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Medical Forum / General / Vision / October 2004Jan, Why should the "prevention" concept be destroyed?
Dear Jan, Subject: "I declare that Otis' idea about preventing myopia in humans must be destroyed." Jan (normally Dutch spoken) It is still not clear why Jan wishes to destroy our concept that concerns nearsightedness prevention with a plus. (i.e., Otis' concept must be destroyed.) Please be more articulate and accurate concerning you idea that the natural eye is not dynamic -- with respect to its average visual environment. (i.e., the AVERAGE value of accommodation.) If you stated that you do not "like" the concept of the dyanamic eye, then that would be fine with me. But "destroy". Why? POINT #1 Medicine is a field of the "second opinion". There is no dishonor in expressing a belief about objective scientific facts -- that differs from the "majority opinion". I would never say that "the second opinion" should be "destroyed". Why do you make that statement about our belief and expectation that then natural (primate) eye is dynamic as PROVEN by direct experimental measurements. POINT #2 Statement: Theodore Grosvenor of the University of Houston College of Optometry -- a proponent of the role of bifocals in the prevention of myopia -- insists that persistent close work causes myopia. He stated that, "Once the eye has started to stretch, it may be too late to keep it from stretching," he says, explaining that most of the children in the study had already become myopic. "The ultimate study would be to put reading glasses on first-graders before anyone has developed myopia," he says. Since my statement about true-prevention is IDENTICAL to Dr. Grosvenor's, I fail to understand why my concept of the natural eye's behavior "must be destroyed". Are you stating that Dr. Grosvenor's opinion must be destroyed. Please explain. POINT #3 Quite a few ODs are aware of the experimental data (primate, adolescent) that shows that the refractive status of the test group goes "down" relative to the control group. You choose to totally ignore this type of repeatable, scientific data and proof. I affirm that this data must be part of science. You insist that this type of scientific proof it MUST NOT be part of "your" science. Should your unique concept of science be the ONLY concept allowed? POINT #4 While it might be very difficult for an OD to offer "correct use" of a plus lens -- that is hardly an excuse for believing that a minus lens has NO EFFECT on the refractive status of the eye. The second-opinion is that the minus lens as an "undesired" secondary effect as stated below. Should their honest opinion about the effect of the minus lens on the eye's refractive state "be destroyed". Please explain. Statements: No clinical or statistical studies have ever demonstrated the long-term safety of a (minus) "corrective" lens. Here are sample excerpts from the professional literature voicing concerns about the safety of (minus) "corrective" lenses: "The use of compensatory lenses to treat or neutralize the symptoms does not correct the problem. The current education and training of eye care practitioners discourages preventive and remedial treatment." R.L. Gottlieb, Journal of Optometry and Visual Development, 13(1):3-27, 1982. "The emphasis on compensatory lenses has posed a problem for many years in our examinations. These lenses do not correct anything and may not serve the patient in his best interests over a period of time." CJ. Forkiortis, OEP Curriculum, 53:1, 1980 "There are frequently ignored patterns of addiction to minus lenses. The typical prescription tends to overpower and fatigue the visual system and what is often a transitory condition becomes a lifelong situation which is likely to deteriorate with time." S. Gallop, Journal of Behavioral Optometry, 5(5):115-120, 1994 "Single-vision minus lenses for full-time use produce accommodative insufficiency associated with additional symptoms until the patient gets used to the lens. This is usually accompanied by a further increase in myopia and the cycle begins anew." M.H. Birnbaum, Review of Optometry, 110(21): 23-29, 1973. "Minus lenses are the most common approach, yet the least likely to prevent further myopic progression. Unfortunately, they increase the near-point stress that is associated with progression." B. May, OEP Publications, A- 112, 1984. Jan -- please explain with this judgment of your fellow-ODs "should be destroyed". I believe they are correct in their belief about the proven effect the minus lens always has on the refractive status of the natural eye. Why do you believe otherwise. At least acknowledge that you express only the "majority opinion", and that we all should respect the "second' scientific opinion. Let us just be candid about this. The minus lens is "easy", and prevention with the plus is difficult. But prevention is not impossible as you want us to believe. POINT #5 Since I agree strongly with the second opinion, as expressed above, I fail to understand why the concept of the dynamic natural eye "must be destroyed". The method of the minus-lens was put in place 400 year ago for one good reason. It worked instantly. I agree that is a good "selling point" for the minus lens, but I doubt that you could say the "works instantly" constitutes "scientific proof". Pleas submit SCIENTIFIC proof that the minus lens has NO EFFECT on the refractive status of the fundamental primate (adolescent eye). That is how you resolve scientific questions concerning the dynamic behavior of the natural eye -- not by insisting that the concept "must be destroyed" with no further articulation. Best, Otis Engineer cc Scientists, optometrists, engineers, and students interested in promoting effective prevention with a plus lens at the threshold of nearsightedness. (Listed on www.myopiafree.com) > Here are sample excerpts from the professional literature > voicing concerns about the safety of (minus) "corrective" lenses: "Voicing concerns?" Is that your evidence? > "The use of compensatory lenses to treat or neutralize the > symptoms does not correct the problem. The current education and > training of eye care practitioners discourages preventive and > remedial treatment." R.L. Gottlieb, Journal of Optometry and > Visual Development, 13(1):3-27, 1982. No statement is made concerning the safety of minus lenses. There is good reason why the education and training of eye care practitioners discourages preventive and remedial treatment. It's because those treatments have never been shown effective, and because those who promote such treatment are considered charlatans by pediatricians as well as authoritative vision researchers. > "The emphasis on compensatory lenses has posed a problem for > many years in our examinations. These lenses do not correct > anything and may not serve the patient in his best interests over > a period of time." CJ. Forkiortis, OEP Curriculum, 53:1, 1980 "May not serve" is not evidence of the effectiveness of preventive or remedial treatment. > "There are frequently ignored patterns of addiction to minus > lenses. The typical prescription tends to overpower and fatigue > the visual system and what is often a transitory condition becomes > a lifelong situation which is likely to deteriorate with time." S. > Gallop, Journal of Behavioral Optometry, 5(5):115-120, 1994 Correlation does not equal causation. There is no evidence offered that increasing myopia is due to neutralizing correction. > "Single-vision minus lenses for full-time use produce > accommodative insufficiency associated with additional symptoms > until the patient gets used to the lens. This is usually > accompanied by a further increase in myopia and the cycle begins > anew." M.H. Birnbaum, Review of Optometry, 110(21): 23-29, 1973. Correlation does not equal causation. > "Minus lenses are the most common approach, yet the least > likely to prevent further myopic progression. Unfortunately, they > increase the near-point stress that is associated with > progression." B. May, OEP Publications, A- 112, 1984. Statement contrary to fact. Myopes who wear glasses part-time evidently get WORSE than those who wear them full-time. > Let us just be candid about this. The minus lens is "easy", > and prevention with the plus is difficult. But prevention is not > impossible as you want us to believe. Conclusion without evidence. Your citations are from journals and publications that are not subject to peer review, and even so they provide no data to substantiate your claims. -MT > No statement is made concerning the safety of minus lenses. There is good > reason why the education and training of eye care practitioners discourages > preventive and remedial treatment. It's because those treatments have never > been shown effective, and because those who promote such treatment are > considered charlatans by pediatricians as well as authoritative vision > researchers. The real charlatans are you doctors who ARE NOT ABLE to cure anything, neither a very simple incepting refractive error nor a deep troubled macular problem. You haven't got any clue whatever. You just go on playing with harmful things, like spectacles, drugs and laser butchery. No patient feels good after has visited one of your offices. The theories on which you base your so called "work" are contradictory. In year 2004 you still believe in the lens as being a factor in accomodation, and still you believe in the iris having something to do with "depth of focus" effect. Now these two things are very easily decided by the own efforts of the intelligent patient, that learns, on will, to watch himself and his own feelings about the eyes, and see very clearly that these two "scientific" beliefs are just "made up" to go on and on in selling your false services. If somebody of the intelligent readers here want to enter into the truth of perfect sight and how to achieve it, please visit http://TheCentralFixation.com > In year 2004 you still believe in the lens as being a factor in > accomodation, It's clear you've never measured accommodation after cataract surgery. > and still you believe in the iris having something to do > with "depth of focus" effect. It's clear you've never used a 35 mm camera. -MT > > In year 2004 you still believe in the lens as being a factor in > > accomodation, [quoted text clipped - 7 lines] > > -MT Remark: Depth-of-focus (or optical dead-band) has an estimated value of +/- 0.3 diopters in room illumination and about +/- 0.6 diopters in sunlight. Yes Rishi, depth-of-field, is part of the concept of the optics of the natural eye. Best, Otis Engineer >> > In year 2004 you still believe in the lens as being a factor in >> > accomodation, [quoted text clipped - 16 lines] >Yes Rishi, depth-of-field, is part of the concept >of the optics of the natural eye. You all think that the camera and the eyes are alike. To what extents are they alike ? Very very small. Why you all use the photgraphy analogy only about depth of field and neglect the analogy about eye muscles changing the lenght of the eye ? The eye and the camera have only small things in common, they are two completely different things. Imperfect sight is MUCH more than out of focus images, because it is a mental thing. > > > In year 2004 you still believe in the lens as being a factor in > > > accomodation, [quoted text clipped - 16 lines] > Yes Rishi, depth-of-field, is part of the concept > of the optics of the natural eye. I started using cameras at age 12. Perhaps my sight was ruined when I tried, in the dark room, to develop pictures and see the black of black as less black, such an idiotic act, I understand. Perhaps there I lost the correct imagination of black, pretending to clarify it... If +/- 0.6 dioptres in sunlight is the maximum contribution to focussing given by the diaphragm of the eye, I wonder how I can see 15/10 at 200 meters on the church's clock letters with 5 dioptres of myopia... Some scientist should explain this to me. Otis, please explain this to me and also to Mr. Tyrner. By the way, if I stare at the clock, the numbers go numb quickly, despite the depth of focus given by the sun. Also, there are moments when the sun is difficult, expecially when you come from indoors, and you need few minutes (or seconds) to get accustomed. Before that, I cannot resolve any number on the church's clock at 200 meters. Where is the depth of focus? Then there are other peculiar experiment any intelligent people can do: for example with license drivers plate on the back of cars. One who is trained in the cure of imperfect sight by means of rest methods, can verify that if he starts from FAR away, let's say, more than 20/10 distance, he can see the plate but the numbers are black. Then he comes closer step by step... Then, it is amazing, ALL OF A SUDDEN, the plate comes out plain and clear, and you read it. There were only few cm between unfocus and focus. Now you please explain. People interested in this stuff, please visit http://TheCentralFixation.com. > If +/- 0.6 dioptres in sunlight is the maximum contribution to > focussing given by the diaphragm of the eye, I wonder how I can see > 15/10 at 200 meters on the church's clock letters with 5 dioptres of > myopia... It's a mistake to talk about depth of field/focus in terms of diopters: Focal length and depth of field are different things. Depth of field is related to (and increases with) luminal coherence. Light passing through a small aperture is more coherent than light passing through a larger one, and so depth of field is greater (the "circle of confusion" or "blur circle" is smaller). In addition, diffraction and abberation are reduced with increased coherence. At a guess, I'd say that these effects are more significant than the increase in depth of field.  SignatureIf you can see the FNORD, remove it to reply by email. > In addition, diffraction and abberation are reduced with increased > coherence. At a guess, I'd say that these effects are more significant > than > the increase in depth of field. Disposable cameras have no focusing adjustment, yet they focus from 5' to infinity. I've always heard this was a result of their small aperture and depth of field, not from reducing aberration or diffraction. Pinhole cameras work similarly, and I'm not sure how "aberration" applies to them. In pinholes, diffraction increases as the hole gets smaller. Below 3/4 mm, with monochromatic light, you can get newtonian rings. -MT > > In addition, diffraction and abberation are reduced with increased > > coherence. At a guess, I'd say that these effects are more significant [quoted text clipped - 12 lines] > > -MT Dear Mike, I think both of you are correct. For large apertures, simple gemetric analysis provides the better answer. When the aperture gets down to 1 mm, difraction effects are used for analysis. It is my understanding that the human eye goes down to 2 mm -- unless drugs are used. A smaller aperture also limits the effect of abberation, coma, and other imperfections. The eye is operating at the limit of what is possible for a 1 inch (optical) camera. Best, Otis Engineer > Dear Jan, > [quoted text clipped - 5 lines] > that concerns nearsightedness prevention with a plus. (i.e., > Otis' concept must be destroyed.) Simple, you can't provide ANY scientifically proof your idea works in humans The only text you provide once in a while is a bunch of repeating blabla.......nothing new. And please Otis don't try to explain again the same old boring stuff you already have. A major snip in a bunch of repeating stuff by Otis............................... SignatureFree to Marcus Porcius Cato: ''Ceterum censeo Carthaginem esse delendam" I declare that Otis idea about preventing myopia in humans must be destroyed. Jan (normally Dutch spoken) Dear Jan, Subject: Putting all the scientific cards on the table. IMAGINATION: "What we can see is only a small percentage of what is possible. Imagination is having the vision to see what is just below the surface; to picture that which is essential, but invisible to the eye." After discussion with Dr. Jacob Raphaelson, it was clear to me that the confines of an optometrist's office prevented scientific work towards a long-term solution for the prevention of nearsightedness. This was not due Raphaelson's technical failure or lack of desire to prevent a negative refractive state of the eye, but rather to the "attitude" to the patient, who completely lacked both motivation and understanding of the necessity of true-prevention (with the plus) at the critical "threshold" level of -1/2 to -1.0 diopter (20/50 to 20/70 level) of myopia. Missing from this discussion was the knowledge that if nothing is done, the child's vision will move "downward" at a rate of -1/2 diopter per year. My interest then turned to establish EXACTLY what the experimental data tells us about the behavior of the fundamental -- or natural eye. This the REQUIRES a simpler form of testing. That means we stop making assumptions about the eye, and use simple words like the "refractive status" of the natural eye (that can be plus or minus), and we talk about our ability to control (with precision) the "input" visual-environment. The result of this type of intellectual and physical testing can not reveal the "cause" of any defect, but only the built-in behavior of ALL natural eyes. [Since this point is totally ignored I must state it explicitly. When you wish to establish a characteristic of all eye you must test ALL EYES, or a sub-set of ALL NATURAL EYES. If you don't do this you can never reach a conclusion about the eye's behavior.] [Further, you must assume that the proven behavior of all natural eyes, must also be the behavior of each eye in this "population" of natural eyes.] [To subvert or deny, or change-the-subject means no more effective SCIENTIFIC discussion. Once someone REJECTS this analytic evaluation -- the possibility of any further intelligent discussion is ended.] When someone "in authority" can sweep 50 percent of these cards "off the table" -- then she controls the perception of the eye's behavior. This is the effect of "Dr Judy's" statement about what "scientific" data is "on the table", and what scientific facts are to be TOTALLY IGNORED. To wit: Re: "Any hypothesis for prevention of myopia that is based on the evidence from animal studies is based on evidence that is irrelevant to humans." Dr Judy From the discussions with Dr. Judy and others it was clear that ALL the ODs on sci.med.vision agreed with the above statement. I would suggest that this "belief" separates a pure engineering-scientific approach to understanding direct-measurements, versus the conjecture that all refractive states are "errors" both plus and minus, which constitutes "OD-Science". If Dr. Judy stated that prevention is almost impossible -- I would agree with her. If she insisted that she can not deal with the great mass of people who want ONLY a instant quick-fix, I would agree with her on that point also. It is not HER job to supply the motivation and support for prevention. But when she insists that the natural eye does not go down from: 1. A forced negative change in the visual environment and 2. The forced wearing of a minus lens. The I must emphatically DISAGREE with her thesis, and her habit of excluding all SCIENTIFIC data she chooses to ignore. The truth is in that type of scientific data. A massive amount of DIRECT experimental data collected over that last 40 years confirms absolutely that the natural eye does the above action -- always when correctly tested. It is the "signature" of a control system that is important in a scientific sense at this point. The "engineering" approach simply asks to test "input" versus "output" questions concerning the natural eye's behavior. There is no mystery here at all. Either all fundamental ANIMAL PRIMATE eyes do this -- or they do not. Either a population of natural eyes is dynamic, or they are not dynamic. If not dynamic, the prevention with a plus would be impossible, and a "fraud", to put is bluntly. But the question can be resolved not in terms of "medical judgment", but in terms of repeatable objective scientific facts, where any intelligent engineer could understand both the nature and purpose of this type of testing. Since we can measure the refractive states of all natural eyes, (the output) and we can control the "input" (a delta in the visual environment) we simply can not fail but to draw the correct conclusion. On a "scientific" level this is a certainty. On "Dr. Judy's" level, this type of perception can not exist, and is prohibited because she can sweep all these scientific cards off the table. If these truths separate "medicine" from "science", then so be it. But that is my understanding of the "bias" of optometry, and why there is necessarily a separation between these two fields of intellectual interest. So when I "argue" the behavior of the fundamental eye and proof, I would take the above perceptions into consideration. This is why I use the term "refractive-state" to describe the eye. If someone reacts with "anger" from that statement, or wishes to "twist" my statement, then I must consider that he has been taught an incorrect perception, and he can not escape it. But using her position as an OD to deny all factual data, is not they way to do scientific research. Best, Otis ___________________________________ P.S. Here is some more of the discussion for your interest: Thanks for your commentary on your decision to exclude all DIRECT experimental-scientific data proving the dynamic behavior of both the monkey-primate and human-primate adolescent eye. With this enforced total exclusion of ALL SCIENTIFIC data (primate eye testing) it is hardly surprising that you have no idea or concept of the behavior of the natural eye -- let alone any concept of preventing the development of a negative refractive state for the fundamental eye. Equally I am certain you are sincere in your "office" or mind-set. An actual solution can only occur when the person concerned with the issue of true-prevention actually pays attention to this objective-scientific data, and realizes how totally you exclude this critical scientific data from your mind. That indeed does define the separation between a pure-medical approach and a pure-scientific approach to defining and testing the eye's natural behavior. Best, Otis _______________________________________________ Subject: Judy's attitude excludes almost all scientific research -- except for her own (passive-eye) opinion. More recent animal studies suggest that accommodation in not a factor in eye growth stimulated by minus lenses. There is no confusion here for me; neo-natal animal eyes do not provide a model for non neo-natal human eyes. Animal eyes that are not naturally myopic and do not naturally develop myopia may provide a model for human eyes that naturally do not become myopic, but do not provide a model for human eye that do become myopic. Any hypothesis for prevention of myopia that is based on the evidence from animal studies is based on evidence that is irrelevant to humans. Dr Judy _____________________________________ Subject: The O'Leary Bifocal Study -- and discussion by Judy The Wildsoet Lab Controlling Myopia Progression - A Confusing Story The dilemma of managing young progressing myopes. The O'Leary study and The Comet Study Two recently published clinical trials involving under-correction and PALs as alternative myopia control strategies add more rather than less confusion. A paper published in the journal, Vision Research (2002, 42: 2555-9), describing a 2-year Malaysian-based study comparing the effects of undercorrecting myopia with full correction on myopia progression in children. The message from the principal investigator on this study, Dr O'Leary, to doctors, patients and parents, as reported in the New Scientist article is "No glasses is the worst option of all, But don't undercorrect. GO for full correction." The Chung, O'Leary et al study is a small (n=94), 2 year randomized and masked prospective study comparing the effects of full-time undercorrection (UC, by approximately 0.75 D) with full-time fully correction (FC) in young myopes (mean: -2.86 D). The study group comprised approximately 1.4 time the numbers of girls as boys with Chinese and Malay ethnic groups being approximately equally represented. Over the 2 years of the study, the full-correction group showed a progression of 0.77 D compared to the UC group that exhibited a progression of 1.00 D. -- minor snip by Judy -- It is interesting to compare progression rates for the two groups in the Chung et al study with values from the more recently published COMET study, converted in both cases to a D per year rate. The progression rate for the Under-Corrected group (-0.50 D per year) corresponds closely to the mean rate reported for participants allocated single vision lenses in the COMET study (-0.49 D per year). A conclusion based on this comparison alone would be that undercorrection neither exacerbates or slows the progression of myopia, when applied unselectively. This outcome is predicted if we assume that the benefit of undercorrection is limited to those with poor accommodation. [What this analysis does not recognize is that if you are going to do ANYTHING for true-prevention, then the plus-lens method MUST start before that -1/2 diopter per year kicks in. Indeed, anyone working on prevention who manages to clear his distant vision from -1.0 diopter (20/80) to 0.0 diopters (20/20), must recognize that, while he is in a "high-school" environment he must continue with this "preventive" method if he again sees his vision becomes less than 20/40. It would seem very important that this discussion be raised with a person at the threshold of nearsightedness. OSB] Animal model studies predict increased (myopic) eye growth with sustained poor accommodation in fully corrected eyes (see Wildsoet, 1997, for a more extensive discussion of animal-based emmetropization studies and their clinical implications). However undercorrection should improve the state of focus at near as less accommodation is required. A potential parallel with animal studies involves the imposition of binocular low powered positive lenses on young monkeys; their eye growth slows, presumably because their eyes now have almost perfect focus at near distances, the limit of the visual world of these young animals (Smith & Hung, 1999). ____________________ WHAT FORCES THE USE OF A MINUS LENS? We should all thoughtfully evaluate the unfortunate effect of using an immediate and easy fix for the problem of nearsightedness. This situation of a self-perpetuating mistake (produced by public need and attitude) is sometimes recognized by the students of medicine. Dr. Perri Klass said it this way in VITAL SIGNS: "...Sometimes the awesome weight of medical knowledge is totally off the beam. You have to practice medicine with that in mind, with the knowledge that a hundred years or so along the road, they'll be telling stories about the medical theories of today to get a laugh of the medical students of 2085..." And about medicines' confidence in its routines: "...Or something so basic, so taken for granted, that no one has gotten around to questioning it. Whatever it is, probably the medical profession is collectively doing something really dumb and really damaging, and doing it with complete good will and typical medical self-confidence." This applies to vision. The demand for negative lens use comes partly from the public's demand for an instant solution, (and corresponding reluctance to properly use a plus lens) and not from a scientific assessment of the behavior characteristic of the normal eye. > > Dear Jan, > > [quoted text clipped - 14 lines] > A major snip in a bunch of repeating stuff by > Otis............................... You are walking around in circles Otis, boring....... > Dear Jan, > > Subject: Putting all the scientific cards on the table. And again a major snip in the same old boring stuff which is already discussed and explained. SignatureFree to Marcus Porcius Cato: ''Ceterum censeo Carthaginem esse delendam" I declare that Otis idea about preventing myopia in humans must be destroyed. Jan (normally Dutch spoken) Dear Jan, Subject: Thanks for your thoughtful review. I know of optometrists who are working for nearsightedness PREVENTION with the plus. The fact that you are using a technique established 400 years ago, and that you perpetuate says a lot about the "science" behind that use of the minus. The fact that you consider detailed analysis of the natural eye's behavior so much "bla...bla" tells me you are not really functioning on a scientific level at all. The fact that Judy tells me that all analysis of the natural eye's behavior (adolescent-primate) eyes, tells me much the same thing. Yes, I understand the "line in the sand" you draw that separates you "medical" approach from a engineering-scientific approach. But there are no "hard feelings". In fact, I could do no better that you in your situation. There is no pretense in me about that fact. I did convey your opinion to others, so that they could undertand that the has almost no choice but to "clear" their vision under their own control -- since you are so blind to analysis and the direct-experimental data. Maybe that is the only hope for the future. I know you are never going to be part of any preventive work -- but a total opponent to anyone who wishes to protect their distant vision, with a plus for near. Best, Otis > You are walking around in circles Otis, boring....... > [quoted text clipped - 4 lines] > And again a major snip in the same old boring stuff which is already > discussed and explained. The obvious answer is that the concept of prevention is not under attack, and will not be destroyed. As a case in point, at least on international drug conglomerate has a vested interest in drugs like pirenzepine that specifically target prevention. If proven safe and effective, no optometrist or group of optometrists will be able to prevent the use of these drugs. You and the "host" of optometrists who claim do be doing "prevention," are doing the world a disservice by not publishing your successes in the peer- reviewed literature. If found effective, then patients will be demanding this service from their optometrists, and you won't need to be wasting your time trying to drum up business on the internet. DrG > Dear Jan, > [quoted text clipped - 51 lines] >> And again a major snip in the same old boring stuff which is already >> discussed and explained. > The obvious answer is that the concept of prevention is not under attack, > and will not be destroyed. As a case in point, at least on international [quoted text clipped - 10 lines] > > DrG You're just going to get the standard excuses ranging from the providers being "too busy" to try to get published to not having the financial resources to fund a legitimate study to the conspiracy theory ("no journal would publish the findings" due to being controlled by the medical cartel). frank >> The obvious answer is that the concept of prevention is not under >> attack, and will not be destroyed. As a case in point, at least on [quoted text clipped - 20 lines] > > frank I would think that the patients themselves would fund such a study. DrG Dear Dr. Leukoma, Re: > Subject: Putting all the scientific cards on the table. Re: > And again a major snip in the same old boring stuff which is already discussed and explained. Jan I would have no problem reviewing the objective facts concerning the dynamic behavior of the natural eye with engineers entering a four year college. This would be an Engineering-Scientific effort and NOT a medical study. I would hope you could understand the difference. A person understanding the true-fact taken from ANIMAL studies (which you reject) could better-understand the nature of his choice. I believe that such a person (with previous 20/20) could work his way out of it (from 20/40). You say that is IMPOSSIBLE. I suggest that, if the individual CONTROLS both the effort and judgement that he would be successful. But you should be excluded since you state that the concept of prevention SHOULD BE DESTROYED. That removes you from involvement -- based on the intense bias of that statement. Engineers have an open mind and examine the facts THAT YOU REJECT. An that is indeed a problem. To further respond: > The obvious answer is that the concept of prevention is not under attack, > and will not be destroyed. Please read Jan's statement on the subject. Are you contradicting Jan? As a case in point, at least on international > drug conglomerate has a vested interest in drugs like pirenzepine that > specifically target prevention. Otis> I do not support drugs for prevention. If proven safe and effective, no > optometrist or group of optometrists will be able to prevent the use of > these drugs. Otis> That is a "medical" issue. I do not make "medical" arguments. > You and the "host" of optometrists Otis> Prevention is indeed difficult, and for obvious reasons (which Dr. Raphaelson spelled out) it can never be prescribed. This issue is scientific preception of facts -- not your interpertation of those facts. Otis> The person who preceives those facts correctly, has a good chance to clear his distant vision -- under his own control. DrL> ...who claim do be doing "prevention," are > doing the world a disservice by not publishing your successes in the peer- > reviewed literature. Otis> My "peers" are on optometrists. They are other engineers and scientists who evaluate the eye as a sophisticated system that controls its refractive state to its average visual environment. If found effective, then patients will be demanding > this service Otis> You get it wrong again. This is not a "patient" issue and you are prescribing nothing. It will be the individual himself who works to clear his vision -- and verifies he is successful by working with his own eye-chart and trial lens kit. The fact (which you ignore) will be taught to him on an objective-scientific basis. Further the conecpt of a scientific paradigm (Thomas Kuhn) will be reviewed. DrL> from their optometrists, and you won't need to be wasting your time trying to drum up business on the internet. Otis> Again, you make assumptions about me that are false. I do not "do" any "business". My site is free. If a person learns enough about these issues, and proceeds in the forceful use of a plus, and clears his vision from 20/60 to 20/25, the his goal is achieved. Otis> That is my exclusive goal at this point. Accurate preception of scientific facts concerning the dynamic behavior of the natural eye are necessarily part of that effort. But conplete control and judgment is held by the person doing this work. If successful, they simply do not need anything you must have to offer. (With all due respect.) Otis> Also, you might answer the five points I asked Dr. Jan to answer -- and he chose to ignore all the points -- while declaring that a person's right to an informed choice, "must be destroyed". Otis> I certainly agree that prevetion is difficult, and depends on the person's ability to make a commitment to heavy use of that lens. At the point they do is successfully, the realize that it is the only why you can truly prevent nearsighedness. Otis> It is also true that if YOU recommend it -- the public will most likely reaject it. Otis> But that is a major issue to consider. Otis> I have suggested a more rational study to be conducted at a Flight College, where these concepts could be taught. Otis> With Jan stating that the prevention concept "must be destroyed", it is rather obvious why that is not going to happen. Best, Otis > DrG > [quoted text clipped - 53 lines] > >> And again a major snip in the same old boring stuff which is already > >> discussed and explained. As usual, you go off on a tangent and do not directly address the issue. DrG > Dear Dr. Leukoma, > [quoted text clipped - 191 lines] >> >> And again a major snip in the same old boring stuff which is >> >> already discussed and explained. So . . . as a favor to a visually impaired person who has /absolutely no/ interest in these Otis-esque threads (except as compared to the Rishi/Evaristo posts) . . . . and as a favor to any others who may feel similarly . . . Would it be too much to ask to include some sort of keyword pairing--may I suggest "Natural Eye--" in any thread that either originates on this topic, or any thread that migrates toward this topic (necessitating the insertion of the keyword into the subject line mid-stream)? In fact, Otis: it seems reasonable to ask that you take responsibility for this, if you will. I would never suggest that you should not be heard. I would just appreciate a convention for the threads that facilitates eschewing them for those so inclined. The new s.m.v. people need--and I appreciate--the services of those valiantly debunking much posted nonsense . . . but some old-timers would rather be free of it. Thoughts?? Thanks. Dear Neil, Subject: Using correct words to describe the true behavior of the natural eye. As you know I put in an exhaustive effort to run-down the various concepts that exist about "nearsightedness". This included interviewing ODs to understand the "issues" as THEY understood them. Dr. Jacob Raphaelson used a plus on a young child -- and cleared his vision to 20/20. What happened? The parents rejected the method -- with violence. Under that circumstance, it was clear that NO OD could do anything about prevention -- and responsibility had to be transferred to the person concerned with keeping his vision clear -- for life. Not an easy task. I also thought, Oh my God -- Raphaelson is RIGHT! The issue is then to under neutral language to describe what is ACTUALLY MEASURED (i.e., refractive state) that can be plus or minus in the natural eye. No OD should object to this neutral language, and we can proceed to our analysis with out "disturbing" them. After all, they declared that all primate (except human) experimatal data is of no interest or consequence for them. Fine, then I accept that. You can never reduce scientific preception into a "quick fix" in 15 minutes with a person. The ODs on this site insist that you can AND MUST! And then the proceed to deny all direct factual data -- which they have declared to be OFF LIMITS. That attitude does exceed their professional authority and competence. So yes, the thread has to do with fundamental SCIENTIFIC preception of the behavior of the natural eye as a system that controls its refractive status to CHANGES in its visual environemt. But my only goal was to assist my sister's chilcren (now 40 years old) in avoiding "stair case" myopia produced by that minus lens. The only way to do this was to make them aware of the consequences of NOT wearing the plus for all close-work. Since they took the responsibility to verify that they ALWAYS PASS the Snellen-DMV test -- they never had a "problem" with an over-prescribed minus. Since I have seen people clear their distant vision with a plus, I have no doubt that a highly motivated pilots (at 20/40) could do EXACTLY the same thing -- given that he has the personal resolve to do so. But beyond this point there is little to be done -- until I have an opportunity to discuss these issues with students entering a four year aeronautical college. I think we have a good case for true-prevention at this point -- if the ODs would be more open about this preventive issue. Best, Otis > So . . . as a favor to a visually impaired person who has /absolutely no/ > interest in these Otis-esque threads (except as compared to the [quoted text clipped - 18 lines] > > Thanks. It's just a setup - if his ideas don't work it's not because the ideas are wrong, but because the patient doesn't believe strongly enough. Rather convenient! Mark > As usual, you go off on a tangent and do not directly address the issue. > [quoted text clipped - 195 lines] > >> >> And again a major snip in the same old boring stuff which is > >> >> already discussed and explained. major snip > When someone "in authority" can sweep 50 percent of these > cards "off the table" -- then she controls the perception of the [quoted text clipped - 5 lines] > evidence from animal studies is based on evidence that is > irrelevant to humans." Dr Judy I have repeatedly asked you to stop quoting this out of context. I'm not going to copy the entire message this statement came from, but if you are going to quote it, please include the paragaphs describing human research that contradicts the animal research and this paragraph that preceded the quote. "Neo natal animal eyes do not provide a model for non neo natal human eyes. Animal eyes that are not naturally myopic and do not naturally develop myopia may provide a model for human eyes that naturally do not become myopic, but do not provide a model for human eyes that naturally do become myopic." In other words, I was stating that evidence from animal studies using non myopic neo natal animals is evidence that is irrelevant to myopic, non neo natal humans and that evidence from animal studeis that has been found to be not true when replicated with human subjects is irrelevant to humans. I did not reject all animal evidence. Dr Judy > The method of the minus-lens was put in place 400 year ago > for one good reason. It worked instantly. I agree that is a good > "selling point" for the minus lens, but I doubt that you could say > the "works instantly" constitutes "scientific proof". How can you say that it works? It does not. Your own case is the proof that it works not. Detachment of the retina and other things: how can you say the minus is safe? The true fact is that IN YOUR CASE it was not. Same is for the other gullible people like you. The minus --- or the plus --- is a disease-creating machine. It should be discarded as soon as ever. |
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