A premed student with bad vision needing your help

[denis101]

Hello everyone,

I am a premed student that is 23 years old who has been admitted to medical school starting this fall. I'm kind of freaking out because I'm having issues with my vision particularly with reading (accommodation). I've been to 3 OD's and 1 MD of ophthalmology. I haven't received IMO satisfactory answers, so in a last resort i'm hoping some students have some insight.

Current prescription eyeglasses:
OD: -3.50 -.50 85
OS: -3.50 -.50 135

I do a ton of up close work. I'm either studying all the time or doing work on the computer. I use to be able to speed read and blaze through material. Now I'm having accommodation problems in both eyes (more in my left) in regards to reading whether it be on the computer or a regular textbook. This is affecting my grades, my ability read and comprehend material. With medical starting quite frankly i'm freaked out.

Every doctor I'm going to says that I should lower my script slightly(-.25 off each eye sphere). It DOES help a little bit, but the distance I can't live with. One diopter makes that much of a difference for me.

In my research it seems that my options are an Antifatigue lens, bifocals, progressive, or separate pair for reading/up close work (very impractical)

My question is:
1. I'm 23 years old. I'm going to be doing up close reading my whole life. Is this abnormal for such a young age individual? (parents have no history of presbyopia before 50)
2. My biggest fear is that if I start correcting with +.75 or higher with a progressive/bifocal/antifatigue lens will my eyes lose they're natural ability to accommodate in the long term? (this worries me that I'll have to increase my + every year and eventually be in a bifocal at 35).
3. With my situation, what is the best course of action that I should take to address the accommodation issue up close so that I can read and be successful in my future education?

Thank you very much!

Dennis

---

Members don't see this ad.

 

[mathcod]

Possible accommodative insufficiency (AI) and/or binocular vision disorder (BVD) if not spectacle related. Doctor should yield most-plus to best corrected acuity binocular-balanced prescription, and do a visual efficiency check. Ideal treatment for AI/BVD is vision therapy. Secondary treatment plus lenses. Antifatigues/progressives/bifocals, reading glasses, or clip-on plus lenses starting low are an alternative. I bought a pair of clip-on readers for literally $1.00 at my dollar store that I wear over my full-time specs if I do binge near work, but you will technically have to converge your eyes more as you lose some of your accommodative convergence but it's an easy, quick, temporary solution and if it doesn't work you only lost a buck. But vision therapy is the primary treatment if AI or AI+BVD.

Never heard of undercorrecting (different from most-plus-to-best-visual-acuity) to help as distance vision is usually paramount for a full time wear spec.

Not presbyopia related.

 

[denis101]

Possible accommodative insufficiency (AI) and/or binocular vision disorder (BVD) if not spectacle related. Doctor should yield most-plus to best corrected acuity binocular-balanced prescription, and do a visual efficiency check. Ideal treatment for AI/BVD is vision therapy. Secondary treatment plus lenses. Antifatigues/progressives/bifocals, reading glasses, or clip-on plus lenses starting low are an alternative. I bought a pair of clip-on readers for literally $1.00 at my dollar store that I wear over my full-time specs if I do binge near work, but you will technically have to converge your eyes more as you lose some of your accommodative convergence but it's an easy, quick, temporary solution and if it doesn't work you only lost a buck. But vision therapy is the primary treatment if AI or AI+BVD.

Never heard of undercorrecting (different from most-plus-to-best-visual-acuity) to help as distance vision is usually paramount for a full time wear spec.

Not presbyopia related.

Will correcting with plus lenses make my eyes naturally worse in respect to accommodation with time? In other words, in 5 years will I be having the same problems and keep having to bump up the plus lenses? Thanks

 

[mathcod]

No, not for plus lenses. Your concern is possible with prism with respect to worsening vergences but not for plus lenses with respect to accomodation. Accommodative dsyfunctions rarely exist in isolation though which is why vision therapy (VT) is the primary treatment (also lowers the dependency on near add). Regardless reading-only specs, bifocals, PALs are very common treatments when difficulty finding a VT practitioner or VT's affordability are barriers to treatment.

 

[PBEA]

Hello everyone,

I am a premed student that is 23 years old who has been admitted to medical school starting this fall. I'm kind of freaking out because I'm having issues with my vision particularly with reading (accommodation). I've been to 3 OD's and 1 MD of ophthalmology. I haven't received IMO satisfactory answers, so in a last resort i'm hoping some students have some insight.

Current prescription eyeglasses:
OD: -3.50 -.50 85
OS: -3.50 -.50 135

I do a ton of up close work. I'm either studying all the time or doing work on the computer. I use to be able to speed read and blaze through material. Now I'm having accommodation problems in both eyes (more in my left) in regards to reading whether it be on the computer or a regular textbook. This is affecting my grades, my ability read and comprehend material. With medical starting quite frankly i'm freaked out.

Every doctor I'm going to says that I should lower my script slightly(-.25 off each eye sphere). It DOES help a little bit, but the distance I can't live with. One diopter makes that much of a difference for me.

In my research it seems that my options are an Antifatigue lens, bifocals, progressive, or separate pair for reading/up close work (very impractical)

My question is:
1. I'm 23 years old. I'm going to be doing up close reading my whole life. Is this abnormal for such a young age individual? (parents have no history of presbyopia before 50)
2. My biggest fear is that if I start correcting with +.75 or higher with a progressive/bifocal/antifatigue lens will my eyes lose they're natural ability to accommodate in the long term? (this worries me that I'll have to increase my + every year and eventually be in a bifocal at 35).
3. With my situation, what is the best course of action that I should take to address the accommodation issue up close so that I can read and be successful in my future education?

Thank you very much!

Dennis

1) yes it is abnormal
2) you may become adapted to such a lens, and possibly miss it if not present, but there should be no "loss of natural ability" solely from using more plus at near.
3) You should see a doctor who will diagnose your problem, obviously treatment will depend on the cause, and the causes are many. Taking any meds? any health problems? past eye history? pertinent physical findings? etc, etc. Using plus lenses may be exactly what you need or it may just hide the real problem. You can see why it is impossible to answer this kind of question over the internet.