A COURAGEOUS EYE DOCTOR DOCUMENTS THE SECONDARY EFFECT OF USING A
NEGATIVE LENS
EYESTRAIN - ITS CAUSES, CONSEQUENCES AND TREATMENT

By Dr. Maurice Brumer, Frankston, 3199, Australia

. . . A succession of practicing optometrists have followed Fournet [a
pioneer in the use of the plus lens] to this day, all convinced of this
major shortcoming [use of a negative lens] in eye care. They have all
been successfully ignored or treated as cranks and heretics, and the
issue has remained at this level for 90 years. The clarion cry of the
eye care professions has been "show us proof of the relationship of
eyestrain and eye disease". I will now demonstrate that no shortage of
this proof exists.

At the 1973 annual meeting of the American Academy of Optometry, a
paper entitled, "Bifocal Control of Myopia", was presented by Francis
Young, Director of the Primate Research Center at Washington State
University, and Kenneth Oakley, an ophthalmologist from Bend, Oregon.
Their study found that the effects of properly fitted bifocals (eye
strain reducing glasses) on young myopes are to drop the rate of
progression of this condition from an average of about one half a
diopter per year to about on fortieth of a diopter per year. This study
involved control and experimental subjects who were matched for age,
sex, initial refractive error and duration of wearing bifocals so that
most of the possible causes of failure to achieve results with bifocals
were controlled.

THE BIFOCAL (PLUS LENS) STUDY
There was a significant number of subjects, 226 in the bifocal group
and 192 in the control group, to assure that the results were
consistent and effective over time. The effect of the bifocal was
uniformly to reduce the rate of progression even in children who had
already achieved as much as 4 or 5 diopters of myopia before they were
fitted with bifocals. In other words, the control group moved into
myopia at a rate 20 times faster than the bifocal (plus lens) group.
The implications of such results are obvious and sinister when it is
considered that myopia is the third largest cause of blindness in
western society.

SERIOUS COMPLICATIONS DEVELOP FROM USING A MINUS LENS
The visual disability in high myopia is usually considerable. I am
including this description of the condition as felt by its victims so
that you may put yourself in their situation:

Apart from the visual incapacity, the high myope is not usually
comfortable in the use of his eyes. When corrected, the small, sharply
defined and bright images are annoying; much use of the eyes brings
about a feeling of strain and fatigue. The degenerated and liquefied
vitreous gives rise to a multitude of "muscae volitantes" and floating
opacities, and these, throwing abnormally large images upon the retina
owing to its backward displacement, cause a great deal of distress and
anxiety to the patient although their actual significance is small.
Most of these patients are naturally anxious. Their disability is
obvious and may have excited sympathy. The memory of admonitions to
care for the eyes lingers into adult life. Thus matters tend to
progress slowly and relentlessly, the patient all the while never using
his eyes with comfort or without anxiety until finally no useful vision
may remain or until the occurrence of a sudden calamity such as a gross
macular lesion, a hemorrhage of a retinal detachment brings about a
more dramatic crisis. (I thank Sir Stewart Duke-Elder for this
description).

The complications of myopia are numerous and grave, frequently
resulting in blindness. The degenerative changes appear typically in
adult life after the myopia has been fully established for some years.

The complications are:

Choroidal thrombosis and hemorrhage.
Vitreous opacity, always present in some degree in high myopia, this
condition may suddenly increase to become a serious complication.
Retinal detachment is the most dreaded and one of the most common
complications of myopia, occurring with considerable frequency in = all
degrees of the defect but showing a progressively greater tendency, the
higher the myopia.
Simple glaucoma is a further complication of high myopia, occurring =
in the higher degrees after mid-life.
THESE PROBLEMS COULD HAVE BEEN PREVENTED
Few of these people faced with the prospect of blindness in old age
realize that their problems actually began in childhood when they were
fitted with their first pair of corrective [negative] lenses by someone
who was probably unconcerned about the tragic, long-term results of
that action. Few of these people realize how their situation became
more precarious each time their glasses were strengthened and nothing
was said about prevention. Now, when it is too late for prevention,
they find themselves in the hands of surgeons who are making their
living from someone else's mistakes by trying to patch up steadily
deteriorating retinas. The patient has become a lifelong victim of
ignorance and exploitation.

THE EYE CHANGES FROM A POSITIVE STATE TO A NEGATIVE STATE AS A RESULT
OF CLOSE WORK
The cause of myopia is further clearly indicated in a study of 1200
Eskimos in Barrow, Alaska, published in the American Journal of
Optometry in September, 1969, which showed that in one generation of
the Eskimo population had moved from no myopia to approximately 65%
myopia among the offspring, 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.

A MASSIVE BODY OF EVIDENCE SHOWS THAT THE EYE CHANGES ITS FOCAL STATE
TO MATCH ITS VISUAL ENVIRONMENT
In presenting these studies, I would emphasize that these represent
only a small (even if spectacular) part of the evidence available today
which demonstrates the blindness and suffering caused by present-day
eye care. While continuing to ignore a massive body of evidence, the
eye care professions continue to ask to be shown proof that myopia
results from excessive close work and that the prescription of
corrective lenses causes the myopia to increase more rapidly that it
otherwise should. It is assumed from the start that the burden of proof
is on us and that we are expected to raise money and conduct endless
studies that will somehow convince everyone that we are right. In many
cases, this is like trying to convince a tobacco company executive that
smoking causes lung cancer. No amount of testing will convince those
people who prefer to believe what pleases them most or what is more
lucrative to them. . . .

[Dr. Brumer reviewed an exchange of letters with a Dr. Lender (a
university optometrist) concerning disagreement about the fundamental
behavior characteristic of the eye under experimental test conditions.]

. . . These letters represent a desperate attempt to cover up a tragic
and horrible situation. They mislead the public and, significantly, the
parliament of my country. They have been unsuccessful in their purpose,
however, and the question now lies on notice in the parliament in
Canberra to the Minister of Health for Dr. Klugman (opposition
spokesman for health) asking him to appoint an inquiry into the matters
I have raised.

THE EYE PROFESSION RESISTS CHANGE -- TO YOUR DETRIMENT
The eye care professions have resisted change irrationally and
fearfully, unwilling to admit that what has gone on before [the use of
a 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 is a tragedy for the public and a 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.

REMARKS ON DR. MAURICE BRUMER'S PAPER
Dr. Brumer had previously been denied permission to present his paper
at the August, 1977 Australian and New Zealand Association for the
Advancement of Science (ANZAAS) Congress because it was too critical of
the prevailing method of eye care. The above paper is of interest
because of Dr. Maurice Brumer's scientific and ethical commitment to:

Coming to grips with nearsightedness. (i.e., The fundamental = behavior
characteristic of the eye.)
The reaction of other members of his profession. (Extremely = critical
-- without clear scientific justification.)
The reaction of the public to Dr. Brumer's effort to come to grips with
the situation. (Nonexistent -- because the public was not clearly
informed.)
The fact that this understanding (that the plus lens works) existed =
in 1977, and since then, nothing further has been done to provide =
pilots with the high quality information they need so that they can
take = the steps that are necessary to preserve their distant vision
for life.