The content of this blog is my personal opinion only. Although I am an employee - currently of Imagination Technologies's MIPS group, in the past of other companies such as Intellectual Ventures, Intel, AMD, Motorola, and Gould - I reveal this only so that the reader may account for any possible bias I may have towards my employer's products. The statements I make here in no way represent my employer's position, nor am I authorized to speak on behalf of my employer. In fact, this posting may not even represent my personal opinion, since occasionally I play devil's advocate.

See http://docs.google.com/View?id=dcxddbtr_23cg5thdfj for photo credits.

Sunday, August 14, 2016

How to Start Wearing EyeGlasses in your 50s

---+ Summary

If you have had good vision all of your life and are only now starting to use glasses:

* Take advice, whether from people who wear glasses, or from vision care professionals (opthalmologist, optometrist, optician) with a big grain of salt. Most people in developed countries now wear glasses, so they are not used to issues people with formerly perfect vision may have on starting to wear glasses.

* Do NOT purchase progressive lenses.  They are very disappointing for somebody who is used to be able to move eyes to focus anywhere without moving head.

* Purchase clear single vision driving glasses, if needed. Get clip-on flip-on sunglass filters, for use when driving into the sun; remove and use the clear glass at night, or possibly "fitover" sunglasses that go over your eyeglasses.

 As of this date (Aug 2016) there is no satisfactory solution for a single pair photochromic tint-changing eyeglasses for driving, usable both day and night.  If you need driving glasses both day and night, and you don't want clip-ons, you will need to buy two pairs, one day, one night.

* Purchase single vision reading glasses, if that's what you need.

I have not tried photochromic lenses. Sound good, maybe next time.

I have not tried bifocals or trifocals, burned as I was by my bad experience with progressives; they may be the 5th or 6th pair I try.

I am optimistic about variable focus lenses, but the market seems sparse and the range of vision restricted.

I like the largest possible lenses for the largest possible range of view. Extra large aviators or rectangular frames/lenses seem to be the largest available - 64mmx56mm.

People who have worn glasses for years often have several pairs, purchased as their prescription changed.  New eyeglass wearers may not have this luxury. I recommend purchasing single vision of whatever prescription you need most (near/far/middle). Clear - certainly if for driving, probably for indoor reading.

Finally: I think vision is a field begging for new technology, like variable focus lenses. Although I do not know how much medical regulation constrains innovation. You need to come from not wearing eyeglasses to see how primitive eyeglasses are.

---+ Details

In my youth I had extremely good eyesight. "Fighter pilot eyes", I was told when I was applying to Canada's College Militaire Royal (I chickened out because I was warned that my allergies might result in me not being accepted to pilot training, and because the IIRC 10+ year commitment - 4-5 years at CMR, 5 years after graduation, + 2 years extra as a pilot - seemed like a very long time way back then).

However, almost 4 decades of computer use have degraded my vision. I got my first prescription eyeglasses 2 years ago, and recently got two more pairs. My vision is holding steady - I wanted new glasses because I had bought the wrong types of glasses back then - and because my insurance plan would only buy me new frames once every 2 years.  (I remain cheap.)

The purpose of this blog entry is to record what I learned about eyeglasses, and hopefully help somebody else avoid making the mistakes I made with my first eyeglass purchases.

---++ Take Advice - Carefully

To start: take the advice of people who wear glasses with a very large grain of salt. Something like 75% of Americans wear glasses or contacts, many of them since childhood.  Most of them do not remember what it is like to have perfect uncorrected vision - and certainly not "more than perfect" vision.  (IIRC I had better than 20/20 vision when I was young - 20:10 and 40:20.)  They probably do not realize how much of a change it is to have to start wearing glasses.

This includes taking the advice of vision professionals - opticians, optometrists, and opthalmologists - under advisement as well. Not only is it likely they do not know realize how much of a change, but their advice may also be influenced by what sorts of glasses sell best.

---++ Progressives - Just Say No(to Vanity

My big, expensive, mistake was thinking that "eyeglasses are an old, established technology", and figuring that I would get the best glasses that my insurance company would pay for.  This seemed to be "progressive" lenses,
true "multifocal" lenses that provide a seamless progression of many lens powers for all viewing distances.
I really need reading glasses for close in, but I had noticed occasional, rare blurry vision, usually when tired, both using my computer (display about 2.5 feet away from my eyes when using my treadmill desk, a bit closer when sitting), and at night or during bright sunlight, e.g. sunrise or sunset.  My vision test revealed a slight astigmatism that, when corrected, helped my distance vision.

(Aside: in an ideal world you would take several vision tests - so called refractions - at different times of the day, at different stages of fatigue.  Also, Zeiss recommends  Diabetics are recommended to have their eyes tested at different times of the day and to consult an ophthalmologist if necessary and also notes that Zeiss' "objective refraction tests" can determine whether your night vision needs different correction than your day vision. However, your opthalmologist-optometrist-optician probably doesn't have the necessary equipment for an objective vision test, and can only give you a subjective vision test.  Also, your insurance will probably not pay for multiple tests - mine does not.)

So, "progressive lenses sound good - one pair of glasses that could satisfy all of my needs?"

BZZTTTTT!! WRONG!!!! At least for me.

What I had not realized - what I probably should have realized - is that with progressives only a very small region is in focus.  When reading a book, often only one or two lines of text were in focus. Sometimes less than a full line of text, for large fonts: the bottom of an S might be in focus, but not the top. Furthermore, I often found that a line of text in a book might be in focus in my left eye, and in my right, but not right in the center.  What I had not realized - what I probably should have realized - is that people who uses progressive are in the habit of moving their head left, right, up and down to focus on things. Whereas I, with my formerly good vision, was (and still am) used to moving my eyes and focussing near or far without needing to move my head

I was able to drive with progressives, but I had to tilt my head or adjust my glasses, and I often needed to tilt my head up or down to read road signs.  It seems that people using progressive lenses are looking at the world through a narrow crack - which is actually quite worrying when you realize that you are sharing the road with them.

Overall, it seems that much of the marketing for progressives is vanity, hiding the fact that you are aging. If I had known this I would probably have tried bifocals or trifocals - I don't care about lines in my glasses - but I have not tried them yet. Cheapskate. Plus I like the largest possible range of vision.

---++ Adjustable Focus Eyeglasses - in My Dreams

Aside: true variable or adjustable focus eyeglasses are available, from the likes of Adlens, Superfocus, Empowered, Adspecs and Eyejusters. Of these, only Adlens seems to be widely available. Superfocus and Empowered seem to have gone out of business. Adspecs and Eyejusters seem to mainly motivated by charity, making eyeglasses available to poor countries, with "Buy One Donate One" offers.  I tried several of these after I realized how useless the progressive lenses were - several of them are much cheaper than regular glasses, especially without astigmatism correction.  Overall, they work, but are not great (for this pampered westerner). Small field of vision. Plus, one of them is only one time adjustable - you have to break off a plastic tab preventing you from adjusting later.  A hacker.acquiantance, "Ches" (Bill Cheswick), liked his Superfocus glasses enough to buy a second pair, but was not wearing them when I last saw him at a workshop. I might have purchased them myself - I am often a gadget-happy too-early-adopter - but they were no longer for sale. At the moment, Adlens appears to be main player in this market. I tried their Alvarez lens - small field of view. Inventors and startup companies with new technology  pop up regularly in the news, but peter out.

---++ Driving Glasses, Sunglasses, PhotoChromic => Uncool Dad

When I purchased the unsatisfactory progressives I also purchased single vision sunglasses, for driving into the sun and spotting while on the water. These have been satisfactory. I don't need them much, but they help when necessary. I have been needing them more and more - ah, the joys of age!

My only complaint about these "driving glasses" is that they are sunglasses, and hence not useful at night.  I don't regret getting all of the fancy sunglass features - polarized, glare reduction, etc.

I do regret not getting some form of tint adjustable photochromic glasses, like the Transitions lenses that used to be advertised so widely on TV (still may be - I watch very little TV nowadays).  Or, at least I would regret not getting photochromic lenses - except that there is no perfect choice of photochromic lens for driving.

Back in 2014, most opticians warned that photochromic lens would not change tint inside a car, because the car windows filtered the UV that drives the transition. Rather defeats the purpose for driving lenses. My own research discovered some photochromic lenses that would work inside a car, whether extra-sensitive to UV, or dependent on less filtered wavelengths. But I played it safe.

Now, in 2016, photochromic driving glasses good for night and day have ALMOST arrived. E.g. see Transition's comparison chart. Their DriveWear brand "fully activates" "behind-the-windshield", but they forbid you to use DriveWear glasses at night, since they never turn completely clear.  This would be worrying if you want to use such driving glasses mainly around dawn and twilight, in mountainous country with big, dark, shadows. The original Transitions Signature line and the Vantage line do not activate behind-the-windshield. The Transitions XTRActive line attains "moderate activation" behind the windshield, but lacks the polarization of the Vantage or DriveWear lines. All of the Signature, Vantage, and XTRActive lenses are recommended to drive at night (note that this was not apparent on the comparison chart - had to search for other marketing material).  But only DriveWear is recommended for prescription sunglasses.

Friends (salt!)  recommend photochromic far seeing outdoor glasses for use both inside and outside the car, with clip-ons or wearovers for use while driving.

You can also get photochromic "overglasses" - would not help in the car, but might help while on the water or snow.

I have not yet taken these friends advice, mainly because I have already spent my budget for the next couple of years, but also because (1) The photochromics that are most recommended for driving, e.g. the Transitions Signatures that turn fully clear, do not seem to be very good sunglasses; (2) the best Transitions sunglasses, the Vantage with variable polarization or the XTractive that are darkest, neither turn completely clear, and (3)

Photochromic lenses ... have been shown significantly to reduce light transmission compared to uncoated lenses, which may reduce the likelihood of identifying navigation lights. Seafarers should be advised not to wear glasses with photochromic lenses or glasses that are permanently tinted when undertaking lookout duties at night. (From the Norwegian Center for Maritime Medecine.)

Bottom line: my hope was vain, of being able to have a single pair of photochromic driving glasses, usable from night through sunrise/sunset to bright daylight near glaring ocean.

---++ Low Tech

So now I have the old prescription sunglasses I bought two years ago, and a new pair of non-tint driving glasses in case I need them when driving at night. Suboptimal: expensive, and a hassle.  I have also purchased "clip-on flip-up sunglass lenses that may permit me to carry only the single pair of driving glasses around.  My teenage daughter already thinks I am totally uncool.

Friends (salt! salt!) recommend wear-over sunglasses - large sunglasses that can fit on top of your eyeglasses.

---++ Lens Size - the larger, the better to see with!

Which brings me to my next to last point: lens size.

Since I am used to being able to move my eyes around, it helps to have the largest possible lenses. DEFINITELY UNCOOL.

Most of the frames my optician has available seem to be motivated by vanity: stylish glasses, with a restricted field of view.

Extra-large aviator lenses were the largest lenses I could find (more specifically, extra large aviator frames, lenses to match).  I am mostly happy with these, except that they leave a big uncorrected gap at the bottom - exactly where I cast my eyes down to look at my keyboard, or to read a newspaper broadsheet, or to see what I am about to trip on in the woods.  I only learned, when I was searching for clip-on sunglasses, that "Extra Large Rectangle" glasses have bigger lenses than "Extra Large Aviators", 64x56 vs 63x51. Next time...

---++ Purchase Strategy

Don't do what I did: don't jump to expensive glasses right away, especially not progressives (which I did mainly hoping to get away with having to track only a single pair).

Friends (salt! salt! salt!) recommend purchasing cheap clear glasses, typically on the web.  20-40$ seem ballpark. 

You may use all your vision insurance benefits - depending on insurance, you may not be able to access unused dollars.

The cheaper glasses may not get the largest lenses :-(

The cheaper glasses may not be scratch and break resistant.

But you can experiment, and figure out what works.

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