Perception is Reality

I think I have determined that some long-time myopes (most?) just assume that their Rx is "worse" every single year. I think they also assume that they can always see a *little* better (smidge, hair, scosh, etc) with just a *little* more Rx. FREQUENTLY myopes will come in complaining that their vision is just not as clear as it used to be...and once we examine them we come up with the EXACT same Rx. So why are they perceiving themselves to be blurry if they're already wearing the correct Rx? I have a few ideas:

1) conditioning: they're just SO used to the O.D. telling them their vision has declined EVERY single year, that they expect it to decline, and if they ever see anything not-as-clearly as they think they should, they attribute that sensation to declining vision

2) retinal anatomy: some people are nearsighted b/c of "axial" myopia, or an enlarged eye. This frequently leads to a stretched retina and subsequent spacing of retinal receptors. If retinal receptors (cones, rods, etc) are not densely packed, the "resolution" goes down. Even in the exact correct Rx, these people don't have the potential to see as well as people with normally-spaced retinal receptors

3) corneal anatomy: some myopes are nearsighted b/c of "refractive" myopia, or a cornea that is to "steep" or pointy. such a cornea can induce distortion that is not conducive to having excellent acuity

4) chronic contact lens wear: heavy contact lens wear frequently causes corneal distortion and morphological changes. These are usually not too dangerous, but again are sometimes not conducive to achieving awesome vision


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