Before the development of high index lenses, both long and short sighted people with high prescriptions had to live with thick and heavy lenses.
Very long sighted people needed spectacle lenses which altered the eye's appearance, magnifying it and making it seem bulbous, whilst very short sighted people required lenses with such thick edges that the size of the eye appeared to be reduced.
High prescription lenses can be fitted into small spectacle frames to keep their weight to a minimum. However, high index lenses have become increasingly popular as they are a thinner, flatter and lighter alternative and they will not distort the appearance of the eye. The higher the prescription, the greater the impact high lenses can have on the appearance.