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.
Showing posts with label Eye Care. Show all posts
Showing posts with label Eye Care. Show all posts
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
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