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  1. #1

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    Ok this is about vision probably mostly age related so would like some feedback. I had Lasik 21 years ago for sever myopia ( nearsighted). I could only wear hard contact lenses my RX was -12 and-13 in right and left eye. That is something like 20/2500 vision I could read the 20/20 line on the chart if my eyes were 6 inches from the line, no joke. Fast forward it worked I passed the driver's exam no need for corrective lenses the next dayand after 3 months my vision was 20/25 same as in was corrected in contacts.

    Well now 21 years later and a bit of regression I can still barely pass the drive exam but see about 20/40 with both eyes open, my right alone is about 20/60. So I tried just correcting this with one soft contact for distance and then letting the left eye be one for close up. It has been hard to read music the lines get running together. My distance vision in this set up is fine I don't need to wear glasses which I hate. I am now trying contacts in both eyes corrected for full distance vision as my left has some correction.

    So far that is not much better in either case but possibly a bit more full distance vision. Readers don't seem to help it just seems the contacts are a bit fuzzy in looking out. I read a lot of music so the distance the music is away has an effect. However that said with out any contacts for glasses I can read music up close good. If I correct for distance and use readers to me it still looks a bit fuzzy like my eye is dirty or hazy. I am completely at a loss of what to do. I don't want to wear glasses all day and contact are great for my cycling and driving and other stuff a struggle with computer but manageable. But reading music staff lines it is easy to have errors. I would be interested in what others experience in any cases of age related vision problems ( up close) and what you do?

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  3. #2

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    I had radial keratotomy done about 27 years ago (LASIK wasn’t approved in the US yet). For about 20 years I had better than average 20/10 vision. In the last few years I began to develop presbyopia I became farsighted. Because my corneas are apparently very flexible or somewhat multi focal now, I actually wear contacts that have almost no refraction -0.5 in the left and +0.5 in the right. With those I can see 20/20 again. With the contacts in, I can see either near or far well. Without them, I can see neither well. I have glasses with progressive lenses, but I don’t use them very often. I’m not sure what the refraction range on them is. But is somewhere in the +3.0-+4.5 range.

  4. #3

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    I had cataract surgery 6 months ago.

    The doctor asked what I would like to see without glasses. I told him I would like to see the music stand. He selected lens implants that would do just that. It worked'
    I can see the music stand clearly at 3 feet. I have bifocals for everything else.

  5. #4
    Quote Originally Posted by BBGuitar
    I had cataract surgery 6 months ago.

    The doctor asked what I would like to see without glasses. I told him I would like to see the music stand. He selected lens implants that would do just that. It worked'
    I can see the music stand clearly at 3 feet. I have bifocals for everything else.
    As much as I would like that I would rather see perfectly clear on my bike as I ride out in the county. The distance horizon clear and perfect. The music stand at 3 feet would be great too but probably not an option with my other needs?

  6. #5

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    I also had cataract surgery, some years ago. The surgeon suggested one implant for distance, the other for closer objects. I thought that would never work for me, so he did one eye first, for distance, and I wore a contact lens in the other eye for closer objects. I got used to it in less than one day, so I agreed with his initial suggestion.

    My eyesight was terrible – for over 50 years, I was close to being legally blind without glasses or contacts. Everything past 6 feet or so was a blur. But one thing I could do – which was a boon when I was repairing computers – was being able to focus on things from a couple of inches in front of my eyes to about a foot out. I miss that after my cataract surgery.

    But for the most part, I can live my life without glasses. I can read without them. But for extended reading periods, I have a pair of glasses that lets me focus on a book with both eyes; I have a pair of glasses that lets me focus on the stage with both eyes. And I have a pair of glasses that I use for computer work – the monitor is about 3 feet from my face – so I can focus with both eyes. These glasses make these 3 things easier, and make it possible to concentrate without tiring my eyes. But they are all prescription glasses, with a different correction for each eye. Over-the-counter reading glasses would do nothing for me.

    I have not worn contacts on a regular basis (except that experiment for a few days after the first cataract surgery) for many years. I always had astigmatism; this meant I could not wear the original soft lenses. When I was an actor, I wore hard lenses regularly, but when I retired from acting, I was happy not to have to deal with them anymore.

    My glasses for using the computer were specifically dialed in for the distance from the monitor at which I usually sit. Perhaps you could have a pair of contacts made specifically for the distance you sit from your music, especially if you spend hours doing so? For me, glasses would be a better fit, especially since it isn't easy to change from one pair of contacts to another. But if you currently wear your contacts regularly, perhaps you could have a pair of prescription glasses measured to wear over your contacts for reading music.

  7. #6

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    AFAIK, these surgical corrections are not indefinite. Not only because age-related processes can alter your vision, but also because the cornea heals over time, undoing the corrective effect of the operation.

    It can't hurt to go see an ophthalmologist. Mark, I understand you only get the hazy effect when trying reading glasses in addition to your contacts?

    FWIW, haziness is one reason I stopped wearing contacts when I was in my early 20s, after maybe 4 years only (I had "semi hard" ones that let oxygen pass). In my case the contacts actually got dirty because of protein deposits, and that happened whenever I was tired and/or blinking less than usual ... as when concentrated on study or sheet music (orchestra rehearsals were the worst; this was in a time where there were no smoking regulations).

    This cured me of contacts for good. Nowadays I have my glasses for far vision, I'll wear a pair of reading glasses that hook nicely onto them when I need near vision; I have a pair of progressive glasses that I can't stand and only wear for gardening or shopping. Most of the time I simply take off my glasses and I've stopped wearing them around the house. For playing the solution with the double spectacles works, but my eyes are still good enough that I can see the fretboard well enough without glasses and also read what's on my stand at a bit more than an arm's length away.

  8. #7

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    1) Don’t trust your eyes to an optometrist, find a board certified MD Ophthalmologist. There are some who specialize in “aged” eyes.

    As seen so far, you’re going to see as many answers as if you asked a ‘what’s the best string?’ Question lol.
    Spending half of 21 on very high prednisone my cataracts went from a minor bother to flat out unable to read. Thought my wife’s blue dress at the daughters wedding was green. Oops.
    So after implant lenses in both eyes I have 20/25, but do need readers for music stand, book reading, and close in electronics work. Having worn glasses for so long it really doesn’t bother me.
    I guess my other thought is (as you are) think about what vision distance is most important… but I would add over the long haul. I sure didn’t anticipate serious jazz and classical playing being taken away due to my systemic illness, but they were. Very unlikely I’ll ever return to it at the level I was. If I had made a decision to focus (hehe) my vision to just music, well, I’d be SOL.
    Best of luck Mark!

  9. #8

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    I have bifocals with the focal point of the lower portion of the glasses at 3 feet. Works great for music stand reading.

  10. #9

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    And by the way, after my cataract surgery my wife would tell her friends, "If your husband is grumpy, tell him to get cataract surgery." My cataracts made my life pretty miserable – when I went to the theatre, I had to close one eye to chase away the blurriness, and things were getting pretty dark. Even so, two ophthalmologists I went to said I wasn't ready for surgery yet – they both said, "Close your eyes. Now imagine that's what you see every day." That was the warning that the surgery could fail.

    The third ophthalmic surgeon I went to said he never even brings that "close your eyes" thing up. He's done thousands of operations, cataract and LASIK, and never had that outcome. Fortunately, both my eye surgeries were successful, and I was much more cheerful afterwards.

  11. #10

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    I've had cataract surgery in both eyes. I was not offered some of the more recent options, so I wear progressive bifocals.

    The lenses have a kind of hourglass shape grind. The distance vision part on top is wide, then it narrows down for middle distance and then widens out near the bottom for reading.

    The point I want to make is that the width of the middle distance section depends on the brand of lens you buy, as I understand it. Some are wider than others. The optometrist had pictures for different brands. I picked the widest and it worked fine. I can't be 100% sure that it really mattered, but it worked.

    I know people who couldn't adjust to progressive bifocals, but for me it felt completely natural from the start. I never think about it. I can see everything.

  12. #11

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    Quote Originally Posted by jazzkritter
    1) Don’t trust your eyes to an optometrist, find a board certified MD Ophthalmologist. There are some who specialize in “aged” eyes.
    That's not the whole picture Don't trust the health of your eye[ball]s to an optometrist, but don't trust the quality of your vision to any ophthalmologist either. Of course it'll depend on the training your eyedoctor had, but they tend to focus on the individual organs. A good optometrist will be better qualified to help you get the best possible vision from your 2 eyes. In principle; these are complementary professions. A good optometrist will also know when to send you to an ophthalmologist, btw, the reverse is less often true in my experience.

    Quote Originally Posted by rpjazzguitar
    progressive bifocals.

    The lenses have a kind of hourglass shape grind. The distance vision part on top is wide, then it narrows down for middle distance and then widens out near the bottom for reading.

    The point I want to make is that the width of the middle distance section depends on the brand of lens you buy, as I understand it.
    Probably more on the price you're willing/able to pay per lens... I think I went with the a compromise; I also wanted real glass (more scratch proof!) and darkening. Maybe 4-5 years ago the optometrist I've been going to for years agreed I was probably ready for them, so I paid him around 700€ for just the pair of glasses

    "Progressive bifocals" is kind of a contradictio

    I know people who couldn't adjust to progressive bifocals, but for me it felt completely natural from the start. I never think about it. I can see everything.
    I really regret not haven taken a trial insurance option which would have allowed me to return or exchange them. I'm not getting used to having to scan for the right focal zone with head movements lots of the time, the mid-range part is too narrow and the near vision bit in the lower part really bothers me during simple activities like walking the dog (or just myself, anywhere where I need to watch my step). I already knew I wouldn't be able to wear them doing computer work - I have a proper set-up that puts the top of the screen at eye height so I'd have to tilt my head back continuously.

    I've known an orchestra player (violinist) who had "quadrifocals" made for him. Essentially he had a zone for his stand, one for the director (the right upper IIRC), one for far and probably one for reading - all calculated to minimise headmovements during his professional activity. According to him it had been quite easy to get used to this ... but I wouldn't want to walk around too much wearing them

    Incidentally I do something comparable myself; my left eye is worse overall but allows me to see closer; my right eye is a bit better for far vision. That works out fine for watching my fretting hand and my stand (or others during ensemble playing).

  13. #12

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    Quote Originally Posted by RJVB
    I've known an orchestra player (violinist) who had "quadrifocals" made for him. Essentially he had a zone for his stand, one for the director (the right upper IIRC), one for far and probably one for reading - all calculated to minimise headmovements during his professional activity. According to him it had been quite easy to get used to this ... but I wouldn't want to walk around too much wearing them
    I know a trumpeter who got himself a shorter, more compact trumpet so that he could get his eyes closer to the music.

  14. #13

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    Wait for a sale at one of the discount vision stores. Bring your music stand and some sheet music. The optometrist can adjust the lens for the exact distance between you and your music. I've been using my "music" glasses for over 6 years and am ready for another pair. Indispensable if you read music during practice or on a gig. Good luck!
    Marinero

  15. #14

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    RJVB I would agree on Optometrist vs Opthalmologist but as we age (assuming the usual jg.be boomer majority) theres just too much risk to trust the changes to a non MD.
    Ive had too much go wrong to not search for medical experts with certification. YMMV.

  16. #15

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    I bought my first pair of reading glasses on my 40th birthday. As a consolation to my decline, I went to Gelb Music in Redwood City and bought a 40th Anniversary Stratocaster. I told my parents that if they had bought me a couple of Strats on the day I was born, our retirements would be a lot more comfortable. The decline continues...

  17. #16

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    An optometrist is an MD. The specialties are just slightly different. My HMO has both, and we get free annual exams from an optometrist, who refers to other specialties as needed. My vision was 20/20 or better until I got into my late 40s, then went south with presbyopia. I had to use reading glasses, then bifocals, then trifocals, and eventually found progressive bifocals, which they really were. They were like regular bifocals, except that the bifocal area was progressive. I loved them. But they're no longer made. Then sometime in my 60s, my vision came back, and I can get by without glasses, and only wear them part of the time, mostly while driving. But the deterioration due to cataracts is progressing, and I'll probably get cataract surgery someday. For now it's bearable. Mark, you really should get a thorough exam from an optometrist, who can diagnose whether cataracts are part of your problem, and refer you to a surgeon if necessary. Don't start there. Cutters want to cut, because that's what they know, and that's where they always start, regardless of the specialty.

  18. #17

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    Quote Originally Posted by sgosnell
    An optometrist is an MD. The specialties are just slightly different. My HMO has both, and we get free annual exams from an optometrist, who refers to other specialties as needed. My vision was 20/20 or better until I got into my late 40s, then went south with presbyopia. I had to use reading glasses, then bifocals, then trifocals, and eventually found progressive bifocals, which they really were. They were like regular bifocals, except that the bifocal area was progressive. I loved them. But they're no longer made. Then sometime in my 60s, my vision came back, and I can get by without glasses, and only wear them part of the time, mostly while driving. But the deterioration due to cataracts is progressing, and I'll probably get cataract surgery someday. For now it's bearable. Mark, you really should get a thorough exam from an optometrist, who can diagnose whether cataracts are part of your problem, and refer you to a surgeon if necessary. Don't start there. Cutters want to cut, because that's what they know, and that's where they always start, regardless of the specialty.
    An optometrist is an OD, not an MD. An optometrist can do some of the things an ophthalmologist can do, but is much more limited in scope of practice. They can only prescribe a limited range of eye specific medications and cannot perform surgery.

  19. #18

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    Quote Originally Posted by jazzkritter
    RJVB I would agree on Optometrist vs Opthalmologist but as we age (assuming the usual jg.be boomer majority) theres just too much risk to trust the changes to a non MD.
    IMHO you need both; regular visits to an ophthalmologist (once a year is advised here, which I only don't do because it's near impossible to get a foot in the door for that 1st visit at a reasonable distance). Plus an optometrist for whenever you notice your correction is no longer appropriate. They're also the kind (not the only!) of specialist to consult when a young child shows signs of dyslexia (this comes from a former colleague of mine who still studies vision problems in children).
    Optometry is not a recognised profession here in France (they invented their own flavour ... surprise) but I can affirm that not all certified optometrists in the Netherlands are also MDs (I'd say most are opticians).

  20. #19
    Quote Originally Posted by jazzkritter
    RJVB I would agree on Optometrist vs Ophthalmologist but as we age (assuming the usual jg.be boomer majority) theres just too much risk to trust the changes to a non MD.
    Ive had too much go wrong to not search for medical experts with certification. YMMV.
    The optometrist I go to is in a full practice with the Ophthalmologists group who did my LASIK 21 years ago. My Ophthalmologist who did my LASIK retired a few years ago but his partners are still in practice. I feel covered pretty well. In fact the Optometrist does a retinal scan all the time and I have a Macula Pucker. This is not macular degeneration and can be fixed if need. Mine does really effect me too much a few wavy lines at times in my right eye had for years. I have a lot of floaters and such as one with high myopia this is expected.

    As of today I went back to the one soft lens in the right eye only. I think I am getting used to my left eye for up close seeing and with both eyes at a distance they are equal. I going to see how this goes trying to read music. I think I can adapt. I don't like glasses at all even reading glasses for up close. All these years of working on guitars and seeing fine detail repairing them probably is the place that will require some magnification no matter what. I Seems with both lenses in it makes things no better if not worse. so only have to buy one set of lenses. Working on restoring this old Gibson LG 1 the past 4 weeks has been a struggle but the good part is the guitar is now in fine playing shape. I just have to fight to see things as I was working on it.

  21. #20

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    No, an optometrist cannot perform surgery. And that's why you should start there. Surgery may not be required, and seldom is. The ophthalmologists want do do surgery, because that's what they do. The more they do, the more money they make. I prefer to let my optometrist do the scans and exams, and she is thorough about them. She doesn't hesitate to refer to whatever specialist may be needed for the condition she finds. No matter the problem, nor what part of the body is affected, you should never start with a surgeon. Go there only when necessary, after other doctors are consulted and say surgery is necessary, whether optometrist, internal medicine, or whatever.

  22. #21

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    Quote Originally Posted by deacon Mark
    I don't like glasses at all even reading glasses for up close. All these years of working on guitars and seeing fine detail repairing them probably is the place that will require some magnification no matter what..
    Maybe look into a headband magnifyer or optivisor? A colleague of mine had one for the smaller electronics stuff he worked on, looked very useful.

    BTW, careful with that LED lighting. It's very tempting to use more and more of it as our vision degrades but it might cause cataracts to progress faster (I'll admit that I never verified this info).

  23. #22

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    Quote Originally Posted by RJVB
    Maybe look into a headband magnifyer or optivisor? A colleague of mine had one for the smaller electronics stuff he worked on, looked very useful.

    BTW, careful with that LED lighting. It's very tempting to use more and more of it as our vision degrades but it might cause cataracts to progress faster (I'll admit that I never verified this info).
    That’s an interesting thought. Most pathologists, like me, now use microscopes with LED light sources, many have for 10 years or longer. I’ve never heard anyone mention an increase in cataract risk. UV light is supposed to be a possible risk factor, but at least the LED lights in our microscopes are supposed to have essentially no UV. They certainly cause far less eye fatigue than the halogen lights we all used to use. I actually stopped having any noticeable eye fatigue after getting my microscope with an LED light.

  24. #23

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    As I said, it's to be verified, and AFAIK those yellow-tinted glasses sold for computer work never really became a thing.

    I've been meaning to read up on this or ask around in my former network, but I do seem to remember that short wavelengths are indeed involved and that long exposure to too much of those isn't very healthy. White LEDs certainly do generate a good amount of energy in the blueish regions. And we're seeing more and more extremely powerful LED light sources becoming readily available, including those beautiful bulbs with filament-like LED arrays but also vehicle headlights *). Best avoid direct lines of sight to those as a matter of precaution. I wouldn't worry too much about LED lighting in microscopes and such; too strong backlighting will probably be counterproductive anyway in such applications (from what I remember ... preparation/dissection binoculars are maybe a bit different).

    *) vehicle headlights (and lack of proper adjustment thereof), a topic for a whole 'nother rant thread!