Author Topic: Over-prescription Discussion.  (Read 2760 times)

Offline OtisBrown

  • Hero Member
  • *****
  • Posts: 1766
Over-prescription Discussion.
« on: December 30, 2013, 07:52:05 AM »
I am interested in true-prevention - when it is reasonably possible.

But when I get questions, I am often told, I have a -6 prescription - can I get back to 20/20 in a month?

I have to decline to answer that question.  But I often ask the person to put up a bright-Snellen and read the letters.  Here is the reason why I ask a person to check.

Offline OtisBrown

  • Hero Member
  • *****
  • Posts: 1766
Re: Over-prescription Discussion.
« Reply #1 on: December 30, 2013, 08:00:10 AM »
Subject: Statement by Cheryl.

Item:  You can ESTIMATE your refractive state - by determining your "edge of blur", by taking your minus off, and reading at these distances.

Item:  If you can read at 50 cm (20 inches), you calculated refractive status is -2.0 diopters.  This woman has a -6.5 diopter lens.

In an "office" an OD has you look through the small holes of a "Phoropter".  He just "cranks up" on the minus lens.  He does NO "home checking" of your Snellen.  The result is incredible over-prescription.  I personally do not make any claims about these issues - I just post them to make clear how many "excessive minus" prescriptions are made - with now awareness in the person about how destructive ANY minus lens is - if you wish to protect  your distant vision - for life.

THE EXAMPLE:

+++++

Summary re edge of blur

 16-12-13 45cm
 25-12-13 59cm
 26-12-13 61cm
 27-12-13 62cm then after focus pushing: 66cm
 29-12-13 51cm (very tired yesterday, watched 3d film in evening)

 Points of note

 Differential prescription of -6.50 both eyes not yet arrived

 Sleep app has shown me I get a lot of poor nights, but better if avoid mental stimulation before bed. Sight poor after poor sleep
 3-12-13 and 4-12-13 -7.75/-7.75 20/25

 5-12-13 after morning vista walk -7.75/-7.75 20/20 on snellen

 22-12-13 -7.75/-7.75 bright morning after 20 mins cloud gazing 20/20 both eyes together

 23-12-13 noticed if keep looking at snellen after initial reading, comes into better focus.

 Right eye lacks significantly behind left when focusing on snellen, even though prescription was measured a month ago by optician as the same in both eyes.

 I have a question for you Alex: General advice is to protect eyes from uv in order to prevent cataracts, yet vista viewing is supposed to be without specs. I don’t look directly at the sun, but should I be wearing a hat?

 Did centimetre test from web calculator. Results -8.00. -0.5 diopter better than eye test about a month ago!

++++++

It is very difficult to "monitor" any person.  But I have seen this situation before - I truly dis-trust any OD measurement.

This is why I have my own Snellen, and verify my own refraction (it is very easy and objective) at home.

I take responsibility to ALWYAS pass the required 20/40 line - to be legal. 
If I wish "better" then I wear the plus for all close work. 

But once I PASS the DMV test - in their office - I never wear a minus lens - because of THEIR objective test - that I pass.  Learn to be wise about this issue.



« Last Edit: December 30, 2013, 08:03:20 AM by OtisBrown »

Offline OtisBrown

  • Hero Member
  • *****
  • Posts: 1766
Re: Over-prescription Discussion.
« Reply #2 on: December 30, 2013, 08:07:25 PM »
More commentary from Dr. Alex's site:

Alex,

 Is it time for me to order a new distance prescription? Or do you need more cm measurements? Though I am wearing -7.75 for distance, this is not good enough for night driving. Just before I started this programme I was prescribed -8.50, though never purchased specs at -8.5. Your myopia calculator suggests I should be -8.00, which seems logical to me.
 What are your thoughts? It would be good to have specs that I can use at night.
 Cheryl

+++++

I will NOT be a critic.  But if you read clearly at 50 cm (20 inches), a power of -2 diopters, it is difficult for me to understand why she has been prescribed a -8.5 diopter lens.

This says that she can not see clearly beyond about 5 inches.

That is how you proven gross over-prescription. 

Offline CapitalPrince

  • Full Member
  • ***
  • Posts: 187
Re: Over-prescription Discussion.
« Reply #3 on: December 30, 2013, 09:05:28 PM »
The problem is that very people  know what the eye prescription actually means. People think "oh its no big deal" only -0.75D. They might feel alittle dizzy when they first wear the glasses and they doctor says "you will get used to it".

If more people knew what the eye prescription means and how very POWERFUL AND DANGEROUS the lens power actually  is they would wake up. I certainly "woke up" when i realized that a -0.5D reduced my distance of focus to 2m.

Offline OtisBrown

  • Hero Member
  • *****
  • Posts: 1766
Re: Over-prescription Discussion.
« Reply #4 on: December 31, 2013, 04:49:41 AM »
Hi Sam,

I truly "gave  up" on a preventive conversation with an optometrist in an office.  The OD has "given up" on any hope of prevention - BEFORE you enter his office.  If you complain about an "excessive minus", you will be told, "you will get used to it".   To me, those are the most deadly words you could say to me.  They piss me off - because they should at least be honest about this issue.  In science, the minus (and long-term near) CREATE negative status for all natural eyes.  (Again, if you attempt to present these objective scientific facts to them - they just say that even the slightest prevention -  it totally impossible.)

I OBJECT.  When I am at 20/40, or better, I simply "gave up" on "optometry discussions", because of this choice to not trust my intelligence, and potential motivation to use the preventive plus - while I can still read the 20/40 line, and do my own testing and checking.  I do not "like" to be "talked down to", as though I am some ignorant slob, who can not understand the real challenge of plus-prevention.

I also object to, "excessive claims", of recovery.  I advocate prevention in good faith.  But that means for me, that I will only suggest that avoiding the minus is possible.  But avoiding the minus, means that I personally verify that I read the 20/40 at home, and always do better than that 20/40 line.  I know that most people do not have the interest or motivation to make that type of commitment - with all due respect.

But we now know for certain (plus studies on children), that if you choose the "easy path", and do not do any prevention, your vision will go down by -1/2 diopter per year, or in college, by -2 diopters in four years.  Again, I regret that an OD in his office will not VOLUNTEER this information to you, while you can still read the 20/40 line.

That is the change I request of an optometrist in his office. This change would place complete scientific responsibility on me, to actually understand this issue, and that an optometrist has no interest, and judges that no one can "recover" from the slightest amount of "nearsightedness."

The reality is that some people do understand the challenge, and will institute the policy of systematic prevention on their own.

This is why I support all means of prevention, but I would think that the "best success" is to know these issues, and conduct prevention on your own.

What you know now, is that some people, like Shadowfoot, Todd, Severson, Colgate have been successful, on the threshold - by wearing a plus for near.  When it comes to verification, I just ask that the person confirm he reads and passes the DMV, and eventually exceed that line.  ( I fully expect that continued wearing of a plus can get your naked-eye vision to close to 20/20.

That is why I always check my visual acuity (and refractive status) at home.  That way, when at 20/25, I can just understand that the -1.0 diopter I am prescribed - is excessive.

But I will get MY OWN minus form Zennioptical, and use it only when absolutely necessary (like in class). That is reasonable.  But at all other times - I will NOT be wearing a minus.  I will in fact be wearing a +2.5 for all close work at home.  (At school, assuming short-term near, probably no plus lens.  But if the reading assignment, or computer work exceeds 5 minutes - I will have the plus on my face).

I might get some commentary from my friends about doing this.  Or perhaps not.  But I would just say that I need these plus lenses for reading - and let is go at that.  This is a very difficult choice for all of us - but I value my distant vision to a profound degree.


The problem is that very people  know what the eye prescription actually means. People think "oh its no big deal" only -0.75D. They might feel alittle dizzy when they first wear the glasses and they doctor says "you will get used to it".

If more people knew what the eye prescription means and how very POWERFUL AND DANGEROUS the lens power actually  is they would wake up. I certainly "woke up" when i realized that a -0.5D reduced my distance of focus to 2m.
« Last Edit: December 31, 2013, 05:03:48 AM by OtisBrown »

Offline CapitalPrince

  • Full Member
  • ***
  • Posts: 187
Re: Over-prescription Discussion.
« Reply #5 on: December 31, 2013, 06:24:56 AM »
hey otis

why doesn't the optometrist measure the refractive state of the eye with a retinascope (i don't know what its called) rather than do a subjective measrurement?

Offline CapitalPrince

  • Full Member
  • ***
  • Posts: 187
Re: Over-prescription Discussion.
« Reply #6 on: January 04, 2014, 01:19:46 PM »
An optometrist "defines" nearsightedness as anything less than PERFECT vision (20/13-20/10) and will prescribe to that standard. 20/20 -the proverbial "perfect"- will probably be given a -0.5D or sometimes more. This is indeed very very harmful.

Because an OD defines nearsightedness as anything less than PERFECT (or slightly positive refractive state) with NO astigmatism, it's possible to find an "error" in just about ANYONE! and a lens will totally exacerbate the "error".

one more person with vision problems = one more sale

Offline CapitalPrince

  • Full Member
  • ***
  • Posts: 187
Re: Over-prescription Discussion.
« Reply #7 on: January 04, 2014, 03:37:08 PM »
so an OD measurement is "accurate" in the sense that it lets people see max visual acuity, which is totally unnecessary. I think most people assume that an OD stops at 20/20.

Offline OtisBrown

  • Hero Member
  • *****
  • Posts: 1766
Re: Over-prescription Discussion.
« Reply #8 on: January 09, 2014, 04:48:45 PM »
Hi Sam,

I am often told by "classical optometrists", that over-prescription can never "happen" because they do their best to give you MAXIMUM visual acuity.  While I "sympathize" that the general public wants 20/13 or even 20/10, from a minus lens, the result is a disaster for all children who wear a -4 diopter - when they have 20/70 vision.  I think this is truly killing our children's eyes - and there is not a blessed thing I can do about it.  But I do thank Dr. Alex for documenting this tragic truth.

http://frauenfeldclinic.com/child-myopia-prescription-realities/

I have no doubt that a child's "habit" will induce about 20/40 to 20/50 (still functional with no minus lens).  But in the terrible desire to give 20/13 vision to all children, the child gets a -2 to -4 diopter lens - for FULL TIME WEAR. 

You can draw your own conclusions about why it is necessary to self-check both your visual acuity and refractive state yourself.




so an OD measurement is "accurate" in the sense that it lets people see max visual acuity, which is totally unnecessary. I think most people assume that an OD stops at 20/20.

Offline OtisBrown

  • Hero Member
  • *****
  • Posts: 1766
Re: Over-prescription Discussion.
« Reply #9 on: January 09, 2014, 05:11:05 PM »

Subject: The sincere ophthalmologist who asks the question, "How can I prevent entry into nearsightedness".

This is obviously a sincere, dedicated man, who will AUTOMATICALLY give a child with 20/70 naked eye - a minus 4 diopter prescription.

http://www.youtube.com/watch?v=vHwXMeCj5vk

It is not really possible to "argue" with such a person.  I obviously argue that you should begin to "reverse" this tragedy, while you can still see 20/40 on your Snellen.

But if you love that 20/13 and 20/10 vision, with a -2 diopter lens, or are "in fear" of the plus, I am not going to argue about it.

Further, if you foolishly wear a -2 diopter, all the time, and go down to -4 diopter, I would describe this as a "lost cause".

But you be the judge.

Offline CapitalPrince

  • Full Member
  • ***
  • Posts: 187
Re: Over-prescription Discussion.
« Reply #10 on: January 09, 2014, 06:11:40 PM »
at least he did acknowledge that the eye adapts to the environment. Food may be a small factor, not as big as he made it out to be. He mentioned that children who play outside may not or develop myopia at a slower pace, and thats very correct. I played outside often before high school and i always had 20/13+.