Show HN: Refractify – Optical software against myopia
refractify.ioLast 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. Are there any publications you can point me to that show the techniques there are ineffective? Your eye's axial elongation is caused by the eye growing longer, which means *more cells in the eye.* Your eye grows in response to visual stimulus, without the brain's involvement. Your eye shape physically changes by *extra cell production* to cause axial elongation. This process is called emmetropization. It's extremely well understood. Peripheral defocus lenses and low dose atropine are proven to work in reducing speed of myopia progression because they reduce the stimulus causing the eye to elongate. Let me say that again: The way axial elongation happens is well understood, and we have known interventions to interfere with the growth stimulus. We know how to control myopia. There is no known way to reverse this growth process. The only scientifically proven intervention for reducing myopia is surgery. There is no concrete evidence of for any other intervention, nor is there any other known mechanism for causing the eye to reshape itself to reduce axial elongation. For the eye to become truly less elongated, your body has to break down the extra cells in the eye and cause reshaping. An example of this is wound healing: your body breaks down the ECM with TMP activation. We know how the *opposite* works, the eye grows in response to overfocus to find focus. When too much is in focus in your peripheral vision (near work, holding things close to your face), the eye thinks it's over-focusing, and physically grows to find focus. Near work is the issue. Outdoor light probably isn't the issue, it's probably because when you're outside, you're not doing near work. For those who do experience improvements, it's not from changes to the cellular structure of the eye. There are multiple temporary known mechanisms for your eye changing focus. One of them is the thickness of the choroid, a tissue layer in the back of the eye. Another is possibly muscular, your axial elongation is known to show variable diopters during the day (maybe +-0.25 but I don't know the actual variance). Studies do show fast-acting axial elongation reduction (minutes to hours) in response to defocus, but this is obviously not from the eye reshaping itself, so this is obviously not reversing myopia, this is just changing temporary variables in the eye. For the majority of people who report "reversing" myopia, it is usually a negligible change (2 diopters) which is easily explainable with these mechanisms, rather than the false belief it's actually changing the elongated eye shape. Ortho-K is another known temporary / superficial intervention. The burden of proof of truly changing the axial elongation and fundamental structure of the eye cells is on you, and on the EndMyopia quacks. There are no studies that demonstrate significant diopter changes that would demonstrate the eye is reshaping itself to actually reverse myopia. You are welcome to find the studies on the Bates method and wearing undercorrected lenses yourself, they don't work and possibly make things worse. Ok, here's proof of axial length changing following application of the method for years: 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. Also the reduced lens method has nothing to do with the Bates method, or undercorrection that leads to blur adaptation. > "The only scientifically proven intervention for reducing myopia is surgery" Which surgery reduces myopia? If you're thinking of LASIK then it doesn't change axial elongation. Great. I would love to be proven wrong. My partial blindness from myopia related diseases will likely progress to full blindness as I age. I would love to be shown my worldview is wrong. For example, I didn't know anything about relative light color refractive differences until this HN post. I hope that science discovers a previously unknown mechanism or method for reducing axial elongation. I also wish that eye doctors knew about the existing evidence. I wish that all opthamologists knew how emmetropization worked, I wish all lenses were peripheral defocused, and I wish more eye doctors prescribed low dose atropine to children, because the evidence is clear. And I sincerely hope that more eye doctors get sued for not using these tools in their practice. Ignoring science based evidence of myopia control in a field where you only need to know about 20 things is negligence. Proving axial elongation is reversible is not done by a n=1 pet theory forum post measured in a home lab by someone who doesn't know what their choroid is. These forums are filled with people with mild myopia, not high myopes, who are "just starting my journey!" or "I had a small correction and I plateaued!" but are still zealously telling everyone else how to reduce their myopia. n=1 is fine for Reddit tier evidence, but without studies, it doesn't matter. What is the source post of this? Is this chart really showing 0.1 millimeters of vitreous chamber depth change over 4 years? That almost sounds irrelevant, so maybe I'm missing something. 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. Apropos reducedlens.org, are there any effective interventions so far? 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. I will submit a request for exception/deeper review to the vendor that flagged the exe. I can also offer a full refund and reversal of the sale if you can not make use of the software at the moment due to your security concern. The exe and the installer are signed by the company I established for the project Refractify LLC. Thanks. Your response reassured me. I've ran the app and it works as described, finally, no suspicious behaviour was observed with procmon. here's the effect at 100% strength: https://imgur.com/a/PfrIsex and a more reasonable 35%: https://imgur.com/a/doT8YKd Thank you, the demo was not working for me on their site! 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 I would love a mac version! The Mac version is in progress. How about Linux (Ubuntu, Mint)? There's a section of the page that says: >Get notified on future versions(including Linux) and clinical studies! why paid ? Developer license maybe? self sign 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? I don't know what that means - All I have are my own anecdotes and others. https://www.youtube.com/results?search_query=endmyopia+resul... I personally went from -3.0 diopters to almost 20/20 vision. So either I'm experiencing a fabulous placebo or the 'known mechanisms' aren't as comprehensive as we've been led to believe. Sorry, but I know EndMopia believers don't know what the choroid is. Science knowledge is terrible in this space. An arbitrary "correction" of two diopters is within the margin of error of the possibility of initial overcorrection, choroid changes, inherent small variability in eye tests, and tricking yourself into believing your vision is better than it is. -3 is trivially myopic, but if you do manage a 4 diopter change, verified by an ophthalmologist, not an optometrist, then you would be a medical miracle and worthy of multiple case studies. Get on it if that's the case! fabulous placebo, got it! 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. Looking forward to it, thanks! I signed up for your email list. 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 What's the deal with why it isn't available on Firefox? Applying multiple svg filters on top of each other in the needed order resulted in Firefox dropping the filters completely. I filed a bug for Firefox: https://bugzilla.mozilla.org/show_bug.cgi?id=1873644 As soon as it is fixed there will be a Firefox extension, and the live demo on the site will start working.
