Author Topic: 1 Year @ The Edge of Blur: This Method Failed  (Read 10036 times)

Offline Myoctim

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #15 on: September 09, 2015, 03:10:38 PM »
Guys, again, let's try to separate hope from fact.

 Do I believe in a dynamic neurological mechanism controlling ocular shape? Yes and yes. However, the blurry vision that comes with slight undercorrection or no correction does NOT lead to the solution. There have been numerous efforts by scientists to replicate animal studies for the treatment of myopia in children.

We know emmetropization being a closed feedback loop.
So if myopic blur really would cause some more myopia it would be the same as your heating control system would turn on the heater when putting the setting (setpoint) to a lower temperature.

Unfortunately optometrists don't care anything about the eye's refractive setpoint. They only compensate for blur by shifting the actually (refractive) value back to normal which doesn't correct anything anatomical.

 
Quote from: jimboston
I discarded glasses for many years -- it didn't prevent me from becoming myopic in the first place nor did it cure me after many years of minus wear. Unfortunately, reading at the edge of blur for a year didn't lead to any improvement as well.

but amazingly print pushing worked for me  :-)

Quote
On myopia improvement

Like Hillyman and many others, there are a few reasons some people see a small but significant improvement in their myopia. I will restate:

- neural (a.k.a blur) adaptation (myopes can tolerate extraordinary amounts of blur; the brain adapts by boosting contrast and prioritizing certain parts of the image)
- wishful thinking + poor measurement practices (unfortunately, most claims of improvement are the result of this formula)

but when looking outside at the neighbour building and all the edges are getting clearer and clearer it's neither a matter of blur adaption nor of "wishful thinking".

Quote
- presbyopia (a small improvement in distance vision after the onset of presbyopia in older myopes like Hillyman & quite probably Becker)

In deed that could be a valid point. If we look at

http://www.ncbi.nlm.nih.gov/pubmed/25683786

the refractive index of the lens often decreases when aging (protein aggregation?) causing a relative hyperopic shift.

But it raises the big question why I didn't improve when trying Bates some years before and why I did improve exactly after starting with print pushing.
-Why all the time before my refractive state seemed to be nailed down not changing at all.
-And why other persons at the same age even got more myopic when always wearing their full prescription at the office.
 

Quote
Well, choroid thickening -> less myopic defocus. Axial elongation -> more myopic defocus. I am not sure what you meant by this comment, but if you are referring to the Human optical axial length and defocus study by IOVS, it did show a small but significant reduction in AL and an increase in choroid thickening (both a positive for myopes) after 1 hour of +3D lens wear.

my mistake, of course I meant "a decreased axial elongation".

Quote
However, a later study which imposed myopic defocus on humans for a whole day:

http://www.ncbi.nlm.nih.gov/pubmed/22971342

showed the eye-shortening, choroid-thickening effect was practically erased after sleep. Experiments on humans with defocus for more than 1 day have not been officially published so this is the last remaining light using that strategy.

interesting, didn't know about that 2nd study.

But that overnight cancelling out effect (of some distance blur after prolonged near work) also is reported by some myopes before it had come that night where the blur stayed and they became real myopes.

Quote
A simple thought experiment. Before and at the onset of myopia, myopic children are already having an elongated eyeball and thus myopic defocus across their retinas. Since the peripheral hyperopic defocus is therefore eliminated, why doesn't myopia progression stop there?

IMHO the answer is if the ratio between hyperopic blur (during near tasks) and myopic blur at the distance is shifted too much to the hyperopic side the control technically result by emmetropization is an increased AL.

So let's expand that thought experiment by freeing half of those kids from their near environment by putting them on an island with no school and electronic gadgets.
The result would be no more prolonged hyperopic blur by underaccommodation and strain and consequently a slowly reduction in AL
Quote
I am not sure what this means for adult myopes, but unless the exact AL/choroid regulation mechanism is unraveled or a surprise study shows myopia reversal in a large population study, our options are limited. Thankfully, the picture is getting somewhat clearer: the human eye needs excellent illumination and visual acuity to properly regulate eye shape.

visual acuity -> particulary avoiding hyperopic blur e. g. by underaccommodation!

 
Quote
Peripheral defocus also seems to be very important. Let's hope we can somehow take advantage of these findings.

I agree 

Offline OtisBrown

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #16 on: September 09, 2015, 03:17:44 PM »
Hi Myoctim,

All the commentary in "blue" was by an "under-cover" optometrist, who wants to keep his job.  (We discovered later.)

If a man is HONEST with me, and his job title makes him biased because of this "money" aspect - I can argue about that issue.

While I do understand his desire to convince you that it is impossible to go from 20/40 (self-measured -1 diopter) to 20/20 (self-measured 0.0 diopters), I truly do not respect an optometrist who does not identify himself accuratly, and the feeds me false scientific information to protect his reputation, and never my long-term vision.

I will never say that prevention (at 20/40) is every going to be easy.  Most people have no motivation to do it.  That is a fact I do respect.

For those who think that light use of a plus can be effective - well they are kidding themselves.  The plus does not "cure", in that sense, but with a broad scientific perspective, it can prevent - if you do it all yourself. 

I just do not "bother" with an OD any more.  I have interest in protecting my distant vision, which is why I am reading this through a +2.5 diopter lens, and personally verifying 20/20 on my "home Snellen".   


Guys, again, let's try to separate hope from fact.

 Do I believe in a dynamic neurological mechanism controlling ocular shape? Yes and yes. However, the blurry vision that comes with slight undercorrection or no correction does NOT lead to the solution. There have been numerous efforts by scientists to replicate animal studies for the treatment of myopia in children.

We know emmetropization being a closed feedback loop.
So if myopic blur really would cause some more myopia it would be the same as your heating control system would turn on the heater when putting the setting (setpoint) to a lower temperature.

Unfortunately optometrists don't care anything about the eye's refractive setpoint. They only compensate for blur by shifting the actually (refractive) value back to normal which doesn't correct anything anatomical.

 
Quote from: jimboston
I discarded glasses for many years -- it didn't prevent me from becoming myopic in the first place nor did it cure me after many years of minus wear. Unfortunately, reading at the edge of blur for a year didn't lead to any improvement as well.

but amazingly print pushing worked for me  :-)

Quote
On myopia improvement

Like Hillyman and many others, there are a few reasons some people see a small but significant improvement in their myopia. I will restate:

- neural (a.k.a blur) adaptation (myopes can tolerate extraordinary amounts of blur; the brain adapts by boosting contrast and prioritizing certain parts of the image)
- wishful thinking + poor measurement practices (unfortunately, most claims of improvement are the result of this formula)

but when looking outside at the neighbour building and all the edges are getting clearer and clearer it's neither a matter of blur adaption nor of "wishful thinking".

Quote
- presbyopia (a small improvement in distance vision after the onset of presbyopia in older myopes like Hillyman & quite probably Becker)

In deed that could be a valid point. If we look at

http://www.ncbi.nlm.nih.gov/pubmed/25683786

the refractive index of the lens often decreases when aging (protein aggregation?) causing a relative hyperopic shift.

But it raises the big question why I didn't improve when trying Bates some years before and why I did improve exactly after starting with print pushing.
-Why all the time before my refractive state seemed to be nailed down not changing at all.
-And why other persons at the same age even got more myopic when always wearing their full prescription at the office.
 

Quote
Well, choroid thickening -> less myopic defocus. Axial elongation -> more myopic defocus. I am not sure what you meant by this comment, but if you are referring to the Human optical axial length and defocus study by IOVS, it did show a small but significant reduction in AL and an increase in choroid thickening (both a positive for myopes) after 1 hour of +3D lens wear.

my mistake, of course I meant "a decreased axial elongation".

Quote
However, a later study which imposed myopic defocus on humans for a whole day:

http://www.ncbi.nlm.nih.gov/pubmed/22971342

showed the eye-shortening, choroid-thickening effect was practically erased after sleep. Experiments on humans with defocus for more than 1 day have not been officially published so this is the last remaining light using that strategy.

interesting, didn't know about that 2nd study.

But that overnight cancelling out effect (of some distance blur after prolonged near work) also is reported by some myopes before it had come that night where the blur stayed and they became real myopes.

Quote
A simple thought experiment. Before and at the onset of myopia, myopic children are already having an elongated eyeball and thus myopic defocus across their retinas. Since the peripheral hyperopic defocus is therefore eliminated, why doesn't myopia progression stop there?

IMHO the answer is if the ratio between hyperopic blur (during near tasks) and myopic blur at the distance is shifted too much to the hyperopic side the control technically result by emmetropization is an increased AL.

So let's expand that thought experiment by freeing half of those kids from their near environment by putting them on an island with no school and electronic gadgets.
The result would be no more prolonged hyperopic blur by underaccommodation and strain and consequently a slowly reduction in AL
Quote
I am not sure what this means for adult myopes, but unless the exact AL/choroid regulation mechanism is unraveled or a surprise study shows myopia reversal in a large population study, our options are limited. Thankfully, the picture is getting somewhat clearer: the human eye needs excellent illumination and visual acuity to properly regulate eye shape.

visual acuity -> particulary avoiding hyperopic blur e. g. by underaccommodation!

 
Quote
Peripheral defocus also seems to be very important. Let's hope we can somehow take advantage of these findings.

I agree
« Last Edit: September 09, 2015, 03:22:09 PM by OtisBrown »

Offline User1235

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #17 on: September 10, 2015, 03:41:06 AM »
Quote
Like Hillyman and many others, there are a few reasons some people see a small but significant improvement in their myopia. I will restate:

- neural (a.k.a blur) adaptation (myopes can tolerate extraordinary amounts of blur; the brain adapts by boosting contrast and prioritizing certain parts of the image)
- wishful thinking + poor measurement practices (unfortunately, most claims of improvement are the result of this formula)


This is interesting how can wishing thinking cause someone from 20/200 to see 20/40.This seems to be too big a leap dont you think?I too hope that i can get 20/40 just by thinking wishfully but the fact is that there must be hardwork and effort put in.

Offline rtdfgdfgdfgdfg

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #18 on: September 10, 2015, 04:41:46 AM »
in the becker myopia youtube presentation , he shows a study showing the eyeball changed shape within one hour

anything is possible

Offline User1235

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #19 on: September 10, 2015, 05:56:42 AM »
Yes i agree but what you are saying is that improvement is based on science(supported by studies) whereas what jimboston says is that improvement is due to "wishful thinking" which doesn't make sense to me

Offline rtdfgdfgdfgdfg

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #20 on: September 10, 2015, 11:43:48 AM »
Yes, I am saying eyesight and eyeball changing shape is based on science

So what ?


Offline Todd Becker

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #21 on: September 23, 2015, 09:30:41 PM »
Just perusing the blog forum and somehow missed this very interesting update from jimboston (who I'll call "Jim").  I value feedback and discussion of both personal experiences and the biological science behind the ideas shared here in this Discussion Forum.  I particularly welcome challenges and disagreements, because they often help us refine our thinking and sometimes suggest new ideas or refinements to our approaches.

I'm sorry to hear, Jim, that despite a sincere and prolonged effort for a full year, you've not had success with incremental defocus in any of its forms, whether using print pushing (with or without plus lenses) or other "active focus" techniques based on the concept of effortful focusing at the edge of blur as a stimulus to remodeling of the eye and thereby reducing myopia.

I will be the first to acknowledge that the technique evidently produces variable responses.  As amply documented on this site and several others, many people (myself included) have been able to eliminate or significantly reduce their myopia.  Another group sees minor or modest benefit -- and then it stalls.  And yet another subgroup, like Jim, sees absolutely no improvement. 

Why is the response variable? I can't provide a definitive answer based upon conclusive scientific studies.  I do have some ideas about why incremental defocus techniques work better for some people than others.

But before giving my thoughts, I'd like to respond to one comment from Jim:


...If you really take the time to study the literature and set your hopes aside, you will find no evidence of axial length permanently shortening or choroid thickness permanently increasing in adult humans. Furthermore, all the claims strong minus prescriptions worsen myopia or reduced prescriptions prevent myopia have been clearly disproved by studies on children with huge sample sizes, from which the only logical conclusion a reader can draw is that the poor visual acuity that comes from no or undercorrection actually accelerates myopia. For those who want the truth, I can also point out that recent findings suggest myopia genesis has a lot more to do with sunlight than it has to do with the wearing of glasses -- look up recent studies from Australia & East Asia for more information.

What about those who have claimed improvement?

I would have been the last to dismiss claims of recovery from myopia, even the spectacular ones, as they were sources of motivation and hope for myopes. Even though there are ZERO refractometer readings or advanced eye biometrics submitted by those who say they have improved, I didn't dismiss them completely, but now I have strong reasons to be extremely skeptical of such claims. First, in just about all cases, people simply don't measure properly so their data is corrupt from the very beginning. Unlike eye geometry, visual acuity is very hard to measure precisely; e.g. most people would not even notice they have astigmatism. Second, those who want to improve are also highly biased & fail to distinguish barely blurred text from text that is barely recognizable; e.g. they would stare at a chart just about making out some letters on a familiar 20/40 line and would then claim to have passed the test, while their refractive error is in reality 20/100.

Finally, please do keep in mind that there has been no scientific evidence or biometric data to support the claims of Becker, DeAngelis, Frauenfeld and other forum users. If you check some studies on blur adaptation you can explain quite easily the quick improvement in visual acuity that some myopes experience if they stop wearing their prescription for a while: the brain can boost visual perception by quite a margin, while refraction remains completely unchanged. In cases like Becker's, presbyopia could be a strong factor for the "improvement". There is also some spasm than can be released if you are overcorrected and/or do lots of near work, but in all cases the improvement will be limited to the range of 0.25-0.75D.

I think that this criticism is both fair and unfair.  Fair, to the extent that Jim is right that there are no studies (yet) that specifically and conclusively demonstrate the long-term, irreversible adaptation that Jim is looking for.  The few studies so far show smaller, more transient improvements.

However, the criticism is unfair for several important reasons:

1.  The "failed" studies that Jim cites didn't really study the technique that I advocate.  They studied the passive, mindless wearing of plus lenses.  Subjects were not advised to read at the edge of blur, either with or without glasses.  They just wore plus lenses all day long, regardless of what they were looking at.  If you really understand the IRDT theory and the importance of the "edge of blur" effect, it is not at all surprising that these "passive" protocols did not result in reduction of myopia.

2.  I see no reason to challenge the integrity or honesty of those of us who have succeed by doubting our claims, or suggesting that our measurements are false, imprecise, biased, "corrupt" or based upon wishful thinking.  It would be nice if I could have wished myself into reading movie subtitles from the back of the theater or getting my optical restriction removed by the DMV.  But at some point, reality intrudes.    If those of us with success stories were just deluding ourselves, we sure have one big amazing conspiracy going on here at Getting Stronger!

The successes with this method are reported throughout this forum, but I collected some of them on this thread:
http://forum.gettingstronger.org/index.php/topic,1077.msg8117.html#msg8117

3.  While I believe that success speaks for itself, I would like to see more scientific evidence to explain our success.  Sometimes scientific and medical progress is made by first achieving a result, even if the original explanation is wrong, or incomplete, or there is no explanation.  The lack of an explanation does not mean the phenomenon is not real.  But to convince others and make progress, I would still like to see more convincing evidence.

So, like Jim, I'd truly like to see more evidence that incremental focusing techniques can induce a significant, sustained and irreversible change in axial length of the eye.  It is not the case, however that there is NO evidence for this mechanism.  It is a fact that small reductions in axial length have been demonstrated in animals and humans, in response to retinal defocus. See for example, the 2010 paper by Read et al.:

http://iovs.arvojournals.org/article.aspx?articleid=2126435

Thus it is at least plausible that a large humber of repetitions of this mechanisms could lead to lasting change. It's just that nobody has done this study, perhaps because it would take months or years to carry out, and the economic and academic incentives have so far not been compelling.    Despite that, here is what the lead author of the above paper, Dr. Scott Read, wrote to me when I asked him about this:

Quote
I agree that it is possible that repeated periods of defocus could influence the length of the eye in the longer term.  There is a relatively large amount of evidence from animal studies into myopia (particularly the work of Josh Wallman, which I am sure you are familiar with) that suggests that exposure to defocus can result in longer term eye length changes.  Most current optical myopia treatment strategies designed to reduce myopia progression (e.g. orthokeratology contact lenses, bifocal contact lenses) are based around theories of defocus induced changes in eye growth (where it is proposed that these optical treatments have effects on myopic eye growth due to inducing myopic defocus, often in the peripheral visual field).  However, a definitive link between periods of defocus and longer term eye growth still needs to be established in humans. Longer term studies that comprehensively measure the eye's response to defocus over time are needed to more clearly understand these changes.  The translation of this type of research into widespread clinical practice is something that is likely to take a fairly long time, and really requires substantive evidence from randomised clinical trials illustrating the efficacy of a treatment, in order to gain widespread clinical support.
 
However, there are a number of previous studies that contribute to our understanding of the influence of defocus upon eye growth in humans in the longer term though, which may be of interest to you.  Including the following papers (you may already be familiar with some of these studies):
 
Phillips JR.  Monovision slows juvenile myopia progression unilaterally.  Br J Ophthalmol. 2005; 89:1196-200 
 
Anstice NS, Phillips JR.  Effect of dual-focus soft contact lens wear on axial myopia progression in children.  Ophthalmology. 2011; 118:1152-61
 
Cho P, Cheung SW.  Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial.  Invest Ophthalmol Vis Sci. 2012; 53:7077-85
 
Swarbrick HA, Alharbi A, Watt K, Lum E, Kang P.  Myopia Control during Orthokeratology Lens Wear in Children Using a Novel Study Design. Ophthalmology. 2015; 122:620-30

And here is what Hung and Ciuffreda, leading optometry researchers from Rutgers and SUNY, concluded from their studies of incremental retinal defocus:

Quote
In addition, the theory has been able to explain how repeated cycles of near-work-induced transient myopia leads to repeated periods of decrease in retinal-image defocus, whose cumulative effect over an extended period of time also results in an increase in axial growth that produces permanent myopia. Thus, this unifying theory forms the basis for understanding the underlying retinal and scleral mechanisms of myopia development.

So the research continues.  This is not a closed book, but an ever-evolving science.

Now, to the important question I raised earlier: 

Why does the incremental defocus technique apparently work so well for some of us, but so poorly for others?

When you think about it, that's actually the general story of medicine and medical therapies.  Response is variable to many treatments for conditions ranging from allergies to obesity to heart disease and cancer.  Even limiting ourselves to the eye, some respond well to treatments for glaucoma, or to laser surgery.  Humans, like all animals, vary.

While the evidence is incomplete, I believe that several important factors may significantly affect the potential effectiveness of incremental defocus:

1. Genetics. While I don't think genetics dooms anyone to myopia, there is evidence that certain ethnic populations are more susceptible to becoming myopic.  Witness the explosive growth of myopia in Asia.  That said, genes are not destiny, and there are at least two important environment factors to consider.

2.  Age and health. The plasticity of the eye varies significantly as a function of age and health.  Many of the studies that show remodeling of axial length were carried out in young chicks or monkeys, where the eye is still growing and the chorioidal tissue and sclera are malleable, changeable tissues.  So just as it is easier to develop myopia more quickly when you are young, I would expect that incremental defocus can reverse the process more easily when you are young.

3.  Diet.  What you eat may play a major role in both the development and reversal of myopia.  Cordain has argued quite compellingly that high carbohydrate diets are insulinogenic and it has been proven in studies that hyperinsulinemia and insulin resistance are connected with elevated incidence of myopia:

http://www.direct-ms.org/pdf/EvolutionPaleolithic/Myopia.pdf
http://www.pensgard.com/nutrition/12_Sugar_Myopia.htm

Other studies show that the rate of growth of the sclera and choroid are under hormonal control of insulin and other hormones.

It is certainly the case that ethnic groups that previously had lower incidence of myopia have recently seen epidemic explosions in myopia.  Some of this may be due to habits, e.g. schooling, but much of it may also derive from a shift to high carbohydrate, sugary diets.

I personally found my vision became crisper when I went on a low carb, Paleo diet.  I also found that eating brightly colored vegetables like red and green peppers, and increasing fatty fish consumption, increased the intensity of colors that I perceived.  I remember noticing how bright the red in the stoplights seemed after I cut way down on carbs.  I also found that intermittent fasting sharpened my vision -- something echoed by others:

http://forum.gettingstronger.org/index.php/topic,1102.msg8420.html#msg8420

In short, incremental focus techniques can be very helpful, but perhaps it requires an eye that biochemically and hormonally able to adapt responsively to the applied stimulus.

I have no idea what Jim's age, health or diet might be.  Or what his genes and ancestry might contribute to the puzzle.  But it could well be the case that certain genetic and environmental factors make his eyes much less susceptible to the possibility of axial length change in response to applied defocus stimulus.

I wish I had more answers, but I don't.  Much of the science here is still in it's infancy.  But two things cannot be denied:

1. Incremental focus definitely works for some (but not all) of us.
2. The lack of conclusive scientific proof of the IRDT theory, does not mean that there is NO scientific support for it.  There is at least partial evidence supporting key aspects of the theory. 

Again, wish the techniques advocated here were universally effective.  They aren't.  But that's true of most medical interventions.  And as long as incremental defocus techniques like print pushing help SOME people, that's good enough for me, for now.

Todd
« Last Edit: October 01, 2015, 01:23:32 PM by Todd Becker »

Offline warnbd

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #22 on: October 07, 2015, 07:04:20 PM »
Otis,

What do you mean by "(We discovered later.) ?



All the commentary in "blue" was by an "under-cover" optometrist, who wants to keep his job.  (We discovered later.)



Offline OtisBrown

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #23 on: October 08, 2015, 02:56:45 AM »
Jim Boston stated that he use "edge of blur", and, "it did not work".  He did not state his prescription. He did not state his visual acuity.  He did not keep any records - that we could believe.  He stated as a fact some very obscure studies, (O'Leary) that were discredited some time ago.)  If you wish to believe him - that is fine with me.  In fact, I agree, that prevention (at 20/40, and self-measured -1 diopter) is indeed difficult. 

Let me add that Jim Boston DID NOT USE A PLUS.  For myself, I think a plus in mandatory.  To suggest you used ONLY "edge of blur", is a reason by Boston got NO RESULTS.   

But, in the final analysis, you have to make a choice, to do prevention yourself.  So let us say that I suspect Boston makes his money selling minus lens glasses - and seeks to discredit, one way or another, the concept that prevention is possible at 20/40. 

It becomes a matter of your judgment call on this issue.  I even agree that ODs, will not even help their own children with plus-prevention, when they are at 20/40.  That is the real tragedy - but I agree that they are honest about it.

I just do not agree that science says that the minus lens is 1) Safe and 2) A good idea for the long-term.

Even MDs, state that they try to avoid the minus - if they can.  (Dr. David Guyton, Johns Hopkins)


Otis,

What do you mean by "(We discovered later.) ?



All the commentary in "blue" was by an "under-cover" optometrist, who wants to keep his job.  (We discovered later.)


« Last Edit: October 08, 2015, 08:50:38 AM by OtisBrown »

Offline Alex_Myopic

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Re: 1 Year @ The Edge of Blur: This Method Failed
« Reply #24 on: October 08, 2015, 02:34:51 PM »
" If you check some studies on blur adaptation you can explain quite easily the quick improvement in visual acuity that some myopes experience if they stop wearing their prescription for a while: the brain can boost visual perception by quite a margin, while refraction remains completely unchanged. In cases like Becker's, presbyopia could be a strong factor for the "improvement". There is also some spasm than can be released if you are overcorrected and/or do lots of near work, but in all cases the improvement will be limited to the range of 0.25-0.75D."

This describes people who had success as if they are over-optimistic or like the brain just does better deblurring while these same people complain about diplopia or plateaus after correcting more than 1 diopter. Why the brain or self-deception doesn't fix that problems also and why are created then?