Contact lenses and diving -Questions Welcome - by Idocsteve

[lsorenson]

Let me tell you something Doc...

I am 50 years of age with at least 5-6 pairs of glasses (bi-focal and single) some 3-4 reading glasses for when I wear contacts laying around the house and a wife who laughs and shakes her head when I can't find the one I'm looking for...

But this is a wonderful thing your doing here spending time helping alot of folks here...! I service medical equipment (CT's and PET scanners) and frankly, I find it quite refreshing to see someone in the medical field spending their time to freely help others... 99.9% being total strangers...!

No question for me but I did want to take the time and thank you for your contribution...

Lee

 

[cowdog77]

Hi Steve,

On my last eye exam I was told I'm starting to get "old eyes" and that I have naturally occurring monovision. My doctor was a bit lost when I asked him what my options were for correction for diving. Could you explain what this condition is and maybe some suggestions on how I can improve my vision for diving?

thanks~!

 

[idocsteve]

Hi Steve,

On my last eye exam I was told I'm starting to get "old eyes" and that I have naturally occurring monovision. My doctor was a bit lost when I asked him what my options were for correction for diving. Do you have any info on this condition re: how I can improve my vision for diving?

thanks~!

Natural monovision means that you see well in the distance with one eye and you have good near vision with the other. This is about the only naturally occurring condition that allows a very small group of patients to go most if not their entire lives without ever requiring glasses.

However monovision, whether natural or induced by contacts or laser vision correction, is not without it's limitations, mainly that distance and reading will never be quite as clear as it would be with both eyes corrected for both viewing ranges, and binocularity is affected to some degree which can be a problem especially when other cues to depth are not available such as night driving and... scuba diving, to name a few.

That much said I cannot comment on your particular situation because you have not provided nearly enough information.

 

[cowdog77]

Thanks for the info. I have an appointment coming soon and will update with more info.
Much appreciated ~

 

[idocsteve]

Thanks for the info. I have an appointment coming soon and will update with more info.
Much appreciated ~

You have an appointment with the same eye doc who seemed lost when you asked him about vision correction options for diving? Or with someone else?

Either way, here's something for you to try at home before you go for your next appointment. Confirm the degree of your natural monovision by viewing a relatively small object at distance such as a storefront sign, cover one eye and then the other to confirm that one eye sees it reasonably well and the other does not. Then do the same thing with a near object, such as a book with relatively small print.

This will do several things

-confirm that the first doc was right and you are in fact nearsighted in one eye and either less nearsighted, emmetropic (no significant refractive error), or mildly farsighted in the other. I've heard the term "natural monovision" tossed around rather loosely and can sometimes refer to a patient who is more nearsighted in one eye than the other, or has astigmatism such that one meridian of an eye is nearsighted and the other is farsighted, and even to describe someone who is much more farsighted in one eye than the other such that even distant objects are blurred. I know I got a bit technical there but point being that "natural monovision" doesn't always mean "one eye near and one eye far"

- it will confirm which eye is which and will also indicate how well you actually see. Better yet would be to compare your vision to that of someone else who is known to have good aided or unaided vision.

If you are in fact natural monovision then the odds are that you need to build on that monovision MORE for scuba diving, in that either the distant eye needs more distant correction and the near vision eye will need more reading, because rarely is natural monovision perfect, however if you do have natural monovision than you are a perfect candidate for a monovision contact lens fit, or bifocal contacts with one eye a bit more corrected for distance and the other reading.

Take these thoughts with you to your next eye exam.

 

[captain]

Since we are talking about monovision I normally wear -3.00 contacts in both eyes and have been using the Diveoptix stick on lens in my mask. Going with only one contact causes a little too much difference so I have been thinking about splitting the difference by using one -3.0 and one -1.50 or -1.75. Any suggestions.

 

[idocsteve]

Since we are talking about monovision I normally wear -3.00 contacts in both eyes and have been using the Diveoptix stick on lens in my mask. Going with only one contact causes a little too much difference so I have been thinking about splitting the difference by using one -3.0 and one -1.50 or -1.75. Any suggestions.

If you're around 50 years old your figures are probably about right, but the best thing to do is speak to your eye doc about the exact numbers, besides where are you going to get your hands on those contact lenses without an Rx?

Also for the most part the dominant eye is fit for distance and the nondominant eye for near but sometimes the roles of the two eyes are switched for example in the case where there is a decrease in the best corrected visual acuity of an eye, or perhaps if one eye has a bit more astigmatism, or if there's an intermittant strabismus and the dominant eye is the one that tends to turn (although that would be unusual).

 

[jstamets]

Do you have any advice about laser surgery with regards to scuba diving? My husband asked our doctor (general GP) and he recommended not getting it done for a few reasons, one of which was that the pressure on the eye at depth may be a potential problem. At this point he is looking into a prescription lens instead.

I know this post is a little stale, but hopefully it will help someone. I had lasik specifically for diving and indicated this to my surgeon, Dr Robin Beran in Columbus (a respected surgeon in the area). He indicated that when the flap is cut and replaced after surgery, it readheres initially by the natural negative pressure of the eye, and then heals in various stages over time. Flap healing is the main concern in this procedure. Since diving increases this pressure, rather than reducing it, it is not a problem. He has had numerous patients who were divers and none had any issues relating to the surgery and felt it was a good solution. There is a time period of several months where any contact with water is prohibited to allow the initial stages of healing to occur. The only issue regarding activity is direct abrasion of the eye and knocking the flap loose and that risk decreases over time (up to two years for a maximum healing - the flap never totally heals, but becomes strong enough that the force required to dislodge it would be sufficient to damage the eye anyway). As far as he knew, the only activity-related issues that have occurred with Lasik was a mountain climber had his vision fog up on a climb, but when he returned home, his vision restored on it's own. It was unclear whether this was due to the temperature, pressure, or other unrelated condition.

I am very pleased with the results. It should be noted that if you are far sighted, such as me (Jupiter was blurry), there is only so much correction that can be done. In my case I was corrected for the "top" of my bifocals, so I still require reading glasses, however the natural magnification in the mask underwater takes care of this while diving. I have a ProPlus2 which helps! But I was blind as a bat before. I have had 11 dives since the surgery and my healing and vision are dead on.

John

 

[idocsteve]

It should be noted that if you are far sighted, such as me (Jupiter was blurry), there is only so much correction that can be done.
John

John thanks for your post.

Not sure about the part quoted above, however.

If you're farsighted, you have better far vision then near...although farsighted individuals can also be blurred in the distance especially if they have some astigmatism which is commonly present along with nearsightedness or farsightedness.

Although LASIK was initially available for nearsightedness only, there have been, for quite a while, several laser procedures for astigmatism and hyperopia, which can correct very large degrees of both conditons, although for extreme hyperopia there are often better alternatives to LASIK.

Results for hyperopia can be somewhat variable and patients with this condition may want to consider this before undergoing the procedure.

 

[jstamets]

Thanks,

I should have said that for me, there was only so much that could be corrected using Lasik. I was definately far sighted with astigmatism (20/200 I think). I was borderline Lasek, but due to my corneal thickness (pretty thick, apparently), the Dr felt I would be a good candidate for Lasik with correction to my upper (distance) correction and supplement with reading glasses. He was less enthusiastic about a more aggressive correction. Since this correction meets my needs, I am happy to throw on a pair of $20 glasses instead of $500 glasses (or more) when needed. As of my last visit, I have 20/20 in each eye with no astigmatism and I am pretty happy. But yes, I should have clarified this earlier - hyperopia was a concern and should be discussed with your doctor and, as always, your mileage may vary.