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Medical Forum / General / Vision / May 2005Vision clearing from -2.75 diopters to 20/25
Dear prevention minded friends, (I have changed Miks name -- for obvious reasons.) Sometimes the natural eye will change its refractive state in a negative direction. For instance, and eye might measure at -2.75 diopters, but have "normal eye" myopia, or pseudo-myopia -- rather than "eye-length" myopia. If that is the case, then the individual can potentially clear his vision by "relaxing" the muscle, and clearing his vison to exceed the required DMV standard of 20/40 or better. Mike received a -1.5 diopter at age 10, and at age 14 was wearing a -2.75 D. He decided to quit "cold turkey", and tried "Bates" and other recommeded methods by "second-opinion" optometrists including suggestions by Dr. Orfield and others. I explained that he MUST pass the legal visual requirement of reading 1.8 cm letters at 6 meters -- when he turned 16. I also stated that vision-clering was VERY SLOW, and the the best estimated of "true-clearing" was about +1/2 diopter per year. The rest was up to him. Here is his pleasant review of his own work -- and results. We are on this earth to help each other. Think of it that way. Please enjoy! Otis Engineer ____________________ Subject: Clearing from -2.75 diopters to 20/20 -- a difficult thing to accomplish. I just received this from Mike. Please remember that the REAL standard that we ALL must pass -- is 20/40, not 20/20. However, once a person passes the DMV-Snellen, it is STILL in his best interest to continue to 20/20, or close to it. As Mike says, it is a great deal of work -- but it beats the alternative -- of having your eyes go "down" at a rate of -1/2 diopter per year (average). [This data comes DIRECTLY from the "bifocal" studies. It indicates the consequences of NOT using the plus properly.] The natural eye -- maintained in the "open" will have a postive refractive state from zero to plus 2 dioters. The strong plus-lens for all reading simply moves all objects out to "infinity". This allows the eye to work the way it is designed to work. This "i-see" forum is where we hear about preventive solutions -- be they the plus lens or other methods. Here is Mike's statement about his use of the plus. Best, Otis ________________________________ Dear Mike, Subject: Reply and discussion Mike> Stacy said that -2.5 diopters myopia is a good thing. Otis> I obviously believe it is TERRIBLE thing. Someone with THAT belief is going to over-prescribe the minus by a profound amount. You found this out when you were reading 20/40 -- and recieved a -2.0 diopter prescription. That is the reason why I asked you read your own eye chart. Trust youself -- and what you see. Take responsibility to know and PASS all legal visual requirements that apply to you. Mike> Speaking as a person who has been at that -2.75 dipter stage -- it is not. I had a heck of a time just getting where I am now. Otis> I know this -- and I admire you greatly for being willing to engage in this type of fight. Mike> Even maintaining this effort is not easy. Otis> I know. This is why I am aware of only about 20 people in this world who have done it successfully. Not easy -- by any standard! Mike> I would have quit long ago but for the fact that the plus works and I got feedback from my eyechart. Otis> You are independent minded -- and establish specific goals in your life. It takes a "strong will" to do this -- indeed. Mike> I have been hearing about bi-focal studies. My theory about bi-focals is that they would make presbyopia occur much earlier and severe in a person. Otis> Actually, the purpose of the bi-focal studies was to demonstrate that the plus could "work" properly under "prescription" conditions. As you know the minus is over-prescribed by -2 diopters. Just getting rid of that -2.0 diopters is a major step. The ODs are attempting a "compromise" -- and that does not work. Go all-out with the plus -- or do not bother with it at all -- in my judgment. Mike> I printed off an eyechart -- when I started the plus use and measured 20/70 to 20/50 initially. It is the standard eyechart with a big E at the top. Otis> Your first major decision was to quit the minus cold turkey. That was the most important decision. Once I knew you could see 20/50 -- I knew there was "hope". Mike> I pulled it out again after a few months and WOW! My vision amazed me. 20/40 was not just legetable -- it was clear. And 20/30 was the clearest I had ever seen it. I read some characters on the 20/25 line. Also my 20/20 and my 20/25 scores are much the same but I thought I would do worse on the 20/20, but they were both almost the same. Otis> I am very pleased with your own PERSONAL success. I am almost certain that you can qualify for flight status -- with just a little more work. As Stacy said, absolute 20/20 is a bit excessive. In fact the JAA (European) standard is more reasonable. They require 20/20 (both eyes) but allow 20/30 in an individual eye. Much more acceptable. Otis> Very few people can do what you have done. Your desire to qualify as a pilot is a strong motivator -- for both your learning and the physical work of using the plus agressively. I think you have down a terrific job, considering the difficulties. Best, Otis Thanks Mike. I may be wrong, but I think you are encouraging people with myopia to drive without their glasses. If that's not correct, please state it. If you are, that is a disservice to public safety. For example, a 1.5 D. myope may be able to "pass the DMV" test without his/her glasses, but to drive, especially at night without the correction is just irresponsible. Even if they can squeeze out 20/25, it's a very blurred 20/25 and they would certinaly not be able to discern a pedestrian in the roadway as they would if they were in sharp 20/20, 20/15, or 20/10 focus. Presumably, you even would recommend a pilot who can just see 20/20 without glasses to fly without them, when the same pilot could see a crisp 20/15 or 20/10 with glasses. Another disservice. Another threat to safety. Certainly a pilot would detect another plane when it was TWICE AS FAR AWAY with 20/10 as compared to 20/20 vision. 20/20 is Snellen standard vision. It is not perfect vision. Most young pilots have or can correct to 20/10, and if they can, that's what they should use. Accepting less could be suicidal and/or homicidal. w.stacy, o.d. Dear William, I may be wrong, but I think you are encouraging people with myopia to drive without their glasses. If that's not correct, please state it. This is absolutly FALSE. First, this man is 15 years old. Second, in conversations with him, I INSISTED that he have a medical exam -- to ellimate all possible MEDICAL problems. He did -- and passed the MEDICAL part. Thirdly, I explained that he MUST pass the DMV-Snellen in the DMV office -- or he could not drive a car. Fourth, to that purpose, I insisted that he check his own chart to make certain that he EXCEED this requirement -- so that when he went to take the test -- he would pass it. You think that myopia is a wonderful thing -- and you are entitled to that point of view. Mike does not agree with you -- and wishes to PROTECT his distance vision -- as you do not wish to do so. He has that right. That is the status, and I will send this to Mike so he knows you are concerned about him. ___________ 20/20 is Snellen standard vision. It is not perfect vision. Most young pilots have or can correct to 20/10, and if they can, that's what they should use. Accepting less could be suicidal and/or homicidal. Yes, you can "crank up" on a minus and produce a -1 diopter prescription -- when no lens is needed or required. This is so-called "best visual acuity" prescription, or "over-prescribed" by several diopters. I shudder to think of the amount of "stair case" myopia prodiced by the BVA practice. Best, Otis cc Mike I had written > 20/20 is Snellen standard vision. It is not perfect vision. Most > young > pilots have or can correct to 20/10, and if they can, that's what they > should use. Accepting less could be suicidal and/or homicidal. > Yes, you can "crank up" on a minus and produce a -1 diopter > prescription -- when no lens is needed or required. > This is so-called "best visual acuity" prescription, > or "over-prescribed" by several diopters. I shudder > to think of the amount of "stair case" myopia > prodiced by the BVA practice. The above nonsense demonstrates a profound ignorance of refraction, or a complete inability or refusal to understand my words above. We DO NOT crank up the minus to achieve 20/15 or 20/10. Young emmetropes already have it with no lenses at all. Hyperopes often need us to "crank up" the PLUS to achieve it, and astigmats need us to zero in on their toricity to achieve it. Yes, a myopic eye will need some minus to be able to read the smallest letters (or see the farthest airplane) their eyes are capable of seeing at optical infinity. That is the very DEFINITION of myopia. That is NOT overprescribing. Over prescribing is adding more minus than is necessary to bring the smallest resolvable target into sharp or clear focus. All optometrists avoid overprescribing minus by various techniques. Obviously, some are so afraid of giving more than is necessary that they end up UNDERCORRECTING the myopia. Fine for a 15 year old, although I'd argue he may be missing some of the whiteboard info at school. NOT fine for a driver or a pilot. I repeat: NOT FINE; read that DANGEROUS. w.stacy, o.d. I bet Otis "shudders" everytime he makes a blatantly false, or misleading statement about myopic progression and minus lenses in this NG. Let's make one thing absolutely clear, Otis, and that is you are voicing an "opinion," and not making a factual statement. DrG I think it's fine for him to advocate plus (or often more appropriately, less minus) for myopia for "training" purposes, as in the safety of ones bedroom or whatever. But not where it counts (like flying, driving, operating a crane, doing surgery, walking a tightrope, playing tennis, racing motorcycles, skiing, you name your activity where there is any danger at all). Deliberately recommending detuning someone to a blurred 20/20 or 20/25 or whatever is "just legal", is just irresponsible, esp. from a person who is holding himself out to know something about physiological optics. I haven't yet decided if it is just truly ignorance, or if it is just snake oil, deliberatly sold to the unwitting. Tell me it's not dementia or paranoia. w.stacy, o.d. > I bet Otis "shudders" everytime he makes a blatantly false, or > misleading statement about myopic progression and minus lenses in this [quoted text clipped - 4 lines] > > DrG Of course he can spout, he isn't accountable. I think it is neither dementia nor paranoia, just plain hatred of the "system" as he perceives it. Of course it couldn't be the genes. It is that cabal of evil optometrists...and ophthalmologists DrG > First, this man is 15 years old. Gawd..... 15 years old, barely hitting puberty, and he calls him a man.... Doesn't drive, can't drink, jailbait..... yet Otis calls him a "man". Oh yeah, what credibility you show Otis. Zilch, none when you use children for your primary source for your opinions. Sheez, another made up character.... In this case, I sure hope so! Allen > Thirdly, I explained that he MUST pass the DMV-Snellen in > the DMV office -- or he could not drive a car. So you told a 15 year old that he "MUST pass the DMV" or he could not drive a car? Was this with our without glasses? I mean I'm a little slow on the uptake, but I think you just told a minor that he had to "pass the DMV" or he could not drive a car. Otis, you are nuts. This is beyond the pale. Give it up. Die or something. This has no relation to reality.... w.stacy, o.d. >Otis, you are nuts. This is beyond the pale. Give it up. Die or something. This has no relation to reality.... This is pathetic sir, no other words, that kid is also on my email group and he knows that he can drive but with glasses if he can not pass the DMV. He is not a retard you know, like most would treat 16 and below as such nowadays, they know a lot. You on the other hand purposely bashing Otis for no reason, his sentence and what he meant is clear (from what we are talking about) You are a little slow on a lot of things... i.e. Vietnam war is over... :-) F-4s are retired like you are >:-> You on the other hand > purposely bashing Otis for no reason, his sentence and what he meant is > clear (from what we are talking about) You are a little slow on a lot > of things... i.e. Vietnam war is over... :-) F-4s are retired like you > are >:-> Aren't you the one who suggested dropping the ad hominums? I will stick to the facts if you will. But I will always object to someone who suggests people do something that could be dangerous. And I will challenge when someone states something that is erroneous or blatantly false. w.stacy, o.d. > Yes, you can "crank up" on a minus and produce a -1 diopter > prescription -- when no lens is needed or required. > This is so-called "best visual acuity" prescription, > or "over-prescribed" by several diopters. I shudder > to think of the amount of "stair case" myopia > prodiced by the BVA practice. Sorry Otis but this simply isn't true. If you a persons best acuity is 20/20 or 20/15, you cannot "crank up" the minus to produce 20/10. This is simply not done in modern eyecare. A myope is routinely given the least minus to produce the best visual acuity (BVA) that they can obtain. The DMV standard for getting an unrestricted drivers license in most states is 20/40 in at least one eye. However, if this were the acuity that everyone actually had when they were driving around on a busy interstate highway at night then the accident rate would increase astronomically. IMHO, everyone should wear their BVA distance prescription when driving PERIOD. I don't care one crapola about your "prevention" theories or about your notions of "the wretched minus". Everyone needs to see as clearly as the optics of their eyes allow when they are driving PERIOD. To recommend anything other than that is like recommending they should have a few drinks and exceed the speed limit when they drive. >Presumably, you even would recommend a pilot who can just see 20/20 >without glasses to fly without them, when the same pilot could see a >crisp 20/15 or 20/10 with glasses. Another disservice. Another threat >to safety. Certainly a pilot would detect another plane when it was >TWICE AS FAR AWAY with 20/10 as compared to 20/20 vision. Sir, are you suggesting that the pilot who maintains 20/20 "SHOULD" wear minus to have 20/10? Let me get that clear first... HAVING 20/10 vision doesn't always mean the pilot will spot the target or the traffic, that is also an issue of training. I know pilots can take up A2A while they are 20/30 or land on an aircraft carrier while they are 20/40!!! That is why service branches have minimums when it comes to visual acuity. Today, if you have 20/20 the service branch WILL DEFINITELY NOT suggest you should go and slap another -1/2 or -1 on your face in order to get 20/10 so you can see the target sharp. If the service branches are not using the snellen for standards then all the medical instructions and documents are lying. If they are using it, what is this fuss of yours? None of the pilots that I KNOW use minus to achieve 20/10, and they have normal 20/20. Let us look at this tragedy here... >Over prescribing is adding more minus than is necessary to bring the smallest >resolvable target into sharp or clear focus. >We DO NOT crank up the minus to achieve 20/15 or 20/10. > pilot who can just see 20/20 without glasses to fly without them, when the >same pilot could see a crisp 20/15 or 20/10 with glasses. Another disservice. So if 20/20 is not normal vision, what is it? Why do service branches use it as standard? What does the AF require from its candidates today? 20/10 or 20/20? Accoding to what standard? What chart do they use? Do 20/10 jocks go fighter/bomber track while 20/20 go tanker/transport? Do 20/10 guys go AH-64 while 20/20 or 20/30 go Blackhawk? Answer my questions without ad hominems please!!! > Sir, are you suggesting that the pilot who maintains 20/20 "SHOULD" > wear minus to have 20/10? No, I'm suggesting that he should wear whatever it takes to get him to a clear 20/10. That could be plus, minus, or any combination of + and -. Let me get that clear first... HAVING 20/10 > vision doesn't always mean the pilot will spot the target or the > traffic, that is also an issue of training. Of course not. But having 20/10 means that he WILL BE ABLE to spot an approaching target sooner than he would if he were a blurred 20/20. I know pilots can take up > A2A while they are 20/30 or land on an aircraft carrier while they are > 20/40!!! Not on my watch, they wouldn't. At least not without their glasses. > So if 20/20 is not normal vision, what is it? It is STANDARD VISION. I thought everyone on this newsgroup understood that simple definition. Why do service branches > use it as standard? Because it is just that. >No, I'm suggesting that he should wear whatever it takes to get him to a clear >20/10. That could be plus, minus, or any combination of + and - Unfortunately and gladly this is not a requirement by the service branches.... it is your "yes-no-maybe so-feel good" assertion and it has no ground in any medical documents that are in use by service branches. It is nonsense to correct someone to 20/10 who already meets the service standards. >Of course not. But having 20/10 means that he WILL BE ABLE to spot an >approaching target sooner than he would if he were a blurred 20/20. I don't know what to say, you are the only "doctor" I have met who refers to 20/20 "blurry" That is a start I guess :-) I can start talking about how fighter pilots spot targets today technically but I won't go there.. >Not on my watch, they wouldn't. At least not without their glasses Your watch has ended, simply put, 20/40 requirement for Navy is there to allow pilots land on the deck without the help of glasses. A pilot over 20/40 will not be allowed to do so. >It is STANDARD VISION. I thought everyone on this newsgroup understood >that simple definition. Well, if it is standard, is it also blurry??? You haven't answered a bunch of my questions, "it is just that" is not an answer from a person in your position. It is the fact that US Military requires 20/20 from its pilot candidates and that is the end of 20/10 story of yours. >Aren't you the one who suggested dropping the ad hominums? >I will stick to the facts if you will. But I will always object to >someone who suggests people do something that could be dangerous. And I >will challenge when someone states something that is erroneous or >blatantly false. I have applied Otis plus theory successfully, at least I am maintaining stable standard vision while my branch of service requires 20/50 from its pilots. So Otis theory worked for me so this doesn't mean he is completely false. Also since when the truths are ad hominems? Vietnam war is over, right? Right! And Phantoms are in museums today, right? Right. You are retired as well from the AF in 1975! Enough said! It is nonsense to correct someone to 20/10 who already meets > the service standards. I never met a pilot who didn't want 20/10 if he could get it, except you. They ALWAYS wanted the crispest vision they could get, always. You seem afraid of having crisp, sharp vision. And you fly planes. My goodness, what a dangerous combo you are. You should stop flying. >>Of course not. But having 20/10 means that he WILL BE ABLE to spot an >>approaching target sooner than he would if he were a blurred 20/20. [quoted text clipped - 3 lines] > talking about how fighter pilots spot targets today technically but I > won't go there.. Here we go again. I never met a doctor that DID NOT use the term "blurry 20/20" We see use it all the time. It simply means you can make out the 20/20 size letters at 20 ft, you can say the letters, but it is BLURRY! What part of that don't you understand??? >>Not on my watch, they wouldn't. At least not without their glasses > > Your watch has ended, simply put, 20/40 requirement for Navy is there > to allow pilots land on the deck without the help of glasses. A pilot > over 20/40 will not be allowed to do so. The the navy has gotten stupid. Why would you "allow" a pilot to land with 20/40 when he corrects to 20/20, 20/15 or 20/10? Why on earth? (actually, I doubt the navy got stupid, I think your statement is in error). >>It is STANDARD VISION. I thought everyone on this newsgroup understood >>that simple definition. > > Well, if it is standard, is it also blurry??? It can be clear or it can be blurred. If the refractive error is not properly corrected it will be blurry. If the refractive error is properly, or fully, corrected (not "over" corrected, just normally corrected) it will be CLEAR. It is not exactly rocket science. Everyone knows the difference between clear and blurry. I think even you do, and maybe Otis does. Why don't you guys admit it? > Right. You are retired as well from the AF in 1975! Enough said! I did not retire, but was honorably discharged at the end of my draft term. And I am not in retirement from optometry. see: http://www.obase.net if you want the correct information. >I never met a pilot who didn't want 20/10 if he could get it, except you. They ALWAYS >wanted the crispest vision they could get, always. You seem afraid of having crisp, >sharp vision. And you fly planes. My goodness, what a dangerous combo you are. >You should stop flying. Times have changed, glasses in the cockpit while flying in combat environment is highly inconvenient and also discouraged. If a pilot has the vision standards brought forth by the service he is flying with then he doesn't require any better through the use of glasses. Service branches opinion on this is "if he has normal vision, he doesn't need glasses in the cockpit" I never said I am afraid of having such vision. As you put it, many pilots with average normal vision have days they can see 20/10 or mostly 20/15. Flying planes or helicopters today is not the same as flying them back in Vietnam. Do you think all the old fart beergut airliner captain have 20/10 vision when they are flying in Class A airspace? No they have radar and assistance. As for the ending comments, spare 'em to yourself please, we are all glad that you are not slapping -1 on us just to give us 20/10 vision when we have natural normal vision. >Here we go again. I never met a doctor that DID NOT use the term >"blurry 20/20" We see use it all the time. It simply means you can >make out the 20/20 size letters at 20 ft, you can say the letters, but >it is BLURRY! What part of that don't you understand??? Well that is not normal natural vision we are talking about. I understand where you are coming from. There is a refraction error obviously, however I do not think a person would see this blurriness at all times. >The the navy has gotten stupid. Why would you "allow" a pilot to land >with 20/40 when he corrects to 20/20, 20/15 or 20/10? Why on earth? >(actually, I doubt the navy got stupid, I think your statement is in error). Has the AirForce gotten stupid too by dropping the limit to 20/70? Those limits are there to allow the pilot operate the aircraft safely in the event of loss of glasses. A navy pilot who has 20/40 will use glasses but in the event of losing his glasses, he should be able to land on the deck. This minimum is designated as 20/40. Same goes for Army and the AF. Now you have correct information. >It can be clear or it can be blurred. If the refractive error is not >properly corrected it will be blurry. If the refractive error is >properly, or fully, corrected (not "over" corrected, just normally >corrected) it will be CLEAR. It is not exactly rocket science. >Everyone knows the difference between clear and blurry. I think even you >do, and maybe Otis does. Why don't you guys admit it? You cleared the information, I never said I didn't admit this. I am by all means against glasses in the cockpit if there are other means and your myopia doesn't really require them. >I did not retire, but was honorably discharged at the end of my draft >term. And I am not in retirement from optometry. Actually that is what I figured however there is not go back and edit responses. So I have stated it wrong. You were a civilian doctor drafted in the AirForce during Vietnam. I do understand your policies and your methods from what you write but most of these things have changed, you can come up to speed by reading the latest military medical documents. > Times have changed, glasses in the cockpit while flying in combat > environment is highly inconvenient and also discouraged. Could you point out the inconvenience of it? Do combat pilots ever wear non-Rx sunglasses while flying these days? > Well that is not normal natural vision we are talking about. I > understand where you are coming from. There is a refraction error > obviously, however I do not think a person would see this blurriness at > all times. How are you defining "normal natural vision"? I would say that if a person sees bluriness at ANY time, there is a problem. It may be normal and natural for a person to see bluriness, but it is certainly not beneficial in the cockpit, even occasionally. > Has the AirForce gotten stupid too by dropping the limit to 20/70? > Those limits are there to allow the pilot operate the aircraft safely > in the event of loss of glasses. A navy pilot who has 20/40 will use > glasses but in the event of losing his glasses, he should be able to > land on the deck. This minimum is designated as 20/40. Same goes for > Army and the AF. Now you have correct information. OK so I think you're saying that 20/70 unaided is ok, but they are NOT recommending flying without glasses for anyone who needs them to see 20/20 or whatever, right? I hope there is still a minimum corrected acuity. I think it used to be 20/20, but in light of your comments, they may have even relaxed that. w.stacy, o.d. >Could you point out the inconvenience of it? Do combat pilots ever wear >non-Rx sunglasses while flying these days? Why do you need sunglasses when flying with NVG under night conditions? Plus, it is highly discouraged to wear sunglasses due to the fact of high performance aircraft ejection issues, that is why HGU-55/P helmets have sun visors. Pilots can do it at their own discretion but issues still stand and the military knows about it. >I would say that if a person sees bluriness at ANY time, there is a problem. It may be >normal and natural for a person to see bluriness, but it is certainly not beneficial in the >cockpit, even occasionally. You are saying that a person can have 20/20 at all times but still can have a refraction error which will cause blurry vision. OK! What can this refraction error be? Astigmatism, etc? If a person has 20/20 vision but also a refraction error can this person see 20/20 at all times? I was talking about people with no refraction error. >OK so I think you're saying that 20/70 unaided is ok, but they are NOT recommending >flying without glasses for anyone who needs them to see 20/20 or whatever, right? I >hope there is still a minimum corrected acuity. I think it used to be 20/20, but in light of >your comments, they may have even relaxed that. Right, well it is not about recommending or not, 20/70 is way too much, it is only allowed at emergency situations to land the aircraft safely. Why does this at 20/50 for the Army, due to the different nature of missions and aircraft. Minimum correctable (aided) vision is 20/20 for all services, no, it is not relaxed. Only AF navigators or naval flight officers can have that aided 20/40 (not correctable to 20/20) > Plus, it is highly discouraged to wear sunglasses due to the fact of > high performance aircraft ejection issues, that is why HGU-55/P helmets > have sun visors. Pilots can do it at their own discretion but issues > still stand and the military knows about it. That's unchanged then. Some pilots liked the optical quality of (glass in those days) lenses over the plastic helmet visors, which tended to get scratched up. > You are saying that a person can have 20/20 at all times but still can > have a refraction error which will cause blurry vision. OK! What can > this refraction error be? Astigmatism, etc? If a person has 20/20 > vision but also a refraction error can this person see 20/20 at all > times? I was talking about people with no refraction error. Certainly there are many, many people who can make out the 20/20 line on the chart, even though it is quite blurred and this blur can be from mild myopia, hyperopia, astigmatism, or any number of organic causes (corneal scar, vitreous floater, retinal defect, etc.) Also, many people with no refractive error (emmetropes) are not able to read 20/20 due to orgranic problems. In fact this thread is a misnomer. Should be something like "vision clearing from -2.75 to -1.00" or "clearing from 20/200 to 20/25" so that you are comparing apples with apples and oranges with oranges. I'm sure you got acuities and refraction mixed up due to otis, who apparently can't bring himself to use accepted terminology properly. w.stacy, o.d. >Should be something like "vision clearing from -2.75 to -1.00" >or "clearing from 20/200 to 20/25" I agree, Otis might have made an error here since I remember reading the same article on his email group where he only mentions acuity. >I'm sure you got acuities and refraction mixed up due to otis, who >apparently can't bring himself to use accepted terminology properly. I don't agree, I know that many people have different acuities and different refraction errors. A person like you said might need a -1.00 to clear to 20/20 from 20/30 though I have never met one. But then another one might need -.25 (I don't know if they even prescribe that one) to clear that line. Eye is the most complex organ in my opinion and I love the way it works and love to learn about it. Yes. For example, let's take two individuals whose Snellen visual acuities were 20/40, but slightly different manifest refractions. If one were to perform a wavefront analysis on both, one might discover that one had more higher order aberrations than the other. Whereas 90% of the refractive error in one eye might be due to simple defocus, the other may have various other components, such as spherical aberration, which may not respond as well to a spherical correction. In other words, not all aberrations are addressed efficiently by simple lenses such as sphere and cylinder. Defocus has a low frequency, with one cycle over the entire reference area, whereas other aberrations have higher frequencies. The role of the pupil also comes into play, as well as other factors such as eyelids and fissure width. For example, it is not uncommon for an Asian individual with a refractive error of -2.00 to have an uncorrected visual acuity of 20/80. DrG > I don't agree, I know that many people have different acuities and > different refraction errors. Totally agree. A person like you said might need a -1.00 > to clear to 20/20 from 20/30 though I have never met one. Maybe you haven't, but how would you know? Most people don't have a clue what their acuities and refractions are. But I have the luxury of looking at them every day on every patient. I'd guess that the many -1.00 myopes I've seen mostly range from 20/30 to 20/50 unaided. I could certainly go to my files and look. But then > another one might need -.25 (I don't know if they even prescribe that > one) to clear that line. Don't think I've ever seen a -.25 without eye disease who couldn't read 20/20 unaided. Eye is the most complex organ in my opinion > and I love the way it works and love to learn about it. And totally agree here, too! w.stacy, o.d. > For instance, and eye might measure at > -2.75 diopters, but have "normal eye" myopia, > or pseudo-myopia -- rather than "eye-length" > myopia. Do you finally acknowledge now that accommodative myopia is the only form of myopia where your plus lens therapy has a chance to work! If so-- hats off to you Otis. Maybe your mind is a little more "dynamic" than I suspected. Dear RM, Mike at 2.75 diopters was NEVER told that he had PREVENTABLE myopia. The OD simply spun the dials on his phoropter, and declared that Mike had myopia and the -2.75 diopter was the "cure". The only way that Mike found out that the negative refractive state was prevetable -- was to start reading his own chart, working VERY HARD with the plus, and verifying that VERY SLOWLY the lines on the eye chart began to clear. But this is no thanks to the OD who said NOTHING about the preventive "second opinion" and how to do it. Fortunately there are now ODs who WILL support the child and parent with this preventive method -- because they are using a strong plus on their own chidren. I would suggest reading this honest second opinion by Steve Leung. www.chinamyopia.org A true professional would have no problem discussing this alternative with parents when their child is reading 20/50 -- and a decision must be made -- not by you -- but by the parents. But you mind is closed to this. By your mind is closed to this -- which is why Mike had no choice but the figure out how to do is himself -- and avoid the -1/2 diopter per year "down" rate that chidren get into when they begin wearing an over-prescribed minus lens prescribed for "best visual acuity" -- because you believe that they "want" 20/10 vision. Respecting a child's right to an informed, second-opinion is the first step in preventing a negative refractive state of the eye. If you informed a parent honestly about this issue, the WORST they could do would be to say they have no interest in true-prevention. And THEN you could place a minus lens on their face. Let use learn to grow in wisdom and knowledge about this subject my friend. Best, Otis > Mike at 2.75 diopters was NEVER told that he had > PREVENTABLE myopia. > > The OD simply spun the dials on his phoropter, and declared > that Mike had myopia and the -2.75 diopter was the "cure". Never mind that Mike told the OD that -250 was blurry. -MT Dear Mike, In semi-darkness the eye goes to a "dark-focus" or tonic accommodation position. This was discovered about 100 years ago by Rayliegh (Sp) and others. In room illumination this same eye could well have 20/40 vision and pass the DMV-Snellen test. (But you NEVER check for this -- of course -- but Mike did.) Now, if Mike spent 16 hours a day in semi, or deep darkness then yes, he should be wearing a -2.5 diopter lens. But, under DMV test conditions -- there would be no reason to do so, and the -2.5 diopters would be grossly over-prescribed. But Mike knows this -- because he know what YOU think and what YOU DO. Equally, Mike accepted personal responsibility to keep his distant vision clear -- even though it took time for him to do it. Yes, his 20/40 was tempoary -- as he worked to clear to 20/20. Now that he is at 20/20 he will pass the DMV with flying collors -- no thanks to you. In the future, should he do long-term studying, and see his eye-chart move down to 20/30, then he, as aresponsible adult, will simply re-start his plus lens use, and clear back to 20/20. Since you told me that only I have "interest" in prevention and you do not -- then you are you concerned that Mike figured out how to do this scientific work "correctly" for his OWN PERSONAL ADVANTAGE. You are acting more like a person "defending the faith", rather than a person concerned with Mike's long term visual welfare. Best, Otis > In room illumination this same eye could well have 20/40 vision and > pass the DMV-Snellen test. (But you NEVER check for this -- of > course -- but Mike did.) Actually I do. Why do you assume so much? > Now, if Mike spent 16 hours a day in semi, or deep darkness > then yes, he should be wearing a -2.5 diopter lens. So Mike doesn't want to see roadsigns at night. > But, under DMV test conditions -- there would be > no reason to do so, and the -2.5 diopters would be > grossly over-prescribed. If -2.25 is blurry, how is -2.50 "over-prescribed?" > But Mike knows this -- because he know what YOU think > and what YOU DO. Then he's lying about the -2.25? > Equally, Mike accepted personal responsibility to keep his > distant vision clear -- even though it took time for him > to do it. So if he gets nearsighted, it's his own fault? > In the future, should he do long-term studying, and > see his eye-chart move down to 20/30, then > he, as aresponsible adult, will simply re-start > his plus lens use, and clear back > to 20/20. Please show us some published evidence that this works. > Since you told me that only I have "interest" in prevention > and you do not -- then you are you concerned that > Mike figured out how to do this scientific work "correctly" > for his OWN PERSONAL ADVANTAGE. I have considerable interest in prevention. Please show me how you know your therapy works, so I can advertise it to my patients. > You are acting more like a person "defending the faith", > rather than a person concerned with Mike's long > term visual welfare. Please show us some evidence that minus accellerates myopia. You haven't done that yet, and you won't do that. We are supposed to accept your Rehm-Brown hypothesis without evidence. Who's defending "faith?" -MT Spare me the long blah blah dialogue about the "second opinion" etc. We are all so sick of hearing your diatribe about Raphaelson, chinamyopia.org, old dead behavioral optometrists, "the wretched minus", the great OD/MD conspiracy to make everyone need eyeglasses, how our minds are "closed" while yours is enlightened, etc. I am glad that you apparently now realize that some myopia is "preventable" and that some is not. Accommodative myopia can perhaps be treated with plus lenses, or more realistically simply by not using the minus lens prescription, when that patient is doing near tasks. Anatomical myopia, which is far more prevalent, and is due to increased axial length and/or refractive power of the lens/cornea, cannot be treated in this fashion. If you are actually agreeing to this Otis then I give you credit for finally learning something from all the schooling and references that have been provided to you over the last two years. PS-- Good eyedocs do not "overprescribe" minus lenses as you seem to suggest. Really Otis-- you are so off track with your crusade against minus lens correction that you need to switch to something else. You are an embarrassment to engineers everywhere. Go back to the sextant and other 15th century technologies where you are better grounded in the science. ============== > Dear RM, > > Mike at 2.75 diopters was NEVER told that he had > PREVENTABLE myopia. |
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