Parallax and Prescription Glasses for Eye Health - Ophthalmology

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Issues with prescription glasses for individuals with binocular disparity and visual usage?


Hello, Doctor.
I would like to inquire about the issue of binocular disparity and glasses prescription.

How I discovered the disparity: Around the fifth or sixth grade, my right eye was detected to have slight myopia (prior to this, annual checks showed both eyes at 1.2 or 1.0, so congenital developmental issues can likely be ruled out).
During middle school, my vision test results were: left eye: uncorrected vision 1.0 or 1.2 / right eye: approximately 0.1, with a refractive error of 100-150 degrees.
However, since I could see both distant and near objects clearly, I did not actively seek to control it or wear glasses.
Initially, I thought it did not significantly affect my daily life.
Back in middle school, I used cycloplegic eye drops for testing, but after finishing one bottle, I did not return for a follow-up.
Recently, I feel that the disparity seems to be increasing, and my right eye feels strained.
Therefore, I visited two different optical shops for eye exams, one a month ago and the other two weeks ago.
The results were as follows:
First exam: Left: 75 degrees / Right: Myopia 325 degrees, astigmatism 50-75 degrees.

Second exam: Left: almost no myopia / Right: Myopia 325 degrees.

Both optometrists indicated that my dominant eye is the poorer-seeing right eye, and I should wear glasses to avoid the left eye being underused, which could lead to amblyopia.
My right eye, which has poorer vision, feels noticeably strained after prolonged use without glasses.
Due to the significant disparity between my eyes, the optometrists advised against getting a full prescription at once to avoid difficulties in adaptation, suggesting a gradual adjustment.
Additionally, they reminded me to "sit down" when using my phone.
Currently, my prescription is left eye 0 degrees / right eye 150 degrees (which allows me to see clearly when looking at close objects, such as when working at a computer).
Initially, wearing the glasses caused some discomfort, and when I took them off, it felt like my vision was not as well-adjusted as before.
However, it seems to be slightly less strained compared to before.
I would like to ask the doctor:
Q1: Can I wear the glasses only during work hours (approximately 9-11 hours, requiring long periods of close-up screen use)?
Q2: According to the optometrist, the current prescription (left 0 / right 150) is a transitional phase, and after adapting, I will still need to get the most suitable lenses for my needs (it is also not recommended to wear contact lenses for long screen use).
How often should I follow up for data tracking?
Q3: How can I prevent the disparity between my eyes from increasing? (It seems that my already myopic right eye's prescription will continue to worsen, and it feels easily fatigued.
Is this related to the ciliary muscle's ability to accommodate in my myopic eye possibly deteriorating?)
Q4: The information online about significant disparity leading to an inability to fuse images sounds very alarming.
How can I avoid this?
Q5: Can excessive disparity lead to amblyopia?
Q6: In recent years, with the widespread use of electronic devices, is poor posture while using them truly a major cause of the development of true binocular disparity?
Thank you very much for taking the time to answer my questions!

Anina, 20~29 year old female. Ask Date: 2022/12/10

Dr. Gao Pilin reply Ophthalmology


Hello: 1.
It is possible.
2.
If possible, you can start with a prescription of +2.50 diopters.
It should not cause discomfort.
An examination every six months is sufficient.
3.
4.
Currently, the disparity should not increase.
You can continue to monitor it.
If the right eye's prescription is not fully corrected, such as using +2.50 diopter glasses, the disparity may not worsen.
5.
No.
6.
If there are no other ocular pathologies, disparity is usually related to poor posture.
It is not necessarily associated with screen time; poor reading posture can also contribute.

Reply Date: 2022/12/10

More Info


Hello! Thank you for your detailed questions regarding parallax, prescription glasses, and eye health. It’s great that you’re taking an active interest in your vision and seeking to understand how to manage your eye health effectively. Let’s address your questions one by one.

Q1: Can I only wear my glasses during work hours (about 9-11 hours of screen time)?
Yes, you can choose to wear your glasses primarily during work hours, especially since you are focusing on a screen for extended periods. Wearing glasses while working can help reduce eye strain and improve visual comfort. However, it’s essential to ensure that you are also taking regular breaks from screen time, following the 20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds. This practice helps alleviate eye fatigue.

Q2: How often should I follow up on my prescription?
Since you are currently in a transitional phase with your glasses, it’s advisable to have a follow-up eye exam every 6 to 12 months. This timeframe allows your eye care professional to monitor any changes in your vision and adjust your prescription as needed. If you notice significant discomfort or changes in your vision, don’t hesitate to schedule an earlier appointment.

Q3: How can I prevent the disparity in vision from worsening?
To prevent further deterioration of your right eye's vision, it's crucial to maintain a balanced use of both eyes. Engage in activities that require both eyes to work together, such as reading or playing games that involve depth perception. Additionally, practicing good eye hygiene, such as ensuring proper lighting while reading and taking breaks from screens, can help reduce strain. If you feel that your right eye is becoming increasingly strained, consult your eye care professional about potential exercises or therapies that can strengthen the eye muscles.

Q4: How can I avoid the fear of developing a condition where I cannot fuse images?
To avoid issues with image fusion, it’s essential to maintain proper eye alignment and coordination. Regular eye exams can help detect any problems early on. If you experience double vision or difficulty merging images, seek immediate attention from an eye care professional. They may recommend vision therapy or specific exercises to improve coordination between your eyes.

Q5: Can a significant disparity in vision lead to amblyopia (lazy eye)?
Yes, a significant difference in vision between your two eyes can lead to amblyopia if not addressed. The brain may begin to favor the stronger eye, leading to further weakening of the weaker eye. This is why it’s crucial to wear your prescribed glasses consistently, especially during activities that require clear vision, to help stimulate the weaker eye.

Q6: Is improper posture while using digital devices a major cause of worsening vision?
Absolutely. Poor posture while using computers or other digital devices can contribute to eye strain and exacerbate existing vision problems. It’s essential to maintain an ergonomic setup, ensuring that your screen is at eye level and that you are sitting comfortably. Additionally, practicing good habits, such as adjusting the brightness of your screen and using anti-reflective coatings on your glasses, can help reduce glare and improve comfort.

In summary, managing your eye health involves a combination of wearing the correct prescription glasses, maintaining good habits while using screens, and regularly consulting with your eye care professional. By being proactive and attentive to your eye health, you can help prevent further complications and maintain optimal vision. If you have any more questions or concerns, feel free to reach out!

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