monovision, contacts: feedback and ?s

[rpre...@email.usps.gov]

I'll be 50 next Sept. My contact rx is (-1.50, -1.75). I have some
astigmatism in one eye but I forget which one or how bad it is; it's
not so bad though that my optometrist has corrected for it.

Fully corrected for distance it's almost (but not quite) impossible to
read with the text source held out from the eyes. In the last year
I've found myself taking off my glasses for comfortable near reading.
I had wanted to have my vision corrected with Intacs, but based on
others' experience I educated myself on presbyopia and decided I didn't
necessarily want to have a surgical correction and have to wear reading
glasses.

So to simulate a surgical monovision correction I've been experimenting
with contact lenses for the last two months. [I used to use extended
wear lenses in my early 30s but stopped after I got married ):]
Although the pinhole test says I'm right-eye dominant, the monovision
adjustment that *seems* to work best is (-1.5, -1.25). (Another thread
referred to this as mini-monovision.) The only workable alternative
I've found to this is (-1.00, -1.75), but I just seem to like the other
setting better. By "like" I mean reading is easier and more prone to
my not being conscious of it and distance vision is good to very good
with vision in the intermediate zone very good. I did not like more
extreme monovision settings. The greater the absolute difference
between the diopters the more the refractive blur even while reading.

I'm now leaning towards skipping surgery and wearing contacts again. I
hate the way I look in glasses and contacts address that. If, with
contacts, I can have good distance vision and still be able to read I
think I'd be happy.

However, (there's always a bug), the last week or so I've noticed that
when I'm reading the focus will blur. I can restore focus with drops
or an eye blink so I think this may be related to dryness, but
sometimes it happens after drops.

My questions are:

1. Why has the near vision degraded recently? Are my eyes adjusting
in a contrary fashion? Are the Accuvue disposables I'm wearing not
fitting properly? Is it dryness? If so, is there a better contact
lens for me?

2. I experience blur and strain when I shift focus from near to far
repeatedly such as when I'm checking data entries between a file image
on the computer terminal and a piece of hard copy on my desk. Is this
damaging? Can I prevent it?

3. If I eschew surgery can I switch back and forth between full
distance correction and monovision with contacts? For instance, if I
was playing a sport I could correct the right eye for distance and
after the game I could put in a -1.25 lens for all purpose vision. Or,
on the other hand, if I was spending the day sick in bed and wanted to
power read a novel I could not put any lenses in either eye. Would my
adjustment to monovision be flexible enough for this sort of strategy
or would the switching back and forth be a problem?

4. Any other comments, suggestions, etc. would be appreciated.

Thanks for your advice and best wishes,

Rick Prescott

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[JWV121]

To answer your questions in order:
1) Your eyes are getting worse for near strictly due to age, you are well
into the bifocal problem called presbyopia. Dryness could be a problem
especially this time of year. The Acuvue is a good lens. Change it
according to the schedule you were given. Use rewetting drops if necessary.
2) It seems to me that the power of the left lens is too strong, inother
words you probably need a weaker lens in that eye to avoid the strain you're
noticing. No you can't prevent it. Its do to aging of the eye.
3) Switching back & forth will cause no problems.
4) Keep the reading lens in the left eye as you are right eyed. I find this
works best in almost all cases.
J. Venuto, O.D.
<rpre...@email.usps.gov> wrote in message
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[Oooggie]

Just my personal experience. I'm also 50 and last year started needing to wear
glasses all of the time. Vanity got in the way and I saw a contact lens
specialist. We spent alot of time with trying different bifocal contact
lenses..no good. My RX is -2.75 and -1.00. After many different monovision
lenses, I've been wearing for the past 8 months -75 in each eye. This seems to
be working great for far vision and intermediate (lots of computer work). For
reading books and newspapers, I get a lot of strain, so I wear reading glasses
over my contacts. But for any other reading, I don't need anything.
Nothing is perfect, but this is a good solution.