20/20 Vision

What Does 20/20 Mean, Really?

Everyone knows the phrase "20/20". There is even an expression "20/20 hindsight" which is often used to describe how things went off the rails and what should have been done in the first place. Most people only know these 20/20 numbers as a way of describing an ideal situation of how they would like to see without glasses or contacts. Your eye doctor is not actually trying to talk in code, but it is easily confusing. So, as a practicing eye surgeon who specializes in vision correction, I thought it might be helpful to provide some inside info on how to decode these numbers.

20/20 simply means that at 20 feet the patient would be able to read something that a "normal person" could read at 20 feet. Yes, I know that sounds circular, but it sets the stage for "normal." 20/200 means that a person with 20/200 vision would have to move up to 20 feet away from something that a person with normal 20/20 vision could see from 200 feet away. These numbers say nothing about your field of vision, and people with tunnel vision who can only see a small area directly in front of them could easily have 20/20 vision and be unable to drive because it feels as if they are looking through a narrow rolled up piece of paper, allowing them to only see a small part of the world around them. One of the tests eye doctors do to determine whether you can legally drive a car is to check your peripheral vision as well, and that is how patients with 20/20 can be denied a driver's license. You can also have 20/20 vision but see double images or have other poor quality “low definition” vision. “20/20” is not so simple and certainly is NOT the only measure or desirable outcome for you.


Here is a key point: Eye doctors view the way patients see in a way that is very different from the way most people think about their sight. Basically, if you need glasses or contacts to see well enough to drive a car, read, and perform activities of daily life, most eye doctors consider that an inconvenience. I certainly agree, which is why I had laser vision correction in 1995 to reduce my need for glasses. And it’s why I performed LASIK on my wife who refused to go to anyone else.


Needing glasses to see clearly is annoying for most people, and most people can have their vision without glasses improved by laser or other means. Eye doctors, however, are generally much more troubled by and concerned about people who, even with glasses or contact lenses, cannot see well. This is not an inconvenience; this is a disability. I know you have friends who have said "I'm legally blind without my glasses," and that, for those people, is certainly annoying. Now imagine people who are legally blind with glasses or contacts. They live in an entirely different world. The good news is that often eye surgeons can improve vision such as in diseases like keratoconus, cataracts, and other significant eye problems.


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