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Medical Forum / General / Vision / December 2006

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correcting spherical without cylinder

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Bucky - 21 Dec 2006 21:29 GMT
I'm probably using the wrong terms, but hopefully you'll get my point.
If I have a contacts prescription of -11 sph, -1.25 cyl. What would
happen if I wore spherical contacts -11 and left the astigmatism
uncorrected? What would my "equivalent" vision be like?

The reason I'm asking is because they do not make disposable contacts
with my prescription, only custom-made torics. But they do have
spherical disposables at the same power. I'm just wondering if I could
see decently (everything except reading and driving) without correcting
astigmatism.
otisbrown@pa.net - 21 Dec 2006 21:44 GMT
Dear Bucky,

There is no "perfect" answer here -- but here is one possibility.

I'm probably using the wrong terms, but hopefully you'll get my point.
If I have a contacts prescription of -11 sph, -1.25 cyl. What would
happen if I wore spherical contacts -11 and left the astigmatism
uncorrected? What would my "equivalent" vision be like?

The spherical equivalent would be:

-11 - (1.25/2) = -11.62 diopters spherical equivalent.

You could go for a slightly stronger -12 diopters
(you optometrist could help you with this).

You might have 20/25, rather than 20/20 -- but
only by reading your Snellen could you tell this.

If your Snellen is better than 20/40, by you
would pass 98 percent of the DMV Snellens.

Best idea?  Go ask you optometrist about
this possibility.

Best,

Otis

> I'm probably using the wrong terms, but hopefully you'll get my point.
> If I have a contacts prescription of -11 sph, -1.25 cyl. What would
[quoted text clipped - 6 lines]
> see decently (everything except reading and driving) without correcting
> astigmatism.
dr.seagal@yahoo.com - 21 Dec 2006 22:07 GMT
Dear Bucky,

It is best to use lenses without cylinder (i.e., without correcting
astigmatism).  This way your astigmatism could be reduced to its
minimal or it might also disappear in some cases.  I have seen
thousands of patients and this is what happens to my patients.

Glasses/lenses without cylinder is more comfortable to use in most
cases (unless your astigmatism is very severe, like -2.5 or higher).
You would not even notice any difference.  The biggest problem you will
have wearing lenses without cylinder is driving at night.  Some of my
patients feel uncomfortable doing it but most of them are okay with it.

When your astigmatism reduces to, say, -0.50, you don't even need
lenses with cylinder anymore.

Hope this helps.

Dr. Seagal

=================================================================
> I'm probably using the wrong terms, but hopefully you'll get my point.
> If I have a contacts prescription of -11 sph, -1.25 cyl. What would
[quoted text clipped - 6 lines]
> see decently (everything except reading and driving) without correcting
> astigmatism.
Mike Tyner - 21 Dec 2006 22:26 GMT
> It is best to use lenses without cylinder (i.e., without correcting
> astigmatism).  This way your astigmatism could be reduced to its
> minimal or it might also disappear in some cases.  I have seen
> thousands of patients and this is what happens to my patients.

Sounds fishy to me. Is it published somewhere?

-MT
Charles - 23 Dec 2006 01:02 GMT
Please share the secret for eliminating astigmatism.  It's all I have.
I went uncorrected for 25 years and then it worsened to where I need
correction - so going uncorrected alone mustn't be the solution.

> Dear Bucky,
>
[quoted text clipped - 28 lines]
> > I could see decently (everything except reading and driving)
> > without correcting astigmatism.

--
Mike Tyner - 23 Dec 2006 01:50 GMT
> Please share the secret for eliminating astigmatism.  It's all I have.
> I went uncorrected for 25 years and then it worsened to where I need
> correction - so going uncorrected alone mustn't be the solution.

But that's what he said! It must be true! I read it on the internet!

You might really like -10.00 or -10.50 spherical contacts.

I like to recommend contacts for the -10.00 part and using glasses for very
precise astigmatism (and later bifocal) refinement.

-MT
dr.seagal@yahoo.com - 23 Dec 2006 02:41 GMT
Dear Charles,

For astigmatism with moderate or high myopia, going uncorrected can be
one of the solutions.  There are other solutions.

For astigmatism without myopia, going uncorrected is NOT the solution.
You are right about this.  I forgot to mention this.  Sorry.

For astigmatism without myopia, one of the solutions is to wear special
glasses.

How bad was your astigmatism in the beginning and how bad is it now?
Also, what is your age?  The reason why I ask is that a 15-year-old boy
improves much faster than a 50-year-old man, who, might not see any
improvement in months, or might not improve at all.

Sincerely,
S.Seagal, O.D.

> Please share the secret for eliminating astigmatism.  It's all I have.
> I went uncorrected for 25 years and then it worsened to where I need
[quoted text clipped - 34 lines]
>
> --
Charles - 23 Dec 2006 23:37 GMT
> Dear Charles,
>
[quoted text clipped - 19 lines]
> > where I need correction - so going uncorrected alone mustn't be the
> > solution.

I'm -1 to -1.5 depending on when, in my worse eye.  I'm in RGP contacts
now, so I don't know what my natural state is at this point.  I had
never seen an eye doctor until I was 23.  I don't know my first Rx, but
I'm guessing -0.5 to -0.75 cylinder.  I'm 36 now.

--
William Stacy - 21 Dec 2006 22:21 GMT
You've gotten 2 bizarre answers, probably more to come.  Assuming the Rx
is indeed a CLRx (not a spectacle Rx that is "OK for contacts" type),
you can get the -11 (no more, and I'm amazed to see who suggested that
little tidbit), and then have the resudual measured while you are
wearing the contacts for the over-wear glasses.  The other "Dr." is just
wrong.  1.25 cyls just don't disappear, and the idea of ignoring it is a
bad one, if you're interested in sharp vision.

w.stacy, o.d.

>I'm probably using the wrong terms, but hopefully you'll get my point.
>If I have a contacts prescription of -11 sph, -1.25 cyl. What would
[quoted text clipped - 8 lines]
>
>  
dr.seagal@yahoo.com - 22 Dec 2006 08:00 GMT
Dear William Stacy,

> The other "Dr." is just wrong.  1.25 cyls just don't disappear, and the idea of ignoring it
> is a  bad one, if you're interested in sharp vision.

You are right about this as far as "conventional optometry" is
concerned.  However, when it comes to Real Optometry, True Optometry,
or REAL EYECARE, astigmatism (and nearsightedness) can be reduced or
completely eliminated if it is not too severe.

"Conventional optometry" deals with sharp vision (quick fix) wearing
glasses, which has side effects or bad consequences.  REAL EYECARE
helps people attain sharp vision bare eye (slightly slower fix).

I am interested in bare eye sharp vision, so are my patients.  Of more
than a thousand patients I have seen so far, not even one failure.

> The other "Dr." is just wrong.

If you say I am wrong, I guess that means my patients came from Mars,
since things like these don't happen in "conventional optometry" in
this world.

Sincerely,
Dr. Seagal

> You've gotten 2 bizarre answers, probably more to come.  Assuming the Rx
> is indeed a CLRx (not a spectacle Rx that is "OK for contacts" type),
[quoted text clipped - 5 lines]
>
> w.stacy, o.d.
Mike Tyner - 22 Dec 2006 09:02 GMT
> I am interested in bare eye sharp vision, so are my patients.  Of more
> than a thousand patients I have seen so far, not even one failure.

That's all I need to know.

-MT
William Stacy - 22 Dec 2006 17:32 GMT
I agree. The guy is a fraud.  Not a doc at all.  Not even a good pretender.

w.stacy, o.d.

>  
>
[quoted text clipped - 7 lines]
>
>  
p.clarkii@gmail.com - 22 Dec 2006 11:29 GMT
err-- please tell us about your training "doctor".

in my experience, astigmatism doesn't just go away.  does your method
involve changing the topography of the cornea or changing the
characteristics of the lens within the eye?  how so?

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

> Dear William Stacy,
>
[quoted text clipped - 31 lines]
> >
> > w.stacy, o.d.
Dr. Leukoma - 22 Dec 2006 13:52 GMT
> You are right about this as far as "conventional optometry" is
> concerned.  However, when it comes to Real Optometry, True Optometry,
> or REAL EYECARE, astigmatism (and nearsightedness) can be reduced or
> completely eliminated if it is not too severe.

This is obviously very important groundbreaking research, and should be
published.  In which journal kind I find this work?

DrG
William Stacy - 22 Dec 2006 17:38 GMT
He/she could start by telling us where his practice is located.  I'm not
asking for a street address, but we could start with a continent or a
planet.

>  
>
[quoted text clipped - 10 lines]
>
>  
dr.seagal@yahoo.com - 23 Dec 2006 01:35 GMT
Dear William Stacy, DrG, Mike Tyner, p.clarkii, Dan Abel, fellow
optometrists, and all truth seekers:

Thank you all for your compliments and for being polite.

Dear Mike,

Mike Tyner wrote:

> > It is best to use lenses without cylinder (i.e., without correcting
> > astigmatism).  This way your astigmatism could be reduced to its
[quoted text clipped - 4 lines]
>
> -MT

This was also what I thought when I first started practising optometry
in Asia years ago.  I knew nearsightedness can be reduced or cured if
it is not too severe, but I didn't know if the same theory applies to
astigmatism.  I had only read it somewhere that astigmatism should not
be corrected and somewhere else that it could be reduced with a special
lens.  I didn't know if it is true since I had never seen it.

Nevertheless, I gave it a try on my patients, since I am a seeker of
truth.  I wanted to see for myself whether or not astigmatism could be
reduced or completely cured.

The results were astonishing.

One of my first few patients, an elementary school teacher's daughter,
an 8-year-old girl, had pretty high astigmatism when she first came to
see me.  Her astigmatism was -2.50D.  I gave her a pair of special
glasses to wear and asked her to come back a few weeks later.

Six weeks later, her astigmatism was down to -0.50D.

Another early patient, a 15-year-old girl (a high school student), was
at -3.50D sph. -0.50D cyl.  Three weeks later, it went down to -3.00D
sph. PL (0.00) cyl.  Her astigmatism disappeared.

>From then on, I knew that astigmatism does change and that it can be
reduced or cured if treated properly.

Some more recent cases for your interest.

1. Philips C. (Name changed for privacy)   age 10
5/13/06   sph.  cyl.  axis          bare eye
O.D.    -2.00  -0.50  90              20/120
O.S.    -2.00  -0.50  90              20/120

5/20/06   sph.  cyl.  axis          bare eye
O.D.    -1.00  -0.50  90              20/30
O.S.    -1.25   0.00                   20/40

6/10/06   sph.  cyl.  axis          bare eye
O.D.    -0.75   0.00                   20/30
O.S.    -0.75   0.00                   20/30

7/9/06   sph.  cyl.  axis          bare eye
O.D.    -0.25   0.00                   20/20
O.S.    -0.25   0.00                   20/20

2. Arthur T. (Name changed for privacy)    age 11
8/9/06   sph.  cyl.   axis          bare eye
O.D.    -2.75  -0.50  180            20/200
O.S.    -3.00  -0.75   25             20/200

8/17/06   sph.  cyl.   axis          bare eye
O.D.    -2.00   0.00                    20/60
O.S.    -2.25   0.00                    20/80

8/31/06   sph.  cyl.   axis          bare eye
O.D.    -1.75   0.00                    20/60
O.S.    -2.25   0.00                    20/80

9/28/06   sph.  cyl.   axis          bare eye
O.D.    -1.75   0.00                    20/60
O.S.    -2.00   0.00                    20/60

I should also point out that astigmatism sometimes also changes
"strangely".  It is either that or these optometrists didn't examine
the eyes properly.  See the following case:

This mother of two boys heard of me through her friends and called me.
I asked her to bring all of the old glassess of the two boys when she
came.

Here is her older son, Andrew C. (Name changed for privacy)   age 11
1st pair of glasses, made in 2002:
            sph.  cyl.   axis
O.D.    -2.75   0.00
O.S.    -3.25  -0.25   95

2nd pair of glasses, made in 2003:
            sph.  cyl.   axis
O.D.    -4.50  -0.25   45
O.S.    -5.50  -1.00   105

3rd pair of glasses, made in 2004: (This pair was lost)
            sph.   cyl.   axis
O.D.    -5.25 ?   ?
O.S.    -7.50 ?   ?

4th pair of glasses, made in 2005:
            sph.  cyl.   axis
O.D.    -6.00  -1.00   95
O.S.    -9.00  -0.50   135

5th pair of glasses, made in August, 2006:
            sph.   cyl.   axis
O.D.     -7.25   -0.25   95
O.S.    -10.00  -0.50   135

Interesting facts:
1. Astigmatism in his left eye (O.S.) changed from -1.00 (2003) to
-0.50 (2005)
2. Astigmatism in his right eye (O.D.) changed from -1.00 (2005) to
-0.25 (2006)

The following is my record of Andrew C. (Name changed for privacy)
age 11
11/4/06   sph.  cyl.    axis
O.D.     -7.75   -0.50   180
O.S.    -10.00  -0.50   135

11/18/06   sph.  cyl.    axis
O.D.     -7.00    0.00
O.S.     -9.50    0.00

12/2/06   sph.  cyl.    axis
O.D.     -6.75   0.00
O.S.     -8.50   0.00

1/6/07 3:00p.m.    sph.  cyl.    axis
O.D.
O.S.                          we'll see.......

The conclusion here is that astigmatism can be reduced and cured, so
can nearsightedness.

> > You are right about this as far as "conventional optometry" is
> > concerned.  However, when it comes to Real Optometry, True Optometry,
[quoted text clipped - 5 lines]
>
> DrG

Dear DrG,
Thanks for reminding me.  I will publish this in the future, unless I
get shot and die.

p.clarkii@gmail.com wrote:
> err-- please tell us about your training "doctor".
>
> in my experience, astigmatism doesn't just go away.

Dear p.clarkii,
My training is the same as yours if you are also an optometrist.  The
difference is that I am not a "follow the dead book" or "follow the
false education" type of person.  I am a truth seeker.  I want to find
the truth.  I want to understand the real science, not "business-based
science".

>               WELCOME TO THE SCI.MED.VISION NEWSGROUP
>
[quoted text clipped - 5 lines]
> remedied, as well as items related to new research and
> associated findings.

When there is a new finding, I will try to learn more about it,
understand it, if it somewhat makes sense, some people tried it with
good results, I will then try it out myself to prove that it is true.

I won't say things like: the study/research doesn't say so, you are
lying, you are a liar.
On the contrary, I will try to understand it and experiment with it.

If the problem can't be solved, it means the theories are incorrect.

Suppose that your child comes home from school one day walking with a
cane and says,
"Mom, I can't walk right any more. They tell me I'll have to use this
cane the rest of my life and that it will only get worse. And one third
of the other kids in school are also going around with canes or
crutches. They said that I inherited this, but you and dad aren't
crippled. My grandparents aren't crippled. I don't understand this.
What's happening to me?"

Now suppose that your child comes home from school one day and says,
"Mom, I can't see the words on the board like I used to. Everything is
blurred. They say I am nearsighted and need glasses. They say I'll have
to wear the glasses the rest of my life and that it will only get
worse. And one third of the other kids are already wearing glasses.
They say that I inherited this, but you and dad aren't nearsighted. My
grandparents aren't nearsighted. I don't understand this. What's
happening to me?"

In reality, can the external doctor help prevent the patient's small
leg injury from getting worse and cure it?
The answer is YES.

Now, in reality, can the eye doctor help prevent the patient's newly
acquired myopia from getting worse and cure it?
The answer is YES, ABSOLUTELY.

In reality, can the eye doctor help prevent a ten-year-old child's low
myopia from getting worse?
The answer is YES, ABSOLUTELY.

In reality, can the eye doctor help prevent a ten-year-old child's
medium myopia from getting worse?
The answer is YES, ABSOLUTELY.

Again, if the problem can't be solved, it means the theories are
incorrect.

In reality, a myopic child's eyeball does not grow longer and longer
until he/she reaches adulthood.

I became an optometrist because I wanted to save people's eyes, not for
the money. None of my patients need to come back for a new pair of
glasses, year after year.  I always tell my patients that one day I
will die of hunger.  However, I will die of hunger happily, since I
enjoy what I do, and, hopefully, I will go to heaven.

Sincerely,
S.Seagal, O.D.

If You Are Not Part Of The Solution You Are Part Of The Problem
Mike Tyner - 23 Dec 2006 03:03 GMT
> This was also what I thought when I first started practising optometry
> in Asia years ago.  I knew nearsightedness can be reduced or cured if
> it is not too severe,

I think you're confusing axial myopia with accommodative myopia.

Western journals don't contain any "myopia control" techniques that work for
axial myopia, except topical muscarinics.

Please tell us if you've seen successful comparisons between treated and
untreated groups.

> but I didn't know if the same theory applies to
> astigmatism.

No reason to think it should.

> The results were astonishing.

I've seen astigmatism get better. I've seen it get worse. I wouldn't trust
my own experience, other than to say small increases and decreases are
common. Looking it up I find astigmatism doesn't respond to spectacle
correction appreciably, either way. That's just what the textbooks say, not
me.

I've had my own diopter of cyl, uncorrected for decades, and it never went
away. Why didn't it?

> One of my first few patients, an elementary school teacher's daughter,
> an 8-year-old girl, had pretty high astigmatism when she first came to
> see me.  Her astigmatism was -2.50D.  I gave her a pair of special
> glasses to wear and asked her to come back a few weeks later.
>
> Six weeks later, her astigmatism was down to -0.50D.

My impression is that you've seen your most "astonishing" results among a
population who are notoriously variable on tests like the Jackson Cross
Cylinder. Were there objective measurements that changed (retinoscopy,
autorefractor, keratometry), or was the JCC your only instrument?

> Another early patient, a 15-year-old girl (a high school student), was
> at -3.50D sph. -0.50D cyl.  Three weeks later, it went down to -3.00D
> sph. PL (0.00) cyl.  Her astigmatism disappeared.

Using what test? Fifteen-year-old girls aren't very reliable, and a sudden
decrease in myopia should make you less confident of any changes in
cylinder.

>>From then on, I knew that astigmatism does change and that it can be
> reduced or cured if treated properly.

Don't be offended but did your optometry degree program require any
statistics courses?

> I should also point out that astigmatism sometimes also changes
> "strangely".  It is either that or these optometrists didn't examine
> the eyes properly.

I would point out that children have the attention span of goldfish when
answering tedious questions.

And that JCC results can be skewed dramatically by changing the instructions
just a little, or by using different targets.

I would point out that minor astigmatism (050) is normally variable, subject
to patient responses and measurement techniques, before considering
hydration, hormones, nocturnal exposure, and habitual lid position.

> The conclusion here is that astigmatism can be reduced and cured, so
> can nearsightedness.

My conclusion is you've never applied the standard statistical methods for
testing a hypothesis.

My conclusion is you might change the shape of your ear cartilage by keeping
it bent a certain way, but you won't change it by hanging a piece of clear
plastic out in front of it.

-MT
dr.seagal@yahoo.com - 23 Dec 2006 07:27 GMT
> > This was also what I thought when I first started practising optometry
> > in Asia years ago.  I knew nearsightedness can be reduced or cured if
[quoted text clipped - 4 lines]
> Western journals don't contain any "myopia control" techniques that work for
> axial myopia, except topical muscarinics.

Why do you think so, I don't quite understand.  Please explain or
clarify.
I would like to know what you think I think about axial myopia and
accommodative myopia, which one can be controlled, reduced, or cured,
and which one can't, or, both can, or, both can't......

> Please tell us if you've seen successful comparisons between treated and
> untreated groups.

I will tell you about this and answer your other questions after you
response.

> I've had my own diopter of cyl, uncorrected for decades, and it never went
> away. Why didn't it?

Are you myopic?  How myopic?  And what is your diopter of cyl?  Do you
wear glasses or contact lenses?  Of what diopter?
I will answer your "Why didn't it?" question and the remaining
questions after you response.
Mike Tyner - 23 Dec 2006 12:23 GMT
>> MT> I think you're confusing axial myopia with accommodative
>>
> Why do you think so, I don't quite understand.  Please explain or
> clarify.

Because no "myopia treatment" successfully reduces axial length. Decreases
in myopia are more likely from relaxing accommodation, not reducing axial
length.

> I would like to know what you think I think about axial myopia and
> accommodative myopia, which one can be controlled, reduced, or cured,
> and which one can't, or, both can, or, both can't......

I'm not qualified to say what you think.

I know that accommodative spasm is common and notoriously variable in the
young population you described.

I know that attempts to reduce or retard axial myopia with lenses and
exercises have failed, as compared to controls.

And I know that a collection of anecdotes cannot outweigh statistical
comparisons between treated and untreated groups.

>> Please tell us if you've seen successful comparisons between treated and
>> untreated groups.
>
> I will tell you about this and answer your other questions after you
> response.

Then I doubt you will offer any new statistical comparisons between treated
and untreated groups.

> Are you myopic?  How myopic?  And what is your diopter of cyl?  Do you
> wear glasses or contact lenses?  Of what diopter?

I'm just another anecdote, and focusing on anecdotes doesn't answer any of
the real questions.

From childhood to about age 40, my refraction changed from pl-025x090 to
pl-100x090 OU and I wore no correction.

I got glasses around age 40, and I've worn them fulltime now for 12 years,
and it's still pl-100x090. If you rely on my example, you'd have to conclude
that astigmatism increases when uncorrected, and stabilizes once you begin
wearing glasses.

Such is the treachery of anecdotes.

-MT
dr.seagal@yahoo.com - 23 Dec 2006 18:04 GMT
Dear Mike Tyner,

> >> MT> I think you're confusing axial myopia with accommodative
> >>
[quoted text clipped - 4 lines]
> in myopia are more likely from relaxing accommodation, not reducing axial
> length.

Normally speaking, when do decreases in myopia resulted from relaxing
accommodation happen?

Also, what can be done to make it happen.  (What can be done to relax
accommodation so that myopia decreases?)
I'm curious to know about your opinions and your methods.  Thanks.

Dr. Seagal
Mike Tyner - 23 Dec 2006 19:19 GMT
> Normally speaking, when do decreases in myopia resulted from relaxing
> accommodation happen?

In my experience, it often happens a year or two after they stop getting
worse. This happens anywhere from 15 to 30.

In others, it happens between 30 and 50, when the entire population shifts
hyperopic. With no accommodation, there is no accommodative myopia.

> Also, what can be done to make it happen.  (What can be done to relax
> accommodation so that myopia decreases?)

Mostly we leave it alone because the evidence is that excess accommodation
doesn't harm or change the eye, even over time. The excess accommodation
often offsets exophoria or divergence excess.

If you wanted to hurry it along, you might be successful with base-out
prism, bifocals, relaxation exercises, biofeedback, and placebo.

-MT
dr.seagal@yahoo.com - 24 Dec 2006 05:43 GMT
> Western journals don't contain any "myopia control" techniques that work for
> axial myopia, except topical muscarinics.

> I know that attempts to reduce or retard axial myopia with lenses and
> exercises have failed, as compared to controls.

Dear Dr.G and Mike Tyner,

Just to confirm, what is the success rate for myopia control in your
office?

What would you do if you know of a myopia control method that really
works?

S.Seagal
Mike Tyner - 24 Dec 2006 11:08 GMT
> Just to confirm, what is the success rate for myopia control in your
> office?

Zero.

> What would you do if you know of a myopia control method that really
> works?

I'd use it.

There is one, by the way.

And the FDA might even approve it before I retire.

-MT
dr.seagal@yahoo.com - 24 Dec 2006 19:08 GMT
> > Just to confirm, what is the success rate for myopia control in your
> > office?
[quoted text clipped - 5 lines]
>
> I'd use it.

Dear Mike Tyner,

Thank you very much.  You responded directly with a definite answer.  I
like that.  Thanks again.

S.Seagal
Dr. Leukoma - 24 Dec 2006 15:04 GMT
> Just to confirm, what is the success rate for myopia control in your
> office?

It's difficult to say how much worse the myopes in my practice would
have gotten without my intervention because I don't treat one eye and
use the other for a control, treat one group and not the other, etc.

> What would you do if you know of a myopia control method that really
> works?

It it was safe, efficacious, and practical to use, then I would employ
it.  If it involves putting small children into helmets with plus
lenses in front of their eyes 24/7, then I would defer.

I don't regard myself as being a dogmatic person, and if such a method
was presented and backed by sound science, then I would embrace it.

But, I happen to believe that we are indeed on the cusp of having such
a method(s), and I think that this is a great time to be an
optometrist.

DrG
dr.seagal@yahoo.com - 24 Dec 2006 19:59 GMT
Dear DrG,

> > Just to confirm, what is the success rate for myopia control in your
> > office?
>
> It's difficult to say how much worse the myopes in my practice would
> have gotten without my intervention because I don't treat one eye and
> use the other for a control, treat one group and not the other, etc.

I guess that means "low success rate" unless you would like to kindly
give a more definite answer.  (I was not asking about how much worse
the myopes got.  I was asking about the percentage of the myopes in
your office whose myopia does not get worse.  Mike Tyner's answer is
zero which means none of the myopes in his office whose myopia does not
get worse.)

> > What would you do if you know of a myopia control method that really
> > works?
>
> It it was safe, efficacious, and practical to use, then I would employ
> it.  If it involves putting small children into helmets with plus
> lenses in front of their eyes 24/7, then I would defer.

Yes, it is safe, efficacious, and practical to use.  No helmets are
used.  I solve myopia problem (axial elongation, etc.) with glasses,
not helmets.

> I don't regard myself as being a dogmatic person, and if such a method
> was presented and backed by sound science, then I would embrace it.

I hope you do embrace it, as the method is science.  If it is not
science, it won't work.  Don't you agree?

> But, I happen to believe that we are indeed on the cusp of having such
> a method(s), and I think that this is a great time to be an
> optometrist.

So do I.  And I really enjoy solving myopia problems (eyeball
elongation, retinal detachment, etc.) instead of creating more myopia
problems.

S.Seagal
Mike Tyner - 24 Dec 2006 20:34 GMT
> Mike Tyner's answer is zero which means
> none of the myopes in his office whose
> myopia does not get worse.

So you're in the habit of leaping to conclusions?

More than half the myopes in my practice are not getting worse.

There are many who get better.

I don't presume to take credit for it.

-MT
Mike Tyner - 24 Dec 2006 20:38 GMT
> Yes, it is safe, efficacious, and practical to use.  No helmets are
> used.  I solve myopia problem (axial elongation, etc.) with glasses,
> not helmets.

You _presume_ that you solve the myopia problem.

> I hope you do embrace it, as the method is science.  If it is not
> science, it won't work.  Don't you agree?

If you don't use scientific methods to test the efficacy of your treatment,
you cannot know that it works. Don't you agree?

> So do I.  And I really enjoy solving myopia problems (eyeball
> elongation, retinal detachment, etc.) instead of creating more myopia
> problems.

And I would really enjoy your telling us how you know you can cure myopia.

-MT
Dr. Leukoma - 24 Dec 2006 21:02 GMT
> Dear DrG,
>
[quoted text clipped - 11 lines]
> zero which means none of the myopes in his office whose myopia does not
> get worse.)

Then you would be drawing the wrong conclusion.  You asked about the
success rate for myopia control in my practice, which can only be
determined by measuring a treatment group against a group of controls.
Some myopes progress, some regress, and some remain stable.

> > > What would you do if you know of a myopia control method that really
> > > works?
[quoted text clipped - 5 lines]
> Yes, it is safe, efficacious, and practical to use.  No helmets are
> used.  I solve myopia problem (axial elongation, etc.) with glasses,

> not helmets.

Inquiring minds wish to know.

> > I don't regard myself as being a dogmatic person, and if such a method
> > was presented and backed by sound science, then I would embrace it.
>
> I hope you do embrace it, as the method is science.  If it is not
> science, it won't work.  Don't you agree?

I believe that science explains why things work...it doesn't make them
work.

> > But, I happen to believe that we are indeed on the cusp of having such
> > a method(s), and I think that this is a great time to be an
[quoted text clipped - 3 lines]
> elongation, retinal detachment, etc.) instead of creating more myopia
> problems.

Then, I look forward to the publication of your findings, preferably in
a peer-reviewed journal.

DrG
dr.seagal@yahoo.com - 24 Dec 2006 21:56 GMT
> > > I don't regard myself as being a dogmatic person, and if such a method
> > > was presented and backed by sound science, then I would embrace it.
[quoted text clipped - 4 lines]
> I believe that science explains why things work...it doesn't make them
> work.

Pardon my poor English writing skill and expressing skill, as English
is my seventh language.  But you get the idea, I hope.

> > > But, I happen to believe that we are indeed on the cusp of having such
> > > a method(s), and I think that this is a great time to be an
[quoted text clipped - 6 lines]
> Then, I look forward to the publication of your findings, preferably in
> a peer-reviewed journal.

If I do write a paper, you should probably be my editor, hehe.

S.Seagal.
Dan Abel - 24 Dec 2006 18:03 GMT
> > Western journals don't contain any "myopia control" techniques that work for
> > axial myopia, except topical muscarinics.
[quoted text clipped - 6 lines]
> Just to confirm, what is the success rate for myopia control in your
> office?

There's glasses, contacts and refractive surgery.  They all work just
fine.  Take your pick.

Or do you want a magic wand?  Try this:

http://www.alivans.com/

Let us know how it works.
Dr. Leukoma - 23 Dec 2006 03:08 GMT
You seem so earnest that I am almost reluctant to point this out, but I
observe that most of your cases suffered from against-the-rule
astigmatism, which very often goes along with accommodative spasm,
suggesting that these patients may have been over-minused to begin
with.  The fact that their myopia decreased by a relatively small
amount further attests to the presence of pseudomyopia.

Now, a regression to zero, or emmetropia, would indeed be something
noteworthy.

DrG

> Dear William Stacy, DrG, Mike Tyner, p.clarkii, Dan Abel, fellow
> optometrists, and all truth seekers:
[quoted text clipped - 234 lines]
>
> If You Are Not Part Of The Solution You Are Part Of The Problem
dr.seagal@yahoo.com - 23 Dec 2006 17:54 GMT
Dear Dr.G,

> The fact that their myopia decreased by a relatively small
> amount further attests to the presence of pseudomyopia.

Normally speaking, when or how does pseudomyopia disappear?
Also, what can be done to reduce or eliminate accommodative spasm or
pseudomyopia?  I'm curious to know about your opinions and your
methods.  Thanks.

Dr. Seagal

> You seem so earnest that I am almost reluctant to point this out, but I
> observe that most of your cases suffered from against-the-rule
[quoted text clipped - 7 lines]
>
> DrG
Dr. Leukoma - 23 Dec 2006 18:03 GMT
dr.sea...@yahoo.com wrote:

> Normally speaking, when or how does pseudomyopia disappear?
> Also, what can be done to reduce or eliminate accommodative spasm or
> pseudomyopia?  I'm curious to know about your opinions and your
> methods.  Thanks.

Pseudomyopia is blur caused by sustained accommodation.  True, or axial
myopia is blur caused by mismatch between the optics of the eye and its
axial length.  In humans, I am not aware of any mechanism by which
axial length can be shortened.  On the other hand, there are credible
mechanisms to explain axial elongation.

Therefore, any decrease in the plus power of the eye (i.e. decrease in
the minus prescription) must be due to something other than a change in
the axial length, and must be due either to change in accommodation, or
the anterior corneal curvature, or the index of refraction of the
media.

In the data you presented, I have noticed that the prescription changes
are relatively small, and that a significant amount of myopia remains.
Which one of the variables do you think you are manipulating in order
to eliminate myopia (given that you haven't really eliminated anything,
only changed the magnitude slightly)?

With regard to reducing or eliminating accommodative spasm, topical
cycloplegics are helpful, as are near adds.
dr.seagal@yahoo.com - 23 Dec 2006 18:52 GMT
Dear Dr.G.

Thank you very much for your response.

> Pseudomyopia is blur caused by sustained accommodation.  True, or axial
> myopia is blur caused by mismatch between the optics of the eye and its
> axial length.  In humans, I am not aware of any mechanism by which
> axial length can be shortened.  On the other hand, there are credible
> mechanisms to explain axial elongation.

Could you please tell me about these credible mechanisms that explain
axial elongation?

> With regard to reducing or eliminating accommodative spasm, topical
> cycloplegics are helpful, as are near adds.

Does accommodative spasm decrease or disappear without human
intervention (using topical cycloplegics, near adds, etc.), that is,
does accommodative spasm decrease or disappear naturally? (due to old
age? or when/what else?)  Thanks.

Dr.Seagal
Dr. Leukoma - 23 Dec 2006 19:26 GMT
> Could you please tell me about these credible mechanisms that explain
> axial elongation?

Well, for one, you could refer to the recent paper by Hung and
Ciuffreda recently discussed.

> Does accommodative spasm decrease or disappear without human
> intervention (using topical cycloplegics, near adds, etc.), that is,
> does accommodative spasm decrease or disappear naturally? (due to old
> age? or when/what else?)  Thanks.

I think so, don't you?  I see a fairly significant number of adults who
show regression, but I'm not sure if it is related to accommodation or
some other mechanism inherent in the aging of the lens.  I know that in
younger people, biofeedback methods have been successfully employed
with variable success.

DrG
dr.seagal@yahoo.com - 23 Dec 2006 22:03 GMT
Dear DrG and Mike Tyner,

> > Could you please tell me about these credible mechanisms that explain
> > axial elongation?
>
> Well, for one, you could refer to the recent paper by Hung and
> Ciuffreda recently discussed.

I think it says pseudomyopia lead to axial myopia, do you believe so?
Could both of you please list all of the causes of axial myopia, all of
the reasons that axial elongation happens?  And which one you believe
in, or agree with, and which one you don't.

Thanks.

S.Seagal
Dr. Leukoma - 23 Dec 2006 23:51 GMT
> I think it says pseudomyopia lead to axial myopia, do you believe so?
> Could both of you please list all of the causes of axial myopia, all of
> the reasons that axial elongation happens?  And which one you believe
> in, or agree with, and which one you don't.

They say that their model predicts how NITM can lead to axial
elongation in susceptible individuals, because NITM acts like a
positive lens in their model.

You are welcome to go first.

DrG
Mike Tyner - 24 Dec 2006 00:38 GMT
> I think it says pseudomyopia lead to axial myopia, do you believe so?

No. Pseudomyopia is indistinguishable from the accommodation used by
uncorrected hyperopes.

Uncorrected hyperopes don't get axial myopia.

> Could both of you please list all of the causes of axial myopia, all of
> the reasons that axial elongation happens?

Genetics would be the only "reason" firmly supported by the myopia
literature. The contribution of environment (working up close, prolonged
close work) is small, and the contribution of corrective lenses is nil.

-MT
dr.seagal@yahoo.com - 24 Dec 2006 02:29 GMT
> Pseudomyopia is indistinguishable from the accommodation used by
> uncorrected hyperopes.

Could you please clarify or explain in detail?  Thanks.

S.Seagal
Mike Tyner - 24 Dec 2006 03:25 GMT
>> Pseudomyopia is indistinguishable from the accommodation used by
>> uncorrected hyperopes.
>
> Could you please clarify or explain in detail?  Thanks.

Which word was unclear?

Hyperopes and emmetropes and myopes all must share the same neurology, the
same basic set of cranial nerves, ganglia, and brain stem reflexes.

So it shouldn't surprise you that latent hyperopia and pseudomyopia are
virtually identical, physiologically.

Tonic accommodation is so easy for hyperopes that it must also be easy for
myopes.

-MT
dr.seagal@yahoo.com - 24 Dec 2006 02:39 GMT
> > Dear DrG and Mike Tyner,
> > Could both of you please list all of the causes of axial myopia, all of
[quoted text clipped - 5 lines]
>
> -MT

Dear DrG,

Mike Tyner shared his view.  What about you?
Could you please share your view on all of the causes of myopia?
Thanks.

S.Seagal
Dr. Leukoma - 24 Dec 2006 04:43 GMT
> Mike Tyner shared his view.  What about you?
> Could you please share your view on all of the causes of myopia?
> Thanks.

I believe that it is genetically based with environmental modulation.

DrG
dr.seagal@yahoo.com - 24 Dec 2006 22:42 GMT
Mike Tyner wrote:
> <dr.sea...@yahoo.com> wrote
> > Dear DrG and Mike Tyner,
[quoted text clipped - 4 lines]
> literature. The contribution of environment (working up close, prolonged
> close work) is small, and the contribution of corrective lenses is nil.

> > Mike Tyner shared his view.  What about you?
> > Could you please share your view on all of the causes of myopia?
> > Thanks.
>
> I believe that it is genetically based with environmental modulation.

Dear DrG,

Mike Tyner believe that the contribution of corrective lenses is nil.
Could you please share your view on this?  Thanks.

S.Seagal
dr.seagal@yahoo.com - 24 Dec 2006 23:05 GMT
> > Could you please share your view on all of the causes of myopia?
> > Thanks.
>
> I believe that it is genetically based with environmental modulation.
>
> DrG

Dear Dr.G,

Could you please explain the environmental modulation part?  How does
the environment cause myopia?  Thanks.

S.Seagal
Neil Brooks - 24 Dec 2006 23:12 GMT
>>> Could you please share your view on all of the causes of myopia?
>>> Thanks.
[quoted text clipped - 8 lines]
>
> S.Seagal

Feel free to jump in here with your beliefs (and evidence--which
comports with the scientific method--in support of those beliefs) at any
time.....
Mike Tyner - 25 Dec 2006 02:28 GMT
> Could you please explain the environmental modulation part?  How does
> the environment cause myopia?  Thanks.

You know, if your own textbooks didn't cover any of this, there's a pretty
good article on wikipedia, under the topic "myopia."

-MT
dr.seagal@yahoo.com - 25 Dec 2006 03:17 GMT
> > Could you please explain the environmental modulation part?  How does
> > the environment cause myopia?  Thanks.
[quoted text clipped - 3 lines]
>
> -MT

Dear Mike Tyner,

It's not that my textbooks don't cover it.  It is just that I would
like to see your view, DrG's view and other optometrists' views on
this.  Only then can I share the "Myopia Control" method that really
works with all of you.

I am going to start a new topic called "The Causes of Myopia" and we'll
go from there.

S.Seagal
Dr. Leukoma - 25 Dec 2006 16:14 GMT
> Dear Mike Tyner,
>
> It's not that my textbooks don't cover it.  It is just that I would
> like to see your view, DrG's view and other optometrists' views on
> this.  Only then can I share the "Myopia Control" method that really
> works with all of you.

Were those case studies you posted examples of your results?

I remember a real life story of a doctor who was promoting refractive
error control.  This was a pediatric OMD who had convinced his
long-time patient and the parents that he was going to lessen his
dependence on glasses for hyperopia.  Every year he gave the young man
a lesser prescription.  By the time he had moved away and became my
patient, he was wearing +2.00.  A real miracle worker, that doctor.

The problem was that I refracted him at +4.00 manifestly, and +5.00
with cycloplegia.  Unfortunately, so strong was their belief in this
"con artist," that they sought a second opinion from another OMD.  This
doctor simply gave him the average of the two prescriptions.  That was
the day I realized that some people are not about to let the facts get
in the way of a good story.

Dr. S, many of us here are weary of semantic games.  If you have
something that is worthy of the scientific method, you can expect a
fair reading and an open and fair discussion.  You needn't try to
figure out which way the wind is blowing, first.  Nobody here that I
know is against myopia control in principle.  There is a reason this
group is called sci.med.vision.

DrG
Dan Abel - 23 Dec 2006 22:13 GMT
> Could you please tell me about these credible mechanisms that explain
> axial elongation?

I have a buckle.
Dr. Leukoma - 23 Dec 2006 23:51 GMT
> > Could you please tell me about these credible mechanisms that explain
> > axial elongation?
>
> I have a buckle.

Hehehe.
Dan Abel - 24 Dec 2006 03:40 GMT
> > > Could you please tell me about these credible mechanisms that explain
> > > axial elongation?
> >
> > I have a buckle.
>
> Hehehe.

It's not funny.  Not funny at all.  I'm pissed.  The buckle causes
irregular astigmatism that isn't correctible with normal lenses.  I am
not able to use that eye.  Would you like to be blind in one eye?
Dr. Leukoma - 24 Dec 2006 04:39 GMT
> It's not funny.  Not funny at all.  I'm pissed.  The buckle causes
> irregular astigmatism that isn't correctible with normal lenses.  I am
> not able to use that eye.  Would you like to be blind in one eye?

It's just that it reminded me of the Bates proponents view that the
tension of the oblique muscles causes elongation.  Didn't mean to laugh
at your misfortune.

DrG
Dan Abel - 24 Dec 2006 19:12 GMT
> > It's not funny.  Not funny at all.  I'm pissed.  The buckle causes
> > irregular astigmatism that isn't correctible with normal lenses.  I am
[quoted text clipped - 3 lines]
> tension of the oblique muscles causes elongation.  Didn't mean to laugh
> at your misfortune.

Thanks.  I think I was just in a bad mood when I read your post.  
Christmas is supposed to be a happy time, but I always get depressed.
otisbrown@pa.net - 24 Dec 2006 04:46 GMT
Dear Dr. L,

Dan had a retina buckle, that can lead
to a detached retina and blindness.

I do not think that is a laughing matter.

I know I do not.

Otis

> > > Could you please tell me about these credible mechanisms that explain
> > > axial elongation?
> >
> > I have a buckle.
>
> Hehehe.
Dr. Leukoma - 24 Dec 2006 04:50 GMT
> Dear Dr. L,
>
> Dan had a retina buckle, that can lead
> to a detached retina and blindness.
>
> I do not think that is a laughing matter.

Of course I don't think a retinal detachment is a laughing matter, but
he had that repaired with a buckle.  Buckles don't cause detachments.
But, they do cause myopia...

DrG
Neil Brooks - 24 Dec 2006 16:27 GMT
> Dear Dr. L,
>
[quoted text clipped - 6 lines]
>
> Otis

I don't happen to think that YOU inducing DOUBLE VISION in trusting but
naive parents and myopes is particularly funny either, but YOU DO seem
to get a chuckle out of that, so......
Dr. Leukoma - 23 Dec 2006 13:17 GMT
I should add also that not only were most of the cases against-the-rule
astigmatism which suggests accommodative myopia, but the amounts were
rather small, such that the spherical equivalent could easily have been
substituted, OR ELSE within the standard deviation of the refraction.
It may also suggest a methodological difference in treatment between
different practitioners.

DrG

> Dear William Stacy, DrG, Mike Tyner, p.clarkii, Dan Abel, fellow
> optometrists, and all truth seekers:
[quoted text clipped - 234 lines]
>
> If You Are Not Part Of The Solution You Are Part Of The Problem
Dan Abel - 22 Dec 2006 17:36 GMT
> Dear William Stacy,

"conventional optometry" is

> concerned.  However, when it comes to Real Optometry, True Optometry,
> or REAL EYECARE

> (quick fix) wearing
> glasses, which has side effects or bad consequences.  REAL EYECARE
> (slightly slower fix).
>
> I am interested in bare eye sharp vision, so are my patients.  Of more
> than a thousand patients I have seen so far, not even one failure.

OK, we have "true", "quick fix" and all caps.  This appears to be Otis
speak.
William Stacy - 22 Dec 2006 17:39 GMT
no doubt one of his proselytes.

>  
>
[quoted text clipped - 22 lines]
>speak.
>  
Jan - 22 Dec 2006 22:25 GMT
Bucky schreef:
> I'm probably using the wrong terms, but hopefully you'll get my point.
> If I have a contacts prescription of -11 sph, -1.25 cyl. What would
[quoted text clipped - 6 lines]
> see decently (everything except reading and driving) without correcting
> astigmatism.

Bucky,

I suppose your prescription has one other important data.
Thats to say the "distance" between your prescribed glasses and the
cornea (front of your eye).

Most of the time this distance is assumed to be 12mm

A contactlens is fitted just in front on your eye at zero mm distance
from your cornea.

At zero distance you need a lenspower of S-9,75=C-1,00 .

So your needed cylinder is brought down from -1,25 to -1,00 here.

If you only have a choice in spherical lenses only, I suggest S-10,00 or
S-9,50.

However, an advice from a real eyecare-specialist face to face instead
of asking here on the internet is a far more wise decision.

Jan (normally Dutch spoken)
William Stacy - 22 Dec 2006 23:15 GMT
That's why I asked at the beginning of this post if he was sure it was
the CLRx or the spectacle Rx.  Makes a big difference in these ranges.

> I suppose your prescription has one other important data.
> Thats to say the "distance" between your prescribed glasses and the
> cornea (front of your eye).
>
> Most of the time this distance is assumed to be 12mm
Jan - 22 Dec 2006 23:38 GMT
William Stacy schreef:
> That's why I asked at the beginning of this post if he was sure it was
> the CLRx or the spectacle Rx.  Makes a big difference in these ranges.

Sure, and the following is also a big one.

> However, an advice from a real eyecare-specialist face to face instead of asking here on the internet is a far more wise decision.

Greetings

Jan (normally Dutch spoken)
William Stacy - 23 Dec 2006 00:07 GMT
>> However, an advice from a real eyecare-specialist face to face
>> instead of asking here on the internet is a far more wise decision.

Depends on who the "real" doc is, regardless of whether it's in person
or on the 'net.  I have lots of patients who'd rather ask me on line
than in person because they are more at ease, less chance to forget  
some of the problems/issues, and they think (sometimes rightly so) that
I'll have more time to think about my answers when I'm at the computer
than when I'm in the exam room.

The 'net is like life.  You have to watch out for conflicting information.

w.stacy, o.d.
Jan - 24 Dec 2006 20:53 GMT
William Stacy schreef:

>>> However, an advice from a real eyecare-specialist face to face
>>> instead of asking here on the internet is a far more wise decision.
[quoted text clipped - 8 lines]
> The 'net is like life.  You have to watch out for conflicting information.
> w.stacy, o.d.

Do you diagnose on line, even the strangers to you without seeing them?

No William your answer pointed only to your real patients who you
already have seen and even then only to a part of them.

Jan (normally Dutch spoken)

BTW, how do you earn your money?
Bucky - 22 Dec 2006 23:02 GMT
thanks all for your input. Don't worry, of course I will see my
optometrist before doing anything. I was just curious to see if this
was a realistic idea, or whether I was way off base.
otisbrown@pa.net - 23 Dec 2006 15:02 GMT
Dear Bucky,

In changing from slight-astigmatism, (say 1/4 diopter) to
spherical-equivalent,
you many get a chage of visual acuity of one line, on
the Snellen, say from 20/20 to 20/25.

Most DMV tests from from 20/50 to 20/40, so you would meet
the legal requirement at 20/25.

Your OD can discuss this issue with you.

Best,

Otis

> thanks all for your input. Don't worry, of course I will see my
> optometrist before doing anything. I was just curious to see if this
> was a realistic idea, or whether I was way off base.
 
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