unable to get 20/20

[fleyes]

Hi
I am 44 yr old pilot who needs to get 20/20 corrected vision (each eye seperately) to pass medical and fly commercialy
I can nearly get 20/25 usually missing 2 or 3, using machine at eye doctors, glasses or soft contact lenses
I have astigmatism 1.00D OD, and 1.50D OS
I have trace of cataract in both eyes .
Retina is normal.
Other things normal as far as i know
Above information from various eye doctors and specialists
I read that GP lenses might improve vision but they didnt help, one eye actually got a lot worse.
Lasik eye people said that they could not get a better result than my glasses or contacts
I also tryed hybrid lenses and they didnt help either
I do see slightly better when i squint which may have helped me when i passed my initial medical
Artificial tears also help a little
Do some people just not get a good 20/20 ?
Have other procedures helped people with problems similar to mine ?
Trying hard to get some closure and keep flying
Thanks
I live in central Florida

[Christopher C Shen, MD]

Unfortunately my experience with contact lenses are very limited but you can always do trial lenses in the clinic to see if it were possible.  I would agree if you were never correctable to 20/20, perhaps there are some inherent limitations to your visual potential although it would be frustrating not to have a clear explanation as to why that would be given the fact that multiple doctors have not found anything in your anatomy to account for it.  20/20 is an arbitrary standard since there are some people who can see even better at 20/15 so one could argue why some people who are 20/20 aren't able to get to 20/15.

[fleyes]

1) Is it significant that one eye got worse with GP lense, is the cornea that pliabe ?
2) Is there much reason to try different brands of GP lenses
3) Is there any reason to try different brands of hybrid lenses
4) Are some eyes just not correctable
5) Someone said to me that if my eyes had never seen 20/20, then they would not be able to recognise what 20/20 was.
6) Any ideas for way forward ?
Thanks

[Christopher C Shen, MD]

If they cannot correct you to 20/20 with glasses or contacts, less likely intraocular lens will be any different.

[RealityEngineer]

Check your inbox (they don't like users posting here, I don't know if this will disappear also).

[fleyes]

Thanks for quick response
I dont think i have the ocular surface disease as my eyes arent sore and vision doesnt fluctuate, and none of the doctors i have seen have mentioned it, unless its hard to see in their exams ?
The lasik people i met with said they could not improve on whatever eye machine or glasses would give me ( poor 20/25 )
Is it possible a new lense as in cataract surgery would improve vision ?
Thanks

[RealityEngineer]

Odd, my original post disappeared. I'll  repost it again if its not there later.

[Christopher C Shen, MD]

Don't really have extensive knowledge in contact lenses so not sure about GP lenses.  Would have thought refractive correction with LASIK or PRK would be viable option if corneal astigmatism accounted for the drop in acuity, but based on topography, perhaps this may not be the issue.  If it's related to ocular surface disease, aggressive lubrication with artificial tears and/or combination of warm compresses and lid hygiene would help.  Otherwise, you could seek a second opinion from another cornea specialist or retina specialist if there is any mild problems in the back of the eye affecting the visual acuity.  Don't think eye exercises would help.

[fleyes]

Thanks for the response
I saw a cornial specialist and they used the Atlas topography machine, and apparently didnt see anything abnormal.
Would the ocular diseases be relatively easy to see, ive seen several eye doctors and no one has mentioned them so should i be ok.
They also cheched Keratometry on different machine and said they were fine.
Could some hybrid lenses be significantly different from others, is it worth trying other brands, i think the idea with these was to try and reshape cornea.
Could different GP lenses have significant difference, as i said the ones i tryed did not improve my sight.
Do the eye exercises have any chance of working, i dont need to "throw away my glasses" just improve by a bit over a line.
Appreciate your help

[Christopher C Shen, MD]

With a normal retina and trace cataract, it would seem possible to get to 20/20, although the cornea is likely the issue so your best bet would be to seek a second opinion from a cornea specialist and have them do corneal topography and explore what options are available.  Also need to exclude any ocular surface disease such as dry eye or meibomian gland dysfunction which could also limit the acuity from improving to 20/20.