Question for an Eye Specialist including optician, optometrist, ophthalmologist

[camion]

I got progressives a few years ago (apparently mid-40s is when it hits for a lot of people). I have been near-sighted since elementary school. They have only been moderately helpful with reading - I still find myself taking off my glasses periodically to read. I occasionally have issues with mid-range so I know what you are talking about, but it is not frequent.

I have an optometrist at Cornell on the UES who I like - PM me if you want a referral. I am probably due for a visit. Smart guy, thoughtful, helpful staff.

I'm in a similar vision situation, nearsighted ever since high school. I have been doing computer work as a major part of my job for decades and have settled on a solution I like.

I have two pairs of progressive lens glasses. One pair is for normal distance vision, driving and general walking around stuff. The second pair is set with the top to be computer distance so I don't have to search for the sweet spot in the progressive area. When I sit down at the computer I just switch to the computer glasses. For me the cost of the second pair has been well worth it, but then don't buy fashion eyeglasses. I look for inexpensive metal frames.

BTW, I'm old enough and near-sighted enough that I can take off my glasses when reading a book and my natural focus distance is about 12 inches. Sweet sweet spot for reading, but a bit too close for my computer monitor.

[budwom]

I go low tech on this and it works. I've gotten by for the past three decades almost exclusively with basic drug store, Costco (or Amazon) reading glasses (10 for $30).

I quickly found that as I graduated to needing stronger reading glasses, let's say 2.00, the old ones (1.50) work fantastic for mid range computer work. In fact I'm using them right now. No mystery to this, this is just the way it works, as you typically read a book a foot or so away, and your computer monitor from two feet.

Just as Julia Child never threw away the liver, I never throw away all the older reading glasses...

[dudog84]

I go low tech on this and it works. I've gotten by for the past three decades almost exclusively with basic drug store, Costco (or Amazon) reading glasses (10 for $30).

I quickly found that as I graduated to needing stronger reading glasses, let's say 2.00, the old ones (1.50) work fantastic for mid range computer work. In fact I'm using them right now. No mystery to this, this is just the way it works, as you typically read a book a foot or so away, and your computer monitor from two feet.

Just as Julia Child never threw away the liver, I never throw away all the older reading glasses...

That kind of insight is what we come to DBR for.

[Rich]

Thank you all for your comments. As a follow up, today I went to a LensCrafters near my apartment for a second opinion on my situation. I had to have another vision exam, but the doctor was great and spent a lot of time explaining.

It seems my new Rx is correct. That's the good news. However, my previous lenses were probably Varilux, which has the widest lens area for the use that would be considered computer distance. My new lenses are made by Zeiss, and that same area is much smaller, which is causing the problem. They're both considered good lenses, but I guess Varilux is the gold standard for progressives and the Zeiss are just made differently. I had no idea that I had to ask for Varilux and no one explained that to me ahead of time.

My dilemma: I could take the chance and replace my Zeiss lenses with the same Rx in Varilux, but the computer distance could still be blurry, these lenses are not inexpensive, and insurance will not cover it. Instead I opted for a second pair of glasses with a single focus lens that is optimal for the computer and I can get by for reading while at the computer.

[Kdogg]

Thank you all for your comments. As a follow up, today I went to a LensCrafters near my apartment for a second opinion on my situation. I had to have another vision exam, but the doctor was great and spent a lot of time explaining.

It seems my new Rx is correct. That's the good news. However, my previous lenses were probably Varilux, which has the widest lens area for the use that would be considered computer distance. My new lenses are made by Zeiss, and that same area is much smaller, which is causing the problem. They're both considered good lenses, but I guess Varilux is the gold standard for progressives and the Zeiss are just made differently. I had no idea that I had to ask for Varilux and no one explained that to me ahead of time.

My dilemma: I could take the chance and replace my Zeiss lenses with the same Rx in Varilux, but the computer distance could still be blurry, these lenses are not inexpensive, and insurance will not cover it. Instead I opted for a second pair of glasses with a single focus lens that is optimal for the computer and I can get by for reading while at the computer.

If you decide to experiment you may want to try a place like Zenni Optical or Goggles4u for cheap trials. They are online eyeglass shops. Most brick and mortar stores are going through Luxottica who has a virtual worldwide monopoly on eyewear.

[DU82]

If you decide to experiment you may want to try a place like Zenni Optical or Goggles4u for cheap trials. They are online eyeglass shops. Most brick and mortar stores are going through Luxottica who has a virtual worldwide monopoly on eyewear.

Just received a pair from Zenni. Single vision with updated prescription to leave in the car just in case my contacts pop out (or something like that.). $49, including the higher value lenses due to my -5 vision. They’re good, enough that I ordered a pair of progressives last night. $149 with the bells and whistles, including a $35 frame. So, I second your recommendation.

[JStuart]

I moved a few years ago and had to find a new optometrist. I went to a local boutique in NYC I haven't been before but with good reviews on Google. I had my eyes examined and received a new Rx for my progressive lenses. I kept my old frames, but ordered new high end progressive lenses (Zeiss) with my new Rx. I try not to skimp on glasses/lenses since my vision is pretty bad and I rely on them for just about everything. But, because of that, they're not inexpensive, even with my vision plan.

The new Rx improved my reading and distance, but I found my mid-range use for my computer monitor to be blurry. I'm an attorney so I am reading from my monitor and paper documents all day long. The optometrist said it’s normal that my mid-range is now blurry since my Rx changed for both reading and distance. He recommended I buy another pair of glasses just for computer use.

Does that sound right? I spent a lot on my progressive lenses so I was taken aback that now I have to invest in "computer glasses" when I never needed them before. I asked about using drug store reading glasses and that idea was soundly rejected as it could damage my eyes long term.

I just want to make sure I'm not being scammed. Any advice is greatly appreciated.

As a practicing Ophthalmologist (M.D.), this almost feels like clickbait, but here goes, all in the hope that everyone can benefit from more information -as accurate as I can provide- and yet it can be quite confusing.
Several absolute principles:
-no one focuses as well as they did before they turned 35-40, when reading glasses and/or bifocals weren't necessary.
-bifocals, trifocals, and progressive multifocal lenses are all terms for adding reading abilities to one's distance glasses. (I intentionally will not complicate the discussion with nearsighted/far-
sighted, or astigmatic corrections. The assumption is that all that is taken care of before the consideration of seeing things within, say, 10-12 feet)
-Standard drug-store/cosmetic counter/Barnes & Noble reading glasses may be all that many people may need, and they have never, ever, damaged anyone's vision, Rich.
-I like to tell patients that when I first went into practice, we had newspaper distance, typewriter distance, and driving distance (I'm an old guy, by the way, saw my first game in Duke Indoor in
1957 when I was 7.)
-Then, a pair of glasses would have either a single bifocal lens for newspaper distance, or a trifocal, with the middle lens for typewriter distance. (see the very bottom diagram below)Thought it would just pop up to be seen, sorry.
-Now, we have cell phone distance, I-pad distance, laptop distance, and desktop screen distance...and a backup camera in the dashboard of one's car.
-And there are many versions of bifocals that cover all those distances in a graduated, 'progressive' pattern as shown in the diagram below (courtesy of Zeiss).
-but nothing works as well as the human lens/ciliary body/zonule system before it ages beyond 35-40.
-to access the variable focus ranges, one has to adjust the head position to bring the different focal portions into range, and for most folks, it works well, but not everyone.

-Another phrase I use is, 'the progressive bifocal lens is computer-designed, but NOT designed for the desktop computer'.
To illustrate this, the computer distance focal range in the illustration is shaded yellow, and in the top example, it takes up a tiny space -and thus a small area of field- in a 'standard' progressive bifocal lens. Many companies have variations (the Varilux lens has at least 17 versions since its introduction) and the yellow range can be wider, larger, etc.
-And there are versions designed just for office (and music distance) that fall under the 'computer bifocal' category, and that is illustrated by the 'business' version Zeiss provided in this old diagram.
-One pair of glasses -no matter how well-designed- can't recreate how well we used to be able to focus instantly, although current designs can come close. But if one spends all day in a cubicle
working on a laptop or desktop, a computer bifocal as a work glasses pair will make life easy. One's optician can take your current best distance Rx, and configure things as you need.
I am hopeful that this makes things clearer in understanding the basics and I'm aware that everyone is a bit different from the average person.

Caveats: I cannot explain everyone's experiences with their current lenses, and YMMV is an important thing to remember.
Mail order lenses comprise the largest number of glasses complaints in my practice. One can get lots of cheap anything on the internet.
Each company has their own designs; none are any better than others, just as Nike and Saucony and Adidas all have similar designs.
These are medical devices, so don't let $ drive your decision making totally.

Lastly, Crazynotcrazie, and Camion, I'm typing this on my laptop with my glasses off...my nearsightedness works, too.
75Crazie, your post #15 is right on, as well as -jk's observation.
PackMan97, your post #7 works for lots of folks.
BudWom, whatever works, works, even if it is 'un-progressive'

And finally, anything you hear about blue wavelenghths emanating from your screens causing retinal damage is, ah, 'alternate fact'. Coatings for reading your screen may make things more comfortable, and might mess with your melatonin cycles, but one third of your macular cones are designed for blue wavelengths by the Original Equipment Manufacturer.
ZeissProgressive.pdf

[rsvman]

I can't relate to any of this, and I guess I should be extremely happy about that. At 65 I still don't have presbyopia. At my house, I am the designated reader of all fine print, even though I am six years older than my bride.

[DU82]

Once again, there’s an expert on a subject on DBR! Thanks, jstuart, very informative.

[camion]

I can't relate to any of this, and I guess I should be extremely happy about that. At 65 I still don't have presbyopia. At my house, I am the designated reader of all fine print, even though I am six years older than my bride.

You young whipper snappers.

Being a nearsighted oldster I avow that you aren't really one of us until you reach the point where you need your glasses in order to find your misplaced glasses.



All of you better stay off my lawn, which I can see perfectly well with my single vision distance glasses.

[Rich]

To close the loop here - I know ya'll were on the edge of your seats! - I ended up buying a separate pair of single vision frames from a major optical retailer just for use at the computer. I can also get by using this pair for reading or looking at my phone, if necessary while working.

The original optician was concerned that I was unhappy with the Zeiss lenses and agreed to replace them with new Rx progressive lenses from the same manufacturer as my previous lenses. They even contacted my previous optician to find out who the manufacturer was and received information about where on the lens the intermediate point should be. It seems my previous optician had notes that I preferred the main focal point to be a tiny bit higher than they measured. Needless to say, the optician won back my business with their customer service!

I got my new progressives today and, I learned, the lenses are actually from a small company called Shamir. So far so good, but I am glad that I invested in a pair of glasses just for computer use. My neck and shoulders thank me!

[Reilly]

... One can get lots of cheap anything on the internet ...

For those without a computer, spending four years in Chapel Hill is also still an option for a Carolina degree.

[Tommac]

I'm like a few of you who would sometimes take my glasses off to read up close, 12-18 inches or really small print. I used to do this all the time at work about 15 years ago when I only had single focal lenses. I grew tired of putting the glasses on to read the computer and then taking them off, so I switched to progressive lenses and found that I adjusted rather quickly. I was surprised at this because I had tried old fashion lined bifocals about 25 years ago and hated them. Now recently I've undergone cataract surgery on both eyes (not at the same time.) I'm now waiting for my eyes to stabilize in order to have the normal refractive exam for new progressive lenses. What I didn't realize before the surgery was that now I can't see up close without glasses like I used to. I'm using 1.75 readers as i type but don't think I would be happy using readers full time. I've been wearing glasses since I was 8 years old so I'm not adverse to wearing progressive lenses now full time. Cataract surgery was fairly successful with 20/20 vision in one eye and close to that in the other. And for you who haven't been through it cataract surgery is a breeze taking about 10-15 minutes for the procedure itself. I had mine done in Mebane, a small town about 20 miles east of Durham off I40/85.

[-jk]

My mom was profoundly nearsighted and loved doing fine needle work without her glasses. She was furious that she was corrected to 20/20 after her cataract surgeries. She ended up getting wearable jeweler’s loupes for cross stitch.

-jk

[camion]

My mom was profoundly nearsighted and loved doing fine needle work without her glasses. She was furious that she was corrected to 20/20 after her cataract surgeries. She ended up getting wearable jeweler’s loupes for cross stitch.

-jk

I've had discussions with my doctor and have been told that I can choose to either be nearsighted like I am now, needing glasses for distance vision. Or I can choose 20/20 distance vision and need glasses for close work. (There are more expensive options that are more versatile.)

I will probably choose to keep my near vision and wear glasses for distance, walking/driving/etc.

[JStuart]

I've had discussions with my doctor and have been told that I can choose to either be nearsighted like I am now, needing glasses for distance vision. Or I can choose 20/20 distance vision and need glasses for close work. (There are more expensive options that are more versatile.)

I will probably choose to keep my near vision and wear glasses for distance, walking/driving/etc.

And that is exactly what I have advised and/or offered to my surgical cataract patients even before the multifocal (and multi-dollar) intraocular lenses were available.
You stated it well. A patient told me years ago, 'doc, for the rest of my life, I think I'm going to be doing more things at computer distance rather than driving distance' (he was in his 70's at that time).

[JStuart]

An Addendum to this thread:
A minor pet peeve of mine, is that I -or any cataract surgeon- don't dial things up in the OR to correct an eye to 20/20, or any other acuity. The procedure clears the optical axis so that light is more clearly focused on the retina, giving that eye the best ability to see as well as it can. The eye is restored to the level of acuity that existed prior; I don't say, 'ah, let's just do a 20/30 result'.
If one's retina has the capability to see 20/20, or 20/15, then the resulting prescription after surgery will allow that eye to see those letters/numbers on the eye chart in my office.
If the intraocular lens -implanted in the OR- has been calculated to require the least amount of distance correction, then that eye can see the 20/20 letters without glasses or contacts, and that is the default choice for most patients, who never needed glasses other than for reading before cataracts formed.
Many patients can chose to remain near-sighted, or have their postop glasses correction leave them at a good reading distance (cell phone or laptop or desktop computer). That correction will allow 20/20 clarity at the distance the patient chooses.
Now if one's retina (fovea, specifically) has deficiencies to where the best acuity is 20/30 or worse, then the best operation, the best calculations, and the best IOL will allow that eye to regain the 20/30 acuity, but not more.
If your camera (retina) has diminished density of pixels, then no amount of lens focusing will double the pixels for the resulting image.
So, the operation and IOL choices attempt to improve things to the best capability of that particular eye, and if it ends up 20/20, all the better.
Hope this helps more than it obfuscates!