patty

I recently got my first pair of glasses with reading correction. The
prescription is:

O.D.: SPH. -5.00 ADD +1.25
O.S.: SPH. -5.00 ADD +1.25

They are Varilux Panamic lenses. My previous prescription was:

O.D.: SPH. -4.75
O.S.: SPH. -4.75

I've had the new glasses for almost 2 weeks now and I'm a little
disappointed because I still have to take my glasses off to do certain
things up close. Reading is OK, but it was OK before. I went back to my
eye doctor to get the prescription rechecked. After the new exam he still
feels that +1.25 is right for me. The new prescription is:

O.D.: SPH. -5.00 ADD +1.25
O.S.: SPH. -5.25 ADD +1.25

After thinking this over last night, I'm wondering if the source of the
problem is the fact that I read at lap distance (which is where they told me
to hold the card when they checked my near vision) but the things I have
trouble seeing up close are more like 8" from my face (example- clipping my
2-yr.-old's fingernails). To be more specific, here are the distances I
use:

Reading a book - 20" from face - glasses OK
Reading a newspaper spread out on a table - 17"-24" from face - glasses
OK
Clipping daughter's nails - 8" from face - glasses no good
Anything closer than 12" from face - glasses no good

So, would a stronger reading correction allow me to see clearly 8" from my
face? If so, what would then happen at lap distance, where I typically hold
a book? Is it unrealistic to expect these glasses to correct everything?
Being new to presbyopia I just don't know how much correction is possible
and so I don't know whether I should go back and insist on another
prescription. I would say these glasses are good for about 95% of what I
do. It's just upsetting that after spending $330 for new lenses I still
have the same problem I had before - needing to remove the glasses for
up-close work. (Reading was OK before with the -4.75 lenses, although I
must admit it's better with these new ones).

Any advice or info on this problem would be greatly appreciated. If you
choose to reply by email, please remove the REMOVE from the address. Thanks
very much.

Patty

mark a

If the OD determined your reading (near) vision at about 20", then it is not
surprising that you would have trouble at 8". But normal reading distance is
about 13" and at 8" you still would not have optimal vision (although it
would obviously be much better).

Progressive lens have the ability to focus from the near to the far
(including all points in between). That's why they are called progressive
lenses. However the intermediate vision channel is smaller than either the
near (reading) or the far. So if the OD set the near vision to 8-10" then
the width of the intermediate power (at 20" for example) would much narrower
and shorter than the near vision area. You might find this to be very
annoying while reading.

dr judy

snip

You have just discovered the joy of being a myopic presbyope, when you take
off your glasses you can see really close up! Being able to read at 8" is
one of the reasons I will never have LASIK.

If the reading add were set to allow you to see clearly at 12" to 8", you
would be blurred at 18", even with a progressive. Even if the 18" was
clear, the clear area would be narrow and the distortions much greater.
You could ask your doctor to change the add to +1.75 or +2.00, which may get
you the 12" to 14" distance, but don't go any stronger.

No glasses can ever restore near vision to how it was before age 40,
although progressives come close. Take your glasses off for the odd task
that needs it and take delight in knowing that your presbyopic, non myopic
friends have to resort to a magnifying glasse on top of their progressives
to achieve the same vision.

Dr Judy

dabel

Welcome to presbyopia! A stronger correction would indeed let you see at
8", but probably wouldn't work for reading. Since you probably spend a
lot more time reading than cutting your kid's nails, you probably should
stick with what you have. For myself, the amount of time I spend looking
at stuff 8" away is pretty minimal. I would suggest that taking your
glasses off is the best solution.

--
Dan Abel
Sonoma State University
AIS
dabel@sonic.net

otisbrown

Dear Patty,

Your -5 prescription enables you to see sharp 20/20, or perfect.

The near prescription gives you clear vision
starting at 31.5 inches, (by calculation). Depending on your age
(and amount of your accommodation you might be able to
read at 20 inches, and that assumes that you have
about 1 diopter of "accommodation."

If you are having difficulty reading at 20 inches, you
might ask that the increase the amount of "add" to
your prescription.

Best,

Otis
Engineer

robert martellaro

Patty,

No. Everything you describe is as it should be. Any increase in add
power will complicate the lens function at normal distances and will
have no affect on the 8" distance. Non-myopes in your age group have
to put on reading glasses *and* use a magnifying glass or loupe at 8".

Hope this helps

Robert Martellaro
Optician/Owner
Roberts Optical
Wauwatosa,Wi
robopt@execpc.com

drfrank21

Contrary to most of the replies here, I usually have good success
by just bumping the add pwr another +.25 to +.50 d (in this case
to a +150 or even a +175 add) which solves the patient's problems.
I take also in consideration that if a moderate myope (such as a -5.00 d)
is used to removing his/her lenses anyway for near work one can be
a little bit more liberal in the add pwr versus a hyperope or low minus
patient.

So I would ask the doc to "trial frame" the stronger add (such
as +1.50/+1.75 add pwr) and see if this is indeed more comfortalble
for you.

frank

patty

Is this trial frame like a temporary lens holder that the doctor can put
different sample lenses into? If so, I assume I would wear my current
glasses and this trial frame together to judge the effect of a change in the
add power. I suppose that this trial method wouldn't show the resulting
change in the other "channels" of the lens, but it sounds like you think
that those changes would be minimal, is that right?

Patty

robert martellaro

Frank,

Bumping the add +.50 will not allow her to see at 8". A +3.50 add might do it.
The glasses would be unwearable of course. Patty said,


Nothing wrong here. Sounds to me like the +1.25 add is the correct power.

Robert

drfrank21

I don't think Patty is a 70 year old where a +3.50 would be required for
8"; am just saying a a +.50 bump up in add power would probably help overall
so she wouldn't have to hold things at 20" to read a book. And a simple trial
frame by the doc (or even the optician) would show Patty what the differnce
would be. Still sounds like she's a little underplussed at near.


As you must know Robert there isn't necessarily a "correct power" or
prescription but what is most comfortable vision- wise for the patient.
Maybe a +1.50 or +1.75 add would indeed be more comfortable for the patient.

frank