Subject: Remarks supporting Steve Leung OD

Re: The person's right to be informed of the
plus-preventive second-opinion

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

Comment by Otis S. Brown , webmaster of Myopiafree.com

George = Professor George Woo

Otis = Otis S. Brown

HAN = HAN Bossino¡

ODs =

(a)

George: Having read several documents pertaining to Mr. Leung's
view on his method of prescribing for myopia, I write to
render my opinion.

George: Chinese pamphlet on myopia prevention (Appendix 1)

George: Mr. Leung's statements and claims are misleading and
incorrect. He claims that by wearing convex lenses from 1
to 3 years when someone is developing myopia are not based
on evidence. Otis: Direct scientific evidence concerning
the dynamic behavior of the fundamental eye? It is obvious
that this man totally ignores such evidence. It is clear
that at least the objective, scientific facts supports the
"second-opinion", even as the "majority opinion" advocates
continued ignorance of these objective, scientific facts.
This man advocates that the "traditional" minus-lens be
continued, and "objection" to its use be completely
surpressed. This board has the power to enforce their
judgment on Steve Leung

George: In the pamphlet, he does not provide any figures for the
amounts of myopia when these convex lenses are prescribed.
The message is that concave are detrimental to myopia and
only convex lenses should be prescribed for myopia. This is
contrary to any conventional treatment for myopia. His
statements that 90% of myopic patients are receiving the
wrong treatment is incorrect and misleading.

Otis: This depends on who is "misleading" whom. While I do not
expect any OD to put himself at "professional risk" in order
to offer a "second opinion", I would at least expect ALL ODs
to be sufficiently informed to DISCUSS this alternative with
a person -- before that first minus lens is applied. At
least the person would have an option to explore more
completely the concept of prevention -- and use it
effectively if that were his choice. I think all
"professionals" have this obligation to offer that
discussion. This man judges he has no obligation of that
nature. I urge you to continue to offer this choice to a
person on the threshold -- with no obligation to go beyond
that point.

(b) George: Note edited by Mr. Leung (Appendix 2)

George: Mr. Leung states that the plus is a fogging method.
According to him, it is the appropriate method to save one's
eyesight. He advocates wearing these convex lenses for
distance and near viewing. Constant wearing of these lenses
is advocated.

Otis: The decision to use the plus "aggressively" must depend on
the person's "choice" after he has time to review the issues
and the experimental data itself. The actual use of the
plus would follow this type of review. Effective use of the
plus (for prevention) does require a "strong will", and a
certain belief that the method can be successful for the
person who is going "all-out" to use the plus correctly.
George: He also states that for those who have already
developed myopia, use of these lenses will stabilize the
amount of myopia suggesting that there will be no further
increase in myopia. There is no evidence to support his
statements.

Otis: Again, this depends on the scientific background of the man
making the statement. A man who has been saturated with the
concept that the eye's refractive status is isolated from
its visual environment, is going to make that type of
sweeping, un-proven statement -- while totally ignoring a
massive amount of direct-experimental data to the contrary.
As long as exclusively "ODs" sit on that "board" you (Steve
Leung) have no chance of fighting this issue. If the board
has some true-scientists, and some people of the "second
opinion" concept you (Steve Leung) might stand a better
chance.

(c) George: Mr. Han's complimentary statements.

George: In a table listing his family members' refractive errors.
Mr. Han's remarks on them are incomplete and wrong. I
assume Mr. Han is a layman an therefore is incapable to
describe myopia treatment clearly. However, this
information is presumably distributed by M. Leung. HAN:
Hey. I wrote those statements by myself. How can you said
that my remarks on my family members' are wrong? Do you
know my family?

(d) George: Dr. Stirling Colgate's letter

George: I note that Dr. Colgate's letter to the NIH was dated
November 8 1977. Young et al's prospective Houston studies
were published in 1985 and 1987. Results of the final
report by the patient care team are contrary to the belief
expressed by Dr. Colgate. ¡@

Otis: I have every confidence in Stirling's statement of
effective prevention when the plus is forcefully used BEFORE
the minus lens is used. As the very minimum, it must be
recognized that no "perfect proof" can be supplied for any
opinion. Otis: Francis Young was only "partially" involved
in the Houston study and did not agree with the protocol
--nor the results since they contradicted his own results --
which demonstrated that nearsightedness COULD BE PREVENTED
on the threshold. This "George" is very selective in what
he chooses to report. A "second opinion" board member would
be of great value in this review. (e)

George: Dr. Paul E Romano's letter

George: With the E-address provided by Mr. Leung, I tried and
failed to access the book prefaced by Dr. Romano.

(f) George: It is noted that Dr. Guyton categorically states in
his email that "clearly the plus lenses would not be
beneficial for distance vision if the individual is already
myopic; they are used for near tasks. Mr. Leung, on the
other hand, is advocating plus lens for distance for near
use. I cannot agree more with Dr. Guyton's advocacy that
Mr.Leung should initiate an actual randomized controlled
study, over 3-5 years, to determine the effectiveness of the
method he is using.

Otis: I advocate that the person himself (pilot) be sufficiently
educated so that he be empowered to make both the eye-chart
and refractive measurements himself. (i.e., an engineering
study at a four year college). Given Francis Young's
results, I have no doubt that pilots on the threshold could
clear their distant vision from 20/40 to 20/20, with
intensive effort with the plus. Since other young men have
already done this -- a formalized study -- conducted by
engineer-scientists could certainly reproduce this obvious
success. The issue will be "who is in control"? If
engineers -- I have high confidence in success. If this
"George" I am certain the effort will "fail".

(g) George: For your information, Edwards et al of Poly U did
conduct a study on the use of progressive lenses (full
correction for distance and addition for near). The
conclusion -- "The research design used resulted in matched
treatment and control groups. There was no evidence that
progression of myopia was retared by wearing progressive
addition lens, either in terms of refractive error or axial
length"

Otis: Even given the fact that the "children" were too young to
"follow instructions", Professor Francis Young's study
demonstrated that the "plus" group showed a "down" rate of
zero diopters (i.e., myopia development effectively
stopped). When two studies contradict each other, neither
one can be "right" and you must look at DIRECT experimental
data taken on an "input" versus "output" basis on adolescent
primates. This experiment proved what the "bifocal studies"
could never prove -- that the natural eye always moves
"down" when you place it in a more-confined visual
environment. Obviously this "professor" NEVER wants these
scientific facts to see the light of day.

(h) George: Mr. Leung's letter to Miss Chong

George: Mr. Leung cited Dr. Young's statement published in
Contacto, a non-citation indexed journal in 1975 to support
his belief. Subsequently, Young participated in a
prospective Houston study. The final report entitled
Houston myopia control study: a randomized clinical trial,
Part @. Final report by the patient care team, was
published in Am. J of Optometry and Physiological Optics
1987.

George: "For the 124 subjects who completed the study, the mean
changes in refraction were found to be -0.34 per year for
subjects wearing single vision lenses, - 0.36D per year for
those wearing +1.00 addition, and - 0.34 per year for
wearing +2.00 add bifocal. These differences were not
statistically significant."

Otis: As Francis Young pointed out, they use a "small plus" in
the lower segmement. Very often the young child would avoid
looking THROUGH the plus. For this reason the study was not
"controlled" in any scientific sense.

Otis: Francis Young's Pullman study used a strong, high-placed
plus, where the kid HAD TO LOOK THROUGH THE PLUS. I
remember the numbers to be about 200+, where the half
wearing the plus showed no "down" movement, were the
single-minus when "down" at a steady -1/2 dipoter per year.
¡@

George: It should be noted that the Houston study compared
bifocal lens wearing children with single vision lens
wearing children with identical amount of myopia. These
single vision lenses are concave. They are not convex
lenses advocated for distance and near use by Mr. Leung.

Otis: At the very minimum, the fact that Dr. Young's study
produced a profoundly different result should ALWAYS be
discussed. Francis Young did not think much of the
"Houston" study for the reasons stated above. (I)

George: I take exception to Mr. Leung's statements that USA is
far ahead of us by 25 years in vision protection for young
people. For your information, Poly U's myopia research
center was evaluated by a panel of world renowned experts in
myopia research two years ago.

Otis: Yes, and 92 percent of the MDs on Taiwan are myopic. Does
this sound like effective "preventive" work. Or blindly
following the "traditional" method of the last 400 years --
regardless of consequences, or ignoring the massive amount
of DIRECT, SCIENTIFIC data that suggests that the
traditional minus lens creates very serious long-term vision
problems for all of us.

George: I am pleased to inform you that our center ranked 2 in
the world. IN the last two international myopia meetings
held in HK and Guagzhou in 2002 and Cambridge earlier this
year, Poly U's presentations on various aspects of myopia
has been significant.

Otis: And with all their impressive "expertise" how much myopia
have they "prevented"?

HAN : Spending money to carry research, but no way to suppress
the wide spread of myopia -- Poly U's Center rank 2 in the
world, but Hong Kong is the No.1 dense myopic population in
the World. Do you feel SHAME? (J)

George: Mr. Leung cited scientific studies by three Chinese
scholars. No reference, however, was given by him. Indeed,
none of his reference cited by him in his letter, is
complete.

HAN : Dr. Xu Guang Dis(®}¼s²Ä¡^, Dr. Jung Yun Xin (ÄÁ¼í¥ý), Dr.
Wang Fang Yun(¨LªÚ¼í), all of them are most famous eye
doctor in China. Maybe George don't read any Chinese
ophthalmic books at all.

(K)

George: Mr. Leung in his letter states that "...if the focal
adaptation of eye-sight can be caught at the threshold of
the situation-focal status is zero or slightly negative
(early myopia), then clear distance vision can be
maintained/or restord by systematic use of plus lenses" In
an article published in Vision Research in 2002, Chung et al
proved under-correction of myopia enhances rather inhibits
myopia progression thus nullifying Leung's insubstantiated
arguments.

Otis: Here again the "George" is selectively reporting what he
wants to believe. A person who is "impartial" would have no
problem discussing Francis Young's Pullman study. This is a
matter of selective bias and preferred ignorance.

(l)

George: It is my professional opinion that Mr. Leung's
statements in the leaflet about the treatment of myopia
cannot be substantiated.

Otis: Fine, I accept that George's statement is the "majority
opinion". In no sense should the George's statement be
allowed to suppress the concept that the natural eye is
"dynamic", nor does his statement PROVE that actions should
be taken against you to "shut you up -- or shut you down".
But we are talking about naked political power of the Board"
-- and not about scientific truth as it concerns the dynamic
behavior of the fundamental eye.

George: His method of prescribing/treatment for myopia is
incorrect and inappropriate. His arguments in the various
documents are not convincing and they are not evidence
based.

Otis: The fact that there is a "majority opinion" and "second
opinion" means that "arguments and documents" are not
"convincing" to EITHER group. That does not mean that
either group is wrong. It is just that two contractory
methods must exist side-by-side for some time into the
future.

Otis: In the long history of medicine (and science) this is about
the only method that allows for necessary and fundamental
scientific change.