Glasses prescription after detached retina

Supernova

Hi all,

I had an op for a detached retina in the right eye 3 months ago, and because the macula detached completely, the sight has not returned to normal. It's a bit blurry and distorted but I am grateful for what I have.

I have worn varifocals for about 15 years and was given a new prescription last month.

The short and medium parts of the right lens don't really make much difference, whatever the distance, only the top long-distance part seems of any use.

Are the varifocals now inappropriate and is there some kind of hybrid solution where the right lens can be at maximum magnification all over but the left eye operating as a varifocal?

Or am I misunderstanding the possibilities?

Thanks!
S

GlasweJen

The only solution I can think of is getting a single distance lens in the damaged eye and a varifocal in the unaffected eye. With a bit of settling in you should get used to not using that eye for near tasks.

Supernova

GlasweJen wrote: »

The only solution I can think of is getting a single distance lens in the damaged eye and a varifocal in the unaffected eye. With a bit of settling in you should get used to not using that eye for near tasks.

Thank you GlasweJen.

Yes, those were my thoughts, but wasn't sure if it was feasible or advisable.

S

mmmsnow

I'm an optometrist and I would recommend speaking with an optom/dispensing optician about this.

Some places will make a fuss about having one lens varifocal and the other single vision but it is doable. If you are having issues getting what you want, look into local independent opticians. I've had similar situations where someone has had a varifocal in one eye and a distance lens in the other (because of macular degeneration) and it worked well for those patients.

Supernova

mmmsnow wrote: »

I'm an optometrist and I would recommend speaking with an optom/dispensing optician about this.

Some places will make a fuss about having one lens varifocal and the other single vision but it is doable. If you are having issues getting what you want, look into local independent opticians. I've had similar situations where someone has had a varifocal in one eye and a distance lens in the other (because of macular degeneration) and it worked well for those patients.

Thank you mmmsnow.

Am on my way to Specsavers now and will discuss! :-)

GlasweJen

mmmsnow wrote: »

I'm an optometrist and I would recommend speaking with an optom/dispensing optician about this.

Some places will make a fuss about having one lens varifocal and the other single vision but it is doable. If you are having issues getting what you want, look into local independent opticians. I've had similar situations where someone has had a varifocal in one eye and a distance lens in the other (because of macular degeneration) and it worked well for those patients.

I agree, I'm also an optom though retired through ill health from optometry and working in an eye clinic at a community hospital.

I must say most of our macula patients are bilateral and so are under the low vision service, I have made up a pair of glasses like the ones I described in the past but not for macula problems. I don't see it being an issue, the hospital can write a letter if it's a problem for the community optician. Part of my role is writing letters for the doctor to sign off to break down barriers between the community optoms and the Ophthalmologists who can't always understand why the opticians wont just do what they suggest on the patients say so *rolls eyes*

Supernova

Thanks both! :-)

Specsavers were quite open to the idea but concerned at the consequences of missing out on the potential near and medium vision benefits.

I can go back on Wednesday and they will try to mock up some trial hybrid glasses in store so that I can experience what it might be like before committing.

It was complicated by the fact that the varifocal sunglasses would need changing too - they were not adjusted properly at all when I initially picked them up last month.

The other option was for a new single lens long-distance pair for driving but perhaps I would miss out on medium distance for looking at the dashboard and the sunglasses need doing too.

Not sure what all this would cost or whether they could do some or all for free. I was not forewarned at all that the retinal damage meant that the varifocal performance would not be as before.

S

mmmsnow

I've had two patients with unilateral drusen causing distortion in their central field, which hindered reading. By glazing the affected eye as distance only, it solved that issue. One of them was a teacher and had been closing her "bad" eye to read. It worked really well.

I've worked in independent practice and for a few high street opticians, when patients with lazy eyes or no sight came in for varifocals, a couple of the high street opticians insisted that the varifocal be in both eyes, even though it wasn't necessary and may have been cheaper for the patient.

kirtondm

How badly is the macula damaged. I am another one to suggest single vision lens

If the VA is very poor then no lens will give you adequete perfomance through the eye and will be perihperal vision only. Often after detachment surgery their are large changes in prescription as well.

I would concentrate on the other eye.

I have lots of patients with only 1 varifocal their is really no reason not to do it.

Supernova

kirtondm wrote: »

How badly is the macula damaged. I am another one to suggest single vision lens

If the VA is very poor then no lens will give you adequete perfomance through the eye and will be perihperal vision only. Often after detachment surgery their are large changes in prescription as well.

I would concentrate on the other eye.

I have lots of patients with only 1 varifocal their is really no reason not to do it.

Thank you kirtondm

Well, the hospital team put it at 90% fixed, but I now think that %s are fairly meaningless. I reckon they did a good job, though - the op was 8 days after complete macular detachment.

I have plenty of central vision and a very minor shadow in the peripheral - formerly straight lines are now quite wavy but has improved, I think.

Before the op my prescription was:

SPH CYL AXIS Near-ADD Inter-ADD BVD
R -4.25 -1.00 97.0 +2.75 +2.00 12.00
L -4.5 -0.50 62.0 +2.75 +2.00

Afterwards it is:

R -4.75 -1.00 105.0 +2.75 11.00
L -4.25 -0.75 85.0 +2.75

With the left eye I can read a book at about 9 inches, with the damaged right eye it's about 5 inches without glasses.

With the left eye through the middle varifocal I can read a computer screen at 24 inches, with the right eye it's 15, but 22 inches through the top distance setting.

With further distances it's harder to judge because looking through the top part seems to lead to quite an unnatural neck position but both eyes are definitely clearer.

Thanks!
S

kirtondm

hmm has the prescription been rechecked. The R eye has increase a couple of steps and if the focus through the specs is closer that needs looking at.

If 90% vision is their that varies may still be suitable if you accept their is a 'blurry' patch in the centre.

Hard to say without seeing you.