Vision Changing Later in the Day!

[jayuk]

True say......Im going to start tomorrow and give it 10 days and re-evaluate I guess

[GarethB]

Once lubricating drops are in the system, I think they stay for between 24 - 48 hours. If I go without lenses for a day or so, I generally forget to use the drops, but when I go back to lenses I can use the drops as if there were no break. Tried to cut the use of drops from 4 times a dat down to 2 times a day still with the lunch time removal to rest the eyes. However after a week the old problems started to come back, but soon sorted going back to the old regime.

[Asif]

Ever since after I had a graft my vision would also change throughout the day. My vision would normally be best in the morning and decrease later on in the day. I woke up 30 mins ago and I can read a car license plate down the road more than 25m away but in abouut 5 hours time I wouldnt see it 10m away....this is uncorrected in my grafted eye.

The change/fluctuation in vision can be caused by a few things, such as your IOP fluctuates throughout the day and so may the shape of the cornea/stiches.

[Lynn White]

Aha..

I do like a scientific discussion!!

OKay guys... just let me say that this situation is not just limited to stitch removal in a graft.I remember.. and Jacqueline, if you are reading, you will probably find the same, when I had and adenovirus infection, my vision would be dreadful on waking and only get right by 4.00 pm...

What is an issue here is that there is no real tear production when you sleep, so hydration becomes an issue overnight. Also, without the restriction of the stitches, the graft becomes more flexible and more prone to such vagaries as lid pressure, the effects of drying and the constitution of the tear film.

Gareth, I am soo interested what you are saying about Systane as this is a severely underestimated lubricant. For instance, I saw an elderley lady last week with moderate cataracts and her VA's were down to 6/24 R&L. I checked her tear film, which was really breaking up fast and decided to try her with Systane for week before referring for cataract removal as I thought they were not bad enough to cause this vision loss. I saw her again yesterday and her vision had come up to 6/6 part R&L!!

As Asif says... there are so many factors affecting vision fluctuation - but hydration is the main one. And the most aggravating!

Lynn

[GarethB]

Lynne,

Good to see you posting again, just want to throw a spanner in the works

Is it possible for the eye to get used to a set of drops that the drops loose their effect?

Reason I ask, is that since bursting a blood vessel not too far from the edge of the iris my lens wear has dropped significantly as the burst blood vessel has healed. Lens management regime of removing the lens regularly before the eye drys and the lens moves is now down to every 30 mins so I gave up wearing the lens for most of the day. As the evening has gone on, the side where the burst blood vessel was has started to feel more and more sore although there is no sign of a problem.

The other thing I have noticed while my sight in that eye was at its best is that the lower edge of the lens is very close to the lower eye lid and when I blink after first putting the lens in, you can see it do an arc clockwise over the iris and rest again where it should. I think while the lens does this it rotates as well so moving from where it should self centre.

What are your vies on contacting the optom and suggesting I get seen earlier and they get a blank lens (no focusing power, juts the shape of the cornea machine on the back), possibly a tighter fit we know is still comfortable and suggest a larger diameter so the lower edge of the lens is below the lower eye lid. My theory is a tighter lens to hold it in the self centred position and larger so the eye lids avoid bashing the lens so much. Then get the focusing power added once we know the lens is in the right place.

I know this sounds like I am doing the optoms job, but I would like to know if providing such information would be useful to them from the patient perspective.

Gareth

[Lynn White]

Okay..

run this by me more thoroughly.. I assume we are talking RGP? Sorry I can't remember what you were wearing !

Just give me some more details on your current lens and I'll get straight back to you

Lynn

[GarethB]

Thanks Lynn,

Currently wearing RGP lenses, and I think the right one which I am having problems, the right is a Rose K style (?) with is about 6 - 7 mm made by Jack Allen Contact Lenses, Enfield, EN3 4LQ. The axis is about 20 degrees but I can not remember the power that is added to the front. The KC distortion is inboard towards my nose and that is where the lens sits comfortably. With the lens here I average 6/6 but can get 6/5. When the lens moves it starts to move up and slighhtly outboard and in this positio the lens sits at about 60 - 70 degrees and I see 6/21.

If you want I can send the last topography scan taken in Novemeber 2005 which shows no changes since August 2004.

Hope this is the sort of information you are after.

Regards

Gareth

[Lynn White]

Yep!!

OK I now know what you are talking about!

The prob is that your KC gives you an off centre corneal apex, so the lens tends to centre on that and not the geometrical centre of your cornea. This is not necessarily a bad thing and modifyng the fit as you suggest may not actually acheive what you think it will. Even people with "normal" corneas often present with weird looking lens movements post blink.

I think the fit may be a red herring.. the problems started after you had this blood vessel burst and I am itching to get you on a slit lamp to see if you have any fluorescein staining on the area where the vessel burst. You may not see any problem under white light. Can you get someone to have a look?

Meanwhile, yes I would love to look at your topography so I can think about the fit of the lens...

Oh and for your info.. if you make the diameter larger, you automatically make the fit "tighter" so you then have to compensate for that etc etc...

Lynn

[GarethB]

Thanks Lynn,

E-mailed the topography of both left and right eye.

Next time I visit my brother in Southwold, I will pop upto Lowestoft to see you. QWe can have fun under the slit lamp

Wife and daughter can have fun on the beach

Hope to spend the day in the lab tomorrow so interesting things with mirrors and low uv light may be in order. If the video camera is available can come up with the srangest of videos

Now is the time all good KCers retire to Bedforshire

Night night all.

[Andrew MacLean]

I am happy to say that I am still not elligible for the JSAC club, but I am interested in what has been said about Systane.

Is it possible that the use of this might prevent the onset of the John Smith Variable Astygmatism?

I currently use carbomber gel or lactilose as required. (about every two hours or so)

Andrew