A question about the differences in my Rx

[GoodAsGold]

I realize that eye exams are not an exact science, especially since you have to rely so much on the patient's own answers during the testing.

So, can anyone tell me if there is a big difference between my prescriptions that were issued within a week of one another (by different ODs)? Actually, the first OD even changed his own Rx after I brought in the one I found from 7 years ago a few days later. Anyway, here they are:

The OD first gave me this Rx until I brought my 7 year old Rx in the next day. He then changed it a bit. Here is the first one and below that, his revised one:

R Sphere -475 Cylinder -175 Axis 12 Add +2.50
L Sphere -475 Cylinder -175 Axis 175

His revised Rx:

R Sphere -475 Cylinder -175 Axis 11 Add +3.25
L Sphere -475 Cylinder -150 Axis 176

My Rx from the old OD 7 years ago:

R -475 -200 10 Add +3.25
L -450 -150 176

Okay, now this is the one I got from the 2nd OD I saw recently and the one I plan to go with. Do the change in distance/astygmatism numbers mean a lot? And does this mean I was inconsistent with my answers? I understand about the change in Add. This OD explained it to me. I just want to know what the other numbers mean.

R Sphere -4.25 Cylinder -2.00 Axis 15
L Sphere -4.75 Cylinder -1.50 Axis 170 ADD +2.50

What will this Rx do for my eyes that the other ones can't or didn't?

[chip anderson]

GoodasGold: Despite your critcizm of Chris, I'm afraid I think like him.

Have you ever concidered seeing a therapist for your obsessing?

The man to ask the questions, is the one who wrote the precription.

If you don't trust the doctor don't go see him.

Chip

[QDO1]

GoodasGold: Despite your critcizm of Chris, I'm afraid I think like him.

Have you ever concidered seeing a therapist for your obsessing?

The man to ask the questions, is the one who wrote the precription.

If you don't trust the doctor don't go see him.

Chip

i agree with chip. I cant see a big deal of difference in the Rx's, except for the add. As all of your previous questions are regarding progressive design issues, and the Add specifically is the part of your prescription that the progression on a PAL is all about

[GoodAsGold]

Listen, all I was asking for is opinions here. I just wanted to know what the numbers represented and if it's a big deal if the Rx is different. I didn't say I don't trust the OD. In fact, I was mostly saying I'm not sure if I trust my own answers as I sat in the chair and looked at the charts, trying to figure out which blurry letters looked less blurry.

By the way, since you're criticizing me....have you ever considered seeing a teacher for your poor spelling skills?

GoodasGold: Despite your critcizm of Chris, I'm afraid I think like him.

Have you ever concidered seeing a therapist for your obsessing?

The man to ask the questions, is the one who wrote the precription.

If you don't trust the doctor don't go see him.

Chip

[GoodAsGold]

Well, since I am not trained to know that, I was hoping that someone here could answer that for me. Otherwise I wouldn't put myself out on the line once again to ask.

So let me get this straight. You enjoy sharing your wealth of knowledge here, however just not with laymen like me who admits she's rather clueless about a lot of the jargon and products. Is it such a crime to ask someone to interpret my Rx? Sheesh. And, just because my previous questions were about progressives doesn't mean that I'm not curious about my entire prescription.

Rather condescending, don't you think?

i agree with chip. I cant see a big deal of difference in the Rx's, except for the add. As all of your previous questions are regarding progressive design issues, and the Add specifically is the part of your prescription that the progression on a PAL is all about

[Chris Ryser]

R Sphere -475 Cylinder -175 Axis 12 Add +2.50
L Sphere -475 Cylinder -175 Axis 175

His revised Rx:

R Sphere -475 Cylinder -175 Axis 11 Add +3.25
L Sphere -475 Cylinder -150 Axis 176

My Rx from the old OD 7 years ago:

R -475 -200 10 Add +3.25
L -450 -150 176

The basi RX is just about all the same.................and not to worry.

However if 7 years ago you had an addition of + 3.50, according to that you must be well over 70 years old. As far as I remember you are wearing progressives which if you can get the with an add of +3.50 provide very small and uncomfortable reading area.

[QDO1]

Well, since I am not trained to know that, I was hoping that someone here could answer that for me. Otherwise I wouldn't put myself out on the line once again to ask.

So let me get this straight. You enjoy sharing your wealth of knowledge here, however just not with laymen like me who admits she's rather clueless about a lot of the jargon and products. Is it such a crime to ask someone to interpret my Rx? Sheesh. And, just because my previous questions were about progressives doesn't mean that I'm not curious about my entire prescription.

Rather condescending, don't you think?

I will rephrase my comment for you:

your distance (or main RX) seems stable

the only thing that is really changing is the ADD

the ADD change is not negliable

the progression part of a progressive lens is related to the add part of the prescription, which as mentioned has altered a reasonable ammont

I observed that previously your questions have been about design of progressives. As you have had 2 sight tests within a few weeks, you are clearly having problems

therefore, as a experienced optician I am thinking... it is a ADD issue, or, a design issue, or a combination of the two - as the two issues are definatally related. Problems would be exaserpated with a poorly set up lens

[Jubilee]

The OD first gave me this Rx until I brought my 7 year old Rx in the next day. He then changed it a bit. Here is the first one and below that, his revised one:

R Sphere -475 Cylinder -175 Axis 12 Add +2.50
L Sphere -475 Cylinder -175 Axis 175

His revised Rx:

R Sphere -475 Cylinder -175 Axis 11 Add +3.25
L Sphere -475 Cylinder -150 Axis 176

My Rx from the old OD 7 years ago:

R -475 -200 10 Add +3.25
L -450 -150 176

It looks here like the doc was concerned about some adaptation problems. He adjusted the axis of the cylinder (astigmatism correction) to be inbetween what his test results were, adn what your previous one was. The difference between the 7yrold RX and the more recent one was 2degrees which with the amount of astigmatism you have this number coincides with what most people tolerate. He was hedging his bet if you will that you might not like the change (based upon experience) and went to something in the middle that should be tolerated well either way.

The same hold true for the left.. He was going to increase your power by 2 steps, one in the spherical power and one in the cylinder. He thought this might be a bit much comparing to your old rx, so he backed off on the cylinder. The spherical equivalents are roughly the same.

The reason why he probably bumped the add, is because it was so much higher than the test. While not 100% true, many people don't like to go down on the add. So if you have been wearing a +3.25 add, and used to that level of magnification it provides, then he was concerned that you would not like having a lower level in the glasses.. thus he bumped it up.

Okay, now this is the one I got from the 2nd OD I saw recently and the one I plan to go with. Do the change in distance/astygmatism numbers mean a lot? And does this mean I was inconsistent with my answers? I understand about the change in Add. This OD explained it to me. I just want to know what the other numbers mean.

R Sphere -4.25 Cylinder -2.00 Axis 15
L Sphere -4.75 Cylinder -1.50 Axis 170 ADD +2.50

What will this Rx do for my eyes that the other ones can't or didn't?

Well it depends..have you filled the other scripts, and they haven't worked? Or what is the reason for the second opinion? This rx is fairly different than the previous set, but this is not unusual either. When we compare spherical equivalents, this right eye is a couple of steps weaker in power compared with the other RXs. The add is back to what the originial doctor first prescribed, making the maginification(reading power) less than what your current pair is, but stronger overall than what the original docs first rx was.

1st Rx Sph Eq = -5.62 Near Power = -3.12
2nd Rx Sph Eq = -5.62 Near Power = -2.37
3rd Rx Sph Eq = -5.25 Near Power = -2.75
Old RX Sph Eq = -5.75 Near Power = -2.50

If you look at the numbers, 3rd rx you received (the latest one) is less strong at the distance than your previous glasses and rxs. For the reading power, we look for the most plus, and that makes them third in terms of power. It looks like he is backing off that high add, but by backing off on the distance rx, the affect on reading will be more like a one step difference than the 3 steps he actually took off on the add.

As you mentioned in previous posts, you don't know the jargon, if your answeres are correct, etc... You actually are proving our point here. Eye Exams are subjective! The time of day, your bloodpressure, medications, etc all play into "which is better, 1 or 2?" That is why the doctor will go through this with you several different times to look for consistancy in your responses, and likes to view your old rx to know what your brain is used to.

While Autorefractors and such have come out based upon the theories of how the measurements of the eye affect the rx, this is not an exact science because our brains and personalities all play a role. Some people demand to be able to read or see better than 20/20. They want 20/15 or better. While some aren't used to that level of clarity and it bothers them.. They only want corrected to 20/20. Some people are quite happy not wearing a -1.50 rx all the time, while some complain they are blind with out it! It is what makes us all unique, and is the reason why your doctor spends the time to go through a series of lenses and measurements and not just gives you the computer print out from the pretesting process.

This is why we promote talking with your eyecare professional and working with them. They are going to be the ones most familiar with all the factors involved. We can only make guesses at what is really going on. I can assume that the first doc changed the rx to be closer to your original for easier adaptation.. but this is only a guess. He/She could tell you for sure. The second doc already explained to you his view point on the add. If you tried the glasses and aren't satisfied.. ask one of them to do a recheck.

Cassandra Brackmann

[drk]

I don't know what's worse:
Heath care consumers that cannot trust their chosen health professionals, and prefer to trust an anonymous internet source, or

Health care consumers that have the obsessive need for control by researching everything for themselves, as though they are going to tell the professional what's what, or

Cheap-skates that want to "get a good deal" online, or

Well-meaning "let me help you" professionals that don't seem to understand that they are doing a disservice to the poster and their own profession by performing "tele-opticianry" on this board.

Has this forum become a substitute for professional care? I guess so.

Professional care sure means evaluating an individual's case and making recommendations! That's beginning to happen more and more, as consumers find this site on search engines.

I don't have a problem with a GENERAL question, such as "are Transitions good products?" Or, "are today's progressives better than 5 years ago?", or "are silicone contacts a nice product?", or "are Luxottica frames good quality?" BUT I DO have a problem with a patient posting their specific cases on this board and asking everyone to take a pot-shot at what's bugging them, if their eyes are changing, what was my Dr.'s treatment plan really getting at, etc. etc.

Let's get professional, Optiboarders! General questions should be cheerily answered. Specific case-related questions is tantamount to practicing opticianry/optometry/ophthalmology on-line. It's doing everyone a good deal of harm!!!!!:( We rail against online CL providers and online spectacle providers, and then we ourselves become on-line optical troubleshooters!

If you can't discriminate between whether it's a general question or a personal request for professional care, then just don't post. (If we professionals want to share a specific case, that's another thing, entirely.)

Addendum: I don't think there's anything wrong with directing the poster to another thread/document that discusses the issue, so they can become more informed. I don't think there's a problem with this forum being a resource to the public. It just shouldn't be "the internet optician shop".

[GoodAsGold]

Thank you, Chris, for answering my concerns about the basic Rx. Actually, 7 years ago my ADD was +3.25. I was 48 when those were prescribed. The OD back then said the need for a close-up Rx was increasing quickly for someone my age. He has since left the state and I haven't seen him since.

That brings me to my recent OD appt. and why he gave me an ADD of only +2.50. HUH? If anything it seems my close-up vision had gotten worse. So, I went back a couple days later with my old Rx and showed him it had been +3.25 for 7 years. So why the decrease? He admitted without seeing that Rx, he only went up to +2.50 which was about the norm for someone my current age of 55. But he changed it to +3.25 and tweaked the distance numbers, too. No explanation. He was rather rushed.

So, I decided to start fresh with a new refraction. It turns out there was an OD across town who I had remembered from several years ago. He understood my desire to know what was going on with my ADD and Rx in general. So he explained that my previous ADD of +3.25 had been for a reading distance that was closer and not the usual distance one would expect to be holding a book. He had me compare the differences---one, holding a book with my elbows bent more--closer up (not as comfortable for a longer duration)...and one with the book held down a bit more with my arms more relaxed, This is where my ADD would be +2.50. The other way it was +3.25. So that's why things have been a bit blurry for me lately. I was trying to read with my book in the "normal" manner, but my close-up ADD wasn't configured for that. He left it at +2.50. I'm not sure why the original OD thought I would be reading that close-up. Maybe I gave him that indication back then.

Anyway, I wasn't writing to ask about that so much as I was about the difference in the Sphere, Cylinder and Axis numbers.

Thank you for replying that the basic Rx isn't much different.

The basi RX is just about all the same.................and not to worry.

However if 7 years ago you had an addition of + 3.50, according to that you must be well over 70 years old. As far as I remember you are wearing progressives which if you can get the with an add of +3.50 provide very small and uncomfortable reading area.

[tomsj]

Actually, what's worst of all, drk, are so-called healthcare professionals who are so threatened by the desire of patients actually to understand their diagnoses that they become beligerant and abusive.

[fjpod]

I realize that eye exams are not an exact science, especially since you have to rely so much on the patient's own answers during the testing.

Actually, determining a patient's refractive error IS an exact science, in my opinion. Prescribing, however, is an artform. It is dependant on many variables, one of which is the patient's customary Rx. So, a good prescriber will always consider you current glasses, he/she should consider how you plan to use the new ones, what kind of work and hobbies you have, the existence of medical conditions, etc. The actual numbers determined during the exam ARE NOT YOUR FINAL RX. Don't over-analyze the numbers. Talk to your doctor about the concerns you have. You're not going to get a "better" opinion on this forum because we don't have your doctor's recordings of your presentation, history, and symptoms.