Worsening Vision, Stronger Prescription Needed?

[johnnyky]

Hi everyone. I am very nearsighted, my last vision test has me at 20/200 without glasses in both eyes. I've worn glasses since 4th grade, I'm 32 now. My vision seems to have gotten much worse in the last year or two. I have trouble seeing things even with my glasses. Like I still find signs & anything more then a few feet to be a bit blurry and not as sharp as I think it should be. I also am having headaches. I have to wear my glasses all day all the time to see. Without them I can't see anything. But I dont think the optometrist I was seeing got my last prescriptions right because shouldn't I have better than perfect, sharp vision with glasses? But I don't. And in the past couple of years I am having a lot of trouble reading too. WITH my glasses. Like I can't read with them on or without them. So maybe i am farsighted and nearsighted both? But noone has ever tested my reading vision? It seems like my right eye is slightly worse than the left. I get aches in it and feels strained. I am seeing a new optometrist in a couple weeks Im hoping he can get to the bottom of this. I had my eyes dilated a year or so ago and the last exam a month or so ago showed nothing abnormal.

Am I crazy or should my prescription be much stronger than what he wrote me? My prescription a month ago read as follows:

right eye: sphere:-2.50, cylinder: -0.50, axis: 013
left eye: sphere: -2.25, cylinder: -1.00, axis: 010

I don't know how to read a prescription but I know the higher the negative numbers the stronger the prescription. So is mine considered strong or moderate or what? I also have astigmatism and have to wear tinted lenses due to extreme sensitivity to light. Im getting a new exam with a different doctor because my prescription this guy wrote barely changed in a year, but yet I know I need a stronger one because I can't see well at all with my glasses on. A few years ago a different eye doctor wrote me one and the negative numbers were almost -4.00 and I saw the best and the clearest ever in my life with those glasses. Thanks for any input.              

[MissJarie]

My sister too is nearsighted, but a year ago we found out her grade lowered (I guess in my country we use a different unit) anyway, apparently her eyesight was getting better. It was the first time I've heard someone's eyesight could improve, I thought it would only deteriorate. So, we had to get another prescription. And then a few months ago, I've learned this eye relaxation method, called Bates Method. So I asked her to do it (with my constant guidance and nagging of course) eventually her eyesight's gotten better, from 175 to 150 on her right eye and 150 to 125 on her left.

I was just wondering if you're interested in the method? All you'll need are your palms, some sunlight, determination and patience. ;)
Anyway, check this out if you want to:
http://perfecteyesightcenter.com/

You could also go through youtube videos, there are so many testimonies in there regarding the method. I honestly can't attest to its changes as my eyesight is normal (but I still do the method just to prevent possible deterioration of my vision.)

[SoftwareDeveloper]

re: "As far as my astigmatism, I suspect it's whats gotten much worse"

Yup, that make sense, that occurred to me as a possibility just after I posted that, but I had something else to do and didn't get back to this site till today. It isn't clear though it if explains all your symptoms,  and it seems odd that the most recent exam wouldn't have caught it if that was the problem, unless the doctor really did make uncommonly large   mistakes with finding your prescription... but thats always possible. Another possible but unlikely scenario is that they made a mistake producing your glasses.

re: "& possibly farsightedness"

You can't be both nearsighted and farsighted at the same time. The issue as I mentioned with older folks needing reading glasses is presbyopia, the eye not being able to change focus from far to near as well as when younger.  Most people don't have that issue at your age, but almost everyone will in their forties  so there is no harm in learning about it early in case thats what it is. (some lucky few have eyes with what they call more natural "depth of focus" which makes up for  the lack of ability to change focus)

Although it seems unlikely you'd need reading correction at your age, if you do  the "no-line bifocals" you refer to are also called "progressive" glasses. Just as with the lined version, if you look up top you can see at distance, and lower down is for nearer, with different model glasses varying in the shapes and sizes of the different "zones".

Since you are talking about glasses I'm suspecting you prefer them to contact lenses, however I found contact lenses to be a more convenient way to deal with presbyopia. Unlike with bifocal/progressive glasses where you need to look through them at a different place to focus on different distances, multifocal contacts let you see at all distances without needing to move your head or look in a specific direction. Not everyone likes them,   there are some drawbacks like poorer vision in dim light, and it depends on whether you like the idea of wearing contacts. However I found them very easy to adapt to, and didn't like progressive glasses. (though I was also highly myopic, and with a difference between the eyes, -9.5D and -6D or so,  which is in general easier to correct for in contacts than glasses).

[johnnyky]

Thanks so much for the great response I appreciate it. I have been nearsighted since the age of 9 or so, and worn glasses ever since. I can't see at all without my glasses everything is very blurry. I also have astigmatism in both eyes think. But in the last few years it seems things have gotten both blurrier and more out of focus without my glasses, and as I said with my glasses even, things are still blurry. My right eye feels like I am always straining it to see even with glasses.

And my complaint is that I can't read at all with my glasses on unless I have it almost right against my face. And without my glasses I can hardly see to read either. Until the last 2 or 3 years I was able to at least read ok without my glasses on.

So when I see the new optometrist, I will definitely tell him about this. Is it possible to get a prescription for lenses that correct my astigmatism, nearsightedness, & possibly farsightedness all in one? If the answer is bifocals, I defintely don't want line bifocals because I mainly wear my glasses just to function to see short and long distances. But I don't want to have to take my glasses off to read because I have trouble with the light and also because it's a hassle.

So maybe the answer will be no-line bifocals? So I'll be able to keep my glasses on to see and also to read print and computer screens and such.

As far as my astigmatism, I suspect it's whats gotten much worse the last few years and that accounts for my increasing lack of clarity even with my glasses and the general blurriness. I think they told me once it was worse in one eye than the other but I don't remember which. I just know that a few years ago even though I didn't see well at all without glasses, things were less blurry now things are totally a blurred haze. Especially things like screens (tv or computer, signs, etc).

To sum up, even with my glasses things are still very blurry and out of focus and not sharp enough, and I can't read at all, and distances are still blurry. I hope this can be resolved.

[SoftwareDeveloper]

re: "So is mine considered strong or moderate or what?"

There is no one standard definition of the various degrees of myopia, but  up to -3 tends to be low myopia, then to -6 moderate, and high above that. A quick search shows this page for example:

http://www.eyehealthweb.com/myopia/
"When looking at an eyeglass prescription, a minus sign indicates a prescription for nearsightedness, and the numbers that follow indicate the degree of nearsightedness.

    0 = normal or emmetropic
    -0.25 to -3.00 diopters = mild nearsightedness
    -3.25 to -6.00 diopters = moderate nearsightedness
    -6.25 to -10.00 diopters = severe nearsightedness
    -10.25 diopters or higher = extreme nearsightedness"


re: "a different eye doctor wrote me one and the negative numbers were almost -4.00"

I don't think its common at that age to become less myopic. If you have trouble seeing distance then initially that does sound like the prescription isn't strong enough, and you should be checked by another doctor to confirm it.  However it would also not be very common for a prescription to be off by -1.5 or more (the difference between -4 and -2.5 prescriptions). I seem to recall that studies show refractions tend to vary at most by like 0.25 or 0.5 between competent doctors (not positive about the exact numbers, but I'm sure its no where near a  1.5D error).

The issue of not being able to see to read  well either does suggest there might be some other vision problem at work, and it seems to make sense to have your next doctor check both far and near vision and confirm there are no other issues.

If someone is so nearsighted they can only see a few inches in front of their face without glasses, then they can have trouble reading  and with distance as well. It  doesn't seem likely your prescription could be off by that much, even if it should be -4 instead of -2.5 it seems likely you'd be able to read.

The prescription is given in units called diopters which give an indication of where the best distance focal point is for your eye without glasses. Here is a chart showing how diopters compare to best focal distance:

http://m1.wyanokecdn.com/7f7ea15cec792c7747db8bf81cd0a2c7.pdf

For instance someone who has a prescription of -1 diopter would see without glasses best at   1 meter out, with a -2.5D prescription you'd see best at 40cm =15.75 inches, or -4D at 25cm=9.7 inches.  People read at different distances, therefore someone who was trying to read a computer at say 25 inches might struggle if they were -4D myopic.

If your glasses were too low powered by 1.5D, you would be left at -1.5D myopic and your best distance point would be about 66.67cm=26.25 inches. That should mean that at your age you can read at that distance or nearer.

re: "noone has ever tested my reading vision?"

Usually in people under 40 that isn't necessary to test separately unless someone indicates they have a problem with it. Normally at your age if your vision is corrected to be the best possible at distance, then your eye is able to "accommodate", to change focus to see things nearer, by several diopters. So if you see well at distance, you can see things closer up as well. The problem is nearsighted people can only see things close up (perhaps only a few inches). Once your eyes are corrected with glasses to see at distance, at your age normally  that   will then let you see near as well.

Those over 40 need to have their reading vision tested because their eyes have less ability to accommodate, presbyopia, they can't change focus by as many diopters. So if they have vision corrected to see clearly at distance, they may not be able to see clearly a few inches away, and they need to worry about special correction for reading (which is why you see older folks needing reading glasses, bifocals or progressive glasses, etc).

There are various eye problems that might lead people to have problems accommodating, focusing near, when younger than that. So if someone is having trouble reading with their  glasses its best to be sure a doctor checks on that.

re: "better than perfect, sharp vision with glasses?"

Glasses give you the best vision possible, but not "better than perfect", there is a limit to how well the human eye can see even with glasses. Ideally they'd give you vision comparable to what you'd have if you weren't astigmatic or nearsightedness (though even the optics of glasses aren't perfect). Some people without other eye conditions    can see 20/20 with glasses, others only 20/25, while some can do better and see 20/10 . Various eye conditions can reduce the best vision you can get even with correction, and its possible that is what is happening in this case.