Monday, October 10, 2011

Will Glasses Really Help Me?

Jaime asks:
"Ever since I was a little kid I've been holding my eyes in focus. It feels like there is a little mechanism behind my eyes inside my head - a wheel - and when I turn that wheel my eyes focus. That is how my eyes are 80-90% of the time. When I "let go", for example when I space out or daydream or some such thing, my eyes fall out of focus. When I'm completely relaxed, so too are my eyes, and everything is blurry. And I mean everything. It is most noticeable on close things. I'm relaxing now, and I can't see what I'm typing at all. I can see the shape of the website, but not words with any detail. But even across the room, I cannot discern the illuminated numbers on the stereo display which is 10 feet away. But I can when I focus my eyes, which I have just done and can now read the numbers clearly. So, I didn't know what to do. As aside, I've suffered from decades of migraines - severe, sometimes days long with, auras, photophobia, vomiting and anxiety. I've also suffered from general fatigue on reading for any longer than about 30 minutes.

So, my sister insisted I get examined for glasses. The assistant at the optometrist asked me to look in something and if I could see it. I said I could see great as I was, but if I completely relaxed, no. She was confused. I told her so was I. I didn't really know how to relax my eyes all the way, so I didn't know how to give her an accurate reading. They used an autorefractor, I think, to get an "objective" measure of my eyes, and it gave them a baseline suggested script. But, I don't understand how it could do that if my eyes were trying to focus. Wouldn't my muscles be affecting the refraction of the machine's light?

Then I saw the doc. I asked him point blank, 1) do I need glasses if I can see fine 2) how coule we guarantee a script was accurate if my eyes were trying to hold focus. He told me, rather refreshingly in honesty, that he couldn't tell me if I should always wear glasses. That if I saw fine, I saw fine, but that in his opinion I would have a better quality of life if I could relax my eyes all the time and still see well - less headaches, better reading stamina, better mood... the idea being my eyes could settle and I would be doing less work all the time. That was convincing. Then he said the machine gave him a baseline, but that he had other ways of "tricking" my eyes into relaxing and he would get a number probably very close to it. He said I was classically farsighted, and not the kind where people get older and their reading vision gets poor. He said since I was a kid I've had misshapen eyes that I've compensated for with remarkably good acuity by using my focusing muscles.

The machine said I was +0.5/+0.75. He came up with the number +0.75/+1.0, which he said he would recommend. He also suggested I wear it all the time. That even though I'm farsighted, it will help with distance vision as well. I can confirm this because, as I said, if I relax my eyes, the electrical outlet in the kitchen (about 20 feet away) gets blurry, but when I focus it's quite sharp.

So, I said I'm looking for confirmation, and my questions to you are this: can I trust this prescription? How do I know my eyes were relaxed enough to give the best prescription? Will wearing these glasses also help with this loss of distance detail, even though I'm farsighted? I guess I shouldn't be concerned because the eye exam was on a wall about 12 feet away, and one of the lens combinations he tried was amazingly clear. Should I wear them all the time? I don't want to dive a couple hundred bucks into glasses for something that just doesn't cut it, or that I don't need. I just want to be sure before I commit to a change like this.

Thank you for any insight! Have a wonderful day."

A: Jamie, Thanks for your questions.  They are good questions and I can tell you have put a lot of thought into them.
Based on what you have told me,  I would agree with your doctor that you are farsighted (what we in the eye care industry call hyperopia).  You have probably had this hyperopia since birth.  Since young people can focus so efficiently, it didn't cause any problems.  Up until recently I would classify your hyperopia as 'latent' meaning present but not problematic.  Now I would classify it as 'manifest' hyperopia, meaning that it is presenting a problem.  I think it would be wise to go ahead and get glasses and wear them all the time.  You can save money on glasses by getting a basic pair without a lot of add-ons such as tints, coatings, and designer frames.  Most hyperopes gradually need a little more power in their prescription (we use lenses with a (+) symbol to denote lenses that correct hyperopia and a (-) symbol to denote lenses to correct nearsightness - myopia in industry terms), so don't be surprised if you need a little more + (plus) in your lenses over time.  With the glasses you should see more comfortably at far and near (in hyperopia you have to focus at all distances to see clearly).  To answer the question you didn't ask - no, wearing glasses won't make your eyes worse, but you will like not having to constantly focus and therefore your eyes will prefer the vision with the glasses compared to the vision without them.  When you hit 40, 45, or 50 yrs of age, your focusing ability will most likely decrease to the point where you may need bifocals or multifocals.  Everything you are experiencing is normal, so enjoy the better vision you are about to experience and be sure and get your eyes checked yearly.

Dr. Felker