My slow but steady Endmyopia journey so far

My slow but steady Endmyopia journey so far
I started on an Endmyopia-inspired journey approx two and a half years ago. An optician had just diagnosed me for -4.50 diopters on both eyes, another .25 setback, as had been the storyline for two decennia. Slow and seemingly inevitable decline. The brainwave “is there no other way?” led to fortunate discovery of the Endmyopia website and this great forum, and inspiration was born.

In april 2019 my first differentials (-2.25) and normalized at -3.75 were purchased from the online optician charlytemple.nl (I’m in the Netherlands). I was fanatically recording my own measurements which fluctuated between -4.00 and -3.50 for the first few months. I stepped down normalized to -3.50 in July 2019, further down to -3.25 in Nov 2019 and then I slowed down. Almost a year later, in Oct 2020, I stepped down to -3.00 and also lowered my differentials to -2.00. My progress seemed to have stalled, I was hardly recording self-measurements anymore and all the pandemic-related events were crowding out most attention for my em-journey. For the next year, I’ve been doggedly wearing the -3.00 glasses but straining a lot, and losing hope that my eyes were still progressing. Night-time driving had me reaching back for my -3.25 set. I mostly thought I’d run out of steam.

Then last month, I had a measurement taklen by an opthalmologist. He measured me between 3.00 and -3.25 with a small cylinder. (-.25 in both eyes). This reminded me that in the past, I’ve been corrected for a small cylinder on and off. I’ve bought a pair of glasses at -3.00 with the cylinder corrected and I see very sharply with them. This has encouraged me a lot, confirming that despite the slow progress of the past year, I have in fact made real progress from seing comfortably with -4.25 glasses (my last pair before the EM journey started) to seeing comfortably with a -3.00 pair. I’m now determined to continue on to -2.00 as the next milestone.

I have learnt a few small lessons through this process, probably all familiar here:

  • I may have stalled a bit because of two reasons: First of all, the -3.00 glasses I bought from the cheap online optician Charly Temple probably didn’t sit on my head in an optimal way. The poor fit caused the lenses to be tilted upwards too much, probably somewhat reducing their effectivity and making it more frustrating for me to look through this pair. And all that time I was thinking “-3.00 is just a step too far for my eyes”.
  • I think the small cylinder might have also made a bit of difference, but I wasn’t aware of it, possibly because my last few pairs from before my EM journey didn’t correct the cylinder but may have slightly overcorrected the diopters.
  • I should have been more disciplined about continuing self-measurement after my initial 6-month enthousiasm, as this might have helped to keep me encouraged
  • Most people I’ve shared this story with think I’m a little bit odd, exceptions do exist
  • It’s slightly inconvenient to always be undercorrected and I started longing for crystal clear sight, especially when outdoors in a bright starry night, spotting birds, etc. I wonder if we should reward ourselves with slightly stronger normalized now and then, just to stay in touch with what it’s like to not always have to do activefocus to see things sharply.

That’s it. Thanks everyone for being part of this great resource and thank you Jake for inspiring people to brave the different path.

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yes, this is recommended I think. It’s fine to switch to slightly stronger normalised at night as well

can’t comment on small cyl as I have more but for sure, if you get your cyl needs from the glasses, you can tolerate much more spherical blur in my experience. So especially when you are not yet steadily reducing I’d keep the cyl and focus on simple spherical reductions, but that’s just my opinion (though Jake also says do some simple sph reductions first). And I’m talking about distance. Close up you might be able to reduce more cyl and for you, drop it altogether

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Congrats on your progress so far, nothing wrong with slow progress, especially when the progress is an improvement trend. Personally I wouldn’t have added the cylinder, but we each make our own choices in this journey so good for you on that count as well. Best wishes moving forward.

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Thanks Reannon! I’m very curious to know about your personal considerations to not include the cylinder, because I was in some doubt about it as well.

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I wouldn’t include the cylinder because anything .75 or less is considered negligible (to the point even the opto won’t correct for it in contact lenses even while they will put it in your glasses), but once you get used to it, it is not as easy to train out again as spherical correction is. So personally if I need a clarity reference I would add spherical. I won’t add cylinder back in, even though my last opto measured me as still “needing” some. Many of us have concluded a little “astigmatism” is normal and easily handled by the visual cortex without needing to complicate our correction.

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Absolutely support this, and this is how I did always. I wasn’t working with a certain diopter at a time and then drop, but I was always correcting my eyes to 20/30 or better. If that meant increasing the diopter for the evening activity then I did that. E.g. If I had work in the office during the day and went to the cinema in the evening then I checked if my daytime correction gave me enough clarity to get the facial expressions and the subtitles in the cinema, i.e. if I could still read 20/25 or better on Snellen at 6 pm. There’s no point in going out undercorrected and struggling to enjoy the evening. Whatever the activity is.

As for the cyl. You are risking cyl induced astigmatism increase.

I wrote about the “on and off cyl” in another post - see below.

Simply put: When your eyes are improving it means that most part of your eye is already at the new lower correction, one part slightly lagging behind. When your eyes are degrading (i.e. the opto journey of getting stronger and stronger glasses) then one part of your eye has already given up on clarity while the rest is still trying to clear the blur.
So an on & off cyl is simply a snapshot in time. Work in progress. If gets corrected in the middle, then the “chewing gum” is never releasing from the previous diopter.

I’m also someone who almost always got measured for -0.25D or -0.5D cylinder. But never got this added to my correction. Yes, there were situations when I really noticed it. But overall it proved to be great not to reinforce or increase the difference within the eye by a cyl correction added.

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There’s that but the counter argument is that you are then increasing the sph also on meridians where your eye doesn’t need it so over correcting yourself while cyl only corrects the angle that you need so is a more precise tool. Remember it should only be for distance for him not for close up

I understand your point. However, with the goal in mind to get to zero, causing the visual cortex to compensate for that complexity now when it will need eliminating later seems counter productive. Especially with consideration for the fact that as I stated before cylinder is harder to train back out. The visual cortex sorts out these things by design, the addition of cylinder correction circumvents the natural process of the visual cortex to manage the imperfections in the image. Probably why cylinder reduction takes twice as long as spherical…

All the more reason the short lived clarity reference from the increased spherical wouldn’t really cause an issue. Over correcting for near work is where the real concerns are.
Ultimately though everyone here does decide for themselves what to do and when. I just hope they are making informed decisions when they do.

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Actually this is not necessarily correct.
I have watched dozens of official opto videos on how to measure cyl - videos created for opto students.
They all start with measuring best achievable vision with sph only. And then next step is that they start adding cyl and every time when cyl is added they deduct from the sph measured in the first step.
So basically they are admittedly pushing the stronger and weaker axis of your eye apart.

Back in the old days (until about 2000) - as it seems to me - there must have been an agreement with the old school optos that cyl is -0.25D, then -0.5D and then converted to sph and then this repeated but not going above -0.5D with the cyl correction.
20+ years ago it was a very rare thing for anyone to have more than -0.5D cyl correction. As my opto reasoned for it: it was because everybody wanted contact lenses and soft toric contacts were not yet available. (And decades before that the cyl correction had been expensive in glasses, too, so corrections were kept sph only to avoid high cost of lenses)

Then soft toric lenses appeared and a new generations of optos graduated who didn’t have to find a solution for non-toric contacts and suddenly it became relatively common to have -1, -2 or -3 cylinders added to glasses. Which is totally crazy and should not have happened to 99.9% of the high cyl wearers. Especially not to primary school kids!
This is when the measuring possibilities and the available products get ahead of opto understanding on application. :slightly_frowning_face:

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maybe, but they already prescribed me -2 cyl at the end of the 80’s, early 90’s.

Contact lenses are not a consideration for kids anyway (at least when I was a kid if was for over 18;s only)

but what you wrote does not mean necessarily that what I wrote is not correct. When you are at the stage you need cyl, you only need the extra diopters on the weak meridian

p.s. this is why I have to assume, unfortunately my cyl is not lens induced unlike 99% of EM guys and gals so no chance for me to get rid of it, short of some miracle. The increase over the years was only around 0.75 cyl - maybe that can be gotten rid of

That’s because you were special, belonging to the 0.01%
Btw what is the axis of your cyl?

Yes or no.
You say that people get the minimum correction needed for the majority of the eye and the increased correction needed for the axis.
I’ll say that people get stronger correction on the axis and weakened correction on the rest of the eye with 2 assumptions:

  • the stronger correction will force that axis of the eye to work (and then create lens induced cyl)
  • as the change between the cyl correction and the base lens is gradual, actually majority of the lens is still at the sph measurement before sph reduction due to cyl added. I.e. if the sph only measurement is -2D and then a -0.5D cyl is added so the sph is reduced to -1.75D, so the strongest axis will be -2.25D, the weakest edges will be -1.75D but the majority of the gradual change between these 2 values will be closest to -2D

This is my theory