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Medical Forum / General / Vision / September 2006-20 Diopter. Is there any help?
I am trying desperately to help my friend. She is 21 and has progressive myopia. Her prescription is -21 and -22.5 diopters. She also has astigmatism of -4. She says her glasses are so thick that everywhere she goes people point and laugh. She has developed an extreme case of self consciousness because of this. She did try hard contact lenses, but said she couldn't wear them because of dryness and pain after a couple of hours. Are they any soft contacts available in this high of a prescription? I should also mention she lives in Germany. She hates to even leave her house because of the ridicule. Any help or ideas would be appreciated. Thank you. Kathy schreef: > I am trying desperately to help my friend. She is 21 and has progressive > myopia. Her prescription is -21 and -22.5 diopters. She also has astigmatism [quoted text clipped - 8 lines] > should also mention she lives in Germany. She hates to even leave her house > because of the ridicule. Any help or ideas would be appreciated. Kathy, let her ask for the possibility of a so called "piggyback" lens system. In short it's a softlens with on top an RGP (rigid gaspermeable) lens. The comfort in wearing a softlens combined with the sharpness in vision of an hard lens. Let her search for a contactlensspecialist who is a member of the VDC, Vereinigung Deutscher Contactlinsspecialisten. Jan (normally Dutch spoken) > I am trying desperately to help my friend. She is 21 and has progressive > myopia. Her prescription is -21 and -22.5 diopters. She also has astigmatism [quoted text clipped - 8 lines] > should also mention she lives in Germany. She hates to even leave her house > because of the ridicule. Any help or ideas would be appreciated. Conventional soft lenses are available in her power. She could also try wearing disposable soft in the max power (some go up to -15), then use "normal" looking glasses over them to correct the balance. I am more concerned to hear of her mental state; she is likely imagining the pointing and laughter and her refusal to leave the house is a serious sign. If you are a true friend, you will try to get her to talk to a therapist about her self image and self consciousness. That will do her more good than contact lenses. Dr Judy > I am more concerned to hear of her mental state; she is likely > imagining the pointing and laughter and her refusal to leave the house > is a serious sign. If you are a true friend, you will try to get her > to talk to a therapist about her self image and self consciousness. > That will do her more good than contact lenses. A combination of both would be a good idea in my opinion. Sadly there *are* people around who ridicule people in this way, and while they may be pitiable individuals, their behaviour can still impact on a person's self esteem. Regards Gary > > I am more concerned to hear of her mental state; she is likely > > imagining the pointing and laughter and her refusal to leave the house [quoted text clipped - 6 lines] > pitiable individuals, their behaviour can still impact on a person's self > esteem. Pointing and laughter are not acceptable and probably not very common. However, it is not possible to make glasses of that strength that don't severely distort the face and eyes. Thus, there will be staring and funny looks. Based on my personal experience and what I have read on this group, contacts are the answer. Not everyone can wear them, but people with high correction should try them. Not only do they make the face and eyes look more normal, but I find that vision is much better. Although I agree with Dr. Judy that perhaps the contacts are less important than issues with self confidence, I've seen examples of where people can overcome difficulties with mental issues with a little physical help.  SignatureDan Abel dabel@sonic.net Petaluma, California, USA Dr Judy schreef: >> I am trying desperately to help my friend. She is 21 and has progressive >> myopia. Her prescription is -21 and -22.5 diopters. She also has astigmatism >> of -4. > Conventional soft lenses are available in her power. She could also > try wearing disposable soft in the max power (some go up to -15), then > use "normal" looking glasses over them to correct the balance. Indeed there are non disposable toric softlenses with a cylinder. However, when I hear "progressive myopia" my first choice would be a RGP contactlens. (in this case a toric one) > I am more concerned to hear of her mental state; she is likely > imagining the pointing and laughter and her refusal to leave the house [quoted text clipped - 3 lines] > > Dr Judy Some times contactlenses alone are already making the difference. BTW, wish more people have such concerned friends. Jan (normally Dutch spoken) > I am trying desperately to help my friend. She is 21 and has progressive > myopia. Her prescription is -21 and -22.5 diopters. She also has astigmatism [quoted text clipped - 8 lines] > should also mention she lives in Germany. She hates to even leave her house > because of the ridicule. Any help or ideas would be appreciated. Conventional soft lenses are available in her power. She could also try wearing disposable soft in the max power (some go up to -15), then use "normal" looking glasses over them to correct the balance. I am more concerned to hear of her mental state; she is likely imagining the pointing and laughter and her refusal to leave the house is a serious sign. If you are a true friend, you will try to get her to talk to a therapist about her self image and self consciousness. That will do her more good than contact lenses. Dr Judy I > should also mention she lives in Germany. She hates to even leave her house > because of the ridicule. Those crazy germans. Pointing and laughing? If they really are doing that, we should invade them again. William Stacy schreef: > Those crazy germans. Pointing and laughing? If they really are doing > that, we should invade them again. We'll meet again, don't know where, don't know when ... Jan (normally Dutch spoken) Are you referring to Dr. Strangelove, or are you flirting? > William Stacy schreef: > [quoted text clipped - 4 lines] > > Jan (normally Dutch spoken) William Stacy schreef: > Are you referring to Dr. Strangelove, or are you flirting? > [quoted text clipped - 6 lines] >> >> Jan (normally Dutch spoken) "Have You Forgotten So Soon" William? , I'm "Crying My Heart Out For You" "I'm in the Mood for Love" and "I Don't Want to Set the World the World on Fire". "Auf Wiederseh'n Sweetheart" "Yours" Jan (normally Dutch spoken) Sorry Jan, but something must be lost in the translation. > "Have You Forgotten So Soon" William? , I'm "Crying My Heart Out For You" > [quoted text clipped - 6 lines] > > Jan (normally Dutch spoken) William Stacy schreef: > Sorry Jan, but something must be lost in the translation. You wanted to invade the Germans again. Referring to that I respond with "We'll meet again, don't know where, don't know when ." (song by Vera Lynn WWII) Well I am to old to explain this to a "youngster" as you are I suppose. Jan (normally Dutch spoken) Maybe, but I know that song well, as so ironically played at the ending of the film Dr. Strangelove, when all the nukes are going off... If you haven't seen it, it is an absolute must (Peter Sellers best movie, IMO). Sorry about drifting off topic, and possibly mistaking your sex (my very first kiss was with a gal with your name). > William Stacy schreef: > [quoted text clipped - 8 lines] > > Jan (normally Dutch spoken) > I am trying desperately to help my friend. She is 21 and has progressive > myopia. Her prescription is -21 and -22.5 diopters. She also has astigmatism [quoted text clipped - 8 lines] > should also mention she lives in Germany. She hates to even leave her house > because of the ridicule. Any help or ideas would be appreciated. Kathy, my prescription is OD -30, and OS -28.50. I have gone through all types of lenses in the past 35 years, and while I know that some of my glasses are pretty strange looking I have never felt that people laughed and or ridiculed me. Soft contact lenses are available in her prescription, although I would suggest using contact lenses that still require glasses to wear over them. I suspect that my prescription climbed higher during the years that I wore soft contacts because I was doing so much close work. So my suggestion would be to still wear a pair of glasses over the contacts that she can take of to read and do other close work. The -4D of astigmatism is a problem, because toric contact lenses are much more expensive and harder to obtain. I suspect that money might be an object, because some of the best looking pairs of glasses I have had in the past have come from Germany, from a company called Zeiss, but they were quite expensive > > I am trying desperately to help my friend. She is 21 and has progressive > > myopia. Her prescription is -21 and -22.5 diopters. She also has astigmatism [quoted text clipped - 13 lines] > my glasses are pretty strange looking I have never felt that people > laughed and or ridiculed me. bryan, my rx is about the same as yours and never have i experienced laughing or ridicule. i do get somments from friends and usually on a first date, but these are good natured and kind, just people wondering about how bad my eyes are. and i don't even wear those super small frames wtih high index lenses which can hide quite a bit of thickness, so my glasses do appear very thick. i think there is something else going on with this girl, such as a body dismorphic disorder. most of us have a few flaws in our looks, but we can live with them without too much trauma. I want to thank everyone for their replies and advice. I have forwarded them on to her, and am waiting for her to reply. It sounds to me as if there is hope for her whether it is the "piggyback" lens or just soft lens and regular glasses. I know she will be thrilled to hear it is not a hopeless case. Why her own optometrist has not suggested these things, I have no idea. Dr. Judy, I also have wondered if the "laughter and pointing" she is receiving is more in her imagination, and questioned her about that. She assured me it was not. However, I did suggest therapy to her as well. I am hoping that if she can wear contacts, it will help immensely with her self esteem. Thanks again. Kathy Out of curiosity, do all of the anatomical components of an eye requiring such correction appear individually almost normal except for some exaggerated development? I would expect such an eye to be over two inches deep. What are typical dimensions for such an eyeball? Bill > Out of curiosity, do all of the anatomical components of an eye requiring > such correction appear individually almost normal except for some > exaggerated development? I would expect such an eye to be over two inches > deep. What are typical dimensions for such an eyeball? The axial length of the typical emmetropic eye is 24 mm, plus another mm for each 3D of refractive error. Actually, according to this formula, it would be 34 mm for -30D. Perhaps there are other factors involved. I once visited an ophthalmologist with a very active practice, whose most myopic patient ever was -37D. Phakic IOL's can be very strong, and do not involve the same risk of retinal detachment as CLE. Are they promising for refractive errors of this magnitude? SignatureRobert T. Kopp http://analytic.tripod.com/ On 9/27/06 9:04 PM, in article pan.2006.09.28.04.04.27.0@hevanet.com, >> Out of curiosity, do all of the anatomical components of an eye requiring >> such correction appear individually almost normal except for some [quoted text clipped - 10 lines] > retinal detachment as CLE. Are they promising for refractive errors of > this magnitude? I looked up what is probably a similar simple optical model of an eye in the OSA Handbook of Optics. It gives radii and indexes of various parts of the eye. I was planning to run a paraxial ray trace to find out whether that matches the overall value of about 67 diopters quoted. Thus, I would guesstimate that to get about 33D of myopia would require increasing the length of the eyeball by about 50%. If I get around to it, I will calculate how much the distance between the cornea's anterior and the orb's posterior has to be increased to get attain 33D of myopia. I will assume that The size and relationship of the cornea and lens is not affected. Bill -- Fermez le Bush > If I get around to it, I will calculate how much the distance between the > cornea's anterior and the orb's posterior has to be increased to get > attain > 33D of myopia. I will assume that The size and relationship of the cornea > and lens is not affected. Here's a better estimate: 1/67D = 15 mm focal length 1/100D=10 mm focal length The difference would be on the order of 5 mm. -MT On 9/28/06 2:51 PM, in article idGdnUtoXc573oHYnZ2dnUVZ_t6dnZ2d@giganews.com, "Mike Tyner" <mtyner@mindspring.com> wrote: >> If I get around to it, I will calculate how much the distance between the >> cornea's anterior and the orb's posterior has to be increased to get [quoted text clipped - 11 lines] > > -MT That may not be a good way to go. You have to take into account the index of refraction of the medium in which the image is formed. It is not a big deal, but will not be trivial. Bill -- Fermez le Bush > That may not be a good way to go. You have to take into account the index > of > refraction of the medium in which the image is formed. It is not a big > deal, > but will not be trivial. That's what I thought, at first, and 15 mm isn't right for the axial length from the corneal pole, either. But for an estimate, the assumptions are the same for both calculations, so the difference between them would be more reliable, and perhaps off by 4/3, the index of water. So my crystal ball says 6.7 mm. I'm curious to see what you get by raytrace. -MT > > That may not be a good way to go. You have to take into account the index > > of [quoted text clipped - 11 lines] > > -MT Its also quite possible that all the myopia is not axial. There may be changes in lens density and thickness. After all, progressive myopia at that level is associated with early cataract so lens changes may well be involved. Dr Judy
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