Former Emmetrope, new Astigmat Here

I’ve always had pretty good eyesight (can read the 20/10 line in good light) and have never worn glasses. I’ve been following Jake here and on youtube for maybe 3 or 4 years now, and have an eye chart at home and reaction balls and try to practice Active Focus whenever I’m outside. The covid has had me spending much more time indoors than I would like and robbed me of a lot of sports and outdoor stuff that I would like to do. I’ve started to get headaches staying indoors and looking at the computer.

I went for full diabetic eye exam (Type 1 - Insulin Dependent) and apparently I tested at -0.25 SPH in both eyes, but with some astigmatism (-0.5 CYL OD, and -0.75 CYL OS). I had my eyes tested at the end of kind of a bad day, so I’m thinking if I had been well-rested the results might have been better.

I had a couple of pairs of glasses and sunglasses made up for $6 each online with the prescription from the optometrist and they make the outdoors look super-clear, which is nice, but if I try to walk I get nauseated. Driving with them on is comfy. I’m almost sure the prescription is stronger than what I should be wearing, so I’m thinking of having some more pairs of glasses made up with no SPH and maybe -0.5 CYL in each eye or -0.25 CYL in each eye. I’m also thinking that I could benefit from some extremely weak plus lenses for working on the computer, maybe +0.5 or +0.25 to take a little strain off my eyes.

I’d like to get people’s opinions here as to whether or not I’d be better off going naked or trying to do the “quarter diopter reduction” to grind off that little bit of astigmatism and pesky myopia. I’m tempted to just do nothing, but then I think the -0.75 CYL in my left eye might be too big to ignore. At $6 per pair of glasses I can afford to experiment a little.

Anyone have any words of wisdom? I’d like to get them perfect while uncorrected, and I certainly don’t want to fall down the rabbit hole of stronger and stronger prescriptions.

Thanks guys!

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My suggestion would be to get your eyes measured again under better conditions. Astigmatism can be transient and unstable, both in magnitude and axis.

Welcome to the forum and good luck with tackling this.

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I agree with @Ursa. Your correction is low enough that you may just be dealing with accommodative (ciliary) strain and everything is transient. Most emmetropes have a little bit (0.25 to 0.50 diopters) of astigmatism as well and you shouldn’t need to correct it to have 20/20 vision. This means you may not need glasses, just more time outside doing distance vision and less time looking at screens.

Once you start wearing minus lenses you run the risk of turning transient myopia into real axial myopia and making it permanent (or semi-permanent since it will get worse each year you wear minus lenses).

I am a high myope, but I have low astigmatism (0.50 in one eye and 0.25 in the other). Though the 0.50 is a drop from 0.75 which isn’t completely settled yet. Technically I can go without any astigmatism correction, but I do appreciate the additional clarity that it offers, so I keep it in. However, if my sphere were -0.25, I certainly would not wear glasses with that. All that will do is make things worse.

From a spherical equivalence perspective, you’re looking at -0.50 in both eyes, which is low enough for many people to go without glasses at all. That is effectively 20/30 vision (well in your case, 20/30 in one eye and closer to 20/35 or 20/40 in the other), and still within range of not needing glasses to drive, etc.

If it were me, I’d probably just go without and figure out how to spend 3+ hours a day doing something outside (or at least spending time looking out the window to get some distance vision) rather than wear the glasses.

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Thank you @Ursa and @Merlin93 – I should get outside more and ideally take as much strain off my eyes as I can. I’m thinking the minus lenses might have some utility as a bridge back between my currently mildly screwed-up or strained state and near-perfect vision, kind of looking forward to when the “under-corrected” ones arrive to see if I can do anything with them. If nothing else it will give me a clue as to what “corrected” looks like and how much I can self-correct through active focus. I plan to wear them to walk around the city at night like Jake suggests in one of his video. I’m not legally required to wear glasses to drive or anything but I also don’t want to be trying to do 0.75 D self-correction at a time if a 0.25 (quarter diopter) would work better.

I’m thinking of trying +.5 or +.25 (plus) indoors as “computer lenses” to see if that helps eliminate some of the strain. I think my computer is usually off to the right side of my vision and that may be giving rise to the astigmatism.

I’m thinking I’ll work on it for a few months and then pay to get re-tested and see how much progress I was able to make.

To Merlin’s point if you wear a wrist brace around all the time it’s going to make you a lot weaker; on the other hand if you actually have a sprain and you don’t brace it up when you should you could just be making it worse. I’m thinking of using the glasses for a couple of hours per day at most.

Another concept I’ve seen tossed around is “functional astigmatism”, I’m not sure I believe in it but apparently some people get better depth-of-field with a little bit of astigmatism and it may be an adaption rather than a glitch.

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Making a dedicated effort to get outside is a really good idea. If you do that for a couple weeks and then see what you eyesight is it can help you decide. In the EM path it always starts by getting rid of ciliary spasm. Most people here start at -2 or more. So glasses are necessary to help in that process. But using a lower lense power is the 1st step. Since you cant go lower than low you need the outdoor time to get spasm release. Maybe only lenses to drive.

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Two more pairs of cheap glasses arrived in the mail today, one has just the full prescribed astigmatism correction with no SPH, OD CYL -0.5, OS CYL -0.75, and one has no SPH and a quarter diopter shaved off the astigmatism correction in each eye: OD CYL -0.25, OS CYL -0.5

I can actually read the 20/10 line easily with both pairs of new glasses with no SPH correction at all (plano). Apparently the -0.25 SPH correction wasn’t needed at all. The “full correction astigmatism-only” pair looks super-clear when I put it on, but it still makes me feel a little nauseated when I walk. The “under-corrected astigmatism-only” pair requires a couple of blinks and conscious attempts to achieve the proper zen state before I can see, but then I can see well (much better than I can get with my naked eyes.) I haven’t had a chance to go wear it outside yet, but I’m hoping it won’t produce nausea like my official prescription does.

So, to Jenn’s point above I think I’ll just wear them outdoors or when driving, with the hope that they’ll give me enough simulus to keep the eyes’ self-emmetropization systems engaged.

Does anybody know if the axis of astigmatism tends to shift around over time or as eyes improve? Or should the axis measurements remain fixed as the CYL prescription decreases? I’m guessing we’re getting into uncharted territory, since most people aren’t doing studies on “almost emmetropes”.

I have irregular astigmatism in my -5 SE left eye, with a pretty shifty axis. From the start of EM my right eye had a stable axis, but now that I am around -1 SE, it seems to be moving around as well. Test yourself on a big version of the astigmatism wheel regularly to keep an eye on this.

Have you any idea if any of your vision habits created your astigmatism in the first place? If you do, perhaps concentrate on correcting those.

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@Ursa Have you any idea if any of your vision habits created your astigmatism in the first place? If you do, perhaps concentrate on correcting those.

I’m guessing it came out of being indoors way too much with Covid and using a laptop screen at home, with the screen being habitually off to the right because I rest the computer on the right arm-rest of the chair. I don’t have a very ergonomic set-up at home. [I think it was in Jake’s podcast discussion with the Optometrist Steinhauer that she mentioned astigmatism arising from looking at the board in the classroom at an angle etc.]
I’m also kind of intrigued by the idea of having some extremely weak plus lenses (maybe +0.50 or +0.25) made up for viewing the computer screen to see if that helps reduce eyestrain a little.

I am hoping when life returns to normal a bit I will get a lot more outdoor time and my eyes will improve. In the meantime though I definitely “caught” some astigmatism, and I think it’s a little more than I can comfortably “active focus” away. I just wore my new “undercorrected astigmatism - only” glasses outside at night and they’re great. They’re not making me feel sick when I walk like the full-strength prescription and I can see the moon and the little LED’s inside the traffic lights and all the faraway text, etc. Indoors I can read the 20/10 line with them on after a few blinks and attempts even though I removed the prescribed -0.25 SPH they prescribed me. I am hoping in a couple of months I can drop the CYL to -0.25 in each eye (currently at OS -0.5 CYL instead of -0.75 CYL; OD -0.25 CYL), and then back to zero (naked) after this Summer once my eyes have got some sunny outdoor time.

That might well be the biggest culprit. It sounds as if you are well on the way to getting rid of this unpleasant visual defect.

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I sure hope so. It’s one of those annoying things that really robs your quality of life through headaches and just not being able to see right. (Everyone here knows it better than me, probably.)

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Your left eye having more astigmatism seems consistent with your habit of placing your laptop on the right, it’s always the eye that has to look across the midline more that seems more affected, I don’t know why this is so overlooked in general eyecare, most people with astigmatism show a strong correlation between their eye scanning habits and both the axis and degree of the astigmatism, in a way it’s even more ridiculous than myopia’s case.

Astigmatism is my main problem right now and it’s surely very annoying, though I don’t get headaches from it I believe it’s the main culprit of me getting tired a bit too easily. On the bright side we found this community so we don’t just hand over our eyes to the “professionals” who admittedly only make it worse in the long run.

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What are your “eye hygiene” habits or routines that seem to be helping for your astigmatism reduction? I need to read up on scanning and eye and head movements.

I’m trying to re-position the laptop computer so it’s in front of me rather than on the side (pushing it out so it rests on my knees rather than the arm-rest of the chair). I need to figure out a better solution for computer use at home. I’m using some cheap +1.0 reading glasses some of the time while I wait on some custom plus reading glasses with +0.5 and +0.25 to arrive in the mail. I ordered them without coatings but once I find a pair I like I think I’ll spring for the fancy premium coatings (maybe the “digital screen protection” coating actually works, who knows.) Do you use some kind of “computer glasses” to mitigate some of the eyestrain that might be causing your astigmatism?

I’m thinking for indoor use I don’t want any astigmatism correction in the lenses at all, but just something to try to “de-load” the eyes a little bit and keep them from mal-adapting to screen use.

Have you been having success with using slightly “under-corrected” lenses and active focus to revert your astigmatism? From what I’ve been doing so far it seems like it will work.

After assessing the type of astigmatism I’m dealing with I’ve been trying to go against the poor habits, a couple years ago both my eyes had 80º axes which corresponded to my tilted posture most of the time, after my scoliosis was corrected and I stopped having that odd crooked posture I now have mirror oblique-ish astigmatism of 80º in the left eye and 100º in the right, it seems like now the cause has been my “chin up” posture so basically in the past week or so I’m trying to center my head and eyes properly on whatever I do, seemingly this is already showing results albeit really small but I don’t know, what I have learned so far is that astigmatism doesn’t give up easily at all, I guess the good part of that is when it’s hopefully gone it won’t come back easily either.

I should mention that in my case I still have some spinal problems so I’m addressing that as well, when I can maintain a correct posture there won’t be any benefit to my eyes maintaining the astigmatism as there won’t be any need for the reverse stress response, that is of course mostly theory, maybe I’m screwed for life, I won’t know till I try all that I can.

As for lens wear I currently don’t wear any and I doubt I’d wear any correction for close up unless my eyes deteriorate further than they already have, if I manage to significantly reduce either myopia or astigmatism I’ll consider some weak plus lens wear but for now I already have subtle abberrations at close up to deal with and that’s enough.

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If you’re medically cleared to do it, weightlifting is enormously helpful with posture. If you’re near a gym with someone who can teach you proper form I would highly recommend it.

I did go to the gym a few years ago but after twisting my ankle badly and tearing some of the ligaments (not at the gym I fell off stairs) I got lazy and didn’t go again after I healed, it certainly helped but the main thing that helped me was going to a chiropract and get my spine corrected, the last stretch of it was left to me as the chiropract said it’s unnecessary for me to keep going, I got lazy of course… but now I’m taking action for it, I might go to the gym again but for the time being I’m doing exercises specifically for the back to help stretch and strengthen the muscles.

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In NYC we’re having a bright sunny day today, and in Times Square I noticed an astigmatism effect that I hadn’t been aware of before. Most of what I’ve been able to figure out with my -0.25 CYL glasses has been that there is some visual clutter or ghosting on distant images especially at night that I can usually clear, but today I found a green-and-white street sign (48th St) that had the sun hitting just right so that without glasses it was invisible to me (just a rectangle of bright glare and completely unreadable) from right across the street, but completely legible with glasses on, could see the color and everything. Without glasses I couldn’t clear it at all. The glasses aren’t polarized and the distance was minimal so I think it’s just an astigmatism effect. Usually it’s a lot more subtle than that. I hadn’t realized it was possible to see things in the glare so clearly.