Subject:  Who is responsible for inducing fundamental change?
         You or the OD?  Who has the motivation to start
         a process of fundamental change (for prevention)?
         Who suffers the consequences of over-prescription
         of a minus lens?

Re:  Raphaelson "solved" the problem of
    nearsightdness-prevention 100 year ago.
    (Read Chapter III, "How to Avoid Nearsightedness")

    Yes he did!  And what happened -- the "Printers Son" rejected
it.  So that was the end of that.  So the consequence of that
rejection (-1/2 diopter per year) must be the responsibility
of the person who did the rejection -- in my opinion.

    So now the great majority of ODs "talk around" the subject --
never pointing to the child's "bad habits" as being directly responsible.
Regretable.

    If some one gave me "straight, honest talk" about this issue
-- then I MIGHT be able to do it myself.  If I do not -- the
responsibility rests on me -- alone.

    Here is "Dr.Judy" and her artful ways of avoiding that
issue.  As she, says, most people have no interest, and
for them perhaps there is no answer other than the minus lens.

    For your thoughtful review.  True responsibility rests
with all of us.

    Best,

    Otis

    ******

Subject:  The OD Cop-out.

    Or why a large number of ODs believe that they have no
responsibility to discuss true-prevention with you.

Re:  > So, even if near work causes myopia -- and the
      plus-lens use prevents it -- how do we avoid the risk causing
      moderate to high hyperopia in 75% and illiteracy in 100% to save
      25% of children from myopia?  DrJudy.

    Dear Friends,

    "Dr" Judy has jumped to a whole series of false conclusions
about the correct use of the plus lens at the threshold.

    I will say this -- if anyone wants to "work" this issue of
true-prevention they should stay away from Dr.    Judy -- as far
away as possible!

    She uses a false concept "the box camera theory" to describe the eye,
i.e., a focal state (emmetropia, 0.0 diopters) is the normal eye.
That means, automatically that you are either "nearsighted" or
"farsighted", i.e., myopic or hyperopic.  There is no such thing
as a "normal eye".

    Once she gets away with using these "false words" to describe
the natural eye, she then can say almost ANYTHING she wishes to
say -- however mis-leading and evasive.

    The entire process of "clearing" your distant vision from
-1.5 diopters to +0.5 diopters means that the natural eye MUST
change its refractive status by +2.0 diopters, i.e., you go from
"myopia" to "hyperopia".  Thus your eyes are NEVER normal,
by using the "false words".

    She then talks about "causing" hyperopia, as though it is a
TERRIBLE situation in an adolescent!

    In fact, the natural eye (in a open environment) has
refractive states that are all positive -- 0.0 to +2.0 diopters.

    To call natural and normal refractive states "defects" or
"errors" boggles the mind.

    I have no idea where she gets the "...  and illiteracy in
100% to save 25% of children from myopia".  First of all, I do
love to read.  Secondly, I do not like becoming nearsighed -- if I
have a choice to avoid it -- even if it DOES REQUIRE that I always
use a strong plus for all close work.  That is MY CHOICE.  I only
need to be taught HOW to use the plus correctly.  The rest must be
up to me.  I would appreciate clear information about this effort
being supplied by Dr.  Judy, since I judge that she is OBLIGATED
to supply that type of information.  Any hope she ever will do
that?

    If this "Dr Judy attitude" is true for 99 percent of the ODs
-- that she is going to do NOTHING for prevention, for fear of
"causing 100 percent illiteracy", in the population, then that
"forces the issue".  It this a statement of a person with any
common sense at all?

    I now have no choice but to learn from other sources (other
than Dr.  Judy) how the eye actually behaves, and apply that
knowledge to my own preventive efforts.

    I have developed my site to help a others learn of these
issues.  I truly hope that a more positive attitude could be
developed in "Dr Judy", but for now I know that is impossible.

    Best,

    Otis

    ________________________

From:  Sci.Med.Vision

Cathy> Please, provide some evidence that the environment for
      myopes differs from that of non-myopes.

Judy > Myopes are known to have a reduced sensitivity to retinal
      blur...to myopic blur.  They are quite responsive to
      hyperopic blur.

Cathy> Are you saying this reduced sensitivity to myopic blur,
      which explains why their eyes do not notice that they have
      become myopic and therefore do not self correct, is not
      genetic?

Judy > ...and an increased rate of growth of the posterior chamber
      of the eye even before they become myopic.

Cathy> As they passed from hyperopia to emmetropia before becoming
      myopic?

Judy > Yes, most myopes pass from hyperopia to emmetropia before
      becoming myopic.  Most myopia does not develop until after
      the age of 10, before that they are hyperopes.

Judy > Size of the eye, corneal curvature and refractive error in
      babyhood / early childhood (all congential features) can be
      used with some accuracy to predict who will become myopic
      later in life.  Numerous studies have studied populations
      of myopes for common factors; family history remains the
      single best predictor of and risk factor for myopia.

snip -------------

Judy > But I can't see a practical way to change the environment:
      if we restrict near work and reading and use plus lenses
      for all children we risk causing moderate to high hyperopia
      in 75% and illiteracy in all to save 25% from myopia; not a
      good risk/ benefit ratio.

[Otis:    This again boggles the mind.  The "practical" manner is that you
       use the plus to change the accommodation signal.  Jeeze!  
       Further, here she goes again with "causing
       hyperopia", which in broad perspective, means helping the
       eye to change to a normal and valueable positive refractive
       status! OSB]

Dr Judy

Cathy> Thank you for acknowledging the negative effects of
      excessive near work and the positive effects of plus
      lenses.

Judy > I am not acknowleding them, only stating that IF they
      exist, then how do we provide a practical treatment.

[Otis:    Notice how DrJudy does not acknowledge ANY FACTUAL,
       SCIENTIFIC TRUTH as she manages to maintain her position as
       "expert".  OSB]

Cathy> They are too big a risk for emmetropes and hyperopes.  How
      is it that you can name a bunch of myopia predictors -- but
      can't see how to treat only those who exhibit those
      predictors?  As I've said before, only those children
      exhibiting myopia need countering plus lenses.  Certainly
      those who have trouble seeing can be distinguished from
      those who do not.

Judy > We can determine who is actually myopic on an individual
      level.  Human clinical trials have not shown any
      significant effect in treating myopes with plus.

[Otis:    Here again Judy is selective.  Only the screwed up
       bi-focal studies "count".  The "quality study" by Francis
       Young is not mentioned nor respected -- even as "the second
       opinion".  OSB]

Judy > The other predictors that are present before myopia exists
      only work on a population level, i.e., a population with a
      family history of myopia, high corneal curve etc will have
      a greater risk of developing myopia.  On an individual
      level, the normal range is so large that it is not really
      possible to pick out individuals who will become myopic
      with enough certainty to risk treatment.

[Otis:    "Risk Treatment?" What is the risk?  That the individual
       will clear his vision by getting his refractive status to
       move from a negative value to a positive value?  What
       about the risk of the minus lens -- that you will develop
       "stair case" myopia?  I guess that responsibility is
       assigned to the person as his "bad heredity", never a
       "responsibility" of Dr.  Judy.  I bet she never mentions
       any of these minus-lens risks when she places that first minus lens on
       a child.  The worst part of this is that the "Dr.  Judys"
       will sit on the "Boards of Optometry", and virtually
       control all the other optometrists to follow this "party
       line".  OSB]

Judy > For example, the group with "K" readings above the population
      median will have a higher percentage of myopes than the
      group with K reading below median, but there will be a
      number of individuals who are not myopic in the above
      median group and a number of individuals who are myopic in
      the below group.

[Otis:    Wow!  The "risk factor" for nearsightedness is:

1.     Your refractive status is 0.0 to -1/2 diopters.

2.     Given that the "bifocal" studies show a standard -1/2 diopter
      per year, it follows that it is virtually certain that the
      person will get very seriously nearsighted if NOTHING IS
      DONE TO PREVENT IT.

3.     Dr Judy feels she has no responsibility to mention any of
      these issues to the person.  Obviously, in HER MIND, it is not HER
      RESPONSIBILITY.    Therefore it must be the responsibility of
      the poor child that is going to get a strong minus-lens.]

Judy > So, even if near work causes myopia -- and plus-lens use
      prevents it -- how do we avoid the risk causing moderate to
      high hyperopia in 75% and illiteracy in 100% to save 25% of
      children from myopia?

[Otis:    After all of this, I strongly suggest that the plus is the
       "second opinion" that MUST BE ACCEPTED before the minus
       lens is used.  If the parents and child REJECT the plus at
       the threshold -- then for that child, true prevention is a
       "lost cause".  But the real issues is "who is responsible"
       -- because sure as hell, Judy is taking no responsibility!]

Best,

Otis

Dr Judy