Dear Friends,

Subject:  Result of "close work" compounded by a consistently
     over-prescribed minus lens. **

Re:  Raphaelson's intuitive sense of "prevention" with the plus.

Re:  Tragic misunderstanding by all of us.  What are our expectations
    of the future.

    This is a very serious problem, and quite frankly the OD's
response is that this is "heredity", and please just "accept" more
and more minus.  After all you want to see a gnat's wing at 200
yards don't you.  (Even if that minus lens creates stair-case
myopia.)

    But equally, the "publics" rejection of the plus (at the
threshold) plays a major role in this problem.

    Personally, I don't understand these "attitude" but there is
nothing I can do about it.

Best,

Otis

**   Over-prescribed.  When you pass all legal requirements for
    vision reading 1.8 cm letters at 6 meters -- passing the DMV
    test, and says you "need" a -2.0 diopter lens.  If you are
    working to "clear" your vision wearing a -2.0 diopter lens
    only "blocks" the clearing process.  If you are helping
    a child "clear" his vision you should not put him
    in a -2.0 diopter lens if his room-illuminated Snellen
    vision is 20/40.

____________________________

December 6, 2000

By Liu Shao-hua
Staff reporter
Taipei Times

Subject:   Myopia Increases Among Children

    One of every five children in the first grade in Taiwan's
elementary schools is myopic (nearsighted).  The proportion of
myopics in this group has increased from 12.1 percent in 1995 to
20.4 percent this year, according to the results of a survey
released by the Department of Health yesterday.

    The results also show that 60.7 percent of sixth graders in
elementary schools, 80.7 percent of third graders in junior high
schools, and 84.2 percent of third graders in senior high schools
suffer from myopia.  In addition, the number of seriously myopic
children is also on the rise.  The proportion of seriously myopic
children among sixth graders in elementary schools has increased
from 2 percent five years ago to 2.4 percent this year.

    Serious myopia is defined as exceeding 600 degrees (6
diopters).  Anything over 25 degrees (0.25 diopters) is myopia.
Normal eyesight is zero degrees.

    "We appeal for reductions to children's work load in schools
and the amelioration of visual environments in daily life," said
Chen Tzay-jinn, director-general of the health promotion bureau,
under the health department.

    The survey was conducted by the department, in cooperation
with National Taiwan University and its hospital, and involved a
sample of 12,000 students from four million students between the
ages of 7 and 18 nationwide.  Myopia has been on the increase in
Taiwan ever since the first myopia survey in 1983.  The department
manages the survey every four or five years.

    The growth of nearsightedness among young children is thought
to result from learning to read very young and using computers
very young, Chen pointed out.

    Last year, the department and the Ministry of Education
delivered official documents to kindergartens nationwide demanding
that children not be taught to read or use computers too early.
"But many teachers and parents protested against this appeal,"
said the department officials.    "They questioned exactly what they
were permitted to teach if reading was not allowed."

    "We do hope that parents and teachers can heighten their
awareness of myopia and understand that early learning does not
guarantee students' performance in the future, but it does bear a
strong correlation to defects in vision," Chen said.  The
department also appealed for children under the age of 10 not to
be taught how to use computers.

    Senior high school students suffer the highest rates of
nearsightedness, at over 84 percent.  "It reached a plateau five
years ago and has not changed this year.  But their myopia has
become more serious," Chen said.  According to the survey, 20
percent of third graders in senior high schools are seriously
nearsighted.

    Many people thought operations could cure myopia.    "But the
superficial improvement of vision does not better the health of
the eye.  More importantly, it might reduce people's awareness of
other problems associated with nearsightedness, apart from visual
ones," said Lin Lung-kuang, ophthalmology professor at National
Taiwan University.  "Myopia cannot be cured.  We have to prevent
children from becoming nearsighted.  Don't let them use their near
vision too early," Lin urged.

    Because of the public's lack of awareness of myopia, the
department estimated its prevalence would continue to grow.

   "Singapore resembles Taiwan in many respects and the extent of its
myopia problem might serve as a warning for us," Chen said.

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

    WHY ISN'T THE PREVENTATIVE APPROACH OFFERED?

    With this type of scientific understanding of the eye's
behavior, you would think that the insightful and motivated
optometrist or ophthalmologist could introduce a practical and
effective method of solution.  Dr.  Jacob Raphaelson did exactly
that in the following example -- with the following result:

            THE PRINTER'S SON

    "It was the year 1904 that I met a mother at a social lodge
meeting.  She told me about her son's trouble with his eyes in
school.  I gave her my card and told her to bring him to my office
and I would fit him with a pair of spectacles.

    "She said that she had no money at the time and that her
husband was a printer working in another city.    She did not expect
him home for the next six weeks.  I told her all this would not
matter, that she should bring the boy over and I would fit him
with a pair of spectacles.  I told her that she could pay for them
when her husband returned home.

    "She brought the boy in and I examined his eyes.  I found
that his vision for distance was poor.    It was less than 20/40.  I
made him a pair of plus 1.00 diopter spectacles.  She was to pay
me when her husband came back home.

    "In about six weeks she came back and returned the glasses to
me.  She stated that her husband was provoked with her for getting
the glasses.  He had tried the boy's eyes with different prints,
far and near, and had found him to have perfect vision with his
naked eyes.  In fact, she said, the boy could see even better
without the glasses than with them.

    "I was surprised that the plus lens could produce recovery
that quickly.  I could hardly believe this story.  I persuaded the
mother to bring the boy back to let me check to see if he could
really see well with his naked eyes.  She again brought the boy in
and I checked his vision.  I found that the father was indeed
right.    The boy had good eyes, with 20/20 vision and better.

    "I was in a dilemma.  I did not have the nerve to say
anything to the mother.  I just let her go.  How was I to prove
that the boy had poor vision before he received his glasses?  And
who would believe that vision could be restored by just wearing a
pair of plus 1.00 glasses for a few weeks?

    "My experience with the printer's son aroused my inborn
tendency for exploration.  It gave me an incentive to try to do
special work on children's eyes and on vision restoration.  It
also enticed me to investigate myopic (nearsighted) eyes because I
was myself nearsighted.

    "On the other hand, this experience was a warning to be
cautious in doing such work.  For selling spectacles to persons
who, supposedly, did not need them was almost a crime.    And the
fitting of glasses without the advice or consent of a medical
doctor to unhealthy or diseased eyes, or even to an unhealthy
person who might need or be under medical attention, was, and is
now, and encroachment on the medical profession.

    "To shield myself against possible enmity and involvement, I
took the following precautions:  First, I quit using the title
'doctor' in any form, in print or verbally.  I was to be known as
a spectacle fitter and nothing more.  Second, I charged a
reasonable price for the spectacles I sold but nothing extra for
any special work or relief I gave.  I did not advertise about this
special work.  I just did it as a matter of routine whenever or
wherever I was given the opportunity.

    "Thus in 1904 I became an independent researcher on the
relationship of the eye's behavior to spectacles, vision, and
health.  I have kept it up, and will continue to do this work as
long as I continue to have the incentive and capability.

    "Who would believe it?  Who would believe that by just
wearing a pair of plus one (+1.00) glasses for a few weeks, that
normal vision to the naked eye could be restored to children whose
eyes have a negative focal state?  This was true in 1904, and it
is also true now, in this decade of 1950." (It continues to be
true in this century of 2100)

________________________________

    It is hard to "square" these two statements.

    The paltry "...do less close work" falls on deaf ears.

    It is just easier to say that stair case myopia
is the fault of YOUR bad heredity -- rather than face
the facts of this situation.

    Until the person himself learns how to take
prevention-with-plus seriously, this situation will
only get worse.  Do you (or are you) part of this
lock-step march into serious myopia.