none of us could blame Raphaelson for being wrong.  all the research
that has accummulated wasn't available when he wrote what he did.

really?  how do you think the Oakley-Young study says anything about
that.  the OY study compared using bifocals to using single-vision
spectacles in a population of children who were mostly near-point
esophores.  it didn't test "the plus".  it didn't prove anything about
"the wretched minus" causing staircase myopia.  it just tested using
bifocal adds in the kids glasses or not.  why do you keep
over-interpreting the results of the OY study?  have you read it?  is
your mind not able to access valid conclusions that can be drawn from
such a study?

is this the closest second-opinion optometrist to wear i live?  there
must not be very many SO optometrists.  i've never met one.  do they
all live in china or something?

Dear AceMan,

Thanks for the "vote of confidence".

It is clear, from the statement of Jacob Raphaeson (The Printer's Son)
that even the most dedicated optometrist could not help the
public with true-prevention with the plus.  Thus the rather
violent "turn down" of the plus by the parent ensured that
the child could get NO PROTECTION OF HIS DISTANT
VISION FOR LIFE.

It is clear from the Oakley-Young study, that if PREVENTION
is desired, then the "plus" must start no later than the
20/60 stage (-1.25 diopters).

Clearly this must be considered an "either-or" choice, again
given the objective facts of the Oakley-Young study.

But, given "The Printer's Son", and the fact that a strong
minus works "instantly" it is hard to see how plus-prevention
could ever be implemented -- except by a parent who is "educated"
in this matter (as the second-opinion) and is willing to help
his child in the use of the preventive-plus.

In any event, at least you will be prepared to work with
second-opinion (preventive) ODs like Steve Leung
when your child's vision starts going below 20/50 on
the Snellen.

www.chinamyopia.org

Best,

Otis

I agree totally, Otis! The responsability rests on the parents and
ultimately on the child. Had I been told about the plus lens, I would
have chosen it. I had no knowlege, no one told me. So I wore the minus
lens and developed stair-case myopia. To this day, most people have no
knowlege of myopia prevention so they fall victim to the wretched minus
lens then get stuck with it for life(unless they risk their eyes with
lasik)

Pot, meet kettle.

-MT

Yes, "L", I understand you quite well.  And I think this describes
your "vision" of yourself and what you think and do:  If you
just admit that the public will REJECT the preventive plus -- if
you were to attempt to offer it -- that would be a major
step forward.

    Every man takes the limits of his own field of vision for the
limits of the world.

    Arthur Schopenhauer

    "I know that most men ...  can seldom accept even the
simplest and most obvious truth if it be such as would oblige them
to admit the falsity of conclusions which they have delighted in
explaining to colleagues, which they have proudly taught to
others, and which they have woven, thread by thread, into the very
fabric of their lives."

    Leo Tolstoy

    Men live by their routines; and when these are called into
question, they lose all power of normal judgment.  They will
listen to nothing save the echo of their own voices; all else
becomes dangerous thoughts.

    Harold Laski

    Imagination is more important that knowledge...knowledge is
limited but imagination circles the world.  To see with one's own
eyes, to feel and judge without succumbing to the suggestive power
of the fashion of the day, to be able to express what one has seen
and felt in a trim sentence or even a cunningly wrought word...is
that not glorious?  When I examine myself and my methods of
thought, I come close to the conclusion that the gift of
imagination has meant more to me than my talent for absorbing
absolute knowledge.

    Albert Einstein

As always, enjoy our discussion of an accurate analytical model
for the proven behavior of all fundamental eyes.

Best,

Otis

++++++++

The only limits on optometry are the current state of knowledge, the
technology, and the ability of the curriculum to squeeze it all in.

I think everybody knows what your limitations are.

DrG

Dear Bill,

Subject:  The scientific secoind-opinion

    Some remarks:

1.  Optometry REACTS to people -- with a minus lens.  (Completely
    understandable and reasonable.)

2.  The minus lens is EASY to apply.  You just sit a person in a
    chair, put up a Snellen, and show that a minus lens
    "sharpens" the Snellen.

3.  There is some check for "medical" issues (like RP and
    glaucoma) but the minus is indeed impressive, and if you only
    have 10 minutes with a person, and the person EXPECTS the
    minus lens -- what else can you do?  The minus requires no
    discussion, no review, no decision or choice by the person.
    Just the obvious fact that the minus "works" -- and that is
    it.

    ++++++++++

    I think that is a fair argument FOR THE MINUS.  The ODs can
and SHOULD make that argument -- that they are LIMITED by what the
public expects, and indeed what works INSTANTLY -- and that is the
only thing that the public will understand and ACCEPT.

    But the larger issue is this -- does the FUNDAMENTAL EYE
change its refractive STATE from a positive value to a negative
value -- when there is a negative change in the eye's average
visual environmet?

    This is were these ODs go into a profound DENIAL state of all
objective science and facts.

    I RESPECT (and expect) a population of fundamental eyes -- to
be dynamic systems.  (i.e., control systems)

    So I test the entire population of eyes, to find out if the
refractive STATE of these eyes will CHANGE their refractive STATE
when a -3 diopter lens is applied.

    From a review of that type of "direct-science", you can pose
the following test, of the OD's "majority-opinion", and call it
the "null" hypothesis -- which is that the fundamental eye is NOT
DYANMIC (in the above sense) and THEREFORE MUST NOT CHANGE ITS
REFRECTIVE STATE -- WHEN YOU PLACE A -3 DIOPTER LENS ON IT.
Retinula has insisted MANY TIMES that the natural eye is NOT
DYNAMIC, and that there will be NO CHANGE in refractive state of
the -3 diotper test group.

    From long review of this type of scientific testing of the
natural eye -- it is virtually certain that the -3 diopter group
will change its refractive STATE by greater-than -2 diopters in
one year.

    If you are a scientist -- you should take the results of this
OBJECTIVE, TESTING SERIOUSLY.  The only request I have is this --
please use the term refractive STATE, where the test is to
determine IF THE FUNDAMENTAL EYE IS DYNAMIC -- OR NOT.    Retinula
does not like the IMPLICATIONS of this test -- so he denies the
science of it.

    As far as I am concerned -- that resolves the scientific
issues -- and answers the question of "The Printer's Son".  There
is a profound difference between dealing with the public (off the
street) where ONLY A MINUS LENS "WORKS", versus dealing with the
scientific issue of determining if the fundamental eye IS, and
PERFORMS as a dynamic system.  The descriptive words we use
concerning the SCIENTIFIC experiment are critical.  DO not use the
word ORGANIC DEFECT to describe what is characteristic and natural
behavior for the fundamental eye.

    Maybe this is too abstract for the M.O.  ODs on
sci.med.vision.  They obviously do not understand the concept at
all.

    Some more commentary:

Bill> Has such behavior been factored into the various
    experiments?

Otis> No, the M.O.  ODs ignore both the question, and the
    scientific testing -- and results.  They are only interested
    in finding a quick-fix that impresses the public instantly --
    and nothing beyond that point.

Bill> The way kids, with or without glasses, are not observed
    during a refraction session.

Otis> NO M.O.  OD PAYS ANY ATTENTION TO HOW THE KIDS USE THEIR
    EYES.  I perceive that issue as critical.    The NATURAL EYE
    will in fact change its refractive STATE to REFLECT its
    average visual environment.  Because they do not wish to get
    involved in that type of SCIENTIFIC REVIEW AND DISCUSSION of
    the objective facts -- proving THAH type of typical behavior
    for the natural eye.  That is why we are having this impasse.
    That alse explains the need for a second-opinion -- and your
    knowledge of it.

Bill> There is more to good visual hygiene than merely telling a
    kid to use glasses only for seeing the blackboard.

Otis> You bet there is.  But the real issue is this.  Who is going
    to discipline the kids, to follow the instructions?  The ODs
    are not going to do it -- it's not their job.  The "control"
    would be the responsibility of the parents to INSTRUCT the
    kids in these preventive methods -- to include the "plus"
    when necessary.

Bill> Moreover, is a kid going to remove his/her glasses when
    going from reading the blackboard to writing into a notebook.

Otis> Assuming the kid still has 20/40 to 20/50, the real question
    is this -- will the kid put on a +2.5 diopter for all reading
    -- and WAIT for his Snellen to clear to better than 20/40 --
    as parent of a visual hygiene process.  Obviously some
    engineer-parents have INSISTED their kids do EXACTLY THAT --
    and the kids refractive STATE does not go from plus to minus.
    i.e., they avoid entry into myopia.;

Bill> If you think so, you do not know kids and have forgotten
    your own childhood.

Otis> I certainly remember doing it as kid.  But I was told that
    "environment" had not connection with the refractive STATE of
    the eye.  So I kept on doing it.

Otis> Only as an engineer did I find out that it was established
    that the refractive STATE of the fundamental eye FOLLOWS that
    applied minus lens.  So for PREVENTION to develop -- we must
    first RESPECT the fact that the fundamental eye is proven to
    be dynamic, and that a slight negative refractive state --
    can be prevented if a plus is aggressively used at the
    critical 20/50 to 20/60 level.

Just one man's opinion.

Otis

Bill