Dear Prevention minded friends.

Subject: Summary and commentary on historic prevention
with the plus -- at the threshold.

Ret> I have serious doubt that a kids vision will go down by 1/2
diopter per year once they are given minus lenses. Show the evidence
for that in humans. I will show you the evidence that it is not true
in a second posting.

Otis> Oakley-Young study showed taht the single-minus
went "down" at -1/2 dipter per year, the "plus" went
down a zero diopters per year.

Ret> ...and no eyedoc over-prescribes minus. we give just enough to
get the patient to see 20/20.

Otis> I have verified cases where the person passes
all legal visual requirement for visual acuity -- and
was PRESCRIBED a -2.0 diopter lens. That, my friend,
is gross over-prescription.

Otis> It is clear that if a child lets his vision go below 20/40,
> and gets down to 20/70, then a minus lens must be used. But,
> given the facts we have now, that can only be the result of the
> person's neglect of using the plus lens, when necessary to clear
> back to 20/40 or better.

Ret> What facts do you have now that proves intervening
with plus lenses on a myope will cause their myopia to be reduced.
Please produce me the facts (in humans, a statistically-valid
population study).

Otis> See below.

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


Retinula asked for proof that a "highly intelligent" person
who would VERY agressively work with the plus -- could clear their
vision to pass all legal visual-acuity requirements.

In the "bi-focal" study, a WEAK 1.5 diopter plus was used,
and the "plus" was not used agressively -- so this was not, nor
could it ever be, a true test of the PEVENTIVE effect of a strong
plus, on the order of +2.5 to 3.0 diopters (to be used at the
20/50 level.)

It is obvious that, if there is no personal commitment in
wearing the plus -- there is no solution.

It person does not have much interest in "protecting" his
distant vision -- it is obvious that he is going to lose it.

Best,

Otis

_____________________________________________________


Dear Friends,

This was written about 100 years ago.

Chalmer Prentice, M.D. may have not got everything right (no
one ever does) but he got this part right.

The difficulty is not the statement of what is necessary. It
is in helping the person develop the knowledge and
force-of-character to successfully implement his prevetive methods
-- before his eyes "adapt" to that minus lens.

Today a great mass of explict DIRECT factual data spells out
the true effect that both a "confined environment" AND a minus
lens ultimately have on the eye.

What have we on i-see about this preventive method?

Best,

Otis

_____________________________________________________


Excerpt

From Chalmer Prentice


The foregoing in connection with limited tests of more than
two hundred similar cases suggests an answer to that most
important question, 'What shall we do to prevent myopia in school
children and students?'

[Comment: These were cases where the person cleared his vision
with the plus. OSB]

In a nomad, who is reared out of doors, who follows such
pursuits that his vision is mostly used at twenty feet and greater
distances, the nerve-impulses to the ciliary muscle become
established so that the easiest vision is for the far point, and
in many years of such use, these impulses become more or less
fixed; while the child of a higher civilization spends its life
within doors, amuses itself with toys, picture books, kindergarten
amusements and learning to read.

We will assume that such a child generally holds its book or
toy ten inches from the eyes, in which case the crystalline lens
requires a much greater convexity, or higher state of refraction
to bring about perfect vision; and this is brought about by an
increase in the ciliary nerve-impulse which contracts the ciliary
muscle. Through long continued use, this excessive impulse
becomes comparatively fixed, and in some instances refuses to
suspend itself sufficiently to bring about distant vision again,
and so myopia has set in.

The regular work of the student and those other pursuits
which require the use of the eye at the near point, tend to
perpetuate this disease and make it progressive.

Again, the important question, 'How are the advantages of a
high civilization to be attained wihout the foregoing
disadvantages?' If the eyes are to be used at a distance of ten
inches, aid them artificially by a ten inch magnifying glass; then
the nerve-impulses to the ciliary muscle will be no more than if
the patient were leading an outdoor life and viewing objects at
twenty feet or more. The nerve-centers are not called upon for so
excessive an impulse, and they become habituated to sending the
same amount of nerve-force as if an outdoor life were led.

In conjunction with this artificial aid to the ciliary
centers, it may be found advantageous to suspend, in a measure,
the excessive nerve-impulses to the interni, by the use of prisms,
base in. Under these artificial conditions, the eyes may be used
in the attainment of all the advantages of the highest
civilization while the nerve-centers are no more taxed than if out
of door pursuits were being followed.

If the little student at school or any other person using the
eyes at the near point, were to be supplied with such glasses
during the hours of study, on leaving the school room they could
be taken off and the natural use of the eye at all other times
would be quite sufficient to cultivate and establish the habit of
accommodation. At least the danger of disturbing the
accommodation would be much less than the dangers resulting to the
eyes and nerve-centers without such aid.

I simply suggest the above as a possible answer to one of the
most important questions of the day.

[The partial Chapter is printed below. OSB]

The Eye in its Relation to Health

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

By Chalmer Prentice, M.D.

Chicago, A.C. McClurg & Company, 1895

Transcription (c) A. Wik, 2004

----------+ | Chapter IX | +--------


Chalmer> The following are some very interesting experiments in
myopia which can be verified by any operator, and which
prove that refractive myopia depends on ciliary spasm,
and that, even in axial myopia, considerable repression
can sometimes be made at the near point.

[Comment: By "repression", Chalmer means that the refractive
power of the internal-lens can be changed by an external
plus lens. By "refractive myopia" Chalmer is talking
about "pseudo" myopia where the eye has a negative
refractive state as measured with an eye-chart
and trial-lens kit and frame.

Chalmer> In either class of cases, repression must be made at the
near point.

[Comment: The "near point" must be moved "optically" out to
infinity with a strong plus, thus removing the
"repression". OSB]

Chalmer> In various lengths of time, we shall be able to reduce
the myopia one or two dioptres, sometimes more.

[Comment: In current parlance, clearing vision from -1.0 diotpers
(20/60) to better-than 20/40. OSB]

Chalmer> In most cases satisfactory results will require
considerable time and patience; but a few experiments
after the following example will suffice to show that in
some very advanced stages of myopia, it is possible to
suppress, or at least check, its onward course by
repression at the near point.

[Comment: I would think that the goal should be vision-clearing
from -1.0 diotper to normal. Un-doing stair case caused
by an over-prescribed minus has proven to be almost
impossible. OSB]

Chalmer> This fact renders the fitting of minus glasses to myopic
eyes an open question.

[Comment: The facts of the Oakley-Young study makes this a
virtual certintity. AT THE VERY MINIMUM, THIS MAKES
PREVENTION A VALID "SECOND-OPINION" with the above
"accepted" limitations. OSB]


EXAMPLE CASES


Chalmer> Age forty-three; myopia; had been wearing over the right
eye -1.25 D, left eye -1 D, with little or no change for
the space of two years; eyes in use more or less at the
near point. I recommended the removal of the concave
glasses for distant vision and prescribed +3.50 D for
reading, writing and other office work.

[Comment: Perhaps a little strong. Dr. Colgate used a +2.5
diopter lens to clear his distant vision from 20/70 to
20/20. OSB]

Chalmer> After reading in these glasses for several days, the
patient was able to read print twelve inches from the
eyes.

[Comment: The focal length of a +3.5 diopter lens is
approximately 12 inches. The eye's adjusted favorably
to the applied plus. OSB]

Chalmer> This patient was of more than ordinary intelligence and
understood the aim of the effort.

[Comment: Absolutly crucial. If the person does not understand
the purpose of true-prevention, then effective
prevention is not possible. OSB]

Chalmer> In six months I changed the glasses for reading and
writing to a +4 D without seeing the patient. After
using the +4 D glasses for several months he again came
under my care for an examination, when the left eye gave
twenty-twentieths of vision, while the right eye was
very nearly the same, but the acuity was just
perceptibly less.

[Comment: This is a superior result. It is considerably above
the DMV requirement of 20/40 or better. OSB]



+++++++++++++++++++++++++++++++++++++++++++

Chalmer> Similar results have been attained in 34 like cases;

Chalmer> ...but the process is very tedious for the patients, and
unless their understanding is clear on the subject, it
is almost impossible to induce them to undergo the
trial.

[Comment: I have no doubt that others at -1.0 diopter and 20/50
could accomplish this result -- if they could over come
their "fear" of using the plus strongly and correctly.
OSB]

++++++++++++++++++++++++++++++++++++++++++++++++++

[Comment: Anyone considering "prevention" must understand this
issue. There is no "easy way" of prevention. As
Chalmers said -- the person must fully understand this
issue. It is for this reason that I suggest full
transfer of "control" to the person himself. If he
lacks the motivation to look at the chart, and "clear"
himself, then no "third party" (i.e., OD) can do it for
the person. This is why I separate a true-medical
problems from preventing a negative refractive status in
the natural eye. I believe that the above statement
simply clarifies that point. OSB]

[Comment: It is of major significance that this proof was
established 100 year ago. There has been NO follow up,
and no meaningful review. It has been established that
when a minus lens is prescribed for a young child -- his
vision goes down at an AVERAGE of -1/2 diopter per year.
Almost all children go through this -1 diopter (20/50)
stage -- yet NO ATTEMPT is made at prevention at that
stage when it could be completely successful. But as
Chalmers said, the process is "tedious for the patient".]

[Comment: Is true prevention worth the "tedium" of
clearing your distant vision with the plus -- before it
is too late. Obviously, Dr. Colgate, Keith,
Captain Fred Deakins, David DeAngelis, and others
have thought so. Something to think about.]

[Comment: If you consider "clearing your vision with
the plus "tedius", then you will not even make an
attempt -- and you will never know. Don't wait
for Retinula to offer you any preventive help.
Looks like you will have to do it youself -- under
YOUR OWN CONTROL. While Retinula is waiting
for hell to freeze over, maybe you can take
plus-prevention and do it youself. I don't
think he leaves you any choice. OSB]