contacts are great but can't read with them

Discussion in 'Contact Lenses' started by Bob, Oct 19, 2004.

  1. Bob

    Bob Guest

    I am considering Lasik or something similar to correct my nearsightedness. I
    have some astigmatism in one eye, but nothing too exciting. I currently have
    contacts, but mostly wear glasses.

    My glasses are an old prescription and don't correct my myopia all that
    well, but good enough. At least I can read the newspaper with them on and
    can sort of see distant things.

    If I wear my contacts - a recent exam (last summer) is when I got them - I
    have great vision - probably 20/15 or so, but I can't see anything within a
    4-6 ft. radius clearly. They're a pain for that reason.

    Now - if I get Lasik - will my eyesight be just like with contacts or what?
    My wife has pretty good distance vision, but only needs glasses for tiny
    print. I'd hate to have to wear glasses for everything within 4-6 ft. With
    my contacts I can't clearly read the speedometer in the car. Now, I can't
    drive with reading glasses. Is this normal presbyopia? If so, I'll stick
    with my current glasses which aren't too great for distance, but good
    enough. I don't know too many people in their 50s who have such bad close up
    vision problems as I do with my contacts in.

    I'm hoping that Lasik's version of 20/20 will reduce the presbyopia radius
    to something normal like tiny print at 12" or so! But I guess that's too
    much to ask for, huh? And I don't like the idea of monovision really.

    I'm a 51 yr old male, with moderate myopia, some astigmatism.
    Bob, Oct 19, 2004
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  2. Bob

    Dr. Leukoma Guest

    If you elect to go with monovision LASIK, make sure that you try it out
    first with contact lenses. Some surgeons neglect this important step.

    Dr. Leukoma, Oct 19, 2004
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  3. Bob

    Dr. Leukoma Guest

    Dr. Leukoma, Oct 19, 2004

  4. I done real good English too.

    Glenn Hagele
    Executive Director
    Council for Refractive Surgery Quality Assurance

    Email to glenn dot hagele at usaeyes dot org

    I am not a doctor.
    Glenn -, Oct 19, 2004
  5. Yes they do, and for the life of me I can't figure that one out.

    Without the contact lens trial the doctors have no way of knowing if
    the patient will like monovision at all, if 0.75 or 1.75 diopter
    undercorrection is better, if the patient will be able to drive at
    night with monovision, etc. If they get it wrong, then they have all
    the overhead expense of doing the surgery again. Doing monovision
    without a contact lens testing just makes no sense to me.

    EVERYONE considering surgically induced monovision should try it with
    contacts for several weeks before they have it lasered into their

    Glenn Hagele
    Executive Director
    Council for Refractive Surgery Quality Assurance

    Email to glenn dot hagele at usaeyes dot org

    I am not a doctor.
    Glenn -, Oct 19, 2004
  6. Bob

    Dr. Leukoma Guest

    Guess I have not room to brag. Whoops, I mean "no" room to brag.

    Dr. Leukoma, Oct 19, 2004
  7. BTW, will you be in New Orleans for the AAO?
    Glenn Hagele - Council for Refractive Surgery Qual, Oct 19, 2004
  8. Bob

    Guest Guest

    One of the forgotten problems in the statement above from Glenn is the
    increase of presbyopia over the years.
    It is not only about either 0.75 or 1.75 diopters at the specific moment you
    If done on a relative young presbyopic you have most certainly a lesser
    addition as done on an older presbyopic.

    Which addition should you choose, to strong and thereby having some spare
    for the without any doubt increasement of presbyopia but at the same time
    having a short reading distance, or a lower addition, knowing later on the
    client has to wear glasses or contactlenses to overcome the increasment in
    needed addition?

    One of the advantages in contactlenses is the possibility to change the
    addition when needed , when having LASIK it is impossible.
    This has to be explained IMHO before surgery.
    Guest, Oct 19, 2004
  9. Bob

    Dr. Leukoma Guest

    Glenn Hagele - Council for Refractive Surgery Quality Assurance
    wrote in
    I didn't realize that optoms were welcomed.

    Dr. Leukoma, Oct 19, 2004
  10. Bob

    DoctorMyEye Guest

    I agree, Glenn. When I see an unhappy post-op LASIK monovision
    patient, they always look at me like I'm from another planet when I
    ask them if they tried monovision in contact lenses before they had it
    lasered into their eyes. Trial fitting MUST BECOME a standard of

    Incidentally, I have stumbled upon a "new" way to explain monovision.
    I mention to the patient that his/her brain is always making choices
    between the two sides of the body that they never "think" about. For
    example, if you approach a curb and have to "think" about how to step,
    you could simply fall while deciding. So, you simply step with your
    "favorite" foot.

    When monovision works, the brain decides at a subconscious level to
    use both pictures simultaneously and share the best of both sides,
    picking one when it "has to."

    This is consistent with the work of Dr. Jan Jurkus from the Illinois
    College of Optometry, who has shown that people who have total
    "one-handedness", as if the second half of their body can't catch
    anything, are very poor monovision wearers. Their brains don't want
    to share the picture from side to side, as they have never done so for
    anthing else.
    DoctorMyEye, Oct 19, 2004
  11. Bob

    Rebecca Guest

    Very important. Reportedly at least 1 in 5 people are not ABLE (for
    physiological reasons) to adapt to monovision, to say nothing of those
    who simply decide they don't like it. For a surgeon to fail to perform
    this step is altogether against the patient's interests because if the
    patient is in that 20+%, either the surgery will have been a waste of
    time because the patient will have to wear glasses again, or the
    patient will find himself subjected to the significantly increased
    risk of a second surgery.

    It should also be a proper trial - the patient should wear the lenses
    for several days so that they can see how their vision will fare
    during all different kinds of activities they normally engage in.

    Rebecca Petris
    Rebecca, Oct 19, 2004
  12. Bob

    CHip Guest

    If you opt for monovision, you
    may have trouble with close-focus work. I had monovision and found
    afterwards that surgery was quite difficult, as was threading needles,
    removing splinters and even fly-tying fish lures. With time I became
    quite farsighted in the eye that was originally 20:20 and am now
    approaching 20:20 in the eye that was burned for reading. Now when I
    wear glasses and look in the mirror one eye looks grossly enlarged in
    the lens.
    CHip, Oct 19, 2004
  13. Bob

    RT Guest

    The way monovision was presented to me was, oh well, if you don't like
    it, you can always have your undercorrected eye retreated to be
    corrected for distance as if it were a no big deal everyday thing. Kind
    of like, if it doesn't fit you can always return to the store for an
    RT, Oct 19, 2004
  14. Bob

    Guest Guest

    The above is correct when wearing contactlenses, having had LASIK or an
    other refraction surgery is a totally
    different story.
    Guest, Oct 19, 2004
  15. Bob wrote in message news:

    From the way you describe things, Bob, it is very possible your
    contact lens Rx is "overminused." That is, it leaves you slightly
    farsighted and you use your remaining accommodation ability to bring
    your effective Rx to plano. In middle-aged people, this often results
    is truly excellent distance vision, but compromised middle-distance
    vision, as well as horrible close-up vision. This overminusing occurs
    because some people like the super-crisp distance vision they get by
    using their accommodation ability to fine tune a slightly plus Rx.
    They don't realize that by doing this they exacerbate any existing
    presbyopia. Even though they know better, ODs often go along with
    this because the patient wants it and it doesn't damage the eye in any
    way. Of course, it is also possible you just suffer from an
    age-accelerated form of presbyopia, but I don't think so, because if
    that were the case spectacles that give you good close-up vision would
    result in quite significant myopia and very poor distance vision, but
    from what you say that does not appear to be the case. I suggest you
    go to your OD and have him fit you with a set of contact lenses that
    have the weakest Rx necessary to bring your distance vision up to a
    clear 20/20. It is likely this will solve your middle-distance
    problem, and improve your close-up vision noticeably. This is also
    the vision you are likely to get with LASIK surgery. Also, as others
    have pointed out, you could also opt for monovision LASIK, though a
    contact lens trial is a must, as many people do not like monovision
    even though it works.

    Bryce Carlson, PhD
    Bryce Carlson, Oct 19, 2004
  16. Bob

    Guest Guest

    An OD ''overminused'' a 51 years old, you must be out of your mind.
    ''Overminusing'' gives you a better vision ? what an unprofessional idea.
    OD's often go along with ''overminusing'' ? see the above

    Read the statement Bob has made about his old glasses, they do not correct
    his myopia completely and therefore you might consider these glasses as
    ''underminused'' and also as a (weak) pair of reading glasses to Bob.
    If Bob's myopia is exceeding the 5 diopters you have to consider the
    accommodation- and convergence- effects when wearing contactlenses instead
    of glasses.
    An eyecare specialist should be familiar with these effects when explaining
    the pro's and contra's in LASIK in my opinion.
    Guest, Oct 19, 2004
  17. Bob

    Dr. Leukoma Guest

    Well then, there you go.

    Dr. Leukoma, Oct 19, 2004
  18. Bob

    Dr. Leukoma Guest

    (CHip) wrote in
    Because I value my stereopsis (3D vision) in the examination room, I cannot
    tolerate monovision. A sense of depth is very important when performing
    binocular retinoscopy.

    Dr. Leukoma, Oct 19, 2004
  19. Bob

    Dr. Leukoma Guest

    I'm sure you're right, Ragnar. However, they might be better served if
    they did let in the occasional critic who has something useful to

    I would like to meet you at the door.

    Dr. Leukoma, Oct 19, 2004
  20. Bob

    Dr. Leukoma Guest

    ....or how silly you look not knowing it.

    Yes, what logic is that?

    If there is a genuine interest in informational exchange, then I am open to
    a "parlay." Otherwise, I guess I can go another 54 years without

    Dr. Leukoma, Oct 20, 2004
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