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Old 07-06-2020, 03:33 PM   #21
flylock shox
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I'm looking at getting laser eye surgery done, and have been told that it will fix my long distance vision but that I'll still need reading glasses a few years from now, which makes sense. However, I've also been told I can preserve some of my near distance vision if I get my long distance vision laser improved to less than a 20/20 standard (kind of a middle of the road approach).

Two questions:

1. Is the latter true?

2. Do you have a sense of which laser technique seems to fail the most, i.e., one that has your patients showing up with complaints in greater frequency?
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Old 07-06-2020, 03:40 PM   #22
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Having had laser eye surgery AND cataract replacement my otherwise uninformed opinion is to have the cataracts done, especially if you’re a bit older. When I had one eye done there were five of us in the prep room and I was the only one who had a cataract; everyone else was doing it for vision correction.
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Old 07-06-2020, 03:58 PM   #23
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Originally Posted by flylock shox View Post
I'm looking at getting laser eye surgery done, and have been told that it will fix my long distance vision but that I'll still need reading glasses a few years from now, which makes sense. However, I've also been told I can preserve some of my near distance vision if I get my long distance vision laser improved to less than a 20/20 standard (kind of a middle of the road approach).

Two questions:

1. Is the latter true? In a sense yeah. What they do is leave some of your nearsightedness uncorrected (ie. -0.50 or -0.75). They can do this one year only (called Monovision) or both eyes. If you work on the computer all day it makes sense. Would you rather wear glasses sometimes far away or all the time up close ?

2. Do you have a sense of which laser technique seems to fail the most, i.e., one that has your patients showing up with complaints in greater frequency?

PRK has better long term outcomes but more pain/blurry vision at first. LASIK has more complications due to surgical flap issues.
Answers in bold above.

Money guy is somewhat correct about Cataract surgery as a refractive procedure.

Pros:
1) long lasting as most of the Rx changed occur in lens.
2) can do multi focal implants
3) can fix higher prescriptions

Cons:
1) most potential risk of side effects (going into the instead of just shaving the surface down)
2) about double the cost.
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Old 07-06-2020, 04:03 PM   #24
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At my last appointment, my optometrist said that next time (coming up soon) we should talk about a multifocal lens in my glasses for reading. Are there other options that I should ask her about?
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Old 07-06-2020, 04:18 PM   #25
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At my last appointment, my optometrist said that next time (coming up soon) we should talk about a multifocal lens in my glasses for reading. Are there other options that I should ask her about?
A lot of it depends on work environment. Are you on a computer all day? Lots of driving. Fine print work etc.

Options are basically

1) two pairs. One for far and one for near/office progressives.
2) bifocals. Cheaper but ugly.
3) Progressives. Customized to what you do for work
4) Digital eye strain lenses. These work great if you are not quite at the point of needing progressives. They can bridge between standard and progressives for a few years.
5) Multi-focal contact lenses.
6) Monovision contact lenses. One eye for near and one for far.
7) Multifocal Intraocular lens. Cataract surgery. Not everyone a good candidate.
8) Quit work and reading all together.
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Old 07-06-2020, 04:35 PM   #26
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Yes.

Astigmatism is interesting in that it does not follow the general rules like Myopia or Hyperopia do. Generally, kids are born with Astigmatism that goes away as they approach grade school. Some forms are genetic in nature and others are structural in nature.

As we age astigmatism tends to change with only a few general rules. It generally goes from an Horizontal Axis to a Vertical Axis (the last number on your prescription is your axis of astigmatism).

Over 50 Astigmatism can improve and even disappear as the lens starts to thicken. However, it can get worse too.

Not sure if you have Astigmatism? What do headlights at night look like to you? The first picture below is normal vision (or corrected Astigmatism) while the second image is uncorrected astigmatism.

I have just enough astigmatism to make contacts a pain lol. I feel I have to blink to get them into the right spot.

If I take my glasses off it’s definitely not as bad as the second picture. That picture does look similar to what I get if my contacts are in the wrong spot, although that’s not as bad either. I just hate having that added halo
or whatever it is with the contacts. My scrip has 170 for both eyes. Iirc my opt thought the astigmatism in my left eye had almost disappeared, but that was wrong.
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Old 07-06-2020, 04:38 PM   #27
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I could get on board with the first part of #8, but if I gave up all reading, I'd probably get bored at some point...

In a normal, non-covid world, I work with young children in a preschool setting. So probably 25% of the week would be computer / print-related work. I live close to work, so not much driving except for errands and social outings.
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Old 07-06-2020, 04:39 PM   #28
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I could get on board with the first part of #8, but if I gave up all reading, I'd probably get bored at some point...

In a normal, non-covid world, I work with young children in a preschool setting. So probably 25% of the week would be computer / print-related work. I live close to work, so not much driving except for errands and social outings.
3 or 4 probably best option depending how much help you need up close.
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Old 07-06-2020, 04:44 PM   #29
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Is it easier to acclimatize to laser surgery than glasses?
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Old 07-06-2020, 05:09 PM   #30
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Is it easier to acclimatize to laser surgery than glasses?
About the same really. Anytime you change something there is an adjustment period.
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Old 07-06-2020, 05:22 PM   #31
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I have diabetes. I was diagnosed in 2012. Probably lived with it for a couple of years before it got unnoticeable. I had an edema on my eye. My ophthalmologist just told me that it is pretty much gone! Am I a rare and incredible? Tell me I am!

#humblebrag
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Old 07-06-2020, 05:25 PM   #32
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Okay, serious question. My optometrist lets me opt out of doing the eye freezing drops since I do it regularly with the opthamologist. However, when I did get them frozen with the optometrist, why was I able to see better, and much quicker than the drops with the opthamologist?

The optometrists drops had me a bit blurred for maybe an hour. The opthamologists drops have me blurred and dilated for a couple of hours!
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Old 07-06-2020, 05:38 PM   #33
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Sometimes my eyes will randomly water and it kind of stings. Could this be due to my prescription for my glasses not being strong enough? I know I need to upgrade my prescription and glasses, but being off work has led me to not being able to afford it. Or is this the sign of something more serious?
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Old 07-06-2020, 05:55 PM   #34
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I have diabetes. I was diagnosed in 2012. Probably lived with it for a couple of years before it got unnoticeable. I had an edema on my eye. My ophthalmologist just told me that it is pretty much gone! Am I a rare and incredible? Tell me I am!

#humblebrag
It means you have good diabetic control. Also. You are incredible.
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Old 07-06-2020, 05:57 PM   #35
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Okay, serious question. My optometrist lets me opt out of doing the eye freezing drops since I do it regularly with the opthamologist. However, when I did get them frozen with the optometrist, why was I able to see better, and much quicker than the drops with the opthamologist?

The optometrists drops had me a bit blurred for maybe an hour. The opthamologists drops have me blurred and dilated for a couple of hours!
There are different concentrations of dilation drops. Typically the Ophto uses higher concentrations because you are there much longer and have to wait more. We know exactly when you are going to be seen and the wait is shorter so we can use a lower concentration.
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Old 07-06-2020, 06:03 PM   #36
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6) Monovision contact lenses. One eye for near and one for far.
I’m a big advocate for monovision. My understanding is it’s not for everyone but it’s awesome. Layman’s explanation is you have a dominant eye for far sight and your prescription for your non dominant is dropped so you can see near. Your brain figures it all out and you never notice unless you close one eye. You see near and see far without reading glasses. Monovision coupled with the truevision (or whatever they are now called) oxygen permeable extended wear lenses are perfect.
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Old 07-06-2020, 06:04 PM   #37
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Sometimes my eyes will randomly water and it kind of stings. Could this be due to my prescription for my glasses not being strong enough? I know I need to upgrade my prescription and glasses, but being off work has led me to not being able to afford it. Or is this the sign of something more serious?
Probably dry eyes. It’s counter intuitive to think dry eyes when they water but your ocular surface dries out enough that it stimulates a Nerve that produces a bunch of extra water to flood the eye for protection.

Go see the Optometrist to determine the type of ocular surface disease you have and then you can have a treatment plan prescribed to you. There are a lot of treatments out there.
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Old 07-06-2020, 06:14 PM   #38
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I’m a big advocate for monovision. My understanding is it’s not for everyone but it’s awesome. Layman’s explanation is you have a dominant eye for far sight and your prescription for your non dominant is dropped so you can see near. Your brain figures it all out and you never notice unless you close one eye. You see near and see far without reading glasses. Monovision coupled with the truevision (or whatever they are now called) oxygen permeable extended wear lenses are perfect.
They work well for about 60% of people. You do give up some depth perception and night vision though. Often I will dispense some distance only dailies with them so you have an option of better distance vision. Can also get glasses made up for over the contacts that will correct the distance vision in the near eye. That can help a lot with long periods of night driving.
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Old 07-06-2020, 06:18 PM   #39
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Ah, interesting. I have moments where I feel my night vision isn’t perfect. That explains it. Minor inconvenience for me though. Love my monovision.
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Old 07-07-2020, 01:14 AM   #40
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For the past few years about 7 or so I have noticed some mornings my vision is blurry. Over the course of few hours it will subside but we some mornings it’s bad enough I can’t read large text and sitting about 12’ away from a 65” tv I can’t even make out the new ticker that’s scrolling on the newsfeed. Other mornings when it happens I notice the edges of shapes/things aren’t really sharp so the severity can vary from time to time and it generally occurs 2-3 times a week but not daily.

Any suggestions?
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