Eyeglass Prescription Adjustments: Key Questions Answered

Q: Eyeglass Prescription Adjustments: Key Questions Answered

Hello, Ah-Hsiang：<br>1. <br>The principle is to ensure clear vision; if you can function normally with slightly reduced prescription, that's acceptable.<br>2. <br>Wearing a slightly lower prescription for nearsightedness can reduce strain, especially for those with presbyopia.<br

Regarding prescription glasses issues?

Dear Dr.
Gao,
I recently experienced delamination of my eyeglass lenses due to prolonged use, so I went to an optical shop to have the lenses replaced (the frame was not changed).
Since I hadn't had an eye exam in many years, the staff at the optical shop conducted a refraction test.
During the process, it seemed they used my original lens prescription as a basis for testing.
My left eye showed no significant issues (the prescription did not increase), but the right eye was slightly blurry.
The optician continued to test with different lens prescriptions, stating that the goal was to correct my vision to 0.8 to 1.0.
Ultimately, they indicated that my right eye needed an additional +25 diopters from the original prescription.
I would like to ask Dr.
Gao the following questions:
1.
Some articles mention that adults have completed eye development, and the likelihood of an increase in prescription is low.
Therefore, prescribing a slightly lower lens power may make the eyes more comfortable, and full correction may not be necessary.
Is this statement correct?
2.
Following up on the above, should adults be prescribed full correction? My understanding is that a slightly lower prescription should be used because, as we age (especially after 40), the eyes may develop presbyopia or hyperopia, so a lower prescription might be sufficient.
Is this reasoning correct or incorrect?
3.
Some articles state that an increase of +25 diopters in lens power is essentially equivalent to no increase.
Is this statement accurate?
4.
Continuing from the above, if the lens power is indeed over-prescribed by +25 diopters, what kind of harm could this cause to the eyes, or what symptoms might arise?
Thank you, Dr.
Gao.

Axiang, 30~39 year old female. Ask Date: 2021/02/05

Dr. Gao Pilin reply Ophthalmology

Hello, Ah-Hsiang:
1.
The principle is to ensure clear vision; if you can function normally with slightly reduced prescription, that's acceptable.
2.
Wearing a slightly lower prescription for nearsightedness can reduce strain, especially for those with presbyopia.
3.
A difference of 0.25 diopters is not significant, but there will still be some variation in clarity.
4.
There won't be any harm; at most, it may lead to increased fatigue.
Taiwan E-Hospital, Puzi Hospital, Ophthalmology Department:
Monday, Tuesday, Thursday, and Friday: 8:00 AM – 12:00 PM
Wednesday: 2:00 PM – 4:30 PM
Online responses should only be taken as references; if necessary, you should visit a medical facility for treatment.
I hope to have the opportunity to serve you.
Gao Pi-Lin

Reply Date: 2021/02/05

More Info

Hello! Thank you for your detailed questions regarding eyeglass prescription adjustments. It's great that you're taking the time to understand your vision needs better. Let's address your queries one by one.

1. Degree Increase in Adults: It is generally true that once a person reaches adulthood, their eye development stabilizes, and significant increases in refractive error (like myopia or hyperopia) are less common. However, this does not mean that changes cannot occur. Factors such as prolonged screen time, changes in lifestyle, and even health conditions can lead to gradual changes in vision. The idea that wearing slightly less than the full prescription can sometimes provide comfort is valid, especially for individuals who experience visual fatigue. However, it is essential to balance comfort with clarity; if you find yourself straining to see, it may be better to wear the full prescription.

2. Should Adults Wear Full Prescription?: The decision to wear a full prescription or a slightly reduced one can depend on individual circumstances. For younger adults, wearing the full prescription is often recommended to ensure optimal vision. However, as you age, particularly after 40, presbyopia (the natural aging of the eye that affects near vision) can complicate things. In such cases, it might be reasonable to consider a slightly reduced prescription for distance vision if you are also using reading glasses or multifocal lenses for close work. Ultimately, the best approach is to have a thorough discussion with your eye care professional about your specific needs and lifestyle.

3. Understanding the +25 Degree Adjustment: The statement that a +25 degree adjustment is essentially negligible may not be entirely accurate. A +25 adjustment can be significant, depending on your original prescription. For example, if your original prescription was -2.00 (200 degrees of myopia), adjusting it to -1.75 (175 degrees) would indeed be a minor change. However, if your original prescription was -5.00, a +25 adjustment would be more substantial and could affect your vision clarity. It’s crucial to understand the context of the adjustment and how it relates to your overall vision.

4. Consequences of Over-Prescribing: If your glasses are over-prescribed by +25 degrees, you may experience several symptoms. These can include visual discomfort, headaches, and eye strain, as your eyes work harder to compensate for the excessive correction. In some cases, wearing an overly strong prescription can lead to a phenomenon known as "over-minusing," where your eyes may feel fatigued, and you might experience blurred vision when trying to focus on objects at various distances. Long-term use of an incorrect prescription can also lead to a condition known as "accommodative spasm," where your eyes struggle to focus properly.

In conclusion, while there are general guidelines regarding eyeglass prescriptions, individual needs can vary significantly. It is essential to have regular eye exams and to communicate openly with your eye care provider about any changes in your vision or discomfort you may experience. They can help tailor your prescription to ensure you have the best possible vision for your lifestyle. Thank you for your questions, and I hope this information helps clarify your concerns!

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