Any opticians or optometrists here?

I went for an eye exam yesterday. I'm 46 and I've been having trouble reading when I wear my contact lenses. Reading a menu in a dimly lit restaurant is nearly impossible. My distance vision is fine, though it could be a touch better. The doc said I'm on the cusp of needing progressive lenses but we'll do that in a year of two. And I have astigmatism (which I knew) I can read just fine when I'm wearing my glasses. OK, so the doctor did all the tests and so on and told me that he's going to decrease the strength of my contacts to try to correct the close-up vision issue. The prescription is weaker in both eyes but the base curve number is higher. I put the new lenses in this morning and it's better, though distance is a little worse, which I knew it would be. My glasses prescription is the same strength as it was before but the other numbers are different. Does that make a difference in vision? I left his office a little confused about what was going on with my prescriptions. I know I could have asked him, but he was really busy and rushing back and forth between patients. It's a busy office and I'm just wondering if he put enough thought into what he was doing. Any ideas? Is he doing the right thing? What about the new numbers on my scrips? I go back in a week.

• Not an optician or optometrist but as a contact and glasses wearer with similar vision issues (including astigmatism and reading problems with lenses in), you may want to discuss monovision contacts, which I have found very helpful. Rather than progressive contacts, one contact is for reading and one for distance. Not everyone can adjust to them but I have found them ideal. Alternatively, you may simply want to have a fashionable pair of reading glasses available to use as needed with your contacts. All that being said, simply call your doctor back and ask his/her office for my information.

• I never thought of getting reading glasses when I'm wearing contacts, R1. Thanks! Good idea.

  OP

• I'm not an optician or OD, but when I hit 40, I started having problems with seeing the computer screen and the "intermediate" zone. I was a long-time contact lens wearer for myopia and figured it was time for reading glasses. As R1 stated, you can try monovision contacts, but they gave me terrible headaches and I hated them. With my eyes getting drier, I decided to give up on contacts and wear progressive lenses in glasses, which I love. I do remember my OD explaining that as the reading gets more prominent, my astigmatism and distance prescription changes to accomodate the add power.

• Do they call bifocals "progressive" lenses now?

• OP, pretty much me in a nutshell. Cheaters are an option but my whole thing is not having to wear/carry glasses. I can read okay (though i do need to concentrate) but it does need to be in bright lights. A restaurant often makes it impossible to read based on their lighting. My contacts are fine for everything else but reading is an issue. It's been since august and I'm almost about to just give in and use cheaters. Good luck!!!

• Buy a pair of reading glasses at the dollar store. Don't pay a lot of money for them because you're only going to lose them and your prescription will change anyway. I was terribly nearsighted for most of my life. I was so happy when ultra thin lenses were introduced, because my glasses were like the bottom of jars they were so thick. I mostly wore my contacts. I needed bifocals and progressive contacts around age 48. I had no problem adjusting vision-wise. It's just that the progressive contacts were larger than regular contacts and really dried out my eyes. But that's changed because now another manufacturer puts out smaller progressive contacts. If you need progressive contacts, have your doctor try several trial lenses on you if they feel at all uncomfortable and you will find the right one for you. I ordered my contacts from Canada for about 5 years because I didn't feel my vision had changed and didn't want to go for an eye exam. All of a sudden, I felt I needed a new RX and went for an exam, My distance vision had improved so much that both the eye dr and the tech who sent my RX for contacts asked me if I'd had eye surgery. I didn't. But I no longer need ultra thin lenses because my distance eyesight is so much better. My near vision is only a little worse. Target sells cheap reading glasses at least once a year in their dollar section. I buy 10 pair and put them around the house. Eventually, my partner makes them all disappear. (He leaves them in restaurants, at his parents house, at his office, in stores, etc)

• Bifocal lenses have a line. Distance on top, reading on bottom. There are only two fields of vision. Progressive or multifocal lenses have multiple viewing fields in one lens.

• The other numbers probably refer to the angle and diopter power of your astigmatism, and will usually vary a small amount from one prescription to another because of inaccuracy or because your astigmatism has changed slightly, which is possible.

• thanks R7

  R4

• Restaurants need to start putting reading glasses on the tables.

• Or offer large print menus, R10. The newer and thinner progressive contact lenses have been great because I could not adapt to monovision. I have very poor vision in only one of my eyes. I prefer glasses when I'm reading at home at night, but contacts are good for things like driving. My ophtho recommended lens strengths for reading glasses (that I buy at the drugstore) for both computer use and reading and that's been helpful. I laughed when he first told me to buy reading glasses because I remember my grandfather buying them at the dime store when I was a kid. He said he would save me a lot of money with that suggestion, and he has.

• Opthamalogists are MDs OP, and opticians and optomatrists are not. I think it is best to go to an opthamalogist. She or he will take care of all you eye health issues, not just you vision.

  charlie

• This is why bifocals were invented, the glasses your grandparents wore, with the line in the middle. They haven't invented bifocal contacts yet.

• The reason you see better through your glasses is due to your spectacle lenses being ten or twelve mm from your eye. Contact lenses for near sighted wearers increase ones near sightedness and the difference is more readily noticed when one is presbyopic (over the age of 38/40) At 46, you might consider switching to multifocal contact lenses. These lenses actually work quite well but require a greater amount of time in the exam room, and many doctors don't like fitting them. Each patient is slightly different, but over all the human eye ages at the same rate for all of us provided there are no other eye problems. Your doctor has made the correction I would have made as this will allow you to use your single vision contacts a little longer. Multifocal contacts will increase your cost for good vision, so stay with your doctor. He is taking all the right actions in your interests.

• "This is why bifocals were invented, the glasses your grandparents wore, with the line in the middle. They haven't invented bifocal contacts yet." Incorrect. There are now and have for many years been bifocal and multifocal contacts and there are also monovision contacts (one lens for reading the other for distance).

• I agree with you, Charlie. But it's easier to get in to see an OD than it is an Ophthalmologist. although they do run their clinics rather too much like businesses. At this point I just want an updated prescription. Presumably if the OD notices something medically amiss with my eyes he'll refer me to an Ophthalmologist.

  OP

• Mono vision is both potentially unsafe and limited to the period of having a one diopter of difference between near and distance prescriptions. The multifocals are great, but for some, they too have their limitations.

• Thanks, r15. My ophthalmologist told me there were no bifocal lenses yet. We'll have a little talk next month!

  r13

• OK, so I went back for my contact lens follow-up today. I told the doc that the reading vision is better but the distance vision is worse and that it bothers me. So he tested some more and increased the strength of the lens in my right eye and left the left eye as is. It's much better. He also suggested getting a pair of OTC reading glasses of the weakest strength for fine print, dark restaurants, etc. if I think I need them. My new glasses are in next week. I'll be curious how my vision is with them. Fingers crossed.

  OP