Just about to take the plunge

Welcome aboard!

Out of curiosity, is that cyl minus or plus? It matters quite a bit in terms of your spherical equivalence and how “wonky” your starting prescription is. :slight_smile:

Are you sure your current optical prescription is accurate? You might want to get a second opinion from a different eye doctor who doesn’t have your prescription history to be sure. Also, given the complexity of your vision correction, you should consider investing in a trial lens set (aka test lens kit) and adjustable trial frame to be able to test your own eyes. It will be very helpful when trying out different lens configurations as you start trying to reduce complexity. Personally, I find my trial lens kit to be indispensable when it comes to reducing the amount of guesswork I have to do when ordering glasses (and answering “what if?” questions). This also saves money as I’m less likely to buy glasses that don’t feel or work right.

I am also in the group of people who have the trifecta of moderate to high myopia with astigmatism and a large diopter gap. Though your astigmatism power and diopter gap (both in sph and cyl) are a bit larger than mine, we’ll need to pursue a similar approach to get back to 20/20.

In my case, my plan is to start with a couple of rounds of binocular reductions once I start to see cm improvements, then focus on reducing astigmatism until that is gone (6-12 months), followed by 3-5 years of equalization cycles to reduce the diopter gap (with two binocular drops between cycles). By the end of all that, I should be in the 1.5 diopter range or so and can follow along with the rest of the “normal” low myopes and suffer through the last diopter hell. :grimacing:

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I love your thorough and well thought out posts, but would ask you not to label the last diopter as hell. I see it as a time of great relief, when most of life can be lived without glasses, and one can take the time to be patient and inventive in trying to clear the last diopter.


Well, given I am not there yet to say what it is or isn’t, I’m just going by what I see other EM students say about it. Based on what I’ve seen and read, that seems like an apt descriptor. I’m not the first one to use that phrase to refer to the final diopter.

But I agree that it seems like a bit of heaven and hell at the same time. On one hand, it is a great relief to be in the final stretch where you’re able to mostly see without glasses and be able to say you made it so far so it’s nearly all behind you. But at the same time, you never know how long it will take to get to 20/20, and for some, I am sure they question whether it is an if rather than a when. From everything I’ve seen so far, the last diopter can be just like the rest with 0.25D improvements every quarter. But for others (most), it seems like it is a multi-year battle of going up and down, struggling to find the right stimulus to get through those last few quarter diopters.

To me, that sounds like hell… but I’m a fairly meticulous fellow who builds his life around structure and planning. That said, I look forward to it all the same!

In any case, I’ll try to avoid using that descriptor in the future. :slight_smile:


It is important not to hide this possibility, and I would be the last to encourage deceptive marketing. But calling it hell might put some people off from even trying EM and this would be a pity. We saw this recently with someone who wanted reassurance that he would reach 0 diopters.

Yeah, that was my assumption based on your reply. I’m a big believer in transparency though, so I’d rather know about the pros and cons upfront. I’m not trying to scare anyone off, just saying things like they are. But I do get your point.

IMO, anyone who comes into this needing reassurances that they will hit 20/20 or expects it all to be easy probably isn’t ready to start yet and needs to do a lot more reading first. There are no quick fixes (as Jake loves to reiterate) so you only get out of it what you put into it.

Yes, early gains can come fast and easy if you have the right habits and follow the path others have laid out. But, folks should know that there comes a point where it becomes a lot harder. Time, willpower, and determination will be required to muscle through to the end. People who stick with will most likely hit uncorrected 20/20 eventually. But, I’m sure a lot of people give up before they get there, or are satisfied with technical emmetropia or near 20/20 vision.


The last diopter is different.

It’s mainly because the zero reset loses magic when the uncorrected eyes become your new norms. You have to work a bit more to figure out how to provide real stimulus for this remaining ~0.5D difference.
While earlier you could easily give a ~1.5D trigger by changing glasses - whether that was from differentials to norms, or from no corrections to differentials, or from no corrections to norms.
I said “have to”, but reality is that you can already drive legally without glasses in most countries, so glasses are no longer crutches, but become a matter of preference on visual acuity.

The most important thing to keep in mind is that the last diopter is not linear.
Reposting the pic I shared earlier. For transparency…


Nice illustration which I enjoyed when you first posted it. I suppose the watery bit represents the doldrums. I suspect none of the diopters can really be called linear.

Different is a good compromise

Water represents the totally unexpected part. Never assume you know everything about your eyes, new layers of knowledge will come with every reduction.
I always smile when people want to plan their journey upfront all the way until 20/20. I admire the ambition but also hope they allow enough patience and tolerance for the unavoidable fine tuning part.
And I’m puzzled if someone refuses to start the EM journey, refuses to stop the progression of myopia just because there’s no guarantee on reaching uncorrected 20/20.

And to give the thread back to @AMati

If this was my prescription, knowing my eyes, I’d test if I could start with less complex glasses by equalising the cyl, by trading the right eye’s high cyl value in for higher SPH in that eye. To get to 1.25 cyl in both eyes (not sure in how many steps), get closer to equal in SPH (not sure how equal, depends on cyl drop and the personal experience around it), with the aim of training the brain to accept a different balance in the visual inputs, even at the price of not reducing SPH for a while yet. And if that worked, I’d definitely use that more balanced distance correction as the reference point when working out the differentials. This would definitely mean a slow start, but the return on the investment would come later.
As with any high cyl, have you investigated the lights in the places where you spend most of your time? My personal statistics shows that people with high cyl usually work at a desk that receives lights from a certain direction, or have a habit of looking above / under / through their glasses at a certain angle. Some people move or change workplaces and the cyl and the axis changes in their next prescription.


If that is what it represents, I have been swimming nearly all the way, with many deep dives. :laughing:

I chose the wrong metaphor with my Tour de France.

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Sorry, should have been more specific. I didn’t realize that the cyl could be + or - ( was going off memory). It is :
RE -5.75 sph -3.25 cyl 180
LE -7.5 sph -1.50 cyl 180.

Do the numbers both being - reduce complexity? It’s still complex but hopefully LESS complex?!?

I’m in a small town. Only 1 optometrist.

I actually am moving to using my glasses more as I’m finding lots of difficulty focusing using my contact lenses. They are Toric and have been for a while. I find I have less focus issues and less strain with my glasses but with three rambunctious boys prefer contacts as they send my glasses flying often :stuck_out_tongue_winking_eye:. I have 2 months worth of contacts left and may use them off and on with my first set of diffs until I get the first normalized.

I kind of am starting to look at this journey like you do when you are trying to lose lots of weight. It looks like it’s the same concept. Lots of dips and valleys, plateaus and slow movement up with the last 10 lbs (last diopter) being the hardest to lose.

I have to go back and read all your posts. Ta ta for now!

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I think that makes sense to try to get the cyl equalized and swap it for sph in my right eye. That one seems to be blurry at the current correction anyways. 2 years ago that eyes prescription was at -6 -3.25 so maybe I could fiddle with it a bit and get some better clarity to start off with. My glasses are the older prescription (it was only the new prescription in the contacts).

I’m a stay at home mom who homeschools. Our front rooms (kitchen and living room get a lot of natural light). I make sure I get outside for quite a while every day. I used to work in an office before having children and did a lot of computer work plus lots of close up during university (masters and bachelors). My being at home has drastically reduced my screen time but I can reduce more as I use my smart phone way too much (for instance I’m doing it right now :confounded:).

Well, it doesn’t really do much to simplify the complexity of your correction, but it does clarify which way your cylinder was measured, which tells us how much overall correction you need and what diopters you’re looking at for spherical equivalency (if we drop your astigmatism and convert the cyl to sph, what would your equivalent correction look like):

RE -7.38 sph 0 cyl 0 axis (-7.38 can be -7.25 or -7.50 depending on which your eyes prefer)
LE -8.25 sph 0 cyl 0 axis

This means your diopter gap is better than it looked initially. It is only 0.87 diopters, where it looked like 1.75D before, which is the same as what I have. So in a way, it does reduce complexity a bit since it means you have less than 1 diopter of equalization to work on rather than nearly 2 diopters. Equalization can be rough if you have a lot of it to do.

Of course, you still don’t know if this prescription is accurate since you said they don’t feel right and the correction is off in each eye. So you should validate that first.

That is unfortunate. You can’t really start on reduced lens therapy if you don’t know where your starting point is and it sounds like your current prescription isn’t right. And note that your contact lens prescription and glasses prescription will be different, so don’t mix them up.

Alternatively, you have a few options:

  1. Make an appointment with an optometrist in another town and drive a bit to get there. It will be worth your time and gas money.
  2. Purchase an EyeQue VisionCheck for $69 on Amazon (do not get the Personal Vision Tracker Plus aka PVT, it is only accurate to about 1 diopter or so, which isn’t very good). The VisionCheck is accurate to about 0.50 to 0.75 diopters, which is still not great, but should get you in the ballpark.
  3. Pick up a trial lens set and check things yourself. That is more expensive and has a bit of a learning curve, but it is super useful for not only checking your vision but for testing out options for differentials and normalized glasses before you spend money on buying them.

If it were me, I would find someone else for a second opinion on the glasses prescription. I’d also invest in the trial lens set for future testing and experimentation.

Once you have a better handle on your existing correction, you’ll be in a much better position to figure out what to use for your first differentials. I would recommend not ordering differentials until you can get that squared away.

FYI, you shouldn’t order normalized until you’ve had your first differentials for at least a month. You may find that your correction requirements will have changed in the meantime… particularly if you decide to drop some astigmatism (and convert to spherical equivalent) in the first differentials, which I would probably do were I in your shoes. Depending on how that goes and how well your visual cortex adapts, you may want to do the same in your first normalized pair.

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There are indeed a lot of similarities, including having to just keep doing what you know it good for your goal, even if you haven’t seen any results yet. :wink:

Thank you so much for your advice! I talked it over with my hubby and will be making an appointment with the optometrist in the next town once I know when he will be off work. I’m going to ask them to test my eyes as if I’ve never been in for glasses before and see what they get. I’m also going to test the waters with them and see if they will help me with my first set of differentials. It’s worth a shot right ?!?


Hi Gem! Lol may I say that you are somewhat of a celebrity. I just came across your videos and NotNot’s videos. They gave me the encouragement I needed and answered some of the questions I had that I couldn’t seem to figure out. Thank you for the welcome and the encouragement!

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While getting a second opinion without bias is a good thing, keep in mind that you’re trying to troubleshoot issues with your existing glasses. You may either wish to explain that you’re having issues with your existing glasses or ask the optometrist to put the final prescription in a pair of trial frames so you can test them out by walking around the shop a bit to see if they feel better then your current glasses. That way, if they are not better, you can ask for some fine-tuning. Of course, you can bring that up after they finish the manifest refraction.

You should also make sure that they do a binocular balance test (if you have the same best-corrected visual acuity in both eyes) and either a monocular duochrome test or 0.5 check at the end to make sure you’re not overminused in either eye on your full distance prescription. That will help ensure that accommodation doesn’t mess with your results in your first differentials.

Gem and Nott Nott definitely front runners for celeb status.
I can see the gushing teens banging down their doors as we speak!
:sweat_smile: :sweat_smile:


Might not work, they can easily analyze the power of your existing lenses. Better to leave your glasses in the car.

Better yet, become proficient at measuring yourself. Might be tough at first given high diopters and complexity, but with work you can get there.

Good luck.

Measuring yourself is a great idea, especially if you have a trial lens set and a JCC flipper lens. In fact, I suggested that above. However, it is hard to figure out the proper diopter correction from cm measurements alone since there is always some amount of error in the measurement and getting consistency at high diopters is tough. Not to mention, accurately measuring astigmatism with cm measurements can be tricky using the clock dial method.

For example, I’m pretty consistent with my cm measurements––I generally get the same range of values during the same times of day/night. So I feel fairly confident that I’m at least doing it the same way each time. Since they’re not changing, those measurements confirm that I’m not seeing any improvement, so I’m probably not ready to reduce yet. However, even after accounting for vertex distance, the numbers come in a bit undercorrected (for me at least) and don’t represent what is needed for full distance vision. Though I suppose once you understand the offset (0.50 to 0.75D in my case), it could work in a pinch. At the least, it is a good place to start before refinement with a trial lens set.

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I am so glad! Yeah, NottNott’s videos encouraged me too when I was first looking into EndMyopia.