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Did you know that over 60 percent of adults and one in four children need some form of vision correction? That's significant, and it plays a large role in how we function in our daily lives. Many adults suffer from eye strain and headaches just trying to see road signs or their computer screens at work and home. Many children struggle to see the board at school, and lack in their work because they can't see properly. It is important to get an annual eye exam to check the health of your eyes. Your optometrist or ophthalmologist may say you need correction. Here are a few things you should know before selecting your eyewear.
1. Don't squint during your exam, and tell your doctor what your main concerns are.
If you have had a comprehensive eye examination before, you are probably familiar with the comparison of corrective lenses ("One, or two? Three, or four?") and reading the ever popular Snellen Chart to help determine visual acuity. Whatever the test, be sure not to overthink what you see; do not squint, if you can help it. This is important for more accurate results for a prescription that will suit you.
You may also want to ask your family members if anyone in the family has had any eye diseases and how immediate those family members are. You will be asked about this, whether it is on your check-in forms or confirmed by your doctor. Some commonly listed eye conditions are: Macular Degeneration, Cataracts, Glaucoma, and Keratoconus.
If you are experiencing anything you may feel is different about your vision, such as blurriness, stacked/double vision, a cloudy/foggy/milky look to your vision, flashes of light, or frequent headaches, inform your doctor. Some conditions may be more serious and require more attention.
2. Corneal Health Assessment/Contact Lens Evaluation
Your children may be getting to the age when they want to try contacts, or maybe you are just tired of wearing glasses and you want not to wear them for special occasions and photos; not everyone likes the look of glasses.
In order to get prescription contact lenses, you must first go through a corneal health assessment to determine whether or not contact lenses are right for you. Some candidates may not be eligible to wear contacts, so it is important to know where you stand in terms of your eye health to avoid damaging your eyes and ultimately, risking the possibility of blindness down the line.
Most contact lens evaluations will have a fee to them separate from the comprehensive eye exam, and the rates can vary depending on what provider you see. Make sure to contact your human resource department or member line (usually located on the back of your insurance card) to check into your coverage, and provide the necessary information to your eye care provider, such as your member identification number or in some cases, the social security number of the policy holder.
If your doctor has deemed you eligible for contact lens usage, there is more to the process. More than likely, they will require you to participate in a contact lens class. The purpose of the class is to teach you how to put your contacts in, how to take them out, and how to properly care for and clean them. You will receive a set of trial lenses to try your new prescription, and generally, the doctor will want to see you back for a follow-up to see if they bode well for you. If everything works out, the doctor will finalize the prescription and you will be free to order a larger supply. In some cases, you may need to try a couple to a few trials if the prescription needs tweaking, or if your eyes react to the contacts in the form of discomfort, dryness, or itchiness. Don't let this scare you. So long as you follow the instructions given, you will be fine. There are thousands of different kinds of contacts out there, with different features, sizes, and wear schedules to them, and your doctor will be happy to find what works well for you.
3. Eyeglass Prescription Vs. Contact Lens Prescription
Many people would assume that a prescription for your eyes would be the same, no matter what it is for. It seems to make sense. You should be looking through the same power of correction, you'd think. Yes, and no. Your eyeglass prescription and your contact lens prescription can vary. The main reason for this is that your lenses in your eyewear sit in front of your eyes and manipulate the way light enters eye, whereas contact lenses sit directly on the surface of your eye, much closer, over the cornea. This makes a difference, so make sure you have a copy of both your eyeglass prescription and your contact prescription wherever you plan to have them filled.
The other factor is that your contact lens prescription will have the detail of what base curve and diameter are assigned to fit the surface of your eye. Another reason is that whatever contact brand the doctor decides to put you in may have limitations to the amount of correction (meaning it only comes in certain powers), and you will have the correction as close as possible to your eyeglass prescription with a lens that feels comfortable and breathable. (You will still be able to see clearly.)
4. P.D., O.C., and Seg
There is a lot of information needed for the art of creating quality, prescription glasses. Picking out appropriate eyewear is not as simple as one may think, yet it is, if you know what to look for.
1. Your pupillary distance, otherwise known as your P.D., is the distance in millimeters between your pupils. There is the single P.D., which is the overall measurement between your pupils, and the dual (or monocular) P.D., which is the measurement from the bridge of your nose to the center of your pupil. A single P.D. example is 60 mm, which would mean that your dual P.D. is 30 mm for each eye. We all know that people come in different shapes and sizes, so P.D. varies from person to person.
If you have a small P.D. (generally, singular is 48 mm to 58 mm, or dual 24 and 24 and 29 and 29), you will need a smaller frame. Depending on your measurement, if it is narrower, you will need a size around 44 mm to 49 mm in lens width, and depending on the width of the bridge of your nose, or if you have a child with a nose bridge that has to develop more, you may wind up with a bridge measurement between 14 mm and 19 mm (for the very small, you may need a padded bridge or a strap to help support the glasses). If you are in the middle, you more than likely have a measurement like 60 mm for singular (30 mm for each eye) to 68 mm (34 mm for each eye). You may need a size 50 to 55 for lens width. If you have a wider measurement like 70 mm for singular (35 mm for each eye) or higher, you may need a size 56 to 62 for lens width. For a traditional lined bifocal, your P.D. will include a distance and a near measurement. The height of your prescription along with your measurements plays a huge role in your visual acuity and the thickness of your lens. My dual P.D. is 30.5 and 30.5; I wear a size 52-16 (lens width, mm, bridge width, mm) to a size 53-17; my prescription is mild. Don't drive yourself crazy trying to memorize all the examples. Since there is so much variance, make sure to ask your optician what size frame would be appropriate with your measurement and prescription, and what material would best suit you. We will get to the material later on.
2. Your O.C. (Optical Center) is the vertical measurement (also in millimeters) taken from the bottom of your lens to your pupil. This measurement is taken for single vision lenses (lenses purely for correcting myopia [commonly known as nearsightedness], hyperopia [farsightedness], and astigmatism, without a bifocal). Not all locations use an O.C. height and leave the clearest point of correction in the middle of the frame's lens area. Usually, when an O.C. height is not taken, the prescription is light or the glasses are meant for reading, where the user moves the frame from in front of their pupils for working to the end of their nose for multi-tasking and seeing distance as well as reading.
Sometimes, where the O.C. height is placed can play a crucial role in how sharply you can see through your new lenses, particularly if you have a higher prescription (generally -3.00D [diopters] or higher, in terms of a minus prescription, or +3.00D [diopters] or higher, in terms of a plus prescription). With the optical center of the corrective lens places directly over your pupil, you will have superior vision, but if you have a higher prescription and your O.C. is placed too high or low, or too far right or left, this is called decentration, where your lens will be decentered from its ideal location to rest right in front of your pupil. Correct O.C. placement will help the way light enters your eye with your corrective lenses.
3. Your seg-height is the measurement in millimeters that determines where your bi-focal, tri-focal, or progressive ("no-line bifocal," for all distances) will rest or begin to blend. Continue below...
When you are measured for your seg-height, be sure to maintain your natural posture, as you would when you would be using your glasses. Sit up some and make sure your eyes are level with the eyes of whomever is doing the measuring. If you lower your head during marking for a progressive lens, you could wind up with your reading power too high up, and what would happen is when you assume your regular posture and look straight ahead at something in the distance (for example, you are driving and looking at the road signs), you would be looking through intermediate (about computer distance) correction. If you lift your chin so you are moreso looking down your nose at the person marking your lenses, you will more than likely have your reading power too low in your glasses, causing you to have to crane your head back or to lift your glasses to see what you want to read. The same rule applies to lines bi-focals and tri-focals. You don't want to have a line in the middle of your vision or so low that you cannot read a thing. Remember, look straight ahead, into your doctor or optician's eyes.
5. Progressive Lenses (AKA The No-Line Bi-focal)
Now, I mentioned this lens a bit above, but let's talk a bit more in-depth about it, like its function and what to expect.
Progressive lenses are basically a blended tri-focal that no one else can see: they look like single-vision lenses to the naked eye. But you will be able to tell looking through them that they are much more than that, and upon close inspection, there are markings etched into the lens in many cases that are very small and almost invisible. Otherwise, they look like normal, everyday glasses.
Progressive lenses are designed for the wearer who is viewing multiple distances and needs correction for not only distance, but up close (see presbyopia) and everywhere in-between, and is generally associated with aging. Around your thirties to forties, you may be diagnosed with presbyopia. A progressive lens is designed to progress down to a stronger power of correction in a channel that will be measured to cross over the center of your eye. On the top of the channel, you will have your distance, which you will use for seeing anything far away like across the room, road signs, and signs on buildings. This will blend down into your intermediate correction, which you will use for anything arm's length, like your computer. At the bottom of the channel will be your reading correction, for anything up close, like fine print on packaging, a book, or for careful crafting like needlework. This lens is perfect for anyone in an office, constantly looking from computer to patient to across the room and back. You get the idea.
If you are 35 or older, your doctor may recommend this lens for you and provide a prescription for it. It is ultimately your choice whether or not you would like to wear a progressive lens, however, if your doctor recommends it for you, there is a reason why that he or she has unveiled during examination.
If you choose to fill your prescription for a progressive lens (most do), there are a few things you need to know. First, a progressive needs space. This will affect what frames you select. You will need to choose a frame that has a good amount of depth to it. Now, you don't have to have huge glasses, just nothing so slim that you would not have room to comfortably use three levels of correction. There may be some frames that are right on the cusp of an appropriate depth, but pushing it too close to too narrow will result in a progressive lens that is more difficult to use. You don't want your distance, intermediate, and reading squished together. Ask your optician to show you what an appropriate lens depth would be for you, as frames can sit differently on different faces with different eyes, noses, ear height, and cheek bones.
Second, this lens has an adaptation period. The typical adaptation period is a week to a few weeks. Everyone is different and some are more sensitive than others. Bear in mind that you may also have a different prescription, which will also need some getting used to. Your eyes are adjusted to either not having any correction at all if you have never worn glasses or contacts, or they are used to an older prescription. Whatever the case, your eyes will need time to adjust to your new lenses.
Third, you are probably going to feel weird when you wear progressives for the first time. Because of the lenses' design with its middle channel and magnification at the bottom, you might feel at first like you have tunnel vision or that the floor is coming up at you, and you will notice that you seem to have lost your peripheral clarity. Indeed, it is disconcerting at first, but not to worry. The lens design has softer vision on the sides, meaning you do not have as strong of visual acuity as your center channel. This is normal, just be careful going up and down stairs or stepping up onto the curb; point your nose at what you want to look at, like your feet when you are moving from one platform to another. You will also notice that you will have to turn your head slightly moreso than you usually would, like when you are driving and want to see something off to the side. This will become second nature, and eventually, you won't even notice that you are doing it once you get the swing of using progressives. The more you use the lens, the more you will get used to it.
When you receive your first progressives, try them out doing something you typically do quite often, like looking at your phone. Look straight ahead, across the room, first. Find something to read. Does it look clear? Good. Hold something to read out at arm's length and look through the middle of your lens. Clear? Great. Hold anything like a book or your phone lower and closer to you, and simply look down through the bottom of your lenses at it. Clear? Perfect! Practice finding your sweet spots by moving your head up and down, looking at objects at different distances. When you wear them for the first time and do this, it will take a moment for your eyes to adjust and you might feel things seem a bit wonky, just for a moment. This will fade.
Fourth and lastly, your optician will adjust your eyewear for you. If you sit down and try on your progressives and you feel that your distance is blurred or just isn't as clear, or that you have to lift your glasses up to view your reading distance, tell your eye care professional. Most of the time, a simple adjustment will fix this issue for you. There is the likely possibility that the frames are sitting too high or low on you, or that you may need a tilt to them. After adjustment, if everything is sharper, try them out for a few days and see how they work for you. If things do not look completely clear, ask the person dispensing your glasses to you if there is anything more they can do to get them properly adjusted. If you have tried adjustments and tried to adjust to the glasses for a few days and they still don't seem to be clear enough, you may need a recheck with the doctor. Your optician will first check to make sure everything was measured correctly, they will read your prescription and ensure that it is what the doctor has written, and they may remark the glasses for you if adjustments do no work, to rule out all possibilities.
6. You and Your Lenses
You now know about some things to expect from your exam, about what prescriptions you will need and why, some of the primary measurements needed for quality eyewear and appropriate sizing, and a widely used lens type. But that isn't all that can help you select eyewear that suits you, believe it or not. There are also different lens materials and features that can not only help to alleviate stress on your eyes, but protect them, as well.
1. For anyone with a light prescription, like powers 0.00 (Plano, or no correction) up to about a power of +/- 2.00, you could use a basic plastic lens, commonly referred to in the world of optics as CR-39 (if you have ever tried to purchase eyewear online, you may have also seen this as a 1.49 index lens.) Generally, this lens is for anyone who lightly uses their glasses, someone who more often wears contact lenses, or someone who is very careful with their glasses and does not wish to spend the extra cash. Many vision plans will cover at least single vision CR-39 lenses if not CR-39 progressive lenses. This material is softer than others, and must be cared for properly, as it can be more prone to deep or intense scratches if mistreated. This material is not recommended on bottomless or completely rimless frames.
2. Primarily for small children and those with medium prescriptions like powers +/- 3.00 to +/- 5.00, a polycarbonate lens would be appropriate. Although still a variant of plastic, in optics, polycarbonate is a more durable lens material. It is well-known for its impact resistance, and is commonly used for protecting the eyes. Polycarbonate lenses are thinner and lighter than CR-39 lenses, and have refraction index of 1.53, allowing more light to enter the eye efficiently. Many eyeglass wearers are candidates for this material and it is widely recommended for most prescriptions (even smaller ones); however, its main consumers are children roughly 13 and under, laborers, and those working on machinery that require OSHA-certified safety eyewear. Although this durable lens can still scratch, as any lens can (no lens is 100 percent scratch-resistant), it is less likely to scratch as badly. Even still, invest a few bucks into a microfiber cloth and an optical spray cleaner. See proper care for your eyewear below.
3. Similar to the polycarbonate lens, Trivex lenses can be used for about the same correctional power, although I personally recommend it for anything up to a power of +/- 4.00 diopters and nothing higher. Coming in at a refraction index of 1.53, Trivex lenses are slightly thicker than polycarbonate lenses. I have also seen Trivex lenses go by the names "EV" lenses and "H.D" (high definition) lenses; they are also a type of plastic. This lens type is known for its lightweightedness and flat nature, which is appropriate for anyone with a higher astigmatism, and provides superior optics when compared to the curved nature of the polycarbonate lens. Trivex is also chemical-resistant, unlike its competitors, so anyone shopping for safety glasses who works with chemicals will want to look into this lens (although anti-reflective coating put on this type of lens is not chemical resistant. See lens features below).
4. Once you hit a power of +/- 4.00 or above, you may be need high-index lenses, but that power does not make them necessary unless you want your lenses to look as flat and thin as possible. High-index lenses are another variant of plastic. Generally, high-index lenses are recommended for anyone with powers of +/- 6.00D to +/- 12.00D, although correction can be much higher in rarer cases. High-index lenses usually have a refractive index of 1.67 and can vary to the thinnest, 1.74 index. Although this option is not as impact-resistant, it is definitely the thinnest and lightest lens option out there. From my experience, some high-index lenses can work with much higher spheres (correction for far or near-sightedness), but may have a limitation of -4.00D for the cylinder (correction for astigmatism). Read about how to read your prescription here: All About Vision: How to Read Your Eyeglass Prescription.
5. Glass lenses have become more and more outdated, but are still used today. I have put only a couple of patients in glass lenses, at their request, in my years of working in optics. The upside to glass lenses is that they are extremely scratch-resistant and easier to clean than most polymer lenses, which is why some still prefer them. The downside is that they are heavier than today's options and can shatter, posing a risk to your ocular health.
Enough to make your head spin, right? Don't overthink it. This is just for your reference if you want to know more about what lenses are appropriate for you. One last thing to know before we move on that plays a role in the thickness or thinness of your lens aside from prescription and material:
This, I will make short, sweet, and to the point to give you a breather. Remember wanting your eye as centered as possible in a frame's lens space when we talked about O.C. height? It's not only to line up the focal point of the lens with your pupil, but plays a role in the edge thickness of your lenses for minus prescriptions and the weight and thickness of plus prescriptions.
A lens comes in a circular shape and must be shaped by a lab technician to fit into a frame properly.
For minus prescriptions, the lens is thinnest in the middle and proceeds to get thicker the further toward the edge you get.
For plus prescriptions, it is the opposite, as they magnify. Plus lenses are thickest in the middle and proceed to get thinner.
Remember decentration? If your eye is decentered from the optic center of the lens, the center of the lens must be shifted to center up with your pupil.
The more it is shifted over, the more of the thicker edge you are shifting over for a minus prescription, which will wind up showing in the final result of your glasses, particularly with higher prescriptions.
Likewise with a plus prescription, only the thickness of the middle of the lens you are shifting over will show, usually resulting in extruding lenses too close to the bridge of the nose, which can affect ability to adjust nose pieces that help with how your glasses rest on your face comfortably and practically.
Also, the more frame you have, the more lens you have, the more weight you have.
Also, also, a lens can only be shifted over so far before you run out of lens.
This is why it is important to ask your optician to assist you with finding a proper frame size. Big may be what's trending, but that doesn't mean it's for everyone. It all depends on your measurements, what type of set your eyes are (inset, even, outset), your prescription, and your lens material.
Extremely mild prescriptions have more leeway for wider or deeper frames, but you still want a pair that fits you properly that won't go sliding down your face once the lens weight is applied. Not all will follow this advice, most commonly teenagers.
Bear in mind that even if you like a larger look, you must consider all the factors (or your optician will consider them for you, but at least if you have read all of this, you can identify what you need to look for and ensure you wind up with something good, which isn't something to make light of).
... Okay, so I don't exactly do short, sweet, and to the point. Well, I don't do short. Ask my friends... It's been too long since we had a photo. Hey, look! A picture of lenses before they are cut! By yours truly.
1. Anti-reflective, commonly referred to as "non-glare," is a coating on your lenses that will reduce the amount of horizontal glare you perceive. Its main uses are for night-driving and screen usage, allowing more light to enter your eye for sharper, crisper vision, reducing strain on your eyes, and for aesthetics for those who do not want blades of light reflecting from their lenses, making it easier to see your eyes. The pitfall of non-glare is lenses that are not properly cared for. The coating can be stripped and/or extracted from the lens by chemicals and abrasive surfaces. For those who work with chemicals, non-glare will not be ideal. Otherwise, it definitely has its benefits with proper eyewear care (below).
2. Photochromic lenses, well-known from the brand Transitions™, are lenses that will darken in response to UV (ultraviolet) light. If you can never find your sunglasses, or are just not keen on wearing them, photochromic lenses might be for you. When you walk outside and expose your lenses to UV rays, a feature in the lens will activate and respond by darkening. On a very sunny day, your lenses will turn very dark, like a sunglass. On a cloudy day, your lenses may not get as dark, but they will darken, depending on the amount of UV coming through the overcast. There are different types of UV radiation, such UV-A and UV-B. Both can cause immense damage to your retina, which is your eye's main event, located in the back of the eye, and to the skin around your eyes, as well. This type of lens will take a minute or two to clear once you step inside, and will activate near windows in a building.
Photochromic lenses are important not only for relieving your eyes from sunny days, but for protecting them from harm that will come back to bite you in your older age. They are recommended for all, particularly for children whose eyes are developing up until their early twenties and are susceptible to damage, and those who have undergone cataract surgery.
Transitions™ have options as far as functionality, such as their Transitions ® Signature ® lenses, which will darken in direct sunlight and become completely clear inside, Transitions ® Vantage ® lenses, which are polarized transitioning lenses that will darken in direct sunlight and reduce glare like a sunglass, and Transitions ® XTRActive ® lenses, which will darken in direct sunlight and are said to hold a tint behind the windshield of a car; they will also maintain a slight tint indoors, for harsh lighting that can be bothersome to some.
The most common colors for photochromic lenses are gray and brown, so consider this with your frame choice. Brown frames or tortoise designs with brown accents, of course, are complimented with brown lenses. Other colors like black, red, purple, blue, and green look best with gray lenses. But you are not always limited to this. Ask your optician what your color options are. Certain lens materials may have limitations as far as what colors are available and what functions your transitioning lenses (not to be confused with the term "progressive") have.
3. Polarized sunglasses are vital for the health of your eyes. UV damage may not be all to blame for diseases like Macular Degeneration (mentioned above), but it certainly is a factor. Protecting your eyes from multiple types of UV exposure can save you from irreversible damage to your eyes later down the road. Polarized lenses come in a variety of lens materials, colors, and options, including mirror coatings for more of a fashion statement and gradient lenses for easy reading. Polarized lenses will not only help with shading from a blaring summer sun or bright mounds of snow, but they will cut through glare, like the blinding glare you may see on the hood of a car. Hand-in-hand with your correction, polarized sunglasses will provide you with excellent, clarity-packed vision.
4. Digital Freeform Progressive lenses are customized lenses that are processed via computer technology. These lenses are incredibly accurate, and create personalized eyewear with precision and clarity. Digital progressive lenses are generally high definition lenses that have your prescription basically etched in by a computer rather than using lenses cast from a mold. These lenses are usually accompanied with a durable, easy-to-clean anti-reflective coating, and have a wider viewing area for your reading. They are optimal for avid readers and office workers, but are recommended for most. These lenses do have a high sticker price, but not to worry, many locations accept thousands of different insurance plans and/or have promotional offers to help drop the price. Many people are updating to this luxurious lens option, and for good reason. These lenses are durable and offer ease throughout your busy day.
7. Cleaning and Caring for Your Eyewear
We touched on this a bit earlier in the anti-reflective segment, but how does one fully care for their eyewear?
1. When they are not on your face, they belong in the case. I can't even begin to tell you to horrors I have seen of mutilated glasses by the hands of small children, the teeth of man's best friend, and so on. Protect your glasses with a good, hard case and don't sleep in them, either.
2. Clean them only with the following: A microfiber cloth paired with an optical spray, moist optical toilettes, dry optical towels with a spray, alcohol wipes, or water if you are in a bind (other optical cleaners like carbon padding is fine, too. Here is an example: https://lenspen.com/product/peeps/) .
Whatever you do, do not clean them with your shirt, paper towel, or anything else abrasive, no matter how convenient or soft you think it is. Never clean your glasses with chemicals like Windex. Don't reach for a Kleenex, either. Some have lotions with chemicals in them. Carry something with you or keep some in the office. Your lenses will thank you.
3. Speaking of chemicals, steer clear of getting any chemicals on your lenses or your cleaning supplies. You may wash your microfiber cloth, but it is best to do by hand and to let air-dry; be cautious of what soap you use to clean it. Do not use fabric softener or drier sheets on your cloth(s).
If you are a lover of hair products, remove your glasses and set them a safe distance from whatever spray you are using. The same rule applies for when you are cleaning house. Do not let the dispersed spray cling to your lenses (also very important for contacts lens users: seal your eyewear away before you spray, if you can). If you wear hair product, refrain from placing your eyewear on the top of your head. Exercise caution when applying sunscreen and bug spray.
4. Do not place your glasses lens-down.
5. Read the information given during your contact lens class on how to properly clean and store your lenses.
6. Take your glasses off with two hands. This will prevent stretching and keep you from visiting your eye center for adjustments. Children are the most likely culprits to use one hand to remove their glasses, and the usually do so quickly. Teach them to use two hands from the start. Hair products aside, you should also refrain from placing your glasses on top of your head because it will stretch them out.