Question about astigmatism with presbyopia

tmm99 · #1 (**permalink**) 04-20-2010, 05:32 PM

I have astigmatism.

Power axis cylinder
Right 0.50 80 -1.25
Left 0.00 120 -0.75

I have no idea what these numbers mean.
Which eye is worse than the other?
Is this a severe astigmatism?

I was prescribed Acuvue Oasys for Astigmatism and when I put the contacts on, I can see far very well, but my near sight is much worse (presbyopia) than when I have no contacts on.

Since I cannot be fitted for Gas Permeable (not much tear in my eyes, plus Proclear multi was not a good fit - the lens moved around too much when I blinked), how about Acuvue for Presbyopia? (that would mean I won't have astigmatism correction) Do you think I can get away with it (or put one presbyopia and one Acuvue Oasys for Astigmatism)?

Welcoming any input!

tmm

Trixie · #2 (**permalink**) 04-21-2010, 11:17 AM

Quote:

Originally Posted by tmm99

I have astigmatism.

Power axis cylinder
Right 0.50 80 -1.25
Left 0.00 120 -0.75

I have no idea what these numbers mean.
Which eye is worse than the other?
Is this a severe astigmatism?

I was prescribed Acuvue Oasys for Astigmatism and when I put the contacts on, I can see far very well, but my near sight is much worse (presbyopia) than when I have no contacts on.

Since I cannot be fitted for Gas Permeable (not much tear in my eyes, plus Proclear multi was not a good fit - the lens moved around too much when I blinked), how about Acuvue for Presbyopia? (that would mean I won't have astigmatism correction) Do you think I can get away with it (or put one presbyopia and one Acuvue Oasys for Astigmatism)?

Welcoming any input!

tmm

Hi tmm, and welcome to Lens 101.

Okay, let's take a look at those numbers.

Power Axis Cylinder
Right 0.50 80 -1.25
Left 0.00 120 -0.75

Okay, power is a measure of how strongly the lenses bend light. If it doesn't have a minus sign in front of it, that means you need help to see things clearly up close. Since you left eye power is 0.00, there is no correction. 0.50 is a very mild correction, about as low as you can go.

Axis - To quote from Wikipedia: "The axis is measured on an imaginary semicircle with a horizontal baseline that starts with zero degrees in the 3 o'clock (or east) direction, and increases to 180 degrees in a counter-clockwise direction." So an axis of 80 for your right eye means the lenses "straighten" the blur caused by your astigmatism by 80 degrees.

Cylinder - It's kind of hard to explain, but cylinder indicates the amount of correction for your astigmatism. Your cylinder measurement is -1.25 in your right eye and -0.75 in your left. Neither one of those numbers represents a very strong correction. So you have mild astigmatism.

If you're having trouble seeing close up with your contacts in, you should talk to your eye doctor about it. I think you might need a different prescription. Before you got your contacts, you did that test where the eye doctor asks "Which is better this? Or this," right? That should have given them the information they needed to give you the correct prescription, but sometimes there's miscommunication. So now is your chance to communicate with your eye doctor and tell them you're not happy with your prescription.

Let me know if I can be of any more help to you.

tmm99 · #3 (**permalink**) 04-21-2010, 02:04 PM

Trixie,

Wow. Thank you very much for your reply. Great explanation!

Yes. I did go through a bunch of ""Which is better this? Or this" with my doctor. What I ended up with is the best prescription for combination of the two eyes. (I could see better just on one eye with a different prescription and I could see better on the other eye with another prescription, but I could see best with both eyes open with a slightly different prescription...) Does this make sense?

Anyway, I told my doctor that I could hardly see close-ups with contacts while I could see close-ups to some degree without the contacts, and the doctor agreed that that's the way it's going to be for me. (I have presbyopia now, but until about 40 years old, I was far-sighted, so maybe I am just not good with close-ups to start with? I don't know.) I can see far (from about 3ft and up) crystal clear with my contacts on.

I wonder if someone like me is a good candidate for just adding astigmatism on one eye and presbyopia (close-up reading) on the other? My doctor didn't suggest this though (in fact, she didn't suggest anything - I was the one who wanted astigmatism contacts...)

Because of my lack of tears, I really don't have much options here. Astigmatism contacts are great for driving, but I can't see anything from up close to about 1ft with them on and I don't want to wear glasses if I could help it.

Thank you!

tmm

packman · #4 (**permalink**) 04-21-2010, 03:32 PM

Quote:

Originally Posted by tmm99

Trixie,

Wow. Thank you very much for your reply. Great explanation!

Yes. I did go through a bunch of ""Which is better this? Or this" with my doctor. What I ended up with is the best prescription for combination of the two eyes. (I could see better just on one eye with a different prescription and I could see better on the other eye with another prescription, but I could see best with both eyes open with a slightly different prescription...) Does this make sense?

Anyway, I told my doctor that I could hardly see close-ups with contacts while I could see close-ups to some degree without the contacts, and the doctor agreed that that's the way it's going to be for me. (I have presbyopia now, but until about 40 years old, I was far-sighted, so maybe I am just not good with close-ups to start with? I don't know.) I can see far (from about 3ft and up) crystal clear with my contacts on.

I wonder if someone like me is a good candidate for just adding astigmatism on one eye and presbyopia (close-up reading) on the other? My doctor didn't suggest this though (in fact, she didn't suggest anything - I was the one who wanted astigmatism contacts...)

Because of my lack of tears, I really don't have much options here. Astigmatism contacts are great for driving, but I can't see anything from up close to about 1ft with them on and I don't want to wear glasses if I could help it.

Thank you!

tmm

Hi tmm99. Thanks for your posts.

Have you asked your doctor about monovision? If I understand your situation correctly, you may benefit from this setup, which gives you a contact lens in one eye to help you read, and a different contact lens in the other eye to help you with your driving. It sounds weird, but I'm told you get used to it. Do you think that would help?
If you need more information, there are some threads here at Lens 101 that deal with monovision.

Knotlob · #5 (**permalink**) 04-21-2010, 04:30 PM

Quote:

Originally Posted by tmm99

Trixie,

Wow. Thank you very much for your reply. Great explanation!

Yes. I did go through a bunch of ""Which is better this? Or this" with my doctor. What I ended up with is the best prescription for combination of the two eyes. (I could see better just on one eye with a different prescription and I could see better on the other eye with another prescription, but I could see best with both eyes open with a slightly different prescription...) Does this make sense?

Anyway, I told my doctor that I could hardly see close-ups with contacts while I could see close-ups to some degree without the contacts, and the doctor agreed that that's the way it's going to be for me. (I have presbyopia now, but until about 40 years old, I was far-sighted, so maybe I am just not good with close-ups to start with? I don't know.) I can see far (from about 3ft and up) crystal clear with my contacts on.

I wonder if someone like me is a good candidate for just adding astigmatism on one eye and presbyopia (close-up reading) on the other? My doctor didn't suggest this though (in fact, she didn't suggest anything - I was the one who wanted astigmatism contacts...)

Because of my lack of tears, I really don't have much options here. Astigmatism contacts are great for driving, but I can't see anything from up close to about 1ft with them on and I don't want to wear glasses if I could help it.

Thank you!

tmm

Hello tmm

Have a look at this thread started by The Woodsman. He has similar problems, though his eyesight is much more extreme in astigmatism than yours.

http://www.lens101.com/bifocal-contact-lenses/113991-new-multifocals-im-not-sure-my-contact-fitter-knows-what-theyre-doing.html#post138284

A multifocal lens may be the way to go. You probably don't need astigmatism correction in your left eye as 0.75D cylinder is marginal, though correction would give better vision if the lenses worked for you.

You can also discuss Punctal Plugs with your optician to help with your dry eye problem.

http://www.lens101.com/general-contact-lens-care-questions/94009-contact-lense-problem-dry-eyes.html

knotlob

Uhura · #6 (**permalink**) 04-21-2010, 04:43 PM

Quote:

Originally Posted by Knotlob

Hello tmm

A multifocal lens may be the way to go. You probably don't need astigmatism correction in your left eye as 0.75D cylinder is marginal, though correction would give better vision if the lenses worked for you.

knotlob

You mentioned multifocal lenses for tmm99, and Packman recommended monovision. They both sound like good solutions to a novice like me, but are there any reasons why multifocal lenses would be better than monovision? There must be something, otherwise you probably would have just agreed with Packman, right?

No offense, Packman . . .

Knotlob · #7 (**permalink**) 04-21-2010, 04:53 PM

Quote:

Originally Posted by Uhura

You mentioned multifocal lenses for tmm99, and Packman recommended monovision. They both sound like good solutions to a novice like me, but are there any reasons why multifocal lenses would be better than monovision? There must be something, otherwise you probably would have just agreed with Packman, right?

No offense, Packman . . .

Hi Uhura

Mono vision is distance vision in one eye and close vision in the second eye. You loose out on depth perception (bad for sports and questionable for car driving) and some people cannot adjust to mono vision. Before Multifocal lenses became available, there would have been little choice apart from reading spectacles.

But now that Multifocal contact lenses are available, you can have (in theory) good long distance vision AND close vision in each eye. The contact lens is effectively a lens with different corrections built in and I guess you have to train yourself to look through a slightly different part of the lens depending on how far away the target is.

I've not tried Multifocal lenses, but the way my presbyopia is going I may be considering that in the future.

knotlob

Rosetyler · #8 (**permalink**) 04-22-2010, 10:31 AM

Quote:

Originally Posted by Knotlob

Hi Uhura

Mono vision is distance vision in one eye and close vision in the second eye. You loose out on depth perception (bad for sports and questionable for car driving) and some people cannot adjust to mono vision. Before Multifocal lenses became available, there would have been little choice apart from reading spectacles.

But now that Multifocal contact lenses are available, you can have (in theory) good long distance vision AND close vision in each eye. The contact lens is effectively a lens with different corrections built in and I guess you have to train yourself to look through a slightly different part of the lens depending on how far away the target is.

I've not tried Multifocal lenses, but the way my presbyopia is going I may be considering that in the future.

knotlob

Thanks for that breakdown, knotlob. Now I see why multifocal lenses may be a better option that monovision. I'm glad Uhura asked.

packman · #9 (**permalink**) 05-04-2010, 02:11 PM

Quote:

Originally Posted by Uhura

You mentioned multifocal lenses for tmm99, and Packman recommended monovision. They both sound like good solutions to a novice like me, but are there any reasons why multifocal lenses would be better than monovision? There must be something, otherwise you probably would have just agreed with Packman, right?

No offense, Packman . . .

No offense taken. You asked a good question, Uhura, and Knotlob makes a good point about monovision giving poor depth perception which is, in his words: "bad for sports and questionable for car driving."

Together we can give a top-notch answer to the question.

Walkaway · #10 (**permalink**) 05-05-2010, 11:08 AM

Quote:

Originally Posted by packman

No offense taken. You asked a good question, Uhura, and Knotlob makes a good point about monovision giving poor depth perception which is, in his words: "bad for sports and questionable for car driving."

Together we can give a top-notch answer to the question.

Good team effort everybody. That's why this forum has threads.