Do eye exams test for whether text looks lighter or darker?
August 21, 2017 6:08 PM   Subscribe

On my recent eye exam with an optometrist in New York, I was asked, at one point, "Do the letters look lighter or darker?" They didn't look lighter or darker in either case. But the optometrist seemed annoyed, and I decided to interpret his question as "does the text look more blurry or more clear?" A month later, my prescription seems iffy, and I'm not sure I did the right thing.

I was thinking, at the time, that by "darker," he meant "due to the text being less blurry, the lines of the text are more solid, and therefore, in a way, they look darker." The optometrist was pushy, and I felt like i was already annoying him with questions, and that if I asked him to clarify what he meant by "darker," I would be splitting linguistic hairs. I think I even did qualify my answer by saying something like "Well, the second one is clearer, so I guess..." and then he finished "'s darker." And I was like, "Yeah."

But it wasn't darker. Not even a little bit. Darker is the wrong word for what it was.

My vision is pretty bad, nearsighted with an astigmatism, much worse in one eye than the other. My new lenses are definitely an improvement over the old ones, in general. However, I feel like they aren't perfect. But I'm not sure if I'm just imagining that, or maybe the issues in question have less to do with my exam, and more to do with me just getting old.

When I read (which is a lot), I go through a period of adjustment, where I really have to concentrate on the text while my eyes adjust. At first the text can seem blurry. This seems to happen more with printed material. This definitely did not happen with my last pair of glasses, or... ever before. Although, once my eyes adjust, I can read better with these glasses than I could with the old ones.

Also, and I realize that the connection here may just be semantic, but I have issues with light. As in, I need a lot of it to be able to read. I am the guy in the restaurant who takes out his phone to use the flashlight to look at the menu, even though nobody else needs to do that. This was also the case before my exam, but... I can't help but wonder.

In other news, I recently moved to Mexico, and these lenses and frames, which I got in Brooklyn before moving, were pretty expensive. So in pre-emptive response to "get another exam, it can't hurt,": Yes it can. It could end up being very expensive and/or inconvenient. I'm looking for opinions from people who can actually speak in terms of experience with eye exams, either firsthand as patients, or as optricians/opthalmologists or similar. Thanks.

p.s. It had been a long time since my last prescription. Six years, I think. And this time, I got "digital" lenses, for whatever that's worth.
posted by bingo to Health & Fitness (16 answers total) 1 user marked this as a favorite
How old are you, and do you have bifocals?

Both the needing more light and the adjustment for clarity are common for astigmatism and tend to be almost a cliche for eyeballs over 40.
posted by Autumnheart at 6:19 PM on August 21, 2017 [2 favorites]

I'm 46. Have never had bifocals before, but maybe I need them. Although I don't think that was even discussed.
posted by bingo at 6:35 PM on August 21, 2017

It's not a great descriptor, but my doctor tried to dial things in focus until they specifically looked smaller, which I remember having a noticable brightness difference from a slightly different size.

I should try a doctor with crazy machines to measure everything, it's 2017 already, I'm not sure I trust all my a/b judgements, especially given ambiguous questions.
posted by TheAdamist at 6:39 PM on August 21, 2017 [1 favorite]

46 is prime age for the point where you start to have problems with small print. As you get older, your cornea starts to harden, your pupil loses some muscle strength that controls its ability to contract precisely, and your eyes become dryer. All of these contribute to increased blurriness and general focusing issues. I just turned 44 last month and I've definitely noticed that I need more light now, and have issues finding a focal point for text even in sufficient light. Also very nearsighted with some astigmatism.

So, if your eye exam was fine enough and your glasses do the job, then I wouldn't say you need to run out and have another one. If you feel that your glasses might be the wrong prescription or that your exam wasn't done correctly (which can happen!), you might want a second opinion. You should have them yearly, though, to keep track of changes in your vision and the health of your retinas.
posted by Autumnheart at 7:07 PM on August 21, 2017 [1 favorite]

Also, for your next eye exam, whenever you decide to have it, I suggest going to an ophthalmologist (medical doctor) vs. an optometrist (not medical doctor). An ophthalmologist will very likely be able to give you a more comprehensive exam and address any ongoing concerns you may have.
posted by Autumnheart at 7:14 PM on August 21, 2017 [3 favorites]

Also, as you are in Mexico, why in heaven's name don't you get a second exam there? Plenty of people pay the cost of going there to save money on their expensive medical care and you won't even have to cover the cost of travel!
posted by eglenner at 7:42 PM on August 21, 2017 [2 favorites]

Yeah, I might get an exam here. I guess I was hoping for reassurances that my prescription is fine. I really like my frames, which were expensive, and I'm not sure I have faith in the process of taking them to a shop that doesn't sell them, having them measured, getting new lenses made and inserted, etc. I would probably have to just start over and get different frames. Not the end of the world, but I hate the idea of the sunken cost.

As for going to an opthalmologist, that's what I used to do. Then I had a GP who told me that I should get checkups from an optometrist, because an opthalmologist would be annoyed that I was using his time for something as mundane as a checkup. In retrospect, this does sound ridiculous, and yet, given the general arrogance of the (American) medical community, it wouldn't surprise me if it's true. On the other hand, I doubt any doctor would be more arrogant than the optometrist who asked me whether the text was getting darker.
posted by bingo at 8:28 PM on August 21, 2017

I'm not sure but it sounds like the problem you are having is that it is harder for your eyes to adjust when you go from normal distance viewing to reading which is normally much closer. This, unfortunately is an all too common age related problem. If your glasses are better for distance than before, then the adjustment that your eyes have to make to go from far to near is greater. If this makes sense, then you need bifocals or progressive lenses which have a section with less correction so eyes don't have to do as much adjustment when you shift to close-up work.

So, if this is the case, one option is to keep your current glasses for general use and get a pair of reading glasses or, even just take your glasses off when you read. (I do this for book where I can hold them up close or using my phone - doesn't work for me for desk work or laptop screen.)
posted by metahawk at 8:37 PM on August 21, 2017

Yeah, without my glasses, I have to put my face about six inches from the page. It's sounding like bifocals are in my future. Getting reading glasses in the short term is also a good idea.
posted by bingo at 8:44 PM on August 21, 2017

I'm not good at making those A/B judgments quickly about something so important, so I select my optometrists for patience (and results, but how am I going to get those if I'm rushed?) Sounds like this one fails on that.

FWIW, I've never been able to see an ophthalmologist without a referral, even with an appointment and me right there in the office ready to give them money. Your ophthalmologist may vary. I trust my optometrists to refer me for medical problems and to explain clearly what they're testing and why in exams. So far, so good.
posted by asperity at 9:34 PM on August 21, 2017

I'll second that you could just get another prescription in Mexico, likely for a lot cheaper than in the US. Fitting new lenses to old frames is a very standard thing that optometrists do. I've kept frames for ten years just getting them fitted with different lenses as my prescription changed. This was with frames bought in India, so I've had them refitted both in India and the US and never had any issues at all. So your frames are not a lost cost at all. I would ask around your network in Mexico to find a recommendation for a good optometrist there.
posted by peacheater at 4:45 AM on August 22, 2017 [1 favorite]

It can take a long time to adjust to new lenses, especially if the lens shape is very different and the prescription is strong. It's going to be fairly hard to determine whether it's this or your prescription over the internet, but another optometrist would be able to check your glasses directly against the results of an eye exam and give you an opinion.
posted by advil at 5:11 AM on August 22, 2017 [1 favorite]

Don't know what city you are in Mexico but a visit to an ophthalmologist should range between 500 and 1500 pesos, depends on the city and the doctor. That's 30 to 80 dollars so not too bad. Lots of good ophthalmologists in Mexico. Ask for a recommendation or memail me.
posted by CrazyLemonade at 12:34 PM on August 22, 2017

I'm in San Miguel de Allende.
posted by bingo at 1:01 PM on August 22, 2017

This practice was recommended to me by someone I know. They're in Queretaro, so it's not the same city but just over 35 minutes away. (Dr. R. Reyes in particular)

Otherwise you can just Google for an ophthalmologist in San Miguel, I'd choose someone that works out of a bigger clinic/hospital. Good luck.
posted by CrazyLemonade at 4:19 PM on August 22, 2017

Just to answer your original question, I have worn glasses since about 3rd grade. Some eye exams have asked if something (usually text) looks lighter or darker, but not all of them, and not the one I just got about a month ago (from an ophthalmologist). So yes, it is a thing, but it's not universal.
posted by fiercecupcake at 11:38 AM on August 23, 2017

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