FMR's Update Journal #2 - Lens power Equalization, Astigmatism reduction, and Ocular/Visual Cortex OD/OS input Balancing (reduction of suppression)

Soon, I will be done with power increases, and will focus attention on my first power reduction, which will entail removing 0.25 D from the right lens (OD).

But the work starts now, long before the actual equalization. Much of what I do over the coming few months will be geared toward balancing my vision between the two eyes. This Journal will follow the whole process.

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Decided I’m going to stay away from eye patching totally if at all possible. Not only do I think the eyes work best as a team, but I have extensive patching experience from a long time ago, and it was a very energy intensive, draining technique…very uncomfortable. I don’t believe in altering the neural input weights between the right and left eye unless truly needed, either.

So, things will mostly focus on improving binocular balance.

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So, OD has a higher lens power right now (0.25 D). But it also AFs better. But it goes blurry faster in spasm/fatigue, too. Text is sharper in this eye, too (at all distances).

Suppression happens more in the OS, and it’s not as good at focus change.

Images are slightly larger through the right eye. Certainly left to right, things appear wider.

I am right eye dominant.

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I started my own journey with equalizing. My difference between the 2 eyes is .75 and I cant wait for the left to catch up with the right since the amount of things I can see with the right is so much more. I went down .25 on the left just a few days ago. I have been working on the left all along to do focusing alone but no specific amount of time. My left eye is responding very well and clearing up even with an overcast sky. I haven’t done much to isolate the left and still the progress is impressive.

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I don’t like patching, and I also don’t like closing one eye as it tends to cause my extraocular muscles to strain, and that strain takes a whole day to dissipate.

I think Jake has mentioned only really doing 15 minutes max of patching a day. What I did when I was equalizing was to achieve binocular active focus, and then cover the good eye to make sure my good eye wasn’t doing all the work. And then, every once in a while, cover the good eye and let the weaker eye try to active focus on its own. But like, really really sparingly. I had a 0.25 diopter difference between the eyes so perhaps this is wall I needed.

By the way, when I covered my good eye, I left it open.

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@hellothere, good points. I’m going to make sure I’m not just using the right eye all the time for camera viewfinder viewing. Camera viewing tends to disrupt binocularity badly and strengthen the eye being used, so alternating eyes is ideal.

And even with tablet use, like writing this now, I’m going to try to be aware of not only the periphery, but also the vision from both eyes. It’s really hard to do both at once (periphery/depth and binocularity).

No glasses for me normally when reading a book or device held in the hand or texting on a device. I do better with no glasses, and holding the object close enough to see well. Keeping the periphery there is important, and mentally checking binocular balance every so often is a good idea too.

I also shift to medium distance every so often during nearwork. It’s blurry at medium distance, but I think those shifts are good too, despite looking at blur. Like I said, I still have pretty good tolerance for blur and don’t really mind it.

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Palming and also central fixation (which was basically AF in my view) are the two main Bates things I’ve done over the years. Palming often helps me see better when eyes are fatigued from too much light. I bet it resets the receptors, both central and peripheral, back into balance. I think they can get over saturated from too much light or blur, or both, when fatigued.

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Change of plans.

My left eye is suffering. Needs more power to help fight mild astigmatism and amblyopic tendencies.

I added 0.25 in front of my left lens, and it was quite jarring, causing a pulling sensation in my eye and neck. Too bad I can’t increase by 0.12 without special lenses I don’t have access to. That would be ideal.

But the left definitely needs more power plus active focus work and relaxation too.

So, I’m changing my plans. Instead of ordering the next stronger pair of glasses, I’m going to only increase the left eye, and will purchase at least 2 new pairs of glasses with no more diopter ratio between the right and left.

If I do this, there’s no going back later, and I’ll never be able to use all my old glasses, except maybe for night driving for a little longer. This is a little scary of a jump to make, but I think it’s time, before Winter. I’ll take all Fall and Winter, into early Spring, to adapt to the change. I think it’s wise to do it now.

I popped the left lens out of a -0.25 sph pair of glasses and held it on top of my left lens. I think it was a bit over 0.25 actually. I hope the pair of glasses I get has the right lens stronger, if one has to be. 50/50 chance.

Oh boy. This is crazy. I can’t believe I’m seriously considering this now.

I really wish I had access to 0.12 increments right now. I really need more like 0.12 stronger in the left to have proper balance. 0.25, even though it means fully equalized, will tend to make the left eye sharper, and have to focus more, which will be jarring.

Then again, being at -4 now, it’s better to do this now rather than in a year or two when my lens power is lower.

I’ll probably still need the old lenses initially and probably can’t do this totally by the book as Jake recommends. I don’t think switching cold Turkey is going to be successful since the change is so big. 0.25 is a big change when you’re at -4 and trying to equalize.

I’m having serious doubts about this whole thing. Sometimes one eye is sharper. Sometimes the other is. But more often, the right is sharper with the current glasses.

I’m definitely going to do this, even though it’s a bit premature.

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Another advantage of the above: it’ll eventually cut my overall binocular blur level slightly and stimulate the visual cortex ability to focus and have depth perception.

But the break-in process will not be fun.

I realized I have a -3.25 OU pair. This is actually the power I wore in 6th grade.

So, I used it to test the right left balance. I will continue to test over the next day or so, but so far, it seems like equalizing is the way to go with the next pair. It’s not as bad as I thought it would be.

Sine my true right left difference appears to be the spherical equivalent of -0.12 D, and I can’t get glasses with that increment at this time, I’m going to break the rules, and will use two normalized pairs (with different diopter ratios) until my eyes change fully. Idea is to flank the desired correction, and the visual cortex will time-average/interpolate between the two…

What I will do for now, is keep using my current normalized most of the time, but introduce the -3.25 OU glasses for short periods each day after going without glasses for at least 15 min. These will be a training pair.

Then, when I get the 3.50 OU, I’ll introduce those and discontinue the 3.25 OU pair. Over time, I’ll reduce the use of my current normalized (-3.50 OD and -3.25 OS). Eventually I’ll be using only the -3.50 OU pair and should be used to it by then.

I’ll have to accept the visual cortex getting a little confused for a while due to vocal plane unevenness and changes. But that’s better in this case I think than abruptly switching to a pair with the wrong diopter ratio (which was too jarring when I tried it last night). I’ll accept that my myopia is not likely to improve during this time, and that’s fine. I’m working more on the diopter ratio, astigmatism, and tiny hint of amblyopia/suppression that I have going on.

I’ll wear the -3.50 for 3 to 4 months, and then evaluate whether I need to go up in power one last time per my Journal #1 strategy, (to -3.75) or alternately stick with the -3.50 for a second 3 to 4 months. (Once these things from this journal #2 are sorted out, I can work on the myopia, or at least the blur adaptation again.)

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So, the equalization is starting now, slowly, via the method above.

First reduction will be at a later date, in a subsequent journal. Not even thinking a lot about that right now, as it’s too far away.

Instead of patching, I block one eye at a time to check focus or balance.

Who would have thought. So far, after a couple of days of using both, it seems like the equalized -3.25 sph glasses are often more comfortable than the OD -3.50 and OS -3.25 I’ve been wearing since May or so. I could potentially see myself switching to the equalized glasses almost entirely within a couple of weeks time (except maybe for driving at night). The vision is a bit less clear, but they often just feel better. I didn’t think it was going to be this easy!

I believe I wore -3.25 OU for several years when I was aged 10-11 or so, before I hit -4. It actually feels familiar.

I’ll be ordering a new pair of normalized and differentials soon to reflect these changes.

Edit: Lines at about 45 degrees are the worst in my left eye…very tough to focus on perfectly, even up close with the right eye covered. I believe I have approx 0.25 of astigmatism, as those lines are just the tiniest bit blurred. For example, looking at this text on the screen, the taper at the top of the letter “t” or number “1” is at 45 degrees, and has just a bit of shadowing about it. And the letter “o” or other circular letters distort as I try to AF. I believe this is from the brain trying to focus the image.

When the image is sharpest, the distortion is also at its worst. I find this interesting.

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I would say patching may or may not be the way to equalize depending on the situation. Best is t troubleshoot the source of the difference first. Dry eyes, teaming issues…

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Yeah, it seems to be due to about 0.25 D of astigmatism in one eye. But equalizing is actually going in the right direction to help with that.

How do I figure out if there are teaming issues? I suspect there are.

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A quick check is those magic eye stereograms. Can you see them/work them? also the double circle things you converge and/or diverge your eyes to see a 3D image of concentric circles, with the effect that the inner circle is more near/far than the outer one.

Outside of that, you’re in vision therapy territory.

I haven’t checked recently, but a few years ago, I could see most of the magic eye images. There was some suppression, and the trickier ones were tougher.

As far as the circle things that you view with polarized lenses (trying to figure out what they’re called and I think you were talking about something different), I cannot see the last one or two in 3D, but I can see all the others (as of 2 years ago).

Edit: this test: http://www.eyecareandcure.com.sg/standard-stereo-test-p-3301.html

I can see all except the last one or two in the top section of the left page (last time I checked a couple of years ago…don’t have the test book in front of me now).

I’ve always felt that when I diverge and look at the two images of a near target, one eye diverges a lot more than the other. I’m not sure if this is really happening, or is my perception of it. The image on the right seems to move to right, while the one on the left (from the right, dominant eye) seems to stay almost fixed in space. Always been this way, as far I can remember. I’m not moving my head. Also, the image from the left when doing this test eye seems prone to suppression (disappearing or getting fainter).

I just realized that it makes sense that I’m doing well with the equalized glasses as I’ve started phasing them in over the past few days…

I always go without glasses a lot (there are activities for which I simply can’t wear glasses a few hours per day most days, and sometimes I just tire of them). Equalized lenses are similar to that in terms of no power differnce. So, I was already partly used to having no power difference.

Imma check that out.

I was thinking, if you can keep the stereogram while you move it around, teaming isn’t much of a problem.

Well, I can no longer tolerate the unequal differentials I was temporarily using (-2.25 OD and -2.00 OS).

This is good since it means the eyes are actually ready to go to equal lens powers.

But it’s bad because I still need glasses for computer, and all I have right now that’s equalized is a -1.75 D OU pair. Not only that, but subjectively the left lens in this pair appears like it could be a tiny bit stronger by 0.05-0.10 D–opposite of what I want, since if anything my right eye is the one that still needs a slightly stronger lens. So, they may not have been made exactly right. Unfortunately, I’d need a manual lensometer and the skill of knowing how to use it to determine that for sure (neither of which I have). Looks like I’m stuck using this pair for now even though it’s not strong enough and might be mismatched. I better order my new glasses as soon as possible! I wonder if I have any more equalized pairs…or another -1.75 D lens in the same type of frame I could swap it with…this is driving me crazy! I can’t use these! Or something I can use…

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