What happened with my refraction?

Discussion in 'Optometry Archives' started by Quick, Jul 27, 2005.

  1. Quick

    Quick Guest

    (I gather it's called a refraction)
    I got fitted for contacts.
    I wanted bi/multi focals. I've been using +2.00
    store bought readers for a couple of years now.

    First exam the doc dilated and used the machine
    you look through at the projected eye chart on the
    wall. "better?", "how about now?", "and now?". One
    eye at a time. Things looked pretty sharp. He trialed
    me with acuvue bifocals. Outside distance was really
    bad. Out of focus, blurry, maybe multiple images. I
    figured it would take time for my brain to deal with
    the multiple images. Over about three weeks I went
    back multiple times and he must have checked me
    with the machine at least 3 more times. Once with the
    contacts in. The distance never got much better. I
    really didn't have a noticeable problem with my distance
    vision before and this was notably worse. He said I
    had a small astigmatism in one eye and very slight in
    the other. I got the impression that he thought it wasn't
    significant enough to take into account.

    We started with:
    Right: +0.75 add +2.50
    Left: +1.25 add +2.00

    Then went to:
    Right: +1.00 add +2.00
    Left: +1.50 add +2.00

    Near was pretty good all the time. I got the impression
    that he was pretty much done with me (like I'd used up
    my trial shot and it was time move on). I suggested that
    we try less distance power since it was *way* better

    Last shot:
    Right: +0.50 add +2.50
    Left: +0.50 add +2.50

    I had had asked to try a bit more add and I think the
    +2.00 was a bit better. Too bad they don't come in +2.25.
    The distance got much better but still the same problem
    just not as bad -- actually about half as bad?

    Anyway the last visit he said we'd tried just about everything
    and "95% of people would be really happy with this vision".
    Basically I think he was just done with me. I don't think he
    was a quack or anything (nice enough guy) but I ended up
    with the impression that when I signed up he was going to
    put me in acuvue bifocals and that was it. I'm just writing it
    off and will start over with another doc. I just told him to send
    my supply to me with the last script -- probably just end up
    tossing them. I really want to try RGPs.

    I probably should have had him send me +0.00 add +2.00?
    My main objective is to get rid of the readers.

    My question is this: It seemed that I could see very sharply
    when tested. Better than uncorrected maybe at distance.
    Darkened room with projected eye chart. Looked to be about
    15 to 20 feet. But only once for a bit did he have me looking
    through both eyes at the same time. But outside of the exam
    room my vision is worse at distance. Maybe past 20 or 30 feet
    to infinity.

    Any ideas? thanks,
    Quick, Jul 27, 2005
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  2. If the room was a bit short, then far distance would be blurry and you
    would have ended up with a stronger prescription. however, the OD
    should know the room is a bit short and be able to compensate.
    firebrandfaerie, Jul 28, 2005
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  3. Quick

    Dr Judy Guest

    \ He trialed
    If you had tried progressive glasses, single vision distance glasses or
    single vision distance contacts, you likely would have also noted clear
    distance vision in the real world. Multifocal contact lenses do cause some
    "ghosting" of distance vision that about 10% to 15% of people can't
    tolerate. If you are determined, you could try another fitter who has more
    than one brand of multifocal to offer and who has lots of experience. And
    you might give monovision (correcting one eye only for near) a try.

    In a case like yours, I would have considered trying the B&L multifocal to
    see if it gave a better result. Or would have tried a modified monovision
    fit, using something like +0.50/ +1.50 add or pl/ +2.00 add in the right eye
    and +1.00/+200 add or +0.50/+2.50 add in the left.

    It does take some fiddling to get multifocals to work. I find that fitting
    people who are used to just readers with no distance correction are among
    the most challenging. And some people's brains just won't accept any
    multifocal contact.

    Dr Judy
    Dr Judy, Jul 28, 2005
  4. Quick

    Quick Guest

    Thanks for the response.

    It's sounding a bit depressing as I was really looking
    forward to the best case -- 6 million dollar man eyes
    and no need to carry the readers... I am determined
    to keep plugging and throwing money at it for a while.

    I already have an appointment with the next doc. He
    said he doesn't fit (many?) Acuvues or CIba because
    he has too many failures with them. At least we'll be
    into other brands. I'm pretty determined to try RGPs
    to at least see what they're like.

    I guess if multifocals just don't work for me the next
    choice would be translating bifocals? I really don't
    want to do monovision as I don't want to sacrifice
    depth perception.

    How much of the flare off of lights is attributable to
    multifocals as opposed to single vision?

    If I went from multifocal soft lenses to translating
    RGPs would I expect to see a noticeable reduction
    in the flare and halo effect? (and the distance problems
    I'm currently experiencing)?

    Quick, Jul 28, 2005
  5. Yes. The quality of vision in gas perm multifocals is vastly superior
    to soft lenses. They are never even close to each other in quality of
    vision. I have 30 happy gas perm bifocal wearewrs for each "happy"
    soft bifocal wearer.
    doctor_my_eye, Jul 28, 2005
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