# Conversation and Fun > Just Conversation >  Hypothetical Question

## OptiFan

I'm not in eyecare. I have a hypothetical question. Say script number
ONE is OD +.75 +.50 35 OS -.50 +.50 40 ADD +2.50 and script number
TWO is OD +.75 -.50 135 OS +.50 -.50 175 ADD +2.75. Are these
approximately the same or are they vastly different?

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## Judy Canty

Hypothetically, you need to take this question and your concerns to a trusted local eye care professional.

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## chip anderson

To avoid the whole consumer controversy, the answer is:  "Close but not the same."

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## OptiFan

> Hypothetically, you need to take this question
> and your concerns to a trusted local eye care professional.


Actually, not hypothetically, I took this question to two different eye
care professionals and got two different answers. I don't particularly
trust either one as far as refractions go.

The first, an optometrist, said they are vastly different.

The second, an ophthalmologist, said they are nearly the same.

Should I keep going to eye care professionals until a majority agree?
Is this is an objective matter or just a matter of opinion? Perhaps if
I knew which one was wrong I might know better which one to trust.




> To avoid the whole consumer controversy,
> the answer is: "Close but not the same."


Thanks. This is what I suspected. I'm trying to figure out why one pair
is much clearer than the other. One pair is CR39 and the other is poly
which may have more to do with crispness and clarity than the RX
itself. Also one pair is bottom of the barrel cheap while the other is
top of the line expensive so the lens quality may differ greatly. 

This is not entirely or even primarily a consumer question. I'm trying
to learn more about applied optics. My undergrad major (many, many
years ago) was physics where I had a course in optics including a lab
section. Knowing how light bends theoretically does not translate
smoothly to knowledge of eye wear optics. Our lab work included quite a
bit on microscopes and telescopes but nothing on eyeglasses. My college
studies were back in ancient times (the 1950's) when microscopes and
glasses were "vastly different" from today's models. Still I can see
well at reading distance out of my grandmother's glasses purchased in
1910 so maybe they are "nearly the same."

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## uncut

Engineer consumer a-lert!

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## DragonLensmanWV

I think it can be said one of those don't know squat about transposing.

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## OptiFan

> Engineer consumer a-lert!


Actually, I'm a retired MD, an internist, and a retired real estate
developer...

but two brothers and my children are engineers. Maybe it's contagious!

I retired in 1985 and am now 83 years old. I have little to do these
days except read books and make a pest of myself on some web forums
where I have an interest in the topic. For some odd reason lately I
find both eyeglasses and the opticianry trade/profession fascinating. 

Once upon a time I owned a medical clinic that employed salaried
ophthalmologists so I'm a bit more than an ordinary consumer. Some of
my best friends are OMD's but none of them have much interest in
glasses. Fifteen to twenty lens transplants a day seem to be more
profitable than refractions.

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## OptiFan

> I think it can be said one of those don't know squat about transposing.


That's what I thought. Is it still the norm for ODs to prefer the
minus notation and OMDs the plus?

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## obxeyeguy

> That's what I thought. Is it still the norm for ODs to prefer the
> minus notation and OMDs the plus?


Yes.

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## Speed

> I'm not in eyecare. I have a hypothetical question. Say script number
> ONE is OD +.75 +.50 35 OS -.50 +.50 40 ADD +2.50 and script number
> TWO is OD +.75 -.50 135 OS +.50 -.50 175 ADD +2.75. Are these
> approximately the same or are they vastly different?



Yes.

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## cleyes

If a new script improves your clarity then it is vastly different, if not then it is similar!

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## Wes

Hypothetically you should ask your OMD best friends.  Even if they aren't that interested in glasses, I'm sure one of them might make an exception for a best friend and take a look at your rx.

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## Wes

Or try googling "transposing spectacle prescriptions."

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## Happylady

double post

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## Happylady

Which one is clearer? Is it the expensive pair or the cheap pair?

They are not vastly different. They are a little different, enough that for some people one pair would be noticeably clearer. Some people might not notice much difference.

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## OptiFan

> Hypothetically you should ask your OMD best friends.  Even if they aren't that interested in glasses, I'm sure one of them might make an exception for a best friend and take a look at your rx.


Unfortunately, my personal morality is not to impose on friends. However
I did speak to one in general terms and he perhaps jokingly said why not
try both. I did just that. Ignoring the parameters of a scientific
experiment, I used one script to get lined bifocals and the other for
progressives, a first time wearer at age 83. The finished products
being extremely different I still have no idea which Rx might work best
for me or whether the difference is trivial or significant. Neither
pair really improves my eyesight all that much except at close range.
Absolutely I can see better to drive, read road signs, notice
peripheral traffic, etc. without glasses.

My regular OMD where I've gone for exams at least annually for the
past twenty years has consistently told me that I don't need
prescription glasses. He says my vision is 20/25 without glasses and
that I should simply use drugstore readers for near vision. He said
there's no reason why I should spend more than a buck or two for
glasses. He's a superb eye surgeon but is one of those not interested in
eyeglasses. He's monitoring my eye health, not my vision. I've had
background retinopathy come and go in one eye and have macular
degeneration scars and severe cataracts in the other. He doesn't
routinely refract anyone in his practice other than his post-surgery
patients but he will do it for established patients on request.

The reason I had two scripts in the first place is because two months
ago I asked my OMD about progressives since I have two friends about my
age who rave about them. He said I didn't need them and the odds were
about 50 to 1 that I wouldn't like them but he gave me a script to try
them. Before I had a chance to go shopping I got an offer in the mail
for a free eye exam by an optometrist at a chain store. When I got his
Rx, which his assistant gave to me rather reluctantly, I was curious
about such an apparent difference. None of this is a big deal. I'm still
playing with progressives but I don't wear glasses full time. I have a
dozen dollar store readers in handy spots. Those have been sufficient
for me for more than 40 years. I really liked the theory of
progressives but in practice for me they're funhouse glasses.

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## Happylady

So which did you have made in which? And which is clearer?

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## OptiFan

> So which did you have made in which? And which is clearer?


The cheap pair is clearer, but there are many differences other than
price. The cheap pair are plain CR39 flat top bifocals while the
expensive ones are progressives in poly with all the coatings the
optician/saleslady recommended. The cheap pair is made from the OD's
script and the other from the OMD's Rx. The cheap pair came from
Walmart and the expensive ones came from a semi-independent, a separate
entrance shop of an OMD where I've never been a patient. 

I bought these before I found this forum and I would not make the same
choices now. I think I might have been taken a bit because I paid for
their "best premium" lenses but after I found this forum and asked more
questions where I bought them I discovered I got Ovation.

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## OptiFan

> Or try googling "transposing spectacle prescriptions."


I did this weeks ago the day I got the second prescription but this
told me absolutely nothing since I have no idea of the significance of
differences in the cylinder/axis. I know I can rotate the lens in the
distance part of my prescription bifocals [+.75 -.50 135] and nothing
changes. It must have some theoretical and clinical difference or it
wouldn't be done universally. It seems this degree of astigmatism
correction isn't noticeable to me in real life thus isn't really
significant. On the other hand it must be noticeable when I'm being
refracted.

In fairness to my doc suggesting I stick with readers my right eye is
heavily dominant. Due to macular degeneration scars I have extremely
distorted central vision in my left eye. I also have fairly advanced
cataracts only in my left eye. Effectively I have only peripheral
vision in my left eye which gives me depth perception but not much
else. Hence there isn't much concern about the left and right lenses
being different. When my left eye is refracted I cannot distinguish any
letter. I look at a small part of the edge of a letter and see it's more
crisp trying to ignore that it's curving the wrong way to draw a
letter. Usually I can't guess the letter successfully but I can see if
the distorted shapes are clear or fuzzy. In a range of less than 36
inches or so I can see best closing my left eye. For some years I used
an eye patch on my left eye when using a computer with 2.00 drugstore
readers to avoid eye strain. I reported this to my doc repeatedly but
the prescription glasses I've had were never any better than readers.
Interesting enough however, my new progressive lenses do seem to help
more at close ranges in that they don't create left eye strain
especially if I tilt my head a bit to try to get both sides evenly
matched in clarity.

I've never gone to an eye doctor who had an auto-refractor. I'm getting
more and more curious about how a prescription based solely on
objective measures would work for me.

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## cleyes

Boy, this is a fine kettle of fish. With your eye issues, the Rx that works best is the one that gives you the best near.   That I would say is #2..... It has the highest total near power. Whether it's in progressive or FT bifocal, cheap or expensive is actually immaterial provided they are both fitted well. The crux of the issue is the Rx for someone who has poor near vision caused by AMD & cat & what sounds like DR. Since you have already filled both Rx, there is no point to your post since your issues can't be addressed here, much less solved.  If you want to compare bifocal to progressive you should have each Rx filled in both formats.
 By using OTC readers, you have demonstrated the irrelevance of your astigmatic correction in your visual performance. However incorrectly place axis can impact on your clarity at near. Further muddying the waters is probably the fact that only one eye reads well, the Rx that gives that eye it's best acuity will work best. This is not an issue of cheap vs expensive glasses.
This is not the place to solve any of your questions.

Posted this before your latest post. My post stands.  There is always more to these questions than we are privy to!

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## OptiFan

> ... Since you have already filled both Rx, there is no point to your post since your issues can't be addressed here, much less solved. <snip> This is not the place to solve any of your questions.


From the beginning my posting here was to learn, not solve particular
problems. I've learned many things and am still learning. My original
question was answered several times, namely there's not a huge
difference between the two scripts.

After I learn and absorb a bit more I think my next move will be to get
another pair of glasses with much higher quality progressive lenses. I
still like the theory of progressives. I may get a new prescription from
a small town/village optometrist an hour away who's been highly
recommended. I'm told he gives 90-minute exams and has an optician with
many years of experience. I have both time and money to waste if waste
is what it turns out to be. My male relatives all lived into their
mid-90's so it may not be too late for me to try to improve my vision.

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## hcjilson

Much ado about nothing!

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## Spexvet



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## OptiFan

I can read the 2 and W without glasses. My kids watched Sesame Street
religiously from the time it started up to the mid-70's but I couldn't
even stand to be in the same room when it was on. I told the kids the
Three Stooges and Roadrunner cartoons were more educational. They
ignored me of course.

I made an appointment with the highly recommended village optometrist
for 9:30 Sept 25 and yesterday I ordered a pair of lined bifocals from
Zenni Optical using the OMD's script. I used to be an adjunct professor
at the University of Missouri-Columbia. I spoke with a colleague still
teaching there and he said he'd show me around the Mason Eye Institute
and introduce me to some of the faculty when I have a day to spare.
They have 17 refraction chairs and an optical shop with a lab and three
experienced opticians. Maybe I can learn a bit more there.

http://medicine.missouri.edu/ophthal...tical-shop.php

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## hcjilson

> I can read the 2 and W without glasses.


More to the point.......DID YOU GET THE MESSAGE?

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## chip anderson

Your near and distance vision will _always_ be better in a segmented lens.  Let me know if the optometrist actually spends 90 minite on exams.   If so let us know the exam fee.   Today nine minite exams are concidered lengthy, three to five (actual doctor's time) being more the norm.   The only ones I have known to take longer were old friends who took the time to BS about huntin, fishin, and women.

Chip

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## OptiFan

> More to the point.......DID YOU GET THE MESSAGE?


Perhaps. Perhaps not. I don't think you people got my MESSAGE. My first
post was actually to see if I might have grounds to make a complaint to
the optometry board about incompetence but I guess he did the
refraction well enough. Now my area of concern has grown from optometry
to opticianry. It might not be obvious to some here who can't even
manage 8th grade English grammar or understand the subtleties and
nuances of "some of my best friends" but I'm a bright fellow: Mensa,
National Merit Scholar, triple major (biology, chemistry, physics), Phi
Beta Kappa, Alpha Omega Alpha in medical school, successful in a number
of careers including making millions in real estate in the 1970's
(partly or mostly thanks to Carter's inflation), two-term state
senator, author of seven non-fiction books and very much interested in
the area of public health.

I have the time, money and political influence to see that Missouri
never licenses opticians and that no community college or vocational
school ever teaches the trade in this state. I have actively opposed
expansion of scope of practice for optometrists with some success for
almost fifty years and I may well set my sights on opticians. I think
it may be contrary to public interest to allow any impression that
opticians are in any way involved with health care. Glasses are medical
devices but so are canes, crutches and wheelchairs. I don't see anyone
licensed to measure butts for wheelchairs or allow wheelchair stylists
to choose fashionable wheelchair colors or require a "fitting" before a
medical wheelchair device is "dispensed." Opticianry may be more than
the dying used car sales racket it seems and be an outright danger to
public health. 

Postings here are open to the general public. The rants here against
competitive lower cost goods and services from corporate entities and
especially from online merchants could well be damaging both health
and financial interests of the public. 

I would expect _professionals_ to be more attuned to "patient"
inquiries. Perhaps it's time for an active consumer section for this
forum.

"Buying a wheelchair online may be cheaper but who will fit it to your
butt? Will the online store install a new screw when one inevitably
falls out? A poorly fitted wheelchair could harm your butt. You may not
think you need the waterproof coating on your wheelchair seat now but
your time will come."

Perhaps a new approach to selling eyewear is needed. Perhaps any
licensed pharmacist should be allowed to dispense eyeglasses. That would
certainly elevate the level of dispensers, enable more open competition
and cut out much of the BS now associated with eyeglass selling. But
then maybe the same people who now sell glasses would just move over
and work under the pharmacist's license. Or perhaps anyone should be
allowed to sell eyewear and let the free market weed out the inferior
goods and services. I think it may be time to drive a stake through the
feebly beating heart of opticianry.  

Society for the Freedom to Purchase Eyewear -- join today!

Am I serious? What is my MESSAGE? 

Likewise I have the money to endow a chair or department of opticianry
at a major university or to finance a new national certification system
to grant meaningful credentials to opticians. Be careful not to play
with things you can't see clearly.

*A single word you say may affect the minds of millions of people.*

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## OptiFan

> Let me know if the optometrist actually spends 90 minite on exams.   If so let us know the exam fee.   Today nine minite exams are concidered lengthy, three to five (actual doctor's time) being more the norm.   The only ones I have known to take longer were old friends who took the time to BS about huntin, fishin, and women.


On my last visit to my OMD in August his nurse, an RN, not a sales
clerk, took me back and spent about ten minutes reviewing my case
history, the doc came in and spent ten minutes going over my history
and doing the refraction. He dilated my eyes and I had about a fifteen
minute wait until he came back. After looking at my eyes with assorted
lenses he spent about ten minutes discussing the pros and cons of
cataract surgery on my bad eye then he spent another fifteen minutes or
so discussing progressive glasses. My wife waited out front an hour and
ten minutes. I don't know how routine this is. He doesn't know I'm a
retired MD but I am a 20+ year established patient. His fee was $178.
My wife goes to a different OMD and he schedules and spends 50 minutes
with her each time including the dilation wait. (She's had dozens of
eye surgeries since 1995 and her eyes are a mess.) Her doc charges
$150. Both of these guys make their money on surgery, not office visits
or exams. My wife's bill for her last operation was over $4,000. She
was in the operating room less than ten minutes. The one and only OD I
saw did spend less than five minutes which I thought was borderline
malpractice and gross incompetence. His fee was free, but normally $45.
The difference in OD's and OMD's may be far greater than I imagined.

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## optical24/7

> Scholar
> Perhaps. Perhaps not. I don't you people got my MESSAGE. My first post
> was actually to see if I might have grounds to make a complaint to
> the optometry board about incompetence but I guess he did the
> refraction well enough.
> 
> 
> Refractions are objective. Who told the OD which was better, 1 or 2?
> 
> ...


..

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## chip anderson

Scheduled time and time actually seeing the doctor are not the same.   Most OMD's now schedule four patients per 15 min.
One does get a _little_ more attention if a surgical fee is potentially in the works.  But a routine eye exam, tech's do it and the doctor steps in for the obligatory "_seeing the patient."

_I have had it take me six hours to get a patient's doctor on the phone when the patient was in my office with a detached retina.   Only got him then at home after the army of women (receptionist, office manager, nurse, optician) and gotten out of the way between the doctor and I.   And yes the doctors in this area know I won't call and try to get a patient examined ASAP because "he's from out of town and just broke his glasses."
I am not trying to condem, or promote any of the O's just saying ophthamic medicine is no longer anything other than a business.    Many offices now answer the phone with a pre-recorded message more interested in your method of payment than your eye condition.   Can't remember the last time I called one and someone asked what the problem was before putting me on hold.

Chip

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## hcjilson

> I'm a bright fellow: Mensa,
> National Merit Scholar, triple major (biology, chemistry, physics), Phi
> Beta Kappa, Alpha Omega Alpha in medical school, successful in a number
> of careers including making millions in real estate in the 1970's
> (partly or mostly thanks to Carter's inflation), two-term state
> senator, author of seven non-fiction books and very much interested in
> the area of public health.
> 
> 
> Am I serious? What is my MESSAGE?


You may be all the things you claim....or you may not! It is not pertinent to this conversation. It is patently clear from this thread you don't know Jack about what we (the three O's ) do. As a self proclaimed "bright guy" you surely read our posting guidelines which are quite specific concerning consumer questions about their problems. May I take the liberty of quoting them for you.

"
Given all of this, I have decided that we  need to strictly and vigoruosly enforce the existing posting guidelines  and remove or close all consumer posts that are attempts to get  diagnostic help or information. The guideline is:"Consumers are allowed to post on the Board, as long as the posts concern general eyecare related topics. However please be aware that any questions that involve diagnosing specific eyecare and eyewear problems *are not appropriate*  for an online discussion forum. These kinds of questions should be  discussed with a qualified eyecare professional who has examined you and  is familiar with your situation. Posts asking for diagnostic help will  be closed or removed."We will give  this a try for a while to see how it goes. However if we continue to be  ignored, treated rudely and abused by people who violate these  guidelines, we may be forced to not allow *any* consumer questions at all. "

If you didn't get the message from spexvet's magnificent contribution to this thread, go back and play it again! If you STILL don't get the message, send him a Private Message and he'll spell it out for you. I'd do it myself but I am too busy wishing I had your credentials!

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