Re: accommodative spasm

cdavis@xxxxxxxxxxxxxxxxxxx schreef:
On Apr 22, 3:55 am, Jan <nos...@xxxxxxxxx> wrote:
cda...@xxxxxxxxxxxxxxxxxxx schreef:

Are ophthalmologists and optometrists trained to recognize
accommodative spasm, lengthening of the eyeball, and pseudomyopia?
What do they do about it and how do they inform the patient about it?
Are they supposed to tell the patient what is going on? If they need
to adjust the distance prescription so the doctor can sell them
progressive lenses, do they tell the patient?
Again you are asking here whit out providing the necessary data about
your own situation.

In earlier postings here you give the impression in one eye your inner
lens (lens crystallina) was removed.

If you want a useful answer on your question than give the necessary data.

Then it is possible for the real specialists here to give a good answer.

Again and again you are suggesting eyecare professionals as a group are
only interested in how to get money out of your pocket and meanwhile you
want answers from the same people who earn there money as an eyecare
specialist here on Internet.

What is your real goal mister flatscreen?

Jan (normally Dutch spoken)

My real goal here is to find out why it is difficult to acquire a good
prescription from an optometrist and also find some answers as to
whether there is something I can do to retain whatever health I have
in my eyes. I went to another optometrist in the Portland area (not
where I live) and some of the results were as I suspected. For
distance I need:

More details please about which one is for the left or for the right eye and please give the best corrected vision acuity numbers

which leaves me wondering about the doctors saying I needed

And what best corrected vision acuity did you get with this prescription?

I do indeed have IOL's in both eyes but he did not know this until
after the refraction, when he did the dilated exam.

Strange, it is quite common to ask you several things (the anamnese).
Maybe you forgot to tell these important issues when the optometrist asked you about your eyehealth history?

Reminds of the man who came to the general doctor.

man: I'm ill
doctor: what's the problem?
man: don't know, you'r the doctor.

He also said
another YAG would not do any good and the haze was from the IOL
itself. I guess that nobody here can tell me whether I really had
cataracts before the surgery. These were supposedly cortical cataracts
of grade 2 in the right and grade 1 in the left.

You give the answer yourself.

I would go in every
year or two complaining of not being able to see well in the distance
(I could see myself in the mirror and read just fine)

If you can read without spectacles I suppose you are myopic in one or both eyes, so your prescription S-0.5 S+0,5 might be more correct as your latest is.

and they would
give me a new prescription and when I said I still couldn't see and
couldn't even read well with the glasses on, they said that was the
best they could do and that my eyes were healthy. Making it seem as if
it were somehow my fault.

Again your information is too less, what are the numbers of this prescription and where they meant for distance or reading or both?
More details please.

They sent me for thyroid workups and MRI.
They sent me for diabetic workups also. All tests were normal. So now
I wonder if it was just too complicated for them to grind the lenses
so they told me I needed cataract surgery.

Here you go again, you change from history to nowadays and backwards and that is quit confusing.
It is hard to follow where to place the different subjects in (time)place.

This might have been fine
but during my latest refraction I realized that, contrary to what I
had been told, I do have accommodation.

If your inner lenses are removed and replaced by stiff IOL's you have NO accommodation possibilities.

This is less strong in my left
eye but now I will exercise that eye more. My right eye only needs
+1.50 to read

That's corresponding with the prescription you got before the last one.
You also should noticed your vision acuity (uncorrected) for distance is less with the same eye.
Your reading distance could be calculated to refraction error 0.5 dpt plus the 1.50 = 2.00 dpts what results in a 50 cm work distance.

and a stronger prescription leaves me feeling like the
lens is too close to my eye. This type of accommodation might make an
exam less than accurate because it takes me a little bit longer than
before to focus up close.

Again, you have NO possibilities to accommodate.

I began reading about accommodative spasm.

For you, no need to.

For me, I don't know if spasm is the correct word. I have been doing
the same things with my eye muscles since before I started school.
What is the difference between progressive myopia and accommodative
spasm? They both seem to lengthen the eye and compromise the vitreous.
Over this many years shouldn't doctors be able to tell and inform the
patient of this condition? Now that I have an IOL

Here we go again, one or two IOL's?

and still over-
accommodate will my eye continue to lengthen and compromise the
vitreous? Maybe I will become nearsighted in that eye again but I will
be given a reading add based on my age and what I "should" need. What
does the chart say for a person 55 years old?

If you still have your own inner lenses it's possible to have a bit of accommodation left, not much however.

These are the questions
brushed aside by OD's and OMD's alike.

I refuse to accept that none of these eyecare professionals informed you about your problem and told you more than you are telling us now.

I still have many productive
years left but I have not driven on the freeway since 1995 because I
could not see far enough into the distance. Now, trying to get a good
pair of reading glasses or bifocals seems impossible. Yet nobody has
mentioned any diagnosis or prognosis.
How do I find a skilled doctor
who will take the time to listen and help me work with my eyes for the
long term, not just until next week. I am private pay and have paid.

For a start, try to write down your history with your eyes in a logical way.
Be precise about the date and the findings on that particular date.
Most of all, do not keep your mouth shut when a professional is asking.

Jan (normally Dutch spoken)

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