Equalizing Low Myopia

Hey everybody,

So my optometrist prescription in right -2 and left -1.75. According to the endmyopia calculator I get -1.25 on my left eye and -1.5 on my right eye.

I’m deciding to go for -1.25 on both eyes, is this the right way to go? I see pretty well in -1.25.

Diopter specific advice is against the rules across the board in EM, with the only exception being paid BackTo20/20 members who can get advice from Jake. Otherwise everyone is responsible to learn the method and make their own (hopefully well informed) choices about the correction they should wear.

This is highly unspecific and hopefully you have a more specific standard for pretty well. Like snellen measurements for instance.

Anyways welcome to the community and best wishes with your improvements.

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Obviously you have to make the decision yourself, but based on what you say that sounds like a reasonable starting place to me.

Remember you don’t want to be doing any near work through those distance glasses: if you’re sitting at a desk or looking at your phone you don’t want to do it through minus lenses that are only helping you for distance.

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With your level of myopia you don’t need differentials just have to work on pushing the screen further and further - wearing no corrections.
For the norms, the 0.5D over correction you measured sounds realistic.
What do you get on the Snellen with left, right, both eyes? What do you get on Snellen with your full opto correction? With -1.25D? With left -1.25D and right -1.5D? (If you can order contacts without corrections it is easiest to get those for the test)
If you get better results with uneven corrections, I’d start with 0.25D sph drop from each eye just to get into the habit. People who start EM with your level of myopia will find it easier to equalise around -0.75D after a few bifocal drops.

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On the Snellen with left, right, and both eyes, I see 20/70.

On the Snellen with my full opto correction, I can see just about everything 20/10.

With my normalized -1.25 on both eyes which I ordered on a bright sunny day I can see 20/30 20/25 very clearly on the Snellen. Same with the right and left. Should I stick with the -1.25 on both eyes?

Also could it be that I only have pseudomyopia since my myopia is so low despite having worn glasses and contacts the last 10 years? I started wearing them when I was 14.

If you get the same results with both eyes then it is likely that the 0.25D difference was just the unnecessary correction of the natural eye dominance (the difference between the eyes being in the range of 0.15D to 0.25D rather than in the range of 0.25D to 0.37D). So based on your post, equalising sounds like a sensible idea.

What can you see indoors with artificial ligths when you are tired at the end of the day? If you have 20/30 on a bright sunny day outdoors at the start of the day, these may be more like a peak time correction. (Peak time correction: the lowest glasses giving you clarity on the best days with the most ideal conditions)
You’ll need to see if this pair of glasses can work in every situation or if you need e.g. 0.5D more for less ideal scenarios.

I think -2D and wearing glasses for 10 years suggest a bit more than pseudomyopia, but either your eyes can tolerate more close up time than average or you have had good habits compensating for close up time. The good news is that you didn’t reach the myopia level when you can’t find your glasses without wearing your glasses. And also, you still seem to have a good range of accommodation in your eyes to now adapt to reductions.

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With artificial lights not perfect lighting at tired at the end of the day of the day I can still see 20/40 20/50 more or less.

That’s what I would do. How do you feel wearing them? If it’s a chore and you feel your eyes getting tired and there’s more blur than you want to deal with then go with more correction. If it seems manageable then stick with those and maybe keep a spare pair of -1.5 for a fallback for when you’re having a bad day.

I think the pseudomyopia tends to be more of a short term thing that would have happened before you were prescribed your first pair of glasses. You could still have some cilliary spasm now that could go away soon and bring you to better vision quickly, but more likely it will take a year or two of good habit to get uncorrected 20/20 or better.

I feel great wearing them, during the day I don’t notice much of a difference compared to my full strength optometrist contacts. At night I notice a little difference but I can still still pretty well. Once I can see 20/20 on the snellen with these normalized is that a sign to drop another .50 diopters to -0.75?

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That’s a good sign.

I would do quarter diopter drops after you’re seeing 20/20 or better in the normalized for a whole month. It’s easy to get “addicted” to the rapid gains at the beginning that stem from being over-prescribed and release of cilliary spasm. Since you see 20/10 corrected that’s probably your ultimate goal. It’s no big deal if you spend a week longer than you needed before you drop, if you make a big half-diopter reduction it’s pretty likely that you’ll just be training yourself to live with a lot of blur.

@nottnott here did big fast reductions, had to take a step back.

If you keep up your good habits you’ll be back to 20/20 really fast, just try to resist the (entirely understandable) urge to do half diopter drops instead of 0.25 drops, especially if you’re getting glasses online for less than $20 a pair.

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Take it slow and easy on yourself. Especially as the distance to blur difference will be more and more
-1.50D = 61.5 to 72.8cm
-1.25D = 72.8 to 88.9cm
-1.00D = 89 to 113.9cm
-0.75D = 114 to 159cm
-0.50D = 160 to 266cm
-0.25D = 267 to 800cm
-0.00D = 800cm and above

Other things to know about the last leg of the journey:

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Thank you, also quick question I play professional soccer and my vision is very crucial as I have to see 20/20 and better on the field. I was told that it is ok if I wear the optometrist prescription during sports -1.75 and -2. Once I can see perfect 20/20 with my normalized contacts, does that mean I should then start wearing those for sports as “full correction” which give me perfect vision and drop down to -1 for normalized to continued vision improvement?

As far as the centimeter test is concerned, I have a really hard time doing the test at my low myopia since I do not have enough measuring tape for those distances. Should I see an optometrist to confirm my improvements, and reduce my normalized based on those confirmed improvements?

Probably. I’d try the reduced prescription in practices first rather than the big game. As your eyes get better the amount of correction you need for “full correction” keeps dropping too. Eventually your old -2 prescription will be “way too strong” and not just too strong. If your games and practices are outdoors you should improve pretty fast (all that distance vision).

If you’re playing at night sometimes or indoors you probably need a little stronger correction than a nice sunny day outdoors.

I would just use the eye chart. Put a mark on the floor 20 feet away from it, and if you’re seeing 20/20 or better for a month then remove -0.25 of correction (heading closer to zero).

I used to use a 3m Snellen for the measurement indoors.
Between -2D and -1D I used to check how much I could read on the Snellen with my norms on and how much uncorrected from 3m distance (each eye separate and both eyes together). You measure the 3 metres once and then you will remember it in relation to a cupboard or the tiles on the floor or marks on the wall, etc. Or you measure your feet in cm and walk away from the Snellen by putting your feet right in front of each other. The good thing with low myopia that a 5 or 10 cm difference doesn’t really matter in diopters.
Once I had the 20/20 sharp almost under any circumstances plus flashes of the line below, I dropped another 0.25D sph. But I had a real high expectation on clarity. Most people would say that it is enough to have 20/25 under any circumstances with 20/20 flashing in often.

Under -1D I marked 1m, 2m and 3m distances on the skirting board with washi tape and I mostly measured my uncorrected vision. I used to go near the Snellen and start walking back from about 70cms and mark the max distance to last point of clarity - mark mentally or in physical reality. Again, even if highly inaccurate -1.00D covers a range of 25cms and -0.75D covers a range of 45cms so you’ll surely know in which range your vision falls into. Or you can use the length of your foot and steps for measurement as described above.

And because below -1D it was all about distance vision I made sure to read street signs regularly. You are supposed to read the departure times on the boards at the stations, you are supposed to read the shop signs from the other side of the road, the signs of the aisles in the supermarket, the menu above the counter in the cafe, the ads on the opposite platform, the bus number from a certain distance to decide if it is your bus or not, recognise your friends’ faces from a certain distance and greet them, etc. These will be real life feedbacks and more important than a few letters on the Snellen at whatever distance.
Or you can go on walks and check how far you can read number plates. Usually 20/40 is required for driving without glasses which is about 5 cars parked along the pavement or a car at 20 meters. When I dropped from norms, I could usually read number plates up to about 3-4 cars’ distance depending on the weather and the time of the day, when I was ready to drop again I could read up to 7 cars’ distance most of the time. That is about a good indication how clear your distance vision is.

Take it easy and look for texts and numbers everywhere. The trap is believing your distance vision is OK just because your vision at home is OK at any distances.

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With my contact lenses at -1.25 I am able to see 20/20 without any issues on a bright sunny day on the snellen. Is this a sign to drop to -0.75? Also at what point could I transition to playing sports without contacts once I see 20/20 without correction I’m assuming?

I know you said not to do 0.50 diopter reductions but I also can see 20/15 with my -1.25 on a bright sunny day, I feel like I was very overprescribed by my optometrist.

If I were you I’d drop to -1.0 rather than -0.75. I don’t know how much lenses cost, but I’d do quarter-diopter steps instead…

OK, I see your second comment. Yes, if you’re really seeing 20/15 a half diopter drop doesn’t sound crazy. There might still be some merit to running around for another couple of weeks with 20/15 vision though. The thing you don’t want to do is get too comfortable with blur where you start seeing it and don’t do anything about it because you’ve got good at living with it.

It’s probably a dumb analogy but you could get used to being slightly drunk all the time and perform well enough that maybe nobody would notice you were drunk, but it would still be inhibiting your performance. Another couple of weeks with your -1.25 contacts would help make sure that 20/15 is the “baseline” you are expecting to see, and not 20/25 with flashes of 20/15.

As for sports with no correction at all, you might be able to do it already(?) It sounds like you’re in the “last diopter” territory now. Generally the approach when you get down to tiny levels of correction is to just wear them when you’re tired or you think it might help. Probably after a few months at -0.75 contacts if everything is going well for you, you could just ditch the contacts altogether, maybe only wear them at night or when you feel like it.

If I were you though I’d still reduce 0.25 at a time. You might still be making improvement now with the -1.25 lenses down to 20/10 or so since with full correction you see 20/10 (or better). I’m not convinced you’ll improve faster with -0.75 contacts than with -1 contacts. It’s totally your call though. If that 20/15 line is perfectly clear go ahead and reduce.

You might also play around a little and wear -0.75 most of the time and wear -1 during an actual game or when you need peak visual performance. I was just reading something that claimed in Major League Baseball the average (uncorrected?) visual acuity is 20/12.

Screenshot 2021-05-26 14.57.12

Is that a 6m Snellen you are referring to?
What do you read in the evening at artificial light?
What do you see at dusk outdoors? How far can you read number plates?
I wouldn’t recommend dropping more than 0.25D. You will not be able to see faces with enough clarity in the evening. Maybe get a pair of -1D as your next norms to use in general and a pair of -0.75D to use exclusively outdoors when it is sunny.