Well, here I am again.
Short background:
Since birth:
OD increasing nearsightedness, minimal astigmatism
OS stable farsightedness, moderate astigmatism
vision uncorrected (my father didn't believe in glasses) until age 17
(I am now 55)
I use both eyes for distance and intermediate, and my right eye for
reading. I didn't have a problem with reading, only the distance as I
got more and more nearsighted in the right eye. That would be the
complaint when I went in every year or two.
12-2004 IOL OD +13.5 AR40e AMO acrylic
04-2005 IOL OS +20.5 CLRFLX AMO silicone
06-07-2005
OD -0.50 -0.25 x160 +2.25 VA 20/20 1 down
OS +0.50 -2.25 x172 +2.25 VA 20/30
PD for distance 32.5/31.5
These glasses are more or less OK for driving but it is like putting a
blinder over my right eye. Distance vision is better if I look out of
the lenses at the very top and over to the right. I only use these
glasses for driving.
09-06-2005
OD -0.50 -0.25 x110 +2.50 VA 20/40 ¾ down
OS +0.50 -2.00 x160 +2.50 VA 20/40 ¾ up
PD for distance 32.0/30.5
I didn't get this filled.
02-03-2006
OD -0.75 +0.75 x080 +2.50 VA 20/20 ¾ down
OS -1.25 +1.75 x083 +2.50 VA 20/25
I didn't get this filled because he wanted me to travel out of town to
see "his" optometrist.
02-15-2006
OD -0.37 +2.75 VA 20/20 (subj. +1.75)
OS +0.25 -1.75 x168 +2.75 VA 20/20
PD for distance 33.0/31.5
These were again like putting a blinder over my right eye and I went
back and asked for an adjustment or remake.
04-19-2006
OD -0.37 +2.50 seg. height 24
OS +0.25 -1.75 x168 +2.75 seg. height 22
I went back and told him this was even worse. I tried to explain that
I have a pair of glasses from before surgery that seem to work well
for my right eye. Here are the readings from this pair of glasses, as
read at the Stanford eye clinic:
Ref line E 546
OD +0.00 +0.00 x90 +2.25 Prism 0.00 in 0.00 down
OS -2.00 +2.00 x79 +2.00 Prism 0.75 out 0.75 up
PD OD 35.5 OS 18.5
These glasses are only good for the right eye but they are good for
all distances in the right eye.
When I showed him these glasses and asked if he could put the same
thing for the right eye in my new glasses he said that they were not
adjusted properly and removed them and adjusted them. I told him that
now they are too close and too high and that I am looking right
through the segment line. I still wear these glasses for reading when
I want clarity but I have to tilt my head to see under the segment
line. Since I did not buy these from him, he won't adjust them again.
He said that he would not do another remake of the glasses he sold to
me and would not give a refund either.
These are the readings taken from the glasses he sold me:
Ref. Line E 546
OD -0.25 +0.25 x37 +2.00 Prism 0.00 in 2.00 down
OS -1.50 +2.00 x63 +2.25 Prism 0.00 in 0.25 down
PD OD 28.5 OS 43.0
I don't wear these glasses for anything.
07-24-2006
Thought I would try again with another optometrist.
OD -0.25 -0.50 x170 +2.25 VA 20/25
OS +0.50 -2.00 x173 +2.25 VA 20/30
PD 63
I told him that for now I just wanted a good pair of reading glasses.
OD +1.75 -0.50 x20
OS +3.00 -2.00 x166
PD 60
I went back and told him that these did not work well for reading
because the cylinder strained my right eye, the image for the left eye
was huge, and the images were not lined up vertically.
09-28-2006
This is the new prescription he gave me:
OD -0.25 -0.50 x20 +2.50
OS +0.50 -2.00 x168 +3.00 ½ up
PD 64
I told him that I just wanted the reading glasses redone for now and
this is what he remade them to:
OD +2.00 -0.50 x20
OS +3.50 -2.00 x168 ½ up
PD 61
I went back and told him that these did not work well for reading
because the cylinder strained my right eye, the image for the left eye
was huge, and the images were STILL not lined up vertically. He told
me to try wearing them over my contact lens. This did not make sense
and didn't work. I have a Preference Toric lens for the left eye that
is +.75 -2.25 x170 BC 8.4 that I wear sometimes and then wear a pair
of OTC readers of +1.50 (no contact lens in the right). This does not
correct my left eye as well as I would like but my right eye is fine.
I recently went up to Portland and saw an optometrist there. I did not
wear any glasses except the OTC readers (when I needed to read) and
the contact lens in the left eye for three days beforehand. This is
the prescription he gave me:
OD Plano -0.75 x5 +2.25
OS +1.25 -2.00 x170 +2.25
I am still waiting to see what these new glasses will be like because
I had to get them filled by someone here in town so that they could be
adjusted. I went to someone I had never seen before and I hope it
works out. I think they are giving me cylinder in the right eye to
compensate for the fact that I don't need as much add in that eye as
the left. You can say what you like about accommodation but there is
evidence in the literature of people who can move the lens forward and
back as needed. It takes me a longer time now to refocus than it did
before surgery but the image I see is not blurry, it is clear. This is
my right eye only but the muscles of the right work with the muscles
of the left to accomplish this somehow. Also, I have large pupils. The
right will dilate to 7mm and the left to 6mm. This is documented.
Well that is the short version but maybe now it will make more sense.
Jan, please let me know if it still doesn't.
Thank you
On May 2, 4:54 pm, cda...@directflatscreen.tv wrote:
> Well, here I am again.
> Short background:
[quoted text clipped - 19 lines]
> the lenses at the very top and over to the right. I only use these
> glasses for driving.
If need to look up and out, the progressive is not centred correctly
or frame is not adjusted correctly.
> 09-06-2005
> OD -0.50 -0.25 x110 +2.50 VA 20/40 ¾ down
[quoted text clipped - 96 lines]
> compensate for the fact that I don't need as much add in that eye as
> the left.
The adds are equal. Since all the refractions have similar cylinder,
I think you can be sure that it exists. You may not be able to
tolerate correction, but it exists.
You can say what you like about accommodation but there is
> evidence in the literature of people who can move the lens forward and
> back as needed. It takes me a longer time now to refocus than it did
> before surgery but the image I see is not blurry, it is clear. This is
> my right eye only but the muscles of the right work with the muscles
> of the left to accomplish this somehow. Also, I have large pupils. The
> right will dilate to 7mm and the left to 6mm. This is documented.
The low myopia right eye and astigmatism left eye will result in
useable near vision without glasses. Trust me, you cannot
accommodate. Pupil size undilated is what is used for depth of focus
which is also useful for reading uncorrected, dilated pupil size is
irrelevant.
>From the power of the IOLs and your previous comments, you had a large
difference in refractive error prior to cataract surgery. You may
have anisekonia (unequal retinal image size in the two eyes) due to
the difference in axial length between the eyes and the astigmatism in
one ey only. This will result in discomfort and the feeling that the
left eye image is too large.
Anisekonia is tough to treat. It requires special measurements. Is
there an optometry school near you? If so, call their clinic and ask
if they can test for anisekonia and try to get a work up.
Dr Judy
> Well that is the short version but maybe now it will make more sense.
> Jan, please let me know if it still doesn't.
>
> Thank you
cdavis@directflatscreen.tv - 03 May 2007 06:14 GMT
> On May 2, 4:54 pm, cda...@directflatscreen.tv wrote:
>
[quoted text clipped - 163 lines]
>
> > Thank you
There is an optometry school in Portland, Berkeley, and, I think, in
San Diego. I will check with them and see if they can do a workup. I
am puzzeled, though, because I didn't have such a disparity in size
before the surgery. Maybe with this new pair of glasses things will be
better, if they get the optical centers lined up with my pupils OK.
This will be the fourth pair of progressive lenses since the summer of
2005. I have tried different optometrists each time and I hope they
don't all use the same lab if it is the labs fault. They should have
been able to pinpoint this problem, though. Anyway, I'm willing to
give it another try. I really like the material that the Preference
Toric is made of. Do you happen to know of a bifocal contact that is
made of a similar material?
Neil Brooks - 03 May 2007 17:57 GMT
>There is an optometry school in Portland, Berkeley, and, I think, in
>San Diego.
NOT San Diego ... AFAIK ... but Fullerton. That's Orange County --
about 80 miles north of San Diego.
Southern California College of Optometry.
www.scco.edu
I might suggest you try to contact Dr. Julie Schornack, telling her
that Neil Brooks sends his regards ;-)
http://www.sccoeyecare.com/facultybios/SchornackBio.htm
Bright woman. Excellent, caring doc.
Good luck!
Neil
cdavis@directflatscreen.tv - 03 May 2007 18:45 GMT
> >There is an optometry school in Portland, Berkeley, and, I think, in
> >San Diego.
[quoted text clipped - 16 lines]
>
> Neil
Thank you. I will be going down that way in June so I will call ahead.
Of course I will give her your regards!