Eye exams, prescription different...wwyd?

[Aerides]

Long story shorter:
I need some mild vision correction, but am perfectly safe and fine in the world aside from needing readers. Distance is going on one eye. Got a scrip (costco eye doc) for glasses this summer but didn't fill because I procrastinate. Decided I want to try contacts instead (keep my regular sunglasses, and supplement with readers, seems easy enough):

- went back to the costco eye doc for contacts. first fitting was way off. I went back and she revised, and that was better... but after using the trials...eh. Up close is worse, and I can't tell if distance is any better. she seemed to think contacts were not good for me but couldn't really explain why

- went to Lenscrafters for a 2nd opinion... And a completely different glasses/contacts prescription. Apparently I need multifocals and have astigmatism which was...news. He fitted me with a 30 day lens which got me reading the eyechart easily for 20/20, but was so uncomfortable I was blinking for hours with a little double vision. Don't even want to put them back in today.

So now what? Do I go to a 3rd? I'm really confused and don't want to invest in any contacts or glasses until I have confidence. But what if I get a completely different answer?

I'm looking around for a super well rated 3rd to try... but this endeavor isn't cheap. I'm leaning towards paying through the nose for the 3rd specialty super star doc, and showing them all my scrips and saying please make sense of this for me.

Anyone have advice or any similar experience?

 

[W2R]

Not sure of your age, so maybe you're too young for this... but could it be that you need cataract surgery? Cataracts can mess up your vision even if you have a decent prescription. The surgery is fast (mine was 7 minutes/eye), easy (I only needed local anesthesia and something to calm my nervousness), painless, and gave me the best vision I have had since I was little.

Probably you don't need this surgery, but it wouldn't hurt to ask the next doc you see whether or not you're getting close to needing it.

Oh, and to answer your question, personally I think good vision is worth the (crazy high) expenses you are incurring. So yeah, I'd pay the 3rd doc.

 

[Qs Laptop]

So now what? Do I go to a 3rd? I'm really confused and don't want to invest in any contacts or glasses until I have confidence. But what if I get a completely different answer?

I'm looking around for a super well rated 3rd to try... but this endeavor isn't cheap. I'm leaning towards paying through the nose for the 3rd specialty super star doc, and showing them all my scrips and saying please make sense of this for me.

Anyone have advice or any similar experience?

I get yearly eye exams. My prescription changes just a bit every time I go to the doctor. So while I don't wear contacts I do need to get new glasses every year. I've found an awesome ophthalmologist. Once, he even took me outside with some sample lenses for some real world eye/lens testing.

I think you are on the right path going to a different doctor. Go to an ophthalmologist, not an optometrist. Go to one that is not affiliated with a place that sells eyewear, especially not a national chain like Lenscrafters. BTW, Lenscrafters, Pearle Vision, Sunglass Hut, Target Optical, and Glasses.com are all owned by one company--Luxottica.

Get yourself to a highly recommended ophthalmologist that specializes in contact lenses. Having correct vision is so important I wouldn't try to cut corners.

 

[OldShooter]

... - went to Lenscrafters for a 2nd opinion... And a completely different glasses/contacts prescription. Apparently I need multifocals and have astigmatism which was...news. He fitted me with a 30 day lens which got me reading the eyechart easily for 20/20, but was so uncomfortable I was blinking for hours with a little double vision. Don't even want to put them back in today. ...

FWIW Lenscrafters is owned by Luxottica, as is Pearle Vision and many, many glasses lines. They are a de-facto monopoly in the US. It does not surprise me in the least that you got a "diagnosis" that involved their most expensive products. I would forget about these guys.

In my personal experience, prescriptions vary a little bit from exam to exam. I have not personally used Costco, but I'd suggest discussing the prescription difference with one of their docs. If minor, no big deal. If significant, then the question becomes "why?"

Re contacts, you are mixing two things here: the prescription and switching to contacts. I would suggest going to Zenni with your best-guess prescription and buying an inexpensive pair of single-vision glasses as an experiment. Buy some on-sale frames and skip the ups and the adds for coatings, etc. Just go cheap and plan to toss the glasses after the experiment. Doing this will separate the prescription question from the contacts question. With one answered you can proceed to the second.

 

[MichaelB]

Not sure of your age, so maybe you're too young for this... but could it be that you need cataract surgery? Cataracts can mess up your vision even if you have a decent prescription. The surgery is fast (mine was 7 minutes/eye), easy (I only needed local anesthesia and something to calm my nervousness), painless, and gave me the best vision I have had since I was little.

Probably you don't need this surgery, but it wouldn't hurt to ask the next doc you see whether or not you're getting close to needing it.

Oh, and to answer your question, personally I think good vision is worth the (crazy high) expenses you are incurring. So yeah, I'd pay the 3rd doc.

Cataract was my first thought as well. I’d also be careful of a diagnosis of a slight astigmatism. It may not need correction and does add complexity and difficulty to finding the proper prescription and eyeglasses.

 

[Aerides]

Get yourself to a highly recommended ophthalmologist that specializes in contact lenses. Having correct vision is so important I wouldn't try to cut corners.

That's what I'm thinking. I'm 53, and I don't have cataracts or anything else going on. I'd really like to go with daily contacts and have a pair of glasses for back up.

The prescriptions are way more than just a little different, enough that I don't know if either one is right, so I might just have to throw them both out... at least I have a good HSA balance.

The ophthalmologist my Mom goes to is a very highly rated, but will cost me more than my 2 other visits so far combined. Still...if you're not spending good money on stuff like eyeballs what is the point I guess!

 

[braumeister]

I'm 53, and I don't have cataracts or anything else going on.

FWIW, my previous primary care doc developed cataracts at the age of 50. He attributed it to excessive sun exposure in his youth (he was a lifeguard at a beach for years).

 

[OldShooter]

... The prescriptions are way more than just a little different, enough that I don't know if either one is right, ...

Spherical correction is the main one. It's specified in dopters. From experience working with target shooting glasses, I think a quarter diopter one way or another is not a big deal. Cylinder and Axis are the corrections for astigmatism. My numbers for these seem to vary quite a bit from exam to exam but the doc considers the differences to be minor. But I am just SGOTI; I still say you should take the scrips to the Costco doc and ask his/her opinion.

 

[Irishgirlyc58]

I have one eye that sees far away and one eye that sees up close.
I wore 1 contact for distance for several years which worked ok.
As I got older reading with that set up became more of a challenge.
I tried different ways to wear contacts but in the end I couldn’t see distance or up close.
I stopped wearing them and just wore distance glasses for driving or watching movies- worked perfectly for years.
But as I got even older I needed readers. So now I have bi-focals for multi tasking, distance for driving, and prescription reading glasses. I like all 3 setups depending on what I’m doing but I have a lot of glasses.
I tried progressives but couldn’t adjust. I’m going to try again with larger frames/lenses to see if I can adjust better.
All this to say- contacts may not be the right solution for you.
Good luck !

 

[Qs Laptop]

Spherical correction is the main one. It's specified in dopters. From experience working with target shooting glasses, I think a quarter diopter one way or another is not a big deal.

I think 0.25 diopters is a big deal. When getting an eye exam changing the lens to another lens, when the eye doctor says, "Tell me which one you see more clearly. How about this one? Or do you like this one?" "This one? Or this one?" And the doctor switches from one to the other, that is typically one-quarter diopter. And yes, I can tell the difference.

Since I get my eyeglasses from Zenni, I have had quite a few sets over the years, because they are inexpensive. I typically buy everyday glasses, sunglasses, and computer glasses once per year. My previous set of computer glasses get repurposed as reading glasses since the +ADD value hasn't changed. I do like to see things clearly so if my prescription changes by 0.25 diopters, new glasses it is!

Here are my glasses from 2012 through 2019, which I recently donated to the Lion's Club.

 

[Qs Laptop]

That's what I'm thinking. I'm 53, and I don't have cataracts or anything else going on. I'd really like to go with daily contacts and have a pair of glasses for back up.

The prescriptions are way more than just a little different, enough that I don't know if either one is right, so I might just have to throw them both out... at least I have a good HSA balance.

When you go to the next opthalamologist's appointment, bring along the two prescriptions. After the doctor has you look through the phoropter and determines your prescription, compare them to the prescriptions you obtained at Lenscrafter's and Costco. See which one is the closest to your newly diagnosed prescription. Better yet, have the doctor set up the phoropter with each of these prescriptions and let you try them out. (This is the kind of stuff I do with my doctor, and he loves it that I take such an interest in my eye health.)

The ophthalmologist my Mom goes to is a very highly rated, but will cost me more than my 2 other visits so far combined. Still...if you're not spending good money on stuff like eyeballs what is the point I guess!

Precisely!

 

[RE2Boys]

FWIW, my previous primary care doc developed cataracts at the age of 50. He attributed it to excessive sun exposure in his youth (he was a lifeguard at a beach for years).

Cataracts can develop regardless of age. I had cataract surgery in both eyes before age 54!

And if you have any vision discrepancies, I would not mess for an optometrists, they are good for basic vision correction and screening only, would not rely on them for serious eye problems. One of my sons was flagged with vision problems in the second grade by an optometrist. Repeated attempts to get a prescription that was suitable for him was very difficult. Only after visiting an ophthalmologists who did additional testing and recognized what was going on was the issue resolved.

 

[Aerides]

Cataracts can develop regardless of age. I had cataract surgery in both eyes before age 54!

And if you have any vision discrepancies, I would not mess for an optometrists, they are good for basic vision correction and screening only, would not rely on them for serious eye problems. One of my sons was flagged with vision problems in the second grade by an optometrist. Repeated attempts to get a prescription that was suitable for him was very difficult. Only after visiting an ophthalmologists who did additional testing and recognized what was going on was the issue resolved.

Pretty sure I don't have cataracts (yet) because they did a whole extra imaging scan and other stuff done with the first exam, so I'd be awfully annoyed if that was missed.

And (afaik) I don't have anything major going on, just some typical age-related vision degradation. But no matter what it is, I know that a bad prescription can be worse than none at all. I'll probably mull it over for the holiday week, and then make an appointment at that fancy place next week. I do plan on taking both scrips with me and just laying out my cards.

 

[Donno]

Pretty sure I don't have cataracts (yet) because they did a whole extra imaging scan and other stuff done with the first exam, so I'd be awfully annoyed if that was missed.

And (afaik) I don't have anything major going on, just some typical age-related vision degradation. But no matter what it is, I know that a bad prescription can be worse than none at all. I'll probably mull it over for the holiday week, and then make an appointment at that fancy place next week. I do plan on taking both scrips with me and just laying out my cards.

I had my first cataract at 56 and since that time, I have only gone to the Ophthalmologist to get my eyes examined. To be honest, I don't care how much money it costs to see an Ophthalmologist vs an eye doctor at any chain, my eyes are worth a quality exam.

 

[pacergal]

If you go the third eye exam route, you might want to try an Opthamologist (medical doc specializing in eye disease), not an optometrist. Both Costco and Lenscrafters have optometrists, I believe. Not saying they are bad, I went to both for years. But, with such different responses, you might want a medical dr option.
Take all of your paperwork and ask his/her diagnosis.

When my insurance changed years ago, the Opthamologist discovered a hole in my retina, that had self healed. I never had any symptoms and it had never been diagnosed or discovered prior.
I continue to see an optometrist at Kaiser now, with occasional consult of opthamologist.

 

[Trailwalker]

For a contact lens fitting, it doesn't matter if you go to an optometrist or ophthalmologist. Either are qualified to figure out (or screw up) your prescription and fit your contact lenses. The ophthalmologist is likely to delegate the fitting to a tech. There are good optometrists in chain stores but due to the business model, it might be harder to find a provider who will take the time to find the best solution.

DW was an optometrist in her own private clinic for over 30 years. The key is for the provider and the patient to have lots of patience during the fitting process. It's likely to take time to get it right between good vision and good comfort. Astigmatism and multi-focal, if that was a correct diagnosis, makes it more difficult to achieve a solution which is as good as eyeglasses.

My two cents based only upon years of hearing the stories. I was going to try contacts once just to see how it felt but chickened out. I need glasses for reading up close only.

 

[JoeWras]

If you go the third eye exam route, you might want to try an Opthamologist (medical doc specializing in eye disease), not an optometrist. Both Costco and Lenscrafters have optometrists, I believe. Not saying they are bad, I went to both for years. But, with such different responses, you might want a medical dr option.
Take all of your paperwork and ask his/her diagnosis.

When my insurance changed years ago, the Opthamologist discovered a hole in my retina, that had self healed. I never had any symptoms and it had never been diagnosed or discovered prior.
I continue to see an optometrist at Kaiser now, with occasional consult of opthamologist.

I think your highlighted line is good advice.

I've personally regularly visited both. A good optometrist is gold. The comparison is similar to a PA vs. an MD. Some PAs are better in day to day practice than MDs.

My last optometrist just retired. He was just so darn good compared to the ophthalmologist I saw for many years. He was the first one who nailed my astigmatism prescription. (Aside: sometimes when they are flipping through the choices, it isn't always diopters, it can also be axis corrections.) He also kept a very close look at my retina and pressures.

 

[badatmath]

Old thread but I wanted to point out that an ophthalmologist is probably partially covered under your medical insurance. I am trying to use both at the moment because the ophthalmologist sends you to a tech for glasses and they don't seem to "get" all my eye issues (RK, other eye surgeries). Not sure they idea of both is going to work mind you!

 

[Qs Laptop]

And (afaik) I don't have anything major going on, just some typical age-related vision degradation. But no matter what it is, I know that a bad prescription can be worse than none at all. I'll probably mull it over for the holiday week, and then make an appointment at that fancy place next week. I do plan on taking both scrips with me and just laying out my cards.

I'm wondering how this turned out. Did you go to an eye doctor?

 

[testing321]

Interesting fact: In writing their prescriptions, optometrists use negative cylinder, ophthalmologists use positive cylinder, and there is a formula to convert one to the other. I discovered this while keeping tract of my prescriptions in a spreadsheet. I noticed a huge change, but after using the formula, they were about the same. https://www.aclens.com/positive-cyl-converter

 

[Aerides]

I'm wondering how this turned out. Did you go to an eye doctor?

Yes, I went to the ophthalmologist my Mom is using for Cataracts soon, as she had done extensive local research to find him.

Basically confirmed (close enough) the original scrip. So I'm back trying to work with the Costco optician for different contacts to find what works best for me. I put it off mostly over the holidays, and because contacts rebates go Y to Y, so no point buying anything in 22.

But at least now I'm confident I got a very thorough exam, have no other issues!

 

[Pluperfect]

I've worn soft contacts for about 45 years, and started with multifocal about 10 years ago. Then I went to multifocal in one eye and toric (for slight astigmatism) in the other.

I decided to go back to multifocal in both eyes, and got a prescription for the same multifocal contact I'd been wearing all along (including in the eye before I switched to toric), and it didn't feel right in that eye. Weird.

So I tried a different brand of contact for both eyes, but that one didn't feel right in my other eye.

I ended up with one brand in one eye and another brand in the other eye. It's worked out really well because contacts have little bitty writing on them that I can see if using uncorrected eyes, so I can confirm if I've put them in the wrong eyes.

I can feel that something is off, but it could be they're just kind of old and don't feel perfect, and swapping contacts from eye to eye and trying to compare is hard. This way I know for sure, and I don't think I'll ever have contacts again that don't have a way to differentiate them.

Anyway, just a data point that what's comfortable in one eye might not be comfortable in the other. And that depending on your astigmatism, it might not be worth it to try to correct it with contacts because improving your distance vision will make your near vision worse. As it is, with my multifocals, I still have to have reading glasses--the multifocal part just makes it so I won't mistake a can of Coke for a can of Dr Pepper.

Also, my boyfriend had never worn glasses but started needing a tiny distance correction when he was about 50, and started wearing one contact when he wants to see really well. It's working out great for him.

 

[Jeffman52]

FWIW Lenscrafters is owned by Luxottica, as is Pearle Vision and many, many glasses lines. They are a de-facto monopoly in the US. It does not surprise me in the least that you got a "diagnosis" that involved their most expensive products. I would forget about these guys.

Hey.. they have been paying my salary for 23 years and my wife's for 33 years. I agree they are expensive but they do not cut corners on quality for glasses. Since I am employed there, I get a free pair every year with all the works and they are always phenomenal.



Lenscrafters, Target Optical, Pearle Vision, SunglassHut, Optical shops of Aspen, Oakley, Grand Vision (just bought last year in Europe about 2500 stores but a few hundred US stores called "for Eyes"), 1-800-Contacts. And just to add to the Monopoly mix, we merged with the largest Lens manufacturer in the World, Essilor in the last couple of years... so now the new company name is EssilorLuxottica.



When I dont W*** there any more, I will probably not use them just due to cost... quality is excellent but wow....