George wrote:
Hi. I’m 26. I have strong astigmatism in one eye and a lot of near-sightedness but little astigmatism in the other. One optometrist has told me, jokingly, that it seems as though my eyes are from two different people. Uncorrected, my left eye is about 20/50, my right eye about 20/100. Supposedly the difference comes from retinal scarring when I was young, but I’ve never been diagnosed with amblyopia.

Here’s my problem: I recently got a pair of glasses from my ophthalmologist that drive me nuts. There’s a feeling of constant tenseness, and I have a hard time maintaining an awareness of things with my peripheral vision, and when I go into busy interior areas, such as a grocery store, I become very confused. My concentration suffers, for instance, and I jarringly lose track of thoughts whenever I shift my eyes to refocus. Reading is also difficult. I told all of these things to the doctor when I went in for a recheck. He said I would get used to the new prescription, and I have not.

I noticed that that the image I’m getting on the left side is squat (from the astigmatism correction) and the right eye is tall and skinny and distorts heavily toward the left and right edges. When I insisted on the difficulty with this prescription, suggesting that the squatness on the left could be causing my discomfort, my ophthalmologist said that he had indeed added an additional dioptre of astigmatism correction, and he could remove it if I wanted, at the cost of sharpness.

There are three things keeping me from having confidence in that solution: 1) It originally came from ME and not from my doctor, who other than shine a light in my eyes performed no tests for binocularity or refractive difference, so I suspect that he’s not properly examining my eyes, merely relying on my last prescription. 2) For about the 8 months leading up to my current prescription, I did not use glasses at all. I performed a lot of high-stress public-speaking related tasks and got very used to squinting and functioning without glasses. 3) I have a very old prescription, from a different doctor, that causes none of the symptoms I described above and is much, much easier to read with.

My question is this: I have no insurance so visits can be expensive. I see a few courses of action: 1) return to my ophthalmologist and request a comprehensive eye exam, telling him about the old prescription and reiterating that I went without glasses for 8 months. 2) Get a comprehensive eye exam from somebody else, and if so, would it be better to go to an optometrist, an ophthalmologist, or an orthoptist?

Before I do anything at all, I’d also like to know what an optometrist thinks might be going on.

Thanks so much!

ANSWER

You mention not using your glasses for 8 months, and I hope this means that you do not drive. Changes in Astigmatism correction can cause the distortion that you are describing. I would suggest a new exam, and I would suggest that you see an Optometrist as these doctors are trained very thoroughly in the determination of the best possible and most comfortable lenses for your glasses.  Explain the problem to the new Optometrist and bring along all of your glasses.

Dr. Joan Hansen - Optometrist, CAO

Pajoe wrote:
I this new eyeglasses that I have for almost 4 days now. At first everything was like magnified and the floor looks elevated and when I watch the television the screen tends to look like a parallelogram and sometimes trapezoidal especially when I look from left to right. Vertical surfaces tend to lean away from me. Is this normal? The doctor said is because they are astigmatism glasses but, when I wear my old prescription glasses everything is normal (depths and shapes) but, the new ones are a little bit clearer. Is this normal? Please help. I paid a lot with prescription.

ANSWER

Dear Pajoe:
If your new glasses are a little bit clearer, then they are probably providing a more accurate correction for your astigmatism. The symptoms you are describing are very typical for someone adjusting to a new pair of glasses with a stronger astigmatism correction, especially if the orientation of the astigmatism correction is at an “oblique” axis – that is, not perfectly vertical or horizontal. I can sympathize with your concerns, as I have had many patients make the same observations in my office. Fortunately, humans tend to be very adaptive creatures, and most patients adapt to the change in visual perception over a period of a few weeks – some take a little longer. In time, most patients find the benefits of the improved visual clarity to be worth the initial adaptation period. Your symptoms should disappear over the next few weeks. However, if you find that things are not improving at all after a couple of weeks, you may wish to talk to your optometrist about providing you with a “compromise” prescription which has less astigmatism correction. It may make your adaptation easier, but you would likely have to accept a decrease in your visual acuity. In my experience, with a little perserverance most patient adapt to, and eventually prefer, the more accurate prescription.
Hang in there a bit longer.
Dr. Smit