Optometrist Questions

“Big drop in nearsightedness prescription at age 60...”

Is this a cause of concern? Reason to believe one prescription may have been a bit off? Could I possibly have been overcorrected for over a decade? Is it possible that my nearsightedness has really improved?

I'm about to invest in a few pairs of new glasses (regular progressives, computer, and sunglasses), and I'm concerned about spending the money if the new prescription is not right.

In August of '22 my sphere prescription was -3.75 right and -4.75 left (pretty close to the previous year) and cylinder was +0.75 right and +0.50 left (a change from previous year).

Today (September '23) my cylinder is the same, but sphere has decreased a lot. It's now -2.50 right and -3.75 left. This seems like a big decrease (improved by 1.25 on the right and 1.00 on the left). That said, my reading prescription increased a bit (just +2.25 to +2.50) and the doctor thought that I should add +1.50 for computer/near PALs because I do a lot of computer work and have been struggling with it.

Both exams were very thorough and I have no reason to doubt the results, but for the fact that I did not think that nearsightedness decreased with age.

Female | 60 years old

6 Answers

Yes. We become more far-sighted and less near sighted with age. Usually about .50 D. Also check your blood sugar levels to make sure they are fine.
Could be a lot of reasons why your Rx could have had a myopic shift. Maybe it was due to cataracts or diabetes. I typically postpone the Rx until everything is ruled out. Sometimes it just happens for no reason.
Certainly possible to change that much in 1 year. Did your Dr. mention cataracts? That would the most common culprit. The only component in a 6o year old eye that can change the power of glasses is the lens of the eye, which is where cataracts form. That change is power will effectively give you more reading power than you had before. Increasing the add power will increase the chage even more. I personally would leave the add at +2.25. if you are getting your glasses from your Dr. then if you have a problem, that Drs office should make it right. If you are getting glasses from someone else, make sure they will redo the lenses if the Dr. needs to change things.
That is a very good question. The prescription decreasing overall (showing less minus prescription compared to previous) is called a hyperopic shift. That type of change can be considered typical and normal for a 60yo, due to the need for more ADD power in the reading prescription (bifocal/progressive); where the distance prescription seems to improve or become less minus. Some other causes for change would be fluctuating blood sugar/diabetes, or even the early start of cataracts that aren't quite affecting vision yet (where your vision is just adjusting by changing the prescription that you need). But if your overall health is fine, per evaluation by your primary care physician, then there is no need for concern being that it is a normal and somewhat expected change in vision due to normal aging changes.
The answer to this question has a few possible answers. Yes, it is possible that you may have been over-corrected, but you may have had some side effects if this was the case such as headaches, eye strain, or fatigue. Your becoming less nearsighted should not be of a concern, because this can happen for a variety of reasons. Age, genetics, environmental issues, general health issues, eye health issues, medications, and the development of cataracts can affect what your prescription is at any particular time. Cortical cataracts can create less nearsightedness in people as we all age as long as there are not other issues as I just mentioned. If you have any questions that you are concerned about, I would discuss them with your eye doctor. This way, you will have all of the information in order to be comfortable with the results of your eye exam. You should also know that prescriptions can and will change as we age and sometimes they remain the same. Good luck and best wishes.
This is a sign of the beginning of cataracts. Myopic patients like you are prone to get cataracts a little earlier than normal-sighted people. Cataracts will change the lens refractive index which will end up with prescription changes.