Medical Forum / General / Vision / April 2006
Contacts - Symptoms of the wrong prescription
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jrmose - 19 Apr 2006 15:07 GMT I have a rather bizarre situation that I've never encountered in my nearly 20 years of wearing contacts.
For the past two or three years, I've had the same prescription: -3.75 in both eyes. Recently, I was due for a check-up and went to a new doctor because my insurance has changed. When he conducted his eye chart tests, he said that my prescription was actually too strong, so he reduced it down to -3.25. It took me about six hours with the trial set to realize that they were too weak. I returned the next day and he increased the vision to -3.50. This seemed to help significantly and so I ordered a year's supply. Having worn the trial set for the two weeks, I changed to new ones and within hours noticed that my eyes were blurring, that I had trouble focusing, and that I would become slightly nauseated. After wearing them half a day, my eyes were exhausted.
By this point, feeling like an absolute freak, I returned to his office and said that while the trial pair seemed to work fine, the new set that I had in was making me feel strange. He convinced me that they were the same exact prescription. I have no reason to question that other than the blurriness, lack of focus, and feeling rather nauseated from time to time.
I should also say that these symptoms go away when I take out the contacts and put on my glasses (that I wear only at night because the prescription is old).
So, based on all these symptoms and patterns, I do wonder if my eyes are so used to the -3.75 prescription that it's difficult for the eye if you try to weaken the prescription. If a prescription is weak (or strong) are the above symptoms normal? Is it rare to reverse a prescription like this?
Or, is it all in my head and I just need to give the contacts time?
My sense is that I need to convince him to put me back at -3.75, when I felt that I could see fine and I never experienced any of these symptoms.
I would be grateful for any advice or feedback. I'm supposed to see him tomorrow (April 20th) for one last follow-up . . .
Thanks.
doctor_my_eye@msn.com - 19 Apr 2006 19:13 GMT There are two groups of people that were put on this earth to make their optometrist go insane. ;) Those two groups are "habitually undercorrected hyperopes" and "habitually overcorrected myopes". As you would think, these are two sides of the same coin.
When you look at something far away, and your eyes are used to being a little overcorrected, your eye naturally accomodates a little bit to cancel the extra power in the contact. If you are young enough, this little accomodation is pretty harmless and actually makes things look smaller, darker and more defined than what a "normal" emmetropic eye would see.
So...if you are under 45 years old, I would probably have left you overcorrected until you get old enough to lose your ability to accomodate that extra .50D. If you are over 45ish you should try really hard to get used to the lesser power.
The little vertigo that you get from wearing less power suggests that you might have a little muscle imbalance that doesn't show up until you stop overcorrecting yourself. When you are wearing extra strong contacts, you pull the lens in the eye to cancel the extra prescription, but that little pull also causes the eyes to turn in towards each other. If the natural, relaxed position of your eyes is to be a little "wall-eyed" (exophoric) you are cancelling that exophoria when your eyes pull in to cancel the strong contact.
When you put on your glasses, even if they are weaker than your contacts, you look down and in through a portion of the lens when you read that acts like a little pair of base-in prisms that helps relax your exophoria. Thats why long term contact lens wearers often like reading in the evening with their glasses on more than with their contacts.
This ain't brain surgery, and we are not talking about you having the "wrong" prescription. If you visit your doctor and complain you have a "wrong" Rx he has every reason to become defensive and think you are just a nutcase. BUT, if you enter the exam room with this little bit of knowledge and talk to him about finding the COMFORTABLE RX he will be more open to listening to your needs.
jrmose - 19 Apr 2006 20:35 GMT I'm actually 35, so being overcorrected may be the way to go. In any regard, this is excellent advice and I appreciate your help.
acemanvx@yahoo.com - 19 Apr 2006 23:44 GMT wow he explained it really well! If you are indeed seeing a blur with -3.25 contacts then -3.75 is in fact NOT too strong, otherwise you will have great difficulty seeing from near. I am only 24 and with the CORRECT power contacts, I cant see from near without reading glasses. Glasses are indeed more forgiving because as the poster above said, they act like mild prisms and also the minification makes nearby objects seem a little further away so its less blurry.
Forget what the optometrist thinks, tell him whatever you want is what you get. I like being undercorrected and I dont care what others think, its right for me and helps my eyes relax and see clearly from near and intermediate. Full power glasses give me eyestrain and a headache!
Dan Abel - 20 Apr 2006 02:37 GMT > Glasses are indeed more forgiving because as the poster above said, > they act like mild prisms and also the minification makes nearby > objects seem a little further away so its less blurry. That's an interesting theory. Do you just lay awake nights making this stuff up?
> Forget what the optometrist thinks, That's an idea also. Why pay somebody for an expert opinion when you can just make stuff up instead?
 Signature Dan Abel dabel@sonic.net Petaluma, California, USA
Philip D Izaac - 20 Apr 2006 05:30 GMT Care to explain your statement ACE
> Snoped................and also the minification makes nearby > objects seem a little further away so its less blurry. Roland J. Izaac
The Real Bev - 20 Apr 2006 06:15 GMT > I have a rather bizarre situation that I've never encountered in my > nearly 20 years of wearing contacts. [quoted text clipped - 10 lines] > blurring, that I had trouble focusing, and that I would become slightly > nauseated. After wearing them half a day, my eyes were exhausted. While I don't have any physical symptoms, my experience is similar: the trial lenses are really good, but the lenses (same exact prescription, no errors) in the ordered multi-pack vary considerably -- in different ways -- from the good trial lenses and from each other. Apparently this is so rare that everybody involved has never heard of such a thing. I guess I'm just lucky.
Any chance that your lenses are Cooper or one of their subsidiaries? Cooper wouldn't answer either my email or snail mail.
> By this point, feeling like an absolute freak, I returned to his office > and said that while the trial pair seemed to work fine, the new set > that I had in was making me feel strange. He convinced me that they > were the same exact prescription. I have no reason to question that > other than the blurriness, lack of focus, and feeling rather nauseated > from time to time. Do the trial lenses still feel OK?
> I should also say that these symptoms go away when I take out the > contacts and put on my glasses (that I wear only at night because the [quoted text clipped - 7 lines] > > Or, is it all in my head and I just need to give the contacts time? I'm bothered by the difference between the trial lenses and the ones that were ordered. Apparently there are two of us now...
> My sense is that I need to convince him to put me back at -3.75, when I > felt that I could see fine and I never experienced any of these > symptoms. > > I would be grateful for any advice or feedback. I'm supposed to see > him tomorrow (April 20th) for one last follow-up . . . My guy ordered me one more pair of lenses and gave up. I hope there's some new technology when I can't wear the good ones any more.
 Signature Cheers, Bev =============================================================== Never try to extort more than it would cost to have you killed.
Dom - 20 Apr 2006 12:10 GMT Just a few thoughts:
One suggestion would be to ask if he'd mind giving you another pair of trial lenses in the same power again as a way of double checking.
It's possible, though not that likely, that your own lenses are from a 'bad batch' (it has happened).
I must admit that my first 'gut feeling' was that you had previously been over-minused and just had to get used to the lesser powered lenses (as another poster suggested).
Another possibility I suppose is that the second pair of trials which you were happy with were in fact -375 rather than -350 as the optometrist believed - mistake on the optometrist's part?
Having said all of this, a difference of 0.25 shouldn't make that much difference except for the clarity of distance vision - vision around the room and close up should be pretty much the same either way. What brand of contacts are they?
As I said, just a few thoughts!
Let us know how you go on the 20th.
Dom
jrmose - 20 Apr 2006 17:03 GMT An update:
I went back to the doctor this morning and used the good advice of doctor_my_eye. We basically came to an understanding that for the next few weeks I will continue to wear the -3.50 Acuvue Advance in both eyes (previously, I was wearing -3.75 Acuvue 2 in both eyes).
If my eyes adjust to the new prescription, I will continue to wear them for the next year.
It turns out that since I last wrote, I'm actually doing better with them. The nauseating feeling has gone away, for instance (and incidentally, I recall that when I first started wearing melanin polarized sunglasses, I had the same feeling the first few days I wore them -- all of this therefore seems symptomatic of a larger issue, which is that my eyes are sensitive to change, however minor).
The blurriness is still there, however, and I've pin-pointed it to the left eye which was prescribed -3.75 years ago, even before the right eye was. Regardless, the doctor thinks my eyes are -3.50 and I'm putting my faith in him and hoping that my eyes will "learn" to see through the new prescription.
Thanks for all the helpful advice and suggestions. Best wishes.
acemanvx@yahoo.com - 20 Apr 2006 19:10 GMT good luck! Ive never seen someone with such senestive eyes that 1/4 diopter wrecks havoc!
Neil Brooks - 20 Apr 2006 19:58 GMT >good luck! Ive never seen someone with such senestive eyes that 1/4 >diopter wrecks havoc! ...in all of your years of looking at the Internet, you mean?
acemanvx@yahoo.com - 20 Apr 2006 22:57 GMT and in real life. I know not a single friend or person like that. In fact the majority of my friends choose to forgo glasses if they are very mildly myopic(-.75 to -1.5) my brother himself is -1.25 and only needs glasses for driving.
Neil Brooks - 21 Apr 2006 00:55 GMT >and in real life. I know not a single friend or person like that. In >fact the majority of my friends choose to forgo glasses if they are >very mildly myopic(-.75 to -1.5) my brother himself is -1.25 and only >needs glasses for driving. Ah, anecdotal evidence :-)
Let's say, for argument's sake, Ace, that you have 25 friends (including your brother). That means that your sample size represents 0.00000833% of the approximate US population.
In order to achieve a confidence level of 95%, with a .90 CI, you would need to base your assessment on roughly 11,856 people.
Statistics 101
See: http://www.cas.lancs.ac.uk/glossary_v1.1/confint.html
That's why there are inherent risks--even for the eye docs here who don't usually lead with "in my practice, I have seen...." unless there's no more compelling data on a given subject.
Also, compensating for uncorrective refractive error is at least in part dependent, I imagine, on the functionality of the accommodative mechanism--younger people probably compensate better. This, more than likely, explains why *your* circle may have fewer problems with this than others'.
BTW: After such a harrowing experience with your ol' pal, I'm rather sensitive to logical fallacies ;-)
Quick - 21 Apr 2006 17:11 GMT >> In fact the majority of my friends ... That could be 2.
-Quick
acemanvx@yahoo.com - 22 Apr 2006 04:26 GMT "Ah, anecdotal evidence :-)"
You can see it for youself that alot of very low myopes are not full time glasses wearers. If a young person is hyperopic, he can accomodate around it unless his hyperopia is high.
Dan Abel - 21 Apr 2006 01:10 GMT > and in real life. I know not a single friend or person like that. Otis doesn't wear glasses?
 Signature Dan Abel dabel@sonic.net Petaluma, California, USA
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