Dear Prevention minded friends,

Subject:  The prevetive second-opinion on prevention
         as stated by Steve Leung OD.

Sci.med.vision is devoted to the development of
new concepts -- and the free and open discussion
of prevetive methods.

The concept that the eye is dynamic, and that
the natural eye controls it refractive state
to its average visual enviroment is proven
on a scientific level.  (See Howard Howland's research,
as well as primate-eye research.)

Even so, the implementation of the preventive
method is difficult -- and requires that
a person (or his parents) make a choice
between these obviously contradictory
methods.

Here is the second-opinion as stated
by a highly qualified optometrists -- for
your interest and discussion.

_________________________________

From:  Steve I.H. LEUNG Optometrist

Dear Myopic Folk,

Subject:  An optometrist's personal experience or MY AWAKENING

    I am a practicing optometrist working in the field of optics
for more than 16 years.  During these years I faced an excessive
high rate of children developing nearsightedness (myopia).  It is
very hard to resist the obvious need to use a minus lens (concave
lens) for these children.  I deeply appreciate that we all value
clear distant vision for life.    Achieving this goal would be of
great value for all of us.

    Everyday, a great many people are developing the vision
problems of nearsightedness, farsightedness, aged vision -- as
well as crossed and lazy eyes.    These people come to my office and
require immediate vision correction.  They all need glasses.

    Among the visual problems, the case of myopia correction
bothers me greatly.  It is a dilemma and tragedy of using a
"correcting" lenses, which in fact these glasses eventually become
a crutch for life.

    In the early years of practice, I was not aware the long-term
bad effect that a minus lens has on the eye.  This is because
neither the curriculum textbooks nor the professors pointed out
the ultimate side effect that a minus lens has on the eye --
during my many years of doing course work in optometry.

    After graduation, I practiced the full scope of optometry,
from refraction to fundus eye examination, and vision correction
by optical means.  But once these means are removed, the vision is
neither improved nor restored.

    The minus lens is merely an aid to vision, i.e., compensation
by external means.

    In the majority of cases, naked-eye vision gets worse with
the traditional minus lens correction.

    The children will need stronger power glasses in the
following years.  It is a matter of treating the symptom -- but
does not achieve an effective cure.

    I have been mulling over in my mind -- to think about
alternative and better methods to manage myopic eyes, because I
also am nearsighted.

    With my accumulating experience, I am well aware that
constant wearing of minus lens glasses are harmful especially the
full power ones.  However, there is no choice but to use a minus
lens if the child cannot see well in his class.

    At times, the best that I can do is to emphasize that the use
of (minus lens) glasses be restricted to chalk board, and always
must be removed after class.  This is the first step in goal of
avoiding the glasses' side effect.

    But being myopic is unfortunate and inconvenient.    At times
it seems that none of us can escape the use of a minus lenses to
restore clear vision.

    I have been driven into deep thinking about a way of, "how to
restore clear vision from myopic and how to maintain distant
vision for life."

    As a father and an optometrist, I felt a strong commitment to
protect my own child's vision.  It was because my child (age 4) in
her curiosity asked me, "Dad, why do you always wear glasses?  Why
are the kids I play with in school wearing glasses?"

    Her statement had a serious impact on me, and I woke up to
the fact that a child should not be fitted with minus lens glasses
-- if there are means to doing so.

    Why?  The earlier age you begin wearing the minus lens, the
faster vision deteriorates.  The minus lens can make vision worse
all by itself!    Many scientists, engineers and health workers have
formed this opinion -- that the minus lens is definitely harmful
to young kid's long-term vision.

    Because I was sensitive to both the requirement to use the
minus lens, but also understood the secondary effect (vision
deteriorates) I began much broader research into the subject
matter.  This included the judgment of engineers and scientists
(and some ophthalmologists) who "object" to the use of the minus
lens.

    Fortunately, I met several enthusiastic engineers, physicists
and scientists via internet in 2001 by chance.    They provided
excellent postings in their web sites where I got a deep insight
about the development and management of child's acquired myopia --
to include the potential of preventing it in the first place by
wise use of a (reading) plus lens.  They are Donald Rehm, Otis
Brown, James Arthur, Dr.  Stirling Colgate and Alex Eulenberg.

    In fact, researchers such as Dr.  Jacob Raphaelson and Dr.
Francis Young had conducted pioneering work to determine the
cause, effect, and remedy for myopia acquired in school.  As early
as 1904, Dr.  Jacob Raphaelson had used the plus (convex) lens to
effectively cure a child's myopia.  Further, Dr.  Francis Young
has revealed the true cause of acquired myopia with his large
number of insightful experiments and scientific publications in
the 1960s.  All the above mentioned scientists advocate that
preventative measures be instituted to help children avoid getting
into myopia in the first place.

    In view of their spirit and fortitude, I felt that I bore a
responsibility as an optometrist if I did nothing to assist in the
prevention of myopia.

    I regret that I became part of the system (use minus lens)
that was put in place long time ago -- and that this system has
not changed in any significant detail since its inception.

    My goal is to look to the future and begin preventive methods
which can be effective for the child who is on the threshold of
myopia.  Today, I make it clear that my mission and task is to try
my best to discuss the alternate opinion on the therapeutic use of
the plus lens -- instead of the compensatory use of minus lens.  I
do everything in my power to explain the long-term effect that the
minus lens has on the eye's refractive status, and I encourage
parents to review this issue for themselves.

    I have supported several hundred children with the plus lens
since 2001.  The long term effect of the lens is developing, and
results will become better as the use becomes more complete.  Most
of the children retain their current refractive (focal) status and
few of them achieved significant vision improvement.  Although it
is unusual, there have been several cases of complete vision
recovery!  I also felt that making this commitment is a matter of
my personal integrity, and is necessarily part of my work and
career.

Steve Leung OD

Steve I.H. LEUNG Optometrist
Hong Kong, SAR, China