Why is finding the right eye prescription so hard?

[DesertBlossom]

This is just kind of a "thinking out loud" post, but musing why finding the right eye prescription for DH has been so hard.

 

A few years ago he said he felt like he could benefit from glasses, so during a military training he went to one military eye doctor and got a prescription. He was reasonably happy with the results, but it wasn't perfect. Last year he got a new prescription with a different military doctor and it was different from the first prescription but he didn't feel like the glasses helped very much. So I made an appointment for him to go the eye doctor I take our kids to (I personally thought he was really good) and he got a 3rd totally different prescription and he says these new glasses don't do a darn thing for him. (Strangely, for each prescription the dioptre number goes down) I suggested he take his old prescriptions in to his last appointment, but I think he wanted this 3rd doctor to not be biased by the previous prescriptions. Well, that didn't work out because this new one is the worst of them all.

 

Ugh. Finding the time to get in for a doctor's visit is hard enough, but I know he's frustrated that he seems to be even farther from finding glasses that work.

[solascriptura]

Maybe he needs bifocals.

[Tanaqui]

Well, I don't know why the new glasses aren't helping, but it's usual for your prescription to change over time. I wouldn't expect his first prescription to still be useful at all - it's been a few years, as you said.

[Murphy101]

What does the rx not working actually mean? Does it not improve his vision, make it worse, or what?

 

Some rx do take time to adjust to. It doesn't mean they are wrong, but I'd give it a solid week of daily wear before declaring they didn't work.

 

And yes, prescriptions can change a lot over a few years. We will go years with little to now change and then suddenly seems like a major change. Such is the aging process sometimes.

[Guest]

I'd go to an opthamologisr instead of an optometrist and explain the issue. They have the most training on vision and eye structures and tend to treat the most precisely, neither over nor under diagnosing, because they have the most tools in the toolbag.

[Guest]

Well, I don't know why the new glasses aren't helping, but it's usual for your prescription to change over time. I wouldn't expect his first prescription to still be useful at all - it's been a few years, as you said.

Yes, eyes change. My prescription will be fine and then out of the blue I'll notice eye strain and headaches. That's my cue to go in again. Sometimes it's a few years and other times it's only six months between changes. It just depends.

[Lanny]

If  you go to a Board Certified Ophthalmologist, or even an Optometrist, that should not be an issue, unless the prescription is not correct.  It is more likely, especially with a strong prescription, and I suspect your DH doesn't have a strong prescription,  that the Lenses are made incorrectly.  That is quite common. I have a hard time thinking that 3 different "doctors" could have written incorrect prescriptions.

 

Suggestion: Have your DH get a Prescription from a Board Certified Ophthalmologist, or  an Optometrist, and then order the glasses from ZenniOptical.com    Rock bottom prices and I believe that very few optical laboratories in the world have the kind of "QC" (Quality Control) system that they do.

 

 

[QueenCat]

How long does he give them to work? It usually takes me a couple of weeks to adjust to a new script.

[melmichigan]

I second an ophthalmologist.  I have found an optometrist in my area that can understand my glasses, but it was a search.  Many of them in our area rely on computers to determine the prescription and machinery to determine your pupil distance on a script.  None of that works with me.

[DesertBlossom]

What does the rx not working actually mean? Does it not improve his vision, make it worse, or what?

 

Some rx do take time to adjust to. It doesn't mean they are wrong, but I'd give it a solid week of daily wear before declaring they didn't work.

 

And yes, prescriptions can change a lot over a few years. We will go years with little to now change and then suddenly seems like a major change. Such is the aging process sometimes.

 

The new glasses I just ordered, he questioned whether they even had a prescription because he couldn't tell a difference. (if you look at the 3 prescriptions below his latest prescription is zero for one eye, and very minimal for the other) I could tell his glasses made my eyes blurry, but he didn't think they helped. He did say he would wear them for a couple weeks and see. 

 

If  you go to a Board Certified Ophthalmologist, or even an Optometrist, that should not be an issue, unless the prescription is not correct.  It is more likely, especially with a strong prescription, and I suspect your DH doesn't have a strong prescription,  that the Lenses are made incorrectly.  That is quite common. I have a hard time thinking that 3 different "doctors" could have written incorrect prescriptions.

 

Suggestion: Have your DH get a Prescription from a Board Certified Ophthalmologist, or  an Optometrist, and then order the glasses from ZenniOptical.com    Rock bottom prices and I believe that very few optical laboratories in the world have the kind of "QC" (Quality Control) system that they do.

The first 2 doctors were military so I don't know. The 3rd is an Optometrist from a chain that has several locations in our state. (Not nationwide) I ordered 4 pair of glasses (2 were sunglasses) from Zenni and he didn't act like any of them helped. I think the prescription is bad, not the Zenni glasses. I have ordered a lot through them and always been impressed.

 

So here are his 3 prescriptions. I don't know what all of the numbers mean. It's just weird that everything about all of them is different. Even the PD distance is different. His first was 68, then 61 and we measured 62 at home for the glasses I ordered from Zenni.

 

FWIW, it's his right eye that he complains about mostly. 

 

2014

OD - Sphere +1.50, Cyl -0.50, Axis 132

OS - Sphere -0.25, Cyl SPHERE

 

2016

OD - Sphere +2.50, Cyl -0.50, Axis 178

OS - Sphere +0.25, Cyl -0.50, Axis 2

 

2017

OD - Sphere +0.75, Cyl -1.50, Axis 120

OS - Sphere 0, Cyl 0, Axis 0

Edited July 11, 2017 by DesertBlossom

[OneStepAtATime]

He may need a full exam through a Developmental Optometrist. Maybe his vision issues are less about visual acuity and more about developmental vision issues?

 

Or perhaps an exam through an opthalmologist for eye health issues.

[Tanaqui]

So that is odd. Looks like 3 years ago he was farsighted in the right eye (that's the OD), then he became more farsighted (which just strikes me as strange - your eyeball grows, it doesn't shrink - I've known many people become more nearsighted as they age, but not the other way around unless they're beginning to experience presbyopia), and then he became dramatically less farsighted.

 

Does he complain about close-up vision, far-away vision, or both? Is it possible he really does need bifocals?

 

Edit: And I actually can read prescriptions a little bit, because I hate not knowing what mine says! OD means right eye, OS means left eye. Some doctors now are just writing "right" and "left", but it comes from Latin. Just glancing at it with no knowledge, you can see that the right eye is way more dramatic than the left, which makes sense if that's the one he complains about. It also has the most changes from one doctor to the next.

 

The first number, with a + or a -, has to do with how nearsighted or farsighted you are. - is nearsighted, + is farsighted. The number refers to how strong the lens needs to be to correct your vision - bigger number = more correction.

 

The rest of it has to do with astigmatism. Cyl tells us how bad it is, and axis tells us where it is, and with that information the lens can be made to correct it.

 

http://www.allaboutvision.com/eyeglasses/eyeglass-prescription.htm

 

Make a new appointment with some highly recommended doctor in your area. This time, bring in all the prescriptions and tell the doctor that you're baffled by how very much they vary. Your husband can bring this up after the exam, but it should definitely be discussed.

Edited July 11, 2017 by Tanaqui

[MaeFlowers]

I hate to even suggest this, but maybe it isn't an eye issue at all. If all else fails, he might want to see neurologist.

[Tanaqui]

I hate to even suggest this, but maybe it isn't an eye issue at all. If all else fails, he might want to see neurologist.

 

That also is a possibility. Usually, with people who can talk, they have the patient tell them if the prescription is working or not, while you're sitting in the chair. They flip knobs and you tell them if it's "better worse or about the same". It's a great system that doesn't have much room for dramatic error.

[DesertBlossom]

So that is odd. Looks like 3 years ago he was farsighted in the right eye (that's the OD), then he became more farsighted (which just strikes me as strange - your eyeball grows, it doesn't shrink - I've known many people become more nearsighted as they age, but not the other way around unless they're beginning to experience presbyopia), and then he became dramatically less farsighted.

 

Does he complain about close-up vision, far-away vision, or both? Is it possible he really does need bifocals?

 

 

I suspect the 2nd prescription is way off. In 2016 I think he went in primarily to get better frames (his military issue didn't fit well) and decided to do a new eye exam at the same time. But that 2nd prescription he never liked at all, hence the reason he went in for another exam this year. Of the 3 prescriptions I think the 1st is still the best.

[DesertBlossom]

That also is a possibility. Usually, with people who can talk, they have the patient tell them if the prescription is working or not, while you're sitting in the chair. They flip knobs and you tell them if it's "better worse or about the same". It's a great system that doesn't have much room for dramatic error.

Funny, he says he hates this part of the exam because he's never quite sure. I remember feeling that way during my exam and 2nd guessing myself.

[Retired]

I've been wearing glasses and contacts for alost 40 years.  I have traveled  and used random professionals and never came across such  different prescriptions.   I even went to the cheapest  Walmart and all those type of places. 

 

He has randomly found some bad doc 

 

He is not speaking up during the exam.   I will sit there and go back and forth on each section till i'm more sure. sometimes I tell them no difference or  I cant' decide.  They will keep working with you.   I also have astigmatism so it takes a while.  My dh also has worn eyewear for longer than I and never had such random prescriptions.  

 

I think he is not participating in the exam well or he has some neurological changes happening.   

 

[DesertBlossom]

 

I think he is not participating in the exam well or he has some neurological changes happening.

Something neurological affecting his eyesight? Considering he never even liked the 2nd prescription I don't think it was ever the right prescription. Maybe he isn't speaking up enough. Though he did complain that the 3rd doctor dismissed what he was saying about his eyes getting worse.

[PeterPan]

The new glasses I just ordered, he questioned whether they even had a prescription because he couldn't tell a difference. (if you look at the 3 prescriptions below his latest prescription is zero for one eye, and very minimal for the other) I could tell his glasses made my eyes blurry, but he didn't think they helped. He did say he would wear them for a couple weeks and see. 

 

The first 2 doctors were military so I don't know. The 3rd is an Optometrist from a chain that has several locations in our state. (Not nationwide) I ordered 4 pair of glasses (2 were sunglasses) from Zenni and he didn't act like any of them helped. I think the prescription is bad, not the Zenni glasses. I have ordered a lot through them and always been impressed.

 

So here are his 3 prescriptions. I don't know what all of the numbers mean. It's just weird that everything about all of them is different. Even the PD distance is different. His first was 68, then 61 and we measured 62 at home for the glasses I ordered from Zenni.

 

FWIW, it's his right eye that he complains about mostly. 

 

2014

OD - Sphere +1.50, Cyl -0.50, Axis 132

OS - Sphere -0.25, Cyl SPHERE

 

2016

OD - Sphere +2.50, Cyl -0.50, Axis 178

OS - Sphere +0.25, Cyl -0.50, Axis 2

 

2017

OD - Sphere +0.75, Cyl -1.50, Axis 120

OS - Sphere 0, Cyl 0, Axis 0

 

I had something like this happen with my eyes. The cylinders are for astigmatism. I'm not an optometrist, just saying they are. The axis is the rotation, and that changes. For me, if the rotation is off, that causes headaches. Astigmatism is a *distortion* of the eye, where it's football shaped. (I have no clue what I'm talking about here, look it up.) 

 

Anyways, I went to a doc for several years who would use very high regular whatever (+ blah blah) in the lenses and the glasses were merely satisfactory but leaving me with headaches a lot. Then I went to a developmental optometrist (not an optham), and that lady kicked some serious astigmatism butt! Astigmatism, best I can tell, is sort of an art. They have to look in your eye and measure things. And some optom kick butt at it and some don't, all I can say. 

 

So that *might* be why the scrip changed so much over the years, because you had different people measuring, different people interpreting how to treat it. 

 

My personal opinion, having grown up in the Navy, was that none of what you went to were very good for eye docs. I'd go find a really good private practice. Not a chain. Find somebody who practices enough that people come to them year after year for 30-50 years and builds a reputation. I drive to the big city (40 min) and go to a very large practice where most are also trained as developmental optometrists. Never had a been one there. They all kick butt.

 

Yeah, the computers measure nowadays. But for astigmatism, you want somebody who really knows what they're doing.

 

My stepfather has eyes that are hard to get a scrip for, and he actually did really well at Walmart. The optom there just had a nack, had the experience, and did a good job! But what you're looking for, no matter what, is somebody who has been there a long time, making people very happy, happy enough that they return.

 

As far as Zenni, I've ordered lots of glasses from there. The quality varies, but that's pretty astonishing to think they now have a reputation for QC, haha. The optometrists usually CRINGE at my glasses and I usually apologize. The low end lenses from them, when you have astigmatism, are CRAP. If you go for the highest index they sell, then they're at least TOLERABLE. I'm saying with his scrip, with cylinders that high, he would have to get the highest index from Zenni even to have them to be decent. My US made, locally made glasses are MUCH better quality on lenses. The actual quality of the materials. I go Zenni because Zenni is 1/3 the price or less, sigh. But I'd be buying US if there wasn't such a price difference, hands down. It really shows up at night, because with astigmatism like that you get a lot of glare. Better glasses have a better quality glare coating that helps with the funky astigmatism glare when driving at night.

 

I agree with speaking up btw. Does he have some anxiety or pull into himself or shut down? It's surprising, but my favorite optometrists are really, really FAST. Like you'd think it would be the opposite, that that would increase my anxiety about it. I always hate when they go through the choices, because it makes me worry about whether I'm doing it right. But you get these really, really good optom (big city, private practice, making people happy enough that they return), and they are just like zip zoom. I don't know, it actually calms me down, sort of counter intuitive.

[Tree Frog]

Just to throw this out...What if it's a problem with the glasses and not his eyes? Has the prescription in the glasses been double checked both to ensure it's accuracy and that he's looking through the strongest part of the lens? Was the right prescription given to him?  I've had both problems. I have astigmatism and prisms, so how/where the lens sits in front of my eyes is incredibly important. Two summers ago, I returned the glasses 5 times before they were mostly right. (Some of those returns were due to the ineptitude of where I purchased my glasses.) I also have 3 different prescriptions: distance, mid, and reading. One time I was given a pair of glasses that had the mid vision put in instead of the distance vision.

 

It's not likely the glasses are the problem, but it could be part of it.

[Lanny]

I second an ophthalmologist. I have found an optometrist in my area that can understand my glasses, but it was a search. Many of them in our area rely on computers to determine the prescription and machinery to determine your pupil distance on a script. None of that works with me.

The prescription especially the P.D. must be perfect. The glasses my wife had before were bad because the P.D. was way off. She and DD measured the P.D. several times with the measuring thing they printed from the Zenni Optical web site. Dead on accurate. Also the lab needs to put the Optical Center of the Lenses in the correct location.

 

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[DesertBlossom]

The prescription especially the P.D. must be perfect. The glasses my wife had before were bad because the P.D. was way off. She and DD measured the P.D. several times with the measuring thing they printed from the Zenni Optical web site. Dead on accurate. Also the lab needs to put the Optical Center of the Lenses in the correct location.

 

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Interestingly, on DH's first prescription his PD is 68. His 2nd prescription is 61. His 3rd prescription doesn't list it, so we measured at home in order to buy on Zenni and I measured 62. My measuring might be off, but 68? There's no way that was anywhere near accurate

[heartlikealion]

Did they ever check the lenses? I know this is crazy and highly unlikely given that he had issues 3x, but one time my eye doctor's office put the left lens in the right and the right lens on the left (different prescription). I was like, "these are not helping" and they shooed me out of the store saying, "you need to adjust." I was ticked with these useless glasses for a couple weeks until I went back and the dr noticed the lenses were in the wrong sides.

 

Now, my personal experience is very limited, but we went to two optometrists and an ophthalmologist recently for the kids. I got the optometrist's info from covd.org. I suggest you look there. Ours does vision therapy at one of her other offices which one or both my kids need. Maybe there is more going on with him than just prescription. I don't know.

[Tanaqui]

Funny, he says he hates this part of the exam because he's never quite sure. I remember feeling that way during my exam and 2nd guessing myself.

The other method is to do some thing that measures the eyeball itself (!!!!) but that's just not as accurate. That's how they get prescriptions for people who are nonverbal. I mean, it's better than nothing, but....

 

If he feels like he's "not quite sure" then he should tell the doctor that, and be upfront - the doctor can keep switching back and forth until he figures it out. It's okay to say "I think this one is better, but do the other one again?" or "I'm just not sure, I guess they're about the same but...." or whatever.

 

I really think he needs to go back to the doctor, or a new one, and lay this all on the line for them that he's been having huge problems with his glasses and he just doesn't know what the issue is. Feeling awkward and unsure during the exam is probably not helping, and the doctor needs to know.

[Lanny]

Probably his P.D. is 61 or 62 and not 68. How on Earth could someone be so incompetent to leave the P.D. off? No Optical Lab can make glasses without the P.D.

 

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[Tanaqui]

They don't always put the pupil distance on prescriptions for some reason. They put it down when they send it to the lensmaker, I mean, but not if they give it to you.

[DesertBlossom]

They don't always put the pupil distance on prescriptions for some reason. They put it down when they send it to the lensmaker, I mean, but not if they give it to you.

He asked for his PD at this new place and they said they don't do it. (It is listed on his 2 military prescriptions) I guess this practice expects whoever makes the glasses to do it. My boys got rxs there last year but we bought glasses at WM so they measured for it.

Edited July 12, 2017 by DesertBlossom

[ktgrok]

Is he squinting during the exam? I have a friend that gets so anxious she strains and squints to see during the test. Then her prescription ends up being wrong. 

[cjzimmer1]

 

 

As far as Zenni, I've ordered lots of glasses from there. The quality varies, but that's pretty astonishing to think they now have a reputation for QC, haha. The optometrists usually CRINGE at my glasses and I usually apologize. The low end lenses from them, when you have astigmatism, are CRAP. If you go for the highest index they sell, then they're at least TOLERABLE. I'm saying with his scrip, with cylinders that high, he would have to get the highest index from Zenni even to have them to be decent. My US made, locally made glasses are MUCH better quality on lenses. The actual quality of the materials. I go Zenni because Zenni is 1/3 the price or less, sigh. But I'd be buying US if there wasn't such a price difference, hands down. It really shows up at night, because with astigmatism like that you get a lot of glare. Better glasses have a better quality glare coating that helps with the funky astigmatism glare when driving at night.

 

 

I have astigmatism that has gotten progressively worse over the years.  They usually end up remaking my lenses at least once and the technician (if they are any good) ends up really bending my glasses to wrap around my face before I can see halfway decent, but nothing really solved the night time glare.  I had pretty much given up driving at night because I just couldn't trust myself to see well enough to stay on the road.  And then I reached the point I needed to get bifocals.  You know everyone tries to avoid them, they are expensive yada yada yada.  I LOVE my bifocals.  The night time glare is completely GONE!  I'm like why didn't you tell me this years ago, I would have paid the extra just to be able to see at night.  No one told me there was a benefit to bifocals.  My DH got bifocals at the same time and he too noticed a reduction in glare (but nothing as dramatic as mine but he doesn't have astigmatism either).  Anyways I just thought I'd throw that out there because no one ever told me that was a possibility that I could actually be able to see again.  

 

But I too have avoided Zenni for myself (while buying them for everyone else), because the amount of effort it took me to get a pair to work for me and needing regular reshaping, I really felt like I needed the hands on approach.

[Retired]

Just to throw this out...What if it's a problem with the glasses and not his eyes? Has the prescription in the glasses been double checked both to ensure it's accuracy and that he's looking through the strongest part of the lens? Was the right prescription given to him?  I've had both problems. I have astigmatism and prisms, so how/where the lens sits in front of my eyes is incredibly important. Two summers ago, I returned the glasses 5 times before they were mostly right. (Some of those returns were due to the ineptitude of where I purchased my glasses.) I also have 3 different prescriptions: distance, mid, and reading. One time I was given a pair of glasses that had the mid vision put in instead of the distance vision.

 

It's not likely the glasses are the problem, but it could be part of it.

 

 

Great thought I've never had glasses not made correctly but it could easily happen I image

[Rosie_0801]

If the vertebrae in the neck aren't positioned correctly, it can affect your eyesight.

 

I had a sudden deterioration in my eyesight once, went to the Chiro for an adjustment, stared down the hallway for about a minute watching my eyesight go back to normal and didn't need new glasses. Strange but true.

[J-rap]

I just wanted to mention that several times in the past when I've gotten a new pair of glasses, it feels wrong at first.  But sometimes it really does take your eyes a little time to adjust to the new, changed prescription.  

 

I don't know why he'd be getting such different numbers though at his various appointments.  Except that, there are always times when they say:  "Is this better...or this?" and I just kind of guess because they look very much the same.  I suppose that could result in a slightly different prescription if you answer one way one time and another way another time.

 

[melmichigan]

The prescription especially the P.D. must be perfect. The glasses my wife had before were bad because the P.D. was way off. She and DD measured the P.D. several times with the measuring thing they printed from the Zenni Optical web site. Dead on accurate. Also the lab needs to put the Optical Center of the Lenses in the correct location.

 

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Exactly!  I refused to have them read my pupil distance at one place and told them they needed to use the same numbers as my last pair (per U of M).  After two remakes they finally admitted that they didn't know how and tried to call the last place I had glasses made, um nope.  P.D. is a big red flag for me whenever I'm forced to use a new provider.