Getting Stronger: Discussion Forum

Discussion Topics => Rehabilitation => Topic started by: Tom on July 11, 2013, 07:17:35 PM

Title: A Compendium on Myopia Rehabililation
Post by: Tom on July 11, 2013, 07:17:35 PM
A Compendium on Myopia Rehabilitation (CMR) - Overview

This post serves as the table of contents of my thought on myopia rehabilitation. CMR is an ongoing project documenting my own experimental and theoretical conclusions, and research findings on matter pertaining to myopia development and its reversal. I intend to expand this topic so that it becomes one of the most comprehensive and detailed resource on myopia rehabilitation on the Web. Although CMR is designed with the general public in mind, it seeks to provide both practical and technical information in an accessible manner, without compromising the details.

There are different types of myopia, each with possibly different underlying causal mechanism. CMR mainly focuses on the so-called near-stress-induced myopia. This comprises both Nearwork Induced Transient Myopia (NITM), and what is commonly referred to as Axial Myopia (most eye professionals don't recognize different kinds of axial myopia). Near-stress-induced-myopia accounts for the very vast majority of myopia.

As you go through the posts, you might occasionally encounter fancy words here and there, or maybe you just want to find some answers quickly. In these cases, "Glossary and Q&A - Part I" (http://forum.gettingstronger.org/index.php/topic,538.msg5043.html#msg5043) and "Glossary and Q&A - Part II" (http://forum.gettingstronger.org/index.php/topic,538.msg6917.html#msg6917) could be useful.

Disclaimer

While I strive to aim for accuracy, the information found under this topic do not constitute medical advice. Consequently, the readers are solely responsible for their own actions.

As an entry point, I strongly encourage you to start your journey with this article (http://frauenfeldclinic.blogspot.ca/2014/02/about-alex-frauenfeld-frauenfeld-clinic.html). You will understand much better the history of myopia treatments, and the inner working of medicine in general.

I only report what works for myself and what I think is true. For similar and more accessible resource on myopia rehabilitation, check out Endmyopia.org (http://endmyopia.org) (found by Dr. Alex Frauenfeld, currently maintained by the non-medical anti-guru and renegade Jake Steiner (http://jakesteiner.com)).

Articles/Links under this topic

Practical Recommendations

Primers

Reviews of Research Studies

Personal Findings/Stories

Appendix
Title: Re: A generalized system for myopia reversal
Post by: mailliam on July 12, 2013, 01:42:12 AM
Hey Tom,

Is the far point 6m/20ft away? Is that number only for an emmetropic person? Would it be further for a myope?

Is there a way to figure out how much closer the far point would be according to the strength of a plus lens?

So based on your post, would a routine like this work (for a myope, without using glasses)

I spend X minutes looking into the horizon until I feel my eyes straining. I then look at something at the far point (accounting for my level of myopia), tolerate the strain and then look back at the horizon.

Is this right?


Liam
Title: Re: A generalized system for myopia reversal
Post by: johnlink on July 12, 2013, 10:53:51 AM
The focusing muscles, ciliary muscles, is really a pair of 2 muscles - one for negative accommodation, and the other for positive accommodation. Don't feel like looking up the names, so let's just call it negative ciliary and positive ciliary, respectively.

My understanding, which I've never seen contradicted until I read your statement above, is that the ciliary muscles do only one sort of accommodation, i.e, they make possible near focus. The more contracted they are the closer we can see. If you have information that there is a second type of muscle that contracts in order to focus further away, please supply the appropriate references, at a minimum the name of the muscles. Otherwise it seems that we have to reject your statement above as an unfounded conjecture.

This reference discusses the antagonist of the ciliary muscles, but the antagonist is not a muscle: http://books.google.com/books?id=GD0CAAAAYAAJ&pg=PA279&lpg=PA279&dq=antagonist+%22ciliary+muscle%22&source=bl&ots=iY2VNvKwAc&sig=nnr86IQaq5fic-OP6L6bd7012H4&hl=en&sa=X&ei=5k7gUaKbNs364AO-kYDwBQ&ved=0CFkQ6AEwBQ#v=onepage&q=antagonist%20%22ciliary%20muscle%22&f=false
Title: Re: A generalized system for myopia reversal
Post by: Steven on July 12, 2013, 12:56:44 PM
Hey Todd and Otis. Yesterday I had a spark that I think will fill the missing puzzle in curing myopia. I think now that we have learnt all we need to know about reversing axial myopia.

I'll be trying to compile my insight into my blog. But in the meantime I think you have to share this discovery with you guys, because you pointed me to the right direction. The discovery, in essence, is just one last extension (the most important one) of Todd's ideas:

========
Basic Phenomena
========

The mammal eye is a very flexible organ that responds very quickly to stimulus.

The focusing muscles, ciliary muscles, is really a pair of 2 muscles - one for negative accommodation, and the other for positive accommodation. Don't feel like looking up the names, so let's just call it negative ciliary and positive ciliary, respectively.

1) Close strain: this is the symptom of negative cililary spasm. It happens when the eye focuses on objects closer than its far point. The closer to the object, the greater the close strain. Subjectively, the close strain feels like a force pushing the front of the eye inward.

2) Far strain: this is the symptom of positive ciliary spasm. It happens when the eye focuses on objects farther than its far point. The farther the object, the greater the far strain. Subjectively, the far strain feels like a force pulling the front of the eye outward.

Important remark: since the ciliary muscles are a antagonistic pair. In the simple situation of the naked-eye, both strains are mutually exclusive. That is:

1) both strains can't happen at the same time
2) When a close strain is felt, inducing a FAR strain would eliminate the close strain.
3) When a far strain is felt, inducing a CLOSE strain would eliminate the far strain.

=========
Cause of Axial Myopia/ Axial Hyperopia
=========

Myopia: chronic close strain along with eye susceptible to negative adaptation. It's possible that the strain come from multiple sources (e.g., constantly focusing within far point, wearing minus lenses, or both)

Hyperopia: chronic far strain along with eye susceptible to positive adaptation. It's possible that the strain come from multiple sources (e.g., constantly focusing beyond far point, wearing plus lenses, or both)

=====
Furthur Complications
=====

1) To stop axial myopia from progressing, eliminating chronic close strain is necessary. However, that alone can only cure pseudomyopia, not axial myopia.

2) To stop axial hyperopia from progressing, eliminating chronic far strain is necessary. However, that alone can only cure pseudohyperopia, not axial hyperopia.

The MOST important insight: to cure both, we need to reshape the eyeball. We can achieve it via inducing the opposite chronic strain APPROPRIATELY. That's the real reason why the eye is reshaped (i.e., the eye is not reshaped because you're focusing on the edge of blur or whatnot, in fact it doesn't even need to, all it needs to cure, say, myopia, is an appropriately applied chronic far strain.)

======
Solutions
======

Since the ciliary muscles are muscles, we can apply the stretch-and-release technique to reshape it accordingly.

1) Myopia reversal: there are many variations of different aggressiveness. But the essential idea is to induce far strain (e.g., by focusing beyond far point) UNTIL the strain become unpleasant, and then release the strain by focusing on the far point, UNTIL the strain become tolerable. And repeat the cycle.

NOTE: Plus lenses shifts the far point closer to the eye. Consequently, applying the stretch-and-release technique is more effective with plus lenses. The higher the plus the better, GIVEN that it's used exactly as instructed in 1) (If you're using a +6 plus lenses, then you better make sure you're an expert in this)

2) Hyperopia reversal: again, the essential idea is to induce close strain UNTIL the strain become unpleasant, and then release the strain by focusing on the near point, UNTIL the strain become tolerable. Repeat the cycle again.


======
The End
======

The chronic strain theory seems to eliminate most inconsistencies I've found in the literature and the forum. Any Questions? Criticisms? Drop a line here, I'll be more than willing to answer. :)

Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.

Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.

2 main things you must do :

a) Forget about minus lenses (use under prescription / half prescription only in urgent cases)
b) Put the strongest plus you find and make a walk in the house, look outside the window, go in the park and either stay on a bench or make a walk etc.

You should be able to walk and see something in parks.
Buy plus glasses that cover as much as possible the whole field of view.
Small glasses are not that efficient.

That's it.
When reading a book you can use +2 or more.
Title: Re: A generalized system for myopia reversal
Post by: Steven on July 13, 2013, 12:46:34 AM
Quote

Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.


I really don't think this is a good and responsible advice for everyone. Putting a +6 lens will cause too much far strain on the person, who is just starting to get used to it. If done improperly, this could cause eye tears leading to other more serious consequences.

It's not just black and white - just like in orthodontics, if you put too much stress on your teeth, it might just break. And everyone has a different breaking strength and adaptation speed.

<quote>
Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.
</quote>

By the way, I personally don't rehabilitate in front of computer. Remember to avoid overbrightness (just middle brightness) and don't staying too close to it. Your eyes can get burned before you know it.

<quote>

Try to follow me carefully.

1. It is very responsible if you want to obtain results with absolutely no side effects (like you get from surgery - loss of visible color spectrum, dried eyes, etc.). Far strain is perfectly fine and safe, because the human eye was made to spot and hunt animals and eat fruits from the trees while looking far away to see any predator.

Only the elongation of the eye in people with myopia is very dangerous since it leads to blindness. So it is irresponsible to put minus glasses on myopic eye because it leads to retinal detachment from the elongation.

http://en.wikipedia.org/wiki/Retinal_detachment

"Retinal detachment is more common in people with severe myopia (above 5–6 diopters), in whom the retina is more thinly stretched. In such patients, lifetime risk rises to 1 in 20. About two-thirds of cases of retinal detachment occur in myopics. Myopic retinal detachment patients tend to be younger than non-myopic ones."

So, using a plus lens no matter how strong is perfectly safe. That is why it is sold without needing a prescription in most shops / supermarkets !!!

The eye tearing can happens only on elongated eye, not in compressed eyes. So in people with myopia that experience retinal detachment.

Yes, It is black and white. If your posture is hunched you will develop a hump. If you stay strait you will avoid humps. The eye can reshape itself because it has no bones or stiff tissue in it, unlike the hump.

If you read that perfect vision book, the author said he stopped making progress with a +2 or so, because it became to weak, and in order for him to reach 20/20 and 20/15 he had to use a stronger plus most of the day.
Title: Re: A generalized system for myopia reversal
Post by: mailliam on July 13, 2013, 03:39:39 AM
             Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.

Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.

2 main things you must do :

a) Forget about minus lenses (use under prescription / half prescription only in urgent cases)
b) Put the strongest plus you find and make a walk in the house, look outside the window, go in the park and either stay on a bench or make a walk etc.

You should be able to walk and see something in parks.
Buy plus glasses that cover as much as possible the whole field of view.
Small glasses are not that efficient.

That's it.
When reading a book you can use +2 or more.

Hey Steven, a question. Is it beneficial to be using plus lenses for distance viewing? I remember reading Todd in his initial article on how to throw away your glasses saying:

Quote
It is important to realize that the strong anticorrective lenses are only to be used for the activities for which your prescription glasses were least needed!  So for myopes, wear the plus lenses only for close work (reading and computer work); for hyperopes, wear the minus lenses when looking in the distance or across the room, but not when reading or at the computer

So for a myopic person:

Minus-lens + closeup work = BAD
Minus lens + distance viewing = OK (good if you have undercorrections that make objects slightly blurry)
Plus lens + closeup work = GOOD
Plus lens + distance viewing = ... bad?
Title: Re: A generalized system for myopia reversal
Post by: Steven on July 13, 2013, 12:30:22 PM
             Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.

Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.

2 main things you must do :

a) Forget about minus lenses (use under prescription / half prescription only in urgent cases)
b) Put the strongest plus you find and make a walk in the house, look outside the window, go in the park and either stay on a bench or make a walk etc.

You should be able to walk and see something in parks.
Buy plus glasses that cover as much as possible the whole field of view.
Small glasses are not that efficient.

That's it.
When reading a book you can use +2 or more.

Hey Steven, a question. Is it beneficial to be using plus lenses for distance viewing? I remember reading Todd in his initial article on how to throw away your glasses saying:

Quote
It is important to realize that the strong anticorrective lenses are only to be used for the activities for which your prescription glasses were least needed!  So for myopes, wear the plus lenses only for close work (reading and computer work); for hyperopes, wear the minus lenses when looking in the distance or across the room, but not when reading or at the computer

So for a myopic person:

Minus-lens + closeup work = BAD
Minus lens + distance viewing = OK (good if you have undercorrections that make objects slightly blurry)
Plus lens + closeup work = GOOD
Plus lens + distance viewing = ... bad?

I don't agree with that logic.

If you put a minus lens on a monkey it will go myopic no matter if the monkey looks far or close. (of course it will become more myopic if it looks close with the minus lens.

Same with plus. (of course you will get rid of myopia faster if you look far away with a plus then reading a book with a plus)

If you don't want to waste time like i did initially by testing various stuff myself - step by step, buy a strong plus go outside on a bench in the park and enjoy better vision every single day.

Same indoors. Find activities that do not need good eyesight.
Title: Re: A generalized system for myopia reversal
Post by: Steven on July 13, 2013, 12:40:20 PM
Quote
The eye tearing can happens only on elongated eye, not in compressed eyes. So in people with myopia that experience retinal detachment.

Hey Steven, with all respect, the human eye is really more complex than you think.

When you're wearing plus lens and looking far, your cililary might be relaxed, but it's precisely because of that that your zonular fibers are now tense. This probably explains why your eyes feel being pulled, outward.

A tear can happen everywhere. While plus lens doesn't increase the risk of retinal detachment, it could very well increase the risk of cornea tears, if misapplied.

Which again makes sense. Why would you minus lens cause harm and not plus lens?

Stating general things without specific data won't help you prove your theory, like: "the human eye is really more complex than you think"

Why don't you try a +6 look far away and see the stunning results on a snellen ?

You can apply a plus lens only in one way, by using it !
The cornea does not get teared up because the eye is no longer elongating under the effect of a plus. The eye ball is getting shorter and shorter and the visual system is more relaxed.

Only thing you can do to hurt cornea is this :

http://en.wikipedia.org/wiki/Corneal_abrasion
Title: Re: A generalized system for myopia reversal
Post by: mailliam on July 13, 2013, 02:26:52 PM
             Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.

Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.

2 main things you must do :

a) Forget about minus lenses (use under prescription / half prescription only in urgent cases)
b) Put the strongest plus you find and make a walk in the house, look outside the window, go in the park and either stay on a bench or make a walk etc.

You should be able to walk and see something in parks.
Buy plus glasses that cover as much as possible the whole field of view.
Small glasses are not that efficient.

That's it.
When reading a book you can use +2 or more.

Hey Steven, a question. Is it beneficial to be using plus lenses for distance viewing? I remember reading Todd in his initial article on how to throw away your glasses saying:

Quote
It is important to realize that the strong anticorrective lenses are only to be used for the activities for which your prescription glasses were least needed!  So for myopes, wear the plus lenses only for close work (reading and computer work); for hyperopes, wear the minus lenses when looking in the distance or across the room, but not when reading or at the computer

So for a myopic person:

Minus-lens + closeup work = BAD
Minus lens + distance viewing = OK (good if you have undercorrections that make objects slightly blurry)
Plus lens + closeup work = GOOD
Plus lens + distance viewing = ... bad?

I don't agree with that logic.

If you put a minus lens on a monkey it will go myopic no matter if the monkey looks far or close. (of course it will become more myopic if it looks close with the minus lens.

Same with plus. (of course you will get rid of myopia faster if you look far away with a plus then reading a book with a plus)

If you don't want to waste time like i did initially by testing various stuff myself - step by step, buy a strong plus go outside on a bench in the park and enjoy better vision every single day.

Same indoors. Find activities that do not need good eyesight.

For an emmetropic monkey yes I agree, but for a monkey that is already myopic I don't think so.

What's been your speed of progress using the +6? What was your initial prescription and are you at 20/20 (or better) now?


Title: Re: A generalized system for myopia reversal
Post by: Tom on July 15, 2013, 10:45:51 AM
Some Positive Testimonies

Case 1 - Shadowfoot

Shadowfoot is one of the success examples among low myopes. He started out here wearing plus lens, got some improvement, but had to drop the plus lens because he was getting red eyes.

[EDIT: Don Rehm gave an explanation as to why staying beyond one's far point could lead to red eyes, and suggests that it is a benigh symptom of negative accommodation.]

Quote
because I was holding the book beyond the far point, where it was a little blurred, the ciliary muscle was making an active effort to relax. This negative accommodation called for an increased supply of blood to the ciliary muscle (located in the area surrounding the iris). It was this increased supply of blood that caused the slight redness, and it was an indication that the eye was really working hard at relaxation. I could see a similar situation in weight lifters whose skin becomes redder in the area of muscles that have just had a hard workout.

The incredible part really happens after this. Namely, Shadowfoot was still improving. And he does so by:

With these routines, Shadowfoot eventually went from 20/40 to 20/20 (see Todd's interview with Shadowfoot here (http://gettingstronger.org/2012/04/how-one-person-improved-his-vision/)).

Case 2 - CapitalPrince's Father

As with Shadowfoot, CapitalPrince's father is also a low myope starting with 20/40. As opposed to some myopia rehabilitators, he felt that reading glasses doesn't exert enough force on his eyes. However, he made a commitment to the following routine:

CapitalPrince's father's persistence clearly paid off quickly. In only 2 months, his visual acuity became better than 20/20.

Case 3 - My Brother

I knew that giving only testimonies of low myopes recovering from myopia will not satisfy the skeptics, as it could be argued that these rehabilitators only had pseudomyopia to begin with.

So here comes my brother, who started wearing minus prescription relatively late (probably around the age of 14). He didn't really like the glasses, and he rarely reads.

By the time he finished his degree, he was using a minus (his worst prescription was around -4D I believe). His myopia didn't really bother him anyway.

And then, around 2010, I advised him to not use his minus prescription for most purposes, and to use it only to see far. I have rarely see him wearing glasses afterwards.

Just recently, he returned from a 4-day vacation to a tourist site on a mountain. He told me that he spent his days playing mini-golf, riding a physical "mario cart", swimming, mountain hiking, tarzan-ing (use your imagination) - Just plenty of outdoor activities.

But something he mentioned got my attention. Out of the blue, he claimed that his vision improved. I knew better and decided to check him out.

I made him to look at the Snellen at 6m, naked-eye, he wasn't able to read any letter. This suggests that his myopia is at least, more than -1D.

I instructed him to find out his far point. And I got 88cm. This suggests that he is -1.13D. However, there's always the possibility that his far point is actually closer. A more conservative refraction estimate would be -1.5D.

This is a very interesting finding. My brother works 8h in front of computer (and is regularly on his iPhone) as with most people. However, but he is regularly outside as well.

Case 4 - Alex_Myopic's Experience

Alex_Myopic has the say this time:

Quote
After doing some active focusing on Snellen chart at 10f  for the third or fourth time (as CapitalPrince suggested) I noticed a greater result. After some minutes I managed to clear my vision almost half diopter and had 10/10 vision without hard blinking or squinting. I wonder what this mechanism is? Somehow after minutes of active focusing the brain manqged to relax the lenses of the eyes for some time.

Last Words

More testimonies will be gathered as our myopia rehabilitation community expands over time. I guess we will just wait and see. If you have any positive experience, do consider taking the time to post it. Who knows, perhaps you might find yourself on this page! 8)
Title: Re: A generalized system for myopia reversal
Post by: chris1213 on July 15, 2013, 06:10:13 PM
TomLu, your statement is very interesting for me and I believe you might be right.

When I first read Todd's article about reversing myopia with the plus lens method (november 2012) I could only see the 20/200 line on the Snellen chart (-2.00 on my right eye and -1.5 on the left one). I started doing print pushing with plus lenses using +0.5 and then some +1 glasses. Even with those I could barely focus so I had to push back and forth every time I used them and suddenly, after some weeks to a month, I woke up being able to read the 20/70 line. After that I started getting used to the +1 lenses and stopped having to move back and forth to focus. I just stayed at the edge of blur. Since then my recovery started getting slower. In February I started being able to read the 20/60 and sometimes the 20/50 line so I upgraded to some +2 lenses and again had to move back and forth to focus. In April I was able to read the 20/50 most of the time and sometimes (mostly mornings) I could read the 20/40. But I just hit the plateau after that.

I think you're right because my fast changes happened when I couldn't really stay at the edge of blur and had to move back and forth to focus. This is really hopeful information and I'm going to experiment with this and hope to have some good news for you after a time.
Title: Re: A generalized system for myopia reversal
Post by: OtisBrown on July 16, 2013, 02:48:53 AM
Hi Chris -
Let me congratulate you on "coming back" from 20/200 (That is considered 'legal blindness' - if you can not read that line.)

Getting close-to 20/50 and 20/40, is indeed both slow and difficult.  I like to say that the "last diopter" is the most difficult, and requires more consistent effort with the plus.  Your experience is correct and consistent with what *I* know.  That is that our eyes go "down" at a rate of -1/2 diopter per year, so logic should tell us that going "up" will be at that rate also.

But the great issue of self-checking and measurement - is that you KNOW this.  As you confirm the 20/40 line, you can play sports, tennis, etc., with NO MINUS LENS.  You can also get any minus lens from Zennioptical for about $10.

I understand the idea of "plateau", and the frustration of it.  But equally, you know you can continue to wear the +2.0 for all close-work, and keep a cheap -1.0 diopter in your car - and just wear it when driving.  For me, objectively passing the 20/40 line is great success.  (Yes, I want "better") but it is good to have a reasonable goal in your life - that you can pass.

Otis



TomLu, your statement is very interesting for me and I believe you might be right.

When I first read Todd's article about reversing myopia with the plus lens method (november 2012) I could only see the 20/200 line on the Snellen chart (-2.00 on my right eye and -1.5 on the left one). I started doing print pushing with plus lenses using +0.5 and then some +1 glasses. Even with those I could barely focus so I had to push back and forth every time I used them and suddenly, after some weeks to a month, I woke up being able to read the 20/70 line. After that I started getting used to the +1 lenses and stopped having to move back and forth to focus. I just stayed at the edge of blur. Since then my recovery started getting slower. In February I started being able to read the 20/60 and sometimes the 20/50 line so I upgraded to some +2 lenses and again had to move back and forth to focus. In April I was able to read the 20/50 most of the time and sometimes (mostly mornings) I could read the 20/40. But I just hit the plateau after that.

I think you're right because my fast changes happened when I couldn't really stay at the edge of blur and had to move back and forth to focus. This is really hopeful information and I'm going to experiment with this and hope to have some good news for you after a time.
Title: A Compendium on Myopia Rehabilitation
Post by: Tom on July 18, 2013, 08:43:12 AM
For the Parents Trying to Reverse Their Children's Myopia

Intro

First of all, condolence to the parents who are dealing with children, who either refuse to wear reading glasses or, if they do, read further within their far point.

Why are they reading further within their far point? Well, they can't see well. Children are accustomed to seeing things clearly and the experience of utter blur is just unacceptable for them. But why do they find blur unacceptable?

And why are they refusing to wear plus? Probably they are just lazy - they hate to have to work. Or is it because they don't feel good with it?

Case study: A 20/20 child

A brilliant child is doing well in school, and we want to help him avoid myopia. We reason that he can read comfortably at 40cm. So we give him a pair of eyeglasses of +2.5D to do it.

Then what happens? He puts on the glasses and feels an immediate tension in the frontal part of his eyes. He feels uncomfortable and scared and automatically lean closer to see - usually much closer than needed.

Although the prescription is optically correct. At 40cm he might still be experiencing close strain. In addition, the plus lens induces a kind of tension forcing ciliary relaxation - a tension whose intensity is determined by the strength of the plus lens in question.

(and he gets red eyes, that could very well be a benign symptom of the radial components of ciliary muscle doing its job)

There are at least two problems here:

Problem 1: Why children lean so close to an viewing object?

As children develop, some of them will remain emmetropic throughout their lives; others might become myopic. There is actually a rarely-explored key difference between the prospective emmetropic child and the prospective myopic child. Namely, that the prospective myope might just not know how to leverage his focusing ability to minimize blur. Instead, he would use peripheral vision to look at everything - And of course he would need to lean closer than needed to see well.

What happens next? The child believes that he is myopic and the parents bring him to see an eye doctor. The child then looks at the Snellen chart, as a whole, and concludes that he can't see well. He then gets his first minus lens.

In many of those first eye exams, if only the child focuses on each letter on the Snellen, instead of focusing on the Snellen as a whole, there's a possibility that the child can actually read all the letters on the chart.

Another question arises. Why then do those children choose to use peripheral vision instead? One speculation in the literature is that their central vision is not fully developed yet (since in child development, peripheral vision comes first and central vision comes much later). If that's the case, then it's probably a very bad idea to teach a young child to read, before they even learn to focus properly.

In some cases, when one acquires efficient focusing skill, they might realize in retrospect that part of their myopia is really just attention-related issues.

Problem 2: Plus lens induces too much strain
 
One thing that can be done is to increase the diopter of reading glasses by an increment of +0.5. We can start with +0.5, ask him how he feels about it, and wait a few days. Once the tension becomes manageable, we can give him a +1D. And then once more with +1.5D. Some children have less tolerance with +2D. However.

As with any person, a child can be conditioned to embrace the blur too. For example, he might initially complain about the +0.5D prescription, but he might just get used to it after a week or so. It's important to eliminate that fear of blur, because once he does, he will know that he doesn't need to approach an object awfully close to see it clearly. The underlying theme is that blur clearing is only healthy and necessary, and that children can be conditioned to enjoy doing it.

All in all, we are better off administering weaker plus lens to children and have them read as far away as possible. Reading too close, even if beyond the far point, could induce proximal accommodation (as shown in the studies of microscopists), which in turn leads to more close strain.

Adjusted Plus Lens

Plus-lens-induced strain is also in part due to accommodation-convergence disturbance and oculomotor imbalance. To remedy this situation, one can use a plus prescription of ~1.5D with a weak base-in prism (to minimize the exophoric effect of convex lenses), or lessen the pupillary distance of the prescription to attain a similar amount of prismatic effect.

Fundamental changes in habit

Children play with what is available to them. If we have smartphone or iPad at home, they will probably become easily addicted to it. And if they can find dolls or legos, they will probably stick to them too.

Back then when computers were not commercially available, children still find ways to entertain themselves - mostly outside. Actually, if there were no addictive toy or gadget in the house, they'll most likely get addicted playing outside. Why not bring them to the parks, or let them play with non-agressive animals?

Besides,we can read the stories to our children, instead of having them read the stories themselves. Just like the adults, addiction is very hard to eliminate, hence a more sustainable approach would be to prevent the addiction in the first place. Don't just stop them from doing something, lure them into the activities that promote distance viewing. 8)

Summary

a) Teach our children how to focus, if applicable.
b) Increase the strength of reading glasses incrementally, but keep the strength relatively low, and the viewing distance relatively far.
c) Consider using a plus lens with base-in prismatic effect.
d) Avoid living in a near environment is still the best shot. Lure the children into entertaining distance activities.
Title: Re: A generalized system for myopia reversal
Post by: CK333 on July 18, 2013, 11:21:55 AM
TomLu, you are doing excellent work!!

I don't have children yet, but I had been wondering how I would best help to prevent myopia in them; in particular, which plus strengths to begin with.  What you say makes sense.

In regards to the stretch and release techniques you describe, I am wondering if this would be of a similar strategy: while at the office, I use a low strength plus lens for my computer work.  Since reading your posts, I have been using plus lenses at my far point/edge of blur, then taking them off.  I rotate between the plus and no lens, for about five minutes, on and off.  In fact, I can feel a slight stretch and pull when I do this.  Since the dipping technique would not be too feasible while at work, I figure this may be of similar benefit?  I'd love to hear your thoughts.

Keep up the insightful posts
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on July 18, 2013, 06:21:36 PM
Tom:

Interesting site! I've been interested in eyesight and how to improve mine since my first pair of glasses when I was 10. Now I am 59, with -5.5 in both eyes. In terms of using plus lenses, if I take off my glasses, does that count as the equivalent of having plus lenses? The edge of my clear vision is about 7 inches away from my face.

I have also come across David de Angelis's book "The Secret of Perfect Vision." He mentions the plus lens approach but also says we should do "ocular stretching" of moving the eyes together at the extreme edge of the eye sockets, and trying to maintain binocular vision. What's your view of this "stretching."?
Title: Re: A generalized system for myopia reversal
Post by: CK333 on July 19, 2013, 10:58:27 AM
Thank you Tom, I see your point.  I do admit that I need more distance viewing time/exercise, as I can see just how important it is.   :)
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on July 20, 2013, 03:41:45 AM
If you intend to go on not wearing glasses, then since your far point is around 20cm, you shouldn't try to look too too far away. You can't just take off your glasses and expect it to improve (that might work for pseudomyopia, but not axial). You got to work on some active focus-promoting thing like focus pushing or dipping.


Tom

Thanks for your reply. I understand focus pushing to be "working at the edge of the blur" to encourage the eyes to focus a little farther out (for myopes). What is dipping?
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on July 20, 2013, 09:48:50 AM
Call

Thanks for the lead to your July 14 post. I had not seen it before, and by coincidence this morning I posted something on my thoughts about the Feldenkrais method for working the blur! It's essentially the same thing taking advantage of the same principle that you described in dipping but more at near point.
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on July 23, 2013, 12:08:08 PM
Tom:

Thanks for your continued postings. I want to understand your latest entry and I am tracking through the past postings to find your definition of "far point" and "maximum starting point." Can you point me to the postings? I got the "equilibrium point" definition.

Also, you mention "zonular spasms" and in other postings the zonules being tense. This strikes me as odd, as I have always understood the zonules to be nothing more than suspensory fibers from the ciliary body holding the lens in place. The zonules and the ciliary body are not antagonist pairs, but please correct me if I am wrong.
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on July 23, 2013, 04:18:49 PM
I am not sure where this idea comes from that the zonules can become relaxed or tense. They are suspensory fibers whose only function is to hold the lens in place, and also transmit any contraction or release of the ciliary muscles to the lens.

I agree in principle with the theory of accommodation as you describe (I quotebelow), and the relationship between what happens in the ciliary muscles and the lens: when the former contracts, the latter thickens. But the zonules do nothing; they do not relax or thicken, and certainly do not exhibit a counter response to what the ciliary muscle is doing. If you find it counterintuitive that the action-reaction is such (one might think that only when the ciliary muscle relaxes does the lens become thicker), Schachar has a great theory.  I have seen it described elsewhere in this forum, using the Mylar birthday balloon as an analogy.



As with the zonular fibers, no, I think you are exactly right. Regardless which theory of accommodation you are subscribed to, standard textbooks suggest that zonules can not control itself, so cililary and zonules can't be antagonist pair. But what is still true is that when the cililary contracts, zonules relaxes, allowing the lens to thicken. And when cililary relaxes, the inner radius (of the cililary ring) increases, and the zonules (suspensory fibers) are now tense, allowing the lens to get thinner.





Title: Re: A generalized system for myopia reversal
Post by: Hillyman on July 24, 2013, 12:25:27 AM

But even Schachar's theory is still crucially similar to Helmholtz's, in the following sense: when cililary contracts, the anterior and posterior zonules become less tense, and when the cililary relaxes, the anterior and posterior zonules become more tense. That's why I said they work in "opposite direction."

In this context, the distinction between equatorial/anterior/posterior zonules becomes crucial, because the equatorial zonule does the exact opposite of what anterior/posterior zonules do. Of course, they are tense all the time, but that doesn't convey this subtlety.

I think the word you want to use to describe the state of the zonules is "taut," rather than "tense." This is because "tense" suggests an active change of state initiated within the zonules, whereas they are merely acted upon by the ciliary muscles. As an analogy in general musculature, a muscle gets "tense" resulting in the tendon connecting it to the bone becoming "taut" (and not "tense").

As to the roles of the equatorial/anterior/posterior zonules, it appears that in fact the anterior and posterior may have different roles and do not work in concert against the equatorial zonule as you suggest. See http://www.iovs.org/content/50/8/4017.full.pdf+html:

"Since the anterior and posterior zonules do not attach to the
lens in exactly the same manner, the respective effect of each
might also be different. The asymmetry in the anchorage points
and orientation of the anterior and posterior zonular fibers
suggest a different mode of action of each."

I think, though, we can probably leave the subtleties of the Zonules of Zinn (my favorite body part name) and continue to focus on the more interesting quest for improving vision. My latest fascination, based on my two weeks in this forum, is the realization that there could be some feedback loop between the tension in the ciliary body and the sclera and choroid layes in the eyeball, that the tension in the former promotes a thinning of the latter two, hence the elongation of the eyeball--in effect, they "speak" to each other into myopia. Talk about subtlety! Of course, through the defocus approach, we are trying for the reverse the signals!
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on July 28, 2013, 03:13:47 PM
Tom,

I like very much your highlighting the increase in the blur that is the effective mechanism to get the eye to improve. This is something worth practicing.
Title: Re: A generalized system for myopia reversal
Post by: Todd Becker on July 28, 2013, 03:26:47 PM
Staying at a slightly blur object is not the thing that helps. It's the incremental increase in blur over time, instead of the incremental blur....The object doesn't need to be close or far - it depends heavily on the ability of the eye to detect the increase in blur, rather than its ability to detect blur.

Tom, I think this is a very interesting idea.  It's a dynamic version of generalized blur-point defocus therapy.  It could be applied to print pushing, with or without plus lenses; or merely focusing around the blur point at various distances.  You may indeed be right that focal-feedback neurology of the eye detects changes in focus/defocus near the blur point better than it detects the absolute degree of defocus. 

Your self experimentation seems to lend to support to this idea.  It would be good to devise some controlled experiments comparing the dynamic defocus method vs. the static defocus method.  Or let's see if others try your method and report their results here.

Good thinking!

Todd
Title: A Compendium on Myopia Rehabililation
Post by: Tom on August 09, 2013, 10:34:06 AM
Close Work - Making it Beneficial

Intro

One of the factors affecting your recovery speed is the way you engage in close work. Regardless of which prescription you are using, you should take close strain seriously.

Lighting for close work

Close work is best done under moderately bright sunlight. If not possible, try to recreate the same environment indoor, with overhead fixture or standalone lamp.

Avoid using poor-quality fluorescent light bulbs. I'm not the only one who suffered from fluorescent light use. See Dr. Alex's post on this here (http://frauenfeldclinic.com/how-fluorescent-lights-kills-your-vision/). For more? See Energy-Efficient Light Bulbs (http://forum.gettingstronger.org/index.php/topic,538.msg5604.html#msg5604).

When reading on a screen (e.g., computer, smartphone), adjust the screen's brightness so that it's on par with the level of background lighting (which should be very bright). Reading under an overly bright foreground, along with a dark background, invites pupil dilation and with light burn.  8)

When done with the adjustment, try to read at the farthest distance possible, while making a conscious effort to relax. The light intensity increases "exponentially" as one moves towards the screen, so it's always a good idea to keep that in mind.

Prescription for close work

The single most myopiagenic activity is to read with a strong minus lens, which has the potential of inducing hyperopic defocus (either due to accommodation lag, or inherently prolate eye shape), or overconvergence (and its associated side effects). One should read either with the weakest minus lenses, or without glasses.

[Edit: The issue of eyeglasses frame got picked up. On the March 11 (2014) blog entry (http://frauenfeldclinic.com/depression-anxiety-might-want-avoid-frames/), Dr. Alex recommends frames with minimal border. This is yet another way to free up the peripheral vision. In general, we only want to correct the central vision when using minus lens, so a smaller frame without border is desirable. For those using plus lens, a bigger frame would tend to positivitize peripheral defocus, and hence is preferred for myopia rehabilitators. Personally, I prefer aviator-style frame with peripheral add, because they are stylish and sufficiently large, to the extent that one can't detect the frame border within one's visual field.]

A traditional minus spectacle has an uniform power across all meridians. Consequently, reading at one's far point with these minus lenses might still induce hyperopic defocus in the periphery. One way to minimize that defocus, is by adding positive cylinder value to your prescription (e.g., -3D with cylinder +1D at 0° axis, as a reading prescription of a -5D non-astigmatic myope). The 0° axis is preferable, since reading is usually done from left to right, in the horizontal meridian. Positivizing cylinder value is applicable regardless of the strength of reading prescription (e.g, be it -4D or +1D).

(Until lenses with peripheral design are widely available, it's pretty tough to eliminate peripheral hyperopic defocus at all meridians, while maintaining zero central defocus. However, if you use contact lenses and are resourceful enough, you should be able to obtain concentric-design bifocal contact with peripheral add online)

Several Tricks

To read as far as possible, one needs to find ways to increase the reading distance. This can be done by:
Here (http://www.myopia.org/ebook/12chapter7.htm) is Donald Rehm's recommendations on focusing distance:

Quote
The book or other material should be held as far from the eyes as possible. The distance from the elbow to the knuckles of the hand has been suggested as the minimum working distance. If the book can he propped up beyond arm's reach and read in this manner, this is even better. If you own or can afford to buy a projector that can project the pages of a book onto a screen across the room, this is better yet. In fact, this type of projector should be in every schoolroom and used by the teacher as much as possible in preference to asking the students to read from their books. If you ever watch a group of schoolchildren studying or writing, and pay particular attention to the distance between their eyes and their desks, you will note that many of them literally have their noses in their work.

When reading, the child should look up and into the distance momentarily at the end of each paragraph, or at least at the end of each page, to relax the eyes. Ideally, the chair should be placed to enable looking out a window or across the room when looking up.

[For similar ideas, see Dr. Alex's distance-vision tricks (http://frauenfeldclinic.com/keep-your-eyes-strong-glasses-free-distance-vision-tricks/)]

Ultimate Trick - The Magnifier Hack

My experience with close work is that reading at 1m (or beyond) with naked-eyes, in an open visual surrounding, essentially eliminates all near stress, thus allowing one to read hours upon hours without noticeable side effects.

For myopes of -1D or less, reading at this distance is easily achievable. For higher myopes, this is still doable to a certain extent, with the help of full-screen maginification programs, and fairly mobile keyboard and mouse (e.g., wireless keyboard):


Computer Work - Font and Color Scheme

The choice of background and foreground color can drastically affect our ability to perceive contrast. Black text under white background provides optimal contrast, without significantly reducing light intensity.

Similarly, An eye-friendly font should have consistent stroke thickness and minimal ornamental features. This would minimize the need to stare at them.

Instead of reading close with a default-size font, one should increase the font size so that reading can be done beyond one's arm length (or preferably, twice the arm length), but perhaps not so big so as to make navigation inconvenient.

A good color-and-font scheme goes a long way in terms of maximizing contrast and minimizing staring tension, convergence. Here (http://sustainabilitist.org/wp-content/uploads/2015/05/Century-Gothic.jpg) is an illustration of a black-under-white, Century Gothic Regular scheme (16pt to 36pt are fine).

How to Engage in Close Work

The first issue of close work is the intensity of near stress. The closer the distance, the more the close strain. To minimize near stress, we need to look rather far away:

Read at a distance beyond 50cm. And think about ways to increase that distance.

On his August 11, 2013 blogpost, Dr. Alex puts: 
Quote
Simple fix, is to create a work environment where the most comfortable position is at the very edge of your focusing ability.

A much subtler way to reduce close strain, is to "free up" the periphery:

If you place the screen/book against the wall, consider displacing them in the middle of the room instead - We only want to obstruct the center of our visual field while reading. Engaging close work in a distant peripheral environment substantially reduces unnecessary near stress. Even chicks agree:

Quote from: "Physical Factors in Myopia and Potential Therapies" by Foulds and Luu
It has been shown in chicks with lens induced myopia the viewing of a near target confocal with the retina but on a transparent background so allowing more distant visual information to contribute to the retinal image, that the myopia was reduced or eliminated, but only if accommodation were intact.34 In this situation, with the eye accommodated to the distance of the near target, additional distance visual information would add a proportion of myopic blur to the retinal image. As myopic blur is known to be protective against myopia, the presence of a proportion of myopic blur in the image appears to have been sufficient to overcome the degree of myopia that had previously been induced in these chicks by negative lens wear.

Here's a rule of thumb:

If you are not experiencing a bit of far tension, or you start to feel close strain after a while, your working distance is probably too short.

Reversing close strain

In the worst scenario, you can undo near-stress symptoms via near-stress relaxation, which just means doing the following 3 things all at once:


The duration of near-stress relaxation period should reflect the duration of close work. Personally, if I do x minutes of close work at arm length, I would also need x minutes to completely reverse the near-stress symptoms (for the record, I don't work at arm length unless I have no choice).

In light of the previous remarks, the following suggestions are in order:

Eliminate any close strain before any near work. Eliminate any close strain after any near work. In particular, eliminate any close strain before going to sleeping, as tonic accommodation can prevent near stress from dissipating.
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on August 10, 2013, 02:47:12 PM
The underlying difficulty perhaps is to show that the myopic person's starting and final prescription is correct - I can easily conceive a scenario where a myope claims to have recover from -3D, while the truth is that he was overcorrected by 1.5 diopters and that all his myopia was cililary.

Ciliary or axial, I would take any reduction I can get!
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on August 25, 2013, 07:59:19 AM
Tom

As a reply to your post #49, this "blur gazing" you speak of, is this just reading something at the edge of the blur and trying to clear it? I just want to be clear of the terms you are using, as your explorations always seem to produce interesting tangents of new thinking.
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on September 03, 2013, 06:52:08 PM
4) Focus at the letter E, 5 minutes with your left eye (both eyes open), 5 minutes right eye, and 5 minutes with binocular vision.
...


The maximized letter E provides a great quality of contrast, because it's a black letter on a white background with well-defined contour. This creates a great environment that we usually can't take for granted, if the blur-gazing were done in other environment (which I prefer).

When you consciously focus peripherally on the letter E, you might feel that something around your retina, as if something is in your eyes. It's a tingling sensation making your eyes watery and numb.


Tom

OK, help me out here: What do you mean by "5 minutes with your left eye (both eyes open)"? Is it with both eyes open or just the left and the the right, and then both?

Are we looking at the E directly, which is what your instructions would suggest, or "peripherally," which is what your ending paragraph is saying? Which is it?

What exactly is it that we are doing when we are "blur gazing"?

Title: Re: A generalized system for myopia reversal
Post by: Hillyman on September 04, 2013, 08:04:47 PM
Who is the author behind the myopiacure blog? I cannot see a name anywhere.
Title: Re: A generalized system for myopia reversal
Post by: chris1213 on September 04, 2013, 10:57:21 PM
I know that website author's name is Corinne.
Title: A Compendium on Myopia Rehabilitation
Post by: Tom on September 07, 2013, 09:00:48 AM
Glossary and Q&A - Part I

If you have any suggestion or question that you think deserve to be here, I'm all ears. I myself have tons of questions to figure out, so I cannot be relied on in terms of addressing specific individual concerns.

Glossary

Q&A

        Personal

        Glasses

        Near Stress



Distance Ranges

An object is said to be:
Having these terms at hand will help simplify several higher concepts in Far-Stress Method.

Far Point

If you're myopic, objects from far will appear blurry to you (with naked eyes), but if you move closer, and closer, the objects will become clearer, and then clearer. The far point is the farthest distance, such that you can still see objects in perfect focus. However, far point can be altered by wearing a prescription:

1) Wearing plus lenses decreases your far point.
2) Wearing minus lenses increases your far point.

Reading within your far point can increase your myopia, by inducing the so-called hyperopic defocus. The first step towards myopia reduction is to read beyond your far point, and undercorrected lenses can be very useful for that purpose.

Hypnoticity

Ever notice some images appear clearer than others, despite both being located at the same distance from you? An image is called hypnotic if it's perceived to have:

a) Well-defined contour
b) High contrast (i.e., dbrk under a light background; light under a dark background)
c) preferably, large and has only one color inside the contour

These properties make hypnotic image less effortful to focus on. Consequently, hypnotic images are perceived to be more "pleasant."

Different images vary in terms of hypnoticity. An example of a highly hypnotic image would be a big black circle under a white background.

It's possible to increase hypnoticity of an image, by getting closer to the object, or by increasing the intensity of light.



Who are you?

A fellow human being researching myopia on his own, through:

What are your intentions behind your myopia advocacy?

I have been diagnosed with myopia and given a prescription probably since I was around 8. I have been becoming more and more myopic since then. By the time I realized the harm full-time wearing of minus prescription has done to me, I was already around -8D.

I have then been trying to find solutions to stop/reverse myopia for almost a decade, and I only got some substantial breakthroughs fairly recently when I realized that myopia is primarily perpetuated by short focusing distance, and compounded by the wearing of minus lens.

Armed with these information, I know that I now have a duty to speak out - as there is the possibility that if I don't, the public might only be informed of our progress on myopia decades later. Since the Web is full of not-so-correct information, I knew that people suffering myopia deserve better - The Compendium on Myopia Rehabilitation is my way of providing accurate and up-to-date information that adheres to my own standard.

Being a person with high myopia, I have seen the profound effects of myopia on my own well-being. I certainly don't want history to repeat itself for millions of other people, and the Compendium represents my contribution in eradicating the myopia epidemic.

Where can I find practical and accessible information about astigmatism (and cylinder lens)?     

What are the pros and cons of pinhole glasses?

A minus reading prescription provides clarity by re-projecting light onto (and around) the retina. The downside of this approach is some bundles of light could be projected behind peripheral retina, thereby inducing peripheral hyperopic defocus.

An alternative way to obtain clear vision, during close work, is through the use of pinhole glasses. Contrary to the mode of action of a minus lens, pinhole glasses ensure that light land on the retina, by filtering out the peripheral beams of light. This peripheral filtering reduces unwanted spherical aberration and retinal defocus, leading to an increase in depth of field (i.e., wider range of clear vision).

Many people notice that holding one's arm immediately above eye level would increase visual acuity. Pinhole glasses essentially operate on the same principle - only in a more sophisticated manner.

For people with -2D of myopia or less, reading can be done at a reasonably far distance. Consequently, using pinhole glasses for close work is not necessary. However, for people with higher myopia, reading distance would be too short without minus lens. In such cases, pinhole glasses can be used instead to read at farther distances. Doing so would eliminate minus-lens-induced-near-stress that would otherwise occur.

Although pinhole glasses provide clarity in a relatively safer way, it is still not without its drawbacks. One of its side effects is that it over-restricts peripheral vision, making it unsuitable for activities requiring attention to the entire visual field.  Another side effect is the dramatic reduction of incoming light, which then needs to be compensated by increasing background light level.

Since peripheral vision and ambient light are both necessary for normal emmetropization, the continued use of pinhole glasses (e.g., more than 2 hours at a time) is not recommended, as it could trigger form deprivation myopia (http://forum.gettingstronger.org/index.php/topic,538.msg5541.html#msg5541).

(No sweat though. The time course of form deprivation myopia differs from that of lens-induced myopia, in that the former would recover as one reverts back to normal visual environment. Form deprivation myopia is only a concern with substantially longer deprivation period  (e.g., >24h), in which case the eyes might recover only to a limited extent.)

How do I know if I'm feeling near stress?

Here is Kathi (http://frauenfeldclinic.com/kathi-26-day-progress-report/) talking about her experience:

Quote
I do notice when my eyes get tired form reading and feel pressure behind them when my glasses are on that goes away when I take off my glasses.

Kathi noticed that near stress can be triggered either by close work, or by minus lens. Notice that she talked about pressure behind her eyes, This symptom is called posterior ocular pressure. In clinical jargon, this corresponds to an increase in vitreous chamber depth.

Here is Alex_Myopic's experience of near stress:

Quote
Something that I forgot to mention is that when I was fully prescribed -2,25D and wore them for hours I had a strong feeling at the end of the day to wear them off because of eye strain. I thought it was due to the heavy metal of the frame but even now I wear the same frame and I don't have this feeling, so maybe it was due to the inner eye strain full correction minus provoked.

Here is Asli Han (http://frauenfeldclinic.com/myopia-forums/topic/how-to-decide-the-prescriptions-and-glass-use/) experiencing near stress, as the result of focusing close for a sustained period of time:

Quote
When I use computer without glasses and read-from 25-32cm, usually in half an hour I feel my eyes getting tired

For myopia rehabilitation, should one use bifocal rather than two separate pairs of glasses?

Personally, I can't recommend doing that. While using bifocals (with appropriate prescriptions for both near and far) for far activities is not really harmful for low myopes, using such bifocals for near activities amounts to overprescribing oneself. This is because while engaging in near work, the top portion would then induce hyperopic defocus on one's upper retina.

In other words, just because one have learnt which portion of bifocal to use for which activity, doesn't mean that bifocal won't affect them. In fact, countless peripheral-hyperopic-defocus studies, both on human and other animals, invariably suggest otherwise.

Can higher myopes use prescription that only corrects one eye?

The approach of correcting only one eye is called monovision. Why on earth would someone do that you ask? This is because even though the oculars receive images of different levels of clarity, after the transmission of electric signals to the primary visual cortex, the brain integrates the two images into one. As a result, the subject actually gets clear binocular vision.

Monovision is not a bad idea, as it enables clear vision without compounding near stress in the uncorrected/undercorrected eye (as a sidenote, you may have to deal with the resulting double vision on your own, if the disparity between two eyes becomes large). There are studies on monovision that alternates the corrected eye. In fact, monovision studies provide the definitive evidence of the harmful effect of negativizing prescription. Monovision is also a solution for presbyopes, which allows one eye for far vision, and the other for close vision.

What are the pros and cons of using traditional minus spectacle to do work at the far point?

Using an undercorrected traditional minus spectacle at one's far point is certainly less harmful than using a full correction, in the sense that the former eliminates central hyperopic defocus which would otherwise occur with the latter. It makes no sense to use a stronger minus prescription, when a weaker prescription can achieve the same task, while creating less near stress.

However, since the posterior retina is not a flat plane, using a traditional minus spectacle, even when reading at the far point, will still overcorrect your eyes in the periphery. This phenomenon of light projecting behind the retina in the periphery, also called peripheral hyperopic defocus, has been extensively shown to worsen myopia.

In fact, more is true. It turns out that any overcorrection/undercorrection, in any meridian, can have an effect on the eyeball, and that effect tends to manifest only in the region affected. In other words, defocus is regionally selective.

Therefore, traditional minus spectacle, which is designed simplistically (i.e., imposes defocus uniformly across all meridians), needs to be used with extra caution. One way of mitigating this issue, is by choosing a minus spectacle with extremely small frame, while taking great care to focus beyond one's far point. Smaller frames for minus prescription prevent the periphery from being overcorrected, and so does reading beyond the far point.

Would it be a good idea for higher myopes (e.g., -3D or more) to rehabilitate with plus lens instead and read at a closer distance?

While reading slightly beyond one's far point, either with naked eyes or with plus lens, seemingly induces the same amount of defocus. In reality, there is something more at play.

In December 2013, we toyed precisely with the idea of reading at the edge of blur with plus lens at close (i.e., 10cm). While we acknowledged the resulting increase in blur definition and text magnification (as induced by the plus lens), and the resulting clear flashes after each session, it also wasn't long before we observe a worsening of myopia over time. After some more observation and experimentation, we also realized that the worsening was primarily caused by the substantial increase of near stress. A bit more research then revealed proximal accommodation as the main driver of such near stress.

To be a bit more pedantic, proximal accommodation was originally discovered by measuring refraction of subjects who were asked to read through a tiny pinhole - a practice which would eliminate primary optical defocus. Earlier research found that proximal accommodation increases along with the decrease of reading distance, at a rate of approximately -0.2D per diopter of accommodation load - A finding consistent with our daily experience with near stress, which is hardly relieved by the effects of even stronger plus lens.

To further complicate the matter, the effect of proximal accommodation operates in a regionally-selective manner. This means that reading in a narrow corridor can still induce proximal accommodation in the ocular periphery, and this is even if the corridor measures 6 meters or longer. Without devices to trick us into believing that the objects are coming from far, the only way to relieve proximal accommodation is to read in an environment with a radius of 1 meter or more.

In practice, this means that while a -3D myope might get away reading at 33cm with naked eyes, higher myopes should, in general, consider using the tools at their disposal (e.g., increased text size, magnifier, pinhole glasses) to read at farther distances (e.g.,1m), while taking active steps to reduce the duration of each near work session.

What are the risks of using thick optical lenses?

While optical lenses are designed to be transparent, as the lens thicken, an unintended effect invariably occurs. Namely, the light rays would become significantly diffused by the lens, and non-stop exposure to diffused blur has been shown, both in animals and by us, to induce form deprivation myopia.

In fact, we were able to replicate form deprivation effects on our own, through the prolonged use of strong minus lenses, strong plus lenses and sunglasses. However, we were also able to recover from form deprivation myopia, provided that these lenses are not used for too long.  This is consistent with the findings on the time course of form-deprivation myopia, and the time course of its associated recovery.

In practice, this means that if thick optical lenses are to be used, they should be removed every hour or so to allow the eyes to recover the resulting optical distortions. However, a far more sustainable solution would be to obtain high-index lenses of the same diopter, as the stronger bending power of high-index lenses allows for thinner lenses to be crafted.

For some technical details on form deprivation myopia, see here (http://forum.gettingstronger.org/index.php/topic,538.msg5541.html#msg5541).
Title: Re: A generalized system for myopia reversal
Post by: Tom on September 09, 2013, 04:05:08 PM
Hypnoticity Revisited

The basic idea about hypnotic images is this:

Focusing on hypnotic blurs facilitates ciliary relaxation and retinal remodelling. This is especially true to an image composed of multiple, spatially-distributed hypnotic images (e.g., a bunch of white flowers in the grass, under moderately-bright sunlight).

OK. Time to invoke some guests again!

Tom> Here's Todd describing using sharp line to clear his vision

Todd> After days of working on pushing my range, I would look, for example, at electrical power lines and see a double sharp-blurry image. The sharpness and darkness of the power lines increased over several weeks. Now I see them sharply.

Tom> Todd then applies this to other objects.

Todd> It is especially useful to focus on sharp lines, such as overhead electrical transmission lines, and houses or trees with sharp edges.

Todd> I found it most helpful to choose objects with crisply defined dark lines or borders, such as telephone poles and power lines or edges of buildings. You’ll soon notice that blurry or “double” images will begin to resolve. I remember becoming excited when I started to see crisp power lines, and billboard signs, and could eventually start to read signs at a distance. 

Tom> Here Alex comes, talking about the benefit of printed letters, in today's blog.

Alex> Most of the eye charts you will see, share this trait.  It is usually letters, and if not letters, than shapes that mimic the concept of the written word.  Clear straight lines, predictable recurring angles, occasionally perhaps circles.  When you are actively working on recognizing an object at the edge of your focusing ability, having a known shape is of great help in achieving active focus.

Tom> Alex on the benefit of contrast.

Alex> It is rather more difficult to pull into focus leaves, blades of grass, or other patterns that may a) be in motion or b) not have a specific, singularly defining, predictable geometry.  Contrast further improves our ability to focus, so for many the black test on white background further increases the odds of pulling the writing out of the blur, into sharp relief.

Tom> Some thought on what to do outdoor

Alex> So when you are outdoors in particular, and the world just seems a bit blurry, find some writing.  License plates are my favorite, as they have very clear fonts, and occur at most any distance you might want to use.  Once you find a few of those, work on the focus there, you may find that the rest of your surroundings begins to resolve into greater clarity.

Tom> Instead of single letter, Alex recommends a letter string.

Alex> There are other factors contributing to this, which is why writing is also better than using simple geometric shapes.  You may notice that you can just read one or two letters – but once you do, the others begin to emerge.  The aspect of reading multiple strings of letters, resolving each, can help further focus your eye.  This is especially true once you are working more with double vision, rather than just blur

Tom> A bonus from Alex, referring to the so-called Placebo Effect

Alex> Your brain plays a sizable role in this.  We see this most clearly in children, that focusing just stops happening, when the child believes that the image is blurred.  The same is true for us adults.  Much as other aspects of our physiology cooperate when we believe that the feat is possible, providing a recognizable shape for the mind to process often jumps starts the process of the eyes focusing.
Title: Re: A generalized system for myopia reversal
Post by: Tom on September 12, 2013, 07:52:00 AM
The short-term effect of overcorrection and undercorrection on axial length, while watching TV!

Studies on animals invading studies on human? Read on!

Gist of the study

Here's how this study goes: 14 emmetropes and 14 myopes undergo an experiment, in which every one of them has (only) their right eye's lenses undergo all 4 experimental conditions:

a) right eye with full prescription
b) right eye with 3 diopters of overprescription
c) right eye with 3 diopters of underprescription
d) right eye with a translucent diffuser, on the top of their full prescription

Immediately prior to the experiment, the subjects watches TV, located at 6m away from them (this is to relax their ciliary). They were then fitted with a lens on their right eye, and continue to watch TV for 60 minutes (so they are always focusing 6m away) For each subject, the experiment is conducted over 4 days, with one experimental condition (order randomized) each day, during a specific time frame (to avoid confounding other factors).

(by the way, reading through the paper, I can't help but think how well this experiment abides by the ethical guideline on human research :P )

Then what happened? Those with 3 diopters overcorrection had their axial length increased kind of (p=0.03). Those with 3 diopters undercorrection had their axial length decreased, for sure (p=0.0001). Those with diffuser also increases slightly (this is called form-deprivation myopia (http://forum.gettingstronger.org/index.php/topic,538.msg5541.html#msg5541)).

The reason behind the "kind of", and the "for sure," is that myopic defocus tends to be around many times stronger than hyperopic defocus. This means that the magnitude of axial length decrease, induced by underprescription, will be more than the magnitude of axial length increase, induced by overprescription of the same diopter.

My Conclusion

We all know what will happen if we are overprescribed. But now, the short-term effect of underprescription, an effect replicated in previous animal studies, is confirmed in human study too.

Notice that the change of axial length does not happen due to staying at the edge of blur. A 3D undercorrection puts one's far point at 33cm, so when a subject undercorrected this way is made to focus at 600 cm, he is exposed to accommodative stimuli of around - 1/6 - (-3) = + 2.833 D. Simply put, the myopic defocus in this case is just not minimal.

A plausible explanation of this experiment's result, is that looking far with more positive prescription substantially reduces ciliary tension. The change in axial length, which possibly affect the entire eyeball from cornea to sclera, could very well be accounted by the crystalline lens thinning triggered by ciliary relaxation.

You can read the study on your own here:

http://www.iovs.org/content/51/12/6262.full?sid=dbdaf664-6184-42eb-a8d7-e94008536dce
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on September 21, 2013, 05:49:58 PM
Hi Tom Lu,

You are a bright person - and can 'figure out' a lot of these issues.  But here a case where these people LOOK AT THE FACTS, and, "can't figure it out".  They are "searching for a *solution*....".

http://www.youtube.com/watch?v=xH_H4BRJMLk

I know how difficult it is to conduct, "just prevention" with a plus.  But these "research methods" do NOT include your use of your own "math skills" and scientific perception.

I gave up "asking" these people for any "solution" a long time ago.

Otis

Otis

I wouldn't be too harsh on the direction of this work. it looks like they are at least exploring the path of defocus as a factor in retarding the progression of myopia.  From the video, it seems the challenge is to provide this defocus effect while allowing the wearer of the DISC lens to have distance vision. It does seem that the idea of simply wearing a plus lens for near work and then just taking that off for distance work may be "too simple"!

I suspect also that including some level of technology--hey, it's a new type of lens--should also make the research more palatable to the optometry field as it validates the research being conducted, while introducing, if one were cynical, a new commercial product to sell to the public.

Nevertheless, I think we should be encouraged by this research, because it begins to introduce into the mainstream optometry thinking the defocus effect as a factor in myopia, instead of attributing the axial length growth in myopia as genetics. By and by, it may open the door for other approaches such as plus-lens and hormesis to be included in the picture.

Title: Re: A generalized system for myopia reversal
Post by: Tom on September 24, 2013, 04:58:24 PM
Light and Myopia - An Incredible Connection

Intro

While walking outside, we sometimes get hit by a drastic increase of sunlight intensity, and then, whatever that was previously blurry, becomes crystal clear followed by a perceived increase in 3-dimensionality. What's going on?

Precursor: Outdoor Activities

One of the breakthroughs in eye research (most notably in the last decades) is the myopia-inhibiting effect of outdoor activities. It all started with epidemiological studies:

Study 1 (http://www.iovs.org/content/52/3/1841.abstract?ijkey=b2068a783d988f86bf26504fa3e949b2fa7588e8&keytype2=tf_ipsecsha)) Myopic children tends to engage in less outdoor activities. In fact, the amount outdoor activities seem to have more influence on myopia development than near work (there is no paradox here, we also know that near work can be done in ways that does not invite myopia development, this explains why in certain studies there are no significant association between near work and myopia)

Study 2 (http://www.iovs.org/content/48/8/3524.abstract?ijkey=ead0d0e610425a1526a745f0d205715e1b6e70d6&keytype2=tf_ipsecsha)) A longitudinal study also shows that children engaging in less sport and outdoor activities tend to become more myopic.

Study 3 (http://synapse.princeton.edu/~sam/outdoor_activity_myopia_Rose.pdf)) Which one is it? Sport or outdoor activities? In 12-year-old children, the higher amount of outdoor activities is associated with less myopia, and not the sport being practiced --- It's the total amount of time outdoor that counts.

Study 4 (http://archopht.jamanetwork.com/article.aspx?articleid=420394)) Apparently, the environment plays the leading role in myopia development. When 6 and 7-year-old children of Chinese ethnicity of Sydney are compared with their Singapore counterpart, the Sydney group has substantially much less prevalence of myopia (3.3% vs. 29.1%). The total hours of outdoor activities per week (13.75h vs. 3.05h) was found to be the strongest factor associated with the difference in myopia prevalence (granted, the data are collected from the questionnaires, but the statistical and clinical significance is there).

These fairly-recent studies sparked a new momentum towards figuring out what makes outdoor activities so beneficial. One other study, showing that myopia progresses faster in winter than in summer, points to the possible link between light and myopia. Other researchers suspect Vitamin D, relaxed accommodation and sunlight-induced increase in retinal dopamine level.

Sequel: Lens-Induced / Form-deprived Myopia vs. Light intensity

The ensuing research split into different directions, occasionally leading to equivocal conclusions. But here are a few from the animal research:

Study 1 (http://www.iovs.org/content/53/1/421.full?sid=39ce3f6b-3f4d-48a2-9815-df5935d710a2)) To test whether the intensity of lighting could have an effect on myopia. Rhesus monkeys are form-deprived under 2 conditions: normal lighting condition (up to 630 lux) and high ambient lighting condition (25000 lux). Both eyes of the ambient group become more hyperopic than those of the normal group.

Study 2 (http://www.iovs.org/content/50/11/5348.full?sid=ee7f4adc-e15c-4014-8fd4-c4b069ba0680)) In chicks, exposure to either bright laboratory light or sunlight, even for just 15 minutes a day, substantially retards diffuser-induced form deprivation myopia. What’s more, the diffuser-wearing chicks who were exposed to only 15 minutes of sunlight a day are still more hyperopic than the non-form-deprived chicks under low laboratory light setting.

Study 3 (http://www.iovs.org/content/44/8/3692.full?sid=8c773ab2-0e01-4e90-a1ca-66a22ac85846)) This is a study with an unusual twist. Chicks under constant light, day and night, exhibit more hyperopia. However, if the chicks wear eye cover or have a hood above them to cover the light, for 12 hours a day, then it would protect them against hyperopia. For chicks, emmetropization is maintained by a regular diurnal light-dark rhythm.

Study 4 (http://www.iovs.org/content/47/11/4700.full?sid=2a6c394f-14b4-4da3-84a2-3ca052152f86)) Young tree shrews who are form-deprived by living in darkness end up developing axial myopia. Refractive status is maintained partially through regular exposure to light.

Study 5 - Ashby and Schaeffel (http://www.iovs.org/content/51/10/5247.full.pdf)) This is the most interesting find so far. Chicks wearing -7D lenses were put into 2 conditions: low lighting (500 lux) and high lighting (15000 lux). The chicks under high lighting compensate fully for -7D at a much slower rate than their low lighting counterpart. What now? Other chicks wearing +7D lenses were also put into the same 2 categories, and the chicks from the high lighting group compensate fully for the +7D lenses at a much faster rate then their low lighting counterpart. Light inhibits lens-induced myopia and accelerates lens-induced hyperopia.

What's more, when chicks got injected with spiperone (a dopamine antagonist), exposing to high illumination no longer spare the chicks from form deprivation myopia. On the other hand, when the chicks got injected with a placebo solution, exposing to high illumination would show its form-deprivation-myopia-inhibiting effect again.

What to extrapolate from these?

In light of these studies, we speculate that:

In terms of image quality, the more intense the light, the smaller the pupil, which results in an increase of depth of focus. As the pupil constricts, the light rays that normally would scatter around the periphery (a.k.a., "optical noises") no longer make their way into your eyes. Consequently, aberration decreases and an increase in depth of focus and perceived clarity ensues (i.e., sharper image with increased contrast). Light provides clarity in a safe way, while reducing unnecessary staring tension at the same time - A brightly-lit image is clearer and more easily focusable.

Although the change in light intensity can be mistaken as clear flashes, distance gazing, under moderately bright sunlight, greatly promote double vision and clear flashes, possibly also in part through a significant reduction in accommodation and convergence.

There is a catch though. Sunlight alone is not the solution to myopia. The human folks in the studies only witness a slower myopia progression (i.e., not a improvement in dioptric terms), as they are still being overprescribed. Animal research suggests that light only reduces the speed of compensation to minus lens, and does not change the target refractive status the eye is compensating for.

Actually, we haven't even talk about the key finding. The Ashby and Schaeffel study did provide us with some clues as to how sunlight inhibits myopia. In that study, a dopamine antagonist essentially disabled the protective effect of sunlight - As the retinal dopamine (a neuromodulator) level decreases, elongation also fails to stop.

This strongly suggests that the process of elongation is in part modulated by....some chemicals in your retina! The biochemical component of axial length regulation could very well look like this:

Level of sunlight => Different levels of retinal dopamine/melatonin => Different rate of proteoglycan synthesis => Different choroidal thickness => Different level of resistance to axial stretching.

Oh. And here comes Dr. Alex:

Quote
Over the past 40 years between my father's practice and my own, regions with less sunlight, more rain, longer winters, etc, tend to bring us higher degree of myopia clients. Of course there are various other possible explanations we wouldn't discount ... however, the client with the desk job in the south of France almost always has a half diopter or even a full diopter less of a prescription than a very similar case in the north of the country.

[Note: On Dr. Alex's Oct. 29 blogpost (http://frauenfeldclinic.com/ambient-brightness-vision/), the relationship between ambient lighting and refractive status is explored.]

[Update: On March 18, 2015, Nature publlished an article titled "The Myopia Boom (http://www.nature.com/news/the-myopia-boom-1.17120)", essentially covering in less detail what you just read.] 8)
Title: A Compendium on Myopia Rehabililation
Post by: Tom on September 29, 2013, 03:36:47 PM
Glycemic Index and its Potential Effect on Accommodation

It's good to know that several people brought up the issue of diet, and independently so.

Todd discovered that his vison is not so good with sugar intake. Dr. Alex also makes similar suggestions. Are they just instinctive hunches? For one, there isn’t lots of medical attention on diet, but then not every eye professional disregards it either. Here’s one that is in line with functional medicine, published in 2013.

Viewpoint: Sugar Stress: How Our Diet Impacts Vision and Development (http://www.oepf.org/sites/default/files/23_FINAL_RASMUSSEN.pdf)

Basic Ideas

Naturally-occurring food tends to have low Glycemic Index (GI). However, that changes when we start to manipulate food through industrialization and mass production. Food with high-glycemic-load are now everywhere.

When our body consumes such food, it leads to an abnormally high amount of sugar in our blood. In an attempt to maintain glucose level in our body, the hormone insulin is then secreted throughout the body. This dramatic increase in insulin, or hyperinsulinemia, activates our stress metabolism, which in turn change our normal behavior to a fight-or-flee response. In short, overabundance leads to hyperactivity - the regular consumption of high GI food, in high quantities, leads to the so-called adrenal burnout.

(the chronic excess in insulin also renders the body resistant to the effect of insulin (a.k.a, insulin resistance), which in turn destabilizes blood sugar regulation and facilitate the storage of body fat. For an introductory video, see Dr. Sarah Hallberg's Ted Talk on obesity and type II diabetes (http://sustainabilitist.org/sarah-hallberg-reverse-diabetes/))

How does that affect vision? The stress response, induced by the high-glycemic-index food consumption, shifts our default focus to far, rendering some of us incapable of accommodating well, when engaged in reading task.This could, if not well managed, leads to extraocular strain, and then perhaps some vergence or suppression issues. The same stress can also exacerbate near stress and potentially increase the progression of myopia (in many cases, however, people simply develop a dislike towards reading, which could also spare them from becoming myopic).

Yet another slippery slope?

I would be reluctant to claim that in the absence of mechanical processes, high GI food would create a myopia epidemic as the one we are having today, but that is different from saying that high carb could interfere with the accommodation system, the same way that alcohol would do. Of course, We could have also argue certain individuals are simply less susceptible to "glucose overdose" and the ensuing hyperinsulinemia, but the fact remains that high GI food is extremely prevalent these days. They are the norm in Standard American Diet (SAD), and some other popular diets alike.

For the record, adrenal burnout is associated with a feeling of discomfort, dizziness, increased heartbeat, hyperactivity and mental fatigue! So this is definitely something one can test, should one decide to do it (for, say, 1 month).

Food and Eating Suggestions

If you are in the mood of reducing your blood sugar level (and the resulting insulin spike and adrenal burnout), you can use the following suggestions as your starting point:


Here is Dr. Alex sharing a bit of clinical experience.

Quote
A good 30% of the success in vision rehabilitation comes from reducing the body's exposure to sugars / simple carbohydrates. The impact of eliminating sugar from the diet on vision is nothing short of astonishing, especially when paired with a good rehabilitative program.

The effects of diet would easily cover the span of a lengthy book. There are a number of vision related supplements, but I haven't been able to correlate actual improvements in vision from any of them. The largest immediately observable impact in diet is the relation of insulin spike to reduced response to refractive change in the eye. In the most basic terms, eating simple carbs triggers a reduced ability to focus clearly.

Individuals wearing glasses, functioning in familiar environments will not notice this change. But if you're actively working to maintain or improve your vision, those insulin spikes create a noticeable and frustrating setback during the "edge of focus" exercises.

Incidentally, Jake (http://endmyopia.org/intermittent-fasting-improve-eyesight-lazy-eye/) did some experimentation and found that intermittent fasting (which dramatically reduces one's insulin level), for as little as 16-24 hours once per week, is associated with increased visual acuity.

Quote
One the days after my intermittent fasts, I would get clear flashes to 20/40, where before I would only get double vision on that line.

I didn't put the fasting and the clear flashes together, for the better part of six months.  It wasn't till winter came, and I quit the fasting, that the progress stopped.

At first I blamed winter.  But then one day a blizzard snowed everything in, and I was forced to do a day of fasting, lest I wanted to brave deep snow and hope to find an errant open store.  The next day, I had the clear flashes again, which had been absent for several months.

That's when I started experimenting specifically with the fasting, and found that I could create clear flashes by doing the fast.

Additional Resources

Since we like to promote healthy diet regardless whether we are myopic or not. Here are some paper/presentation on how diet could possibly affect myopia (and trigger other health conditions):

Title: Re: A generalized system for myopia reversal
Post by: mailliam on October 07, 2013, 05:34:06 AM
Hey TomLu, just had a read through some of your updated posts. They have been really useful.

Some questions:

You mentioned that myopic defocus tends to be around 5 times stronger than hyperopic defocus, can you explain why? (this is for my curiosity rather than for any practical use in vision improvement).

Regarding your conclusion in post #36, you said, "In a sense, this is problematic for IRDT, because underprescribing by 3 diopters put your far point at 33cm. Focusing at 600 cm, while your far point is at 33cm, can be hardly considered an incremental (myopic) defocus." I think because the defocus was applied to only one eye, the increment isn't as large as you describe here. I just tried holding up a +6 lens to my right eye only and I can still easily read.

Perhaps an alternative treatment for myopia could be glasses with a myopic defocus in one lens and a full prescription lens in the other. And two pairs of glasses prescribed to patients to wear on alternate days so that both eyes are given equal amounts of myopic defocus.



Title: Re: A generalized system for myopia reversal
Post by: Myoctim on October 09, 2013, 10:40:49 AM

Hey TomLu, just had a read through some of your updated posts. They have been really useful.

Some questions:

You mentioned that myopic defocus tends to be around 5 times stronger than hyperopic defocus, can you explain why? (this is for my curiosity rather than for any practical use in vision improvement).

(http://)Updated the culinary rocking post. Enjoy,

Liam, the reason why researches conclude that myopic defocus is much stronger than hyperopic defocus, is because that's what they have determined experimentally. To figure out the causal mechanism would probably take decades or so. The effect of hyperopic and myopic defocus just doesn't add up linearly. You could overprescribe an animal by -5D all day all night and the animal's eye will compensate for that (i.e., end up getting -5D with a +- 1.5D offset), but if you let that same animal to look far without glasses, even for one hour every day, he'll probably only get -1D.



So 2 hours outdoor activity should compensate for 2*5h = 10 h nearwork?
But what if that ratio is decreased by genetic variation? Wouldn't such a person be predisposed for myopia?

Also it would be interesting at which pathway the cililary spasm triggers axial elongation. Does the cililary itself release myopic growth signaling molecules?
Title: Re: A generalized system for myopia reversal
Post by: Myoctim on October 12, 2013, 12:04:04 AM

By the way, outdoor activities does not provide myopic defocus by itself. Actually, myopic defocus might not even be the main underlying cause of the myopia-inhibiting effect of outdoor activities.


As for the cause of axial myopia, it's not even clear if cililary tension is necessary to increase vitreous chamber volume.


But imagine going outdoors after an 8 h near working day and just having some ciliary spasm. There should be a high contrast myopic defocus counteracting axial elongation.

Concerning me I never understood why me getting myopic as a child of emmetropic parents and grandparents.
I guess my ancestors simply did spend much more time outdoors.

Looking at axial myopia, I did a lot of reading and AFAIK it is said myopes tend to underaccommodate e.g. reading with some hyperopic defocus. Is there any new research about that?
Title: Re: A generalized system for myopia reversal
Post by: Tom on October 14, 2013, 08:25:12 AM
A Primer on Form Deprivation Myopia

At the time I posted the first form-deprivation-myopia draft, I struggled a bit with its relevance to myopia rehabilitation. As it turns out, form-deprivation myopia proved indeed to be, to some degree, relevant to myopia reversal, as the latter requires eliminating all major causes of myopia, which includes the regular exposure to an abnormal visual environment.

Form-Deprivation Myopia - Introduction

An old way to induce myopia in animals is through form-deprivation. Sometimes by suturing an animal's eyelid, and sometimes by forcing the animals to wear a diffuser, which would make images blurry.

The myopiagenic effect of form deprivation doesn't come instantly - it takes at least 72 hours of chronic deprivation for the effect to kick in. Form-deprivation myopia can be generated in human too, and this is apparent to patients suffering from ptosis (i.e., close eyelid) and cataract (i.e., intraocular lens clouded by protein deposits). Wearing a diffuser or living in darkness all day long is a good way to generate deprivation myopia.

In general, the longer the deprivation period, the higher the axial length. Somehow the lack of stimuli reduces the retinal dopamine level, without any ciliary involvement. The deprivation, or the lack of it, essentially controls the production rate of retinal neuromodulators, ultimately leading to choroidal thinning and vitreous chamber elongation.

However, if form-deprivation-myopic animals were exposed to light, then something miraculous happens - their myopia would be reversed, sometimes completely within days of exposure. Form deprivation myopia is modulated by light intensity and can be controlled fairly easily.

[In a very real sense, this shows that form-deprivation myopia is different from defocus-induced myopia, in that the latter has a more permanent effect. To be more specific, form-deprivation myopia differs from defocus-induced myopia in terms of time course and the effect of lighting (see http://www.iovs.org/content/42/3/575.full?sid=b0d00dcc-d543-4540-990a-cf58733fc201), so the use of form-deprivation myopia, as the main paradigm for the study of human myopia, risks of being way off the target.]

Form-Deprivation Myopia - More Details

We can still learn something from deprivation myopia though. For example:

a) Deprivation myopia is a type of axial myopia, albeit different from defocus-induced axial myopia. It raises the possibility that accommodation might not even be a causal component in the development of a typical human myopia (although that is not to say that accommodation can't be a symptom associated with myopia). In fact, we once thought that since atropine greatly reduces the progression of myopia and that it paralyzes the ciliary, so it must have been that accommodation plays a key role in myopia development. It turns out that atropine also greatly reduces form deprivation myopia (although defocus theory of myopia development might still work without accommodation).

b) There are some similarity between deprivation and defocus-induced myopia. Here are some key findings from deprivation studies:

Study 1: When monkeys wear a diffuser occluding their nasal field, they only become myopic in the nasal region. Deprivation myopia works in a regionally-selective manner.

http://www.iovs.org/content/50/11/5057.full?sid=8c773ab2-0e01-4e90-a1ca-66a22ac85846

Study 2: It's not a matter about just periphery or central field. When only the central field is occluded, chicks still get myopic, and the degree of myopia increases as we widen the occlusion range. We have to look at the eye as a whole.

http://abstracts.iovs.org//cgi/content/abstract/54/6/4040?sid=cd774c6a-12b8-4c67-9dfb-debb3cab5433

Study 3: Rhesus monkey can, in the not-so-severe cases, recovery from deprivation myopia too. Light plays a role in modulating ocular growth.

http://www.iovs.org/content/53/1/421.full?sid=39ce3f6b-3f4d-48a2-9815-df5935d710a2

Study 4: The eyes of rhesus monkeys become more prolate as they are deprived of visual stimulus. Visual stimulus modulates the shape of eyeball.

http://www.iovs.org/content/50/9/4033.full?sid=a19eebb8-6eda-42fb-b9bb-cf8d03b908f1

Incidentally, these four key points also summarize defocus-induced myopia pretty well.
Title: Re: A generalized system for myopia reversal
Post by: Myoctim on October 19, 2013, 01:45:02 PM
(http://)
(here is something I didn't want to talk about: it is possible that the reduction in axial length is not due to reduction in vitreous chamber volume, but only due to intraocular lens thinning, in which case the finding is not so useful, since we already know about how underprescription can relax the cililary)

Hi Tom Lu,
what's the problem with lens thinning?
AFAIK emmetropization is using lens thinning to compensate for axial elongation by stretching the lens in
emmetropic kids while in myopic kids it was found that process having ceased for some unknown reason.

BTW I always wondered about why frauenfeld success clients being less affected by presbyopia when getting older.
I think a shortened eye ball by retinal shaping won't be an explanation but a more flexible lens due to lens thinning
pretty much would.
But of course lens thinning wouldn't reduce the risk for retinal detachment
Title: Re: A generalized system for myopia reversal
Post by: Patrea on October 22, 2013, 09:12:36 AM
I have been dipping into this and other myopia-related posts - for years, it seems! - could you post a summary of recommended actions :).
I have made some progress, but it is keeping up the +lens exercises in a busy day that is tricky
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on October 23, 2013, 07:34:38 AM
As for your remark on presbyopia, I can say that this is not a resolved issue even among the eye professional community (almost nothing relevant to myopia rehabilitation is resolved, actually 8) ).

The two dominant theories on presbyopia are that they are either due to age-related lens stiffing, or age-related loss in cililary flexibility. It could very well be a combination of both, or any other controversial theory, of course.

The Frauenfeld participants are almost uniformly myopes or former myopes, as a consequence most of them have been subjected to overaccommodation over a long period of time, so your sample is biased to start with, as myopes tend to develop more efficient accommodation system as a side benefit of "self-induced overcorrection." That's not to say that myopes will not suffer presbyopia - just that the presbyopic myopes are much better off than presbyopic hyperopes.

If I were to speculate, some presbyopia-related advice by Dr. Alex would be outdoor activities and focusing within far point for a brief period of time. Actually, I would be interested in digging up the incidence rates of presbyopia in hunter-gather societies, although this topic is about myopia only :)

Tom and Myoctim

Myopes have presbyopia at probably no different a rate than the non-myope population.  I've worn minus glasses all my adult life (-5.5), and starting at about my mid-40s needed a bifocals with a plus prescription in the lower part of the lens so that I could accommodate to the normal reading distance of 20 inches or so.  My plus add is 2.25. Most people who can afford them wear bifocal prescriptions as progressives, with each lens providing an incremental progression of plus-lens effect as one looks down; no bifocal line is visible in the lens.

I was also curious about Dr Frauenfeld's comment that the patients he has followed over time do not seem to encounter presbyopia as they get older.  And then I came across this:

http://www.i-see.org/gottlieb/presbyopia_chart.pdf

This is an exercise for reversing presbyopia. It was developed by an OD and involves overconverging the eyes so that one sees three dots from the two on the chart. He markets this separately on the Internet and he has some anecdotes of its efficacy.

What piqued my interest is that this is the same exercise in principle as the "three cups" exercise that was recommended by John Bershak, who was one of the earliest proponents of reshaping the eyeball for myopia reduction that I had come across. So the question is: is there some common ground in reversing presbyopia and reducing myopia--and thus the situation that we hear about regarding Dr. Frauenfeld's eye patients? It certainly would bring some interesting threads in vision rehabilitation together!

As a side note: I have tried the over convergence chart above. There seems to be some effect in that reading material seems clear at a reduced plus add.
Title: Re: A generalized system for myopia reversal
Post by: Hillyman on October 23, 2013, 08:34:37 PM
Scharchar was thinking about reducing the distance between the lens and cililary (surgically?). It's the same story of mistaking symptoms as causes and treating the symptoms instead of the causes. We now know that presbyopia is just a normal part of aging (much as Alzheimer's), but we also know that some risk factors make people age faster, so why can't the eye professionals think along this line?


I remember reading Schachar on presbyopia. His theory was that the lens in the eye is one of the parts that keep growing through life, like the ear lobe, or the nose. So at some point (at 40+ years of age), the lens' diameter is big enough that the zonules become slack. The ciliary function still works, but part of its pull is used just to take up the slack in the zonules, so the lens has a reduced pull on it for it to "plump up" for near-focus accommodation. He had some experimental surgery to take up the slack by inserting very small inserts outside the eye around where the ciliary ring would be to stretch the ciliary ring itself. At least, this is what I remember about his approach--the idea borders on the scary, if you ask me. I can't seem to find any more reference to it in the internet, though.

There are older people who do not have presbyopia, and who continue to have full accommodation range into old age. That would be explained that the lens in their eyes grow much, much slower.  After all, there are old people with normal looking noses!

Schachar's theory that the ciliary pulls on the lens to make it plump up for near focus goes counter to the usual theory by Helmholtz that the ciliary relaxes for the same effect. I like his reasoning as to why this would make sense: biological systems do not function by relaxing in order to pay attention to something in the environment (such as near work).
Title: Re: A generalized system for myopia reversal
Post by: Tom on November 02, 2013, 07:21:39 PM
Energy-Efficient Light Bulbs

Our increasingly-sedentary lifestyle leads to less exposure to sunlight, and more exposure to indoor lighting.

Not all light bulbs are created equal. Fluorescent light bulb, especially the poor-quality, yellow-colored ones, blurs your vision and might hurt your eyes. The blurring caused by these light bulbs is unlike the one caused by minus lenses, and induces a headache-like sensation that goes away hours after the exposure.

The best way to figure this out is to try it on your own. Light up your house with only incandescent / halogen light bulbs, and then change the bulbs to some cheap fluorescent ones. You should notice that with fluorescent lighting, everything appears blurrier. Not just that, even the fluorescent light bulbs themselves appear blurry when you look at them (as opposed to looking at other light bulbs).

Why is that so? Hard to say. Some speculate that the human eye has evolved to see under light generated by a incandescent source. The color spectrum generated by sunlight, or incandescent light bulbs, are very smooth across different wavelengths. The fluorescent lighting, on the other hand, has a distinctively spiky colour spectrum which unnaturally emphasizes some shades of green, for instance. In addition, it has also been said that fluorescent lighting produces ambiguous shadow, which is an important cue for human's perception of depth. This failure to produce shadow might be the precursor of eye strain and other ophthalmologic concerns.

Let's bring someone else into the conversation instead. Here is Adrienne Piggot talking about her experience with fluorescent light bulbs:

Quote
The fluorescent light bulb will often give me a headache, or in the worst case actually cause a migraine, in which case I’m in big trouble and I need all kinds of medication. [...]I have really debilitating migraines. The light from incandescents doesn’t affect my head.

[To be fair, she probably has some neurological issues. For most people, fluorescent light induces only a tingling sensation.]

Fluorescent light bulb does not exactly represent a sustainable source of light energy either. All fluorescent light bulbs contain a tiny trace of mercury. As such, they should not be disposed of carelessly, because mercury flows through the air if light bulbs break (which will most likely happen if it goes to the landfill). In addition, fluorescent light bulbs tend to emit an abnormal level of UVA and UVB, which can adversely affect the retina - the same way that overexposure to sunlight can affect our vision in the long run.

Is there any high-quality fluorescent bulb that doesn't blur vision? I personally haven't find one - not even those marketed as "full-spectrum". Plus, those with color temperature beyond 5000K tend to overstimulate our vision and possibly disrupt our circadian rhythm.

Before we jump into LED, there is actually one Madrid study subsequently picked up by media (http://www.dailymail.co.uk/health/article-2324325/Do-environmentally-friendly-LED-lights-cause-BLINDNESS.html), showing the adverse effects of LED on the retina. Another subtle disaster in the making?  ::)


Alternatives?

Dr. Alex prefers neodymium light bulbs. However, there is great diversity in terms of quality even among these! For example, the second-generation neodymium light bulb GE Reveal is meant for the mass consumption:

1) They are made of materials of rather poor quality.
2) The lighting tend to be less intense, requiring you to buy more.
3) They last, on average, 1000 hours.

[To be fair, it's not that they are terrible, but they are below the threshold of satisfaction  8)]

Verilux, Chromalux, PureLite are some companies claiming to produce neodymiums of higher quality, although it's unclear whether their higher price is well justified. The one I have is Chromalux A21 Frosted 150W, but whichever one you like, the light bulb you choose should fit the regular E26 socket. This means that all you need is really a change of choice, which is not hard to do.

UPDATE: One of my Chromalux burnt out fairly quickly, due to its high wattage and constant, daily use. The others are still working fine. Apart from the wasted heat generated by the these light bulbs, they are really only inferior to sunlight.

No Easy Solution

The world has gone far to be able to un-modernize itself. Opt for sunlight when it's available. When background lighting is insufficiently low, turn down the screen brightness to minimize the staring-at-a-bright-light-source effect (avoid that awkward level of brightness). A brightly-lit room (with eye-friendly light bulbs) goes a long way to relieving eyestrain!
Title: Re: A generalized system for myopia reversal
Post by: OtisBrown on November 14, 2013, 04:38:04 AM
When and how to move to a lower prescription:

http://frauenfeldclinic.com/prescription-reduction-timing/

Thanks!
Title: Re: A generalized system for myopia reversal
Post by: Alex_Myopic on November 14, 2013, 11:47:06 AM
And I was just thinking to change from -0,75D to -0,5D lenses since I have managed 20/20 with -0.75D although not with great ease and only with both eyes.
I noticed that if I wear -0.75D to see some small subtitles in a movie (3m away from the tv) for 60 minutes, my eyes deteriorate at focusing at 30 minutes more or less but if I see a movie with larger subs without glasses my eyes are more stable and if I blink I can "clear" the subs when they appear defocused.
Title: Re: A generalized system for myopia reversal
Post by: OtisBrown on November 14, 2013, 01:03:02 PM
Hi Alex,

It is always pleasant to hear reports like you just made.  Everyone wants success - but few achieve it.  When I was "nearsighted" (totally my fault) I could not read the 20/200 line.  What I would have given, to "just read" the 20/40 line (with both eyes open) and go pass the required DMV in my state.

I know you do not like the idea of wearing a "stress reduction" plus - the way that I do - but that is always a personal choice.  I also do not make any "claims" of result, because I expect the person to see objective results himself - and report them honestly - as you are doing it.  I would also expect you read most of the letters on the 20/40 line, given the statements you have made.  You are also lucky you can keep that wretched minus off you face - most of the time!

Congratulations on your success.


And I was just thinking to change from -0,75D to -0,5D lenses since I have managed 20/20 with -0.75D although not with great ease and only with both eyes.
I noticed that if I wear -0.75D to see some small subtitles in a movie (3m away from the tv) for 60 minutes, my eyes deteriorate at focusing at 30 minutes more or less but if I see a movie with larger subs without glasses my eyes are more stable and if I blink I can "clear" the subs when they appear defocused.
Title: Re: A generalized system for myopia reversal
Post by: Alex_Myopic on November 14, 2013, 02:42:51 PM
Thanks a lot Mr Brown.

I can read now 20/32 with some difficulty. I observed this instability at this transient reduction of myopia and the fact that somehow 20/20 prescription for myopia for use closer than 6 meters somehow steals my progress and I wanted to share this.
Title: Re: A generalized system for myopia reversal
Post by: OtisBrown on November 16, 2013, 07:21:15 PM
Hi Tom Lu,

I truly like the concept of "Generalized System for Myopia Reversal".  But I believe that we should start "early", and perhaps make a strong personal commitment, while we still have 20/60.

Here is a video of how the natural eye "induces", negative status.

http://www.youtube.com/watch?v=YiuC7a1lkrk

Tom, I was curious about your opinion of this video - about how a child SLOWLY creates negative stauts - because of his reading habit.

I would certainly agree that most children do this (nose on page) - and understand the consequence of doing this - are very serious.

What do you think?


Thanks,
Title: Re: A generalized system for myopia reversal
Post by: eliddell on December 01, 2013, 06:24:28 AM
What is ciliary rocking?
Title: Re: A generalized system for myopia reversal
Post by: Alex_Myopic on December 02, 2013, 01:23:13 PM
Here are examples of vision rocking exercises that truly when during doing this (with the first one) I can focus a little better. Maybe stronger and more flexible ciliary muscle compensates for myopia.

Quote
SET UP
1. Place the I Love To See Chart on the wall so that the center of the chart is at eye level. You can
do this technique either sitting or standing.
2. Sit (or stand) 8 - 10 feet from the chart.
Instructions (1 eye at a time)
1. Cover your right eye with an eye patch. Keep the covered eye open.
2. Pick a letter on the chart as your distant focus point. Hold your index finger 6 - 8 inches
directly in front of your left eye and slightly below the letter. (Then, when you shift your focus in
and out between the letter to your finger, your eyes will not move from right to left.)
3. Set the metronome at 30 beats per minute. Shift your focus from your finger to the letter in
time with the beats, making one shift per beat.
4. Continue for 3 minutes.
5. Palm (P. 78) over both closed eyes for 1 - 2 minutes.
6. Repeat steps 3 - 5 with the metronome set to 45 beats per minute.
7....

or this one

Quote
1. Cover one eye with your hand (or an eye patch) and keep the covered eye open.
2. Hold the Dot Chart in front of the open eye. If you are nearsighted, hold the chart just beyond
the distance at which you can see the top dot clearly. If you can still see the top dot clearly at
arm’s length, use a smaller dot. If you are farsighted, hold the chart just closer to you than the
distance at which you can see the top dot clearly.
3. Keep your focus on the dot and with a slow, steady motion, move the chart closer to you until
it is 2 - 3 inches from your eye.
4. Continue to keep your focus on the dot as you slowly move the chart away, until your arm is
outstretched.
5. Continue moving the chart in and out as you stay focused on the dot. Continue for 3 - 4
minutes.
6. Palm (P. 78) over both closed eyes for 1 minute.
7. Repeat steps 2 - 6 again; if you can, focus on a smaller dot.
8. Palm over both closed eyes for 1 minute.
9. Repeat steps 2 - 8 with the other eye.
Title: Re: A generalized system for myopia reversal
Post by: chris1213 on December 03, 2013, 06:34:03 PM
Tom,

Thank you for explaining what ciliary lock-up is in briefer words.

But you might want to consider the following:

When working with plus lenses or under prescription on close up distance, there's a way to gain more improvements and it implies, after having "warmed up" your eyes for about 20 minutes wearing the plus or under prescription, to back up the furthest you can while the letters are still readable. The letters should not be sharp but shouldn't be blurred either, it's the point where you can barely read them. Blink a few times and then, staring at one part of a word or a letter, without blinking, you allow your eyes to focus the image. It takes around 15 seconds for the eyes (and brain) to focus the image and then you want to stare at it the most you can without blinking (a.k.a without straining; that's why the eyes need to be warmed up). This keeps the ciliary where it has to be for it to focus. The "exercise" should not be done more than 10-15 minutes the first times so we don't strain our eyes.

Now, going back to the ciliary lock-up,  I believe the exercise justifies staring at one distance for some time and shouldn't be confused with lock-up because you're still working on focusing at a range beyond what you might have considered "possible." However, for the rest of the times, while focusing up close I think that what you say is very important because once the ciliary locks-up the rest of day it becomes harder to keep focusing at longer distances.

Thank you Tom for the insights,

Chris

PS: The exercise I mention is a very rough summary of one of the installments that Alex Frauenfeld shares, so the credit goes to him.
Title: Re: A generalized system for myopia reversal
Post by: OtisBrown on December 03, 2013, 06:48:10 PM
Hi Chris,

Excellent statements.  It is indeed difficult to describe this, "accommodation rock" exercise.  Assuming you have confirmed you can read the 20/40 line, and want to practice "plus-accommodation rock", I do it this way.

I sit an my computer, wearing a +2 diopter, which "just blurs at 25 inches.  Then I work that way for about five minutes.  Then I look up quickly, over the top of my plus-glasses at the Snellen chart.  Sometimes I can clear a line or two by doing this.  As you suggested - this is to prevent "lens lock-up" - from never looking up.

You could also do it at work, by reading at the "just blur point", and when you "look up" your eyes rotate "outward", and that signal, "kicks" the accommodation system out-ward - as far as it can go.  That is the basic theory of this method.

As always, I enjoy all the analytic ideas we are presenting here.
Title: Re: A generalized system for myopia reversal
Post by: Alex_Myopic on December 04, 2013, 01:02:38 AM
Hi TomLu,

since you found the exercises helpful I'll repost them full with the metronome and charts.
Title: Re: A generalized system for myopia reversal
Post by: Alex_Myopic on December 04, 2013, 01:55:23 PM
Here they are:

http://www.2shared.com/file/dWW8pZkZ/vision_rock.html (http://www.2shared.com/file/dWW8pZkZ/vision_rock.html)

password:rocking
Title: Re: A generalized system for myopia reversal
Post by: jansen on December 09, 2013, 10:11:41 PM
Just an interesting thought adding on to the discussion about warming up the ciliary muscle, right now I'm trying out the warming up process by using a weaker pair of plus lenses at first, and then moving onto a stronger pair. Hoping i can break out of my almost year long plateau now.
Title: Re: A generalized system for myopia reversal
Post by: Alex_Myopic on December 10, 2013, 09:21:55 AM
There are mentions in this forum about the benefits of cold showers. Alternate hot and cold showers are also like a good exercise for circulatory system, they boost the immune system and give more energy. I have tried them and it works.

Here is an eye exercise which I think is very beneficial especially for the eye muscles and myopia reversal but I don't have very specifil results, somehow scientific intuition.

Quote
Hot and Cold Hvdro-Tlierapy

This is probably the best possible way to increase blood flow to ANY part of the body. If there's any part of your body that needs a bit of healing, this technique will speed up your recovery by many many times.

It's so simple, yet so overlooked. Consider this one of the best kept natural healing secrets you will ever learn.
The idea is very simple to understand. If you apply heat to a part of the body, the blood vessels and capillaries open up and drive blood to the surface of the skin. If you apply cold to a part of the body, the blood is driven away from the surface.
If you alternate the hot and the cold, the blood is driven first up and then down (or in and out, whichever way you want to see it)

Blood brings oxygen and nutrition (food) to every cell of the body, and takes away the waste products, toxins and pollution, so the cell remains strong, clean and healthy. Without a good blood flow, healing simply CANNOT TAKE PLACE.

This exercise takes 7 minutes to do properly, so it will extend your 15 minute routine if you do it fully. If you don't have the time, just do less repetitions.

If you do have time, or you are really committed to speeding up the return of your sight, then you can do this exercise twice a day (morning and night) in addition to your 15 minute exercise routine.

How to do it
1. Prepare 2 bowls of water, one cold and one hot.
2. Soak a cloth in each bowl.
3. Take the cloth from the hot bowl, wring it out a little so it doesn't drip
everywhere (or do this in the bath!!), and hold the cloth on your eyes for 30 seconds.
4. Then put the cloth back in the hot water bowl.
5. Take the cloth from the cold water bowl, wring it out a little, and hold that cloth on your eyes for 30 seconds.
6. Put it back in the cold water bowl and repeat the cycle 7 times (that's 7 hot and 7. cold)

Notes:
The greater the difference in temperature, the greater the increase in blood flow, but please don't go burning yourself! Use your common sense and build up gradually until you are using very hot water and ice water.

If you're feeling really brave you can try doing this in the shower every morning and night, and give your whole body a hydrotherapy session!
Title: Re: A generalized system for myopia reversal
Post by: OtisBrown on December 10, 2013, 10:07:06 AM
Hi Alex,

Subject: I also believe that, "recovery of naked-eye vision" - by your measurement and control - is totally necessary.

I do not advocate this for a person can not read the 20/70 line. I will do everything to help a person who has great fortitude to work on recovery to 20/60.  I know most people are "intimidated" by looking at a Snellen, but also by the idea of obtaining a lens to do their own checking. 

They think it is too complex, or beyond their ability.  I have created this video to show how truly simple it is to order lenses.  This is not "prescription" but wise self-protection.  (The example values are -1 and -0.5 diopters).

http://www.youtube.com/watch?v=5YTF2D3I4Ao

I am a fairly "intense" person, so, I expect I will do all this work on my own.  I also do not claim "success" beyond the limits I have suggested.  I do this, because I know that no optometrist can do any of this for me.  Therefore I must do this myself.

http://www.zennioptical.com/howto

I just do not think that the "economics" of an OD in his office - will work for me.  No insult intended - if I do everything myself.

Otis
Title: Re: A generalized system for myopia reversal
Post by: Alex_Myopic on December 10, 2013, 11:44:27 AM
Hi Mr Brown,

informing me that I should expect about +1/2 diopter of myopia recovery per year in the last diopter, made somehow less my frustration of my plateau.
Also wearing +1 and not +1,5 for seeing around at home I think you also suggested correctly.
Title: Re: A generalized system for myopia reversal
Post by: Alex_Myopic on December 15, 2013, 04:03:47 AM
In the Hot and Cold Hvdro-Tlierapy instead of cloths I use 2 cold/hot gel compresses, it's much easier.
Title: Re: A generalized system for myopia reversal
Post by: Tom on January 02, 2014, 10:08:43 AM
The Incremental Retinal Defocus Theory and its Merit

This shouldn’t be too relevant for most of you, but if you are interested, make sure you make it to the end.of this post. I thought I knew what IRDT is until I went through the papers by their authors - Chances are that one can't guess what IRDT is by its name.

Intro

Since Hung and Ciuffreda published their initial paper on Incremental Retinal Defocus Theory (IRDT), they have been trying to convince their colleagues about the predictive power of their theory. Namely, that IRDT is consistent with the recent myopia findings on the effects of undercorrection and light.

To begin, what exactly is this Incremental Retinal Defocus Theory (IRDT)? It’s an unifying theory on myopia development, maintaining that the decrease of retinal defocus, in a time increment, reduces the release rate of retinal neuromodulators, which in turn reduces the proteoglycan synthesis rate, rendering scleral tissues more vulnerable, which leads to an increase of the axial growth rate.

In a similar but opposite manner, IRDT also maintains that the increase of retinal defocus, in a time increment, will send a cascade of chemical signals which would ultimately retard the rate of axial growth.

Hung and Ciuffreda emphasizes that it’s the change of retinal-image defocus area, rather than the magnitude of defocus itself, that triggers the different behaviours of retinal neuromodulators (e.g., dopamine), and the ensuing effects on axial length.

Without further ado, Let’s look at what Hung and Ciuffreda have to say on different optical treatments on myopia.

The alleged effect of full-correction

With full correction, looking at optical infinity and 25cm do not result in substantial difference in retinal defocus. At optical infinity, although an individual might experience slight accommodation lead, the images at this distance are clear overall. Similarly, while at 25cm the same individual might experience a very slight accommodation lag, the presence of accommodation ensures that the retinal defocus at 25cm ultimately remains minimal.

That is, assuming that the person’s accommodation amplitude is at least 4D, then the person’s accommodation system, which enables adaptation to various visual stimuli, ensures that changes in retinal defocus from far to near is minimal. As a result, there is little change in the rate of axial growth.

Problems

All seems good, except that people wearing full prescription tends to see their diopter increasing year after year (until it stabilizes). Are they progressing at a genetically-determined default rate? No. It’s generally false that full prescription stabilizes myopia. In fact, anecdotal reports invariably suggest that most myopes who switch to an +2 undercorrection (for far and near) experience a slight initial reduction in myopia.

In fact, my experience with myopia shows that full prescription does exactly the opposite of stagnating myopia. My myopia only stopped when I stopped using minus lens for close work, while simutaneously abstaining from focusing within 50cm. In brief, evidence suggests that the appeal to the so-called genetically-programmed progression rate is precisely an appeal to the “unquestioned wisdom from the past.”

The alleged effect of 0.75D undercorrection

Assuming that a person’s default distance is at optically infinity (i.e., -0.75D of accommodation stimulus), with the usual accommodation lead at far distance, the individual, with the accommodation “disabled” at far, now experiences a relatively significant retinal defocus at optical infinity (i.e, >= 6 meters).

However, during a close work session, the individual shifts from far to, say, 25cm, at which point the individual would experience a significant reduction of retinal defocus (after the adjustment made by the accommodation system). Consequently, an increase in axial growth rate would ensue, as a result of the cumulated effect of regular far-to-near activities.

Problems

I understand that these researchers were trying to find an approach that would explain the O’Leary et al. study, but I just have to say that the reasoning they cooked up is too much of a stretch (and this is not to even take into account the criticisms of that O’Leary study, which some believe either contains serious methodological flaws, or reveals no statistical significance between the full prescription group and the undercorrected group, after a correction on the data)

Dr. Alex Frauenfeld’s approach to myopia rehabilitation, which typically consists of giving a 1D undercorrection for far, and a 2D undercorrection for near, would probably make no optical sense according to IRDT. Firstly, the +1 undercorrection for far would “disable” the accommodation system, creating a significant amount of retinal defocus at far. Secondly, when a Frauenfeld patient focuses near slightly beyond their far point, there would be practically no retinal defocus.

What this means that the regular shifting from far to near represents a significant decrease of retinal defocus, and the magnitude of this decrease is even greater than that resulted from a typical 0.75D undercorrection. Consequently, one would expect a Frauenfeld patient to become even more myopic. In reality though, just the opposite is true. Frauenfeld patients generally fare very well with their myopia - Just the opposite of what Hung and Ciuffreda's reasoning would have predicted.

The alleged effect of strong plus lens

Wearing a strong plus in effect disables the accommodation system. As a result, a subject can no longer focus far and near equally well. Focusing far with plus lens then produces a significant increase of retinal defocus, which retards the axial growth rate over time.

Problems

Read between the lines and you might see a double standard emerging 8). There is an implicit assumption that the research animals don’t engage in far-to-near activities, and that’s the reason why there is an overall increase of retinal defocus. There are actually animal studies in which the focusing distance is controlled, so that animals only look at a particular distance most of the day.

Under those experimental settings, the increase of retinal defocus only happens in the initial days of the experiments. However, despite the lack of change in retinal defocus in the later days of the experiments, the myopia-inhibiting effect of plus lens still make itself present. IRDT would have predicted than little refractive change would occur in the later days of such an experiment.

Other predictions

Since children can accommodation fairly well, a small overcorrection would lead to little change in retinal defocus (after accommodation), hence the effect of overcorrection wouldn’t be significant. Similarly, since multifocals allows one to see both far and near equally well, IRDT predicts little change of myopia progression from the use of, say, bifocal.

Problems

Overcorrection in animals and humans invariably worsen myopia (dubbed by the mainstream as the normal genetically-programmed myopia progression rate). Previous studies on multifocals, especially the bifocals, do display some degree of myopia-inhibiting effect. These effects were brushed off as being insignificant.

Alledged ideal prescription

Hung and Ciuffreda suggests a full prescription for far, and a weak undercorrection (+0.5 or +0.75 add) for near tasks, as their computer simulation suggests that doing so would minimize any change in retinal defocus, and hence result in little myopia progression.

Problems

With these prescriptions, the patients would still experience chronic close strain. The full prescription ensures that ciliary never relaxes, and the tiny amount of undercorrection in the prescription for near almost guarantee that reading will be done with a fair amount of close strain.

Final words

The Incremental Retinal Defocus Theory is not a theory about minimal myopic defocus. Rather, it’s a theory about the change of retinal defocus, in an increment of time. In fact, IRDT would predict that constant edge-of-blur will produce no change in retinal defocus over time, thus no change in myopia progression.

IRDT strikes me as being out of touch with the reality of myopes. For the sake of completeness though, here (http://www.oepf.org/sites/default/files/journals/jbo-volume-15-issue-3/15-3%20Hung-Ciuffreda.pdf) is the link to one of Hung and Ciuffreda’s paper.
Title: Re: A generalized system for myopia reversal
Post by: Tom on January 18, 2014, 05:43:44 PM
A Theory of the Development of Near-Stress-Induced Myopia - Mechanical Component

Many people (e.g., Bates method’s advocates, behavioral optometrists) came to suspect the connection between nearwork and reduced visual acuity. Here’s a theory of myopia based on the idea of near stress. I hope it helps in addressing some gaps in our current understanding about myopia.

Near Stress

The ocular system is intricately fine-tuned and highly adaptive to our visual environment. For example. the accommodation system, essentially composed of pupil, ciliary and the crystalline lens, constantly adjusts to the visual stimuli, based on their contrast, brightness, color, proximity, size, etc.

When focusing on a close object (i.e., within 1 meter) or confined in a near environment, the eye receives proximal cues from our surrounding. This would innervates the parasympathetic nervous system, which then activates the contraction of ciliary muscle. This process, called proximal accommodation, represents a coarse mechanism by which the eye adjusts to the visual stimuli. The degree of proximal accommodation depends on the perceived proximity of visual stimulus, and not necessarily on the degree of accommodative stimulus.

This means that regardless the prescription being used, engaging in near work within, say, 50cm, invariably triggers proximal accommodation, whose magnitude increases as we lean closer to the focusing object. Some remarks from Ip et al. (http://www.iovs.org/content/49/7/2903.full):

Quote
Longer time spent on reading for pleasure and reports of close reading distance (< 30 cm) were associated with a more myopic refraction after adjustment for age, sex, ethnicity, and school type (P(trend) = 0.02 and P = 0.0003, respectively). Time spent in individual near-work activities, however, correlated poorly with SER (all r < or = 0.2) and was not significant in multivariate analyses for myopia (SER < or = -0.50 D), with adjustment for age, sex, ethnicity, parental myopia, school type, and outdoor activity.
[...]
Although myopia was not significantly associated with time spent in near work after adjustment for other factors, there were significant independent associations with close reading distance and continuous reading. These associations may indicate that the intensity rather than the total duration of near work is an important factor.

In addition to the coarse mechanism of proximal accommodation, a finer mechanism of accommodation also exists, which operates mainly based on the defocus of the visual stimulus (i.e., magnitude and direction of the defocus). This is called blur-driven accommodation, or simply accommodation for most people.

Emmetropization (i.e., the regulation of axial length during our growth) is essentially a byproduct of accommodation. However, blur-driven accommodation could be exploited to disrupt normal emmetropization and induce myopia. To illustrate, when a full minus prescription is used for reading at 50cm, the eye is exposed to 2D of accommodative stimuli. As a result, blur-driven accommodation kicks in. The ciliary tenses up, and the crystalline lens thickens in order to reduce the blur. This blur-driven accommodation increases as you negativize the prescription lens power and lean closer to focusing objects.

In addition to these two accommodative mechanisms, another one related to vergence, called convergence accommodation (i.e., accommodation that results solely from converging the eye axes) can also contribute to near stress as we move the eye axes nasalward (i.e., towards our nose). Just as focusing close increases convergence accommodation, the general use of traditional minus spectacle, whose prismatic effect increases esophoria and makes images appear smaller, also puts more convergence demand on our eyes.

Prolonged proximal, blur-driven and convergence accommodation put tremendous demand on the focusing muscle (i.e., ciliary) and the crystalline lens. This leads to accommodative stress, which is described anatomically by Dr. Kaisu Viikari as follows:

Quote
The accommodation spasm strains and swells the accommodation muscle (m.ciliaris, whose processus ciliares are responsible for secreting the aqueous humor). Also the lens of the eye thickens, producing stronger refraction. *On top of not working in an ideal fashion, these swollen anatomical structures take up space* and narrow the angle: the circulation and outflow of the aqueous humor are decreased, and the intra ocular pressure increases.

Just as convergence and accommodation can "increase" each other, convergence itself poses a threat in its own right. As a person leans very close towards an object, achieving better visual acuity requires the medial recti and oblique muscles to contract (by shortening themselves). This isotonic contraction would then move the eyeballs inwards so that image fusing becomes possible.

However, if the convergence is sustained, then the prolonged isotonic extraocular contractions would increase pressure in the vitreous chamber. This is the phenomenon of convergence stress.

Together, the joint phenomenon of accommodative and convergence stress is referred to as near stress, with close strain simply referring to their respective symptoms (e.g., pressure in the back of the eye, distance blurring).

The Effects of Prolonged Near Stress

In general, accommodative stress induces ciliary tension, making the crystalline lens rounder. Since the crystalline lens naturally tends towards a rounder shape (in order to release its internal pressure), eliminating accommodation after an episode of near stress will not undo the thickening of crystalline lens immediately.

This means that there is a time lag between the end of an accommodative-stress episode, and the full recovery of the ciliary and the crystalline lens (and the entire eye for that matter) to their original resting state. This phenomenon is coined accommodation hysteresis (also known as accommodative adaptation), with temporary near and distance blurring being its chief symptom.

Similarly, there is time lag between the end of a convergence-stress episode, and the full recovery of the medial recti and the oblique muscles (and the entire eye for that matter) to their original resting state. This phenomenon is coined vergence hysteresis, with temporary posterior ocular pressure and temporary pressure around the nose being its chief symptoms.

Depending on the intensity of near stress, hysteresis (accommodative or convergence alike) could last from minutes to hours. For those with more flexible ciliary, crystalline lens, extraoculars, and stiffer connective tissues (i.e., retina, choroid and sclera), hysteresis is almost not a concern. Consequently, these are the people who experience little myopia. On the end of the spectrum, some folks might exhibit innervation deficiency of sympathetic nervous system (which regulates ciliary relaxation) and cranial nerve III, IV and VI (e.g., those exhibiting a natural tendency to tighten the extraoculars) or they might just have less flexible ciliary/zonular fibers, extraoculars and weaker connective tissues. For them, hysteresis needs to be taken more seriously.


If near stress persists and remains unmanaged, then things become a bit more serious:

Summary

A saying found in Myopia Manual says it all:

"Any system, under stress, will adapt to that stress, in the direction of the stress, to accommodate that stress"
Title: Re: A generalized system for myopia reversal
Post by: caimanjosh on January 23, 2014, 11:31:26 AM
Good addition to the info on the connection between light and myopia.  I had previously noticed that my distance vision was much better in direct sunlight.  During the previous summer, I took advantage of that by often going up to our building's roof and reading, using my strongest plus lenses, in direct sunlight.  Perhaps this helped my vision out even more than I thought it would, due to the possible chemical changes that the sunlight would cause in my eyes.  I'm looking forward to doing more of that once late spring arrives. 
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on February 11, 2014, 04:05:35 AM
Hi Tom,

You might wish to include the concept of "negative accommodation" - in your analysis.

http://razlab.mcgill.ca/docs/negativeaccommodation.pdf

I truly believe that a person must look for an "average" of his vision - on his Snellen.   A "clear flash", while not permanent, is a good indication that a person's efforts will be rewarded.  For instance, if a person, wearing a plus, starts at 20/40, and persists, and starts seeing 20/20 in "flashes", that should encourage him.  Continued wearing of a plus, and exercise, can slowly increase the time he sees 20/20, and eventually, the 20/20 does become more stable.

But that must always be a choice of the person who is doing exercise or wearing the plus (to end stress at near).
Title: Re: A Compendium on Myopia Rehabililation
Post by: CapitalPrince on February 11, 2014, 05:30:07 AM
sometimes when i look at an image that I can barely see and i actively try to focus on it, I get this feeling as if the lenses in my eyes are being flattened. It's a sharp feeling. This only happens very rarely and most of the time i just feel some discomfort when i look at a blurry image.

The conditions have to be right to get that feeling either the distance or blurry, and you have to actively work on focusing. Only a slight discomfort may not bring permanent changes to the eye. I believe if one can find those optimum conditions, improvements can happen very rrapidly.
Title: Re: A Compendium on Myopia Rehabililation
Post by: mailliam on February 18, 2014, 08:10:16 AM
sometimes when i look at an image that I can barely see and i actively try to focus on it, I get this feeling as if the lenses in my eyes are being flattened. It's a sharp feeling. This only happens very rarely and most of the time i just feel some discomfort when i look at a blurry image.

The conditions have to be right to get that feeling either the distance or blurry, and you have to actively work on focusing. Only a slight discomfort may not bring permanent changes to the eye. I believe if one can find those optimum conditions, improvements can happen very rrapidly.

Wow you described the feeling perfectly. It's like my eyes are being stretched from the top and bottom simultaneously.

My vision also becomes super sharp. It's pretty much a clear flash, but I feel more in control of it.

The only times I ever feel like I improve my vision is after getting this feeling. The longer I hold it, the more I feel I improve.  If I just look outside for brief moments (1-3mins) without getting this feeling, I don't feel like I did anything for my eyes at all.

You mention optimum conditions, I feel these are what works for me:

- Natural light
- No glasses
- Objects at varying distances (sharp edges or text are easiest to focus on)
- Fasting (or at least an hour since your last meal)
- Deliberate practice (set out a timer to do this for at least 30 minutes, it usually takes me 10 minutes before I get that sensation you describe).
- A bit of movement (I sway side-to-side a little - activates my periphery)

This really only works if you are already seeing 20/40. You can do the same exercise but while using a normalized prescription (as Frauenfeld recommends) so that your corrected vision is about 20/30 to 20/40.

The biggest hurdle is life. Not being organised to put in that half an hour. Also the tendency to say, 'Ah that's more than enough for today' (that's why I recommend the timer).

I feel I am on the home stretch to my vision improvement journey. It's not a question of if I can get to 20/20 but more a question of when. I won't give a date because I might jinx it (or I get complacent and not put in the work).

P.S - TomLu, I haven't had a chance to go through some of your updated posts but I'm reading them now. Thank you for your contributions.
Title: Re: A Compendium on Myopia Rehabililation
Post by: CapitalPrince on February 19, 2014, 09:53:11 AM
I find that blinking, shifting, central fixation triggers this feeling, but still the conditions have to be right and its hard to maintain this positive stimulus

I also noticed that connecting my laptop to the television is also works fiarly well. Since I am a student, i can't spend several hours per day gazzing in the distance of using a snllen

An important concept is "locking in" improvements. Dr. alex wrote an article about this.

If a person uses the plus lens or does active focus for short sessions, I don't think the improvements would stick. Just as if i do close work for short periods of time  and go outside everyday, its very hard to make the eye go down. Only when students put their face in the book for hours at a time does the eye go down.
Title: Re: A Compendium on Myopia Rehabililation
Post by: caimanjosh on February 20, 2014, 01:00:10 PM
I'm eagerly awaiting this "theory of hyperopization" post, and also point "b" for "A Causal Model of Myopia Reversal".  Point "a" I think all of us reading this thread know, but I've no idea what the other method would be yet..
Title: Re: A Compendium on Myopia Rehabililation
Post by: CapitalPrince on February 20, 2014, 01:33:37 PM
dr frauenfeld says active focus/pushing focus (with or without plus lenses) is the key to reversing myopia and will eventually reverse axial myopia. but results will be slow.

 http://frauenfeldclinic.com/active-focus-the-key-to-reversing-myopia/
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on February 20, 2014, 08:46:59 PM
Subject: Plus-prevention  is indeed the second-opinion.

In all fairness - here is the advertisement.

http://www.bettervision.com/pr-plus-lens-1.html

But real success - depends on the person "starting early" (20/50) and being persistent for the long-term.
Title: Re: A Compendium on Myopia Rehabililation
Post by: CapitalPrince on February 25, 2014, 04:45:04 PM
Hi Tom I like the article on hyperopisation, Whenever i put the text slighty blurred and i blink a lot and i really try to focus on the letters, i feel the sensations that you described.
for some reason blinking and opening the eyes really help. I'm curious what it takes to "lock in" the improvements. I believe doing these for at least an hour at a time willhave the most benefit. 10 minutes of close work here and there will not cause the eyes to go down, only when a child does close work for hours and hours without breaks does his eyes go down.
Title: Re: A Compendium on Myopia Rehabililation
Post by: CapitalPrince on February 26, 2014, 05:32:09 AM
Also if a +4D child is given a +4D lens, he would probably be +6/+7 or more in a few years. But its REGARDLESS if he does "near work", since all his work is "beyond inifinity". I never realized this connection before, so it absolutely shows that the eye is bidirectional. But to achieve hyperopisation when the eye is in a myopic State is a lot harder since one has to work at the edge of blur for extended amount of amount to induce a strong enough stimulus for the eyes to change.
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on March 10, 2014, 06:55:19 AM
Hi Tom,

Subject:  A statement by two medical experts on wearing the "plus" for prevention.

I like to search out optometrists who advocate this new approach.

http://www.bettervision.com/pr-plus-lens-1.html

I am pleased to see this statement.  It makes prevention with the  plus the "second-opinion".


A small update on the prescription section of the close work post (http://forum.gettingstronger.org/index.php/topic,538.msg4855.html#post_prescription).
Title: Re: A Compendium on Myopia Rehabililation
Post by: CapitalPrince on March 12, 2014, 10:09:56 PM
hey Tom,

often people who are myopic are noticed to have somewhat "lifeless", bulgy, immobile, and "aloof" looks. Do you know why this happens?
Title: Re: A Compendium on Myopia Rehabililation
Post by: Tom on March 16, 2014, 11:06:26 AM
Just sent an email to Richard Anderson, the author of myopiaprevention.org:



Hello Richard. I spent the past week reading your website in its entirety. And here are some comments:

“Myopia forms because the eye grows too long. There is no anatomical method to shrink an eyeball short of cutting part of it off.”

“True myopia (nearsightedness) means that the eyeball has grown too long. That physical change can not be reversed .”


One would think that it’s impossible, but this is exactly what happened in the animal studies, and consistently so.  The animals who were fitted plus lens generally had a decrease in axial length below baseline level - Not just an inhibition of axial elongation.

On the human front, here is a study to be included in the undercorrection section:
http://www.iovs.org/content/51/12/6262.full?sid=dbdaf664-6184-42eb-a8d7-e94008536dce

And this, under the reading glasses section:
http://www.ever.be/view_abstract.php?abs_id=2042

“The web is full of false information and many doctors have become skeptical of any progress in this area because there have been so many false claims over the years. Patients have become skeptical of doctors because they are offered few options besides "wear the glasses" when their eyes and vision get worse.”

I think the medical community haven’t catched up with science in general. It’s only reasonable if patients look somewhere else if solution is nowhere to be found. At least the web opens up the alternative solutions that are otherwise unavailable. There is always the possibility that you or me or anyone else is not entirely correct anyway.

“The problem is getting worse every year and regular glasses are part of the problem.”
“I'm here to say that your doctor should offer you better options.”


Thanks for speaking out on this. I believe that more eye professionals need to change their usual practice before myopia spirals down into a serious epidemic. See http://bjo.bmj.com/content/82/3/210.full

“There is a good theory based on many studies that high carbohydrate diets could make myopia worse.”

You are not the only one suspecting the connection. I’ve tried incorporating some of your references into this post:

http://forum.gettingstronger.org/index.php/topic,538.msg5474.html#msg5474

“Bifocals and PALs are normally used for the condition of presbyopia, which is what happens to everyone, usually in their forties, when it becomes difficult to focus on both distant objects such as street signs and near objects such as a book. The solution is to make the corrective lens have two powers, one for each distance.”

But have you thought about the risk factors making crystalline lens stiffer over time? People should be aware that Bifocal/PAL does not address the causes of presbyopia.

“The reason would be that while wearing the glasses, the person would create a clear central focus so that they could read. This creates a peripheral hyperopia in many eyes, which would create more myopia, just as if the glasses were not being worn. The peripheral hyperopia would be there with or without the reading glasses. “

I think it should be emphasized that defocus changes as one changes the focusing distance as well. This explains why reading glasses won’t work if you read within your far point. I believe that special contact lenses study could be make to fail as well, if the subject were instructed to read very close. There is a difference between relative peripheral refraction, and the actual peripheral defocus in practice.

“Proponents of reading glasses state they should work because they relax the eye while reading, the assumption being that reading by itself causes myopia.”

If they believe that reading by itself causes myopia, why would they even use reading glasses? I think the main reason of using reading glasses is just so that near stress can be eliminated, but that won’t happen if one continues to read very close.

“Everyone became nearsighted before they got their glasses. If no glasses was a cure, there should be no blurred vision to begin with.”

“There is also the fact already mentioned that people become nearsighted before they start wearing glasses so that suggesting not wearing glasses as a "cure" is logically suspect.”

I believe that the logical suspect is that wearing full minus prescription is better than wearing no glasses. I have all the reasons to believe that near stress is the cause of myopia (which explains how people become myopic in the first place), and that traditional minus spectacles would make it worse. I also think that your recommendation is more dangerous than you think: the animals got myopic by wearing minus lens, and when the lens is removed, they recover from myopia. The same thing happens to me, and countless people on gettingstronger.org forum and frauenfeldclinic.com.

“Animals (including people) become nearsighted if they do not have clear vision as they are growing up. An example would be a child born with a cataract, which does not allow clear vision. If the cataract is not removed early, the eye will quickly become very myopic (and still blind). But it has been shown that brief periods of clear vision, as short as one hour a day in monkeys, are able to greatly negate the myopic effects. A corralary in humans may be that full distance correction needs to be worn at least part of every day to prevent myopic progression. If you don't have any glasses, you never have the clear vision that appears protective.”

I thought about this extensively a year ago and I can tell you that it’s not correct. Form deprivation is not the same as unclear vision. Form deprivation myopia occurs when there is occlusion or obstruction to our visual field. If unclear vision causes myopia, then animals wearing plus lens should have become more myopic, but that is the opposite of what happened. Again, even if clear vision is necessary for a brief period every day, I still think that your recommendation is more dangerous than you think.

“One study that was done with under-correction was stopped after two years when it became obvious that the under-corrected students were progressing faster than the fully corrected students. “

My experience suggests that undercorrection alone does not prevent myopia, as we also have to take into account the focusing distance in question. Also, this study did draw some criticisms. See:

a) http://wildsoetlab.berkeley.edu/index.php?title=Controlling_Myopia_Progression_-_A_Confusing_Story

b) http://www.i-see.org/oleary_critique.html

“Due to these factors, many people wear sunscreen on their skin and sunglasses on their eyes. Whether these actions negate or reduce the beneficial effect of being outdoors is not known.”

This is a good point. Using hat outside can mitigate both types of risks.

“Processed carbohydrates are a cheap source of calories and are heavily advertised by the food industry because they are profitable. “

You must have been aware that the same thing applies to the industry of ophthalmic lenses, and the influence they exert on our research studies. It also seems to me that this website is set up to promote orthokeratology and the website orthokdoctors.com. I think myopia is best tackled through myopia rehabilitation (see www.frauenfeldclinic.com).

“there has been no study to show that pseudo-myopia, if not treated, leads to more myopia.“

What if there is no interest in conducting such studies? In fact, we do have countless indirect evidence suggesting that it is the case (e.g., the atropine studies, the studies showing how NITM can increase vitreous chamber depth in susceptible individuals). One just have to seep through the papers.

The idea that pseudomyopia leads to mypia is something that I can witness everyday. After all, research are conducted by humans, who might have all kinds of intentions and biases.

“Scientific thought has a history of both charlatans and subpresssion of alternative viewpoints “

This is why I'm writing to you. Maybe some of the research studies will be regarded as bogus as we look back hundreds of years later, and the charlatans are not necessarily the laypersons.

“Most do so because they haven't seen the studies, but others will elect to ignore them.”

I think there is a possibility that some researches are only conducted to prove their point, some might not be even well controlled, yet some others might have a hidden agenda, but I agree that in general, we shouldn’t deny a study unless we have compelling reason to do so.



Also, I really appreciate the three clauses in your mission statement. This shows that you are an optometrist open to alternative viewpoints, such as the theory and application of myopia rehabilitation through behavioral methods:

http://forum.gettingstronger.org/index.php/topic,538.0.html

All the best,

Tom
Title: Re: A Compendium on Myopia Rehabililation
Post by: Tom on March 17, 2014, 05:08:14 PM
Myopia and the Associated Pathological Changes

The long-term repercussions of higher myopia are usually not readily apparent to its sufferers until it is fairly late.  And hence this post, which is based on this meta-analysis (http://onlinelibrary.wiley.com/doi/10.1111/j.1475-1313.2005.00298.x/full). The motivation here is twofold. On one hand, knowing the possible complications of myopia provides one with strong incentives towards myopia rehabilitation. On the other hand, knowing about the pathological changes associated with myopia might shed some light on how myopia could have developed in the first place (at least for me - see if I can get some inspiration from that!).

Cataract

Cataract refers to the condition that as one ages, sometimes protein deposits would start to accumulate in the crystalline lens. Consequently, the lens becomes more opaque, which then over time induces form deprivation myopia. Cataract has at least 3 types: posterior subcapsular, cortical and nuclear. While different types of cataract might not share the same etiology, cataract is generally associated with higher myopia. Although it’s known that cataract can worsen myopia, it’s unclear how myopia progression can induce pathological changes in the crystalline lens. It is speculated that such changes might have occurred due to “damage of rod outer segments,” and an increase in the production of “penoxidation by-products.”  Large cohort studies have demonstrated that cataract in general could result as a complication of high myopia.

Glaucoma

Primary open-angle glaucoma (POAG) is a condition generally associated with pathological changes in optic disc, defects in optic nerve layers and high intraocular pressure. Glaucoma is most likely the result of axial elongation and sustained pressure in the vitreous chamber, and whose incidence is strongly positively-correlated with the severity of myopia. Corroborating evidence includes the fact that emmetropes have substantially lower intraocular (vitreous) pressure than myopes, and that high myopes have larger and longer optic disc, and shallower cup depth. Here are the excerpts of a few findings:

(OR stands for odd ratio, IOP for intraocular pressure)


Abnormalities Related to Connective Tissues

Although the strength of connective tissues might vary from one individual to another, an increase in myopia could have lasting repercussion on the posterior part of the globe. Ocular conditions pertaining to this category are numerous, they include vitreous liquefaction, posterior vitreous detachment, Fuch’s spot, lacquer cracks, retinal breaks, macular holes, choroidal atrophy, lattice degeneration, posterior staphyloma and white without pressure.

The association between such abnormalities and myopia progression is generally based on clinical data only. Certain chorioretinal conditions might have been triggered by mechanical stretching or biochemically-modulated atrophy. Here are a few findings:

(AL stands for axial length, and OR for odd ratio)


Optic Disc Abnormalities

Numerous studies suggest that myopic progression is associated with larger, longer, tilted or rotated optic disc:
In another study, tilted disc is associated with the presence of myopia, suggesting that tilted optic disc might have provided predisposition towards myopia development. This could explain in part the variability of diopters in samples where subjects are exposed to similar prolonged near stress environment:


Visual Impairment

In very rare cases, myopic degeneration (due to high myopia) in advanced age could lead to visual impairment (in addition to cataract and glaucoma). Furthermore, myopic age-related macular degeneration is a significant cause of blindness in Asia, suggesting that for people with weak connective tissues, higher myopia increases the risk of macular degeneration in advanced age:

Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on March 21, 2014, 06:25:52 AM
Hi Tom,

For those interested Richard's true-prevention  - here is the video:

http://www.youtube.com/watch?v=vNNQY2_bTlo

Here is Richard's attractive site on prevention.

http://myopiaprevention.org/

It is funny how "close" Richard gets to the correct solution, with the kids and being in the "open".  The plus, when properly worn (before you become nearsighted, i.e., still read 20/40), creates that "out-door" environment - that he says will keep your child's refractive STATE positive.  But he avoids that type of discussion - completely.

Here is a video on using the plus for threshold prevention.

http://www.youtube.com/watch?v=uWjnNM0VYM4

I love it when an OD actually recommends the plus.

Where are the  "cost comparisons" of these two methods?

I am certain that Richard is a sincere, dedicated optometrist.  He sees that he can "fix" you with an "instant" minus lens - and does not know if you wish TRUE prevention.  So he tells you "up front" that he does not offer you prevention - because that is, in his mind  - impossible.

It is hard to avoid the conclusion that he considers you ignorant (in some manner), and that he has to make his living.  So he sees you as a "$$$$$ bottom line " for his business.  In fact, I do not object.  But I do not ask him for help with prevention AFTER he has told me point-blank, that prevention never going to be possible.

I am not even critical of him.  But if I wish for TRUE prevention (at 20/40) I will have to do it myself.

That is indeed a "bitter pill" to swallow.  I know we want Richard to hold out "hope" to us.  What he holds out is Ortho-K, that does work.

Otis



Just sent an email to Richard Anderson, the author of myopiaprevention.org:



Hello Richard. My name is Tom Lu. I spent the past week reading your website in its entirety. And here are some comments:

------

“Myopia forms because the eye grows too long. There is no anatomical method to shrink an eyeball short of cutting part of it off.”

“True myopia (nearsightedness) means that the eyeball has grown too long. That physical change can not be reversed .”


One would think that it’s impossible, but this is exactly what happened in the animal studies, and consistently so.  The animals who were fitted plus lens generally had a decrease in axial length below baseline level - Not just an inhibition of axial elongation.

On the human front, here is a study to be included in the undercorrection section:
http://www.iovs.org/content/51/12/6262.full?sid=dbdaf664-6184-42eb-a8d7-e94008536dce

And this, under the reading glasses section:
http://www.ever.be/view_abstract.php?abs_id=2042


“The web is full of false information and many doctors have become skeptical of any progress in this area because there have been so many false claims over the years. Patients have become skeptical of doctors because they are offered few options besides "wear the glasses" when their eyes and vision get worse.”

I think the medical community haven’t catched up with science in general. It’s only reasonable if patients look somewhere else if solution is nowhere to be found. At least the web opens up the alternative solutions that are otherwise unavailable. There is always the possibility that you or me or anyone else is not entirely correct anyway.

“The problem is getting worse every year and regular glasses are part of the problem.”
“I'm here to say that your doctor should offer you better options.”

Thanks for speaking out on this. I believe that more eye professionals need to change their usual practice before myopia spirals down into a serious epidemic. See http://bjo.bmj.com/content/82/3/210.full

“There is a good theory based on many studies that high carbohydrate diets could make myopia worse.”

You are not the only one suspecting the connection. I’ve tried incorporating some of your references into this post:

http://forum.gettingstronger.org/index.php/topic,538.msg5474.html#msg5474

“Bifocals and PALs are normally used for the condition of presbyopia, which is what happens to everyone, usually in their forties, when it becomes difficult to focus on both distant objects such as street signs and near objects such as a book. The solution is to make the corrective lens have two powers, one for each distance.”

But have you thought about the risk factors making crystalline lens stiffer over time? People should be aware that Bifocal/PAL does not address the causes of presbyopia.

“The reason would be that while wearing the glasses, the person would create a clear central focus so that they could read. This creates a peripheral hyperopia in many eyes, which would create more myopia, just as if the glasses were not being worn. The peripheral hyperopia would be there with or without the reading glasses. “

I think it should be emphasized that defocus changes as one changes the focusing distance as well. This explains why reading glasses won’t work if you read within your far point. I believe that special contact lenses study could be make to fail as well, if the subject were instructed to read very close. There is a difference between relative peripheral refraction, and the actual peripheral defocus in practice.

“Proponents of reading glasses state they should work because they relax the eye while reading, the assumption being that reading by itself causes myopia.”

If they believe that reading by itself causes myopia, why would they even use reading glasses? I think the main reason of using reading glasses is just so that near stress can be eliminated, but that won’t happen if one continues to read very close.

“Everyone became nearsighted before they got their glasses. If no glasses was a cure, there should be no blurred vision to begin with.”

“There is also the fact already mentioned that people become nearsighted before they start wearing glasses so that suggesting not wearing glasses as a "cure" is logically suspect.”

I believe that the logical suspect is that wearing full minus prescription is better than wearing no glasses. I have all the reasons to believe that near stress is the cause of myopia (which explains how people become myopic in the first place), and that traditional minus spectacles would make it worse. I also think that your recommendation is more dangerous than you think: the animals got myopic by wearing minus lens, and when the lens is removed, they recover from myopia. The same thing happens to me, and countless people on gettingstronger.org forum and frauenfeldclinic.com.

“Animals (including people) become nearsighted if they do not have clear vision as they are growing up. An example would be a child born with a cataract, which does not allow clear vision. If the cataract is not removed early, the eye will quickly become very myopic (and still blind). But it has been shown that brief periods of clear vision, as short as one hour a day in monkeys, are able to greatly negate the myopic effects. A corralary in humans may be that full distance correction needs to be worn at least part of every day to prevent myopic progression. If you don't have any glasses, you never have the clear vision that appears protective.”

I thought about this extensively a year ago and I can tell you that it’s not correct. Form deprivation is not the same as unclear vision. Form deprivation myopia occurs when there is occlusion or obstruction to our visual field. If unclear vision causes myopia, then animals wearing plus lens should have become more myopic, but that is the opposite of what happened. Again, I think your recommendation is more dangerous than you think.

“One study that was done with under-correction was stopped after two years when it became obvious that the under-corrected students were progressing faster than the fully corrected students. “

My experience  suggests that undercorrection alone does not prevent myopia, as we also have to take into account the focusing distance in question. Also, this study did draw some criticisms. See :

a) http://wildsoetlab.berkeley.edu/index.php?title=Controlling_Myopia_Progression_-_A_Confusing_Story

b) http://www.i-see.org/oleary_critique.html

“Due to these factors, many people wear sunscreen on their skin and sunglasses on their eyes. Whether these actions negate or reduce the beneficial effect of being outdoors is not known.”

This is a good point. Using hat outside might mitigate both types of risks.

“Processed carbohydrates are a cheap source of calories and are heavily advertised by the food industry because they are profitable. “

You must have been aware that the same thing applies to the industry of ophthalmic lenses, and the influence they exert on our research studies. It also seems to me that this website is set up to promote orthokeratology and the website orthokdoctors.com. I think myopia is best tackled through myopia rehabilitation (see www.frauenfeldclinic.com).

“there has been no study to show that pseudo-myopia, if not treated, leads to more myopia.“

What if there is no interest in conducting such studies? In fact, we do have countless indirect evidence suggesting that it is the case (e.g., the atropine studies, the studies showing how NITM can increase vitreous chamber depth in susceptible individuals). One just have to seep through the papers.

The idea that pseudomyopia leads to mypia is something that I can witness everyday. After all, research are conducted by humans, who might have all kinds of bias and intentions.

“Scientific thought has a history of both charlatans and subpresssion of alternative viewpoints “

This is why I'm writing to you. Maybe some of the research studies will be regarded as bogus as we look back hundreds of years later. The charlatans are not necessarily the laymen.

“Most do so because they haven't seen the studies, but others will elect to ignore them.”

I think there is a possibility that some researches are only conducted to prove their point, some might not be even well controlled,, yet some others might have a hidden agenda, but I agree that in general, we shouldn’t deny a study unless we have compelling reason to do so.

-------

Also, I really appreciate the three clauses in your mission statement. This shows that you are an optometrist open to alternative viewpoints. I happen to host a topic about myopia, so you can check it out  out in your spare time:

http://forum.gettingstronger.org/index.php/topic,538.0.html



All the best,

Tom
Title: Re: A Compendium on Myopia Rehabililation
Post by: Alex_Myopic on March 22, 2014, 02:13:56 PM
and that he has to make his living.  So he sees you as a "$$$$$ bottom line " for his business.

One relative story of mine. My faucet was leaking from the point of the rotation. I asked the plumper if this was fixable and said no so he changed the whole faucet. I didn't had time that moment to try to fix it myself because the tenant was hurried. So the plumber took 20 euros for changing the whole faucet and about 50 for the new faucet which he bought from a store he had business with.
When I had time I managed to fix the old faucet in few minutes with just cannabis fibers for plumbers and teflon tape. I'm not more capable from him in plumping.

Why not doctors take the money in similar ways?
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on March 29, 2014, 05:01:11 AM
Hi Tom,

I think you are doing excellent academic research on your compendium.  You might submit your ideas to this conference for 2014.  Here are some topics you should include in your book.


http://www.clspectrum.com/articleviewer.aspx?articleID=105665

Previous conference on myopia prevention - FYI:


++++++

From: Berkeley Optometry Alumni Office <optoalumni@...
Subject: REMINDER: 2013 Translational Research Conference, August 17th &
18th

Date: July 26, 2013

Don't forget to register for the 2013 UC Berkeley Clinical Translational
Research Conference Series on Myopia in August - Saturday, 8/17 and Sunday,
8/18! REGISTER NOW

http://www.berkeleyclinicaltranslation.org

 
QUESTIONS:   What do you know about controlling myopia progression & managing high myopia?

1. Did you know that CRT (ortho-k) can slow myopia progression in
children, measured in terms of axial length changes, by about 50%?

2. Did you know that some concentric bifocal soft contact lenses that
are already approved for presbyopia, can also reduce myopia progression by
about 50%?
 
3. Did you know that the human choroid can thicken (just as in
chickens), when eyes are exposed acutely to myopic defocus (e.g., wearing
plus lenses), leading to an apparent shrinkage of axial length and
reduction in myopia?

4. Did you know that topical atropine in a very low concentration more
in keeping with homeopathy practice, with only small, short-lived effects
on pupil size and accommodation, can slow myopia progression by about the
same amount as the above contact lenses?

5. Did you know that a new drug, 7-methylxanthine (in a totally new
class, adenosine analog), has already been approved for use as an ORAL
tablet to control myopia progression in children in Denmark?

6. Did you know spending time outdoors helps to slow myopia progression
and lowers the risk of becoming myopic, although they reason for this
protective effect is not well understood?

7. Did you know that ~96% of ALL young adult males in Seoul, South
Korea, are now myopic, arguing that genes are likely more a determinant of
susceptibility than an absolute determinant of myopia?

8. Do you know that very long, highly myopic eyes become mechanically
unstable and thus will show myopia progression, despite intervention with
improvements in visual hygiene and/or optical interventions, thereby
requiring more invasive and risky intervention with scleral buckles
inserted under general anesthesia?

9. Did you know that all myopes carry an increased risk of retinal
 detachment, maculopathy, cataracts, and glaucoma, and it is only the
 relative risk that changes with the amount of myopia?

10. Do you know that the parents of myopic children are frequently
better informed about the causes of myopia progression and potential new
treatments that the clinicians they consult?

If "I don't know" was your answer to any of these questions, turn over
to learn how to register for the above conference, which should be a "must
attend" for you.

In it's seventh year, this annual campus-based event will host
 world-renowned myopia researchers from overseas, including Professors Ian
 Filtcroft, MD, from Dublin's Children's University Hospital in Ireland;
 Audrey Chia, FRANZCO, from the National University of Singapore; Michael
 Collins, OD, PhD, from Queensland University of Technology in Australia; as
 well as US-based Professors Earl Smith, OD, PhD, from University of Houston
 College of Optometry; Jay Neitz, PhD, from University of Washington,
 Seattle; Jeff Walline, OD, PhD, from Ohio State University and Robert
 Wojciechowski, PhD, from Johns Hopkins University. To get the full scoop on
 the speakers, click here.

http://www.berkeleyclinicaltranslation.org

CE credit will be offered: 9 (3+6) hours, including one hour TPA (all on
Sunday)

REGISTER NOW

http://www.berkeleyclinicaltranslation.org

 Following closely on the heels of this event is the 14th International
 Myopia Conference, this year also being hosted by UC Berkeley myopia
researchers. This conference will take place August 19-22 at Asilomar
Conference Grounds in Pacific Grove, CA.

For more information, please contact Christine Wildsoet at

wildsoet@... or call 510-643-4472.




Diet (http://forum.gettingstronger.org/index.php/topic,538.msg5474.html#msg5474) post expanded - a result of additional infos.
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on April 04, 2014, 12:23:09 PM
Hi Tom,

I get the impression that all optometrists believe that any "prevention" at 20/40, is impossible.  I wonder if you could provide some commentary on this video.

https://www.youtube.com/watch?v=Dz2UHcmyR4E

I of course believe that, if the person is highly motivated, he can get out of 20/40.  But if you ask an OD to "conduct" a prevention study - you get the "fish eye" from them.

Finally, I just avoid them, and recognize that people like Todd - did prevention himself - and was successful.

Sounds good. I'll see what I can do in my spare time.

Quote
If "I don't know" was your answer to any of these questions, turn over
to learn how to register for the above conference, which should be a "must
attend" for you.

The answer is "yes" to all the questions. Maybe I should put those questions in Q&A and people can look over  ::)
Title: Re: A generalized system for myopia reversal
Post by: svartberg on April 04, 2014, 11:21:55 PM
Prescription for close work

The single most myopiagenic activity is to read with a strong minus lens, which has the potential of inducing hyperopic defocus (either due to accommodation lag, or inherently prolate eye shape), or overconvergence (and its associated side effects). One should read either with the weakest minus lenses, or without glasses.

[Edit: The issue of eyeglasses frame got picked up. On the March 11 (2014) blog entry (http://frauenfeldclinic.com/depression-anxiety-might-want-avoid-frames/), Dr. Alex recommends frames with minimal border. This is yet another way to free up our peripheral vision. In general, we only want to correct the central vision when using minus lens, so a smaller frame without border is desirable. For those using plus lens, a bigger frame would tend to positivitize peripheral defocus, and hence is preferred for myopia rehabilitators. Personally, I prefer aviator-style frame with peripheral add, because they are stylish and big enough that one can't see the border within one's visual field.]

Since a traditional minus spectacle has an uniform power across all meridians. If you read at your far point, there is still a potential of inducing hyperopic defocus in the periphery. One way to minimize that defocus, is by adding positive cylinder value to your prescription (e.g., -3D with cylinder +1D at 0° axis, as a reading prescription of a -5D non-astigmatic myope). The 0° axis is preferable, since reading is usually done from left to right, in the horizontal meridian. Positivizing cylinder value is applicable regardless of the strength of your reading prescription (e.g, be it -4D or +1D).

(Until lenses with peripheral design are widely available, it's pretty tough to eliminate peripheral hyperopic defocus at all meridians, while maintaining zero central defocus. However, if you use contact lenses and are resourceful enough, you should be able to obtain concentric-design bifocal contact with peripheral add online)

Great thread, still much left to process

Such good info above, luckily I got a rimless pair and could validate alex post right away (funny how I never made the connection)

You lost me at the positive cylinder valus though, what exactly does it do ? how do you calculate it ? is it really that important ?

Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on April 05, 2014, 07:00:11 AM
Hi Tom,

You are correct. But understand where they are "coming from".  They concluded a long time ago that "prevention is impossible".  (Prevention of negative status for the totally natural eye - in my words.)  I agree that prevention (at 20/40, and -1 diopter) is extremely difficult, and requires the person to "wake up" and do prevention by himself.  An optometrist will never attempt to conduct a pure-prevention study - because he always believes that "only an optometrist can do prevention".  Yes, the disconnect, is that they obviously feel that they can only "deal with it" - after the fact.

But,  with all of this, some few ODs have recognized that while "official optometry", declares that prevention (even at 20/40) is impossible, they declare the minus, "poison", and will not use it on their own children.  In fact they insist that THEIR child, always wear a plus for all close work.  Clearly they understand that the ignorance of the public will always "cause the rejection" by the public.

That to me is the only issue.



These people are researchers - Edward Mallen is actually in my people-to-be-contacted list. Both of them are among those who sounded the alarm about NITM. Notice that they are the theories guys - Bridging the missing link between the researchers and the public is kind of like my duty  8)
Title: Re: A Compendium on Myopia Rehabililation
Post by: Tom on April 05, 2014, 10:49:13 AM
I got an update from Scott Read (author behind many important studies, including the  TV undercorrection study (http://forum.gettingstronger.org/index.php/topic,538.msg5339.html#msg5339)). These folks are currently focusing on devising biometric to measure scleral changes during near work. This would allow us to better understand in more details how near-stress induces myopia.

Me here:

Quote
Hello Scott, Emily and Michael. My name is Tom and I host a topic on gettingstronger.org forum:

http://forum.gettingstronger.org/index.php/topic,538.msg4584.html#msg4584

I have read your 2012 study (http://www.sciencedirect.com/science/article/pii/S0042698912003008).that examines the role of accommodation in axial elongation and choroidal thinning. This is a very important result - Because the public desperately needs to know that NITM in susceptible individuals can lead to permanent myopia.

One way to reduce accommodation gain during close work is to read at 1 meter and beyond. However, this proves to be not very practical at times. For that reason, using reading glasses (plus lens) to read beyond one's far point can eliminate blur-driven accommodation.

However, the matter is not as simple as I once thought. My experiments with convergence and accommodation invariably suggests that even if blur-driven accommodation is completely eliminated, I still experience near stress (symptom of vitreous elongation) when I'm reading at very short distances. The same stress would subside minutes or hours after cessation of close work. This means that there is another crucial driver of near stress in addition to the commonly-known accommodation, and I suspect that the culprit is proximal accommodation.

In light of that, I wonder if you are interested in setting up a study with 2 treatment groups, both being optically corrected so that they read slightly beyond their far point, for 30 minutes, but one group reads at 20cm and the other group can read at, say, 50cm. Assuming that the subjects' left eye are occluded, then convergence shouldn''t be involved in the task. The usual biometrics would then be recorded, several times during and after the reading task (perhaps some scleral biometric as well).

If axial length still increases during the reading task, then this would provide strong evidence that proximal cues, even in the absence of hyperopic defocus, can indeed elongate the eyes temporarily. If not, that will prove me wrong. I know that Emily is writing a thesis on NITM-induced myopia, so maybe we can learn something new from this kind of study.

I sincerely believe that there is a potential that conclusive evidence of myopia via NITM can come from QuT, so I'm interested in anything that you have to say about this.

Thanks for your groundbreaking works on unraveling the causes of myopia.


Regards,

Tom

Scott here:

Quote
Dear Tom,
 
Thanks for your interest in our work, and for your suggestion for a potential future study in this area, we agree that this is a relatively complex area, and that there are a number of factors related to the changes in the eye with near work that remain to be fully explored.
 
We are currently running experiments examining the choroidal response to nearwork, as well as developing methods for assessing changes in scleral biometrics with close work.  We hope that our current work will help us to better understand the mechanisms associated with near work induced axial elongation, and help to provide us with methodologies for exploring the changes in the eye associated with near work in more detail in future clinical studies.
 
Best Regards,
Scott
 
Dr Scott Read 
Senior Research Fellow | School of Optometry and Vision Science
Contact Lens and Visual Optics Laboratory | Queensland University of Technology 
O Block, Room D517, Victoria Park Road, Kelvin Grove, QLD, 4059, Australia


t:   (07)  3138 5714
Title: Re: A Compendium on Myopia Rehabililation
Post by: chris1213 on April 09, 2014, 09:59:10 PM
Hi TomLu: I don't understand this much, where are u getting your facts from or how are you studying it?

Quote
Some of you are not going to like this, but my evidence invariably suggests that hyperopization is largely the additive effect of farwork-induced-transient-hyperopia. The so-called "active focus", is really one way to induce transient hyperopia. Not just that, I was able to clear up images at any distance (provided that the objects are far enough). Put it more explicitly, the reason why people think that only staying at the edge of blur works, is because they thought the symptoms resulted from prolonged distance gazing represents a worsening of myopia (which is understandable - It took me one year to figure out that it's false)

Could you elaborate or explain it a little more?
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on April 10, 2014, 09:28:21 AM
Hi Tom,

A lot of this issue becomes a matter of answer the question, "who do you trust"?

Alex> Who Do You Trust With Your Eyesight Health?

Alex>Dispensing with false modesties, that answer is:  Trust this site.

Alex> Trust me with your eyesight health, and with answers to questions about how you can improve your eyesight.  If you look at these comments from participants in the Vision Improvement Course, previous clients, patients, and just readers of the site, you’ll start to see the trend.


http://frauenfeldclinic.com/how-to-improve-eyesight-without-surgery/

+++++

I would add the question, who do you trust, and why do you trust?  It is clear that successful prevention (from 20/40 to 20/60) will require that you TRUST the concept behind it.  The person I learned to TRUST was a Dr. Raphaelson, who described the minus lens (if ever worn) as POISON.  It a deep scientific sense - I did trust both that idea, and the SCIENCE behind the concept.

I hope Tom includes the proof that the minus is a "terrible idea" and should be avoided, once you confirm you objectively read and pass the 20/40 line.

I do not get into a "dispute" about this, but I know that almost all ODs believe that any form of prevention - is something they will never encourage - or accomplish.

Title: Re: A Compendium on Myopia Rehabililation
Post by: chris1213 on April 10, 2014, 07:49:25 PM
I see, now when you say the "persistent application of near stress that blurs my vision" are you talking about near stress with or without plus lenses?
Title: Re: A Compendium on Myopia Rehabililation
Post by: chris1213 on April 10, 2014, 09:41:38 PM
Interesting, interesting...

I want to know one more thing, how close do you read when you feel close-up stress? cause I remember that on some post you said your prescription was about -9 if I'm correct (?). If you're reading too close, I think that even with a plus, or an under correction or with no glasses the near stress would still be present. I can read with a +1 at about 60 cm and see fine, without glasses I can sit at about 1 meter away clearly, but I've noticed that if I sit at about 40 cm with a +1, my eyesight will deteriorate a little bit. So there must be a correlation between the distance and the stress despite the use of plus lenses.

On a side note, I believe that someone with a prescription over -6 would benefit more using an under-correction of no more than +0.25 and working on focusing pulling on far objects. Comparing eyesight 'training' with weight loss, someone with a prescription over -6 is like an overweight/obese person going on a diet. He/she would loose pounds way faster than someone who has an average weight and wants to loose the body fat to be able to show the abs. I mean, if we read Mr. Anders' story here http://forum.gettingstronger.org/index.php/topic,522.msg4503.html#msg4503 (http://forum.gettingstronger.org/index.php/topic,522.msg4503.html#msg4503), he was at -7.25 and his eyesight went down about 2.75 diopters the first year but after that the improvements got slower, at about -1.5 per year.

Just questions and opinions here, nothing else.
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on April 11, 2014, 09:41:51 AM
Hi Tom,

If it helps - I went through this same "logical process" myself.  It is very good to go though it - because what you come up with just might be the solution.


Far-stress-induced hyperopia is just the term coined to explain the effect of prolonged far stress on the ocular globe. Its mechanism appears to be just the opposite of that from near-stress-induced myopia (which you can find in the theory (http://forum.gettingstronger.org/index.php/topic,538.msg6159.html#msg6159) post). Since there are few reputable infos on this one, I know that I have to somehow exploit the knowledge that's currently available and  extrapolate something useful from those.

However, it turns out that in this case, personal observations came to me first, before I could figure out the anatomical details. Over the months, I have been compiling a list of hyperopization symptoms (which you can find here (http://forum.gettingstronger.org/index.php/topic,538.msg6368.html#msg6368)). I knew that if I persist and carefully observe long enough, then whatever works will become more obvious and lead to predictable symptoms, and those that don't will fail that same criteria. That is pretty much what happened, and this is how I learn to identify the different symptoms - I don't think I could have come up with it in one day.

Once I have more or less mapped the symptoms of myopiazation and hyperopization, the other missing puzzles just fall in the right places. For example, it was the persistent application of far stress that gradually clears up my vision, and the persistent application of near stress that blurs my vision. Many actions and their consequences just become more and more predictable as days go by. Again, these remarks are hard to get in one day, but if you play around with different kinds of lenses, at different distances, for a long time, then at some point you might become acquainted with the symptoms and its associated causes. It was a matter of connecting the dots together.
Title: Re: A Compendium on Myopia Rehabililation
Post by: Alex_Myopic on April 14, 2014, 10:46:42 AM
"If near stress persists and remains unmanaged, then things become a bit more serious:

...

    The tension and pressure inside the eye creates more intraocular fluids and heat inside the eye. In particular, the gel in the vitreous humor heats up and some gel would start to liquefy and move around. These little organic debris are usually harmless (and naturally occurs with age anyway), but if they intersect the light rays going towards the macula, then one might see some little transparent "objects" flying around. These "objects" are colloquially referred to as floater, and these vitreous debris would occur more with higher myopia. Some details by Morita et al.:"

If this is true then plus lenses can even prevent eye floaters with an immediate effect (making near far) and not just by preventing myopia.
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on April 26, 2014, 07:09:04 AM
Hi Tom,

Subject:  Real - versus "fraud" claims.

I have seen endless selling of, "easy, quick, get-out-of -9 diopters" in nine weeks.  Here is an example of that type of thing.

https://www.youtube.com/watch?v=y8-xfgXqqGw

I personally, believe that prevention is possible, if they person still retains 20/40, (at about -1 diopter), but it is never going to be, "easy", quick, and permanent.

Far from it. But that is the type of problem we have about "people selling magic cures".  Perhaps you can address this problem - with your own concept and ideas.




Q&A (http://forum.gettingstronger.org/index.php/topic,538.msg5043.html#msg5043) post expanded.
Title: Re: A Compendium on Myopia Rehabililation
Post by: Tom on April 26, 2014, 10:40:10 AM
A Subjective Account of the Repercussions of Extreme Myopia

For an example of how extreme myopia could affect you as you age, let's listen to Lisa Emrich as she talks about her myopia experience:

Quote
Since the ago of four, I have relied upon eye doctors to keep me seeing well.  Both my parents are nearsighted and when their genes mixed, the result was double bad eyesight for me.  For those who know how prescription strengths work, I just picked up a new pair of eyeglasses today which are powered at -13.75 in one eye and -13.25 in the other.

While it's true that refraction is positively correlated to parental refraction, every doctor and patient need to become aware that:
While it's important to emphasize that diseases occur only via the interaction between gene and environment, it's even more important to emphasize, in the case of myopia, that it is the near environment that pulls the trigger, for the "susceptible" individuals.

Quote
I remember in high school being warned, kindly but repeatedly, about reporting any sudden change in vision, especially the appearance of “flashes” of light.  The doctors who had cared for me since the age of four put the fear of a torn or detached retina in the front of my mind.

This is the doctor responsible for most of her myopia, telling her to be careful of any sign of retinal detachment. A hundred years later, people will probably look at this with dismay and incomprehension.

Quote
When I moved to Washington, DC, I needed a new doctor so I called home for a recommendation.  The morning in 2000 when I woke up and couldn’t see well out of my right eye - it appeared as though I was looking through vaseline-covered lenses - my new eye doctor’s quick response ensured that I receive prompt medical attention, resulting in the diagnosis of optic neuritis.  This is the first concrete point in time that I can connect directly to the multiple sclerosis diagnosis I later received.

In addition to myopia, she probably has some systemic inflammation in the body, which over time reduces the structural integrity of her ocular connective tissues.

Quote
During the past ten years or so, my vision finally stabilized.  No longer do I require updated prescription lenses each year.  However, I did develop a new problem - presbyopia - which is a sign of being “of that age.”  With presbyopia, the lens of the eye loses its ability to focus up close.  Ever watch “older” folks read the paper way out at arms’ length?  Well, I was approaching that situation so now I wear multifocal contact lenses to compensate.

At least it's better with the multifocal. One would bet that she doesn't "exercise" her eyes regularly (i.e., engage in activities requiring focusing on different focal planes)

Quote
Somewhere along the way, I also developed two “floaters” in my right eye.  They are harmless but were a distraction at first.  Floaters may have different causes.  Mine were explained as the result of little bits of the gel inside the eye (the vitreous) sticking together and creating a shadow on the retina.  Uveitis, an inflammation in the eye which can be caused by rheumatoid arthritis, might cause floaters in addition to light sensitivity and blurred vision.

The first cause that she was trying to describe is called the posterior vitreous detachment (PVD). For the record, the vitreous gel doesn't glue together. Rather, it got detached from the retina.

Again, one example of how the body really functions as a system, and failure of one part can affect another. In her case, the systematic inflammation happens due to multiple sclerosis and rheumatoid arthritis (or so she claimed).

Quote
Last month when we were preparing for a yard sale, I noticed new floaters in my left eye.  Not something which was alarming, but definitely not welcome.  During the next day, the amount of floaters increased.  I thought to myself that this wasn’t good and I became concerned that this might be a new manifestation of optic neuritis.

Then, I noticed the flashes of light.  Uhoh!!  I had been warned since childhood that flashes of light = retinal tear or detachment.  The flashes increased during Sunday night and I called my eye doctor first thing Monday morning.  After a thorough eye exam, I was diagnosed with PVD.  I did not in fact have any retinal tears.  Phew.

This must have been a pretty scary experience, and it illustrates the necessity of being proactive about one's own health, before the emergencies occur.

Quote
I’m told that gravity will help to settle the floating, detached vitreous toward the bottom of the eye.  The flashes ,which continued for almost three weeks, have subsided.  I still see floaters in my central vision, but my brain is learning to adapt to the distraction.  Hopefully those floaters will indeed float out of my line of sight.  Only time will tell.

Here is her advice to others:

Quote
If you ever experience any of the following symptoms, please call your doctor immediately:
1. Black curtain coming across your vision


2. Sudden onset of numerous flashes


3. Sudden onset of a floaters that look like sand


4. Sudden blind spot in your side vision

1), 3) are symptoms of PVD, 2) is a symptom of retinal detachment, and 4) of macular holes.

There is a topic that is missing, and that is what causes these symptoms to occur. You can find out more in the post "Myopia and the Associated Pathological Changes (http://forum.gettingstronger.org/index.php/topic,538.msg6639.html#msg6639)".

As a sidenote, it seems that she is under the impression that RA and MS just happen out of thin air. In fact, new information is coming out about how an inflammatory diet, coupled with compromised immune system, can a portal to these diseases.

P.S. - In addition to near stress, connective tissues can be degraded by the shear force of saccadic movements over time. If such a mechanical model (http://www.iovs.org/content/53/10/6271.full.pdf) is true, then highly myopic people reading with full prescription and fast saccades, is a very bad idea.
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on May 12, 2014, 07:44:40 PM
Hi Tom,

Optometrists are all "over the map" when you talk about prevention. It would be nice if they discussed this issue with you before that FIRST minus lens is applied.

https://www.youtube.com/watch?v=RxZDOhSDXxQ

I obviously think the person should do some verification at home, and not rely exclusively on an OD to tell him which line he reads on his Snellen.

But at least Bennie says that prevention is possible.




Close work post (http://forum.gettingstronger.org/index.php/topic,538.msg4855.html#msg4855) expanded.
Title: Re: A Compendium on Myopia Rehabililation
Post by: Tom on May 14, 2014, 03:41:22 PM
Testimonies of Inadequate Medical Practices in the Eye Care Industry

Well, our societies have reached a critical time in history that we can no longer take our doctors' expertise for granted. For that reason, we will just let the patients have their say. 8)

People
Anne

Originally posted here (http://frauenfeldclinic.com/myopia-forums/topic/feeling-disappointed-frustrated-and-angry/).


Hi everyone,
I took my youngest son to see the ophthalmologist today and I am feeling so disappointed, frustrated and angry ….
Let me first give you some background history:

I joined the Frauenfeld Clinic program on March, 24th 2014 after my 2 youngest children (Robin,7 and Eline, 10) had been diagnosed with myopia. This made me really worry (it kept me awake at night) about their future eyesight. From my own childhood, I can clearly remember that, once I started wearing glasses (around the age of 10-11), my eyesight only got worse. It made me really sad and at one point (age 31-32), my right eye was at -8 and my left eye at -9 and I could not live without my glasses. I have been wearing contact lenses for most of the time and they were always less strong then my glasses.As I grew older, I made a little progress in both eyes (R: 7.5 and L:6.5).

When, I took Robin and Eline to an ophthalmologist she pointed out that our children “inherited” our myopia (my husband is also myopic) and she prescribed minus lenses (-2 for Robin and -1 for Eline).
As I have always been convinced that there must be other ways to help them, I started looking around for other solutions to prevent their eyes from getting any worse. One of the things I came across was the use of reading glasses.

It all made a lot of sense to me so I decided to talk to my optician about it. He had never heard about it and looked at me as if I was some crazy woman who wanted to try something out that could be harmful and advised us to use -1.75 lenses for Robin (they measured his eyes again) and -1 lenses for Eline. I felt so disappointed when we left because he didn’t even bother listening to me.

A couple of days after our visit to the optician, I came across the Frauenfeld clinic site and decided to subscribe.I decided to try the program myself (hoping this would enable me to demonstrate some improvements to the ophthalmologist so this would then convince her to help my kids) and for the last couple of weeks I have been focusing on improving my own vision.

I ordered my first close-up prescription R: -6 and L: -5 (based on the results of the Myopia calculator. This is -1.5 diopters lower than my distance prescription.I received my glasses on April 14th. Before this time, I’d been doing the morning focus differential awareness and stress reduction exercise; the 2×30′ outdoor activity and peripheral awareness exercise.

Since it felt so comfortable, I have been wearing my reduced prescription for most of the time. They offer me excellent vision for close-up work. I can work on my pc and read without any problems (taking into account the blur zone). The distance between my pc and my eyes is about 55cm (best vision is at 50cm).As I was in between jobs for about a month and the weather was nice, I spent a lot of time outside.Already, after a couple of days, I could notice some difference in my vision: in the morning I could read my alarm clock without glasses, could watch tv (most of the times only with some blurriness) and go for walks with my reduced prescription, could read sign posts, license plates…

When I went back to work, I didn’t experience any real problems with close-up work or walking around the office. I only experienced some blurred vision when I had to look at a presentation on a screen at a distance from me. After wearing my glasses for about 3 weeks I could also use them to drive to school and work.

Just for professional purposes, I decided to order reduced contact lenses (L: -5 and R: -6) and combine these with an additional pair of minus glasses (-0.75) to use for distance vision when needed. It would not be very practical to switch between glasses when I’m working at a client’s side.

I received my contact lenses today and decided to try them out. I was surprised how much more they improved my vision and decided to do a Snellen test. I was surprised that I could read the 20/13 line at a distance of about 5.20 m (didn’t try if I could read it from >5m). With my reduced glasses, I can read the 20/25 line (with active focusing) at a distance of about 5m.

My neighbours recommended me to take my kids to their ophthalmologist. I had to wait for more than 2 months before I could take my son to his appointment, which was today. In the meantime, I encouraged my children to play as much outside as possible, I watched the time they spend working up close, watching tv, playing games, reading, etc …

So this afternoon, we went to see the ophthalmologist. I was glad I’d already made some progress with my own vision. I very carefully (knowing how upset some professionals get when you ask them too many questions) asked her if my son’s vision could be improved (or if we could at least try to just stop the progression at this point) by using reading glasses for close-up work. I also told her about my own experience. Her first question was: “are there any other relatives in your family with myopia?” She then said that the main cause of myopia is that it’s hereditary (so not caused by cramped eye muscles) and that she had never heard of the stuff I was talking about.

She said that due to his young age (7), Robin’s myopia was (probably) due to the elongation of his eyeballs and that this was something genetic (so we couldn’t do anything about it). If he would have -2 than she would recommend him to wear his glasses all the time (this really shocked me).
To find out his true myopia (the genetic one) she could put some drops in his eyes to paralyse the eye muscles so they wouldn’t be cramped anymore. She also mentioned she didn’t expect this measurement to be any different from the one she did today and that this would then prove that his myopia was not caused by cramped eye muscles but by genetic elongation of the eyeballs.

With respect to my own progress, she explained this was due to my age as your vision can get better as you grow older (I’m 44 years and I don’t think that such improvement in vision over a period of 5 weeks can be linked to me getting 5 weeks older). She said my true myopia (the genetic one) might be less f.i. -4. Then why did I end up with -8 and -9 at age 32 ?

When she measured Robin’s vision, she came up with the following results: right eye: -1.75 and left eye: -1.25. At the time of the measurements, Robin was feeling tired as he’d been on a school camp for 3 days and had only been back home for about an hour. He also had a light infection in one of his eyes (at least that’s what the ophthalmologist said). She recommended us to come back to see her on an annual basis as his eyes would get worse every year.

So this is why I feel frustrated, disappointed, sad and even angry! How can I encourage my children to use reading glasses for up-close work if I can’t find an ophthalmologist who wants to give us a prescription? As an adult, I can order my own glasses over the Internet without needing any prescription.
Over a period of about 4 months, my son has been given 3 different prescriptions:
- Feb-March: -2 in both eyes
- End of March: -1.75 both eyes
- May, 14th: -1.75 right eye and -1.25 left eye → how come there is a difference in both eyes? There wasn’t one in the previous 2 measurements.

To be honest, right now I don’t really now what to do next.
Which prescription is the right one?
I live in Belgium and I just think that I will never be able to find a professional who will be willing to help me as this is still a very conservative country when it concerns eye care, medicine, etc
Has anyone of you been in the same situation as me or has anyone some advice for me?

Best regards to all of you,

Anne


David

Originally posted here (http://frauenfeldclinic.com/myopia-forums/topic/optometrist-visit-and-update/).


Hey all,
I started the program back in October and had been not using glasses for a bit before that, but wasn’t doing active focus or blur horizon work, till October. Anyway, had my first Optometrist visit in 2 years, just to break the ice and get things checked up from a general health standpoint. Some interesting takeaways:

1. I wanted to believe better, but was surprised how much glasses were pushed and mostly by the assistants and desk folks (they just assume that you are there to get your prescriptive fix). It truly was very sales oriented. I knew this was the case, but thought surely there might be a little more to the checkup than that. (They did take a picture of my retina which was cool to see and probably the most beneficial part of the visit)

2. I cleared 20/20 with both my right and left eye (measure by themselves) with my cheap -2.50 glasses from Zenni optical. Not that this was a surprise as I’ve been able to do this for the last month or so, but something about doing it in the Optometrist office that made it feel better. I did get an appointment for 8:30 am and went for a 10 min walk before the visit so it was good conditions for measurement. I started with -4.00 2 years ago and have only been doing targeted stimulus since October 2013.

3. Even with the reading, my optometrist wanted to pass this off as a case of blur interpretation and some overprescription that he said I was able to deal with the overprescription because of a higher accommodative range, so essentially I was able to deal with a -4.00 because I could accommodate better than the average person…however, this doesn’t explain the fact that -3.75 felt blurry if I put on my old glasses back when I first started…even my -4.00 glasses were not 20/20 compared to my -4.00 contact lenses I used all the time. He claimed that my true prescription was -3.00 or -3.25 which he said he got from when he shined a light into my eye while flipping through the lens settings and that when it flashes back bright that is the true myopia value (axial myopia?) of my eye at the time. Alex, does this seem right to you that maybe I’m -3.00 in my “true” value, but I’m able to use active focus to pull 20/20 with -2.5? When He put it on -3.25 I was able to read 20/15 no problem and half of 20/10. Since when was 20/20 not good enough :)? To his credit he was fine with me staying with my -2.50s (that I sheepishly had to admit I bought online without their prescription), but said he would only write a prescription for -3.25 (in case I wanted it) because that was his determination of my “true” value was. Interesting to say the least. I wonder what he will say next year when I’m hopefully -2.00 or possibly lower? More blur interpretation? Maybe I’ll just interpret the blur better all the way down to 20/20 ;). I just wonder what the threshold for improvement is for them that they no longer could consider it blur interpretation. I know better, my vision is qualitatively (as well as quantitatively) better than it used to be. I also understand that, if they truly believe myopia is not reversible, then logically they have to have another explanation if they want to keep that paradigm.

My centimeter measurements are running in the 36-38 range after I push focus for 5 min or so, right in the -2.75 range which makes sense with my experience with the -2.50. On good sunny days, I’m nearly ready to push to -2.25, but on cloudy days or night the -2.50 offers enough stimulus still. Anyway, a small little update. I’m still keeping at it even though I haven’t been in the program since December.

Take care everyone and all they best with your efforts!

David


Jeanie Brave

Below is a letter (original link here (http://www.i-see.org/otis_brown/chapter_11.html)) from Jeanie Brave to Otis Brown, about her daughter's excessive overprescription.


JEANIE BRAVE'S LETTER:

Here are copies of my daughter's eye records and
prescriptions. You will never know how grateful I am for you and
Mr.  Severson. When I stop and think of what could have happened
to Shanna had I not found you -- my blood starts to boil.  I have
come to realize that people never question eye doctors as they do
medical doctors.  We are all at their mercy and do not even know
it.  You have my permission to give my telephone number to anyone
who you feel needs it.

A CHECK-UP BEFORE SCHOOL

Shanna received the new contacts on August 5.  She puts in
-10.0 Diopter and is able to see -- she says one mile down the
road.  I immediately told her to take them out.  After begging my
optometrist to please give me information to stabilize her vision,
he becomes EXTREMELY UPSET.  I then went to the libraries and book
stores looking for information but I found only William Bates'
name.  I then ordered his book.  Next I found Mr.  Severson and
finally you in the back of his book.  After reading your books I
immediately knew I had the wrong optometrist -- so I nicely asked
his assistance in obtaining a -6 Diopter lens for studying.  The
doctor reluctantly gave them to Shanna, telling us to use them for
STUDYING ONLY. I then confirmed the focal status of Shanna's
eye's, by assisting her in checking her vision against the eye
chart -- both inside and outside.

8/26/95   20/20   -8.0 RE -7.5 LE
8/26/95   20/100  -6.0 RE -6.0 LE (Provided for reading)
8/31/95   20/40   -6.0 RE -6.0 LE
9/26/95   20/20   -6.0 RE -6.0 LE (See the -10.0 D prescription below)

     Since she was seeing so well on 9/26/95, I told her to remove
her contacts and then come back outside.  Without ANYTHING on she
stood 20 feet away and could focus on the 20/70 and 20/50 line for
about 2 or 3 seconds -- then she said it would flash or float
away.

AN EXCESSIVE -10 D PRESCRIPTION?

   Prescription by Dr. Bob Smyeth, Optometrist, Dated 8/5/95:
   Patient:  Shanna Brave, Birth Date, 3/2/82:
8/5/85   20/20    -10.0 RE -9.5 LE (Prescription)

Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on May 19, 2014, 06:27:34 AM
Hi Tom,

Subject:  Testimonies of Inadequate Medical Practices in the Eye Care Industry

I know that medicine (and optometry) is locked into the default minus lens - in a tragic believe that over-prescription constitutes, "perfect science".

Since you are writing a compendium on "nearsightedness", (and reactions to it) you might include a history of the problem is your book.

I obviously "forgive" the OD in his office, with is default minus lens - who basically "killing" a child's distant vision with that FIRST minus lens.  It is tragic that so few ODs will admit that all they do is use a "default", and will not allow anything else to exist.

With kindness, and consideration - we both need to address that issue - by understanding the history of this problem.

Title: Re: A Compendium on Myopia Rehabililation
Post by: Tom on May 19, 2014, 05:36:14 PM
Glossary and Q&A - Part II

The old Q&A has now exceeded 20000 characters - Hence a second Q&A post.

        Miscellanous



What are the potential sources of error in the refraction/visual acuity obtained by eye professionals? 

In a clinical setting, refractive status is measured with autorefractor, and visual acuity iwth Snellen Chart.

Autorefractors are reputable for its sensitivity to blinking and eye movements. In countless instances, researchers have had to trim the measurements so as to exclude the outliers that invariably occur in the data.

When measuring visual chart using Snellen Chart (or other similar charts), one needs to take into consideration that visual acuity can be made substantially lower just by reducing the background lighting. Eye professionals tend to gather visual acuity measurements in a dark room. Consequently, the visual acuity obtained tend to be our worst data - We may even be prescribed the strongest minus lenses as a result.

Many people are not aware of the impact of near stress on refractive status/visual acuity. An early morning visit (before doing any close work) to eye doctors will result in less unbiased measurements. Visiting eye doctors in the evening, after many hours of close work, can easily lead to overprescription.

You can also find similar information on Dr. Alex blog here (http://frauenfeldclinic.com/childs-glasses-excessive-prescriptions).

Often people who are myopic are noticed to have somewhat "lifeless", bulgy, immobile, and "aloof" looks. Do you know why this happens?

I'm not sure to what extent we can generalize that claim. Some eye professionals (especially the behavioral optometrists, or other folks from the Skeffingtonian school of thought) do notice that myopes tend to be more introverted, with a more inward personality.

There is a theory out there claiming that introverted people, who tend to feel uncomfortable in a social setting, are driven towards activities requiring near vision, and hence become myopic as a result.

Or it could be the adrenal burnout outlined in the diet (http://forum.gettingstronger.org/index.php/topic,538.msg5474.html#msg5474) post.

Or it could be innervation insufficiency in the sympathetic nervous system (e.g., natural tendency to tense up easily, difficulty in relaxing). This insufficiency might result in greater near stress and longer dissipation of near stress to baseline level.

(I know for one that I don't feel very comfortable in front of a large crowd - it's a mix of self-awareness, higher demand on oneself, and just simply reflexive body response.)

Also, check out sections 3.18.1 and 3.18.2 in the Myopia Manual (http://www.myopia-manual.de/private/manual-2014-jan.pdf).

Are there any eye professional advocating ideas similar to those found in the Compendium of Myopia Rehabilitation?

Yes. There are indeed a few eye professionals advocating similar ideas. The readers can find more tangible advice and elaborated details in the Compendium though.

Eyecare Practitioners

Arcadiy Davydov - An behavioral ophthalmologist/optometrist from Russia. Dr. Davydov believes in the careful use of prescription that takes into account the focusing distance. This table  (http://www.forbestvision.com/dynamic-fixation-trainer-2/)from his website elaborates on that.

Benny Shao - A developmental behavioral optometrist from California. Dr. Shao believes in the idea that close environment causes ocular "pressure spikes", which drive axial elongation over time, in susceptible individuals. He illustrated this idea pretty well in one of his blog post (http://www.bettervision4kids.com/progressive-myopia-nearsightedness/how-to-treat-progressive-myopia-in-children/).

Merrill Bowan - A neurodevelopmental optometrist from Pittsburgh, Philadelphia. Here (http://simplybrainy.com/pdf/PreventingRefractiveError.pdf) is his most updated paper on myopia (note that the paper dated back to 1998, and a lot has been learnt since then).

Steven Gallop - A behavioural optometrist from Broomall, Philadelphia. Gallop is himself a patient of high myopia and published several articles on myopia reduction via using appropriate lenses (undercorrection/base-in prism) for close work. His website (http://vision-therapy-pa.com/) contains many articles on different ocular issues.

(The late) Antonia Orfield - Dr. Orfield, formerly a teacher, went to optometry school after recovering from around -3.5D of myopia in 7 years. She advocated minimum minus prescription for far, and undercorrection for near. In this (http://www.oepf.org/sites/default/files/journals/jbo-volume-5-issue-5/5-5%20Orfield.pdf) article, she documented her recovery from myopia in an almost spiritual manner.

Glen Steele - An optometrist from Memphis, Tennessee. He advocates the use of minimum minus prescription to reduce near stress, and encourages parents to become informed of the effects of "improper lighting, close working distance, and prolonged reading without taking a break" (http://www.healio.com/optometry/contact-lenses-eye-wear/news/print/primary-care-optometry-news/%7Bdc52f0cb-d794-4a11-9e71-ef794857db5c%7D/several-treatment-options-recommended-for-myopic-children) on myopia.

Academics

Neville McBrien - A professor of Optometry and Vision Sciences (University of Melbourne). Dr. McBrien published several instrumental studies on lens-induced myopia, scleral changes during myopisation and form-deprivation myopia. He advocates against the traditional treatment of fully correcting myopia via minus lenses. Here is a quote from "The Mechanisms Regulating Scleral Change in Myopia":

Quote
Recent studies have confirmed the importance of visual information in the control of scleral remodelling in myopia. Studies have established that accurate correction of induced myopia, simulating correction of myopia in humans by the wearing of eyeglasses or contact lenses for myopia, prevents the recovery response.49,63 In contrast to the animals allowed to recover from induced myopia, animals wearing lenses that fully corrected the induced myopia did not recover and their sclerae retained a ‘myopic’ phenotype of reduced glycosaminoglycan synthesis (Fig. 13) and reduced thickness.49 This phenotype persisted over an extended period of lens wear and beyond the period during which eye growth was found to stabilize. Despite the fact the visual image is immediately placed in focus on the retina, and that the eye has returned to a stable growth rate, the sclera retains a myopic biochemical phenotype for a substantial period of time. Such a finding has important implications for the correction of human myopia.
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on May 24, 2014, 03:35:02 PM
Hi Tom,

Let me correct a mis-conception about the plus (when used in a bifocal). (Steel's paper:)

++++++

Three-diopter add at home, pinhole glasses at school

Donald Rehm: Reading glasses or bifocals have been shown by numerous studies to slow the movement into myopia, not stop or reverse it.

This is not exactly what Don stated.  I have exhaustively reviewed Dr. Young's papers, and they indeed show a very slow "reverse" of the myopia - on the threshold.  These were 16 year-old young men - but the "reverse" was about +1/4 diopters per year.  I wish this mindless "trashing" of the plus would stop.

Don> This failure is due to the fact that a full 3 D add is not given, because it would overly disrupt the accommodative/convergence relationship.

Otis>  Perhaps.  But the choice is to use the the +3 has been recommended many times.  But Don feels the child should wear a "Myopter", and I have no objection to doing that.  But to get full effect of the +3, the child must understand to "push away" until the "just blur" point is reached.  Only in that manner, can the plus be fully effective - for the long term.  This is why I expect that for a disciplined person (at 20/40) can get that +1/2 diopter per year reasult, when otherwise, his refractive state will go down by -1/2 diopter per year.

Don>  I recommend the Myopter (see www.myopia.org/myopterpaper.htm) with a 3-D add for all close work at home, reading slightly beyond the far point with a little blur and forcing the eyes to relax. This should undo the stress that has been set up during the day’s schoolwork so the next day’s work can be done without building on the ciliary spasm of the previous day.

Otis>  As always, these suggestions depend on the person himself to fully understand the reason why - it would be wise to wear a strong plus, while you can still read the 20/40 line.  This means no bi-focal, and, in time, a return to reasonable 20/20, and positive refractive status.

Otis> This is truly a matter of a person's self-intelligence, and self-motivation.

Otis> This is why I try to set a "limit" on personal recovery, and the need to wear the plus through the college years - assuming you have the motivation to do so.  It is truly a difficult challenge - that can never be prescribed.

+++++

http://www.healio.com/optometry/contact-lenses-eye-wear/news/print/primary-care-optometry-news/%7Bdc52f0cb-d794-4a11-9e71-ef794857db5c%7D/several-treatment-options-recommended-for-myopic-children

There is always a lot of talk about "prescribing something", after the child is actually myopic.  Tragically no "thought" is given to helping the child begin the use of the plus, while the child still reads the 20/40 line.  The OD also talks about the child sitting there "passively", and having no interest in prevention in any sense of the word.  This is the reality of "office prevention" and why no OD will even discuss the subject.

The deeper reality is this - that the OD admits to -  is that our eyes "go down" at a rate of -1/2 diopter per year, from the moment of SLIGHT myopia of 20/40 and -1 diopter.  That is the real issue - and the response is very seldom "therapy" -- that the child and parent will understand.

Just my opinion.  Even Raphaelson stated that the "parenst" (in their ignorance) would never understand plus-prevention. He was totally correct.

Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on May 24, 2014, 08:27:58 PM
Hi Tom,

I do not ordinarily post "testimonials", unless the person is fully aware of that -1/2 diopter per year, if he chooses to NOT wear the plus when he still can read the 20/40 line.  Further, by this manner of optometry thinking, there is, and can be no "cure", since that -1/2 diopter per year is reality, and can not be "wished away". 

This is even tougher that I thought it would be.  I think even Raphaelson thought it would be easier than that.

But after the truly dedicated Raphaelson told me that the "general public", in ignorance, would always REFUSE to wear the plus (at 20/40), I knew that no OD could help with this issue.  Only the person who understood and ACCEPTED that repeated re-starts with the plus - could make himself successful.  So, no OD can help anyone with prevention.

I  explained Raphaelson's plight to my nephew, and that no one was interested in protecting his distant vision, except for himself.  Here is his remarks about his own commitment to wearing the plus when it went down to 20/40.  (His expression, it was "... it was getting blurry out there".)

++++++

YOU MUST TAKE CONTROL

From Jacob Raphaelson's experience with, "The Printer's Son", (Chapter 3), it has become clear that you must understand the bad results that occur when you use the negative lens. More than this, Jacob's analysis demonstrated that even a completely dedicated eye doctor can not overcome the popular misconceptions that exists in the public's mind about eye doctors and the use of the preventive lens.

I made a major effort to help my niece and nephew. They developed a clear understanding of the problem of nearsightedness and the type or solution that could be expected. I believe that providing them with a "fighting chance" to defeat the problem is better than providing no chance at all. Both used the plus lens and retained clear distant vision without prescription lenses. They understood that it would take long-term commitment to achieve the desired result. I asked my nephew to write a short note to describe his own effort and outcome as he worked to maintain clear distant vision through college.

FOUR YEARS OF COLLEGE WEARING A PLUS LENS

Dear Uncle,          February 19, 1990

     Thank you very much for the book, "How to Avoid Nearsightedness".  I got it yesterday after I came back from the weekend.  I am looking forward to reading it soon, but for now I have a great deal of school work to read.

     I would imagine you'll be pleased to have me tell you that one of the first things I did after opening your book was to check my eyes with the eye chart.  I am able to read the 20/20 line on the eye-chart. I have been using my drug store plus lenses most of the time now.  I have always passed the driver's license eye test.

     I use these glasses nearly 100 percent of the time when I read text books and use them for about 70 percent of the total reading I do.  I started using them as much as possible again because, at the end of last semester my sight was pretty bad (I didn't check them on a chart).  I am lucky to have an uncle who showed me back in eighth grade that I could prevent my nearsightedness.

     One thing college has taught me is to listen to others and then use or adapt methods to work for me.  In the last few years I have had a great deal more reading work to do. If I don't use the magnifying lenses I notice fairly quickly that my sight starts to deteriorate.  Then I realize it's time to do something to stop that process.

     At the moment, I am wearing the magnifying lens because I know what it does for my vision.  Thanks for taking the time to tell me how to avoid a situation, wearing glasses at all times for the rest of my life, that I would find unpleasant, and for sending me a copy of your book so I can learn more in-depth about the methods I am using.

Keith B.

+++++

As expected, when Keith had long-term close work to do - for 8 hours a day, he noticed again that it got "blurry out there".  It was my understanding of Raphaelson that convinced him to re-start the wearing of a plus, and to never let his visual acuity go below 20/40, or refractive state below -1 diopters.

No OD could be involved, because they are all convinced that recovery from 20/40, is just "out of the question", and completely impossible.

Keith understood that any true-prevention, had to be a personal responsibility.  He understood that he must verify that he exceeds the legal requirement - by self-checking.  But more than that, you do not "stop" at 20/40.  You keep on wearing the plus until you get to 20/20.

Is this not a verification of a "cure".  It is verification that a person, understanding Raphaelson's remarks, could personally use a plus, and avoid going down by -1/2 diopter per year - in college and in graduate school.  That does indeed require "educated competence", but a great deal of self-motivation to wear a plus, not to "cure" but to prevent.

Here are the FACTS that are part of that education.  Check Vis 6 - 17 on this page.

http://myopiafree.wordpress.com/facts/


This is verification that a wise, motivated person, knowing full well that if you do not do "prevention" yourself, then you will lose your distant vision at rate of -1/2 diopter per year - for each year in school.

Further, that if you let this "go" for to long, (refuse to wear the plus for close work) you just can not "reverse it".  Therefore, the time for prevention, is before you even START wearing an  over-prescribed minus lens - all the time.

For those who do not wish to understand this issue, or think "plus prevention" is a joke, I am certain you will say, '... well he would not have become nearsighted at age 14... from 2 more years in high school, and four more years in college, with some graduate school.'  The truth is that he would have become about a -2.5 to -3 diopters more nearsighted, if he had declined to wear the plus - during the college years.

Keith is a lot smarter than that.  I admire him for his insights - to protect his distant vision - by this plus-preventive process.

EXAMPLE:

Some people do not need the "encouragement" of analysis and science.  They just "figure it out" themselves - and do it.  Here is an example.

http://schwerdfeger.name/articles/pluslens.shtml

But please note - the medical department considered this man with 20/20 - to be "myopic" - by THEIR measurements.  This is why I suggest a person be expert enough to measure both his visual acuity and refractive state  himself.

Do not rely on the "medical department" to make measurements.


Don will reappear in the "journey" post - which I have been thinking how to write for a long time (technically, I have spelled out the details in the theory post, but I still need an informal post to convey the message to the public as to what it means in practice and what not to do).

For those who wish to review the FACTS, you will find them here:

http://myopiafree.wordpress.com/facts/

Just click on Vis 6 - 17.

Yes, that -2/3 to -1/2 diopter per year is depressing.  But it is better to understand these facts, and act on them, before you start wearing a strong minus all the time.  This is an issue of "educated responsibility".  No OD, in his office, will tell you anything that makes you responsible for protecting your distant vision - for life.


In the meantime, here is a testimony (http://forum.gettingstronger.org/index.php/topic,538.msg4642.html#msg4642) post.
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on July 05, 2014, 02:22:06 AM

With due respect for both Jim and Tom, let me add my commentary.

Except that the eye doesn't always work predictably
...
As for the preconditions and the feedback-driven changes required, Well, still working on it.

I suspect the results might be completely unexpected.

Otis>  If you restrict yourself to the natural eye, "in nature", the effect of placing this natural eye in a "long-term near" situation, are indeed predictable.  But what is also predictable - is this type of science and fact - is totally ignored.

Quote
the most reliable way for me to induce hyperopization so far, is to simply go outside for a walk for an hour or so, and just let the eyes take care of the rest.

I'd add outdoor sports could be the overall best combo of preconditions, but then the natural follow-up question is:

How do we lock in the improvement?

Otis>  I know this is intensely personal, but I do agree that 'getting outside' is a big part of the right answer.  For me, I, "lock in" my distant vision by wearing a "open environment" plus lens for all the close work I am now doing.

Otis>  I wish you all good luck and success - but indeed the plus (and open environment) does produce, "hyperopiazation" (change in refractive state - of the natural eye - in nature.

Enjoy,

Title: Re: A Compendium on Myopia Rehabililation
Post by: warnbd on July 06, 2014, 06:00:06 PM
Tom

If I might, I would like to challenge in your most recent post shown in quote below, the premise that any close work within 1 meter causes myopia, even with minus/plus lenses beyond one's far point but less than 1 meter.  I have been following the under-correction method of doing close work at the point of blur/active focus for the last 6 months (see my thread "My Myopia/Astigmatism Journey") which has resulted in improving my vision by 2 diopters.  Most of this work has been at distances of 20" to 28", at or just past my far point.  Does my experience contradict your statements about spending time with a focal plane of < 1 meter away inducing myopia? Please pardon me if I am misinterpreting any verbage incorrectly. 

warnbd



In Dec. 2013, I set up a series of self-experiments, and discovered that I was able to induce myopia by simply reading very close (with minus/plus/pinhole prescriptions), yet beyond my far point. This convinced me that near-stress-induced myopia is primarily caused by close reading distance (for more, I substantiated a theory in the Theory post (http://forum.gettingstronger.org/index.php/topic,538.msg6159.html#msg6159)).

This means that prolong close activities, within 1m or so (depending on your optical profile) can slowly induce myopia.

  • ~1 meter and beyond
  • Under high ambient lighting

Title: Re: A Compendium on Myopia Rehabililation
Post by: Alex_Myopic on July 07, 2014, 03:04:54 AM

In May 2014, I observed that prolonged use of sunglasses can also induce another kind of myopia, called form-deprivation myopia (more on the form-deprivation post (http://forum.gettingstronger.org/index.php/topic,538.msg5541.html#msg5541)). The symptoms here are detectable, but pretty hard to describe. In any case, the point is that ambient lighting regulates emmetropization via its anti-myopia effects.


That's in agreement with Bate's method books about the good of sunning and not wearing sunglasses to much (which ca prevent from photophobia as well)  but hat instead!
Title: Re: A Compendium on Myopia Rehabililation
Post by: Alex_Myopic on August 18, 2014, 09:44:17 AM
Ηι Τοm,

I don't know if you have read about the amygdalin or "vitamin B17" and acting as a smart bomb against cancer.

I'm sorry for about grandmother.
Title: Re: A Compendium on Myopia Rehabililation
Post by: ZC on October 22, 2014, 12:03:37 PM
Wash your eyes? At the risk of appearing barbaric, I'll ask the question. How do you wash your eyes?

Most days I shower soon after waking. But sometimes on weekends I might, e.g., play tennis first and shower later. It would never occur to me to wash my eyes. I am not even sure I know what that means. My best guess would be washing your face, eyelids included. How'd I do?
Title: Re: A Compendium on Myopia Rehabililation
Post by: svartberg on November 11, 2014, 05:18:33 PM
Thanks for the reply Tom.

So the issue you mentioned is only for Minus lenses ?
I'm actually getting the distortion as I go higher on the plus lenses.
Title: Re: A Compendium on Myopia Rehabililation
Post by: CapitalPrince on November 12, 2014, 09:27:45 PM
any type of lens will create a distortion. also plus lenses tend to make things bigger, and and minus lenses make things smaller. But distortion/magnification should not be a problem unless wear + or - 2.0D or more . Another good reason to keep myopia in control
Title: Re: A Compendium on Myopia Rehabililation
Post by: svartberg on November 12, 2014, 09:39:12 PM
Thanks CapitalPrince

Ah I was referring to distortion at edges of lenses, noticeable if I move eyes from one corner to the other
(better example if I fix my gaze at an object at front, then rotate my head left and right the distortion becomes really obvious.)

You are right, I only start really notice this distortion at about +1.5 ...
Still using +0.75 here, but curious about this and if it will have any negative effect

Title: Re: A Compendium on Myopia Rehabililation
Post by: CapitalPrince on November 12, 2014, 10:46:24 PM
hey svartberg its CapitalPrince here not Tom :)

every lens has an optical center so when you look at the edges of your lenses things start to get distorted. it won't do any harm and there are no negative effects. the distortion on a +1.5 to +2.5 is minimal (i guess you could use high index, but that comes with the price of lower abbe value.

I currently use a -0.25/+1.5D progressive lenses. I find it much better than having several pairs of plus lenses.  I can't imagine the distortion for someone wearing -5/6/-7D diopters
Title: Re: A Compendium on Myopia Rehabililation
Post by: svartberg on November 12, 2014, 10:56:28 PM
Haha my bad, thanks for the info CapitalPrince !
Title: Re: A Compendium on Myopia Rehabililation
Post by: caimanjosh on November 13, 2014, 12:07:46 PM
any type of lens will create a distortion. also plus lenses tend to make things bigger, and and minus lenses make things smaller. But distortion/magnification should not be a problem unless wear + or - 2.0D or more . Another good reason to keep myopia in control

I do note that my +4.5 and +5 lenses have significant distortion -- the edges are quite easy to read through, while the center is significantly more difficult.  Also, the magnification is fairly large at this level.  Does this represent a problem?  I feel like I've continued to make progress by progressing to these more powerful lenses, albeit considerably slower progress. 
Title: Re: A Compendium on Myopia Rehabililation
Post by: caimanjosh on November 20, 2014, 05:34:55 AM
[From the Q&A]
Quote
While optical lenses are designed to be transparent, as the lens thicken, an unintended effect invariably occurs. Namely, the light rays would become significantly diffused by the lens, and non-stop exposure to diffused blur has been shown, both in animals and by us, to induce form deprivation myopia.

In fact, we were able to replicate form deprivation effects on our own, through the prolonged use of strong minus lenses, strong plus lenses and sunglasses."
Huh, that's kind of alarming from my perspective.  I'm currently using +4.5/+5 lenses that seem to suffer from this in the center.  Previously, I had been combining a +3.5 and a +1.5 lens to make a +5 "lens".  (Because I didn't have any higher power lenses, and I was being a cheap bastard and trying not to buy any ;D .)  With that setup, I didn't notice any blurring in the center.  But with the single +5 lens, I do.  Now I'm thinking that for anything over +4 or so, combining lower power lenses may be a better way to go.  Maybe I should've listened to my cheap instincts after all.  I may have to rejigger my reading glasses again.  Thanks for the informative posts, Tom.
Title: Re: A Compendium on Myopia Rehabililation
Post by: svartberg on November 20, 2014, 05:55:49 AM
caimanjosh, why such a high plus are you 20/15 ?
One trick to reduce plus, is to increase distance to book/monitor instead
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on November 20, 2014, 09:55:17 AM
HI Caimanjosh,

I generally think that (for prevention) for people with 20/30 to 20/40, a +3.00 would be fine.

I have no problem if you choose to wear a +5, but it is more than is necessary.

What distance can you read though a +5?  Theory would say about 10 inches?

Just curious for you to check.

Thanks,



[From the Q&A]
Quote
While optical lenses are designed to be transparent, as the lens thicken, an unintended effect invariably occurs. Namely, the light rays would become significantly diffused by the lens, and non-stop exposure to diffused blur has been shown, both in animals and by us, to induce form deprivation myopia.

In fact, we were able to replicate form deprivation effects on our own, through the prolonged use of strong minus lenses, strong plus lenses and sunglasses."
Huh, that's kind of alarming from my perspective.  I'm currently using +4.5/+5 lenses that seem to suffer from this in the center.  Previously, I had been combining a +3.5 and a +1.5 lens to make a +5 "lens".  (Because I didn't have any higher power lenses, and I was being a cheap bastard and trying not to buy any ;D .)  With that setup, I didn't notice any blurring in the center.  But with the single +5 lens, I do.  Now I'm thinking that for anything over +4 or so, combining lower power lenses may be a better way to go.  Maybe I should've listened to my cheap instincts after all.  I may have to rejigger my reading glasses again.  Thanks for the informative posts, Tom.
Title: Re: A Compendium on Myopia Rehabililation
Post by: caimanjosh on November 21, 2014, 12:38:57 PM
caimanjosh, why such a high plus are you 20/15 ?
One trick to reduce plus, is to increase distance to book/monitor instead

My right eye is close to 20/15, certainly it's 20/20 anyways.  Left eye more like 20/30 to 20/40. 
I have thought about just using weaker plus lenses and increasing the distance to the book (I use these when reading).  However, I notice that what often happens is that my body "creeps" the book closer to my face once I stop paying attentioin to that -- either I lean over slightly, or end up bringing my arms closer.  This ends up making the reading easier, and thus, I think, negates the purpose of making it as challenging as possible.  Whereas if I use a stronger plus, my body's natural tendency is to try and move the book farther away to make things more comfortable.  Thus, that works more in favor of my objective.  I think my reading distance is around a foot away or so with these lenses -- maybe as little as 10 inches at times, and maybe as much as 15 at other times, during a "clear flash". 

I did slowly (over the course of months, maybe an inch at a time) move my monitor at work farther away from me, and keep using the same plus lenses.  Since I'm not holding my monitor (unlike a book), this seems to have worked fairly well. 
Title: Re: A Compendium on Myopia Rehabililation
Post by: Tom on June 14, 2015, 02:50:32 PM
I had some new inspiration and finding on cataract, but because my info is not in depth enough to warrant a blogpost. I just put it here (http://forum.gettingstronger.org/index.php/topic,554.msg4932.html#msg4932).

We are having some debate with professionals here. Will post some if it turns out to be interesting enough. 8)
Title: Re: A Compendium on Myopia Rehabililation
Post by: Tom on July 09, 2015, 07:43:25 PM

Even worse, is an optometrist, who is "pushing", Ortho-K, as a means to avoid nearsightedness.

https://www.youtube.com/watch?v=vNNQY2_bTlo

The BIG PROBLEM?  He is wearing glasses.  If Ortho-K is that great - then why is he NOT 20/20??

This truly is about money, isn't it. 

I wear a plus for "near", to save my distant vision.  You see my videos, and I READ the 20/20 line objectively.

Un-like Anderson, I do not need, nor want your money.  Neither did Dr. Prentice.  It all depends on you. 

There is nothing "easy" about prevention.  I never said it was.  Anyone who says that - is cheating you.

 Try to think about it.
Ha! I never got a response from Dr. Anderson (http://forum.gettingstronger.org/index.php/topic,538.msg6632.html#msg6632). I hope that at some point he manage to earn enough money from Ortho-K, and start to truly work on myopia prevention after his retirement!
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on July 09, 2015, 08:31:07 PM
Hi Tom,

It is possible to learn enough from the insightful optometrist, that the minus lens is a "bad idea", and you should seek to avoid wearing it.  The ODs who call the minus lens "poison" have the correct idea.  But of course the public, (at 20/40), can not be "prescribed a plus", at that point.  So this tragedy must continue.

Both of us know for certain - that Anderson is never going to happen. IT is a waste of your time to attempt to talk about any of this. In fact excessive concentration on the word, "MYOPIA" causes major intellectual blindness, to
all possibilities -- that a person can be wise enough to start prevention, while still at 20/40 (self-measured -1 diopters), and slowly get back to
0.0 diopters, and close to 20/20.   Here is the 7 minute video discussion this issue on NOVA.

https://www.youtube.com/watch?v=rlz2_U4MdiI

People like Todd, and pilots, do manage to over-come their resistance to wearing a "plus for near", and wear no minus at all (if reading the 20/40 line).

But that take real intelligence, and continuous motivation.  You must truly convince yourself that it is necessary, and then
never quit wearing the plus, while in school.

This is absolutely never a medical problem, and the solution is indeed pure-personal.   This is the line that separates
scientific knowledge and what a medical person THINKS he knows.



Even worse, is an optometrist, who is "pushing", Ortho-K, as a means to avoid nearsightedness.

https://www.youtube.com/watch?v=vNNQY2_bTlo

The BIG PROBLEM?  He is wearing glasses.  If Ortho-K is that great - then why is he NOT 20/20??

This truly is about money, isn't it. 

I wear a plus for "near", to save my distant vision.  You see my videos, and I READ the 20/20 line objectively.

Un-like Anderson, I do not need, nor want your money.  Neither did Dr. Prentice.  It all depends on you. 

There is nothing "easy" about prevention.  I never said it was.  Anyone who says that - is cheating you.

 Try to think about it.
Ha! I never got a response from Dr. Anderson (http://forum.gettingstronger.org/index.php/topic,538.msg6632.html#msg6632). I hope that at some point he manage to earn enough money from Ortho-K, and start to truly work on myopia prevention after his retirement!
Title: Re: A Compendium on Myopia Rehabililation
Post by: rtdfgdfgdfgdfg on July 10, 2015, 10:16:38 AM
print pushing works

what more is there to say
Title: Re: A Compendium on Myopia Rehabililation
Post by: HansK on July 10, 2015, 11:16:26 AM
Unfortunately, for me and others (gekonus etc.), it does not work.
Title: Re: A Compendium on Myopia Rehabililation
Post by: OtisBrown on July 10, 2015, 11:42:02 AM
Hi Hans and Gekonus

You guys made a good effort.  I am not certain how much, "plus wear", and "print pushing" you did while " wearing a plus,"
but at least you made an effort.

For me, I am just lucky,  I wear the plus 2.75 as I type  this, and go down stairs, and read the 20/20 line.  i know that
no  one who is "medical" can do anything for prevention (as Dr. Prentice stated it), and I must personally always exceed,objectively
the 20/30 line.

I know you are going to go through a four year college.  So perhaps your effort is finished, now. You do know
that some people are successful (Todd, Severson, Shadowfoot) while others ... are not.

The minus will always work for you ... and you know the plus prevention will never work for you.

This is why I respect the optometrist.  He can not figure out who can makes themselves successful, and who can not.

This is indeed, "intellectual and personal", and can never be a "prescription".  I never want to be considered
a critic of an optometrist - for exactly that reason.  I enjoy talking with you.

Unfortunately, for me and others (gekonus etc.), it does not work.
Title: Re: A Compendium on Myopia Rehabililation
Post by: HansK on July 10, 2015, 02:40:37 PM
Hi Hans and Gekonus

You guys made a good effort.  I am not certain how much, "plus wear", and "print pushing" you did while " wearing a plus,"
but at least you made an effort.

For me, I am just lucky,  I wear the plus 2.75 as I type  this, and go down stairs, and read the 20/20 line.  i know that
no  one who is "medical" can do anything for prevention (as Dr. Prentice stated it), and I must personally always exceed,objectively
the 20/30 line.

I know you are going to go through a four year college.  So perhaps your effort is finished, now. You do know
that some people are successful (Todd, Severson, Shadowfoot) while others ... are not.

The minus will always work for you ... and you know the plus prevention will never work for you.

This is why I respect the optometrist.  He can not figure out who can makes themselves successful, and who can not.

This is indeed, "intellectual and personal", and can never be a "prescription".  I never want to be considered
a critic of an optometrist - for exactly that reason.  I enjoy talking with you.

Unfortunately, for me and others (gekonus etc.), it does not work.

I made effort, no question. I have several pair of glasses (1 distance prescription [slightly undercorrected] and 2 "near" prescriptions] and when I am at home, I have them next to me. My mother always asks me what I am doing with those lenses and why I am changing them.

75-85% of the time, I have a slight myopic defocus. Sometimes, while reading, I find reading sharp text "relaxing". I even quit ortho-k, but I did not make any consistent improvement. Short-term yes, I was able to read 20/30, sometimes even 20/20, but after a while, I was back where I started.