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

AGI

AGI Yesterday my orthoptist measured my esophoria to be 1^. She uses a different method, though.

I'm not sure if I was ever measured by this method, but your result of 1^ seems to be minor.
The topic of fluctuations in results of heterophoria is very interesting. Every time when I do the Maddox Rod test, the red line is relatively close at first, but the longer I look the further it gets what means it's not very stable, but it also proves that eye muscles may constantly struggle to maintain the fusion/single image and they does sometimes better, sometimes worse. However, I think the maximum results is the most relevant, because even if your eye muscles do better sometimes, they still need to put some effort and the more effort they put, the more tired they are at the end. Looks like I'm also one of those who cannot handle prisms.

AGI Yesterday my orthoptist asked me to do 80% of the training in "divergence mode" from now onwards. Those exercises are definitely more challenging. Afterwards I do not have pain / soreness, although my eyes quickly get tired when I look at objects 1-2 meters away through a base-in loose prism.

I also find divergence exercises way more challenging than those improving convergence, but my orthoptists never really care about it.

  • AGI likes this.
        13 days later

        Have you tried "accomodative" contact lenses? I wear Biofinity Energys all day every day (+5.5 and +1.5), with glasses over top that correct for astigmatisms only.

        I get weird feelings of warmth from my vision being off, along with slight headaches, dizziness, nausea… that could just be stress related. Bodies react to stress in countless ways.

          pejalo
          Yes, I tried plus power lenses, they actually make my symptoms worse.
          Though it's an excellent question because now I perfectly know why and I would like to share it with you here. When it's heterophoria that is the culprit of symptoms, your eyes try to "mask" your binocular vision issues by your accommodation. That's why many of us complain of blurred vision among arising symptoms.
          It's a huge discovery to me that if you do the cover test (one of the principal heterophoria measurement method) with your accommodation excluded your result may be completely different from one when your accommodation is "turned on". I mentioned in this thread that my exophoria was 14, but it's actually 21-25 when my accommodation is loosened.
          How to loose your accommodation? It can be simply done by wearing +3D lenses.

          By the way, this also provides the final answer for the title question I asked almost a year ago. It's not a spasm of accommodation itself. It's my exophoria that brings the spasm of acc.

          pejalo I get weird feelings of warmth from my vision being off

          I'm surprised, but kind of glad to read this because I also have these feelings of warmth. Now I'm 100% sure they come from my vision, but everyone was telling me it was stress related. Could you describe these feelings a bit more? Where are they located, what parts of your body? By the way, did you test your binocular vision?

          • AGI replied to this.

                pejalo "accomodative" contact lenses

                Dominic Yes, I tried plus power lenses

                Can you guys please elaborate on this? Sorry, I don't know much about glasses. Is this correction what's typically prescribed for presbyopia, namely, +0.5, +1 etc reading glasses? Thanks.

                    3 months later

                    @Dominic How are you? It's been 2 months since your last message. Anything changed? Your condition is somewhat similar to mine. For 4 months I have had persistent accommodative spasm and convergence insufficiency. It was a sudden onset. My symptoms are stabbing eye pain when looking at screens and feeling like image is "out of sync" (that is 24/7), there is some misalignment but difficult to describe. There is no double vision but something is off. No headaches though. It turned out I had sinusitis and had to do a surgery, but that didn't resolve vision problems. I will start vision therapy soon. So far at home exercises and wearing correction of plus lenses (+0,75 on both eyes) didnt give me any results.

                    Few questions: Did you measure your exophoria at near/far at the begnning over a year ago and now? Do you know if it has changed? For how long have you tried plus lenses? From what I've read they say that there sometimes might be an adjustment period where the eyes might hurt a bit. And I assume despite the pain you still use screens from time to time (like me) because nowadays you literally cannot do anything without them. On average how much time daily do you still spend looking at them?

                    Also, you might be interseted in the book I recently found: "Clinical Management of Binocular Vision". Very in depth about the things you write about. There is 4th version downloadable on the internet. There is also 5th ver in online stores, although i's pretty expensive.

                    dev