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Medical Forum / General / Vision / May 2005

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Changes in astigmatism and decreased BCVA

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silverblue001@hotmail.com - 30 May 2005 15:30 GMT
Okay, I posted something similar in the past (in the "autorefractor"
thread), but I'm still having problems so I really hope someone can
give me some additional input (sorry, this is rather long winded).

Last time I posted that after wearing contacts, my visual acuity with
glasses was horrible (below driving level).  Some people suggested that
I would probably need a different prescription for glasses after
wearing contacts ... well, this is in fact the case, but I'm not
satisfied with it, and I'm now more confused than ever.

My cylindrical correction two years ago was:

L:  2.25 x 80
R:  4.25 x 88

This was a time when I hadn't been wearing contact lenses for an
extended period  (i.e., a year or so).

Last year I began wearing contacts again and noticed a change in visual
acuity ... but after one week of not wearing contacts at all, my BCVA
increased and my Rx was found to be:

L:  2.00 x 90
R:  4.00 x 90

This year I wore contacts regularly until my appointment because I
wanted to see if my ophthalmologist could give me a glasses
prescription that would enable me to see well after wearing contacts.
Again, my initial visual acuity was below driving level (20/50, 20/60).
She attempted to correct it and my resulting Rx was:

L:  1.75 x 87
R:  2.75 x 88

Great, except my VA is still not what it should be (currently at 20/40
... and just barely).  Furthermore, even the lines that I could read
without much trouble had some blur.  So now I'm left going around in
circles.  My ophthal. suggested that something could be wrong with the
contacts (and I wouldn't be surprised if she was correct). This has
occurred two years in a row with two different sets of contact lenses
(same brand).  My contact lens fitter has denied that any change in my
vision could have been caused by soft contacts.  According to him, the
fit was fine.  So what is going on?!  I'm thinking about switching to
RGPs since I've had enough of this ... but I know RGPs have a greater
tendency to "mould" the cornea than soft contacts, so I'm a bit
hesitant.  Any suggestions would be greatly appreciated.

Oh ... just a quick overview of my background:

Age:  21

Rx:
OD:  Sphere -15.50
OS:  Sphere -15.00

Past eye problems:  RDs in both eyes (due to extensive lattice degen. +
high myopia).  This was five years ago.  Currently everything is
stable.

BCVA (before all of this occurred):  20/30 in both eyes.
drfrank21@gmail.com - 31 May 2005 01:09 GMT
> Okay, I posted something similar in the past (in the "autorefractor"
> thread), but I'm still having problems so I really hope someone can
[quoted text clipped - 6 lines]
>
> Last year I began wearing contacts again and noticed a change in visual

acuity ... but after one week of not wearing contacts at all, my BCVA
> increased and my Rx was found to be:
>
> L:  2.00 x 90
> R:  4.00 x 90

> Great, except my VA is still not what it should be (currently at 20/40
> ... and just barely).  Furthermore, even the lines that I could read
[quoted text clipped - 22 lines]
>
> BCVA (before all of this occurred):  20/30 in both eyes.

I'd try rigid gas perms. If you only had 20/30 bva before bilateral
rd's and subsequent surgery/sb/laser,  you may not be able to attain
20/30 bva and your current status may be the best you can get.

But trying gas perms may get you your optimum acuity whatever that
might be.

frank

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