Vision - Need good OD and optician in Detroit area

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Need good OD and optician in Detroit area

Jonathan Westbay

2004-09-21, 3:28 am

I have just been having bad luck with eye professionals in my life.
Other people's recommendations have directed me to people who screw up
time after time, on my Px and in dispensing. I just want maximum
acuity and comfort... Is that too much to ask?!?! I used to be an
extremely high achiever, but I started to slowly slide into my current
state, where lately I have just been floundering, moving into high
myopia (-4) and my astigmatism is getting worse and things just seem
off (about -1.5). I know that's really not that hard of a Px.
Perhaps I'm more critical and sensitive than the average person, but
after consulting several professionals, I get different measurements,
different answers, time after time. Why the lack of consistency?
This is objective data, folks. It's not even going into the art of
ambiguous choices. A lack of consistency in things even like hard
measurements. This coming from both boutique shops and also your
Wal-Mart type places. I'm obviously cursed. I'm researching the best
I can, but I find I just can't concentrate on things the way I can
without glasses or contacts. (unfortunately sticking things right up
in my face results in poor posture). But I have seen flashes of
clarity in which my eyes are so much more comfortable and able to take
in information more quickly. Maybe this just isn't possible with
glasses. I have worn contacts and things do seem more natural, but
they weren't toric lenses. I'm going to need something to compensate
for my astigmatism, now. Perhaps I always have. But for a long time
I was so fed up with spending money but leaving dissatisfied, that I
didn't get another checkup for several years. This past April I
finally got re-examined, but things aren't right. I want to make them
right. I am sick of trying so hard, but yet things just getting worse
and worse, harder and harder. I'm still only 25 years old.

I have so many questions and they are just too numerous to ask online,
I think the best course is to find a good professional in the area. I
am hesitant to undergo LASIK, but I am interested in different types
of contact lenses, they seem to me to be the best choice....if done
PROPERLY. A big "IF" that is. Plus whatever glasses are best for
doing intensely fast scanning of information on a computer. I'm
particularly interested in the computer end of things... I find that
LCD's are actually less easy on my eyes than CRT, despite all the
contrary claims. So, I'm obviously in the minority, which lowers my
odds of getting help. I have done research on this issue and noticed,
for example, that grey text is easier to view... it has something to
do with contrast and black point, I don't understand exactly, but it
does have factual basis. I asked this question to a local,
well-established business recommended by a neighbor who has been
wearing glasses since she was 4 and wears nothing but glass lenses.
The optician said "sorry we don't know about technical stuff like
that"....how unimpressive. If you deal with computer issues on a
daily basis, this is a very basic and important distinction. I'm sure
the required knowledge of optics to properly correct a high Px is way
more involved. They acted all high and mighty about being licensed
opticians and better than your chain-store shop, but yet , in the year
2004, CRT vs. LCD isn't any part of their basic knowledge. Good
vision is more than just eyes, it requires the right
environment....VDT's, lighting, I know these all come into play. I am
sure there are those who specialize in such specific adjunct issues
whom would have better advice, but my eye professional ought to at
least know some basic conclusions from the body of research.

So, I need to find a good OD, optician, computer vision specialist,
lighting specialist...whomever can help optimize my visual
environment. And it seems my friends and family, while they have good
intentions, aren't going to offer the best recommendations. After
doing some research, I was fascinated by Dr. Paul Harris's article on
symphony musicians, since I am a musician myself. Through his
colleague Dr. Hohendorf, I was able to get some recommendations of
behavioral OD's in my area. But I just don't know whom to trust at
this point. Furthermore, if I go back to contacts for primary wear,
as I have in the past, I noticed that none of these people are members
of CLSA. I'm not sure if that's the only possible qualification of a
good CL fitter or not. I privately asked a certain experienced fitter
online who posts a lot of helpful advice... 'can you recommend
someone'? No response. Odds seemed like I'd get some type of answer,
at least a simple 'sorry, can't help'. Of course, feeling weakened
from my less than optimal state, I feel even more ignored by people in
person. I am determined and motivated. I'd do eye exercises half the
day, if they would actually help. I just feel less crazy without
glasses. Psychological? You bet. Naturally what your eyes are
feeding your brain, is going to affect your psychology. I was
extremely prodigious as a child, and it seems that when I started to
wear glasses, is the point at which my memories are blank. And
gradually over the years, I felt that I was losing my edge. Still, I
graduated at the top of my class, was tops in my engineering school,
then my eyes took a turn for the worse after being
stable....coincidentally I'd started switching eye professionals at
this time, not by choice, but due to an unfortunate argument they had
with my father....and I couldn't concentrate any longer, started
losing my hair early, developed this weird nervous habit of picking my
body hairs to try to relieve the tension....and everything just seemed
to fall apart. And maybe it was just circumstance and I'm just
scarred from the experience. But I believe I can help myself recover,
if I feel that I have the tools to succeed again. Visual learning is
the most efficient way of taking in information, and I feel that my
current optical system isn't doing the best job. I wouldn't be
scatter-brained if it didn't hurt my eyes to concentrate and if things
didn't feel off balance....whether i'm actually 20/20 or not. There's
more than 20/20. I know I sound self-obsessed, but until I straighten
out myself, I can't help others. I feel really sad because every day
I'm missing the chance to see more and be able to help more people.
I'm very motivated. I'm spinning in circles because that's how my
eyes feel.

Later, when things are straightened out, I will try to post more
specific and searchable questions to add to the body of knowledge on
the 'net. I really do hate redundancy. I wanted to wait and make the
perfect post, or at least something more focused. But I'm not focused
and things are just getting worse. I am exasperated and I know I have
to take some kind of action. Do SOMETHING. I should not have waited
as long as I have. I can only hope that this doesn't make me look
bad, and disrespecful of others' time.

So, in short, please at least wish me luck. Better yet, give me a set
of criteria for finding the best professionals. Best of all,
hopefully you can offer some names. Contact me privately if you must,
but hopefully anyone who searches for "detroit" will find this message
and be helped--that's my hope.

Jonathan Westbay

2004-09-21, 3:28 am

> Too many eye doctors look at issues like yours
> 180 degrees backwards, assuming that complaints of ocular discomfort
> arise from lunacy, stress, or other emotional issue.....
> Managing a life with such an ongoing challenge can be
> the root cause of stress, worry, and other emotional manifestations .
> . . not the other way around.
>
> Keep seeking the cure and ignore any suggestion that "It's all in your
> head."

Thank you for backing me up.
There's actually truth to both sides. Our mind and body have a
symbiotic relationship--it is a feedback loop of sorts. It would
probably be impossible to verify scientifically, but anecdotally, we
know the power of positive thinking to heal the body, and negative
thinking to weaken it. I have always had problems with stress and
emotional confrontations, and there have been a lot of scarring
circumstances in my life. That stress has probably influenced my
deepest thought patterns. And it probably also affected my physical
development. Both views are correct. But for now, I just want to
deal with the fact that without glasses, I'm fine. With contacts, I
get dry eyes, but still pretty OK. With glasses, I'm miserable. I
don't think it's healthy to wear contacts all the time, so I want to
make the glasses a bit more tolerable.

At one time, I was going to just buy them on the internet. Because
the bad service I've gotten so far locally is worth nothing to me...in
fact its worth is negative, because it weakens my faith in people.
Good service is worth everything to me when it comes to my eyes. I go
back for another re-exam tomorrow, and to get those miscut lenses
replaced. It's been long enough now that I can restrain my anger at
having to walk back into that office. Hopefully it will be the last
time I have to go there, and I find a top-notch person. Wish me luck.

Ellen--Thanks for the suggestion in Ann Arbor. However, it's a bit
far if I need to come back for refittings, routine service, etc. Even
if I work them into my normal travel route, it wouldn't work that
well, because I normally only travel inside the Detroit area.
However, I'll give them a call and see if they know anyone closer to
me. Ideally someone close to downtown. Hopefully something good will
come of that.

Neil_Brooks

2004-09-21, 3:28 am

Jonathan Westbay wrote

>
> Actually, I don't think enough. My thoughts feel really stuck, it's
> frustrating because I used to be a genius, and I can't remember how I
> thought then. I am stuck living in the present moment. What I do is
> reason too much, because my constant headache seems to be retarding
> the quality of my thoughts, and reducing my ability to intuitively
> resolve the issue. I do try and relax, but there is something that's
> physically aggravating me. Perhaps I'm more sensitive than most, but
> still, the problem is real, whatever it is. I feel agitated whether I
> think or not. Yoga, deep breathing, tai chi, meditation, none of that
> helps, because I'm interested in staying in reality, and something in
> my reality is causing me pain. This pain isn't there without the
> glasses. So, I'm thinking, because it's the rational response to
> solving a problem.
>
> Without any correction, I feel fine. Unfortunately that's not really
> an option for fully functioning. I can't even think well without
> glasses because I don't visualize very well, I need things written out
> and need to be able to quickly scan the information. When the glasses
> are on, my eyes feel stiff and I want to stare, because eye movements
> hurt. I also get this weird feeling in my body, not sure how to
> describe, but it's tiring.
>
> I am beginning to think this is a comfort issue. The weight of the
> nosepads on my sinuses. Although I get dry eye discomfort with
> contacts, this is of a different nature. I have posted already on
> Optiboard re: nosepads and the ethmoid sinus region. I will post it
> again here on Usenet for your reference. I also mention some of my
> other weird problems, where people keep thinking I'm crazy, I was even
> convinced I might just be crazy....until finally, someone was able to
> discover the rare yet actual problem. I am not just a malingerer. I
> don't even like asking for help, and I don't like seeing
> professionals. But my problems are real and they need solving. So
> don't judge me as someone who needs to just "Chill out"...I used to
> judge people that way, too, since I was always a high achiever and
> lived a fairly sheltered life. But after what I've been through, not
> being able to explain my seemingly imaginary problems, I can't write
> everyone off like that any longer.

While Dom's comment was, I suspect, well-meaning and well-intended,
I'd just ignore it. Too many eye doctors look at issues like yours
180 degrees backwards, assuming that complaints of ocular discomfort
arise from lunacy, stress, or other emotional issue.

In my experience, eye problems can be incredibly frustrating and
unrelenting. Managing a life with such an ongoing challenge can be
the root cause of stress, worry, and other emotional manifestations .
.. . not the other way around.

Keep seeking the cure and ignore any suggestion that "It's all in your
head."

.. . . but you know that ;-)

Good luck!

Neil

Neil_Brooks

2004-09-21, 3:28 am

Jonathan Westbay wrote

> Neil0502 wrote:
>
> Thank you for backing me up.
> There's actually truth to both sides. Our mind and body have a
> symbiotic relationship--it is a feedback loop of sorts. It would
> probably be impossible to verify scientifically, but anecdotally, we
> know the power of positive thinking to heal the body, and negative
> thinking to weaken it.

Fair point.

> I have always had problems with stress and
> emotional confrontations, and there have been a lot of scarring
> circumstances in my life. That stress has probably influenced my
> deepest thought patterns. And it probably also affected my physical
> development. Both views are correct. But for now, I just want to
> deal with the fact that without glasses, I'm fine. With contacts, I
> get dry eyes, but still pretty OK. With glasses, I'm miserable. I
> don't think it's healthy to wear contacts all the time, so I want to
> make the glasses a bit more tolerable.
>
> At one time, I was going to just buy them on the internet. Because
> the bad service I've gotten so far locally is worth nothing to me...in
> fact its worth is negative, because it weakens my faith in people.
> Good service is worth everything to me when it comes to my eyes. I go
> back for another re-exam tomorrow, and to get those miscut lenses
> replaced. It's been long enough now that I can restrain my anger at
> having to walk back into that office. Hopefully it will be the last
> time I have to go there, and I find a top-notch person. Wish me luck.

Done ;-)

Please let us know how it turns out.

Incidentally, I was born and raised in Detroit (NW suburbs, actually).
Kresge Eye Institute is among the best in the country and it's
downtown (it's affiliated with Wayne State). They could likely give
you some good referrals.

www.med.wayne.edu/kresgeeye/

Jonathan Westbay

2004-09-21, 3:28 am

> Incidentally, I was born and raised in Detroit (NW suburbs, actually).
> Kresge Eye Institute is among the best in the country and it's
> downtown (it's affiliated with Wayne State). They could likely give
> you some good referrals.
>
> www.med.wayne.edu/kresgeeye/

Yeah, I contacted them via email a couple days ago but no response
yet. They have an automated online referral system, but that just
turned up some guys in Southfield. Wayne State would actually be much
closer, although I don't actually live downtown, I live about 10 miles
south in Allen Park. Today I noticed they have a downriver office.
If they also have good docs, that would be best yet.

I think I'm fed up with glasses and hopefully I can get fit for a
quality pair of contact lenses, not the usual soft lens crap. With
soft lenses I don't blink enough because the lens moves, and things go
out of focus, so unconsciously I keep my eyes open longer so I can
concentrate, but then I get dry eyes and my vision gets blurred.
Since properly fitted hard lenses won't move much, As long as I can
wear them all day and still maintain optimal clarity and corneal
health, I'll be pretty happy. I think the RGP's do well in that
regard, but so far I haven't found docs who encourage them, probably
because they don't specialize in it--fitting is an art in itself. I
don't need bifocals and I'd actually considered a second pair of
contacts for long periods of computer work, just to cut down on
eyestrain. Have a pair of weak glasses to slip over them for the
occassional distance needs. And otherwise chuck glasses out the
window.

Then when I get old and presbyopic, I'm sure the new lens implants
that actually focus like the original crystalline lens will be quite
common, or perhaps something even better.

Jonathan Westbay

2004-09-21, 3:28 am

> Phew... take a deep breath. Sounds to me like your problems are internal
> rather than with your optometrist... seriously, chill out and try to
> relax. You think too much.

Actually, I don't think enough. My thoughts feel really stuck, it's
frustrating because I used to be a genius, and I can't remember how I
thought then. I am stuck living in the present moment. What I do is
reason too much, because my constant headache seems to be retarding
the quality of my thoughts, and reducing my ability to intuitively
resolve the issue. I do try and relax, but there is something that's
physically aggravating me. Perhaps I'm more sensitive than most, but
still, the problem is real, whatever it is. I feel agitated whether I
think or not. Yoga, deep breathing, tai chi, meditation, none of that
helps, because I'm interested in staying in reality, and something in
my reality is causing me pain. This pain isn't there without the
glasses. So, I'm thinking, because it's the rational response to
solving a problem.

Without any correction, I feel fine. Unfortunately that's not really
an option for fully functioning. I can't even think well without
glasses because I don't visualize very well, I need things written out
and need to be able to quickly scan the information. When the glasses
are on, my eyes feel stiff and I want to stare, because eye movements
hurt. I also get this weird feeling in my body, not sure how to
describe, but it's tiring.

I am beginning to think this is a comfort issue. The weight of the
nosepads on my sinuses. Although I get dry eye discomfort with
contacts, this is of a different nature. I have posted already on
Optiboard re: nosepads and the ethmoid sinus region. I will post it
again here on Usenet for your reference. I also mention some of my
other weird problems, where people keep thinking I'm crazy, I was even
convinced I might just be crazy....until finally, someone was able to
discover the rare yet actual problem. I am not just a malingerer. I
don't even like asking for help, and I don't like seeing
professionals. But my problems are real and they need solving. So
don't judge me as someone who needs to just "Chill out"...I used to
judge people that way, too, since I was always a high achiever and
lived a fairly sheltered life. But after what I've been through, not
being able to explain my seemingly imaginary problems, I can't write
everyone off like that any longer.

To summarize the nosepad issue, I first thought of this because the
sinuses are responsible for vocal resonance, and I notice I seem to
lose it with glasses on. Everyone's ethmoid structure is different,
like a fingerprint. I have genetics from well-respected opera
singers, so mine are probably more sensitive, more developed than
most, and may be larger and go into the region where my nosepads are
resting, or somehow aggravate connected nerves. The ethmoid region
also connects to the optic nerve. This pain and discomfort could
restrict eye motion. If you've had bad sinus headaches you can
understand. It's hard to concentrate. You don't feel very good.

I'm not sure if I fully understand this, but I believe I'm on the
right track. I put a cotton ball between the nosepads to get them off
the sides and distribute the weight across the top of my nose instead.
This seems to be an improvement. I recall seeing other posts about
comfort improving with a "strap" or unifit bridge. Unfortunately the
trend for modern light metal frames seems to be side pads. I don't
like weight on the bridge of my nose really either, but I think, at
least for me, it's better to have it on top, where it won't dampen the
resonance. And probably best to distribute it widely as possible,
less force per square unit of measurement.

Thinner, lighter lenses would help too, but I have heard there's a
loss of optical quality, increase in chromatic aberration, more
distortion, etc...but perhaps the increase in comfort would outweigh
the inferior optics. I currently have CR39 because I was told it
gives the best vision. I also have a neighbor who wears nothing but
glass and claims she can't see well out of plastic. But, again,
perhaps comfort is really my problem. I can either spend lots of
money on multiple frames to find out, or hope for some good advice
from someone who understands what I'm looking for here.

> As Jan suggested, keratoconus is one possibility you should check out

My docs have not mentioned keratoconus. My eyes just hurt. The
weight of the glasses is probably just pressing on a nerve that is
reducing eye motility, and hence my vision seems worse. Reading and
other critical work depends more on comfortable eye motion than
refraction. My eyes are hurting and it just makes me want to stare.
If this is true, then I'm not blaming the Doc. It's a dispensing
issue. My lenses should be remade, because the parameters are off, I
had them independently checked multiple times. But perhaps comfort
and this nosepad is the biggest problem yet.

> A hard contact lens would possibly give you the best quality vision, but
> initial comfort is an issue.

Although I'm sensitive in certain areas, in many places, I can cut
myself and not notice till I see the blood. I guess the only way I'd
know is to try. However, I have heard that proper fitting can REALLY
make a difference with hard lenses. That's why I need to find the
right person for the job.

However, unless there are lenses I can comfortably wear all day, I
need to optimize my glasses as well. But I'll probably never be 100%
happy with something pressing on my face. I'm just very sensitive in
that area. But I know things can be better, even though so far the
people I've been to say nothing can be done. Eventually, I'll find
that person who understands. That has been my experience in many of
life's trials.

The Real Bev

2004-09-21, 3:28 am

Jonathan Westbay wrote:

> I'm not sure if I fully understand this, but I believe I'm on the
> right track. I put a cotton ball between the nosepads to get them off
> the sides and distribute the weight across the top of my nose instead.
> This seems to be an improvement. I recall seeing other posts about
> comfort improving with a "strap" or unifit bridge. Unfortunately the
> trend for modern light metal frames seems to be side pads. I don't
> like weight on the bridge of my nose really either, but I think, at
> least for me, it's better to have it on top, where it won't dampen the
> resonance. And probably best to distribute it widely as possible,
> less force per square unit of measurement.

I share your pain. When all you could get were metal frames with
nosepads I stupidly ordered a pair of bifocals and a pair of reading
glasses. Misery. They changed the size and shape of the pads half a
dozen times, but they all caused pain and/or shut off my breathing.
Whoever designed my nasal passages has a LOT to answer for. I finally
broke down and ordered new glasses -- as small as possible and with
old-fashioned plastic frames instead of the stupid metal ones. I'm much
happier now.

You probably still ARE a genius -- I don't think you lose that, at least
until you get much older, and probably experience makes up for the loss
of pure brainpower. I know a couple of genuine geniuses and they don't
seem to be losing it. They seem to share your intensity, which I think
is probably not necessarily a good thing -- it certainly makes for
difficulty in social relationships with 'normals' and it probably isn't
generally conducive to happiness.

Still, you're stuck with it. The 'take a deep breath' suggestion is
pretty good, but you probably can't do it. Any chance you can talk
yourself into believing that a short time out will improve your
perception of reality? It might actually be true, you know.

Hang in anyway, the right frames might solve at least part of your
problem.

--
Cheers,
Bev
=========================================================================
If you are going to try cross-country skiing, start with a small
country.

Dom

2004-09-21, 3:28 am

Jonathan Westbay wrote:
When the glasses
> are on, my eyes feel stiff and I want to stare, because eye movements
> hurt. I also get this weird feeling in my body, not sure how to
> describe, but it's tiring.
>
> I am beginning to think this isacomfortissue.
>

snip

> But, again,
> perhaps comfort is really my problem.

snip
>
>
> My eyes just hurt. My eyes are hurting and it just makes me want to stare.
>

Maybe your glasses are too strong... maybe you have been
"overminussed"... given a prescription that seems clear in the testing
process but is actually too strong. This is easy for the optometrist to
do (unintentionally, of course) when the patient does many hours of
intense close focussing work. This type of patient is called a "minus
eater". Ask your optometrist for a cycloplegic refraction (drops to
force your focus to relax). Have the eyetest first thing on a Monday
morning, having spent the weekend outdoors and not reading much, or
better still after a week off (again, no reading or computer during your
break!!).

But I still say you are thinking & worrying too much!!

Dom

Jonathan Westbay

2004-10-07, 7:08 am

A quick followup--I did actually end up seeing Dr. Sworst at the
Kresge Eye Institute on the 28th of last month. Right off, she didn't
impress me with her knowledge: she insisted that I wasn't correcting
astigmatism by tilting old glasses with spherical lenses. That is
simply untrue, astigmatism is a function of sphere on the axis of
tilt, and I have the equations to prove it. It's common sense anyhow,
based on observation, you can see the power increase on that axis as
things get squashed.

That got things off to a bad start. She admitted that she does not
have a complete knowledge of optics and did not have much knowledge of
computer vision issues. (perhaps her "low vision" patients are happy
just to be able to see ANYTHING). Her main specialty is lens fitting.
She seems to have the caring and patience to do so, and I respect her
experience, but I was not very impressed with her overall knowledge,
based on several other faulty responses. I was expecting more. I
was given soft lenses just like my old ones, just a different more
oxygen permeable brand, Focus N&D. I do not see any better than
before.

However, she did correctly evaluate that I have a significant dry eye
problem that is causing blurred vision at all distances.
Meibomianitis. My meibomian glands are clogged and thus, my tear film
is of very poor quality. I produce enough tears, but they quickly
evaporate, she mentioned something like 6-7 seconds.

She advised art. tears, which I feel are just gumming things up and
blurring my vision more. I am also to do lid scrubs and warm
compresses, which do feel nice, but ultimately, I think the problem is
more holistic. It seems that a hormonal imbalance has caused my skin
to be quite oily, and it is a very poor quality oil, very thick. I
developed trichotillomania after this change, I never had the tendency
before, but now, it actually feels productive to scrape that thick
gunk that seems to be permanently fused onto my body hairs, etc...in
fact I don't really touch the head hair. Anyway, I'm guessing the
meibomian glands are probably functioning just the same as other
sebaceous glands. And my whole body, no matter how much I wash, that
crud doesn't seem to go away. The situation seems pretty hopeless. I
may no longer be able to wear contacts and now that I think about it,
I can see that it is blurring my vision with glasses as well. And to
top it off, because of this, I'm not a good candidate for refractive
surgery.

I used to be the top of my class. I was a 4.0 student in college on a
full scholarship. I figured I just got depressed and lost my ability
to concentrate, somehow. I blamed myself for things falling apart,
even though I have always tried my best to stay positive and not fall
into a rut. Now I see it's the other way around. I have probably
been living with this undiagnosed problem for years and the resulting
blurry vision has hampered my performance. That is what's depressing.
And it's a very real problem. I am not a big believer in
psychological explanations of a problem. Usually neurosis is a
symptom, not a cause. Crazy people have just been improperly
diagnosed. People are quite resilient, at least I know I am. If the
world stopped being a blur, I would be right back up on my feet moving
full speed ahead. But the way I see it, the problem comes down to
body chemistry.

I've done things in my past that probably resulted in bad karma. But
I am determined to do good in this world and I hope I am given the
tools to realize my dream.

Unfortunately I'm probably going to have to rely on glasses in the
meantime, and Kresge doesn't specialize in that, so I'm back to square
one. Is help on the way?....

neil0502

2004-10-07, 11:09 am

"Jonathan Westbay" wrote

> A quick followup--I did actually end up seeing Dr. Sworst at the
> Kresge Eye Institute on the 28th of last month. Right off, she didn't
> impress me with her knowledge: she insisted that I wasn't correcting
> astigmatism by tilting old glasses with spherical lenses. That is
> simply untrue, astigmatism is a function of sphere on the axis of
> tilt, and I have the equations to prove it. It's common sense anyhow,
> based on observation, you can see the power increase on that axis as
> things get squashed.

It's also possible that you're simply changing the correction of that
astigmatism, not--as she said--"correcting it." Two different outcomes....
or just devil's advocacy and semantics on my part ;-)

> That got things off to a bad start. She admitted that she does not
> have a complete knowledge of optics and did not have much knowledge of
> computer vision issues. (perhaps her "low vision" patients are happy
> just to be able to see ANYTHING). Her main specialty is lens fitting.
> She seems to have the caring and patience to do so, and I respect her
> experience, but I was not very impressed with her overall knowledge,
> based on several other faulty responses. I was expecting more. I
> was given soft lenses just like my old ones, just a different more
> oxygen permeable brand, Focus N&D. I do not see any better than
> before.
>
> However, she did correctly evaluate that I have a significant dry eye
> problem that is causing blurred vision at all distances.
> Meibomianitis. My meibomian glands are clogged and thus, my tear film
> is of very poor quality. I produce enough tears, but they quickly
> evaporate, she mentioned something like 6-7 seconds.

Dry Eye Syndrome is a major PITA (you've just opened up Pandora's box in
terms of availability of online information, good and bad). Some doc's
prescribe Doxycycline/Tetracycline for this--if you want to throw med's at
it.

> She advised art. tears, which I feel are just gumming things up and
> blurring my vision more. I am also to do lid scrubs and warm
> compresses, which do feel nice, but ultimately, I think the problem is
> more holistic. It seems that a hormonal imbalance has caused my skin
> to be quite oily, and it is a very poor quality oil, very thick. I
> developed trichotillomania after this change, I never had the tendency
> before, but now, it actually feels productive to scrape that thick
> gunk that seems to be permanently fused onto my body hairs, etc...in
> fact I don't really touch the head hair. Anyway, I'm guessing the
> meibomian glands are probably functioning just the same as other
> sebaceous glands. And my whole body, no matter how much I wash, that
> crud doesn't seem to go away. The situation seems pretty hopeless. I
> may no longer be able to wear contacts and now that I think about it,
> I can see that it is blurring my vision with glasses as well. And to
> top it off, because of this, I'm not a good candidate for refractive
> surgery.

I agree with the holistic approach. How about some sort of
(holistic-physician supervised) detox diet, then a total rebuild of your
basic diet. Body chemistry changes . . . and can be changed. The less
'crap' that you put into your body, the better off you'll be . . . likely
on all fronts.

> I used to be the top of my class. I was a 4.0 student in college on a
> full scholarship. I figured I just got depressed and lost my ability
> to concentrate, somehow. I blamed myself for things falling apart,
> even though I have always tried my best to stay positive and not fall
> into a rut. Now I see it's the other way around.

While I agree(d) with your comment that it's a two-way street (maladies and
angst), you're seeing (no pun) what I meant. This particular direction is
oft underestimated. The more you can expiate any lingering
guilt/self-doubt, the better off you'll be . . . .

> I have probably
> been living with this undiagnosed problem for years and the resulting
> blurry vision has hampered my performance. That is what's depressing.
> And it's a very real problem. I am not a big believer in
> psychological explanations of a problem. Usually neurosis is a
> symptom, not a cause. Crazy people have just been improperly
> diagnosed. People are quite resilient, at least I know I am. If the
> world stopped being a blur, I would be right back up on my feet moving
> full speed ahead. But the way I see it, the problem comes down to
> body chemistry.

a) see above re: body chemistry
b) agree with your observation. Many substance-addicted people, too, are
simply self-medicating for undiagnosed illness--mental or physical

> I've done things in my past that probably resulted in bad karma. But
> I am determined to do good in this world and I hope I am given the
> tools to realize my dream.

Seems like the most critical of tools--the one resting atop your neck--is
top notch. Heck of a start!

> Unfortunately I'm probably going to have to rely on glasses in the
> meantime, and Kresge doesn't specialize in that, so I'm back to square
> one. Is help on the way?....

Have you contacted/been evaluated by/asked for referral(s) from the Kellogg
Eye Center at UofM? Not sure how portable you are, but the right doctor's
are worth the trip. You have a formidable intellect. It's my guess that
you'd automatically be more comfortable--results and recommendations being
equal--with a fairly big-brained doc. They're not always in your back
yard.

Hang in there, Jonathan. I feel your pain (more than you might imagine).

Neil

Jonathan Westbay

2004-10-08, 2:08 am

> It's also possible that you're simply changing the correction of that
> astigmatism, not--as she said--"correcting it." Two different outcomes....
> or just devil's advocacy and semantics on my part ;-)

Let me clarify. The doctor insisted that lens tilt was NOT correcting
astigmatism. She basically asserted that it was only increasing
spherical power.

The fact is, if you tilt your glasses forward (which would be on the
180 axis, allowing for slight assymmetry), astigmatic power not only
DOES increase on that axis, it actually increases at a rate THREE
TIMES greater than sphere, roughly. The following equations from a
reputable source demonstrate this relationship:

http://www.umsl.edu/~swlong/downloa...Lens_Design.pdf

"Pantoscopic Tilt and Induced Astigmatism
If a patient looks obliquely through a spherical lens he will
encounter
some astigmatism due to the marginal astigmatism aberration.The
formula for the sphere S and cylinder C induced by tilting a spherical
lens
of power F through and angle ? is

S =[1+sin^2 ? /(2 n )]F ,
C =S tan^2 ? ."

> Dry Eye Syndrome is a major PITA (you've just opened up Pandora's box in
> terms of availability of online information, good and bad). Some doc's
> prescribe Doxycycline/Tetracycline for this--if you want to throw med's at
> it.

I believe this has been a chronic issue, not an acute inflammation. I
am leary of using antibiotics as a long-term solution. I was on
antibiotics quite frequently as a kid, and I believe they wreaked
havoc on my immune system. I finally decided to stop seeing the
doctor when I would get sore throats, sinus infections, etc...stopped
getting allergy shots....it took a while, but I believe I restored my
natural immune function greatly. Year by year, I suffer from
allergies less, and do not get sick as frequently.

> I agree with the holistic approach. How about some sort of
> (holistic-physician supervised) detox diet, then a total rebuild of your
> basic diet. Body chemistry changes . . . and can be changed. The less
> 'crap' that you put into your body, the better off you'll be . . . likely
> on all fronts.

The problem is that there could be many sources of chemical poisoning
besides food. It could be indoor air quality. It could be chemicals
in the water supply. But the nutritional approach is worth a shot. I
do take food-based multiple vitamins and have taken a variety of
supplements, although I really haven't noticed any changes over the
years. For example, I have been taking flax seed oil, which is
recommended because of it's Omega-3 content, it is supposed to improve
the quality of skin oils.

Ironically, the best Omega-3 source is fish. Which I am HIGHLY
allergic to. Oily skin conditions are also often related to the way
the body processes omega-3 and other lipids. I'm beginning to think
there's a connection here....

I'm wondering if it is just genetic. Sebaceous oil quality can also
be related to hormonal levels. Specifically, I have gathered that low
estrogen may be a factor. Not typical of males to worry about
estrogen

but some levels are necessary for proper function in
both men and women.

Since I can't reverse puberty, I'm not sure how to deal with that
potential problem. Exercise seems like it would raise testosterone
levels and just further the imbalance.

I realize I am getting outside the scope of vision. But perhaps
vision practitioners need to at least be aware of referring such
problems to someone who is knowledgeable in treating systematic
sebaceous dysfunction. I would wager that most meibomian dysfunction
cases also have general sebaceous disorders.

> Seems like the most critical of tools--the one resting atop your neck--is
> top notch. Heck of a start!

Honestly, I am not all that quick. Supposedly I was when I was
younger. Nowadays, I am just very deliberate and focused. But thanks
for the compliment, although I've never really felt comfortable taking
them. Well, maybe once upon a time...

> Have you contacted/been evaluated by/asked for referral(s) from the Kellogg
> Eye Center at UofM? Not sure how portable you are, but the right doctor's
> are worth the trip. You have a formidable intellect. It's my guess that
> you'd automatically be more comfortable--results and recommendations being
> equal--with a fairly big-brained doc. They're not always in your back
> yard.

Most importantly, a big-brained doc would be more comfortable with me.
I was expecting to find that at Kresge, it is a reputable institution
as well. But the doctor seemed threatened that I would challenge and
question her expertise. Most people don't have the time or
inclination to do so, and really, society would be better off if
people stuck to their strengths. But it is challenging when
capitalist greed necessitates supplanting working solutions with
something that can be sold and marketed profitably. We need watchdogs
to keep the system in check. Often, those in control of the media and
institutions are drowning out the voices of the knowledgeable few who
are wholeheartedly dedicated to helping, and the pursuit of truth.
And conversely, often alternative therapies are used by deceptive
people to take advantage of those who are desperate for answers and
haven't received help from conventional practice.

Sometimes faith is necessary to accept things that simply work. And
science is just a method used to prove hypotheses we'd like to be
true...research can be manipulated.

Either approach is valid, practiced by someone who is enlightened and
has integrity. I welcome all such people.

Jonathan Westbay

2004-11-06, 2:08 am

Ok, I finally got some RGP lenses. Menicon Z. It feels like having a
piece of glass stuck in my eye.

I have read that 2.5 diopters of corneal astigmatism warrants a
bitoric fit. My doc did spherical. Would this make a difference?

My pupils are not centered in my iris, they are skewed nasally. I
don't know if this would cause visual issues. The pupil is nowhere
near centered in the lens. I am still experiencing a lot of glare and
spherical aberration-type discomfort. I notice that putting my hands
between my eyes (in a "praying" position) to block my central vision
seems to reduce this constant visual tension and pulling sensation I
experience. Not sure if this is related.

They claim the fit is perfect. But I don't think it should be hurting
this much. "get used to it" seems like a recipe for corneal moulding
and scarring.

I confronted them about the lens tilt theory, and they are not even
capable of properly calculating tangential functions. Then have the
gall to tell me I read into things too much, when I am not qualified!!
Of course I have not gone to optometry school and my knowledge is
limited. But I know what I know, and "stop asking questions and trust
us" is an unacceptable response.

I'm hesitant to even order glasses, because they don't seem to
understand refraction. my prescription is not stable -- although my
diopter of astigmatism is mild, it has varied by as much as 10 degrees
in the left eye. They say it doesn't matter because glasses are
typically 6 or 7 degrees off and within tolerance. Well, that being
the case, that means it could be a compounded 17 degrees error.
Unacceptable, in my opinion. Then they had the nerve to suggest I
would be charged $20 for a re-exam. I thought all neccessary followup
was covered.

I was referred by a member of the CLSA. Kresge Eye is affiliated with
several colleges of optometry. But based on my experience, it seems
like I need to seek another opinion. But who? I have already
approached the highest echelon in my area. I am so frustrated. I
don't have insurance. I cannot afford an ongoing fruitless quest, I
need a miracle worker...at least as close as humanly possible.

Rushtown

2004-11-06, 2:08 am

A little off topic---but how can one check out the quality of an OD on the
internet. And I don't just mean no discipline problems---but percentage of
good outcomes per thousand procedures? That would be very helpful information,
right?

Ann

2004-11-06, 7:07 am

On 06 Nov 2004 06:35:18 GMT, rushtown@aol.com (Rushtown) wrote:

>A little off topic---but how can one check out the quality of an OD on the
>internet. And I don't just mean no discipline problems---but percentage of
>good outcomes per thousand procedures? That would be very helpful information,
>right?

I attend two eye hospitals. One for the medical side of the problem
and one for the prosthetics. The second one is a famous UK eye
hospital and it is claimed by the other one, has a much better success
rate on paper because they only operate on patients with a good chance
of success. The other hospital takes more risks in that they offer
surgery to people who have only a small chance of improving vision or
of improving someone's vision just a tiny bit. People are grateful
for this because a tiny bit extra vision is useful but the major
hospital allegedly won't touch them.

All this means is that knowing the success rate alone isn't much use.

Ann

Mark A

2004-11-06, 11:09 am

"Rushtown" <rushtown@aol.com> wrote in message
news:20041106013518.07117.00000156@mb-m10.aol.com...
> A little off topic---but how can one check out the quality of an OD on the
> internet. And I don't just mean no discipline problems---but percentage
of
> good outcomes per thousand procedures? That would be very helpful
information,
> right?
>
I doubt that is possible. But you could check with you state board that
licenses OD's to see how many complaints have been filed against him/her.

Neil Brooks

2004-11-06, 7:10 pm

Jonathan Westbay wrote:

[snip]

> I was referred by a member of the CLSA. Kresge Eye is affiliated with
> several colleges of optometry. But based on my experience, it seems
> like I need to seek another opinion. But who? I have already
> approached the highest echelon in my area. I am so frustrated. I
> don't have insurance. I cannot afford an ongoing fruitless quest, I
> need a miracle worker...at least as close as humanly possible.

Did you reach out to Kellogg, at UofM?

Ann

2004-11-10, 2:13 am

Mark A

2004-11-10, 2:13 am