There have been many changes since I last posted.

I can use macOS! It is now better for me than old Windows 10 builds, and I have been using it exclusively. I am able to use a MacBook Air M1 on the internal screen and a Hackintosh connected to an external IPS monitor. All of this was previously unthinkable. I had previously posted that macOS was unusable and Asahi Linux is usable when I spent a short time with my partner's MacBook. When I actually ordered my own MacBook Air M1, which I intended to use with Asahi Linux, to my complete surprise I found that macOS was completely usable.

..So what changed vs the time I spent only using Windows 10 build 1507?

I have been treated for binocular vision dysfunction by an optometrist who specializes in vertical heterophoria. I have vertical and horizontal prisms in my lenses now. It took months and a prescription adjustment for my eyes to truly begin to relax. I can now tolerate my full astigmatism correction. I am two-thirds of the way to my full vertical heterophoria correction. I believe there I still work to be done on my horizontal prisms. The most dramatic change I experienced was a reduction in headaches and face pain.

In October and into November, there was a period of two to three weeks where I had very few symptoms at all. During this golden period I was still unable to use modern Windows 10 or 11 builds. I was able to use my MacBook Air M1 for many hours per day. I used it above 50% brightness to avoid PWM. It was bright but somehow it did not bother me much.

This period was ended when I was prescribed a statin drug. On the second day of taking Crestor, I began to experience double vision. On the third day, my double vision was much worse, and I began to experience muscle weakness throughout my body. My arms were so weak that I could barely lift them. I had serious statin-induced myopathy.

This reminded me of a discovery I made from my 23andMe data several years ago. I have a genetic muscle metabolism defect called adenosine monophosphate deaminase 1 deficiency. I am homozygous for the mutation which causes the defect, which means the enzyme adenosine monophosphate deaminase 1 (AMPD1) is not present in my muscles. A lot of the research on this defect is of poor quality and compounded by the presence of subjects who are heterozygous and therefore have significant residual enzyme activity. I feel confident in saying that I experience impaired muscle endurance, and especially, delayed muscle recovery. People with AMPD1 deficiency are more likely to experience statin-induced muscle symptoms.

Binocular vision dysfunction places a greater load on extraocular muscles which must be constantly active to compensate for misalignment. This on its own might be enough to trigger symptoms. Add in muscle impairments and modern flickery technology and you have a recipe for disaster.

It is interesting that my eye muscles were affected first by statin-induced myopathy, and not the larger muscle groups which are usually mentioned in the medical literature. I think it shows that my eye muscles are still under extra strain and that my prismatic correction is not perfected yet.

It took about a week after stopping Crestor for normal muscle tone to return. However,  I am now three weeks past taking the drug and I still experience very poor muscle endurance, even more-so than normal, and occasional weakness in my forearms. Normal activities like brushing my teeth are apt to cause pain and weakness. It is possible that I experience some degree of muscle breakdown. My eyes have not returned to the level of endurance I experienced in the golden period. I am hopeful that in time my muscles will recover fully.

I have slowly worked my way back to several hours a day of screen time and I am continuing to see improvements.

    So glad you are feeling better...being able to use a modern Mac is fantastic.

    degen Add in muscle impairments and modern flickery technology and you have a recipe for disaster.

    Martin has a theory about this. Not sure if you optometrist tested for suppression, but it is common in folks with BVD. The brain ignores the input from one eye, but you are not conscious of this.

    The flickering forces the brain to use two eyes -- in fact, to treat suppression, a vision therapy exercise is to use flickering light, similar to PWM. "Treating" suppression before fixing binocular vision problems can cause double vision and is a danger of "self-prescribed" vision therapy.

    degen This is a very interesting and promising development! Years ago as a teenager I was diagnosed with "lazy eye" at a Lens Crafters and given prism glasses that I never wore because I was like 15 and didn't want to look like a nerd, heh. Years later after discovering this forum I got a referal to a specialist who diagnosed me with Convergence Insufficiency, Left Intermittent Exotropia, and Binocular Vision Suppression. The doc sent me home with some "eye pushup" exercises which were tedious and mostly unhelpful.

    Can I ask which doctor you saw? I imagine these specialists are hard to come by and I would love to get some more information about how to find folks that specialize in these BVD issues. Thanks!

      I will be tested for BVD by a optometrist in a couple of weeks here in Germany and might get prism glasses. My symptoms line up: difficulty focusing on text (even analog text) and I experience less symptom and better focusing when patching my non-dominant eye.

      degen how do you check for AMPD1 in 23andMe? What SNP?

        I'm also very glad to hear the prism eye glasses worked for you. I've been working with my Diplomate Binocular Vision and Perception doctor and we're just trying everything he can think of. I've gone through several sets already attempting to eliminate the computer eye strain on both Mac and PC's. The last appointment he ordered a set with Prisms, so I'm just waiting for them to come to see if that will help. After that he said there is still a more expensive lens company that we could try.

        I'm curious….do you wear the prism glasses only when working on the computer, or do you also wear "walking around glasses"…and if so, do the "walking around glasses" also have the prism adjustment in them?

        Thanks.

          15 days later

          degen what were your diopters? My testing was not really conclusive, perhaps I have 0,5 diopters. Then again there is normal anatomical variance, many people have a alight astigmatism but their brain and muscles correct it.

            13 days later

            degen How is your BVD and use of displays by this point? I’m curious to know if you managed to get back to using displays comfortably.

              FNP7 Yes, I am using screens mostly comfortably again. I would say I am about 75-80% back to where I was. It took quite a while after the statin exposure for the double vision after blinking to resolve completely. Now when I blink I see a single image quickly, unless my eye muscles are tired. My main complaint is some lingering pain in the inner corner of my left eye which can intensify after a long day of close work. Overall my left eye, even fully corrected is a lot weaker than my right.

              karut I have quite a decent amount of astigmatism, up to -2.50 diopters in my left eye. The prismatic corrections for my BVD are much smaller in comparison, 0.75 diopters and smaller.

              brvideo I have two sets of glasses, a close work and distance pair. There are horizontal and vertical prisms, and they are present in both pairs and in the same diopters. This is actually something I want to talk to my optometrist about, because I think I might need more horizontal prism in my near pair, but I can’t tolerate more in my distance pair. On the other hand it makes sense to me that vertical prism is the same in both pairs, as that correction must always be active for my eyes to fully relax.

              Zodios rs17602729

              How I found it was to import my 23andMe data into Promethease, years ago.

              If you import it into Promethease now this SNP is not reported on at all anymore, not even if it’s normal, just completely gone. Possibly they had to remove it for FDA compliance.

              SelfDecode did report that SNP on my imported data, which also showed homozygous deficient, but I wouldn’t recommend that service for other reasons.

                voidv2 I saw Dr. Debby Feinberg from Vision Specialists of Michigan. A truly first class optometrist who has changed many lives, especially those who have suffered concussions and develop BVD as a result. Another major cause of BVD is facial asymmetry. She places emphasis on correcting vertical Heterophoria and believes that small corrections in this domain can bring big results.

                I looked at my raw data from Ancestry, it's reported as G;G for me there.

                  18 days later

                  degen Do you have to use your glasses when not in front of computer?

                    tfouto I have two pairs of glasses, one for distance and one for near (such as at the computer). I am always wearing one pair or the other when I am awake. My eyes relaxed the most this way.

                    dev