Medical Forum / General / Vision / June 2007
Macular whatsis?
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The Real Bev - 24 Jun 2007 17:05 GMT A Chinese friend just got some information -- written in Chinese -- about a problem a relative has involving a macular something-or-other that grows over the macula and ultimately destroys vision. It can be removed surgically if caught soon enough. When he googled for "macular sheath" "macular covering" and some other variants he found nothing.
What is this problem and what is the procedure for fixing it?
 Signature Cheers, Bev =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- He's your god. They're your rules. *You* burn in hell!
Charles - 24 Jun 2007 18:04 GMT > What is this problem and what is the procedure for fixing it? I would guess he is talking about macular degeneration. Google that for lots of information.
 Signature Charles
Ms.Brainy - 24 Jun 2007 18:20 GMT > In article <rDwfi.15$XQ...@newsfe12.lga>, The Real Bev > [quoted text clipped - 6 lines] > -- > Charles Macular degenaration is a whole different thing. My guess would (more likely) be macular pucker.
The Real Bev - 24 Jun 2007 19:14 GMT >> <bashley101+use...@gmail.com> wrote: >> [quoted text clipped - 5 lines] > Macular degenaration is a whole different thing. My guess would (more > likely) be macular pucker. Thanks, Brainy, the friend looked at the URLs I sent him and said that macular pucker sounds like it. Is usenet wonderful or what?
 Signature Cheers, Bev ===================================================================== A: Because it messes up the order in which people normally read text. Q: Why is it such a bad thing? A: Top-posting. Q: What is the most annoying thing on usenet?
Ms.Brainy - 24 Jun 2007 19:24 GMT > Thanks, Brainy, the friend looked at the URLs I sent him and said that > macular pucker sounds like it. Is usenet wonderful or what? Indeed. And this is why I am here, despite the trolls, the noise and the silly fights.
Revival - 24 Jun 2007 20:30 GMT >despite the trolls, One of whom you are.
>the noise To which you contribute.
>and the silly fights. In which you participate.
>My guess would (more likely) be macular pucker. Dear Lord! For once it seems you have provided someone with an intelligent answer - a whole new trend on your part, I see. It takes only a true genius to work out that this man was referring to a 'macular pucker', does it not? Considering we have been discussing this on sci.med.vision for the past few weeks - My applaud.
>Indeed. And this is why I am here, Ah, it is? I was given the strange idea that you are here to practice a little basic spelling - but then again, perhaps you have entered your very own 'Coma'. Of course, by all means 'Brainy' should attempt to justify her chosen screen name - at present one might find it rather questionable.
otisbrown@pa.net - 25 Jun 2007 03:31 GMT Dear Revival,
Subject: Information on the Internet.
Re: Sorting the wheat from the chaff.
You are correct, Revival. But as you have seen, Neil Brooks likes to play "head games" with you -- and with many people looking for accurate information about preventive methods on sci.med.vision.
It takes real intelligence and wisdom to sort out what you believe about these issues.
Enjoy,
Otis
> >despite the trolls, > [quoted text clipped - 25 lines] > -- > Message posted viahttp://www.medkb.com Neil Brooks - 25 Jun 2007 03:59 GMT > But as you have seen, >Neil Brooks likes to play "head games" with you -- and >with many people looking for accurate information >about preventive methods on sci.med.vision. Oh, no, Uncle Otie. Far from it. I'm a HUGE proponent of accurate information.
Speaking of "accurate information," would you care to ACCURATELY answer some important, cogent, and relevant questions??
Here:
1. There seems to be a great deal of evidence that primates have widely differing visual systems. How is it that you feel so secure in saying that "all primate eyes" behave similarly ... in ANY regard?
2. In these monkey studies that you reference, isn't it true that the SAME STUDIES showed that, with even BRIEF periods away from the minus lens, the myopia was prevented?
3. If there was no medical indication that these monkeys needed corrective lenses at all, can you be sure that appropriate CORRECTION of somebody's REFRACTIVE ERROR will have similar results? If so, how?
4. You continually claim that a minus lens causes something that you call "stair-case myopia." Presuming that you mean that it does this in humans, do you have any valid clinical evidence for this claim?
5. You have repeatedly claimed that the Oakley-Young study is "proof" of this "stair-case myopia" phenomenon, but Oakley-Young only establishes that-in some people-myopia can get worse over time. It doesn't even CLAIM that a minus lens CAUSES this. Please explain your position.
6. Also-at least in part, based on the Oakley-Young study-you recommend that people use plus lenses to prevent myopia. Are you aware that the only people in the Oakley-Young study for whom plus lenses made ANY difference were those with diagnosed "near-point esophoria?" This is a convergence disorder. Do you have ANY EVIDENCE that the same result is likely with people who DO NOT HAVE this convergence disorder?
7. You claim to have known Donald Rehm, the founder of the International Myopia Prevention Association, for some decades. I presume that you are familiar with his FDA petition. In it, Mr. Rehm states:
" if we converge without accommodating the appropriate amount, or if we accommodate without converging the appropriate amount, problems can develop for this small percentage of children such as eye fatigue, double vision, or other types of fusion problems. That is, the two images can no longer be fused together without discomfort. Normal binocular vision is interfered with."
Is there a valid reason why you have not attempted to make people aware of these SERIOUS risks of unprescribed plus lenses?
8. You continually cite Fred Deakins as a (questionable) success story. Do you think it is honest NOT to mention that Mr. Deakins is--in truth--myopic, that he is trying to sell a $40.00 product, and that his "testimonial" is used as an inducement to buy this product?
9. Do you have any economic interest in the product sold by Mr. Deakins?
10. You claimed that you were not selling a book--until, that is, I provided links to websites where it WAS being sold for $24.95 (with your home address as the "send check to" address). You then claimed that the entire book was available for free on the internet--until, that its--I pointed out that only approximately four of 14+ chapters were on the internet. Would you please clarify whether or not you have ever received money for a copy of your book, "How to avoid nearsightedness: A scientific study of the normal eye's behavior?" If so, please state how many copies you have sold, and when the last copy was sold. If not, please state how long it has been since you received any money for this book.
11. Do you believe that it is dishonest NOT to mention that you have a commercial interest in inducing people to visit your website?
12. Presuming that you understand the difference between accommodative spasm (pseudomyopia) and axial-length myopia, would you please provide credible proof that either a) pseudomyopia CAUSES axial-length myopia, or that b) relieving pseudomyopia REDUCES axial-length myopia
13. You CONSTANTLY make reference to "Second Opinion" optometrists--presumably meaning those who share your views. Other than the now-infamous Steve Leung, are there ANY OTHER such "second opinion optometrists" in the ENTIRE WORLD? Does any of these people have any evidence to support the claims that you make? Would you please provide it?
14. Mr. Steve Leung is also trying to sell a book. Do you have any economic interest in the book sold by Steve Leung? Do you think it is honest NOT to mention that Mr. Leung is--in truth--myopic, that he is trying to sell a book, and that the "testimonials" on his website, and your repeated referrals TO his website are used as inducements to sell both your and his book?
15. Do you feel that it is HONEST NOT TO admit that--even though your niece, Joy, NEVER WORE MINUS LENSES, and DID USE PLUS LENSES, she is, at this time, a myope with a restricted driver's license? [http://www.chinamyopia.org/otis%20&joy.htm]
16. I have posted, many times, links to the actual summaries of the myopia progression studies that you lie about [http://darwin.nap.edu/books/0309040817/html/62.html]. Why do you tell people that they WILL SHIFT MYOPIC BY 1.3 DIOPTERS during the four years of college when the studies DO NOT SAY THAT AT ALL? Please explain your position and provide citations to the appropriate studies.
17. You enjoy citing the Francis Young 1969 Eskimo study, claiming that it is "proof that near work causes myopia." Are you aware of the contemporary theory that states that, in fact, myopia in the Inuit population was a result of the introduction of a "Western" diet high in simple carbohydrates (junk food)? http://www.second-opinions.co.uk/myopia.html http://www.newscientist.com/article.ns?id=dn2120
18. You enjoy using the term "closed-loop feedback system" to describe your concept of the "dynamic eye," yet (see question #3) the following is a much BETTER representation of a closed-loop feedback system:
Think of your home's oven as an analogy.
You set the thermostat for 350 degrees (F).
If the oven is already at 275F, then the thermostat will signal an INcrease in temperature.
If the oven is already at 425F, then the thermostat will signal a DEcrease in temperature.
IF, however, the oven is already at 350F -- the desired temperature -- then the thermostat will not signal any change.
Please explain why your position is at variance with this analogy.
19. You seem to stop by sci.med.vision for the sole purpose of "roiling the waters--" adding posts designed only to harrass and annoy optometrists who, universally, do not agree with you.
You then excerpt--often improperly and with incorrect attributions-- these conversations on other sites, adding your little 'comments' WITHOUT the doctor having any ability to challenge what you say.
Do you think this is intellectually honest?
If you are interested in debate, exchange, argument, or discussion, wouldn't it be better to actually ANSWER questions directly?
20. Presuming that your theories are based, at least in large part, on the emmetropization process, at what age does this stop in humans? In other words: you are recommending a particular therapy to halt myopia progression that--based on your arguments--should be equally effective at REVERSING it. If so, then why are all of its advocates (and most of its known 'test subjects') myopic?
This seems to be a bit of a paradox, no?
Thanks, Otis. I'm sure this will be helpful for people who are trying to separate truth from fiction.
Mike Tyner - 25 Jun 2007 12:10 GMT > It takes real intelligence and wisdom to sort out > what you believe about these issues. And as we know, what you BELIEVE is way more important than what actually IS.
-MT
otisbrown@pa.net - 25 Jun 2007 04:20 GMT Dear Revival,
Subject: The inane posters on sci.med.vision
You can expect the usual drivel to follow.
Looks like so much "chaff" to me, but you will have to decide.
Otis
> >despite the trolls, > [quoted text clipped - 25 lines] > -- > Message posted viahttp://www.medkb.com Neil Brooks - 25 Jun 2007 04:33 GMT >Subject: The inane posters on sci.med.vision Like the one who constantly dodges these questions??
http://www.nbeener.com/NDB_OSB_Qs.txt
Come on, Otis. Honesty really IS the best policy.
Really.
otisbrown@pa.net - 25 Jun 2007 04:28 GMT Dear Revival,
Subject: What Bates thought -- and his life-time goal.
Re: We can't see the forest -- because the trees are in the way. (And the majority-opinion ODs can never see the forest.)
I think that Bates and Prentice had the ability to see things "differently". (In a true PREVENTIVE sense.)
I think a lot of them get sucked down into fine detail of the eye, and then miss the character and behavior of the entire forest. (If you like the metaphor.)
I know how easy it is for that to happen. We want to know the EXACT structure of the bark on the tree, and fail to go to the next mountain, look back, and see the general behavior of the entire forest.
I think that before we plunge into a picture of the eye as a frozen box camera, we should think about how a sophisticated eye will behave under direct scientific, and experimental control.
That issue, I think, is what Bates and Prentice were attempting to develop many year ago.
I hope we can follow modern leaders like Steve Leung on this subject.
www.chinamyopia.org
Othewise, we will perpetuate stair-case myopia for our children with an over-prescribed minus -- endlessly.
Otis
> >despite the trolls, > [quoted text clipped - 25 lines] > -- > Message posted viahttp://www.medkb.com Neil Brooks - 25 Jun 2007 04:34 GMT >Dear Revival, > >Subject: What Bates thought -- and his life-time goal. [snip]
Yeah, yeah. You've posted this one, verbatim, on numerous sites.
Try something new. Answer these questions:
http://www.nbeener.com/NDB_OSB_Qs.txt
Thanks.
DoctorRick - 25 Jun 2007 12:45 GMT >>My guess would (more likely) be macular pucker. > >Dear Lord! For once it seems you have provided someone with an intelligent >answer - a whole new trend on your part, I see. It takes only a true genius >to work out that this man was referring to a 'macular pucker', does it not? You and Otis have once again hijacked another thread. The topic was epiretinal membranes, and now you've started name-calling and arguing.
And you seem to act like it was obvious from the start that Macular Pucker was the syndrome the original poster was talking about. We had no idea you were so learned Dr. Revival (or Zetsu, or whatever other name you are using at the moment).
So you are actually a 12 year old kid huh? We all liked it better when "Revival has homework and cannot come out and play". Go away.
>Considering we have been discussing this on sci.med.vision for the past few >weeks - My applaud. Check your spelling Revival-kid.
>>Indeed. And this is why I am here, > >Ah, it is? I was given the strange idea that you are here to practice a >little basic spelling - but then again, perhaps you have entered your very >own 'Coma'. Of course, by all means 'Brainy' should attempt to justify her >chosen screen name - at present one might find it rather questionable. You, using your many different pseudonames, along with Otis who blathers-out the same old crap and refuses to answer logical questions, are trashing this forum for people who come and post here with genuine problems. But I suppose that was your plan all along.
Churie. - 25 Jun 2007 14:25 GMT > >>My guess would (more likely) be macular pucker. > [quoted text clipped - 29 lines] > questions, are trashing this forum for people who come and post here > with genuine problems. But I suppose that was your plan all along. Hi Dr Rick is right.Please check on the poster by Mr Raj sometime back on Macular Pucker and the reply posts for the same.
p.clarkii@gmail.com - 24 Jun 2007 21:37 GMT > A Chinese friend just got some information -- written in Chinese -- about a > problem a relative has involving a macular something-or-other that grows [quoted text clipped - 9 lines] > =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- > He's your god. They're your rules. *You* burn in hell! most likely your friend is referring to an epiretinal membrane (ERM). traction by the membrane causes the syndrome titled "macular pucker." the membrane can be surgically-removed ("peeled"). sometimes the syndrome is referred to as "cellophane maculopathy" based upon the shimmering, reflective appearance it gives during a funduscopic exam.
Jane - 25 Jun 2007 00:40 GMT > A Chinese friend just got some information -- written in Chinese -- about a > problem a relative has involving a macular something-or-other that grows [quoted text clipped - 9 lines] > =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- > He's your god. They're your rules. *You* burn in hell! An epiretinal membrane (AKA macular pucker) is a layer of scar tissue on the macula, and it's probably what Bev's Chinese friend was referring to. However, it does not "ultimately destroy" vision as stated above. In the majority of cases, it has little effect on vision and needs no treatment. It's reported that many people are not even aware that they have this condition until their doctor calls it to their attention. (I wasn't aware of my ERM when it was initially diagnosed by my optometrist during a routine exam; I had 20/20 vision in my affected eye.) In a minority of cases (like mine), the ERM can become denser, significantly impairing central vision it the affected eye. In the USA an ERM is usually "peeled" during a vitrectomy, which is an outpatient procedure lasting about 30 minutes.
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