Can an astigmatism suddenly go away or did I get a poor eye exam?

September 25, 2010 11:02 AM

Can an astigmatism suddenly go away or did I get a poor eye exam? Details within.

Yesterday I went Lenscrafters / Eye Exam 2000 and had an eye exam. It was a horrible experience. It was very corporate, I was switched from a previous Doctor that I liked, I felt rushed, things weren't explained to me when I asked questions, and I'm doubting the prescriptions I was given.

As an example, at the very end of the exam the optometrist said, "Are you sure about the contact lens prescription? I was thinking about bumping you up .25 diopter, but I'm not sure. What do you think?" [You're not sure!? You're the one with the training and the instruments!]

Anyway, for many years my eyeglass prescription was:

OD -5.75 -0.25 x 95
OS -6.00 -0.25 x 90

The new one is:

OD -6.00
OS -6.50

That's it. No cylinder, no axis, no pupillary distance. In the place for cylinder and axis, it only says "PS". I'm assuming this means there was no astigmatism measured. And I'm guessing they don't measure pupillary distance until you actually order glasses from them.

After my optometrist waffled back and forth, my contact lens prescription stayed the same.

So I guess I'm asking:
1) Can astigmatism suddenly go away or did I get a poor/ inaccurate eye exam?
2) Can your eye prescription change but your contact lens prescription not?
3) How can I get an accurate pupillary distance reading without ordering glasses from them?
4) Can you recommend a good eye doctor in Los Angeles so I don't repeat this next time?

I'm really frustrated because I feel like I flushed $150 down the toilet and it could've all been avoided if I'd insisted on seeing the optometrist I trusted.

You are not my doctor, my optometrist, or my opthamologist and you are not providing medical advice.

posted by sharkfu to Health & Fitness (18 answers total)

Response by poster: I should note also that I wasn't given an eye glass prescription in the traditional sense-- I was given the sheet the technician filled out when the machine estimated my vision automatically and then the doctor initialed it. It's a full 8x11 sheet, not the smaller prescription pad I've gotten at previous doctors. For the contact lense prescription, I was given the actual form that says "prescription" and has the doctor's name and license/registration number.
posted by sharkfu at 11:07 AM on September 25, 2010

I don't know about astigmatism disappearing, but as someone whose vision never quite corrects to 20/20, I've had discussions with my optometrist about my prescription, and sometimes there is an element of " you're in-between these two, do you prefer the stronger or the weaker correction?"
posted by needs more cowbell at 11:20 AM on September 25, 2010

I have a very mild astigmatism in one of my eyes. Each time I go to the eye doctor, he says, "We can try Expensive Unknown brand of contacts that will officially correct for that, or we can stay with Cheap brand that doesn't correct for astigmatism, whose fit you love, and bump the prescription up .25 and you won't be able to tell." Maybe your new optometrist had that discussion in his head, with himself?

I accurately measured my PD at home in a mirror via instructions from the Glassy Eyes website (I think) and my cheap glasses work totally fine. I've also gotten a scrip without PD and ordered glasses very cheaply at Costco, and the people there were happy to measure.
posted by charmedimsure at 11:42 AM on September 25, 2010

As my eyes have changed, I've gotten scripts with and without astigmatism correction. I don't think the astigmatism is vanishing, just that they're trying to pick the best option out of the various that are available. Too, contacts without astigmatism correction are much cheaper, so they may be trying to do you a favor by giving you a different type of correction.

Hey, I've *never* had a contact lens exam/fitting where they didn't give me a trial pair of the new script. Did you get those? I've also been told that I should come back in a week for a re-fitting (free) if they don't work out, at both very corporate-feeling places and at small practices.
posted by galadriel at 11:46 AM on September 25, 2010

If your cylinder had previously been 0.25, that's barely discernible astigmatism. If your optometrist considered your astigmatism near zero, there would be no need to record cylinder or axis values.

My optometrist has recorded my right eye astigmatism at 1.25, significantly more than yours, but when I asked if if I really needed to buy more expensive toric contact lenses to correct it, he said I could try regular lenses and if I was happy, to keep using them.

But if you weren't happy with the experience, certainly see someone you trust next time.
posted by maudlin at 11:52 AM on September 25, 2010

I recently had the same thing happen - astigmatism in my right eye went from -1.25 to -0.25 when I switched doctors. I got contact lens with no astigmatism correction and I've been fine. Definitely try before you buy, though.
posted by pravit at 11:57 AM on September 25, 2010

Many optometrists and opticians will refuse to measure or provide you your PD because they really really really don't want you to buy your glasses somewhere else. I've been given various reasons from plain old "that's the policy" to a lecture as to why buying glasses online is bad. In any case, you can get a good measurement by asking a friend to use a ruler while you look straight ahead. I personally don't trust myself to do it with a mirror, but many people do that too.
posted by ellenaim at 12:10 PM on September 25, 2010

Also, if contacts are your primary form of vision correction, it's likely that there'd be no difference anyway. I have been told by two different optometrists that I have slight astigmatism, but that it's less than the lowest correction offered in contacts. It is corrected in my glasses, but I can't tell any difference in my vision between the two.

FWIW, the prescription with the astigmatism was -2.50 x -.50 x 80
posted by mercredi at 12:13 PM on September 25, 2010

Yes, it's possible. My astigmatism has come and gone over the years (it is functionally absent right now, but it's always a crapshoot whether I'll get a scrip for toric or regular lenses.) It's one of several reasons I won't get lasik done - every few years my prescription changes radically.

Also, there are not enough sedatives in the world to make me sit still for LASERS IN MY EYES.
posted by workerant at 12:22 PM on September 25, 2010

I suggest asking for a second opinion with the doctor you trust (you imply that he or she still works there.) Make it clear that you aren't happy, and that if you stay unhappy, you will take your future business somewhere else.

Too late for this time, but I also suggest getting your eye exams at the most highly-qualified ophthalmologist you can find. That person may not be working at Lenscrafters. I emphasize may, because the ophthalmologist I now go to was working at a Lenscrafters when I first saw her. She's an MD who's lectured at Harvard Medical School and is ridiculously overqualified to be doing simple eye exams. The exams she does are not simple; they are the most through exams I've had anywhere, and if she sees anything noteworthy, she tells me about it and explains what it means. I have the utmost confidence in her. She did not like giving me my PD, since it means I won't be buying her massively overpriced Luxottica* frames, but she did give it to me.

Also, if you have health insurance, make sure you don't have vision care as part of it. I get free eye exams every two years because BCBS picks up the cost. ($80 for that very thorough exam...)

* Almost all of the chains are owned by Luxottica, and they all sell their frames for the same money. Most independent shops also sell Luxottica frames, so they also charge big bucks for frames that are manufactured for pennies.
posted by Kirth Gerson at 12:57 PM on September 25, 2010

Not an issue with astigmatism, but I did have my prescription actually go down for the first time in my life at my last optometrist visit; he said that he felt my previous prescription was too strong. I noticed that my eye strain improved moderately.

3) How can I get an accurate pupillary distance reading without ordering glasses from them?

You can ask (sometimes they'll give it to you, sometimes not), or you can have a friend measure yours for you with your old glasses, a dry-erase marker, and a ruler. Look straight ahead into the distance, and have your friend mark the center of your pupils on either lens. Then measure in millimeters.
posted by PhoBWanKenobi at 1:08 PM on September 25, 2010

I haven't read the meat of your question, but in answer to the header question -- the astigmatism in one of my eyes actually *reversed direction*. I'm reasonably sure this wasn't a mistake -- my vision started feeling very funny, I went to the optometrist, and a new prescription solved the problem.

My eyes are special snowflakes; YMMV.
posted by endless_forms at 1:12 PM on September 25, 2010

About two or three years ago, I had an exam at Lenscrafters and the doc said I had definite astigmatism. Now, I've been insanely nearsighted since I was a kid, but I'd never been diagnosed with astigmatism before... but I figured she knew what she was talking about, and my new Rx for contacts did seem to be better. When I went to a new (non-Lenscrafters) independent eye doc last year for an exam, he said I had no astigmatism in one eye at all, and very, very mild astigmatism in the other -- mild enough that it barely had to be corrected for. I asked him if astigmatism could reverse in a year or two, and he didn't say anything very committal -- I think in my case, at least, he thought that the old Rx was really just a mistake.
posted by scody at 1:52 PM on September 25, 2010

I was told exactly once that I had an astigmatism, 0.25, and it was at a local independent chain. My ophthalmologist, who had been on sabbatical at that time, has never picked it up and he's crazy thorough. I mentioned it to him and he said that the 0.25 - be it astigmatism or variation in the spherical measurement - is really just a matter of vision at the moment the exam is done.
posted by cobaltnine at 6:30 PM on September 25, 2010

For cheap eye exams (you mention throwing away $150), ForEyes is pretty good. The base exam is $50 and then they'll offer you a peripheral vision exam and an eye pressure check for a few more dollars. Resist the high-pressure sales pitch* and buy your glasses online (glassyeyes.com is the portal you want, with lots of coupon codes) ... I actually got prescription sunglasses for $8 from Xenni and regular prescription glasses (i.e. no Transitions) for $25-30 from Goggles4U.

*They had the audacity to try to pressure me into buying glasses when, during the part of the exam where I sit and wait for my eyes to dilate, my mom called crying to tell me my cousin had died. I was still on the phone with her, very obviously talking about funeral costs, and they were asking me if I wanted to buy today.
posted by IndigoRain at 8:04 PM on September 25, 2010

Sometimes people feel more comfortable with slightly over- or under-corrected vision... that's why your doctor asked you how you felt in your current prescription. If your vision is already great and the measured difference is slight, there's no need to fix something that isn't broken.
posted by anaelith at 5:10 AM on September 26, 2010 [1 favorite]

I have had my astigmatism temporarily correct itself (for 24 hours or so) by sleeping really hard on my face, which apparently shoves the "eye goop" (a recognized medical term) into a slightly different shape. My ophthalmologist actually said that there's a technique that does the same thing with rigid contact lenses.
posted by infinitywaltz at 8:52 AM on September 26, 2010

If your cylinder had previously been 0.25, that's barely discernible astigmatism.

Yes. That -0.25 is modifying the -5.75. The change from -6 to -6.5 is actually more meaningful, and you didn't even notice that.
posted by smackfu at 7:29 AM on September 27, 2010 [1 favorite]