Progressive lenses

Can’t get used to your progressive lenses? It may not be the reason why you or your optometrist think! Progressive lenses can be a frustrating thing for many people to try to get used to.  They can cause dizziness, headaches, depth perception problems and more. Most of the time you’re told to ‘just get used to it’ (that’s what many eye doctors are taught in school). If you struggle with them, sometimes it’s suggested that you just need to buy a more expensive lens.It wasn’t until several years after graduation from optometry that my engineering brain caught up with me, and I started to realize the main reasons why people can’t get used to progressives.

Most of this stems from the fact that glasses do more than just make you see clearly.  Most people, including many eye doctors, don’t realize that the prescription you’re given can change more than just your clarity.
Your glasses can also change:

• How your eyes work together
• How you perceive depth/space
• How your inner ear and vision work together

1. The prescription could be causing the problems.  

Most prescriptions are given to make you see clearly but can have unintended consequences.  The same prescription that makes things clear, may actually be causing headaches, migraines, dizziness, light sensitivity or other problems. Giving a glasses prescription isn’t as simple as measuring a shoe size.  The prescription should take into account what makes things clear for you, and then be altered and adjusted based on how your eyes and your brain work together. You may have even had a second opinion on your prescription, and still, be frustrated.  The problem is that optometrists and ophthalmologists are still taught only to prescribe based on clarity.  Our education seems to overlook how the lens can change so much more (for better or worse).

THE FIX:  Find an optometrist who specializes in neuro-optometry and is familiar with using prism for depth perception, not just muscle weaknesses (this is not always the best way to use prism).

2. How the glasses are made could be causing the problem. 

So you’ve sat there and had the conversation about good, better, and best lens designs. You’ve been given options to choose from with your lenses.  When was the last time this happened with a drug prescription?  In order for the glasses to be considered ‘the prescription’, it only needs to match the prescription for clarity.  Many lens manufacturers make other adjustments to the prescription such as adding prism (which can change how your brain processes depth and space).  Even the pupillary distance (PD) measurement, or where the heights of your lenses are set can change the actual prescription.

I can still remember a patient who came to me with the complaint that she was dizzy and often falling forward off of her horse.  Her prescription was great for clearness, but the lens design had prism in it that caused her to always be off-balance leaning forward.  A simple change, using prism in the correct fashion, and she no longer was dizzy or falling off her horse.

THE FIX:  Make sure that the glasses are made exactly as prescribed by the optometrist in Victoria or Nanaimo who understands how they will impact how your eyes and brain work together. Ensure that where-ever you have your glasses made, they will guarantee that you will be satisfied with your glasses (often a 100% refund policy for 2 months).

3. Your progressives may have been prescribed for the wrong reasons or overpromised.

Progressive lenses allow a person to be able to see at both distance and near.  Think of your glasses like shoes, the shoes that multi-task for you (a water-resistant runner for example), is not as good in the rain as a boot and not as comfortable to run in as a good runner.  Progressive lenses are the same. The place this causes the most problems is at the computer. Remember, the top of your glasses is set for distance (think 10 ft and further), and the bottom is for reading. 

When you use your progressives at the computer, one of two things will happen:

• You will begin to tilt your head back.  Your brain has learned to tilt your head back to get better focus on your screen.  You will start to adopt a posture with your head tilted back.  This is a great thing if you’d like to pay for your physiotherapist or chiropractor’s new car.
• Your eyes will use the wrong area of the lens. You feel like you can see the computer ok, so what could be the problem?  Migraines, headaches, and screen sensitivity are caused because the eyes will start to strain and your brain has to expend extra energy trying to use them together.  Often this is incorrectly attributed to ‘blue light’ as the culprit.  Please see the other blog article on this because spoiler alert; it’s not!   Caution! Even ‘task glasses’ or the way that most computer glasses are calculated are very generic prescription modifications that can be causing you problems.

THE FIX: Now that you’ve found the optometrist who specializes in neuro-optometry or vision therapy, be sure to be specific about how you will need to be using your glasses. Measure your distance to the computer screen at your work station.  Use glasses that are specially designed for your desk setup, and ensure that they are prescribed specifically for you and your setup, not just a generic ‘computer’ or ‘task’ lens-based off your distance prescription.