Myopia Reduction and Astronaut Training

There is Astronaut Training of the Sheila Frick and Mary Kawar variety.

And then there is another kind of astronaut training making the news which was brought to my attention via a comment by Tom  Headline, COVT on the VTPU Facebook page, regarding Mike Massimino.  Prior to reading this, the only Massimino I had heard of was Rollie, coach of the 1985 Villanova Wildcats (the lowest seeded team to ever win the NCAA championship).  You can read about the story in Mike’s experiences in his book, Spaceman: An Astronaut’s Unlikely Journey to Unlock the Secrets of the Universe.


On page 52 we learn that Mike’s Rx was -3.50 in one eye and -4.00 in the other eye, well below the amount of myopia for which one could qualify for NASA’s unaided visual acuity standard.  He tried orthokeratology and it worked to improve his unaided VA, but he was then medically disqualified based on his corneal topography and inability to be corrected to 20/20 (he confesses that he wore his orthokeratology contact lenses too long without having them checked, and their poor condition resulted in his warped corneae).

Bob Gibson (not the Cardinals’ pitcher) and Keith Manuel were the two optometrists who worked for NASA.  Their job was to conduct the eye exams and report the results to the flight surgeons who made the final recommendations on medical fitness to the selection committee.  The acuity test that they used involved a “Landolt C” machine which flashed the letter “C” with its gap in various orientations – a more stringent visual resolution task than the standard Snellen Chart.

Landolt C

Mike’s results were, in his words, a disaster.  (A sad irony occurred to me, thinking of about the broken “O” ring as the source of the space shuttle Challenger disaster.)   Steve Smith, Mike’s neighbor, gave him the best advice he received: “You have to look at this like any other engineering problem.  You have to collect all the information an data you can, and figure it out.”  It was at that point that Mike began looking into vision training, which he describes as follows:

“Vision training is a program of exercises that teaches you how to relax your eye muscles in order to improve your unaided acuity.  It’s not a miracle cure, but it can give you incremental improvements, which was what I needed.  It just takes time … I found an optometrist who specialized in vision training, a woman named Desiree Hopping.  First she gave me a new pair of glasses with under corrected lenses; they would take the strain off my focusing system and help my eyes to relax.  Then she gave me some exercises.  There was one where I had to stare at a bunch of marbles spaced out on a string at different intervals, shifting my focus to each one.  I had to stare at different eye charts at different distances, the idea being that I would train my eyes to relax and focus on an imaginary point beyond where the eye chart is, causing the letters on the chart to appear sharper.  These exercises required deep, deep concentration …

From the 26:00 through 30:00 minute mark of an interview through the Royal Institution in London, Mike comments on his experiences with orthokeratology and vision therapy.   To which the interviewer aptly observes: “Where there’s a will, there’s a way”.

7 thoughts on “Myopia Reduction and Astronaut Training

    • Point well taken, Dr. Dan. So let’s do that. We don’t know how much of Massimino’s improvement was a result of reduced minus lens power, blur interpretation, or a combination thereof, because he didn’t report in the book on what the changes wherein his refraction of what his endpoint acuity was at the time he passed the retirements. (I suppose Dr. Desiree Hopping could shed some light on this over a beer at an AOA or COVD meeting.) Way back when, I did a literature review review on Myopia (Press LJ. Annual review of the literature: Myopia. J Optom Vis Devel 1986:18(1) :1-17), I pointed out the use of operant conditioning and behavioral modification programs to improve unaided acuity. Leber and Wilson published a study in JBO in 1993 using computer driven behavioral techniques, referring to it as Myopia Reduction Training:

      Click to access 4-4%20Wilson.pdf

      So I’m comfortable putting this under the heading of “Myopia Reduction” or “Myopia Control”, even though the jury is out on how much measured myopia (based on retinoscopy, or subjective minus lens to 20/20) actually is reduced, though again your point is well taken.
      By the way, in the book Massimino describes how he trained himself on improving on taking the Landolt C test at Emory University that was identical to the one the NASA ODs used – supporting your point about blur interoperation. Then again, what are the factors that allows one’s visual resolution of detail on Landolt C’s to improve? He also described how important it was for him to be relaxed during visual acuity testing. He relates the experience of having an optometric extern berate him for messing up her attempts to do refract him during one of the measurement sessions (the NASA ODs were adjunct faculty at U. of Houston College of Optometry) – that he wasn’t cooperating and therefore the measurements were fluctuating. All in all, a section of the book you’d enjoy reading.

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