Medical Forum / General / Vision / March 2006
Scientific opinion -- and your opinion
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otisbrown@pa.net - 02 Mar 2006 22:42 GMT Dear sci.med.vision people,
Subject: Thanks for assisting in judgment of prevention work.
You have expressed a number of opinions regarding prevention.
Neil Brooks it truly amazing.
Central is runner up.
Eye_Question is reasonable.
Bev expresses he opinion well.
The majority opinion ODs are doing the best that they can.
Eye_Question -- in fact asks some good questions regarding the AOA, and the need to "reduce" near-work.
Ace has a good mind, in asking many, many questions but is a bit "scattered".
But I conclude, that a "better" solution will be the second-opinion OD who "wakes up" to the necessity of prevention at the threshold, and helps his own child with the preventive process.
For the majority-opinion ODs -- I like you, you are indeed professional. I could not do a better job than the one you are doing. We in fact could have a beer together (or wine and cheese) as the case might be.
I have enjoyed these conversations, and have learned a great deal of your thinking about these issues.
I see no possibility that the majority-opinion ODs could EVER introduce effective prevention to you.
As always, enjoy our pleasant analytical analysis of the dynamic and proven behavior of all natural primate eyes.
(Whether their refractive state be positive, zero, or negative.)
Best,
Otis
Mike Tyner - 02 Mar 2006 23:12 GMT > I see no possibility that the majority-opinion ODs > could EVER introduce effective prevention to you. We're still waiting on your efficacy data.
Please come back when you have some.
-MT
Dr. Leukoma - 03 Mar 2006 00:19 GMT > I see no possibility that the majority-opinion ODs > could EVER introduce effective prevention to you. LOL! It's for certain that you cannot.
On the other hand, I could start dispensing the atropine and reading glasses tomorrow, and there does exist lots of efficacy data on that.
DrG
Neil Brooks - 03 Mar 2006 00:44 GMT Dear Reader,
Otis Brown is in no way qualified to give medical advice.
Before you consider paying attention to anything that Otis Brown (otisbr...@pa.net) writes, I urge you to review all of his previous posts.
Otis's motives are purely financial. His book--derided by the medical community--is what he's trying to sell you, for either $17.00 or $24.95, depending on the website you find. The doctors who participate on this forum have your, or your child's, best interests in mind.
Not only is there no scientific data on humans to support his fantasy, but there IS plenty that proves him wrong. There is not a single MD or OD who has ever acknowledged agreeing with Otis Brown's theories.
If you can find a shred of evidence or scientifically accepted proof of the efficacy of using plus lens therapy to prevent the progression of myopia in humans then, by all means, follow his advice, but do so only under the care of a licensed optometrist or ophthalmologist.
"Scientifically accepted proof" results from experiments conducted within the "scientific method" explained here:
http://en.wikipedia.org/wiki/Scientific_method
Otis's posts tend to fall into the category of anecdotal (or made up):
http://en.wikipedia.org/wiki/Anecdotal_evidence
Otis's posts can be reviewed at: http://snipurl.com/i7k2
The results of clinical trials of using plus lens therapy to prevent the progression of myopia can be found at (hint: it did not work):
http://snipurl.com/fij0
http://snipurl.com/fimq
http://snipurl.com/fimr
The details of a proper, controlled test have been proposed and can be reviewed at the following site, beginning with Page 40, Section 7(A) and continuing through Page 42:
http://books.nap.edu/books/0309040817/html/40.html
The remainder of this text (http://books.nap.edu/books/0309040817/html) provides significant information as well. Nothing contained within supports Otis's theory. Much, in fact, directly contradicts it.
Don't waste your time with Otis Brown. Don't waste your money with Otis Brown. Take your children to a qualified optometrist or ophthalmologist.
Eye Question - 03 Mar 2006 01:31 GMT > Otis's posts tend to fall into the category of anecdotal (or made up): > > http://en.wikipedia.org/wiki/Anecdotal_evidence Most people in this group contends that no one can naturally prevent or reduce myopia. From a statistical standpoint even if one person improves their eyesight, then even anecdotal evidence does disprove the consensus of this group.
Look at it from a different point: ( the reason the defination for anecdotal evidence is being disputed on wikipedia )
The only time a sample size of 1 is statistically valid is when you're disproving a conclusion that claims to be correct for 100% of the population in question (which really only happens in logical arguments, not statistical arguments). So, if you're trying to make the argument that cigarettes don't cause cancer, the argument is flawed because the statistical evidence you're arguing from is too weak to support the conclusion. However, the exact same anecdotal evidence could be used to support a very strong argument that cigarettes don't always cause cancer, so to say that an argument is fallacious just because the evidence it's based on is anecdotal is clearly wrong.
I was formerly very nearsighted person who had a very successful lasik surgery. I had always felt that every time I went to the eye doctor growing up, my eyes were aways .25 worse than the last time. It didn't matter if I went 2 times a year or every few years it was always a .25 increase in perscription. At age 14 my parents didn't have money to get my glasses replaced so I kept the same glasses until 18. I learned the less often I get the perscription changed, the slower my myopia progressed. During my late childhood and early teens, I had a bad habit of playing a pocket football game at close range ( with negative lenses). It was during this period that my myopia increased.
My dad never was myopic until he was in his mid-twenties. At this time, he was a radar operator on a sub and was constantly viewing a radar screen at 12" for 8 hours a day. He always blamed his nearsightedness on this use of his eyes. His famous saying "You develop what you use". It makes sense, if you use your eyes for close work, your eyes will become very good at close up viewing. Ihave found this true for virtually every aspect of human development, even more-so in the younger years.
I have a younger son, who was identified by a school screening program as having vision problems. The district kept sending letters home basically stating we "had" to take him to an eye doctor and get a professional exam. I told the "ex" to ignore it because he could see 20/40 on my chart hanging in the basement. She took him anyway. I seen the report from the doctor, it recommended eyeglasses for constant use, even for reading. I made a list of questions for the doctor, one was why constant use. He stated several reasons:
1. He will want to wear them ( the wow factor ), 2. He woudn't lose them if he always had them on 3. A difference in his perscription would cause him to have lazy eye if he didn't use them all the time.
I asked him for the written perscripion, he said I didn't need it. I asked in a more theatening tone and he wrote it out for me. I don't think he was to pleased, when I told him if I get him glasses it would be from walmart, not his overpriced designer frames.
I asked this group about the possible lazy eye and even the medical professionals here didn't think it was a risk. Looking at my own history, and the posts here I did get a second opinion who recommended only wearing them when needed for distance. I did get glasses for him. About the only time he chooses to wear them is eating supper and the tv is 30 feet away.
Thanks to Otis, I got a second opinion with a doctor that emphasizes proper reading habits and only wants him to wear glasses if he needs them to see something. From personal experience, I had always felt constant use of negative lenses caused my myopia to increase. I do not feel that a child at 20/40 should be using negative lenses ( my opinion, NOT medical advice ).
With any perscription there are possible side effects for some people. For a child that is slightly myopic, I feel the perceived risk of negative lenses outweights the benefit of making my child wear negative lenses. I have been involved with enough clinical trials for FDA approvals of perscriptions to know that many studies are skewed to be in benefit of the sponsors. A side effect that causes a reaction in 5% of the people only shows up in .5% in the trial.
> Dear sci.med.vision people, > [quoted text clipped - 45 lines] > > Otis Neil Brooks - 03 Mar 2006 01:52 GMT > > Otis's posts tend to fall into the category of anecdotal (or made up): > > [quoted text clipped - 3 lines] > their eyesight, then even anecdotal evidence does disprove the consensus of > this group. Oy. Correlation does not imply causation. Ask Mike Tyner whether or not he is plagued by elephants in his yard.
[alll the rest snipped]
If myopic, remove your glasses to read.
Whether myopic or not, take frequent breaks when reading.
No randomized controlled trial supports the notion that plus lenses prevent myopia progression or that minus lenses promote myopia acceleration.
But that is simply the fundamental nature of our discussion regarding the natural eye....
otisbrown@pa.net - 03 Mar 2006 02:00 GMT Dear Eye_Question,
Subject: Slight clarification of my statement.
I state that it is possible to prevent -- before you begin wearing that minus lens.
This means before your eye-chart goes below about 20/50 to 20/60. It takes about a -3/4 to 1.25 diopter lens to "clear" the 20/20 line at that point. (Depending on the measurement "conditions".
I do suggest that SOME people have been able to clear their eye-chart to 20/40 or better by use of the plus. I is not easy, and will depend on the motivation of the person concerned with that issue.
I agree that BEFORE that step is taken, the person should be examined for all pure-medical issues. If none, then the POSIBILITY for "clearing" is possible under the control, and by the direction of a prevention-mined OD, like Steve Leung.
It is 1,000 time easier to just get a -1.25 diotpor len, and place it in front of the eye and make vision very, very sharp.
And perhaps that is the ONLY WAY for 99.9 percent of the population.
Given the general "attitude" expressed on sci.med.vision by a large percentage of people, I would suggest just placing a strong minus on the person and say, "the hell with it". I certainly do not need the harassment of Neil Brooks -- and you do not need it either. So no OD is going to attempt to help you with prevention -- for that reason alone -- nor would I expect them to.
But that simply says that "practice" is determined by the mentality of Neil Brooks and "Central". If you want them -- you can have them.
You write a good post. To further respond
Most people in this group contends that no one can naturally prevent or
reduce myopia.
Otis> I ONLY contend that in can be prevented at the threshold. Nothing beyond that point. By "threshold" I mean before you start wearing a minus lens. Beyond that point the "cause" is lost, and I will not discuss that issue.
From a statistical standpoint even if one person improves their eyesight, then even anecdotal evidence does disprove the consensus of this group.
Otis> If the person (after a pure-medical exam with all MEDICAL issues ended) determines that his eye chart is 20/50, and wishes to use any method OF HIS CHOOSING, and clears his chart (and refractive state) to 20/30, and passes the DMV, then this issue does not involve the optometrists on this site. The person himself has sovled the scientific question and problem.
Preventing a negative refractive state of the eye is indeed difficult.
But is is obvious that the real control is with Brooks and "Central". So trust your visual future to them.
Best,
Otis
Neil Brooks - 03 Mar 2006 02:04 GMT > But is is obvious that the real control is with > Brooks and "Central". So trust your visual > future to them. You HARLOT!
Don't you realize that it's you and me, Babe. I can't STAND that you're trying to bring the Central Scrutinizer into this relationship.
Hmph.
HMPH, I say.
BTW: I believe you lasted only mere seconds this time. Bravo.
Mike Tyner - 03 Mar 2006 05:41 GMT > I state that it is possible to prevent -- before you begin > wearing that minus lens. You used to say it was possible to reverse - by 63% in 100 days.
If you were wrong about that, how do we know you're right about this?
-MT
Dr. Leukoma - 03 Mar 2006 02:59 GMT Sorry, EQ. About all you've demonstrated is that you are superstitious, harbor fears of minus lenses from listening to Otis, and have confused cause with effect.
BTW, myopia can be prevented/retarded with the use of certain drugs, notably atropine. Why not discuss atropine therapy, then?
DrG
Eye Question - 03 Mar 2006 04:48 GMT > have confused cause with effect. I have it right. Cause is the why something happens, the effect is the result. A few example:
Causes | Effects =========================== smoking | possible heart attack ( source AMA ) close work | possible myopia progression ( source AOA ) no gas | car doesn't run ( source AAA )
Unless there is a circular reference between cause and effect, the elements are not reversable. If I had it confused I would be claiming myopia is the causes for close up work. Does the following make sense?
Causes | Effects ================================== heart attack | smoking myopia progression | close work car doesn't run | no gas
My opinion on atropine - The risks of using any remedy must be weighed against the good it will do. The decision to take any perscription should be based on research made by the patient, with guidance from a doctor.
> Sorry, EQ. About all you've demonstrated is that you are > superstitious, harbor fears of minus lenses from listening to Otis, and [quoted text clipped - 4 lines] > > DrG otisbrown@pa.net - 03 Mar 2006 05:22 GMT Dear Eye Question,
Subject: Objective scientific (proven) facts -- and deadly human nature.
You have seen some incredible blindness in Neil and "Central".
I would not have believed it -- until I saw it. These ODs MUST deal with such people. I never will (I hope.)
The public wants very, very shapr vision instantly. The ONLY thing that can provide that is a strong minus lens.
Human nature will always demand that -- and for that reason I have no argument dealing with "human nature".
But I consider nearsightedness to be like "scurvy", in that we induce a negative refractive state in ourselves, because we have gradually migrated from a "far" environment to a "near" environment. The proof for this is in the fundamental scientific studies of the dynamic primate eye. (Totally trashed by the majority opinion ODs -- for obvious reasons.)
But science is science and that information is critical -- for those who follow scientific matters.
Yes, there are people who know this. But you can not reduce exact knowlege of the natural eye's proven behavior into dealing with the mass population walking in off the street. The problem is when when we attempt to do so.
Prevention with the plus takes a LOT OF MOTIVAION and Dr. Colgate said. That alone is enough to prohibit true-prevetion as a "prescription" -- and I have NEVER argued otherwise.
It is like an obese engineer. The engineer knows that starviation (conservation of energy) will produce gradule weight loss. But "human nature" in the obese rules against it.
Thus I have no problem with a person who has the preventive plus offered to him -- and turns it down, because it "interfers" with his life-style. The only thing I suggest is that the problem is "human nature" in rejecting the preventive plus.
But that becomes exclusively the province of the person who begins to comprehend the necessity of introducing this preventive method at the threshold -- when it must be done to be effective.
And that puts the problem in your court -- on way or the other.
Best,
Otis
CatmanX - 03 Mar 2006 21:09 GMT > I would not have believed it -- until I saw it. These ODs MUST > deal with such people. I never will (I hope.) Yes we do, and that is why we know that your method doesn't work, as we have tried it and still try it, but the myopia continues to deteriorate.
> The public wants very, very shapr vision instantly. The ONLY thing > that can provide that is a strong minus lens. You don't talk to many people. Myopes want clear near vision. They mostly are happy with distance blur, hence the big Rx changes when they do come in as they are happy to cope with the blur until it is too debilitating.
> Human nature will always demand that -- and for that > reason I have no argument dealing with "human nature". See above paragraph.
> But I consider nearsightedness to be like "scurvy", in that > we induce a negative refractive state in ourselves, because [quoted text clipped - 3 lines] > dynamic primate eye. (Totally trashed by > the majority opinion ODs -- for obvious reasons.) Yes, because when put to the test, your theories were found to be wrong. If they were right, everyone would be treating patients with plus.
> But science is science and that information is > critical -- for those who follow scientific matters. Science is simply saying "is this thing repeatable and reliable?" Bates was found to be wrong, Young was wrong, Goss and Grosvenor appear to be wrong and sadly, Janet Stone may be wrong. You are a fool because you think science conspires against you, when in fact it wanted to support you but you were found lacking.
> Yes, there are people who know this. But you > can not reduce exact knowlege of the natural eye's > proven behavior into dealing with the mass population > walking in off the street. The problem is when > when we attempt to do so. The problem is when stupid people think they are right when they are wrong. You can't produce one piece of evidence they can support your theory irrefutably.
> Prevention with the plus takes a LOT OF MOTIVAION and > Dr. Colgate said. That alone is enough to prohibit true-prevetion > as a "prescription" -- and I have NEVER argued otherwise. Colgate should stick to toothpaste. Wearing high plus does not counter internal stress and drive. It does not entirely eliminate retinal blur, and as such has been found not to be repeatable.
> Thus I have no problem with a person who has > the preventive plus offered to him -- and > turns it down, because it "interfers" with > his life-style. The only thing I suggest > is that the problem is "human nature" in > rejecting the preventive plus. No, the problem is that it doesn't work. Human nature says that if it doesn't work, then I won't do it. Simple.
> But that becomes exclusively the > province of the person who begins > to comprehend the necessity > of introducing this preventive > method at the threshold -- when > it must be done to be effective. No, it must be shown to be effective, or it is not viable. You can't show effectiveness, so your theory is not viable. Your problem is that you won't let go of the bone, even though it is dried out and useless.
> And that puts the problem in > your court -- on way or the other. No, the problem is in your court, show some proof or shut up.
> Best, > > Otis (THE FOOL) Dr. Leukoma - 03 Mar 2006 12:52 GMT Circular reference = Otis and Steve Leung
Cause and Effect = increasing myopia leads to stronger glasses, and not the other way around.
Disproven or at least unproven theories = plus lenses prevent or slow down the progression of myopia.
DrG
Dan Abel - 03 Mar 2006 20:55 GMT > > have confused cause with effect. > [quoted text clipped - 16 lines] > myopia progression | close work > car doesn't run | no gas I believe rather strongly that strong myopia causes close work. If you can't see far, then you instead concentrate on things that you *can* see.
I have anecdotal evidence to prove this.
 Signature Dan Abel dabel@sonic.net Petaluma, California, USA
acemanvx@yahoo.com - 03 Mar 2006 05:56 GMT I agree with alot. Eye Question's results concide closely with mine. Its true near work induces myopia. Its also true the longer you put off getting new glasses, the slower your eyes get worse. Mine also got -.25 or -.5 worse everytime I got new glasses. I would get new glasses yearly but one time I put them off for 3 years and it only got -.25 worse then -.25 worse again shortly after getting new glasses. I now undercorrect myself with weaker glasses and also do some exercises and have improved a diopter!
The sad thing is some optometrists are greedy and want your money. They pescribe glasses even though you dont need it then tell you to wear them full time even though you can see fine near and intermediate without glasses. They want your eyes to worsen fast so you return twice a year and buy more glasses and the optometrist has you as a customer and makes money! Otis is very right when he says you should get a 2nd opinion if your told to wear glasses full time when you can see FINE at closer range due to myopia! Ditto if you pass the DMV then glasses arent required!
Otis is right, its 1000x easier to use the evil(my word) minus lens and get stair case myopia. The sad thing is most parents, child(ren) and optometrists want a quick, easy fix. There has been evidence of myopia prevention and improvement. In fact I am living proof of improvement. Although Otis doesnt believe in vision improvement, only prevention, I do believe in improvement.
Long term usage of atropine isnt healthy for the eyes, but short term use can be done to slow rapidly advancing myopia
Dan Abel - 03 Mar 2006 20:46 GMT > > Otis's posts tend to fall into the category of anecdotal (or made up): > > > > http://en.wikipedia.org/wiki/Anecdotal_evidence Not only is this not a credible cite, but there is a note at the top saying that it is disputed.
> Most people in this group contends that no one can naturally prevent or > reduce myopia. From a statistical standpoint even if one person improves > their eyesight, then even anecdotal evidence does disprove the consensus of > this group. Most ODs posting on this group have agreed that high myopes often experience a reduction of their myopia in a certain age range. That was certainly true for me.
Some children don't become more myopic. Two of mine never did. I beat them with a stick three times a day to keep that from happening. We debated long and hard about the oldest, as to whether we should beat him with a stick twice or four times a day to prevent myopia. We were mistaken. He is mildly myopic.
> I asked him for the written perscripion Ace posts that it is spelled "pescription".
ObHumor: The above is *not* funny. It is not *supposed* to be funny. We didn't beat our children. The two youngest are not myopic. Go figure.
 Signature Dan Abel dabel@sonic.net Petaluma, California, USA
otisbrown@pa.net - 03 Mar 2006 01:44 GMT Dear Second-opinion friends,
I am getting tired of harssment by Neil Brooks.
Below is his latest email. My wife fears him -- and I must respect that.
So, I will apoint "Central" to be your true intellectual leader, with support from Neil.
Enjoy,
Otis
___________
Email to me from Neil Brooks:
Felt a little ignored again?
Felt like the rest of us were bereft of your insanity, so you were compelled to force yourself upon the rest of us again??
More Thorazine, Dear Boy. STAT!
Neil Brooks - 03 Mar 2006 01:56 GMT > Dear Second-opinion friends, > [quoted text clipped - 24 lines] > > More Thorazine, Dear Boy. STAT! a) Funny. I don't recall e-mailing you;
b) Nonetheless, does this mean that you're leaving? Shall I, then, bask in the glow of the -- what? Three minutes or so until your next post?
Oh, joy.
tick-tock, tick-tock, tick-tock. Hitting F5 now? Still clear? Cool!
The Central Scrutinizer - 03 Mar 2006 16:03 GMT >So, I will apoint "Central" to >be your true intellectual leader, Nope, I'll pass. First, I'm not qualified and never pretended to be. Second, you're insane and dangerous.
What does you being insane and dangerous have to do with this question? Not a thing. Buuut it's truuuuue....
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