discrepancy between my results and optometrist's results

[caimanjosh]

I've been working on improving my myopia for the last 1.5 years or so.  Before I'd started, my most recent prescription was for -2 right eye, -2.75 left eye.  (Back then, I wasn't checking myself with an eye chart, so I don't know what I could clear at that point.)

Fast forward to today.  Now, with unaided eyesight, in a well-lit room (bright daylight coming through big windows), I can just barely clear the 20/15 line on an eye chart with the right eye, and can clear the 20/40 line with my left eye (or even 20/30 if I spend some time focusing).  However, I just went and had an eye checkup (mostly since I was curious to see what they said about my myopia rehab experiments), and their prescription is:  -.75 right eye, -1.75 left eye.  These measurements would suggest considerably more myopia than my own eye chart tests would seem to suggest.  Indeed, my own tests would suggest that my right eye is not myopic at all.  (I no longer wear glasses at all at this point.  Nor do I intend to start again.)

How to account for the difference between my own measurement efforts and the optometrist's?  The cynic/paranoid side of me wonders if maybe they intentionally over-measure myopia to ensure that everyone goes home with a prescription indicating they need glasses (the optometrist's is physically located within a glasses retail store..).  The less paranoid side of me figures it's just a measurement error, but wonders -- my error, or theirs?  I'd be curious to hear others' thoughts.

[OtisBrown]

Hi Caiman,

I have 20/20, checked on my own Snellen.  Yet every time I go to an OD, they put a "Phoropter", in front of my face, spin the dials, and say, 1 better? 2 better?.  Then they want to PRESCRIBE a lens for me - when I have 20/20.  When I asked the "tech" what she measured, she stated that I would have to ask the optometrist what my prescription would be.  (This is why I "gave up" on the tech, and do this measurement myself.)

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


I gave up on any trust I might have had for an OD in his office.  Is this "right"?  Or is this "wrong"?  I know they TRY to do a good job - but they always over-prescribe by about -1 diopter.  There is no reason for me to "argue" with them on that point. I just do my own measurements - and more accurately in my judgment.

I do not know, and I do not care - what an OD might thing.  I just do not want my vision destroyed by an excessive minus lens. 

This is why I made the video - so you can check yourself.  The legal standard is that I must read the 20/40 line, with both eyes open.  That is ONE objective requirement that we all must pass.  (That 20/40, is "worst case" for me).  By checking with my own test lens - I can see if a -3/4 will give me 20/20.  If it does, then I have NO HEALTH PROBLEM.  I have "negative status", that I can slowly recover by wearing a plus for near. 

If a -3/4 diopter did NOT give me 20/20, then I would know that I have a "medical problem", and would go for a medical exam. 

I think that anyone working on "vision improvement" should make these simple measurements himself.  This is NOT the "practice of medicine", and you are not "prescribing for yourself".  Remove "medical terms" for self-measurement, and you will do better.

If you can, with both eyes open, read better-than 20/40, then you will pass the DMV requirement.  That means you can avoid wearing a minus lens - most of the time.  I am "practical" here.  If I were at 20/40, I would buy a -3/4 minus from Zennioptical for $9, and just keep it in my car.
I would do that, until I can confirm 20/25 on my own Snellen.  Then I can stop wearing the minus lens for driving.

But I would be wearing a +1.5 diopter for ALL CLOSE WORK.  As my Snellen improved, I would plan to increase that to +2.0 to +2.5 diopters, to keep the 20/25 to 20/20, I eventually objectively confirm.

No, I would not go to an OD for a verification of my own Snellen improvement.  I will do that objectively - myself.

I've been working on improving my myopia for the last 1.5 years or so.  Before I'd started, my most recent prescription was for -2 right eye, -2.75 left eye.  (Back then, I wasn't checking myself with an eye chart, so I don't know what I could clear at that point.)

Fast forward to today.  Now, with unaided eyesight, in a well-lit room (bright daylight coming through big windows), I can just barely clear the 20/15 line on an eye chart with the right eye, and can clear the 20/40 line with my left eye (or even 20/30 if I spend some time focusing).  However, I just went and had an eye checkup (mostly since I was curious to see what they said about my myopia rehab experiments), and their prescription is:  -.75 right eye, -1.75 left eye.  These measurements would suggest considerably more myopia than my own eye chart tests would seem to suggest.  Indeed, my own tests would suggest that my right eye is not myopic at all.  (I no longer wear glasses at all at this point.  Nor do I intend to start again.)

How to account for the difference between my own measurement efforts and the optometrist's?  The cynic/paranoid side of me wonders if maybe they intentionally over-measure myopia to ensure that everyone goes home with a prescription indicating they need glasses (the optometrist's is physically located within a glasses retail store..).  The less paranoid side of me figures it's just a measurement error, but wonders -- my error, or theirs?  I'd be curious to hear others' thoughts.

[Alex_Myopic]

By having 20/20 vision even if someone doesn't measure it he knows he has good vision by recognizing faces at distance, seeing the bus number from far, seeing letters at far that other people can also see etc So having the doctor tell us to put glasses in order to see 20/15 is not so important except maybe if we want very good vision at night.

Today I've heard by an ophthalmologist on the tv that "they know who will become myopic in his life by the time he is in his mothers womb, by measuring the diameter of his eyeball"!!!

[OtisBrown]

Hi Alex,

You are correct.  What they know is this.  If you are in a "school environment", and have emmetropia (refractive state of 0.0 diopters) at age 7, your refraction will go down by -1/2 diopter per year - for each year in school.

This is not "eye to long", it is just a process of the natural eye "adapting" to long-term near.  But they sweep that issue "under the rug", and just tell  you its your "bad heredity".

No, it is a natural process - that you must understand.

It is a warning to never expect any help about prevention - from an ophthalmologist.  I learned to dis-trust this type of "self-justifying" statement - because it is totally dis-proven.

This is probably one of the issues that inspired Dr. Bates to conduct his 1912 study.

Optometry is "pure default". The minus lens "works instantly". They do not want to be "bothered" with the concept that the minus is making your distant vision profoundly worse.

Science says it is.  They say it is not. Who do you believe?

By having 20/20 vision even if someone doesn't measure it he knows he has good vision by recognizing faces at distance, seeing the bus number from far, seeing letters at far that other people can also see etc So having the doctor tell us to put glasses in order to see 20/15 is not so important except maybe if we want very good vision at night.

Today I've heard by an ophthalmologist on the tv that "they know who will become myopic in his life by the time he is in his mothers womb, by measuring the diameter of his eyeball"!!!

[caimanjosh]

I have 20/20, checked on my own Snellen.  Yet every time I go to an OD, they put a "Phoropter", in front of my face, spin the dials, and say, 1 better? 2 better?.  Then they want to PRESCRIBE a lens for me - when I have 20/20.  When I asked the "tech" what she measured, she stated that I would have to ask the optometrist what my prescription would be.  (This is why I "gave up" on the tech, and do this measurement myself.)

I gave up on any trust I might have had for an OD in his office.  Is this "right"?  Or is this "wrong"?  I know they TRY to do a good job - but they always over-prescribe by about -1 diopter.  There is no reason for me to "argue" with them on that point. I just do my own measurements - and more accurately in my judgment.

I do not know, and I do not care - what an OD might thing.  I just do not want my vision destroyed by an excessive minus lens. 

At this point, I'd agree with this.  I do think both my eyes were over-prescribed by about -1 diopter.  Why is this, I wonder?  From what those of us on this forum now realize, this is a terribly harmful practice in the long term.

In any case, I plan to stick to my own strong plus lenses for reading, and just test myself on my own eye chart from time to time to monitor my vision. 

[OtisBrown]

Hi Caiman,

Subject: It is very difficult to give anyone "advice" on prevention.  (I almost give up on doing that.)

Item: But if it is difficult for me, it is indeed impossible for  an OD in his office to give you any meaningful advice.

I do suggest the following:

1) Down-load a Snellen.  Mark the lines in FEET (so you can read them at 20 feet.
2) Check the DMV requirement.  It is for 20/40, not 20/20.
3) Set a reasonable goal, of reading the 20/40 - as the point where you stop using a minus lens (except to drive).

THE OD "PRESCRIPTION".

They never bother to have you check your own Snellen.  (They just "jump into" prescription.)  Their "prescription standard is for HOW SHARP THEY CAN MAKE YOUR VISION - WITH NO LIMITATIONS.  This means, that if you have self-checked at 20/40 (at home) you will be prescribed a -2 diopter lens - ALWAYS.

Is that "right"?  what do you think?

This is why I do my own checking.  The ODs THINK that ANY PREVENTION - is totally impossible.  (Maybe it is - for THEM in their OFFICE.)

But it does not have to be impossible for  you.  This is why personal, objective verification is critical.  Assuming you read 20/40 (naked eye), they you can get self-confirmed, objective improvement.  When YOU make the measurement - it is by definition, objective.

Why do ODs over-prescribe?  It is because the public is ignorant, and they just assume you do not mind "stair case" myopia - you are CERTAIN TO GET - FROM THAT FIRST EXCESSIVE MINUS LENS.

I do not know what your Snellen is - but you must know.  This is not a "medical problem", but is it a matter of your committement to wearing the plus - if you wish to do sol.

Best,

I have 20/20, checked on my own Snellen.  Yet every time I go to an OD, they put a "Phoropter", in front of my face, spin the dials, and say, 1 better? 2 better?.  Then they want to PRESCRIBE a lens for me - when I have 20/20.  When I asked the "tech" what she measured, she stated that I would have to ask the optometrist what my prescription would be.  (This is why I "gave up" on the tech, and do this measurement myself.)

I gave up on any trust I might have had for an OD in his office.  Is this "right"?  Or is this "wrong"?  I know they TRY to do a good job - but they always over-prescribe by about -1 diopter.  There is no reason for me to "argue" with them on that point. I just do my own measurements - and more accurately in my judgment.

I do not know, and I do not care - what an OD might thing.  I just do not want my vision destroyed by an excessive minus lens. 

At this point, I'd agree with this.  I do think both my eyes were over-prescribed by about -1 diopter.  Why is this, I wonder?  From what those of us on this forum now realize, this is a terribly harmful practice in the long term.

In any case, I plan to stick to my own strong plus lenses for reading, and just test myself on my own eye chart from time to time to monitor my vision.

[caimanjosh]

I do not know what your Snellen is - but you must know. 

My best Snellen reading (naked eyes) is 20/15 in bright daylight, so I think I'll be skipping on the minus lenses for the foreseeable future. 

[Alex_Myopic]

@caimanjosh

What critical methods did you use to get from -2D to 20/20 in about a year?

[OtisBrown]

Hi Caiman Josh,

Subject:  That is truly impressive.

Item:  In fact that is superior vision.  All the credit belongs to you.  Even reading the 20/25 line is superior vision, relative to the requirements of the DMV.  I would be very happy if all people took the responsiblity to home-verify that level of vision at home.

I do not consider this success to be, "practicing medicine on yourself'.  It is just common-sense science, and personal resolve.

i personally do not "claim success" beyond a "starting value" of about 20/60 - because I know few people have the determination and "independent" mind to stick with the plus, and wait the nine months to begin exceeding the 20/40 line.  They all "talk" about it, but it is only talk.  In fact, the will not even look at a Snellen.

Perhaps others will learn from you success.  I hope so.

I do not know what your Snellen is - but you must know. 

My best Snellen reading (naked eyes) is 20/15 in bright daylight, so I think I'll be skipping on the minus lenses for the foreseeable future.

[caimanjosh]

@caimanjosh

What critical methods did you use to get from -2D to 20/20 in about a year?

Hi Alex,
I can briefly summarize what I did and what I think are the important things to keep in mind.  First, I started by just swearing off my prescription glasses altogether.  Things were fairly blurry for the first couple of months, but I really believe that this was a hugely important step.  I live in a place with great public transit and don't own a car, so I didn't have to worry about wearing them to drive.  (For those with more severe myopia where this just isn't an option, or who need to drive a car often, probably obtaining reduced power minus lenses from zennioptical would be key.) 

Shortly after that, I started with the familiar (to those on this forum) regimen of print pushing with plus lenses.  The key point here, which I think many don't realize, is that you must strive to improve your print pushing as much as you can.  That is, strive to push the print farther away (though still readable) whenever possible.  And once it gets to a decent distance away, do what I think is one of the most important things -- get stronger plus lenses.  It's like lifting weights -- if you're not lifting more weight than you were 6 months ago, you probably haven't built much strength/muscle.  Same for print pushing.  I ended up buying cheap reading glasses in .5 diopter increments, from +1 up to +4.5.  Every couple of months, whenever I felt I could, I started using the next lens power up.  I think this kind of progression is absolutely key to making long-term improvement.  (At this point, I'm combining some of my plus lenses to make even stronger ones -- for my right eye, I combined a 4 and 1.5 lens together, with tape, to make a +5.5 lens.  I use this when reading in bright daylight.) 

I hope these ideas help some others in their vision improvement journey.  Good luck! 

[Alex_Myopic]

@caimanjosh

Thanks for the answer. Plus based at the edge of blur ending with strong plus at near your way.

I hope you get even +3/4D refractive state as Mr Brown states for perfect night vision, then OD at least will stop telling you are myopic!

[OtisBrown]

Hi Caiman Josh,

Subject: Why you never "hear" about the need to wear the plus, "on your own", from an "office OD".

Item: You were lucky, you stated wearing the plus (and avoided wearing that -2 diopter).

Item: Further, passing the 20/25 line I think is a wonderful, and a personal success.

I wish no "fight" with an OD in his office.  That fight - produces only "anger", and no solution.  I have prepared this video, to discuss this issue of personal responsibility, and the need to self-check both your Snellen and refractive status - yourself.

https://www.youtube.com/watch?v=k3zzTZiojb0

I would also add that even if you are a "pure-exercise" person - you still should go through this measurement process - to satisfy yourself that you are objectively successful - both in terms of refractive state, and visual acuity.  (Bates' efforts truly inspired me on that statement.)

I wish there were more people (who are wearing a -1.0 diopter lens) who would understand that plus-prevention is based on pure-science.  No OD can ever "prescribe prevention", so you must do prevention (after confirming 20/50) yourself.

I always add that medical doctors recommend the plus - and use it on their own children.

http://kaisuviikari.com/wordpress/

To say that all MDs support the minus, is just hogwash.  The minus solves an immediate problem - but it truly opens up a "bottom less pit" if you even start wearing it.

Thanks for your success - I hope other readers can understand how difficult (but possible) prevention is.

@caimanjosh

What critical methods did you use to get from -2D to 20/20 in about a year?

Hi Alex,
I can briefly summarize what I did and what I think are the important things to keep in mind.  First, I started by just swearing off my prescription glasses altogether.  Things were fairly blurry for the first couple of months, but I really believe that this was a hugely important step.  I live in a place with great public transit and don't own a car, so I didn't have to worry about wearing them to drive.  (For those with more severe myopia where this just isn't an option, or who need to drive a car often, probably obtaining reduced power minus lenses from zennioptical would be key.) 

Shortly after that, I started with the familiar (to those on this forum) regimen of print pushing with plus lenses.  The key point here, which I think many don't realize, is that you must strive to improve your print pushing as much as you can.  That is, strive to push the print farther away (though still readable) whenever possible.  And once it gets to a decent distance away, do what I think is one of the most important things -- get stronger plus lenses.  It's like lifting weights -- if you're not lifting more weight than you were 6 months ago, you probably haven't built much strength/muscle.  Same for print pushing.  I ended up buying cheap reading glasses in .5 diopter increments, from +1 up to +4.5.  Every couple of months, whenever I felt I could, I started using the next lens power up.  I think this kind of progression is absolutely key to making long-term improvement.  (At this point, I'm combining some of my plus lenses to make even stronger ones -- for my right eye, I combined a 4 and 1.5 lens together, with tape, to make a +5.5 lens.  I use this when reading in bright daylight.) 

I hope these ideas help some others in their vision improvement journey.  Good luck!

[musafighter2]

Hi,
Just wondering, to those who go back to their OD after this process and find that their vision 'has' improved, what is the response/reaction of the OD?

Thanks

[NickGrouwen]

Hi caimanjosh,

I do not know how well-lit your optometrists office is but I can tell you that reading a Snellen chart in bright daylight is a piece of cake compared to reading the same chart with indoor artificial lighting. Even for someone with HORRIBLE myopia as me, bright natural sunlight is truly different, more powerful, than artificial lighting. I see so much clearer in bright daylight than in artificial light of similar intensity.

For the eyes, there is NO LIGHT like sunlight. Nothing else even comes close. I think.

So I hate to say it, and again I DO NOT KNOW the difference in lighting between the bright daylight in your home and the lighting at the optometrist's offce, but you might have over-measured because of the sunlight being so powerful. Try recreating the lighting conditions in your optometrist's office in your own home and try to pass the eye exam under those conditions. You might apparently only have 20/20 vision in bright daylight when realistically speaking you should be having 20/20 even with regular indoor lighting and on not-so-bright days, since not everyday is a bright sunny day.

[caimanjosh]

To revive this old thread....Nick, you make some good points.  I suppose the question is, what lighting conditions are to be considered "standard" for testing vision on a Snellen chart?  Is direct sunlight on the chart standard (probably not), bright daylight, bright artificial light, or moderate artificial light?  I'm not sure.  However, even under moderate daylight (not-too-bright cloudy day), I can still (barely) read 20/20, so I know I'm close. 

Also, I read De Angelis's book (The Secret of Perfect Vision), and I think I may have an answer to why the optometrist measures me as nearsighted and I don't.  In the book, he explains there are 2 factors:

1) They measure vision 1 eye at a time.  Monocular vision tends to be perhaps 5-10% weaker than binocular vision.
2) They correct vision so that it's better than 20/20.  (Others on this forum have commented on that -- with glasses on, many can read 20/15 or even better.) 

So, given these 2 factors, I think it's likely that optometrists are going to prescribe weak minus lenses to many who would, in fact, test their vision as 20/20 on a Snellen chart.