RFI: Current state of vision correction

[rob_s]

Went to the eye Dr yesterday and decided to try contacts again. 2 hours into day two and they're not going to work out for me. has me thinking...

Is this really the best we can offer in 2020 for vision correction? I am nearsighted, and last year added progressive lenses, and have an astigmatism in my left eye. It seems like the various corrective options are:

• wear glasses to correct for all three (which still isn't great because of having to look out of the different parts of the lens at different distances)
• get contacts to correct some but not all of the issues (which is what I have now, corrected for nearsightedness and reading but not astigmatism)
• Get contacts that correct for nearsightedness and pair with reading glasses
• get lasik (last time I looked into this it was something like correct for reading in one eye and distance in the other or some other nonsense, and the potential side effects are worrisome)
• Radial Keratotomy (only corrects for nearsightedness, as I understand it)

That list really hasn't changed in... 20 years? 30?

I can't believe there's not some better solution to just fix the eyes entirely.

[Totem Polar]

Following.

[RoyGBiv]

@rob_s Why not get a contact that corrects for the astigmatism?
I'm not a huge fan of contacts myself. I much prefer regular glasses for working at a computer.
But my contacts correct for mild farsightedness and astigmatism in both eyes.
Some days the astigmatism seems worse than other days. Pop in my contacts and POOF, clear vision.

[HeavyDuty]

I’ve tried contacts a few times now, but they never work for me. I’ve resigned myself to progressive bifocals when I leave the house, and cheaters at home. I’m lucky enough that my distance has “degraded” to 20/20 (from 20/15) and I only need near correction and for a mild astigmatism. The bifocals allow me to see the dashboard, clean up distance due to the astigmatism, and function at work.

[ranger]

Just walked in the door from my annual eye checkup. I am still loving daily “mono” contacts. Will continue daily contacts until I need cataract surgery where I will get “mono” lenses implanted

[UNM1136]

Last I knew PRK was the lesser known cousin of Lasik. I have toyed on and off for 30+ years, and now, at 48 my rx seems to be stabilizing, two years down one more to go before I start surgeon shopping. My doc, who I have been seeing for 15+ years recommends PRK for the "active lifestyle". Think @Cecil Burch or @SouthNarc classes, or shooting sports where brass projectiles erupt from the side of the platform as a normal course of action, or overcharged guns just blow up.

My doc has consulted with pro MMA fighters and recommended PRK vis Lasik because even with the greater complexity of the surgery and longer recovery time, PRK is more durable if you may have things (brass, fingers, fists) flying into your eyes. One fighter let the surgeon talk him into Lasik at a lower cost and took a fist to the eye, and is trying to find grounds for a lawsuit after the eye was wrecked... I have perfect corneas for Lasik, like 3x thicker than necessary.

Lasik is the simpler surgery. ALL of my co workers who had Lasik had dry eyes, night time starbursts, and are all in readers like five years later. Lasik seems to me to be the "hey doc, specialize in me and I will pay for myself and double your profits after you complete this weekend seminar"/fly by night optomolgist program. My doc tells me the recovery time is longer, but most of the Lasik failings are addressed by the older procedure.

The surgeon I want to go with has a ton of experience (30 years+), and is a USPSA shooter. I just sincerely hope he doesn`t still have the 5 Traffic Tickets I wrote his spoiled, bratty son about 15 years ago to the value of about a grand after a particularly bad traffic incident. I recognized the name on the registration immediately.

One more thing for you to research....

Also, if you want to try monovision where one eye is corrected for distance and the other for close in work, you doc can prescribe you one contact lens for near, one contact lens for far, and let you see if your brain will compensate and look through the correct eye for what you need at the time. Some people can make it work, others can't.

And also (again?) for a long, long time (think decades) PRK was allowable for many military jobs with considerable medical and eyesight restrictions (some pilot, SF, etc). Lasik was a disqualifier until recently, after a period of time where DOD was giving free Lasik to anyone who wanted it and qualified. I would argue that those providing Lasik to DOD folks got very good, very quickly due to the volume they were doing on large posts.


pat

[rayrevolver]

Another thread for me to watch. Just had my eyes checked for new glasses on Monday. Been wearing contacts for almost 30 years.

The last 10+ years my prescription has not changed and I am the perfect candidate for some form of corrective surgery. I threaten to do it every year but as I get older I know the window is closing.

I will look into PRK and possible reach out to a childhood friend who became an ophthalmologist. If I get any information I can share here.

As for contacts, I have been using Pure Vision 2 and I can't really complain, they seem crystal clear when new. Over the course of a month I don't notice a degradation in clarity but maybe dry eyes starts happening towards the end of the day.

I am nearsighted and something like 20/400 without help. I know the big letter is an E, but its pretty blurry.

Since I have been happy with contacts, I ask myself what do I hope to gain with surgery? Is it being able to hop out of bed and not need glasses? I wonder if it would help my eye strain when trying to shoot at 25 yards?

[rob_s]

@rob_s Why not get a contact that corrects for the astigmatism?

The last time I tried that, they didn't work for me. The astigmatism lenses are directional. which requires them to be weighted at one edge to keep the correct orientation. For me, whenever I would blink, the contact would rotate ever so slightly and it was very disorienting and caused headaches. When I got my current prescription and my current doc said he wasn't including astigmatism correction, he said this was still a concern that hadn't been addressed with any new tech.

[mmc45414]

That list really hasn't changed in... 20 years? 30?
I can't believe there's not some better solution to just fix the eyes entirely.

Sorta yes, but probably no. What is not on the list is lens implants, typically used for resolving a cataract issue.
I only know this because I developed cataracts pretty young, mid to late forties. They say they can be brought on by lots of UV exposure, and I have spent a fair amount of time outdoors, including on water with a lot of reflection. But not sure this is to the level of being available as vision correction, and it sure would be expensive compared to lasik, but I wonder if maybe it might become more available. Just to clarify, the term "cataract" is IMO misleading, it sounds like something extra is growing in your eye, but I guess it is, but it is growing in your lens. Probably the term "removing cataract" is what is misleading, because they remove your entire lens, and slip in a synthetic lens, sorta like a forever contact. Speaking of forever, they set the expectation that my vision will never change significantly, since it is now a piece of plastic. And since they implant a lens, you can pick your vision.

get lasik (last time I looked into this it was something like correct for reading in one eye and distance in the other or some other nonsense, and the potential side effects are worrisome)

I think this is blurring (see what I did there? ) two issues, lasik correction for distance vision, and what I have always heard called "monovision" for having one eye for distance and one for reading. And monovision is what I have, but I backed into it. My right eye required the surgery first, and when I learned that my distance vision could be corrected at the same time (nearsighted since sixth grade..) I said Hell To The Yeah! I asked for not total correction, I asked him to get me to the point I could see distance but still see pistol sights. I ended up with a little more than the intent (it is a bit inexact, you are picking a piece of plastic you think will net a certain result) and it is now legal for me to drive uncorrected. Not saying it is right for me to drive uncorrected, but I meet the government standard. But it was damn nice to be able to operate boats (always worried about losing eyeglasses overboard, rather than cheap shades) and snowmobiles (fogging is a bitch) without glasses.

But this left me nearsighted in my left eye, monovision by default. I got glasses for driving that corrected my right eye a little and my left nearsighted eye like always. I also got glasses for sitting in front of a computer or reading that brought both eyes back to that focus point. But it was damn nice to be able to see to snowmobile and still read the map without glasses. And I would not have had the balls to just do this proactively, but after living that way for three years when my left eye degraded to the point of being done I chose to get an implant that I am looking through to type this on my laptop without any glasses. I have a pair of bifocals (insert behind a pair of ESS ICE Narrows), mainly for motorcycling so I can see the GPS or map without looking under or over my glasses like I do in the car.

You could try this with a single contact, but I would only suggest you do it if you are willing to get a lens ground for a pair of glasses. I tried it with contact lenses for a few hours (years before my surgery). Driving home after dark the first day I had to pull over and let my wife drive, and I threw them away that night and abandoned the idea. But even now I can drive in daylight, but the fact that it is/was legal for me to drive after dark is appalling. But when driving I am most often going to be wearing sunglasses anyway (so NBD if they need to be corrective) and I need to wear glasses when I drive after dark (not all that much anymore) and if I am sitting at my desk. I sure am glad I do not need glasses every single time I get a text message...

Not sure if any of this helps astigmatism.

What I did was covered by insurance, because it was not a vanity or convenience procedure. But I wonder, if at some point, especially in large markets like south Florida, there might be options to get it electively? It would be big bucks, but you might only need one eye, and it could be done for the rest of your life.

[Duelist]

RGP contacts gave me my best vision in contacts. They corrected my astigmatism in both eyes and gave me very clear, 20/15 vision.

Glasses are second best at those things, and as I’ve gotten older, I’ve added low magnification progressive bifocal to them. Eyes get tired, and I can’t see shit.

Soft contacts that correct for astigmatism sometimes work for me, sometimes don't, and sometimes I can’t see a thing with my weaker left eye.

I’ve essentially given up on contacts. RGPs were great for vision and maintaining a stable prescription, but are too susceptible to dust and dryness at low ambient humidity levels. Since I live in Arizona, dust and low humidity are year round. Soft contacts are better on the dust and dryness, but worse on vision stability, don’t correct as well for astigmatism or acuity, and worse on infection susceptibility. I use them occasionally, for dance performances or some more intense classes. If I still was willing to do martial arts, I’d probably use them more, but I’m not volunteering to get beat up anymore. Already hurt enough on the daily.

Glasses work pretty well for most things. They’re expensive, but last if you don’t act like a 12yo. I have WileyX prescription sunglasses for shooting.

Nobody is cutting on my eyes unless I get cataracts.