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AnnieCL Asked January 2019

Mom's eyesight seems to vary from day to day. One day she is OK with her prescription glasses, next day she is frustrated. Any advice?

We're on the 3rd Rx.

DrBenshir Jan 2019
Most likely causes are:

1. Fluctuating blood glucose - watch for patterns associated with what she eats. She may have been told she is "bordeline" diabetic. This is by far the most common cause of this type of problem. Get her tested, even if she has had a physical within the last year. They need to check fasting blood glucose and her A1c. If she is careful about her diet she may test in a high normal range but actually be diabetic.

2. Medication reactions - does she take the same prescriptions daily, or is there variation?

3. Problems with the prescription itself - too many eye doctors use digital measures for prescription glasses, but this can be highly inaccurate. Make sure the doctor checked her prescription out of the instruments with a trial frame and had her looking at the distances she uses.

4. Poorly fit progressive lenses - although convenient, progressive lenses are not for everyone. They do not give best sight in all conditions, and often impair balance and coordination. The peripheral distortions can be more obvious as lighting changes.

5. Dry eyes - must be managed with good quality eye drops and possibly ointment at night. There are also some nutritional supplements that can help.

6. Fuchs dystrophy or other corneal problems - this is usually related to a recently discovered genetic anomaly, MTHFR. She would need to take methyl folate and possibly methylcarbolamine in addition to eye drops.

7. Psychiatric disorders - patients with bipolar or dissociative tendencies can have multiple prescriptions. There will be a pattern and there are specialists (not many) who will know how to manage this.

8. Other undiagnosed vision problems - this probably should have been much higher on the list. This includes double vision with a small angle so that it looks blurry instead of completely separate; visual field defects; late effects of concussion or a small stroke.

Cataracts should not cause daily fluctuations unless there is also poor control of blood glucose. There are other more obscure possible causes but these generally have other symptoms associated with the fluctuating vision such as headaches, incontinence, changes in sleep patterns, etc.

Check the website of the Neuro-Optometric Rehabilitation Association for someone near you who is experienced with these types of problems. If there is no one near enough, contact the association and ask for a referral. Other sources are COVD.org and OEPF to find a specialist who will understand the specifics of Mom's issues and may be able to prescribe appropriately.
Lymie61 Jan 2019
Great info thanks! Just one addition I would make is to make sure she is drinking enough water/fluids. If she is getting enough water one day but not the next that I find can have a big effect on vision (and visions in my mom's case, hehehe).
cherokeegrrl54 Jan 2019
O my goodness does this sound familiar!!!! My 85 yr old mom has just about driven me nuts with her complaints of one day she can see, next day her eyes are blurry and she cant see clearly...and she believes the dr or optician gave her the wrong eyeglass rx.....she even had 4 eye exams in less than 12 months and 3 new pair of glasses before i moved close to her in july. She does suffer from dry eyes , has been on restasis and any number of other otc drops for 17 yrs. She just had a brand new procedure called Iluxe ( Pronounced eye luxe) this week....this procedure expresses the meibomian? glands (MGB). I saw on the instrument after the treatment how much gunk was in the glands! So far she sees much clearer, eyes feel much better-....its a new procedure so medicare doesnt cover it yet and its not cheap... but if your parent has been diagnosed with dry eyes please look into this.....so far so good! Her glands were totally blocked so she may have to repeat in 6 to 12 months....she goes back in 30 days for check up I so hope and am being very positive with her that this is going to help her and so far thats been the case.....I understand how frustrating it can be when our parents make these complaints. I wish all of you the best in dealing with these issues....many blessings to all the caregivers on this forum...
Weeroo Jan 2019
just a heads up, I found relief from blocked glands by using a gel pack, heated, then massage lids after. Might be cheaper! found one shaped like little eye mask and heats in microwave, at Walgreens.
Also there is a new lid scrub that you don't rinse off that is GREAT! and really easy to use.

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MountainMoose Jan 2019
Does she live in a dry climate? Perhaps she gets dry eye. That happens to me, living in a dry climate where my eyes are okay one day and the next everything's blurry. Perhaps check with her eye doc to find out the best eyedrops for her, and encourage her to use it daily.

I also keep my old readers. Some days the stronger powered glasses work better than the older weaker powered glasses. Does she have her old glasses? Perhaps one set works better than another on certain days.

rocketjcat Jan 2019
I agree with MountainMoose...she may have dry eye and /or floaters. My vision varies daily or even by the minute. Sometime crystal clear, sometimes blurry. I’ve gone through multiple glasses prescriptions. It’s very hard to get an accurate exam since I have to blink and blink and wait for the vision to clear each time asked “Whats better 1 or 2?” Even then I’ve gotten bad readings and bad glasses. Back to the eye doctor. Try over the counter drops a few time a day and see if at any time her vision is good or if she notices an improvement. Then you’ll know that the glasses are ok. My best luck is with Systane Ultra Preservative Free during the day and Systane Gel Nightime before bed. It may be worth shot.
AnnieCL Jan 2019
Thank you! I'm going to try the drops you recommended.
Gigi7799 Jan 2019
Does she have dementia? My mom's vision tests 20/20 with her glasses but she has great difficulty reading. The ophthalmologist said it a brain connection issue. Her brain has difficulty interpreting the words and transposing them into thoughts. This came on fairly rapidly and she can not do jigsaw puzzles either now. Even large pieces. Hopefully your mom's issue is something correctible.
AnnieCL Jan 2019
Yes, she does have dementia. I think all of the answers are indeed possible explanations contributing to her eyesight difficulties. Thank you, I will definitely bring it up with her primary care doc at her next appointment.
Cherrysoda Jan 2019
Also sounds familiar, be patient, sight changes due to sugar, and other things-sunlight, darkness, dry eyes, emotions, medications etc. Could also be-and this has happened to me, she has the right RX but its set wrong...meaning ..I forget the techy term, but its the way the eyes are lined up to see in the rx. Does it feel better to her if she pushes them to one side? Does she get headaches? Are they bi focals? I personally do better with seeing glasses and puter glasses and then reading glasses.

I'd say if its the 3rd RX from the SAME place, its time for a NEW DOCTOR and maybe she would feel comfortable in an older rx. (that has happened to me before too, I just went back to an older RX)

Also talk to her regular docs about MEDICATIONS, many have weird side effects, some affect vision, some vision side effects can be a warning that a medication is bad for her. And have her checked for vertigo as well-inner ear troubles, that can really mess up our vision and we are blaming the wrong organ!
AnnieCL Jan 2019
Thank you so much! Yes, I will take her to a different doc. All of the suggestions are possible.
Cupofjoe34 Jan 2019
Bring here to a eye specialist she could have a more serious issue. I find my meds cause my eyesight to fluctuate daily and it's due to early glaucoma or eye pressure. Hope this helps much love and luck jo

lynina2 Jan 2019
Take her to a different eye doctor. Aside from the worries other have expressed on this thread, there could be a problem with the equipment or production or training at the vision center. This happened with my teenage daughter. Went through two additional prescription adjustments that only made things worse. Finally, went back to original opthalmologist to reconfirm the accuracy of the first prescription and had glasses made elsewhere. Problem solved. No problems since AND never went back to the place that never got it right.

Longears Jan 2019
The situation is frustrating for everyone! Vision is so important to quality of life!!

If her glasses have progressive lenses vice bifocals or trifocals there is a bit of a learning curve for getting clear vision. The near, medium & far progressive "zone" is in a vertical strip centered on the front of the eyes. To see clearly you must keep that zone in front of your iris & lens. You have to turn your head & look directly at things. You can't just move your eyes. Keeping the glasses correctly aligned is real important to keeping the vision zone where it does the job.

The progressive zone comes in various widths. The narrowest width absolutely requires keeping the glasses aligned & looking directly at things for best vision. Hope this helps some!

sudalu Jan 2019
My 97 yr old mother has the same complaints. She has extreme dry eyes and dandruff. She says she can't cry (no tears). Her eye doc recommended warm compresses on the eyes, plus drops (Systane). Problem is, she lives in an assisted living facility and she won't ask the nurse to apply the drops when needed, and she can't remember to use the warm compresses.
anonymous559173 Jan 2019
Assisted Living, the care aides or nurse should have to do that for her, ask and talk to the staff.  She can get assistance, even  if you have to grovvile,
My mom was in assisted, the to extended, I spoiled the staff crazy like, it did
work they were always ready to help my mom.  Bribery works.  Choclate, donuts, flowers, cards of thank you. anything to support them.
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