bifocals may be your answer

acemanvx[at]yahoo.com wrote:
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Well, given that it has always been hard for me to do close work for
any length of time, I would be happy w/ stronger glasses if I could see
comfortably.

Very interesting story. If he in fact has pseudomyopia or latent
hyperopia and relieves it, wont he see worse with latent hyperopia? He
will need a higher plus glasses and see worse without glasses. I have
pseudomyopia, probably about 1.5 diopters left of it. Natural vision
improvement helped relax some of my pseudomyopia.

On 3 May 2006 06:59:09 -0700, norman_conway[at]yahoo.com wrote:

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Hi. Ol' Johnny One-Note here again:

I think you could get pretty thorough cycloplegia with either a couple
of drops of Cyclogyl -- maybe 15 minutes apart, or with Homatropine
(maybe a touch less effective), or -- if you want to remove all doubt,
and can live with 10d - 2wks of symptoms -- four days of Atropine.

The last is the gold standard of "total cycloplegia."

If what you have is accommodative spasm, or accommodative infacility,
or ciliary spasm, or--more generally--accommodative dysfunction, then
you will likely want to have the doctor push the most plus power on
you that you can accept, both in a distance Rx and in a near Rx
(whether using bifocals or separate reading glasses), watching your
eye alignment carefully to check for any esodeviation that might need
to be managed through adjustments to the powers or through addition of
prism.

In some cases, you've developed enough "hypertonicity" in your ciliary
muscles that it's difficult for you to accept much additional plus. In
MY experience, I used cycloplegic drops every night (lower-strength;
effects gone by morning) for months, eventually "breaking the cycle."

But ... NOTE WELL: virtually all cycloplegic drops use a preservative
called Benzalkonium Chloride that has known cytotoxic effects to
corneas. They should not be used long-term, *especially* if you have
any pre-existing ocular surface issues OR dry eyes.

It *IS* possible to get your "cramped," or "spasmed" eyes to learn to
"relax," with time.

Another thing that I do is what's called "periocular warming" to help
relieve small amounts of accommodative spasm.

Make/buy yourself a corn/rice bag ... like so:

http://www.quilt.com/MiscQuilting/RiceBags.html

Warm it in the microwave (I use about 2min on high) until it's warm
(NOT hot). Place it over your closed eyes for about 10 minutes a
couple times a day.

It works. No voodoo. Actual science. Here:

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

OR http://tinyurl.com/obpyd

Best of luck!

Neil

On Wed, 03 May 2006 03:45:52 GMT, LarryDoc <larrybic[at]yahoo.remove.comwrote:

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Thanks, Dr. B, for the additional info.

<norman_conway[at]yahoo.com> wrote

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It makes intuitive sense that accommodative spasm _should_ decrease, but
most eye doctors can remember patients who couldn't accept full plus.

Accommodation and convergence are locked together and spasm of accommodation
affects convergence too.

Most likely the "failure to accept" means that relieving accommodation makes
the eyes struggle to stabilize at a new convergence posture. Usually it
works, but sometimes it doesn't.

-MT

Dr. Leukoma wrote:
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It is very easy to tell when my CLs are inside out, and I am sure this
was not the case.

I have thought a bit more about this being latent hyperopia, and it
might be. I have had problems w/ eyestrain since I was a kid, and
reading has never been easy. Also, I have noticed for many years now
that my vision has a myopic shift during the day--perhaps up to 1D at
times, though I can't be sure--which makes getting a refraction
difficult. If I am refracted in the morning, my glasses seem
over-plussed by the evening, and vice versa.

I guess the one thing that puzzles me, though, is that I never get used
to wearing higher plus glasses. My understanding is that, over time,
accomdative spasm should be relieved with higher plus glasses. And
since my glasses range from +.075 to +3.75, I am wondering why the
higher Rx does not eventually become acceptable.

So what type of cycloplegic might work if this is a case of latent
hyperopia? Is this something I can use that, over time, might stabilize
my Rx (albeit at a higher level than I would like) and potentially
relieve eyestrain? I'm an MD so I could get hold of it and give it a
trial and see what happens.

Thnaks for all the thought and suggestions on this!!

IMHO, I don't understand how a person could wear a Purevison inside out
and not know it, and in both eyes at the same time, but I guess it
could happen.

In "what will they think of next" department, would you believe that a
group of OD's has already "patented" the use of soft lenses for
orthokeratology?

DrG

Were the contacts Focus Night&Day or Purevision? If so, you may have
been wearing them inside-out without realising, and given yourself
unintentional ortho-K. It happened to a patient of mine, who recovered
fully a few weeks after discontinuing lens wear. There are other case
reports out there - it's a known phenomenon.

Just one idea.

Dom

norman_conway[at]yahoo.com wrote:
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In article <1146615337.351834.60460[at]j73g2000cwa.googlegroups.com> ,
"Neil Brooks" <neil0502[at]yahoo.com> wrote:


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FYI, tropicamide is considered to be a mydriatic (causes pupilary
dilation), not a true cycloplegic. It's cyclo effect is secondary,
highly variable and generally of little consequence.

LB, O.D.