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Medical Forum / General / Vision / February 2009Correction for peripheral vision?
I have a macular hole in one eye, so the eye doc doesn't bother to try to prescribe for it. He recommends a balance lens. While I cannot read, my peripheral vision is unimpaired, and even "balanced", it's pretty much a blur. Seems to me that if the eye doc had a big poster with thick lines on it, I could tell him when I could see them the best with my peripheral sight. Does anyone know of any ophthalmologists/optometrists who do peripheral refractions? Thanks. > I have a macular hole in one eye, so the eye doc doesn't bother to try > to prescribe for it. He recommends a balance lens. [quoted text clipped - 9 lines] > > Thanks. I am not a vision health professional. I think you are going to be disappointed. Just what do you expect? If there were an intelligent designer for eyes, they did not design for high acuity peripheral vision. If your central vision is shot, you have to settle for what you can get peripherally. The concentration of cones, to almost complete absence of rods is in the macula. It would be possible to form sharp images on some peripheral portions of the retina, but even if that were done, you will not see sharp images. Bill  SignaturePrivate Profit; Public Poop! Avoid collateral windfall! Salmon Egg has written on 1/20/2009 9:25 PM: >> I have a macular hole in one eye, so the eye doc doesn't bother to try >> to prescribe for it. He recommends a balance lens. [quoted text clipped - 11 lines] > > I am not a vision health professional. Thanks for responding. > I have a macular hole in one eye, so the eye doc doesn't bother to try > to prescribe for it. He recommends a balance lens. [quoted text clipped - 7 lines] > Does anyone know of any ophthalmologists/optometrists who do peripheral > refractions? He doesn't need to do a peripheral refraction, he can determine your central refraction by retinoscopy or by auto refractor; peripheral and central refraction are close to the same. Next time in, ask him ot write your actual refraction, not balance for that eye and demo with a trial frame and trial lens so you can tell whether the difference is noticable. When you take it to get filled, have the optician check the actual power of your current "balance" lens and tell you if the actual prescribed power is much different. Since both eyes are usually close in power, and a balance lens is chosen to be similar in power to the other eye, your current balance lens may be pretty close to your actual prescription. If there is a large difference, then you can get it filled. The peripheral retina is not capable of good acuity and you will likely find that the periphery is not much clearer but it is worth a try if there is actually a difference. Dr Judy In article <485d0e3f-3a53-4630-aa54-56eb97387af2@r10g2000prf.googlegroups.com>, > He doesn't need to do a peripheral refraction, he can determine your > central refraction by retinoscopy or by auto refractor; peripheral and > central refraction are close to the same. Next time in, ask him ot > write your actual refraction, not balance for that eye and demo with a > trial frame and trial lens so you can tell whether the difference is > noticable. What is a "balance lens"? Bill SignaturePrivate Profit; Public Poop! Avoid collateral windfall! > In article > <485d0e3f-3a53-4630-aa54-56eb97387af2@r10g2000prf.googlegroups.com>, [quoted text clipped - 7 lines] > > What is a "balance lens"? My wife has one of those. It means that there is no correctable vision in that eye, so just make the lens so that it looks like the other one. SignatureDan Abel Petaluma, California USA dabel@sonic.net Dr Judy has written on 1/22/2009 2:22 PM: >> I have a macular hole in one eye, so the eye doc doesn't bother to try >> to prescribe for it. He recommends a balance lens. [quoted text clipped - 26 lines] > likely find that the periphery is not much clearer but it is worth a > try if there is actually a difference. Thank you. How do I find an eye doc who uses retinoscopy or an autrefractor? > > The peripheral retina is not capable of good acuity and you will > > likely find that the periphery is not much clearer but it is worth a > > try if there is actually a difference. > > Thank you. How do I find an eye doc who uses retinoscopy or an autrefractor? I think that the OP has no concept of what the capability of peripheral vision is. (I am not a vision professional but I need to know something about the eye in order to understand how optical instruments work.) I suggest that the OP try reading with the aid of a magnifying glass by using peripheral vision. I am sure that the OP will find the magnifying glass will improve reading capability very little if at all. Bill SignaturePrivate Profit; Public Poop! Avoid collateral windfall! Salmon Egg has written on 2/4/2009 6:16 PM: >>> The peripheral retina is not capable of good acuity and you will >>> likely find that the periphery is not much clearer but it is worth a [quoted text clipped - 8 lines] > using peripheral vision. I am sure that the OP will find the magnifying > glass will improve reading capability very little if at all. The OP is not interested in reading with his peripheral vision, but he'd like to see better when he is driving or at a concert. > Salmon Egg has written on 2/4/2009 6:16 PM: > >>> The peripheral retina is not capable of good acuity and you will [quoted text clipped - 13 lines] > The OP is not interested in reading with his peripheral vision, but he'd > like to see better when he is driving or at a concert. It would be nice if someone knowledgeable would answer the question. Since nobody has, I will answer it. A quick check of Google shows that retinoscopes run about US$50 to US$500. It seems reasonable to me that most eye doctors would have one of these in their office. Autorefractors are priceless (they all said "get quote" or "inquire"). Off the top of my head, they look expensive and I doubt that they are very useful. I would expect that a well equipped office might have one. I don't believe that I've been checked with a retinoscope, but who knows what all those machines are? I have been checked twice with an autorefractor, both times after surgery. I would suggest calling your regular eye doctor, the one who does the refractions on you. SignatureDan Abel Petaluma, California USA dabel@sonic.net Dan Abel has written on 2/5/2009 1:59 PM: >> The OP is not interested in reading with his peripheral vision, but he'd >> like to see better when he is driving or at a concert. [quoted text clipped - 12 lines] > I would suggest calling your regular eye doctor, the one who does the > refractions on you. My doc used a retinoscope and a phoropter, but I'm not sure how the former leads to a prescription. Why would an eye doc use those if he/she had an autorefractor??? > Dan Abel has written on 2/5/2009 1:59 PM: > > I would suggest calling your regular eye doctor, the one who does the > > refractions on you. > My doc used a retinoscope and a phoropter, but I'm not sure how the former > leads to a prescription. This is what I have learned from reading about retinoscopy. The refraction needed for the retina to see images clearly is the same power needed for the eye doctor to see your retina clearly. Thus, if the doctor looks at your retina using the retinoscope, the power dialed into the phoropter, corrected for distance, is the power needed for your correction. > Why would an eye doc use those if he/she had an autorefractor??? I could only guess. SignatureDan Abel Petaluma, California USA dabel@sonic.net > My doc used a retinoscope and a phoropter, but I'm not sure how the former > leads to a prescription. > > Why would an eye doc use those if he/she had an autorefractor??? The phoropter is most accurate. Autorefractors and retinoscopes make good estimates but they almost never match exactly with each other or with the phoropter. Macular holes don't really require you to use "peripheral" vision. They only cover 5 degrees or so and the actual focal length is pretty uniform over a much wider area. So you have no reason to worry that the actual prescription would be different. Even if it did, when you use your "peripheral" vision to choose lenses one-or-two, you have then performed the most accurate "peripheral" refraction possible. Good doctors won't rely on just an estimate. Most will try to confirm their estimates with a phoropter. -MT Juan Wei <juanwei26@gmail.com> wrote in part: > The OP is not interested in reading with his peripheral vision, > but he'd like to see better when he is driving or at a concert. Then understand how peripheral vision works: the density of rods and cones is much lower than the fovea. What the peripheral vision does is spot changes light-dark-light. Sharper focus will increase acuity of attention triggering. It increases alertness at the cost of distraction. Improving peripheral focus is easy -- use contact lenses, especially RGPs. All light entering the eye passes through the iris & contact lenses. How much improvement depends on the match between lens curvature and retinal non-sphericity. Building glasses with peripheral lenses is not going to be anywhere nearly as good. Those lenses can only be set for one center and there will be a break/blindspot between the central and peripheral lenses. -- Robert > Dr Judy has written on 1/22/2009 2:22 PM: > [quoted text clipped - 32 lines] > > - Show quoted text - All eye docs do retinoscopy. Many have an autorefractor. Call your eye doc and ask if your current balance lens is close in power to the actual. The big thing to remember is that the peripheral retina is not capable of sharp vision; it is wired to detect movement and gross objects. Correcting the eye very likely will make no difference at all to your visual experience. Dr Judy > I have a macular hole in one eye, so the eye doc doesn't bother to try > to prescribe for it. He recommends a balance lens. [quoted text clipped - 9 lines] > > Thanks. A macular hole is reparable by a surgery. Why don't you go for it instead of refracting your peripheral vision and/or using a balance lens? [I am not a vision professional, but I have had a macular hole (stage 3) which was successfuly repaired and I regained my central vision. Presently my corrected vision in that eye, after a mac hole, retinal detachment and a cataract, is 20/40, and actually I "achieved" 20/30 in my last eye exam, which impressed my ophthalmologist, but I know it was not really real -- I simply have become a good guesser :-) ] Ms.Brainy has written on 1/22/2009 11:45 PM: >> I have a macular hole in one eye, so the eye doc doesn't bother to try >> to prescribe for it. He recommends a balance lens. [quoted text clipped - 11 lines] > > A macular hole is "may be" > reparable by a surgery. Why don't you go for it > instead of refracting your peripheral vision and/or using a balance > lens? I did. The hole closed but the vision did not return. |
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