Some Theories of Mine

ok so I've been an OD for 10 years. not a long time in the scheme of things. but still...I have a few theories on eyes that I don't think have much information out there on the net & I'd like to share. These theories may be INCORRECT for all I know. I just came up with them based on 10 years of experience, which is admittedly not a lot. Here's what I think:

Theory #1: most spherically nearsighted people are accommodative insufficient. that means as long as you don't have a lot of astigmatism, then I think most nearsighted people don't "focus" their eyes very well. Tonic accommodation & myopia progression are probably factors, as those are accounting for some of their myopia as well as taking away some accomodative amplitude. spherical myopes see awesome up close uncorrected with zero accommodation, and i think sometimes (often?) this affects their accommodative amplitude. some of this is helped with a base-in prismatic effect in glasses, but when spherical myopes wear contact lenses to do heavy near work (computer, etc) they're the ones with all of the "computer vision syndrome" symptoms of headaches, eyestrain, blur, etc. Should we be fitting more of these patients in multifocals? Probably, IMO.

Theory #2: lenticular astigmatism most commonly manifests secondary to constant accommodation. I think that patients with normal corneas who are progressing in their amount of astigmatism in the absence of a change in corneal toricity are probably doing so b/c of constant tonic accommodation.

If there is info out there on these topics, I haven't seen it. If you find some info, please comment below. I'm sure I have other theories I haven't remembered to post here...if/when I do remember them I'll add them later


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