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Contact lens prescription fluctuates
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Contact lens prescription fluctuates

My contact lens prescription regularly fluctuates. Both eyes are usually around +6.0, occasionally +6.5, most of the time they're stable and drift just a little.

Around once a year my eyes undergo significant fluctuations. In the past two weeks my eyes have dropped from +6.5R +6.0L to +4.75R and +5.0L. They may reach as low as +4.5. I expect in 1-2 weeks they'll go back up toward +6.0. This has been happening for years. I have every contact lens strength from +4.5 to +6.5.

I see a good optometrist at least annually, he's looked at my eyes in both states, and he has no idea what's going on. He sent me to a doctor for a diabetes test, the doctor asked me a series of questions then said it wasn't even worth doing the blood test.

One change to my diet recently: I have started eating cereal with yoghurt for breakfast instead of eggs with cheese, and I've started eating more chocolate. My body seems to work better on protein and fat, but cereal's easier and everyone likes chocolate. My eye fluctuations appear to have started before the diet change. I've also started eating more gluten, which until not long ago I was actively trying to avoid, just to see what happened. When I eat low sugar low gluten/carb I tend to lose weight.

Can anyone suggest if this fluctuation is a problem, and how I should go about diagnosing the cause?
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233488_tn?1310696703
I don't know why your optometrist is so clueless. This is a common problem with contact lens wearers and is caused by "warping" of the cornea which can cause irregular astigmatism and blurred vision not corrected with glasses or contacts. I have seen cases where it's taken 3-6 months for the warped cornea to return to "regular astigmatism or spherical shape"  Another mechnism is corneal swelling (edema). If the cornea steepens (as in your case) it makes the eye more myopic or less hyperopic.  In rare cases permanent irregular astigmatism or keratoconus has been caused by contacts.

If your A1C test was normal you do not have diabetes. I would suggest you see a Eye Md ophthalmologist that specializes in cornea/refractive surgery.  Don't wear your contacts for 2-3 weeks before seeing him/her. They will do a cornal topography test.  You can ask about whether you should continue contacts with this history; wear glasses or consider hyperopic refractive surgery.

JCH MD
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Avatar_m_tn
One more thing. After reading diabetes symptoms one thing stands out: I always get up during the night at least once once and often twice to use the bathroom. Occasionally it's 4 times. I drink 2.5L of water during the day at my desk in an air conditioned office. I drink 0.5L of water with dinner. I'd like to drink more, I have to restrict myself otherwise I'm up 4 times during the night.

36 year old male, asthma and hay fever, otherwise healthy.
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233488_tn?1310696703
I don't know why your optometrist is so clueless. This is a common problem with contact lens wearers and is caused by "warping" of the cornea which can cause irregular astigmatism and blurred vision not corrected with glasses or contacts. I have seen cases where it's taken 3-6 months for the warped cornea to return to "regular astigmatism or spherical shape"  Another mechnism is corneal swelling (edema). If the cornea steepens (as in your case) it makes the eye more myopic or less hyperopic.  In rare cases permanent irregular astigmatism or keratoconus has been caused by contacts.

If your A1C test was normal you do not have diabetes. I would suggest you see a Eye Md ophthalmologist that specializes in cornea/refractive surgery.  Don't wear your contacts for 2-3 weeks before seeing him/her. They will do a cornal topography test.  You can ask about whether you should continue contacts with this history; wear glasses or consider hyperopic refractive surgery.

JCH MD
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Avatar_m_tn
John,

Thank you so much for your valuable reply. Is there a condition name that I should give to my optometrist to look into, or some reference? I will have to go through him to get to see a ophthalmologist. He's said a few of his patients experience these symptoms.

I don't have glasses. Even if I did, now that my prescription has fluctuated they wouldn't be the right prescription anyway. If I got glasses that were correct now I'd have to change them in two weeks anyway. Having six boxes of contacts gets around that problem, six pairs of glasses is more expensive, but still possible.

I haven't had an A1C test, my doctor asked me questions and determined it was unnecessary. I have a new doctor now so I'll follow up with him.

Many thanks,

T
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233488_tn?1310696703
I would suggest you get a second opinion rather than try and educate your optom on things he/she should already know. You can find a cornea/refractive specialty ophthalmologist Eye MD near you at www.geteyesmart.org

JCHMD
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Avatar_m_tn
Thank you John, I'll do that, or I'll get a referral from my GP direct to an ophthalmologist .
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233488_tn?1310696703
Best of luck
JCH MD
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