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Medical Forum / General / Vision / June 2005Longsighted but excellent close up?
Thought I might go to the optician to ask about Glasses... (me, 28, male) What with: May 2005: Right Distance +0.50 Sph, -0.75 Cyl, 135 Axis Left Distance +0.75 Sph, -0.50 Cyl, 35 Axis I don't really notice too much, apart from perfect close up vision, depending on the size of the print, perfect arm length vision, and actually as far as Im concerned, not very sharp distance vision. I have a friend who has similar if not the exact same figures, he was sold a pair of glasses, and it makes his close up vision a fraction sharper. Where for me, I tried his glasses on, and it made my closeup, blurry! So I've been really confused on what it all means. Im considering just buying the cheapest pair they have just to give it a try. One thing I've noticed a long long time, is that my eyes feel constantly tired. I don't know if this is related to my thyroid problem, which is now apparently normal, or if I am genuinely tired, or if the tired eyes are making me feel more tired that I actually am. So I went to the optician to ask for advice, and they even ask if it's for reading or... Well, I don't know... it's got+0.50 +0.75, that means reading, right? So then how come I feel my distance vision isn't that sharp? And that actually I feel it changes from moment to moment and alternates between two states (which would be typical for me, everything else seems to alternate). So can you guys help me make sense of it all? Cheers Simon > Thought I might go to the optician to ask about Glasses... (me, 28, male) > [quoted text clipped - 11 lines] > a pair of glasses, and it makes his close up vision a fraction sharper. > Where for me, I tried his glasses on, and it made my closeup, blurry! I wouldn't put any significance on the observation that your near vision is worse when looking through your friends glasses. They are almost certainly different prescriptions. Wearing your friends shoes might not seem as comfortable to you either. > So I've been really confused on what it all means. Im considering just > buying the cheapest pair they have just to give it a try. One thing I've > noticed a long long time, is that my eyes feel constantly tired. I don't > know if this is related to my thyroid problem, which is now apparently > normal, or if I am genuinely tired, or if the tired eyes are making me > feel more tired that I actually am. Your prescription is quite light. Most farsighted individuals with slight astigmatism, such as yourself, tend to report fairly clear distance vision although they may notice that it seems to fluctuate somewhat. Usually they test 20/20 at distance. The rub for farsighted individuals comes with their near vision. When tested it usually tests 20/20 (at your age), but prolonged near work (reading, computer work, sewing, studying, etc.) can cause eyestrain and headaches. This sounds like what you are reporting when you talk about your tiredness. Farsighted patients report a variety symptoms ranging from dull pressure around their eyes, occasional blur at near, non-specific tired feeling around their eyes, headaches, stinging discomfort in their eyes, and a feeling that their eyes are crossing. Tiredness when doing prolonged nearwork is certainly a symptom of farsightedness. Usually if the plus lens prescription is used only for near work then the symptoms are relieved. Sometimes using the prescription also helps a little with distance vision but as I said before that is usually not the major problem. Purchasing the eyeglass prescription you listed, IMHO, is totally optional. I tell people that if they are having symptoms with near work then get them and use them primarily as readers. If they are not having problems then don't get the glasses! Patients younger than their mid-30's, such as you, can oftentimes tolerate a little farsightedness. As you approach age 40, you will likely develop more symptoms. Hope this helps. >> Thought I might go to the optician to ask about Glasses... (me, 28, >> male) [quoted text clipped - 17 lines] > almost certainly different prescriptions. Wearing your friends shoes > might not seem as comfortable to you either. Ah yes, I forgot they test the pupils, and lenses will be made for different astigmatisms... > Your prescription is quite light. Most farsighted individuals with > slight astigmatism, such as yourself, tend to report fairly clear > distance vision although they may notice that it seems to fluctuate > somewhat. Yes... that's it entirely... Yesterday, I looked say, North, clear, then West and got frustrated. I was trying to look at signs and wondered why, I wouldn't say clear, but, some signs weren't as sharp as others. I even stood in the shop reading at arms length a card with very tiny text at arms length, just about, and then he asked me to look over the road, and that didn't seem sharp. Most disconcerting. Though maybe I just favour a particular contrast or colour. > Usually they test 20/20 at distance. The rub for farsighted > individuals comes with their near vision. When tested it usually [quoted text clipped - 5 lines] > non-specific tired feeling around their eyes, headaches, stinging > discomfort in their eyes, and a feeling that their eyes are crossing. Dull pressure? That sounds like the perfect explanation about what Im feeling. It feels almost like a problem with my sinuses, but around my eyes. Im feeling a lot more hopeful this can all be explained and resolved now. > Purchasing the eyeglass prescription you listed, IMHO, is totally > optional. I tell people that if they are having symptoms with near > work then get them and use them primarily as readers. So they definitely are reading glasses? I got confused yesterday when my optician, after looking at the results from my eye test, asked if they were to be reading glasses! Is there a choice? > If they are not having problems then don't get the glasses! Patients > younger than their mid-30's, such as you, can oftentimes tolerate a > little farsightedness. As you approach age 40, you will likely > develop more symptoms. That is a very subjective statement though... If you are not having problems, don't get glasses. That was pretty much the statement given to me at my eye test, but he didn't explain what kind of problems would qualify, or indeed explain about eye strain or headaches and how to spot them and recognise them as being eye related etc. > Hope this helps. It does. Thank you very much for your reply, it's highly appreciated. Cya Simon >So they definitely are reading glasses? I got confused yesterday when my optician, after looking at the results from my eye test, asked if they were to be reading glasses! Is there a choice? Not a choice, no - but that prescription COULD be for either distance or reading glasses. In your case, your symptoms are up close, so that's where you'd wear the glasses. >That is a very subjective statement though... If you are not having problems, don't get glasses. That was pretty much the statement given to me at my eye test, but he didn't explain what kind of problems would qualify, or indeed explain about eye strain or headaches and how to spot them and recognise them as being eye related etc. Simon's answered this already, but just to add... if the headaches are on your forehead/brow region then they are more likely to be eye related than neck related. > Not a choice, no - but that prescription COULD be for either distance > or reading glasses. In your case, your symptoms are up close, so > that's where you'd wear the glasses. Then in that case Im even more confused. What's the difference between prescriptions for reading and prescriptions for distance? The prescription card I had had space for "Distance" and "Near" I believe, and only the "Distance" one was filled out. > Simon's answered this already, but just to add... if the headaches > are on your forehead/brow region then they are more likely to be eye > related than neck related. Thanks Simon > Then in that case Im even more confused. What's the difference between > prescriptions for reading and prescriptions for distance? The > prescription card I had had space for "Distance" and "Near" I believe, > and only the "Distance" one was filled out. For young people (under age 40), often one Rx will work well for both distance and near, and you can use them for either or both functions. (I think your original post indicates this to be the case). I think 3/4 D oblique astigmatism is significant enough to warrant getting a pair of glasses, then use them wherever they help you, which is probably going to be for just about everything. w.stacy, o.d. > Then in that case Im even more confused. What's the difference between > prescriptions for reading and prescriptions for distance? The prescription > card I had had space for "Distance" and "Near" I believe, and only the > "Distance" one was filled out. Prescriptions for single-vision lenses for _near_ are usually written in the "Distance" field, even if they're for near vision only. It's proper to add the note "NVO" or "Use Near PD" to signify the lenses should be centered about 3-4 mm closer together, to account for convergence. >> Simon's answered this already, but just to add... if the headaches >> are on your forehead/brow region then they are more likely to be eye >> related than neck related. And more likely to be sinus-related than eye-related. Is the pressure worse when you get up of a morning? Does it get worse when you bend over? Or does it gradually increase when you read or drive or play Zuma? -MT >> Then in that case Im even more confused. What's the difference >> between prescriptions for reading and prescriptions for distance? [quoted text clipped - 6 lines] > should be centered about 3-4 mm closer together, to account for > convergence. AS a total lay person, that means very little to me. But from what Im gathering from everything, because Im not over 40, I won't be suffering from Presbyopia, so one reading only is all that is required and those glasses (even I said for Reading only, being totally confused), would be suitable for all uses... Both distance (if required) and reading. >>> Simon's answered this already, but just to add... if the >>> headaches are on your forehead/brow region then they are more >>> likely to be eye related than neck related. > > And more likely to be sinus-related than eye-related. Still love to know how I answered my question... Certainly the feeling is kind of like the feeling I had when I had a sort of eye infection and mucus was streaming from behind my eye. A sort of dull heavy ache... > Is the pressure worse when you get up of a morning? Does it get worse > when you bend over? Or does it gradually increase when you read or > drive or play Zuma? I noticed it this morning when I first got up yes, and it clears up when Im outside, so I'd say its made worse by close up work. Certainly looking at this monitor right now its hard to focus and see clearly and that's where the ache is starting to come into play. I guess I don't notice it so much at work anymore, since they've given me a 17 inch monitor that I've had for the past few months. Bending down actually alleviates the problem. It has been known in the past for me to have splitting headaches that traverse from the front to the back of my head, and when I was reading my Harry Potter books a few years back, I would be getting eye strain and getting sleepy too very quickly. Don't notice eye strain when I drive or, I don't know what Zuma is... but I'll let you know about the driving tomorrow after I've been in the car. Thank you Simon > Thought I might go to the optician to ask about Glasses... (me, 28, male) > [quoted text clipped - 11 lines] > a pair of glasses, and it makes his close up vision a fraction sharper. > Where for me, I tried his glasses on, and it made my closeup, blurry! If they were not exactly the same, then you might well see worse with them. > So I've been really confused on what it all means. Im considering just > buying the cheapest pair they have just to give it a try. One thing I've > noticed a long long time, is that my eyes feel constantly tired. I don't > know if this is related to my thyroid problem, which is now apparently > normal, or if I am genuinely tired, or if the tired eyes are making me > feel more tired that I actually am. You have astigmatism which can result in eye strain if not corrected. > So I went to the optician to ask for advice, and they even ask if it's for > reading or... [quoted text clipped - 4 lines] > two states (which would be typical for me, everything else seems to > alternate). Your prescription could also be written as Right Distance -025 Sph, +0.75 Cyl, 045 Axis Left Distance pl Sph, +0.50 Cyl, 125Axis The + doesn't mean near or far, the word "distance" in the prescription means it is specifiying your distance RX. If you are under 40, the distance and near RX is the same. Astigmatism will affect both near and far, I would tell a patient with your kind of Rx to use them for "detailed visual tasks" near and far. Dr Judy > Thought I might go to the optician to ask about Glasses... (me, 28, male) > [quoted text clipped - 3 lines] > Right Distance +0.50 Sph, -0.75 Cyl, 135 Axis > Left Distance +0.75 Sph, -0.50 Cyl, 35 Axis Well then all, I got the glasses today, and everything just seems to take on a whole new clarity, sharpness, focus, and contrast. It's not that different, but it's different enough, and it certainly feels like it relieves a little of the pressure on my eyes. So things might be going well. Im still confused over being asked if I wanted reading glasses... Is it possible in this configuration to get a pair of glasses that will do near and distance (if required), or can they only be used for near? Distance is blurry with them on. Is that normal? Thanks Simon > Distance is blurry with them on. Is that normal? Yes, the blurry distance vision can be intentional if your worst symptoms were up close. It's also possible that you'll adapt and get better faraway vision. A "distance" prescription might use less plus but it wouldn't help your near vision as much, and sometimes makes near vision more taxing, rather than less. -MT >> Distance is blurry with them on. Is that normal? > [quoted text clipped - 6 lines] > your near vision as much, and sometimes makes near vision more > taxing, rather than less. Thanks for the concise version Mike. :-) I feel much happier. Now if I can only get used to wearing glasses in public. :-) Cheers Simon > Distance is blurry with them on. Is that normal? This complaint relates to what I was referring to in my original reply. The problem with a farsighted correction is that most farsighted people see pretty well in the distance anyway. Their major problem is eyestrain ("pressure" in your case) after doing near tasks. When you give a farsighted person their full plus prescription (by the way, plus lenses do not automatically mean that an Rx is a reading prescription-- farsighted corrections are by definition always plus corrections for distance) oftentimes they do report slight blur in the distance. This occurs because their ciliary muscle within their eye has not adapted to the new prescription. The new prescription allows the muscle to relax but it has become used to contracting constantly to help you see without your glasses. It is the excessive contraction of that ciliary muscle within your eye that is causing that feeling of pressure you are getting. Just keep wearing your glasses and your ciliary muscle with adapt to its new refractive posture and the distance will clear up and possibly appear slightly better than before (due to the astigmatic component of your prescription). However, you will immediately notice benefits with your new glasses when looking at nearer objects. That is why many doctors, including myself, refer to these kind of corrections as "reading" corrections even though they can be used for both distance and near. I tell my patients who get prescriptions like yours to initially start wearing their glasses only when doing near tasks and if the eyestrain complaints continue then to slowly increase their use of them more and more. If distance viewing appears too blurry right now for you to feel comfortable driving with them, then don't use them for that but use them more and more for other tasks. You will find that, in a few days to a few weeks, distance looks sharp and clear with your new glasses once your ciliary muscle becomes used to it's new "posture". The more you wear them the faster you will adapt. Sorry for droning on and on-- in a nutshell, you'll get used to your new glasses and they will seem fine in the distance. > Is it possible in this configuration to get a pair of glasses that will do > near and distance (if required), or can they only be used for near Thats the prescription that you have now. As I said before, they will help you immediately at near and eventually the distance will look clear once you get used to them. If your eyestrain symptoms of "pressure" are relieved by only using them at near (reading, computer, etc.) then you don't need them at distance. I'd wager that your 20/20 in the distance now anyway. >> Distance is blurry with them on. Is that normal? [snip] (sorry) > Sorry for droning on and on-- in a nutshell, you'll get used to your > new glasses and they will seem fine in the distance. Hey no, drone on. Plain English, with explanation about what's happening. I enjoy that, I can understand more, thanks. >> Is it possible in this configuration to get a pair of glasses that >> will do near and distance (if required), or can they only be used [quoted text clipped - 6 lines] > computer, etc.) then you don't need them at distance. I'd wager that > your 20/20 in the distance now anyway. I note the attention to not drive with them if I feel uncomfortable, and I definitely feel uncomfortable. I mean, I can make things out, but they do seem blurry and not as clear as I'd prefer while driving. I'll wear them more when I get home. I just need to get used to wearing them in public I guess. In contrast, for close objects, I was sitting in my car, and while other cars looked a tad blurry, things in the car were crystal clear, the odometer, even the writing on my radio. To get the same effect without glasses, I had to, in the words of Red Dwarf "move my head closer to the object". But with the glasses on, I could see at a intermediate distance quite readily and with much more clarity it was unbelievable. So I mean, that's the other confusing thing and the only thing I havent had answered yet, which is, why can I see an object better at say three inches, than I can at Arms length, when I am long sighted? Thanks Simon > So I mean, that's the other confusing thing and the only thing I havent > had answered yet, which is, why can I see an object better at say three > inches, than I can at Arms length, when I am long sighted? You do have a working accommodation system, so it's _possible_ to see at 3 inches. We can bet you wouldn't tolerate if for long. *If* you have sufficient accommodation to clear it, a retinal image gets 12 times larger when you move the object from 36 inches to 3 inches. In jargon-speak we call it "relative distance magnification." -MT Doctor Stacy has touched on your answer above, but I'll mention it again here. Think of your prescription an a map of three dimensional space. The +50 means that in one meridian (or plane) you are farsighted. The -.75 means that 90 degrees away you are nearsighted (by -.25, this is straight algebra) So, when you are uncorrected, some of the image is in front of your retina and some is behind it. (If you want to be a real trivia freak, the gap between the two meridians is called "the interval of Sturm") When you put on your eyeglasses, you are collapsing the interval of Sturm, ie you are putting all light in the same plane. That is why you have those "Eureka" moments with your glasses on. When the other posters talk about how young you are and how your glasses can work for far or near, they are saying that an astigmatic correction like you have is good for far or near, you decide when you want to wear it. When you wear your glasses and don't like them, its because there are certain distances that your brain has adapted well to being uncorrected, and it doesn't like the new image. If I had your prescription I would wear them all the time to collapse that interval of Sturm full time and let my eye muscles relax. >Doctor Stacy has touched on your answer above, but I'll mention it >again here. Think of your prescription an a map of three dimensional [quoted text clipped - 16 lines] >prescription I would wear them all the time to collapse that interval >of Sturm full time and let my eye muscles relax. That was interesting. Thanks for explaining that so clearly. Tom RM gave an excellent description of the problems related to plus lens adaptation. you stated "I'll wear them more when I get home. I just need to get used to wearing them in public I guess. " as RM said, perhaps you will get relief from your eyestrain by wearing them only when doing near tasks. most hyperopes do. you stated "why can I see an object better at say three inches, than I can at Arms length, when I am long sighted?" it's because the image of an object held 3 inches from your face is 10 times bigger than the image of the same object held at arms length. its easier to see something 10 times bigger even though its more strain on your eyes! > Sorry for droning on and on-- in a nutshell, you'll get used to your new > glasses and they will seem fine in the distance. Thanks for droning on and on. It explains what has happened to my wife in the last year or so. At first she only wore her glasses for driving (+1D for distance with a +2 add), but now wears them all the time. It's an interesting role reversal. I was severely myopic (-10D and -12D correction) and wore glasses almost constantly for 35 years, whereas she didn't wear glasses until about a year ago. I've had cataract surgery in both eyes and don't wear any correction for distance.  SignatureDan Abel Sonoma State University AIS dabel@sonic.net
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