The world of suppressed fetishes, obsessions, fantasies, neurois and idiosyncrasies - occupying the secret thoughts of untold thousands – has in recent years surfaced on the internet as the afflicted discover they are not alone with their desires. 

The internet has provided a method of interaction among those with similar passions. Many have tried counseling to address what they had considered an unusual or even abnormal problem, achieving little, if any, relief. I am speaking of a desire in which some find a rare, at times arousing, pleasure in what others do not, and have therefore assumed they were abnormal. They suppress their “secret” from even their closest friends and family in fear of being deemed eccentric.The advent of the internet has opened up a whole new world, freeing the obsessed from oppression. Those with similar desires throughout the world have formed a network with others who share the same affliction. Although psychiatry dubs these “abnormal” interests as fetishes, many have discovered their obsession to be quite common. The anonymity provided within the internet has freed those afflicted to discuss and even pursue their interests within their new found community. They have created their own websites and discussion groups to satisfy their long suppressed monomania.There are groups for men who simply enjoy seeing women in glasses, just as other men prefer certain hair color, and women of a variety of body types. Many of these men actually prefer women wearing high minus, or high plus prescriptions.

Then there are those who actually would prefer to wear strong glasses and resort to wearing glasses over contacts (GOC). In fact, the desire is sometimes overwhelming.

Bobby in the Czech Republic writes, “The temptation to try wearing the glasses over contacts was so strong that I could not resist it any more and tried to go full time [sic]”.He ordered a pair of -20D blended myodiscs to wear over high plus contacts. He was so pleased with his new glasses that he wrote, “After I had left the shop I took a walk in the streets. There was a florist shop, just 300 meters far. I bought a rose and walked back to the optic shop. When I came in the door rang and the owner came out of the lab. I handed her the rose and said, “Thank you very much and this is for you.”The optician opened her eyes wide and said, “Oh, how come?”“Mrs K, you do not know how important this thing is you have done for me,” Bobby replied.You can read his entire story and many others on his site following the link listed at the end of this article, along with others that may be of interest.

You have patients like Bobby, who perhaps not desiring (or at least admitting to) a need to wear strong lenses, but just the desire to wear glasses. Most of us have had emmetropes request glasses made with plano lenses to complete their desired image, or to please a spouse. This is not new to anyone in the optical profession, however, there is reluctance among some professionals to prescribe or even provide eyewear to those they determine are not in need of correction. Perhaps that patient who feigns headaches or insists they need glasses is actually being honest. Though the need may not be physiological, it most certainly could be psychological and you would do them a disservice to ignore it.

Why or how do some people acquire this obsession? One can only conclude that there is no single answer. The afflicted can often pinpoint the exact moment when they became a devotee or admirer of eyeglasses or any number of disabilities; others tend to think it is congenital. Generally, the interest began at an impressionable age when the afflicted observed someone who made a big impression. Others will hold their parents culpable for various reasons. It is not unusual to find the youngest child in a family of myopes insisting that they need also need glasses.

It seems possible that at some point a chemical reaction occurred in the person's brain that released endorphins, or something called endogenous opioids, imprinting a pleasure response to whatever stimulus was observed. This imprinting is apparently permanent. When it involves something innocent like glasses or an admiration for people having certain disabilities, the obsession, though atypical, is harmless. It is only when the imprinting is the result of drug use, pornography, or illegal activity that it becomes harmful.

Schools that train students to work with the differently-abled often require students to simulate having the disability as closely as possible so that they may better empathize with their patients/clients. With this in mind, it could be beneficial for EyeCare professionals to use the GOC technique as a means of experiencing the world as our patients do. It could also be means to evaluate the optical, as well as the cosmetic benefits of using various indices of refraction and lens designs; e.g. evaluate image difference wearing –10 D CR39, poly, and 1.7 index. Do the same to evaluate various aspheric plus lenses. Part of this experience should include wearing the glasses as your patients would as they become misaligned.BIID is an acronym for Body Integrity Identity Disorder which has recently been coined to refer to those who do not feel their body is as it should be. Individuals with the disorder have the persistent desire to have their body physically match the idealized image they have of themselves. Although the term was specifically attributed to those who desire an amputation to paradoxically become whole, it is not unlike the need others may have to wear not just glasses, but glasses with inordinately thick lenses. Though the lenses may appear unflattering to the observer, they may be a godsend to the wearer.

A member of one group, using the online name “hyperope” wrote, “I am also a vision-impaired ex-wannabe, who ‘crossed the bridge’ last year and had eye surgery in India to remove the lenses from my eyes. (Essentially cataract surgery w/o the BIID cataracts.) I thought for decades about this - agonized over the decision – until I felt absolutely sure about it. I have never been happier about my eyesight. I can still see OK with very thick glasses, but my vision is limited.”Still others have a tendency to either cross their eyes and order glasses with 10 to 20 diopters of BO prism, or are admirers of women with severe strabismus.Some of you may have encountered patients who rejected the option to have small, thin, high index lenses in favor of purchasing a large frame for their high minus CR-39 lenses. Although you may feel you are doing them a disservice by complying, you may, like Bobby’s optician, find yourself on the receiving end of a rose.