I’ve been doing some patching for my non dominant left eye (which is currently stuck at 20/30 on the Snellen) to catch up to my dominant right eye (now at 20/20 on Snellen; yay! ) before I reduce. When patching, sometimes the entire Snellen chart would look fuzzy, other times I got to that very-annoying-and-stubborn-double-vision-phase. There are a few times that I did resolve the double vision, but it takes effort, and it goes away after 3 to 5 seconds.
Active focus is certainly working & helping it become easier to clear day by day, but my left eye will start to feel sore, especially near the inner part of the eye. (Tears can happen, but not much these days.) I’m not sure if it’s because I’m overdoing it or perhaps I am releasing years of ciliary lockup. Does eye strain pain and releasing ciliary spasm pain feel the same? If they feel different, how so?
Im not sure actually. there are alot of people on here that may know this.
I haven’t heard of ‘releasing ciliary spasm pain’ before.
I mean you’re eye may hurt from eye strain WHILE you’re trying to release your ciliary spasm. But I’m not sure that means that there is pain associated with essentially relaxing your eyes…
There seems to be some misunderstanding about ciliary spasm, and for how long the ciliary muscle can be ‘locked’ into spasm. Usually ciliary spasm is temporary and although it may take longer for the ciliary muscle to release in people who habitually engage in long periods of close vision, at some point it releases, although perhaps not fully. It would certainly release during some of the sleep stages.
Pseudomyopia is temporary myopia created by the inability of the ciliary muscle to relax easily and quickly, but this can be controlled for by cycloplegic drops, which make it impossible for the ciliary muscle to tense, so giving the real refractive error.
Ciliary spasm can also be a more permanent condition, but one would certainly know if this is the case, as there is a massive disconnect here between the refractive error as measured by the autorefractor and the perceived refractive error. This needs treatment. It also seems to be fairly rare.
I have rabbitted on about this before, and also linked to this entry, so perhaps I should shut up now, but it still alarms me when I read about ciliary muscles being ‘locked up’ for years. I am not discounting the possibility that some residual habitual ciliary spasm can be released at the start of EM, but this is more likely to be the result of not overcorrecting for screen distance and reducing close vision time.
I think the pain is more likely to be caused by excess efforts to AF rather than anything to do with ciliary muscles. I have failed to find anything online that could show a link between the relaxation of the ciliary muscles and pain, but of course absence of evidence does not mean evidence of absence, so if anyone finds anything interesting on this, I would be happy to read it.
Looking back on it now, it could be both: probably I was unaware that I had ciliary spasm (since my left eye is usually blurrier than my right), and then when trying to AF at a distance, my left eye strained.
I’ll admit, my differentials are useless right now; both eyes can see super clearly at my laptop screen that’s placed more than my leg’s length away! I want to reduce them, but I am afraid to do so, since my left eye hasn’t reached full clarity on the Snellen when using my normalized. I’m not sure if introducing my next differential beforehand is a good idea. Maybe I’m being too careful?
I’ve thought about getting a normalized that’s 0.25 diopters stronger, but then there’s no blur challenge. That’s why I’ve been patching instead.
This probably means that I should take more breaks from my laptop, and start learning how to type with my feet…
If your diffs are useless it is probably time to get new diffs. They may have been too strong to start off with.
Norms without blur challenge are also useless.
Whether you should be tackling your diopter gap now or can leave it till later depends on how high your myopia is, and how big the diopter gap. Patching seems to work for some people, and not at all for others.
While I think you are totally right, on the other hand practically it’s possible to have ciliary spasm “for years”. Not in the sense that the muscle locks up once, and stay locks for years. Most likely if nothing else, then sleeping will release it.
But, if you have overcorrection for your usual viewing distance (which can be even a 20/20 correction if you spend 12 hours a day in close-up on phone / computer screen) and you always wear that glasses, then practically you are constantly in a locked-up mode. Especially because for many people they wake up, put on glasses, checks phone for 10-20 minutes. If they don’t wear an undercorrection then it won’t release after it, because practically infinity is brought to the edge of accomodation distance, so anything closer than that need accomodation, so need ciliary muscle activation. And during the day they make it worse with additional close-up. And even if they do distance, it won’t (totally) release. Yes, most likely it will release while sleeping, but then it starts again.
So in short, no, I don’t think it’s possible for the ciliary to spasm once and stay in spasm for your whole life. But it’s possible that you spasm it early in the morning and then it stays in spasm for the remainder of the day. Not because it could not relax, but because you give no opportunity for it to relax.
For reduction you should only care about the distance where you use them. It doesn’t matter what you see in the distance with your normalized when you are thinking about differential reduction. Just reduce the differential if you are sure both eyes can see clearly with them in close-up (and obviously don’t reduce the normalized, but you shouldn’t do that at the same time anyway. Except for equalizing reductions, but that’s a complicated topic anyway).
Unless one lives in a box without windows only big enough to contain your laptop on a table and your chair, one will engage in vision at different distances during the course of the day, and this will ensure that the ciliary muscle relaxes to some extent, if not to the full 6m and further range of vision if one’s home is rather small. Just shifting one’s vision from phone distance to computer screen distance will bring about a change in accommodation and therefore a reduction in the tension of the ciliary body. I should imagine one would look through a window occasionally.
You would not even be able to focus on anything outside of your screen distance range without relaxing the ciliary muscle. I am sure you can find the kitchen, bedroom and bathroom well enough with your differentials, and probably even without glasses unless you have very high myopia. The fact that you cannot see clearly at those distances does not mean that the ciliary muscles are not fully relaxed (or close to it).
What do you think the 20/20/20 rule is for if not to relax the ciliary muscles? I remain to be convinced of ciliary muscles being ‘locked up’ even for the course of 12 hours.
To some extent, yes. Fully, no. With full correction infinity is at your edge of blur. It’s not possible to look farther than the infinity
The intent of the 20/20/20 rule is to relax your eyes, the official recommendation doesn’t talk about ciliary muscles (and Jake doesn’t recommend the 20/20/20 rule). I could only find mentioning dry eye.
And as far as I know there is no scientific base behind the 20/20/20 rule, except for maybe epidemiology studies. But I could not find any study regarding it.
My personal opinion is that the 20/20/20 rule simply do nothing
Neither could I, only an article deconstructing it. But I still think it is a good idea to change focal distance regularly. The main point might be to relax the eyes (whatever that means) but it also definitely relaxes the ciliary muscles.
It would be pretty easy to test though. Just get someone who wears full correction glasses, and do a usual office job and uses mobile phone heavily. Then give them cycloplegic eye drops random time a day (it takes 7-8 hours for the effect to totally vanish, so you cannot really check multiple times one day), and check visual acuity. If you find that there is acuity change in any given moment, regardless when you did the test, then practically they have ciliary spasm for the whole day. If you can find a period where there is no acuity change, then there were no spasm. We just need to get some volunteers I suspect this test would be interesting even for “Endmyopia students”, because I suspect many people have spasm more time than they think.
Totally agree. The premise is good, I only have problem with the exact rule. I think 20 minutes is not frequent enough to have effect. And 20 seconds is too short to actually release a ciliary spasm if it’s already formed.
That makes sense. Does this also apply to a cylinder reduction? I’ve read that for cylinder it’s trickier and longer for the eyes and brain to adapt, so I wasn’t sure if getting a cylinder reduction in my differentials while dealing with patching in normalized would be too much on my eyes and/or brain.
Unfortunately (or fortunately for me ) I have never had to deal with equalizing, neither with astigmatism. So I cannot really make any recommendation. But yes, generally the differentials and normalized should have the same diopter gap and the same complexity. But as I saw in other people’s report, there is no consensus which is the “ideal” way. Also not sure what Jake recommends.
I was going to suggest something similar, just to test the hypothesis. If one finds a really big difference in visual acuity between non-cycloplegic and cycloplegic measurements, the solution usually offered is vision therapy (or psychotherapy ). I suspect the difference for most people would not be that alarming.
I do not spend hours and hours in close vision and find, quite surprisingly, that at screen distance it is better at the end of the day.
This is the article on the 20/20/20 rule, just in case you have time to waste.
Thanks, it was interesting So my hunch was right that the numbers have no scientific base. But at least there were some experience base. I still think that it should be a much lower number to not just reduce, but eliminate the problem. More like every 5 minutes look somewhere else than your screen. But then you cannot use that as a “rule”, it should be more like a habit.
Also totally offtopic and totally unicorn farming, but I still have a hunch that somehow using peripheral vision (instead of tunnel vision) is the key of healthy close-up habits. And not using peripheral vision and just totally concentrate on central vision* is the main cause of close-up strain and ciliary spasm (and so indirectly myopia). But I simply can not get myself into the habit correctly to test it And obviously have nothing to support it, except for some anecdotal experiences.
*we have a phrase for that in Hungary: “belenőtt a monitorba”, literally: “he/she grew into the screen”. It used when someone is so occupied with whatever happens on the screen that they don’t notice anything else.
Nice one - that only happens to me with books.
I think there is something to your peripheral vision hunch. I have a small laptop screen, and a large area of peripheral vision potential around it, especially in my very large living space… I cannot see only the screen, even when I concentrate on it. There is still plenty of input from the periphery, and as I am not ‘working’ or meeting a deadline on the screen, I look away from it through the big windows and to the mountains very often. Also no glasses with frames to cut off the periphery from central vision.
I am sorry that we seem to have derailed your thread somewhat. Although I have astigmatism in both eyes, a great deal more in the left than the right, I do not use differentials, so also no cylinder correction at sceen distance. Here again, it will have to be trial and error on your part, although other forum members might share their experiences with this.
Agree with Ursa’s points that consider reducing if both eyes are getting too comfortable.
My interim suggestion would be. Can you stand up and work? I work at a standup desk and its much easier to adjust from 60-70-80 cm. I’ve found standup desks are good when you’re at the end of a pair of differentials because you can stand back and outstretch your arms more easily and comfortably. But only an interim solution until you get your new Diffs.