Progressive lenses

[jessmarimba]

I think I'm lucky in that my left eye is very much dominant. My right (bad) eye barely factors into my visual perception - and with how we've chosen to treat my vision, that's been an encouraged development. I don't notice that I can't see clearly in that eye when I'm running/biking, though I imagine it affects the peripheral vision on my right side. I can function almost perfectly with my left eye half-corrected doing everything except driving at night and reading. We've talked about making me a pair of glasses with just the astigmatism correction so I can wear them over my contacts to see road signs in low light but I haven't taken that step yet - but it might be an option for you if the toric is unbearable but normal lenses are ok? I wonder if your brain is still trying to rely too much on input from your left eye and won't accept that it's an unreliable source. I also wonder if they might have a problem matching the focal point of your astigmatism prescription to your visual focal point? If your astigmatism isn't standard but is more unevenly distributed (if your eyeball is shaped really wonky) I could see that being a result. The toric might help but might not, I found them to move more than normal contacts and it was sometimes difficult to keep them in the right position on my eye. I'm curious now though, your depth perception seems to be an odd symptom for just astigmatism, more of a source data/computational analysis miscommunication. I wonder if you might not be helped more by some sort of exercise that teaches your brain how to better interpret the visual input it's gonna get.

(For reference, my distance prescription for contacts is about -6.5 in each eye, my bad eye also should have an astigmatism correction to -5.5 or -5.75. But it's bad enough that if it's not corrected, it doesn't register as visual input.)

[Crankin]

Wow, my vision (the distance stuff) is a 2.75 for my left contact and 3.5 for my right. The distance vision is actually better in my left eye. My prescription has gone down a lot in the last 2-3 years as it used to be 4.5 and 3.75, then I switched doctors and the new one gradually reduced it, and I can see a lot better now. I have had so many eye doctors in the 21 years I've lived here, I can't keep track. My reading prescription got worse at the same time the distance got better, but now, that has stabilized. I have absolutely no problem with the regular Accuvue contacts. I wear them from the minute I get up to the minute I get into bed.
I am not really sure if the astigmatism has anything to do with my horrible depth perception, it's really just a thought in my head, in the hope that if it gets fixed, my riding skills might improve. When I try to explain how things look/feel to me, to my DH, it's really hard for him to understand.

[OakLeaf]

I wonder if a neuropsych workup might give you some clues and as jess suggested, some exercises? It seems like you've had to make a lot of accommodations through your life. (I'm curious ... how is your balance with your eyes closed? Not that it's necessarily better, that's a whole 'nother set of issues that I've been working on myself in PT, but it might help isolate your visuoperceptual issues from balance issues related to tendon and muscle sense organs and strength.)




Also FWIW, I wore Accuvue successfully for years until they came out with their latest "new improved" version. As soon as my optometrist put the trial lens in my eye it felt like it was inside out - the edge was very perceptible. There's got to be some kind of record for the shortest time anyone's ever worn a trial lens! He said a lot of people have issues with the new coating. I'm wearing Cooper Avaira now.

[Tokie]

This has gotten very technical, so my reply is a bit out of context....but Crankin, I am very petite too, and used to only wear children's frames - usu a bit clunkier than adult styles. My optometrist carries small frames, the last 2 pair I have purchased are from "Bevel" brand - pricey, but well made,fashionable, and well-proportioned for petite faces. Frameless models- any brand- are good for any size face. And when your prescription changes, they can make new lenses in any shape/size that you prefer! Tokie

[Crankin]

Oy, Oakleaf, I would be embarrassed as he** to go for a neuropsych eval, as it would make me look like an overachiever . And, since I know most of them around here, I know they are not too proficient in evaluating these issues, but more in the areas of learning and ADHD. I almost wonder if there's any PTs who work with this stuff and maybe an eye doctor who knows a lot about depth perception. I am not sure about my balance with my eyes closed, maybe I should test it.
And yea, those new Accuvues suck. I also put one in for about 5 minutes and said "no." I am wearing the older version. Again, the doc thought I was nuts, that I could feel a difference. The thing is, that the balance and probably the depth perception issues run in both sides of my family. My dad is super uncoordinated and my mom's sister makes me look like an Olympian. My mom, however, was extremely athletic and coordinated, which is where I probably get the endurance genes from. Too bad I didn't get the rest.
I am somewhat leery of "eye exercises" to cure anything. I just remember lots of ODs trying to cash in on visual training to cure everything from reading disabilities to bad behavior in adolescents.
You are right, I have many compensatory strategies, mostly consisting of knowing what I am good at and sticking to that. But the thing is, I am somewhat of a risk taker as I get older, and now I'd like to be able to do more.
ETA: Tokie, yes the last place I got glasses at had "tween" sized glasses and they were perfect for me. I will keep the Bevel brand in mind.

[BikeDutchess]

Just like some of you, I wear contacts for distance but need readers for close-up. So I've been having more trouble reading my Garmin when riding, and I imagine trying to find/dig out goatheads and such from my tires would be a challenge too. I just found & ordered sunglasses with built-in magnification from this place: http://www.dualeyewear.com/ Sort of like bifocals, but without any correction in the main viewing area. They aren't terribly expensive at $50 a pair.

I just received my order today and like the way they look! I can read my watch, my phone, etc., with these on! I only wish they had adjustable nose pads so they wouldn't rest on my cheeks. Haven't had a chance yet to try them out riding, so will report back in a few weeks!

[bmccasland]

Just like some of you, I wear contacts for distance but need readers for close-up. So I've been having more trouble reading my Garmin when riding, and I imagine trying to find/dig out goatheads and such from my tires would be a challenge too. I just found & ordered sunglasses with built-in magnification from this place: http://www.dualeyewear.com/ Sort of like bifocals, but without any correction in the main viewing area. They aren't terribly expensive at $50 a pair.

I just received my order today and like the way they look! I can read my watch, my phone, etc., with these on! I only wish they had adjustable nose pads so they wouldn't rest on my cheeks. Haven't had a chance yet to try them out riding, so will report back in a few weeks!

OOOOoooo, now there's a thought! I have interchangable lenses for my riding glasses. Hopefully I could find a reader lens to fit whatever brand it is that I have. I have the same trouble seeing, and have been stuffing a pair of readers in my jersey pocket (in their little case). Thanks BikeDutchess!

[WindingRoad]

I think I'm lucky in that my left eye is very much dominant. My right (bad) eye barely factors into my visual perception - and with how we've chosen to treat my vision, that's been an encouraged development. I don't notice that I can't see clearly in that eye when I'm running/biking, though I imagine it affects the peripheral vision on my right side. I can function almost perfectly with my left eye half-corrected doing everything except driving at night and reading. We've talked about making me a pair of glasses with just the astigmatism correction so I can wear them over my contacts to see road signs in low light but I haven't taken that step yet - but it might be an option for you if the toric is unbearable but normal lenses are ok? I wonder if your brain is still trying to rely too much on input from your left eye and won't accept that it's an unreliable source.

Yes, your brain has likely suppressed your left eye at this point. You may even have a slight eye turn in that eye because if your aren't really using it the muscles don't try to fixate with the other eye any more so they may go to a incongruous resting position.

I also wonder if they might have a problem matching the focal point of your astigmatism prescription to your visual focal point?

Most definitely. Your left eye i has what is called an Axial Refractive Myopic error so the retinal image that forms on that eye is WAAAAAY bigger than what is on your other retina. This causes your brain to suppress the one side because it cannot fuse images with such disparity.

If your astigmatism isn't standard but is more unevenly distributed (if your eyeball is shaped really wonky) I could see that being a result. The toric might help but might not, I found them to move more than normal contacts and it was sometimes difficult to keep them in the right position on my eye.

If you decided to add astigmatism correction to your prescription at any point you would likely be more comfortable in glasses. Remember that retinal image disparity issue I mentioned above, well if your glasses sit at a very specific distance (vertex distance) from your eye SOME of that can be alleviated. It's due to physics of how images form on the retina. Contact lenses will NOT help with this at all. Not to mention as your are already noticing toric lenses with considerable power in them are uncomfortable.

I'm curious now though, your depth perception seems to be an odd symptom for just astigmatism, more of a source data/computational analysis miscommunication. I wonder if you might not be helped more by some sort of exercise that teaches your brain how to better interpret the visual input it's gonna get.

Not surprising the depth perception is not good, at this point you don't have true binocular vision with the left eye being suppressed most of the time.

(For reference, my distance prescription for contacts is about -6.5 in each eye, my bad eye also should have an astigmatism correction to -5.5 or -5.75. But it's bad enough that if it's not corrected, it doesn't register as visual input.)

Jess I'm curious have you always had this much uncorrected astigmatism and wasn't treated for amblyopia as a child?

[Crankin]

Winding Road, I wasn't sure if you were talking to me or Jess in those responses! I too, have an astigmatism in my left eye, which remains uncorrected with my contacts. I have not been able to tolerate the toric lens, though I am going to try again this year, in May.
So, I've had my glasses for a week. I wore them right out of the office where I got them, and despite the weird feeling of being outside with them (the transition lenses don't darken when you are driving with tinted windows), I survived driving on the freeway. I wore them all day Saturday, too and most evenings. I see perfectly and now my ears don't even hurt from the arms.
I will occasionally wear them to work and for social events, but since I am doing some sport almost every day, I continue to use contacts 95% of the time. They are very funky and fit my personality, but frankly, I feel like a "4 eyes."
I do think my astigmatism has fooled my brain for so long it really does have something to do with my poor balance and visual/depth perception. Since I've been taking the weights and core class, I notice there are things I just cannot do. Meaning, it "feels" very wrong, and if I do the movement, I will fall. Like yesterday, we had to do explosive jumps up on a step bench with 2 risers. I can't judge how far to jump so I land on the bench, and I feel like I will go right over the other edge. So, I kind of did a 2 foot hop up. I *can* jump down onto the floor fine.

[WindingRoad]

Sorry Crankin' I just saw your post, it's been a busy month I saw your post earlier about vision therapy too. It's interesting you mentioned that because I am supposed to begin vision therapy myself due to the fact that I have a pretty severe muscle imbalance in my eyes. That being said, it's my understanding that vision therapy is more of a muscular training and would help with a problem like I have with excess convergence. For unequal or high astigmatism with associate related image disparity I don't think it would help. I am by no means an eye doctor yet but from what I have learned vision therapy works for some, really well, and others, not so much (which is the hoax part we often hear about).

Regarding your contacts and not having the astigmatic correction, that isn't uncommon. I am supposed to have astigmatic correction too but each time I have attempted (an failed) to wear contacts the torics felt like putting a bath mat in my eye and my vision would never 'settle'. I did find out that if you are prone to migraines (as I am) this adds an especially interesting element to wearing contacts. When I have a bad migraine attack my corneal curvature actually changes due to my eye pressure change??? Long story short, the contact no longer fits and I blink it out OK so back to the balance issue. If you have uncorrected astigmatism, yes you will likely have some impaired balance as a result. However, if you try to correct it now it will be a gradual process and your brain may not be able to tolerate the change. It's been compensating all this time just to allow you to see two images that look pretty close to the same, you go messing with that and the brain gets very annoyed. It may just say, ok I don't like this image from this left eye, I'm gonna shut it off. Insert 'eye turn', 'double vision' or any other bizarre thing your brain can come up with. What I'm saying is that once we are adults it isn't always a good idea to try to fix it if it ain't broken. Your balance would likely be much worse if you tried to 'add in' your astigmatism now. I experience this first hand too so I feel your pain. I feel like a total dork sometimes in Yoga when I just fall over Cycling is different though because you can get more 'gravity' cues to compensate for the visual imbalance. FWIW I have never been able to do those kinds of jumps you mention either for exactly the same reason. I'm always afraid I'll half way miss the freaking bench and kill myself. Again my two cents.

[Crankin]

Thanks for that feedback. My DH finally got a toric for one eye last year. He says he didn't experience any change in his balance, and he finally felt that he could "see" perfectly. However, he has above average spatial skills and wasn't having issues in the first place.
I think I may try the toric when I go for my appointment, but I am not hopeful... so far, the two times I have tried, it felt like someone was wiping sandpaper on my eye. The first time, it caused me to have a super allergy attack, which lead to asthma symptoms, and went to bronchitis. Lovely.
So, if I wore my glasses when I was at the gym, things would be easier? Not that I could ever imagine wearing glasses during exercise. But, taking this class has really pinpointed my issues, narrowed them down in ways that are good. I am making some progress trying to stand on the upside down bosu ball, but it's embarrassing to be dorkier than the out of shape, extremely obese person in class.
All of this is very interesting to me. When I first became a teacher of learning disabled kids, back in the 70s, vision training was in vogue to "cure" reading problems. That was discredited quite rapidly, so I've always been leery of any of this stuff.

[jessmarimba]

Jess I'm curious have you always had this much uncorrected astigmatism and wasn't treated for amblyopia as a child?

I juuuuust saw this post.

I don't know how bad it has always been. I got glasses at around 7, contacts at 11 and RGP contacts in high school. I don't think I even paid attention to the astigmatism correction until I switched to disposable contacts and realized how expensive they were. We probably stopped correcting the astigmatism when it got over -3, because the one or two brands that make toric lenses stronger than that are pretty cost-prohibitive.

I'm wondering if it might be keratoconus, but I haven't had anyone check.

No amblyopia as a child, but uncorrected I've never been able to tell the difference between my eyes, it's just been blurry out of both.