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Medical Forum / General / Vision / April 2005Optimize correction for distance and not reading - why?
I have been wearing soft contact lenses for years and I'm happy with them. Recently my eyesight has changed some, and the dr. wants to give me much stronger minus correction to make my distance vision clearer, and since I'm 45 now and just beginning to start having trouble reading or using the computer with my current prescription (-3.5 left -4.5 right) I have to consider (ugh!) reading glasses. Question: Since I drive maybe 5-10 minutes a day at the most, and spend 8- 10 hours reading or working on the computer, does it make ANY sense at all to set my contacts to correct for my distance vision and make me wear glasses 8-10 hours a day? It seems vastly more logical to have my contacts optimized for reading (or maybe optimized for a slightly longer distance, such as TV watching distance -- not that I watch a whole lot of that), and let me wear glasses if I need them to drive. I discussed this a little with my eye doctor at my last visit, and I'm going back for a fitting of a more modern lens of a different brand next week, so I wanted some opinions on this. The dr. seemed to resist this idea. I realize that the "norm" is to correct for distance vision and base everything else off that, but it seems dumb. Thanks. David W. Dear David W. There is no reason why the OD can not agree to your request. The only requirement -- consistent with comfort -- is that you meet the visual requirements (read 1.8 cm letters at 6 meters) when you drive a car. At other times, in you current contacts, your distant vision will be slightly blurry. If that is OK with you -- then no problem. Best, Otis Engineer If I need to wear glasses to meet the vision requirements to drive, that is fine with me. I predict that if I get my vision optimized for something like 5 feet instead of what? 20 feet? infinity? that the machines test for, then, since I still have some accomodation, I should be able to read without reading glasses. But if my contacts are set for 20 feet or infinity, then I probably won't be able to read without reading glasses. Thanks for the reply. David W. > Dear David W. > [quoted text clipped - 13 lines] > Otis > Engineer Dear David W. There is a tendancy to "over-prescribed" a minus lens. I have a report from a man who checked his own eye chart and found he could read the 1.8 cm letters at 6 meters) This passes the DMV-Snellen in most states. When he went for an "exam" the OD claimed that he required a -2.0 diopter lens to "see normally". You might down-load a chart from: www.i-see.org and check this yourself. Please remember, I NEVER provide medical advice -- and I would insist that you pass all LEGAL requirments for vision -- as they apply to you. It is also possible that the individual who made the measurement at -2 diopters had a "bad day", or that the measurement was just an error. In any event -- there should never be an objection for a man double-checking a measurement. Just a word to the wise. Best, Otis Engineer > Dear David W. > > There is a tendancy to "over-prescribed" a minus lens. Dear David W, Please disregard Otis's postings. He is not in the medical profession and is in no position to give medical opinions on whether a doctor over-prescribes or not. Thank you! Allen Dear David W. You can "listen" to Allen if you wish. But I believe you are smarter than that. Neither of us will know what you choose to do. You asked an honest question -- and got a reasonable reply. I respect your intelligence and wisdom on this issue -- others do not -- in my opinion. Any OD worth is salt should have no problem explaining this issue to you. Further he should have no problem with YOU reading your own eye chart, and explaining the legal requriement to you. If he does -- there is a problem of bias -- indeed. Take care. Otis Engineer Don't you ever get tired of pushing your agenda on everyone who posts a question in this newsgroup Otis? Perhaps using too much of the "wretched" minus was a mistake, or perhaps it was part of the great eyedoc conspiracy! Watch your back Otis. PS-- you told this story to some unsuspecting newbie a couple of weeks ago and the amount of minus was -3.50 diopters. You need to keep better track of your white lies. ----------------------------------------- > Dear David W. > [quoted text clipped - 21 lines] > Otis > Engineer Dear RM, There were two people involved. One was a young man "Mike" who had a -2.75 diopter prescription -- at age 14. He quit -- on his own. His eye-chart was 20/50 to 20/70. After working intensevely with a plus -- he cleared and passes the 20/40 and 20/30 line. When he goes for the DMV test -- he will pass it. He parents asked him to go for a medical test. He PASSED all medical requirements. In a darkened room, using a poorly illuminated Snellen, the OD "read" -2.0 diopters. There is no doubt that different illumination levels -- produce different "measurements". The real (and exclusive) questtion -- is what "Mike" will do about it. Continued work with the plus could well produce 20/20 for him. In which case your argument is MOOT. You are not concerend with this. Mike T. posted a statement to the effect that if he attempted to offer "true prevention" with a plus then some ophthalmologist would get on his "case" by saying that he is not a "real doctor". There is a powerful dis-incentive for your to do any preventive work of this nature -- and it is necessary to understand WHY you can not do this work. But you should not act to prevent others from doing this work on their own -- if they value their distant vision during the school years. The other man reported a "prescription" of -3.5 diopters. When he checked his own eye-chart, he found he could read the 20/50 line. Only AFTER he did this check, did some OD on this site say -- Oh, you must be over-prescribed. Funny -- that this man had to do HIS OWN CHECKING. If he did not -- he still would be wearing that over-prescribed -3.5 diopter lens. Now do you understand why a person should do his own checking? Best, Otis Engineer > Dear RM, > > There were two people involved. > > One was a young man "Mike" who had a -2.75 diopter prescription -- at > age 14. He quit -- on his own. His eye-chart was 20/50 to 20/70. Dear prevention minded readers, Please disregard any postings by Otis. He is in no position to give medical advice since he does not have any medical training. Otis also appears to make up "subjects" as he goes along. Thank you! Allen > Mike T. posted a statement to the effect that if he > attempted to offer "true prevention" with a plus > then some ophthalmologist would get > on his "case" by saying that he > is not a "real doctor". Blatantly inaccurate quote. > There is a powerful dis-incentive for your to do any > preventive work of this nature -- and it is necessary > to understand WHY you can not do this work. No, it's necessary to understand WHY you insist on doing it. It doesn't work. > Funny -- that this man had to do HIS OWN CHECKING. Funny how the man told his doctor that -325 was blurry. -MT This is what happens to these threads. Someone posts a very valid question and it goes off on a tangent where there is name-calling and accusations. Now I understand why people drop off and don't patricipate anymore. Dear Kem, This man asked a valid question. "Can I wear an under-prescribed contact, and then wear a minus for driving a car." These "experts" proceeded to ignore this man's question -- and attack me, calling me "names" and the like. If they had responded to this man honestly, there there would have been no problem. Best, Otis Engineer Dear D Walker, Subject: Intense bias You asked a basic question -- about the refusal of your OD to honer your request. Rather that argue with me -- or taking any "suggestions" that I have made -- just ignore them. Open the Yellow-Pages, and find a "cooperative" OD. Tell him what you want -- and see if he will comply. If not, call anoter OD. There are ODs who are more reasonable -- and will support you -- rather than hinder you. Please note that no OD on this site gave ANY REASON at all as to why you could not get what you requested. Sheeze -- talke about bias. Best, Otis Engineer Dear David W. Further Suggestion. It is intersting to note that I attempted to answer your questions HONESTLY. All the others -- ignored your request and ATTACKED ME! Your request is very simple. I would suggest you call your original OD back and ask him to explain FULLY why he can not HONOR YOUR REQUEST. I can think of only one reason. He is afraid that you will drive a car -- with just your contacts in -- and not a minus lens over the contact. Maybe he is afraid you might do this. Ask him if that is the "correct" reason. I would be curious to know also. This is a fair-and-hones question. It deserves a honest answer -- no evasions. Best, Otis Engineer it is quite reasonable to slightly undercorrect someone like yourself, say by about 0.50 diopters, in both eyes. Alternatively, you could be undercorrected slightly in just one eye and leave the other in good distance focus. i myself am naturally slightly myopic being about -1.00 in one eye and -0.75 in the other. I do not wear any correction around the office. I can see comfortably up close like this and I appreciate that since I am presbyopic. I have a pair of single vision distance glasses that I keep in my car and wear them when I drive only (and sometimes at sporting events, concerts, etc). In the event that you choose to do this, which is quite reasonable, please be sure that your distance glasses correct you completely to 20/20 for driving. Regardless whatever the minimum driving standard is in your state (usually 20/40 in one eye), that is not good distance vision and you should fully correct yourself so you can see well. Minus lenses do not hurt your eyes despite what some morons claim in this newsgroup (=Otis). Dear RM, It would be nice if you understood the king's English. I have NEVER said anything like this: RM-OD> Minus lenses do not hurt your eyes despite what some morons claim in this newsgroup (=Otis). What I said was that if you place a minus lens on a group of natural eyes, the poplation of eyes wearing the minus lens will move negative (as a natrual process) relative to the control group. This is a dynamic property of the young, dynamic eye -- which you totally miss. The natural eye is proven to be a sophisticated control system. It is your habit of "spinning" facts that makes your "understanding" tragic. The rest of your recommendation to this mand is (finally) reasonable. If you had done this at the start, you would have saved a lot of difficulty for D. Walker. Best, Otis Otis, you repeatedly claim that the "wretched" minus causes you eye to "go down". I understand the kings english, and I remember the foolishness you proclaim. > What I said was that if you place a minus lens on a group of > natural eyes, the poplation of eyes wearing the minus lens > will move negative (as a natrual process) relative to > the control group. Dear prevention minded friends, Please disregard Otis's postings. He is not in the medical profession and is in no position to give medical opinions or advise. Thank you! Allen > What I said was that if you place a minus lens on a group of > natural eyes, the poplation of eyes wearing the minus lens > will move negative (as a natrual process) relative to > the control group. You said it but you've never mentioned any research comparing humans wearing glasses to those who don't. > This is a dynamic property of the young, dynamic eye -- which > you totally miss. It's a myth, fostered by your blind faith. Else you'd present human citations. > The natural eye is proven to be a sophisticated control system. Yes but it simply doesn't work the way you think it does. > It is your habit of "spinning" facts that makes your "understanding" > tragic. Or your habit of spinning conclusions off assumptions. You assume myopic humans wearing glasses get worse than myopes who don't. > If you had done this at the start, you would have saved a lot > of difficulty for D. Walker. If you offered some comparison between humans wearing glasses and humans who don't, you would have saved a lot of embarassment for yourself. -MT >I have been wearing soft contact lenses for years and I'm happy with them. > Recently my eyesight has changed some, and the dr. wants to give me much [quoted text clipped - 21 lines] > base > everything else off that, but it seems dumb. I've done this many times for patients. Your doctor should do what you request, as long as you assure him you won't be back complaining about the distance blur. Your other options are monovision (one eye set for distance, the other for near) or multifocal contact lenses. Dr Judy > Thanks. > > David W. Thanks, I appreciate the responses. David >>I have been wearing soft contact lenses for years and I'm happy with >>them. [quoted text clipped - 35 lines] >> >> David W. > I discussed this a little with my eye doctor at my last visit, and I'm > going back for a fitting of a more modern lens of a different brand next > week, so I wanted some opinions on this. The dr. seemed to resist this > idea. I realize that the "norm" is to correct for distance vision and base > everything else off that, but it seems dumb. I think it makes more sense to correct for distance, and wear reading glasses, but that is probably mostly because that is what I am used to. When I read or look at the computer, my eyes don't move very far, which glasses work OK for. When I am outside, I move my eyes more, which contacts work better for. Perhaps your doctor has had experience with patients requesting correction for close and glasses for distance, only to have them come back in a week or two to say that it just isn't working. You should ask your eye doctor why they are resisting your request. I have IOLs implanted in both eyes due to cataract. My doctor asked me whether I wanted them set for close or distance. I chose distance, and my doctor thought that was a good decision based on my lifestyle. An IOL implant is generally for life, so this was a permanent decision. You can easily change your mind the next time you get glasses and contacts, unlike me.  SignatureDan Abel Sonoma State University AIS dabel@sonic.net My advice is to wear contacts all the time, and for close work just wear some reading glasses over your contacts, you know, the 15 dollar pairs you buy at walgreens, buy them at like +2 diopters to counteract the negative prescription. Then just take off the glasses when driving. I don't know why anyone and not even otis hasn't suggested this. And for everyone who says glasses don't make you more myopic. I am an example of why that is false. Although I must say, my efforts to reverse my myopia have either not worked or made my myopia worse. I don't know why. I sit in the back of the class in my high school, I'm 16 and in the eleventh grade. I have to push the glasses up to my face and I have to squint really hard to see. They are my third strongest pair. I wore glasses at 7. I think because i have no windows, and I read garfield books all day on the bed. How could I not become myopic. I never took off my glasses, because the eye doctors were like, you'll get used to it, or go read with them. I thought I was being a good boy by listening to them, that they cared about me. Now when I take off my glasses, my right eye is -9.00 and the left eye is -7.5, and I am only sixteen. I can't even read a book without my glasses. Now if minus lenses don't cause myopia and close work does not cause myopia, then what does? >My advice is to wear contacts all the time, and for close work just >wear some reading glasses over your contacts, you know, the 15 dollar [quoted text clipped - 16 lines] >lenses don't cause myopia and close work does not cause myopia, then >what does? post hoc ergo propter hoc. http://www.datanation.com/fallacies/posthoc.htm > My advice is to wear contacts all the time, and for close work just > wear some reading glasses over your contacts, you know, the 15 dollar > pairs you buy at walgreens, buy them at like +2 diopters to counteract > the negative prescription. Then just take off the glasses when > driving. I don't know why anyone and not even otis hasn't suggested > this. What you are suggesting is the default. That's what most people do. That's what his doctor wants him to do. He's asking why he can't do it backwards, having the contacts set for close and wearing glasses over them for distance. SignatureDan Abel Sonoma State University AIS dabel@sonic.net >>My advice is to wear contacts all the time, and for close work just >>wear some reading glasses over your contacts, you know, the 15 dollar [quoted text clipped - 7 lines] > backwards, having the contacts set for close and wearing glasses over them > for distance. It's the default for a good reason. Most people are more bothered by distance blur than by near blur. But there is no reason not to go your way. I've done it in the past, a few, read that very few, times. People just feel too restricted. However, reading the original poster leads me to believe they wanted to try around 5 ft for the CL Rx. No problem there; do it all the time with the "modified mono fit" where I correct one eye at distance (optical infinity plus 0.25) and the other at about a .75 or 1.00 add (3 or 5 ft out). Works well for lots of people. A little myopia feels good to a presbyope... w.stacy, o.d. Well then he's an idiot! Why do you wanna wear glasses while driving. Your peripheral vision is limited by like 100 percent, your field of vision is like 50% of what it should be and do you know how much you have to turn your head when you back up if you wear glasses? It's worse than yoga! |
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