You've got to hide your myopia away: John Lennon's contact lenses
onlinelibrary.wiley.com
onlinelibrary.wiley.com
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
> safer than laser 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).
> They probably just mean in terms of reversability
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
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.
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.
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
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.
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.
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.
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!
How do you do with oncoming headlights while driving at night?
(I'm close to the age where my mom and sister had to start wearing glasses.)
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
Another random comment: I just love that his contacts apparently only fit because of ptosis from using weed.
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
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.
In many situations they're not practical. Sports and sex to name a few.
For sex I kinda like the blurred vision though.
Glasses always create a distance between your face and the world.
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.
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.
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.
Temples*
Dunno, that all sounds more like great ways to break eyeglasses.
I wear my glasses to bed, while sleeping.
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.
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.orasis-pharma.com/
https://ir.lenz-tx.com/news-events/press-releases/detail/18/...
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.
I think it's funny how many people really don't want to just wear glasses.
(Like 120 degrees vs 170, or something along the lines of that.)
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.
> 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.
Yes, this sentence. Right here. This is why you can't get why many people really don't want to just wear glasses.
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.
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.
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.
That’s how it works yes.
https://2.bp.blogspot.com/-ZtY3nJ2WptU/VUt7x1dPTQI/AAAAAAAAC...
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.
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.
It's like asking why JFK didn't use the Internet.
/s