Eyesight without glasses

[peterg]

Hi Jim,

Let me add some context of my personal situation, which is still evolving and I have my own questions that I am still struggling to understand.

I started in early December to work without glasses at my computer.  I think I had to pull up to about 14-15 inches initially and it was a struggle to maintain it.  So, it sounds like my eyes were slightly better than your starting point, as you say 10 inches.  In the course of a month or so, I was able to get to around normal reading distance -- or about 20 inches.

Unfortunately, I can't compare the big E with your big E vision to tell you what I saw.  I did not look at an eye chart before I started naked eye computer work.  However, on Dec. 22, 2011 I did put up an eye chart, and I could only make out the big E.  It was still very blurry.  During that first view, I squinted and saw I could also make out the next line when squinting.  Then after squiniting at it for a while, I noticed I could do slightly better with that next line.  I can't say I was reading it, and I have my doubts becuase I had squinted and seen it was F & P, but i  seemed slightly better just from the squinting I had done for a few minutes.  Over the next severl days, I started making out the next row after the FP, or 20/70.   The major problem I had, was questioning whether it was at all meaningful, as it was all rather blurry, from Big E (20/200 to the 3 letters of the 20/70 line).  I had read stuff where various eye doctors suggest the person is just learning to decipher the blur.

So, keeping all that in mind, with continuous doubt in my mind (even today), I know that I have been starting to see better.  In my situation, I have come to believe I actually see double (or maybe triple) in the distance, and that over time my eye has compensated for that (along with the distance glasses, so instead of seeing double my brain would just blur it all out unless it was close enough to see.

Just my layman's feelings.

Right now, my main hope is to conquer my disability of seeing double (or triple) in the distance.  I get glimpses of being able to do that, but it takes effort.  But, if I conquer that problem, then I am fairly certain I will no longer need distance glasses for everyday life, including for driving.  Still need to figure out the night vision thing though.

I do think it is also important to note, that in my situation I got occasional sudden bursts of clear vision.  I got them without having used plus glasses but rather just using my plain old eyes at the blur along with staring into the distance unaided.  I have now moved to plus glasses, in an effort/hope to accelerate or continue with the improvement.

[peterg]

Otis - your basic optics math:  0.4 meters, or power of 1/.4 = 4 diopters.  That division is 2.5 diopters.  Did you make a mistake?  Just asking so that it is clear.

[OtisBrown]

Peter -- thanks for catching the typo I made.
Further commentary on your use of the plus.

Peter> I do think it is also important to note, that in my situation I got occasional sudden bursts of clear vision.  I got them without having used plus glasses but rather just using my plain old eyes at the blur along with staring into the distance unaided.  I have now moved to plus glasses, in an effort/hope to accelerate or continue with the improvement.

Otis> When you were "deeper" into nearsightedness, and has problems with the 20/100 line -- I tend to agree with you, that just not wearing a minus is a good idea.  You also established that your self-measured refractive status is -1 diopter.  Knowing that fact is empowering in my opinion.  I personally think that if you are seeing "flashes" of 20/20, but an average of 20/60 -- you are in excellent shape.  I know you are using a +1 at this time, and I would hope you continue.
Otis

Otis - your basic optics math:  0.4 meters, or power of 1/.4 = 4 diopters.  That division is 2.5 diopters.  Did you make a mistake?  Just asking so that it is clear.

[jansen]

Hello everyone,

In my opinion, it is basically whatever you are comfortable reading with. But generally, people around 20/60 do use a +1.00-+1.50 or so. When you are around 20/40, i would recommend switching to +2.00.

[OtisBrown]

Hi Jansen,
I know that pilots who are starting with the plus (at 20/60 to 20/70) begin with a +1.5 to +1.75 for all close work.  As they "exercise" with the plus, and other methods, they notice that 1) There Snellen slowly starts to get better, i.e., they see 20/40 and 20/50 better and 2) They notice that they can begin to use a +2 to +2.25 diopter at the same distance where they could only wear the +1.75.  This is because the eye slowly changes its refractive status in a positive direction, and you measure this with you Snellen and this method.  I did the extra step of obtaining test lenses just to protect myself, to make certain that I was in full control of my vision.  Otis

Hello everyone,

In my opinion, it is basically whatever you are comfortable reading with. But generally, people around 20/60 do use a +1.00-+1.50 or so. When you are around 20/40, i would recommend switching to +2.00.

[jimnicol]

Hi Jim,

Let me add some context of my personal situation, which is still evolving and I have my own questions that I am still struggling to understand....

Thanks, Peter...I definitely see double at distance without my glasses...looking at power lines for example there are two images...one dark and a lighter one, almost like a shadow of the first. I'm sort of on hold, waiting for my Zenni glasses, which are 1/2 a diopter weaker than my current prescription, to come in. Hoping that after wearing them for a while I'll see some improvement.

[Todd Becker]

I definitely see double at distance without my glasses...looking at power lines for example there are two images...one dark and a lighter one, almost like a shadow of the first. I'm sort of on hold, waiting for my Zenni glasses, which are 1/2 a diopter weaker than my current prescription, to come in. Hoping that after wearing them for a while I'll see some improvement.

Jim,

The double image you are seeing is actually a good sign.  As I've described in earlier posts on this thread, the retina is not a single focal plane but has some depth.  So the darker, crisper image you see is in focus, whereas the fainter blurry secondary image is in a different focal plane, and thus out-of-focus.  

The more you practice focusing on the darker, crisper image, the more prominent it will become.  Eventually, the fainter secondary image will fade away and you'll have improved your vision! You can do this even without wearing any special lenses.

Try it and see if it works for you like it did for me and others.

Todd

[OtisBrown]

Question for Peter:
You had mentioned "seeing double" -- which is an effect that some people see as they are working with the plus.  Some people simply don't see this temporary effect.

Peter obtained some low-cost test lenses from Zennioptical. 

I wonder if you could check your vision WITH a -1 diopter, and determine if you see "double" of your Snellen though that -1 to -1.25 lens.

That will be helpful for all of us to know.

Thanks!

[peterg]

Hi Otis,

In fact I did this double-vision test last week.  With -1 on my eyes (both eyes), I seemed to be viewing a clear snellon chart.  When I used -.75 on both eyes, I ended up seeing double, which again I could work on fusing through in order to clear my snellon.  So it seems somewhere between -.75 and -1 is when I get the problem.  I should add, my double vision is not always in the same place.

Example, sometimes I see:
1.  A A  (side by side - I think the majority of time)
2.  A
     A  (on top of each other)
3.  A 
        A  (some sort of diagonal)

Peter

[jimnicol]

I definitely see double at distance without my glasses...looking at power lines for example there are two images...one dark and a lighter one, almost like a shadow of the first. I'm sort of on hold, waiting for my Zenni glasses, which are 1/2 a diopter weaker than my current prescription, to come in. Hoping that after wearing them for a while I'll see some improvement.

Jim,

The double image you are seeing is actually a good sign.  As I've described in earlier posts on this thread, the retina is not a single focal plane but has some depth.  So the darker, crisper image you see is in focus, whereas the fainter blurry secondary image is in a different focal plane, and thus out-of-focus.  

The more you practice focusing on the darker, crisper image, the more prominent it will become.  Eventually, the fainter secondary image will fade away and you'll have improved your vision! You can do this even without wearing any special lenses.

Try it and see if it works for you like it did for me and others.

Todd

Thanks, Todd...I'll work on that.

[peterg]

Update. 

I patched my right eye (dominant) for about an hour yesterday when using the computer screen, to force the left to do all the work.  The reason I did this, was that after many years of my right, dominant eye being weaker, my vision therapy over the last few months has caused my right eye to actually become stronger then the left!

This morning, I tested on my eye chart and for the first time read all 8 letters of the 20/15 line correctly.. 

I asked my behavioral OD last Sunday if it would be possible via retinoscopy to quickly measure my eyes again.  It was done and measured right eye -.5,  left eye -1 then 30 seconds later, retest via retinoscopy left eye switched to -.75.

I will continue to do some patching occasionally, to help work the left eye as I hope for big benefits to my vision with more equally capable eyes that can work together.

The other thing to note, is that contrary to the idea of poor lighting in an OD office, I actually see my OD's eye chart better than my snellon at home.  I am conservative in my assessment, but at home I am fairly certain I am 20/40.   At the ODs office, the same sort of initial self-test puts me at 20/30.

[OtisBrown]

Dear Peter,

With all due respect, it is hard to get good accuracy with a retinoscope.  You have seen a change of 1/4 diopter in a period of minutes.  Your measurement using your own Snellen at home (that can be repeated as many times as necessary) can be far more accurate (in my opinion).  In this case, monitor your Snellen, and  verify 20/40 (with you stated it is).  Then hold up a -1/4 diopter lens.  Is the 20/20 line clearer?  Then the -1/2 diopter.  Does the clear the 20/20 line?  If it does, your refractive state is -1/2 diopters.  (I know your retina is good for 20/15, but this is a good standard way to check -- as you work to get the 20/20 line clear.

http://www.youtube.com/watch?v=ezOoPKZwNDk

I would also add, that since you are 20/40 to 20/30, on you "in home" Snellen, you day visual acuity will be quite a bet better in Sunlight -- probably 20/25 to 20/20.

The reason for this is that the aperture "closes", and increases depth-of-field.  But this means for all practical purposes you can drive a car in day with no lens.

Otis

Update. 

I patched my right eye (dominant) for about an hour yesterday when using the computer screen, to force the left to do all the work.  The reason I did this, was that after many years of my right, dominant eye being weaker, my vision therapy over the last few months has caused my right eye to actually become stronger then the left!

This morning, I tested on my eye chart and for the first time read all 8 letters of the 20/15 line correctly.. 

I asked my behavioral OD last Sunday if it would be possible via retinoscopy to quickly measure my eyes again.  It was done and measured right eye -.5,  left eye -1 then 30 seconds later, retest via retinoscopy left eye switched to -.75.

I will continue to do some patching occasionally, to help work the left eye as I hope for big benefits to my vision with more equally capable eyes that can work together.

The other thing to note, is that contrary to the idea of poor lighting in an OD office, I actually see my OD's eye chart better than my snellon at home.  I am conservative in my assessment, but at home I am fairly certain I am 20/40.   At the ODs office, the same sort of initial self-test puts me at 20/30.

[peterg]

Hi Otis, the reason I asked for the retinoscopy was to see what the OD would measure that way.  This was just self-interest with me wondering.  Although I am not sure of the process, would it be safe to say in a regular exam the OD does retinoscopy, and then proceeds to test with lenses using the retinoscopy results as a starting point.  This difference in retinoscopy results may also just be showing the same thing I show when I look at the eye chart and get a variable response.  Initially I do not see 20/20, it is after a bit of work which is getting more and more minor that I begin to clear 20/30, 20/25, and 20/20. So it is all in some ways interesting to me.  I guess the main thing I am waiting for is the day I can look in the distance, and not see blur far away (even if I can't read a very distant sign) and hold it.  I think this means sight to infinity (correct me if I am wrong).  I believe I have had glimpses of that if not daily, certainly more than on one occasion.  It is sort of like the eye chart, I can't necessarily hold it long, but the length and frequency is improving.

[OtisBrown]

Hi Peter,
In my judgment learning HOW to make a measurement, and MAKING IT YOURSELF -- WITH CONFIDENCE -- is what prevention is all about.  As you know, I report "variation" in my Snellen, running from 20/25 to 20/18 to perhaps 20/15.  I think that is the variation you are seeing, and I think it is completely normal.  As your refractive state changes, you will see the AVERAGE of what you read slowly change from 20/40 to 20/30, to a more steady 20/25, 20/20, and perhaps 20/18.  I like the idea that you personally check this change in refractive state, using your own trial-lens kit.  The two measurement are very similar, but the measurement you will believe is THE MEASUREMENT YOU MADE YOURSELF -- OBJECTIVELY.

As you know, I go to an ophthalmolgist for MEDICAL checks.  They check my refractive state with the retinoscope, but I always check myself at home.  That is how I separate my personal responsiblity to myself, from a medical responsibility.  When you start getting in the range of 20/30 to 20/18, you can largely avoid wearing a minus lens.  But I also believe, that if you keep wearing the plus (increased from 2.0 to 2.5) your refractive state will become more positive, and you will begin to see in the range of 20/25 to 20/18 very consistently.

The chart you read is OBJECTIVE on your part.  Looking in the distance, while impressive, is subjective.  The goal is to, in a consistent manner, begin reading your chart at the 20/25 to 20/20 range -- however long it might take to get there.

Otis

Hi Otis, the reason I asked for the retinoscopy was to see what the OD would measure that way.  This was just self-interest with me wondering.  Although I am not sure of the process, would it be safe to say in a regular exam the OD does retinoscopy, and then proceeds to test with lenses using the retinoscopy results as a starting point.  This difference in retinoscopy results may also just be showing the same thing I show when I look at the eye chart and get a variable response.  Initially I do not see 20/20, it is after a bit of work which is getting more and more minor that I begin to clear 20/30, 20/25, and 20/20. So it is all in some ways interesting to me.  I guess the main thing I am waiting for is the day I can look in the distance, and not see blur far away (even if I can't read a very distant sign) and hold it.  I think this means sight to infinity (correct me if I am wrong).  I believe I have had glimpses of that if not daily, certainly more than on one occasion.  It is sort of like the eye chart, I can't necessarily hold it long, but the length and frequency is improving.

[jimnicol]

Hi again, just an update from here. I got my Zenni glasses at -4.50R -4.75L (down from -5.00R -5.25L) and also picked up from eyewebcare.com contact lenses at -4.25R -4.50L. The glasses are a little uneven (L is more underpowered than R) so I'm getting another pair reducing the R lense to -4.25 to even things out and give both eyes the same room to improve. After a week I was getting along fine with the glasses, to the point where I don't really notice any deficiency with both eyes open, and only a little weakness in L eye if I close my right. And with the contacts I was reading 20:20 on the 20' eye chart after 3 days. I'm thinking I won't even get through the 1 box (6 lenses) I ordered because I'll want to reduce the prescription by another -.5 fairly soon.

Haven't done much with plus lenses yet...all they do with close work is bring things into focus; there's no plus blur for the eyes to work against.

Thanks again for all the help...it's starting off quite encouragingly for me.