Please help me find new glasses

[SeanKathy]

I had my first eye exam a few weeks ago after being told by my family doctor that I should have a routine glaucoma test; I am female age 43. The optometrist recommended bifocals because he found that I need near and far correction plus I have an astigmatism. My RX:

Sphere Cylinder Axis Prism

OD -75 -50 79
OS -75 -80 56
add
+150
FT
+175

I picked out frames with clip on sunglasses in the optometrist’s office and was told that I could not get progressives with these frames because they were too small (Candie’s Tyra with clip, vertical (b) 25.6). I was interested in progressives but basically got talked out of trying to find a different frame for them (I do not know the brand they were selling). I bought the frame with the clip on sunglasses because I always wear sunglasses outside and wanted to be able to use my new glasses for driving in the daytime. I asked if I could use the bifocal glasses that I was buying for my computer work and I was assured that they would be fine. I ordered the bifocal glasses and have been using them for a couple of weeks. They are great for reading, watching TV, and driving day and night. I cannot use them to do any general work around the house or at my computer. I have even found that I would rather walk without my glasses—I live in AZ and I have to watch where I step when outside to make sure that I do not accidentally step on something that bites. When working at my computer I can tilt my head back and use the bifocal area to view my monitor, but that neck position gets fatiguing very quickly. The bifocal area makes the fonts on my monitor larger but not necessarily better—possibly slightly dimmer. My glasses do not seem to have the intermediate area that I need to do most of my daily activities.

I want to get another pair of glasses that I can use at my desk and for my housework and it would be nice if I could use them for scanning the ground near my feet when I walk. I have talked to a couple of different places and they both are recommending their brand of progressives (Essilor Ovation and Provision Platinum). The Ovation dealer said that he could use my current frame for my new lens.

Can anyone give me a recommendation on what to look for when shopping for my second pair of glasses? Should I look for new glasses that I can use for reading/intermediate/distance vision or glasses just for reading/intermediate vision? Is there a particular brand that might work well for me?

Thanks in advance for any help.

[chip anderson]

A: How high is your monitor, the top should be 2" below eye level.

B: Have you tried the PC Peekers drop~ins when useing your computer.

C: You cylinder cannot (or at least isn't .80) these things are in 1/4ers or at the extreem 1/8ths, not 1/10ths.

D: There are lots of "Computer progressive lenses" out there that give good vision for most house work but 10 to 12 feet is about it for distance. Ask about them.

E: When I see a precription that has a different add for right and left , I generally find that in the long run, the space cadet that precribed it ends up changing his "evaluation of the patient's condition" and writes a new Rx with the same near (add) power.

[SeanKathy]

My monitor is not two inches below eye level, it is about eye level with my current chair. I will try changing my chair to something that adjusts higher.

I called my Optometrist's office to check on my RX and spoke to someone who explained my prescription. Cylinder is 50 for both OD and OS (I thought is was OS 80 due to poor handwriting). The ADD area is +150 for FT (for bifocals) and +175 for progressives.

I found the PC Peekers on the internet and I am going to order a pair if I cannot find them in town first.

Thank you for your help.

[Jacqui]

If I were making them for myself, I would get a pair of wide flat top bifocals (35 wide or executive). I'd change the Rx to OD Plano - 50 x 79 OS Plano - 50 x 56 with a 75 add. This would give you the intermediate and read corrections and should work much better with the computer. This is only my opinion, others may see it differently

[shellrob]

First, I cannot stand to see the different add powers. If a progressive is measured and dispensed the correct way, there's not need to compensate for the higher add. That's a big pet peeve of mine.


Without knowing what your actual seg height measurement is, it's hard to say if the lenses will or will not work. If another place says they can do it and you love the frames you got, then go for it.

Your other option would be to get a second pair for computer and near vision work.

Good luck to you.

[Stopper]

Just take your glasses off to see the computer.

[Chris Ryser]

I picked out frames with clip on sunglasses in the optometrist’s office and was told that I could not get progressives with these frames because they were too small....................................................... .. I was interested in progressives but basically got talked out of trying to find a different frame for them ............................... I cannot use them to do any general work around the house or at my computer. I have even found that I would rather walk without my glasses—I live in AZ and I have to watch where I step when outside to make sure that I do not accidentally step on something that bites.................

Your optpmetrist did the right thing by not selling you a progressive lens because of the frame being to small. If you get another pair get one with larger lenses for computer and othe close up work and you can wear a comfortable progressive lens.

For the crawly biting Arizona population on the ground I have one advice............every bifocal, even the progressives, when looking down will give you a fuzzy image, you got to take off your glasses or have to look over the top.

[drk]

Hey, I have a few points:

First, I agree with Shellrob about the unequal add thing. Why is this done?

Secondly, your add power is too high for 43. Something's amiss. Are you really 43? Your add should be +1.00, and you shouldn't need to wear a full time multifocal yet.

Thirdly, your average person at your stage just takes the glasses off indoors, and wears distance only lenses outdoors, w/ clip-ons.

Fourthly, you should not need to do anything other than take your glasses off for the computer.

Now let's make the assumption that you truly do need a +1.50-1.75 add. In that case, you would benefit from a multifocal, since you would be taking your distance-only glasses on and off too much. You also would borderline benefit from a computer Rx, because desk-level work would be out of focus. For "straight" computer viewing, you still don't need anything, though.

Progressives look nice. They interfere with distance vision and have some "swimminess". They will provide some computer usefulness. A good all-around choice, and one that the vast majority of people favor. You need a fitting height of at least 18 for your purposes.

Segmented multifocals in your case are presumably better for your small frame. Undistorted distance and near vision. Uglier. No better or worse to navigate in than progressives. Gives you no help at all with the computer.

Your best solution from here:
1.) If you love your frame: get the bifocal lines set lower so you can walk more easily. Then, as suggested above, get computer/reading glasses for heavy reading and heavy computer use, ASSUMING that your eyes need to go from your desk to the screeen to the desk to the screen, repeatedly. If not, and you're just surfing the web, skip the computer glasses and simply take your regular glasses off.

2.) If you do not love your frame: select one with a significantly larger B dimension and get fit into a progressive for your general purpose pair. For the computer, if you are going back and forth a lot, you may do OK with the progressives, or you may need a separate computer pair. The Zeiss Gradal Top would be the optimum choice for general purpose since it optimizes your distance and computer vision. Again, if just surfing, you will better served to remove the general purpose glasses.

Post your experience from here.

[CuriousCat]

This is coming real close to selling eyeglasses on line. The proper thing to do is refer this concerned consumer to a local ECP.

[shellrob]

I don't agree Judy. The person asked for advice and is now receiving it. She's been offered different resolutions and can take the information back to her own ECP. If I wanted to sell her glasses, I'd ask for the frame info, have her ECP give me the measurements and get her Visa #. I don't think anyone has crossed the line.

[DocInChina]

When I see a prescription that has a different add for right and left , I generally find that in the long run, the space cadet that prescribed it ends up changing his "evaluation of the patient's condition" and writes a new Rx with the same near (add) power.

Speaking for the Space Cadets....

if a patients current DV Rx (5 years old for example) went from a -5.00 OD and -4.00 OS to a -3.50 OD and a -3.75 OS I would likely keep the OD over corrected and have dissimilar adds to balance the accommodation at near.

....your add power is too high for 43. Something's amiss. Are you really 43? Your add should be +1.00, and you shouldn't need to wear a full time multifocal yet. .

Since the only people likely involved in the examination were SeanKathy and the ECP I think it would be proper not to pass judgment on another professional's prescription. Many times what we would predict to be the near add can be found to be more or less. There is a bell curve for most things and some people have to fall at the ends of the curve.

If I were making them for myself, I would get a pair of wide flat top bifocals (35 wide or executive). I'd change the Rx to OD Plano - 50 x 79 OS Plano - 50 x 56 with a 75 add. This would give you the intermediate and read corrections and should work much better with the computer. This is only my opinion, others may see it differently

Totally agree.

This is coming real close to selling eyeglasses on line. The proper thing to do is refer this concerned consumer to a local ECP.

Exactly right!

Doc

[drk]

if a patients current DV Rx (5 years old for example) went from a -5.00 OD and -4.00 OS to a -3.50 OD and a -3.75 OS I would likely keep the OD over corrected and have dissimilar adds to balance the accommodation at near.



Since the only people likely involved in the examination were SeanKathy and the ECP I think it would be proper not to pass judgment on another professional's prescription. Many times what we would predict to be the near add can be found to be more or less. There is a bell curve for most things and some people have to fall at the ends of the curve.
Doc

In your scenario, aren't they UNbalanced for accommodation, and you're preserving that? Why?

I can pass judgement all I want. Nobody at 43 has a +1.75 add, especially a myope. Sorry, dad.

[Steve Machol]

A word of caution. No one on this site can diagnose you nor should you take any comments as a diagnosis. That can only come from your eyecare professional.

[DocInChina]

In your scenario, aren't they UNbalanced for accommodation, and you're preserving that? Why?

I can pass judgement all I want. Nobody at 43 has a +1.75 add, especially a myope. Sorry, dad.

If they are an otherwise asymptomatic patient wearing the same Rx for years, what would you possibly gain in shifting the visual space that they have apparently been happy with? IMHO, I would prescribe the more comfortable Rx and shift them slowly overtime to balance. Does not make me right nor you wrong. we just have different philosophies which brings me back to the ORIGINAL point of my posting... let the doctor who conducts the exam make the call and lets not try to second guess nor bash other professionals. Yes you can pass judgment all you want. I just don't think it is appropriate nor professional to do so directly to a patient especially since you did not examine them.

No need for sarcasm.

Doc

[CuriousCat]

Yeah, yeah, yeah, ya'll can do anything you want...but consider how you would feel when your next patient comes in with all this advice from ECP's who not only don't know anything much about the patient but also don't have to fit, dispense, adjust or provide aftercare for this purchase...and have second guessed the exam to boot.

[Cindy Hamlin]

Yeah, yeah, yeah, ya'll can do anything you want...but consider how you would feel when your next patient comes in with all this advice from ECP's who not only don't know anything much about the patient but also don't have to fit, dispense, adjust or provide aftercare for this purchase...and have second guessed the exam to boot.

Very good analogy, Judy. We have all been on the receiving end of this. SeanKathy please go back to your doctor or optician who makes your glasses and have a very frank discussion about your needs, wants, etc. Give them the opportunity to accomodate your needs.

Most ECP's have a policy that deals with accomodation to progressives if you can't use them they will normally place you in a lined bifocal or other options. Get all the info you need from YOUR ECP. Take those recommendations and run with them. Unforutnately, there are times that you cannot use a certain frame for the lens you need that is why we are the professionals. We are here to make sure that you get the best possible prescription and glasses that can be made.

If you are here because you have concerns then find an ECP that you feel more comfortable with and see them. In the long run none of us will be there when you need us to adjust, repair, clean, warranty the lenses and frame, etc.

[drk]

So I guess the response to all "consumer" questions here is "See your eyecare professional"?

If nothing illegal or immoral is going on here, I say we discuss it.

If it's such "bad form" to discuss cases online, I suggest we close it to "outsiders"...

[shellrob]

Right on DRK. Like I said before, if I was trying to sell glasses online, then I'd ask for your credit card#. I think all the responses given have been fine and not crossed the line. You're always going to come across that patient that seems to know too much. Or you know that an Optican has told this patient more than enough information.They come into your office demanding a certain lens, basecurve, material. We've all had that happen. Well, big deal. I'd rather a patient come here and get accurate information about lenses, frames, etc, then to hear it from a family member, friend, uneducated Opticans, or whoever. If they come into my office demanding a Transistions piccolo lens(or whatever brand), ar, and a drill mount frame, I'm not complaining. Of course, I would make sure that the particular lens in question is right for their needs and all that, but they've been educated here by Opticians from around the world who are the best in the field. What's wrong with that?

[drk]

Amen, bro!

[CuriousCat]

Many of the responses here went way beyond simple advice, especially when questioning the accuracy of the exam. +1.75 add too strong for 43, not necessarily. Mine was that power at that age. I'm 55 and a +2.25 and a coworker is 49 and wearing a +2.25 as well. Dissimilar adds, also possible. Not an everyday occurence, but it does happen. All the other advice, however well intentioned, is just muddying the waters. The only real solid advice is to follow the counsel of a local ECP with whom SeanKathy is comfortable and trusts.

We're all very good at what we do, but personally I would be highly offended if my patient came to me with an OptiBoard printout and questioned my skills and abilities. Few posters here have suggested questions that might be asked or even bothered to refer SeanKathy back to an ECP.

[drk]

Many of the responses here went way beyond simple advice, especially when questioning the accuracy of the exam. +1.75 add too strong for 43, not necessarily. Mine was that power at that age. I'm 55 and a +2.25 and a coworker is 49 and wearing a +2.25 as well. Dissimilar adds, also possible. Not an everyday occurence, but it does happen. All the other advice, however well intentioned, is just muddying the waters. The only real solid advice is to follow the counsel of a local ECP with whom SeanKathy is comfortable and trusts.

We're all very good at what we do, but personally I would be highly offended if my patient came to me with an OptiBoard printout and questioned my skills and abilities. Few posters here have suggested questions that might be asked or even bothered to refer SeanKathy back to an ECP.

Please tell me when dissimilar adds are indicated. Thanks.
Also, aren't you a hyperope?

[CuriousCat]

I would suppose dissimilar adds are indicated when the prescribing doctor feels it's necessary. Yup, I'm a hyperope and my rx has remained stable for the last 4 years.

[drk]

Judy, let's bury the hatchet. I re-read your short corridor progressive article yesterday...mighty nice...:cheers:

[shellrob]

I'm sorry but the accuracy of the exam should be questioned. I haven't been in this business as long as some of you, but in the 8+ years that I have been, I've worked with a large amount of doctors and never once have I seen different add powers. Ever. I don't understand that. I guess I'm asking the same question as everyone else because if a patient walked into my office with a script written that way, then I would question it thinking it was written wrong. It's the same as some doctors writing the cyl like -.34. Come on now. Give me a break.


I do understand what you're saying Judy as far as someone questioning your abilities because of a patient receiving different information from different sources, but I wouldn't susupect it would ever happen, if ever. I think most of the consumers on here are lookking for advice on certain types of lenses, coatings, and frames in trying to find a great pair of glasses for themselves.

[Jedi]

The ADD area is +150 for FT (for bifocals) and +175 for progressives.

You guys should re-read the posts. This client doesn't have dissimilar adds right and left, but differents adds based on lens choice.