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Nearsightedness (Myopia) and Vision Therapy
This is a brief description of the condition, how it arises, evolves and how it is usually treated. Alternative treatment methods, principally vision therapy, are also introduced. Such alternative methods are primarily aimed at myopia reduction or myopia control. More and more people are looking for myopia reduction methods and no professional is better equipped to provide myopia reduction options than behavioral optometry. Not all behavioral optometrists provide myopia reduction specifically, but most will provide a level of care that tends to be more likely to control the factors that contribute to the increase of myopia that standard eye care generally accepts as normal and unavoidable. For more in-depth reading visit the Articles section – particularly: What’s So Great About 20/20? and Myopia Reduction:A View From The Inside. You might also want to order Dr. Gallop’s book “Looking Differently at Nearsightedness and Myopia.”
Nearsightedness, often referred to as myopia, is the most common reason for people under the age of 40 to visit the eye doctor. Typically, a child who fails the eye screening at school goes to the eye doctor. This visit usually results in glasses. These glasses are called “corrective” although this term is inaccurate. A corrective device should correct something. Typical glasses merely mask the problem. When the glasses are removed, things still look blurry in the distance. In fact, most people undergo continuing deterioration once they start wearing such “corrective” lenses.
Most people become dependent on these lenses. Like other dependencies, there is a tendency to need something stronger as time goes by. These lenses are compensating rather than corrective devices. They compensate for an inability to see clearly in the distance. They do not address the actual cause. The nearsightedness can be eliminated in many cases when the cause is properly addressed. The condition can be improved and stabilized in those cases where total elimination is not possible. The same holds true for farsightedness and astigmatism.
A nearsighted individual is unable to see clearly in the distance without artificial lenses. A large segment of the population is nearsighted. Very few are born nearsighted. In fact, most people are born slightly farsighted. Behavioral optometrists regard this small amount of farsightedness as a protective cushion. This cushion provides a margin of safety in the event that there is too much stress placed on the visual system. Modern culture, with all of its near work, all but guarantees there will be considerable stress on the visual system. Some people are better able to weather the storm than others. The visual system can and should be protected whenever possible. The things that can protect this cushion are proper visual hygiene, preventive/vision enhancing lenses and vision therapy/visual training.
Many visual problems, including nearsightedness, arise because the visual demands of our culture run contrary to the original nature of the way the visual process was meant to be used. We spend most of our time indoors, and much of that time reading or at the computer. Throughout most of the history of human beings we spent most of our time outdoors. Our visual demands were more varied. They generally involved a broader range of physical activity, and consisted of much more distance viewing. In order to see far away, we must relax the lenses inside our eyes. Near focusing requires work to flex the muscles inside the eyes. More people of all ages are becoming nearsighted. In the past it was unusual for people over the age of 16 to begin a nearsighted progression. It is fairly common today. This is due to the true nature of most nearsightedness, which is improper or inefficient use of the visual system.
The process of becoming nearsighted is often an adaptation to visual difficulty. The primary problem is typically what behavioral optometrists refer to as “nearpoint stress,” that is, the continual demands for focusing, seeing, and performing at near. Prolonged work utilizing close, flat surfaces is visually stressful. Our two eyes placed as they are (facing forward in the front of the head) allows for a three-dimensional perception of the world. A flat surface restricts the freedom of the visual system to flex and relax within three-dimensional space. Also, prolonged visual activity in the absence of movement is stressful. The visual process is one of action. Prolonged sedentary activity is similar to prolonged two-dimensional viewing in its negative effects. Just as the eyes were designed for three-dimensional flexing, the body is designed for movement. Prolonged stillness can be stressful. The fact is, most people are not able to use their eyes with maximum efficiency and comfort while reading or working at the computer.
Vision-enhancing lenses should be worn for all prolonged near activities. Vision-enhancing lenses help to keep the visual system relaxed. They also reduce the strain on the entire visual system during these activities. It is always best to have the right tool. This is similar to using a hammer to drive a nail. We would never think of doing this with our bare hands. Our hands are not designed to do this task even though it is a task that is often necessary to do. Since the visual system was not designed for the stress our culture places on it, we must use an appropriate tool for the job. Lenses that are worn to see clearly in the distance do not accomplish the goal of seeing comfortably and efficiently close up. In fact, distance lenses put added stress on the visual system when worn for near work. Specially prescribed near lenses are required. These lenses will increase comfort, productivity, and endurance during close work. They will if worn appropriately, in many cases, permanently increase distance clarity as well.
There are numerous options for dealing with nearsightedness. By far, the most common is compensating lenses (glasses or contact lenses). Such lenses will simply mask the problem allowing, and will cause things to worsen in the majority of cases. More recently, surgical procedures have emerged that achieve the same effect. These procedures permanently alter the shape of the cornea, changing the way light focuses inside the eye. However, surgery is simply a more permanent way of masking the surface problem without addressing the actual causes. Therefore, the nearsightedness can return, which does in fact occur after these surgeries at least 20% of the time. This is particularly true for people under the age of thirty and may be one the reasons that these procedures are not performed on younger people. It is also important to note that there is no guarantee that the need for glasses will be eliminated by such surgery. There also remain unanswered questions as to the long-term effects on the physical health of the eye itself after surgery.
Orthokeratology is a safer way of masking nearsightedness. This approach requires wearing special contact lenses that gradually change the shape of the cornea. In some cases these lenses are only worn during sleep, and the eye retains its modified shape throughout the day. Therefore, compensating lenses need not be worn during waking hours.
Since 1920 the work of Dr. W.H. Bates (and later, others) has inspired many people to try doing without their glasses. Bates advocated going without glasses and doing various exercises to “strengthen the eyes” and promote relaxation. His ideas were completely at odds with his peers, but he certainly helped break the rigid pattern of thinking of his day. Bates may have been the first to think in terms of myopia reduction.
In the late 1920s A.M. Skeffington and others began the thinking and hard work that led to what is now known as Developmental or Behavioral Optometry. Behavioral optometry has developed countless techniques to prevent, stabilize, or reverse the symptoms and effects of nearsightedness (as well as many other visual problems). Vision-enhancing lenses are an important part of the process of improving vision. Vision therapy is another excellent means of improving vision.
Vision therapy is a program of activities that help people observe, learn about, and change how they are using their visual process. Although often referred to as “eye exercises” vision therapy is much more than that. It is important to understand that we do not really see with our eyes – we see with our brains. And vision therapy is a means of retraining the brain. By setting up the proper conditions, and using the appropriate language, equipment, and lenses it is possible to retrain the brain. This is an important point. The eyes and their supporting muscles can only do what the brain tells them to do. When the visual process is not working properly it is because there is confusion in the brain. That is, the brain is not processing visual information accurately. This can be improved with therapeutic lenses and vision therapy in most cases. Myopia reduction is best achieved by working with a behavioral optometrist who offers vision therapy and therapeutic lenses.
Standard, medically oriented approaches to eye care will not usually provide comprehensive information on the causes and possible treatment options available. These standard approaches are limited to compensating for the surface issues, using compensating lenses or surgery. There is no room for creative thinking and treatment options in these approaches. You must seek creative solutions for yourself. Developmental/behavioral optometry offers more in-depth philosophies of visual care, more comprehensive diagnostic techniques and truly corrective treatment options.
There are also a number of do-it-yourself myopia reduction programs available claiming to help people reduce or eliminate myopia. While many of these programs come from well-intentioned people and philosophies of vision care, none of them address the full-scope of issues that are important to long-term improvement of visual function. It is best to find a trained, dedicated professional to properly address these issues and provide the most comprehensive care for myopia reduction and all other visual conditions.
Contact Dr. Gallop for more information about behavioral optometry, vision therapy or your own nearsightedness.
Optometric Extention Program Foundation www.OEPF.org
College of Optometrists in Vision Development www.COVD.org