Over-Prescription Issues in High Myopia Patients

Issues with Over-Prescription of Glasses

Hello Doctor: I am a patient with high myopia.
I wear contact lenses during the day and switch to glasses (for both distance and near vision) after work.
Currently, my contact lens prescription is R -10.00 and L -9.50, while my glasses prescription is R -11.50 and L -10.50.
I used to see clearly with my glasses, but I experience headaches and eye fatigue as soon as I put them on.
For the past six months, my vision remains clear when I first put them on, but after about an hour, it becomes blurry.
In August, I had an eye examination that included OCT and dilated fundus examination, and everything was normal.
The doctor indicated that I have pseudomyopia, likely due to overcorrection, and suggested adjusting my prescriptions to: contact lenses R -9.00 and L -9.00, and glasses R -9.75 and L -9.25.
I would like to ask: (1) Should I modify my current pair of multifocal glasses, or should I get a new pair that does not need to be multifocal? (2) Can prolonged use of overcorrected lenses cause symptoms like mine, where vision is clear at first but becomes blurry after one to two hours? (3) If I switch to glasses with a lower prescription, will my vision initially be blurrier, and will it gradually become clearer? Thank you.

Yi, 30~39 year old female. Ask Date: 2017/10/02

Dr. Cai Wenyuan reply Ophthalmology

Hello, it is best to use the measurements taken after dilation as the standard.
Wishing you safety and health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Ophthalmology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2017/10/02

More Info

Understanding over-prescription issues in high myopia patients is crucial for ensuring optimal visual health and comfort. High myopia, defined as a refractive error greater than -6.00 diopters, can lead to various complications, including retinal detachment, glaucoma, and cataracts. Patients with high myopia often experience unique challenges, particularly when it comes to corrective lenses.

1. Adjusting Prescription: It is essential to follow your eye care professional's advice regarding your prescription adjustments. If your current glasses are causing discomfort, such as headaches and eye fatigue, it may be beneficial to consider the suggested adjustments. The recommendation to change your contact lenses to R-9.00 and L-9.00, and your glasses to R-9.75 and L-9.25, indicates that your previous prescription was indeed over-corrected. Over-correction can lead to symptoms like blurred vision after prolonged use, as the eyes struggle to focus correctly.
Regarding whether to modify your current multifocal glasses or to get a new pair, it depends on your lifestyle and visual needs. If you primarily need glasses for distance vision and only occasionally for near tasks, a single-vision pair may suffice. However, if you frequently switch between tasks that require different focal lengths, maintaining a multifocal option might be more convenient.

2. Effects of Over-Prescription: Wearing an over-prescribed lens can lead to visual discomfort. Initially, the lenses may provide clear vision, but as your eyes adapt, they may become fatigued, leading to blurred vision after a short period of use. This phenomenon occurs because the eyes are forced to work harder to compensate for the excessive correction. The muscles responsible for focusing can become strained, resulting in symptoms like headaches and eye strain.

3. Transitioning to Lower Prescription: When you switch to a lower prescription, it is common to experience a temporary adjustment period. Initially, your vision may seem less clear, especially if you are accustomed to a higher correction. However, over time, your visual system can adapt to the new prescription, and clarity may improve. This adjustment period can vary from person to person, but it is essential to give your eyes time to adapt.
In addition to prescription adjustments, consider the following recommendations for managing high myopia:
- Regular Eye Exams: Frequent check-ups with your eye care provider are essential to monitor changes in your vision and eye health, especially given the risks associated with high myopia.

- Visual Hygiene: Practice good visual habits, such as taking regular breaks from screens and ensuring proper lighting when reading or working. The 20-20-20 rule—looking at something 20 feet away for 20 seconds every 20 minutes—can help reduce eye strain.

- Consider Orthokeratology: Some patients with high myopia benefit from orthokeratology, a non-surgical method that uses specially designed contact lenses to reshape the cornea temporarily. This can help reduce dependence on glasses or contact lenses during the day.

- Discuss Options with Your Eye Care Provider: If you continue to experience discomfort or vision issues, discuss alternative options with your eye care provider. They may suggest different types of lenses, such as progressive lenses or specialized contact lenses designed for high myopia.

In summary, addressing over-prescription in high myopia patients involves careful consideration of individual needs and symptoms. Adjusting your prescription based on professional guidance can significantly enhance your visual comfort and overall eye health. Always communicate openly with your eye care provider about any concerns or symptoms you experience, as they can provide tailored advice and solutions.

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