Myopia: a modern yet reversible disease

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Posted 09 Aug 2014 in Uncategorized

Here is the video and slide set from my presentation at the Ancestral Health Symposium, August 9, 2014, in Berkeley, California. I enjoyed meeting many of you who were at the conference.  I’d recommend watching the video first, and perhaps follow along with the uploaded slide set in a separate window, since it is  more convenient for viewing references and other details.

(Note: You’ll notice some minor differences in the video and slide versions, as the AV team inadvertently projected an earlier draft rather then the final slides I had provided).

Video:

 

Slides:

(Click on image below and allow 30-60 seconds for slideshow to upload)

Screen Shot 2014-08-09 at 8.45.47 PM

 

Overview of the talk.  For ease of reference, here is slide-by-slide “table-of-contents” summary of the presentation. People are always asking to provide a detailed explanation of exactly what steps to take to improve their vision.  You’ll find this bottom line “practical advice” in Slides 23-36

  1. Title: Myopia: a modern yet reversible disease
  2. My story:   I wore glasses from Grade 10 until 15 years ago. I don’t wear glasses any more!
  3. To reverse myopia, we need to first understand the causes.
  4. Myopia defined.   Myopia can lead to serious problems like cataracts and macular degeneration
  5. The prevalence of myopia has increased by 50-100% since 1970, across all age groups in the U.S.
  6. There is evidence for both genetic and environmental causes.
  7. An 1883 study of military recruits found myopia was much higher in students and merchants than farmers
  8. A 1969 study of Eskimos found that myopia had increased dramatically since Western schooling was introduced
  9. A 2012 study of German students found more than 50% of university graduates had myopia vs. 25% for dropouts
  10. In countries like Singapore and Taiwan, myopia is common among even young school children
  11. There is evidence that certain genes predispose to severe myopia. Copper deficiency induces myopia due to increased scleral wall elasticity.
  12. Cordain found that a high carbohydrate diet and deficiency of EFAs and minerals promote myopia
  13. It appears that a myopiagenic environment (near work) is needed to activate  genetic predisposition to myopia
  14. What is the biological mechanism?
  15. The normal lens changes shape to focus
  16. Myopia progresses in two stages: (1) near work induces lens spasm, causing pseudo-myopia; (2) use of minus lenses temporarily improves distance vision, but leads to eye elongation and axial myopia.  The result of elongation is a need to prescribe stronger minus lenses, in a vicious cycle of ever stronger lenses.
  17. Eye elongation is explained by the incremental retinal defocus theory.  Retinal defocus causes release of neuromodulators that lead to decreased scleral tissue integrity, and axial growth
  18. The IRD theory has been proven empirically in chicks, monkeys and humans using optical reflectometry
  19. How can myopia be reversed?
  20. First, it is useful to understand the framework of hormesis — the beneficial response to low dose stress
  21. Weight lifting is a good example of hormesis and the principle of Specific Adaptation to Imposed Demand
  22. What if gyms had the same business model as optometrists?  They would prescribe exoskeletons to help us walk, but these “crutches” would make us weaker, not stronger.  Lenses are crutches
  23. To reverse myopia with hormesis, we need to use active focus.  That means print pushing and plus lenses while reading, and progressively weaker minus lenses and image fusing for distance activities
  24. To embark on this journey, you must first determine how myopic you are, using a Snellen chart
  25. For print pushing, you need plus lenses only if your myopia is less than -2D. Otherwise use your naked eye
  26. Find the distance (D1) where print is at the edge of focus and (D2) where it starts to blur.  Read between D1 and D2
  27. Move back from your computer or book to stay between D1 and D2. Do this for 2-4 hours a day, taking frequent breaks.  Graduate to stronger plus lenses when you drop below 2D, and continue until you achieve 20/20 vision!
  28. For distance (walking, TV, movies, meetings) buy glasses with a 0.5D reduced prescription
  29. Once your vision gets better, you may notice “double vision” or ghosting.  This is a good sign and something you can use to improve your vision!
  30. Find distant objects with sharp contrasting edges: telephone wires, tree branches, edges of buildings or signs
  31. Focus on the darker of the double image and away from the fainter image.  With time, the darker image will become darker, and the fainter image will fade away
  32. Eventually the double image with fuse into a single crisp image — very exciting!
  33. Most people have a weak eye and a stronger eye with less myopia.  The stronger eye will dominate, so strengthen the weaker eye by patching, shielding or winking shut the stronger eye…until the two eyes are roughly even.
  34. Frequently asked questions
  35. How much time should I spend on print pushing?  Spend 2-4 hours a day while doing routine computer work or reading. This is not a separate exercise, but something you build into daily activity
  36. How long before my vision improves?  Be patient — it’s like exercise or diet and won’t work overnight.  Expect some improvement within a few weeks, but it may take a year or more to clear your vision
  37. Is this the same as the Bates method?  Bates had some incorrect ideas about focusing, but his relaxation techniques can help reduce ciliary strain on the lens (pseduomyopia).  However, his method does not help if you have axial myopia and spend a lot of time at the computer or reading.  Print pushing specifically helps with that.
  38. Does active focus really work?  Check out my blog and forum for success stories
  39. And for the skeptical, here is a page of references on the epidemiology and causation of myopia
  40. And more references on methods and websites that provide a similar approach to mine
  41. Your eyes are adaptive organs which allowed them to become myopic, but you can use that same adaptability to reverse the process using active focus for both near and far activities
  42. Rediscover your natural vision — make it fun, make it a habit, make it a game.  You only have your glasses to lose!

Also be sure to check out these related posts and discussions:

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198 Comments

  1. Alison

    Hello Todd

    I would like to know how have you been your progress using plus lenses.

    What were your first plus lenses prescription?

    2D or 1D

    I need to have an idea to start doing print pushing effectively

    Thanks

    Reply
    • Todd

      I started with +2D. But the key is to chose whichever plus lenses allow you to read at the edge of focus while sitting at your computer. Go through the video and slides again — it’s all there.

      Reply
  2. Katherine

    Hi! Excellent talk! I am very interested in natural vision improvement. My issue is that I’m not able to give up contact lenses at this time. I normally wear them for 6-8 hours a day, but I know this method works best with glasses because you can take them on and off.

    I did order a pair of contacts that are a couple of diopters lower than what I’m currently wearing (current: -3.25 left eye, -2.00 right eye. New contacts: -2.75 and -1.50) Will wearing the new lenses, combined with magnifying lenses during reading still help me to improve my eyesight? Eventually I’d love to give up all glasses and contacts.

    Reply
  3. tommy

    Will not wearing plus lenses affect the result?

    Reply
  4. Tony

    Hello.I want to ask you something Todd.I have -4.00 both eyes.Will print push work if i wont use plus lenses during all my journey to 20/20?

    Reply
    • Todd

      Plus lenses are not essential to the method, but they make it a lot more convenient once your myopia is reduced to less than -2 diopters (equivalent to 19 inch edge of focus). Adding plus lenses brings in the edge of focus closer, making it easier to practice print pushing. But you could also just sit farther than 19 inches away from the computer if you want. You might tire of that when the computer is quite far away. So that’s why we use plus lenses!

      Reply
  5. John

    Todd will print pushing work by watching movie subtitles without glasses?

    Reply
    • Todd

      Yes

      Reply
  6. Rob

    Hi Todd.

    I have watched your very exciting presentation several times and get the idea behind reduced prescription and print pushing. My problem is the starting point. Today I am using glasses with the following prescription:
    Right: -3.25/-1.00*60
    Left: -4.75/-1.00/160

    And also use a pair for computer work which are:
    Right: -2.50/-1.00*60
    Left: -4.00/-1.00/160

    My right is the dominant one for long distance viewing and the left one takes care of near distance viewing.

    What I notice is that my left eye is getting the blur level faster than the right one (for long distance viewing). This is more visible when using my computer pair for long distance viewing. It is almost like the right eye feels OK with the lower prescription but the left one gets a very blurry view. using my long distance glasses makes the difference less visible since the blur level is far away but it is the same situation. My question is how to start with a reduced long distance prescription? I have ordered a pair with 0.5D lower prescription and try using only the left eye for long distance viewing (right eye closed) and print pushing. But It would be more usable if I could use both eyes for long distance viewing. Should I aim for a even lower prescription for my right eye (I know you answered earlier comments on this)? And my other concern is the blur level. Is 0.5D less for the left eye a too big leap? At what distance should the blur level occur in order for the active focusing to be most effective without straining the eye? For me it occurs just a couple of meters in front of me (left eye).

    Hope you could give some advice on the starting prescription.

    Thanks.

    Reply
    • Todd

      Rob,

      It’s actually the norm to have a different refractive state in each eye. This is called “mono vision”, often an adaptive response, allowing the eyes to specialize and thus cover a greater net focal range.

      If you want to reduce your overall degree of myopia, start by putting the effort on reducing myopia in your weaker (left) eye. Do that by relatively handicapping your dominant right eye, so that your left eye is forced to change. You can do that by winking the right eye shut periodically, or (more comfortably) taping diffuser paper over the right lens or holding your right hand along your nose, angled to let some light in. (You’ll be seeing the back of your hand but your brain will tend to just filter that out). Alternatively, you can under correct the right lens to induce a strong blur, so that the brain will pay attention only the the left eye, which is at the edge of blur.

      The most flexible way to do this is to buy some adjustable lenses from adlens.com, and continually fine tune the adjustment to blur out the dominant eye, allowing the weak eye to pick up the slack. The analogy is how you would strengthen a weak left arm by preferentially working it in the gym.

      Once your two eyes are more even in myopia, you can then use balanced lenses (undercorrected or plus lenses, depending on distance and degree of myopia) to continue reducing your myopia.

      Todd

      Reply
  7. Hi, I learned about print pushing techniques and have been practicing it in combination with bates method for about 2 months now. However instead of signs of progress, I feel like its deteriorating!

    I have prescription of -3.0 D spherical correction with -0.5D astigmatism correction on Right and -2.75 D spherical correction on Left.
    I was prescribed contacts of -3.25 D on Right and -2.5 D on Left.

    I have been practicing print pushing for about an hour 4-5 days a week and almost daily the Bates method (say 6 days a week). I do not use plus lenses for print pushing, but with my naked eye, contacts removed and glasses apart.

    I have glasses of correction -2.25 D on Right and -1.75 on Left ie. 1D lesser in each eye. I use glasses when on a walk, TV, movies and others.
    I use contacts for about 8-10 hours a day, might be extended in some busy days.

    Am I doing it wrong?
    How long each day should I practice print pushing?
    Is the time allocated not sufficient?
    Or do you think I am doing print pushing wrong way?

    I have watched the above video and the slide a number of times. And I think I still might have trouble finding the exact position I must try to focus.
    It would be great if you guys could publish an animation video showing the characters on the screen, timely moving back and forth as we are supposed to do during print pushing and showing us in the video how actually the texts should appear as we move, how and when should we consider moving back and forth !

    Reply
    • Todd

      Sorry to hear of your struggles with print pushing, Anup.

      Go back to the video around the 18 minute mark or look at slide 26 on “Print pushing”. The slide shows precisely what the print should look like at D1, D2 and D3, and shows how to achieve this by leaning towards or away from the print. I think this illustrates the concept as well as any video could.

      You mention that you are print pushing an hour a day, but you wear contacts for an additional 8-10 hours a day. Wearing full correction contacts may be the problem, undoing the benefits of the print pushing. Your myopia is weak enough that you should not need to wear contacts while working at the computer or reading a book. You should be able to read in focus at less than 33 centimeters (13 inches) from your face. If that’s uncomfortable, then use under-corrected lenses while reading perhaps -1 to -1.5 diopter lenses and sit a little farther back.

      I’d also suggest for distance getting yourself some glasses that are under-corrected by 0.5 diopters.

      Todd

      Reply
      • Thanks Todd!

        I shall be more cautious now while I print push.
        I also have decided to avoid contacts as much as possible. Rather than using under corrected contacts, it will be easier to get glasses.
        I shall now work on computers and do reading books completely without correction and practice print push almost all the time ( not to exceed 4 hrs mark as it said 3-4 hrs a day ). Or can I keep on doing it all day long? However I don’t think its a good idea, is it?
        I shall also reduce the use of full correction lenses to 4 – 5 hrs a day, using them only when absolutely needed.

        Please correct me if I decided wrong!

        Thanks again.

        Reply
        • Todd

          Good plan, Anup. The amount of time that you choose to spend print pushing is more art than science. The key thing is to be sensitive to fatigue. If you find you are getting tired or experience soreness or “red eye”, then you are overdoing it. Rest from reading is as important as good reading hygiene.

          Equally important: test your Snellen at least once a week, under similar lighting conditions, and similar time of day or state of restfulness. Self-testing your Snellen is the best way to track your objective progress.

          Good luck!

          Todd

          Reply
          • Thanks Todd!

            And yes, not to forget, I have just started and I know I have yet to see the changes in myself. However I strongly believe myopia can be reversed as I read your presentation.

            Reply
  8. KBLC

    Hi Todd,

    if someone reads at the edge of focus, there is no stimulus for the eye to change its shape, isn’t it? Because edge of focus means no defocus.

    So if I push to D2, seeing that little shadowing (i.e. defocus), the blur should clear up — if not, should I go back to D1 and try again after 1 minute or so?

    Essential question: Does the material have to clear up at D2 to apply stimulus to change the shape of the eye? Can you learn that – while being at D2 – “saying in your mind “now”” so that you can (even if temporary) clear the blur?

    Reply
    • Todd

      Hi KBLC,

      You are right — one really needs to push into D2 (the edge of blur) to achieve defocus. In reality, this is very close to D1 (the edge of focus). I find it useful to alternate between the two in order to be sure I’m at the edge. It’s kind of like finding the edge of your driving lane by occasionally hitting a few bumps in the divider.

      Here is the full distinction that I first drew in 2011:

      http://forum.gettingstronger.org/index.php/topic,8.msg781.html#msg781

      Now to your question: Blur sometimes clears readily, other times it doesn’t. That depends on the specifics of your situation — genetics, age, time of day, fatigue, adaptability. Clearing is a good sign that your eye is adjusting, but sometimes the eye is less responsive. You also have to distinguish immediate, short term change, from permanent change. Clearing is not a sign that your eye has permanently shortened. It is only an indication of short term response. It takes repeated cycles of stimulus and clearing to effect permanent change. Conversely, you don’t necessarily have to experience clearing to achieve long lasting change.

      In short, clearing is a convenient sign that you are working at a range where the stimulus is effective. But I wouldn’t take it as an absolute essential.

      Nevertheless, I think it is useful to wander back and forth between D1 and D2, rather than staying always at D2. Otherwise, how do you know you are at D2? You want to provide a frequent and moderate stimulus that your eye will respond to. Just as with lifting weights or any kind of training, a stimulus can be too weak to be effective, or excessively strong — in which case the eye or any organ just “gives up”.

      All this said, I see print pushing as an art as much as it is a science. I provide only guidelines. While the technique has its roots in biology and studies in different species, the specific protocols for print pushing have not been tested or validated in clinical trials. So you have to experiment and find what works for you.

      Hope that helps,

      Todd

      Reply
  9. Todd,
    I admire your objective success, in reading the required 20/20 line on your “home” Snellen chart.
    When you started this preventive process, (with some myopia), when, and how did you decide to stop wearing a strong minus?

    Reply
    • Todd

      Hi Otis,

      I stopped wearing my minus lenses cold turkey. I forgot to take them with me on a two week vacation. When I found my vision improving as a result, I abandoned my minus lenses and never looked back. I could do that because my myopia was relatively mild. If it had been stronger than about 2 diopters, then I might have opted to use undercorrected minus lenses for a while.

      Later, I came across Brian Severson’s work (and yours) and added periodic use of plus lenses as an “adjunct” to facilitate myopia reduction. Plus lenses aren’t strictly necessary as long as your use your eyes correctly and frequently push them to the limits of their focusing ability. But they are a real help when you read a lot, both as a preventive measure and to work your way out of myopia.

      Todd

      Reply

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