Medical Forum / General / Vision / April 2007
Are there tables of the right add to use for various working distances?
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Sherman - 09 Dec 2006 23:37 GMT I'm 60 and nearsighted, currently about -6, and have been getting less nearsighted for the last 10 years or so after topping out at about -7.5. Anyway, I'm now using my 2-year-old reading glasses as my desktop computer glasses, so it's that time again.
Up to now I've worn progressives as distance and general-purpose glasses, and separate single-vision glasses for my desktop computer and another set for serious reading. So that's three so far. But now I'm considering getting a laptop, which I assume would fit in there between the desktop and reading glasses, but possibly one pair of glasses might work for two of those three (I doubt it).
Going into this round of lens replacement, I would like to get an independent source of information as to the appropriate add for various close-in working distances, just as a check on what the optician tells me. Since I have very little accomodation left, it's important that I do this right.
In addition, in case I continue to get less nearsighted, I'd like to see if through careful selection this time I might be able to "stage" the three single-vision glasses so that they just shift in function from reading, to laptop, to desktop, so that I only have to replace the reading glasses as time goes on (well, and the progressives of course). The left eye has been .75 less nearsighted than the right for about 15 years now, and if that continues, then this might work.
At first I thought I could just use the diopter to focal length relationship to calculate this information, but then I wondered whether there might be things that make that formula less valid. Such as perhaps the fact that the glasses lens is maybe an inch in front of the eyeball, or the fact that the lenses are spherical instead of parabolic. And I have this vague recollection that when I asked a version of this question years ago (about computer glasses), the optician said that the amount of add could vary somewhat depending on the strength of the distance prescription. The implication was that in actual practice the add for a specific working distance might be different for a very nearsighted person than for a moderately nearsighted one, for whatever reason.
Well, I guess what I'm looking for is a table, or tables, of distance-versus-add that eyecare professionals use in actual practice to get the best results for people wearing glasses. If there is such a thing.
As an aside, I've also thought about under-correcting on the progressives this time by .25, just so they would last longer. Any thoughts on that?
Thanks for any help.
William Stacy, O.D. - 10 Dec 2006 00:07 GMT > Well, I guess what I'm looking for is a table, or tables, of > distance-versus-add that eyecare professionals use in actual > practice to get the best results for people wearing glasses. > If there is such a thing. you could use a table, but why not just use the formula:
d=1/f where d=distance in focus and f=power (add)
d is in meters and f is in diopters
w.stacy, o.d.
Sherman - 11 Dec 2006 05:45 GMT William Stacy, O.D. says...
> you could use a table, but why not just use the formula:
> d=1/f where d=distance in focus and f=power (add)
> d is in meters and f is in diopters I could. That would yield these values:
Reading - 16" +2.5D Computer - 28" +1.5D (actually +1.4D)
It seems to me that both of these are at least .25D too much add compared to what I've used in the past. My readers have always been +2D add, and I think my computers were +1.0 add, maybe even less.
I still wonder if these calculations aren't off a bit because the lens is an inch in front of the eye. Doesn't that make the lens effectively less minus than the calculation would suggest?
When I've attempted to wear contacts in the past, the Rx for the contacts was always a good bit less minus than my glasses, and it was explained to me that that was because of the difference in where the lens sits relative to the eye. Well, I see the same thing when I slide my glasses down to the end of my nose - they become less powerful, less minus.
On the other hand, the adds are relative to the distance Rx, so maybe it all comes out even anyway. It's just that the calculated values look like they're too much add. That's why I was looking for a table showing what opticians and optometrists actually use in practice.
William Stacy, O.D. - 11 Dec 2006 05:55 GMT > William Stacy, O.D. says... > [quoted text clipped - 13 lines] > always been +2D add, and I think my computers were +1.0 add, > maybe even less. Sure. you probably have *some* residual focusing left (more than zero), and don't forget there's a depth of focus depending on pupil size and lighting, which adds a little range on either side of whatever you chose.
> I still wonder if these calculations aren't off a bit > because the lens is an inch in front of the eye. Doesn't > that make the lens effectively less minus than the > calculation would suggest? vertex distance indeed is a factor. how much, depends on the powers. and yes, if it's minus, they are effectively less minus, if they are plus, they are effectively more plus. this effect is based on a different formula.
> When I've attempted to wear contacts in the past, the Rx for > the contacts was always a good bit less minus than my [quoted text clipped - 3 lines] > down to the end of my nose - they become less powerful, less > minus. of course. the higher the minus, the greater this effect, and it goes to zero as the power of the lens approaches zero.
> On the other hand, the adds are relative to the distance Rx, > so maybe it all comes out even anyway. It's just that the > calculated values look like they're too much add. That's > why I was looking for a table showing what opticians and > optometrists actually use in practice. actually, we use formulas some of the time, rarely use tables, and most often we just dial the lens powers in and check the ranges physically...
w.stacy, o.d.
Salmon Egg - 11 Dec 2006 20:38 GMT On 12/10/06 9:45 PM, in article 457cf069$0$1985$892e0abb@auth.newsreader.octanews.com, "Sherman" <noone@home.com> wrote:
> On the other hand, the adds are relative to the distance Rx, > so maybe it all comes out even anyway. It's just that the > calculated values look like they're too much add. That's > why I was looking for a table showing what opticians and > optometrists actually use in practice. My little experience has been that I can do the job of specifying add for computer glasses, at least for me, better than optometrists I went to. At first, when personal computers were rather rare, they seemed to wing it more than calculated it.
Because of other eye problems, I have been seeing ophthalmologists more often then optometrists. I have had better luck recently getting the adds I want. I don't know if it is because ophthalmologists are not that tied to the quality of the glasses they prescribe or whether computer glasses are no longer as novel as they used to be.
Bill -- Fermez le Bush
David Combs - 30 Dec 2006 22:30 GMT >On 12/10/06 9:45 PM, in article >457cf069$0$1985$892e0abb@auth.newsreader.octanews.com, "Sherman" [quoted text clipped - 19 lines] >Bill >-- Fermez le Bush (as I've said before), what I do, since I have virtually zero accomodation, is borrow for a few minutes their test-frames, and also a couple of .25 test-adds, and play with those while looking at some detailed object at the distance the test-frames are set for, and find the extra (over their prescription) .25 or .50 on the left or right that will bring the left and right "depth of field" near-far-range to be EXACTLY the same.
Only *I* myself (or you yourself) can do this adjusting -- no machine and no "is it clearer this way, or that way" procedure can do it as well as I can (on myself), moving say a magazine nearer and farther and noting the distances at which it stops being *perfectly* clear, first with one eye, than with the other -- and getting those distances to be equal.
Once I'm satisfied, they then adjust the prescription to match what I've just discovered.
Anyway, that's what I do.
Before I started doing this, either reading or working on the computer was uncomfortable for sure!
David
William Stacy - 30 Dec 2006 22:40 GMT >Only *I* myself (or you yourself) can do this adjusting -- >no machine and no "is it clearer this way, or that way" [quoted text clipped - 4 lines] >distances to be equal. > Actually, we do that all the time for patients. That's why the rod that holds the nearpoint test card on a refractor or phoropter is graduated in inches, centimeters and diopters. We can watch the numbers as we move the card in and out, getting very accurate distances to first blur with any lens combo in place. Way easier than your method, and probably more accurate.
w.stacy, o.d.
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