Show HN: Refractify – Optical software against myopia

1 year ago (refractify.io)

Last summer there was an Ask HN[1] about a Nature article that said bluring the blue and green color channels on screen may be good against early myopia development. The OP wanted such software and there was none available.

So I quit my job and implemented this software, did a short video with a 3D artist about it.

Turns out marketing is expensive, so I made an open source browser extension version too.

How it works?

There is a small neural network on the retina that tries to detect if the eye is far-sighted(most people are born far-sighted), and it is producing dopamine to slow or increase eye growth rate. It is not very smart, and if you do a lot of near-work it can think you are still hyperopic, causing further myopia progression.

So, based on the refractive properties of the eye the software calculates the signal that would convince the retinal neural network that the eye is long enough, so it would produce dopamine, a known signal to stop axial eye growth. (based on myopic defocus LCA from the papers[2][3])

Some myopia control techniques work similarly, like MiSight and Hoya lenses.

Since then I got a Neurobiologist co-founder and the goal is to best understand the Retinal NN to create the best anti-myopic effect that does not interfere with productivity.

The effect can be tried live on the site. Also check out the github repo. Any questions suggestions welcome!

[1] https://news.ycombinator.com/item?id=37019143 [2] https://www.nature.com/articles/s41598-022-26323-7 [3] https://www.sciencedirect.com/science/article/abs/pii/S00144...

Wow, this is the first Hacker News post I've seen where someone actually understands myopia, emmetropization, and peripheral defocus. Every other post on myopia is filled with people guessing their own random nonsense about Bates, wearing underpowered lenses, and outdoor light. Completely unifnored. I also had no idea about the relative blur of different color wavelengths. I wonder if that's related to the possible "toxic" effect of blue LED light on the macula.

I've installed your Chrome extension and I'm eager to learn more. It's too late for my vision, but it's still getting worse for me in middle age, so I'm very interested in the state of the art based in real science.

  • Btw the Chrome plugin could use an on/off option in the context menu to help with quick comparisons.

Congrats!

For anyone who's interested, there's a group of us dedicated to natural myopia reduction at reducedlens.org, which is a free and open-source fork of endmyopia. I've even started measuring my axial length to try and get better data on if this stuff actually works (only one measurement so far though, so nothing interesting yet).

The nature paper was pretty crazy. Basically because blue bends more than red (think of a prism), it also focuses a bit sooner. This phenomenon is known as longitudinal chromatic aberration, or LCA for short. This means if you're myopic, blue might be more blurry than red, and vice-versa if you're hyperopic. The researchers in the nature paper had participants watch a movie where they straight-up blurred the blue or red with software, in order to produce fake LCA signals. They found the participants axial lengths still shortened or lengthened anyway in response.

  • ReducedLens is absolute quackery! This is why I hate myopia discussions. Myopia is not reversible, if you think it is, you don't understand what axial elongation actually means.

    • How is it absolute quackery?

      "Myopia is not reversible, if you think it is, you don't understand what axial elongation actually means."

      There was a member on the forums who was measuring his axial elongation while at the same time applying the reduced lens method. His result is shown in the following plot.[0] It is a significant improvement that can't be ignored, and can't be explained by day to day fluctuations or measurement error. So we know that at least some level of axial elongation can be reversed, and the idea is not complete quackery.

      [0] : https://i.imgur.com/J7WCNfY.png

This is very cool and exciting. It seems like a good method to reduce the development of myopia.

However, my understanding is that myopia is also simply age related. Discussions I've had recently were looking at the hardening of the lens as a factor.

I've been trying to re-train my eye with an eye chart, and I've been surprised how after just a few weeks, my vision has gotten much clearer. Going from 20/40 to nearly 20/25.

In the past few weeks I've started taking collagen to increase/maintain flexibility in the eye, and will continue with the eye exercises.

This is in no way to say that refractify is not valuable. I think it is and I'd add it to my routine.

I should also state that I have corrected my eyesight once before. When I first became a software engineer, I noticed my eyesight degrade quickly (I was in my 30s). I made a conscious effort to spend time outside looking long-distance such as reading street signs from as far away as I could. My eyesight improved dramatically. However, as I've aged, I went from 20/15 to 20/40. Note: 20/15 was examined by a doctor, 20/40 is self measured with an eye chart.

  • Could you describe a bit more about how you've re-trained your eyes with an eye chart?

    • I downloaded a Snellen chart, and put it up on the wall. I practice twice a day. I read somewhere that you can also have a closer chart and a distance chart and to swap looking at each throughout the day.

      Of course, you could memorize the letters, but that isn't really helping you. What you want to do is to focus on the blurry point, try to make out the letters. Over time, you'll slowly find that you are able to improve.

      Previously, when I was younger, I just focused on getting outside more and trying to read signs that were far off in the distance, or ensure that I was looking at far distant objects regularly.

I purchased the Windows version and uploaded the file to VirusTotal. It gave me two detections: https://www.virustotal.com/gui/file/4da40fd5c643e9c7e771b896...

  • Nah, virustotal does that stuff all the time. Two detections is low out of all the malware scanners it used. I usually just use malwarebytes.

    • Many times this warnings are triggered by the packager, but if one ignore them, what is the purpose of the scan?

      The software author should take a look if this is the case, for to change the packager's configuration (no encryption [if some algorithms in the programs are important, to protect them with through implementation, not packager ], or if the binary is small to not compress, or to adjust other params, etc), or to change of packager, or to contact with the antivirus company.

    • I understand, I’m not accusing or implying the product is malicious.

      However, I have password managers, access banking websites, etc so I’m cautious of exes from smaller developers.

      I wasn’t able to easily find the real identity of OP but the binary is code signed by a registered company it seems.

      2 replies →

This might be one of the coolest projects I’ve seen recently, are you planning on doing this for smartphones too? Also I wonder how Apple would respond there, just block it like they did Flux?

  • Thank you for the kind words. Smart phones are in progress, yes. Apple will possibly not like it as it alters the look, but we will try and see.

    • Pitch it as an Accessibility improvement.

      As someone who is -12.5 diopters in my good eye, I’m excited by the prospect of improvement.

This is brilliant, thanks for making this. I am currently trying it out on Chrome and I can feel the difference. Any future plans of bringing this to the mac? I recently made an app[1] in the similar space for mac and I would love to collaborate to bring this to the mac if you'd be interested.

BTW, all the links in your footer except privacy policy are 404s

[1] https://lookaway.app

You might be interested in endmyopia.org

Its about controlled axial length changes to the eyeball with differing methods.

  • What mechanism causes TMP activation / ECM breakdown to cause eye reshaping required to reverse axial elongation? There are no known mechanisms of this, so any claim of reversing or "ending" myopia don't have any basis.

    How do minor correction improvements anecdotally reported track choroidal thickness? Oh, they don't?

  • A deeper look into this shows that the owner of the site (Jake Steiner) is very controlling, and hides advice and information behind paywalls. I recommend reducedlens.org over endmyopia.org for this reason.

> Pre-clinical studies suggest that it may slow the progression of myopia or even prevent it.

But the video says “treating” it, so which one? I assume it’s just to prevent it but if you have it you better start looking for that Lasik surgery.

> The effect can be tried live on the site

I tried the button on both Safari (initially) and Chrome, and I'm struggling to understand if I'm actually seeing what I should see. When on, zooming in to the text shows it's turned a very slight green shade of grey, vs grey when it's off. Visually that's the only difference I saw.

Perhaps I misunderstood "blurring the blue and green channels". I expected some sort of slight but noticeable blur, ie across pixels, but should I actually be seeing _blending_ of the blue and green channels, ie colour mixing but on a per-pixel level?

Since last summer I learnt some about emmetropization, visual cues to myopia control and the state of consumer software business. Please let me know if you would like to discuss anything.

Interesting.

Is the physical screen ideal or are software solutions expected to have similar efficacy?

I wonder if it's possible to make an android app that does this globally.

What's your business model?

  • Most optical properties of myopic defocus can be simulated on screen. Since the processing is on the retina, screen altering can be effective. Android app is in progress.

This seems great, but I have 2 questions:

1. Since this is for "early myopia", does it mean it is useless for adults? If not, which groups of adults will find it useful?

2. What do you think about this and is this even related?

> The overall findings are equivocal with under‐correction causing a faster rate of myopia progression. There is no strong evidence of benefits from un‐correction, monovision or over‐correction. Hence, current clinical advice advocates for the full‐correction of myopia

https://www.tandfonline.com/doi/full/10.1111/cxo.12978

Edit to clarify, full correction with glasses should mean always seeing the sharpest picture possible

  • Thank you, 1. As long as the myopia is progressing there is an opportunity to slow that and avoid complications of high myopia. While screen altering may in principle go beyond the effectiveness of optical devices for myopia control as we can provide arbitrary input to the retinal neural network, realistically myopia reversal for adult humans is not considered achieveable. Intervention should ideally be started as soon as possible. In fact there is the possibility of delaying the onset of myopia or fully preventing it for some future generations, but obviously we are a long way off from there in terms of clinical studies.

    2. I think undercorrection is somewhat related. I have not yet read the study you linked, I usually refer to this review for undercorrection. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213207/ I think it would be possible to achieve some results that way as some of the studies from the review suggest, but in practice it is difficult to precisely control the amount of myopic defocus on the retina that you get that way. Most of the time you get no myopic defocus at all due to accomodation and with strong undercorrection you risk losing the visual cues to the sign of defocus, which results in deprivation myopia. I think this is the reason that MiSight contact lenses are known to be effective, while naive undercorrection has mixed results at best.

    • May I suggest an anecdote on why some studies have reported undercorrection progressing myopia: as my far sight deteriorated, without correction, I had more incentive to do "near work" like look at screens or look at books (because they were not blurry), than spend time outdoors (because they are a little blurry).

> This makes the screen look on the retina naturally as if it was at a greater distance.

You can also do this the low tech way by using dirt cheap plus lens glasses. With the added benefit that they make a tiny phone screen look as huge as a cinema screen.

  • If you induce myopic defocus by plus lenses you create an urge to move the screen closer, which removes the effect. We need to achieve the right defocus on the retina. Wheres with the software solution you can not "cheat" by moving closer.

    • That’s true. Tends to shift the problem towards having horrible posture.

Sorry, but when there is no solid scientific verified foundation but you already selling software for $12 a piece I call it snake oil.

> The participants were asked to watch binocularly a movie on a large TV screen (65 inches, LG OLED65C9, 4 K, 2019) at 2 m distance in a dark room. > With a video format of 1280 × 720 pixels

So you have to work in pitch dark room for this approach to reproduce, no thanks.

Will this increase the risk of hyperopia? Afaik its common people are both myopic and hyperopic at the same time