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Ophthalmology & Optometry/Distance vision with new glasses blurry

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QUESTION: I recently purchased new glasses after wearing my previous ones for 5 years because I was starting to strain while reading.  With my new prescription the reading and mid vision was good but the distance after about 40 feet was blurred, not sharp at all.  When I would put my old glasses on and look at the same objects such as road signs, people, buildings, they come into clear focus.  I have worn the new glasses for 3 weeks now, could there be something wrong with the prescription. My age is 60 if that matters any.  Below are my last 3 exam results.

NEW EXAM  2/9/13     Sphere OD  + 2.50    Cylinder - 0.50    Axis 126    Add + 2.50
         Sphere OS  + 2.00    Cylinder - 0.25    Axis 090    Add + 2.50

PREVIOUS   6/30/11    Sphere OD  + 2.25    Cylinder - 0.75   Axis 145    Add  + 2.50
(NEVER FILLED)          Sphere OS  + 1.75     


OLD 1/24/08          Sphere OD  + 2.00    Cylinder - 0.50    Axis 140    Add  + 2.25
(STILL WEARING)        Sphere OS   + 1.50    Cylinder - 0.25   Axis  120   Add  + 2.25

Thank you

ANSWER: Richard,
What you're experiencing isn't unusual; the good news is that it's normally an easy fix.  As we age many people tend to increase in "plus," which is what your Rx did (went from +2.00 to +2.50).  In the exam room, it's easy to pick out a higher number, as it makes things closer more comfortable. We do normally adjust these numbers for distances, but many people have a hard time adjusting to 'more plus.'  Moving it back down, but increasing the bifocal to compensate is normally the fix that works best for me.
I would get back in touch with your Dr. and request a consult / Rx check--these should be no charge. I would suggest bringing the new Glasses, and with them on, standing in the optical, have them put some "minus" lenses in front of the new ones. Putting a -0.25 in front of your glasses would make the right eye +2.25 instead of +2.50.  Maybe you want -0.50, and that would bring it back down to +2.00.  *BUT* as you put minus in front of them, it will decrease the bifocal strength, so be careful, that may need to be bumped up to compensate.
Good Luck!
Dr.D

---------- FOLLOW-UP ----------

QUESTION: SO you think by backing down the RX on the Sphere of both eyes and possibly increasing the Add might help the distance vision or just the right eye. Is there anything in the RX with the Axis that might cause the problem, or any type of Glaucoma that would affect my distance vision only ?

Answer
Glaucoma, cataracts, and other eye conditions typically affect both far and near vision. The fact that your old glasses are comfortable make me feel confident it's a strength issue.  I was giving an example of the right eye, but I would expect them to change both eyes and move them down a quarter or half step. This should make the distance vision much more comfortable.  The axis may be part of the issue, but I don't think it's as dramatic as the other changes noted.
Good Luck!
Dr.D

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John M. Dovie, OD, FAAO

Expertise

As a residency-trained Fellow of the American Academy of Optometry I am able to answer most questions regarding eye and vision health. Anything is welcome, ranging from dry or allergy eyes, bifocal contact lenses, or thoughts on LASIK surgery. As I am not a surgeon, detail-oriented surgical-related questions may be better answered by an ophthalmologist.

Experience

Selected to participate in the PCO residency program in Philadelphia at The Eye Institute, where I worked OD and MD specialists gaining invaluable experience in various clinics including glaucoma, cornea and cataract, oculo-plastics, retinal disease, neuro-ophthalmic disease, primary care, emergency medicine, and special populations. Have practiced and trained in numerous settings including hospital, academic, retail and private practice. I earned my Fellowship in the American Academy of Optometry (FAAO). There are currently only about 3000 active fellows worldwide, and there are only about 70 Fellows in the state of Virginia. I currently own and operate my own optometric practice/clinic.

Organizations
American Academy of Optometry, American Optometric Association (Contact Lens/Cornea Section member since 2001), Southwest Virginia Optometric Association, Virginia Tech Alumni Association

Publications
Seminars/Presentations:
“Nyctalopia as the Presenting Sign of Vitamin A Deficiency: A Late Complication of Gastric Bypass Surgery.” Clinical Case Study Poster presented at The American Academy of Optometry Denver, Colorado, December 2006, co-authored with Bradley Lane, OD.
“The Importance of Considering Paranasal Sinus Mucocele as a Differential Diagnosis in Diplopia.” Clinical Case Study Poster presented at The American Academy of Optometry San Diego, California, December 2005, co-authored with Kelly Malloy, OD, FAAO and Cherie Farkash, OD.
“Acute Onset of Halos and Glare: Bilateral Keratitis—An Atypical Presentation of Amiodarone Keratopathy.” Clinical Case Study Poster presented at The American Academy of Optometry Tampa, Florida December 2004. Also Presented to New Jersey Academy of Optometry, Neptune, New Jersey March 2005.
“The Opportunity for an Optometrist to Save a Life.” Clinical Case Study and Grand Rounds Presentation presented at The Pennsylvania College of Optometry, Philadelphia, Pennsylvania, September 2004.
Publications:
“Corneal whorls cause wonder.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 10/15/2006.
“Acute onset of halos and glare: bilateral corneal epithelial edema with cystic eruptions--atypical presentation of amiodarone keratopathy.” Co-authored with Andrew Gurwood, OD, FAAO. Published February, 2006, Optometry.
“Pondering the posterior polka-dots.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 5/15/2005.
Professional Involvement:
“AION: Amiodarone-Induced or Anterior Ischemic Optic Neuropathy?” Participated as a peer-review referee for Expert Review of Ophthalmology (London, UK); refereed 10/2006.

Education/Credentials
Bachelor of Science, Cum Laude, Virginia Tech. Bachelor of Science, Pennsylvania College of Optometry. Doctorate (OD), Pennsylvania College of Optometry Residency, Pennsylvania College of Optometry Fellow of the American Academy of Optometry

Awards and Honors
Winner, First Place, "Best Beside Manner" by Our Health Magazine: 2012, 2013, 2014 Winner, First Place, "Best Eye Doctor" by The Roanoke Times: 2013, 2014 Recognized as a Fellow of the American Academy of Optometry, December, 2006 Recipient of the Onofrey G. Rybachok Memorial Scholarship, 2000-2001 Member: The Golden Key International Honor Society Member: The National Biological Honor Society Member: The National Honor Society Eagle Scout awarded 1994

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