reverse myopia

5 Tips for Reversing Myopia

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In my experience so far with reversing myopia, I’ve learned a few things that have made a big difference for me. They’re mostly related to ways you can make this journey easier for yourself. If you’re still experimenting with reversing myopia, below are some tips you can consider, too. 

Tips for reversing myopia
Tips for reversing myopia

#1 Use the Eye Chart Regularly

Put up one or two eye charts in places that will be easy for you to use to check your vision casually and without much effort. (Get free printable eyecharts here.) This tip is actually CRITICAL because it keeps the idea of vision improvement in your mind and incorporates it into your daily routine without adding extra work. Without a convenient and well-placed eye chart, I think I would forget about checking my vision and give up. 

I put one up near my work space (directly behind my computer monitor), so that whenever I looked up from my work/screen, I could see how well I was seeing. The distance doesn’t matter so much as long as you have something of varying font sizes and an easy way to remember how well you are able to see certain sizes (20/40, 20/50, etc) from day to day, and time to time. With this method, you will almost effortlessly start to notice how your vision changes based on the close up work that you do: reading a book versus reading on your phone versus working on your computer. Glance at the chart before you even start working – I found that my vision is often better after I’ve been outside driving or playing racket sports. 

#2 Pay Attention to How Well You Are Seeing

Pay attention to your vision everyday or as often as you can. If your vision is getting worse, you’ll catch this sooner and have a better opportunity to adjust habits that may be contributing to the deterioration. Small +/- changes in vision seem not to be always permanent initially. Conversely, if your vision is improving, then consider what might be helping. 

Check your eyes separately. Pay attention to how your vision in each eye differs. Pay attention to whether words become more clear if you focus your eye on it longer. Or if you see a word clearly and slowly back away from it, does it stay clear? And for how long? People’s eyes work together in different ways. I have one eye that seems to always improve faster than the other one. When your vision varies, think about what factors may have changed it. More sleep or less sleep? Less screen time? Reading more or less or for a long period of time? Or even the sequence of wearing contacts first, followed by wearing your glasses later during the day. Interestingly, I have found that I can see noticeably better in reduced RX glasses if I wore contact lenses (at a higher relative RX) during the daytime.

#3 Use a Computer Monitor

Use a monitor instead of a laptop screen and place it as far as is realistic for you and your screen size. This could also reduce eye strain, not to mention the superior ergonomics of the position. With a monitor so far, I think I may be doing some light variation of print pushing (a method articulated by a fellow named Todd Becker) without realizing it. I currently have a 27” screen that is placed about 90cm, 3ft from my eyes. I’m not the first person to have thought of this, and I recently came across this article on endmyopia.org which is a popular reversing myopia website.  My husband thinks I’m nuts, but I used the same set up for my kids through the Zoom school pandemic and while it looked stupid, at least their eyes didn’t become more myopic during that period. (Luck of the draw or careful attention to eye breaks and screen time/distance, we’ll never know!)

#4 You Can Reverse Myopia While Wearing Contacts

You can continue to wear contacts regularly and still use the reduced RX method to “work” on vision improvement. I got tired of wearing my glasses so often (I’m quite myopic, my glasses were heavy, and it was hard to play sports). I learned that I could buy contacts without an RX on https://www.visiondirect.co.uk/no-prescription-needed, so I didn’t necessarily need an optometrist exam every time I wanted to adjust my RX. Then I bought one pair of inexpensive glasses with a mild -0.25 RX (from zennioptical.com), so I could see better for driving or for any other time when you would like to see a bit more clearly.  

#5 Have Patience

Maybe you’ll be lucky and be one of those people I’ve read about online who seem to experience drastic, quick improvements. In general, though, you really need to adopt the mindset that this process will take place over a long period of time. If you’re the impatient type, trying to reverse your myopia or at least with the reduced lens method, is probably not for you! My experience feels painstakingly slow. I recently wore a reduced RX for almost a year without seeing any change and then out of the blue, I started seeing 20/15 periodically and now almost daily. I’m guessing that will amount to just -.50 improvement this recent year. 

Overall, the more convenient you make the process for yourself and the more you incorporate mindful vision habits, the easier it will become for you to continue trying to improve your vision!

Eye Massage and Eye Acupressure Points for Myopia

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I reviewed some online literature on eye massage to add to my repertoire of things to try for slowing / reversing myopia. As an acupressure layman, I found the acupressure points and techniques seemed to vary just enough from site to site to confuse me initially. Finally, I cobbled together some basics. 

(Note: there are also eye exercises and acupressure points on other parts of the body that directly affect the eyes. I think I will have to review those thoroughly another time.)

My basic takeaway

  • The theory is that eye massage improves the blood circulation to the eyes and relaxes the eye muscles. Tight eye muscles are understood to eventually contribute to myopia. 
  • Eye acupressure is practiced regularly in schools in China, but studies haven’t been conclusive about their benefits on myopia and I’m not sure that any studies could ever be conclusive. After all, how could they really know if the kids were doing the massage correctly? Plus, there are so many other factors that may also affect myopia progression. 
  • You have to be able to do this pretty regularly for some duration to judge whether there is any benefit to you. 
  • I don’t get the feeling that eye massage could slow myopia down significantly on its own but perhaps it would be helpful as a supplement to other methods like myopia control.

Acupressure points for myopia

I cross-checked the acupressure points that children were taught to use in some of the myopia and acupressure studies with some other articles that I found about acupressure for improving vision and eye health. Below are the points (and diagram of what) I found. I listed all the variations in naming that I came across:

  • BL2 / Zan Zhu / Cuanzhu / 攢竹 – located on the inner end of the eyebrow
  • EX-HN5 / Tai Yang / 太阳 – located on the flat sides of the temple
  • BL1 / Jing Ming / 睛明 – located in the inner corner of your eyes
  • ST1 / Cheng Qi / 承泣 – located directly below the pupil between the eyeball and the intraorbital ridge. A questionable source, Dr. Deborah Banker identified this as the access point for the ciliary muscle. Although her credibility is unclear, the ST1 point is indeed frequently mentioned as an important acupressure point. 
  • ST2 / Si Bai / 四白 – located on the depression of the infraorbital foramen below ST1, about where the nostrils begin
  • Tianying / Ashi – I could only find mention of this point twice, but I included it because it was mentioned in articles that were specifically dealing with myopia.  It seems to be located vertically between BL2 and BL1. It is also the first point referred to in this video by Dr. Grace Tan, whose credentials seemed legit (if you are open to TCM). The Dr. Banker article stated that this point could manipulate the superior oblique muscle which is a muscle that can cause the eye shape to change.
  • Series of points covered by scraping along the eyebrow and just below the lower lash line, points which were included in both of the studies of Chinese students and also an easy to follow video of Dr. Grace Tan performing the massage: 
    • ST1 (see above)
    • TE-23 /Sizhukong / 丝竹空 – located on the outer end of the eyebrow
    • BL2 (see above)
    • EX-HN4 / Yuyao / 鱼腰 – located in the middle of the eyebrow in the hollow, directly above the pupil
    • GB1 / Tongziliao / 瞳子髎 – located on the outer corner of the eye
Eye acupressure points for myopia
Eye acupressure points for myopia

How to do acupressure on the eye points

For each of the points, there were different recommendations for what to do – it seems that you could do either a circular massage or a press and release: 

  • Circular motion – This is a circular kneading motion on the point with your fingers. Apply gentle pressure at the same time as kneading.
  • Press and release – Press at a 90 degree angle for 10-30 seconds and slowly release. Do this for a couple of minutes for each point. If you prefer a more precise time prescription, you’ll just have to make it up as I found a range in my review of the literature. 
  • Scraping – Apply light pressure and sweep your fingers along your brow line and below your bottom lash line. This encompasses stimulation of multiple points around the eyes.

Resources

Research on whether eye exercise or massage can be helpful:

Identifies different eye acupressure points and talks about the specific eye problems that they may address:

Explains how to do the acupressure:

Videos that show how to do eye acupressure:

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Reversing Myopia: Update #1

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Reducing myopia: Going the other way seems doable. . . but slow

It has been about one year since I began trying to reverse myopia and I am relatively encouraged by the results after visiting the optometrist to validate my progress. If you’re new to trying to reduce your myopia, check out this post first: 

  • Going off of the contact lens prescription, my right eye improved by -1.00 diopter. My left eye improved by -1.25 diopters. 
  • Going off of the spectacle prescription, both my eyes improved by about -0.50 diopters (SPH), and neither eye needs astigmatism correction -0.50 (CYL) to see 20/20. 
  • I read on this post that the average rate of change on eye improvement forums seems to be about 0.25 to 0.75 diopters per year. 

In order to minimize variation in measuring my eyesight, I made sure to go to the same optometrist (actually, I’ve been to the same one for the last 13 years). Here is a chart of the optometrist prescription changes and my own reduced lens RXs over the last year:

Eye Exam DateGlasses RX (from optometrist)Contact Lens RX (from optometrist)My Reduced Glasses RX for reversing myopia during this time
October 2018Corrected to see 20/15:
R: -8.00 w -0.50 astigmatism
L: -6.25 w -0.50 astigmatism		Corrected to see 20/20:
R: -7.50
L: -6.50		I first started wearing reduced lens June 2019:
R: -7.25 w -0.50 astigmatism
L: -6.00 w -0.50 astigmatism
End of September 2019Corrected to see 20/15:
R: -8.00, no more astigmatism
L: -6.25 w -0.50 astigmatism

Corrected to see just up to 20/20:
R: -7.5, no more astigmatism
L: -5.75 w -0.50 astigmatism		Corrected to 20/20:
R: -7.00
L: -6.00		In October 2019, I started wearing:
R: -7.25 
L: -6.00 
Early August 2020Corrected to see 20/15:
R: -7.5
L: -5.75 w -0.50 astigmatism

Corrected to see just up to 20/20:
R: -7
L: -5.75 (no astigmatism correction)		Corrected to 20/20:
R: -6.50
L: -5.25		In March 2020, I started wearing:
R: -7.00 
L: -5.75 

Things that may have contributed to this vision improvement

I do think the improvement is significant enough to indicate that something about the reduced lens method could be working. At the current rate, I will have decent vision without glasses in 5-6 more years! Here are all the things that may (or may not) have contributed to this improvement:

  • I wore reduced lens by about 0.25 diopter from 20/20. Each time, I started to see 20/20 with my glasses, I reduced the lenses by 0.25 diopters more. For what it’s worth, -0.50 amount of astigmatism (CYL)  is approximately 0.25 (SPH) according to this helpful manual. I find that to seem about right in my own testing.
  • I did not wear differential lenses (for close up work) as suggested by some myopia reversal sites. It’s a bit of work to do that.
  • I tried to incorporate regular eye breaks during screen time with this cool timer (that I originally bought for my kids).  I used eye charts as a way to check my vision in a consistent way. Unfortunately, I still sometimes have 2-3 hours of uninterrupted screen time when I’m really focused. I used eye charts as a way to check my vision in a consistent way.
  • I averaged 6.5-7 hours of sleep at night. I’m trying to bring that up to 7-8 hours.
  • I average 1-2 hours outdoors everyday. 
  • I drank chrysanthemum tea with goji berries about 1-2x week on average.
  • I’m in my forties. According to some accounts, this is when distance vision gets a little better and close vision gets more difficult – but not typically by a lot.

Things to note

  • Night vision – on endymyopia, many folks seem to say night vision is challenging despite improvements to daytime vision. I agree night vision is definitely not as good as day vision, but I am probably still seeing 20/25 at night. My optometrist said that even measured at 20/20, I could expect my night vision to feel especially worse, because I was used to a certain amount of clarity at night (because I can be corrected to see 20/15 and am used to that clarity). 
  • Despite not doing a whole lot of conscious active focusing or print pushing or wearing a differential lens, my eyes did improve. I’m guessing that I will need to step up the active focusing on things, etc.in the next year to come if I want to keep improving my vision.

Thoughts? More info? Better info? Questions? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Can Axial Length Be Reduced?

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Updated 4/14/22

Image credit: myopiaprofile.com (a very helpful site, btw!)

This is a niche post for those of us trying to explore the causes and cures for myopia. Since the causes of myopia are not fully understood, the treatments are still under discovery and experimentation. If you search online, you probably won’t find much evidence that the axial length of the human eye can be reduced – this is a key measurement that folks are using as an objective way to determine if axial length myopia can be reversed. However, I suspect that there exists some evidence – it just hasn’t reached Google’s top search results. I discovered that the axial length of my child’s eye was reduced over a 3 month period, leading me to think some researchers out there may have similar data on children.

So my current answer to “can the axial length of an eye be reduced?” Yes, based purely on numbers and measurements for a single child data point – more on this below, along with the caveats. All in all, it’s still encouraging information. (Update as of 11/17/22: In absence of a new post on axial length, I wanted to share that our optometrist once described a case of one teenage patient whose axial length dropped significantly for an unknown reason and the patient’s RX correspondingly dropped about 2 diopters! So YES, axial length absolutely can change, but IF and HOW it will happen is not understood.)

Here are the axial length measurements on my 8 yr old child who has an RX of OD: plano, OS: -1.25:

DateLifestyle habits leading up to the measurement dateAxial length (on Carl Zeiss IOLMaster)
Start of June 201920-20-20 near work rule, outdoor time ~1.5-2 hrs/day, “active focus” 2-3x/wk for a few minutes at a timeOD: 24.37mm
OS: 24.65mm
End of June 201920-20-20 near work rule, outdoor time ~2-3 hrs/day, “active focus” 2-3x/wk for a few minutes at a timeOD: 24.36mm
OS: 24.66mm
End of August 201920-20-20 near work rule, outdoor time ~3-4 hrs/day, “active focus” 2-3x/wk for a few minutes at a time, plus lenses when readingOD: 24.43mm
OS: 24.75mm
Beginning of Dec 201920-20-20 near work rule, outdoor time ~1.5-2 hrs/day, “active focus” 1-2x/wk for a few minutes at a time, regular wear of multifocal soft contact lensesOD: 24.38mm
OS: 24.67mm

Things to note on the data

  • In a 3 month period, there was a .05mm reduction in the right eye and a .07mm reduction in the left eye. The practitioner wasn’t surprised by the positive change and said this was known to happen with the initial wearing of multifocal soft contact lenses, from which I inferred that more reduction isn’t to be expected. 
  • .07mm is estimated to be the equivalent of 0.25 diopters, according to our optometrist.
  • .12mm is the average growth/year in the axial length of non-myopic children, according to our optometrist.
  • Although we incorporated many good vision habits, the reduction in axial length did not occur until my child was able to wear multifocal soft contact lenses. 
  • Even though the right eye is not myopic, we decided to wear multifocals in both eyes to try and help prevent the right eye from becoming myopic. After one eye becomes myopic, it is common for the other eye to become myopic as well. 
  • The increase in axial length came during the summer at a time when we were able to spend a lot of time outdoors in a lot of sunshine, we no longer had school (less near work time), and when we had added the use of plus lenses for reading. 
  • I checked my child’s vision with an eye chart a few times a week, and it seemed to me like his eyes were getting better during the 3 months that there was an increase in the axial length.
  • Our attempts at “active focus” were so few per week that it’s not a significant factor for consideration. 
  • My child gets almost zero screen time. He reads books a lot but will only occasionally read as much as 45 minute blocks which are then peppered with a 20-20-20 rule.

Thoughts on the effect of the multifocal soft contact lenses

Since I’m sitting around with my single child data point, I’m wondering if the axial length reduction is more easily induced in children. Typically the younger you are, the more likely your body is able to recover or have positive changes. I’ve noticed those patterns generally with how quickly children can recover from the same cold that knocks adults out. Similarly, oral immunotherapy on preschool age children can cure their allergies vs older children and adults are more likely to become desensitized (which is not a cure). 

Multifocal soft contact lenses were originally created for adults with presbyopia, but many adults have trouble adapting to the vision that they get with multifocals because the contact provides center distance vision and essentially places patches of plus power throughout the lens. I guess adult eyes don’t accommodate as well as children’s eyes and they tend to see both the blurry and the clear images at the same time. Children, on the other hand, are known to adapt to multifocal soft contact lenses rather easily. It would be interesting to see if adults who have progressing myopia would benefit from wearing multifocal lenses to slow or halt their myopia.

Multifocal soft contact lenses and “active focus” – Since seeing that the contact lenses seemed to make the most difference in my child’s axial length, I’ve been thinking about how they work and how it might compare to the concept of active focus which I read about on endmyopia.org. According to endmyopia, active focus is the activity you need to do to stimulate your vision to improve – you look at something that’s just very slightly blurry and then focus on it to see if you can clear the blur. When you wear multifocals, your eyes also have to do something similar on a constant basis. Because there are patches of less clear vision, your eyes have to learn to adapt to pick out the parts that are clear to create the focused image that you finally see. I could be totally off-track, but just throwing it out there. Thoughts, anyone?

If you have any axial length measurements or similar experiences, please do share! Anyway, we’ll be measuring axial length again in another few months. Stay tuned.

Resources

This is a very helpful post in providing more numbers for understanding axial length, and understanding of possible ethnic differences, and growth differences in myopic and non-myopic children:

Here are other posts that are helpful for trying to understand how practitioners use axial length in managing your child’s myopia:

How Much Outdoor Light Do You Need to Prevent Myopia?

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If you’ve been reading about the latest findings on why we’re all becoming so nearsighted, then you know that researchers have found a strong link between myopia and outdoor light. They think that outdoor light (possibly even more so than near work) may have the strongest impact on protecting against myopia. However, the simple recommendation of spending more time outdoors is a little ambiguous and not enough information to decide whether following this recommendation was feasible or worthwhile.  As much as I would like to spend my entire day at the beach, in a time-constrained world, I wondered how much and what kind of outdoor light do we need for it to make a difference?

Looking into the distance may also be part of the reason outdoor time prevents myopia
Looking into the distance may also be part of the reason outdoor time prevents myopia

Why outdoor light matters

Why outdoor light matters is still unclear to researchers. There are a few candidate theories, but if the reason is unclear, that means the kind of outdoor light you need is, well, unfortunately, another educated guess. Here are the theories so far:

  • The dopamine theory: Outdoor light triggers retinal dopamine. Animal studies show that when the eye has low levels of dopamine, its’ axial length increases.
  • UV exposure: Being exposed to UV light in the range of 360 nm to 400 nm light may be the part that helps control myopia
  • Vitamin D levels: Vitamin D is believed to help proper eye growth and the body can only produce adequate amounts of Vitamin D levels through physical exposure to the sun’s UVB rays. One study found a correlation between low vitamin D levels and myopia in children.
  • More distance viewing: Being outside causes more frequent distance viewing, as opposed to near work and the closer viewing environment that we have when indoors.
  • Brighter, outdoor light: The higher light levels that are outside are thought to be key – this doesn’t necessarily negate the other theories above. 

How much light and how bright?

Based on the theories above, here are the study recommendations:

  • There was a range of “how much light” recommendations from the studies. On the lower end, I saw that 14 hours outdoors/week could lower the chances of myopia by ⅓. On the higher end, Dr. Ian Morgan, a researcher who specializes in myopia and the environment, has concluded that children need to spend at least 3 hours/day in light levels of at least 10,000 lux to be protected. 
  • 10,000 lux is described as “the level experienced by someone under a shady tree, wearing sunglasses, on a bright summer day.” For comparison, average indoor lighting is about 500 lux. Consequently, sitting by the window with natural outdoor lighting is probably more protective than being indoors without natural light.
  • Despite the fact that the UV exposure may play a role against myopia, it is still recommended that we wear UV protective eyewear and clothing. Since it’s unclear if and how much UV exposure is needed, doctors still recommend protecting against the damaging effects of UV light. However, since many contacts and glasses nowadays include UV protection, they are continuing to investigate the possibility that a different balance may be needed between UV protection and myopia protection. 
  • To get adequate levels of vitamin D (30 ng/mL or more), some experts recommend about 10-15 minutes of sun exposure on your arms and legs without sunscreen between 10a-3pm each day. However, you need to tailor this recommendation for yourself by factoring in sunscreen (which blocks UVB), your skin pigmentation (darker skin needs longer exposure), and where you live in the world. For example, if you live at latitudes 37 degrees north of the equator, there is less UVB exposure resulting in less if any vitamin D production. You may also look into adding more vitamin D rich foods or supplements to your diet.

Most of this research is around outdoor light and its impact on children’s myopia, but it’s probably meaningful to adults who have progressing myopia, too. All in all, 2-3 hours outdoors daily can be a tall order for over-scheduled, over-worked lives – both kids and adults, especially in winter! 

How much time do you and/or your family get to spend outdoors on average? If you’re already fighting myopia in your family, see my other posts on our experiences with myopia control for children and reversing myopia as an adult.

 Resources

How much outdoor light is needed – some different viewpoints

UV light is blocked in contacts and in glasses

Sun protection can still be used outdoors for myopia prevention

Vitamin D, myopia, and sun exposure

Can You Control or Reverse Your Myopia?

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In my quest to quell my child’s myopia, I discovered the myopia reversal community online. It seems there are many adults who are trying to improve their vision naturally. Yet while the medical eyecare community has not reached the point where they will even consider that myopia reversal is possible, myopia control for children is a growing sub-specialty and reaching mainstream eyecare practices in the US. In Asian countries where myopia is unusually high, myopia control is already a common practice. Considering that myopia control didn’t exist when I was growing up, (and yet here it is), I’m wary of dismissing the possibility of myopia reversal too quickly.

My takeaway

Researching and comparing these two “fields” was helpful for me in deciding how to manage my child’s myopia and also in convincing me that it was worth trying to reverse some of my own myopia. Below are some of the similar ideas that I found between the two areas .

Single vision lenses (SVL) will likely progress your myopia – This is not yet a commonly known fact, especially among adults. On the plus side, as I mentioned earlier, myopia control is definitely a growing sub-specialty and I think it’s only a matter of time before it will become common practice:

  • Myopia control view: Optometrists who provide myopia control options to children know that the traditional single vision glass lenses or contact lenses will mostly likely cause your prescription to get worse and worse. (Yes, that’s the lenses that you and I grew up wearing.) The current thought is that myopia stabilizes in adulthood, but the eye is particularly susceptible to growth in childhood and teenage years since those are “growing” years for the body. SVL are known to cause peripheral light to focus behind the retina, which is thought to stimulate the axial growth of the eye and therefore increase myopia.
  • Myopia reversal view:  In the philosophy of two popular myopia reversal methods, Jake Steiner’s endmyopia.org and Todd Becker’s gettingstronger.com, it is also believed that the cycle of progressively stronger RXes are due to wearing SVL that perfectly correct or overcorrect your vision. If your myopia is worsening as an adult, it seems that perfectly corrected or overcorrected SVL could also be a contributing factor. They call it “lens-induced” myopia

Reducing near work strain is important in treating myopia – Giving your eyes a break from reading a book or the computer screen is common wisdom (that many of us probably have trouble following). However, myopia treatment takes this a step further.

  • Myopia control view – Multifocal or bifocal glasses and multifocals contacts give the child different corrections for distance viewing and near viewing. The theory here is that the near viewing through an add power reduces the strain of close work. Although studies haven’t found much clinical benefit from bifocal glasses as from the multifocal contacts, researchers think it may be due to children not being able to use the bifocal lenses correctly (looking thru the right part for the particular activity at hand).
  • Myopia reversal view – Similarly, many myopia reversal methods also include wearing either a reduced RX or plus lenses for near work to reduce strain. 

Outdoor time affects myopia – Spending time outdoors is believed to play a central role in vision.

  • Myopia control view – Research in myopia control is full of studies on the possible link between myopia and time spent outdoors. It is believed that spending more time outdoors (3 hours/day) can help prevent myopia in children (although studies find that it’s not helpful once myopia has begun). Although there are many theories (i.e., the eye needs vitamin D, outdoor time replaces screen/reading time, being outdoors skews the eyes towards using distance vision, etc.), it’s also not clear why the outdoor time may prevent the eye from growing too much.
  • Myopia reversal view – Jake Steiner’s endmyopia.org frequently posts about the importance of incorporating outdoor time into part of the rehabilitation. While myopia control researchers still don’t feel that they have found the reason that outdoor time is beneficial, Mr. Steiner believes that outdoor time spent actively trying to see things more clearly is the reason that outdoor time can improve vision.

The effects of both treatments are variable in individuals – both research and anecdotal evidence show that neither myopia control nor reversal methods are guaranteed to work. Researchers don’t know why myopia control works for some children but not so much in others. I haven’t found any formal myopia reversal studies on adults – perhaps I just haven’t logged enough hours in the search. Nevertheless, the treatments do seem to work  for many adults anecdotally and definitely for many children.

Resources

This Medium post by an Australian optometrist describes how the traditional approach of glasses for children is becoming outdated and that myopia is becoming recognized as a condition that can be treated:

Two of the most popular myopia reversal techniques seem to be Jake Steiner’s endmyopia.org and Todd Becker’s gettingstronger.org:

Lens-induced myopia was reversible in a study of chicks

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Reversing Myopia: Getting Started

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Once you become myopic, is it possible for your vision to improve? Ophthalmologists and optometrists say NO, and rather emphatically so. However, welcome Internet research, pseudoscience, and anecdotal evidence. Even the burgeoning science found in myopia control methods has many theories in common with the myopia reversal movement. After a lot of reading, it seems like it may be possible to reverse some myopia and that it’s worth giving it a try.

(As of 8/16/20: My one year progress update.)

 

My takeaway: the basic method of reversing myopia

The basic method of reversing myopia looks like this:

  • Reduce your glasses or contact RX by a small amount at a time, 0.25 to 0.50 diopters (some people do more, but it seems like you may end up reducing so much that your eyes cannot focus enough to improve).
  • When wearing your reduced RX, routinely spend time focusing on slightly blurry things and trying to make them clear. When you can see 20/20 or 20/25 with the reduction, then reduce the RX some more. This could take weeks or months – each person’s eyes are different. Reduce each eye enough so that both eyes see about the same. Sometimes you will reduce more in one eye than the other.
  • Wear an even lower RX when doing near work (computer, reading, task work). Some methods say that this lower RX should just be enough so that you can see well enough to do your near work. This reduces the focusing and strain that your eyes go through in order to switch from distance focus to a near focus. It also reduces the strain of near work. This has some similarity to the concept of wearing plus lenses or multifocal lenses in myopia control for children. Another method suggests that this lower RX should be low enough so that print (whether on your computer screen or book) can have a slight blur so that you can work on trying to clear the blur.
  • Make lifestyle changes: 

Some amount of improvement, around 1.00 to 2.00 diopters, anecdotally seems very possible. In a variety of YouTube videos and online comments/blogs, many individuals seem to have been able to achieve at least this amount of improvement. I list them in Resources below.

My myopia reversal experience so far

I’ve been nearsighted since I was 8 years old, becoming highly myopic by high school. I figure I have nothing to lose by trying out the myopia reversal methods.

I started out with a glasses RX of -8.00 (R) and -6.25 (L), with -0.50 astigmatism in both eyes for most of my adult life. In June 2019, I began wearing glasses with a slightly reduced RX of -6.00 and -7.25, with -0.50 astigmatism in both eyes. I purchased glasses with this self-customized RX on http://www.zennioptical.com. (BTW, if you don’t have a complicated RX, I’ve discovered that getting glasses from your optometrist’s eye shop can be the biggest waste of your money ever! But that will have to be a topic of another post.) I determined my starting RX by purchasing a test lens kit and checking my vision with these free, online eye chart printables. I wanted to make sure that I would be seeing about the same out of each eye with my modified RX. I did get a lower RX for near work but I didn’t end up using it as I found it cumbersome to remember to switch glasses.

I found almost right away that I could see 20/25 with the reduced RX. This made me suspect that I had originally been over-corrected. I made the lifestyle changes as best I could, although getting adequate sleep or taking screen breaks during “crunch time” work was probably not always at ideal levels. I tried to look at slightly blurry words and seeing if they could become clear by focusing on them just a bit longer. This was usually street signs, etc. while I was out driving or waiting in lines or doctors’ offices.

At the end of September 2019, I saw the optometrist for a regular eye exam. He found that the astigmatism in my right eye had gone away. He also said that I could see 20/10 with my original RX. When I asked him to adjust my glasses RX to see just 20/20, he gave me this new glasses RX: -7.5 (R), no astigmatism correction; -5.75 (L), -.5 (CYL), 180 (AXIS). 

My contacts RX was adjusted from R: -7.50, L: -6.50 to R: -7.00, L-6.00. When I checked the eyechart wearing this new contact RX, I actually couldn’t see any difference with my stronger, previous RX.

Prior to this recent myopia research, I’d never paid much attention to daily visual strength changes. By paying attention to what I can see on an eye chart, I’ve learned that eyesight can have minor changes daily and from hour to hour sometimes just based on what I’ve been doing. This leads me to realize that even the optometrist’s measurements can not be perfectly accurate so I am taking my recent optometrist prescription with a grain of salt.

However, it does seem that “the disappearance” of my astigmatism in the right eye is significant and the fact that I can see 20/20 with -0.50 diopters less in both eyes seems like a big improvement over my RX of just 4 months ago. I still suspect original over-correction may have had something to do with my new RX, so I will have to see how the next year goes.

As of 8/16/20: My one year progress update.

Resources (updated 11/17/22):

I found these two sources to be the most helpful sites in outlining straightforward methods for reversing myopia:

There are two other sources that are “well known” (pop up high on search results) and also worth reading through for theory and techniques. They also have a lot more detail on their methods and the rationale behind them:

Forums where vision improvement is discussed – you’re not alone!!!:

Anecdotal evidence of eye changes/improvement:

On reddit, there are some good arguments against trying to reverse your myopia or against whether it can work at all. The link below on blur adaptation seemed interesting, plausible to me. However, the fact that my son’s optometrist had actual data points of axial length reduction is also encouraging:

Where to buy inexpensive glasses with your own customized prescription:

Where to buy contact lenses with your own customized prescription:

Free eye charts to check your vision:

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Myopia Control Options and Our Choice

Wish I Knew Before2 Comments

Updated 5/7/21

It’s great to try and prevent myopia, but what if your child is already myopic? Or what if your child becomes myopic in spite of all your attempts to prevent it? Did you know that there are now ways that you can try to slow down your child’s myopia? Below I summarize the options that I researched and what we decided to try for myopia control.

When I was growing up, anyone who became nearsighted just got glasses and were told that there was nothing to be done to either improve or slow down their myopia. However, now, although it’s not widely practiced, many optometrists and ophthalmologists are offering their pediatric patients some options for myopia control.

These options don’t guarantee that your child’s vision will no longer deteriorate, but in very many cases, it slows down the progression by about 50% per year. Let’s say your child’s vision worsens by about -1.00 diopter per year and they are only 8-9 years old.  They may be highly myopic by the time they reach college (when vision changes typically stabilizes). You might even be able to cut that in half! It’s a win even if they end up at -3.00 diopters instead of -6.00.

There are a lot of eye health risks (such as higher risks of retinal detachment, among others) that come with high myopia, in addition to the inconvenience of not being able to do anything without your glasses.  That is significant considering that your child still has a lot of growing and potential deterioration of the vision.

Current Options

First of all, regular glasses or contact lenses (basically single vision lenses) are not an option because they won’t do anything to slow down your progression. 

In my research, I found the following options, first explained in my layman understanding and my opinion of the pros and cons of each. In the Resources section below, you can find great articles on all the more clinical and detailed explanations of each.

Atropine Eye Drops

Atropine eye drops are an eye medicine that you put in your child’s eye nightly. For myopia control, a very low dose is used. They relax your child’s eye-focusing muscle so that they don’t over focus. 

  • Pros: 1-2 eye drops are fairly easy to learn to put in your child’s eyes nightly and children probably get used to this pretty quickly. 
  • Cons: Although they seem to have a high rate of effectiveness (slowing progression at ~77%), the studies for long-term use of these eye drops aren’t available. Our own optometrist wouldn’t recommend these drops for longer than 5 years, citing lack of studies and side effects such as light sensitivity and blurred near vision.

Ortho K

Ortho K (corneal refractive therapy) are gas permeable contact lenses, which are small and firm compared to the multifocal soft lenses (next option). You put them on at night and during your sleep, it will shape your cornea according to your prescription. When you wake up, you remove them with a tiny plunger (not as scary as it sounds), and your vision is corrected. The correction is only temporary though, which is why you have to do it every night. 

Researcher believe that ortho-k also slows myopic progression in a way that is similar to multifocals. They shape the cornea in a way that keeps the axial length of the eye from growing as much. (Myopia worsens when the eye continues to grow.) Effective rates are ~50%.

  • Pros: The lenses are small and probably easier to get on a young child. You don’t have to worry about anything happening to the lenses during the day. Corrected vision wouldn’t have any potentially blur spots as with the multifocals.
  • Cons: They can take a couple of weeks to take effect and get used to as the eye undergoes reshaping. You have to clean them everyday. This option felt invasive to me in the sense that the eye was undergoing a physical reshaping.
size of an ortho-k lense (L) vs a soft lense (R)

Multifocal Soft Lenses

Multifocal soft lenses (MFSL) are soft contact lenses with two or more powers that were originally made for nearsighted adults who started having presbyopia (needing reading glasses). These apparently help stem myopic progression by providing some amount of myopic blur which slows down the rate of retina growth. 

I didn’t understand how a kid could see well through essentially a reading glasses prescription. An optometrist friend explained that when the eye looks through the lenses they will pick out the clearest parts of the image for a particular distance, so it doesn’t matter that the powers are different in some areas of their vision. The effective rates for this option are 30-50% in recent research.

  • Pros: These come in dailies, so you don’t have to worry about cleaning. They’re worn during the day and can be removed easily without any discomfort. They’re not as physically invasive as atropine drops or ortho-k which shapes your cornea.
  • Cons: They’re larger lenses (than the ortho k lenses) so can be more difficult to put in a child. Some children complain of some blurred distance vision (due to the add powers in the lens). Some studies found they decrease the speed of accommodation when worn.

Bifocal or Progressive Lens Glasses

Bifocal glasses / Progressive lens glasses are your regular glasses with the added reading glass portion on the bottom half or a progression of powers through the lens. They are also available in progressive format so that the power transitions without an obvious, unsightly line in the lens. You correct your child’s distance vision with the top half. The bottom half will be a reading glass prescription that helps their eyes to not focus so hard on the near work such as reading, computer, writing. The ranges I saw in effective rate of these glasses is around 10-30%.

  • Pros: No need to worry about contacts or eye drops
  • Cons: Glasses can be cumbersome for kids to wear and some children have difficulty with seeing comfortably with the different powers in the glasses.  Low efficacy rate.

SightGlass Vision Diffusion Optic Technology Lenses

Coming soon – SightGlass Vision Diffusion Optic Technology (DOT) lenses are new special lenses designed specifically for myopia control and to be worn as eyeglasses. The idea behind the lenses is that they diffuse contrast for the child (in a way that mimics outdoor light setting) under the theory that high contrast environments such as reading, and other near-work cause the eye to grow longer and progress myopia. It sounds like the most promising eyeglass solution available yet. Studies have touted up to 74% reduction in myopic progression and up to 50% reduction in axial length growth. They’ve been approved for sale in Canada, but not yet in the US.

  • Pros: No need to worry about contacts or eye drops. Efficacy rate may be comparable to contact lens or atropine options
  • Cons: Glasses can be cumbersome for kids to wear, not yet available

Finally, some parents also choose to do both atropine drops in conjunction with one of the options above for maximum effect. If you just can’t get your child to put on contacts, for example, then glasses plus atropine drops may be your best bet.

Our Choice for Myopia Control

None of the options seemed perfect to me. Generally speaking, it seems that ortho-k has the most studies demonstrating its ability to slow progression. In the end, we chose multifocal soft lenses for our child because I felt it was the least invasive of the options that had high efficacy rates (ortho-k, atropine drops, MFSL). I haven’t ruled out the other options yet, but this is the one we are starting with. We also are incorporating as many healthy lifestyle and eye habits as possible. Since no one seems to know for sure, it doesn’t hurt to try everything that’s probably good for us anyway!

Considerations in choosing can include the health of your child’s eyes, their willingness to use contacts/drops, and their RX. Remember that the effective rates are just averages and your own results may be different.

A lot of studies and research continue to be done in these areas. Unfortunately, results are sometimes conflicting or inconclusive. Nevertheless, there are a lot of helpful articles on these topics that describe the different theories on what causes myopia and the different myopia control options that we have now to help you decide what to do for your child.

Resources

The BEST overview of the options from an optometrist’s perspective that I have ever read. This article also contains an interesting part on the predictor of myopia in children. He lists cutoff points of cyclopegic refraction that tell you the likelihood of your child developing myopia. It also includes a table showing the different types of health risks associated with myopia as it worsens:

Other links with good overviews of the myopia control options:

This blog by an Australian optometrist, compares Ortho-K and MFSL very clearly and even explains the theory behind the lenses and how they work. Be sure to read part 1 and 2.

Apparently, time outdoors doesn’t have the same protective effective if myopia has already begun:

Unclear if outdoor time or near work actually affect myopia progression:

List of research about environmental impact (near work, outdoor time, lighting, etc.) on myopia with comments by the website’s OD:

Myopia experts around the world discuss the state of myopia control efforts:

Slowing progression of myopia must include reduction of near work activities, and increase of natural light and outdoor activity:

Information on the progress of SightGlass glasses and how they work:

The Slippery Slope of Smartphones and Screen Time

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Screen time is great! It immediately distracts my kids and gets them to stay still. They love the screen so much that they’ll watch videos in languages they don’t know just to have the right to the screen. For me, when I’m standing in line at the grocery, I can check my emails or run through my grocery list. I can leave work early and be with my kids more often since I have email and text access to stay caught up with the office. It’s so efficient, time is never wasted, and dealing with the kids could never be easier, but. . .

The unfortunate truth

The ugly truth is that I’ve seen my kids become monsters with terrible moods once I remove the screen. I’ve seen them so absorbed in the screen that they can’t see or hear anything that’s going around them. I’ve seen the red, glazed eyes after the screen is switched off.

As for myself, to be on a call with my kids around, I have to shush my kids repeatedly. Writing work emails and texts actually require a significant amount of concentration so that I have to step away from my kids or just plain ignore them since they don’t seem to understand when I tell them that I need to focus for a few moments on my phone. In those moments, I must seem obsessed with my phone and I have to completely disengage with my kids. Working while out with my kids or being “available for work” when I was with them is actually stressful and brings down the quality of my time with them. 

I’m not alone

From my personal experience, I realized that the detriments of screen time outweighed its benefits in my household. Then I saw that I wasn’t alone. An article in The Atlantic pointed out that screen time was enabling “tuned out parents” and that the dangers of screen time ran both ways. The New York Times featured a piece on how even some people who work in the industry of producing smartphones and their apps are wary enough to place very strict rules around their kids’ exposure to screen time. 

My takeaway

It starts with us! Parents on the phone while pushing their kids in the stroller. Reading phones while at sport practices or at the park and playground. We have to learn to put the screens aside as well.

  • At kids’ activities: I’m going to watch my child play, chat with another parent, play with my child, or do some exercises myself! I should be in the moment and pay attention when I can. 
  • If I absolutely have to be on the phone, I’m going to explain to them why it’s so important that I need to be using my phone at that time. 
  • During wait times with bored kids at the restaurant, grocery, or waiting room: I’m not going to use my phone as a first resort. Instead, I’ll play a game with the kids. Have a conversation. Find out about their days. Talk about something interesting. Teach them about something. What did parents do before the age of smartphones? This is an opportunity for kids to practice self-discipline and good behavior. Right, rolling your eyes? I know it’s hard work and I want to tear my hair out too sometimes, but I’ve seen parents do it well – bringing non-screen activities or chatting with kids happily. 

As for the kids’ screen time, we’ve minimized this to almost none. Any screen time is supervised. Other parents will sometimes tell me that their kids spend all their time on the iPad or watching TV and that nothing else will satisfy them while at home since they began allowing screen time. As I mentioned earlier, I found watching Netflix videos, playing video games, and using other phones/tablets to be a slippery slope in my household. Kids were inevitably unhappy when the screen time ended. Their brains and eyes seem fried from the other world that they had been sucked into and their moods were just plain nasty. It happened every time. 

So we removed anything that resembled routine screen time. It was hard at first but then they eventually found other things to do. And we had less tantrums and bad moods to deal with too! As they get into their teens, though, this probably becomes even trickier, but it is worth it to me.

Resources:

  1. https://www.theatlantic.com/magazine/archive/2018/07/the-dangers-of-distracted-parenting/561752/
  2. https://www.parents.com/toddlers-preschoolers/everything-kids/parents-trying-to-limit-kids-screen-time-should-start-with/
  3. https://www.nytimes.com/2018/10/26/style/phones-children-silicon-valley.html
  4. https://www.nytimes.com/2019/07/06/style/parenting-coaches-screen-time-phones.html

6 Habits to Fight Myopia

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I’ve been nearsighted since I was eight and I’ve always hated that. Contacts or glasses – it’s just one extra thing you have to do. Plus, I can hardly do anything without them. Ever read “Lord of the Flies”? Remember Piggy and how useless he becomes without his glasses? Don’t worry if you’ve never read it, but if you have, then you can know that I have recurring nightmares about becoming Piggy.

Children’s vision at highest risk 

habits to prevent myopia
Myopia is on the rise, but there are ways to fight it

Kids are usually born with perfect vision and we should help them preserve their vision for as long as possible! Our eyes are in growth and development mode from infancy through adulthood. Vision tends to stabilize in adulthood, but during the long prior developmental period, children’s eyes are more vulnerable to positive or negative factors that can affect their growth. (Enter coronavirus and distance learning for the kids – yikes, what is going to be the impact?!!)

Eye health declining globally

Generally, there’s two reasons that experts say are responsible for myopia or other eye problems. One, genetics (not much you can do about that currently) and two, environmental factors such as exposure to outdoor light, eye strain, near work, and fatigue. 

There appears to be a worldwide rise in myopia possibly due to environmental factors, but the research isn’t definitive yet. About half the young adults in the US and Europe have myopia (double the number from 50 years ago) and in China 90% of young adults and teenagers are nearsighted compared to 10%-20% just 60 years ago. In fact, researchers estimate that one third of the world population will be nearsighted by 2020. Freaky, right!? 

The truth is that researchers are still not sure what may be causing the surge of myopia. They just have a lot of theories with various data to support. However, there is a lot of data that often points to the following culprits: 

  • Rise in close work: any activities that focus your eyes on nearby objects such as crafts, reading, electronic devices, even Legos!
  • Lots of screen time. It has even caused dry eye in children, a condition typically found in middle-aged adults 
  • Too much time indoors! The less time you spent outdoors the likelier you are to be myopic, apparently exposure to bright, natural light (outdoors) is necessary for natural eye development

What can be done?

If you want to reduce the likelihood for eye problems, research results suggest the following: 

  1. Most importantly, raise your awareness of eye-straining activities (you gotta realize it’s a problem if you are ever going to remember to do anything about it – don’t wait until you have symptoms!)
  2. Make sure you do near work such as reading, homework, legos, puzzles in good lighting and even better, if it is in natural lighting
  3. Build habits for regular breaks and reasonable usage for devices and other near work, like the 20-20-20 rule (For every 20 minutes of close work, look at something 20 ft away for 20 seconds).
  4. Ensure that you maintain a good reading and writing distance – this is often overlooked especially in children, but very important. The links below will help you ensure that you do close work with the right distances:
  5. Getting sufficient sleep to reduce eye fatigue and strain when doing close tasks 
  6. Replace indoor time with more time outdoors. According to Ian Morgan, a myopia researcher at the Australian National University in Canberra, children need about 3 hours of outdoor time daily to be protected against myopia. I researched this topic further here.
  7. Check your vision regularly. These free, eye chart printables can be helpful for checking regularly at home.

Resources

Global rise of myopia: 

A look at the possible causes of myopia:

More on children’s screen time, and tips for healthier viewing: 

Dry eyes caused by screen time:

Outdoor light has protective effect on vision:

How much outdoor light you need to protect against myopia: