Eyeglasses

Long post, should be of interest in regards to optics for even
photographers who do not wear glasses (yet).

I got new eyeglasses today, progressive bifocals (no line) and the
auto-tint sunglasses thing this time (Reactint grey poly). Vision is
very important to me and I asked a lot of questions, so this is my
summary to share and I would like to know anything folks here have to
add, confirm, dispute, or comment on.

The appointment was at the chain store Lens Crafters (EyExam of
California) and I was a bit concerned about the rushed factory precision
with which my exam was executed... I know I'm being picky but it seemed
my questions were an unwelcome intrusion in their system... anyways,
that's just a personal annoyingly picky observation - the price was
right, fast convenient service and pointed glam treatment like I was a
movie star coming in for a face lift. That is obviously part of the
emmployee training. I only got glasses the first time 3 years ago at the
same place so this is only my second such appointment ever. No
insurance. $600 including $100 more for somewhat 'designer' frames,
progressive bifocals & auto-tinting sunglasses effect. I tend to avoid
doctors, dentists & such and do not generally trust them.

It's nice to have a new prescription, it really matters to me to be able
to see everything clearly. I lost one lens out of the old pair & have
been struggling with makeshift walgreens reading glasses & such for a
week (UGH!). The last set was uneven for left & right for a reading
distance of what I'm now told is tested at 16-inches, this exam came out
the same for both eyes. Testing them now... looks like the right eye is
not as sharp at that 16-inch distance... hmm... OK that's my first
intuitive test, now I see that tilting up fixes the problem in the right
eye but not symmetrically.

Here's the (confusing) data:

2006
sph cyl axis prism add (add for distance)
+1.00 -0.50 157 +1.25 (right)
+0.50 -0.50 077 +1.25 (left)

2009
sph cyl axis prism add (add for reading)
+025 PS +1.50 (right)
+025 PS +1.50 (left)

Note the difference: (add for distance)/(add for reading)
-perhaps I wrote it down wrong in 2006?
For this one I confirmed the math for reading glasses:
+025 distance plus +150 = +1.75 (in walgreens reading glasses terminology).

Last time, I was told I had an astigmatism in one or more eyes, I don't
recall. That seems to be the cyl/axis data? My observations above about
tilting and asymmetry suggest an asymmetry for which I don't have the
knowledge to describe properly. Do the 2006 numbers explain that or some
other situation? Should I complain that this exam was not accurate
enough, or just pay more for a more custom service next time? They said
something about a free adjustment appointment in a month or something
like that...

I didn't like the quick lens switcharoo testing method, I would have
preferred a focus ring that I could control. Sometimes I need to focus
(mentally) on different aspects of the experience, and coordinate with
the optician's timing which was a bit of a struggle and I wasn't always
convinced that the test was nailed in such a fast-paced one-chance
interaction. I would have liked to understand better when we were
looking for astigmatism or whatever it was, rather than just answering
yes/no. I would offer to tip them $50 or whatever... to go a little
slower g if it helped.

Distance acuity is measured at about 20 feet, through a mirror in a
10-foot room. Infinity is considered close enough to that, so it's not
worth testing or perhaps impractical indoors. Those are the only
distances tested. Anything else can be accomplished by tilting the
progressive bifocals. I asked about closer distances, the reply seemed
to be that was just impractical plus my bone structure places my eyes
relatively far apart and in a cross-eyed test I was unable to align my
eyes any closer than about 16 inches. This was a noticeable 'fail' in
the test sequence. The question was asked if I sometimes see double
(yes). I have a very difficult time viewing stereo pair photographs,
it's near impossible for me without some kind of aid.

I asked, "what about optimizing for photography and or computer work,
because that's super-important for me?" I edit photos on a 26-inch
monitor at 20 to 34 inches away, and it's my understanding that an SLR
camera simulates a focal distance of about 30 inches. And what about
closer viewing, like examining plant specimens for identification? At
45, I miss not being a little kid with razor sharp vision :-( The reply
was that I could get another pair of glasses optimized at that range,
even progressive bifocals between that range.

My right eye is dominant. I guess that's normal for right-handed people.
The asymmetry however seems to give a sharper image at the 30-inch range
in my left eye which seems unfortunate. One interesting test result
regarding eye dominance was the peripheral test where you stare at a dot
and click a button when you detect the machine's twitching subtle
peripheral flashes... on the left eye, the right part of my field of
vision blacked out sometimes. Apparently this is not unusual, blinking
restores the black area. What's going on is my mind says the left eye
doesn't need to worry about the right side so it literally blacks it
out. It's fascinating how much of our vision is the result of our
brain's interpretation. It's hard for me to judge things sometimes
because my brain is messing with reality & making all sorts of
assumptions & corrections that I'm not aware of. Interesting.

Last time we talked about anti-scratch coatings because I work outside
with muddy hands all the time. I don't know what I got this time. I
asked about glass versus plastic again, because glass is more durable.
The warning was even more severe this time about glass being a hassle
for them and the risk of eye injury in an accident if they broke into
shards. I'd be willing to risk that for better optics, I scratch them to
hell in no time and that's no fun to look through scratched glasses or
replace every 6 months. I wonder about anti-glare coatings too, now that
I think of it. That's a big deal on camera lenses. I'm not independently
wealthy but my vision is extremely important to me and I'd be willing to
pay for improvements on my eyeglasses. Maybe I can keep these for backup
and dirty work and get a better custom pair as a more informed consumer?

They had a new gizmo that photographs the retina to look for diseases &
stuff. I came out OK on that. I asked to have the images emailed to
me... not yet... What it does is shoot through the pupil (black center
opening in your eye) & shows the retina (inside surface of your eye)
where the image is captured in your eye. It just looks like blood
vessels plus the macula: http://en.wikipedia.org/wiki/Macula I forget
the term for the gizmo, there was a video about it in the waiting area.

I asked if I wanted a custom pair of glasses for that distance, the doc
said +1. I have a Canon 500D closeup filter which is +1 diopter in 35mm
SLR terminology, at 24 inches from my screen it looks fantastic through
my right eye. On the left eye, I have to hold it about 2 or 3 inches
away from my eye. The closeup lens looks much sharper than my new
glasses. Maybe it would be nice to have another pair just for computer
use. The Canon 500D closeup is a nice big 2-element piece of glass. It's
probably unreasonable to expect a pair of multi-purpose eyeglasses to
match that performance but if so, that's a shame.

I bent the frames a bit so they sit tilted slightly to correct for the
asymmetry. The lens over my right eye is a bit higher now. Try testing
your glasses this way, covering each eye with your hand.

I brought my camera in, explaining that was something important to my
needs and met confused blank stares from both people I talked with. I
could have tested the text size charts with the camera for hours to get
it right g. Maybe there's a way to come up with eyeglass prescription
data myself?

--
Paul Furman
www.edgehill.net
www.baynatives.com

all google groups messages filtered due to spam

"Paul Furman" wrote in message
...
Long post, should be of interest in regards to optics for even
photographers who do not wear glasses (yet).

I got new eyeglasses today, progressive bifocals (no line) and the
auto-tint sunglasses thing this time (Reactint grey poly). Vision is very
important to me and I asked a lot of questions, so this is my summary to
share and I would like to know anything folks here have to add, confirm,
dispute, or comment on.

The appointment was at the chain store Lens Crafters (EyExam of
California) and I was a bit concerned about the rushed factory precision
with which my exam was executed... I know I'm being picky but it seemed my
questions were an unwelcome intrusion in their system... anyways, that's
just a personal annoyingly picky observation - the price was right, fast
convenient service and pointed glam treatment like I was a movie star
coming in for a face lift. That is obviously part of the emmployee
training. I only got glasses the first time 3 years ago at the same place
so this is only my second such appointment ever. No insurance. $600
including $100 more for somewhat 'designer' frames, progressive bifocals &
auto-tinting sunglasses effect. I tend to avoid doctors, dentists & such
and do not generally trust them.

It's nice to have a new prescription, it really matters to me to be able
to see everything clearly. I lost one lens out of the old pair & have been
struggling with makeshift walgreens reading glasses & such for a week
(UGH!). The last set was uneven for left & right for a reading distance of
what I'm now told is tested at 16-inches, this exam came out the same for
both eyes. Testing them now... looks like the right eye is not as sharp
at that 16-inch distance... hmm... OK that's my first intuitive test, now
I see that tilting up fixes the problem in the right eye but not
symmetrically.

Here's the (confusing) data:

2006
sph cyl axis prism add (add for distance)
+1.00 -0.50 157 +1.25 (right)
+0.50 -0.50 077 +1.25 (left)

2009
sph cyl axis prism add (add for reading)
+025 PS +1.50 (right)
+025 PS +1.50 (left)

Note the difference: (add for distance)/(add for reading)
-perhaps I wrote it down wrong in 2006?
For this one I confirmed the math for reading glasses:
+025 distance plus +150 = +1.75 (in walgreens reading glasses
terminology).

Last time, I was told I had an astigmatism in one or more eyes, I don't
recall. That seems to be the cyl/axis data? My observations above about
tilting and asymmetry suggest an asymmetry for which I don't have the
knowledge to describe properly. Do the 2006 numbers explain that or some
other situation? Should I complain that this exam was not accurate enough,
or just pay more for a more custom service next time? They said something
about a free adjustment appointment in a month or something like that...

I didn't like the quick lens switcharoo testing method, I would have
preferred a focus ring that I could control. Sometimes I need to focus
(mentally) on different aspects of the experience, and coordinate with the
optician's timing which was a bit of a struggle and I wasn't always
convinced that the test was nailed in such a fast-paced one-chance
interaction. I would have liked to understand better when we were looking
for astigmatism or whatever it was, rather than just answering yes/no. I
would offer to tip them $50 or whatever... to go a little slower g if it
helped.

Distance acuity is measured at about 20 feet, through a mirror in a
10-foot room. Infinity is considered close enough to that, so it's not
worth testing or perhaps impractical indoors. Those are the only distances
tested. Anything else can be accomplished by tilting the progressive
bifocals. I asked about closer distances, the reply seemed to be that was
just impractical plus my bone structure places my eyes relatively far
apart and in a cross-eyed test I was unable to align my eyes any closer
than about 16 inches. This was a noticeable 'fail' in the test sequence.
The question was asked if I sometimes see double (yes). I have a very
difficult time viewing stereo pair photographs, it's near impossible for
me without some kind of aid.

I asked, "what about optimizing for photography and or computer work,
because that's super-important for me?" I edit photos on a 26-inch monitor
at 20 to 34 inches away, and it's my understanding that an SLR camera
simulates a focal distance of about 30 inches. And what about closer
viewing, like examining plant specimens for identification? At 45, I miss
not being a little kid with razor sharp vision :-( The reply was that I
could get another pair of glasses optimized at that range, even
progressive bifocals between that range.

My right eye is dominant. I guess that's normal for right-handed people.
The asymmetry however seems to give a sharper image at the 30-inch range
in my left eye which seems unfortunate. One interesting test result
regarding eye dominance was the peripheral test where you stare at a dot
and click a button when you detect the machine's twitching subtle
peripheral flashes... on the left eye, the right part of my field of
vision blacked out sometimes. Apparently this is not unusual, blinking
restores the black area. What's going on is my mind says the left eye
doesn't need to worry about the right side so it literally blacks it out.
It's fascinating how much of our vision is the result of our brain's
interpretation. It's hard for me to judge things sometimes because my
brain is messing with reality & making all sorts of assumptions &
corrections that I'm not aware of. Interesting.

Last time we talked about anti-scratch coatings because I work outside
with muddy hands all the time. I don't know what I got this time. I asked
about glass versus plastic again, because glass is more durable. The
warning was even more severe this time about glass being a hassle for them
and the risk of eye injury in an accident if they broke into shards. I'd
be willing to risk that for better optics, I scratch them to hell in no
time and that's no fun to look through scratched glasses or replace every
6 months. I wonder about anti-glare coatings too, now that I think of it.
That's a big deal on camera lenses. I'm not independently wealthy but my
vision is extremely important to me and I'd be willing to pay for
improvements on my eyeglasses. Maybe I can keep these for backup and dirty
work and get a better custom pair as a more informed consumer?

They had a new gizmo that photographs the retina to look for diseases &
stuff. I came out OK on that. I asked to have the images emailed to me...
not yet... What it does is shoot through the pupil (black center opening
in your eye) & shows the retina (inside surface of your eye) where the
image is captured in your eye. It just looks like blood vessels plus the
macula: http://en.wikipedia.org/wiki/Macula I forget the term for the
gizmo, there was a video about it in the waiting area.

I asked if I wanted a custom pair of glasses for that distance, the doc
said +1. I have a Canon 500D closeup filter which is +1 diopter in 35mm
SLR terminology, at 24 inches from my screen it looks fantastic through my
right eye. On the left eye, I have to hold it about 2 or 3 inches away
from my eye. The closeup lens looks much sharper than my new glasses.
Maybe it would be nice to have another pair just for computer use. The
Canon 500D closeup is a nice big 2-element piece of glass. It's probably
unreasonable to expect a pair of multi-purpose eyeglasses to match that
performance but if so, that's a shame.

I bent the frames a bit so they sit tilted slightly to correct for the
asymmetry. The lens over my right eye is a bit higher now. Try testing
your glasses this way, covering each eye with your hand.

I brought my camera in, explaining that was something important to my
needs and met confused blank stares from both people I talked with. I
could have tested the text size charts with the camera for hours to get it
right g. Maybe there's a way to come up with eyeglass prescription data
myself?

--
Paul Furman

I bet they didn't test you in dim light, either.....I have always had poor
night vision, and have never been tested for it.....Even when I took the
Navy flight physical exam. They washed me out because of weak ankles and a
nervous habit of biting my fingernails....Thank God, or I wouldn't be here
right now. I was stationed on a destroyer and spent many hours plane
guarding aircraft carriers during nighttime air ops. I would have surely
caught the lip of a carrier and been killed had I gone to flight school. My
night vision has always been deplorable, even when I was in my 20's. Even
today, I can pass a DMV driving test with flying colors, even without my
glasses, but I have to have my wife or a band mate friend take me to evening
gigs because I am incapable of driving home after dark.

On 2009-04-07 19:59:30 -0700, Paul Furman said:

THE SNIP
Here's the (confusing) data:

2006
sph cyl axis prism add (add for distance)
+1.00 -0.50 157 +1.25 (right)
+0.50 -0.50 077 +1.25 (left)

2009
sph cyl axis prism add (add for reading)
+025 PS +1.50 (right)
+025 PS +1.50 (left)

Note the difference: (add for distance)/(add for reading)
-perhaps I wrote it down wrong in 2006?
For this one I confirmed the math for reading glasses:
+025 distance plus +150 = +1.75 (in walgreens reading glasses terminology).

Last time, I was told I had an astigmatism in one or more eyes, I don't
recall. That seems to be the cyl/axis data? My observations above about
tilting and asymmetry suggest an asymmetry for which I don't have the
knowledge to describe properly. Do the 2006 numbers explain that or
some other situation? Should I complain that this exam was not accurate
enough, or just pay more for a more custom service next time? They said
something about a free adjustment appointment in a month or something
like that...

You are correct the cyl/axis data is indicative of astigmatism in both
eyes. I think you were robbed.

You have been given a very poor refaction (optometrist speak for a
vision exam).

Your 2006 Rx is indicative of astigmatism which is corrected with a
sphero-cylindrical, or toroidal lens. The Rx shows the difference in
both eyes and the angle of astigmatism. The +1.25 add gives you the
reading correction. This seems to be an appropriate correction for most.

Now for 2009. You seem to have found a clown refractionist, trying to
do an eye-ball refraction without any concern for your vision issues.
Astigmatism is not going to vanish. It will change, but not magically
disappear.
You have been given a new Rx without astigmatism cylinder correction,
only a simple spherical lens + reading correction. They gave you a
cheap fix and hoped you would go away.
I am surprised you are not getting headaches, and possibly a little nauseous.

If you look at the ball park numbers for the left eye, in 2006 in one
axis you had +0.50 -0.50 giving you an effective 0.00 correction in one
axis and +0.50 in the other. The effective reading correction would be
+1.25/1.75
In 2009 they have given you an averaged +0.25 with a reading correction
equaling +1.75, The same as in your major astigmatic axis in 2006.

There are similar issues with your right eye.
A competent optometist would also do a binocular balance between the two eyes.

You have been given a poor test and you should demand a refund or a
proper test. Better yet go and see a real optometrist who will not try
to shine you on.

No adjustment of frame is going to fix that problem.

I have lived with severe astigmatism all my life and I would not accept
an exam which did not address the correction I need.

--
Regards,
Savageduck

On Tue, 07 Apr 2009 19:59:30 -0700, Paul Furman
wrote:

Long post, should be of interest in regards to optics for even
photographers who do not wear glasses (yet).

I got new eyeglasses today, progressive bifocals (no line) and the
auto-tint sunglasses thing this time (Reactint grey poly). Vision is
very important to me and I asked a lot of questions, so this is my
summary to share and I would like to know anything folks here have to
add, confirm, dispute, or comment on.

A word first...I am retired, but I spent my working career in the
field of medical instrumentation. I sold medical equipment for
several years, and then started my own company as a distributor of
medical equipment. One of my primary suppliers was Carl Zeiss, Inc. I
sold and distributed Zeiss Operation Microscopes and Slit Lamps. (I
wasn't involved with Zeiss laboratory microscopes. Just the ones used
in surgery.) I also sold and distributed lasers used in eye surgery.
I mention this to show that I have more than a passing knowledge of
the field.

I would never have an optometrist do my eye exam. I have them done by
an opthalmologist (an M.D.) because part of the process should be a
medical examination. My prescription is determined by an optometrist
who is on the opthalmologist's staff, but the examination is done by
the opthalmologist. The medical exam and the prescription
determination are two different things.

I would never have my perscription filled by the opthalmologist's
office. I ask for it, and take it to a place like Lenscrafters to be
filled. The on-site opthalmologist's lab charges far too much for
glasses. Ridiculous.

I currently have three pair of glasses: a pair of bifocals for
ordinary use, a pair of tinted prescription bifocals (sunglasses), and
a pair of single-vision computer glasses. I also have a SCUBA dive
mask with a prescription lens.

Bifocals are set to the working distance you assume for close work.
Reading, for example. Because my computer screen is a different
distance from eyes than I would hold a newspaper or book, my computer
glasses are what would be the bifocal part for this distance. I can't
see across the room in them, but the screen is sharp and clear.
Because all of the lens is the same prescription, I don't have to tilt
my head when viewing the monitor.

There are some other points in your post I disagree with, but they are
just points of personal preference. For example, I prefer the
super-thin plastic lenses (scratchproof coated) because they are
lighter and more comfortable. I don't like the auto-tints because
they are not effective as sunglasses and change too slowly when you
come out of the sun. Your milage may vary.

You do want that fast switcheroo, by the way. That's the way vision
works. When your view changes from your wris****ch to something
across the room, you don't dial in the new setting. The eyes
instantly re-focus and the test replicates that.

--
Tony Cooper - Orlando, Florida

On 2009-04-07 21:29:41 -0700, TonyCooper said:

On Tue, 07 Apr 2009 19:59:30 -0700, Paul Furman
wrote:

A word first...I am retired, but I spent my working career in the
field of medical instrumentation. I sold medical equipment for
several years, and then started my own company as a distributor of
medical equipment. One of my primary suppliers was Carl Zeiss, Inc. I
sold and distributed Zeiss Operation Microscopes and Slit Lamps. (I
wasn't involved with Zeiss laboratory microscopes. Just the ones used
in surgery.) I also sold and distributed lasers used in eye surgery.
I mention this to show that I have more than a passing knowledge of
the field.

I would never have an optometrist do my eye exam. I have them done by
an opthalmologist (an M.D.) because part of the process should be a
medical examination. My prescription is determined by an optometrist
who is on the opthalmologist's staff, but the examination is done by
the opthalmologist. The medical exam and the prescription
determination are two different things.

I would never have my perscription filled by the opthalmologist's
office. I ask for it, and take it to a place like Lenscrafters to be
filled. The on-site opthalmologist's lab charges far too much for
glasses. Ridiculous.

I currently have three pair of glasses: a pair of bifocals for
ordinary use, a pair of tinted prescription bifocals (sunglasses), and
a pair of single-vision computer glasses. I also have a SCUBA dive
mask with a prescription lens.

Bifocals are set to the working distance you assume for close work.
Reading, for example. Because my computer screen is a different
distance from eyes than I would hold a newspaper or book, my computer
glasses are what would be the bifocal part for this distance. I can't
see across the room in them, but the screen is sharp and clear.
Because all of the lens is the same prescription, I don't have to tilt
my head when viewing the monitor.

There are some other points in your post I disagree with, but they are
just points of personal preference. For example, I prefer the
super-thin plastic lenses (scratchproof coated) because they are
lighter and more comfortable. I don't like the auto-tints because
they are not effective as sunglasses and change too slowly when you
come out of the sun. Your milage may vary.

You do want that fast switcheroo, by the way. That's the way vision
works. When your view changes from your wris****ch to something
across the room, you don't dial in the new setting. The eyes
instantly re-focus and the test replicates that.


Tony,

I go to a practice which has two optometists and two opthalmologists as
well as a team of dispensing opticians.

The real difference between the two specialities is the way they go
about addressing the diagnosis and treatment.

The schooling an optometist has includes ocular pathology and disease
along with all that is needed for refraction of the eye. He is not a
medical doctor and as such is not qualified to treat any ocular
pathology or perform any surgery. He does have an extensive background
in physics, optics, visual optics and the science of refraction of the
eye. He should approach an eye exam by conducting a screening for
pathologybefore conducting the refraction. If detected he is obiged to
refer to an opthalmologist for consultation.

The opthalmogist is first a medical doctor with a speciality. His
expertise is in the treatment of ocular pathology and performing ocular
surgery. If you actually inquire of an opthalmologist as to the time he
spent in college studying refraction and visual optics vs. pathology
and surgery you would be quite surprised.

The bottom line is if you have no eye disease or pathology, an
optometrist is best qualified to provide you an accurate vision
correction. Unfortunately in this day of vanity so many are sold on
laser surgical correction which can only be performed by an
othalmologist.

I have worn glasses most of my life. For the last 25 years I have worn
progressives. Like you I wear the super thin coated plastic lenses. I
do use the auto tints, mainly because they offer good UV protection. I
too find they are not truly adequate as sunglasses, so I use matching
clip-ons the custom frame magnetics works best for me. I also have a
pair of dedicated sunglasses with my Rx in progressive lens. Those cost
about $650.
I am fortunate to have good medical insurance with a good seperate vision plan.

AT the practice I go to I find they are reasonable in what they charge
both for testing and dispensing. I might get a slightly better deal
going to Lenscrafters, but I prefer to have all dealt with in one
"shop" so to speak.

To conclude, I feel that from my experience with my vision problems,
Paul needs to seek a consultation with a quality professional, be it
optometrist or opthomologist.

--
Regards,
Savageduck

On Tue, 7 Apr 2009 22:05:05 -0700, Savageduck
wrote:

On 2009-04-07 21:29:41 -0700, TonyCooper said:

On Tue, 07 Apr 2009 19:59:30 -0700, Paul Furman
wrote:

A word first...I am retired, but I spent my working career in the
field of medical instrumentation. I sold medical equipment for
several years, and then started my own company as a distributor of
medical equipment. One of my primary suppliers was Carl Zeiss, Inc. I
sold and distributed Zeiss Operation Microscopes and Slit Lamps. (I
wasn't involved with Zeiss laboratory microscopes. Just the ones used
in surgery.) I also sold and distributed lasers used in eye surgery.
I mention this to show that I have more than a passing knowledge of
the field.

I would never have an optometrist do my eye exam. I have them done by
an opthalmologist (an M.D.) because part of the process should be a
medical examination. My prescription is determined by an optometrist
who is on the opthalmologist's staff, but the examination is done by
the opthalmologist. The medical exam and the prescription
determination are two different things.

I would never have my perscription filled by the opthalmologist's
office. I ask for it, and take it to a place like Lenscrafters to be
filled. The on-site opthalmologist's lab charges far too much for
glasses. Ridiculous.

I currently have three pair of glasses: a pair of bifocals for
ordinary use, a pair of tinted prescription bifocals (sunglasses), and
a pair of single-vision computer glasses. I also have a SCUBA dive
mask with a prescription lens.

Bifocals are set to the working distance you assume for close work.
Reading, for example. Because my computer screen is a different
distance from eyes than I would hold a newspaper or book, my computer
glasses are what would be the bifocal part for this distance. I can't
see across the room in them, but the screen is sharp and clear.
Because all of the lens is the same prescription, I don't have to tilt
my head when viewing the monitor.

There are some other points in your post I disagree with, but they are
just points of personal preference. For example, I prefer the
super-thin plastic lenses (scratchproof coated) because they are
lighter and more comfortable. I don't like the auto-tints because
they are not effective as sunglasses and change too slowly when you
come out of the sun. Your milage may vary.

You do want that fast switcheroo, by the way. That's the way vision
works. When your view changes from your wris****ch to something
across the room, you don't dial in the new setting. The eyes
instantly re-focus and the test replicates that.


Tony,

I go to a practice which has two optometists and two opthalmologists as
well as a team of dispensing opticians.

The real difference between the two specialities is the way they go
about addressing the diagnosis and treatment.

I'm well aware of that.

The schooling an optometist has includes ocular pathology and disease
along with all that is needed for refraction of the eye. He is not a
medical doctor and as such is not qualified to treat any ocular
pathology or perform any surgery. He does have an extensive background
in physics, optics, visual optics and the science of refraction of the
eye. He should approach an eye exam by conducting a screening for
pathologybefore conducting the refraction. If detected he is obiged to
refer to an opthalmologist for consultation.

And that. The question in my mind is how capable he is in performing
the medical screening, and how extensive the screening is. Also, I
prefer the consulting be done in conjunction with the visit.

The opthalmogist is first a medical doctor with a speciality. His
expertise is in the treatment of ocular pathology and performing ocular
surgery. If you actually inquire of an opthalmologist as to the time he
spent in college studying refraction and visual optics vs. pathology
and surgery you would be quite surprised.

No, I wouldn't be. Not after the hundreds of hours I've spent with
ophthalmology residents in medical schools. In fact, the
opthalmologist I go to now I first met when he was a resident.

The bottom line is if you have no eye disease or pathology, an
optometrist is best qualified to provide you an accurate vision
correction. Unfortunately in this day of vanity so many are sold on
laser surgical correction which can only be performed by an
othalmologist.

Perhaps you read my post without your glasses and missed the part
where I said: "My prescription is determined by an optometrist
who is on the opthalmologist's staff, but the examination is done by
the opthalmologist. The medical exam and the prescription
determination are two different things."

It's still there. Above.

I don't consider what the optometrist does as an "examination"
because, to me, the medical assessment is the examination. The
optometrist is basically a technician.

I go to an opthalmologist because he *is* trained on eye disease and
pathology. The opthalmologist employs the optometrist because he
(actually, it's a she in my case) *is* trained in vision correction.

I have worn glasses most of my life. For the last 25 years I have worn
progressives. Like you I wear the super thin coated plastic lenses. I
do use the auto tints, mainly because they offer good UV protection. I
too find they are not truly adequate as sunglasses, so I use matching
clip-ons the custom frame magnetics works best for me.

That's a personal choice, but one I wouldn't subscribe to. I wouldn't
want the extra weight. If it doesn't bother you, that's fine though.

I also have a
pair of dedicated sunglasses with my Rx in progressive lens. Those cost
about $650.
I am fortunate to have good medical insurance with a good seperate vision plan.

My insurance covers the cost of the visit to the ophthalmologist and
the fitting by the optometrist, but not the lenses or frames.

AT the practice I go to I find they are reasonable in what they charge
both for testing and dispensing. I might get a slightly better deal
going to Lenscrafters, but I prefer to have all dealt with in one
"shop" so to speak.

Personal choice.

To conclude, I feel that from my experience with my vision problems,
Paul needs to seek a consultation with a quality professional, be it
optometrist or opthomologist.

It's up to Paul to use who he feels comfortable with. I feel more
comfortable using an opthalmologist. If he heeds your advice to seek
a "quality professional", I personally feel he's more likely to find a
more qualified optometrist who works for a opthalmologist than he will
in a chain store outlet.

I think the chain store outlets like Lenscrafters are quite capable in
filling perscriptions, though. My own glasses are not from
Lenscrafters, but they are from a similar place.

On the subject of laser surgery...I don't feel that it's a vanity
issue. The benefits are more in convenience than vanity. My daughter
had it done, and wishes she hadn't waited so long to do it. She wore
contacts and had nothing but problems with contacts. You might say
that contacts are a vanity choice, but she's active in sports, lives
in a beach town, and spends quite a bit of time out on the boat. The
laser surgery freed her up.

--
Tony Cooper - Orlando, Florida

Paul Furman writes:

They had a new gizmo that photographs the retina to look for diseases &
stuff. I came out OK on that. I asked to have the images emailed to
me... not yet... What it does is shoot through the pupil (black center
opening in your eye) & shows the retina (inside surface of your eye)
where the image is captured in your eye. It just looks like blood
vessels plus the macula: http://en.wikipedia.org/wiki/Macula I forget
the term for the gizmo, there was a video about it in the waiting area.

Retinal camera or fundus camera. Something that belongs in a medical
practice, but is used to generate fees in eyeglass shops.

On 2009-04-07 23:32:54 -0700, TonyCooper said:

On Tue, 7 Apr 2009 22:05:05 -0700, Savageduck
wrote:

On 2009-04-07 21:29:41 -0700, TonyCooper said:

On Tue, 07 Apr 2009 19:59:30 -0700, Paul Furman
wrote:

A word first...I am retired, but I spent my working career in the
field of medical instrumentation. I sold medical equipment for
several years, and then started my own company as a distributor of
medical equipment. One of my primary suppliers was Carl Zeiss, Inc. I
sold and distributed Zeiss Operation Microscopes and Slit Lamps. (I
wasn't involved with Zeiss laboratory microscopes. Just the ones used
in surgery.) I also sold and distributed lasers used in eye surgery.
I mention this to show that I have more than a passing knowledge of
the field.

I would never have an optometrist do my eye exam. I have them done by
an opthalmologist (an M.D.) because part of the process should be a
medical examination. My prescription is determined by an optometrist
who is on the opthalmologist's staff, but the examination is done by
the opthalmologist. The medical exam and the prescription
determination are two different things.

I would never have my perscription filled by the opthalmologist's
office. I ask for it, and take it to a place like Lenscrafters to be
filled. The on-site opthalmologist's lab charges far too much for
glasses. Ridiculous.

I currently have three pair of glasses: a pair of bifocals for
ordinary use, a pair of tinted prescription bifocals (sunglasses), and
a pair of single-vision computer glasses. I also have a SCUBA dive
mask with a prescription lens.

Bifocals are set to the working distance you assume for close work.
Reading, for example. Because my computer screen is a different
distance from eyes than I would hold a newspaper or book, my computer
glasses are what would be the bifocal part for this distance. I can't
see across the room in them, but the screen is sharp and clear.
Because all of the lens is the same prescription, I don't have to tilt
my head when viewing the monitor.

There are some other points in your post I disagree with, but they are
just points of personal preference. For example, I prefer the
super-thin plastic lenses (scratchproof coated) because they are
lighter and more comfortable. I don't like the auto-tints because
they are not effective as sunglasses and change too slowly when you
come out of the sun. Your milage may vary.

You do want that fast switcheroo, by the way. That's the way vision
works. When your view changes from your wris****ch to something
across the room, you don't dial in the new setting. The eyes
instantly re-focus and the test replicates that.


Tony,

I go to a practice which has two optometists and two opthalmologists as
well as a team of dispensing opticians.

The real difference between the two specialities is the way they go
about addressing the diagnosis and treatment.

I'm well aware of that.

The schooling an optometist has includes ocular pathology and disease
along with all that is needed for refraction of the eye. He is not a
medical doctor and as such is not qualified to treat any ocular
pathology or perform any surgery. He does have an extensive background
in physics, optics, visual optics and the science of refraction of the
eye. He should approach an eye exam by conducting a screening for
pathologybefore conducting the refraction. If detected he is obiged to
refer to an opthalmologist for consultation.

And that. The question in my mind is how capable he is in performing
the medical screening, and how extensive the screening is. Also, I
prefer the consulting be done in conjunction with the visit.

The opthalmogist is first a medical doctor with a speciality. His
expertise is in the treatment of ocular pathology and performing ocular
surgery. If you actually inquire of an opthalmologist as to the time he
spent in college studying refraction and visual optics vs. pathology
and surgery you would be quite surprised.

No, I wouldn't be. Not after the hundreds of hours I've spent with
ophthalmology residents in medical schools. In fact, the
opthalmologist I go to now I first met when he was a resident.

The bottom line is if you have no eye disease or pathology, an
optometrist is best qualified to provide you an accurate vision
correction. Unfortunately in this day of vanity so many are sold on
laser surgical correction which can only be performed by an
othalmologist.

Perhaps you read my post without your glasses and missed the part
where I said: "My prescription is determined by an optometrist
who is on the opthalmologist's staff, but the examination is done by
the opthalmologist. The medical exam and the prescription
determination are two different things."

It's still there. Above.

I don't consider what the optometrist does as an "examination"
because, to me, the medical assessment is the examination. The
optometrist is basically a technician.

I go to an opthalmologist because he *is* trained on eye disease and
pathology. The opthalmologist employs the optometrist because he
(actually, it's a she in my case) *is* trained in vision correction.

I have worn glasses most of my life. For the last 25 years I have worn
progressives. Like you I wear the super thin coated plastic lenses. I
do use the auto tints, mainly because they offer good UV protection. I
too find they are not truly adequate as sunglasses, so I use matching
clip-ons the custom frame magnetics works best for me.

That's a personal choice, but one I wouldn't subscribe to. I wouldn't
want the extra weight. If it doesn't bother you, that's fine though.

I also have a
pair of dedicated sunglasses with my Rx in progressive lens. Those cost
about $650.
I am fortunate to have good medical insurance with a good seperate vision plan.

My insurance covers the cost of the visit to the ophthalmologist and
the fitting by the optometrist, but not the lenses or frames.

AT the practice I go to I find they are reasonable in what they charge
both for testing and dispensing. I might get a slightly better deal
going to Lenscrafters, but I prefer to have all dealt with in one
"shop" so to speak.

Personal choice.

To conclude, I feel that from my experience with my vision problems,
Paul needs to seek a consultation with a quality professional, be it
optometrist or opthomologist.

It's up to Paul to use who he feels comfortable with. I feel more
comfortable using an opthalmologist. If he heeds your advice to seek
a "quality professional", I personally feel he's more likely to find a
more qualified optometrist who works for a opthalmologist than he will
in a chain store outlet.

I think the chain store outlets like Lenscrafters are quite capable in
filling perscriptions, though. My own glasses are not from
Lenscrafters, but they are from a similar place.

On the subject of laser surgery...I don't feel that it's a vanity
issue. The benefits are more in convenience than vanity. My daughter
had it done, and wishes she hadn't waited so long to do it. She wore
contacts and had nothing but problems with contacts. You might say
that contacts are a vanity choice, but she's active in sports, lives
in a beach town, and spends quite a bit of time out on the boat. The
laser surgery freed her up.

I think we are pretty much both on the same page here, though I have
confidence in my optometrist's training and methodology to provide a
thorough exam, including opthalmoscopy, slit-lamp exam, tonometry,
perimetry and a complete balanced refraction. As well as his ability to
recognize retinal damage, lens opacities and other pathologies, benign
or otherwise
I trust his professionalism to refer me to one of his opthalmologist
collegues if there is any questionable finding.

What I wear now are absolutely featherweight even with the attached
shades, but they are not inexpensive.

As far as laser surgery goes, I may have been somewhat hypobolic. It is
a valuable corrective treatment, as are contacts, which at one time
used to be standard non-surgical treatment for conditions such as
keratoconus.

I can truly understand not wanting to wear glasses, however both of us
are of an age that even if we were corrected for normal distance vision
our old eyes would not permit the luxury of spectacle free reading. (
I know they have the strange idea of correcting one eye for distance
and one for reading. That just does not seem to be a choice I would
make, wanting to maintain reasonable depth perception.

By the way, I am just a month into this retirement gig, and I am
getting used to it very quickly. My Agency has already approached me
regarding returning to work as a retired annuitent, giving me the
opportunity to pretty much "double-dip". The only thing is it would be
a return dealing with much of the Law enforcement stuff currently under
discussion in other threads. I am pretty much done with that.


--
Regards,
Savageduck

Paul Furman wrote:

I only got glasses the first time 3 years ago at
the same place so this is only my second such appointment ever. No
insurance. $600 including $100 more for somewhat 'designer' frames,
progressive bifocals & auto-tinting sunglasses effect. I tend to avoid
doctors, dentists & such and do not generally trust them.

$600??? For a pair of glasses? Add opticians to your list.
____________

Here's the (confusing) data:

2006
sph cyl axis prism add (add for distance)
+1.00 -0.50 157 +1.25 (right)
+0.50 -0.50 077 +1.25 (left)

Astigmatism

2009
sph cyl axis prism add (add for reading)
+025 PS +1.50 (right)
+025 PS +1.50 (left)

No atigmatism and more far sighted
______________

Note the difference: (add for distance)/(add for reading)
-perhaps I wrote it down wrong in 2006?
For this one I confirmed the math for reading glasses:
+025 distance plus +150 = +1.75 (in walgreens reading glasses
terminology).
Last time, I was told I had an astigmatism in one or more eyes, I
don't recall. That seems to be the cyl/axis data? My observations
above about tilting and asymmetry suggest an asymmetry for which I
don't have the knowledge to describe properly. Do the 2006 numbers
explain that or some other situation? Should I complain that this
exam was not accurate

1. Draw three vertical line like this... |||
2. Now draw three horizontal lines next to them
3. Take off your glasses and look at the lines

Do either set of three look sharper than the other set? Yes = astigmatism
_________________

They
said something about a free adjustment appointment in a month or
something like that...

To adjust the *frame* fit.
________________

I asked, "what about optimizing for photography and or computer work,
because that's super-important for me?" I edit photos on a 26-inch
monitor at 20 to 34 inches away, and it's my understanding that an SLR
camera simulates a focal distance of about 30 inches. And what about
closer viewing, like examining plant specimens for identification?

Computer: second pair of glasses or clip on "reading glasses"

Camera: clip on +1.5 eyepiece (on camera)

Plant specimens: Hastings triplet for 10X, regular magnifying glass for less
power.

--

dadiOH
____________________________

dadiOH's dandies v3.06...
....a help file of info about MP3s, recording from
LP/cassette and tips & tricks on this and that.
Get it at http://mysite.verizon.net/xico

Savageduck wrote:

I know they have the strange idea of correcting one eye for distance
and one for reading. That just does not seem to be a choice I would
make, wanting to maintain reasonable depth perception.

I did that for a while before no line bifocals. I had both the close and
distance portions of the lenses adjusted for different positions; eg...

left close portion - very close to medium close
right close portion - medium close to far close
left distance portion - far close to medium distance
right distance portion - medium distance to far distance

It took 3-4 days for my eyes to quit wondering what was happening but after
that it worked fine...no depth perception problem and world's better than
tri-focals. With tri-focals, my head was bouncing around like a little
stuffed animal hanging from a mirror in a Chevy.

--

dadiOH
____________________________

dadiOH's dandies v3.06...
....a help file of info about MP3s, recording from
LP/cassette and tips & tricks on this and that.
Get it at http://mysite.verizon.net/xico