Changing Rx and Diagnosis

[itj]

I am in my early thirties and finally decided to see an Optometrist regarding
difficulty I have been having with slight blurriness when watching a
television seated anywhere from seven to twelve feet away, reading a book, or
working at my laptop (which I due a minimum of eight hours a day since I am
in Information Technology as a profession).  Upon my first visit during which
I my eyes were dilated, I was diagnosed with mild astigmatism as well as
slight hyperopia and given an Rx for +0.50 -1.75 x 010/pL -1.25 x 001.  I got
the glasses and found they only slightly helped.  I went back for a second
test during which my eyes were not dilated and was diagnosed with latent
hyperopia and given an Rx for -0.50 -1.75 x 008/-1.00 -1.25 x 180.  I got the
second pair of glasses and do have more improvement in my vision.  Based upon
what I have read, hyperopia calls for a "+" diopter in the Rx, which is what
I was initially given, and myopia calls for a "-" diopter, which is what I
was subsequently given on the follow up visit when I was diagnosed with
latent hyperopia.  My concern is whether or not the two different Rx are
consistent with standard practice as solutions to the two diagnosis.  Will
someone much smarter and more experienced than I please give me their opinion.

Thank you very much for any information or help that may be provided,

[itj]

Thank you again for such a prompt response.  I understand the dilemma of not having enough data to give me an answer as to what Rx I may need, and this is honestly not something I would ask you for since I am sure that is not the intent of this forum.  I am only trying to understand the reason for the confusing "-" values of the second Rx.  To do this, I think our only option unfortunately is to work in the realm of presumption and theory.  With that being said, in your opinion, based upon the details already given, would you say that the -0.50 OD and -1.00 OS in the second Rx is meant to address the slight blurriness when viewing objects at distances of seven to twelve feet?  Would you also theorize that since I "may be young enough that my focus muscle may be strong enough" to compensate for the hyperopia, this explains why the second set of glasses correct none of the hyperopia?  I apologize for basically posing the same questions again in a different manner, and I sincerely hope that this does not annoy you.  I suppose I am just trying to understand why I the second Rx with "-" diopters would be given to a person diagnosed with hyperopia - latent or otherwise unless the "-" diopters are intended to address the slight blurriness at distance while the latent hyperopia accommodation addresses the slight blurriness with near objects.

Thank you again for your time and patience.

[John C Hagan III, MD, FACS, FAAO]

First its extremely important to know the amount of latent hyperopia. This can only be done by dilating your eye with a fairly strong cycloplegic drop and determining the true amount of total hyperopia. It would be important to be sure you eye is healthy and without disease.

It would be important to know your age and what your symptoms are.  Lastly a test done as a second visit or prior to dilating the eye called "fogging and pushing plus" would be done to see how much of the total hyperopia your eye will "accept".

Then based on clinical judgement a determination of the RX needs to be done. In some cases I will tell a person that the glasses will be initialy blurry but should be clear after a week or two of wear.


So I do not have enough data to give you an answer as what RX you need.

JCH MD

[itj]

First, thank you for your very prompt reply and details.  So would you say that the hypothesis is I may be young enough to accommodate for the latent hyperopia thereby compensating for my problem of slightly blurry vision when reading a book or viewing a computer screen - explaining why my second Rx corrects none of the hyperopia, and the "-" OD and OS of the second Rx is to aid in the slightly blurry vision when viewing objects at distance like a television at seven to twelve feet away?

Again,
Thank you very much for your help and guidance

[John C Hagan III, MD, FACS, FAAO]

latent hyperopia in a young person give very inconsistent and variable readings. Your second RX indicates that your eye did not "accept" the hyperopic correction. Your glasses now correct your astigmatism but none of the hyperopia. Your are young enough that your focus muscle may be strong enough to do the work.

If not you would have to have a stronger (+) pair for reading/computer and your present pair for distance.

JCH MD