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  • Exophoria/Accommodation Spasm/Astigmatism - What should I do?

Dominic I tried plenty of supplements, but I have not MacuGuard. Do you think it's better than usual lutein&zeaxanthin supplements?

I think so, yes. First of all, because the thread author said "There's nothing there we haven't all discussed before - lutein, zeaxantin, astaxantin, etc. - but it really works for me. I've tested it a couple times now - and I'm really sure it helps, and here's how I know…".

Second, because it has astaxanthin, which is a stronger antioxidant than lutein & zeaxanthin. And because I have a lot of relief from taking Acomodin, which contains astaxanthin too.

And third, because I've personally tried two "lutein & zeaxanthin" supplements (Natural Factors and Doppelherz) and they made no difference.

Dominic I got a kind of new diagnosis of neurosis with psychosomatic symptoms and lamotrigine for treatment.

Before you start, I'd like to warn you that going off psychiatric drugs is much much harder than starting them.

Check https://www.survivingantidepressants.org/ . For many of us there, it has taken years to slowly wean off psychiatric drugs (for me - 2 years already and I still aren't there yet). I don't intend to scare you - just to inform you! 🙂

Dominic 3 weeks ago I have started taking vitamine D and magnesium

Those do help me a lot, but be careful with the vitamin D - it shouldn't be taken long term, as it leads to calcification of soft tissues (the vitD redirects the magnesium/calcium into places it shouldn't go to).

Safer (and effective for me) things to take include this vitamin b complex (1 pill/day) and this vitamin c (half a pill/day). (obviously they are just workarounds though).

Make sure you take a big magnesium dose, and in a highly-bioavailable form. I take this (2x2 pills/day - two with breakfast and two with lunch).

          logixoul

          Okay, let's give MacuGuard a chance then.
          I know about troubles of going off psychiatric drugs as I used to take escitalopram for 3 months and I couldn't stop over the night. My biggest worry when taking such drugs is my vision (eye accommodation) that gets very blurry even when small doses are taken.
          Amitriptyline helped me a lot, up to 40%, but side effects were totally unbearable even if it didn't affect my vision. Sadly I have no other options, but drugs treatment.

          It's interesting what you said about vitamine D. It may be the reason why I feel worse right after taking a vit D pill. It makes me sleepy and gives me even more hot flashes I usually get from displays. That's why I take it at night.

          I will try your magnesium supplement, thanks.

              Dominic Sadly I have no other options, but drugs treatment.

              If you have no options other than drug treatment, consider trying a muscle relaxant (tolperisone) before you get on psychiatric drugs (which you say give you accomodation problems). You could talk to a neurologist or neuro-ophthalmologist about whether tolperisone is right for you. Its side effects are all very rare, and it has zero withdrawal effects. A downside is that it can interact with some other medications. And I think it isn't available in the US.

              The reason I suggest muscle relaxants is because in my own case my troubles include spasms of the muscles around my eyes. Maybe it's similar with you. Just tossing you that idea, since you sound like you don't have many options.

                  logixoul I think suggesting a new drug to my neurologists is pointless, they always know better even if they are wrong. However, I will buy tolperisone as soon as possible to see how it works for me. As I presume you were taking this drug, weren't you? You think how long does it take to feel a difference? Days or weeks?

                      Dominic I was taking it for my neck-twisting muscle spasticity (cervical dystonia) and for my (subsequently developed) whole-body muscle spasticity. It did help for all of my body's spasticity, but I cannot say for 100% sure that it also helped my eyes' muscle spasticity. (I had been taking it for an year from before I developed serious screen strain - which happened when I switched from tolperisone to baclofen in 2020. Baclofen caused my heterophoria).

                      For my cervical dystonia I'd say it took 1 day (or a couple of days) before it started working.

                      I'm suggesting tolperisone only because you are pretty desperate, and because it's a safe thing to try out. Hope it helps you, if you do try it.

                          4 months later

                          Hi guys,

                          After several months I have a quick update on my situation.
                          Here are my tests I did lately and their results:

                          wearing different glasses including:
                          -correcting my small astigmatism (0.5 and 0.25)
                          -correcting my small nearsightedness (0.5 and 0.25)
                          -prisms correcting exophoria (of power of 2)
                          -prisms correcting vertical heterophoria (power of 1)
                          -plus power glasses (+0.5, +0.5)
                          Both work in the same way reducing my symptoms from screens up to 50%, but giving me a strong tension around my eyes to the point I have to take them off every half an hour for a while. The tension from glasses appears both at near and far when I'm outdoors. The glasses also makes me a bit dizzy and unfocused all the time I wear them. Waking up after a day with the glasses is a nightmare, tension headache and foggy blurred vision.

                          -zero power glasses with blue light filter
                          -zero power glasses
                          -zero power glasses with strong blue light filter (orange glasses)
                          This is actually weird, because both zero power glasses work for me in the same way as all the lenses mentioned before, just on a smaller scale. It means they reduce my symptoms by 20-30%, but they also put some pressure on my eye/head muscles. The last ophtalmologist I saw told me it's impossible to feel anything from zero power glasses suggesting it's in my head.

                          -patching my left eye for half a day
                          Symptoms reduced up to 50%, but I still feel tension around my left eye even if it's patched.

                          -wearing plus power glasses and applying tropicamidum drops multiple times to "block" accommodation for half a day
                          Symptoms reduced up to 50%, but I literally cannot open my eyes in the following day waking up with the worst burning tension headache ever.
                          -3 days of exercising with accommodation flippers
                          No change
                          -7 days of divergence exercises with "Magic Eye" book (I recommed giving the book a try)
                          No change

                          -4 days of taking 200mg daily of Tolperisone
                          Tolperisone is a muscle relaxant suggested by logixoul . Months ago when I first tried it I was pretty sure it worked wonders, however now I know it was more yerba mate I was binge drinking than the drug itself. For some reason mate with catuaba bark works for me very well in general. Unfortunately this time Tolperisone didn't change anything in my symptoms.

                          Here I am now. Last week I saw another vision specialist who wants to operate my heterophoria. It's not common you undergo a surgery for heterophoria, but looks like I don't have a choice. The problem spreaded all over my life turining it into hell. Before having a surgery my new idea is trying a keto diet (it's my 5th day today) and trying a combo of atropine (for potential accommodation spasm) and amitriptyline in the long term (at least 3 months).

                              Dominic What is the heterophoria in prism diopters? Unless it is extremely large, operating on the eye could make it worse. Please get a second opinion, even if somewhere online like: reddit.com/r/optometry. If you buy a Maddox Rod, you can test yourself as to what heterophoria you have.

                              Vision Therapy programs take several weeks if not longer. A few days is not going to make big difference. @martin has been doing them for years now. If you have exophoria, the plus lenses are likely going to make it worse, and you need to be doing convergence exercises, not divergence ones.

                                  ryans

                                  14 prisms

                                  I saw many vision specialists before but we never discussed a surgery. Anyway I’m going to see at least two different ophthalmologists who specialize in strabismus surgery before I make up my mind.

                                  I did a 7 month vision therapy focusing on convergence. It was my worst decision as it made my symptoms much worse. After the VT I feel the symptoms almost all the time and I cannot wear any glasses as they put a lot of pressure on my eye muscles.

                                  I have a Maddox Rod. It proves I have a heterophoria.

                                    @Dominic do your symptoms happen, or happen as badly, even with reading paper books and e-readers?

                                      Deepdeep Yes, even reading a book or an ebook on my Kindle is painful in terms of my symptoms. It’s a bit better than looking at screens but still quite hard.

                                          Dominic Then I saw another eye specialist (very reputational, expensive and hard to get a consulation with) who completely denied all the previous diagnosis

                                          Classic :-(

                                          I understand your despair but this should be a warning when you think about eye surgery. I know nothing about strabismus surgery but I have experience with other forms of "minor" surgery. For instance, I had seven operations at my toes due to ingrown nails. They caused permanent damage and turned out to be completely unnecessary. I would consult a million specialists before going down that way…

                                          Dominic I bought a cheap pair of glasses correcting my astigmatism (-0,25 on left and -0,5 on right eye)

                                          I have -0.25 astigmatism in my left eye. I tried glasses and letters appeared neater and bolder, but that did not make any difference in terms of eyestrain / neck pain. Most doctors won't give you a prescription for that condition.

                                          xelaos Do you have some issues with you jaw?

                                          I have had jaw manipulations several times but I did not notice any improvement of my eye condition. I also started wearing a mouth guard three years ago because I was grinding my teeth at night. That is hopefully going to be helpful in the long run to preserve my teeth, but I never observed any correlation with my eye problems.

                                          ryans olks who also had all "our" symptoms gone with neck chiropractic care.

                                          I have seen chiropractors and osteopaths for twenty years. No progress as to eyestrain. Recently I have moved away from chiropractors and whenever I have a problem I see a physiotherapist or an osteopath.

                                          Dominic Hi! Yes, my problems also started when I bought a new laptop - LG Gram 17.

                                          How long ago was this? Do you mean that before buying that laptop you had zero issues?!?!?

                                          Dominic When the first two are more undestandable as they are close to brain and eyes, getting warm palms and feet is quite a mystery.

                                          I gave in using prismatic lenses after three days. I had pain everywhere. It started with my neck, then my arms - both biceps and triceps, then elbows and wrists, and it finally propagated down to my ankles. On my last day I also developed a piercing headache on the top of my left eye and eye burning which I never had before. It took me 8-9 days without glasses to recover decent vision at near. This is a fresh story. Last week.

                                          Dominic I had a consultation with an oral surgeon as I cosindered my wisdom teeth as potential culprit, but he ruled it out.

                                          I got rid of my wisdom teeth ten years ago. No change in my eye sensitivity afterwards, and my issues have got worse and worse for the past four years.

                                          Mrak0020 Whatever damage eyes are taking, it can be accumulated. The best thing to do is avoid accumulation by all costs. Probably it is not a significant damage and can easily be healed with time. More damage you take, more time you need.

                                          I agree with these statements. Now I am using my laptop at native resolution (first time ever on any computer) and the latest version of Windows 10 and I am doing better than months ago. I have no idea what I did to improve. I am a very bad sleeper and never found a correlation between eyestrain and lack of sleep, but perhaps adding several hours of sleep for some weeks has helped?

                                          Mrak0020 One of my eyes was hit by a laser

                                          I had a laser accident too twenty years ago. Those days I was not using screens but studying on paper became really problematic as the hit eye would pour tears and hurt all the time. After a few days I went to an eye doctor who confirmed there was a scar in my left eye, but told me it was superficial and would most likely heal on its own. He prescribed eye drops and glasses for myopia. The eye got better and the glasses quickly began giving me headaches. The next doctor I saw told me not to wear glasses anymore as they were an over-prescription. I guess, if you have a trauma you need to give time to the eyes to heal.

                                                              @Dominic Perhaps you can ask your doctor if it could make sense to take a Visual Evoked Potential test. Here for example they explain a bit about the technique.

                                                              I took the tests twice at a distance of one year. The first test was negative. The last one evidenced some mild dysfunction of the retina, but I have not discussed the results yet. Also, I get from talking to optometrists and orthoptists that borderline results have to be taken with grain of salt. I guess it is a very pushed technique and, although not new, still in the research phase. In any case, there is currently no cure if a dysfunction is found.

                                                                Dominic Sorry for the late response. If you are ok with reading at a distance, using a large (flicker-free) monitor or a projector might be something to try if you havent already.

                                                                  AGI I have never heard of VEP before, thanks, I booked the first possible date. It will be very useful to rule out some possibilities.

                                                                  AGI Dominic Hi! Yes, my problems also started when I bought a new laptop - LG Gram 17.

                                                                  How long ago was this? Do you mean that before buying that laptop you had zero issues?!?!?

                                                                  Kind of. All the very hard and apparent symptoms started immediately with the new laptop, so it was definitely a huge trigger for my BVD, however now I connect the dots and see I had some mild issues before. I was usually very tired and my vision was temporarily blurry right after looking at screen or reading a book. I was told it was normal, but now I know it was BVD.

                                                                  • AGI replied to this.

                                                                        Dominic Any chance your eyes are really tired - sort of eye breakdown - and you need to take a pause?

                                                                        Do you ever get double vision? What about watching TV? Do you struggle converging at any distance or only at near?

                                                                        Another thing I thought of giving a go to is CBD oil but so far I have not met a doctor willing to prescribe it. In fact, my GP and neuro-ophthalmologist were not even aware that this product existed.

                                                                            AGI I wish I just needed to take a break, but I tried it many times and all the nightmare comes back within seconds with any up-close task.
                                                                            I don't get double vision which was very confusing when trying to diagnose a strabismus. The rule is pretty simple, the closer I look the more pain I get, so watching TV is uncomfortable, but less painfull than looking at my phone for example.

                                                                            CBD oil is pretty popular and easy accessible in my country and unfortunately doesn't help me at all.

                                                                            • AGI replied to this.

                                                                                Dominic It looks like your condition has degenerated very quickly if you were sort of symptoms-free one and half year ago. I have been hanging in here forever compared to you. I read online and I was told by one optometrist and one orthoptic that there is a sort of breakpoint, past which rest is the only solution and recovery can really take months without doing any close-up work. It is similar to a nervous breakdown. You do not know if/when you recover. I will confirm with my specialists out of my curiosity as well. I am due to see all of them in September for another round of consultations.

                                                                                I have no idea what the degree of your heterophoria is and I am not a trained specialist. However, I hope you ponder well on your idea of having a surgery. Sorry for being very direct, but after what you experienced (multiple pair of glasses, vision therapy) where do you get the confidence that a surgery will solve your issue? Also, at least in my case I do not think that esophoria is the principal culprit. That is what my orthoptists believe too. You know that there are people with severe heterophoria or strabismus who just get tired at the end of a day of computer, whereas in front of certain displays I develop symptoms instantaneously with a mild heterophoria? One of my orthoptists has exophoria and her symptoms are completely different from mine. She can use any phone and any monitor. She only gets tired more quickly that the average person. Both my orthoptists say I should strengthen my vergence and do all I can to have my eyes in the best shape, but are not confident that my symptoms can diminish by more than 10-20% by doing vision therapy. Please stay away from surgeons and medicines unless at least 50 doctors tell you it is the only way out :-)

                                                                                    AGI You know that there are people with severe heterophoria or strabismus who just get tired at the end of a day of computer, whereas in front of certain displays I develop symptoms instantaneously with a mild heterophoria?

                                                                                    Neurolens did a study which showed the amount of phoria does not correlate with the symptoms. You could have a very small phoria and feel horrible or an extremely large one and go throughout life without ever knowing.

                                                                                    • AGI replied to this.
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                                                                                        ryans This confirms my fear that heterophoria is not my only / main problem. Since I have nothing else to focus on, though, I try to make my eyes as "robust" as possible.

                                                                                        By the way, can you pinpoint this study by Neurolens? Thanks.

                                                                                            dev