My perscription has changed, but?

[Edster1]

Hello, in the last 13 years my perscription has changed over time (for both eyes however I am only talking about the one eye here) from OD +2.50 -1.75 005 to +1.25 -0.75 180 add+1.25. I don't feel my vision is as accurate anymore and my eyes tire easily. Recently I was wearing my right contact and I put my glasses on, interestingly my vision was perfectly clear for close vision and also for distance. As well the effect of magnifying the world returned, as when I was younger putting on my glasses made everything appear larger or closer. I wore the one contact and my glasses all day and emjoyed great vision. Can you shed some light on what I observed?
Thanks
ED
Ps. My left eye has also changed by the exact same amount of spherical and cylindrical power as the right but the numbers are more severe.

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

=

[Edster1]

Ok, I guess.

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

It means I have read the discussion to that point and have no further comments.
JCH MD

[Edster1]

I'm not sure what "=" means.
There are two questions in the first of my two previous posts, can you help with them?

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

=

[Edster1]

I would also like to elaborate on some of the previous posts we've made.
First, I made a mistake and gave the wrong current perscription that I am wearing. I have all my RXs written out in chronological order and I read from the wrong one. It should be +1.50 -1.25 177 not +1.25 -0.75 180? The left eye is correct.
I don't wear my contacts. I don't feel I can see well enough with them and they don' allow me to look over them as with my glasses. When I put them on recently if was a brand new pair and it was the first time in over a year. So to be clear the improved vision happened moments after putting the contact in and my glasses over and did not change over the 10 or so hours that I wore them both. Also my eyes did not tire as they normally do by the end of the day. Tomorrow I will repeat this experiment.
I was first prescribed glasses because I sat in the back of the classroom and could not see the chalk board clearly. I went for many years and still do from time to time, without wearing them. I play sports and watch TV with and without them. When I was younger I would bring a book closer to my face and rotate it slightly to read it clearly. I can still do that but I have noticed that tiny print like that on an Aspirin bottle has become unreadable. No doubt the onset of Presbyopia.
I do appreciate your expertise here. Thanks again for your help.

[Edster1]

"Latent (uncorrected) hyperopia" is what I was thinking. I have every RX since 1997 and I can see a trend that shows the Optometrists were giving me a less powerful RX allowing or forcing me to accommodate more. I have read of this approach in training material. Also I have observed that it seems to be the standard to take either the previous RX and/or a measurement from the previous pair of glasses to create a baseline for the phoropter. I believe there is another machine (I'm not sure what it is called) that checks the patient's ability to focus (accommodate). Am I correct there? I do know the Phoropter is more of an art form than a ridged procedure, that is why my two RXs a half hour apart are not the same. I've also watched multiple Phoropter demonstration videos that also support this. That being said, how should I approach a new Optometrist to get an RX that doesn't make me accommodate as much? Thanks.

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

In general you can expect to have a great deal of change in your vision over the next 2 to 10 years.  You likely have a great deal of latent (uncorrected) hyperopia. The eye loses its ability to focus as we age (presbyopia).  It starts earlier in farsighted (hyperopia) and effects near, then mid range then distant vision. Then vision without glasses is much worse than when younger and no line bifocals are needed. Contact lens wear becomes much more difficult due to  a variety of reasons (dryer eyes, less motification, needing different RX for different distances, etc.)

Likely the reason for your observation about clear near and distance vision is that with contact lens wear especially with wearing a long time or a tight fit the cornea swells (edema) causing it to bend light more (induced myopia) which helps the eye focus at near. As the swelling goes away the near vision is more difficult to read.

JCH MD

[Edster1]

I'm 38
Current Glasses
OD +1.25 -0.75 180 add +1.25
OS +2.75 -2.75 005 add +1.25
Contacts
OD +1.25 -0.75 180
OS +2.75 -2.75 180
11 years previous Glasses which had hardly changed from age 7
OD +2.50 -1.75 005
OS +3.50 -3.50 178
A couple other notes:
My eyes tire very quickly with my current glasses. I did not have the bifocal in these lenses.
Also after this happened I went to two different exams on the same day with these results;
OD +1.50 -1.25 176 add +1.25
OS +2.75 -3.00 180 add +1.25
&
OD +1.50 -1.00 175 add +1.75
OS +2.75 -3.00 178 add +1.75
Thanks

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

1. What is your age?
2. What is your complete glasses RX in both eyes?
3. What is your contact lens RX in each eye?

Can't answer without that info

JCH MD