@martin

I think that you should read the PDF I posted above, it's super interesting!

I have the exophoria closely and I have always thought that I would need an internal base prism! Instead, the doctor specialized in PDS (and his optometrist) have prescribed me a prism with 3 diopters prismatic with external base (190 °) only in the right eye (which is the one in which I feel the greatest muscular tensions starting from the eye to the ear). I'll copy you a piece of the article in which he speaks directly of this contradiction:

J.B. Baron also showed in his practice that
in some human patients having insufficiency
of convergence, improvement was obtained
through the use of low powered base out
prism. That was quite unexpected, because it
was written in all textbooks of strabismus that
the direction of prism indicated to help under­
convergence should be a base in rather than a
base out prism.
The fact that many patients responded
positively to base out prism was the intriguing
fact that promoted the first author’s clinical
investigation. Methodical patient evaluation
brought the new knowledge that these cases
were the ones we classified as left pure PDS
type. Clinical investigation also concluded that
patients with convergence insufficiency not
responding to base out prism belonged to other
PDS types that responded positively to other
kinds of prisms. We therefore theorized that
when prisms helped, we were eliminating the
underlying problem that resulted in the postural
condition rather than masking a symptom.
This was the basis for the establishment of
the active prism treatment protocol that was
developed by the first author3 and validated in
the following years.6
The protocol of active prism consists of
prescribing low powered prismatic lenses
from 1 to 4 diopters with base out or upper
temporal base, applied to one or both eyes
simultaneously.

mike So this is what i want people to try:
Look with both eyes open.
Keep an bad-screen-phone in your left hand, a bit to the left.
Put your right hand open and standing between your nose and your right eye.

Hi,

Could you please explain the reason why this might work? I mean, why do you think it might be better than just wearing an eyepatch?

      logixoul

      I think that if you just cover the screen, you still have the peripheral vision of your "covered eye" and it doesn't go completely in its resting position.

          logixoul

          I wish I had the perfect answer.

          First I discovered that covering one eye did so I could look at bad screens. Then i I discovered after some weeks that I could look with both eyes at an bad screen (iPhone 5S) and it worked so much better then before.

          The question is what i did to get that progress, was it only covering one eye!? I think that have both eyes open could have helped.

          For me going from a iPhone 7 to a iPhone 11 Pro took 9 months of training, so bear in mind that it can take some time of training. Don’t expect results direct.

              logixoul

              xelaos

              mike

              I actually spoke to my optometrist (The same one who prescribed Neurolens + my current lenses) about this subject a few days ago. Not sure if this applies universally, so I'd recommend checking with your doctors as well in case your situation is different than mine.

              I told him that wearing the patch on my left eye yielded a medium reduction in symptoms, and that wearing it on the right eye yielded a larger reduction. He suggested that this may be happening for one of two reasons:

              1. I have binocular vision dysfunction, and wearing the patch allows the uncovered eye to relax during use instead of constantly trying to adjust.
              2. More simply, the patch just flat out reduces the level of flicker getting to my system, meaning I'd have less strain due to less input.

              He said that he wouldn't recommend wearing the patch for more than ~4 hours a day, and only when I'm using problematic screens. He mentioned that overusing it could potentially lead to deprivation amblyopia since the patch is essentially training the brain to ignore signals from the occluded eye (It would take a long time & should be reversible, though). This was one optometrist's opinion, so I'm not 100% sure if this is the medical consensus, but this makes me think using the patch long-term is not a good solution. I'd definitely recommend checking with a doctor before doing it long-term, IMO.

              Now, the interesting thing is that Mike's method of slightly covering one eye could potentially be very helpful in not only determining if the issue is #1 (BVD) or #2 (Flicker exposure), but it could also be a good long-term solution if it doesn't lead to any kind of amblyopia (Since the covered eye is still being used). I'm going to check with my ophthalmologist and get their opinion on it, I'll definitely post back when I get an answer.

              **Side note: I've seen people mention that they would use the eyepatch for a while, then be able to use flickering screens with both eyes, but that ability would go away eventually and the pain would return. Could it be possible that using the patch extensively trained their brain slowly to ignore signals from the occluded eye, allowing them to use flickering screens w/ both eyes, but then went away as the eye recovered? It would make sense as to why the "cure" disappears like that.

                      bkdo Now, the interesting thing is that Mike's method of slightly covering one eye could potentially be very helpful in not only determining if the issue is #1 (BVD) or #2 (Flicker exposure), but it could also be a good long-term solution if it doesn't lead to any kind of amblyopia (Since the covered eye is still being used). I'm going to check with my ophthalmologist and get their opinion on it, I'll definitely post back when I get an answer.

                      I look forward for your post back on that!

                      bkdo **Side note: I've seen people mention that they would use the eyepatch for a while, then be able to use flickering screens with both eyes, but that ability would go away eventually and the pain would return. Could it be possible that using the patch extensively trained their brain slowly to ignore signals from the occluded eye, allowing them to use flickering screens w/ both eyes, but then went away as the eye recovered? It would make sense as to why the "cure" disappears like that.

                      Now it’s 3 years ago i started my one eye training. For the first 1,5-2 years i trained quite much, after that I haven’t train so much. I haven’t loss any progress, just going forward.

                      “ In some instances, an eye patch may need to be worn over the dominant eye. This helps strengthen the weaker eye over time. Depending on the severity of the condition, this may be the only course of action needed at this time. Patients may only need to wear the eye patch for a short period of time in order to achieve satisfactory results.”
                      https://www.dizzinessandheadache.com/blog/binocular-vision-dysfunction.html

                            I wonder to myself what might happen with my current glasses because I am using two all the time.

                            I wear my old glasses at the computer because they're less blurry at the distance to the screen. With those my right eye is in clear focus and my left eye slightly blurry. With my new glasses (which I wear outdoors) at the screen my left eye is in clear focus and my right eye is quite blurry..

                            And it's looking like I need a third one now for reading.. Some people have progressive lenses.. I wonder if I would hate those.

                            bkdo . Could it be possible that using the patch extensively trained their brain slowly to ignore signals from the occluded eye, allowing them to use flickering screens w/ both eyes, but then went away as the eye recovered?

                            I am not an expert but I think this is entirely possible. Patching too much may cause this. This is called suppression -- when the brain ignores the input from one eye. The person is not consciously aware it occurs; one eye isn't dark or anything.

                              mike

                              Mike, did you train your eye to ignore the input of the "covered eye"? I know not willingly but as a result. Did you do some tests to verify that you still see both images when looking at problematic devices? Maybe with an cover / uncover test.

                              • mike replied to this.

                                  xelaos

                                  Interesting question. After your post I have tried some cover / uncover test, and moved a finger on the side of an eye, where the other eye don’t see for the nose. What I can tell I look with both eyes on the screen. If someone know of an online test i can take for this i can try it.

                                    I'm doing this "pirate" method now consistently, switching eyes. I'm using it with "sunscreen" though, so no LED backlight. I would say it feels better.

                                    A quick update about my eyepatch exercises.

                                    As reported here, I went through quite some stress owing to a change of hardware at work. I was really in pain and with no way out on sight, so I decided to increase the time spent with an eye patch on. Earlier, patching either one or the other eye had turned out easy and pleasant while reading at night. These days instead I would quickly lose sight of the text on my Kindle and often see a black halo. It took me a short while to figure out what the halo was. Simply, my uncovered eye would either erratically jump from the target or switch off, and I would see the patch in front of the covered but open eye. Insisting to read caused quite a strong nausea and headache. In the subsequent days, I began using a second type of eye patch at work as well, one that I could slide on my glasses with neutral blue light-cutting lenses. I changed the patch from the left to the right eye every half an hour for a total of 4-5 hours a day. I also had to work long hours and I slept really little. After 3-4 days I woke up on a Saturday morning and my eyes could not sustain reading a sign in the street. They would cross. This had never occurred to me. I took a couple of days of rest and I am now back to decent conditions, I mean, I can work. It was scary, though.

                                    My symptoms have plateaued. They are still bad but I hope in a few weeks I will be able to use the new hardware with acceptable pain. It had taken me a few weeks to get used to my HP ZBook Firefly 15 G7 Mobile Workstation on Windows 10 as well.

                                    xelaos I guess you could do it yourself with a recording of yourself or asking for someone to observe your eyes.

                                    https://www.youtube.com/watch?v=iCS5fFodq3g&ab_channel=CarrickInstitute

                                    I have the feeling that this is what happens to me when I am exposed to bad devices / lighting. My eyes can't keep their focus anymore. They jump around. During my orthoptist's visits, I never had this issue, because I always happened to be in a decent condition. I am due to see the orthoptist in a week. Hopefully, she can pick a change of the movements of my eyes and say if they jump outwards or inwards when my symptoms are triggered.

                                        AGI I have the feeling that this is what happens to me when I am exposed to bad devices / lighting. My eyes can't keep their focus anymore

                                        Please be extra careful. If you feel any problems with light afterwards, consider the following.
                                        From you description it seems your symptoms could be a bvd, but also could be an eye reaction to some sort of dangerous light, which I have. It triggers eyes to immediately extra converge when looking at the phone, and later eyes cant return to normal position. I also cant read some signs afterwards, have to fix that with exercises.
                                        But that is only a small, least dangerous portion of things it causes to me. The dangerous part is growing light sensitivity, some sort of small retina or cornea damage, immediate red eyes, red blood vessels appearing the moment I look at the device etc.
                                        Eyes need some time to heal from the damage.

                                        P.S. I just noticed you wrote "white background glows inhomogeneously" in another thread. That seems to be somehow connected to what I am researching; other people with reaction to some sort of light often mention blinding white, sparkling white, spiky white.
                                        There where two reports when lowering the contrast helped. That is dependent on device though, only few of them can be fixed that way.

                                          AGI

                                          For me constant switching eyes is more demanding than just using one eye for longer periods. Maybe this leads to problems with your uncovered eye.

                                          However, I have the issue of suppressing double vision especially in demanding conditions all the time. This dates way before patching my eyes. In your situation did they cross because they felt more relaxed or because there was to much pressure? I have both experiences based on different conditions.

                                            AGI After 3-4 days I woke up on a Saturday morning and my eyes could not sustain reading a sign in the street. They would cross. This had never occurred to me.

                                            That happened to me when I was wearing a prismatic patch for some months. I guess wearing an eye patch would do the same over time: the eyes are allowed to and get used to looking in different directions.

                                              So I've tried the Nintendo switch on my old Samsung monitor and it gives me major eyestrain after 10 mins of gameplay. it's even worse than my infamous iMac 27" 2019 (sold) that started all my eyes problems. (I wrote about it here)

                                              The switch has the same kind of "shaking but static" picture. I've used this monitor before with a WiiU and a Ps4 without any issues. The monitor isn't the problem here, it's the device.

                                              I want to give this eyepatch thing a try but I'm too scared to destroy my uncovered eye. Playing fast-paced games with one eye doesn't sound like a great idea, I was thinking maybe to start by navigating the menus and maybe play (slowly) some slow-paced games/demos...

                                              I was wondering if the covered eye should stay still or follow the movement of the other eye, and which eye to start with.

                                              What do you guys think?

                                                anon123 I want to give this eyepatch thing a try but I'm too scared to destroy my uncovered eye.

                                                IMO you don't need to worry about your uncovered eye - plenty of us here are using an eyepatch for hours a day (only up 4 hours though) and experience no issues with our uncovered eye.

                                                However, people on this thread have raised the issue about the covered eye - see AGI's and KM's latest posts.

                                                I personally cover the eye that hurts more, because that way I'm able to use my screens for much longer.

                                                anon123 I was wondering if the covered eye should stay still or follow the movement of the other eye

                                                You mean, whether you should consciously move the covered eye? I don't think you should, and I don't think it'd be even possible.

                                                    An update on my situation:

                                                    tldr: Still doing well with the patch, hopefully seeing a neuro-opthalmologist to get answers to the questions

                                                    -Been using the eyepatch on my right eye , ~4-5 hours max usage per day. Still experiencing reduced symptoms while & and after wearing the patch, and I haven't had any negative side effects aside from the normal slight strain that comes from using just one eye.

                                                    -Spoke with my opthalmologist, I'm hopefully getting a referral to a Neuro-opthalmologist where I can explore the potential BVD/convergence issue further.

                                                    -I tried a different test with the eyepatch based on Mike's suggestion. I had the eyepatch set up so it covered half of the right eye, so only my left eye could see the screen + flicker. The right eye could only see the peripheral view, if that makes sense. This made it so I was only getting exposure to flicker with one eye, but not breaking binocular fusion. I noticed that I didn't have the same level of symptom relief as when I fully covered the eye, meaning that my issue could potentially be related to binocular fusion. I'll be asking the doctor about this as well.

                                                    -I bought a Brock String and have been messing around with it. I don't have any issues with the exercises, and I'm able to keep each bead in focus with no problems. Not sure if I should keep using it.

                                                    -I'm still very hopeful that pursuing the BVD issue will lead to some kind of explanation for our symptoms, I'll post back here if I learn anything new that may help 😀

                                                      bkdo

                                                      -I tried a different test with the eyepatch based on Mike's suggestion. I had the eyepatch set up so it covered half of the right eye, so only my left eye could see the screen + flicker. The right eye could only see the peripheral view, if that makes sense. This made it so I was only getting exposure to flicker with one eye, but not breaking binocular fusion. I noticed that I didn't have the same level of symptom relief as when I fully covered the eye, meaning that my issue could potentially be related to binocular fusion. I'll be asking the doctor about this as well.

                                                      I had the similar experience. You could also use polarisation glases (different one each eye) + polarisation foil on a screen to have a similar effect (block only the screen) which also didn't help me.

                                                          xelaos

                                                          That's very encouraging to hear that you had a similar experience. This is my impression, based on what my optometrist said about the eyepatch:

                                                          I was actually hoping that doing that test didn't help, because then it would potentially point to it being an issue of exposure, rather than BVD. If patching only works because it's simply reducing the amount of flicker hitting our eyes, then there's really not much we can do beyond just patching (At this time, at least. Maybe we'll find a solution for that as well in the future). Since we still get symptoms with this test, I think it implies that the issue is with binocular fusion, since this test should theoretically keep fusion intact while blocking flicker. If the issue is BVD, there are definitely many potential treatment options. I think, lol.

                                                            dev