Help me with my vision!

March 3, 2005 11:39 AM

My girlfriend's been having some problems with her vision and she's not really sure if her eye doctor(s) are understanding her adequately, or are thinking of things that could be less common that could be the problem.

Basically she has pretty bad vision and has been wearing (soft)contacts without any problems for 12+ years. However, 2 years ago, she starting having trouble seeing clearly out of her right eye while wearing contacts. Her left eye has an astigmatism that is not corrected by the contacts and so she is pretty dependent on her right eye seeing clearly. 2 years ago, her eye doctor had her try basically every brand in existence looking for something that worked before trying the new Focus Night and Day under the assumption that it was a dryness problem. Her prescription was bumped up in these lenses from a -7.75 to -8.50, her eye doctor's reasoning being that since these were made of a different material they required the uping of the prescription and not that her prescription had changed.

One year later, the contacts were still better than those she had tried, but she's still having times where her vision seems "off" in inexplicable ways in her right eye, in addition to times when the right eye contact goes completely blurry (though the complete blurriness is corrected by removing the contact and cleaning it, while nothing helps the "off" feeling). She has a new eye doctor, whom she's explained this all too, but who seems to still think it's just a dryness problem and is having her try a bunch of contact brands, though now at the -8.50 prescription.

Are her problems really all just dryness related? Given that the new doctor is trying the -8.50 prescription and not the -7.75 prescription, was her old doctor just wrong and what she needed was the bump in power mostly? Will just trying contact brand after contact brand really work this time? Could there be any other, possibly more serious problem underlying these vision problem?

posted by JonahBlack to health & fitness (21 comments total)

I had this exact same problem -- also isolated to my right eye -- and also got told it was a dryness issue. I didn't want to believe the doctors, since it seemed like it was very clearly a vision issue; the focus problems in my right eye persisted even when I wasn't wearing contacts at night. I had that same off feeling she describes, like everything in my right eye was "fuzzy," but I couldn't really tell what it was. Comparing the actual vision between my two eyes by opening and shutting them didn't really show a difference, but when both were open, it seemed like my depth perception was very obviously skewed and my vision blurred.

I ended up taking a break from contacts for two months. Even though I far prefer wearing contacts, I got some new glasses which I could stand and wore them religiously. Now that I'm back to my old soft lenses, my vision seems like it's back to normal, and it's been normal for several months now. I'd recommend giving the contacts a break for a little while.
posted by eschatfische at 11:56 AM on March 3, 2005

A. When in doubt, go to an ophthalmologist, as eye 'doctors' are just crap.

B. If her prescription is too strong, it can tire the eye and perhaps cause blurryness. Can she try a lesser power contact for a few weeks?

C. You don't mention her age, but early cataracts can cause similar problems. See A.

D. Get Lasik and be done with the contacts completely.
posted by eas98 at 11:57 AM on March 3, 2005

That is so very strange, I have the same problem as your girlfriend and eschatfische. I wore contacts exclusively for years, but this 'weirdness' has gotten steadily worse with age. Working at the computer is a nightmare. Taking a break made me think it was getting better until noon and I was peeling the damn thing off my eyeball. I eventually got sick of paying for contacts I couldn't use and stopped wearing them completely. If you find a solution, I would love to hear about it.
posted by dual_action at 12:21 PM on March 3, 2005

eas98, she says she has gone to both ODs and MDs with this problem, and her current eye doctor thought it could have been the too strong a prescription problem, and gave her a lower prescription to try out, but that was just worse than before. She's only 24, so hopefully cataracts are not the problem. And as far as Lasik goes, she tried that route and was informed that she is not a candidate, partially due to the strength of her prescription.

Hopefully eschatfische has the solution, it certainly would be easier than anything more serious. She hates her glasses, but anything is better than the weird not quite right feeling.
posted by JonahBlack at 12:28 PM on March 3, 2005

Could the more acute "off" periods be migraines? Remember, you don't have to have a headache to have a migraine.
posted by duck at 12:32 PM on March 3, 2005

I described a similar condition to my optometrist, and he told me it was eyestrain. I notice this a lot more after I've been at work all day. I think the "taking a break" from the contacts is a good idea. She should also make sure she's not getting allergic to her solution. I developed an allergy to either my contacts or my solution (we could never pin it down) that only subsided when I changed contact brands AND saline brands. Now, I have a pair of glasses I don't mind, so I try to wear them one or two times a week, and this has helped my "tired" eyes. I know it sounds blase`, but eyestrain could be it, especially if the doctor's been dialing her script up for lack of a better idea. If her eyes are strained, it may take a little while for them to sort out what's going on, so if she's a little blurry, it may clear up.
posted by Medieval Maven at 12:32 PM on March 3, 2005

Well, I have this problem too, and I'm in the midst of treating it. Contacts wearers -- you do know that when you wear contacts, your body interprets them as foreign material in your eye, and tries to incorporate them into your eye tissue, right? So tiny blood vessels gradually begin to grow across your contact lenses - usually not visible to the naked eye, but visible to the doctor under certain lighting. When those vessels start to get thicker, becuase you've been wearing contacts forever and ever, or because you wear them all day every day, your vision begins to get compromised.

The only solution, according to my opthal., is to give the eyes a break more often. This allows oxygen to reach the natural lens surface, retarding the growth of the blood vessels and keeping the eye clearer. That gybes with what eschatfische is saying; a long break with plenty of air reaching the eye can apparently improve matters significantly. My doc has me wearing glasses one full day each week, sunrise to sunset. But it's not really enough to solve the fuzziness, so I may be heading for extended four-eyes wear pretty soon, too. Gotta go out and get me them Tina-Fey-girl-hipster frames, or I'll hate being seen in them.
posted by Miko at 12:55 PM on March 3, 2005

Miko, I have to say, that first paragraph is the most squicky-making thing I have read in a long time. [Sitting here in my Tina Fey glasses....]
posted by matildaben at 1:42 PM on March 3, 2005

Miko has it right on. I had to take a break from contacts for two years because the veins that had grown through my corneas had permanently scarred my eye, and my eyes were so constantly irritated that even a couple hours with contacts in caused this annoying blurriness that persisted even with the lenses out.

Now? I wear contacts. For 8-10 hours, 5 days a week. Glasses at all other times and on the weekend. The burriness (and eventual extreme agony of scratched corneas) has disappeared.
posted by xyzzy at 1:53 PM on March 3, 2005

Not blood vessels, Miko - just protein deposits. Everything else you said is certainly right.

Bear in mind that astigmatism correction is based on this model: your lens contains one aberration equivalent to a spherical lens of a certain strength, plus one aberration equivalent to a cylindrical lens of a certain strength with its axis oriented a certain direction.

However, the lens of your eye does not know from spheres or cylinders. It's just misshapen, optically speaking. So the corrections are always approximations.

Such severe corrections (>8 diopter) result in a lumpy lens that may swirl around, misaligning the cylinder relative to the eye. This is one way that such lenses can go off. In general there's a certain strength of correction that contacts are really good at; weaker corrections tend not to stay put and stronger ones require a bulky lens.

Intermittent visual problems are often migraine related, as a prior poster noted.
posted by ikkyu2 at 1:55 PM on March 3, 2005

The migraine comments are interesting as she does suffer from them, and really only in the past 3 years. However, the problem with the contacts seem to be a daily sort of thing, and she doesn't have any of the normal migraine issues (headache, pain, extreme sensitivity to noise and light) during the times when she feels her contacts are off, though sometimes very bright rooms seem to exerabate the off feeling. It seems that a break from the contacts and possibly some new glasses to prompt her to wear them more often is what is order.
posted by JonahBlack at 2:07 PM on March 3, 2005

I was given a sort of similar explanation to Miko's by two of my ophthalmologists. When you wear contacts for a long time and often, blood vessels start to grow into the cornea of the eye (the part the contacts cover) because it's being deprived of oxygen. Once they start growing in there, you can't make them go away, and they can screw with your vision. The solution (I was told) is to wear them less often to give your eyes a break and to try to wear oxygen-permeable lenses. And make sure you don't wear them too long during the day; never go to sleep with them in as it exacerbates the problem.
posted by Melinika at 2:29 PM on March 3, 2005

Friend of mine had a similar issue which increased in frequency with time. Was a "visual migraine" according to her doc. She saw a optometrist, opthalmologist and a neuro opthamologist. Try the last one there, since evidently your GF has tried the first two already.

My friend says there were "optional meds available if it became annoying enough or painful." It hasn't yet, so she doesn't use meds, but it is somewhat annoying and she had one of these episodes yesterday. In her experience, "only one eye is affected - vision through a pinhole - all else blank and gray at best." Good luck!
posted by lorrer at 3:25 PM on March 3, 2005

I don't mean to scare you, but 'weird' vision problems can often be an early sign of MS.

It probably isn't, but if her ophthalmologist can't seem to find a solution, this is another avenue to look at.

Here's some info from the National MS Society.
posted by anastasiav at 3:26 PM on March 3, 2005

I currently have this exact same problem with contacts. Every two years, when I get my eyes checked, I make the rounds through every possible lens vendor out there that makes Toric lenses and each one causes the same problem.

I've been to an ophthalmologist and an array of optometrists and none of them have ever been able to explain the cause of this (which worried me until reading this AskMe). Prior to having this problem I wore my lenses as sparingly as possible due to the problems that Miko described above (at most, 8 hours per day, rarely on weekends) since I do not really have any problem with wearing glasses.

Needless to say, I have had to stick with glasses for the last 4 years. Each time I try lenses the same problem occurs (in a relatively short period of time) and if it is still happening after this long, I have a feeling it will never disappear.
posted by purephase at 3:46 PM on March 3, 2005

Another friend of mine has MS. I hear moving to CA may help reduce or slow symptom spread.

http://imaginis.com/multiple-sclerosis/who-gets-ms.asp says "In the U.S., multiple sclerosis occurs more frequently in states that are above the 37th parallel than in states below it.... An individual who is born in an area with a higher risk of developing MS and moves to an area of lower risk, acquires the risk of the new home if the move occurs before the individual is 15 years old." If she's still somewhat young, from what I understand moving south can still slow MS's progress.

Diabetes can also cause strange eye reactions. Not sure at what stage of the disease onset of vision problems would be, though, could be in later stages only.
posted by lorrer at 3:46 PM on March 3, 2005

The migraine comments are interesting as she does suffer from them, and really only in the past 3 years. However, the problem with the contacts seem to be a daily sort of thing, and she doesn't have any of the normal migraine issues (headache, pain, extreme sensitivity to noise and light) during the times when she feels her contacts are off, though sometimes very bright rooms seem to exerabate the off feeling. It seems that a break from the contacts and possibly some new glasses to prompt her to wear them more often is what is order.

And the MS idea isn't good... Hopefully it isn't that because she doesn't tend to have double vision or any greying of vision, however, she has commented previously, and completely unrelated that the right side of her face (same side as vision problem) occassionally goes numb, but only very very occasionally.
posted by JonahBlack at 4:31 PM on March 3, 2005

ikkyu2, I have the utmost respect for your medical knowledge and I always appreciate your posts on these topics. But I think you might be thinking of a different phenomenon here. I've heard from my opthalmologists in both crystal-clear and clinical language that these problems result from the growth of blood vessels where they don't belong. Also, when they do the lighting test to look at my retina, I can see the blood vessels myself. (Talk about squicky...) For more on this vision problem, see this Mayo clinic page, and scroll down to "corneal vascularization", or even here at About.com, where it's called "neovascularization".

I have experienced protein deposits, too, and they may happen for similar reasons, but they feel completely different and have different effects. With deposits, there's a grainy, rough feeling to the lens. Blurry-vision problems from protein deposits end when you remove the contact lens. You can see the cloudiness on the lens itself, but your eye is clear again immediately. However, with this blood-vessel problem, the fuzziness persists even after the lenses are removed. It takes quite some time -- ranging from days to months to years, judging by experiences here -- to reduce the vessel growth.

Yeah -- for those of you blessed with perfect vision, be thankful. Having to touch your eye to insert a lens -- ? Even that grosses the 20/20s out, but that's just the beginning...
posted by Miko at 6:22 PM on March 3, 2005

Ratz a fratzit, you'd think I just learned the intenets yesterday. Let me try once again with that About.com link on neovascularization. Sorry. For good measure, here's a another helpful-ish link, and here's really, really icky photo of someone who learned about this much too late.

I've been wearing contacts since my early teens, which is nigh on 20 years now. People experiencing this today are probably part of a great wave of vascularization sufferers that began wearing lenses in the 80s or early 90s. Soft, daily-wear lenses weren't available until the 80s, so it wouldn't be until now that you'd find out what happens to l people who've been wearing these things daily for 15, 20, 25 years or so. And it's only in the last maybe five years that I've even heard eye doctors start talking about the blood vessels.

I think my generation fell into the gap between the end of hard lenses and the recent understanding of long-term damage to the eye caused by lack of oxygen. I started wearing the things when extended-wear lenses were just another miracle of modern science; I even wore the "30-day extended wear" ones -- remember those? You were supposed to be able to wear them for 30 days at a time, even while sleeping. Now, we know that wasn't a good idea, and new lens wearers may be hearing that they need to give their eyes frequent rest. But I don't think that message was widely spread in years past.
posted by Miko at 6:44 PM on March 3, 2005

Has she made sure the doctors examining the eye problem know about those episodes of facial numbness on the same side? That's important info that might suggest a neurological or cardiac source. If she hasn't seen a primary care doc about this yet, it sounds like a good time for a checkup and a thorough listing to the doc of anything else that has seemed "off" lately.
posted by nakedcodemonkey at 11:19 PM on March 3, 2005

just a data point for migraines. i wear glasses (not contacts) and, maybe once every 3 or 4 months, typically when i'm very tired, i lose the ability to see in the centre of my field of vision. it's the strangest thing, difficult to describe - i can see at the edges of my vision, but not directly looking forwards - and it makes typing very difficult. i have never had a serious headache in my life and this loss of vision is not associated with any kind of pain or sensitivity to noise or light. however, i was told (years ago) that it is a migraine.
posted by andrew cooke at 2:16 AM on March 4, 2005