Why Did My Prescription Go Up

Navigating changes in your vision can feel like traversing unfamiliar territory. One moment, your prescription seems perfectly adequate, and the next, you find yourself squinting to read street signs or struggling to focus on your computer screen. This experience often leads to the question: "Why did my prescription go up?" Understanding the reasons behind changes in your prescription is crucial for maintaining optimal eye health and making informed decisions about your vision care.

Understanding the Basics of Refraction and Prescription

Before diving into the reasons why your prescription might increase, it's important to understand the basics of refraction and what a prescription actually represents.

Refraction is the bending of light as it passes through the cornea and lens of your eye to focus on the retina. The retina then converts this light into electrical signals that are sent to the brain, allowing you to see. Refractive errors occur when the eye does not bend light properly, resulting in a blurred image. Common refractive errors include:

• Myopia (Nearsightedness): Difficulty seeing distant objects clearly.
• Hyperopia (Farsightedness): Difficulty seeing close objects clearly.
• Astigmatism: Blurred vision at all distances due to an irregularly shaped cornea.

Your prescription is a numerical representation of the lens power needed to correct these refractive errors. It includes values for:

• Sphere (SPH): Indicates the degree of nearsightedness (minus sign) or farsightedness (plus sign).
• Cylinder (CYL): Indicates the degree of astigmatism.
• Axis: Indicates the orientation of the astigmatism.
• Add: Indicates the additional magnifying power needed for reading, typically for those with presbyopia.

An increase in your prescription simply means that the lens power required to correct your refractive error has changed. This change can occur gradually over time or more rapidly, depending on the underlying cause.

Common Reasons for Prescription Changes

Several factors can contribute to changes in your prescription. Some are related to natural aging processes, while others may be influenced by lifestyle factors or underlying health conditions.

1. Age-Related Changes

As we age, the structures of our eyes undergo natural changes that can affect our vision.

• Presbyopia: This is perhaps the most common age-related vision change, typically beginning around age 40. The lens inside your eye becomes less flexible, making it harder to focus on near objects. This results in a need for reading glasses or an increase in the "add" power of your prescription. Presbyopia is a progressive condition, meaning the "add" power will likely increase over time.
• Cataracts: Cataracts are the clouding of the natural lens of the eye. As cataracts develop, they can cause various vision changes, including blurry vision, glare, halos around lights, and changes in refractive error. In some cases, cataracts can lead to an increase in nearsightedness (myopia), requiring a stronger prescription for distance vision.
• Changes in the Cornea: The shape and curvature of the cornea can change slightly with age. These changes can contribute to astigmatism or alter the existing refractive error, leading to a need for a new prescription.

2. Lifestyle and Environmental Factors

Our daily habits and environment can also impact our vision and potentially lead to prescription changes.

• Digital Eye Strain: Prolonged use of digital devices like computers, smartphones, and tablets can lead to digital eye strain. This can cause temporary blurred vision, headaches, and eye fatigue. While digital eye strain doesn't directly cause a permanent increase in your prescription, it can exacerbate existing refractive errors and make your current prescription feel inadequate.
• Prolonged Near Work: Engaging in activities that require sustained focus on near objects, such as reading, writing, or crafting, can contribute to the progression of myopia, especially in children and young adults. This is because the eye may adapt to the prolonged near focus by elongating, which increases nearsightedness.
• Environmental Factors: Exposure to certain environmental factors, such as dry air, allergens, and pollutants, can cause eye irritation and dryness. This can affect the clarity of your vision and potentially lead to temporary fluctuations in your prescription.

3. Medical Conditions

Certain medical conditions and medications can also affect your vision and lead to prescription changes.

• Diabetes: Diabetes can cause fluctuations in blood sugar levels, which can affect the lens and cornea of the eye. These fluctuations can lead to temporary or permanent changes in refractive error. In some cases, uncontrolled diabetes can also lead to more serious eye conditions like diabetic retinopathy, which can significantly impair vision.
• Glaucoma: Glaucoma is a condition that damages the optic nerve, which connects the eye to the brain. While glaucoma typically affects peripheral vision first, it can also cause changes in refractive error in some cases.
• Autoimmune Diseases: Certain autoimmune diseases, such as rheumatoid arthritis and lupus, can cause inflammation in the eye, which can affect vision and potentially lead to prescription changes.
• Medications: Some medications, such as steroids, antihistamines, and antidepressants, can have side effects that affect vision. These side effects can include dry eyes, blurred vision, and changes in refractive error.

4. Pregnancy

Pregnancy can cause a variety of hormonal and physiological changes that can affect vision.

• Hormonal Changes: Hormonal fluctuations during pregnancy can affect the shape and thickness of the cornea, which can lead to temporary changes in refractive error. These changes are usually mild and resolve after delivery.
• Fluid Retention: Fluid retention during pregnancy can also affect the pressure inside the eye, which can temporarily alter vision.
• Dry Eyes: Many pregnant women experience dry eyes due to hormonal changes. Dry eyes can cause blurred vision and discomfort, which may make your prescription feel inadequate.

5. Eye Injuries and Surgeries

Trauma to the eye or eye surgeries can also lead to changes in your prescription.

• Corneal Scars: Corneal scars from injuries or infections can distort the shape of the cornea, leading to astigmatism and changes in refractive error.
• Cataract Surgery: While cataract surgery aims to improve vision, it can sometimes lead to changes in refractive error, especially if the artificial lens implanted in the eye is not the correct power.
• Refractive Surgery: Procedures like LASIK and PRK permanently reshape the cornea to correct refractive errors. However, in some cases, the effects of refractive surgery can regress over time, leading to a need for glasses or contact lenses again.

Specific Conditions that May Cause Prescription Changes

Here are some specific eye conditions that may lead to an increase in your prescription:

• Keratoconus: This condition causes the cornea to gradually thin and bulge outward into a cone shape. Keratoconus can lead to significant astigmatism and nearsightedness, requiring frequent prescription changes.
• Progressive Myopia: This refers to nearsightedness that continues to worsen over time, typically during childhood and adolescence. The exact cause of progressive myopia is not fully understood, but it is believed to be influenced by genetic and environmental factors.
• Accommodative Dysfunction: This condition affects the ability of the eyes to focus properly, especially when switching between near and far objects. Accommodative dysfunction can lead to blurred vision, eye strain, and headaches, and may require a prescription change to improve focusing ability.

Symptoms That May Indicate a Need for a New Prescription

It's important to be aware of the symptoms that may indicate your prescription needs to be updated. These symptoms include:

• Blurred Vision: This is the most obvious sign that your prescription may need to be adjusted. Blurry vision can affect your ability to see clearly at near, far, or both distances.
• Eye Strain: If you find yourself squinting or straining your eyes to see clearly, it may be a sign that your current prescription is no longer adequate.
• Headaches: Frequent headaches, especially those that occur after prolonged reading or computer use, can be a sign of eye strain and may indicate a need for a new prescription.
• Double Vision: Seeing double can be a sign of various eye conditions, including refractive errors, muscle imbalances, and neurological problems. If you experience double vision, it's important to see an eye doctor for a comprehensive evaluation.
• Difficulty Seeing at Night: If you have trouble seeing clearly at night, especially while driving, it may be a sign of nearsightedness, astigmatism, or cataracts.
• Halos Around Lights: Seeing halos around lights can be a sign of cataracts or other eye conditions that affect the clarity of the cornea and lens.
• Eye Fatigue: If your eyes feel tired or heavy after prolonged use, it may be a sign of eye strain and may indicate a need for a new prescription.

How Often Should You Get Your Eyes Checked?

The frequency of eye exams depends on your age, risk factors, and existing eye conditions. However, here are some general guidelines:

• Children: Children should have their first eye exam at around 6 months of age, followed by exams at age 3 and before starting school. After that, they should have their eyes checked every one to two years, or more often if they have vision problems.
• Adults: Adults should have their eyes checked every one to two years, or more often if they have risk factors for eye diseases, such as diabetes, high blood pressure, or a family history of glaucoma.
• Seniors: Seniors should have their eyes checked every year, as they are at higher risk for age-related eye diseases like cataracts, macular degeneration, and glaucoma.

If you notice any changes in your vision, or if you experience any of the symptoms mentioned above, it's important to see an eye doctor as soon as possible, regardless of when your last eye exam was.

What to Expect During an Eye Exam

During an eye exam, your eye doctor will perform a variety of tests to assess your vision and eye health. These tests may include:

• Visual Acuity Test: This test measures your ability to see clearly at different distances using an eye chart.
• Refraction Test: This test determines your refractive error and the lens power needed to correct your vision.
• Eye Muscle Test: This test assesses the alignment and movement of your eyes.
• Slit-Lamp Examination: This examination uses a microscope to examine the structures of your eye, including the cornea, lens, and iris.
• Tonometry: This test measures the pressure inside your eye, which is important for detecting glaucoma.
• Dilated Eye Exam: This examination involves using eye drops to dilate your pupils, which allows your eye doctor to see the back of your eye, including the retina and optic nerve.

Based on the results of these tests, your eye doctor will determine if you need a new prescription or if you have any other eye conditions that need to be addressed.

Tips for Maintaining Healthy Vision

While some vision changes are inevitable, there are steps you can take to maintain healthy vision and potentially slow down the progression of certain eye conditions.

• Eat a Healthy Diet: A diet rich in fruits, vegetables, and omega-3 fatty acids can help protect your eyes from age-related eye diseases.
• Wear Sunglasses: Protect your eyes from harmful UV rays by wearing sunglasses when you are outdoors.
• Take Breaks from Digital Devices: Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.
• Maintain a Healthy Weight: Obesity can increase your risk of developing diabetes and other health conditions that can affect your vision.
• Get Regular Exercise: Regular exercise can improve your overall health and reduce your risk of developing eye diseases.
• Quit Smoking: Smoking increases your risk of developing cataracts, macular degeneration, and other eye diseases.
• Manage Underlying Health Conditions: If you have diabetes, high blood pressure, or other health conditions, work with your doctor to manage them effectively.

When to Seek Professional Help

If you experience any sudden or significant changes in your vision, it's important to seek professional help immediately. These changes may be a sign of a serious eye condition that requires prompt treatment. Some warning signs to watch out for include:

• Sudden Loss of Vision: This can be a sign of a retinal detachment or other serious eye condition.
• Sudden Double Vision: This can be a sign of a stroke or other neurological problem.
• Sudden Eye Pain: This can be a sign of glaucoma or other eye infection.
• Flashes of Light or Floaters: These can be signs of a retinal tear or detachment.

Conclusion

Changes in your prescription are a common occurrence, and understanding the potential causes can help you take proactive steps to maintain your eye health. While some factors, like aging, are unavoidable, lifestyle choices and managing underlying health conditions can play a significant role in preserving your vision. Regular eye exams are crucial for detecting and addressing vision changes early on. By staying informed and working closely with your eye doctor, you can ensure that you receive the best possible care for your eyes and enjoy clear, comfortable vision for years to come. It's essential to remember that this article is for informational purposes only and does not constitute medical advice. Always consult with a qualified eye care professional for any concerns about your vision or eye health.