Medical Forum / General / Vision / May 2005
Myopia
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William Stacy - 04 May 2005 19:54 GMT It may startle some people who have claimed that I have no interest in myopia prevention, but on my web site is the following article that I wrote several years ago:
http://www.obase.net/myopia.htm
Some of the more traditional o.d.s may disagree with that article.
w.stacy
LarryDoc - 04 May 2005 21:09 GMT Here's one "the plus" junkies/zealots are going to hate:
This morning I examined a person who was wearing - .75 contact lenses for in the right eye only. Every refraction in past years indicated that patient X was -.75 RE and -2.25 LE. No contact lens was worn in the left as the patient was enjoying the monovision experience.
Today's exam: Right eye +.25, left eye -1.50. That's a .75- or 1.00 REDUCTION in myopia in BOTH EYES, yet one was using the evil minus lens and the other was essentially using "the plus". Now, patient x doesn't need to use glasses or contacts at all!
Go figure.
Oh.....that's right. That's why we have jobs. People's prescriptions change. Plus or no plus. Minus or not. Maybe the room was too dark the last exam and too brightly lit this one. Nahhhh.
--LB, O.D.
Scott Seidman - 04 May 2005 21:26 GMT LarryDoc <larrybic@yahoo.remove.com> wrote in news:larrybic- BA03FF.13093904052005@news.verizon.net:
> Maybe the room was too dark the > last exam and too brightly lit this one. Nahhhh. > > --LB, O.D. Maybe your patient just assumed personal responsibility for his own vision. That'll do it every time.
Scott
RM - 05 May 2005 01:40 GMT He was probably an engineer-pilot who is intelligent and is enrolled in a 4-year college.
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> Here's one "the plus" junkies/zealots are going to hate: > [quoted text clipped - 15 lines] > > --LB, O.D. otisbrown@pa.net - 05 May 2005 16:33 GMT Dear RM,
Probably the engineer-pilot paid attention to the published SCIENTIFIC reports showing that the natural eye "adapts" (by moving negative) in a four year college.
http://news.bbc.co.uk/1/hi/education/3907893.stm
Oh, I forgot -- you do not tell your clients about this -- it might concern them when they see their vision gradually down, from 20/20 to 20/30, and 20/40.
But you simply will not volunteer information of this nature -- will you.
Best,
Otis
Dr. Leukoma - 05 May 2005 16:38 GMT So, what was the result of Dr. Garrido's research into "special lenses" for prevent myopia?
Seems like the sensible thing to do would be not go to college or not study.
DrG
otisbrown@pa.net - 05 May 2005 16:46 GMT Dear DrG,
It is up to the reader of this report to draw his own conclusion about what sort of "preventive" step he might wish to take.
If he were examined by Steve Leung OD, I am certain that Steve would have no problem recommending the use of the plus for prevention.
It is really up to the individual to judge the relative value of his distant vision when it is 20/30 or 20/40.
Both of us know that "the public" as little interest in "protecting" their distant vision at that level -- but if they do -- the "plus" can be effective for them.
I don't think you have any objection to that statement.
Best,
Otis
Dr. Leukoma - 05 May 2005 17:32 GMT But then they would have to go all the way to Asia to be examined by Dr. Leung, who may not have a problem recommending plus for prevention, whereas I would. But, then, what do I know after 20 years?
DrG
Mike Tyner - 05 May 2005 16:54 GMT > Probably the engineer-pilot paid attention to the > published SCIENTIFIC reports showing that > the natural eye "adapts" (by moving negative) > in a four year college. Flash! College students get nearsighted! Stop the presses!
> http://news.bbc.co.uk/1/hi/education/3907893.stm That would be the article where Dr. Gerrido says:
"We have to find another way to prevent the onset of myopia."
As in "the old methods DON'T WORK."
-MT
otisbrown@pa.net - 05 May 2005 17:00 GMT Dear Mike,
There is no doubt that "prevention" is difficult. It does depend on the person deciding on the relative value of his distant vision. YOU CAN NOT PRESCRIBE THIS.
Where the person himself studies all these issues, and understands YOUR POSITION, and factors in the fact that you "defend your turf", then he might get the better idea.
For Mike, who was at -2.75 diopter (probabably over-prescribed) to work his way back to 20/25 took MAJOR EFFORT.
Only the person himself can make that decision. You, my friend, can NOT make that choice for him.
Best,
Otis
Mike Tyner - 05 May 2005 19:01 GMT > Only the person himself can make that decision. You, > my friend, can NOT make that choice for him. I'd be glad to offer it. Just show me how you know it works.
Efficacy. Efficacy.
-MT
otisbrown@pa.net - 06 May 2005 05:36 GMT Dear Mike,
The PREDICTION that it COULD work comes from the study of the dynamic nature of the primate eye -- where you test the "input" (visual enviroment) versus "output" (refractive status). Very clear in concept.
The implement, however, must be by the person himself.
As you say, HIS (not Your) judgment of his own efficacy.
SInce "Mike" and "Jon" -- who have done it themselves know the "efficacy" of their own efforts -- I don't see how you could be involved.
We both agree that the natural eye can have pseudo-myopia, pseudo-hyperopia, and maybe pseud-emmetropia.
Let us just say that they verified that their vision cleared, by their own efforts -- and let it go at that.
If you have any suggestions or recommendations -- I would be glad to forward them.
And lastly, we should both congratulate them on solving a very old and difficult problem -- by their own judgment and perseverance.
Unless you regard them as incompetent.
Well done.
Best,
Otis
William Stacy - 06 May 2005 13:49 GMT > We both agree that the natural > eye can have pseudo-myopia, > pseudo-hyperopia, and maybe > pseud-emmetropia. Who agreed with that? If pseudomyopia is defined as an eye that under certain conditions measures myopic due to a spasm of the ciliary muscle, (do we agree on that?), then what would pseudo-hyperopia be, an eye that measures hyperopic due to an over-relaxation of the ciliary muscle? What would that be? How can a muscle relax more than totally? Can a muscle go into "negative contraction"? Never seen or heard of that. And what would pseudo-emmetropia be? Maybe a hyperopic eye that is not fully relaxed? I suppose I could accept that because it is certainly a common state of low hyperopia, but I'm not sure of what benefit or use such a definition would be.
w.stacy, o.d.
LarryDoc - 06 May 2005 15:02 GMT I can't believe you folks are STILL doing this! It's two and half years of the same BS! This must be the longest single-minded run of garbage discussion on the internet!
I swear the stuff that Otis writes flows out of his a.s, because clearly there's nothing in his brain. He is only capable of typing the same words, over and over and over. Anything not previously typed and then cut-and-pasted into his obvious template is so bizarre, completely wrong or outright lies that he must be totally delusional. Why not just reply with that?
Geez!
LB, O.D.
RM - 06 May 2005 02:09 GMT > There is no doubt that "prevention" is difficult. It certainly is since nothing has been shown to be effective. Most of all, your plus lens approach. I think meditation and goat sacrifice have a better chance of working than your all-ready-proven-to-be-ineffective method.
> It does > depend on the person deciding on the relative value of > his distant vision. YOU CAN NOT PRESCRIBE THIS. So when a person decides for himself that he wants to prevent myopia, what method should he use? Plus lenses don't work!
otisbrown@pa.net - 06 May 2005 04:24 GMT Dear RM,
As far a prevention is concerned, I believe that it will depend on the person himself.
Clearly (from the bifocal studies) the refractive status (at West Point) moves down at a rate of about -1/3 diopter per year. (Or -1.33 diopters in four years -- as we discussed.)
Equally, any "clearing" would probably be at a similary rate, say +1/3 diopter per year -- for sake of argument.
Strong use of the plus is required.
The only person likely to pay that "price" is a person whose "profession" requires that they maintain their distant vision, through the college years.
I doubt that you could ever be involved in this work, since the concept requires that the individual do the work with considerable force.
An the person who, was say at 20/50 or 20/60, who SLOWLY clears to 20/40, and then 20/30, then to 20/25, and 20/20, is going to say the hell with OD involvement, there is no reason to pay them -- for work I did myself.
This is of course the implication of the two men who cleared their vision to exceed the required LEGAL standard.
You may not like it -- but that is the way it is.
Since they are going to enter a four year college, all the need to do is to make certain they pass the legal visual standard that applies to them.
Since that will develop in the next four years, only they will be following this type of "progress".
At that point, the effort and understanding -- and results will depend on them -- alone.
By that time, you and I will have lost track of them -- and the issue be a matter of their own judgment.
Something to think about.
Best,
Otis
RM - 06 May 2005 06:03 GMT > As far a prevention is concerned, > I believe that it will depend > on the person himself. I would also guess that it would depend on the science, physiology, biochemistry, and anatomy of the eye. Don't you think? Sheer will and desire cannot cause the physically impossible to occur. Can a tall man, by sheer will and desire, cause himself to become shorter?
> Strong use of the plus is required. It doesn't work Otis. Its been tried in multiple studies and it doesn't work. Your brain is not only static, I think it's dead. You are truly a man of strong faith Otis.
> I doubt that you could ever > be involved in this work, > since the concept requires > that the individual do the > work with considerable > force. You're right. I will never be involved in having a person do something that has been proven to be ineffective.
> You may not like it -- but > that is the way it is. I would be happy for anyone to be able to reverse myopia. Just show us a valid scientific study where it has been proven to work and I will start my patients on it right away.
> Since they are going to > enter a four year college, all the > need to do is to make certain > they pass the legal visual > standard that applies to them. So you think this approach will only work for someone who is going to go to a 4-year college? Why so? What about those entering a 2-year associate program, or those attending beauty school. How about trade school. Wouldn't you guess simply their age is more relevant-- or is it just for engineer-pilots?
> Something to think about. something for you to fanaticize about while you are waiting for your turn in shuffleboard.
RM - 06 May 2005 02:05 GMT Otis, Of course I discuss this with patients. They ask about it all the time. The issue is-- what can anyone do to prevent "student" myopia? Your plus lens approach has been tested and found to be ineffective.
Why do you point out this article, which all eye doctors have known about for years from 1st hand experience, as if it somehow proves something about the quackery that you advocate? It simply points out the relationship between near work and myopia. Duh!
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> Dear RM, > [quoted text clipped - 16 lines] > > Otis
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