Getting Stronger: Discussion Forum

Discussion Topics => Rehabilitation => Topic started by: Don67 on February 24, 2014, 05:43:09 AM

Title: How to start correcting astigmatism?
Post by: Don67 on February 24, 2014, 05:43:09 AM
I am so happy to have come upon Todd's blog and forums over the past couple of weeks.  I've had great success recently with intermittent fasting and now want to apply hormetism to improving my eyesight.  I've begun to try to implement practices based on what I've read in Todd's posts and from the forum, but I would appreciate any additional help given the level of astigmatism from which I am beginning.  I'm in my mid-forties and recently received the following prescription from my optometrist. 

Right: -1.00 sphere, -2.50 cylinder, 105 axis
Left: -.025 sphere, -4.00 cylinder, 80 axis
Progressive lenses with 1.5 add in both.

Given the strength of the astigmatism, going to strict spherical lenses seems like it might be too much.  My myopia itself doesn't seem to bad, if I could find a way a correct the astigmatism.

Thanks in advance for suggestions on where to start in earnest.
Title: Re: How to start correcting astigmatism?
Post by: CapitalPrince on February 24, 2014, 06:17:23 AM
how did you get that much astigmatism when your spherical is so low? Did your doctor just increase the cyl every year? Thats mindless

Astigmatism may be due to bad posture/read titling. This is why doctors should not touch cylinder and instead tell the patient to fix his habits first.

Since yuor astigmatism is so high and spherical so low. Its best to wear glasses that are half of your astigmatism.

this is just one prescription you could try

R. -0.5D -1.25Dx105
L.  0    -2.00Dx 80

You should take off your glasses for close work, if the astigmatism iis not too bad at  near.

but its not going to be easy to get rid of -4D/-2.5D of astigmatism.
Title: Re: How to start correcting astigmatism?
Post by: Don67 on February 24, 2014, 06:29:12 AM
Thanks.

Two years ago, my prior optometrist gave me:

Right: -1.50 sphere, -1.75 cyl., x 095
Left: -.075 sphere, -2.75 cyl. x 080
Progressive lenses add 1.50

Under the exam conditions last month, I was clearer with the stronger astigmatism adjustment.  Since I could still see reasonable well with the old glasses, should I perhaps begin to adjust from the old prescription?
Title: Re: How to start correcting astigmatism?
Post by: CapitalPrince on February 24, 2014, 07:18:42 AM
i think those glasses have too high of a spherical for you.

just order a few glasses from zennioptical.com with different and lower amount of  astigmatism. Just make sure you try not use glasses for all close work.

i don't know any techniques to specifically reduce astigmatism. maybe someone else can comment.

Title: Re: How to start correcting astigmatism?
Post by: OtisBrown on February 24, 2014, 11:12:21 AM
Hi Don,

I agree that an OD is doing the "best he can".  But I just do not believe the "astigmatism" measurement is accurate.  What happens is that the "nearsightedness" is "converted" into astigmatism.

For the values you provided the Right eye is about -2.25 (Spherical equivalent), and the Left eye, about -2.25 diopters.

(You take 1/2 the cylinder value and add it.)

I personally always ask to be measured with pure spherical lens.  But it is always good to do this "conversion" to compare various prescriptions that you have received in the past. 

I also order my lenses from Zennioptical - and they are excellent.  I would bet that if you had a -2.25, you could read the 20/20 line on your Snellen at home.

(Just my opinion.)

One issue has become clear.  As a person reduces his "myopia" to zero diopters (i.e., 20/20 on his Snellen) his astigmatism value also reduces to almost zero. 

It is a benefit of Todd's work with the plus lens.


Thanks.

Two years ago, my prior optometrist gave me:

Right: -1.50 sphere, -1.75 cyl., x 095
Left: -.075 sphere, -2.75 cyl. x 080
Progressive lenses add 1.50

Under the exam conditions last month, I was clearer with the stronger astigmatism adjustment.  Since I could still see reasonable well with the old glasses, should I perhaps begin to adjust from the old prescription?
Title: Re: How to start correcting astigmatism?
Post by: Don67 on February 24, 2014, 11:25:30 AM
Thanks, Otis.    Would you recommend I order and use something below -2.25 in order to work on improving my vision with Todd's techniques?
Title: Re: How to start correcting astigmatism?
Post by: OtisBrown on February 24, 2014, 01:43:44 PM
Hi Don,

It is a matter of personal bias - that I think most "astigmatism" is either excessive or not necessary.  I use a simple "test lens" to confirm my own vision - as well as this Snellen chart - that is easy to down-load.

http://www.i-see.org/block_letter_eye_chart.pdf

I consider you to be approximately a -2 diopter person.  That means you should be able to read at 20 inches - with no lens on your face.  Do you wear your glasses all the time?

I would suspect you can probably read the 20/60 to 20/70 line (with slight squinting).  Are you interested in checking yourself?  I put a bright light on my Snellen - for an accurate reading.

You are going to get a vast array of opinions - here an everywhere.  But I would start with my own Snellen readings. 

You can get your own lenses from Zennioptical.com - for about $9.  That is how I do it.



Thanks, Otis.    Would you recommend I order and use something below -2.25 in order to work on improving my vision with Todd's techniques?
Title: Re: How to start correcting astigmatism?
Post by: Myoctim on February 24, 2014, 03:18:38 PM
Would you recommend I order and use something below -2.25 in order to work on improving my vision with Todd's techniques?

Hi Don,

according to my own astigmatism experience I can't recommend a total cyl. drop at your values.
The spherical equivalent (SE) approach works fine for low astigmatism but gets to it's limits with increasing values.

-2.25D SE should mean you can read your computer without glasses at 44cm/17inch - can you?

Best would be to find a behavioral optometrist who gives you a reasonable undercorrection or getting access to a trial lens kit to find out if the SE works for you and how much to reduce.

It is said using the Tibetan Wheel should be helpful.

http://commons.wikimedia.org/wiki/File:Tibetan_wheel.jpg
Title: Re: How to start correcting astigmatism?
Post by: OtisBrown on February 25, 2014, 04:20:22 AM

Hi Don,

I can only recommend what *I* would do.  Just for the experiment, I would order the -2.25 diopters, and see if I could read the Snellen at a reasonable level.

FYI, when an OD starts to "check your eyes", he starts with a "spherical minus lens".  He then sees if he can get 20/20 through a spherical minus lens.  I think most ODs and persons can see 20/20 through a spherical minus at that point.  Then he starts to "tweek", that "spherical minus", giving you various degrees of "cylinder". 

I always ask for them to just measure 20/20 with a spherical - and to "not bother" with the "cylinder" part.

You could talk to your OD about this issue - if you wish.


Thanks, Otis.    Would you recommend I order and use something below -2.25 in order to work on improving my vision with Todd's techniques?
Title: Re: How to start correcting astigmatism?
Post by: Don67 on February 25, 2014, 05:56:30 AM
Thanks all.

Myoctim, I can read my screen at 17 inches but the letters are a bit blurry - I believe I'm using normal font sizes, but I also wonder if the blur could be compounded by the HDTV-type monitor I have been supplied in my office -- it has a certain "pixelation" even with my corrective lenses on given the type of screen.

Thanks for the suggestion on the Tibetan wheel and on the image suggested by TomLu.  With the clock faced chart, the 9 to 3 and 10 to 4 lines are darker for my right eye and the 9 to 3 and 8 to 2 lines are darker than the other lines for my left eye.

Given the high cylinder prescribed at my exam last month, I am quite reluctant to lock that in by sticking with glasses following that and it has been a bit part of my inspiration to try to figure out what I can do to help my vision heal.

TomLu, good question on the progressive add -- I believe it is designed to correct for presbyopia.  Any suggestions on how to combat that?

Thanks again!
Title: Re: How to start correcting astigmatism?
Post by: Don67 on February 26, 2014, 11:27:11 AM
Thanks, TomLu.  The discussion of presbyopia was helpful.  I'll try the Gottlieb exercises.

I'm still trying to make sense of the astigmatism axis.  http://www.tedmontgomery.com/the_eye/glasses.html provides a nice primer for a newbie like me on making sense of prescriptions but the prescription and my observations on the test wheel are not quite at a 90-degree difference either.  Maybe I'll see if I can be re-checked by the optometrist.
Title: Re: How to start correcting astigmatism?
Post by: Myoctim on March 02, 2014, 03:46:36 AM
a) your right eye has the least amount of astigmatism at the horizontal meridians (i.e., the 0 degree line and the 150 degree line), so I don't know why the cylinder axis is 95 degree.

b) your left eye has the least amount of astigmatism at the horizontal meridians (i.e. 0 degree line and the 30 degree line) too. So again, I don't know why the cylinder axis is 80 degree.

I'm also having a 95° axis prescription, so I can see clearly horizontal lines with my spherical value but I need that additional "cylindrical boost" for also seeing clearly at the vertical plane.

But in Don's case his left eye's horizontal meridian nearly is emmetropic.
Using a (strong) spherical equivalent of -2.25 D wouldn't that mean stimulating the horizontal plane to get more myopic? Using a cyl. undercorrection wouldn't tackle that plane.

BTW, AFAIK while some chick research always resulted in compensation for + and - lenses there only was emmetropization for one of the 2 planes when using cyl. lenses.
Title: Re: How to start correcting astigmatism?
Post by: Don67 on March 04, 2014, 05:40:04 AM
Thanks all.  So, my first order from Zenni optical arrived. 

These are single vision:
R: -0.75 -2.0 x105
L: 0.0 -3.5 x80

vs. my prescription from January which was progressives with a 1.5 add.
R: -1.00  -2.50 x105
L: -.025  -4.00 x80


Using the new glasses, I can see roughly 20/20 (with some blur) with both eyes open on my Snellen - 20/20 (with a bit of blur) with the left eye only  but not quite 20/30  (with a fair amount of blur) with the right eye only.

So, I'm assuming I should try to read at the blur without my glasses closeup, try some exercises for presbyopia, and try to increase focus on edges/lines in the distance with the new weaker glasses.  Does that sound about right?
Title: Re: How to start correcting astigmatism?
Post by: Don67 on March 10, 2014, 04:25:26 AM
Glad to have contributed a little something TomLu.

My second set of test glasses from Zenni arrived.

I tried CapitalPrince's suggestion but I'm not quite ready for this much reduction yet
R. -0.5D -1.25Dx105
L.  0    -2.00Dx 80
I have lots of blur with a blurry at 20/50 at best combined and roughly 20/60 in each eye alone (blurrier on the right), but these are lenses to work toward being able to use.

I also ordered a set of spherical equivalents of -2.25 in each eye, as Otis suggested per my recent prescription.  Unfortunately I am blurry everywhere with these but much worse with the left eye (a blurry 20/100) than the right (a blurry 20/60).  So, like Myoctim, I will need to stick with some cylinder correction, at least for now.

One possibility is that I might try the spherical right lens at -2.25 with the L: 0   -2.00Dx 80 to see how that works since I seem to be roughly a blurry 20/60 for each of these lenses.  Any thoughts on whether working with such a combination potentially would be helpful in working on the astigmatism in both eyes (even if it would not do anything for the myopia in the right given the -2.25 diopter)?

Thanks again, all!
Title: Re: How to start correcting astigmatism?
Post by: Don67 on March 10, 2014, 08:03:59 AM
Hi Otis,

The -2.25 spherical lenses are in.  When I try the Snellen under bright light using these glasses, the left eye is a somewhat blurry 20/100 and right is a somewhat blurry 20/60.
Title: Re: How to start correcting astigmatism?
Post by: Myoctim on March 11, 2014, 05:31:41 AM


My second set of test glasses from Zenni arrived.

I tried CapitalPrince's suggestion but I'm not quite ready for this much reduction yet
R. -0.5D -1.25Dx105
L.  0    -2.00Dx 80
I have lots of blur with a blurry at 20/50 at best combined and roughly 20/60 in each eye alone (blurrier on the right), but these are lenses to work toward being able to use.


Hi Don,

it is said a blur of 1 D astigmatism equals a 0.5D spherical blur.
My personal experience is using a 0.75D astigmatic undercorrection works well.

So for reading you could use
R + 1 D       -1.75D cyl
L + 1.75 D  -3.75D cyl

for distant vision
R -0.5D   -1.75D cyl
L +0.25  -3.25D cyl


Quote from: Don67
One possibility is that I might try the spherical right lens at -2.25 with the L: 0   -2.00Dx 80 to see how that works

unfortunately that would result in overcorrection.
Also, as I posted, it could stimulate your emmetropic meridian to get more myopic. I personally wouldn't risk it.
Title: Re: How to start correcting astigmatism?
Post by: Don67 on March 11, 2014, 05:55:53 AM
Thanks much, Myoctim. 

Just to be sure I understand the logic, you are suggesting going with lower negative/plus spherical correction but with still relatively strong cylinder.  Is that right?  Seems like that should help challenge the myopia while being reasonable/gradual in pushing against the astigmatism. 

Also, did you mean to suggest -3.25D on the cyl for both the reading and distance rather than -3.75D on the reading?  I want to be a bit more cautious on what I order in this range since Zenni charges an extra $9 per pair of glasses with more than -3.0D cyl and they are also recommending a higher lens quality for this prescription which could bring the cost up quite a bit for an experimental pair or two.

Does it seem the reading lenses you suggest would be more helpful in working on hormetic correction than just trying to read at say 17-20 inches without corrective lenses?  I think I understand your logic and it seems worth a try.

As I continue to experiment with this, it seems like my astigmatism and presbyopia are pretty big challenges affecting my ability to go directly after the myopia.
Title: Re: How to start correcting astigmatism?
Post by: CapitalPrince on March 11, 2014, 09:51:43 AM
hey Don,

Do you see alot of double vision or wavy things with that amount of astigmatism?
I have about -0.75D astigmatism and its somewhat noticeable.

you are going to have different opinions here, but i think you should just wear a spherical (either low minus or plus) for near and a undercorrection cylinder for distance.

 you definitely do NOT want to use any minus cylinder for near.
Title: Re: How to start correcting astigmatism?
Post by: Don67 on March 11, 2014, 10:01:15 AM
Thanks, CapitalPrince.

Double vision is a better descriptor than wavy I suppose.  The edges of everything tend to appear fuzzy.

FWIW, I've also noticed that if I limit my vision to a narrow vertical slot (e.g. hold my hand over my eye so that I am looking between two fingers), then my left eye vision is about 20/30 on my Snellen (and a blurrier 20/50 for the right eye).
Title: Re: How to start correcting astigmatism?
Post by: Myoctim on March 11, 2014, 02:58:28 PM
Just to be sure I understand the logic, you are suggesting going with lower negative/plus spherical correction but with still relatively strong cylinder.  Is that right?  Seems like that should help challenge the myopia while being reasonable/gradual in pushing against the astigmatism. 

Also, did you mean to suggest -3.25D on the cyl for both the reading and distance rather than -3.75D on the reading?  I want to be a bit more cautious on what I order in this range since Zenni charges an extra $9 per pair of glasses with more than -3.0D cyl and they are also recommending a higher lens quality for this prescription which could bring the cost up quite a bit for an experimental pair or two.

Hi Don,

sorry, for my typo, of course I meant -3.25D cyl. for both (an undercorrection of 0.75 D) . The less expensive -3.0 D cyl. should also work.

Maybe the "blur factor" by 0.5D sph blur + 1/2 * 0.75D cyl. blur = 0.875 D is too much for a comfortable distant vision (exept for TV).
I guess

-0.75D -1.75D cyl
 0.0D  -3.25 D cyl (or less expensive -3.0D)
 
would give you a more comfortable vision.

Quote from: Don67
Does it seem the reading lenses you suggest would be more helpful in working on hormetic correction than just trying to read at say 17-20 inches without corrective lenses?  I think I understand your logic and it seems worth a try.

also looks like I got you wrong by thinking you want to use that -2.25D and the 0D -2D cyl together at your left eye which would result in overcorrection.

So you can use that R -2.25D SE for distant vision, but I think using a cyl. correction (like -0.75D -1.75D cyl) would give you a more pleasant vision and you are avoiding the risk of equalizing your meridians for the prize of getting more sherical myopia.
IMHO particulary reading at 17 inches could change your nearly emmetropic L -0.25D sph value.
Title: Re: How to start correcting astigmatism?
Post by: Don67 on March 11, 2014, 03:45:00 PM
Thanks, Myoctim.

My 17 inch comment refers to roughly the distance I can stand from my computer monitor which is where I spend most of my day and still see without glasses but with a blur.  So, I was just trying to clarify how best to work on the myopia -- a) simply reading without glasses on and trying to get my eyes to correct the blur, b)/c) using a lower powered minus lens with or without astigmatic correction, or d) I suppose trying to go to a small Diopter plus lens with astigmatic undercorrection.

Title: Re: How to start correcting astigmatism?
Post by: Don67 on May 19, 2014, 05:05:20 AM
It's been a couple of months and so I thought I'd post an update.

Using my Snellen this morning, I can see a clear 20/20 with:
R: -0.75 x -1.75 x 105
L:   0.00 x -3.00 x 80

I've been using a pair of near vision lenses for reading at the blur with:
R: +0.75 x -1.75 x 105
L: +1.50 x -3.00 x 80

My presbyopia seems a bit better although that's hard to measure.

Since I'm feeling my sight is now pretty solid in the current lenses, I guess it's time to try to push things a little more.
I'm considering reducing the sphere and cyl by 0.25 in both lenses for the distance glasses to see how that goes (and correspondingly increasing the near lenses' sphere and cyl. by 0.25).  Does that seem sensible?

Also, anyone have experience of just using a set of bifocals for this ongoing work rather than two separate pairs of glasses?
Title: Re: How to start correcting astigmatism?
Post by: OtisBrown on May 19, 2014, 10:49:21 AM
Hi Don67,

I know I have my "biased" opinion - but here is what I would attempt to do.

Don> I've been using a pair of near vision lenses for reading at the blur with:
R: +0.75 x -1.75 x 105
L: +1.50 x -3.00 x 80

I know you want to be comfortable - but with that prescription, (spherical equivalent) I would attempt to READ with no lens on.

That is a tough choice for you.  But even Dr. Alex stated that to "reduce" astigmatism (for near) it would be wise to avoid wearing glasses.

The Sph. Equi is L:  +1.5 - (3/2) or 0.0 diopters, for reading at 20 inches.

The other Sph. Equi. is R:  0.75 - (1.75/2) or approximatly 0.75 - 1, or -1/4 diopters.

Most "near" or "add" prescriptions do not "correct" for astigmatism.  But that is just my biased opinion.


Title: Re: How to start correcting astigmatism?
Post by: Don67 on May 20, 2014, 05:32:22 AM
Thanks, TomLu and Otis.  I appreciate the replies and guidance.  I'll attempt to continue the improvements I've had so far.  Dealing with my astigmatism and presbyopia certainly add to my challenge but make it worthwhile to keep trying.
Title: Re: How to start correcting astigmatism?
Post by: OtisBrown on May 22, 2014, 04:51:05 PM
Hi Don,

Here are a professional's remarks about astigmatism.  I personally use a "spherical" lens to check for any astigmatism I might have.

Here is a video on this important subject:

https://www.youtube.com/watch?v=kKY-Z8gYSAY

For distant objects, >20 feet, I would wear the astigmatic lens.

But "near vision" very seldom requires extreme sharpness.  For near,  I would try to read with no glasses, and only use a lens for distant objects.  This is just how *I* would do it.



Thanks, TomLu and Otis.  I appreciate the replies and guidance.  I'll attempt to continue the improvements I've had so far.  Dealing with my astigmatism and presbyopia certainly add to my challenge but make it worthwhile to keep trying.
Title: Re: How to start correcting astigmatism?
Post by: Don67 on May 23, 2014, 02:54:10 AM
Thanks, Otis.  The man on the video does a nice job explaining this.

Does any have a source for inexpensive test lenses and a lens holder?
Title: Re: How to start correcting astigmatism?
Post by: OtisBrown on May 23, 2014, 03:32:29 AM
Hi Don,

It is indeed an "extra step" to obtain  your own test lenses - at low cost.  I have seen endless over-prescriptions, that I strongly object to.  This is the reason I obtain my own "minus lenses", have my own Snellen, and do all my own checking.  I go to an OD or MD, but everything they want to PRESCRIBE a lens that I do not need nor want.  There is no point in arguing about this issue. 

This only good source of some test lenses, is Zennioptical.  They cost about $4 per lens.  I will post a video on how to order them in due course.  For me, this is full empowerment.  I do not disparage an OD or MD, but he does not have "time" for me protecting *my* distant vision by my own efforts.  This is part of what Dr. Bates suggested - to avoid wearing of a lens - if you pass the required lines on your own Snellen.

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

This is the only source of low-cost lenses to do the type of self-checking that i could find.  What Dr. Alex has discovered, is that "reducing" nearsightedness, also seems to "reduce" astigmatism - and I believe him.  But that also means "reducing" the amount of time you read with an astigmatic lens.  This is indeed an "extra step".  The complete video is here.

http://www.zennioptical.com/howto



Thanks, Otis.  The man on the video does a nice job explaining this.

Does any have a source for inexpensive test lenses and a lens holder?
Title: Re: How to start correcting astigmatism?
Post by: Don67 on May 23, 2014, 04:30:15 AM
Thanks, Otis. 

However, since I'll still need astigmatic correction for distance viewing for quite awhile, I would imagine I need something a little more complicated to check what cyl. I currently need. Is that correct?
Title: Re: How to start correcting astigmatism?
Post by: Myoctim on May 27, 2014, 02:23:11 PM
However, since I'll still need astigmatic correction for distance viewing for quite awhile, I would imagine I need something a little more complicated to check what cyl. I currently need. Is that correct?

Hi Don,

that's also my idea.
There once was a recommodation for a affordable chinese trial lens set on the Frauenfeld site. 

Because I don't need all that high values from the set I think about only buying the trial frame and some +/- 0.25D and 0.5D spare lenses in sph. and a -0.25 and a -0.5 cyl. lens for checking for any improvement and a possible change in axis.



Title: Re: How to start correcting astigmatism?
Post by: Myoctim on May 28, 2014, 08:41:24 PM
Hi Myoctim and Don,

Don can avoid "astigmatic" lens for near, but he likes astigmatic for far.  Here is one source of a trial lens kit.

http://www.optometrial.com/trial-lens-sets/232-lens-sets/trial-lens-set-232pc-lens-shiny-plastic-rim-1

The "astigmatic" requires that you rotate a -1 diopter (astigmaic) lens through 180 degrees, and find "sharpest" vision.  But that does require a "trial frame", and the lenses.  I still maintain this is the only way to get your own "best measurement".

I wish some "group" would sell a "reduced" trial frame with spherical and astigmatic lenses, so we could test ourselves.  It would be very instructive and "liberating".  For now, I just use a few lenses from Zennioptical.  If more people would ask - a "market" could develop for some of us.

Hi Otis,

THX for the link.

So how to check for an astigmatism improvement?
-Rotating a + 0.25 cyl. lens in front of my current prescription and looking if it get's clearer?
-Otherwise I would need a bunch of -1.25D cyl, -1.0D cyl., -0.75D cyl. and -0.5D cyl. lenses.

Ordering only a $ 1.5 trial frame

http://www.optometrial.com/trial-lens-sets/trial-frames

and some replacement lenses

http://www.optometrial.com/trial-lens-sets/trial-lens-replace

shouldn't be so expensive.


BTW, it's not a matter of liking the astigmatism correction but simply of needing it. Particulary when driving at a rainy night it's much safer!
For getting an impression what I mean maybe you should simulate a >1D of astigmatism by aligning a +1D cyl. lens with the axis of your existing low astigmatism in a way they add.

I guess without the depth of field by a small pupil you wouldn't be pleased about that acuity!




 
Title: Re: How to start correcting astigmatism?
Post by: Alex_Myopic on June 03, 2014, 10:29:14 AM
Most cases of astigmatism are only due to the bad shape of the cornea. So can night-time contact lenses have a permanent effect on cornea reshapening?

"Night-time contact lenses: During sleep, special gas-permeable contact lenses exert gentle pressure on the outer layer of cells in the cornea, reshaping its surface. The next morning, the eye has a different refractive value, so that wearers can see clearly during the day without glasses or ordinary contact lenses."


But even if these contact lenses are gas-permeable they are not 100% and very good hygiene rules must be taken in order not to get infected.