Time to see a new optometrist?

December 21, 2011 6:36 AM

How can my eyes be healthy when I need to wear glasses?

Had my checkup yesterday, and my lenses needed updating as expected (I'm nearsighted.) My optometrist said that my eyes are healthy, though I can expect that I'll need stronger and stronger lenses as I get older. It didn't occur to me until after I left to ask him how can my eyes be healthy if I need corrective lenses, let alone lenses with a stronger prescription. Can anyone shed light on this? Google isn't bringing up anything.

If you have any tips on supplements, foods, etc. that have helped you with your vision (if such things exist) I'd like to read more about them. :)

posted by Anima Mundi to Grab Bag (14 answers total)

Best answer: Your vision depends largely on the shape of the parts of the eye, not on the health of the eye. You can have perfectly healthy eyes that don't see very well.
posted by xingcat at 6:37 AM on December 21, 2011 [11 favorites]

Your eyes are healthy in the sense that you don't have, say, any diseases that affect them. Shortsightedness is a matter of the shape of the eye. When we say "shortsighted" we're sort of saying "more shortsighted than we'd like," because while most people can get to 20/20 vision easily with prescription lenses, there are plenty of real people with better than 20/20 vision. It's like if you're short and very healthy, but often unable to reach things, so you start wearing platform shoes all the time.
posted by Tomorrowful at 6:43 AM on December 21, 2011 [3 favorites]

This is kind of like saying, "how can my skin be healthy if I am getting wrinkles?" As the body ages, different parts start to function differently even without being diseased or damaged. Elastin in the skin becomes less taut; the lens in your eye becomes more rigid and less able to be flexed (which is what allows your eye to focus). What's more, not only will you likely become less able to focus on distant objects, generally everyone (per my DO, to whom I put the question last week) gets presbyopia--the inability to focus on close up objects (which is why older people tend to wear reading glasses and/or hold books out at arm's length).

You have all this and more--so very much more--to look forward to on your ineluctable march to the grave. Gather ye rosebuds while ye may.

Here are some eye exercises, though I can't vouch for their efficacy.
posted by Admiral Haddock at 6:50 AM on December 21, 2011 [3 favorites]

Best answer: I'll tweak what xingcat is saying is that your eyes see perfectly, they just see things much sharper when they're up close.

Echoing them though: not having clear vision is not a sign of unhealthiness. People who wear glasses don't have diseased eyes.

To be corny, they just see the world differently then people who have clear vision.
posted by royalsong at 6:50 AM on December 21, 2011

I think the optometrist means you don't have signs of glaucoma, cataracts, retinal disorders, or conjunctivitis.
posted by anniecat at 6:52 AM on December 21, 2011 [3 favorites]

I am the same way... very short sighted but very healthy eyes.

Here is a decent image from Wikipedia that shows what folks mean about it being your eye shape, not a disease that is causing the short sightedness.
posted by utsutsu at 7:04 AM on December 21, 2011

I have always been told it has to do with the shape of your eyeball. People who are nearsighted have a condition called myopia, meaning the eye is longer than normal or the cornea curves too much, so light rays entering the eye hit the retina incorrectly. Nearsighted people can see close-by objects or print clearly, but objects that are far away appear blurred. In contrast, people who are farsighted — a condition called hyperopia — have eyes that are shorter than normal or their corneas curve too little. This means that light from close objects doesn't focus correctly on the retina, causing those objects to appear blurred, while objects farther away are seen clearly...
posted by jim in austin at 7:08 AM on December 21, 2011

I think that what constitutes "health" and what constitutes "disease" is probably a philosophical question. But being nearsighted is easily treatable with current technology, and it doesn't require any intervention other than wearing corrective lenses. Because the problem is limited and easily corrected, it's not considered a disease.
posted by craichead at 7:08 AM on December 21, 2011

Best answer: Every optometrist who has ever checked my eyes has drooled over how healthy they are. By which they mean that I have no buckling or tears to the retina, no signs of disease, no cataracts, no nothing.

I also have vision somewhere in the 20/1200 range. So, yeah, it's possible to have wonderfully healthy eyes that don't work for beans.
posted by thomas j wise at 7:15 AM on December 21, 2011 [1 favorite]

Here are some eye exercises, though I can't vouch for their efficacy.

They appear to be based on the Bates method, which has no scientific basis.
posted by Lentrohamsanin at 7:15 AM on December 21, 2011 [1 favorite]

For the nearsightedness, it's a "glass is half full/empty" perspective. Yes, you can't see things far away, but I'll bet you take your glasses off when you need to study something in very close detail and put it right next to your eyes. That's not normal either. Our eyes are microscopes. Yeah, it isn't lasers, but its still cool. And you're healthy too. Win-Win!
posted by jwells at 7:30 AM on December 21, 2011

Many people in wheelchairs are perfectly healthy. That doesn't mean they're optimally functioning machines, just that they are sickness free.

Vision goes bad in many of us, and people who suggest diet changes (assuming you already have an adequate diet) and exercises are hacks trying to sell you something.

Just get Lasik from a reputable doctor -- best $2400 I've ever spent. In fact, best decision I've ever made bar none.
posted by coolguymichael at 8:52 AM on December 21, 2011

You didn't mention how old you are, which is somewhat relevant. Usually people's vision stabilizes once they get into adulthood and they stop growing much (because as your eyes grown and change shapes, this will affect your prescription, as others have rightly noted). When I was younger I'd go up about a 0.5 step a year (yes I am seriously blind (-9, -8.5) why do you ask?), but once I got into my late 20s early 30s, it's been like every couple of years, and I have friends whose eyes have pretty much completely stabilized. In fact, they look for this before doing Lasik, because if they do it and then you grow some and your prescription changes, then you'll be back to needing glasses again.

One thing not mentioned above but is an interesting vision fact is that as we get older, the lens in our eye grows more stiff and is unable to be bent as much as before. Where this comes into play is that when we look at things near to us, we need to increase the focal strength of the lens to have the light land focused on our retina due to the angle at which light hits our eyes. We do this by, essentially, using the muscles in our eye to squish our lens, increasing its power. This is why far sighted people can get by for much longer without glasses than near sighted people, they just do this lens squishing thing for objects you shouldn't need to, but it is tiring and is why they usually get headaches from reading too much (without their glasses). However, as we age, our lens loses some of this flexibility and can't do this as much, and that's why most older people (even people who have had lasik) need reading glasses.

Now this doesn't have much to do with us near sighted people, but is why a lot of us end up in bifocals as we get older. And needing to go from single lenses to bifocals still doesn't say anything about the health of your eye (it's like the wrinkle thing mentioned above).
posted by katers890 at 9:04 AM on December 21, 2011

Response by poster: Good points made, especially the skin wrinkle analogy. I wasn't even thinking along the lines of glaucoma, cataracts, etc.
posted by Anima Mundi at 11:29 AM on December 21, 2011