Would stronger reading correction fix this problem?

Discussion in 'Optometry Archives' started by Patty, Oct 30, 2003.

  1. Patty

    Patty Guest

    I recently got my first pair of glasses with reading correction. The
    prescription is:

    O.D.: SPH. -5.00 ADD +1.25
    O.S.: SPH. -5.00 ADD +1.25

    They are Varilux Panamic lenses. My previous prescription was:

    O.D.: SPH. -4.75
    O.S.: SPH. -4.75

    I've had the new glasses for almost 2 weeks now and I'm a little
    disappointed because I still have to take my glasses off to do certain
    things up close. Reading is OK, but it was OK before. I went back to my
    eye doctor to get the prescription rechecked. After the new exam he still
    feels that +1.25 is right for me. The new prescription is:

    O.D.: SPH. -5.00 ADD +1.25
    O.S.: SPH. -5.25 ADD +1.25

    After thinking this over last night, I'm wondering if the source of the
    problem is the fact that I read at lap distance (which is where they told me
    to hold the card when they checked my near vision) but the things I have
    trouble seeing up close are more like 8" from my face (example- clipping my
    2-yr.-old's fingernails). To be more specific, here are the distances I

    Reading a book - 20" from face - glasses OK
    Reading a newspaper spread out on a table - 17"-24" from face - glasses
    Clipping daughter's nails - 8" from face - glasses no good
    Anything closer than 12" from face - glasses no good

    So, would a stronger reading correction allow me to see clearly 8" from my
    face? If so, what would then happen at lap distance, where I typically hold
    a book? Is it unrealistic to expect these glasses to correct everything?
    Being new to presbyopia I just don't know how much correction is possible
    and so I don't know whether I should go back and insist on another
    prescription. I would say these glasses are good for about 95% of what I
    do. It's just upsetting that after spending $330 for new lenses I still
    have the same problem I had before - needing to remove the glasses for
    up-close work. (Reading was OK before with the -4.75 lenses, although I
    must admit it's better with these new ones).

    Any advice or info on this problem would be greatly appreciated. If you
    choose to reply by email, please remove the REMOVE from the address. Thanks
    very much.

    Patty, Oct 30, 2003
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  2. Patty

    Mark A Guest

    If the OD determined your reading (near) vision at about 20", then it is not
    surprising that you would have trouble at 8". But normal reading distance is
    about 13" and at 8" you still would not have optimal vision (although it
    would obviously be much better).

    Progressive lens have the ability to focus from the near to the far
    (including all points in between). That's why they are called progressive
    lenses. However the intermediate vision channel is smaller than either the
    near (reading) or the far. So if the OD set the near vision to 8-10" then
    the width of the intermediate power (at 20" for example) would much narrower
    and shorter than the near vision area. You might find this to be very
    annoying while reading.
    Mark A, Oct 30, 2003
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  3. Patty

    Dr Judy Guest


    You have just discovered the joy of being a myopic presbyope, when you take
    off your glasses you can see really close up! Being able to read at 8" is
    one of the reasons I will never have LASIK.

    If the reading add were set to allow you to see clearly at 12" to 8", you
    would be blurred at 18", even with a progressive. Even if the 18" was
    clear, the clear area would be narrow and the distortions much greater.
    You could ask your doctor to change the add to +1.75 or +2.00, which may get
    you the 12" to 14" distance, but don't go any stronger.

    No glasses can ever restore near vision to how it was before age 40,
    although progressives come close. Take your glasses off for the odd task
    that needs it and take delight in knowing that your presbyopic, non myopic
    friends have to resort to a magnifying glasse on top of their progressives
    to achieve the same vision.

    Dr Judy
    Dr Judy, Oct 30, 2003
  4. Patty

    Dan Abel Guest

    Welcome to presbyopia! A stronger correction would indeed let you see at
    8", but probably wouldn't work for reading. Since you probably spend a
    lot more time reading than cutting your kid's nails, you probably should
    stick with what you have. For myself, the amount of time I spend looking
    at stuff 8" away is pretty minimal. I would suggest that taking your
    glasses off is the best solution.
    Dan Abel, Oct 30, 2003
  5. Patty

    Otis Brown Guest

    Dear Patty,

    Your -5 prescription enables you to see sharp 20/20, or perfect.

    The near prescription gives you clear vision
    starting at 31.5 inches, (by calculation). Depending on your age
    (and amount of your accommodation you might be able to
    read at 20 inches, and that assumes that you have
    about 1 diopter of "accommodation."

    If you are having difficulty reading at 20 inches, you
    might ask that the increase the amount of "add" to
    your prescription.


    Otis Brown, Oct 30, 2003
  6. Patty,

    No. Everything you describe is as it should be. Any increase in add
    power will complicate the lens function at normal distances and will
    have no affect on the 8" distance. Non-myopes in your age group have
    to put on reading glasses *and* use a magnifying glass or loupe at 8".

    Hope this helps

    Robert Martellaro
    Roberts Optical
    Robert Martellaro, Oct 31, 2003
  7. Patty

    drfrank21 Guest

    Contrary to most of the replies here, I usually have good success
    by just bumping the add pwr another +.25 to +.50 d (in this case
    to a +150 or even a +175 add) which solves the patient's problems.
    I take also in consideration that if a moderate myope (such as a -5.00 d)
    is used to removing his/her lenses anyway for near work one can be
    a little bit more liberal in the add pwr versus a hyperope or low minus

    So I would ask the doc to "trial frame" the stronger add (such
    as +1.50/+1.75 add pwr) and see if this is indeed more comfortalble
    for you.

    drfrank21, Oct 31, 2003
  8. Patty

    Patty Guest

    Is this trial frame like a temporary lens holder that the doctor can put
    different sample lenses into? If so, I assume I would wear my current
    glasses and this trial frame together to judge the effect of a change in the
    add power. I suppose that this trial method wouldn't show the resulting
    change in the other "channels" of the lens, but it sounds like you think
    that those changes would be minimal, is that right?

    Patty, Oct 31, 2003
  9. Patty

    drfrank21 Guest

    I don't think Patty is a 70 year old where a +3.50 would be required for
    8"; am just saying a a +.50 bump up in add power would probably help overall
    so she wouldn't have to hold things at 20" to read a book. And a simple trial
    frame by the doc (or even the optician) would show Patty what the differnce
    would be. Still sounds like she's a little underplussed at near.

    As you must know Robert there isn't necessarily a "correct power" or
    prescription but what is most comfortable vision- wise for the patient.
    Maybe a +1.50 or +1.75 add would indeed be more comfortable for the patient.

    drfrank21, Nov 1, 2003
  10. Patty

    Mark A Guest

    Being farsighted, I wear two pair of glasses to read the small print. The
    older ones fit nicely over might current pair.
    Mark A, Nov 3, 2003
  11. Patty

    Patty Guest

    Just to clear up some questions that have arisen in this thread:

    I'm 44 years old, 5'6" tall, and I hold a book in my lap to read - this is
    20" from my face. This is where I choose to read - it's easier to just rest
    the book in my lap rather than hold it up with my arms.
    It's not because I can't see it closer than 20".

    At the eye exam, they told me to hold a card at my normal reading distance,
    so I held it in my lap - 20" from my face. Then they told me to read the
    smallest line of print that was clear. They never actually put any lenses
    on me.

    When you say you see "nothing but trouble if the add is overplussed" could
    you be more specific about what would happen with a small change from what I
    currently have (+1.25) to say +1.50 or +1.75? I don't have any previous
    experience with multifocal lenses so I don't know what the consequences of a
    change might be. I do understand that you think a small change would still
    not be enough to see at 8".

    Patty, Nov 4, 2003
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