FMR's Update Journal #2.5 - Equalization Continued; Focus on Astigmatism reduction and less phone usage

Never thought I’d open an intermediate journal, but it’s time. I have a couple of current obstacles that I need to take care of.

I need to get the left eye astigmatism under control; it’s driving me crazy and preventing good progress. I want decent clarity in both eyes, not a scrambled image in one!

@kem, I’ll be reading a lot of your old posts. I know I can beat this mild but annoying astigmatism, but it seems like such an obstacle at the moment!

Current normalized: -3.50 DS OU alternating with an unequal -3.75 OD and -3.50 OS pair as needed, such as driving or when fatigued. Occasionally using the older -3.50/-3.25 pair when doing gardening because things are closer and I need less correction. Differentials are used only for computer, and are -2.25 DS OU, but I plan to switch to -2.75 in the coming weeks so I can work significantly further away from the screen. No correction for reading or handheld electronic device use.

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Good luck! It’s hard, slow, but worth it! I know exactly what you mean about it slowing progress!

It is possible, though! Improvement if not perfection.

You patch often? I patch every day and the results are there. I don’t wink… I bought an eye patch and put it over my good eye.

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I do both, but covid lock down keeps me from doing winking as much (less drive time).

An eye patch is 10 dollars. It’s a great investment for those who need to equalize. Unless there is some EM fairy I’m not aware of, an eye patch is the only way to equalize successfully in conjunction with lowering the script accordingly.

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That’s true. Timing is important. It’s much easier without cylinder, though.

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I think I figured out where the astigmatism is from…

It seems to be from tight extra ocular muscles. But why mostly in the left eye?
Well, I just discovered that I often rotate my head to the left when looking at things, but much less often do I rotate toward the right. Maybe I developed this habit from driving, to look more toward the oncoming (left) side; I don’t know. It may also have to do with where the furniture is situated at home in relation to walls, doors, and windows. Almost everything worth looking at (e.g. for breaks), in every setup I use, is on the left. I must have favored left-rotation so much over many years as a habit, because I actually have less neck flexibility toward the right. Additionally, my left side has always been the one that tends to bother me more in the neck area…for many years now. I know why now.

I gently did the extra ocular clock movements a few times. Not only did I discover improved vision in the left eye, but I can feel the tightness now, as you would with any muscle. It feels like minor eye fatigue from reading.

I’ll do these 2-3 times per day, but gently, with glasses on, while doing distance active focusing. The eye should adapt to the spherical lens in front of it done this way (versus without correction).

Additionally, I am going to, a few times per day, work on neck flexibility in the rightward direction.

I think hard blinks and lid stretches (opening wide to unstick the eyelashes) sometimes worsen the astigmatism, too. Both are another bad habit holdover I have from when I used to wear contact lenses. I still do them often when actively focusing.

I’m not going to do patching. I did it extensively and unnecessarily about ten years ago for other reasons, and it didn’t really accomplish much. I think it’s better for me to work on integrating vision from both eyes (binocular) as much as possible.

So far so good. In 12 hours, I’ve already achieved improved clarity and reduced astigmatism.

I’m of the mind that vision therapy should improve the vision afterward, not so much temporarily reduce it from strain.

April has always been one of my best months for new vision improvement and habits.

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I understand that you have more than normal 2 pairs of glasses and some of them are equalized and some unequlized?

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That is correct. I’m not 100% equalized just yet.

The next step is to get rid of the current unequal intermediate pair and the current differentials, replacing both with a single stronger pair of equalized differentials that is halfway between in power.

But when you spend many months using a given pair, it can be hard to stop using it, as you get very used to it. That is my situation with my -3.50/-3.25. I wore them for about 6 months, and still occasionally use them.

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You want the same ratio in all your glasses. For example, 3.0,3.25 in all glasses and not using another one with 3.0,3.0

Ideally, yes. But if it were that simple.

When I go without glasses, the ratio is 1:1. Great, right?

My differentials were 1: 0.875 a few months ago (0.25 difference), and I could no longer tolerate them. So I went 1:1 on those.

At the same time, my normalized were 1: 0.929 (also a 0.25 D difference).

I then went 1:1 on the normalized because of the concerns of having differing ratios. But I went with -3.25, which ended up too weak after a few weeks, my vision was really fatigued because I couldn’t see well.

The only thing stronger I had that was usable was the previous pair, which was unequal.

At the same, I realized I still needed unequal lenses, but 0.25 was a bit too much. I couldn’t and still can’t get 0.12, though.

I’m trying my hardest to stick to -3.50 equalized this time around. And maybe I’ll be able to as I get the astigmatism under control.

But there may still be times when I need better vision, and the -3.75/-3.50 might provide that (ratio: 1 : 0.933). I’m really trying not to use it, but even if I go a few weeks, I might need it again at some point.

Now, if I could get lenses in 0.12 D, I’d just do that and use it for everything. (The ratios would still not all be equal, but they’d be closer having the same small diopter difference in all pairs).

In short, I’m trying to only use the -3.50 and -2.25 equalized pairs now, but I’m still in a transition period.

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Yea sometimes it can be complicated story

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Sad that with computerized grinding we can’t get more precise than a quarter diopter. They must just use blanks off a shelf in set grinds…

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Oh, we can. It’s just less expensive to have rough increments, so it’s rarely done.

Over -4.50 or so, 0.25 is perfectly fine in many cases.

I’ve did some googling and found this:

Essilor seems to be able to create lenses with 0.01 dioptre precision. Though I’m not really sure how it works and if there is not some trick in this.

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It shouldn’t be too hard with computerized grinding to make the lenses. As for measuring, it’s a binary search algorithm I’m sure. You can go from the nearest diopter to the nearest 1/128 in 7 steps. At some point though as the patient you won’t be able to tell the difference. How precise that is I don’t know.

I think for all practicality, 0.12 or 0.10 steps are fine enough. With 0.12, people can often tell a difference at lower and moderate correction levels, but it’s subtle.

Where it really comes into play potentially, is in equalizations, or cylinder corrections.

0.12 and even 0.10 used to be somewhat common at custom optical shops. But now that retail optical companies have mostly taken over, there has been a move to consolidate to 0.25 and save money.

When you add in that most lenses today are plastic, not glass anymore, and that a study or two showed that 0.25 was good enough, you see where we are today.

Actually, I’ve read that some want to do away with 0.25 and move to 0.50 for military issued glasses, etc. Bad idea.

I don’t know if there are any soft contact lens brands above -6.50 or so that come in 0.25 for sphere. Everything I’ve seen is 0.50.

Yeah, my contacts come in 0.5. (13.5/14) if you’re lucky that leaves you slightly under prescribed. If you’re unlucky…

Playing with trial lenses, 0.25 is a big deal at -13.5. They don’t make the 0.25 because of the market, and inventory costs, not because it isn’t useful. Many places don’t even carry the higher ranges even at needing half the inventory to cover the range. We’re spoiled by the efficiency of mass production, little is still custom made.

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And not everything is stocked.

-0.50/-8.00= 0.0625

-0.25/-4.00= 0.0625

-0.125/-2.00= 0.0625

I think you can see where I’m going with this.

I will put up with (and be thankful for) what I do have.

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Except the function is hyperbolic, not linear.

I have trouble wrapping my head around the math vs experience. The only thing I can reconcile with is perhaps I’m this myopic because I have a small accommodation range?

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