Just starting, with strong diopter ratio

Hi everybody!

I first learned about Jake’s method more than a year ago, but got busy with an international move… and I probably wasn’t ready then. But I think I am now, after reading about the encouraging successes on this forum.

The odds are pretty much stacked against me, since I have:

  • strong myopia
  • astigmatism
  • amblyopia
    But I’m eager to get started and beat the odds.

Measurements from the optometrist:
Right: -4.25 (SPH), -1.75 (CYL)
Left: -9.00 (SPH), -3.75 (CYL)

My actual prescription for my left eye is lower (-7.00 SPH and -3.75 CYL). It’s been under corrected for years, supposedly to avoid double vision (I wasn’t questioning the optometrist back then…).

I’ve read a lot about amblyopia during the last year, and even found exercises that help. A few days ago, I had a breakthrough and got both eye to work nicely together. I’ll probably write about it another time.

I’m not sure whether to try to work on my stereo vision first (before starting reducing myopia), or do both simultaneously. I know some people on the forum had similar problems, and it looks like I have a lot more reading to do.

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Welcome to the forum.

By the sound of it this is @Ursa’s area of specialty. :wink:

I’m sure I’m not the only one who’d like to hear the story. Could give ideas to anyone who feels that the weaker eye is falling behind.

There’s a lot of good info on the forum, so reading is definitely a good idea. In the meantime you can measure your cms and work out the differentials to use for close-up work, and see how the stereo reacts to that.

Good luck!

Area of experience, not area of expertise - although I am doing my best to learn more. :wink:

This is a more extreme example of my own starting situation, but I also had (still have) a big diopter gap in both sphere and cylinder The good news is that I have improved in both eyes to about the same amount, with the weaker left eye lagging behind the right eye by about 6 months.

I have done no exercises for amblyopia and as I did EM cold turkey, using reduced glasses only for measurement and the little driving I do, I did not force or hold back any changes in my eyes.

When I first tried to use one-lensed diffs (-4 for the left eye) to try to get my eyes working together at screen distance, I was totally unable to do so on account of double vision. One image much higher than the other, the two text lines sloping in opposite directions, and one darker and smaller than the other, and my visual cortex quite sensibly refused to deal with it. I had been working without correction at the screen for many years, and the left eye image was supressed at that distance. I did regularly check to see if there was any improvement in this crazy vision, and recently found out that my pupillary height is different in my eyes, and by pushing my one-lensed glasses down my nose a little I had less double vision. And best of all, with this slight adjustment, my vision snapped into place at the right distance, which is the left eye being taken into account. This works for only such a short range that it is impossible to work in this way - and causes headache if I try for too long

The other good news is that this distance to binocular clarity with the same diffs has increased over the space of a year (44cm in Jan. 2020 and now 58cm), which is another confirmation for me that my left eye is improving and that I am relearning to converge accurately at close vision distance.

@sylvain You will not be doing EM cold turkey, even if you were tempted to, on account of your high myopia, but my story illustrates than one can improve even with a crazy mismatch in the eyes. Good luck and welcome to the forum.

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Thank you @Ursa and @BiancaK for the welcoming messages. It’s good to know others have taken that route.

About stereo vision, let me share my story as it may be useful to others. Sorry it’s a bit long, but the trick was autostereograms (you can skip to that part if you’re in a hurry). Disclaimer: I’ve done all of this without the supervision of an orthoptist (I have an appointment next week for an evaluation).

It all started after hearing of a study at McGill by Prof. Hess and his team (example of one of their publications) and reading Susan Barry’s book “How I fixed my gaze”. I felt comforted in the idea that amblyopia in adults is not a lost cause.
The McGill study made use of a modified Tetris game using blue/red 3D glasses (anaglyph) where one eye sees the falling blocks while the other sees the blocks that have already fallen.
I’ve reproduced this experiment for myself (for those who are interested, I can share my software).
I also made my custom exercises with text in which 1/3 of the words are seen by the left eye (blue), 1/3 by the right eye (red) and 1/3 by both eyes.
In both exercises (Tetris and text), what I noticed is that the image from the left (weak) eye was shifted slightly right and upwards compared to the right image. Practicing helped reduce the gap a bit, but it never locked in place, it was kind of floating. Also shapes are distorted: the left eye sees things a bit more squished vertically). I did these exercises for several weeks more than a year ago, then stopped for a while.

I also observed this offset in real life. Throughout my day, I often find myself closing my eyes in turn, and clearly see the shift taking place.

So… back to my breakthrough. As I was pondering where to start in my journey towards a better eyesight, I read again about amblyopia and ways to reduce it. I found some more advanced ways of helping both eyes to work together, including the use of 3D shutter glasses, but I haven’t tried that yet.
But then, exactly a week ago, when reading about stereo vision, I found a reference to autostereograms. You might remember the book “The Magic Eye” from the 90s. A 3D image pops out of a pseudo-random picture, when looked at in a certain way. Not everybody sees the 3D shapes, but I used to be able to do it as a teenager, and so I wondered if that was still the case (I found examples online).
And I was! But the interesting thing is: I felt something in my eyes, a discomfort at first, but I soon realized that my left (weak) eye was working hard. Some muscles were engaged in a way they usually aren’t. I focused on that feeling, and, after closing my eyes to go to sleep, I was able to reproduce it. That was Friday night.
The next day, my Tetris game with blue/red glasses was suddenly easy. Everything was aligned, not floating anymore. All I had to do was to actively engage my left eye, and I believe the Magic Eye pictures I had looked at the night before had allowed me to discover how to do it. To me it feels like how people describe how they discover active focus: you can’t explain how to raise and eyebrow, but once you know how to do it…

I spent a lot of time outdoors last weekend, and I was able to keep this focus (maybe I should call it “active coordination”) all the time. I even doubted I was able to turn it off. The images from both eyes were aligned ; sure, one of them was blurrier, because under-corrected, but at least there was not double vision. This was true for both near and far objects. I was able to read with both eyes engaged, and could appreciate a small improvement in depth perception.

Since then, I was able to improve my stereo vision further by using my newly acquired trial lens set (-1D in the left eye, and +1D in the right) for close-up reading. This is the highest quality of depth perception I remember experiencing!

Because I have an orthoptics appointment next week, I decided to not force it and let my left eye be lazy again for a few days, so I have a documented baseline before I resume my efforts.

I’ll report what comes out of the orthoptics appointment. Over the phone I got the feeling the doctor wasn’t too confident about the chances of reducing amblyopia in adults. Let’s see if I can change her mind.

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Thanks for these fascinating details. Kent (@kem) found a professional willing to work with him on tackling his own amblyopia and I hope you can do the same. If not, you are on your own - but you seem determined to do so anyway.

Sylvain, you sound like a sensational candidate for this method of getting better vision. Keep us posted!

Thanks for sharing.
I only had a 0.25D difference but even that needed “eye coordination triggers” every now and then or the mono eye images shifted left and right.

Hi all,

An update on my journey is long overdue.

In January, I saw an orthoptist but that wasn’t very helpful (basically, I should be happy to have at least some degree of stereo vision, and she said her typical exercises would not help me). I also felt that she lacked the curiosity to try and understand what I was telling her about my experience, and I realized I had to solve this all by myself. At least I now have a baseline with standard tests, and I can always go back for a follow-up appointment in the future, if I feel my eyesight has improved.

I am now convinced that my amblyopia consists of several factors, some of which may be the consequence of others. It doesn’t really matter in which order they appeared. They are so intertwined that I need to tackle them at the same time, and make small progress on all fronts.

  1. Convergence
    After discovering (with the help of stereograms) that I could actively force my left (amblyopic) eye to look exactly in the right direction, I am now able to check once in a while that things are still aligned. I can close my eyes in turn and make sure the image doesn’t jump. In order to make the task easier, I had to adjust my prescription to make sure the left image was good enough (see next section on acuity).
    I had assumed that, once I discovered this ability to actively converge, it would stay locked in place and the problem would be solved forever. Unfortunately, after a couple of weeks of not paying attention, I realized that my left eye had become lazy again (only a tiny angle error), and that was associated with poor visual acuity. In other words, my left eye stopped tracking the right one at the same time as its contribution was blurrier.

  2. Visual acuity (optical)
    Because of strong myopia and astigmatism, my left eye has a hard time getting a clear image. With the use of my lens test kit, I experimented (and then ordered) temporary glasses with -1D for the left eye, and +1D in my right eye, on top of my contact lenses. This is explained by the fact that my left eye had been undercorrected for many years (to avoid double vision) and my right eye had recently felt over-corrected, especially for near work on the computer.
    This provided the right balance, but the optical quality of contacts + glasses wasn’t satisfying, and I also came to the conclusion (after a couple of weeks) that +1D in my right eye was slightly too blury for all-day use.
    So I ordered a new pair of contacts with a -1D increase (left) and only 0.5D decrease (less myopia correction) in the right eye, compared to my last official prescription.

  • Before: -7.00 -2.25x40 (left) and -4.00 -1.25x100 (right).
  • Now: -8.00 -2.25x40 and -3.50 -1.25x100.
    In a way, it’s like taking a step back on the left eye to give it a chance to improve.
    I’ve been using this for 2 and a half months and it’s pretty good. But I feel there are times when my vision gets blurrier. This can happen when I’m reading a book (sometimes with a patched eye), and I know my left eye should be able to read the text pretty clearly. Once it got completely locked in a state of astigmatic blur (kind of double vision). A quick test with a CYL lense from by kit confirmed that it could be “fixed” optically. But since I knew it was a transient problem, I tried to fix it with exercises.
    I found that moving my eyes side to side (or up/down), or changing between focus planes helped restore a good acuity. Now, throughout the day, I try to remember to look at things (text in particular) at different distances and angles.

It’s not clear to me what muscles involved in moving the eyes sideways (which I’m streching/relaxing with exercises) could be the cause of transient astigmatism. If someone has an explanation, I’d be happy to hear it. It’s worth noting that such exercises are not unlike some from the Bates method, so… someone else must have found them useful for something.

One last note on visual acuity and optics: I have spatial distortion in the more astigmatic eye (it looks squashed vertically). But when both eyes are open, they still fuse nicely, without double vision.

  1. Suppression
    Even with perfect optical correction, and good focus, my left eye is still not as good as the right eye. It could be that the shape of my eye is so irregular that it can’t be fully corrected with standard lenses. But there is something else in the visual quality: less contrast, harder to see in low light, and kind of noisy overall. I attribute this to suppression, since the brain has learned to partially ignore the signal from the left eye when the right eye can do the job by itself.
    I know this is an effect of amblyopia that is hard to fix in adults, but based on the studies I’ve read, I started 2 kinds of exercises:
  • alternate patching with active shutter glasses (I built my own version of these). I usually do that while watching TV.
  • patching one eye with a translucent film. I read that, in adults, patching the amblyopic eye was actually more effective than patching the fellow eye (as it’s done for children), and could restore some acuity. I experienced such an improvement (at least temporarily). Since I also wanted to practice focusing with my amblyopic eye alone, I ended up with a protocol where I patch the amblyopic eye for 2 hours, the fellow eye for 2 hours, then the amblypic eye again, and I finish with the shutter glasses. I’m able to do this a few days a week when I work from home.

Overall, I find that this takes a lot of time and energy to remember to use both eyes, and actively find good acuity with my left eye, otherwise it gets dominated by the right one. It’s much slower progress than I anticipated, and I hope to soon get to a point where the left eye is strong enough to start reducing diopters.

If you have any thoughts on my process, I’d love to hear them.

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I can’t believe it took me so long to realize… it was so obvious, and I was so concerned with astigmatism that I missed it: what I was experiencing was ciliary spasm! It turns out that, in my case, the symptom is not just transient myopia, it is mostly transient astigmatism. After reading a bit more about it, it seems very likely that the contraction of my ciliary muscle is not uniform.

So I went to the local pharmacy and bought reading glassed (+1D) for close-up work, and the problem is gone. I’ll be using those for a while, as my first differentials (on top of my contacts), and maybe try something a bit stronger to get a bit more blur and practice AF (it’s pretty clear with +1D).

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This whole saga is very interesting, and I think it’s extremely cool that you’re building your own hardware / tools to help along the journey.

It’s too bad that the orthoptist isn’t curious enough to help out, but on the other hand that may have been a blessing in disguise because it forces you to break new ground and figure out what actually works.

I’ve been tempted to go for vision therapy myself just to learn the tricks of the trade and see if there’s anything that would be useful to me, but after spending an afternoon calling around to try to schedule an appointment there’s not much interest in helping emmetropes who want to improve performance other than to tell me it’s $750 for a half-hour consultation.

Have you tried partial occlusion? I’ve read about putting tape over the glasses near the nose bridge on one or both eyes so that the dominant eye can’t fill in for the lazy eye and the two are forced to work together for the brain to make a complete image. It’s a low-tech and free solution (a penny worth of tape and a pair of glasses you already have.)

You can move the tape around strategically to deal with your situation.

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@nycmao thanks for the tip, I’ll give that a try.
I naturally doing something similar: I sometimes place a finger in front of my dominant/strong eye, and look “through” it. This allows me to check the alignment (nowadays it’s good and stable) and the quality/focus of the weaker eye, especially with text.
Overall, I think my binocular fusion is pretty good, with no double vision in spite of the astigmatism-caused distortion (vertical squashing). So this gives me hope that my brain can adapt to all the variations that are coming its way.

What I’m more worried about is finding active focus in a way that both eyes can do it together. I’m still working with occlusion, to make sure each eye has a chance to discover and practice it on its own. It’s very hard for me to detect when the right eye produces a sharp image but the left eye isn’t. I’ve lived with poor focus in the left eye for so many years that I’m not able to detect blur unless it’s in the right eye.

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Have you tried prism flippers with and without your autostereograms?
Brock string?
Marsden ball?
It sounds like you’re already doing “too well” on your own to attract the interest of the orthoptist but I don’t see why the typical vision therapy exercises wouldn’t benefit you.

The idea with the prism flippers is to make convergence a little bit harder (because you have to overcome the prism) and to sort of “wake up” the part of the brain that makes sure the eyes are aligned. As I understand it, with a little practice one can become much faster and more adept at convergence.

My opinion is that a lot of the medical community defines “normal” or “healthy” as functioning better than the bottom 2% of patients, rather than looking for optimal levels of functioning. So they may turn you away for treatment because you’re now in the 20th percentile of convergence, even though with training you might be able to make it to the 50th or 90th percentile.

I had used the brock string in the past, but mostly as a diagnosis tool. I haven’t found that it allowed me to fix things. Since I discovered proper convergence using autostereograms, however, I’m able to see the results using the brock string. I’ll give prism flippers a try if it can help strengthen convergence or make it faster.

Right now I’m working with that partial patch (using tape) as you suggested, and it allows me to keep both focus and convergence in check while I do close-up work.

Supposedly it can. The way I’ve read about it being done is you time how many flips you can clear up in a minute. So you might be able to clear three flips per minute when you start out, and in a few weeks or months you can clear 15. I’m just making up numbers and obviously it depends on you and your prism flippers, but the point is with practice it’s possible to improve a great deal.