Are there any opticians who could advise me?

[Greenelefant]

I have been getting blurred vision in my right eye and some tension headaches. I wear reading glasses as I am slightly longsighted, have slight astigmatism and a few years ago was found to have a vertical eye muscle imbalance so have a small prism in my glasses.

I had an eye test in Jan which showed my prescription hadn't changed but showed no vertical eye imbalance. I'm confused by this as when I look at things one eye at a time the image clearly jumps down when I close my left eye.

As I'm still getting blurry right eye and what feels like eye strain I went to another optician last week for a second opinion. He did the tests where you look at vertical/horizontal lines to see if they line up. What happened was that when I first looked at the image all the lines were misaligned but then my eyes/brain adjusted so that the lines lined up again. The optician seemed really confused about this as after 5 seconds or so the lines were matched up so the test would say I don't have an eye muscle imbalance. But to my layperson view it seems clear I do still have the imbalance but my brain is adjusting for it, and therefore causing the eyestrain?

I'm concerned that neither optician seemed to know what to do with me and didn't seem to have any explanation for what I'm experiencing. The first optician said to stop using prisms but the second optician said to use a prism but gave me one that works the opposite way to the prism I had in my recent glasses (up instead of down I think).

I'm not sure it's worth getting a third opinion but I just don't feel confident that I'm getting the right advice. I've ordered the glasses that the second optician recommended but not picked them up yet.

I would really appreciate any advice.

Anyone?

Could you get a referral to a specialist at the hospital? This sounds a complex situation, I hope you get the right lenses soon

Thanks. Who would refer me?

Where do you live? In London we can just walk into Moorfields or the Weston Eye Clinic as both run an A n E. You need to get your GP to refer you to your the eye clinic in your local hospital or go and see your optician who can at least tell you what is going on.

I don't think it is serious enough to be a case of eye A&E. There's nothing wrong with my eyes, it's just a case of wanting the right prescription.

I have seen two opticians and neither can tell me what is going on.

Find another optician, it’s not an A+E thing. The blurriness in your RE is a different issue to the imbalance between the two eyes.

You have a decompensating phobia. It will vary during day depending on how tired you are. I would prescribe based on symptoms. No ophthalmology department would accept a referral for this at the moment

You have done the right thing seeing the Optom first OP. Next step would be to see the GP, blurred vision can have a neuro cause, don’t google just see GP for possible referral, should the GP think it’s required.

@Earlgreyandcake that sounds interesting, could you explain more? I am also being investigated for vestibular decompensation after my dizziness returned after having vestibular neuritis 2 years ago. But the blurry eye has been happening for a few years now. It does make me anxious when it happens.

I have had a head MRI in the past at the time that the blurry eye started, as had pins and needles all down my right side as well. No cause was found. I'm also having another head MRI next week due to the dizziness.

Blurred vision and decompensated phoria probably different things. Is vision in RE always blurred or intermittent? Do u know what your VA in that eye was? If not ask your optom and let me know

It is intermittent.

Distance acuity is 6/6+

Near acuity is n 4

Reading addition is +0.75 both eyes

First optician said no prism
Second optician said 0.50 up in the right eye

That VA is good. If it's intermittent very likely just tiredness or dry eye. That's a tiny amount of prism - I'd see how the new specs are and take it from there

Great, thank you that's really reassuring. I do have anxiety and when my eye blurs I worry about it and focus on it which probably makes it worse. The first optician also suggested tiredness/dry eye. It's odd that it's only in one eye but perhaps that's my dominant one so gets more tired?

That's what it sounds like. And if u sometimes need prism you probably have a very dominant eye

Thank you so much for your help. I was otherwise considering getting a third opinion from a different optician but not sure if I'm overthinking things!

Don't get another opinion. Prescriptions and need for prism vary from day to day and indeed hour to hour. Evan if another optom got a different result it wouldn't necessarily make a difference as to how your eyes function day to day

Following as for me, sometimes writing flips backwards. The optician said that if it keeps happening (it has happened for 20 years) to get a referral- but I can't remember to where!

I wonder if it is a similar thing.

That sounds like something different that couldn't be corrected with specs or an ophthalmology referral. Are you dyslexic?

Thanks @Earlgreyandcake not dyslexic.

Pins and needles, blurred vision, dizziness, sounds to me as a neurological issue. MRI should hopefully give you some answers. Good Luck OP.

When you get the blurred vision, blink a few times, or put in some dry eye drops. If it clears you’ll know it’s dryness.

Have you had an OCT done? It looks at the individual layers of the retina and can pick up small defects easily.

As the PP said - muscle imbalances vary throughout the day and are usually worse towards the end of the day.

The pins and needles was a few years ago and I actually think it was caused by anxiety because as soon as I got the all clear from the neurologist it pretty much disappeared.

Yes I had an OCT scan and all looked perfect, which is reassuring.

I think one of the problems is that I only wear my reading glasses (with the prism) for working in front of the computer so I take take on and off a bit throughout the day and don't wear them in the morning or evening. I'm wondering if this is making my eyes/brain confused. If so, I suppose the solution would be to either use reading glasses without a prism or start wearing glasses with a prism all day? Think I would prefer the first option.