Question
My daughter's vision therapist comments that there is a lot of "instability" in her eyes. She says she tries one lens in her eye and the eyes focus one way, and then tries another lens and the eyes focus differently. Also she just had an expander placed in her mouth by the orthodontist. Can this potentially affect her vision (ie by moving around the bony structures of her face)?
Answer
I honestly do not think the expander is likely to be contributing to the eyes being unstable. But the very fact that your daughter is in vision therapy is a more likely explanation. People needing vision therapy are more likely to have problems like what your therapist calls "instability." Stick with the therapy and the problem will most likely improve.
Tuesday, March 16, 2010
Chronic left eye irritation
Question
29 y/o Male with chronic left eye irritation. Perfect vision. No Problems with right eye.
I did have an eye injury in Marine Corps from a small sliver of metal about 6 years ago. The Metal was removed, but evidently left a small scar on the lens of my eye. I got out of the military and went to college, but was irritated with my left eye the whole 4 years. I don't know if the scar is part of my problem or not, but here are the rest of my symptoms:
-Eye is fine in the mornings for the most part.
-As the day goes on it feels dry and stings.
-There are stringy strands that appear in the eye and eventually end up in the corner of my eye if I don't pick them out first.
-The left eye does not drop tears onto my face like the right eye does when crying.
Eye Doctor said blepharitis a couple of years ago, but treating it as such does not help.
Would you please give your opinion on what is wrong with my left eye.
Ron
Answer
Without seeing you this will be difficult, but let me throw out some ideas:
- the stringy strands are a hallmark of ocular allergy. Now by the other symptoms I am sure allergy is not the only problem, but may be part of it. Try cold compresses and an over the counter anti-histamine drop (ask the pharmacist.)
-the injury from 6 years ago makes me think you may have recurrent corneal erosion - the top layer of the cornea did not heal properly and sometimes the epithelium wears off and exposes the very sensitive nerves beneath it. (however, recurrent erosions are usually worse in the morning) This would need to be treated, preferably by a corneal specialist.
-just plain dry eye. (the stinging and burning) for this I would first try putting in artificial tears every hour or so for a few weeks. If it helps, back down the frequency to see how far you can go between drops to stay comfortable.
-the left eye not tearing makes me wonder if there was more damage from that injury that somehow affected the tear glands. But that sounds far-fetched.
-the fact that you had blepharitis makes me wonder if you might also have meibomian gland dysfunction (also called posterior blepharitis) It is very common and often gets missed by an eye doctor not specifically looking for it. This would have to be diagnosed and treated by an eye doctor.
I would try the anti-histamine drops and artificial tears. If that does not help, try to see a corneal specialist - or someone who specializes in dry eye conditions. They could prescribe better allergy drops than you could get over the counter, check for recurrent erosion and the meibomian gland dysfunction and treat accordingly. There is even a prescription drop for dry eye now called Restasis that might be of some help, depending how the exam goes.
Good luck with solving this problem.
29 y/o Male with chronic left eye irritation. Perfect vision. No Problems with right eye.
I did have an eye injury in Marine Corps from a small sliver of metal about 6 years ago. The Metal was removed, but evidently left a small scar on the lens of my eye. I got out of the military and went to college, but was irritated with my left eye the whole 4 years. I don't know if the scar is part of my problem or not, but here are the rest of my symptoms:
-Eye is fine in the mornings for the most part.
-As the day goes on it feels dry and stings.
-There are stringy strands that appear in the eye and eventually end up in the corner of my eye if I don't pick them out first.
-The left eye does not drop tears onto my face like the right eye does when crying.
Eye Doctor said blepharitis a couple of years ago, but treating it as such does not help.
Would you please give your opinion on what is wrong with my left eye.
Ron
Answer
Without seeing you this will be difficult, but let me throw out some ideas:
- the stringy strands are a hallmark of ocular allergy. Now by the other symptoms I am sure allergy is not the only problem, but may be part of it. Try cold compresses and an over the counter anti-histamine drop (ask the pharmacist.)
-the injury from 6 years ago makes me think you may have recurrent corneal erosion - the top layer of the cornea did not heal properly and sometimes the epithelium wears off and exposes the very sensitive nerves beneath it. (however, recurrent erosions are usually worse in the morning) This would need to be treated, preferably by a corneal specialist.
-just plain dry eye. (the stinging and burning) for this I would first try putting in artificial tears every hour or so for a few weeks. If it helps, back down the frequency to see how far you can go between drops to stay comfortable.
-the left eye not tearing makes me wonder if there was more damage from that injury that somehow affected the tear glands. But that sounds far-fetched.
-the fact that you had blepharitis makes me wonder if you might also have meibomian gland dysfunction (also called posterior blepharitis) It is very common and often gets missed by an eye doctor not specifically looking for it. This would have to be diagnosed and treated by an eye doctor.
I would try the anti-histamine drops and artificial tears. If that does not help, try to see a corneal specialist - or someone who specializes in dry eye conditions. They could prescribe better allergy drops than you could get over the counter, check for recurrent erosion and the meibomian gland dysfunction and treat accordingly. There is even a prescription drop for dry eye now called Restasis that might be of some help, depending how the exam goes.
Good luck with solving this problem.
Posted by
Beacon Lee
question regarding visual acuity
Question
i have applied for a job where the required Vision standards are : 6/6 with out spectacles (or other forms of corrective lensess) and must not suffer from colour / night blindness.
But i put on spectacles with -1.75 D(sph)
so is it 6/6 or not??
Answer
Hi Mayank,
If they require 6/6 withOUT correction, they are being very selective indeed. Your unaided vision would be approximately 6/40 or possibly worse, buy any eye doctor or clinic would be able to measure it for you.
Regards,
Mitch Axelrod,OD
i have applied for a job where the required Vision standards are : 6/6 with out spectacles (or other forms of corrective lensess) and must not suffer from colour / night blindness.
But i put on spectacles with -1.75 D(sph)
so is it 6/6 or not??
Answer
Hi Mayank,
If they require 6/6 withOUT correction, they are being very selective indeed. Your unaided vision would be approximately 6/40 or possibly worse, buy any eye doctor or clinic would be able to measure it for you.
Regards,
Mitch Axelrod,OD
Posted by
Beacon Lee
(Updated) Question on Prescription Problem
Question
Hi, Dr. Placentra Johnston,
I just had my eyes examined by a new eye dr (my old one isn't in the network anymore) for both an eyeglass prescription and contacts. I went through a couple trial lenses before given the contact prescription (monovision lenses). I had the prescription filled by Costco (one year supply) to save money (I have gotten lenses from here before). However, when I put them in, I can't see close-up; I have to put on reading glasses. I asked the dr to double-check the prescription (his wife had written it) and he called me back and said the prescription matched the file, and he didn't know what to tell me. In the meantime I spoke with Costco who compared my old prescription (2 years ago) with this one and said they saw a significant change which they didn't understand, and that may be the problem. Could you take a look at the prescriptions (old contacts, new contacts, new eyeglasses) and tell me what you think the problem could be.
Thank you very much.
Mary
Old contact lens prescription:
Preference Toric; R 8.70, 14.40, -2.25, -.75, 110
L 8.70, 14.40, -.50, -1.25, 50
New contact lens prescription:
Air Optix Toric; R 8.70, 14.50, -3.25, -.75, 120
L 8.70, 14.50, -.50, -1.75, 40
New eyeglass prescription: R -3.75; -0.75, 123
L -2.50; -1.75; 42
Add R +2.25
L +2.25
Answer
It could be the axis shift in the reading eye. The left eye went from axis 50 to axis 40. But your distance eye, the right has gotten much more nearsighted, so that could also be it. Try closing the right eye and see if you can read with the left (with contact lenses on.) If so then the problem is in the right eye. If you can't read well with the left contact lens, the problem would be because your right eye changed so much.
But this should not be your job, or mine. If a patient has a problem with the prescription written, most reputable doctors, will invite the patient to come back in and be re-checked, and usually at no charge. Now, your chances of receiving that invitation decreases significantly when you buy your contact lenses at Costco. In most cases, the doctor is counting heavily on the profit from selling the contact lenses to offset the usually rather low cost (or verylow reimbursement rate from the insurance company) of the eye exam. Your coming back in for a problem visit without having purchased the lenses from him cuts into his profits significantly.
Moreover, if the doctor did not supply the lenses, you are unlikely to be able to trade them back in at Costco if there is a change. This is why it is always better to get your contact lenses from the office that wrote the prescription. You are not just buying materials. There is significant service element that goes along with contact lenses and respect for the need for that service is why the doctor's office may charge a little bit more.
You might ask the doctor to let you come back in for a check-up AND that in the future you will purchase the materials from him.
Hi, Dr. Placentra Johnston,
I just had my eyes examined by a new eye dr (my old one isn't in the network anymore) for both an eyeglass prescription and contacts. I went through a couple trial lenses before given the contact prescription (monovision lenses). I had the prescription filled by Costco (one year supply) to save money (I have gotten lenses from here before). However, when I put them in, I can't see close-up; I have to put on reading glasses. I asked the dr to double-check the prescription (his wife had written it) and he called me back and said the prescription matched the file, and he didn't know what to tell me. In the meantime I spoke with Costco who compared my old prescription (2 years ago) with this one and said they saw a significant change which they didn't understand, and that may be the problem. Could you take a look at the prescriptions (old contacts, new contacts, new eyeglasses) and tell me what you think the problem could be.
Thank you very much.
Mary
Old contact lens prescription:
Preference Toric; R 8.70, 14.40, -2.25, -.75, 110
L 8.70, 14.40, -.50, -1.25, 50
New contact lens prescription:
Air Optix Toric; R 8.70, 14.50, -3.25, -.75, 120
L 8.70, 14.50, -.50, -1.75, 40
New eyeglass prescription: R -3.75; -0.75, 123
L -2.50; -1.75; 42
Add R +2.25
L +2.25
Answer
It could be the axis shift in the reading eye. The left eye went from axis 50 to axis 40. But your distance eye, the right has gotten much more nearsighted, so that could also be it. Try closing the right eye and see if you can read with the left (with contact lenses on.) If so then the problem is in the right eye. If you can't read well with the left contact lens, the problem would be because your right eye changed so much.
But this should not be your job, or mine. If a patient has a problem with the prescription written, most reputable doctors, will invite the patient to come back in and be re-checked, and usually at no charge. Now, your chances of receiving that invitation decreases significantly when you buy your contact lenses at Costco. In most cases, the doctor is counting heavily on the profit from selling the contact lenses to offset the usually rather low cost (or verylow reimbursement rate from the insurance company) of the eye exam. Your coming back in for a problem visit without having purchased the lenses from him cuts into his profits significantly.
Moreover, if the doctor did not supply the lenses, you are unlikely to be able to trade them back in at Costco if there is a change. This is why it is always better to get your contact lenses from the office that wrote the prescription. You are not just buying materials. There is significant service element that goes along with contact lenses and respect for the need for that service is why the doctor's office may charge a little bit more.
You might ask the doctor to let you come back in for a check-up AND that in the future you will purchase the materials from him.
Posted by
Beacon Lee
(Updated) Question on Prescription Problem
Question
QUESTION: Hi, Dr. Placentra Johnston,
I just had my eyes examined by a new eye dr (my old one isn't in the network anymore) for both an eyeglass prescription and contacts. I went through a couple trial lenses before given the contact prescription (monovision lenses). I had the prescription filled by Costco (one year supply) to save money (I have gotten lenses from here before). However, when I put them in, I can't see close-up; I have to put on reading glasses. I asked the dr to double-check the prescription (his wife had written it) and he called me back and said the prescription matched the file, and he didn't know what to tell me. In the meantime I spoke with Costco who compared my old prescription (2 years ago) with this one and said they saw a significant change which they didn't understand, and that may be the problem. Could you take a look at the prescriptions (old contacts, new contacts, new eyeglasses) and tell me what you think the problem could be.
Thank you very much.
Mary
Old contact lens prescription:
Preference Toric; R 8.70, 14.40, -2.25, -.75, 110
L 8.70, 14.40, -.50, -1.25, 50
New contact lens prescription:
Air Optix Toric; R 8.70, 14.50, -3.25, -.75, 120
L 8.70, 14.50, -.50, -1.75, 40
New eyeglass prescription: R -3.75; -0.75, 123
L -2.50; -1.75; 42
Add R +2.25
L +2.25
ANSWER: It could be the axis shift in the reading eye. The left eye went from axis 50 to axis 40. But your distance eye, the right has gotten much more nearsighted, so that could also be it. Try closing the right eye and see if you can read with the left (with contact lenses on.) If so then the problem is in the right eye. If you can't read well with the left contact lens, the problem would be because your right eye changed so much.
But this should not be your job, or mine. If a patient has a problem with the prescription written, most reputable doctors, will invite the patient to come back in and be re-checked, and usually at no charge. Now, your chances of receiving that invitation decreases significantly when you buy your contact lenses at Costco. In most cases, the doctor is counting heavily on the profit from selling the contact lenses to offset the usually rather low cost (or verylow reimbursement rate from the insurance company) of the eye exam. Your coming back in for a problem visit without having purchased the lenses from him cuts into his profits significantly.
Moreover, if the doctor did not supply the lenses, you are unlikely to be able to trade them back in at Costco if there is a change. This is why it is always better to get your contact lenses from the office that wrote the prescription. You are not just buying materials. There is significant service element that goes along with contact lenses and respect for the need for that service is why the doctor's office may charge a little bit more.
You might ask the doctor to let you come back in for a check-up AND that in the future you will purchase the materials from him.
---------- FOLLOW-UP ----------
QUESTION: Dear Dr. Placentra Johnston,
Thank you for taking the time to answer my initial question. What is puzzling to me is why I am having trouble seeing when I went through the trial lens process. I assume it is possible that Costco messed up the order, although I am sure it doesn't happen that often. And you're right, the Dr won't see me again (at least at no charge) based on the fact I didn't get the contacts through him (although I spent a lot more money on the glasses I ordered through him). However, my gut is telling me the prescription wasn't written correctly...that the final trial lens (which I had 3 trials for my left eye) isn't what was ultimately written. Plus I tried two different manufacturers (Accuview and Ciba) although I don't know if that would be a factor. When you look at my eyeglass prescription (I can see out f my glasses fine), how does that translate to contacts? I read that usually the prescription for glasses are stronger than contacts by .25 at least. Perhaps knowing how the eyeglass prescription translates will help me understand what may have happened.
Thanks again for your help.
Mary
Answer
Your contact lens prescription makes sense in view of the glasses Rx. However, the new contact lens prescription is stronger for distance (especially in the right eye) than the old contact lens Rx. This would make it more difficult to read if the increased power were not needed.
Did you try the little exercise I suggested in my first response?
It is indeed very possible that the Rx that got written does not represent the final trial lens you accepted. When there are multiple trial lenses used, it can take a lot of effort of the doctor's part to keep his records straight about which trial lens the patient finally accepted. But....unfortunately, the only one who can solve that for you is the doctor who wrote the Rx. Moreover, even if you and I were able to figure out what the problem is, you would still have to go back through the doctor to get him to rewrite the prescription. The optical shop at Costco is not authorized to change a prescription on the patient's say-so.
I am sorry for your unfortunate situation. As I see it, about the only answer is to bite the dust and pay for another visit with the doctor. ....OR - ask for a copy of all your records and take them to your old doctor (another paid visit of course) to see if he can figure out what you needed. I cannot do this online because in my status here you and I do not have an official doctor/patient relationship and I am not legally able to write or alter a prescription for you.
QUESTION: Hi, Dr. Placentra Johnston,
I just had my eyes examined by a new eye dr (my old one isn't in the network anymore) for both an eyeglass prescription and contacts. I went through a couple trial lenses before given the contact prescription (monovision lenses). I had the prescription filled by Costco (one year supply) to save money (I have gotten lenses from here before). However, when I put them in, I can't see close-up; I have to put on reading glasses. I asked the dr to double-check the prescription (his wife had written it) and he called me back and said the prescription matched the file, and he didn't know what to tell me. In the meantime I spoke with Costco who compared my old prescription (2 years ago) with this one and said they saw a significant change which they didn't understand, and that may be the problem. Could you take a look at the prescriptions (old contacts, new contacts, new eyeglasses) and tell me what you think the problem could be.
Thank you very much.
Mary
Old contact lens prescription:
Preference Toric; R 8.70, 14.40, -2.25, -.75, 110
L 8.70, 14.40, -.50, -1.25, 50
New contact lens prescription:
Air Optix Toric; R 8.70, 14.50, -3.25, -.75, 120
L 8.70, 14.50, -.50, -1.75, 40
New eyeglass prescription: R -3.75; -0.75, 123
L -2.50; -1.75; 42
Add R +2.25
L +2.25
ANSWER: It could be the axis shift in the reading eye. The left eye went from axis 50 to axis 40. But your distance eye, the right has gotten much more nearsighted, so that could also be it. Try closing the right eye and see if you can read with the left (with contact lenses on.) If so then the problem is in the right eye. If you can't read well with the left contact lens, the problem would be because your right eye changed so much.
But this should not be your job, or mine. If a patient has a problem with the prescription written, most reputable doctors, will invite the patient to come back in and be re-checked, and usually at no charge. Now, your chances of receiving that invitation decreases significantly when you buy your contact lenses at Costco. In most cases, the doctor is counting heavily on the profit from selling the contact lenses to offset the usually rather low cost (or verylow reimbursement rate from the insurance company) of the eye exam. Your coming back in for a problem visit without having purchased the lenses from him cuts into his profits significantly.
Moreover, if the doctor did not supply the lenses, you are unlikely to be able to trade them back in at Costco if there is a change. This is why it is always better to get your contact lenses from the office that wrote the prescription. You are not just buying materials. There is significant service element that goes along with contact lenses and respect for the need for that service is why the doctor's office may charge a little bit more.
You might ask the doctor to let you come back in for a check-up AND that in the future you will purchase the materials from him.
---------- FOLLOW-UP ----------
QUESTION: Dear Dr. Placentra Johnston,
Thank you for taking the time to answer my initial question. What is puzzling to me is why I am having trouble seeing when I went through the trial lens process. I assume it is possible that Costco messed up the order, although I am sure it doesn't happen that often. And you're right, the Dr won't see me again (at least at no charge) based on the fact I didn't get the contacts through him (although I spent a lot more money on the glasses I ordered through him). However, my gut is telling me the prescription wasn't written correctly...that the final trial lens (which I had 3 trials for my left eye) isn't what was ultimately written. Plus I tried two different manufacturers (Accuview and Ciba) although I don't know if that would be a factor. When you look at my eyeglass prescription (I can see out f my glasses fine), how does that translate to contacts? I read that usually the prescription for glasses are stronger than contacts by .25 at least. Perhaps knowing how the eyeglass prescription translates will help me understand what may have happened.
Thanks again for your help.
Mary
Answer
Your contact lens prescription makes sense in view of the glasses Rx. However, the new contact lens prescription is stronger for distance (especially in the right eye) than the old contact lens Rx. This would make it more difficult to read if the increased power were not needed.
Did you try the little exercise I suggested in my first response?
It is indeed very possible that the Rx that got written does not represent the final trial lens you accepted. When there are multiple trial lenses used, it can take a lot of effort of the doctor's part to keep his records straight about which trial lens the patient finally accepted. But....unfortunately, the only one who can solve that for you is the doctor who wrote the Rx. Moreover, even if you and I were able to figure out what the problem is, you would still have to go back through the doctor to get him to rewrite the prescription. The optical shop at Costco is not authorized to change a prescription on the patient's say-so.
I am sorry for your unfortunate situation. As I see it, about the only answer is to bite the dust and pay for another visit with the doctor. ....OR - ask for a copy of all your records and take them to your old doctor (another paid visit of course) to see if he can figure out what you needed. I cannot do this online because in my status here you and I do not have an official doctor/patient relationship and I am not legally able to write or alter a prescription for you.
Posted by
Beacon Lee
enopthalamos question
Question
hi
i recently noticed my left eyelid droops lower than my right eyelid. recently i had a maxillary sinus fracture. could a maxillary sinus fracture result in enopthalamos?
Answer
Dear Jonathan,
The superior wall ( roof) of the maxillary sinus is the same as the floor of the orbit. A fracture involving this wall of the maxillary sinus can cause enophthalmos. We shallneed a CT Scan to determine what exactly is the case.
You can e mail the report to dranand@lasikindia.in
Hope this helps,
Best,
Dr Anand Shroff
www.shroffeye.org
hi
i recently noticed my left eyelid droops lower than my right eyelid. recently i had a maxillary sinus fracture. could a maxillary sinus fracture result in enopthalamos?
Answer
Dear Jonathan,
The superior wall ( roof) of the maxillary sinus is the same as the floor of the orbit. A fracture involving this wall of the maxillary sinus can cause enophthalmos. We shallneed a CT Scan to determine what exactly is the case.
You can e mail the report to dranand@lasikindia.in
Hope this helps,
Best,
Dr Anand Shroff
www.shroffeye.org
Posted by
Beacon Lee
can i get my vision back
Question
I sas stabbed in my eye abot 3 years ago and have very minimal vision out my left eye the doctors took out my lens and said that i also suffered from a lot of blood in my eye would a cornea transplant give me my vision back
Answer
I am sorry to say that it is doubtful you could get your vision back from a corneal transplant, or surely the doctors would have recommended it. I am sure you have a lot of corneal scarring if whatever you were stabbed with went through your cornea. But, depending how far into the eye the weapon traveled, there could also have been damage to your retina and that would most likely not be fixable. Since I cannot see your eye, I cannot determine this. However, a visit to almost any eye doctor should result in an answer to your question.
I sas stabbed in my eye abot 3 years ago and have very minimal vision out my left eye the doctors took out my lens and said that i also suffered from a lot of blood in my eye would a cornea transplant give me my vision back
Answer
I am sorry to say that it is doubtful you could get your vision back from a corneal transplant, or surely the doctors would have recommended it. I am sure you have a lot of corneal scarring if whatever you were stabbed with went through your cornea. But, depending how far into the eye the weapon traveled, there could also have been damage to your retina and that would most likely not be fixable. Since I cannot see your eye, I cannot determine this. However, a visit to almost any eye doctor should result in an answer to your question.
Posted by
Beacon Lee
Eye Trouble
Question
Dr. Axelrod,
My eyes water a lot. Sometimes, it also pains in the eyes. So I've to resort to eye drops after which, I feel better. This has been the case since the past 12 years. I'm 26 years of age. I saw a solar eclipse back in 1995.
My eyes usually water in winters but this is not always the case. I've contacted many eye specialists/surgeons. My eyes and eyesight are 100% okay except for a few minute lines on the eyes and even though my eyesight is ok, I wanted to know whether this is some disease and will this trouble me in future.
Thanking you and waiting for an answer.
Answer
Hi Abhishek,
Usually the cause would be dryness or an incompetent tear film. Since drops help it is likely the case. You can try gently massaging the edges of both upper and lower eyelids with very warm water while the eyes are closed for a minute each day and take fish oil / flax seed oil omega 3/6 etc. Nothing to do with the eclipse and I don't know what you mean by minute lines. Certainly an eye doctor can address these issues as they are common. Generally our eyes get dry and irritated more easily as we age but it isn't truly serious. Use lubicatig drops not the ones that advertise redness removal.
Good luck,
Mitch Axelrod, OD
Dr. Axelrod,
My eyes water a lot. Sometimes, it also pains in the eyes. So I've to resort to eye drops after which, I feel better. This has been the case since the past 12 years. I'm 26 years of age. I saw a solar eclipse back in 1995.
My eyes usually water in winters but this is not always the case. I've contacted many eye specialists/surgeons. My eyes and eyesight are 100% okay except for a few minute lines on the eyes and even though my eyesight is ok, I wanted to know whether this is some disease and will this trouble me in future.
Thanking you and waiting for an answer.
Answer
Hi Abhishek,
Usually the cause would be dryness or an incompetent tear film. Since drops help it is likely the case. You can try gently massaging the edges of both upper and lower eyelids with very warm water while the eyes are closed for a minute each day and take fish oil / flax seed oil omega 3/6 etc. Nothing to do with the eclipse and I don't know what you mean by minute lines. Certainly an eye doctor can address these issues as they are common. Generally our eyes get dry and irritated more easily as we age but it isn't truly serious. Use lubicatig drops not the ones that advertise redness removal.
Good luck,
Mitch Axelrod, OD
Posted by
Beacon Lee
eye problem
Question
Dr. Johnston,
My eyes water a lot. Sometimes, it also pains in the eyes. So I've to resort to eye drops after which, I feel better. This has been the case since the past 12 years. I'm 26 years of age. I saw a solar eclipse back in 1995.
My eyes usually water in winters but this is not always the case. I've contacted many eye specialists/surgeons. My eyes and eyesight are 100% okay except for a few minute lines on the eyes and even though my eyesight is ok, I wanted to know whether this is some disease and will this trouble me in future.
Thanking you and waiting for an answer.
Answer
It is difficult to say whether your eyes were damaged by viewing that solar eclipse back in 1995 without even doing an exam on you. But even with an exam, damage like that would be hard for a doctor to see.
But since you complain of watering and pain that is resolved by the use of eye drops, it makes me wonder if you might just have dry eye. This is somewhat unusual in a 26 year old, but still is quite possible. I know, your complaint is watering, not dryness. But, actually excess tearing IS a symptom of dry eye. If the tears are not of the proper chemical mix then your eye feels dry and makes more of the watery layer of tears, when in fact it is one of the other layers (oily layer or mucous layer) that is deficient.
Dry eye is treatable now by a prescription eyedrop called Restasis but I would not know if this is available in India or what it would be called there. It is a drug based on cyclosporin and its purpose is to decrease inflammation. A lot of dry eye now is being attributed to inflammation.
Another way of decreasing inflammation is the use of Omega 3 fatty oils (fish oil or flax seed oil) in your diet. But before you go trying all that, you would need an eye doctor to specifically test you for dry eye.
If you don't have dry eye syndrome, then your complaints may very well relate to the solar eclipse exposure you suffered 12 years ago. I would continue the use of eye drops as much as is necessary to control the symptoms and minimize further exposure to the sun. (wear sunglasses and a sun visor when outdoors) As for long term problems from this, it is very difficult to say. While whatever damage you had, IF there was damage at all, happened long ago, but when we are younger, our bodies generally compensate better for physical problems than they do when we are older. I am sorry to say: it is possible that you may note some changes when you are older resulting from exposure to that eclipse.
Dr. Johnston,
My eyes water a lot. Sometimes, it also pains in the eyes. So I've to resort to eye drops after which, I feel better. This has been the case since the past 12 years. I'm 26 years of age. I saw a solar eclipse back in 1995.
My eyes usually water in winters but this is not always the case. I've contacted many eye specialists/surgeons. My eyes and eyesight are 100% okay except for a few minute lines on the eyes and even though my eyesight is ok, I wanted to know whether this is some disease and will this trouble me in future.
Thanking you and waiting for an answer.
Answer
It is difficult to say whether your eyes were damaged by viewing that solar eclipse back in 1995 without even doing an exam on you. But even with an exam, damage like that would be hard for a doctor to see.
But since you complain of watering and pain that is resolved by the use of eye drops, it makes me wonder if you might just have dry eye. This is somewhat unusual in a 26 year old, but still is quite possible. I know, your complaint is watering, not dryness. But, actually excess tearing IS a symptom of dry eye. If the tears are not of the proper chemical mix then your eye feels dry and makes more of the watery layer of tears, when in fact it is one of the other layers (oily layer or mucous layer) that is deficient.
Dry eye is treatable now by a prescription eyedrop called Restasis but I would not know if this is available in India or what it would be called there. It is a drug based on cyclosporin and its purpose is to decrease inflammation. A lot of dry eye now is being attributed to inflammation.
Another way of decreasing inflammation is the use of Omega 3 fatty oils (fish oil or flax seed oil) in your diet. But before you go trying all that, you would need an eye doctor to specifically test you for dry eye.
If you don't have dry eye syndrome, then your complaints may very well relate to the solar eclipse exposure you suffered 12 years ago. I would continue the use of eye drops as much as is necessary to control the symptoms and minimize further exposure to the sun. (wear sunglasses and a sun visor when outdoors) As for long term problems from this, it is very difficult to say. While whatever damage you had, IF there was damage at all, happened long ago, but when we are younger, our bodies generally compensate better for physical problems than they do when we are older. I am sorry to say: it is possible that you may note some changes when you are older resulting from exposure to that eclipse.
Posted by
Beacon Lee
Is Equate multipurpose solution regulated by the FDA?
Question
My eye doctor recently recommended that I use Opti Free multi purpose solution rather than Equate multipurpose solution. She said that Equate multipurpose solution was not regulated by the FDA. Is that true?
I have been using Equate multipurpose solution without incident for yrs now. Opti free multipurpose solution costs roughly $14 vs Equate which costs roughly $4.
Answer
Yes, that is true in the sense that Equate is not a particular chemical formula.
What the repackagers do, from what I understand, is take bids from the various manufacturers to supply them with large batches of one of their older contact lens formulas. (these are older products that of course at one time met FDA standards but have been replaced by the newer formulas that represent the latest advancements in technology and are sold under the brand names.) Whoever gives the repacker the best price that year (or whatever span of time is in question) is the manufacturer that gets the contract (this time) and that formula is what is sold as "Equate" or whatever "big box" brand.
But the problem is, for those who are allergic, or if there is a problem with that solution, as there was a few years back with several of the products, there is no simple way to be sure which product is in the Equate bottle.
The next time the bidding goes out, another manufacturer may win the bid and THEIR product is then sold as "Equate," in fact a different product under the same name.
For someone who is allergic to one of these formulas, this can cause uncomfortable consequences. The solution manufacturers like to claim 1 or 2% allergy rates to their products, which is probably one reason this repackaging process is permitted. But in practice I have always suspected the rate of people who are intolerant (cannot use a certain solution due to poor reactions that are not exactly the same as allergy) to be much, much higher.
For this reason, if you always use a certain name brand, and if you have a problem, your doctor can easily direct you to a solution that will solve the problem. Not so if you have been using a generic product of uncertain origin and chemical formula.
My eye doctor recently recommended that I use Opti Free multi purpose solution rather than Equate multipurpose solution. She said that Equate multipurpose solution was not regulated by the FDA. Is that true?
I have been using Equate multipurpose solution without incident for yrs now. Opti free multipurpose solution costs roughly $14 vs Equate which costs roughly $4.
Answer
Yes, that is true in the sense that Equate is not a particular chemical formula.
What the repackagers do, from what I understand, is take bids from the various manufacturers to supply them with large batches of one of their older contact lens formulas. (these are older products that of course at one time met FDA standards but have been replaced by the newer formulas that represent the latest advancements in technology and are sold under the brand names.) Whoever gives the repacker the best price that year (or whatever span of time is in question) is the manufacturer that gets the contract (this time) and that formula is what is sold as "Equate" or whatever "big box" brand.
But the problem is, for those who are allergic, or if there is a problem with that solution, as there was a few years back with several of the products, there is no simple way to be sure which product is in the Equate bottle.
The next time the bidding goes out, another manufacturer may win the bid and THEIR product is then sold as "Equate," in fact a different product under the same name.
For someone who is allergic to one of these formulas, this can cause uncomfortable consequences. The solution manufacturers like to claim 1 or 2% allergy rates to their products, which is probably one reason this repackaging process is permitted. But in practice I have always suspected the rate of people who are intolerant (cannot use a certain solution due to poor reactions that are not exactly the same as allergy) to be much, much higher.
For this reason, if you always use a certain name brand, and if you have a problem, your doctor can easily direct you to a solution that will solve the problem. Not so if you have been using a generic product of uncertain origin and chemical formula.
Posted by
Beacon Lee
Eye Color
Question
Hello if the eye was to suffer a thermal heat burn and the heat charred the eye would it cause a color change by darkening the color of the iris if so would there be any way of restoring the eyes color back to the way it was. Thank you.
Answer
Dear Peter,
There may be treatments which are more cosmetic but depend on the eye condition.
We need to know the extent of injury, as to what part has been injured. Is the cornea alone been affected? or there is accompanying intraocular damage as well.
Please get an ophthalmologist to examine and send us the report on dranand@lasikindia.in
We can guide you better after seeing the report.
Regards,
Dr Shroff
www.shroffeye.org
Hello if the eye was to suffer a thermal heat burn and the heat charred the eye would it cause a color change by darkening the color of the iris if so would there be any way of restoring the eyes color back to the way it was. Thank you.
Answer
Dear Peter,
There may be treatments which are more cosmetic but depend on the eye condition.
We need to know the extent of injury, as to what part has been injured. Is the cornea alone been affected? or there is accompanying intraocular damage as well.
Please get an ophthalmologist to examine and send us the report on dranand@lasikindia.in
We can guide you better after seeing the report.
Regards,
Dr Shroff
www.shroffeye.org
Posted by
Beacon Lee
enopthalamos question
Question
QUESTION: hi
i recently noticed my left eyelid droops lower than my right eyelid. recently i had a maxillary sinus fracture. could a maxillary sinus fracture result in enopthalamos?
ANSWER: Dear Jonathan,
The superior wall ( roof) of the maxillary sinus is the same as the floor of the orbit. A fracture involving this wall of the maxillary sinus can cause enophthalmos. We shallneed a CT Scan to determine what exactly is the case.
You can e mail the report to dranand@lasikindia.in
Hope this helps,
Best,
Dr Anand Shroff
www.shroffeye.org
---------- FOLLOW-UP ----------
QUESTION: Hello Dr. Shroff
I sent the medical records to you, were you able to receive them? Looking forward to your feedback. Thank you for your help sir.
Answer
Dear Jonathan,
Yes I did, you have a fracture of the maxillary sinus and hence the enophthalmos.Also, there is deviation of the nasal septum, however do not know if this was pre existing or happened after the injury, but this too can cause enophthalomos if due to the injury.
You need to see either an occuloplastic surgeon or a maxillofacial surgeon
Hope this helps,
Best,
Anand
QUESTION: hi
i recently noticed my left eyelid droops lower than my right eyelid. recently i had a maxillary sinus fracture. could a maxillary sinus fracture result in enopthalamos?
ANSWER: Dear Jonathan,
The superior wall ( roof) of the maxillary sinus is the same as the floor of the orbit. A fracture involving this wall of the maxillary sinus can cause enophthalmos. We shallneed a CT Scan to determine what exactly is the case.
You can e mail the report to dranand@lasikindia.in
Hope this helps,
Best,
Dr Anand Shroff
www.shroffeye.org
---------- FOLLOW-UP ----------
QUESTION: Hello Dr. Shroff
I sent the medical records to you, were you able to receive them? Looking forward to your feedback. Thank you for your help sir.
Answer
Dear Jonathan,
Yes I did, you have a fracture of the maxillary sinus and hence the enophthalmos.Also, there is deviation of the nasal septum, however do not know if this was pre existing or happened after the injury, but this too can cause enophthalomos if due to the injury.
You need to see either an occuloplastic surgeon or a maxillofacial surgeon
Hope this helps,
Best,
Anand
Posted by
Beacon Lee
strabismus, fish eye, dead eye
Question
I have had strabismus for about 40 years. I call the condition dead eye or fish eye because when looking straight on, the left eye does not seem to focus on anything. I now have a cataract on the left eye and I will be getting a lens implant. My question is will this lens implant improve my overall ability to focus and actual look like the eye is focusing?
Answer
Hi Sheryl,
I don't have enough information to know what your post-operative eye will be capable of. Your eye doctor should be able to answer your question, though. Hopefully the eye will be able to see as well as it ever did before the cataract, but it depends on if the the eye was lazy or had amblyopia. The eye will cosmetically not look different after the surgery. Your eye doctor will be happy to discuss those things with you.
Best of luck,
Mitch Axelrod,OD
I have had strabismus for about 40 years. I call the condition dead eye or fish eye because when looking straight on, the left eye does not seem to focus on anything. I now have a cataract on the left eye and I will be getting a lens implant. My question is will this lens implant improve my overall ability to focus and actual look like the eye is focusing?
Answer
Hi Sheryl,
I don't have enough information to know what your post-operative eye will be capable of. Your eye doctor should be able to answer your question, though. Hopefully the eye will be able to see as well as it ever did before the cataract, but it depends on if the the eye was lazy or had amblyopia. The eye will cosmetically not look different after the surgery. Your eye doctor will be happy to discuss those things with you.
Best of luck,
Mitch Axelrod,OD
Posted by
Beacon Lee
Eye pains
Question
Hello Dr Margaret,please i need your help.My mum who is 54years old complains of slight pains in her eyes when she moves her eyes to the left and right and discomfort especially when she looks at light.What could be wrong with her? Please i need your advice on how to help her.
Thanks from I.K.
Answer
Your mom needs to visit an eye doctor. The symptoms you mention could be the result of inflammation of some of the muscles in the eyes, which would need to be treated with eye drops. Or else she may have rather severe eyestrain, for which she may need glasses. Sometimes people needing glasses can see ok (they think) but their eyes are working way too hard to focus and they wind up with symptoms somewhat like you describe.
Hello Dr Margaret,please i need your help.My mum who is 54years old complains of slight pains in her eyes when she moves her eyes to the left and right and discomfort especially when she looks at light.What could be wrong with her? Please i need your advice on how to help her.
Thanks from I.K.
Answer
Your mom needs to visit an eye doctor. The symptoms you mention could be the result of inflammation of some of the muscles in the eyes, which would need to be treated with eye drops. Or else she may have rather severe eyestrain, for which she may need glasses. Sometimes people needing glasses can see ok (they think) but their eyes are working way too hard to focus and they wind up with symptoms somewhat like you describe.
Posted by
Beacon Lee
vision after cross linking
Question
I had a cross linking procedure 6 weeks ago due to post lazek ectasia,now I am suffering from hypermetrope, would it stay as is or improve back
Also is there any other solution as contact lenses after the procedure than the RGB since they are real tough to use, I have heard about hybrid lens, and scleral fixation which one to use and from where to purchase Thanks
Answer
Dear Ahmed,
C3R is done to prevent progression of the anterior bulging of the cornea, however since this is after a laser procedure on the cornea, it may or may not stop progression. It has been shown in literature that some cases of post LASIK ectasia continue to progress even after C3R and may need to repeat C3R.
Hence, it requires you to follow up with the centre for topography tests to monitor this.
Usually, we need to wait till 3 months minimum, repeat the topography and compare it with the pre-C3R topography... if its the same, then we need close followup... if its worse, then probably the ectasia is still progressing... then we need to take a call as whether to wait and watch or repeat the C3R.
Post C3R visual rehabilitation has many options like using spectacles, contact lenses ( best fitting - ROSE - K lenses), surface ablation, INTACS, PHAKIC IOL, other incisional corneal procedures for astigmatism... etc. but this can be decided only after we evaluate the patient and hence can be best answered by your treating doctors.
Hope this helps.
Best,
Dr Anand Shroff, MS (OPHTH), FICS
www.lasikindia.in
www.shroffeye.org
I had a cross linking procedure 6 weeks ago due to post lazek ectasia,now I am suffering from hypermetrope, would it stay as is or improve back
Also is there any other solution as contact lenses after the procedure than the RGB since they are real tough to use, I have heard about hybrid lens, and scleral fixation which one to use and from where to purchase Thanks
Answer
Dear Ahmed,
C3R is done to prevent progression of the anterior bulging of the cornea, however since this is after a laser procedure on the cornea, it may or may not stop progression. It has been shown in literature that some cases of post LASIK ectasia continue to progress even after C3R and may need to repeat C3R.
Hence, it requires you to follow up with the centre for topography tests to monitor this.
Usually, we need to wait till 3 months minimum, repeat the topography and compare it with the pre-C3R topography... if its the same, then we need close followup... if its worse, then probably the ectasia is still progressing... then we need to take a call as whether to wait and watch or repeat the C3R.
Post C3R visual rehabilitation has many options like using spectacles, contact lenses ( best fitting - ROSE - K lenses), surface ablation, INTACS, PHAKIC IOL, other incisional corneal procedures for astigmatism... etc. but this can be decided only after we evaluate the patient and hence can be best answered by your treating doctors.
Hope this helps.
Best,
Dr Anand Shroff, MS (OPHTH), FICS
www.lasikindia.in
www.shroffeye.org
Posted by
Beacon Lee
painful eyelid
Question
Dear sir, In April this year I had cataract surgery which went smoothly. Two weeks after I experienced pain and do not like the light I was told I have blepharitis and was advised to clean the eye area. The pain is persistant without antibiotics the pain is there all the time. It is now September and I am wondering just how much longer this will go on for as no-one can find anything wrong.
Answer
Hi Sue,
One can't tell what's wrong without examining the eye with the biomicroscope in the office. Any foreign particle or surface defect or 'sore' should be discoverable. Do see the doctor again or get a second opinion. Often frequent lubricating eye drops are discussed or topical a anti-inflammatory is used.
Best of luck,
Mitch Axelrod,OD
Dear sir, In April this year I had cataract surgery which went smoothly. Two weeks after I experienced pain and do not like the light I was told I have blepharitis and was advised to clean the eye area. The pain is persistant without antibiotics the pain is there all the time. It is now September and I am wondering just how much longer this will go on for as no-one can find anything wrong.
Answer
Hi Sue,
One can't tell what's wrong without examining the eye with the biomicroscope in the office. Any foreign particle or surface defect or 'sore' should be discoverable. Do see the doctor again or get a second opinion. Often frequent lubricating eye drops are discussed or topical a anti-inflammatory is used.
Best of luck,
Mitch Axelrod,OD
Posted by
Beacon Lee
new prescription
Question
hi there had my new 2year eye test and was told i needed new glasses/presciption for distance ie: driving etc ive had them for 3 days but seem to find myself squinting and if i close my better eye my weaker is blurred even with my new glasses. ive had pains in my eyes and headaches since wearing my new glasses and also get slight double vision. when im not wearng my glasses my eyes seem to be just as bad. also if i wear my glases watching tv or on pc its blurry.
Answer
Please - go back to the doctor or optician and tell them of your experiences. There are two possibilities: 1) the glasses were made incorrectly and do not match the prescription that was intended for you or
2) The prescription given is what the doctor intended, but does not work for you.
A return visit should clear this up for you. Occasionally a person needs a few days to get used to a new prescription, but your symptoms sound so obvious and so extreme that I am certain a mistake was made at some level and you will never be able to get used to this prescription. It almost sounds like they gave you someone else's glasses! People in the optical industry know this happens occasionally and should be willing to fix it for you at no charge.
hi there had my new 2year eye test and was told i needed new glasses/presciption for distance ie: driving etc ive had them for 3 days but seem to find myself squinting and if i close my better eye my weaker is blurred even with my new glasses. ive had pains in my eyes and headaches since wearing my new glasses and also get slight double vision. when im not wearng my glasses my eyes seem to be just as bad. also if i wear my glases watching tv or on pc its blurry.
Answer
Please - go back to the doctor or optician and tell them of your experiences. There are two possibilities: 1) the glasses were made incorrectly and do not match the prescription that was intended for you or
2) The prescription given is what the doctor intended, but does not work for you.
A return visit should clear this up for you. Occasionally a person needs a few days to get used to a new prescription, but your symptoms sound so obvious and so extreme that I am certain a mistake was made at some level and you will never be able to get used to this prescription. It almost sounds like they gave you someone else's glasses! People in the optical industry know this happens occasionally and should be willing to fix it for you at no charge.
Posted by
Beacon Lee
new prescription
Question
hi there had my new 2year eye test and was told i needed new presciption for distance ie: driving etc ive had them for 3 days but seem to find myself squinting and if i close my better eye my weaker is blurred even with my new glasses. ive had pains in my eyes and headaches since wearing my new glasses and also get slight double vision. when im not wearng my glasses my eyes seem to be just as bad and cant adjust. also if i wear my glases watching tv or on pc its blurry
Answer
Dear Luke,
There is no answer for this on the net. It needs to be physically inspected for two things:
1. If the glasses have been made correctly as per prescription
2. Is the prescription corret.
The best would be to go to the same or another optical centre to check this as it requires a check.
Best,
Dr Shroff
www.shroffeye.org
hi there had my new 2year eye test and was told i needed new presciption for distance ie: driving etc ive had them for 3 days but seem to find myself squinting and if i close my better eye my weaker is blurred even with my new glasses. ive had pains in my eyes and headaches since wearing my new glasses and also get slight double vision. when im not wearng my glasses my eyes seem to be just as bad and cant adjust. also if i wear my glases watching tv or on pc its blurry
Answer
Dear Luke,
There is no answer for this on the net. It needs to be physically inspected for two things:
1. If the glasses have been made correctly as per prescription
2. Is the prescription corret.
The best would be to go to the same or another optical centre to check this as it requires a check.
Best,
Dr Shroff
www.shroffeye.org
Posted by
Beacon Lee
(Updated) Question on Prescription Problem
Question
QUESTION: Hi, Dr. Placentra Johnston,
I just had my eyes examined by a new eye dr (my old one isn't in the network anymore) for both an eyeglass prescription and contacts. I went through a couple trial lenses before given the contact prescription (monovision lenses). I had the prescription filled by Costco (one year supply) to save money (I have gotten lenses from here before). However, when I put them in, I can't see close-up; I have to put on reading glasses. I asked the dr to double-check the prescription (his wife had written it) and he called me back and said the prescription matched the file, and he didn't know what to tell me. In the meantime I spoke with Costco who compared my old prescription (2 years ago) with this one and said they saw a significant change which they didn't understand, and that may be the problem. Could you take a look at the prescriptions (old contacts, new contacts, new eyeglasses) and tell me what you think the problem could be.
Thank you very much.
Mary
Old contact lens prescription:
Preference Toric; R 8.70, 14.40, -2.25, -.75, 110
L 8.70, 14.40, -.50, -1.25, 50
New contact lens prescription:
Air Optix Toric; R 8.70, 14.50, -3.25, -.75, 120
L 8.70, 14.50, -.50, -1.75, 40
New eyeglass prescription: R -3.75; -0.75, 123
L -2.50; -1.75; 42
Add R +2.25
L +2.25
ANSWER: It could be the axis shift in the reading eye. The left eye went from axis 50 to axis 40. But your distance eye, the right has gotten much more nearsighted, so that could also be it. Try closing the right eye and see if you can read with the left (with contact lenses on.) If so then the problem is in the right eye. If you can't read well with the left contact lens, the problem would be because your right eye changed so much.
But this should not be your job, or mine. If a patient has a problem with the prescription written, most reputable doctors, will invite the patient to come back in and be re-checked, and usually at no charge. Now, your chances of receiving that invitation decreases significantly when you buy your contact lenses at Costco. In most cases, the doctor is counting heavily on the profit from selling the contact lenses to offset the usually rather low cost (or verylow reimbursement rate from the insurance company) of the eye exam. Your coming back in for a problem visit without having purchased the lenses from him cuts into his profits significantly.
Moreover, if the doctor did not supply the lenses, you are unlikely to be able to trade them back in at Costco if there is a change. This is why it is always better to get your contact lenses from the office that wrote the prescription. You are not just buying materials. There is significant service element that goes along with contact lenses and respect for the need for that service is why the doctor's office may charge a little bit more.
You might ask the doctor to let you come back in for a check-up AND that in the future you will purchase the materials from him.
---------- FOLLOW-UP ----------
QUESTION: Dear Dr. Placentra Johnston,
Thank you for taking the time to answer my initial question. What is puzzling to me is why I am having trouble seeing when I went through the trial lens process. I assume it is possible that Costco messed up the order, although I am sure it doesn't happen that often. And you're right, the Dr won't see me again (at least at no charge) based on the fact I didn't get the contacts through him (although I spent a lot more money on the glasses I ordered through him). However, my gut is telling me the prescription wasn't written correctly...that the final trial lens (which I had 3 trials for my left eye) isn't what was ultimately written. Plus I tried two different manufacturers (Accuview and Ciba) although I don't know if that would be a factor. When you look at my eyeglass prescription (I can see out f my glasses fine), how does that translate to contacts? I read that usually the prescription for glasses are stronger than contacts by .25 at least. Perhaps knowing how the eyeglass prescription translates will help me understand what may have happened.
Thanks again for your help.
Mary
ANSWER: Your contact lens prescription makes sense in view of the glasses Rx. However, the new contact lens prescription is stronger for distance (especially in the right eye) than the old contact lens Rx. This would make it more difficult to read if the increased power were not needed.
Did you try the little exercise I suggested in my first response?
It is indeed very possible that the Rx that got written does not represent the final trial lens you accepted. When there are multiple trial lenses used, it can take a lot of effort of the doctor's part to keep his records straight about which trial lens the patient finally accepted. But....unfortunately, the only one who can solve that for you is the doctor who wrote the Rx. Moreover, even if you and I were able to figure out what the problem is, you would still have to go back through the doctor to get him to rewrite the prescription. The optical shop at Costco is not authorized to change a prescription on the patient's say-so.
I am sorry for your unfortunate situation. As I see it, about the only answer is to bite the dust and pay for another visit with the doctor. ....OR - ask for a copy of all your records and take them to your old doctor (another paid visit of course) to see if he can figure out what you needed. I cannot do this online because in my status here you and I do not have an official doctor/patient relationship and I am not legally able to write or alter a prescription for you.
---------- FOLLOW-UP ----------
QUESTION: Dear Dr. Placentra Johnston,
Thank you again for your time. I did want to let you know that I did the exercise you had originally suggested, and the problem is with my left eye. I can't see close with it, but I can see distance fine with my right eye. And when I use 1.5 power reading glasses I can see close without a problem.
I understand that in order to resolve this I will have to have a doctor rewrite/reissue a prescription. I was trying to figure out if it was more likely the prescription was not written correctly versus Costco filling my prescription wrong. The response I got from the doctor when I called to tell him of this problem was "I don't know what to tell you". I don't know how much success I will have asking for my records, but at this point I think your suggestion is probably the best thing to do, and to go back to my original eye doctor.
Thank you again for your time and help. It is very kind of you to do this for others.
Regards,
Mary
Answer
My last suggestion: now that you know the problem is with the left eye, could you see ok with your OLD contact lens Rx for the left eye? If so you could just call the more recent doctor and ask him to rewrite the left contact lens Rx for the OLD Preference Toric with the old numbers. He may be willing to do this without a visit. But he may not.....good luck with this.
QUESTION: Hi, Dr. Placentra Johnston,
I just had my eyes examined by a new eye dr (my old one isn't in the network anymore) for both an eyeglass prescription and contacts. I went through a couple trial lenses before given the contact prescription (monovision lenses). I had the prescription filled by Costco (one year supply) to save money (I have gotten lenses from here before). However, when I put them in, I can't see close-up; I have to put on reading glasses. I asked the dr to double-check the prescription (his wife had written it) and he called me back and said the prescription matched the file, and he didn't know what to tell me. In the meantime I spoke with Costco who compared my old prescription (2 years ago) with this one and said they saw a significant change which they didn't understand, and that may be the problem. Could you take a look at the prescriptions (old contacts, new contacts, new eyeglasses) and tell me what you think the problem could be.
Thank you very much.
Mary
Old contact lens prescription:
Preference Toric; R 8.70, 14.40, -2.25, -.75, 110
L 8.70, 14.40, -.50, -1.25, 50
New contact lens prescription:
Air Optix Toric; R 8.70, 14.50, -3.25, -.75, 120
L 8.70, 14.50, -.50, -1.75, 40
New eyeglass prescription: R -3.75; -0.75, 123
L -2.50; -1.75; 42
Add R +2.25
L +2.25
ANSWER: It could be the axis shift in the reading eye. The left eye went from axis 50 to axis 40. But your distance eye, the right has gotten much more nearsighted, so that could also be it. Try closing the right eye and see if you can read with the left (with contact lenses on.) If so then the problem is in the right eye. If you can't read well with the left contact lens, the problem would be because your right eye changed so much.
But this should not be your job, or mine. If a patient has a problem with the prescription written, most reputable doctors, will invite the patient to come back in and be re-checked, and usually at no charge. Now, your chances of receiving that invitation decreases significantly when you buy your contact lenses at Costco. In most cases, the doctor is counting heavily on the profit from selling the contact lenses to offset the usually rather low cost (or verylow reimbursement rate from the insurance company) of the eye exam. Your coming back in for a problem visit without having purchased the lenses from him cuts into his profits significantly.
Moreover, if the doctor did not supply the lenses, you are unlikely to be able to trade them back in at Costco if there is a change. This is why it is always better to get your contact lenses from the office that wrote the prescription. You are not just buying materials. There is significant service element that goes along with contact lenses and respect for the need for that service is why the doctor's office may charge a little bit more.
You might ask the doctor to let you come back in for a check-up AND that in the future you will purchase the materials from him.
---------- FOLLOW-UP ----------
QUESTION: Dear Dr. Placentra Johnston,
Thank you for taking the time to answer my initial question. What is puzzling to me is why I am having trouble seeing when I went through the trial lens process. I assume it is possible that Costco messed up the order, although I am sure it doesn't happen that often. And you're right, the Dr won't see me again (at least at no charge) based on the fact I didn't get the contacts through him (although I spent a lot more money on the glasses I ordered through him). However, my gut is telling me the prescription wasn't written correctly...that the final trial lens (which I had 3 trials for my left eye) isn't what was ultimately written. Plus I tried two different manufacturers (Accuview and Ciba) although I don't know if that would be a factor. When you look at my eyeglass prescription (I can see out f my glasses fine), how does that translate to contacts? I read that usually the prescription for glasses are stronger than contacts by .25 at least. Perhaps knowing how the eyeglass prescription translates will help me understand what may have happened.
Thanks again for your help.
Mary
ANSWER: Your contact lens prescription makes sense in view of the glasses Rx. However, the new contact lens prescription is stronger for distance (especially in the right eye) than the old contact lens Rx. This would make it more difficult to read if the increased power were not needed.
Did you try the little exercise I suggested in my first response?
It is indeed very possible that the Rx that got written does not represent the final trial lens you accepted. When there are multiple trial lenses used, it can take a lot of effort of the doctor's part to keep his records straight about which trial lens the patient finally accepted. But....unfortunately, the only one who can solve that for you is the doctor who wrote the Rx. Moreover, even if you and I were able to figure out what the problem is, you would still have to go back through the doctor to get him to rewrite the prescription. The optical shop at Costco is not authorized to change a prescription on the patient's say-so.
I am sorry for your unfortunate situation. As I see it, about the only answer is to bite the dust and pay for another visit with the doctor. ....OR - ask for a copy of all your records and take them to your old doctor (another paid visit of course) to see if he can figure out what you needed. I cannot do this online because in my status here you and I do not have an official doctor/patient relationship and I am not legally able to write or alter a prescription for you.
---------- FOLLOW-UP ----------
QUESTION: Dear Dr. Placentra Johnston,
Thank you again for your time. I did want to let you know that I did the exercise you had originally suggested, and the problem is with my left eye. I can't see close with it, but I can see distance fine with my right eye. And when I use 1.5 power reading glasses I can see close without a problem.
I understand that in order to resolve this I will have to have a doctor rewrite/reissue a prescription. I was trying to figure out if it was more likely the prescription was not written correctly versus Costco filling my prescription wrong. The response I got from the doctor when I called to tell him of this problem was "I don't know what to tell you". I don't know how much success I will have asking for my records, but at this point I think your suggestion is probably the best thing to do, and to go back to my original eye doctor.
Thank you again for your time and help. It is very kind of you to do this for others.
Regards,
Mary
Answer
My last suggestion: now that you know the problem is with the left eye, could you see ok with your OLD contact lens Rx for the left eye? If so you could just call the more recent doctor and ask him to rewrite the left contact lens Rx for the OLD Preference Toric with the old numbers. He may be willing to do this without a visit. But he may not.....good luck with this.
Posted by
Beacon Lee
Irritable Eyes
Question
I am a 55 year old male. I wear glasses for watching TV (long distance)Couple of years ago had a sty on my eye which the doctor lanced . After that had an infection in my eye and was given chloromex . I now have very scratchy eyes (gritty feeling) which comes and goes. There is no pain and my eyesight does not appear to be getting worse. An Optometrist said he thought I had a herpes infection on the lids of my eyes. I regularly watch my eyes with a baby shampoo and sometimes wipe my eyes with salt water. Is there anything else you could recommend I do. I have not used any eyedrops. I do supper from mild depression and take Nuzak .
Any help will be appreciated
Thank You
Leon
Answer
This is really hard to say without doing an exam, but from the fact that they have you doing lid scrubs with baby shampoo, it sounds like you may have blepharitis. Sometimes along with the usual type (anterior) of blepharitis, there is also posterior blepharitis, which is also called meibomianitis. It is often missed by doctors doing your exam because unless they think of specifically testing for it, they would not see it. You can try this treatment without a diagnosis because the treatment is harmless in any case. If it does not help in two or three weeks, then you can stop but if it helps, keep doing it.
For meibomianitis, we have you
1) start with hot compresses (warm or hot water on a washcloth, wring it out and hold the hot cloth over your eyes until it cools) Then
2)do the same scrubs you have been doing with the baby shampoo. Then
3) you do a lid massage - this is an attempt to squeeze the material out of the meibomian glands. These glands usually supply the oily layer of your tears but in meibomianitis, they get blocked. By massaging the lids, you are expressing the material out of the glands so they are no longer blocked, the oily layer of your tears becomes adequate so your tears stay on your eye longer and keep it wet better. So - to do this lid massage, you want to squeeze gently by pressing your finger along the edge of the eyelid - what we call the lid margin. You press by rolling the finger from the crease in your upper eyelid, down to the edge where the lashes come out. On the lower lid you roll upward toward the lower lid margin where the lashes are coming out.
Repeat this sequence of three steps twice a day for three weeks. If your eyes feel better, keep doing it. If they don't you need a different diagnosis. I hope this helps you.
I am a 55 year old male. I wear glasses for watching TV (long distance)Couple of years ago had a sty on my eye which the doctor lanced . After that had an infection in my eye and was given chloromex . I now have very scratchy eyes (gritty feeling) which comes and goes. There is no pain and my eyesight does not appear to be getting worse. An Optometrist said he thought I had a herpes infection on the lids of my eyes. I regularly watch my eyes with a baby shampoo and sometimes wipe my eyes with salt water. Is there anything else you could recommend I do. I have not used any eyedrops. I do supper from mild depression and take Nuzak .
Any help will be appreciated
Thank You
Leon
Answer
This is really hard to say without doing an exam, but from the fact that they have you doing lid scrubs with baby shampoo, it sounds like you may have blepharitis. Sometimes along with the usual type (anterior) of blepharitis, there is also posterior blepharitis, which is also called meibomianitis. It is often missed by doctors doing your exam because unless they think of specifically testing for it, they would not see it. You can try this treatment without a diagnosis because the treatment is harmless in any case. If it does not help in two or three weeks, then you can stop but if it helps, keep doing it.
For meibomianitis, we have you
1) start with hot compresses (warm or hot water on a washcloth, wring it out and hold the hot cloth over your eyes until it cools) Then
2)do the same scrubs you have been doing with the baby shampoo. Then
3) you do a lid massage - this is an attempt to squeeze the material out of the meibomian glands. These glands usually supply the oily layer of your tears but in meibomianitis, they get blocked. By massaging the lids, you are expressing the material out of the glands so they are no longer blocked, the oily layer of your tears becomes adequate so your tears stay on your eye longer and keep it wet better. So - to do this lid massage, you want to squeeze gently by pressing your finger along the edge of the eyelid - what we call the lid margin. You press by rolling the finger from the crease in your upper eyelid, down to the edge where the lashes come out. On the lower lid you roll upward toward the lower lid margin where the lashes are coming out.
Repeat this sequence of three steps twice a day for three weeks. If your eyes feel better, keep doing it. If they don't you need a different diagnosis. I hope this helps you.
Posted by
Beacon Lee
reacurring eye errosion
Question
hi i recently went to see my eye dr. because my left eye felt scratched and kept watering i am a 44 year old male and wear perscription glasses for far sight> at the visit she told me i had scratched my eye and had reacurring errosion because it would not heal >>>>they put a contact lense in with medication on it and it seemed to work>>>but now 2 days later it is all red and swollen and wont stop watering what should i do? it is sunday and they r not open thanks kevin>>>>>
Answer
Hi Kevin you need to see a doctor about this. You could have an infection or problem because of the contact lens (I assume you have been sleeping in it). If the doctor does not have an emergency number or answering service, then try a different doctor and try to be seen. The earlier treatment is begun the better, so try not to wait until tomorrow unless you have to and the condition is not too bad as you did not mention pain. Depending on where you live you may be able to find a doctor even at a commercial or mall setting.
I hope you get better soon,
Mitch Axelrod,OD
hi i recently went to see my eye dr. because my left eye felt scratched and kept watering i am a 44 year old male and wear perscription glasses for far sight> at the visit she told me i had scratched my eye and had reacurring errosion because it would not heal >>>>they put a contact lense in with medication on it and it seemed to work>>>but now 2 days later it is all red and swollen and wont stop watering what should i do? it is sunday and they r not open thanks kevin>>>>>
Answer
Hi Kevin you need to see a doctor about this. You could have an infection or problem because of the contact lens (I assume you have been sleeping in it). If the doctor does not have an emergency number or answering service, then try a different doctor and try to be seen. The earlier treatment is begun the better, so try not to wait until tomorrow unless you have to and the condition is not too bad as you did not mention pain. Depending on where you live you may be able to find a doctor even at a commercial or mall setting.
I hope you get better soon,
Mitch Axelrod,OD
Posted by
Beacon Lee
Far Eye Sight Weakness
Question
Hello doctor,
I am worrried very much about my daughter's eye sight and hence is writing to you.
My daughter is 10+ years of age. She started using glasses for far sightedness about 2 years now. It increased very rapidly to around 4 in the last couple of years. Now again she complain a little bit about the vision, So I will go and get her eye glasses tested again.
I would really appreciate if you can suggest as to why the visin is deteriorating so rapidly and most importantly, what can we do to stop it or reduce it. Any medications, exercises etc..
Thanks in advance.
Ashish Agarwal
Answer
Dear Ashish,
If in Mumbai, we at Shroff Eye Hospital have a separate childrens visual programme which includes eye exercises etc specfic for her eye condition which is thoroughly evaluated.
However, usually If she reads too much, we would undercorrect her spectacle for reading, so that there are no jumps in numbers or powers due to this. Otherwise, the increase in power could be a growth spurt or family history of the same.
If in Mumbai, please visit us (address as below),
Best Regards,
Dr Anand Shroff, MS OPHTH, FICS
www.shroffeye.org
Shroff Eye Hospital is India's First Eye Hospital that the Joint Commission International (International Division of JCAHO, USA) has given accreditation for excellence in patient care and health care delivery. Shroff Eye is also India's first Wavelight Concerto 500Hz LASIK center.
Shroff Eye Hospital
Vision Research Centre
222 S V Road
Bandra (W)
Mumbai 400 050
Phone: +91-22-6692 1000
Fax: +91-22-6694 9880
email: shroffeye@vsnl.com
Shroff Eye Clinic
Gobind Mahal
86 - B Netaji Subhash Road
Mumbai 400 002
Phone: +91-22 - 22814077, 2811863, 22029242
Fax: +91-22 - 22812751
email: shroffeye@vsnl.com
Visit:
www.shroffeye.org
www.lasikindia.in
Hello doctor,
I am worrried very much about my daughter's eye sight and hence is writing to you.
My daughter is 10+ years of age. She started using glasses for far sightedness about 2 years now. It increased very rapidly to around 4 in the last couple of years. Now again she complain a little bit about the vision, So I will go and get her eye glasses tested again.
I would really appreciate if you can suggest as to why the visin is deteriorating so rapidly and most importantly, what can we do to stop it or reduce it. Any medications, exercises etc..
Thanks in advance.
Ashish Agarwal
Answer
Dear Ashish,
If in Mumbai, we at Shroff Eye Hospital have a separate childrens visual programme which includes eye exercises etc specfic for her eye condition which is thoroughly evaluated.
However, usually If she reads too much, we would undercorrect her spectacle for reading, so that there are no jumps in numbers or powers due to this. Otherwise, the increase in power could be a growth spurt or family history of the same.
If in Mumbai, please visit us (address as below),
Best Regards,
Dr Anand Shroff, MS OPHTH, FICS
www.shroffeye.org
Shroff Eye Hospital is India's First Eye Hospital that the Joint Commission International (International Division of JCAHO, USA) has given accreditation for excellence in patient care and health care delivery. Shroff Eye is also India's first Wavelight Concerto 500Hz LASIK center.
Shroff Eye Hospital
Vision Research Centre
222 S V Road
Bandra (W)
Mumbai 400 050
Phone: +91-22-6692 1000
Fax: +91-22-6694 9880
email: shroffeye@vsnl.com
Shroff Eye Clinic
Gobind Mahal
86 - B Netaji Subhash Road
Mumbai 400 002
Phone: +91-22 - 22814077, 2811863, 22029242
Fax: +91-22 - 22812751
email: shroffeye@vsnl.com
Visit:
www.shroffeye.org
www.lasikindia.in
Posted by
Beacon Lee
Puffy Eye
Question
Hi,
I woke up this morning with my left eye rather puffy, I used to suffer badly with sty's on this eye but haven't had any for about 4 years, I have however had different sleeping patterns and been feeling tired, but the puffyness is only effecting the one eye and top lid.
I'd be grateful if you could help me,
Thank you,
Yours sincerly
Ceyda-Simone
Answer
Hi Ceyda-Simone,
The puffiness could be an infection like a stye, an allergic response or an insect bite. Worst worry would be the infection, so if there is a small localized tenderness like a stye, use warm compresses through the day for several days to see if it improves. While a cool compress would be better for allergy, the allergic response is usually brief, happens suddenly, and doesn't hurt much. If the lid is swollen, warm, and tender, it should be seen by a doctor as it may get worse and extend behind the eye. Since you've had styes before, you know what they're like. If you think this is worse then see a doctor. If the swelling has reduced since awakening that is a good sign and you can wait and see how you do. Sorry not to be exact, but not being able to look at it leaves only the possibilities to discuss rather than the answer.
Regards,
Mitch Axelrod,OD
Hi,
I woke up this morning with my left eye rather puffy, I used to suffer badly with sty's on this eye but haven't had any for about 4 years, I have however had different sleeping patterns and been feeling tired, but the puffyness is only effecting the one eye and top lid.
I'd be grateful if you could help me,
Thank you,
Yours sincerly
Ceyda-Simone
Answer
Hi Ceyda-Simone,
The puffiness could be an infection like a stye, an allergic response or an insect bite. Worst worry would be the infection, so if there is a small localized tenderness like a stye, use warm compresses through the day for several days to see if it improves. While a cool compress would be better for allergy, the allergic response is usually brief, happens suddenly, and doesn't hurt much. If the lid is swollen, warm, and tender, it should be seen by a doctor as it may get worse and extend behind the eye. Since you've had styes before, you know what they're like. If you think this is worse then see a doctor. If the swelling has reduced since awakening that is a good sign and you can wait and see how you do. Sorry not to be exact, but not being able to look at it leaves only the possibilities to discuss rather than the answer.
Regards,
Mitch Axelrod,OD
Posted by
Beacon Lee
Distance Vision Improved with Readers
Question
Although I currently wear multifocal contacts (OD -7.25 High, OS -5.75 High), I recently ran short of these lenses and temporarily switched back to a leftover pair of my previous single-focal contacts (OD -7.50, OS -5.50). For computer reading, I scrounged an old pair of +1.50 OTC readers. I realize the readers are not as strong as they should be (especially for book reading) - but they help. To my surprise I discovered the readers actually improve my distance acuity as well! Everything, from nearby objects to distant road signs, is sharper, although the improvement diminishes in the far distance (beyond 200 feet). What does this suggest about my non-multifocal prescription? I am reasonably happy with the multifocal contacts, as they allow me to read and see adequately for driving w/o glasses (though, I suspect, not quite as clearly as I now see wearing low mag readers over my old non-multifocal contacts). Could my distance Rx be too strong? Do +1.50 readers when worn with -7.50 contacts result in a net -6.00 Rx? I suspect it's not that simple - but clearly there's an explanation.
Answer
Hi Jack,
It certainly sounds like you may need an adjustment of some sort.
My advice is to contact your Doctor for a checkup.
You might need your distance cut back a bit although not as strong as the readers.
Bifocal contacts can be tricky to adjust and the machines we have in the office are the best tools to use.
Hope this helps,
Dr. Mike
Although I currently wear multifocal contacts (OD -7.25 High, OS -5.75 High), I recently ran short of these lenses and temporarily switched back to a leftover pair of my previous single-focal contacts (OD -7.50, OS -5.50). For computer reading, I scrounged an old pair of +1.50 OTC readers. I realize the readers are not as strong as they should be (especially for book reading) - but they help. To my surprise I discovered the readers actually improve my distance acuity as well! Everything, from nearby objects to distant road signs, is sharper, although the improvement diminishes in the far distance (beyond 200 feet). What does this suggest about my non-multifocal prescription? I am reasonably happy with the multifocal contacts, as they allow me to read and see adequately for driving w/o glasses (though, I suspect, not quite as clearly as I now see wearing low mag readers over my old non-multifocal contacts). Could my distance Rx be too strong? Do +1.50 readers when worn with -7.50 contacts result in a net -6.00 Rx? I suspect it's not that simple - but clearly there's an explanation.
Answer
Hi Jack,
It certainly sounds like you may need an adjustment of some sort.
My advice is to contact your Doctor for a checkup.
You might need your distance cut back a bit although not as strong as the readers.
Bifocal contacts can be tricky to adjust and the machines we have in the office are the best tools to use.
Hope this helps,
Dr. Mike
Posted by
Beacon Lee
axis
Question
In '07 I had an exam at Kaiser Hospital with an axis reading of OD 91 and OS 105. I wore glasses with that Rx. with no problems, but lost them recently. I just had an exam and the axis readings were OD 100 and OS 85. The sphere and cyl. readings in both exams were the same. Is it unusual that the axis readings would switch in such a fashion or do you believe the Dr. entered them incorrectly?
Answer
People can shift axis like that sometimes. Did you get the new glasses yet - and do they seem ok? If not, I would go ahead and buy the new glasses. Then if you have a problem, take them back and raise the question of the axis shift with the doctor. Most optical places will change the prescription for you at no charge if the doctor writes a new Rx within say 30 or 60 days.
For another consideration, you may want to look at the amount of astigmatism correction. This would be the second set of numbers, usually listed under the word "cyl" on the prescription. If the word "cyl" is not written on there, there will first be a set of numbers that indicates an amount of nearsightedness or farsightedness. It will start with a (+) sign or a (-) sign followed by something like 3.25 or any set of number with two digits after the decimal. Then there will be another (-) sign if you got the Rx from an optometrist, or it may be a (+) sign if you got the Rx from an ophthalmologist followed by another notation with two digits after the decimal point. This will be the amount of astigmatism correction. If that number is 1.25 or less, I would not worry about the axis because you will most likely not notice the difference. If that number is over 2.50, the difference in axis will be very noticeable and you are more likely to have trouble adapting to the new Rx.
Nonetheless, I would give the doctor the benefit of the doubt and try the Rx before you worry any more about it. In most optical shops, procedures are in place to resolve problems people might have adapting to a new prescription without involving added cost to the patient.
In '07 I had an exam at Kaiser Hospital with an axis reading of OD 91 and OS 105. I wore glasses with that Rx. with no problems, but lost them recently. I just had an exam and the axis readings were OD 100 and OS 85. The sphere and cyl. readings in both exams were the same. Is it unusual that the axis readings would switch in such a fashion or do you believe the Dr. entered them incorrectly?
Answer
People can shift axis like that sometimes. Did you get the new glasses yet - and do they seem ok? If not, I would go ahead and buy the new glasses. Then if you have a problem, take them back and raise the question of the axis shift with the doctor. Most optical places will change the prescription for you at no charge if the doctor writes a new Rx within say 30 or 60 days.
For another consideration, you may want to look at the amount of astigmatism correction. This would be the second set of numbers, usually listed under the word "cyl" on the prescription. If the word "cyl" is not written on there, there will first be a set of numbers that indicates an amount of nearsightedness or farsightedness. It will start with a (+) sign or a (-) sign followed by something like 3.25 or any set of number with two digits after the decimal. Then there will be another (-) sign if you got the Rx from an optometrist, or it may be a (+) sign if you got the Rx from an ophthalmologist followed by another notation with two digits after the decimal point. This will be the amount of astigmatism correction. If that number is 1.25 or less, I would not worry about the axis because you will most likely not notice the difference. If that number is over 2.50, the difference in axis will be very noticeable and you are more likely to have trouble adapting to the new Rx.
Nonetheless, I would give the doctor the benefit of the doubt and try the Rx before you worry any more about it. In most optical shops, procedures are in place to resolve problems people might have adapting to a new prescription without involving added cost to the patient.
Posted by
Beacon Lee
Dim vision/loss of contrast
Question
Hello Dr. Johnston,
My husband has been experiencing gradual vision loss, best described as dimness of vision or lowering of contrast. He doesn't have MS, macular degeneration, or any problem with transmission via the optic nerve. He doesn't have a brain tumor. He doesn't recall any associated eye pain, and the loss has been quite gradual. My husband's vision problems haven't resulted in a loss of acuity; he describes it as "like looking through a screen." He does need to have brighter light on his work. It's been 5 years since he started noticing problems in dim light, and in the last two years has also been experiencing problems in normal light. He is still fine to drive, but feels that if his vision worsens much more this will change. He does experience headaches when doing reading-intensive work (he's a computer programmer). He's 48. He has had several complete ophthalmic exams, and does not have cataracts or glaucoma. He hasn't ever had any head trauma. All his blood work appears normal -- no thyroid problems, no signs of systemic infection.
The doctors don't have any new avenues to suggest, and his vision continues to worsen. Any suggestions would be appreciated.
Answer
Ok, the information you added this time helps me understand. There are two things I can suggest but they kind of depend how close you live to a major metropolitan area.
1) If you can find a neuro-ophthalmologist (there are not very many of them, and most likely are only available in metropolitan areas) I would go there for an evaluation. They may be able to test for conditions your general eye doctors might not have.
2) On a related note, there are some types of electro-physiological tests done at some research institutions that might shed light on his problem. Something called Visual Evoked Potentials and a few other electro-physiological tests are available in some places. A quick search online brought up this information: http://webeye.ophth.uiowa.edu/dept/service/elecphys/elecphys.htm. If you have an optometry school in your area, you could start by calling them. Or you could search further online for a center you can reach that has these facilities available. This type of equipment is not at all likely to be available in a regular ophthalmic office.
I wish you luck finding a solution to this issue. The reason I needed to know your husband's age is that in old age, vision just does tend to decline gradually. What you describe might be normal for an 85 year old, but is not acceptable for a 48 year old. One more thing - the headaches doing reading-intensive work may be a separate issue. I know you say he has had several ophthalmic exams. But - sometimes when the exam is focused on the medical aspects, regular vision problems may get less attention than they should have. Considering the computer and reading-intensive nature of your husband's work, may I suggest a computer workstation analysis by an eye doctor who specializes in this? This type of eye doctor can be found at www.Prio.com or possibly by looking under "developmental" or "occupational" vision evaluations.
Hello Dr. Johnston,
My husband has been experiencing gradual vision loss, best described as dimness of vision or lowering of contrast. He doesn't have MS, macular degeneration, or any problem with transmission via the optic nerve. He doesn't have a brain tumor. He doesn't recall any associated eye pain, and the loss has been quite gradual. My husband's vision problems haven't resulted in a loss of acuity; he describes it as "like looking through a screen." He does need to have brighter light on his work. It's been 5 years since he started noticing problems in dim light, and in the last two years has also been experiencing problems in normal light. He is still fine to drive, but feels that if his vision worsens much more this will change. He does experience headaches when doing reading-intensive work (he's a computer programmer). He's 48. He has had several complete ophthalmic exams, and does not have cataracts or glaucoma. He hasn't ever had any head trauma. All his blood work appears normal -- no thyroid problems, no signs of systemic infection.
The doctors don't have any new avenues to suggest, and his vision continues to worsen. Any suggestions would be appreciated.
Answer
Ok, the information you added this time helps me understand. There are two things I can suggest but they kind of depend how close you live to a major metropolitan area.
1) If you can find a neuro-ophthalmologist (there are not very many of them, and most likely are only available in metropolitan areas) I would go there for an evaluation. They may be able to test for conditions your general eye doctors might not have.
2) On a related note, there are some types of electro-physiological tests done at some research institutions that might shed light on his problem. Something called Visual Evoked Potentials and a few other electro-physiological tests are available in some places. A quick search online brought up this information: http://webeye.ophth.uiowa.edu/dept/service/elecphys/elecphys.htm. If you have an optometry school in your area, you could start by calling them. Or you could search further online for a center you can reach that has these facilities available. This type of equipment is not at all likely to be available in a regular ophthalmic office.
I wish you luck finding a solution to this issue. The reason I needed to know your husband's age is that in old age, vision just does tend to decline gradually. What you describe might be normal for an 85 year old, but is not acceptable for a 48 year old. One more thing - the headaches doing reading-intensive work may be a separate issue. I know you say he has had several ophthalmic exams. But - sometimes when the exam is focused on the medical aspects, regular vision problems may get less attention than they should have. Considering the computer and reading-intensive nature of your husband's work, may I suggest a computer workstation analysis by an eye doctor who specializes in this? This type of eye doctor can be found at www.Prio.com or possibly by looking under "developmental" or "occupational" vision evaluations.
Posted by
Beacon Lee
glaucoma
Question
HI,
Could you tell me situations where glaucoma can occur. I had glaucoma long back after a LASIK surgery, Could you list out any other situations, symptoms, if any. If i am not mistaken, it can be treated by eye-drops as well as oral drugs. Correct.?
Answer
Dear Devi,
yes, Glaucoma can be Primary or Secondary to a surgery, trauma etc.
Also, most cases are under control with drops or oral medications, rarely does one need surgery.
You can read more about Glaucoma, causes, prevention etc on www.shroffeye.org
Hope this helps,
Best,
Dr Anand Shroff
dranand@lasikindia.in
HI,
Could you tell me situations where glaucoma can occur. I had glaucoma long back after a LASIK surgery, Could you list out any other situations, symptoms, if any. If i am not mistaken, it can be treated by eye-drops as well as oral drugs. Correct.?
Answer
Dear Devi,
yes, Glaucoma can be Primary or Secondary to a surgery, trauma etc.
Also, most cases are under control with drops or oral medications, rarely does one need surgery.
You can read more about Glaucoma, causes, prevention etc on www.shroffeye.org
Hope this helps,
Best,
Dr Anand Shroff
dranand@lasikindia.in
Posted by
Beacon Lee
problems with my vision
Question
Hello . I am a 31 year old female.I have worn glasses since I was 10 years old . I have a astigmatism . I had a pair of glasses that the lens was all crackly and dry looking . it was the right lens. Now I have had 3 eye exams in the last 4 months . The right eye is completely blurry . I can see out the left eye good and clear but I can not see anything out the right eye with the left one shut . You know how when you look at the pictures and it shows you one side with bad vision , and the other side as being clear . That is how my vision is . I am getting to the point that it is very noticeable to me . I have had my eyes dilated and my eyes looked healthy . I am a truck driver .... I need great vision . Can you offer any suggestions as to what has caused this . Am I possibly going blind ? Thank you for any response ...
Answer
Hi Pamela,
You definitely need to discuss this with your eye doctor or find another. Certainly there is an explanation for your blurred vision in one eye (I assume it is with best glasses still blurry). Especially with a CDL, you need to meet minimum vision requirements. The possibilities for blurred vision are numerous but it should be pretty easy for the eye doctor to figure out what's wrong. If they can't, then you need to see a different eye doctor or have more advanced testing. If you have been told everything is fine, but can't see, there is a disconnect. Write back if you have more details or questions.
Regards,
Mitch Axelrod, OD
Hello . I am a 31 year old female.I have worn glasses since I was 10 years old . I have a astigmatism . I had a pair of glasses that the lens was all crackly and dry looking . it was the right lens. Now I have had 3 eye exams in the last 4 months . The right eye is completely blurry . I can see out the left eye good and clear but I can not see anything out the right eye with the left one shut . You know how when you look at the pictures and it shows you one side with bad vision , and the other side as being clear . That is how my vision is . I am getting to the point that it is very noticeable to me . I have had my eyes dilated and my eyes looked healthy . I am a truck driver .... I need great vision . Can you offer any suggestions as to what has caused this . Am I possibly going blind ? Thank you for any response ...
Answer
Hi Pamela,
You definitely need to discuss this with your eye doctor or find another. Certainly there is an explanation for your blurred vision in one eye (I assume it is with best glasses still blurry). Especially with a CDL, you need to meet minimum vision requirements. The possibilities for blurred vision are numerous but it should be pretty easy for the eye doctor to figure out what's wrong. If they can't, then you need to see a different eye doctor or have more advanced testing. If you have been told everything is fine, but can't see, there is a disconnect. Write back if you have more details or questions.
Regards,
Mitch Axelrod, OD
Posted by
Beacon Lee
Bifocal Lenses
Question
Hello. I am currently a college student wearing bifocals. I was wondering if it is a possibility to get contacts with bifocal prescription. I know this is a silly question to ask but the reason I am wondering is with note taking in college and even sitting in the front, my glasses chop the words in half while note taking and I often lose track of where I am due to this problem. Thank You
Answer
Yes, I have often fit young people with bifocal contact lenses. It is not silly at all for the exact reason you described - taking notes in class is difficult otherwise if you need bifocals.
Whether you personally can be fit with bifocal contact lenses will depend on several factors related to your prescription (soft bifocals that correct astigmatism for example do not work for everyone and some prescriptions do better in gas permeable contact lenses than soft) but your doctor will be able to determine this, provided you have a doctor who likes to fit bifocal contact lenses. Not all do.
Lastly, if the bifocal contact lenses are not for you for one reason or another, there is something that always works. You can always put half-eye reading glasses over the contact lenses so when you look down you are looking through the readers. You could just put them on when in class and you expect to have to take notes.
Hello. I am currently a college student wearing bifocals. I was wondering if it is a possibility to get contacts with bifocal prescription. I know this is a silly question to ask but the reason I am wondering is with note taking in college and even sitting in the front, my glasses chop the words in half while note taking and I often lose track of where I am due to this problem. Thank You
Answer
Yes, I have often fit young people with bifocal contact lenses. It is not silly at all for the exact reason you described - taking notes in class is difficult otherwise if you need bifocals.
Whether you personally can be fit with bifocal contact lenses will depend on several factors related to your prescription (soft bifocals that correct astigmatism for example do not work for everyone and some prescriptions do better in gas permeable contact lenses than soft) but your doctor will be able to determine this, provided you have a doctor who likes to fit bifocal contact lenses. Not all do.
Lastly, if the bifocal contact lenses are not for you for one reason or another, there is something that always works. You can always put half-eye reading glasses over the contact lenses so when you look down you are looking through the readers. You could just put them on when in class and you expect to have to take notes.
Posted by
Beacon Lee
black eye
Question
Hello Dr. Johnston,
I woke up this morning with a black eye? Under my eye and in the corner by the nose there is a bruise that is black and purple. My eye is fine and there is no discoloration in the eye itself, just below it in one eye. I am guessing it is a broken blood vessel that is bleeding under the skin and looks just like a "black eye". I was not hit or suffered any other type of trauma unless I scratched it in my sleep and was not aware of it. Should I see a doctor or wait and see if it gets worse or goes away on its own. I am 63 and in good health. I had taken two Ibuprofen in the evening for a sore knee from jogging. Other than that I am not on any medication. It is a mystery to me and I have not heard of this before. Should I be concerned?
Thank you for any information you can offer.
Answer
This is a curious occurrence. But for me it does not signal the need for an emergency visit. Why not wait to see what it looks like tomorrow? If it seems to be getting better (AND YOU ARE SURE YOU ARE OTHERWISE IN GOOD HEALTH) then I would attribute it to a fluke occurrence and let it heal on its own.
However, if your eye is sore, or the black area gets larger, you feel any type of pressure,dizziness, have a headache or in the event of any change for the worse, then I would go in to be seen. I am almost more inclined to have you see your internist though as opposed to an eye doctor. As you said, the eye is fine. It is the skin and the tissue under it that is affected.
Also, if this resolves without incident but then it recurs, I would definitely go in and be seen.
Hello Dr. Johnston,
I woke up this morning with a black eye? Under my eye and in the corner by the nose there is a bruise that is black and purple. My eye is fine and there is no discoloration in the eye itself, just below it in one eye. I am guessing it is a broken blood vessel that is bleeding under the skin and looks just like a "black eye". I was not hit or suffered any other type of trauma unless I scratched it in my sleep and was not aware of it. Should I see a doctor or wait and see if it gets worse or goes away on its own. I am 63 and in good health. I had taken two Ibuprofen in the evening for a sore knee from jogging. Other than that I am not on any medication. It is a mystery to me and I have not heard of this before. Should I be concerned?
Thank you for any information you can offer.
Answer
This is a curious occurrence. But for me it does not signal the need for an emergency visit. Why not wait to see what it looks like tomorrow? If it seems to be getting better (AND YOU ARE SURE YOU ARE OTHERWISE IN GOOD HEALTH) then I would attribute it to a fluke occurrence and let it heal on its own.
However, if your eye is sore, or the black area gets larger, you feel any type of pressure,dizziness, have a headache or in the event of any change for the worse, then I would go in to be seen. I am almost more inclined to have you see your internist though as opposed to an eye doctor. As you said, the eye is fine. It is the skin and the tissue under it that is affected.
Also, if this resolves without incident but then it recurs, I would definitely go in and be seen.
Posted by
Beacon Lee
Sunday, March 14, 2010
Problem with cornea transplant
Question
Hi!
Do you know what to do when there?s a problem with the healing process after eye surgery?
I don?t know the correct names or medical terms but will try to explain our problem.
My husband has got keratoconos and had a partial cornea transplant done in December 2008.
Everything looked good for a few months but then (as the local eye doctors say) a melt-down process started.
They have since then redone the procedure 2 times. The last time (in July) they transplanted much more of the cornea.
They have also had to patch the transplanted cornea a few times due to leakage of eye fluid.
It does not want to heal properly and his doctors have not figured out why.
He is 30 years old and besides the keratoconos a healthy man as far as we know.
He takes several types of medicine. Opnol drops, Oftaquix drops, Tetralysal pills and now also Ciklosporin drops to hopefully provent a new melt-down process.
They have checked him for rheumatism since that can provent healing. They will also check for something to do with acne.
Do you know if there?s anything else the doctors can do? What could be preventing the healing process from working?
Do you know if there?s anyone specialized in problem cases who his doctor could contact to discuss his case?
Respectfully yours
Mrs. K
Sweden
Answer
Dear Angela,
The two incidents are usually unrelated and independent ie the keratoconus and the melt down process.
There could have been some problem with healing process
Probably your husband must have first undergone a DALK (deep anterior lamellar keratoplasty) and then full thickness k'plasty. Since he is being investigated for rheumatism and rosacea, there might be some autoimmune condition which is underlying and active due to which there was a melt.
In summary, he needs to be under the care of a good cornea specialist and rheumatologist.
Hope this helps,
Best,
Dr Shroff
Hi!
Do you know what to do when there?s a problem with the healing process after eye surgery?
I don?t know the correct names or medical terms but will try to explain our problem.
My husband has got keratoconos and had a partial cornea transplant done in December 2008.
Everything looked good for a few months but then (as the local eye doctors say) a melt-down process started.
They have since then redone the procedure 2 times. The last time (in July) they transplanted much more of the cornea.
They have also had to patch the transplanted cornea a few times due to leakage of eye fluid.
It does not want to heal properly and his doctors have not figured out why.
He is 30 years old and besides the keratoconos a healthy man as far as we know.
He takes several types of medicine. Opnol drops, Oftaquix drops, Tetralysal pills and now also Ciklosporin drops to hopefully provent a new melt-down process.
They have checked him for rheumatism since that can provent healing. They will also check for something to do with acne.
Do you know if there?s anything else the doctors can do? What could be preventing the healing process from working?
Do you know if there?s anyone specialized in problem cases who his doctor could contact to discuss his case?
Respectfully yours
Mrs. K
Sweden
Answer
Dear Angela,
The two incidents are usually unrelated and independent ie the keratoconus and the melt down process.
There could have been some problem with healing process
Probably your husband must have first undergone a DALK (deep anterior lamellar keratoplasty) and then full thickness k'plasty. Since he is being investigated for rheumatism and rosacea, there might be some autoimmune condition which is underlying and active due to which there was a melt.
In summary, he needs to be under the care of a good cornea specialist and rheumatologist.
Hope this helps,
Best,
Dr Shroff
Posted by
Beacon Lee
Progressives
Question
Dear Doctor:
I have been wearing progressive glasses for years with no problems. I recently had my yearly checkup and my opthamologist said I had a very slight change and I could either keep my current lens or if I wanted new frames, I should go with the new prescription. The Prescription is the following:
Cylindrical Axis
+1.25 100
+3.25 80
OD -4.75
OS -5.25
+2.50
+2.50
I am 57 years old. I went to the same optician that I always use that has over 15 years experience. She filled the new prescription and the distance was fine but I had some difficulty reading. The letters were slightly blurry. She tried several things in adjusting them but nothing worked. I then said, well why don't you just replace the new lenses with my old prescription. She then had the new frames fitted with the old prescription. The same problem occured. It seemed impossible. She checked my old frames and lenses and the new frames and lenses and they were exactly the same but I had blurry reading vision in the new ones. She spoke on the phone to my opthomologist and covered all the areas of concern and they couldn't come up with a reason. My opthomologist seemed to feel that if they were using slightly different blanks to make the lenses, it might chnage the vision ever so slightly. Do you have any ideas before I go out again to try something else? Thank you so much. PS> I was wondering perhaps if there might be a problem with newer coatings that might effect the vision but the optician said no.
Answer
Coatings should not make all that much difference. But in my experience, the BRAND of progressive lens can make a huge difference. On your old glasses, there will be a marking on the lens, very hard to see, but the optician knows how to find it. The marking tells what BRAND of progressive lens the old ones were. I would insist on remaking the new glasses in the same brand of progressive as the old ones.
While up to say, 60 % of people can wear any brand of progressive, and some can wear many brands, there is a small majority of people who, once their brain adapts to one brand of progressive, they cannot adapt to any other.
The other thing you may insist the optician duplicate from your old glasses is the base curve. This can be measured off the front of the lens. The optician will know how to do this. Then they need only tell the lab you must have that exact base curve.
While you are at it, make them also match the PD (pupillary distance) from the old glasses to increase the likelihood that the next remake will be comfortable for you.
Dear Doctor:
I have been wearing progressive glasses for years with no problems. I recently had my yearly checkup and my opthamologist said I had a very slight change and I could either keep my current lens or if I wanted new frames, I should go with the new prescription. The Prescription is the following:
Cylindrical Axis
+1.25 100
+3.25 80
OD -4.75
OS -5.25
+2.50
+2.50
I am 57 years old. I went to the same optician that I always use that has over 15 years experience. She filled the new prescription and the distance was fine but I had some difficulty reading. The letters were slightly blurry. She tried several things in adjusting them but nothing worked. I then said, well why don't you just replace the new lenses with my old prescription. She then had the new frames fitted with the old prescription. The same problem occured. It seemed impossible. She checked my old frames and lenses and the new frames and lenses and they were exactly the same but I had blurry reading vision in the new ones. She spoke on the phone to my opthomologist and covered all the areas of concern and they couldn't come up with a reason. My opthomologist seemed to feel that if they were using slightly different blanks to make the lenses, it might chnage the vision ever so slightly. Do you have any ideas before I go out again to try something else? Thank you so much. PS> I was wondering perhaps if there might be a problem with newer coatings that might effect the vision but the optician said no.
Answer
Coatings should not make all that much difference. But in my experience, the BRAND of progressive lens can make a huge difference. On your old glasses, there will be a marking on the lens, very hard to see, but the optician knows how to find it. The marking tells what BRAND of progressive lens the old ones were. I would insist on remaking the new glasses in the same brand of progressive as the old ones.
While up to say, 60 % of people can wear any brand of progressive, and some can wear many brands, there is a small majority of people who, once their brain adapts to one brand of progressive, they cannot adapt to any other.
The other thing you may insist the optician duplicate from your old glasses is the base curve. This can be measured off the front of the lens. The optician will know how to do this. Then they need only tell the lab you must have that exact base curve.
While you are at it, make them also match the PD (pupillary distance) from the old glasses to increase the likelihood that the next remake will be comfortable for you.
Posted by
Beacon Lee
lasik correction
Question
Dear Dr. Shroff,
Is it still true that Lasik cannot correct BOTH far- and nearsightedness? I'm 56 and have been wearing glasses for about 10 yrs, more for reading than distance. But my distance is losing it as well. I understand Lasik cannot correct both conditions and I've never cared for contacts.
Let me thank you in advance. I know you must be extremely busy. Very generous to share your time.
Regards,
Ed
Answer
Dear Ed,
No. LASIK generally corrects only the distant numbers and cannot help the reading numbers.
Reading numbers are due to ageing of the eyes and as one cannot stop an ageing process, one therefore cannot stop the effects that it can have on the eyes.
There are however two scenarios where LASIK can still be considered.
Onne: Is to do monovision, whener one can check with their contact lens specialist and ask for a trial. Here one eye is corrected for far vision and one for enar. Hence visin may not be very crisp for both focuses, for first few weeks when one needs to 'get used' to this, but is functional vision
Option two: is hen one has Hypermetropia, or plus numbers for far and also has plus numbers for near. Then LASIK can help read for both ditances.
However, you must bear in mind that ageing may happen at the lens level as well, and if you develop cataract, then the lens exchange will need to be done and life of LASIK is then enjoyed until this process.
Again, today there are many options for lenses which help both near and far focusses, such as multifocal implants or accomodative lenses.
These lenses are then a permanent treatment and may help you better than LASIK as it will treat not just your spectacle correction but also you will not get cataract in future.
The best way forward would be to first read more and learn more about these options and then visit a good eye centre.
Lots of detailed information is available on www.shroffeye.org and wwwlasikindia.in
Hope this helps,
Best,
Dr Anand Shroff
dranand@lasikindia.in
Dear Dr. Shroff,
Is it still true that Lasik cannot correct BOTH far- and nearsightedness? I'm 56 and have been wearing glasses for about 10 yrs, more for reading than distance. But my distance is losing it as well. I understand Lasik cannot correct both conditions and I've never cared for contacts.
Let me thank you in advance. I know you must be extremely busy. Very generous to share your time.
Regards,
Ed
Answer
Dear Ed,
No. LASIK generally corrects only the distant numbers and cannot help the reading numbers.
Reading numbers are due to ageing of the eyes and as one cannot stop an ageing process, one therefore cannot stop the effects that it can have on the eyes.
There are however two scenarios where LASIK can still be considered.
Onne: Is to do monovision, whener one can check with their contact lens specialist and ask for a trial. Here one eye is corrected for far vision and one for enar. Hence visin may not be very crisp for both focuses, for first few weeks when one needs to 'get used' to this, but is functional vision
Option two: is hen one has Hypermetropia, or plus numbers for far and also has plus numbers for near. Then LASIK can help read for both ditances.
However, you must bear in mind that ageing may happen at the lens level as well, and if you develop cataract, then the lens exchange will need to be done and life of LASIK is then enjoyed until this process.
Again, today there are many options for lenses which help both near and far focusses, such as multifocal implants or accomodative lenses.
These lenses are then a permanent treatment and may help you better than LASIK as it will treat not just your spectacle correction but also you will not get cataract in future.
The best way forward would be to first read more and learn more about these options and then visit a good eye centre.
Lots of detailed information is available on www.shroffeye.org and wwwlasikindia.in
Hope this helps,
Best,
Dr Anand Shroff
dranand@lasikindia.in
Posted by
Beacon Lee
light source while watching tv
Question
I am wondering about watching TV with a light source. How much light is necessary while watching TV? My husband insists on having a bright overhead light while watching TV, but I believe having one or two table lamps on is enough to not cause any harm or strain on our eyes and or our children eyes while watching TV. Could you tell me how much light is enough?
Answer
Dear Janette,
The correct light is like that of a natural source, preferably tube lighting, not the yellow lighting.
Yes, the room should be well lit that the eyes do not see a contrast in the light source from the TV which would otherwise strain the eyes.
Dim light for TV can be occassional.
Hope this helps,
Best,
Dr Shroff
I am wondering about watching TV with a light source. How much light is necessary while watching TV? My husband insists on having a bright overhead light while watching TV, but I believe having one or two table lamps on is enough to not cause any harm or strain on our eyes and or our children eyes while watching TV. Could you tell me how much light is enough?
Answer
Dear Janette,
The correct light is like that of a natural source, preferably tube lighting, not the yellow lighting.
Yes, the room should be well lit that the eyes do not see a contrast in the light source from the TV which would otherwise strain the eyes.
Dim light for TV can be occassional.
Hope this helps,
Best,
Dr Shroff
Posted by
Beacon Lee
optometrist or ophthalmologist for OCT test
Question
Hello, I recently had my yearly eye exam by an optometrist. She has recommended that I have an OCT test due to my eye pressure results from the standard test. She took several readings and could not get a low enough score, although the #'s weren't very far off (except in the 1st readings) She thought I may not be "relaxed" enough to get the correct readings and recommended that I have the OCT test just to be on the safe side. Should I see an ophthalmologist for this test or have her office administer it? I am a 65 year old female. Thank you in advance for your time. Mary
Answer
There is nothing difficult in administering the OCT test. And the results provided can be interpreted by any eye care professional. If your optometrist has access to an OCT, I am sure she is quite capable of using it appropriately. Moreover, as she has other back records about you, she may be better able to interpret the findings in the light of what she already knows about you, whereas an ophthalmologist would have only the data collected on one visit.
All optometrists who graduated in the last thirty years or so have been trained to treat glaucoma, which also means they are thoroughly trained to test for it as well. Not all states have laws that permit Optometrists to treat glaucoma, but by now, most of them do. If your OD has access to an OCT, I am betting she also treats glaucoma and there is no reason you should not trust her to do so.
However, as in all medicine, which doctor you see is entirely a question of trust. If you feel you can trust this doctor, you should stay with her. And if you don't you should move on. It is not a matter of which type of degree a person holds that makes them a good doctor, but rather the drive they have in their heart to help people.
Hello, I recently had my yearly eye exam by an optometrist. She has recommended that I have an OCT test due to my eye pressure results from the standard test. She took several readings and could not get a low enough score, although the #'s weren't very far off (except in the 1st readings) She thought I may not be "relaxed" enough to get the correct readings and recommended that I have the OCT test just to be on the safe side. Should I see an ophthalmologist for this test or have her office administer it? I am a 65 year old female. Thank you in advance for your time. Mary
Answer
There is nothing difficult in administering the OCT test. And the results provided can be interpreted by any eye care professional. If your optometrist has access to an OCT, I am sure she is quite capable of using it appropriately. Moreover, as she has other back records about you, she may be better able to interpret the findings in the light of what she already knows about you, whereas an ophthalmologist would have only the data collected on one visit.
All optometrists who graduated in the last thirty years or so have been trained to treat glaucoma, which also means they are thoroughly trained to test for it as well. Not all states have laws that permit Optometrists to treat glaucoma, but by now, most of them do. If your OD has access to an OCT, I am betting she also treats glaucoma and there is no reason you should not trust her to do so.
However, as in all medicine, which doctor you see is entirely a question of trust. If you feel you can trust this doctor, you should stay with her. And if you don't you should move on. It is not a matter of which type of degree a person holds that makes them a good doctor, but rather the drive they have in their heart to help people.
Posted by
Beacon Lee
ocular headache/ toric iols
Question
I can see clearly with my new toric IOLs, but I have dull ocular headaches. Do you think there could be a correlation between the IOLs and the headaches?
Answer
Dear Ann,
Could be if the powers are not well adjusted to or facing some dryness issue.
Try using them sparingly initially and slowly increase the time of use.
If it still persists, revisit your opticia to check the powers
See if this helps.
Best,
Dr Shroff
www.shroffeye.org
I can see clearly with my new toric IOLs, but I have dull ocular headaches. Do you think there could be a correlation between the IOLs and the headaches?
Answer
Dear Ann,
Could be if the powers are not well adjusted to or facing some dryness issue.
Try using them sparingly initially and slowly increase the time of use.
If it still persists, revisit your opticia to check the powers
See if this helps.
Best,
Dr Shroff
www.shroffeye.org
Posted by
Beacon Lee
CT Scan
Question
Why would my mother have been told she needs a CT scan done of her eyes?
She has Glaucoma (both eyes) and has also been diagnosed with PVD.
Thanks
Answer
I have a suspicion what was recommended was not exactly a regular CT scan, but rather scanning laser ophthalmoscopy. Such tests go under the brand names of equipment - OCT, GdX, HRT. These tests are commonly done for glaucoma. They document the amount of nerve tissue (nerves that give you vision) that is present. Over time they let the doctor see if nerve tissue is being lost due to the glaucoma, and whether the treatment being recommended is effective. If this test was recommended for your mother, she should go ahead and have it done. The information gained is very useful in managing glaucoma.
Why would my mother have been told she needs a CT scan done of her eyes?
She has Glaucoma (both eyes) and has also been diagnosed with PVD.
Thanks
Answer
I have a suspicion what was recommended was not exactly a regular CT scan, but rather scanning laser ophthalmoscopy. Such tests go under the brand names of equipment - OCT, GdX, HRT. These tests are commonly done for glaucoma. They document the amount of nerve tissue (nerves that give you vision) that is present. Over time they let the doctor see if nerve tissue is being lost due to the glaucoma, and whether the treatment being recommended is effective. If this test was recommended for your mother, she should go ahead and have it done. The information gained is very useful in managing glaucoma.
Posted by
Beacon Lee
contact lenses
Question
I am a 62 year old male.I wear a contact in both eyes for reading and distance.My question is when reading the l.eye when I blink down and open my eye the reading is very clear for a split second and then goes to a blurr.My doctor told me the problem was dry eye and has given me drops for dry eye.The drops I have been using now for 6 months.A drop in the am %26 again in the pm.I went back for a 6 month check-up and still have the same problem.The doctor says I have tryed everything I can do.
The lense is a Proclear Multifocal 8.7 14.4 +0.50/+2.50d.Could you give me some suggestions.
Answer
The symptom you describe is sometimes due to a lens that is flattened against the eye immediately after the blink but then puckers up after. Dry eye doesn't fully explain your symptom unless your symptom resolves for some time after instilling the drop. If your vision was stable for a while after the drop then dry eye may explain it. So you can have your doctor try a different lens to see if it fits better or gives more stable vision. There are many choices and he (or a different doctor) likely has a different lens for you to try.
Best of luck,
Mitch Axelrod, OD
I am a 62 year old male.I wear a contact in both eyes for reading and distance.My question is when reading the l.eye when I blink down and open my eye the reading is very clear for a split second and then goes to a blurr.My doctor told me the problem was dry eye and has given me drops for dry eye.The drops I have been using now for 6 months.A drop in the am %26 again in the pm.I went back for a 6 month check-up and still have the same problem.The doctor says I have tryed everything I can do.
The lense is a Proclear Multifocal 8.7 14.4 +0.50/+2.50d.Could you give me some suggestions.
Answer
The symptom you describe is sometimes due to a lens that is flattened against the eye immediately after the blink but then puckers up after. Dry eye doesn't fully explain your symptom unless your symptom resolves for some time after instilling the drop. If your vision was stable for a while after the drop then dry eye may explain it. So you can have your doctor try a different lens to see if it fits better or gives more stable vision. There are many choices and he (or a different doctor) likely has a different lens for you to try.
Best of luck,
Mitch Axelrod, OD
Posted by
Beacon Lee
contact lenses
Question
QUESTION: I am a 62 year old male.I wear a contact in both eyes for reading and distance.My question is when reading the l.eye when I blink down and open my eye the reading is very clear for a split second and then goes to a blurr.My doctor told me the problem was dry eye and has given me drops for dry eye.The drops I have been using now for 6 months.A drop in the am %26 again in the pm.I went back for a 6 month check-up and still have the same problem.The doctor says I have tryed everything I can do.
The lense is a Proclear Multifocal 8.7 14.4 +0.50/+2.50d.Could you give me some suggestions.
ANSWER: The symptom you describe is sometimes due to a lens that is flattened against the eye immediately after the blink but then puckers up after. Dry eye doesn't fully explain your symptom unless your symptom resolves for some time after instilling the drop. If your vision was stable for a while after the drop then dry eye may explain it. So you can have your doctor try a different lens to see if it fits better or gives more stable vision. There are many choices and he (or a different doctor) likely has a different lens for you to try.
Best of luck,
Mitch Axelrod, OD
---------- FOLLOW-UP ----------
QUESTION: Thanks for getting back so quickly.The problem is the same even after the using drops.I told the doctor the same thing you are telling me.It appears when a blink the lens is press up against the eye and then releases.The doctor appears to be aware of that but tells me that there are only what is out on the market to choice from as far as lens and fit.should I see another doctor.Thanks again
Answer
Yes you need a different doctor. There are many multifocal contact lenses to choose from. Make sure the new doctor knows the trouble you were having and let them discuss your options. Before you actually go for the exam you can tell his staff which lens you've tried and ask them to ask the doctor if they would have other options for you.
Regards,
Mitch Axelrod, OD
QUESTION: I am a 62 year old male.I wear a contact in both eyes for reading and distance.My question is when reading the l.eye when I blink down and open my eye the reading is very clear for a split second and then goes to a blurr.My doctor told me the problem was dry eye and has given me drops for dry eye.The drops I have been using now for 6 months.A drop in the am %26 again in the pm.I went back for a 6 month check-up and still have the same problem.The doctor says I have tryed everything I can do.
The lense is a Proclear Multifocal 8.7 14.4 +0.50/+2.50d.Could you give me some suggestions.
ANSWER: The symptom you describe is sometimes due to a lens that is flattened against the eye immediately after the blink but then puckers up after. Dry eye doesn't fully explain your symptom unless your symptom resolves for some time after instilling the drop. If your vision was stable for a while after the drop then dry eye may explain it. So you can have your doctor try a different lens to see if it fits better or gives more stable vision. There are many choices and he (or a different doctor) likely has a different lens for you to try.
Best of luck,
Mitch Axelrod, OD
---------- FOLLOW-UP ----------
QUESTION: Thanks for getting back so quickly.The problem is the same even after the using drops.I told the doctor the same thing you are telling me.It appears when a blink the lens is press up against the eye and then releases.The doctor appears to be aware of that but tells me that there are only what is out on the market to choice from as far as lens and fit.should I see another doctor.Thanks again
Answer
Yes you need a different doctor. There are many multifocal contact lenses to choose from. Make sure the new doctor knows the trouble you were having and let them discuss your options. Before you actually go for the exam you can tell his staff which lens you've tried and ask them to ask the doctor if they would have other options for you.
Regards,
Mitch Axelrod, OD
Posted by
Beacon Lee
Eye muscle twitching during/after pregnancy
Question
The muscle below my right eye began twitching constantly in the second month of pregnancy. My OB said it could be related but I gave birth 6 weeks ago and it is still twitching. I try to limit my caffeine intake but it hasn't seemed to help. Could this be anything serious? Is there anything I can do to stop it?
Answer
Hi Amy,
In all my years of practice, eyelid twitching is usually due to some form of stress. It cold be stress on the eyes from not wearing the proper prescription, stress due to lack of sleep, stress because you forgot to pay the gas bill etc, etc. If you have not had an eye exam in the last year, I would start there. Pregnancy rarely has any bearing on your glasses prescription unless you were diabetic during your pregnancy.
I hope this helps,
Dr. Wojciak
The muscle below my right eye began twitching constantly in the second month of pregnancy. My OB said it could be related but I gave birth 6 weeks ago and it is still twitching. I try to limit my caffeine intake but it hasn't seemed to help. Could this be anything serious? Is there anything I can do to stop it?
Answer
Hi Amy,
In all my years of practice, eyelid twitching is usually due to some form of stress. It cold be stress on the eyes from not wearing the proper prescription, stress due to lack of sleep, stress because you forgot to pay the gas bill etc, etc. If you have not had an eye exam in the last year, I would start there. Pregnancy rarely has any bearing on your glasses prescription unless you were diabetic during your pregnancy.
I hope this helps,
Dr. Wojciak
Posted by
Beacon Lee
ever increasing prescription
Question
i have recently had an eye test and have found out that my short sightedness has got worse, , my first test when i was about 13, my eyes were only -.25 a test about 3-4 years ago was only at -.75 now my eyes are -2.50 and -2.00, im 22 years of age and i have been in univeristy and studying, is this considered quite a steep increase and should i be wearing this new prescription full time or try and jst use it when i really need to? my new glasses seem quite strong for me, if they are overcorrecting my short sightnednes will wearing them make my eyes go even more short sighted and should i go back and get the optician to double check?
Answer
Your eyes still getting worse while you are still in the university is not so unusual, though that leap from -0.75 to -2.50 does sound a little extreme.
1) if it feels too strong, definitely go back and have it rechecked. If you wear glasses that are too strong you are likely to grow into them - and will wind up needing that Rx soon.
2) with your type of Rx, I recommend definitely NOT wearing them while studying on paper or computer. I believe you can see fine to read paper with your natural eyes and can see the computer ok if it is not too far away. If you wear your glasses for these activities, it is almost the same problem as wearing glasses that are too strong. It can make your eyes get worse faster. At -2.50 I would say you should wear them outdoors, definitely for driving, and for TV. You can try to get by without them the rest of the time.
i have recently had an eye test and have found out that my short sightedness has got worse, , my first test when i was about 13, my eyes were only -.25 a test about 3-4 years ago was only at -.75 now my eyes are -2.50 and -2.00, im 22 years of age and i have been in univeristy and studying, is this considered quite a steep increase and should i be wearing this new prescription full time or try and jst use it when i really need to? my new glasses seem quite strong for me, if they are overcorrecting my short sightnednes will wearing them make my eyes go even more short sighted and should i go back and get the optician to double check?
Answer
Your eyes still getting worse while you are still in the university is not so unusual, though that leap from -0.75 to -2.50 does sound a little extreme.
1) if it feels too strong, definitely go back and have it rechecked. If you wear glasses that are too strong you are likely to grow into them - and will wind up needing that Rx soon.
2) with your type of Rx, I recommend definitely NOT wearing them while studying on paper or computer. I believe you can see fine to read paper with your natural eyes and can see the computer ok if it is not too far away. If you wear your glasses for these activities, it is almost the same problem as wearing glasses that are too strong. It can make your eyes get worse faster. At -2.50 I would say you should wear them outdoors, definitely for driving, and for TV. You can try to get by without them the rest of the time.
Posted by
Beacon Lee
ever increasing prescription
Question
QUESTION: i have recently had an eye test and have found out that my short sightedness has got worse, , my first test when i was about 13, my eyes were only -.25 a test about 3-4 years ago was only at -.75 now my eyes are -2.50 and -2.00, im 22 years of age and i have been in univeristy and studying, is this considered quite a steep increase and should i be wearing this new prescription full time or try and jst use it when i really need to? my new glasses seem quite strong for me, if they are overcorrecting my short sightnednes will wearing them make my eyes go even more short sighted and should i go back and get the optician to double check?
ANSWER: Your eyes still getting worse while you are still in the university is not so unusual, though that leap from -0.75 to -2.50 does sound a little extreme.
1) if it feels too strong, definitely go back and have it rechecked. If you wear glasses that are too strong you are likely to grow into them - and will wind up needing that Rx soon.
2) with your type of Rx, I recommend definitely NOT wearing them while studying on paper or computer. I believe you can see fine to read paper with your natural eyes and can see the computer ok if it is not too far away. If you wear your glasses for these activities, it is almost the same problem as wearing glasses that are too strong. It can make your eyes get worse faster. At -2.50 I would say you should wear them outdoors, definitely for driving, and for TV. You can try to get by without them the rest of the time.
---------- FOLLOW-UP ----------
QUESTION: thanks for the quick response,
I sometimes wear contact lenses, your point about wearing the prescription when reading was interesting, does it make your eyes worse and how does it do that? should i try and limit my contact lens use as I will be wearing them for near and far distances, the last thing i want is my prescription to keep on increasing!
the most recent appointment, they used one of those auto machines and the machine said it came out as that and said that I will adapt to the new prescription,can i ask the optician to give me a slightly lower precscription so as to avoid my eyes getting more short sighted?
thanks in advance
Answer
Actually, there is controversy over whether reading with your correction on, or wearing glasses that are too strong does make your eyes worse. But I believe it does. What happens is this: If you have your proper correction on for distance viewing, then your eye muscles can only be at rest when you are looking at something twenty feet away or farther. To focus on anything closer, your eye muscles have to pull in to change the shape of the lens that is inside your eyes. When you are young, you don't realize this is happening because it is fairly automatic for young people.
So, if the eye muscles have to spend a large part of the day pulling inward to focus on a page or computer screen, they get tired and sort of stuck. Picture making a fist and holding it tight for like 8 hours. It would be hard to open it at the end of the day, right? Well, making your eyes focus up close all day as many do in our society is similar. At the end of the day, the eyes can be stuck in the near focus just a tiny bit. Over the course of weeks and months, this can translate into an actual permanent prescription change.
So, in your case, reading without your eyewear is more like making a loose fist all day, rather than a tight one. Your eye muscles can be almost at rest when you are focusing at near. So at the end of the day, it is much easier for your eyes to switch focus back to the far distance and they don't get stuck.
As for wearing your contact lenses, I would just do the best you can. If you have to read when you are not home, just go ahead and do so with the contact lenses on. But if you are home and just doing a bunch or reading or computer work, then just don't wear the contact lenses for that. Every little bit of not reading with the eyewear on helps.
If you still have concerns that your prescription is too strong, I urge you to go back and have it rechecked. The machines can make mistakes just like people can. If it turns out to be correct, then yes, you can ask the optician to cut the Rx a little. You will have to keep it clear enough to drive safely, but outside of that, there should be no reason the optician would not comply with your request.
QUESTION: i have recently had an eye test and have found out that my short sightedness has got worse, , my first test when i was about 13, my eyes were only -.25 a test about 3-4 years ago was only at -.75 now my eyes are -2.50 and -2.00, im 22 years of age and i have been in univeristy and studying, is this considered quite a steep increase and should i be wearing this new prescription full time or try and jst use it when i really need to? my new glasses seem quite strong for me, if they are overcorrecting my short sightnednes will wearing them make my eyes go even more short sighted and should i go back and get the optician to double check?
ANSWER: Your eyes still getting worse while you are still in the university is not so unusual, though that leap from -0.75 to -2.50 does sound a little extreme.
1) if it feels too strong, definitely go back and have it rechecked. If you wear glasses that are too strong you are likely to grow into them - and will wind up needing that Rx soon.
2) with your type of Rx, I recommend definitely NOT wearing them while studying on paper or computer. I believe you can see fine to read paper with your natural eyes and can see the computer ok if it is not too far away. If you wear your glasses for these activities, it is almost the same problem as wearing glasses that are too strong. It can make your eyes get worse faster. At -2.50 I would say you should wear them outdoors, definitely for driving, and for TV. You can try to get by without them the rest of the time.
---------- FOLLOW-UP ----------
QUESTION: thanks for the quick response,
I sometimes wear contact lenses, your point about wearing the prescription when reading was interesting, does it make your eyes worse and how does it do that? should i try and limit my contact lens use as I will be wearing them for near and far distances, the last thing i want is my prescription to keep on increasing!
the most recent appointment, they used one of those auto machines and the machine said it came out as that and said that I will adapt to the new prescription,can i ask the optician to give me a slightly lower precscription so as to avoid my eyes getting more short sighted?
thanks in advance
Answer
Actually, there is controversy over whether reading with your correction on, or wearing glasses that are too strong does make your eyes worse. But I believe it does. What happens is this: If you have your proper correction on for distance viewing, then your eye muscles can only be at rest when you are looking at something twenty feet away or farther. To focus on anything closer, your eye muscles have to pull in to change the shape of the lens that is inside your eyes. When you are young, you don't realize this is happening because it is fairly automatic for young people.
So, if the eye muscles have to spend a large part of the day pulling inward to focus on a page or computer screen, they get tired and sort of stuck. Picture making a fist and holding it tight for like 8 hours. It would be hard to open it at the end of the day, right? Well, making your eyes focus up close all day as many do in our society is similar. At the end of the day, the eyes can be stuck in the near focus just a tiny bit. Over the course of weeks and months, this can translate into an actual permanent prescription change.
So, in your case, reading without your eyewear is more like making a loose fist all day, rather than a tight one. Your eye muscles can be almost at rest when you are focusing at near. So at the end of the day, it is much easier for your eyes to switch focus back to the far distance and they don't get stuck.
As for wearing your contact lenses, I would just do the best you can. If you have to read when you are not home, just go ahead and do so with the contact lenses on. But if you are home and just doing a bunch or reading or computer work, then just don't wear the contact lenses for that. Every little bit of not reading with the eyewear on helps.
If you still have concerns that your prescription is too strong, I urge you to go back and have it rechecked. The machines can make mistakes just like people can. If it turns out to be correct, then yes, you can ask the optician to cut the Rx a little. You will have to keep it clear enough to drive safely, but outside of that, there should be no reason the optician would not comply with your request.
Posted by
Beacon Lee
cornea
Question
At my last visit to my eye doctor, he referred me to a cornea specialist, the optometrist said I had bubbles under my cornea. Many years ago I had RK surgery, this was also mentioned at the exam. What would bubbles under the cornea mean?
Answer
It probably means there are fluid filled cysts on the back surface of your cornea. They are probably from the deep RK incisions. Unless the clarity or health of the cornea is threatened, there may be nothing to do or worry about. So get the opinion from the corneal specialist and they will inform you about anything important to know.
Best of luck,
Mitch Axelrod,OD
At my last visit to my eye doctor, he referred me to a cornea specialist, the optometrist said I had bubbles under my cornea. Many years ago I had RK surgery, this was also mentioned at the exam. What would bubbles under the cornea mean?
Answer
It probably means there are fluid filled cysts on the back surface of your cornea. They are probably from the deep RK incisions. Unless the clarity or health of the cornea is threatened, there may be nothing to do or worry about. So get the opinion from the corneal specialist and they will inform you about anything important to know.
Best of luck,
Mitch Axelrod,OD
Posted by
Beacon Lee
PrismsBotched exam?
Question
I have been wearing prisms for about 40 years. My initial physician speculated the double-vision and lack of depth perception was experiencing was due to a head injury in childhood, but this isn't for sure. He said the injury was near the optic nerve.
Every doctor I've seen since followed through with prisms after seeing the double vision in their exams.
The current prism is a 3.
In my most recent exam. with new doctor, I mentioned I was experiencing sporadic double vision, so imagine my surprise when he didn't seem to detect my double vision, nor did the prescription call for prisms. When I mentioned this, he had the eyeglass maker next door check my glasses, then he added the prism.
I can't help but feel something went wrong. It seems to me that 40 years of prisms shouldn't be eliminated without mentioning it to the patient.
Did the doctor miss something, or have I miraculously been cured?
I intend to dispute his bill, but I'd like to know if it's just my imagination and lack of expertise.
As an update, I have telephoned and written to this doctor and he has not replied to my inquiries. I did pay half his bill of $170.00.
Answer
Actually the need for prism is easy to miss in a routine exam. I don't believe most doctors do all the available eye muscle functioning tests on every patient every time because such testing rarely turns up anything that is relevant to the handling of the case. It becomes much more important to check everything related to possible eye disease or dangerous conditions that could need immediate referral. The need for prism is much less definite and prescribing prism is more an art than a science.
In fact, if you don't specifically point out that you have needed prism in the past, you may easily wind up not getting it. It is even hard to miss prism in an existing pair of glasses when reading the prescription off them.
I would not be too hard on the doctor for not picking up the need for prism. It did get added back to your glasses, right? So no harm was done.
I have been wearing prisms for about 40 years. My initial physician speculated the double-vision and lack of depth perception was experiencing was due to a head injury in childhood, but this isn't for sure. He said the injury was near the optic nerve.
Every doctor I've seen since followed through with prisms after seeing the double vision in their exams.
The current prism is a 3.
In my most recent exam. with new doctor, I mentioned I was experiencing sporadic double vision, so imagine my surprise when he didn't seem to detect my double vision, nor did the prescription call for prisms. When I mentioned this, he had the eyeglass maker next door check my glasses, then he added the prism.
I can't help but feel something went wrong. It seems to me that 40 years of prisms shouldn't be eliminated without mentioning it to the patient.
Did the doctor miss something, or have I miraculously been cured?
I intend to dispute his bill, but I'd like to know if it's just my imagination and lack of expertise.
As an update, I have telephoned and written to this doctor and he has not replied to my inquiries. I did pay half his bill of $170.00.
Answer
Actually the need for prism is easy to miss in a routine exam. I don't believe most doctors do all the available eye muscle functioning tests on every patient every time because such testing rarely turns up anything that is relevant to the handling of the case. It becomes much more important to check everything related to possible eye disease or dangerous conditions that could need immediate referral. The need for prism is much less definite and prescribing prism is more an art than a science.
In fact, if you don't specifically point out that you have needed prism in the past, you may easily wind up not getting it. It is even hard to miss prism in an existing pair of glasses when reading the prescription off them.
I would not be too hard on the doctor for not picking up the need for prism. It did get added back to your glasses, right? So no harm was done.
Posted by
Beacon Lee
Upper eye lid swelling
Question
Hello Dr Shroff,
I have been suffering from a swelling on my upper left eye lid for the last 4 weeks. I have been to an ophthalmologist who dilated my eye, checked for anything wrong internally and thankfully answered back in the negative. I was advised to have anti inflammatory and swelling reduction medicine, which I had for 5 days but it has not ceased.
I woke up this morning to a very bad swelling and redness on my eye lid. I had used MAXIDEX last night and this is what it resulted in. This morning I applied Fucithalmic and had some more of those anti- swelling tabs together with an anti-allergy syrup. The problem is it gets better during the day and comes back with a vengeance in the night. There is no pain, no itchiness or any other discomfort.
I am flying next week and am worried that it might make it worse. Would you advise the next course of action?
Would really appreciate a quick response,
cheers
Answer
Dear Ruchi,
Wondering if this swelling is generalized or localized like a stye?
If it is a localized bump, it needs local hot fomentation at the earliest frequently to reduce it.
yes, the above medications also would help, but nothing like the hot fomentation.
If it is a generalized swelling one needs to look for causes such as foreign body under the lid, allergic reaction etc.
If the generalized swelling has beocme like a 'bump' now, it could have turned into a hard cyst.
Only after examination one would determine the exact diagnosis and treatment line accordingly.
If you have any eye report which describes this it would help greatly which can be then e mailed to dranand@lasikindia.in
Hope this helps,
Best,
Dr Anand Shroff
www.shroffeye.org
www.lasikindia.in
Hello Dr Shroff,
I have been suffering from a swelling on my upper left eye lid for the last 4 weeks. I have been to an ophthalmologist who dilated my eye, checked for anything wrong internally and thankfully answered back in the negative. I was advised to have anti inflammatory and swelling reduction medicine, which I had for 5 days but it has not ceased.
I woke up this morning to a very bad swelling and redness on my eye lid. I had used MAXIDEX last night and this is what it resulted in. This morning I applied Fucithalmic and had some more of those anti- swelling tabs together with an anti-allergy syrup. The problem is it gets better during the day and comes back with a vengeance in the night. There is no pain, no itchiness or any other discomfort.
I am flying next week and am worried that it might make it worse. Would you advise the next course of action?
Would really appreciate a quick response,
cheers
Answer
Dear Ruchi,
Wondering if this swelling is generalized or localized like a stye?
If it is a localized bump, it needs local hot fomentation at the earliest frequently to reduce it.
yes, the above medications also would help, but nothing like the hot fomentation.
If it is a generalized swelling one needs to look for causes such as foreign body under the lid, allergic reaction etc.
If the generalized swelling has beocme like a 'bump' now, it could have turned into a hard cyst.
Only after examination one would determine the exact diagnosis and treatment line accordingly.
If you have any eye report which describes this it would help greatly which can be then e mailed to dranand@lasikindia.in
Hope this helps,
Best,
Dr Anand Shroff
www.shroffeye.org
www.lasikindia.in
Posted by
Beacon Lee
No depth perception
Question
Hello--
I recently went into an Army hospital to have a flight physical to be a UAV operator. I was given a test to see how good my depth of field was. It was 10 rectangles, each with 3 circles each, and pair of glasses. It seems I have NO depth perception whatsoever.
I do have awful vision.. not quite sure on the numerics or anything. I am 18 years old and have been in glasses since the age of 3. I have a cross eye in my left eye. As I have gotten older, though, it's gotten better. It used to cross immediatly upon removing my glasses, but now it takes about 10 minutes.
How can I find out what causes this depth problem?
(From looking online, I know how I see depth.. colour/size/placement, etc, of objects.. but wondering what in my eyes could cause no natural perception.)
thanks
Answer
Depth perception comes from the discrepancy between the way each of the two eyes sees things, since both eyes are in a slightly different location on your head. Therefore, depth perception only arises IF your two eyes work together perfectly. As you said yourself, your eyes cross so that means they do not work together.
An eye doctor doing an exam on you would be able to tell you whether there is any chance of you gaining depth perception, now that your eyes don't cross so much. There is such a thing as vision therapy, a program of eye exercises that can improve depth perception in some cases. If your lack of depth perception is hindering your career choice, it may be worth a visit to an eye doctor who does vision therapy to find out if such a program of exercises would help you. To find such a doctor, you can Google "vision therapy" and your geographical location or check out this site: http://www.visiontherapydirectory.com.
Hello--
I recently went into an Army hospital to have a flight physical to be a UAV operator. I was given a test to see how good my depth of field was. It was 10 rectangles, each with 3 circles each, and pair of glasses. It seems I have NO depth perception whatsoever.
I do have awful vision.. not quite sure on the numerics or anything. I am 18 years old and have been in glasses since the age of 3. I have a cross eye in my left eye. As I have gotten older, though, it's gotten better. It used to cross immediatly upon removing my glasses, but now it takes about 10 minutes.
How can I find out what causes this depth problem?
(From looking online, I know how I see depth.. colour/size/placement, etc, of objects.. but wondering what in my eyes could cause no natural perception.)
thanks
Answer
Depth perception comes from the discrepancy between the way each of the two eyes sees things, since both eyes are in a slightly different location on your head. Therefore, depth perception only arises IF your two eyes work together perfectly. As you said yourself, your eyes cross so that means they do not work together.
An eye doctor doing an exam on you would be able to tell you whether there is any chance of you gaining depth perception, now that your eyes don't cross so much. There is such a thing as vision therapy, a program of eye exercises that can improve depth perception in some cases. If your lack of depth perception is hindering your career choice, it may be worth a visit to an eye doctor who does vision therapy to find out if such a program of exercises would help you. To find such a doctor, you can Google "vision therapy" and your geographical location or check out this site: http://www.visiontherapydirectory.com.
Posted by
Beacon Lee
Red & Yellow eyes in flash photos
Question
I noticed on my photos from last night that one of my eyes is glowing red and the other yellow (from flash). What could be causing this and should I be worried?
Answer
Hi Natasha,
The angle at which the light enters the eye will affect the color of the pupil (if your head is turned or tilted usually). Most of the time the flash glows red, but yellow is not unusual.
If you have any concerns, my advice is to get a complete eye exam.
Hope this helps,
Dr. Wojciak
I noticed on my photos from last night that one of my eyes is glowing red and the other yellow (from flash). What could be causing this and should I be worried?
Answer
Hi Natasha,
The angle at which the light enters the eye will affect the color of the pupil (if your head is turned or tilted usually). Most of the time the flash glows red, but yellow is not unusual.
If you have any concerns, my advice is to get a complete eye exam.
Hope this helps,
Dr. Wojciak
Posted by
Beacon Lee
Oasys vs accuvue 2
Question
I have been using an Accuvue 2 single lens in my right eye for reading. It works fine. It's a 4.0. I recently was advised to try an Oasys 4.0 and I did. I find that the ordinary Accuvue is much better for me-I can read much better than with the Oasys. They are both 4.0. Shouldn't they be the same as far as clarity is concerned? I can understand a difference in comfort (there is no difference for me in comfort) but I am thinking if both are 4.0 then my clarity should be the same and it's considerably different (worse) using the Oasys.
Answer
Hi John,
I guess even though they are the same power the optics are different. If the lens fits well and is not defective or inside out, then that is the only explanation. And that should not surprise you as patients often report a preference in vision across various brands/models of contacts.
Regards,
Mitch Axelrod, OD
I have been using an Accuvue 2 single lens in my right eye for reading. It works fine. It's a 4.0. I recently was advised to try an Oasys 4.0 and I did. I find that the ordinary Accuvue is much better for me-I can read much better than with the Oasys. They are both 4.0. Shouldn't they be the same as far as clarity is concerned? I can understand a difference in comfort (there is no difference for me in comfort) but I am thinking if both are 4.0 then my clarity should be the same and it's considerably different (worse) using the Oasys.
Answer
Hi John,
I guess even though they are the same power the optics are different. If the lens fits well and is not defective or inside out, then that is the only explanation. And that should not surprise you as patients often report a preference in vision across various brands/models of contacts.
Regards,
Mitch Axelrod, OD
Posted by
Beacon Lee
PrismsBotched exam?
Question
QUESTION:
I have been wearing prisms for about 40 years. My initial physician speculated the double-vision and lack of depth perception was experiencing was due to a head injury in childhood, but this isn't for sure. He said the injury was near the optic nerve.
Every doctor I've seen since followed through with prisms after seeing the double vision in their exams.
The current prism is a 3.
In my most recent exam. with new doctor, I mentioned I was experiencing sporadic double vision, so imagine my surprise when he didn't seem to detect my double vision, nor did the prescription call for prisms. When I mentioned this, he had the eyeglass maker next door check my glasses, then he added the prism.
I can't help but feel something went wrong. It seems to me that 40 years of prisms shouldn't be eliminated without mentioning it to the patient.
Did the doctor miss something, or have I miraculously been cured?
I intend to dispute his bill, but I'd like to know if it's just my imagination and lack of expertise.
As an update, I have telephoned and written to this doctor and he has not replied to my inquiries. I did pay half his bill of $170.00.
ANSWER: Actually the need for prism is easy to miss in a routine exam. I don't believe most doctors do all the available eye muscle functioning tests on every patient every time because such testing rarely turns up anything that is relevant to the handling of the case. It becomes much more important to check everything related to possible eye disease or dangerous conditions that could need immediate referral. The need for prism is much less definite and prescribing prism is more an art than a science.
In fact, if you don't specifically point out that you have needed prism in the past, you may easily wind up not getting it. It is even hard to miss prism in an existing pair of glasses when reading the prescription off them.
I would not be too hard on the doctor for not picking up the need for prism. It did get added back to your glasses, right? So no harm was done.
---------- FOLLOW-UP ----------
QUESTION: When I made the original appointment, I mentioned I was having double vision episodes, and I replied "yes" when the assistant asked me if I were having double vision during the Pre-exam.
I appreciate what you're saying, as I have lived long enough to make a lot of mistakes. This incident had made me lose faith in the doctor, however, and I admit to being annoyed that he hasn't replied to my inquiries.
Yes, I got the prisms, but how do know it's the correct amount since he didn't do that part of the exam?
Thank you for your time.
Answer
Well, of course it is annoying that the doctor has not taken the time to respond to your inquiries. It sounds like you just had an overall bad experience in that office, so I assume you will not go back there next time.
However, still trying to defend the probable validity of your prescription, when I said prescribing prism is more of an art than a science, I meant that even when the doctor knows a patient needs prism, the amount he prescribes is not so much an exactly scientific result of the testing as it is a more "seat of the pants" decision. Oh, there are rules we all learned in Optometry school, but in practice I think most eye doctors wind up throwing the rules about prescribing prism out the window and just go with what works for each individual patient. Sometimes it is a trial and error situation at best.
If the glasses you got seem to be working, I would not worry about the prism amount any longer. In most cases, if the prism amount is not right, the patient will have problems and can tell there is a problem much more accurately than the doctor could.
QUESTION:
I have been wearing prisms for about 40 years. My initial physician speculated the double-vision and lack of depth perception was experiencing was due to a head injury in childhood, but this isn't for sure. He said the injury was near the optic nerve.
Every doctor I've seen since followed through with prisms after seeing the double vision in their exams.
The current prism is a 3.
In my most recent exam. with new doctor, I mentioned I was experiencing sporadic double vision, so imagine my surprise when he didn't seem to detect my double vision, nor did the prescription call for prisms. When I mentioned this, he had the eyeglass maker next door check my glasses, then he added the prism.
I can't help but feel something went wrong. It seems to me that 40 years of prisms shouldn't be eliminated without mentioning it to the patient.
Did the doctor miss something, or have I miraculously been cured?
I intend to dispute his bill, but I'd like to know if it's just my imagination and lack of expertise.
As an update, I have telephoned and written to this doctor and he has not replied to my inquiries. I did pay half his bill of $170.00.
ANSWER: Actually the need for prism is easy to miss in a routine exam. I don't believe most doctors do all the available eye muscle functioning tests on every patient every time because such testing rarely turns up anything that is relevant to the handling of the case. It becomes much more important to check everything related to possible eye disease or dangerous conditions that could need immediate referral. The need for prism is much less definite and prescribing prism is more an art than a science.
In fact, if you don't specifically point out that you have needed prism in the past, you may easily wind up not getting it. It is even hard to miss prism in an existing pair of glasses when reading the prescription off them.
I would not be too hard on the doctor for not picking up the need for prism. It did get added back to your glasses, right? So no harm was done.
---------- FOLLOW-UP ----------
QUESTION: When I made the original appointment, I mentioned I was having double vision episodes, and I replied "yes" when the assistant asked me if I were having double vision during the Pre-exam.
I appreciate what you're saying, as I have lived long enough to make a lot of mistakes. This incident had made me lose faith in the doctor, however, and I admit to being annoyed that he hasn't replied to my inquiries.
Yes, I got the prisms, but how do know it's the correct amount since he didn't do that part of the exam?
Thank you for your time.
Answer
Well, of course it is annoying that the doctor has not taken the time to respond to your inquiries. It sounds like you just had an overall bad experience in that office, so I assume you will not go back there next time.
However, still trying to defend the probable validity of your prescription, when I said prescribing prism is more of an art than a science, I meant that even when the doctor knows a patient needs prism, the amount he prescribes is not so much an exactly scientific result of the testing as it is a more "seat of the pants" decision. Oh, there are rules we all learned in Optometry school, but in practice I think most eye doctors wind up throwing the rules about prescribing prism out the window and just go with what works for each individual patient. Sometimes it is a trial and error situation at best.
If the glasses you got seem to be working, I would not worry about the prism amount any longer. In most cases, if the prism amount is not right, the patient will have problems and can tell there is a problem much more accurately than the doctor could.
Posted by
Beacon Lee
eye power
Question
sir,
my eye power is -5.. do i come under 6/6??
Answer
Dear Tamil,
You may or may not, as this has to be determined by the optometrist or eye doctor checking your visual acuity.
Please ask this Q to someone who will be testing you as your answer comes in the examination process.
Thanks,
Dr Shroff
sir,
my eye power is -5.. do i come under 6/6??
Answer
Dear Tamil,
You may or may not, as this has to be determined by the optometrist or eye doctor checking your visual acuity.
Please ask this Q to someone who will be testing you as your answer comes in the examination process.
Thanks,
Dr Shroff
Posted by
Beacon Lee
Seeing bright lights and ghost images of different types
Question
Sir,
I am a RP patient. I am 40 yrs old. I have totally lost my vision in both the eyes, but still some light perception remains. I used to have severe headaches, as I had high eye pressure. The doctor kept me on medication to control the eye pressure for about a year and later minor angular eye surgeries were performed in both the eyes. But the eye pressure could not be brought down. So, he had to do the major Glaucoma eye surgery. Now the eye pressure has come down below 20 but I am facing a new problem. I am seeing bright lights and ghost images in both my eyes. Constantly I see them on the nose, cheeks and forehead etc. It is really difficult to explain what really I am experiencing. If I close my eyes, even then the lights and the images persist. I find it difficult to concentrate on anything. My doctor has told me that this is happening because of the drying of nerves and the nerves are giving away bright lights and color images. My doctor has also told that nothing can be done about it as the problem will remain even if one decides to remove the eyes. I had accepted mentally that I will loose my vision but this problem of seeing bright lights and ghost images is totally unbearable. The doctor also told me that since I am seeing theses images through the brain, I should consult a psychiatrist. Please advice for my next course of action. My life has become very difficult, not for the vision that I have lost, but for these bright lights and the ghost images which are driving me mad. Truly thank you..
Answer
Dear Fatema,
I have also consulted a psychiatrist regarding your symptoms.
There is a possibility that these are visual hallucinations which can be either organic i.e. some intracranial pathology or it can be part of psychotic symptoms.
To rule out either one needs to do a CT/MRI.
However, it is best to be under the care of the specialist and follow his advise.
Best,
Dr Shroff
Sir,
I am a RP patient. I am 40 yrs old. I have totally lost my vision in both the eyes, but still some light perception remains. I used to have severe headaches, as I had high eye pressure. The doctor kept me on medication to control the eye pressure for about a year and later minor angular eye surgeries were performed in both the eyes. But the eye pressure could not be brought down. So, he had to do the major Glaucoma eye surgery. Now the eye pressure has come down below 20 but I am facing a new problem. I am seeing bright lights and ghost images in both my eyes. Constantly I see them on the nose, cheeks and forehead etc. It is really difficult to explain what really I am experiencing. If I close my eyes, even then the lights and the images persist. I find it difficult to concentrate on anything. My doctor has told me that this is happening because of the drying of nerves and the nerves are giving away bright lights and color images. My doctor has also told that nothing can be done about it as the problem will remain even if one decides to remove the eyes. I had accepted mentally that I will loose my vision but this problem of seeing bright lights and ghost images is totally unbearable. The doctor also told me that since I am seeing theses images through the brain, I should consult a psychiatrist. Please advice for my next course of action. My life has become very difficult, not for the vision that I have lost, but for these bright lights and the ghost images which are driving me mad. Truly thank you..
Answer
Dear Fatema,
I have also consulted a psychiatrist regarding your symptoms.
There is a possibility that these are visual hallucinations which can be either organic i.e. some intracranial pathology or it can be part of psychotic symptoms.
To rule out either one needs to do a CT/MRI.
However, it is best to be under the care of the specialist and follow his advise.
Best,
Dr Shroff
Posted by
Beacon Lee
ocular headache/ toric iols
Question
QUESTION: I can see clearly with my new toric IOLs, but I have dull ocular headaches. Do you think there could be a correlation between the IOLs and the headaches?
ANSWER: Dear Ann,
Could be if the powers are not well adjusted to or facing some dryness issue.
Try using them sparingly initially and slowly increase the time of use.
If it still persists, revisit your opticia to check the powers
See if this helps.
Best,
Dr Shroff
www.shroffeye.org
---------- FOLLOW-UP ----------
QUESTION: Hi, Dr. Shroff
My torics are not contact lenses but are AcrysofIQ toric IOLs implanted after cataract surgery 7 1/2 and 4 1/2 weeks ago. The headache is not tooo bad, what I feel mostly is a pressure in the sinus area below the eye. One eye did get a black eye from the anesthesia shot. That was following the first surgery 7 1/2 weeks ago. The black eye cleared up, but now appears to be returning and I feel a little tingling in the sinus area there (and the skin sinks in a little). 7 1/2 weeks seems like a long time to still have those types of effects from surgery. I am 54 y.o.
Thanks so much for your reply!
Answer
Dear Ann,
Sorry, did not pay attention to the IOL part.
You need to get checked for sinusitis which does play up with similar symptoms, esp as there are many eye drops being put frequently after the cataract surgery.
In absence of this, it may be that you need to use some prescriptive glasses, which if not being used can also give rise to such symptoms,.
Both of this can be ruled out by your treating eye doctor.
Revisit the clinic and ask them to check your refraction and see the need for glasses.
Hope this helps,
Best,
Dr Shroff
QUESTION: I can see clearly with my new toric IOLs, but I have dull ocular headaches. Do you think there could be a correlation between the IOLs and the headaches?
ANSWER: Dear Ann,
Could be if the powers are not well adjusted to or facing some dryness issue.
Try using them sparingly initially and slowly increase the time of use.
If it still persists, revisit your opticia to check the powers
See if this helps.
Best,
Dr Shroff
www.shroffeye.org
---------- FOLLOW-UP ----------
QUESTION: Hi, Dr. Shroff
My torics are not contact lenses but are AcrysofIQ toric IOLs implanted after cataract surgery 7 1/2 and 4 1/2 weeks ago. The headache is not tooo bad, what I feel mostly is a pressure in the sinus area below the eye. One eye did get a black eye from the anesthesia shot. That was following the first surgery 7 1/2 weeks ago. The black eye cleared up, but now appears to be returning and I feel a little tingling in the sinus area there (and the skin sinks in a little). 7 1/2 weeks seems like a long time to still have those types of effects from surgery. I am 54 y.o.
Thanks so much for your reply!
Answer
Dear Ann,
Sorry, did not pay attention to the IOL part.
You need to get checked for sinusitis which does play up with similar symptoms, esp as there are many eye drops being put frequently after the cataract surgery.
In absence of this, it may be that you need to use some prescriptive glasses, which if not being used can also give rise to such symptoms,.
Both of this can be ruled out by your treating eye doctor.
Revisit the clinic and ask them to check your refraction and see the need for glasses.
Hope this helps,
Best,
Dr Shroff
Posted by
Beacon Lee
vision problems years after lasik
Question
I am 37 year old female. I began wearing glasses for nearsightedness when I was 8. At age 30 I had lasik surgery. My vision at the time was somewhere around -10. Following the surgery I had 20/20 but soon after I began having difficulty seeing at night and got glasses to help. I believe the prescription was somewhere around -1.5 in Right eye and -.5 in left. A while after that, I started having a really strange sensation that my left eye was not focusing properly. It became so uncomfortable that I started wearing the glasses all the time because it seemed to help. I still wear glasses all the time however every time I get a new pair it takes a long time to adjust. I keep having to have the left side of the frame adjusted to just the right spot or I feel that same strange sensation. Also, I get headaches, light sensitive and it feels like it is hard to focus on things that are moving fast like cars or on the TV. I am wondering if there is something I can do. I usually have a lot of anxiety about getting new frames because I am never sure if I will eventually get used to them. Any help would be greatly appreciated.
Answer
Dear Natalie,
It is possible that your headaches and symptoms are related to maybe a prescription which is not being addressed by the current prescription or you may be having a sinus headache / allergies / cold where the nerve supply being similar to that of the eyes, gives rise to the above symptoms which you may think of as coming from the eyes, but cause is elsewhere.
take it step at a time, first check with the optometrist if there is any change in prescription.
If not significant then a physician would help rule out other causes.
Hope this helps,
Best,
Dr Shroff
I am 37 year old female. I began wearing glasses for nearsightedness when I was 8. At age 30 I had lasik surgery. My vision at the time was somewhere around -10. Following the surgery I had 20/20 but soon after I began having difficulty seeing at night and got glasses to help. I believe the prescription was somewhere around -1.5 in Right eye and -.5 in left. A while after that, I started having a really strange sensation that my left eye was not focusing properly. It became so uncomfortable that I started wearing the glasses all the time because it seemed to help. I still wear glasses all the time however every time I get a new pair it takes a long time to adjust. I keep having to have the left side of the frame adjusted to just the right spot or I feel that same strange sensation. Also, I get headaches, light sensitive and it feels like it is hard to focus on things that are moving fast like cars or on the TV. I am wondering if there is something I can do. I usually have a lot of anxiety about getting new frames because I am never sure if I will eventually get used to them. Any help would be greatly appreciated.
Answer
Dear Natalie,
It is possible that your headaches and symptoms are related to maybe a prescription which is not being addressed by the current prescription or you may be having a sinus headache / allergies / cold where the nerve supply being similar to that of the eyes, gives rise to the above symptoms which you may think of as coming from the eyes, but cause is elsewhere.
take it step at a time, first check with the optometrist if there is any change in prescription.
If not significant then a physician would help rule out other causes.
Hope this helps,
Best,
Dr Shroff
Posted by
Beacon Lee
Subscribe to:
Posts (Atom)