[High Myopia] Need help about how to start with EM. Analysis paralysis hitting hard?

Hi there!

First of all, my apologies because this opening post has turned up being too long…

It has been a while since I’ve registered here at the EM forum (ca. November 19) and for different reasons, I sort of left all the EM journey behind and couldn’t start with it. The thing is that now in the present, after I decided to take this seriously and finally start with it, sadly I couldn’t reach a point in which I’m sure about how to proceed. It must be a mixture between analysis paralysis and high myopia related issues that mild myopia users may not experience.

At the moment this is my prescription:

R: -7.25 -1.00 CYL 143º // Contact lens -6.50 CYL -0.75 140º (biofinity toric from cooper vision)
L: -8.00 -0.25 CYL 20º // Contact lens -7.50 (biofinity from cooper vision)

And these are the 5 annoying things that stop me:

1) HOW TO ACCURATE MEASURE THE DISTANCE TO BLUR:

As it would be both, kind of tricky and hardcore to measure right from the surface of the open eye, I think I’m not doing it accurate enough and I’m very frustrated as 2-3mm difference can be translated into a -0.25…

I do have one of these lasers measuring tools from Bosch (Zamo) and it seems a pretty cool toy to be used for this, but the minimum operating distance must be >15cm and currently I can’t go beyond 13-14cm :frowning: In the EM guides was mentioned one DIY tool involving a flexometer and some mini snellen chart or similar thing attached to it.

This seems to be the easiest way to track the progress until I can get longer distances, but I don’t know what should I use in the chart. I came up with this humble creation:

According to the size I should pay attention to, I will get one or another amount of cm. Which font size should I pick? (For instance, MS word or notepad uses 11 size by default). Is this a matter about losing the sharpness of the overall and not from one size in particular? Any advice about it? And also very important too! Any suggestion about how to hold this mini chart tight in the flexometer? I Couldn’t figured out yet how to build a frame or bracket mount for it.

2) CHOOSING THE RIGHT DIFFERENTIALS

Sadly I spend a lot of hours in front of the computer or close up distances (lockdown and other restrictions with lack of outdoor life + PC or books + the office)… I do really want to get nice refreshing differentials to relief some strain in my poor mistreated eyes, but first I really need the confirmation of the process. Is this sketch right?

progression

After wearing the first differentials for a while, it’s time to get the first normalized and its corresponding differentials, take the time to get use to it and repeat until succeed… Or on the other hand, one would wait for the second differentials until the eyes get used to the first normalized?

Going further, as I do have a trial kit, I have measured these approximate readings:

PC USAGE (80-95 cm to screen):

• If I overlap one +0.50 lens to my full glasses lens seems like nothing happens. Starts getting blurry at +0.75, and with +1.00 it’s perhaps too blurry. I still can read the text, but it takes a bit of effort and not sure if AF will work to this degree. +1.25 it’s clearly too much and out of range.
• With my trial frame if I get rid of the astigmatism and use only myopia lenses, I think I could go for -7.75 L and -7.50 R, but it seems perhaps blurry enough to make the AF very hard or even impossible.

BOOK USAGE (distance to book ca. 45 cm):

• If I overlap one +2.00 lens to my full glasses lens it’s a bit blurry, but I can read quite easily. +1.75 it’s even more comfortable, +2.25 feasible though in the limit. +2.5 is too much.
• With my trial frame if I get rid of the astigmatism and use only myopia lenses, I think I could go for -6.00 L and -5.50 R

And here comes the question: The forbidden advice about which prescription should I go for!

Would be better to keep the -1.00 CYL for the right eye or reduce it by just a quarter for both eyes? (meaning, -0.75 R CYL and 0.00 L CYL). Maybe better just go directly to myopia only and discard all the CYL values? (In my opinion, there is a huge difference in terms of blur with and without CYL, so better keep it with a quarter or a maximum of a half less?). Could you please also give me one visual example about the limit of “too much blur, rather be conservative” to work with to enable an easier AF and prevent blur adaptation and double vision? And what should be the strategy to tackle the astigmatism and get rid of it? Reduce by a quarter each alternating cycle of normalized/differentials?

About getting the glasses… for the PC I do need the 1.74 Index as otherwise it will end up pretty heavy and uncomfortable in the nose, plus it creates a big distortion in the face. I am aware about the ABBE index, but I’m not so sure about which kind of materials should I expect to be offered to choose from within this index, or if there is none to be chosen as there is only one (needless to say, I don’t want distortions, chromatic aberrations and other undesired things). For the reading ones maybe will be enough with 1.67 index. Is there any tool or formula to get the resulting mm of the lens according to the diopters and the index?

The fear of ordering a wrong pair of glasses causes me some anxiety, as the last ones I’ve order (and the reason to register here in November 2019) were exactly 598€ and they were never worn, never used. More than half thousand euros directly sent into the trash can, as the optician refused to change the lenses because otherwise “it will be under my real prescription”. This time I would order them to the EU/Spanish Zenni equivalent (SmartBuyGlasses), which should cut the expenses by a half at least, but wasting 150-200€ per glasses doesn’t sound good to me either. I really need to nail the prescription, or be very close to it…

3) MEASURING THE PUPILARY DISTANCE

Another tricky thing before ordering any glasses is the PD measurement. As before, it seems that it is important to be accurate with high myopia and perhaps it’s better to measure eye by eye instead doing it for both at the same time (comments about this?). I’ve seen suggested in the Discord server the “Glass on” app for Android, but even in the promotional video for this app on YouTube they also say that with high myopia it’s important to be accurate and perhaps better to measure eye by eye,

Because I have one of these trial frames, not sure if I can profit from it and use it to measure this PD. The numbers from 25-40 mm right above the eye do measure it, right?

Will that work or do I need to try something else? For a long distance the 598€ optometrist wrote a PD of 31.5 mm R and 30 mm L, though not sure how much could this vary to mid and close distance. Sadly, the cooperation of a friendly optometrist does not seem to be possible and I’m on my own… At least at the moment :confounded:

4) MEASURING THE VERTEX DISTANCE

If the PD and the right prescription wasn’t tricky enough I think I also need to take in consideration the vertex distance. As I said before, a difference of 2-3mm could result in -0.25 diopters in this high myopia league, up to -0.5 if the mm doubles. It seems that (according to the formulas), one can finally forget about all of this stuff in the range of -2.25 or -2.5 as the variation is minimal or directly non existent, but I’m around -5 diopters ahead of it.

Is there any accurate way to know which vertex distance I am actually using in my current glasses? Do you know where could I get a cheap distometer? (such as this one for instance). For those simple as a transparent rule I require a second person I don’t have :pensive:

Is there any way of assuring an identical or a very similar vertex distance between the glasses ordered online and the ones I’m wearing? As said before, I’m afraid of ordering the right amount of diopters per eye, but due to the incorrect or unknown vertex missing or adding some strength to the lens. Does this distance can eventually be adjusted in an optic?

Lastly I have dumped the vertex formula into an excel sheet and played with it a lot already, but any advice regarding how should I proceed with the contact lenses? Should I base their power in the normalized or in the full strength glasses? I’m afraid of getting good results, but then ruining them when wearing the contact lenses because they may be overprescribed.

5) CONTACT LENSES

I do use contact lenses too. Years ago I’ve stopped using them for work or close up reading, as it caused me a lot of pseudomyopia and dry eye. Now I only use them when I’m travelling, practicing sports, or in any kind of outdoor activity that either requires high precision or makes the experience more enjoyable/safe. Yet… I also have problems with the contact lenses sigh (-_-). The issue is related with both, preserving the parity of their prescription with the glasses (either full prescription / normalized) and the power to be chosen and used in the contact lenses.

It seems that nearly all manufacturers do not work with quarters above -6.00 diopters, but only halves, and theoretically I should use -6.25 for the right eye and -7.50 for the left one. As this -6.25 doesn’t exist, I was suggested back then to use -6.50 and I’ve been using it since 2017 or 2018. This has created a big imbalance between the right and left eye, as with contact lenses my right eye is more dominant than before and does all the work, while the left eye seems to be asking for more power as I can’t see as sharp as with the right one. That was later experienced with the glasses too, and I would say that even today I can see a tiny bit better with the right eye when I wear them. I was then suggested to increase a quarter in the contact lens for the left Eye to fix it, but because this -7.75 does not exist, I should jump directly to -8.00. That was rejected by me in less than a week of trial as it was leaving behind the right eye capabilities and it was asking for more power (another non existing quarter, translating into -7.00!). This would also made my current 615€ glasses obsolete as I will need even stronger ones, and so it would continue the never ending story until reaching -50 diopters or who knows what. Conclusion: I really REALLY need to be careful with the contact lenses strength and match them as accurate as possible with the prescription of my full powered glasses and/or the normalized ones if I want to hold tight the myopia or thinking about reducing it. Besides thinking in an eventual future reduction, I checked this with an optometrist in the past month and it seems that both eyes work fine with -7.5 and -6.25. If I reduce the right eye, the left eye sort of activates itself and I find it better.

After hours of research I think I could answer myself the question of which brand works with quarters beyond -6.00: Air Optix plus HydraGlyde for myopia, Proclear toric for astigmatism. Those proclear have less air permeability than the biofinity, but I guess that the sacrifice of breathability could be assumed until I reach -6.00 and switch back to biofinity.

If you were able to go until the end of this post, my most sincere gratitude to you, and even more if you can help this desperate moleman

PS: I’m Leo in the Discord server. If texting here would be longer than my post, voicechatting or just chatting in Discord is more than welcome!

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Woah. Dude. With that much analysis no wonder why you’re having trouble!

Too many questions, too much analysis.
I honestly can’t answer them all.

Please take it back to basics.

Buy your first differentials at around 1.0 to 2.0 diopters less than your current prescription.
Don’t worry about astigmatism yet.

You probably won’t get it perfect. You just have to be comfortable with that reality.
EM isn’t a science. You can’t analyse your way out of every issue.
EM is more like baking a cake, there is a clear recipe, but you just gotta start mixing stuff in the bowl and get on with it.
The people that are really good at EM have burnt alot of cakes to get to where they are.

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Thank you Alex for taking your time to read this wall of text and answer me (despite being a short one :laughing:).

From your reply I get at least one important thing: Forget about the CYL for now and keep its values in the differentials.

Regarding the trial and error, as none of us have such super technological equipment to measure with precision of micrometers of course some trial and error is implied in the game and must be accepted. However… If that costs a lot of money that’s a different topic, and I can’t afford wasting 600€ (as an example) until I get the right prescription for my differentials :pensive: If money wasn’t a problem I wouldn’t care at all, but at the moment I’m unemployed without any income and the savings are sort of sacred thing to touch until I get a new job. Being high myopic sucks twice.

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Where there is a will, there’s a way.
You can definitely find glasses for cheaper than 600 euro.

There are some cheaper options as you mentioned Zennis.
Or contacts can also be pretty cheap.

I’ve been advocating trying to find lenses online, usually somewhere in Asia.
I know people buy lenses from Thailand, Philipines, China online.

I bought all of my lenses from -8 to -0.25 for about $200 USD. I’m set from here to 20/20.

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Yes, I’ve mentioned already that I have my future dealer for lenses, and the price should be something between 200€ (based on the frame, the lenses alone I think it’s something around 160€). The thing is that with high myopia precision is key as just a couple mm make a big differente. If there is no return policy to replace the lenses for a newer ones in the case I’m not satisfied (I need to call them to clarify this first), I may end up paying the same as in an optic :grimacing: Therefore the research and the emphasis on finding the most accurate way possible to do a relatively good measure to minimize that risk.

In any case the start line of the race definitely is how to create one DYI tool with a flexometer. I want to mirror and replicate something like this, but couldn’t figured out yet how to make the chart stay tight.

flexo1

Any suggestion?

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For computer use, If I were you I’d just start both eyes at SPH -7.75 and no astigmatism correction. That sounds like a good starting point to me. If you take out too much correction you might start leaning in to your screens / getting bad posture / getting headaches.

I’ve had great luck ordering from goggles4u but I hear Zenni is excellent too, you can give them your PD numbers for each eye from the optometrist. I was ordering $5 glasses (cheapest frames, no coatings), and now that I’ve gotten comfortable with them I’m spending the extra $10 for fancy coatings, sunglasses, etc. Since you want higher index I think it adds $20 per pair, you should be able to get a pair or two for under 60 EUR if you want the nice coatings. Don’t spend 600 EUR.

I wouldn’t worry about vertex distance, instead just wear your glasses properly (or however you always wear them) and then push the distance to the screen a little bit or drop the SPH each time you buy new glasses as you make progress. Leaning forward in your chair or sliding the glasses down your nose does indeed change the optical task, but you just have to try to maintain good posture and assume that your vertex distance stays the same by wearing your glasses the same way.

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In regards to the ruler. I just use a piece of paper with text on it detached. I have a ruler glued to my phone case. Ugly but it does the trick.

image

In regards to cost of glasses. You’ll find better prices. As mentioned by @nycmao .

A bit of searching in this forum and you’ll get a good idea of the ‘correct’ price you should be paying.

As I mentioned above. I bought in bulk and it works out to, lens + frames, probably about $4-5 USD per 0.25 reduction I’m doing.

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I’m glad others are responding to the technical details. I totally relate to the deep analysis and wanting to get it just right. Slowed me down. Until I got tired of myself, ha! I’m on my first pair of normalized, so little experience. But I agree with the frustration of knowing when you’ve done sufficient study. Just make yourself jump in, it’s the only way forward. Even the optometrists have to make some judgment calls. So will we.

Best wishes on moving ahead!

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Hi Topo

Glasses are cheaper through Zenni but, the higher your diopters, the more expensive the lenses - I know because I’ve seen the prices change on the Zenni lenses as I’ve reduced.

If you are terrified of wasting money on frames you might not like, buy the frames with -1 diopter lenses first. This might end up being a throw-away pair, but it will cost you the equivalent of two KFC burgers. After that, you use the same frames again and again. That means you can pop out lenses and replace if you need to experiment a bit

All the best (sometimes we can theorise all we like, but we just need to start )

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Hey Leo,

note: I only read the thread title.

This is about task paralysis. How to Unlock Your Motivation. - YouTube

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Hi Leo,

Great infomation. Hopefully more people with high myopia will reply.

This graphic is great except the 4-6 week is a bit to fast. Jake says 3 to 4 months, which would be about 12 to 16 weeks between normalized, half it for close up and a figure of 6-8 weeks sould seem suitable.

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You are certainly the other side of the spectrum, many newbies want everything super simple you have swung the whole other way… This process may be a bit of a leap of faith for you… but you just gotta dive in. The sooner you get the diffs the better your eyes will be, you can always adjust your distance to the screen if you need to, so go ahead and get them ordered. Measuring cm is difficult for high myopes some use their diffs for that too (another good reason to get them) even still you might end up working off the optometrist baseline at first, after which it is just a matter of clearing blur till it stops returning and applying the alternating reduction cycle. Sure there is more to it, but you don’t have to tackle ever inch of it before you even start…

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Jake says 3 to 4 months. Great timing with this video @jakey

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As always, depends on habits and things. If you changed multiple things at once for example (diopter ratio, cylinder, etc), can take longer. Or of course, not enough distance time or too much phone time.

Zoomed out though, the 3-4 months really seems to be the number. :slight_smile:

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After many days researching and working on EM the template (see at the end of this post), I think I have reachead a point in which I just need to clarify this four things before getting my first normalized:

1. How to measure the distance to blur:

My apologies, but the question of the opening post remains a bit unsolved… I know how to track the distance and create a log with Varakari’s vision tool, but don’t really know how to accurately measure the cm (and each mm counts at this point). Any tricks regarding this? How do you do it if you are high myopic as me? Any suggetions about how to attach a small sheet with letters to the flexometer? I’m lacking some DIY engineering capabilities :thinking:

Also I think I would need sort of a reference about when the blur is too much blur to avoid causing more damage than good. Of course this is hard to get because it’s completely personal and subjective, and it’s not easy at all to replicate the distortion each one perceives. Perhaps Photoshop may help a bit?

blur grade
Basically, stick to 3, 4, 5? More than 5 will cause ghosting or this should be the limit? Any suggestion?


2. How to measure the Pupillary Distance:

As I’ve mentioned, I don’t count with the support of a friendly optometrist. I’ve have found a very old prescription of a monocular distance of OS 30 mm OD 31.5 mm. How could I confirm this by my own? At this degree of myopia I’m pretty sure that each mm out of the optical center of the lens will have a noticeable impact, even with differentials.

3. Clarify the methodology and time required:
(Sort of a quick second round about what I’ve mentioned in the opening post).

Considering a very general and broad approach, as each one has its own peculiarities, we then agree that one should expect around -1.00 diopter per year, right? (a quarter each 3-4 months or 12-16 weeks).

And about the process… I should get two pairs, normalized and differentials and work with them at the same time and therefore, jump in pairs of new differentials and new normalized each time I want to reduce, right?

4. Safety:

For driving or any other activities that requires 20/20 vision or better… During this EM journy should I count and assume at some point (even if it’s temporary) with double vision or ghosting, even if I’m wearing full prescribed glasses or full contact lenses? Or on the other hand, this issues will only manifest while wearing normalized / differentials? This scares me a bit… I can’t imagine how terrifying it must be to ride the bike or the motorbike and lacking good eyesight :scream:

PS: A bit unrelated, but could you please check this and provide me some feedback about it?

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If you are realistic, it is not possible to have text at blur level 5 all day without getting your eyes strained and brain exhausted. I’d set the blur at max line 2 and see if my eyes can clear that up to line 0. If that happens all the time all day long, I’d push the screen another 2 cms away so I get level 2 back again.

Edit:

No. For driving you should always wear corrections that give you DV and blur free vision. EM doesn’t encourage driving with glasses that are not safe for the road - for yourself or others. As driving is distance vision, a bit of overcorrection will not damage your eyesight but will keep you safe.

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More like 1.
From discord #eyeball-these-links. Care of @NottNott

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-0.75 is more likely in one year. If propability of doing each reduction in 3 months is 50%, then first reduction in 3 months is 50%, second is in 6 months is 25%, third in 9 months is 12.5%, four in a year is 6.25%

Only wear one pair until you are comfortable then you can add wearing the second pair. If you wear two new pairs it can be a bit overwhelming to begin with. You can buy two pairs together, but don’t be surprised if you make some mistake and wish you had bought one. It’s a trade off, but with delivery cheap (about $5), I tend to buy individually.

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Oh, you got me wrong regarding driving. I would never ever do that without any full prescription. What I said is, if I may suffer from ghosting or double vision during the journey of reduction the myopia, and they will stay even while wearing full prescription.

Regarding the blur, I thought that 3 should be the maximum. Interesting. :thinking:

Regarding the image of the car (seen in the wiki, also seen in the links from the discord server)… I consider that a not so good example to measure blur. I find the plain text with white background easier to describe/perceive :confounded:

Now I can consider the chapter of the timing closed.

About the work with pairs… Still need to confim. Maybe I’m risking being very repetitive (perhaps problems of not being a native speaker :sweat_smile:), but this should make everything clearer and easier to be understood:

Approach A:

Starting from the full prescription…

get 1st differentials with no normalized yet
then 1st differentials with 1st normalized**
then 2nd differentials with 1st normalized
then 2nd differentials with 2nd normalized**
then 3rd differentials with 2nd normalized
then 3rd differentials with 3rd normalized**

And so on.

Aproach B:

Starting from the full prescription…

get 1st differentials with 1st normalized
then 2nd differentials with 2nd normalized
then 3rd differentials with 3rd normalized

And so on.

If I got you right (encouraging A), at some point A has the same steps as B. This leads me to prefer B, but maybe due to the lack of experience about how the eyes will adapt to it. Have anybody tried both approaches?