Different Prescriptions with different optometrist after cataract surgery

[prabs2101]

Hi all,

I am 37 year old guy who was having high myopia -14 Sph and -4 Cyl 180 axis in both eyes, got early cataract and done with surgery with monofocal IOL implant of power +4D (Alcon Acrysof).

Now after 5 months, from the same clinic (where I got operated) I have got a prescription as below-

Prescription 1
RE   -0.00 Sph .  -0.50 Cyl 180 axis . Vision 20/30
LE   +0.75 Sph .  -1.00 Cyl 165 axis,. Vision 20/30
Reading addition +2.50 in both eyes at N6

To cross check, within a week, when visited another well known highly reputed clinic, they prescribed as below-

Prerscription 2
RE    -0.00 Sph  -1.00 Cyl  5 axis . Vision 20/30
LE   +0.75 Sph  -1.75 Cyl 165 axis . Vision 20/30
Reading addition +2.75 in both eyes . at N6

Can anyone suggest me, which one is correct or better

where is the problem ?
How different these prescriptions are ?
Which one I can consider as correct ?
Should I go to third optometrist ?

[SoftwareDeveloper]

I'll add that studies show your eye's refractive error  can vary a bit even throughout a  day. You could have the same person do your exam at different times the same day and wind up with different results. Things like dry eye can impact refractions since the tear film on your eye has a surprising amount of lens power, and perhaps your eyes  were dry one day and not the other.

If you are concerned and don't mind time/money, you could always get a third refraction and see if it matches one of those (though it might differ and add to the confusion, matching one part of one and part of the other). Or you could then average them (offline they might require a written prescription, but if you order glasses online you can just enter values yourself)

Also of course the exams aren't completely precise, as the doctor noted they are subject, but  they are  also done to the nearest 0.25D and you might be close to a boundary. e.g. if someones exact reading is at -0.62D the closest notch is -0.5, and if their exact reading is -0.88D the closest notch is -1D, so your eye could change by only -0.26D and switch from -0.5D to -1D.

[JohnHaganMD]

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[prabs2101]

Thanks a lot Dr. Hagan,
I have visited optical shop again and tried oth prescriptions. With both prescriptions I can see 20/30 but with prescription 2 having -1.0 Cyl in RE and -1.75 Cyl in LE, clarity and contrast is better so I have chosen it as final.

One question-
Is it better to have more negative  spherical equivalent (Prescription 2: RE -0.5D LE -0.125D as compare to Prescription 1: RE -0.25D  LE +0.25D)t in high myopia after cataract surgery ?

[JohnHaganMD]

No the ideal is to have the exact sphere, cylinder and axis that gives you the best visual acuity.  Anything more or less reduces best corrected visual acuity

[JohnHaganMD]

First of all there isn't that much difference between the two Rx's and you don't see better with one than the other. Second refractions are subjective tests which means you pick the lens that is clearest, thus some people are not very good observers and the same technician testing a person may come up with two different Rxs when testing the same person at different times.   So you picked the RX differently when you were tested. If you go to a third person you may pick yet another prescription.  I would just get the one you felt most comfortable with the testing as I said you see the same with both (20/30)