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?

myopic kids should be fully corrected

Maybe, yes, for seeing at the furthest distance. However if they are avid readers and wear their glasses to read they are actually being hugely 'over corrected' whilst they are reading. So it is important to note environmental factors. And it was the most myopic that appeared to progress in their myopia at a faster rate when fully corrected, according to the study I mentioned, IIRC. However even the most myopic progressed in their myopia the least with the greatest undercorrection according to that study, IIRC.

calpop, my gut feel is to wear the glasses which are best tailored to the activity you are engaging in only whilst you are engaging in that particular activity. Driving glasses for driving, reading when you need them for small print, none for walking about generally if that is safe and comfortable for you. This reasoning works for me. And my vision has improved.

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.

I found this point, from the research linked below, interesting:

"^This study showed there is a significant difference in binocular visual acuity within three different refractive corrections (p

So I think the solution to avoiding overcorrection is to

1. really pay attention to the answers you give and be informed as to what they mean (see my quote @ 9.23) in a subjective refractive eye test. 2)Recognise a -ve lens is designed to improve distance vision. If you wear a -ve lens for close vision this is an overcorrection for close distance. Your eyes may accommodate for it but will be working harder. Continued accommodation might induce a biofeedback response. 3)only wear a -ve lens in situations that absolutely require distance vision in order to avoid overcorrection and having to accommodate it and the possible resultant bio feedback.

I will read your study,highhighmountain,but it'll be in a few days.
Meanwhile I know nothing about you,your background or credentials but I do know about the speakers I've heard over the last few years!
But - I disagree about your "over correction for near point".If you were emmetropic - perfect vision in the distance- you would be accommodating at near.If you are myopic wearing your glasses effectively makes you emmetropic at distance and your eyes are then accommodating for near vision in the same way that the eyes of someone with perfect vision would. You aren't over corrected.
There is more to the near bit for some people,but not for everyone.

I will read your study,highhighmountain,but it'll be in a few days.

Thank you Infinite, I would be interested to hear your views.

Meanwhile I know nothing about you,your background or credentials but I do know about the speakers I've heard over the last few years!

Granted. However you don't really need my background in order to evaluate the points I have been making.

But - I disagree about your "over correction for near point".If you were emmetropic - perfect vision in the distance- you would be accommodating at near.If you are myopic wearing your glasses effectively makes you emmetropic at distance and your eyes are then accommodating for near vision in the same way that the eyes of someone with perfect vision would. You aren't over corrected.

Interesting point. I meant that in terms of -ve lens correction not being needed for close vision and therefore 'overcorrecting'. My understanding also fits rather neatly into why the phenomenon of +ve lenses improving myopia occurs. How would your explanation fit with this?

Infinite

I'd also be interested on your thoughts concerning why my myopia progressed beyond adolescent growth. Also why it started to improve, before the age where presbyopia would be expected , when I did not wear a new higher prescription but continued to wear my older weaker prescription. I even went back to wearing a next pair of glasses when prescribed (maybe myopia had settled down, I thought) when it initially got better and hey presto my myopia started to progress again.

If you are myopic wearing your glasses effectively makes you emmetropic at distance and your eyes are then accommodating for near vision in the same way that the eyes of someone with perfect vision would. You aren't over corrected.

This point also makes me wonder about whether the standard of 20/20 and better is correct in terms of the long term functionality of our eyes. I wonder how many people with this standard of vision naturally need reading glasses at an earlier age compared to those more inclined towards myopia. Because I am beginning to increasingly believe (non inherited) myopia and hyperopia might develop as a result of the body's biofeedback response to specific environmental conditions.

I wonder how many people with this standard of vision naturally need reading glasses at an earlier age compared to those more inclined towards myopia.

I mean this in terms of the myopics being able to read without any glasses not in terms of them needing a reading addition to their distance lens.

If you are myopic wearing your glasses effectively makes you emmetropic at distance and your eyes are then accommodating for near vision in the same way that the eyes of someone with perfect vision would. You aren't over corrected.

However, if your body has undertaken axial growth as a result of a biofeedback response to activities that required close vision, then as soon as you start having to accommodate at a higher rate for close vision again the whole process would repeat itself. Resulting in further axial growth.

On this subject, this study is pertinent:

iovs.arvojournals.org/article.aspx?articleid=2126435

Mine have deteriorated over the past couple of years because I only wear mine when driving as I legally need to. I hate wearing them and daren’t use contact lenses. Don’t hate the way they look or anything, they’re nice enough (and cost enough) but I hate having something on my face.

They have got worse but I don’t know if that’s because I’m not wearing my glasses often or whether it naturally would’ve happened regardless. My DM has awful eye sight, DF still has 20:20 vision. Would appear I inherited my Mother’s eyes...

Pink, can I ask how much they have deteriorated by?

I would love to hear an optician's opinion rather than anecdotal data.

I've had several opticians insist my eyes couldn't have improved - eyes don't do that according to them and previous prescriptions must have completely wrong - though it's the same comapny doing them all.

I went from 10 hour days at computer screen to none and hours being outside - a year of that I noticed I could see things in distance I’d previously started to struggle with.

The previous prescription was with about four different optician – first one giving it then next confirmation – then having to get new stronger lenses – which I wanted in same frames and fuss that caused – then it confirmed I was still Okay with those – then pg brought a complete change in lifestyle. Next few opticians – I don’t need any and apparently never did

Wow, bigKite! Good to know your eyes have improved, though.

This is what I find really difficult, the opacity and defensiveness during the whole process from the industry. IMO it crosses over into research and the weight given to some pieces over others.

Although as I said in my earlier post because of the phenomenon of people noticing an underprescription for myopia more than an over prescription for myopia there will be a (partly legitimate) bias towards over prescription as people would complain less. This is because an over prescription can most usually be quickly accommodated for by focussing with the eye muscles versus seeing with an underprescription would require axial length growth. Although for older more presbyopic patients might have less tolerance of an over prescription. It can be why some new glasses can make the eyes feel 'tired'.

Seeing with clear visual acuity with an underprescription, I meant to say.

Actually had my eyes tested this morning. My short sightedness has got worse but he told me there would come a time where it would start to improve as we naturally get more long sighted as we age. Also that wearing glasses when you don't need to won't worsen the sight - it's not that your muscles become lazy, that's a myth. I'm getting more dependent on my glasses due to my collagen in the eyeball firming up (or something like that - it's linked to collagen anyway) Not wearing them when you need to can link to eyestrain and headaches. And more wrinkles!

So you may not have noticed an over prescription, with your precious glasses, bigKite. Did you wear those glasses all the time?

Those lifestyle changes would concur with the research I have read suggesting a correlation between greater time spent outdoors plus less time spent indoors doing close work and better distance vision.

My mother started needing reading glasses when she was about 47. She is now 80, and has the same pair of glasses. In fact her sight has become better than it was 3 years ago as she was suffering from very bad dry eye syndrome which caused scratches to her cornea which has now been corrected to a large extent - the consultant told her it is rare that he tells someone of her age that her sight is better!

I am now also 47 and have never needed glasses but I can now struggle with very small print or strange colour schemes where you don't have a lot of contrast between the text and the coloured background. But I want to put off needing glasses as long as possible.

My husband was about 47 when he needed glasses, too, but he has recently needed a stronger prescription.

What I do find interesting is that my mother and I needed glasses at a similar age. Yet I studied doing close work with books, and have spent my career looking at a screen, which is supposed to be bad for your eyes. On our experience, that would appear not to be the case - or at least it doesn't make long-sightedness come on any younger.

it's not that your muscles become lazy, that's a myth.

No, it's increased axial growth / ciliary muscle spasm that could be due to wearing negative lenses, especially during close work, causing myopia progression. See the several pieces of research I have posted earlier on in this thread.

On our experience, that would appear not to be the case - or at least it doesn't make long-sightedness come on any younger.

Maybe not. I have been talking mainly about short sightedness and close work.

bigKite Just realised I meant 'previous' not 'precious' glasses!

So you may not have noticed an over prescription, with your precious glasses, bigKite. Did you wear those glasses all the time?

No - just needed them for meetings when there were overhead projections used or occasionally for seeing overhead screens when traveling by trains. The lived in my bag and came out when needed.

If I had been driving, I'd have needed them - one of my parents had driving glasses but at an older age than I was then – but that wasn’t an issue for me.

First prescription glasses were perfect - sorted out the few problems I'd started to notice.

I didn't understand why the prescription was changed few years later to a stronger one -I’d had no issues partly why I asked for them to put in the second pair of frames. They were quite difficult about it but conceded the second frame I had was practically new as I had never needed them. I don’t think I liked them as much.

Then entire lifestyle changed, and it was couple of years before next eye test where they decided I needed nothing - it's been over a decade and I still don't apparently need any yet.

I've always suspected the long hours of screen work and that stopping caused the change but optician' always reject that idea and insist I never needed glasses that their company had previously sold me.

It’s perfectly normal for myopia to get a little better as you age. For example DH was -2.00 at 29 (when I first met him) and now he’s -1.00 at 45. Many myopia will get this shift in the latter part of their 30s/40s.

The majority of the evidence points to undercorrection of myopia causing greater deterioration than full correction, which is why most optometrists fully correct.

Interesting, bigKite. As far as I have read there is correlation between a lot of time spent doing close work and screen time along with less time spent outdoors and myopia too. So I don't know what your optician was talking about. And maybe your next prescription was stronger than needed as you didn't feel you needed a change of prescription at all. I posted research upthread concerning subjective refractive eye tests repeatability showing variance by just over half a diopter too. That coupled with people generally not noticing a too strong prescription less, in terms of visual acuity, than a too weak one (as I discussed) and you can see how easy it would be for this to happen.

The majority of the evidence points to undercorrection of myopia causing greater deterioration than full correction, which is why most optometrists fully correct.

Not the majority as far as I have read. Most often cited are two studies (one by Chung and one by Adler) which were flawed in terms of not accounting for the amount of time spent doing close work air time outdoors. The advantage of fully correcting were very small too, only just statistically relevant. I have posted a later study upthread which conflicts with their findings. This study does adjust for the aforementioned lifestyle factors. Here:

https://www.researchgate.net/publication/277561477Effecttofundercorrectionnonmyopiaaprogressioninn12-year-old_children