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Some says it can reverse myopia, is this a bogus claim?
Some says it can reverse myopia, is this a bogus claim?
aren't there claims on using atropine as well?
Seems like orthokeratology is the only thing that works consistently.
http://www.revoptom.com/continuing_education/tabviewtest/lessonid/106321/
That doesn't 'reverse' myopia. It temporarily reshapes the cornea.
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OP's subject is if it "helps" myopia. Orthokeratology is the only method of vision correction that seems to stop the progression of myopia and not just because of the corneal reshaping. It seems to stop the axial length of the eye from enlarging because of peripheral defocus. I don't know all the details but its being extensively researched now.
scholar.google.com ---> http://www.iovs.org/content/52/5/2170.short
http://journals.lww.com/optvissci/A...Refraction_in_Orthokeratology_Patients.8.aspx
http://journals.lww.com/optvissci/A...al_Increase_in_Axial_Length_in_the_Two.8.aspx
http://abstracts.iovs.org/cgi/content/abstract/52/6/2837
easy sauce
Which article can't you access?
Your ARVO journal states: "Overnight OK[orthokeratology] lens wear inhibits axial length growth and myopia progression over a 12-month period." which is the 4th link out of the 4.
Sorry, I'm on mobile, and the hyperlinks are wonky. I was referring to the 2nd. The two optometry articles I can't access more than the abstracts. The 3rd is a case report. The last, to which you referred is by a bunch of B & L folks--no bias there. The only legit one appears to be the Japanese one (1st article). Color me skeptical.
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I think the real question here should be "is low myopia really such a bad thing that warrants needing to be reversed?"
a proper reading prescription (if necessary) combined with well performed vision therapy can reverse myopia in many cases. No two patients are the same so you can't make a blanket statement and we're talking low grade myopia here not minus 10. although I've had a patient with a minus 9 drop two diopters.
I think the real question here should be "is low myopia really such a bad thing that warrants needing to be reversed?"
What you're talking about sounds like relaxing accommodation, not reversing myopia. Is this vision therapy reshaping the cornea or changing the axial length? I seriously doubt that.
That depends on your definition of myopia and whether you think myopia is physical (i.e. axial length etc) or behavioral.
Even if tonic accommodation is causing pseudomyopia that is still physical because the ciliary muscle is causing the lens to thicken.
What do you think is causing the ciliary muscle to do what it does?
The ciliary muscle is innervated with sympathetic and parasympathetic autonomous fibers however it can be controlled voluntarily even though it is smooth muscle. For example I can accommodate while looking at something closer or just accommodate voluntarily with no target closer. Few people can do it voluntarily.
I don't know all the history of these ODs but there are a bunch of older OD quacks so that is why I am cautious. Our education is very allopathic based nowadays. Maybe you can inform me more by what you mean exactly as "behavioral". I might have mistaken your intention.
There is the practice of some that prescribe bifocals (or progressives) to young myopes, (even children) to reduce the accommdative demand.
Whether that works or not. Who knows..
Simple answer: yes.
Complicated answer: Chickens that had reading lenses or (+) lenses attached to their eyes from birth and never allowed to see without them ended up having adaptational responses to this. Meaning they developed hyperopia. So in a sense if you want to walk around for years with only being able to see closer than you would with your current myopia and if it is done when you are very young then maybe it can reverse myopia. But you would develop amblyopia faster than you would fix your myopia if you played with the lenses during the critical period of vision development which would actually be way worse. When myopia fixing lenses were put on [(-) lenses], the chickens developed myopia.
Hello, I just registered to reply because this topic is close to me.
I am a high tech worker who is slowly losing his sight. I did a vision check and they recommended me no glasses because my number is so low (-0.25 to -0.5)
But I'm extremely afraid of deterioation due to 10 hours per day computer screen time. My screen is positioned about 30cm-40cm from me. I can't move it further because there's a wall blocking. And i can't sit away further because it get's inconvienant. I can't buy larger screen, either. I wish I could.
I am afraid of deterioration because my eyes focal center is positioned always 40cm away from me. I'm convinced this had something to do with my sight deteriorating slowly. because..
What kind of animal, living in the wild, have myopia?
Do dogs have myopia, do cats, monkies, birds, elephants, horses and other mammals have it? I doubt.
Do villagers living in africa in the most ancient tradition, have myopia?
Is the precentage of farmers who are having myopia, is bigger, than the precentage of high tech workers who are having myopia? I doubt.
All this convinces me that myopia. at least my own minor myopia, is the pressure of sitting all day long, reading books, computer screen, TV and so forth. because if I would go outside and farm all the day I doubt this kind of situation was occuring. But this is all my speculation..if you have a research that proves otherwise I would like to see it.
I thought - If i could move the screen away - OR - move my focal focus point further away, by wearing reading glasses (let's say +1 for instance) then my vision would stop deteriorating. I am now replying in this thread because I really want to discuss this with professionals from the field to see whether am I right or wrong. I am now on the verge of making an important decision, whether to not buy reading glasses - and then risking more deterioration. or, buying reading glasses and then risking deterioration because I did something totally wrong to my eyes. I don't know what to do.
The experiment about the chickens makes sense. at first, the chickens only saw very far away. too far. and they developed, like you said, hyperopia. and then they suddenly saw from very close all the time - and developed myopia. But something's missing from the experiment. what if the chickens wore the +1 lenses once again after their were myopic? would their myopia improve? would it disappear? what would happen? that's the answer i'm looking for. Is there any kind of experiment such as this?
Hello, I just registered to reply because this topic is close to me.
I am a high tech worker who is slowly losing his sight. I did a vision check and they recommended me no glasses because my number is so low (-0.25 to -0.5)
But I'm extremely afraid of deterioation due to 10 hours per day computer screen time. My screen is positioned about 30cm-40cm from me. I can't move it further because there's a wall blocking. And i can't sit away further because it get's inconvienant. I can't buy larger screen, either. I wish I could.
I am afraid of deterioration because my eyes focal center is positioned always 40cm away from me. I'm convinced this had something to do with my sight deteriorating slowly. because..
What kind of animal, living in the wild, have myopia?
Do dogs have myopia, do cats, monkies, birds, elephants, horses and other mammals have it? I doubt.
Do villagers living in africa in the most ancient tradition, have myopia?
Is the precentage of farmers who are having myopia, is bigger, than the precentage of high tech workers who are having myopia? I doubt.
All this convinces me that myopia. at least my own minor myopia, is the pressure of sitting all day long, reading books, computer screen, TV and so forth. because if I would go outside and farm all the day I doubt this kind of situation was occuring. But this is all my speculation..if you have a research that proves otherwise I would like to see it.
I thought - If i could move the screen away - OR - move my focal focus point further away, by wearing reading glasses (let's say +1 for instance) then my vision would stop deteriorating. I am now replying in this thread because I really want to discuss this with professionals from the field to see whether am I right or wrong. I am now on the verge of making an important decision, whether to not buy reading glasses - and then risking more deterioration. or, buying reading glasses and then risking deterioration because I did something totally wrong to my eyes. I don't know what to do.
The experiment about the chickens makes sense. at first, the chickens only saw very far away. too far. and they developed, like you said, hyperopia. and then they suddenly saw from very close all the time - and developed myopia. But something's missing from the experiment. what if the chickens wore the +1 lenses once again after their were myopic? would their myopia improve? would it disappear? what would happen? that's the answer i'm looking for. Is there any kind of experiment such as this?
Kephart did a study of school children and changes in static retinoscopy for when they were in school versus summer vacation. The results were statistically significant showing a decrease in myopia when the children were not in school.
Here is what myopia is all about from my point of view (pardon the length):
Everyone tend to agree that structure determines function. However, people dont tend to realize that function can modify structure: the size of every muscle is determined by function, as is the size, direction, and structure of every tendon and bone plus the circulatory and even the nervous system. There are records of sudden emotion causing functional symptoms. For example, a person receiving very distressing news (i.e. a death) can have an acute attack of glaucoma. If it doesnt last too long, the glaucoma goes away. However, a lasting high pressure in the eye can become irreversible and structural changes will occur in the eye.
What data do we have or what tool can we use to see that myopia can be acquired or developed? Retinoscopy. Getman performed nearpoint retinoscopy on school children while reading. When reading easy material the children showed a with motion. When reading slightly difficult material they scoped netural. When presented with very difficult reading material there was a definite against motion. This shows that under stress the child is accommodating more than the fixation distance requires. Kephart did a study of school children and changes in static retinoscopy for when they were in school versus summer vacation. The results were statistically significant showing a decrease in myopia when the children were not in school.
Lets talk about the nervous system for a second. Two parts of the central nervous system are at work with accommodation and convergence: the autonomic and the voluntary. These two system usually work in sequence in the body; one will start an activity and the other takes over and finishes. However, with the visual system the two nervous systems must work simultaneously in order to maintain single, clear vision. This is highly stressful to the brain to have these two systems working simultaneously and usually, through brain scans, you find one nervous system being in dominance over the other and it often fluctuates which one is in dominance. The body creates a buffer area to absorb excessive stimulation and preserve clear and single vision.
The buffer in the accommodative and convergence patterns is called hyperopia and exophoria respectively. The normal eye is not emmetropic or ortho under a cover test. These are indicative of a problem in the visual system. The normal eye is hyperopic and exophoric because of its use as a buffer. When the visual system is under stress it absorbs the buffer zone. When there is too much stress and the buffer zone is all used up we enter emmetropia and orthophoria and then we move into esophoria and myopia. If not countered, the individual that continues under this stress will undergo physiological changes and myopia with become structured and irreversible (function modifying structure).
So what do we do about it? Prescribe a lens to minimize the stress. In this case, plus at near. Now the best way to treat myopia is to prevent it from happening in the first place which means it needs to be treated when the patient is still hyperopic or at least emmetropic at distance. Unfortunately most patients dont come and get an exam at this point in myopia development but we can treat them in the intermediate stage when patients are first starting to enter myopia with proper lens prescription (usually a bifocal at this point, at the very first stage you can usually get away with prescribing single vision) and vision therapy or at least a lesson on proper vision techniques (emphasizing peripheral awareness). In the best of all possible situations the myopia is resolved. This doesnt happen all the time, but at the very least the myopia is stabilized and doesnt progress beyond a half to one diopter.
Hope this helps. If you have any more questions, I will try to answer them best I can.
The amazing thing is that you actually seem to believe what you're saying (i.e., that you can reverse or at least halt myopia with lenses and vision therapy). I'm sure that allows you to sell it well to your patients and makes you quite a bit of money. Congratulations.
If you're going to reply, at least have something constructive to say.
I'm merely presenting an alternative viewpoint supported by clinical evidence and logic.
If you have evidence or arguments that can refute what I'm saying I'll be happy to read it and take it into consideration.
I never claimed this was the case for all myopes and was not intending to make such a blanket statement that included every myopic case. I apologize if it came across that way. I was giving an example of a possibility when a glasses prescription can be used to help myopia. There are plenty of cases where this is not so.
I agree with your statement of there being a genetic component. I've seen the same trends and data that support that case. I'm not arguing for nurture over nature. There is always a combination of both.
Could you give us an example of someone who you believe would have their myopia halted (or reversed) by using lenses and/or vision therapy?
+.50 to +.75 should be used if you see the following:
patient reports blur at distance even though acuity is 20/20
Improved near acuity through plus
Pursuit fixations smoother through plus
Near point retinoscopy shows neutral
no change in acuity at distance through plus
Lateral phoria test indicates esophoria
reading distance is more than two inches shorter than the Harmon Distance (distance from elbow to knuckle)
They show less plus on the static ret than they do on the distance subjective test
so if someone presents in the above fashion by prescribing low plus you believe you are halting or even reversing the progression of myopia?
quack, quack
(sorry couldn't resist)
you do realize there is no good data to support such an incredulous claim.
Don't just shoot me down. Back yourself up. Where's your data? Where's your argument for the contrary? If you have a patient present in the fashion I described what would you do? I have not once told any of you that you were wrong. In fact I've actually said I've agreed with you in some instances.
You asked for my opinion and I gave it. The least you can say is thank you for participating and giving an alternative point of view. I'm here for a good, professional debate on myopia and the use of plus lenses. You are entitled to your opinion and if you have something constructive to contribute go ahead, if not, stay out of the conversation.
Also, I'm discussion myopia that is developing in elementary to early middle school age children. Not anything congenital or adult onset.
If you are talking about pediatric myopia progression then like those experiments with the chickens. If you want the kids to wear (+) lenses all the time for years ever since birth then yes maybe their axial length will adjust slowly and they will not be as myopic as they would be. But I doubt any human studies have been done on this. Myopia is partly genetic and partly epigenetic (environmental) just like most other conditions. The highest risk factor for developing myopia is having two myopic parents.
+.50 to +.75 should be used if you see the following:
patient reports blur at distance even though acuity is 20/20
Improved near acuity through plus
Pursuit fixations smoother through plus
Near point retinoscopy shows neutral
no change in acuity at distance through plus
Lateral phoria test indicates esophoria
reading distance is more than two inches shorter than the Harmon Distance (distance from elbow to knuckle)
They show less plus on the static ret than they do on the distance subjective test
occasions when plus should not be prescribed? Yes. Here you go:
distance and near acuity reduced through plus lenses
poorer pursuits through plus
near point ret showing increase in against motion through plus
so if someone presents in the above fashion by prescribing low plus you believe you are halting or even reversing the progression of myopia?
quack, quack
(sorry couldn't resist)
you do realize there is no good data to support such an incredulous claim.
If myopia is induced, in some percentage of the population, by long term near work, and if that is proven by research, then...
looking at far distances and stopping the near work, can halt myopia progression. (obviously, if there is such a research noted above, then if a person was not doing the near work from the first place he would be less myopic) and..
plus lens makes you focus at the far distance while actually doing the near work. (According to my understandings)
it's that simple! it's extremely logical theory. why wouldn't it work?
if there is a large scale research already attempted this, then please show me.
another way of putting this is replacing strings :
if there is a research proving some percentage of the population becomes myopic because of near work, then that percentage can X entirely in order to halt myopia.
now, you can replace X with one of the below because they're all equal :
X = "stop near work" = "use plus lenses" = "focus far" = "move the screen away" = "be outside"