In her weekly post, the Real Bev warns us: "Please do not reply to
posters in an effort to denounce, ridicule, embarrass or otherwise
engage in non-productive discussion".

A nice sentiment, but it's frequently violated. I recently submitted a
post on the etiology of myopia, thinking that it might get an
intelligent discussion going.

I was wrong. Dr. Leukoma's response was "Perhaps we should bequeath
this NG to the quacks, once and for all".

I guess that according to him, anybody whose ideas don't agree with his
is a quack.

When I then challenged him to refute my claim about the persistence of
accommodation, I expected an answer along the lines of "Dummy!
Don't you know that it takes about one second for the lens to change
its focus from near to far?".  That's true, as any ophthalmology
textbook will tell you, but that's misleading because it refers only
to a focus change after momentary accommodation.

Instead, I got this:

"I give most readers here credit for high intelligence, Rich.  They
don't need my help to see through you".

How very clever, I thought. He can't refute the claim, so he changes
the subject--to the *ludicrous* charge that I am hiding something!

Then we had Mike Tyner, who appears to have understood only a small
part of my post.

When I pointed out that much of his response was incoherent or had
little or nothing to do with my post, his defense was that "Your
original post wandered from accommodation to myopia, back and forth
again".  I guess he has some difficulty comprehending two (TWO!) ideas
at the same time :-)

Getting back to what this forum *should* be about, how the eye works,
their posts lead me to believe that the optometrists and
ophthalmologists here don't keep up with current research.

For example, they "know" that it is nonsense to claim, as I do, that
accommodation persists long after a nearwork task is completed. They
are completely wrong.

Apparently they are ignorant of the phenomenon of Nearwork-Induced
Transient Myopia (NITM),  also known as accomodative hysteresis. The
evidence from dozens of studies is conclusive, beyond dispute.

When I claim that a significant part of myopia is permanent
accommodation of the lens, it is supported, although indirectly, by
these studies.

One researcher in this field, in a personal communication, assured me
that in some of his studies, what he calls the "decay period" after a
nearwork task is ended can last as long as SIX HOURS.

Consider a person who is an avid reader. He reads for, say, two hours,
probably at a very close distance, as many avid readers do. By this
time his accommodation is at a point that it will take, say, 4 hours to
decay completely.

However, after an hour's rest, he goes back to reading, so that the
lens doesn't have enough time to de-accommodate, thereby causing
another boost to his existing accommodation. After weeks or months of
this nearwork pattern the lens gets to the point that it never
de-accomodates completely.

I proposed this some time ago, and later discovered a paper in which
one of the leading researchers in this field proposed the very same
thing. I don't have the paper at hand, but essentially he hypothesizes
that consecutive periods of transient accommodation could eventually
coalesce so as to produce a permanent condition, myopia.

Unfortunately, he, and as far as I know all the others in this field,
explain this by resorting to the retinal defocus theory, which proposes
that accommodation "lags" behind the amount needed for a given
distance; with the focal point situated behind the retina, there is a
mechanism (they are vague about this) that makes the eye increase its
length so that the retina matches the focal point. Could another
explanation be that the lens fails to fully de-accommodate? They
don't even consider this.

I'll say it again, in the crudest way possible: Myopes are myopic
because they have
accommodated so much and for so long that their lenses have become
permanently accommodated for near vision.

Please don't remind me about axial elongation and heredity. I know
all about it.

The NITM phenomenon is relevant to attempts to slow or stop the
progression of myopia.  The first rule should be: do all you can to
minimize accommodation. When somebody (was it Ace?) advised people to
have frequent rest periods during nearwork and to look in the distance,
he was slammed by some of the professionals, but supported, I believe,
by at least one.

Of course it's important to have gatekeepers to safeguard the
scientific process, but there's such a thing as going too far,  into
"pathological skepticism", as described at

<http://www.amasci.com/freenrg/wbelief1.html>

I was a bit surprised to see the announcement for the 3rd European
Meeting on Physiological Optics, the first time I have seen such a
notice on s.m.v.  I learned of it a couple of months ago and was
thinking of participating, but now I see that DrG and Scott Seidmann
might be there, so I'd better stay away :-)

--Rich