Saw Dr. Debby trained specialist! Have BVD.

ryans

I saw a Dr. Debby trained BVD specialist today. I have a small vertical heterophoria and convergence excess ( @martin condition).

I had previously tried the Neurolens, by different eye doctor. They were total bunk for me...it prescribed a 0.6 BI prism, which is the exact wrong thing for someone with convergence excess!

My new Rx from the specialist has a small astigmatism correction, and also:


+0.50 ADD (for the convergence excess)
0.25 BD OD
0.50 BD OS

It may require adjustments over time. I will write back when I have them and can test them out.

My lessons for you all: Neurolens is worth a try, but don't entirely trust it. The Neurolens Rx is determined by a machine in 2 minutes. My BVD specialist was almost 90 minutes. And if one optometrist doesn't help, find another!

Dr. Debby has a list of good specialists here.

Dominic

ryans Looks like you got two almost mutually exclusive prism prescriptions, it's weird and interesting. BI prism like your Neurolens are is usually prescribed in case of exo phoria/tropia. Did any specialist say you have exo phoria/tropia?

Clokwork

With BVD, is viewing screens always a problem or only with certain ones?

ryans

Clokwork My problems are only with certain screens. Same as martin. Whatever they are doing, they seem to be making an existing BVD worse. But many people with BVD suffer from symptoms their whole life, on things nothing related to screens.

I think everyone on this forum needs to get a BVD exam from a competent specialist. It may not be everyone's problem, but it's worth a try. Just because you are "fine" on good screens and other areas of life, does NOT mean you can rule out BVD.

The patching that @mike uses is one test you may use at home. But really, I recommend going to see a specialist.

Clokwork

Didn't someone post some links of a good way to find a good doctor? I live on the west coast of the US and am willing to travel.

ryans

Clokwork I recommend starting with the Dr. Debby network ~ she was a pioneer in this stuff and trained lots of competent specialists personally. You can find one close to you here.

Note her network concentrates on prisms, and not on vision therapy. Depending on your condition, either or both might be helpful. But Dr. Debby doctors can definitely give you a diagnosis for sure.

A "regular" optometrist, in my experience, just doesn't do a good job of diagnosis or treating BVD. Best to go to a competent specialist. There are people who take flights, drive many hours, and even come from other countries to see Dr. Debby and the specialists she trained.

Clokwork

ryans A "regular" optometrist, in my experience, just doesn't do a good job of diagnosis or treating BVD

Oh trust me. I found out the hard and expensive way…

ryans

Dominic So, no specialist told me I had exophoria, the Neurolens measurement device did (2 minute test), but was wrong. Thus, the Neurolens prism did not help me.

The Maddox Rod test the specialist did, was pretty clear the problem was esophoria, and the Neurolens was totally wrong. I found people in a Binocular Vision Dysfunction group where they were also misdiagnosed by the Neurolens device. I suspect the reason is, Neuorlens contoured prism HAS to be more base in (exophoric) at near, that's just how their lenses work (they purchased the patent from Kodak).

Neurolens is worth trying as it has a money back guarantee -- but if they don't work, don't trust their prescription and don't give up.

I highly recommend seeing a competent specialist.

degen

ryans I agree, but I have to go a step further. I put my trust in Neurolens, and I hugely worsened on their lens. Now I have to drop out of school, and my future is decidedly negative.

Before Neurolens, I was using a neutral lens, and slowly worsening, and before that, Bilateral 0.5 Diopter Base Down lenses which relaxed my eyes in the first place, and which I unfortunately got away from using as I did not understand the significance of the prism. I believe the optometrist who prescribed the Base Down prism did not fully understand it’s immense utility, and only reported that it was useful in many of her patients with BVD.

I truly believe Neurolens is bunk and I am willing to die on that hill.

ryans

degen . Now I have to drop out of school, and my future is decidedly negative.

Really sorry to hear that. Maybe you can defer until the Fall semester?

degen optometrist who prescribed the Base Down prism did not fully understand it’s immense utility

Most optometrists are great at correcting refractive errors, farsightness, etc. They are not equipped at handling prisms/BVDs. Neurolens is actually capitalizing on this fact -- the Neurolens measurement device costs the optometrist ~$40k USD to measure and prescribe it all. The Doctor doesn't have to do any examination or really need much skill.

degen I truly believe Neurolens is bunk and I am willing to die on that hill.

I agree. I've heard lots of success stories but am starting to hear some of the unsuccessful ones too. Neurolens is actually two things:

The Neurolens measurement device that measures and prescribes prisms. This looks total bunk, but I can see the appeal of using tech to try to measure eye deviations.
The Neurolens lens themselves (e.g. what they put into glasses). Neurolens purchased the Kodak patent for the progressive prisms (e.g. multiple prism powers at different distances in one pair of glasses, where regular prisms would require multiple glasses for near vs. far). I think the lens themselves can be useful as they are the only progressive prism available, but they are also very expensive. Note that these must be more base-in at near; Neurolens can't do more base out at near.

Given Neurolens offers your money back, I suppose it's worth trying.

I will need two glasses (and two frames) for my new prescription, and it's still cheaper than one pair of Neurolens, which isn't covered by any insurance.

degen

ryans I will try my best. Every step of the way to try and get help, including deferring to the next semester, has been stymied by the need for medical documentation. This is very understudied stuff and I now risk being kicked out of my program, losing access to student loans, and the support of my doctor, and the support of family and friends who this seems increasingly like failure after failure without good medical explanation.

I have high hopes for your new prescription with Base Down prism. Here is my last known "good prescription" (near work):

Edit: removed my prescription details

degen

degen Here is my neutral "distance" prescription. My near work prescription in my previous post has more utility with this as a baseline.

Distance:

OD: +0.75-1.00 x 180

OS: +0.75-1.00 x 180

ryans

degen Gotcha. I'd definitely try to see a BVD specialist. Even if prescribing base in was correct for you, there is an art and science for prescribing how much.

Patients often cannot tolerate the "full" correction..."less is almost always more". And sounds like you may have a missing vertical component.

From this FAQ:

“I have tried prism and it did not work. How is your prism different?”

Through our training by Dr. Debby Feinberg, we can measure and prescribe prism to the quarter of a prism diopter. Less is usually always more. Although people can have large horizontal and vertical misalignments, it is false to think that they need a large amount of prism to correct them. During our prism evaluation, we can trial frame the aligning prescription and use the least amount of prism to alleviate symptoms.

Another reason the Neurolens aren't great is they separate 'near' (bottom of glasses) and 'distance' (top of glasses)...when working at a computer all day, you want the entire glasses to be usable, especially on a larger screen. Being forced to look through the bottom all day on a computer, I think, promotes a worse neck posture.

ensete

Interesting to see if this works or is just more snake oil. I tried Vision Therapy and saw 2 "Vision specialists" who both prescribed me Prism Lenses (both arrived at the same prescription) and they did absolutely nothing except lighten my wallet by several hundred dollars.

bkdo

ensete

At least in my case, I can definitely vouch for prism lenses (If you do have BVD). Neurolens has been consistently underwhelming IMO, but normal prism lenses have reduced my symptoms by ~60% overall.

Have you gotten any kind of formal diagnosis in that area?

martin

Good to read this🙂

If you have severe case of heterophoria, just glasses alone wont fix it. They can ease the strain, but vision therapy is what will really move you forward. Glasses in this case are like crutches🙂

ryans

Got the prism glasses yesterday. I am still having a hard time adjusting to them. Interestingly, I get similar symptoms to a bad screen: dizziness, nausea, strange ear pressure, anxiety. The eye doctor said it may require multiple adjustments to get to the right rx. Going to keep using them until I can handle a 'good' screen before I try anything else.

The Crizal Prevencia has this annoying purple reflection but that's a minor issue.

I also ordered myself a Maddox Rod for $30 USD.