I have been going through some of my favorite pieces of research for a friend, and an interesting book project. While I’ve been discouraged to talk about that, I’d like to bring you some of the choices pieces here, to the blog. It’s hard to choose since so many of them are equally compelling and disturbing.
So in no particular order, take a look at this (titled “Vision Therapy to Reduce Abnormal Nearwork Induced Transient Myopia”; by Ciuffreda, Kenneth J. OD, PhD, FAAO, and Ordonez, Xavier OD. Published by the American Academy of Optometry):
After brief periods of nearwork, some younger patients complain of transient distance blur that is correlated with a transient pseudomyopic shift in their distance refraction. This phenomenon has recently been documented objectively. However, there is lack of objective documentation demonstrating the effects of conventional optometric vision therapy in symptomatic individuals manifesting this “abnormal nearwork-induced transient myopia” (ANITM). Five symptomatic subjects received 7 to 10 weeks (5 to 6 sessions) of accommodative facility vision therapy (i.e., lens flippers and Hart chart). Objective recording of their ANITM and its decay were taken before and after the vision therapy, using a Canon R-1 autorefractor. A daily log was maintained, describing qualitatively their nearworkrelated symptomatology. After therapy, there was marked reduction of symptoms and considerable improvement in clinical accommodative facility measures, as well as improvement in the objective findings. These results demonstrate multi-faceted positive effects of optometric accommodative vision therapy in this diagnostic group of symptomatic individuals.
If you come here often, you may be thoroughly bored by the very proverbial very dead beaten horse.
That study was published a decade and a half ago (!). It was published in the Journal of Optometry and Vision Science, which should be firmly on the list of subscriptions of your vision health professional. Things get hardly more mainstream vision science than the American Academy of Optometry. Tl;dr though, all of it, to most ophthalmologists (I’m a bit proud of my well timed knowledge and application of Internet slang). And here, not only do we already know what NITM is, we also know that the participants eyesight improved significantly, measured objectively, using vision therapy.
I do get a lot of e-mails, asking me if this site is for real, if eyes can be rehabilitated, and why in the world nobody knows about this.
People do know. Everybody who is involved in the science of myopia, knows. Your optic shop, entirely not to be confused with vision science, is staffed by lens salesmen in lab coats. What you may want to try, is this: Go to a car dealer specializing in selling large trucks and high performance luxury cars. Get one of the sales staff, and ask him/her about the merits of electric cars.
Take that advice at face value. Electric cars, as you’ll be told, are entirely useless. And of course, so is vision therapy.
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
Here is a testament of how much persistence pays off: Since we last looked at Sara’s progress, she has cut her earlier close-up prescription strength in half (!), and is now again ready to reduce it further. From a -3.00 for close-up, she is looking at -1.25 / -1.00 now. Amazing progress, which we are going to look at here in a bit of detail.
It’s important to look at experience like Sara’s, to put in perspective this particular method of treating eyesight …
Back in the days when I worked with clients at my office directly, most stories were more or less the same. Anybody who could come to me, was serious about reducing myopia (considering the high cost of the service at the time). Almost everybody who started, continued on, and experienced significant improvement.
Basically, if you’d come to my office, it was a safe bet that you’d have good eyesight before long.
Fast forward to today, where a retired Alex very tenuously runs this experiment of myopia rehabilitation over the Internet. Surprisingly enough we made it through the past several years and the many hiccups, going strong, and lots of positive experiences from online participants. I never thought it was possible, but here we are. Still, there now is a very wide range, from some (fortunately small minority) who report no improvements, to those who improve at unusually fast rates. Sara falls into the range that should be considered normal, where consistency and diligence pay off. Here is what she writes in the forum:
It’s been a while since I’ve posted about my progress, largely because I haven’t had much over the summer. But I think I’m finally starting to see improvement again.
Distance Vision
Since August 12, I’ve been wearing a -3.25 (OS) / -3.50 (OD) normalized prescription. When I first put them on, I had a blur at 20/50 but could clear to 20/25 with active focus. Since early Sept, I’ve been able to clear to 20/20 in the morning with mediocre lighting (took away the extra lamp) on my Snellen, though it is not a strong/dark 20/20.
Differential
In August, I was noticing that my -2.00 differential prescription was letting me see 75-81 cm clearly in the mornings, so I felt that it was time for a new differential. As my -1.50 pair were too weak at the time (40s from what I recall), I opted to purchase a -1.75 pair.
On August 25, I switched to the -1.75 differential prescription. I saw good improvement there through Sept, going from 64-68 cm in early Sept to 73 cm in the past week. So I decided to try the -1.50 again, and this past week I’ve been seeing 62-70 cm clearly with it, or averaging 64.6 with both eyes.
With both differential prescriptions, the right eye continues to lag behind the left. This past week while wearing the -1.50, the left was averaging 59 cm while the right was averaging only 52.2.
Morning Centimeter Values
These have been a point of frustration, but I think they are finally improving. In late June into early August, I was still getting occasional values of 34 cm (binocular), but mostly 35. Then starting in late August, my smallest readings started becoming 35, and I saw more values of 36, and even a 37 and a 38 the last couple days. The right eye isn’t improving as reliably as the left, though.
Next Steps
Here’s where I could use your feedback.
You said a while back that equalizing my distance glasses will help my right eye catch up, even if it challenges it for a while. I have a -3.00 pair waiting in my closet, and I tried them on this morning with these results:
Each eye separate – Can clear somewhere between 20/50 and 20/40 Eyes together – Can clear somewhere between 20/30 and 20/25
With my current prescription (-3.25/-3.50), I still do have focus pulling opportunities, like reading restaurant menus on walls, and text on karaoke screens, so I am concerned that moving down to -3.00 might be too challenging, but on the other hand, I am willing to give it a try since I have been able to get 20/20 in the mornings and it might help my right eye catch up.
So I am thinking I will change to the -3.00, even if I feel a bit more blind for a while. If it only makes things more strained, I may have to rethink the move, though.
I’ve also been thinking that it is better not to let the differential prescription get so strong in the future. 80 cm is a bit excessive for my near needs, and is perhaps impeding my progress in terms of uncorrected cm values.
I’m going to order some new differential glasses (-1.25 and -1.00), so that I will be ready when the -1.50 gets me too much distance. (Some mornings, it already gives me 70 cm.)
Note how sometimes you may not have apparent improvements for a while. I talk about this in the blog, improvements are not a linear process. You will have periods of creating a lot of stimulus, and eventually your body responds to that persistent challenge.
Sara posted previously on several occasions, and we even looked at some of her progress here in the blog. This is what you want to emulate. The logs, the consistent effort to keep prescriptions at a good blur horizon, and persistent good habits. You will improve if you approach rehab like Sara. And while there are no guarantees with biology, this is as close to certain as we will get.
It also helps greatly when you post your experience. I get a lot of e-mails from people who choose to investigate rehab based on stories like Sara’s. There are more of them here, if you need some encouragement.
I get a lot of e-mails from readers asking about high myopia and the possibility to reverse it. As I always tell them, high myopia is (in practice) no different from low myopia. You’re just starting out a bit further away from full recovery to 20/20. Of course there are some differences in physiology (potential axial myopia), but none of that matters for how you approach your improvement goals.
People often struggle to believe me. Can it really be so simple?
Don’t overthink it, I have said many thousands of times, in the office. If you spend mental energy and time on myopia rehab, spend it on building habits. Get those habits, and then see the results first hand – that is simply the best way to spend your time on this topic.
Being ~7 months in myself, I can say that I am noticing definite improvement already. Being on the higher-end of myopia here (Originally OS -7.50, OD -6), it will take me a while to reach my ultimate goal. However, setting smaller goals is really keeping me going. Things such as being able to make out some of the keys on the keyboard at work and walk around at night without glasses and not stumble into things, etc.
I feel much more comfortable wearing my normalized than I ever did wearing my full script. My astigmatism has reduced significantly already according to my latest Optometrist visit. OS from 1cyl to .5cyl and OD from 1.25cyl to .5cyl. On the Sph side of things, I’m down about .5 to .75 diopters so far. CM measurements have gone from OS 14CM to 16CM+ and OD 16.5cm to 19CM+.
My first normalized are now my night driving glasses and my 2nd normalized I have been wearing since July are -6.25 OS, -5 OD. Seeing 20/25-ish with them now in good daylight with some clear flashes to 20/20 or better. From -7.50 to a -6.25 OS and -6 to -5 OD isn’t too shabby.
Cutting down significantly on the Contact lens usage has also reduced my headaches and let me perform more peripheral and focus pushing/pulling exercises throughout the day.
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Theoretical debates come up on the how and why of myopia rehab. They are valid and interesting. But they are also entirely irrelevant if your main goal is better eyesight.
Is it axial myopia that Steve is reducing? Or is it ciliary spasm? Is it overprescription, habituated, that’s being addressed? Is it just active focus, providing an edge over the previous passive eyesight? We could spend hundreds of pages debating.
Fact though is, Steve will be on this curve as long as he chooses to work on his eyesight. It can be any of the above at any particular point in his recovery, but that doesn’t mean he’ll stop improving at any point once another underlying issue is addressed by the same continual positive habits. Axial myopia isn’t a problem, as some in the opthalmology field suggest (without any scientific base for their argument). You will find me occasionally writing here about the theory and possible contributing causes, since it is interesting. Just be sure though to set your priorities, and if they are for improvement, allow the process to work for you.
Adopt the habits, measure your results, have Steve’s experience.
That’s my proposal for you, high myope, looking for better eyesight. Better vision, and the small victories along the way will be your reward (like not bumping into things at night, without glasses).
Enjoy!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
Following, a guest post by Jake Steiner, a brilliant practitioner of functional and holistic ophthalmology. Leave a comment if you would like more guest posts of this nature.
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Technology doesn’t necessarily make us any smarter.
Going to see ophthalmologists, when I travel to a new country, is a bit of a strange hobby of mine. It’s always fascinating to see how money (in a relative sense of wealth of the country), culture (self reliance vs. co-dependence), and the tentacles of Big Optometry™ affect the vision health state of the population.
Rich countries with lots of government healthcare funding tend to have the fanciest doctor’s offices.
It’s not unusual to see equipment that costs hundreds of thousands of dollars, used to make the exact same determinations that I might use a 20 cent tool for. The meaning derived from either, is usually exactly the same.
The level of professional arrogance usually is directly proportionate to the cost of the equipment in the respective office. Titles usually are also thick and many, on the practitioner’s business card, and the ostentatious name plate on his desk. Really, by the time you make it to the man’s desk, don’t you probably also know his name? But that’s not the point. It’s all about professional authority. You must be reminded of how little you matter, in the scheme of things. Bow before the throne.
This time travels took me to the United States of America. By all accounts, this is the capital of professional arrogance.
Mr. Long Titles explains axial myopia to me. Call me unethical, but I came to him under the guise of a clueless patient, looking for myopia advice. It’s a terrible way to find amusement, or perhaps just professional curiosity. What does Mr. Long Titles tell his thousands of clients, about their eyes?
The exam is lengthy and eye wateringly expensive. Somebody has to pay for all that fancy equipment, after all.
It turns out that I have axial myopia. Yes, though I can see 20/20 without glasses, the expensive equipment has determined that I didn’t pay for naught. There if fault in my vision, and I will need the help of this man’s connections to medical science. Ever smugly, he directs me to the gleaming and expensive autorefractor. I recognize the top of the line, most expensive model. Clearly somebody is doing rather well.
Here Is An Interesting Secret: You Can Induce Axial Myopia, For Yourself, In A Matter Of Hours.
Axial myopia, the elongation of the eyeball, is the specter of looming and permanent eyesight deficiency. It’s the monsters under your bed. Axial myopia, they say, once it sets in, is irreversible. You will forever be in the shackles of glasses, high index and with anti scratch, anti reflective, anti fingerprint coating, that’ll be 680 dollars.
Except that none of it is true. It doesn’t take years for axial myopia to happen. It’s not a genetic problem. It’s not irreversible. None of it is even remotely true.
Don’t try to tell Mr. Long Titles this, though. Not only will you be ejected from the office, you’ll also have to endure the wrath of a man who clearly knows more than all of actual current medical science. Try as you like, you won’t find undisputed studies that corroborate his explanations. Take this from me, a guy who woke up this morning with no axial myopia, and yet had a measurable (and true) axial elongation by later afternoon on the same day.
You too, might have axial myopia. And as Alex does say, it doesn’t matter one bit whether you do. Get rid of the strain, challenge your eyesight daily, and whether it’s muscle spasm or elongation, it’ll all go away.
Alex says, Jake. People won’t take your word for these things, on the Internet.
So let’s look at the same journals that Alex likes to quote (not nearly often enough). Bear in mind that these are the journals that Mr. Long Titles should be reading, while he’s on the toilet, or otherwise when the urge strikes to further his education. Though of course he doesn’t, like most of his peers. They are already infallible and all knowing, ever since med school gave them the holy blessing of their first official title.
Facts about Axial Change: IOVS
Investigative Opthalmology & Visual Science. That’s the title, ominously including the word “investigative”, of one of the most respected medical science journals in the field. Don’t worry though, the word “investigative” by default keeps out most practitioners you’re likely to meet. The secrets contained within the pages of IOVS are mostly safe from your eye doctor’s non-prying eyes.
Here is what IOVS publishes, an interesting (and not otherwise surprising) study about axial elongation:
“Transient Axial Length Change during the Accommodation Response in Young Adults”
That, just the title. Does it say, transient? As in, it’s temporary? Not possible, would huff Mr. Long Titles.
Let’s look at the article:
PURPOSE. To measure the degree of transient axial elongation during the accommodation response in emmetropic and myopic young adults. To evaluate the effect of refractive error and accommodative demand on transient axial elongation of the eye.
METHODS. Axial length of the right eye was measured in 30 emmetropes and 30 myopes, by using the IOLMaster (Carl Zeiss Meditec, Inc., Dublin, CA), while accommodative stimuli of 0, 2, 4 and 6 D were presented with a Badal optometer.
RESULTS. Axial length increased in both emmetropic and myopic subjects during short periods of accommodative stimulation. Greater transient increases in axial length were observed in myopic than in emmetropic subjects. The mean axial elongation with a 6-D stimulus to accommodation was 0.037 mm in emmetropes and 0.058 mm in myopes (P = 0.02). The degree of transient axial elongation correlated well with the stimulus to accommodation in emmetropes and myopes. Anterior chamber depth decreased, on average, by 0.19 mm in emmetropes and 0.18 mm in myopes when observing a 6-D stimulus to accommodation.
CONCLUSIONS. During relatively short periods of accommodative stimulation, axial length increases in both emmetropic and myopic young adults. At higher levels of accommodative stimulation, a significantly greater transient increase in axial length is observed in myopic subjects than in their emmetropic counterparts.
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I have to admit, I felt quite honored about Alex’ invitation to post in his excellent blog. I could have just gotten straight to quoting the article, rather than preening before you, for several paragraphs.
The article was published in 2005. A decade and a half has passed since that particular insight into the nature of axial elongation. Many articles have come before it, and since. Even the author, somewhat credible. Edward A. H. Mallen is with the Department of Optometry at the University of Bradford.
Edward used excellent equipment to empirically test axial elongation. He found that axial length increases in a rather short time, and that it is in fact transient. Anyone with the equipment can easily repeat the process and come to the same conclusions. It’s not likely to be done by Mr. Long Titles, since he (nor anyone like him) is going to look to disprove his own gospel.
And that’s how axial elongation is going to remain the mythical tale of the irreversible cause of your myopia. The mafia bosses of the world might look on with great envy, at the ruthlessly efficient strong arm tactics and great profits of the vision “health” industry.
We got a few comments on my inaugural contribution to Alex’ blog! Well done. Alex responded by sending me a login to the site, and carte blanche (for now at least, till he realizes the folly of that decision) on adding posts. If you enjoy it, do leave some comments to calm his conservative Austrian nerves a bit. ;-)
Just A Bit Of Background About Me:
I come from the evils of institutional finance. I’m a pretty selfish guy, all things told. I had the rather lucky fortune of getting out of that game at the peak, and then dedicating myself to travel and discovery. At some point I had become a bit obsessed with eyesight, since mine had been poor and getting worse in a scary way. Life isn’t so much fun when you can’t see well at all! It also became a great excuse to travel with a specific focus, seeking out practitioners from many cultural backgrounds and ideologies.
Over the years, I have literally been pocked in the face with needles (China, not surprisingly), experienced rather fascinating tribal style rituals (didn’t do so much for my eyesight, unfortunately), and spent an unholy amount of money on Western ophthalmologists.
The good news is that I do have 20/20 vision these days, at least in good lighting (still sometimes using -1.50 for wandering around strange locales at night). The other good news is that myopia isn’t considered to be unpreventable or incurable, in lots of places. Some of those places might not be your first choice for seeking eyesight improvement, being extreme in superstition as much as the West is obsessed about mixing the medical profession with profit motives (a bit of a questionable combination, that one).
In Alex style, the inspiration for this post comes from the comments:
Reading the forum, I have to say that Sara is one of the greatest writing contributors to the site. Somebody give this girl a guest post login!
Here is what I responded:
Which leads us to the title of this article, in fine timing with the current rumblings of trouble coming out of Russia.
What we get in the West, is consumer facing medical advice that is created by corporate interest. Universities receive funding from corporations. Studies are funded by corporate interests. Industry journals are funded by advertising. It’s not malice by intent, but money is a key aspect in how treatment is realized. The system couldn’t exist without the corporate sponsorship (since the government, which should fund these things, doesn’t). I come from exactly the financial end of all of this. Believe me, in the big picture contact lenses and glasses become revenue projections and dividend payment expectations, nothing more. Nobody cares about your eyesight, at least not anybody with the means to make a difference.
So what happens, when you get out of the West, and away from profit motivated medicine?
If you go to poor enough countries, you get all sorts of weirdness. In all honesty, I’d say that for 80-90% of pointless ritual and superstition, you get 10-20% of meaningful advice. It’s a mixture that in enough cases produces results, that people hang on to the whole story, even if most of it isn’t helpful. Compare that to profit ideals of the West, where here it might be the shaman holding on to his power over the community (maybe, if we are going to be jaded about it).
On the other hand, there is Europe and the eastern block, and Russia in particular. Interesting since there is a blend of Western drive for understanding (instead of mysticism elsewhere), but without the unchecked quest for maximizing profit. While I’m not a fan of communism, or likely to buy a vacation home in Russia, their perspective on myopia is rather insightful.
You find these guys who are highly educated, having been to medical schools that are nothing short of impressive. But there isn’t a 30 billion dollar market cap lens manufacturer whispering in their ears. There isn’t anybody telling them that the only truth is selling lenses and up-selling lens coatings, and up-up-selling fashion brand frames (unless you go to Moscow, I can’t vouch for that town even a little bit).
So, what do you get with meaningful education, and no profit motive?
You get actual insight. I’ve been to 26 optometrists and ophthalmologists in Russia, over the years. 19 of them recommended that I wear the lowest possible prescription, that I don’t read in dark rooms, that I don’t spend too much time in front of a computer, and that I get outside and use my distance vision.
Oddly familiar, all of that, if you read Alex’ blog, right?
Those 19 shops didn’t have a whole lot of fancy frames, and when I asked for high index and oleophobic coating, and Transitions VII photochromics (just because I have an odd sense of humor), they just looked at me like I’m out of my mind. It’s an interesting coincidence, really. You don’t have fancy stuff to sell, so you don’t sell fancy stuff. Customers don’t really have money, so they get advice on how to see just as well, without spending what they don’t have.
Myopia Increase Is A Capitalist Illness.
I’m for capitalism, for the most part, outside of this topic. Still, you go to Singapore and Hong Kong, and you see 90% of students being myopic. Think of that for a moment – that figure should boggle the mind! Then you go to Vietnam or Russia, and the figure is more like 20-30%. Same (or similar at least) study and close-up habits, but the former with money and the later without.
You take in enough of this, and you realize why Alex isn’t enjoying his retirement. It’s a health scam of the most epic of proportions, worldwide, without anybody at the wheel. It’s true, you can’t even blame anybody! Everybody is just a little cog in the big machine of salaries and profit.
I’m supposed to also be somewhat retired, not teaching about myopia recovery. Even for someone as selfish and jaded as me, that’s just hard to ignore. It all started with trying to unplug my family and friends from Zeiss and Bausch and Lomb and Acuvue and the rest of them. But then you make new friends, and they have friends, and before long you are basically spending all of your productive time trying to help people wrestle their eyes back from corporate ownership.
So here we are. You, a tiny minority fortunate to have found answers to myopia. Me, caught up in Alex’ vision of using the Web to raise awareness. Let’s spend a few minutes to give something back:
Please don’t be passive about consuming all of this information. Consider occasionally getting involved in discussions on health blogs, prod the awareness especially of prolific writers, offer them my help to improve their vision. If you follow a health blog, drop an e-mail to the author. Hint that they might consider their eyesight health. Whether or not they choose to talk about it, I’ll still gladly help them (free, no catch). Keep in mind that people don’t appreciate fervent beliefs or grand enthusiasm on fringe subjects (which sadly, this is). Just a matter-of-fact comment on the silliness of glasses might inspire some to look for answers.
You can also always reach me directly at:
Cheers!
Comments Are Open For This Post.
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
The most reliable, and ultimately decisive tool used at the optometrist, is a test lens kit and eye chart. Sure, there is the autorefractor and various other options but ultimately you always end up in front of test lenses, and an eye chart.
We talk about measurements a lot, here, and I offer a number of tools to measure myopia for yourself. These options are as good or better than what you get at the optic shop, for a number of reasons we frequently discuss here in the blog, as well as the full course.
Let’s clarify one thing, first. A test lens kit, is a test lens kit. At a nice optic shop office, you might see one of these:
While it looks imposing, it’s just an enclosure for test lenses. It makes measuring quick and convenient for a place that will see many customers every day. In principle and practice however, above contraption is exactly the same as one of these:
Instead of dials setting the lens in front of your eyes in the first version, this latter one has you inserting lenses, one by one, into the frame. It’s a bit more effort than turning a dial, but the way it works is exactly, 100% the same.
You don’t need a test lens kit. The links in the first paragraph take you to the centimeter calculator and printable diopter tape. Both of those work fine to give you an idea of your myopia degree. That and via the forum you can ask me what you want to get for prescriptions. It works well enough and is the most immediate and cheapest option.
However, if you really want to keep track and enjoy the process of analytically tracking results, you want a test lens kit.
You don’t need the expensive gear from the optic shop. You can buy a test lens kit, complete, for around 90 Euro (120 USD), from various online sources, like this one.
With that kit, you can emulate exactly the experience you would get at an optic shop.
It also helps answer the question of how much prescription for close-up and distance are exactly ideal for you, at any given time. And while the guess work is manageable the way we do things without the trial lenses, if you are serious about vision improvement, the investment may be worth it anyway.
How It Works
The lens kit includes lenses in 0.25 diopter increments. At the optic shop, they would use the autorefractor to get a baseline of how much prescription you might need. They will use those values to start out which lenses to dial in when you look at the eye chart.
Instead of the autorefractor, we use the printable diopter tape, or just any centimeter measuring tape and the online calculator. We use the diopter numbers you get from either of those, to pick the first test lenses.
You then simply insert the test lenses into the frame, put the whole contraptions on like a regular pair of glasses, and then look at your eye chart, affixed on an appropriate wall. Now, just as the optometrist would, you determine which lines of the chart you can see clearly. Not strong enough? Exchange the lenses for another 0.25 increase. Rinse, repeat.
Prescriptions are a simple question: How many diopters do you need to see the 20/20 line clearly?
And of course if you are working to improve your vision, you will want to figure your close-up prescription, which means using the test lenses to see if you get a good blur distance while using your computer or reading. As a starting point you might subtract 1.5 diopters from your distance prescription, and use the resulting values to load your test kit.
Once you have the kit in hand, it’s really very easy to do. It also adds to initial confidence when you have the whole set of tools available to measure for yourself, as well as track your progress with a full set of lenses.
Likewise you can also shop on eBay or any of the many other online outlets for sets that may most appeal to you. There are sometimes fantastic vintage sets available that are gorgeous collector items. There are high end German made options, and inexpensive Chinese alternatives. Around 100 USD / Euro will get you what you need, and beyond that you might indulge to your own preference.
Gorgeous. You might find one of these on Etsy.com if you are quite fortunate!
Enjoy!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
I keep being told, for years now, to reach out to other health oriented online resources. They say I need to mingle, make friends, exchange insights, introduce our respective audiences to our content. They say I need social media presence and make podcasts and video blogs and post cat pictures on Instagram.
As you probably already noticed, none of that is happening.
It is of course all well intentioned advice and I appreciate it as such. If I were to video blog, the reason that none of the above is happening, might be more apparent. I’m rather old and weary as it is, and this site is already far beyond my comfort zone and available time.
That said, eyesight improvement does need more exposure. If you enjoy this blog, if you maybe have enjoyed the course, you might feel generously inclined to help the cause (and I dread to ask, truly):
If you read other health sites, do consider dropping the author a line. Jake mentioned it in a previous post, and I’m willing to do the same: I will gladly help anyone with their eyesight, or discuss vision health, or potentially refer to other relevant and meaningful health topics here. I won’t insist on exposure or advertising or anything of the like. I’m glad to make new health topic contacts and friends, as much as I might not be the one to actively be reaching out.
If you would like to see this resource continue to exist, perhaps even grow and reach others currently stuck behind glasses, a quick e-mail to your other favorite sites may do just that. It would also lift my fall time spirits, as the Web does often feel like a whole lot of effort put into a whole lot of futility.
As always, thank you for all your support and kind e-mails,
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
This is an advanced topic, suitable for those who already did the full Vision Improvement Course and made it specifically to a consistent double vision experience.
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If your normalized prescription gets you to 20/30 or 20/40 on the Snellen, and you frequently work to the double vision distance up-close, you probably have more margin in your vision than you might be aware of. To see if that is the case, and to leverage that hidden diopter, here is a good activity set for you:
Your differential prescription (close-up) should be anywhere from 0.75 to 1.50 diopters lower than your normalized, for this to work best.
If you have a peak prescription already, it is also ideal of this activity (it makes sense for most participants who already had two reductions to get a peak prescription, which should also equal your next normalized prescription – questions about this, feel free to post in the forum).
Try this when you have a day off, weekend, or holiday. Pick a sunny, relaxing day. Avoid excess sugar and simple carb consumption (insulin spikes).
You want to be mixing close-up and distance vision, with a lot of outdoor exposure.
1. Start the day with some reading, no longer than 15-20 minutes, at a challenging double vision distance.
Of course after breakfast and whatever else you may want to do first – then get some good natural ambient light, and really get the most possible distance, well into double vision. This is a short “calibrating” activity, which will help prime your visual cortex for working on double vision at a distance (which you will want to do next).
2. After the short close-up time, go for a walk. You want to be a full diopter lower (ideally) from your regular normalized prescription.
You may have old glasses that would work for this (be careful to avoid prescriptions with more astigmatism correction than you use currently). Ideally you have a peak prescription, or in many cases the differential prescription will also do the trick (as long as you don’t have a lot of astigmatism correction still in your regular normalized).
Take a slow walk, ideally in a place where you get some text at varying distances. Shop signs, traffic signs, street signs, car license plates, etc. You can read these! Take your time, as you are well in double vision distance now. That blurry sign will resolve, if you give it a few extra moments. Stop, focus on it, blink with intent. When the sign clears, don’t blink again, use the clear focus to look around and appreciate the clear flash. It will persist in most cases until you blink again.
This is like running on the treadmill at the gym. Just as you won’t run all day, consider this a very active exercise. No need to overdo this. An hour is plenty of time, unless you are still significantly enjoying the experience after that much time.
Of course you don’t want to to be biking or driving for this. It is a slow, methodical, meditative focusing exercise.
3. Observe how well you can see distant signs, given some extra time. If you have been keeping track with your normalized prescription, you will notice that you can likely get the same clarity results with the diopter lower in correction.
Of course this doesn’t mean that you are magically one diopter lower. When you loose the light (overcast weather, setting sun, etc), the experience will fade. Likewise after any amount of close-up strain you likely won’t be able to replicate the experience.
This is strictly a clean, maximum capability exercise. It gives you a lot of stimulus and also helps build confidence as to where your vision is progressing to.
4. Take some close-up time.
Again here, you want to be well into double vision distance. You might notice that you are now able to see clearly (close-up) at a distance that you rarely experience otherwise. You will want good ambient lighting for this.
Spend an hour or two in that double vision distance with close-up. Avoid the temptation of moving closer. In most cases either a book or a computer screen are much better suited than a tablet or smartphone (the latter two you want to generally avoid more often than not).
Stay in that distance. Take as much time as you comfortably enjoy, creating stimulus for your eyes.
Once you notice your ability to resolve the double vision fading, consider stopping the close-up activity. Either just relax, interacting with others, or go for another walk and see if you still get good distance with the lower prescription.
5. Whenever your ability to work at the distance fades, don’t force it. Consider the activity completed successfully.
The first time will be shorter and more challenging than the next one. It’s a peak challenging activity, both for your eyes and your visual cortex. Your eyes are challenged for active focus, and your brain is constantly having to process multipole images that are not aligning perfectly. It’s something you might do a day or two out of the week, at most. Always consider how you feel, and stop if it becomes tiresome. The experience should be fun and uplifting, so it’s best to stop before you cease to have that experience.
6. Keep a log of the experience.
One day we’ll have a good logging program for you. In the meantime just write it down, and set a reminder in your calendar to do it again next week.
7. Consider the meaning of what you experienced.
Your eyes and your brain have to work together for clear vision. The lower the demand, the less accurate processing will be resulting. If you wear glasses that correct your vision to infinity, the demand is very low. If every last imperfection is corrected to the maximum, including difference between left and right eye, and astigmatism, your visual cortex has almost no work to do to reconcile double vision.
Our bodies are conserving resources. “Use it or loose it”, as the saying goes. You need a balance of stimulus and relaxation to get back to healthy condition. The relaxation part is important as much as the stimulus – having a relaxing walk is often as good as pulling focus. Watching a movie close to blur distance but without challenge can be relaxing as well. Enough sleep is important. And of course the real key is to take all of these things and build habits around them.
Here, a guest post from Nathan (who you might know from occasional forum posts). I had asked him to write something for you, since his vocation is particularly well suited to the topic of myopia rehabilitation. Nathan is a pathologist, so he is used to applying knowledge of the human body to logically analyzing the subjects we look at here in the blog (and the course, obviously).
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First, I’d like to thank Alex for the opportunity to write a guest post on his blog. Hopefully I have some insights that might be of use.
I’m a pathologist-a medical doctor that specializes in diseases and disease processes. I’ve also had myopia since about the third grade.
I still remember the day I was told I might be nearsighted-caught on school screening, when I couldn’t read the last line on the snellen chart. Little did I know how much worse my vision would become. I hated glasses from the beginning, and in junior high I switched to contact lenses. I found contacts much better, but I really didn’t like them either. The years went by, and I attended the university, and then medical school, followed by years of residency (essentially advanced medical training). And my vision became worse the entire time. My final and worst prescription was -6.75.
Finally, about three years ago I decided to get Lasix surgery-and finally be rid of my glasses. I paid my fee, did all of my preoperative preparation with an optometrist, and finally went to have the surgery with a specialist opthamologist. At the last minute, when I was sedated, and in the operating room chair, the opthamologist came in and told me that he wouldn’t operate. He said something about my cornea not being the optimal shape-and he said that since I was a pathologist he had to be extra careful-if there were any complications it could ruin my career.
I was disappointed in not finally resolving my myopia, but thankful that the surgeon didn’t take any risks with my vision. I resolved myself to living the rest of my life with glasses or contacts.
Then, while doing research on a completely different topic, I stumbled on Todd Becker’s excellent blog, gettingstronger.org. The blog deals with using stress to gain strength. One of the topics that he addresses is myopia rehabilitation.
Up until that point, I had no idea that myopia rehabilitation was possible. But as I read his article and contemplated the points, I realized that it must be possible.
The human body is adaptable. In fact, all biological systems are adaptable, through feedback mechanisms. You could even call that one of the definitions of life. Every system in the body responds to environmental conditions, and adapts to stress. The brain, heart, lungs, digestive system, bones, muscles, skin, endocrine system, all respond to stress. The eyes must also.
The most effective stress for change is applied at the “margin of capability”. In other words, if you want to build muscle, you need to lift weights at the edge of your ability to lift. Too little, and the muscle isn’t challenged. Too much, and you can’t lift the weight. The same goes for all the other systems-the stress should be just right.
All of a sudden, concepts like “blur horizon”, and “active focus”, just made sense. It is applying stress at the point most likely to cause an adaptation!
I started with a prescription of -6.75 diopters (and some small amount of astigmatism). For the first 2 years, I did the work all by myself, with just some organizing principles. After two years, I went back to the optometrist. My prescription was -4.75. For the first time in my life, my eyes has improved!! And this, in spite of having made many mistakes.
Shortly after that, I discovered Alex’s website. While I already was familiar with the basic principles, I found that the specific application of his principles was very helpful. I guess that comes from many years of practical application.
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I believe we need more of Nathan’s type of perspective. I am of course biased (so just taking my word on myopia subjects is inherently flawed), and others in my field prefer not to deal with the consequences of the rehab path. And otherwise there is a lot of holistic talk online, without quite enough basis in evidence or proper studies. What we need is more individuals in the medical profession but outside of ophthalmology (pathology as example is a great field for the myopia subject), looking at the myopia topic.
Enjoy!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
Advanced subject – below will make most sense if you already experienced improvements in your eyesight.
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Everything we discuss here about improving vision goes back to just two basic principles: 1) Reducing strain and 2) creating positive stimulus.
Much of the challenge of applying these two simple ideas is in the detail.
Remember that (almost) everything that happens with your vision is ultimately up to your brain, the visual cortex in particular. So when you push focus or adjust prescriptions or do anything at all relating to the process of seeing, your brain is what drives it all. Even though a lot of the deficiency is in the eyeball, it’s easy to underestimate how much of your vision really does happen inside of your head rather than at the front of it.
To this point, let’s look at a tangible and effective activity that shows us just how much the brain is important and needs to be appreciated in the process:
Take a normal day where you already several hours of close-up time. You are using a differential prescription that is quite challenging and you are always at least a few centimeters into blur. Since you already did the course and had several reductions in your prescriptions, your challenging distance gives you some blur and also quite a bit of double vision images.
This is really not easy, but you tend to work at this distance, looking for the most possible improvement. After some hours though it becomes more difficult to clear the double vision images and more of what you see just looks like blur.
Of course here, your eyes are getting tired and you should have a break. But there is often something else going on as well.
Take off your differential (close-up) prescription and put on your normalized (distance) prescription. Go back to your close-up work, at the same distance as before. Now of course, everything is completely clear. Appreciate this clarity for a moment. Take a few minutes of appreciating the sharpness and effortlessness in seeing everything.
Now go directly back to your differential prescription, and the double vision distance.
Blink a few times, resume working. Nothing is different. Give it a few minutes, though. Notice how while you are still challenged, you are now able to resolve a bit more of the double vision? Note: This may not always happen, and certainly is usually limited to experienced individuals and the double vision distance.
Why Does This Happen?
If you have children, you know what happens after a while of them doing their homework and are getting tired. Things you know they know, they can’t remember. Everything becomes a struggle. Why? Their little brains are just getting tired.
Similarly, your visual cortex starts to tire of resolving the image. The reference experience of sharpness stops being at the forefront and you start getting more blur. Now when you get a moment of your brain relaxing with sharp vision and bring back that reference experience of clarity, you start to see more clarity even when you go back to the more challenging environment.
Now this isn’t what you want to start doing on any regular basis. What you do want to do, is take a good break with lots of distance vision and nice outdoor lighting. In some instances though it makes sense to have these kinds of experiences to understand and remind yourself that the biology needs to be respected. The system needs a break from close-up and challenge. We have to appreciate the strain we are creating, and relieve it before we start to see chronic symptoms (ciliary spasms).
If only close-up work was like running. We would have a whole lot less myopia cases, since your body quite clearly begins to complain when you run long enough – though unfortunately our vision doesn’t.
Be kind to your eyes. Enjoy some healthy eyesight today!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
Improving your vision – almost always a question of how much effort you are willing to put in for the first month or two. With that being the case, it is encouraging to look at Paul’s figures for exactly how much he has improved in his first five weeks:
I’ve been using my first Normalized prescription now for 5 weeks. Haven’t touched my old full prescription glasses in all that time!
For reference, my old prescription was: OD -3.25, -0.75 Cyl, 180 Ax OS -3.00, -0.75 Cyl, 160 Ax
My Normalized prescription is: OD -2.50 OS -2.25 with no CYL correction.
The first week was definitely the hardest in the sense that I really noticed the difference in my ability to see clearly, especially indoors or under poor lighting. But day by day it got better and now it feels just fine when I’m outdoors on a sunny day. With a bit of focus pulling I can read car license plates from about 30 meters away. But under cloudy conditions or near dusk, my distance vision noticeably drops, and I can barely make them out at 15 meters.
I also did some Snellen measurements within the first 2 days of switching to my Normalized prescription and just repeated the measurements yesterday. Here’s what I got:
Day 2 with Normalized, 20 foot Snellen: Right 20/40 Left 20/30 Both 20/25
Week 5 with Normalized, 20 foot Snellen: Right 20/25 Left 20/20 Both 20/20
These Snellen measurements were taken indoors under the best artificial lighting conditions I could manage, but now that I know how much full sunlight helps I’m sure I’m better than 20/20 outdoors in the sun with this Normalized prescription.
My centimeter has improved too. The last measurements I took before starting to use my Normalized prescription was:
Right 40cm, Left 44cm, Both 42cm
Now it’s: Right 42cm, Left 48cm, Both 45cm
Finally, at work while using my Differential prescription (OD -1.50, OS -1.25), I can comfortably work at about 75cm from the screen, and edge of blur is about 85cm.”
Improving your vision is in no small part a process of self discovery and personal initiative. I like to read stories like Paul’s, where it becomes immediately obvious that he will succeed. Let’s look at some more of his forum commentary:
Because my current prescription is a bit complex I ordered a range of uncut opthalmic lenses from -1 to -6 from ebay (20 lenses for £10!)
This has meant that I was able to give myself a regular eyetest and can be super specific about cm distances with the varying lens strengths
I have put all the data at the bottom (there’s a lot) so in the meantime here are my facts and questions-
I get 20/20 vision with a prescription exactly 1 dioptre less than my current prescription.This is really exciting as it means that I can go ahead and order new glasses for my main prescription (and hopefully stop the steady deterioration of my eyesight).”
Well done, so far. That post had been back in September. And then he writes in an update yesterday:
A quick update and question. I have been using a differential prescription of R -2 L -3.5 (a big reduction from R -4, L -5.75 but I generally use them for reading and use 40cm blur distance). However, my main prescription glasses recently broke (daughter stepped on them – good for her ha ha) and I am now left only with the reading glasses or the option of using my old contact lenses while I am waiting for a replacement. I am loathed to wear the CLs as they are higher still prescription and give me headaches quite fast, plus it is too much much of a bother to take them out to read, so I have been going without. I find it is a bother to be in blur by the the end of the day, so end up reading just to get some sharp vision. Is this okay? Or should I just put in the CLs? Hopefully the main prescription will arrive soon, and anyway it is time to start thinking about using normalised.
I have not redone snellen yet but I am finding big improvements, becoming more aware of clearing vision at blur distance. Recently, following a morning yoga class one bright morning (feeling relaxed and energised) I noticed a VAST improvement in my sight. With differential prescription glasses on I found I could read number plates sharply from cars right along the street, and experienced almost no double vision at all for a good hour or so.”
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It’s an interesting experience (and timing), because (my response):
It can be fortuitous to loose or break ones normalized at just the right time. You end up using the differential and possibly discover that you actually have more margin in your distance blur horizon than you thought.
Back in the office days I would confiscate clients normalized when the circumstances where just right (no driving, good general progress, lacking confidence in their eyesight distance).
It’s something I can’t do online, unfortunately.
For you though it seems that this happened at a great time. Find that new distance when you feel ambitious and keep a log (or remember landmarks) for those peak clear flashes. Remember that your distance vision can improve at a different rate than your close-up centimeter, also.”
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If you are serious about improving your eyesight, Paul’s approach is exactly what you want to be doing. He is methodical, he keeps track of his progress (avoid subjective opinion in favor of tangible numbers), and he asks questions. It make me happy to see the course being put to good use.
The full thread with several more observations is here.
Put in the work, get the results. Sometimes I get frustrated about all the snake oil eye cure things online. It’s not even that they waste your money, but that they waste your time and destroy your confidence and motivation. I’d love to find a way to have good impartial reviews of various eyesight health venues to give people a better perspective of real vs. fake.
Either way, Paul has done well. If you get a strong start, the odds that you will persist are very high. Persistence equals improving vision, reason for you to do it, and reason for me to keep logging back in and providing support.
I hope you are enjoying some healthy eyesight today!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
Greetings! Jake here, your host for today. Alex is on minimal duty this week and asked me to fill in on the blog.
Low hanging fruit is a recent post by Inge and Alex’ response to it. It’s something I wish would receive far more attention, as it highlights so much of the problem with how we currently deal with myopia.
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Overprescription, with any sort of serious medication, is generally something most medical practices avoid – for all the obvious reasons. This is unfortunately not the case in optometry. In optometry, prescriptions are made for the maximum possible degree of correction. It is certainly bad news for your long term vision health.
There is a reason for this, which is that our eyes are not a static system. Our eyes are very complex, ready to adapt to many distances and lighting conditions. You can see well in bright light and at a two centimeter distance, and well in dusk 20 meters away (at least with healthy vision, you should be able to). That’s an amazing range for our biology, and of course as far away from the idea of “static”, as possible.
Not so, for glasses. Glasses are the opposite of our eyes. Glasses don’t account for any lighting or distance change. They’re just a piece of glass. They create a focal plane just for one single distance. It’s so much like a pirate’s wooden peg leg, for a medical solution to myopia. It would be laughable, if it weren’t just sad.
What happens when we try to fix a highly dynamic system with a pathetically static one?
We have to account for all circumstances. The worst possible lighting, the largest possible distance. Since glasses are the stone age equivalent of medical science (though quite profitably so), we have to get you the most possible prescription, so you can see clearly in even the most apocalyptic scenario.
And since most of your vision needs don’t include any apocalypse, for the most part you are just (possibly) entirely overprescribed for the occasion at hand.
This practice was established in times when the medical establishment thought it ok to put morphine in cough syrup and give to your children to help them sleep better. We did make it past the morphine for children phase of medicine, but not so much in the optometry department. There, we stayed just where we were a hundred years ago (and several hundred years, really).
Once you realize the incredibly large fallacy of trying to fix a dynamic system with a static solution, the rest is all pretty obvious. It’s not medical science at work, it’s just retail practice of a quick fix. They make money, you can see clearly without having to rethink any of your eye strain habits. Everybody wins (sort of).
Then we have cases like Inge, as she describes in the forum:
My prescription glasses are -2, prescribed in 2011. I remember that they gave me a headache in the beginning when I got them and I was sure they were to strong for me, they checked once more and concluded with the same prescrition. I can see most of the letters on the 20/15 line with -1.5 lenses, 20feet snellen.
All measurements taken without glasses.
Centimeters from Snellen chart to unreadable 20/20 line * Left: 140 * Right: 156 * Both: 166
Centimeters to blur line Mobilephone app: * Left: 75 * Right: 83 * Both: 86
At 08.05 after using computer working and eating breakfast.
From 2,9 meters in the room fully lit. Snellen chart at work. * Left: 20/70 (Blur) * Right: 20/70 (blur) * Both: 20/50 almost 20/40
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There are lots more measurements, I just took the best ones for maximum effect. See Inge’s whole post here.
Here’s the problem, in rather obvious terms. Inge, in good lighting, can just about see 20/40. And yet Inge gets a -2.00 prescription that is so hopelessly overprescribed, that she gets headaches. Even though she complains of the symptom. the optometrist insists on the prescription.
Pirate, wooden peg leg.
They have to do it, because Inge might be driving at night in a hail storm, get into an accident, and blame the glasses if they were anything less than perfectly clear. Static solution for a dynamic system, it just doesn’t work well except in one single scenario. See clearly in a midnight hail storm, but have headaches on a sunny afternoon.
Alex talks about this quite a bit. The hail storms and the overprescriptions, and morphine for headaches.
Here is what I will say is very well possible for Inge:
Inge could pass the driver’s license test, in a matter of two months, without glasses.
If she applies the contents of Alex’ course perfectly, gets eye strain under control, shifts down prescriptions as quickly as reason allows, she could in fact pass the state requirements in most places in the U.S. without wearing any glasses.
This, if one were to ask an optometrist, would be somewhere between miraculous, and impossible.
You can’t be needing a -2 diopter correction (which is quite a lot of focal plane change!), and then suddenly see perfectly well (as far as the government is concerned) two months later without glasses. If this were possible, Alex should change his corporate status to “religious entity”, because miracles. How else could optometrists explain a recovery like the one possible for Inge?
In reality it may take her four months. Or six. Life gets in the way. But if you bring me somebody like Inge and place a large bet, I can get here there in two months.
And that’s the crux of all this. You have an entirely curable condition, that doesn’t get any chance at all, because there is no profit in actually helping people. It’s widespread throughout modern Western medicine, and it’s par for the course for how we deal with problems not close to our heart (with substituting compassion for profit).
All we have, is guys like Alex.
Comments are open for this post.
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
Everything is here in Alex’ blog for the motivated reader, to improve their vision. You don’t need to spend money on the paid course, you can easily dig through the forum and blog, and impressively enough, it really is all here. Props to Alex to spend a lifetime providing myopia rehab advice, retiring, and then building an amazing resource like this.
More impressive even, if you ever met Alex. This guy has never even owned a cell phone, much less used a computer or e-mail (till in his 60′s!).
Anyway, let’s look at Robin, who is making great strides, with the help of only himself:
This is not my first post on the forum but I haven’t yet introduced myself.I’m 21 , a college student and I am an avid reader of the blog and forum posts for information,tips and motivation though I’m not a paid member.Though I hail from India I started my schooling abroad(in KSA) and stayed there still my 7th grade.Well I had a close up lifestyle now that I think about it.Well,I became myopic by the age of 10 starting at -1.5D I think.Bythe age of 12 I was at -3.25(now that I think about it , I went to the optometrist after dusk and the lighting was quite bad,so I think that was an over prescription then).Then my prescription become stable before it jumped up again at the start of college to -4D(Though I am again guilty of making the trip to the optometrist in bad light conditions.)It was then that I really started looking seriously at my eyesight and decided to make use of the internet to look up ways to improve my eyesight.I found out about some Tibetan eye exercise and palming and started practicing them though I never felt that it would help my vision though I should say that palming still feels really good and eyes feel relaxed after doing it.Then I found out about gettingstronger.org and subsequently this site.I started rehab in Dec2013 starting at -4D,25cm in both eyes(no astigmatism) After removing full prescription for all close up and print pushing(pushing focus with naked eyes : By Jan 2014 Cm reading:LE:30-32cm RE:27-28cm I only got hold of my normalized prescription by the end of march which was a mistake as my improvement stagnated there. My first normalized was -3.25D in both eyes.I started at 20/30,20/25 in April to 20/20 in July.My night vision though was still lagging but improved gradually.By September 5 I switched to -2.75D starting at 20/40,20/30.By Oct 23 I could read 20/20 in the morning though my night reading is in the 20/40s have attached the progress report below. My question is: The main reason that I have not mentioned cm is that I had stopped measuring cm regularly as I had lost motivation to measure cm as there is not much improvement cm wise(Last cm measurement on Oct 23: LE:32-33cm RE:28-29cm or 30cm)
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I took the liberty of bolding the key aspects. And here is the whole forum thread.
Alex is still answering all of the e-mail that is relevant, I’m just helping out with the Website (briefly and very, very temporarily).
Since I’ve been having to look at it quite often recently, one might say that whole project could possibly use a bit of additional organizing (and a bit more of a clear approach on the basics). I wouldn’t say that it’s made easy for the first time casual visitor, I feel your pain if you just started out browsing around here. Another one of Alex’ tricks no doubt, having me deal with this long enough to have my OCD kick in and write you a few quick ebooks on all the key aspects of improving your eyesight.
Also and meanwhile, the paid course is easily the best hundred bucks you will ever spend on protecting this very precious one of your five senses. It’s quicker, easier, and it also supports this project.
Hopefully the man will be back in action next week, and everything will be back to normal. He’s fine, don’t worry. Do take care of your eyes!
- Jake Steiner
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
Jake Steiner here, bringing you some more eyesight basics that the mainstream prefers not to tell you about.
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Here we will take a quick look at how the premise of accommodation, and more specifically accommodative error play a fundamental role in how your myopia develops. More importantly, we’ll look at how science corroborates the need for specific glasses to be used during close-up, to reduce your risk of developing myopia.
Alex is very much focused on the practical aspects of myopia rehabilitation, skipping a lot of the science details that lead to the practices he prescribes for you, here at his site.
It’s fascinating though, the amount of knowledge and specifically the details of it, that drives the seemingly simple habit changes you adapt into your daily life. I quite enjoy his approach, since it gives you the fastest, most tangible access to eyesight improvement activity. You are never forced to contemplate any of the dry academic materials that create the “end user” topics. A great example of it is one of Alex core tenants: While reading / using a computer / screen, always be wearing a specific prescription intended for close-up use.
Of course Alex does explain why, in simple terms. Your myopia symptom limits your distance vision. Glasses only correct one focal plane, intended to help your distance vision. Wear those same glasses up-close, and you create more myopia.
That’s palatable, straightforward, and close enough for most people. It’s a good compromise, for a rehab focused site.
There is so much though to all of this, that I think you don’t get to fully appreciate, without delving a bit further into the why’s and how’s of the subject. There are hundreds of massive studies on the subject of close-up lenses, done with dozens and hundreds of participants, over the course of half a century, all disagreeing with each other. The military has done them, lens manufacturers have sponsored them, the holistic contingent has added their own variations. You never see or hear about these things most likely, but these debates rage on in academic circles. And very fortunately you end up with a guy like Alex, who takes these tens of thousands of pages of dissertations and studies and conclusions, a whole mountain of discussion, and just gives you the simplest possible verdict.
To appreciate what Alex is doing there, let’s take a more in-depth look at what creates the “differential prescription” part of his rehab approach.
First, you want to understand the premise of accommodation, which drives every last bit of the narrative. Here is a good definition of the term, by Wikipedia:
Accommodation(Acc) is the process by which the vertebrateeye changes optical power to maintain a clear image or focus on an object as its distance varies.
Accommodation acts like a reflex, but can also be consciously controlled. Mammals, birds and reptiles vary the optical power by changing the form of the elastic lens using the ciliary body (in humans up to 15 dioptres). Fish and amphibians vary the power by changing the distance between a rigid lens and the retina with muscles.[1]
The young human eye can change focus from distance (infinity) to 7 cm from the eye in 350 milliseconds. This dramatic change in focal power of the eye of approximately 13 dioptres (the reciprocal of focal length in metres) occurs as a consequence of a reduction in zonular tension induced by ciliary muscle contraction.
So that makes sense, right? Accommodation is the “auto focus” in your eyes, the means by which you can see both near and far clearly.
Accommodation is affected, to a great extent, by the glasses you put in front of your eyes. So much so, that it’s fair to say that accommodation is the key topic in the development of myopia. Science, of course, agrees. In March of 1999, Ophthalmic and Physiological Optics published one of the many articles on the subject of accommodative adaptation, and accommodative error. Here’s the quick summary version:
Accommodative adaptation, resulting from the sustained output of slow blur-driven accommodation during the course of a sustained near-vision task, has generally been assessed under open-loop conditions. This study examined whether adaptation influences closed-loop accommodation during the course of a sustained near-vision task. Accommodative adaptation was assessed in 18 fully-corrected subjects by comparing pre- and post-task values of dark accommodation recorded objectively with an infra-red optometer. Subjects performed a continuous 10 min binocular near-vision task at a viewing distance of 33 cm, with the within-task accommodative response being assessed at 1 min intervals during this period. Subjects were categorized into adaptors (N=11) and non-adaptors (N=7) on the basis of whether their initial 10 sec post-task adaptation exceeded +0.30D. The adapting group exhibited a significant decline in the lag of accommodation during the first 3 min of the near-task, whereas no significant change in the within-task response over time was observed in the non-adapting group. These results indicate that accommodative adaptation increases the accuracy of the within-task, closed-loop accommodative response. Furthermore, we speculate that a deficit in accommodative adaptation, being accompanied by increased retinal defocus during near fixation, may contribute to the development of nearwork-induced myopia.
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The emphasis is there in the last sentence is mine. Original article and download options are here. If you are into this subject, it’s quite the dead horse of a subject. Yes of course, accommodative response and the accommodative error in particular, create a myopic symptom.
Here’s what matters: If you wear your regular distance prescription for close-up, you get a *lot* of accommodative error. Depending on genetic predisposition this will translate to less or more myopia, sooner or later. It’s not a question of *if* but rather of *when* and *how much*.
If you don’t need glasses, close-up will still produce accommodative error. This error creates a real myopia risk.
So what does Alex do when he talks to you about fixing your myopia? One of the first things, without too much technical details, he tells you to adjust your prescription for close-up use. It’s the same thing I do, though I never took Alex’ quite so elegantly simplified approach (hey, it works!). Alex took a whole lot of science, and boiled it down to a proposition that is very simple and very elegant: Use only as much correction as you need to get a blur horizon at your ergonomically comfortable distance.
This is truly brilliant, especially if you come from my position. I’m the guy who read the tens of thousands of pages of arguments back and forth, and bought some of the expensive equipment to test on myself. In the end, Alex has the best way. To truly appreciate the magnitude of the simplicity, take a look at this bit of science, published in Optometry & Vision Science in 2008:
The study recognizes accommodative error as a problem, and looks to establish exactly how much and what kind of correction is needed for close-up use. Essentially it’s the same thing Alex let’s you figure out quite simply at home, done by guys who take the much, much longer route:
Optimal Dioptric Value of Near Addition Lenses Intended to Slow Myopic Progression
Purpose. The purpose of this study was to determine the optimal power value of near addition lenses, which would create the least error in accommodative and vergence responses.
Methods. We evaluated accommodative response, phoria, and fixation disparity when the subject viewed through various addition lenses at three working distances for 30 young adults (11 emmetropic, 17 myopic, and 2 hyperopic). Accommodative response was determined with a Canon R-1 infrared optometer under binocular viewing conditions, phoria was determined by the alternating cover test with prism neutralization, and fixation disparity was measured with a Sheedy disparometer.
Results. We found that the optimal powers of near addition lenses for the young adult subjects associated with zero retinal defocus were +0.92 D, +1.04 D, and +1.28 D at three viewing distances, 50 cm, 40 cm, and 30 cm, respectively. The optimal powers associated with −3 prism diopters (Δ) near phoria were +0.58 D, +0.35 D, and +0.20 D at the three distances, 50 cm, 40 cm, and 30 cm, respectively. In addition, we found high correlations between the initial accommodative error and the optimal power of the near addition lenses and between the initial near phoria and the optimal power of the near addition lenses.
Conclusions. The results suggest that when the effects of near addition lenses on the accommodative and vergence systems are both considered, the optimal dioptric power of the near addition lens is in a range between +0.20 D and +1.28 D for the three viewing distances. Using progressive lenses to delay the progression of myopia may have promising results if each subject’s prescription is customized based on establishing a balance between the accommodative and vergence systems. Formulas derived from this study provide a basis for such considerations.
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That’s plenty right there to give you a headache. Imagine reading not just this, but the accompanying full PDF of the study.
It’s interesting though, even if the details are dense. There is clearly not only an appreciation in optometric science that close-up use is responsible for accommodative error, and that this error takes notable responsibility in the development of a myopic symptom. The evidence is significant enough that studies are conducted not just about the accommodative error, but how glasses play into correcting specifically for close-up use.
There are others out there who recommend adjustment for close-up use. You’ll find things like “plus lens therapy”, which often is proposed by individuals who don’t fully understand the drivers behind the concept. That’s a pretty common one online, and it concerns me because the lack of understanding opens the door for a whole lot of misuse and lack of positive results. Then there are those who propose the use of lower prescriptions, also often without demonstrating an understanding of the “why” of that course of action. Again, there is a problem with presenting something without fully understanding the full picture, as it creates a risk for misuse.
And finally you get behavioral ophthalmologists who take accommodative error and attempt to compensate for it, by offering a correct close-up prescription. I’ve met a whole lot of these guys over the course of my career, and they’re the better solution of all the options. They still tend to obfuscate a lot, and remove you from being able to prescribe for yourself. The most brilliant approach is by guys like Alex who have intimate knowledge of the biology and science, and then look for the best way to put all of that into your hands, in a way you can easily use it yourself.
Blur horizon based centimeter measurement and resulting diopter correction is a very, very effective way to compensate for accommodative error. You get to the same functional results as the guys from the complex study I reference above, without all the involved steps and measurements. It’s truly brilliant, and sadly not far more popular. To my knowledge Alex is the the only guy out there who gives you this unprecedented level of access to such an inaccessible health science subject. All you need to do is download the diopter measuring tape, figure out your close-up distance, and you’re good to go. And you have the support forum to eliminate the risk of misuse, in case you are confused and need more help.
These are the guys who should be dominating the public discourse on eyesight health, instead of being marginalized and running small rehab sites as retirement projects.
Another issue with all of this is the extent to which it will have a positive effect on your eyesight, depending on accompanying practices. Just wearing a correction alone doesn’t necessarily give you better vision. Lots of studies end up saying that a close-up correction showed little effect on myopia development, which can leave you confused as to why you’d want to use it for yourself. Again here though, Alex says 1) get a differential prescription and 2) work at the blur horizon / push focus. Lots of brilliant in those two seemingly very simple tenants. As a fellow professional I have deep admiration for Alex’ insights. Two simple sentences addressing the whole mountain of a topic of accommodative error, as well as all that goes into positive stimulus (another article that, entirely).
Hopefully this wasn’t entirely too boring, and provided a bit of a glimpse into what happens behind the scenes of your hopefully favorite rehab program.
And please do support this site by 1) writing elsewhere on the Web and linking to it (so, so important) and 2) using the paid Web course, if you are working to improve your eyesight. Resources like this will only continue to exist at the grace of your support. Guys like Alex get more grief than it’s worth, and these things aren’t exactly big money makers or providing a whole lot of personal satisfaction. I myself spent the last 10+ years charging thousands of dollars to individual clients, and never even considered going online and giving everything away and dealing with all the Internet troll-dom. I’m helping out because I don’t want to see these little islands of hope getting swallowed up in the ocean of for-profit optometry.
If you can do just one thing, it’s to write about your experience online and link back to Alex’ site.
Cheers!
- Jake Steiner
Comments are open for this article.
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
I need some help with my 9 year old son. He has been complaining about not being able to see the chalkboard in school for about 6 months. I initially had him tested, and he tested at -1 diopter. I tried to teach him about taking breaks, good distance when reading, good habits, etc-I think he did some of them. I also tried to teach him to “pull focus” in the distance. For the last month, I’ve had him use plus lenses, and we read together and “push focus” every day for about 30 mins.
Recently the teacher told us he is squinting a lot in class. He tells me he can read the chalkboard about 3/4ths of the time, and the other 1/4th he can’t.
I had him tested at the optometrist today-his prescription is: -1.0 od, -1.25 os.
I think he needs some glasses help to perform in school.
But what prescription should I get him for a “normalized prescription”.
How strong should I make his “differential prescription”.
I’ve been through the child myopia program very carefully. I just need a little help with the prescriptions.
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There is so, so much of this that it would warrant an entire separate site, or at the very least significantly more work on the paid child program and child related blog articles. The whole myopia problem is a childhood problem, and the degree of the issue is quite unclear to many parents. The child’s eye is highly susceptible to stimulus and focal plane change, and you’re likely to see some very concerning results from young children and minus lens use.
In 2012 the results of a child myopia study were posted in AAO / Ophtalmology, which while not as conclusive as some of the others, is good in that it is both recent and succinct to a point I like to make often:
Get Your Kids Outdoors, Prevent Child Myopia!
It’s not just that, of course. I might also say take away the iPads and iPhones, and iAnything else as well. Nobody in the real world reads studies dealing with child myopia, so in the end the only thing you ever hear is glasses, or on the very fringes, some questionable alternative therapies. Let’s use one of these studies to help make my point about outdoor time.
Here’s what the study looked to assess:
Objective
To summarize relevant evidence investigating the association between time spent outdoors and myopia in children and adolescents (up to 20 years).
In other words, is there any point to Alex’ rantings about child free time use?
Results
The pooled OR for myopia indicated a 2% reduced odds of myopia per additional hour of time spent outdoors per week, after adjustment for covariates (OR, 0.981; 95% CI, 0.973–0.990; P<0.001; I2, 44.3%). This is equivalent to an OR of 0.87 for an additional hour of time spent outdoors each day. Three prospective cohort studies provided estimates of risk of incident myopia according to time spent outdoors, adjusted for possible confounders, although estimates could not be pooled, and the quality of studies and length of follow-up times varied. Three studies (2 prospective cohort and 1 RCT) investigated time spent outdoors and myopic progression and found increasing time spent outdoors significantly reduced myopic progression.
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Some of the study details come up with figures, like 2% of myopia risk reduction per additional hour spent outside per week. I found the rationale a bit lacking in terms of the specific numbers to arrive at this conclusion, though it does present an easy incentive and soundbite for child myopia prevention.
If you want to use 2% as a figure, I’d offer another 5% reduction in myopia risk for every hour less spent playing games on handheld screens (not highly scientific, that number).
You also want to avoid the temptation of other quick fix ideas for child myopia, such as ortho. It’s on my list to eventually have a much more detailed article on that subject, which I have meanwhile been trying to avoid addressing. If you are tempted by ortho and have a myopic child, there is some emerging research suggesting that it’s not all roses like the sellers of the product suggest. As always, when the therapy is based on masking the symptom, we tend not to get very far.
Orthokeratology attempts to reduce myopia by remoulding the corneal shape with contact lenses. A recent resurgence is predicated on new contact lens designs with a prefigured back contact surface and higher oxygen transmissibility. This Clinical Controversy presents an analysis of the risk factors associated with orthokeratology and its suitability for children, followed by commentaries from specialists who have an interest in the method. Some state that there is a lack of data on relative risks of corneal infection and that there is a need for large-scale randomized controlled studies; however, opinion is expressed by others that orthokeratology is a clinically safe procedure using modern lenses. It is noted that the physiological and biophysical bases of orthokeratology are virtually unknown, and further research on the human cornea is indicated to scientifically establish the safety of orthokeratology. Prospective patients, and their parents in the case of children, should be fully informed of the risks.
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And yes, of course. Wolf in sheep’s clothing. Not much of a sheep though, mostly it’s make-lots-of-money in pipe-dream-for-parents clothing. Ortho makes money though, where not buying iPads and taking your children outside doesn’t. Also, taking them outside isn’t so easy with most parents work schedules and other obligations, making ortho and iPads a highly attractive proposition.
Well done on your efforts so far in correcting his myopia symptom.
Are you making sure that he always has good distance from close-up reading? Smartphone and tablet games in particular can undo a lot of otherwise positive efforts.
A few things to consider:
Keep a log of his centimeter / Snellen results. These may well vary, but month over month you’ll want to be looking for any deterioration (and of course ideally, improvement).
If it were my child, I’d be looking for possible changes in the problem area, like sitting up a row further in school potentially, before I would go the minus lens route (since that is a notable setback). I’d be inclined to take out any sort of recreational close-up computer use for a few months, though not as punishment – possibly replacing with better distance such as playing games on a TV screen.
Realizing that 2-3 months can have a significant positive impact on a small degree of myopia in a young child, I would be looking at maximizing efforts for that short time, before possibly conceding to minus use.
I would potentially go so far as looking to replicate the distance / lighting type / blackboard scenario that happens at school, to be able to assess the problem at home. That, combined with Snellen results would help me see where my efforts are headed, and whether I can correct enough of the symptom to eliminate the immediate issue (of reading the blackboard).
A whole lot of this is psychological in terms of looking for success. If I can get him motivated and understanding that we can fix it now and not end up having to wear glasses (before he gets them and gets a taste of the quick fix of seeing clearly), then I have a better chance of fixing it now.
That, the ideal scenario.
On the other side, as I often tell clients, one has to look at the big picture. If circumstances or the child’s current disposition don’t allow for a full correction of the issue right now, sometimes we must concede. The most important thing is not to cast a negative emotional space around the whole subject of fixing eyes, with the child.
So if the age is more rebellious or tantrum prone or otherwise already challenging, I’d be looking to still minimize the close-up issue, and make sure that minus use is very limited. Ugly glasses, as a little secret sauce tip, can help with that one.
Maybe I have to wait a few months or a year or two before a window opens up when we can really work on improving eyesight. In this case I want to make sure that I preset the future to make my life easy later on – ie. minimal myopia increase due to low close-up strain, and minimal glasses use (because they are ugly, and because we learned to only use them when necessary).
As you know, myopia is very fixable – taking the time to map out the best scenario for long term success is key.
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If I sold Ortho or glasses or Lasik, I’d have industry support and vendor support, and would be making easy money with lots of happy people enjoying being told that it’s not their fault and that the cure is a quick trip to their wallet.
Alas, it isn’t so. There’s the easy way, and there’s the right way. Nate deserves cudos for looking for a real fix, and his son is lucky to have him.
Enjoy some healthy eyesight today!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
A quick question about when to decrease normalized prescription.
I started with a prescription of -6.75. I heard about myopia rehab at gettingstronger, and did it on my own for about 2 years. At the start of this year I had a trip to the optometrist, and was told that my fully corrected prescription was -4.75. I started the year with a normalized prescription of -4.25. This year I’ve slowly worked my way down to -3.25, trying to make an adjustment of .25 diopters every 2-3 months.
I can currently read the 20/20 line with my -3.25 lenses. It is initially blurry, but I can “pull” it into focus without too much effort. It’s pretty clear once I pull it into focus, but their is a residual “haze”, that I can’t resolve. I also find that I can’t really drive at night with my current glasses-I need to go up a notch or two.
My question is: have I pushed too far? Is there danger in making an adjustment before my eyes are ready, that will slow my progress? Which line should I be able to read with the normalized lenses, and even more important, how clear should that line be?
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Nate has been after his goal aggressively and consistently, pushing that blur distance as his eyesight continues to improve. It’s a challenging course of action and one has to give Nate due credit for his efforts. You could just as well take a relaxed approach and just push your prescription a little bit – but then you aren’t dramatically cutting prescription dependence the way Nate has been experiencing.
So much of what you want out of your eyesight experience just boils down to the focal plane. Do you want to challenge yourself a little, and get small, consistent improvements? Or do you want to push hard, and get the most out of your biological ability to recover distance vision?
Only you can answer that for yourself. Meanwhile I’m here to continue to provide you the tools for whichever experience you prefer.
As for Nate’s question, whether he is being too aggressive in reducing prescriptions, see the full forum thread.
Enjoy healthy eyesight today!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
2014 is almost over, and the time is hopefully finding you with much better eyesight than when you first discovered this site. I’m glad to be looking back and finding that everything is still here and functioning! A few of the things worth noting:
Course Participation
We had a pretty steady stream of new participants in the paid course this year. It hasn’t quite managed to get the site to break even, but it’s reasonably close. At this point without spending money we don’t quit get enough traffic to justify all the work, so I have been doing a fair bit of paid advertising. Hopefully next year we’ll get into some more partnerships with other health sites and possibly lower the cost of running the site.
Participants feedback has been almost universally positive (which I continue to be surprised by). A lot of it is probably patience and kindness, more than the quality of the course presentation itself. This year in total I had three refund requests. Everybody who actually did the course and communicated with me at all, mentioned improvements. Excellent work on everybody’s part!
Marketing
There still isn’t anything that is sustainable. I know that we need to be talking to other health related sites and become part of a community. As I’m entirely averse to e-mails and digital communication beyond any bare minimum, I haven’t engaged in that at all.
I did hire a few people to do this for me, but none of them ended up being well suited for the task. Likely it’s related to me not having much skill in managing people, much less remotely. Let’s see if I get things together on that front next year – and if you have any inclination to help, this would be the place I need it most!
The Website
I can’t count the times I wanted to host the site myself, in my own house. That way I could take the physical box and blow it up.
If you are not technically inclined and old like myself, you can possibly imagine. These things don’t just function in some predictable, linear fashion. You might set it up, it will all work, until one Sunday morning when you really need some time to relax. Then everything will implode, without any warning or notice. And it will refuse to resume operation, while also and magically everyone will want to be online just at that time. Then you get dozens of e-mails with questions and confusion, and your Sunday turns into an eternity in some virtual cage of doom.
Fortunately, I have had a lot of help. Jake Steiner himself has built and/or fixed things countless times, all while refusing to participate in any way in the discussion or be identified. That part has always been amusingly ironic to me. And speaking of …
Jake Steiner
I have seen a quite good ebook, part of a series, and several instructional guides that will make it online soon. These are exciting developments.
More than this site or forum or blog, I consider this one of my better accomplishments on the Web front. I have managed to annoy Jake all year (almost two by now) with a carefully timed mix of articles of professional incompetence, and pleas for help from readers to his inbox. I think he realizes by now that the Web is not all bad, and that more needs to be done to prevent all of the pseudo science, optometric illiteracy, and corporate greed from monopolizing the conversation.
Mostly we have just been getting site improvements anytime I ask him to partake. Instead of writing about how to use sports for focus pulling, he will make animated banners instead – which is understandable in a way, since there is nothing like going online to ruin your professional reputation. Jake is one of the best in the industry, a consult with him will set you back five figures, and even if you want to spend the money you’ll still have to wait a year to get on the schedule. It’s great for Jake, but of course a waste of skill and talent as far a the public is concerned. I think we might finally have a bit of an understanding, and access to very valuable insight, without the prohibitive cost and long wait times. Keeping in mind that I won’t be around forever, and also that I would prefer that you have more alternatives than just this one site.
Mobilizing more professionals to take part in the dialog, from a holistic and rehabilitative perspective is key to give readers like yourself a meaningful option when researching your own vision health. Of course the big theme always is …
Looking For Ways To Make Eyesight Health Appealing
The marketing guys always tell me all the things wrong with the site. You might see it if you come often – one day there are promotions for the course, popups and reminders, and the next day they are all gone again.
I’m not a fan of pushing people or tricking people into working on their eyesight. Unfortunately though the Web is host to so many misguided eyesight practices that most sane and reasonable people find themselves very hesitant to try yet another scheme. What you are seeing then, is me looking for a good compromise between incentive and self determination. Right now I extended the trial of the core course to really let new participants get more than just a taste of the process, before they decide whether it has merit (and whether it is worth their financial support).
All in all, it has been a good year. You have all been very supportive, and also a few of you take the time to post updates in the forum – which is great encouragement to others! Looking on to next year, the biggest hope I have …
More Participant Engagement
I realize of course how things work. I use the Web all the time, to look up things. I’ll read some article, get the answer, and go on with life. I don’t start helping the site owner promote his subject area or otherwise ever even think of the effort that went into creating the answer I was looking for. Entirely normal.
For that the paid course is perfect. It’s a good trade between the streamlined answer to myopia reversal, with a bit of personal support, for the participants financial support.
On the free side however, which makes up a very large part of the site and my time, we don’t really get that trade. I’d love to see some of those who enjoy just the free content (which, by all means!) to possibly find time to return the favor by helping me get into a bit more of a community oriented, online dialog with other health related writers, blogs, and sites. It’s not something I’d expect, but it would be a fantastic experience for 2015! Remember that you could only find this site by either paid ads or Google searches, both of which require resources and time on my part – if you want to pay it forward, have others be able to find this site, we need to continue to build the voice and reach.
This, and continually more free content, some of which the likes of Jake are creating, should help many more people get a real alternative to being trapped with glasses and contact lenses.
I hope you have enjoyed more healthy eyesight this year!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
With my trial lens set I found out: RE: -0,25 160° LE: -0,75 11°
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What is it, guys? +0.5? -0.5? 85 degrees or 160 degrees? 90 degrees or 11 degrees?
If it wasn’t entirely par for the course, above would be a statement of utter embarrassment that defines much of the prescription lens industry. Those numbers are as random as the lottery.
If you have been visiting the blog for a while, you are of course aware of my position on most optometrist’s ability (or willingness) to correctly assess astigmatism. Just as Rene experienced, the results you tend to get are about equivalent to a stoned clown at a traveling circus spinning a giant wheel of astigmatism-fortune-prescription values. There are of course reliable ways to measure astigmatism, but they’re not commonly used by the strip mall optometry contingent.
I should have prefaced this article with a warning that it may not be the most measured in tone. Fraternizing with the more risqué type practitioners (Jake!) clearly has been having some questionable effects.
Let me illustrate the point above, and the optometric value of most astigmatism assessments:
And while of course the image isn’t a fair representation, the results that you are likely to get at the optometrist do reflect my opinion about astigmatism prescriptions.
The problem with unchecked astigmatism prescription is that it quite literally reshapes your eye, in a way that makes you more dependent on prescriptions.
The astigmatism prescription quite literally creates the problem, in more than a few cases. And equally damning (but fortunate), you can undo that same astigmatism prescription by managing your prescription needs more responsibly (or finding an optometrist who uses techniques to actually assess your astigmatism correctly).
Let’s look again at the two optic shop prescriptions that Rene received:
Just look at that. Sadly, glasses prescriptions are treated much like candy being sold at a candy store. Nobody takes them seriously, and the prevailing wisdom is quite literally, “more is better”. It boggles the mind! What you are looking at above is the second set of numbers for the amount of astigmatism correction, and the third row is the degree (where on the eye the correction is applied).
The results are so much the opposite that I couldn’t have made one up to better illustrate the point. If you take the two results, they quite literally (I’m literally having to use the word literally quite a lot, here) cancel each other out. You take optometrist A and optometrist B, and the net result is zero astigmatism.
There isn’t even a point in looking at the third row (degrees), to see that the astigmatism evaluation is just a completely random number. In my many astigmatism related articles I sometimes joke about how I might invent a magic eight ball (remember those?) to give optometrists yet another tool to accurately assess astigmatism prescription. And again, these whimsically created lenses they tell you to put in front of your eyes will create a focal plane stimulus, to which your eye will respond. In the end you will have a measurable problem that you didn’t have, at all, before you went to the optometrist in the first place. For the full thread of Rene’s topic, click here.
And as always, I must say that there isn’t any malice involved. Just as psychiatrist prescribe psychosomatic drugs like candy, and surgeons sell invasive procedures, so does the optometry field dispense diopter correction with total abandon. It’s the whole paradigm of health that is broken. The industry should never be run as a for-profit enterprise. Once you combine health and profit, this is exactly what happens.
Rene has the right approach. Measure diligently, and if you are dealing with a challenging case of astigmatism, invest in a test lens kit to get meaningful and accurate results for yourself.
Lastly, don’t follow my lead in terms of tone. There is no benefit to confronting or personally attacking anyone for their profession – the problem goes far beyond the optometrist, the school, and the lens maker. Everybody does the best they can, inside the broken system that is health for profit.
Hopefully you are enjoying some healthy eyesight today,
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
I always refer to using letters and text in general, when working on pushing or pulling focus. Unlike other objects, text has the significant benefit of giving you feedback – if you don’t see a tree leaf, you won’t know it. But if you can’t read half of the letters in a word, you surely do! This is why you want to use writing as a reference tool for your focus work, a ubiquitous feature both near and far, most anywhere you go.
That being said, you may get bored with letters. Though I advocate practices that amount to the foundation for positive habits, rather than “exercises”, you can surely alternate for the sake of keeping things fresh.
What you want to be looking for is visuals that provide that reference ability that writing has. Lines are helpful, anything that has a predictable and consistent flow to let you know how much and how clearly you are perceiving it. Along with that, you want to be able to challenge your eyes for focus. Some clients like to use the Snellen chart, and get good results from working with it for half hour or more per day. Again though this amounts to exercise more so than habit. A more habit based activity would be adding reading signs while you are going for a walk.
Here is one that goes towards exercise rather than habit, but can be fun – especially for children:
The Maze Game
A maze can be a fun tool to get your eyes moving and following the lines to try to get through the maze. It is also handy in that you can easily print out any kind of maze, at any kind of size, to hang on the wall. You can display mazes on your smartphone screen or laptop. I had a client who even bought maze tiles for his bathroom!
Easiest might be to search Google Images for the word “maze”, and browse the resulting pages for inspiration. You can do variations like kid’s maze to get some ideas for the young ones, too. Google then even provides suggestions for variations – easy, hard, holiday themed, and more. It’s brilliant!
Of course the key here is to really get into a distance where you are challenged by blur. Better even is to use the maze game when you are dealing with double vision, where the lines are ideal for practicing to fuse the image. Fellow practitioners also use mazes frequently for fusing double vision. I have used mazes with clients who felt particularly challenged by double vision, with great success.
Hopefully you are enjoying the blog despite the less frequent articles lately. While I am not always writing, I am thinking of you and the site, and am always anxious to bring you new inspiration and ideas to help with your eyesight improvement goals.
Enjoy!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
In the course we talk about prescription use in a number of installments. I also have an entire category of paid support that includes prescription suggestions. The reason for this is of course that prescriptions significantly affect your eyesight health.
As you likely already know from reading the myopia basics, all of your myopia past the first -1.50 diopters is likely caused by nothing other than your prescription glasses. Glasses seriously affect your eyesight!
At the same time, I often make your prescription reduction and close-up prescription choice sound like a simple one. Why?
I want you to feel comfortable in measuring your eyesight, and experiencing the effect of a dedicated close-up prescription (so much less eye strain!). I also want you to experience the effect of discovering active focus, and your own ability to see the eye chart more clearly, with less prescription, than you thought possible. All of these things require you not to be afraid to get to know and change your prescription needs.
Your eyes can be quite forgiving, so there isn’t much risk in a well understood prescription change. At the same time though, even small variations in focal plane can notably affect your eyesight. Sara writes in her forum topic titled, “Crooked Glasses Causes Problems?“:
My centimeter values started really tanking this past month and a half, and I’ve been worrying that some new unknown factor is impeding progress. From a high of around 38 cm, I was down to 35 or 36. Then I realized that I’d sat or stepped on my distance glasses one day (can’t remember what I did exactly) and they were sitting a bit crookedly on my nose. I was getting double vision for distances that didn’t used to be problems, and could no longer focus pull. I stopped doing most near work for a while, wondering if excess close focus was the problem, but that didn’t solve it. Then I tried on another pair of my glasses (same frames, different prescription — one of the equalized pairs) to see if they fit better, and yes, they did. To a casual observer, the first pair were not obviously crooked, but it was more clear when I put on the other pair.
Now I’m able to focus pull on the Snellen once more. But I won’t know for a while to see if I can bring my numbers up past 36 cm again.
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For the full thread, click the link to the topic above. It does include some of my own observations.
You wouldn’t notice the effect of crooked glasses if you have a strong prescription and never challenge your eyes for focus. It’s one of the many (questionable) benefits of the current mainstream prescription paradigm – the glasses are so strong that you see clearly, no matter what. Of course that’s also where the increasing myopia comes from.
Since the refraction in your glasses lens changes depending on where you see through it, crooked lenses change your effective focal plane (and prescription) to some degree.
You can try this yourself by moving your frames on your face, especially while looking at some distant writing that you can barely read. Having a challenging reference (much like an eye chart at the optic shop) allows you to see to what extent moving the lens in front of your eye affects your immediate vision.
There is more subtle effect that you may not immediately perceive, that can come from crooked lenses. A lot of it happens in your brain’s visual cortex, which may have trouble dealing with a sudden change in focal plane.
Your optometrist is trained to assess where the optical center falls on the frame you buy, and adjusting the frame for your face. Crooked glasses defeat much of this, and can cause other side effects (headaches, nausea, noticeable eyesight fatigue).
When you move from the single prescription paradigm to a rehabilitative use of glasses, you will start noticing when the focal plane isn’t quite where it should be. You also notice the effects of too much close-up time and poor lighting. All of these things are beneficial and necessary to help protect your eyes, as well as recover healthy vision.
I often talk about reducing prescription complexity. The simpler the focal plane change, the less chance there is for something like crooked glasses to affect your vision. All of the steps we take for protecting your vision are designed to be both simple to implement and also safeguard you from hurting your eyes.
What’s the short answer to crooked glasses vs. worsening eyesight?
No, crooked glasses probably won’t make your eyes worse. They can slow down your ability to improve your eyesight, though. And they can cause headaches and dizziness and generally feeling unwell. And if you use your full distance prescription for close-up, your glasses will make your eyes worse, whether or not they are crooked.
So it is a good idea to make sure your lenses are set up correctly, to avoid negative side effects.
What about glasses you ordered online?
If you ordered the glasses online and input the correct values for PD and frame size, you are likely getting a well set up lens. While a good optometrist is still the best choice, the online shops tend to have a very reliable setup that tends to deliver properly.
I hope you are enjoying some healthy eyesight today!
Myopia is a combination of NITM and lens-induced causes. In many cases, eyesight can be rehabilitated. Read more here ..
After brief periods of nearwork, some younger patients complain of transient distance blur that is correlated with a transient pseudomyopic shift in their distance refraction. This phenomenon has recently been documented objectively. However, there is lack of objective documentation demonstrating the effects of conventional optometric vision therapy in symptomatic individuals manifesting this “abnormal nearwork-induced transient myopia” (ANITM). Five symptomatic subjects received 7 to 10 weeks (5 to 6 sessions) of accommodative facility vision therapy (i.e., lens flippers and Hart chart). Objective recording of their ANITM and its decay were taken before and after the vision therapy, using a Canon R-1 autorefractor. A daily log was maintained, describing qualitatively their nearworkrelated symptomatology. After therapy, there was marked reduction of symptoms and considerable improvement in clinical accommodative facility measures, as well as improvement in the objective findings. These results demonstrate multi-faceted positive effects of optometric accommodative vision therapy in this diagnostic group of symptomatic individuals.
