Progressive lenses

[murielalex]

I've had progressives and regular bi-focals for years and I still have trouble with progressives no matter how many times I get things adjusted or change lenses. I'm constantly taking my glasses off or moving them around on my nose. I've even tried bi-focal contacts. I'm used to it by now except when I'm at the shooting range when I'm trying to get perfect vision at a distant target and at my gun's site at about the same time. Other than that, I've just accepted things as they are. All in all, I'm glad I've still got great vision, even if I'm blind as a bat without my glasses. I have a couple friends losing their sight to macular degeneration, and I simply can't imagine what that must be like.

[Crankin]

OK, I finally found cool, funky glasses that will work for progressives. Taking the advice I got here, I found one optical place that carried Bevel brand, which has a line for petite women. I almost fainted from the prices (and that says a lot to induce that in me); I don't mind paying for titanium on my bike, but do I really need it in eyeglasses? Not to worry, as they didn't have any of the petite sized frames at the store.
So, I worked with a very nice optician, who listened to my concerns: head too small, glasses that fit me often not big enough for progressive prescriptions, crooked head. She pulled out 4-5 pairs that fit and I liked, that would "probably" work. Then she found a pair that are really funky, with a bigger lens area than I would have imagined. But the frames themselves are smaller. I decided to go wild and get them... They are D&G.
I got the transitions lenses, along with the Varilux progressives, on the hope that I might actually wear these outside of my house once in awhile. I've been wearing contacts for 35 years and rarely, if ever wear my glasses. I do wear reading glasses about 50% of the time, over my contacts. I will report back in a couple of weeks.

[GLC1968]

Interesting, Crankin. I'll be curious to see how you like them.

I went back to my place and spoke to them about my problems with my progressives. She was willing to work with me to find a good solution. Basically, the problem is that my reading Rx is so strong and my distance is so mild that it has a lot of distortion as the lens transitions between the two. Our solution based on my usage needs was to remove the reading Rx from my lens. So my progressives will give me the slight distance correction (in only one eye) and my mid-range vision (like for computer or car dashboard or ingredient lables or smart phone). For up close reading, I just ordered a pair of inexpensive readers. When I read, it's often for extended periods of time when I'll have no issue with changing my glasses anyway.

We'll see how this works. The new lenses won't arrive for another 2 weeks. I think it'll be great for awhile, but as my eyes continue to degrade, I'm sure I'll have to come up with another solution.

[WindingRoad]

I think if you are looking at progressive lenses for the first time especially the frame fit is crucial to getting them to work for you. A lot of the styles these days are plastic and they don't really fit 'back' on a lot of peoples noses so the lenses sit too far out from their eyes. When this happens it narrows your field of view through the progressives. It's like a keyhole, if you stand back from it the field of view is really small but if you put your eye right up next too it you can see a much larger field of view. Also, some progressive addition lenses (PALs) are just better than others. Some have a much more smooth transition from distance to near with WAY less distortion. Varilux is probably one of the best manufacturers of PALs that have the least amount of distortion. To get the best out of your lenses put a GOOD QUALITY anti reflective coating on them. NOT generic stuff from Wally World or Lenscrafters. Get Crizal if you can. It is the hardest coating on the market, you will pay more for it but you won't be back with little hairline scratches every 6 months from cleaning them with your t-shirt. Zeiss can be a good anti reflective coating too but they makes cheap crappy versions too so you must be careful what you get. That's how places like Wally World lure people in by throwing the name Zeiss around and acting like they offer quality goods. They don't. Realize too that some lens materials will not come with certain options available to it. Certain materials don't have the right qualities to apply non reflective coatings and most reputable companies like Crizal know that, this is why they won't even offer their product on some materials. Best thing to do is spend a bit extra for your PALs and get the good stuff. This is one place you don't want to be cheap. You really do get what you pay for.

Oh and as for PALs making your eyes get worse, absolutely not. Unfortunately at a certain age we ALL lose our ability to read up close. Some of us who are myopic (nearsighted) can extend the time till bifocals are required by taking our distance correction off to read but then of course you can't see anything far away. The decline of reading ability has nothing to do with wearing PALs it has everything to do with the normal aging process. So by all means be comfortable and don't strain your eyes trying to see without your glasses because it won't stop your eyes from getting worse what it will do is give you a splitting headache after a while.

Just my two cents

[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.