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Hyperopia and Presbyopia Progression

For and about anyone having difficulty seeing near/reading.

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NNVisitor 21 Jul 2017, 12:06

Xplore

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

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


NNVisitor 21 Jul 2017, 12:06

Xplore

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

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


Cactus Jack 21 Jul 2017, 08:17

Xplore,

You posted

Left +3.75 SPH -0.25 CYL. 25 AXIS

Right +3.50 SPH. 0.50 CYL. 170 AXIS

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

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

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

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

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

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

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

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

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

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

Hope this helps some.

May I ask where you live?

C.


Xplore 21 Jul 2017, 06:57

Cactus Jack,

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

I should try?


Cactus Jack 21 Jul 2017, 02:14

Xplore,

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

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

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

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

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

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

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

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

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

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

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

C.


Xplore 20 Jul 2017, 22:41

Cactus Jack

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

Left +3.75 SPH -0.25 CYL. 25 AXIS

Right +3.50 SPH. 0.50 CYL. 170 AXIS

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

Solution that works with them.

Thanks


Cactus Jack 20 Jul 2017, 11:14

Xplore,

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

C.


Cactus Jack 20 Jul 2017, 11:11

Explore,

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

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

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

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

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

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

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

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

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

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

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

Please let us know how we can help.

C.


Xplore 20 Jul 2017, 08:01

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

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


Greg 18 Jul 2017, 07:45

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


Plus Tony 12 Jul 2017, 10:25

Hi Greg

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


NNVisitor 11 Jul 2017, 23:40

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


john 11 Jul 2017, 20:09

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


Maxim 11 Jul 2017, 16:25

amendment to Cactus Jacks remark:

I have got both, progressives and lined bifocals.

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

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


Greg 11 Jul 2017, 14:35

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


Cactus Jack 10 Jul 2017, 17:43

Alix,

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

C.


Alix 10 Jul 2017, 16:12

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


NNVisitor 08 Jul 2017, 21:35

Alix

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


Andrew 08 Jul 2017, 13:54

Alix,

Yes.


Charlie_Delta 08 Jul 2017, 10:57

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

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


Cactus Jack 07 Jul 2017, 20:19

Alix,

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

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

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

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

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

Just remember that lenses typically come in 0.25 diopter increments.

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

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

C.


Alix 07 Jul 2017, 19:13

Hi guys,

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


Plus Tony 07 Jul 2017, 05:08

Carrie

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

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

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


Cactus Jack 05 Jul 2017, 18:41

Guest,

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

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

C.


Roy 05 Jul 2017, 06:40

Guest,

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

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

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


Guest 05 Jul 2017, 03:56

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


Guest 05 Jul 2017, 03:56

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


Guest 05 Jul 2017, 03:56

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


Soundmanpt 04 Jul 2017, 10:01

Carrie

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


Carrie 03 Jul 2017, 12:41

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

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

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

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

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


Charlie_Delta 29 Jun 2017, 14:29

Rubydunes,

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

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

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

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

Sage advise and points well taken on everything you mention.

Cheers,

Charlie


Ruby dunes 29 Jun 2017, 12:59

Charlie- Delta,

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

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

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

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

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

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

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


Lou 29 Jun 2017, 11:13

Hi

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

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

Anyway, my prescription is unchanged at:

R: +0.50 Sphere -0.50 Cylinder Axis 92

L: +0.25 Sphere -0.25 Cylinder Axis 85.

All the best

Lou


Soundmanpt 29 Jun 2017, 10:14

Carrie

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


Lou 29 Jun 2017, 04:51

Hi Rubydubes

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

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

Best wishes

Lou


Carrie 28 Jun 2017, 13:54

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


Charlie_Delta 28 Jun 2017, 11:06

Rubydubs,

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

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

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

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

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

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

Charlie


Rubydubes 27 Jun 2017, 16:03

Hi Lou-

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

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

R: +4.5 -1.00 ADD +1.5

L +2.25 -.25 ADD +1.5

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

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

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

I have read that hyperopia can fluctuate during the day.

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


Lou 27 Jun 2017, 14:43

Hi Mike

It does help, thank you very much.

Your response was much appreciated.

Take care

Lou


Mike 27 Jun 2017, 12:09

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


Lou 27 Jun 2017, 09:39

Hi

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

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

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

Many Thanks

Lou

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

R: +0.50 Sph -0.50 Cyl Axis 90

L: +0.25 Sph -0.25 Cyl Axis 80

up to:

R: +0.75 Sph -0.75 Cyl Axis 92

L: +0.50 Sph -0.25 Cyl Axis 83

down to:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.50 Sph -0.50 Cyl Axis 83

down further to:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.25 Sph -0.25 Cyl Axis 85

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

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

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

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

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

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

I'm 43


NNVisitor 25 Jun 2017, 11:13

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

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


 25 Jun 2017, 10:18

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


Lou 24 Jun 2017, 05:10

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

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

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

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

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

I'm 43

My full prescription is:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.25 Sph -0.25 Cyl Axis 85

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

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

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

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

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

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

Many Thanks in advance


 23 Jun 2017, 19:17

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

How do you find reading with your glasses on?


Lou 23 Jun 2017, 08:10

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

R: +0.50 Sph -0.50 Cyl Axis 90

L: +0.25 Sph -0.25 Cyl Axis 80

up to:

R: +0.75 Sph -0.75 Cyl Axis 92

L: +0.50 Sph -0.25 Cyl Axis 83

down to:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.50 Sph -0.50 Cyl Axis 83

down further to:

R: +0.50 Sph -0.50 Cyl Axis 92

L: +0.25 Sph -0.25 Cyl Axis 85

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

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

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

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

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

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

I'm 43


cactus Jack 22 Jun 2017, 08:23

Mike,

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

C.


Mike 22 Jun 2017, 07:04

Cactus Jack

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


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