Diag12.txt


Dialog1.txt


REVIEWING THE BOOK, "HOW TO AVOID NEARSIGHEDNESS"

IMAGINATION

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


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

Arthur Schopenhauer


Physical concepts are free creations of the human mind, and
are not, however it may seem, uniquely determined by the external
world. In our endeavor to understand reality we are somewhat like
a man trying to understand the mechanism of a closed watch. He
sees the face and the moving hands, even hears it ticking, but he
has no way of opening the case. If he is ingenious he may form
some picture of the mechanism which could be responsible for all
the things he observes, but he may never be quite sure his picture
is the only one which could explain his observations. He will
never be able to compare his picture the real mechanism and he
cannot even imagine the possibility of the meaning of such a
comparison.

Albert Einstein


It is difficult to say what is impossible, for the dream of
yesterday, is the hope of today, and the reality of tomorrow.

Robert H. Goddard

_________________________________


I believe that by using the neutral term "REFRACTIVE STATE", and
talking ONLY about proving (or dis-proving) the behavior of the
fundamental eye, (all eyes) will it be possible avoid most of the
problem of bias concerning the eye's behavior.

I have been evaluating these problems for the last 30 years
so I think these observations have validity.

___________________________


Jon > After reviewing your book ["How to Avoid Nearsightedness"]
again the following came to mind.

Otis> Thanks for the further review. I always enjoy a
pleasant academic discussion about science, and
engineering-scientific methods for solving difficult
problems.

Jon > One of the aspects which is lacking in all the presentation
I have seen is a continuity of logic in the text.

Otis> That depends of course on the "organizing concept".
Obviously the concept of medicine is "default", in that the
only thing the "lay public" will ever understand is a "magic
pill". The "organizing concept" for my book is the
perception that ALL EYES from the moment of birth (when the
accommodation system can work) control their focal state to
the accommodation signal.

Jon > By this I mean that there are not a clear references for
each step of the presentation.

Otis> Perhaps, but that would be like asking the Wright
brothers to document every step they made, and publish their
intermediate results BEFORE they built the Wright Flyer. We
are convinced that the brothers were correct when they got
their plane into the air -- not by the wind-tunnel and the
academic work they did prior to getting the plane to work
correctly.

Otis> Where I made a statement, I supplied a reference -- which
I checked myself when ever possible. I have read books with
800 references (Klaus Schmid), i.e., "The Myopia Manual".
We each do things to the best of our ability.

Jon > The problem with myopia is presented, and documented,

Otis> Actually, "myopia" is discounted. A negative focal state
of the natural eye is a problem, but only through our habit
of developing "problem myopia". We completely fail to
perceive that the eye is controlling its focal state to the
visual environment. If we agree that nature (or evolution)
designed a very sophisticated eye that behaves this way,
then we cannot and must not use words of "defect" to
describe what is behaving normally. IMHO.

Jon > ... but the specifics of the action of the cilliary body,
and action of the lens are not referenced,

Otis> These have been referenced in the BOX CAMERA theory of
the eye and I only sketched a picture of them in chapter 3.
Indeed as a PICTURE of the eye the image is excellent. But
as a FUNCTIOAL representation, the picture explains nothing
at all.

Jon > ... rather they are taken as a given. Where are there
references on what happens to the structure of the lens when
the visual system is forced into a myopic focal state?

Otis> The system is not "forced into the myopic state". The
natural eye is just endowed with the ability (and necessity)
of changing its focal state to the visual environment. This
is completely expected behavior of a well-designed
auto-focused camera. Nothing is defective because the
natural eye has a focal state that we do not like.

Jon > The reason I present this is that in my past conversations
with optometrists, and ophthalmologists, they were vague on
the sequence of events which were presenting in
accommodation.

Otis> They have a very vague idea of accommodation -- as does
the general public. My FUNCTIONAL MODEL of a fixed lens on
a "lead-screw" was to ATTEMPT to pry their minds away from
the "muscle" idea of accommodation. This is part of the
Box-Camera image they have of the eye. Attractive but
wrong.

Otis> In a mathematical sense I ask you to accept that there are
two "stop" positions for the lens, i.e., maximum far and
maximum near. These would be the non-linearity of the
system. Between these two measured points, the lens simply
reproduces the power of the visual environment. Thus;

Otis> Lens focal power = Visual environment

Otis> [ Within the boundaries of the two "stop" positions.
There is no "stress" or "strain" associated with these
movements of the natural accommodation system, and it would
be tragic to read anything of a "defective" nature into the
behavior of this system. ]

Otis> Are you willing to accept this simplified model of active
accommodation?

Jon > As a matter of fact I distinctly remember one conversation
with an optometrist where they did not know how to do
simple, and I mean very simple, optical calculations.

Otis> No doubt true. But that is why it is a waste of time to
argue any of this with them. They only feel that their job
is to "sharpen vision" with a lens, and nothing else. The
general public's attitude enforces that view -- even if they
might wish to change. That is the "world view" of the
"public" and you and I are not going to change it.

Jon > Can you provide a reference that documents the physiologic
change in the visual system in a myopic focal state?

Otis> I think you are asking the wrong question. As far as I
am concerned, I can measure the "focal state" of the eye by
looking at an eye chart, by directly measuring the "blur
point". Thus if I read the 20/20 line, I will assume I have
some degree of a positive focal status. To find out the
amount I place a plus lens in front of my eyes. If I still
read 20/20, I continue to use a stronger plus until I find a
lens that JUST BLURRS the 20/20 line. This becomes a
measure of my focal state (as an auto-focused camera). I am
measuring the "stop" position of the accommodation system by
this process. I am NOT measuring a DEFECT. It is a
completely different way of looking at DIRECT FACTUAL DATA.
The conceptual model is profoundly different -- but very
clear conceptually. The only requirement here is that all
natural eye have complete control over that blur point.

Jon > This may be well known, and I may have overlooked this in
the references I have at hand.

Otis> The optometrists teach themselves that all focal states
both positive and negative are ORGANIC DEFECTS and
REFRACTIVE ERRORS. They do this so that they can then say
that they have "fixed" your REFRACTIVE ERROR, with a minus
lens, It is a screwed up way of looking at it, but that is
the way they see it.

Jon > The second topic on which I would like your input for
references is how optometry measurements are accomplished.

Otis> In simple stark language, exactly as I described it
above. Except that they call the eye defective because it
has a "focal state". The real problem is in their mind, and
total refusal to conceptualize the behavior of the eye as a
control-system.

Jon > Is there some classic text of which you are aware on this
subject?

Otis> Yes, the physiological optics book by Southall pulls the
history and box-camera theory origin together quite nicely.
The other would be the work of Hermann Hemholtz, but that is
out of print also. But all this is simply the effect of
applying "theory" to the minus lens which was already in
wide spread use in 1860. In other words and ex-post-facto
medical theory. Not a theory with PREDICTIVE capabilities.
That would be the purpose of a FUNCTIONAL picture of an
auto-focused eye.

Jon > The third topic concerns the reference, "Introduction to
Physiological Optics" which is out of print. Do you know of
any other comparable reference which is in print?

Otis> Tragically, no. I got it from Peter Greene, and I wish I
knew of some other source.

Jon > The fourth topic concerns the reference you provided for
George Hung's book:

Jon > http://www.worldscientific.com/books/engineering/4652.html

Jon > You had mentioned that he had sent you copies of his papers,
but you did not specifically state whether or not you had
reviewed this book.

Otis> Having read all his papers, as well as the work of Dr.
John Semmlow and Dr. Lawrence Stark, I felt that that his
book would be a summation of those papers.

Jon > The fifth topic concerns where to obtain the papers by F.A.
Young.

Otis> Towards the end of our work, Francis send me a box with
is collected works. I do not think he ever published a book
with is collected works however. I can review the
individual high-points of his work if you have questions.
Be glad to do it.

Jon > Is there a bound volume of this individual's work? Is there
any bound volume of work which brings together all of these
references?

Otis> The best references would be found in, "The Myopia
Manual" by Dr. Klaus Schmid (physicist).

Otis> These answers will probably not satisfy you. Indeed,
when I talked with Dr. Jacob Raphaelson in 1968, his
answers did not "satisfy" me either. Until I began to
understand many issues of good sense and technical analysis.

Otis> My goal was to prove Dr. Raphaelson TOTALLY WRONG, or
TOTALLY RIGHT. However, in order to do this, I had to
re-think completely the behavior of all natural eyes, based
on DIRECT measurement. In the last 50 years, this result
can be confirmed in the direct experimental data (without
any optometrist involvement). This eventually becomes a
matter of YOUR judgment, which I cannot affect or control.
In that sense, we are each unique in what we learn and are
willing to understand.


++++++++++

An Engineering and Scientific Review of
Nearsightedness and the Potential for Prevention.

What follows are independent opinions concerning prevention by
the
physicist Jon Neumann and myself about vision research and the type of
solution that might become possible. There are NO EASY ANSWERS, but
developing new ideas and concepts must always be part of a process of
solving old problems.

If this discussion helps you to improve your own judgment
about your choice then the purpose of this analysis will
have been served.

______________________

The reasonable man adapts himself to the world; the
unreasonable one persists in trying to adapt the world to himself.
Therefore all progress depends on the unreasonable man.

George B. Shaw

Every creative act involves ... a new innocence of
perception, liberated from the cataract of accepted belief.

Arthur Koestler

_______________________


Physicist: Jon Neumann

Engineer: Otis Brown

Otis> The major "driver" for me was raw curiosity. I had been
able to predict that the situation of nearsightedness should
at least be preventable, by proper use of a plus lens.
Since I had never heard of any one either attempting it, or
doing it successfully, I assumed that it was impossible --
and that there was solid SCIENTIFIC justification for that
belief. I had read an article stating that "Submariners
developed nearsightedness proportional to the time they
spend in submarines" -- sometimes in 1966. The author was
Dr. William Ludlam, so I wrote up what I though was a
reasonable analysis of the eye, and sent it to him. He
wrote back as said the concept was "not new", and referred
me to Dr. Jacob Raphaelson. I then sent some of my papers
to Jacob, and ultimately visited him is 1967. It became
clear to me that Jacob had become successful with the plus
lens, but the method was rejected by the public.

Otis> It was then clear the level of motivation had to be intense
at the 20/70 level for the method to become successful and
the pilot would have to verify the results himself. It is
indeed a very difficult -- when the minus lens is so easy to
use.

Otis> This is a choice that is difficult. If the person lacks the
motivation, then he will not use the plus lens at the 20/70
level -- when it must be used to be truly successful.

Otis> If an optometrist makes the recommendation, the person
assumes he if "fixing" the defective eye. From all that I
have written, I am certain that is not the case.

Jon > I agree with what you are saying. If a person uses the plus
lens properly they will achieve the results in all but two
to three percent of the cases which corresponds with
statistical evidence of true pathological myopia in the
population.

Jon > From my own experience of wearing the lenses as much as
possible during the course of a day I have experienced a
difference. I have come to realize is that we do not need
that much visual acuity during the course of a normal day.
What I found to be the case is that when I needed it, and
did not have it I initially had the tendency to get
stressed. A major part of this is due to how I have been
socialized. After wearing the lenses for an extended period
of time there is a difference when I take them off. I do
not know how to accurately describe the difference, but
there is no doubt in my mind it is there, and not part of my
imagination.

Otis> I should ask you what your goal is. Certainly I have
enjoyed our conversations, as I think you have. Clearly,
except for slight jabs, I really do not give optometrists a
hard time about this. I honestly think they have an
"impossible" situation that is totally out of control, and
they are frustrated with it. But equally, they tend to be
arrogant about it -- and that is always a mistake.

Otis> I do not appreciate THAT ATTITUDE. As long as an
optometrist will acknowledge that the minus lens is pure
"default" and there is no other justification for it -- then
I have no problem at all. I also appreciate that the great
mass of us are extremely resistant to the recommendation
that we must begin using a strong plus (consistently) at the
20/50 (-1/2 diopter) level.

Jon > Having worked with many people in the professional fields I
am not tolerant of their attitudes. They can easily remedy
their impossible situations, but they choose, or are
inclined to not do so. The optometrists, and
ophthalmologists whimsically justify, and pontificate
according to the audience at hand, and their fancy at the
moment. An extraordinarily small portion of the profession
will even venture out of traditional dogma to even entertain
any other paradigm. If there is a default given as to a
procedure, and protocol, and it is not substantiated by
scientific evidence, and people are not clearly informed, I
do have a problem with their "default" prescription to the
masses. This is especially true when one considers the
amount of long-term damage that is done to the population.
Until the norm is to question, and scrutinize the base
principles, the status quo will drift from a de facto
pronouncement to a legally enforceable de jure.


YOUR EFFORTS WITH THE PLUS

Otis> Since you are working to "improve" your vision, I wonder
what your goal is going to be, i.e., what you consider a
success and equally, a failure. If you are at -4 diopters,
then would you consider it a success if you improve to -3
diopters in one year. Do you have any children or nephews?
If so, what advice would you give to them? And would they
accept it, or do you judge that only you should work the
issue? [I am not being harsh, judgmental or critical, just
curious.]

Jon > I normally do not view undertakings in the light of success,
or failure, but rather in the light of a path with as solid
a foundation as possible, and a series of mini-milestones.
What I would like to do is to get back to normal vision.
Whether or not that can be attained remains to be realized.
I do not think anyone has attempted this with a solid
foundation, and real discipline. Many of the people who
think they are disciplined really are not. Not even
seasoned pilots, for I have seen how these captains of
commercial airlines conduct preflight inspections.

Jon > What I think is that from all available evidence getting
back 1.0 D in about one year is do-able. This assumes that
the visual system is similar to a spring which has not been
elastically deformed by an over-extension. This is similar
to a very massive spring being acted upon by a very small
force to regain equilibrium with a very long time constant.
Beyond that I have an idea that the visual system may also
readapt, but not unless it is under some type of
constructive stress.

Jon > If you look at musculo-skeletal injuries there is a body of
evidence incorporated into physical therapy where the
healing process of the injured area is accelerated by
exercising related structures. Outside of the focal system
of the lens the only other structures are the inter-ocular
muscles. In myopia there seems to be an adaptation to
convergence with divergence being deficient. For myself
this is the case. The medial rectus, and lateral rectus
muscles have adapted to a deviated state. Since there is an
imbalance this has to affect the shape of the eyeball. In
general the entire ocular musculature is not adequately
exercised.

Jon > Rotational, lateral, vertical, and combinations of these
dynamic exercises may very well provide a constructive
stress to the visual system to further force a
re-adaptation. In our modern visual environment the ocular
musculature is almost atrophied. Compare the Eskimos and
how they are constantly scanning. They do not fixate for
long periods of time. I am not sure how far the visual
system can readapt, and I am sure that no one else knows
either. Most of the statements I have heard have stated
that once the visual system has progressed to a certain
point there is no hope of any type of recovery. Has anyone
really conscientiously attempted this, if so under what
circumstances, and how did they arrive at these conclusions?
John> Based upon the available evidence, the statement that
the shape of the eye is fixed does not make sense to me.

Jon > Since it is established that the eye elongates, my question
is, "Where does it elongate?" The other part of this is
making sure that no further damage is sustained by the
overuse of minus lenses. If a person wears plus lenses for
two hours, and minus for another six there will be little,
if any progress expected. Each step of the way has to be
clearly laid out so that anyone can follow the logic, and
reasoning which is exactly what Einstein did in his
lectures. Anyone could follow the examples, logic, and
presentation which is what needs to be realized in this
case.

Jon > I do not have any children, nieces, or nephews. If the
situation presents where I can have any input I will do so,
whether or not it is well received. I would tell them
exactly what I know to be the case, and let them take it
from there. First, I am working on myself to set an
example, and then I will see what happens, keeping in mind
that I do not know how far I can take this. In regards to
your questions I never would have viewed this as being
harsh, judgmental, or critical.


EYE CHART AND WHY MOST PEOPLE WILL DO NOTHING

Otis> Most people at 20/50 will "hold back", even pilots. They
want some one in "authority" to tell them they must do it.
Since it is not economically to tell the brutal truth, (by
an optometrist) all they will ever get is the "silent"
treatment. This is understandable, but tragic. It is just
another fact and reality of the situation.

Jon > My guess that the reason people will hold back is that they
do not have access to the information in a clear,
consistent, logical, and substantiated presentation with
references. The other aspect is that they do not know it is
permissible to ask questions. That being the case they may
not know, or have any idea of what questions to ask. For
these reasons they have to acquire a certain threshold of
information to pursue any meaningful dialog. I think the
other reason people do not ask is that they are afraid to be
just plain curious. I still remember my exposure to
teaching at the university.

Jon > I am not sure how anyone is viewing the economic aspects of
what the profession is doing. It may be that it is more
advantageous to prescribe plus lenses. If they do, then all
children will have glasses, not just the ones with problems.
If an adult has normal vision then they also need a
prescription tailored to their needs. Specifically a
bifocal may be warranted where the lower half is used for
reading, and the upper half for the working distance in
their office which may be markedly less than twenty feet.
Taking this into account you have access to a population to
which you did not have access. This may translate into a
greater economic advantage than the current model. I would
venture to guess that insurance companies with more refined
actuarial models may have a very great interest in this
idea. Who has really looked at the economics from this
standpoint?

Jon > Since our environment has changed the real issue is quality
of life, and freedom of action.

Jon > The visual profession models itself after the medical
profession which functions in a reactionary crisis mode
designed to alleviate symptoms, not solve fundamental
problems. It is the analog to the fast food industry even
though it is medicine, and the visual profession.

Jon > If what you are proposing is sloganized, and marketed into
the mindset it will eventually catch on when it reaches a
critical social mass. I have never seen anyone in the
visual profession advertise from a preventative perspective.
Can you imagine an advertisement with a group of people
varying in age from children to young adults, all with
glasses. The voiceover states something like, "They can see
up close with their glasses on." All the people in the group
take off their glasses while the narrator says, "They can
see up close and far away with their glasses off. They can
see they will not be nearsighted in fifty years. See what
plus lenses can do for you. Go to www.DrSee.com at the XYZ
Clinic for information." This is just right for a thirty
second commercial. Simple, and to the point, but the
optometrist has to be able to follow through with a very
structured and straight forward program, otherwise it will
not be effective. All the bases have to be covered with a
total solution.

Otis> So now it comes down to a pilot making a decision. He knows
that he has no interest in "eye length". His ONLY
requirement is the eye chart. If he passes it -- he goes on
with his career. If he does not see it -- he fails
completely. It is that stark. Since I cannot look through
his eyes, I have no idea what he is seeing.

Jon > I contend that if a pilot is presented with a clearly
documented program similar to their training they will be
very amenable to participating in what you have to present.
One of the things to which they gravitate is structure, and
their ability to see the flight through. I do not think
there is that much decision making involved, if they have a
structure. In an analogous manner explain to them the
airframe, power plant, avionics, and control system, and
they will have the foundation similar to what they had in
flight school. That is why I have been hammering at some of
the details. Give the 30,000 foot view, and let them choose
the granularity of information which suits their makeup and
flight plan. They know how to read Jeppesen IFR charts, and
what to do with trip kits. They like to fly, and will do
anything to keep doing it. Where is the decision?

Otis> Only when he reports back to me that his vision is clearing
do I have any hope that he will be successful. It is that
initial "jolt" of the plus that produces vision-clearing
(seen by the pilot on his eye chart) that convinces him that
he must continue, and that he will be ultimately successful.
When I talk to him I impress on him that he CANNOT QUIT when
he just gets to 20/20. He must continue with an even
stronger plus, until he can read 20/20 through at least a
+1/2 diopter lens. This obviously takes at least 6 months
-- but if he wants his career he must do it.

Jon > The feedback mechanism is important. The Snellen charts
only give gross feedback. That is one of the reasons I was
asking you about the time constant involved. That is the
other reason I have been using a metric ruler, and that a
person can use a plus lens, and the ruler; it is more
sensitive to changes in the visual system. In the short
time I have been wearing plus lenses I have noticed small
changes such as the range of my far point blur point not
changing as greatly over the course of a day. I would not
have been able to determine this with a Snellen chart, but I
can with a metric ruler. It is the difference of one
centimeter instead of three over the course of a day. Not
much, but it is definitely there, and measurable.

Otis> Thus prevention is a goal that is very difficult. It is not
easy, not quick, and not certain. But the facts do indicate
what is possible. Our ability to make the "facts" work for
us in a "scientific" sense (rather than a "medical" sense)
is what the future is all about.

Jon > This may be the right time for this since people are getting
tired of the same old same old, and all the associated
consequent problems. McDonald's has reported a net loss for
the first time in its history. The Internet has spawned a
large number of grass roots organizations, causes, and
movements. This brings me to the focus of who will have the
most vested interests in seeing what you are presenting, and
following through. The qualities for which you are looking
are motivation, structure, and discipline. Pilots
definitely fit into this category as do housewives, women in
general, religious groups, and anyone similar. Women's
groups may be the best since they have really effectuated
social changes; they gave themselves the right to vote, and
overcame other obstacles. Every political candidate knows
the power of these women's tea groups, and I would not be at
all surprised if your wife could lend some valuable input
along these lines.

Jon > As I conceive it there needs to be documentation to appeal
to three groups as follows:

1. Non-pilots, i.e. the general public.

2. Pilots, any other professionals such as ship's captains, and
other professionals who have a need for visual acuity.

3. Those involved in the visual profession.

Jon > Whatever is presented needs to be a total solution.

Jon > That is as far as I can take this for the time being so in
closing I will leave you with the following from the
political arena:

"Unless you become a belligerent claimant for your rights
you are considered to have acquiesced." Author Unknown

Jon > My variation on this is,

"Unless you become continually persistent in your demand for
information you are considered to have consented."


__________________________________

I learned a long time ago:

1. Always use clearly defined words to present EXACTLY what
you mean. NEVER use "defective" words to describe the dynamic
behavior of all fundamental eyes.

2. NEVER get between a man and his money.

3. NEVER get between a doctor and his patient.