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When Two Eyes Have Very Different Power

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When Your Two Eyes have a Large Power Difference

Do you know what’s anisometropia?

It’s when the two eyes have a difference larger than 1.50 or more. A lot of people are lucky enough to not have to know about it.
For those that do, they usually have their vision or comfort affected.
I would like to share the way for patients and some other doctors that they can help their patients better.

It’s when the two eye’s prescription is over -1.00. Usually people have symptoms of eyestrain or headaches when it’s more than 1.25 or higher with or without glasses. If the two eye differences are over -2.00, they can easily get headaches from the two eyes not balance together, when they wear glasses.

Usually these are difficult ones for an Optometrists too.

When making glasses for them, glasses for nearsighted people makes the image smaller. But if one eye is -1.00, and another eye is -7.00, than the images that reach the brain through the glasses are in two different sizes, and they would fight with each other, causing headache, eyestrains, and eye fatigue.

The best option is contact lenses and vision therapy.

The contact lens would help them minimize the two image sizes.

They would also need vision therapy to train the eye and brain to reuse the two confusing images and align better together to make one useful image.

The other option is glasses that corrects for image size difference. But both lenses would be rather thick, and no aesthetically pleasing.

Sometimes, the Optometrist might want to take the short cut, and make the one eye prescription a little bit off, so the two eyes are closer in prescription, or match the better eye, and have a smaller difference, but one eye would have the lazy eye and see a worse. (There is a right way to do it, and the wrong way to do it.)

I have a case here where one eye is -1.25, and one is -7.00, with high cylinders and 20/30 in the right eye, but 20/60 in the left eye.

He came in with this, seeing 20/30 in right eye, and 20/60 in left eye.
-1.25 -3.00 x005 +2.50
-7.00 -2.00 x161 +2.50

Here is his new RX, I corrected him to 20/25, 20/50 while reducing the cylinder.
-1.25-2.50×005 +2.00 for computer
-7.00-2.00×160 +2.00

He’s in his 60s now, she doesn’t want vision therapy. This is his best progressive lenses so far. She doesn’t have headaches, eyestrain and can read very comfortably.

I order him the lenses that corrects the prism effect when he looks off to the lower part of the lens rather than the lens center, in index 1.74. (ask me privately if you want to know which lens.)

He also ordered a second pair for reading. He’s still having trouble for the reading glasses however.

Though the reading glasses is single vision, he still looks down off the center a bit, and is still having prism effect. I may change it to a mini progressive in the design that has the prism correction.

This is the hardest part, when people look off the center to read for anisometropia. 

For a myopic lens, the images usually jumps lower than where it looks like the solid line at the B image above.  The higher the RX, the more the jump. Since the two eyes are at -1.00, and -7.00, the two eyes would end up one reading on a higher line, and one at a lower line, causing headaches, eye fatigue and jumping lines when reading. 

For younger patients, it’s very effective to have them to wear contact lenses and vision therapy. They may invest in a few months to one year of their time, but they can move ahead for 5 years in life, with reduced vision fatigue and improved performance in reading, learning and driving.

What about you? Do you have eye fatigue? What do you think is the cause? Let me know if you want me to share other eye fatigue causes and relief.

你知道什么是鸳鸯眼睛 (屈光参差)吗?

很多人很幸运,不必知道它。
对于那些有鸳鸯眼睛的人,通常他们的视力或舒适度会常年受到影响。
我想为患者和其他一些视光医生同行(Optometrist),和配镜师 (Optician)分享一下,让他们可以更好地帮助患者。

两眼如果相差-1.00(100度)或以上,就是鸳鸯眼了。
通常对于视光医生来说,这些度数也是最难搞的。
在为客人做眼镜时,近视人士戴的光学镜片会使图像变小。但是,如果一只眼睛是-1.00 (100度) ,另一只眼睛是-7.00 (700度),则通过眼镜到达大脑的图像是不同大小的。两个眼睛会打架,不会合作,合并不到一个图像,反而容易引起头痛,和眼睛疲劳。

这些患者最好的选择是隐形眼镜和视觉训练。
隐形眼镜可以帮助他们减少两个图像尺寸的差异。
这些鸳鸯眼睛人士还需要视觉训练来训练眼睛和大脑,把两个令人困惑的图像,更好合并成一个有用的图像。
另一个选项是可校正图像尺寸差异的眼镜(anisometropic lenses)。但是两个镜片都会相当厚,不好看。

有时侯,有些验光师可能希望采取捷径,把一只眼睛的处方调低一点,让两只眼睛的度数更接近,或者用两眼都用更好的一只眼睛的度数,减少差异,但是那只深度数的眼睛会看到更糟,形成懒惰眼 (调低度数有正确的方法,也有错误的方法)

我这里有一个客人的情况,一只眼睛是-1.25,一只眼睛是-7.00,右眼看到20/30,还有散光,而左眼看到20/60。

他是这样的度数的,右眼看到20/30,左眼看到20/60。
-1.25 -3.00 x005 +2.50
-7.00 -2.00 x161 +2.50

这是我给他的新度数,我在减小散光的同时帮他调到右眼看到20/25,左眼看到20/50.
-1.25-2.50×005 +2.00 用于电脑和手机的距离(55cm)
-7.00-2.00×160 +2.00

他现在已经六十多岁了,他不想进行视觉训练。(个人资料有更改,以保隐私)这是迄今为止他感觉最好的渐进镜片。他以前都不能多看书。他现在没有头痛,没有眼睛疲劳并且可以非常舒适地阅读超过一个多小时。

我给他订购了可以调正棱镜效果的渐进镜片,当他朝镜片的下部而不是镜片中心阅读/注视时,都没有图片移位。我给他配的光学片折射率为1.74。(如果您想知道哪个牌子,哪个镜片style,请私下问我。)

他还配了第二副单光的来阅读。不过,他这老花镜有点模糊。

尽管老花镜是单光的,但他仍然低着头向下看,并且仍然具有棱镜效果。这镜片公司的单光片还没有做到校正棱镜效果(其他公司的也没有)。我在想可以将其改为具有棱镜校正功能的微型渐进镜片(with lower add),方便他看电脑,看手机和书。

有兴趣学习的小伙伴,可以看这图,

当人们把视线从镜片中心移下,两眼镜片度数差别大就很不舒服,这是光学界最难矫正的部分。(白内障还能做手术)。

近视镜的话,图像通常跳到上面B图像的实线的位置,和直的那条线有差别。度数越高,跳跃越多。由于患者两只眼睛分别是-1.00和-7.00,因此两只眼睛最终会一边看的高一点,另一边看的低一点, 而在阅读时导致头痛,眼睛疲劳和看到字在跳行。

对于年轻的鸳鸯眼睛患者,戴隐形眼镜和视觉训练非常有效。他们可能要花几个月到一年的时间进行训练,但是他们可以省下生活5年的工作时间,减少视力疲劳,并提高阅读,学习,工作和驾驶性能。

如果到40岁还没矫正好,那时候老花了,会看的很辛苦。鸳鸯眼睛的人找个好的视光医生,和每年检查很有帮助,会减少很多开车和看书的眼睛疲劳。

你呢?你的眼镜疲劳吗?你觉得是什么原因?如果想看到更多眼睛疲劳的原因和缓解方法,请留言。

她诊所的服务包括:

  • Orthok for myopia control, OK镜和多种控制近视方法
  • Eye Fatigue Treatment, 治疗眼睛疲劳
  • Learning Disability Treatment, 治疗读写障碍
  • Customized computer vision glasses, 个人定制,防疲劳眼镜 (隐形眼镜)
  • Trendy sunglasses, 潮牌太阳眼镜

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Dr. Yan Ling Liang
Markham Optometrist
www.wardenoptometry.ca
905-940-2015
Changing lives one eye at a time!

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