5 ms·

At the risk of sparking some kind of Apple flame war: I went to the optometrist recently and my vision had abruptly tanked, I have a much stronger prescription

At the risk of sparking some kind of Apple flame war: I went to the optometrist recently and my vision had abruptly tanked, I have a much stronger prescription than a year ago. “Have you been pulling long screen hours?” “Yeah. Very long.” “Well that’s why.” “Outside of cutting screen hours, is there anything else I can do?” “Get the highest DPI display you can afford and crank up the font size. Won’t help much, but it’ll help a little.” So I splurged on the 6k display. I can literally feel it in my temples after a long session.

was_a_dev 4y ago
I've recently been looking at collimated displays, they're used by flight sim users to improve immersion in game. They use a large fresnel lens in front of their monitor in order to collimate the light. For their purpose it adds a perception of depth to the viewed image. However, they also claim there is a natural relaxing of the eyes, which adds to the immersion. I wonder if such a display would work in an office environement. A quick look for any literature came up blank.
goldenkey 4y ago
As an optometrist with a deep knowledge on this subject, let me first say, the established edifice of eye care and laser eye surgery is an abomination that ruins lives. The advice your optometrist gave you is the information they were indoctrinated with and sadly, it's erroneous. What follows is my best synopsis on what is wrong with the industry, what causes worsening vision, and what you can do to resolve your vision issues in a matter of months and never have to worry about it again. You'll still need some form of corrective lenses though - I'm not selling bullshit. ----------------- Most cases of myopia (nearsightness), involving progressively worsening vision, are largely due to inaccurate lens prescriptions. An optometrist or optician will have you sit with your head in the phoropter asking "better/worse" while flipping lenses - pretty much a binary search type of approach. But this is often done hastily and results in inaccurate prescriptions. ----------- Unfortunately, inaccurate scripts are often inflicted upon children which as I will describe later, compounds into worsening vision over time, with the opticians/optometrists prescribing higher and higher power lenses that are only solving an issue that is created by the previous history of inaccuracy! Telltale signs of inaccurate scripts include: - minor corrections Eyes are not static objects and vision actually does vary from month to month, day to day, lighting conditions, blood pressure, etc. If a correction is minor, it's almost always unecessary and harmful. - slightly different prescriptions for left (OS) and right (OR) eyes. 99.9% of folks have equivalent vision in both eyes. Like I said above, if a difference is minor, a correction would almost always be harmful. - minor cylinder corrections (astigmatism.) Astigmatism is extremely rare and when it does occur it's almost never minor. These corrections are especially egregious as they cause distortion compensation. ----------- So why do eye professionals commit these cardinal acts of eye destruction upon their patients? Well we already discussed hastyness but that is clearly a vice that is going to result in bad outcomes in any profession. What else? Well, eye professionals are taught to seek out as perfectly sharp an image as possible, and then back off the power a bit to reduce the possibility of eyestrain, headache, and dizziness. Some professionals don't even back off the power though.. In order to accomplish this task of perfect sharp vision, they add all of these minor corrections. When these ill-fitting lenses are worn for months on end, the body has a somatic response. The eyeballs elongate, which pushes the focal plane back, causing further myopia. [1] The patient goes back to the eye doctor and now receives an even more incorrect script based on the transient state their eyes are in, induced by a cascading patterned history of harmful scripts. In the worst case, the eye doctor recommends laser eye surgery which shaves the corneal lens of your eye into an artificial lens. Essentially, they carve your current harmful prescription straight into your eyeball. And then guess what happens? The eyeball shortens and often, the patients vision becomes progressively worse again. It can take months, but it does happen. [2] And now the fix that they recommend? More laser eye surgery. It's barbaric. So please, do not get eye surgery before trying what I recommend below. Surgery on the cornea is advertised as non invasive but it can cause life long issues such as chronic dry eye. Please try to assess whether your vision is actually bad, or just a transient state due to a long history of bad prescriptions and poor habits. ---------- How do you break the cycle and restore your vision? 1) First, look at your current script. How asymmetric is it? How small are the cylinder values, if any? Lower the scripts power and make the prescription symmetric. Remove the minor cylinder values. So for example, if you had -3.6 and -3.4 with some small astigmatism corrections, just ask for a script for -3.4 SPH in both eyes. 2) Make sure the pupillary distance is correct - eye professionals are notorious for fucking this up because the PD needs be to custom set for the frame the lenses will be going in, otherwise you'll have lenses with a focal center that is not aligned with the center of your eyeball. This causes distortion and uneven focus, causing eye strain and worsening vision. 3) Aspheric lenses - buy good lenses like Seiko double aspherics - just like cinema or photo lenses cost a lot of money because they reduce abberation and edge distortion, your eyes benefit from the same technology. Bottom dollar spherical lenses are okay, but strain is not healthy for eyes, and a good $300 set of Seiko transition lenses with coatings can last 10+ years. It's worth your eye health. 4) Have multiple pairs of spectacles. Use the weakest usable one (or no specs) depending on the task you are doing. For instance, I'm on my phone in bed, so I am not using any glasses. This will improve your vision over time. You can slowly reduce the power of your scripts if you care about it. I went from -4.75 to -3.5 and I'm happy with what I'm at, so I don't spend any effort trying to lower any further. But if you have the money, the time, and the will, you can get to -1.X territory through judicious use of a set of activity appropriate lenses. Lastly, buy your own frame, buy your own pupilary distance tools, buy your own trial lens kit and trial frame like the Oculus UB6. Take time and figure out the right prescription for yourself without it being rushed. Test it and have it remade if the center of focus of the lenses is not at the center of your eyes. PD is integral! ------------- An eye professional who cares and understands these things CAN help and even properly measure these values but they are rare. Sometimes if you want something done right, you kind of have to do it yourself. Or at the very least, guide or give your demands. After all, you are the paying customer. Hope this helps others break the cycle of worsening vision. If anyone has any question, feel free to reach out. [1] https://www.ncbi.nlm.nih.gov/books/NBK470669/ https://www.ncbi.nlm.nih.gov/books/NBK470669/ [2] https://www.webmd.com/eye-health/news/20030410/some-patients-need-second-lasik-surgery https://www.webmd.com/eye-health/news/20030410/some-patients...
- sj4nz 4y ago
  SEIKO Vision by their website does not appear to be available in the United States (no providers are listed in their directory)-- do you happen to know anything equivalent available there?
  - goldenkey 4y ago
    Seiko's US website has some PDFs if you do some searching but the JP website is a far better resource, and the products are international for the most part. [1] You can read about the double aspherics here: https://www.2020mag.com/article/double-asphericity-a-freeform-solution-for-single-vision-part4 https://www.2020mag.com/article/double-asphericity-a-freefor... [1] https://www.seiko-optical.com/fileadmin/media/marketing_shop/order_artwork/SEIKO_Endconsumer_Flyer_AZ_en_ok.pdf https://www.seiko-optical.com/fileadmin/media/marketing_shop...
- jmull 4y ago
  I'm calling bullshit on most of this. You're making a lot of strong claims that are unsupported or even counterfactual. E.g.: > Most cases of myopia (nearsightness), involving progressively worsening vision, are largely due to inaccurate lens prescriptions. Interesting idea, but what do you have to support this provocative claim? You argument about minor corrections isn't even logical, which makes me doubt your judgement in any of this. And it's never a good sign when the citations provided contradict the claims. [1] doesn't support the claims it's attached to. In fact, it says: "The underlying biological cause of myopia is unknown, and there is no widely accepted means of prevention or cure." I hope you're not really a practicing optometrist.
  - goldenkey 4y ago
    I don't have a list of references ready for these kinds of debates but the information is out there if you even do a cursory glance. The Japanese have been the most vigilant in doing research on myopia. [1] [1] https://pubmed.ncbi.nlm.nih.gov/32740040/ https://pubmed.ncbi.nlm.nih.gov/32740040/
- germinalphrase 4y ago
d3nj4l 4y ago
A hard amen to this. I can't afford the 6K display, but getting a decent 4k one for $400 has more than paid for itself in reducing stress. I never noticed it, but my eyes were working overtime reading blurry text.
- benreesman 4y ago
  Even 4k is a huge step up from what I had been using which was just whatever. Getting up to a modern DPI is a game changer right?
  - ehnto 4y ago
    Not to assume you play games or watch YouTube, but on low DPI you also don't realise what you are missing in detail. Entire objects reveal themselves in this new space between the pixels. Where once was a splodge is now a person far off into the distance. You could almost liken low DPI to being near sighted, which I also am. Once you hit higher DPI suddenly you can see the view far off into the distance clearly. I have been messing with VR lately and that is a new dimension as well, similar in change to the jump to high DPI. Ignoring the stereoscopic part, you also don't realise the scale of things until they are in the correct FOV in front of you. I see now why simracing boffins faff about with FOV so much on their screens! I took the effort to calculate FOV for my desktop monitor and where I sit, and in FPS games and it made a huge difference to immersion.
    - thunkshift1 4y ago
      What dpi is considered high or good
    - benreesman 4y ago
      Oh man, I never got into gaming because two of my brothers were so off-the-charts that I was like “why bother”. When I was like maybe 19 there was this Quake3 player who went by Zero4 who was in the top few on Earth at that time, and my 16 year old brother slapped him around so effortlessly during their biweekly workouts I knew that it was going to be more fun to watch than to be 1-px railed before I figured out which gun I was holding :)
rileyphone 4y ago
You can also do eye exercises, like going between focusing on something close, eg a finger, and focusing on something far away.
- benreesman 4y ago
  I try to walk around every 15 30 minutes and stuff. My workflow is especially dangerous in this regard because I do almost everything in the terminal so it’s especially easy to get sucked in. I’ve known sightless hackers who were awesome, it’s definitely not game over, but it also definitely slows you down. For most hackers our eyes and the musculature starting all the way back in your lower spine through to your fingertips is such a huge part of our livelihood. I’ve been trying to treat all of it with more care.
  - csdvrx 4y ago
    > My workflow is especially dangerous in this regard because I do almost everything in the terminal so it’s especially easy to get sucked in. As someone who also mostly works in the terminal and who has stopped wearing glasses thanks to a weird approach, try a pure white or slightly yellowish background with a black font in the daytime. Most terminal users will find that weird, but among other weird things I tried it worked wonders for me!
  - ehnto 4y ago
    It is a bummer that we can often see neglect in that area even amongst people really passionate about computing. Apologies for the anecdote. I know for myself, I sometimes felt a stigma to investing in "nerdy" equipment designed to make computing more sustainable. Almost like if I don't commit to the furniture maybe I will become that out and about person I think I should be. Funnily enough, it was only after I had gotten into a bunch of outdoor hobbies that I decided to really splurge on quality of life equipment at the computer.
    - benreesman 4y ago
      I tend to offset expensive purchases with cheap ones. Expensive chair, cheap as hell desk. Expensive monitor, cheap computer. Expensive keyboard, cheap mouse. You can get a really nice workstation if you choose the expensive parts deliberately for the ergonomics. I don’t want to speak for you but you said one or two things that echo with me: by hyper-optimizing my workstation to be the most comfortable place in my house I think I sort of feed a tendency to hide from difficult parts of life by just working too much. I also think you’re onto something about activity, particularly outdoor activity being the best counterweight to that tendency, I just struggle to get an active routine going from a cold start. Usually if I’m active I can keep it that way, but whether it’s C19 lockdown or a death in the family, it’s very easy to get knocked back into that sedentary state. Any of that resonate?
bradlys 4y ago
How did you avoid your prescription increasing a lot for so many years? Did long screen hours also correlate with not going outside? It's known that having less light exposure (e.g. going outside) correlates heavily with decreased eyesight.
- benreesman 4y ago
  I’m not sure obviously but I think it’s just a really sharp increase in screen time.
goodguyamercunt 4y ago
I don't want to sound stupid but just because a single doctor said it doesn't make it true.
- benreesman 4y ago
  Oh sure, I don’t think I would have gotten surgery without multiple opinions! But while there are no guarantees it sounded plausible and a few Google searches found other people saying it had helped, the downside is a quite high but not utterly ruinous expense on the thing I look at more than anything else, and even a pretty expensive retail computer monitor would only have to extend my useful eyesight by a comparatively modest period of time to pay for itself. And while it very well may be placebo, it certainly feels less physically stressful on my eyes and facial muscles, so I don’t regret it even though I’ll have to cut the budget somewhere else.

was_a_dev 4y ago

I've recently been looking at collimated displays, they're used by flight sim users to improve immersion in game. They use a large fresnel lens in front of their monitor in order to collimate the light. For their purpose it adds a perception of depth to the viewed image. However, they also claim there is a natural relaxing of the eyes, which adds to the immersion. I wonder if such a display would work in an office environement. A quick look for any literature came up blank.

goldenkey 4y ago

As an optometrist with a deep knowledge on this subject, let me first say, the established edifice of eye care and laser eye surgery is an abomination that ruins lives. The advice your optometrist gave you is the information they were indoctrinated with and sadly, it's erroneous. What follows is my best synopsis on what is wrong with the industry, what causes worsening vision, and what you can do to resolve your vision issues in a matter of months and never have to worry about it again. You'll still need some form of corrective lenses though - I'm not selling bullshit. ----------------- Most cases of myopia (nearsightness), involving progressively worsening vision, are largely due to inaccurate lens prescriptions. An optometrist or optician will have you sit with your head in the phoropter asking "better/worse" while flipping lenses - pretty much a binary search type of approach. But this is often done hastily and results in inaccurate prescriptions. ----------- Unfortunately, inaccurate scripts are often inflicted upon children which as I will describe later, compounds into worsening vision over time, with the opticians/optometrists prescribing higher and higher power lenses that are only solving an issue that is created by the previous history of inaccuracy! Telltale signs of inaccurate scripts include: - minor corrections Eyes are not static objects and vision actually does vary from month to month, day to day, lighting conditions, blood pressure, etc. If a correction is minor, it's almost always unecessary and harmful. - slightly different prescriptions for left (OS) and right (OR) eyes. 99.9% of folks have equivalent vision in both eyes. Like I said above, if a difference is minor, a correction would almost always be harmful. - minor cylinder corrections (astigmatism.) Astigmatism is extremely rare and when it does occur it's almost never minor. These corrections are especially egregious as they cause distortion compensation. ----------- So why do eye professionals commit these cardinal acts of eye destruction upon their patients? Well we already discussed hastyness but that is clearly a vice that is going to result in bad outcomes in any profession. What else? Well, eye professionals are taught to seek out as perfectly sharp an image as possible, and then back off the power a bit to reduce the possibility of eyestrain, headache, and dizziness. Some professionals don't even back off the power though.. In order to accomplish this task of perfect sharp vision, they add all of these minor corrections. When these ill-fitting lenses are worn for months on end, the body has a somatic response. The eyeballs elongate, which pushes the focal plane back, causing further myopia. [1] The patient goes back to the eye doctor and now receives an even more incorrect script based on the transient state their eyes are in, induced by a cascading patterned history of harmful scripts. In the worst case, the eye doctor recommends laser eye surgery which shaves the corneal lens of your eye into an artificial lens. Essentially, they carve your current harmful prescription straight into your eyeball. And then guess what happens? The eyeball shortens and often, the patients vision becomes progressively worse again. It can take months, but it does happen. [2] And now the fix that they recommend? More laser eye surgery. It's barbaric. So please, do not get eye surgery before trying what I recommend below. Surgery on the cornea is advertised as non invasive but it can cause life long issues such as chronic dry eye. Please try to assess whether your vision is actually bad, or just a transient state due to a long history of bad prescriptions and poor habits. ---------- How do you break the cycle and restore your vision? 1) First, look at your current script. How asymmetric is it? How small are the cylinder values, if any? Lower the scripts power and make the prescription symmetric. Remove the minor cylinder values. So for example, if you had -3.6 and -3.4 with some small astigmatism corrections, just ask for a script for -3.4 SPH in both eyes. 2) Make sure the pupillary distance is correct - eye professionals are notorious for fucking this up because the PD needs be to custom set for the frame the lenses will be going in, otherwise you'll have lenses with a focal center that is not aligned with the center of your eyeball. This causes distortion and uneven focus, causing eye strain and worsening vision. 3) Aspheric lenses - buy good lenses like Seiko double aspherics - just like cinema or photo lenses cost a lot of money because they reduce abberation and edge distortion, your eyes benefit from the same technology. Bottom dollar spherical lenses are okay, but strain is not healthy for eyes, and a good $300 set of Seiko transition lenses with coatings can last 10+ years. It's worth your eye health. 4) Have multiple pairs of spectacles. Use the weakest usable one (or no specs) depending on the task you are doing. For instance, I'm on my phone in bed, so I am not using any glasses. This will improve your vision over time. You can slowly reduce the power of your scripts if you care about it. I went from -4.75 to -3.5 and I'm happy with what I'm at, so I don't spend any effort trying to lower any further. But if you have the money, the time, and the will, you can get to -1.X territory through judicious use of a set of activity appropriate lenses. Lastly, buy your own frame, buy your own pupilary distance tools, buy your own trial lens kit and trial frame like the Oculus UB6. Take time and figure out the right prescription for yourself without it being rushed. Test it and have it remade if the center of focus of the lenses is not at the center of your eyes. PD is integral! ------------- An eye professional who cares and understands these things CAN help and even properly measure these values but they are rare. Sometimes if you want something done right, you kind of have to do it yourself. Or at the very least, guide or give your demands. After all, you are the paying customer. Hope this helps others break the cycle of worsening vision. If anyone has any question, feel free to reach out. [1] https://www.ncbi.nlm.nih.gov/books/NBK470669/ https://www.ncbi.nlm.nih.gov/books/NBK470669/ [2] https://www.webmd.com/eye-health/news/20030410/some-patients-need-second-lasik-surgery https://www.webmd.com/eye-health/news/20030410/some-patients...

sj4nz 4y ago
SEIKO Vision by their website does not appear to be available in the United States (no providers are listed in their directory)-- do you happen to know anything equivalent available there?
- goldenkey 4y ago
  Seiko's US website has some PDFs if you do some searching but the JP website is a far better resource, and the products are international for the most part. [1] You can read about the double aspherics here: https://www.2020mag.com/article/double-asphericity-a-freeform-solution-for-single-vision-part4 https://www.2020mag.com/article/double-asphericity-a-freefor... [1] https://www.seiko-optical.com/fileadmin/media/marketing_shop/order_artwork/SEIKO_Endconsumer_Flyer_AZ_en_ok.pdf https://www.seiko-optical.com/fileadmin/media/marketing_shop...
jmull 4y ago
I'm calling bullshit on most of this. You're making a lot of strong claims that are unsupported or even counterfactual. E.g.: > Most cases of myopia (nearsightness), involving progressively worsening vision, are largely due to inaccurate lens prescriptions. Interesting idea, but what do you have to support this provocative claim? You argument about minor corrections isn't even logical, which makes me doubt your judgement in any of this. And it's never a good sign when the citations provided contradict the claims. [1] doesn't support the claims it's attached to. In fact, it says: "The underlying biological cause of myopia is unknown, and there is no widely accepted means of prevention or cure." I hope you're not really a practicing optometrist.
- goldenkey 4y ago
  I don't have a list of references ready for these kinds of debates but the information is out there if you even do a cursory glance. The Japanese have been the most vigilant in doing research on myopia. [1] [1] https://pubmed.ncbi.nlm.nih.gov/32740040/ https://pubmed.ncbi.nlm.nih.gov/32740040/
germinalphrase 4y ago

d3nj4l 4y ago

A hard amen to this. I can't afford the 6K display, but getting a decent 4k one for $400 has more than paid for itself in reducing stress. I never noticed it, but my eyes were working overtime reading blurry text.

benreesman 4y ago
Even 4k is a huge step up from what I had been using which was just whatever. Getting up to a modern DPI is a game changer right?
- ehnto 4y ago
  Not to assume you play games or watch YouTube, but on low DPI you also don't realise what you are missing in detail. Entire objects reveal themselves in this new space between the pixels. Where once was a splodge is now a person far off into the distance. You could almost liken low DPI to being near sighted, which I also am. Once you hit higher DPI suddenly you can see the view far off into the distance clearly. I have been messing with VR lately and that is a new dimension as well, similar in change to the jump to high DPI. Ignoring the stereoscopic part, you also don't realise the scale of things until they are in the correct FOV in front of you. I see now why simracing boffins faff about with FOV so much on their screens! I took the effort to calculate FOV for my desktop monitor and where I sit, and in FPS games and it made a huge difference to immersion.
  - thunkshift1 4y ago
    What dpi is considered high or good
  - benreesman 4y ago
    Oh man, I never got into gaming because two of my brothers were so off-the-charts that I was like “why bother”. When I was like maybe 19 there was this Quake3 player who went by Zero4 who was in the top few on Earth at that time, and my 16 year old brother slapped him around so effortlessly during their biweekly workouts I knew that it was going to be more fun to watch than to be 1-px railed before I figured out which gun I was holding :)

rileyphone 4y ago

You can also do eye exercises, like going between focusing on something close, eg a finger, and focusing on something far away.

benreesman 4y ago
I try to walk around every 15 30 minutes and stuff. My workflow is especially dangerous in this regard because I do almost everything in the terminal so it’s especially easy to get sucked in. I’ve known sightless hackers who were awesome, it’s definitely not game over, but it also definitely slows you down. For most hackers our eyes and the musculature starting all the way back in your lower spine through to your fingertips is such a huge part of our livelihood. I’ve been trying to treat all of it with more care.
- csdvrx 4y ago
  > My workflow is especially dangerous in this regard because I do almost everything in the terminal so it’s especially easy to get sucked in. As someone who also mostly works in the terminal and who has stopped wearing glasses thanks to a weird approach, try a pure white or slightly yellowish background with a black font in the daytime. Most terminal users will find that weird, but among other weird things I tried it worked wonders for me!
- ehnto 4y ago
  It is a bummer that we can often see neglect in that area even amongst people really passionate about computing. Apologies for the anecdote. I know for myself, I sometimes felt a stigma to investing in "nerdy" equipment designed to make computing more sustainable. Almost like if I don't commit to the furniture maybe I will become that out and about person I think I should be. Funnily enough, it was only after I had gotten into a bunch of outdoor hobbies that I decided to really splurge on quality of life equipment at the computer.
  - benreesman 4y ago
    I tend to offset expensive purchases with cheap ones. Expensive chair, cheap as hell desk. Expensive monitor, cheap computer. Expensive keyboard, cheap mouse. You can get a really nice workstation if you choose the expensive parts deliberately for the ergonomics. I don’t want to speak for you but you said one or two things that echo with me: by hyper-optimizing my workstation to be the most comfortable place in my house I think I sort of feed a tendency to hide from difficult parts of life by just working too much. I also think you’re onto something about activity, particularly outdoor activity being the best counterweight to that tendency, I just struggle to get an active routine going from a cold start. Usually if I’m active I can keep it that way, but whether it’s C19 lockdown or a death in the family, it’s very easy to get knocked back into that sedentary state. Any of that resonate?

bradlys 4y ago

How did you avoid your prescription increasing a lot for so many years? Did long screen hours also correlate with not going outside? It's known that having less light exposure (e.g. going outside) correlates heavily with decreased eyesight.

benreesman 4y ago
I’m not sure obviously but I think it’s just a really sharp increase in screen time.

goodguyamercunt 4y ago

I don't want to sound stupid but just because a single doctor said it doesn't make it true.

benreesman 4y ago
Oh sure, I don’t think I would have gotten surgery without multiple opinions! But while there are no guarantees it sounded plausible and a few Google searches found other people saying it had helped, the downside is a quite high but not utterly ruinous expense on the thing I look at more than anything else, and even a pretty expensive retail computer monitor would only have to extend my useful eyesight by a comparatively modest period of time to pay for itself. And while it very well may be placebo, it certainly feels less physically stressful on my eyes and facial muscles, so I don’t regret it even though I’ll have to cut the budget somewhere else.