Krista wrote:
Hi there,

I am hoping for some advice regarding my 3 1/2 year old son and his new script.  First of all, I took him into the optometrist only because I read in his school registration that routine check ups were good from age 3.  I have never suspected any visual problems - in fact, I expected that his sight was great.  He can read letters, big and small, is agile, and has never shown any signs of sight problems.

He has been prescribed a +8 in both eyes (from a ped optometrist on a second opinion) and previously a +5 from our first visit to a different dr.

We decided to fill the +8 script and when we received his glasses we were pretty shocked at how substantial the lenses are.  I am finding it really hard to understand how he possibly needs these without us noticing an issue.

He has only had the glasses for a week, but is not really fond of wearing them.  He says they help close up but make things blurry far away (like the TV about 6 feet from him).  He also says everything looks really big with the glasses on.  He is a smart kid and has started saying he can see better without them so now I’m confused on whether or not to make him wear them… he might very well be saying that because he is having trouble adjusting to the new addition to his face.

Overall, I’m confused on what to do.  I can’t imagine 2 optometrists are wrong, but I still feel uneasy.  Any advise would be appreciated.

Many thanks!

ANSWER

Krista,
A lot of Moms have the same feelings that you are having.  Hopefully I can offer some advice to clarify things for you.  I am not surprised that you did not notice any signs that your son was having a vision problem.  This is the case the vast majority of the time.  Your son is far-sighted (hyperopic).  This means that even to focus on something 20 feet away he has to exert a large effort to keep objects at this distance clear. The amount of effort he has to exert to focus on something like a book is even higher.  Children have an extremely good focusing ability so are able to focus in if required to make things clear, however this entails exerting an extreme amount of effort.  Sustaining this amount of effort is difficult to say the least and can lead to eyestrain and headaches among other problems. As you can imagine determining a glasses prescription on a three year old can be challenging.  Due to the fact that children have such a good focusing ability, eye drops are usually instilled to dilate the pupils and block the child’s focusing ability.  With the use of the eye drops an accurate glasses prescription can be determined.  That being said it can still be a challenge and this could lead to different prescriptions being found.  Also, it is possible that if not enough of the drops got in the first time, his focusing may not have been completely blocked, which could account for the discrepancy.  I would recommend that you keep the +8.00 glasses and get him to wear them full time.  Of course it will take a little bit of time to get used to the prescription, as it is fairly strong.  However if he wears them all the time after a few weeks I am certain that he will be automatically putting them on as soon as he wakes up in the morning.  In my experience kids always make out well with this type of prescription as they really do need it and will want to wear the glasses.  A lot of parents are worried about how they will make their child wear the glasses, but almost without fail when they return to see me they report no problems. By wearing the glasses all the time he will adjust faster.   Good luck and if you have any more concerns I would recommend returning for a follow up appointment with your optometrist.
Dr. Doman

Trish wrote:
Good morning,

My question is with relation to tints. When billing for tints why is a tint number or percentage identified? Is this information writen on teh prescription? If not, how does the lab know what tint to add to teh lenses?

Thanks,
Trish

ANSWER

Hello Trish,
The number used to classify tints identifies how dark the tint is.  If a tint is 70-80%, it is a full sunglass-type tint.  If a tint is 10-30%, it is more of a light, cosmetic tint.  If, for example, your prescription reads 70% Brown, it is saying that you want a pair of brown sunglasses.  This number will be written on the prescription in most cases.  Thank you for your question.
Dr. Donati

Mary wrote:
Is the PD a mandatory part of the prescription, or does the optometrist have the right to omit that on the written prescription if i were to choose to purchase eyeglasses elsewhere or over the internet?

ANSWER

The pupillary distance or PD is the measurement of the distance between your pupils.  It is part of the act of dispensing a pair of glasses, not part of the optical prescription.  Currently a PD measurement does not have to be included on a prescription for glasses.  When you purchase glasses that is when this measurement is taken.  Opticals employ licenced opticians who are qualified to take this measurement.  I would caution you against buying glasses on the internet.  There are a number of factors to consider when purchasing glasses.  Depending on your prescription certain frame shapes will be better than others.  When purchasing glasses online there is no way to know if the glasses are made to the correct specifications.  If they are not this could cause problems including blurred vision, nausea, and headaches just to name a few.  Also if you  purchase glasses online there is no way to have them adjusted to fit your face correctly.  Everyone needs their frame adjusted to fit properly behind the ears, on the nose and to make sure they are straight.  By purchasing them online it is impossible to have this done.  Currently each province has regulations to protect the public on who can sell glasses.  These individuals need to have special training to ensure that the public’s safety is not endangered.  When you buy glasses online you are putting your own safety at risk as professionals are not ensuring that the correct prescription has been made.
Dr. Doman

Robert wrote:
After 20+ years of having a prism as part of my prescription… my current prescription as of last week has no requirement for a prescription.
The fellow at Sears optical was quite surprised and called the optometrist who said I’d be fine… I’m concerned about the sudden change… does this sound reasonable?

Thanks
Rob

ANSWER

Rob,
Prescriptions that include prism can sometimes change so that the prism is no longer required. This does not happen very often, in my experience. I would suggest that you have your Optometrist re-check your eyes to specifically measure the prism component, and explain the results to you.

Dr. Joan Hansen, Optometrist for CAO

Kate wrote:
Hello,
I went to an optometrist yesterday. He was not very talkative; I was asking a lot of questions as he was doing exams and just writing stuff down. He would answer me with one word answers. Then, without explaining why, he put drops in my eyes, I didn’t even have time to ask “why”. Only after he had already put them in he said it was to measure pressure. Also, I know from previous exams that I have astigmatism. To him, however, this was irrelevant as it is not in my prescription! He said my problem was focusing of the eyes, on my prescription there is a number 6 in column “prisme” and it looks like it’s a fraction, but I cannot read it. Should I get another exam? If I bring my prescription from 2 years ago and this one (as my eye sight did not change at all), will I be able to get lenses?

ANSWER

Kate,
I would recommend calling your optometrist’s office.  Optometric assistants are very knowledgeable and would be able to answer your questions about your prescription.  Astigmatism can change throughout your life and it is possible it may have improved.  You will be able to get new glasses with your new prescription.

Dr. Doman

Timmy wrote:
Hi, i have a question regarding prescriptions for glasses and contacts. I understand you should not be using the degrees prescribed to you for glasses for buying contacts because contact lenses sits on your eyes directly as opposed to the glasses being a few inches away.
So my question is, would my eyes get worst or some sort of negative impact if I do wear contact lenses having the same degrees as my eye glasses?
the degrees for contacts should be slightly stronger or weaker? so if you wear contact lenses that are not exactly the same degree, what are the dangers of doing so? will it be merely less clear or will it make your eye sight worsen?

Thank you for your time

ANSWER

Hello Timmy,
Yes it is true that in most cases the prescription your optometrist gives you for your glasses is different than the one given for your contact  lenses.  Whether the contact lenses are stronger or weaker will depend on the prescription.  Wearing contact lenses that are the incorrect prescription (stronger or weaker) can cause symptoms of blur, headaches, dry, uncomfortable eyes and/or spasm of your focusing system.  Furthermore, if the lenses do not fit correctly, there are many other eye-health related problems that you would be at risk for.
When purchasing contact lenses from your optometrist, he/she will ensure that you have the correct strength and fit needed, and would be happy to give you a copy of that prescription for your records.

Thank you for your question. 
Dr. Donati

Dominique wrote:
How important is the precision of  the “axe” values in the prescription? These values change each time I go to a different optometrist and the latter do not all provide the same precision for their measurements. Specifically, 7 years ago I got the values R/L 175/170, 1 year ago, 165/178 and this year 170/180. I would like to purchase bi-aspherical lenses, but those are expensive, so I would like to be sure that my prescription is good enough.

ANSWER

Dominique,

The axis value (or axe in French) is an important part of a glasses prescription.  However, this value can vary from visit to visit.  The axis represents the orientation of the power of your astigmatism.  The power of your astigmatism is the second number on your glasses prescription.  If you have a small amount of astigmatism (I would say less than -1.50), it is possible for the axis to vary from visit to visit sometimes by approximately 10-20 degrees.  On the other hand if you have a large amount of astigmatism, this number would likely only vary within 5 degrees.  From looking at your numbers, especially from last year to this year the change in axis is very small.  When you purchase new lenses if you have any problems all optometrists and opticians will work with you to solve the problem.  I would go ahead and get the new prescription filled.

Dr. Carol Doman

Amira wrote:
Hi. It’s been 4 years since I’ve had an eye exam. Recently I got one and my RX was -5.25. My contacts prior to this were -3.25. I purchased my glasses with the new RX and it’s been 2 weeks since I’ve been wearing them but they sometimes make me feel off balance and they appear TOO clear and my eyes feel a bit of strain. Does this mean my RX is too high or should I give myself more time to adjust to wearing the glasses?

ANSWER

Dear Amira:
It is certainly possible for your eyes to change as much as you have noted over a period of four years, especially if you are under twenty years of age. Such a large change in prescription often creates difficulty in adaptation for a few weeks. If after four weeks your symptoms are not showing signs of improvement, I would bring your concerns to the attention of your optometrist.
Best regards,
Dr. Henry Smit

Jayne wrote:
The Dr. that refracted my son’s eyes wrote his prescription as:

Right Eye: +100 +200 x 110
Left Eye: 150 +225 x 75

But the store that made his glasses interpreted this as:

Right Eye: +3.00 -2.0 x 20
Left Eye: +3.75  -2.25 x 165

Is this correct? He has astigmatism and needs glasses for distance.

ANSWER

Hello Jayne,
Yes these two prescriptions you have given me are exactly the same.  This is just a different way of recording the information.
Thanks for your question,
Dr. Donati

Jo wrote:
Hello

I was at the optometrist 1 month ago, and they give me a sample pair of regular contact lenses of both -6.50 which are to be worn night and day for a period of 1 month.
I have astigmatism and got the original lenses 1 week ago, Bausch and Lomb Purevision toric night and day.
My ophthalmologist prescription was:
RE: -7/ -1.5 axis: 15
LE: -7.25/ -1.75 axis: 170

On the optometrist prescription was following:
RE: -6.50 /-1.75 axis 10
LE: -6.50 /-1.75 axis 170

The axis for the LE went 5 less, I don’t understand why.

Both are 8.7 radius and diameter of 14.00.
I feel there is a blur sometimes on the nasal corner of both eyes which comes and goes with time and the vision feels blurry. I checked the lenses and there is something written on them with a small mark. Is there a particular way to put them in? The optician didn’t say anything about this.

When I order my next pairs of contact lenses could I maybe order the axis of 15 instead of 10 for the RE?
Thank you in Advance.

ANSWER

Dear Jo

The prescription for spectacles and contact lenses is often a bit different as contact lenses sit on the cornea (front of the eye) - depending on how the lenses fit, thus causes changes both to the power and axis of the astigmatism.  You will always see better with your spectacles rather than contact lenses as lenses need to move for good tear exchange. So, every time you blink you will have a loss of focus for a second or two.  There are marks on the contact lenses to check how they sit and fit to your eye.  Due to gravity and the built in prism ballast, the marks usually point downwards.  If you can orientate the marks to point down before you put the contact lenses in it will settle faster.  If you are having problems with the contacts it is a good idea to have a contact lens check before you order new ones.