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Dear Reader,

Subject:  Remarks on Joy's visual experience with the
         PREVENTIVE plus -- through the college years.

Re:  As posted on Steve Leung's site.

Reference:  The natural eye's response to 12 years
in a school enviroment.

http://www.geocities.com/otisbrown17268/DynamicEye.html

    Because of conversations with Dr.    Jacob Raphaelson, it was
rather clear the plus-prevention will require considerable effort
by the person interested in keeping their vision clear through the
school years.

    The established DOWN rate (for the un-protected eye) is a
standard -1/2 diopters per year.

    Thus, if you are SLIGHTLY negative at age 13, and do NOTHING
for protection or prevention, you refractive STATE will go down as
long as you are in a "school" environment.

    Joy did well in high school, college and graduate school.

    And that meant a graduating age of 25 years of age.

    Or 12 years of schooling.    Thus, 12/2 = -6 diopters of myopia
ON THE AVERAGE.  And the "standard" translation to the Snellen,
with -1 diopter clearing the 20/20 line from 20/70, would mean a
-6 diopter would be about 20/240.  Legal blindness is about
20/200.  Thus she would have been FUNCTINALLY BLIND with no
glasses -- had she not worn the plus through these 12 years of
school.

    Joy obtained a weak minus for driving a car.  But
she never wore the minus, for other than that reason.

    Her Snellen was about 20/40 to 20/50, and she is content
with this level of visual acuity.  I do not think she
has worn the preventive plus in the last 10 years,
and little interest in using the plus.

    As most optometrist will tell you, a SLIGHT negative
refractive STATE, is of considerable value to a person her age.
Since she is not a -6 diopter myope, with 20/240 vision (which
would force her to wear that wretched minus PERMANENTLY for the
rest of her life -- I think she is a major success.

    In fact, I have suggested that she continue as she is, and
not wear the plus, UNLESS she has a strong motive to clear the
20/40 (or better line).  And that is an honest choice of
alternatives for her.

 Here is her commentary:

    Steve

    www.chinamyopia.org

    Here is some more commentary from my niece on her use of the
plus lens.

    Best,

    Otis

    ********

    Uncle Otie,

    The e-mail message that I wrote below is evidence of how
behind I am.  It was an answer to the e-mail Alison Dall had
written to me almost three years ago.  It's embarrassing that I
never responded to her.  I wrote the e-mail below but never sent
it!  Her e-mail address is at the end of the message.

    Have you kept in touch with her?  I could send it now.  I
hope she didn't give up on having her son use the glasses.

    In any case, this information might be helpful to Steve and
perhaps for your records.

    One thing I would add in the way of advice is that it has
been very helpful for me to have several pairs of glasses so I
have them handy in places where I usually read.  I also sometimes
can use different diopters that way.  I should get a pair with
less diopters to use at the computer.  I would think that for
children it would be especially important to make sure that the
diopters fit the work, without making it too hard or easy for the
child to see and to make sure the glasses don't interfere with
their work or play.

    The other thing I didn't mention in my unfinished e-mail was
that the first time I started using a computer for several hours
on a daily basis (while doing an internship without using plus
lenses), I noticed my vision got worse very quickly, probably
within a couple weeks.

    Here's the e-mail I was going to send 2-3 years ago!  (I only
corrected typos, so my job and age information are not
up-to-date.) Joy

    Subject:  RE:  Plus Lenses for Myopia

    Dear Alison:

    I'm sorry I didn't get back to you sooner.  I realize this is
an important decision for you and your son.

    I am Otis Brown's niece.  Thanks to him, I have been wearing
the plus lenses since fifth grade.  I am now 32 and was very happy
to pass my driver's license eye exam once again this July (though
because the vision in my left eye is not so good, I just got a
restriction--I must have a rearview mirror on the left side, which
is standard for most cars, anyway).

    As I know my uncle has expressed to you, finding the
motiviation to wear plus lenses while reading is not so easy, and
I think it might be especially hard for a younger person.  Even
after more than 20 years of wearing the plus lenses, I struggle to
do so consistently.  But I'm happy that I have the choice of
whether to wear glasses or not.  There's no doubt in my mind that
I would have to wear glasses or contacts all the time if I had
started wearing negative lenses more frequently.

    Perhaps knowing some of my history will help you to guide
your son:

    When I started wearing the plus lenses in fifth grade, I was
a little bit shy.  The glasses, as a new item, called attention to
me.  The fact that they were different than regular glasses meant
that I might have to explain why I was wearing them.  At the same
time, I think some of my friends thought they were kind of cool.
I can't remember how often I wore the glasses.

    In junior high and high school, I continued to wear the
galsses on and off.  My memory is a bit vague, but I assume, as
has been my trend, I wore the plus lenses more at home than at
school.  Perhaps participation in sports helped me to maintain far
vision, but because my studies were very important to me, I always
read a lot.  (I also had the advantage of not growing up using a
computer; I believe computers can ruin your eyes very quickly.)

    In college, I continued with tennis, but I had trouble seeing
the chalkboard, so I got negative lenses.  (Again, my studies were
important to me and my mother wears glassses and doesn't mind it a
bit, so she did not pressure me to wear the plus lenses.)
Nevertheless, I rarely wore the negative lenses, and I continued
to wear the positive lenses (in part due to the encouragement from
my uncle).  Even my memory of plus-lense use in high school and
college is a bit vague, probably because I've never been very
strict about wearing the lenses every single time I sit down to
read.

    Partly it's hard because it's easier for me to read without
the lenses.  (In order to improve my vision, I try to read at a
distance that will slightly blur the text, but without glasses I
see the text clearly.) Also, my glasses always have to be at hand.
Even at home, I don't always read in the same place, so it's an
extra step to get my glasses before I read something (and oten I'm
just reading short items--letters, articles, etc.--so it's easy to
think that a little reading without glasses won't hurt).

    After I finished college, I continued to do work that
required plenty of reading.  (I did a master's in Spanish
literature and a certificate program for translation, among other
things.) Currently I work as an editor and it is a big challenge
for me to wear the plus lenses, but all the more crucial.  I sit
in front of texts and the computer eight hours a day.  Because I
can't afford to slow down my work, and because the many texts
(including the screen) that I look at are at all different
distances, I am not able to wear the plus lenses much of the time.
I still have my negative lenses from college, but I only wear them
when I feel it's absolutely necessary--mainly if I'm driving in an
unfamiliar place or if I'm at a workshop and need to see at a
distance.  I haven't tested my eyes since before I took my
driver's exam, but I know my vision is not as good as it oculd be.
I still need to work on wearing the plus lenses every time I
possibly can.

    Subject:  Plus Lenses for Myopia

    I got your e-mail number from Otis Brown's mailing list.  Do
you have an interest in using plus lenses to help myopia?  I would
like to try to help my son but would like to speak to anyone who
has already tried or is considering using this method.

    Regards,

    Alison Dall

    Subject:  Fw:  Thanks for write-up

    Dear Steve,

    Here is my response to my niece -- for your reference.

    Best,

    Otis

    *****

    Dear Joy,

    Thanks for your review of your use of the plus lens.

    I think you did exactly what was necessary.

    What you have avoided is about -5 to -7 diopters of myopia or
(20/350 to 20/490) vision.  If you want to know how your vision
would have looked, get a +3 to +4 diopter plus lens and look
through it at distant objects.    That is how your vision would have
become -- only worse.

    I know you might not believe it, but it is the truth.

    We always have problems with prevention -- but you managed to
overcome them.

    The use of a mild minus lens for night driving is reasonable
-- because the eye will take on a more negative focal state at
night But you are also wise to remove them as soon as you do not
need them.

    I do not know what happened to Alison Dall.  People will
"flash" enthusiastic, and then will quit after one or two weeks.

    It takes strong judgment to continue the process to be
effective for the long-run, as you have done.

    I sent your email to Steve Leung -- for his reference.  I
wish him well with the effort, but success depends on the quality
and insight of the person who is able to use the plus lens for the
long-term.  He has a daughter, and perhaps she will be able to
learn from her father.

    Again, thanks for your effort with the plus lens.    I wish I
had had the intelligence, motivation and insight to make the plus
lens approach effective for myself at very young age.

    Love,

    Otie