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Medical Forum / General / Vision / October 2005One eye Myopia?
Hello good folks. I'm looking for a little education & advice. Please & thank you. I'm 30 years old and as far as I know, I've always had poor vision in my left eye. And by poor I mean about 20/200 without any correction and about 20/70 with lenses. The vision in my right eye is very close to 20/20. My day to day vision is close to 20/20 so I have never worn glasses for any length of time. Optometrists have told me that this is because my brain compensates and uses more of the "good" eye. So my question is this: Is there anything I can do to improve the vision in my left eye? I am interested in making a career move which requires correction to at least 20/40. Could any of the surgical options be beneficial to me? Any help is much appreciated. > Hello good folks. I'm looking for a little education & advice. Please & > thank you. [quoted text clipped - 5 lines] > glasses for any length of time. Optometrists have told me that this is > because my brain compensates and uses more of the "good" eye. You'll have to tell us why the poor eye cannot be corrected beyond 20/70. Only in that way can the possibility of improvement be evaluated. It's hard to understand why BOTH eyes have to be 20/40 or better. Your depth perception must be pretty good. > > I'm 30 years old and as far as I know, I've always had poor vision in > > my left eye. And by poor I mean about 20/200 without any correction and [quoted text clipped - 5 lines] > You'll have to tell us why the poor eye cannot be corrected beyond 20/70. > Only in that way can the possibility of improvement be evaluated. I agree. Pretty hard to give any advice about how to fix something when you don't know what's broken. > It's hard to understand why BOTH eyes have to be 20/40 or better. Your depth > perception must be pretty good. You lost me here. The poster has 20/200 uncorrected vision and doesn't normally wear correction. I would think the depth perception would be quite poor. Sorry, but no one has ever told me "why" it can't be corrected better than 20/70. I think I've always just "maxed out" the lenses at the Dr.'s office and been told that this is the best we can do. The last prescription I got (about 2 months ago) was for R -25 & L +200. And as far as I know, my depth perseption is fairly good. I don't bump into things, drive daily, play sports, etc. > And as far as I know, my depth perseption is fairly good. I don't bump > into things, drive daily, play sports, etc. Don't need depth perception for the above activities. I have no depth perception, and I drive, fly a plane, walk and play sports with no problems. Allen Wrong. You have lots of depth perception. You only lack stereopsis, just one of 5 or 6 clues to depth... w.stacy, o.d. > I have no depth perception, and I drive, fly a plane, walk and play sports > with no problems. > > Allen > Wrong. You have lots of depth perception. You only lack stereopsis, > just one of 5 or 6 clues to depth... Geeze, William, at the rate you're knocking words out of my vocabulary, I'm going to have to give up communicating! So, vision out of one eye means you still have depth perception, just not STEREOPSIS? A guy at work was complaining that when he got something in his eye and had to patch it, he couldn't pick up his coffee from the table. He thought that was because he had been using that patched eye for that. I explained that I thought he had lost his depth perception. > So, vision out of one eye means you still have depth perception, just > not STEREOPSIS? Right on. Consider the most basic clue to depth: overlap. If one opaque object is covering part of another, the brain knows that the one doing the covering is closer. Another, relative size. If a baby looks like it is twice as large as a sumo wrestler in the same photo, the brain knows it's because the baby is closer. More subtle and difficult to explain, but very effective, is parallax. When the viewer is moving, or an object is moving, a strong clue to depth is appreciated. A good example of this is the apparent 3-D effects given by Disney films, where the more quickly moving objects seem to be closer to you than the slower moving background. One eyed people should learn to move their head from side to side as they park their cars in close quarters, as parallax is nearly as good as stereopsis for that task. > A guy at work was complaining that when he got something in his eye and > had to patch it, he couldn't pick up his coffee from the table. He > thought that was because he had been using that patched eye for that. I > explained that I thought he had lost his depth perception. You were partly right. If you'd said he lost his stereo vision or stereopsis, you would have been exactly correct. If he moved his head a bit as he reached, he probably could have snagged it. w.stacy, o.d. > Wrong. You have lots of depth perception. You only lack stereopsis, > just one of 5 or 6 clues to depth... This is good to know *smile*. I was told at a young age I didn't have depth perception. I figured what I don't have, I don't miss. I always told people I can tell if I was close to something as things got closer (I.E. the car gets bigger, I am closer to it). Based on what you say, everybody has depth perception reading your other post? Allen > Based on what you say, everybody has depth perception reading your other > post? > > Allen Not sure about the other post, but anyone who can see anything has *some* depth perception. Only those of us who are blessed with normal binocularity have stereopsis (stereo vision, 3-D vision, etc). The rest have monocular depth perception. Like you get when you look at a photo or a Disney film. It has depth, but not precise depth like you get with stereo... w.stacy, o.d. > Not sure about the other post, but anyone who can see anything has > *some* depth perception. The post to Dan Abel was the one I was referring to. > rest have monocular depth perception. Like you get when you look at a > photo or a Disney film. It has depth, but not precise depth like you > get with stereo... Can't simulate this on the computer *big smile*. Wonder if my landings would be better with additional depth perception. I guess I compensate with "engine power" or the sense of touch to compensate for the lack of precise depth perception as you describe. I can see the runway come up at me, but I use the sense of feel to land the plane if this makes sense? Allen > Wonder if my landings would be better with additional depth perception. I > guess I compensate with "engine power" or the sense of touch to compensate > for the lack of precise depth perception as you describe. I can see the > runway come up at me, but I use the sense of feel to land the plane if this > makes sense? Actually, landing an airplane does not require stereopsis at all. You are using other clues to where you are. The horizon is the big one. Parallax and runway size are others. You don't need stereo unless you're flying in close formation and you need to stay close, but not too close, to your wingman or leader as the case may be... w.stacy, o.d. > You don't need stereo unless > you're flying in close formation and you need to stay close, but not too > close, to your wingman or leader as the case may be... Wouldn't my peripheral vision do this and my "size association" compensate for my lack of stereo? While I don't see out of both eyes simultaneously, if I close one eye, that affects my peripheral vision adversely. I guess it's hard to describe something that is lacking..... Allen >>You don't need stereo unless >>you're flying in close formation and you need to stay close, but not too >>close, to your wingman or leader as the case may be... > > Wouldn't my peripheral vision do this and my "size association" compensate > for my lack of stereo? And your parallax will help, but not good enough, at least it wasn't in th 70s for the USAF. Stereo depth is extremely accurate at that distance, far more so than the monocular clues all combined. > I guess it's hard to describe something that is lacking..... Right. A person with normal stereo can simulate how you see by covering one eye, but you have no way to appreciate stereo and so you can't get too excited a 3-D movie. It's also like trying to appreciate how a person with a color vision defect sees the world. No way to do that or to tell them how normal color "looks". w.stacy, o.d. >A person with normal stereo can simulate how you see by covering >one eye, but you have no way to appreciate stereo and so you can't get >too excited a 3-D movie. I remember sitting in the "Captain EO" movie theatre, at Disneyland, some years ago, for the screening of the Michael Jackson 3-D feature. Knives, swords, and all other matter of highly lethal objects were thrown directly 'toward' the audience. I was acutely aware that--of some 3-400 people--I was the only one not ducking to avoid the projectiles. They weren't three-dee-to-me :-( [But Vincent Price's voice /was/ cool!] >Wonder if my landings would be better with additional depth perception. I >guess I compensate with "engine power" or the sense of touch to compensate [quoted text clipped - 4 lines] >Allen > Allen, does FAA medical require you to be tested for your depth perception, I know the military does but like Bill said it is for flying in formations, and I don't think civilians are authorized to fly formations. On the other hand, you may want to try a pair of plus lenses and take control in your own hands and fix your depth perception which is most likely connected to your myopia? **sarcasm* *Happy landings man!* * > Allen, does FAA medical require you to be tested for your depth > perception, I know the military does but like Bill said it is for flying > in formations, and I don't think civilians are authorized to fly > formations. Mehmet, Since I am fresh off my medical (last month), I was tested for the following: Acuity (near and far) Color - read numbers on a color chart Peripheral - look straight ahead and doc moved pencil up and down and left and right Stereoscopic - look into a machine and was asked to say where a line was over which music note, Failed this miserably as I saw the line and saw the music notes independently, but not over each other. I thought in my childhood, I had a depth perception test, thus the diagnosis, but none of these above are depth perception tests? What vision test does depth perception testing? > On the other hand, you may want to try a pair of plus lenses > and take control in your own hands and fix your depth perception which > is most likely connected to your myopia? **sarcasm* Dang, is that why I was handed some plus lenses and recommended to endure 18 hours of blur to take control? *big smile* Who needs to see the runway? > *Happy landings man!* CAVU for you too! Allen > Stereoscopic - look into a machine and was asked to say where a line was > over which music note, Failed this miserably as I saw the line and saw the > music notes independently, but not over each other. This sounds like a test for the existence of binocular function. It probably assumes that if you fail it, you don't have stereo, so it's not worth testing. Problem is, some people who have stereo will fail such a test for one reason or another. > I thought in my childhood, I had a depth perception test, thus the > diagnosis, but none of these above are depth perception tests? Nope. > What vision test does depth perception testing? There are 2 ways. Vectographic, which uses special cross polarized filters to simulate depth on corresponding polarized test cards/slides. The other way, which I used back in the 70s in the USAF, is the Howard Dolman test in which you use strings to line up a moveable peg with a stationary one in a box that has all monocular clues to depth mostly eliminated. w.stacy, o.d. > Sorry, but no one has ever told me "why" it can't be corrected better > than 20/70. I think I've always just "maxed out" the lenses at the > Dr.'s office and been told that this is the best we can do. The last > prescription I got (about 2 months ago) was for R -25 & L +200. Your left eye is hyperopic, not myopic. It does not see better than 20/70 because it is amblyopic, which means that the brain cells responsible for the left eye are underdeveloped. Ideally you should have worn glasses before the age of 6 and might have needed to patch the right eye for a time. However, 20/70 is not bad and it may be possible to improve your best corrected to 20/40. Do you wear your current glasses full time now? If not, then you should try that for a few weeks then talk to your eye doctor about trying to improve that eye to 20/40. With some eye exercises and possibly part time patching of the right eye you might be able to do that. A contact lens on the left eye would likely provide the best correction for you. BTW, the surgical approaches are substitutes for glasses; if glasses don't provide 20/40 best corrected, then surgery won't either. Dr Judy > And as far as I know, my depth perseption is fairly good. I don't bump > into things, drive daily, play sports, etc. Since I can see fairly well, I have been opting not to wear glasses or contacts for the last 20 or so years. I've recently been contemplating a career change, which started me on this path. From what I've been reading it looks like I'm going to give it a try with contacts and a patch (where does one get an eye patch these days?). The other part of the story is that I don't really have an eye docter, either. The only person I have seen about this recently is the optomotrist at Four Eyes. And I'm not knocking his ability, but I would like to find an Opthomologist who might be more knowledgable. Is there any way for me to find someone reliable. I'm fairly new to the Baltimore area and don't know too many people to ask about this. Thanks. > reading it looks like I'm going to give it a try with contacts and a > patch (where does one get an eye patch these days?). I've always bought my patches at any regular drug store, with the other eye products. Why wear a patch, though? It makes it hard to see. :-) > The other part of the story is that I don't really have an eye docter, > either. The only person I have seen about this recently is the > optomotrist at Four Eyes. And I'm not knocking his ability, but I would > like to find an Opthomologist who might be more knowledgable. My experience is that the OD has training and experience with glasses and contacts that the OMD doesn't.  SignatureDan Abel dabel@sonic.net Petaluma, California, USA > It's hard to understand why BOTH eyes have to be 20/40 or better. Your > depth perception must be pretty good. I'd think there would be very little in the way of stereopsis. SignatureScott Reverse name to reply > It's hard to understand why BOTH eyes have to be 20/40 or better. Perhaps the poster wants to switch to a job that requires that level of acuity in both eyes. For example, to obtain a commercial drivers license in most states the acuity in both eyes must be 20/40 or better. Not so for a standard automobile license where only one eye needs good acuity. If the original poster is really 20/70 in his amblyopic eye with his best correction, and he is age 30, then I seriously doubt he will ever be able to achieve the 20/40 metric he is seeking (unless he has a cataract). Oftentimes correcting an amblyope with glasses when they aren't used to wearing them just to maximize the acuity in their weaker eye will result in transient binocular rivalry that can be more problematic than good. I agree with the second paragraph, but not the first. It is well known that amblyopia, especially of the type caused by previously uncorrected anisometropia (which admittedly is just my guess at this point), resolves nicely with extensive occlusion of the better eye, and 20/70 to 20/40 is, I would say, not exactly a monumental leap. Sure, he may have to work at it, and it may not be completely comfy, but it should be doable. w.stacy, o.d. >If the original poster is really 20/70 in his amblyopic eye with his best >correction, and he is age 30, then I seriously doubt he will ever be able to [quoted text clipped - 5 lines] > > William Stacy <wstacy@obase.net> wrote in news:src3f.15801$6e1.10206 @newssvr14.news.prodigy.com: > Sure, he may have > to work at it, Do you mean: "He needs to take responsibility for his own vision, and pay heed to the 'second opinion'"? Sorry, couldn't resist!! SignatureScott Reverse name to reply Sorry folks, I do appreciate all the responses but I'm confused by all the technichal terms. I've never been told what the problem is. I've just been given the strongest lense and been sent out with "this is the best we can do". At my last exam I was given a prescription for R -25 & L +200. >>I'd think there would be very little in the way of stereopsis. depth perception? I've never had a problem doing daily things, playing sports, driving, etc. I think its fine. As for the patching...I'm willing to give it a try if there's a chance of it working. Would I just be wearing glasses and covering my right eye, forcing the left to do more work? i would have to go along with an earlier poster-- I don't think you will be able to recover 20/40 or better acuity in your left eye with glasses and patching. i also think you may run into binocular perceptual problems since you have gotten used to not wearing any glasses and now at age 30 try to force some vision from your left eye with an aniso- correction. > i would have to go along with an earlier poster-- I don't think you > will be able to recover 20/40 or better acuity in your left eye with > glasses and patching. i also think you may run into binocular > perceptual problems since you have gotten used to not wearing any > glasses and now at age 30 try to force some vision from your left eye > with an aniso- correction. Nuts to that. Don't believe it. I was right in guessing you were an anisometrope, PREVIOUSLY UNCORRECTED, which means if you get a pair of glasses (or contacts) that correct your aniso and you wear them full time, and you patch the good eye as much as possible, YOU WILL OBTAIN AT LEAST 20/40 in the bad eye. Hands down. I don't have a clue as to where these guys are getting their info. Anisometropic amblyopia is almost a no brainer! It's a matter of learning how to aim that eye. Nothing more, nothing less. w.stacy, o.d. > > i would have to go along with an earlier poster-- I don't think you > > will be able to recover 20/40 or better acuity in your left eye with [quoted text clipped - 11 lines] > almost a no brainer! It's a matter of learning how to aim that eye. > Nothing more, nothing less. I'm confused. What's the difference between amblyopia and PREVIOUSLY UNCORRECTED anisometropia? My wife has amblyopia, and was told that vision in her right eye is toast. Vision in her left eye has suffered the normal ravages of age (we're both 55), so she's wearing glasses full time now (+1.0 in the left eye, with a +2.0 add). She was talking to me about how since she is wearing glasses anyway, that she doesn't think that her prescription of MATCH for the right eye is correct, since she thinks it is correctable. I told her that I didn't have a clue, since my experience is with severe myopia. I suggested that she see the private practice OD that I've been seeing for several years. There's some time pressure here, since I've retired and my insurance expires at the end of November. My HMO gives eye exams, but the plan we have with them doesn't cover the cost of glasses or contacts. Amblyopic people are funny that way. Some of them are obsessed with keeping the optimum correction in that eye regardless of the level of acuity and the fact that they will never use that eye under bi-ocular conditions. By the way, contact lenses are far more effective in dealing with anisometropia than spectacles, as they produce image sizes that are more similar. The amblyopia can be treated and still not have binocular vision because of retinal image size differences. Also, it is possible to restore the visual acuity without being able to restore binocularity, and binocularity is required for stereopsis. Stereopsis is a type of depth perception. The effect of stereopsis is lost with distance, where monocular clues like shadow, relative size, relative movement, etc. are used instead. DrG > Amblyopic people are funny ... It is good to be able to see the humor in our situations. As we amble and fumble and blink at the blurry lights. -- Magoo > I'm confused. What's the difference between amblyopia and PREVIOUSLY > UNCORRECTED anisometropia? Amblyopia is subnormal acuity of one eye due to non-use of the macula under two eyed viewing conditions. This is always due to one or both of two causing conditions, uncorrected anisometropia and constant strabismus, both of which allow only one macula to be aligned (strabisms) or in focus (aniso) with the object of regard at one time. The full term amblyopia ex anopsia means poor vision from disuse. My wife has amblyopia, and was told that > vision in her right eye is toast. Vision in her left eye has suffered > the normal ravages of age (we're both 55), so she's wearing glasses full [quoted text clipped - 3 lines] > that she doesn't think that her prescription of MATCH for the right eye > is correct, since she thinks it is correctable. OK if the right eye measures say +4.00, then she has anisometropic amblyopia. This is easily corrected in early childhood, more difficult to treat in adulthood. You can imagine it would be tough to get her to patch her left eye for any length of time at this point. But studies show that adult amblyopes who lose their good eye (accident, disease, etc) do eventually achieve normal or near normal acuity. If the eye is strabismic, then it's a similar story. I told her that I > didn't have a clue, since my experience is with severe myopia. I > suggested that she see the private practice OD that I've been seeing for > several years. There's some time pressure here, since I've retired and > my insurance expires at the end of November. My HMO gives eye exams, > but the plan we have with them doesn't cover the cost of glasses or > contacts. If she has a reasonable amount of aniso (not 4 D. or more), she might want to try an Rx with it in there. I know most docs don't do it because they don't "believe" it will help, but I have seen it help (and have seen it fail), and I let the patient decide. As has been noted, contacts are easier for aniso, and there is no upper limit that I'd Rx contacts for. Two eyes are better than one... w.stacy, o.d. >which means if you get a pair of glasses (or contacts) that correct your >aniso If you want to try this, I would recommend contacts as retinal image size differences are minimized compared to glasses. This problem is ONE of the difficulties that you need to control. > and you wear them full time, and you patch the good eye as much as > possible, I think it would be pretty hard to handle this since the patient is 20/70 in the left eye with the best correction and things won't look very good out of that eye. Patching won't be accepted by most patients under these circumstances. I personally don't think it would be effective either. >YOU WILL OBTAIN AT LEAST 20/40 in the bad eye. Hands down. Pretty strong statement. Remember, the patient is 30 and hasn't worn a correction and his BVA OS is 20/70. > I don't have a clue as to where these guys are getting their info. In my case, optometry school, graduate school, lots of clinical experience. > Anisometropic amblyopia is almost a no brainer! It's a matter of learning > how to aim that eye. Nothing more, nothing less. Oversimplified. I have no information about problems the patient has "aiming the eye" so I'm not sure what you mean. However, if he is indeed amblyopic then as you know there is much more to the problem than simply putting a sharp image on the retina and having the eyes align! For good acuity and stereopsis, neural connections need to be formed properly with both eyes during brain development-- remember the patient is age 30! And the patient has developed his own method of visual perception without the use of stereopsis-- sometime when you restore a degree of binocularity to an amblyope who isn't used to it they get rivalry effects that can be very distressing. But the proof is in the trying. Give it a try. If I were a betting man you know where I would put my money. > If you want to try this, I would recommend contacts as retinal image size > differences are minimized compared to glasses. This problem is ONE of the > difficulties that you need to control. No argument there, except in those rare cases where specs cause LESS aniseikonia than cls. > >>and you wear them full time, and you patch the good eye as much as >>possible, [quoted text clipped - 3 lines] > that eye. Patching won't be accepted by most patients under these > circumstances. I personally don't think it would be effective either. It is tough, and is why docs like you dismiss the possibility out of hand. If I had aniso, I'd sure try it and would be pissed off if my doc pre-empted that possibility for me. >>YOU WILL OBTAIN AT LEAST 20/40 in the bad eye. Hands down. > > Pretty strong statement. Remember, the patient is 30 and hasn't worn a > correction and his BVA OS is 20/70. The fact that it is previously uncorrected is the very reason I would be hopeful. If she HAD been previously corrected and was only 20/70, then the prognosis would obviously (to me) be worse, since she would have at least had the opportunity to use the macula. >> I don't have a clue as to where these guys are getting their info. > > In my case, optometry school, graduate school, lots of clinical experience. Well, I'm going to dimiss the last one, since you've obviously not tried something you don't believe in. I got my understanding of binocular vision from U.C. Berkeley Sch. Optom., and those studies on loss of the non-amblyopic eye were available way back then... >>Anisometropic amblyopia is almost a no brainer! It's a matter of learning >>how to aim that eye. Nothing more, nothing less. > > Oversimplified. I have no information about problems the patient has > "aiming the eye" so I'm not sure what you mean. Amblyopia is always accompanied by unsteady or eccentric fixation, or both. The brain can learn to aim the eye. There is nothing physically wrong with an amblyopic eye. Elementary. However, if he is indeed > amblyopic then as you know there is much more to the problem than simply > putting a sharp image on the retina and having the eyes align! For good > acuity and stereopsis, neural connections need to be formed properly with > both eyes during brain development-- remember the patient is age 30! Damn, you'd think she was over the hill. Of course there is lots more, but I just don't believe in being pessimistic just because it's easier. And > the patient has developed his own method of visual perception without the > use of stereopsis-- sometime when you restore a degree of binocularity to an > amblyope who isn't used to it they get rivalry effects that can be very > distressing. True, and it doesn't always work. > But the proof is in the trying. Give it a try. If I were a betting man you > know where I would put my money. I do. w.stacy, o.d. All patients with anomalous retinal correspondence or eccentric fixation have amblyopia. However, not all patients with amblyopia have anomalous retinal correspondence or eccentric fixation. DrG But all patients with amblyopia have either eccentric fixation or unsteady fixation. w.stacy, o.d. >All patients with anomalous retinal correspondence or eccentric >fixation have amblyopia. However, not all patients with amblyopia have [quoted text clipped - 3 lines] > > Having thought about it a minute, I also don't agree that all patients with ARC have amblyopia. I've seen alternating tropes with harmonious ARC who are 20/20 in both eyes. w.stacy, o.d. > But all patients with amblyopia have either eccentric fixation or > unsteady fixation. [quoted text clipped - 8 lines] >> >> > But all patients with amblyopia have either eccentric fixation or > unsteady fixation. > > w.stacy, o.d. I absolutely stand by the statement that not all amblyopic patients are eccentric fixators. However, I might be willing to agree with the statement that amblyopic patients show unsteady fixation. DrG OK I studied under Merton Flom, who claimed that all true amblyopia is accompanied by unsteady or eccentric fixation. I know not everyone agrees, but haven't seen much proof to the contrary. If you do visuoscopy on an amblyope, they will not be able to hold steady macular fixation. If they do, they are not really amblyopes, and probably have some other pathology going on. By the way, unsteady fixators are all eccentricly fixating MOST of the time, by definition... w.stacy, o.d. > > [quoted text clipped - 12 lines] > > > By the way, unsteady fixators are all eccentricly fixating MOST of the > time, by definition... But they aren't necessarily eccentrically fixating in the same place, unless they have a microtropia. In *my* experience, eccentric fixators aren't necessarily unsteady but can be quite steady in an eccentric way. DrG Physiologic nystagmus must increase in extent, and become non-physiologic or pathologic if you like, unsteady fixation, as the degree of eccentricity of fixation increases, given the anatomy and physiology of the retina. There is no way the brain can direct the eye to fixate as steadily with a non macular area of the retina as it can with a normal, functioning macula. How are you determining the steadiness of your eccentric fixators? w.stacy, o.d. >But they aren't necessarily eccentrically fixating in the same place, >unless they have a microtropia. [quoted text clipped - 5 lines] > > I have them look into the central circular reticle in my ophthalmoscope. DrG I must confess I haven't picked up a direct 'scope in a long time but that's a good way to do it. I haven't even seen a visuoscope since optometry school. Anyway, pretty esoteric stuff, and pretty far off the subject header, and we're not too far apart... w.stacy, o.d. >I have them look into the central circular reticle in my >ophthalmoscope. > >DrG > > > Sorry folks, I do appreciate all the responses but I'm confused by all > the technichal terms. I've never been told what the problem is. I've > just been given the strongest lense and been sent out with "this is the > best we can do". At my last exam I was given a prescription for R -25 & > L +200. > As for the patching...I'm willing to give it a try if there's a chance > of it working. Would I just be wearing glasses and covering my right > eye, forcing the left to do more work? So you have, as I suspected, anisometropic amblyopia. You should get a pair of glasses (or contacts) that correct it, and start patching the R eye as much as possible (with the correction in place). You will see an improvement in the L eye vision within a couple of weeks. The more you patch the quicker it will happen, and the more uncomfortable it will be. Just do it. You should be 20/40 O.S. in no time. w.stacy, o.d. (p.s. get a cycloplegic refraction, just to be sure the L eye is not actually + 4 or something. If it is, wear that instead of the +2) > So you have, as I suspected, anisometropic amblyopia. You should get a > pair of glasses (or contacts) that correct it, and start patching the R > eye as much as possible (with the correction in place). You will see an > improvement in the L eye vision within a couple of weeks. The more you > patch the quicker it will happen, and the more uncomfortable it will be. > Just do it. You should be 20/40 O.S. in no time. Okay William, the OP has achieved his 20/40 vision acuity by patching the right eye. He keep on wearing glasses (wich I doubt) and stop the patching, how long does it take to fall back to 20/70 in the left eye ? And what about binoculair vision? In other words, what did he achieved? If he want to give it a try then with contactlenses I suggest. You avoid several difficulties as there are: 1: The induced exophoria when looking to the left and esophoria when looking to the right. 2: The induced hyperphoria when looking through the upper or lower part off the glasses (superior or inferior the optical baseline) 3: The induced esophoria when looking at an object nearby just in front of you. 4: The difficulty to accommodate differently in both eyes to an object nearby. ( i.e at 50cm for the left eye about 1.1 dpt and the right eye 2.2 dpt) 5: The difference in size of the images ( about 20%) Another suggestion to ''patch'' could be wearing contactlenses and a spectacle with R/L plano (zero power) glasses. In front of the right eye you should stick on the glass, a piece of impossible to look through, Scotch tape of about 2 by 2 cm. When needed you can look ''besides'' the blocking but most of the time you can avoid using the ''good'' right eye by looking straight ahead with the right eye patched because the tape is in front. SignatureJan (normally Dutch spoken) > > [quoted text clipped - 12 lines] >does it take to fall back to 20/70 in the left eye ? > It will vary a lot. It may never return to 20/70 >And what about binoculair vision? >In other words, what did he achieved? > > If he attains binocularity, he should maintain VA and may actually gain slowly. If he regresses, may need to re-patch occasionally. >If he want to give it a try then with contactlenses I suggest. > [quoted text clipped - 12 lines] > > I agree partly with what you are saying but most people adapt readily to such disparities ("prism adaptation") without any problem. In 4, I disagree with the need or even with the ability of the two eyes to accommodate different amounts. In 5, it depends on the amount of aniso. 20% is huge, and I doubt is accurate unless the aniso is also huge, in which case 20/70 is not even in the ball park. >Another suggestion to ''patch'' could be wearing contactlenses and a >spectacle with R/L plano (zero power) glasses. [quoted text clipped - 5 lines] > > A nice, creative idea... w.stacy, o.d. Jan wrote: If he want to give it a try then with contactlenses I suggest. You avoid several difficulties as there are: 1: The induced exophoria when looking to the left and esophoria when looking to the right. 2: The induced hyperphoria when looking through the upper or lower part off the glasses (superior or inferior the optical baseline) 3: The induced esophoria when looking at an object nearby just in front of you. 4: The difficulty to accommodate differently in both eyes to an object nearby. ( i.e at 50cm for the left eye about 1.1 dpt and the right eye 2.2 dpt) 5: The difference in size of the images ( about 20%) I agree partly with what you are saying but most people adapt readily to such disparities ("prism adaptation") without any problem. In 4, I disagree with the need or even with the ability of the two eyes to accommodate different amounts. In 5, it depends on the amount of aniso. 20% is huge, and I doubt is accurate unless the aniso is also huge, in which case 20/70 is not even in the ball park. w.stacy, o.d. William, in 4 I should have used the word "impossibillity" instead of ''difficulty", however when the OP accommodates 2dpt the effective results are for the right eye about 1.9 dpt and for the left about 3.25 dpt So both eyes accommodating with the same power it results in differend focus distances, just one example why to choose contactlenses instead of glasses About 5 Wiliam, believe it or not but the difference in magnification is realy around the 20% when wearing glasses, just another reason to choose contactlenses. BTW, this magnification has nothing to do with system (optical) or axial (lenght) atropia and is only related to the vertexdistance (top cornea-backside glass), the lenspower and the own magnification of the glass ( factors curve, central thickness and index) -- Jan (normally Dutch spoken) Made a terrible mistake, I was assuming the OP is OD hyperopic and OS myopic. Excuses, >> So you have, as I suspected, anisometropic amblyopia. You should get a >> pair of glasses (or contacts) that correct it, and start patching the R [quoted text clipped - 33 lines] > can avoid using the ''good'' right eye by looking straight ahead with the > right eye patched because the tape is in front. You need to post the most recent correction. I'm guessing the left eye is more hyperopic or less myopic than the right, and you have anisometropic amblyopia in that eye, or it has more astigmatism with the same result. If I'm right, you can for sure improve things by wearing a full correction (contacts or glasses), and patching the right eye as much as possible. The amblyopic (lazy) eye should improve fairly dramatically within a few weeks, easily to the 20/40 you need, unless you have some other problems. Surgical options are possible, but first post that Rx and we'll talk about those... w.stacy, o.d. > Hello good folks. I'm looking for a little education & advice. Please & > thank you. [quoted text clipped - 12 lines] > > Any help is much appreciated. |
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