Iseerm.txt


Subject: Difficulty of offering prevention with a plus from a
optometrist's point-of-view.


Re: An optometrist (RM on sci.med.vision) explains why he can not
offer the possible use of the plus for prevention at the
threshold of nearsightedness.


Otis> I am pleased that Mike has finally stated the reason why he
-- as an optometrist -- can not offer true-prevention with
the plus.

Otis> You might have "legal problems" if you attempted to do so
and the patient did not understand WHY the plus had to be
intensively used at the threshold of nearsightedness.

Otis> This effect is described in "The Printer's Son" and is a
cautionary note for an optometrist who attempts correct-use
of the plus. We ALL need to think about that issue.

RM > Once again, you are conveniently misrepresenting what you
were told! You do indeed have trouble with objective
thinking now don't you!

Otis> [Comment: It is tragic that RM chooses to be insulting about
this
honest issue. It just makes preventive work with the plus
that much more difficult. OSB]

RM > Mike Tyner told you that he would not object to someone
who was already using plus as a prevention method continuing
to do so. After all, it hasn't proven to do anyone any
harm. However, it has not been proven to help anyone
either.

Otis> [Comment: Tragically, I guess this means that the person must
do it himself -- look at his eye chart, "push" with the
plus, and verify the fact that his distant vision SLOWLY
clears. Not an easy task for anyone. It is again tragic
that the implication of RM's statement is that he can not offer
any help or support. OSB]

RM > If they choose of their own accord to do it, then so be it.
It might in fact prevent them from becoming an accommodative
myope (whom in fact is the ONLY type of myope your method
can help). Too bad most myopes aren't accommodative myopes.

Otis> [RM has no proof for this statement -- only his convenient
assumptions. But again if you "clear" yourself -- under
your own control, then I guess RM's opinion does not matter.
OSB]

RM > Since you have trouble keeping the facts straight, as well
as the actual statements that people make to you, let me
spell out to you the reasons why I don't recommend plus as a
treatment.

Otis> [The simple scientific facts concerning DIRECT MEASUREMENTS is
stated in the segment below. I doubt that RM can change
these simple facts. OSB]

RM > 1. It has not been proven to work.

Otis> [Proven to WHOM? Stirling Colgate and other pilots have
demonstrated that they have been able to clear their distant
vision with a plus. But when they do this -- the "prove" it
to themselves. OSB]

RM > 2. It adds financial burden to patients to buy plus lenses.

Otis> [This is an INCREDIBLE statement! An optometrist must earn a
living as a professional. Some optometrists will support
you in your use of a plus -- because they have their OWN
CHILDREN wearing a plus a the threshold of nearsightedness.
Obviously "prevention" requires much more motivation and
commitment that the minus -- AS WE ALL ACKNOWLEDGE! The
"financial charge" should be based on the optometrists time
and effort. But the "right of choice" must belong to the
person (or his child) on the threshold. The "costs" are not
a concern of mine under these circumstances. A person's
"right of choice" is my concern. OSB]

RM > 3. It visually disrupts that patient's vision, and/or is
impractical to the patients lifestyle.

Otis> [RM presumes a great deal in this statement. It is up to the
"patient" about his use of "impractical" and "lifestyle".
OSB]

RM > By this I mean that looking through plus lenses in the
distance blurs their vision.

Otis> [This is not quite what the plus-lens preventive method is all
about. The plus used only for near -- does NOT blur distant
vision. This is a "false argument". OBS]

RM > And wearing them only at near necessitates that they carry
them with them all the time and constantly take them on and
off.

Otis> [This is indeed a "life-style" choice. Plus-for-prevention is a
trade-off. Use it for near -- and protect your distant
vision for life. This issue must be decided by the person
concerned with long-term protection of his distant vision.
Because of this "inconvenience" I only recommend
true-prevention for the most motivated of people --
specifically pilots. OSB]

RM > I would not hesitate to suggest that the patient endure
these annoyances IF IT WAS PROVEN TO ACTUALLY HELP ANYONE.
However, since it hasn't been, it would be wrong for me to
suggest it.

Otis> [Again the issues -- proven to WHOM? Prevention is honestly
difficult. And I agree that it is perhaps difficult for an
OD to suggest it. But equally, I believe that you should be
INFORMED ADEQUATELY of the need to use the plus on and
either-or basis. The "or" is that when you start wearing
the minus lens all the time -- your vision goes "down" at a
rate of about -1/2 diopter per year. RM has this convenient
excuse for NOT PROVIDING accurate information of this
nature. OSB]

RM > 4. Patient's who are already slightly myopic are seeing an
eye doctor because they are having problems with distance
blur. Why would anyone accept a prescription that makes
their vision worse instead of better?

Otis> a. RM again assumes that "everyone" wants the minus -- and
will not accept the "either-or" decision a person must make
in this situation. But again -- this general "attitude"
forces the person to review these issues himself.

Otis> b. Because there profession is a "pilot" and they want to
get out of it.

Otis> c. Because they understand an intelligent alternative and
decision must be made at this critical point.

Otis> d. Because they know the implications of objective,
experimental facts -- concerning the proven effect of a
minus lens on the eye's refractive status.

Otis> e. Because they do not wish to develop "stair-case" myopia
-- induced to a large extent by that over-prescribed minus
lens. OSB ]

RM > People who drive or perform critical distance tasks are
seeing an eye doctor for help, not to make their symptoms
worse.

Otis> [In fact wearing the minus lens ALL THE TIME will make the
"symptoms worse" over time -- which is the issue of this
discussion and the scientific facts reported below. OSB]

RM > As I said above, I would not hesitate to suggest that the
patient endure even more distance blur, or deal with the
annoyance of using a reading-only prescription, IF IT WAS
PROVEN TO ACTUALLY HELP ANYONE, BUT IT HASN'T BEEN!

Otis> [Again the issue -- proven to WHOM! This depends on the
person's understanding of the issues involved. Clearly
forceful use of the plus requires strong motivation -- and
perhaps most are not "up" for this effort. OSB]

RM > 5. And finally, since there is no proven medical/scientific
merit to using plus lenses to prevent or reduce myopia,
suggesting that patients actually use it does in fact
constitute a potential legal/licensing issue for an eye
doctor (as it should).

Otis> [I agree that only the issue is PREVENTION -- before the minus
lens is applied. OSB]

Otis> [I also appreciate the truth that if ANYTHING happens when you
wear a plus -- under OD "control" -- that you can go back
and sue the OD who gave you a plus. This is the tragic
truth as to why most ODs will not even discuss the possible
use of the plus for prevention. Further, if there is any
"complaint" by anyone about the plus -- the optometrist will
be called before an "Optometry Review Board" who might well
revoke his license. OSB]

Otis> [There is SCIENTIFIC merit to the concept that the natural eye
is dynamic. Convincing a person to use the plus CORRECTLY
is almost impossible. (Read, "The Printer's Son", Chapter 3
on "www.i-see.org") OSB]

RN > If you want to change the way eye doctors prescribes lenses
for myopia, GO PROVE YOUR POINT IN SCIENTIFIC STUDIES.

Otis> [The scientific proof is absolutely solid. RM confuses "medical
proof" with scientific proof. I prefer that you personally
look at the scientific facts which are critical -- and RM
totally ignores that necessity. OSB]

Otis> [As it stands now, the person himself must prove to himself (by
clearing to 20/20) that he can use the plus effectively.
OSB]

RM > Quit misquoting people. It is clear that you aren't
convincing anyone.

Otis> [And equally ANYONE who objects to the "traditional" minus lens
gets this treatment. That is why I discuss these issues on
"i-see". OSB]

Otis> [I NEVER "practice medicine". I only report facts accurately,
and encourage a the person I talk to in order think carefully
about their long-term vision. OSB]

RM > Perhaps you don't care if you are right or wrong, you just
like to read your own prose and see how others react to your
incredible statements.

Otis> [Perhaps I care too much. As far as "right" or "wrong", I
do care about an accurate analysis of the natural eye's
behavior (proven in pure-science) and the way these
scientific fact are perceived. It is clear that scientific
facts and truth can not be reduced into a "magic pill" that
satisfies a person in 15 minutes in an office. Maybe that
defines the difference between "medicine" and
engineering-science.]

Otis> [If you consider my scientific statement made below
"incredible" then I can do nothing about this issue. I only
seek to get the facts "straight" on a fundamental scientific
level.]

RM > Get off this myopia-prevention crusade.

Otis> [This is indeed an incredible statement. You would think
that these ODs are interested in PREVENTING nearsightedness?
Their job is in making your vision instantly sharp
with a minus -- the same as it has been done without change for
the last 400 years. I regret that work on true-prevention
causes so many people so much difficulty.]


___________________________________________________


Dear Friends,


Subject: What science (objective facts, repeatable scientific
experiments) tell us about the behavior of the
fundamental eye.


Re: Steve Leung OD has incredible personal fortitude to face the
type of abuse and assumptions as stated above.


Those of you who have worked their way out of nearsightedness
with the plus -- know the truth of this difficult situation.

Not a pretty picture. If I were an optometrist I do not
think I could take this kind of abuse.

But add in Raphaelson's statement about "The Printer's Son",
and you have to wonder if their can ever be ANY progress.

But let me state the simple objective facts as they now exist
for the natural eye's behavior.

1. When you place a minus lens on a population of eyes -- the
eyes wearing the minus lens go down relative to the control
group.

2. When you place a similar population of eyes in a
more-confined environment -- the refractive status of the
group in then "confined environment moves in both the
direction and magnitude of that "nearer" environment.

These are simple scientific facts -- from repeatable,
objective experiments. If any one doubts these basic scientific
fact -- then the experiment can be repeated to confirm them.

I do not see how much simpler this scientific truth can be
concerning the dynamic behavior of the adolescent eye.


Best,


Otis