What are my glasses/contacts/lasik touch-up options?
November 8, 2021 1:00 PM   Subscribe

Currently I have no problem reading at a close range (cell phone, documents etc) but my intermediate and distance vision took a huge dive in the last 2 years and now is very blurry. Sometimes I see double and or I have astigmatism. Please help me figure out the best option for me.

Lasik: I had Lasik done 9 years ago and that's about how long the surgery is going to last. Ideally, I'd like to avoid wearing glasses so that leaves me with getting a Lasik touchup or contacts. With Lasik, they said that I would loose any ability to read and would for sure need readers. I do so much up-close reading (cell phone and documents) that I think it would be really annoying to constantly reach for readers.

Multi-focal contacts: One suggestion was multifocal contacts however they said I would need prescription in both distance and up-close (I can't just get a distance contact). I have a trial pair in and I got a small headache. Plus, I don't want to unnecessarily get a reading prescription if it's not needed. These multi-focal contacts were blurry with a clear spot in the middle of whatever I was looking at so not that much better. Also, neither the distance and up-close is that clear.

Glasses: I could get progressive glasses which would give me crisper vision but I don't need a reading prescription.

I feel like these days, bc of cell phones and computers, we do about 50/50 distance vs. close-up looking. For example, when following the GPS, I am looking at my cell phone for directions and also need to read street signs which I have had trouble with.

The optometrist said that I can't just get distance contacts like I had before Lasik. I'm not sure why. How are people dealing with these vision issues? Are there other options? Open to any advice.
posted by ColdIcedT to Health & Fitness (7 answers total) 3 users marked this as a favorite
How old are you? I'm asking because our vision really changes around 40/in our 40s. Right now I have fine reading vision without any correction, but when I wear my glasses or contacts, reading is a bit more challenging. It's enough to take my glasses off for better reading, but with contacts, I do find that reading glasses help, especially with tiny print (though, I'm not using them now, for example, as I type on my desktop).

I don't know if it's worth hanging in with the contacts but I've heard some folks do like that approach. Could you get one distance and one contact that's just nothing/don't wear a contact in that eye? Same with glasses: could you get a progressive glasses with distance on top and plain glass with no correction on the bottom? The thing about glasses and being near-sighted: you can always take the glasses off, but it's a bit of a pain to keep doing that. The progressive lenses (even if the bottom didn't have a correction) would mean you could keep wearing them. If you don't want glasses at all, I'd say to keep trying with different contact lens options.
posted by bluedaisy at 1:40 PM on November 8, 2021

I had my Lasik about the same amount of time ago - my doctor is exactly ONE MONTH older than I am and she and I had a long talk about what to expect at that time. As your eyes age, you need SOME type of correction, and you can use Lasik (typically) to correct for near or far - some folks do BOTH (one eye for near, one for far) but I didn't like that. I took the DISTANCE correction. At this point, my distance vision is about 20/40 - I have a light daily contact lens that I use if I'm going to be driving, and if I have them in, I need readers to make up my close-up vision. It was explained to me that at this age, whatever I gain in distance with correction I lose in close-up, and vice versa.

It's worth asking your doc again about the options you might have with contacts and progressive lenses - as I said, I have contact lenses JUST for distance, and I only use them if I'm going to be driving or sightseeing. For me, this is the FIRST time I've ever been able to wear off-the-shelf lenses. I think my doctor worries that the need for contacts makes me an unhappy patient, but the opposite is true. I'm just so pleased to have the option! Previously, it was expensive, custom-made toric lenses that still couldn't compensate for my astigmatism. The Lasik corrected that almost entirely.
posted by ersatzkat at 2:04 PM on November 8, 2021

The trouble with the lens in the human eye is that once the proteins that make it up grow in, that's it; they don't get the same kind of regular removal and renewal cycle that happens everywhere else in the body. So your eye lenses are literally the oldest parts of you, and they simply wear out and start to harden up after forty-ish years of service.

This is presbyopia, and it's a zucking nuisance. Once it's started happening it only ever gets worse, your eyes will never again have the range of focusable distances that they used to achieve when you were young, and you will need increasingly annoying means of external focus assistance to compensate. Best you'll ever do with Lasik tweaks is get to choose what range of distances you don't need external compensation for, and that range will decrease over time.

I'm sorry for your loss.
posted by flabdablet at 3:23 PM on November 8, 2021 [1 favorite]

Biophysical chemistry of the ageing eye lens

There is One Weird Trick that can sometimes be helpful: turn up the ambient brightness. This makes your pupils contract, and as every photographer knows, reducing aperture increases depth of field.

Opiates will also give you pinpoint pupils, if they're your jam. Probably best not every day, though.
posted by flabdablet at 3:45 PM on November 8, 2021 [1 favorite]

My mom wore one near and one far contact lens for literally almost my entire life, and never used or liked multi-focal contacts (she tried them once but her brain was firmly wired for one near, one far and they didn't work out). I don't see why you couldn't have a single contact for distance and a slight correction for near vision (when/if needed) for the other eye.
posted by Medieval Maven at 5:42 PM on November 8, 2021

Just for fun I want to point out that there is a new alternative to lenses or surgery. You can use special eyedrops as a treatment for presbyopia! The FDA just approved Vuity.

Note: these eyedrops are not suitable for use at night, especially during nighttime driving.
posted by metonym at 6:01 PM on November 8, 2021 [3 favorites]

I had a similar issue, starting two years ago around age 43. It took me 2 years and 3 optometrists to get the right diagnosis because it's apparently not very common, especially once you're out of your teens/20s. Turns out I have keratoconus, which is when your cornea becomes misshaped, messing with the physics of your eyes. I think the optometrists I saw previously didn't even have it in mind for me because I don't fit the age profile. Not saying this is what you have, but it might be worth asking.
posted by scottso17 at 4:14 PM on November 10, 2021

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