cellio | Entries tagged with vision

The Monday before last I took my new glasses back to the optician for two reasons: acutely, one lens had fallen out (heat + new plastic = bad; wash them in less-hot water, she says), and more seriously, the placement of the left bifocal was subtly off.

She measured the glasses, re-measured me, and then measured my old glasses. Verdict: the new ones are "right" and the old ones were incorrectly made. (Given all the trouble NeoVision gave me over the old ones, I'm not surprised.) The old ones had the wrong pupilary distance, she said, off by a total of 6mm between the two eyes. Why did my brain accept that? Dunno, but it probably got masked by the whole taking-a-week-to-adjust-to-new-glasses thing. My brain learned to cope with the error, I guess.

She asked if I thought I could get used to the new glasses. They were, in fact, ok for everything except working with my computer at work -- but that's pretty important, and I'd spent most of a week trying to get used to it. I asked if the bifocal could be moved without affecting the distance vision; nope. I asked if I could have a bigger bifocal, and she said that was possible. (Alas, the jump to the next size was 7mm, when I was hoping for about 4mm.)

This was about to lead to the uncomfortable conversation about who pays for this (it's not their fault the previous guys did something wrong, but we did use that as a partial baseline), but she called my insurance company and apparently they will pay for one "no-fault" remake. So I sent them back for a wider bifocal and no other changes. (I considered asking them to lengthen the focal distance on the bifocal, but decided that would be borrowing trouble and risk leaving me with nothing usable.)

I picked the new glasses up Friday morning. It took me a little while to adjust distance vision to work around the extra bifocal width, particularly when looking down. But I was able to read the computer at work more easily (after moving the monitor some). Reading paper (after minor adjustments) works fine. I read torah this morning with them. Ironically, I was having a little difficulty with my computer at home tonight, but it's gotten better over the last couple hours, so I guess I'm adapting. At one point I wondered if I was seeing worse with the new bifocals than the old, but three seconds with the old glasses told me otherwise. It is a crisper image; maybe the light is reflecting differently or something, and these lenses aren't yet as dark as the previous ones (plastic does that and transition lenses do that over time, apparently). It's almost certainly all really minor stuff, but I'm really sensitive to minor stuff. I'll get used to it.

But, as I said, it'll take a week, probably. It's annoying in the short term and better in the long term. Given that, I wonder what the optimal frequency of changes is. I used to keep glasses for, oh, 5-7 years before changing, because they were good enough, manual prescriptions were a crap shoot, and glasses were expensive. Now automation gets me better prescriptions and lenses have actually gotten cheaper in the last two decades (huh?), so it really just comes down to the transition period, I guess. Hmm.

It's the 21st century. Where are my high-tech adjustable glasses? :-)

At the end of last week I got a call saying my new glasses were in. (That was faster than I expected.) Monday morning I picked them up. The frames fit well; the side-pieces are a little more delicate than I had realized, and this is probably only noticable with lenses as thick as mine in the frame, but I think that will be ok. It was immediately obvious that the distance correction was better, and using the bifocals to read something in the office felt "different" but not "wrong".

Monday I had a little trouble with using the computer initially; I ended up adjusting the position of my monitor slightly, which helped. I know from past experience that it takes me a week or so to adjust to new glasses, so I just plugged away.

This afternoon I finally realized what was wrong about the bifocals (other than the focal distance having subtly changed); the placement of the left bifocal, relative to my eye, is a little different than on the old pair of glasses. I don't have quite as much bifocal-covered space to the left side of the field as before, and apparently it matters. Lens curvature prevents me from really comparing them "head to head", but getting them as close as I can I can see the difference. The bifocal looks fine in the lens; it's not obviously crooked or off-center or the like. But it's not quite right for my eyes, so Monday morning I will go back to see what they can do about it. (And I have learned to take a new measurement now: bridge to far edge of bifocal.)

I was going to keep wearing the new glasses over the weekend anyway (won't be using the computer on Shabbat, for starters...), but after doing all this comparing of lenses the new ones were dirty, so I washed them -- and the left lens fell out. Argh! I cannot get it to fit snugly in the frame; I thought I had it in at one point, but it slipped while I was putting the glasses on my face. I wonder what that's about. I inspected the frame with a magnifying glass and I can't see any hairline cracks. (I'm not going to try forcing things and risk creating one.) So now I'm back to the old glasses, and I can't do anything about it until Monday. And the distance vision isn't quite as clear. Bummer.

A while ago I asked about opticians. Thanks for the pointers. On the basis of the feedback I got from a coworker, this morning I took my prescription over to Optometric Associates of Pittsburgh, who seem to have the right amounts of customer care and attention to detail (and proximity doesn't hurt). So far, thumbs-up. (Of course, the real evaluation won't be possible until the glasses come in.)

The optician I met with, Jan, asked me what I was looking for in frames; I said my priorities were lens size/shape, fit, and "not garish", and all other properties were solidly second-tier. I said I wanted lenses no smaller than my current ones because these are my do-everything glasses (not into separate reading/computer glasses), and asked her to turn those comments into recommendations.

I was pleased that for every frame she pulled, she started by having me put it on so she could check the fit of the bridge and withdraw any that weren't right. (I have a small bridge, apparently.) Of the four frames she handed me three were good candidates, and my explanation of why the one wasn't led to some of the other options.

She had been doing this much just by looking. At this point she measured the lenses on my current glasses and the top candidate; the new ones are exactly one millimeter bigger in each of length and width. Score; the current ones turned out to be 1mm smaller than specified. :-) (We had been talking about the size-weight tradeoff; too small and I wouldn't be able to see, but I was mindful of being too heavy, too.) The shape of the new ones is pretty similar to that of my current ones.

I told her that bifocal placement was very important to me (had problems with that in the past), and that one of my current lenses is good and the other is a smidge high. She said the difference was obvious, though the folks who made the glasses had claimed it didn't exist; it turned out to be a difference of half a millimeter. She measured the distance between my pupils with a machine rather than a ruler, explaining that it was more precise. (Having now read a bit about it, I'm glad to see that it "reads" my eyes rather than depending heavily on my maintaining focus in one area. One of my eyes wanders and is hard to keep on target sometimes.)

She was very friendly and accommodating when I explained past problems I've had and would like to avoid. She explained the quality-control process ("you won't even see the glasses until I've confirmed all these measurements are exact"). Even if that's just part of the patter, I left feeling confident. Now I just have to wait a few weeks.

( stats )

This morning at my ophthamologist's office, through the collection of lens parts that she used to mock up a new glasses prescription for me, I read a letter from the 20/30 line. I have never done that before. Woot! Yeah, office conditions are probably optimized compared to real life, but even if the raw numbers don't matter the deltas should. And yeah, it's only one letter, but it still passed a threshold. (If I understand correctly, this would mean a rating of 20/38 on that single test.)

Now if I can just find an optician to correctly make them for me. I had rotten luck with that last time around. (The guy I used before those guys was excellent -- but he retired, which is why I went to someone else.) Locals, any recommendations? I have a complicated, finicky prescription and complicated, finicky needs on things like the precise placement of the bifocals. I need someone skilled and detail-oriented who (1) is that scrupulous about what comes back from his lab and (2) can work with me on this. I recognize that this is a non-standard level of service for which one should expect to pay extra. (I would also like someone to advise me on frame shape to optimize my vision; most places want to optimize their bottom line or some sense of "fashion".)

Bonus points for proximity to either Squirrel Hill or South Side Works, because even if he is excellent I'll probably have to make a couple extra trips as part of this. My glasses just don't happen as one-shots. So running up to, say, Cranberry at lunch time (because places aren't open at 8:30AM) would be a challenge, though doable if absolutely necessary.

( geekiness for the curious )

The interview meme is making the rounds again.

( singing, adaptive technology, trope, food, retirement )

Dear Blogger users,

I would like to be able to comment on your posts at times, but the Blogger captcha (the prove-you're-a-human-and-not-a-spambot image with distorted letters) has been getting harder and harder to read over the last several months, such that it usually takes me 3-4 tries and today I failed after 8. I infer that clicking on the little wheelchair icon is supposed to give me an alternative, but it didn't do anything for me.

Does Blogger give you the ability to whitelist IP addresses? Is there some other way to solve this problem? Or do I need to stop believing that I'll be able to comment on posts?

A couple weeks ago at work we got our first look at the new version of Bugzilla, which we'll be forced to upgrade to soon. (Our current version is incompatable with the version of Perforce we're upgrading to.) Both Perforce and Bugzilla have web interfaces, and in the new versions, both assume a much wider browswer window than I am prepared to provide. That I have to jack up the font size doesn't help, but, fundamentally, people are, more and more, designing inaccessible web sites on the theory that of course you can spare 1000+ pixels in width. The web-design industry is mature enough (or at least old enough) that we should be past that... grumble. But I digress.

So, while talking with my manager about some of the things we were trying to do to address this (our build manager, in whose lap all this falls, has been wonderfully helpful), my manager said "I just ordered some new 22" monitors; I'll put you on the list". (I could, if I like, have a pair of 18?" monitors, but I can't actually place two monitors such that I can see everything.)

This morning the monitor fairy came. :-) 22" turns out to be widescreen (not the 4:3 or whatever of regular monitors); the new one might be half an inch shorter than my old one. But it's tall enough, and the extra real-estate is nice. The recommended resolution is only 1680x1050 (or something like that), which surprised me. (I expected to see a number over 2000 for the wide dimension.) That resolution actually works for me; yay! This was also the highest setting available on my computer; I assume that's a function of the graphics card and not the monitor. (I would not be able to put higher resolution to good use.)

One problem: I noticed some pretty significant color distortion in the top quarter of the screen. We actually thought it was defective, so we swapped it out for another one (slightly different model). The problem was less pronounced on the second one but still there. That's when I noticed that it changed with my height; if I raised my chair a couple inches the problem got much better. But I can't raise my chair a couple inches because then the keyboard will be in the wrong place. (Tried it for an hour. No.) If I could tip the monitor forward a little that would make a difference, but it's already at the max setting there. Perhaps I will channel my inner MacGyver and rig something to let it tip a bit without falling. (Ok, that's more like my inner MacGyver's four-year-old apprentice or something. MacGyver would rig it to track my eyes and auto-pivot in both dimensions, using nothing more than duct tape and pocket lint.)

Mind, I will find ways to live with the color distortion if necessary. The real estate is worth it. It's not a perfect solution; I have to roll my chair sideways a bit to fully utilize the screen. But it's pretty good, and if it just plain gives me the room to have some extra-wide windows that I can move around as needed, that'll do.

I failed to record my monitor customizations before removing the old one, so I was recreating color depth, brightness, etc by feel today, but I thought I'd written this down somewhere and, sure enough, I did. So I'll try those settings tomorrow (they're somewhat different from what I came up with today) and see how that affects my color distortion.

One other problem (handily solved): the first monitor did not have buttons but rather touch controls. With tiny little labels that are impossible to read in dim lighting. I had to borrow a flashlight and use my magnifying glass to configure the monitor. The second one (an older model) has buttons. Yeah, I'll keep that one. What was Samsung thinking? Touch controls?! (And finicky ones, too.)

The results of my distance-vision test this morning were a little better than normal. In fact, my weaker eye scored its best ever. (We only got the "denominator" into double digits in the last year...) I commented on this and my ophthamologist said it might be partially due to her newer equipment: the contrast is better on the new LCD "eye chart" than it was on the old projection chart, which in turn gives better readings than the posters of yore. (Personally, I think my gadget-assisted glasses prescription helps, particularly in the weaker eye.)

Measured visual acuity depends on the equipment. What it also depends on (based on my own observation) is operator variation. Your vision score includes a judgement call by the person administering the test. Whether you get an extra point can depend on how quickly or how certainly you read a letter. When you say "um, I think it's an F -- no, wait, it's a P", what happens to your score is not well-defined.

This doesn't really matter for an individual patient with a consistent doctor (presumably what the test was designed for); what matters is not so much your raw score but whether and how it changes from year to year. But when that score is used for other purposes, like deciding who can drive and who can fly a plane, it gives me pause. According to today's eye test, if both of my eyes were as bad as my weaker one I would still be allowed to drive (albeit only during daylight). Yikes.

I've noticed that when there is a great feline tussle in my house that leaves piles of hair around, the vast majority of the time the hair belongs to Baldur. I see several possibilities: (1) his greater surface area makes him more likely to be hit; (2) his hair just doesn't stay attached as well as the other cats'; (3) he gets picked on a lot (he's the biggest cat BTW); or (4) he has developed the "eject hair" escape technique. Hmm.

I missed the first episode of the new TV show "Pushing Daisies" but caught the second. Wacky! Surreal! Fun! The narration as commentary is a nice touch. Yeah, that it's written by the person who did "Wonderfalls" shows; I hope "Pushing Daisies" fares better. ("Wonderfalls" was great for about 8 or 9 episodes, then sucked for a couple more, and was then pulled after 13.) I'm also watching "Journeyman", about which I'm undecided.

We drove through the rockslide zone of Route 28 on the way to visit my parents today. No rockslides were in progress at the time, and it looked like last week's had been completely cleared. The news had said inbound lanes would be completely closed for the weekend, but we saw continuous traffic while we were driving outbound so we didn't look for an alternate path home. It turned out that one lane was open. That was fine for a Sunday, but I'll bet it sucks for commuters right now. That said, rockslides suck more.

Two Shabbatot ago a first-time (in our minyan) Israeli torah reader asked me to be his checker. I expressed concern that I wouldn't be able to keep up; he said he reads holy texts slowly. His "slow" was too fast for me. Then this past Shabbat a different reader asked me to check for him and I figured this wouldn't be a problem; I had just a bit of trouble keeping up. Both times I was checking from the new Plaut (oodles better than the old Plaut), and using a magnifying glass to be safe. I conclude that my problem is Plaut + magnifier, not necessarily me, and I should only check when I can do it from larger Hebrew text such as what Trope Trainer produces. (I'm not the only torah reader in our group who uses that software, and in fact I have been handed TT output to check from at times.)

Without saying anything about the merits of Al Gore's work, I do admit to being puzzled by how this is a peace issue. Of course, in political processes all bets of rationality are off, but still... isn't there a more appropriate category in which to consider his work?

I heard a cute story recently: One night at dinner the seven-year-old girl asks her parents "where did I come from?" Oh crap, the parents each think; we thought we had a few more years before we'd have to deal with this. They exchange glances and then fumble through a discussion of birds, bees, and what happens "when mommies and daddies love each other very much". The girl says "oh" and everyone sits in silence for a few minutes. Then she continues, "my friend Becky comes from Cleveland".

I like the technician who did some routine tests for me this morning. She talks and shares reports. :-)

( Read more... )

For the two or three people reading this who haven't already seen the interview game, here's how this works:

If you want to be interviewed, leave a comment saying so.
(I will probably fail to get back to you for some time, because this is a busy time of year.)
I will respond, asking you five questions.
You'll update your journal with my five questions and your five answers.
You'll ask other people five questions when they want to be interviewed.

My ophthalmologist left her old practice and set out on her own. This morning was my first visit in the new digs. Hey, new gadgetry!

An assistant read the prescription from my current glasses and then crafted a new one. (I hadn't asked for a refraction, but I wasn't charged for it so that's fine.) She now has a gadget similar to the one at NeoVision; I stared into the thing at an image (this one was a house in a field) and watched its focus change as the machine auto-adjusted to my eye. I love that thing; it's much less frustrating (and I imagine more accurate) than 15 minutes of "which is better, A or B?" (while they change lenses too quickly for me to focus and evaluate). They still do that to refine the prescription, but I had to evaluate no more than half a dozen configurations (so I could feasibly get them to slow down).

All that said, my ophthalmologist said "I'm not an optician; if you have one you like you should go there". I don't have one I like, but I'll keep looking. But now I know that I'm likely to get a good prescription from her if I need to -- one at least as good as what NeoVision did, anyway.

The eye chart has also been updated. Who thought there was much they could do there? But the lighting was more uniform and I think the resolution was better. (It was a display, not a projected image.) The remote control suggested to me that it could be infinitely programmable (though I didn't ask), which is refreshing. (I fear memorization giving false positives.) For the first time that I can remember, the post-slash number for my weaker eye was a two-digit number (20/80). The stronger eye also produced a better reading than usual. I know there's a great deal of variation in how those numbers are generated and interpreted (20/20 is not the universal standard you would imagine), but I have to assume that the improvement is due to the tools and not to a change in my vision. (It could be the new glasses; I didn't think to bring the old ones along for comparison.)

A small thing, but she was also able to give me printed, rather than hand-written, prescriptions. I'll bet pharmacists wish more doctors would do that. :-) The down-side of the same underlying cause: there was no physical chart for me to browse while waiting for the doctor after the preliminaries. (Hey, it's data about me and funded by me (or at least on my behalf); I should be able to look at it, right?)

I have no idea what she charges my insurance company. (My deductible, of course, has not changed.) My out-of-pocket cost actually went down; while she's farther away (= more gas), I no longer have to pay $5 for parking (and it was nowhere near $5' worth of gas). So, a win on everything except time, and the time hit isn't that bad (Fox Chapel).

In the past I have recommended NeoVision to folks in Pittsburgh. Put that on hold for a while, ok?
( the adventure continues )

Grumble. This should not be this difficult!

Yesterday I picked up a new pair of glasses. There were obvious problems with bifocal placement, so I returned today to see what could be done. (The bifocal for my dominant eye was not centered left-right in my field of vision, among things.) They made some adjustments to the frames (so maybe my glasses are a little off-center now? can't tell).

That gave me enough to reveal the second-order problem: the bifocals are fuzzy at the old focal distance, and the new focal distance is too short. It was already short; reducing it from about 9" to 6" is Not Acceptable. This is most noticable with a computer monitor, but it applies to print too.

The ophthamologist (/optician) was there today (that's why they said I had to return today to deal with it), and he said the price of good distance vision is poorer close vision, or something like that, and really, I need to get a special pair of computer glasses. He started by saying that using a bifocal to read a computer screen is bad ergonomics anyway; I said I've been doing it for close to 30 years. He countered with "your eyes have changed in 30 years", and I responded that they haven't changed appreciably since yesterday, when this worked fine with my old glasses. He suggested that there's an adjustment period, which I was willing to grant, so I took the new glasses away again.

I don't think adjustment periods can fix focal distance, though. That is a problem. I think he's right that the distance vision on the new glasses is a little better than on the old ones, but he didn't warn me that the new prescription would impede the bifocal so. If that's a trade-off, it needs to be a customer-specified trade-off.

Why can't I have both? The bifocal is just a magnification layer on top of the base (distance) lens, but why can't we precisely control that layer? And if layering can't yield the results, is there any technological reason one can't make an actual compound lens, with part of the base lens sliced out and replaced?

I'll try the new glasses a while longer (I won't be using the computer on Shabbat, after all). Maybe I'll get lucky. But I suspect I'm going to be back in the optician's office on Monday.

Without blinking I would pay a four-digit number of dollars for user-adjustable glasses, even if I had to look like Geordie LaForge (though I'd rather not). That would give me both context-switching and adjustment over time. Depending on the specifications, I'd pay a lot more. Being able to see as well as possible is important. Is there anyone in this space of optics work who can deal with an end user (with an end-user's budget)?

Going back to the optician's "you're not young any more" comment, I asked why my coworkers my age and older don't all have two pairs of glasses, and he said my eyes are Hard in ways theirs probably aren't. (He also accused them of abusing their eyes.) His answer for me is separate pairs of glasses, but management there is an invasive hassle. I did have a pair of computer glasses once (when my employer was willing to pay for them); changing glasses every time I got up or sat down, and sometimes just while in my office but switching to speaking with a visitor or using the whiteboard, was a real hassle. And that was without the problem of carrying them around. (I didn't carry them between work and home.)

I got my last pair of glasses from NeoVision in Shadyside and was highly satisfied with the experience. It's time for a new pair (sort of), so a couple weeks ago I made an appointment with their office on the south side a block from work. (Appointment because this time, as last time, I was having them produce the prescription as well. I'm a big fan of one-stop care for this kind of thing, having in the past been caught between the glasses place and the doctor's office when the resulting glasses weren't right.)

The people at the new location today were really disorganized, and they didn't seem to grok customer care. The doctor (same guy as in the other location) is good, but the rest of my experience today was pretty poor, from the long wait before anyone even acknowledged my existence to losing my paperwork (and repeatedly failing to get my name right so they could retrieve it -- it's only six letters, for crying out loud) to pretty much abandoning me when it was time to actually choose frames. At each stage I thought I was five minutes away from success so I didn't walk out. I think they call this "being nibbled to death by ducks". :-)

Then I came home to find a letter from my ophthamologist's office. (Oh right, I thought; I owe them some money from my last visit. Must be that. Nope.) My doctor is leaving the practice. The practice is happy to offer their other fine doctors, they say; I've had personal experiences with two of them and judge them not-so-fine. So Monday morning I'll try to find out where my doctor is going. If I can't follow her, I don't feel particularly constrained by the current practice.

NeoVision's doctor is actually an ophthamologist (surprised me!), so on one hand he's a possibility. (I'd want to research him, of course.) I like him, which is a good start. However, it would mean dealing with his possibly-incompetent staff more than once every few years. Or I guess I could go to the Shadyside office; that could work. (Hours are limited.)

Funny, I expected to lose both my vet and my primary-care physician before I lost my ophthamologist. (VCA has trouble keeping good vets and the physician has got to be close to retirement by now.) I have hopes that I haven't really lost the ophthamologist; we'll see.

(Post by email. Let's see if the formatting works this time. If not, I'll fix it tonight.)

I saw my opthamologist again this morning. She noted a small problem and gave me some new eye drops (along with instructions to return in a week).

She said the drops are a mild steroid. Steroids are supposed to make you strong, right? But they're drops, not pills, so I don't think I get the usual benefits. I don't imagine that my eyeballs are going to be doing push-ups or lifting impressive weights or the like, so what effect do I get? I'm kind of hoping for X-ray vision, myself. :-)

I'm looking for an eyeglasses solution for bright sunny days. Currently I use clip-on sunglasses when driving and squint the rest of the time, but there's got to be a better way. Here are some parameters:

I don't carry a purse, briefcase, backpack, etc with me all the time, so carrying around an extra pair of glasses is challenging. That said, I'm willing to accept breakage in cheap plastic sunglasses stuffed into a back pocket (or on a belt, or something like that) as a recurring cost. (But not for prescription glasses; that's way too expensive.)

Clip-ons are kind of uncomfortable for routine use.

I'm interested in knowing about tint/polarization/??? options for a sole pair of glasses, if there are any that also work well indoors and at night. 20 or 30 years ago there was a fad called, I think, "photo-gray" -- lenses that automatically darkened or lightened based on light levels. Whatever happened to that approach? (My ideal, I-think-ficticious, pair of glasses involves a little knob for that. :-) )

What other options are there?

This book could have been written just for me. It explains basic grammatical concepts, first explaining how they work in English (a refresher for some, news for others) and then explains how the same concept works in biblical Hebrew -- well, from what I've seen so far. Score! Of course, some Hebrew concepts don't exist in English (or are very limited), but they seem to do a good job of explaining those too. (Haven't finished reading it yet.)

Comprehension definitely helps with learning torah portions. ( Read more... )

Does anyone reading this know how to export a Windows color scheme? Having developed one on one machine, is there a faster path than recreating it to get it onto a second machine? (Source is Win2k, target is XP.) Oh, and a raspberry to Microsoft, which both offers color schemes in its window manager and then selectively ignores them in one of its major applications (Outlook). (No, I don't use Outlook by choice.)

My niece came back from a semester in Italy asking questions about my (Italian) grandfather's citizenship status. Apparently if he got his US citizenship late enough, my niece thinks she can claim Italian citizenship. Sounds odd to me; I thought these things tended to go back, at most, to grandparents, and this would be her great-grandfather. But a quick look at Wikipedia confirms. Ok, the question is whether he became a US citizen before my father was born. Well, I presume that my niece is smart enough to figure out (with internet aid) how to get the relevant records, since no one in the immediate family seems to know.

Y'know, I never would have made a trip to a library for something I was merely curious about, and probably wouldn't have rememebered the curiosity the next time I was in a library anyway. (Dozens or hundreds more would have come and gone.) But less than a minute immediately spent with Google and Wikipedia got me a reasonably authoritative answer to, in this case, a question of Italian citizenship laws. I find this ability to satisfy my curiosity really handy. Currently I have to be sitting at my desk to do it, and many idle curiosities fall by the wayside because we were at the dinner table or out with friends or walking down the street or whatever. But someday that won't be a limitation; it already isn't for many people. Now, if we can just keep governments and ISPs from messing up the free and open network that makes all this possible. (Mind, this trick doesn't always work, or I wouldn't have asked the question about Windows color schemes. But it works often enough.)

Thanks to xiphias for pointing out this post about planned changes to the LJ profile page. Blech. How very...juvenile.

A while ago cahwyguy posted a cute link to the 3rd annual Nigerian email conference.

Last Thursday I started seeing "floaters" in one eye (the good one, natch). That can mean nothing (it happens as you age), or it can be an early sign of retinal damage. Friday morning I saw an opthamologist (not my usual one, but one who was available), and she said she didn't see any damage but she couldn't get a good look due to quirks of my eyes. She said to assume it's normal and call if things get worse. Sunday I started seeing cloudiness in that eye and called, and she said to come in the next day. So Monday I saw yet another opthamologist (again, luck of the draw), who gave what felt to me like a cursory exam and then said things are fine. He was rather dismissive and rude (it was clear he thought I was over-reacting), and I intend to complain to my own doctor about him. He attributed the cloudiness to some drops they'd given me on Friday, and said the effects can last five or six days (which they didn't tell me on Friday).

Yesterday I called my own doctor to discuss the continuing problem. She said the symptoms are consistent with a torn retina, and sent me to a retinal specialist, who I saw this morning. He performed a thorough exam, including taking pictures of my retinas with some high-tech gizmo where they tell you not to move your eyes for several minutes (easier said than done).

He found no tears, no bleeding, and no signs of fluid accumulating behind the retina (which would happen if there were a tear that he couldn't see for some reason). He believes that the vitreous fluid in that eye has detatched from the retina, which happens to everyone eventually but usually a lot later. While the retina detatching from whatever is behind it is very bad, the vitreous detatching from the retina is nothing special.

Ok, I said, but what about my impeded vision? He thinks the cloudiness is actually another floater (obviously a less-dense one), and that eventually floaters tend to settle to the bottom of the eye and/or your brain gets used to them and you stop noticing them. Either way, all I can do is wait. I see him again in six weeks. Meanwhile, he showed me how to test my peripheral vision; I'm to do that daily and call immediately if there's a change.

So the good news is that there's no obvious damage, but in a way, the bad news is that there's no obvious damage. If there were a small tear, that would give them something to fix. But on the other hand, I'm just as glad not to be facing eye surgery this week, as that always has the potential to end badly.

While annoying, the floaters don't affect my distance vision in any noticable way. However, they affect my close vision quite a bit. Reading is a challenge, particularly against white backgrounds (paper or online). Larger fonts help, as do reverse video and lowering the contrast. (A yellow background is better than a white one, for instance.) Alas, many web sites (including the company wiki, but maybe I can get that fixed) and software packages impose black text on white backgrounds with nothing you can do about it. I've already got monitor brightness cranked way down; I'm going to need to figure out what else I can do.

If the problem doesn't go away and it's deemed serious enough, there is something the specialist can do for me -- but it's risky. The vitreous fluid doesn't serve a function other than to be there (keeping the various bits of your eye away from each other, I gather). There is a surgical procedure where they can remove the gunked-up fluid and replace it with something artificial. There is, however, a risk that it can affect vision in the wrong direction. I don't know the specifics; it's early to be thinking about that. (It can also cause glaucoma, but I already have glaucoma so I don't know if I have to care.)

The doctor I saw today seemed to be very ept and personable. He answered the questions I thought to ask at the time, and used teacher's aids to explain what was going on (a model of the eye). He was recording a running commentary as he examined me, so he could send it to my own doctor, which meant I got to hear everything he thought important during the exam. (When the recorder was off he then translated med-speak for me without my having to ask.) So far, kudos to this doctor.

Another thing I learned today: those vision tests where you read letters off a chart on the wall? Put a great big "SWAG" around any results you get from that. Lighting in the room, brightness of the bulb in the projector, focus, and a bunch of other factors can affect your score -- and these all vary from one exam room to another. Bugger! Here I thought it meant something when I did, or didn't, get the same results on successive visits!

Oh, and some letters are harder than others -- a fact I have noted before -- and sometimes the person administering the test will fudge your score based on that. So if you got the "Q" (which looks an awful lot like an "O") that might count for more than correctly getting the "L" (which is pretty unambiguous). Or not. It depends on the technician, or maybe on the phase of the moon. This, at least, is something where any given practice could set policies; I'll have to ask about that.

(Why yes, I do read my chart while waiting for the doctor. I think this is perfectly appropriate.)

I saw my opthamologist for my regular checkup today and was surprised to learn that medicine's understanding of glaucoma has changed since it was last explained to me. I guess I think of glaucoma as an old, well-understood disease that doesn't change much.

For the first time ever, while my eyes were numb anyway they applied a second gadget. After the round of "heywaitaminute, tell me what you're doing before you do it", I learned that this gadget measures the thickness of the cornea. (The technician doing it didn't know the mechanism and I haven't gone looking yet. I wonder if it's sound-based; how else would you measure the thickness of something like that?) She noted that my corneas are thicker than normal but would not pronounce that good or bad.

My opthamologist pronounced it good. Well, not good in absolute terms, but it turns out that people with thicker corneas tend to measure higher for eye pressure, which is what the glaucoma test measures. So my pressure might not be as high as they think it is. Hey, I said, my pressure has always been borderline anyway; is high pressure the sole detector for this disease and do I really have it?

She said that contrary to what I was told when I got the diagnosis (and several times since), high pressure isn't the definition of glaucoma. That's just high pressure. Glaucoma is a condition of the optic nerve usually caused by high pressure, though there exist people who have low pressure and the optic-nerve condition (and people with high pressure without effects). I do have damage to my optic nerve, though she hasn't noted it getting worse (which is both good and expected).

I should have asked her to describe what the medicines I take do, just to satisfy my own curiosity. (And, well, my co-pays just went up again...) My impression is that one is about lowering the amount of ocular fluid produced and another is about venting it, and I'm not sure what the third is. Oh well; I can ask next time. She said that she is not going to change the treatment at this time based on the cornea thing because that's speculative, which sounds right to me. There's plenty of time to ask later if I'm actually taking the right mix of drugs; it sounds like, at worst, I'm taking something ineffective. I'd rather not waste money on something known to be useless, but when in doubt, my eyes are a heck of a lot more important than saving some money.

She also suggested that it may be time to get pictures of my optic nerves taken. I gather that the philosophy is similar to that of the mammogram: at a certain point you start looking and from there on you're looking for changes. She described the process for the eyes as "sort of like a CAT scan but without radiation", which doesn't tell me directly (I don't know from CAT scans) but I can apply Google. She said it can wait until summer, when I'm next due for a visual-field test, and they can do 'em together. Ok, whatever.

I'll be interested to compare notes with my father, from whom I inherited the glaucoma, to see what his doctor has been doing lately.

Tidbit picked up in passing: my opthamologist has been practicing for 13 years. I've been seeing her for about 8; I hadn't realized she was so new when I started going to her. When choosing a doctor there's an interesting trade-off between recency (more up-to-date education) and decades of experience (seen more "in the wild"); I'm pretty happy with her, though I got her semi-randomly so that's just luck.

On Windows XP (probably up to date), does anyone know of a way to make the mouse cursor bigger? I had to set the resolution on this laptop above my preferred 1024x768 because that resolution absolutely sucked on this display, and then tell Windows to use extra-large fonts and twiddle my applications. (Mozilla's minimum font size is now 20, to give you an idea of the magnitude of the problem.) But this means that everything graphical is still down at its "normal" size (per the resolution). I can live with not being able to see images well for a week; it's not like I'm doing much browsing or graphics manipulation, after all. But the mouse cursor is also a graphic image, and that I care about.

I've already found the accessibility option for "tell me where the cursor is on demand" (it animates), but if I could make the mouse cursor itself bigger, or bright red (inverse-video would be better but hard, I imagine), or something, that'd be really helpful.

With the way technology is advancing, I'm guessing I'll never be able to reasonably buy a laptop of my own because of stuff like this. When a resolution I can actually see is considered non-native because it's "too low", I'm in trouble. (Yes I did try 800x600 too. No dice; it looked as bad as 1024x768. And there's nothing between the two..)

Update: Problem solved. Thanks everyone!

This is mostly for my own notes, but I welcome feedback. I just suspect that most people won't care. :-)

I have a new LCD monitor at work (yay!). Every monitor is a little different, so I am once again playing with settings. This monitor offers a great variety of things I can twiddle, and I don't fully understand the impact of some of them. So right now I'm tinkering, but I would welcome suggestions from those with clues here about combinations of settings that would be suitable (specific goals below). For example, I haven't been able to characterize the color impact of brightness and contrast, but there seems to be some. Some of you gave me a bunch of advice when I was experimenting with this a year or so ago, so no need to repeat anything there. (The main thing I take from the prior discussion is that color temperature is probably where the action is.)

I can set: brightness, contrast, color temperature (individual RGB values), gamma (3 pre-defined and unnamed modes), and three independent mysterious numeric parameters under an "image" menu (course, fine, sharpness). (I couldn't see any obvious impact from changing these.) There are also three pre-set color combinations (white point??), called cool (blue), normal, and warm (red); I've bypassed those for the "custom" option (RGB values). "Cool" is definitely too blue and warm seems awfully red.

My current settings are:
Brightness 30
Contrast 90
Gamma: "mode 3" (the one I parse as darkest)
R: 70
G: 70
B: 60

My main goal is to keep the bright white pixels from screaming at me quite so much as they currently do (specifically: black text on white background is harsh; it wasn't so great on the CRT monitor either), while maintaining sufficient contrast and getting colors that are as close to normal as I can achieve. It appears that the absolute RBB values, and not just the ratios among them, matter for overall brightness; I'm not sure yet how that interacts with the brightness control.

I'll try replicating the settings I use at home (also an LCD monitor) at work, but won't be back in the office to try until Tuesday.

I'd been meaning to order new glasses for a while, but did not want to get caught in another dispute between the doctor who wrote the prescription and the optical shop that made them (like last time). So I'd been looking for a place that provides both services so I could surround any mistakes with a someone-else's-problem field. Dani had a good experience at NeoVision in Shadyside, so I went there.

The exam started off with a fascinating gadget (that, alas, I did not get the name of). One eye at a time, they told me to stare into the gadget and not blink. I watched a grapheme (not text) blur into and out of focus before "snapping" into focus -- without any communication from me. That was neat! It got the right eye just fine (which is usually the one that's hard to get a reading on), but did not "snap" to focus on the left (unusual). I reported that fact and they said that's ok; they'll tune things during the exam.

Their optician then did a fairly conventional refraction, except for two things: (1) when I told him I needed more time to focus before being able to answer "is that better?" he listened and slowed down, and (2) instead of the wacky frames into which they fit physical lenses, he had a device where he just twiddled knobs or something, with the result that the transitions were smoother. (I had not previously seen such a gadget.) Within some parameters that I don't know, adjustable glasses are clearly feasible.

The final version he came up with allowed me to read text on the wall chart that I had not been able to read with the glasses I walked in with. So that's a good sign. I told him I was most concerned with the bifocal, for both reading and computer use, and he inserted something to show me what that would look like. (For reading, anyway -- no handy computer, and they are different in feel.) Bifocals are just an add-on; there's no tuning involved. So there's not a lot of flexibility there. If I ever decide to try again with the all-bifocal-all-the-time glasses (exclusively for computer use), we could presumably fine-tune it.

Of course, the danger of all of these things is judging on a few seconds' worth of exposure; the real evaluation requires longer. (That's part of why I want those adjustable glasses!)

Their guy is an opthamologist, so he started to do a glaucoma test. I wasn't expecting that but the insurance covered it, so I let him do it. Unbeknownst to me, that insurance would bite the dust two days later. Let's hear it for lucky timing. (The new corporate overlords do have vision coverage, though it's a bit weaker. More imporantly, though, even though we've been assured that insurance will be back-dated to the beginning of the month and we're not uninsured, we haven't yet been able to actually sign up for insurance. I had a doctor's appointment scheduled for this week that I've had to move already; I hope they fix this before next month's dentist appointment!)

I picked up the glasses today. They are taking some time to adjust to, both distance- and close-vision, but the drive back to the office was perfectly fine (so distance seems promising) and I haven't ripped them off my face to return to the old ones yet. So we're already well ahead of the last time I got new glasses. Focusing on the computer screen is different but possible. Reading paper seems to be fine, though I haven't tried anything challenging yet like smaller newsprint.

So a provisional thumbs-up to NeoVision. I'm hoping that by the end of tomorrow these will feel perfectly normal. Right now, about 12 hours after putting them on, I still feel like I'm wearing someone else's prescription. (I have the impression that most people adjust more quickly than I do.)

Oh, I personally think the new glasses are a little aesthetically-challenged, but appearance is so far down on the list compared to functionality that I don't really care. I asked them to recommend a shape and size for the lenses.

Update Apr 12 morning: Distance vision in the left lens is a bit off; I can't read street signs as clearly as I could with the old glasses. The right lens is spot-on, though, and better than the old one, and bifocals seem to be better overall. I'm going to have them look at that left lens, though.

The interview meme is back. If you want me to ask you questions, post and say so (and then you answer them in your journal).

1. Your four favorite blogging topics are food, gaming, Judaism, and work. Does this represent a fair division of your life? Would you change the relative proportions, if you could? ( Read more... )

2. There are lots of similarities between being a technical documentation author and being a rabbi arguing over the mishnah. Do you like this analogy? How does it make you feel? ( Read more... )

3. You get the chance to make a major manufacturer or producer of goods and services introduce one new thing that you really want. It has to be currently physically possible (i.e. no teleport booths, no fusion reactors) and it will be priced realistically. What do you want? ( Read more... )

4. What's the biggest threat to your continued happiness? ( Read more... )

5. How many fences around fences do you feel comfortable drawing? As a Reform Jew, you have a duty to interpret for yourself. For example, we separate milk and meat because we are commanded not to boil a kid in it's mother's milk. The first fence is extending that to not cooking any meat in any milk. The second fence is to prohibit eating meat and milk at the same meal. The third fence extends this to not eating chicken (considered meat) with cheese even though chickens are in no way mammals, chicken eggs can be eaten with cheese, and fish can be eaten with cheese. Feel free to go with other rules, if you'd like. ( Read more... )

Monica

new glasses, take 2

new glasses, take 1

ordered new glasses

a first

interviewed by hlinspjalda

Blogger captchas

new monitor

20/what?

random bits

eye tests

interviewed by steven

ophthalmologist: new practice

glasses again

new glasses

not a good eye-care day

eye check-up

dear LJ brain trust (glasses)

random bits

whew, I guess

learned from my eye doctor

eye exam

random accessibility question

new monitor

glasses

interviewed by dsrtao

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