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Medical Forum / General / Vision / December 2004An Optometrist Evaluates Prevention -- as the Scond Opinion
Otis> Dear Dr G., "You can fool all the people some of the time, and some of the people all the time, but you can't fool all the people all the time." A. L. Otis> Sorry, scientific truth is the repeatable experiment that proves that all fundamental eyes are dyanmic. DrG > Nice try, Otis. But what you are doing is making an "a priori" assumption. That is a very "anti-scientific" attitude. Saying that NATURAL eyes are dynamic is not very informative. You first need to define "NATURAL," and then "dynamic." DrG > The rest of this post is just pure unadulterated biased opinion of Otis. DrG _________________________ Dear Dr G., You express a pure unadulterated biased opinion about the behavior of the eye -- as it has been taught for the last 400 years. I regret that you do not even pay attention to the facts and the second-opinion of other optometrists. While you express a strong MEDICAL opinion, yours is an opinion with very little scientific facts supporting it. Here are the remarks of BOTH as SCIENTIST and OPTOMETRIST about the dynamic behavior of the fundamental eye. Best, Otis ------------------------------- Dear Friends, Subject: Statement of OD SUPPORTING prevention with plus. While a large percentage of ODs believe that there is no relationship between the eye's environment and its refractive status -- equally there are a substantial number of ODs who believe in SCIENTIFIC (not medical) proof, and say so explicietly. Here is a statement of Dr. Herb B., supporting your right to an informed, competent second opinion on the prevention of nearsightedness with a plus. Thank you Dr. Herb B., for your honest scientific assessment of the objective experimental data concerning the dynamic behavior of the eye. Best, Otis _____________________________________________ From: Dr. Herb B., MS, OD To: "'Otis S. Brown'" <otisbrown@pa.net> Subject: Plus Theory (Dynamic eye concept) Dear Otis; I just wanted to thank you for your efforts on behalf of myopia prevention. Also, personally, for clearing up something in my life, which is why do I not understand the majority of my colleagues who don't believe in any kind of rehabilitative or therapy work to improve myopia (and other visual skills, such as tracking, accommodation, perceptual skills, etc.)It is SO frustrating to me and I think they are so closed-minded. But your comments on how SCIENCE proves the concepts valid whereas MEDICAL thought does not! That is what it is, because I was (am a scientist) long before I went into optometry (MS, Geology) and I tend to look at the data and facts and proof, not just believe in cook-book recipes that were fed to me in optometry school. I hope that this little email will also help other people who are confused as to how OD's (and MD's) and scientists can think so differently. Or is it that so many OD's and MD's don't think, just do what they were taught? And scientists are taught to be intellectually curious and dig up the truth as best they can. Sincerely, Herb B., MS, OD ______________________________________________ Dear Friends supporting the second opinion Subject: Plus lens and DYNAMIC behavior of the native eye. While I advocate the plus FOR PREVENTION, I would say that the concept depends on the fact that the natural eye is "dynamic", and controls its refractive status to its average visual environment. I believe that the scientific (not medical) proof for the above statement in excellent, and if correctly understood, can lead a young person to a point where he personally clears his distant vision from 20/60 to the legal statdard. But I get massive objection from may ODs who only want to put a minus lens on you -- and say THAT IS SCIENCE. As a result I do a lot of "fighting" about this issue. Ultimately it is the person himself who decides the issue -- by either taking prevention seriously at the 20/50 to 20/60 level -- or rejecting the concept with scorn. The fact that high quality, intelligent optometrists SUPPORT the conept gives us hope for the future. Otis Dear Prevention minded ODs and friends, When the ODs on this site question my engineering credibility -- I am going to respond. Some ODs in fact support the concept of prevention with the plus -- and we shoud understand the scientific support of the ODs who will offer you a "fighting chance" at prevention. After all -- you have nothing to lose, and can easily turn down an optometrist who offers to help you in this manner. But once you turn "prevention" down -- you don't get a "second chance" at it. Here are some thoughtufl remarks by "Herb" to counterbalance the majority opinion experessed by the ODs on this news-group. Best, Otis ______________ From: Herb B. OD Subject: Using Plus to Prevent Myopia Dear Dr. X Otis asked me to write you an email of support for using plus lenses to head off myopia in the early stages. I do not consider myself an authority on this matter, simply an optometrist who is interested in prevention and alternative therapies for visual problems, including myopia. A little background: I am a career changer who was a geologist. My daughter's visual and spatial problems lead us to send her to a behavioral optometrist here in Denver, who succeeded in motivating my daughter to do vision therapy for her accommodative, binocular, and visual-perception problems. I got interested and found I had similar problems. I, too, went through vision therapy as an adult and was able to regain my binocular vision, i.e. I had no 3D, and also perceptual problems. I then worked as a vision therapist for this other doctor (in the DC area) and finally decided to go to optometry school to be able to really get into this area. However, I think its important to note that no one ever told me that I or my daughter could even think about reducing or preventing myopia, which we both have at about -3 D to -4 D. It wasn't until later that I learned that my nephew had actually succeeded in throwing away his myopia glasses after working very hard with Dr. Amiel Franke in DC. So then later, after optometry school, I was interning with my daughter's OD here in Denver and that is where I learned of using biofeedback to reduce beginning myopia in a 17 year old who wanted to be 20/20 for the Air Force. That was successful in reducing her from 20/40 to 20/20 in just a few weeks. I think she probably did other exercises, too. As far as plus therapy, I routinely RX low plus on beginning myopes, and higher plus over their distance Rx if they insist on wearing minus. I have not come to the point of being in a situation where I do not Rx minus lenses at all, but I foresee that coming in the future when I am more independent. A short story. I had just arrived at optometry school in Forest Grove, Oregon, in 1994. I went to the insurance agent to get car insurance. There, the lady told me she had identical twin daughters, then about 20 years old, who when young, went to Pacific Optometry School across the street literally, and were told to both wear minus lenses for distance vision. One girl was compliant and wore her glasses always. The other, was a rebel! She would not wear her glasses. Now, 15 years later, one wears a substantial minus Rx and the other wears no glasses at all! I have seen the identical story with my own two children, but they are not twins. The rebellious one wears no glasses and the other is very near-sighted. So, as I said to Otis, there is much evidence that plus works to prevent myopia in many cases, especially in convergence excess, high AC/A, and Acc. Ins. At the VERY WORST, it does NO harm! So I am appalled that your board would hassle you. I am wishing you the best. I could contact my mentor if you would like to get some references on plus, if you don't already have them. Sincerely, Herb B., MS, OD This posting is an automatic reply to any sci.med.vision newsgroup thread that is receiving comments from a person named "Otis", "Otis Brown", "otisbrown@pa.net" or "Otis, Engineer". Otis is not an expert in any field of vision. His medical and eyecare training is nil. He is a proponent of a myopia (i.e. nearsightedness) prevention technique that is unproven at best, and has in some aspects even been disproven by controlled scientific studies. He has posted and reposted his ideas approximately 1000 times over the last two years despite being repeatedly debunked by numerous doctor practitioners and vision scientists. No one means to suppress the opinions of others. This message is only meant to forewarn anyone who might misconstrue Otis as a trained eyecare expert. DO NOT REPLY TO HIS POSTINGS. Do not feed the troll! Please see the weekly posting "welcome to sci.med.vision" which usually appears on Mondays for information on how to filter out his posts so that you may be able to participate in worthwhile discussions in this forum. Thank you for your cooperation and understanding. > Dear Prevention minded ODs and friends, > I am wishing you the best. I could contact my mentor if you > would like to get some references on plus, if you don't already > have them. Yes, Herb, I'd be very interested in any published references you may have. -Mike Tyner, OD Dear Prevention minded friends, As usual, Mike Tyner and "RM" (who ever he is) warn you aginst optometrists who wish to help you with prevention -- but telling you what is experimentally true about the dynamic behavior of the eye. You can pretty well guss at their motives. Prevention with the plus is difficult -- but possible. Here is Herb, discussing "standard practice" and why it never changes. But this is a "free" site, and you should put understand the concept of the "second-opinion" and how it might affect your visual future. I am certain that Mike and "RM" will declare that Dr. Herb B. does not exist either. Think for yourself! Best, Otis Engineer __________________________ From: A prevention minded optometrist Dear Otis; Subject: Using Plus to Prevent Myopia Thank you for sending the email along to Dr. Leung, I do remember some research from my op school days that said the average child, say about age 5, is hyperopic, but their accommodation is so strong in a "normal" child, that they can see perfectly near and far. If such a child does have accommodative insufficiency, then they could have acuity problems and would need plus for near certainly and sometimes for far. Now, the child who is "plano" at age 5 does indeed have a higher likelihood of becoming myopic (statistically) because he or she does not have the "cushion" of plus power to take up the slack so to speak when their near-point visual demands increase with schooling later on. This is the point where I have all along prescribed plus, but often low plus, for near. I admit I am not an authority on the uses of higher plus that you are talking about, but I am certainly open to it if the person is motivated. This is the case with all therapies that the person has to do themselves as opposed to something the doctor does to them passively, like minus lenses. I consciously picked an optometry school to attend that "believed" in behavioral optometry, which gives a more open attitude to prevention and teaches many near-point tests that the average OD will not usually do. Unfortunately, as I was attending, a new dean, who was an OD and MD, came in with some of his minions, and they introduced much more of the medical model. This in optometry seems to dismiss all these preventive strategies in favor of speed, efficiency, and money, relegating refractions to technicians or machines, so the OD can be a "real" doctor, and just breeze in for a few minutes to analyze the results of the technicians! This way they can see many more patients and make much more money and gain prestige from the uninformed masses. This is a very unfortunate trend. In the case of optometry, I really believe that many of the "old-timers" who were behaviorally-oriented, were more progressive than the newer crop of graduates, who seem to be frustrated ophthalmologists. Sincerely, Herb Herb B., MS, OD > I am certain that Mike and "RM" will declare > that Dr. Herb B. does not exist > either. I only asked for published references. Are you saying they don't exist? -MT Dear Mike, I have repeatedly provided direct experimental proof that the natural eye is dynamic. This is so simple that I do not see how you "miss" the point -- but you do -- totally. This is basic "input" versus "ouput" testing. But you sweep all the experimental (SCIENTIFIC) data off the table are TOTALLY BIASED, and they you pronounce that "there is no data". I guess that some will believe you -- but others are going to "wake up". Even your fellow ODs (Herb) have a hard time taking your total rejection of this direct experimental data. Try reading the work of Franis Young and other gifted experimeters. But all you will do is to generate excuses to ignore all of it. But I will be pleased to present further arguments describing your "science" my friend. Best, Otis "Dr. Herb" also offered to provide us with some references regarding prevention with plus. Dr. Tyner asked for them. I too would be interested in them. Dr. Herb can feel free to post them on this forum, or email them privately if he preferes to do that. > Even your fellow ODs (Herb) have a hard time > taking your total rejection of this direct experimental [quoted text clipped - 10 lines] > > Otis Dear Nipidoc, I will forward your request to him for his response. Please remember -- we are talking ONLY about prevention before a minus lens is used. As such the use of the plus MUST involve the intellectual understanding of the person who is using it. That is the only issue. Best, Otis > Please remember -- we are talking ONLY about prevention > before a minus lens is used. As such the use of the > plus MUST involve the intellectual understanding > of the person who is using it. Ah... so that's why -250 myopes don't get better when they remove their glasses - they lack the intellectual understanding. Now I get it. -MT Dear Mike, Since Jan declares that the concept of prevention "must be destroyed" I think there is a valid case that the person should intellectually evaluate that kind of opinion. That is what I meant by "intellectual". You have obviously missed that point my friend. Best, Otis > Dear Mike, > [quoted text clipped - 9 lines] > > Otis Since Otis states that plus lenses will prevent myopia, THAT statement must be proven. I think there is a valid case that the person should intellectually evaluate that kind of opinion. DrG > That is what I meant by "intellectual". > You have obviously missed that point my friend. Obviously my education is inadequate. We need more engineers teaching physics, medicine, and statistics. -MT "Mike Tyner" <mtyner@mindspring.com> wrote in news:nh8xd.3855$yK.259 @newsread3.news.atl.earthlink.net: >> That is what I meant by "intellectual". >> You have obviously missed that point my friend. [quoted text clipped - 3 lines] > > -MT This is the part of this whole exchange that I hate. There is absolutely nothing wrong with engineers teaching physics, medicine, and statistics. In fact, I teach a little of all three. Don't tar us all with the same brush. Scott I apologize. Otis tarnishes your profession. He takes his training in engineering and tries to extend it into a field that he knows nothing about. ---- > "Mike Tyner" <mtyner@mindspring.com> wrote in news:nh8xd.3855$yK.259 > @newsread3.news.atl.earthlink.net: [quoted text clipped - 13 lines] > > Scott > This is the part of this whole exchange that I hate. There is > absolutely nothing wrong with engineers teaching physics, > medicine, and statistics. In fact, I teach a little of all three. > Don't tar us all with the same brush. I apologize, too. The notable difference is that you likely have some formal training in those areas. -MT > Dear Mike, > [quoted text clipped - 9 lines] > > Otis And again Otis quote incorrect. There is no need to be the ''intellectual type'' to recognize what I mean. Only Otis is missing what it stands for.  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) Fair enough. I look forward to Dr. Herbs references supporting the claim that the use of a plus lenses prevents the development of myopia before minus lenses are used. > Dear Nipidoc, > [quoted text clipped - 10 lines] > > Otis <otisbrown@pa.net> wrote in message > > I have repeatedly provided direct experimental proof > that the natural eye is dynamic. I thought Dr. Herb might have some evidence that plus lenses work on human myopia. Guess not. -MT > I have repeatedly provided direct experimental proof > that the natural eye is dynamic. You have offered no direct experimental proof that the natural eye is dynamic. You just keep proclaiming it over and over again as if that is enough. It is insufficient to quote an animal study where the animals are drastically overminused. It is insufficient to keep dredging up statements from old optometrists whose theories have since been disproven. It is insufficient to point out case reports of a couple of "pilot engineers" who have cleared their vision (if they even really exist) and then draw conclusions to the "entire population of adolescent eyes" (your words!). You have no proof, just a loud repetitive mouth. And just what are your qualifications that allow you to give anyone advise about their vision problems? Do you have scientific or clinical training in visual sciences? Why won't you ever answer? > Dear Mike, > > I have repeatedly provided direct experimental proof > that the natural eye is dynamic. Sorry Otis, I did not see your direct experimental proof, I must have missed it. Would you kindly repost it. I can't understand why you don't concider the hyperopic eye as "Natural". Please explain. > This is so simple that I do not see how you "miss" the > point -- but you do -- totally. > > This is basic "input" versus "ouput" testing. Not so basic if it requires the Px to be inteligent and understand that the natural eye is dynamic. > But I will be pleased to present further arguments > describing your "science" my friend. We had enough of arguments based on your theories, show us proof. We can only act on evidence based medicine. Not on what Otis Brown thinks will happen if a propper study is conducted. > Best, > > Otis Roland J. Izaac Otis> I have repeatedly provided direct experimental proof that the natural eye is dynamic. Rol > Sorry Otis, I did not see your direct experimental proof, I must have missed it. Would you kindly repost it. Otis> Dear Roland -- if you will accept the separation of science (i.e., DIRECT MEASUREMENTS of the refractive state of the natural eye from MEDICINE, i.e., dealing with a mass of people who only want an immediate "fix" with the minus lens -- then we can proceed. It will be up to the person engineer-pilot, to decide what course of action he might wish to take to implement prevention. Otis> I will be pleased to repost the experimental data proving that the natural eye is "dynamic" in a few days. I can't understand why you don't concider the hyperopic eye as "Natural". Please explain. Otis> To avoid "fighting" with you, I use the term "refractive status" where the eye can have a refractive status running between -1 diopter to +2.0 diopters and remain completely natural. Otis> The word "hyperopic" is translated "farsighted", which implies "defect" to the layman. To avoid any minstaken conotation of this nature, just use the neutral term, refractive status. Otis> This is so simple that I do not see how you "miss" the point -- but you do -- totally. Otis> This is basic "input" versus "ouput" testing. Not so basic if it requires the Px (patient) to be inteligent and understand that the natural eye is dynamic. Otis> Which does suggest that the engineer take time to go through a tutorial on measurement systems, and an analysis of the behavior of the natural eye -- and why the engineer can expect that the eye will be proven to be dynamic. Again, on an "input" versus "output" were you apply a "delta" to the visual environment and measure the expected e ^ (-t/TAU) time-constant responsed. Otis> Obviously you expect everything to be reduced to 15 minutes with a person -- and that is absolutly not possible. Otis> You could define this at the difference between engineering-science (learning the truith about the natural eye's behavior) versus servicing a a large number of people who walk in off the stree -- and expect ONLY a minus-lens quick-fix. > But I will be pleased to present further arguments > describing your "science" my friend. Rol We had enough of arguments based on your theories, show us proof. Otis> Concerning the dynamic nature of the natural eye -- but of course. We can only act on evidence based medicine. Otis> I am not asking you to "act". I am asking you to think. The evidence I present is based on science, and not on medicine. There is a profound difference in attitude and understanding between these two professions. Not on what Otis Brown thinks will happen if a propper study is conducted. Otis> I would be please to work towards prevention with other engineers who will evaluate your opinion, the experimental data, and make THEIR DECISION based on these aspects of this difficult situitation. Otis> I look forward to the day when we can take that FIRST STEP my friend -- along scientific, not medical lines. Best, Otis > Otis> I have repeatedly provided direct experimental proof > that the natural eye is dynamic. [quoted text clipped - 23 lines] > where the eye can have a refractive status running between > -1 diopter to +2.0 diopters and remain completely natural. So if it falls out of this range, it cannot be concidered completely natural. Does it follow then that an eye with a "refractive status" 0f -1.25 is not completely natural and therefore is not concidered dynamic and will not follow the visual environment? Please answere > Otis> The word "hyperopic" is translated "farsighted", which > implies "defect" to the layman. To avoid any minstaken [quoted text clipped - 18 lines] > the visual environment and measure the > expected e ^ (-t/TAU) time-constant responsed. "....and the eye will be proven to be dynamic" That sounds like future tense to me Otis. You are sugesting treatment with a plus lens be introduced because you believe it will be proven correct some time in the future. That my friend is quackery. You want to make quacks out of us? > Otis> Obviously you expect everything to be reduced > to 15 minutes with a person -- and that is absolutly > not possible. Actually if we suspect accomodative myopia, a cyclo refraction can show it in a short time. Why wait months and years? > Otis> You could define this at the difference between > engineering-science (learning the truith about the > natural eye's behavior) versus servicing a > a large number of people who walk in > off the stree -- and expect ONLY a minus-lens > quick-fix. Can't make sence of the above > > But I will be pleased to present further arguments > > describing your "science" my friend. No, no, no. please present further arguments defending your science instead. > Rol We had enough of arguments based on your theories, show us proof. > [quoted text clipped - 8 lines] > There is a profound difference in attitude and understanding > between these two professions. Offering the "Second opinion" to patients is acting without proof. > Not on what Otis Brown thinks will > happen if a propper study is conducted. [quoted text clipped - 3 lines] > the experimental data, and make THEIR DECISION > based on these aspects of this difficult situitation. Unfortunately Otis, the decision to incorporate plus therapy in our practicees does not lie with engineers. > Otis> I look forward to the day when we can > take that FIRST STEP my friend -- along scientific, [quoted text clipped - 3 lines] > > Otis |
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