The Optician's Response

by Specs4ever

A few years ago I received an e-mail that I found to have some interesting information, and observations about my stories. I wrote a reply, and kept the e mail and my reply on my hard drive, with the intention of trying to make it into a story. But to do this I would have had to make it longer, and in doing this I would have changed it from a true story to an almost true story. In the end I have decided that Vision and Specs is a perfect venue for this true tale. 

Dear Specs4ever:

I have been reading your short stories from your web site for a couple of years now, and recently I found the newer ones that you have been posting on www.sweb.cz/bobby/goc/. I have found the tales to be amusing, and for the most part interesting.

If there is any truth to your stories it seems that you have in your travels, found practically every high myope in the world. In actual fact, I have read that around 25% of the world’s population is myopic. Of this 25%, about 10% are high myopes. High myopia is defined as being over 6 diopters. So, less than 2.5% of the world’s population is highly myopic, and of these people, probably less than 1% would be over –15 diopters. And, as the diopters get higher, the percentage drops. So, the chance of you running into a lot of very high myopes is really very slim. And, when you take into account the fact that most high myopes wear contact lenses, a person’s chance of running across a glasses wearing high myope becomes practically impossible. I have been an optician now for almost 30 years in a city with a population of around 50,000, and I have only had one steady female customer over –18. Before I sent you this e-mail, I decided to phone many of the other opticians in town to see if they had any myopes significantly higher than –10D as customers. As an end result, we have come up with a 15 year old girl that is around a –13D, and another around the same age who is around -17. There is a 70 year old lady that is over –20, a 40ish lady that is around –25, and another 2 ladies in their late 40’s or early 50’s that are in the mid teens. There are 6 men ranging in age from the early 30’s into the 60’s that are in the mid to high teens. So, in a city of 50,000 there are 13 very high myopes. Of the 13, 6 wear contact lenses almost all the time. Thus, as you can see, the chance of meeting one of these people is very slim.

Your stories of people wearing glasses when they don’t need them, or stronger glasses than they are prescribed to increase their prescription do not work for me. Yes, it is possible to accommodate to a higher prescription, but in actual fact this higher prescription can not be maintained, and the eye will return to the prescription that it feels comfortable with. And the tale of the young lady that wore contacts under her glasses to increase her prescription is definitely fiction, but should be accompanied by a warning that the end result will not be a stronger prescription, but could do damage to a person’s eyes.

Before you think I am being too critical of you, I must tell you that you have helped me with some of my customers. And, some of my customers might be of interest to you. I have a young lady who has been very nearsighted since she was around 8 years old. She has just turned 16, and still won’t wear her glasses all the time. Since her prescription, including a little bit of astigmatism is now in the – 10D range, I can only think that she has an amazing ability to interpret the blur. When she got her latest pair of glasses, I asked her if she was ready to wear them out of the store, and she replied that she wasn’t yet. I then asked her how she managed to read without them, and she sheepishly admitted that she had to hold her book pretty close to her eyes to see. But she left the store with her glasses in their case. I personally don’t think she is being intelligent about this, but she is the one that will have to come to terms with it. 

I have also had a number of customers who are in the low minus range who tell me that they are absolutely helpless without their glasses. One lady comes to mind that broke her frames, and wouldn’t leave the store until we had sized her lenses to a new frame. And she was less than a –2. If she had had a bit of astigmatism as well, I might have understood that she had a problem, but she didn’t.

One of the things that I learned from your stories was that plus contacts could be worn under minus glasses. One of my customers, a 72-year-old lady who is just over –12D with no astigmatism became my test case, as she had a new pair of bifocals on order. I opened up a pair of +9 contacts, and with them in, I found that I could see reasonably well through her glasses. It was an interesting experiment, and it gave me good insight into what she could see with, and without glasses. My conclusion was that she was pretty helpless without glasses, but her vision was quite acceptable with them. I began dispensing glasses to this lady in the early 70’s. At this time I was working directly for the optometrist, and I wasn’t yet licensed. Actually, I was never formally schooled. I was grand fathered into my license because of my years of experience when licensing was required for us. This lady was in her mid 40’s and was around a –9D at the time. Her oldest daughter also came for an examination as well, and it was discovered that she needed glasses as well. I always thought that if a child required fairly strong glasses, then their prescription would continue to climb, but the young lady, who started with about –3D, had only increased to –6D by the time she left school and got married. Now she is in her mid 40’s, and she has begun to need a higher prescription every couple of years. She is presently in the –8D range. This is unusual. Her Mother has only gone up –3D over 30 years, and her increases have been very gradual. There were many times that she didn’t even have the new prescription filled until after her next increase, or until she needed new glasses. 

And, most of the people that I have met with the stronger degrees of myopia do not see as well as you seem to make them see in your stories. My minus 12D lady can only be corrected to 20/30, and from my chats with other opticians; I find that this is not an unusual situation. Although my other lady customer who is in the –18D range is correctable to 20/20, the other people I have chatted with tell me that this is unusual.

In the past few years I have been seeing a number of children who have started off wearing glasses at the age of 8 or 9. Every once is a while one of these children will go through bouts of serious myopic progression, and by the time they are 17 or 18 they are very close to –10D. But, for the most part this is an exception, rather than the rule.

I have heard of children who start off life almost from birth with very high minus prescriptions. I personally have not had one of these cases, and I rather doubt that I ever will. But, I do acknowledge that they are out there, just not in the numbers that you seem to indicate.

I have enjoyed your stories, and I realize that a little bit of exaggeration is part of a writer’s privilege. All I can ask of you is that you possibly temper the exaggerations with a bit of a disclaimer.

I replied to this lady with the following e mail:

I really can’t find fault with anything that you have written in your letter. For a city with a population of 50,000 I suspect that you are right on the money. However, my observations are from years of traveling from city to city around the USA. So, I suspect that I have likely seen more high myopes than you have. Some of the characters in my tales are based on real life people. However, far more of my characters have been based on people who wear a much lower prescription in their glasses, and using my writer’s privilege I have increased their prescriptions substantially for the story.

While my story of the girl who wore contact lenses under her glasses to increase her prescription was originally fiction, I have since had a chance to correspond with another young lady who has actually done this in real life. She has increased her prescription from –7.75 enough by wearing –1.50D contacts under her glasses to first allow her to wear –10.50D glasses with a bit of overcorrection. Then, doing the same thing she has gone from –10.50D glasses up to –12.50D glasses, and is now wearing –1.50D contacts under the –12.50D glasses. So, I am more than willing to suppose that this method does actually work.

I don’t know what city you are from, however I have seen a fairly significant number of young teenage girls with prescriptions that exceed –10D in some of the malls where I have been going. So, I suspect that there are more young ladies than you think with higher prescriptions out there. You just haven’t seen them.

For me, my interest lies in high myopia, and females. Combine the two of them and you have a story about a highly myopic female. I have a reasonably good imagination, and I make up a lot of different scenarios based on this. Sure, a lot of what I write is totally fiction. But some of it is based loosely on truth. I have heard of people wearing much stronger prescriptions than they require. If this person is between the ages of 12 to 20, I feel the person can and will induce a lot of real myopia. But a person who wears a stronger prescription than they require will probably not induce permanent myopia if they are over 20 or 21

I will not start my stories with a disclaimer, however in deference to your suggestion; I will post your letter and my reply as a story in itself, although this one is true, and is not fiction.

Specs4ever

Sept 2006

As the reader can see, this has taken me 5 years to get around to finally posting it