It happens to many people: you go in to see your optometrist for one reason or another, and after a few tests and some chatting with the doctor you walk out of the exam room with a new prescription you weren’t expecting. Maybe it’s your first prescription ever, or your first prescription after a long period of not needing vision correction. Maybe your prescription has changed in an unexpected way, the power has gone up or maybe even gone down. Maybe you’ve been told that you now have a prescription for both distance and for near.
It can be a lot of information to take in at once. It’s normal to have a few questions in response, and your optometrist and optician will help explain what your prescription means and what you can do with it.
Here are a few of the most common questions we hear from patients.
I never needed glasses before, does this mean my eyes have gotten worse?
This question comes up a lot from patients who have no prior history of needing visual correction, at least to their knowledge. They present with more recent complaints of blurry vision at certain distances, or new eye strain while doing specific tasks. This comes up commonly in middle-aged patients who find themselves now needing reading glasses, but it occasionally presents itself in younger patients who need new distance glasses where before they never felt they were necessary.
So what’s going on? The answer depends a lot on the type of prescription given.
Our eyes change quite a bit as we age. The most rapid, drastic changes happen as we grow from infants to toddlers to school-age children and into our teen years, as expected. Children can leave their eye exam with no required prescription one year, but then learn that they require vision correction at the next exam. While this is a normal occurrence, it should be closely monitored by the optometrist and parents, as this is also the opportune time where steps can be taken to encourage certain prescriptions to not grow too strong as the child ages.
But changes don’t necessarily stop once we hit adulthood; they’ll slow down drastically, maybe even pause for a few years, but as we approach middle age our eyes begin to change in a different way. The refractive lens inside of our eyes begins to grow more opaque, and the muscles and fibers stiffen. As this happens, we begin to lose the ability to accommodate for near distance viewing, and thus begin to have symptoms of eye strain and blurry vision while trying to look at things up close, such as with reading or working on computer tasks. This is where a patient might find themselves needing glasses for the first time in their lives, specifically for near work. This is a completely normal part of aging.
Of course, there are other reasons why someone might find themselves with a brand new prescription after a routine eye exam. The need for a prescription might be a symptom of a larger issue going on in the body. Perhaps a patient has not kept up with regular eye exams and thus missed having their visual correction needs caught earlier. Asking your optometrist questions about your prescription is always encouraged so that you can better understand your eyes and what kind of changes you might expect in the future.
I need reading glasses. Can I just use drugstore readers?
Let’s talk a little bit more about those age-related changes.
As mentioned before, between the ages of forty and sixty-five the lens within our eyes is expected to completely lose the ability to accommodate for near distances. This will begin the need for reading glasses, and the prescription we will require for clear near vision will increase in power over that twenty-five year period as the lens stiffens and becomes more and more opaque. This process eventually leads to cataracts, but that’s a discussion for another day.
The short answer to the above question is yes, though it depends on if you are in a pinch or don’t have access to specifically made prescription-reading glasses.
Over the counter reading glasses, regardless of whether they’re found at the dollar store or at the drugstore, are simply magnifiers. The lenses inside are no different than the circular lenses inside those round hand held magnifiers you used to play with as a kid. They lack any kind of anti-reflective coatings, or any scratch-resistant ones. The material is a basic plastic, shaped in a way to refract at the required magnifying strength indicated on the inside of the temples.
So how are prescription reading glasses better?
The prescription in over the counter readers is very basic, made with just a basic spherical plus power. If your eyes have any kind of astigmatism, as most people do, over the counter readers do not have any kind of correction for it, thus your near vision will not be as clear as it could be. Over the counter readers are also made with the same level of strength in both lenses, so if you have a different prescription in each eye you will be under-correcting or over-correcting one of your eyes using them, which can cause more of the eye strain you’re trying to avoid.
Prescription reading glasses are made exactly to your vision requirements as prescribed by the optometrist. If your prescription is different between the two eyes, then your glasses will be made to that. If your prescription has astigmatism, or additional correction for something like prism and diplopia, then the lenses will be made exactly to that. This ensures accurate visual clarity and significantly lessened eye strain. Additionally, those with stronger prescriptions can use higher index lens materials to help thin out those lenses and reduce the overall weight. Coatings for scratch resistance, anti-reflective or even blue-light blocking can be applied as recommended to help with the clarity and countering eye fatigue.
So while over the counter readers are okay in a pinch and better than no correction, they are not a comparable replacement for made-to-prescription readers.
Can my prescription be used for contact lenses, or do I have to use glasses only?
It’s good to be aware of all your options when it comes to visual correction. If you have a prescription but are on the fence about wearing glasses, it’s worth a conversation with your optometrist about these other options.
It’s important to note that a glasses prescription is specifically designed for use in glasses, and is determined by the optometrist via means that mimic actually wearing glasses. Contact lens prescriptions are different, and are determined by entirely different means, as they also account for things that affect the lenses sitting directly on your eyes, such as base curve and diameter. Contact lenses are not one-size-fits-all, and a glasses prescription is not going to produce the same clarity in contact lenses if you do not take those into account.
Your optometrist can help you determine if you are a good candidate for contact lens wear, based on eye health, prescription, lifestyle and needs. They can formulate what your prescription translates to in contact lenses, and also help you decide which type of contact lenses are right for you. Maybe you only want to wear them once in a while, for sports or for special events? Then one of the many soft daily lenses might work best. Maybe you want to wear them as much as possible, and are good about hygiene and have healthy eyes and a healthy tear film layer? Then it’s worth exploring one of the many monthly lenses available and discussing what kind of cleaning and storage options work best with what lens.
Maybe you have a prescription that is difficult or impossible to correct properly with soft lenses? Then it’s time to ask questions about custom lenses; a hard RGP lens can improve visual clarity for people with significant astigmatism far better than glasses in some cases. If you are nearsighted and wish to avoid wearing glasses or contact lenses during the day, then maybe you are a candidate for orthokeratology therapy, and specifically designed contact lenses that are worn while you sleep that reshape the cornea overnight to temporarily reduce your prescription.
It is worth noting that certain visual needs won’t work well when translated to contact lens use. For example, single vision reading prescriptions don’t make much sense as contact lenses when you only require them doing specific tasks. But this can open up a conversation with the optometrist about multifocal contact lenses.
I have a prescription for progressives, but there's too many choices!
If you are new to progressive correction – where your distance and your near are corrected in one lens – then trying to pick a progressive lens that’s right for you can feel daunting. There are many lens manufacturing companies, and each may offer anywhere between three to twelve different progressive “designs” that all differ from one another in various ways: wider or narrowing reading zones, longer or shorter transitional lengths, etc.
Progressives are a more complex lens that requires more consideration and accurate measurements. A discussion with your eye care professional is always recommended before making any purchases, especially given that progressives cost more than single vision lenses. Everyone’s needs while wearing glasses differ from one another, and those needs can factor into what kind of design will work best. Some places try to make this selection easier for the patient by narrowing down the choices to a few signs offered by one or two lens labs, but while still keeping up with other products in case a patient with very specific needs comes in.
At the end of the day, it’s always best to ask your eye care professional when you have questions or concerns about your prescription and what is the best thing to do with it. They are always happy to help explain what your prescription means, where it comes from and what kind of options you have going forward.
If you have questions about your prescription or if you want to book your routine eye exam to check your current prescription, then please reach out to our offices at 360 Eyecare – Rosedale or 360 Eyecare – Beaches to speak with our team. We’re more than happy to help!