Are some eye doctors bad at prescribing astigmatism glasses?

[glassman123]

I used to go to this Optometrist at Pearle Vision. I used to be nearsighted and all the prescriptions she gave me for eyeglasses were fine. But then when I started to have astigmatism, she needed to add astigmatism to the glasses. She gave me this prescription:

OD: -175 (spherical), sph (cylindrical)
OS: -125 (spherical), -050 (cylindrical), 75 (axis)

When I tried her glasses, I kept feeling dizzy and the floor looks so close. I almost fell down some stairs due to the glasses. And I was nauseous for days. Even when they told me to give the glasses a few days to get used, I still couldn't get used to them after a few days. So, I returned them for a refund. I then went to this Ophthalmologist a few months later and he prescribed a slightly different prescription, also with astigmatism. This is what he gave me:

OD: -125 (spherical), -050 (cylindrical), 85 (axis)
OS: -150 (spherical), -050 (cylindrical), 95 (axis)

When I had the glasses made based on that new prescription, the glasses were fine and I never experienced any dizziness or the floor being up close. I've been using it for 4 years and have been very happy with them.

Since it's been 4 years, it's time for me to go for another eye checkup. I didn't have time to go see that Ophthalmologist due to his limited hours, so I decided to try that Optometrist at Pearle Vision again. She updated my prescription and gave me this:

OD: -150 (spherical), -075 (cylindrical), 90 (axis)
OS: -125 (spherical), -100 (cylindrical), 75 (axis)

When I picked up this glasses last week, oh boy, was it bad! Again, the floor was up close and I have that nauseating feeling that just wouldn't do away. And what's worse, things look a little titled. And again, I kept wearing the glasses for 3-4 days and I couldn't get used to them.

It's very weird. The Optometrist was fine when prescribing simple nearsighted glasses, but then when she starts prescribing me astigmatism glasses, it feels so strange and I can't get used to them. But when that Ophthalmologist prescribed me astigmatism glasses, they were fine! I don't understand.

So, are some eye doctors bad at prescribing astigmatism glasses?

[glassman123]

So where do you think went wrong in my case? Are you saying it's the quality of the lenses? Or did I do something wrong when I was being tested?

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

Those two RXs are very similar. As we've said many times before the RX is only one of over a dozen variables that go into the making of a pair of glasses. Even two ***@**** with identical RX can feel different due to these variables.  Just think how two different shoes of the same size can feel different.
JCHMD.

[glassman123]

Thanks for the response. So, do you see any unusual difference between the prescriptions that both doctors prescribed that would cause such a unusual effect on me? I notice the Optometrist is prescribing a different axis than the Ophthalmologist. Could that be it?

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

Well certainly there are optometrists and ophthalmologists and technicians that are better than others in almost all cases its not the skill of the tester but the observational powers (which vary wildly) of the person being tested or the problems some visual systems have adjusting to glasses that cause the problem.   Every practice has its share of "glasses rechecks".

JCH MD