Dear Prevention minded friends,

Some scientists believe that if you can prevent
pseudo-myopia -- you can prevent myopia.

The jury is still out on that scientific subject,
but here is some of the discussion supporting
your right to be informed about a peventive
method to move all "near" objects out to infinity
by use of a strong plus lens.

As always, enjoy our pleasant thoughtful
discussion about the dynamic behavior
of the natural eye.  (Unless you
believe otherwise.)

Best,

Otis

                    ________________________________

             The Truth About Seeing

         Prevention with the plus -- as the second-opinion.

    [A Note From the Web Master:  I'd like to add that in my own
experience, the optical profession is made up of highly qualified,
competent, caring individuals, some of whom I happen to disagree
with.  Regardless, I do not envy their positions, for they face
quite a dilemma.  The existing standard for treating
nearsightedness is to let it run wild; traditional treatments do
not help nearsightedness, and quite probably make it worse.  On
the other hand, in adopting newer treatments for nearsightedness
the brave ones risk raising the eyebrows of parents, patients, and
colleagues alike with unfamiliar treatments that most of us are
not accustomed to.  (A major goal of this site is to educate the
public so that we can be better patients!) That there is a
spirited debate between the two camps should not be taken as any
sign of disrespect for the optical professionals we so depend on
-- none is intended.  ja]

     +++++++++++++++++++++++++++++++++++++++++++++++++++++

      THE TRUTH ABOUT SEEING:    GUARDING YOUR CHILD'S VISION

    By Vera F.  Rollo, Stirling Colgate, and Otis Brown

    It's not that eye specialists and optometrists in treating
nearsightedness want to provide an incorrect method of treatment.
The fact is, however, that many health care professionals feel
forced to follow the tradition of the last 300 years.  Actually
there are two options in treating nearsightedness.  The
traditional one is to prescribe minus lenses (which gives a "quick
fix").  This unfortunately results in progressive worsening and
the requirement for stronger minus lenses at each subsequent eye
examination.  The other option is to provide a positive lens
(essentially a magnifying or relaxing lens) for reading.  This
approach produces a long-term solution by gradually restoring
clear distant vision to the naked eye -- but only
at the threshold before the eye "adapts" to the over-prescribed minus.

    The plus lens is used only for close work at this point.  The
20/40 the person has is acceptable for most DMV-Snellen tests.

    You may say, "But that doesn't make sense.  Isn't that
contradictory?"

    Well perhaps, on the face of it, yet we are familiar with
quick fixes that only make the problem worse in the long run.  The
easy fix taps into the very strong human tendency to resist
innovation and scientific knowledge, to do things the way one has
always been taught.  Yes, even in spite of the evidence!

    The evidence, supported by studies done as early as 1961, is
that the understanding of the normal (remember the word normal)
eye is quite neglected, [1].  Most researchers and medical
professionals have focussed on the defective eye and the diseases
of the eye.  Only a few researchers have studied the normal eye
and what a marvelous organism it is.

    The eye develops its focal state in response to its
environment.  This is an essential behavioral characteristic of
the normal eye.  The eye does not develop nearsightedness (a
negative focal state) until about the age of seven or eight when a
child reaches second or third grade.  When a youngster studies,
reads, writes, he or she is looking near at hand.  After years of
this close work, the eye gradually adapts to this close focal
environment.  In a word, he or she becomes nearsighted.

    Prescribing and using a minus lens enables the student to
immediately see an eye chart, which is at a distance.  This is
because the negative lens makes the chart have the focal
properties of an object much closer.  The negative lens encourages
the eye to adapt to all objects being closer, and so the eye
becomes even more nearsighted.

    But, you may ask next, what else can an optometrist or
ophthalmologist do?  After all, hasn't instant clarity of vision
been provided for the child?  Hasn't the child's long-term vision
been preserved?

    Not really.  Not when studies have shown that, instead, the
eye professionals should be discussing the alternative method, and
encouraging youngsters to study wearing a plus lens.  At the very
least, eye doctors should advise the student and his parents that
he must make a clear cut choice between these two major
alternatives.

    Many eye professionals do, in fact, make this recommendation.
You see, the plus lens will make reading easier, too.  It enlarges
the type on the page and relaxes the eye.  But most important of
all, it helps your child avoid the problem of progressively
worsening myopia.

    But don't all health professionals know this?  Some do, some
don't.  Many find it difficult to make the extra effort to
discuss, educate and explain this preventive approach to their
clients.  Some even resist the facts demonstrated by many
scientific studies.

    Let's take a look at just three things:  common
misconceptions about nearsightedness; the studies that prove that
the eye is dynamic; and some examples that show that plus lenses
do work to prevent nearsightedness.

    First, nearsightedness is not a disease.  The medical term
for the eye's long-term behavior is "myopia" -- which sounds like
a disease, but it isn't -- in fact, it isn't even an eye defect.
It's an adjustment, or accommodation, that the normal eye always
makes to the reading environment.

    The use of a minus lens began in the seventeenth century when
Johann Kepler, astronomer and scientist, found that he was
becoming nearsighted, [2].  He applied a negative lens to his eyes
and found that this lens instantly made distant objects clear.
This same idea is routinely used today.

    Secondly:    A further misconception is that the eye is like a
static box camera.  It is and it isn't.  It is a camera all right,
but it is not static.  Back in the 1860s Dr.  H.  Helmholtz and
Dr.  F.  C.  Donders came up with the box camera theory, [3], [4].
But this theory simply ignores the fact that the normal eye is a
dynamic structure which accommodates continuously in response to
changes in its environment, or visual demands placed on it.

    Thirdly:  The evidence began to surface a long time ago about
the problem of the reading environment.  In a paper presented to
the Royal Society of London, in 1813, the Honorable James Ware
related his observations on nearsightedness, [5].  He found that
the educated officers of the Queen's Guard were frequently
nearsighted while among the 10,000 foot guards a scant half-dozen
were nearsighted!  None of the foot guards had been educated
enough to be able to read.  Nearsightedness, myopia, was correctly
attributed to the habit of looking at near objects.

    In modern times, Dr.  Frances Young studied the Eskimos of
Point Barrow before and after the introduction of schools.  You
can guess the results of his study.  There was found a sudden and
dramatic increase in myopia where nearly none was present in the
past.  A very large percentage of the children in schools became
myopic, [6].  A reading environment can be hazardous for the
health of your eyes!

           How Was A Solution Achieved?

    An early, successful prevention of myopia was accomplished by
Dr.  Jacob Raphaelson, [7].  This result, occurring in 1904, had
rather ironic consequence for him.

    A mother mentioned to him that her son had difficulty in
seeing in school.  The doctor made an appointment to fit the boy
with glasses.  Raphaelson found that the boy's vision was poor,
worse than 20/40.  The mother promised to pay the doctor when her
husband, a printer, returned in about six weeks.  So Dr.
Raphaelson provided positive lenses, rather than the conventional
negative lenses, and agreed to wait for payment.

    The boy used these lenses and in under six weeks his vision
was tested and found to be excellent.  His nearsighted eyes had
been returned to 20/20.  But when the father appeared, he refused
to believe that the doctor had effected a cure, because the boy's
eyes were fine!  The mother returned the glasses to Dr.
Raphaelson.

    The point should not be lost that had Dr.    Raphaelson fitted
the boy with negative lenses, the boy would have immediately seen
clearly at a distance.    Both the boy and the mother would have
been immediately happy and Dr.    Raphaelson would have been paid
for the prescription of glasses that provided this solution.  As
the years passed, Raphaelson would have been paid again and again
for increasingly stronger negative lenses.  This argument, that
only a instant solution can be provided, and that recovery cannot
be achieved with a plus lens, surfaces in various forms to this
day.

    For years, since 1879 in fact, studies of military cadets in
the United States have shown that their vision changes over the
years of their academic work.  Records reveal that a large
percentage of the cadets (39% of those at the U.S.  Military
Academy in 1956) [8] became nearsighted and needed negative lenses
by graduation.    Further, of those who developed 20/25 vision, only
one percent recovered to 20/20 over the four years, [9].  (They
were not provided with plus-lenses, and for this reason had no
chance to recover.) In early years their degraded vision was
blamed on the fumes of gas lighting, and later, on any number of
factors, but the upshot of the studies was that none of these
circumstance were really behind the cadet's loss of visual acuity.
The myopia (change of focal state) was caused by constantly
looking close, studying, reading, looking at books, rather than at
distant objects.

    "Chickens Don't Lie", might well be an amusing title for the
study done by Dr.  Howard C.  Howland of Cornell University in
1987.  (The formal name of the no-nonsense study, however, was
"Accommodation, Refractive Error and Eye Growth in Chickens"),
[10].  Dr.  Howland wanted to find out the effects of positive
lenses and negative lenses on normal eyes.

    Dr.  Howland took five chickens and put plus lenses on them.
Another five chickens were equipped with minus lenses.    Yet a
third group had a plus lens on one eye and a minus lens on the
other eye.  A control group was maintained for standard scientific
protocol.  In every case the eyes of the chickens with plus
lenses, upon examination, were found to have accommodated in a
positive direction.  Also, in every case the eyes of the chickens
with minus lenses accommodated in a negative direction.  This
clearly showed that lenses do profoundly affect the focal state of
the eye.  Translated into human terms, the negative lens caused
nearsightedness, and the positive lens restored clear distant
vision.

    DOES THE NORMAL HUMAN (PRIMATE) EYE BEHAVE THE SAME WAY?

    Monkeys were used in another study to find out more about the
normal eye.  This study was conducted by Frank Young, Ph.D.,
Washington State University.  Monkeys were used because they are,
frankly, the closest animals to humans.  [1]

    Dr.  Young confined adolescent monkeys in a box where they
were looking very close, about 14 inches in most directions with
20 inches as a maximum, for eleven months.  A control group of
monkeys was maintained and kept in regular cages.  No lenses at
all were used on the animals.  Here, the argument being tested was
the expectation that environment would not cause a negative change
of focus in the normal eye.

    Young, checking the monkeys in the boxes, found that all
their eyes accommodated in the direction of nearsightedness -- to
varying degrees.  The correlation to the changed visual
environment was excellent.  The correlation coefficient was in
fact 0.97, where 1.00 would be perfect correlation, [11].  The
control group showed no meaningful change in their focal status,
indicating that if you do not change your visual environment, the
focal status of your eyes will not change.  This experiment
explicitly demonstrates that the normal eye always changes its
focal state to match one's changed visual environment.

        BUT WAIT, WHAT DOES ALL THIS PROVE?

    It shows that the eye is not a rigid "box camera" as was
previously thought, but is in fact a dynamic living organism that
always adjusts its focus to its environment.  It always changes,
it always accommodates!

    Frankly, and somewhat understandably, studies of the normal
eye have been avoided with the thought that they are unnecessary.
Medical researchers, instead, have concentrated on eye diseases
and disorders.    This in the face of much accumulated statistical
data that clearly shows that the focal status of all military
academy students moves toward nearsightedness -- from their plebe
year to graduation, [9].

              WHAT SHOULD YOU DO?

    To protect the eyes of your children, you may wish to consult
with your eye care professional.  Ask him for a discussion
concerning the effective use of a plus lenses for recovery and
prevention.  We are assuming that the child either has 20/20
eyesight and you want to prevent nearsightedness.  Or, that your
child has just failed to read the 20/20 line on the eye chart, and
is therefore on the threshold of nearsightedness.  You obviously
want to work with the eye specialists to help your child clear and
maintain his distant vision.

    Further, you should obtain an eye chart so that you can check
your child's eyesight yourself.  (These charts cost about $8.00).
Your eye doctor will sell you one, or will assist you in getting
one if you ask for it.

           WHAT WILL YOU ENCOUNTER?

    You will meet some eye professionals who are willing to help
you.  You might, perhaps, ask for a "behavioral optometrist".  Now
some optometrists and ophthalmologists may resist innovation and
oppose your efforts to help your child recover from
nearsightedness, as a personal bias.  It is also true that some
ophthalmologists are supportive of the preventative approach since
they have, for some time, recognized the bad effect that a
negative lens has on the normal eye.  With this recognition they
have either declined to use the lens at all, or have
under-prescribed the negative lens, [12].

    If your selected doctor is unwilling to discuss the normal
eye's behavior with you, as well as the bad effect the negative
lens has on the eye, or is opposed to any use of a positive lens
for recovery and/or prevention, it would be wise to seek another
doctor with a more reasonable outlook.

    Your decision is critical at this stage!  While completely
successful recovery may be obtained when your vision is 20/25,
20/30, and even 20/40, there is a limit to the eye's ability to
respond properly to a positive lens.  You should be knowledgeable
of the long-term effect that a lens has on the eye -- before you
finally chose to use the negative-lens approach.  The negative
lens will push your eyes rapidly towards 20/100, and worse.
Tragically, it is also true that after this happens, a positive
lens can no longer have the desired recovery effect, [13].

         WHAT IS THE JUDGMENT OF EYE DOCTORS?

    Members of the health profession have developed the
alternative approach to the historical practice.  Since 1949 they
have pioneered a plus-lens (bifocal) approach, [14].  In addition,
individual members of the eye-care profession have strongly railed
against the complacency that exists within the profession.  In a
paper presented to the ANZAAS Scientific Congress in Auckland,
Maurice Brumer said, [15]:

    ".  .  .  The eye care professions of Optometry and
Ophthalmology have resisted change irrationally and fearfully,
unwilling to admit that what has gone on before [the use of the
negative-lens] has been wrong and harmful, and by doing so they
have unleashed on the public they serve a cataract of horror.
This continued situation [of failing to inform the public
adequately of the danger of minus-lens use] is a tragedy for the
public and disgrace for optometry.

    "While it is understandable that optometrists will not find
it easy to admit that what they have been doing is wrong and
harmful, especially for those academic university optometrists
responsible for the education of our graduates, to preserve the
current horrors to protect our professional prestige and privilege
is an abdication of our responsibilities, ethics and morality.

    "I can make no apology for causing embarrassment to my
professional colleagues.  The interests of the public are
paramount and must be served.  The purpose of this paper is to
direct the future to end the disgrace of the past."

     ALL THIS IS FINE, BUT DOES IT REALLY WORK?

    One of the authors of this paper, Dr.  Stirling Colgate, has
used the above described technique to restore his own vision.
When he was 14 years old he found that he had 20/80 vision.  By
persistently using the plus lens for all close work, he
successfully returned his vision to 20/20.  While overseas during
WWII he twice lost his positive lens glasses and soon developed
myopia.  Each time, after roughly six months, he again obtained
positive lenses for reading and returned his vision to 20/20.  He
is a physicist with the Los Alamos National Laboratory.  Yes, both
personal experience and scientific studies prove that it works.
In Dr.    Colgate's judgment, anyone could accomplish the same
result if he has similar motivation, commitment and understanding
of the normal eye's behavior.

             REFERENCES

Frances A.Young, "The Effect of Restricted Visual Space on the
     Primate Eye", Am.  J.  Ophth., Vol.  52, No.  5, Part
     II, 799-806, 1961.

Kepler, J., (1571-1630) "Dioptice:  Seu demonstration eorum quae
     visui et visibilibus propter conspicilla non ita pridem
     inventa accidunt", Augsburg, 1611

Helmholtz H., (1821-1894) "Physiological Optics", Translation by
     the Optical Society of America, 1924 Note:  Helmholz
     introduced word hyperopia.  Donders, F.  C., (1818-1889)
     "Accommodation and Refraction of the Eye", London, The
     New Sydenham Society.  1864

Note:  The words emmetropia and ametropia were introduced by
     Donders.

Donders took the focal states of the normal eye to be DEFECTS of
     the eye.  Any non-zero focal state of the eye was, by
     definition, a defect (ametropia).  A focal state of
     EXACTLY zero was defined as "normal".  Under this
     definition, very few, if any, animals or humans have
     eyes that are normal!

Ware, J.  "Observations relative to the near and distant sight of
     different persons", Phil.  Trans.  Roy.  Soc., Part
     1:31-50, 1813

Young,F.A., Leary, G.  A., Goo, F.  J., Johanson, C., Baldwin, W.
     R., West, D.C., Box, R.  A., and Harris, E., "Refractive
     Errors, Reading Performance, and School Achievement
     Among Eskimo Children", Am.  J.  Optom.  & Arch.  Am.
     Acad.  Optom., 47 (5), 384-390, 1970.

    (A review of this study is provided by Dr.  Maurice Brummer,
reference 15).

    The cause of myopia is further clearly indicated in a study
of 1,200 Eskimos in Barrow, Alaska, published in the American
Journal of Optometry in 1970, which showed that in one generation
of the Eskimo population had moved from no myopia to approximately
65% myopia among the off-spring, and that neither the grandparents
nor parents over 40 had any myopia.

    Thus the first generation between grandparents and parents
was similar in that myopia was nonexistent, but in the second
generation between the parents and their children, suddenly myopia
occurs in a surprisingly high number of children.  As a matter of
fact, of 53 offspring who were in their early 20's, 88% had
myopia.

    Such a sudden and great degree of change cannot readily be
accounted for on the basis of heredity, especially when there has
been no identifiable force which could have brought about this
obviously considerable mutation in the genetic composition of the
offspring.

    The obvious difference between the parents and the children
is the amount of near work which is currently being done by the
children.  About the time of the second World War, the white man
intruded into their lives, requiring the development of education
among a population which was uneducated and illiterate.

    The Eskimo has become an avid reader because of his
environment.  While he spends a great deal of time out-of-doors in
the warmer, daylight summer months, he spends relatively little
time out-of-doors in the cold, dark winter months.".

Raphaelson J., "A Preventive and Remedy for School-Myopia",
     Book 3, 1958, 105 pages.

Gmelin, Maj.  Robert T., MSC, USA, "Myopia at West Point:  Past
     and Present." Military Medicine, 141 (8) 542-3, August
     1976.

Reynolds Hayden, M.D., "Development and Prevention of Myopia at
     the United States Naval Academy", Volume 25, (old series
     Volume 82), Number 4., Copyright, 1941, The American
     Medical Association.    Frank Schaeffel, Adrian Glasser
     and Howard C.  Howland, "Accommodation,

Refractive Error and Eye Growth in Chickens", VISION RES., Vol 28,
     No.  5 pp 639-657, 1988.  Pergamon Press.

RESULTS:

    All eyes treated with positive lenses became consistently
more positive (hyperopic).

    Negative lenses produced more negative (myopic) refractions
(focal states) in all eyes.

    In a test of plus/minus lenses on left/right eyes.

    The eye with the plus lens moved in a positive direction.

    The eye with a minus lens moved in a minus direction.

    The control group did not change significantly in any
direction.

Brown, Otis S., "How to Avoid Nearsightedness", C & O Research, pp
     53-56, 1989.

Southall, J.  P.  C., "Introduction to Physiological Optics",
     Dover Publications, Inc.  1937.  [Reference:    page 141,
     "While there is still a strong prejudice (judgment) in
     some quarters AGAINST the full correction (of a minus
     lens)...".]

Rehm, Donald S., "The Myopia Myth -- The Truth about
     Nearsightedness and How to Prevent it", pp 103-6, 1981

Betz, J.  N., "Success with Bifocals for Children", Credit to
     O.E.P., Opt J Rev Optom 86:  42, 1949 Brumer, Maurice,
     "Eyestrain -- Its Causes, Consequences and Treatment",
     Australian and New Zealand Association for the
     Advancement of Science (ANZAAS), New Zealand 1/26/79