Blurry Vision: Causes and Solutions for Focus Issues

Inability to focus the eyes?

Hello Doctor: On January 23rd of this year, I woke up and noticed something strange with my vision.
I can see clearly, but it seems like there are double images.
Recently, I discovered that my eyes cannot focus.
However, I find it strange because I can see things clearly, whether they are far away or close, and even small text in books.
I have had my eyes examined at an ophthalmologist and achieved visual acuity of 1.0 to 1.2, and I can read very small letters clearly.
Yet, when I hold up a finger to look closely, I find that I cannot focus; the finger appears to spread out to the sides.
I have been prescribed glasses for my astigmatism and myopia, and dilation tests have shown no issues with my retina.
I have high myopia of -7.25/-7.25 and astigmatism of -2.50/-5.00.
My glasses are properly prescribed.
I have visited many eye clinics, and the last two mentioned that my eyes seem to be slightly outward, but I can still converge my eyes to see up close.
My eye mobility is still adequate.
Initially, I felt more fatigued because I have to care for my 7-month-old child, resulting in about 5-6 hours of sleep at night, often interrupted.
The ophthalmologists suggested that this could be due to fatigue and advised me to practice convergence exercises and try eye drops to relieve fatigue for two weeks.
If there is no improvement, I should return for a follow-up.
However, I am genuinely worried because this issue has persisted for a month.
Will this lead to permanent damage? As for the treatments I have undergone, a licensed traditional Chinese medicine ophthalmologist performed acupuncture on my two eye sockets.
He suggested that there might be paralysis of the third cranial nerve.
I didn't feel much during the acupuncture on my left eye, but the right eye felt extremely painful for a while.
I also forgot to mention that I cannot focus on my finger with either eye, even when looking with one eye at a time.
Could you please advise me on what I should do next? What additional tests should I undergo? Is there a chance for improvement? Thank you for your response, Doctor.
Thank you!

Jin Yu, 30~39 year old female. Ask Date: 2019/02/23

Dr. Cai Wenyuan reply Ophthalmology

Hello, it is recommended to visit a medical center for an examination.
Wishing you safety and good health.
Sincerely, Dr.
Tsai Wen-Yuan, Director of the Ophthalmology Department, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2019/02/23

More Info

Blurry vision and difficulty focusing can be concerning symptoms, especially when they persist over time. Based on your description, it seems you are experiencing a combination of visual disturbances, including double vision (diplopia) and difficulty focusing on objects at various distances. Given your history of high myopia (725 diopters) and astigmatism, it’s essential to consider several potential causes and solutions.

Possible Causes
1. Refractive Errors: Even with corrective lenses, refractive errors can sometimes lead to issues with focusing. High myopia and astigmatism can cause visual distortions, especially if the prescription is not perfectly matched to your needs. It’s worth revisiting your optometrist to ensure your glasses are accurately prescribed.

2. Eye Fatigue: Your recent lifestyle changes, including caring for a young child and potentially reduced sleep, can lead to eye strain. Prolonged screen time or reading without adequate breaks can exacerbate this issue, leading to symptoms like blurry vision and difficulty focusing.

3. Convergence Insufficiency: This condition occurs when the eyes do not work together effectively while focusing on nearby objects. You mentioned being able to perform convergence exercises, which suggests that your eye muscles may be functioning, but fatigue or strain could be impacting their coordination.

4. Neurological Factors: Although less common, neurological issues can also cause visual disturbances. If the eye examinations have ruled out significant retinal or structural problems, it may be worth considering a neurological evaluation if symptoms persist.

5. Dry Eye Syndrome: Insufficient tear production can lead to blurry vision and discomfort. If your eyes feel dry or gritty, this could be a contributing factor.

Recommended Solutions
1. Regular Eye Exams: Continue to have regular check-ups with your eye care professional. If symptoms persist, ask for a comprehensive eye exam that includes tests for binocular vision and eye coordination.

2. Visual Therapy: If convergence insufficiency is diagnosed, vision therapy exercises may help improve your ability to focus and coordinate your eyes. These exercises can be guided by an optometrist specializing in vision therapy.

3. Rest and Breaks: Implement the 20-20-20 rule: every 20 minutes, take a 20-second break to look at something 20 feet away. This can help reduce eye strain.

4. Proper Lighting: Ensure that your reading and working environments are well-lit to minimize strain on your eyes.

5. Hydration and Lubrication: If dry eyes are a concern, consider using artificial tears or lubricating eye drops to keep your eyes moist.

6. Manage Stress and Fatigue: Given your current life circumstances, finding ways to manage stress and ensure adequate rest is crucial. This may include delegating tasks or seeking help with childcare to allow for more rest.

7. Consult a Specialist: If your symptoms do not improve, consider consulting a specialist in binocular vision or a neuro-ophthalmologist for further evaluation.

Conclusion
While it’s understandable to be concerned about the potential for permanent damage, many cases of blurry vision and focusing difficulties can be managed effectively with the right approach. It’s crucial to remain proactive about your eye health and seek further evaluations if necessary. Remember, your well-being is important, and addressing these symptoms early can lead to better outcomes. Please continue to communicate with your healthcare providers about your concerns and progress.

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