Can't figure out if I'm getting eye strain or releasing ciliary spasm

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.

1 Like

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.

1 Like

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).

2 Likes

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. :thinking:

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 :slight_smile:

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 :slight_smile:

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 :smiley: 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. :slightly_smiling_face: 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. :dizzy_face:

Unfortunately (or fortunately for me :slight_smile: ) 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.

1 Like

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 :astonished:). 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. :wink:

1 Like

Thanks, it was interesting :slight_smile: 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 :slight_smile: 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.

1 Like

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.

1 Like

No worries :smile: I’m happy to read these kind of discussions. Thank you & everyone here for being super nice and helpful. Thanks for taking the time out of your busy day to answer my questions. :blush:

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.

Thanks for sharing that article @Ursa. It’s interesting to see other unrelated uses of the 20-20-20 rule :slight_smile:

One thing I noted is that it was designed to relieve computer-related eye fatigue. I have also been using a similar technique (20 sec typing break every 10 min) for years to prevent repetitive stress injuries (i.e. arms/wrists) during my work day at the computer.

While there may not be specific studies around this, I think it’s fair to assume that our bodies are not meant to stay completely absorbed in the same task for hours at a time.

1 Like

Good idea :grinning: I think that’ll definitely convince me to walk away from my laptop more often. For me, sitting down just induces laziness from moving away from my screen.

1 Like

Hello. :slightly_smiling_face: I just wanted to give a quick update on my progress since I first posted this topic. It’s been a little over 6 weeks since then.

Today when I patched my nondominant left eye towards the Snellen, not only is my double vision gone, but it actually stayed that way after blinking! For once my left eye can see the 20/20 line clearly, without it turning double or looking like I had some extra astigmatic blur! That really is a big step for me!

Even though I’m excited, I’m aware that I need to see whether or not it can consistently stay that way. So I probably will continue to wear these normalized for another week or two to see how it goes.

Cheers :blush:

4 Likes

Fantastic news!

6 weeks is a good amount of time. You could be close to reducing.

In regards to when to reduce have a look at this thread.

It starts with my comment and some talk about ocular dominance but then David and Jakey then start talking about best practice reductions. This has been the best source of info on that topic I’ve found anywhere.

2 Likes

Thank you! :smiley: This is gold~ :raised_hands: :trophy: