Denise Skidmore, Part II, minus over minus plan begins

The original thread, Denise Skidmore, From -17D is getting a bit long…

So summary for those of you just joining that don’t want to wade through nearly 600 posts, I’ll bold topics so you can skim if you already read the other thread.

I got here from researching LASIK (on a bargain), then contacts, then EM. It didn’t sound like LASIK (+IOL because neither procedure is strong enough alone) was going to improve the quality of my vision over glasses, and had more potential side effects, but I was encouraged to try contacts as a preview, and in researching those I happened across someone daring to mess with her own prescription… I research stuff all the time as a hobby and have done self-experimentation in other fields before…

My last manifest refraction I have record of is a spherical equivalent -17.5/-16.75. If I went down at 0.75 diopters a year, I’d be 24 years in the process, and the number of people on this board that have made consistent gains over multiple years is pretty low, there’s a high chance I’d backslide at some point and not make it in 24 years. I’d be an old woman fighting retina damage, cataracts, or glaucoma before getting my eyes to 20/20.

I’ve also learned that what I consider half blind may be what most of the rest of you see all the time. I have a best corrected visual acuity at distance close to 20/20. I can get 20/20 in the right eye and binocularly. My left eye has an “unfortunately placed” vitreous detachment it is hard to see through. My near vision however, is approximately equal to a 5x magnifying lens. I just need to accept that that level of near vision visual acuity isn’t obtainable at distance due to visual angles and the resolution of the rods/cones on the retina. I need to back off to a healthier viewing distance and accept the lack of clarity if I want to stop progressing. I may be able to train my visual cortex to pull out a little more meaning at distance vision without that level of fine detail.

So why am I even here if I know I’m not going to succeed in getting to 20/20, and I don’t want to give up my awesome close inspection vision?

  • I want to stop progressing. The side effects of my current lenses are bad enough without making them stronger.
  • I want to stop having eye strains and headaches every time the doc gives me a new prescription.
  • Indirectly: I want to cut down the vertigo and increase the peripheral vision (this is brought about by wearing contacts, not EM directly)

Challenges at my level of myopia:

  • Cm measurements are unreliable. A two tenths change in cm measurement would be a quarter diopter change.
  • Vertex distance is a bear. The difference between my contacts prescription and my glasses prescription is about 3D. Even if cm measurements worked for me, I need to do more math.
  • Vertigo is a bear. I can’t even tolerate an adjustment to my frames in the same lenses, it will take me a couple weeks to adapt. Switching glasses is not something I’m comfortable with. I have experimented with “defocus” lenses, a prescription considerably weaker such that I can’t see the floor clearly does not cause vertigo, but lets me see well enough to act like a sighted human.
  • Refraction is unreliable. A 2mm adjustment in the position of the glasses on my face would change my reading by more than a quarter diopter.
  • Glasses are expensive. Even normally cheap zenni glasses in the lowest index of refraction they’ll let me choose, there’s a surcharge for the custom work that my high prescription demands. I’m not going to just be able to drop $20/pair, I’m looking at $40-$90 depending on how heavy I’m willing to put up with. (Not even the recommended index of refraction, but the highest that they will do a spherical grind on.)
  • Contacts have a limited selection. My doctor was only able to get his hand on two brands that might fit me at my strength. He’s not perfectly happy with what he ended up fitting me in.
  • Contacts in my range only come in half diopter increments.

Challenges with the rest of my life and EM:

  • Near work pretty much defines me, that’s how I got to be so myopic.
  • I’m partially disabled, so long walks to do AF are not going to happen.
  • I live in the middle of nowhere, even if I did take an AF walk, I’d encounter not many street signs.
  • I’m way too easily bored to just AF off the edge of the deck if I wanted to “pull sheep” or “pull trees” the way Hannie does “cow pulling”.

What I’ve done so far:

  • I’ve started wearing contacts. This base sits at 0 mm vertex distance, reducing issues with vertigo, peripheral vision, and reliability of measurement. I’ve found getting the contacts out challenging, and I need the wetting drops 2-3 times a day, but overall they’ve been nice to wear. These contacts are prescribed by my doctor and are a bit strong in the left eye and a bit weak in the right eye (-13.5/-14).
  • I now have differentials, which relieve my strain at the PC.
  • I’m trying to improve my vision habits, especially with using workrave to encourage me to take more breaks from the computer.

Ok, so now we’re up to the current day. I got new -12 contact lenses in the mail this week from http://www.saveonlens.com/. I had a little trouble with not getting my confirmation number, but customer service was able to send me my info and the lenses did come, and they look like authentic CooperVision products. They are the same material, base curve, and diameter as my prescribed contacts, but just low enough in diopters to be the less expensive branding. (Biofinity and Biofinity XR are similar enough to share a package insert, but the difference is $24 a box.) I did a reading distance subjective refraction earlier this week and a 10’ Snellen subjective refraction today.

Refraction results
Driving: -12 contacts + -2 glasses / -12 + -1.75
Computer: -12 + -0.75 / -12 + -0.5

If you’re paying attention, that lens combo has reversed the diopter ratio from my contacts prescription, but that is more consistent with the manifest refraction for glasses and 3 prior pairs of glasses. I wasn’t going to complain much at the time if I could only get the right eye under-prescribed, I was willing to keep that. I wonder though if my prescribed lenses would be more useful swapped, I’d see 20/20 on the right and be only a quarter diopter under-prescribed on the left.

9 Likes

I think just using differential is enough for this. At least it was enough for me during the 2 years I already had them, but did not deal Endmyopia otherwise (so no improvements). Before that my eyesight got blurry a few months after a new prescription.

If axial length is behind the improvements then the initial improvements may be faster. Because the eye don’t improve from diopter, but (in this case) improve from axial length which is a pretty much linear process. The diopter is not, which is may the reason why at low diopter the improvements are looks slower. So I can totally imagine that going below 8-9 diopter can be done much faster than the 0.75 - 1 diopter per year. But of course I have absolutely no experience with it. I don’t know if @jakey ever saw improvements from such high diopter.

3 Likes

The downside is that this shows no objective improvement in my first 2 months. I’d already said i didn’t think I had a lot of ciliary spasm, that it only took a few seconds for my eyes to adjust when putting on strong readers over the contacts.

1 Like

Yeah I also didn’t have too much either as I wore some weaker lenses at the computer as they were more comfortable, but I still had SOME

1 Like

I feel a bit more comfortable with the differentials, but if I’ve improved it’s less than a quarter diopter. My cm measurement to clear the double vision says I need even more power than what the doc gave me…

Still hemming and hawing about a pair of after-contacts glasses. I can’t dial in an exact prescription without the vertex distance of the lens/frame combo. I can’t get that vertex distance without ordering glasses. but maybe I don’t need an exact prescription, maybe I should shoot low and not try to get them useful for anything but getting ready for bed and daybreak doggie doodie duty dawdles.

For you it’s extremely hard to get the differentials right,as you explained. It even took me with much lower prescription several months. But once you get it right I’m sure they’ll help more than a quarter diopter. Maybe forget the measurements just try to find the lowest diffs that can work for you at your most common close up task the weakest you can tolerate without perpetual strain.

It might even be easier for you to just do a few rounds of differentials reduction until you find a stable lower limit before even considering normalised

" the average vertex distance of spectacle lenses that are fitted properly is 8-12 mm." I don’t stand a chance of getting the prescription right blind ordering lenses. Better too low than too high, and my face and frames on the small side, so if I calculate with a 7mm vertex distance I should be on the safe side?

Yeah, I’ve got to start somewhere. Thankfully vertex distance isn’t so much of an issue when the contacts are doing the heaviest lifting. I’ll give this new setup a couple months for my workday setup, I may tweak my weekend setup meanwhile.

What piece of media has impacted your life the most? reminded me of Paradox of Choice. I’m not going to obtain any more knowledge than I have now on this topic without just buying the glasses. Time to plow forward. Differentials @ 7mm = -14/-13.75 … bought…

2 Likes

Somehow I missed David’s post when he made it.

Just contacts + differentials + being able to understand and control my own refraction is a huge benefit to me. The research on youth says that this will slow progression, although not necessarily stop it. There’s very little research on progression in middle aged adults.

Not seeing it yet, but I’ve not really found active focus yet either.

1 Like

I’m not sure I’d really benefit from normalized. My best corrected visual acuity isn’t above 20/20. I spend 1.5 hours on weekdays driving, I’ll want close to 20/20 then, and I’m wearing differentials most of the rest of the time.

Today I was wearing just the -12s for awhile. I had to pull my computer monitor closer, but i was pretty comfortable walking around the house and taking the dog outside. I might want more after nightfall or when running the tractor…

So far the -12s have been a lot easier to get out of my eye, they fold much easier, but I’ve not tried a 13 hour day in them yet which would likely dry them out more. The contacts tweezers still do nothing, just slide right off, I think those are going into a craft box with my beads or something…

Unpopular opinion here maybe, but I don’t get why 20/20 should be the the destination. It is simply a subjective standard, emmetropia is not a defined point, it is somewhere around that point that is different for every single person. People seem to treat this as a sort of race or marathon, and it’s neither, because as I see it, there is no end goal. You can stop wherever you want and call it a win, you can keep going beyond 20/20, it is a journey of self-discovery and emancipation from mainstream eyecare, yes, but to each their milestones. Simply getting down to the single digit myopia is a dizzying change in life conditions; glasses become cheap and vision much more stable behind them, or you can get perfectly by with only contacts. Going from high myopia where one can’t go wash their face without glasses to moderate myopia where one can drink their coffee before needing to put lenses on; those two people are living wholly different lives. I started at -2, and I don’t think even getting back to 20/20 can make that much of a difference for me (though it will very much make a difference I am intensely looking forward to)
Even then, my current goal isn’t even 20/20; of course I want 20/20 but that is a milestone I’m not looking at at all for now. To me right now I just want to get rid of all this ghosting I experience, I am yearning to just see blur, like a plain, blurry moon at night, and not three of them.

Best of luck to you, I’m very much looking forward to your improvements!

6 Likes

The reduction of a large cluster of them to just 3 of them is already a win for my left eye. My right eye is more modest, and has only ever seen two of them, and they have moved closer together.

If you are counting on EM to eliminate your astigmatism, you may have to drop the hypothesis that this will be the result of axial shortening. The cornea needs to be remodelled, and although I do not exclude the possibility, I cannot see the mechanism for that so clearly. I wouldn’t mind so much carrying the astigmatism with me if I could reduce my left eye from -4, -1(likely more) to the last diopter range. I am happy enough with my -1,-.25(possibly a little more) right eye.

My latest measurement for the left eye seem to be showing an improvement in sphere and a ‘deterioration’ in cylinder. My first point of astigmatic ghosting refuses to budge, but I can get a clear enough main image a cm or 2 further out. Is this useful? I have no idea. We fumble on. :smile:

1 Like

I’m not sure like for example I don’t measure too accurately but I’m sure mine is at least 15mm

This might be OK. How close is closer? As long as you wear lenses to get 2020 vision regularly as you say, you won’t become blur tolerant

It’s already known that axial elongation happens on both side of the eye. Or to be more precise the whole eyeball gets larger, although the biggest change is lengthwise:

myopic eyes became much larger in all three dimensions, but more so in length (0.35 mm/D, 95% confidence interval [CI] 0.28–0.40) than in height (0.19 mm/D, 95% CI 0.09–0.29) and more so in height than in width (0.10 mm/D, 95% CI 0.01–0.20). ( source )

But for that I think the cornea also has to be remodelled during elongation. And I don’t think there is any reason to not suppose that it’s true for axial shortening.

1 Like

How much evidence do we have for this? There are people with only astigmatism, or astigmatism and hyperopia. There are people with greatly enlarged eyeballs and no astigmatism. I don’t see a necessary connection between the two.

Making it a race could help us get there faster. That seems to be nature’s plan for everything. We are all forced to compete with each other for so many things and we discover that we get better when we push ourselves. And nothing pushes people like a race (again seems to be nature’s plan).

I am starting to think that high astigmatism is same as myopia. That may explain why Autorefractor confuses between spherical & cylindrical measurements.

So, if high astigmatism is same as myopia, then it would have same causes & cures. Though, I still think astigmatism is easier to cure than myopia.

The cure for both myopia & astig could be to engage the peripherals of the eye with the help of sub-occupital muscles. When you engage the peripherals, it gives clarity. So, most probably it is related to rods in the peripherals. The sub-occupital muscles are related to myopia and being to able to hold the eye in a particular shape. (I think those muscles are related to distance viewing in myopia. I don’t know if they have a role in astig).

Low astigmatism seems to be just visual cortex adjustments issue.

My only “evidence” is: how can the whole eyeball gets larger if the cornea doesn’t change? If it would be only length change, then it could be explained by something in the retina, but no, the whole eye gets larger. Which means there must be some change on the cornea side too in my opinion.

1 Like