Amy

based on a story first written by Clay and Augmented by Barry

I went to Lenscrafters to check out some new specs the other day. An attractive blond lady—early to mid twenties was there picking up her new specs, which were slight plus in a Blue plastic oval frame. She was standing in front of the counter getting ready to put on her new glasses, as I noticed the tell-tale line of flat-top bifocals. It was her first pair, I could here her say. As I listened in to the clerk dispensing the specs, I heard her ask why bifocals at her age. The optician said it was very common in young farsighted people to need more help in reading up close.

As she tried on the bifocals she could not believe the difference they made. Were her eyes really that bad? I noticed her reading the small card they give you to read close up and then glancing in the distance back and forth, lifting the bifocals up and looking at the card without the specs and commenting she could not read the bottom five lines without the bifocals. Then she asked the clerk about the line in the bifocals; she wondered how noticeable it was to other people. The clerk reassured her that nobody would notice. Then the clerk, a cute twenty something herself, asked the new bifocal wearing girl to look closely at her gold metal framed glasses.

As the blond lifted her head to peer at her with the lower segment of her new FT25 bifocals, she noticed that the clerk was wearing bifocals as well. “I never would have guessed you needed bifocals too,” she said, “your so young.” “See, as I said, we see them at any age. I'm twenty seven and have had these for three years. I started out wearing the half glasses just for reading. They really made me feel old but I quickly found that I could not read anything without them. After a trip to my eye doctor, she suggested that I try bifocals. She said I was farsighted and needed more help in reading. She prescribed bifocals. I have +1.00 in each eye with a +2.00 add, just a little stronger than your +1.50, but if you're like me you will get an increase quickly. After less than a year I went from a +.75 to a + 1.25 add and I'm ready for something stronger already. I recently bought some + 3.00 reading glasses that I use when I read at home. They are pretty strong but I can sure see up close with them.”

As the clerk clean her new bifocals she asked the optician how much she should wear them. She told her to wear them as much as she could to become comfortable with them, but as needed. And not to be surprised that wearing them all the time would be the best.

While the clerk was finishing up adjusting her new bifocals, she picked up the reading card again trying to read it, saying she never knew how much she was missing. Putting her new bifocals on she tried again to read the car and found it once again clear through her bottom segment. The optician gave her the standard warning about steps and moving your head to read and not just your eyes. The optician said she wears her bifocals from first thing in the morning to the last thing at night and would never go without them. She said her distance vision would be OK but could not read anything without them. With that, the new wearer was still raising and lowering her chin glancing in the distance and looking at her watch, commenting what a difference they made. She was still very apprehensive about that new line in her glasses, saying she really felt it was right in the way of everything she looked at. The clerk assured her that feeling would pass quickly. She suggested a pair of full frame reading glasses would make reading and close tasks more comfortable. The clerk reached into her purse and retrieved her + 3.00 reading glasses. She quickly tried them on and found them very comfortable to read and quickly commented that even her distance vision was OK.

The optician checked her prescription against her new bifocals, realizing that she had a + 3.00 distance correction in each eye with an add of + 1.50. It was obvious the reason she could see far away with the clerks reading glasses. After a few minutes of wearing the reading glasses she handed them back to the clerk. In just that short time her eyes had adjusted to the glasses and now even her distant vision was blurry. Quickly she wasted no time in putting her new bifocals back on, finding instant relief in her new bifocals.

The optician, noticing her apprehension about her new bifocals, suggested that they eat lunch together as it was the noon hour. Amy (the new bifocal wearer) eagerly agreed. As they left the store Amy was removing and putting on her new bifocals as they strolled through the mall, trying to get used to her new lenses.

At the restaurant the waiter brought menus. She noticed that Carol (the optician) lifted her head to read the menu from the bottom segment of her bifocals. “Do you automatically do that?” she asked. “What do you mean?”--”The way you lift your head to read from the bifocals”--”I don't know I'm even doing it any more, its just natural. I guess I can't see up close and automatically just lift my head to read.”

Amy, by this time was doing the chicken dance trying both parts of her glasses to read the menu. “So how are the bifocals?” asked Carol. “I'm still trying to decide which part to use. Its amazing how I never realized that I needed glasses, let alone bifocals; I feel so old! Are you sure no one will notice the line and that I am wearing bifocals?” Amy asked. Carol told Amy that in her three years of wearing them that her boyfriend noticed hers only after she mention that she had them. She once tried the no-line type and just could not get used to the small reading part of the glasses. They lasted only one month. It was then she went back to her eye doctor and had to get stronger bifocals—this after only one year of having an add prescription. She noticed that reading had become difficult like before she had the bifocals. He doctor told her to expect a stronger add every year, and she has been right on track. Carol had started with an add of + .75, then + 1.25, recently increased to + 2.00 and now feels she needs more help already. Carol said: “I'm resolved to wearing bifocals and I think the next time I will get the style with the line all the way across my glasses so I have the whole bottom part of the lenses for up close. They will be great for work, and I need the large segment to help me see up close. 

Amy took of the bifocals, but immediately put them right back on. It had become apparent that she had already grown comfortable in the clear vision the bifocals provided. Lunch continued with any more talk of bifocals.

Amy told Carol she had a second appointment with her optometrist in three months and she would see her then . . . Amy spent the next ninety days getting used to her new clear vision and bifocals. She wore them day and night and was never without them. Day by day her eyes grew accustomed to have the bifocals. Her unaided vision was now only fair without the lenses. Toward the end of the three months Amy noticed that she was holding the newspaper down on her lap to read it and that it was difficult to make out the fine print on some of the purchase orders she was required to check. 

Her appointment with her optometrist went as planned. Her distance vision required a stronger plus lens for each eye, but by the time the doctor had finished she was able to easily read the 20/20 line. When it came to the near point part of the examine she just could not read most of the chart even with her glasses. Placing the phoropter back in front of her eyes, the doctor used a small slide beam which was attached to the phoropter at right angles and hung the close read snell chart on a card, about 16 inches in front of Amy. He rolled the add lenses on the phoropter to 1.5 diopters. It helped when he dialed in the add, but Amy still could not read any of the bottom 6 rows, and was struggling even with the top lines. The doctor explained to her about increasing the add to compensate. The phoropter started again on its relentless clicking. Slowly the 5th row swam into focus, .25 diopter per click, and it clicked 5 times before she could see the bottom line clearly. Amy worried that her add was strong for someone her age. The doctor told Amy that it would probably stabilize in a couple of years but to be prepared for a stronger add in the future. As the doctor prepared her new prescription, Amy put on her bifocals just in time to read her new scrip—R + L +3.75—add +2.75.

On her way to Lenscrafters Amy could not believe how bad her eyes had become in such a short time. She went from no glasses to full time wear in just 3 months.

In the mall, Amy removed her bifocals as she strolled the stores. As soon as she tried to read the price of an item on th shelf she immediately knew that bifocals had become a permanent fixture. Amy tried to read, but it was not use. On came the bifocals. To her amazement, even with the glasses she still could not make out the price on the shelf. She tried the top and then the bottom segment—still a blur. She couldn't wait to get her new glasses. At Lenscrafters Carol waited on Amy right away. She has Amy how the bifocals had worked. Amy told her they had become a permanent part of her life. She tried to do with out them from time to time, but has to wear them for any up-close task. She has to put them on even to dial her cell phone at the mall.

Carol asked Amy for her new prescription and commented about he increase in scrip. Amy wondered about the stronger bifocal segment and when it would stop increasing. Carol told her if it would make her feel any better, that she had a big increase at her last visit as well. Carol's new script was R + L 2.75 with a 2.25 add. Amy told Carol she like her new glasses and wondered about the executive style bifocal Carol was wearing. Carol explained to Amy that they were great for work but did not look the best cosmetically and admitted to having a pair of rimless FT35 bifocals for other things. Carol said going without her glasses was no longer an option. She wore them all the time. Carol asked Amy about her job. Amy told her she worked in a book store as the manager, saying she did close tasks all day and would be totally incapacitated without her bifocals. In fact the other day she'd come to work without her glasses, tried to read by holding the material as far away as she possibly could, but ended up going home to get her bifocals.

Carol gave Amy her new executive bifocals to try and Amy looked far away and close saying she really liked the wide close-up view the bifocals gave her. She decided to get two pair, one in executive, the other in FT 35's.

As Amy returned to pick up her new bifocals, she noticed one of her employees from the book store, another twenty some brunette. Amy never noticed her wearing glasses before. As she approached, Cathy, she heard Carol telling her she would need reading glasses over her contacts, so that is why she needed bifocals. “Another one of us” Carol told Amy. She was just prescribed bifocals too—R +.50 L +.25 add +1.75. The routine continued with all three eating lunch together, Amy with her new executive bifocals and Cathy realizing how much clear her world had become with her new “round segment” +1.75 bifocals. Even her food was now blurry without her new glasses.

Nine months passed before Amy returned to the Optometrist. By now she was having trouble with both her distance and close vision. When she was trying to read the newspaper she was constantly trying to hold it away from her so the print would be in focus. Once again it was hard to read price tags in the shopping mall, and it was hard to see her cell phone numbers. She discussed with the Optometrist the challenge of working all day in a book store where more and more of her day was spent in front of a computer screen, which was about 24 inches away. The optometrist listen carefully and said that he would test her vision before making any recommendations. Once again Amy was in the chair and the phoropter moved in front of her eyes. The Optometrist brought the phoropter up to 3.75 and then switched on the distance chart. Amy was struggling to read the 20/80 line. The phoropter once again started clicking adding .25 diopters at each lens change. It was 8 clicks before Amy could read the 20/20 line. Next the reading test. At 16 inches Amy required 5 more clicks which brought her add up to +4.00. Then the optometrist slid the card back to 24 inches to simulate the distance to Amy's computer screen. First he tried the distance lenses—a blur—then he tried the reading add—still blurry. By now Amy was beginning to panic. The optometrist took the phoropter back to the distance setting and added 8 clicks. Suddenly the reading chart swung into sharp focus. Amy was relieved. Her new script read-- L+R 5.75 add (+2.00) +4.00 . The optometrist explained that for some reason she was loosing her accommodation and recommended that she consider some sort of multi focal lenses. Amy asked about the newer progressive lenses but the doctor said he didn't think it would be sufficient for her needs. “You can try the stronger bifocals but it would seem that you have lost a significant amount of accommodation since the last eye exam. If you could pull the computer screen in closer the bifocal would work, but then usually you have to hold your head back to get the segment aligned to the work. I believe a trifocal lens would work best,” he said. Amy didn't know what that meant until he explained that there would be an intermediate segment for reading at distance such as when she was using the computer. . .and off Amy went to Lenscrafters.

Carol again waited on Amy, and this time she seemed surprised about Amy's increase in script. Amy noticed that Carol was no longer wearing the executive bifocals. Instead she had on new glasses. Amy asked Carol's advice, and Carol's recommendations included both executive trifocals as well as a pair with progressive lenses for evening wear. 

Carol was now wearing progressives on a daily basis and thought they were fine for the amount of detailed close work in the optical shop, however, she did feel that in Amy's case she might be better helped with a regular trifocal. Amy ordered both an FT 35 trifocal as well as a pair of executive trifocals. At the same time Cathy came back in to pickup her new bifocals with an increase in scrip R+L 1.50 add 2.25. This time she had decided to try executive bifocals to give her a wider field of vision for close work. Amy's executive trifocals were ready in just over two hours and so the three went out to lunch together to celebrate their new lenses. Amy found the intermediate lens a real help in reading signs and window advertising in the mall, and now she could once again read the menu in dim light in the restaurant. Cathy seemed to be more at ease with the executive bifocals, saying she really liked the wider field of vision and magnification for reading. 

Amy noticed that her executive trifocals were much heavier than the older bifocals but was happy that she had clear vision again, and wore them on a daily basis for all her needs. The lenses were mounted in small oval metal frames, which seemed to break too easily, however Amy persisted until her next doctors appointment. 

Six months later she was having difficulty with reading distant road signs when driving. Recently she had been forced to hold things out further when reading and it was difficult to see clearly doing the close work. Her unaided vision was now poor without lenses She made an appointment with the optometrist. She arrived at his office and the assistant did some simple distance and close reading tests. This time, with her trifocals on she could read the 20/60 line on the distance chart, but when the close reading test chart was presented she could only read the letter E—the largest one of the chart—so once again she was back behind the phoropter listening to it click stronger lenses for distance and stronger adds for close work. 

Even the optometrist seemed surprised at the deterioration in her vision. Before the 20/40 line was clear the phoropter read + 7.50 and it click four more lens powers to + 8.50 so she could read the 20/20 line. The doctor presented the close read snell chart. Once again she was back at the top of the chart with six lines of blurred print to try and conquer. Quickly the lenses rolled by—sixteen clicks and still she couldn't read the last two lines. He moved up two more lenses and she could read the whole chart. Her new scrip was + 8.50 add + 4.50 (+2.25). The optometrist also said she needed to increase the width of the intermediate segment to 8 mm from the existing 5 mm so she would have an easier time in front of the computer. That type of lens was only available in optical glass which meant that the lenses would be thicker than previous scrips. The doctor wrote on the prescription that the optician should fit me with the largest frame that I could accommodate, so that the lenses would be deeper to accommodate the larger 8 mm segment and to provide a larger reading area as well. This time there was to be no question concerning the style of lens for her new glasses. He stipulated the executive trifocal lenses and indicated that the intermediate lens was to be directly in front of Amy's pupils to provide Amy with the maximum help for her vision. 

Back to Lenscrafters to see Carol, who expressed some concern over the doctor's directions, however did some measurements helped Amy select a new larger plastic frame with square lenses to hold the extra large lenses as prescribed. After a few trials they found a comfort bridge which seems to be a bit stronger and had sturdy temples. It was light blue in colour with broad temples and to accommodate the new trifocal lenses very large lens openings. Carol carefully measured each of the segments for the trifocal and drew them with a black grease pencil on the demo lenses and placed the order. 

It was almost a week later when Amy received the call from Carol to come in for a fitting. When Amy went to pick them up, Carol was there and proceeded to carefully place them checking the fit and making sure they were aligned correctly so the mid distance segment was directly in front of her pupils. She then heated the temple and fit them carefully behind Amy's ears. The glasses were even heavier than before and they were almost 5/8th inch thick at the centre of the distance segment and even thicker in the intermediate and close reading segments, but Amy had no choice but to accept this if she wanted clear vision. Because the lenses were glass, they were very heavy, and they tended to slip down Amy's nose even though Carol had carefully adjusted the temples to provide a secure fit. Amy kept on having to push the glasses up so Carol provided a small plastic strap which attached to the ends of the temples and then crossed the back of Amy's head to firmly anchor the glasses. The strength of the new lenses took some adjustment. For the first hour or so Amy's eyes watered as she looked through the new lenses as she wandered around the shopping mall. She looked at herself in the reflection of the shop windows. She was sure by now everyone could notice her enlarged eyes behind the new thicker and much more powerful plus lenses. Because there were big differences between the powers of each lens segment, Amy believe that they would clearly see light bouncing off the lines of the trifocals. 

After about three hours her eyes had grown accustomed to the new lenses. She could see clearly in the distance, although she found it difficult to adjust for the big jump between the intermediate and reading segments. At lunch with Carol, Amy was able to read the menu once again. The waitress came to take their order and complimented Amy on the new frames, but commented on the strength and thickness of her new glasses. Amy was very embarrassed. The waitress was obviously interested in the trifocal lens and asked Amy if she might try them. Amy release the little strap and handed the powerful trifocals to the waitress. 

Almost as soon as the waitress put them on she was shocked at how clear her vision was with Amy's new trifocals. She said she was already on her second pair of bifocals but hoped that she didn't end up with glasses like Amy's. Carol said that if she could see better with Amy's new glasses she was probably in need of a change in her scrip and see the eye doctor soon. The waitress, Joan, returned the new glasses and Amy put them on fastening the strap and was immediately more comfortable as her vision became clear again behind the powerful trifocals. Joan put on her own bifocals and with a little bit of squinting managed to write out their selections. Amy encouraged her to soldier on for the sake of her sight and accept the inevitable increases that would come in the future. Joan tried to understand what was happening to her vision and agreed that it was important to maintain a resolve for clear vision. 

Later that month found Amy, Carol and Cathy at lunch in their favourite restaurant. Cathy had been back to her eye doctor earlier in the week and was now celebrating her first pair of trifocals—this time FT 35's. Meanwhile Carol had seen a significant jump in her scrip, and had been forced to give up on the progressives and was now sporting new executive trifocals similar to those that Amy was wearing, perhaps even a bit stronger in the reading segment. 

When the waitress Joan, appeared, she was bare eyed and carefully working her way toward the table where the three friends were sitting. As she started to take their order, she was squinting to see, but appeared to be having trouble seeing . . . she stuttered a bit and then asked Amy to wait a moment. She said that she wasn't able to see well without her glasses but was still finding it difficult to walk about with them on. She still found the multiple segments of the lenses made it appear that her vision was jumping. It made it difficult for walking particularly in the stepped areas of the restaurant—they were so powerful they made her dizzy. Amy and her friends waited as Joan pulled her glasses from her pocket. The frames were plastic, bright blue in colour. They had wide temples designed to be sturdy, with large, deep lens openings, the kind that the opticians recommended for bifocals. As Joan slipped them on Amy noticed the magnification of her eyes and the tell tale glint of two thick lines that cut deeply across the full width of the lenses indicating executive trifocals. For a moment Joan just stood there waiting for her eyes to adjust to her powerful new lenses. Amy said, “I like the style of your frames. I see you have joined the trifocal club, perhaps a little sooner than you wanted. How are you doing? Those look pretty strong to me—are you getting used to them?” Joan smiled shyly and said: “First I should apologize to you Amy, I was just so shocked last time you were in, when I first saw your new glasses. Then I tried them on my vision was clear and realized that my eyes also had become much worse. I made another appointment with my doctor as Carol suggested. The appointment had not gone well. “I was in the chair for well over two hours. Using the old prescription, she couldn't read either the distance or close in charts.” Again, the relentless clicking of the phoropter as the lenses were increased, the final test of course was for intermediate vision because Joan had really lost most of her accommodation. The doctor prescribed trifocals for full time wear. When I went to see the optician, he suggested these stronger frames as he told me that the lenses were going to be quite thick, because they have to be so powerful in all three segments. Now I just can't function without these new trifocal glasses, although I just never believed I'd need these so soon. I'm only 25!” Joan's lenses were about 2/3rds of an inch thick at the centre. The distance lens really magnified her eyes, and when she looked at the group seated around the table she was already using the intermediate lens segment as it gave her more assistance to see them all clearly. 

All the girls were surprised at the thickness of their new glasses.

Amy has another appointment at the eye doctor tomorrow! 

It was Thursday and Amy was at the optometrist at 5:15 for her 5:30 PM appointment. The assistant began with a new computer based test. She placed Amy behind a new automatic phoropter that had just been installed in the office. The assistant carefully lined up the phoropter to Amy's eyes and then sat down at a small computer to enter Amy's existing refraction. Once that was in the machine, the assistant selected a program which used a small beam of light bounced off Amy's retina to measure her distant vision. She told Amy not to blink, but just to stare at the light. Amy could see the light but she could see some blurred lines at the end of a small tube. Almost immediately as she stared at the lines lenses began shuffling in front of her eyes and slowly the lines swam into a chart. After a few seconds the chart made up of radiating lines, came into focus. The process was repeated again for the reading test and then finally for the intermediate script. The Autophoropter provide the following script on a little print out: L + R + 10.50 add + 5.50 (+2.50). Amy moved with the assistant in to the main examination chair. The assistant dialed the new numbers into the phoropter and lined it up in front of Amy's eyes, then swung it aside. She left Amy to wait. As Amy waited she decided to look through the phoropter to see what the new lenses were like. After about 10 minutes looking through the phoropter through the new lenses the doctor came in. By this time Amy was using the phoropter to watch the distance chart. She realized that she could see the chart better but some of the lines were still fuzzy. The doctor came in and smiled and then read the results of the auto-phoropter. He asked Amy if she had noticed any changes over the pass months. Amy said that she had been using the intermediate segment more and more particularly when she was driving and she was having a bit of difficult again with reading .

The optometrist carefully examined her eyes using a very bright light which he shone through a series of different lenses, pronounced them healthy, but that he noticed some deterioration in the lenses in her eye. He proceeded to conduct his own test. On the distance test the lenses slipped quickly by until he had added about 1.5 diopters up to +12.00. With this Amy could only read the 20/40 line, so the doctor tried two more lenses and then two more—the 20/20 line was just barely in focus so he tried to more. Back to the reading test for close vision. Amy could just barely make out line 3. Again the phoropter started adding more and more power to the close vision setting. It was the same with the intermediate vision. He settled on L + R +13.75 add + 6.50 (+ 3.50) and asked Amy to read the close up chart which she seemed to be able to do, but when it came to move between the bottom 20/20 line Amy was still having trouble. The doctor moved the phoropter back in front of Amy and move the small chart to about 10 inches in front of her eyes. Then he tried 4 more clicks. Finally she could see the bottom line, but the add, + 7.50 was a big jump from the intermediate. The doctor pulled the snell chart back to about 14 inches and used a +4.75 and then left the computer segment at + 3.50. So now Amy was prescribed even more powerful quadrafocals, 4 powerful lens segments to provide her with good vision, as her eyes had lost all their ability of accommodation. Again he specified full width executive style segments for the powerful quadrafocals. 

Joan, Carol and Cathy get their new quadrafocals next week.