Can myopia increse without induced axial elongation?

So I feel like I should try to give an explanation about what has happened.

When I was 14 I needed glasses, a very small amount of myopia. I had 0.5 diopters in my right eye and 20/20 vision in my other eye. I remember when I was 14 yr I eventually found endmyopia ( when I was 14 the site was not as direct as it is now, it was mostly Jake Steiner’s youtube channel). I did manage to understand some key concepts after watching many videos and reading on the site, and here is what I remember.

1.Do not wear glasses when doing close up work
2.Learn how to Active focus
3.Do not completely stop wearing glasses or you’ll experience “blur adaptation” and your visual cortex will not have any reference to help “clear “ your vision

Well guess what happened, 14yr old me just stopped altogether wearing glasses. I eventually did reach blur adaptation and I kinda “gave up”. I say it in quotation marks because I still did active focus in one eye and I was always clinging on to the hope that eventually I would reach 20/20 in my 0.5 diopter eye. However it was extremely hard, I had to actively focus on one eye closing the other one, and that in most cases was not practical.

The good thing is that I never wore my glasses for close-ups, never, by the time I learned about the fact it had only been a week since I was given my first pair of glasses. I developed an extremely conscious habit of never wearing glasses for close up. So I thought that there was no possible way my myopia increased

But here is my problem. I am 19 years old now, and I just went to the optometrist today after 5 years of not being there since my first eye test. My myopia has increased in both eyes. I have 0.75 diopters in my left eye (the one that previously had 20/20) and my right eye now has 1.5 diopters.

I understand that the reason why we don’t use glasses when we’re doing close up is to prevent myopia-induced axial elongation. But since I have never worn glasses for close up how come it has increased? In theory should I not have pseudomyopia? As in, the length of my eyes is fine. Is it just that my ciliary muscle is “stuck” in “close up mode”?

With my new diagnostic, I really want to press my foot on the pedal and get back to 20/20. Since I am no longer 14 I feel that this time I will take a much more intelligent approach to get there. This time I am willing to wear my glasses and make measurement logs and actually engaged on the site and forum. But I am desperate for this answer. If this is just a product of ciliary muscle spam and do I actually have pseudomyopia instead of induced axial elongation will this mean that I have it “relatively easy”? I know that for my high myopia readers it is easy to reduce your first diopter but the last 1.0 diopter is a pain

I appreciate the time taken to read and respond, thank you :slight_smile:

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I’m too lazy to address the rest but I see this and the first thing that comes to my mind is

Stop looking at things only with your left eye.

Oh and welcome back friend

No, I have never looked at things only using my left eye.

My left eye 4 years ago was 20/20. It is 0.75 as of today. I don’t fully understand why, I’m simply wondering why my non-myopic eye has gained 0.75 (left eye) and why my previous 0.5 eye (right eye) is now 1.5 diopters. Considering I never wore glasses for close-up work ever, add to the fact that I barely wore my glasses in general, it doesn’t explain itself to be myopia-induced axial elongation.

I’m wondering if anyone has had any similar experiences like mine, is this simply just muscle ciliary lock-up spam, i.e is this just pseudomyopia?

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That wouldn’t surprise me at all. I never had a prescription until January of this year, and I’m already back to better than 20/20 according to eye chart, opto, and autorefractor.

You can still get cilliary lock-up or spasm or transient astigmatism from close-up work (even axial elongation), you just don’t have runaway lens induced myopia like a lot of people (which is great!)

The regular EM stuff should work just fine for you.

I personally like and have had good luck with plus lenses for close-up (some people have problems with this, I didn’t experience any problems). I personally like base-in prism in my computer glasses. It can take a while to get rid of cilliary spasm or lock-up. You want to get the screens as far away from you as you can (to edge of blur) and do as much outdoor time and active focus as you can get. I’ve also enjoyed doing DIY vision therapy (but that’s just me, plenty of people here never did any of that and reduce just fine without it.) I love all that vision therapy stuff.

Anyway, without having your axial length measured there’s no sure-fire way to tell whether or not you have any axial elongation already. Certainly the small amount of myopia you have right now could be entirely cilliary-lock up and not axial yet.

If I were you I’d watch all the low-myopia and last diopter videos and try those methods. Walk around at night once in a while with full correction to get used to total clarity and try to reset the blur adaptation.

You’re not in a bad place right now, probably you spared yourself several diopters of additional myopia already.

If I were you (and you haven’t already) put up an eyechart somewhere and check yourself throughout the day and see how you’re doing. For me even 10 minutes of smartphone use trashes my eyes for an hour or more.

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Peep this math real quick though.
Upon first glasses receipt, Left eye 20/20. Right eye from 20/20 to -.75. Right eye is worse than left eye.

Upon second glasses receipt. Left eye increases by -.75. But Right eye increases by -.1

You only need one more data point for this to be a pattern of your right eye being worse off than your left eye.

You might be slipping with your right eye and you don’t even notice.
I would really think about this. Maybe you tend to only give people your most attractive side of the face, the left side. I notice you got a guitar in your picture. Maybe when you play the guitar you look outward with mainly your left side.

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Remember, not wearing glasses for close up isn’t enough. Holding a book at 50cm is a bit hard since it’s so far. But that’s already 2 diopters from infinite. In other words, if you spent tons of time reading books, your eyes might try to make that your relaxed eye distance that distance, in other words, myopic to that point.

That is why phones are so bad, at the usual 33cm or so of distance held from the face, that’s 3 diopters to see the screen clearly (vs infinite). I could easily see someone doing phones all day getting at least 2 diopters myopia from that.

And even without phones, homework on a table is what, 40-50cm? 2 diopters?

There are only two solutions I know of. Either break up closeup time to small times (and get good long distance viewing time, e.g. the 20/20/20 rule) or use plus glasses.

Not using glasses for closeup is good as it can limit progression. But to prevent it requires other approaches.

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We got to get rid of this myth. Jake brings this up too. It’s so bad for normal functioning. When the optometrists recommend it that’s how you know it doesn’t work.
Huberman’s "Distance Viewing For 20min For Every 90 Minutes of “Close Viewing”
^This is the way

And even Jake has mentioned this. You can get sufficient gains even as a cubicle worker, if you are getting enough good vision time as compensation. 2 hours or so.

Just thinking about the evils of phones and their promotion of ADHD-like symptoms, and creating a vision version of that, my god, cringe. Down with the 20/20/20 rule

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Or wear plus glasses or the appropriate differentials.

I’m an office worker, working 6-8 hours a day every weekday in front of screens 60-70cm away. Yet over two years I have dropped my full correction down from -4.75 to -3.0. I spend hours on the weekend staring at a phone that’s 35-40cm away. My only distance time is driving, and that evaporated with work-from-home due to covid. I got my gains because of good correction management (and active focus). You do not need distance time, there are alternatives.

20/20/20 or two hours a day at distance, or whatever. The point is you are either driving the myopia direction autocalibration mechanism, or the hyperopia mechanism, or a combination. If you insist on focusing closer than relaxed, you have to make up for it with activities that induce the opposite direction calibration.

That’s what makes the last diopter so hard for most people. They don’t want to use glasses and/or are afraid of plus glasses (for closeup only of course, don’t use them for distance). So they spend more and more time close-up accommodating as they get closer to 20/20, which slows them down. It can work (with sufficient distance AF to counteract and exceed the myopia stimulus), but it will make it take longer, and is not feasible without distance work. However, good prescription choice (including plus glasses) is an alternative that should work well even with the final diopter (or beyond).

At least that’s my theory. By my calculations, and given the surprisingly steady and predictable improvement rate I have (0.25D each 110 days), I will find out in 2024 and 2025 if my theory is right! :slight_smile:

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I think myopia can increase because of bad habits and blur adaptation- even if you don’t wear glasses for close-up activities.

In my case, my right eye was -1.5 when I first got glasses (my left eye is 20/20).
After about 4 months of getting glasses, I stopped using them for about two years (because I didn’t like them and I was afraid of how others might react).
After this two year period, my right eye worsened to -2.0 (later it became -1.75) but my left eye stayed the same at 20/20.
I think the reason why my right eye got worse is because without glasses, I’m only using my left eye to see things.
Thankfully my right eye only stopped at -1.75 since I decided to start using glasses for distance again 14+ years ago.

Majority of people with glasses now started out by not wearing glasses at the beginning and then it just “happened” to them that their eyesight deteriorated.

As the others said: not wearing glasses close up is not enough in itself.
You have saved your eyes from lens induced myopia but with lack of other good habits you could not avoid the habit or lifestyle induced myopia.
Did you spend a lot of time looking at the smart phone screen and also at other screens? Did you always push the close up texts / images to the max distance of clarity? to arm’s length? Did you have good lights around you? Did you have regular breaks? Did you have non-screen activities that required your eyes to move around? to change focal planes? Did you raise your eyes higher and further than the monitor? and did you make sure you maintain the reference of clear vision?

Fully disagree. You won’t be able to follow a live game in a stadium uncorrected if you never practiced looking at that distance. Same way, clear text at a Snellen at 6m won’t equal clear text at 20m or 50m.
But if you exclude distance vision from your life, you can match your uncorrected vision with your lifestyle distances and declare the improvement to be enough for you.

As discussed in other threads already, EM for me means living life glasses free. While what you are proposing is to shift the last diopter and have “plus glasses for close up and no glasses for distance” instead of “no corrections close up & -1D for distance”.
Why would you rely on glasses if you can get your eyes working on a wider range of accommodation, too?

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Depending on how you have to spend your time, you may be in front of a screen 10 or 12 hours a day (or more)–surely an unnatural act. A healthy eye can accommodate at its maximum for a few hours per day (maybe less) before it’s exceeded its natural limits and is triggering the myopiazation response. Plus lenses are “eye protection” for all that unnatural close-up.

Just like healthy ears can hear very loud sounds and very soft sounds (and you want to keep your ears healthy) if you got a job at an airport or nightclub or firing range you’d need to wear hearing protection or you’d start going deaf. If you work as a researcher or computer programmer or at some job where you’re in close-up mode almost all the time you probably should be using plus lenses for some of that.

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Yes, that’s me, too. And I still believe and promote total glasses free life as the ultimate target :relaxed:

I don’t like limiting what is possible. I don’t see it as computer OR outdoor activities. Plus glasses OR minus glasses. It should not be “either / or” when thinking about the final state of vision.

If you have a good work setup and can get the screen far enough away you can probably get away with it. I never had any problems until I started using a laptop during the Covid lockdown.

If you keep pushing your natural vision further you may eventually get to a place where you’ll notice you drop from 20/10 to 20/13 if you do a lot of close-up without plus. You could go glasses free all the time but you probably can’t do lots of computer work without glasses AND get your full maximized natural distance vision.

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As @jakey says and I fully agree with it: It’s not the 6 to 10 hours spent in front of the screen with work or studying (even if totally unnatural compared to the lifestyle in the 20th century and before) but the other 18 to 14 hours that matter more. That’s what people should be focusing on for real improvement. And, yes, that includes a good and relaxing sleep, too, plus all of the non-work time.

There are various studies on recovery outcomes showing that people do not improve beyond the point they can imagine as possible for their condition or just possible for themselves. Be careful where you set your limit. Your imagination might be more limited than what you are capable of. That’s all I’m saying. (Note: it is a general “you” for everyone)

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I was thinking about your goal a moment ago in the shower and there’s nothing wrong with having that as your goal (being completely glasses free) and in fact you’re already there (I think). Or at least you’re at the stage that if a whirlwind came through and all your glasses disappeared you wouldn’t be in any danger or have any real trouble.

Depending on what you want to do there are other goals (related to eyesight), and I don’t think it’s either/or thinking or limiting if you see a role for glasses to help achieve those other goals. Glasses are just a tool and you can use them or not. It just comes down to your personal philosophy.

I want to use the word “puritanical” but I can’t think of any way to use it without sounding like I’m making fun of you, so I won’t use it. :stuck_out_tongue:

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(How about this wording? :stuck_out_tongue_winking_eye:)
I can totally admit that I have a bias and preference for natural and simple solutions.
Ready for a whirlwind :sunglasses: (even without the sunglasses :sweat_smile:)

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My vision got worse too without wearing glasses so I´ve been confused about this too.

I think it just means you had really bad habits.

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I totally admire and understand your desire to be able to go glasses-free once back at 20/20.

I did that for nearly 10 years in the 90’s (via contacts for correction, but glasses free nonetheless). I had headaches and eye strain for much of that, especially once I started working in front of a computer all day (and playing video games on PC’s in the evening/weekends). I found in 2002 when I first did an EM-like thing that if I used what we call differentials (plus glasses at the time since I wore contacts), my headaches and eyestrain went away. I’ve used reduced-strength glasses for all close-up since then

That was a huge quality-of-life changer for me, not having debilitating headaches/eye strain, while still being able to do my software engineering full-time.

I will not give that up when I’m at 20/20. That is why I will use plus glasses for PC work (and even any significant phone time) once my eyes are no longer myopic.

Sure, I could go without glasses, but the headaches and eye strain pain is simply not worth it, especially when a simple pair of glasses that I only use for close-up will prevent them completely.

As an aside, it was the realization that I’d always need glasses for part of my life that led me to quit my EM-like process back in 2003. What was the point, I thought, of going back to 20/20 if I still need glasses (for headache control) most of the day? I’d even lose my super-macro closeup vision! This logic also helped save me from considering Lasik, which I am grateful for!

But your goals are different, and I guess you don’t have the eyestrain/headache issue, so I’m jealous :slight_smile:

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