Surprised that I haven’t seen anyone recommend or even mention implantable lens technology, for long-term vision correction (maybe I missed the mention). AFAIK, it’s reversible, and safer than laser surgery (LASIK, PRK, etc.)—-nota bene: I am not a doctor, and this is not medical advice.
Anecdotal, but I got lenses implanted in both eyes recently, after living with astigmatism, nearsightedness, and Rx glasses for many years. Very happy with the outcome—-now I can drive without any glasses at all! Well, I do wear sunglasses in the summer, as one does; but now I can wear whatever sunglasses strike my fancy—I’m no longer limited to using those annoying clip-on sunglasses, over my (former) Rx glasses.
I could have chosen a ‘progressive’ Rx for my implanted lenses. However, the surgeon would not provide, for my eyes, high assurance that I’d have crisp vision at both nearby and far distances. So, I chose to get implants that would let me drive legally without glasses; and also do most activities without glasses. For reading and computer use, I can use either: cheap ‘drugstore’ magnifying glasses, or Rx glasses for the same purposes. But definitely research those tradeoffs, and discuss with your doctor.
Is this statement backed by peer reviewed science? I could not find anything. When I Google for "safer than laser surgery", 100% of the results say that ICL (implantable contact lens) are riskier than laser (LASIK).
otteromkram 151 days ago [-]
They probably just mean in terms of reversability; LASIK is obviously permanent, but ICL can be undone.
Both procedures are relatively low risk; each has their own set of drawbacks and qualifying conditions (eg - ICL isn't recommended for people who are over 45 years old).
vl 151 days ago [-]
45 years old is bizarre FDA restriction rationalizing that you might need lens replacement or +glasses soon anyway. Other countries don’t have this limit for ICL.
FuriouslyAdrift 150 days ago [-]
Over 45 you would do RLE (refractive lens exchange) which also protects against cataracts... since you are replacing the lens.
vl 150 days ago [-]
There are a lot of 45-year olds that won’t need RLE until 65, if ever. Why do they need to travel to Mexico to get ICL instead of doing it in US? Same thing with modern multi-focal RLE lenses. They got approved in US just couple years ago, and people used to go to Tijuana just to get access to them for years before that.
throwaway2037 151 days ago [-]
> They probably just mean in terms of reversability
No, everything I read says the ICL procedure is higher risk than LASIK. The risk is infection after the surgery.
vl 151 days ago [-]
It has less side-effects because incision is way smaller.
jvanderbot 150 days ago [-]
Incision? Ha! I got PRK in which they just ablate the entire eye, it feels like. Took a week to be able to see again.
How far we've come.
garaetjjte 149 days ago [-]
Isn't PRK safer because there's no permanent flap, instead removing outer layer that can regrow?
cosmie 149 days ago [-]
Yes.
The flap created for LASIK (and LASIK-like surgeries, such as SMILE or LASEK) heals, but doesn't have the structural integrity that occurs when the epithelium has to fully regrow like for PRK. So that flap becomes a semi-permanent weakness that can be dislocated down the road and cause problems.
In general PRK is still considered the safest laser surgery option, but trades off the long-term risk of the epitheium flap for a much longer initial post-op recovery time. With PRK you have to be careful that there's no hazing as the epithelium regrows, but once it's regrown it's as good as it ever was. So for folks with a high risk of future eye injuries, PRK tends to be preferred (or required, in some instances like the special forces).
prmoustache 151 days ago [-]
> I’m no longer limited to using those annoying clip-on sunglasses, over my (former) Rx glasses.
On the subject of clip-on sunglasses, nowadays some brands are offering prescription glasses that work with magnetic sunglasses covers. The sunglasses cover seats flush to the prescription glasses, and just make the package marginally thicker. They really look like you are using regular sunglasses when moutned on. I am also a contact lense user, specifically on days I might use cycling sunglasses, but those magnetic sunglasses are my goto solution for everyday use. Mine are from the Afflelou Magic collection.
The good thing with those magnetic sunglasses is they don't have arms so they take very little room in a pocket or a bag and they are inexpensive so you can keep spare everywhere: house, car, office, backpack...
The only downside I could find is when you are driving a motorbike you have to think about putting your helmet visor down before you reach a certain speed, around 55-60mph (might be lower on windy days) otherwise your sunglasses might fly away. The magnet is simply not strong enough. But my main helmet has its own internal sun visor
mywittyname 150 days ago [-]
My surgeon was willing to do contact lens implants, but was very adamant that lasik was a more appropriate course of action. Despite being more than willing to pay the price premium. So I went with lasik, as recommended.
Unfortunately, that left me with all of the negative side effects (halos at night, dry eyes) I was hoping to avoid by choosing an implanted lens. While I don't regret getting lasik, hearing someone who had a successful ICL surgery makes me wish I had taken that route instead.
xeromal 150 days ago [-]
Who knows what your doc was thinking but I figure they knew more about you and your personal situation than a random hacker news commentor. Medicine often times has trade offs so there's a chance you'd regret lens implants in one way or another if anything financially. Anyways, hope your vision is good now.
jval43 150 days ago [-]
>halos at night
I have ICLs and suffered from those too, along with other internal reflections at night. It will get better with age as your pupils get smaller, but it takes years.
As for ICLs don't be fooled by the marketing too much. I've read countless medical studies since having them and I'm reading about all sorts of increases in risks for eye issues. Btw dry eyes are a possibility too, as with any cut into the eye. Long-term studies are rare too, as 5 or 10 years is already considered long. I expect to live a lot longer than that.
Not to mention that while "reversible" is true, the procedure is not as easy as putting them in and you really don't want to take them out it unless you absolutely have to. It's a rather substantial cut they have to make to take the unfolded ICL out again.
swader999 150 days ago [-]
Lasik isn't always the best for astigmatism.
lhl 150 days ago [-]
I did ICL a few years ago, had a good experience. I did a fair amount of research. One interesting thing to note is that the FDA is often several years behind for both ICL and Laser tech (eg, it looks like the EVO/EVO+ (V4c, V5) lenses finally got approved in 2022 but was originally introduced in 2008 and approved in many other parts of the world in 2011. For lasers, Canadian lasers/TransPRK procedures generally seemed a generation or two better than what was being offered in the US as well).
While TransPRK (or LASIK) was an option for me, I decided to go with ICL:
* No flap or corneal ablation (so is still an option in the future, I suppose), just a 3mm incision that completely heals
* no eye dryness risk (corneal nerves not damaged); in general less reported complications post-surgery from my research. generally proper placement, and also making sure you have a good first week of recovery/good followup are the big things
* V4c/V5 (w/ KS-Aquaport) does not have fluid flow issue older gens did, and had a larger exit pupil hole (although my left eye even years later still has some haloing in low light due to it opening a bit bigger)
* the ICL can be removed or replaced in the future for upgrades or prescription changes
* ICL is an actual outpatient surgical procedure, is more expensive than most modern laser options and you should use an experienced/good surgeon. I went w/ Dr Kimiya Shimizu, one of the most experienced in the field (and is the KS in the KS-Aquaport, invented the injector technique as well). There are other Dr's as well who have done thousands of procedures, it's probably worth going for more experience. With proper insertion, he was actually able to use a regular (non-Toric) implant to correct for my slight astigmatism in both eyes.
Obviously, having work on your eyes is a serious thing, so I'd recommend everyone do their own research, but ICL for me was a big QoL improvement.
vl 151 days ago [-]
ICL is relatively new and is surprisingly little known. I learned about it by chance from friend, did it, and it worked out great, beyond any expectations. I see way better than with any glasses or contacts.
I went with “mono vision”, i.e. my eyes are preset for different distances - one for close, one for far. This takes some time to get use for, but I consider it more convenient for me as I get older. I wouldn’t recommend this setup for a younger person, obviously.
jval43 150 days ago [-]
For younger people they leave the bodies own lenses in, so there's no restrictions on focusing.
Downside is that there is an additional risk of glaucoma if the bodies lenses interact with the ICLs.
swader999 150 days ago [-]
Just did the exact same as you. Love the result. Life changing.
sschueller 151 days ago [-]
I am amazed what soft contacts can do. I have a myopia greater than -14 on each eye and the contacts I wear are as thin as any other regular set.
In comparison the glasses I have even with the most advanced glass is extremely thick and only a small area doesn't cause color shifting.
j45 151 days ago [-]
Lennon was wearing the best shape for high prescriptions.
Small, and round. Both will make the highest prescriptions very thin since the flaring out of the lens doesn't happen. Most of the mainstream optometrists don't specialize in frames like these.
Lenses are also available in 1.7+ high index in plastic lenses or even higher if you don't mind glass. Glass lenses while brittle at high index, can be additionally hardened as well.
It's helpful to find a frame manufacturer that can hide higher prescriptions in the thickness of the frame.
Companies like OGI, Anne Et Valentin have suitable frames for high prescriptions, which include adjustable nosepads to get the lenses right, and also a hybrid frame where the lenses might be wrapped in a combination of metal and plastic.
WWLink 151 days ago [-]
The periscope effect can be pretty darn bad with the small lenses though unless they're right on top of your eye lol.
j45 151 days ago [-]
Certain frames can help with that a lot.
At least one of the manufacturers above have such an option iirc
13of40 151 days ago [-]
I wear soft contacts and one of my eyes has astigmatism. I've never understood how a symmetrical lens can correct an asymmetrical eyeball. Another strange thing I've seen is that after having put these things in my eyes about 2000 times at this point, I think I can tell that they vary in thickness, sometimes even in the same pack, but it doesn't seem to affect their performance. It all seems a little magical, so I guess I should find some time and go down the youtube rabbit hole that probably exists.
kvgr 151 days ago [-]
Its not symetrical, one part is heavier and turns in the eye. What optometrist told me.
mywittyname 150 days ago [-]
For mild astigmatism, you can use regular lenses and get pretty good results.
151 days ago [-]
JoeyJoJoJr 151 days ago [-]
I have tried contact lenses, but it seems they keep rotating around slightly and don’t match the angle of my astigmatism exactly, causing my vision to become blurry. I don’t know if it was a bad fit, but my optometrist told me it is because astigmatism correcting lens come in 15 degree increments, and the angle of my astigmatism falls right in the middle of these increments. I have never heard of anyone else having this issue and would have thought that surely it would be more widespread. Has anyone else had this issue, and have they corrected it?
cm11 151 days ago [-]
Hybrid lenses have worked for me. Hard contact in the center with a soft "skirt" around the edge. Ideally, it's the vision of the hard lens and the comfort of the soft.
Or just hard lenses. My first were hard and in retrospect, they were less comfortable, but I had nothing to compare them to so I was more than happy with them. That was quite some time ago, but it was my understanding that hard lenses worked better with astigmatism.
A new doctor said I was on the edge between soft and hard and suggested I trial soft. It felt like wearing nothing. I did sorta notice they would blur on and off at times, but I opted for them and wore them for several years. Then he suggested the hybrid one for one eye and that's what I've been with.
jasonkester 151 days ago [-]
I tried those too, and had the same issue. I’d find myself manually rotating them every few minutes, like focusing a pair of binoculars.
Wherever it was that they wanted to settle (assuming they were ever planning to settle) left everything out of focus.
Eventually I got tired of poking myself in the eye all the time and gave them back.
Lewton 151 days ago [-]
This is the reason why I wear glasses now, it's not really fun to have your vision go blurry at random while biking
UniverseHacker 151 days ago [-]
Astigmatism correction requires toric contacts- you should have a small line you have to orient upwards to align it properly, which myopia only contacts don’t have.
BlueGh0st 151 days ago [-]
Toric lenses align themselves, the mark is for visual inspection by the doc while in the eye.
mb5 151 days ago [-]
They do align themselves but, for me at least, it can take a little while. Aiming the mark downwards really speeds things up.
foldr 151 days ago [-]
Hmm, I have astigmatism and have never had to worry about the alignment of my contact lenses in order to get good correction. Perhaps they are somehow engineered so that they automatically settle in the correct orientation.
It is much more likely that your astigmatism is very mild, and your optometrist decided not to correct it, and corrected only the myopia. This is common because toric contacts are more expensive, more difficult to put in, less breathable, and fall out easier.
As a longtime user of toric contacts, I have tried a dozen brands and every single one has the exact same mark. The shape will keep them from moving out of orientation, but it isn't enough to put them back into orientation if put in wrong, at least not quickly.
Care to share exactly what contacts you are using? Do you have astigmatism in one or both eyes? If it is toric and for astigmatism it will say so on the box- many people have it in only one eye, so the boxes will be different, and only one will say toric.
If you really are using toric contacts, but not aligning the mark, I am willing to bet you will be able to find the mark, align it properly, and your vision will be remarkably better.
Edit: One reason you absolutely need the mark is because the optometrist also needs to be able to tell if they are staying in orientation like they're supposed to, by visually checking the alignment mark. It needs to point straight upwards (vertical). If not, they can prescribe you one that is made pre-rotated to compensate.
foldr 151 days ago [-]
No, my prescription is for astigmatism, and my contacts are contacts specifically for astigmatism. In my experience, they orient themselves (and indeed I have never had to worry about their orientation).
I have never previously thought about this in terms of rotation (as I was not even aware that the contact lenses were asymmetrical), but I do normally have to blink a few times after inserting the contact lens before I have sharp vision. But in my experience it takes a few seconds for this to happen and does not depend on inserting the lens at any particular orientation.
I have glasses too, so I would notice if the contact lenses were giving me significantly worse vision!
The brand is '1 Day Acuvue Moist for Astigmatism'.
UniverseHacker 151 days ago [-]
It might be different for different people, but if I don't align mine, it takes more than a few blinks to align them. I think they will eventually but it could be a very long time (hours?)
kevin_thibedeau 151 days ago [-]
The marks aren't the same across brands. Some have three dashes with two oriented horizontal and one up. Others have two equal dashes (My axis was 90° at the time). Others have two with unequal length.
therein 151 days ago [-]
I have astigmatism and toric lenses never worked well for me. I could feel them rotate in my eye and they would never settle perfectly. This was back in 2006, though. And they weren't bad contacts either, they were ordered from Switzerland, allegedly custom made etc. I tried for a few weeks, they never worked well. Every ten blinks or so I'd get blurry vision.
UniverseHacker 151 days ago [-]
You should try again, I've been wearing them since before that time, and they are much better now than they used to be.
Scoundreller 151 days ago [-]
Probably just need a fitting with a different brand.
A lot of times your local distributor doesn't carry many of the astigmatic lenses because they can sit on the shelf for a while (it can 100x the available combinations) so they special order. I doubt they're specially manufactured per order for soft lenses.
kevin_thibedeau 151 days ago [-]
Mass produced torics are available up to -8 power. I'd try them again to take advantage of modern design and fabrication improvements.
13of40 151 days ago [-]
That's good to know - thanks! My astigmatism one is definitely special, because it takes an extra two or three weeks to get it from Costco, but I didn't know there was an orientation mark on it. I'll take a look.
UniverseHacker 151 days ago [-]
I'm blown away that apparently lots of people on here are using toric contacts but their optometrist never instructed them on how to use them ??!!?!? That is horrible.
cwmma 151 days ago [-]
not all of them work the same, only some of them need to be line up, others will line up on their own
UniverseHacker 151 days ago [-]
I think they are pretty much all the same (I've tried almost every brand of them over the years), but will orient themselves... however at least for me it can take a long time, and vision is pretty bad while that is happening. I can't imagine skipping the extra few seconds required to have them perfectly aligned from the beginning.
Arelius 151 days ago [-]
Interesting! I have always worn symmetric contacts when I (rarely) wear contacts, because I can’t get astigmatism contacts them to sit comfortably in my eyes and not pop out. I wonder if I were to align them first if they would be comfortable enough to wear. I’ll give it a try next time I’m at the optometrist.
UniverseHacker 151 days ago [-]
Even when they fit properly, they are slightly less comfortable and pop out a little easier, but they have gotten leaps and bounds better in the last few decades. If they didn't work for you a while ago, it's worth trying again.
SoftTalker 151 days ago [-]
I have astigmatism, and have worn rigid gas permeable (RGP) lenses starting over 40 years ago. I have tried various types of soft lenses a few times but could never see as well with them.
sgt 151 days ago [-]
Astigmatism here too. I have soft lenses for sport use but I can't really read with them easily. Things go out of focus often and I have to wait for eyes to re-focus etc if at all possible.
But for sport use it's fine. For every day use I use glasses and it's perfect. Except of course for the inconvenience of wearing them!
Do you think RGP could be worth trying out for me ?
quercusa 151 days ago [-]
I've used RGPs for 45 years (now -6.5) because I've been told multiple times that they provide the clearest vision. They only times I have any issues with comfort is grass allergy season but antihistamine drops work great. They tend to be a bit more expensive up front but they also last for years.
My understanding is that even non-toric RGP lenses can correct some degree of astigmatism.
Once thing that you can do with contacts is so-called Monovision [0], where one lens is slightly under-corrected and your brain figures out which to use. I'll put on reading glasses for close detail work but otherwise go from driving to working at a computer without any focus troubles.
> My understanding is that even non-toric RGP lenses can correct some degree of astigmatism.
This is correct. Both of my eyes have astigmatism, but in differing amounts. One eye is corrected with a non-toric RGP while the other requires a toric RGP. The line is around a 1.75/2.00.
SoftTalker 151 days ago [-]
RGPs are initially not very comfortable, it's been a long time but when I first got them I would only wear then a few hours, then I slowly worked up to wearing them all day. But now I rarely notice them, unless I get a bit of dust or a loose eyelash under one of them (that can be really uncomfortable).
The nice thing is that they last pretty much forever and care is pretty easy. Just clean them daily and soak them overnight in disinfectant/conditioning fluid.
elliottkember 151 days ago [-]
I used them for years before I got LASIK. They were fantastic – great vision and very comfortable to wear all day.
I wouldn't wear them for sport though because they're quite expensive and they come out easily (they're very small). There's some slim chance they could damage your eye because the material is hard.
Honestly, your setup sounds pretty much ideal. If you're not into the idea of LASIK or PRK or even ICL then I would stick with what you have – glasses plus lenses for sport. Saves you the trouble of switching contacts and reduces your chance of infection or eye troubles wearing and switching lenses all the time.
tehlike 151 days ago [-]
Have you considered LASIK?
sgt 151 days ago [-]
LASIK is scraping away cornea, not recommended for high myopia
malfist 150 days ago [-]
Neither LASIK nor PRK involve scraping. Ablation with a laser is how they work
sgt 150 days ago [-]
Fair enough, I had described it as "scraping" with a laser but I guess technically that's not how it works. Ablation is the correct term.
saghm 151 days ago [-]
Not OP, but I'm a lifelong glasses wearer with a strong prescription who has started considering LASIK in recent years; have you had it done, and would you recommend it?
SoftTalker 151 days ago [-]
I've only heard from others but the people I've talked to all had some issues post-op which they seemed to rationalize and claimed that it was a net improvement, but I've ruled it out as something I'll ever have done.
It would be really nice to have 20:20 vision without contacts or glasses but some of the stuff I've heard (extreme dry eye feeling, distortions, glare/dazzling at night) just don't sound worth it.
elliottkember 151 days ago [-]
It changed my relationship with the world. Dependency is the name of the game – it all depends how dependent you are on glasses.
If you lost your glasses, would you be able to walk around? I was -6.5 and 3.5 astigmatism and I was stuck if I lost my glasses. Had to carry contact lens boxes and solution with me. Post-LASIK I'm something like +0.5.
I get halos if I look directly at overhead street lights at night, that's about it. It's underwhelming as a side-effect. I don't stare at street lights at night very often!
gwbas1c 151 days ago [-]
I'm naturally 20/20 and I get halos from bright lights at night too; maybe not like post-lasik, but it's something to do with age.
(I'm close to the age where my mom and sister had to start wearing glasses.)
SoftTalker 151 days ago [-]
Yeah ideally it sounds nice. But I've never lost my glasses. I don't carry contact lens supplies with me, worst case with my RGP contacts I can clean them with hand soap or dish detergent and tap water in a pinch.
How do you do with oncoming headlights while driving at night?
vl 151 days ago [-]
So I did ICL (and I recommend it over LASIK), ICL gives thin distinct halos at night around bright lights. I saw them for 2 first weeks only, then I stopped seeing them - brain filtered them out. Now I only see halos in very unusual lighting situations, or if I specifically look for them for fun (and it takes some effort).
MR_Bulldops 151 days ago [-]
I had it done 2 years ago and started taking it for granted about 4 days after the operation. I have perfect sight with no complaints and almost never think about it.
I was 30 years old and wore -4.0 lenses.
filoleg 150 days ago [-]
Got mine done 8 years ago with around -3 lenses, but also with some notable astigmatism (forgot the number). Couldn’t have been happier.
Yes, sometimes I get dry eyes, but it is such a minor thing that I don’t even notice it, and it can be alleviated entirely by just using eyedrops twice a day. If I could go back in time and reconsider my decision, I would still go with it 10 times out of 10, not even a question.
eszed 150 days ago [-]
I had LASIK in 2012 (wanted to, but couldn't afford it ten years previously). It was amazing. Dry eyes persisted for about a year, which is longer than most people say. Halos? Yeah, a bit, I guess, but not enough to be bothersome. I got a full decade of 20:20 vision. About a year ago (I'm in my 40s) I started to need distance-vision glasses for driving and sports, but a mild prescription and I don't bother with them around the house. I'm still grateful I did it.
vikingerik 150 days ago [-]
I had Lasik in 2007. I had a medium prescription (-3.5 diopters.) Definitely glad I had it, although I do have the tradeoffs of dry eyes (manageable with eyedrops) and some visual artifacts at night (I can drive fine, though wondering if it will eventually be problematic.) The upside of never wearing or thinking about glasses is tremendous, though.
malfist 150 days ago [-]
I had it done last year and it's been phenomenal. Just had my annual eye exam and my vision is 20/20, near vision is great and eye health is great. Highly recommend it.
Expect some discomfort afterwards for a day or two. Then expect painfully dry eyes in the morning for a month or three and a bit of light sensitivity. After that it's all roses
pasc1878 151 days ago [-]
LASIK does not work for strong prescriptions (I think I was told if lens needed was -10 or greater in magnitude.
vl 151 days ago [-]
Look at ICL first, safer than LASIK and reversible.
password4321 151 days ago [-]
Consult the HN hive mind here (mind the timestamps):
I think it's funny how many people really don't want to just wear glasses. I love that I can completely change my look just by getting some new glasses, though I'm admittedly fortunate to have a low rx such that I can get away without wearing them sometimes when I misplace them.
Another random comment: I just love that his contacts apparently only fit because of ptosis from using weed.
saghm 151 days ago [-]
I have an extremely strong prescription (and have been wearing bifocals since I was 16), so I basically need to wear them at all times other than in the shower and in bed. I really don't like not being able to see things without them if I want to look at something while in bed (or worse, when I accidentally drop them when trying to grab them after I wake up and then can't find them easily due to not being able to see without them), but contacts seem like they'd just make that worse by increasing the effort needed to put them on. The eye doctor I saw from when I was a kid until college apparently had laser surgery and suggested that I should get it whenever my vision stopped getting worse (which happened throughout my childhood but would be expected to stabilize in adulthood). For me, the motivation wouldn't be cosmetic, but quality of life; being able to see without an external tool is just inherently easier.
astura 151 days ago [-]
>I really don't like not being able to see things without them if I want to look at something while in bed (or worse, when I accidentally drop them when trying to grab them after I wake up and then can't find them easily due to not being able to see without them)
I wear my glasses to bed, while sleeping. Avoids this issue entirely. Highly recommend. It's not uncomfortable and they don't fall off.
I also wear them during sports (including gymnastics when I was younger) & during sex. It's not really that big of a deal if you are really used to wearing them. I've been wearing glasses since before I could talk.
I'm guessing a lot of people just don't get used to them.
saghm 151 days ago [-]
The few times I've fallen asleep wearing glasses, they've pressed against my face in several places to the point where they're imprinted and sore, and the glasses have gotten slightly bent. I do tend to aggressively toss and turn when sleeping though, so this might not be a common issue.
pasc1878 151 days ago [-]
Or you turn over and break the arms of the glasses.
newzisforsukas 148 days ago [-]
> arms
Temples*
newzisforsukas 151 days ago [-]
> Highly recommend
Dunno, that all sounds more like great ways to break eyeglasses.
151 days ago [-]
astura 151 days ago [-]
They don't break.
pasc1878 151 days ago [-]
Oh they do
tomcam 151 days ago [-]
I wear my glasses to bed, while sleeping.
Can’t tell if parody? If serious… how the hell do they not warp out of shape or lose hinges?
astura 151 days ago [-]
Why would they?
tomcam 151 days ago [-]
Literally every single time I’ve gone to sleep in my glasses, the weight of my head has bent the glasses into uselessness.
Obscurity4340 151 days ago [-]
How? Can't you only really sleep on your back that way?
astura 151 days ago [-]
No, I sleep on my stomach.
How? Um, just lay down without taking them off? Idk what else to say?
hollerith 151 days ago [-]
Some eyeglass frames are very flexible. Are yours?
In my experience, farsighted people tend to be very casual with their glasses, whereas us nearsighted folks protect them carefully.
My theory is that being nearsighted, I can see my glasses - every smudge or speck of dirt is immediately visible to me because it's not too far from my focal distance. For farsighted people, the glasses on their face are so far out of focus that those things simply disappear.
If I lay down with my glasses and they rub against my face or the pillow, I know they're going to get smudged and I'll suffer eyestrain until I find a lens cloth and carefully clean them. Any nick in the lens will drive me crazy until I can get it replaced. As such, I am very protective of them - any time I lay down I'm fold them closed and lay them face-up on the headboard so they won't need more than quickly brushing off a few specks of dust. I also buy very thin, light frames because I can see them pretty clearly in my peripheral vision.
The people I've known who are farsighted (including my husband), are oblivious to anything on the glass. He'll just roll around in bed with them, and maybe once a week ask me to clean them for him. We have to get him heavier frames because the lightweight ones would be a mangled mess in a month.
So yeah, I'm guessing you have the latter experience... Sturdy frames and you aren't too bothered by some smudges when you get up.
slaymaker1907 151 days ago [-]
I've tried contacts and as a counterargument, I've found that there are few scenarios where contacts work but glasses don't and that it's way more effort and expense to use contacts vs glasses. People have mentioned sports, but there are probably more sports and exercise where glasses work better than contacts like swimming (sure you need special goggles, but contacts are simply a non-starter) and cycling. I actually prefer a pair of aviator glasses for cycling because they keep things like bugs and pollen from going into my eyes even if it's too dark for sunglasses.
However, I totally agree that eye surgery is probably the best option since then you don't have the downsides of either contacts or glasses. The only reason I'm hesitant to do it is because my prescription isn't that strong and I've heard it can mess with your close up vision later in life. But for someone with severe issues, fixing the myopia and then just using reading glasses as needed is definitely a huge QoL improvement.
prmoustache 151 days ago [-]
Funny because I mostly use my contact lenses when cycling. PHotochromatic lenses are where its at if you encounter varying degrees of lightness, like going from direct sunlight to under the shade of a forest. And I prefer using clear cycling glasses over contact lenses than my regular prescription glasses even when riding by night as they have more coverage and protection.
tomcam 151 days ago [-]
I think it's funny how many people really don't want to just wear glasses.
People who are active, sports-oriented, live in places with bad weather, or who work outside may view things differently
raincole 151 days ago [-]
> I can get away without wearing them
Yes, this sentence. Right here. This is why you can't get why many people really don't want to just wear glasses.
bobbylarrybobby 151 days ago [-]
For me, glasses get smudged and fog up, slip down my nose, and are something to worry about during sports. Contacts “just work”.
loeg 151 days ago [-]
Glasses are also absurdly expensive for what they are (maybe this is a US thing). Contacts are also expensive, but you can sort of appreciate the manufacturing challenge.
slaymaker1907 151 days ago [-]
That's why I order mine online from Zenni. I've heard reports of some quality control before and I've had one pair come that was a bit off, but I've still saved an ridiculous amount of money as someone who loses glasses constantly. I just ordered a pair that was ~$50 and a lot of that was just expedited shipping. I made no attempt to find the cheapest frames/lenses either like a lot of the ads for normal discount glasses show. Oh, and that's WITHOUT insurance.
I have no idea why they're so expensive at most vendors. It shouldn't be cheaper for me to order glasses without insurance. That said, the cost breakdown I saw from Zenni definitely showed that the major cost was for the lenses and given that they seem to be the cheapest vendor, I suspect they're actually telling the truth. Lenses seem to be pretty complex as well to manufacture, even for simple prescriptions.
loeg 151 days ago [-]
My impression of Zenni / EyeBuyDirect is also not great. Sure, they are inexpensive, but they are also flimsy. When I tried them, the pairs I got caused pretty bad discomfort, too.
callalex 151 days ago [-]
They are expensive because they are run by the Luxottica cartel.
tomcam 151 days ago [-]
My wife used to make me get the “best” glasses from boutique stores because average places like LensCrafters never suited me. Average price from boutiques about $1300 in the 2010s. I have -4.50 vision and need bifocals.
Tried Zenni about 12 years ago. Best lenses ever by far. Also the best style for me—$30/pair. My kid’s glasses are $9/pair but would be $7 without custom engraving.
fsckboy 151 days ago [-]
>absurdly expensive for what they are (maybe this is a US thing)
It's actually a European thing. Luxottica, an Italian company, has largely monopolized glasses worldwide.
from wikipedia: Luxottica retails its products through stores that it owns, predominantly LensCrafters, Sunglass Hut, Pearle Vision, Target Optical, and Glasses.com. It also owns EyeMed, one of the largest vision health insurance providers. In addition to licensing prescription and non-prescription sunglasses frames for many luxury and designer brands including Chanel, Prada, Giorgio Armani, Burberry, Versace, Dolce and Gabbana, Michael Kors, Coach, Miu Miu and Tory Burch,[8] the Italian conglomerate further outright owns and manufactures Ray-Ban, Persol, Oliver Peoples, and Oakley...In March 2018, the European Commission unconditionally approved the merger of Essilor and Luxottica.[14] On 1 October 2018, the new holding company EssilorLuxottica was born, resulting in combined market capitalization of approximately $70 billion.[15] The merger with Essilor additionally gave Luxottica control of Foster Grant and Costa Del Mar, sunglasses brands acquired by Essilor prior to the merger
Now, I'm not an expert on European regulation, but I do get a lot of good information from Europeans here on HN, and I'd guess that the EC approved the merger because the company respects the GDPR
They’re pretty expensive here in France, too, and the famous “free healthcare” only covers a small fraction of the cost. The rest is out of pocket if you don’t carry some other form of insurance, usually through your employer.
mrob 151 days ago [-]
If you don't need astigmatism correction, spherical contact lenses give much better image quality than glasses. You don't get the image minification/magnification that you get with glasses, and the off-axis optical aberrations are much reduced because the lens moves with your eyeball, meaning it's always correctly aligned.
Astigmatism correction in contact lenses sacrifices some image quality (sharpness is reduced), but it might still be better than glasses depending on how much correction is needed.
It's possible to combine spherical contact lenses with cylindrical glasses, which might give the best overall image quality depending on the exact correction needed.
Related to this, different glasses lens materials cause different levels of chromatic aberration, measured by Abbe number. The cheapest (PADC, e.g. CR-39) is one of the best you can get.
vr46 151 days ago [-]
This is interesting as I have been a photographer for decades as well as playing various sports, and have had endless fantastic discussions with my opt over the years about the various merits of different lenses and glasses but this has never come up.
I wore only contacts from December 1992 to maybe a few years ago, when presbyopia made things impossible, and I have been lamenting - truly lamenting - the state of things with glasses.
I procured some Natural Vue lenses for multifocal vision last month, as I had previously tried them with decent results, but the outcome is not good at all. My near vision is rubbish.
I wish I could wear contacts again, my QoL has taken such a massive hit. I’m -10 in specs with astigmatism.
jdietrich 151 days ago [-]
Have you tried monovision contacts? It's not for everyone, but works really well for a lot of people.
We've also now got two FDA-approved medicines for presbyopia, with at least two more pending applications.
> many people really don't want to just wear glasses
> I can get away without wearing them
There's a fallacy of some sort here but I do not know enough rhetoric to determine which one.
simlevesque 151 days ago [-]
> I think it's funny how many people really don't want to just wear glasses.
In many situations they're not practical. Sports and sex to name a few.
JodieBenitez 151 days ago [-]
Agree about sports, or any outdoor activity, gardening, lumberjacking, and more.
For sex I kinda like the blurred vision though.
151 days ago [-]
slaymaker1907 151 days ago [-]
I posted this in another comment, but I've found sports is kind of a tossup. My current glasses are large aviators because they do a great job at keeping gnats out of my eyes that are all along my favorite trail right now. If I wasn't wearing glasses, I'd want to be wearing goggles anyway. If I want to go swimming, it's also a lot simpler with glasses since I can just take the glasses off in seconds compared to removing contact lenses.
I think this also extends to sex. With glasses, you can just take them off once you're ready and then afterwards you can just go to bed right afterwards if you want to. With contacts, you need to make sure you take them out before going to sleep.
bruce343434 151 days ago [-]
You don't pee after sex?
31carmichael 145 days ago [-]
I don't think that people who wear glasses while they are sleeping have much sex.
bigstrat2003 151 days ago [-]
I wear glasses just fine during sex.
simlevesque 151 days ago [-]
You can. But it's not as great to put your face in a pair of boobs with glasses.
Glasses always create a distance between your face and the world.
ix101 151 days ago [-]
Next day at work.. "hey Joe why are you squinting the whole time?"
"Ah that... Well, thing is my glasses are so smudged, but I don't wanna forget how they got that way ;)"
"Ah! Say no more."
swader999 150 days ago [-]
It's much safer with some sort of eye protection.
fawley 150 days ago [-]
They don't get smudged when giving oral?
lysace 151 days ago [-]
Glasses have a vastly inferior field of view (FOV) compared to soft contacts. That's why I wear the latter.
(Like 120 degrees vs 170, or something along the lines of that.)
HumblyTossed 151 days ago [-]
>I think it's funny how many people really don't want to just wear glasses.
I paid for college working in the glasses business. Glasses are just not comfortable to wear all day. You can have them adjusted up the wazoo, but after a few hours, they're just annoying. Then the lenses are easily smudged. Or they're easy to bump. The reasons are long.
akira2501 151 days ago [-]
Glasses are fine to wear all day. People often select their eyewear based upon style. Which is fine, but to avoid the problems you're describing, you really should get several pairs then to avoid the fatigue those types of frames often produce.
Meanwhile you just get a pair of glasses that are built for comfort but don't look particularly good and they'll sit on your face comfortably all day. I honestly don't even think about it. I tried but cannot remember the last time I have.
Three or four times a year I end up laying down in bed, roll over, and realize I forgot to take my glasses off. Either I'm super odd or it's possible to get glasses and not have these problems.
Scoundreller 151 days ago [-]
For me, it's the 100% unobstructed field of vision with contacts. Sometimes I wear my glasses anyway to give my eyes a break but it's otherwise morning to night contacts.
mauvehaus 150 days ago [-]
Sorry, what? I've been wearing glasses for three decades and the only time they feel uncomfortable is when I'm also wearing both over-ear hearing protection and over-glasses safety specs. I've resolved that by getting a pair of prescription safety specs.
Oh yeah, and when the nosepads are brand new and sticky. Otherwise I've never had a problem.
I'm at -3 or thereabouts with a cylindrical on both eyes, if that matters.
seer 151 days ago [-]
Waring contacts opened me up to soo many activities that I just couldn’t do as a child (or would be far too uncomfortable) - swimming, social dancing (slasa), contact sports (taekwondo) or most sports for that matter.
Eventually I did LASIK because of an eye infection scare though, figured it was better to take the risk once and fix your eyesight, than go about life constantly at risk of getting blind.
But it was never a _go back to glasses_ situation, I couldn’t even imagine my life without being able to do all the activities I enjoyed doing.
I think it depends a lot on your myopia level. For instance I have low level so my face is looking normally behind my glasses. In my partner's case however it is very different. She needs very high level of corrections which means that her prescription glasses lenses are still super thick despite the technology advancements:
1. she is limited by the kind of frames she can wear because of weight.
2. her face look way different with or without glasses, like she is behind a magnifier so she doesn't like it.
maxerickson 151 days ago [-]
I can manage without correction but still remember the first time I walked in the rain after switching from glasses to contacts, 20 some years ago. I'd only put up with the glasses for a little while at that point.
Nowadays I don't wear a contact in my better eye, so that I can focus to read, just one in the worse eye for distance vision.
bigstrat2003 151 days ago [-]
I consider glasses to be purely functional, not a matter of style. In fact I think glasses are ugly. The only reason I don't use contacts is because I would never be able to suppress my blink reflex to get them in.
dangsux 151 days ago [-]
[dead]
WalterBright 151 days ago [-]
I've worn glasses since I was 5. On three occasions, they have prevented something from damaging my eye. Tried contacts for about a year - gave them up after 3 incidents of being blinded by grit getting in them while driving.
sgt 151 days ago [-]
My 2 year old took a flat screwdriver and stabbed me in the face with it. Saved by my glasses, which were scratched!
ajkjk 151 days ago [-]
Well that is... An uncommon experience.
WalterBright 151 days ago [-]
Is it? I know many people who've wound up in the emergency room with some eye damage. I don't know if these incidents would have significantly damaged my eyes or not, I just know they bounced off the glasses.
ajkjk 151 days ago [-]
I'm quite sure that if any non-vanishingly-small percentage of people had issues with their contacts like that, they would not be ubiquitous like they are.
edit: also wtf why do you know "many" people who've been to the ER with eye damage? I've only ever known that to happen to one person and it was due to a stick going into their eye..
WalterBright 150 days ago [-]
> had issues with their contacts like that
If you think I'm lying about that, you're mistaken. A tiny piece of grit blowing into the window would cause my eyes to squeeze shut from the pain. It was all I could do to open them enough to pull over.
They were hard contacts, which were necessary for my astigmatism. I don't think the soft ones had that problem.
Believe what you want.
> why do you know
People who work with machine tools. A lot of people learn the hard way to use goggles. My incidents were with machine tools and being slapped in the face with thorny blackberry vines I was trying to decimate.
I've had a couple other incidents with power tools where the flying debris didn't hit my face, but if it did, without goggles, there would have been damage. For example, one time my angle grinder disk exploded. Another time my radial arm saw picked up a piece of wood and used it to punch a hole through the wall.
One acquaintance leaned over the car battery to attach jumper cables. The outgassing hydrogen exploded into his face and burned off the top layer of his eyeballs. He spent a week with his eyes bandaged wondering if he was blinded (fortunately, he recovered, but he said the pain was incredible).
Others have had their eyebrows singed from a carburetor backfire.
ajkjk 150 days ago [-]
I didn't mean to imply I thought you were lying; I just don't think it's representative of the rate of that happening, so it's a bit weird to present it as, like, 'what can happen if you wear contacts'.
151 days ago [-]
loloquwowndueo 151 days ago [-]
You could wear contacts and protective goggles when driving :)
supertofu 151 days ago [-]
It seems that there is a generational divide between glasses acceptance. When I was a kid in the 90s, having glasses was seen as cool and desirable. I remember being puzzled by all the 80s movies which mocked characters with glasses, when having glasses was seen as a positive trait among my peers.
Teever 151 days ago [-]
I can't recall which episode it is exactly, but there's a Seinfeld episode where he's doing a standup bit in the opening sequence where he's talking about how glasses are a thing that are associated with intelligence and style while hearing aids are not.
Coincidentally I was thinking about this but yesterday and how it relates to Bluetooth earbuds. Somehow Apple managed to make hearing aids cool.
It crossed my mind when I was thinking about a coworkers hearing aids and if they were ever picked on as a child for wearing them. I bet that the rise of earbuds has made life a lot easier for children who are hard of hearing.
bigstrat2003 151 days ago [-]
> Somehow Apple managed to make hearing aids cool.
Just like with all fashion things, the causality goes the other way. People think Apple is cool, so when Apple does a thing they think that thing is cool.
KineticLensman 150 days ago [-]
> I was thinking about a coworkers hearing aids
For info: I started wearing hearing aids later in life. Couldn't function without them and the occasional glance people give them is nothing compared with being thought stupid because you apparently haven't understood something (people seem much more likely to assume you are stupid rather than deaf).
Even though they are free ('socialised') medicine - UK NHS here - they are still functional blue tooth devices that can stream audio, etc, which is awesome.
atestu 151 days ago [-]
AirPods were widely ridiculed by the press when they first came out. Lots of online comments about q tips and “tech bros.” Idk when or what changed but they became cool a year or so later… not sure about the timing but they weren’t an overnight sensation.
xp84 150 days ago [-]
IDK if your area is just really different than mine, but getting glasses at around age 9 in the mid-90s absolutely killed, permanently, whatever coolness I had, and with it, my self-confidence died that day too.
They were hideous frames, but honestly I don't think any frames would have been considered 'cool' where I was.
To this day I hate glasses. Since discovering how easy it is to wear contacts at 26, I only wear glasses between the bathroom and bed.
dhosek 151 days ago [-]
It always startles me a little given how iconic the “John Lennon” glasses are that he started wearing them so late in his career. I’m guessing that the sunglasses he wore on stage at times when the Beatles were still performing live were prescription lenses.
HumblyTossed 151 days ago [-]
With his Rx, he would definitely need some correction.
dhosek 151 days ago [-]
Well there were a lot of performances where he had no glasses of any kind…
andrewpennachio 151 days ago [-]
Never made the connection until reading this, but I suspect Steve Jobs' choice of spectacle was a nod to or was influenced by Lennon's 'granny' glasses.
divbzero 151 days ago [-]
The shape and color of Steve Jobs’ frames were similar to John Lennon’s, but I believe Jobs opted for rimless lenses.
franksvalli 151 days ago [-]
Not to mention the name of his company!
ggm 151 days ago [-]
The contract between Apple and "Apple Corp" came into sharper focus when Apple launched iTunes.
melling 151 days ago [-]
Paul has a funny story about John trying to get by without his glasses.
It's mentioned in the article, great to hear Paul tell it though!
fsckboy 151 days ago [-]
when I just read this FTA, i was shocked, thinking "how did I never know this till now?"
>In 1973, he stopped wearing the ‘wire rimmed Lennon glasses’2 and expanded to slightly non-round styles. His blood spattered spectacles even featured on the cover of Yoko Ono's 1981 album ‘Season of Glass’ following his murder in 1980.
I am short-sighted for 40 years and think from time to time to switch to contact lenses (mostly for the comfort in winter).
I am however getting older and have near-vison decreasing (you know, thise people who hand stuff at arm length to read). I find myself getting off my glasses often to see from a close distance (I hate the hybrid glasses).
I guess that contact lenses are not possible for me in that context.
whyleyc 151 days ago [-]
Actually multi-focal contact lenses are a thing.
I was surprised to hear this too, since I wondered how they could work in practice - there’s a handy explainer here if you are interested:
I’m in the same boat. If I put in contacts to correct my vision for distance I have to wear reading glasses to be able to see my phone or read a book.
xyst 151 days ago [-]
Was LASIK surgery experimental back then? Would have alleviated the issues John experienced on a frequent basis with those pesky rigid contact lens.
I think I had similar diagnosis of myopia and astigmatism as John and its worked wonderfully for me. Fortunately this was completely recently where the techniques have been perfected/improved with technology.
deelowe 151 days ago [-]
I've met so many people who've had issues with Lasik at this point that I've decided I'm not going to risk it unless absolutely necessary.
JohnFen 151 days ago [-]
Me too. It's why I won't even consider such a procedure at this point.
Glasses work well for me, so a permanent surgical solution is only something I'm willing to consider if the risk of it adversely affecting my vision is very close to zero. Right now, that's not the case (as evidenced by the fact that I know multiple people who have had adverse effects in the longer run).
elliottkember 151 days ago [-]
This is a very clear-cut case of selection bias. People who have a bad experience are much more likely to talk about it.
deelowe 151 days ago [-]
Lasik has a less than 70% long term success rate and a fairly high severe failure rate. Apologies but I cannot recall the stat in that one but it was multiple percents. And by severe, I mean near blindness.
Maybe that’s acceptable to you, but not to me.
Mattwmaster58 150 days ago [-]
can you cite the studies? Considering LASIK and most things I google for are just blogspam, I prefer peer reviewed papers
dr-detroit 151 days ago [-]
[dead]
xyst 151 days ago [-]
What types of issues? I understand there are a wide range of issues that would exclude a person from being a good candidate (ie, persistent dry eye, uncontrolled diabetes, age, other eye conditions). But any good surgeon would clearly explain that to a patient and not recommend the surgery if it wasn’t ideal.
In my case, the only possible complication was dry eyes prior to surgery. If it wasn’t resolved, then would be canceled.
but fortunately was mitigated with over the counter and some prescription eye drops applied liberally.
I too was skeptical but I think the key is finding a good surgeon with a looong history of doing these surgeries.
ryanwhitney 151 days ago [-]
I was something like -8, -9.5 before getting LASIK at about 21.
My eyes couldn’t focus beyond a reading distance afterwards. No lens could get me to a legal driving eyesight.
Surgeon had no idea why. He re-lifted the flaps afterwards and flushed beneath them on the hunch that it might be from slight ripples. Horrible experience, didn’t fix it.
Hard contacts worked, but a second surgeon advised against having anything in my eye while we figured it out.
After about a year, it healed enough that eyeglasses could refract me to good vision again.
So I still wear glasses, but my vision is much better without them. (-2ish range these days.) Pretty awful experience, but I like glasses and it was a big improvement from where I was before.
xyst 151 days ago [-]
Shit that’s terrible. Wonder if your eye was still undergoing changes. 21 is relatively young.
My surgeon requested vision history from my referring optometrist. And did his own work up at the office. Took 2-3 months of follow ups and “adjustments” (ie, prescribing eye drops to fix dry eyes) to ensure vision was stable and dry eyes wouldn’t impact outcome.
ryanwhitney 151 days ago [-]
I think there was some guidance around waiting 2–3 years since your prescription changed, which I met—though that's obviously imperfect.
There was never any clear cause/effect. My best guess is that it was from being super tense during the surgery. I found it extremely uncomfortable and intense to be fully conscious, knowing it would be bad news if I moved my eyes during the procedure. (They're holding a flap of your eyeball open during it, etc—super fun.)
Would have requested a little higher dose of Valium if I could do it over again. :) And maybe crossed a border to a high-volume specialty shop instead of my local ophthalmologist.
deelowe 151 days ago [-]
In many cases (nearing 40%) people end up with worse vision after some number of years. A very high percentage end up with significant problems such as really bad astigmatism. Severe issues such as near blindness, detached corneas, etc are also way too common. There are several good YouTube videos on the subject.
And anecdotally, half of the people who I know that got it done 10+ years ago have had their eyesight regress back to the way it was before or worse.
I honestly don’t know how lasik is allowed to persist with such high risk of complications.
dhosek 151 days ago [-]
I can’t keep my eyes open for the glaucoma test. I’m pretty sure that LASIK Would be impossible for me (unless they have A Clockwork Orange–style devices holding the eyelids open).
pjerem 151 days ago [-]
> (unless they have A Clockwork Orange–style devices holding the eyelids open).
I’m not sure if it’s the exact device depicted in that film. But the lids are forcibly held in an open state during surgery while you hold your head still on a table and focus on a green light.
buildsjets 151 days ago [-]
No. The first Laser did not even exist until mid-1960, so they were definitely not in surgical use in 1963-1966. Even the Soviets did not develop Radial Kertotomy surgery until 1974. RK uses a physical scalpel to make small radial incisions around the iris, and the scarring that occurs during healing causes the eyeball to shrink and warp the lens.
LASIK hadn't even made it to the conceptual stage then. Early trials for vision correction via radial keratotomy were ongoing at the time of his death.
pmarreck 151 days ago [-]
LASIK wasn't a thing until starting around the late 80's/early 90's.
Mistletoe 151 days ago [-]
Before that it was radial keratotomy which my Mom had. Maybe it is apocryphal but she told me they discovered it when a Russian someone got exploded glass in their eye and it improved their vision.
According to the wikipedia article, it was a Russian child that fell while riding a bike and his glasses broke and sent pieces of glass into both eyes. The doctor made radial cuts to remove the glass, and discovered that his vision improved afterward.
xyst 151 days ago [-]
Makes sense, ha. I only briefly read it was invented in the 50s. But 90s for mainstream adoption and approval sounds about right
jrimbault 151 days ago [-]
I also had a great success with LASIK, but it wasn't invented before his death.
Anecdotal, but I got lenses implanted in both eyes recently, after living with astigmatism, nearsightedness, and Rx glasses for many years. Very happy with the outcome—-now I can drive without any glasses at all! Well, I do wear sunglasses in the summer, as one does; but now I can wear whatever sunglasses strike my fancy—I’m no longer limited to using those annoying clip-on sunglasses, over my (former) Rx glasses.
I could have chosen a ‘progressive’ Rx for my implanted lenses. However, the surgeon would not provide, for my eyes, high assurance that I’d have crisp vision at both nearby and far distances. So, I chose to get implants that would let me drive legally without glasses; and also do most activities without glasses. For reading and computer use, I can use either: cheap ‘drugstore’ magnifying glasses, or Rx glasses for the same purposes. But definitely research those tradeoffs, and discuss with your doctor.
Wish I’d done it sooner!
More info here: https://www.webmd.com/eye-health/what-to-know-icl-surgery
Both procedures are relatively low risk; each has their own set of drawbacks and qualifying conditions (eg - ICL isn't recommended for people who are over 45 years old).
How far we've come.
The flap created for LASIK (and LASIK-like surgeries, such as SMILE or LASEK) heals, but doesn't have the structural integrity that occurs when the epithelium has to fully regrow like for PRK. So that flap becomes a semi-permanent weakness that can be dislocated down the road and cause problems.
In general PRK is still considered the safest laser surgery option, but trades off the long-term risk of the epitheium flap for a much longer initial post-op recovery time. With PRK you have to be careful that there's no hazing as the epithelium regrows, but once it's regrown it's as good as it ever was. So for folks with a high risk of future eye injuries, PRK tends to be preferred (or required, in some instances like the special forces).
On the subject of clip-on sunglasses, nowadays some brands are offering prescription glasses that work with magnetic sunglasses covers. The sunglasses cover seats flush to the prescription glasses, and just make the package marginally thicker. They really look like you are using regular sunglasses when moutned on. I am also a contact lense user, specifically on days I might use cycling sunglasses, but those magnetic sunglasses are my goto solution for everyday use. Mine are from the Afflelou Magic collection.
Here is an ad showing how it looks and works: https://www.youtube.com/watch?v=Xa-80ezvni4
The good thing with those magnetic sunglasses is they don't have arms so they take very little room in a pocket or a bag and they are inexpensive so you can keep spare everywhere: house, car, office, backpack...
The only downside I could find is when you are driving a motorbike you have to think about putting your helmet visor down before you reach a certain speed, around 55-60mph (might be lower on windy days) otherwise your sunglasses might fly away. The magnet is simply not strong enough. But my main helmet has its own internal sun visor
Unfortunately, that left me with all of the negative side effects (halos at night, dry eyes) I was hoping to avoid by choosing an implanted lens. While I don't regret getting lasik, hearing someone who had a successful ICL surgery makes me wish I had taken that route instead.
I have ICLs and suffered from those too, along with other internal reflections at night. It will get better with age as your pupils get smaller, but it takes years.
As for ICLs don't be fooled by the marketing too much. I've read countless medical studies since having them and I'm reading about all sorts of increases in risks for eye issues. Btw dry eyes are a possibility too, as with any cut into the eye. Long-term studies are rare too, as 5 or 10 years is already considered long. I expect to live a lot longer than that.
Not to mention that while "reversible" is true, the procedure is not as easy as putting them in and you really don't want to take them out it unless you absolutely have to. It's a rather substantial cut they have to make to take the unfolded ICL out again.
While TransPRK (or LASIK) was an option for me, I decided to go with ICL:
* No flap or corneal ablation (so is still an option in the future, I suppose), just a 3mm incision that completely heals
* no eye dryness risk (corneal nerves not damaged); in general less reported complications post-surgery from my research. generally proper placement, and also making sure you have a good first week of recovery/good followup are the big things
* V4c/V5 (w/ KS-Aquaport) does not have fluid flow issue older gens did, and had a larger exit pupil hole (although my left eye even years later still has some haloing in low light due to it opening a bit bigger)
* the ICL can be removed or replaced in the future for upgrades or prescription changes
* ICL is an actual outpatient surgical procedure, is more expensive than most modern laser options and you should use an experienced/good surgeon. I went w/ Dr Kimiya Shimizu, one of the most experienced in the field (and is the KS in the KS-Aquaport, invented the injector technique as well). There are other Dr's as well who have done thousands of procedures, it's probably worth going for more experience. With proper insertion, he was actually able to use a regular (non-Toric) implant to correct for my slight astigmatism in both eyes.
Obviously, having work on your eyes is a serious thing, so I'd recommend everyone do their own research, but ICL for me was a big QoL improvement.
I went with “mono vision”, i.e. my eyes are preset for different distances - one for close, one for far. This takes some time to get use for, but I consider it more convenient for me as I get older. I wouldn’t recommend this setup for a younger person, obviously.
Downside is that there is an additional risk of glaucoma if the bodies lenses interact with the ICLs.
In comparison the glasses I have even with the most advanced glass is extremely thick and only a small area doesn't cause color shifting.
Small, and round. Both will make the highest prescriptions very thin since the flaring out of the lens doesn't happen. Most of the mainstream optometrists don't specialize in frames like these.
Lenses are also available in 1.7+ high index in plastic lenses or even higher if you don't mind glass. Glass lenses while brittle at high index, can be additionally hardened as well.
It's helpful to find a frame manufacturer that can hide higher prescriptions in the thickness of the frame.
Companies like OGI, Anne Et Valentin have suitable frames for high prescriptions, which include adjustable nosepads to get the lenses right, and also a hybrid frame where the lenses might be wrapped in a combination of metal and plastic.
At least one of the manufacturers above have such an option iirc
One brand: https://synergeyes.com/consumer/duette/duette-cl/
Or just hard lenses. My first were hard and in retrospect, they were less comfortable, but I had nothing to compare them to so I was more than happy with them. That was quite some time ago, but it was my understanding that hard lenses worked better with astigmatism.
A new doctor said I was on the edge between soft and hard and suggested I trial soft. It felt like wearing nothing. I did sorta notice they would blur on and off at times, but I opted for them and wore them for several years. Then he suggested the hybrid one for one eye and that's what I've been with.
Wherever it was that they wanted to settle (assuming they were ever planning to settle) left everything out of focus.
Eventually I got tired of poking myself in the eye all the time and gave them back.
Edit: Answer here, by the looks of it: https://news.ycombinator.com/item?id=41237519
As a longtime user of toric contacts, I have tried a dozen brands and every single one has the exact same mark. The shape will keep them from moving out of orientation, but it isn't enough to put them back into orientation if put in wrong, at least not quickly.
Care to share exactly what contacts you are using? Do you have astigmatism in one or both eyes? If it is toric and for astigmatism it will say so on the box- many people have it in only one eye, so the boxes will be different, and only one will say toric.
If you really are using toric contacts, but not aligning the mark, I am willing to bet you will be able to find the mark, align it properly, and your vision will be remarkably better.
Edit: One reason you absolutely need the mark is because the optometrist also needs to be able to tell if they are staying in orientation like they're supposed to, by visually checking the alignment mark. It needs to point straight upwards (vertical). If not, they can prescribe you one that is made pre-rotated to compensate.
I have never previously thought about this in terms of rotation (as I was not even aware that the contact lenses were asymmetrical), but I do normally have to blink a few times after inserting the contact lens before I have sharp vision. But in my experience it takes a few seconds for this to happen and does not depend on inserting the lens at any particular orientation.
I have glasses too, so I would notice if the contact lenses were giving me significantly worse vision!
The brand is '1 Day Acuvue Moist for Astigmatism'.
A lot of times your local distributor doesn't carry many of the astigmatic lenses because they can sit on the shelf for a while (it can 100x the available combinations) so they special order. I doubt they're specially manufactured per order for soft lenses.
But for sport use it's fine. For every day use I use glasses and it's perfect. Except of course for the inconvenience of wearing them!
Do you think RGP could be worth trying out for me ?
My understanding is that even non-toric RGP lenses can correct some degree of astigmatism.
Once thing that you can do with contacts is so-called Monovision [0], where one lens is slightly under-corrected and your brain figures out which to use. I'll put on reading glasses for close detail work but otherwise go from driving to working at a computer without any focus troubles.
[0] https://my.clevelandclinic.org/health/treatments/monovision
This is correct. Both of my eyes have astigmatism, but in differing amounts. One eye is corrected with a non-toric RGP while the other requires a toric RGP. The line is around a 1.75/2.00.
The nice thing is that they last pretty much forever and care is pretty easy. Just clean them daily and soak them overnight in disinfectant/conditioning fluid.
I wouldn't wear them for sport though because they're quite expensive and they come out easily (they're very small). There's some slim chance they could damage your eye because the material is hard.
Honestly, your setup sounds pretty much ideal. If you're not into the idea of LASIK or PRK or even ICL then I would stick with what you have – glasses plus lenses for sport. Saves you the trouble of switching contacts and reduces your chance of infection or eye troubles wearing and switching lenses all the time.
It would be really nice to have 20:20 vision without contacts or glasses but some of the stuff I've heard (extreme dry eye feeling, distortions, glare/dazzling at night) just don't sound worth it.
If you lost your glasses, would you be able to walk around? I was -6.5 and 3.5 astigmatism and I was stuck if I lost my glasses. Had to carry contact lens boxes and solution with me. Post-LASIK I'm something like +0.5.
I get halos if I look directly at overhead street lights at night, that's about it. It's underwhelming as a side-effect. I don't stare at street lights at night very often!
(I'm close to the age where my mom and sister had to start wearing glasses.)
How do you do with oncoming headlights while driving at night?
I was 30 years old and wore -4.0 lenses.
Yes, sometimes I get dry eyes, but it is such a minor thing that I don’t even notice it, and it can be alleviated entirely by just using eyedrops twice a day. If I could go back in time and reconsider my decision, I would still go with it 10 times out of 10, not even a question.
Expect some discomfort afterwards for a day or two. Then expect painfully dry eyes in the morning for a month or three and a bit of light sensitivity. After that it's all roses
https://hn.algolia.com/?query=Lasik
Another random comment: I just love that his contacts apparently only fit because of ptosis from using weed.
I wear my glasses to bed, while sleeping. Avoids this issue entirely. Highly recommend. It's not uncomfortable and they don't fall off.
I also wear them during sports (including gymnastics when I was younger) & during sex. It's not really that big of a deal if you are really used to wearing them. I've been wearing glasses since before I could talk.
I'm guessing a lot of people just don't get used to them.
Temples*
Dunno, that all sounds more like great ways to break eyeglasses.
How? Um, just lay down without taking them off? Idk what else to say?
My theory is that being nearsighted, I can see my glasses - every smudge or speck of dirt is immediately visible to me because it's not too far from my focal distance. For farsighted people, the glasses on their face are so far out of focus that those things simply disappear.
If I lay down with my glasses and they rub against my face or the pillow, I know they're going to get smudged and I'll suffer eyestrain until I find a lens cloth and carefully clean them. Any nick in the lens will drive me crazy until I can get it replaced. As such, I am very protective of them - any time I lay down I'm fold them closed and lay them face-up on the headboard so they won't need more than quickly brushing off a few specks of dust. I also buy very thin, light frames because I can see them pretty clearly in my peripheral vision.
The people I've known who are farsighted (including my husband), are oblivious to anything on the glass. He'll just roll around in bed with them, and maybe once a week ask me to clean them for him. We have to get him heavier frames because the lightweight ones would be a mangled mess in a month.
So yeah, I'm guessing you have the latter experience... Sturdy frames and you aren't too bothered by some smudges when you get up.
However, I totally agree that eye surgery is probably the best option since then you don't have the downsides of either contacts or glasses. The only reason I'm hesitant to do it is because my prescription isn't that strong and I've heard it can mess with your close up vision later in life. But for someone with severe issues, fixing the myopia and then just using reading glasses as needed is definitely a huge QoL improvement.
Yes, this sentence. Right here. This is why you can't get why many people really don't want to just wear glasses.
I have no idea why they're so expensive at most vendors. It shouldn't be cheaper for me to order glasses without insurance. That said, the cost breakdown I saw from Zenni definitely showed that the major cost was for the lenses and given that they seem to be the cheapest vendor, I suspect they're actually telling the truth. Lenses seem to be pretty complex as well to manufacture, even for simple prescriptions.
Tried Zenni about 12 years ago. Best lenses ever by far. Also the best style for me—$30/pair. My kid’s glasses are $9/pair but would be $7 without custom engraving.
It's actually a European thing. Luxottica, an Italian company, has largely monopolized glasses worldwide.
https://www.forbes.com/sites/anaswanson/2014/09/10/meet-the-...
from wikipedia: Luxottica retails its products through stores that it owns, predominantly LensCrafters, Sunglass Hut, Pearle Vision, Target Optical, and Glasses.com. It also owns EyeMed, one of the largest vision health insurance providers. In addition to licensing prescription and non-prescription sunglasses frames for many luxury and designer brands including Chanel, Prada, Giorgio Armani, Burberry, Versace, Dolce and Gabbana, Michael Kors, Coach, Miu Miu and Tory Burch,[8] the Italian conglomerate further outright owns and manufactures Ray-Ban, Persol, Oliver Peoples, and Oakley...In March 2018, the European Commission unconditionally approved the merger of Essilor and Luxottica.[14] On 1 October 2018, the new holding company EssilorLuxottica was born, resulting in combined market capitalization of approximately $70 billion.[15] The merger with Essilor additionally gave Luxottica control of Foster Grant and Costa Del Mar, sunglasses brands acquired by Essilor prior to the merger
Now, I'm not an expert on European regulation, but I do get a lot of good information from Europeans here on HN, and I'd guess that the EC approved the merger because the company respects the GDPR
Astigmatism correction in contact lenses sacrifices some image quality (sharpness is reduced), but it might still be better than glasses depending on how much correction is needed.
It's possible to combine spherical contact lenses with cylindrical glasses, which might give the best overall image quality depending on the exact correction needed.
Related to this, different glasses lens materials cause different levels of chromatic aberration, measured by Abbe number. The cheapest (PADC, e.g. CR-39) is one of the best you can get.
I wore only contacts from December 1992 to maybe a few years ago, when presbyopia made things impossible, and I have been lamenting - truly lamenting - the state of things with glasses.
I procured some Natural Vue lenses for multifocal vision last month, as I had previously tried them with decent results, but the outcome is not good at all. My near vision is rubbish.
I wish I could wear contacts again, my QoL has taken such a massive hit. I’m -10 in specs with astigmatism.
We've also now got two FDA-approved medicines for presbyopia, with at least two more pending applications.
https://www.vuity.com/
https://www.orasis-pharma.com/
https://ir.lenz-tx.com/news-events/press-releases/detail/18/...
https://www.ocuphire.com/product-pipeline/phentolamine
> I can get away without wearing them
There's a fallacy of some sort here but I do not know enough rhetoric to determine which one.
In many situations they're not practical. Sports and sex to name a few.
For sex I kinda like the blurred vision though.
I think this also extends to sex. With glasses, you can just take them off once you're ready and then afterwards you can just go to bed right afterwards if you want to. With contacts, you need to make sure you take them out before going to sleep.
Glasses always create a distance between your face and the world.
(Like 120 degrees vs 170, or something along the lines of that.)
I paid for college working in the glasses business. Glasses are just not comfortable to wear all day. You can have them adjusted up the wazoo, but after a few hours, they're just annoying. Then the lenses are easily smudged. Or they're easy to bump. The reasons are long.
Meanwhile you just get a pair of glasses that are built for comfort but don't look particularly good and they'll sit on your face comfortably all day. I honestly don't even think about it. I tried but cannot remember the last time I have.
Three or four times a year I end up laying down in bed, roll over, and realize I forgot to take my glasses off. Either I'm super odd or it's possible to get glasses and not have these problems.
Oh yeah, and when the nosepads are brand new and sticky. Otherwise I've never had a problem.
I'm at -3 or thereabouts with a cylindrical on both eyes, if that matters.
Eventually I did LASIK because of an eye infection scare though, figured it was better to take the risk once and fix your eyesight, than go about life constantly at risk of getting blind.
But it was never a _go back to glasses_ situation, I couldn’t even imagine my life without being able to do all the activities I enjoyed doing.
LASIK was soo cool and transformative that I recommend it to anyone now, and honestly the operation itself was a fun adventure in and off itself - even blogged about it at the time https://medium.com/@ivankerin/a-humble-mans-account-of-the-l...
1. she is limited by the kind of frames she can wear because of weight. 2. her face look way different with or without glasses, like she is behind a magnifier so she doesn't like it.
Nowadays I don't wear a contact in my better eye, so that I can focus to read, just one in the worse eye for distance vision.
edit: also wtf why do you know "many" people who've been to the ER with eye damage? I've only ever known that to happen to one person and it was due to a stick going into their eye..
If you think I'm lying about that, you're mistaken. A tiny piece of grit blowing into the window would cause my eyes to squeeze shut from the pain. It was all I could do to open them enough to pull over.
They were hard contacts, which were necessary for my astigmatism. I don't think the soft ones had that problem.
Believe what you want.
> why do you know
People who work with machine tools. A lot of people learn the hard way to use goggles. My incidents were with machine tools and being slapped in the face with thorny blackberry vines I was trying to decimate.
I've had a couple other incidents with power tools where the flying debris didn't hit my face, but if it did, without goggles, there would have been damage. For example, one time my angle grinder disk exploded. Another time my radial arm saw picked up a piece of wood and used it to punch a hole through the wall.
One acquaintance leaned over the car battery to attach jumper cables. The outgassing hydrogen exploded into his face and burned off the top layer of his eyeballs. He spent a week with his eyes bandaged wondering if he was blinded (fortunately, he recovered, but he said the pain was incredible).
Others have had their eyebrows singed from a carburetor backfire.
Coincidentally I was thinking about this but yesterday and how it relates to Bluetooth earbuds. Somehow Apple managed to make hearing aids cool.
It crossed my mind when I was thinking about a coworkers hearing aids and if they were ever picked on as a child for wearing them. I bet that the rise of earbuds has made life a lot easier for children who are hard of hearing.
Just like with all fashion things, the causality goes the other way. People think Apple is cool, so when Apple does a thing they think that thing is cool.
For info: I started wearing hearing aids later in life. Couldn't function without them and the occasional glance people give them is nothing compared with being thought stupid because you apparently haven't understood something (people seem much more likely to assume you are stupid rather than deaf).
Even though they are free ('socialised') medicine - UK NHS here - they are still functional blue tooth devices that can stream audio, etc, which is awesome.
They were hideous frames, but honestly I don't think any frames would have been considered 'cool' where I was.
To this day I hate glasses. Since discovering how easy it is to wear contacts at 26, I only wear glasses between the bathroom and bed.
https://www.today.com/video/paul-mccartney-says-john-lennon-...
>In 1973, he stopped wearing the ‘wire rimmed Lennon glasses’2 and expanded to slightly non-round styles. His blood spattered spectacles even featured on the cover of Yoko Ono's 1981 album ‘Season of Glass’ following his murder in 1980.
https://images.artbrokerage.com/artthumb/onoyoko_129502_12/1...
but then i realized, "ok, that's really grotesque, but at least I have done a great job of ignoring Yoko Ono!"
I am however getting older and have near-vison decreasing (you know, thise people who hand stuff at arm length to read). I find myself getting off my glasses often to see from a close distance (I hate the hybrid glasses).
I guess that contact lenses are not possible for me in that context.
I was surprised to hear this too, since I wondered how they could work in practice - there’s a handy explainer here if you are interested:
https://www.warbyparker.com/learn/how-do-multifocal-contacts...
I think I had similar diagnosis of myopia and astigmatism as John and its worked wonderfully for me. Fortunately this was completely recently where the techniques have been perfected/improved with technology.
Glasses work well for me, so a permanent surgical solution is only something I'm willing to consider if the risk of it adversely affecting my vision is very close to zero. Right now, that's not the case (as evidenced by the fact that I know multiple people who have had adverse effects in the longer run).
Maybe that’s acceptable to you, but not to me.
In my case, the only possible complication was dry eyes prior to surgery. If it wasn’t resolved, then would be canceled.
but fortunately was mitigated with over the counter and some prescription eye drops applied liberally.
I too was skeptical but I think the key is finding a good surgeon with a looong history of doing these surgeries.
My eyes couldn’t focus beyond a reading distance afterwards. No lens could get me to a legal driving eyesight.
Surgeon had no idea why. He re-lifted the flaps afterwards and flushed beneath them on the hunch that it might be from slight ripples. Horrible experience, didn’t fix it.
Hard contacts worked, but a second surgeon advised against having anything in my eye while we figured it out.
After about a year, it healed enough that eyeglasses could refract me to good vision again.
So I still wear glasses, but my vision is much better without them. (-2ish range these days.) Pretty awful experience, but I like glasses and it was a big improvement from where I was before.
My surgeon requested vision history from my referring optometrist. And did his own work up at the office. Took 2-3 months of follow ups and “adjustments” (ie, prescribing eye drops to fix dry eyes) to ensure vision was stable and dry eyes wouldn’t impact outcome.
There was never any clear cause/effect. My best guess is that it was from being super tense during the surgery. I found it extremely uncomfortable and intense to be fully conscious, knowing it would be bad news if I moved my eyes during the procedure. (They're holding a flap of your eyeball open during it, etc—super fun.)
Would have requested a little higher dose of Valium if I could do it over again. :) And maybe crossed a border to a high-volume specialty shop instead of my local ophthalmologist.
And anecdotally, half of the people who I know that got it done 10+ years ago have had their eyesight regress back to the way it was before or worse.
I honestly don’t know how lasik is allowed to persist with such high risk of complications.
That’s how it works yes.
https://2.bp.blogspot.com/-ZtY3nJ2WptU/VUt7x1dPTQI/AAAAAAAAC...
https://en.wikipedia.org/wiki/Radial_keratotomy
https://en.wikipedia.org/wiki/Radial_keratotomy
https://en.wikipedia.org/wiki/LASIK#History
It's like asking why JFK didn't use the Internet.
/s