• Advice You're Thankful for Contest

    Now that it's getting close to Thanksgiving, we're running a contest to hear advice you've received that you're most thankful for! This can be any type of advice and the advice with the most reactions will win!

    JOIN CONTEST

Med School and Deteriorating Vision

Sartre79

Full Member
15+ Year Member
Mar 29, 2003
629
1
Midwest
  1. Resident [Any Field]
    I actually had a friend who was in law school that experienced something similar. I think the Docs told her her eyes were very overstressed and that she need to stop reading etc. for awhile. Just goes with the territory I guess
     
    About the Ads

    Discobolus

    Dutch-American
    10+ Year Member
    5+ Year Member
    May 31, 2004
    381
    6
    44
    Red State
      I'm glad to hear I'm not the only one. I've worn glasses since the 3rd grade but have noticed my ability to see fine details on power point slides during lecture getting worse over the last year. I was even going to get an optometrist appointment during the Christmas break, but noticed during the break that my vision got a lot better. I haven't gone to class much this semester (or studied much for that matter), and my eyes seem to be doing a lot better.
       

      Pox in a box

      1K Member
      10+ Year Member
      Jan 8, 2005
      1,345
      1
        There's actually a neurophysiological mechanism in place that may be affecting your vision. In your eye, your pupil dilates for distance vision (called mydriasis). This is a sympathetic process. To do this, you contract your radial muscles (dilator muscles). For near vision (miosis), you contrict your pupils using your circular, or sphincter muscles (parasympathetic). Now the lens by itself is round. Normally, the lens is in its relaxed state (sympathetic for far vision). The zonular fibers keep the lens stretched and flattened for distance vision. Ciliary muscles oppose these zonular fibers. The ciliary muscles relax and the zonular fibers pull on the lens. For parasympathetic near vision, the ciliary muscles are contracted and the lens assumes a more rounded state. Said in another way, for near vision, your ciliary muscles contract to oppose the zonular fibers. While most of your refraction actually occurs at the cornea, a good deal is done using the lens. When you are constantly focusing for near vision (i.e. reading Robbins or First Aid), your eyes get tired (especially the ciliary muscles). So, to remedy the situation, as often as possible, I'd suggest going to watch a movie at the outdoor theater, stargazing, or just taking some time to look up every now and then. You probably won't be at 100% as long as you're in medical training but at least now you know why. If the problem is a bit more serious, you may want to consider in your differential diagnosis diabetes, but surely the vision problem isn't disturbing you too bad.
         

        typeB-md

        Be more like McCain!
        10+ Year Member
        5+ Year Member
        Jan 26, 2005
        700
        1
          Pox in a box said:
          There's actually a neurophysiological mechanism in place that may be affecting your vision. In your eye, your pupil dilates for distance vision (called mydriasis). This is a sympathetic process. To do this, you contract your radial muscles (dilator muscles). For near vision (miosis), you contrict your pupils using your circular, or sphincter muscles (parasympathetic). Now the lens by itself is round. Normally, the lens is in its relaxed state (sympathetic for far vision). The zonular fibers keep the lens stretched and flattened for distance vision. Ciliary muscles oppose these zonular fibers. The ciliary muscles relax and the zonular fibers pull on the lens. For parasympathetic near vision, the ciliary muscles are contracted and the lens assumes a more rounded state. Said in another way, for near vision, your ciliary muscles contract to oppose the zonular fibers. While most of your refraction actually occurs at the cornea, a good deal is done using the lens. When you are constantly focusing for near vision (i.e. reading Robbins or First Aid), your eyes get tired (especially the ciliary muscles). So, to remedy the situation, as often as possible, I'd suggest going to watch a movie at the outdoor theater, stargazing, or just taking some time to look up every now and then. You probably won't be at 100% as long as you're in medical training but at least now you know why. If the problem is a bit more serious, you may want to consider in your differential diagnosis diabetes, but surely the vision problem isn't disturbing you too bad.

          i just referenced it in my BRS and the answer they gave was: "get glasses"
           

          zeloc

          Senior Member
          15+ Year Member
          Aug 22, 2003
          406
          28
          1. Attending Physician
            One of my friends who is now an M2 student had to get glasses for the first time after M1 year. He'd had 20/20 vision up until medical school. Seems to me excellent proof that nearsightedness is caused by excessive reading, especially since this is after the formative period of the eyes. I know another M1 who's having the same problem. My optometrist's vision also deteriorated while she was in optometry school, and since she knew I was going into medicine, she told me to take a break after every 1 hour of reading and gaze at some distant object. This keeps the eyes' focusing ability in good shape and should prevent the eyes from getting worse.
             

            zeloc

            Senior Member
            15+ Year Member
            Aug 22, 2003
            406
            28
            1. Attending Physician
              danwsu said:
              I noticed that my vision got alot better when I went home for winter break. I could see alot farther and didn't have to wear my glasses as often.

              Discobolus said:
              I was even going to get an optometrist appointment during the Christmas break, but noticed during the break that my vision got a lot better. I haven't gone to class much this semester (or studied much for that matter), and my eyes seem to be doing a lot better.

              Maybe getting glasses right away isn't the best idea.
               
              About the Ads

              Careofme

              Senior Member
              10+ Year Member
              15+ Year Member
              Jan 11, 2002
              261
              1
              41
              Planet Earth
              1. Medical Student
                Funny thing...exact same thing happened to me. I've always had perfect 20/20 vision...all through undergrad and grad school - no problems. However, during my second year I started noticing that I had to beging squinting to see the powerpoints clearly, I couldnt see long distances, and even reading signs while driving became quite a task. For many months I just thought it was stress so I squinted - finally I gave in and got glasses...unfortunately, my second year was jsut about over and didnt really need my farsightedness any longer....

                Long story short: my vision deteriorated due to the mandatory lecture hours (damn administration and their rules), it never got better, I got fed up with my glasses, switched to contacts and have lived happily every after (but with poor vision). :laugh:

                care
                 

                Joel Fleischman

                Senior Member
                10+ Year Member
                7+ Year Member
                Feb 2, 2005
                138
                1
                In the OR, or seeing a consult (more likely)
                1. Resident [Any Field]
                  Between MSI and MSII I had to get a much stronger perscription.
                  My eye doc told me to put in saline eye drops every night. According to him, as you strain your eyes you will progressively tear more, and your tears will become saltier ( I guess I am supposed to say Hypertonic or something like that now) ....
                  I've been using visine... not sure if my eyes are any better but they feel better.
                  Anyone have alternatives to Advil/Tylenol to the chronic headache I've had since Path/Pharm started?
                   

                  Ypo.

                  Full Member
                  10+ Year Member
                  7+ Year Member
                  Jul 17, 2004
                  7,250
                  6
                    SarahGM said:
                    Funny, you are like the THIRD person to tell me this today!

                    Point taken. :)

                    Sorry, I can't resist...It could have something to do with the tiny font size of your quote. I'm serious! If you can read that, you aren't having vision troubles! :thumbup: :laugh:
                     

                    SarahGM

                    Senior Member
                    7+ Year Member
                    15+ Year Member
                    Jul 20, 2003
                    863
                    1
                    41
                    upper upper UPPER west side
                      yposhelley said:
                      Sorry, I can't resist...It could have something to do with the tiny font size of your quote. I'm serious! If you can read that, you aren't having vision troubles! :thumbup: :laugh:

                      LOL. I actually made it so small because otherwise, it takes up a whole page! I just like it a lot :)

                      So anyway... to all those who are in the land of vision correction... help a girl out! After finally figuring out that I should see an optometrist and NOT an opthalmologist, what should I expect when I make my way downtown to Lens Crafters? A vision test and then a prescription? How much do things cost? What are the relative costs of contacts vs glasses? What do you prefer -- and does it depend on how much you need to wear vision correction? Do you need both -- ie, usually wear contacts but have glasses for things like at night after your contacts are taken out, anatomy lab, etc? What are the relative costs? Ack, so many questions, sorry! I haven't had my eyes checked in probably 15 years!
                       
                      Aug 17, 2002
                      2,283
                      576
                      Christchurch, NZ
                      emlitofnote.com
                      1. Attending Physician
                        Needed glasses for the first time midway through MS I; failed the vision test transferring my driver's license with one bad eye....

                        Never wear 'em, except when in lecture (who goes to lecture?), driving somewhere unfamiliar at night, and when playing Xbox games. It's fun to have supermegaultravision on occasion.
                         

                        TruckGirl

                        Member
                        10+ Year Member
                        7+ Year Member
                        Feb 3, 2005
                        38
                        0
                        1. Resident [Any Field]
                          I've been wearing glasses since I was 9 years old (I'm now 22). Every 2 years or so, my vision would go down by -0.5 or something like that and I'd get a stronger lens.

                          Now I'm nearly finished with M3 and my vision is -6.00 (sorry if I'm using the European grading system). I noticed that in the first couple of years of med school where most classes were lectures, I couldn't focus very well on the text even though I had my lens updated. It happens if you strain your eyes too much.

                          I used to wear compressed lens glasses until about a year ago, when I switched to contact lenses. I use the Bausch & Lomb PureVision lenses, because they've got more pores in them and allow me to wear them overnight. That means that I can have them on for a whole month without ever taking them off if I don't want to. I prefer the overnight kind because I'm not bothered to be wearing lenses every morning when I've hardly had any sleep. Prices vary depending on where you are in the world. In Europe it costs around 150 euro for 3 months supply, in the Middle East the same product costs 80 euro for 3 months supply. Other kinds of lenses would cost less since they're not overnight. The Johnson & Johnson Acuvue brand is quite good.

                          The cost for glasses increases if you want to have the lens compressed (if it's too thick), if you want it to be anti-reflective, or if you want a designer frame. If you're not using glasses much and won't be keeping them on all the time, then I don't recommend you spend too much on them. The problem with glasses though is that you'd also have to have your sunglasses' lens changed into a medical one. With contacts, you won't go through that trouble, and contacts make you look better (no matter what people say about you looking good in glasses, you'd always look way better without them).

                          I rarely wear my glasses, except sometimes at home so that my eyes can relax from contacts, but sometimes when I have oral exams I might wear glasses on purpose because they make me look very clever and the examiners also feel that I'm a studious person.
                           

                          Neuronix

                          Total nerd
                          Staff member
                          Administrator
                          Volunteer Staff
                          Verified Expert
                          15+ Year Member
                          Mar 14, 2002
                          14,291
                          6,182
                          the beach
                          1. Attending Physician
                            In my opinion, you SHOULD see an ophthomologist. They will examine your eyes with a dilated slit lamp exam to make sure there's nothing pathologic going on with your retina or other parts of your eyes that could be affecting your vision. Optometrists miss that stuff all the time, so if you haven't had an eye exam in a really long time, I would recommend an Ophtho. There's actually three spurts in incidence of myopia (nearsightedness). First in young children (me), then in teens around puberty, and then in young adults in the early 20s. So for all of you needing glasses when starting med school, this is normal and physiologic. There are however other things that can cause vision reduction in an early 20-something, so again I recommend an ophthomologist.

                            Can you tell I'm coming off Ophthomology rotation? :) As for me, I could never tolerate contacts, so I've been wearing glasses since age 8. Glasses should cost $100 - $200 with a coupon (Lens Crafters sends these out all the time). Depending on your prescription, light weight lenses can be nice, but don't spend the money on like "ultra light weights", as the last time I looked they offer very minimal weight and size reductions for more money. With prescription sunglasses, refuse glare protection. I've had both kinds and I've never had probs with glare on regular prescription sunglasses AND the polarized lenses aren't as dark so people can still see your eyes (a style thing). I dunno how much a visit to an Ophtho costs these days.

                            As for Lasik, it's not to be considered until your prescription is stable for a few years. Otherwise, you may end up with glasses again or another surgery. Also, if your nearsightedness is under about -2, when you do become presbyopic in old age you'll probably be able to read and see your computer screen without reading glasses, so it could actually be a good thing. Everyone will need those sorts of glasses eventually as the lens stops accomodating, so Lasik doesn't make you eyeglass free forever...
                             

                            SarahGM

                            Senior Member
                            7+ Year Member
                            15+ Year Member
                            Jul 20, 2003
                            863
                            1
                            41
                            upper upper UPPER west side
                              Neuronix said:
                              In my opinion, you SHOULD see an ophthomologist. They will examine your eyes with a dilated slit lamp exam to make sure there's nothing pathologic going on with your retina or other parts of your eyes that could be affecting your vision. Optometrists miss that stuff all the time, so if you haven't had an eye exam in a really long time, I would recommend an Ophtho. There's actually three spurts in incidence of myopia (nearsightedness). First in young children (me), then in teens around puberty, and then in young adults in the early 20s. So for all of you needing glasses when starting med school, this is normal and physiologic. There are however other things that can cause vision reduction in an early 20-something, so again I recommend an ophthomologist.

                              Can you tell I'm coming off Ophthomology rotation? :) As for me, I could never tolerate contacts, so I've been wearing glasses since age 8. Glasses should cost $100 - $200 with a coupon (Lens Crafters sends these out all the time). Depending on your prescription, light weight lenses can be nice, but don't spend the money on like "ultra light weights", as the last time I looked they offer very minimal weight and size reductions for more money. With prescription sunglasses, refuse glare protection. I've had both kinds and I've never had probs with glare on regular prescription sunglasses AND the polarized lenses aren't as dark so people can still see your eyes (a style thing). I dunno how much a visit to an Ophtho costs these days.

                              As for Lasik, it's not to be considered until your prescription is stable for a few years. Otherwise, you may end up with glasses again or another surgery. Also, if your nearsightedness is under about -2, when you do become presbyopic in old age you'll probably be able to read and see your computer screen without reading glasses, so it could actually be a good thing. Everyone will need those sorts of glasses eventually as the lens stops accomodating, so Lasik doesn't make you eyeglass free forever...


                              Thank you thank you! The thing is, I think I have *some* coverage for opthalmologists in my student insurance plan. Maybe I'll call the doctor and ask if he/she thinks I need to come in.
                               

                              zeloc

                              Senior Member
                              15+ Year Member
                              Aug 22, 2003
                              406
                              28
                              1. Attending Physician
                                Neuronix said:
                                There's actually three spurts in incidence of myopia (nearsightedness). First in young children (me), then in teens around puberty, and then in young adults in the early 20s. So for all of you needing glasses when starting med school, this is normal and physiologic. There are however other things that can cause vision reduction in an early 20-something, so again I recommend an ophthomologist.

                                Needing glasses when starting med school is certainly not normal and physiologic. Myopia only occurs when there has been some strain on the eyes. There are indeed three spurts in the incidence of myopia, but these are effects, not causes. It is a good idea to see an ophthalmologist. They have so much more experience than optometrists, and it's hard to believe how good some of the great ophthalmolgists are.
                                 

                                Neuronix

                                Total nerd
                                Staff member
                                Administrator
                                Volunteer Staff
                                Verified Expert
                                15+ Year Member
                                Mar 14, 2002
                                14,291
                                6,182
                                the beach
                                1. Attending Physician
                                  zeloc said:
                                  Myopia only occurs when there has been some strain on the eyes.

                                  Like reading SDN for several hours a day? :laugh: Our eyes go through strain to focus all the time. In all kinds of jobs you spend lots of time reading, staring at computer monitors, etc... Who in our society doesn't "strain" their eyes? I'm sure you can come up with examples, but I think you get my point.

                                  Interestingly, the rates of myopia for illiterate societies is very very low. It's been shown that when another society comes in and makes them literate, the rates of myopia go to the same level as ours. END READING NOW!
                                   

                                  Paws

                                  Full Member
                                  7+ Year Member
                                  15+ Year Member
                                  Jun 3, 2003
                                  1,096
                                  8
                                    Hey Sarah,

                                    Head on down to Orchard Street (and get some nice kosher nosh while you're there :) ) and see Sol Moscot. 87 Orchard Street, and the eye exam is FREE and the glasses are pretty reasonably priced. Well, dang cheap really. They're also on 14th street but hey, then no snacks from Katz's deli. A quick switch to the F train (I think) should set you about 1/2 block away from Orchard Street (second avenue).

                                    If you go to Orchard Street, the optho doing the exam went to Columbia about 50 years ago so ask him about it. :thumbup:
                                     

                                    zeloc

                                    Senior Member
                                    15+ Year Member
                                    Aug 22, 2003
                                    406
                                    28
                                    1. Attending Physician
                                      Neuronix said:
                                      Like reading SDN for several hours a day? :laugh: Our eyes go through strain to focus all the time. In all kinds of jobs you spend lots of time reading, staring at computer monitors, etc... Who in our society doesn't "strain" their eyes? I'm sure you can come up with examples, but I think you get my point.

                                      Interestingly, the rates of myopia for illiterate societies is very very low. It's been shown that when another society comes in and makes them literate, the rates of myopia go to the same level as ours. END READING NOW!

                                      I think you'll agree that there are people who go through medical school that have good vision, and although we have a literate society, there are plenty of people who do not need glasses. People strain their eyes to varying degrees while partaking in the same activities. Try observing people you know who do not wear contacts (ie have 20/20 vision). You might notice some different habits, eg, they blink more frequently, take breaks while using SDN to gaze around the room before continuing, etc. Perhaps I should have said excessive strain, but what might be excessive to one person might not affect someone else as much.
                                       
                                      About the Ads
                                      This thread is more than 16 years old.

                                      Your message may be considered spam for the following reasons:

                                      1. Your new thread title is very short, and likely is unhelpful.
                                      2. Your reply is very short and likely does not add anything to the thread.
                                      3. Your reply is very long and likely does not add anything to the thread.
                                      4. It is very likely that it does not need any further discussion and thus bumping it serves no purpose.
                                      5. Your message is mostly quotes or spoilers.
                                      6. Your reply has occurred very quickly after a previous reply and likely does not add anything to the thread.
                                      7. This thread is locked.