-1.00 Moderate Astigmatism

Hello Forum members,
I have read a lot about astigmatism in the forum, blog and FB group. People have different ways to resolve this. I need a bit of guidance. Not asking for Diopter specific advice, all I want advice is how to eliminate moderate astigmatism. I ask for reduction strategies. I went to an eye specialist and they said I have -1.00 cyl in both eyes. I asked them to increase my sph by 0.5 and it felt bad and letters were off. With -1 cyl, letters were good and crisp. So I know spherical equivalent won’t work for me. I need advice on how to go about with cyl reductions with mild astigmatism like mine. I’m thinking I should equalise my sph diopters first like jake recommends on his blog. I feel then I should reduce .25 cyl and keeping sph diopters same once equalised. I need help from experienced cyl reducers on cyl reductions. For example, does reducing cyl by .25 increments feel good, and is active focus easy with them? Is ACTIVE FOCUS the same with cyl reduction like sph reductions?

My long “road to emmetropia” journals have a lot more, but here’s my non-diopter specific advice.

Doing a trade of 1.00 cylinder for -0.50 sphere is way too much of a focal plane change. The most I’d recommend is 0.50 cylinder for -0.25 of sphere…that’s why it was way off for you. A much better approach is a 0.25 drop per the reducing complexity post.

I’m assuming you’re in moderate myopia or more (in the -2.00+ sphere range). If so, then start by dropping some cylinder out of your differentials. You could probably get away with 0.50 or 0.75 (that’s about the difference I carried most of the time between normalized and differential).

Cylinder/astigmatism didn’t seem to reduce for me with just normal active focus. I ended up having to challenging my ciliary muscles with two types of activity. The first was related to my axis. Since I have basically axis 180, it means horizontal lines are hardest to see, followed by 45 and 135 degrees (diagonals). I looked for these and tried to clear them. I also found an app called “Astigmatism” on the Google Play Store (unfortunately, only works on Android devices). At peak, I was doing these exercises for five minutes a couple times a day.

I found when I was working hard on cylinder like this, I found that vision is very sensitive to the cylinder correction. I had to clear a lot out, which then made it hard to see. A slow, moderate approach is a lot better, if not easier to take emotionally.

Good luck with your reduction in cylinder. It’s not easy, but it’s definitely worth improving it, as clearing cylinder helps spherical gains to come a little easier.

Kent

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could I not do the trading thing and and just reduce astigmatism incrementally without reducing sphere once I equalise. I was thinking if I do that I could make small .25 gains with regular active focus once I equalise.

If I understand this, you’re saying, forego the cylinder for sphere trade; just reduce cylinder incrementally. That is a good approach. Typically you don’t need as much cylinder in differentials as in normalized. That’s one reason to start lowering in differentials ahead of normalized. You do want to keep the difference the same, i.e., let’s say you have -1.00 cylinder in one eye and -1.25 in the other–both should be reduced by the same amount.

Jake suggests reducing the cylinder before equalizing. He also suggests working on differentials first. Of course, he also says to intersperse sphere drops between rounds of cylinder, and I agree with that strategy.

I was a half diopter off and it drove me crazy, so I equalized in amongst spherical and cylinder drops. I learned from that craziness that it’s so much better to work the plan ever so gently, and to really let changes settle in. It makes the next step easier, too.

As I mentioned, AF and cylinder challenge are two different animals, at least in my experience.

Doing .25 changes at a time is good strategy. I still recommend starting with the differentials. I also recommend test lens kit. It sounds like your opto is open, I’d go back and ask for a minimum cylinder differential prescription and have her help you with that. It’s worth the cost to know your close up prescription is a) not too strong and b) not too weak.

Okay sir, thanks. I told her to reduce 1.5 for my diffs when I had my eye exam and she did it. I think she dropped the astigmatism completely for those. I’ll tell her to maybe increase my astigmatism for differentials one day if she can. For now its fine because my laptop is placed on a table right next to my window and in natural sunlight my -1.00 astig in both eyes does not affect me even a bit. It’s only at night when I read small text I get heavy ghosting on it. Although I have noticed that e.g if your sph is -4.00, you could see letters clearly at 25cm with ghosting in indoor lighting but if you go nearer to text than 25cm e.g 16cm the ghosting goes completely altogether. I only noticed that last night when I was reading a shampoo black bottle, which had small white text on it. If I got closer than 25 cm the ghosting vanished. Just a tip for the astigmatics.

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