help

[Josiecu]

I am 45 years old and I have been wearing super thick glasses since I was 4 years old
My vision is one eye +18.5 and the other +20.5.    I do wear gas permeable contact lenses but because I also have Rheumatoid arthritis, my eyes get very dry and I cannot wear for too long.
Because my glasses are so thick, i am embarrassed to wear them in public.  I am so tired of this problem.   I want to find a doctor that specializes in my problem and could either fix some of my problem or help me get glasses that don't look like binoculars.

[Michael J Kutryb, MD]

With that amount of farsightedness (hyperopia) laser vision correction is out of the question.  You need to be very aware that you could be extremely high risk for developing glaucoma and need to be followed by an ophthalmologist.  These type of eyes tend to be rather small and don't have much room for the early and moderate development of cataracts that can start in the 40's.  Again, be on the lookout, expecially, for narrow angle glaucoma. Other than glasses or contacts, your only other options would be clear lense extraction, which is cataract surgery before you really have a cataract.  You might be a very challenging case, and should be extremely selective in choosing only a very experienced, excellent surgeon if you ever go that route.

[mark276]

Don't despair. It is understandable that you are disappointed that you cannot wear your contact lenses for longer periods, especially since the 'dry eye' is caused by Rheumatoid arthritis. Hopefully you can put the lenses in and take them out without too much problem. Presumably you have tried most makes of eye drops that contain 'tear substitutes'?

With regards to glasses, have you tried high-index lenses? I can reccommend them. Many of these lenses have an aspheric design which reduces the 'magnified' look that normal lenses produce in a strong farsighted prescription such as yours. High index lenses in plastic are available up to a index of 1.74 and glass lenses up to 1.9 index. They are much thinner and lighter than normal lenses. Do you wear bifocals? Other solutions to reduce thick glasses are possible.