DrLScience.Txt

Subject: Scientific and Medical Methods and Proof


"I know that most men ... can seldom accept even the
simplest and most obvious truth if it be such as would oblige them
to admit the falsity of conclusions which they have delighted in
explaining to colleagues, which they have proudly taught to
others, and which they have woven, thread by thread, into the very
fabric of their lives."

Leo Tolstoy


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

Arthur Schopenhauer


Otis> Please allow me to summarize the various statements made on
sci.med.vision. These statements reflect the thinking of
main-stream optometrists at this time. Please remember that
there are many ODs who do not share DrL's opinion and
absolute judgment. But it is indeed difficult for the
"second opinion" ODs when this type of judgment "controls"
the standard prescription policy.

Otis> Remember, unless the patient's understanding of the use of
the plus lens is excellent, he most likely will go elsewhere
if the plus lens is offered (on the threshold), and the
patient has no understanding of any of these issues.

Otis> The effect on the second-opinion OD who attempts prevention
at the threshold, it that the patient will "go elsewhere",
and most likely to Dr L, and his use of the minus lens.
Since the superficial "sharpness" of the minus lens
impresses the patient, he concludes that DrL is the
"real" scientific doctor.

Otis> It must be stated that this is the actual reason why an
optometrist can not offer the use of the plus to the public.
It takes an "educated" parent to learn to accept the use of
the plus on a child on the threshold of nearsightedness.

Otis> Below, DL demonstrates how he proves that a minus lens has
no effect on the refractive status of the native or natural
eye.

_________________


DrL > I do insist that a minus lens has no negative effect on the
refractive status of a myopic individual when properly
prescribed and properly used. Scientists who run this type
of experiment would not disagree.

Otis> But to insist that a minus lens has NO EFFECT on the
refractive status of the natural eye is ridiculous. The
scientists who run this type of experiment know better.

___________


Otis> Here DrL insists that a minus lens has "no effect" on the
refractive status of the natural eye.

Otis> At some point, this becomes a statement of "faith" rather
than a statement of objective, scientific fact.

Otis> He is in a position to make his statement "stick" however and
to deny objective, experimental reality.

Otis> Here is an expansion of Dr L's statement and the type of
"science" he conducts to prove that a minus lens has no
effect on the eye's refractive status. All "direct"
experimental data, where the environment is strictly changed,
and the refractive status of the control group versus test
group is accurately measured -- totally ignored.

Otis> DrL then goes on to declare that all these studies are
anecdotal, in preference to his conclusion using his own
anecdotal methods. Wow!

___________________


Dr. "G" Leukoma at drgNOSPAM@... wrote on 5/30/04

DrG > To Otis

DrG > I did not say that a minus lens has no effect on the
refractive status of the eye. I said that a minus lens
"properly prescribed to neutralize refractive error" has not
been demonstrated to have an effect on the refractive status
of the eye. I have indeed observed this every day, because
that is what I have done everyday for 20 years.

DrG > I have observed that children who have never worn eyeglasses
will present in my office with myopic refractive error. If
they are borderline and are very young, I have a discussion
with the parent on the options of

(a) doing nothing at this point, or

(b) prescribing glasses at this point.

DrG > In other words, I have been conducting an ongoing experiment
in my practice in which there is a treatment group and a
control group. What I have observed in my practice is that
the treatment group does not get myopic any faster than the
control group. Furthermore, virtually all myopic patients
who wear minus lenses eventually exhibit a slowing down in
the rate of their myopic progression, and eventually no
longer get more myopic.

BillPhD> To DrG,

BillPhD> I am also an engineer with specialization in optics
and lasers. I start from the assumption that the body
tries to adjust itself to its environment. It is like a
physiological version of Le Chatelier's principle.

BillPhD> Instead of treatment and control groups, have you
classified your patients in terms of those who do close
work and those who do not? Again, and I am speculating,
that those children with progressive myopia have greater
near accommodation than those who do not. Extreme
accommodative capability makes it POSSIBLE for close
work. In my case it was comic books in poor light.
Such accommodation may tend to become permanent until
fitted (minus-lens) glasses rekill the equilibrium.


DrG > The devil is always in the details.

DrG > All children do close work. The universe of the infant is
the crib. If you examine my response to Otis, you will see
that my reference was very young children, age +/- 5 years.

DrG > Regarding young children who demonstrate above average
amounts of myopia, or above average myopic progression, I
always ask the parents about the behavior of the child. The
response is almost always that reading is the favorite
pre-occupation of those children, i.e. the child is always
engaged in a book. This behavior, rather than being
discouraged, is in fact encouraged by the parents. It tends
to translate into higher academic performance.

DrG > However, the original question was in regard to treating
with a minus lens, and my response was that it doesn't seem
to make a difference whether a minus lens is prescribed, or
not prescribed in terms of myopic progression.

DrG > I am one of those who tends to believe that accommodation is
either not a factor or a minor variable in the genesis of
myopia.

__________________


Otis> In the passage below, DrL asserts his scientific credentials
-- I guess to prove that the methods presented here are
based on "science".

_______________


Otis> The papers (published with Dr. Francis Young) were
published with established scientific researchers. It is
true however, that they ask scientific questions concerning
the behavior of all natural eyes as sophisticated control
systems. Clearly by your definition, that part of the
concept is not part of optometry. If you wish to declare
all these scientific studies "off limits" because they do
not address "cause" of "refractive error", you are free to
do so.

DrL > What the heck are saying, man? I have a degree in
chemistry, worked as a biomedical engineer for a fortune 500
company, and studied all the requisite "scientific"
disciplines on my way to becoming an O.D. As an
accomplished "scientist," I find your attitudes and ideas
rather "unscientific."

________________

Otis> While DrL may have good academic credentials, he completely
ignores other scientists with even more impressive
credentials than he has -- who in no sense believe that his
assertions are accurate and correct -- or even scientific.