There’s a term “pseudomyopia” that is sometimes used by people skeptical of vision improvement methods. It’s also called accommodative spasm, accommodative myopia, or ciliary spasm. In a nutshell, as far as our context goes it’s a way of saying that if you had/have myopia and improved your vision, then that wasn’t myopia in the first place. Meaning, “real” myopia (also called axial myopia or organic myopia) is incurable, and if you prove that statement wrong by reversing it with treatment or exercises, you don’t count and it doesn’t matter that your vision is better. They move the goalposts on you.
I’m not going to show fancy diagrams and pretend like I’m an expert on physiology, and I’m not going to try to settle any disputes about the mechanisms at work in and around the eye that change focus or cause refractive errors (blur). You can google that stuff to your heart’s content. What I’m going to do is try to explain the situation so that you can see that the whole question of things like pseudomyopia does not really matter, if the term is ever used to slap you in the face with when you undergo an alternative treatment and share your accomplishment of improved vision.
100% of people with myopia exhibit signs of undue tension with the way they use their eyes. If you improve your vision somewhat after doing exercises like the ones I promote, and you feel some of the tension gone, but you are told that you only had pseudomyopia, then what of the remaining tension? If you can tell you have more work to do, then do it, and don’t let anyone tell you that you’ve hit your limit on how much better you could see. At the end of the day, you really don’t care what they call it if you can see better with your own eyes.
You would think that if your improvement can be written off so easily as pseudomyopia, you would have been told earlier about this great opportunity to improve your vision somewhat, not have to wear such strong glasses, and get along better without your glasses. But you weren’t told that. You were told that there’s nothing you can do but wear glasses. Why the inconsistency? Eye doctors can’t have it both ways and justify it. If there were a way for people to improve vision, shouldn’t they be all over it? But that isn’t what they are taught to do. They are taught a great and intricate procedure to prescribe glasses, one that only someone with years of training can competently administer, and they do it whether they think you have myopia or pseudomyopia. That’s the world they live in.
Back in the early 1900s, before he wrote his book Perfect Sight Without Glasses, Dr. Bates wavered a bit on his view of what was going on when he observed myopic people improve their vision. In articles published up to 1912 he towed the line of the conventional wisdom at the time that only pseudomyopia had any chance of being affected by his methods, and that axial myopia (aka: “real” myopia) is incurable. The explanation made a certain amount of sense.
In 1913 his writings suggest that he began to change his mind about that, after observing too many patients who were improving their vision when he was sure they had real myopia. Years later after more study, experimentation and experience applying his treatment with patients, he officially recanted his previous position, saying how foolish he had been, and that his methods affect real myopia.
That’s the stance the natural vision improvement community, including teachers of the Bates method and others, hold today. Myopia is reversible in virtually all cases, excluding the rare conditions as a result of deformity or injury. Not only is it possible, but it’s feasible to do so. Pseudomyopia and myopia are treated the same way. Pseudomyopia might respond quicker to treatment, but that’s most of the difference. Long term they are both reversible.
What’s more, this study indicates that pseudomyopia leads to axial (“real”) myopia, showing how they are linked as part of the same process.
Cycloplegic Refraction
The way eye doctors test for pseudomyopia / accommodative spasm is by administering a cycloplegic drug via eye drops, which paralyzes the ciliary muscle inside the eye and dilates the pupil.
The idea is that this will eliminate pseudomyopia, and all that’s left is organic myopia.
This assumes that by paralyzing one part of the eye, the rest of it will continue to function normally. It also assumes that the chemical won’t work its way back in the orbital socket to affect the extraocular muscles (surrounding the eyes). Would introducing foreign chemicals upset the delicate balance that someone who has recently improved their vision has? People improving their vision find that it fluctuates a lot – sometimes they can see clearly in the distance for a few minutes, and then it reverts back to blurry, or several times in a minute – and is sensitive to any changes or stressors. The drug also dilates the pupil, making blurry vision even more blurry, and even more blur than normal can be distressing and in itself affect the ability of a person to maintain good, relaxed vision habits for the duration.
What Causes Pseudomyopia?
The conventional wisdom is pseudomyopia is caused by the ciliary muscle tensing up as a result of long periods reading or from mental stress. They’re actually pretty much right about that. Nervous children can exhibit it often.
However, long term myopia is caused by the same thing. Pseudomyopia is merely a way of accounting for the inescapable fact of the change in the short term, while mild or pathological myopia (severe myopia over -6D) is the long term result but is treated as if your actions have little to do with it. It isn’t necessarily long periods reading, but the way you do it can be one factor, as you can note from the way you might read an interesting book for hours without feeling much eye fatigue while a boring textbook will make your eyes feel tired quickly, especially at night when you’re falling asleep. Or you can compare yourself to another person who doesn’t get vision problems from reading. It isn’t luck. It’s the way you use your eyes and the way these habits and patterns promote chronic tension in and around your eyes.
Conclusion
Pseudomyopia is a handy cop-out. You try improving your vision, you get a little success, but then you have trouble. How convenient that you have the pseudomyopia excuse. I guess it feels good to conclude that you’ve done all you could, and at this point it’s not your fault, it’s biology!
My biggest beef in philosophy with traditional medical circles is the idea that alternative therapies are “dangerous” because by trying them a person might not seek help from a qualified medical doctor, particularly one who only prescribes traditional treatments. Should people not be allowed to make their own choices? Do the opportunities for other choices need to be effectively outlawed through messes of regulations? And yet the medical establishment isn’t recommending an intelligence test before you are allowed to make other choices with your health such as how much you exercise or what food you eat. It’s not about protecting you. It’s about limiting your choices so as to uphold the status quo. The mentality is to get people to expect the worst, have no faith in their own power, and not take personal responsibility to get off their asses and improve their health. So no, trying to improve your vision is not dangerous, but accepting these types of limitations imposed on your own self-improvement is pretty depressing, the way I see it.
So the bottom line is I don’t recognize these types of limits. If someone wants to call me ignorant of anatomy and optics, that’s fine with me. I’m not here to win an argument. I’m here to promote ideas that I think will help you.
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I founded iblindness.org in 2002 as I began reading books on the Bates Method and became interested in vision improvement. I believe that everyone who is motivated can identify the roots of their vision problems and apply behavioral changes to solve them.
Good day. Please provide me with a thorough vision therapy program for spasm of accommodation. As all the articles that I read only says target move aways and plus for near.
David, thanks for this. It’s amazing to me how many people think their vision is getting worse when they’re merely over-tired or have had a life challenge, so they go get glasses which just locks in the problem. Yet if their vision seems to be getting better, they discount it as a fluke! Plus, if I can see better than I used to, I don’t care whether you call it pseudo-myopia or my imagination! I know when things look clearer and brighter. Great article — I’m sharing it.
I’m a year late in replying, but… Isn’t it crazy the way some people are ready to doubt every good thing that should be so inspiring. It reminds me of a poker player who called it an emotional freeroll. A freeroll is when you get entered into a tournament with no entry fee and thus no investment. If you avoid any investment in hope of success, you avoid the pain of disappointment. I guess that works, but what a horrible way to live!