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I am happy to assist you with your question tonight.
I often see patients who have diplopia and who have had eye realignment surgeries to correct this double vision.
There are several factors we need to consider here. The diplopia can be corrected by 3 possible solutions. 1 surgery, 2 prism, and 3 eye training exercises.
The best approach will vary based on each individual case and sometimes it will require several of these solutions to get the best effect.
As an primary care doctor, your optometrist focuses on prism spectacles and possibly eye training exercises, while the ophthalmologist will focus on surgery.
Prism is rather tricky and not always the best approach. Prism will move the image you're looking at so that it (hopefully) matches up better with your deviated eye.
Surgery is also rather tricky in that the deviated eye is moved to (hopefully) match up better with the image.
Because prism moves images and not the eye it will definitely appear that your right eye has moved. Again, this is just an appearance as prism does not move the eye, but it does move the image of your eye when you look in a mirror.
The real trouble with prism glasses is the adaptation to the new quality of vision you experience. Your brain has been used to looking at the work one way. You now have two differences in the quality of the images your eye captures and your brain interprets. These differences areise from the astigmatism correction and the prismatic effect. The astigmatism correction is likely responsible for the skewed appearance and fishbowl effect. The presence of prism can compound these concerns.
The fact that you notice these problems, however, is not necessarily a bad thing. An ample adaptation period may be required for the brain to get used to the new quality of vision. I know this may sound like a cop out answer, but it is very well documented. Often times within a few weeks the brain interprets the new quality as normal. The distortions you mentioned will likely disappear and hopefully the diplopia will have been eliminated.
I'm making assumptions that the prism and astigmatism were measured correctly for this adaptation period to occur successfully.
That being said, prism is not always the best approach and despite our best efforts there is a percentage of patients who will not be able to adapt to prism. You should know in a few weeks if you belong to this category. If non-adaptation is an issue then yes you should address this with your optometrist who will refer you to a ophthalmologist for a surgical consult, or possibly to a vision therapist to help you strengthen the muscles of your eyes.
You will not do harm to your eyes by trying to adapt to these glasses. I strongly recommend you give them a go. Though it may seem goofy and even cause discomfort or headaches for a while this adaptation will occur much quicker if the spectacles are worn full time. After 14 days or so if you still note concerns then it is time to try the next approach.
Seeing clearly is a goal that is more than reasonable. It is to be expected. I wish you the best in your adaptation. I will be available to answer any follow-up questions you may have.
Please consider leaving a positive rating based on this answer. After you give the positive rating I will still be available to continue the follow-up dialogue. Thanks for the opportunity to help.
I will be available to answer any follow-up questions you may have. Please don't forget to offer a positive rating once your question has been answered fully.Also, please note that the information here does not replace an examination and should be used as educational purposes only.
Thank you for responding. What I don't want to happen is harm to the positive effects of my original eye surgery. When I say that I mean, the surgery has given me single binocular vision without glasses. I still have monocular double vision in both eyes, but that's from the astigmatism. The problem is, after wearing these glasses, when I take them off I am seeing double again. What I don't want to happen is ending up with double vision every time I take off these glasses (swimming, playing, etc.). I don't have that problem now. I only have double vision when they were putting things in front of my eyes at the optomotrist.
They didn't mention anything about the narrow rectangular glasses, which were provided at the same place. I'm worried they may be too narrow as I see both the old world (below glasses) and new world through lenses.
Finally, with the glasses on, my right eye has moved up. It is not the appearance of it moving up. It actually is pointing up more with them as opposed to without them. I don't want that... if I can avoid it.
Perhaps I need a second opinion and perhaps I need to get back into the original doctor and address my concerns. I felt rushed through the process and didn't have time to think about all this while I was there. My eyes were diolated from the full eye exam and my vision was cloudy and disrupted from that, making it more difficult to see how the prism testing was affecting me.
I don't believe I have suppression. Although my 3D vision may have decreased slightly I can still see out of both eyes with and without glasses. I do also see that my right eye does point up more than my left with the glasses on. It is not a perception thing. My eyes are not stationary on the diplopia, they move. My brain adjusts and the eyes move. When I take the glasses off, I see double for a minute or so and then I adjust and see a single vision again (with both eyes). When I put the glasses back on, I see double again and then a single image after a few seconds. I can force the double vision by closing my eyes and relaxing them and then opening them without focusing.
I have setup an appointment with an opthamologist, but unfortunately I cannot get in for 3 months (they are booked). I am also trying to consult back with the eye doctor that prescribed the glasses.
It's a complicated case and I'm not ready to where these glasses until I know they are the best thing for me.