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Comment by the_d3f4ult | Hacker News Reader

The title is misleading. This would work to slow the progression of myopia, but won't do anything to reverse myopic changes. This works in a similar way to low-dose atropine which is already around the corner for slowing the progression of myopia (in children). For adults with myopia your only options to be spectacle independent are LASIK/PRK/SMILE, implantable contact lenses or cataract surgery.

https://www.aao.org/eyenet/article/how-to-use-low-dose-atrop...

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Will strongly recommend people not to consider laser treatments. Got SMILE done and its awful 4 years later - at least my eyes don't hurt anymore.

The entire business model exists only by not informing you of everything that can go wrong.

Ironically I now know more about these procedures than I ever did before, and all I've learned is how the entire industry is aligned to not tell patients about what things effects the outcome and how little they actually can do if the results are not good.

Edit : If you google lasik/Smile complications and so on you'll just find a rabbit hole of despair from people who had their eyes ruined. I'm kinda amazed that medical professionals actually has the conscience to perform these procedures. Theres also this tendency to blame dry eyes - which is just the industry's way of camouflaging the real issues.

I don't dismiss your concerns. I remember reading about them at the time. And to be honest, the older I get, the more surprised I was to risk one of the most important things I have.

However, I did Lasik, maybe 10-15 years ago, no problems now and never had a problem.

The industry did feel a bit sketchy though. Not sure if it's improved. I'm sure most of the professionals involved are excellent - but at the time, it felt very private, and not in a good way.

/anecdote

My eye-doctor an old guy just before retirement said after being asked about laser treatments: He had a patient that spent 5k on a laster surgery. Nothing went wrong, but it didn't improve his eyes. It would have been better to go on a good vacation.

There is sadly no guarantee that they help, and they can damage your eyes in the worst case.

I have very dry eyes. Does that mean I can never get lasik?

It’s a mark against you being a good candidate. Doesn’t mean you can’t get it.

I had dry eyes post surgery. First 6 months I was miserable. Had to put goop on my eyes at night the viscosity of Vaseline. Felt like years before I got to a normal state.

It’s been about 16 years. I wear glasses again, but I can get by without. Still occasionally have dry eyes.

Let's start a thread sharing some experience with laser treatment:

A friend of mine did a Lasik surgery, but lost his sight after a week (1/10 on one eye). AFAIK, there was no wrongdoing from the doctor side, so no financial compensation.

I did LASIK surgery when I was in my 20's. After almost a decade, my vision is pretty much perfect. Recently, Ive been prescribed with glasses only for when I work with computers because Im getting visually tired quicker.

I think it was a good decision in my case, mainly because in my 20's I used to be into decently active activities (5ks runs, long distance biking, etc), so I didn't have to choose between seeing correctly or enjoying what I was doing to the fullest.

Contact lenses are a thing.

Not everyone can use them. I have sinus allergies and astigmatism. The combination makes it hard to fit me with lenses that actually correct my vision well enough to be useful and makes those lenses very uncomfortable almost immediately.

Google the complications of contact lenses...

I had ReLex SMILE done 4 years ago. Total costs were around $5k. Easily one of the best decisions of my life. I score the absolute maximum on the tests, there were no complications and it only took a couple days to heal. I actually took the bus back to my apartment after the surgery by myself.

I know that outcomes vary but for me by now I don't actually remember what it was to be shortsighted and all outdoor activities are soo much nicer without contacts or glasses. I'd definitely do it again in a heartbeat.

My mother got lasik and everything went fine. Her vision started to decline a bit some 15 years later but her overall experience was positive. I would wager "most" people have a good experience, but the risk of a big negative is probably not worth it.

I got relax smile 1 year ago with 34.

It is one of the best things I did.

I read up on it before and didn't read something totally crazy but as with everything there is always risk to it.

That's one reason why I have problems to just suggesting it to everyone/anyone while my results are great.

But I also had 5 Dioptrien.

A digression, there is a meta-strategy here I like to use: when researching anything you're interested in getting, try searches like "complications", "issue", "troubleshooting", they'll often reveal a lot about what can go wrong that you won't find out if you only search for stuff like "opinion" or "review" etc.

Good idea. With the prevalent issue of positive review spam, I often look for negative reviews first to see a thoughtful one where the buyer actually used the item, rather than the flood of positive "reviews" of short-term usage.

But it would be great if people do research before hand before going laser treatments.

I somehow ended up on the FDA page about the surgery, which told of the odds (20 years ago) of any complication from reflections that impair vision while driving at night to blindness, and described what the complications were like. I didn't like the odds.

What are they? 1 month post prk and the night vision is a mess. I guess I'll have to learn to live with it

It's anecdotal I know, but my mother _did_ get -4 down to -1 just with exercises every morning and evening for several months, so I'm sure it _is_ possible at least with some individuals. It just requires work and dedication.

On the other hand for myself I did go for LASIK since I was -7 and didn't fancy the years of work it might entail. And it was like ... 2 day affair from going to the doctor to being fully functional without any side effects ... It was risky though as some people I know did do the same, and ended up with complications that took months to iron out.

Can you share what exercises your mother did? Sounds like some very nice progression for her.

Glad Lasik worked out for you. What side effects did your friends experience? I've thought briefly about Lasik, but I have this (potentially irrational) fear of persistent headaches as a side effect, which would be a nightmare for me. So I stick with spectacles - it has no detrimental effect on my life, but I do wonder if it would be possible to get back good eyesight again.

Checkout endmyopia for similar alternative therapy to glasses.

It sounds like quackery but I tried it for a couple months and comfortably went down .5(or is it "up" -.5?) and stopped going up every year. I stopped because the constantly switching strengths, self testing and having to remind myself to take breaks and look far away was more than I had the mental bandwidth for at the time. The "marketing" website reads like snake oil sleazery but what worked for me was the community wiki. Id spend hours correlating what was in the wiki with what he was hinting it at in his "hear my pitch for 10 minutes before I get to the point" videos until I got the hang of the routine, which was basically:

Have two pairs of glasses, one of them about half strength(self test for the exact number) for computer and close up work or in-home. Use your full strength glasses for important tasks like driving. Every 20-30 minutes take a break and look into the distance(works well with Pomodoro technique, if you do that), practice your blurring exercises.

Edit: at .5 adjustment I'm right at the edge of variance. It's possible to do nothing and have a slight improvement on your yearly optometrist visit because of secondary factors like change in environment or nutrition. I'm not a health expert so I can't say, but if anything that site helped me to do fewer things that strain my vision and a few things that made me more comfortable. Would I have fully cured if I kept going? Science says probably not, but I don't regret my effort.

Science is ever changing. After trying this out my self, I can say with confidence that current state of myopic management with glasses will be deemed as quackery on par with drinking crude oil to cure diseases in past centuries.

Near work imposed in schools and wearing glasses constantly is the reason for current myopia epidemic as can be evidenced by low myopia rates in schools following western curriculum that is more holistic in nature.

Don’t remember the details of the exercises as it was long ago - some russian self help book, I think by Mirzakarim Norbekov , but the essence was to get one of the “eye test” boards and each morning focus on the elements you can see best and try to resolve just the ones below. Do it enough and you slowly start to “go down” the chart, getting better and better.

As for lasik - I blogged about it back in the day - https://medium.com/@ivankerin/a-humble-mans-account-of-the-l...

The problems - one mate didn’t properly understand the commands he was given, (not a native speaker) and ended up poking his eye sort of mid operation. They fixed his good eye, and told him to wait for a couple of weeks until the “flap” healed and regrew so they could do it again on the other eye. Totally avoidable if he was paying attention - I had no problems and it was over in like 5 mins.

Another mate didn’t get corrected to the exact focal length so they had to do it again a couple of months later. Not a big deal just unpleasant.

I decided to go for the operation after I had an eye infection and figured I was risking my eyes every time I was putting the contacts in, so might as well risk it once and be done with it. Glasses were not an option as I wanted (and still do) practice various sports, and -7 is not fun at all.

"but the essence was to get one of the “eye test” boards and each morning focus on the elements you can see best and try to resolve just the ones below"

I do this every day over years now "just in case it works" - hasn't helped me at all. Wish I could believe these delusions.

I'm -6 and the risk of complications is what makes me think I'll probably never want to do any corrective procedure. I had been considering it for a while, but one time when I went in for a checkup, I happened to chat with another guy there who was seeing the doctor because his surgery was making him see halos. Apparently they usually go away eventually, but I decided I'd rather not find that out personally.

And I feel there's a kind of meditative calmness to the blurriness that I think I might miss. It's quite nice when I'm going to bed or waking up and everything is just a blur, no distractions to catch my eye because I can't see them! I'm probably doomed if I'm ever in an apocalypse and lose my glasses, though (see Twilight Zone "Time Enough at Last").

I can totally relate to the meditative calmness you talked about. I'm pretty sure, it contributed to my personality development as well. I wonder if I'd have been more distracted and restless if I could see everything clearly.

Wow, for the first time I feel like I'm missing out for _not_ having bad eyesight!

Sunglasses may have a similar effect — and they can be removed :)

That's the first time I've heard someone express what I feel too! I'm -8.5 and -9.5 in contact lenses and that blurriness feels very relaxing for the brain. Though it's a bit unpractical having to hold my phone 15 cm from my face in the bed...

Also, our super power is the power to see extremely small details, which proves useful sometimes!

The other day I had a splinter in my left index fingertip that was so small I couldn‘t see it even under a magnifier. After some clueless and painful poking with a needle, removing my glasses did the trick. I located the splinter and got it out within seconds. Around -6 in glasses.

I have a similar correction and I was surprised when I was helping my brother reassemble a small motor he couldn’t see the fine details.

It wasn’t until I started wearing contacts (and thus couldn’t easily take them out) did I realize that short-sightedness gives me very good up close vision.

There's a new procedure coming out in the next few years called LIRIC which seems much better with hopefully a lot lower risk of side effects.

https://crstoday.com/articles/2019-apr/laser-induced-refract...

Shoot wish I saw this post before getting PRK last month..

Lucky you. I hate the blurriness and to me this sounds like a "coping mechanism"

I played a FPS where you could have the wall textures blurry or sharp. The blurry setting made me fiddle with my glasses unconsciously, so I went with sharp, even though I ended up looking at big squares in the limit, like a weird mosaic decorated the wall.

I went without glasses for a long time until I accepted that sitting in the front and still having issues reading from the board is just stupid.

I already had 5 Dioptrien at that point.

My eye wear guy who took my eye readings had issues properly configure my measurements.

I decided to just take what the machine calculated and the first days it was difficult to wear.

But after thati gained back so so much detail.

It's just ridiculous to play around and not accepting glasses.

I'm mad at myself that I waited for accepting it for way too long.

I've always been a little surprised why we haven't figured out a treatment for myopia beyond LASIK, e.g. some way to manipulate the muscles around the eye.

Anyway, the first thing that came to my mind when I read this article was pinhole glasses which people have also (most likely wrongly) claimed help correct myopia https://en.wikipedia.org/wiki/Pinhole_glasses

> I've always been a little surprised why we haven't figured out a treatment for myopia beyond LASIK, e.g. some way to manipulate the muscles around the eye.

Generally the reasons behind myopia are changes in the shape of the eye or the lens, not something the muscles are doing wrong. (And a contributing factor with age is the decreased flexibility of the lens over time).

Most naive expectation is if myopia changes the shape of your eyes, just squish them a bit!

You joke but there are orthokeratology lenses which do just that. It's a contact lense worn overnight which compresses your eye during sleep.

That'll squish the lens, but the overall shape of the eyeball is what causes the myopia in most cases.

Tecnically the crystaline lens is in an anterior chamber inside your eye, so these contacts can't really squish the lens itself.

These contact lenses are squishing against your cornea. So in actual fact an anterior portion of your eyeball is being re-shaped.

Here's a wikipedia link: https://en.wikipedia.org/wiki/Orthokeratology

To people considering LASIK I want to say try ortho-k first. You'll get the sharpness, the halos and the whole experience but at least it will be reversible. I've been on ortho-k for around a decade.

There is a procedure that stops myopia progression, although it's not offered in US. Very effective when done in young age.

https://en.wikipedia.org/wiki/Scleral_reinforcement_surgery

> Scleral reinforcement is a surgical procedure used to reduce or stop further macular damage caused by high myopia

Doesn't sound like it fixes myopia, rather that it addresses one of the side effects of high myopia?

When done in children, it stops progression of myopia. I had it done at 13 after loosing 1 point every year, and it stopped at 6.5. God only knows what would it be without it.

I had scleroplasty done on my eyes at the age of 13, at 8.5D, to stop progression, and it did help - I only progressed to 9.25D in 30 years since…

Doesn’t seem like done in any other countries other than Russia - https://www.nature.com/articles/eye2009322

Me too, stopped at 6.5. Wikipedia says they do it in Japan too.

> I've always been a little surprised why we haven't figured out a treatment for myopia

Isn't the treatment for "treatable" myopia "spend more time in the sun"? IIRC, something about spending time in the sun prevents/reverses myopia in most children.

I also seem to recall that you can sleep in pure oxygen and it will change your eyesight (the cornea gets its oxygen directly from the atmosphere and high oxygen concentration encourages growth which thickens the cornea).

If myopia is structural though (misshapen eyeball, aged muscles not working to focus, etc.), what kind of non-surgical treatment would you expect to work?

One other problem that comes up is that the neural "integrators" in the human control systems get "leaky" with age. If you ask someone above about age 40 to look completely to the right or left, you can observe their eyeball "vibrate" as the saccades correct the integration error in tracking position.

(This was given as an exercise in a bioenginering class for "model the human eye tracking system". You had a series of observations you had to take and measure and then derive both the control system and the rough time constants. One of the observations that you had to account for was why the older grad students/professors had this "vibration". You could create this behavior if your "integrator" block was leaky.)

> One of the observations that you had to account for was why the older grad students/professors had this "vibration".

Microsaccade amplitude is correlated with uncorrected myopia, actually. If you have visual blur it seems fixational eye movements have higher amplitude. (Proper corrective lenses generally remove this effect).

Of course, if someone has astigmatism, often it won't be properly corrected looking far right or left, too. I'm guessing this is the effect you measured.

https://iovs.arvojournals.org/article.aspx?articleid=2281647

Ho, too bad :(

Fixing my myopia would be one of my life’s dream. I’m unfortunately non eligible to laser surgery due to my amblyopia. I’m stuck there forever waiting for a non invasive treatment that nobody is searching for because, well, we have the LASIK.

Man fixing it would be my dream too, especially with masks these days.

I'm eligible for LASIK but I'm still waiting for a non invasive treatment as well. I know it is "safe" but it can go wrong and after reading some of the horror stories in forums I would _hate_ it if it goes wrong. Even smaller side effects like having dry eyes all the time and eyes hurting when there is wind sounds annoying.

Oh you can try hard contact lenses. Sadly I’ve not been able to tolerate them for some reason that my ophthalmologist cannot explain but while I was wearing them, the correction was extraordinary, because it also fixes all forms of astigmatisms.

Maybe what didn’t work for me will work for you.

Are hard contact lenses better than soft for astigmatism? Have you tried soft ones? I've only tried the latter and could never get used to them seeming to go out of focus or drift around whenever I blinked.

They are well better because they are 100% effective. I have tried soft ones (torics) and never been satisfied with them (still better than glasses). With the hard ones, the astigmatism basically disappears because a drop of tear forms between your eye and the lens so the optical system is composed with your eye, the tear drop, and the lens. This way, the surface of your eye have not any impact on the optical result.

(please excuse my writing, it's difficult for a non native to talk about technical topics with a lot of vocabulary I'm unfamiliar of)

Just wait until you're older.. my dream is for presbyopia to be fixed. Presbyopia is essentially when your eyes can no longer auto-focus, it's incredibly annoying. I think some Israeli company was supposedly working on auto-focus glasses for this... good idea, since the market is basically everyone. But it looks like they stopped.

https://eye-see-mag.com/en/high-tech/autofocus-lenses-for-pr...

I've been following the development of eye drops which promise to reach the lens and make it flexible again:

https://clinicaltrials.gov/ct2/show/NCT04806503

That would be really something.

Wow it really would be!

Should we invest in the company that makes them. What an amazing development

Novartis acquihired them very early on and now is performing clinical trials.

Results from the most recent completed study are encouraging:

https://www.healio.com/news/optometry/20201012/further-study...

Silly Question: It it a good experiment to put the medicine in one eye and the placebo in the other eye? What could be other consequences of such a thing?

Vision therapy for both presbyopia and myopia relies partly on neuroplasticity: https://news.ycombinator.com/item?id=16194580

There is a sizable incumbent revenue stream from expensive progressive lenses for those with presbyopia, which may or may not influence investment in alternative solutions.

Ortho-k lenses won't fix it, but they do have some effect on it (https://pubmed.ncbi.nlm.nih.gov/21037497/).

> too bad

I suggest and encourage you to try the exercises that others in this page have mentioned; some people have written their guide or guidelines and one well known is

"The No Bulls#*t Guide to Vision Improvement", by C. G. Hayes

(search for > Guide to Vision Improvement.pdf < or similar).

First of all, the best wager is to place bets on ways that some witness have worked, and it is not ruled out they could work for you also.

If anything, you will have gained points exercising discipline.

> The No Bulls#*t Guide to Vision Improvement

All of this sounds so quacky. The name, the "secret knowledge industry doesn't want you to know about", the marketing...

Sounds. Have you read it?

> the "secret knowledge industry doesn't want you to know about", the marketing

Have you dreamt those features, or are they somewhere in the document?

Are you sure it’s only children? Another user posted this link, their clinical trial was in adults.

https://www.kubotaholdings.co.jp/en/kubota-glass-technology-...

Atropine drops for myopia management are already commonly prescribed in Singapore (which pioneered the treatment), and seem to work quite well.

There is also some evidence that Ortho-k lenses slow the progression of myopia.

https://pubmed.ncbi.nlm.nih.gov/21037497/

https://clinicaltrials.gov/ct2/show/NCT03465748

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