myopia, high astigmatism, sore eyes, will contacts help?

I'm a senior who has worn glasses for myopia since age 12. Over the
years my eyes have steadily worsened, and my latest prescription is -7
in each eye, with about -3 astigmatism. I had several pairs of new
glasses made, none of them allow me to read without eyestrain.

I finally went to a college of optometry in a city near me and saw the
chief optometrist, who came highly recommended. After an exam he told
me that he couldn't improve on the prescription that I was wearing,
and that only rigid contact lenses would help me. He also said that I
could consider cataract surgery (I do have a small cataract in one eye
that hasn't changed in 20 years).

Another optometrist that I saw later didn't think contact lenses would
do much to help me see comfortably, but he was enthusiastic about the
surgery. He referred me to a local ophthalmologist who I haven't seen
yet, as I'm very reluctant to have surgery.

Since then I've had two changes of prescription, which did not help at
all. I have about 20/40 distance vision, which I'm not compaining
about, but I do miss being able to read, use the computer, or read
music without serious eyestrain after more than a few minutes.

I'd appreciate opinions the chances of contact lenses working in cases
like mine. Actually I have worn them before, many years ago before the
days of "soft" lenses, and I recall being able to wear them for only a
few hours at a time.

Thanks for anyone's help with this.

Mops

 

A lay person, here ....

Have you been prescribed eyeglasses *specifically for reading
distance* or bifocals ??

You're quite myopic, and past the age where one usually has much
accommodative ability.

The Rx that allows you to *drive* ... probably would NOT give you
good vision, up close.

Have you been *that kind of specific* with your prescribing doctor ?

In the alternative/meantime, have you ever tried slipping a pair of,
say, +2.00 diopter drug store reading glasses OVER your current
eyeglasses, and THEN trying up-close work ??

Good luck !

 

First, let me clarify.....it's not that I can't "see" to read, in fact
with no glasses I can read the finest print, and it's sharp, not
blurry. But that I can't read comfortably, for more than a few
minutes, even with reading correction in my specs.

I was examined by an ophthalmologist a few months ago, second time in
a year, and I was told that other than a small cataract I have normal,
healthy eyes.

As for an explanation of 20/40 vision, the doc at the optometry
college just said, "I cannot correct your vision to 20/20 with
glasses". He didn't say why.

Can you explain what tear glands have to do with it? As far as I
know, I have no problems with dry eye, or anything like that.

Thanks for your opinion. That is the kind of info I am looking for. I
would be content with 20/40 vision, as long as I could read without
eyestrain.

The surgery that was recommended was the usual cataract surgery, which
I understand is just replacing the lens.

Mops

 

Yes, both, and also progressive lenses, which I've worn for years.

I have one pair of glasses that gives me fairly good distance vision,
for driving, but are most uncomfortable for anything closer than about
ten feet.
They are bifocals, but are useless for reading...the most
uncomfortable.

Yes, I have tried that. It doesn't help for reading, but helps with
the piano. In order to get the notes in sharp focus I have to tilt the
clip-ons upwards a bit, then everything's nice and sharp. Hard to get
the clip-ons to stay in that position tho.

Also, with close work, wearing my progressives (which I wear most of
the time), things look sharper if I look through the inside corner of
the lens. Of course I can't do that with both eyes at once, so it's
not much help. Does that give any hint of what the problem might be?

Thanks!

Mops

 

Thank you very much for your response.

I suspect that you may be right about my present glasses not being of
the best quality. All three pair came from the big, well-known "big
box" optical store. I went there only because they had frames that
suited my (small) face, and were oval rather than rectangular, to
minimize the lens thickness at the edges.

However, considering that the prof at the college of optometry didn't
think any specs would improve my vision, I'm not too hopeful. I really
wish I had a definitive answer to whether or not contacts are worth a
try.

But for now I'm going to seek out a reputable optometrist (how to find
one?) somewhere in this area, and take your suggestions.

Thanks again for taking the time to write!

Mops

I

 

Mike, thanks for your reply.

I have tried this, and I'm quite comfortable reading with my left eye
alone, not as much with the right (probably because I have to get
closer), but I'm not comfortable with the idea of covering one eye
while I read...don't know why, but it just doesn't seem like the right
thing to do.

OK, I'm not surprised.

That's more or less what the eye doc told me. He said that the
cataract was not serious enough to be interfering with my vision.

LOL...I'm not looking for opportunities to buy even more eyeglasses!
I've had four in the past 3 years. But I understand that if I were to
get contacts, I'd still need glasses for reading, computer, etc. I've
no problem at all with that. It would be so wonderful to be able to
see without discomfort.

Thanks for writing!

Mops

 

Did any of the doctors you saw say anything about your tears and lids?

Sore eyes after just a few minutes of reading sounds like a dry eye/
poor tear quality/ blepharitis problem. Artificial tears used just
before reading may help.

And don't be reluctant about surgery. Cataract surgery is very safe
and may be the real answer for your problems.

Judy

 

YeahBut....

If there IS an ocular surface issue ... my nickel's worth of lay
person advice is ....

You need to get the ocular surface (tear film, cornea, etc.) under
control BEFORE considering any cataract surgery.

Cataract surgery CAN, and often DOES cause dry eye in people without
it, and exacerbates it in people who already have it.

http://www.ncbi.nlm.nih.gov/pubmed/19568353

et al.

It's a thing to be verrrrrry careful about. Dry eye sounds like ...
dandruff, or something that's a minor nuisance, at worst.

It can be ... but it can be debilitating.

In regards TO the dry eye possibility, in your case: here's another
simple thing to try: many dry eye patients find it easier to read ...
in the shower ... than ... elsewhere.

But ... to the earlier point ... if a good (*preservative-free*)
lubricating drop does NOT improve your vision ... you may well NOT
have dry eye.

A corneal specialist with a focus on dry eye can do simple tests to
verify, rather definitively, whether or not you ARE a dry eye
patient....

 

Dr. Judy, thank you very much for your input. I appreciate it.

No, it was never mentioned.

Well I got the artificial tears, and although they were soothing, they
didn't affect my eye discomfort. which is more like a muscle thing, a
pulling sensation at the inside corner of my right eye (especially),
rather than an irritated sensation that I suppose dry eye would
produce.

Last night, for the first time I tried using my husband's laptop
computer while sitting in our recliner. I've used it before at a table
with no real problem, tho it's less comfortable for my eyes than my
desktop. Well, in the recliner it was just unbearably uncomfortable,
almost painful, and I had to quit using it after about ten minutes.
The discomfort continuted for a while afterwards, which is not
unusual. I often find that after I read the paper in the morning, my
eyes are sore for a half-hour or so.

I'm wondering it the extreme eyestrain with the laptop could be due to
the astigmatism?...because I wasn't looking squarely at the screen?

That is nice to hear. But I'm hoping there's a less extreme solution.

Dr. Judy, do you think rigid contacts would be likely to help?

Mops

 

I did get the preservative-free drops, and they don't seem to do much
for my problem.

But thanks anyway for the suggestion.

Mops

 

I think somebody needs to make sure your eyes are working together
properly.

You may have an issue with alignment ....

http://www.strabismus.org/

Mike's question, and your answer, about whether or not reading with
one eye improves it ... does make that a distinct possibility.

It's easily evaluated, and quite often easily treated. A strabismus
ophthalmologist (or good optometrist) should be able to verify your
"binocular function."