I went to the ophthamologist yesterday and here is what I learned from my eye test

Discussion in 'Eye-Care' started by acemanvx, Dec 29, 2005.

  1. acemanvx

    acemanvx Guest

    I am back from the ophthamologist! I will tell you
    everything that happened in order.

    I went to an eye exam room and tried on trial lenses. For my left
    eye I found that -5 was all I needed. -5.5 didnt help things any and -6
    actually started to give me hyperopic blur. -4.5 was only a tiny bit
    blurry. For the right eye it was trickier but a -4.5 lense seemed to
    give the clearest vision but the BCVA wasnt as good as my left eye. I
    also tried a -4 and a -1 cylindar and it appeared to work as well as
    the -4.5 lense. I then placed minus lenses over my -4.25 glasses and
    -.75 and -1 both appeared to give me the best vision. The right eye
    didnt benefit much from more minus. I tried other minuses as well and
    for fun I tried -20, whoa! so blurry! Then I tried +20 and superman
    blur! I then put two +20 lenses together and looked thru them and I
    could barely see my own arm! Two +20 lenses plus my -5 simulates -45
    diopters but with 1.8x magnification, something a real -45 wont have.

    The lady(optician?) then confirmed with a machine that my distance
    glasses were indeed -4.25 First she tested my distance vision in each
    eye. First the right and I saw all of the 20/50 line and I believe 2 of
    the 20/40 line although I admit I kind of guessed. The left eye saw all
    of the 20/50 as well and none of the 20/40. Then I looked with both
    eyes and got all of the 20/40 line minus one or two. She put down 20/40
    OU, I mentioned I am between 20/40 and 20/50 with those -4.25 glasses
    and she and my dad agreed. It was one of those projector eyecharts and
    the room was 20 feet long and the chart projected onto a square frame
    hanging on the wall. No mirrors needed. She also used a near chart and
    held it like 10 inches from my eyes. I mentioned I had presbyopia and
    that this was too close to see clearly with my glasses(which werent
    even full power!). I read the 20/50 line and she wrote that down
    too(for near vision).

    I went back to wait for my turn for more testing. I then went into the
    other eye exam room and given numbing drops so I can get a glucoma test
    with reduced discomfort. The drops burned somewhat for half a minute
    and I said wait till they take effect so he waited a minute then
    proceeded to do the tests.

    Next came the cyclopegia. He used cyclogyl, also known as
    cyclopentolate. I expressed concern with this conflicting with the
    numbing drops I got earlier but he said the two act seperately and
    have absolutely no relationship with each other. I believe he inserted
    2 drops in each eye then said come back in an hour where its effects
    will take on. I went to the bathroom to look in the mirror and sure
    enough my pupils had started to dilate! Soon they were absolutely huge!
    I noticed lights were overly bright and there was glare around the
    bathroom light! When we went outside, I was blinded by the light and
    couldnt even keep my eyes open! My mom came and handed me her
    sunglasses which helped immensely but I was still extremely senestive!

    After an hour and a half I returned and the ophthamologist's assisant
    looked into my eyes, holding a minus lense in front and said my myopia
    went down half a diopter. I then requested to look thru a phororaptor
    and see which minus power I now needed. The ophthamologist says he
    doesnt believe in doing that under cyclopegia because my pupils are now
    huge among other factors and the results wouldnt matter. He looked into
    my dilated eyes with a bright little light(that hurt!) then looked
    holding a +90(!!!) diopter lense for magnification! The lense was about
    half inch and so thick it was nearly sphere! Anyway my eyes are just
    fine. No cateracts, no diseases, no glucoma, no pathalogies. Just I
    have lots of myopia. He did say come back next week and he will give me
    a manifast refraction so I can update my records and pescription.


    I asked him some questions and got answers. Heres the answers:
    He agrees alot of people, more than 25% cant be corrected to 20/20. He
    doesnt believe in eye exercises, not even to improve pseudomyopia. He
    belives some people are happier being undercorrected, especially with
    presbyopia because full power glasses gives headache, eyestrain and
    will make your eyes worse. He also agrees I have presbyopia, something
    "not very common" at my age of 23.


    I will ask the ophthamologist several questions when I return.

    1. What factors determine BCVA? High order aberrations appear to be the
    most talked about factor and may be true in my case.

    2. What is the difference between presbyopia and accomodative
    dysfunction?

    3. Whats your stance on contact lenses, including RGP and orthoK?

    4. If someone asked you if he should consider laser refractive surgury,
    whats your stance and opinion on this?

    5. What amount of magnification does this +90 diopter lense give?
    I am also very curious the effects of placing that in front of your eye
    since your eyeball is about +60 diopters, that lense would cause an
    image to focus way in front of your retina, in fact the focus point
    would be outside your eyeball! How high can plus lenses get and would
    the focus come in front of the plus lense itself if high enough?

    6. How high can myopia get? I have heard a few reports of -100s on the
    internet and of one guy who was a -96 then a year later he progressed
    to -104!

    7. I will think of more questions. Any of you have stuff I should ask
    him?
     
    acemanvx, Dec 29, 2005
    #1
    1. Advertisements

  2. acemanvx

    Neil Brooks Guest

    Sigh. A bit of judicious editing is rarely a bad thing.

    [caffeinated yakking snipped]
    Ace-

    Maybe you could limit your questions to actual, meritorious, relevant
    questions that have to do with *your* two eyes.

    Also, I think the Internet is a better place for satisfying yourself
    concerning academic issues. The ophthalmologist is the appropriate
    person to talk to about issues that would inform an actual course of
    treatment (e.g., Ortho-K, refractive surgery, etc.).

    The doc is likely to be more responsive to you if you are respectful
    of his/her time.
     
    Neil Brooks, Dec 29, 2005
    #2
    1. Advertisements

  3. acemanvx

    acemanvx Guest

    Oh I almost forgot to mention this. The ophthamologist said I can test
    my myopia by doing the near point test. Measure how far you can see
    clearly and this is your diopters. If you can see from 20cm you are a
    -5, if 25cm, you are a -4, and so on. Its accurate to determine the
    changes in my myopia. This is something I already knew but I bet many
    people didnt!

    I also want to mention things became clearer with my -4.25 glasses
    while I was cyclopegized. I also want to mention the cyclopegia was
    incomplete since I could still see well enough from near to read with
    those -4.25 glasses. I measured +1.25 diopters of accomodative
    amplitude under cyclopegia as opposed to +2.5 diopters normally.
    Therefore I have reason to believe I got more than -.5 diopters
    pseudomyopia. I may have more like -1.5 diopters of pseudomyopia. At
    least I am satisfied in knowing not all my myopia is real. I will
    countinue to work on vision improvement to resolve all my pseudomyopia.
     
    acemanvx, Dec 29, 2005
    #3
  4. acemanvx

    Dan Abel Guest

    Yeah. I really wasn't impressed with the idea of asking a newsgroup if
    they have any questions for *his* doctor! I have my own doctor. And if
    I have general questions I'll ask them here or do a Google.
     
    Dan Abel, Dec 29, 2005
    #4
  5. The 14 year old abberrated "presbyope" from hell.

    The doc might have to schedule more than 30 minutes?
     
    William Stacy, Dec 29, 2005
    #5
  6. acemanvx

    Dick Adams Guest

    It does not seem that you are being very supportive. Here is a kid
    who seems to have a real vision problem. Certainly he does not
    understand it, nor communicate about it very well.

    Wouldn't you be interested to find out more about it, even if you
    can't figure it out right away?

    Or is this group, ostensibly offering advice to ordinary people, here
    more truly for the purpose of sassing them?
     
    Dick Adams, Dec 29, 2005
    #6
  7. "It does not seem that you are being very supportive."

    Hello... It appears someone made a wrong turn...

    You have arrived at

    sci.med.vision

    NOT

    alt.support.myopia

    Please sound your ship's bell as you depart.

    Goodbye and Good Luck
     
    William Stacy, Dec 29, 2005
    #7
  8. acemanvx

    Dan Abel Guest


    Let me quote from the original post in this thread:

    "3. Whats your stance on contact lenses, including RGP and orthoK?

    4. If someone asked you if he should consider laser refractive surgury,
    whats your stance and opinion on this?

    5. What amount of magnification does this +90 diopter lense give?
    I am also very curious the effects of placing that in front of your eye
    since your eyeball is about +60 diopters, that lense would cause an
    image to focus way in front of your retina, in fact the focus point
    would be outside your eyeball! How high can plus lenses get and would
    the focus come in front of the plus lense itself if high enough?

    6. How high can myopia get? I have heard a few reports of -100s on the
    internet and of one guy who was a -96 then a year later he progressed
    to -104!

    7. I will think of more questions. Any of you have stuff I should ask
    him?"

    You'll notice I snipped #1 and #2. That's because they were about Ace.
    The rest of these aren't. Perhaps you are correct, and it is just poor
    communication. Perhaps he meant that he was going to ask, "What should
    *I* do?", but that isn't what they say.
     
    Dan Abel, Dec 29, 2005
    #8
  9. acemanvx

    Dan Abel Guest

    My experience has been that doctors will answer a couple of "gee whiz"
    questions. After that, it depends on their schedule. If they have a
    waiting room full of patients, that's it.

    Same thing with multiple subjects. At some point, it's time for a
    separate appointment, either with them or someone else.

    Want advice on RGPs or orthoK? Make an appointment with the contact
    lens fitter (I'm assuming that's correct).

    They are also good at redirecting and focusing. If the patient wants to
    find out everything the doctor knows about LASIK, then the doctor turns
    it around by asking if the patient is thinking about it. If not, then
    no talk. If Aunt Hilda is thinking about it, well she needs to make an
    appointment.

    My HMO has a policy of one subject, one appointment. If you want to
    talk about three things, then you need three appointments. I've never
    been held to that, and I doubt that most are. Still, there are those
    with a laundry list of petty questions. If they have to make multiple
    appointments (suffering multiple waits) and pay multiple copays, then
    perhaps they will pare down their list.
     
    Dan Abel, Dec 29, 2005
    #9
  10. acemanvx

    Dick Adams Guest

    Maybe his optometrist can figure it out.

    Can't figure why this thread got Dr. Stacy's fanny so far out.
     
    Dick Adams, Dec 29, 2005
    #10
  11. It wasn't this thread alone; I'm just completely tired of discussing
    myopia prevention. It is a proper topic for discussion here, of course,
    but I'm really annoyed by the incessant and mindless repetitions of
    archaic mantras by certain posters together with the nearly as
    repetitive responses from legitimate sources, which have once again come
    to dominate this little corner of the internet. Therefore, I've decided
    to completely ignore the threads that are related to this topic
    (excepting maybe those that come from NEW posters). So that's my new
    year's resolution, and maybe it will also help keep me from getting into
    so many little nasty exchanges with complete strangers (as well as free
    up some time!).

    w.stacy, o.d.
     
    William Stacy, Dec 30, 2005
    #11
  12. acemanvx

    Neil Brooks Guest

    I keep hoping to be the lightning rod, freeing up the OD's and MD's to
    take good care of the legitimate posters with their legitimate
    concerns.

    As somebody (Dr. G, perhaps) pointed out: I derive great joy out of
    this, though I confess that when we get as outnumbered as I feel we
    are these days, even I begin to grow weary of the incessant inane
    chatter (even my own!).

    Meanwhile, if--in the alluvium--you find something sincere or
    interesting, feel free to jump in. If it's nothing but the usual
    bull$hit, though ... leave it to me. I was born for this [cracking
    knuckles...].

    The doctors who frequent this site--as I've said many times--are
    really quite meritorious for their contributions here. Leave
    yourselves unsullied. Stay out of the mud with the likes of Dear,
    Sweet Uncle Otie.

    I'll set the pick. Y'all just drive toward the ocular net....

    Meanwhile, etch this picture into your respective minds:

    http://nbeener.com/Otis_Brown_BARS.bmp
     
    Neil Brooks, Dec 30, 2005
    #12
  13. acemanvx

    otisbrown Guest

    Dear Ace,

    Subject: Diopter measurement standard.

    Re: Average refractive power of the
    natural eye is about 60 diopters
    with a "length" of about 2.4 cm.

    A very strong myopia will be
    about -10 diopters. I have
    heard of -23 diopters.
    I think the eye would tear
    itself apart beyond that point.

    The probability of the retina
    "floating" lose (i.e., detached
    retina) goes up rapidly much beyond
    -6 diopters.

    As you get older, look for "flashes"
    of light, or "curved" lines -- when
    you know they are straight.
    Be perepared for this.
    Call an ophthalmologist
    and have this checked.
    The consequence of ignoring
    these symptons can be
    serious.


    Best,

    Otis

    _______________


    6. How high can myopia get? I have heard a few reports of -100s on the
    internet and of one guy who was a -96 then a year later he progressed
    to -104!
     
    otisbrown, Dec 30, 2005
    #13
  14. acemanvx

    Quick Guest

    Yes... everyone agreed to try this months ago...
    and the saying goes something like "don't wrestle
    with pigs. You both get dirty but the pigs like it".

    -Quick
     
    Quick, Dec 30, 2005
    #14
  15. acemanvx

    Dan Abel Guest

    Not to be picky, but I like:

    Don't wrestle with pigs. The pig will win, you'll get dirty and the pig
    likes it.


    Still, even though I like this and use it on newsgroups, I don't think
    it applies here.
     
    Dan Abel, Dec 30, 2005
    #15
  16. acemanvx

    acemanvx Guest

    This ophthmalogist happens to be a friend of ours and a really nice guy
    too. He did not mind the questions I asked him. Theres alot I can learn
    about my eyes and vision in general from him. Like for example, while
    unusual, 23 year olds can have presbyopia. Also alot of people dont
    correct to 20/20, doesnt mean theres any pathalogies, just that their
    optics arent perfect.

    Otis, ive heard of several cases being more than -23. Ive heard two or
    three being in the triple digits! One of them had -104 diopters! LOL he
    would be your worst nightmare of abuse of minus lense! Imagine getting
    worse from -96 to -104 diopters in 1 year! How fast can myopia progress
    in a year? You said most people go down by 1/2 diopter but whats the
    worst case you know, Otis? As for the retina, all myopes are at
    increased risk and have to watch out for signs of trouble.

    No one commented on the fact my cyclopentolate left +1.25 diopter
    residual accomodation. Should I be having NO accomodation when
    cycoplegized with this agent?
     
    acemanvx, Dec 30, 2005
    #16
  17. acemanvx

    Dr. Leukoma Guest

    So your ophthalmologist says that a 23 year old can suffer from the
    same mechanism at that which causes prebyopia in a 50 year/old?

    Just FYI, the cycloplegic and manifest refractions are typically the
    same in a 50 y/o patient. A difference of 1.25 diopters does not
    indicate presbyopia.

    DrG
     
    Dr. Leukoma, Dec 30, 2005
    #17
  18. acemanvx

    acemanvx Guest

    What I meant is I have an accomodative amplitude of +2.5 diopters but
    the cyclopegia reduced my ability to accomodate by +1.25 diopters. I
    could still accomodate but only half the amplitude. I had a near point
    test and was seeing 20/50 with my glasses. If I had a high accomodative
    amplitude I theoratically should be seeing 20/20 near point. However my
    accomodation is not good anymore.
     
    acemanvx, Dec 30, 2005
    #18
  19. acemanvx

    acemanvx Guest

    by the way, my near point vision of 20/50 was with the card held about
    10" away and that was before I got cyclopegized. It was also used with
    -4.25 glasses which slightly undercorrected me
     
    acemanvx, Dec 30, 2005
    #19
  20. acemanvx

    Dr. Leukoma Guest

    Sorry, Ace. I misread your original narrative, and so I went back. I
    see that your ophthalmologist did NOT do a cycloplegic refraction, and
    so the question still hasn't been settled. I almost always perform a
    cycloplegic refraction, when I dilate, especially if there is any
    question.

    An accommodative amp. of 1.25 under cycloplegia indicates incomplete
    cycloplegia, but does NOT indicate presbyopia. If your normal amp. is
    low, even without cycloplegia, I would call it accommodative
    insufficiency, and ask you certain questions about your medical
    history, including childhood febrile or viral illnesses. You don't
    have presbyopia, and that term is not appropriate for a 25 y/o.

    DrG
     
    Dr. Leukoma, Dec 30, 2005
    #20
    1. Advertisements

Ask a Question

Want to reply to this thread or ask your own question?

You'll need to choose a username for the site, which only take a couple of moments (here). After that, you can post your question and our members will help you out.