Author Topic: A Compendium on Myopia Rehabililation  (Read 44995 times)

Offline Tom

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A Compendium on Myopia Rehabililation
« on: July 11, 2013, 07:17:35 PM »
A Compendium on Myopia Rehabilitation (CMR) - Overview

This post serves as the table of contents of my thought on myopia rehabilitation. CMR is an ongoing project documenting my own experimental and theoretical conclusions, and research findings on matter pertaining to myopia development and its reversal. I intend to expand this topic so that it becomes one of the most comprehensive and detailed resource on myopia rehabilitation on the Web. Although CMR is designed with the general public in mind, it seeks to provide both practical and technical information in an accessible manner, without compromising the details.

There are different types of myopia, each with possibly different underlying causal mechanism. CMR mainly focuses on the so-called near-stress-induced myopia. This comprises both Nearwork Induced Transient Myopia (NITM), and what is commonly referred to as Axial Myopia (most eye professionals don't recognize different kinds of axial myopia). Near-stress-induced-myopia accounts for the very vast majority of myopia.

As you go through the posts, you might occasionally encounter fancy words here and there, or maybe you just want to find some answers quickly. In these cases, "Glossary and Q&A - Part I" and "Glossary and Q&A - Part II" could be useful.

Disclaimer

While I strive to aim for accuracy, the information found under this topic do not constitute medical advice. Consequently, the readers are solely responsible for their own actions.

As an entry point, I strongly encourage you to start your journey with this article. You will understand much better the history of myopia treatments, and the inner working of medicine in general.

I only report what works for myself and what I think is true. For similar and more accessible resource on myopia rehabilitation, check out Endmyopia.org (found by Dr. Alex Frauenfeld, currently maintained by the non-medical anti-guru and renegade Jake Steiner).

Articles/Links under this topic

Practical Recommendations

Primers

Reviews of Research Studies

Personal Findings/Stories

Appendix
« Last Edit: June 13, 2015, 06:31:04 PM by Tom »
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Offline mailliam

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Re: A generalized system for myopia reversal
« Reply #1 on: July 12, 2013, 01:42:12 AM »
Hey Tom,

Is the far point 6m/20ft away? Is that number only for an emmetropic person? Would it be further for a myope?

Is there a way to figure out how much closer the far point would be according to the strength of a plus lens?

So based on your post, would a routine like this work (for a myope, without using glasses)

I spend X minutes looking into the horizon until I feel my eyes straining. I then look at something at the far point (accounting for my level of myopia), tolerate the strain and then look back at the horizon.

Is this right?


Liam

Offline johnlink

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Re: A generalized system for myopia reversal
« Reply #2 on: July 12, 2013, 10:53:51 AM »
The focusing muscles, ciliary muscles, is really a pair of 2 muscles - one for negative accommodation, and the other for positive accommodation. Don't feel like looking up the names, so let's just call it negative ciliary and positive ciliary, respectively.

My understanding, which I've never seen contradicted until I read your statement above, is that the ciliary muscles do only one sort of accommodation, i.e, they make possible near focus. The more contracted they are the closer we can see. If you have information that there is a second type of muscle that contracts in order to focus further away, please supply the appropriate references, at a minimum the name of the muscles. Otherwise it seems that we have to reject your statement above as an unfounded conjecture.

This reference discusses the antagonist of the ciliary muscles, but the antagonist is not a muscle: http://books.google.com/books?id=GD0CAAAAYAAJ&pg=PA279&lpg=PA279&dq=antagonist+%22ciliary+muscle%22&source=bl&ots=iY2VNvKwAc&sig=nnr86IQaq5fic-OP6L6bd7012H4&hl=en&sa=X&ei=5k7gUaKbNs364AO-kYDwBQ&ved=0CFkQ6AEwBQ#v=onepage&q=antagonist%20%22ciliary%20muscle%22&f=false

Offline Steven

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Re: A generalized system for myopia reversal
« Reply #3 on: July 12, 2013, 12:56:44 PM »
Hey Todd and Otis. Yesterday I had a spark that I think will fill the missing puzzle in curing myopia. I think now that we have learnt all we need to know about reversing axial myopia.

I'll be trying to compile my insight into my blog. But in the meantime I think you have to share this discovery with you guys, because you pointed me to the right direction. The discovery, in essence, is just one last extension (the most important one) of Todd's ideas:

========
Basic Phenomena
========

The mammal eye is a very flexible organ that responds very quickly to stimulus.

The focusing muscles, ciliary muscles, is really a pair of 2 muscles - one for negative accommodation, and the other for positive accommodation. Don't feel like looking up the names, so let's just call it negative ciliary and positive ciliary, respectively.

1) Close strain: this is the symptom of negative cililary spasm. It happens when the eye focuses on objects closer than its far point. The closer to the object, the greater the close strain. Subjectively, the close strain feels like a force pushing the front of the eye inward.

2) Far strain: this is the symptom of positive ciliary spasm. It happens when the eye focuses on objects farther than its far point. The farther the object, the greater the far strain. Subjectively, the far strain feels like a force pulling the front of the eye outward.

Important remark: since the ciliary muscles are a antagonistic pair. In the simple situation of the naked-eye, both strains are mutually exclusive. That is:

1) both strains can't happen at the same time
2) When a close strain is felt, inducing a FAR strain would eliminate the close strain.
3) When a far strain is felt, inducing a CLOSE strain would eliminate the far strain.

=========
Cause of Axial Myopia/ Axial Hyperopia
=========

Myopia: chronic close strain along with eye susceptible to negative adaptation. It's possible that the strain come from multiple sources (e.g., constantly focusing within far point, wearing minus lenses, or both)

Hyperopia: chronic far strain along with eye susceptible to positive adaptation. It's possible that the strain come from multiple sources (e.g., constantly focusing beyond far point, wearing plus lenses, or both)

=====
Furthur Complications
=====

1) To stop axial myopia from progressing, eliminating chronic close strain is necessary. However, that alone can only cure pseudomyopia, not axial myopia.

2) To stop axial hyperopia from progressing, eliminating chronic far strain is necessary. However, that alone can only cure pseudohyperopia, not axial hyperopia.

The MOST important insight: to cure both, we need to reshape the eyeball. We can achieve it via inducing the opposite chronic strain APPROPRIATELY. That's the real reason why the eye is reshaped (i.e., the eye is not reshaped because you're focusing on the edge of blur or whatnot, in fact it doesn't even need to, all it needs to cure, say, myopia, is an appropriately applied chronic far strain.)

======
Solutions
======

Since the ciliary muscles are muscles, we can apply the stretch-and-release technique to reshape it accordingly.

1) Myopia reversal: there are many variations of different aggressiveness. But the essential idea is to induce far strain (e.g., by focusing beyond far point) UNTIL the strain become unpleasant, and then release the strain by focusing on the far point, UNTIL the strain become tolerable. And repeat the cycle.

NOTE: Plus lenses shifts the far point closer to the eye. Consequently, applying the stretch-and-release technique is more effective with plus lenses. The higher the plus the better, GIVEN that it's used exactly as instructed in 1) (If you're using a +6 plus lenses, then you better make sure you're an expert in this)

2) Hyperopia reversal: again, the essential idea is to induce close strain UNTIL the strain become unpleasant, and then release the strain by focusing on the near point, UNTIL the strain become tolerable. Repeat the cycle again.


======
The End
======

The chronic strain theory seems to eliminate most inconsistencies I've found in the literature and the forum. Any Questions? Criticisms? Drop a line here, I'll be more than willing to answer. :)

Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.

Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.

2 main things you must do :

a) Forget about minus lenses (use under prescription / half prescription only in urgent cases)
b) Put the strongest plus you find and make a walk in the house, look outside the window, go in the park and either stay on a bench or make a walk etc.

You should be able to walk and see something in parks.
Buy plus glasses that cover as much as possible the whole field of view.
Small glasses are not that efficient.

That's it.
When reading a book you can use +2 or more.

Offline Steven

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Re: A generalized system for myopia reversal
« Reply #4 on: July 13, 2013, 12:46:34 AM »
Quote

Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.


I really don't think this is a good and responsible advice for everyone. Putting a +6 lens will cause too much far strain on the person, who is just starting to get used to it. If done improperly, this could cause eye tears leading to other more serious consequences.

It's not just black and white - just like in orthodontics, if you put too much stress on your teeth, it might just break. And everyone has a different breaking strength and adaptation speed.

<quote>
Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.
</quote>

By the way, I personally don't rehabilitate in front of computer. Remember to avoid overbrightness (just middle brightness) and don't staying too close to it. Your eyes can get burned before you know it.

<quote>

Try to follow me carefully.

1. It is very responsible if you want to obtain results with absolutely no side effects (like you get from surgery - loss of visible color spectrum, dried eyes, etc.). Far strain is perfectly fine and safe, because the human eye was made to spot and hunt animals and eat fruits from the trees while looking far away to see any predator.

Only the elongation of the eye in people with myopia is very dangerous since it leads to blindness. So it is irresponsible to put minus glasses on myopic eye because it leads to retinal detachment from the elongation.

http://en.wikipedia.org/wiki/Retinal_detachment

"Retinal detachment is more common in people with severe myopia (above 5–6 diopters), in whom the retina is more thinly stretched. In such patients, lifetime risk rises to 1 in 20. About two-thirds of cases of retinal detachment occur in myopics. Myopic retinal detachment patients tend to be younger than non-myopic ones."

So, using a plus lens no matter how strong is perfectly safe. That is why it is sold without needing a prescription in most shops / supermarkets !!!

The eye tearing can happens only on elongated eye, not in compressed eyes. So in people with myopia that experience retinal detachment.

Yes, It is black and white. If your posture is hunched you will develop a hump. If you stay strait you will avoid humps. The eye can reshape itself because it has no bones or stiff tissue in it, unlike the hump.

If you read that perfect vision book, the author said he stopped making progress with a +2 or so, because it became to weak, and in order for him to reach 20/20 and 20/15 he had to use a stronger plus most of the day.
« Last Edit: July 13, 2013, 12:48:41 AM by Steven »

Offline mailliam

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Re: A generalized system for myopia reversal
« Reply #5 on: July 13, 2013, 03:39:39 AM »
             Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.

Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.

2 main things you must do :

a) Forget about minus lenses (use under prescription / half prescription only in urgent cases)
b) Put the strongest plus you find and make a walk in the house, look outside the window, go in the park and either stay on a bench or make a walk etc.

You should be able to walk and see something in parks.
Buy plus glasses that cover as much as possible the whole field of view.
Small glasses are not that efficient.

That's it.
When reading a book you can use +2 or more.

Hey Steven, a question. Is it beneficial to be using plus lenses for distance viewing? I remember reading Todd in his initial article on how to throw away your glasses saying:

Quote
It is important to realize that the strong anticorrective lenses are only to be used for the activities for which your prescription glasses were least needed!  So for myopes, wear the plus lenses only for close work (reading and computer work); for hyperopes, wear the minus lenses when looking in the distance or across the room, but not when reading or at the computer

So for a myopic person:

Minus-lens + closeup work = BAD
Minus lens + distance viewing = OK (good if you have undercorrections that make objects slightly blurry)
Plus lens + closeup work = GOOD
Plus lens + distance viewing = ... bad?

Offline Steven

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Re: A generalized system for myopia reversal
« Reply #6 on: July 13, 2013, 12:30:22 PM »
             Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.

Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.

2 main things you must do :

a) Forget about minus lenses (use under prescription / half prescription only in urgent cases)
b) Put the strongest plus you find and make a walk in the house, look outside the window, go in the park and either stay on a bench or make a walk etc.

You should be able to walk and see something in parks.
Buy plus glasses that cover as much as possible the whole field of view.
Small glasses are not that efficient.

That's it.
When reading a book you can use +2 or more.

Hey Steven, a question. Is it beneficial to be using plus lenses for distance viewing? I remember reading Todd in his initial article on how to throw away your glasses saying:

Quote
It is important to realize that the strong anticorrective lenses are only to be used for the activities for which your prescription glasses were least needed!  So for myopes, wear the plus lenses only for close work (reading and computer work); for hyperopes, wear the minus lenses when looking in the distance or across the room, but not when reading or at the computer

So for a myopic person:

Minus-lens + closeup work = BAD
Minus lens + distance viewing = OK (good if you have undercorrections that make objects slightly blurry)
Plus lens + closeup work = GOOD
Plus lens + distance viewing = ... bad?

I don't agree with that logic.

If you put a minus lens on a monkey it will go myopic no matter if the monkey looks far or close. (of course it will become more myopic if it looks close with the minus lens.

Same with plus. (of course you will get rid of myopia faster if you look far away with a plus then reading a book with a plus)

If you don't want to waste time like i did initially by testing various stuff myself - step by step, buy a strong plus go outside on a bench in the park and enjoy better vision every single day.

Same indoors. Find activities that do not need good eyesight.
« Last Edit: July 13, 2013, 12:42:48 PM by Steven »

Offline Steven

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Re: A generalized system for myopia reversal
« Reply #7 on: July 13, 2013, 12:40:20 PM »
Quote
The eye tearing can happens only on elongated eye, not in compressed eyes. So in people with myopia that experience retinal detachment.

Hey Steven, with all respect, the human eye is really more complex than you think.

When you're wearing plus lens and looking far, your cililary might be relaxed, but it's precisely because of that that your zonular fibers are now tense. This probably explains why your eyes feel being pulled, outward.

A tear can happen everywhere. While plus lens doesn't increase the risk of retinal detachment, it could very well increase the risk of cornea tears, if misapplied.

Which again makes sense. Why would you minus lens cause harm and not plus lens?

Stating general things without specific data won't help you prove your theory, like: "the human eye is really more complex than you think"

Why don't you try a +6 look far away and see the stunning results on a snellen ?

You can apply a plus lens only in one way, by using it !
The cornea does not get teared up because the eye is no longer elongating under the effect of a plus. The eye ball is getting shorter and shorter and the visual system is more relaxed.

Only thing you can do to hurt cornea is this :

http://en.wikipedia.org/wiki/Corneal_abrasion

Offline mailliam

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Re: A generalized system for myopia reversal
« Reply #8 on: July 13, 2013, 02:26:52 PM »
             Everyone who had myopia and tried a +6 lens knows how efficient stronger lenses are at provoking quick re-adaptation of the eye to its new environment.

Trying to use soft plus lenses and trying to read at the computer it's hard to do (when you also have myopia) and it makes your experience unpleasant and your back hurts.

2 main things you must do :

a) Forget about minus lenses (use under prescription / half prescription only in urgent cases)
b) Put the strongest plus you find and make a walk in the house, look outside the window, go in the park and either stay on a bench or make a walk etc.

You should be able to walk and see something in parks.
Buy plus glasses that cover as much as possible the whole field of view.
Small glasses are not that efficient.

That's it.
When reading a book you can use +2 or more.

Hey Steven, a question. Is it beneficial to be using plus lenses for distance viewing? I remember reading Todd in his initial article on how to throw away your glasses saying:

Quote
It is important to realize that the strong anticorrective lenses are only to be used for the activities for which your prescription glasses were least needed!  So for myopes, wear the plus lenses only for close work (reading and computer work); for hyperopes, wear the minus lenses when looking in the distance or across the room, but not when reading or at the computer

So for a myopic person:

Minus-lens + closeup work = BAD
Minus lens + distance viewing = OK (good if you have undercorrections that make objects slightly blurry)
Plus lens + closeup work = GOOD
Plus lens + distance viewing = ... bad?

I don't agree with that logic.

If you put a minus lens on a monkey it will go myopic no matter if the monkey looks far or close. (of course it will become more myopic if it looks close with the minus lens.

Same with plus. (of course you will get rid of myopia faster if you look far away with a plus then reading a book with a plus)

If you don't want to waste time like i did initially by testing various stuff myself - step by step, buy a strong plus go outside on a bench in the park and enjoy better vision every single day.

Same indoors. Find activities that do not need good eyesight.

For an emmetropic monkey yes I agree, but for a monkey that is already myopic I don't think so.

What's been your speed of progress using the +6? What was your initial prescription and are you at 20/20 (or better) now?



Offline Tom

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Re: A generalized system for myopia reversal
« Reply #9 on: July 15, 2013, 10:45:51 AM »
Some Positive Testimonies

Case 1 - Shadowfoot

Shadowfoot is one of the success examples among low myopes. He started out here wearing plus lens, got some improvement, but had to drop the plus lens because he was getting red eyes.

[EDIT: Don Rehm gave an explanation as to why staying beyond one's far point could lead to red eyes, and suggests that it is a benigh symptom of negative accommodation.]

Quote
because I was holding the book beyond the far point, where it was a little blurred, the ciliary muscle was making an active effort to relax. This negative accommodation called for an increased supply of blood to the ciliary muscle (located in the area surrounding the iris). It was this increased supply of blood that caused the slight redness, and it was an indication that the eye was really working hard at relaxation. I could see a similar situation in weight lifters whose skin becomes redder in the area of muscles that have just had a hard workout.

The incredible part really happens after this. Namely, Shadowfoot was still improving. And he does so by:
  • Taking frequently breaks after reading
  • Staying beyond his far point
  • Doing distance gazing several times a day
  • Ditching the reading glasses

With these routines, Shadowfoot eventually went from 20/40 to 20/20 (see Todd's interview with Shadowfoot here).

Case 2 - CapitalPrince's Father

As with Shadowfoot, CapitalPrince's father is also a low myope starting with 20/40. As opposed to some myopia rehabilitators, he felt that reading glasses doesn't exert enough force on his eyes. However, he made a commitment to the following routine:
  • Gazing at the Snellen chart, with the intention of trying to clear up the letters
  • Snellen-gazing for 1 hour each session, but several sessions per day

CapitalPrince's father's persistence clearly paid off quickly. In only 2 months, his visual acuity became better than 20/20.

Case 3 - My Brother

I knew that giving only testimonies of low myopes recovering from myopia will not satisfy the skeptics, as it could be argued that these rehabilitators only had pseudomyopia to begin with.

So here comes my brother, who started wearing minus prescription relatively late (probably around the age of 14). He didn't really like the glasses, and he rarely reads.

By the time he finished his degree, he was using a minus (his worst prescription was around -4D I believe). His myopia didn't really bother him anyway.

And then, around 2010, I advised him to not use his minus prescription for most purposes, and to use it only to see far. I have rarely see him wearing glasses afterwards.

Just recently, he returned from a 4-day vacation to a tourist site on a mountain. He told me that he spent his days playing mini-golf, riding a physical "mario cart", swimming, mountain hiking, tarzan-ing (use your imagination) - Just plenty of outdoor activities.

But something he mentioned got my attention. Out of the blue, he claimed that his vision improved. I knew better and decided to check him out.

I made him to look at the Snellen at 6m, naked-eye, he wasn't able to read any letter. This suggests that his myopia is at least, more than -1D.

I instructed him to find out his far point. And I got 88cm. This suggests that he is -1.13D. However, there's always the possibility that his far point is actually closer. A more conservative refraction estimate would be -1.5D.

This is a very interesting finding. My brother works 8h in front of computer (and is regularly on his iPhone) as with most people. However, but he is regularly outside as well.

Case 4 - Alex_Myopic's Experience

Alex_Myopic has the say this time:

Quote
After doing some active focusing on Snellen chart at 10f  for the third or fourth time (as CapitalPrince suggested) I noticed a greater result. After some minutes I managed to clear my vision almost half diopter and had 10/10 vision without hard blinking or squinting. I wonder what this mechanism is? Somehow after minutes of active focusing the brain manqged to relax the lenses of the eyes for some time.

Last Words

More testimonies will be gathered as our myopia rehabilitation community expands over time. I guess we will just wait and see. If you have any positive experience, do consider taking the time to post it. Who knows, perhaps you might find yourself on this page! 8)
« Last Edit: August 28, 2014, 12:55:40 PM by Tom »
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Offline chris1213

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Re: A generalized system for myopia reversal
« Reply #10 on: July 15, 2013, 06:10:13 PM »
TomLu, your statement is very interesting for me and I believe you might be right.

When I first read Todd's article about reversing myopia with the plus lens method (november 2012) I could only see the 20/200 line on the Snellen chart (-2.00 on my right eye and -1.5 on the left one). I started doing print pushing with plus lenses using +0.5 and then some +1 glasses. Even with those I could barely focus so I had to push back and forth every time I used them and suddenly, after some weeks to a month, I woke up being able to read the 20/70 line. After that I started getting used to the +1 lenses and stopped having to move back and forth to focus. I just stayed at the edge of blur. Since then my recovery started getting slower. In February I started being able to read the 20/60 and sometimes the 20/50 line so I upgraded to some +2 lenses and again had to move back and forth to focus. In April I was able to read the 20/50 most of the time and sometimes (mostly mornings) I could read the 20/40. But I just hit the plateau after that.

I think you're right because my fast changes happened when I couldn't really stay at the edge of blur and had to move back and forth to focus. This is really hopeful information and I'm going to experiment with this and hope to have some good news for you after a time.

Offline OtisBrown

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Re: A generalized system for myopia reversal
« Reply #11 on: July 16, 2013, 02:48:53 AM »
Hi Chris -
Let me congratulate you on "coming back" from 20/200 (That is considered 'legal blindness' - if you can not read that line.)

Getting close-to 20/50 and 20/40, is indeed both slow and difficult.  I like to say that the "last diopter" is the most difficult, and requires more consistent effort with the plus.  Your experience is correct and consistent with what *I* know.  That is that our eyes go "down" at a rate of -1/2 diopter per year, so logic should tell us that going "up" will be at that rate also.

But the great issue of self-checking and measurement - is that you KNOW this.  As you confirm the 20/40 line, you can play sports, tennis, etc., with NO MINUS LENS.  You can also get any minus lens from Zennioptical for about $10.

I understand the idea of "plateau", and the frustration of it.  But equally, you know you can continue to wear the +2.0 for all close-work, and keep a cheap -1.0 diopter in your car - and just wear it when driving.  For me, objectively passing the 20/40 line is great success.  (Yes, I want "better") but it is good to have a reasonable goal in your life - that you can pass.

Otis



TomLu, your statement is very interesting for me and I believe you might be right.

When I first read Todd's article about reversing myopia with the plus lens method (november 2012) I could only see the 20/200 line on the Snellen chart (-2.00 on my right eye and -1.5 on the left one). I started doing print pushing with plus lenses using +0.5 and then some +1 glasses. Even with those I could barely focus so I had to push back and forth every time I used them and suddenly, after some weeks to a month, I woke up being able to read the 20/70 line. After that I started getting used to the +1 lenses and stopped having to move back and forth to focus. I just stayed at the edge of blur. Since then my recovery started getting slower. In February I started being able to read the 20/60 and sometimes the 20/50 line so I upgraded to some +2 lenses and again had to move back and forth to focus. In April I was able to read the 20/50 most of the time and sometimes (mostly mornings) I could read the 20/40. But I just hit the plateau after that.

I think you're right because my fast changes happened when I couldn't really stay at the edge of blur and had to move back and forth to focus. This is really hopeful information and I'm going to experiment with this and hope to have some good news for you after a time.

Offline Tom

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A Compendium on Myopia Rehabilitation
« Reply #12 on: July 18, 2013, 08:43:12 AM »
For the Parents Trying to Reverse Their Children's Myopia

Intro

First of all, condolence to the parents who are dealing with children, who either refuse to wear reading glasses or, if they do, read further within their far point.

Why are they reading further within their far point? Well, they can't see well. Children are accustomed to seeing things clearly and the experience of utter blur is just unacceptable for them. But why do they find blur unacceptable?

And why are they refusing to wear plus? Probably they are just lazy - they hate to have to work. Or is it because they don't feel good with it?

Case study: A 20/20 child

A brilliant child is doing well in school, and we want to help him avoid myopia. We reason that he can read comfortably at 40cm. So we give him a pair of eyeglasses of +2.5D to do it.

Then what happens? He puts on the glasses and feels an immediate tension in the frontal part of his eyes. He feels uncomfortable and scared and automatically lean closer to see - usually much closer than needed.

Although the prescription is optically correct. At 40cm he might still be experiencing close strain. In addition, the plus lens induces a kind of tension forcing ciliary relaxation - a tension whose intensity is determined by the strength of the plus lens in question.

(and he gets red eyes, that could very well be a benign symptom of the radial components of ciliary muscle doing its job)

There are at least two problems here:

Problem 1: Why children lean so close to an viewing object?

As children develop, some of them will remain emmetropic throughout their lives; others might become myopic. There is actually a rarely-explored key difference between the prospective emmetropic child and the prospective myopic child. Namely, that the prospective myope might just not know how to leverage his focusing ability to minimize blur. Instead, he would use peripheral vision to look at everything - And of course he would need to lean closer than needed to see well.

What happens next? The child believes that he is myopic and the parents bring him to see an eye doctor. The child then looks at the Snellen chart, as a whole, and concludes that he can't see well. He then gets his first minus lens.

In many of those first eye exams, if only the child focuses on each letter on the Snellen, instead of focusing on the Snellen as a whole, there's a possibility that the child can actually read all the letters on the chart.

Another question arises. Why then do those children choose to use peripheral vision instead? One speculation in the literature is that their central vision is not fully developed yet (since in child development, peripheral vision comes first and central vision comes much later). If that's the case, then it's probably a very bad idea to teach a young child to read, before they even learn to focus properly.

In some cases, when one acquires efficient focusing skill, they might realize in retrospect that part of their myopia is really just attention-related issues.

Problem 2: Plus lens induces too much strain
 
One thing that can be done is to increase the diopter of reading glasses by an increment of +0.5. We can start with +0.5, ask him how he feels about it, and wait a few days. Once the tension becomes manageable, we can give him a +1D. And then once more with +1.5D. Some children have less tolerance with +2D. However.

As with any person, a child can be conditioned to embrace the blur too. For example, he might initially complain about the +0.5D prescription, but he might just get used to it after a week or so. It's important to eliminate that fear of blur, because once he does, he will know that he doesn't need to approach an object awfully close to see it clearly. The underlying theme is that blur clearing is only healthy and necessary, and that children can be conditioned to enjoy doing it.

All in all, we are better off administering weaker plus lens to children and have them read as far away as possible. Reading too close, even if beyond the far point, could induce proximal accommodation (as shown in the studies of microscopists), which in turn leads to more close strain.

Adjusted Plus Lens

Plus-lens-induced strain is also in part due to accommodation-convergence disturbance and oculomotor imbalance. To remedy this situation, one can use a plus prescription of ~1.5D with a weak base-in prism (to minimize the exophoric effect of convex lenses), or lessen the pupillary distance of the prescription to attain a similar amount of prismatic effect.

Fundamental changes in habit

Children play with what is available to them. If we have smartphone or iPad at home, they will probably become easily addicted to it. And if they can find dolls or legos, they will probably stick to them too.

Back then when computers were not commercially available, children still find ways to entertain themselves - mostly outside. Actually, if there were no addictive toy or gadget in the house, they'll most likely get addicted playing outside. Why not bring them to the parks, or let them play with non-agressive animals?

Besides,we can read the stories to our children, instead of having them read the stories themselves. Just like the adults, addiction is very hard to eliminate, hence a more sustainable approach would be to prevent the addiction in the first place. Don't just stop them from doing something, lure them into the activities that promote distance viewing. 8)

Summary

a) Teach our children how to focus, if applicable.
b) Increase the strength of reading glasses incrementally, but keep the strength relatively low, and the viewing distance relatively far.
c) Consider using a plus lens with base-in prismatic effect.
d) Avoid living in a near environment is still the best shot. Lure the children into entertaining distance activities.
« Last Edit: July 11, 2015, 08:54:05 PM by Tom »
The Sustainabilitist
Stretching Further the Concepts of Sustainability and Resilience
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Offline CK333

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Re: A generalized system for myopia reversal
« Reply #13 on: July 18, 2013, 11:21:55 AM »
TomLu, you are doing excellent work!!

I don't have children yet, but I had been wondering how I would best help to prevent myopia in them; in particular, which plus strengths to begin with.  What you say makes sense.

In regards to the stretch and release techniques you describe, I am wondering if this would be of a similar strategy: while at the office, I use a low strength plus lens for my computer work.  Since reading your posts, I have been using plus lenses at my far point/edge of blur, then taking them off.  I rotate between the plus and no lens, for about five minutes, on and off.  In fact, I can feel a slight stretch and pull when I do this.  Since the dipping technique would not be too feasible while at work, I figure this may be of similar benefit?  I'd love to hear your thoughts.

Keep up the insightful posts

Offline Hillyman

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Re: A generalized system for myopia reversal
« Reply #14 on: July 18, 2013, 06:21:36 PM »
Tom:

Interesting site! I've been interested in eyesight and how to improve mine since my first pair of glasses when I was 10. Now I am 59, with -5.5 in both eyes. In terms of using plus lenses, if I take off my glasses, does that count as the equivalent of having plus lenses? The edge of my clear vision is about 7 inches away from my face.

I have also come across David de Angelis's book "The Secret of Perfect Vision." He mentions the plus lens approach but also says we should do "ocular stretching" of moving the eyes together at the extreme edge of the eye sockets, and trying to maintain binocular vision. What's your view of this "stretching."?