The Bershak method

[Hillyman]

I came across this about 3 years ago

http://web.archive.org/web/20080216074610/http://www.i-see.org/bershak.html

When I first read it, I thought it was another interesting theory about 3 years ago. Since then, I have come across the Frauenfeldclinic.org site (now renamed to endmyopia.org) and have had some success in reducing my prescription from -5.5 to -4.5. And I seemed to be stuck there for the past 6 months or so.

A month or two ago, I started practicing a variation of the Bershak's Three Cups exercise again. I have come across an interesting offshoot of that exercise. There was something that kicked in when I did the exercise, and I found that if I tried an extreme coverging while covering one eye, I had a discernible improvement in clarity, something that I would guess would be in the range of 0.25 diopters. (If I did this with my right eye, my left eye if uncovered would be pointed at the bridge of my nose!) The effect works on either eye. This felt like I was applying a muscular strain in order to see farther out--counterintuitive to the idea that one should relax to see farther!

I just re-read Bershak's article again--and I finally got it that this was the effect of the extraocular muscles that he was talking about, as as way to break down the stiffness of the eyeball.  A bonus: I have observed a slightly improvement in my acuity. I am going to continue with experimenting with this.

I haven't been able to find much in the internets on this approach and none here. (I had mentioned it once in the context of presbyopia). Thoughts on the Bershak approach?

[Tom]

Hillyman. Glad that you have a renewed interest in this. You asked that question about 1.5 years ago, and it literally took me around 5 months to come up with a potential answer. Yes, there are definitely medial recti muscles at work here. But the literature is very mixed about the effect of convergence/divergence to myopia, and generally do not take into account the individual nuances and holistic effects:

• Downward convergence was found to increase axial length slightly around 2014.
• The studies on prismatic bifocal, Richard McCollim's weird experiments, Alex_Myopic and my own experience corroborates the benefit of divergence in the context of myopia prevention/reduction, while some other studies fail to replicate this finding.
• A Russian opthalmologist, Arkadiy Davydov, proposes a method to improve eyesight based on what he refers to as dynamic vision. This seems to be consistent with your remark about your variant of the 3-cup exercise.
  

In any case, I did and still do believe in behavioural methods which unstiff ocular muscles/globe as a side benefit, as I believe that not only are they interesting in the context of blur clearing, but are good for our eye health in general. My reply to your question 1.5 years ago essentially laid out a framework upon which methods on reversing/delaying presbyopia can be built upon, but unfortunately, I'm not old enough to be able to experiment on myself.

[gekonus]

Well I tried looking at a very close object with one eye covered, its very difficult and after I looked away everything was super blurry for like 3 secs.. how does this trick improved your vision mate?

I thought that maybe a divergence exercise (3 cups for example) should maybe do the trick, but it doesnt do anything aswell.

[Hillyman]

Tom:

Thanks for your reply. I remember posting something about the convergence effect I was getting and I thought it was 3 years ago that I came across the Bershak method. Your reply shows it was only 1.5 years ago. I must be having double vision from all this over-convergence and seeing 3 instead of 1.5.

I missed your reply as it came quite a bit later and I visit the forum irregularly.To your point that there must be some effect of the extraocular muscles (EOM) pressing the eyeball against the orbit, there may be something to that, but Bershak's point and this writeup from Merrill Bowan, a behavioral optometrist who specializes in learning disabilities http://web.archive.org/web/20081119091825/http://www.simplybrainy.com/simplybrainy_034.htm suggest that how the eye focuses may involve EOM and not just the ciliary muscles acting on the lens. I find intriguing Bowan's line of thinking of "accommovergence" where the mechanism for convergence and accommodation work as one system, instead of two systems working in parallel, and this falls into Bershak's approach of using convergence/divergence exercises to get improved accommodation. Additionally, Bowan posits that accommodation is a multifactorial process involving these elements in the eye:

1. The cornea
2. The iris (through the depth of field effect)
3. The anterior chamber
4. The lens
5. The vitreous body
6. The choroid thickens (it's apparently made of "erectile tissue"(!))

So it may not be too outrageous to think that EOMs are also involved in focusing.

It seems the good Dr Bates also had the same thinking that the EOM were involved in accommodation. I don't know whether this puts him more or less into favor with the current eyesight improvement school of thought!

If the EOM are involved in accommodation and eyestrain, my thought then was that the Feldenkrais approach for relieving motor dysfunction may help. Moshe Feldenkrais has built a solid therapeutical approach for relieving muscle tension and also of developing new neuromuscular ways of functioning (his approach is useful for helping stroke patients remap their brains to recover the motor function lost in the stroke, I believe).  The key to making the body learn new ways of moving  is to go through the desired motion s-l-o-w-l-y for 10-15 repetitions.  If EOMs are involved in how the eye function, the prime suspect of astigmatism (the uneven curvature of the cornea) would be uneven tension in the EOM, which distends the surface of the cornea from its original perfect curve by pulling from the back of the eyeball unevenly, or even squeezing the eye through the action of the oblique muscles . So performing slow X patterns with both eyes (slow, meaning about 8-10 seconds to trace each "arm" of the X, say, from the northeast to the south west) may be beneficial. In fact, I am doing this. With the recent if slight improvement in acuity from the three cups exercise and this X-exercise, I seem to be having a better time with my vision this past week (I wear an undercorrected myopia prescription, and with no correction for my astigmatism, which is about 0.50). Of course, I could just be imagining things.

One thing I did not imagine: I am right-handed but had the interesting experience of being left-handed for a day or two after one of the Feldenkrais Awareness through Movement sessions. Sometimes, we can only marvel at how the body works.

[Hillyman]

Gekonus:

When I first looked at the Three Cups exercise (there is a nice template to use in the document in the link in my first posting), I did not think much of it--convergence exercises are fairly easy for me, and I was able to get the "third" cup quite easily even by converging on a point between my eyes and the diagram.  I was also able to get the "divergent" effect, that is, the third cup comes into view when the focus point of the eyes is farther than the diagram. It wasn't until I was doing the exercise at a farther distance than at just reading distance that I felt an interesting tension in the eyes.

It was an odd sensation in that it felt like there was a voluntary muscle action on the eyeball. That's when I first started covering one eye and tried to increase this sensation. When I looked at a page just at my blur distance with my one open eye and voluntarily increased this tension, the page became clear! This was also when I discovered that the tension was linked to convergence: although I was looking straight ahead at the page with my open eye, the other eye, when uncovered, was pointing practically straight at the bridge of my nose. I got the same effect with either eye.

That's all I can describe. Don't converge with both eyes open (it hurts! plus you've got massive double vision). "Converge" with one uncovered eye looking straight ahead and the other covered eye doing the crazy pointing inwards. While doing that, look normally at what's in front of you with the open eye. Look at something just beyond your blur distance--this is not an exercise for looking at something at your extreme near point.  I've also tried in this situation to look up and down and left to right (with the other eye still covered--heaven knows what kinds of movements that is making behind my covering hand!) to get a sense of the muscle tension at these different positions of the open eye. I hold it for just a few seconds--no need to force anything to the point of discomfort.

[strongmama]

Fascinating! I did some experimenting and will share my experiences, but first, about the Bowen article: How are the AC/A and CA/C ratios calculated? I've seen the first one mentioned before, but I'm not sure what the second one is. The talk of microprisms reminds me of the myopter, which I've read about but never tried. I would love to hear more about this if anyone has any info. I plan to bring it up with my behavioral optometrist.

So I tried the Bershak exercises. I'm myopic but never worn glasses and have excellent convergence/divergence skills. I could do the basic 3 cups quite easily, so I tried moving back, slowly rolling my desk chair back while keeping the cup in focus. I'd never done that before. The cup is right side up in convergence, and it was so cool -- it seemed to float out into the room as I backed up! I finally lost it at around 5 or 6 feet from the screen. But this was too far away for me to start again, much too blurry although I'd kept it clear as I slowly rolled back. I had to lean back about halfway to find focus, then I could go back much more quickly the second time. I repeated in divergence where the cup has the bottom up and it was not as dramatic, not coming out into the room, and I was able to go only slightly farther in overall backing up.

I tried the one eye covered method you described, and it did nothing for me. I could feel my muscles move, but it did not change any focus. Having never worn glasses, my myopia is perhaps different from yours. Mine can vary greatly and is more of a muscle spasm than axial elongation. I was having some wacky focus contractions while trying to get the converged cup back once farther away (very blurry seemed to have a yellow dot in the middle of a flower), but I did not get that in and out of focus pattern when I tried with one eye covered.

My husband who had Lasik 10 years ago has a convergence/divergence issue where he focuses before the bead on the Brock string. It occurred to me he must see with his eyes in the position that I needed mine in to see the cup floating out. To focus on text or objects with his eyes not working together, his brain suppresses the image of one. It is alternating strabismus. We've been doing 3D exercises plus the Brock string to turn both eyes back on, but he can't do something like the 3 cups yet. I wonder if any of this relates to your experience? I am not sure how, but that is what I'm thinking about now.

[Hillyman]

Strongmama:

Yes, my "exercise" of increasing some tension in an open eye while keeping the other one covered is hard to describe, and its effect for me--actually getting a discernible albeit temporary improvement in acuity--is harder to explain still. There was a comment on my thread that this might be due to "ciliary action" but as I understand it, the standard explanation of ciliary action is to bring the accommodation to a nearer focus, and not to see farther, which is the effect I am getting.

I am trying to extend this to a being able to feel the tension while both eyes are looking forward, and not while one is looking straight forward and the other extremely cross-eyed.  In doing this, I find that I need to have a slightly different way of seeing, which I call for lack of a better description as "intentional seeing". This is different from my normal seeing (I've been wearing glassing for more than 50 years) which is to be passive and let the acuity come in through the glasses. In intentional seeing, I have an attitude of "reaching out" to the distance while being aware of the tension that I speak of in the "exercise" in my original posting. (My current pair is slightly underprescribed by about 0.50 or less.) This is also different from "active focus" that might have been mentioned in other forums and in the previous Frauenfeld Clinic forums, which I understand to be the idea of "relaxing" the focus; my "intentional seeing" is an active participation in the process of seeing to gain acuity farther out through some muscular action, instead of "relaxing" into the distance.

Is it working? Well, it's slow work, but my night vision seems to be brighter. This has also led me to wondering if there isn't some subtle difference in seeing between those with 20/20 vision and those who are myopic, other than in the acuity, of course. I ponder whether our visual system is not a self-optimizing system, and we get myopic when some part of the self-correcting system goes out of whack, and we spiral into blurriness. That part may be something about the way the brain approaches seeing, and that is what I am exploring to regain.

[strongmama]

Thanks for the update! I am eager to follow your progress. Yes, Bates talks about relaxation and blinking, but I've recently been reading Kaisu Viikari and for her fogging method she talks about not blinking. There are definitely a lot of mechanisms at work. Plus/minus is much too simplistic a view! At least behavioral optometrists are aware of other things like saccades and tracking.

If you want an update on my husband, he's been going for weekly vision therapy for 4 months now and they're starting to break down the suppression. He is able to see some double now when she tests with the prism bar. She says his system is stuck up close, over converging, and she has him doing exercises for peripheral awareness to get him to loosen up... so added stuff I've come up with: Since he can see double now, he can hold up a finger and see 4 circles on the 3 Cups printout! He was looking at it like that for the first time last night. I explained to him how the two circles closest to each other can overlap and become 3D. I think he'll try to see that. The last homework I invented for him was super helpful: His assigned homework is to look at the Brock string, but that's frustrating for him because it crosses in front of the bead and try as he might he can't make it look like it's supposed to unless it's really close (crossed eyes). So I told him to try the technique I used when I learned to see Magic Eye pictures which is to look across the room then become aware of what he's trying to see. So he should focus his eyes across the room so they diverge more and try to find where he should look so the string crosses the right place, becoming aware of it with his peripheral vision. This gets his eyes at the right angle and not over-converged. It is blurry because it's not what he's focusing on, but I theorize that like the Magic Eye pics his brain will eventually realize it can bring it into focus with his eyes at that angle. This very much relates to what you're doing!