Vitreous Enhanced (Induced?) Presbyopia

Discussion in 'Optometry Archives' started by Dick Dead-Eye, Aug 29, 2005.

  1. To begin with, my eyes have always been subpar.
    I've worn glasses since whenever I can remember, for myopia with a
    strong astigmatism and had surgery to correct amblyopia (not sure which
    eye) when I was about 6 or 7.
    Then back in the fall of '79, when I was 13, I awoke with floaters in my
    left eye, which becane inflamed with a rip roarin' case of
    chorioretinitis (at the time they suspected it was caused by
    toxoplasmosis), with the vision deteriorating to less than 20/200.
    The inflammation cleared up and, while technically my vision returned to
    20/20, the field was reduced by scarring around the edges and the
    vitreous was--at least partly--detached.
    Fast forward to Jan.'89 when, one morning, I suddenly noticed a couple
    of small, pure black spots in the near center vision of my right eye.
    It turned out to be a "cold sore" on my optic nerve! Like my left eye,
    10 years earlier (which they now believe may have also been caused by a
    herpes infection, not toxo), the right eye became inflamed, started to
    recover, then reinflamed, this time totally cooking it, to be followed
    in a few months by a trauma induced cataract! P=(
    So now I am totally blind in one eye and half blind in the other (in the
    sense of the field is reduced and the detached vitreous has greatly
    reduced the quality of the remaining vision in that eye: It takes
    longer for the eye to adjust to darkness {and, even then, it's only
    about half--or even less--sensitive than my [previously] "good" eye},
    there is a mild reduction in overall "brightness contrast" {a slight
    "film"?} and there is a mostly transparent--except when I squint, when
    it looks "bubbley/sudsy"--wrinkly wad of "pie/cake dough" {i.e., when
    you stir or kneed the dough, it holds together but "wrinkles"} swishing
    around in my vision, which sometimes looks--albeit, usually faintly and
    out of focus--like either a fishing net sprawling around in water or a
    dim puff of smoke).
    In the past few years, I've had a few--what I believe are--"vitreous
    events", where, when I shifted my vision, I'd notice a litte spot (or
    strand?) that visually seemed to slightly flap or pull--it didn't look
    like the retina, but maybe a piece of loose but tethered vitreous (at
    least one of them looked like a small air bubble under a transparent
    sticker stuck to a window). After a couple of weeks or so, it would
    seem to have just about disappeared when, suddenly, (at the
    correspondingly opposite side of my vision field?) I'd notice a real
    vivid, small patch or strand of floaters that was tethered/anchored to
    that one area. After 2-3 weeks that tethered patch/strand would start
    to "weather" and fade into the background, never completely disappearing
    (other than the accompanying floaters), just adding to the vitreal
    artifacts.
    A couple of years ago, I had a couple of similar episodes, though these
    times the eye fluid (vitreous?) became not blurry, hazy or
    cloudy--suggesting inflammation--but a bit "gooey", yet certain things I
    could see off in the distance, relatively clear, while at the same time
    the facial features of someone standing 20-30 feet away may be a
    blur--it actually looked like if you squinted to *almost* a blur. As it
    cleared up, the (vitreous?) fluid had a slight, but definite, greasy,
    shiny slick to it. It was after those episodes cleared up that I started
    noticing that real small print--like the newspaper stock market
    results--started to become difficult (albeit, just slightly) to read.
    Then, last Feb ('04), another episode started, this time to the point of
    causing some mild inflammation: The distant "wall chart" vision
    remained relatively close to 20/20, but I needed a magnifying glass to
    be able to read even regular newspaper size print!
    Even a couple of months after the inflammation cleared up, it was
    apparent I now needed reading glasses/bifocals: Do I nned reading
    glasses because of the event, or was the vitreous event caused by my eye
    (focus) muscles changing?
    The recent eyeglass history for my left eye is so:

    (Sph = "Sphere", Cyl = "Cylinder", Axs = "Axis";
    Adj.Sph, Adj.Cyl = Adjusted Sph, Cyl = Sph/Cyl + Add)

    Year Sph Cyl Axs Add
    ==== ===== ===== === =====
    1988? -0.25 +2.75 80 ---
    1990 -3.00 +4.00 85 --- Adj.Sph Adj.Cyl
    2002 -2.00 +3.00 80 --- ======= =======
    2004 -2.00 +3.00 85 +1.25 -0.75 +4.25
    2005 -2.00 +3.00 85 +1.75 -0.25 +4.75

    The vision didn't really change between 1988-90, it was just that, until
    the right eye went down the tubes, I had used my eyes complementarily:
    My (then) "bad" (left) eye was used for close-up vision and the (then)
    "good" (right) eye was used for distance.
    Once the right eye became useless, the left eye was re-evaluated.
    A couple of other characteristics/properties that may be contributing
    factor(s):

    --- The left eye pressure is relatively low (7-13--whereas the right eye
    is usually 1 or less!)--so don't even THINK of suggesting anything
    surgical (vitrectomy, LASIK, etc.)! P=/
    --- The left eye also has a slight "reverse sided" cataract (whereas a
    "normal" cataract develops on the outside of the lens, this one is on
    the *inside* of the lens).

    With all that said, here is the $50 question: Is there such a thing as
    "dual focus"?
    In other words, could my distance vision be both -2.00/+3.00 *AND* about
    -0.25/+2.75, with perhaps some tweaking of the Cyl and/or Axs?
    It was during the time I had my order in for my first pair of bifocals
    last summer, that I tried on all of my old glasses and found that my
    "1988" pair seemed perfect for reading--and not half bad for distance!
    Over the past year, since I got the bifocals, I've checked my distance
    vision through the bifocal and it seems less and less clear: When I
    first looked though the "1988" glasses and the bifocals, the distance
    didn't really look blurry, everything just had a slight "ghosting" to it
    (like looking though binoculars or a telescope that is out of focus:
    When you adjust the focus of the binoculars/telescope, are you changing
    the Sph, Cyl, both or neither?); recently, though, I've found that
    looking in the distance through the new bifocals (and "1988" glasses)
    does introduce a definite blurriness, besides the "ghosting" (which my
    oculist said was going to start happening as the "Add" increased, even
    at mid-distance, thus requiring either trifocals or progressives--which
    I *have* considered).
    Even more "perverse", if I turn my glasses backwards so that the outside
    face of the glasses is "facing my face" with the (normally positioned)
    left eyeglass in front of my left eye and the (normally positioned)
    right eyeglass hanging off to the left of my head: If I rest the top
    edge of my left eyeglass against my left eyebrow, tilt the bottom of the
    resting eyeglass out/up slightly (15°-30°--The Sph and/or Cyl
    component/action?)) and turn the tilted glass slightly counterclockwise
    (5°-15°--The Cyl and/or Axs component/action), (albeit, everything looks
    a little smaller) looking through the upper part of the bifocal section,
    the distance looks almost as clear as through the regular distance part
    of the lens! The kicker is that when I turn my attention to up close
    (intended "bifocal") vision, holding the glasses in the same position,
    at the same angle, looking out through the same area of the bifocal, I
    can still read up close, perfectly clear (maybe even *slightly* better
    than via the prescribed way!), whereas the non-bifocal part is just as
    fuzzy as the other way!!
    Thus the main question: Is it possible to have two (or more) equally
    valid focal values, at least for distance?
    One difference I notice is that, looking through the regular distance
    lens, the "vitreous wad" is more like a "puff of smoke" and out of
    focus, whereas, through the bifocal, everything looks "watery" (at
    times, anyways, even a little greasy?), like I am looking through a
    clear piece of "Saran Wrap" that is spread out but anchored underwater
    (i.e., I am looking *through* the vitreal fluid--at least more--in focus?).
    Could the "ghosting"/slight double imaging (at least partly) be the
    image reflecting (refracting?) off of the vitreous, like looking through
    a double paned window, thus what may be my "natural" 20/20 vision with
    -0.25/+2.75 is "ghosted" by the "double pane" effect of the vitreous,
    which is cancelled out with the -2.00/+3.00 values--and now that it is
    starting to present itself, presbyopia isn't compatible with the
    -2.00/+3.00 values???
    Can the Cyl and Axs have two different values for bifocals or does the
    bifocal and rest of the glass have to have the same values?
     
    Dick Dead-Eye, Aug 29, 2005
    #1
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