Re: accommodative spasm

On Apr 23, 8:41 pm, Dr Judy <mpac...@xxxxxxxxxx> wrote:
On Apr 22, 2:13 pm, cda...@xxxxxxxxxxxxxxxxxxx wrote:





On Apr 22, 10:45 am, Dr Judy <mpac...@xxxxxxxxxx> wrote:

On Apr 22, 11:18 am, cda...@xxxxxxxxxxxxxxxxxxx wrote:

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:
Plano
+1.25
which leaves me wondering about the doctors saying I needed
-.50
+.50.

In previous posts you have said you also have astigmatism. Are you
leaving the cyl part out?

Those two Rxs are not much difference, basically +0.50 to +0.75 one
over the other. If you did leave the cyl out and one was written in
+cyl form, the other in -cyl form, there may be no difference. If you
do have some haziness of the IOL or small pupils, that may explain the
difference.

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. 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) 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. They sent me for thyroid workups and MRI.
They sent me for diabetic workups also. All tests were normal.

Well you certainly got a thorough work up. If all was otherwise
healthy and you were complaining of not seeing well, then the logical
next step is to treat the only remaining condition --- the cataract.

during my latest refraction I realized that, contrary to what I
had been told, I do have accommodation. 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 and a stronger prescription leaves me feeling like the
lens is too close to my eye.

Unless you got a multifocal IOL or accommodating IOL, you do not have
accommodation. Pupil size effects may allow for reading large print
without glasses. If you find +1.50 works at near for the right eye,
then the R -0.50, L +0.50 Rx is likely more accurate -- +1.50 would be
the near Rx of -0.50 with a +2.00 add.

What is the difference between progressive myopia and accommodative
spasm? They both seem to lengthen the eye and compromise the vitreous.

Progressive myopia is increasing myopia, usually due to lenghtening of
the eyeball. It is not reversable. Myopia can also increase due to
changes in corneal curvature in some corneal diseases and due to
increased curvature/increased density of the lens as cataract
develops.

Accommodative spasm is a spasm of the ciliary muscle causing
accommodation when it is not needed. It is reversable, unstable and
does not cause lengthening of the eyeball.

Over this many years shouldn't doctors be able to tell and inform the
patient of this condition?

Doctors seldom will tell you that you have progressive myopia, since
progression during the teens and early twenties is the normal course
of myopia. So your doctor will simply tell you that you have myopia.
Accommodative spasm is rare, likely your doctor would discuss this
with you.

Now that I have an IOL and still over-accommodate will my eye continue to lengthen and compromise the vitreous?

You are not over accommodating if you have IOL. If you have one of
the genetic pathological myopias in which the eye continues to
lengthen all through life, then it will do so.

Will I 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?

Usually the add is prescribed based on measuring your eye, not on a
chart. Fifty five year olds and people with IOL usually need between
+1.75 and +2.50 add, depending on where they hold print, BCVA and type
of work done. These are the adds mentioned in previous posts.

Now, trying to get a good pair of reading glasses or bifocals seems impossible. Yet nobody
has mentioned any diagnosis or prognosis.

What has been wrong the glasses you have tried to date? Did you take
them back? You have had at least one diagnosis -- cataract.
Refractive error is not consided a disease and you would not expect to
have a diagnosis or prognosis is there is no disease.

Dr Judy

Thank you. I will get my long history together along with all
prescriptions and measurements that I have. I don't have records from
before 1995, only what I had been told were the needed corrections.
Where I said that I could not see, I meant nothing well with the
glasses on but I could see in the mirror and read with them off. I did
go back, several times, but he would not remake them unless I paid
more money because a new slab-off was time consuming and expensive. He
did not do any remakes.-

If you want any opinions, please just post you post surgery Rx's and
the problems you found with them when filled. The pre surgery scripts
aren't of much relevance now.

Dr Judy- Hide quoted text -

- Show quoted text -

Thank you again. As soon as I get back from Portland I will look them
all up and post them. If they were written in +cylinder form should I
post them that way or convert them to minus cylinder?

.

Relevant Pages

  • Re: Odd visual effed
    ... I thought a cataract was due to it going cloudy? ... because the prescription in that eye is changing quickly, ... I told him that while I do take the glasses off to read ...
    (sci.med.vision)
  • Re: Odd visual effed
    ... My optometrist has just told me that I am getting a cataract ... because the prescription in that eye is changing quickly, ... lenses in the glasses was made to prescription wise. ...
    (sci.med.vision)
  • Re: accommodative spasm
    ... prescription from an optometrist and also find some answers as to ... next step is to treat the only remaining condition --- the cataract. ... eye but now I will exercise that eye more. ... Myopia can also increase due to ...
    (sci.med.vision)
  • Re: Odd visual effed
    ... just noticably different with each eye. ... said that since the prescription for that eye is changing ... I told him that while I do take the glasses off to read ... Both the previous optometrists are no longer available. ...
    (sci.med.vision)
  • Re: Odd visual effed
    ... The cataract is more dense in some places than others, ... part of the eye, he just waffled and said it was hard to see. ... said that since the prescription for that eye is changing ... I told him that while I do take the glasses off to read ...
    (sci.med.vision)