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Hyperopia and Presbyopia Progression

For and about anyone having difficulty seeing near/reading.

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Maurice 29 Mar 2017, 12:24

Plus Tony, good to hear from you. Glad the single vision lenses are still doing their job. Keep us posted when you graduate to multifocal lenses. Thanks, Maurice

Plus Tony 23 Mar 2017, 11:14

Hello Maurice

Not yet. I'm still wearing my single vision prescription 100% of the time but there has been so sign of any deterioration in my vision. I know that I can handle a bit of extra plus for distance from my own experiments and although I have been tempted to self prescribe I have stuck to my official prescription for now partly because I am very fond of the glasses that I usually wear. Remarkably even though I've been wearing specs full time for over 18 months I still encounter people who haven't seen me wearing them and who ask all the standard questions which I still quite enjoy. I would be happy to have an increase but I'm prepared to be patient.

Maurice 22 Mar 2017, 12:47

Plus Tony, hope that you are seeing well. Just wondering if you had yet "graduated" to bifocals/progressives?

hooked 13 Mar 2017, 15:37

Thanks for your Explanation.

No, it is clear for me that a doctor doesn't Support any efforts in getting more myopic or hyperopic and I don't Support that, too. But I read some links and maybe there are some People who want to stay with their used-to refraction error. In any case you usually need glasses after the Operation (may it be reading glasses or some small shortsightedness) hence there may be not so much a difference.

Cactus Jack 13 Mar 2017, 10:08


I am not an Eye Care Professional (ECP), but an Amateur in the original French sense as a person who studies or learns a subject out of Love of Knowledge. Most of what i have leaned about vision is in trying to solve my own vision problems when I could not get satisfying answers from my ECOs.

My background is Electronic Engineering and Computer to solve Industrial problems. I have done quite a bit of industrial teaching and have a reputation as a pretty good explainer.

Most Eye Surgeons will offer choices when deciding what IOLs to install during Cataract Surgery. However, they try to get close to 6/6 or 20/20 vision. I am 79 and had Cataract Surgery in 2001. I opted for Mono-vision where one eye is close to 0.00 and the other is about -1.50. Mono-vision allows me to function without my glasses, but I wear trifocals when I need really good vision.

Most Eye Surgeons will install IOLs that let you remain Myopic or Hyperopic, IF you have a very good reason. The reason most of them became doctors is that they want to help people have better lives. They are psychologically disposed to try to make things "better". Some will install IOLs that make a person more Myopic or Hyperopic, but there usually needs to be a confirmed diagnosis of BIID (Body Integrity Identity Disorder)

These days, few people have the old type Cataract Surgery where the Crystalline Lens and Capsule are completely removed. There has to be a medical reason for not replacing the Crystalline Lens with an IOL. If the Crystalline Lens and Capsule is completely removed, the surgery goes from a fairly easy, low risk, Outpatient procedure to a serious, risky, surgery that often requires weeks or months for recovery. it becomes necessary to wear very high PLUS glasses which severely limit peripheral vision.

Before you wish very high PLUS glasses on another person, you need to get some experience wearing them. You can do that by doing some GOC with some high minus contacts and appropriate high PLUS glasses.


hooked 13 Mar 2017, 07:43

Thank you for that excellent explanation. I didn't know these details.

I was just wondering because I always thought hyperopia won't increase when getting older.

Are you an expert?

You mentioned cataract surgery and you mentioned one can choose the final prescription.

Do you think (or know any studies) that there are some people which won't be corrected to zero diopters but prefer to stay myopic/hyperopic?

Cactus Jack 10 Mar 2017, 08:07


The amount of her increase is very small, in the overall scheme of things. It is interesting that at age 20 her prescription was approximately +6. it decreased over the years and then started increasing at an age where Presbyopia becomes a factor. Her distance prescription is almost where it was at age 20.

The laws of Optical Physics are NOT variable and the tissue that makes up the eyeball, while not a rigid a bone, it is pretty dense and stiff. 1/2 diopter change is really tiny and the cause could be anywhere. Could the eyeball have shrunk 0.15 mm, sure, but it is more likely that there was a tiny change in the eye's lens system.

The eye's lens system actually consists of 4 PLUS lenses, but we only typically think of the Cornea and the Crystalline Lenses. The other two lenses are actually liquids. The Aqueous Humor (AH), between the Cornea and the Crystalline Lens, and the Vitreous Humor (VH), inside the eyeball, between the Crystalline Lens and the Retina. The AH does not contribute much PLUS and the VH contributes more. The Index of Refraction of the Humors can change as ones blood chemistry changes. The Humors seem to be particularly sensitive to Blood Glucose (BG) levels, that is why people with Diabetes experience vision changes as their BG changes. Often, Diabetics who do not have good BG control will have several pairs of glasses with different Sphere prescriptions so they can pick the pair that gives them the best vision at any particular time.

Typically, the changes are much more than your wife is experiencing and the changes occur at different times of the day, rather than over years.

It looks to me like your wife's vision has been very stable for years, I don't think you should expect much of an increase or change in the future, other than her Add, unless she likes to do a lot of very close work. It looks to me like she might still have some accommodation, available, but not a lot. There might be a little "trading" of PLUS between here Sphere correction and her Add. None of this is anything to get excited about.

At some point she may need Cataract Surgery and at that time, she can select what prescription she would like from that point forward.

Here is a link to a paper entitled "The Eye" you might find interesting:


hooked 10 Mar 2017, 05:26

What I can tell you. My wife's optometrist told her it is quite normal to have an increase in hyperopia starting from age 40.

Even if Cactus Jack gave an explanation I'm wondering why hyperopia increases because that would mean that the eyeballs become shorter. And I can't find any reason for that.

@Cactus Jack: I don't agree completely with your theory. My wife wears glasses all the time hence the muscles can relax and the eyes were dilated to get the amount of latent hyperopia, too. Hence I assume this increase is not due to some "uncorrected" latent hyperopia. But maybe I'm wrong.

spexfan 09 Mar 2017, 23:50

Am fascinated by the rx increases of hooks' partner ie. she seems to have gained about +3.5 diopters total since presbyopia started at 40....but +1.5 of that went to her distance rx over time.

I've always been hoping to increase my + distance rx since I got multifocals. Just got a +.25 distance increase at my last exam which was slightly blurry at first but is very clear 3 months later. I've gained a total of +2.5 since I started wearing multifocals (since about 10 years ago...I'm 47 now.) but +2.25 of that went to the add.

Maybe I've got a bit a few distance rx increases ahead?! Would be curious to hear more from hooked or others with similar situations. FYI I am currently +1.5/+1.75 add +2.25.

Cactus Jack 07 Mar 2017, 11:10


Your wife likely had some Latent Hyperopia along with her actual Hyperopia, but there is really no way to tell, now. True Hyperopia is caused by a mismatch between the total PLUS optical power of the eye's lens system and the distance from the Crystalline Lens to the Retina. The typical cause is that the eyeball did not grow quite enough in adolescence. The distances involved are small, only about 0.3 mm per diopter.

Hyperopia is the only refractive error that can be corrected internally using one's Ciliary Muscles and Crystalline Lenses. Often without a person even being aware that they are doing it. Over time, the Ciliary Muscle gets used to the constant correction and has difficulty relaxing. When that happens, the condition is called Latent Hyperopia. That typically works until Presbyopia begins to become a factor and an Add is needed. As the Add increases, and takes over the focusing workload, the Ciliary Muscles begins to relax and more PLUS is needed for distance vision along with more PLUS for close focusing help.


hooked 07 Mar 2017, 08:42

I had some spare time and read this thread form the beginning.

It is still quite interesting.

10 years ago I wrote that presbyopia sets in. I was 41 at that time. Now I need reading glasses and even for things far away glasses may help (for the right eye, the left one is still fine).

And then an update on my wife's progression of hyperopia and presbyopia.

Age 20: + 6 (average, for OL subtract 0.5, for OD add 0.5)

Age 25: + 5.5

Age 30: + 5

Age 40: + 5.5 ADD + 1

Age 45: + 5.75 ADD +1.5

Age 48: + 6 ADD 2

Age 51: + 6.5 ADD 2

I always thought hyperopia won't increase but it might be the case.

I must admit (we're kind of a fetish side) I like that her farsightedness increases.

And there is a big difference in magnification and cut-out (as the opposite to cut-in) between the + 6 and the + 6.5 glasses. But this might also be due to the different kind of frames.

Cactus Jack 02 Mar 2017, 08:37


The difference is only 1.75 diopters, it just happens that your Right eye is a bit nearsighted (-1.00) and the Left Eye is a bit farsighted (+0.75). Nothing to get excited about except that it affects your depth perception and 3-D vision and makes you vision system work harder than it should have to. You are probably doing close work with with your Right Eye and distance with your Left.

You really should get glasses and wear them full time for about 2 weeks before deciding how often to wear them. I think you will be amazed at how comfortable it is to have both eyes working as a team, rather than independently.

Vision actually occurs in the brain. Your eyes are merely biological cameras. You brain has been working overtime to correct your vision. It is better to correct your vision optically and relieve your brain of the extra work. You may think, after wearing your glasses for 2 weeks, that the glasses have made your vision worse. That is not true, all that has happened is that your brain has learned to work with high quality images and has set aside the image processing algorithm it has been using. You can force it to go back to the old algorithm by not wearing your glasses, but it will probably complain.

In some ways, glasses or contacts are just labor saving tools. Most of us are "hooked" on things that make us comfortable or save work. Could you become "dependent" on your glasses? Yes. I am pretty dependent on clothes and shoes because I don't have fur or hard surfaces on my feet to protect them from stones in the walkway. I am also dependent on my glasses because I like seeing comfortably and well.

May I ask your age and where you live?


BB1 02 Mar 2017, 06:30

Cactus Jack

I didnt know its pretty common. Most people i know who wear specs are nearsighted in both eyes. I was just diagnosed w/ antimetropia. My prescription is OD -1.0 OS +0.75. My eyesight is somewhat fine, I just have difficulty driving at night, and occ headaches.

Should i get glasses? And if i should, should i wear it full time?


Cactus Jack 02 Mar 2017, 05:56


It is fairly common. What makes it rare is if there is a large difference. It its more rare for the eyes to have exactly the same prescription. Differences of 1 to 3 diopters are pretty common, but usually they are on the same side of 0.00, but they don't have to be.

Eyeball growth is usually at the heart of any Refractive Error and nothing requires that the eyeballs grow at the same rate. The actual cause of Myopia or Hyperopia is a mismatch between the total optical power of the eye's lens system and the distance from the back of the Crystalline Lens to the Retina. In an adult eyeball of about 25 mm diameter, because the eye's lens system is inset, the distance is about 17 mm and the total power is about +59 diopters. If you do the math, it is about 0.3 mm per diopter.

The most common problem, caused by a big difference or a difference on opposite sides of 0.00, is the difference in image size on the Retinas. That can cause symptoms of double vision, that typically cannot be corrected by prism in the glasses.

May I ask your prescription and the problems you are having?


BB1 02 Mar 2017, 01:59

anyone here have antimetropia / 1 eye nearsighted and 1 eye farsighted?

Cactus Jack 20 Feb 2017, 23:30


It takes a little explaining, but I think I can help you understand how the test works.

The first thing you have to remember is that corrective lenses are just that. They have the opposite sign of the actual refractive error. To keep the numbers straight, I call the reverse of the glasses your "Eye Power" or EP. For prescriptions below about +/- 4.00 your glasses power and your EP will be the same but with different signs.

Because you are Hyperopic, your EP is -1.75R/-1.50L A person who is Myopic will have a + EP corrected by - lenses.

The only purpose of the + reading glasses is to move the point where the text just gets fuzzy around the edges to an easily measured range of less than arms length.

However, you don't want it too close, because it actually gets harder to measure the distance accurately, which causes errors. The test is crude enough without encouraging errors. if I suspect or know that a person has a pretty low refractive error, I suggest +1.50 or +1.75. Because you are Hyperopic with a known prescription and Presbyopia. We have to modify the test slightly.

You should do the test with your glasses on, which should correct you to about 0.00 for distance.

Theoretically, you could do the test using your reading Add, but I think it would be easier and more accurate to wear readers over your glasses.

The math is not difficult to understand, but you have to remember what I talked about in the first paragraph and understand the fundamental formula in optics.

Lens power = 100 cm or 39.37 inches / focal distance.


Focal Distance = 100 cm / Lens power

Step 1 is to calculate the Focal Distance of the OTC readers you will be using.

lets say that you are using +1.75 readers. The Focal Distance is 100 cm / 1.75 = 57 cm.

If a person is significantly Hyperopic or Myopic you have to adjust the OTC reader power, which may be difficult or do the test with their glasses on and the OTC readers over them.

When you do the test, the difference in the measured focal distance and 57 cm is the refractive error or EP. If the measured focal distance is MORE than the calculated focal distance, their EP is (-) MINUS and they likely need more PLUS to correct it. If the measured focal distance is LESS than the calculated focal distance of the readers, their EP is (+) PLUS and they likely need more MINUS to correct it.

The amout is easily calculated by dividing the difference between the calculated and the measured distance into 100 cm.

Hope this helps. Review what I told Fubius and see if it makes sense. He got some funny results on the second test and I am still trying to figure out what is going on. I hope he responds soon with answers to my questions.

Let me know if you need more help.


spexfan 20 Feb 2017, 20:49

Cactus, could you explain the formula you've applied to calculate Faubius' hyperopia? ie. the plus power lens/legible distance/under-or-over correction?

I'm wearing +1.75R/+1.5L with a 2.25 add and am curious to know how I'd tolerate a little extra plus power. Would be interested in doing some experiments.


Cactus Jack 20 Feb 2017, 15:35


Sorry about repeatedly getting your name wrong. The spell checker is changing it and I didn't catch it. Spell checkers are great, sometimes, but other times they are a nuisance.


Cactus Jack 20 Feb 2017, 01:58


Post below is for you. Sorry about the typo.


Cactus Jack 19 Feb 2017, 16:14


I am a little confused by the results of your second test.

The first test with the +2.00 reading glasses indicated that you may be a bit hyperopic. The +2.00 glasses were OK, and the 58 cm results indicate that. If you had a 0.00 prescription the distance should have been 50 cm with the +2.00 glasses. 58 cm indicates that your refractive error, early in the morning is about +1.75 (100/58 = 1.72) with the +2.00 glasses. The difference is about -0.25. When dealing with eye prescriptions, you have to remember that the glasses or contact prescription is the reverse sign of the actual refractive error in the eyes. -0.25 in your eyes means that you need +0.25 to correct it. In other words, mild Hyperopia.

However, based on your 2nd test results, after a day of close work, I thing there is something going on that we have not identified. That is not to say that it is serious, we just need to figure out what is going on so you can describe it to the Optician.

Were you wearing the +2.00 glasses for the 2nd test?

I would have expected that after a day of close work, you might be temporarily a bit Myopic. If so, and you were wearing the +2.00 glasses, I would have expected the fuzziness to start at a closer distance than 50 cm, not 77 cm. If you were NOT wearing the +2.00 glasses and got 77 cm, it just means that you have some temporary "Pseudo" or false Myopia which is easy to address.


I may ask you to do some other tests.


Faubius 18 Feb 2017, 03:09

Cactus Jack

i've done the test procedures you described,unfortunately i had to use a +2 pair because i didn't find the one you asked for,i hope it's not a problem.

However with test procedure 1,the fuzziness was between 57cm and 59cm for an average distance of 58cm.This test was in the morning at inside home with a good sunlight not too bright as you suggested.

And test procedure 2,which was more hard to measure since the fuzziness started beyond my full arms lenght,so take in count that maybe ther's a slight margin of error,anyway in this case the fuzziness was between 75cm and 78cm for an average distance of 77cm.This test was done at with artificial light settled at medium level and after doing extensive close work.

i also casually noticed that my eyes are not the same since my left eye during the misurations had an average difference with my right eye of around 10cm.

I hope i've provided enough datas,what does all that mean?

P.S.I also tried to look around the web to test my eyesight for near with some eye charts and it happens that i could read around half of it in most cases,i don't know if it's important just wanted to add more informations

 17 Feb 2017, 15:56


An eye exam is not like an exam that you might take in school and there is really no way to study for it. However, you can prepare for it and learn about your role in the exam. The best eye exams are a team effort between you and the Examiner. Part of the preparation is to learn what to expect, particularly if this is your first eye exam.

One important thing you need to keep in mind is that the Examiner has no way to experience what you are seeing. He/she has to depend on your answers to questions.

There are two parts to an eye exam. The first part is the Objective part. This part consists of:

1. Taking a Visual History where you describe your vision and the kinds of problems you are having.

2. Checking the internal pressure in your eyes for symptoms of Glaucoma. This is one of the very few parts of an eye exam that is even mildly uncomfortable and the discomfort only lasts for a few seconds. There are two basic ways to do the pressure test.

A. Using a special instrument to lightly touch your Cornea. Not to worry here. Before doing this type of test a drop of mild anesthetic will make sure you don’t even feel it.

B. There is a new type instrument that uses a puff of air directed against your cornea. No anesthetic is required, but the puff will startle you. The puff of air is harmless and there are huge benefits. Detecting Glaucoma early, before it can do damage can save your eyesight.

3. The examiner will also get a preliminary estimate of your refractive error by using an Auto-Refractor or manually by using a small hand held instrument called an Ophthalmoscope or Retinoscope.

The Auto-Refractor is a relatively new instrument that was developed in conjunction with NASA to check Astronauts vision in space. You look into the machine with each eye individually where you will see a scene or a pattern. The machine will adjust its internal lenses to focus the image you see on your retina. The Auto-Refractor only takes a few seconds for each eye and it then prints out your estimated prescription.

Some Examiners prefer to use manual methods that have been used for many years. Using an Ophthalmoscope or Retinoscope and a Trial Lens set or a Phoropter (a fancy machine with a built in lens set), the Examiner will look into your eyes and select the lenses that allow him to see your retina, most clearly.

The object of this part of the exam is to get a starting place for the Subjective part of the exam where you have to describe what you see.

Typically the Subjective part of the exam starts with the Right Eye shutter open and the Left Eye shutter closed.

Step 1 is typically determining the cylinder and axis of any Astigmatism correction you need. This is actually the hardest part of the exam because you will be asked to judge relative blurriness of two images rather than the sharpness of an image.

You will be shown a line of text and a supplemental lens will be rotated into place. This lens is a cylinder lens that is mounted on a 45 degree pivot and can be flopped back an forth to bracket a trial axis or orientation of the long axis of the cylinder lens. The thing that is confusing about this test is that the straight lines (strokes) of the letters will alternate in clarity as the lens is flipped back and forth depending on their direction. I suggest concentrating on an “O” if possible. Depending on your answers, the examiner will adjust the axis knob unit the image you see is equally blurry with the supplemental lens 45 degrees each side of the selected axis.

At this point the Examiner will probably swing the supplemental lens out of the way and may change the cylinder power while asking you which lens in clearer.

For your first exam, you may be uncomfortable asking the Examiner to let you fine tune the Cylinder Axis, but I have found that most will appreciate your wanting to actively participate. The way that works is that he will place your hand on the Axis control knob. This time, you move it back and forth a few degrees looking for the sharpest image. It is a bit like “Fine Tuning” an old Analog TV set or moving the tuning knob on an analog AM radio for the best signal.

The next step is determining the Sphere correction. This is an easy part of the exam because all you have to do is pick the sharpest image, but there is a tricky part. Your auto-focus mechanism will try to help, if it gets a chance. The Examiner has a couple of ways to minimize the action of your ciliary muscles and crystalline lenses.

The Examiner can, in effect, sneak up on your Sphere prescription or he can use drops to Dilate your eyes. Lets talk about sneaking up on your prescription first. There are actually 4 lenses in your eye’s lens system. All of them are PLUS lenses and the total power is about +56 to +60 diopters. The only variable focus lens is the crystalline lens whose PLUS power is controlled by your ciliary muscles. For distance, your Crystalline lens is fully relaxed and has somewhere around +15 diopters. When you focus to read, your Ciliary Muscles squeeze the Crystalline lens to increase its PLUS power by the amount necessary to focus which depends on the distance to the object.

This will take a little thought to get your mind around, but if you are nearsighted, your lens system has too much PLUS for the distance from the lens system to your retina and you need MINUS lenses to neutralize some of that excess PLUS power. You ONLY have the ability to increase the PLUS power of your lens system. You have NO ability to reduce the PLUS power of your Crystalline lenses more that fully relaxed.

To try to keep your Ciliary Muscles and Crystalline lenses from getting in the act, the examiner will start with NOT ENOUGH MINUS or TOO MUCH PLUS (same thing) and gradually increase the MINUS one or two steps at a time, while reducing the size of the line you are asked to read. He will not tell you what power lens or what line you are looking at. Eventually, he will reach the 20/20 line and a lens power that lets you read it with no mistakes.

He will then follow the same procedure with your Left Eye.

When he has completed both eyes, he will open the shutters and you may see two images. This part of the test is to check your muscle balance using some prisms. He will probably ask you to tell him when the two images are aligned horizontally and then vertically. While the images are separated, you have an important check to make. Compare the sharpness of the two images. If they are not equally sharp, be sure and tell the Examiner which image is clearer. If there is a difference, he will likely reduce the sharpness of the clearest image until they match. The important thing at this point is that they match. That lack of sharpness will be corrected in the next phase with both eyes working together.

Next he will fuse the images so both eyes are working together and repeat the Sphere procedure by gradually increasing the MINUS or decreasing the PLUS until you see the smallest line of letters very clearly.

That pretty much completes the exam except for checking your near vision with a small chart about 14 to 16 inches from you.

Many people, who wear glasses, actually look forward to eye exams. Once you have become accustomed to having very good vision, you will probably find anything less, unacceptable. Many times, after the exam, it will be suggested that you get another exam some time in the future. Note that I used the word “suggested”. it is NOT a Command. If your detect a problem or if your vision seems uncomfortable, please don’t wait until the “suggested” date to seek an appointment to get your vision checked.

Let me know if you have more questions


Cactus Jack 17 Feb 2017, 15:54


I would like to suggest two things. There is a relatively easy test you can do at home to get an idea of your vision. The test is a practical application of the principles of optics codified by Sir Isaac Newton around 1700.

You will only need 3 things to do the test.

1. A pair of Over-the-Counter (OTC) Reading Glasses of +1.50 or + 1.75 power. These glasses will cause some artificial Myopia to make the test easier to do and more accurate and get the distance where the letters just become fuzzy around the edges into an easily measured range

2. A measuring tape that can measure about 100 cm.

3. A book or newspaper with average small print. (The target)

Test Procedure 1: Morning test when you are fresh.

In good, but not BRIGHT light, put on the Reading Glasses.

1.Hold the book or newspaper about 30 cm from your face and gradually move the Target away from your face until the text just starts to get fuzzy around the edges.

2. Note the distance from your face

3. Repeat steps 1 and 2, Three times and average the results.

4. Tell me the results.

Test Procedure 2:

1.Repeat Test Procedure 1 when you have been doing extensive close work.

2. Tell me the results.

Be sure and tell me th power of the glasses and when the test was performed.

Also, I suggest you read "How to Study for and Eye Exam", which follows in the next post.


Faubius 17 Feb 2017, 14:54

Hello i'm a 22 year old guy from Italy,i found this website while searching informations about glasses and vision.

In the last months i've noticed that my vision is not perfect anymore,at first i thought it was caused by allergies or tired eyes since i started to work in front of a computer screen for many hours at day.

But now i'm thinking that maybe i have hyperopia because the symptoms i'm actually having are:when i start to read a book/journal or at the screen of the computer/tablet/smartphone my vision is perfectly clear but after 1/2 minutes it gets really blurry to the point i can barely make out the letters even if they're quite big,and when i look far it's still blurry(only for some minutes and for small things),although blinking and squinting very much and putting things a bit far,help in reducing a bit the blurriness to a manageable level it still give me a lot of eye strain and headaches.

I wanted to hear your opinion about it before booking an eye test to the optician,my last eye test was 10 years ago and at that time i had perfect vision so maybe something changed,i don't even remember what happens during the eye test so if you could give me informations about it,it would be great

So what's your opinion?Do i have hyperopia?Am i going to get glasses?

P.S. Sorry for my bad English,i should've studied it more in high school

Catwoman 12 Feb 2017, 10:28

Cactus Jack:

Thank you for the wealth of information. I had no idea of "true and false" myopia or anything about the crystalline lenses and celery muscles. :)

The 2 pairs of cateyes that I wear on the weekend do have progressive lenses, while the 5 pairs I wear the rest of the week are regular bifocals. I use the computer all the time at work, and I have plenty of light in my office. I have not noticed any problem with reading the screen, home or away. At home I read more close-up, mainly newspapers and magazines, quite often during commercials of TV programs, so the multi-vision (as opposed to single-vision) lenses help.

For very small print I may take my glasses off and look at it a few inches away, as not even my +2.75 add can do the trick. The same applies for when I apply makeup or eye shadow (only for special occasions anymore).

Cactus Jack 11 Feb 2017, 11:19


You probably have a combination of True, Axial Myopia and False, Pseudo Myopia, they can add together. Pseudo Myopia can decrease, but Axial Myopia generally does not. Both Presbyopia and Pseudo Myopia are related to the Ciliary Muscles and the Crystalline Lenses. Your add has been increasing as your Crystalline Lenses get stiffer and your Ciliary Muscles get weaker.

Your distance prescription may decrease some, but probably not down to 0.00 and your add will probably not increase much more, unless you like to focus very close. At some point your add will be strictly related to the distance from your eyes to what you are wanting for focus on. You may need a different power add to be able to use a computer and read with the same pair of glasses. That is whey they make progressives and trifocals.


Catwoman 11 Feb 2017, 10:33

When I was 38, I got my first bifocals, at +1.50. A few years later, it was up to +2.00, then to +2.50, and last summer +2.75. With my myopia seemingly decreasing, maybe some year the numbers will balance out, except of course for the astigmatism that has been a family bane.

Cactus Jack 03 Feb 2017, 10:14


I suspect both your distance and add will need changing. Don't be surprised if this process takes several weeks or months to completely stabilize. You might check with your ECP about their policy on prescription changes. Some will remake glasses for prescription changes, free,

only within 90 days. Others offer more time or won't remake them free unless it is an error on their part.

Once your vision has stabilized, the changes will probably be small and infrequent. The primary change will be in Cylinder and Axis, but that can be minimized by using the technique for "Fine Tuning) the Axis, outlined in "How to Study for an Eye Exam"


Russ 02 Feb 2017, 15:52

Thanks for the info CJ. Latent hyperopia sounds like my distance problem. I have been wearing my glasses full-time in order for my eyes to adjust, accommodate, etc. to the vision correction. Will see how quickly my add needs an increase.

Cactus Jack 31 Jan 2017, 10:07


It would have been very rare for you to have noticed your farsightedness. Hyperopia or farsightedness is the ONLY refractive error that you can correct internally, using your Ciliary Muscles and Crystalline Lenses. Particularly, since you did not mention any Astigmatism correction (Cylinder and Axis).

Presbyopia, which is the gradual stiffening of the transparent protein that makes up your Crystalline Lens, is gradually catching up with you. That happens to almost everyone by the time they get to 40, though it can happen at any age. It depends on your genes.

There are two kinds of Hyperopia. One is caused by a mismatch between the length of your eyeball and the total PLUS power of your eye's lens system. Typically, it is caused by the failure of the eyeball to grow quite long enough by about 0.3 mm per diopter. It is considered permanent.

The other type of Hyperopia is called Latent Hyperopia. It is caused by the Ciliary Muscles and Crystalline lenses not fully relaxing for distance. Once you start wearing external PLUS lenses, to correct your Hyperopia and bifocals to correct your Presbyopia, your Ciliary Muscles will gradually relax and your will need more external PLUS for distance and your Add will increase. However, your Add will never be more than about +2.50 pr +3.00, unless you need to focus very close. Once your Hyperopia is corrected, you can calculate the amount of Add you need by measuring the distance from your eyes to the visual target and dividing that into 1 meter. The result is the Add power.


Russ 31 Jan 2017, 05:28

I am 43 years old and was having difficulty seeing the text on my phone. Went to the eye doctor and came out totally surprised. I did need assistance for close-up work, but the doctor told me that I needed glasses for distance and probably had needed them for years. My prescription is +1.50 add +1.25 and +1.75 add +1.25. I have gotten the glasses and am getting used to wearing them all the time. Question-----should I have noticed the "farsightedness" related to distance???

Anyway, wearing glasses is pretty cool.

Plus Tony 23 Jan 2017, 14:30

Cactus Jack

Thanks for your advice which I have passed on. My friend was slightly taken aback when I suggested that she should see a pediatric opthamologist but I explained the rationale as you explained it here and she understood the logic. It will be interesting to see whether she is able to arrange an appointment through the NHS or whether she will have to go private. I suspect the latter.

Incidentally she says that she doesn't feel any additional strain at near but of course that doesn't necessarily mean that presbyopia isn't starting to make an appearance.

Thanks again

John S 21 Jan 2017, 17:26

CJ, I completely agree. I think there might be a few more increases to come. Hopefully his eyes will stabilize soon. I don't think his add will go up again. I think the doctor probably increased it because he asked him to see closer. You know how teenagers are addicted to their phones.

A few months after he got his glasses he was doing better in school. But part of the improvement was due to a few threats from his parents. I'm sure his glasses played a part of it also.

He wore his old glasses most of the time, but his new ones stay on him. I will post a picture of his glasses on V & S. Before anyone asks, no pictures of him wearing them.

Cactus Jack 21 Jan 2017, 15:41

John S.,

Your friend's 12 YO son is a good example of Latent Hyperopia in action and the fact that it can occur at a very early age. He probably has had Hyperopia for a long time and his visual environment finally caught up with him. I have a hunch that he may not be through with increases in his Plus for distance. Once his Hyperopia has been fully resolved and corrected, he may have enough Accommodation range available to not need an Add of +2.00. One of the things that will work against him is the tiny text on Smart Phones.

The clue that he really needed glasses was the discomfort when reading. I have an 8 YO great nephew that had behavioral problems when he was around 4 or 5. Hated to do anything that involved focusing close. My brother, his grandfather, finally put the clues together and insisted that he get his eyes checked. Turned out he had Hyperopia and Astigmatism and close focusing was very uncomfortable. At first he rebelled at wearing glasses, but quickly discovered the difference. He is now in the 3rd grade and a very different child. Turns out he is rather smart and I alerted his grandfather and his father that the problem would be keeping him challenged as he plays catch up and experiences the joy of discovery.

Your friend may experience something similar as his son begins to take advantage of comfortable close vision. You might suggest a followup check in a few months and suggest looking into some low cost spares from Zenni.

Times surely have have changed when a 12 YO wearing bifocals and having prescription reading glasses is no big deal to his friends and class mates.


John S 21 Jan 2017, 11:21

My friend’s son that got his first glasses 6 months ago stepped on his glasses. His glasses didn’t feel as strong as they used to, so when he went in to get his glasses fixed he got a checkup. His new glasses are: R +1.50, L +1.75 -0.25 X 118, Add +2.00. Without his glasses his distance vision is 20/40, and his close vision is 20/200.

He got bifocals this time. He said the stronger lenses made a big difference. He really likes them.

A couple of his friends asked him about his new glasses. They said they were cool because they had a line. How things have changed.

Newspex 20 Jan 2017, 11:03

Hi John S,

Thanks for coming back to me - I got L+1.25 R+1.00 -0.25 about 10 years ago when I was 39.

I have been wearing L+0.5 ADD +1.5 R+0.25 -0.25 ADD +1.5

These work fine apart from when I remove then and look in the distance as I mentioned.

Newspex 20 Jan 2017, 11:03

Hi John S,

Thanks for coming back to me - I got L+1.25 R+1.00 -0.25 about 10 years ago when I was 39.

I have been wearing L+0.5 ADD +1.5 R+0.25 -0.25 ADD +1.5

These work fine apart from when I remove then and look in the distance as I mentioned.

John S 19 Jan 2017, 19:18


Since you not received your answer, I will jump in.

Your reading muscles are relaxing more since you have increased your correction. They have been compensating to keep your distance vision clear. When you give the muscles a break by using the correct reading power, they get used to it, and don't want to work to give you the extra power you need to correct your distance vision. Basically, you should also be wearing distance correction in addition to reading.

What power were your old glasses, and what are you wearing now?

Cactus Jack 19 Jan 2017, 13:21

Plus Tony,

There could be several things going on. The interactions between the focus control system and the eye position control system are complex. At 39 in addition to her other issues, I suspect Presbyopia is also getting into the act.

Prism might help some, but there is no way to offer suggestions other than to suggest that she should see a Pediatric Ophthalmologist. They specialize in children's eye misalignment problems and also see adults with eye misalignment problems.


Plus Tony 19 Jan 2017, 12:26

I got into a conversation the other day with a fellow hyperope with a prescription just a little stronger than my own (she is L +1.50, R + 2.50) and is 39 years old. She was first prescribed glasses as an adult about 3 years ago and now wears her glasses full time. She is in good general health and has excellent vision with glasses although she is very much reliant on her left eye.

She had previously worn glasses as a child and was patched for a lazy eye. She stopped wearing glasses at about the age of 9 or 10 when she was told her lazy eye could not be improved further. When she removes her glasses her right eye tends to turn in. She said that she had noticed recently that her right eye sometimes turns in while she is wearing her glasses although it seems to be intermittent. She wondered whether this could be corrected by prism. I said that I wasn't sure. She mentioned that at her last eye test the optometrist had said that her right eye was corrected as much as it could be so I assume that adding plus would not help to stop the turn.

I seem to remember reading (probably here) that while prism can correct certain eye position issues it doesn't help with amblyopia. Is that correct? I suggested that she should discuss it with her optometrist which she said she would.

John S 16 Jan 2017, 12:24


Please re-read what Newspex posted. I think you missed when he took he glasses off, his distance vision was blurry.

Soundmanpt 16 Jan 2017, 10:53


Your eyes are still adjusting to the change in your prescription which is very normal. The same thing likely happened with your previous glasses when you first got them but as your eyes adjusted you didn't have the blur anymore.

Newspex 16 Jan 2017, 10:47

I have recently upgraded my reading/ pc glasses, but I have noticed that

after wearing them for a prolonged spell they make distance vision blurry for about 10 minutes when I remove them.

The old pair didn't seem to do it.

Cactus Jack 15 Jan 2017, 18:46


Sometimes the ES server does not respond very quickly. If the background of the Submit button turns BLUE when you click on it, your post is acceptable. You don't need to click again. Multiple posts are usually caused by the server being slow to respond your first click. If the Submit button turns Blue, just be patient and the server will retrieve your post when it can. It rarely take more than 30 seconds.


Jackson 15 Jan 2017, 16:48


Yes, they are just reading glasses.

Jay 15 Jan 2017, 15:49

My apologies. I was having trouble posting.

Jay 15 Jan 2017, 15:45

Just getting reading glasses, Jackson?

Jay 15 Jan 2017, 15:45

Just getting reading glasses, Jackson?

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