Dear Judy,

I want to thank you for being very clear about your OD belief-system.  I happen
(for reasons of engineering and science) to disagree various items you state, by
I always believe that is it possible to disagree about the behavior of the eye
-- without being disagreeable.

It is just necessary that you be clear about what you believe and why you
believe it.

Judy, if you have some further clarifying remarks, I would like to listen to
them.

Otis


(Excerpt from discussion)

===========

Judy> The (minus) studies were retrospective and the only patients who get
prescribed excess minus are exotropes.

Judy> Some long in use treatments are called "generally regarded as safe"
despite lack of current standards clinical trials.

Judy>   Minus lenes fall into that category.

Judy>  We are confident that they don't cause myopia due to a number of
clinically noticed factors:


Judy> People become myopic without using minus lenses.


Judy> Uncorrected hyperopes, who accommodate excessively all time for all
distances, do not become myopic.


Judy> Myopia progression happens in myopes who don't use minus lenses.


Judy> Myopia progression usually stops in late teens/early twenties'


Judy> The exotrope studies found that excessive minus, worn for up to 7 years,
did not result in increased myopia


Judy> Animal models strongly suggest that retinal blur not accommodation is the
etiology (cause) for myopia with retinal blur in myopes existing whether or not
they are corrected.

Alex> > You complain about the Young-Oakley study only being on esophores,

Judy> Not a complaint, just an observation that plus at near has been shown to
slow progression slightly but only in esophores in other studies.

Judy> This observation was in agreement with Young-Oakley.

Judy

--- In Myopiafree2@yahoogroups.com, Alex Eulenberg <alex@...> wrote:
>
> > There are at least two studies of excessive minus worn for up to 7 years
with both myopic and non myopic alternating exotropes that show no difference in
progression towards myopia between those who wore minus and those who did not.
>

> Why only exotropes?

The studies were retrospective and the only patients who get prescribed excess
minus are exotropes.

Some long in use treatments are called "generally regarded as safe" despite lack
of current standards clinical trials.  Minus lenes fall into that category. We
are confident that they don't cause myopia due to a number of clinically noticed
factors:
People become myopic without using minus lenses.
Uncorrected hyperopes, who accommodate excessively all time for all distances,
do not become myopic.
Myopia progression happens in myopes who don't use minus lenses
Myopia progression usually stops in late teens/early twenties'
The exotrope studies found that excessive minus, worn for up to 7 years, did not
result in increased myopia
Animal models strongly suggest that retinal blur not accommodation is the
etiology for myopia with retinal blur in myopes existing whether or not they are
corrected.

> You complain about the Young-Oakley study only being on esophores,

Not a complaint, just an observation that plus at near has been shown to slow
progression slightly but only in esophores in other studies. This observation
was in agreement with Young-Oakley.

Judy

drjudy65 wrote:
> --- In Myopiafree2@yahoogroups.com, Alex Eulenberg <alex@...> wrote:
>>
>> I think the worst part is when optometrists confidently tell their
>> patients that the minus lenses they prescribe will have no effect on their
pateints' ultimate refractive state.
>
>> However, I do insist that they stop claming to know that their
>> minus-lens treatment won't aggravate the condition they are treati
>
> There are at least two studies of excessive minus worn for up to 7 years with
both myopic and non myopic alternating exotropes that show no difference in
progression towards myopia between those who wore minus and those who did not.
>

"At least two." Wow.

Why only exotropes? (You complain about the Young-Oakley study only
being on esophores, which incidentally comprise about a quarter of all
myopies). Why not randomized, as you insist for plus lenses?

How about an experiment just on incipient myopes (who can get along
without minus lenses), no prisms. The Kushner study said "4 to 6 prism
diopters of base-in prism is typically incorporated in the spectacles",
also "patching" was used. Kushner's 74 subjects is impressive, but then
again, it is one clinician's own retrospective.

http://archopht.ama-assn.org/cgi/content/full/117/5/638

The other study is also a laugh, statistically: "Forty exotropic
patients, ages 1 to 15 years". Just stop right there.

http://www.ncbi.nlm.nih.gov/pubmed/2771338

Still no straightforward comparison of glasses vs no glasses for
incipient myopes with otherwise healthy eyes. This question is so basic
to the practice of optometry that it should be the subject of a
multicenter trial, with hundreds of age-matched subjects, along the
lines of the COMET and CLEERE studies.

Ball is in Optometry's court.

--Alex

--- In Myopiafree2@yahoogroups.com, Alex Eulenberg <alex@...> wrote:
>
>
> I think the worst part is when optometrists confidently tell their
> patients that the minus lenses they prescribe will have no effect on their
pateints' ultimate refractive state.

> However, I do insist that they stop claming to know that their
> minus-lens treatment won't aggravate the condition they are treati

There are at least two studies of excessive minus worn for up to 7 years with
both myopic and non myopic alternating exotropes that show no difference in
progression towards myopia between those who wore minus and those who did not.

http://www.ncbi.nlm.nih.gov/pubmed/2771338
PubMed: 2771338
"The mean annual changes in refractive error for hyperopes (-0.13 +/- 0.44 D, N
= 15), emmetropes (-0.26 +/- 0.37 D, N = 17), and myopes (-0.75 +/- 0.77 D, N =
18) were similar to values reported in the literature for nonexotropic
children."

http://www.ncbi.nlm.nih.gov/pubmed/10326961

"RESULTS: At the time of initial examination, the mean (+/-SD) refractive error
was 0.00 +/- 1.40 diopters (D) in the control group, 0.00 +/- 1.50 D in the
study group, and -0.10 +/- 1.50 D in the 5-year study group, all of which were
essentially identical. Five years after initial examination, the mean change in
refractive error was -1.40 +/- 2.80 D in the control group, -1.52 +/- 1.80 D in
the 6-month treatment group, and -1.54 +/- 1.80 D in the 5-year treatment
group."

Judy

drjudy65 wrote:
> --- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>>
>> No PLUS-PREVENTION study has ever been run.
>
> Thank you for that clarification.
>
> So why do you complain that optometrists do not inform patients about plus
prevention?

I think the worst part is when optometrists confidently tell their
patients that the minus lenses they prescribe will have no effect on
their pateints' ultimate refractive state. As quoted recently by Otis:

> Tyner> Myopia is mostly due to the eye growing longer than
> average. The control mechanism for axial growth does not
> appear to involve accommodation, because manipulating
> accommodation with glasses/no glasses/plus glasses all have
> no effect,. At least not enough to warrant intervention..

That is blatantly untrue. The "no glasses" option has not been
investigated, and plus lenses are studied only in combination with minus
lenses (bifocals), usually full-strength.

It's one thing to say that a method is "unstudied" but quite another to
say that it has been tried and proven ineffective.

Moreover, it is downright fraud to assert that one's treatment does not
produce a certain effect when the treatment has not been tested for that
effect.

Yeah, I agree with Otis that it would be nice if optometrists offered
the plus-lens option for incipient myopes, but there are political and
economic factors that keep them from doing so and I will not insist.
However, I do insist that they stop claming to know that their
minus-lens treatment won't aggravate the condition they are treating.

Judy:
> If there are no published studies to show that it works, why do you expect
optometrists to
> even know about it, let alone recommend it?

If there are no published studies to show that minus lenses are safe for
incipient myopes, I do expect optometrists to refrain from claiming
otherwise. Let them tell their patients that the treatment is
"experimental."

Would be too much to expect them to stop recommending that first pair of
minus lenses until their safety has been clearly established through a
controlled, randomized, multi-center clinical trial?

--Alex

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote

>
>      But anyone considering true-prevention must realize this
> issue that a OD must protect himself – and, for that reason, can
> expect NOTHING from a OD

The reason ODs do not recommend "plus prevention" is very simple.  They have no
evidence that it works.  As you yourself recently said:

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:

> No PLUS-PREVENTION study has ever been run.

>
>      So, when I recommend ... A SCIENTIFIC STUDY.
>
>      I have no doubt that such a study will be BLOCKED by the
> Judy-types in this world.

I and other ODs have no ability to stop you from conducting your study.  If you
want to do it, get funding and do it.  Please do not blame me for your failure
to do your study.

Judy

Dear Scientific friends,

I have been told by a non-scientist that the Oakley-Young study was "not
significant".  No proof was supplied to support this sweeping statement.

Here are the significance levels and translated "Z" values.

Probablity -- Z-Value

0.05   Z = 1.65

0.01   Z = 2.33

0.001  Z = 3.08

0.0001 Z = 3.61

Infinitely  Z above 3.87


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

Now the question, were the results of the Oakley-Young study significant?

In the first year they far exceeded the Highly-Significant level.

In the second-year, (Z = 3.87 or greater), the significance was "off the map".

So when a OD tells you that a scientific study was "not sighificant",then ask
him which crystal ball he uses to determine scientific significance.

That is the difference between engineering and science, and some OD his his
office making un-reasonable statements that have no justification in science.

Second-opinion best,

Otis

ODLimits.txt

Dear Scientific and preventive friend,

Subject:  Remarks about why ODs are limited.

Reference:  My remarks about Dr.  Rapaelson's experience with the
      general public, and his support for his three children.

      (Below, some names have been changed.)

      I am very specific in never saying "cure".  I strong don't
say "medicine".

      I have never said anything about what Judy does IN HER
OFFICE.

      I respect Judy in THAT CONTEXT.

      But when Judy comes on an engineering second-opinion site,
where I use exact definitions for the refractive STATES(Snel) of
the natural eye, then we do have a problem.


      ABOUT MEDICAL PRACTICE – AND THE "PUBLIC'S" RESPONSE.  THE
RISKS TO AN OD FROM SOME DEMENTED PERSONS THAT ARE PART OF THE
GENERAL PUBLIC.

      Our long experience with Nate Dull Babbling DEFINES MY
STATEMENTS.  (This is an example of the power of ignorance -- in
the public.

      I feel great sympathy for Judy and all other majority ODs
like her.  They MUST defend themselves, by adhering to the "status
quo".  If they do not do EXACTLY what other ODs are doing – they
either get sued, or charged with mal-practice, and driven out of
the business.  I see no future for ODs in that sense.

      If Judy would ADMIT that tihs issue is the "driver" for her
profession – then we would never have a problem.  The issue is
PRECEPTION of the eye's dynamic behavior, and this is a scientific
issue for the person himself to resolve.

      But anyone considering true-prevention must realize this
issue that a OD must protect himself – and, for that reason, can
expect NOTHING from a OD – and understand WHY they can't expect
anything -- EVER.

      This is the true experience of Jacob Raphaelson.  You can't
help people who are ignorant, and (semi-psychotic).  You can only
provide what is traditional, and works instantly and obviously.
Anything beyond that point is in the realm of science, not in
office-optometry.

      I think this explains both Raphaelson's issues, and Judy's
"defence" of the status-quo.  I say this to RESPECT JUDY, in her
office.  But the accurat answer is in science, and not in Judy's
office.  I think it is very important to understand why that is
so.


      But Judy does not even comprehend this issue.

      When Judy insists that plus-prevention studies HAVE BEEN
CONDUCTED – she is again telling an office-fib.  And the reason is
to protect the "status quo", which is how she makes her living.

      So, when I recommend that a person actually MEASURE his
refractive state(Snel) – he is either going to "rise" to the
challenge –- or NOT BECOME INVOLVED IN A SCIENTIFIC STUDY.


      I have no doubt that such a study will be BLOCKED by the
Judy-types in this world.  I don't kid myself about that issue.


      But I am obligated to provide a engineering/scientific
analysis of the data, and a "management" plan, should we ever
reach that point where we are allowed to present the concept to
would-be pilots entering a four year engineering college.

      If I were presented with scientific facts, the concept, and
the empowerment to "control" my long-term visual future -- I think
I would "rise" to the challenge of it.


      Best,


      Otis

PlusJake.txt


Otis> > Judy, when I say PREVENTION, I mean specifically Snellen clearing
      to be starterd BEFORE that first minus lens.

Otis> I mean this for an EDUCATED student entering
      a four-year college.

Judy> Thanks for the clarification as to what you mean by
      prevention.

Judy> It may comfort you to know that I don't believe I have ever
      seen a patient who was a student entering an engineering
      pilot college program, so I have never really been in a
      position where it would be possible to offer prevention
      advice.

Judy

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


Dear Judy,

      I certainly agree that it would be very rare for a
majority-opinion OD to offer any preventive advice.

      That is why Alex maintains i-see, and I maintain Myopia-FREE,
to provide the information you can not and will not provide.

      In fact, it was Raphaelson's attempt (and failure) to get
"through" to the "public" the need for true-prevention at the
threshould.

      Thus, (from his auto-biography) it was clear to me that
Raphaelson realized that:

1.  He induced a negative refractive STATE in his own eyes by his
     "reading habits" as a child.

2.  The only "solution" for him was a minus lens (after doing this
     "reading" for years -- and after it was too late for the plus).

3.  Raphelson then became an optometrist, and, when he had three girls he
      ENFORCED the idea that they use the plus for all close work,
      but more importantly, he insisted that they never "lean down" on the
      page and get their eyes closer than -2.9 diopters (or 13 inches).

4.  That this is something ONLY the parent could do for the child.

5.  Clearly this is a "responsible parent", or "educated parent"
      concept, and, can not be "prescribed" in ANY MEDICAL SENSE.

6.  This type of prevention IS NOT MEDICAL.  It is based on
      respect for what we know about the dynamic behavior of the
      natural eye (the blue-tint model in your parlance).

7.  Science, engineering and prevention, can not be "reduced" to a
      "magic" minus lens that clears in five minutes.  You can't
      have it BOTH WAYS.

8.  If you want to declare your self "not responsible", for any of
      this -- then that is fine with me.  But PLEASE do not call
      engineers, scientists, pilots, and other people who
      disagree with your antique concept, "optometrist bashers".

9.  This is why I obtained my own trial lens kit -- to make
      confirm my OWN refractive state -- as positive, and my
      Snellen as "clear".  Because of what I learned from
      Jake Raphaelson

Second-opinion best,


Otis

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>
>
> Dear Judy,
>
  You should never volunteer ANY INFORMATION about prevention,
> and no aspects of prevention -- EVER

> Judy, when I say PREVENTION, and specifically BEFORE that first minus lens,
for entering engineering pilot college students I mean

Thanks for the clarification as to what you mean by prevention.

It may comfort you to know that I don't believe I have ever seen a patient who
was a student entering an engineering pilot college program, so I have never
really been in a position where it would be posssible to offer prevention
advice.

Judy

Dear Judy,

Subject: You in the closed confines of your office.

Maybe you are totally correct.

You should never volunteer ANY INFORMATION about prevention,
and no aspects of prevention -- EVER.

This is a SCIENTIFIC SITE about true-prevention.  You have made your POSITION
very clear.

If a person wishes to AVOID ENTRY, and avoid stair-case myopia, then he should
take the time to understand your "position" with great accuracy.

This means that no parent, or the child can EVER relys on you for preventive
help.

It means that the engineer/scientist MUST understand that, if scientific support
is needed -- you will not be providing any.

It suggest that if any PREVENTIVE study is to be ever started, it would have to
involed the self-education of the engineer/pilot himself.

When you say that the Oakly-Young study was "not SIGNIFICANT" then the person
should realize that you are NOT TELLING SCIENTIFIC TRUTH.

On THAT BASIS, they have better understand science and facts FAR BETTER THAN YOU
WILL.

But that is the "sticking" point between us.

Judy, when I say PREVENTION, and specifically BEFORE that first minus lens, (for
entering engineering pilot college students, then I mean the following:

1.  The pilot (who WILL gain the necessary scientific knowledge) will enter the
study with the above understanding.

2.  Given the "limits", i.e., starting refractive STATE(Snel) no worst that -1.5
diopters, and Snellen 20/70 or better, and the pilots retaining FULL CONTROL OF
HIMSELF, then I believe that PREVENTION is possible.

3. It is clear from the Annoplis/West Point studies, that it is necessary to
FIRST get to 20/40 or better, and then to 20/20 under the PILOTS control and
understanding.  (This would be part of the EMPOWERMENT phase).

4. But then to MAINTAIN prevention, the use of the plus would have to be
continued, or re-started by the pilot if his Snellen went below 20/20, (or his
refractive STATE(Snell) in the negative range.


This is indeed a difficult choice for a person to make, and depends NEVER ON
YOU, JUDY, but on individual qualites of the intelligent engineer, and what he
wants and need in his life.

Second opinion best,

Otis






--- In Myopiafree2@yahoogroups.com, "drjudy65" <mpace99@...> wrote:
>
> --- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@> wrote:
> >
> >
> > No PLUS-PREVENTION study has ever been run.
>
> Thank you for that clarification.
>
> So why do you complain that optometrists do not inform patients about plus
prevention? If there are no published studies to show that it works, why do you
expect optometrists to even know about it, let alone recommend it?
>
> Judy
>

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>
> Dear Judy,
>
> You are saying that if a person has "prescription" of
> any amount (even -1/2 diopter), then he is myopic?

Yes

> Never clear his Snellen back to normal.
> Never change his refractive STATE(Snell) in a postive
> direction?

Being myopic at one point in time does not mean that refractive error will not
change (either increase or decrease in myopia) in the future. Refraction can
change at any point.

Judy

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>
>
> No PLUS-PREVENTION study has ever been run.

Thank you for that clarification.

So why do you complain that optometrists do not inform patients about plus
prevention? If there are no published studies to show that it works, why do you
expect optometrists to even know about it, let alone recommend it?

Judy

Dear Reader,

Subject:  Successful prevention depends on a person who will accept the PERSONAL
challenge of it.

Chris is a pilot who wore minus glasses (-2.5 diopters) for the last 30 years. 
He choose to accept the challenge of "clearing" his vision from 20/200 to
normal.

Currently, after six weeks he is reading between 20/30 to 20/50, and should
confirm he passes the legal requirment of passing the DMV requirement of 20/40
or better in a few more months.

Here is his statement -- about his work on prevention (from I-see).

Best,

Otis

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


Healing eyesight and personality change (was: Additional Information for Chris)


Otis wrote: "Now, just being consistent with the plus, and passing the DMV,
under YOUR control must be your future -- for at least the next six months."


Otis,
Great minds think alike! My objective is to get a new license in June or July
(can't remember which) when my auto tags expire. That way I don't have to wait
in line on two different occasions (long lines here in Nevada at the DMV). I
WILL succeed, I can promise you that!

Changing subjects now: A couple days ago I had prepared a massive email
explaining another phase of my training, but when I pressed "send," Microsoft
Explorer puked it back and I was miserable because I had not saved the message,
so I have to recreate it again. To paraphrase, I read recently that this whole
process of healing your eyesight naturally takes a long time, because in order
to succeed, you have to change your personality also. (Try taking this out to
the bar and starting up a conversation--they'll call you a fruitcake!) Okay, so
I mention this in passing to my mother in law and my wife. They looked at each
other briefly (to see if they were thinking the same thing apparently) and then
proceeded to tell me how my personality has changed drastically in the last
month or so. They didn't want to tell me because they didn't know how I would
take it. I looked startled because I didn't FEEL like my personality has been
changing, but my wife hit me square in the face with this comment: "but Chris,
do you think it's just a coincidence that your two daughters want to spend a LOT
of time with you now? They cry when you leave for work, they want to call you on
your phone, and they scream with glee when you come home." I proceeded to cry,
realizing that all this HAS really been happening to me, WITHOUT ME REALIZING
IT! I was trying to figure out how I was going to change my personality, but
meanwhile it has ALREADY CHANGED without me even knowing it. Truly incredible
experience. My wife no longer has to put up with me going off into "la-la land"
where I space out and stare off into space. She gets the visual contact every
time she talks now, and would you believe that I didn't even realize I was doing
it? Just wanted to pass this along. I've got several more, like
utilizing/strengthenging the right side of my brain. I'm using every weapon in
the arsenal against my myopia, it's not even funny. Apparently it's working!!

Cheers,

Chris

Dear Scientific Friend,

Subject: Calculation of the significance levels of the Oakley-Young study.

Re: Essential to understand how to conduct a pure plus-prevention study at a
four year engineering college.

SOME majority-opinion ODs deny ANY significance to the Oakley-Young study.

Others, like Dr. Kaisu Viikari confirm the need for the plus -- as a successful
prevention tool.

http://www.kaisuviikari.com/

Thus, the concept of successful plus-prevention remains an "open" scientific
question.

In my judgment if Dr. Kaisu were in a leadership position, and each individual
pilot/scientist made his own measurements, his efforts would succeed.

With respect to the Oakley-Young study, the results are highly significant.

But if you are interested in science –- then you must know what you are doing.


And that would mean each man in the study, would have to have the following
scientific background.

Here are the data from the Oakley-Young study:

225 wearing a plus (ages from 6 to 17)

192 NOT wearing a plus, but a "single minus".

Here is the classic equation from college statistics:


Xt - Xc

Z = ---------------------------------------------------

Square Root of [ ( Sigma^2/ Nt ) + (Sigma^2 / Nc ) ]


Xt = 0 diopters (the 225 Plus group did not go down to any extent.)

Xc = -1/2 diopters across the 192 people in the control group.

Sigma-t = Test group was estimated to be 1.4 diopters.
(Number obtaine from a review of the Eskimo study -- and
some good statistical judgment of this issue.)

Sigma-c = Control, 2.0 diopters

After one year with 0.5 diopter difference:

Z = 0.5 / 0.172

Z = 2.91

SIGNIFICANCE LEVELS:

Significant would be above Z = 1.65

Highly Significant above Z = 2.33


Z = 2.91, is substantially above highly significant after one year!!

After two years:

Z = 1.0 / 0.172

Z = 5.82

This Z value is in fact "off the map" of the Probability Curve.


The real issue (for a plus preventive study) would be for the engineer/pilots to
understand the challenge of this science.

What we need is better measurements made by the pilot himself. That way the
person will TRUST his measurements and collectively trust his study.

Support of a plus-prevention ophthalmologist would be of great value to the
study.

The quality of the study, would depend completely on the quality of the
engineer/scientist who will (collectively) lead this study.  We all should learn
to trust that type of scientific competence.

Empowering second-opinion best,

Otis

Dear Open-minded Scientific Fried,

      Here are the number-of-eyes, and the standard-deviation
(sigma) for populations of eyes in each class.

      In any future (plus-preventive) study, it would be essential that
the engineering/pilots make the measurements and do the
calculations.

      That is the only way they will BELIEVE their science and
their objective results.

      Otis

Subject: Science and Standard Deviation for Populations of Eyes.
======================

      Title:  Ocular Biometry of Eskimo Families

      Francis A.  Young

      George A.    Leary

      This is a synopsis of the Standard-Deviation of populations
of Eskimo eyes -- for general interest and over-view.

      Page 292

      TABLE 1


      The number of subjects, means, Standard Deviation (SD) ...
for the grandparents, parents, and older and younger children.


G.  Parents:

N = 96 Eyes

Mean = 2.21 Diopters

Sigma = 1.31 Diopters

Parents:

N = 180 Eyes

Mean = 1.19 Diopters.

Sigma = 1.55 Diopters.


Older Children:

N = 194 Eyes

Mean = -0.93 Diopters

Sigma = 1.97 Diopters

Younger Children:

N = 218

Mean = 1.4 Diopters

Sigma = 1.4 Diopters

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

Enjoy Science, and facts, and how to solve scientific problems.

Otis

Dear Judy,

You are saying that if a person has "prescription" of
any amount (even -1/2 diopter), then he is myopic?
Always?
Never clear his Snellen back to normal.
Never change his refractive STATE(Snell) in a postive
direction?

I will challenge you on that point -- with the restriction
that the person be no "deeper" than -1.5 diopters, and
Snellen no "deeper" that 20/70.

That would allow the person to function with NO MINUS LENS -- except
for driving a car.

Further, it would encourage the "test group" to wear the plus,
and measure his refractive STATE(Snell) and record it.

But that requires a trained engineer, not an optometrist
to conduct this type of scientific study or preventive
effort.

Second-opinion best,

Otis

Dear Judy,

You were correct the first time.

No PLUS-PREVENTION study has ever been run.

Further, no study that was designed to EMPOWER the
person himself (as a group) to use the plus CORRECTLY
has ever been designed, let alone conducted.

Obviously, with children, such a study would be IMPOSSIBLE.

But for an educated Pilot-ENGINEER entering a four year college,
with detailed knowledge of the Oakley-Young study (from which he could learn and
understand from HIS proposed study), the a
competent PLUS study could be conducted.

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

Judy> I didn't say no plus study has been run.

Judy>  Many have been run. They find little to no effect.

Otis> Judy -- this is your intense bias.

Otis> Let me repeat, NO COMPETENT PLUS-PREVENTION STUDY HAS EVER BEEN RUN.

Otis> Judy, pleas show me a study were the minus was REJECTED, and EXCLUSIVELY A
PLUS WAS USED -- UNDER THE CONTROL OF THE PERSON (COLLECTIVELY) HIMSELF.

Thanks in advance for your answer.

Otis

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


--- In Myopiafree2@yahoogroups.com, "drjudy65" <mpace99@...> wrote:
>
> --- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@> wrote:
> >
> > >      On the basis that Judy says that no "plus" study has been run
> > – she is correct.
>
> I didn't say no plus study has been run.  Many have been run. They find little
to no effect.
>
> > But that ignores the implication of (Young's) sexcellent study.
>
> Young's study was far from excellent.  It was not randomized, it was not even
single blinded, cycloplegic refractions were not done, matched control groups
were not used.  It was interesting and sparked others to replicate it with
better control.  Those studies did not find the same effect.
>
> Judy
>

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>
> >      On the basis that Judy says that no "plus" study has been run
> – she is correct.

I didn't say no plus study has been run.  Many have been run. They find little
to no effect.

> But that ignores the implication of (Young's) sexcellent study.

Young's study was far from excellent.  It was not randomized, it was not even
single blinded, cycloplegic refractions were not done, matched control groups
were not used.  It was interesting and sparked others to replicate it with
better control.  Those studies did not find the same effect.

Judy

--- In Myopiafree2@yahoogroups.com, Alex Eulenberg <alex@...> wrote:
>
> drjudy65 wrote:
>
> >
> > No.  Reread my words. I said that Otis complaining about optometrists
> > failing to recommend myopia prevention methods
>
> Is not wearing minus lenses a "myopia prevention method" that must be
> tested?

If minus is prescribed, myopia already exists and it is too late for prevention.


No, it is other way around, prescribing minus lenses for myopia.
> is the intervention, which must be tested and proven safe, which
> optometrists have not done.


When the animal emmetropization experiments were first done, at least two
studies looked at what happened to human non myopes who were prescribed minus to
treat exotropia.  This was due to concern about the minus perhaps causing
refractive change.  Those wearing the minus did not get more myopic than those
who didn't.

>
> > when he is unable to
> > provide controlled human clinical trial evidence that effective
> > preventative methods exist is bashing.
>
> First of all, there is plenty evidence that one can improve acuity
> through training.

We are talking about refractive error prevention, not acuity.

> If we're talking about the long term effects of wearing negative lenses,
> then in the absence of controlled human clinical trial evidence that
> minus lenses are safe for myopes, optometrists should not claim that
> they have "no effect", when the animal evidence suggests that they would
> make myopia worse.

Animal evidence doesn't suggest that.  Animals with myopia who have their myopia
corrected with minus either stabilize or get less myopic.  They don't get
progressive myopia.  Animals without myopia who are forced to wear high minus
become myopic.  Optometrists seldom prescribe minus for humans who are not
myopic.

Judy

SciYoung.txt

Dear Scientific Friend

Subject:  The scientific fact and data that these majority-opinion
      OD bury – is MASSIVE.

Re:  The long-term evaluation of Francis Young's SCIENTIFIC work.

Re:  Fundamental Statistical Analysis

Re:  The need to determine the Standard-Deviation for science by
      the engineering community.

      When presented with the Oakley-Young study, these
majority-opinion ODs are famous for stating that, "it is not
significant", or "it means NOTHING", and the like.

      But to "kill" the real implications of Dr.  Young's study,
they had to run one where they know how to "corrupt" the results –
so they could claim that, "a preventive plus has NO EFFECT".

      This also prevents even the IMPLEMENTATION OF A PURE
PLUS-PREVENTION EFFORT.

      All of these are comfortable office-fibs, to avoid having the
public "alarmed", when they see their child get stair-case myopia
from that first minus.

      Remember, I don't deny that the child INDUCED that first
negative state –- it is just the compounding effect of that minus.
The time to STOP and PREVENT, is to converse with the parent and
child, and just tell the SCIENTIFIC truth.

      But, from Judy's statements the majority-opinion ODs are
NEVER going to do that.

      FOR ENGINEERS WHO UNDERSTAND AND USE STATISTICS.  THIS TYPE
OF KNOWLEDGE WOULD BE REQUIRED OF PILOT/ENGINEERS WHO WILL CONDUCT
THEIR OWN STUDY.

      In statistics, a result of p (0.05) is called a SIGNIFICANT
RESULT.

For P(0.01) it is HIGHLY SIGNIFICANT.

For P(.001) well that is "off the map", in science.

And for P(0.0001) well that is considered scientific proof.

      I hate having ODs tell me about a "study" -- where they ran
the study, over-prescribed the minus "on-top", (incompetent at
best), and then claimed, "the plus had no effect".

      The only exception to this was Dr.  Young – who ran a good
study you can TRUST.  If we are going to argue about this, then
just say that true-prevention must be under the physical and
intellectual control of the pilot himself.

      Young's study 200+ kids were in the group.  The difference in
refractive STATE was 2/3 diopters in ONE YEAR for the kids from 6
to 8 years old.

      In the second year, the difference was 1.33 diopters.

      Since these were young children they could not an EFFORT TO
USE THE PLUS effectively.

      On the basis that Judy says that no "plus" study has been run
– she is correct.  But that ignores the implication of this
excellent study.

      [In any truly scientific study, the pilots (with refractive
STATES(Snel) should be no "deeper" in that -1.5 diopter, with
Snellens no less than 20/70.]

      For these reasons, I am forced to use data from Young's work.
That data does indeed show that a pure-plus effort (with older
pilots) could potentially succeed, and THE PILOTS (by THEIR
statistical analysis), WOULD KNOW IT IN THE FIRST YEAR.

      In some cases, Dr.  Young did not supply the
standard-deviation, for a complete analysis.

      In a plus-prevention study, it would be essential to have the
students measure their refractive STATE(Snel), and calculate their
statistics of their own study.

      If you want a person (engineer) to trust his own results,
then insist that he personally (as part of a scientific group)
make these critical measurements.

      I will supply an analysis of Frank Young's work on this site
in due course.

      Best,

      Otis

drjudy65 wrote:
> --- In Myopiafree2@yahoogroups.com, Alex Eulenberg <alex@...> wrote:
>
>> In post 2091 (August 8, 2008), Judy wrote:
>>
>>> You complain that optometrists ignore the "science" about myopia
>>> prevention and fail to inform patients about methods to prevent
>>> myopia. When asked, you fail to provide links to any published
>>> human clinical trials supporting the safety and effectiveness of
>>> these methods. I perceive this complaining as optometrist
>>> bashing.
>> So "optometrist bashing" according to Judy, is merely insisting
>> that optometrists consider the whole of the scientific evidence
>
> No.  Reread my words. I said that Otis complaining about optometrists
> failing to recommend myopia prevention methods

Is not wearing minus lenses a "myopia prevention method" that must be
tested? No, it is other way around, prescribing minus lenses for myopia.
is the intervention, which must be tested and proven safe, which
optometrists have not done.

> when he is unable to
> provide controlled human clinical trial evidence that effective
> preventative methods exist is bashing.

First of all, there is plenty evidence that one can improve acuity
through training.

If we're talking about the long term effects of wearing negative lenses,
then in the absence of controlled human clinical trial evidence that
minus lenses are safe for myopes, optometrists should not claim that
they have "no effect", when the animal evidence suggests that they would
make myopia worse. That's all Otis is saying. Is it "bashing" to point
out that the safety of a profession's treatment has been called into
question by one group of scientists and yet never proven safe?

>
> We do consider "all the science" giving more weight to more recent
> work

That is simply prejudice.

  and more weight to human rather than animal evidence, especially
> when the human studies have different results than the animal
> studies.

The human studies have different results because they are differetn
experiments. The human studies only compare slight differences in degree
of the same thing -- minus lenses. No study has tested the safety of
minus lenses on humans as normally initially prescribed, versus the
"null option" -- no glasses (let alone plus lenses), which many people
can do without when they are originally prescribed.

Again, it is not "optometrist bashing" to point this fact out, and to
urge optometrists to disclose the possible hazards of minus lenses.

--Alex

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>
>
> Dear Judy,
>
> Do you disagree with Dr. Kaisu's judgment.  If you do, please detail exactly
WHY you disagree with her.

I'm not commenting on most of her ideas, I have no desire to engage in a third
party discussion with you.

A few things do stick out:

> these are the points where the nervus trigeminus comes out, and this nerve
plays a central role also in accommodation (Panacea pp. 192-3). fig. 3.

The trigeminal nerve is not involved in accommodation. It is primarily a sensory
nerve for the face but also carries motor function for the jaw muscles.
http://bjr.birjournals.org/cgi/reprint/74/881/458.pdf


> Bifocals should be of the so-called Executive lens type, with a
> straight border as high as possible. This type is the most
> attractive and least noticeable,

I would disagree.  The executive bifocal is highly noticable, interferes the
most with inferior viewing and is thick and heavy.

Judy

--- In Myopiafree2@yahoogroups.com, Alex Eulenberg <alex@...> wrote:

>
> In post 2091 (August 8, 2008), Judy wrote:
>
> > You complain that optometrists ignore the "science" about myopia
> > prevention and fail to inform patients about methods to prevent
> > myopia. When asked, you fail to provide links to any published human
> > clinical trials supporting the safety and effectiveness of these
> > methods. I perceive this complaining as optometrist bashing.
>
> So "optometrist bashing" according to Judy, is merely insisting that
> optometrists consider the whole of the scientific evidence

No.  Reread my words. I said that Otis complaining about optometrists failing to
recommend myopia prevention methods when he is unable to provide controlled
human clinical trial evidence that effective preventative methods exist is
bashing.

We do consider "all the science" giving more weight to more recent work and more
weight to human rather than animal evidence, especially when the human studies
have different results than the animal studies.

Judy

Otis:
> I strong object when you state that intellectual discovery, i.e., the
> blue-tint model of the natural eye, constitutes "optometry bashing".

Judy:
> You must have me confused with someone else, I have never said that.

In post 2091 (August 8, 2008), Judy wrote:

> You complain that optometrists ignore the "science" about myopia
> prevention and fail to inform patients about methods to prevent
> myopia. When asked, you fail to provide links to any published human
> clinical trials supporting the safety and effectiveness of these
> methods. I perceive this complaining as optometrist bashing.

So "optometrist bashing" according to Judy, is merely insisting that
optometrists consider the whole of the scientific evidence (including
the fact that full time use of minus lenses causes a negative refractive
shift in laboratory animals), and the "first do no harm" principle (test
the treatment for safety before giving an unqualified recommendation,
for example saying it's OK to wear the glasses "all the time"+).

The fact that no controlled clinical studies exist where incipient
myopes with and without minus lenses are followed is not "optometry
bashing" on Otis's part, it is lack of due diligence on Optometry's part.

--Alex

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>
>
> Dear Judy,
>
> I strong object when you state that intellectual discovery, i.e., the
blue-tint model of the natural eye, constitutes "optometry bashing".

You must have me confused with someone else, I have never said that.

Judy

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>
>
> the correct model of the natural eye (with positive and negative
> refractive STATES -- is indeed accurate and pure mathematical
> science.

> Yes, in your office bias, you "don't see it that way".

Donders, Wildsoet, and I all agree that eyes come in a variety of refractive
states and that those states can change over time.  So how is that view of the
eye "failed" and "distorted" and how is is different than your view of the eye?

Judy

Dear Judy,

I strong object when you state that intellectual discovery, i.e., the blue-tint
model of the natural eye, constitutes "optometry bashing".

This is profoundly FALSE.

I simply reflect the second-opinion of medical doctors that under the RIGHT
circumstances, and with the RIGHT engineers and scientists, true PREVENTION
would be possible.

Indeed I do respect (greatly) Dr. Villiari's judgment.

Do you disagree with Dr. Kaisu's judgment.  If you do, please detail exactly WHY
you disagree with her.

Thank,

Otis

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

By Dr. Kaisu Viikari, Ophthalmologist:


PREVENTION OF MYOPIA

After these elementary concepts of ophthalmology, we will move on to the
wide-ranging and challenging field of myopia and pseudomyopia prevention.

To sum up, myopia is a condition where the eyeball already has been subjected to
stretching, it has become axially elongated and the state is irreversible,
whereas pseudomyopia means Asp, lens myopia, which can still be reversed.

Even if most of the means for preventing myopia have been known for a hundred
years, the results remain non-existent.


THE GREATEST OBSTACLE FOR THE SUCCESS OF PREVENTION HAS BEEN THE BELIEF THAT
MYOPIA IS HEREDITARY.

  The most important means of prevention is getting plus glasses (+3.0) for near
work as early as possible.
This, however, has received less attention, as this point has been highlighted
in the current form for no more than the last few decades.

We must keep an eye on children's reading distances, which many parents
fortunately do understand, but if you watch a class of schoolchildren on
television, for example, at least every one small child out of two draws or does
sums with his nose stuck to the paper! This no longer is a case of reading
glasses of even +3 d being enough!

In this precise situation, the reading glasses will force relaxation of the
accommodation tension and increase the distance.
Teachers have more than enough work here, and I dare say this should take first
place in priorities.

Looking too close is a bad habit, by no means a necessity.

If the child will not learn to keep his working distance long enough, the
primary method is to teach him to regularly support his chin with his hand at a
forearm's distance from the desk. The children also quite commonly seem to have
the habit of lying on their tummies in front of the television, which is not at
all to be recommended, as the viewing distance often is very short.

The most superior trick is to rest the accommodation by looking "dreamily" far
away, and lifting the gaze from the page without focusing e.g. after every
passage. This piece of advice is just as important for children and adults. The
need for a good working light is self-evident, even though poor light alone is
not the crucial cause in the development of myopia, unlike often suspected by
laymen.

In China, where they are ahead of us in so many things, children are taught to
massage the acupressure points around their eyes in order to prevent myopia,
surely a tradition based on experience. This is quite right, as these are the
points where the nervus trigeminus comes out, and this nerve plays a central
role also in accommodation (Panacea pp. 192-3). fig. 3.

This Chinese poster tells how massaging and pressing the correct acupuncture
points around the eyes can cure myopia.

Night myopia is the result from an effort to see better at low levels of lights,
such as twilight or at night. The dark period in the autumn is the
ophthalmologist's nightmare. The darkness draws people being near to emmetropy
to an accommodation tightness, and this makes it even more difficult to fight
against adding the minus strengths, and their reduction being met with great
resistance.

In those who already are myopic there is all reason to find measures that would
prevent the deterioration of the situation. They include:

Nobody at any age should ever be allowed to read with distance minus glasses;
however, there is nothing to stop you from using undercorrected minus glasses at
a distance.

One should have at least two pairs of minus glasses, the weaker one to be put on
as soon as one gets home, in case it is not possible to abandon the glasses
altogether at home.

One should also attempt to manage driving in the daytime with the weaker
glasses, with the stronger pair kept for night time driving.
We should watch television from as a long a distance as possible, staying as
near as needed but always attempting to move the chair a little bit farther.

Monofocal minus glasses should not even exist, and consequently
Up till -3.0 -  -4.0 dioptres, the lower section of the glasses should either be
empty ( = half glass, which is the cheapest of bifocals) or the lower section
should be a ±0 =, a so called plano lens). Outside these values should be used
bifocal combinations with the appropriate dioptric values.

In a situation where a plus half-glass only is indicated, which one so often
sees people wearing (these should also be worn constantly), the frame must be
open at the top; "a boom" at the top in the middle of the field of vision does
nothing but harm.


Even in other contexts, the reader must understand that the guidelines given
here are rough generalizations, allowing applications demanded by the case and
conditions.

However, such as progressive glasses, which so often are almost pushed on the
customers, are the detriment of all treatment. Firstly, astigmatic distortions
cannot be avoided with these; the stronger the glasses, the more disturbing they
will be. Another great disadvantage that the user is not usually aware of is
that when the strongest part of the spectacles is only met in a gradual manner
in the lower section, its effectiveness often remains completely outside the
viewing area.

Bifocals should be of the so-called Executive lens type, with a straight border
as high as possible. This type is the most attractive and least noticeable, if
this should be particularly important for anyone. Of course there are other
fully acceptable lenses with large lower sections, but in these the border is
often seen as "claws", a less attractive line.

A good alternative for progressive lenses is trifocals, also in the Executive
type; but these will only be needed by persons of a slightly more advanced age.

The wearing of minus glasses is no obligation, unlike the plus glasses, without
which nobody should be. But people are so strange: you could be pleading with a
myopic not to wear glasses (which would be quite possible for many), but they
refuse point blank! Whereas hyperopics, no matter how much you plead with them
to wear their glasses, would like to put them aside.

How often have I aired my standard remark, when waiting for a patient to dig out
their glasses, that they are in the wrong place. My often-repeated guideline
concerning plus glasses is "from the bedside table to the bedside table!" and
those who have adhered with it have found that it gives them strength.

The current enthusiasm about collecting second-hand glasses for the developing
countries frightens me. A very great number of these are minus glasses of the
wrong type. When people in those countries with no appropriate expertise try on
the minus glasses and feel that they make the world "brighter", they become
enamoured with them, and so an impetus has been given to the progress of evil –
but the business will flourish!


To get an idea of the fanatic dependence on their glasses of myopics, I would
recommend reading case 306 in Tetralogia and case 306 in Panacea.



COMPLICATIONS OF MYOPIA

All I have discussed above would not be so startling, if myopia did cause not
only plenty of clinical suffering but also evil that cannot be reversed. How
many people could not work in their dream profession because they were myopic.
How many eyes were blinded by detachment of the retina (ablatio retinae) caused
by the stretching of the eyeball, even in very young people! In these cases,
too, operative results have improved over the years, but the losses are still
great. Myopia makes you vulnerable to degeneration of the retina, and many
people have had they eyesight affected by this problem. Vitreous degeneration
and glaucoma due to myopia are also common.


Dr. Viikari

Christine's words are ALL THE WORDS OF DONDER'S ASSUMPTIONS.

But the dynamic picture of the natural eye, STRIPPED OF HIS ASSUMPTIONS, is the
picture of an eye that is dynamic, and if you restrict our language to ONLY
measured refractive STATE(Drug), then the correct model of the natural eye (with
positive and negative refractive STATES -- is indeed accurate and pure
mathematical science.

Yes, in your office bias, you "don't see it that way".

That only proves the nature of your office bias.

But let me be kind -- and say it this way:


      "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

So you have woven a "fabric" around a distorted concept, and can never see the
proven SCIENTIFIC reality of the eye's proven behavior.

Sad, but there it is.

I know you don't wnat to "hurt" anyone with your practice, and ideed, from
Raphaelson, it is obvious (to me) that you have no choice.

The only person who would have a choice in this matter is the person who can
"figure it out" before you place that first over-prescribed minus lens on the
child's face.

But that is my and other doctor's second-opinion.

Best,

Otis







--- In Myopiafree2@yahoogroups.com, "drjudy65" <mpace99@...> wrote:
>
> --- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@> wrote:
> >
> >
> > Dear Judy,
> >
> > I am not going to discuss the historical mis-concepts
> >
> > The correct behavior of the natural eye is demonstrated
> > by this accurate scientific model, simplified by
> > Christine Wildsoet, where the refractive STATES(Drug)
> > are measured objectively.
> >
> > http://vision.berkeley.edu/wildsoet/myopiaprimer.html
>
> Wildoet uses Donders' terms and concepts thoughout the site.  If you are using
Dr Wildsoet as support for your assertion that Donders' theory has "failed", how
does her use of Donders' terms myopia, hyperopia, emmetropia and refractive
error support you?
>
> If Donders' ideas have "failed" why would Wildsoet say:
> "Refractive errors exist when the length of the eye and its optical power
mismatch."  Isn't that statement a simple, concise statement of Donders theory?
>
> Judy
>

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...> wrote:
>
>
> Dear Judy,
>
> I am not going to discuss the historical mis-concepts
>
> The correct behavior of the natural eye is demonstrated
> by this accurate scientific model, simplified by
> Christine Wildsoet, where the refractive STATES(Drug)
> are measured objectively.
>
> http://vision.berkeley.edu/wildsoet/myopiaprimer.html

Wildoet uses Donders' terms and concepts thoughout the site.  If you are using
Dr Wildsoet as support for your assertion that Donders' theory has "failed", how
does her use of Donders' terms myopia, hyperopia, emmetropia and refractive
error support you?

If Donders' ideas have "failed" why would Wildsoet say:
"Refractive errors exist when the length of the eye and its optical power
mismatch."  Isn't that statement a simple, concise statement of Donders theory?

Judy