Eyewear options for severe myopia 25+ Diopters

[leni777]

Dear Dr.

I have a 33 year-old sister that suffers sever myopia since birth. Her exact prescription is the following:
OD: 25.50, 375X40
OS: 25.00, 200X144
She's had three retinal detachments, the last one in 1999 and at that time, she had surgery for a scleral buckle in her left eye. I should also mention she started wearing contact lenses at the age of 5 but is pretty disciplined in taking them off as soon as she gets home every day. The last couple of months, she has been complaining that her eyes hurt. After consulting her opthalmologist and a few retinal specialists, they have advised her to stop wearing contacts altogether for a while. Besides that, she needs to avoid computer work (she's in sales so her use is moderate), avoid lifting heavy items and doing anything strenuous that could provoke another retinal detachment.
She's only 33 and very vital, she enjoys working out, dancing, and loves her job and telling her she can't basically do anything comes as a huge blow, not just for her but for our whole family.

She does have a pair of glasses she bought here, in Spain, about 10 years ago. At that time, they told her the refraction index (not sure if that's the same as the hyper index) is 1.9 and while they're not pretty or anywhere near aesthetically pleasing, they're supposedly the most modern. The glass is pretty thin in the center and then gets thicker towards the outside, you can see the circle and they make her eyes look really tiny.

Is there something better out there in the market right now? Putting aesthetics secondary (although that's important also), what are her options as far as eyewear is concerned? While the optician we consulted with told us there's only a handful of manufacturers worldwide, we have hope that there's someone out there, perhaps in the US, that has come out with some type of glass or technology to help dealing with this life change a little easier.

Any suggestions, names, advice... would be really great appreciated. Thank you in advance and regards.

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

-

[a4b]

Probably the retina specialists are more conservative in Spain than they are in the US. However, they are obviously concerned about the re-occurrence of retinal detachments after your sister has had three already. In order not to provoke further detachments, it is also important to avoid hard knocks. Extended airline flights (with reduced cabin altitude) are also thought to act as a trigger.
There have been many advances in the last ten years with eyewear so your sister should be able to find a pair of glasses which would disguise her high prescription. Today, 'blended myodiscs' are an aesthetic solution.
I have sent you a PM with further suggestions.
Regards

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

I don't know why all the limitations on her activities. I would get another opinion for a retina surgeon. Most retina surgeons alllow their patients to return to full activitiy after a RD repair.

JCH MD

[leni777]

Thank you for the great tips (i'll add a humidifier and hefty supply of fish oil for the holidays :)), will find out how feasible it is to try to contact/glasses idea. Didn't even know of the 1/day wear lenses... and I'll definitely let my sister know about the Schirmer test. Really, thanks and best of luck to you! :)

[kg17]

Your sister is between a rock and a hard place.  I, too, am a high myope and have struggled with contact lens wear for years.  At -17 diopters, glasses is not a good option for me either.

Here's what she might try:

If the ophthalmologist gives the okay, aggressively treat any dry eye (very common in high myopes and aggravated by thick contact lens wear) by using silicone punctal plugs, restasis (at least 3 months trial), 2000 mg of fish oil daily, and increase humidity in home/work.

Then try a daily disposable lens like Acuvue 1-day or Acuvue 1-day moist.  Daily disposables are much thinner and can be less irritating for a high prescription.  You can also eliminate use of cleaning solutions which can very irritating for the eye.  The prescription strength only goes to -12 so you have to add glasses as an "over-refraction" to get to full prescription.  These glasses will be thinner and provide better visual image than your sister's current glasses.

It's not the most ideal.  But it might be a better solution.  Ask ophthalmologist to test your sister for dry eye (Schirmer test).

Good luck