A quick one today, from the forum.  Blake asks:

So I just had a thought. My Rx is so high it causes a fisheye effect and it causes me to be very self concious, which was a big reason for going back to contacts. Would it be wiser to wear my full distance Rx in contacts and wear a +.25 or so for distance and then a +1.5 or so for close up work as opposed to a 1.5 lower Rx in glasses for close up and than a pair for full distance?

I do answer this question from time to time, but there really isn’t an excellent rehab Q&A library for these things.

There should be.

Here’s what I suggest for Blake.  Bear in mind that this is specifically for you if you aren’t following the mainstream single prescription paradigm (and use lower prescriptions for close-up):

A bit of an involved topic. Short version:

You could wear a normalized prescription contact lens (reduced distance prescription, don’t get into that till the sessions talk about it). With that, you could go for a plus lens to reduce the focal plane change for close-up.

Upside:

High diopters in particular, contact lenses maintain notably higher quality vision. Translates to lower net strain and a happier visual cortex. Also less impact on peripheral vision, liming which has shown to be a contributing stimulus to increasing myopia.

Also, cheaper and easier to switch between these than equivalent glasses prescriptions.

Downsides:

Contact lenses aren’t great for keeping your corneal tissue healthy, and especially paired with reduced blink rate during close-up, lead to low oxygen risk with less available tear fluid.

In your case, I’d be tempted to go with contact lenses at least in the beginning, save money on reducing prescriptions, and use that at least until progress slows to a normal rate. Then reevaluate whether you feel better not having those lenses in your eye during close-up.

Make sense?

Rather than tell you what to do, I like to give you as many of the effects and potential outcomes as I can, and let you chose what’s best for you.  Especially for higher prescription cases, there’s a lot to be said for individual preference.

Interesting e-mails (and a few comments too!) on yesterday’s vegetarian bug sandwich post.  Quite enjoyed reading your perspectives.  :-)

Cheers,

-Jake