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Medical Forum / General / Vision / August 2007Presbiopia contacts need advice !
Need help! My friend has presbyopia, he wearing bifocal glasses . His vision: refractometer ‘s readings : OD + 2.25 , OS + 2.5 New Glasses prescription OD +1.75 OS + 2.0 Add +2 +2 He was very comfortable it these new glasses. Recently He decided to try contacts. His contacts prescription : OD +1.75 OS + 2.25 Add low Add high From the specification of these particular brand of contacts: add low means +1-+1.75 Add high means +1.75 to +2.5 And he still can not read , he uses + 1.25 glasses to read . If we do some math in glasses his left eye reads perfectly with +4.0 correction (2+2=4) In lenses left eye for reading : (2.25+ (from 1.75 t0 2.5))= from +4 to + 4. 75) and He still can not read without glasses (+1.25) It means : when he is in contacts his left eye correction for reading is from +5.25 to +6 (he still can not read with the right eye) I am thinking that in contacts+glasses his eyes overcorrected (total correction left :from+5.25 to +6.00) provided he reads perfectly in glasses +4 I read that bifocal contacts just sometimes don’t work for everybody (I have MS in physics and understand how optical devises work). I think that in his case the best is to have just regular contacts (not bifocal)to see far and glasses to read. If anyone can answer me if I am right? Or what the best solution for him if he wants to wear contacts ? > I read that bifocal contacts just sometimes don't work for everybody (I > have > MS in physics and understand how optical devises work). Then you understand why all contacts producing simultaneous near and far focus must also produce some "fog." > I think that in his case the best is to have just regular contacts (not > bifocal)to see far and glasses to read. That option gives the best vision. I would use +2.00 in both eyes, for convenience (one box vs two) with the option of wearing +300 in the right eye occasionally, to reduce the demand for reading glasses at a party or shopping, etc. "Monovision" is simulataneous too, but monovision gives more granular control of how much fog vs how much near assistance. And which eye tolerates which better. Many more options than "low" and "high." Bifocal contacts work for some, remarkably well, but the failures are usually very happy with some intermediate degree of monovision, having low-power drugstore "booster" glasses to give both eyes better vision close in. Your friend would probably be happiest at a desk with +350 drugstore glasses, or +175 over a pair of +200 contacts. So the best advice is use contacts for what contacts do best, distance vision and maybe some help at intermediate. If you want _one_ solution that covers everything, it probably won't be contacts. -MT, OD Mike ! You are absolutely right! He has +3.25 (one eye needs little more) he reads comfortably in that! +3.5 will be perfect !! I was worried that hi is way too overcorrected ! I think it will spoil his vision. I will show him you response ! Thank You! Monovision is nice idea once in a while, But I think playing golf or tennis should be really hard. Lena . > I read that bifocal contacts just sometimes don't work for everybody (I have > MS in physics and understand how optical devises work). > I think that in his case the best is to have just regular contacts (not > bifocal)to see far and glasses to read. > If anyone can answer me if I am right? Or what the best solution for him if > he wants to wear contacts ? the problem is that not everybody thinks like you. some people HATE the idea of wearing reading glasses. and it is true that the optics of multifocal contact lenses is not optimum and the patient who decides to wear them has to adapt to differences in vision between both eyes and slighly blurred vision. but once you adapt to them, you'll generally get along pretty well. the point is, if you want to avoid reading glassess, you only choice with contacts is either multifocal lenses or monovision. >the problem is that not everybody thinks like you. some people HATE >the idea of wearing reading glasses. 1. That particular “everybody” was absolutely OK wearing glasses, contacts was my idea. 2. Using bifocals he still needs glasses to read!! 3. My post was mainly about that he is 2 D overcorrected ! (+6 vs + 3.5); Sister of my grandmother, was an ophtolmologist , she was pointing out very often that incorrectly fitted glasses will spoil the vision. His prescription just doesn’t look professional. |
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