Author Topic: post lasik myopic regression prevention  (Read 4314 times)

Offline RynEyes

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post lasik myopic regression prevention
« on: March 07, 2015, 08:45:23 AM »
Hi all,

I had LASIK after graduating from college about a year and a half ago and had excellent results for the first year (20/15 both eyes). My prescription before was around -1.75 and -1.5 I think.  I had worn contacts throughout college only during class and tried to take them out whenever I could.  I've never had glasses, only the contacts during that period.  I then began to notice my distance vision was starting to regress.  It is nearly non-existant in good light, but is noticeable at night while driving. I'm getting some minor double vision with distant street signs.

I just had an eye appointment, my doctor said I had regressed by .25 diopters and wrote a prescription for -0.5 lenses for me to wear at night. I have an engineering job where I'm basically staring at blueprints with tiny font all day long, which I have a feeling is the reason why I regressed.

I started doing some research and found the plus lens method.  The science and theory behind it made complete sense to me.  The lens pushes the image out farther away, the eyes are stressed to bring the image to focus, then the eyes adapt to be able to focus at greater distances without the stress. I've experienced the efficacy of this process of stress, recovery, adaptation through exercise and gaining strength. I figured that model would be true for other biological mechanisms such as eyesight.

So I got some plus lenses and tested it out. After reading at the edge of focus for a few minutes, I took the glasses off and sure enough, my vision was much sharper and briefly there was no double vision while focusing on distant signs at night. 

So my question is this, can plus lens therapy be used to prevent/reverse myopic regression after LASIK?  Am I still able to permanently regain the acuity I seem to have lost, even though the surface of my eyes have been altered with LASIK?

Thanks

Offline strongmama

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Re: post lasik myopic regression prevention
« Reply #1 on: May 05, 2015, 12:31:14 PM »
I am eager to follow your progress. My husband is in a similar situation. He had LASIK about 9 or 10 years ago and is now starting to decline. At his appt in March 2015 he tested at 20/30 and was given this prescription:

RT:  -.25   -.75    140 
LT:   -.25   -.50   079

I know, what a ripoff, trying to make a big sale off of that, basically trying to ensure a repeat customer. At least he's taking me seriously now and doing plus lenses and exercises. I will share my own story in a thread soon, but I wanted to let you know I'm here.

And a shout out to Mr. Otis (I also saw his reply to you on his website https://myopiafree.wordpress.com/lasik/ ), I'm a big fan!

Offline OtisBrown

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Re: post lasik myopic regression prevention
« Reply #2 on: May 05, 2015, 05:03:42 PM »
Hi -

I was well-aware, the even some very wise optometrists concluded that 1) Long-term close work with no plus lens, creates slow negative change and 2)  It would be very wise to start wearing a plus, as soon as you get SLIGHTLY into it.  Also, 3) This is totally personal.  No OD has any interest in this type of prevention - for many reasons.  Most people simply do not have the conviction, or the discipline for long-term plus-wear.  You can not "blame" the optometrist for that specific problem. 

I had cataract surgery (and it was good).  In fact, I told the ophthalmologist that I would be happy, with 20/30.  But after the operation, my eyes were "emmetropic", and testing with my own Snellen, I verified 20/25 vision.  I was VERY happy with that.  But I also knew that I HAD TO WEAR THE PLUS FOR ALL NEAR, and I HAD TO GET SOME $7 TEST LENSES, to also check my refractive status - myself.

I know I can not give "advice" to anyone.  But, if your husband wants to keep his distant vision, then I suggest he do what I do.

Wear a +2.5 for all close work.  This is just a self-discipline issue - with great knowledge that it is necessary.  I find it incredibly easy, to have a "plus" in my pocket, and when I set down, on my face, go the plus lenses.

For myself, I just "round off" the prescription - to get rid of the astigmatic part of it - with is pure cosmetic.   Rather than paying $150 for glasses, you can get them from Zennioptical.com for about $9.  Then wear the minus lens as little as possible.

The conversion is to take 1/2 the astig. value and add it to the first value. Thus the temporary lens you get from Zenni would be:

RT:  approximately -0.5

LT:  approximately -0.5

Both eyes are very close in terms of refraction.  The OD always prescribes for the strongest minus possible.  Just click here,
then click on $6.95 glasses.  Then select the frames.  Use a PD of 60, that words for most of us.  Then just click though several times
to get the "hang" of it.  If you need more help - I can supply it.  Doing it yourself - is very helpful for true prevention.

http://www.zennioptical.com/

People panic when they are given any prescription.  To reduce this panic, learn more. Then put up a "bright Snellen", and
wear the plus.  Then be prepared for long-term plus lens wear - as I am doing it.

I was "burned" one time - and I do not blame the OD.  But I refuse to be "burned" a second time.


I am eager to follow your progress. My husband is in a similar situation. He had LASIK about 9 or 10 years ago and is now starting to decline. At his appt in March 2015 he tested at 20/30 and was given this prescription:

RT:  -.25   -.75    140 
LT:   -.25   -.50   079

I know, what a ripoff, trying to make a big sale off of that, basically trying to ensure a repeat customer. At least he's taking me seriously now and doing plus lenses and exercises. I will share my own story in a thread soon, but I wanted to let you know I'm here.

And a shout out to Mr. Otis (I also saw his reply to you on his website https://myopiafree.wordpress.com/lasik/ ), I'm a big fan!
« Last Edit: May 06, 2015, 06:07:18 AM by OtisBrown »

Offline OtisBrown

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Re: post lasik myopic regression prevention
« Reply #3 on: May 06, 2015, 03:38:42 AM »
Hi -

Very few people "want" to wear a preventive plus, when they are at 20/30 to 20/40.  They assume that an optometrist will "know about this", and will attempt to help you.  The final reality is as described here - with my commentary.

http://endmyopia.org/optometrists-know-that-glasses-are-bad-but-they-dont-tell-you/#comment-289

I know that "plus prevention" is a issue that will create total silence in an optometrist. It also creates total silence in the "general public" if not outright hostility.

People EXPECT a discussion, about the preventive-alternative.  But you are dreaming if you think this is ever going to happen.

I do not fight with an optometrist.   I just choose to wear my plus, verify my own Snellen, and measure my refraction myself. 

That way I base prevention on science that is clear an understandable.  This way I have no "argument" with an OD in his office. 

My life is better because I take that scientific responsibility.

« Last Edit: May 06, 2015, 05:16:29 AM by OtisBrown »

Offline caimanjosh

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Re: post lasik myopic regression prevention
« Reply #4 on: May 06, 2015, 06:57:12 AM »

So my question is this, can plus lens therapy be used to prevent/reverse myopic regression after LASIK?  Am I still able to permanently regain the acuity I seem to have lost, even though the surface of my eyes have been altered with LASIK?


To keep it short and sweet -- the answer is yes, absolutely.  You've stumbled upon the true method for protecting your eyes in our constant-close-work modern society.  Get some strong-ish (maybe +3 or so) plus lenses on the cheap, and use them periodically when you're reading or using the PC.  You'll be golden. 

Offline strongmama

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Re: post lasik myopic regression prevention
« Reply #5 on: May 06, 2015, 12:15:47 PM »
Oh we threw away the prescription glasses! I told him about the dangers of the astigmatism correction.

Otis, we've already been following your advice:

He wears a +2.5 for reading and we log reading time Yeah, nagging wife making sure he gets his time in every day, and if his numbers aren't improving I point out how he hasn't been doing his reading! This is to give positive stimulation and reverse the pressure for axial elongation. The thing about the Lasik is I don't know what his measurements were previously, so I don't know how serious any detachment risks, etc. might be. And on the computer at work he now wears a +1.5 and sits back to reduce strain. We saw big improvement as soon as he started that. The plan is to gradually increase it of course.

I bought test lenses on Zenni following your advice from the video and got him to try looking through them, but that might have been a bad idea. Would you believe yesterday he could read all but 1 of the 20/20 letters on the online snellen?! On our wall chart, which does not have consistent lighting, he's consistently getting a blurry 20/30. I have been testing him in different conditions to be sure he's a safe driver, and the answer is yes. But since seeing the test lenses he's thinking about getting a pair of -.25 glasses, just for emergencies if he goes somewhere new and needs to read road signs better. I'm concerned he'll get addicted, but I'm not going to let that happen.

Sorry if I'm intruding on your thread, RynEyes. Hope you're making progress!

Offline OtisBrown

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Re: post lasik myopic regression prevention
« Reply #6 on: May 06, 2015, 12:41:14 PM »
Hi -

Most of what I have done came from a truly honest optometrist.  He had made himself "nearsighted" the way we all do it.  Long-term close work - with no preventive plus.  But he realized that the natural eye was indeed, "dynamic" and insisted (indeed forced) his own three children to wear the plus, always, for all work.  All that I have done, is set his concept into a "mathematical format". 

I know you can not "follow" a kid around and "nag" him into wearing a plus all the time.  This is why no "blame" attaches to an optometrist - for any of this problem.  I spelled out this problem to my nephew - as to what was certain to happen - if he rejected wearing the plus though the school years.

It is hard to get this "preventive concept" correctly.  We are all "lazy", and anything that is "long term" is indeed resisted.

Yes, I do want a person to get his own minus lens - and look though it himself.  The advantage - is that he has CONTROL of his use of the minus lens.

The risk is that the "sharpness" you get from the minus - is addictive - for all of us.  But that is the issue.  It does take some deep "common sense".

After Lasik, you have 20/20 (positive refractive status). Then nose on the book or computer, and SECOND negative status.  That is the "stage" I am in.

But intelligence is acting BEFORE the situation gets, "out of hand".

I do not nag others - to wear the plus.  I nag myself to do it.

Once you find out that you can do it - is it not that difficult.  But it is always an "educated-motivation" issue.

It is only your husband who can decide - for the long-term.


Oh we threw away the prescription glasses! I told him about the dangers of the astigmatism correction.

Otis, we've already been following your advice:

He wears a +2.5 for reading and we log reading time Yeah, nagging wife making sure he gets his time in every day, and if his numbers aren't improving I point out how he hasn't been doing his reading! This is to give positive stimulation and reverse the pressure for axial elongation. The thing about the Lasik is I don't know what his measurements were previously, so I don't know how serious any detachment risks, etc. might be. And on the computer at work he now wears a +1.5 and sits back to reduce strain. We saw big improvement as soon as he started that. The plan is to gradually increase it of course.

I bought test lenses on Zenni following your advice from the video and got him to try looking through them, but that might have been a bad idea. Would you believe yesterday he could read all but 1 of the 20/20 letters on the online snellen?! On our wall chart, which does not have consistent lighting, he's consistently getting a blurry 20/30. I have been testing him in different conditions to be sure he's a safe driver, and the answer is yes. But since seeing the test lenses he's thinking about getting a pair of -.25 glasses, just for emergencies if he goes somewhere new and needs to read road signs better. I'm concerned he'll get addicted, but I'm not going to let that happen.

Sorry if I'm intruding on your thread, RynEyes. Hope you're making progress!
« Last Edit: May 06, 2015, 05:27:03 PM by OtisBrown »

Offline RynEyes

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Re: post lasik myopic regression prevention
« Reply #7 on: May 06, 2015, 03:02:44 PM »
Just a little update on my progress so far. 

After using the plus for a few weeks and using push/pull techniques, I began to gain a new sensation with my vision; I believe that sensation to be divergence, or relaxing the eyes to gaze further in the distance.  Previously, I could not do that voluntarily. I think all the excessive near work took its toll on me by causing my vision to “stick” at that distance and not relax enough to be able to focus on things beyond that.  Pseudomyopia, or constant ciliary spasms is what I’d self diagnosed myself with. Whether or not that is technically correct, I do not know, but I seem to have resolved the issue, so ultimately it doesn’t matter :).   

While at work, I try to use a light plus (+1.50) for periods of excessive near work. I use these because I’m working with large drawings, so I need a larger focal range than if I were just looking at a computer screen and maintaining that distance.  If I were at a computer for long periods, then I would use a more challenging lens.  While at home, I use a +2.5 for computer use and reading.

After a couple months of this, I can more easily focus on distant objects with no blur.  There is still a bit of double vision remaining, but only at long distances.  The object I’m focusing on is sharp, but I can clearly see a faint ghosting of it directly above.  This is most apparent with text with high contrast background.  I think it might be some uncovered astigmatism, but I’m currently working to correct that.  I’ll post another update in the future o this.

Offline OtisBrown

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Re: post lasik myopic regression prevention
« Reply #8 on: May 06, 2015, 05:36:44 PM »
Hi RynEyes,

I obviously  can not tell any person what he should or should not do.  What you describe is excellent, to use different powers of "plus" for given circumstances.  I read the computer at about 22 inches - so I wear about a +2.0 D for that distance.  I like to read at about 16 inches, so I use about a +3.0 for that distance.  (This is the final stage - of successful prevention.)

I do recommend that you do has a Snellen chart up (with bright light) not for a rigorous test, but repeated "glancing", to know about where you stand on that Snellen.  This is to protect you.  Just knowing the general range is of value.  In fact it is impossible to make "just one" measurement and reach any conclusion at all.  In fact this long-term checking is exactly the problem with an "office visit" - because of this normal variability in our Snellen vision.  This is why,  in the long run, your attention to this "extra step" is important to you -- personally.

The other issue, is that you do not want to "go down" a second time.  It take real self-faith, to continue this process, in yourself.  After some time, it becomes automatic, and you get comfortable with wearing the plus for near, and always passing the required DMV test.

Success ultimately depends on  your feeling and judgment that this is the right concept - to use for your personal benefit.


Just a little update on my progress so far. 

After using the plus for a few weeks and using push/pull techniques, I began to gain a new sensation with my vision; I believe that sensation to be divergence, or relaxing the eyes to gaze further in the distance.  Previously, I could not do that voluntarily. I think all the excessive near work took its toll on me by causing my vision to “stick” at that distance and not relax enough to be able to focus on things beyond that.  Pseudomyopia, or constant ciliary spasms is what I’d self diagnosed myself with. Whether or not that is technically correct, I do not know, but I seem to have resolved the issue, so ultimately it doesn’t matter :).   

While at work, I try to use a light plus (+1.50) for periods of excessive near work. I use these because I’m working with large drawings, so I need a larger focal range than if I were just looking at a computer screen and maintaining that distance.  If I were at a computer for long periods, then I would use a more challenging lens.  While at home, I use a +2.5 for computer use and reading.

After a couple months of this, I can more easily focus on distant objects with no blur.  There is still a bit of double vision remaining, but only at long distances.  The object I’m focusing on is sharp, but I can clearly see a faint ghosting of it directly above.  This is most apparent with text with high contrast background.  I think it might be some uncovered astigmatism, but I’m currently working to correct that.  I’ll post another update in the future o this.
« Last Edit: May 07, 2015, 08:47:42 AM by OtisBrown »