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Re:Investing in lighting did great things for my mental and ... by goldenkey on Saturday May 28, 2022 @09:18AM (#31540114)
As an optometrist with a deep knowledge on this subject, let me first say, the established edifice of eye care and laser eye surgery is an abomination that ruins lives. The advice your optometrist gave you is the information they were indoctrinated with and sadly, it's erroneous.

What follows is my best synopsis on what is wrong with the industry, what causes worsening vision, and what you can do to resolve your vision issues in a matter of months and never have to worry about it again. You'll still need some form of corrective lenses though - I'm not selling bullshit.

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Most cases of myopia (nearsightness), involving progressively worsening vision, are largely due to inaccurate lens prescriptions.

An optometrist or optician will have you sit with your head in the phoropter asking "better/worse" while flipping lenses - pretty much a binary search type of approach. But this is often done hastily and results in inaccurate prescriptions.

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Unfortunately, inaccurate scripts are often inflicted upon children which as I will describe later, compounds into worsening vision over time, with the opticians/optometrists prescribing higher and higher power lenses that are only solving an issue that is created by the previous history of inaccuracy! Telltale signs of inaccurate scripts include:

- minor corrections

Eyes are not static objects and vision actually does vary from month to month, day to day, lighting conditions, blood pressure, etc. If a correction is minor, it's almost always unecessary and harmful.

- slightly different prescriptions for left (OS) and right (OR) eyes.

99.9% of folks have equivalent vision in both eyes. Like I said above, if a difference is minor, a correction would almost always be harmful.

- minor cylinder corrections (astigmatism.)

Astigmatism is extremely rare and when it does occur it's almost never minor. These corrections are especially egregious as they cause distortion compensation.

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So why do eye professionals commit these cardinal acts of eye destruction upon their patients? Well we already discussed hastyness but that is clearly a vice that is going to result in bad outcomes in any profession.

What else? Well, eye professionals are taught to seek out as perfectly sharp an image as possible, and then back off the power a bit to reduce the possibility of eyestrain, headache, and dizziness. Some professionals don't even back off the power though..

In order to accomplish this task of perfect sharp vision, they add all of these minor corrections. When these ill-fitting lenses are worn for months on end, the body has a somatic response. The eyeballs elongate, which pushes the focal plane back, causing further myopia. [1]

The patient goes back to the eye doctor and now receives an even more incorrect script based on the transient state their eyes are in, induced by a cascading patterned history of harmful scripts.

In the worst case, the eye doctor recommends laser eye surgery which shaves the corneal lens of your eye into an artificial lens. Essentially, they carve your current harmful prescription straight into your eyeball. And then guess what happens? The eyeball shortens and often, the patients vision becomes progressively worse again. It can take months, but it does happen. [2] And now the fix that they recommend? More laser eye surgery. It's barbaric.

So please, do not get eye surgery before trying what I recommend below. Surgery on the cornea is advertised as non invasive but it can cause life long issues such as chronic dry eye. Please try to assess whether your vision is actually bad, or just a transient state due to a long history of bad prescriptions and poor habits.

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How do you break the cycle and restore your vision?

1) First, look at your current script. How asymmetric is it? How small are the cylinder values, if any?

Lower the scripts power and make the prescription symmetric. Remove the minor cylinder values. So for example, if you had -3.6 and -3.4 with some small astigmatism corrections, just ask for a script for -3.4 SPH in both eyes.

2) Make sure the pupillary distance is correct - eye professionals are notorious for fucking this up because the PD needs be to custom set for the frame the lenses will be going in, otherwise you'll have lenses with a focal center that is not aligned with the center of your eyeball. This causes distortion and uneven focus, causing eye strain and worsening vision.

3) Aspheric lenses - buy good lenses like Seiko double aspherics - just like cinema or photo lenses cost a lot of money because they reduce abberation and edge distortion, your eyes benefit from the same technology. Bottom dollar spherical lenses are okay, but strain is not healthy for eyes, and a good $300 set of Seiko transition lenses with coatings can last 10+ years. It's worth your eye health.

4) Have multiple pairs of spectacles. Use the weakest usable one (or no specs) depending on the task you are doing. For instance, I'm on my phone in bed, so I am not using any glasses. This will improve your vision over time. You can slowly reduce the power of your scripts if you care about it. I went from -4.75 to -3.5 and I'm happy with what I'm at, so I don't spend any effort trying to lower any further. But if you have the money, the time, and the will, you can get to -1.X territory through judicious use of a set of activity appropriate lenses.

Lastly, buy your own frame, buy your own pupilary distance tools, buy your own trial lens kit and trial frame like the Oculus UB6. Take time and figure out the right prescription for yourself without it being rushed. Test it and have it remade if the center of focus of the lenses is not at the center of your eyes. PD is integral!

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An eye professional who cares and understands these things CAN help and even properly measure these values but they are rare. Sometimes if you want something done right, you kind of have to do it yourself. Or at the very least, guide or give your demands. After all, you are the paying customer.

Hope this helps others break the cycle of worsening vision. If anyone has any question, feel free to reach out.

[1] https://www.ncbi.nlm.nih.gov/books/NBK470669/

[2] https://www.webmd.com/eye-health/news/20030410/some-patients...

Re:Investing in lighting did great things for my mental and ... by benreesman on Saturday May 28, 2022 @10:50AM (#31540771)
I’ll agree with the siblings that you’ve made more claims than provided footnotes, but I will also clarify that I left something out (I figured it was assumed) in the dialog I described.

My optometrist did in fact put having a current prescription as the #1 thing. I’m a lazy guy in some ways but I value what eyesight I’ve got so I go every year on the dot to get my prescription measured by competent professionals.

I asked: “(Given that we have the correct prescription and that my screen usage is unfortunately not likely to go down) what can I do now?”

Cranking up the font size and paying for a solid monitor is obviously mitigation at best: the healthy thing for a guy like me would be to run around and throw spears at moving animals, not live in a glass box staring at a glass panel.

But circumstances being what they are? I can pull a longer stretch more often on the better display without getting a headache than I could before. It’s anecdotal, N=1, but the only subject is me and I’m not selling anything.

Re:Investing in lighting did great things for my mental and ... by goldenkey on Saturday May 28, 2022 @02:56PM (#31542742)
It's not bad advice to make font sizes larger. You should also be using something like F.lux or night mode all the time. Yellow light is much less straining on the eyes than white or blue light.

Resolution really doesn't matter much when it comes to strain. I have a 2011 2560x1440 27" monitor that I've always used large font on. What's important is being able to see without straining and a larger UI helps. Having higher resolutions is nice but largely unecessary. Blur is not going to happen from making things larger if you do it right. Doing it right means that you shouldn't be changing the actual output resolution of your OS, but rather the interface size itself. On OSX you'll want to use the HiDPI (Retina) resolution options. Enabled through this script: https://github.com/xzhih/one-key-hidpi On Windows you can just set the magnification/font size through the settings panel. This applies to any resolution display -- use the full physical resolution!!

Frame rates are actually more of a factor. 120hz+ is going to cut down on strain. Avoiding PWM [1] on phones, tablets, laptops, and monitors will also help.

But really, the gold standard is for you to wear a different set of spectacles when you do your computer work. You shouldn't need the power of your full prescription to do close up work. It's destroying your eyes.

[1] https://www.notebookcheck.net/Why-Pulse-Width-Modulation-PWM...

Re:Investing in lighting did great things for my mental and ... by csdvrx on Saturday May 28, 2022 @12:00PM (#31541347)
Wow, it's the first time ever I see a confirmation that the weird approach I followed (mostly due to mistrust and weird teen ideas that the body might adapt) and worked on me has scientific bases and could work for others too and from an optometrist!

TYSM for speaking out!!!

Re:Investing in lighting did great things for my mental and ... by goldenkey on Saturday May 28, 2022 @03:03PM (#31542787)
No problem, I'm glad you didn't get caught in the cycle!
Re:Investing in lighting did great things for my mental and ... by sj4nz on Saturday May 28, 2022 @10:15AM (#31540493)
SEIKO Vision by their website does not appear to be available in the United States (no providers are listed in their directory)-- do you happen to know anything equivalent available there?
Re:Investing in lighting did great things for my mental and ... by goldenkey on Saturday May 28, 2022 @03:02PM (#31542778)
Seiko's US website has some PDFs if you do some searching but the JP website is a far better resource, and the products are international for the most part. [1]

You can read about the double aspherics here:

https://www.2020mag.com/article/double-asphericity-a-freefor...

[1] https://www.seiko-optical.com/fileadmin/media/marketing_shop...

Re:Investing in lighting did great things for my mental and ... by jmull on Saturday May 28, 2022 @10:19AM (#31540523)
I'm calling bullshit on most of this.

You're making a lot of strong claims that are unsupported or even counterfactual.

E.g.:

> Most cases of myopia (nearsightness), involving progressively worsening vision, are largely due to inaccurate lens prescriptions.

Interesting idea, but what do you have to support this provocative claim?

You argument about minor corrections isn't even logical, which makes me doubt your judgement in any of this.

And it's never a good sign when the citations provided contradict the claims. [1] doesn't support the claims it's attached to. In fact, it says:

"The underlying biological cause of myopia is unknown, and there is no widely accepted means of prevention or cure."

I hope you're not really a practicing optometrist.

Re:Investing in lighting did great things for my mental and ... by goldenkey on Saturday May 28, 2022 @03:13PM (#31542875)
I don't have a list of references ready for these kinds of debates but the information is out there if you even do a cursory glance. The Japanese have been the most vigilant in doing research on myopia. [1]

[1] https://pubmed.ncbi.nlm.nih.gov/32740040/

Re:Investing in lighting did great things for my mental and ... by germinalphrase on Saturday May 28, 2022 @10:24AM (#31540558)
The premise of this post is that (most?) optometrists are ‘doing it wrong’ - so is there any way for a layperson to vet the quality of an optometrist beyond their basic credentials?
Re:Investing in lighting did great things for my mental and ... by goldenkey on Saturday May 28, 2022 @03:08PM (#31542838)
Most optometrists are fine when it comes to diagnosing eye health. They have equipment that largely aids them in those diagnostics.

For myopia, there's really not much you can do other than ask them their approach to vision correction. For example, do they recommend multiple pairs of glasses for different activities? If they don't, you can immediately cull them or you can use them as a service and give them instructions. Doctors ultimately serve you, and if you want a couple scripts, minor corrections removed, etc. these aren't groundbreaking demands they'll reject.