When to Wear Glasses for Amblyopia and Myopia: A Guide

The timing for prescribing glasses for a patient with unilateral amblyopia and myopia in the other eye?

When I was around 10 years old, in the fifth grade, a school vision screening revealed a vision problem.
After consulting an ophthalmologist, I was diagnosed with amblyopia.
At that time, my left eye vision was 0.2 and my right eye vision was 1.2.
The doctor recommended wearing glasses for occlusion therapy, twice a day for about 30 minutes, until I reached junior high school.
My left eye improved to 0.8, and I stopped wearing glasses.
However, during a military service examination, after dilating my left eye, I could only see 0.3, but without dilation, I could see 0.8.
Since I had never developed a habit of wearing glasses, I relied on monocular vision until last year when I noticed slight blurriness in my right eye.
I went to an optical store for an eye exam and got a pair of glasses.
Currently, my left eye's uncorrected vision is 0.3, and I find that small text on the computer screen appears much blurrier than before.
According to the prescription from the eye exam, my glasses are prescribed as follows: left eye +3.50 with astigmatism of 1.50, right eye -1.25 with astigmatism of 0.50.
When wearing glasses, my corrected vision is barely 0.8 for the left eye and comfortably 1.0 for the right eye.

I am currently troubled by not knowing when to wear glasses.
At present, I almost exclusively rely on my right eye for monocular vision, as my left eye can only see 0.3 and only perceives light, making me feel that I can see clearly in most situations.
The only time I struggle is when looking at the computer screen, which is about 1 meter away; smaller text is somewhat unclear without glasses, but wearing them makes it slightly clearer.
However, when wearing glasses, I find it very unclear for close-up tasks, such as looking at my phone, which is about 30 centimeters away, making it extremely blurry, and I have to remove my glasses to see clearly.

Additionally, when wearing glasses, my left eye vision is corrected to 0.8, and when using both eyes, I feel that my vision is unclear, such as when looking at the computer screen, where the text appears somewhat doubled.
If I wear glasses regularly, I worry that my right eye's myopia may worsen, but if I don't wear glasses, I am concerned about the left eye deteriorating faster.
Therefore, I would like to ask when I should wear glasses.
Should I wear them all the time, or only when looking at the computer screen? If I wear glasses all the time, will it cause my right eye's myopia to worsen? Or should I wear different prescriptions for different situations?

Guai Gui, 40~49 year old female. Ask Date: 2022/04/07

Dr. Liang Ce reply Ophthalmology

It is recommended that you visit an ophthalmology clinic for consultation to determine if further examinations are necessary.
Thank you, and wish you good health!

Reply Date: 2022/04/07

More Info

When it comes to managing amblyopia (lazy eye) and myopia (nearsightedness), understanding when to wear glasses is crucial for maintaining optimal vision and eye health. Based on your experience and the details you've provided, let's break down the considerations for wearing glasses, especially in the context of amblyopia and myopia.

Understanding Amblyopia and Myopia
Amblyopia is a condition where one eye does not develop proper vision, often due to a lack of visual stimulation during critical developmental periods in childhood. In your case, it seems that your left eye was weaker, and the treatment involved patching the stronger eye to encourage the weaker eye to develop better vision. Myopia, on the other hand, is a refractive error where distant objects appear blurry while close objects can be seen clearly.

Current Vision Status
You mentioned that your left eye has a corrected vision of 0.8 with glasses, while your right eye can see 1.0. However, without glasses, your left eye's vision drops to 0.3. This significant difference indicates that your left eye still requires support to function optimally, especially in terms of visual acuity.

When to Wear Glasses
1. Everyday Activities: Given that your left eye has a much lower visual acuity without correction, it is advisable to wear glasses during most daily activities. This includes walking around, engaging in conversations, and performing tasks that require visual clarity. Wearing glasses consistently can help prevent further deterioration of your left eye's vision and promote better binocular vision.

2. Screen Time: Since you experience difficulty seeing smaller text on a computer screen, wearing glasses during these times is beneficial. The distance of approximately 1 meter from the screen is within the range where glasses can help improve clarity. If you find that your glasses do not provide adequate clarity for close-up tasks (like using a smartphone), you might need a different prescription for near vision, such as reading glasses.

3. Near Vision Issues: If your glasses make it difficult to see objects up close, consider discussing with your eye care professional about getting a pair of glasses specifically for near tasks. This could be a separate prescription that allows you to see clearly at closer distances without compromising your distance vision.

4. Avoiding Over-Reliance on One Eye: Since you have been relying on your right eye due to the amblyopia in your left eye, it’s important to encourage the use of both eyes. Wearing glasses can help balance the visual input from both eyes, which is essential for developing depth perception and reducing the risk of further amblyopia.

Concerns About Myopia Progression
There is a common concern that wearing glasses might worsen myopia. However, the progression of myopia is influenced by various factors, including genetics, environmental factors, and visual habits. Wearing glasses does not cause myopia to worsen; instead, they help you see clearly, which can reduce eye strain. It is important to have regular eye exams to monitor your vision and adjust prescriptions as needed.

Conclusion
In summary, it is advisable to wear your glasses consistently throughout the day, especially for activities that require clear vision. If you find that your current prescription does not adequately address your near vision needs, consult with your eye care provider about the possibility of having a second pair of glasses for close-up tasks. Regular follow-ups with your eye doctor will ensure that your vision remains stable and that any necessary adjustments to your eyewear can be made promptly. This proactive approach will help you maintain both your amblyopic and myopic vision effectively.

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