Dear Friends,

Subject: Some commentary on prevention-with-plus for your
interest.

Re: If I "prescribed" a "preventive plus", and the
person developed 1/4 diopter of astigmatism -- I would
be sued for mal-practice. This is the reason why
no OD will "prescribe" the preventive plus. The
other part of the "reason" it total arrogance
on the part of the (majority opinion) OD who
believes he is a "God" in his office.

But don't take my word for it. Read and
think for yourself.

Here are some posts that might interest you. Discussion of
the accuracy of a 1/4 diopter "astigmatic" measurement.

Best,

Otis

_______________________


From: "Mike Tyner"


"Yasar, Mehmet C PFC A Co 602d ASB" <mehmet.yasar@...>
wrote

John> Mike, Can you help me find where I am standing according to
Army regs? Let me quote the standard procedures for the
Army exam...

John> So what is mine after this transposition? As far as I
understood, they are not doing the spherical eq. for
flight duty exams.

If your script was written -075 + 025 x 030,

that transposes to -050 -025 x 120.

Either way, you're in.

-MT


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

TOPIC: Plus Lenses stop myopia progression... NOT! John M.



TOPIC: Current Progress in vision-clearing from -2.75 diopters



== 1 of 7 ==
Date: Wed 31 Aug 2005 15:57
From: "otisbrown@..."

Dear Friends,

There is no doubt about the diversity of opinions about
nearsighedness prevention "out there". The fact of the
second-opinion should be understood.

Some will work with the "second opinion", and others will
not.

It is essential that the person understand that he must pass
the legal requirements that are imposed on all of us for driving a
car, i.e., reading 1.8 cm letters at 6 meters.

Here is an update from Mike as to his progress.

As always, enjoy our pleasant analytical research into the
dynamic behavior of the eye -- as a competent system.

Best,

Otis

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

Dear Mike,

Subject: Your outstanding success from -2.75 dipoters (20/70)

Re: Update

I am very pleased that you have cleared your distant vision
to better-than 20/40. That is a major personal accomplishment.

Your decision to quit "cold turkey" BEFORE you contacted me
was a major step in the right direction.

Some additional commentary:

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

Mike> I wore my friends +1.5 lens and I looked at my eyechart. I
read a little better then before I began using the plus. I
am pretty sure that I have cleared atleast 1.5 diopters off
of of my origional 2.75 and I still have a year until I see
my O.D.

Otis> I agree that you are correct. It would be nice if you had
your own trial-lens kit, but "borrowing" a lens is a good
check. My interest is that you always pass the DMV at
20/40, and continue working towards 20/20. (Just don't get
frustrated -- clearing is a very slow process indeed.)

Mike> I am confident that my next prescription will -1 diopter or
better and that has me excited. I am very glad that I made
decision to use the plus.

Otis> Please remember that John M., who PASSES the military flight
requirement MEASURES at -1 diopter!!! Thus I suspect that
the eye-chart measurement you are making is far more
accurate that the "diopter" measurement. If you start
"seeing" in the range of 20/30 to 20/15 vision, then you
would pass the Military requirement -- in the same manner
that John passed the requirement.

Otis> Again, I wish you had your own "trial" minus lens to check this.
Remember, the official (DMV) test is room-illumination.
Semi-darkness testing yields a profoundly different result.

Mike> I read 20/30 almost all of the time now and the 20/25 quite
often but 20/20 is still blurry.

Otis> I have received a new "requirement" from Dr. Judy. Reading
1/2 the letters on a line "passes" the line. The previous
standard was reading 4 out of 5 letters.

Otis> I have presented you with John M's statement about
"ghosting". That is a concern, but I personally would
prefer to "clear" to 20/20 or 20/15 and "accept" some
ghosting (slight shadow) if that is part of the "bargin".


== 3 of 7 ==
Date: Wed 31 Aug 2005 19:41
From: "RM"

RM > Otis "Engineer" is a zealot who advocates his "plus lens"
prevention theory without good reason.

[Comment: No, there is a good reason. At least some people have
the intelligence and motivation to do this work under their
own control. Your "attitude" gives them no choice but to
do this work themselves. OSB]

RM > There is no scientific data to prove what he proposes.

[Comment: That is because admiting to scientifc truth -- would be
bad for his "professional position". This man is more
interested in that -- that your long-term visual welfare.
OSB]

RM > He would ask that all myopes ( = nearsighted persons ) go
around wearing plus reading glasses in hopes that it will
eventually reverse their nearsightedness.

[Comment: Absolutly false. I have been VERY CLEAR about the
words THRESHOLD MYOPES, i.e., able to function without a
minus lens, or 20/70 vision. The intention is that they DO
NOT STAY AT 20/70, but SLOWLY clear to 20/40 or better.
Only if there is a reasonable possibility that a person can
"clear" to pass the DMV, would I encourage the use of the
plus "for prevention". Tragically, once a over-prescribed
minus lens is worn all the time it makes recovery virtually
impossible. There are rare exceptions, however. OSB]

RM > Nevermind that the blurry distance vision that myopes
complain about is made worse by plus lenses!

[Comment: A convenient "story" that RM tells all his patients --
to shut them up. The Oakley-Young study says the dead
opposite. The single-minus group had their vision "made
worse" by the MINUS LENS. There vision went "down" at a
rate of -1/2 diopter per year. The "down" rate of the
"plus" group was zero diopters per year.

RM > Nevermind that there is no proof for what he claims.

[Comment: Maybe in RM's mind. But that is the "majority
opinion". You have a right to understand the "second
opinion" regarding prevention with the plus. OSB]

RM > If you are interested in Otis' approach, I have some other
links that you might also be interested in:

[Comment: I would point out that RM has posted NO IDENTIFICATION
as an OD. As such, you can take his commentary for what it
is worth. I have given complete identification as Steve
Leung OD has done. Make your own judgment accordingly.
OSB]

== 4 of 7 ==

Date: Wed 31 Aug 2005 18:20

From: p.clarkii@... (Optometrist -- we believe)

Clark> who cares about this? go away troll.

[Comment: Is this a "professional" who is greatly concerned with
PROTECSTING YOUR LONG-TERM visual welfare? If this is the
attitude of your average OD, then I truly fear for your
vision. OSB]


== 5 of 7 ==
Date: Wed 31 Aug 2005 19:33
From: "otisbrown@..."

Dear Friends,

It is obvious that these "professional" ODs don't care about
Mikes long-term vision -- BUT MIKE DOES.

I will forward your remarks to him. If he had any respect
for you it is fast evaporating.

Fortunatly there are true professional optometrists who
support prevention (on the threshold) as the second opinion --as
it should be.

As I have acknowledged, some people see great value in
prevention (entering a four year college) and are willing to
accept objective facts concerning their natural eye's behavior
under that circumstance.

This is the "right" decision and choice for Mike.

There is a massive amount of DIRECT SCIENTIFIC FACTS
demonstrating that (on input versus output) testing that the
refractive state of the eye "follows" its average visual
environment. Mike is simply using his understanding of these
scientific facts to keep his distant vision clear -- when his
friends (at 20/50) will lose theirs. A perfectly reasonable
choice.

Perhaps others can learn from his success, and from the
recommentadations of Steve Leung OD

www.chinamyopia.org

who has his own children wearing a plus for preveniton.

In the future I would expect other ODs to be supportive of
this goal.

Best,

Otis

== 7 of 7 ==
Date: Wed 31 Aug 2005 21:04
From: "Yasar, Mehmet C PFC A Co 602d ASB"

otisbrown@... wrote:

Otis> Please remember that John M., who PASSES the military flight
requirement MEASURES at -1 diopter!!! Thus I suspect that
the eye-chart measurement you are making is far more
accurate that the "diopter" measurement. If you start
"seeing" in the range of 20/30 to 20/15 vision, then you
would pass the Military requirement -- in the same manner
that John passed the requirement.


John> Read my prescription after cycloplegic exam Otis,

OD -0.75 + 0.25 x40
OS -0.75

John> Glasses precription both -0.50

John> Military standard transposition minus cylinder method:

OD -0.50 - 0.25 X 130
OS -0.75

Mike> I read 20/30 almost all of the time now and the 20/25 quite
often but 20/20 is still blurry.

John> Mike should SUBSCRIBE TO SCI.MED.VISION DEFINITELY. Both
eye vision also doesn't help during exam, each eye is
tested seperately, that is what it counts, I highly doubt
that Mike can see 20/30 clearly each eye.

Otis> I have received a new "requirement" from Dr. Judy. Reading
1/2 the letters on a line "passes" the line. The previous
standard was reading 4 out of 5 letters.

John> Reading snellen does not mean a lot and doesn't bring out
the real underlying refraction problem. I can still read
20/20 both eyes, does that mean anything? I am still -.75!

[Comment: If you wish to PASS the DMV, your eye chart means a
great deal. They do not check for your refractive status.
Only the "military" does that. As a minimum you must be
reading 20/20 -- and THEN you worry about your "refractive
status. OSB]

Otis> I have presented you with John M's statement about
"ghosting". That is a concern, but I personally would
prefer to "clear" to 20/20 or 20/15 and "accept" some
ghosting (slight shadow) if that is part of the "bargin".

John> Mike, just pay attention to that "+0.25" cylinder I have
which I didn't HAVE before I used plus for 8 months.

[Comment: How critical is 0.25 diopters of astigmatism. John has
"paniced" because of this 1/4 diopters. He also paniced
because of slight ghosting. Anyone who knows the nature of
the measurements knows that 1/4 dipoter is the MINIMUM
measurement, and that normal "errors" can result in
"changes" 1/4 diopter. For instance, if John had 10 ODs
measure him, he could expect to see "spherical", 1/4
dipoter and 1/2 diopter over a 4 week period. Further,
there are ODs who simply will not write a
"prescription" for 1/4 dioper, and simply will write
a spherical prescription. This "disaster" of 1/4 diopter
has been magnified out of proportion to what it actually
means. But since he feels this way he NEVER should have
been encouraged to use the plus lens in the first place.
However, this "variation" in human judgment will
effectively prevent any OD from helping you with
prevention, and forces you to make that decision to
that best of your ability. We are "afraid" of measurements
we do not understand. To reduce this fear, I suggest that
the individually PERSONALLY make this measurement so he
understands the "random error" in this 1/4 diopter
measurement. OSB}

John> I don't have anything else to say. Plus cylinder helps me
with the cyclo part of the military exam since it brings
down the minus HOWEVER it doesn't help one bit reading the
chart!

John> It is still my worse eye. It is my understanding that Mike
is obsessed with the plus like I was, he should talk to his
OD instead of waiting another year. Next year it might be
too late for him since he is still growing up. Plus lenses
are harming him, he doesn't even know that.

[Comment: If Mike wishes to talk to his OD, then the OD will
recommend that he begin wearing that -2.75 diopters lens
all the time -- even though there is NO REASONABLE REASON
TO DO SO. Further, if he takes this OD's advice, his
eye-chart will again begin moving back to 20/70, 20/100,
etc. If Mike does not mind losing his clear distant vision
for life -- then perhaps he should follow your advice, or
the advice of the OD. If it were me, and I had cleared to
20/30 or better I would NEVER wear a minus lens unless it
were LEGALLY REQUIRED. OSB]

[Comment: John has made is own choice in this matter -- and I
approve of his choice. I can never "fight" for a person's
long-term visual welfare until the person himself makes
that decision. Knowing that my vision was going to go down
by -1.3 diopters in a four year college would be a "wake
up" call to me. In the past the minus lens has been called
"poision glasses for childrens". The SCIENTIFIC research
AFTER that time simply confirms this statement. It is the
minus lens that is "risky" -- if you wish to preserve your
distant vision through four years of college. OSB}