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 The "Long-Arm" Syndrome
Are The "Cheaters" Cheating You?
The "Long-Arm" Syndrome
It happened overnight. You had no problem reading that book yesterday, yet today the
arms of a orangutan wouldn't let you hold your reading material far enough away to see
clearly.
You have also tried many different approaches to solve this problem. You look like you
are playing an imaginary slide trombone with that book you are trying to read. You have
turned the light up bright enough to burn a hole in the page. You only read the
newspaper under direct sunlight. You have your spouse either, hold the menu far away,
lend you their "reading glasses" or, just read the menu for you. You may be saluting a
thousand times a day by constantly putting on and taking off your glasses. You may have
two dozen pair of those "flea market specials" in every imaginable place so that should
you actually need to clearly see something in your hands, you will be prepared. Of
course, you have lost or broken at least a dozen of these in the past year.
The monster has a name and it is called, Presbyopia.
Presby what? Presbyopia affects everyone at some point, by creating the need for
separate prescriptions to see far away activities like driving I-95, and close activities like
reading a book. (Working on the computer is an additional complex and separate issue).
In addition to this, the mid-range or intermediate vision also suffers when Presbyopia rears its
ugly head. The person you are talking to across the table in the restaurant, the papers on the top
of your desk, men trying to shave in the mirror or women trying to apply makeup in the mirror
are all blurred because this midrange vision is also affected. It does not matter if you
are near-sighted, far-sighted, or have astigmatism, if you are a stockbroker, Realtor, or auto
mechanic, live in Alaska or Australia, presbyopia happens to everyone.
That's the bad news. The good news is that there are many ways to beat the "evil"
Presbyopia. In order of my personal preferences, based on the best functional
performance to the worst; Bifocal/Multifocal contact lenses, Monovision contact lenses,
Progressive glasses, standard bifocal glasses, and two separate pairs of glasses. You will
notice that contact lenses are in the top two performance categories. The contact lenses
will out perform glasses for many reasons but mainly are superior because the vision is
more "natural."
Bifocal contact lenses seem to be one of the best kept secrets in the world. When I offer
this option to the person with Presbyopia, the response I receive is always "I have never
heard of bifocal contact lenses before - are they new?" Bifocal contacts have been around
for more than thirty years. They are often not recommended because they are difficult to
fit - it is a moving lens on a moving eye that still must be in the correct position so that
the person can see clearly where they are looking. They are not however, difficult to "get
used to", which is the most common concern when discussing bifocals. Since Bifocal
contacts are the way to look your best while seeing your best I will always recommend
this as my preferred choice.
Monovision contacts is the next best option and although this concept sounds totally
absurd - one eye set up to see more of the distance and the other eye more of the close, it
is very effective and in my experience is approximately 95% successful. Both eyes are
actually working at all distances. The Monovision balance that is achieved does not hurt
or over work either eye. Even though the vision isn't quite the same as with bifocal
contacts, the vision doesn't suffer from some of the limitations of glasses.
Progressive lenses are the best option in glasses to address Presbyopia because they
function as though there are an infinite number of prescriptions to keep everything clear
from far away to close. I have heard complaints from people who've tried and failed in
Progressive glasses. The failures when more closely examined are almost always because
originally they were not properly measured, fitted, or manufactured. Progressive glasses
are very technologically advanced and when properly fit, provide better vision and make
you look better than standard bifocal glasses.
Whether Bifocal contacts, Monovision contacts, or Progressive glasses are used,
Presbyopia does not mean that you have to look old. You can maintain your youthful
appearance while maximizing your vision. One or more of these superior alternatives can
be appropriate for you. They can be just for what your eyes have been looking.
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Are The "Cheaters" Cheating You?
Like a thief in the night that lurks without warning, so too was your close vision robbed.
You woke up from a restful sleep to find that you couldn’t read the morning paper
because it was too blurry. You heard from your friend that they have these 'cheaters' at
the drugstore and so you went and tried them out and lo and behold you could read again.
Since you are able to read with these ready-made off-the-shelf devices, you might have
wondered as to the differences between these and appropriately prescribed and properly
manufactured prescription reading glasses. Although you might think that I, as a
physician am going to tell you that the ready-mades are just junk, this does not give a
balanced view of the problem nor clear the misconceptions of the 'magnifiers.'
Ready-mades are mass-produced, quickly-assembled optical devices, that are actually
prescription lenses you may buy without a prescription. The instructions for selecting the
proper power are as follows: "try me on; can you read this?; must be OK." Well, that
may be a bit dramatic but that does essentially describe the procedure. No one will tell
you that these "cheaters" will ruin your eyes, including myself, but there are several
things to consider before you take that $2-$10 plunge.
If your near vision is blurred there is the possibility that this is the result of a medical
problem that requires more investigation than trying on a few 'cheaters.' Macular
degeneration, central serous retinopathy, optic neuritis, diabetes, and several other
conditions can simulate a need for reading glasses. Obviously, these are circumstances
that demand a thorough eye examination.
Reserving comment on the quality of the frames that are used, the lenses are made with
many assumptions. These 'cheaters' were made for the masses and therefore assume that
your two eyes are exactly the same, which is rare. These 'cheaters' assume that you have
no astigmatism, and nearly 60% of the population does. These 'cheaters' also assume
that your eyes are over 65 millimeters apart when you read, but that only accounts for
about 10% of you. The placement of the optical centers (the point in each lens that
should be placed over each pupil) for the 'cheaters' seems to be random, and actually
have a rather wide range. The misalignment of the optical centers with your pupils will
cause a significant 'prismatic effect' that forces your eyes to turn excessively and can
result in blurred vision, a pulling of the eyes, and general fatigue.
Although none of these symptoms will destroy your eyesight, it seems to me that your
eyes deserve better correction. They have served you well for many years, and this is not
the best payback. Even more outrageous is when I hear from a patient that their last eye
doctor told them to "just go buy some readers from the drugstore, that's all you need!" I
think that is a disservice and there are better ways to save a dollar than to impart your
vision to this advice.
If you only need an occasional aid to read the stock quotes, or find a number in a phone
book, or thread a needle, or read a medicine bottle, then a ten-dollar 'cheater' will
probably do the trick. If, however, you work at a desk most of your day, spend time at a
computer, or just like to read, then invest in a top quality, corrected curve reading
prescription that is measured and made for you specifically, and purchase your glasses
from a reputable optical retailer. Your eyes will be beholden.
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