Joel Hunter, MD Refractive Surgeon, Hunter Vision Updated 11/24/20 12:48 PM
20/20 visual acuity has become the gold standard in defining “good” vision. It’s something that most of us desire, especially as we age. For those seeking to undergo a vision correction procedure such as LASIK, 20/20 can be most likely achieved so they can finally get rid of their eyeglasses once and for all.
But have you heard of 20/15 visual acuity?
It’s definitely something that has been under the radar since optometrists and ophthalmologists have considered 20/20 as the standard for so long. Heck, if you get your eyes examined in England, don’t be alarmed if your eye doctor tells you that 6/6 is possible with vision correction procedure. Our British friends use meters to measure visual acuity, which, by technical definition, is equivalent to 20/20 in the United States.
My goal in this article to present a thorough explanation of 20/15 vision and why it deserves to be famous, too.
How visual acuity is measured
For you to understand what 20/15 vision is, it’s important to know first what visual acuity is an how it is measured.
Visual acuity refers to a vision’s clarity and sharpness. Nearly all of us have undergone an eye test, I’m sure. And staring at the Snellen chart, for instance, is a first step in finding out how well you can read those bold letters on the wall down to the seemingly incomprehensible figures at the bottom of the chart. If not the Snellen chart, your eye doctor may have asked you to read the “tumbling E” chart where the capital “E” is displayed in rotating angles, or the Jaeger eye chart (the one with blocks of text that get smaller and smaller in font size).
Going back to the Snellen chart, it was developed by Dr. Herman Snellen of the Netherlands in 1862 to help patients identify the clarity of their vision at a distance. The earlier versions used abstract symbols until he finally decided to settle for letters with the big “E” on top of the rows. Ideally, the chart is placed 20 feet away from you to find out if you can read the letters aloud per row with your one eye covered. But not all eye clinics have 20-foot long rooms though (doctors have to think about saving on rent too, you know) so they use mirrors to simulate the distance.
As you read from the top row down to the bottom, you’ll be asked to stop if you can’t identify nearly 50 percent of the letters on a line. Then the process is repeated to test the other eye. So, if you can read the extra large “E” at the top, this means that you can recognize objects from 20 feet away that you should be able to see from 200 feet away and that your vision is 20/200.
Further down the chart, the letters get smaller and smaller until you reach the bottom where your vision is measured as 20/20. As I’ve mentioned above, this is a standard set and agreed upon by eye doctors to indicate that a patient can see objects clearly at a 20-foot distance. So if you have a 20/80 vision, this means you must be 20 feet away from an object compared to person who can normally see it 80 feet away. At this level, you’re able to comfortably read the newspaper’s headline but would find it hard to get through the rest of the text without your eyeglasses or contact lenses.
Here’s the catch though: having a 20/20 vision only refers to the clarity or sharpness of your vision given a specific distance. There are still other factors that may affect your vision such as depth perception, color vision, focus, side vision (what you can see on your periphery) and even eye coordination. Still, the Snellen chart makes a good tool for measuring eyesight and determining your visual acuity; that’s why it’s still being used to this day. In fact, researchers from Johns Hopkins University School of Medicine found out that most American ophthalmologists cannot comprehend non-Snellen vision formats easily. That’s why visual acuity reporting should have their Snellen equivalent as this is convention already.
So if you have a 20/20 vision, congratulations on passing one requirement to becoming a fighter pilot. But as I continue to emphasize in my posts, only a few people have naturally good vision. We may experience nearsightedness (myopia), farsightedness (hyperopia), or astigmatism at some point. If your visual system does not fully develop during childhood (amblyopia) or your eye lens loses its elasticity during middle age (presbyopia), you will also suffer from poor vision. The American Optometric Association also adds other factors such as retina-related disorders (such as macular degeneration), cataracts, and glaucoma.
So if you feel bad for not having 20/20 vision, relax. It’s completely normal to have an imperfect visual acuity since 20/20 vision is very rare, especially for those not getting any younger. In fact, it is estimated by the World Health Organization (WHO) that 1.3 billion people worldwide have some form of vision impairment.
What is 20/15 vision?
According to the American Academy of Ophthalmology, having 20/15 vision gives someone sharper-than-average vision. That’s because being able to see something so clearly at 20 feet that someone with normal vision can see at 15 feet away isn’t common at all. That’s five more feet of clear and razor-sharp visual acuity!
Medical researchers from the National Institutes of Health found out that only 35 percent of adults have 20/20 vision without using glasses or contact lenses or resorting to eye surgery. While no report about 20/15 vision was included in the study, one can only imagine the very, very few people who have such quality.
Is 20/15 vision better than 20/20?
Having 20/15 or 20/20 vision puts one in the same range of visual acuity. The International Council of Ophthalmology’s standards, for instance, categorizes those with 20/12, 20/16, 20/20 or 20/25 vision into the Normal Vision range. Those with 20/32 to 20/63 vision, however, fall into the Mild Visual Impairment range.
On the other hand, the WHO defines normal vision if one has a vision equal to or better than 20/40 (or 6/12 using 6 meter notation adopted by the organization).
In other words, having 20/15 vision means you have more exceptional visual acuity than someone with 20/20 vision. But such measurement only reflects a basis of comparison for vision clarity and sharpness that eye doctors can use so that a treatment procedure can be prescribed.
In addition, 20/20 vision does not also mean perfect vision. You may be able to see something so clearly 20 feet away but may be having difficulty focusing on it up close. As I stated earlier, other factors can contribute to having vision that would make others jealous of one’s ability to see in ultra-high definition regardless if an object is near or far.
What factors cause 20/15 vision to change?
Visual acuity decreases as we age. So if you have 20/15 or 20/20 vision, at some point you’ll be experiencing visual acuity changes. You may need more light when reading, be more sensitive to glare, experience dry eyes, squint more often when in front of the computer, or find it difficult to differentiate colors. As you reach your 60s, the risk of having advanced presbyopia increases along with the presence of floaters. More so, women at their menopausal stage are more likely to experience dry eyes.
Other age-related changes that you may experience include smaller pupil size, absence of peripheral vision, macular degeneration and glaucoma.
How do I get 20/15 vision then? Is it possible?
While rare, achieving 20/15 vision is still possible. Getting your eyes to achieve this vision may be possible (but not 100 percent guaranteed) with the use of eyeglasses or contact lenses (although your eye doctor may stick to setting 20/20 as a goal instead). However, an immediate solution would be corrective surgery. With this, there are some options available today.
New forms of eye treatment technology can produce results close to 20/15 vision as claimed by a medical practitioner in this interview conducted by the American Academy of Ophthalmology. Light adjustable lenses and other advanced intra-ocular lenses used to treat cataracts are used to help patients achieve 20/15 vision.
But a more popular procedure is LASIK. Take note that most LASIK treatments’ goal is to restore a patient’s vision to 20/20 so you’ll seldom hear about setting a 20/15 goal. If you’re a good candidate for this treatment, you should set a realistic expectation when you’re planning to restore your vision to normal levels. In my earlier post, I’ve mentioned that the results you’ll achieve will be different from others. I often tell my patients before undergoing LASIK that they should anticipate to see as well as their eyes can see, but not better than that. They should also be able to get rid of their eyeglasses or contact lenses.
But there are patients who have better than 20/20 vision and still would want to improve it. In such case, I’d opt to advise them against having LASIK for the reason that they’re placing unrealistic expectations on the results of the procedure. There’s only so much that your eyes can achieve even with corrective surgery.
And then there are alternatives besides LASIK. PRK, ICL, RLE, and refractive cataract surgery are some of the procedures that I recommend to patients based on the case they have.
The point here is that LASIK should be performed to correct vision up to a realistic level to keep a patient satisfied. For many of my patients, 20/15 is very realistic. And, on average, better than 20/20 is the most likely outcome.
How much is a LASIK procedure?
If you’re keen on getting your vision to normal level, you’d be asking the same question that almost all of my patients tell me: Can I afford LASIK?
But the question as to how much LASIK is won’t get you to the answer that you really need. Rather, it’s important to consider this: will the benefits of LASIK be something that is worthwhile in the long-term? Most people who get LASIK regret not doing it earlier, as I wrote in my earlier post.
Yes, LASIK can be expensive but that doesn’t mean that it’s not a wise personal investment. I do understand that paying out-of-pocket is something that most patients are not ready to do.
The good news is that eye surgery cost in Orlando, Florida is now more affordable with a payment plan tailored to your tight budget.
At Hunter Vision, we fully understand the value of taking care of your eyes with or without the expensive procedures. You get expert care from one of Florida's best eye doctors BUT without asking you to dig a hole in your pocket through our payment plan.
Your eyes are too important to try to save a few dollars. Go somewhere that charges enough for you to be comfortable throughout the process.
We see far too many patients who tried to save a few dollars elsewhere end up here to see if we can fix what the other guys did. Most of our patients pay a bit over $130 per month at 0% interest for 24 months to change their whole world. I’d love to see you here, but I care way more that the place you choose is giving you all you deserve.
Our affordable payment plans for vision correction surgeries including LASIK can fit your tight budget. That's why we offer payment plans for as low as $130 per month - yes, that's not a typo - so you can start and end your day without your eyeglasses.
Author: Joel Hunter, MD is an Ophthalmologist, Refractive Surgeon, and the Founder of Hunter Vision, a LASIK Clinic in Orlando, Florida.
A recognized and respected specialist in vision correction who has performed a countless number of refractive surgeries, Joel gives lectures across the country and trains fellow doctors in the newest LASIK surgery techniques.