Author Topic: Deep Blur vs. Incremental Blurr  (Read 2413 times)

Offline Todd Becker

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Deep Blur vs. Incremental Blurr
« on: September 17, 2014, 09:20:15 PM »
There's been some good discussion on this site regarding the merits of using deep blur versus incremental blur or defocus to reverse myopia.  While I've advocated incremental blur -- using plus lenses or the unaided eye to focus on print and objects at or just beyond the "edge of blur" -- others, like Jim (Boston), Nick (Grouwen) and Capital Prince's father have found that an entirely different method works for them -- deep blur, or staring at very blurry visual features that resist immediate resolution.  Nick has described the method quite vividly in his thread on "Hocus Focus".  Typically this method involves staring at distant objects for long periods of time -- as much as an hour per session.  While it can seem boring and difficult to integrate with daily activities like work, the technique has yielded very large, often sudden and impressive reductions in myopia for several of you. 

I think it is quite interesting and possible that BOTH techniques work, and that deep blur may work better for some while incremental blur may work better for others.  I'm not sure why, but here is a speculative hypothesis, which for shorthand I'll call the Dual Mechanism Hypothesis:

The Dual Mechanism Hypothesis holds that myopia is caused and can be reversed by separate processes which can either exist separately or coexist:  pseudo myopia and axial myopia.  My hypothesis is that deep blur works primarily to reverse pseudo myopia, whereas incremental blur more directly addresses the reversal of axial myopia.   Let's assume for the moment is that deep blur is a method of allowing ciliary muscles that are in spasm to relax.  It is plausible that without constant cognitive effort directed towards focal resolution, the ciliary muscles will relax.  This relaxation then allows the lens to flatten and better focus distant objects.  The fact that this improved focus is often brief and transitory is consistent with the challenge of relaxing a tensed muscle at first, since it will readily re-tension.  With time and learned relaxation, deep blur may become more effective and result in more sustained reductions in myopia that are less prone to reversal.

On the other hand, incremental blur works on a much longer time scale to correct axial myopia, by spurring incremental changes in the growth of scleral tissue that results in differential changes in the shape and axial length of the eye.  These changes cannot happen overnight, but require sustained and repeated stimulus to growth.  While these changes are slow and incremental, they are also long-lasting.

Myopes differ by whether they are primarily afflicted by pseudo myopia, axial myopia, or a combination of the two.  My research indicates that people generally start out with pseudo myopia, and that axial myopia is induced mostly after commencing with use of corrective minus lenses.  However typical that may be, of course there can be other paths and individual variations in the genesis of myopia.

One consequence of the Dual Mechanism Hypothesis (DMH)  is that deep blur will be mainly effective on individuals with reversible pseudo myopia.  Since pseudo myopia can explain refractive errors up to about -6D, the deep blur technique could be effective for many mild myopes.

Many myopes however -- especially those who have worn minus lenses a long time, and in addition those who have myopia stronger than about -6D -- have some degree of axial myopia.  While deep blur may allow relation of their over-tensed ciliary muscles, allowing partial reduction in myopia, it won't address residual myopia that results from a lengthen eye.  For that, a more sustained stimulus is needed, and this is where incremental blur or defocus proves itself to be useful.  Those, like myself, who made progress using incremental blur had to work at it for months or years of repetitious effort.  Because of that, we resorted to techniques that are readily integrated into daily activities, ,such as print pushing and under correction for distance.  (I don't think many of us could find the time or tolerance for a daily, hour-long deep blur session that continued for months).

I think that DMH can make sense of the facts as I know them and the situations that many of you have described.  Is it true?  That's much harder to say.  To establish the truth of this hypothesis would require a lot of testing and validation, including a way to quantify the relative contributions of axial and pseudo myopia in individuals and to track how those measures change over time and in response to various focusing or defocusing techniques.  It's a big project beyond what anyone I know would undertake.

And yet the DMH a framework for thinking about the relative merits and refinements of the deep focus and incremental focus approaches. It has opened my eyes to the possibility of a hybrid approach that combines incremental blur for reading with perhaps tolerating and even using deeper degrees of blur when engaged in more relaxed activities involving just looking around.  In fact, I think I've probably used some aspects of deep blur when I've looked at distant objects that generate double vision, e.g. telephone wires and tree branches, allowing them to eventually fuse.  The sudden improvements that sometimes accompany fusion events like this suggest that the underlying process involves ciliary relaxation rather than axial changes to the eye.

The Bates Method, to the extent that it strives for relaxation, may also have merit in addressing pseudo myopia.  I'm finding myself more open to the possibility that both the "relaxation" of deep blur and the "stress" of incremental defocus may have useful, albeit complementary, roles in addressing the two different mechanisms underlying myopia.  So maybe I'm mellowing on my skepticism about Bates!

So now you can chime in with any research or personal evidence that would support or refute this Dual Mechanism Hypothesis.

Cheers,

Todd
« Last Edit: September 17, 2014, 09:36:53 PM by Todd Becker »

Offline ZC

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Re: Deep Blur vs. Incremental Blurr
« Reply #1 on: September 19, 2014, 05:16:27 AM »
That was a great journal article. Thanks for posting it.

Let's see if I've got this straight.

Let's say I am a nine-year old and I will be a myope one year from today. My buddy, CZ, is an emmetrope and will continue to be one one year from today.

My axial length is longer than CZ's and longer than the average axial length of those emmetropic nine-year-olds who will be emmetropes when they are ten.

Is it the case that:

1. I am emmetropic at age nine because my lens (cornea?) has flattened as an adaptive mechanism; or
2. I am emmetropic only as an artifact of the study definition of myopia. That is, I am myopic compared to CZ but I have not yet crossed the study's threshold separating myopes from emmetropes?

Offline OtisBrown

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Re: Deep Blur vs. Incremental Blurr
« Reply #2 on: September 19, 2014, 08:34:51 AM »
Hi ZC and Todd,

Subject:  All these refractive measurements are essentially relative.

If you will allow me to add my commentary.

The child who is emmetropic at age 14, (refractive STATE 0.0 diopters, (measured with Snellen and trial-lens kit), will not stay at 0.0 diopters for the next 8 years.

The child at 20/40, and -1.0 diopters, will not stay at -1.0 diopters, for the next 8 years.

From the study of the natural eye that is proven responsive to long-term near, their eyes "collectively", will go down by -1/2 diopters per year.

Thus in 8 years, you can add -4 diopters to their refractive state, at age 14.  Rather than argue about their future refractive state - I simply present objective facts.

http://myopiafree.wordpress.com/study/

The statement, or belief-system that says that you are "emmetropic", and will not become "myopic", just goes against the objective facts.

These measurements were all objectively made by scientists.  The data shows a general picture for ALL NATURAL EYES, that have been proven to be dynamic.  But this requires that we "re-think" the entire concept of natural eyes with both positive and negative refractive STATES, that we measure ourselves.  Virtually, primates, with POSITIVE STATES, become MYOPIC, (change of refractive state) if placed in cages for seven years.
 
http://myopiafree.wordpress.com/graphics/
 
But, in an office, and OD feels his only obligation is to "fix you" instantly with a strong minus lens.  We must learn to take the time to understand the science that supports wise prevention, with a plus lens.

Any serious scientific review - should include a review of this problem of the natural eye's adaptiveness to long-term near, not in becoming "defective", but in being dynamic.


That was a great journal article. Thanks for posting it.

Let's see if I've got this straight.

Let's say I am a nine-year old and I will be a myope one year from today. My buddy, CZ, is an emmetrope and will continue to be one one year from today.

My axial length is longer than CZ's and longer than the average axial length of those emmetropic nine-year-olds who will be emmetropes when they are ten.

Is it the case that:

1. I am emmetropic at age nine because my lens (cornea?) has flattened as an adaptive mechanism; or
2. I am emmetropic only as an artifact of the study definition of myopia. That is, I am myopic compared to CZ but I have not yet crossed the study's threshold separating myopes from emmetropes?
« Last Edit: September 19, 2014, 12:38:46 PM by OtisBrown »

Offline Arachne

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Re: Deep Blur vs. Incremental Blurr
« Reply #3 on: September 20, 2014, 10:45:27 AM »
That's an interesting article, Jim.

When I was five years old (54 years ago!), I had a course of treatment for amblyopia at an eye clinic. I distinctly remember the consultant at that time saying that I would become myopic. In fact, I didn't experience any myopic symptoms at all until nine years later. I can only speculate that his prognosis was based on my eyes' axial length.