Dear Prevention-minded friends,

Subject:  The need for a pure-plus effort.

1.  A bifocal (study) is run.

2.  The results are good.  (i.e., the plus group does
not go down, and the single-minus goes  DOWN at
a rate of -1/2 diopter per year.

There are two conclusions you can draw:

1. Run another bi-focal study to discredit the above, or

2. Conduct an "open" PLUS study (where the person has
the intelligence and motivation) to do what is essential.

Here is a discussion about why these bifocal studies
"fail" -- for your interest.

Otis

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


From Alex of i-see:

Another critique of the "bifocal experiments"

The following is from a letter to the editor of the Journal of the
American Optometric Association, by bifocals-for-myopia proponent
Paul Harris, O.D., in response to an article showing "limited"
effects.

<<Although the article as published showed some positive effect, its
protocol was seriously flawed, as have been nearly all research
protocols of this type. I am continually amazed at the resources that
are consumed attempting research where the protocol dooms the study
to either failure or minimal effect before the first patient has been
seen.>>

You can read his full commentary here:

http://www.babousa.org/news597.htm

Dr. Harris's point is that the amount of plus in a bifocal that
should be used must be determined on an individual basis, and that
you can get better results if you use the right formula.

Perhaps, but as I've said before, I think you get better results if
the children are told how important it is to actually read through
the "plus" section and hold the reading material as far away as
possbile so as to reduce accommodation (or hyperopic blur, if that's
your theory).

At the end of the letter, written in January 1997. Dr. Harris makes a
plea to all researchers to consult with him before planning their
next doomed-to-failure experiment.

I don't think anyone listened. The COMET study, the plus lens study
to end all plus lens studies was being organized at just that time:

http://www.nei.nih.gov/neitrials/static/study9.asp

http://www.iovs.org/cgi/content/full/44/4/1492

And once again it was proved that plus lenses don't do much if you
have no idea what they're for or how to use them.

Unlike the case with the Young-Oakley experiment (http://
www.myopia.org/bifocals.htm), it does not appear as if the subjects
were given any instruction at all on how to keep their near work at
an appropriate distance. If anything, it sounds as if they were told
to bring things closer in order to see "clearly" through the "plus"
part of the lens!

http://www.optvissci.com/pt/re/ovs/fulltext.00006324-200601000-
00013.htm

<<As a result of the optical properties of the PALs [progressive
addition lens=a type of bifocal], special instructions were required
to help the children use the PALs correctly to obtain clear vision at
different viewing distances. These same instructions were given to
children with SVLs [single vision lenses -- i.e. normal glasses].>>

In fact, I wonder if their very ignorance of the principle of plus-
lens myopia prevention led the subjects to do even more eye-straining
work in their glasses because they thought that their magic myopia-
preventing glasses would protect them!

--Alex

Dear Me,

Subject: Congratulations -- you are protecting your distant vision
the way it must be done.

When the eye has a negative refractive STATE of about -1/2 diopter,
you will see slight blur at distance.

As the eye "adapts" to a "distant environment" produced by
your long-term use of the preventive-plus, the refractive
STATE of the eye will change in a positive direction.


Me>  What I don't fully understand is: Why can I now see clearly at
29" using +1.25D lenes, when previously 24" was the max?

Otis> This is a direct confirmation of the benifical effect of the
plus lens.

Otis>  Here is the math:

But let me simplify:

1.  If your refractive STATE were zero, then the point of "just blur"
would be 1 meter when looking through a +1 diopter lens.

2.  If your refractive STATE were -1 diopter, the maximum
"just blur" distance would have been 0.5 meters.

Now:

1.  When your "just blur" distance was 24 inches, through a
+1.25 diopter lens, your refractive STATE was about 0.6 diopters,
given that combination.

2.  Your new refractive STATE changed, from 24 inches
to 29 inches through a +1.25 diopters lens was about
0.75 diopters.

3.  Your refractive STATE changed by +0.15 diopters.

Commentary:

This is not a lot, and depends on your judgment.  But it directly
confirms that your vision is improving as it should provided you
continue.

When you can read at 31 inches through a +1.25 diopter lens,
your refractive STATE will be zero -- which is considered ideal
for the normal eye.

Other scientists and physicists can confirm the math as I have
presented it.

(But I will confirm it in due course.)

Me> Is it possible to train the eye to accomodate more. -OR- or am I
simply reducing residual effects of  NITM caused by many years of
computer work?

Otis> You are reducing the effects of NITM, and confirming the
change in your refractive STATE by your own measurements.

Just my engineering second-opinion,

Otis

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


"Me" <m...@...> wrote:


Me> My job currently reqires full time computer use, so I am viewing
a computer 8+ hours a day.  I have been experimenting with plus
lenses +1.25D lenses for a few months now when I use my computer.
Without any lenses my vision is good,  I see typically 20/15 distance
vision and can focus down to about 6".

> During computer usage,  I typically view the monitor from about 32"
without plus lenses.  When I started using plus lenses,  I could
focus clearly at about 25".   I have attempted to keep the monitor
just on the edge of being out of focus.  After about two months, I
have noticed that Ican now focus clearly on the screen at 29" using
the same plus lenses.

> I have also noticed that after long hours at the computer,  my
distance vision would be worse than it was first thing in the
morning.   When wearing plus lenses, I noticed that I do not have any
change in my distance vision, even after hours at the computer.

> I have read quite a bit about Nearwork-Induced Transient Myopia
(NITM) and believe it explains why I see more clearly for distance
after using plus lenses at the computer.

> What I don't fully understand is:

> Why can I now see clearly at 29" using +1.25D lenes, when
previously 24" was the max?

> Is it possible to train the eye to accomodate more. -OR- or am I
simply reducing residual effects of  NITM caused by many years of
computer work?

Me

Dear Reader,

Subject:  Choosing "trade-offs" reasonably.

If I had a choice, I would rather that I cleared my
vision with a plus (used before the minus), and keep my Snellen clear
during the school years.  But that is a choice or engineering
"trade-off".

But when I get to 45 and over, I will have
clear distant vision (pass the DMV), but I will
"lose" some of my near vision.  But knowing about the
change in range of accommodation with age -- I can
mitigate some of the effect.

My neice has about 20/40 vision, and a refractive
STATE of about -1 diopters.

As some of the majority-opinion ODs suggest -- she
has the best of both "worlds".

To meet the legal requirement to drive, she gets
a weak minus which she keeps on the dash.  She wears
it to meet the law.  She wears no minus at any other time.

Because she is getting "older", the fact that her
refractive STATE is -1 diopter means that she will
keep her NEAR vision -- probably through age 70 or greater.

This is because the depth-of-focus of about 1 to 1.5 diopters
will take care of her near vision, and a range of
1 diopter of accommodation will take care of the rest.

I do not think she has used any lens (plus or minus) for
the past 15 years.

She went through college and graduate school wearing the
plus -- and passing the DMV at that time.

I have discussed, I recommended this course of action
to her.  And she likes wearing no lens at all.

That is the best type of solution for her.

Just one man's opinion,

Otis

Dear Second-opinion (preventive) friends,

Subject: It has been almost universally true,  that
when a new preventive method is developed, the
"conventional" optometrist will attack it, using
everything in his power to destroy it.

Here is an example of the "attack-dog" mentanlity.

The first statment refers to Donald Rehm.  PClar
responds.

Otis

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

From Otis on sci.med.vision:

Dear Second-opinion friends,

Subject: Here is a discussion on how to avoid ENTRY into
myopia.

http://breakfornews.com/forum/viewtopic.php?t=2254

It is about 35 minutes -- so click, listen, and
enjoy.

Some day you may be directed to listen to
this audio -- to help your own children with
prevention.

Keep an open mind,


Otis

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

From PClar on sci.med.vision:

yes--  parents should definitely familiarize themselves with a
handful
of different fairy tales so they can stimulate their children's
imaginations and help them fall to sleep at bedtime.  Rapunzel is one
of my favorites, but there are delightful books chock-full of
interesting tales by such talented authors as the Brothers Grimm
(http://en.wikipedia.org/wiki/Children%27s_and_Household_Tales).

actually, the tale written by Don Rehm that Otis is referring to, is
inappropriate for children in my opinion since it contains hate-
mongering sections such as when Mr. Rehn accuses the director of the
National Eye Institute of accepting bribes from large optical
companies so as to deliberately "hook" U.S. citizens on the use of
eyeglasses (http://www.myopia.org/nei.htm).  Children shouldn't learn
to behave in such a manner and it is regrettable that Mr. Rehm never
matured beyond the mental age of 12 before writing his website.


But I do agree that you should keep an open mind when you read the
stuff written by fanatics like Don Rehm and Otis Brown.  they do not
intentionally mean to be liars and con-men (I think) but instead they
are simply mentally-challenged and mis-informed so that they actually
believe the dingle-berry claims they make.  Otis Brown would actually
recommend that nearsighted people wear reading glasses so that their
distance vision is even more blurred than it normally would.  He
believes that such a treatment can prevent further changes in a
persons eyeglass prescription even though clear scientific studies
have disproved what he says decades ago.  I suppose he doesn't care
that people, should they take his advise, might run over small
animals
or children while driving or be unable to see cars stopped ahead of
them on the road.  Mr. Brown's treatment method has actually caused
some people to develop double-vision, and has caused at least one
angry citizen to file a formal complaint to the authorities in the
state where he lives.  So I would ask, which would be worse-- the
disease or the (alleged) cure?

In the end, Mr. Rehm and Mr. Brown are rather pitiful and should
probably be humored rather than challenged.  If you try to confront
them and ask them to PROVE their claims they become unstable and
perhaps could harm someone or even themselves.  It's pretty safe to
assume that their mental illness manifests itself in more ways than
just what they say to us in this newsgroup.  They could have family
who live with them at home and their well-being could be in jeopardy.
If we "set them off" by publically-demonstrating their ignorance in
this newsgroup (again) we might be hearing about their reaction when
we turn on CNN and listen to breaking news stories about murder-
suicides,etc.

Just remember-- it's your vision and your eyes.  Don't trust your
health to untrained and inexperienced wackos who post ideas on the
internet.  Visit a real eye doctor and find out the truth.

PClar OD

Dear Competent engineers,

Subject:  Measuring your refractive STATE -- with
your own equipment.

Re: Why not.  We measure our own blood-pressure.

As part of an educational effort (empowerment
of the person) why not have him make
this measurement.

Here is the discussion.

http://www.revoptom.com/index.asp?page=2_1294.htm

Enjoy,

Otis

On Sep 29, 2007, at 3:44 PM, drjudy65 wrote:
>
> So who says it cannot be prevented?  We say that no method of
> prevention has been found to be effective, not that a method will
> never be found!

I think that statement "no method of prevention has been found to be
effective" while true in some sense, is misleading. It assumes a
definition of "found" meaning "agreed to be true by the medical
authorities". Certainly many optometrists, such as Merrill Bowan
(http://www.simplybrainy.com/simplybrainy_048.htm) have "found"
effective ways to prevent myopia. Merrill Bowan's method has not been
investigated in a randomized clinical trial.

"No method of prevention has been universally accepted as effective;
for those few lens-based methods which have been investigated in
clinical trials, the trials have shown only a marginal effect at
slowing progression. No modern clinical trials have been done on any
method to prevent the onset of myopia in schoolchildren."

--Alex

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...>
wrote:
>
>
> Dear Prevention minded reader,
>
> Subject:  The second-opinion SUGGESTS that it
> is possible to avoid ENTERING into a negative
> STATE.
>
> Re:  Very similar to scurvy.  It was profoudly easy
> to "treat" bleeding gums, and watch 30 percent
> of the sailors die.  It was virtually impossible
> to get them to change their eating habits.

It was actually very difficult to treat the bleeding gums associated
with scurvy in 17th and 18th century sailing ships.  Sailors did not
eat salt meat, beans and hardtack out of habit -- it was all the the
Navy fed them!


> There is a profound difference between saying that
> a situation CAN NOT BE PREVENTED, versus saying
> that you can not get out of it.
>
> No one has seriously attempted to START the preventive
> process BEFORE that first minus lens is applied.
>
> So stating that a negative refractive STATE can NEVER
> BE PREVENTED -- is jumping to your forgone conclusion.

So who says it cannot be prevented?  We say that no method of
prevention has been found to be effective, not that a method will
never be found!

> That is the same thing as stating that scurvy
> CAN NEVER BE PREVENTED.
>
> Up to the point it was prevented (by Captain Cook) I am
> certain that the medical mantra was that
> scurvy could not be prevented.

It had been known since before 1600 that fresh food prevented scurvy
but there was no way to store fresh food on the long voyages. Once a
successful method of preserving lemon juice was developed and when
the Navy was finally willing to spend money on it, then scurvy was
not a problem.  It was not a problem of the medical people not
knowing how to prevent or treat scurvy, it did not depend upon Cook's
voyage, it was a political and financial decision of the Navy and the
British government.

Judy

Dear Prevention-minded friends,

Subject:  Who EXACTLY must be "convinced" to use plus-prevention.

As far as I am concerned, it must be the person HIMSELF,
who should understand that 0.5 diopter/year DOWN rate
that developes if a plus is NOT used for prevention.

Further, the person must understand that if you place
a -3 diopter lens on a population of eyes, the refractive
STATE will change by -2 diopters in less than six months.

That is pure science.  If the peson can not take scientific
facts seriously -- then he will not understand the
necessity of clearing his Snellen under HIS control.

Here is some more discussion by A.G.

Remember, my intent is to help the person understand
these issues.  The goal it to get out if it -- before
the minus len is worn.  Thus the goal is never to
"slow down the rate at which it is getting worse" -- far
from it.  It is the goal of having the person
clear his Snellen under HIS control.  And keeping
his vision clear to avoid that -1/2 dipoter per
year that always develops for the un-protected eye.

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


Mike Tyner <mty...@...> writes

>Even so, if you walked into any optometrist I know, chances are you
could
>convince him to follow just about any reasonable course of "myopia
>prevention" if you show you've done reseach and know what you're
talking
>about.

[It is not the OD that can be "convinced".  It must be
the person himself.  OSB]

Mike> Undercorrection, overcorrection, bifocals, contacts, ortho-k,
no treatment at all, special plus readers, anything so long as kids
can see the blackboard and drivers can drive and there's no
suffering. Why wouldn't we?

[Because some idiot like Neil Brooks will file "charges" agaist
you for making the attempt.  OSB]


>It. Just. Don't. Work. Enough. To. Matter. They're teaching that in
the universities RIGHT NOW. I really think you should hurry over to
their newsgroups and change their minds RIGHT AWAY. This is
important. You really must fix this.



AG> I would agree that a statement that nothing yet tried has been
shown to
work well enough is reasonable. I believe that some work within
academia
is still in progress towards at least slowing the progression of
myopia,
such as COMET 2 (search on COMET 2 myopia to find loads of pdfs or
see
short mention in http://www.opt.indiana.edu/bcor/research.htm), a
trial
of progressive addition lenses in particular circumstances, and a
trial
by O'Leary on reducing blur by correcting aberrations to an unusually
high degree using contact lenses (was publicised, no doubt to aid
subject recruitment, in 2005:
http://news.bbc.co.uk/1/hi/health/4437067.
stm).

If you subscribe to the conventional view that the increased
prevalence
of myopia in developed countries is due to near work then it seems
reasonable that removal of near work (though entirely impractical)
would
greatly reduce the problem. The practical details of finding a way to
reduce myopia while preserving literacy, education, and indeed
entertainment remain, but it is surely worth at least keeping a watch
on
the problem, in the hope that it will become easier as technology
moves
forward, for instance by making computer projectors and large high
quality displays more widely available.
A.G.McDowell

Dear Reader,

Subject:  Clearing your Snellen under your
control.

It takes strong personal resolve to use the plus
correctly.  The majority-opinion OD has concluded
that he can not help you with plus-prevention -- as
stated below.

That means that you have the choice of doing it yourself.

Here is the commentary:

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

Otis> Further his successful efforts could only be recognized
against the back-drop of 30 percent dead on long
voyages.

MikeOD> Scurvy reversed and incidence pretty much dropped to zero
when Vitamin C was
added.

Now say 30% of the human population gets nearsighted. What happens
when you
add Vitamin P?

It's idiotic - the average joe optometrist would jump at the chance
to
recommend your treatment, and 30 years ago many of them did. Why did
they
quit? Anybody know?

But it isn't the average joe optometrist you have to convince. It's
the
ophthalmologists and pediatricians. And they aren't here, hint hint,
and
neither are the professors who write their textbooks. If you win them
over,
we guys in the trenches will follow suit right away. You don't seem
to
believe me. We really would.

Even so, if you walked into any optometrist I know, chances are you
could
convince him to follow just about any reasonable course of "myopia
prevention" if you show you've done reseach and know what you're
talking
about. Undercorrection, overcorrection, bifocals, contacts, ortho-k,
no
treatment at all, special plus readers, anything so long as kids can
see the
blackboard and drivers can drive and there's no suffering. Why
wouldn't we?

It. Just. Don't. Work. Enough. To. Matter. They're teaching that in
the
universities RIGHT NOW. I really think you should hurry over to their
newsgroups and change their minds RIGHT AWAY. This is important. You
really
must fix this.

When you're done, would you change a few state regs, FTC rulings, and
overturn some case law for us? Whatta guy!

-MT

Subject:  Telling the truth about the dynamic
behavior of the fundamental eye.

Otis> But you must get your facts right (about the dynamic
behavior of the eye in the first place) to do it "right".

MikeOD> As long as we don't actually test your "prevention" in
humans.

Mike>  You can believe anything you like because you have no license
to maintain.

Mike>  I couldn't find evidence that it works in humans. That's why
we believe you're lying.

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

Subject:  Remarks about scurvey-prevention and negative refractive
STATE prevention.

Yes, Mike, it took a considerable act of "faith" for
Captain Cook to introduce anti-scurvy efforts for
his crew.

And I am certain that some of the crew were
calling him a "idiot" for instituting those life-saving
efforts.   (Not to his face, of course.)

Further his successful efforts could only be recognized
against the back-drop of 30 percent dead on long
voyages.

Yes, soving difficult problems does take a lot of "faith" -- no
doubt about it.  But it is in science that this "faith" must rest.

But you must get your facts right (about the dynamic
behavior in the first place) to do it "right".

Just my second-opinion,

Otis

Dear Prevention minded reader,

Subject:  The second-opinion SUGGESTS that it
is possible to avoid ENTERING into a negative
STATE.

Re:  Very similar to scurvy.  It was profoudly easy
to "treat" bleeding gums, and watch 30 percent
of the sailors die.  It was virtually impossible
to get them to change their eating habits.

Here is the majority-opinion for your interest.

There is a profound difference between saying that
a situation CAN NOT BE PREVENTED, versus saying
that you can not get out of it.

No one has seriously attempted to START the preventive
process BEFORE that first minus lens is applied.

So stating that a negative refractive STATE can NEVER
BE PREVENTED -- is jumping to your forgone conclusion.

That is the same thing as stating that scurvy
CAN NEVER BE PREVENTED.

Up to the point it was prevented (by Captain Cook) I am
certain that the medical mantra was that
scurvy could not be prevented.

And I am certain that when Cook instituted his PREVENTIVE
methods, memebers of the crew called Cook an
idiot for these life-saving methods.

Best,

Otis

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

Myopia; Shortsightedness

Edward B. Feinberg, MD, MPH, Professor and Chair, Department of
Ophthalmology

Nearsightedness is when the eyes focus incorrectly, making distant
objects appear blurred.

Causes, incidence, and risk factors    Return to top

A nearsighted person sees near objects clearly, while objects in the
distance are blurred. As a result, someone with myopia tends to
squint when viewing far away objects. This characteristic is the
basis of the word "myopia," which comes from two Greek words: myein,
meaning shut, and ops, meaning eye.

A nearsighted person can easily read the Jaeger eye chart (the chart
for near reading), but finds the Snellen eye chart (the chart for
distance) difficult to read. This blurred vision results when the
visual image is focused in front of the retina, rather than directly
on it.

It occurs when the physical length of the eye is greater than the
optical length. For this reason, nearsightedness often develops in
the rapidly growing school-aged child or teenager, and progresses
during the growth years, requiring frequent changes in glasses or
contact lenses. It usually stops progressing as growth is completed
in the early twenties.

Nearsightedness affects males and females equally, and those with a
family history of nearsightedness are more likely to develop it. Most
eyes with nearsightedness are entirely healthy, but a small number of
people with myopia develop a form of retinal degeneration.

Symptoms

Blurred vision or squinting when trying to see distant objects
(children often cannot read the blackboard, but can easily read a
book).

Eyestrain.

Headaches (uncommon).

Signs and tests

A general eye examination, or standard ophthalmic exam may include:

Visual acuity, both at a distance (Snellen), and close up

(Jaeger) Refraction test, to determine the correct prescription for
glasses

Test of color vision, to test for possible color blindness

Tests of the muscles which move the eyes

Slit-lamp exam of the structures at the front of the eyes

Measurement of the pressure of fluid in the eyes

Retinal examination

Treatment

Nearsightedness is easily compensated for by the use of eyeglasses or
contact lenses, which shift the focus point to the retina. There are
several surgical procedures that reshape the cornea, shifting the
focus point from in front of the retina to the retina.

Radial keratotomy is a surgical procedure popular in the recent past.
Now it has been almost completely replaced by LASIK, in which an
excimer laser is used to reshape the cornea.

Expectations (prognosis)

Early diagnosis of nearsightedness is important, because a child can
suffer socially and educationally by not being able to see well at a
distance.

Complications

Complications may be associated with the use of contact lenses
(corneal ulcers and infections )

Complications of laser vision correction are uncommon, but can be
serious

Although it is rare, people with myopia may develop retinal
detachments or retinal degeneration

Calling your health care provider

Call for an appointment with your ophthalmologist if your child shows
these signs, which may indicate a vision problem: sitting close to
television, holding books very close when reading, or having
difficulty reading the blackboard in school or signs on a wall.

Call for an appointment with your ophthalmologist if your child is
having difficulties at school that may be caused by a vision problem.

Call for an appointment with your ophthalmologist if a person with
nearsightedness experiences flashing lights, floating spots, or a
sudden loss of any part of the field of vision.

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

Prevention

There is no way to prevent nearsightedness. Reading and watching
television do not cause nearsightedness. In the past, dilating eye
drops were proposed as treatment to slow development of
nearsightedness in children, but they have never been proved
effective.

The use of glasses or contact lenses does not affect the normal
progression of myopia in the growth years -- they simply focus the
light so the nearsighted person can see distant objects clearly.

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

Update Date: 11/14/2005

Updated by: Edward B. Feinberg, MD, MPH,
Professor and Chair,
Department of Ophthalmology,
Boston University School of Medicine, Boston, MA.
Review provided by VeriMed Healthcare Network.

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...>
wrote:
>
>
> Dear Prevention-minded reader,
>
> Subject:  Different values for "myopia".
>
> The adult human eye has a total power of about 60 diopters.
>
> To add another 50 diopters would give a total power
> of 110 diopters.  And this is under the age of 11.

Read more carefully; the range of ages at diagnosis (ie first
discovered to be myopic) was birth to age 11.  The range of
refractive error (-5.50 to -50.00) was for adults.

I would assume that the person with -50.00 was an older adult, not
an 11 year old child.

Judy


>
> Incredible.
>
> Enjoy,
>
> Otis
>
> ++++++++++++++++++
>
> New locus for autosomal dominant high myopia maps to the long arm
of
> chromosome 17.Paluru P, Ronan SM, Heon E, Devoto M, Wildenberg SC,
> Scavello G, Holleschau A, Mäkitie O, Cole WG, King RA, Young TL.
>
> Division of Ophthalmology, Children's Hospital of Philadelphia and
> the University of Pennsylvania, Philadelphia, Pennsylvania 19104,
USA.
>
> PURPOSE: To map the gene(s) associated with autosomal dominant
(AD)
> high-grade myopia.
>
> METHODS: A multigeneration English/Canadian family with AD severe
> myopia was ascertained. Myopes were healthy, with no clinical
> evidence of syndromic disease, anterior segment abnormalities, or
> glaucoma. The family contained 22 participating members (12
> affected). The average age of diagnosis of myopia was 8.9 years
> (range, birth to 11 years). The average refractive error for
affected
> adults was -13.925 D (range, -5.50 to -50.00). Microsatellite
markers
> for genotyping were used to assess linkage to several candidate
loci,
> including three previously identified AD high-myopia loci on
> 18p11.31, 12q22-q23, and 7q36. Syndromic myopia linkage was
excluded
> by using intragenic or flanking markers for Stickler syndrome
types
> 1, 2, and 2B; Marfan syndrome; Ehlers-Danlos syndrome type 4; and
> juvenile glaucoma. A full genome screening was performed, with 327
> microsatellite markers spaced by 5 to 10 cM. Two-point linkage was
> analyzed using the FASTLINK program run at 90% penetrance and a
> myopia gene frequency of 0.0133.
>
>
> RESULTS: Linkage to all candidate loci was excluded. The genome
> screening yielded a maximum two-point lod score of 3.17 at theta =
0
> with microsatellite marker D17S1604. Fine mapping and haplotype
> analysis defined the critical interval of 7.71 cM at 17q21-22.
>
>
> CONCLUSIONS: A novel putative disease locus for AD high-grade
myopia
> has been identified and provides additional support for genetic
> heterogeneity for this disorder.
>
> PMID: 12714612 [PubMed - indexed for MEDLINE]
>

Dear Prevention-minded reader,

Subject:  Different values for "myopia".

The adult human eye has a total power of about 60 diopters.

To add another 50 diopters would give a total power
of 110 diopters.  And this is under the age of 11.

Incredible.

Enjoy,

Otis

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

New locus for autosomal dominant high myopia maps to the long arm of
chromosome 17.Paluru P, Ronan SM, Heon E, Devoto M, Wildenberg SC,
Scavello G, Holleschau A, Mäkitie O, Cole WG, King RA, Young TL.

Division of Ophthalmology, Children's Hospital of Philadelphia and
the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.

PURPOSE: To map the gene(s) associated with autosomal dominant (AD)
high-grade myopia.

METHODS: A multigeneration English/Canadian family with AD severe
myopia was ascertained. Myopes were healthy, with no clinical
evidence of syndromic disease, anterior segment abnormalities, or
glaucoma. The family contained 22 participating members (12
affected). The average age of diagnosis of myopia was 8.9 years
(range, birth to 11 years). The average refractive error for affected
adults was -13.925 D (range, -5.50 to -50.00). Microsatellite markers
for genotyping were used to assess linkage to several candidate loci,
including three previously identified AD high-myopia loci on
18p11.31, 12q22-q23, and 7q36. Syndromic myopia linkage was excluded
by using intragenic or flanking markers for Stickler syndrome types
1, 2, and 2B; Marfan syndrome; Ehlers-Danlos syndrome type 4; and
juvenile glaucoma. A full genome screening was performed, with 327
microsatellite markers spaced by 5 to 10 cM. Two-point linkage was
analyzed using the FASTLINK program run at 90% penetrance and a
myopia gene frequency of 0.0133.


RESULTS: Linkage to all candidate loci was excluded. The genome
screening yielded a maximum two-point lod score of 3.17 at theta = 0
with microsatellite marker D17S1604. Fine mapping and haplotype
analysis defined the critical interval of 7.71 cM at 17q21-22.


CONCLUSIONS: A novel putative disease locus for AD high-grade myopia
has been identified and provides additional support for genetic
heterogeneity for this disorder.

PMID: 12714612 [PubMed - indexed for MEDLINE]

Dear Judy,

I don't think so.

The Admirality may have "known" a great many
things ... but they did ABSOLUTLY NOTHING
ABOUT IT.

The book that documents this fact is,
"The Discoverers", by Daniel J. Boorstin.

What he said (Page 289) was this:

"Apparently Cook himself never knew Lind's work, but
he had heard of the use of citrus fruits and other
possible preventives of scurvy."

Boorstin also said:

...A Scottish naval surgeon,
demonstated that citrus fruit could prevent scurvy
(1753).  ...he did attract the notice of Lord
Anson.

...But the Admirality delayed so long acting on his findings that
this has become the sociologists' classic case of
bureaucratic apathy.

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

It took a first-rate Naval Captain to get off his
duff and do what "apathy" in its own way ... prevented.

Sounds familar.  Can you think of anything similar?

Best,

Otis



--- In Myopiafree2@yahoogroups.com, "drjudy65" <mpace99@...> wrote:
>
> --- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@>
> wrote:
> >
> >
> > Dear Judy,
> >
> > In fact, James Cook never sal the research -- although
> > he must have heard various "suggestions".
> >
> > The Admirality had some knowledge of it -- but
> > did absolutely NOTHING about it.
> >
> > It took the good judgment and FORTITUTED of
> > a poor sea-captain to actually implement the
> > anti-scurvey efforts.
> >
> > Even so, I am certain that there were
> > "stuffed-shirts" in the Admirality, who
> > scoffed at Cook's successful efforts and
> > claimed that just "random chance" produced
> > no scurvey for a three years voyage.
>
> I don't think so, read the book I recommended which goes into the
> politics of the eighteenth century Navy in detail.  The Navy knew
for
> a century or more that fresh food prevented scurvy and they hoped
any
> acid based food was the answer because malt wort and vinegar were
> cheap whereas citrus fruit was expensive.  It took a very
determined
> Chief Surgeon to insist that James Lind's clinical trial meant that
> the money had to spent on citrus fruit and to supply lemon juice to
> sailors.
>
> Judy
>

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...>
wrote:
>
>
> Dear Judy,
>
> In fact, James Cook never sal the research -- although
> he must have heard various "suggestions".
>
> The Admirality had some knowledge of it -- but
> did absolutely NOTHING about it.
>
> It took the good judgment and FORTITUTED of
> a poor sea-captain to actually implement the
> anti-scurvey efforts.
>
> Even so, I am certain that there were
> "stuffed-shirts" in the Admirality, who
> scoffed at Cook's successful efforts and
> claimed that just "random chance" produced
> no scurvey for a three years voyage.

I don't think so, read the book I recommended which goes into the
politics of the eighteenth century Navy in detail.  The Navy knew for
a century or more that fresh food prevented scurvy and they hoped any
acid based food was the answer because malt wort and vinegar were
cheap whereas citrus fruit was expensive.  It took a very determined
Chief Surgeon to insist that James Lind's clinical trial meant that
the money had to spent on citrus fruit and to supply lemon juice to
sailors.

Judy

Dear Judy,

In fact, James Cook never sal the research -- although
he must have heard various "suggestions".

The Admirality had some knowledge of it -- but
did absolutely NOTHING about it.

It took the good judgment and FORTITUTED of
a poor sea-captain to actually implement the
anti-scurvey efforts.

Even so, I am certain that there were
"stuffed-shirts" in the Admirality, who
scoffed at Cook's successful efforts and
claimed that just "random chance" produced
no scurvey for a three years voyage.

Sound familiar?

Otis





--- In Myopiafree2@yahoogroups.com, "drjudy65" <mpace99@...> wrote:
>
> --- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@>
> wrote:
> >
> >
> > Scurvy.txt
> >
> > Dear Alex, and prevention-minded friends,
> >
> > Subject:  How AVOIDING entry into scurvy -- was achieved!
> >
> >      I would suggest that this type of problem is not "open" to an
> > absolute blind study.
>
> Sure it is, and James Lind conducted a clinical trial in 1747 of
> various items thought to be effective against scurvy.  He didn't do
> it as a blind trial, but he did have various groups, each with a
> different treatment and random assignment.
>
> > In the 1750, a Captain James Cook, became very concerned. He
> > "read the literature", but could come to no absolute conclusion.
> > But he formed to very strong judgments:
>
>
> Actually you got your dates and persons a little mixed up.  Citrus
> fruit were known to be effective antiscorbitics as early as 1600.
> In 1747 James Lind demonstrated the effectiveness of citrus fruit
in
> curing scury in one of the earliest clinical trials: he gave
various
> foods or supplements, all rumoured to prevent scurvy to different
> groups of sailors suffering from scurvy and found citrus to be the
> effective remedy.
>
>  http://en.wikipedia.org/wiki/Scurvy
>
>  http://en.wikipedia.org/wiki/James_Lind
>
> Cook fed his seamen both sauerkraut and a citrus syrup, the
> sauerkraut did not work as well as the citrus.  His three year
voyage
> was in 1768, not 1750.
>
> http://en.wikipedia.org/wiki/James_Cook
>
> Citrus was expensive and the Navy continued to use other things
like
> saurekraut, vinegar and malt based on testimonial evidence, not
> Lind's clinical trial results, and scurvy continued to be a
problem.
> Finally, the Navy heeded the clinical trial and added lemon or lime
> juice to sailors' rations during the Napoleonic wars.
>
> For a well written book about scurvy and its cure see:
>
> http://www.amazon.com/Scurvy-Surgeon-Mariner-Gentlemen-
> Greatest/dp/0312313926
>
> In it, you will find that relying on testimonials and common
> knowledge and ignoring a scientific clinical trial resulted in the
> delay of implementation of a cure for scurvy.
>
> Judy
>

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...>
wrote:
>
>
> Scurvy.txt
>
> Dear Alex, and prevention-minded friends,
>
> Subject:  How AVOIDING entry into scurvy -- was achieved!
>
>      I would suggest that this type of problem is not "open" to an
> absolute blind study.

Sure it is, and James Lind conducted a clinical trial in 1747 of
various items thought to be effective against scurvy.  He didn't do
it as a blind trial, but he did have various groups, each with a
different treatment and random assignment.

> In the 1750, a Captain James Cook, became very concerned. He
> "read the literature", but could come to no absolute conclusion.
> But he formed to very strong judgments:


Actually you got your dates and persons a little mixed up.  Citrus
fruit were known to be effective antiscorbitics as early as 1600.
In 1747 James Lind demonstrated the effectiveness of citrus fruit in
curing scury in one of the earliest clinical trials: he gave various
foods or supplements, all rumoured to prevent scurvy to different
groups of sailors suffering from scurvy and found citrus to be the
effective remedy.

  http://en.wikipedia.org/wiki/Scurvy

  http://en.wikipedia.org/wiki/James_Lind

Cook fed his seamen both sauerkraut and a citrus syrup, the
sauerkraut did not work as well as the citrus.  His three year voyage
was in 1768, not 1750.

http://en.wikipedia.org/wiki/James_Cook

Citrus was expensive and the Navy continued to use other things like
saurekraut, vinegar and malt based on testimonial evidence, not
Lind's clinical trial results, and scurvy continued to be a problem.
Finally, the Navy heeded the clinical trial and added lemon or lime
juice to sailors' rations during the Napoleonic wars.

For a well written book about scurvy and its cure see:

http://www.amazon.com/Scurvy-Surgeon-Mariner-Gentlemen-
Greatest/dp/0312313926

In it, you will find that relying on testimonials and common
knowledge and ignoring a scientific clinical trial resulted in the
delay of implementation of a cure for scurvy.

Judy

http://www.healthline.com/galecontent/myopia-5/4

Author Info: L. Fleming Fallon Jr., MD, DrPH, The Gale Group Inc., Gale,
Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002

<<Alternative treatments

Some eye care professionals recommend treatments to help improve
circulation, reduce eye strain, and relax the eye muscles. It is
possible that by combining exercises with changes in behavior, the
progression of myopia may be slowed or prevented. Alternative treatments
include: visual therapy (also referred to as vision training or eye
exercises), discontinuing close work, reducing eye strain (taking a rest
break during periods of prolonged near vision tasks), and wearing
bifocals to decrease the need to accommodate when doing close-up work.>>

No mention of plus lenses or reduced prescriptions, however. But "it is
possible" that the progression of myopia may be "prevented".

So prevention is possible, accourding to this source.

Or at least possibly possible.

It is interesting to note the obvious spin control here. They say that
the PROGRESSION of myopia can possibly be prevented, but shy away from
saying that ENTRY INTO myopia can be prevented, which, physiologically,
is the same thing (negative change in refractive state).

--Alex

Scurvy.txt

Dear Alex, and prevention-minded friends,

Subject:  How AVOIDING entry into scurvy -- was achieved!

Re:  The elements of the problem are very similar -- to
AVOIDING entry into nearsightedness.

      The formulation of a problem is often far more essential
than its solution, which may be a matter of mathematical
or experimental skill. To raise new questions,
new possibilities, to regard old problems from a
new angle, requires creative imagination and marks
real advances in science.

                                - Albert Einstein


      Since I am familiar with this story -- the means and method
are comparable to PREVENTING entry into a negative refractive
STATE for the eye.

      When voyages began to extend beyond three months, a small
percentage of sailors got bleeding gums and other "heath"
problems.  When the sailors went around the world, with voyages of
2 to 3 years, scurvy would run from 30 percent to 40 percent, with
30 percent dying of scurvy related issues.  This was from 1530's

      No one knew what to do.  The symptoms were treated -- but it
was a big mystery.

      I would suggest that this type of problem is not "open" to an
absolute blind study.

      In the 1750, a Captain James Cook, became very concerned. He
"read the literature", but could come to no absolute conclusion.
But he formed to very strong judgments:

1.  Be clean:  He forced the ship to be clean in every respect,
        down to the bilge.  The sailors hated the idea.

2.  He insisted that the OFFICERS eat sauerkraut -- and denied it
        to the seaman -- at first.

3.  He insisted that the sailors eat fresh food, meats (when
        available), and would stop to collect any fresh food that
        was available.  The sailors HATED the idea.

4.  The crew had been fed preserved foods (SALTED pork and the
        like).  The crew loved there "preserved" food -- and hated
        all the fresh food.

5.  Eventually when the crew saw their experts (the officers)
        eating sauerkraut -- they learned to eat it also.


      The result of ALL these efforts by James Cook, was that while
some of the crew died of accidents, no one got scurvy -- on a
three year voyage.

      Now, was this "proof"?  Not according to the "medical"
definition -- where the entire world must be a "blind study" --
(RCCT) before ANY RESULTS are "accepted".

      It is this intellectually BLIND insistence (by medical
people) on ALWAYS a blind study for SCIENCE TRUTH -- that drives
me up the wall.  Call it "medical truth" but please NEVER call it
"scientific truth".  Science NEVER requires a "blind study".

      Even with Cook's "proof", the rest of the British navy would
not take PREVENTION seriously. I think it took another 50 years
before these results were accepted by that Navy.

      So, Alex, to further enhance your comments:

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

Alex> Like the sailors who "spontaneously" recovered from scurvy.

Otis> Obviously it was not "spontaneous".  It took the wise mind
        and judgment (and support) to make scurvy-prevention
        effective.  And the proof was STATISTICAL, i.e., rate from
        30 percent to 1 percent.  It STILL took another 50 years
        before the rest of the Navy "woke up" to the idea of
        scurvy-prevention.  I think the same will be true of
        PREVENTING a negative refractive STATE of the natural eye.
        It is the PUBLIC that needs to be flogged to wear that plus
        for reading -- if you get my "drift".

Alex> Oh, by the way it turns out they just happened to be eating
        lemons.

Otis> And the people with great force-of-character are looking at
        their Snellen -- and clearing them, under THEIR own WISE
        control.

Otis> That is wise.  Can we "prove" it??  No, because they
        personally had to look at the facts themselves, and
        understand that they will NEVER get any help with
        prevention -- from people like Dr.  Judy.

Otis> Some things you can not do "by yourself".  But preventing a
        negative refractive STATE for your eyes -- is an item where
        there is no choice -- if you take your distant vision
        seriously.

Alex> Maybe we should look into that?

Otis> That is indeed why your are doing far more than the National
        Eye Institute is EVER going to do about it.

Otis> But the REAL ISSUE is the public's rejection of the
        preventive method at the threshold.  And that is an
        INTELLECTUAL issue the person himself must over-come.

Otis> The problem is that we attempt to FORCE the OD to be
        responsible for it -- when in fact we are PERSONALLY
        responsible for it.

Otis> Now if we could only understand that issue correctly.

Otis> Does 88 percent myopic entering Hong Kong university mean
        anything to us? Did 30 percent death rate from scurvy mean
        anything to anyone -- for 200 years?

Otis

Dear Reader,

If an OD or MD wishes to state that it is impossible
to GET OUT OF myopia -- I am close to agreeing with
him (once the child begins wearing a strong minus
ALL THE TIME).

But I do not agree that a negative refractive STATE
of the natural DYNAMIC eye -- CAN NOT BE PREVENTED.

This issue is the degree of responsibility the person
himself wants to take, to keep his Snellen clear
(always pass the DMV under HIS control.)

Clearly, if the person has that degree of wisdom,
monitors his Snellen, always "clears" it, then
the issue NEVER becomes medical -- for the simple
reason that the person himself "controls" the
situation -- and at very low cost.  (If money
matters.)

Here is Alex Eulenberg's discussion with Judy and Julie
about these issues for your enjoyment.

Otis

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


Re: Full disclosure by doctors


Julie (M.D.):

> I also would prefer a doc that wasn't absolute that no method has
> been shown to be successful to reverse myopia. As I mentioned
> before, I know of cases of myopia that reversed either with plus
> lenses or no lenses.

Judy (O.D.):

> I don't understand your point. Spontaneous change in refractive
> error is not evidence for a successful method.

First of all, "with plus lenses" is a method. Second of all, "with no
lenses" is a "method" called "undercorrection" or better yet, "wait
and see".

Of course, uncorrected myopia can be stable or progress as well.

But whenever you have a recovery, not knowing exactly what was going
on, to say it was "spontaneous" is jumping to a conclusion. You are
assuming that nothing else changed. However, look at those cases of
so-called spontaneous recovery and you might see something
interesting.

Like the sailors who "spontaneously" recovered from scurvy. Oh, by
the way it turns out they just happened to be eating lemons. Maybe we
should look into that?

Allow me to quote a classic sci.med.vision thread from 1995, where
Larry Bickford made Dr. Judy's point quite forcefully:

Larry Bickford, O.D:


http://groups.google.com/group/sci.med.vision/msg/e83f4705ebda8887
>> Congrats on the .50 reduction. I guess I must have seen this happen
>> in my practice a thousand times. I bet half the population of
planet
>> Earth could measure a .25 change from one exam to the next and
>> probably a few million or so might see .50 change from
morning 'till
>> evening. Hey---refract someone who's just spent 8 hours in front of
>> a computer and get one number and repeat the test the next morning
>> before work and guess what? Different results! Or try downing a pot
>> of caffeine before a refraction. Not to mention the possibility
that
>> your current RX miight be overcorrected by .5 because of any one of
>> number of possibilites. And listen: people's refractive errors do
>> change, one way or the other, just a little or sometimes a little
>> more, or less, over the years. That's one of the reasons I have a
>> job!

To which I replied:


http://groups.google.com/group/sci.med.vision/msg/d836404bee339ead
>> You said it! The point of vision therapy is to TAKE CONTROL of the
>> factors that influence one's refractive state!


Judy continues:



> Do you want me to lie to patients when they ask? No clinical
> trials have found a method to slow myopia progression by any
> meaningful amount, let alone reverse it. That's the truth, I can't
> hide the truth.

Judy, no one's asking you to lie. Whether or not something has been
"shown" to be effective depends on what kind or level of proof a
certain person is willing to accept. Some people believe that medical
knowledge is impossible without a randomized, double-blind, placebo-
controlled trial.

However, Kenneth Oakley (http://www.myopia.org/bifocals.htm) and
Martin Haberfeld
(http://www.i-see.org/plus_therapy/) were doctors to whom it was
"shown" that their respective techniques were effective -- by their
own clinical experience. The same could be said for all of the
currently practicing eye doctors listed here:

http://www.i-see.org/eyedocs.html

But back to Judy's situation. OK, Dr. Judy, since no effective method
has been "shown" to you, you have every right to say that "no
clinical trials have found a method...." Actually, I believe atropine
has been shown to be very effective clinically in slowing or even
arresting the progression of myopia (although I wouldn't recommend
it). From PubMed:

http://www.ncbi.nlm.nih.gov/sites/
entrezdb=pubmed&cmd=retrieve&uid=17295137

<<Myopic progression was significantly less (P = 0.005) in the
atropine group (+0.06 +/- 0.79 D) than in the control group (-1.19
+/- 2.48 D). Axial length increase was also significantly smaller in
the atropine group (0.09 +/- 0.19 mm) than in the control group (0.70
+/- 0.63 mm) (P = 0.004). One child (4.3%) developed an allergic
reaction. No other major adverse effects related to the treatment
were noted. CONCLUSION: Topical 1% atropine ointment is a safe and
effective treatment for retarding myopic progression in moderate to
severe myopia.>>

What I do object to is the unqualified assertion that myopia cannot
be prevented, controlled, or improved by any method, which
fortunately, you have not said.

However, such statements are not uncommon. The following comes from
the U.S. government sponsored Medline Plus encylopedia:

It says flatly: "There is no way to prevent nearsightedness." Not no
known way, but no way, period. In fact, just about everything now
being investigated and researched as a risk factor for myopia in the
abstracts you can find on PubMed has already been deemed
inconsequential. Pretty ironic... here it is, from the same National
Library of Medicine that brings you PubMed:

http://www.nlm.nih.gov/medlineplus/ency/article/001023.htm

<<Prevention

There is no way to prevent nearsightedness. Reading and watching
television do not cause nearsightedness. In the past, dilating eye
drops were proposed as treatment to slow development of
nearsightedness in children, but they have never been proved
effective.

The use of glasses or contact lenses does not affect the normal
progression of myopia in the growth years -- they simply focus the
light so the nearsighted person can see distant objects clearly.>>

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1722525

Br J Ophthalmol. 1998 March; 82(3): 210–211.

Ophthalmologists should consider the causes of myopia and not simply
treat its consequences
D FLITCROFT

<<For late onset myopia, the association with educational attainment
suggests that increased near work either disrupts normal
emmetropisation mechanisms or results in regulation of ocular growth
towards myopia as an adaptation to prolonged near work..... If myopia
is an adaptive physiological response to prolonged near work,
correction of myopia with lenses during childhood may increase the
final degree of myopia by requiring further adaptive changes in axial
length to neutralise the effects of the lenses. Certainly in animal
studies minus lenses do result in ocular growth towards myopia.>>

--Alex

JRalMyop.txt

Subject:  A medical doctor supports prevention.

      Here is Dr.  J.  Ralls discussing prevention issues from a
medical perspective.

      Dr.  Ralls is a friend of preventive methods.  But it up to
YOU to use them.

Enjoy,

Otis

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

      Exactly.  The mechanism is not understood and that is the
reason that eye doctors are unable to provide patients with advice
on how to prevent or reverse myopia.  For any suggested method,
the percentage success, the amount of time, the exact way to do
the method and adverse effects are unknown.  Would you recommend a
drug to a patient if how it works, whether it works, odds of
success, dosage amount, period of time to take it and adverse
effects where unknown?

      Actually, in many ways, yes, I do recommend medications that
have many gray areas, particularly botanical remedies that may or
may not work for a condition, have an excellent safety record,
centuries of use, but not the extensive research required by the
FDA for prescription meds.  I recommend exercise for weight loss
but I can't tell the patient that it will definitely work for her,
just how much it will take to loose weight etc.  When I look in
the PDR, many meds have the info "the exact mechanism of action is
unknown." SSRIs and other antidepressants have a lot of guess work
in them for example.  Family medicine isn't engineering.  Patients
ask when will their cold be gone.  It's an absurd question and I
am so sick of it.  I ask them, how long does it take for you to
read a book?

> Shame on the medical profession for not fully informing patients
        of our entire understanding of myopia.

What do you mean here ???

What information?

Currently I tell a patient:

      "You have myopia, I can provide you with good vision with
glasses, contact lenses or laser surgery"

      Do you want me to add:

      "Research is ongoing on methods to prevent future increases
in your myopia, but to date no method has been shown to be
successful"

Absolutely.  And let them know that there are co-morbidities
and what to watch out for i.e. flashes of light for retinal
detachment.  I've had patients come in having that for 3 weeks and
just blowing it off.

I also would prefer a doc that wasn't
absolute that no method has been shown to be successful to reverse
myopia.

As I mentioned before, I know of cases of myopia that
reversed either with plus lenses or no lenses. These patients did
not go back and inform their doctor that their vision had returned
to the old baseline.

And why would they?  Most patients I ask
about this don't know why they have myopia, don't know there are
co-morbidities, and they don't bother to ask questions.

If that's how the culture is thinking, little emphasis ( i.e.  cash )
will be put on prevention and cure, and lots of energy with be put
into the status quo, including LASIK, which I equate with liposuction.
I think it is the responsibility of the medical profession to lead
the way in explaining this condition to patients in order to
change the understanding of our culture in general.

This will create momentum for more research.  Especially as the
population ages, anything we can do to understand vision and preserve
sight could have a huge impact on quality of life for the elderly.
As I see it now, almost everyone is jumping on the LASIK bandwagon.
Which is a dead end.

I've said this before again and again.  It's
very similar to the issue of mammography.  It's a mediocre cancer
screening.  Everything I've read about breast cancer research
indicates that the future for prevention is diet and exercise and
the future for screening is in molecular biology and the
development of a blood test, like the PSA, only better.
Unfortunately now we have this huge industry in breast imaging and
most of what I read in the mass and medical media is encouraging
more precise (and more costly) imaging.

Again, a dead end but a money maker.  I'm so tired of explaining it
to my patients but I do and let them make the choice whether they
want to follow the standard of care - which I must Rx for legal
reasons, or just guess and follow a different path, knowing that
there is a huge gray area here and no one has the one correct answer
for their individual case.  They have a right to be informed of all
the data, the debate on when to start screening and how often etc.

> I've have a patient loose part of her vision in her 30s from
        retinal detachment.  Can she drive safely?  Did anyone tell
        her not to wear her distance prescription for close work?

      Is there any science based evidence that not wearing glasses
prevents retinal detachment?

      I don't think it matters.  If an intervention is harmless,
like eye exercises, which seem like a great idea even without
research, why not let patients know about it?  Back to the breast
cancer analogy, there is research showing that there is no
statistically significant difference in outcomes between women who
do self breast exams and those who don't.

But my field still recommends teaching it to patients as it is a
harmless intervention that might make a difference in an individual
case.

We are told to teach it but not put a guilt trip on patients who
don't do it as it appears to be useless per the present research.
My medical assistants are supposed to the patient education on
this but I'm sure when we are busy they don't cover the topic on
every physical.  But that is the "policy."


      Julie Ralls, M.D.

      Tired Family Physician

      Motto:  A Headstand a Day Keeps the Doctor Away

      Theme:  Every Thing is TERRIBLE!! :((((

      Advisory: DRIVE FRIENDLY

From sci.med.vision (thanks Judy)

Otis:
> I would agree that 99 percent of the population has
> no interest in taking control, and using a strong
> plus "correctly".

Mike:
> 99% of the population does not have myopia.

The plain reading of Mike's comment is: "the reason why 99% of the
population has no interest in myopia control is because they are not
myopic themselves".

He wouldn't have been the first optometrist on sci.med.vision to
claim a 1% world rate for myopia:

Bill Stacy did, back in 1995:

http://groups.google.com/group/sci.med.vision/browse_thread/thread/
76fdace722861c37/b1359d311ce4979b

And of course Dr. Judy backed Mike up with the WHO statistics, and I
don't even know if she would have retracted that claim if I hadn't
pointed out the "uncorrected" bit to her. (I know, Judy, as Otis once
said, "correcto-mundo ... but you didn't let me finish" ... shall we
give Judy the benefit of the doubt here?)

In any case, Mike's statement was a non-sequitur, because even Otis
wasn't saying that 99% percent of the population was myopic.

He was saying that 100% percent of the population is AT RISK for
myopia, and yet only 1% think it is an important enough issue that
they would use the plus lens to prevent it if they thought they could.

All that said, I think the case could be made that 99% of children
entering school do not have myopia; and that is precisely the
population that should be concerned about prevention.

So maybe Mike was right after all.

--Alex

Dear Mike,

Subject:  I have come to a realization that theories don't mean that
much. FACTS and RESULTS MATTER.

This is exactly my thesis.  The fact indeed show that the eye will
move (slowly) in both directions.  If the facts did not show this --
I would not be posting, and MyopiFree would NOT EXIST.

So what does happen when you place a -3 diopter lens on the eye.  The
majority-opinion ODs do the best they can to DENY this scientific
results (for rater obvious reasons -- bad for business, you know).
But this denial has to do with their business, and never with FACTS
and RESULTS.  See the ACTUAL dynamic behavior of the eye
with a -3 and +3 diopter lens on a population of eyes (in
terms of refractive STATE.)

http://www.geocities.com/otisbrown17268/FundEye.html

You have already seen the results since your Snellen went from 20/200
to 20/40 in two years from wearing the plus correctly.

And equally, you have confirmed that your refractive STATE went from
-2.75 diopters to -0.75 diopters in that same period of time.

This confirmed result is SCIENCE -- not medicine.  When you trust the
facts -- then you get it "right".

Because the eye goes DOWN at -1/3 diopter per year (in college) it
continues to be necessary to wear a +2 to +2.5 when you have long-
term reading to do.

That is the trade-off.  Continue with that process, and you never
become DEPENDENT on a minus lens.

After you get out of college, you can cut-back on your use of the
plus -- if you choose.

It takes a wise person to accept this trade-off for what it is.

But the facts are the facts, science is science, and that is the way
it is.

Best,

Otis

No one can "control" a person's choice -- in vision clearing.

It is like working on "weight loss".  It is never "easy", and
no one should think that way.

Here are Mike's statements about his current visual-acuity
for your interest.

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

I will elaborate on my statement,

First off I can read around 20/60 every time I look at the IVAC
without fail. Often I can read 20/40. On good days I can read 20/30.
These measurements are all with my naked eye vision.

I tested my eyesight through my -1.75. I couldn't read 20/20 and I
got half of the letters right on the 20/30 line.

I also have -2.75 and -2.5 lenses from my worst prescription. Through
those I actually just break even. I read about 20/60 to 20/80 with
them.

I dismiss the theory that this might be an astigmatic problem because
I can read 20/15 through a -1 with no astigmatic value. Therefore I
concluded that it had to be the actual minus power.

I have come to a realization that theories don't mean that much.
FACTS and RESULTS MATTER.

thanks

Mike

Dear Reader,

Subject: Personal experience in vision-clearing.

Mike was at 20/200 two years ago.  He chose to quit
"cold turkey".  From reading i-see, and then
MyopiaFree he chose to use the plus to clear his vision.

Currently, his Snellen varies (by his own checking.  For
baseball, and outside work, it is 20/30.  On the IVAC Snellen,
it is 20/40.

Here is Mike's observation on "near work".

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


Otis,

In an electronics class that I am taking I have to solder chips,
resisters, ect to boards. I am required to wear safety glasses that
will not accomedate my plus lenses. I have to work with my naked eye
vision at extremely close distances like 4 inches. I was initially
worried about this but I have noticed an unexpected side effect.

I can achieve better acuity with a minus.

I held a -1 to my left eye and a -1.25 to my right at the same time.
I read 20/15. I could only read 20/20 before. I not only passed the
line but I got every letter right.

In each eye seperately a -1 cleares me to 20/20 in my right and 20/15
in my left.

I also looked through my prescription -1.75 and it was blurry. I
could tell that it was way too strong.

thanks

Mike

Since Otis won't post the original link, here it is:

http://groups.google.com/group/sci.med.vision/browse_thread/thread/ab6
24fb06c5b893a/5eb23aa0f1aa7dd3?hl=en&#

Mikes message was posted at 10:11 Sept 18, text below:


<otisbr...@...> wrote



> I would agree that 99 percent of the population has
> no interest in taking control, and using a strong
> plus "correctly".


99% of the population does not have myopia.

When the real population is tested, plus does not work.



> 2.  I do not support the concept that PREVENTION
> is medical.  Futher, I do not support the concept
> that a "plus" is a medical device.  That would
> be like suggeting that a toothbrush is a medical
> device,


I believe toothbrushes are classified by the US FDA as Class B
medical
devices.


> Just one man's opinion.


Exactly. And worth every penny.

-MT

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...>
wrote:
>
>
> Subject: And just to be fair to me.
>
> > Judy> Unlike me, Otis does not provide links to statements he
> attributes to other people nor the context in which they were said.
>
> Here is the full context of the discussion with
> Brainy and Mike:

Well, when will you post Mike's original remarks???  This isn't it.

Judy

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...>
wrote:
>
>
> Judy> Unlike me, Otis does not provide links to statements he
> attributes to other people nor the context in which they were said.
>
> Otis> Here is the full link of the conversation.  Let
> the reader decide.

Snip wrong link

Oh pu-leeze, you have posted your post on sci.med.vision of my post on
myopiafree.  Can't you just post the original comment by Mike???

Judy

Subject: And just to be fair to me.

> Judy> Unlike me, Otis does not provide links to statements he
attributes to other people nor the context in which they were said.

Here is the full context of the discussion with
Brainy and Mike:

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

Dear "Brainy",


Subject: You obviouly have missed my point.

I SUGGESTED (admited) the very few people have
an "interest" in keeping their vision clear at
the 20/50 level.  (By Bates, or any other method).

That is why I stated that 99 percent of the population
has no interest (and the motivation) to clear
their vision.  I think that is an accurate statement,
and I think you would have been part of the
99 percent who had no interest.

That is a FAIR AND HONEST STATMENT.

Then MikeOD, made the flippant remark that
99 percent of the population ARE NOT MYOPIC.

I did not "attack" Mike as you stated.

I simply ASKED HIM POLITELY to document
his statement.

And then you JUMPED on that request
as an ATTACK -- which is obviously was not.

Then we get all of these "statistics".

JudyOD says that 2.5 percent are myopic.

Then MikeOD says 29 percent.

Then I post the records for China -- and they
are indeed mixed -- but I posted them
as 88 percent for ENTERING university students.

I would SUGGEST there is a lack of CONSISTENCY
in reporting SCIENCE here -- and we should
understand these reports that are truly
all over the "map".

Let us not attack each other because optometry
is confused about statistics, and reports
rates of from 2.5 percent to 88 percent
myopic.

This is SUPPOSED to be a leanring process.

And those are indeed the facts.

Best,

Otis