Is it logical

[gekonus]

How about this idea: First of, the whole concept is plus lenses for close up work right? then how about wearing weaker minus lenses ALL THE TIME for distance viewing even if your myopia is weak? Lets say a -1 Myopic person would wear -0.5 lenses till his eyes adapt to the lenses? wouldnt it be faster to improve that way?

[OtisBrown]

Hi Gekonous,

Subject:  It depends on your concept - of the eye as a dynamic system.  (The concept is a paradigm, and is respected in science.)

Item: Having self-measured refractive STATES, and never failures.

FACT:  But let us start by saying that the minus lens causes negative status in all normal eyes.  (The Helmholtz theory IGNORES this fact.)

http://www.ocf.berkeley.edu/~wildsoet/images/neg_lens_induce_myopia.swf

As an engineer, I spent a lot of time with this specific issue.  I agree that initially, the quick-fix minus SEEMS like it is logical.  But it is not for the above reason.

The minus lens is always sold as being perfect, and perfectly safe.  It is also sold on the idea that no one would ever understand the need for the plus, before they go below self-measured -1 diopter.

But the Helmholtz theory, by which you prescribe a minus lens - it not accurate, and at a certain point, it is a failure.  This was Dr. Bates' thesis - and is he correct.  The alternative concept, it the dynamic eye concept, is where long-term near CREATES negative status - in all natural eyes.

It has been proven to be correct to say that, when you place a totally natural eye in a cage, the eye takes on a serious negative status.  (i.e., monkey are indeed myopic, when forced for long-time into a cage, with no ability to look into the distance.)

But to check this out, you can just put a strong minus, on the young primate eye, and indeed, objectively that natural eye ALWAYS moves negative in terms of refractive state.

This means that it is the natural eye in "long-term" near, that takes on mild negative states - always.

The concept, if you accept science and facts, (and reject the Helmholtz theory failure), it that you must keep your eyes looking, "in the distance", by always wearing a plus lens for near (that fully neutralized that near environment.)  Basic optical analysis will show that the plus (on an eye at -1/2 diopter, can have that effect - although it takes time for wearing a plus - to have that desired effect.

If you do have 20/40, and self-measured -1 diopter, my goal would be to NEVER start wearing a minus lens.  (This is again Dr. Bates idea.)  But this also must mean that I must wear a plus that FULLY neutralized my near environment, and that meas I wear a +2 to +2.75, for all near, and does depend on my habitual reading distance.  That means I must self-select the plus lens I am going to be wearing for all near.

I do not believe in "half measures", like you suggest.  I believe in going "all out" with the plus, or just not "bothering" with it at all.  For me there is no compromise.

There is no "fast way" to get out of it.  Our eyes go "down" at a rate of -1/2 diopter per year.  You really can not expect your eyes to go "up" at a rate of much more than +1/2 to +1 diopter per year.

It takes a truly interested, person to rise to that challenge -- with all due respect.

How about this idea: First of, the whole concept is plus lenses for close up work right? then how about wearing weaker minus lenses ALL THE TIME for distance viewing even if your myopia is weak? Lets say a -1 Myopic person would wear -0.5 lenses till his eyes adapt to the lenses? wouldnt it be faster to improve that way?

[OtisBrown]

Hi Gekonous,

The minus lens (for a natural eye with mild negative status) and been logical for the last 400 years.  But, for the long term, you vision simply gets worse, and worse, and worse.

At some point you have to ask, "... WHY ...".

The answer for an optometrist (that I fully understand), is that the minus lens is logical.  "Why"?  Because it works instantly, and on one "wants" prevention.

If you can not answer that question, in an logical manner, the even the slightest amount of prevention - is indeed impossible.  The optometrist has answered your question.

It is you alone who must decide if threshold prevention (by any method) is logical for yourself.

Some very insightful scientists, like Stirling Colgate, have "figure out" the truth - but they never get a prescription.

+++++

By now, you will insist that no one has the intelligence, and MOTIVATION to self-apply the plus lens, while they still have 20/40.  You obviously can not prescribe this degree of insight.

+++++

A PERSONAL NOTE BY DR. STIRLING COLGATE

Dr. Stirling Colgate, a research scientist with the Los Alamos National Laboratory, correctly deduced the behavior of the normal eye, and began using a plus 2.5 diopter lens to reverse the effect of a confined environment on his eyes. By doing this, he successfully recovered from a slight amount of myopia.

"Fortunately, I understood most of this for myself when I was studying biology and physics when I was 14. I first started to become nearsighted at 13 to 14. As soon as I noticed it, I immediately acted upon it by buying a pair of reading (farsightedness) glasses, (positive lenses), at the dime store. I used these for reading. A positive lens substitutes for further contraction of the ciliary muscle; thereby allowing the eye focus to remain in the relaxed state of infinity when reading a book up close. Within several weeks my eyesight had returned to normal -- relaxed state of focus at infinity.

"Since I am a physicist I am not dependent upon optometry or ophthalmology for my professional peer group. I have managed my own eyesight all during my life (now 63). I have undertaken to try to explain this because I believe that the condition of myopia (and then having to wear nearsighted glasses for life) is totally unnecessary for the majority of the human race. I believe that the condition of progressive myopia is a grotesque and needless distortion of human physiology, created by our intellectual environment of reading and continued because of our collective denial of that very intellect.

SOME ADDITIONAL COMMENTARY:

PREVENTION IS DIFFICULT

We should learn from the man who successfully defeated the myopia situation. Dr. Stirling Colgate details his struggle and success with the problem in the following paragraphs.

"Science has progressed to understanding this mechanism of slow adaptation of the relaxed focal length (focal state) of the eye to its average focal environment. A significant number (several dozen) professional people in ophthalmology and related disciplines have empirically and intuitively come to the same conclusions (that nearsightedness is preventable) and unsuccessfully attempted, even with the dedication of a lifetime, to reverse the orthodox view of solely genetically determined eye focus.

"Many individuals in the ophthalmology profession have not yet recognized a mechanism of slow adaptation of the relaxed focal length (focal state) of the eye to its mean focal environment for various reasons. Among these reasons are:

"There is a long-standing orthodox view that all focal states are hereditary and therefore nothing affects focus after conception.

"The public demands instantaneous sharp vision; i.e. Johnny can't read the black board and I won't stand for any nonsense about getting glasses that make it still fuzzier -- even temporarily.

"The scientific understanding of the (normal) eye's development is not yet widely published, so there is always an excuse to ignore it.

"There have been many non-scientific books about sight-without-glasses that have not logically argued the reasons, not given the physics background, nor have they discussed the biological mechanism. For example, eye exercises involve contracting the ciliary muscle, causing a nearer more myopic focus and, therefore, resulting in a negative change of focus for the eye.

"If reading glasses were used at the onset of myopia, up to 90 percent of nearsightedness could be avoided. Furthermore, reading glasses should cost no more than $5.00 to $7.00 to manufacture and sell for $10.00 to $15.00 without a prescription.

"Many optometrists and even some ophthalmologists believe that myopia and wearing glasses is not such a bad thing; after all, many people want to buy glasses in order to look chic. The very many that undergo the discomfort and expense of wearing contact lenses is an overwhelming vote to the contrary. People would rather not be nearsighted.

"Finally, social pressure of intellectual achievement is forcing the age of first reading to an earlier, even preschool age, hence causing earlier myopia, and a potential for further progression.

WHY DO SO FEW PEOPLE KNOW ABOUT THIS?

"It is perhaps worth speculating why there has not been any prior recognition by the medical and optometry professions of the approach to the management of eyesight focus. I believe there are many additional 'reasons' but I have heard these:

"Nearsightedness is not a very severe handicap, and mostly those affected are studious anyhow and don't need distance vision.

"It is not a problem for medicine and so medical doctors are not concerned.

"If you don't want to be nearsighted, give up reading.

"Negative lenses that correct nearsightedness are relatively cheap and easy to wear so why bother with another approach.

"Glasses are a status symbol of the intellectual

"Contact lenses make nearsightedness even less of a problem.

"Only recently has nearsightedness become a severe problem -- it is both more prevalent and, because of earlier onset, leads to progressive myopia.

"Traditionally, medicine treats or cures the symptom and, only recently, is preventative medicine respected.

"Only very recently is there a rational scientific explanation for the scientific observation of the developmental mechanism of the normal eye.

"Only the last statement is acceptable to me. So now that there is such a scientific basis, let's get on with the solution.

+++++

If I am sitting in an office, and you come in, I will hold up a minus lens, and impress you.  I will not engage you in the above conversation, because I doubt you will have Dr. Colgate's wisdom.

But you are not in my office (or any OD office) so you can consider these issues by your own logic.

Todd Becker developed the correct method of prevention for himself.  He was logical about it.

Enjoy,

[warnbd]

gekonus,

What you have described is part of the protocol that Todd Becker has proposed on his blog.  You need two sets of glasses.  One is for distance, with .25/.50 diopter under-correction(from your full prescription).  Use these for all general distance viewing (10+ft).  For doing the near work, a second set of glasses with diopters that will give you a Blur distance that you use in reading or computer work to do the focus pushing. This way you can do focus pulling, and focus pushing during waking hours.
As you progress, new sets of glasses are needed periodically until you reach your goal. 

warnbd

[gekonus]

Yeah Im asking if its healthy for even a -1D person to wear -0.5D glasses for ALL distance viewing, or is it better to look at the distance without that -0.5D lense

[OtisBrown]

By how much are you over-prescribed?  Do you ever check?  Why, when you pass the DMV with 20/40 vision would you wear a strong -2 diopter ALL THE TIME?  It is well known that doing that - makes matters  worse, not better.

Here is the discussion.

http://frauenfeldclinic.com/inges-overprescription-starting-2-00/

A person who does no checking, becomes, very quickly, a victim of a minus lens.  As they said, a strong minus is like morphine, it makes you feel so much better.

If your goal it to get "out of it", then passing the DMV, objectively, is a good start.  Being wise, and doing all of this yourself, under your persistent effort - can make you successful.

Yeah Im asking if its healthy for even a -1D person to wear -0.5D glasses for ALL distance viewing, or is it better to look at the distance without that -0.5D lense

[Todd Becker]

warnbd and jigsaw have the right idea.   Plus lenses for near vision and slight under correction for distance both have the same effect on the eye -- they induce incremental defocus.  So reducing your distance prescription by 0.25-0.50 is helpful.   Eventually, the goal is to wean yourself off the minus lenses entirely.  But if your myopia is strong (e.g. more than -3D), it's best to step it down gradually.  Otherwise, you are walking around in a blurry haze.

Just as it is important to take breaks from using plus lenses for close work, I would also suggest that you may not want to wear the reduced prescription all the time at first, particularly when you are tired or have particularly demanding activities, such as driving, that require sharp focus.  There is no problem alternating between full and reduced prescription.  Eventually, as your eyes adapt, the reduced prescription will become your normal prescription.

[caimanjosh]

My 2 cents....if your myopia is pretty low (less than -2), I'd say just go without any glasses at all for distance viewing, whenever possible.  (Driving or other activities where clear sight is essential for safety would be a definite exception.)  I took this approach back when I started on my myopia rehab journey, and I think it was a big factor in my eventual success.  I was probably -2 or even -2.5 in my dominant eye when I stopped wearing glasses.

This isn't to say that you couldn't take the gradual, incremental reduction approach -- but for low myopia, you have the option to save yourself hassle and money by just not wearing glasses. 

[Alex_Myopic]

We tend to say low myopia when it's less than 2 (absolute values), I think mainly for statistic reasons. But if we consider in terms of accommodation, -2 diopters is needed to see from infinite or 6m to 50cm!

[OtisBrown]

Hi Alex,

Subject: Who is making an ACCURATE measurement?

Item: Why does an OD in an office --  not "bother" to even check for your naked-eye visual acuity?

Item: If you watch videos of OD's exam, it is always, starts with a "Phoropter" (simple trial lens) in front of the face, and then he, "spin dials".  Thus, the OD NEVER KNOWS what line you can actually could read.  Further, he does not "care to know" either.

I personally understand that i MUST meet a reasonable visual acuity standard - under *my* control. That is why I have a Snellen "up" and monitor it.  I always check BEFORE I go to an OD for any exam.  I have gotten prescriptions (for distance) when I have proven 20/20 vision.  This is why I object to the "office routine" of never checking for your own visual acuity.

The next issue is that people who either PASS, or are CLOSE TO PASSING the official 20/40 line, wind up being prescribe a -2 to -2.5 diopter lens.  This happens every day.  I hope it did not happen to you, or other people posting here.

But the OD accounting of it, if you have a -2 diopter perscription, you can only see clearly at 20 inches. All beyond 20 inches it totally, "blurred out".

I do not agree with them, when I can personally verify 20/40 on my own Snellen.  (I do accept that I will get a -1 from Zennioptical for $9, to keep in my car - to drive.

But, I always obey the law - that I must passe the 20/40 line.

But I would consider this 20/40 (and -1 ) a TEMPORARY situation - based on my steady motivation - to do it myself.

That means, I would be wearing a +1.75 to +2.25 for near, and just WAIT to do much better than 20/40.  That is the REAL challenge of prevention, to take this "near plus wearing" very seriously.

That is the way I would "avoid the minus" after I get to 20/40. That is why I would avoid a -2 diopter lens, when a -1 gives me 20/20 - by my own checking an my own responsiblity to be objective.

Assuming you have CONFIRMED 20/40, that means that at 10 feet (T/V distance) you will see quite clearly.  So the implication that you can't see "anything" beyond 20 inches is false.  The only issue might be the blackboard at 20 feet, and "view-graphs" that are truly bad. 

But the basic idea of passing the 20/40, and rejecting the minus - most of the time - is very logical. I take personal reading of the 20/40, as a "marker" towards future success.

Thanks for your commentary - i totally agree with you.

We tend to say low myopia when it's less than 2 (absolute values), I think mainly for statistic reasons. But if we consider in terms of accommodation, -2 diopters is needed to see from infinite or 6m to 50cm!

[OtisBrown]

Hi Jigsaw,

You left one item off the list:

6)  Assuming you have confirmed 20/40, yourself, the the most completely "relaxed" accommodation system (i.e., looking at distant objects all the time will always be true), when.

a)  You look in the distance with no -2 diopter lens on your face.  Your accommodation system will be in maximum relaxation, as far as it can become relaxed. and

b) When, for close work (reading at 20 inches) you select a plus lens that "just blurs" the near work.  (Still readable, but you notice slight blur.)  Pulling it in to 18 inches clears off that slight blur.  A +2 will completely neutralize the -2 diopter power stress that is caused by reading at 20 inches.

If you do this, consistently, then your accommodation system is "looking in the distance", or most relaxed, 16 hours a day.

I vote for # 6, as being the most relaxed, or "most simulating living in the open - all the time."

For those responding, please include 1 to 6.

LOGICALLY, AND AS SCIENCE, THE WORST THING YOU COULD DO:

Just for comparison, you should ask, what is the WORST thing you could do.  I would suggest,  that wearing a -2 diopter lenses - ALL THE TIME, would be the worst think you could do - if you are truly interested in SLOWLY getting back to 20/20.  Your goal, I would think, would be to stop wearing any minus lens, once you confirm 20/40 or better.

Here is the reason why wearing a minus lens is so bad:

The reason is that the wearing of a -2 diopter, when reading at 20 inches does the following:  There is a "stress" power of -2 diopters when reading at 20 inches.  Now, when you wear a -2 diopters, you DOUBLE the stress on your accommodation system to, -4.0 diopters.  That is indeed what does produce stair-case myopia - for a person who does not know the basic optical physics of the accommodation system.

If you are truly trying to "get out of it", it makes no logical sense to wear a -2 diopter, when you personally confirm you can read the 20/40 line.

[Myoctim]

This brings up an issue that's never been resolved.  It basically comes down to:  When is the ciliary the most relaxed?  The possible answers for a myope (let's assume a -2.00 prescription) include:

1.  When staring into space without glasses
1a. When looking "dreamily" into space without glasses
2.  When staring into space with plus lenses
3.  When looking at an object in the distance with a full prescription, i.e, -2.00
4.  When looking at an object in the distance with a reduced prescription, say -1.75
5.  When looking through pinhole glasses

But what's about tonic accommodation?

If there is no target like for pilots flying through clouds there is tonic accommodation.
It is said tonic accomodation being something about -1D.
Does it mean it beeing a resting state and we need negative accommodation for infinity?

My experience when looking without glasses too long at beyond my far point there occurs some strain finally resulting in an increased blur.
If my ciliary would be most relaxed why there should be such a strain?

[caimanjosh]

Hi caimanjosh,

This brings up an issue that's never been resolved.  It basically comes down to:  When is the ciliary the most relaxed?  The possible answers for a myope (let's assume a -2.00 prescription) include:

1.  When staring into space without glasses
1a. When looking "dreamily" into space without glasses
2.  When staring into space with plus lenses
3.  When looking at an object in the distance with a full prescription, i.e, -2.00
4.  When looking at an object in the distance with a reduced prescription, say -1.75
5.  When looking through pinhole glasses

I haven't seen a consensus here though I do believe there was a discussion of what distance is long enough to relax the ciliary, and though the usual answer is either 20 feet or infinity, somehere here cited a reference for something much shorter, maybe 7 feet?

Dr. Alex, on the other hand, keeps saying it's important for ciliary relaxation to see "clearly", which implies either a full prescription, or a reduced prescription, the latter of which would give "clear viewing" when doing active focus.  Alex seems to steer folks away from going without glasses until they reach a certain point in their rehabilitation, which I'm guessing is somewhere in the 1.XX range, judging by a post by one of the members.

I don't have a precise answer on this (although I think we can safely rule out #3 and #5).  What I would note is that if you wear slightly reduced prescription glasses, your eyes won't be getting much stimulation if you're looking at anything closer than X number of feet (say, 10 or 15 feet, I don't know exactly).  Myopic defocus -- that is, some level of blurriness -- is a prerequisite for getting your eyes to improve.  Whereas if you go without glasses, you'll be getting moderate to strong myopic defocus at most distances.  Considering that most of our time these days is not spent gazing off at distant mountains -- park rangers excepted -- I think most people would benefit more from just going without glasses once their myopia is below -2 or so.  Again, safety first, but when you can safely do it, I really think getting defocus as frequently as possible is likely to lead to faster improvement. 

[caimanjosh]

Glad to hear it!  Tonic accommodation is undoubtedly necessary for strong-to-moderate myopia -- in cases where one just can't function properly without some level of correction -- but where it isn't needed, the KISS philosophy (Keep It Simple Stupid may be the way to go.  Good luck and keep us posted! 

[OtisBrown]

Hi Jigsaw,

Otis> I strongly support this approach.

Jigsaw>  The timing of your post is great.  Up to this point, I've been more concerned about making incremental reductions in my prescription, but I finally decided to throw caution to the wind.  I am now on day three of no glasses except for driving and it really makes a difference.  I am now firmly in 20/70 territory.  The reduced distance prescription I had been intending to use (-1.25) now seems too strong.

Otis> I would admit that it is hard to do this, and progress is indeed slow.  If you get to read the 20/40 line (1/2 letters correctly), that will be an outstanding success.  (I think we need to be objective about this goal - and have "markers" along the way.)  I figure this will take about two to three months.  It is truly hard to keep up the motivation.  More power to you !!

Whereas if you go without glasses, you'll be getting moderate to strong myopic defocus at most distances.  Considering that most of our time these days is not spent gazing off at distant mountains -- park rangers excepted -- I think most people would benefit more from just going without glasses once their myopia is below -2 or so.  Again, safety first, but when you can safely do it, I really think getting defocus as frequently as possible is likely to lead to faster improvement.

caimanjosh,

The timing of your post is great.  Up to this point, I've been more concerned about making incremental reductions in my prescription, but I finally decided to throw caution to the wind.  I am now on day three of no glasses except for driving and it really makes a difference.  I am now firmly in 20/70 territory.  The reduced distance prescription I had been intending to use (-1.25) now seems too strong.

Tonic accommodation be damned!

Actually, tonic accommodation is a reality, but it apparently doesn't matter in cases like this.  I don't know where the line is drawn between where tonic accommodation matters and where it doesn't.