Shotwell.txt
Sh

Dear Donald,

Subject: The "use" of the Shotwell study.

Would you be interested in a copy of this study? Please let
me know. (Are you at the Florida address?)

I of course agree with you that nearsightedness can be
prevented with a plus.

However, what the OD or MD will do is to point to this
"Shotwell" study and say, "...see we already attempted to do what
you ask, and it FAILED COMPLETELY. Go away and do not bother
us anymore."

As far as I am concerned the "Shotwell" study is "false" for
a number of reasons. But the biggest reason is that their idea of
ensuring "compliance" was to have the "midshipman" MAIL IN A POST
CARD EVERY SIX MONTHS!

Further, of about 240 starting, only about 20 remained in the
various groups. It is obvious that no one gave a damn -- or knew
what the hell was going on -- and certainly not the "midshipmen",
since this was a "blind" study.

The only real "counter" you have to this incompetent study is
the Young-Oakley study, which showed what could be the effect of
an intelligently used plus -- at the threshold.

Here are the remarks of the "majority opinion" OD, Retinula,
for your interest. This will most likely be the "position" of the
FDA or NEI, if they become involved. Your lawyer should be
supplied with these publications for his interests. (Just my
opinion.)

Best,

Otis

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

Discussions on i-see.

Subject: Discussion of the Shotwell study and the Oakley-Young
study

From: <i-see@yahoogroups.com> To: <i-see@yahoogroups.com>
Subject: Digest Number 1709 Date: Thursday, December 15,
2005 7:17 AM

There are 16 messages in this issue.

Topics in this digest:

1. No change in refractive error at the Naval Academy. No effect
of plus lenses. From: "retinula" <retinula@...>

3. Re: No change in refractive error at the Naval Academy. No
effect of plus lenses. From: "Otis S. Brown"
<otisbrown@...>

4. Re: No change in refractive error at the Naval Academy. No
effect of plus lenses. From: "Otis S. Brown"
<otisbrown@...>

5. Re: No change in refractive error at the Naval Academy. No
effect of plus lense From: "retinula" <retinula@...>

6. Re: No change in refractive error at the Naval Academy. No
effect of plus lenses. From: "Otis S. Brown"
<otisbrown@...>

7. Understanding the SCIENTIFIC BASIS for the preventive
second-opinion From: "Otis S. Brown" <otisbrown@...>

9. Re: No change in refractive error at the Naval Academy. No
effect of plus lenses. From: "drjudy65"
<mpace99@...>

10. Re: No change in refractive error at the Naval Academy. No
effect of plus lense From: "retinula" <retinula@...>

11. Re: Understanding the SCIENTIFIC BASIS for the preventive
second-opinion From: "retinula" <retinula@...>

13. Re: Understanding the SCIENTIFIC BASIS for the preventive
second-opinion From: "Otis S. Brown" <otisbrown@...>

_________________________________________________________

Message: 1 Date: Wed, 14 Dec 2005 12:10:16 -0000 From:
"retinula" <retinula@...>

Subject: No change in refractive error at the Naval Academy. No
effect of plus lenses.

Otis> What concerns me is that he completely understand the
records at West Point, that the "un-protected" eye will go
down by -1.3 diopters average (-1.6 diopter max).

Ret > Once again, you have picked a single study that argues your
point of view.

Otis> The above statistics for the behavior of the natural eye are
NOT THE RESULTS OF A SINGLE STUDY! They are the results of
the collection of all the records of ANY four year period
of time. The same "down" rate was seen at the Naval
Academy at Annapolis.

Ret > Do you really want us to believe that everyone's vision
"goes down" by 1.3 - 1.6 diopters (per year, or per 4
years, or what?).

Otis> Notice, Retinula can never get this RIGHT! It is that the
AVERAGE down rate was -1.3 diopters, with the "spread)
being -1.1 to -1.6 diopters per ANY four year period of
time were ALL refractive data is maintained. It is this
self-serving "fibbing" that bothers me the most.

Otis> I have seen a lot of self-protected distortion -- but
Retinula "makes up" what he wishes to believe as he goes
along.

Ret > Regardless, you are wrong.

Otis> After grotesquely distorting scientific truth, Retinula no
promotes his "position".

Ret > Here is a study from the Naval Academy at Annapolis that
examines refractive changes in cadets over a four year
period as well as the effects of plus lenses and bifocals.

Otis> I have reviewed some of the reports of this study. I
personally suspect it was poorly run, and there was minimum
compliance with the "protocols".

========

Am J Optom Physiol Opt. 1984 Feb;61(2):112-7.

Plus lens, prism, and bifocal effects on myopia progression
in military students, Part II.

Shotwell AJ.

Military academies routinely lose a percentage of their
pilot-qualified students to myopia during the 4-year academic
program.

This study investigated the progression of myopia during such
a program and evaluated the usefulness of reading glasses to
prevent myopia progression and subsequent acuity loss.

A group of students at the United States Naval Academy
comprised three randomly divided groups:

a placebo group (no. 1 pink tint), a plus with prism group
(+1.25 D with 2 delta base-in each eye), and

a bifocal group (+1.50 D near addition).

All the lens powers were relative to the experimental
subject's distance refraction and were for use full-time when
reading.

The pre- and post-test refractive errors at distance were
determined using 1% tropicamide HCl.

At the end of 4 years, the tropicamide refraction showed
approximately -0.25 D of myopic shift in all groups.

There were no significant differences between the myopic
shifts in the controls and experimental groups.

______________________________________________

[Comment: Given that the midshipman sent in "postcards" every six
months, I doubt that there was much if any "compliance". To
draw "long" conclusions from this is not even reasonable.
Yet this "study" is used to completely DENY the results of
the Oakley-Young study. OSB]


Ret > See Otis, no mass migration toward myopia. No effect of
plus lenses.

__________________________________________________________

Message: 3
Date: Wed, 14 Dec 2005 14:20:17 -0000
From: "Otis S. Brown" <otisbrown@...>
Subject: Re: No change in refractive error at the Naval Academy.
No effect of plus lenses.

___________________________________________________________

Message: 4 Date: Wed, 14 Dec 2005 14:23:15 -0000 From: "Otis S.
Brown" <otisbrown@...>

Subject: Re: No change in refractive error at the Naval Academy.
No effect of plus lenses.


Dear Andrew,

Subject: Conflicting studies of the dynamic behavior of the eye.

Re: The "plus" studies.

Francis Young is a friend. I wished to know him personally
-- to know if I could trust him.

The so-called bi-focal studies are very difficult to run.

Retinula loves to cite "failed" studies the were run by
optometrists -- with a desire to maintain the "status-quo". In
other words -- be careful of studies were the "foxes" are in
control of the chicken coop. A word to the wise.

More later.

Otis

---------------------------

From Andrew,

Retinula

That Shotwell study keeps on being trundled out:-)

One day there will be a truly open minded examination of
these kinds of populations to see what is different about each
group.

This open minded examination will not exclude things like
religious preferences or if they took vitamins and so forth,
because to exclude that would be narrow minded.

But until such day as open mindedness is allowed in
scientific examination of vision problems we can expect to hear
that 'myopia is incurable'

after all the number one thing that has to be discounted at
all costs is that vision problems arise from family influences or
a mind under strain! to allow such things would be heresy!
Better to allow ritual sacrifice than to allow such obscene ideas!

Andrew
___________________________________________________________

Message: 5 Date: Wed, 14 Dec 2005 14:27:14 -0000 From:
"retinula" <retinula@...>

Subject: Re: No change in refractive error at the Naval Academy.
No effect of plus lense

Retinula to Andrew statement:

I do not disagree with what you are saying. I do not have
the "answer" to myopia prevention. but i can say one thing
without a doubt -- it is not plus lenses. if it were, then a large
majority of the studies that have examined "the plus" would
produce positive results rather than the opposite!

as you imply, maybe a combination of factors, some of which
we don't even understand yet, are involved. one needs to be open
to all the possibilities and then to test them ruthlessly without
biased once a model is arrived at.

and quite possibly the answer could be that no
environmental/psychological/organic changes that a person could
make could affect myopia development. you too should be ready to
accept that conclusion if the data shows it!

and you know of course that i could trundle out many more
studies than Shotwell. i just chose that one because it was at a
military academy involving pilots (uncle otis' favorite) and it
specifically tested plus lenses. as i said above, if plus were
indeed the answer then that study would have produced a different
result -- but it didn't. so a rational person would reevaluate
their plus lens theory, but not -- well, nevermind.

Retinula OD
________________________________________


Message: 6 Date: Wed, 14 Dec 2005 14:32:42 -0000 From: "Otis S.
Brown" <otisbrown@...> Subject: Re: No change in
refractive error at the Naval Academy. No effect of plus
lenses.

Dear Andrew,

Subject: Retinula will ALWAYS be majority-opinion "selective" in
the studies he cites.

Since there is no "arguing" with Retinula, and he is totally
blind about the proven dynamic behavior of the natural eye, I
would suggest recognizing the type of "bias" he represent.

Myself, and other ODs will report the Oakley-Young study,
that was better organized and controlled, that demonstrated that a
strong-plus, used systematically has the effect of stopping
refractive movement in a negative direction.

The "plus" group went down at 0.025 diopters (virtually zero)
while the full-minus went down at a rate of -0.53 diopters per
year.

So rather than attempting to deal with Retinula's intense
bias, the better idea is to simply state the second-opinion, and
the basis for it.

But the real "test" of an optometrist in reviewing these type
of studies, is the judgment of a parent who has HIS OWN CHILD at a
refractive state of zero diopters.

What to do?

Given the he can only "control" his own child, then the ONLY
prevention he can conduct is to put his own child in a strong
plus. This is the real "measure" of a competent "second opinion".

This is of course what Steve Leung is down with his own 5
year-old daughter.

We can "learn" from this -- or ignore it. But at least you
should be aware of this type of second-opinion judgment.

Best,

Otis

_______________________________________________________

From: "Otis S. Brown" <otisbrown@...>

Subject: Understanding the SCIENTIFIC BASIS for the preventive
second-opinion

Dear Prevention minded friends,

Subject: Second-opinion on preventing negative refractive states.

I suggest that there is a profound difference concerning "pure
science" and "pure medicine". And I suggest the difference is
this:

Medicine: Must deal with a great mass of people walking in off the
street. There might be some "intelligent" people but
that can never be the assumption of the medical doctor.
The result is that we get "canned" procedures that
"work" instantly. I consider that people in this
profession have no choice but to conduct that kind of
work -- and I would do the same thing IN THEIR
PROFESSION. That would not make it "right" but I do
understand them -- and what they are doing.

Science: Must "step back" from that situation, and think about the
behavior of the natural eye as a dynamic system.
Engineers and scientists simply do not deal with
children, nor with others that do not understand
the need to work on prevention with the plus.

But when you ask very fundament questions about whether a
population of eyes (primates) are dynamic, you get the
"second-opinion" answer, that POTENTIALLY a negative refractive
status could be prevented -- before the minus lens is applied.

I believe that pure science (i.e., the SCIENTIFIC -- not
medical -- experiments proves that point.) But that is the nature
of our arguments. Many concepts in science simply can never be
reduced to "medicine" and we should understand that truth.

I enjoyed your write-up about pure science, and the "habit"
of tossing science out the window when a concept (like the dynamic
eye) can never produce a quick-fix in 15 minutes.

But that is how I separate "medical issues" from scientific
concepts and experimental and objective testing.

But that is why it took a scientist like Dr. Stirling
Colgate to do the "work" correctly and clear his vision from 20/70
to 20/20.

His statements are confirmed by direct experiments with the
primate eye, again on a pure-scientific (not medical) level.

Use the term "refractive state" where the natural eye can
have positive and negative refractive status (as a dynamic device)
and this situation becomes much clearer.

Best,

Otis
__________________________________________________________

Message: 10 Date: Thu, 15 Dec 2005 00:43:04 -0000 From:
"retinula" <retinula@...>

Subject: Re: No change in refractive error at the Naval Academy.
No effect of plus lense

Ret > perhaps Andrew would argue the converse -- that self-esteem
might impact myopia development. i suppose this study
suggests that isn't true. comments andrew?

Judy > These children had high levels of self-esteem, suggesting
that having myopia does not negatively impact self-esteem.
Follow-up reports will monitor self-esteem and related
factors in this cohort of myopic children over the course
of adolescence and early adulthood.

> Judy

_____________________________________________________________

Message: 11 Date: Thu, 15 Dec 2005 02:51:08 -0000 From:
"retinula" <retinula@...>

Subject: Re: Understanding the SCIENTIFIC BASIS for the
preventive second-opinion

Otis> I enjoyed your write-up about pure science, and the "habit"
of tossing science (proven primate studies) out the window
when a concept (like the dynamic eye) can never produce a
quick-fix in 15 minutes.

Retinula> who are you talking to with this diatribe? i think you
are talking to yourself. i think you like your own prose.

______________________________________________________________


From: "Otis S. Brown" <otisbrown@...>

Subject: Re: Understanding the SCIENTIFIC BASIS for the
preventive second-opinion

Dear Retinula,

Subject: Analytical analysis -- and true-prevention.

Retinula, I know you love to quick-fix the public with an
excessive minus lens -- and create stair-case myopia (which you
deny). And the pubic, in its ignorance, will accept nothing
else other than the minus lens. That has been the tragic
history of this problem.

But this is a "second opinion" site -- in case you did not
notice.

I express the second-opinion of Steve Leung, that
nearsightedness -- on the threshold -- can be prevented by forceful
use of the plus on a systematic basis.

The parents who turn this down "cold", will see their children
develop stair-case myopia. If the parents are completely aware
of this fact -- they really have no one to blame but themselves.

You do not like that concept, so you are going to withhold
critical scientific truth -- for your own convenience. You might
"love" to do this -- and think it "right" but there are a growing
number of ODs and MDs who think that we must fundamentally "change
the system".

This is "i-see" were we can explore the actual scientific
experiments -- and make our own choices -- with FULL UNDERSTANTING
OF THE CONSEQUENCES OF NEGLECT.

That is the way it goes. You can figure that these
second-opinion discussions will continue.

So enjoy them.

Best,

Otis

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

--- In i-see@yahoogroups.com, "retinula" <retinula@y...> wrote:

Otis> I enjoyed your write-up about pure science, and the "habit"
of tossing science out the window when a concept (like the
dynamic eye) can never produce a quick-fix in 15 minutes.

Ret > who are you talking to with this diatribe? i think you are
talking to yourself. i think you like your own prose.

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

Comment: It is obvious that there is no "reasoning" with
Retinula. That is why the concentration MUST BE
ON THE OBJECTIVE PRIMATE DATA. But I do not "deal" with a
great mass of people walking in "off the street". I expect
considerable intelligence, and an even a greater degree
of motivation must exist in the person who wishes to
protect his distant vision for life. That is the only
future I see for true-prevention. The rest is so much
self-protective non-sense produced by Retinula. But as
long as a bogus Shotwell study is held out as "scientific
truth", there will be no possibility of any preventive work
with the plus. OSB]