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Mister Roberts 18 Jan 2018, 13:42

Has anybody used EyeQue cell phone self eye exam device? If so I wonder if it could be used for GOC Rx?

George1968 17 Jan 2018, 15:45


How often were you wearing your glasses before this prescription? Had you already been fulltime? If not, how are you adjusting to fulltime wear (I am assuming with the new prescription you are now a fulltime wearer).

 16 Jan 2018, 15:10

What is the maximum prism that can be obtained by decentering

a 52mm -4 lens?

Josh 16 Jan 2018, 15:02

Hi JenD, if you want to know more about your eyesight i invite you to join to then you can chat about your vision and glasses.

JenD 16 Jan 2018, 14:40

Thanks, the doctor didn't know exactly how long it had been. I just said that it had been a while. She kept asking if the image was too sharp and clear.

Soundmanpt 16 Jan 2018, 14:13


Thanks that is a big help. Okay you even included the fact that yoo're in

grad school and doing a lot of reading. Doing close work is helpful for people trying to induce myopia. Now in your case you weren't trying to do that but it doesn't matter the result is the same. In other words so much reading has probably helped to make your eyes a bit more nearsighted.

Also if it has been 2 - 3 years since you were prescribed with your -1.50 glasses going up even by -1.25 isn't out of line at all. Yes of course it is nearly twice what your glasses were but that's only because your prescription wasn't all that strong to start with. Needing an increase of -.50 per year is about normal really. Honestly i don't know why your doctor was freaking out. The increase wasn't all that much and only about average considering how long it has been since you got your other glasses. You say you're in your early to mid twenties so it's very normal for your eyes to still be changing and the added strain of extra reading is sure to add to that as well. so nothing that should make the doctor freak out.

Also if I were you I would insist on the doctor to give you -2.75 -.50 157 / -2.75 -.25 28. in your new glasses. For the difference of only -.25 it doesn't make any sense to only give you -2.50 knowing tha your going to be slightly under prescribed. That means it will be much faster for you to be returning for new glasses because you're are too weak. Your young i'm sure that your eyes won't have any problem adjusting to either -2.50 or -2.75 glasses the same way.

JenD 16 Jan 2018, 13:43

It's been quite a long time. Maybe 2-3 years. I'm in my early/mid 20s but I read a lot for graduate school. She said the prescription was probably closer to -2.75 -0.50 but she likes to give people a lower power. Should I get the thin lenses? She said I might need them now.

Soundmanpt 16 Jan 2018, 13:28


Okay I think I can help you with understanding the numbers on his prescription slip.

The OD stands of his right eye and the OS is for his left eye.

The SPH is is distance. In his case he is farsighted meaning that his glasses are mostly for helping him see things close up better. His right eye is considerably better than his left eye. The higher the number the stronger the lens. But in his case the SPH really is for his distance. In other words he needs this for things like driving a car. The CYL means he also has astigmatisms which si the shape of the internal eye. not something that you would be able to see by looking at his eyes. Again his right eye is better than his left eye there as well. Axis is not a power number but just to tell the angle the lenses needs to be positioned. The next thing is prism and he apparently only has prism in his left lens of his glasses. This is harder to explain but it means that lens is made in way to force his eyes into a certain position. How the add is in the bottom of his glasses and it is for reading from say a book. So it is even stronger than the SPH is because it is in addition to the SPH numbers you see. Since you're fascinated by your boyfriends glasses i'm sure that you tried his glasses on yourself. I doubt that you were able to see much with his glasses on and you shouldn't ear his glasses for very long because that prism can do nasty things to someones eyes that don't need prism. But because you probably can't see very well wearing them I don't thing you will have them on long enough to do any harm to your eyes.

Soundmanpt 16 Jan 2018, 13:09


Okay that helps but I ask once again how much time has gone by between these 2 prescriptions. That makes a lot f difference. If it has only been a year then going up a full diopter is quite a bit, not terrible though. But if it has been 2 or 3 years in between then your eyes didn't really change much from year to year.

i can tell you that at -1.50 you were around the point of starting to need your glasses full time. At that point it was up to you if you wanted to wear glasses full time or not. Now you really should be wearing glasses full time. Again though I really need to know the time frame of both prescriptions to answer you better.

Josh 16 Jan 2018, 12:54


I guess you didn´t wear your glasses fulltime, that way i could say you didn´t notice how bad your eyes really were, now it´s time to go fulltime, could you tell your age?

Andrew 16 Jan 2018, 09:22


Many years ago, I had a similar jump in my prescription. As I was a student at the time, it was described to me as being at the upper limit if “normal.” It had also been a year since my previous sight test (if not a little longer). I don’t know how long you left it between eye tests, but if the optician did not ask to see you rather sooner than before, it might be a good idea to go back in six months rather than leaving it a year (or more). Age and occupation can also be a factor.

JenD 16 Jan 2018, 03:33

Forgot to post the new prescription!

It is

-2.50 -0.50 157

-2.50 -0.25 028

Weirdeyes 16 Jan 2018, 00:47


They are plus lenses which magnify your eyes. Your boyfriend is farsighted. A normal eye relaxes for distance, but uses the ciliary muscles to focus up close. Someone who is farsighted has to use the ciliary muscles to focus at all distances. So they might be able to see clearly at all distances. Unfortunately this causes eyestrain. Since your boyfriend has bifocals I assume he probably can’t focus very much anymore. That means his vision is probably blurry at all distances. He has astigmatism, which makes things blurry and distorted at all distances. Since he has base out prism that means his eyes have a tendency to cross. Out of curiosity do his eyes look different sizes when he wears glasses? I have a somewhat similar prescription and I worry about that.

Marianna 16 Jan 2018, 00:18

Always been fascinated by my boyfriend's glasses. They magnify his eyes and came across this site so I can get a better understanding of why. I found his prescription and this is what is written on it. I would really appreciate if someone will tell me what it all means.


SPH +2.50

CYL -0.50

AXIS 105

ADD 1.50


SPH +4.00

CYL -1.25

AXIS 135



ADD 1.50


Josh 15 Jan 2018, 20:50

JenD, for what you said your current rx is around -5, so it´s wise what dr said, very dangerous driving without correction, even with your current glasses you are very nearsighted. make sure to get your new glasses soon.

Soundmanpt 15 Jan 2018, 13:56


We can't really answer your question because you didn't provide what your new prescription has increased to? It sounds like you had a really big increase the 20/400 doesn't really help. also how long ago was it when you got the -1.50 -.25 160 / -1.50 prescription?

JenD 15 Jan 2018, 13:25

Is my vision really a lot worse?

I just had an eye exam and my doctor was freaking out a little about how poorly I see in my current glasses. She said I wouldn't be legal to drive with them on and my vision has worsened to 20/400 without glasses. She was definitely quite surprised that I didn't get new glasses sooner and kept saying that the image with my new glasses on might be really sharp and take a while to adjust to. She also said that she didn't give me an extra step in power because the change was already quite big. Is she exaggerating?

Old prescription: -1.50 -0.25 160; -1.50

New prescription is attached.

GreginColo 12 Jan 2018, 06:03

Paul, just curious about how the latest exam went for your older son. Thanks in advance for the update if you choose to provide one.

Puffin 08 Jan 2018, 15:28


Glad to hear Maddie is adapting to her glasses and suddenly much clearer vision.

And that word "adapting" is important, because it doesn't happen overnight; it's as if her visual system needs to be coaxed from ignoring the useless fog in the distance to deciphering what can now be seen. So that's one reason why Maddie isn't given the full (assumed) prescription right away - the results of such a sudden change (from fog to clear-ish) are not always predictable, so it is wise to be cautious. It's not as if she needs to drive a car, and correcting most of her myopia is a lot better than nothing.

The ECP is also trying to avoid overcorrecting Maddie's vision, thus making her hyperopic (ie the opposite situation to hers). This would bring other difficulties such as eyestrain and/or a squint (a turned in eye) which would be problematic to resolve. So, caution first, avoid overcorrection, give her most of her prescription and see what happens.

As for her level of myopia, well some decades ago I thought anything over 10 dioptres just didn't exist - I was initially surprised when I read about cases over that level. Since then I've spent many years reading about vision and by now there's not much that surprises me.

I have read of a case of a woman who was born with ~17 dioptres of myopia in each eye but her prescription did not change that much as she grew into adulthood, only by 5 or 6 dioptres, which is not that much of an increase.

So don''t worry. Let Maddie get used to seeing, and let the ECP decide what to do in six months time; by then the situation will be clearer, in all senses.

 08 Jan 2018, 13:14

Katie 02 Jan 2018, 23:59

Maddie's first day with glasses was great! It was like the glasses gave her joy, and put a spark in her day, not to mention, she looks cute as a button with her little glasses. I was a bit nervous about her needing glasses so young, especially because of the high prescription, but after watching her today, I can'y complain. I can only imagine how much life her full prescription will give her. Plus, she starts vision therapy Thursday, hopefully that will help her too.

Cactus Jack 02 Jan 2018, 16:25


I think in a few days, Maddie, will start becoming a different child. Her world has been very small, but there is no way she could have experienced what it is like to really be able to see things.

It may happen as soon as bed time tonight, but don't be surprised if she cries when you take her glasses off and may cry until you help her put them on in the morning.

It is common for a first prescription to be under corrected in young children. It makes it easier for them to learn to see.

Remember she has a whole world to discover. In a few days she will be playing catch up. Help her to discover that world.


Soundmanpt 02 Jan 2018, 14:47


Cactus jack has been providing you with very good advice so i don't wish to enter into that at all. But I will say the reason Maddie is keeping her glasses on is because even at 3 she is able to see the improvement that her glasses are providing her. If they were helping her you can be sure she might not be so willing to wear them.

Katie 02 Jan 2018, 14:08

I took Maddie in to get her new glasses today. Because they saw how I was not sure of her glasses or preacription, they were kind enough to take us back in to the examination room to show me that maddie, is actually very nearsighted, and that while her current glasses will help her see, she actually needs an even stronger prescription.

We have been home a few hours now, and Maddie does not seem to mind her glasses at all. She has kept them on this whole time, and I can see the difference, she seems more smiley and active. She is actually playing around.

Paul 01 Jan 2018, 15:49

Cactus I really appreciate you taking the time to give a detailed answer.

I fear what you say will be close to the eyetest result on Wednesday. Malc carefully tried on his brothers' glasses and can see the TV clearly with both, he thought Jack's better. The previous under prescription and degenerating vision means we have to expect a massive increase.

I expect the cross eyes will also need attention. Poor lad also has astigmatis. A lot to bear for a 4 year old.

In our home he fooled us all. Only when out and about did we realise the extent of the problem.

Cactus Jack 01 Jan 2018, 14:57


Motion sickness is typically caused by a difference between what your eye are seeing and what your semi-circular canals are feeling.

The brain often compensates for problems with one sense (vision) by developing another sense to extreme levels. Sometimes is is hearing, but Malc may have developed very high sensitivity to balance signals from his semi-circular canals. When I was young, I absolutely could not read in a car, without getting nauseous.

I think his Myopia has increased enough, that looking out the windows of the car is a waste of time.

It appears that you like to work in English measurements rather than Metric. Here is a simple formula for calculating effective lens power. Just divide the distance in inches into 40. It is not exact because 1 meter = 39.37 inches, but close enough. If Malc is holding something about 6 inches from his eyes to see something clearly with his glasses, it means that he needs about, 40 / 6 = 6.66 diopters, more correction in his glasses. The calculation is not very exact in this case, because of Vertex Distance effects with high prescription glasses. I suspect Malc needs somewhere around -16 of correction. Because of Vertex Distance effects, that would require glasses in the -20 range to produce -16 at his corneas. I don't know if Jack's glasses are large enough to allow Malc to try them, but it might be an interesting experiment to let Malc try them and ask what he can see with each eye individually. Also, if you have any of Malc's weaker glasses you might asking him what he can see wearing them over his -10 glasses.

It is very sad, but a fact of life that your boys are very Myopic. I would suggest that you and your brother should look on the bright side of a bad situation. We live in an age of incredible advances in understanding genetics, sequencing genes, and on the threshold of being able to correct genetic problems and also correct gene related health problems. Hopefully, these advance will benefit your boys in the future and their Progressive Myopia can be stopped in the near future and perhaps even reversed. The important thing right now, is to give the boys the best possible vision. Vision is the most important factor (80%) in learning.

When you say that Malc keeps loosing his glasses, is he misplacing them or purposely taking them off? It may be that they are just not providing enough benefit ti be worth bothering with.

It is pretty common to under prescribe first glasses if the prescription is high. Children with high myopia typically do not know how to use their Ciliary Muscles (Focusing Muscles) for focusing close and they have to learn how to do it. Once they develop the ability to use their focusing muscles, most ECPs will prescribe full prescription for distance. However, in the case of Progressive Myopia, some ECPs will prescribe bifocals or separate glasses for read in the hopes that it will minimize the rate of increase. There is a theory that the focusing effort stimulates eyeball growth and increased myopia is the result.

You did not mention that Malc is having some problem with his eyes crossing. I mentioned that my background is Electronic and Computer Engineering. i have studied and tried to analyze how the Eye Positioning Control System works because I also have a problem with my eyes trying to cross. Typically, children with very high Hyperopia or long sightedness have more problems with their eyes trying to cross than children who have high Myopia, Like Malc, Jack and Will. I have a theory that is pretty involved. I will try to explain that in my next post.

Again, I hope this is helping. Please feel free to tell me if you are having trouble understanding any of this.


Paul 01 Jan 2018, 09:53

Hopefully someone can help to put our minds at rest.

Malc is causing concern. Yesterday we drove south to catch up with my brother home from France for Hogmanay. Malc was very car sick both ways, he has not done that since he first got glasses, he didn't look out of the window, just held a picture of his favourite character right infront of his nose.

He loves Uncle Brian, my brother, but when we got to the house he seemed to be confused which man was his uncle. He made no smiles until Brian came over and picked him up.

Brian hasn't seen the twins since they got their glasses and when the two of us went for a short walk he cried when talking about the sight of his two nephews wearing such thick strong glasses. Brian asked if Malc 's vision was poor again. He had given Malc a pack of playing card of his favourite cartoon pictures and he only recognised them when he held the cards very close. Brian tried to play snap with Malc and Malc got everything wrong and kept lifting the card nearer.

We drove home this morning and there were two cars in the driveway, Malc asked which one was ours.

Since getting home I have tried to be calm but have been testing what Malc can see. It seems he needs to hold the cards about 6 inches or less before he recognises the picture.

The past six weeks have been manic. The twins got their glasses, work at the shop long hours before and after Christmas, a flu bug hit the kids. I feel guilty to say we have not been over concerned until yesterday. Malc keeps losing his glasses and after reading below it maybe they just don't give good vision any more.

I thought the doctor said they would not under prescribe Malc last time, could I have misunderstood and this coupled with worsening vision means he just cant see well now.

Thankfully we changed his visit for an eyetest to this Wednesday, I am anxious what strength glasses he will now need. The doctor has said his condition is pathologically progressive and they hopefully could slow things down. I know his eyes have become a lot more crossed recently.

What sort of increase is likely in 6 months? How strong do they make glasses suitable for him to wear to get good results?

Sorry to ramble on but we are now worried.

Cactus Jack 31 Dec 2017, 16:54


I was working on the post below, off line, and did not see your additional questions.

I am not surprised that your ECP under corrected Maddie. i should have mentioned that as a possibility.

There can be several reasons why full correction for for high Myopia does not provide 20/20 vision. The most obvious one is what Weirdeyes mentioned. Vertex Distance effects cause all kinds of thing to happen to the images delivered to the eye. The most obvious one is minification of the images, which you experience with your prescription. There is another VD effect related to the distance of the back surface of the glasses from the Cornea. The farther a Minus lens is from the Cornea, the less effective it is. For example, a -18 lens 10 mm from the Cornea has an effective power at the Cornea of -14.75.

The minification effect makes things smaller on the Retina. The Retina has millions of Rods and Cones, but only about 1 million nerve fibers in the optic nerve. The Retina does preliminary image processing to compress the signals from the rods and cones and if something is very small, it may get lost in the compression process. Not unlike what takes place in a digital camera. That means that a person who wears very high minus glasses Visual Acuity, even with perfect correction, drops below 20/20. Contact Lenses have Zero Vertex Distance, so the image is not minified very much and better Visual Acuity results.

Another factor affecting VA is that if the eyeball gets elongated too much, the Retina can get stretched and that can cause distortion with the risk of Retinal Detachment.

Maddie is much too young to wear contact lenses.


Cactus Jack 31 Dec 2017, 16:12


You have the numbers right. However, Your Astigmatism is very significant while Maddie's is pretty much a nuisance. I suspect your Sphere prescription has stabilized and your Axial Myopia is not dangerously high. Maddie needs to be monitored by her ECP to be aware of Retinal Detachment as she gets older.

The problem is not with her eyes, but her genes are the likely cause. Axial Myopia is caused by a mismatch between the PLUS power of her eye's lens system or the length of her eyeballs. Either one, or both together, can cause Myopia.

Unfortunately, there is no simple way to estimate a 2 or 3 year old’s refractive error without optometric tools.

An Eye Exam has two parts. The Objective part, where the Examiner looks into your eyes with an Ophthalmoscope or an Auto Refractor and the Subjective part, where you tell the examiner what you see. Maddie is too young to be able to tell the examiner what she sees with any accuracy. I suspect they used an Auto Refractor to get close to her prescription.

You can request a re-check of her prescription if it would make you feel more comfortable , but that may not be necessary or even useful. I can almost guarantee that the prescription is NOT exactly correct, but it may be acceptable for the visual needs of a 2 year old. There may be an easier way to tell if the glasses are close to what she needs.

The first thing is to observe her visual habits, can you estimate her recognition distance? In other words, how close does something have be for her to recognize it and reach for it? Does she appear to recognize a close relative by voice sound or clothing color, rather than by sight?

Does she run into things? If the prescription is pretty close, she does not see anything clearly beyond about 3 inches or 8 cm from her eyes.

How does she react to wearing the glasses, after she gets over the strangeness of having them on. Most children initially fight wearing glasses until they discover what they have been missing. From then on, they get upset when they have to take them off. You won’t have to force her to wear them she will want wear them because she has a lot of catching up to do.

In her situation, a weaker pair of glasses won’t slow down her Myopia. She is growing and so are her eyeballs. It might help a little to wear weaker glasses when she starts trying to focus close to read or look at picture books, but you ECP is the person to ask. The most important thing right now is to let her vision develop. Her brain has to learn to see and learn how to use her Ciliary Muscles to focus and how to control her eye positioning muscles.

I hope this helps. Please let us know how she reacts to the glasses.

May I ask where you live? (Country)


Weirdeyes 31 Dec 2017, 13:32


I’m not an expert in myopia, but part of the reason she can’t see 20/20 with her full prescription is because of minification. Her glasses make things look smaller. Making it stronger will only make the minification worse. Contact lenses help with this.

Katie 31 Dec 2017, 13:26

One more thing, that I don't understand is that the doctor said she will not be able to see 20/20 with her glasses even in 6 months with the full prescription. Why not? Can't they just give her a higher prescription to help her see even better?

Katie 31 Dec 2017, 13:21

Also, I forgot to mention, but it might be important, the doctor is not giving her her full prescription now. She will give that in 6 months, and in three months she will increase the prescription by 2.5 diopters (half of what she took out). Leaving her at -17.5 and -20.25 for her sphere, which is what the doctor said her true prescription is.

Weirdeyes 31 Dec 2017, 13:07


Plus glasses won’t help at all in her case. She’s already very nearsighted. The theory for wearing plus glasses is to stop you from focusing too much when doing close work. The typical reading distance is 14 to 16 inches. The furthest she can see without glasses is about 3 inches. What might work is a reduced prescription for close up work, but that’s generally not necessary.

Katie 31 Dec 2017, 12:41

So, I assume that makes Maddie's -13.5 and -16.75 along the short axis. This still makes her prescription higher than mine, and there is a 25 year age difference. Plus the fact that she is only 2 and this is her first pair. Is there something wrong with her eyes that is making her vision so bad? Also back to my initial question. How do I know if this is her actual prescription and not a mistake? Because her prescription is awfully high. Also, when the glasses come should I make her wear them all the time, won't that just make her eyesight even worse? Should I get her a weaker pair to wear all the time so her glasses do not cause her already bad eyesight to get even worse? Along the same line, should she wear a pair of + or reading glasses for reading and other close work when she gets older to help keep her eyesight from getting even worse than it ultimately naturally will?

Cactus Jack 31 Dec 2017, 12:01


You have substantially more astigmatism than your younger sister, along with your Myopia. You said your sister has a different father. I suspect you both inherited a predisposition for Myopia from your common mother.

Myopia and Astigmatism have different causes. Axial or True Myopia is caused by a mismatch between the total PLUS power of the eye's lens system and the length of the eyeball. Astigmatism is typically caused by uneven curvature of the front surface of the Cornea.

The Axis angle is the Long Axis of the Cylinder correction. The Cylinder power on the Long Axis is 0.00. However the Cylinder power along the Short axis (90 degrees from the Long axis) is the power listed.

Your lens powers are

-9.25 along the Long Axis and -13.25 along the Short Axis


-8.75 along the Long Axis and -14.50 along the Short Axis


GreginColo 31 Dec 2017, 11:24


No doubt you know your boys will have some visual challenges as they grow up, but good these were caught early while much on their early development is occurring. As you have already, seen Cactus Jack is a wealth of information to supplement what you learn from your ECP.

If I am recalling correctly, there was a similar post some while back from a mother, i think in the UK, whose youngsters, forget if they were boys or girls or a combination, had early high myopia similar to your sons. I think she posted under the name "Concerned Mama" if a recall correctly. I don't recall any recent posts from her, to see how her kids are progressing, but that might be a possible resource for you.

There is a lesser known US actor named Jon Tyler, who has been very open in sharing some about his visual history and need for strong myopic correction, if I recall beginning around age 2, similar to the Rx of your younger guys. In his case one of his siblings was also very myopic, but two others had fairly normal vision, so its weird how genetics work.

Do you know the Rx of of your boys' ancestors with myopia, and at what age they started needing glasses. Also do the boys have cousins from the the same ancestry, and if so, how is their vision.

I know it may seem overwhelming, and no doubt scary, at the time but you seem to be asking the right questions and getting the right help for your sons. Best wishes to you and your family.

Cactus Jack 31 Dec 2017, 11:20


There are some excellent eye hospitals in the UK. One of the best in the world is Moorfields, in London.

Thanks for the info on your education. I'll try to not get too deep into the math and physics. If you don't understand something, please tell me.

I don't know how it is in the UK, but for years it was said that you had to have a University degree to be successful. That has turned out to be poor advice, particularly if you spend a lot of money and get a degree in a field that is not very marketable. The most important thing is to learn how to learn and never stop studying and learning. I graduated from High School in 1954, at that time Computers were "laboratory curiosities". Thomas Watson, head of IBM, said that he thought there might be a market for 12 computers in the world. Of course, back then, the integrated circuit and microprocessor had not even been imagined. My electronics education involved vacuum tubes. I worked my way thru college fixing TVs, mostly replacing burned out tubes. These days about the only vacuum tubes are the Picture Tubes in old TVs, but they have almost disappeared. I had to teach myself about how Computers work and how to apply them for solving problems.

It is very likely that your boys will become more nearsighted, but you and your wife did good by catching it early and seeking care for them. Malc is growing and his eyeballs are also growing which will increase his Myopia. The good thing is that he knows to tell you when he can't see well. You might want to ask his doctor if a reduced prescription for reading might slow the rate of increase.

There is a simple reason why Will lets you know if you get the glasses wrong and Jack does not. Will needs -24 to be able to see pretty well. If he wears Jack's glasses, the difference in the two lenses, are uncomfortable and he does not see very well beyond about 6 inches with one eye and 12 inches with the other. When Jack is wearing Will's -24 glasses, he can easily compensate by using his Ciliary Muscles and Crystalline Lenses (his auto-focus system) to compensate for the extra Minus. Unfortunately, it does not work the other way around. Will (nor anyone else) can reduce the fully relaxed power of his Crystalline Lens to make up for the additional Minus that he needs for distance.

Sometimes, it is desirable to remove the Crystalline Lens (see previous post) in people who are very Myopic, to reduce the Minus Power they need in their glasses.

That can actually improve their Visual Acuity. The explanation for that is a bit complex so lets don't worry about that right now.

The surgery is actually the same as Cataract Surgery. The downside is that they loose their ability to focus. There are solutions for that.

There is considerable R & D being done to improve vision for people who are very Myopic. You boys will likely benefit from future developments.

Your family history and situation might be useful for genetic research. You might enquire if DNA samples from you, your wife, and your boys would be helpful in identifying the genes that cause extreme Myopia. Obtaining a DNA sample is a painless swab from inside the cheek.

Let me know, if you have more questions.


Katie 31 Dec 2017, 08:46

I am 27 and my prescription is -9.25, -4.00 and -8.75, -5.75.

Paul 31 Dec 2017, 05:46

Hi cactus,

Thanks for the reply. Jack and Will are identical twins and see the same eye doctor at the hospital who sees Malc. We live in Northern Scotland. My education suffered as we started a family so young and I continue to work in the same supermarket in Elgin.

I fear that all three have a condition which will get worse, how bad can it get? We have brought forward Malc's eyetest to next week as he says he cant see the TV unless he sits right up close. He has an ipad and holds that very very close too, we were told to watch out for that. His last new glasses were in June.

We try to be very careful with the twins but sometimes I get the glasses the wrong way round. Wills lets me know straightaway but Jack doesn't seem bothered. Without glasses they just lie still but with glasses they are into everything. They are retested end of January.

The doctor says the twins are the most severe he has seen in 30years and says when older they may operate to remove the eyelens, I think that's right.

Cactus Jack 31 Dec 2017, 05:16


May I ask your age and prescription?


Katie 31 Dec 2017, 00:13

Hi, thanks for getting back to me. My sister is almost 3. I am not sure about her dad's side of the family, but on our mom's side, there is me, our grandma and an aunt and an uncle. Another thing that had me worried was how different her eyes are, but I reading what you said to Paul, I guess it is not much.

Cactus Jack 30 Dec 2017, 22:33


One other comment. There is not that much difference between Jack's and Will's prescription. It seems like a lot, but if the cause of the myopia is the distance from the Crystalline Lens to the Retina, there is less than 1 mm difference between -21 and -24.


Cactus Jack 30 Dec 2017, 22:25


Unfortunately, It appears that your boys are the exception to what I told Katie. Hyperopia sometimes gets better, but Myopia typically increases as a child grows.

The eyes are biological cameras and the optics of the eyes obey the Laws of Optics codified by Sir Isaac Newton, of gravity fame, over 300 years ago.

Occasionally, babies are born with Myopia. It appears that in your boys case, there is a genetic link from your wife's father and from your father's father.

I have several questions I would like to ask. They are not personal questions, but if you would prefer to answer privately I will provide an email address:

1. Where do you live? (country)

2. What is your educational background in math and the sciences? (helps me answer questions)

3. Are your boys under the care of an Eye Care Professional who specializes in High or Progressive Myopia?

4. If so, has there been any mention or explanation of the optics of the eye or the usual causes of Myopia?

5. Are Jack and Will identical or fraternal twins?

A couple of comments:

The 3 diopter mismatch in Jack's eyes are nothing to get very excited about. The eyes develop independently and not common to have exactly the same prescription in both eyes. I suspect Will has some difference, but at 1 year old there is no way to determine what it is exactly using an auto-refractor or an Ophthalmoscope. The important thing is to provide them with correction that allows them to see, with reasonable clarity, objects that are more than about 5 cm or 2 inches away. Without his -10 glasses, everything is very blurry for Malcolm beyond about 10 cm or 4 inches.

By the way, I am 80. I am NOT an Eye Care Professional (ECP). My background is Electronic Engineering and Computers (IOW, Problem Solving). I studied Optics in Physics and became seriously interested in Vision, when I was told by ECPs that a particular problem I had, could not be corrected. I did not believe them and started working on the problem with an understanding ECP. Turned out it could be corrected and the ECP and I became friends. He thought I should be teaching.

I guess you could call me an Amateur in the original French sense, as one who studies a subject out of Love of Knowledge about the subject.

I would like to find you to easy-to-understand explanation of the optics of the eye. I had a link to a paper that was excellent, but when the hard disk crashed, that was one of the things that was lost. I will look for a good explanation.

I will try to explain, in words, until I can find some easy to understand illustrations.

The eyes are similar to high end Digital Cameras. The lens system actually has 4 elements that contribute to the total PLUS power of the system. From front to back the lenses are:

1. The Cornea - Fixed Focus and normally strong PLUS (in adults about +40 diopters)

2. Aqueous Humor - Fixed Focus and normally weak PLUS. So weak it is typically ignored in most explanations.

3. Crystalline Lens - Variable Focus. About +20 diopters when relaxed for distance. The Ciliary Muscles can typically squeeze the Crystalline Lens to increase its power to more than +33 diopters in children to allow them to focus very close.

4. Vitreous Humor - Fixed Focus weak PLUS transparent gel. It is typically ignored also.

The Retina is like the film or Digital Image Sensor in the camera.

Note that all the lenses are PLUS lenses and the total varies with the individual. In a adult the relaxed total is around +59 diopters.

The most basic law of optics is pretty simple. It states that a +1.00 diopter lens will focus parallel rays of light from a distant object at a distance of 1 meter, 100 cm or 1000 mm. Mathematically, it is expressed for our purposes as: Lens Power in Diopters = 1000 mm / Focal Distance in mm.

An adult eye is about 25 mm (1 inch) in diameter. The lenses are inset into the eye and the typical distance for a person who does not need any correction is about 17 mm. If we divide 17 mm into 1000 mm the result is about +59 diopters Sound familiar?

If the eye is smaller than 25 mm or 1 inch, as it is in a baby, the distance from the Crystalline Lens to the Retina is much less than 17 mm and it takes more PLUS to focus closer. Normally, a baby will learn to use his Ciliary Muscles to supply that extra PLUS in a month or so.

Optically, there can only be two causes of the high Myopia. Either their lens system is much stronger than than what is required or their eyeballs are a bit longer (larger than is typical).

I hope this makes sense. I look forward to your response. If you would like to chat privately, my email address is


Paul 30 Dec 2017, 19:21

We are young parents, I am 22 my wife 21. We have three lovely boys. Malcolm just 4 and one year old twins, Jack and Will.

We noticed Malc bumped into things when he started to walk, turned out he needed glasses. His prescription has got worse and he now wears minus 10 glasses. He likes them and is no problem.

The twins seemed to pay no attention to faces when smaller and they are also now wearing glasses but much stronger. Jack has mismatched eyes one minus 18 the other minus 21. His brother Will has a staggering minus 24 both eyes.

Neither my wife nor I wear glasses. My late father in law was very short sighted as was my paternal grandfather. No other family members wear glasses.

I am hoping from what you say Cactus that their visions will improve as they grow older.

Cactus Jack 30 Dec 2017, 18:09

Hi Katie,

How old is your sister? Does myopia run in your family? High Myopia usually has a genetic component.


antonio 30 Dec 2017, 17:52

Is your younger sister blinder than you without glasses ? Just test it. If not the doctor might have confused prescriptions.

How far can your sister identify a designed animal on an image clearly. Write here and we can calculate . How near does she hold a picture book to her eyes ?

Best regards Katie, antonio

Confused 30 Dec 2017, 16:53

Hi, my name is Katie, and my younger sister just got prescribed glasses for the first time. I also wear glasses, have most of my life, and am pretty nearsighted, or so I thought until my sister got her prescription. I think the doctor made a mistake. Her prescription is higher than mine. Anyways, this is her prescription: Right eye: -12.5, -1.00, 70 and left eye: -15.25, -1.5 and 025. How do I know if her prescription is correct? Without taking her in for another appointment? The prescription just seems awfully high for a kid. Any thoughts?

Cactus Jack 30 Dec 2017, 16:34


I suggest you read "how to Study for an Eye Exam" before your appointment. Complaining that your vision is worse in low light condition is also a good complaint.


Joey 30 Dec 2017, 11:24


I got glasses 2 years ago for a tiny prescription of -0.25 and -0.25 cyl -0.50. I am going for another appointment and am wondering if i say im having troubles seeing at night would they increase it? I plan on saying red is clearer once as well.

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