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Medical Forum / General / Vision / January 2006myopia question
My 8 yr old just had his first eye exam, after the school did their vision screening. Here is what they found: R: -1.5 L: -.75 Based on some information I read on the web, I challanged the OD with his recommendation to wear the glasses at all times (even for close up work). I fear his recommendation will increase his myopia. He stated that "because of the difference, he was at risk of lazy eye, if not wearing full time correction". He also stated "e would be in alot worse situation 3 years from now if it went un-corrected." Anyone have any recommendations? Do I make him wear his glasses? > He stated that "because of the difference, he was at risk of lazy eye, if > not wearing full time correction". Most of us would disagree. If he doesn't have "lazy eye" by age 8, he isn't likely to get it from a 3/4D difference in myopia. The crucial finding is his corrected acuity. If he can see 20/20 in each eye now, with correction, he's already past the stage where "lazy eye" occurs. > He also stated "e would be in alot worse > situation 3 years from now if it went un-corrected." I can't see how that holds up, either. In my experience, kids who are already -075/-150 at age 8 are likely to get more nearsighted, regardless of what you do. The exception are a few who have "pseudomyopia", something the doctor would rule out by retesting after dilation. > Anyone have any recommendations? Do I make him wear his glasses? One of the many opinions you're likely to get here: at school yes, at home no. He can get by without glasses, but his teacher may need to make special arrangements to let him sit closer to the chalkboard, etc. *If* there's anything you can do to slow the process, wean him from reading and working very close ("nose in the book") and make sure he gets occasional "far-vision" breaks while doing close work. Wearing or not wearing glasses doesn't seem to make much difference either way. -MT, OD After reading a bit in this group about Diopters vs. 20/xx I'm a bit confused with the perscription I was given for my 8yr old ( see below ) R: -1.50 ( 20/100 vision uncorrected ) L: -0.75 ( 20/30 vision uncorrected ) To me it seems like a -0.75 is a very strong perscription for a child with 20/30 vision. I also had him try reading a snellen eye chart and came up with more like ( R: 20/50 L: 20/30 ). I'm very concerned about all the mounting evidence that suggests that ODs actually increase myopia through the perscription of minus lenses. Anyone have any recommendations for good OD in the Downers Grove, IL? Something just doesn't add up.... > My 8 yr old just had his first eye exam, after the school did their vision > screening. Here is what they found: [quoted text clipped - 10 lines] > > Anyone have any recommendations? Do I make him wear his glasses? >I'm very concerned about all the >mounting evidence that suggests that ODs actually increase myopia through >the perscription of minus lenses. i am unsure exactly what "mounting evidence" you are referring to. myopia is not increased by prescribing minus lenses-- that much is clear. i think that wearing glasses for your son is optional. he is not strongly nearsighted if he can see 20/30. perhaps he should wear them in school and pass on them elsewhere. children like him usually make up there own mind how they will wear their glasses and their eyes change regardless of what they do. he could change and become more nearsighted quickly, or he could not progress at all. if you doubt what your OD has told you, i recommend getting another exam elsewhere and listening to what the eye doctor tells you. do you really own a snellen eye chart? where did you hear that ODs can cause myopia by prescribing minus lenses? your posting has an all-to-familiar ring to it. > do you really own a snellen eye chart? where did you hear that ODs can > cause myopia by prescribing minus lenses? your posting has an > all-to-familiar ring to it. I'm embarrassed to admit that it took 2 posts for me to recognize ace... w.stacy, o.d. > After reading a bit in this group about Diopters vs. 20/xx I'm a bit > confused with the perscription I was given for my 8yr old ( see below ) That's the problem trying to predict diopters from snellen acuity. Half the time it's in the ballpark, the other half it's misleading. > R: -1.50 ( 20/100 vision uncorrected ) > L: -0.75 ( 20/30 vision uncorrected ) > > To me it seems like a -0.75 is a very strong perscription for a child with > 20/30 vision. -0.75 isn't a "very strong perscription" no matter who has it. > I also had him try reading a snellen eye chart and came up > with more like ( R: 20/50 L: 20/30 ). I'm very concerned about all the > mounting evidence that suggests that ODs actually increase myopia through > the perscription of minus lenses. Where is this evidence "mounting"? MDs also prescribe glasses for 3/4D myopes. -MT > Where is this evidence "mounting"? MDs also prescribe glasses for 3/4D > myopes. I did a "google" on myopia. Its the first thing I do after every visit to a doctor who gives me or my kids a perscription. The most convincing arguments against negative lenses was: http://www.preventmyopia.org/ This was the first thing google pulled up. Another link I found from was. http://www.aoa.org/x1786.xml which states: "There is also growing evidence that nearsightedness may be caused by the stress of too much close vision work." Common sense that minus lenses move things closer. From what I can tell, this debate has been going on for years in this group. ( thanks to google again ) I agree that there is more data available that I would ever care read supporting both sides. Google did however point me to the people that seem to have very intelligent recommendations. ( this group ) As a parent, I am only trying to make sure I am doing the best for my child's vision. I was just trying to verify that 0.75 is not an overcorrection for 20/30 vision, and to see if a second opinion is justified for the recommendation of needing to wear them constantly. > > After reading a bit in this group about Diopters vs. 20/xx I'm a bit > > confused with the perscription I was given for my 8yr old ( see below ) [quoted text clipped - 19 lines] > > -MT > As a parent, I am only trying to make sure I am doing the best for my > child's vision. I was just trying to verify that 0.75 is not an > overcorrection for 20/30 vision It's reasonable. > and to see if a second opinion is justified > for the recommendation of needing to wear them constantly. The only proven benefit in constant wear is they don't get lost as often. -MT, OD > The only proven benefit in constant wear is they don't get lost as often. And, as a parent of a 9 year old who's been wearing glasses since he was 6, another benefit is more happiness. At first he was to take off his glasses to read, then we had "home" and "school" glasses--too confusing and stressful. But we did put his glasses on a lanyard and they just hung around his neck when he was reading. They never got lost. I, however, lost my glasses in school when I was 9. I will never forget that trauma.  Signature~RT "And, as a parent of a 9 year old who's been wearing glasses since he was 6, another benefit is more happiness. At first he was to take off his glasses to read, then we had "home" and "school" glasses--too confusing and stressful. But we did put his glasses on a lanyard and they just hung around his neck when he was reading. They never got lost. I, however, lost my glasses in school when I was 9. I will never forget that trauma." Whats his pescription now? I hope his eyes dont get as bad as yours were(-8?) Of course theres lasik or probably some other surgury in the year 2018 by the time he turns 21. Technology will be so advanced that almost everyone will end better than 20/20 and see better than they did with glasses. In fact I read about the 20/10 goal of lasik by the year 2010! I also read by the year 2020 myopia will be a thing of the past with just about everyone getting a permaent correction to their myopia. Of course theres the issue of safety but I read that oneday this permaent correction will be as safe as the temporary correction contacts give. When and if the time comes when some permaent intervenion or solution to myopia is created thats as safe as contacts, count me in as well. I am not sure how long lasik will be around but ive read that something better and safer than lasik is in the works. It will be like when lasik/prk was a revolution over RK. > Whats his pescription now? His glasses prescription: Progressives OD -7.00 -0.25x101 ADD +3.00 OS -6.75 -0.25x94 ADD +3.00 His contacts: Purevision both are -6.50 >I hope his eyes dont get as bad as yours > were(-8?) Mine were never even close. (for your files, so you don't need to ask again) OD: -4.25 -0.50x150 OS: -3.50 -1.00x025 cornea: R 671 L 658 pupil 6.0 >Of course theres lasik or probably some other surgury in the > year 2018 by the time he turns 21. Counting on it :) Signature~RT "His glasses prescription: Progressives OD -7.00 -0.25x101 ADD +3.00 OS -6.75 -0.25x94 ADD +3.00 His contacts: Purevision both are -6.50" Wow how did his myopia progress so fast and get so high at the age of 8? I sure hope it slows down dramatically from there! That progressive glasses are a great idea even though many dont believe in the plus lens theory, but Otis really does. May I ask why the contacts are so close to the glasses pescription? I looked at my research records and heres one prime example: I'm taken in to the exam room where they check my vision for one last time......my contact prescription is -4.75 for my left and -5.00 for my left(she actually mistyped this). My eyeglasses prescription is -5.50 in both eyes. I have a slight astigmatism that shows up only in the computer read out....not visible to the naked eye exam. Rhonda, the technician, tells me my eyes test out at -6.00 for both eyes. This concerns me a bit, but she assures me that this is the same reading that they have obtained through out my previous tests the past few weeks. Citing my own example, my glasses pescription was -5.5 and -5 several months back but I saw perfect with -4 contacts in each eye. Now im a -5 and -4.5 and I see almost perfect with -3.25 contacts. Is there more calculations than just vertex distance for contacts? Ive seen two people both -5, one needed -4.75 contacts, another did fine with -3.75 contacts! Should I assume the one with -4.75 contacts got overcorrected? Anyway 8 is sure young for wearing contacts. Does he use them generally for just sports? I use my contacts for distance but also have a weaker pair I use for intermediate. "Mine were never even close. (for your files, so you don't need to ask again) OD: -4.25 -0.50x150 OS: -3.50 -1.00x025" Thats actually not bad at all! Spherical equivalent of -4 and -4.5, this is half diopter better than where I am now! What was your UCVA back then? Of course even -4 produces plenty of blur, a little less than -4.5 but still blurry. I will post my official pescription once I get a chance to be tested with trial lenses. I can post what mine was 7 months back but the glasses for that are too strong now as my pescription is a little lower now. OS -5.5-.5 OD -5 -.5 I forget the angle. I was -5.75-.5 in the left eye 2 years back for a spherical equivalent of -6 and the right eye had a spherical equivalent of -5.25. Now my spherical equivalent is -5 and -4.5 and under incomplete cyclopegia it improved another half dioper. Complete cyclopegia would improve it by a diopter and a half which is how much tonic accomodation or pseudomyopia I have left. I could and should get down to the -3 range for both eyes. This should get me to 20/300 no problem. I was 20/600. Now I am getting to the point of being 20/400 but theres still many bad days I cant quite make out 20/400. "Counting on it :)" I have a thread on the future of lasik and other refractive surguries. No one knows for sure what the future will bring but undoubtly much better than anything out now and with much less risks. > in both eyes. I have a slight astigmatism that shows up only in the > computer read out....not visible to the naked eye exam. And as we all know, the "computer read out" is always more accurate than the cross-cylinder. > I have a thread on the future of lasik and other refractive surguries. An' it's just a-tizzy with anticipation we are... -MT > And as we all know, the "computer read out" is always more accurate than the > cross-cylinder. More sarcasm, apparently. Quite likely autorefractor results are more reproducible than humanrefractor results. But we know that they are always wrong, and that is why we will always need more ODs (well, for one thing, because variety is the spice of life, and, for another, autorefractors do not have such interesting theories about what is best for the patient). -- Dicky > More sarcasm, apparently. Quite likely autorefractor results are more > reproducible than humanrefractor results. That hasn't been my experience. How many have you compared? -MT > Wow how did his myopia progress so fast and get so high at the age of > 8? He's almost 10. He started in glasses at age 6 at -1.75 and it changes every 6 months or so. He's a progressive myope. There's no "reason" why he's a progressive myope other than it runs in the family and possibly because he played too much gameboy and reads a lot. I'm sure you and Otis will tell me it was the evil minus lens. >I sure hope it slows down dramatically from there! His OD expects him to end up in double digits. It has slowed down. In the past year he's only had a diopter change. In the beginning his prescription doubled every year. >That progressive > glasses are a great idea even though many dont believe in the plus lens > theory, but Otis really does. It has nothing to do with prevention, only so that he can read. His arms aren't long enough with his glasses on and if they were, things would be too small. Without his glasses on he reads at about 2 inches from his face. >May I ask why the contacts are so close > to the glasses pescription? You may ask, but I don't know. I'm not his optometrist. But I believe his glasses are deliberately under Rx'd so that he can see better close up. He can't read 2 inches from his face with his CLs on, but he can read at the proper distance with CLs where he cannot in his glasses without the ADD. > Thats actually not bad at all! Spherical equivalent of -4 and -4.5, > this is half diopter better than where I am now! What was your UCVA > back then? Of course even -4 produces plenty of blur, a little less > than -4.5 but still blurry. I was "counting fingers." I could not function without corrective lenses. Sorry if that doesn't fit in your "calculations" or your concept of what is "bad" or not. Post-LASIK I see 20/15, which is great. Signature~RT "He's almost 10. He started in glasses at age 6 at -1.75 and it changes every 6 months or so. He's a progressive myope. There's no "reason" why he's a progressive myope other than it runs in the family and possibly because he played too much gameboy and reads a lot. I'm sure you and Otis will tell me it was the evil minus lens." Well you didnt have progressive or pathalogical myopia. You are right myopia runs in families, everyone in my family is a myope, but dads a hyperope. Lots of close work accelerates myopia and my parents said all the computer and reading I did made me more myopic. "His OD expects him to end up in double digits. It has slowed down. In the past year he's only had a diopter change. In the beginning his prescription doubled every year." double digits? wow man. That would be out of range for lasik. We would be talking about IOLs then. Also its not good for the retina to be stretched. "It has nothing to do with prevention, only so that he can read. His arms aren't long enough with his glasses on and if they were, things would be too small. Without his glasses on he reads at about 2 inches from his face." Does he have trouble accomodating? No matter, progressives are a great idea and even if you didnt believe in prevention, it very well may. "You may ask, but I don't know. I'm not his optometrist. But I believe his glasses are deliberately under Rx'd so that he can see better close up. He can't read 2 inches from his face with his CLs on, but he can read at the proper distance with CLs where he cannot in his glasses without the ADD." Whats his distance vision in those glasses? How much do they undercorrect him and whats his BCVA? Again itll help slow his myopia, I sure hope so :) "I was "counting fingers." I could not function without corrective lenses. Sorry if that doesn't fit in your "calculations" or your concept of what is "bad" or not. Post-LASIK I see 20/15, which is great." Yea from like 20 feet. You had it much better than me that you corrected to 20/15. Your UCVA was around 20/200 or just shy of that. I am kind of functional but its most unplesent to go without correction for distance. Both my UCVA and BCVA were half yours so I have it much worse! > Well you didnt have progressive or pathalogical myopia. and I'm not his only family member either. It takes 2 to have a baby and then there are all those pesky relatives and siblings... > double digits? wow man. That would be out of range for lasik. We would > be talking about IOLs then. Also its not good for the retina to be > stretched. I don't know what the technology will be in 15 years, and neither do you. > Whats his distance vision in those glasses? How much do they > undercorrect him and whats his BCVA? Again itll help slow his myopia, I > sure hope so :) I have no idea, no idea, no idea. I hopes his myopia slows too. It appears to have slowed down in the past year or two as I said but that is most likely a function of him getting older. > Yea from like 20 feet. You had it much better than me that you > corrected to 20/15. I was never corrected to 20/15 with glasses or contacts. My soft CLs didn't correct for my astigmatism and my glasses never felt "right." My vision post-LASIK is better than any vision I got with prescribed corrective lenses throughout my whole life. >Your UCVA was around 20/200 or just shy of that. I > am kind of functional but its most unplesent to go without correction > for distance. No, as I told you before, my UCVA was counting fingers. Try to objectify all you want and translate it into the Snellen chart, but that's what is on my records. No, I don't test myself at home and so I haven't challenged my optometrists and ophthalmologists about this. All I know is how I could (not) see out of my eyes. >Both my UCVA and BCVA were half yours so I have it much > worse! Yes Gil, you do have it much much worse in many ways. Signature~RT "and I'm not his only family member either. It takes 2 to have a baby and then there are all those pesky relatives and siblings..." yea. Myopia is in our genes too but my brother got off easy, hes only -1.25 and almost never wears glasses. "I don't know what the technology will be in 15 years, and neither do you." No one knows for sure but high myopia is never a good thing, period. "I was never corrected to 20/15 with glasses or contacts. My soft CLs didn't correct for my astigmatism and my glasses never felt "right." My vision post-LASIK is better than any vision I got with prescribed corrective lenses throughout my whole life." Hmmm this is interesting. The glasses part I could partially blame the minification. Perhaps You never got glasses that properly corrected your astigmastim? Even today some optometrists dont know how to properly address astigmastim and some opticians dont make the cylindar part of glasses quite right. Hence why your glasses never felt quite right. As for contacts, them not correcting your mild -1 diopter astigmastim could easily explain the loss of one line. Of course sometimes a spherical equivalent is used. Theres toric contacts now but probably werent any in the past. RGP contacts would definately give you your 20/15 in addition to superior quality of vision. This is what Ragnar used to wear till he couldnt tolerate them then he chose the lasik route instead of going back to glasses. I am in the same boat, was never corrected to 20/20. I guess the same factors can be blamed. However while you just had simple regular astigmastim left uncorrected by contacts and poorly corrected by glasses(in addition to spectacle minification) I have complex astigmastim as well as a greater than average amount of high order aberrations. Something todays laser technology also cant really address. I could and should achieve 20/20 if I go the RGP route. There also are wavefront glasses which will only get better and better. Ditto with surgical technologies. Todays glasses dont always do a good job correcting astigmastim, especially complex or irregular. I have more of that kind than you so my BCVA wasnt as good as yours. "No, as I told you before, my UCVA was counting fingers. Try to objectify all you want and translate it into the Snellen chart, but that's what is on my records. No, I don't test myself at home and so I haven't challenged my optometrists and ophthalmologists about this. All I know is how I could (not) see out of my eyes." Then ill translate it to being worse than 20/200 or not being able to see the big E on standard snellen charts. Ive also been told im counting fingers. On my home chart I see 20/600 most of the time and on good days I barely make out 20/400. Reguardless both of our UCVA was inadequate for distance. My pescription is a diopter higher than you plus I have complex irregular astigmastim and more high order aberrations so of course my UCVA sucks and I dont correct to 20/20. I really hope my vision keeps improving :) > "and I'm not his only family member either. It takes 2 to have a baby > and > then there are all those pesky relatives and siblings..." And all those pesky relatives need pesky pescriptions! :-) SignatureDan Abel dabel@sonic.net Petaluma, California, USA and to see if a second opinion is justified > for the recommendation of needing to wear them constantly. ok so maybe I was wrong. It isn't ace, it's otis in his halowe'en outfit... >>Where is this evidence "mounting"? MDs also prescribe glasses for 3/4D >>myopes. > > I did a "google" on myopia. Its the first thing I do after every visit to > a doctor who gives me or my kids a perscription. The most convincing > arguments against negative lenses was: http://www.preventmyopia.org/ The website above contains a number of unsupported allegations, namely: "After focusing on close-up objects for extended periods, the focusing muscles in the eyes (which are called the "ciliary muscles") lock up. This results in the eyes becoming more and more elongated." - not supported by research "Unfortunately, distance glasses actually make nearsightedness worse..." - not supported by research "If strong enough reading glasses are used, nearsightedness should be prevented." - not supported by research "For the child who is on the verge of becoming nearsighted, "plus three" reading glasses should usually be prescribed." - not supported by research "Decreased accommodation slows the rate of myopia progression" - arguably supported by at least one small study in 1975 but NOT supported by many other studies since. The COMET study is one of the biggest and best studies: http://www.iovs.org/cgi/reprint/44/4/1492.pdf and its recommendations do not include anything about avoiding a minus lens. This is a useful summary of the current state of knowledge: http://bjo.bmjjournals.com/cgi/content/full/86/11/1306 This > was the first thing google pulled up. Another link I found from was. > http://www.aoa.org/x1786.xml which states: "There is also growing > evidence that nearsightedness may be caused by the stress of too much close > vision work." That's commonly accepted. Common sense that minus lenses move things closer. ??? > From what I can tell, this debate has been going on for years in this group. > ( thanks to google again ) I agree that there is more data available that I [quoted text clipped - 6 lines] > overcorrection for 20/30 vision, and to see if a second opinion is justified > for the recommendation of needing to wear them constantly. -075 sounds reasonable. A second opinion can never do any harm. Dom Dear Dom, Subject: Your majority opinion. Every statement you made -- is your majority opinion. The second opinion --- that IS SUPPORTED by research on the primate eye shows that: 1. If you take a population of primates and place them in a tightly-confined environment, then their refractive state will move in the direction of the applied "nearer" (in diopters) confined enviroment. This is a dead certainty in pure scientific research. 2. Exactly the same reqult will occur for the primte eye (by direct "input" versus "output" testing of the dynamic behavior of the primate eye. This, however is pure science and direct measurement of BOTH parameters. The second opinion as stated on www.chinamyopia.org Is based on this scientific research. Best, Otis > Anyone have any recommendations for good OD in the Downers Grove, IL? > Something just doesn't add up.... I think that they will all want to do the same thing. You might consider eyeglasses for reading which make his eyes equally nearsighted by adding +0.75D to the least nearsighted eye. But you are on your own, if you do that, going up hill against the tide. Kid will probably not want to fool with two pairs of eyeglasses or bifocals. You will need his intrapupilary distance if you order eyeglasses on the Internet (and a bit more math to refigure it for reading distance). I had a similar imbalance, and had a pair of reading glasses which corrected it when I was a kid. There would be no way to say whether they did me any good. (Who would you compare me to, as a control group?) The only thing that definitely did my myopia any good was IOL implants, but you wouldn't want to do that to your kid until he was 70 or 80 years old and had cataracts. Well, I'll probably get blasted for practicing medicine without a license. Move over, Otis. (sigh!) -- Dicky > Well, I'll probably get blasted for practicing medicine without a license. > Move over, Otis. (sigh!) No, no. By all means continue the treatment in this case. You might want to invite him in for a consult... We promise not to report you. just a bit dazed and quite confused at this point.... After reading the responses and a 12 pack of beer, I have a NEW PLAN OF ACTION: 1. Take da kid down to sam's club to see if the're $29 exam agrees with da ODs. 2. Tell the kid the possilbe risks and let him make his own decision, ( it just ain't matter what his momma or OD saiys ) Problem solved, time to git some sleep... not bad for a few posts to the experts! Thanks all. > > Well, I'll probably get blasted for practicing medicine without a license. > > Move over, Otis. (sigh!) [quoted text clipped - 3 lines] > > We promise not to report you. LOL careful with all that beer! 12 is alot! Good idea letting the kid decide for himself, its his eyes to do what he wants. Although I believe a young kid probably will avoid glasses if he can due to the teasing and what not. See my first reply above this post! Maybe you can provide a few shrooms to go with the beer, huh ace? Shrooms made you a genius; maybe it would work with her/him (or whatever the alias is). > LOL careful with all that beer! 12 is alot! Good idea letting the kid > decide for himself, its his eyes to do what he wants. Although I > believe a young kid probably will avoid glasses if he can due to the > teasing and what not. See my first reply above this post! > After reading a bit in this group about Diopters vs. 20/xx I'm a bit > confused with the perscription I was given for my 8yr old ( see below ) [quoted text clipped - 4 lines] > To me it seems like a -0.75 is a very strong perscription for a child with > 20/30 vision. Wrong, ace, 20/30 is about right for -.75. If anything, I'd guess 20/30 is more like -1.00. I also had him try reading a snellen eye chart and came up > with more like ( R: 20/50 L: 20/30 ). I'm very concerned about all the > mounting evidence that suggests that ODs actually increase myopia through > the perscription of minus lenses. Really, ace? w.stacy, o.d. > After reading a bit in this group about Diopters vs. 20/xx I'm a bit > confused with the perscription I was given for my 8yr old ( see below ) [quoted text clipped - 31 lines] >> >>Anyone have any recommendations? Do I make him wear his glasses? The prescription seems about the right strength for his uncorrected acuities. His glasses should really help him see the blackboard more clearly; and also would help for watching TV at home. There's no evidence that wearing or not wearing his glasses will increase his myopia. However if he is already myopic at age 8 then unfortunately there's a fair to good chance that his myopia will increase anyway (glasses or no glasses). Is myopia in the family, or does he read a lot? (or use computers a lot etc?). Depending on your kid's temperament and self-confidence, you shouldn't need to "make" him wear his glasses as he'll probably *want* to once he realises how much better he can see with them. As far as wearing for reading is concerned, I'd suggest that if he is currently a good reader then I'd go without. However if there's any suggestion of difficulties with reading such as losing place, avoiding reading, poor comprehension, eye strain, headaches etc, then he could try wearing them. The reason the glasses *may* help for reading is because they correct the imbalance between his two eyes, so that both eyes can be 'in focus' at once. I certainly wouldn't have him wearing them full time. I can't see that there's too much risk of developing a lazy eye as it would have already happened by now. Dom Does a 3/4D difference make a big impact at near and far? What might any associated symptoms be? Surely if he *needs* them to correct the imbalance between the two eyes for reading he *needs* them for distance too? >> After reading a bit in this group about Diopters vs. 20/xx I'm a bit >> confused with the perscription I was given for my 8yr old ( see below ) [quoted text clipped - 31 lines] > >Dom > Does a 3/4D difference make a big impact at near and far? What might any > associated symptoms be? Surely if he *needs* them to correct the imbalance > between the two eyes for reading he *needs* them for distance too? In the case of an 8-year-old who needs -075 in one eye and -150 in the other, it's doubtful he'd notice the imbalance at all when doing close work without glasses. -MT > Does a 3/4D difference make a big impact at near and far? What might any > associated symptoms be? Surely if he *needs* them to correct the imbalance > between the two eyes for reading he *needs* them for distance too? For distance vision it's the myopia that makes the impact rather than the difference between the eyes. For near vision, what I said was that: >... if there's any >>suggestion of difficulties with reading such as losing place, avoiding >>reading, poor comprehension, eye strain, headaches etc, then he could >>try wearing them. The reason the glasses *may* help for reading is >>because they correct the imbalance between his two eyes, so that both >>eyes can be 'in focus' at once. So there isn't necessarily a *need* to wear them for reading, but they *may* help if he is experiencing any difficulties with reading. The flip-side is that they *may* not make any difference to his reading, either. Dom With regard to eyeglasses to correct, in an 8-yr. old, the following unsymmetrical myopia: >R: -1.5 L: -.75 > So there isn't necessarily a *need* to wear them for reading, but they > *may* help if he is experiencing any difficulties with reading. The > flip-side is that they *may* not make any difference to his reading, either. In general, the thread has overlooked the possibility of balancing the kid's eyes, for reading, with eyeglasses which make the least nearsighted eye as nearsighted as the most nearsighted one. As a life-long myope, I am reasonably well convinced that progression may be in part due strain in attempting to converge dissimilar images, as well as to accommodate, in the face of some predisposing factors, through concave lenses. Please review my post: news:DI%yf.4626$8r1.3740@trndny01 or http://groups.google.com/groups?selm=DI%yf.4626$8r1.3740@trndny01 When I was a kid, I felt that 0.75D imbalance caused a reading strain, as well as using distance eyeglasses for reading. That got worse over the years. Note the characteristic hard-nosed put down: news:350zf.71$2O6.31@newssvr12.news.prodigy.com or http://groups.google.com/groups?selm=350zf.71$2O6.31@newssvr12.news.prodigy.com Yes, I have said I am not a practitioner of healing arts. I do not practice medicine. Based in intelligence and education, I am able to rationally speculate on the implications of my experience, and to communicate my views to others. Some of you guys, on the other hand, seem to be purely snotty! -- Dicky P.S. Some may be interested to note the above-illustrated way to convert a news ID to an archive address. Also, not everyone may know that clicking on a news ID (or archive address) will usually bring up the subject article. (That is a reason for giving the a post's news ID when responding to it, and for not needing to quote it in its entirety.) -d. > As a life-long myope, I am reasonably well convinced that > progression may be in part due strain in attempting to converge > dissimilar images, Despite the fact that many/most progressive myopes are within 050D and full-time wearers progress despite essentially identical corrected VA? > as well as to accommodate, in the face of some predisposing > factors, through concave lenses. Hyperopes accommodate like heck and don't get nearsighted. 44% of urban Mexican children are nearsighted and 80% of them never wore glasses. > When I was a kid, I felt that 0.75D imbalance caused a > reading strain, as well as using distance eyeglasses for reading. > That got worse over the years. Post hoc, ergo propter hoc, right? -MT > > As a life-long myope, I am reasonably well convinced that > > progression may be in part due strain in attempting to converge > > dissimilar images, > > Despite the fact that many/most progressive myopes are within 050D and > full-time wearers progress despite essentially identical corrected VA? How much attention has been given to the matter of dissimilar images (which I suggest may sometimes be a factor in myopia development and progression)?? > Hyperopes accommodate like heck and don't get nearsighted. Quite possibly they get less hyperopic, maybe even to emmetropic, in some lucky cases. How would that be noticed? > 44% of urban Mexican children are nearsighted and 80% of them never wore > glasses. Makes sense. What is your point? Though glasses are much cheaper in Mexico, they are still relatively expensive with respect to Mexican incomes. Urban kids do more close stuff than country boys, like TV, Internet, games, and maybe school books. Maybe that they can't see the black board makes them grow up to the high calling of migrant labor. > > When I was a kid, I felt that 0.75D imbalance caused a > > reading strain, as well as using distance eyeglasses for reading. > > That got worse over the years. > Post hoc, ergo propter hoc, right? I made no unqualified claims. You know, you guys are real put-down artists. After slicing us up with your opaque OD jargon, you coup us with (what appears to be) Latin. -- Dicky > How much attention has been given to the matter of dissimilar images > (which I suggest may sometimes be a factor in myopia development and > progression)?? Dunno. How important can it be when so many (equally) corrected myopes continue getting myopic and so many asymmetric hyperopes don't? > Quite possibly they get less hyperopic, maybe even to emmetropic, in some > lucky cases. How would that be noticed? By population diagrams. In fact, they do get less hyperopic from birth to age 1 or 2 (an age where, I'm certain, myopia could be corrected by plus lenses. If you can find a 1-year-old myope.) >> 44% of urban Mexican children are nearsighted and 80% of them never wore >> glasses. > Makes sense. What is your point? The point was in the part you clipped, where you claim that looking through concave lenses causes myopia. > > > When I was a kid, I felt that 0.75D imbalance caused a > > > reading strain, as well as using distance eyeglasses for reading. > > > That got worse over the years. >> Post hoc, ergo propter hoc, right? >I made no unqualified claims. You know, you guys are real put-down >artists. >After slicing us up with your opaque OD jargon, you coup us with (what >appears to be) Latin. Sorry, I was ridiculing the implication that your eyes got worse _because_ you wear glasses, an example of the well-known "post hoc" fallacy. If that isn't what you meant, I apologize. -MT Dear Mike, Mike> 44% of urban Mexican children are nearsighted and 80% of them never wore glasses. Otis> That is true. When you place primates in a "confined" environment, there there eyes also "move negative" and eventually go from a positive refractive state -- to a negative refractive state. (As a natural process.) So yes, it is completely possible for primate eyes as well as human-primate eyes to have a negative refractive state -- when they have not yet worn a minus lens.; Perfectly logical. Pure science fact and truth my friend. Best, Otis > Otis> That is true. When you place primates in a "confined" > environment, > there there eyes also "move negative" and eventually go from > a positive refractive state -- to a negative refractive state. (As a > natural > process.) We never had any argument with that, except that a myopic eye is too POSITIVE. > So yes, it is completely possible for primate eyes as well as > human-primate eyes to have a negative refractive state -- when they > have not yet worn a minus lens.; No question. And it's logical to ASSUME that minus lenses accellerate it and plus lenses slow it. But if you ever question your assumption (we both know you won't) you will find that the preponderance of evidence shows that lenses have little or no effect either way, at the age where humans start getting myopia. I'm convinced that plus lenses would CURE myopia at age 1 or 2. I just can't find any 2 year old myopes. -MT Dom You said that "for distance vision it's the myopia that makes the impact rather than >the difference between the eyes", that's only the case surely when the myopia is corrected? Or are you saying that the better eye will compensate for the other? >> Does a 3/4D difference make a big impact at near and far? What might any >> associated symptoms be? Surely if he *needs* them to correct the imbalance [quoted text clipped - 17 lines] > >Dom > Dom > You said that "for distance vision it's the myopia that makes the impact > rather than > >>the difference between the eyes", that's only the case surely when the myopia is corrected? Or are you saying that the better eye will compensate for the other? Not sure I fully understand what you're asking here.... I meant that the primary reason he will have trouble seeing at distance is his myopia... in contrast, the primary reason he *may* have trouble seeing at near is his anisometropia (difference between eyes). Then again, he might not have any trouble at all with close reading, but *if* he does then it's likely due to the anisometropia. In my opinion. Dom I see you call it anisometropia. What I meant was surely if the young guy goes uncorrected he will notice there's a difference between his eyes, and also suggested that if you have one eye stronger than the other does the better one end up being the one that provides the image and so in theory improve your vision? >> Dom >> You said that "for distance vision it's the myopia that makes the impact [quoted text clipped - 10 lines] > >Dom >I see you call it anisometropia. What I meant was surely if the young guy > goes uncorrected he will notice there's a difference between his eyes, and > also suggested that if you have one eye stronger than the other does the > better one end up being the one that provides the image and so in theory > improve your vision? The issue is whether the "weak" eye develops normally. When it doesn't, that's called amblyopia. This only happens up until age 8 or so, and only when the "weak" eye is constantly deprived of a clear image. It happens when one eye is very farsighted or when there's a cataract in one eye. "Constant" is the key. Kids with mild nearsightedness, even with anisometropia, get a clear vision in both eyes up close, so the risk of amblyopia is virtually nil. Mildly anisometropic nearsightedness might lead to "preferring" one eye, also called "dominance," but it won't hinder development of the other eye. -MT > I see you call it anisometropia. What I meant was surely if the young guy > goes uncorrected he will notice there's a difference between his eyes, Not consciously but it *may* make reading and comprehension difficult at a more subconscious level. and > also suggested that if you have one eye stronger than the other does the > better one end up being the one that provides the image and so in theory > improve your vision? Still not sure I understand what you're asking there, but in anisometropic myopia there's always one eye in focus, and which one it is varies depending on what you're looking at. So each eye has an opportunity to develop good vision. And once you're older than around 8 years old, conventional wisdom says that it's too late to strengthen an eye in the context of lazy eyes. So I wouldn't worry about lazy eyes or the strengthening of vision, I would only be concerned with current functioning. Dom >>>Dom >>>You said that "for distance vision it's the myopia that makes the impact [quoted text clipped - 10 lines] >> >>Dom Dear Eye Question, Subject: Concerned with being offered a true, "preventive" second opinion. You are right to "sense" that you are not getting the complete "story". When direct experiments are run on primates, the refractive state moves in the direction of the applied minus. You should do some more research on this preventive method. I am an engineer -- but I strongly support fundamental change is "policy" on prevention. You should read my site www.myopiafree.com And, more importantly, the optometrist Steve Leung www.chinamyopia.org The ODs on sci.med.vision are telling you what they WANT to believe. But the problem is that they want YOU to believe that a minus lens has no effect oin the refractive state of the natural eye. And that is just false-science. They an argue that: 1. Your child needs vvery-sharp visoin -- all the time. But:, ur child's vision (at 20/30 both eyes together) in fact would pass the DMV test in most states. I would take the time to understand these issues. There are ODs who now put their children in a "plus" as soon as his vision is the status of your child. I know this is tough -- but the decision now will have life-time consequences for your child -- what ever decision you make. Best, Otis (I am an engineer. I do not "prescribe" anything. I wish that I had been provided with this information when I was at -1/2 diopter. It is an honest choice for you. I would gladly PAY AN OD just for this information and support. That is the true nature of the second opinion. >(I am an engineer. I do not "prescribe" anything. Actually, what you are is a blowhard. Whether or not you, in legal terms, practice medicine without a license will be determined in the ongoing investigation of your practices. Buyer beware. SignatureLive simply so that others may simply live > My 8 yr old just had his first eye exam, after the school did their vision > screening. Here is what they found: [quoted text clipped - 10 lines] > > Anyone have any recommendations? Do I make him wear his glasses? I'd recommend he wear the glasses for distance only. The lazy eye risk is almost nil in this case. The risk of increased myopia is very high, regardless of whether or not he uses the glasses. Plus lenses will not help. Let us know what happened a year from now. w.stacy, o.d. Your OD did a disservice by reccomending full time glasses wear. A low myope does NOT need glasses for close work, actually the opposite is true, he should NOT wear glasses for near, it will do nothing but cause eyestrain. Nearsighted means one can see great from near, so no glasses to be worn for near. The ODs here already said not to worry about lazy eye. You and your son can take measures to greatly slow the progression of myopia. Otis firmly believes in the plus lens theory to stop and even reverse the progression of myopia. An 8 year old probably doesnt want to bother with reading glasses when he sees fine from near. The next best thing to do is have him hold reading materials away from him and not 6 inches close like some people like to read at! Have him take frequent breaks looking off into the distance after doing prolonged near work. Keep him off the "evil" minus lens as long as possible and as long as he can see well without them. Once he can no longer see clearly without minus lens, wear glasses only for distance such as seeing the board in school or watching TV. Never wear glasses for near work. "*If* there's anything you can do to slow the process, wean him from reading and working very close ("nose in the book") and make sure he gets occasional "far-vision" breaks while doing close work." Good advice. "After reading a bit in this group about Diopters vs. 20/xx I'm a bit confused with the perscription I was given for my 8yr old ( see below ) R: -1.50 ( 20/100 vision uncorrected ) L: -0.75 ( 20/30 vision uncorrected ) To me it seems like a -0.75 is a very strong perscription for a child with 20/30 vision. I also had him try reading a snellen eye chart and came up with more like ( R: 20/50 L: 20/30 )." -.75 is right on the money to bring 20/30 back to 20/20. Weaker glasses wouldnt correct him to 20/20 There is no way he is 20/100 with only -1.5 diopters. Your testing him at 20/50 is more like it. Heck even I used to see 20/70 or 20/80 years back when I was -1.5 and I was only corrected to 20/25. Some optometrists dont know how to properly measure one's vision. I was proclaimed 20/20 before even though I guessed ONE letter right on the 20/20 line with correction. "That's the problem trying to predict diopters from snellen acuity. Half the time it's in the ballpark, the other half it's misleading." actually, it should be in the ballpark all the time or something is wrong. Over 95% of people who post their pescription and UCVA fall in the ballpark. There is this one guy who was seeing only 20/60 with -.75 pescription, correctable to 20/20+ with glasses. He got lasik and is now -.5 after 6 months and sees 20/20. We went by the theory he was straining his eyes without glasses, resulting in tonic accomodation and hence increased blur. Glasses relaxed his eyes and tonic accomodation went away. I have done much research on the correlation of diopters to 20/xxx and for lower pescriptions, its much more predictable than for high pescriptions. Take a -1 for example, results typically in 20/40 UCVA. Take -4.5 or -5.5, both can still be 20/400 but the -5.5 would see a much blurrier 20/400. "-0.75 isn't a "very strong perscription" no matter who has it." Very weak pescription. Most people who get glasses for the first time are higher than -.75 and the vast majority of -1 and under rarely or never wear glasses. "I was just trying to verify that 0.75 is not an overcorrection for 20/30 vision" If he corrects to 20/20, -.75 is right on the money. "Wrong, ace, 20/30 is about right for -.75. If anything, I'd guess 20/30 is more like -1.00." I am in agreement with this. I even have a thread on ***Diopters to 20/something conversion. The math and science behind this!*** Very interesting thread and I learned more about diopters to 20/xxx as well!!!!!!!! :) > Your OD did a disservice by reccomending full time glasses wear. Of course, you, with your OD degree in hand from Psychotropic University, are in a good position to offer advise, right? > You and your son can take measures to greatly slow the progression of > myopia. Otis firmly believes in the plus lens theory to stop and even > reverse the progression of myopia. What a match. Drug-stupified Ace in association with the Senile Crusader Otis. Thats quite of pair of experts to be giving advise about eyecare isn't it. > Keep him off the "evil" minus lens as long as possible and Tell us more you genius. > Good advice. Perhaps the authorities in your state (Florida?) should review your propensity to give medical advise, as well as the type of fungi you like to grow in your house and ingest. On 1/16/06 6:39 PM, in article 1OYyf.12063$PL5.5395@newssvr11.news.prodigy.com, "Eye Question" <junk@nospam.org> wrote: > My 8 yr old just had his first eye exam, after the school did their vision > screening. Here is what they found: [quoted text clipped - 10 lines] > > Anyone have any recommendations? Do I make him wear his glasses? I am not a vision professional. Nevertheless, I remember being intimidated when I first got glasses at about the same age. When asked whether one or two was better, I felt obligated to give an answer whether I noticed or not. Since then I became more myopic until recent cataract operations. I guess my eyeball is still elongated, but most of my correction is now in the implants. Bill -- Ferme le Bush Dear Friend, Subejct: Wearing a minus lens all the time. I suggest that you udnerstand the "explosition" of majority opinion you will receive on sci.med.vision. The majority opinion INSISTS that your child wear these strong minus lenses all the time. Just remember the SECOND OPINIO which is the dead opposite of the first opinion. Which is: www.chinamyopia.org To the effect that you should be VERY CAREFUL with that minus lens. I am not a "doctor" but I think you should look for a second-opinion doctor who may help you with this issue. Also, remeber, these ODs who do not like the second-opinion, call anyone who suggests it a "waco". Factor that into your choice of a "preventive" OD. That has been the history of "change" in medicine. Best, Ots > I suggest that you udnerstand the "explosition" another word otis wants to add to the dictionary > The majority opinion INSISTS that your > child wear these strong minus lenses > all the time. guess you haven't been reading. noone suggested that he wear the glasses all the time. and the lenses are not strong. > Just remember the SECOND OPINIO > which is the dead opposite of the > first opinion. thats right, the "second opinion" (an "otisism"; another phrase otis would like added to the dictionary) is dead opposite to the proven methods for eye care. i guess otis is going to stick out his head again and suggest unproven medical practices. wonder if the regulatory authorities in Pennsylvania are reading this? > I am not a "doctor" but well then why are you offering medical advise? who cares what you think? you are an obsessive old man on a crusade for an disproven medical theory. > The majority opinion INSISTS that your > child wear these strong minus lenses > all the time. Which of us recommended that, Otis? When you're giving medical advice, it's best to listen first and talk later. -MT > Dear Friend, > > The majority opinion INSISTS that your > child wear these strong minus lenses > all the time. > Best, > > Ots Otis, please do me the courtesy of not misquoting me or other optometrists who contribute to this list. To quote myself in this thread: "As far as wearing for reading is concerned, I'd suggest that if he is currently a good reader then I'd go without." and "I certainly wouldn't have him wearing them full time." Your allegation is insulting and inaccurate. Dom >My 8 yr old just had his first eye exam, after the school did their vision >screening. Here is what they found: [quoted text clipped - 3 lines] >Based on some information I read on the web, I challanged the OD with his >recommendation to wear the glasses at all times You need to challenge the diagnosis (amblyopia), not the remedy. If you're not satisfied with the explanation then get a second opinion. You can get more info here http://www.nei.nih.gov/health/amblyopia/index.asp#3 Hope this helps, Robert Martellaro ~~~~~~~~~~~~~~~~~~ Optician/Owner Roberts Optical robopt@execpc.com ~~~~~~~~~~~~~~~~~~ "An expert is a person who has made all the mistakes that can be made in a very narrow field." - Niels Bohr |
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