Atropine questions
acem...@yahoo.com
If atropine is tried, wont it blur my vision so my BCVA is 20/100? How
will I get an accurate cycloplegic refraction if the best lenses is
still blurry and I cant tell the difference between small increments of
half diopter when "one or two is better" Also is it true atropine's
effects last a week? I want to get this out of the way because my
manifast pescription is too strong for seeing clear from near and
someone said I may have significent tonic accomodation rather than
presbyopia.
Dr. Leukoma
People undergo cycloplegic refractions all the time. Ironically, a
cycloplegic can sometimes improve the ability to discriminate between
two lenses if it eliminates the accommodative fluctuations. Atropine's
effects last several days. Maybe cyclopentolate can do the job, and
recovery is quicker.
DrG
acem...@yahoo.com
I had cyclopentolate which reduced my myopia by just half a diopter but
I noticed I still had some accomodation so I feel it was incomplete. My
BCVA did not decrease. I understand it may improve discimination
because youd be able to tell if your overminused. However if atropine
blurs your BCVA to around 20/100 you may not be able to discrimiate
well with all that blur. Or am I missing something? I want to try it if
it is useful for uncovering all my tonic accomodation and it may help
releave some of it too.
retinula
acem...@yahoo.com wrote:
> I suspect I have some tonic accomodation, probably 1.5 diopters of it.
> If atropine is tried, wont it blur my vision so my BCVA is 20/100?
why do you think that? if you are properly refracted you should reach
your maximal acuity while cyclopleged-- probably 20/20 or better. the
lenses that are required to achieve that acuity will represent your
true myopia (=anatomical myopia) without any tonic accommodation. it
will represent the lowest prescription you would be able to achieve by
using any of your NVI relaxation schemes.
> Also is it true atropine's
> effects last a week?
no
> I want to get this out of the way because my
> manifast pescription is too strong for seeing clear from near and
> someone said I may have significent tonic accomodation rather than
> presbyopia.
people have been telling you that for ages. are you finally catching
on? no one your age is presbyopic. perhaps you're finally getting it.
Mike Tyner
<acem...@yahoo.com> wrote
> because youd be able to tell if your overminused. However if atropine
> blurs your BCVA to around 20/100 you may not be able to discrimiate
> well with all that blur.
Why would atropine blur your BCVA to 20/100? I've never seen it do that.
It should be that different from cyclopentolate. They both enlarge the pupil
to a comparable degree.
-MT
acem...@yahoo.com
Thanks for your reply. Ive been thinking why atropine blurs vision and
maybe its because when its used in the dormant better eye in young
children with amblyopia, they lose their accomodation in that eye and
experience hyperopic blur. Their nondormant eye now becomes the better
eye and gets exercised, thereby hopefully correcting amblyopia.
Atropine would NOT work in myopic amblyopic children. Whoever said
atropine blurs must have meant only if you are hyperopic because you
can no longer accomodate around it.
Does atropine always result in a complete cycloplegia? I may need like
a week of atropine treatment to really be sure I unlock all my tonic
accomodation. How long does atropine last? Ive read it lasts a week on
average. If I cant see well from near with -4.5 glasses, I could have
significent tonic accomodation and if I dont, what other explanation is
there?
acem...@yahoo.com
http://www.tfn.net/~kate901/amblyopia/atropine.htm
more proof:
atropine is used to blur vision in the non-amblyopic eye and offers a
useful alternative to traditional occlusion therapy with patching,
especially in older children who are not compliant with patching.
Drops Do as Well as Patches for 'Lazy Eye'
Atropine drops given once a day to treat amblyopia, or lazy eye, the
most common cause of visual impairment in children, work as well as the
standard treatment of patching one eye, according to the March issue of
Archives of Ophthalmology. Amblyopia is a condition in which an
otherwise healthy eye has poor vision because the brain has learned to
favor the other eye. Most eye care professionals treat the condition by
putting a patch over the unaffected eye, thereby forcing the child to
use the weak eye. Atropine drops blur the vision in the unaffected eye,
and parents say it is easier than requiring a young child to wear an
eye patch.
Are they wrong? I looked it up and they say atropine blurs your vision!
Mike Tyner
"Mike Tyner" <mty...@mindspring.com> wrote
> It should be that different from cyclopentolate.
I shoulda said "should NOT be".
The blur, for a myope, comes from wide pupils causing huge increases in
aberration, mostly spherical IIRC.
The pupils are a little wider with atropine, but not "20/100" worth. Total
aniridia wouldn't cause that, by itself.
If you use atropine once or twice a day for a week, it will take several
days, maybe a week, to fully recover your accommodation. Why are you working
so hard?
Since you first began posting, we've been telling you your problem is
basically excess accommodation. It isn't making anything worse because your
prescription is decreasing, not increasing. It will take care of itself.
After age 48 you'll probably be rock solid at -200, just where you'd want to
be for reading.
If you want to "train away" the excess accommodation, stare at small print
just beyond your farpoint and learn to control your accommodation.
Relaxation would be bery, bery goood, too yoo.
Knowing your absolute refractive measurements under total cycloplegia
doesn't change anything, except it might tell you when to stop your training
(ie when you reach the normal 050 difference between dry and wet
refractions.)
You could occupy yourself for hours staring at just-blurry print. It would
help some, but your accommodation is going to relax eventually, whether you
fiddle with it or not.
So you could just forget about it. Get glasses or contacts for driving with
minimum tolerable minus and if that's blurry at near, get drugstore plus. Or
skip contacts - get PALs, or a second pair for reading. And get on with your
life. Whatever that's worth.
-MT
Mike Tyner
<acem...@yahoo.com> wrote
> http://www.tfn.net/~kate901/amblyopia/atropine.htm
>
> more proof:
No, one mother's understanding. Technically, what she calls "CV" is only
"CV" if the child wears a +250 add in the atropinized eye.
This is one of the benefits of atropine patching, for children who already
wear glasses. The atropinized eye remains mercifully clear at distance, and
functional for school.
It's the difference in NEAR VISION that challenges the "bad" eye in that
circumstance. So mother Kate was saying that the blur in NEAR vision can't
be made more than about 20/100.
You are quite right that there are situations where atropine simply wouldn't
work. If the atropine eye was -250, they'd _have_ to wear glasses or it
wouldn't do anything.
Full atropine dilation only reduces Snellen acuity by a line or two.
Remember there's still a large percentage of the cornea and lens that have
no aberration. As a result, the blur of dilation isn't debilitating blur
like out-of-focus. It's a clear image surrounded by haze, blacks are
slightly grayer and whites are slightly grayer but the image is still there.
And the IRIS isn't the only thing that frames your pupil. Slit your lids and
you're 20/15 for vertical lines.
> Are they wrong? I looked it up and they say atropine blurs your vision!
Not 20/100. 20/25.
-MT
acem...@yahoo.com
several
days, maybe a week, to fully recover your accommodation. Why are you
working
so hard?"
sometimes tonic accomodation is stubborn and may take repeated use of
atropine to yield it all away. One guy mentioned he had 3 diopters of
it and it took 4 days of repeat atropine to unlock it all.
"Since you first began posting, we've been telling you your problem is
basically excess accommodation. It isn't making anything worse because
your
prescription is decreasing, not increasing. It will take care of
itself.
After age 48 you'll probably be rock solid at -200, just where you'd
want to
be for reading."
-2, not -200 lol! I cant even imagine -200 diopters, just not possible
*eek!* Well have to see how much tonic accomodation I have. My eye
exercises reduced it by a diopter or so but I still have more. I am not
gonna wait till im old, I want to do something asap because my
accomodative amplitude is reduced due to some of it "locked" and also I
just dont want such blurry distance vision.
"If you want to "train away" the excess accommodation, stare at small
print
just beyond your farpoint and learn to control your accommodation.
Relaxation would be bery, bery goood, too yoo."
I have been doing just that, its what one lady did to improve by 1.25
diopers. Atropine will let me know how much more I have to go.
"You could occupy yourself for hours staring at just-blurry print. It
would
help some, but your accommodation is going to relax eventually, whether
you
fiddle with it or not."
again, I am not gonna be more myopic than I really am. I also want to
free up accomodation.
"This is one of the benefits of atropine patching, for children who
already
wear glasses. The atropinized eye remains mercifully clear at distance,
and
functional for school."
I guess he must have been a (latent) hyperope because the 20/100 was
for distance. no matter, once the amblyopia is cured, atropine can be
discountinued and normal vision restored shortly.
"As a result, the blur of dilation isn't debilitating blur
like out-of-focus. It's a clear image surrounded by haze, blacks are
slightly grayer and whites are slightly grayer but the image is still
there."
also known as loss of contrast. my pupils dilate naturally so they
would barely get bigger with atropine but they wont shrink in light so
ill need sunglasses or stay away from bright lights.
"Slit your lids and
you're 20/15 for vertical lines"
if your retina is capable and if you dont have lots of aberrations in
the center of your cornea.
"Not 20/100. 20/25."
I already cant correct to 20/20 so I guess I wont experience additional
distance blur with atropine unless I happen to be hyperopic which is
highly unlikley with my manifast -4.5 probably my cycloplegic would be
like -3 or so but the lower, the better and perhaps once the atropine
wears off, not all my tonic accomodation will return
retinula
> maybe its because when its used in the dormant better eye in young
> children with amblyopia, they lose their accomodation in that eye and
> experience hyperopic blur. Their nondormant eye now becomes the better
> eye and gets exercised, thereby hopefully correcting amblyopia.
not sure what you mean here.
anyway, atropine blurs hyperopes because they can't accommodate and
clear their vision. its blurs more for higher hyperopes of course.
but atropine also blurs anyone because of the profound dilation it
causes.
> Atropine would NOT work in myopic amblyopic children.
they are also blurred due to dilation. and of course they can only see
at distance with the proper eyeglass Rx on and they can only see at
near at a working distance equal to their true myopic state.
> Whoever said
> atropine blurs must have meant only if you are hyperopic because you
> can no longer accomodate around it.
you are right in that atropine blurs hyperopes more but it also causes
significant visual blur in myopes.
> Does atropine always result in a complete cycloplegia? I may need like
> a week of atropine treatment to really be sure I unlock all my tonic
> accomodation. How long does atropine last? Ive read it lasts a week on
> average.
there is a lot of variability in peoples response to atropine.
mydriasis (=dilation) lasts much longer than the cycloplegia
(=paraplysis of accommodation) so the complete effects of atropine may
take 1-2 weeks to wear off because the dilation is slow to go away
completely. in cases of profound ciliary spasm atropine can be given
up to twice daily for multiple days. one drop may not completely relax
accommodation especially in children. its effects in adults is usually
more complete.
using atropine is not fun.
acem...@yahoo.com
> anyway, atropine blurs hyperopes because they can't accommodate and
> clear their vision. its blurs more for higher hyperopes of course.
> but atropine also blurs anyone because of the profound dilation it
> causes.
Thats what I was thinking. For latent hyperopes, they will experience
worse uncorrected vision. For pseudomyopes, their uncorrected vision
will improve
> you are right in that atropine blurs hyperopes more but it also causes
> significant visual blur in myopes.
Should I expect the blur of atropine to be equal to cyclopentolate? My
BCVA with glasses wasnt really effected and my uncorrected vision was
about the same indoors, its outside in bright light that everything was
all washed out and looked like a watercolor because my pupils were
huge. Normally they shrink, resulting in a pinhole effect and giving
much improved visual accuracy. This is also why eye exams should be
done in a dimly lit room with an illuminated eyechart.
> there is a lot of variability in peoples response to atropine.
> mydriasis (=dilation) lasts much longer than the cycloplegia
> (=paraplysis of accommodation) so the complete effects of atropine may
> take 1-2 weeks to wear off because the dilation is slow to go away
> completely. in cases of profound ciliary spasm atropine can be given
> up to twice daily for multiple days. one drop may not completely relax
> accommodation especially in children. its effects in adults is usually
> more complete.
How long does cyclopegia last? I want to make sure I get to the
optometrist or ophthamologist asap after inserting drops of atropine. I
may need 5 to 7 days for a complete cyclopelgic. I had cyclogyl before
and only got a drop and only one season and I could tell it was
incomplete as I could still accomodate but not as well.
> using atropine is not fun.
But its educational and important for me to know my true myopia. Would
I stand correct in saying ill experience the same blur and dilation as
cyclogyl except a longer duration and complete cycloplegia.
acem...@yahoo.com
very soon with an opthamologist for atropine to see how much
pseudomyopia, tonic accomodation I have
serebel
Like a good obsessive nut, yes, waste a doctor's time.
acem...@yahoo.com
He doesnt care as hes getting paid. Besides my complaint is legitimate.
My accomodation is nowhere near normal for a person in his mid 20s.
Some of the optometrists here have been telling me I have accomodative
excess, tonic accomodation, pseudomyopia. The fact my vision improved
in the last 18 months due to eye exercises and wearing weaker minus is
proof I have tonic accomodation. I feel I may have quite a bit left
still. I may even get vision theraphy to much more rapidly eliminate
the rest of my tonic accomodation. Ive been told my true structual or
axial myopia could be -3 or even -2 based on the info ive given out.
read this thread
otis...@pa.net
Dear AceMan,
Subject: Work for true-prevention.
If you had put this much effort into it -- when your Snellen was
20/60 (about -1.25 diopters) -- I believe you would have cleared
to pass the DMV -- in about 4 months -- as others have done.
No one, repeat no one, wants you to get stair-case myoipia
from an over-prescribed minus. But often the OD has NO CHOICE
because the person concerned with it -- WILL REFUSE THE
USE OF A STRONG PLUS FOR PREVENTION.
But that becomes "our fault" if we are offered plus-prevention (as
the second-opinion) and turn it down cold -- in favor of that
impressive minus lens.
But maybe, the next generation (your children) will lean
from the struggle you are going though with this work.
That is a true "learning process".
Best of luck,
Otis
acem...@yahoo.com
hope my cycloplegic refraction is low! I am also looking to get soft
contact lens orthoK to further reduce my myopia. I will be very happy
if I get down to -2 then I can see the computer monitor without
glasses. I wont need glasses for most things.
otis...@pa.net
Good luck, AceMan!
Otis
BD
acem...@yahoo.com
Whatever improvements I get, I am getting soft contact lens orthoK to
further improve my vision. I expect a reduction of -1 to -1.5 diopters,
maybe even -2 if I get really lucky. RGP orthoK can improve from more
than twice to three times as much but its much more expensive. I see no
reason to first try soft contact orthoK for a tiny fraction of the cost
to see how well it works for me. I can always "upgrade" to RGP orthoK
when and if I feel like it and have the money. Hopefully atropine,
natural vision improvement and orthoK get me to the point I dont need
glasses for the computer and if I get there, I wont need glasses much
at all! I would need to get down to -2 for that to be possible.
acem...@yahoo.com
clinic. The tech/assisant first measured me "objectivately" with
autorefractor then a peripheral vision test. He then refracted me with
a phoropter, first with my distance glasses then with phoropter using
different lenses. My distance glasses were -4.5(left) -4(right) and I
looked at the mirror which had snellen letters projected from behind
and bounced off another mirror. The tech said I was 20/25 in this eye
and 20/30 in that eye. I thought to myself "strange" as those glasses
undercorrected me by half diopter and that 20/25 and 20/30 was my BCVA
with *full* power glasses. Maybe my vision improved. The tech then took
out a small bottle of tropicamide. I was like wait, am I getting
atropine? He said the optometrist said no. I got tropicamide instead.
The female(tall blond nice looking) optometrist refracted me to confirm
the tech's results. BCVA was 20/20(left) 20/25(right) which I thought
was impossible. I got every single of the 4 letters right on the 20/20
line!
That eyechart must not be calibrated right and not the approperate
distance. My BCVA is 20/25 and 20/30 in a proper 20 feet eyechart which
this one wasnt. There is an ophthalmologist and lasik surgeon in that
clinic. Now I see why so many people get "20/20" they are only "20/20"
on their eyechart, but on a proper eyechart, they arent.
Not only did I see 100% 4 out of 4 of the 20/20 line, that was with
minification of -5 lens! Youd need some special eyes to see better than
20/20 or 20/20 with lots of minus which makes everything smaller and
further away.
She then inserted strange yellow eyedrops to numb my eyes then give me
a glucoma or eye pressure test. I felt nothing. She also looked into my
dilated pupils which tropicamide a few minutes ago caused. My retina is
fine, my eye is perfectly healthy. I just have plain old myopia and she
didnt believe I had pseudomyopia. Only a few children do and they get
atropine for months, sometimes even years, she said. I did not need
atropine, she said. I thought to myself theres no way im bothering with
something(atropine) that takes months when I can improve my vision
naturally, and do away with whatever little pseudomyopia I had left. I
did ask her why are things a little blurry from near with my distance
glasses and that I see much clearer and closer without. She said its
normal because you have to accomodate and thats a strain. You can and
should take your glasses off to read if nearsighted. Thats what I do
already, glasses are worse than useless for near.
The optometrist then handed me my autorefraction results and
prescription papers. I questioned the accuracy of the autorefractor, it
gave me different results and overcorrected me. The prescription papers
said -5.00 +.50 x90(right) -5.50 +.50 x85(left) which is confusing and
should be written as -4.50 -.50 x180(right) -5.00 -.50 x175(left) I
question the astigmatism in the right as the astigmatic wheel shows it
to be oblique but my topographies I got 2 years ago show asymetric
irregular astigmatism in that right eye. It cant be corrected with
todays technology and is costing me a line of BCVA. As far as regular
astigmatism goes, the amount I have is neglecable and accounts for only
a -.25 spherical equivalent. Therefore my S.E is -5.25 and -4.75 which
is a -.25 diopter overcorrection. When two lenses were shown that
appeared the same, the lower power should have been given. I got the
-.25 higher one. Another indicator of overcorrection is I measured
20/25 and 20/30 with my -4.5 and -4 glasses, yet they give me -.75
diopters more minus for 20/20 and 20/25! Doing the nearpoint measure, I
achieve 21cm which corresponds to -4.75! My -5 and -4.5 glasses I have
correct me fully and the -4.5 and -4 undercorrect me by half diopter,
costing me just a single line.
So it looks like I will keep on doing NVI to improve a little further
and will be getting soft contact lens orthoK to chop off another 1 to
1.5 diopters off. The orthoK is instant gratification, the NVI will
take some time for gradual improvements. My UCVA will greatly improve,
ill be alot less "blind" without glasses and ill be able to read from a
comfortable distance instead of so close. Once I get the soft contact
orthoK, I will let you know how it goes and how much improvement I get!
Dr. Leukoma
some confidence that the reporting is objective. Unfortunately, it is
permeated with your own biases and editorial comments and has no
utility whatsoever. In fact, you very well might have made up the
entire incident.
DrG
serebel
Dr. Leukoma wrote:
> Ace, in order for your narrative to have any meaning, we need to have
> some confidence that the reporting is objective. Unfortunately, it is
> permeated with your own biases and editorial comments and has no
> utility whatsoever. In fact, you very well might have made up the
> entire incident.
>
> DrG
>
>
The retard does make things up as he goes along. I like the "eyechart
wasn't calibrated right".
acem...@yahoo.com
I speak for others when they were told they had "20/20" vision when
tested in a clinic that does lasik or is affiliated with lasik. The
clinic I went to has a lasik surgeon and there was pictures of 100+
people who had lasik on the wall in the waiting room. People also go
there for eye exams and to assert the health of the eye. Those guys who
were told they had "20/20" admit the testing was faulty and too
generous and consider themselves closer to 20/30. It explains why so
many people are told they have 20/20 and in some cases, 20/15 after
lasik. If they were tested on a proper eyechart, they would be a line
to a line and a half worse. There is an optometrist here who claims
half the people he tests are 20/15. I pointed out his eyechart isnt the
proper distance and those 20/15 guys would be 20/20 on a correctly
distanced eyechart. Every correctly distanced eyechart has put me at
20/25 to 20/25- BCVA except this one which I passed 4 out of 4 on the
20/20 line. I know the truth now, had my suspicious but they have been
confirmed. Thats lasik "20/20" for ya which isnt as good as real 20/20
in quantity, acuity and quality. I dont correct to 20/20 because my
glasses minify and make that line too small and also because my eyes
are quite myopic as well as having high order aberrations. Alot of
people actually fall closer to 20/25 BCVA, 20/20 BCVA is above average
and 20/15 BCVA is outstanding and uncommon.
Ann
I can read every letter on the chart with corrected myopia of -6.5 and
some astigmatism. And that's using a chart at the hospital set the
proper distance without using mirrors. So maybe the chart isn't
wrong. Maybe your ideas are wrong instead.
Ann
acem...@yahoo.com
Ann wrote:
> I can read every letter on the chart with corrected myopia of -6.5 and
> some astigmatism. And that's using a chart at the hospital set the
> proper distance without using mirrors. So maybe the chart isn't
> wrong. Maybe your ideas are wrong instead.
>
> Ann
If you still see all of 20/20 with your prescription glasses then you
be (halfway)between 20/20 and 20/15 with soft contacts and possibily
20/15 with proper RGP contacts. Have you looked at other eyecharts for
consistity? I have seen dozens of eyecharts and this is the only
eyechart where I was able to see all of the 20/20 line. Not only that,
but I read 20/25 with my slightly weaker glasses when on other
eyecharts I can only read 20/30 to 20/40. If this is the type of 20/20
people get after lasik, its lasik "20/20" and would be 20/25 to 20/30
in reality and may be worse in real world. I know a bunch of "20/20"
lasik patients passing that line in an improperly distanced mirror
eyechart, they would be no better than 20/25 in a proper eyechart and
in the real world they are like 20/40, they cant see license plates nor
street signs from anywhere near the distance they could with glasses
before lasik!