Eye therapy for myopia

[Joe Nobody]

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I don't mean to be rude in barging in off the street, but this question's bothering me and I've run out of likely sources of information:

My wife needs extreme correction in her contacts and glasses, so she's considered LASIK surgery. She was disappointed to learn that she can't get it on both eyes, however, and after reading something about therapy, she's wondering if that's an option. There's more than one Web site claiming to offer home training kits (that exercise your eyes by viewing a video tape through special glasses) and claim that over (sometimes a long period of) time, vision can be improved without surgery. As lay persons, though, we're wondering if it really could/does work...?

If anyone has any insight on the subject or could point me to possible sources, I'd appreciate it. 🙂

 

[cpw]

Those systems are great if you have mild FARSIGHTEDNESS or binocular vision problems. Unfortunately in your wifes case her Rx is too high for those systems to do any good. All those are are glorified vision therapy regimins that aren't even specific to the needs of the patient. Vision therapy is great for people with converence problems, accomodative problems, etc.. but they're NEVER going to "cure" myopia.

Unfortunately your wife's best options are going to be Cls and glasses if they can't do LASIK. (I'm in the same boat, so I totally understand.. I can't do LASIK either)

Let me know if you have other questions. I don't want you to blow more than $100 on something I know isn't going to work. We've had many lectures on those systems. It'll work better on people who have complains of eyestrain while reading and the like.

 

[rpames]

I have not had any lectures on those programs, but from what I have seen and after asking my dad (an OD)...they are bunch of crap. I was not even aware of any success such as CPW spoke of.

Like CPW said, if surgery can't be done to help her, watching a video won't do a thing. My sister is in the -12.00s. You don't get much more near sighted than that, an she still is using contacts just fine.

Good luck!

 

[MPS]

There is some evidence to suggest that "training" improves your ability to read a letter chart: however, there is no evidence to suggest that it alters refractive error. It is likely, therefore, that training improves a person's ability to interpret a blurred image.

The current evidence would suggest that your wife would be best served by having an accurate and up to date full prescription for her myopia (see http://www.telegraph.co.uk/connected/main.jhtml?xml=/connected/2002/11/20/ecnspecs21.xml).

 

[LSUMED2006]

While I am not in optometry school, I can speak from personal experience. Is your wife a candidate for the "Night and Day" contact lenses? I have eyesight in both eyes of around -6.00, and these are a dream for me. I wear them for a month without removing them, only adding some rewetting drops once in the morning. I had wanted LASIK surgery, but after wearing these, I don't even think about it anymore.

This is just one idea, but for me, these lenses are incredible.

Jason

 

[rpames]

Night and Day lenses scare me. I don't think I would want something in my eye for 30 days strait. It takes me 30 sec. to put my contacts in when I wake up, and about 15 sec to take them out. I never thought it was big problem. I have been wearing them since 4th grade too. I guess the FDA would not have approved them if they weren't reasonable safe.

 

[LSUMED2006]

What I like about them so much is not so much that they can be worn without being removed; it is that they can be worn all day 18-24 hours without becoming uncomfortable. Other contacts I had would become incredibly uncomfortable to me after 14-16 hours or so; however, these give me know problems. I needed some lenses that I could consistently wear for 24-36 hours without having to even think abou them. These lenses are exactly what I was looking for; the fact that I can wear them when I sleep is just a plus. The only downside I have found is that they were extremely uncomfortable the first day I wore them; after that, I don't even think about them.

Rpames, I do agree with you that it does seem intuitively bad to have something in your eye for 30 days...

 

[rpames]

You make a great point, I did not think about the longer wear time it would provide. If I get up at 6:30am to get to class and then I'm studying until mid night, my contact do get pretty uncomfortable. Night and Day contacts would avoid that.

 

[cpw]

I have seen Night and Day used quite a bit with med students and residents that are up 30+ hours on call. They work great for that. Like rpames I think having something in my eyes 30 days is kind of gross. To me it seems like wearing the same pair of underwear for days on end without cleaning it. [insert puke gremlin here] But, for a lot of people these lenses are GREAT! I just wish they're start making them in torics. 🙁

 

[Francine]

I'm going to jump right in here as a first-time poster and be a bit controversial. Vision Therapy is anything but bunk, if done properly under the care of a VTOD (a vision-training optometrist.) I had two successful sessions of it: Once, after an eye accident, and much later, when I had started to become presbyopic. I had alot of trouble doing the exercises the second time around at first, as presbyopic eyes are quite resistant to therapy. But I did improve a great deal, and I got really interested in VT and what it can do in general. I'm going to eventually become an optometrist, hopefully, but right now I am still getting my BS. From asking alot of questions of my ODs and other ones, and from doing alot of reading, I have to say that I concur with the moderator. High myopia is probably not going to improve through any "natural" means. Sometimes a person is suffering from not much more than severe eyestrain, or their accommodative facility is poor, and they experience difficulty with their distance vision. I believe this is called "functional myopia," as the eyeball has not lengthened to any great extent. For a person like this, VT could be really helpful. I don't have the experience to be able to say that your wife should try VT anyway. The reason why I say this is because the etiology of progressive high myopia is not really well understood. There are many theories as to its cause, but there is alot of disagreement even among researchers. Therefore it might even be possible that trying to, say, increase your wife's amplitude of accomodation via VT might make her myopia progress even further.

Nonetheless, I am a firm believer in the efficacy of VT, as I have experienced it first-hand. I hate to say this so early in the game, but the people who say it's bunk are usually those who have never read much literature on it or investigated it thoroughly. It's actually a specialized kind of physical therapy, which works more on the brain than it does the eyes. I get this info from the mouths of a number of VTODs that I am acquainted with.

As far as exercises go, I wouldn't BUY anyone's non-specialized eye exercise program. There is lots of FREE info out there about useful exercises for vision improvement, and there are alot of people who either don't have access to a VTOD, don't have the money, or who are medical do-it-yourselfers. But I for one believe you have a 1000% better chance of improving your vision with a VTOD at the helm. There are so many variables. How can a videotape determine which exercises you should do more of? And there are lots of useful devices used therapeutically, like prisms, etc. that those programs don't use, and don't suggest. And the VTOD can determine if your response to the exercises is "normal," and therefore if they are working for you. I'm always going around providing links for people, where they can find a vision-training doc.

Cheers,
Francine

 

[cpw]

That was my entire point, Francine. I think in the hands of a good vision therapy trained OD VT is GREAT! I was just saying that those online or TV touting "miracle" programs are bunk. They're not going to let anyone throw away their glasses and they're not going to "cure" myopia.

VT works great for people with fusional vergence dysfunction, convergence insufficiency,accomodative problems etc. In the hands of a properly trained OD you can help eleviate all kinds of symptoms.

You just have to know what's bunk and what's not. You want a therapy program specifically tailored for your individual needs. Programs offered on infomericals won't give you that.

 

[Francine]

Dear Super Moderator,

Yeah, it appeared that you felt that way. But I wasn't going to start saying that you and I agree right in my very first posting. I felt it would be a bit presumptuous, as I am as yet a person totally without credentials. [Excuse me...I just re-read my posting and I realize that I did say that I concurred with your opinion. I had originally intended to edit that out, for the reasons I give here.]

It is amazing what VT can do, isn't it? After I was helped by it, I suggested it to a friend of mine whose daughter was having trouble in school and said she couldn't see the blackboard. Apparently the school had said her vision was fine, and even my friend's HIP optometrist said so as well. But it was obvious that the child was crosseyed...! I knew my eye doc had worked with alot of children, and so no one could "snow" him in any event. Well, my friend decided to pay for VT out of pocket, and her daughter, who started VT at age 10, recovered completely.

Apparently I wasn't supposed to do as well as I did. VT is not commonly given to presbyopic people. It's a good thing I didn't know this, as it probably would have inhibited my progress. No one's ever told me my IQ either, LOL, and I would rather not know it, hehe...

Cheers,
Francine

 

[MPS]

Francine,

I don't think that anyone on this board would argue that VT doesn't work: I don't think that there is any doubt that it works on people with certain problems. There is, however, no evidence to suggest that VT can reduce myopia: in fact there is evidence to suggest that such things as hypnosis and VT make no significant difference to refractive error (though they may improve a subject's ability to read a letter chart, probably as a result of motivational factors/practice effects). The only instance in which there might be a place for VT as a means of treating "myopia" is the case of physiological accommodative spasm: although the idea has scientific plausibility, I've yet to see any scientific evidence to suggest that it works. Have any of the other posters read of properly controlled studies examining this?

 

[FZISHN]

What are the conditions that need to be met for LASIK? What are the diopter cutoffs and astigmatism cutoffs? I am not in optometry and I probably and utilizing the wrong terminology/criteria, but if anyone has an idea about the cutoffs, please post or pm me.

My father is extremely nearsighted (-12 also) with an astigmatism so bad he needs torqued contact lenses (which are very expensive).

Any advice on cheaper torqued lenses or LASIK would be great.

Can he wear regular contacts just for social occasions (not torqued?), not for driving or reading?

Thanks!

 

[rpames]

I'm not sure of the lasik cut offs, but toric lenses I do know about. I have to wear them as well. He can wear what ever lens he want, but if he want to see, he needs the toric lens. That is if his astigmatism is as bad as you imply.

 

[FZISHN]

Do you know anywhere to get toric lenses that arent ridiculously expensive? I heard they were $300/pair.

 

[Francine]

You might read through my posting thoroughly before you comment. VT can and does improve the patient's refractive error. I've not only read a good deal about it, I've exerienced it first-hand. This is not a psychological reaction, although VT works on neural connections via improving the "posture" of the eyes. So it is the EOMs and ciliary muscles that VT exercises "work."

VT is best-known for improving binocular vision problems, accommodative problems, and vergence problems. It often has rather spectacular results in correcting strabismus, but even so many OMDs claim that it is "bunk."

What VT cannot do is shorten or lengthen the eyeball. Refractive errors can occur anyway along the visual pathway. Where they can be improved, vision can be improved.

You can find a great deal of literature about VT if you go to the OEP, COVD, BABO, or PAVE websites. There are many textbooks written on the subject as well. The studies, textbooks, etc. are quite easy to find.

Fran

 

[MPS]

Originally posted by Francine
You might read through my posting thoroughly before you comment. VT can and does improve the patient's refractive error. I've not only read a good deal about it, I've exerienced it first-hand. This is not a psychological reaction, although VT works on neural connections via improving the "posture" of the eyes. So it is the EOMs and ciliary muscles that VT exercises "work."

VT is best-known for improving binocular vision problems, accommodative problems, and vergence problems. It often has rather spectacular results in correcting strabismus, but even so many OMDs claim that it is "bunk."

What VT cannot do is shorten or lengthen the eyeball. Refractive errors can occur anyway along the visual pathway. Where they can be improved, vision can be improved.

You can find a great deal of literature about VT if you go to the OEP, COVD, BABO, or PAVE websites. There are many textbooks written on the subject as well. The studies, textbooks, etc. are quite easy to find.

Fran

Fran,

Believe me, I do know what you're getting at: it's just that I think that you need to be careful before holding VT up as a panacea. True, there is a considerable amount of information in text-books and on websites about vision training, and I don't doubt that your visual problems improved after you had vision therapy. What I was after was a properly controlled study showing that VT can reduce myopia (or pseudomyopia).

 

[Francine]

MPS, I now realize what you're looking for, and I frankly don't know if a specific study like that exists. Most of the literature I have come in contact with has studies with people possessing a variety of errors: binocular, steropsis, pseudomyopia, amblyopia, etc. I'll look around a bit and see if I can find one in particular about myopia, or pseudomyopia, which is the sort that would respond well to VT.

I'm not touting VT as a panacea. But it is much more useful than most people, including vision professionals, are aware of. As I've said, people with presbyopia don't often undertake it, as it is commonly believed that it cannot help them. I do have a habit of getting on a soapbox about it, though, mostly because IMO it is so underutilized.

I don't disagree that motivation is a powerful factor in this form of therapy, though, because it is so difficult...! But I don't believe that psychological factors alone can account for the degree and kind of improvements I've seen, and have personally experienced.

BTW If such a study doesn't yet exist, perhaps you or I or both of us can undertake one someday...

Cheers,
Francine