Low myopia, high astigmatism

I´ve known about endmyopia for 1-2 years. But I have not been a serious learner / believer until recently. This was my first prescription (2018).
Right eye. Sph -0.5, Cyl -0.5 (axs 11)
Left eye. Sph -0.25, Cyl -0.5 (axs 1)
(I didnt use glasses for closeup, only for classes / cinemas / TV watching).

I recently read “Le Rough Guide” and today I measured my eyes again at an optometrist.

(MY CURRENT NORMALISED)
Right eye. Sph -0.25, Cyl -1 (axe 16)
Left eye. Sph +0.25, Cyl - 0.75 (axe 175)

I am not sure how, or where to start. I didn’t find many similar examples of my case on the site. And there were not a-lot in the guide about this. I basically have 0 myopia and high astigmatism. So I have some questions I was hoping someone could help me with.

a) Do I need to get differentials as my prescription is so low. I dont feel like I “need” any correction for closeup. Although there is one worry. While reading at night I find myself getting eyestrain.

b) The best way to “attack” my CYL. I am considering dropping the entire -1 and adding -0.5 SPH in both eyes. My current glasses have -0.5 astigmatism and I have 20/20 with them, so I think the -0.5 increase I got today was BS. If I understand it correctly I think they might have reduced 0.5 SPH and added 0.5 CYL instead. I felt like I saw worse with that prescription (test lenses) than my current normalised).

(ii) Or is it better to drop -0.25 CYL in both eyes - rinse and repeat - until 0.0.

How is your visual acuity on 6m Snellen with normalized?

Firstly, ensure you don’t have ciliary spasm and have correct prescription.

a) definitely no. You get strain because of astigmatism. But you should avoid correcting it for close up.

b) I would say your left eye will be plano in the next glasses, and replace right 1 cyl with 0.5 sph. After this next pair, you can also go with R -0.5 L plano or without glasses at all.

ii) You also may go this way, but I think reducing 0.25 cyl is too less - reduce by 0.5 cyl.

1 Like

Thank you for the reply. I will pint the 6m Snellen tomorrow at school. But I checked my vision with my normalised at the eye-doctor and got 20/20.

a) I understand. Should I instead compensate with more light, or even more frequent break to avoid the astigmatism eye-strain?

b) If I understood you correctly I drop my astigmatism completely on one eye at a time while adding 0.5 SPH. Is astigmatism easier to drop if you do it one eye at a time? I have not seen anything about this at the blog.

If you see 20/20 without AF, then it’s full correction and not normalized - reduce more.

What’s your visual acuity on 6m Snellen without glasses?

a) maybe both. Or try one, then other, then both and choose easiest that works.

b) left eye without anything, right eye 0.5 sph more and drop cyl.

By the way, it is present in site or even wiki - more reading is recommended, too many basic questions. Your eyes aren’t basically myopic at all - you can afford that I guess.

1 Like

You’re starting out already in the last diopter. If your distance to blur is further than your work, you don’t need glasses for that work. While you’re printing charts, get an astigmatism wheel too. Do you have true directional blur, or do you have image doubling? Sometimes the doc treats both with cylinder.

Your left eye is so close to 0 (spherical equivalent) you’d probably not have any glasses at all except the fact that you’re -0.75 equivalent in the other eye. If you have doubling rather than blurring, I’d say ditch the glasses altogether unless you need them to drive.

2 Likes

(i) I have looked at a astigmatism wheel and I see the top lines “12 o´clock” lines and “6 o´clock” lines thick. While the others are much thinner. I am not an expert yet, so does that mean my astigmatism is “real?”

(ii) When I cover my right eye I see good with my left. Almost 100% clear. The -1.0 CYL as I experience it is way more blurring. I found a trick to reduce / temporarily remove my vision doubling. I cover my right eye while looking at an object in the distance. After 20 seconds with relaxing focus I remove my hand and see with both eyes and my eyes works better together creating a more clear image. Is this just me tricking myself?

I also notice that my right eye is the eye that gets eyestrain when I work at closer distance. Maybe I should add a little correction for it?

It’s all real, it’s just that some are cylindrical astigmatisms and some are not. If it’s wider, but has distinct edges, that may be doubling. If its wider but has fuzzy edges, that may be true cylindrical astigmatism.

Cylinder dependence is very individual, and in your case you don’t have much sphere to play with to try easy reductions between the cylinder reductions, you just have to try something out and see how it works for you.

2 Likes

If you’ll excuse me, this new prescription is pure insanity in my very humble opinion.
The way I see it, your eyes remained stable and are as they were when you got your first glasses. Eyes don’t suddenly start doing pirouettes with more cylinder for less myopia, that is the optometrist making trade-offs to make you more dependent on cylinder. You could of course try to get another opinion, or to measure on your own.

So yes you do have astigmatism, but how much does it bother you? Glasses are an aid, not a therapy, just to be clear. How well do you see on the Snellen without correction? Is your astigmatism debilitating when you are outside or watching TV?
If you feel dependent on your glasses and ditching them gives you headaches, you could perhaps reduce slowly the cylinder and see how you feel. It seems all so unnecessary at -.5 cyl though to be honest with you. Focus on getting active focus and plenty of outdoor stimulus and see how you repond.

4 Likes

I have about the same axes as you and my binocular vision is indeed much better than what one eye sees. My brain seems to be able to cancel the worst of the astigmatic blur by using my second eye’s input. That’s why lens-dependence with astigmatism is very subjective; some people’s visual cortex seems to work it out well enough that they can get away with more reductions while others can feel every little bit of blur. Good on you if you fall into the former category. Just be honest with yourself, what you really need and what you really see. There are no rules, it’s not an optometry shop here; you assess your needs objectively and go from there.

3 Likes