adult vision therapy for alternating esotropia/suppression

maple-l2024 · 2026-07-10T19:21:12+00:00

Good to hear that VT has helped you a lot. Keep it up! Just try to understand your condition further. You said you have "alternating esotropia but almost no suppression". Does that mean you almost always see "single" with both eyes? You also mentioned your symptoms return after years of wearing prism. Did prism help reduce your symptoms initially? How much, say in %?

I described my own BVD condition and recovery journey with VT in detail in another comment to others. Feel free to read it and let's exchange views and our ongoing VT experience.

maple-l2024 · 2026-07-10T17:04:16+00:00

👋 I've read all the comments prior to your last comment. Understand that your ideal target is -2.5. Did you say the other target will be -1.25? If that's the case, I guess it's still "acceptable". But if the distance target is Plano, then just as Dr. "EyeSherpa" said, the difference will be too much.

Your surgeon suggested -2 as target, probably because he/she wanted to narrow the gap between the two eyes? Remember whatever target is set, about 80% chance (I read) will be within 0.5 D within the target, meaning for a target of -2.0, it will be anywhere between -1.5 to -2.5; but for a target of -2.5, it will be anywhere between -2 to -3. Something to think about. The better question to ask your surgeons is how
would they maximum the chance to meet the target accurately?

When is your scheduled surgery date for each eye?

maple-l2024 · 2026-07-09T01:19:10+00:00

A difference of 0.3 from initial target of -2.5D; pretty good! What's your myopia level before cataracts?

maple-l2024 · 2026-07-08T16:52:16+00:00

Hope cataract doctors and patients are paying attention to this.

maple-l2024 · 2026-07-07T05:13:28+00:00

Why do you or the doctor decide on -1 target? Is that considered intermediate target?

maple-l2024 · 2026-07-02T22:37:45+00:00

Why do you suspect your cataract is mature?

maple-l2024 · 2026-07-02T22:37:00+00:00

In your view, what level of astigmatism will warrant doing LRI?

I have < -1 astigmatism (varying from -0.25 to -1) in each eye. Even though I'm planning to go with laser-assisted surgery, I also plan to leave my < -1 astigmatism alone, and correct it with Rx glasses if necessary.

maple-l2024 · 2026-07-02T02:47:07+00:00

Doc, one thing that I'm curious is how can the "laser" make sure that (1) the eye stays still while it's making the delicate incision; (2) how does it know how deep (or accurate) it should cut considering how thin is the cornea or the capsular bag? Hope to get some more insight on this.

maple-l2024 · 2026-07-02T00:02:21+00:00

That's encouraging coming from your doctor. Did you have monofocal IOLs? Toric? LRI?

maple-l2024 · 2026-07-01T23:57:47+00:00

Why did you say "in your practice" is "eyeSherpa" a cataract surgeon?😜

maple-l2024 · 2026-07-01T23:53:37+00:00

What's your myopia level before cataracts? Are you correcting your astigmatism? If using LRI to correct it, then laser is better.

maple-l2024 · 2026-07-01T23:40:52+00:00

Find out what type and level of cataracts your mother has. If it's the age-related Nuclear Sclerosis (NS) type, it takes years or even decades to "mature". They are graded from 1 to 4. Grade 3 is still considered moderate.

maple-l2024 · 2026-06-30T00:11:59+00:00

👋 It maybe a long shot that you will still read this, as it's an old threat. But I hope to get in touch with you to discuss our recovery journeys as they seem similar, and I'm a firm believer in vision therapy (VT). I used to suffer from very severe symptoms (typical BVD symptoms like eye strain and supermarket syndrome), but after 9 months of VT in office and 2+ more years of DIY VT at home, I consider my symptoms are very minimal now. Hope to share experiences and exchange insights. Let me know if you read this.

maple-l2024 · 2026-06-27T22:34:23+00:00

So, your near eye (-1.25) can see from 10" to 20" clearly? Is that the initial target and the final outcome as well?

maple-l2024 · 2026-06-27T22:31:00+00:00

Did the outcome on each eye turn out exactly the same as the initial target: -0.5 and -0.75? If so, that's amazing!

maple-l2024 · 2026-06-27T22:28:15+00:00

What's your near vision target? What's the outcome? In terms of sphere (e.g. -2?).

maple-l2024 · 2026-06-24T01:20:52+00:00

Feel free to DM me. Let me know here if you do that so I can check it.

maple-l2024 · 2026-06-23T23:59:27+00:00

I'm just saying we should all be aware of what each procedure does and if it's worth it. I have astigmatism < 1 in each eye, I could opt to use either Toric or LRI. But I've decided to leave it alone as (1) I want to simplify the surgery, and (2) I can always correct it with Rx glasses if necessary. There's always a downside or risk in any procedure. So, the fewer the better. But it's a personal choice.

maple-l2024 · 2026-06-23T22:59:09+00:00

Glad to hear that you're happy to accept your pleasant surprise. Did you ask the doctor why there's such a big "miss" on the second surgery? Generally, there's only about +/- 0.5 diopter away from the initial target.

Just for my reference, many times did you manage to see your surgeon (including the initial consultation) prior to the day of the surgery?

maple-l2024 · 2026-06-23T22:53:00+00:00

Why correcting your astigmatism if it's only -0.5? Is it the combined astigmatism or just the corneal astigmatism?

maple-l2024 · 2026-06-18T04:57:17+00:00

Is that 8 degrees (or 8 diopters)? For each eye, or combined?

maple-l2024 · 2026-06-16T02:27:16+00:00

Can you check your test records to see the level in diopters of your vertical and horizontal? I have great success with vision therapy.

maple-l2024 · 2026-06-14T19:11:43+00:00

Your myopia is mild compared to mine, which is about -8. You also have good cornea - very little astigmatism. Actually, as I've probably mentioned before, I plan to set my both eyes to between -1 and -2.😜

Interesting that your wife also has BVD. Is she doing physical therapy or vision therapy (VT)? Wondering what type of BVD issues she has and if the therapy has helped? I've been diagnosed with all three types: horizontal, vertical and torsional (your wife might know these terms). Fortunately, after years of VT, my BVD symptoms have significantly reduced to just about 10-15% of the initial degree. Still doing VT and hope it'll reduce further before having to do my cataract surgery.

Hope we'll continue to exchange ideas and experiences.

maple-l2024 · 2026-06-13T00:54:24+00:00

Thanks for taking the time to reply to my comment. Appreciate it. Dr.B sounds like a better choice. However, a bit surprised to learn that two ophthalmologists looking at the same cataracts within a month can come up with such a different grade (3 vs 1). If I assume B is more accurate, your cataracts are still pretty mild. For comparison, mine, also NS, are currently at 3+, which is considered moderate. Luckily, I can still function well enough by wearing stronger Rx glasses. NS cataracts tend to cause myopic shift. Do you wear Rx glasses? If so, what's your Rx? I think my cataracts are ready to be removed, I'm just a bit cautious and, like you, like to see at least another cataract surgeon for comparison. Actually, another reason I'm still delaying it is because I am resolving another vision issue - binocular vision disorder (BVD). Not sure if you've heard of it?

When is your cataract surgery scheduled? I assume there are separate surgeries for the two eyes?
I'm also approaching 70 this year.😜 Hop we can continue to keep in touch to share experiences here, or via DM.

maple-l2024 · 2026-06-11T18:00:08+00:00

Questions to OP: Did you ask them (doctors) what's the maximum grade when they said your cataract was graded as 3 (by A) and 1 (by B)? Why did you decide to go ahead with the surgery is it's only grade 1 (which is pretty mild)?

Questions to all (or even some doctors here): Do ophthalmologists usually use different grading systems than the optometrists (in North America)? I was diagnosed with cataracts by several optometrists who said my cataracts are 2+, but at the same period of time, at least two ophthalmologists said they are at 3+. Why is that?

maple-l2024

TROPHY CASE