The optical assistant (OA) may be asked by a patient to explain their prescription. So in this article, we will look at some of the common questions patients may ask – and how to answer them clearly and succinctly.
“I have been told I am short-sighted. What does that mean?”
Shortsightedness, or myopia, is a condition where your eye is either more powerful, or longer than the standard eye or a combination of both. This means that when light enters your eye, instead of being correctly focused on the retina, and thus providing clear vision, it focuses in front of the retina, which results in a blurred image.
There may be a point close up that you can see clearly without spectacles, but things in the distance will be blurred. The more short-sighted you are, the more blurred things will be. Your spectacles will correct your vision by using a concave lens that will diverge the light, and thus push the focus back onto the retina, enabling you to see things far away clearly.
“I have been told I am long-sighted. What does that mean?”
Long-sightedness, or hypermetropia, is the opposite of myopia. It is when the eye is either not as powerful, or shorter than a standard eye or a combination of both. This means that when light enters your eye, it is not able to bring the light to focus on the retina and so your vision will not be clear.
Sometimes, it is possible for the eye to accommodate, which means it can adjust its focus by adding more plus power to bring the image onto the retina, and hence improve the vision. However, this is only possible if the lens in your eye has the ability to accommodate or the eye muscles involved in this are strong enough, and this ability declines as we get older. It may also create strain within the eye by continually having to accommodate.
This is compounded when we look at something close, as the eye has to accommodate even more to see things close up. The effort of this additional accommodation may result in headaches, eyestrain and blurred vision if the eyes are unable to sustain this.
It is worth noting that this is very relevant to young hypermetropic children, as they will have a high degree of accommodation available and may be able to mask a fairly high degree of hypermetropia. The problem arises when the accommodative effort is too great to sustain, and so in response the eye develops a squint, which can result in a permanent reduction in the vision if the hypermetropia is not corrected.
If a parent tells you that their child seems to have an intermittent squint, typically later in the day when the eyes are tired, or when doing prolonged close work, you should book them in for an eye examination as soon as possible in order to prevent any possible long-term reduction to their vision.
“I have just been told I have astigmatism. Can you explain that to me?”
Astigmatism means the shape of the eye (usually the cornea) is not spherical and has a different curvature in each meridian. Imagine the shape of a football being spherical, but with astigmatism the eye is more rugby ball shaped, with one meridian being a steeper curve than the other.
This means that when light enters the eye, it will not focus as a single point but will form two different focal points. This means that the lens to correct your astigmatism will have a different prescription in each of the two meridians of the lens in order to bring each point to a single focus on the retina.
“Why do I now need glasses to see small print as I have always had very good eyesight?”
This is a very common question and something that comes to us all at some point in our lives. Up until the age of about 40 years, our crystalline lens in the eye is very flexible, and able to adjust its focus (accommodate) from distance to near objects. As time goes by, the lens becomes less flexible and this ability to accommodate is reduced.
When the amount of available accommodation is insufficient for the patient to see things close up, spectacles or contact lenses are needed to provide that extra amount of power. This condition is called presbyopia and translates from the Greek into ‘old eye’ (although it’s probably best not to tell your patient that).
“Since I started wearing reading glasses my vision has deteriorated. Are the glasses to blame?”
Patients sometimes think spectacles have made their eyesight worse, especially reading spectacles. This is not the case, and wearing spectacles just means the patient will see more clearly. Patients will find that typically there will be a change to their reading prescription every two years or so, and this is because the crystalline lens will continue to lose some flexibility over time.
This change in flexibility occurs whether the patient wears spectacles or not, but some patients blame their spectacles for making their eyes worse. Explaining that this is a natural change to the eye over time and is not dependant on wearing spectacles helps to reassure your patients.
“My husband and I are quite short-sighted. Will our children also be short-sighted?”
As with all genetic characteristics, there is a chance your children will develop myopia, but there is also a chance they will not. It is important to bring your children for regular eye examinations (as it is for all children, regardless of family history), so this can be monitored.
If they do show signs of developing myopia, there are many new advances in managing the development of myopia in children, both with spectacle lenses and contact lenses.
These are just some of the possible questions patients may ask you, and it helps to be able to answer these questions in layman’s terms in order to provide an understandable explanation.
Finally, after four years of writing articles for OA Corner I am hanging up my hat. I hope you have enjoyed reading these bite-sized snapshots and have found them interesting and thank you for reading them.
Sue Deal FBDO R is a practising dispensing optician, ABDO College examiner, senior tutor and supervisor for dispensing opticians. She is also a practice visitor and external moderator for ABDO. She holds the ABDO Medal of Excellence for her outstanding services to the profession.