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Medical Forum / General / Vision / September 2006Glasses for 5 year-old twins?
We have 5 year-old identical twins who will turn 6 next month. The optometrist checked them 3 years ago and said they needed glasses, but a second opinion from 2 child opthamologists said they could do without glasses. They were just checked again by the same optometrist who said they are both far-sighted with a weaker right eye and wrote a prescription for something in the range of -1.75. I noticed that they could both read the tiniest paragraph on the cardboard sheet as well as identify the smallest pictures, so they can obviously compensate (one of the benefits of being so young) and that the glasses would mostly be to relieve the strain. Not having glasses would not harm their eyes. I'm a bit reluctant to have them start wearing glasses and will probably get a second opinion again. What's the general consensus re: fitting them with corrective eyewear at this age when they can obviously compensate and don't seem to complain of headaches, sore eyes etc? They will be starting grade 1 soon, but I don't imagine that they'll have too much difficulty seeing the board since they are far-sighted. Do optometrists look at this situation differently than opthomologists? Thanks in advance. Dear Pat, It is always wise to obtain the second-opinion. Then you can decide youself. This statement is not consistent: Pat> They were just checked again by the same optometrist who said they are both far-sighted with a weaker right eye and wrote a prescription for something in the range of -1.75. Otis> In general a "farsighed" person will require a POSITIVE value, say +1.75 diopters. A "nearsighed" child will have some blur at distance, and will required a -1.75 diopter lens. Perhaps you could obtain a clarification. Best, Otis > We have 5 year-old identical twins who will turn 6 next month. > [quoted text clipped - 24 lines] > > Thanks in advance. On 8/23/06 11:19 AM, in article 1156357180.064782.282030@74g2000cwt.googlegroups.com, "otisbrown@pa.net" > Dear Pat, > [quoted text clipped - 45 lines] >> >> Thanks in advance. I agree with Otis on the disparity between the prescription numeric value (-1.75) and the diagnosis of "farsighted." You do not need to be a rocket scientist or health care professional to know that. The fact that they do see the smallest pictures would be an indication to me that they are near-sighted. With further testing there should be no doubt. Your more profound question is more difficult to answer. Should the twins be fitted with prescription glasses? If you read this newsgroup over the years, you would know that any answer to that question is controversial. It seems to me, that the almost party line response from the professionals is yes but a small proportion is wavering toward no. Otis and I, who are not vision professionals, probably would lean toward no. With twins, you might be in a position to do an experiment. Give one corrective glasses as proposed by your optometrist. The other would not get glasses or get bifocals to be used for reading but with no power for distant vision. As a parent, you obviously want the best for your kids. The trouble is, as you already point out, you do not know what that is. With hindsight, I would consult a vision specialist to find out if not getting glasses will do actual harm to your twins. My guess is that they will say no, but that it would make it tough to do well in school because they cannot see the blackboard well. Then I would give one twin the glasses and not the other. In a year or two you can fit both with glasses if necessary. Good Luck! Bill -- Ferme le Bush > On 8/23/06 11:19 AM, in article > 1156357180.064782.282030@74g2000cwt.googlegroups.com, "otisbrown@pa.net" [quoted text clipped - 26 lines] > > Good Luck! I think both of you are misguided; the original poster likely got the sign incorrect and meant +175 and not -175. Both of you guys should be jumping up and down that the provider of these twins are suggesting the holy grail of PLUS lenses and not the evil twin of the MINUS lens (only a fiend would prescribe a minus lens). Without knowing what the dry and possibly wet refraction results, it would be pure speculation on whether the kids should be wearing a correction or not but I guess you and Otis know more about this than a lowly optometrist. frank On 8/23/06 3:39 PM, in article 1156372767.389389.82850@75g2000cwc.googlegroups.com, "drfrank21@gmail.com" > I think both of you are misguided; the original poster likely got the > sign incorrect and meant +175 and not -175. Both of you guys [quoted text clipped - 7 lines] > be wearing a correction or not but I guess you and Otis know more > about this than a lowly optometrist. You are are attributing more to me than I wrote. I noted the the OP said that his twins could accommodate to close work. If that truly is the case, why would a main line optometrist suggest a +1.75D lens? I once was a "rocket scientist," but it does not take one, or an MD or OD, to ask such a question. Bill -- Ferme le Bush > I noted the the OP said > that his twins could accommodate to close work. If that truly is the case, > why would a main line optometrist suggest a +1.75D lens? Age 5 is the age when most kids start school, when it's reasonable to predict an increase in near work and grading based on performance at near. Age 5 is late enough, beyond the period of emmetropization, when plus lenses might interfere with the natural resolution of hyperopia. Age 5 is old enough that we can usually get reasonable data using cover test and cycloplegia. I don't believe either of those tests were mentioned, and it's enough of a judgement call that I wouldn't vote without knowing the results. That said, it's usually tough to keep a kid in glasses at age 5. And twins? One approach - get some +175 drugstore readers and let the kids show us how much good they do. If either Mikey likes it, get them a "real" pair. -MT I guess the /do no harm/ rule is the one we want to follow. She explained that the opthamologists probably did not recommend corrective lenses two years ago is that the visual demands of 3 year-olds are not that great (distance reading, detail work etc.). Now that they are headed into grade 1, these demands will increase. I know that when I can't see or read something (I have a mild Rx for astigmatism, something like 0.5), I can get either of the twins to read it for me or tell me what it is, so they certainly can see fairly well. It's frustrating to have to keep 2nd-guessing the OD though. If we get another opposing opinion, I think we're going to have to change optometrists :-( -Pat > On 8/23/06 11:19 AM, in article > 1156357180.064782.282030@74g2000cwt.googlegroups.com, "otisbrown@pa.net" [quoted text clipped - 82 lines] > Bill > -- Ferme le Bush It could have been a +1.75 instead of -1.75. She did mention that the eyeball was shorter, while someone who is short-sighted (myopia) has an eyeball that is longer. > Dear Pat, > [quoted text clipped - 47 lines] >> Thanks in advance. >> > It could have been a +1.75 instead of -1.75. She did mention that the > eyeball was shorter, while someone who is short-sighted (myopia) has an > eyeball that is longer. It sounds like they are hyperopic and +1.75 is fortunately not a huge amount of that, so the Rx probably is pretty optional at this point. As a result, you will get a wide spectrum of answers, none of which will probably harm or help the kids all that much, but nobody knows for sure. Having said that, if they were my kids, I'd probably go with the Rx, at least part time (reading, tv, etc). If they were +3.00 or more, I'd say it was probably not optional and witholding the Rx could be damaging. If it were over +4.00 I'd call the cops if you didn't give them the Rx. w.stacy, o.d. On 8/23/06 9:31 PM, in article IY9Hg.2556$yO7.408@newssvr14.news.prodigy.com, "William Stacy" <wstacy@obase.net> wrote: >> It could have been a +1.75 instead of -1.75. She did mention that the >> eyeball was shorter, while someone who is short-sighted (myopia) has an [quoted text clipped - 12 lines] > > w.stacy, o.d. If the twins could do close work as indicated by their dad, that means that they could get accommodation of 1.75 + 3 = 4.75D presuming they viewed pictures at 33cm. Is that a reasonable amount even for young eyes? I am not the vision pro. What harm occurs when a strong positive lens is used for young eyes? That is other than just bumping into things. Bill -- Ferme le Bush 5 year olds have great accomodation. Even if they were +3 or +4 they wouldnt need glasses *unless* it was for amblyopia controll if one eye was significently weaker and started getting lazy. I doubt they would wear glasses when it would make *no* difference in their vision! I for one would never wear glasses if I could see perfect without! Just give them eye exams annually and make_sure_that their refractive state does not fall into the negetive. When they fall down to +.5 it may be time to take action with a plus lens(with prisms if neccessary) for near work to prevent a negetive refractive state. > 5 year olds have great accomodation. Even if they were +3 or +4 they > wouldnt need glasses *unless* it was for amblyopia controll if one eye [quoted text clipped - 5 lines] > to take action with a plus lens(with prisms if neccessary) for near > work to prevent a negetive refractive state. Do you see any potential harm in placing all of that effort on a young accommodative mechanism? Do you understand the near vision triad? Can you explain accommodative esotropia or esophoria? Could you please explain how it comes in to play here ... if it does at all. In light of your answers to the above, can you please explain your rationale for giving the above advice, and ... on what basis you provide it? Thanks, Ace. You're always annoying ... and quite often dangerous. Good to see =that= hasn't changed. > 5 year olds have great accomodation. Even if they were +3 or +4 they > wouldnt need glasses *unless* it was for amblyopia controll if one eye [quoted text clipped - 5 lines] > to take action with a plus lens(with prisms if neccessary) for near > work to prevent a negetive refractive state. prisms???? it has been quoted to me, "once you go to prisms you cant go back". are you sure you mean prisms? >On 8/23/06 9:31 PM, in article >IY9Hg.2556$yO7.408@newssvr14.news.prodigy.com, "William Stacy" [quoted text clipped - 33 lines] > > Sure they *can* accommodate that much, but it causes esophoria and often esotropia, the former of which is usually uncomfortable for the child and the latter of which is always harmful to the child. Ace, Otis, et alia always view the human vision system one dimensionally, as if binocularity was of no importance. Ignorance is bliss. w.stacy, o.d. Dear Pat, If the optometrist said "too short", then the refractive STATE is positive. The refractive state of the young, normal eye runs between zero to +2 diotpers -- in the young. It is difficult to call refractive STATES in this range a "problem". Their Snellen is most probably normal for age 5 -- about 20/30. (Worth your own checking). Perhaps you could get this majority-opinion optometrist to explain EXACTLY why he thinks these children should be wearing a "plus" lens at this point in their life. I would suggest the second-opinion, which was previously suggested to you -- to keep a lens off their face until they have more time to develop. It is good that you understand these two contradictory, or second-opinions. It allows you to make a choice in this matter. Best, Otis > It could have been a +1.75 instead of -1.75. She did mention that the > eyeball was shorter, while someone who is short-sighted (myopia) has an [quoted text clipped - 50 lines] > >> Thanks in advance. > >> I asked her if the primary purpose for getting them corrective lenses was to relieve strain and her reply was yes. She also said one of the twins' right eye was a 'bit lazy', but she was so all over the map that I'm definitely going to get an opinion from the opthamologist they saw two years ago. If he again recommends against any correction at this stage, it's time to find a new OD. > Dear Pat, > [quoted text clipped - 86 lines] >>>> >>> Dear Pat, If the ophthamologist recommends that a child with a refractive STATE of +1.75 diopters NOT wear a plus lens -- I would consider this a vaid second-opinion and NOT put the child into a strong plus at age 5. There is indeed a "secondary" effect to a +1.75 diopter lens worn all the time, and that is that the refractive STATE of the child will move in a strong positive direction. And that is what the ophthamologist would wish to avoid for your twins. There are STRONG OPINIONS about this issue -- and you will have to sort them out to the best of your ability. Best, Otis > I asked her if the primary purpose for getting them corrective lenses > was to relieve strain and her reply was yes. [quoted text clipped - 91 lines] > >>>> > >>> Otis is right, plus at this point will be overkill, not only will it prevent myopia, it will leave them with too much hyperopia which will cause big problems in the future as they lose their accomodation and end up in bifocals. Let them undergo emmetropization, they shouldnt be +1.75 as they get older due to emmetropization. Otis has said its normal for young people to have this much positive refractive state which will go down to about +.5 several years from now and to plano somewhere in high school. Thats where they may want to use plus glasses for reading to avoid inducing a negetive refractive state. > There is indeed a "secondary" effect to a +1.75 diopter lens worn > all the time, and that is that the refractive STATE of the child > will move in a strong positive direction. In all my years of practice, I've never ever heard an optometrist, an ophthalmologist, or any scientist in the field agree with that statement, and I've never seen it happen to any of the hundreds kids I've prescribed plus for. You and ace are misleading inoccent people in a harmful way. Your incessant b.s. on myopia development is at least not as potentially harmful as the above advice. w.stacy, o.d. Dear Pat, As I said -- you will encounter strong opinions about a child's refractive STATE of +1.75 diotpers. There seems to be no overt problem -- that the OD could articulate. I would agree with the ophthamologist -- in his recommendation that no plus be applied at this point. None of us will know of your choice -- and that is up to you -- clearly. Also, was the recommendation that the child wear the +1.75 diopter all the time. Or was it ONLY for reading. You should ask the OD that quesiton -- and ask why. Otis > > There is indeed a "secondary" effect to a +1.75 diopter lens worn > > all the time, and that is that the refractive STATE of the child [quoted text clipped - 8 lines] > > w.stacy, o.d. The OD suggested that they be worn most of the time, else they would be tempted not to wear them since they can see okay without them. > Dear Pat, > [quoted text clipped - 36 lines] >> w.stacy, o.d. >> > There are STRONG OPINIONS about this issue -- and > you will have to sort them out to the best of your ability. Of course, nobody's opinion matters more than yours. So give us your opinion why Ong, Shotwell, Grosvenor and Parssinen did not find staircase myopia. -MT Mike, Please keep the subject -- on topic. In case you forgot -- these are NOT COLLEGE KIDS. They are 5 year-olds with normal refractive STATES of +1.75 diopters. The optometrists recommend NO PLUS AT THIS POINT -- and you seem to insist that these twins wear a +1.75 diopter 16 hours a day, 7 days a week -- forever. I personally think that is a bad idea -- for this SPECIFIC situation -- as do two highly qualified medical doctors. That is the issue for Pat to review. Otis > > There are STRONG OPINIONS about this issue -- and > > you will have to sort them out to the best of your ability. [quoted text clipped - 5 lines] > > -MT >Mike, > [quoted text clipped - 6 lines] > >The optometrists recommend NO PLUS AT THIS POINT They haven't been seen by the optometrist yet. The poster keeps telling you that and you just ignore it. Ann -- and >you seem to insist that these twins wear a +1.75 diopter >16 hours a day, 7 days a week -- forever. [quoted text clipped - 15 lines] >> >> -MT > Please keep the subject -- on topic. I'm sorry I crossed threads. We were still hoping you would explain why Ong, Shotwell, Grosvenor and Parssinen could not find the "staircase myopia" you keep bringing up. Waiting... -MT > It could have been a +1.75 instead of -1.75. She did mention that the > eyeball was shorter, while someone who is short-sighted (myopia) has an > eyeball that is longer. Amblyopia, or lazy eye, is more prevalent in farsighted children in the eye that is more farsighted. I have seen amblyopia develop in children with a difference of 1.00 diopter between the two eyes. Lazy eye also has a strong genetic basis. Also, unless a cylcoplegic refraction has been performed (i.e. dilating drops), it is quite possible that the 1.75 diopters of farsightedness is an underestimation. Obviously, if a child has a lazy eye, they will compensate by using the good eye. The key points are to (1) obtain an accurate assessment of monocular visual acuity, and (2) an accurate refraction, i.e. with cycloplegia. This will help you decide if doing nothing is causing more harm than doing something. DrG Dear Pat, As an engineer -- I prefer to do my own measurements and testing, just to double check. A competent person (medical, engineering, or science) should have no problem with YOU doing the checking. Just to make certain of your twin's Snellen reading, I would suggest that the read a "easy" Snellen on my site: www.myopiafree.com This is the IVAC Snellen, and had "pictures" that the twins can easily see. If you inform your professional, I think he will be positive with you doing these "at home" measurements. There are ophthamologists who are very reluctant to put a 5 year-old into a minus. That is the second-opinion on the subject. Further, as stated here, a percentage of 5 year-olds do not have 20/20, but rather 20/30. The DMV in most states is between 20/50 and 20/40 -- and there is no reason to "rush" a child into a minus lens. So these are issues you should consider. Best, Otis +++++++++ > We have 5 year-old identical twins who will turn 6 next month. > [quoted text clipped - 24 lines] > > Thanks in advance. Pat, you opted not to listan to this optom 2 years ago, you choose not to listen to them now. Why do we need to answer you? You will not listen to us either. You want to hear what you want to hear, not what is happening with your children. Yes, optoms look at eyes differently to ophthals. We actually know more when it comes to functional issues. With their script, it may be advisable to get glasses for near work, but I would like to see how their eyes function. The script should reduce by 1/2 over the next 4-5 years, and glasses will make no difference to the final Rx. They make a huge difference to how they go with learning to read however. dr grant I negelected to mention that they actually saw TWO opthamologists back after the OD 2 years ago. Both suggested not getting glasses for them. I'm not *ignoring* the information from the optometrist. I go to her myself and she has me seeing very clearly :-) However, my gut feeling is that it's not as cut-and-dry when it comes to young children - especially mine - that's why I'm also looking for input here. Reading isn't a problem. They've been able to read for about a year now, and would be able to read this message :-) I just want to make sure that I make the right decision to give them the best possible outcome, which would include getting glasses for them if there was a risk of one eye becoming lazy etc. I didn't want to bring up the ethics issue, but ODs here in Ontario get a small fee from the province for an eye exam and make most of their money from the sale of prescription eyewear. She seemed very anxious for me to look at frames while we were in the office, but I'm not going to be rushed into a decision. I'm surprised at the number of barbs thrown in this discussion. While this may not be an *exact* science, but it is a science, isn't it??? > Pat, > [quoted text clipped - 13 lines] > > dr grant Dear Pat, The refractive STATE of the eye will "move positive" if you place a +1.75 diopter on it -- and wear it all the time. In this case the childs vision went from about +2.0 diopters to +3.25 diopter in eight months. This is probably why the ophthamologist recommended that the twins not wear the "plus" at this point. But that is why their must be a second-opinion -- and that you have a choice in this matter. The "name calling" that goes on about your right to an informed, competent second-opinion is NOT PROFESSIONAL. Best, Otis ++++++++++++++++++++++ Hi I wrote on March 15 regarding my son. Here is the link in case is of any use, there were a lot of nice people helping me. http://groups.google.com/group/sci.med.vision/browse_thread/t hread/a6... To make the story short: My four years old boy was diagnosed with strabismus and amblyopia. He started crossing (in) his right eye when he was almost 4 years old. The ophthalmologist prescribed glasses OD +2.25 (sphere) OS +1.75 (+0.25) and then advised us to patch him 2 hours a day, and do some manual activities while patched. We did this for 7 months, the amblyopia is gone for now. Both eyes are 20/30. The doctor has raised the prescription twice, so in 8 months my son has needed 3 different prescriptions, why didn't the doctor go all the way since day one? Anyway, my son has been wearing the last prescription, 3.25 in both eyes, for 5 days now and we noticed today, as he was watching TV, that he still crosses his right eye. Is that that he may need a little more time to get used to the new prescription, and then he won't cross? Or this is just wishful thinking, and he'll need surgery? And how useful will be vision therapy in his case? Thanks > I negelected to mention that they actually saw TWO opthamologists back > after the OD 2 years ago. Both suggested not getting glasses for them. [quoted text clipped - 37 lines] > > > > dr grant > I'm surprised at the number of barbs thrown in this discussion. While > this may not be an *exact* science, but it is a science, isn't it??? The barbs are caused by one or two resident trolls who repeatedly substitute imagination for science. A broken clock is right twice a day, and that seems to be enough for Otis. -MT, OD I want to point out that her own optometrists both opted NOT to prescribe your sons glasses. I am not a doctor and have no say in this. Otis isnt a doctor either and is marely explaining the eye from an engineer's point, not a medical point. What Otis is saying is to listen to your second opinion optometrist who said NO to glasses for your sons. > I negelected to mention that they actually saw TWO opthamologists back > after the OD 2 years ago. Both suggested not getting glasses for them. [quoted text clipped - 6 lines] > Reading isn't a problem. They've been able to read for about a year > now, and would be able to read this message :-) Not that Im a doctor or nowt, but, I can read this message too. But with a pair of just weak reading glasses of about +.75 and an astigmatism correction of -.50 in each eye, I can see even better. The text it sharp, in focus, edges are no longer fuzzy. They *may* be able to read, but they will probably read better WITH glasses. You could do what I did, and just get a cheap pair made up and see if the kids notice anything different. You don't have to make them keep wearing the glasses! > I didn't want to bring up the ethics issue, but ODs here in Ontario get > a small fee from the province for an eye exam and make most of their > money from the sale of prescription eyewear. She seemed very anxious > for me to look at frames while we were in the office, but I'm not going > to be rushed into a decision. Not a good situation. In the UK, you're under no obligation to buy glasses from whoever did the eye test - well, maybe some of the smaller independants do (though Im not saying they're all bad). Over here, we have a chain called SpecSavers, who give you your Rx and I can then go away and get them from somewhere else if I want. You could find a different optician and see if the results agree if its that important? Cya Simon > I'm not *ignoring* the information from the optometrist. I go to her > myself and she has me seeing very clearly :-) However, my gut feeling > is that it's not as cut-and-dry when it comes to young children - > especially mine - that's why I'm also looking for input here. Actually, yo are ignoring the optoms advice as you haven't acted. The 2 ophthals are only saying they don't need glasses as the eyes are straight and they can read the bottom line of the chart. They have taken no readings on how your children's eyes perform up close, which, to me, as a paediatric optom, is the major thing of importance here. > Reading isn't a problem. They've been able to read for about a year > now, and would be able to read this message :-) Au contrair mon petite. The ability to read and the capacity to sustain the activity are 2 separate issues. One is the processing of visual code, the other is the ability to contract a muscle for a lengthy period of time. With a script of +1.75, your children have to do 50-60% more work to get things clear up close than the kid sitting next to them in class. Try putting a bag full of books on your back and walk around with it on all day and see how you feel. The problems we get from moderate levels of hyperopia are fatigue and avoidance, not blur and can't read. Additionally, there is the issue of the script. +1.75 is not necessarily the full prescription. Thet may be +3.00 or +4.00 and the optom has only given a script of +1.75, which is what I would do in the same circumstance. > I just want to make sure that I make the right decision to give them the > best possible outcome, which would include getting glasses for them if > there was a risk of one eye becoming lazy etc. You can't give them a lazy eye from glasses in this case, nor will they develop one if they don't get them. This is not the issue for your children. The correct script will enable the to get maximal comprehension from the text they read, no glasses may well cause them to not get as much information from the text, which can lead to poor academic performance down the track. While I am not specifically advocating glasses here, this is the area which I spend most of my time on and an appropriate assessment of the children is critical. If you want a second opinion, look up a COVD fellow at www.covd.org that is in your area. http://www.covd.org/membersearch.asp?cn=CA > I didn't want to bring up the ethics issue, but ODs here in Ontario get > a small fee from the province for an eye exam and make most of their > money from the sale of prescription eyewear. She seemed very anxious > for me to look at frames while we were in the office, but I'm not going > to be rushed into a decision. I only think about the welfare of your children, I make no money from advice here, in my practice, I only concern myself with the welfare of my patient and what is best and make my recommendations. I only have a script of +1.00 and I actually stopped reading in grade 1 due to the same issue of eyestrain. I was 28 before I realised I had a problem and that I hadn't read a book since then. > I'm surprised at the number of barbs thrown in this discussion. While > this may not be an *exact* science, but it is a science, isn't it??? There is a lot of interpretation of what constitutes vision. We also have a few non-professionals here who like to scare-monger that you will damage your children's eyes. They post fictitious accounts and have no basis to make these posts, but they like to think they are saving your soul from the damnation of glasses. One absolute guarantee I can make to you is that reading glasses will not do any harm to your children in any way. All the best. dr grant FCOVD FACBO (Yep I am actually an accredited children's specialist) > Au contrair mon petite. The ability to read and the capacity to sustain > the activity are 2 separate issues. One is the processing of visual [quoted text clipped - 8 lines] > and the optom has only given a script of +1.75, which is what I would > do in the same circumstance. Actually, I was in for my own check-up yesterday (time for reading glasses) and asked to see my kids' results. One has +1.25 in each eye, while the other has +2.5 in the right eye, and +1.25 in the left. Dear Pat, Pat> They were just checked again by the same optometrist who said they are both far-sighted with a weaker right eye and wrote a prescription for something in the range of 1.75. Otis> Natural Refarctive STATES for children tend to run between zero to +2 diopters. Otis> It is not clear why a +1.75 diopter lens was "prescribed". Has the OD explained WHY a child when normal refractive STATES "needs" a plus lens. Please ask the OD to be articulate in layman's language to explain why. Otis> We would all like to hear the explanation. Particularly since the second-opinion is to NOT wear that plus at this time. Best, Otis > > Au contrair mon petite. The ability to read and the capacity to sustain > > the activity are 2 separate issues. One is the processing of visual [quoted text clipped - 14 lines] > One has +1.25 in each eye, while the other has +2.5 in the right eye, > and +1.25 in the left. Dear Pat, Also, let me add, that under the circumstance that the child's refractive STATE is +1/2 diopter, I would argue that a plus should be used -- to maintain this refractive STATE. Otis > Dear Pat, > [quoted text clipped - 36 lines] > > One has +1.25 in each eye, while the other has +2.5 in the right eye, > > and +1.25 in the left. > Also, let me add, that under the circumstance that the > child's refractive STATE is +1/2 diopter, I would argue > that a plus should be used -- to maintain this > refractive STATE. How you know that works? -MT >We have 5 year-old identical twins who will turn 6 next month. > [quoted text clipped - 14 lines] >I'm a bit reluctant to have them start wearing glasses and will probably >get a second opinion again. I would ask the eye doctors who prescribe their rationale for treatment. IOW, why are they recommended and what is the risks of them not wearing them. >What's the general consensus re: fitting them with corrective eyewear at >this age when they can obviously compensate and don't seem to complain >of headaches, sore eyes etc? They will be starting grade 1 soon, but I >don't imagine that they'll have too much difficulty seeing the board >since they are far-sighted. I tend to NOT prescribe for low amounts of hypermetropia in children when they are completely asymptomatic and do not have any significant findings -- glasses aren't free. However, if they have subnormal VA, esophoria, difficulties in school/learning that I can possibly attribute to refractive error, then I will not hesitate to prescribe. What is "low"? I tend to follow the guidelines given in the American Academy of Ophthalmology's Preferred Practice Patterns for Pediatric Eye Examinations (which only go from age 0-3). >Do optometrists look at this situation differently than opthomologists? I think optometrists tend to prescribe more for low asymptomatic pediatric hypermetropes than ophthalmologists do. >>Do optometrists look at this situation differently than opthomologists? > > I think optometrists tend to prescribe more for low asymptomatic > pediatric hypermetropes than ophthalmologists do. Does the situation change when you become adult? I have a low reading for hyperopia, but the optician said I didn't need glasses, only if I had a problem. Why shouldn't the same apply to children? > >>Do optometrists look at this situation differently than opthomologists? > > [quoted text clipped - 6 lines] > > Why shouldn't the same apply to children? My point exactly. As long as they have no trouble seeing and no symptoms, glasses are useless. If I were hyperopic and glasses did nothing, why_would_I_wear them? >My point exactly. As long as they have no trouble seeing and no >symptoms, glasses are useless. Children with convergence excess and a high AC/A ratio many times fatigue quicker or use excessive effort when reading/studying. Many times they don't realize this because they have no point of comparison -- IOW, they don't realize what clear, comfortable, effortless vision is. When they fatigue quicker than their peers, they are at an educational disadvantage. >If I were hyperopic and glasses did nothing, why_would_I_wear them? If they in fact, "do nothing" they shouldn't be prescribed. A doctor should be able to give a valid reason or purpose for prescribing glasses. Everytime I prescribe glasses, I am able to do so. >> I think optometrists tend to prescribe more for low asymptomatic >> pediatric hypermetropes than ophthalmologists do. > >Does the situation change when you become adult? I have a low reading >for hyperopia, but the optician said I didn't need glasses, only if I >had a problem. I am MUCH LESS apt to prescribe for asymptomatic low hypermetrope adults. In fact, I almost never prescribe for them. I mean the purpose of glasses are to solve or prevent problems. >Why shouldn't the same apply to children? Because children don't know what is best for them many times. >>>I think optometrists tend to prescribe more for low asymptomatic >>>pediatric hypermetropes than ophthalmologists do. [quoted text clipped - 10 lines] > > Because children don't know what is best for them many times. I saw what you wrote to Ace. Yes, Children don't have a valid point of reference and do not know what's best for them. Sounds like me to be honest though. Im 29, and as I said in another thread, I think Im about +.75 in each eye, and ok, I have a slight -.50 astigmatism, but even at these small values, the difference the glasses make are unbelievable. They really do bring everything into sharp focus and get rid of eye strain and ease fatigue. Cheers Simon >I think Im about +.75 in each eye, and ok, I have a slight -.50 >astigmatism, but even at these small values, the difference the >glasses make are unbelievable. It's very subjective. Some people find such a prescription to provide little improvement; others find the changes "unbelievable". >They really do bring everything into sharp focus and get rid of eye >strain and ease fatigue. The clearer one's focus, the less eye strain and the less fatigue the easier one is able to process visual stimuli and learn. IOW, you don't want your brain power dealing with optical defocus, strain and fatigue when it could be processing important information. > >> I think Im about +.75 in each eye, and ok, I have a slight -.50 >> astigmatism, but even at these small values, the difference the >> glasses make are unbelievable. I also have slight astigmatism in roughly the same range, but only lost the ability to accomodate after about age 40. Prior to that, my vision was 20/17 in my best eye. Young children can probably accomodate such variations more easily. > I also have slight astigmatism in roughly the same range, but only > lost the ability to accomodate after about age 40. Prior to that, my > vision was 20/17 in my best eye. > > Young children can probably accomodate such variations more easily. For small amounts, you are quite right. Your kids apparently have an amount of hyperopia that is on the borderline between a small and a moderat amount. We probably wouldn't be having this discussion if they were +.75 or +4.00. By far most authorities wouldn't Rx for the former and would for the latter for little kids. It's that pesky borderline situation that warrant discussion and consideration. The biggest problem on s.m.v. is that we have a couple of guys who disagree with mainstream modern eyecare and prescribing. I wouldn't have any problem with that, except that neither of them has any formal education in the subject, only some highly questionable self-education. If they could find a single o.d., m.d., or Ph.d. in the eye field come on this forum and support their positions, now there would be a good discussion. But they can't find even one to do so. Dear Pat, You came to S.M.V looking for the second-opinion -- that was already confirmed by two ophthamologists. You can, if you wish, follow the OD majority opinion, and place the twins in a +1.75 dipoters plus -- which they will wear all the time. The opthamologists who SUGGESTED that you kids not wear the +1.75 diopters -- do not have time to post on s.m.v. The have job to do, and their own children and grandchildren to worry about. On most medical subjects (if the natural eye's proven behavior is even "medicine) you will find two opinions -- often profoundly contradictory. The point is to identify these opinions -- and make your choice accordingly. To read some more of this "second opinion" I would suggest reading: www.chinamyopia.org Steve Leung OD simply does not have time to come on s.m.v. He has his hands full helping his own children. That is how it should be. If you keep the "plus" off the twins, then their refractive STATE will "move" slowly down, to 1.5, then 1.0, then +0.75 then 0.5 diopters. This is a normal process -- and you can monitor if you wish. Under specific circumstances, when their refractive STATE is +0.5 diopters, and in school, I do argue that at that point, the plus could be used -- for prevention. But these are the nature of scientific arguments. For now, I would consider following the advice of the two ophthamologists you consulted. Best, Otis > > I also have slight astigmatism in roughly the same range, but only > > lost the ability to accomodate after about age 40. Prior to that, my [quoted text clipped - 60 lines] > > --------------070108000209000101040308-- Once we get an appointment, I'll post his recommendation and reasoning here. The last second opinion was 2 years ago. Now that they are turning 6 and starting grade 1, he may have a different recommendation. There's certainly no urgency to rush them into corrective lenses today :-) > Dear Pat, > [quoted text clipped - 113 lines] >> --------------070108000209000101040308-- >> A wise choice. As long as the twins have good visual-acuity -- there is no reason to take any action -- unless the ophthamologists should recommend it. Otis > Once we get an appointment, I'll post his recommendation and reasoning > here. The last second opinion was 2 years ago. Now that they are [quoted text clipped - 116 lines] > >> --------------070108000209000101040308-- > >> > Once we get an appointment, I'll post his recommendation and > reasoning here. The last second opinion was 2 years ago. Now that [quoted text clipped - 3 lines] > There's certainly no urgency to rush them into corrective lenses > today :-) A wise choice, and good luck. Remember too, just because people post here with a degree of certainty, doesn't make them right. Sometimes they're just kooks who havent met you or your children! > You can, if you wish, follow the OD majority opinion, and > place the twins in a +1.75 dipoters plus -- which they will > wear all the time. I believe the majority of ODs here have recommended NOT using glasses without further evidence of problems. Not that you care. > On most medical subjects (if the natural eye's proven behavior > is even "medicine) you will find two opinions -- often profoundly > contradictory. And since you have more training and experience, your opinion is naturally more important. > Steve Leung OD simply does not have time to come > on s.m.v. He has his hands full helping his own children. > That is how it should be. Too bad he's too busy to publish his results anywhere we can read them. -MT > I saw what you wrote to Ace. Yes, Children don't have a valid point of > reference and do not know what's best for them. [quoted text clipped - 9 lines] > Cheers > Simon You have a spherical equivalent of only +.5 but for someone like you with poor accomodation, your vision will be blurry at all distances and you wont be able to read without reading glasses or plus. You might be able to strain to accomodate in the distance enough to pump out a couple 20/20 guesses but your eyes will quickly fatigue and your head hurt from the strain. I am not gonna label you as picky because its much worse to be farsighted than nearsighted. Myopes like me see perfect from near, whereas hyperopes see extremely blurry from near. Also myopes can go without correction and almost never get headaches, in fact to the courty(spell?) minus glasses *can* give headaches, especially if they are just a bit too strong! The reason is accomodating places a strain and being myopic relaxes all accomodation. When I get orthoK and reduce my -4.5 myopia, I will go without glasses most of the time like my -1 bro never wears glasses except to drive. > You have a spherical equivalent of only +.5 but for someone like you > with poor accomodation, your vision will be blurry at all distances and > you wont be able to read without reading glasses or plus. You might be > able to strain to accomodate in the distance enough to pump out a > couple 20/20 guesses but your eyes will quickly fatigue and your head > hurt from the strain. What the hell are you drivelling on about? Where are you getting this garbage from? Stop playing doctor and find a train track to play on. Cya Simon Sorry Simon, we know he is a deadshit, but can't do much about it. Sooner or later he will brainfart and implode. grant > Sorry Simon, we know he is a deadshit, but can't do much about it. > Sooner or later he will brainfart and implode. > > grant Problem is, a normal person, might take this lump of sh.t seriously! When people start using long complicated words with "authority", they can only somehow think they're qualified and listen to them! I was half taken by "Ace"s post at first, then I realised, I can read without glasses, I have no blur, and my accomodation is just fine! > > You have a spherical equivalent of only +.5 but for someone like you > > with poor accomodation, your vision will be blurry at all distances and [quoted text clipped - 11 lines] > Cya > Simon Ok questions: Can you see 20/20 without correction, if not, how close? How blurry are things from near(16 inches) without your reading glasses? Why are you wearing glasses? >>>You have a spherical equivalent of only +.5 but for someone like you >>>with poor accomodation, your vision will be blurry at all distances and [quoted text clipped - 18 lines] > glasses? > Why are you wearing glasses? So you have to ask questions? Why did you give me your considered opinion before asking? Yes, I can read 20/20 without correction. In fact, better. At sixteen inches, things are clear, but not necessarily sharp. Fractionally, marginally things are a little, shall we say, "anti-aliased" lightly around the edges. Why am I wearing glasses? Im not. In May 2005, I went for my annual eye test, and was told that things are fractionally worse than they were the year before at +.75 in one eye, and that glasses weren't recommended but I could get them if I wanted. I had a pair made up to see if they would help with eye strain. They did. They also made things a lot sharper than I could possibly have expected. But that could also be due to the astigmatism rather than the hyperopia. I put them on now, and things still remain sharp. But I don't wear them all the time. I still suffer from eye strain, but things are manageable. Cya Simon Then its the headaches that force you to wear glasses even though your distance is 20/20 and your near vision is only a little blurred due to hyperopia and astigmatism. In your case, your wearing glasses not for good vision, but the big difference in not having to strain to accomodate your hyperopia. I have simulated +.75 and even though my vision was still clear, it was a strain and my eyes and head begin to hurt! So I can see your reason for part time glasses wear, especially for near. Being myopic, I dont have the headache problem and I see perfect from near. > Then its the headaches that force you to wear glasses even though your > distance is 20/20 and your near vision is only a little blurred due to > hyperopia and astigmatism. Who said anything about headaches? I didn't. Again, you're just making stuff up. > In your case, your wearing glasses not for good vision, but the big > difference in not having to strain to accomodate your hyperopia. Unless you've read differently, not only do help with eye strain at times of need, but THEY ALSO GIVE ME BETTER VISION AND MAKE EVERYTHING SHARPER. Of course, in case you've forgotten, again, I also have a slight astigmatism. So the glasses also solve that little hurdle as well. > I have > simulated +.75 and even though my vision was still clear, it was a > strain and my eyes and head begin to hurt! Eh? So beause that's how it is with you, that's how it must be with everyone? Don't really care how it makes you feel, Im the patient. Explain this +.75 simulation? Monkeying around with your lenses again or something? > So I can see your reason for > part time glasses wear, especially for near. Except you don't, because, as I've already said, although I've had them made up, I don't wear them, despite the obvious benefits. The reason why I don't wear them, is because I have acceptable vision, that I personally feel that I don't need to wear them. > Being myopic, I dont have > the headache problem and I see perfect from near. Problem solved then. You have confused me. Let me try to understand it, you were told you had 20/20 vision without glasses, yet got prescribed glasses so the optometrist/optican can make profit even though you dont need glasses and the very slight difference wasnt worth you bothering with the hassles of glasses. You see without glasses better than most people see with glasses! So you have absolutely NO problems without glasses except the tiniest bit of blur from near due to hyperopia and astigmatism > You have confused me. Let me try to understand it, you were told you > had 20/20 vision without glasses, Yes (and if you read to the bottom I'll explain. again). > yet got prescribed glasses No. > so the > optometrist/optican can make profit Incorrect given the above. > even though you dont need glasses > and the very slight difference wasnt worth you bothering with the [quoted text clipped - 3 lines] > So you have absolutely NO problems without glasses except the tiniest > bit of blur from near due to hyperopia and astigmatism Let me explain again. Yearly, I go to the optician for a checkup. Im a computer user. I get told what my values are time after time. Sometimes its plano, sometimes it's just a slight hyperopia and slight astigmatism (-.50). Last time, I was checked to be +.75 hyperopia and -0.50 astigmatism. My optician said that the values were higher, and I'll probably need to think about getting glasses at some stage, but he said "you don't need glasses now, unless you feel you have a problem". I didn't feel that I had a problem. But I did have a degree of eye strain that was getting me down at the time. I went to the optician and had them make up a cheap pair of glasses for me to see how things worked. So I found that the glasses actually relieved my eye strain at the time. But on top of that, the glasses actually made things clearer and sharper to see. I didn't expect that. It's been a year since I had the glasses made, and six months since I was told that I had returned to plano. Given my thyroid condition that seems to affect my vision each time I need an increase in my meds, and the fact Im plano, I don't wear the glasses so much anymore. I just wear them as required, such as if my eye strain gets me down or Im having trouble reading things. Yes, even now, the glasses would still work. I can look at the text Im writing now without glasses, and it looks ok here at the moment, it's fine. But the glasses will just make it a little sharper, as well as helping with any eye strain. Do they help? Yes. Do they help even now? Yes. Do I need to wear them? No. Why did I get them? At the time I had a lot of eye strain. Do I wear them now? As required. Does that explain it all? Honestly Ace, you have to learn to read and stop making assumptions, such as "Oh, you have headaches" when I never said a word! Cya Simon Simon Dean said: > Yearly, I go to the optician for a checkup. Im a computer user. I get > told what my values are time after time. Sometimes its plano, sometimes > it's just a slight hyperopia and slight astigmatism (-.50). Ok, have you asked your doctor why your prescription isnt stable? Mine has been stable for years save for the gradual improvement in the last 18 months, but thats due to addressing the pseudomyopia component. > Last time, I was checked to be +.75 hyperopia and -0.50 astigmatism. > > My optician said that the values were higher, and I'll probably need to > think about getting glasses at some stage, but he said "you don't need > glasses now, unless you feel you have a problem". So you are a latent hyperope and starting to become presbyopic and its showing in the manifest refraction. Whats your cycloplegic refraction? That could be the reason you had eyestrain, especially for close work like computer. > I didn't feel that I had a problem. > > But I did have a degree of eye strain that was getting me down at the time. > > I went to the optician and had them make up a cheap pair of glasses for > me to see how things worked. latent hyperope, see above. > So I found that the glasses actually relieved my eye strain at the time. > But on top of that, the glasses actually made things clearer and sharper > to see. I didn't expect that. Thats normal. I also see clearer from near if I take my glasses off or put on reading glasses over my full power glasses. > It's been a year since I had the glasses made, and six months since I > was told that I had returned to plano. Given my thyroid condition that > seems to affect my vision each time I need an increase in my meds, and > the fact Im plano, I don't wear the glasses so much anymore. I just wear > them as required, such as if my eye strain gets me down or Im having > trouble reading things. In what way is your thyroid condition affecting vision? Id get a cycloplegic refraction and find out once for all how hyperopic you are. > Yes, even now, the glasses would still work. I can look at the text Im > writing now without glasses, and it looks ok here at the moment, it's > fine. But the glasses will just make it a little sharper, as well as > helping with any eye strain. Thats hyperopia for ya! Youll need readers, especially as you get older. I take my glasses off to read because im myopic. > Honestly Ace, you have to learn to read and stop making assumptions, > such as "Oh, you have headaches" when I never said a word! > > Cya > Simon I guess I must have assumed wrong. Thanks for clearing it up. You are a hyperope with more latent hyperope and at your age, your accomodation decreasing. > Simon Dean said: > [quoted text clipped - 7 lines] > the last 18 months, but thats due to addressing the pseudomyopia > component. Two schools of thoughts, first there were different testers, and then there could be hypothyroidism issues. Havent exactly got a firm answer yet. >> Last time, I was checked to be +.75 hyperopia and -0.50 >> astigmatism. [quoted text clipped - 7 lines] > refraction? That could be the reason you had eyestrain, especially > for close work like computer. Yes, I'd quite like to have a cycloplegic exam done. As for presbyopia, that only comes after about the age of 40 (usually) doesn't it? >> So I found that the glasses actually relieved my eye strain at the >> time. But on top of that, the glasses actually made things clearer >> and sharper to see. I didn't expect that. > > Thats normal. I also see clearer from near if I take my glasses off > or put on reading glasses over my full power glasses. It's normal? Even for people who are plano? Mind you, I suppose part of the issue with pluses, they work like a magnifying glass don't they? >> It's been a year since I had the glasses made, and six months since >> I was told that I had returned to plano. Given my thyroid condition [quoted text clipped - 6 lines] > cycloplegic refraction and find out once for all how hyperopic you > are. Have a look for hyperthyroidism. That apparently with thyroid eye disease can push the eyeball out. I wondered whether being hypo could have the opposite effect. Certainly being hypo though could encourage you to lose a certain amount of muscle tone or control, which apparently is one of the reasons why people who are hypo, get excess acid - or maybe they don't get excess acid, it just has an easier time of coming up thereby creating heartburn. So it could be perfectly feasible that you aren't in control of your eyes as much when you're hypo. Certainly I think I've found a correlation between my vision and going back down in the trough of hypo. > I guess I must have assumed wrong. Thanks for clearing it up. You are > a hyperope with more latent hyperope and at your age, your > accomodation decreasing. Never assume, Ace, it's a dangerous game. Simon Dean: > Two schools of thoughts, first there were different testers, and then > there could be hypothyroidism issues. Havent exactly got a firm answer yet. Hope the doctors figure out this baffling case. > Yes, I'd quite like to have a cycloplegic exam done. As for presbyopia, > that only comes after about the age of 40 (usually) doesn't it? Just ask your optometrist for cyclopentolate, cyclogyl. Presbyopia starts at birth but usually doesnt become an issue till your mid to late 30s if you are plano. Because you are hyperopic and may have more latently, you are feeling the effects earlier. Plus glasses sharpen things for near. Taking off my minus glasses does the same for me so I am mildly presbyopic or have reduced accomodation. Ive been told by an optometrist that myopes dont have as good accomodation because their eyes have adapted for near by becomming myopic and are used to seeing from near without glasses. > It's normal? Even for people who are plano? Mind you, I suppose part of > the issue with pluses, they work like a magnifying glass don't they? You are +.75 which means you have to constantly accomodate so things come in focus behind your retina. This is not a large refractive error and is why you still see 20/20 distance and only slightly blurry near. Plus both magnify and sharpen, its the same when I put them over my full power distance glasses, things get bigger and sharper! Of course I just take my minus glasses off, tried putting plus just to see how it works. > Have a look for hyperthyroidism. That apparently with thyroid eye > disease can push the eyeball out. I wondered whether being hypo could [quoted text clipped - 6 lines] > think I've found a correlation between my vision and going back down in > the trough of hypo. Ill have to read into this. If it happens to me, I will end up less myopic. > Never assume, Ace, it's a dangerous game. People do that all the time :) More lies and misinformation. Why don't you pull the plug---on your useless life. >Presbyopia > starts at birth but usually doesnt become an issue till your mid to > late 30s if you are plano. WRONG. Presbyopia is defined, from the Latin route of the word as "old sight". It is a condition resulting from loss of accommodation due to age-related changes in the eye. Of course YOU might say that you begin dying the moment you are born. >Taking off my minus glasses does the same for me so I > am mildly presbyopic WRONG. YOU are a child. You do not have presbyopia. > You are +.75 which means you have to constantly accomodate so things > come in focus behind your retina. WRONG. ON the retina photoreceptors, NOT behind it. And how in hell did you make this up. Complete NONSENSE: > > Have a look for hyperthyroidism. That apparently with thyroid eye > > disease can push the eyeball out. I wondered whether being hypo could [quoted text clipped - 6 lines] > > think I've found a correlation between my vision and going back down in > > the trough of hypo. GO AWAY>>>>>> > And how in hell did you make this up. Complete NONSENSE: > [quoted text clipped - 8 lines] >>>think I've found a correlation between my vision and going back down in >>>the trough of hypo. With respect, I wrote that. I know TED can affect hyperthyroid sufferers. I suffer from hypothyroidism and wondered if there might at all cause things to happen the opposite way to TED, some interaction with the eyes at least. What gets me wondering, is that my eyes are usually the first thing to go a bit blurry and tired. After a few months, I find my TSH is high and I need more thyroxine. Once I've actually got my thyroxine level adjusted, my eyes seem to miraculously return to plano. That could explain the rollercoaster eye prescription for myself. I hypothesised that there might be some issue with muscle control etc, given that people who have hypothyroidism do have problems with stomach acid, I've sometimes heard it suggested it's because when hypothyroid, you can have problems with the lower oesophageal sphincter. If that's the case maybe it could affect the muscles of the eye and explain problems with focusing. I have no idea if it's true, it's a promising idea, but Im not suggesting people with eye problems have thyroid problems though... Cya Simon > With respect, I wrote that. I apologize for the confusion. I should have noticed that the flow of thinking is more sensible than anything Ace might dream up. I scanned and stopped. Sorry. From what I know of thyroid eye disease, the physiological changes from Grave's disease (hyper) or Hashimoto's (hypo) thyroiditis occur as an autoimmune pathology affecting the extraocular muscles. In rare(r) cases, the compression of tissues behind the eye can affect the optic nerve and cause decreased vision. Control of thyroid hormones does not appear to significantly effect the course of the disease. AFAIK, there is no clear rationale for that. Also, the eye pathology can occur without clear hormone imbalance and hormone imbalance can occur without eye pathology. The internal ciliary muscle is not affected. There is no model for why visual acuity might fluctuate as a result of hyper/hypo T. In Grave's, some patients do recover at least some normalcy in the extraocular muscles following thyroidectomy and careful hormone control and without surgery. What YOU decribe seems more like that which occurs with faulty glucose metabolism as in uncontrolled diabetes. As diabetes is an autoimmune disease as is Grave's and Hashimoto's, I think that is where you should be looking. That's pretty much all I know off right off without involved research. Perhaps one of my colleagues might be able to add some additional insight. LB, O.D. >>With respect, I wrote that. > [quoted text clipped - 12 lines] > eye pathology. The internal ciliary muscle is not affected. There is no > model for why visual acuity might fluctuate as a result of hyper/hypo T. Right, OK, knew there had to be a reason for the "bulging" eyes type of thing, and of course if you got some stuff going on behind the eye. The whole TED is something Im not familiar with - having never had it, and never researching it. > In Grave's, some patients do recover at least some normalcy in the > extraocular muscles following thyroidectomy and careful hormone control [quoted text clipped - 4 lines] > disease as is Grave's and Hashimoto's, I think that is where you should > be looking. Im still going to think about the "muscle control" aspect when hypothyroid, although the diabetes is an interesting one, given that I am overweight and consume lots of sugar. But I have had my blood tested with the pinprick thing - Is that a blood glucose test? Anyhow, either way, that came back normal so we pretty much ruled that out, and given my thyroid problems and regular blood tests every few months, nothing else has shown up. > That's pretty much all I know off right off without involved research. > Perhaps one of my colleagues might be able to add some additional > insight. Well, just so the question of my hypothesis isn't lost, what causes this "rollercoaster" effect of plano to +0.75 to plano to +0.75 where the +0.75 seems in my experience to correlate with undercorrection of my thyroxine levels. I'll leave that for the board. Cheers Simon > Im still going to think about the "muscle control" aspect when > hypothyroid, although the diabetes is an interesting one, given that I [quoted text clipped - 3 lines] > my thyroid problems and regular blood tests every few months, nothing > else has shown up. The "pinprick" blood sugar test only measures blood sugar at the instant the test was done. It is NOT a test for diabetes. You should find out if you had a GTT (glucose tolerance test--short term sugar reaction) or the most appropriate test, the hemoglobin A1c test (long term sugar reaction.) Both of the fore-mentioned are done to diagnose diabetes. LB, O.D. > The "pinprick" blood sugar test only measures blood sugar at the > instant the test was done. It is NOT a test for diabetes. You should [quoted text clipped - 4 lines] > > LB, O.D. Thanks for the info. I'll check into this when Im next at the docs! Ta Simon Dear Ace, It is true that some people LOVE glasses. That is fine -- so give them the glasses they love. We often do not get what we want -- we get what we deserve. Think about it. Otis > You have confused me. Let me try to understand it, you were told you > had 20/20 vision without glasses, yet got prescribed glasses so the [quoted text clipped - 5 lines] > So you have absolutely NO problems without glasses except the tiniest > bit of blur from near due to hyperopia and astigmatism otisbrown@pa.net schreef: > Dear Ace, > [quoted text clipped - 4 lines] > We often do not get what we want -- we get > what we deserve. That's correct Otis and some people SHOULD love glasses, you for instance. Simon explained clip and clear why he OCCASIONALLY wear glasses. > Think about it. Fully agreed. Free to Marcus Porcius Cato's "Ceterum censeo Carthaginem esse delendam" In conclusion, I think that the "old plus lens junk recovered by Otis" should be destroyed. Jan (normally Dutch spoken) > We often do not get what we want -- we get > what we deserve. > > Think about it. I've thought about it, and conclude you a selfish arrogant dangerous cold hearted ignorant manipulative and evil. To talk like this suggesting people who wear glasses get all that they deserve. "We get what we deserve", good, I hope you get yours too. > > We often do not get what we want -- we get > > what we deserve. [quoted text clipped - 8 lines] > > "We get what we deserve", good, I hope you get yours too. He did. Google around and you can find a picture of his wife, Carol. Bela Lugosi comes to mind.... http://www.svcn.com/archives/wgresident/08.16.00/gifs/remember-when-0033.jpg >> "We get what we deserve", good, I hope you get yours too. > [quoted text clipped - 4 lines] > > http://www.svcn.com/archives/wgresident/08.16.00/gifs/remember-when-0033.jpg Otis would kind of remind me of Herman Munster, oafish buffoon, except, Herman's lovable. Great pic. Ta Simon Dangling from the end of a rope comes to mind. |
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