor, with your original distance glasses. Tell the doctor you lost your glasses you use for reading. You were thinking about getting bifocals or progressives because you hate switching between the two pairs. The doctor will probably ask how long you have had reading glasses. Say you had them for about 10 years because it was hard to read small print with your distance rx, and you had headaches when you were reading. It took you a while to figure out why you were getting headaches. You mentioned it during an eye exam, and the doctor said you needed a reading prescription to relieve muscle strain. Then it made sense why you got headaches when you were reading. Now that you lost them, it is really hard to do any close work. It evens bothers you when you text on your phone.

2. Same story except you did not lose them. Take both pairs in with you. The older ones are for distance, the newer ones are for reading. The reason you came in for an exam, it has been a few years since you had your eyes checked, and that you think the reading rx might need to be stronger. They don't feel like they make as much difference in your vision as they used to. You are starting to get mild headaches again, just like before you got reading glasses. It is very hard to focus on real small things for any length of time. You might mention some type of hobby that requires intense close work. Electronics, coin collecting, etc.

It is your choice which one you want to go with. Either method should get the add that you need, if the doctor listens. The doctor needs to understand that you cannot function without a reading rx.

The following applies to the near reading chart only: The doctor will ask you to read the chart. Of course you can't, at leasrt the small stuff. He should start adding plus to your distance rx until the near chart looks good. Do NOT strain to try to read the smallest letters. It is counterproductive. Let the added plus make the letters clear. That is very important. If you strain, you will get a smaller add. When the smallest print on the near chart looks good, a little more plus should make the letters slightly larger. Choose the lens that makes the letters larger, but still clear. Some doctors will add just enough plus until the patient can see the chart. That usually does not relax the muscles. You want to get on the other end of the scale. You want to get the most plus you can take, and still see the chart well. There could be a few power steps while the chart is still clear. By letting the doctor add more plus power, you will start to see the near chart blur, then you want back up one step. That will let the muscles relax more, hence more relief. Initially with no add, the chart will very difficult to read. As more plus is added the chart will become clear, then it will start to blur again when too much plus is added. You want to be as close to the "blur again" lens as you can get.

If you don't get good results, try another doctor. One of them will understand what your needs are. You will eventually find a doctor that will be glad to correct your vision. When you find that doctor STICK with him/her. Obviously, you want a decent reading add out of the visit. You should end up with at least a +1.25 add for reading (minimum). Anything less than that, will probably not give you all the relief you need. Little stronger than that (+1.50 or +1.75) should be in the ball park. Once you start wearing the add, your eyes will get used the add and relax a little more. That is why is better to try to get the reading a little stronger, so you do not have to change the lenses again to a stronger add in a year or two. Impress on the doctor you would rather the reading be on the stronger side, just because of the annoying headaches.

You can also ask for a computer rx, if the distance to your monitor is not close to 16". You will need to tell the doctor the distance between you and the monitor. My monitor is about 28" away. The add would be reduced for that distance. The computer add is usually about 1/2 of what the reading add is, depending on the distance. I would strongly recommend only single vision lenses for computer work.

Once you have your rx, you can order inexpensive glasses online, if you like. Your rx is pretty simple, nothing special. If ordering progressives, you need to have your measurements correct.

If you go to the drug store, you can try different strength reading glasses over the top of your normal distance rx. That will simulate what the add will look like. That is all the doctor is going to do. He will add plus until your reading is good. The strongest rx you can find that works well for about 16"-18", is what the add should be. If you use the first method, you could go in to the exam with over the counter readers, and say you had to put them on over you other glasses to prevent headaches until you got new reading glasses.

When your muscles fully relax, a full reading add is a +2.50 for reading distance of about 16". It will probably be many years before you can except the full add.

I made a post about my vision problems when I was a kid. It might sound like what you are currently going through. Checkout the "When I was at School" thread. My post is on March 4th.

Please check back in with your results.


Neil 21 Apr 2012, 15:59

Cactus Jack--completely agree and understand your point.

In no way was I thinking that smartphone usage CAUSES presbyopia.


Andre 21 Apr 2012, 13:59

So I posted about my issues a few months back - Here is a quick recap.

In early January I was having issues with small text, headaches ect. I am 36 yrs old. My prescription was:

-1.25 -2.00 82

-.75 -1.25 90

The Dr said that I had a big change and gave me a script of

-.25 -2.00 82

pl -1.25 90

She said I was too young for multifocals and that my distance was "over cranked"

She said that it may take a while to adjust to the new script.

Well its been almost 4 months and I'm still having issues. The new script has helped with the near vision and has gotten rid of the headaches but my distance vision isn't what it should be. Things aren't clear - I can still see but its not perfect. I really notice it at night when I try to read the guide on the TV or far off street signs.

If I put my old glasses on then I can see distance 100% perfect (like HD) but then I can't read anything with them on (its worse now then it was).

Should I go back to the same Dr or see a new one? My wife is convinced that I need bifocals or progressives.


Cactus Jack 21 Apr 2012, 09:12

There is a principle in logic called (in latin) "Post hoc ergo procter hoc" "After this, therefore because of this" (in English). It is considered a false premise and an error in logical thinking. It would be like saying that the Tsumami last year in Japan caused the Tornado outbreak this year in the US midwest. Probably NOT.

Tiny text on mobile devices do not CAUSE presbyopia, they simply reveal the naturally occurring process at an earlier age than trying to read normal text does.

Presbyopia starts in childhood when the crystalline lenses gradually begin to thicken and loose their flexibility. Many studies have demonstrated and analyzed the process and there is even a formula for calculating the relative accommodation based on age. The age at which presbyopia become a significant factor depends on three things: Text or target size, distance from the cornea, and accommodation. There is nothing new here except the tiny text that needs to be read from close distances.

I expect there will be proposals for Nobel Prizes in Medicine for such ground breaking research into the KNOWN. There have been awards for less and the monetary component of the Nobel is nothing to sneeze at.

C.


Andrew 21 Apr 2012, 01:30

Thanks, Astra. I had never even thought of the effect of trying to use these devices while on public transport as I have to drive to work.


Neil 20 Apr 2012, 15:04

My wife definitely falls into the smartphone-to-presbyopia demographic. She is constantly facebooking, texting, etc. on her iPhone. She got her first add at 35, though she was a little farsighted in the first place.


Astra 16 Apr 2012, 03:14

Re: LT Lurker 15 Apr 2012, 18:31

nice sharing ! bookmarked !


Astra 16 Apr 2012, 03:12

aged Saduo should be aged 20+


Astra 16 Apr 2012, 03:09

Re: Andrew 15 Apr 2012, 16:05

South Korea Central Daily News, 4, citing a recent study reported that the South Koreans aged Saduo symptoms of presbyopia ratio is rising, and indulge in the use of smart phones is a big reason.

According to the findings of presbyopia check for eight hundred patients, the rate of South Korea's 36-year-old to 40 who have presbyopia five years ago (2006) to three percent, but this year has risen to seven percent . South Korea presbyopia expert Wu Hsien, observing that these presbyopic patients, most of the characteristics of frequent use of smart phones, tablet computers, mobile devices such close operation. "

Zhu Tianji, Seoul St. Mary's Hospital, professor of ophthalmology, focus on watching the text on the smart-phone screen or computer games, the number of pictures per minute blink only about five times the usual 15-20 times a lot less and blink less lacrimal gland secretion is reduced, resulting in reactive oxygen species lead to presbyopia.

The light of the Seoul World Ophthalmology Dean Lizhong Hao pointed out that the majority of smartphone users eye fatigue, and "judged mainly due to the use of mobile phones or view the e-mail habits," the shaking of the bus and subway. In order to focus in the shaking of the screen, the lens and muscles of the eyes will be over-stretched, to protect the corneal tear film instability, eyes more likely to fatigue.


LT Lurker 15 Apr 2012, 18:31

I mentioned this from a Finnish eye care professional

http://www.kaisuviikari.com/books/PANACEA_by_Kaisu_Viikari_1978.pdf

Fantastic info!


Andrew 15 Apr 2012, 16:05

Astra, any chance of a translation of that?


Astra 15 Apr 2012, 08:31

chinese article: recent research findings from Korea indicates usage of mobile devices lead to increasing presbyopia prevalence.

http://tw.myblog.yahoo.com/yahoo-heg/article?mid=1699&prev=463&l=f&fid=34


Cactus jack 14 Apr 2012, 08:11

Stephen,

It should say detected rather than detached. This spell checker is too smart for my own good. I didn't fully check the checker after it had checked me.

C.


Cactus Jack 14 Apr 2012, 08:09

Stephen,

Thanks for the update. It is great that your crystalline lenses have relaxed so quickly. Probably, the reason for your very rapid adaptation is that you detached the developing problem early and did something about it. The longer you wait, the stiffer the lenses get and the longer it takes for them to fully relax.

Presbyopia literally means "old eyes", but these days, with the high, close-up visual workload, many people, much younger than you, are finding that focusing help is a very useful tool. Some may say that you should not bother with glasses with such a low Rx. I think the key point is effortless vision at all distances. There is a lot to be said for comfort and visual efficiency.

C.


Stephen 14 Apr 2012, 06:20

Have been wearing my new glasses for about a week-and-a-half. The distant vision, with glasses, is now very sharp and crisp. Also, I am pretty amazed how clear my close-up vision is now. I guess my vision was slowly getting "old".


LT Lurker 13 Apr 2012, 02:33

Very interesting information CJ

The progression has been reasonably rapid I would say.From doing lots of close work in the evening to doing very little after early afternoon has taken a couple of years.

I think night driving is a bit of a problem on unusual roads and lengthy daytime driving produces a definite headache.

Excessive blinking, massaging her temples extreme light sensitivity combined with general fatigue.All of these are the classic hyperopia symptoms that are almost always apparent.

But the strength of denial is overwhelming and she insists she has perfect eyesight!Sure she has good acuity sometimes but that is until the muscles can't work out any more and she tears and blinks and rubs!

I read one paper by a Finnish hyperopia expert who believes that a give away sign of someone struggling with hyperopia is a vertical frown line and the more pronounced this is the more hyperopia she has generally uncovered.

My wife has a lengthy one of these!


Cactus Jack 12 Apr 2012, 05:24

With as many women and fewer but still substantial number of men as there are in that famous watercourse, it is a wonder that there is still room to sail a dhow on it.

The ciliary muscles are still muscles and no matter how strong they are for their size, they still get tired. A trained weight lifter can only lift the weights so many times and hold them in the air for so long without tiring. The key is the magnitude of the weight, You wife's crystalline lenses have gone front he consistency of gelatin dessert to a very heavy gel that while the ciliary muscles can still squeeze them, it just takes lots of very tiring work. It is sad when vanity gets in the way of doing very enjoyable things, but it is VERY counterproductive to comment on that point.

As a practical matter, the cylinder correction in one eye just means that in that eye the she needs +1.00 to see lines like the horizontal bar (called a stroke) in an "H" clearly and +0.75 to see the vertical lines 90 degrees from the +1 direction. Which stroke of which letter is clear depends on the axis. In optical terms, the astigmatic eye has focus points at two different distances depending on which way the line runs. Generally, the sphere correction is considered to be major element in the Rx and the cylinder power just modifies that in one axis. Don't dwell on that very long, it will cause mental fatigue. To really get the picture of the effects of astigmatism, you need to play with a trial lens set for a while where you can see and feel the different curvatures of lenses.

The first reaction of a person who is not nearsighted, but is developing presbyopia is to move close things away to bring them into focus because it requires effort to focus using their crystalline lenses. When reading small text, moving something farther away makes the text effectively smaller and harder to read (the letters stimulate fewer sensory cells in the retina (think pixels)) so they then move the target closer and strain to focus if they still can.

An eye exam consists of many elements. The ophthalmologist probably spent most of her time carefully inspecting the retina for possible disease or damage, that is usually their forte'. The two parts of the refraction part of the exam are the objective part and subjective part. The objective part is done by looking into the eye using an opthalmoscope and trying various lenses to find the ones that neutralize the power of the eyes lens system and bring the retina into the best focus. The auto-refractor just projects an image on the retina and moves its internal lens system back and forth with great precision to focus the projected image clearly. It then calculates the lens pose required based on the focus distance and displays it or prints it out.

In both cases that is the starting point for the subjective par of the exam, where, if you will, "the rubber meets the road" and what the patient sees or says they see determines the actual Rx. Theoretically, the auto-refractor just saves time in the objective phase, but in some places, such as asia where myopia is endemic, they just use that as the Rx, maybe with a little extra minus, and let their accommodation handle the slight excess.

In all instances, the subjective part of the exam starts with too much plus - fogging, to try to keep the ciliary muscles and crystalline lens from confusing the issue by adding undesired plus at this time. If there is any question about the crystalline lens being fully relaxed, a dilating agent is used to try to make sure. However, if a person has latent hyperopia, a dilating agent may not be able to do the job completely and only time will allow the crystalline lens to fully relax.

The sphere Rx is determined by gradually reducing the excess plus (or adding more minus, optically the same thing, until the patient can read the 20/20 (6/6) line on the chart. That is the far point Rx. For the near point, a small chart is placed at the typical reading distance (preferred is better, but few ODs will ask). Unless a dilating agent has been used, the patient's auto-focus system will provide as much additional plus power to focus on the chart as it comfortably can and if no more than that is needed, the test will stop there. If more is needed to focus, then plus is added until the patient can read the appropriate line and that become the add for near point focus. If the patient has no accommodation left, the add will wind up being what Sir Isaac said you need to focus at that distance. After I had lost all my accommodation, my ophthalmologist just handed me a board with a chart on it and a measuring chain. He said hold this where you normally like to read. I did and he used the chain to measure the distance to my eyes and calculated the add.

C.


LT Lurker 12 Apr 2012, 01:21

CJ Thank you for your comments.

My wife is in that famous Egyptian watercourse bobbing ever towards the Med.

5 years ago she was a voracious reader and did loads of handicrafts needlepoint,jewellery etc.Now she reads for 20 minutes max, she can spend a bit longer on a computer but that is punctuated by eye rubbing and loads of breaks.So I guess presbyobia has been affecting her for a while, she has just moderated her habits.

I think she does have higher levels of accommodation available but as she can't sustain close work any more than 20 minutes I think it must be diminishing at a fair rate.

To see at 28cms requires 3.57D + her error of 1D (in one eye) = 4.57D Does the minus -0.25 mean she needs to see just 4.32D for 28cms?

Also if she has some thing put within 40cms she moves it away and then back in nearer.

Her previous test was done by an opthalmologist and took 45 minutes whilst her latest test was by an optometrist and thistook 10 minutes.

The opthalmologist found +1.75 just by fogging where as the optometrist just used her autorefractor!

I myself am 45 and wear a -2.5 correction, when I move, say page of text closer from 1m out or so, it goes blurred quite a way out (40cms) with my correction, but I can then bring this into focus albeit with strain.

Does the opto use this initial blur point as the near point? or do they use a nearer point, once the eye refocusses under strain?

If so my wifes initial near point is way out, she just strains and brings it into focus.


Cactus Jack 11 Apr 2012, 22:48

LT Lurker,

I doubt your wife's astigmatism is contributing anything to the situation. It just hurts acuity at all distances and could be a factor in fatigue.

Everyone is different and your wife is very fortunate to have good accommodation at her age. However, remember that her hyperopia is using up some of her precious accommodation.

She may like the situation as it is today, but don't expect it to remain this way unless your wife is one of those rare people where presbyopia develops very, very slowly and can read handily up into their 60s without reading glasses.

C.


Cactus Jack 11 Apr 2012, 22:41

Perette,

Astigmatism is generally caused by uneven curvature of the front surface of the cornea. The exact cause is unknown, but it causes problems at all distances.

The close work is causing temporary, pseudo (false) myopia. Myopia has the effect of wearing built in, plus reading glasses in the lower ranges. if you read for an extended period at say 40 cm or 16 inches, your reading segment add is providing +1.25 and your crystalline lenses are adding +1.25. After an extended period of close work, when you look up, you are temporally nearsighted until your crystalline lenses gradually relax. Sometimes it can take a rather long time.

There is a way to prevent this. Bite the bullet and go ahead and eliminate the need for your crystalline lenses to have to supply any plus so they remain relaxed while you do close work. You can do this with bifocals, progressives, or try vocals depending on your visual environment. Glasses like these are called functional bifocals etc. You technically don't NEED them, but they make it easier for you to function more efficiently at work. There is a small disadvantage to doing this. It will likely encourage faster de-conditioninn of your ciliary muscles and make your presbyopia seem to progress faster. However, the end point is the same no matter what you do.

You have not mentioned anything about your occupation or where you live. If you use the computer a lot and also read a lot, there is another trick that I use and you can do also. Get some clip-on magnifiers. They are very inexpensive. If you get some +1.25 or +1.50 clip-ons and clip them over your regular glasses, they will become "computer glasses". Your usual distance segment will become an intermediate segment that focuses around 25-30 inches and your reading segment will focus at 13-16 inches depending on the strength you get. If you need to see something in the distance, just flip them up or unclip them and everything is back to normal.

If you want to try the clio-ons, I order from www.rx-safety.com. They are located in New Jersey USA and they have them from +1.00 to +5.00 at US$14.99 each and are well worth the money. As a temporary test, you can also just try some +1.25 or +1.50 OTC readers over your regular glasses and see if that helps. Even though I wear try-focals and use the intermediate segment for the computer, I often wear the clip-ons if I am going to be doing a lot of work on the computer. I don't have to tilt my head back and I don't get a crick in my neck.

If you decide to get some stronger glasses, your OD may give you some static, but you don't need his OK to try the clip-ons or reading glasses over your regular glasses.

Let me know what you would like to do and if you need anything more.

C.


LT Lurker 11 Apr 2012, 17:47

My wife is an unusual case, she is 44 and has had a prescription of +1.25 +1 -0.25 no add.

She has been told she can put her glasses away for a bit which she gladly did.

She can still read small text on an iPad upto about 28cms or so albeit with a fair strain for about 10-20 mins max.

From this she must have around 5 -5.5D in accommodation left.I am wondering if the little bit of astigmatism in the one eye allows this close work to happen.

Usually when she watches tv she presses to astigmatic eye and eventually falls asleep even in her favourite programmes!

Donders, Hofstetter etc have higely varied ideas as to what accommodation could and should be at certain ages and I think Hofstetter suggests the maximum available for a 44 yo could be as much as nearly 7D!

Does anyone have any ideas on this?


Perette 11 Apr 2012, 17:05

Cactus Jack, thanks for the detailed explanation! However I have worn glasses since college! In my case, astigmatism was an issue right from the start. I have seen the same optometrist since my late twenties. One thing he told me last year was that, until now (when I got my first "add"), my prescription was very stable.

You say that after I do near work my eyes are, in effect, nearsighted. Is there any solution to this?


Cactus Jack 10 Apr 2012, 23:50

Perette,

Welcome to the mysterious world of Hyperopia and Presbyopia. Hyperopia and Presbyopia have two different causes, but the correction is the same, external PLUS lenses.

Hyperopia is caused by a mismatch between the length (size) of your eyeball and the total relaxed power of your eye's lens system. You probably have had hyperopia for most of your 41 years, but you never noticed it before.

Almost everyone is born with hyperopia and two very useful tools for dealing with it. The most important tool is the eye's autofocus mechanism which consists of the crystalline lens and the ciliary muscles. The cornea is quite powerful. It is fixed focus and it provides about +20 to +25 diopters of focusing power. The crystalline lens is variable focus. In its relaxed state it contributes +10 to +15 diopters and the humors contribute a few + diopters to bring the total relaxed focusing power up to around +40 to sharply focus distant images on the retina which, in a "perfect" eyeball is about 25 mm from the back of the crystalline lens. When a person is young, the crystalline lens has the consistency of gelatin dessert and the ciliary muscles, which are the most powerful muscles for their size in the body, can effortlessly squeeze the crystalline lenses to significantly increase their plus power for focusing close OR correcting for hyperopia internally.

The other tool is the body's ability to cause the eyeball to grow and slowly correct for hyperopia through childhood and young adulthood. This appears to be regulated by a specific hormone produced by the retina in response to blurry images. This would always result in perfect vision, except for the fact that the retina's ability to produce the growth hormone seems to be regulated by one's genetic make up. If the retina does not produce enough of the growth hormone or cuts off production too soon, the eyeball winds up too short (hyperopia). If the retina produces too much hormone or it does not stop production soon enough, the eyeball winds up too long (myopia).

By the way, the distances involved in the eyeball being too short or too long are usually amazingly small. About 0.6 mm per diopter.

All this automatic correction takes place without any conscious effort or awareness on the part of the hyperopic individual, because the auto-focus mechanism in the eye corrects it. The myopic individual is not as lucky. He has a problem because if the eyeball is too long, he has TOO MUCH PLUS in his relaxed lens system and there is no way to relax the crystalline lens beyond fully relaxed. The only solution then, is an external MINUS lens to neutralize some of the excess PLUS.

Now lets go back to the person with hyperopia and throw presbyopia into the mix. Presbyopia is a gradual thickening or stiffening of the protein that makes up the crystalline lens. It starts in early childhood and gradually gets thicker and harder for the ciliary muscles to squeeze. Depending on the amount of hyperopia it is correcting all the time and how hard the lens is to squeeze, a point is reached where the tiny muscles just can't make the crystalline lens produce enough plus to both correct the hyperopia and focus close. Once a persons distance vision is corrected to 0.00 for distance, the amount of plus you need to focus at a particular distance is determined by the laws of optical physics developed by Sir Isaac Newton about 300 years ago. The law is described by the following formula 100 cm / focus distance = lens power required in inches it is 39.37 / focus distance = lens power. To read at 40 cm or 16 inches requires +2.50 diopters that has to come from somewhere. If the ciliary muscles and crystalline lenses can supply it and still correct for hyperopia, you don't need external help. If it can't fully correct the hyperopia, you need some + lenses for distance and likely some additional + to help you focus for reading. Bifocals anyone?

Now, what is happening with you. A stiff crystalline lens, as a result of presbyopia, is very hard for the ciliary muscles to squeeze, but if they can squeeze the lens, they can change its power pretty quickly. However, there are no muscles to help the crystalline lens relax for distance, so when you look up, your are actually a little nearsighted until the lens slowly relaxes.

What to look forward to. You may need a bit more plus for distance as your crystalline lenses relax more for distance. Many hyperopes develop what is called latent hyperopia caused by the crystalline lenses and ciliary muscles correcting hyperopia for years. It can sometimes take months to fully relax. The other is that you will probably need a stronger add sooner than you think. The reason for this is that your bifocals are doing some of the work that the ciliary muscles had to do. Even though they are strong for their size, they can become de-conditioned very quickly and loose some of their ability to squeeze the crystalline lens, which is constantly getting stiffer and harder to squeeze. At some point, presbyopia wins and you need either bifocals, trifocals, or progressives to do the focusing for you. However, unless you like to work or read very close, it is unlikely that you will ever need much more than a +2.50 add.

I hope I have not bored you with all these details, but perhaps the world of hyperopia and presbyopia is not quite as mysterious as before.

C.

P.S. All this long winded explanation was not just for you. There are millions of people experiencing all this all over the world. Maybe it will help some of them, also.


Perette 10 Apr 2012, 21:27

Though I should add, I haven't worn contacts for ages!


Perette 10 Apr 2012, 20:56

I turn 41 next month.

I should add, I also have astigmatism. I don't know the exact numbers, but I know it's high enough to require toric contacts.


Cactus Jack 10 Apr 2012, 18:16

Perette,

What you are experiencing is common and nothing to get excited about. I will be happy to explain what is going on. May I ask your age?

C.


Perette 10 Apr 2012, 13:44

I'm having a vision issue that's counter-intuitive. Last year I was fitted with progressive lenses for the first time. I don't remember my prescription but I am roughly plus 1.5. I think my add was 1.25. Now what is happening is that I am having blurry distance vision after prolonged near work. It eventually clears up but obviously it is getting more and more bothersome. Any idea of the cause? Thanks.


Cactus Jack 09 Apr 2012, 12:27

Julian,

Thanks, I am asking myself how could I forget Macrae and his great posts. They tell the saga of a person making peace with Hyperopia in a very funny way.

I think I still have most of my "marbles", but they say you can't tell if you loose them. I like the explanation that as you get older, you have so many items in your memory, that it can sometimes take a while to sort through everything to find "file" you want.

Thanks again.

Steven23,

If you have trouble finding these posts in the archives, let us know.

C.


Julian 09 Apr 2012, 10:18

...or even his FIRST post


Julian 09 Apr 2012, 10:17

Cactus: the member you are talking about is Macrae, and his firts post on this thread was on 21 September 2007. I did have the whole saga saved to a disk, but it got corrupted. It is well worth reading.


Cactus Jack 08 Apr 2012, 12:18

Last post for Steven23 was from me.

C.


 08 Apr 2012, 12:17

Steven23,

There are millions of people who think they have perfect vision when that are actually a little bit hyperopic (long or farsighted). The reason for this is that you have the internal ability to correct some hyperopia using the reserve focusing power of your focusing system - until presbyopia takes that away.

Many of those millions also have what is called latent hyperopia. What that means is that their focusing system has become so used to correcting their hyperopia that it has trouble fully relaxing back to where it should be for distance vision. Presbyopia makes full relaxation more difficult because of the increasing stiffness of the crystalline lenses which makes what relaxation is possible, happen verrrry sloooowly. The slight increase in your wife's sphere correction from +0.50 to +0.75 is actually a little less than is typical, which either means that she did not have much latent hyperopia or her crystalline lenses have not yet fully relaxed. This, by the way is a good reason for wearing the glasses, to promote full relaxation of the crystalline lens an stability in the Rx.

The change in the astigmatism correction (cylinder and/or axis) is probably measurement error. It is very difficult to measure low levels of astigmatism accurately because it depends to a great extent on the skill of the patient in judging relative blurriness from one trial lens and one trial axis to another. It is much more difficult than judging relative sharpness of two lenses. The difference between old and new cylinder and axis Rx is almost trivial. Of course you want the Rx to be as close as possible and there are some ways to improve the accuracy, but it takes some practice on the part of the patient. Remember, the examiner cannot tell what a person actually sees, only how he/she describes what they see.

The increase in the add is also normal and typical. Fundamentally, the amout of add you need after any hyperopia (or myopia) is corrected depends on two things. How much accommodation (focusing ability) you have after presbyopia has done its thing and how close you need/like/want to focus clearly. The actual amount of + you need to focus at a particular distance is governed by Sir Isaac Newton's formula, 100 cm divided by the focus distance in cm = lens power or 39.37 in. divided by the focus distance in inches = lens power. This additional plus needed to focus is provided by the autofocus mechanism in your eyes when you are young. Or, a combination of your focus mechanism and external + lenses in glasses or contacts as we get older and presbyopia sets in. However, once your focus mechanism can no longer do its job because of presbyopia, the only governing factor is the focus distance. To read at a typical distance of 40 cm or 16 inches requires +2.50. If you need to focus closer for whatever reason, you will need more plus in the add, but not a lot. I like to read in bed and the book is usually about 30 cm or 12 inches from my eyes so my add should be +3.33, but you can't get that so I settle for a +3.25 which focuses tiny bit farther away. I also have a pair of single vision reading glasses that have the Rx of the reading segment of my regular glasses with an add of +3.25 instead of my regular +2.75. I can read in bed for hours in comfort.

As far as deciding when to wear glasses full time, it is really up to the individual and how much discomfort they can tolerate. If VANITY gets in the way of the decision, the amount of discomfort a woman can tolerate to "impress" others is amazing. Checked out any women's shoes lately?

If you can, go back and read some of the posts on this thread in the ES Archives. There were a series of posts several years ago by one of our members about his adventures with advancing presbyopia that are extremely well written and very humorous. I will see if I can find them and give you a reference. Right now, I am having trouble remember the members name. I guess my age is showing.

If those meager clues trigger any memories in other members, I would appreciate any help you can offer.

C.


Steven23 08 Apr 2012, 06:32

Hi there. I'm wondering if anyone can help with two questions.

My wife is 51 and had perfect eyesight most of her life. However, she was prescribed glasses in mid-2008 after she complained abut difficulties in reading. The optician said most of this was age-related. Her prescription back then wa:

R +0.50, Cyl -0.75 ax 145

L +0.50, Cyl -0.25 ax 90

Add +1.00

In November last year, she went back to the optician after many months of saying the glasses were no longer helping her. Her new prescription is:

R +0.75, Cyl -0.50 ax 145

L +0.75, Cyl -0.25 ax 85

Add +1.75

In the intervening three and a half years her sight had deteriorated slightly, both with regard to hyperopia but especially her presbyopia, for which the ADD has gone from +1.00 to +1.75. The astigmatism in her right eye has also decreased a little. Is it possible to hazard a guess as to what her hyperopic/presbyopic progression is likely to be in the next year or two based on these two sets of numbers?

Also, when she received the new prescription, my wife refused to have it made up into a single pair of glasses, even varifocals, saying she was "not ready". I haven't commented on her decision other than to be supportive. She now has two pairs of glasses, one of which she now uses for reading/close work and the other for watching TV and driving.

I realise that everyone is different in terms of how they feel about their vision and when they choose to wear glasses. In your own case, when you were first prescribed glasses for him/herself with a new prescription for hyperopia/presbyopia, when did you finally decided to wear glasses full-time?


Cactus Jack 04 Apr 2012, 17:20

Stephen,

Thank you. I look forward to hearing of your progress. PLease feel free to ask any questions you may have.

C.


Stephen 04 Apr 2012, 17:05

Picked up my new glasses yesterday morning. Have been wearing them full-time in the hopes of adjusting to them quickly. Distance vision is still fuzzy, but I understand that should go away in a few weeks, as my eyes adjust and relax. Close-up vision is great.


Stephen 01 Apr 2012, 19:34

Thanks Cactus. Will touch base after I pick-up my glasses.


Cactus Jack 01 Apr 2012, 12:05

Stephen,

The results are pretty much what I expected. One reason farsighted people experience hyperopia early is that your ciliary muscles and crystalline lenses can correct some of it, but in doing so, it uses up some of your focusing range for close work.

Here is what you can expect in the next few years so be prepared for it.

1. Perhaps a small increase in your distance Rx +0.25 or +0.50 if you have a little latent hyperopia like most farsighted people.

2. An increase in the add as your crystalline lenses become stiffer and your ciliary muscles loose some strength. In a years or so, when you don't have much accommodation, the add will depend strictly on the focus distance where you like to read. The power of a lens needed to focus close is easily calculated. In inches it is 39.37/focus distance = lens power. For example for a typical reading distance of 16 inches, 39.37/16 = +2.46 or a +2.50 add.

You may not notice much difference in your distance vision when you first get your glasses. You will in a few weeks.

C.


Stephen  01 Apr 2012, 06:02

Cactus Jack, I went to the eye doctor yesterday. She said I had a small amount of farsightedness and was dealing with the onset of presbyopia. For both eyes, the prescription is +.50 with an add of +1.00. I took your advice and had the appointment first in the morning, but there was still a little "fuzz" in trying to read the smaller print at a distance. Will pick up my glasses on Tuesday.


Stephen 26 Mar 2012, 06:23

Will keep you updated. I live in New York City.


Cactus Jack 26 Mar 2012, 06:16

Stephen,

Sounds like you understand what is happening and more importantly, understand that all this is just part of life. I would like to suggest that you do not put off getting an exam. Nothing will be gained or improved by delay and there is a lot to be said for clear, effortless vision at all distances.

If you get an Rx and would like to consider ordering glasses online at low cost, several of our members have a lot of experience with some of the best online retailers and can suggest those who offer the best quality and value.

May I ask where you live? Sometimes, where you live can affect the suggestions offered.

Please let us know what you decide to do and the results.

C.


Stephen 26 Mar 2012, 05:48

Thanks for the advice. At 44, I am not adverse to bifocals. Yes, my eyes are getting old.


Cactus Jack 25 Mar 2012, 20:15

Stephen,

Sounds very typical. You probably need to get an eye exam early in the morning so your ciliary muscles and crystalline lenses are relaxed for distance. All exams start with distance vision and then proceed to other things. You need that right first.

Be sure and tell the examiner about your occupation and what you are experiencing. He may suggest bifocals with a low add depending on what he/she finds. If you have an aversion to bifocals, you might try a pair of single vision computer/reading glasses with a low plus, but again depending on your work keeping track of single vision "readers" can be a nuisance. One of the neat things about bifocals worn full time is that you rarely misplace them.

BTW, bifocals don't necessarily mean you are getting old these days. They might just mean that you can't read the text on your smartphone or tablet very well. Even teens are wearing bifocals to be able to text more efficiently.

C.


Stephen 25 Mar 2012, 18:24

The blurriness seems to be more noticeable at work. I do a lot of close-up work. Anyway, I keep thinking "old eyes" and it it time to look into wearing glasses.


Cactus Jack 25 Mar 2012, 16:56

Stephen,

Presbyopia generally causes problems focusing near. However, presbyopia is related to the stiffening of the crystalline lens because of age which causes it to be slow to relax after a lot of close work effectively making you temporarily nearsighted (pseudo myopia).

How is your distance vision when you wake up in the morning before you have done any reading or close work.

C.


Stephen 25 Mar 2012, 16:13

Am 44 years old and am having trouble focusing at a distance. Print at a distance is fuzzy. Have not had my eyes checked in 5 years, but at that time my distant vision was perfect. Is this fuzziness just a part of presbyopia. And yes, I know I should see an eye doctor.


Hansel 14 Mar 2012, 16:09

FAO GWGS

Perhaps ask her to get the number of your bank from the phone book? Ideally later in a day with cloud cover.

A fail would provide an opening gambit?

Alternative

Find some mall print, struggle yourself and ask for help? She struggles too, "well perhaps we both need a trip to the optician, where do you usually go?"

Alternative 2

Do you wear reading specs yourself? Bewail your own vision and how you feel the need to get a retest, then you could be unkind and ask how, no disrespect she has managed, given the fact that she is at the age, not to need glasses herself! ;-) She might open out... or hit you!


gwgs 14 Mar 2012, 03:41

Thanks for the advice Soundman, she has made several other mistakes in the last week which are unlike her. I would definitely go ahead with your advice if we were a big conglomerate but given we are a relatively small company with a few members of staff I think she may find this offensive and although your method would certainly sort the problem out I think it is quite a harsh way to deal with it as with her not having had her eyes corrected by now she must have some hang up about glasses. The lady in question is certainly suffering from presbyopia, and this maybe why she is resistent to getting them, as it is an age related problem (she must be between 45 and 50 years old).

What makes this problem even more crazy is that reading glasses are now so readily available that you can purchase a pair for less than £10 from any supermarket or pharmacy, and therefore she needn't have to even go to an optometrist to get corrected if this is her problem.

The plot thickens however as I spotted a card on her desk yesterday from a company called "Accuvision", which had an appointment time of last Saturday which after googling them it transpires this is a laser surgery company.

This might not be for her though as she has a family with a couple of grown up kids, but I would've thought anyway that this type of surgery won't cure presbyopia as she is probably at the beginning of the deteoriation of her eyesight and as such over the years it will require her prescription to be updated. Do you think this is true?

I had thought that I could get her to read my credit card details to me for instance, as she may have trouble with that given the small text, but this may not work as the numbers in the middle of the card as substantially bigger than the ones at the bottom. Where as I can engage the others in the office in random chats about their eyesight or new glasses etc, I haven't managed to crack this one as she seems a very closed book with regard to her close up vision.

Any further help with hints on how to get this sorted would be appreciated!!


Soundmanpt 13 Mar 2012, 13:29

gwgs

I think the answer you are asking is a very simple one. It is one thing if you notice someone having trouble seeing things but it is not effecting their work. But it is clear from what you have described that it is bad enough now that she is making mistakes and mistakes cost money. I am not sure what you company policy is but in some cases the company will often pay for the eye exam as well as her glasses. Without a doubt she living in denile and refuses to believe she needs glasses. But since she works under you and her work defines you as well and is making you look bad I think you may have to tell her she MUST get her eyes examined within the week and she must bring back a note from the eye doctor as well. Just so she can't claim she went and didn't require glasses. Also even after she gets glasses you should be sure she is wearing them while at work. Of course what she does when she is away from work is totally her business. But as we all know I think once she gets them she will soon be very happy she has them and may even thank you for pushing her. If she is straining that much her eyes must be very tired at the end of the day.


gwgs 13 Mar 2012, 10:31

Some say this should probably go in the Nearsightings thread, but I thought it may be read more on this one, and therefore give me more feedback on it.

Every single girl that has worked in my office ever since I started many moons ago has worn glasses, or started wearing during their employment here. Out of 5 girls in the office 4 of them wear glasses of varying styles and prescriptions. The unglassified lady is my PA and has been showing signs for a while of needing glasses for close up/reading but despite a couple of subtle hints from me she has never done anything about it.

Over the last couple of weeks my observations of her failing close up eyesight has intensified, with her having her web browser's zoom level at 150%, instead of the regular 100%, as well as MS Word, and Excel also at 150%!! When typing labels for files and other sorts of things the font also seems to be rather bold and big.

She has also misquoted model numbers off an appliance and phone numbers in her hand written contacts book incorrectly in the last week, and self admittedly says she can't read the small prints of food or drinks so when I said that she'd got something wrong last weeek she said "it all looks the same to me, the E's and the A's and the 0's and the 8's". I said in a sarcastic tone last week after these errors "maybe you need a trip to Specsavers", at which she said this would probably be a good idea actually. But this didn't happen.

To save any further errors, and maybe her deteriorating eyesight, can anyone think of a way to actually get her to have her eyes checked up as it is obvious to me that she requires reading glasses!!??


lion 08 Mar 2012, 05:26

test


SC 07 Mar 2012, 04:12

LT Lurker

No I never got headaches - just couldn't see.

Completely different after getting glasses - can sometimes feel the headache coming on in minutes if I don't wear them. Particularly noticeable after first plus distance RX.


Carrie 05 Mar 2012, 14:09

Her contacts and glasses are the same prescription.


Soundmanpt 05 Mar 2012, 13:24

Carrie

In the case of your college friend it could be that she got her full prescription when she got her contacts. if this is the same young lady you have mentioned before that got her first glasses not long after you got yours. She got glasses stronger than yours right away even though she only wore them for reading and then a few months later got contacts. They would have to check her eyes with contacts so her contacts may be slightly stronger than her glasses? Did you check the rx on the packages of contacts? So at any rate your friend may only need a very slight increase or none at all when she goes for a eye check. That would explain why wearing her contacts with her glasses is much too strong for her. Her eyes can't handle that much over correction. also she may not be trying real hard either.


Soundmanpt 05 Mar 2012, 13:15

Revolver

It's funny you suggested that. The reason I told Carrie to pull out her previous glasses (her first ones as well) is that the rx on them is +.75 / +1.00 so with the contacts just about what her full prescription should be at her next exam. If her doctor thinks she will be at +3.00 at her next exam that is.


Revolver 05 Mar 2012, 12:08

Carrie:

Now that you have CL's, there's a relatively inexpensive way to self-check your own preferences. Just by some bottom end readers, start with +1.00 (or +.75 if you can find them), and then move up to +1.25, +1.50 etc. Don't know if that will accelerate latent hyperopia, but it will allow you to become used to the stronger lenses.


Carrie 05 Mar 2012, 11:55

Soundmanpt I will certainly try wearing my old glasses over contacts. My friend gave me quite a few unused contacts. All I need to do is find my old glasses! Back to wearing my glasses today. I don't think I'd ever get contacts of my own as I love glasses on myself and others (mostly women, some men). It was interesting that my friend couldn't see as much as me with contacts and glasses. I will also have another go with my current glasses and the contacts.

I'd like to get to my full prescription as soon as possible so I've been thinking over the last couple of hours that if I keep practising with a stronger prescription I might get closer to the full prescription at my next eye test than I would otherwise. I have read on Eyescene that hyperopia can't be induced but if you have latent hyperopia can the process of getting to the full prescription be speeded up?


Soundmanpt 05 Mar 2012, 11:17

Carrie

Its always kinda fun to try new things and I am sure trying contacts for the first time would be one of them. Being only off by -.25 less than your own glasses your vision with her contacts was very close. Also interesting that things look much different looking through contacts compared to looking through your glasses. Especially since now your only able to see clearly with your glasses. I assume the glasses you put over the top of the contacts were your current glasses making you a good deal over corrected. If you decide to wear her contacts again, i'm sure you kept them, try putting on your orginal glasses over them. That way your only over correcting by about +.75 My guess is you will be able to see slightly better than perfect at all distances. I think you will like the result.


Revolver 05 Mar 2012, 10:30

Carrie:

It's not unusual for latent hyperopes to "need" a stronger plus early on, but quite often this need is not necessarily the result of your hyperopia developing further but a result of the doctor intentionally under prescribing to allow you to adapt to being first time plus wearer. Although they usually tell you this is going to happen. Here's an actual experience I had that will illustrate the point.

Was at a favorite watering hole/restaurant where the servers had to come up to the bar to get beverages for the tables. I was sitting next to the waitress serving station at the bar, and a new server came up and stood there, wearing gorgeous semi-rimless rectangles with a dark blue plastic top and medium wide matching temples. Could see they were a fairly strong plus, complimented her on how well they went with her short blonde hair, and that was enough to launch a conversation about her glasses.

She was a college student, probably early 20's, and they were her first pair. She said one was +3.25 and the other was +3.00 and she started wearing them full time after a few days as she had great difficulty with both near and far when she wasn't wearing them.

She liked wearing glasses,her concern was that the doctor said she had to come back in 6 months and she would get stronger lenses, he didn't know if he'd raise her all the way then or after one more increase after that, and she didn't want to look bugeyed. He said her final rx would be +4.75 in one and +4.50 in the other, which he couldn't give her on her first visit as adaptation would be very difficult.

Not saying that happened to you, but in any event, a fairly rapid increase in first time plus wearers is not uncommon. It was refreshing to talk with someone who knew exactly what her prescription was and be so informed about vision.


Carrie 05 Mar 2012, 09:53

I tried contacts at the weekend. My college friend has stopped wearing her contacts and just wear her glasses but still has lots of unused contacts. She showed me how to put them in and persuaded me to have a go. I'm a bit squeamish about putting my fingers close to my eyes but I had a go. It wasn't quite as bad as I imagined and I managed to get contacts in both eyes on the first attempt! My prescription is +0.25 weaker than hers in both eyes but I could see perfectly with the contacts in. It felt strange being able to see so clearly without my glasses on. Just to see what would happen I put my glasses on while still wearing the contacts. Close up was intensely clear but what was interesting was that distances weren't too bad - that familiar fuzziness I had when I first got glasses and tried my distance sight with them. If I concentrated on an object or lettering in the distance I managed to focus on them without too much difficulty but my eyes defocussed if I moved them to look at something else and I would start again. My friend put her glasses on over her contacts but couldn't see anything in the distance no matter how hard she tried. Even with my slightly weaker glasses on she couldn't focus.

It made me wonder if my actual prescription is nearer to +3 than +2. I probably could now cope with a prescription slightly stronger than my friend's but not much more just yet. It would be interesting to know what sort of prescription I'd get once all my latent hyperopia had come out. I have no plans to get new glasses for a while as I love the ones I've got and I've only had them since November.

I might get an eye test at a different place from where I went last time to get a 2nd opinion. The last place was ok but I'm worried that they might be deliberately under prescribing so I go back for an eye test and possibly new glasses sooner. But then it could just be me adjusting to the prescription quickly.

It would be interesting to hear what others think. I'm not bothered if I need stronger glasses.


Revolver 22 Feb 2012, 09:53

For a rare change, I disagree with CJ. Try simple +1.00 readers, off the shelf, and see how they work for you. Depending on what type CL and what base curve you use, with only a half diopter of cyl nearly all of them will flatten the cornea enough that the astigmatism is masked. By ordering prescription readers with the .50 cyl you will be inducing that amount of cyl over the top of what has become a spherical correction. In any event you will have very little invested in the readers and they will be useful for short periods even if you find that readers w/cyl are better.


Cactus Jack 21 Feb 2012, 18:41

Smudge,

When you order the reading glasses for use WITH your contact lens, just order;

R & L Sphere +1.00 Cyl -0.50 Axis 175

That will correct the astigmatism and give you the most comfortable vision.

If you want reading glasses for use WITHOUT the contact lens:

R & L Sphere -0.75 Cyl -0.50 Axis 175

C.


Smudge 21 Feb 2012, 17:03

Just got a new prescription

R: BALANCE (Lazy eye)

L: -1.75 -0.50 175

Add: +1.00

My first ever prescription with an add!

Quick question - about 3 days a week I wear a -1.75 contact lens in my left eye (not toric lens). If I was ordering reading glasses to wear over my contacts, would I order +1.00 or would I also include the -0.50 Cyl (which is not being corrected by my contact lens)?


Astra 19 Feb 2012, 10:23

Re: LT Lurker 17 Feb 2012, 19:26

My husband is age 57.

but that optometrist says he don't need glasses.

p.s. the store owner invited us to visit the stores.


LTLurker 19 Feb 2012, 08:20

SC-Thanks for your experience. Was it down to blurring rather than headaches and strain that got you through the door?

Cheers

LTL


Cactus Jack 18 Feb 2012, 18:19

Jose,

It is hard to say what might happen to your son's vision over the next 10 years. If he was a bit nearsighted in both eyes, I would say that it was likely that he would become a bit more nearsighted as his visual workload increases in school and university. It is pretty common. Based on that, It is possible that the nearsighted eye may get a bit more nearsighted and the farsighted eye may actually become LESS farsighted over time.

At his age, genetics and growth are the primary factors that affect changes in prescription with visual environment a close secondary factor. Nearsightedness (myopia) and Farsightedness (hyperopia) are generally caused by a mismatch between the length of the eyeball and the power of the eye's lens system. Length (eyeball size) is usually the causative factor and the length error is only about 0.6 mm per diopter. In your son's case, his farsighted eye (+1) is about 0.6 mm short of the optimal length and the nearsighted eye (-1.5) is about 0.9 mm too long. Eyeballs can only grow and do not shrink. Eyeballs do not always grow at the same rate which causes the difference, but it is possible that his eyeballs will grow a bit more over the next few years and the effect will be as described above.

Hope this was helpful. Just remember that everyone is different.

My own experience was that at 14, I was 0.00 in one eye and -1.50 in the other. Over time both eyes tracked pretty much together and I wound up in my 30s at -4.50 and -2.75.

C.


Jose 18 Feb 2012, 14:48

Hi Cactus, my son mentions how clear his vision is in the nearsighted eye. For a few days, the lens on the farsighted eye caused some fuzziness, but that has gone away.

I know that myopia can be progressive---was wondering if he can expect the hyperopia to get worse.


Carrie 18 Feb 2012, 10:13

Soundmanpt

My girlfriend does feel she can't see as much without her glasses now as she did before she was wearing them all the time but she can see really clearly all the time with her glasses so she's really not bothered. She can get around without glasses it's just so much easier with them. She has no problem at all wearing her glasses. She'd never get big bold ones like mine as she is quiet, a bit shy and not as out going as me but with a cheeky side to her (That's what I love about her). Her current glasses are just nice simple rimless ones and her previous (first) ones were thin metal frames.

As this section is about Hyperopia I think any further questions about my girlfriend's eyesight and glasses should go in a different section as she has Myopia. Perhaps the "Vision" section would be best.


jane 18 Feb 2012, 09:39

It's been ages since I posted but I've just got a new prescription a couple of weeks ago, having been having major problems with near work yet again. I also didn't realise how large I was having to make the print on the computer until the eye dr pointed it out to me. Finally, my eyes seem to be adjusting and the eye dr has upped my distance prescription. In 2010, I was prescribed +1.5/+.5 (Right) and +2.5/+.5 (left) with the add still needing to be +3.75 which I was well and truly used to. Now my new prescription is +2.25/+.5 R and +3/+.5 L with add +3.75. However, I couldn't read as far down the near distance chart as he wanted with this prescription and when he got me to look at a newspaper it was out of focus. He got me to try using some other types of magnifiers that i could use for reading newspaper size print and I ended up getting a dome magnifier. It felt kind of surreal when I saw on the receipt that the magnifier was described as a low vision aid - that seems scary - but I am starting to realise, even in the short time that I have had it that i really need it.


SC 18 Feb 2012, 06:28

LT Lurker,

Fought the battle and lost. First noticed on some rainy January in Portsmouth just after turning 41 that I couldn't read the back of the wine bottle in a dimly lit restaurant but didn't really see it as a problem.

Before I was 43 I was using a glass globe ornament to read the the serial numbers om the back of a PC - again just down to bad light.

Whilst I was 43 I actually had to stop reading a book - it was one of those with a page or two for every day of the year - I think I gave up sometime in June.

In December, just before my 44th birthday, my sister-in-law persuaded me to try on her readers when we were playing a board game - I knew I couldn't read small print but I didn't realise howthe bigger print had become thin and grey rather than bold and black.

Got an interesting book for my birthady but when I opened it I knew I couldn't read it - gave up the next day.

No sign of the hyperopia until 18 months later, although now I understand that problems around 41 would likely indicate around +1.25


guest 18 Feb 2012, 03:48

Just a question. From everything that I can gather, people with presbyopia need to hold text, etc further away. My mother now wears glasses full time (I am not sure of her exact prescription but it is about +2 for each eye with an add of +2.25). The thing that seems weird is that before she got these, she was always holding things really close to read and squinted really badly. Can anyone explain what this is all about? i am just curious.


Soundmanpt 17 Feb 2012, 21:45

Carrie

As I recall when you met your partner she was not wearing her glasses much at all? When you entered her life and with your encouragement, she was soon wearing her glasses full time. Does she feel like her vision is now much worse now when she takes her glasses than before she was wearing them all the time?

You did nothing wrong by urging her to wear her glasses as she really should have been wearing them a lot if not full time anyway. You just gave her the push she needed and it doesn't sound like she has any problem with wearing them now anyway? This way your both happy.


LT Lurker 17 Feb 2012, 19:30

SC- Interesting to read your post,can I ask whether you consciously made the decision to hold off until 44 or were you fighting a "battle" for any length of time?

Cheers

LTL


Carrie 17 Feb 2012, 19:28

Antonio

She says it's gradual - things go from slightly fuzzy to too blurry to see properly. She can see a pc or laptop screen ok so long as she doesn't sit back. She can't read captions or credits on the tv from across the room. Road signs and street names are unreadable until she's close. If she tried to read the number plate of the car in front she'd probably have already driven in to the back of it before she could read the plate!


LT Lurker 17 Feb 2012, 19:26

Astra - It looks more like emmetropia,ie perfect eyesight, with the tiniest amount of myopia.

This small amount would only be corrected if your husband was a pistol shooter or such like,otherwise most optos would just leave it.

This small amount of myopia will shelter him a bit longer from presbyopia.

The prescription shows also,there is no cylinder (astigmatism) and no Add (presbyopia)

so it is back to age, he is likely to become demonstrably presbyopic between 45-50 with his prescription or lack of.

So its all about time really.


Cactus Jack 17 Feb 2012, 18:30

Jose,

Has your son said anything about his vision with his glasses or any comments by his friends in school about his glasses?

C.


antonio 17 Feb 2012, 18:00

hi Carrie,

do you know how far from your gf things get blurry to her when she is without her glasses ?

best regards, antonio


Carrie 17 Feb 2012, 14:27

To the anonymous poster 16 Feb 2012, 10:02

I probably could see my girlfriend better but with the lights off or low and/or being so close to her that even perfect eyesight couldn't focus it doesn't make a huge difference. If we are lying in bed together just looking at each other we do tend to wear our glasses.

As only the 2 of us see each other without glasses it's like another item of clothing coming off. We love seeing glasses on each other and taking them off as the last item of clothing is quite a sexy and exciting part of the foreplay!

I'm not going in to detail! I'm feeling a bit sex starved as I haven't had any since last weekend. I do like teasing my girlfriend by saying if I'm feeling horny I might go and have a one night stand with another woman or even.... a man! (of course I wouldn't, I love her too much and she knows I wouldn't). Hopefully we will get our own place this year.


Jose 17 Feb 2012, 06:53

To me, the glasses look like ones that Buddy Holly wore---black horn rims---50's, 60's look. My son thinks they are "cool".


 16 Feb 2012, 10:02

Carrie,u said don't wear them during sex, gave 2 good reasons. But wouldn't they enhance sex, lots more pleasure? Maybe should continue this on XXX link! LOL


Julian 16 Feb 2012, 08:08

Jose: retro? This is the first time you've mentioned the style. Do tell us more!


Jose 16 Feb 2012, 07:55

My son has been wearing his new glasses for a week now---full-time. Seems to enjoy the "look" of wearing glasses---retro as the glasses are.


Astra 15 Feb 2012, 03:48

I would like to ask,

This is husband reading from an auto-refractor:

OD -0.25 0.00 000

OS -0.25 0.00 000

does this mean presbyopia onset ?


JR 13 Feb 2012, 19:08

Way to go, Carrie. I wish I knew you. BTW, me too.


Carrie 13 Feb 2012, 17:43

Thanks for all the replies to my rambling questions!

I have tried not wearing my glasses but it feels strange. The only times I don't wear my glasses when I am awake are showering/washing and during sex (glasses could get damaged in the bed and they're bloody painful if you lie on them!). I wear them when I go swimming and the gym.

I probably could go without wearing them full time but as I need them for distance and reading that's pretty much most of the time anyway. Nothing is properly in focus without them. I can't really read anything on my phone if I don't have my glasses on unless, like reading anything else, I concentrate on each word. I have difficulty seeing street signs properly without glasses so I couldn't drive without glasses. I want to wear them, I like wearing them and I like to see clearly all the time. Why should I feel uncomfortable when a simple pair of glasses make me comfortable? That's why I wear them all the time.

I think my girlfriend needs her glasses more than me. Something doesn't need to be very far from her without her glasses and it soon gets blurry. As she is short sighted she can read without her glasses.


SC 13 Feb 2012, 07:01

Carrie,

I managed to get to 44 without glasses an I'm now about +1.5 distance so you, if +2 is a final distance rx, would probably have made 40 without ever knowing you were a hyperope and with no problems close up.

You can also recover - my wife said she wore low plus lenses from aged 15. I remember when we first met she would occassionaly wear for TV but never for close up or driving and then she gave up around 23yo. Didn't get glasses again until last year aged 45yo and still doesn't wear for distance (current distance rx is +0.5). Maybe she could recover because it was only occasional use, but she doesn't complain about distance whereas +0.75 was enough to get me hooked!


Revolver 12 Feb 2012, 19:53

LT Lurker: it's aesthenopia, not "tropia". Big difference, tropias are a real, physical, medical condition that often require surgery. Aesthenopia is more mental,as in,"even though I can see fine w/o glasses I find it much more pleasing esthetically to wear them".


LT Lurker 12 Feb 2012, 19:23

Carrie, I think Soundmapts spot on the assessment of your situation.You I believe could hang on without any specs at all as you at your age will have plenty of accommodation to perform any task.

This is not without a price, the asthentropia you experienced from prolongued near work was the cost.

Avoidance of corrective lenses for some people is as critical as for theose who wish to embrace them and as such these persons will battle away for years and years in order not to become a spectacle wearer.

This battling can continue to age 45 or so when that war is finally lost and the available accommodation has diminished too much and it is at this point that the corrective lenses will finally , and often grudgingly be accepted.

This is completely down to Presbyopia which has been literally counting down from about 10 years of age when finally there is not enough accommodation to see what is required.

One's profession and pastimes are important too as people can dodge the specs further if they e.g change jobs or give up reading or sewing.

The more close tasks one has the harder it is so I guess you could say that if you really didn't want to wear glasses you could have functioned without, you could try going without for a day or so, but probably you are inclined towards comfort and that is what the majority of hyperopes are corrected for.

The earlier one presents the earlier the full hyperopic correction and as such reliance comes from comfort.The older one gets the less comfortable vision becomes until enough is enough or the arms are too short.


Soundmanpt 12 Feb 2012, 12:50

Carrie

I well remember your first posts in here when you were prescribed your first glasses. Even though they were very weak and you were told you only needed them for reading you were very excited because you had always wanted to wear glasses but had never needed them before. Your rx was something like +1.00 and being young you could see to read without any problem, but if you were going to be doing a lot of close work the glasses would take the strain off your eyes. But the fact that you always wanted to wear glasses, you decided to wear them full time from the first day you got them. Of course they made reading easy right away and your vision was perfect without glasses for distance. But the weakness of your lenses allowed you to wear them for distance as things were only slightly blurry at first. Soon the blur was gone and you were able to see distance with or without your glasses as your eyes were adjusting to them. After a while you found that distance was better with your glasses and not as good without them. You could still able to see quite well without glasses for most anything but as it got closer to being a year since you got your glasses you were finding that you needed them more and your vision even with your glasses wasn't as good as when you first got them. So the question is if had say decided after 6 months that you didn't want to wear your glasses full time could you have reversed what you had trained your eyes to do? Probably not as your eyes now were very used to seeing through corrective lenses all the time. I'm sure when you went for your exam the eye chart was far from clear for you which is why the doctor suggested you wear your glasses full time now. But you enjoy wearing glasses so I am sure you didn't really mind getting an increase. Unlike your first glasses that you barely needed, now you really need them. Distance without them is much more blurry now and reading near impossible. And you your gf now wears her glasses full time so you must be one happy girl?


Carrie 12 Feb 2012, 06:56

I'm wondering if I had only worn my glasses for reading instead of deciding to wear them full time I would feel so uncomfortable without my glasses on. Would my distance sight be the same as it is now? I know my sight has got worse because I had to get the stronger prescription last year and the optician said I needed my glasses for distances and not just reading. I know my eyes would have changed anyway if I didn't have glasses by now. I also know it's fairly likely I will need a stronger prescription by the time I'm in my mid 20s because of my "latent hyperopia". What I'm trying to say is would I be able to cope better without my glasses if I had only worn them part time? Have I got myself so used to wearing glasses all the time that my eyes and brain feel I need the correction all the time? I love my glasses and have wanted to wear glasses for a long time which is why I wear them all the time. I'm just curious what it would be like now if I hadn't wanted to wear my glasses all the time.


Soundmanpt 11 Feb 2012, 16:36

Jim H.

Also your wife has something that Carrie doesn't have in her glasses and that is astigmatism which helps seeing at all distance an issue.


Soundmanpt 11 Feb 2012, 16:34

Jim H.

Because your wife is already very accustomed to wearing her glasses at work during the day, she will likely be doing at least that much with her new prescription. As her eyes adjust to the new lenses she should be able to see much better with her close work and her distance will be a little blurry for a time but like Carrie found the eyes soon find distance vision becoming more and more clear with her glasses and less clear without them. I think the days of seeing your wife without her glasses on will be less and less.


Jim H 11 Feb 2012, 14:37

LTL : She is 26. She did get a prescription that she left in the car, I just presumed she did not receive one since she ordered lenses at the optometrist.

New Rx: R +2.00 -0.75 x 175 L +1.75 -0.50 x 175

Carrie : I'm sure she will get used to wearing her glasses a lot more often but it will be interesting to see if she will wear them at social and more formal functions, maybe even out skiing. That is the real test! Her eyestrain is almost almost constant now.


LT Lurker 10 Feb 2012, 22:32

Hey JimH

How old is your wife?

Cheers

LTL


Carrie 10 Feb 2012, 15:52

Jim H My glasses are just under +2 and I wear them all the time and I feel I need to now. When I first got my stronger prescription I could have coped with not wearing them all the time but I wanted to. I seem to have fully adjusted to the new prescription now and I can't see anything clearly without them. It's not a total blur just slightly out of focus. I can't read without them unless I really concentrate hard on each word which takes ages and gives me a headache/eye-ache.

I think your wife might find the same thing happens when she gets her new prescription. Hopefully she, like me, will enjoy wearing her glasses that give her crystal clear sight. I'm sure I can see better now than I have done for several years.


Soundmanpt 10 Feb 2012, 13:38

OnLooker

That may work for the computer but she will soon find many other things she wont be able to enlarge and her eyes will not be able to see it. She can fight it, but she fighting a losing battle. She will give in to wearing her glasses more often maybe even full time.


OnLooker 10 Feb 2012, 06:19

Latest on my wife's struggle against hyperopia and presbyopia, instead of wearing glasses she started increasing the size on web pages.


Jose 09 Feb 2012, 23:18

Thanks for the advice. My son just got his glasses today and seems excited about wearing them. Hopefully that enthusiasm lasts.


Soundmanpt 08 Feb 2012, 14:30

Jim H.

If she has been getting eyestrain even when she has been wearing her glasses I would say it is a clear sign her glasses were too weak and she needed her lenses to be stronger. It sounds like her doctor gave her a very good exam and her eyes should soon feel much better with her new lenses in place. It may take her a few days to get her eyes adjusted to seeing distance with them again, but I think once her eyes adjust she will most likely be wearing her glasses full time. What will happen is she won't be able to see near as well anymore without her glasses. You may not want to tell her that.


Jim H 08 Feb 2012, 08:39

My wife had an eye exam a couple days ago as its been over 2 years now. Her current Rx is R 1.25 -0.50 x 110, L 1.00 -0.50 x 110 which she wears all the time at work and sometimes at home. She has eyestrain almost every day even when she would wear them all day, to which she blamed it on the weather or lack of sleep. Her vision is quite good without her glasses so I was setting my expectations low and didn't think there would be a big change.

Well was I surprised when I got a text during her exam that read 'my pupils are dilated and he's doubling my prescription! They are working too hard and hiding the problem'

She has nice frames so she is getting new lenses put in them. The doc told her that it may take a bit to get used to but to wear them all the time and if after 2 weeks she still has eyestrain, to come back and he will make sure it gets adjusted for no charge. She was happy he spent so much time with her and she even had to sit there for a few minutes with trial lenses to adjust to stronger lenses until he found the right one.

Unfortunately she did not bring a prescription home so I am not sure of the new rx but I would guess around + 2. I was nice to see her beautiful blue dilated eyes, and she could not read anything for the rest of the day without her glasses and even struggled with them.

Not sure when the new lenses will be ready and they will be a day to fit them in her glasses. I will update if anyone is interested.

Jim


Jim H 05 Feb 2012, 15:32

Jose,

here is a girl that appears to be nearsighted in her right eye, and farsighted in the left. Hopefully this will help

http://www.youtube.com/watch?v=bvSzgMhXG1Y


Cactus Jack 04 Feb 2012, 14:30

Jose,

Not unusual at all for there to be a difference between the Rx in the two eyes. In your 15 years old's case, there is a 2.50 diopter difference, one eye just happens to be on the myopic side of 0.00 the other is on the hyperopic side.

When I was his age, I had a very similar situation except my left eye was -1.50 and my right eye was 0.00. Expect for the glasses to take getting used to, I think he will be surprised at how well he can see with both eyes working together.

C.


varifocals 04 Feb 2012, 13:36

Jose.

No it can happen.

I knew a lady who worked in a library who was plus in one eye 7 myopic in the other.


Jose 04 Feb 2012, 13:14

My 15 year-old some was complaining that his vision was blurry in his left eye. Had him checked by an eye doctor and it turned out the left eye was nearsighted, but the right eye was farsighted. -1.50 in the left and +1.00 in the right. This seems a little unusual to me.


Revolver 04 Feb 2012, 10:01

There is one other problem with over the counter readers, although unless worn for very long periods of time and/or for distance tasking (latent hyperopia could demand this) the pupillary distance could cause problem by inducing unwanted prism. Most OTC readers are made with a PD of 63, which is on the high side especially when you consider they are made for near point tasking which calls for decentering 3mm. But again, unless worn for long periods of time this situation would probably not present.


Cactus Jack 03 Feb 2012, 11:41

christine,

You have latent hyperopia and the OTC readers have helped your eyes relax which is a good thing. It will save you some fairly short term Rx changes.

Yes, by all means tell the examiner your visual history. It will help you get a very good initial Rx.

You have done nothing wrong. Millions of people with hyperopia and/or presbyopia use OTC readers to initially correct their vision and help them focus on close things. The only problem with that solution is that you don't have the benefit of a professional eye exam to detect astigmatism or other vision problems. Often, if the only problem is mild hyperopia, the examiner will suggest OTC glasses with good quality lenses. Some readers have poorly made lenses and are not really comfortable for full time wear. The only advantage to them is that they are cheap. However, you can get good low cost glasses on line. We will tell you how if you want to try them after you get an Rx.

One other really important benefit of an eye exam is that the eyes are windows into the body and often, serious health problems are first detected during an eye exam. High blood pressure and diabetes are good examples. Both are silent in their early stages, but are nevertheless doing damage. Early detection and management are the keys to successful control and minimizing the damage and having a long and active life.

C.


Soundmanpt 03 Feb 2012, 11:30

christine

Personally I always think that before anyone starts wearing the over the counter readers they should first get their eyes examined to find out what prescription they need. Also there can always be other vision issues that won't come out with just getting over the counter readers such as astigmatism. I guess you were starting to have trouble with reading as the reason you tried them? Now that being said if you go to the doctor a the doctor gives you a reading rx of course you then may want to save money by purchasing your glasses off the rack as compared to spending much more at an optical store.

Now to answer your question. When you go for your eye check yes of course you should tell the doctor what you have been doing. It is always best so the doctor knows as much as possible about your eye health to tell them as much as possible.

Let us know your results and be sure to ask for a copy of your prescription. There are many in here that can then tell you exactly what it means and what you may want to get if over the counter readers will still work for you.


christine 03 Feb 2012, 11:09

I've been wearing some +2 over the counter readers for about a year now. At first, I couldn't use them at the computer as I had to get too close to see it clearly but for the last couple of months, I have been able to see the screen much better with them and in fact, really struggle when I am not wearing them. I suppose it is time to get my eyes tested but I don't know whether I should 'fess up' to having been wearing over the counter glasses. Can anyone give me any advice or suggestions?


Andre 01 Feb 2012, 15:57

The Doc said that the autorefractor showed a big change from what the script in my glasses is currently. Apparently it was so different that she had the girl re-do the test. (After our discussions on here I called and asked some questions)

I just need these headaches to go away - She said that it may be difficult to get used to the new script but eventually it would be for the best. She kept using the phrase "happy medium"

Hopefully I can get some relief - She was concerned that there was an underlying problem for the change but I had a recent physical and all is well.


Cactus Jack 01 Feb 2012, 11:39

Andre,

Yes, pretty much the same. The only thing wrong with the reduction is that we really do not know how much of a reduction it is from your actual current Rx. It appears to be +1.00 from your old Rx, but we can't be sure. At 36, it is likely that your sphere Rx is pretty stable, but there was a little sphere change.

Unless you have a bit of pseudo myopia (same thing as latent hyperopia except in the other direction) it is unlikely that your distance vision will adapt to the reduced minus.

Let me know if I can be of help.

C.


Andre 01 Feb 2012, 10:54

Thanks Cactus

Like I said I think I will try out the new script and see what its like for a week or two. I will probably use them just on the computer/close to start out with and then see where it takes me.

Since the new script is just a reduction of the sphere wouldn't it be the same as having a +1.00 add? or have +1.00 readers but with the astigmatism correction?

The Doc told me I am on the road to bifocals/progressives. Isn't this sort of the same thing? I just will use one pair on the computer and the other for distance.

If my distnce is good with the new script I will transition to it but for now I will just go with using the new one as readers. If that gets too cumbersome then I will go back and get myself a pair of progressives (I would guess a +1.50 or +1.75 add would be appropriate) from Zenni if the doc won't co-operate.


Cactus Jack 31 Jan 2012, 21:08

Andre,

I forgot a few words in the 4th paragraph.

. . . you could probably order Trifocals from Eyeglass . . .

Sorry about that.

C.


Cactus Jack 31 Jan 2012, 21:04

Andre,

Apparently, film and TV production and post production are a tough visual environment. I recall a series of posts a couple of years ago with a TV producer in her mid 20s from the UK. She was having some problems similar to yours, but in her case she was having to shift focus from a wall of monitors to a computer monitor, at normal distance, to the script and she was getting massive headaches.

Her ECP refused to prescribe bifocals, progressives or trifocals, because she was too young to need them. If you will pardon my abbreviation, that is BS. There are such things as Functional Bifocals, Progressives, and Trifocals to help you FUNCTION, even though you technically don't "NEED" them. The ciliary muscles are the hardest working muscles in the body and the strongest for their size, but the job she was asking them to do for hours in a darkened room was above and beyond the call of duty. I can't recall exactly what we suggested, but I think she found a different ECP that would listen to her problems and prescribe functional 35 mm trifocals, because of their very wide field of view for all segments. She only used them when she was actively involved in production. Other wise, she just wore single vision glasses.

I am wondering if something like that might be useful for you. However, I suspect you may not need the distance segment for your work so perhaps a bifocal (because of the field) with the distance segment set for the distance to your monitor or other mid range target and perhaps a +1.00 for the Add.

You could order the Functional Bifocals from Zenni, but if you needed a distance segment, you could get those from Eyeglass Factory Outlet in Florida. They are not as inexpensive as Zenni, but still very reasonable. You could wear what ever glasses you wanted for ordinary activities.

If this sounds interesting, I would suggest going to a Wal-Mart vision center for a reasonably priced exam and just tell the OD that your glasses are about 4 years old and you thought it was time for a new exam. If you like sharp distance vision, mention it. Once you have a current, straight forward, Rx we can take it from there.

Before you get another exam, we need to talk about how to get the most accurate cylinder and axis Rx. With your astigmatism, it is important an you need to know how to do it. Your skill is very important in that part of the exam.

If you wish to contact me privately, it is cactusjack1928@hotmail.com.

C.


Andre 31 Jan 2012, 10:43

Cactus

1 - I live in the US

2 - Distance vision seemed good with my old glasses

3 - I work in the film industry in post production

4 - Yes I wear them full time - I got my first pair when I was 18 and went full time around 25 - I've always had high astigmatism

5 - I have no problem with ordering online - I have actually already ordered a pair in the new prescription from Zenni

I think what I will do is try out the new script with just starting on the computer and near work. Use them as almost reading glasses and hold onto my current pair for distance for a while.

I tried to communicate that I was having near issues and headaches and she said it was due to the distance correction being too high.

She thinks that my last doc corrected my distance but didn't account for the near vision. She said that they like to find a middle ground. She said since I was younger that I was able to handle it but now as I'm getting older my eyes won't relax.

When she showed me the difference for near with he old vs. the new it was outstanding. Normally I can relax my eyes and it gos all blurry with the new script that didn't happen. The distance seemed OK as well but its hard to tell when you sit in the chair.

I'll give it a few weeks as she said and then go back if I am having troubles.


Cactus Jack 31 Jan 2012, 08:03

Andre,

There are many ECPs that have been trained to under correct. They think they are doing you a favor. Remember, they get to "experience" your vision for less than a half-hour at rare intervals. You get to experience them every waking hour in your visual environment. Many ECPs are not into LISTENING closely to what the patient is saying.

Presbyopia can cause problems at any age, it depends on your genetics. It just typically starts becoming a nuisance around 40, but it is a bell curve distribution. A very few children have trouble focusing close, many need close focusing help in their 40s to 50s, and a very few don't need help even into their 60s and 70s. If you plot it, the curve looks like a bell.

I have a couple of suggestions.

1. I think you need to visit another ECP wearing your old glasses and tell them you are having headaches when you use the computer or read for a long period.

2. Order some glasses online with the Rx you want.

Hopefully, you have not ordered glasses yet. May I ask a couple of questions?

1. Where do you live? (country)

2. How was your distance vision with your old glasses?

3. What kind of work do you do?

4. Do you wear your glasses full time? (I suspect you do with that much astigmatism)

5. Are you comfortable ordering glasses on line?

C.


Andre 30 Jan 2012, 20:25

So I posted about a month ago having trouble with near vision. Cactus suggested that I try some OTC readers over my current pair. It helped but wasn't a long term solution.

My prescription was (4 years old)

-1.25 -2.00 82

-.75 -1.25 90

Lately the headaches have been worse and I have been having a lot of trouble with working on the computer and my phone.

So today I went to the doctor and received the following prescription

-.25 -2.00 83

pl -1.25 83

The doctor said that I was still a little young (I'm 36) for an ADD though I would need one for sure in a few years.

She thinks that my eyes have changed over the past 4 years and are "going the other way" as she put it. She was concerned about the big change but then saw that it had been 4 years since my last appointment.

She said that it will take a while to get use to the new script and that if I have too much of a problem she will adjust the prescription so I can ease into it. She said she would give back half of the minus and then slowly work to what she gave me today.

Will this new prescription be as tough to get used to as she says? She said that the first few days were going to be pretty rough. She suggested that I start using the new one for near work and then slowly start wearing them for distance.

She showed me the difference and for close work it was outstanding. She said the distance won't be as crisp but she'd rather do that then sacrifice the near since I was getting so much strain. Why wouldn't she just give me an ADD?

I'm OK with not going there yet but am just wondering about the rational behind it.


Cactus jack 22 Jan 2012, 18:16

Zone1,

A better explanation would be that your eyes RELAXED into them.

C.


Zone1 22 Jan 2012, 17:19

An update: I ended up wearing the glasses to lunch that day. I did take them off but it felt uncomfortable and the distance blur was more that with the glasses on. I kept them off for about 5 minutes and yes my distance vision was back to 'normal' but I felt a strain. So I put them back on and within a few seconds my distance vision was pretty much the same but I felt no strain. So I left them on.

What's more is that since that day (Friday) I have become a full time wearer. I left them on on my way home from work. When I walked into my home, my wife noticed first thing and asked "why are you wearing your reading glasses? Did you forget to take them off?". I explained what I went through and she said welcome to getting older and suggested to leave them on for the weekend - so I did (I was going to anyway). She wears glasses full time since I knew her - but hers are a minus. After two days full time wear I feel so much more comfortable on my eyes that I decided what I felt had to be.

I learnt from this site that I'm not damaging my vision by using reading glasses for everything - it's probably that my eyes are relaxed and I probably need them anyway. I was just wondering why my eyedoc didn't say anything about using them for distance…although he did test the distance. He asked me to read the chart and I could. He put the reading lens and I could not see much. He did say that at some point I will need to wear glasses for distance but since I could read distance without that I shouldn't be concerned at this stage. What he didn't know was that I was wearing the glasses pretty much 70% of the day anyway. Is it possible that my eyes 'grew' into these?


SC 21 Jan 2012, 00:16

Zone1,

Have you checked your prescription - is it written as sph 0.0, astigmatism, add +2.5 or is the sphere +2.5?

I struggle to understand why an optician would not realise that you had hyperopia given your age and symptoms. As we've seen with other posters sometimes they are not told they have been given a distance prescription and just wear for reading


Neil 20 Jan 2012, 14:36

Cactus Jack,

Thanks for your detailed explanation.

Personally I am surprised at this development of "elective" IOL surgery for younger people. I would view surgical lens replacement as a last resort, when there are simpler options available, like eyeglasses and contact lenses.


Cactus Jack 20 Jan 2012, 02:37

Neil,

I was a bit surprised myself at the radio ad. Apparently, IOL implantation surgery, which is really the same as cataract surgery, is now considered no more risky than lakik or regular cataract surgery. If someone is getting to the age where bifocals, trifocals, or progressives are pretty certain, the idea of permanently avoiding them with mulitfocal IOLs has about the same appeal to someone over 40 as lasik does to a 20 to 40 YO who wants to avoid or eliminate glasses. To add some icing to the cake, the idea that by doing that, you can also avoid cataract surgery clinches the deal for some people.

There may be some advantages in not waiting too long if it becomes obvious that cataracts are developing. Apparently, the typical lens clouding form of cataracts cause the crystalline lenses to become somewhat more difficult to remove by emulsification if you wait too long.

There are apparently a lot of people in their 40s to 50s who have a deep seated fear of developing cataracts. They have memories of people from their childhood who had to wear very high plus lenticular glasses (cataract glasses) and don't want that to happen to them. Of course, IOLs have almost eliminated the need for cataract glasses except in very unusual cases.

When I had cataract surgery about 10 years ago, I was offered the newly developed multi-focal IOLs, but I opted for fixed focus IOLs and trifocals. I was used to wearing trifocals and I have not regretted my decision. I now have better than 20/20 vision with my glasses and very good night vision. Not bad for a 74 YO.

I have not kept up with multi-focal IOL development because I don't believe that is an option for me. However, I understand that there have been significant improvements in the optical quality of the lenses. However, I understand that they typically screen patients and if they really like very sharp vision, they usually go for single focus lenses. The ideal thing would be an ultra flexible, gel like IOL that could be squeezed by the ciliary muscles like a young person's natural crystalline lens. Removal of the crystalline lens does not affect the ciliary muscles and they could potentially learn to focus the super flexible IOLs with a little training and conditioning.

C.


Neil 20 Jan 2012, 00:01

Cactus Jack,

I'm asking about the radio ad you mention, encouraging IOLs for those over 40. Getting IOLs at age 65 or 75 is one thing, but aren't there additional risks in getting them at such a young age, when the natural/biological lens is working well?

Thanks


Cactus Jack 19 Jan 2012, 20:34

Zone1,

Your ciliary muscles are relaxing back to their true distance state which is characteristic of Latent Hyperopia and your ciliary (also focusing) muscles are still trying to do their job which is good. Often, dilation is used to relax the ciliary muscles to get a very accurate Rx, but Latent Hyperopia can be so powerful, the dilation will not fully relax the muscles during the early stages of correcting Latent Hyperopia. Sometimes it takes months.

It appears that you are almost there and a dilated exam may actually be useful at this point in determining your true distance Rx. I suspect it will be in the +2 to +3 range at this time, but that does not mean that it is absolutely through relaxing. However, I do think you are pretty close.

C.


Zone1 19 Jan 2012, 18:47

Thanks Cactus…I know that its inevitable that wearing glasses is on the cards for everyone at some stage. I don’t have an issue with wearing them all the time. After seeing the eyedoc a few weeks ago and getting an increased Rx for reading - nothing was said about needing or using for distance and full-time wear. I just went about my normal routine and wore them for reading, close things, and pretty much work. I am just puzzled this morning that everything is clear with them on after two hour wear. I would have assumed that wearing the weaker ones (+2 or even lesser) I would have seen distance clearly earlier.

Everytime I got an increase in reading, distance was slightly worse. It’s only in the last 1.5yrs that I noticed that when I took them off that distance was about equally blurred with and without for about 5 minutes. With these new ones (+2.5) I must admit that I’ve been wearing them more as I was too lazy (and as mentioned before) felt ‘old’ by taking them off/on all the time. So I put up with the blur. However it feels different now that all is clear and a blur when I take them off. The blur lasts about 1-2 minutes, then clears up (I tried) – then takes about the same to get clear again with the glasses on.


Cactus Jack 19 Jan 2012, 18:02

Zone 1,

Welcome to the mysterious world of latent hyperopia. Unlike people with myopia, you have (had) the internal ability to correct for some hyperopia by using your ciliary muscles and crystalline lenses to provide the plus you needed to overcome your hyperopia without your being aware of it. After years of compensating to provide clear distance vision, your ciliary muscles and crystalline lenses just took care of the problem. Then, presbyopia reared its ugly head and you began having problems with near vision. Solution, reading glasses. Now, after years of compensating and then wearing the reading glasses for a large percentage of the day, your ciliary muscles and crystalline lenses have started to relax and it turns out your distance hyperopia Rx is pretty close to your previously useful reading Rx. The neat thing is that with your hyperopia corrected, you still have enough accommodation to be able to read and use the computer without bi or try-focals. However, that will untimely change and it may happen a bit quicker than you had planned.

You should probably wear the glasses full time. What is going on is actually a good thing because it will give you a head start on dealing with the latent hyperopia. With the head start, your vision should stabilize with only a change or two of Rx. Sometimes it can take many months for latent hyperopia to stabilize and require 3 or 4 Rx changes to allow you to function normally and comfortably.

The headaches and focusing problems are your eyes way of telling you that they are not happy and to please put your glasses back on.

What you are experiencing is exactly what many thousands of others have experienced. The best thing is to NOT deny it and hope it will go away. It won't. Just do what you have to to solve the problem and get on with your life. There might be a comment or two, but you can take comfort that the same or very similar situation awaits almost everyone.

C.


Zone1 19 Jan 2012, 17:50

I should probably point out that I don’t have issues wearing glasses. I always left them on in the office because I thought it looked silly having the glasses down the nose like a granny, or constantly taking them off and putting them on – made me feel ‘old’. So I just left them on and no-one knew distance was a blur.


Zone1 19 Jan 2012, 17:40

I’ve been lurking around for about 4 months and found this place interesting. I am 40yo male that started wearing readers about 2-3 years ago. I started with about +1. I was using +2 for about a year now. I only wore them at the office when on the PC and at home when on the PC. About 4 weeks ago I went for an exam and got +2.5. These really helped with the headaches and reading became a lot easier. I loved the new frames so much that I was leaving them on for pretty much most of the working day in the office and removed them during lunch. I put up with the distance blur in office as I don’t need to see far things clearly. The only issue was the clock on the wall. I would look over the top of them to see the time.

After about 2 weeks of wearing the glasses pretty much full time in the office, I would look over to the clock, look over the glasses and notice that I had pretty much of the same blur through the lenses or not. It took about 10-15 secs to focus. I also noticed that when I took the glasses off for lunch and home time, I would get a headache and focusing problems. But I put up with it.

The reason for this message is that this morning I noticed something weird. I went about my normal working routine…put my glasses on and started typing (work)…I looked outside my window and noticed that I could read a sign off in the distance. I thought it was weird as I could never see this before…it was always a blur. I looked over to the clock and it was perfectly clear. I looked over the top of the glasses and it was a complete blur. I took the glasses of and was amazed that everything was a blur. I put the glasses back on and everything was very crisp clear. I can’t believe it. They are meant to be ‘readers’ and the eyedoc never said anything about distance vision.

I will obviously leave them on for work as it’s too difficult without for close work. But lunch is in about 2.5hrs and I’m wondering if I should leave them on.


Cactus Jack 19 Jan 2012, 12:08

Eye Tri,

Typical cataract development is caused by a molecular change in the gelatin like (protein) substance that makes up the crystalline lens. One of the effects of the change is that the lens swells slightly which, increases its relaxed plus power. The result is an increase in nearsightedness or a decrease in farsightedness.

Years ago, cataract surgery was not done until the cataracts were "ripe". The reason was simple, in those days cataract surgery was a very serious operation involving the complete removal of the crystalline lens capsule which required months for recovery and VERY high plus glasses to restore reasonable vision. Today, cataract surgery is typically an outpatient procedure. The surgery itself requires about 15 minutes per eye and recovery (for me) was overnight. Both eyes are not usually done at the same time in case problems develop. It is surgery after all.

There is one school of thought that if cataracts are developing, there is no surgical reason to wait because waiting too long, until the crystalline lens becomes harder, makes the surgery more difficult. The procedure today uses a tiny ultrasonic "jackhammer" to emulsify (nearly liquify) the crystalline lens so it can be sucked out through a 3 mm incision and the lens capsule is left pretty much intact. Then a new rolled up lens is inserted through the incision and your body heat causes it to unroll to its normal shape and size (about 6 mm). The surgeon positions it inside the crystalline lens capsule and the surgery is pretty much complete. In most instances the 3 mm incision closes and heals without a stitch, which might cause distorted vision.

With the development of optically satisfactory multi-focal intra ocular lenses (IOLs), some people, who are developing presbyopia and want to avoid bifocals or trifocals and the need for future cataract surgery, are opting for the surgery long before cataracts fully develop. In fact, one ophthalmologist here is even running radio ads recommending lasik for people under 40 who need vision correction or multi-focal IOLs for those over 40. One of the side benefits offered by the IOLs is that "you can avoid future cataract surgery". Right, you just had it.

C.


Revolver 19 Jan 2012, 09:49

Eye Tri:

Absolutely correct advice. I peaked out at +1.50 OU for distance with a +2.50 add, and then watched the slow change come as the cataracts developed. Just prior to the surgery was plano in the best eye and couldn't get much relief from any correction in the other, turns out it had developed a full diopter or more of astigmatism. Was wearing a variety of readers for near point and mid (computer) range prior to surgery, post surgery am nearly plano in both eyes and can function quite well with +1.75 readers.


EyeTri 19 Jan 2012, 05:16

My question is actually about hyperopia/presbyopia regression. At the moment I am 69 years old. Up until 3 years ago my prescription was pretty stable at +2.25 OD and +3.00 OS. The glasses I am wearing are +1.25 OD and + 1.75 OS. I have cataracts (not bad enough for surgery). My optometrist says the reduction in my prescription is an effect caused by the cataracts. I think her exact words were: "As cataracts develop they make nearsighted people more nearsighted and farsighted people less farsighted".

Has anyone else experienced this? What is the mechanism that would cause this?


Cactus Jack 17 Jan 2012, 07:34

OnLooker,

I suspect TIME is reason for the curious abilities. By that, I mean that it does not take much time to thread a needle. She can probably concentrate and force enough accommodation to thread a needle, but it is much more difficult to accommodate for much longer periods. In addition while the brain is not very good at multi-tasking things that require higher brain functions. It is hard to maintain the "single focus" concentration needed for needle threading while reading and absorbing the content. Up to a point, the solution is to read from increased distance where you can focus with little effort.

It sounds like between arm length and small text, you won't have to wait much longer for, if not full time wear, much more frequent wear. TIME in this case is on your side.

C.


OnLooker 17 Jan 2012, 04:05

I forgot to say that she's 38.


OnLooker 17 Jan 2012, 04:04

My wife, officially +1 and some astygmatism for 3 years now, never wears her glasses. Observing her, she's now pushing further stuff for reading it, i gather even a little more than 1 m away from her eyes! But she doesn't seem to have problems elsewhere like threading a needle. It's wierd how her accommodation power seems to be on and off depending on whether she's reading or doing something else! Can anyone explain this?


Cactus Jack 11 Jan 2012, 23:59

KellyAnn,

This hard for some people to understand, but vision actually occurs in the brain. The eyes are merely biological cameras. The brain has amazing power to create a "clear" image from a blurry one, if it knows what something is supposed to look like.

What is going on with your husband is that the new glasses are providing very clear images to his brain and his brain is having to reprogram itself to deal with the better visual information it is getting. The clue that it is making rapid progress is when he takes the glasses off, it is taking longer and longer for his brain to go back to work because it now knows that the glasses significantly reduce its workload. In effect the glasses are a "labor-saving" and "energy-saving" device for the brain.

In a few days, everything will likely sort itself out, the headaches will go away, and as SoundmanPT said, he will wonder why he didn't get them sooner. The whole idea is effortless, comfortable vision.

C.


Soundmanpt 11 Jan 2012, 23:39

KellyAnn

You are quite welcome. He will be fine in a few days.


KellyAnn 11 Jan 2012, 23:32

Right - too funny! I just don't remember and yes, mine are always blurry without my glasses on...period. He was just wondering because it only stays "more" blurry for a little while after he takes his glasses off and then his vision goes back to the norm which in his eyes was not that bad. I told him once his eyes adjust to the glasses there is no going back - just a fact! Again, thanks!


Soundmanpt 11 Jan 2012, 23:27

KellyAnn

Again very normal. The more he wears them and his eyes become totally adjusted to them it will stay blurry without for longer and longer all the time till it just stays blurry all the time. And of course he probably isn't happy that things are blurry without them, but he need to remember it is much more important that everything is nice and clear with them. You said you have worn glasses for a good while so I imagine now when you take off your glasses everything is blurry and pretty much stays that way correct? But it is nice to put them back on and once again make everything very clear.


KellyAnn 11 Jan 2012, 23:19

Thanks for the quick response. I will let him know the headaches should subside. Another question. He is saying that when he takes them off for a little while everything is really blury but then returns to where it was. Once he really adjusts to wearing glasses will his normal vision without the glasses be more blurry which will force him to put them back on! Hope this is not confusing. I just don't remember since I've worn glasses for so long.


Soundmanpt 11 Jan 2012, 23:12

KellyAnne

That is very normal for the first few days and should slowly start to go away with each passing day. It is caused by his eyes learning to change positions to be able to see at different distances. But he should not give in to the desire to want to take them off. It sounds like the prescriptions are all good as he can see fine at all distances with them. Like you know it would have been much easier if he had gone the same route as you did, by first wearing single vision first and then graduated into progressives the way you did. He will very soon wonder how he got by without them before this long.


KellyAnn 11 Jan 2012, 22:50

Question, my husband finally picked up his new progressive glasses yesterday and has been wearing them - yeah! He has never worn glasses or contacts before. He is getting headaches but can see great at all distances. Are the headaches normal in adjusting to wearing glasses since he's never worn glasses before? I don't remember ever getting headaches but always wore single vision glasses/contacts before getting progressives. His prescription is listed in an earlier post.


KellyAnn 08 Jan 2012, 19:48

Soundmanpt

Never any headaches which is strange in and of itself and yes, the Dr. said that he had had unknowingly been using his left eye for distance. He objected to getting progressive lenses until she told him that once she corrected his distance and astigmatism he would not be able to read anything. So, progressives it is!


Soundmanpt 08 Jan 2012, 12:02

Clare

Like most things vision related it can be a little subjective, but there seems to be less tolerance as to when cyl. (astigmatism) becomes enough to cause headaches and the need to wear correction full time. Most doctors will almost always recommend full time wear at -.75 or more. Astigmatism effects vision at all distances. people can even react differently when they are first prescribed a cyl correction. Some don't seem to notice it at all and others find it makes them dizzy and feel as if the world is spinning for several hours until they adjust to the correction and then they are fine.


Philip 08 Jan 2012, 06:06

Hi Clare. How are you? Have you had a test recently? Any signs of presbyopia?


Clare 07 Jan 2012, 14:17

Soundmanpt - I agree that -0.75 of astigmatism can cause fatigue if uncorrected. I wonder if it is subjective though?


Soundmanpt 06 Jan 2012, 19:11

KellyAnn

Like Cactus Jack said I think he will quickly find that they will help much more than he thinks they will. I am curious if he ever complained of headaches? His astigmatism is enough to often cause headache pain by the middle of the day. The reason he didn't notice he was having any problem with distance is really for 2 reasons, One is that you get used to seeing that way and also the fact that his distance vision was okay in his left eye meant that he was without knowing it using his left to see distance.

By the way it is much easier to adjust to new glasses if you make a point of putting them on first thing in the morning rather than maybe not putting them on until hours later.


KellyAnn 06 Jan 2012, 14:43

Jose

Yes, he could read fairly well. This was his first exam, glasses are ordered. I was just wondering if with this prescription he will notice a difference. He has never had an exam or glasses before. He was not aware that was nearsighted in his right eye and also had astigmatism.


John S 06 Jan 2012, 10:39

Dan,

I would guess that she added plus until you said you could just see it. Probably being conservative. You can judge of how much add you need.

The pros and cons of add strength:

More add - Less working distance and closer focal point. Causes the accommodation muscles to relax more, no headaches.

Less add - More working distance and farther focal point. Accommodation muscles still need to work for reading, possibility of headaches.

What I mean by working distance is, if you use an add that gives you a center point of 22 inches, you will probably have usable vision from 16 to 28 inches. If you increase the add so that it is set at 16 inches, the range would decrease, maybe to 13-19 inches. No matter what power you choose, there will be a compromise. Many people have glasses with two different add strengths for that purpose.

Using a progressive you can get somewhat get around the being so precise. Since the lens is a variable power, you can use the spot you like, to a point. If the add is too extreme for your use, it will be too hard to find the correct spot to look through.

For you the easiest thing to do is, using your latest rx, put your +1.50 lenses on top. Determine if they give you the close vision that works for you. Where you normally read, is the add centered for that distance? Try a stronger pair, you will see the effect of less range. It is a compromise of good range and relaxing the muscles.

You want to end up with a add that is correct for *most* of your near activities. You can never get an add that does all.

If you are ordering from Zenni, you can get a pair for $50. Make sure you get your PD correct, that is very important. You know the glasses are going to work. Use them for a while, you'll know if you want to change the add a little. In a progressive, the larger the lens size, the better. The larger lens gives you more reading area. I would recommend a minimum vertical lens height of 32mm.


Jose 06 Jan 2012, 06:49

Kelly Ann---had your husband been able to read any small print prior to getting his glasses?


Dan 06 Jan 2012, 04:21

John S,

Thanks for the suggestion of going more than the +1 my eye doctor put as my optional add. I wonder why she didn't go higher if they usually go more for a bifocal?

Jamie,

I have been wearing my bifocals more often but definitely not full time. I may try progressives but I do not have major issues seeing close up. It's more of a comfort thing if I'm on the computer for a really long time. I'll most likely get around to it eventually, either now or in a year or two when my eyes get worse haha.


Cactus Jack 06 Jan 2012, 00:24

KellyAnn,

Because of the difference in the sphere correction and the astigmatism, he should wear the glasses all the time. He might be initially reluctant, but I suspect within a few days, he will find the additional comfort and reduced fatigue to be a compelling argument for full time wear. I suggest that you do not push him or ask too many questions. It will be best if he reaches the place where he prefers his glasses on his own.

A little complement can't hurt, but don't overdo that either. It might sound contrived. Remember, men are from Mars and he may need to spend a little time in his cave, but he will be back.

The +1.75 add will make him think that the glasses have caused his close vision without glasses to get worse and in a way he will be right, but only because his ciliary muscles are not having to work quite as hard to focus close and they will like the additional help that the add provides and may complain some if he tries to read without his glasses. This effect is quite normal.

He has been able to put off getting glasses for a bit longer than is typical so he has some catching up to do. It will happen much faster than he expects. Again, normal.

C.


KellyAnn 05 Jan 2012, 23:27

Well, finally got my husband to have his first eye exam. He is 47. His prescription is:

OD -0.75 -0.75 095 Add 1.75

OS - 0.00 - 0.75 085 Add 1.75

Appears he's been using one eye for distance and one for reading and didn't realize it. Should he wear these glasses all of the time. The Dr. gave him a progressive prescription. Will there be a big difference in how he is seeing?


Carrie 05 Jan 2012, 19:25

LTLurker

Varifocals said if my vision gets worse my girlfriend will be blurry close up. At the moment she would have to be fairly close to me before she was too blurry to see properly without glasses. As I wear my glasses all the time she is always in focus when I look at her. My glasses are a little stronger than your wife's glasses but I am younger than her so it is probably easier for me to force my eyes to focus. But I often close my eyes when I'm kissing my girlfriend (I did this with past boyfriends as well) so it doesn't make any difference if I'm wearing my glasses or not. If things get, let's say more passionate, then our glasses come off!


LTLurker 04 Jan 2012, 17:31

Hey Carrie,

Hope you are well! I was just interested in what you said about not seeing your girlfriend clearly close up...how close are you talking about?

My wife always has to back off a bit in order to see - she is +1.25 although just now she is in a deep denial phase

LTL


Jamie32 31 Dec 2011, 12:30

Dan: Knew you had a pair of bis, was curious if with your new exam and optional add, if you were going to use this maybe to go full time with the bifocals/progressives


Cactus Jack 30 Dec 2011, 15:38

Andre.

I think your wife needs a different Dr.

With the following Rx

-1.25 -1.75 100

-1.25 -1.00 72

She might be able to read large text without her glasses because of the -1.25 nearsightedness, but the rather significant astigmatism would make small print hard to read at all distances and reading or fine work would not comfortable.

If her Rx is sharp and comfortable for distance, some readers over her glasses might be worth considering. If her distance Rx is not really right, that needs to be addressed first, again by a different examiner.

C.


Carrie 30 Dec 2011, 12:55

Varifocals we had a great Christmas, thanks. Hope you did too. My girlfriend confessed she fancied me at school but never did anything as I was always with a boyfriend and showed no sign of being interested in the same sex and she had a girlfriend. I wasn't interested in girls/women then or if I was I unconsciously denied it to myself.

If I can't see my girlfriend close up I'll just keep my glasses on! I'm not bothered if my eyes get a bit worse. My girlfriend isn't very short sighted but bad enough to need her glasses full time (about -2.50 she thinks).


Andre 27 Dec 2011, 13:51

So as Cactus Jack recommended I've been experimenting with wearing a pair of OTC readers over my glasses and I find that my eyes relax and then afterward seem to want the extra help. I'm sure if I wore them everyday while I was reading or on the computer I'd be hooked and couldn't function without them. I haven't had an exam in about 4 years so I'm probably due.

I wanted to ask about my wife. She's 40 and had an exam in the summer. She was positive as was I that she would need an add. About 6 years ago when we got married she got contacts and that was the first sign that she was having trouble with her near vision. She found she couldn't read with her contacts and then after the wedding never touched them again.

After our son was born she noticed she couldn't see his face clearly up close with her glasses on. Shortly after that she had to remove her glasses to read and over the past year she was constantly trying to find the right distance to read her phone.

Her prescription over the past two years has been (the sphere has been decreasing over the past 8 years)

-1.25 -2.00 97

-1.25 -1.50 68

She tried OTC's and found they didn't help

She made an appointment and got the following

-1.25 -1.75 100

-1.25 -1.00 72

When she said that she was having trouble reading up close the doctor said that she didn't need an add and probably never will. She said the new script would help since her other glasses were a bit to strong.

I am just surprised since she is showing all the signs and is clearly having trouble up close even with the new prescription.

Will she probably never need an add? Or is this a Dr who doesn't like to prescribe them?


John S 26 Dec 2011, 10:42

Dan,

If you were already wearing 1.50 OTCs, and were happy with the range, I don't think you would want to go less add than that for a progressive. Some doctors add a little for a progressive anyway.

Once I got correctly fitted progressives they were glued to my face when I was doing close work. Now as I got older they are on when I am awake to bed. I wish they had progressives when I was going to school.

The swimming effect is caused by unwanted astigmatism. You see it most when looking to either side of the intermediate zone (middle of the lens). There is a ton of cylinder correction that is a blur. That is just something that happens in a progressive lens. I heard many people say just point your nose toward what you want to see.

I forgot to mention in one of my last posts about a distortion that can occur. The lower part of the progressive lens should be tilted slightly in toward your face. The lens would be further out near your eyebrows. This gets rid of distortion in the reading area, and also widens the reading area. It seems like the tilt has more of an positive effect on the more inexpensive lenses. I do not know this for a fact, on my lenses it seems like when tilting the lenses, it seems like the add power drops slightly. I don't have a reference to measure that effect. It could be stronger than the lens spec when the lens is straight, or when tilted it may drop below the spec'd add.

The technical name is Pantoscopic Tilt. I did not notice the add power change noted in this article. But I can notice it. Be aware of that when you order a frame, that you easily tilt it. If it is a very rigid frame I don't think you will be able to bend it.

http://www.opticampus.com/files/progressive_lens_dispensing.pdf

Pay attention to figure 12 in the article. The rest of it is good reading also.


Dan 26 Dec 2011, 00:11

Jamie32/John S,

I already have a pair of lined bifocals that I wear on occasion that I bought from Zenni a year or so ago.

I think I may try progressives this time as I'd like to use them instead of lined bifocals if I can get used to the "swimming effect" some describe.

My prescription that I just got was.

OD -1.00 -0.25 x 75

OS -1.25 -0.25 x 95

Add +1.00 (optional)


Jamie32 25 Dec 2011, 13:15

So Dan, here's a question for you. If the doc gave you an optional add, did you end up getting a pair of bifocals or are you just going to continue what you've been doing for now


John S 24 Dec 2011, 08:07

Dan,

Sounds like the same old story... You told both doctors that you had to remove your glasses or wear reading glasses on top on your contacts? I thought the mindset might have changed by now.

What rx did the doctor prescribe that gave you an add?

Ben was lucky, he found a good doctor on the first try. She gave him no static at all.

Something is wrong with the big picture. You explain the problem, the doctor wants you to live with the problem instead of helping you with it. Like it will hurt them to give you an add. You should just go into the exam wearing a set of bifocals from Zenni with the add that you want, and get a checkup. The glasses seem fine, it has been a few years since I had an exam.


Varifocals 24 Dec 2011, 06:19

Thats fine Carrie & I hope you both have a nice christmas together.

The opposite vision problems will make things interesting especially if your vision gets worse as she will be blurry close up.

My wife is myopic & I am a plus like you so I can follow things.

I wear full time & although not strong my eyes feel wierd & strained without glasses.

The story of howyou became re united is lovely.

Is she very myopic & a full time wearer now.

care


Carrie 24 Dec 2011, 05:34

I didn't really have to force my eyes to adjust to seeing distances with glasses I just discovered that if I put them on as soon as I woke up I could see distances just as good as without them. Now I need to put them on first thing to make everything sharp - I can see things but nothing is properly in focus until I put my glasses on. I told my girlfriend that I really need my glasses all the time now. She was sympathetic but reminded me that it's the same for her (but she can read without her glasses as she is short sighted not long sighted like me).

Last night was exactly 1 year since I met the girl who is now the love of my life. If I hadn't recognised her from school and gone over to say hello we might not have ever met as she didn't recognise me as she couldn't see me clearly enough without her glasses! In a few weeks time it is our 1st anniversary of being together (sorry to ramble but I am very happy and proud to be in a same sex relationship!)


Dan 24 Dec 2011, 01:25

Oops...last post was from me to john s


John S 24 Dec 2011, 01:25

I know what you mean about doctors not wanting to prescribe bifocals. I actually just had an eye exam the other day where the doctor gave me an optional add. It was the first time someone has actually prescribed it. i had gone to another doctor a bit ago who said i could try reading glasses over my contacts. but she decided to reduce my distance prescription slightly instead so i could see close up better with less strain.


John S 24 Dec 2011, 00:37

Carrie,

The doctor does not know if you are straining to see close up. If you can read the near chart, that is all he has to go by. The signs of near vision problems are - Headache, trouble focusing or a delay in focusing when looking far to near, or vice-verse. A dullness in the text, you have probably noticed that before you got your glasses. Some of the symptoms may not occur until doing close work for an extended time. The doctor has many tools to determine your distance vision. For near, he only has your input.

Even when the symptoms are brought to the doctor's attention, he may choose to listen or ignore. As CJ has said, it seems the close vision problems in young people seem to get ignored even more in the U.K. than the U.S.

More than not, a person with hyperopia will need near additional near correction sooner that a myopic person. Of course, many myopes can just remove their glasses to read more comfortably. With the advent of computers and cell phones, the demand on the accommodation muscles used for reading is so much, they just can't deal with it. You can see the difference an add makes. Look at a book, put your old glasses on top of your new ones. That will simulate a weak reading add. The distance will look terrible, the close should look great.

This is from an older post I had made (saves me from typing it all again)

I noticed when I was 13, I kind of had to force my eyes to see close up. I also noticed a difference slightly in my distance when doing that. I tried my Dad's glasses, they were +1.00 Add +1.50. I could see great in the distance and reading. So I knew glasses would help me. What I did not know was, how hard it would be to get the right ones. I thought you went to the eye doctor to get glasses so you could see. When other kids went, they got glasses when they did not want them.

I put up with it till I was 17, and got an exam. The doctor prescribed a +1.00 for distance - yes that was it. Never having an exam before, that was not what I expected or needed. I told him that it did not fix my problem. He said, that is as good as it will be. I told him I tried my Dad's glasses, I could see fine. I did not have them with me (he only had one pair, I could not sneak them out of the house). His response was, don't wear them. I was getting nowhere fast. I gave up and went home. Thinking back now, I would have loved to have walked in with them on!

I booked an appointment with different doctor. Now that I had learned more about how a eye exam worked, I was prepared this time. Told him I not did have glasses, and it was very hard for me to read. He checked my distance, and set it at +1.00. Then he checked the near. He added an additional +1.50. He said, you need bifocals (like I did not know).

The rx definitely helped me a lot. When I went back for a check up, I asked for an increase because I worked in electronics. He agreed to increase the add to a +2.00. I think that was good for reading at 16".


Soundmanpt 23 Dec 2011, 15:37

Carrie

Your more than welcome for any help I might have been. The only reason I suggested maybe getting bifocals was because when you got your first glasses you were told you only needed them for reading and it because you always wanted to wear glasses you chose to wear them full time. And from what you were saying you did have to force your eyes to adjust to them for distance and you had to wear them a good while before the blur was completely gone. That is why I asked you after you had gone for your recent exam how well you were able to see the eye chart without your glasses? I would think if you were able to see it quite well then you really only needed an increase for your close vision meaning that a mild pair of bifocals could be a good option if you didn't want your distance vision to be worse. It was merely something if you were interested in to ask the doctor about. But it sounds like you don't really have a problem with it except your a little surprised at now really needing your glasses all the time where before you could have easily gone around without them if you wanted. But as you say you like wearing your glasses so i'm sure it's no big deal anyway.


Carrie 23 Dec 2011, 13:44

Soundmanpt + varifocals thanks for your replies. It has made me feel much better. I tried going without glasses again today and it was the same as yesterday so it looks like it wasn't a temporary thing. It's strange to think that a few weeks ago I probably didn't need my glasses all the time, I just felt I did as I had got used to wearing them all the time. Now with a slightly stronger prescription it seems my eyes have fully relaxed and have no intention of going back to how they were and now I really do need my glasses all the time! I don't know if my eyes are getting worse or if they've been like this for quite a while and I've managed to force my eyes to focus without realising it. I know my optician said I had some latent hyperopia and probably had a growth spurt which might have been the reason I needed a stronger prescription. I don't suppose it's possible to detect if I have any more latent hyperopia but as I'm not in my 20s yet is there still a chance my prescription will change again? I have read that your body doesn't stop growing until your mid 20s.

I like wearing glasses but I don't think I need bifocals as my optician did't say anything about them. They know I wear glasses all the time and did say that with my new prescription I should wear them for distances and reading anyway. I can see perfectly with my glasses, far distance all the way to really close.


Soundmanpt 23 Dec 2011, 09:45

KellyAnn

Not very likely he his nearsighted at 47 and from what you describe he could benefit from a weak pair of readers. But if it has been a long time since he had an eye exam it would be best to get one just to be sure. You could maybe have if test out some over the counter readers at your store and look for some that are only +1.00's. Depending on the store some only go as low as +1.25's. Be careful as he may be reluctant and even deny needing any vision help. but the fact that you wear glasses may help.


KellyAnn 23 Dec 2011, 06:36

Just wondering. I have had progressives since I was 39. My husband has never had an eye exam and does not wear glasses but is approaching 47. Sometimes he has a problem reading something really small but not often. Do you think he could possibly be a little nearsighted which is why he can still read fairly comfortable. Not sure what age you would normally need reading glasses.


Soundmanpt 22 Dec 2011, 17:47

Carrie

Yes, what is happening is very normal. That is why I have asked you several times about updates in regards to your vision. When you were first prescribed glasses slightly more than a year ago, you only needed them for reading. And even for reading with the weak rx that you had you really would have only found them of much use if you were doing a lot of reading at a time, as you could certainly been able to see most any size print for a short time without glasses. But you had wanted glasses for sometime and was very pleased with getting them and decided to wear them full time more for your enjoyment than for need. As long as it was your intent to wear them all the time you did nothing wrong, but when you got your glasses your distance vision was perfect and didn't need any correction. Wearing your glasses full time meant that your eyes were going to have to change to allow your eyes to see distance with them. This is why for a while your glasses were an asset for reading and other close needs, but your distance was less than clear and even slightly blurry with them. Then as your eyes were adjusting you soon were able to see distance without any problem both with and without your glasses. After a few months you started to find that distance was now a bit better with glasses and not as clear without them anymore. Now as it was getting around a year since you had gotten glasses your eyes were changing and you went for an exam and found that your eyes had changed to twice what your first glasses were. So it is not surprising that you are now finding that it is much more difficult to read without them and of course your distance is also more difficult as well. You didn't notice your distance as much with your first glasses because they were weak enough not to make much difference. You have an option if you don't want to need your glasses so much for distance, you could order a pair of bifocals or progressives with a only maybe a +1.25 for your distance with an add for reading.

In case your wondering if you had only wore your glasses as needed your eyes would still have changed anyway so you did nothing really wrong.


varifocals 22 Dec 2011, 08:43

Yes Carrie in my experience it is normal.

I have travelled the same road & I am much happier wearing my glasses all the time.

I have relaxed eyes, no headaches which was the start of my glasses journey.

I have varifocals whivch I have found are better than bi focals & also have a pair of perscription readers.

I had my check last week & only a slight increase which is good & my cataract progressiobn is slow.


Carrie 22 Dec 2011, 07:29

I tried going without my glasses when I got up this morning but I was struggling. Normally I could get around without glasses and my eyes would just feel just slightly uncomfortable and if I tried reading without them it would be more uncomfortable and I would have to concentrate trying to keep focussed. This morning, without glasses, just walking around was like trying to read without glasses and actually reading was very difficult. I had to wait until my eyes focussed on each word as they de-focussed slightly every time I moved to the next word. I could feel an eye-strain headache coming on so I put my glasses on. Everything was clear again! It was a bit of a shock to suddenly find that I seem to have become dependant on my glasses in quite a short time. It was the first time I had gone without glasses for more than an hour for a long time as I normally put them on pretty soon after waking up and don't take much notice of what everything looks like without them on.

Is this normal? I know my prescription isn't very strong but I really can't see very well at all without them today.


Cactus Jack 13 Dec 2011, 15:45

Andre,

Your ciliary muscles, for their size, are the strongest, most exercised muscles in the body. Unfortunately, like any muscle, they will begin to gradually loose their strength if they are not exercised. Presbyopia complicates the problem because as your crystalline lenses become stiffer with age, your ciliary muscles need to be strong to squeeze them so you can focus close. Then, once you have made your crystalline lenses focus for reading, they are very slooow to relax for distance.

If you did not have significant astigmatism, you could take off your glasses for reading, but that has the same optical effect as wearing low powered readers over your glasses by reducing the amount of plus your crystalline lenses need to supply for reading. Unfortunately, it is a battle you cannot win in the long run.

My suggestion is to go ahead and get bifocals or progressives with a reasonably low add and start getting used to them while the amount of add you need is small. I think many people make a mistake by trying to wait until they REALLY need +2.50 or more to function and then have a rough time getting used to them.

C.


Carrie 13 Dec 2011, 15:41

Soundmanpt

I'm pretty much used to the new prescription now. Close up is better than with my old glasses and distance is a bit better. Without them feels weird. Reading without them soon makes my eyes ache. Distances without them is ok but better with glasses on and my eyes feel more relaxed with them on. Yes I am wearing the plastic framed ones most of the time. The rimless ones will be for smart occasions or if I fancy a different look.


Andre 13 Dec 2011, 13:46

So what you are saying is that if I start using an add (reader over top of my glasses) of any kind my near vision will decrease at a faster rate until it plateaus?

Its not bad at this point more of an annoyance than anything. Would holding off and just removing my glasses when I need to read something up close delay my need for bifocals/progressives for a while? Or should I just bite the bullet since its going to happen in matter of time anyways?


Cactus Jack 13 Dec 2011, 09:04

Andre,

Welcome to the "joys" of presbyopia. What you are experiencing are the early symptoms. Temporarily, you can benefit by wearing low + OTC reading glasses over your regular glasses, but soon you will need bifocals in some form to help you deal with the presbyopia.

The amount of add you will need will depend on your preferred reading distance and Newton's optical formulas. For example, if you like to read at 16 inches or 40 cm, you will need +2.50. If you like to read at 13 inches or 33 cm, you will need +3.00. The only question is how much of that amount you can supply internally using your ciliary muscles and crystalline lenses and how much needs to be supplied by an external lens in your glasses, but the total will always be governed by your reading distance.

Just remember that the amount of add you need will change pretty rapidly once you start wearing an add from any source because two things are at work. One, your presbyopia is slowly increasing as your crystalline lenses become stiffer. Two, your ciliary muscles are rapidly becoming de-conditioned as the add does more and more of their work for them. However, the add will never exceed the amount dictated by Newton's laws of optics.

C.


Andre 13 Dec 2011, 08:39

I'm 36 and have a current prescription of

-1.25 -2.00 82

-.75 -1.25 90

Over the past year or two I've been noticing that I have been having trouble with my near vision. Things would be blurry for a second and then I would have to re focus. If I read for a long time I get a headache and then it takes a few minutes to focus in the distance after I look up. It is really noticeable in low light - Its gotten to the point that if I want to read anything super small like a prescription on ingredients on a label I need to remove my glasses and then I can read it perfectly. I'm even noticing when I read books its more comfortable to do with without glasses. If I relax my eyes with my glasses on then everything dissolves into a blur. The second I take them off things go back into focus.

The other day I did an experiment - My mother in law wears + glasses and left a pair in my car. I put them on and they were way too strong (I think her prescription is +2.50) - I then put them over my regular glasses and I could read perfectly.

Does this mean I need progressives? My wife (shes a few years older) has a very similar prescription to mine and has had some near problems but was told by her optometrist that she didn't need an add and may never need one. That she should just remove her glasses when she needs to see up close.

I know due to my astigmatism that OTC readers are not an option.


DWV 12 Dec 2011, 20:20

You can get bifocals with an add of 0.5, although I'm not sure why. Perhaps the doctor in question also sells glasses, and progressives or bifocal lenses are more profitable.

I've ordered glasses with an add of 0.5, but for watching TV.

As for stairs, I figure it's better to get used to strong multifocals when you're younger and more adaptable (and less prone to broken bones).


Soundmanpt 12 Dec 2011, 14:16

Carrie

It's been a couple of weeks since you got your new glasses with a pretty decent increase in your rx. How are you doing with getting used to them? I'm sure they are likely much better for close vision, but how is the distance now both with them and without them? Are you still wearing the full frame plastic ones more than the rimless ones?


Soundmanpt 12 Dec 2011, 08:58

Rachel T.

May I ask why your increasing the strength of your glasses so soon? In looking back I see you were only first prescribed glasses Oct, 27th and you picked up your first glasses on Nov 2nd. You seemed very concerned and worried that wearing glasses would cause you to need stronger glasses which you didn't seem to happy about. Now in only a month your wanting to make your glasses stronger? If your real rx seems to be too weak and you feel you need them to be stronger most places will remake your glasses with the necessary change in power if it is prescribed by your doctor at no additional charge to you within the first 60 days or so.


Aubrac 11 Dec 2011, 04:01

RachelT

I've a few friends who wear varifocals and they all had the 'swimmy' effect at first. I think it results from the brain usually choosing which image it likes best i.e. with bifocals or monovision, a near or distant image that is clearest, but with varifocals there are gradations of lens strength and so at first it switches back and forth finding the clearest image hence the swimmy effect.

By persevering with FT wear all my friends soon adapted to varifocals and never have any problem now.


John S 11 Dec 2011, 02:03

RachelT,

I am not sure why someone would prescribe a +.50 add. It is basically non-existent. The only reason I can think is, the doctor thought it would make reading a little easier. The keyword is "little". I think a +1.00 add is the lowest that would have any real effect. I can think of a few people on the board in their low 20s, that have adds. Dan has uses a +1.25 add, Ben has a +2.00 add. Both are slightly nearsighted, but the reading add really helps them.

I would not give up on the distance being more than you can handle. Since you are a latent hyperope, your rx should increase somewhat. You will probably get used to the extra distance rx in time, maybe a few months. That small increase should not be that difficult to put up with until then. But, if you don't wear the newer glasses all the time, the process is going to take longer.

I got glasses when I was 17, my rx was +1.00, add +1.50 - both eyes. Pretty similar to yours. I asked for a +2.00 add when I went for a follow up exam. It made a noticeable difference to me.

A lot of doctors are very stingy on prescribing adds. That is something I have never understood. When you are a young hyperope, the process should be give more plus than needed, ask the patient to try very hard to read the distance chart for a few minutes to try to get the muscles to relax. About half of them use that procedure. Then for reading, 99% of them bring the plus up and ask when you can read the near chart. The same procedure should apply. Add too much plus, let the muscles relax, then back down the plus power until you can read the near chart. That method should help relax the muscles used for accommodation.

I think you have 2 choices. Go to a different doctor with your 1st pair, and say the add just doesn't seem to help much anymore. Tell him you do sewing, when your eyes are tired, you can't see to thread a needle. Say it has been a few years and you think you need a boost for reading. Or, pick up a pair of OTC readers at the drug store, see how high you can go. Try starting at +2.00, then go up. You will probably end up around +2.50. Then you will know what your reading rx is, and decide what you want to with your distance rx. In my case, the increased add would relax my muscles much faster than increasing the distance rx.

One other factor to pay attention to, a progressive lens sometimes requires a +.25 to +.50 addition to the add to make it have the same reading distance as a lined bifocal or single vision lens. Some doctors will increase the add slightly if you are going to get progressives. The progressive add just does not seem to have as much power. I been wearing progressives 25 years, and I have seen the effect myself. You probably aren't ending up with much power having a +.50 add in a progressive, no less +.50 doesn't really do much.

You also mentioned a swimming effect. That is the nature of a progressive. As you increase the add that will be more pronounced, especially in a cheaper progressive. It is something you need to get used to. Most people eventually get used to it.


Rvolver 09 Dec 2011, 13:50

Rachel T: By bumping your distance rx an extra +.50 you increased your add by the same amount, that is to say, your reading segment is now at +1.00 effective near power. That doesn't diminish the fact that you prefer even more power at near, and you could obviously do that by increasing the actual add power on the rx. Remember, add is just that: you are adding plus power to whatever the distance power is.


RachelT 09 Dec 2011, 13:10

Hi Soundmanpt,

My new glasses are:

L: SPH +1.25 CYL -0.25 AXIS 010 ADD +0.50 PRISM 1 IN

R: SPH +1.75 CYL -0.50 AXIS 175 ADD +0.50 PRISM 1 IN

I don't seem to be able to adjust to the increase. I should have upped the add instead as I can definitely take more correction close up. I've put two pairs together and can read the computer more than comfortably.


Soundmanpt 08 Dec 2011, 16:53

Rachel T.

Please write down the exact rx you used for your glasses you just got. I am curious what you put down for the add. Otherwise I think it is just a matter of adjusting to them for your distance that might take a few days. Do you recall when you got your prescribed glasses that it took a few days for your eyes to see distance good witht them?


john 08 Dec 2011, 15:31

RachelT- did you get no-line(progressive) bifocals?? That may cause the 'swimmy' I think the over +.5 is not the problem.You may need to get lined bifocals if the swimmy dong go away after a few more days.


RachelT 08 Dec 2011, 14:04

Hi all,

It's a long time since I last posted. I've just got some new glasses which I ordered online. They are +0.50 stronger than my prescribed glasses.

My distance vision with them is quite 'swimmy' (after 3 days), do you think I can adjust to +.50 more than my prescribed prescription, or have I gone too far?

My actual prescription is:

L: SPH +0.75 CYL -0.25 AXIS 010 ADD +0.50 PRISM 1 IN

R: SPH +1.25 CYL -0.50 AXIS 175 ADD +0.50 PRISM 1 IN

Merry Christmas everyone.


Revolver 01 Dec 2011, 13:43

Was in a bar, mid afternoon so it was just me and the bartender, a very attractive petite Asian-African-Anglo about 30 or less. Always carry an up to date pair of -1.00 unisex and use them to start a glasses conversation. She tried them, said they didn't do anything, but then went on to say that her hobby is reading and she has a pair of drugstore readers that she has to wear to avoid eyestrain. Asked her what strength they were, she said +1.50 so she knew what she needed and wanted. She also said she couldn't wear them for distance, too blurry.


Jamie32 01 Dec 2011, 07:02

Dan,

Good to see you back. I think you are right about the subject. As mentioned, i've been wearing my bis with a 1.5 add more when on the computer lately to help with that. But, find lots of other times when I don't really need any help up close.

I think could be our electronic devices are making it more difficult and so we need that help there that don't need otherwise.

Seems like you are getting more comfortable when wearing those reading glasses when needed


Dan 01 Dec 2011, 03:42

Chatting with a friend tonight and I mentioned i was wearing my reading glasses to help with the computer (i sometimes wear +1.5 readers over my -1 contacts or bifocals with a +1.25 add).

Anyway, my friend ended up mentioning that she does indeed have reading glasses as well that she uses when she does a lot of close work. Found out her prescription is -1 and -1.25 in contacts and her reading glasses are +1. She is 21 and in college.

Shows you that a lot of people need a bit of extra help with near work--especially low myopes. We both agree we take our single vision distance glasses off to read as well. Nice to know there are others out there. She also mentioned some trouble with distance so looks like an increase is in her future.


Soundmanpt 28 Nov 2011, 09:52

Carrie

Glad to hear that you got your glasses. They both sound really nice.The style you showed looks very nice and very fashionable as well and the rimless should be kinda fun for a change to wear at different times. Getting 2 pairs is a pretty good idea as I think you will find them much more necessary than your first glasses. I'm sure it won't take long for you to adjust to the stronger glasses as you already are very used to wearing glasses full time. The distant blur will go away in a short time and you will be seeing perfect with your glasses at all distances. However things will soon become much more blurry without them, but I doubt that will disappoint you at all.

As interesting and hot as it sounds for both of you to wear your glasses when in bed together it is probably a good idea to take them off when things get too hot. Even more dangerous for your gf and you when you are both wearing the rimless glasses as they tend to be much more delicate. The chances of those getting broke is much more likely. Too bad it sounds very hot.


Carrie 26 Nov 2011, 11:10

I got 2 new pairs of glasses a few days ago. 1 are rimless (similar to my girlfriend's) and the other are large dark plastic ones similar to these http://2.bp.blogspot.com/_wB8WYI9f_KU/Smtv5JlkqKI/AAAAAAAAAGw/yaqTXIJAcuw/s400/Photo+51.jpg (gorgeous girl wearing them!).

I'll wear the big ones most of the time and wear the rimless ones for when I want a different look or for smart/serious occasions.

The new prescription does look stronger than my old one and is quite noticeable when I put my glasses on. Close up and reading is incredibly clear. That was ok with my old glasses but so much better with my new ones. Distances are not too bad, about the same as with my old glasses at the moment but should also get perfectly clear soon (better than with my old glasses).

My girlfriend likes both pairs of glasses and likes the way my new prescription makes my eyes a bit bigger. I like the way the big glasses get steamed up from her breath when we're kissing!

She wanted me to wear one of my new pairs of glasses when she took me to bed the first day I had them. I said only if she wore hers in bed too. She did, but we both had to take our glasses off eventually as there was a danger of them getting broken "in the heat of passion". I think we both confessed to having a glasses fetish without actually saying so!


Pete 25 Nov 2011, 03:16

Hi!

After less than two months wearing occasionally OTC glasses I done eye test yesterday and have my first prescription: Sph+0.5 Cyl-0.5 both eyes.

I was told to wear them for closework and for driving.

So as I thought I was a little long-sighted.

Pete


lentifan 17 Nov 2011, 18:16

Based on my own experience, going downstairs wearing progressives was never a problem. I went from single vision to progressives and did notice initially the restriction of field of vision, but after about 3 weeks I no longer noticed this.

I have heard that people who have used bifocals tend to have more difficulty with changing to progressives.

Perhaps if you have a big add, going downstairs might be an issue, but I don't think this will apply to most people if they are switching from single vision lenses when presbyopia first begins to set in. The add will typically be only a couple of dioptres or so.

I agree with the advice to wear them all the time. That way you get used to them quickly.


Mr Jules 17 Nov 2011, 09:29

Alex - thanks for the words of advice on progressive.

How long have you been wearing progressives ?

4 years ago, I never worse glasses at all. Then started with reading glasses. In January 2011, my latest eye test picked up a need for distance glasses, too. The distance glasses are also a 'plus prescription'. Though lately, I struggle to read with my distance glasses.


Alex 17 Nov 2011, 09:17

Mr. Jules and others,

It's not so bad -- the brain adjusts and your eyes eventually automatically find the area of the lenses which affords the clearest image. I can't even tell I have progresives on. All distances are clear to me without a jump from far to near. For going down stairs, if your add is high, simply bend your head down a little further and look over the top of the bifocal area. If you are nearsighted and your add still gives you some minus power, you should be able to negotiate the stairs just fine.

Progressives are the best invention ever :)


Mr Jules 17 Nov 2011, 08:37

It's thing about restricted vision and walking down steps, which puts me off buying bifocals.

With separate single vision glasses, I have a better field of vision. Even if I have do swap between glasses from time to time.


Melyssa 17 Nov 2011, 07:08

Carly,

My husband got progressives for the first time a few years ago. His RX is -8.25/-8.00, with an add of +2.25. He got used to them in less than a week.

Astra,

To walk down steps without looking down, just get a good grip on the railing and hang on for dear life. :)


Astra 16 Nov 2011, 23:39

Soundmanpt,

How to walk down a step without looking down ?


Soundmanpt 16 Nov 2011, 23:22

Carly

Because your rx is very mild for both your distance an your add I think you would adjust to your glasses in a couple of days. The secret is to wear them staring in the morning as soon as your getting dressed and don't be taking them on and off all day long. The only warning I will give is to be very careful when going up or down steps with them. DO NOT LOOK DOWN WHILE WEARING THEM ON STEPS.


Carly 16 Nov 2011, 17:24

I've just been prescribed with progressives. I've never worn glasses before (I'm 36).

They are not that strong (left eye +1, right +0.75, ADD +.50 (a little bit of astigmatism too).

My question is about progressives, I've read a lot online about how hard they are to get used to. Can anyone advise on how long it might take for me to get used with the transitioning view? Also, any tips to make my eyes accustomise quickly? I've read it can take 6 months to do this and this worries me a bit as I think I'd just give up.

Thanks


Soundmanpt 05 Nov 2011, 19:50

Carrie

Did he also test your distance with your glasses on? If so how well could you see the eye chart? If your glasses are still good enough to see the eye chart perfect then maybe you should ask your doctor if he feels getting bifocals now would keep your distance vision from getting worse? Of course some of that is up to you as well. With stronger glasses and wearing them full time your distant vision will soon be a bit worse than it is now with single vision glasses. But if your okay with the idea of getting bifocals / progressives then you could probably keep your distant vision the same as it is now and only get a stronger reading segment for close up. I well remember you were quite happy with needing glasses a year ago when you were first prescribed and instantly became a full time wearer even though you barely needed them for reading. That being said and knowing that you will again be wearing glasses full time you may be fine with needing your glasses even more for distance than before.

Your gf must only go every 2 years or as needed to get her eyes examined? But if she is having some issues now she may want to go back sooner than a year out. Sounds like you have influenced her to wearing her glasses full time as well? At -2.00 or -2.50 she should benefit by wearing them anyway so not a bad idea for full time wear now. I'm sure now she can hardly do without them except maybe for reading or other close things.

You never did give any updates on your other 2 friends that got glasses around the same time as you.


Carrie 05 Nov 2011, 07:05

Soundmanpt

I did wear my glasses when I went in for my eye test. When I read the distance eye chart I did find that the whole thing seemed not in focus and I really struggled to read the smaller letters and couldn't read the bottom 2 lines at all. When the optician was testing my near sight he clicked up to stronger lenses and each time the text got clearer. The distance chart looked slightly out of focus through the test lenses, about the same as when I looked at it without my glasses. The optician said the blur would go soon go and that I did need a bit of correction for distances not just for reading. If I was only going to wear glasses for reading he would have recommended wear them as much as possible until I could see distances clearly and then wear them for reading/computers and driving/tv/cinema. But as I was planning to wear the new prescription all the time he didn't need to! I thought he was going to prescribe bifocals at one point but it seems that my prescription is fine for all distances.

We're going glasses shopping this afternoon to check prices. Depending on prices and how nice the frames are I might order them straight away or look online again.

My girlfriend isn't due for an eye test until about this time next year. She had only recently got new glasses when I met her last year. She thinks she will probably need stronger glasses by then as her eyes have changed quite a bit over the last few years. She said her 1st prescription was just over -1 and her 2nd (current) prescription is over -2. She can't remember exactly but she thinks one eye is -2.5 and the other is close to that. She does wear her glasses all the time now. I don't want to wish worse eyesight on her but it seems likely to happen anyway. I wouldn't even mind if she got contacts (she's not planning to), she's just as sexy without glasses.


Rayray 04 Nov 2011, 12:54

RachelT i think the wavy vision thing might be due to them being varifocals and the different segments - as you get used to wearing glasses a lot or all the time you will find you move your eyes less and your head more so you are always looking through the centre of the lens and through right segment for the distance you are looking at - it just comes naturally over time.


RachelT 04 Nov 2011, 02:10

I just wrote a lengthy post and then pressed the reset button rather than the submit button... I wasn't wearing my glasses. Enough said!

It's going great, loving better vision with reading/pc work. When I took off my glasses at the end of the day yesterday I found that my vision was worse than before, especially close up. I'm wearing them now and there was a slight wavy nature with movement, but not like yesterday. So I'm slowly getting used to the lenses.

The best benefit I've found yet is my husband's reaction. I think he might be one of you!


Soundmanpt 03 Nov 2011, 15:41

Rachel T

Well first off congradultions on becoming a gwg. You did good and didn't waste anytime letting everyone see you in your new glasses. Many have a real problem with that. Don't worry like Cactus Jack said that feeling of the things moving will go away very quickly. It's just your eyes adjusting to your glasses. You will probably notice that your eyes won't feel tired as they have in the past when you leave work now. But things will be blurry when you take them off. The good thing is it sounds like you got some glasses you really like wearing and that always helps.


Cactus Jack 03 Nov 2011, 04:25

RachelT,

The difference in apparent motion you are experiencing is caused by the image on your retina being slightly larger with your glasses. I suspect that by this evening, you won't notice it any more.

I look forward to your report.

C.


RachelT 03 Nov 2011, 03:25

Hi all,

I picked up my glasses yesterday. I love the frames, my favourite pair are quite bold and retro styled. The girl at the opticians made a few adjustments to them so that they fitted properly and I left the shop wearing my favourite pair. Wow, it was a bit of a rush. Things kind of move a little when I move my head. It's hard to explain and I wonder if that will go away?

I kept them on and went into the office, obviously to a deluge of comments about my new specs. Lots of positive comments which was great. Some people remarked how blind I must be, which made me chuckle internally... How little they know!

When I took them off in the evening things did feel a little blurry. I've put them on now and will wear them all day and let you know how my eyes adapt.

I'm not in denial, as some of you have stated, I was just inquisitive about my eyes. I like the look and am enjoying being a gwgs, so far...


Soundmanpt 02 Nov 2011, 17:59

Carrie

Well I would call a +.75 increase in both eyes a decent increase considering your current glasses are very mild. I'm sure you were quite happy with needing an increase. A bit like when you got your current glasses it may take a short while for your eyes to adjust to them for distance before the blur goes away again. I think it will be easier than it was with your first glasses though.

Did you wear your glasses when you went in for your exam? When the doctor had you read the eye chart without your glasses how did you do with that part of the exam. What line were you able to see clearly? I ask because you have been wearing your glasses full time since you got them and there has been much talk as to what effect it would have on your vision for distance?

Remember to check out my favorite on-line source, "zennioptical.com" as they offer very nice glasses at very low prices. Besides since you enjoy wearing them full time it might be fun to have several pairs to change into every now and then. Maybe to go with a certain outfit your wearing.

Are you now hoping your gf will also be needing an increase also? When is she due for her eye examine? Will you be going with her when she goes?

You know after you get your new glasses and wear them for a bit if you try your current glasses you will be amazed at how they will be nearly useless to you.


Carrie 02 Nov 2011, 15:40

I had my eye test this afternoon. As I suspected I did need an increase. The optician wasn't concerned and put it down to to latent hyperopia or a growth spurt or a combination of both.

New prescription L+1.50 R+1.75. Haven't chosen the frames yet but I know what sort of style I want. Just got to find the right ones for me at the right price! My girlfriend is going to help.


John S 02 Nov 2011, 15:17

Pete,

If the +1 is good for distance, the chances are good that the muscles are relaxing. How about your reading? Do you notice a difference using the +2.50 lenses, easier to read? That would work out to be a +1.50 add. When they fully relax that should be a +2.50 add.

Remember, the more you wear them, the more results you will get.

Have you thought about ordering bifocals from Zenni? If you don't mind wearing them, you could wear them full time. That should speed up the process. Your eyes should get used to the correction. If you want to wear glasses, that would be good way to do it.


Hyperfan 02 Nov 2011, 12:06

Would like to thanks you a lot, Cactus for your perfect answer.

Anyway, what is she said to me about the meeting with her eye Doctor : "i saw the doctor on friday ..., he was a bit confused as not long time ago i got the last ones... he didnt expect me to need anothers so soon, tired sight its called in a coloquial language so...will be 4 on the left eye and 3,5 on the right one, as he doesnt want me to get used and change too often, he said thats not that good"

She is not afraid at all with this new prescription, and just want to choose the perfect frame (shape and color).

Nature and time will be more, I know, and I agree. And she knows and she agrees too...

Is she the perfect Lady ? Humm.. Maybe.

Anyway, thanks again.


Cactus Jack 02 Nov 2011, 09:25

Hyperfan,

She is probably a latent hyperope and presbyopia is catching up with her.

She is fast loosing the ability to accommodate because of the presbyopia and that is being complicated by hyperopia. Unless she needs to focus closer than 16 inches or 40 cm which requires +2.50 of normal accommodation or external help, the rest is hyperopia.

1. If the +4 and +3.50 are single vision reading glasses, Distance vision may be too blurry to be useful. So I suspect they are only for close.

2. I suspect the examiner is trying to stay up with her increasing presbopia with single vision reading glasses for as long as possible. There is no way to tell how much latent hyperopia she has until her ciliary muscles and crystalline lenses fully relax. She could wind up with around +2 to +3 in the distance part of her glasses and an add of +2.50 to +3.00 in the reading segment. Remember the reading add is in addition to the distance Rx so she could wind up with a absolute +6 in the reading segment.

3. She probably needs them now, but the examiner is trying to minimize the expense and hassle of frequent Rx changes in bifocals or progressives. She may also be resisting the idea of either. I suspect the inevitable within 6 months.

Vanity is powerful and it is often accompanied by denial.

Be patient, time and nature are your friends.

C.


Hyperfan 02 Nov 2011, 07:55

Need your help...

One of my friends is a 35 years old female.

About 18 months ago, she have been prescribed +1, and wear them only for reading.

About 9 monts later, she jumps to +2, and wear them only for close. She said they seems a little weak, and go to the eye doctor last friday. The new prescription is +4 and +3,5.

Of course, I suppose a latent hyperopia, but I have two (or three...) questions...

1/ Do you think she will have to wear her new ones full time, or only fo close ?

2/ With this progression, do you think she will need to change again in 6 or 9 months, for stronger ? Until wich prescription... +6?... More ?

3/ In how much time she will need bifocal, or progressive ?

Thanks, all, for you help.


LTLurker 01 Nov 2011, 17:12

Hey Onlooker,

That sounds good.

My wife has given up on glasses for the time being although it means she does only a little close work.

An hour here or there, followed by rubbing and often a headache which is blamed on everything but her hyperopia.

She is determined to go as long as possiblle without!

This is a tactic which works up to a point, at 43 she still has a fair bit of accommodation available to temper her 1.25 / 1.0 prescription but as time moves on this is becoming evidently more difficult.

2 more years max I think for her and the tide of presbyopia will be too much and she will have to go with a full time possibly bi focal correction.I have a feeling there is about 0.75 more manifest which was uncovered under fogging a few years back.

Right now she can still read at 30cms for about 10 mins, then the book etc is pushed back to 40 or even 50cms!

If I put some paperwork in front of her it is always - pulled away and then brought in to about the 30cms range.

The idea that she has - use it or lose it- maybe a good tactic for the cillary muscles but unfortunately does nothing to ameliorate the hardening of the crystaline lens.

This idea that the crystaline lens is chiefly responsible rather than the cillary muscles deconditioning seems to be favoured by a considerable amount of people studying presbyopia.

I think my wifes case is a good pointer to this - as she has potentially moderate hyperopia even at 43. She is still able to function reasonably without glasses

although she experiences a great deal of asthenopia, because she has worked and worked her muscles and her (my estimate) 5-6 D of accommodation she has left is not good for prolonged activity.

She could have gone full time 4 years ago as her optician advised her that her distance vision would clear after a few weeks.This actually happened quite quickly although she made sure she didn't wear them for distance as the optician said she would get to become dependant!

So I would say its all about time and the presbyopia clock is ticking from day 1 - by 43,44,45 years it is close to running its course and the combination of hyperopia and presbyopia is one that is too much to continue unaided.


OnLooker 01 Nov 2011, 08:43

My wife is reading q lot on the computer screen these last days so a lot of squinting, eye rubbing and finally glasses on...Let's hope this will push her to become full time wearer or let me say systematic wearer as far as reading is concerned as there's no hope she will wear her glasses full time even if her vision becomes crappy!!


Pete 01 Nov 2011, 06:11

John S

I am not wearing glasses full time but recently I noticed when I cover my left eye my vision with +1D glasses is much better (sharper) then with both eyes open or with my feft eye open only. Do you think it is a progress? ...i hope so.

regards

Pete


Cactus Jack 31 Oct 2011, 12:33

RachelT,

May I suggest that you are worried about the wrong things.

Remember, glasses or contacts are intended to correct existing optical problems with your vision. What you are experiencing is very typical of latent hyperopes and all that has happened is that presbyopia, which happens to almost everyone, is creeping up on you. The BI (Base In) Prism is just to help you a little bit when you read. The amount of BI is tiny and it will be invisible to you and others. When you read or look at something close, your eyes HAVE to turn inward or converge. All the prism does optically do a little of the convergence for you. The actual amount is 0.57 degree per diopter and it is very unlikely that that would cause dependency. Glasses and contact lenses are just tools to help us function. We use tools all the time, when you think about it, clothes at the most basic level, are tools to keep us warm because we don't have fur. You will probably never become DEPENDENT on glasses or contacts, but because of aging, you will become dependent on them to read comfortably for extended periods.

What will probably happen is that you will come to like the comfort glasses offer just as you come to like comfortable shoes and prefer wearing them more than you like wearing uncomfortable, but very dressy ones.

Part of your concerns seem to be related to vanity. Hopefully, you chose some attractive frames. My suggestion is to wear them full time for a few days and let you and your acquaintances get used to them and get it over with.

Will your Rx increase, YES, but probably less than you think. Your distance Rx will increase a bit as your ciliary muscles and crystalline lenses relax. Your add will increase because presbyopia tends to increase, but it will probably never get higher than +2.50 unless you do a lot of very close work or your distance hyperopia is not fully corrected. Is all this caused by your glasses? NO, it is caused by nature taking its normal course. Welcome to reality.

C.


varifocals 31 Oct 2011, 05:40

Rachel T

Hi the advice you have been given by the experts on your glasses is correct.

Remember I have been there too.

The perscription is not strong in the first place & maybe you have been wound up a bit by someone.

The glasses ease eye strain, trust me, I have been there.

I lived on headex, stupid looking back on it.

The plus glasses will magnify your eyes & make them more attractive.

Glasses can be the jewelery of your face.

Get nice frames that fit in with your hair colour & face.

Then with no eye strain, you will wonder why you got so worried.


Soundmanpt 30 Oct 2011, 18:44

Rachel T

Sorry I know you addressed this to CJ and I will let him answer most of your questions and I think he will agree with me that I don't think your rx is very strong at all. I think he may have meant that for a first rx you have a bit of everything going on. But none of your numbers are even close to being strong. Also I truly think your glasses will look very nice and no your eyes won't look crazy big at all. Actually I think your eyes will look about the same as your eyes look now. It is very possible that you will need an increase in a year, but still I doubt that it make the appearance much different.

Really I think when you get them and start wearing them you will be very happy with them and soon will find you enjoy wearing them as your eyes won't be tired and you won't be straining to see things.


RachelT  30 Oct 2011, 17:39

Hi all,

I've been reading up on this thread (I do listen to your advice Cactus Jack!) and I am worried.

Everyone in a position similar to me seems to follow the same path and quickly need stronger glasses. I asked my optician if my glasses were weak or strong and he said that they were reasonably strong for somebody of my age getting an initial prescription. He said that usually latent hyperopia of my degree is identified at a much earlier age.

Having read a lot here and also looked at images of people who are long sighted I have to admit that I do not like the idea of wearing glasses that make my eyes look gawky. I don't like the look of plus lenses and the way they refract light.

Should I be worried? My colleague's glasses don't look that bad and I guess my prescription is similar to hers.

Also, can anyone tell me more about what the base in prism is and what it means? From what I've read here it means I'll become dependant on my glasses and won't easily operate without them and worse still I'll look cross-eyed when I take my glasses off.

I am really worried. Hopefully when I pick up my glasses this week my fears will be allayed. I might ask the optician about this too, but I don't want to make a fool of myself or let on that I've found this site. I never realised on my first post that this is a fetish site! I don't mind that at all, in fact it gives me a bit of confidence about wearing glasses when I get them, but I'm not sure I want others to think I have some sort of fetish! I do like guys in glasses though x


Soundmanpt 30 Oct 2011, 11:57

Carrie

By the way how are your 2 friends that got glasses at about the same time as you doing? I know the one that had one minus eye and one for close quickly went to full time wear but the other one that needed even stronger glasses than you was living in denile, but was finding it more and more difficult to get by without them and finally got contacts. They too are about due for exams.


Soundmanpt 30 Oct 2011, 11:53

Carrie

Are you going in soon to get your eyes examined? I'm sure you will let us all know the results when you do. Unless you get a big increase and I doubt that will happen it shouldn't take long for your eyes to adjust to a little stronger rx for distance and you will again enjoy that clear sharp vision for reading as you did when you first got your current glasses.

A friend that is an optician got her first glasses about 1 1/2 years ago and just slightly weaker than yours (+.50 / +.75) but like you she was happy with needing glasses, but surprised that she needed glasses. She wears them most all the time. They recently got an eyechart to put up for customers / patients to test their vision with for distance. Being a new toy the employees were testing it out for themselves. She took her turn and could easily read all the letters perfect with her glasses. But without her glasses it was not so easy and she couldn't see several lines at all. She will so be their long enough to get a free pair so she will soon be getting a real exam. She even tried the same test the next day after not wearing her glasses that day and it wasn't much better. She's hoping maybe she can get progressives now.


varifocals 30 Oct 2011, 10:15

Hi Carrie.

The advice you have been having on progression I have experienced too.

The headaches, then the first glasses to cope with it & a fuzzy background which, over time clears.

Then stronger glasses for the reading, fuzzy distnce vision & so on.

Also total dependancy.

As well as varifocals & have a pair of percription readers which give me a wider field of vision.

They are good & were obtained on the internet.

Optics is a very interesting subject


Carrie 30 Oct 2011, 07:16

Probably because I wear my glasses all the time I find that everything is just very slightly out of focus when I take them off. Distances are clearer with glasses on. Maybe if I left my glasses off for longer I could go back to see the same with or without them. But my eyes feel funny after a while if I don't have my glasses on. When I first got glasses I could read without them without too much trouble. They just made text really clear and stopped my eyes feeling tired. Now I have to concentrate quite hard to read without glasses. What makes me think I need stronger glasses is more noticeable when I'm reading than any other time. I'm sure text was sharper when I first had my glasses.

I do remember distances being a bit blurry at first but as will continue to wear glasses all the time I should soon get used to a stronger prescription if I get one.

I'm going to start checking out new frames now.


Soundmanpt 29 Oct 2011, 12:53

Carrie

Not at all surprising that you are feeling you may need an increase for your glasses. You mentioned after trying on your friends glasses that probably needed stronger glasses as you could see quite well with hers. Her glasses were about +1.00 stronger than yours. It seems that yours are no longer even stronger enough for distance and of course your close vision would be slightly worse as well. It took a couple months of full time wear for your distance vision to go from blurry with them to blurry without them. With a little stronger rx your distance will again be a little blurry at first but it won't take as long for that to clear up. Let us know what your results are at your upcoming examine.


Carrie 29 Oct 2011, 10:07

It's well over a year now since I got glasses and I was going to go back for another eye test in August, as that would have been 1 year since I got glasses, but I never got round to it. I tried to get an appointment today at the same place I went last year but they were fully booked. I now have an appointment for Wednesday at 4pm.

My current (first) prescription is L+0.75 and R+1.00. Very simple and fairly weak, I know but they made a difference. I still wear them all the time. They are still fine but I feel I need a little more power as I've noticed that things are not as clear as when I first got them and I really struggle to read for any length of time without them. I quite like the idea of getting stronger glasses!


Brian 27 Oct 2011, 19:33

Rachel, You were likely prescribed a prism correction because your eyes converge outward while reading and using the computer. I have the same problem.. I started at 2BI and am now 3BI. That along with the plus reading correction should make near work a lot easier for you. With everything going on your your prescription you are probably better off wearing your glasses all the time, at least initially to get used to them. I would think once you get used to them you'll probably like the way things look much better with the glasses on than with them off.


Soundmanpt 27 Oct 2011, 18:11

Rachel T

I am not at all surprised that you were prescribed bifocals (progressives). The fact that you were able to see close and in the distance with your co workers glasses was a pretty good sign. Even though your rx is not very strong you do have a lot going on there. You have a slight bit of astigmatism and even a little prism.

I think you will quickly find that your glasses are very useful from the first day you get them. As the optician suggested you will find that since you do much work on a computer you will be wearing them at work full time and will be rewarded with not having your eyes feel so tired at the end of work each day. Then you may also find that as your eyes adjust to them you may feel more comfortable leaving them on for distance as well. Where I worked we would often suggest with someone getting their first glasses to wear them full time for the first week to 10 days and then decide what you need them for and what you can do without them.

But congratulations on becoming a GWG. Do let us know when you get your glasses how they work for distance and close and on the computer.


RachelT 27 Oct 2011, 15:00

I went for the eyetest at lunchtime today and it was almost exactly as Cactus Jack had informed me, not that being pre-warned is necessarily pre-armed!

To cut a long story short I do need glasses, or at least I've been prescribed glasses. I asked the optician about how often I need to wear them and he said just for when I'm doing prolonged reading and computer use.

I've copied the prescription on the card he gave me below:

L: SPH +0.75 CYL -0.25 AXIS 010 ADD +0.50 PRISM 1 IN

R: SPH +1.25 CYL -0.50 AXIS 175 ADD +0.50 PRISM 1 IN

I'm not sure what this means, but he did say I could get bifocals or varifocals. I said I didn't want any visible line and so he's said varifocals.

I picked two pairs of glasses (so expensive!) and I am picking them up when they are ready, which should be next week.

So, I'm a little worried and a little excited.

Thanks for all the advice

Rach


Mr Jules 27 Oct 2011, 11:18

Catcus Jack,

as ever, thanks for information about using red and green. You learn something every day ! Overall, I would say, more time was spent checking my vision for distance, than for reading. With reading, it was just a case of holding a page of different sized print and checking which lenses worked best.

But to re-assure others, an eye test really is quite painless. I now see it as a regularly occurrence (every 1-2 years) as part of the other check ups in life, like a visit to the dentist.

Here in the UK, eye tests are charged at a fixed amount (approx $35 dollars). If you are on certain types of social benefit, you can have a free test with low cost glasses, if you need them. I don't fall into this category.

So after my last test, I sent my reading glasses off to be re-glazed with new lenses. (approx $55 dollars).


Carrie 27 Oct 2011, 00:55

RachelT

Do you know your friend's prescription? If you can see well with her glasses I think you will probably need glasses with a similar prescription.


Cactus Jack 26 Oct 2011, 18:29

Mr. Jules,

The red and green tests are used to check how close the Rx is to your actual needs. Hyperopes are particularly hard to refract because they tend to try to accommodate and that can mislead the examiner as to your true Rx. By evaluating the relative clarity of the letters in the green and red areas he.she can tell if you need more plus or less.

C.


Mr Jules 26 Oct 2011, 15:54

My distance is +1.75, and my reading is +3.00 (= add +1.25)

I can just about read with my distance glasses for short periods. But switch to my reading glasses for longer reading or using a computer.

Thought my optician was spent a lot of time checking my distance vision at my last eye test. Why do they use green and red backgrounds ? Well, whatever the reason, my distance glasses give me clear vision !

If the add gets any greater at my next eye test, think I will consider varifocals. Reading with my distance glasses with my current add +1.25, is about as much as I can cope with.


RachelT 26 Oct 2011, 15:47

Thanks Cactus Jack and others. I really appreciate you taking the time to explain things. I'm not worried about the exam, just a little unsure about the prospect of needing reading glasses in my early thirties.

I went to Superdrug (a chemists) at lunch and tried some readers. I found the +1.50 to work well. The +2.50 were too strong, at least when I looked across the shop.

I phoned and booked an eyetest for tomorrow lunch. I'll let you know how I get on.


John S 26 Oct 2011, 13:02

I believe Mr. Jules said he is using +3.00 reading glasses. His distance is +1.75. That works out a +1.25 add. I certainly could not read with a +1.25 add. My arms would need to be almost 3 feet long.


Varifocals. 26 Oct 2011, 12:05

Marley

I have +3 addition for my varifocals.

It is not a problem.


Cactus Jack 26 Oct 2011, 10:43

Marley,

A +3.00 add is in addition to the distance Rx and +3.25 or +3.50 add is not uncommon.

I strongly suspect his Eye Care Professional knows what he is doing.

C.


Cactus Jack 26 Oct 2011, 10:36

Marley,

Not necessarily. It depends on how close he likes / needs to read text. You tend to hold small text closer. Also, his distance Rx could be a factor if these glasses are reading glasses.

C.


Marley 26 Oct 2011, 09:40

Mr Jules,

+3.00 for readers is extreme. Is that the doctor's recommendation???

Marley T.


Mr Jules 26 Oct 2011, 08:33

I agree with Cactus Jack. An eye examination is painless. And certainly a lot more pleasant than a visit to the dentist. Over the last 4.5 years, I've had four eye tests. They are thorough, with my distance test involving quite a lot comparing letters on green and red backgrounds. What I got was distance glasses which allow me to see clearly !

I also agree that your eyesight can change quickly. Within six months of my first reading prescription of +1.00, I had trouble with small print again. So after the next test, I went from +1.00 to +1.75.

Now on +3.00 for reading - prescription is nearly a year old. I may well go back to my optician in the Spring next year. The very smallest print does not seem clear enough with my +3.00 readers any longer. But they are fine for the time being.

Sure I'm midway through classic presbyopia eyesight changes. And wonder at what point your eyesight stabilises.


Cactus Jack 25 Oct 2011, 17:32

RachelT,

An eye exam is the easiest medical type exam you will ever get. It is painless and the results are usually very beneficial. You were meant to have sharp, comfortable, effortless vision. If it takes some glasses or contacts to do it, so what.

An eye exam is a cooperative effort between the patient and the examiner has no way to see what you see and must depend on what you tell him/her. There is one part of the exam that is a little bit tricky and hard to get right. That is the part where you are checked for astigmatism and the examiner is trying to discover what cylinder correction, if any, you need and its axis (angle). It happens pretty early in the exam where each eye is being checked individually. You are shown a row of letters and the examiner will flip a lens back and forth an ask you which is clearer or perhaps more blurry. As he/she flips the lens back and forth the lines that make up the letter with change in blurriness depending on which direction they run. This is often confusing. During this phase of the exam, I try to concentrate on an "O" if possible. What the examiner is doing, is trying to "bracket" the angle of your astigmatism if you have any. When he/she gets close, the letter(s) will appear equally blurry no matter which way the lens is flipped. If you are not sure, ask to see it again.

Once the examiner is satisfied with that part, he/she will start determining the sphere correction you need. He/she will start with too much plus and the letters on the chart will look intentionally blurry. He will then step by step reduce the plus (or increase the minus (same thing)) until you can see a line of fairly large letters. He will then reduce the size of the letters and continue reducing the plus until that line gets clear and repeat that procedure until he gets to the 20/20 line.

Then he will do the same thing again with the other eye.

The next important step in the exam occurs when he first shows you the images from both eyes together, usually separated. He is actually checking for muscle imbalance problems, but you need to compare the images and if they are not equally clear, you should tell him even if he does not ask you. If they are not equally clear, he will probably blur up the clearest eye so they match and the blur will be corrected later in the exam after he has checked for muscle imbalance.

Once the images are fused, he will probably start do the sphere test again with both eyes together. When he is satisfied with how well you see the 20/20 (6/6) line, he will have your distance Rx.

The next step is to check how well you see close up.

He will put a small version of the wall chart about 100 cm or 16 inches in front of you and ask you to read the lines. If you have trouble, he may increase the plus (or reduce the minus) in your distance Rx until you can comfortably read small text. Depending on the results, he may suggest bifocals, progressives or reading glasses to help you read close up. Be sure and tell him you use the computer a lot.

That is pretty much it.

If you wind up with an Rx, I urge you to not spend much on your first glasses. It is possible that your Rx will change within 6 months or so. If you try, you can probably find some attractive frames that don't cost an arm and a leg. The clerk's job is to sell you the most expensive frames and lenses they can. You do not have to buy glasses from the place of your exam, but it is not a bad idea unless they try to high pressure you. You can just say you want to ask a friend to help you pick out some frames. The important thing is to ask for your Rx and PD (pupillary distance) if they don't offer it to you. If they balk at the PD, don't worry, we can tell you how to measure it in a few minutes with a mm rule and a bathroom mirror. When you can, let us know your Rx and your wishes. We will be happy to offer suggestions on what to order.

I hope this helps. The main thing is to not worry about it. Even if it turns out that you don't need glasses, eye exams do more than just check vision. The eyes are windows into the body and sometimes lurking health problems are discovered.

C.


Soundmanpt 25 Oct 2011, 17:07

Rachel T

Your more than welcome, but please don't be worried. Getting your eyes examined is not a big deal at all and completely painless. From what you are describing about your eyes being tired at the end of the day I am sure that is due to eye strain and working a computer will certainly do that. Getting glasses will do several things, first off your eyes won't feel tired again and it will be much easier to see your screen. Will you be okay with the idea of wearing glasses if you need them? My guess is you may fit right in if others do the same type work as you do.

You said your friends glasses were reading glasses, are you sure that they aren't a no line bifocal?

Good luck with the exam. Don't put it off make your appointment and get it over with.


RachelT 25 Oct 2011, 15:38

Thanks for all the commments, although they have me worried!

I am 32 and I've never been for an eye test, apart from the school tests they used to do and which I never had a problem with.

I have noticed my eyes getting tired at the end of the day, especially if I've been doing a lot in Excel. I'm in marketing, so I do a lot of computer work.

I will book in at the opticians and see if I do need some help.

Thanks again

Rachel


Soundmanpt 23 Oct 2011, 19:29

Rachel T

I almost forgot, but it would be a ggod idea to maybe get your eyes checked in the near future and be sure to tell the doctor about how your friends glasses seemed perfect for you. If you can it would be very helpful if your friend would let you borrow them when you go for an exam so you can show the doctor how they work for you.


Soundmanpt 23 Oct 2011, 19:26

Rachel T

Like CJ said it would be a good idea to maybe have look back at many of the past comments in here as it may tell you a lot about what is happening to you.

I would be interested to know your age, when you had your last eye exam and if you have any idea what your friends prescription is?

Next time your in a store that sells over the counter readers you might want to try testing yourself by first starting with the +1.00 glasses and working up to the ones that work best for you at all distances. If your in college you may well benefit from wearing a mild pair of reading glasses.


Cactus jack 23 Oct 2011, 18:27

RachelT,

Denial is a river in Egypt, isn't it? You may need some glasses, but you have enough accommodation to effectively wear "internal glasses" for now, but that will not go on for ever. How long is determined by your genetics and your age,

What you are experiencing is called Latent Hyperopia and millions of people experience it also. People with hyperopia can do this until presbyopia sets in, but people with myopia cannot.

The clue is that the plus reading glasses made the text clearer AND you could see clearly across the room with them. If you were not hyperopic, things across the room should have been blurry.

Several of us have explained why this is and how it works 20 or 30 times on this and other threads. I urge you to look back through hyperopia, presbyopia, vision, and New Glasses and other threads to help you understand.

Depending on your age, you may be able to use your accommodation to solve you vision problem, but it will ultimately catch up with you. In the meantime, your eyes will just have to work extra hard so you can see clearly at all distances. At some point, they will start to complain with headaches and excess fatigue.

C.


RachelT 23 Oct 2011, 15:37

I don't need glasses or wear them, but I recently tried on my friend's reading glasses and was amazed at the sharpness of text on the page and also when I looked across the office I could see fine.

Does this mean I need glasses or can just accommodate her lenses?


Neil 17 Oct 2011, 13:39

Cactus Jack,

Here is a question for you based on your most recent post in this thread.

Suppose someone who has no symptoms of hyperopia whatsoever, i.e., no eyestrain or other complaints, sees fine, focuses perfectly well, etc., but decides to see an ECP. Let's say the reason is an itchy eye or something similarly benign. Then the optometrist uncovers some hyperopia during the exam. Does the ECP prescribe correction for such a person? I would guess there are standard protocols for such instances?


DS 16 Oct 2011, 18:58

Brita,

Yes... because your spherical equivalent is (-), you are "net" nearsighted and may stave off a dependency on glasses for an extra year or two with acceptance with the slight blur of your uncorrected astigmatism.

Unfortunately, the sph equivalent is small enough to not be much help, the astigmatism still blurs fine print, and you're still labeled a presbyope if you can't read with your distance correction.


Soundmanpt 16 Oct 2011, 18:04

Brita

For the record its axis not axels, but close enough. As you said all you have for a an rx is astigmatism correction in your glasses, Astigmatisms effect both your close, mid range and distant vision. But because it is pretty mild you likely only notice it as you say for your night driving. But I would bet if you do a lot of reading you may well start to notice the letters running together or even a mild headache. Because your rx is written as minus numbers that indicates you went to an optometrist which is most common at most shops. If you had gone to an optomoligist he would have written your rx as plus numbers.


Brita 16 Oct 2011, 15:53

Hi, I have mild glasses with only astigmatism correction of -0.50 and -0.75(can't remember the axels). They don't really improve my vision that much during the day but when driving in the dark they help a lot.

I am 43 year old female and I was wondering if my astigmatism being on the minus side will give me extra help on the prespyopia progression?

So far I have not noticed any problems seeing near. But do I expect to have need for near correction in near future?


John S 13 Oct 2011, 11:28

Pete,

Do you notice any progress yet?


Cactus Jack 10 Oct 2011, 10:12

Stewart,

It depends mostly on how much latent (hidden) hyperopia you have and your age.

The onset of presbyopia and the need for help to focus close is usually what reveals your hidden hyperopia. Unlike myopia, you have had the ability to compensate for a small amount of hyperopia by using some of the excess focusing power in your crystalline lenses. As presbyopia sets in with age, you begin to gradually loose that ability and at first you need some plus help, reading. The amount of plus depends on the focal distance involved and how much of that plus you can comfortably supply.

The fact that you can see distant things through the +0.50 part of your glasses means that you have a small amount of hyperopia and it is possible that you have a little more, but probably not much. It is likely that you may need a little more plus for distance in a few months as your crystalline lenses relax, but I doubt it will be more than +1.50. The bifocal add will likely get up to about +2.50, but won't go much higher unless you like to read very close (e.g. in bed). The day may come when you need trifocals for intermediate distances, but that depends on what kind of work you do and how much you use the computer.

The main thing is not to worry. What you are experiencing had been experienced by millions of others. Look back through these threads and posts and you will see many discussions on the same topic.

C.


varifocals 10 Oct 2011, 09:56

Yes Stewart, the distance is initially blurry then it slowly adjusts.

Nothing to fret about, I have been there too.


Stewart 10 Oct 2011, 09:27

I have been wearing readers for about a year and just got bumped from +1.25 to +1.75. I can see close more clearly, but my monitor which is about 18" away now isn't clear. I went back to the dr, and was prescribed bifocals (progressives) with +.50 on top. I find I see must easier with them for close and monitor, and that they make no difference for distance. I am happily wearing them at work and home.

Everyone I know with readers who got a + distance scrip went full time in short order..what I read here is their distance is at first blurry but they adjust and go straight to full time within a few weeks. My distance vision is now OK and I would rather not mess it up. Will wearing the +.50 end up moving me to full time prematurely?


varifocals. 06 Oct 2011, 10:31

Pete.

What you are told is so.

It is hard to introduce plus ut I have done it by gently increasing my rx from the perscription.

Each eye has 3 sets of numbers.

I leave the right & middle ones alone & slightly up rate the left sperical.

Then get the new glasses done on the internet.

It works but the myopies have it easier


John S 06 Oct 2011, 08:44

Aubrac,

In my opinion, when the add gets up to the 2.50 range, the jump is too much for me. Tri-focals or progressives. I prefer a well fitted progressive. I was wearing a +3.50 add, and asked the doctor to take it up a +4.00. He had no problem with that, we have become friends over the years. He understands the unusually high add that helps me out in the electronics field.

Most progressives max out at +3.50. There are only 2 manufacturers that produce that lens.

I wear them full time, the transition is smooth between distance & near. Sometimes I don't even think about having then on, they have become part of my face. When I come home and get on the computer, if it is only going to be 5-10 minutes, I usually don't bother to put my SV computer rx on.

I have met so many people that complain they just can't do close work anymore, I am too old, stuff is too small to see. You won't hear that from me. It is funny to see someone pulling something further way to try to see it. It would be nice if the doctor would ask what distance do you like to work at. They are probably worried about remaking glasses.

These lenses give me vision like I was kid, and I love it.


Aubrac 06 Oct 2011, 05:49

How well and quickly do you adjust to bi-focals? I found a pair the other day and have been doing GOC with them. Prescription is about +1.5/+2 with an add of about +3.

I have been wearing them FT and seem to adjust for distance without any problems but maybe the add is a little too strong as I find the sea of blur from the lower half very difficult and unwelcome.

I am trying to get my wife into bi-focals but don't want to put her off by having this problem. She works as a dentist and so probably needs a smaller area of lens for close work rather than half of the lens. Her scrip will probably be in the region of +2.25 with +2 add.

She also has 3 degrees base out prism in each lens and so would this make a bi-focal lens more noticeable?

Any comments and experiences welcomed.


John S 05 Oct 2011, 21:23

A few typos...

The last time you had an exam was 4-5 years ago in your home country.

He will try a series of lenses, to try to improve your distance vision (plus or minus).


John S 05 Oct 2011, 19:59

Pete,

Cactus Jack is saying, you are probably stuck with what you have got. You probably cannot induce myopia, you CANNOT induce hyperopia. The action you are doing now is the only thing that might work.

Wearing correction all the time (strong reading & distance) should cause the muscles to relax to a distance state. This could take a while. If it is going to work, it should happen in 3-6 months. Your eyes have been use to creating the extra plus power to focus for reading. They are not going to just stop overnight. It will take time, and you have to stick with it. In time, the muscles should learn they no longer need to work.

To answer your question, how do you know when the muscles start to relax. After reading for an extended time, when you remove your glasses, your close vision will be blurry. It will take 10 or 15 seconds to return to normal. If you start to experience that, the process has started.

I initially said to wait for an exam, I have had second thoughts. Keep continuing to wear glasses. In a few weeks, if you want to try an exam, go for it. You will learn the parts of the exam, and that should prove useful. Use the OTCs to read a book while you are waiting in the office, to prep the muscles. If you are successful relaxing your muscles, you will understand more next time you go (different doctor of course). You want to relay to him that glasses you have on seem to work very well. The last time you had an was 4-5 years ago in your home country.

The exam will usually consist of:

Glacoma test - A puff of air to your eye to determine blood pressure.

Possibly a auto-refractor - A electronic unit that displays a picture. When looking at the picture, it determines your distance rx in a few seconds.

The doctor should start the manual exam with lenses. He will first determine your distance rx. There will probably be a chart or text projected on the wall. That will consist of plus or minus lenses, and he will when/if there is an improvement. The best way I can explain it is, when there is too little plus, the text will be smaller and darker. As he increases the plus, the text will become larger and then become washed out. It will have a soft haze around the letters. The lighter the text the more plus that is being used. You can create the same effect by slowly moving your reading material past the focus point. He also might use a Red/Green chart. Let him sharpen it to the best it will get.

Next he should check for astigmatism. That will consist of turning the angle of cylinder lenses. You will not see him rotating the lenses from the back of the refractor. Neither of these you want to cheat on, tell the truth.

Then he should put up the near reading chart. The doctor does not have an easy way to determine how well you read. The reading rx is determined by your responses to the addition of plus lenses. Most doctors will put up the near chart and ask you to read the small bottom line of text. Your response should be, it is very hard to read. He might ask you what line you can read. Ask him if he wants you concentrate real hard to try to see the line. He should say, read what you can easily. Go 2 lines up and read it slowly, as if your are having difficulty. At this point, he will start adding plus and ask when you can read the bottom line. You want to let him keep adding plus and telling him it is better, until you start to see the text blur(washed out) very slightly. That will be the reading rx, stop him there. If he backs up, and asks which is better. Get him to add the extra step of plus back in to give it a VERY slight washed out blur. You should be able to read it easily. Don't let him go past the point that it is too washed out too read. He will ask you to read the line, do so kind of fast. Tell him it looks very good. If he puts up a chart of vertical and horizontal lines, and asks which are darker. You want let him go a few steps past when the vertical lines become darker. Then say that both sets of lines look equal in darkness. That is called the Fused Cross Cylinder test. It might be a replacement for the near text chart. It is explained in the document linked at the bottom of the post.

He should look at your retina by shining a light in your eyes.

That should be the end of the exam.

The doctor has several ways to determine your distance rx, it is almost impossible to cheat. Reading is a different story. He cannot determine your focusing muscle action, except by what you tell him. If nothing else, you will know if you need a distance rx, and learn the steps that a doctor does during a test.

Cactus Jack, please correct anything that is inaccurate. Thanks

http://www.opt.uab.edu/class2011/2nd%20year/CEVSII/Near%20Testing.doc


Cactus Jack 05 Oct 2011, 11:59

Pete,

I don't recall all that led up to Presby Lover being able to wear plus glasses full time. Based on Optical Physics and the physiology of the eye, I suspect there was some hyperopia there to start with. Just because you have some hyperopia does not mean that you cannot try to induce some myopia by wearing minus glasses.

Even a hypeope can wear minus glasses quite successfully if they have enough accommodation range in their crystalline lenses to supply enough plus to neutralize the minus in the glasses and also overcome the hyperopia.

However, unless your genes will let your eyeball grow larger (longer) you can't induce true myopia and unless your scleral tissue (hard white part of the eyeball) is different from everyone else's, it is nearly impossible for the eyeball to shrink and become shorter or your cornea or crystalline lenses are capable of shrinking, you simply can't make yourself more hyperopic.

All the following apply to distance vision. Emmetropia (perfect vision), myopia, and hyperopia are really just descriptions of variations on ONE thing. The accuracy of the match between the eye's lens system and the distance from the back of the crystalline lens capsule to the retina. Emmetropia means the match is perfect. Myopia (near or shortsightedness) means either the lens system has too much plus or the distance to the retina is too far. Hyperopia means that either the lens system does not have enough plus or the distance to the retina is too short. The laws of optical physics rule here and nothing can change that.

Near vision is slightly more complex. Many people think the eye works like cheap fixed focus cameras which is why THEY don't have to wear glasses to read or see things far away like weak eyed people. Actually the eye works like an autofocus camera. One (only) of the lenses (the crystalline lens) can change power from a relaxed +15 (about) to as much as +25 in very young people. The ciliary muscles control its power and focusing ability.

A person who is myopic has too much plus in their lens system for distance and in effect they have built in reading glasses. When you wear the +1.50 reading glasses you are just making yourself temporarily myopic. Without the glasses, you are pretty close to having a refractive error of 0.00. The +1.50 glasses cause you to be able to focus clearly at 67 cm or less. Beyond that, everything will get increasingly blurry the farther away it is. Reading a numbers plate is just a quick test of visual acuity to see if a person sees well enough to safely drive without correction. It is 20/40 or better if you can read it from the prescribed distance.

I admire your tenacity, but unless you can get the laws of optical physics changed, think of yourself as Don Quixote of La Mancha, tilting at windmills. To paraphrase Claude Rains in Casablanca, I would be shocked, shocked, to learn that you really had any significant latent hyperopia. You just don't fit the pattern. However, I could certainly be wrong. I think all you are going to do is bring on early presbyopia, but that may not be a bad thing either. You can always wear multi-focal glasses with close to 0.00 in the distance part or maybe a bit of minus.

C.


Pete 05 Oct 2011, 02:33

Hi all.

I started to wear OTC glasses last friday. I can read with them on as long as I can without any blur. With the distance glasses on (+1.5D) there are some blurs. Distance blurs are bigger if the object is far from me. As I mentioned I can see registration plates from 7 feets but I realised smaller letters in the same distance are still not very clear.

Cactus Jack

On the post from Presby Lover (14 Apr 2010, 21:55) i found something interesting. Presby Lover tried to induce myopia just like me and ended up as full time plus wearer.

I am wondering why I have less chance to be hyperopic than Presby Lover?

I think I will wait with my exam. How long it can takes until first symptoms of relaxed muscles?

BTW. I am wearing distance pair only couple hours/day as I often drive a car.

Pete


Cactus Jack 04 Oct 2011, 12:21

very progressive,

Yes, you probably need a new Rx. Your crystalline lenses have probably become a little stiffer since January, but the big problem is that your ciliary muscles have become de-conditioned and are no longer strong enough to effectively squeeze your ever stiffening crystalline lenses to focus. It happens very quickly. Also, if you had some latent hyperopia that you had internally corrected, your ciliary muscles and crystalline lenses may be gradually relaxing. All of this can change your Rx.

All in all, what is happening is fairly typical and expected.

C.


very progressive 04 Oct 2011, 10:25

Can someone tell me what it means that I can no longer read my computer screen ( about 2.5 feet away), thru the distance portion of my glasses?, and not even the progressive area, but rather the portion with the add for reading? Wearing my glasses for the computer (use all day) seems a little dimmer (less contrast), yet if I don't wear them I tend to get some running of print and double vision). My eyes seem to be more relaxed, thru the near add part. Also, as of recently I have difficult time reading (at the distance , I like to hold a book)with my multi focal contacts. Could my presbyopia be progressing at this pace, or is it possible that as I am wearing my glasses more and they are becoming more comfortable ?? Will the mid range of my glasses need to be stronger, and how will that affect the distance and rx for the add? I jst started wearing bifocals around Jan. 2011. could I need a change in rx, this soon? Thanks !


Cactus jack 04 Oct 2011, 07:59

Pete,

I don't think it is likely that you have much or any latent hyperopia, but it certainly can't hurt to get a "wet" (cycloplegic or dilated) exam. The rules vary by country as to who can administer the cycloplegic agents. Usually, those exams are very complete and it is useful to establish a base line from a health standpoint. A dilated exam really facilitates a good retinal exam. An experienced practitioner can spot many early signs of other health problems by examining the retina. However, that type exam is not a good place to try to "cheat". There are better places and ways, but a very through exam is an excellent way to know exactly where you are. Most destinations are easier to find if you know your present location.

All Opthalmologists can administer cycloplegic drugs because they are M.D.s, Optometrists and Opticians may or may not be able to do it.

How long have you been trying to wear the OTC readers for distance?

How long for reading and using the computer?

C.


John S 04 Oct 2011, 06:40

Pete,

It would probably work out better if you waited a little longer for an exam until your muscles start to relax.

You could go into the exam wearing the OTC glasses. Explain you have worn bifocals for reading since you were a teenager because your eyes feel tired, and you get headaches after reading for 15-30 minutes. Then you have a difficult time focusing on the print. Your distance vision seems to be ok.

You lost your bifocals, and you got the OTC to use until you got new glasses. You would like to get bifocals again because the distance if blurry with the OTC. Tell the doctor that the OTC lenses work great for reading. You want to let the doctor know that you like the rx in the OTC.

Ask if there is a way to tell if your eyes are going to get worse as you get older. Mention that the last exam you had, the doctor recommended to get dilated next time to make sure you were fully corrected.

If is does not work out at the first doctor, try another doctor.

Good Luck


Pete 04 Oct 2011, 02:26

Thank you very much for answers John S and Cactus Jack. It seems you guys know everything about eyes. One respond is more optimistic for me as I still have a chance to try. I think I will wait couple of weeks and I will visit the optican for eye test. Hope this will resolve my doubts.

I would like to get wet exam to be hundred percents sure if I am latent hyperopic or not. Do you know is there any way I can sugest wet exam to the optometrist?

I don't know if I have any astigmatism but my close and distance vision without glasses is still ok, so I am affraid I don't have it.

Pete


Crystal Veil 03 Oct 2011, 12:26

No sign of this development in Holland yet....


varifocals 03 Oct 2011, 11:24

Yes in Bedford which is a glasses town with 4 large public schools & a college there is a large increase in glasses especially, in proportion from a few years ago plus lens bi focals..

i think heavy mobile phone usage has created a bit of this.

Specsavers have opened a larger store to cope.


Soundmanpt 03 Oct 2011, 11:11

Yes there are many more young people, mostly women, wearing progressives now than there used to be. I have had conversations with several optometrists and what they are seeing is that many of the young people that get low minus glasses seem to have trouble seeing their I-Phones and other small devices clearly. So I think we cab thank texting for that added bonus.

At an even higher rate we are seeing many more young people wearing plus glasses now as well.


varifocals 03 Oct 2011, 09:43

One thing that is suprising in the current eye scene , is that there appears to be an increasing number of 20 year olds wearing bi focals than was the case years ago.

There are no hard & fast rules.

My wife has had glasses full time since 7, now in 50s but still is only - 3.50.

No myopic progression there, yet loves glasses.

She has a +2.25 add on too which means here reading glasses for a low minus.

I wish she had stronger lens but nothing has happened.

Oh woe!


Aubrac 03 Oct 2011, 09:14

Megan

There is no magic age at which people need glasses. Yes there is a tendency for glasses at 40 plus but many much younger people wear plus prescription glasses both for distance and close work.

My wife got her first glasses (apart from wearing glasses as a child) at 35 and although at first she only wore them occasionally, now six years later she is happier wearing them nearly full time.

I am a little surprised that with the level of astigmatism in your new prescription, you do not find things at distance and close much clearer at all angles. You may still be able to accommodate for the plus correction but there is no way to do this for astigmatism. It is rather like a letter 'E' that may seem fairly clear on the top bar but gets progressively more blurred from the middle to the bottom bar, although I only use this as an example.

Also people with low plus prescriptions do have good days and bad days, sometimes they are able to accommodate and focus to see clearly, like maybe when you took your driving test, while at others they may not realise they are driving without the benefit of properly clear vision they really need in poor light or at night.

Eyestrain and tiredness usually result from the eye muscles working too hard to form an image the brain can interpret. You really have two options, one is to wear glasses all the time for two weeks, after this period you will probably find you have really good distance and close vision with no strain but have become more dependent on your glasses, no bad thing if you can see better with strain.

The alternative is occasional glasses wear when you are out and looking at signs, notices, etc, in shops and airports, and for longer periods of close work and reading and reading.

Suggest you try the latter option first, and if this does the trick, fine, if not try the first option. It will in all likelihood be only a matter of time before you find wearing glasses FT the preferred course but entirely up to you.


Cactus Jack 03 Oct 2011, 08:43

Pete,

Thanks for the information.

The test is a very crude way of getting an idea of your refractive error. It is amazingly good for getting an idea of a persons overall Rx, however it does not account very well for astigmatism.

From a pure optics point of view, glasses or contact lenses cancel out or neutralize refractive error and sphere refractive error - the first number in an Rx - is ALWAYS caused by a mismatch between the total PLUS power of the eye's lens system and the distance between the back of the crystalline lens and the retina. Isaac Newton, of gravity fame, discovered and developed the basic formulas for optical physics about 300 years ago and they are what we use today and unless there is a serious change in the laws of physics, they will be applicable 300 years from now.

The fundamental formula or equation is that a +1.00 lens will focus parallel rays of light from a distant object at 1 meter (100 cm). To express that mathematically: 100 cm/focal distance = lens power. If you know any two of them, you can calculate the third by re-arranging the formula using the rules of algebra.

A few items you need to know before we analyze your test results.

1. The typical "perfect" eyeball is about 25 mm from the back of the crystalline lens to the retina.

2. If you do the math described above, the total plus power of the "perfect" eyeball's lens system has to be +40 diopters for distance with the crystalline lens fully relaxed.

3. There are 4 lenses in the eye's lens system. From front to back they are the Cornea, the aqueous humor, the crystalline lens, and the vitreous humor. The only variable power lens is the crystalline lens. Its relaxed power is about +12 to +15 for distance and the ciliary muscles can normally squeeze it to increase its thickness and power by as much as +10 diopters when a person is young to focus very close.

4. A person who is myopic has too much PLUS in their lens system for the length of the eyeball (probably MORE than 25 mm). A person who is hyperopic does not have enough PLUS in their lens system for the length of their eyeball (probably LESS than 25 mm).

The purpose of the OTC glasses in the test is to make you temporarily myopic by a known amount and make the total power of the lens system such that the focal distance is conveniently measurable.

Lets analyze the results assuming that the +1.50 and +2.50 glasses caused your crystalline lenses to be fully relaxed:

With the +1.50 glasses 100 cm/1.50 = 66.66 cm focal distance. You got:

Left 63.7 cm 100/63.7 = +1.569 - (+1.50) = +0.069

Right 61.7 cm 100/61.7 = +1.620 - (+1.50) = +0.120

With the +2.50 glasses 100 cm/2.50 = 40 cm focal distance. You got:

Left 42.5 cm 100/42.5 = +2.35 - (+2.50) = -0.15

Right 42 cm 100/42.0 = +2.38 - (+2.50) = -0.13

As you can see, the refractive error is very close to 0.00. The +1.50 glasses show you to be a tiny bit myopic and the +2.50s show you to be a tiny bit hyperopic. However, it is entirely possible that the OTC glasses are not exactly +1.50 and +2.50. Also, there is a possibility that the convergence response can be triggering some focus response in your ciliary muscles.

The question is: at 32, what can you do if your genetics are against you? You already realize that you probably cannot induce any true myopia and any form of hyperopia is probably a waste of time and effort. Here are the possibilities.

1. You can likely encourage early "pseudo" or "false" presbyopia. Presbyopia is actually caused by changes in the flexibility of the crystalline lenses which is a very slow process. However, by wearing + glasses to help you focus at close distances, you can de-condition your ciliary muscles and they will not be able to squeeze the crystalline lenses to focus.

2. You might be able to enjoy some pseudo myopia for a few years, until true presbyopia sets in, by wearing some low minus glasses full time. You might be able to work up to -2 or so if you do bifocals or tri-focals.

3. You could do full time GOC and work yourself up to anything you want.

I hope this helps. Remember we did no check for astigmatism. You can print out some astigmatism tests on line if you want to, but I suspect you don't have much.

If you want to try any of the above and need help, let us know.

C.


John S 03 Oct 2011, 08:32

Pete,

I meant to say a nearsighted person with a -1.50 rx. That should be about the same as placing a +1.50 lens on a normal eye.


John S 03 Oct 2011, 08:29

Pete,

There is no exact formula for converting rx to distance. It would be hard to say what a person would be able to see. An average would be the 20/60 line (American Snellen chart), if a person was nearsighted and had a +1.50 rx.

Using your measurements, you might have a slight distance rx around +0.50, if your muscles relax that might go a little higher.

Reading clearly to 42 cm with a +2.50 lens, I think you if you went for an exam you would probably get a reading rx. I would wait for an exam for at least a 3-4 months. You may be able to increase the rx some.

You can try +1.00 for distance, if it is not too blurry. It should get better.


varifocals 03 Oct 2011, 04:15

Megan.

Wear 'em!

I did the same as you & became a "headex "addict!

Now wear full time , eyes are relaxed , so it is much better.No more pills.

I dont care if my perscription goes up, comfort comes first.


Megan 03 Oct 2011, 02:33

Hi

My prescription has gone from r+0.75 -0.50 x 96 l+0.50 -0.25 x 60 to r+2.00 -1.75 x 100 l+1.5 -1.25 x 62 over that past 13 years. I am 37 and I still hardly wear my glasses because I do not have to wear them for anything specific.I even managed to get my drivers licence renewed last month.My vision is better than my husband who has a mild prescription of -1.00 with no astigmatism.I will only really wear my glasses if I plan to be reading for extended periods of time. I have been feeling a bit of eyestrain recently especially in places like malls and airports. Should I be wearing my glasses more or should I hang in there and try preserve my vision until the inevitable happens after 40?


Pete 03 Oct 2011, 01:54

Hello.

I done the test Cactus Jack mentioned.

With glasses +1.5 average results are:

left eye 63.7 cm

right eye 61.7 cm

I also done the same test with glasses +2.5 and in my opinion the readings are more believable:

left eye 42.5 cm

right eye 42 cm

I am curious the results of the test.

I will also try the test sugested by John S. Could you please explain what peopel without hyperopia will see on the selen chart with glasses on?

BTW. I am from Slovakia but I live in Scotland


John S 02 Oct 2011, 18:09

Sorry, Pete. That post was from me.


Pete 02 Oct 2011, 18:06

You might have some latent hyperopia. What is the farthest can you comfortably read with the +2.50 lenses?

If you can obtain +1.00 OTCs, see how your distance vision is with that rx. By your description, it sounds like it would be close. Most people without some hyperopia would not be able to focus 7 feet away clearly using +1.50 lenses.

The idea is to cause the muscles to relax. The best way is to keep your close work