Vision Changes: Is Lowering Prescription Right for You?

Reduction in prescription strength?

Hello, Doctor: When I went to get new glasses, my left eye prescription remained the same with -4.00 diopters of myopia and -2.00 diopters of astigmatism, and my left eye is very clear and bright, so I got the same lenses.
However, my right eye, which was originally -5.50 diopters of myopia and -1.50 diopters of astigmatism, was found to have worsened astigmatism due to blurred vision, while the myopia remained unchanged.
The optometrist mentioned that at a certain age, vision changes become less likely, and it can be difficult to adapt to new prescriptions.
They advised that if I could see clearly with balanced vision in both eyes, I should stick with the same lenses.
However, after returning home, I felt that perhaps my old glasses were no longer clear, leading my eyes to strain unconsciously, resulting in discomfort such as soreness, stinging, and dryness in my right eye when looking at the computer.
The next day, after a re-examination, it was found that the astigmatism in my right eye had increased to -2.00 diopters, and the myopia decreased to either -5.00 or -5.25 diopters.
Although it is still somewhat blurry, it is considered clear enough, and the perception of the floor does not seem to shrink too much.
Initially, I experienced slight dizziness when wearing the new glasses.
While my left eye is very bright and clear, my right eye remains somewhat blurry.
The optometrist explained that there will naturally be differences in vision between the two eyes, similar to the differences in strength between the left and right hands.
They suggested wearing the comfortable prescription of -5.00 diopters of myopia and -2.00 diopters of astigmatism to help me easily adapt to the new glasses.
I would like to ask the doctor if it is correct to lower the prescription since I often need to look at the computer and phone up close.
Could this adjustment lead to not wearing the full prescription, causing my eyes to strain unconsciously and easily become fatigued or experience stinging? Or could the imbalance in vision between my two eyes cause other issues? I am unsure if the optometrist's explanation is professionally accurate.
Thank you, Doctor.

Ying, 30~39 year old female. Ask Date: 2022/02/27

Dr. Liang Ce reply Ophthalmology

We recommend that you discuss the above situation with the optical store or medical facility where you purchased your glasses.
Alternatively, you may consider consulting with an ophthalmology clinic at a larger hospital to determine if any relevant examinations are necessary.
Thank you, and wishing you good health!

Reply Date: 2022/02/27

More Info

When it comes to vision changes and the decision to adjust your eyeglass prescription, there are several factors to consider. Based on your description, it seems that you have experienced some discomfort and changes in your vision, particularly in your right eye, which has led to a reevaluation of your prescription.
Firstly, it’s important to understand that the human eye can experience variations in vision due to several reasons, including age, fatigue, and underlying refractive errors such as myopia (nearsightedness) and astigmatism. In your case, you mentioned that your left eye has a stable prescription of -4.00 diopters for myopia and -2.00 diopters for astigmatism, while your right eye was initially measured at -5.50 diopters for myopia and -1.50 diopters for astigmatism. The fact that your right eye's prescription was adjusted to -5.00 or -5.25 diopters for myopia and increased to -2.00 diopters for astigmatism indicates that there has been a change in your visual needs.

The discomfort you are experiencing, such as strain, pain, and dryness in your right eye, could indeed be related to the mismatch between your current prescription and your actual visual requirements. When your eyeglass prescription does not fully correct your vision, your eyes may work harder to focus, leading to fatigue and discomfort. This is particularly true when engaging in activities that require prolonged near vision, such as using a computer or looking at a smartphone.
Your optometrist's suggestion to balance the prescription between your two eyes is a common practice, especially when there is a significant difference in the refractive error between the eyes. However, it is crucial that the prescription provides adequate correction for both eyes to minimize strain. If your right eye is still somewhat blurry with the new prescription, it may indicate that the adjustment was not sufficient to meet your visual needs, especially if you are frequently using your eyes for close work.

It’s also worth noting that as we age, our eyes undergo changes that can affect our vision. This includes the potential for presbyopia, which is the gradual loss of the eye's ability to focus on nearby objects. This condition typically begins in the early to mid-40s and can complicate existing refractive errors. If you are experiencing difficulty focusing on close objects, it may be beneficial to discuss multifocal or progressive lenses with your eye care provider.

In summary, while adjusting your prescription to a lower degree may seem reasonable, it is essential to ensure that it adequately corrects your vision to prevent strain and discomfort. If you continue to experience symptoms such as pain or fatigue, it would be advisable to return to your eye care provider for a thorough examination and possibly a reevaluation of your prescription. They may also consider other factors such as dry eye syndrome or other ocular conditions that could be contributing to your discomfort. Regular follow-ups and open communication with your eye care professional are key to maintaining optimal eye health and comfort.

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