Limiting precision work would have worse consequences for society than the
myopia it is presumed to cause. The fact is, if it is desired to eliminate
myopia through surgical intervention, it can be done, though less drastic
methods will also correct it satisfactorily.

Dear AceMan,

Subject:  Success clearing from 20/70 to 20/40 or better.

Why it is so darned difficult.  Why a person
will "reject" it.

The primate data is the final word on the dynamic behavior of the
fundamental eye.

The issue of "vision clearing" with the plus -- must be addressed by
the person (or parent) concerned with PROTECTING his child's
distant vision -- for life.

As you have seen and engineer "wised up" and INSISTED that
his children always wear the "plus" while reading.  The result
was that they kept a positive refractive STATE through the
school years.

The REAL REASON why a "plus" is not offered -- is that
it is not MEDICAL.  It is rather a matter of person choice and
PERSONAL RESOLVE.  Prevention is indeed tedious -- and
most people will reject it on the threshod, when it CAN BE
SUCCESSFUL.

I would take this as an educational process of you Ace, so
that when your children start getting into a negative
refractive STATE -- you can give them the PREVENTIVE
support that you never had.  But this knowledge transfers
"control" to you -- completely.

Enjoy,

Otis

++++++++++

Chalmer Prentice, M.D. may have not got everything right (no
one ever does) but he got this part right.

The difficulty is not the statement of what is necessary. It
is in helping the person develop the knowledge and
force-of-character to successfully implement this advice.

Today a great mass of explict DIRECT factual data spells out
the true effect that both a "confined environment" AND a minus
lens ultimately has on the refractive status of the eye.

What happens when you try to help a person use the plus as
described by Chalmer at the 20/50 level? The person states -- I
don't understand why I must use the plus -- my eye's are OK. Take
your plus lens and shove it.

This should explain why, even the ODs who "wake up" to the
necessity of using the plus -- never volunteer information about
it.

When I encounterd this information (after a long search)
I was pissed.  Why not just TELL ME ABOUT THIS?

If I have the fortitude, and am 20/70, then I should
know this -- and DO IT MYSELF.  While indeed
difficult, what is wrong with that?

----------------

The Eye in its Relation to Health

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

By Chalmer Prentice, M.D.

Transcription (c) A. Wik, 2004

Chapter IX

...The following are some very interesting experiments in
myopia which can be verified by any operator, and which prove that
refractive myopia depends on ciliary spasm, and that, even in
axial myopia, considerable repression can sometimes be made at the
near point.

[In the case of 20/50 myopia, "repression" means using a
strong plus that completely ellimates the "near" environment.
This means that the person finds the "blur point" at near, and
pulls the book in SLIGHTLY. This is to insure that the "plus" has
the maximum possible effect. OSB]

In either class of cases, repression must be made at the near
point.

In various lengths of time, we shall be able to reduce the
myopia one or two dioptres, sometimes more.

[I would suggest that the person himself (at -1 diopters) IF
HE HAS THE MOTIVATION can clear his distant vision to pass the
required 20/40 line on his own eye chart. OSB]

In most cases satisfactory results will require considerable
time and patience; but a few experiments after the following
example will suffice to show that in some very advanced stages of
myopia, it is possible to suppress, or at least check, its onward
course by repression at the near point.

[This just suggests that much greater emphasis should be
placed on PREVENTION with the plus -- when the person himself can
take the responsibility to do this work completely under his own
control. OSB]

This fact renders the fitting of minus glasses to myopic eyes
an open question.

[From the Oakley-Young study, it is clear that a slighly
myopic eye will pick up a rate of -1/2 diopter per year (average)
if a minus is worn all the time. The issue now is far more than
an "open
question". It is a proven reality. OSB]

AGE 43 NEARSIGHTEDNESS

...Age forty-three; myopia; had been wearing over the right
eye -1.25 D, left eye -1 D, with little or no change for the space
of two years; eyes in use more or less at the near point. I
recommended the removal of the concave glasses for distant vision
and prescribed +3.50 D for reading, writing and other office work.

After reading in these glasses for several days, the patient
was able to read print twelve inches from the eyes. This patient
was of more than ordinary intelligence and understood the aim of
the effort. In six months I changed the glasses for reading and
writing to a +4 D without seeing the patient. After using the +4
D glasses for several months he again came under my care for an
examination, when the left eye gave twenty-twentieths (20/20 OSB)
of vision, while the right eye was very nearly the same, but the
acuity was just perceptibly less.

[Since then, the DMV standard around the world has become
approximately 20/40. Almost the only people legally REQUIRED to
have 20/20 are professional pilots. Be clear in your mind about
this issue. OSB]

During this time the general health had improved somewhat,
including considerable gain in the nervous condition.

Similar results have been attained in thirty-four like cases;

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

EMPHASIS:

"...but the process is very tedious for the patients, and
unless their understanding is clear on the subject, it is almost
impossible to induce them to undergo the trial."

^^^^^^^^^^^^^^^^^^^^^^^^^

[Anyone who is considering "prevention" at the -1.5 diopter
level (20/60) must realize that the process is tedious. That
seems to be the real "objection" to prevention. This really
becomes a "personal" issue for you to resolve. It is easy to
"talk" about vision-clearing with the plus. Sounds simple until
you realize that you must make the use of a strong-plus a "habit"
for from 8 to 15 months. Just remember, it takes about 15 months
to develop -3/4 diopters of myopia -- and it is likley to take the
same amount of time to clear back to 20/40 (to pass the DMV) and
then to 20/25 and 20/20. If you are looking for an "easy" or
"quick" method -- there is none. OSB]

_____________________________________________

Otis> This suggest that a "tutorial", or an "education" review
must be supplied to the person BEFORE that minus lens is
used. Clearing vision from 20/70 to 20/40 (-1.0 diopters to
-1/4 diopter) is possible and reasonable -- provided the
issue is handled HONESTLY. I suggest the term "second
opinion" should be used as part of an offer of
true-prevention.

Otis> If the person can not accept this requirement, and gets
"stair-case" myopia because of an over-prescribed minus lens
then he would have only himself to blame -- in my opinion.

Otis> I would GLADLY PAY a professional for his time to describe
the above to me. I would have nothing to lose. I think it
is time that we learn to take this issue more seriously.

Otis> Today, we can state that there is almost absolute proof for
this dynamic-eye concept -- provided we keep the subject on
a pure-scientific level.

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

you are writing in a very declarative and authoritative style.  is this
somebody research work you are quoting or are you just telling us what
your personal beliefs are?

and in particular I would ask you to provide the reference for the
following statement.and grow longer?

who says that the ciliary muscle pulling on the retina causes the
eyeball to elongate?  and why would pulling on the retina cause
collagen fibers in the sclera to change their configuration

gee, do you think this is some kind of news or something?

by the way, if you are using a simple-minded model that says excessive
accommodation induces myopia then you should know that thats an OLD
idea and various methods to relax accommodation and ciliary muscle
contraction (e.g. bifocals, having myopes take their glasses off to
read, using plus reading glasses) have all been tested and found to be
ineffective.

i realize that you think you are quite a bright guy but people have
thought these same thoughts for decades and done all the research to
investigate them.  the work has moved much further along than your
current understanding of the problem is.  i suggest you find some
current review articles on myopia using PubMed and do a little reading.

Could you quote that clinical evidence?  Has it been published in
refereed journals?

Could you provide some published anatomy work showing that the ciliary
muscle pulls on the retina?

Once we have read those citations, we may be interested in commenting.

The other factors are genetic

Yes.  Numerous published studies have suggested that genetics can
explain 60% to 80% of myopia.

Dr Judy