I got my first glasses when I was 15. I had been getting more and more nearsighted. but I didn’t really know how bad it was. The best I can remember, my first glasses were about -3.5 or so. That was about 1989, so it is hard to remember. I have them in the drawer with the rest of them I’ve worn over the years. I never got behind in school because I could see up close and could get by with sitting close to the front of the classroom to see what was on the board. What happened was, my mom took me to get my learner’s driving permit. 15 was the age then, but it may be different now. When I had to look into the eye test thing. I couldn’t read any of it. After that happened, they took me to the optometrist. I got glasses, and it was amazing what I could see. I didn’t realize what I wasn’t seeing. The best I can remember, things had started to get a little blurry when I was around 10. So I had been in a blur for five or so years.
A few years later, I went back to the optometrist, and the prescription went up a little more. Then a bit later, it got a bit higher to the -5 range. The worst it ever got was -6.5 in both eyes or so, and it stayed that way with some slight variations. About 10 years ago, I got progressive bifocals, and that helped a lot with everything. December 2021, I started noticing some blur in the right eye. I tried on several pairs of my old glasses, and one pair that was a little stronger than the ones I was wearing then cleared things up a bit. So I started wearing them. By about March, things were getting worse. One day, while I was outside on the front porch, I closed my left eye, and just looking through the right, I couldn’t read “stop” on the big red sign at the end of the road in front of the house. The sign really isn’t even that far away. I figured I should get it checked out.
I got an appointment with the eye doctor, and she determined that I had cataracts, and they set me up to see the ophthalmologist in the same practice. At that appointment, I didn’t get refracted, so I didn’t know what was going on yet. That would not be until June. So the months passed, and since the left eye hadn’t changed much, I got by OK. I teach school, and even though it’s a lot of reading as a part of the job, I was good for the most part. I hit ctrl + a lot to make everything bigger on the computer.
At the ophthalmologist appointment, they did all kinds of tests and measurements, looked in with the slit lamp, all of it. I was in there for three hours. The doctor was a young guy, early 30’s or so. Really nice guy. He said the cataracts were moderate and were causing a myopic shift. He didn’t go into a lot of the details with me, but it was a thorough examination. He started talking about lens replacement surgery but scared me when he said there was a high risk of retinal detachment with the surgery in my case since I was younger (48) than the typical cataract patient. He said that if not during the surgery, but that same day, I’d probably have a detachment. Risk factors are male, younger with little to no post-vitreous detachment, myopic. I finally got refracted and a new glasses prescription (OS -6, OD -8.75). I thought to myself, that’s not too bad. I couldn’t get any better than 20/30 in either eye, though. And to tell the truth, the 20/30 line was a little fuzzy but I could stumble through it. I was more motivated to guess at the letters after he told me better than 20/60 was the requirement to legally drive. He mentioned Lasik or PRK or contacts, but I had long ago decided against refractive surgery after reading and learning about it, and I had gotten to where I couldn’t tolerate contacts for long about 20 years ago. I had worn contacts a good bit from about 20 to 35 years old or so, but then I just got comfortable with glasses and stuck with them. I’m glad I said no to the Lasik for what follows.
I ordered the glasses online from Zenni when the dilation wore off that afternoon and did the quick ship so they would come soon since we were going on vacation to the mountains the next week. I got some semi-rimless black frames in 1.67 index, no add, just single vision. I am so used to taking my glasses off to see up close that I decided this would work better, and progressive lenses are way more expensive. They came, I put them on, and everything was clear again. I had some weird focusing issues at first, like when looking at something up close after coming inside into lower light from outside and such, but I adapted. Things looked good for a few months.
By October of last year, things were getting blurry again, but now in both eyes. So much so that I couldn’t read road signs and depth perception was way off. It scared me one morning when I was driving to work and ran up behind a road scrape that was going very slow. I had to put on brakes fast. I couldn’t see people’s faces clearly. But, I could see with the glasses really good up close, within about two feet or so. I wasn’t scheduled to go back for a check up until December. I had the thought that I could take the prescription from June and use that to order some new glasses. I popped the lenses out of some of my old glasses and experimented to see what looked clearer by putting them in front of my current glasses. I went on Zenni again, found some semi-rimless frames I liked, and went with OS -8, OD -11, 1.57 index. I figured for $23.90 I wouldn’t be out much if they were not right. They finally arrived. I opened them up and tried them on, sitting in my truck outside of the post office. Damn, everything looked perfect. I couldn’t believe it. It seemed like light overcorrection for anything close, though. I was back in business again. Things were clear, I felt good driving. I could read the signs over the aisles in the stores with no problems. I adapted to the new glasses quickly. They were heavier and thicker, but I was like, screw it, I can see. One of my students, a 12th grader, said, “You got some Coke bottles!” I’m like, “Yeah, I did.” Another one asked me if I was blind.
So December comes around, we get out of school, and the next week, I had the appointment with the same ophthalmologist. I wore my June glasses prescription into the appointment. I didn’t want to wear the ones I’d ordered on my own since he would question that move on my part. I had driven over there with them, though, since they were still pretty clear. We went through all the same tests and exams, dilated, except for the autorefractor. I didn’t look into it that day. I guess the assistant didn’t think it was necessary. Somehow, I refracted to -4 while cycloplegic. I could read the letters projected on the mirror to 20/40 or 20/30 or so. We talked about the lens replacement IOL surgery option again, and he said the same thing, and it would be better to wait to have it although it would be inevitable since cataracts aren’t going to get better. He said to try contacts, so I agreed. I put in -4 contacts. Everything looked blurry more than a foot or so away. He insisted this was the correct power. I’m thinking to myself, this is impossible but I didn’t want to argue right then. I left and went out to the parking lot to leave. I had on sunglasses. I thought, maybe it will clear up when the dilation wears off. I’m not the doctor, maybe he was right. Things didn’t clear up. I had no business driving home like that, but I did. When I got home, I put my glasses on that I’d gotten June (OS -6, OD -8.75) while I still had the -4 contacts in. Things got super clear. The dilation had worn off too. I took the contacts out later and put back on my bootleg glasses (OS -8, OD -11) that I was pretty used to although there was some blur. I called the doctor’s office a few days later and talked to the doctor, telling him I’d put the glasses on over the contacts and how clear everything looked. They scheduled me to come back on December 30.
When I went back, I didn’t have to go through the same tests. I had to read the chart with my old glasses from June covering one eye at a time and through the pinhole. That was ridiculous. 20/400 both eyes with the old glasses. Undilated, the autorefractor came out to OS -10 and OD -13. The manual refractor where the doctor flips the lenses came out to OS -11 and OD -14.75. There was a little astigmatism. +.50 in one eye and +1.00 in the other. I was kind of shocked and got scared. I knew I was seeing worse, but that is a big change. The doctor mentioned surgery again. He couldn’t explain how I’d come out to -4 in the first visit and now this. I said I sure didn’t know if he didn’t. He said this was still just a myopic shift and didn’t explain much else. Since then I’ve researched it, and the cataracts, in my case, a nuclear sclerosis, causes the lens to grow in thickness and result in lenticular myopia in addition to the typical myopia that results from axial length and cornea shape, etc. He wanted me to see a retina specialist and mentioned how they could tack the retina down with a laser to try to prevent a detachment in surgery. He said, “He couldn’t give me 14 glasses” as I’d have no peripheral vision. He didn’t want to give me the printed sheet with the prescription information on it like they always have done. He said I needed to try wearing contacts and then get some reading glasses. Here we go again. For some reason, it occurred to me to take a picture of the computer screen where they had put in all my information with my phone. Glad I did. It had the full new prescription with diopters, cylinder, and axis measurements. They brought me some -9 and -12 contacts, left and right. I put them in. Things looked foggy at all distances and terrible up close. I agreed to try it but I knew this probably wouldn’t work. Just because it is so hard for me to stand the contacts in my eyes after a few hours. At this point, I was still scared and was trembling I was so nervous. I told them I’d try to wear the contacts and left. I thought I might get used to the contacts, but I didn’t at any point over the next few hours.
I saved all my dad’s old reading glasses. He had lots of pairs over the years. He wasn’t nearsighted like me, nobody else is in the family, so I don’t know where I got this from. When I got home, I got them out and tried them on with the contacts in. I could see better up close with one particularly strong pair. I could read the phone, etc. I didn’t like how things looked though. It seemed artificial or something. Not what I was used to. Everything looked too big. OK, a few hours later, so I went back onto Zenni and ordered me a new pair of glasses, same frames, 1.57 index, $23.90, based on the new prescription from earlier that day. I knew couldn’t do the contact and reading glasses thing. I wouldn’t be out much money to try the glasses.
In the mean time, I was still wearing the -8/-11 glasses every day, all day. They finally came in about two weeks later. I was nervous going to the post office to get them. I was anticipating seeing a lot better. I opened them up, unwrapped the cloth from around them, and they didn’t look too bad, a little thicker, with polished lens edges. They had ground down the back edges of the right lens so that both left and right looked to be the same thickness. I suppose that at almost -15, that one would have been a good bit thicker on the edges than the left side if it had not been ground down. I put them on. Everything was indeed clearer, but not as much as I had hoped for. I guess that is the way with stronger prescriptions or more advancement with the cataracts. It was about midday and the sun was out, and things did look better the further away. Close-up was of course overcorrected, but I knew that would be the case since there was no progressive add. I looked at myself in the rear view mirror, and my eyes looked so small behind them. But I could see better, so I was happy. I figured I would adapt to them after a few days. I was struggling a little, and changing light conditions or looking from far to near suddenly really caused things to go out of focus. It occurred to me that maybe these were too strong, so I ordered another pair based on the autorefractor reading of -10 and -13. These finally arrived, same frame and 1.57 index, and the 13 side was about ½ inch thick and had not been ground down to match the left. But I was still like, screw it, I need to see. Computer looked pretty clear, and I could do my job. I wore these most of the time except for driving for a few weeks, and switched back and forth. I found that later in the day, the stronger pair worked better.
I went to the retina specialist. He examined me and said I had the best looking retinas he’d seen in a while. He said the cataracts were grade 3. He said as a high myope to close each eye to look through the other at least once each day to make sure there were no dark spots and what to notice to know if there is a retinal detachment. He said it was better to wait on the surgery, too. He said, most importantly, that there was no evidence that laser tacking the retina as a prophylaxis against retinal detachment before cataract surgery was effective and to go ahead with the surgery if it was warranted. This bothered me since the ophthalmologist seemed to think the lasering would be a good idea.
The last few weeks, I’ve been wearing the stronger pair all the time. Sometimes things look great, sometimes things get blurry. I found that if I take them off and look into the blur for a few minutes, when I put them back on, things look better. If I work on the computer too long, things get blurry, too. I noticed that I can read the phone if I have to with them on. The strong pair. I don’t know for sure, but it may mean the myopia has crept up a bit since December. I have no idea what the upper limit of this is. -20 diopters is the limit for ordering online from Zenni. If it exceeds that, I would have to spend a lot at an optical shop to get glasses made. I don’t know at what point glasses won’t make anything better and at what point the cataracts will make everything so bad I will have to get the artificial lenses put in. I’ve got a lot of questions about all this, and I don’t feel like the ophthalmologist I’ve seen knows the answers. I just wonder if he’s ever had anyone come in with this big of a shift. I just wonder, based on what he said about retinal detachments, if he’s confident he could do my surgery. I don’t think he is confident. I think he is used to much older clients who come in at a more typical age for cataracts. I am thinking I need to see another ophthalmologist to get checked out and basically a second opinion. I am going to try to get by until the summer and then see where I am then. This is all a bit distressing, and if I am honest, I have really struggled with it. It’s not that I mind the glasses and having to wear them, but it’s more that I cannot anywhere even get close to 20/20 anymore. I have tried to just tell myself that this is how I see now and to get used to it, but for the past few months, as soon as I start getting used to it, it is worse again. Some days, it seems like I can see better. Some days, not so much. Add to that, I’ve got floaters in the vitreous like you would not believe and have had them for quite some time, and so part of the problem is that everything looks like it is moving around all the time, and this is particularly noticeable on the computer or on a bright day. I found that I could put the computer on high contrast with black background or do dark mode on certain sites, and that helps. Making the fonts bigger helps too. Cataract surgery won’t fix the floaters, though. I worry too, that how will whatever doctor decide what IOL power to put in. If by some reason, they took into account my current refraction that is due to the thickening of the eyes’ natural lenses, I might come out way hyperopic. I am not exactly sure how they do the IOL calculations. That is, how they get the values to put in the formula. I watched several videos that a cataract surgeon from California has on YouTube. He is a great guy, and I wish I could go see him, but that is 3000 miles away. He seems very knowledgeable and understanding. He explains everything. He has a video about a guy who had had a myopic shift and describes how he picked the right IOLs and how the outcome was still a little on the myopic side afterwards along the lines of -3. The guy was about -13 in one eye and -17 in the other, not far off from me. At this point, -3 would be great. I’d get the best of both worlds, able to see up close and far away with some glasses. I kind of like wearing glasses, I guess. Every day since 1989 makes it that way. It’s just natural to wake up and put them on and go about the day. Even though mine are heavy and thick now, I think about that I’m grateful to see what I do at this point. I’d like to be able to see up close still even after cataract surgery. I think they can do it to where I could still be a tiny bit nearsighted and not need glasses to read and just a light pair of glasses for distance. I don’t want to need glasses for reading. I’m used to being able to see up close. I don’t want to lose that. On a side note, I have noticed that bare-eyed, I can see hyper-clearly about 1.5 to 2 inches from my face. I mean, rather than pictures and letters on the phone, I can now see the little crosses, pixels, that make up the pictures and letters. I guess that is a benefit of higher myopia. I can read things that are excruciatingly small if I can get it close enough.
I’m thinking the best thing I can do is stick with the glasses, the ones I’ve got, for now, make an appointment with a new ophthalmologist in a few months, get checked out thoroughly, and if I can get refracted so I’m still legal to drive and can function, go a while longer before getting the surgery. I will probably spend a little more next time and get higher index lenses since if the script does go up, 1.57 would be too heavy to wear. These I’ve got now start feeling heavy later in the day and by nighttime. I’ve not really told anyone how bad my eyesight has gotten because I just don’t want them knowing. I’m sure people have noticed that I went from an average pair of glasses you might see anyone might wear to visually-impaired-blind-guy glasses. I wear a baseball cap a lot since the glasses catch the light, and it helps me see a little better. The wife knew I got new glasses, of course, but I am not going to be describing what I actually can see to her. She’d probably try to take my truck keys and try to get my driver’s license revoked. Now if it gets to the point I feel it is unsafe for me to drive with the best correction I can get from glasses, yes, time to schedule and get the surgery and risk it for a better outcome.
https://vision-and-spex.com/my-true-myopic-shift-story-t2549.html