The Importance of Prescribing Lenses: More Than Meets the Eye - Part 3: Too Close For Comfort
Originally posted on August 20th, 2013
In The Importance of Prescribing Lenses: More Than Meets the Eye - The Sequel we discussed the important role played by the brain in the visual process. We also touched on the idea that the eye doctor might also play an important role in how your visual process functions and develops.
The main problem is usually close work,
even when the main symptom is nearsightedness.
The human visual system is not really designed for the kind of close work we spend so much of our time doing. Our visual systems are designed for action. In fact, the primary purpose of the visual process is to direct action. Most modern close work involves sitting still and reading - two things that are not particularly active, nor particularly natural, especially for young children. Many visual problems involve stress on the visual process resulting from excessive, though clearly necessary, close work and the struggle to meet the unnatural demands asked of the visual system.
One of the most common responses to visual stress related to close work is nearsightedness - the inability to see past a certain distance without artificial lenses. Not all nearsightedness arises this way…just most of it. The typical response of eye doctors is to simply address the symptom by prescribing compensating lenses (which they describe as "corrective lenses") and telling people it’s hereditary even though the vast majority of nearsightedness is not hereditary. This approach not only fails to address any of the possible (that is, likely) causes, but it almost always leads to a worsening of the very condition it is supposed to "correct."
If you are already nearsighted you have probably seen your prescription increase any number of times since you first started wearing glasses. This happens in no small part because the visual habits that helped cause the problem remain intact, and then simply continue, with glasses that ignore the causes thrown into the mix. Another key factor, ignored by the vast majority of eye doctors, is that doing close work while wearing lenses prescribed for distance puts extra strain on the visual system. This is a fact, and frequently causes increased nearsightedness and the perceived need for stronger lenses.
Find a doctor who will listen to and understand your complaints
and address your true visual needs.
Most eye doctors respond almost exclusively to the issue of seeing clearly at a distance. Symptoms like this are actually, in most cases, signs of more complex visual issues. The symptoms are not the real problem - they are actually signs of the person’s attempts to solve the original problem - yet symptoms are all most doctors look at. I prefer to evaluate the visual process as a whole and focus on people's visual needs at near first. I want to help reduce the stress inherent in typical modern-day visual demands before addressing a person’s needs for distance seeing. Prescribing lenses that make distant objects clear is easy. Assessing and managing the causes is more complicated. Only behavioral optometrists are equipped with the knowledge and desire to go the extra mile to provide the level of care that addresses causes, not just effects. It’s important to know that nearsightedness, as well as most visual complaints that propel people to the eye doctor, are very often the result of a more complex visual scenario.
Another thing I have learned over the years is that it is not always possible to achieve maximum clarity and maximum comfort with the same lenses. At some point I decided that comfort should come first. Another common misconception among eye doctors is that the distance clarity must be addressed before anything else is considered. This is simply not true in most cases. It is much better, in my view, to hold off on maximum distance clarity until the visual process is working at something more like optimal capacity, minimal stress and maximum comfort. My experience tells me that clear eyesight is the result of a better functioning visual system, not the basis.
Lenses can be prescribed in much more creative and positive ways than most of us are accustomed to. Lenses can stimulate development, reduce stress, enhance performance, and comfort - all while having little or nothing to do with directly improving clarity. I want to find out what the brain is capable of before using compensating lenses to do all the work.
Find a behavioral optometrist near you next time you’re thinking about your vision and what might be possible.
Next time: 3-D or Not 3-D, That Is The Question