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Medical Forum / General / Vision / August 2005To Jonsy123 about plus lenses...
Hey Jonsy, I have read your posts and sorry about what you are going through. How old are you? Are you in a career field that you are required to have 20/20 vision or better? Military or civilian aviator, etc? If not, why worry? You can wear glasses and I don't think there is anything wrong with wearing glasses. If you develop higher myopia, you can always have a PRK or LASIK with wavefront, and results I hear for those surgeries are pretty satisfactory. But I highly doubt that by wearing minus you will develop -6.00,-7.00 D ... I have slight myopia, my last exam revealed -.50 with refractor and before that exam I used plus lenses for 8 months in the hopes of "reversing" mypoia but they don't work that way, and they didn't reverse my myopia. More importantly, as many doctors on this NG said wearing plus lenses can cause convergence insufficiency. This can cause compensatory over-focusing (over-accommodation), and often results in a slight amount of pseudomyopia. Wearing plus lenses will also reduce your normal accommodative convergence, leading your medial recti eye muscles to work overtime to keep the eyes aligned. That will cause strain. These are things the trained professionals said on this NG. Be wary about the plus, I am not saying don't use them, but don't you think that doctors would be prescribing them if they really reversed myopia? My Rx when I was 18 was -.50 (right eye), when I was 26, it was -.50 and today I am 28 and it is still -.50 ... Before I turned 28, I used pluses for 8 long months, what did it change, nothing. Depending on your age, my advice, use them for close work but don't overkill... > Hey Jonsy, > [quoted text clipped - 23 lines] > long months, what did it change, nothing. Depending on your age, my > advice, use them for close work but don't overkill... I left the whole post intact so that maybe Otis can chime in about his so called plus therapy from an engineer's point of view. Otis, face it, go to alt.med.vision or some other place. You have no credibiility I would think that engineers are not qualified to give vision therapy, but what do I know since I am not in the medical profession anyway. Allen "More importantly, as many doctors on this NG said wearing plus lenses can cause convergence insufficiency. This can cause compensatory over-focusing (over-accommodation), and often results in a slight amount of pseudomyopia. Wearing plus lenses will also reduce your normal accommodative convergence, leading your medial recti eye muscles to work overtime to keep the eyes aligned." These are points I did not know. Thanks. The question is this, if you have to read for 12 hours per day, what would cause less strain and accommodative myopia for the eye: plus lens, or wearing nothing at all ?. Please, can anyone direct me to a single published article which say that using plus glasses for near-field-work does not stop the deterioration of accommodative myopia ?. Is there any doctor here, who can give me an idea of how I developed my myopia, apart from reading too much ? (taking into account my twin brothen, who does not read at all, has 20/20, my parents were 20/20 until over 40, and my vision was 20/20 until 3 semesters after I started the university). >These are points I did not know. Thanks. > >The question is this, if you have to read for 12 hours per day, what >would cause less strain and accommodative myopia for the eye: plus >lens, or wearing nothing at all ?. > Do you realistically read 12 hours straight everyday, or did you ever have to? Plus lense will not remove the "strain" or your accomodation effort completely, you will still have to accomodate. Considering the side effects of plus, I would use it to a minimal degree, and would take frequent breaks from near work and get good night rest. >Please, can anyone direct me to a single published article which say >that using plus glasses for near-field-work does not stop the >deterioration of accommodative myopia ?. > I am an example, plus lense didn't have any reversing effect on me. Accomodative myopia can be treated as far as I know, but noone here knows you have accomodative myopia. Do you know you have accomodative myopia? >Is there any doctor here, who can give me an idea of how I developed my >myopia, apart from reading too much ? (taking into account my twin >brothen, who does not read at all, has 20/20, my parents were 20/20 >until over 40, and my vision was 20/20 until 3 semesters after I >started the university). > Your eyes adapted to the environment you were in, pretty normal. "Do you realistically read 12 hours straight everyday, or did you ever have to?" Yes, unfortunately, I really read 12 hours a day, during the exam period (which is 3 months for the summer, and 2 months in the winter) though not straight, every 4-5 hours I take a several minutes brake from the books and writings (to go to the computer). "Plus lense will not remove the "strain" or your accomodation effort completely, you will still have to accomodate." read my comment at the end. "Considering the side effects of plus, I would use it to a minimal degree, and would take frequent breaks from near work and get good night rest." Did you personally experienced side-effects ?, did you get eye-strain from the plus ?. "Do you know you have accomodative myopia?" "Your eyes adapted to the environment you were in, pretty normal." So, doesn't this mean I have accommodative myopia ?. What else could I have ?. The accomodation is not over, every several weeks I find it to deteriorate more (especially now at the exams period). I guess that the accommodation will be over, once I can't see past ~25cm (the distance I read the books), this will make me about -4D. I still don't see why using plus won't stop the deterioration. Let's say I use plus in order to project the image from an object at 25cm (the book) to the farthest point I can see now (say, 90cm), so, assuming with the plus my eyes "see" the book from 90cm, and 90cm is the farthest point I can see clearly today, what is there to accommodate any further ?. One more thing, are you sure YOU had accommodative myopia ?, no offence here, but for 10 years you seem to have the same minus number, maybe in your case this is simply some minor genetic defect ?. On the other hand, in my case, my myopia began right after an intense, 1.5 year period of near-field reading, which I never done before, and deteriorated ever since. Dear Jonsy, Subject: Do what Yasar suggests -- just wear your minus lens and forget about "protecting" your distant vision. Prevention is indeed difficult. It takes considerable resolve -- and if you are concerned about any aspect of it -- don't do it on my suggestion. As you know, I believe that it is possible to prevent, based on direct experiments with primates. But that is my judgment after evaluating Dr. Francis Young's work with primates and long discussions with people working in the field. Casual use of a +1/2 diopter lens will have NO EFFECT. So don't bother. Just wear that minus lens all the time -- and don't worry about the consequences. Lasik works, contact lenses work -- don't worry, be happy. Best, Otis Dear Jonsy, Subject: Sorry for the previous post. You are going to here profoundly contradictory advice on prevention -- and not one can tell you what to do about prevention. Certainly not me. If you want to hear some more "interesting" discussions on prevention-with-plus you might click on: http://www.visionimprovementsite.com/ and then click on "forum" for the various discussion topics. Keep an open mind. I would check your own eye chart -- just for base-line information. Enjoy, Otis >One more thing, are you sure YOU had accommodative myopia ?, no offence >here, but for 10 years you seem to have the same minus number, maybe in >your case this is simply some minor genetic defect ?. > No, I had nothing until I was 17. I had 20/15 in both eyes. Those years, early 90's, we didn't have PC's but Commodore Amiga type console computers which didn't have low glare low radiation monitors but high glare TV screens, if I had something hereditary it would have shown up earlier, don't you think? >On the other hand, in my case, my myopia began right after an intense, >1.5 year period of near-field reading, which I never done before, and >deteriorated ever since. > I want to know what are you trying to argue on this NG? You are misdiagnosed? You want to stop myopic progression? You want to use plus lenses? I am not sure what you want to do. "I want to ask you one more time, Are you in a career field that you are required to have 20/20 vision or better?". No, but I enjoyed the ability I had when I was young (and still have to a point today) of being able to move from reading books, to looking at my room, without having to put glasses. This ability give you independence, which I like. "How old are you and when was your last cyclo eye exam and what was the prescription?". I'm 25 y/o. When I was 21, I had 20/20. When I was 23 (3 semesters after I started learning) I had -0.5D, on both eyes. Today, at 25, I still don't know, but the condition is definitely worse than it was 2 years ago (back then I was able to read the computer screen from 2 meters, today I can read the same font types, on the same screen, only from ~90cm). "I want to know what are you trying to argue on this NG?". See my next answers: "You are misdiagnosed?". According to what *all* the doctors/optometrists say here, it is not important if I was misdiagnosed, since the treatment for all kinds of myopia (apart from myopes with esophoria at near) is the *same* : minus glasess or surgery. According to them, there is NO other effective possibility. "You want to stop myopic progression?". If it is possible, then why not ?. On the same sense that there is not point in succumbing to a hearing aid when you can simply preserve your hearing by putting earplugs when you spend much time in a noisy place. "You want to use plus lenses?". Well, if by using plus I can reduce any further accomodative myopia, then why not ?, what am I gaining by not trying to prevent it ?. If all I need to do is spend my 12 hours a day of reading, wearing +2D glasses, and by this preserve what I have left from my long distance eye-sight, then isn't it a crime not to do it ?. Of course, like I thought in the first case, it seems to be NOT that simple, for reasons nobody understands. According to what I read until now, all the eye-doctors, optometrists, and engineers, 100% agree that IN THEORY, accomodative myopia should be prevented by wearing a plus, by the simple notion that there is nothing to accommodate, when you don't have to focus on near objects (and when using a plus, you don't!). BUT, experiments which were published in literature, like the one linked in the bottom of this post, shows that in *real life*, this theory of preventive plus does not work. From a scientific point of view, no one really knows why it doesn't work for accommodative myopia, it beats logic, but still, a fact is a fact. Eye doctors and optometrists live with this fact, and act accordingly (and can anyone blame them for putting their trust on the same scientific mechanism that brought humanity this far ?), while some scientists, seem to disregard the observations done in these experiments, and claim the logic of plus can not be denied, and the only explanation is that these experiments were not carefully built. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra ct&list_uids=6703005&query_hl=1 >No, but I enjoyed the ability I had when I was young (and still have to >a point today) of being able to move from reading books, to looking at >my room, without having to put glasses. This ability give you >independence, which I like. > Hey I enjoyed it too. I had 20/15 at all times, now I have between 20/20 and 20/30 at times but it is not a good thing for a pilot, especially after all those years of good eyesight. My only advice, noone here tells you otherwise, you are free to do so, just go ahead and give the plus a try and you shall see that it will not reverse anything. In the beginning you will see that it helps to relieve accomodation and you won't notice as much blur after close work, but that will diminish also. Use it about a 8 month period like me and see what will happen to your near point conv. Also I don't think you will be able to see at 30 cm with a +3.00, I have only half diopter in my right eye and I can see at 35 cm with a +2.00. Yes I use the plus only for a few hours when I use computer or reading during the day. Not all day long. Dear Jonsy, The +1.25 is a very weak lens. In neuralizes only a small fraction of the "near" environment. The people who have work AGRESSIVELY on vision clearing (from 20/50) have STARTED with +2.0 diopters, and, as the vision cleared (refraction changed) they increased the plus-power to +3 diopters -- and read at the "just bur" point. Further they knew what they were doing, and made OBJECTIVE measurements of their eye chart, i.e., they DID IT THEMSELVES. It make a profound difference when the person SEES THE RESULTS HIMSELF. But that is a major difference. Does the person wish to take over complete control of this "preventive" process. For this reason I don't consider true-prevention to be "medical" at all. You choice, my friend. Best, Otis >Yes, unfortunately, I really read 12 hours a day, during the exam >period (which is 3 months for the summer, and 2 months in the winter) >though not straight, every 4-5 hours I take a several minutes brake >from the books and writings (to go to the computer). > Ok take breaks more often, is this not possible? I want to ask you one more time, Are you in a career field that you are required to have 20/20 vision or better? How old are you and when was your last cyclo eye exam and what was the prescription? >Did you personally experienced side-effects ?, did you get eye-strain >from the plus ?. > Yes, after a few months use of plus, I started seeing ghosting, hazing images on vertical objects, I have not had anyting like that before plus use. Second, during my military flight eye exam, I almost failed the Near point convergence test, I could not follow the object (pen) coming towards my nose from about 3 feet, I could not hold it together when the examiner moved it towards me at a fast rate, I grabbed the pen myself and tried it again and I was able to do it at a slower rate. This is a no-go. the examiner let me did it, but not every examiner will let that fly. This, as two doctors on this NG put out, is a side effect of plus use. >So, doesn't this mean I have accommodative myopia ?. What else could I >have ?. > It appears you had it in the first place, but not anymore. I am not a doctor I can't tell you what you have. But it just makes me think, why don't we give a pair of plus to every kid that starts grade school today? Kindly ask DrG or Dr Stacy or Dr Tyner why accomodation is not completely eliminated with plus use. They have explained to me once and they can explain to you also. Dear John, Subject: Between a rock and a hard place. People are profoundly "different" in how they react to advocacy for "change". If you read my site, you would find a pilot who went through the same thing you did -- as saw slight "ghosting". And you worked very hard at it -- and I appreciate the fact that you did. I read a report by Dave Guyton that stated that about 30 to 40 percent of people with 20/20, have that "ghosting" or diplopia -- but they do not notice it since they always had it. But I would suggest that a person who previously had 20/40 vision, and beginst to "clear" under his own control (monitors his eye chart) might well see the "ghosting" that was always there -- but now that his vision begins to clear -- he begins to notice it. I will post your remarks, and this response on my site -- so that a person working to "clear" with the plus is aware of this issue. Clearly, I considered this issue with my "advocacy" with my sister's kids. Because of the records at West Point, that show that the natural eye goes "down" by -1.3 diopters (1.6 to 1.1 diopters) it is clear that a "trade off" of this nature is very difficult. A person aware of these statistics is simply going to have to make a decision about what HE wishes to do about it. This does become a PERSONAL matter, of evaluating "risks" with benifits. And each person (on the threshold) will simply have to evaluate them as they concern his desire to retain his clear distant vision through a four year college. Best, Otis > I will post your remarks, and this response on my site -- so > that a person working to "clear" with the plus is aware > of this issue. Dear John, I know you know Otis's history, but this is for new comers to disregard Otis's postings. He is not in the medical profession, nor is his site a medical profession website. Please disregard Otis's postings. Thanks! Allen Dear Reader, For some reason Allen thinks he is a "God" of sci.med.vision -- but I don't know why. In many posts I use the term "engineer" to define an interst and curiosity about the dynamic behavior of the natural eye. I have also suggested that only true-prevention is possible -- but difficult. I urge a person (who is on the threshold) to verify his eye chart to determine his legal status, i.e., does he pass the DMV test used in his state. Above all, I believe we should think (abstractly) for ourselves, and develop new "preventive" methods -- that you MIGHT have to implement for youself. I think that the person himself must take a more forceful interest in prevention, including getting the nose off the page (and stop reading at -10 diopters (4 inches) as I see some children do. This becomes a matter for the parents to pry their child's nose OFF THE PAGE. Obviously this has NOTHING to do with the plus lens, but reflects on what the parents should be monitoring with their own children. I think even the ODs would be in agreement with that recommendation. I will make it -- if they will not. Best, Otis > I think that the person himself must take a more forceful interest > in prevention, including getting the nose off the page (and stop > reading at -10 diopters (4 inches) as I see some children do. Dear Reader, What Otis thinks means nothing if he is not in the medical profession. Otis is not in the position to give medical advice on vision prevention measures. He is an engineer, not a doctor. Please see your doctor, rather then read from an "engineers" point of view. Thank you! Allen > I urge a person (who is on the threshold) to verify his eye chart > to determine his legal status, i.e., does he pass the DMV test > used in his state. Of course, once you reach 20/40 you're already nearsighted and it's too late to "prevent" anything. > Above all, I believe we should think (abstractly) for ourselves, > and develop new "preventive" methods -- that you MIGHT have > to implement for youself. I absolutely agree. Because so far we haven't found anything that works, except pirenzepine. -MT Dear Mike, Subject: Limitations of prevention -- both legal an practical. As you state it -- you are correct. You not found anyting that: 1.Will impress the public instantly -- and can be used on everyone without an analytic discussion and review. 2. Can work ONLY if the person himself takes over complete control and "does it himself". John just stated the actual "reasons" why you can NEVER offer "prevention-with-plus". They are subtle, but John has spelled them out completely. Jacob Raphaelson intimated them in, "The Printer's Son", and I think that we engate in endless "academic" discussions whilst totally ignoring the reality spelled out by John and others. Best, Otis |
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