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Medical Forum / General / Vision / October 2006This Otis character
I realize that many regulars here will be distinctly disinterested in this topic, but I'm trying to figure out just what kind of kook this guy is, without going back and reading his old messages. It seems he believes that wearing glasses for myopia can worsen the myopia (I've seen the phrase "staircase myopia"). Is this related to his bizarre habit of using the phrase "refractive STATE"? What exactly is a refractive STATE?  Signature- Mike Ignore the Python in me to send e-mail. > I realize that many regulars here will be distinctly disinterested in > this topic, but I'm trying to figure out just what kind of kook this [quoted text clipped - 5 lines] > Is this related to his bizarre habit of using the phrase "refractive > STATE"? What exactly is a refractive STATE? He appears to believe many things: -A theory can be valid and true when it is supported by outdated and presumably discredited sources; -A person asking for clarification on his opinion actually believes the opposite; -He has insight into people's beliefs, and can point them out quite specifically, rather than *asking* about them, as most people do (must be psychic) -It's okay to completely ignore requests for clarifications -It's OKAY to capitalize random WORDS in a sentence, as it must MAKE them more true. In short - he's dangerous, likely mildly psychotic if he can't recognize that NO ONE in this group has patience for him anymore... Or maybe he's just the most talented troll ever to have stumbled around Usenet. Lord knows he gets people riled up in here. > Or maybe he's just the most talented troll ever to have stumbled around > Usenet. Lord knows he gets people riled up in here. He is what is called a mission troll. Maybe he sincerely believes his kook theories but a troll none-the-less who probably enjoys getting people riled up. SignatureCharles > In short - he's dangerous, likely mildly psychotic if he can't > recognize that NO ONE in this group has patience for him anymore... He has a couple of sidekicks. And I don't believe he is dangerous as long as you understand that he doesn't know what he is doing. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > I realize that many regulars here will be distinctly disinterested in > this topic, but I'm trying to figure out just what kind of kook this > guy is, without going back and reading his old messages. Bev has a periodic post (weekly, I think). Otis isn't mentioned by name, but fits the profile. > It seems he believes that wearing glasses for myopia can worsen the > myopia (I've seen the phrase "staircase myopia"). Yup. > Is this related to his bizarre habit of using the phrase "refractive > STATE"? What exactly is a refractive STATE? I just guessing here, but I suspect that Otis has gotten beaten up too many times for misusing words and phrases. By making up his own, nobody can criticize them, since nobody knows what they mean. SignatureDan Abel dabel@sonic.net Petaluma, California, USA Dear Mike, Subject: My "belief" about the dynamic nature of the eye. It seems he believes that wearing glasses for myopia can worsen the myopia (I've seen the phrase "staircase myopia"). No, what I believe is this. That a population of natural eyes will have a refractive "spread" of from about -0.7 diotpers to about +2.1 diopters. I believe that these eyes are "potentially" dynamic, i.e., that if you place a -3 diopter lens on them, their natural eyes will "respond" by changing their refractive STATE, in the direction of the applied -3 diopter lens. Clearly they either will (they are dynamic) or they will not (they are passive box-cameras). Seen from this perspective, you are only talking about a measured value (i.e. refractive STATE). The animated "picture" by C. Wildsoet, shows this graphically and dramatically. But the implcations are clear. An eye with a refractive STATE of +1/2 diopters will change (as a dyanmic system) to about -1.5 diopters in about 120 days. But of course there are many who wish to deny this type of scientific experiment. I judge this type of repeatable scientifc test to be important, supporting the PREVENTIVE second-opinion advocated by: www.chinamyopia.org You can make your own judgment about this proven behavior of the natural eye. Best, Otis > I realize that many regulars here will be distinctly disinterested in > this topic, but I'm trying to figure out just what kind of kook this [quoted text clipped - 5 lines] > Is this related to his bizarre habit of using the phrase "refractive > STATE"? What exactly is a refractive STATE? > I believe that these eyes are "potentially" dynamic, i.e., > that if you place a -3 diopter lens on them, their natural > eyes will "respond" by changing their refractive STATE, > in the direction of the applied -3 diopter lens. If this were true, there would be no +3.00 hyperopes. They'd all cure themselves. Doesn't happen. Come to think of it, there would be no -6.00 myopes, either. Where do we get those? > Clearly they either will (they are dynamic) or they > will not (they are passive box-cameras). Why aren't you wearing plus? Is it because you believe emmetropization stops? In your black-and-white universe, it continues forever so you should be wearing undercorrection. > Seen from this perspective, you are only talking about > a measured value (i.e. refractive STATE). Which you have never measured. > The animated "picture" by C. Wildsoet, shows this > graphically and dramatically. > > But the implcations are clear. If you're 18 months old. Dr. Wildsoet doesn't say emmetropization lasts for a lifetime. That's your idea, but apparently you don't actually believe it or you'd be wearing plus. > An eye with a refractive STATE of +1/2 diopters will change (as a > dyanmic system) to about -1.5 diopters in about 120 days. So an eye with a refractive STATE of +3.00 diopters will change (as a dynamic system) to about +1.00 in about 120 days. Does that really happen? > But of course there are many who wish to deny this > type of scientific experiment. Which you have never performed. > I judge this type of repeatable scientifc test to be important, > supporting the PREVENTIVE second-opinion advocated > by: If you have a repeatable method for preventing myopia, you should be able to tell us how you know it works. You know, t-tests, comparisons between groups of human myopes wearing and not wearing glasses? You never mention those. > You can make your own judgment about this > proven behavior of the natural eye. By looking up Shotwell, or Grosvenor, or Ong, on Gwiazda, or Parssinen, or Wiesel, all of whom disagree with you. -MT > I realize that many regulars here will be distinctly disinterested in > this topic, but I'm trying to figure out just what kind of kook this [quoted text clipped - 10 lines] > > Ignore the Python in me to send e-mail. Dear Mike, Now you have seen how Otis weaves his craft. He uses generic terms, such as NATURAL, and STATE, and FUNDAMENTAL, but conveniently ignores the all-important details, such as how the eyes of different species react differently to the same stimuli. Thus, he thinks he cannot be proven wrong. He would also have you believe that optometrists routinely put minus lenses on their patient that are 3 diopters stronger than required, because that is the only possible state of affairs that would justify his position on stair-case myopia. The problem is -- as with many of his decrees -- this state of affairs simply does not exist in the real world. DrG Most patients fortunately dont get overcorrected by much, if at all. There are some children that "eat minus" and a cycloplegic refraction is needed to assess the true prescription. There is much proof that myopia can be prevented or at least slowed down. Its environmental with genetic tendencies. Otis, those majority opinion optometrists will never believe a word you say > Most patients fortunately dont get overcorrected by much, if at all. > There are some children that "eat minus" and a cycloplegic refraction > is needed to assess the true prescription. There is much proof that > myopia can be prevented or at least slowed down. Its environmental with > genetic tendencies. Otis, those majority opinion optometrists will > never believe a word you say There is only one proven method to slow the progression of myopia, Ace, and that is the one method you and Otis continually ignore: drugs. Atropine has been shown to stop the progression of myopia completely, while Pirenzepine is less effective. You can forget anything else at this point, except maybe some future wavefront glasses or contact lenses. Simple plus lenses and bifocals have been proven not to work. DrG > > Most patients fortunately dont get overcorrected by much, if at all. > > There are some children that "eat minus" and a cycloplegic refraction [quoted text clipped - 11 lines] > > DrG Then why isnt atropine used much to prevent myopia or stop it from worsening? I know long term use of atropine has risks but its the lesser of the evils to high myopia which results in extremely blurred vision and worse yet, a stretched thinned retina which can easily detach, more floaters, macular problems and other problems. I would have been willing to get atropine when I was 12 and -1 to halt further progression of myopia. Ill stop atropine at 18 where most peoples eyes are more or less stable at that point. Needing readers for 6 years is better than a lifetime of significent myopia. By the way, what are the long term risks of orthoK? alot of us are wondering. > > > Most patients fortunately dont get overcorrected by much, if at all. > > > There are some children that "eat minus" and a cycloplegic refraction [quoted text clipped - 21 lines] > are more or less stable at that point. Needing readers for 6 years is > better than a lifetime of significent myopia. Start on Atropine, Ace. Start on it today. Don't forget: it has a bi-phasic half life--the first in twelve hours. Use it twice a day. Let me know how ITS--and the cytotoxicity of the preservative, BAK--work out for you over time. _I_ already know the answer. You go find out for yourself. Or, you could just wear glasses or contact or have refractive surgery. Neil > Start on Atropine, Ace. Start on it today. > [quoted text clipped - 8 lines] > > Neil I know you used atropine because of your accomodative spasm. I discussed with my optometrist and she said dont bother, only children have accomodative spasm(false but I didnt want to argue) and that youd need several months of atropine regime. I still think a small part of my myopia is pseudo but I will just let it go away on its own. How long can atropine be used before the cytotoxicity becomes a problem? I would have been happy to use atropine at low dosages and slow my myopia down then my eyes would be nowhere near as bad(-4.5 and -5) as they are now. Its too late now. I am considering Intacs and have alot more to reserch on them. Those will correct my myopia at a cost of about $5000 and some risks incurred. An ounce of prevention is worth a pound(or ton!) of cure. Plus lenses with prisms will work without the double vision side effect. Even if you dont want to use the plus lens, just go without correction(except for driving) and hold reading material away from you or into the point of slight blur. This will slow your myopia progression and keep your eyes from getting as bad as mine are. >> Start on Atropine, Ace. Start on it today. >> [quoted text clipped - 21 lines] >risks incurred. An ounce of prevention is worth a pound(or ton!) of >cure. Ase: "I didn't want to argue" WOW, that is a first... The know-it-all didn't want to argue. Too bad he/she/it can't take on that trait here! Maybe Daddy will spend the 5K, since you don't want a car. You would rather be chauffeured around. Then again, your personality speaks for itself. Hey Odis, The Wal-Mart only has a eye doctor one day a week, maybe you could help him out. Bring Barney with you. I'm surprised he has not taken a room in your house, to help with marketing that useless publication. It is only a few miles away from your place. New Chinese buffet over there, too. I do really miss Chestnut Logs, that was a great place to eat. That mansion across from you is still for sale? > Then why isnt atropine used much to prevent myopia or stop it from > worsening? I know long term use of atropine has risks but its the [quoted text clipped - 5 lines] > are more or less stable at that point. Needing readers for 6 years is > better than a lifetime of significent myopia. Atropine has side-effects: dilated pupils and accommodative paralysis that requires reading glasses. AND YET, if you ever take the time to get off this NG and dig into the REAL scientific literature, you will discover that there are advocates of using atropine NOW. Others are content to wait for Pirenzepine, which has few, if any side-effects. Or, wait for another drug to be discovered. Since retinal DEFOCUS seems to be the stimulus and scleral remodeling the engine for myopiagenesis, there is considerable interest in studying the role of defocus. This does leave the door open for an possible optical solution, but nothing as simplistic as any proposed by Otis. REAL scientists follow the evidence. DrG > Atropine has side-effects: dilated pupils and accommodative paralysis > that requires reading glasses. AND YET, if you ever take the time to [quoted text clipped - 12 lines] > > DrG I guess Otis can finally rest in peace once myopia prevention gets underway with Pirenzepine and its few side effects. Youll need plus glasses with Pirenzepine but Otis will suggest plus glasses are used for reading anyway! Otis may have a simple theory but it makes sense and if it didnt work, why does he swear by it? Pirenzepine is going to further help because as Otis says, many children do not correctly nor consistly use the plus lens(i.e they sometimes forget) Pirenzepine will stop most or all accomodation and make it impossible to forget the plus lens, something Otis is keen to tell you. The myopia epidemic will resolve with Pirenzepine and Otis' plus lens theory(use prisms to prevent a slight possibility of double vision) so I can see the prevelence of myopia being much lower in the next few decades as well as high myopes being almost unheard off as they will use Pirenzepine and plus lens so they will be mildly myopic worst case. Lasik will fall into obsolence due to lack of myopic patients to treat as well as due to the high risks of lasik. > I guess Otis can finally rest in peace once myopia prevention gets > underway with Pirenzepine and its few side effects. Youll need plus [quoted text clipped - 5 lines] > stop most or all accomodation and make it impossible to forget the plus > lens, something Otis is keen to tell you. Why plus glasses with Pirenzepine? Pirenzepine doesn't affect accommodation. Ace, I simply cannot believe that after everything that has been published and discussed that your faith in Otis hangs on such a weak thread. It is surely not myopia prevention that drives Otis. If it was, then he would have embracing these new findings like the rest of us. His method is useless and impractical to implement, and he can continue to bark safely from the sidelines. It's a way of life for him. > The myopia epidemic will resolve with Pirenzepine and Otis' plus lens > theory(use prisms to prevent a slight possibility of double vision) so [quoted text clipped - 3 lines] > Lasik will fall into obsolence due to lack of myopic patients to treat > as well as due to the high risks of lasik. Myopia will not disappear with Pirenzepine. There are many difficult questions to be answered, such as how early and safely can this therapy be started, how long will it need to be continued, etc? At this point, it would appear that the drug would have to be started at about the age of 5 years and continued into young adulthood. What would be the side-effects of such long-term use? It would make more sense in cases where the risk of high genetic myopia was present. Myopia is going to be around for the rest of our lifetimes and beyond. DrG > Why plus glasses with Pirenzepine? Pirenzepine doesn't affect > accommodation. Ace, I simply cannot believe that after everything that [quoted text clipped - 4 lines] > can continue to bark safely from the sidelines. It's a way of life for > him. > Myopia will not disappear with Pirenzepine. There are many difficult > questions to be answered, such as how early and safely can this therapy [quoted text clipped - 7 lines] > > DrG Then how exactly does Pirenzepine work? If near work causes myopia, what role does Pirenzepine play in that? Im sure Otis has a smile about Pirenzepine, but is Pirenzepine enough alone or are other measures still needed to really prevent a negetive refractive state? Why start Pirenzepine at 5? What if its started as soon as the child shows signs of myopia(for example, -1 at age 12) then wouldnt it stop further progression and keep his vision at -1 or better? Strong myopia genes is an even better reason for Pirenzepine and in that case, it very well may be that the side effects of Pirenzepine is preferable over being a -10 or something! I think Pirenzepine could make a big dent in myopia. There will probably always be myopes in our lifetimes but the prevelence and severity will be much reduced. Myopia will be alot less common and high myopia(-6 or worse) will become a rarity. > > Why plus glasses with Pirenzepine? Pirenzepine doesn't affect > > accommodation. Ace, I simply cannot believe that after everything that [quoted text clipped - 21 lines] > Pirenzepine, but is Pirenzepine enough alone or are other measures > still needed to really prevent a negetive refractive state? Pirenzipine is a selective muscarinic antagonist that blocks that effects of acetylcholine on some of the receptors controlling eye growth. It is most likely that blur causes myopia, and not accommodation. The blur is most likely caused by the "lag" of accommodation. As the reading distance decreases, the blur probably also increases but is offset by the angular magnification. Research is now "focusing" on the role of image quality at the retinal level. > Why start Pirenzepine at 5? What if its started as soon as the child > shows signs of myopia(for example, -1 at age 12) then wouldnt it stop [quoted text clipped - 5 lines] > but the prevelence and severity will be much reduced. Myopia will be > alot less common and high myopia(-6 or worse) will become a rarity. It just picked "5" at random, because this seems to be the earliest age at which some children become myopic, excluding those who are highly myopic at birth, of course. DrG > Pirenzipine is a selective muscarinic antagonist that blocks that > effects of acetylcholine on some of the receptors controlling eye [quoted text clipped - 5 lines] > offset by the angular magnification. Research is now "focusing" on the > role of image quality at the retinal level. > It just picked "5" at random, because this seems to be the earliest age > at which some children become myopic, excluding those who are highly > myopic at birth, of course. > > DrG In the case, its hyperopic blur when images focus behind the retina that stimulates the eye to enlongate to remedy this defocus from excessive near work. Otis believes the plus lens tricks the eye into seeing at infinity. A -3 myope and someone with +3 readers both see clearly at 13 inches but in the -3 myope, the eye had to enlongate to achive the effect that otherwise could have been done with +3 readers. Pirenzipine alone might not be enough to stop myopia completely, especially with a strong genetic deposition and reading at way too close a distance, especially if you forget to take your minus glasses off! Pirenzipine and reading at half meter(or further) gives the best results. Had that been done on me back when I was 12 and -1, I probably would not be any worse than -2 today and wouldnt need distance glasses much. It sucks for me now ill need orthoK or Intacs to achieve that. Dear Ace, It is proundly easy for a kid to put his nose (almost) on the page and read at 4 inches (-10 diopters). If he did this for 10 or 20 seconds -- then OK. But when he does this for hours on end, then, the natural eye will change its refractive STATE in a negative direction -- same as the primates when you place a -3 diopter lens on them. This is a natural process, where the eye functions as "designed". The primate data is very clear on that point. But the majority-opinion orders you to IGNORE all scientific data of this nature -- and so you do. As you know, I argue ONLY prevention on the THRESHOLD -- exclusively. Because if you are going to PREVENT, then that is the time to be doing so. This places a considerable responsibility on the parent and child to make this type of either-or choice. >From long experience with this issue, I had to ask myself -- OK, plus-prevention is difficult -- but what about the PARENTS, who get this idea CORRECTLY. And I do mean OPTOMETRIST-Parents. Since the public will reject outright the use of the preventive-plus, that leaves the "convinced" second-opinion optometrist the only possibility of helping his own children. Once you start with the minus (and refuse to modify your "habits), the your distant vision is so much "water over the dam, or so much spilt-milk.) So if you wish prevention, you must condider this issue properly. When the OD-Parent INSISTS that his own children NOT read at -10 diopters (4 inches), and always read at 13 inches or greater. (-3 diotpers), then that is a "start". Further, assuming a refractive STATE of zero, the child could put on a +3 diopter lens and completely neutralize that -3 diopter "environment" permanently. But this must be consistent. The expected result would be that the refractive STATE would move SLOWLY in a positive direction, i.e., move towards the desired +0.75 diopters. By understanding the refradtive profile of the natural eye in the wild, average 0.75 diopters, SD 0.7 diopters, we should understand how valuable it is to "build up" this desired refractive STATE. Thus plus-prevention (in this manner) is the correct understanding of the proven behavior of the eye. Implementation will depend on a deeper understanding. The "standard" OD has about 20 minutes with you. He must practice "defensive" measures, i.e., to avoid you suing him. Thus he will keep his mouth shut about any preventive method -- for that reason alone. But, then no problems are solved or resolved in that manner. Steve Leung has the personal courage to publish these issues on his site: www.chinamyopia.org as the SECOND OPINION. It would pay to understand these issues -- before you get in "deeper" than about -1 diopters and 20/50. Best, Otis > Most patients fortunately dont get overcorrected by much, if at all. > There are some children that "eat minus" and a cycloplegic refraction > is needed to assess the true prescription. There is much proof that > myopia can be prevented or at least slowed down. Its environmental with > genetic tendencies. Otis, those majority opinion optometrists will > never believe a word you say > It is proundly easy for a kid to put his nose (almost) > on the page and read at 4 inches (-10 diopters). Have you actually ever tried this? It is very difficult, I promise you. SignatureDan Abel dabel@sonic.net Petaluma, California, USA Dear Dan, Subject: Children reading at 6 inches (-6 diopters), 5, 4 (-10 dioters) and 3 (-13 diopters) > > It is proundly easy for a kid to put his nose (almost) > > on the page and read at 4 inches (-10 diopters). > > Have you actually ever tried this? It is very difficult, I promise you. Dan, why not "click on: www.myopiafree.com and review the kids resting their chin on their arm, and reading at these distances. They have no problem at all reading at these distances. Why do you think they can not do it? The pictures tell the story. In fact, I remember doing it myself. As a child I did not know the consequences. As an engineer, studing the behavior of the primate eye -- I have no doubt that this is "control-system" action. This is indeed a "bad habit" of SOME CHILDREN. Best, Otis > Dear Dan, > [quoted text clipped - 12 lines] > and review the kids resting their chin on their arm, and > reading at these distances. Are we talking about: http://www.geocities.com/otisbrown17268/Kid10D.jpeg They don't appear to be reading, although maybe that's a quibble. I'm not sure that is 4 inches, either. The difficulty in reading at 4 inches (at least for me) has more to do with scanning from left to right. The kids in this picture aren't doing that, since they aren't actually reading. Of course, those kids don't look old enough to either read *or* write. Are you sure they aren't just scribbling? I think that we both agree that letting kids read at 4 inches is a bad idea. My experience with reading at -10 was that I had to close one eye and move the book back and forth in front of the open eye. Of course, I had very little accommodation at the time. This is why I wore contacts for 14 hours a day, 7 days a week. When I took the contacts out at night, I was reading at -10. SignatureDan Abel dabel@sonic.net Petaluma, California, USA > > Dear Dan, > > [quoted text clipped - 25 lines] > look old enough to either read *or* write. Are you sure they aren't > just scribbling? There is no way a child can read with both eyes at 4 inches. In fact, I would consider habitually reading and working at that distance to be a sign of a binocular vision disorder, usually convergence insufficiency. Working that close actually favors monocular vision over binocularity. This is yet another of Otis' red herrings as he assumes that all myopia begins with reading at 4 inches. DrG Dan> They don't appear to be reading, although maybe that's a quibble. I'm not sure that is 4 inches, either. Otis> That is indeed a quibble. The fact is that kids do this for BOTH reading and writing. If you had clicked further down you would have seen an older child WRITING at about 5 inches. Dan> The difficulty in reading at 4 inches (at least for me) has more to do with scanning from left to right. Otis> But kids do it. It is a "lazy habit" -- where in the natural eye changes its refractive STATE in the more-negative direction. The priamte data confirms this. You have every right to deny scientifc fact if you wish -- but that does not change the objective measurements. Please use the term "refractive-STATE" so that there is no doubt concerning this objective measurement using a retinascope and associated standard techniques. Dan> The kids in this picture aren't doing that, since they aren't actually reading. Otis> That is truly a quibble. In point of fact, they have a clear image on their retinas, so their accommdation is adjusted for the -10 diopters -- which is the point I am making -- and you are missing. Dan> Of course, those kids don't look old enough to either read *or* write. Are you sure they aren't just scribbling? Otis> And if they were looking at an HO train, then would you say that their accommodation system is NOT set for -10 diopters (4 inches). Or will you agree with me on that point? Dan> I think that we both agree that letting kids read at 4 inches is a bad idea. Otis> Profoundly so. But it takes a "strong" parent to truly STOP a child from doing this. Of all the issues, to me, that is the most important of issues. Otis> But I regard this issue like incipient obesity. It takes BOTH the parent and child to stop it. If any of you wish to say it is impossible to stop obesity and incipient nearsighedness -- I WILL AGREE COMPLETELY WITH YOU ON THAT POINT. Otis> But when you tell me that the natural eye will not change its refractive STATE by -2 diopters (in 119 days) when I place a -3 diopter lens on it (as a natural process), I must ask you to confirm that the fundamenal eye DOES NOT CHANGE IT REFRACTIVE STATE IN THIS MANNER. Otis> One issue it the parents and child. But the issue of objective testing the fundamental eye for this dynamic property is fundamental science. Call it the dyanamic-eye paradigm, if you wish, versus the "will not change" paradigm. Otis> But that is in the nature of scientific insight. Best, Otis > > Dear Dan, > > [quoted text clipped - 34 lines] > 14 hours a day, 7 days a week. When I took the contacts out at night, I > was reading at -10. > Otis> That is truly a quibble. In point of fact, they have a clear > image on their retinas, so their accommdation is adjusted > for the -10 diopters -- which is the point I am making -- and > you are missing. On this point you are profoundly wrong. DrG > Dan> The difficulty in reading at 4 inches (at least for me) has more > to do > with scanning from left to right. > > Otis> But kids do it. I don't believe you. Maybe we should ask one. Ace? Dear Ace, In fact my opinion, simply reflects the judgment of professor Francis Young and T. Grosvenor -- that if you are going to start plus-prevention you MUST start it before your Snellen goes below 20/50, and your refractive STATE below -1 diopter. That is indeed the SCIENTIFIC second-opinion -- as stated below: +++++++++++++++ Despite the fact that results of studies of children who have been given bifocals are highly equivocal, Theodore Grosvenor of the University of Houston College of Optometry -- a proponent of the role of bifocals in the prevention of myopia -- insists that persistent close work causes myopia. (In what researchers generally consider to be the most carefully performed study to date, the two scientists ** disagree on the results.) Some of the studies have not borne out his hypothesis, he says, because they were conducted too late. "Once the eye has started to stretch, it may be too late to keep it from stretching," he says, explaining that most of the children in the study had already become myopic. "The ultimate study would be to put reading glasses on first-graders before anyone has developed myopia," he says. ** [One of the scientists was Dr. Francis Young. His bifocal study showed that a combination of under-correction and a strong plus stopped the eye's movement into myopia, i.e.,, would help the natural eye maintain clear distant vision if used systematically when the eye was at the 20/40 to 20/50 level. Thus is a exact agreement with Francis Young on plus-prevention. But if you reject it at that point, you can expect your refractive STATE to go down at the proven rate of -1/2 diopter, or stair-case myopia. THEN I agree, you can not get out of it. But you could have avoided GETTING IN TO IT -- as Professor Grosvenor suggests -- and I do agree with him. OSB] ++++++++++++++++++++++ > Most patients fortunately dont get overcorrected by much, if at all. > There are some children that "eat minus" and a cycloplegic refraction > is needed to assess the true prescription. There is much proof that > myopia can be prevented or at least slowed down. Its environmental with > genetic tendencies. Otis, those majority opinion optometrists will > never believe a word you say > the all-important details, such as how the eyes of different species > react differently to the same stimuli. And how developing eyes differ from eyes that have reached full size. For Mike Ruskai- There surely is a period in humans where lenses can impact the "refractive state." It's called emmetropization, and it's manifested by a decrease in the standard deviation of human refractive error for the first year, maybe two or three. But three-year-olds don't get myopia. Onset is often 9-11 years, when the eye is 95% of adult size, but myopia frequently waits until 18. Otis is right, college is a risk factor for myopia. But all that tells us is you shouldn't go to college. It doesn't tell us that plus lenses prevent nearsightedness. The literature tells us that working distance does matter, so Otis is right about reading at very close working distances. Where it falls apart is assuming that accommodation is the mechanism. It doesn't appear to be, or each of the six studies I mentioned would have shown vast differences between kids wearing glasses, not wearing glasses, or wearing bifocals. They all come out the same. Relieving accommodation by removing glasses or wearing bifocals doesn't make enough difference to matter. The same statistical methods show that pirenzipine slows myopia dramatically. Otis thinks optometrists, out of the goodness of their hearts, willingly resist prescribing special glasses for every emerging myope. I think instead we're waiting for the FDA to approve pirenzipine gel. -MT This Otis guy is an unscientific, irrational troll who ignors the true published science regarding the human eye and instead swears to a set of anecdotal comments and old-time animal experiments which he rationalizes as "proof" that his beliefs are true. Furthermore he believes there is a kind of conspiracy among eyecare professionals to induce myopia among the general population so that they will need to wear corrective lenses and require refractive surgery, etc. The guy is truly irrational at best and is unable to examine the facts regarding a topic. When he is presented with clear proof that what he says is wrong he disappears for a few days and then resurfaces again to continue to proclaim the same old disproven notions. He misquotes people too. Once he was caught red-handed misquoting a pilot who is currently stationed in Korea and was called out publicly in the newsgroup for it. Once he pretended he was a friend of a retired university professor who researched myopia but a poster in this newsgroup actually knew this professor and spoke with him about Otis and found out he was lying (again). Here is Otis' picture: http://www.nbeener.com/Oda_May_Brown.html?1107470227575 Otis so infuriated another poster here so much that he even reported Otis to the medical licensing authorities in the State of Pennsylvania. Here is a link to that complaint, which was filed about 10 months ago. http://nbeener.com/OTIS_INVESTIGATION.pdf Here are two disclaimers I once composed and posted automatically in response to anything he wrote: --------- 1. This posting is an automatic reply to any sci.med.vision newsgroup thread that is receiving comments from a person named "Otis", "Otis Brown", "otisbrown@pa.net" or "Otis, Engineer". Otis is not an expert in any field of vision. His medical and eyecare training is nil. He is a proponent of a myopia (i.e. nearsightedness) prevention technique that is unproven at best, and has in some aspects even been disproven by controlled scientific studies. He has posted and reposted his ideas approximately 1000 times over the last two years despite being repeatedly debunked by numerous doctor practitioners and vision scientists. No one means to suppress the opinions of others. This message is only meant to forewarn anyone who might misconstrue Otis as a trained eyecare expert. DO NOT REPLY TO HIS POSTINGS. Do not feed the troll! For anyone who is interested in understanding the current state of scientific/medical research on myopia prevention, I offer the following link: http://annals.edu.sg/pdf200401/V33N1p4.pdf Please see the weekly posting "welcome to sci.med.vision" which usually appears on Mondays for information on how to filter out his posts so that you may be able to participate in worthwhile discussions in this forum. Thank you for your cooperation and understanding. ------------- 2. Otis "Engineer" is a zealot who advocates his "plus lens" prevention theory without good reason. There is no scientific data to prove what he proposes. He would ask that all myopes (=nearsighted persons) go around wearing plus reading glasses in hopes that it will eventually reverse their nearsightedness. Nevermind that the blurry distance vision that myopes complain about is made worse by plus lenses! Nevermind that there is no proof for what he claims. If you are interested in Otis' approach, I have some other links that you might also be interested in: GET RICH QUICK http://www.clickvolume.net http://www.meetmark.com HARD PENILE ERECTIONS USING NATURAL HERBS http://www.herbaalex.com/panadex.htm LOOK AND FEEL YOUNGER http://www.youngeryounger.com FIND A BEAUTIFUL RUSSIAN WIFE http://www.russianladies.com For information on killfilling (filtering out the posts of a troll or spammer like Otis) see the following link: http://www.hyphenologist.co.uk/killfile/killfilefaq.htm For additional information on handling "trolls", refer to this link: http://www.hyphenologist.co.uk/killfile/anti_troll_faq.htm ------------ To summarize, Otis is an idiot who misrepresents himself as someone who is trying to help. In a way he is a kind of internet predator. He has been repeatedly debunked and discredited so badly that any NORMAL person would simply slink away and hope to be forgotten yet he apparently is unphased. Truly he is a strange character! > Otis so infuriated another poster here so much that he even reported Otis to > the medical licensing authorities in the State of Pennsylvania. Here is a > link to that complaint, which was filed about 10 months ago. > http://nbeener.com/OTIS_INVESTIGATION.pdf Another guy, "Leung," on the Natural Vision Improvement site, followed OSB's plus theory and recently (last week??) reports unwavering diplopia (double vision). Asked what to do, I suggested he run to an optometrist, lose the plus lenses, and report Otis to the State of Pennsylvania. You see, folks (Dan ... for whom I have big respect ... included): he DOES hurt people ... regularly. The issue is philosophical. Some people think we can/should save people from themselves; others believe it is not their/our responsibility. Personal choice, to be sure. I loathe his reckless disregard for the well-being of others and have immeasurable contempt for his pseudoscientific bull$hit. He is a sociopathic old dude who bears no consequences for his actions ... yet. He is the WORST kind of troll--one with zealotry, bad information, and no conscience whatsoever. Since I agree with Professor Grosvenor's and Professor Young's second-opinion statement and concept, then you must have the same opinion of them also. Otis > This Otis guy is an unscientific, irrational troll who ignors the true > published science regarding the human eye and instead swears to a set of [quoted text clipped - 94 lines] > simply slink away and hope to be forgotten yet he apparently is unphased. > Truly he is a strange character! Further, I support these judgements of the profession about the minus lens. Before you put you child in an excessively strong minus -- perhaps you should understand these "concerns" of true professionals. But just call it the second-opinion. Otis ++++++++++++++++ Subject: The Effects of "Corrective" Lenses: Insight and Comment From Eye Doctors No clinical or statistical studies have ever demonstrated the LONG TERM SAFETY of a (minus) "corrective" lens. In fact, a certain percentage of doctors believe that -- as the second-opinion -- "corrective" lenses (also known as "compensatory" negative lenses) usually create dependency and make the eyes move more rapidly in a negative refractive direction. These concerns have been voiced in the professional literature by concerned doctors who support the concept the "second opinion" to do work for the prevention of nearsightedness with a plus lens. Here are sample excerpts from the professional literature voicing concerns about the safety of "corrective" lenses: "The use of compensatory lenses to treat or neutralize the symptoms does not correct the problem. The current education and training of eye care practitioners discourages preventive and remedial treatment." R.L. Gottlieb, Journal of Optometry and Visual Development, 13(1):3-27, 1982. "The emphasis on compensatory lenses has posed a problem for many years in our examinations. These lenses do not correct anything and may not serve the patient in his best interests over a period of time." CJ. Forkiortis, OEP Curriculum, 53:1, 1980 "There are frequently ignored patterns of addiction to minus lenses. The typical prescription tends to overpower and fatigue the visual system and what is often a transitory condition becomes a lifelong situation which is likely to deteriorate with time." S. Gallop, Journal of Behavioral Optometry, 5(5):115-120, 1994 "Single-vision minus lenses for full-time use produce accommodative insufficiency associated with additional symptoms until the patient gets used to the lens. This is usually accompanied by a further increase in myopia and the cycle begins anew." M.H. Birnbaum, Review of Optometry, 110(21): 23-29, 1973. "Minus lenses are the most common approach, yet the least likely to prevent further myopic progression. Unfortunately, they increase the near-point stress that is associated with progression." B. May, OEP Publications, A- 112, 1984. For more information on this "sea change" in attitude to work towards effective prevention with the plus please read: > Since I agree with Professor Grosvenor's and Professor Young's > second-opinion statement and concept, then [quoted text clipped - 100 lines] > > simply slink away and hope to be forgotten yet he apparently is unphased. > > Truly he is a strange character! <otisbrown@pa.net> wrote more nonsense to the effect that: > Before you put you child in an excessively strong minus -- perhaps > you should understand these "concerns" of true professionals. So according to Otis, don't put -3 diopter lenses on emmetropic monkeys. > No clinical or statistical studies have ever demonstrated the > LONG TERM SAFETY of a (minus) "corrective" lens. According to Otis, the half dozen studies showing NO impact were all lies, part of the vast conspiracy. > In fact, a certain percentage of doctors believe that -- as the > second-opinion -- "corrective" lenses (also known as > "compensatory" negative lenses) usually create dependency and > make the eyes move more rapidly in a negative refractive direction. So according to Otis, accommodation causes myopia and +3 hyperopes get cured by leaving their glasses off. > "The use of compensatory lenses to treat or neutralize the > symptoms does not correct the problem. The current education and > training of eye care practitioners discourages preventive and > remedial treatment." Could it be... because it doesn't work? No, according to Otis, they're part of the vast conspiracy. > "The emphasis on compensatory lenses has posed a problem for > many years in our examinations. These lenses do not correct > anything and may not serve the patient in his best interests over > a period of time." According to Otis, that's convincing proof. > "There are frequently ignored patterns of addiction to minus > lenses. The typical prescription tends to overpower and fatigue > the visual system and what is often a transitory condition becomes > a lifelong situation which is likely to deteriorate with time." So according to Otis, myopia never decreases. > "Single-vision minus lenses for full-time use produce > accommodative insufficiency associated with additional symptoms > until the patient gets used to the lens. This is usually > accompanied by a further increase in myopia and the cycle begins > anew." So according to Otis, wearing larger shoes causes the feet to grow. > "Minus lenses are the most common approach, yet the least > likely to prevent further myopic progression. Unfortunately, they > increase the near-point stress that is associated with > progression." So according to Otis, association proves causation. So why isn't Otis wearing plus? -MT > So according to Otis, wearing larger shoes causes the > feet to grow. Wait a minute... there may be something to this. I bought larger pants; and I got fatter. So I had to buy even larger pants. Guess what? So the anecdotal evidence seems to be consistent with this. -Quick Oh, oh... you know what this means... You must stop wearing the dreaded pants. AND you must exercise faithfully without the pants on. It is difficult, but someone must do it if you want to get better. AND if you can pass the DMV test without them, drive without them. It is the best way for the natural, fundamental and dynamic body. Do NOT let anyone talk you into buying pants again, but if you must, for special occasions, be sure they are the dollar type you can get on the internet. Of course this is the second opinion speaking. w.stacy, o.d. > > [quoted text clipped - 11 lines] > > >It seems he believes that wearing glasses for myopia can worsen the >myopia (I've seen the phrase "staircase myopia"). I've read the replies, and it's pretty much what I suspected. Now, at the risk of feeding the troll... Nearly 20 years ago, less than two years after I first started wearing glasses for myopia at age 10, I decided (for reasons not currently remembered) that I didn't like wearing glasses, and left them off almost always. At my next eye exam, my prescription went slightly down. After wearing glasses more regularly subsequently, my prescription went slightly up at each exam since, save one. I'm currently wearing -3.75 contacts in each eye. I don't know what I started at, but it was initially a fairly light prescription. On the surface, this might seem to support the case that wearing glasses causes myopia to progress. I expect anecdotal cases like this serve as fodder for that view. But what's the reality? I was 11/12 years old, and still growing. I also had the bad habit of squinting during the eye exam, which could easily have thrown my prescription off. Also, during virtually every exam I've ever had, there have been two different settings with the phoroptor that I found difficult to distinguish (I sometimes think the letter chart is too limited a target for such purposes). Maybe I guessed differently at the two adjacent exams. The important question, which I left unasked in my original post, is by what mechanism is this worsening of myopia supposed to occur? The only plausible candidate that I can think of is that an overcorrection will cause the eye to constantly accomodate, and eventually leave the lens permanently changed. I don't think this can actually happen, but, as I said, it's the only remotely plausible scenario I could think of. I can't think of any way at all that the shape of the cornea could be changed by glasses. Surely Otis has some kind of fundamental explanation for his claim, no? Signature- Mike Ignore the Python in me to send e-mail. > Nearly 20 years ago, less than two years after I first started wearing > glasses for myopia at age 10, I decided (for reasons not currently > remembered) that I didn't like wearing glasses, and left them off > almost always. How did you get myopic having never before worn minus lenses? Is it because you read with your nose 5 inches from the book? > At my next eye exam, my prescription went slightly down. After > wearing glasses more regularly subsequently, my prescription went > slightly up at each exam since, save one. I'm currently wearing -3.75 > contacts in each eye. I don't know what I started at, but it was > initially a fairly light prescription. True, or axial myopia, doesn't reverse itself. There is no model that explains shortening of the eye. There is a model that explains variable focus via accommodation. Accommodative myopia, also called pseudomyopia, can be theoretically be reversed. I can also be detected with a good cycloplegic refraction. However, there is a physiological limit to pseudomyopia, and it seldom accounts for more than a diopter or so of the total prescription. There is also a small category of myopes who also exhibit nearpoint esophoria, for whom studies do show that bifocals are effective in retarding myopic progression. The nearpoint esophoria strongly suggests an accommodative mechanism underlying the myopia. Most myopes do not exhibit nearpoint esophoria. And so, there are a few successes out there with bifocals, plus lenses, relaxation techniques, etc. enough to keep Otis in business. There have been a few people posting their "successes" in reducing their myopia by a diopter or so, and then no more progress because the remaining myopia was axial and permanent. DrG > On the surface, this might seem to support the case that wearing > glasses causes myopia to progress. I expect anecdotal cases like this > serve as fodder for that view. > > But what's the reality? 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. Department of Ophthalmology, Central Hospital of Central Finland, Jyvaskyla. 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 [at] 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. otis' mind is made up! how dare you try to confuse him with the facts! > Br J Ophthalmol 1989 Jul;73(7):547-51 Related Articles, Links > [quoted text clipped - 26 lines] > reading distance but that progression cannot be reduced by diminishing > accommodation with bifocals or by reading without spectacles. > On the surface, this might seem to support the case that wearing > glasses causes myopia to progress. I expect anecdotal cases like this > serve as fodder for that view. yes, and who knows what the real causes and data are behind your story > But what's the reality? > > I was 11/12 years old, and still growing. bod growth = eye growth = increased myopia (in many cases) > I also had the bad habit of > squinting during the eye exam, which could easily have thrown my > prescription off. most definitely > Also, during virtually every exam I've ever had, there have been two > different settings with the phoroptor that I found difficult to > distinguish the purpose of a subjective refraction is to find a point such as this. it should be that way. > The important question, which I left unasked in my original post, is > by what mechanism is this worsening of myopia supposed to occur? either increased eye length, or increased ciliary muscle tone (reversible), or possibly the genesis of cataracts > The only plausible candidate that I can think of is that an > overcorrection will cause the eye to constantly accomodate, and > eventually leave the lens permanently changed. I don't think this can > actually happen, but, as I said, it's the only remotely plausible > scenario I could think of. nope. increased accommodation causes increased ciliary muscle tone which causes constant low-level tonic accommodation. this can be totally eliminated in a cycloplegic exam and goes away anyway during presbyopia which occurs about age 40. possibly plus lens "training" could relax some of this type of myopia but it never amounts to more than about 1/2 to 1 diopter. > Surely Otis has some kind of fundamental explanation for his claim, > no? sure he has a fundamental explanation. its just wrong and has been thoroughly disproven in scientific studies. centuries ago people had a fundamental explanation of the horizon-- they thought it was the edge of a flat world. experimentation proved otherwise but Otis likes to hang on to the old disproven ways. Dear Mike, Subject: The refractive STATE of the natural and fundamental eye. To answer your question about measuring the eye's refractive STATE. The method of measurement of refractive STATE (which can be positive or negative -- depending on the individual's average visual environment.) The refractive status is done by retinoscopy. To make these measurements, cycloplegia was induced by the topical application of tropicamide (1%, 2 drops). Please do NOT assume anything about the measured refractive STATE of the natural eye. Just report measured facts -- as a matter of objective science. Report what you measure, not what you wish to believe. Best, Otis > I realize that many regulars here will be distinctly disinterested in > this topic, but I'm trying to figure out just what kind of kook this [quoted text clipped - 5 lines] > Is this related to his bizarre habit of using the phrase "refractive > STATE"? What exactly is a refractive STATE? > The refractive status is done by retinoscopy. > Report what you measure, not what you wish to believe. I been doing retinoscopy for 25 years, maybe 50,000 myopes. How many have you measured? At least half of mine were wearing full correction without getting worse. Like you. You have to admit SOME humans don't get worse wearing minus, because you're one of them. Among those who were getting worse, I can't see that it mattered whether they wore glasses or not. Every study I've seen comparing myopes wearing minus versus those who weren't showed no difference between the two groups. Perhaps you could point us to an article that shows your "staircase myopia" in humans. Or perhaps not. And for Mike Ruskai: >> Is this related to his bizarre habit of using the phrase "refractive >> STATE"? What exactly is a refractive STATE? It's a pretty standard reference, but Otis constantly borders on practicing medicine or optometry without a license, so he avoids and even criticizes using medical terms like "myopia" and "hyperopia." In our view, he's practicing optometry (or medicine) without a license because he recommends preventive therapy for myopia. Further, when he says that the eye responds to lens changes within 120 days, he's promising results that can be easily verified (or controverted.) Otis avoids standard labels. In real life, the labels are useful, because myopia follows a pattern, and hyperopia follows a different pattern, with different symptoms and different anatomical features. None of the four major conditions are altered much by optical intervention, be it plus or minus, relative to the current "refractive state." Notice that Otis refers to "plus lenses" without any regard for current "refractive state." In his "prevention" program (therapy) he recommends "strong plus" or "weak plus" but doesn't seem to realize that "weak plus" becomes "strong plus" when the wearer is substantially nearsighted. All the experiments I've found have made their "plus" uniform with respect to the wearer, so that a -4 myope wears -2 and a -1 myope wears +1. This is the same as an emmetrope (+0) wearing +2 lenses and is accurately described as wearing "2 diopters of plus." Otis also avoids standard conventions for signing the degree of deviation. A myopic eye is too convergent, and in optics the degree of convergence is generally signed positive, so a nearsighted eye is too "plus." Since these people wear "minus" lenses to offset their condition, Otis calls it "going down" or "going minus" when the eye is actually becoming more convergent. -MT |
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