Reminiscing about Patients I Had in the Past.

by Anon

Looking back I remember a young girl who came in for an eye exam before she went back to college in the fall.
She was 19 years old at the time and wearing low minus glasses.
After the usual preliminary exams to determine eye health I sat her in the chair
and gave her a refraction. She was slightly nearsighted and had a tendency for her
eyes to cross.
Now being one of those shady doctors like they describe on the Eyescene website,
I took the opportunity to help her along on the road to myopia and strabismus.
She was a -.5 at the time so I gave her -1 to get her going. I also put 2 base out prism's in her rx.
I told her to come back in 6 months so we could see if the prism was having any effect on reducing her strabismus. At this time she was not complaining about double vision.
When she returned in 6 months she said she was having ocassional double vision, mostly in the evening when studying.
I told her this was not good and that she was most likely destined to be quite crosseyed for the rest of her life. I asked her if anyone else in their family was crosseyed and she said her mother had been but had surgery to correct it. The surgery had corected the visual effect but she still saw double without her glasses. I asked if her mother was nearsighted she said yes, but she didn't know her prescription other than she has vertical wavy lines in her lenses. I surmised she had fresnel prism's.
I asked the girl to come back in 6 months.
She was back and I did exam on her and she had gone up to -1.50 naturally so I bumped her to -2.50 with 4 base out prism. I told come back in 6 months and we would hope for the best.
6 months went by and she returned  complaining of double vision all the time even with her glasses on and things were quite blurry in the distance.
I checked her and she had gone up to -5.25 naturally so I gave her -6.50. It took 7 base out prism to get her vision fused so I gave her 10. I told her her glasses were going to be significantly thicker this time but it didn't seem to bother her. In fact she told me she rather enjoyed getting thicker glasses each time as she thought they made her look sexy.
I made note of that in my memory banks.
I told her she could probably go a year for her next exam and this pleased her. I figured we had a pattern here so no need to get too agressive on the increases.
She was back in a year. This time complaining of double vision again and things were quite blurry in the distance for tha last 3 months.
She had gone up to a -8 naturally and it took 14 base out prisms to fuse the double vision. She had always bought her glasses from me so we discussed the thickness of her new glasses. It was then that she told me she was a glasses fetishist and desired the thickest possible lenses for her prescription. She also told me her father was also nearsighted and
was initially attracted to her mother because of her extremely crossed eyes. After she had her surgery to straighten her eyes her father had started wearing glasses with considerable prism in them and appeared extremely crosseyed to look at him. Apparently this didn't seem to bother her mother.
So I had the glasses made up with CR39 lenses and plano bases. They came out with an edge thickness in her small frames of about 3/4 of an inch. She seemed overjoyed about this.
Another year went by. This time she was only complaining of blurry distance vision.
I figured she was getting to the age where her accomadation was going to be falling off and she probably couldn't stand too much of an increase. I thought this was probably the last chance for a big increase so I would see just what she could stand. She had gone up to a -10 naturally so I tried -15 when I opened the phoroptor. In this situation it is better to start high and come down to what they can tolerate. She said, wow, the letters are small but very clear. I thought, this is good. I went up slowly one click at a time to -16. She said it was still clear but slightly smaller. I figured I better not push my luck so I stopped. I did the other eye the same way and the result was identical. I was amazed she had that much and maybe more accomadation. I opened the other side of the phoroptor
and she exclaimed how the letters were so clear and not as small as they had been with just one eye. I decided to see just how much accomadation she had so I clicked up both sides one notch at a time  very slowly so she could get used to the view of each increase.
I went to -16 and she kept saying it was still clear and sharp. I went to -17. Still good.
-18 and now she said it was a bit fuzzy. Back down to -17.5. She said to stop. It was just right. This was absolutely amazing to me. I had never seen a person with this kind of accomadation before. I had been checking her sphere correction with the 14 prisms in
front of her also. When we finished, I told her that the new lenses were likely to be about an inch thick at the edge. She said what about my prism correction? Isn't it going to increase? I said we could decenter the sphere correction to gain what was needed there
so the lens wouldn't get any thicker. She then suggested I increase the prism to 20 and also decenter as much as possible. Okay, knowing her quirk I went along with it.
She had a quite small frame but even so the lenses ended up an inch thick at the edges.
I thought they were fabulous but I couldn't say anything.
When she came to pick them up, she put them on and I almost got instantly wet.
Her eyes were crossed in so you couldn't see all of her iris's.
I asked if they were ok and she said they were the best correction she had ever had.Things were absolutely super crisp. She showed me by stepping to the window and reading a sign across the street that I could only make out that it was a sign. I said how about reading. She then picked up a paper on my desk and proceeded to read it to me holding it just 6 inches from her face.
I asked how it was at arms length and she moved it and kept reading like any normal person. Absolutely amazing I thought.
Since I was only 10 years older I thought, why not go for it,?
I asked if she would like to go to dinner for purely professional reasons so I could observe how she got along with her new prescription. (what a hokey line that was)
She said yes that would be fine.
After she left I went into the lab. My help had gone home. My prescription is -5.0. I made up a pair of glasses with a -15 prescription and 20 base out prism's.
I got a pair of +14 contacts and put them in. The new glasses were just right. I looked in the mirror and almost went off. I was almost as crosseyed as she was and the glasses were almost as thick.
I went to her house to pick her up and knocked. She came to the door, took one look, grabbed me and planted a french kiss on me that I felt in my stomach.
It all worked out and we have been married for 20 years, have crosseyed kids and living happily ever after.

 

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