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Medical Forum / General / Vision / June 2006Will Orth-C replace Ortho-K -- for Ace
Dear Ace, For your interest, here is a new site where it is claimed that you can "improve" your distant vision from -2 diopters -- and perhaps more. http://www.reversingnearsightedness.com It this correct? Will it work? What do YOU THINK? What do the ODs think of this method? Best, Otis Very interesting read. Do you know anyone who had experience with it? You never told me about your own myopia and how much of your vision you improved. You also have told people to throw in the towel and get lasik. Whats the point of lasik if you can improve your vision naturally? I am skeptical of orthoC. It sounds too easy and I dont see how a plano contact can improve your vision in 15 minutes. It takes many months of proper eye relaxation techiques(spell?) to achieve results. I recall your wisdom saying the rate of improvement is 3/4 to 1 diopter per year. I have been improving my vision for a year and this is exactly how much improvement I have achieved. I am motivated and will keep doing vision improvement and reduce my myopia further. I think I can improve another 1.5 diopters and possibly clear 20/200 UCVA! Dear Ace, Subject: PREVENTION, not "cure" for a negative refractive state. Re: Getting "blown off" by DrL who, when I ask for help with prevention -- tells me to get stuffed. There is no questions in my mind, (and from the study of the primate eye) that you INDUCE a negative refractive state from your own (my own) bad visual "habits". I accep that fact, long after it was too late to do anything about it. We both have learned about this majority-opinion "attitude" when we ask for "help" with prevention, and suggest the use of the plus for that purpose. I am convinced, now, that if a negative refractive state is ever to be prevented, then it must be prevented at the threshold -- or not at all. But further, given the fact of "no help" from these majority-opinion ODs, you have no choice but to figure out how to "prevent" under your own control. This is why I "promoted" my nephew in his use of the plus. i.e., learn how from my mistake. (A "metaphysical" solution -- if you understand that issue.) To furter respond: =========== Very interesting read. Do you know anyone who had experience with it? Otis> I have heard of one -- I will post it. You never told me about your own myopia and how much of your vision you improved. Otis> I never suggested that. My vision was "shot" from my bad visual habits as a 6-year-old child, and "compounded" by an over-prescribed minus -- which I was ordered to wear ALL THE TIME. These are inter-locking errors, and the situation can not be "reversed" beyond about 20/60 (or -1.25 diopters.) I refuse to make ANY "CLAIMS" ABOUT ANY OF THESE STATEMENTS. You also have told people to throw in the towel and get lasik. Otis> Not exactly. What I said that you should have been offered the preventive method when you were at -1 diopters. Once you start that stair-case business with an over-prescribed minus -- "recovery" is no longer possible. But you seem to "agonize" over that issue. If you wish your vision "clear" from -5 diopters -- then the only method that works in 1 week is Lasik. But that is indeed your choice. Whats the point of lasik if you can improve your vision naturally? Otis> If you mean can you "improve" your vision naturally from 20/70 to 20/40 or better, and avoid stair-case myopia (as my nephew did) then you should do it. The problem? EVeryone seems to "want" 20/10 vision from that minus -- even when they are passing the 20/40 line!!! Otis> There is a profound conflict. You can not have BOTH extremenly sharp vision instantly from a minus, and not get stair-case myopia as a "seconday" effect. Otis> That does mean that you understand these issues -- from a second-opinion OD. And you make up your mind accordingly. This is again the reason that I "arm twisted" my nephew to understand these issues, and make the second-opinion choice -- to his personal advantage. This is an engineering "trade-off". Best, Otis > There is no questions in my mind, (and from the study of the primate > eye) that you INDUCE a negative refractive state from your own (my own) > bad visual "habits". You know, I think I agree with you to an extent here, except I'm not ready to call reading a "bad habit." Now when you figure out that minus lenses don't contribute (in humans older than 6), we'll be on the same wavelength. -MT Dear Mike, Subject: The issue was that I PERSONALLY was in control of my eye-to-target distance. As a child, I simply did not realize the importance of that "distance". As an engineer studying the dynamic behavior of the naural primate eye -- I realize how CRITICAL it was to "control" that distance. No OD or MD could do this for me. I "own" my eyes -- therefore that was my responsibility. It is not the "reading" per-se, it was that distance. (You will see kids reading on my site with there eye's 4 inches off the page. Some mothers think that is "cute". I think that is a real problem -- but we do disagree on that point as gentlemen. After all, you are not the child's mother.) I think this is part of the "Scurvey" metaphor. That would be like the seamen going to the dentist to have there bleeding gums fixed with a medication -- when the "real" reason had nothing to do with denistry. The dentist could only "fix" the result. He has absolutly NO CONTROL over the resaons for the "bad teeth". But that is why I take personal responsibility -- and through education of this nature, provide this information to my nephew. Assigning "responsibility" in this manner, then I recognize that you truly are not "responsible" -- with due respect for the dentist who had to deal with bleeding gums with astringent -- when he has no "control" as all over the real reason for the loose teeth of the sailer. Best, Otis > Assigning "responsibility" in this manner, then I > recognize that you truly are not "responsible" Oh thank goodness! We've all been forgiven by Otis. -Quick No, Quick, I recognize the optometry is "limited" by the Neil Brooks effect. (i.e., they must "protrect" themslves, and the "method" is determined by the lowest common denominator among us. This simply means that if you want true-prevetion, you are virtually forced to figure why you will not receive any "preventive" help. Further, when I asked Dr. G for "preventive" help with the plus, he told me it was a "fantasy". But, if you read Steve Leung ODs site, www.chinamyopia.org it is clear the PREVENTION with the plus is not a "fantasy". What IS A FANTASY is the idea that you will get any help from the majority-opinion ODs to support true-prevention. Best, Otis > Further, when I asked Dr. G for "preventive" help > with the plus, he told me it was a "fantasy". [quoted text clipped - 5 lines] > it is clear the PREVENTION with the > plus is not a "fantasy". Steve Leung resides and practices in Hong Kong, where the following study was done: =============================================================== The Hong Kong progressive lens myopia control study: study design and main findings. Invest Ophthalmol Vis Sci. 2002; 43(9):2852-8 (ISSN: 0146-0404) Edwards MH; Li RW; Lam CS; Lew JK; Yu BS Centre for Myopia Research, The Hong Kong Polytechnic University, Kowloon, Hong Kong. RESULTS: There were no statistically significant differences between the PAL and the SV groups for of any of the baseline outcome measures. After 2 years there had been statistically significant increases in myopia and axial length in both groups; however, there was no difference in the increases that occurred between the two groups. CONCLUSIONS: The research design used resulted in matched treatment and control groups. There was no evidence that progression of myopia was retarded by wearing progressive addition lenses, either in terms of refractive error or axial length. ================================================================ If it looks like a fantasy, walks like a fantasy, and sounds like a fantasy, it is a fantasy. DrG htttp://www.coppellfamilyeyecare.com here's more studies on humans (not chickens and monkeys): ============================================ Am J Optom Physiol Opt. 1984 Feb;61(2):112-7. Plus lens, prism, and bifocal effects on myopia progression in military students, Part II. Shotwell AJ. Military academies routinely lose a percentage of their pilot-qualified students to myopia during the 4-year academic program. This study investigated the progression of myopia during such a program and evaluated the usefulness of reading glasses to prevent myopia progression and subsequent acuity loss. A group of students at the United States Naval Academy comprised three randomly divided groups: a placebo group (no. 1 pink tint), a plus with prism group (+1.25 D with 2 delta base-in each eye), and a bifocal group (+1.50 D near addition). All the lens powers were relative to the experimental subject's distance refraction and were for use full-time when reading. The pre- and post-test refractive errors at distance were determined using 1% tropicamide HCl. At the end of 4 years, the tropicamide refraction showed approximately -0.25 D of myopic shift in all groups. There were no significant differences between the myopic shifts in the controls and experimental groups. --------------- --------------- Br J Ophthalmol 1989 Jul;73(7):547-51 Related Articles, Links Effect of spectacle use and accommodation on myopic progression: final results of a three-year randomised clinical trial among schoolchildren. Parssinen O, Hemminki E, Klemetti A. Two hundred and forty mildly myopic schoolchildren aged 9-11 years were randomly allocated to three treatment groups and the progression of myopia was followed-up for three years. The treatment groups were: (1) minus lenses with full correction for continuous use (the reference group), (2) minus lenses with full correction to be used for distant vision only, and (3) bifocal lenses with +1.75 D addition. Three-year refraction values were received from 237 children. The differences in the increases of the spherical equivalents were not statistically significant in the right eye, but in the left eye the change in the distant use group was significantly higher (-1.87 D) than in the continuous use group (-1.46 D) (p = 0.02, Student's t test). There were no differences between the groups in regard to school achievement, accidents, or satisfaction with glasses. In all three groups the more the daily close work done by the children the faster was the rate of myopic progression (right eye: r = 0.253, p = 0.0001, left eye: r = 0.267, p = 0.0001). Myopic progression did not correlate positively with accommodation, but the shorter the average reading distance of the follow-up time the faster was the myopic progression (right eye: r = 0.222, p = 0.0001, left eye: r = 0.255, p = 0.001). It seems that myopic progression is connected with much use of the eyes in reading and close work and with short reading distance but that progression cannot be reduced by diminishing accommodation with bifocals or by reading without spectacles. --------------- Am J Optom Physiol Opt. 1982 Oct;59(10):828-41. PMID: 7148977 Attempts to reduce the rate of increase of myopia in young people--a critical literature review. Goss DA. Results with, and opinions on, various experimental treatments for increasing myopia in young people are presented and discussed. None of the many different therapies has been shown to be consistently effective in reducing the rate of increase of myopia. The difficulties encountered in conducting clinical research of this nature are discussed. ---------------- Am J Optom Physiol Opt. 1987 Jul;64(7):482-98. PMID: 3307440 Houston Myopia Control Study: a randomized clinical trial. Part II. Final report by the patient care team. Grosvenor T, Perrigin DM, Perrigin J, Maslovitz B. In a randomized clinical trial designed to test the efficacy of bifocal lenses for the control of juvenile myopia, each of 207 children between the ages of 6 and 15 years wore single vision lenses, +1.00 D add bifocals, or +2.00 D add bifocals for a period of 3 years. For the 124 subjects who completed the study, the mean changes in refraction were found to be -0.34 D per year for subjects wearing single vision lenses, -0.36 D per year for those wearing +1.00 D add bifocals, and -0.34 D per year for those wearing +2.00 D add bifocals. These differences were not statistically significant. --------------------------- Ophthalmology 2002 Mar;109(3):415-21; discussion 422-4; quiz 425-6, 443 Related Articles, Links Interventions to retard myopia progression in children: an evidence-based update. Saw SM, Shih-Yen EC, Koh A, Tan D. CONCLUSIONS: The latest evidence from randomized clinical trials does not provide sufficient information to support interventions to prevent the progression of myopia. --------------------------- Investigative Ophthalmology & Visual Science, Vol 40, 1050-1060, Copyright © 1999 by Association for Research in Vision and Ophthalmology Tonic accommodation, age, and refractive error in children K Zadnik, DO Mutti, HS Kim, LA Jones, PH Qiu and ML Moeschberger College of Optometry, The Ohio State University, Columbus 43210-1240, USA. PURPOSE: An association between tonic accommodation, the resting accommodative position of the eye in the absence of a visually compelling stimulus, and refractive error has been reported in adults and children. In general, myopes have the lowest (or least myopic) levels of tonic accommodation. The purpose in assessing tonic accommodation was to evaluate it as a predictor of onset of myopia. CONCLUSIONS: This is the first study to document an association between age and tonic accommodation. The known association between tonic accommodation and refractive error was confirmed and it was shown that an ocular component, Gullstrand lens power, also contributed to the tonic accommodation level. There does not seem to be an increased risk of onset of juvenile myopia associated with tonic accommodation. ------------------------- Optom Vis Sci 1999 Jun;76(6):363-9 Effects of spectacle intervention on the progression of myopia in children. Ong E, Grice K, Held R, Thorn F, Gwiazda J. The literature on myopigenesis suggests an active emmetropization mechanism regulated by optical defocus. The strongest evidence comes from compensatory ocular growth in response to lens-induced defocus in different species of animals. Based on these results, it has been suggested that, however useful, spectacle intervention for the optical correction of human myopia would lead to its exacerbation. The present study seeks to evaluate the progression of juvenile-onset myopia in children differentiated by their lens wear patterns. Data from 43 myopes from our longitudinal study of refraction were evaluated, with myopia defined as a spherical equivalent of at least -0.50 D. Refractions were obtained in the laboratory by noncycloplegic retinoscopy performed by one experienced optometrist at regular intervals. Information regarding the subjects' prescription lens-wearing history was obtained from the subjects and their eye care providers. Based on their wearing patterns, subjects were divided into four categories: (1) full-time wearers; (2) myopes who switched from distance to full-time wear; (3) distance wearers; and (4) nonwearers. Exponential functions were fit to the individual refraction data. The age of onset of myopia, the mean myopia at onset of spectacle wear, and the refractive shift over a period of at least 3 years were derived from these fits. Results show that the 3-year refractive shifts are not significantly different among the four groups. A comparison of the extreme conditions, i.e., full-time vs. nonwear categories, also revealed no significant difference when the data were corrected for age effects despite the fact that the nonwearers exhibited an age-adjusted 3-year progression approximately one-half that of the full-time wearers. In summary, the present study failed to demonstrate any overall effects of spectacle intervention on the progression of human myopia. Further investigation using a larger sample is warranted. Could it be that accomodating at all, for long periods of time, is really the problem - moreso than the amount of accomodation (distance)? What I'm thinking is, even with +1-2 diopters for reading, you are still not "at the stops" like when you are outside looking far away. It could be that your system tries to converge to a state where it doesn't need to accomodate at all. I wonder if the results would be different if the reading glasses were powerful enough to put you at virtual infinity while reading (like +3 or more?)? At the same time, this doesn't explain why people get more myopic if they read at closer distances. > here's more studies on humans (not chickens and monkeys): > [quoted text clipped - 216 lines] > using > a larger sample is warranted. Dear Charles, Subject: The preventive second-opinion I tend to "reduce" the issue as a matter of DIRECT scientific test -- to determine if the fundamental eye is dynamic -- or not-dynamic. Thus the issue is that the majority-opinion believes that the natural eye will not change its refractive STATE if you place a -3 diopter lens on it (making the accommodation system at -3 diopters) (AVERAGE CHANGE in the NUMERICAL VALUE OF ACCOMMODATION). Thus, the issues is to establishe if a population of fundamental eyes will change their refractive STATE if you take a statistical sample of a population of fundamental eyes -- and place a -3 diopter lens on one group -- and not the other. Thus the majority-opinion PREDICTS that the refractive STATE of both groups WILL BE IDENTICAL AFTER 12 MONTHS. The eye -- if it is dynamic -- (the purpose of this test) should change its refractive STATE, and a DIFFERENCE in refractive STATE should be greater-than -2 diopters after 12 months. Thus the predictions of these two concepts is this: M.O. Refractive State Groups identical at start. Refractive state after 12 months No change is refractive state between groups. S.O. Refractive state Groups identica at start Refractive state (because the eye is dynamic) Difference greater than -2 diopters. This is the basis for Steve Leung's second-opinion. It is also the basis of Dr. Francis Young's endorsement of Steve Leung's approach -- and the parents should review this science -- supporting the necessity of using the plus at the threshold. Clearly this will take a fully-informed parent. And that truly is not easy. But, if the parent is SUPPORTIVE and understands this issue -- the prevention can be offered. To further respond: Chas> Could it be that accomodating at all, for long periods of time, is really the problem - moreso than the amount of accomodation (distance)? Otis> The natural eye is controling its refractive STATE to the AVERAGE value of accommodation. In the above example the AVERAGE ACCOMMODATION VALUE was made into -3 diopters between the test group and the control group. If the natural eye were not dynamic -- then no change in refractive STATE would develop between the test and control group. What I'm thinking is, even with +1-2 diopters for reading, you are still not "at the stops" like when you are outside looking far away. Otis> You are correct. In Francis Young's study, he used a WEAK +1.5 dipoter -- and the kids received NO INSTRUCTION on how to use the plus. If they did not "push" their work away when reading -- it would partially negate the effect of even this weak plus. It could be that your system tries to converge to a state where it doesn't need to accomodate at all. I wonder if the results would be different if the reading glasses were powerful enough to put you at virtual infinity while reading (like +3 or more?)? Otis> Where the person understand the INTENT of a strong plus (as Dr. Colgate did) then the result can be a SLOW CLEARING of his Snellen. But it takes a lot of PERSONAL insight and fortitude to do it properly. But that is what true prevention is going to take. And that is what Steve Leung is attempting to institute with these kids on the THRESHOLD of a NEGATIVE REFRACTIVE STATE FOR THEIR FUNDAMENTAL EYES. Best, Otis Otis, you tend to "reduce" all of the overwhelming list of studies that literally PROVE your approach is wrong by ignoring them. according to you, something is wrong with these studies or they are all part of some kind of conspiracy against plus lenses. all the arguments you provide, along with the names of the doctors and researchers that you drop to lend credibility to them, are OLD arguments. they were the arguments that were mainstream back in the 1960s and 1970s before all the research piled up against the simple-minded idea that excessive accommodation causes myopia progression. sorry to fill you in but it just isn't that simple! why do you find it so hard to grasp that? why do you take it so personally? just move on to a theory that fits the data rather than denying it and steadfastly planting yourself in yesteryear. Charles-- young hyperopes who have a refractive error of +2.00 to +3.00 go around accommodating 24/7. they oftentimes wear no corrections and they strain their accommodative mechanism just to see in the distance and REALLY strain it when they do near tasks. why is it that, after years of excessive accommodation their eyes don't adapt by becoming more myopic (=less hyperopic). if such an accommodation-responding model of refractive power development really existed thats what would happen-- but it doesn't. so much for the simplistic "dynamic model" that sounds so logical to Otis but just simply isn't the way the human eye works. And you made this statement-- "At the same time, this doesn't explain why people get more myopic if they read at closer distances." What is the evidence for that? does this come from anecdotal reports or is there some quantitative study that shows that reading distance equates in some way to myopia development. I do not doubt that myopia development in fact does have something to do with a predominant near demand on the eye but you seem to be alluding to some kind of quantitative correlation that I am not familiar with. > Dear Charles, > [quoted text clipped - 3 lines] > to > determine if the fundamental eye is dynamic -- or not-dynamic. snip stuff > Best, > > Otis > Charles-- young hyperopes who have a refractive error of +2.00 to > +3.00 go around accommodating 24/7. they oftentimes wear no [quoted text clipped - 6 lines] > simplistic "dynamic model" that sounds so logical to Otis but just > simply isn't the way the human eye works. Is there really data to support that? Is it possible that hyperopes, on average, tend to get less hyperopic in their youth? It seems that any available data might be skewed since (I think) only the most extreme hyperopes would even come in for treatment when young, since they can accomodate quite a bit to make up for low to moderate amounts. It was just a thought anyway, I don't have any background in this area. > And you made this statement-- "At the same time, this doesn't explain > why people get more myopic if they read at closer distances." What is [quoted text clipped - 4 lines] > demand on the eye but you seem to be alluding to some kind of > quantitative correlation that I am not familiar with. I just got it out of one of the summarized results in the post I replied to: "Myopic progression did not correlate positively with accommodation, but the shorter the average reading distance of the follow-up time the faster was the myopic progression (right eye: r = 0.222, p = 0.0001, left eye: r = 0.255, p = 0.001). It seems that myopic progression is connected with much use of the eyes in reading and close work and with short reading distance but that progression cannot be reduced by diminishing accommodation with bifocals or by reading without spectacles." >> Charles-- young hyperopes who have a refractive error of +2.00 to >> +3.00 go around accommodating 24/7. they oftentimes wear no [quoted text clipped - 12 lines] >extreme hyperopes would even come in for treatment when young, since >they can accomodate quite a bit to make up for low to moderate amounts. Charles, I'm a high hyperope. Have been since infancy. My cycloplegic prescription HAS NOT CHANGED since infancy ... despite the fact that I was "LOCKED" in accommodative spasm (a charley horse in the focusing muscles that came from straining for so long to see at near) for YEARS. I'd have given quite a few dollars to get some myopia, or axial lengthening out of that. Didn't happen. Of course, if you ask Otis, he'll claim to know my ophthalmologic history BETTER than I do ... solely to support his theory. He's sick. Literally sick. Do your own research and draw your own conclusions. Listen to Otis at your peril. Ask yourself why there is near universal agreement on that ... except among psilocybin users. > Is there really data to support that? Is it possible that hyperopes, > on average, tend to get less hyperopic in their youth? The average human refraction becomes less farsighted for a brief period in early life. By age six, the average begins to shift minus - steeply in some populations and not so much in others. It seems more important that the standard deviation of refractive errors declines until about age one, then it diverges again. Seems to me this should be a pretty firm indication of the human "emmetropization period". Many doctors would hesitate to prescribe full plus for hyperopic infants, on the chance that some accommodation is necessary for emmetropization. -MT >Dear Charles, > [quoted text clipped - 9 lines] >diopters) >(AVERAGE CHANGE in the NUMERICAL VALUE OF ACCOMMODATION). And this raises some very interesting questions ... that you will go to your grave not having answered ... because you are both a charlatan and a buffoon: 1. There seems to be a great deal of evidence that primates have widely differing visual systems. How is it that you feel so secure in saying that "all primate eyes" behave similarly in ANY regard? 2. In these monkey studies that you reference, isn't it true that the SAME STUDIES showed that, with even BRIEF periods away from the minus lens, the myopia was prevented? 3. If there was no medical indication that these monkeys needed corrective lenses at all, can you be sure that appropriate CORRECTION of somebody's REFRACTIVE ERROR will have similar results? If so, how? > This is why I "promoted" my nephew in his use of the plus. i.e., learn > how from my mistake. (A "metaphysical" solution -- if you understand > that issue.) OH OKAAAAYYYYY Practicing without a medical licence by giving medical advice! Allen Dear Otis, You are saving your nephews eyes! What dioptric value of myopia was he and where was he at? 20/50? 20/70? Where is he at now? Sorry to hear about your ruined eyes at 6! Thats a very young age to be myopic and your doctor did a great disservice by telling you to wear glasses full time(unless you had significent astigmastim then bifocals should have been pescribed) Its a fact nearsighted people see great from near without glasses. Plus lenses should be used from near to halt and even reverse myopia! My eyes also got ruined but not as fast nor bad. I checked my old pescription and I used to be -4.25! I was 17 back then too! Basically I have undone the damage of 6 years and im now seeing as well as I did back when I was 17! Let me try to remember what my pescription was over the years at age 10=-.5 but no glasses given at age 12=-1 at age 13=-1.5 at age 14=-2.25 at age 15=-3.25 at age 16=-3.75 at age 17=-4.25 at age 18=-4.75 at age 21=-5.25 at age 23=-5.75 I am almost 24 now and have gotten down to -4.75 in the worse eye! Thats a whole diopter improvement! "Once you start that stair-case business with an over-prescribed minus -- "recovery" is no longer possible. But you seem to "agonize" over that issue. If you wish your vision "clear" from -5 diopters -- then the only method that works in 1 week is Lasik. But that is indeed your choice." A full recovery isnt possible past the threshold of -1 to -2 diopters but I can improve my vision and be less myopic. I wont clear 20/40 but ill still improve. Yes I do agonize, I wish I knew about prevention back when I was 12! Yes lasik is a "cure" of sorts but it does not address the underlying problem of myopia. Lasik wont guarantee my eyes wont change and it wont relieve any strains of bad vision habit. You see better but your eyes arent relaxed like they should be. Finally youve read all the risks of lasik. Lasik seems to be the easy way out and most people couldnt be bothered to take years to improve a couple diopters when lasik takes a day and they see 20/20 or close to it. "The problem? EVeryone seems to "want" 20/10 vision from that minus -- even when they are passing the 20/40 line!!!" except only 1%, maybe a tiny bit more can be corrected to 20/10. I can quote this optometrist who said 20/10 is so rare he sees less than 2% test at 20/10, period. I could say people want to be 20/20 even if they are only a little shy of it. Then they ruin their eyes and go downhill fast! They are like oh well who cares, I see 20/20 with glasses! "There is a profound conflict. You can not have BOTH extremenly sharp vision instantly from a minus, and not get stair-case myopia as a "seconday" effect." Sad thing people choose instant gratification and pay the price. They choose the minus lens instead of plus and enjoy clear vision but become more and more myopic "She said they didn't really work, and most of the people got hollow(?) vision (where the edges of every object is blurry)." I think ill stick to natural vision improvement and forgo orthoK, orthoK and any sort of contact lens. I will forgo glasses whenever its not neccessary. I undercorrect myself most of the time to allow for improvement. "Now the "road back" is indeed difficult. But PLEASE do not let me stop you. It IS POSSIBLE, but vision clearing seems to "work" at about +1/2 diopter per year. I hope your motivation is very strong. Here is an optometrist who has done it." I am reading it now. Long read! He was about -3.5 and got down to -.5 so thats 3 diopters of improvement which is doable. I hate to sound pessimistic but I am being relistic. I used to be -5 now I am -4. I will be very, very happy to get down to -2 or even -3 it will make a very big difference in my UCVA and reduced dependancy on glasses. Accroding to my book on "relearning how to see" the testimonals show most people reducing their myopia by 2 to 3 diopters. Occasionally 4. Me going from -5 to -2 will be bliss!!!!!! :) :) :) :) Dear Aceman, Subject: Keith "preserved" his distant vision -- by his own efforts. Re: I described to Keith Dr. Rapahelson's experience with, "The Printer's Son", which basically says that an OD can not help you with true-prevention. As long as Keith personally passes ALL LEGAL VA TESTS, BY PERSONAL VERIFICATION, then he has NO MEDICAL PROBLEM! Although Keith was declared "nearsighted" at age 13, (darkened room, poor illuminated Snellen, instrument myopia effect) he did not "fill" the "prescription".) I think it took him some time (after seeing "blur" himself -- he did not check his chart) to finally "wake up" and realize that he had to take personal control over his distant vision -- which is what he did. Since the "down" rate at a 4 year college (West Point) is -1.3 diotpers to -1.6 diopters -- men in perfect health -- but much "close work), it followed that if Keith wished to keep his vision "clear" he had to monitor his chart, and keep his vision clear during those four years. The consequences of HIS neglect, would have been about 20/140 vision. This is the "Scurvey" example. The person himself (with accruate knowledge of the natural eye's behavior) ends the "near" environment with the systematic use of the plus, and as per the primate studies, always passes the DMV -- under his control. But that reflects on the wise judgment of Keith. Many, many people have no interest at all in their distant vision, and could NEVER pursuade themselves to use the PREVENTIVE plus as he did. Thus, Keith removed this issue from optometry. After all, who is going to wear a minus -- if he always personally verifies he always passes the DMV test? More later, Otis "While I never read in glasses, I took notes in them. I sat through high school and college and graduate school in them. No one ever suggested a bifocal in class or plus spectacles over the contacts to read. I told two contact lens specialists in two cities that I couldn't read through my contact lenses. They both frowned and said "You should be able to read through them," and that was that when I was a child." I also almost never read in glasses. Its bad for your eyes and makes things worse. Nearsighted people see fine from near without glasses, why wear glasses for near for nothing or worse? As for her not seeing clearly in contacts, sounds like insufficent accomodation. I have the same issue. "I reduced my need for minus prescriptions by gradually adapting to weaker and weaker lenses in the reverse of the process of adaptation that led me into serious myopia in the first place." Look what she did! No wonder why my vision has improved! I remember bumping my glasses pescription to -4.5 down from -5.75 and I was seeing 20/80 at first then 3 weeks later 20/70. Now I see very near my BCVA in them! Its amazing how clear those old -4.5 glasses are! I used to see 20/70 with -4.25s now I see 20/40 sometimes in those! Thats just ONE line shy of my 20/30 BCVA! " You train a patient whenever you put a lens on him," Francke told me. That means you change programs in the brain. Why not train patients into weaker instead of stronger lenses? Even if it takes seven years, that person can be changed for life" It took me a year of training to reduce my myopia by a diopter. Good things come to those who are patient. I expect to improve another half to full diopter by the beginning of 2007. "In some cases, as Dr. John Thomas has suggested,33 strong lenses may even cause tissues changes. We know from research with chickens and monkeys34 that a blurry image on the fovea causes increased axial length and stretching in the posterior pole like that in some hereditary myopes. It also may be true of humans, as observed in identical twins.35 Thomas speculates that it may be the blurry image created by the high minus lens distortion at the periphery that causes myopic degeneration and eyeball stretching. Indeed, in chickens "only peripheral field occlusion is necessary to induce a myopia shift, while the central retina is receiving sharp images," Crewther, Crewther, Nathan and Kiely reported.36 Elio Raviola and Torsten Wiesel speculated years ago that "the retina exerts a control on eye growth by releasing regulatory molecules whose production is influenced by the pattern of light stimulation."37" Otis was right! "Luckily, I never did develop major retinal changes that we see in high myopes." This is why very high myopes(-10 and up) sometimes(fairly commonly) cant correct to 20/20 with contacts and even worse with spectacles(due to minification) One optometrist who posts on google groups said he sees patients around -15 diopters(myopia in the teens) with only 20/40 to 20/50 BSCVA. Looking at my notes, this guy whos -18 diopters can only correct to 20/60 with glasses. I know several more around -10 with 20/30 in glasses. One guy was -14 and 20/30 BSCVA, 20/25 with contacts which dont minify. Here is the link Otis posted: http://www.optometrists.org/Boston/articles.html Thanks Otis, great read! I have learned so much and I look forward to greatly reducing my dependancy on glasses over time, little by little. I want my good vision back and I am going to work to get it! Dear Otis, Ace> You are saving your nephews eyes! What dioptric value of myopia was he and where was he at? 20/50? 20/70? Otis> You only need a trial-lens kit and a Snellen at 20 feet to do this "conversion". It works out it takes about a -1.25 to -1.75 lens to "clear" the 20/20 line. But this depends STRONGLY on the illumination of the Snellen chart. Ace> Where is he at now? Otis> When he started this process at age 13, I am certain he was "indifferent" to it. Only in college, when he saw his vision going "down" did he "wake up" as realize the consequence of NOT ending his near environment with a +2 diopter plus. Otis> I am certain his eye-chart changed, but he always passed the DMV -- which is all that I would worry about. He wrote a short passage for my book (on my site -- for free) describing his experience. Otis> He is now 40 years old. Remember -- I consider it a great success -- if he just kept passing the DMV (of 20/40). Otis> He last passed the Snellen at 20/15 (both eyes). Otis> But remember, the majority-opinion ODs will insist that Keith never would have been myopic anyway, and the plus never had this "preventive" effect, i.e., Keith did not have the "myopic-genetic" gene. Thus this proves nothing, by their "book keeping". Otis> But Keith knows the Oakley-Young study, as well as the West Point statistics. And this is the second-opinion. Best, Otis > Otis> You only need a trial-lens kit and a Snellen at 20 feet to do > this "conversion". > It works out it takes about a -1.25 to -1.75 lens to "clear" the 20/20 > line. But > this depends STRONGLY on the illumination of the Snellen chart. Coming from a man who is not in the medical profession, seems that you are out of line Otis giving medical advice. Keep adding this to public forums and yes, the lawsuit against you sure will put you on the losing side. Otis, you are not in the medical profession and in no position to give medical advice. The above is medical advice on eyes that need correction. Allen Why are you giving Otis such a hard time? Glasses doesnt really count as medicine, its an optical device. Otis saved him from a lifetime of myopia! Contacts are kinda medical devices but glasses arent in the same class. If anyone wants to sue Otis, we will all testify FOR him. I support Otis all the way and will get others to be on Otis side. He has done NO one harm and has saved many from myopia. Why does it bother you so much? You want people to be myopic so you can make your money selling them glasses, eh? > Why are you giving Otis such a hard time? Glasses doesnt really count > as medicine, its an optical device. You can't get glasses without a prescription to correct eyes that need medical attention to correct. Therefore, without the proper credentials, you cannot just willy nilly give out glasses or provide medical advice without the proper credentials. > Otis saved him from a lifetime of > myopia! Contacts are kinda medical devices but glasses arent in the > same class. Incorrect. They both correct vision. So, glasses are medical devices just as contact lenses. I> f anyone wants to sue Otis, we will all testify FOR him. I > support Otis all the way and will get others to be on Otis side. He has > done NO one harm and has saved many from myopia. Why does it bother you > so much? You want people to be myopic so you can make your money > selling them glasses, eh? Since I am not in the medical profession, I don't make any money selling glasses. I think it's important that new people coming to this newsgroup knows that Otis is not in the medical profession and is not in the position to give medical advice. Can't be any simpler then that. Allen "You can't get glasses without a prescription to correct eyes that need medical attention to correct." online you can and in thrift stores too. You can get reading glasses anywhere without a pescription so technically Otis has done NOTHING wrong by telling someone to get reading glasses(also known as plus lenses) as they arent considered pescription nor medicial devices, but passive aids for presbyopia and the like. Loophole there for Otis! "Incorrect. They both correct vision. So, glasses are medical devices just as contact lenses." I think glasses is class I medical device, contacts are class II. Much stricter regulations for contacts than glasses. "I think it's important that new people coming to this newsgroup knows that Otis is not in the medical profession and is not in the position to give medical advice. Can't be any simpler then that." Otis has not once claimed he was a doctor of any kind and what he says is his opinion from a non medical standpoint. Perhaps he should make a disclaimer in his signature saying hes not a doctor and whatever he says is his opinion and should not be substituted as medical advice but just an opinion only. This disclaimer frees him from any liabilities. > online you can and in thrift stores too. You can get reading glasses > anywhere without a pescription so technically Otis has done NOTHING > wrong by telling someone to get reading glasses(also known as plus > lenses) as they arent considered pescription nor medicial devices, but > passive aids for presbyopia and the like. Loophole there for Otis! Wrong again. Otis is telling people to put on plus lenses on eyes that are myopic without regard to their usage. Readers are exactly for that, assist in reading, not correcting defective DISTANCE vision. Nope, not a loophole, Otis is continuing to hang himself every time he gives medical advice on eyes that need correction for distance. > I think glasses is class I medical device, contacts are class II. Much > stricter regulations for contacts than glasses. Bottom line, is that it takes a medical practitioner to dispense class I medical devices, not an UNQUALIFIED engineer. > Otis has not once claimed he was a doctor of any kind and what he says > is his opinion from a non medical standpoint. Perhaps he should make a > disclaimer in his signature saying hes not a doctor and whatever he > says is his opinion and should not be substituted as medical advice but > just an opinion only. This disclaimer frees him from any liabilities. Your right, he has not claimed he was a doctor, but he is claiming from UNRELIABLE and UNVERIFIED sources. He drops what he calls other doctor names like they support him in his so called plus therapy. He claims that others have improved their vision, yet his so called subjects have yet to come forward. People coming in this group need to know his sources are not current sources. They need to know he is not qualified to give medical advice. They need to know he is not in the medical profession. Every post I have responded to him has included quotes from him in which he is giving medical advice. He is not qualified to give MEDICAL advice. I will continue to do this so that others don't fall into his quackery position. Allen I understand the point being made about prescription eyeware being dispensed only from medically trained professionals but I am curious as to how stict that rule is because you can walk into most drug stores and Wal-Mart and purchase plus lensed glasses over the counter. There is a little instruction card that helps you self-diagnose your degree of presbyopia. So if Otis says, "go get some plus lenses" he is tehcincally not in the wrong, even if his methodology for their use is currently not the normal standard of care regarding myopia prevention & reduction. Does this also mean we can file a complaint against Wal-Mart for dispensing plus lenses without the specific recommendation of a doctor in the same way Neil Brooks has done to Otis? In fact, I see Wal-Mart's selling of plus eyeware akin to them selling Tylenol or any other OTC products. They come with instructions and reccomendations for usage and disclaimers absolving them of any liability should the user deviate from the instructions and warnings. Really no different then Otis placing a disclaimer stsating he is not a doctor and his views are opinions. Makes for an interesting thought. Scary thing is this is open to many interpretations. It's stuff like this that keeps the sharks, er, I mean, attorneys, in business :) Not trying to stir the pot anymore, just trying to look at things objectively and play devil's advocate. > I understand the point being made about prescription eyeware being > dispensed only from medically trained professionals but I am curious as [quoted text clipped - 7 lines] > for dispensing plus lenses without the specific recommendation of a > doctor in the same way Neil Brooks has done to Otis? Otis is recommending plus lenses for myopia, nothing about presbyopia. He is technically wrong for suggesting plus lenses on myopic eyes. Walmart is not telling us to use plus lenses on myopic eyes. > In fact, I see > Wal-Mart's selling of plus eyeware akin to them selling Tylenol or any [quoted text clipped - 3 lines] > Otis placing a disclaimer stsating he is not a doctor and his views are > opinions. Nope, there is a difference. We walk into Walmart, try on some readers, buy them and walk out. Same with Tylenol. No medical advice was given by Walmart. Otis is giving medical advice by telling folks that have myopia to wear plus lenses. That is medical advice, which he is not qualified to do. > Makes for an interesting thought. Scary thing is this is open to many > interpretations. It's stuff like this that keeps the sharks, er, I > mean, attorneys, in business :) We need those sharks to protect us from the likes of Otis. An innocent bystander can get hurt if they are incorrectly guided by the likes of Otis who is not qualified to give medical advice. Allen > Otis is giving medical advice by telling folks that have myopia to wear > plus lenses. That is medical advice, which he is not qualified to do. Not only that, he's recommending putting *kids* into plus lenses. I shudder to think what would have happened if I had sent my 6 year old at -2D (his first prescription) to school with readers on and told him to function normally, like read the blackboard or join in sports!  Signature~RT Allen, If we took this arguement further, just about any product you can purchase at the store can be used in a potential way that can cause harm. That is the point you and others are emphasizing regarding Otis. You feel he is taking an object and utilizing it in a way that is inappropriate, a way that was not originally intended. I still feel that if you need to have a prescription for distance, why not for close work as well? The only difference I see is the legalitiies regarding safety and driviing, yet there are many close-up functions that require clarity and can be dangerous. Plus lenses are sold OTC, without a prescription, as "magnifying glasses." This is how the laws are circumvented. Also, it is understood that the vast majority of people who purchase them are adults with presbyopia, a condition that affects or will affect 100% of the human population. To my knowledge, nobody has gotten sick and died from picking the wrong power of OTC reading glasses. With respect to the use of plus lenses for the treatment of myopia, there is no scientific evidence that it works, except for a small subset of myopes who also have nearpoint esophoria and a large lag of accommodation. Otis thus far has not suggested how patients can self-diagnose for those two necessary conditions. One study published in 2001 suggested that plus addition lenses could in fact increase the progression of axial myopia in patients who do not have nearpoint esophoria or accommodative lag by increasing the retinal defocus. Also, by eliminating accommodative convergence, plus lenses might actually induce nearpoint exophoria, which in turn can cause convergence insufficiency, headaches, diplopia, and loss of place when reading. All eye doctors understand how plus lenses can exacerbate convergence insufficiency, and all eye doctors understand how many young people with convergence insufficiency also develop pseudomyopia as a result of trying to recruit accommodation to help with convergence. Otis originally used a trojan horse to gain entry into this NG. At that time he was plugging the use of reading glasses by pilots to prevent myopia. Now he is talking about the use of plus by parents on their children. To go along with that, he has a website to lend a figleaf of credibility, as well as a circular reference from an O.D. in Hong Kong (you scratch my back and I'll scratch yours). DrG > Otis originally used a trojan horse to gain entry into this NG. At > that time he was plugging the use of reading glasses by pilots to > prevent myopia. He gave up the pilot reference as I proved to him his inaccurate statements by providing the military and FAA regulations. Now he is on the DMV kick.... Had I had the medical background, I would have hammered him on the inaccuracies of the medical stuff, but I will leave that to the professionals. *smile*. Allen > Allen, > [quoted text clipped - 7 lines] > safety and driviing, yet there are many close-up functions that require > clarity and can be dangerous. Bassslapper, I think the point I am trying to drive home is how things are being presented. Yes, if you walk into a Walmart, and buy plus lenses, tylenol or anything else of your free will, and you decide to put the tylenol in your eyes for dosage, that's your business. You misuse the item you purchased, that is your own fault. You were not told to do this crazy stuff. If you come to the newsgroup asking for advice on how to clear up myopia and Otis suggests putting Tylenol in your eyes to clear up your vision, and you buy this theory, he is giving a form of medical advice no matter how outlandish it is. You have people coming here trying to find tips and tricks to preserving their vision, and Otis does not put a disclaimer on his posts. He slings doctors names around like they were side by side in studies, quotes subjects as if they were his patients and so on and so on. This is what I am trying to drive home. He needs to be put in his place, and shown as a unreliable source of information. Allen Dear Bass, Let me assume that you have a child. Let me further assume that you have taught your child to read at a young age, and the child "leans forward", and as a very bad "habit" reads at 4 inches. (-10 diopters). >From the study of the primate eye, it is virtually certian that if you do this to the primate eye, the REFRACTIVE STATE of the primate eye will move in a negative direction. I suggest that on scientific grounds (not medical, and just described) that you stop your child from doing this -- by what ever means possible. That is NOT MEDICAL ADVICE. I regard this as forcing sailors to "eat frersh veggies". A wise recommendation. Let me also assume, 10 years from now, that your child goes to an OD, and PASSES all MEDICAL checks, but reads 20/40 at home. (Your PERSONAL check.) But the OD has the child read a poorly illuminated eye chart, and the OD reports your child at -2 diotpers and 20/100. Now, what are you going to do? You can follow Steve Leung OD advice, and have the child begin very consistent use of the plus (under your control), have the child monitor his eye chart, and have the child always pass the DMV test -- under, your, and the child's control. (This is what my nephew did.) Or, you can decide to "fill" the prescription for the -2 diopter lens, and force the child to wear the -2 diopter all the time. But I consider this a personal decision you can make, given "second opinion" information that is available at the present time. But the advice is that you understand these two profoundly contradictory concepts -- and the need to decide this issue before the situation gets out-of-hand. It is a tough choice, and only you personally are going to be making it -- for your child. Our discussions here are only to prepare you for that expected event. Success favors a prepared mind. Best, Otis > blah blah blah "That is NOT MEDICAL ADVICE." so you like to claim. but you try to tell people things that are scientifically-disproven yet you falsely claim them to be proven. just let it come to court. just let it the true weight of the FACTS be put on the table where sane objective people can weight them and decide. then you will lose and you know it. then you can't lurk out of reach of the law on the internet like you do now when you won't answer questions directly and you just resort to your rant about raphaelson blah blah blah. > Let me also assume, 10 years from now, that your child > goes to an OD, and PASSES all MEDICAL checks, but [quoted text clipped - 4 lines] > > Now, what are you going to do? i recommend following the doctors advice instead of some nutcase who posts on the internet. if you follow him, then you deserve what you get. > You can follow Steve Leung OD advice i don't think steve leung is an od. further he's under investigation by his local licensing board isn't he? where is living-- china? who cares about steve leung anyway? > Or, you can decide to "fill" the prescription for the -2 diopter > lens, and force the child to wear the -2 diopter all the time. [quoted text clipped - 7 lines] > need to decide this issue before the situation > gets out-of-hand. there isn't any questions about it! follow the doctors advice! minus lenses have one effect and one effect only. they allow myopes to see better. and they DO NOT cause progressive stairstep myopia (another PROVEN scientific fact that otis will not accept and instead claims that the OPPOSITE is true based upon baby chicken and baby animal studies. its PROVEN that minus lenses do not cause myopia in humans, but otis won't acknowledge it). > It is a tough choice, and only you personally are > going to be making it -- for your child. its a simple choice. believe the guy with doctor after his name, or believe otis brown who is a retired electrical engineer who admittedly knows nothing about the anatomy and physiology of the human eye? get your medical advice from a doctor, or from some kook on the internet? Then why doesnt the patient in question find an optometrist who believes that close work promotes myopia and tells him the approperate actions? Dear Aceman, Subject: P.Clar believes exclusively in his OWN opinion. Re: Pay attention to the MEDICAL SECOND OPINION as stated by Professor Paul Romano. THEN make your choice about accepting the MEDICAL second-opnion for using the plus for prevention. THAT CHOICE will have life-time consequences for you and should NEVER be made by ANY OD in 15 minutes -- as P.Clar wishes to do. PClar> its a simple choice. believe the guy with doctor after his name, Otis> Ace, people with both MD and OD behind there name SUPPORT PREVENTION -- AT THE THRESOLD. PClar does NOT wish to discuss this issue with you in his office. Therefore you must do your own research -- as per this sci.med.vision group. That is WHY we are conducting this scientific review. PClar> or believe otis brown who is a retired electrical engineer who admittedly knows nothing about the anatomy and physiology of the human eye? Otis> PClar states his opinion. PClar lacks the analytic skills to understand and represent the living eye as a dynamic system. But his profession is bound by the Neil-Brooks effect, so do not expect any cogent analysis of the natural eye (pure science) to be developed by PClar. That is the true reason for a competent preventive second opinion. PClar> get your medical advice from a doctor, Otis> Yes, by all means -- see DOCTOR Paul Romano, ophthalmologist. PClar> or from some kook on the internet? Otis> Some majority-opinion kook like PClar who denies your right to an informed, competent second-opinion. Best, Otis > Subject: P.Clar believes exclusively in his OWN opinion. Pot...kettle...black. -MT Dear Mike, Majority opinion calls second-opinion wrong, wrong, wrong. Second-opinion calls majority opinion wrong, wrong, wrong. Best, Otis > Second-opinion calls majority opinion wrong, wrong, wrong. Fringe-fanatics say "conspiracy, conspiracy, conspiracy." Why have all the attempts to replicate Young's results failed? -The followup studies used falsified data. It's a conspiracy. Where is Dr. Leung's efficacy data published? -No journal will publish it. It's a conspiracy. Why has nobody published a study showing minus lenses accellerate myopia? -Nobody will attempt such a study and no journal will publish it. It's a conspiracy. Why did so many doctors stop prescribing bifocals for myopia control? -They couldn't make any money prescribing bifocals. It's a conspiracy. Why does the FDA refuse to require warning labels on minus lenses? -It's a conspiracy. Why was the Chung study aborted? -It's a conspiracy. Those undercorrected children were actually getting better. The researchers lied. Why don't vision-science academics and PhDs recommend plus lenses? -They don't want to prevent myopia. It's a conspiracy. Why can't you name more than 4 or 5 contemporary "second opinion" doctors? -It's a conspiracy. Why didn't the 400-odd children in the COMET study gain significant benefit from plus lenses? -Their instructions were wrong. It's a conspiracy. Why didn't Shotwell's study show benefits of plus lenses? -The data was falsified. It's a conspiracy. Why doesn't evidence-based medicine accept the benefits of plus lenses? -It's a conspiracy. IT'S A CONSPIRACY, I TELL YOU! WHY WON'T ANYBODY LISTEN? -MT Dear Bass, I wrote up the "disparity" between your child reading the 20/40 line at home, versus a -2 diopter "prescription" he MIGHT recieve in a dark room with a poorly illuminated Snellen. I then read RTs statement about his own child. The issue putting a strong minus on a child who PASSES the DMV (20/40) requirement. Further the question is what action you will take to "protect" your own child, i.e., support the child in the use of the plus as recommended by ODs like Francis Young and other scientists. Or do you get a "plus" lens and insist that your child read through the plus for all close work as Dr. Stirling Colgate did. NO ONE CAN TELL YOU WHAT TO DO HERE. The ODs will "protect" themselves from the Neil-Brooks effect -- so they are not going to make statements where you basically "take control" -- and support your child with the pereventive method. But you can be prepared for that expected event -- and understand why you can expect no help from an "majority opinion" OD, and act accordingly. Best, Otis Plus lens therapy aside, Otis is trying to convey that there is an alternative to prescribing minus lenses in early clinically symptomatic myopes. He is also stressing prevention to avoid or minimize the symptoms of myopia, like getting a child to not stick his face so close to a book. The counter arguement seems to feel that there is no way to prevent myopia, if it is going to happen it is going to happen and that environmental factors do not have as much of an influence on myopia. Unfortunately, this arguement has at times digressed into name calling. Dear Bass, Subject: Scurvey analogy and incipient myopia. I think these majority-opinion ODs are completely missing the point. Read the remarks on scurvey. In "scurvey", the sailors would get bleedging gums and lose teeth. Clearly a DENTAL PROBLEM, right? Except it was not. Certinaly the sailors needed "medical" help -- but the real issue was that they had moved from a "shore" life to a seaborne life where they were eating almost exclusivly salt pork and other preserved foods. And then the results only appeared after about 1.5 to 2 years at sea! Very hard to connect this change with "loose" teeth. In a very similar way, we have, in the last 200 years moved from a situation where (most of us) spent 2 to 5 years in school, and then got out and worked. To day we spend 12 to 16 years in that "confined" enviroment and do not expect the refractive state of our naturel eye to change accordingly???? The primate data confirms this behavior of all natural eyes. No "two ways" about it -- as long as you respect the design of the living eye as a dynamic system. Which can, and does have both negative and positive REFRACTIVE STATES. Clearly there are resons to develop methods to prevent the development of a negative refractive state -- if we have the "understanding" to do so. The "difficulties" of understanding -- and actually conducting -- this preventive work are well understood by me. But the real issue is what you decide to do for your own child. For that reason you must sift through these arguments and reach your own conclusions. They like to tell you to go to a full-professional optometrist. And who might that be. If it is Steve Leung OD, he will tell you exactly what I have expressed -- that he has his on child wearing a strong plus as soon as that child's refractive state is at zero. Thus, there recommendation simply comes right back to you -- that you fully understand this contradictory advice -- and then YOU decide which MEDICAL (if you wish) approach you are going to use to help your own child. The "ball" is still in your court. Best, Otis > They like to tell you to go to a full-professional > optometrist. And who might that be. If it > is Steve Leung OD, he will tell you exactly > what I have expressed -- that he has his on > child wearing a strong plus as soon as > that child's refractive state is at zero. Would this be the same Steve Leung who references Otis Brown as an authority on the subject of myopia prevention? That is what is termed a "circular reference," neither of which has any ground in reality. DrG Dear DrG, Yours is the majority opinion. I accept that -- and understand the reasons for it. But you "trashing" of the second opinion, truly defines the meaning of the second-opinion, and the need for the public to be informed of it. I personally wish that I had been so informed. This is also true of Professor Paul Romano, discussing prevention as the second opinion. You "reasoning" is also circular. i.e., a minus lens "works" instantly, therefore it must be "science", and anyone who disagrees with that quick-fix philosophy must be wrong. Yes, you come across loud and clear. Best, Otis > > They like to tell you to go to a full-professional > > optometrist. And who might that be. If it [quoted text clipped - 10 lines] > > DrG > Plus lens therapy aside, Otis is trying to convey that there is an > alternative to prescribing minus lenses in early clinically symptomatic [quoted text clipped - 4 lines] > environmental factors do not have as much of an influence on myopia. > Unfortunately, this arguement has at times digressed into name calling. Not so fast, lapper. Otis is promoting a therapy that had enjoyed some popularity at one time...i.e. about 25 years ago. Those were the days when freewheeling entrepreneurs could promote any theory that made some sort of sense without resort to actual statistical proof. Nevertheless, experience is a hard teacher, and most of use learned that anecdotal evidence is not the stuff of science nor clinical practice. Fast forward 25 years. The studies have been funded, and the results are overwhelming in their conclusion that plus lens/bifocal addition lenses are not effective in preventing/retarding myopia EXCEPT in a minority of cases involving accommodative lag and nearpoint esophoria -- hence the origin of the "anecdotal evidence." Let's take a quick poll. All eye doctors who have seen a myope with nearpoint esophoria in the past month, please raise your hands. No hands counted. The reason this has been reduced to name calling is that insulting eye professionals on sci.med.vision has become the obsession of one Otis Brown, engineer, who shoulders a life-long grudge against optometrists because he is highly nearsighted. Rather than accepting responsibility for his own genes, Mr. Brown blames optometrists for not offering him the "minority opinion." The sad fact is that Mr. Brown would have become nearsighted in any event. So, Mr. Brown has convinced himself of the notion that he did not achieve his true calling in life -- that of a pilot -- because he was not offered the "second opinion" by his optometrists. The fact is that myopia in that range is almost always genetic. DrG Dr G, With the human body being a very adaptable mechanism, I find it difficult to belive that symptomatic myopia, fundamentally a gentically predisposed condition, does not have some environmental influence. I think it is safe to say that all the near point stress placed on our eyes from our technologically advanced world has exacerbated myopia. We also have more advanced techniques to diagnose myopia and other eye disorders, which means a higher likelihood of people having corrective lenses for these conditions. Using Mr. Brown as an example, his genetic make-up would have predisposed him to myopia and then his environmental stimulii would have helped it develop to it's current state. He insists one of his bad habits was holding a book 4 inches from his face as a youngster. IMO, it stands to reason that this behavior had to have some impact on the development of his myopia. The degree to which it may have influenced it is debateable and not proveable at this point in time, though speculation abounds. I am sure there are many people out there that are not happy at being myopic, myself included. If there were a natural way to correct it I would, at the least, research said therapy and try to discern if it had any merit. I understand that Mr. Borwn's perspective regarding plus lenses flies in the face of conventional medicine and does not have enough proof to be accepted by the medical community. It is just sad that instead of intellectual rebuttal regarding this and other ideas it has turned into a phallus waving contest. > Dr G, > [quoted text clipped - 6 lines] > disorders, which means a higher likelihood of people having corrective > lenses for these conditions. All of the real studies that get published agree that in terms of significance, heredity is #1 and the amount of close work is #2. Chew on that awhile. By the way, would you care to define what is meant by "near point stress" and tell me how that causes myopia with enough precision to permit effective interventional approaches? > Using Mr. Brown as an example, his genetic make-up would have > predisposed him to myopia and then his environmental stimulii would [quoted text clipped - 4 lines] > it is debateable and not proveable at this point in time, though > speculation abounds. Agreed, and certainly debatable. > I am sure there are many people out there that are not happy at being > myopic, myself included. If there were a natural way to correct it I [quoted text clipped - 4 lines] > that instead of intellectual rebuttal regarding this and other ideas it > has turned into a phallus waving contest. I am myopic, and have been since age 7. I am not bothered by it, no more than I am bothered by being 6 ft tall, and weighing 175 lbs., wearing a size 10 shoe. It is what it is. What is "Mr." Brown's perspective? Near as I can tell it is a contrarian perspective. It's not that he doesn't simply have enough proof, but there is a large body of published scientific work that says his ideas do not work. Basslapper, I invite you to step outside the confines of this NG and do the research yourself. Where is the first place you would go? Would you go first to a rather amateurish website called isee.org? Would you go to a garish yellow website written in chinese with cartoon figures on the home page? Would you purchase a book written by a physician at the turn of the 20th century and sold by a crazy Italian person by the name of Rishis? Or, would you to the huge scientific database at the National Archives of Medicine and examine the professional and scientific literature? DrG Chew on what? We agree thast genetics is #1 and near point stress #2. We also agree that it is not known how much near point stress factors into myopia. It could be minimal to the point of making no difference and it could be so much that it is substnatial. Factor into that each person is a unique individual that responds to their enviornment differently and you end up with a bunch of "ifs." Regarding near point stress and myopia, my understanding is there is a spastic response of the ciliary muscle and an increase in intraoccular pressure from perpetual close work. This leads to elongation of the eyeball to where it reforms to make the relaxed state be at a closer point. This is at the sacrifice of distance vision. If this is accurate tehn I would think prevention would involve eliminating the ciliary spasm before the eyeball elongates. I am sure we can postualte different means to go about doing this. Obviously I would start with the scientific database available to me and go from there. I think even the most off-the-wall stuff has it's place in research, if to at least help reaffirm the credibility of what the standard medical annuls list. It's all about interpretation and rational use of the information. Too many people get caught up in the emotional aspect and lay blame upon others when they don't get the answers they want. Conversely, lots of what is stnadard in medicine and other fields now was considered quackery when it was first mentioned (i.e. earth is round vs. flat) > Chew on what? We agree thast genetics is #1 and near point stress #2. > We also agree that it is not known how much near point stress factors > into myopia. It could be minimal to the point of making no difference > and it could be so much that it is substnatial. Factor into that each > person is a unique individual that responds to their enviornment > differently and you end up with a bunch of "ifs." I submit that the term "near point stress" is nearly archaic, except among some behavioralists. > Regarding near point stress and myopia, my understanding is there is a > spastic response of the ciliary muscle and an increase in intraoccular [quoted text clipped - 4 lines] > spasm before the eyeball elongates. I am sure we can postualte > different means to go about doing this. Another archaic notion. > Obviously I would start with the scientific database available to me > and go from there. I think even the most off-the-wall stuff has it's [quoted text clipped - 5 lines] > other fields now was considered quackery when it was first mentioned > (i.e. earth is round vs. flat) The problem with this discussion in particular and this NG in general is that the playing field is not equal with respect to individual knowledge and training in the subject. For example, it is clear from this discussion that you haven't really kept up with the research and I have. DrG DrG, I do not doubt you have much more training, experience, and information in this field then I. I present my points based on my limited knowledge in the hopes of receiving objective and informative answers to my questions, or at least a nice debate. Therefore, I ask you to please give me some specifics when regarding to my answers being archaic. For example, in your opinion, what context should the term, "near point stress" be used, if at all? I would also like for you to tell me your point of view regarding the etiology of myopia. You can be as specific as you like. If you have studies or publications that you feel are good reads in expressing your position please send me links or tell me where to go so I can peruse said information. > DrG, > [quoted text clipped - 7 lines] > point of view regarding the etiology of myopia. You can be as specific > as you like. Sorry. It seemed like you were lecturing me on myopiagenesis, and that our discussion could only take place within the limited parameters of your hypotheses. Quite frankly, even one person engaging in this behavior on a daily basis is too many, and we all know who that is. > If you have studies or publications that you feel are good reads in > expressing your position please send me links or tell me where to go so > I can peruse said information. I recommend that you go to Medline and type in search terms "myopia," "accommodation," "myopia prevention," and other relevant terms. You will find that the direction of research in the past 5 or 10 years has been on "retinal defocus" as opposed to "accommodative stress." DrG No problem. With so much venom slinging back and forth I can understand why some people may be a little more "on edge" then others. Also, through internet communication there lacks the facial expressions and emotional inferences that are part of communication. That makes it easy to miscommunicate online. I will go troll Medline. Thank you for the reference. Dear Bass, I take responsibility for myself. As a child, I in fact did "dumb things" as you see a child doing it on my site. There a many who believe they can do ANYTHING they want with there bodies -- and NOTHING is going to chage. (I would accept this a "public ignorance" and say I can not "deal" with it.) But the responsibility is still mine. The real issue is who is responsible. You are a dentist, and with slightly more experience (and equipment) could measure the refractive state of your child's eyes. There is NO LAW against doing so. If you check your child's refractive state, and find it to be +3/4 diopters -- your child is "safe" for some time. (Trial lens kits should be "sold" off the shelf -- like blood pressure gages. You would not "prescribe" -- only measure. That is the difference.) With you child reading the Snellen at 20/20, and you find that a +1/4 dipoter lens blurs the 20/20 line, then the child's refractive state is zero. That is a good indication that the child will get into a negative refractive state -- if nothing is done. (i.e., no preventive plus.) In due course, (due to my curiosity) I found out that my parents had been told that I (at age 5) was going to become "nearsighed". As far as I am concerned, he should have proceeded to explain the "second-opinion" at that point. But that would not have been "medicine" but science. The actions taken at that point would have depended on the wisdom and good-judgment of my parents. That is the type of knowledge (as a wise person) you could have, or could develop. I would personally PAY FOR THIS INFORMATION AND SUPPORT. Do you think you will ever get it. If you judge anything, judge the "majority opinion" reaactions you see to these conversations. I would talk this over with the "behaviorial" ODs you talk to. If you are willing to support it -- then that is the first step you can take for prevention. I lived in Bowie, and so I know some of the ODs in the Washington area. I would be willing to talk with you and them on this second-opinion issue. We learn to "share" responsibility in this manner -- to resovled an hoestly very difficult problem. Best, Otis Dear Ace, Subject: Disclaimers -- on my site: Ace> Otis has not once claimed he was a doctor of any kind and what he says is his opinion from a non medical standpoint. Perhaps he should make a disclaimer in his signature saying hes not a doctor and whatever he says is his opinion and should not be substituted as medical advice but just an opinion only. This disclaimer frees him from any liabilities. Otis> Thanks for understanding that issue. Otis> On my site I spell out the nature of my work. I specifically state that the person should go to a "second-opinion" OD like Steve Leung OD. Reading that site will show that Steve recognizes the "risk" of an over-prescribed minus lens. Further, experts like Dr. Francis Young endorce Steve's position of HELPING parents understand the nature of the preventive choice. Thus going to an "expert" is receiving contradictory advice -- perhaps -- but that does make YOU responsible for making a decision that will have life-time consequences for your long term vision. Otis> In addition to my disclaimers, I post my auto-biography, so there is no doubt about my interest in the natural eye as a dynamic system. Anyone who reads these statements, and still THINKS this is "medical" advice, truly has his head were the sun does not shine. Otis> But you see the problem. Read 20/20 is not enough by Chris. With the population DEMANDING very sharp vision with a strong minus -- what OD can "resist" that demand? Certainly not I. If you want it -- go and do it. Otis> But remember this -- the PREVENTIVE advocacy runs and an "under-current" through optometry -- as the second-opinion. There are MD (ophthalmologists) who will not "prescribe" unless vision is less than 20/40. I just suggest that they go further, and at least offer a DISCUSSION of the preventive alternative. They, and the parents have NOTHING TO LOSE from the explanation. I personally would THANK an OD or MD who though well of me -- and explained these issues to me. I MIGHT have made a "better" choice -- as you MIGHT have. Now, we will never know. Thanks to the Neil Brooks effect, virtually anyone in "medicine" will keep his mouth shut, because that effect. Otis> That is why I use engineering concepts, and only represent the living eye as a dynamic system. Best, Otis Dear Ace, Just for the record, here is my disclaimer. I do not see how anyone could miss the point. Further, what you are learning here -- might help you with your own children when the time comes. Just knowing of the nature of the second-opinion (intelligent choice) might help them avoid the situation you and I are in. I take this as a "learning" experience. I wish I had been on the "receiving" end of the advocacy. And anything I suggest -- I wish I could have done for myself. Best, Otis ___________ Legal Notes on, "How to Avoid Nearsightedness" and your choice about using the preventive method. "We can't solve problems by using the same kind of thinking we used when we created them." Albert Einstein LEGAL DISCLAIMER FOR PREVENTING A NEGATIVE REFRACTIVE STATE Let me recite my personal disclaimer. Because I am not medically trained and because I am averse to the prospect of being sued for giving advice (medical or otherwise), I am stating emphatically that everything written here ("How to Avoid Nearsightedness", including all related pages on this site) is nothing more than my personal opinion and experience. If you are interested in reading about that experience, I invite you to continue reading. If you want a medical opinion or advice, you should contact a medical professional. If something I write seems to be advice, you should re-read this paragraph and understand that I am only using literary license to convey my experiences and opinions. I offer you NO ADVICE and I do not recommend to anyone that they should subscribe to any treatment for any condition without proper medical advice, EVEN IF I TELL YOU THAT I AVOID SOME MEDICAL ADVICE OR TREATMENT FOR MYSELF. I take PERSONAL RESPONSIBILITY for my health. You should take personal responsibility for your health (not my advice - just my opinion). It is up to you to decide if medical professionals and the medical industry, the food industry and others act in your best interest or not. It is up to you to decide, if after reading my experiences, how and whether to address any health issues including those related to your vision. |
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