Author Topic: the last diopter  (Read 4188 times)

Offline CapitalPrince

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the last diopter
« on: January 14, 2015, 09:31:09 PM »
heres some commentary regarding the last diopter i asked the frauenfeld clinic

capitalPrince> I read in your articles and lots of other places online that say the last diopter is the hardest. Why is that?

Neha Gupta>
The 0.25 diopter increments of prescriptions are huge, relatively speaking, at the last diopter. 
Also, you technically need quite a bit of stimulus to really get excellent vision from a low myopia degree.  Plus use for close-up, active focus with the eye chart.  Lastly, the perceived difference of say 10% which would be huge for a -4 diopter, is almost not noticeable at the last diopter.

So it seems the last diopter is quite challenging. it just requires much more active focus, since hyperopic growth is necessary and the improvements need to be actually "refractive state changes" and not simply "reducing prescriptions". David de angelis and antonia orfeld both struggled with the last diopter.

 So don't give up hope as it may take a year or more to get an "ACTUAL 0..25D change".
« Last Edit: January 14, 2015, 09:34:11 PM by CapitalPrince »

Offline OtisBrown

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Re: the last diopter
« Reply #1 on: January 18, 2015, 11:05:03 AM »
Science and Physics:  I will never contradict statistical facts - once they are understood by you.

https://myopiafree.files.wordpress.com/2014/12/vis_6_17_p_pdf.pdf

Prevention work must be limited by these objective facts.  Recovery is possible from about 20/40, and -1 diopter.

This is why I "limit" any claim I might talk about.  I expect the person to have enough mathematical knowledge
to understand the above statistics.

Enjoy the challenge of science and math.
« Last Edit: January 18, 2015, 12:19:18 PM by OtisBrown »

Offline gekonus

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Re: the last diopter
« Reply #2 on: January 19, 2015, 07:11:00 AM »
heres some commentary regarding the last diopter i asked the frauenfeld clinic

capitalPrince> I read in your articles and lots of other places online that say the last diopter is the hardest. Why is that?

Neha Gupta>
The 0.25 diopter increments of prescriptions are huge, relatively speaking, at the last diopter. 
Also, you technically need quite a bit of stimulus to really get excellent vision from a low myopia degree.  Plus use for close-up, active focus with the eye chart.  Lastly, the perceived difference of say 10% which would be huge for a -4 diopter, is almost not noticeable at the last diopter.


More than a year for a 0.25 change? sounds discouraging, but I bet its way faster than this. My vision seems to be the same with my 'full prescription' however I see slightly better naked eye than what I used to before the plus lenses. Not saying I improved by 0.25D, but just by a tiny bit feeling

So it seems the last diopter is quite challenging. it just requires much more active focus, since hyperopic growth is necessary and the improvements need to be actually "refractive state changes" and not simply "reducing prescriptions". David de angelis and antonia orfeld both struggled with the last diopter.

 So don't give up hope as it may take a year or more to get an "ACTUAL 0..25D change".

Offline CapitalPrince

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Re: the last diopter
« Reply #3 on: January 20, 2015, 11:59:19 AM »
A child with 20/30 in the classroom could either

1) wear Plano/+1.5d bifocal or progressive

2) wear a plus low on the nose and look over the top while taking notes
Y
For the classroom the bifocal/progressives works better. I tried with only a plus today and looked over the top. In a small class of 30 people it was weird wearing glasses that way.  For other purposes besides the classrooms the plus only and looking over the top works well

Offline CapitalPrince

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Re: the last diopter
« Reply #4 on: January 20, 2015, 02:38:53 PM »
I went to another OD today was yet suprised again. I asked her (the OD) about prevention by using plus lenses or bifocal. She said she does it often with progressives/bifocals. But the plus add is mosrly very weak, usually around +0.5D +0.75, it varies by the patient's myopia obviously. she was very happy to sell a plano/+1.5D bifocal for the classroom, for $75 exam+$300 bifocal glasses = $375.

This OD was definitely not "boneheaded"surprisingly. She (even though she looked young)  told be she wears bifocal contacts to take off the nearpoint stress. She agreed that nearpoint stress causes myopia. Since this is near a college town, she said she saw many students vision going to hell.

She probably will not volunteer this information to an ignorant person who is at 20/40. it's also very difficult to make a child wear a strong plus and push the reading material/. So a bifocal with a "moderate minus" and "weak plus", is a settlement. Again prevention = no money for OD. bifocal = lots of money

But this bifocal business (even though it costs alots) is still a hell alot better than a STRONG minus and being told prevention is impossible.

« Last Edit: January 20, 2015, 02:41:05 PM by CapitalPrince »

Offline CapitalPrince

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Re: the last diopter
« Reply #5 on: January 20, 2015, 11:02:41 PM »
It's been mentioned several times people don't use strong enough of a plus. A +0.5 will have almostt no effect. Sometimes a +1.5 isn't even enough for closer work.

Sometimes I wear. 2 +1.5d together to create 3d

A person who is at 20/30-20/40 should have multiple plus lenses. Usually one at the computer about arms length perhaps 80cm  and one at 40cm

Offline gekonus

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Re: the last diopter
« Reply #6 on: January 21, 2015, 07:26:19 AM »
So a stronger plus has a faster improving rate? I cant really get higher than +1.5D otherwise I'll have to sit very close to the screen which is uncomfortable..


Offline CapitalPrince

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Re: the last diopter
« Reply #7 on: January 21, 2015, 07:49:36 AM »
Hi gek

I explained this concept several times. It's not the plus that makes your vision better, it's the active focus.  The plus changes the focal plane. The plus moves the blur horizon closer. If +1.5 is too much for your myopia. Try a lower plus like +1d and read further like 50cm

Offline gekonus

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Re: the last diopter
« Reply #8 on: January 21, 2015, 07:51:02 AM »
but you just said that a +0.5 will have almost no effect, and maybe not even a +1.5

Offline CapitalPrince

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Re: the last diopter
« Reply #9 on: January 21, 2015, 08:00:44 AM »
People who are closer to 20/20 20/30 can read through a stronger plus. A +0.5 will not be effect for someone who has 20/30 vision. If you are more myopic you need a weaker plus.

Offline gekonus

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Re: the last diopter
« Reply #10 on: January 21, 2015, 08:03:07 AM »
Also, its quite tricky to understand what your REAL acuity is, because it depends on the lighting, etc.

For example, when I check myself with the I V A C - Interactive visual acuity check website, I cant see anything on the 20/40 line from 5 Meters. (Indoor medium lighting).

However , outside on a sunny day Im definately 20/40 or a bit better

Offline OtisBrown

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Re: the last diopter
« Reply #11 on: January 22, 2015, 08:26:07 PM »
Hi Capital,

It truly does take a strong "resolve" to consistently wear a plus in a class room.  But so many people are wearing glasses, that I would think that few people would notice - except your friends.  You do not have to explain completely, but just send them to my site, and explain that -1/2 diopters per year, that college students experience, if the decline to wear a plus during the college years.

I think it would be "neat" to do this work, checking my own Snellen, being in control of my own life, doing an "experiment", in my life - that has life-time consequences.

No one in a shop, with an impressive minus lens, can ever prescribe this.  It is just impossible for them.

I like the idea, of personally, an objectively verifying my Snellen at the 20/20 range - and will ignore any "prescription" that an OD might prescribe.  Last time I went, about three months ago, I looked at the Snellen and read the 20/20 line for them.

AFTER I did that, they put a "Phoropter" (trial lens set), and started the, "is one better, is two better", (looking for presumed astigmatism). 

I simply said, I noticed, NO DIFFERENCE, because I had proven 20/20 vision.  They were a bit "miffed" about my response, I am sure.   I certainly had
no wish to explain that I thought there "prescription process" was worse than a waste of time.  (It was in fact, NOT AN OPTOMETRIST, operating the
Phoropter.  (Beneath the dignity of the OD - I suppose.)

After that, I sat with the optometrist, who looked at everything, and wrote a prescription for reading glasses.

Because it  no longer takes a "qualified optometrist" to hold up plus and minus lenses (spin dials), I simply gave up on these "techs", and have
my own "home" trial lenses, and Snellen, for visual acuity.

I do not like to "fight" with an OD about this issue.  But, I want to protect MY distant vision, and I know that they can't do that for me.

I truly wish there was a way - that I could work with an OD on this issue, when I am at 20/40.  But I  am afraid it is the
issue that a man can not have, "two masters".  You can not "share" the responsibility for prevention, at 20/40.

Either you choose to make a total personal commitment, to reading your own Snellen, and measure your own refractive state
yourself - or you get the worse possible treatment. 

There is no negotiation - since the OD, in his office, had decided that you are not competent to do prevention yourself.



A child with 20/30 in the classroom could either

1) wear Plano/+1.5d bifocal or progressive

2) wear a plus low on the nose and look over the top while taking notes
Y
For the classroom the bifocal/progressives works better. I tried with only a plus today and looked over the top. In a small class of 30 people it was weird wearing glasses that way.  For other purposes besides the classrooms the plus only and looking over the top works well
« Last Edit: January 24, 2015, 10:43:42 AM by OtisBrown »

Offline Alex_Myopic

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Re: the last diopter
« Reply #12 on: January 28, 2015, 11:30:24 AM »
Ι have managed for the first time to see today a tv show with small subtitles without any light at all and with more stable vision! This gives me hope that I am going closer to 20/20 from 20/25, even after a 5 months plateau. Progression is slow but just in one day sometimes I feel that my vision got better than almost ever (after I became myopic!). If I succeed I'll post some details that I suspect they might have helped me. One is that I think my right eye is more than -0.25 myopic than the other dominant so I patch my left while print pushing sometimes.

After 20/40 I felt more that myopia rehabilitation is logarithmic in relation to time and not analog!
« Last Edit: January 28, 2015, 11:32:03 AM by Alex_Myopic »

Offline caimanjosh

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Re: the last diopter
« Reply #13 on: January 30, 2015, 08:28:37 AM »
It's been mentioned several times people don't use strong enough of a plus. A +0.5 will have almostt no effect. Sometimes a +1.5 isn't even enough for closer work.

Sometimes I wear. 2 +1.5d together to create 3d

A person who is at 20/30-20/40 should have multiple plus lenses.

I very strongly agree with this.  I've noticed some people on the forum saying that they've plateaued in the myopia improvement efforts, and often these people say they've been using a +2 lens or whatever.  In my experience, if you continue to use the same lens for longer than 3-4 months, you're very likely to plateau.  I always experienced my best breakthroughs in vision when, after using a particular lens (say, +4) for a few months, I then moved up to a stronger plus lens (in this example, +4.5).  I believe that's the key to progress -- strong plus lenses over a period of time.  At this point, I own plus lenses in 1/2 diopter increments all the way from +1 to +6.  I've used all of them at one point or another.  Currently I read with +6 lenses, and my vision's never been better.

Offline CapitalPrince

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Re: the last diopter
« Reply #14 on: January 30, 2015, 08:43:19 AM »
Congrats caiman on your success

Are you mosltly reading with a.slight blur or strong blur?