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Medical Forum / General / Vision / July 2007

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Do I need a Toric Lens?

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86hawkeye - 07 Jul 2007 15:03 GMT
First time posting here.

Following is my eyeglasses script:

OD: +1.00 sph
OS: +3.00 -1.00 x 115
add +1.00

Am I sort of borderline for a toric lens in the left eye?  The right
eye is (quite) dominant and I'm concerned that wearing a toric in one
eye and a biomedics EP in the other will be uncomfortable.  The OD
gave me a Vertex toric to try in the left eye and it seems to be a
little better at distances than the +2.50 biomedic EP I have for the
left eye, but it's not as comfortable.

Any thoughts?

Thanks!
Mike Tyner - 07 Jul 2007 15:51 GMT
> gave me a Vertex toric to try in the left eye and it seems to be a
> little better at distances than the +2.50 biomedic EP I have for the
> left eye, but it's not as comfortable.

Don't ask if it's "better", ask if it makes a difference with both eyes
open.

Yours is a prescription where the "non-dominant eye" often harbors a subtle
amblyopia.

Meaning with both eyes open, minor changes in the left eye make no
difference.

-MT
86hawkeye - 07 Jul 2007 17:32 GMT
> > gave me a Vertex toric to try in the left eye and it seems to be a
> > little better at distances than the +2.50 biomedic EP I have for the
[quoted text clipped - 10 lines]
>
> -MT

Thanks.  Do you think the Biomedics EP is a good approach for my
situation?
Mike Tyner - 07 Jul 2007 19:02 GMT
> Thanks.  Do you think the Biomedics EP is a good approach for my
> situation?

You haven't mentioned your age or any need for bifocals, and that does
complicate things.

I'm not familiar with the EP, but I usually try monovision first. I don't
know that your left eye could contribute any useful near vision with a +400,
for instance, but I'd want to try that before bifocal contacts.

-MT
86hawkeye - 07 Jul 2007 23:08 GMT
> > Thanks.  Do you think the Biomedics EP is a good approach for my
> > situation?
[quoted text clipped - 7 lines]
>
> -MT

I am 44.  OD thinks the EP will help with reading, which is becoming
more of a factor with the right eye.
Mike Tyner - 08 Jul 2007 00:00 GMT
> I am 44.  OD thinks the EP will help with reading, which is becoming
> more of a factor with the right eye.

That makes sense. I ordered a trial pair of EPs today, for a patient about
as old as you. Her first trial pair (B&L Multifocal) were ordered by my
partner and didn't work out well at all.

In your case, if you don't suppress the left eye very much, you might find
that +100 in the right and +425 in the left would give you plenty of help up
close, for casual use. You can always "boost" it with a pair of OTC +125 or
+150s.

Significant suppression (amblyopia) usually messes up monovision, but
otherwise, growing up with a lot of difference between the two eyes usually
makes monovision easier. It deserves a try, especially if your left eye sees
20/20 with glasses.

-MT
86hawkeye - 08 Jul 2007 03:27 GMT
> > I am 44.  OD thinks the EP will help with reading, which is becoming
> > more of a factor with the right eye.
[quoted text clipped - 14 lines]
>
> -MT

Do you mean +4.25 in a monovision contact vs. the +2.50 I have from
the Biomedics EP?  The left eye seems to see up close very clearly
with the +2.50 EP....as good as glasses.  I just don't think I'll get
distance as well as glasses without a toric, but I'm thinking it won't
be as comfortable having a different type of lens in each eye.

If by supress the left eye you mean close it when I'm outside in the
sun or basically don't use it, then I think I do that quite a bit, so
I'm not sure the monovision would do the trick, if I understand you
correctly.

Thanks!
86hawkeye - 08 Jul 2007 03:33 GMT
> > > I am 44.  OD thinks the EP will help with reading, which is becoming
> > > more of a factor with the right eye.
[quoted text clipped - 27 lines]
>
> Thanks!

I would add that I think I am about 80-85% with the contact in the
left eye vs. glasses (100%), so that's not that bad.  Right eye is
just as good with either contact or glasses.  It's kind of weird in
that when I look at distance with only the right eye, it's OK, but
when I use both it seems a little better.  Puzzling to me, since I
would not think the left eye would add much to the already good right
eye.

I have a folow-up Tuesday and I'll see if there's a more comfortable
toric to try (using Coopervision Vertex now).  Feels like someone
stuffed a water balloon in my eye ;)
Ms.Brainy - 08 Jul 2007 04:04 GMT
> > > I am 44.  OD thinks the EP will help with reading, which is becoming
> > > more of a factor with the right eye.
[quoted text clipped - 29 lines]
>
> - Show quoted text -

I am not sure you understand exactly the meaning of monovision.  For
various definitions go to
http://www.google.com/search?hl=en&rls=RNWE,RNWE:2005-43,RNWE:en&defl=en&q=defin
e:Monovision&sa=X&oi=glossary_definition&ct=title

You can find more detailed articles by googling "monovision".

Although it may sound "un-natural", I read an article some time ago
that claims that our brain is wired naturally for monovision.  My
understanding is that you don't need to close the other eye shen you
exercise monovision, your brain will do the trick for you.
86hawkeye - 08 Jul 2007 04:15 GMT
> > > > I am 44.  OD thinks the EP will help with reading, which is becoming
> > > > more of a factor with the right eye.
[quoted text clipped - 38 lines]
> understanding is that you don't need to close the other eye shen you
> exercise monovision, your brain will do the trick for you.

Thanks, Brainy.  I did not understand.  I just thought monovision
meant non-multifoval lenses.  Didn't know about assigning one eye for
distance and the other for close up.  With that information, I'm not
sure I'm a good candidate for it, since my right eye is so dominant.
86hawkeye - 10 Jul 2007 03:53 GMT
> > > > > I am 44.  OD thinks the EP will help with reading, which is becoming
> > > > > more of a factor with the right eye.
[quoted text clipped - 43 lines]
> distance and the other for close up.  With that information, I'm not
> sure I'm a good candidate for it, since my right eye is so dominant.

I have an additional question.  If the spherical equivalent of my
astigmatic script is a +2.50 Biomedics EP multi-focal contact
(converted from +3.00 -1.00x115), would dialing it down to +2.25
possibly help me see intermediate distances (computer screen) better?
The reading distance is really good, but the computer screen distance
seems not to result in a real clear 2 eye image.  It's like my brain
is saying "woah, left eye, you're trying to get in on the act here,
but you're not quite as good as the right eye".

Thoughts?
 
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