posted a reply but it didnt show up so heres it again. high order
aberrations prevent the eye from seeing its best. I get 20/30 with
conventional glasses. Looking forward to 20/15 or even 20/10!

Dear Central,

In fact, there is a "school of thought" (i.e., second opinion) that
when a child's refractive state is +3 or so (and he is young
and "adaptive) the "plus" should be kept off his face, until
his eyes "adapt" down to a normal zero to +2 diopters.

On a optical control-system the effect of putting a +3 on
a child at +3 diopters, is that his refractive state
will not only stay at +3 but will "move positive" -- as
was the case for Neil Brooks.

There is no "magic pill" here -- just an honest difference
of opinion.

But, "Central" many a truth is said in jest.

Best,

Otis

Dear "Central",

Subject:  Adaptive optics -- Adaptive Eye to A lens.

Re:  The second opinion on the plus lens.

Looks like you were correct about Neil Brooks.  An over-prescribed
plus can certainly make a monkey-primate eye "more positive".
It is possible that the same "adaptiveness" also occurs
for the human-primate eye.

Dr. Allen supports the second-opinion which is to "go slow" about
putting a young child in a full-strength plus lens.

You suggestion about stair-case hyperopia is correct.

Best,

Otis

==========================

            How to Eliminate Hyperopia

            (A HIGH positive refractive state of the fundamental eye.)

          by Merrill Allen, OD, PhD, FAAO, FCOVD

              PROFESSOR of OPTOMETRY

            Indiana University.

Summary:  The young eye should be given time to move towards zero
     diopters refractive state (emmetropiia).  A strong plus
     lens will interfere with the "normalization" process
     (i.e,, interfere with "emmetropization".) This statement
     is the "second-opinion" by a highly qualified experts.

Re:  When I'm in the mall, I see thick glasses on small children
    and I have to control myself.  I know that wearing those
    glasses blocks emmetropization.  (i.e., blocks the
    process of normal vision growth.  Subsequently, a
    proven characteristic of the primate eye.    OSB) If Mom
    would put the glasses on the child only in the
    afternoon, the child would grow out of his/her hyperopia
    and require several spectacle power reductions.  If the
    child's correction is less than the refractive error,
    he/she will grow out of the need for those glasses and
    soon weaker lenses will be needed.  Dr.  M.  Allen

       __________________________________

    Humans are adaptable.  The refractive error distribution in
the population of newborns is almost a normal curve.  By the first
grade the distribution has become leptokurtic with the great
majority of the population falling within -0.5 and +2.00 diopters
of error.  The babies have grown out of their refractive errors!

    Graduate Students at Indiana University did a study of babies
at 2 weeks of age who performed as well on focusing tests as
college students.  The one baby who did not was about 5 D
hyperopic.  After 6 weeks or so it was clearly withdrawn and
abnormal in personality.  The baby could not respond to the test.
Application of +4 D glasses changed the baby's personality
overnight!  Regarding the overcoming of hyperopia by optometric
intervention, the baby above was not followed, but if the baby
continued to wear those glasses, now as an adult, he/she will
still be +4 hyperopic.

    I worked with an 18 month old esotropic girl whose eyes were
so crossed I thought she had convergence fixus.  However when I
held her at arms length and turned my body through 360 degrees her
vestibulars took over and her eyes straightened and she showed
nystagmus.  At each of the three visits I increased the plus to
take home.  Her eyes straightened with +11D.  Then at the age of
three years while moving to another city she lost her glasses and
went without them for 3 months.  The new eye examination showed
her Rx to be +4.  She had lost 7 diopters in three months!

    I did not realize the significance and was not smart enough
to say to Mom:    "Let's leave the glasses off for another 3
months," or "Let's wear plano glasses with binasal occluders for 3
months." The last checkup of this patient was at age 18 years when
she was wearing +4D contact lenses!  We cured her of esotropia and
reduced 7 diopters of hyperopia!  She has of course continued to
be straight eyed.

    Wild monkeys have low hyperopia or emmetropia and no myopia.
Caged monkeys have less hyperopia and much more myopia.  Because
the evidence for emmetropization is so strong, I suggest a couple
of approaches on how to emmetropize young hyperopes.

    Only prescribe as much plus as needed to keep the eyes
straight.  (In the case of our baby that couldn't focus and had
personality problems, the plus probably wouldn't be needed for
more than a week or two as the child figured out how to use his
eyes.

    At most the Rx should only be about half of the retinoscopic
Rx and then reduced in power as the eyes change.  With esotropia,
more plus power may be needed at first to establish normal
binocular vision, after which treatment of hyperopia may proceed.
Alternatively for esotropia, the no Rx, binasal approach, see
below, is highly recommended.  Use no lens power but provide
binasal occluders such as frosty Scotch tape applied with the
outer edges placed at the distance apart of the centers of the
pupils, minus 4mm.

    A growing child will require frequent occluder adjustments as
his/her pupillary distance increases.  The binasals will
straighten crossed or exotropic eyes as well as cause
emmetropization.  Within 6 months the occluders can be removed.
Strabismus and refractive error should be cured in that time!  if
you or the parents forget, the child will grow out of the binasals
[they will cover less and less of the visual field] and will be
cured.

    We know that older people grow into myopia, so I would not
put an upper age on when a person can grow out of hyperopia.  The
important condition is that they be able to intensively pursue
visual tasks requiring accommodation.  If they are not visually
involved, and if we eliminate the need to emmetropize, they will
not emmetropize!

    When I'm in the mall, I see thick glasses on small children
and I have to control myself.  I know that wearing those glasses
blocks emmetropization.  If Mom would put the glasses on the child
only in the afternoon, the child would grow out of his/her
hyperopia and require several spectacle power reductions.  If the
child's correction is less than the refractive error, he/she will
grow out of the need for those glasses and soon weaker lenses will
be needed.