Myopia: A Modern Yet Reversible Disease — Todd Becker, M.S. (AHS14)

Our speaker today is Todd Becker, and he's going to speak on myopia, a modern yet reversible disease. Thank you. It's great to be here. How many of you wear glasses or contact lenses? That's a pretty good percentage of the audience. All right, so we're going to be talking about your eyes today, and I hope you'll find the talk interesting. But. But I'd like to start out with two pictures. Both of them feature myself and my daughter. The first one on the left was on a Merry Go Round at the San Francisco Zoo when she was about a year old. And the one on the right was more recently. And you might notice some differences between the picture. Well, beside the fact that my hair is gray, I was wearing glasses in the one on the left about 20 years ago. And so part of the talk today is my story about what I did to learn about myopia and how I got rid of my glasses. But the talk really has two parts. The first part is going to be about the causes of myopia, and you really have to start there if you're going to be effective in reversing myopia. And the second half will be a technique that I've developed, and it's similar to techniques that others have developed. But it's my own particular twist on it, on how to use active focusing to reverse myopia. The photograph there shows some girls in high school in Singapore in a language arts class using their iPads. And you can see that all the girls in the class are wearing glasses. In some of the Asian countries, like Singapore, myopia is very prevalent. So, first of all, what is myopia? Well, it's colloquially nearsightedness. And what it is biologically is a refractive defect of the eye where when you're looking in the distance, distant objects appear blurred because the images are focused in front of the retina rather than on the retina. It's really a very common disorder, probably the most common refractive error of the eye, and it's becoming more prevalent and severe. Myopia can lead to macular degeneration, cataracts, eye floaters, retinal detachment in serious cases. So it's something to be concerned about. Now, my talk's about myopia, but some of you are farsighted and have hyperopia. It's the opposite condition. I had to focus the talk, so I chose myopia because it's more common. But a lot of the principles here, if you pay attention, apply to hyperobia as well, so question is, is myopia caused genetically or is it environmental? There's evidence on both sides. For example, twin studies and parent child studies show a higher correlation than you would get with fraternal twins. Or just by chance, there's a number of gene mutations that have been identified, like SCO2, which has to do with copper metabolism, which are implicated in severe myopia. And there's wide variation between different ethnic groups. So, for example, it's much higher in Asia. You know, 70 to 90% in some countries, maybe a third of people in the US or Europe have myopia, and it's much less common in Africa. On the other side, there's a lot of environmental factors. So, for example, there's been a large increase among aboriginal peoples, for example, Eskimos, once they were introduced to Western schooling. There's a correlation between achievement level in school or academic level in myopia. And there's some experimental demonstrations that defocus generated by close work is a cause of myopia. And we'll be getting into that in some detail. If you go back some of the early studies on myopia, there's one from Holland in the 1880s looking at military recruits, looking at the occupations of where people came from when they were coming into the army. And if you looked at farmers and fishermen, it was about 2 1/2% prevalence of myopia. If you looked at leather workers who used their hands, coursework, maybe about 5%, hand workers who are doing fine work, perhaps jewelers, it jumps up to 12%, merchants who were doing a lot of accounting work, paperwork, 15%, and advanced students about a third. So that was some indication that there might be a relationship between the kind of activity you're doing and the incidence of myopia. If you look more recently, myopia has really increased since 1970. All right, in all age groups. And what this shows here are different age groups, from youth to my age, where the incidence and prevalence of myopia has almost doubled. And the gray and black show the incidence of the more severe or advanced types of myopia, where you see particularly a large change. So if you look also at aboriginal peoples, I think a good example is Eskimos. And this was a study done by French Francis Young in 1969 in Alaska. If you look at the incidents by age group, it's very interesting because in 1969 there had been a school in operation for about 30 or 40 years. So those folks who were older than 40 had not had Western education. You can see there's virtually no incidents of myopia there, whereas those who had been introduced to Western schooling had had in some cases more than 50% incidence. Again, some evidence of an environmental factor. If you look at Germany, there was a study done just recently where people who did not complete secondary or vocational education had maybe 20, 30% or 20% myopia. Those who completed their secondary education, it bumped up to maybe 35. And then those who completed university, more than half of them had myopia. And there's some geographic distribution that indicates countries where, particularly in Asia, where there's more schooling, even at young ages like 7 to 9, we see that in Singapore, for example, 34% myopia, whereas Nepal it's only 3%. And that compares to a modest maybe 7 or 8% in the US again in school children. So there's another environmental factor, which is diet. And there's some studies, particularly by Cordain, showing that, for example, eating a lot of carbohydrates, not surprisingly, might induce a higher incidence of myopia. And it's been tied to hyperinsulinemia, to excess carbohydrate intake, to a deficiency of fish oil and essential fatty acids, and to mineral deficiencies. Now, Cordain took the view that actually genetics were not that important because he was studying children in the islands of Vanatua who were in school eight hours a day, and yet they only had about 2% myopia. But as I'll argue later, it's not genetics or environment, but I think the two come together and if you think about it in terms of epigenetics or environment acting on the genes, it's kind of like alcoholism, right? You can have a gene for predilection to alcoholism, but if you're not exposed to alcohol, you won't have that condition. Well, there was a study done by Douglas Frederick in 2002 showing that if you had the genetic indicators for myopia and you engaged in practices, myopa gen practices like education near work, you could get strong myopia, more than two diopters. Whereas if you're not predisposed and you had those habits, you might get some milder myopia. However, if you had practices that were non myopogenic, basically either a low level of education or occupation that didn't involve a lot of near work, there was either mild or no myopia. It's a very interesting paper. So let's get into the biology. How can you explain this? So I think it's important to start with an understanding of how the eye focuses light. If you look at the eye, it has this lens in it, the crystalline lens, which, just as in a camera, can change shape to focus light on the back of the retina where you perceive the image. Now, when you're looking at distant objects and most of the rays are coming in parallel, the lens is fairly flat, so there's not much focusing needed. However, when you're focusing close up, the lens actually has to expand and become more curved. And just like with a magnifying glass, you'll tend to be able to focus the light. Now, a healthy eye can go back and forth between those to focusing states rather easily. However, what happens in myopia, it really is a process that develops in a couple of stages. So first of all, as we saw in the previous diagram, you have a thinned lens when you're looking at far objects, and you have a thickened lens when you're looking at near objects. If you spend a lot of time working on the computer or reading or looking at your smartphone, after a while when you're doing near work, the lens will spasm and it will be much harder for it to thin out again when you look in the distance. So now when you look in the distance, rather than focusing on the retina, you're focusing in front of the retina and you perceive a blurred image. So this can be transient. And this is what happens when you might be in grade school, but if you're doing a lot of near work or you're looking at your smartphone all the time, that spasm becomes more permanent. And so you go to the optician and the optometrist, and they fit you with minus lenses, which are convex lenses. And when you put those in front of the eye, it sort of has the effect of making it look as if you're seeing things in focus when you're looking in the distance and all is well. However, there's a problem here because that distance correction now causes focusing behind the retina when you're looking up close. And this induces a very interesting process, and I'll get into the biology of it, whereby the eye elongates and the axis of the eye gets longer. All right? And it has to do with a biological mechanism having to do with defocus. Now, when the eye elongates, all of a sudden the eye is longer. This is fine when you're doing near work, where you're spending most of the time. However, you get the same problem as you did with pseudomyopia in that you're now focusing in front of the retina and those images are out of focus. So what do you do? You go back to the optician and get a stronger prescription, and the process repeats itself over and over and over again. And this was my experience where I had to get stronger and stronger prescriptions in order to see and focus. So there's a theory called the incremental retinal defocus theory, and this was developed by Hung and Chiafreda. And there's some very interesting recent data in humans showing that if you actually fit a person with a minus lens, the axis of the eye will grow. And here, in just the course of an hour, the length of the eye is increased by more than 5 millimeters, which is significant because the eye is only 25 millimeters long. On the other hand, if you put a plus lens in front of the eye, over the course of an hour, it will shrink right, by about 10 millimeters. And if you just put a neutral lens on, there's no change. Now, this is a study in humans. This is very recent. A lot of the older data was in primates and in chicks, but this is exciting because they now have tools using a photometer where they can actually measure the length of the eye when you're focusing. And this is, I think, pretty interesting proof of what's going on. So what's actually happening is that when you're fitting the eye with this lens and you're focusing behind the retina, there's a process by which there's a growth of scleral tissue, and the scleral tissue grows in response to some neuromodulators that are secreted when there's a defocus. It's actually quite interesting. It's been experimentally demonstrated. So these neuromodulators increase the elasticity of the scleral tissue and allow the eye to elongate. The same process, by the way, can happen in hyperopia, where you're focusing in the other direction and you can cause the eye to become shorter. So let's see if we can put this into practice. Can we take this learning and turn it into actually a method for reversing myopia? I mean, there you saw an experimental demonstration how actually putting a lens in front of the eye can change its shape. So in this regard, I'd like to touch on a key principle that I write about in my blog, getting stronger, and that is hormesis. Hormesis is a beneficial response of an organism to a low dose stressor that's otherwise detrimental or lethal at high doses. And it works by activating various defense organization repair mechanisms. And there's a lot of examples you might be familiar with. For example, exercise and immunization, calorie restriction, exposure to hot or cold. These provoke an adaptive response. UV radiation, phytonutrients, formation calluses. If you play the guitar, go barefoot, you get the growth of skin there. And I will argue that active focusing is also analogous to exercise in this respect. Exercise, particularly weightlifting, is a great example of hormesis. Right. If you're lifting heavy objects, you're causing these micro tears, micro trauma to the muscle, and you get a super compensation as a result. As long as you don't overdo it, your muscles will grow back stronger. The key is you've got to do training optimally by working at the edge of failure. If you overtrain, you'll damage the muscle. If you under train, you don't get a response. And this is sometimes called the specific adaptation to impose demand or the SED principle. So how can we apply this to reversing myopia? But first, imagine that you walked into a gym and you wanted to get stronger, and you applied the same model that an optometrist did. Now you go into the eye doctor, and what they're giving you when they give you a pair of glasses or lenses, is essentially a crutch. Right. You want to have immediate satisfaction, see things, crystal clarity right away. You don't want to do any work. Well, if you went into the gym and instead of working out, they said, here, we're going to put an exoskeleton on you. And this is not a joke. There's a defense contractor who's actually proposing this for soldiers who have to go on long hikes and training missions, that you would wear this exoskeleton and as you move, that would amplify your muscular strength and it would make life easier. Well, what do you think would happen if you wore this exoskeleton all the time? Probably the same thing that happens to astronauts in space. Their muscles atrophy, they get weaker, and when they take off the exoskeleton, the problem's even worse. Well, my argument is this is exactly what you're doing when you're wearing glasses. You're weakening your eyes. So let's talk about then how we can apply hormesis to make your eyes become less myopic. Well, there's a few techniques. First of all, there's print pushing and plus lenses, which you use while you're reading. Secondly, there's for distance, there's the use of progressively weaker lenses or a fusion of ghosted images, which I'll talk about. So you first have to understand how myopic you are. And the best way of doing this is to use a Snellen chart. You're all familiar with this. If you've gone to the DMV or if you've gone to the eye doctor. It's a series of letters with different lines and you stand 20ft back and see how far down you can read. So if you could read down to line four there, or let's say line five, the PEC FD, you would have 2040 Snellen score, which means you can see at 20ft what a normal person can see at 40ft. And if you can only read the E at the top, well, then you've got a problem. But if you translate that into the prescription you'll get. So if you look at that 2040 person, they might get a prescription that's about 0.75 diopters, which means they could see normal sized text about 52 inches in front of them without glasses. So you first have to know your strength. Now here's where the interesting thing comes in. If you really want to work on reversing your myopia, you have to read without glasses. If you have. So I'd like to distinguish three different distances. And this is my daughter acting as a model here in front of the computer. So you're sitting at the computer or a book and you're reading. Take off your glasses. Now if you wear them and hold some printed matter in front of you, hold it at a distance where you can see things just in focus and pull it in. That's D1. That's what I call the edge of focus. Now push it out just a little bit further until it just starts to blur. You can just see that beginning of blur. And that's what I call the edge of blur. And that is D2. Push it back a little further away and it starts to become indistinct. That's too far. That's the edge of readability. Well, this is analogous to when you go into the gym choosing the proper weight. You want to pick that weight. That's putting you right at the edge of discomfort. What you want to do is, if you're go here is move back and forth between D1 and D2 while you're reading and just keep pushing it a little bit and you'll feel that it's a little bit discomfort. A little bit uncomfortable, but never painful and never difficult. And so you'll be reading between D1 and D2, and do this for about two to four hours every day. Take a break every 15 to 30 minutes or so. And eventually what you'll find is you can increase D1 and D2. You can push it a little bit further away. Maybe the second day you get another inch away. All right, keep doing this. You'll be surprised actually by how quickly it works. Once you get to 20 inches away, if you can see that, you're in great shape now, you need to use plus lenses. So if your myopia is strong, you don't need to use anything. But if your myopia starts to get weaker now you use plus lenses. So here's what you do. If your correction is a little bit weaker, if you have a correction of less than minus two diopters, you go into the pharmacy and you'll see these racks with readers. And you might try on the Plus 1 or the Plus 1.25 or the Plus 1.5. Pick a pair so that you can read comfortably at 15 to 20 inches. So now you're actually starting to handicap yourself. This is like going for a run carrying weights, right? And you're going to get stronger, faster this way. You might buy several pairs, and as you get stronger and stronger, you might be up to A two. Now you're going to find that as you look at the distance, everything is starting to get clear. And that's pretty exciting. Keep going and keep testing your snellen every week to see if you can read further and further down on those lines. Okay, what do you do when you're not reading? Say you're going for a walk, watching tv. You're sitting in a room like this, and you want to improve. Maybe you're riding as a passenger in a car. I wouldn't advise this when you're driving. So what you do there is you get weaker lenses. So let's suppose your prescription is for a minus 3, right? So get a minus 2.5. Now, maybe your optometrist is cooperative and we'll do that for you. But if not, go to online, go to zennioptical.com put in your prescription, and you have here some frames, about $7. And with the lenses, it might cost $20. Order yourselves a few pairs of progressively weaker. So if you're at minus 3, get a minus 2.5, get a minus 2, get a minus 1.5. And then as you get better and better, move down to the weaker lenses. Okay, now I'm going to talk about a technique which is really fun and very playful in the spirit of Darrell Edwards. And this is a real story. How did I actually discover this technique? Well, I was vacationing and I left my glasses at home on the other side of the US So I was without glasses for two weeks. And at first I was very frustrated. I brought some good books to read, and my eyes were all blurry. So I went for a walk and said, okay, I'm just going to see what I can do without glasses. What I noticed is that when I looked in the distance, particularly at objects that had sharp contrast, like the edge of a building or overhead telephone wires, that I could see a crisp image. And then I saw next to that a very faint secondary image. And this is sometimes called diplopia or double vision. And it's not a serious problem unless it's in a single eye, which then you should see your eye doctor. But generally it's just a refractive issue. When your eyes have mild myopia, not very strong myopia, you'll see these two images. Sometimes you'll see more than two. And it's really just a refractive phenomenon. But it's actually quite useful because the more you stare at this, you'll find that one of those two images is darker than the other. And as you keep staring, you'll find that one gets darker and the other gets lighter and fainter, and eventually it fuses. And this was very exciting discovery for me that by looking at distant objects, particularly with high contrast, I could start fusing the images. So this was my method for active focusing and looking in the distance and the plus lenses for working at the computer. Okay, so there's some key questions here. Does the method really work? How much time should I spend each day doing this? How long before my vision improves? And is this the same as the Bates method? Well, a couple facts. First of all, it worked for me and for really dozens of others. And I write a blog, gettingstronger.org that's had over 1.3 million views. There's two posts in particular that I encourage you to look at that have to do with vision improvement. One of them is called Improve Vision and Throw Away youy Glasses. And then I have a forum where there's a thread called Eyesight Without Glasses, and these have over 100,000 views. And also I'll show you some slides with references at the end of the talk, and they'll be on my website if you're skeptical or if you want to follow up on the science behind this, how much time should you spend at it? First of all, you've got to have the right mindset. These are not exercises that you do, like going to the gym. These are activities you integrate into your daily activity. While you're working at the computer, while you're at work every day, or while you're going for walks, spend at least 2 to 4 hours print pushing without plus lenses if you have strong myopia, and with plus lenses, if you have mild myopia and take breaks. It's very important. Don't sit there looking at the screen all the time. Look in the distance, look up close, look near, look far. Key point. Again, it should feel awkward, but never painful. If you do get red eye or strain, stop, take a few days off, try it again. How long does this take to work? That's the other question I always get. Again, be patient. It took years for your eyes to get into this condition. It's not going to change overnight. How do you approach exercise, going to the gym and diet? You don't expect immediate results. You've got to work at this. However, keep in mind that you're going to see clearly and that's going to be exciting. I mean, the one thing I have to say here is that this was the most exciting thing for me, to be able to take off my glasses and see everything in crisp detail. To see expressions, to see the leaves on trees, fine little branches, to see little patterns in the sky that I'd never seen before. If that doesn't motivate you, I don't know what can. It's just incredibly liberating to be free of your glasses and not to have contact lenses. So typically, most people see some improvements within a few weeks and the rate of improvement is generally faster. In the beginning, it's common to see a sudden improvement and then no change for a while, and then a sudden improvement. But that's the way it works with going to the gym or losing weight. It's not a steady line, but again, the excitement comes at the end when you don't need glasses anymore. Is this the same as the Bates method? Well, not really. Bates had a theory that you need to relax the eye, and he had a faulty idea of physiology. He thought that focusing the eye's muscles had to do with muscles that surrounded the eye tensing or relaxing, and that you were actually changing the shape of the eye. We now know that's not the case. It's the ciliary muscles and changing the Shape of the crystalline lens. I mean, he was probably right about eye strain and the fact that you need to relax. However, he only addressed really half the problem, which is what I called pseudomyopia, right? That initial period where you're not being able to see in focus. He really didn't address axial myopia because he didn't know that the eye would get longer or shorter. And unfortunately, his methods of relaxation and distance viewing, they're great, right? I think they're fantastic, but they really don't do anything for those of us who are sitting at a computer all day, right? Because you can only spend a certain amount of time looking in the distance. And what we know from the incremental retinal defocus theory is that it's kind of the time averaged exposure to different focal lengths that's important. So if you're going to be spending a lot of time at the computer, you need a technique. And that's where the print pushing idea comes. Holding the piece of paper or the screen at that right distance, not getting too close, not relying on your lenses, but working right at that threshold between focus and blur, focus and blur, It's a very tiny threshold and you can find it pretty easily. So that's what Bates didn't offer. Okay, so I would like to summarize. Your eyes are adaptive organs, just like your muscles, just like your metabolism, just like everything about you. You've been reading close up for years. You've been working with smartphones. Those are a particular problem with kids. They're looking at their smartphone or their video game all the time. And as a result, your lenses are in spasm. You need progressively stronger lens prescriptions to correct that problem. But that only makes your eye get longer and, and your myopia worse. So reverse the process. Do the opposite, right? Use that same adaptability to reverse the process and use active focus. Take time out from your busy routine. Look at distant objects. Move back when you read. If you're sitting watching a TV program, sit as far back as you can. If you're in a lecture hall, sit as far back as you can to see everything without your glasses. If your myopia is weak and your eyes are getting really good, use plus lenses to accelerate the process. And when you take those plus lenses off, you'll find, wow, everything is really crystal clear. So stimulate your eyes. It's very important. Play with your eyes. Have fun with this. This is not a chore. Build it into your daily life. Make it a habit, but make it a game. When you're walking along a trail. Look at every little branch. Trace those branches. Look at the shadows. See what you can make out. Right. There's this wonderful world around you. You're not noticing but a fraction of the details. And it's just so stimulating to be able to do that without your glasses. What I can tell you is the more you do this and the more disciplined you are about doing it, the better your results will be. So anyway, that's all I have to offer you today and I'm happy to take questions. First. Before I take questions, I just wanted to flash on here some references on the epidemiology and on the biological mechanism. This will be on the video and you can take a snapshot. And finally on methods that you can use to improve your vision and some websites. I particularly recommend the DeAngelis book and the Severson book and Otis Brown. Really good methods. My site, gettingstronger.org Fraunfeld Clinic Power Vision System. These are all good sites that have similar methods. Okay, we have time for 10 minutes. Want to take the first one? Thanks. That was really interesting. I was wondering, do you still have to do these types of exercises now or are you just kind of cured? So just as you would when you're fit, you go to the gym every so often, right? I would say periodically I have a pair of plus lenses. If I'm reading a lot of, I'll pull them out and use them for a bit, but not very much actually because what I tend to do is just sit back a little bit further from my screen and try to avoid the bad habits in the first place. With the screen being such a potentially negative part of the environment, I noticed that your daughter was modeling in front of the screen. Is it better to try to train with books and not look at screens? Is there a certain volume of, you know, time to look at a screen? Considering how much you said the smartphones and the computers are damaging our eyes, yeah. I think it's preferable to have a well lit book in front of you would be ideal. But sometimes you don't have that option. So if you are doing computer work, I don't see any real difference. As long as you have good lighting and you're healthy, you can use a computer or a book. Thanks. Okay. So it seems that in my family we run Myopia. My brother has two eyes that are around 21,000, so he just can't do anything without glasses. I have an unusual problem in that this eye is perfect and this eye is really myopic. When I go to the Snellen charts, I can't read the biggest letter anymore. But the problem is that I remember what it is. So your two eyes are different. Very different. And this is, by the way, very common. It's called ambalopia. I have it too. In fact, I have one eye that's slightly farsighted and one that's slightly nearsighted. So here's what you do, right? If you have the two different eyes, block one eye and work with the weaker eye, because your stronger eye is going to dominate and do more work for you. You can put a patch on your glasses. You can just hold your hand like this or you can wink. Right. Wink from one eye to the other. And it's awkward at first, but your winking muscle gets stronger. Yeah, because I have 20, 20 and 2400. So I find that my problem is I can read right here and I can read right here. And it's only like right here that's difficult because my eyes are not used to vying for dominance and they don't like that. So I should probably read a lot right here. So my eyes get used to seeing three dimensionally. Would that be. Yeah, but your eyes are so different. I think you probably want to work your weaker eye first until it gets closer, because it's much easier to do this method when your eyes are close. So in my case, it was my left eye that was weaker, and I spent a lot of time working that until the two were even. So would you have some advice for my brother who would probably have to be about this close to the computer before he could be at the edge of readability? That's tough, but that's where you start. Maybe his nose will get in the way. Yeah, now that's where you start. One thing he can do is use weakened prescription. So cut a few diopters off the prescription so that you're at a reasonable distance. In this case, it would be a minus prescription, but just weaken the prescription and start there. Great, thanks. For someone with a really strong prescription, if they go through this process, are they going to have to replace their glasses along the way because it can be pretty pricey. Yes. And that's why I recommended this website, zennioptical.com very inexpensive frames, you know, get several pairs for $15 or $20 frames. Or glasses, about $6 for the frames. And with lenses, it might be 20 to $30 total. Okay, thanks. Similar question about uneven. Like, I have a minus 6.5 and a minus 5. Do I work like, do I just do, like a negative 6 and leave this the same, or do I kind of step them both back at the same time? I mean, how do you work with this without the blinking thing or whatever? Yours are pretty close, so they might work. But if you want wink or block the stronger eye and work with the minus 61 first until it's down to a minus 5. And you can use the Snellen chart there, too. With a single eye, read as far as you can and wait till your eyes are more even, and then they'll proceed together. It's just like, what if you went into the gym and you had a strong right arm and a weaker left arm? You would want to work the weaker arm first until they were both similar. If I could get glasses that I only am stepping down one lens for something like that, or just put a patch or a diffuser in front of one lens. Okay, thank you. Hi. I was just curious to see how much your axial length has actually changed since doing this method. Unfortunately, I don't have the device for measuring my axial length. That requires a sophisticated apparatus. However, the study that I cited there, you can read about 28 different patients and see all of the measurements that were made on their eyes. But typically, if you look at the results that they got, it would be by several millimeters. Several microns. Yes. Okay. So I think one of the things that your method teaches is improving your visual acuity and not necessarily changing any of the optics of the eye, which can help. But I just want to say that the optical issues that are in place are not being corrected for. It's just improving your visual acuity through practice. I just want to say that. Yeah, if you have other eye conditions outside of myopia. Yes. This doesn't deal with those. Thank you for a very insightful talk. I have a question about the font size. When you're doing this, a lot of people, especially here in the Bay Area in tech, are using bigger font size where they're staying at the same distance. So would you still recommend, even if you use a bigger font size to move away from the screen? Is that a right. Obviously, there's a connection between font size and distance. So the recommendation here was for normal size font. If it's larger, you would have to move back farther to get the same benefit. So being on a short distance, despite using a bigger fund, the problem is focusing at a short distance. Is that correct? That's right. So you want to. You want to increase the distance, whatever the font size is, by moving back Farther and farther, progressively. Thank you. If you have kids who have 2020 vision, how do you prevent them from ending up with glasses like I have? Yeah, good question. So first of all, good hygiene, which means don't work too close up. Right. Work for their way. But if they want to do that, they can go buy weak plus lenses like the plus ones, the readers, very inexpensive. Just go into any pharmacy, they're there. If they're doing extended work, have them wear those. A lot of people look at this as a preventive technique and do an experiment. Have them put the plus lenses on and read for an hour and take them off and ask them, do you now see the world more crisply and clearly than you did before? Just ask them. Thank you. Okay, I think two more questions. I've never had an issue with myopia, but I'm getting to a point where I need glasses to read. And more recently, driving at night is less comfortable. Wondering any ideas around those two issues? I think the two go together. As you age, it is, you know, your vision does deteriorate and it's harder to see things at night. In particular, one thing I didn't touch on is good diet. I think that helps a lot in terms of a low insulin type diet and also plenty of phytonutrients to make your rods and cones healthy so you can detect color in low light. But I also just think that these methods of healthy focusing are going to be helpful at night because you'll see the correlates and the details that you need to see more crisply. So same same principles that you. The same principles, yeah. Okay, final question. What would happen if people kept going after division became normal again? Would it continue improving? Ah, there's one post on an interview that I did on my site with a student who had poor vision. He got to 2020 and he said, I want to do better than this, I want supervision. And he got himself down to 2015. Go on my. It's called how one person improved his or one person improved his eyesight and he used the method to get all the way to 2015. And if he kept going like that, would that create the opposite problem for myopia? Ah, no. I mean, so you can. You just get better and better distance vision. Right? But you can use the same process for hyperopia. If you cannot see things that close up, then you and you have to read like this. Then do the opposite. Pull them in, pull them in until they're at the edge and eventually you'll be able to read more close up. You basically can change the shape of your eye in either direction by using active focusing. Right. So would continuing after it was normal, after myopia is fixed, create hyperopia? Not necessarily. No. I mean, because it's right. As long as you're flexible and you're able to exercise your eyes so that you're looking both close up and in the vision. And I advocate alternating the two, it increases the range of focus from near to far. Thank you. I got a question. If you improve your myopia using your technique, do you think that's going to reduce your chances of macular degeneration? It may. If you look at some of the causal contributors to macular degeneration, retinal detachment, eye floaters, you'll see myopia listed prominently there. It's not the only cause, but there is a connection there. Okay, thank you very much.