Looking for contacts after RK

I had RK 20 years ago to correct myopia. I guess I have those kind of
eyes that just keep going, and going, and going because now I am very
farsighted and wear a strong reading pescription. I have progressive
lenses now and they are not too bad because my reading prescription is
pretty close to my distance.
I have been thinking of contacts. Maybe distance in one eye, reading
in the other. I am

R +3.50, -.75, 100 (dominant)
L +4.75, 1.00, 067
+2.25 add

Any contacts need to be able to work with me falling asleep in front
of the TV at night. My most eye-strenuous needs are a computer screen
and golf. I don't want to spend to much in case it doesn't work out,
maybe pick up something on the internet, but I recognize from reading
this group that cheap contacts over RK can be pretty tricky. My
reading eyes have been pretty stable for the last few years.
If I can get a specific brand recommendation I could shop doctors or
go sreaight to the internet because my Dr. has a limited selection.
Any suggestions?

Thanks
Putts

This is a long and complicated subject. The majority of post-RK patients I
have worked with have required custom-designed rigid gas-permeable lenses
to achieve the best vision. These lenses are able to correct not only the
farsightedness, but also the irregular astigmatism that often occurs as a
result of RK. These lenses and the time it takes to fit them will require
an investment of time and money.

On the other hand, some post-RK patients have done quite well in soft
lenses. You have a borderline amount of astigmatism for a conventional
soft lens, and you may need a toric lens to correct the astigmatism. You
would need to go for a trial fitting first to find out. Also, post-RK
corneas are more sensitive to oxygen deprivation and very easily grow blood
vessels that follow the RK incisions. And, since you like to sleep in your
lenses, they should have the highest possible oxygen permeability. The
soft lenses that fit this criterion are the Focus Night and Day, the Acuvue
Advance(not FDA approved for overnight wear), and Purevision(available
outside the U.S. at present). None of these lenses are available in toric
versions for the correction of astigmatism.

You cannot purchase lenses on the internet without a prescription, and you
cannot get a prescription without seeing a doctor for a trial fitting. As
I said, this is a complicated subject.

DrG


(E-Mail Removed) (puttster) wrote in
news:(E-Mail Removed) om:

> I had RK 20 years ago to correct myopia. I guess I have those kind of
> eyes that just keep going, and going, and going because now I am very
> farsighted and wear a strong reading pescription. I have progressive
> lenses now and they are not too bad because my reading prescription is
> pretty close to my distance.
> I have been thinking of contacts. Maybe distance in one eye, reading
> in the other. I am
>
> R +3.50, -.75, 100 (dominant)
> L +4.75, 1.00, 067
> +2.25 add
>
> Any contacts need to be able to work with me falling asleep in front
> of the TV at night. My most eye-strenuous needs are a computer screen
> and golf. I don't want to spend to much in case it doesn't work out,
> maybe pick up something on the internet, but I recognize from reading
> this group that cheap contacts over RK can be pretty tricky. My
> reading eyes have been pretty stable for the last few years.
> If I can get a specific brand recommendation I could shop doctors or
> go sreaight to the internet because my Dr. has a limited selection.
> Any suggestions?
>
> Thanks
> Putts
>

"Dr. Leukoma" <(E-Mail Removed)> schreef in bericht
news:Xns95304CE65A15Edrgleukomacom@204.127.199.17. ..
> You cannot purchase lenses on the internet without a prescription, and you
> cannot get a prescription without seeing a doctor for a trial fitting. As
> I said, this is a complicated subject.
>
> DrG

Sadly you can purchase lenses on the internet without a prescription DrG.
Outside the US everything is possible.

Jan (normally Dutch spoken)

"Jan" <(E-Mail Removed)> wrote in
news:410277cf$0$738$(E-Mail Removed):

>
> "Dr. Leukoma" <(E-Mail Removed)> schreef in bericht
> news:Xns95304CE65A15Edrgleukomacom@204.127.199.17. ..
>> You cannot purchase lenses on the internet without a prescription,
>> and you cannot get a prescription without seeing a doctor for a trial
>> fitting. As I said, this is a complicated subject.
>>
>> DrG
>
> Sadly you can purchase lenses on the internet without a prescription
> DrG. Outside the US everything is possible.
>
> Jan (normally Dutch spoken)
>
>
>

Sorry, my mistake. And here I thought that the U.S. was less regulatory.
Perhaps it would be more correct to say that it would be foolish to self-
prescribe.

DrG

"Dr. Leukoma" <(E-Mail Removed)> wrote in message news:<Xns9530821BA2DE1DrLeukoma@207.217.125.205>.. .
> "Jan" <(E-Mail Removed)> wrote in
> news:410277cf$0$738$(E-Mail Removed):
>
> >
> > "Dr. Leukoma" <(E-Mail Removed)> schreef in bericht
> > news:Xns95304CE65A15Edrgleukomacom@204.127.199.17. ..
> >> You cannot purchase lenses on the internet without a prescription,
> >> and you cannot get a prescription without seeing a doctor for a trial
> >> fitting. As I said, this is a complicated subject.
> >>
> >> DrG
> >
> > Sadly you can purchase lenses on the internet without a prescription
> > DrG. Outside the US everything is possible.
> >
> > Jan (normally Dutch spoken)

>
> Sorry, my mistake. And here I thought that the U.S. was less regulatory.
> Perhaps it would be more correct to say that it would be foolish to self-
> prescribe.
>
> DrG

Ok. I see the acuvue advance is cheap enough to give it a go. I'll
try one eye reading, one eye distance. Can you advise on how to
convert my reading prescription to a mono lens?
If this doesn't all doesn't work out, can I get a recommendation for a
lens to be fitted by the Dr? I have been looking at the C&H Macrolens
and the Menicon but there aren't many places in town that handle them.

Thanks all for your advice

"puttster" <(E-Mail Removed)> schreef in bericht
news:(E-Mail Removed) m...
>
> Ok. I see the acuvue advance is cheap enough to give it a go. I'll
> try one eye reading, one eye distance. Can you advise on how to
> convert my reading prescription to a mono lens?
> If this doesn't all doesn't work out, can I get a recommendation for a
> lens to be fitted by the Dr? I have been looking at the C&H Macrolens
> and the Menicon but there aren't many places in town that handle them.
>
> Thanks all for your advice

The best advice given should be : visit an eyecareprofessional who is
familiar with and known for his or her skill on fitting contactlenses.
You may ask the specialist you are visiting about his skill in fitting hard
contactlenses.

Keep in mind, fitting contactlenses is NOT possible without having a
client/patient " face à face" in front of you.
I.e , to find out which eye is to be used as the "far distance" one, it is
not simply take the dominant eye (one of the more simple decisions that has
to be made).

Paying peanuts getting .......?

BTW, this advise is for free but not a primate Otis.

Jan (normally Dutch spoken)

(E-Mail Removed) (puttster) wrote in
news:(E-Mail Removed) m:

> "Dr. Leukoma" <(E-Mail Removed)> wrote in message
> news:<Xns9530821BA2DE1DrLeukoma@207.217.125.205>.. .
>> "Jan" <(E-Mail Removed)> wrote in
>> news:410277cf$0$738$(E-Mail Removed):
>>
>> >
>> > "Dr. Leukoma" <(E-Mail Removed)> schreef in bericht
>> > news:Xns95304CE65A15Edrgleukomacom@204.127.199.17. ..
>> >> You cannot purchase lenses on the internet without a prescription,
>> >> and you cannot get a prescription without seeing a doctor for a
>> >> trial fitting. As I said, this is a complicated subject.
>> >>
>> >> DrG
>> >
>> > Sadly you can purchase lenses on the internet without a
>> > prescription DrG. Outside the US everything is possible.
>> >
>> > Jan (normally Dutch spoken)
>
>>
>> Sorry, my mistake. And here I thought that the U.S. was less
>> regulatory. Perhaps it would be more correct to say that it would be
>> foolish to self- prescribe.
>>
>> DrG
>
> Ok. I see the acuvue advance is cheap enough to give it a go. I'll
> try one eye reading, one eye distance. Can you advise on how to
> convert my reading prescription to a mono lens?
> If this doesn't all doesn't work out, can I get a recommendation for a
> lens to be fitted by the Dr? I have been looking at the C&H Macrolens
> and the Menicon but there aren't many places in town that handle them.
>
> Thanks all for your advice

I am not advising you to prescribe for yourself, but the definition of an
"add" is something that is added, i.e. in this case added to the distance
prescription. So, a person with a -2.00 distance and +2.00 add would
require a plano lens for reading.

I fit the Macrolens, but I have them customized for the unusual shape of
the post-RK cornea. They are difficult or next to impossible to fit
without a good set of trial lenses.

Menicon is just a manufacturer. Years ago they had a product called the
Plateau lens. It was the first lens to be advertised for post-refractive
surgery. The Plateau lens was just their version of a large, reverse
geometry RGP lens. This is a sub-specialty where experience can mean the
difference between success and failure.

Then again, I don't really know your personal criterion for success.

DrG

"Puttster" <(E-Mail Removed)> schreef in bericht
news:qlRMc.26489$(E-Mail Removed)...

> Jan, You have puffed yourself up to be a condescending know-it-all but
point
> of fact you answered none of my questions.

Indeed I advised you instead of answering, so did others.

> What is the point of your post?

Keeping people out of trouble.

> Are you trying to ruin the whole concept of news groups, with your tired
> old "see a professional?"

Not at all, since this newsgroup is called sci.med.vision and not
advise.med.vision
Eyecare professionals are paid for such, are you not?

> Stop being so pompous and get with it, man. If
> you can answer the question, please try again. If you can't, then please
> stop discouraging others from trying.
> Thank you.

You'r wellcome

Jan (normally Dutch spoken)
>
>

"Puttster" <(E-Mail Removed)> schreef in bericht
news:ycTMc.26686$(E-Mail Removed)...
>
> "Dr. Leukoma" <(E-Mail Removed)> wrote in message
> > I am not advising you to prescribe for yourself

> > They are difficult or next to impossible to fit
> > without a good set of trial lenses.
> >
> > This is a sub-specialty where experience can mean the
> > difference between success and failure.
> >
> > Then again, I don't really know your personal criterion for success.
> >
> > DrG
>
> At this point I would like to see if contacts might work for me. Maybe an
> internet pair will work fine, maybe it will simply convince me to stay in
> bifocal lenses, maybe it will encourage me to see a specialist.


Indeed DrG is more kind and friendly as is the Dutch guy.
The advise given by DrG is not that direct as mine (the Dutch are famous for
being direct) Puttster, but in the end he says the same.

Jan (normally Dutch spoken)

"(E-Mail Removed)"
<(E-Mail Removed)> wrote in
news:410407aa$0$198$(E-Mail Removed):

>
> "Puttster" <(E-Mail Removed)> schreef in bericht
> news:ycTMc.26686$(E-Mail Removed)...
>>
>> "Dr. Leukoma" <(E-Mail Removed)> wrote in message
>> > I am not advising you to prescribe for yourself
>
>> > They are difficult or next to impossible to fit
>> > without a good set of trial lenses.
>> >
>> > This is a sub-specialty where experience can mean the
>> > difference between success and failure.
>> >
>> > Then again, I don't really know your personal criterion for
>> > success.
>> >
>> > DrG
>>
>> At this point I would like to see if contacts might work for me.
>> Maybe an internet pair will work fine, maybe it will simply convince
>> me to stay in bifocal lenses, maybe it will encourage me to see a
>> specialist.
>
>
> Indeed DrG is more kind and friendly as is the Dutch guy.
> The advise given by DrG is not that direct as mine (the Dutch are
> famous for being direct) Puttster, but in the end he says the same.
>
> Jan (normally Dutch spoken)
>
>

Oh, I'm probably half Dutch, then.

DrG