Yet again....

Let me lay it out for you ... as a sort of syllogism:

For the prevention method to work, the person attempting it must be
motivated and intelligence.

In your case, the prevention method involves NOT using a minus lens,
but using a PLUS lens.

Your niece, JOY, followed your method, at the age which you deemed
appropriate.

Your niece, JOY, is now a myope with a restricted driver's license.

ERGO ....

Your niece, JOY is neither motivated nor intelligent.

That's a terrible thing to say, Uncle Otie.

Do you say it directly TO her, or only on venues like this one?

While it is perhaps IMPOSSIBLE to "Prescribe" prevention,
there are highly qualified experts, like Dr. David Guyton
(at JHU), who truly see the NEED for it.  Here
is is commentary (supporting the preventive second-opinion).

                     The Myopia Story

    Eye specialists have debated for decades the best way to
treat nearsightedness -- the inability to clearly focus distant
objects in children.  Bifocal glasses, eye drops, eye exercises,
and biofeedback have all been tried, but the long-term
effectiveness of these treatments is uncertain.  A new study
supports another approach -- no treatment at all.

    Youngsters' eyes manage to keep images in focus even as they
grow and change shape.    For un-blurred vision, light entering the
eye must focus on the retina -- the layers of specialized cells
lining the eyeballs' back inner surface.  If an eye is too long,
then images come into focus in front of the retina, a condition
known as myopia or nearsightedness.  An eye that's too short will
focus light behind the retina, causing hyperopia or
farsightedness.

    A report in the August "Nature Medicine" shows that the eyes
of young rhesus monkeys change shape in an attempt to focus
blurred images.  Texas researchers raised 11 infant monkeys with
glasses fixed permanently in front of their eyes.  The left lens
was always plain, flat glass, while the right lens (plus or minus)
caused images to focus either in front of the retina or behind it.
After three months, one eye had grown more than the other,
presumably to position the retina at the proper spot for clear
vision.  When the spectacles were removed, the monkeys' eyes again
grew at different rates and eventually returned to similar
lengths, restoring their vision to normal.  (i.e., the focal
status of the right eye changed to match the left eye.)

    If visual cues such as poorly focused images signal the eyes
to grow or stop growing, then treating myopia with glasses or
contact lenses before the eyes stop growing could interfere with
this natural correction.

    We asked Dr.  David Guyton, the Krieger Professor of
Pediatric Ophthalmology at Johns Hopkins' Wilmer Eye Institute, to
discuss how these new findings may change the treatment of myopia
in children and young adults.  -- The Editors

            ***************

      The Physician's Perspective -- David L.  Guyton, MD

    According to old-wives' tales, wearing glasses makes the eyes
worse.    Generations of ophthalmologists and optometrists have told
their patients just the opposite, that the eye's development is
predetermined by genetics and cannot be affected by glasses.  A
growing body of animal and human research, however, suggests that
the old wives were right after all.

    The ability of young rhesus monkeys' eyes to gradually change
shape in response to what they see comes as no surprise to vision
scientists.  Over the past two decades, their studies have
demonstrated that the eyes of young birds, tree shrews, guinea
pigs, and marmosets react to unfocused images by altering their
growth to correct the problem.

    It is highly likely that the eyes of infants and young
children also adapt to what they see.  This adaptation occurs by a
relative change in eye length that works something like this:  As
the front of the eye grows and becomes less curved, images focus
deeper and deeper within the eye.  If the lengthwise growth
perfectly matches the change in the eye's other dimensions, then
images continue to focus on the retina.  If there is a mismatch
and the focus is off by even the thickness of this paper, then
vision will be blurred.  Remarkably, the eye apparently senses
where images focus and compensates when needed.  If light focuses
in front of the retina, the eye will stop lengthening until the
images catch up.  If the focus is behind the retina, the eye grows
in length at an accelerated rate until the retina is "pushed back"
to the correct spot relative to the eye's other dimensions.

    Thanks to this feedback mechanism, the eyes generally
maintain clearly focused images throughout early life despite
dramatic changes in size.

    In addition to eye size and shape, the distance between the
eye and the objects it is viewing also determines where images
focus.    Near objects come to focus behind the retina, but the lens
changes shape and pulls the images forward until they are clear
enough to recognize.  However, they often remain slightly behind
the retina.  This slight mismatch may be the mechanism by which
prolonged close work such as reading can signal the eye to grow
longer.  If such a signal occurs frequently and strongly enough in
early life, the human eye may gradually lengthen and become
permanently focused for near objects.  This produces
nearsightedness.

    Most of the adaptive changes in eye length occur during
infancy and youth, while the eye is still growing in its socket.
When the front of the eye stops growing, around age nine or ten,
any further adaptive change can occur only in the myopic direction
-? the eye can grow longer, but not shhorter.  Activities such as
prolonged reading at close distances may cause the eyes to
continue lengthening well into one's 20s.

    If this cycle of incomplete focus and eye lengthening is the
primary cause of myopia, how can we intervene in this process?
Some practitioners believe that limiting the amount of close-up
reading or television watching a child or young adult does each
day may prevent myopia.  These days that is a difficult task.  So
I advise parents to encourage children to hold objects and reading
materials as far away from their faces as comfortable, and to sit
at least three feet away from the television screen.  (Those who
insist on holding books close to their eyes, or sitting a foot
from the television or computer, may already have developed
significant myopia or some other problem that warrants a
professional eye examination.)

    For my young patients with simple myopia, I suggest they
leave their distance glasses off while reading, something I have
always done myself.  A child who cannot see the board at school,
for example, should wear glasses to see the board, but remove them
when reading a book or writing.

    Prolonged reading without glasses shouldn't stimulate the eye
to lengthen any farther than what is needed to comfortably focus
the eye at rest at the customary reading distance.  By comparison,
when one reads through glasses or contact lenses designed to bring
the distant world into sharp focus, the page is focused behind the
retina.  This may prompt another round of eye lengthening with
worsening of the myopia.

    For someone who is quite myopic or has astigmatism, the
glasses-off technique is not really feasible.  In such cases I
often prescribe glasses that correct only part of the myopia, or
correct only the astigmatism.  This leaves the patient exactly
focused for his or her customary reading distance.

    Since contact lenses cannot be removed as easily as glasses
for prolonged reading, wearing full-power reading glasses in
addition to contacts may help reduce further increases in eye
length.  Surgical procedures that correct myopia by reshaping the
curvature of the eye, if performed too early in life, will likely
have the same effect as wearing glasses that correct for distance
only, and the myopia may simply reappear.

%%%%%%%%%%%%%%%%%%%%%%

                         Vision Research

  In Sharpening Children's Focus, Glasses May Fuzz the Future

    Experiments with monkeys suggest that wearing glasses to
correct a vision problem might make a young child's vision worse,
researchers announced yesterday.

    The finding, based on experiments in Rhesus monkeys,
indicates that use of corrective lenses actually alters the way
that eyes grow -- a finding that could eventually affect the way
doctors help fix children's vision problems.

    "Our results raise important questions concerning how and
when refractive errors in young children should be corrected,"
wrote researchers Earl L.  Smith and Li- Fang Hung of the
University of Houston and M.L.J.  Crawford of the University of
Texas graduate school of biomedical sciences in the current issue
of Nature Medicine.

    The research raises the possibility that prescribing glasses
for very young children to correct myopia -- nearsightedness --
may make that myopia worse, exacerbating a problem that may have
corrected itself over time without medical intervention.  Ten
percent of children between the ages of 1 and 12 wear glasses,
according to the American Academy of Ophthalmology.

    The researchers, however, did not recommend that parents keep
their children's world blurry.  "These results do not say 'Don't
give them glasses,' " Smith said.  "There are very good reasons to
prescribe glasses for infants," including prevention of amblyopia,
or "lazy eye," and of the muscle control problem known as
strabismus.

    The researchers were quick to caution against drawing other
broad conclusions from the study.  The monkey measurement period
corresponded to the first two or three years of human life and
might not apply to children who get their first pair of glasses in
grade school, Smith said.  "Our results can only be applied with
some degree of confidence to very young infants."

    The researchers suggested that a "partial correction
strategy" that leaves vision slightly less than perfect might help
the eyes to continue their attempt at self-correction.

    In the experiment described in the new article, 11 infant
rhesus monkeys wore headgear fitted with two lenses:  a plain
piece of flat glass over the left eye, and a lens over the right
that would blur the vision, either to a negative or a positive
amount.  (The headgear "sort of looks like a very small football
helmet," researcher Smith said.)

    During the 49-day period in which the monkeys wore the
spectacles, almost all of those fitted with lenses that simulated
hyperopia, or farsightedness, became more myopic; almost all eyes
with lenses that simulated myopia became more hyperopic.

    Earlier studies have shown that chicks fitted with lenses
will adjust the growth of their eyes to compensate for the visual
shift, but the experimental record in mammals is more mixed.  This
is the first experiment that shows compensation in higher
primates, whose eyes closely resemble those of humans.    Because of
the genetic similarities between the species, Smith said, "It's
usually a fairly good bet that the data will extrapolate" to
humans.

    In an accompanying piece, Josh Wallman, a professor of
biology at the City College of the City University of New York,
and Sally McFadden, of the department of psychology at the
University of Newcastle in New South Wales, Australia, wrote that
the monkey experiments pointed to a basic mechanism of "visually
guided growth" that is not yet well understood -- but that is
somehow able to distinguish between blurred vision caused by
myopia and blurred vision caused by hyperopia.    "That's the big
mystery," Wallman said in an interview.  "How can the eye do it?"

    "Such visually guided growth might go awry if most objects
viewed are nearby, as with children who read a lot," Wallman and
McFadden wrote.  "In this situation the eye might elongate to
maximize the sharpness of most contours on the retina, resulting
in myopia." Several studies have shown a correlation between
myopia and educational level or amount of reading.  Eventually,
they wrote, the insights into the system of compensation that
helps fine-tune the eye's development "may lead us to a way of
preventing myopia entirely."

On Jun 27, 12:45 pm, "otisbr...@pa.net" <otisbr...@pa.net> wrote:

On Jun 27, 12:45 pm, "otisbr...@pa.net" <otisbr...@pa.net> wrote:

maybe someday there will be an effective form of prevention.  at that
time, we will discuss it with out patients.  right now, there's nother
to discuss.

but Chung et al. (Chung K, Mohidin N, O'Leary DJ. Undercorrection of
myopia enhances rather than inhibits myopia progression. Vision Res.
2002, 42: 2555-9.)  demonstated that undercorrecting myopia with
weaker minus lenses actually accelerated the development of myopia.
and why do you say that we "all know something about the bad effects
of minus lenses"?  there are no bad effects.  prove that there are-- I
have proof that there aren't!  and lets stick with humans and not
chickens or monkeys!  and lets stick with real scientific studies and
not cherry-picked individual success stories.

no optometrist gives a kid wtih 20/40 vision -2 or -3 lenses.  quit
exaggerating Otis.
and there are lots of ways to get 20/40 vision rather than
nearsightedness.  what about astigmatism or hyperopia or amblyopia.
you like to keep the situation simple don't you Otis?  thats where you
can sort of keep up.

prove to us you are an engineer.  i seriously doubt it, unless
dementia has affected your rational judgment.

indeed there ARE two conflicting approaches involved.  one that relies
on proof of efficacy and science.  and another approach that asks
people to accept unproven ideas sole based on faith while having no
regard for the fact that the treatment they propose can actually (and
HAS actually) brought harm to innocent people.

Dear Scott,

Subject: proof

I would be most grateful if you would allow me to
continue to propound "Straw Man" arguments,
attributing things to people that they DID NOT
say, and then arguing against them.

Would you mind?

Best,
Old_A$$ Brown

Dear Scott,

Scott, please read my words carefully.  I SUGGEST that
is MIGHT be possible to avoid ENTRY in a negative
refractive STATE for the fundamental eye.

This is the issue of testing a population of fundamental
eyes to determine if they are DYNAMIC or not.

It is not an issue to "cure" anything at all.  The issue
is a question of precedence.

Scott> No, you haven't.  You have heard "prove it" when you assert
that wearing a
positive lens can arrest the progression of myopia.

Scott, it is not my intention to arrest "progression".  It is rather
that the person avoid ENTRY into a negative refractive STATE
for his natural eyes.

If you learn to respect the proven behavior of a population
of natural eyes (in terms of refractive STATE), our
converstations might improve.

But that requires more abstract reason and logic to
understand these issues.

Enjoy,

Otis

Otis Brown,

I think these questions are key.  I too would like to see you respond
to them.  Please do not change the subject and talk about Dr.
Raphaelson or some other BS.  Speak directly and answer directly
please.