To ask if not wearing glasses when you need makes you eyes worse

[User40407]

I’ve always told my ds1 who wears glasses that he should always wear to prevent his eyes getting worse. I’ve just read something that says wearing glasses only corrects your sight when you are wearing them and not wearing them has no impact on your eye sight either way. Aibu to ask if this is true?

But this is something an experienced optom can navigate through 👀👀

However the patient does not get issued with a CV!

Many children’s eyes will refract an image that is too long hence it goes past the retina as there eyes haven’t developed into the right shape/size yet. However the eye muscles also move to focus images however the muscles can only do so much so sometimes the image still be not aligned with the retina so you will be short sighted so need glasses. It will help relax the eye muscles; If the muscles are straining it can cause a squint. So yes there is some truth in the glasses helping to stop the eyesight worsening but depending on how short sighted you are as the more the glasses correct the more you would be straining without them. As the eye develops the size and shape changes so sometimes this will mean the eye can focus properly. Short sightedness normally occurs when your growing as it is the opposite and the eye grows too much so the image is focused too short of retina and im fairly sure the eye muscles can’t make the image project further just pull it in if it’s over shot the retina in long sightedness. Glasses won’t help the shape of your eye so for short sightedness they won’t make a difference to the progression of your visual acuity other than when wearing them but with long sightedness and muscle strain yes. I think that’s if long sightedness effects close up things because the distance between your eye and object is even shorter so the image will end up even further back and vice verse with short sightless the image will fall even shorter of your retina. People have issues with long sightedness when they are old because even with perfectly shapped eyes the muscles move the image so we can see at different distances but when you get old the muscles weaken.

Alfie , so it didn't work for you but worked for me. My opinion is that wearing my -ve prescription glasses was progressing my myopia. The research is not complete. We all have to make our own decisions which all come with risks.

Regarding the post about reading glasses with age...
Accommodation - the muscular ability of your eyes to focus on things close to you naturally deteriorates progressively from around mid 40s...and whether you wear your prescribed reading glasses religiously or not at all, will still happen. You cannot slow this significantly by not wearing, or accidentally accelerate it by wearing.
It is correct this will result in moderately myopic people preferring to read without their glasses 👓

Ithink the eye muscles are fully relaxed for distance vision. It is in close vision they contract.

Short sightedness normally occurs when your growing as it is the opposite and the eye grows too much

There are theories concerning certain environmental conditions can cause an overgrowth in axial length. These conditions include lots of close work, poor light, lack of time spent outdoors outdoor and wearing -ve lenses (lens induced myopia see research I linked to earlier on in this thread).

What allsizes8to14 said at 2257 yesterday
It's about the developing eye
If a puppy's eyes are covered at birth, it can end up blind as connections not made between eyes and brain.

My vision was not corrected when young. My husband's was. He is more shortsighted (short sight is due to physical eye anatomy) but he can see - resolution- better than I can as his was corrected properly when young.

Just, yes, regarding the puppy. That is the phenomenon of form deprivation.

However my eyes were not covered. I could see well for close work but not for distance. Not the same. I am against over correcting. So would only wear a full distance correction when I required to see at a full distance capacity.

Every single member of my family is myopic so I’m going with it probably wasn’t close work and poor light from when I was 3

Iam, well, we are different. At 3 I could read. And did pour over my books. I was always being told off for sitting far too close to the tv too! My parent did not wear glasses till middle age. I didn't wear them until 16. However from when I started wearing them all the time they got a diopter worse each time I returned for a check up. Until I started to not wear the new prescription for general use.

It is correct this will result in moderately myopic people preferring to read without their glasses 👓

Naturally because -ve lenses force the eye to work harder to focus on near distances! Myopic people (without any other eye issues) do not need corrective lenses for close work.

highhighmountain, I know I just realised I made an error in my post I meant to say the muscles can only do so much you are long sighted.

Myopia WILL progress when your young so I presume when you decided to blame your glasses you were old. I do think it’s a interesting point re biofeedback though my dad is an optician and he said glasses don’t cause myopia and I don’t think opticains would have that opinion to sell more specs ahah , there is science behind it all. My experience is that bearing in mind to get glasses for the first time you must be short sighted which can’t have been caused by glasses, and in terms of progression at my last eye test my eyesight had only mildly declined despite the fact I wear my glassses daily although not full time as not that bad but I need for driving.

When I worked in an opticians the manager told me that if they are offering a free eye test, they often will advise glasses for a very small prescription where it probably isn’t even needed, because it costs money to do the test and they need to upsell. Obviously that is not the case in very poor eyesight. This is why I do not go for £30 MOTs. They have to make the money back somehow.

though my dad is an optician and he said glasses don’t cause myopia and I don’t think opticains would have that opinion to sell more specs ahah , there is science behind it all. My experience is that bearing

Some of the research papers, I linked to upthread, indicate -ve lenses can cause and progress myopia. There is a whole host of research regarding lens induced myopia.

My experience is that bearing in mind to get glasses for the first time you must be short sighted which can’t have been caused by glasses

As I have said, I believe, and much of the research I have read suggests there are also other environmental factors at play. For example there are theories concerning sunlight and dopamine response in the eye. However the research regarding lens induced myopia is certainly concerning and is not reproduced in research studies concerning humans because doing so would be immoral.

although not full time

That is rather telling. It is what I am essentially advocating. Wear them only when you need to see to a particular standard.

I presume when you decided to blame your glasses you were old.

I had stopped growing but my myopia was still progressing until I took the aforementioned action,

I broke my glasses 6 months ago and only just got new ones. In that time one eye has improved and the other stayed the same (short sighted). Anecdotally I feel that wearing glasses all the time can worsen your eye sight.

Windbeneathmybingowings
Eye test is objective not subjective. They can’t advise a prescription that’s not there, people can however choose weather to wear glasses or not. It’s up to them, I know friends that have strong glasses than me and don’t use them. My glasses are weak but invaluable to me to read signs like departure boards or drive

Myopia progresses when you are young. As you get older it can improve slightly a few years before there’s a need for varifocals.

Eye test is objective not subjective. They can’t advise a prescription that’s not there, people can however choose weather to wear glasses or not. It’s up to them, I know friends that have strong glasses than me and don’t use them.

The main eye test (where you are asked questions) is subjective. It is called a subjective refraction test for that reason. The result depends on your answers! However it is used because it achieves better visual acuity than objective eye tests with an automated refractometer for which results are more repeatable but tend to overestimate refractive error in terms of achieving the best visual acuity. A combination of tests is used for this reason. The refractometer test is a better indication of refractive error progression as the results are more repeatable.

they often will advise glasses for a very small prescription where it probably isn’t even needed,

This could easily happen IMO as the subjective tests have shown to vary between 0.25 to 0.5 diopters for the same test subject even on the same day. Yet a lot of people cannot discern the difference in glasses of less than a diopter's difference. Traditionally, years ago, when the eye test was given by an NHS optometrist, IIRC there was actually policy of under prescribing, at least for children. Not long after that my optician, in the early years when I didn't wear my glasses all the time, advised that my prescription didn't need to be changed at less than a diopter's difference. My most recent eye test with less than a diopter's increase from the (years old glasses) I had been wearing (which were nearly 2 diopter's weaker than the most recent prescription that I didn't wear or take to the eye test at a new opticians) I was advised to have glasses made up to the new prescription. A few years ago when I first started my experiment of improving my vision (of wearing older, weaker prescriptions) and my vision was measuring half a diopter better I was asked if I wanted new glasses or would like to continue wearing the stronger ones I already had. Go figure...it's interesting isn't it?

I think, though, there is implicit bias in the industry. Some optometrists are more wary of overprescribing than under prescribing because of a couple of inconclusive pieces of research that suggested under prescribing May progress myopia further. However those pieces of research did not account for the amounts of close work the subjects did (wearing their distance glasses) or time spent outdoors. There has been correlations found between myopia and these two environmental factors. The more recent research I linked to upthread did account for these factors.

My glasses are weak but invaluable to me to read signs like departure boards or drive

Absolutely. We live in an environment where visual acuity is important. There are times, like driving, when to see to a standard is absolutely required. However advice to wear glasses with -ve lenses at full correction all the time could actually be progressing their myopia. If you are sat reading a book in a small room, for example, you are not going to need to wear a 'fully corrected' -ve prescription to read at a distance.

Myopia progresses when you are young. As you get older it can improve slightly a few years before there’s a need for varifocals.

This is said because the majority of axial growth takes place whilst the subject is still growing (until the end of adolescent growth). However an a biofeedback type response to wearing 'full correction' -ve lenses for close work could still be involved in younger people's axial over growth, if they wear a -ve prescription. Because it increases the work the eye muscles need to do for close focussing. The biofeedback of axial growth could be compensating for this. Just as it could be compensation for doing close work in bad light or a large proportion of time of time spent reading.

Presbyopia occurring in later ages where the lens is stiffer and thicker and the muscles have to work harder to focus results in being far sighted and needing glasses for close work. There has also been found a correlation between wearing +ve lenses and improvement in myopia. The theory being the eye muscles do not have to work as hard so removing the need for compensatory biofeedback and the occurrence of overdeveloped eye muscles that do not fully relax enough to see well at a distance.

Funnily enough, I have read that if you actually strain your eyes with close work, your distance sight can improve, as the body refrains from contracting the strained muscles so those muscles are more readily in a relaxed state which is needed for distance vision.

@Windbeneathmybingowings
Your post concerns me, that is shocking and not anything I've ever come across in my career, it's that kind of thing that reduces confidence in the profession. Hence my earlier advice of finding a good optom and sticking with them (ask people for their recommendations)

@highhighmountain
There is no minimum change in prescription you can give, but you do have to be able to quantify it. The NHS audit optoms tightly to make sure change is given justifiably and there are penalties even the risk of being struck off it you are found to be consistently over prescribing.
A change of 0.50, that I could quantify by it improving the number of letters read in the room would make a discernible difference in the persons life and I would absolutely prescribe it. Waiting until someone had change by a dioptre is inadvisable for 2 reasons, firstly the person would be unnecessarily struggling in too weak glasses, secondly a dioptre of change is quite hard to get used to

A change of 0.50, that I could quantify by it improving the number of letters read in the room would make a discernible difference in the persons life and I would absolutely prescribe it.

Absolutely and I agree in terms of achieving the best visual acuity. However I don't agree with wearing a full correction for myopia at times of doing close work or indeed any time when the full distance correction is not needed in terms of activity for reasons I have posted about in my earlier posts.

Waiting until someone had change by a dioptre is inadvisable for 2 reasons, firstly the person would be unnecessarily struggling in too weak glasses, secondly a dioptre of change is quite hard to get used to

I understand people often have to accustom to stronger prescriptions (as the brain has to get used to making sense of the new sensory input) and a graduated approach can make this process easier as can wearing glasses as often as possible. However, this aim needs to be balanced with that of not progressing myopia further IMO and IME due to the biofeedback of wearing -ve lenses for closer vision (as I have mentioned in earlier posts).

The NHS audit optoms tightly to make sure change is given justifiably and there are penalties even the risk of being struck off it you are found to be consistently over prescribing.

However a full (correct) -ve lens prescription for myopia is an over correction when used continually during close work or even mid distance for lower prescriptions. An audit would not tackle this issue.

. Some optometrists are more wary of overprescribing than under prescribing because of a couple of inconclusive pieces of research that suggested under prescribing May progress myopia further.

Sorry, I have just realised I meant to say some optometrists are more wary of under prescribing than over prescribing in my earlier post.