Did everybody get it wrong about the role of the lens in myopia?

If you are nearsighted you probably know the reason: your eyeballs are too long. This
has been known for more than a hundred years, and no reputable eye researcher would
dispute it.

However, there is another reason: you probably use your eyes too much for near vision,
most commonly reading or computer use. The result is that with prolonged periods of
focusing for nearwork the crystalline lens within the eye finds it difficult to re-focus to
see well at a distance.

It is proposed here that the contribution of the lens in myopia is as much as or more so
than the contribution of axial length.

A MAJOR CAUSE OF MYOPIA IS THE CRYSTALLINE LENS BEING

PERMANENTLY FOCUSED FOR NEAR VIEWING

Although this hypothesis will be denounced as preposterous, it is an established fact that

nearwork causes myopia. .

This phenomenon (accommodative hyteresis or NITM-Nearwork-Induced Transient

Myopia) is so well documented that it is beyond dispute. If, after a period of near focus,
the gaze is then shifted to a distant object, the result is a temporary myopia (typically
0.25 - 0.30 D), because the eye requires a certain period of time to re-focus for distance
viewing.

The time required is related to the amount of time spent on the nearwork task: the longer
the period of nearwork, the longer the decay time, i.e. the more time is required for the
eye to relax its accommodation. Some experiments have shown that with longer
nearwork tasks, the eye can take as long as six hours to recover its capacity for distance
vision.

In these experiments the eye has always recovered its ability to focus for far vision, but
these experimental nearwork times have always been relatively brief, usually for a period
of minutes, or at most for a few hours; it is not inconceivable that in the real-world
situation of long periods of nearwork over months and years a transient myopia could
become permanent.

The inability of the lens to change its focus is so common as to be almost universal--in
anyone in their 40's. s. Although this condition, presbyopia, refers to the inability to focus
for near, the principle is the same: the lens is unable to change its shape, and therefore its
focusing power, due to the viscosity of the lens substance (there are a few other
explanations).
Two other experiments also support the lens hypothesis:

The prolonged recovery period from accommodation following an experiment in

artificially-induced myopia.

The changes in accommodation produced by the application of vibration to the eye.

Recovery From Artificially-Induced Myopia

An experiment was performed which, accidentally, produced an extreme form of

accommodative hysteresis. It showed that recovery from a high degree of
accommodation can take years.

The experiment involved forcing the oblique muscles to contract to a degree much higher
than that which occurs during normal rotational eye movements, such as those involved
in reading (described in Myopia, Experiments and Contradictions, on this site).

This contraction caused a dramatic 5-diopter increase in myopia. It was initially assumed
that the increase was caused by axial elongation, but another phenomenon was observed:
an extreme degree of monocular diplopia, presumably caused by spherical aberration.
Since spherical aberration always accompanies accommodation, this suggested strongly
that compression of the globe not only lengthened the eye, but also caused the lens to
accommodate.

This correlates well with the fact that spherical aberration increases as the eye
accommodates, becoming negative as the accommodation goes beyond some 3 D. Also,
it is well-documented that spherical aberration. is more common in high myopia.

It was surmised that external pressure on the globe had forced the vitreous forward
against the posterior surface of the lens, which in turn flattened its periphery.

This change in lens shape is precisely what happens when the lens accommodates under
normal conditions. According to Roorda and Glasser, "The increasing negative aberration
of the accommodating lens arises from a more pronounced increase in optical power near
the central region of the lens compared to the peripheral region. In other words, as the
lens accommodates, the central curvature steepens while the peripheral curvature
flattens.

When the experiment was stopped, it required some two years for the refraction to revert
to the pre-experiment state.

Vibration and The Eye

On the assumption that it might be possible to alter crystalline lens power, a device was
constructed for the purpose of applying vibration to the eye. Application was through a
soft rubber tip placed on the upper eyelid and vibrated at a rate of 60 Hz and amplitude
of 1 mm. The vibrated eye was abducted as far as possible and the other eye was
occluded.

The result was that the visual acuity improved significantly. This suggests that the lens
had been accommodated, and, and that vibration had "softened" the lens allowing it to
revert to a less accommodated state.

There are a number of very strong arguments against the lens hypothesis, and these are
addressed in Myopia, Experiments and Contradictions, on this site.

The argument that this hypothesis can not be true because it would have been discovered
by now is weak. In the history of science there are numerous examples of well-
established long-standing theories that were eventually overturned. See:

http://www.amasci.com/freenrg/wbelief1.html

To state the hypothesis in the simplest possible terms:

A major cause of myopia is that with prolonged nearwork the lens becomes permanently
accommodated for near vision.

• The Lens in Myopia

• Abstract
• Experiments in Myopia
• Greatest Blunder in the History of Eye Research?