High myope’s reduction schedule?

Hello EM Friends,

Since I’m a high myope, I’m EM’ing with contact lenses. I started my EM habits about a month ago (May 2, 2021). This included differentials for close-up (+1.0 glasses over -9.5R/L contacts), 20/20/20, some outside time, limited phone screentime, and attempts at AF. I would consider the -9.5 contacts as full distance Rx, as I can see 20/25 to 20/30 most of the time indoors. I wear -0.5D glasses for night driving.

I’m thinking my next reduction would be to drop by 0.5D in contacts for normalized. From what I’ve read, I understand that I should only change one focal plane at a time, so this would mean that I leave the differentials the same. My partial reduction schedule:

D1 (as of 5/2/2021)
Full distance = -9.5 contacts
Normalized = -9.5 contacts (no change from full)
Differentials = -9.5 contacts +1.0 glasses = -8.5

N1 (in two weeks?)
Full distance = -9.0 contacts + -0.5 contacts = -9.5
Normalized = -9.0 contacts
Differentials = -9.0 contacts +0.5 glasses = -8.5

D2
Full distance = -9.0 contacts + -0.5 contacts = -9.5
Normalized = -9.0 contacts
Differentials = -9.0 contacts +1.0 glasses = -8.0

N2
Full distance = -8.5 contacts + -0.5 contacts = -9.0
Normalized = -8.5 contacts
Differentials = -8.5 contacts +0.5 glasses = -8.0

Etc., etc., etc.

Questions:

  1. For someone who is EM’ing with contact lenses, is this the right way I should be reducing? The reduction schedule above changes one focal plane at a time, which means that I switch between +0.5 and +1.0 glasses for close-up, with each reduction. (Please note: I’m not asking for diopter advice, since it’s forbidden. :grinning: I’m just checking to see if the reduction pattern is correct, since the “only one focal plane change at a time” rule is not as straightforward for someone who is EM’ing with contacts.)

  2. Can I just go to N1 in about 2 weeks (i.e., 6 weeks after D1), which follows Jake’s 4-6 week rule? Or am I looking for key indicators that will let me know I’m ready for N1?

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That sounds reasonable to me!

If I were you I would try. You should have less cilliary spasm now, since you’ve been using reduced correction in front of the computer and have been keeping it as far away as you can.

Maybe someone else has a different opinion but what you’ve written sounds totally reasonable except for the -0.5 contacts over your -9 contacts (I’m sure you meant glasses over contacts!) :smiley: Unless stacking contact lenses is a thing-- Contacts for your contacts.

If it turns out that it feels like it was too big of a drop you could always use -0.75 glasses over the contacts and then switch to the -0.5 later on.

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:rofl: Good catch! Yes, I meant -0.5 glasses over contacts. Good idea about the -0.75 glasses over contacts, if the -0.5 are not quite working. Good thing Zenni Optical has such reasonable prices, as I’ll need to buy some glasses with this Rx, if needed. Thanks!

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:man_shrugging:

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My understanding of the diffs vs. norms was that you establish a healthy gap between the 2 pairs of glasses. The gap is at least 1D but can be 1.5D, too. You increase the gap when you drop the diffs and keep the norms, and you go back to the normal gap when you drop the norms and keep the diffs.

With this in mind, I’d skip your planned N1 as it creates a gap of 0.5D only which is not enough to trigger your eyes for accommodation between close up and distance
When feeling ready I’d go to D2, keeping the full distance as -9.5D. I.e. I’d have the -9.5D contacts with +1.5D glasses = -8D
Also I’d keep working to get to 20/20 with binocular vision with the distance with the full correction, and separately to near 20/20 with dominant eye and near 20/25 with the non-dominant eye. Your full correction should give you full clarity under any circumstances immediately - like a fresh stronger prescription after an opto visit.

Is that in rubbish light at the end of the day? or with fairly relaxed eyes with natural lights just indoors? How much distance you can get indoors? more than 5 meters?
How about outdoors at great distances? Number plates at 20meters, street signs (street names, shop names) on the opposite side of the street? How about details of objects at 50m?

So
D1 (as of 5/2/2021)
Full distance = -9.5 contacts
Normalized = -9.5 contacts (no change from full)
Differentials = -9.5 contacts +1.0 glasses = -8.5

D2
Full distance = -9.5 contacts
Normalized = -9.5 contacts (no change from full)
Differentials = -9.5 contacts +1.5 glasses = -8.0

and then N1:
Full distance = -9.0 contacts + -0.5 glasses = -9.5
Normalized = -9.0 contacts
Differentials = -9.0 contacts +1.0 glasses = -8.0

Hope it makes sense.

@Alexbreedon1111 might want to comment on it based on his own experience.

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One thing I’ve been wondering is whether you are correctable to 20/20. Some people are not. As @BiancaK suggests, your full correction should give the best correctable vision. Then with EM, we go with slightly reduced for norms.

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I have this setup:
-7 contacts

Diffs: nothing
Norms: -1.5 glasses
Nearwork: +1.5 glasses

@Linda-L you may choose toric lenses if spherical don’t correct to 20/20 or wait till you will have 20/20 indoors then reduce. 20/25 is not full correction obviously.

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@Linda-L

Yeh I’ve come from -10
You can follow my gains thread here

With high myopia there’s a good chance that 0.5 reductions should be fine.
I would give it a shot!
I personally did about 3-4 0.5 reductions until my eyes told me that I needed to do 0.25 reductions.
This can be due to ciliary spasm releasing as well as over correction.

Its great to have a plan/schedule. Its good for motivation and generally knowing when u need to buy new glasses/contacts.
But once you’ve done that I’d suggest to throw it out the window.
The first few reductions are really about re-connecting with your eyes and listening to them. Rather than some sort of schedule your brain has in mind.

So yeh…I’d be open to the possibility of reducing by 0.25. I would be open to the possibilty of reducing sooner and later. Once again, some of my first 0.5 reductions were only a week long, because of ciliary spasm. Another reduction I’ve had recently took over 3 months. Its just the way it is.

In regards to reducing in two weeks for your N1.
Its all about feeling comfortable in your D1s.
People feel comfortable in different ways.
I personally felt comfortable when I could active focus on my computer screen with my D1s but thats not a requirement.
Once you feel ready, you can work well in your D1s then jump into your N1s!

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Thank you everyone for your advice/feedback to my post. It’s very much appreciated.

@BiancaK Thanks for your suggested reduction schedule. It does makes sense. I’ve tried using my +1.5 glasses over my -9.5 contacts, but unfortunately, it’s too blurry for me. This is because my desk/computer set-up is such that I sit about 75-80cm away from my monitor (using a wireless keyboard/mouse). So, I’m finding that the +1.0 glasses work best for me. On some days, by the afternoon when my eyes are tired, I even find myself needing to wear my +0.75 glasses or keeping the +1.0 glasses on but leaning closer to my monitor. On the other hand, whenever I need to look at my tablet (which is typically about 50 cm away), the +1.5D glasses over contacts do work well.

I can see 20/25 or 20/30 indoors first thing in the morning, with fresh/relaxed eyes. The indoor lighting (from both natural and artificial light sources) is typically between 160-200 lux. (On a really good day, I can sometimes see 20/20 in the morning with fresh/relaxed eyes.)

@shaerah and @miffiffi Yes, I am correctable to 20/20. I can achieve 20/20 by wearing my -0.5D glasses over my -9.5 contacts, which I only need to do when I’m driving at night. I feel my -9.5 contacts alone are good enough for driving during the day. So, it sounds like my -9.5 contacts should actually my norms, not my full correction. Per the EM Wiki, the difference between full and norms for high myopes can be 0.5D.

@Alexbreedon1111 I just finished reading your gains thread. Very impressive. It gives me hope! I do like your idea of throwing my schedule out the window and letting my eyes tell me when to reduce. Since I’m new to this, I’ll probably try something more structured until I know what I’m looking for in terms of indicators that I’m ready to reduce. Maybe this will come sooner than later. I’m feeling pretty comfortable now in my D1s for most days of the work week, and for most hours of the work day. But as mentioned in my response to @BiancaK, I occasionally need to adjust my D1s by swapping out the +1.0D glasses with +0.75D glasses over my contacts.

Based on all of this info, I think I’m going to try to reduce my contacts to -9.0D this week and see what happens. :crossed_fingers:t3: Thanks everyone.

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Ciliary spasm exists without nearwork and overcorrection - read Ursa’s posts, she reduced 1.5-2 diopters of spasm despite having no overcorrection or strenuous nearwork, on the other hand being underprescribed chunks of life.

So you’re an other argument against myopia=astigmatism. You seem to have near zero, despite having -10 contacts correction (that’s above -11 in glasses). I digged into research, and I can argue that myopia is not only mental, but dental and cranial. It’s interesting but osteopaths sometimes say about eyes more than sooo often arrogant and proud ophthalmologists.

I have everything other from laptop that is close up from 33 cm, I’d say that distance is more ergonomic and allows you to relax your arms more.

By the way, how did you come to active focus and how do you recognize it?

Yeh totally understand. I was more structured in the beginning and then as it all becomes second nature you don’t think about it as much.

I do think a little bit of structure helps in regards to buying new frames/lenses. Planning for these because depending on where you live they can take quite a while to arrive. I found that when I become pretty comfortable in a pair of norms/diffs I then would go and pay for my next set of glasses, these would then take 2-4 weeks to come. By the time the new glasses arrived I was really ready to reduce.

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Good question, because I don’t know if I have actually achieved it completely. I can find it for a few seconds or longer (depending on a lot of conditions), but I can’t seem to be able to hold it for long. Are you able to do it?

No, my vision is blurred every time unless I have an ideal correction. Otherwise I can’t change even a tiny bit.

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