Dear Stirling,

Subject:  What is WRONG with optometry?

Re:  The answer -- the same thing that is WRONG with
      ALMOST all of us!

I met a wonderful man.  He threw optometry "out the window",
and put his kids in a plus.

He then quit optometry and went into real estate.

What is wrong (us, the ignorant, none motivated public) is that
we want an instant quick-fix, and anyone who says anything
different is crazy, a "crank", or an "isolated" scientist.

I get this sad impression that these majority-opinion ODs
think that everyone is some kind of STUPID.

That MIGHT be true of 99 percent of the population -- but
not everyone.

It is the 1 percent that "wakes up" as you have done that
solve the problem.

Please forgive this "rant" but I truly wish we (the National Eye
Institute)
could get off their duff, and acknowledge that not everything
in this would can be "medicine".  Not everything can be
a quick-fix and five minutes and "heredity".

At least the NEI could state the case for the preventive
second-opinion, and promote an OPEN plus-prevention
effort at a pilot-college like Embry Riddle.

I am willing to teach a course of that nature.  (Yes,
brick-bats will be thrown at me.  I just ask
for scientific honesty.)  I would do this for FREE.
I just need supporting friends.

But for now, thanks for your efforts.

So far, I count about 10 to 20 people who have
truly understood, and have ACTUALLY USED THE PLUS
CORRECTLY AND SUCCESSFULLY.

Now that leaves about a 100,000,000 who missed
the boat.  And tragically, once you start with the minus, your
distant vision becomes so much spilt milk, so much
water over the dam.

Sincerely,

Otis

Taxono.txt

Dear Vision-clearing friends,

Subject:  Using clear words to describe the behavior of the
	   fundamental eye.

Re:  Tragic and false idealizations of the past -- and there
consequence.

      A "theory" was developed about 150 years (call it the
Donders-Helmholtz concept).  It simplified the discussion about
the eye.

      The theory was this.

      Only a refractive STATE of exactly zero could be called
normal.

      ALL OTHER STATES WERE DEFECTS OR ERRORS.

      The word coined for a refractive STATE of exactly zero was
"emmetropia".

      All other eyes were "ametropia", or "error" or "fault".

      This was a sweeping and WRONG conclusion.

      Because of this wrong-headed concept, refractive STATES that
are absolutely normal are classed as "hyperopia".

      Thus if you have 20/20, and a positive refractive STATE,
which is normal, you are told your eyes have ERRORS.

      By this logic, a negative refractive STATE of -1 diopter was
called an "error".  Here, there MIGHT be some logic to it -- but
is it rather superficial.

      Based on the performance of the natural eye, (Wildsoet,
blue-tint animation), it is clear that the natural eye is dynamic
when tested in SCIENCE.  But when medical people see it, out comes
the WRONG vocabulary -- which is bound to confuse everyone.

      You stated that you wished a theoretical discussion about the
concept of the natural eye's behavior -- and proof?

      The issue must start with taxonomy and concept.

      Oh, and remember, there are second-opinion optometrists who
support both the science and method of prevention.  See:

      www.chinamyopia.org

      ...for practical application of the science of the
fundamental eye's proven behavior.

      Best,

      Otis

Intend.txt

Dear Prevention-minded friends,

Subject:  Well intended advice.

Re:  The response of a majority-opinion OD.

Friend> We have lost precious time that we could have been using
        to get the word out about plus prevention.

Friend> This is time you could have spent talking to optometrists or
        optometry students or parents or children who could make a
        difference.

Otis> And here is the majority-opinion optometrist who I must
        "talk to" about assisting parents and children with
        plus-prevention:


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

      From Dr.  Catman Grant

      Speaking seriously, and as a professional, there are a few
points I wish to make.

1) In my consulting room, as you correctly stated, I am God.

2) I earned that right through study, hard work and developing a
      reputation for quality work, excellent results and caring for
      my patients and their welfare.

3) You have not earned that right.  You are a pathetic little
      pissant that insults the very fibre of prevention of myopia.
      You do not deal with 20 patients a day wanting to see
      clearly, you do not have to ensure that a kid can see the
      board in class, as well as read and function outside the
      classroom.

4) You have no concept of the issues, I and every other OD must
      face on a daily basis for the best welfare of each and every
      one of our patients.  You prefer to pontificate about evil
      minus and second opinion crap, whose supporters are less
      credible than yourself.

5) You keep talking about second opinion doctors, but never name
      any other than Steven Leung.  Why is this?  I do know several
      OD's in Hong Kong and Singapore and Steven Leung is held in
      the esteem that I hold you and Nancy.  He has no basis to his
      method, he just uses the fear of parents to sell his glasses
      for his own profit.  His website is a fraud and most of the
      links don't work.  There is no scientific validation, just
      fear-mongering.

      All in all, you are a pathetic, miserable sycophant that has
nothing to provide other than fear.  No answers, no proof,
nothing.

      Crawl back under your rock and fester away.

      dr grant (CatMan), a majority-opinion OD.

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

      Talking to a person who declares himself a "God" -- is
impossible.

      You would have to be naive to think that there could be ANY
RATIONAL CONVERSATION with such a "God".

      When I SUGGEST that you my be forced to do it yourself --
then this man's attitude against plus-prevention is indeed the
reason.

      Look to your own resources for prevention -- because you will
get only hostility from Catman Grant.

      It is better that I talk to the person himself about
Catman Grant's incredible arrogant and IGNROANT attitude,
and the effect his over-prescribed minus is going
to have on the un-suspecting public.

      I EXPECT more that this from a so-called "professional".  The
Second-opinion PROFESSIONAL will be found at:

      www.chinamyopia.org

      Otis

JudyPers.txt

Subject:  Judy and -1/2 diopter per year.

The purpose of myopiafree is to help you gain "perspective"
of the majority-opinion optometrist.  What she
does -- and what she can not do.

I am fair minded about this.  Judy would not "prescribe"
a minus at -1/4 diopters (about 20/25) -- and I agree
that she should not do that.

What I think should be done at 20/40 (about -3/4 diopter)
is that you should have a discussion.  If you
are entering a four year college at 20/40 to 20/50,
you should be presented with the West Point
statistics that show that a person at -3/4 diopter
can be expected to go DOWN by -1.3 diopters,
with a spread of -1.1 D to -1.6 diopters.

But no OD will credit you with the intelligence
to understand this issue -- and the persistence
to use the plus to keep your refractive STATE
at -1/2 D and your Snellen at 20/40.

Here is Judy's statent on I-see with some
commentary by Otis.

===========

Dear Friends,

Otis> Keith was declared "myopic" at age 13.  After some "give and
       take", Keith got the idea -- thank God.

Otis> Here is my response to majority-opinion Judy.

Otis> The un-protected eye goes "down" at a rate of -1/2 diopter
       per year in grade and high school, and -1/3 diopter per
       year in college and graduate school.

Alex> (Suggests no prescribing for 20/40 vision) -- being left
       uncorrected.

Judy> Not just the "right" ones.  Most of us would not correct a
       -0.25 or - 0.50 young myope unless there were complaints of
       trouble seeing the blackboard.  By age 16, with a driver's
       license likely involved, we would correct.

Otis> We all agree that the person must pass the DMV.  If that
       required a -1/2 diopter, that is fine.

Judy> Our experience is that those uncorrected 13 year old mild
       myopes usually progress by a diopter or two during the teen
       years.

Otis> Absolutely correct.  They go down at an average of -1/2
       diopter per year.  It would be NICE if Judy would MENTION
       this fact to a person at -3/4 diopters -- and send them to
       the i-see site.

Judy> The fact that they do progress despite not being corrected
       is why we are skeptical of claims that not correcting will
       prevent progression.

Otis> Plus-prevention is far more "aggressive" than "doing
       nothing".

Otis> I agree that SOMETHING must be done when the child's Snellen
       is 20/40 at age 13.

Otis> I also agree that Brooks would create havoc for any OD who
       would suggest plus-prevention -- and the self-discipline that
       it truly requires of the person himself. But at least Judy
       could SUGGEST this possibility, and send the person to sites
       that SUPPORT it and EXPLAIN it.

Judy> Spend some time with an optometrist and you will see a
       number of myopes who come in saying:  "well you told me last
       year I was borderline, I didn't get the glasses and now I
       really can't read the road signs"

Otis> No kidding!  Why not discuss this issue with the person and
       give him some credit for intelligence and MOTIVATION.  After
       all, they are his eyes -and HIS visual future.  He has a
       right to an informed second-opinion at that point REGARDLESS
       of what Judy might think.

Judy> ...or "I only wore my glasses to drive a night but now I
       can't see very well for day time driving" or "I didn't get
       the glasses last year because I didn't have insurance, but
       now I really can't see".

Otis> And if the person "woke up" and noticed the "blur" at
       distance and got VERY BUSY with the plus.  And cleared his
       Snellen to 20/40, 20/30, and 20/25 (pass all the DMV tests).
       Then none of this "I didn't wear my minus lenses -- and my
       vision got worse".

Otis> No, I got "busy" with the plus, cleared my Snellen, and pass
       the DMV. I don't need that wretched minus lens any more.

Judy> So our experience is that myopes progress without
       correction, myopes progress with correction, most stop
       progressing about the same time growth stops and that
       hyperopes stay hyperopic despite 24/7 accommodation.

Otis> That would be 16/7 accommodation.

Otis> Her experience is NEVER that the person himself, woke up and
       aggressively cleared his Snellen with a plus.  And kept his
       vision clear through high school and college -- because he
       had BOTH the intelligence and above all else -- the
       MOTIVATION to keep doing it.

Otis> Because Judy NEVER wants to know of that possibility.

Judy> To justify doing the glasses/no glasses myopia progression
       study, you will need to propose a progression hypothesis for
       how correction would enhance progression...

Otis> Just take a population of fundamental eyes, place a -3
       diopter lens on 1/2 of them and watch them go DOWN by -2
       diopters in six months.  The minus lens can be understood as
       a simplistic "default" lens -- but never as a solution.  I
       think a person should be presented with these scientific
       facts by a professional.

Judy> ...  that also explains progression without correction,
       progression that stops at adulthood, and hyperopia.

Otis> To a person who knows ONLY the quick-fix with a minus in her
       office -- AND NOTHING ELSE.

Best,

Otis

Judy

Dear Soyew,

Subject: The preventive second opinion.

Thanks for the remarks!

I personally think that plus-prevention is
tough -- by wise.

I will post some remarks as to why
an OD can not help you with plus-prevention,
and why it must be a personal choice.

That -1/2 diopter per year is the "price" we
pay for our modern civilization.

It takes time to "conceptualize" the
issue that way.

Best,

Otis


--- In Myopiafree2@yahoogroups.com, "soyew7" <soyew7@...> wrote:
>
> Starting from ur argument and makin ur points through out the post. I
> realy liked the way u said "we can see the eye going down -1/2
> diapoter but we doint see the eye goind up +1/2 in studies". or
> something close to that. I know this ain't an english class but i
just
> wanna say i enjoyed the post. :)
>

Starting from ur argument and makin ur points through out the post. I
realy liked the way u said "we can see the eye going down -1/2
diapoter but we doint see the eye goind up +1/2 in studies". or
something close to that. I know this ain't an english class but i just
wanna say i enjoyed the post. :)

MyCut.txt

Dear Chris,

Subject:  We truly have our "own" way to finding "truth".


      There is truly no way that anyone can tell you how to
"prevent".

      Experimental data is "passive", that is it is not convincing
in itself.

      But my basic approach is to simply take some normal eyes and
TEST THEM.

      I put a -3 diopter lens on them, and watch them change as per
the applied -3 diopter lens.  If they do, then that suggests that the
use of the minus is "well intended", but a risk.

      If they do not change -- then basically I am done.  But the
eye does respond, by always changing by -2 diopters in six months.


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

      So that being the case (if you can accept it) then exactly
what is a positive or negative refractive STATE of the eye.

      It is simply the eye working as it should work (in my
opinion).

      But the real question I had (from way back) was this -- don't
the ODs KNOW this?  If they KNOW IT, why don't they just TELL US?

      The real answer is that they prefer to NOT ask questions that
spring from curiosity. And that is probably the difference
between me and them.

      An no, I hold no grudge.  When a man puts his own child into
a strong minus at 20/40 -- I shudder at the consequencesa because
I know them all to well.  But I can not fault him, nor his
dealings with the public.

      I just think it is very bad idea.

      From multiple "plus" (bi-focal) studies (with various
results), it is consistent across the board that when we start
with the minus, our refraction goes down at -7/10 to -5/10
diopters per year.

      I think there are about five studies I can quote, maybe more
for the straight-minus group.  ALWAYS!

      The point is that NO STUDY SHOWS THE EYE MOVEING UP at +1/2
diopter per year.

      I truly think that no OD can "promote" plus prevention,
because it depend on the person (with wisdom and motivation) and
NEVER on the OD.

      The -1/2 diopter per year convinces me of the "one way trip"
produced by our "school environment", and the minus.  Our eyes
simply do not "fail", they do what they are SUPPOSED to do.  We
fail when we see 20/40 and PANIC.  I don't think we are stupid,
but sometimes you have to wonder about this issue.

      And I sympathize with the OD.  I mean, what the hell is he
going to do with you in five minutes.  TALK to you?  That does not
work.

      So we are back to square one!

      As far as I am concerned, then, the "plus" must become like
brushing your teeth on a regular basis.

      But wait, do I think, geese, I must brush my teeth or I will
lose them EACH DAY.  And then I go brush my teeth?

      Of course not.  I do it automatically by routine.

      This is what my nephew did through college.

      So he has clear distant vision at age 40, and as you know 88
percent of the Hong Kong students are myopic -- and will stay that
way.

      You have to ask yourself -- who made the better choice?

      Just my thoughts for today.

      Otis

Dear Chris,

I had some BAD habits as a kid.  I recognize them
as the "cause" of nearsighedness.  This is MY OPINION,
not YOUR opinion.

But in my OPINION, I should have been FORCED to
wear a strong minus when my Snellen was 20/60.

But that is the way I understand this issue.

Some more commentary:



--- In Myopiafree2@yahoogroups.com, "armistice1112"
<armistice1112@...> wrote:
>
> What do you mean strong plus. I have a plus
which at a comfortable
> distance from the paper, I am at the point of just blur. Is that
> strong enough?

Otis> I think that is as good as it gets.

Otis>  It is VERY HARD to think in terms of
NOT fixing distant vision with a minus (so obvious)
and understand the dicipline of the plus for
near.

Otis> That "thinking" seems to be very difficult
for all of us.

Best,

otis



>

What do you mean strong plus. I have a plus which at a comfortable
distance from the paper, I am at the point of just blur. Is that
strong enough?

PClarPLS.txt

Subject:  M.O. OD asks for plus-prevention study -- and the would
        BLOCK it in every way possible.

Dear Keith,

Subject:  Plus-prevention is indeed difficult.

      You finally realize that you must do it yourself. Here a
majority-opinion OD argues against it, says it is impossible, and
then demands a plus-prevention study.

      [Which he would do everything in his power to DESTROY.]

Best,

Otis

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

Subject:  M.O. OD asks for plus-prevention study -- and then would
        BLOCK it in every way possible.

Re:  Been there -- done that.

From:  PClar M.O.  OD

Otis> What happened is the recognition of how totally you IGNORE
        all scientific facts about the fundamental eye's proven
        behavior -- when you dislike the implication of scientific
        facts.

PClar> what has been "proven" over this length of time is that
        plus lenses, under-correction, bifocals, having myopes read
        without their glasses, etc.  IS ALL INEFFECTIVE.  read the
        literature you old fool!

PClar> why do you harass all the doctors here as if their is some
        myopia prevention treatment that should be applied that
        they are refusing to apply?  all the treatments that you
        suggest have been tested multiple times and proven to be as
        effective as fairy dust.

[Comment:  I am NOT "harassing" these majority-opinion ODs.  What
        I stated was that the person himself would have to size-up
        the facts himself, and reach a point where he understands
        the necessity of using the plus for prevention. It is my
        belief that a mature adult, entering a four year college
        could assess these issues, and clear his Snellen -- UNDER
        HIS OWN CONTROL -- the way that Dr.  Stirling Colgate did
        it.  I consider this SCIENCE, and NOT medicine. OSB]

PClar> as you point out, no one has more interest in this issue
        than the Asian's and that's why researchers in Singapore
        and Hong Kong have taken the lead on this issue.  their
        conclusions are the same -- nothing that has been tried so
        far works except the anti-cholineric drugs therapies and
        those are still being worked out.  and don't start farting
        out the name of Steve Leung -- he's and idiot and no one
        over there accepts him at all.  he hasn't proven a thing.

PClar> YOU are the one who has sat on your butt over the last 25
        years and done nothing. if you think you have a clue about
        how to prevent myopia then go out and PROVE it.

[Comment:  I have taken Francis Young's bifocal (plus) study, and
        SUGGESTED that his results could be repeated, but with the
        proviso that the engineering students understand the
        statistics concerning the natural eye's behavior.  Thus
        THEY would be the leaders of the study. So far, it is
        people like PClar (M.O. OD) who effectively BLOCK even the
        first steps towards this type of plus-preventive study.
        THAT is why there is no successful preventive study.  OSB]

PClar> i don't care if you use engineering students, retired
        optometrists or whatever, if the study design is valid then
        everyone will take notice.

PClar> quit posting unsubstantiated drivel on the internet and
        instead take the time to prove what you claim and we will
        all be happier.

PClar.

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

Otis> We all do typos, and spelling errors.  But I truly "wonder"
        at a man who has gone through four years of college
        FOLLOWED by four years of optometry school, and still does
        not understand that you capitalize the first letter of each
        sentence.

Best,

Otis

AlexWP.txt

Re:  The West Point (Gmelin) Study and results.

Subject:  The refractive behavior of the young eye.

A large number of studies of school children show
that when their eyes "go negative", they will continue
to go down at -1/2 diotper per year.  In college
this rate slows down to about -1/3 diopter per year,
till graduation.

These statistics are reviewed below:

Otis Brown quoted Gmelin quoting McKinney's "Study of
       Refractive Trends at West Point", saying:

Otis> The AVERAGE increase in myopia was -1.37 diopters (the range
       being -1.12 diopters through -1.62 diopters).

Alex> What I think Gmelin and McKenny were saying was that for those
       myopic cadets (or perhaps non-myopic as well) whose myopia
       increased, the increase was an average of -1.37 diopters
       over four years, or about a third of a diopter per year.
       Those cadets, myopic or not, who did not experience a myopic
       shift were not included in the figure.

Otis> Tragically, we would need ALL of the original data to settle
       this dispute.  We would have to know EXACTLY what was
       considered a negative change.  Would it be 1/8 diopter?  1/4
       diopter? 1 diopter?  The report does not say.  It would
       make a huge difference.  For example, all went down, but
       only 5 were greater that 1 diopter.

Otis> So that would be your -1.1 to -1.6 diopters (for the five)
       All others (250) stayed where they were, or went postive.
       Maybe, but that is the issue.

Alex> This figure cannot be compared, unadjusted, to the results of
       animal experiments where the refractive trend of all
       subjects is included in the average.

Otis> As always, a matter of human judgment.

Alex> Francis Young speaks about this discrepancy of convention in his
       1981 paper, "Primate Myopia".  I quote:

Young> <<When fully adult monkeys (one even gave birth in the chair)
were
       enclosed in the hooded situation, 7 of 10 developed myopia
       or changes toward myopia which averaged 0.75 D in the period
       of 1 year.  While this amount is not spectacular, it does
       exceed the usual amount of myopia of approximately 0.5D
       developed in children over the same period.  The
       calculations of the amount of myopia developed included
       those subjects who did not change into myopia whereas in
       most human situations we exclude the subjects not changing
       and deal only with subjects who are changing into myopia.
       If the nonchanging subjects are excluded, the amount of
       myopia developed is approximately 1.25 D of myopia in 1
       year.  Human subjects of a comparable age (18 to 23 years),
       such as submariners, cadets at Virginia Military Institute,
       or at the U.S.  Naval academy tend to change at a rate of
       approximately 0.25 D a year into myopia.>>

Otis> Excellent!  I read the paper.  The amount of accommodation
       change was very small, about -0.8 diopters.  The resultant
       refractive STATE change was also very small.

Otis> In order to make a judgment of the behavior of all natural
       eyes, you must take the AVERAGE of the refractive STATES of
       all natural eyes.  You can not just take, selectively, one
       eye.  The "noise" or randomness of these measurements is
       such that it will effectively hide the deeper meaning of the
       behavior of the population of natural eyes.

Otis> What is truly required is a much greater change in the value
       of accommodation.  When a -3 diopter lens is applied to a
       population of natural eyes, the refractive STATE will change
       by -2 diopters (average) in six months.

Otis> This is truly the inherent behavior characteristic of all
       normal and fundamental eyes.

Otis> In some aspects of science, you must realize that you can
       not perform this experiment on the primate-human eye.  And
       you must exagerate the conditions of the test -- to get
       meaningful results.

Otis> How you think about his -- is up to you.


Alex> When the entire population of cadets is included in the numbers,
       there still is a "negative" refractive trend, but it is much
       smaller.

Otis> But the critical issues is to note that a Cadet with a
       refractive STATE of zero and 20/20 has about a 1 in 100
       chance staying at zero through four years of college.  If
       you are a cadet at zero, you should know this fact, and the
       supporting information as per above.  It might inspire you
       to do something wise to prevent entry into myopia.

Alex> From the National Research Council book "Myopia:  Prevalence and
       Progression":

http://books.nap.edu/openbook/0309040817/html/31.html

Study> <<At entry 362 (43.7 percent) were myopic, while at graduation
443
       (53.5 percent) were myopic.

Alex> Using Gmelin's frequency distributions for calculation, the mean
       refractive error at entry was -0.873 D., while at graduation
       it was -1.251 D. This is a mean change of -0.378 D., which
       would be a rate change of -0.0945 D./yr, if the interval
       between exams was four years.>>

OTis> Again, a matter of judgment.  The Annapolis report showed a
       "down" rate of -1 diopter in four years.  If the person has
       a refractive STATE of +1 diopter -- then he is safe.  If
       zero diopters, he is a serious risk of going negative.  That
       is the true issue -- and he should know about it.

Otis> If you wish to make the argument that nothing should be done
       -- I accept your argument.

Otis> Indeed, most people truly do not care for or about
       preserving or keeping their distant vision clear for life.
       That is always a personal choice or decision.

Otis> Clearly I belive that the =1/3 diopter/per year figure is
       very, very accurate, and that any person, enterning a four
       year college witha refractive STATE of -1/4 diopter (20/30)
       should understand these statistics.  Again, this is a
       personal choice.

Otis> If the person UNDERSTANDS them and these issues, it might
       encourage him to clear his Snellen by assidious use of a
       strong plus for all close work.

Otis> If he does this, he can avoid picking up that -1.1 to -1.6
       diopters of myopia for the four years in college.

Otis> This is indeed a personal, "judgmental" issue.

Best,

Otis

--Alex

Otis S. Brown quoted Gmelin quoting McKinney's "Study of Refractive
Trends at West
Point", saying:
> The AVERAGE increase in myopia was -1.37 diopters (the
> range being -1.12 diopters through -1.62 diopters).
What I think Gmelin and McKenny were saying was that for those myopic
cadets (or perhaps nonmyopic as well) whose myopia increased, the
increase was an average of -1.37 diopters over four years, or about a
third of a diopter per year. Those cadets, myopic or not, who did not
experience a myopic shift were not included in the figure.

This figure cannot be compared, unadjusted, to the results of animal
experiments where the refractive trend of all subjects is included in
the average.

Francis Young speaks about this discrepancy of convention in his 1981
paper, "Primate Myopia". I quote:

<<When fully adult monkeys (one even gave birth in the chair) were
enclosed in the hooded situation, 7 of 10 developed myopia or changes
toward myopia which averaged 0.75 D in the period of 1 year. While
this amount is not spectacular, it does exceed the usual amount of
myopia of approximately 0.5D developed in children over the same
period. The calculations of the amount of myopia developed included
those subjects who did not change into myopia whereas in most human
situations we exclude the subjects not changing and deal only with
subjects who are changing into myopia. If the nonchanging subjects
are excluded, the amount of myopia developed is approximately 1.25 D
of myopia in 1 year. Human subjects of a comparable age (18 to 23
years), such as submariners, cadets at Virginia Military Institute,
or at the U.S. Naval academy tend to change at a rate of
approximately 0.25 D a year into myopia.>>

When the entire population of cadets is included in the numbers,
there still is a "negative" refractive trend, but it is much smaller.
  From the National Research Council book "Myopia: Prevalence and
Progression":

http://books.nap.edu/openbook/0309040817/html/31.html

<<At entry 362 (43.7 percent) were myopic, while at graduation 443
(53.5 percent) were myopic. Using Gmelin's frequency distributions
for calculation, the mean refractive error at entry was -0.873 D.,
while at graduation it was -1.251 D. This is a mean change of -0.378
D., which would be a rate change of -0.0945 D./yr, if the interval
between exams was four years.>>

--Alex

Washand.txt


      "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


      Men live by their routines; and when these are called into
question, they lose all power of normal judgment.  They will
listen to nothing save the echo of their own voices; all else
becomes dangerous thoughts.

      Harold Laski


      Imagination is more important that knowledge...knowledge is
limited but imagination circles the world.  To see with one's own
eyes, to feel and judge without succumbing to the suggestive power
of the fashion of the day, to be able to express what one has seen
and felt in a trim sentence or even a cunningly wrought word...is
that not glorious?  When I examine myself and my methods of
thought, I come close to the conclusion that the gift of
imagination has meant more to me than my talent for absorbing
absolute knowledge.

                                  Albert Einstein



      Subject:  The claim that ALL EXPERTS AGREE.

      What follows is a proudly presumptive and proven false
assumption that, "all experts agree..."

      That is the reason for the development of the preventive
second-opinion, despite what Leukoma ASSUMES.

      Best,

      Otis

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

From: "Dr.  Leukoma"

DrL > Experts are in agreement on many things. The experts agree
       that myopia is genetic with an environmental component.
       That close work is involved in myopia progression has been
       acknowledged for many years.  The experts also agree that
       providing the myopic child with their best distance
       correction is in the child's best interests, and is
       consistent with the published research.  Experts also agree
       (and have agreed for years) that myopes with accommodative
       lag who are either orthophoric or esophoric at near -- a
       minority -- seem to benefit more from bifocals than other
       myopes.  Recently, two researchers (Hung and Ciuffreda) have
       written a paper on near-induced transient myopia.  They
       maintain that some people exhibit a significant latency in
       relaxing their accommodation after prolonged near work, and
       that this latency can contribute to axial myopia.  It is a
       very interesting thesis. Experts also agree that
       accommodative "stress" is not involved in myopiagenesis, but
       that poor accommodation and retinal blur probably are
       involved.

DrL > In my practice, I strive to adhere to the above concepts in
       my treatment recommendations.  Once the concept of
       "accommodative stress" has been discarded, and the concept
       of retinal blur is accepted, more of the observed facts seem
       to fall into place.  The more one is familiar with the
       research, the more readily it becomes apparent just how far
       out in left field Otis really is.

      =========

      Bill Ph.D.

      Although I truly believe that medicine has improved much in
the last 150 years, it is difficult me to believe that "experts"
have stopped agreeing to many false assumptions since the middle
of the 19th century.  In the days of Semmelweis, pus and blood
stains on white coats were considered signs of sage wisdom and
experience.  In my days, mustard plasters and tonsillectomies were
standard practice.  Whatever happened to cryogenic treatment of
stomach ulcers?  Even more recently, there was a course change on
the benefit of hormone replacement therapy.

      Even though experts agree, it ain't necessarily so.  If you
want to show how smart you are, predict the next medical old
wives' tale that is going to be shot down.


      Bill


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

From:  Otis

      Subject:  Re:  Experts Agree

      Dear Bill,

      You are correct about Dr. Ignaz Semmelwies.  AFTER he
reduced the death rate from 30 percent to 1 percent, he was
declared a fraud.  Then the no-hand-washing doctors ran THEIR
study and PROVED that "hand washing" had no effect, and that the
death rate remained at 30 percent whether they washed their hands
-- or did not.

      Here is some more commentary on this issue for you enjoyment:

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

      THE HISTORY OF EXISTING PRACTICE

      The use of a lens to deal with any and all problems of the
eye began in the 14th century. The practice of using a negative
lens for nearsightedness has continued, almost unchanged, for the
last 300 years.  The compelling reason for this practice is the
public's demand for an instant solution, and a corresponding
refusal to consider the use of an alternative approach.

      A REVIEW OF THE PAST APPROACH

      We should all thoughtfully evaluate the unfortunate effect of
using an immediate and easy fix for the problem of
nearsightedness.  This situation of a self-perpetuating mistake
(produced by public need and attitude) is sometimes recognized by
the students of medicine.  Dr. Perri Klass said it this way in
VITAL SIGNS:

      "...  Sometimes the awesome weight of medical knowledge is
totally off the beam.  You have to practice medicine with that in
mind, with the knowledge that a hundred years or so along the
road, they'll be telling stories about the medical theories of
today to get a laugh of the medical students of 2085..."


      And about medicines' confidence in its routines:


      "...  Or something so basic, so taken for granted, that no
one has gotten around to questioning it.  Whatever it is, probably
the medical profession is collectively doing something really dumb
and really damaging, and doing it with complete good will and
typical medical self-confidence."


      This applies to vision.  The demand for negative lens use
comes partly from the public's demand for an instant solution,
(and corresponding reluctance to properly use a plus lens) and not
from a scientific assessment of the behavior characteristic of the
normal eye.


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

      As always this must become a responsibility of BOTH the
parent and child.

      Further there is a "window" of opportunity that exists for
prevention if the parent and child are willing to ACCEPT
prevention before the child's Snellen goes below 20/60 (about -3/4
diopter).

      As Mike Tyner said, he found his child with a refractive
STATE of -3/4 diopters (20/60) and put the 5 year-old into a
strong minus.

      I can not argue with that type of action.

      I am certain that the doctors who did not wash their hands,
delivered their own wives with no hand washing.

      But when they realized the consequences for their own wives
and children -- they gradually "woke up".

      That is the nature of the problem.

      Best,

      Otis

Dear Alex,

Subject:  EXACTLY what did Gmelin and McKenny mean when they said the
following:

From the class of 1975, 554 cadets (67 percent) of a class
of 828 graduated wearing
spectacles or contact lenses.

By comparing the refractive error (spherical equivalent) of each cadet
as it was recorded in his 201 File, both for his entrance physical
examination (1970) and his commissioning examination (1974),
visual acuity degradation can be demonstrated empirically.
At the completion of four years in a academic environment, there
were fewer hyperopic and many more myopic cadets in the class
of 1974

These were stated in McKinney, "A Study of Refractive Trends at West
Point", (tragically un-published).

McKinney>  2.  The AVERAGE increase in myopia was -1.37 diopters (the
range being -1.12 diopters through -1.62 diopters).

It is my thesis is that he means exactly that.

For example, a Cadet with -1.25 diopters (20/70) would, after
four years, wind up with an increase of minus refraction of between
-1.12 to -1.62 diopters.

Or, equally, if the person had -2.0 diopters, at the end for
four years, his refraction would have increased
by between -1.12 to -1.62 diopters.

I truly doubt that there was an intention to say anything else
other than that.

If you think the meaning of this statement is anything else,
other than that please let me know.

If he intended to say anything else other than that -- I would
be very interested in the original data to resolve
this issue.

Since these records are maintained year after year, I
would see no problem verifying this fact.

Perhaps other interested parties would like to make
a statement about this "down" rate in for years for
all cadets with an initial negative refractive STATE.

I would have no problem requesting this information
under the "Freedom of Information" act.  I consider
it base-line data for any future study of plus-prevention
at this type of four year college.

Best,

Otis

Dear Dr. Leukoma,

Subject: A sincere and honest answer.

Thanks for the your insight, and your statement
about your son.

While we may disagree about the natural eye as a dynamic
system -- we do not disagree about you decision to
put your child into a strong minus when his
Snellen is 20/50.  That is indeed a judgment call.

I personally think you are dealing with a situation
that is completely out-of-hand, and there is
nothing you can do about it. Not in the sense
of dealing with the public in the five minutes
you have to do so.

That that is how I draw the line separating
medicine, from second-opinion science.

With deep respect to you,

Otis

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

--- In Myopiafree2@yahoogroups.com, "Otis S. Brown" <otisbrown@...>
wrote:
>
>
>
> Dear Scientific friends,
>
> Subject:  A parent puts his child into a strong minus lens.
>
> I have no objection to an optometrist who believes that
> the only answer to a negative refractive STATE must
> be a minus lens.
>
> One of my major question was this.  Sure, I understand
> that you can never "deal" with the public in
> five minutes, and ONLY a minus lens
> will "work" in that circumstance.
>
>
> But what about the OD's own child.
> I mean do they feed their own children
> the "poison" minus?  The answer is yes,
> as described below.
>
> Here is the statement by DrG.
> This is a totally honest, and fair judgment.
>
> Since the "experts" obviously can not agree on any of this, perhaps
> you should have a better understanding of the science
> and issues behind this honest second-opinion.
>
> Here is some commentary for your interest:
>
> ==================
>
> > Dear DrG,
>
> > Subject:  Dealing with your own children.
>
> Otis> I do respect you in this way.
> You only "know" to put your own children in a minus.
>
> DrG> I "know" that my son loved to play baseball.  Therefore, I had
a
> choice to make: either give him eyeglasses so he could see the
ball,
> or do nothing and have him be hit in the head by a baseball he
> couldn't see, or not play baseball at all.
>
> Otis> Further, I do agree that plus-prevention is difficult,
> and must be STARTED before the refractive STATE
> goes below -1/2 diopter.
>
> DrG> So THAT'S the problem.  I started him in bifocals when he was -
> 0.75 instead of -0.50.
>
> Otis> That is indeed difficult.  But some optometrists
> recognize the problems, and START their
> own childern in the plus (at a refractive STATE
> of zero) because they recognize the consequences
> of the Eskimo data provided by Frank Young.
>
> DrG> Since the cause of myopia is genetic, it certainly is
difficult
> to imagine doctors doing this on their own children.
>
> Otis> But, I agree, once you START with the  minus, your distant
> vision becomes so much spilt milk, so much water over the dam.
>
> DrG> With minus lenses, my son was able to play baseball every year
> since he was 5 years/old, become an accomplished pianist, and go on
> to a prestigious university.  Instead of going over the dam, he
> crossed the bridge.
>
> DrG
>

Dear Scientific friends,

Subject:  A parent puts his child into a strong minus lens.

I have no objection to an optometrist who believes that
the only answer to a negative refractive STATE must
be a minus lens.

One of my major question was this.  Sure, I understand
that you can never "deal" with the public in
five minutes, and ONLY a minus lens
will "work" in that circumstance.


But what about the OD's own child.
I mean do they feed their own children
the "poison" minus?  The answer is yes,
as described below.

Here is the statement by DrG.
This is a totally honest, and fair judgment.

Since the "experts" obviously can not agree on any of this, perhaps
you should have a better understanding of the science
and issues behind this honest second-opinion.

Here is some commentary for your interest:

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

> Dear DrG,

> Subject:  Dealing with your own children.

Otis> I do respect you in this way.
You only "know" to put your own children in a minus.

DrG> I "know" that my son loved to play baseball.  Therefore, I had a
choice to make: either give him eyeglasses so he could see the ball,
or do nothing and have him be hit in the head by a baseball he
couldn't see, or not play baseball at all.

Otis> Further, I do agree that plus-prevention is difficult,
and must be STARTED before the refractive STATE
goes below -1/2 diopter.

DrG> So THAT'S the problem.  I started him in bifocals when he was -
0.75 instead of -0.50.

Otis> That is indeed difficult.  But some optometrists
recognize the problems, and START their
own childern in the plus (at a refractive STATE
of zero) because they recognize the consequences
of the Eskimo data provided by Frank Young.

DrG> Since the cause of myopia is genetic, it certainly is difficult
to imagine doctors doing this on their own children.

Otis> But, I agree, once you START with the  minus, your distant
vision becomes so much spilt milk, so much water over the dam.

DrG> With minus lenses, my son was able to play baseball every year
since he was 5 years/old, become an accomplished pianist, and go on
to a prestigious university.  Instead of going over the dam, he
crossed the bridge.

DrG

SecOpin.txt

Subject:  The plus used for prevention.

Here, the concept of plus-prevention is developed.

Notice the majority-opinion "judgment" about
the plus for prevention.

Otis

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

      AURORA - A 6th grader at a school for advanced students,
Austin Skeans spends lots of time doing homework.  That means lots
of time looking at things close to his eyes, such as textbooks and
notebooks.


      That's in addition to the time kids like him spend looking at
computers, handheld video games and cell phones for text
messaging.

      Austin's eyes needed some help doing all that close-up
focusing.

      "Before I had my glasses, what I did was I was looking down
at my work, and then I looked up and then it would be blurry for a
couple seconds," said Austin.

      He didn't realize that was a big deal when he went in for his
routine eye exam, but his eye doctor did.

      That's a sure giveaway that they've been straining to see up
close, said optometrist Mark Maybury at Eclipse Vision Source in
Aurora.  To spend hours focusing on little letters all the time, I
just don't think the eye was meant to do all that in the first
place.

      When Maybury determined Austin's eyes were straining to focus
on things close in, he gave Austin a prescription for reading
glasses that he believes will help keep Austin from needing
stronger and stronger distance glasses over the years.

      The lenses don't do all the work for the child.  They just
put the child's visual system in their comfort zone so they can
read without the stress and strain, because ultimately, it's the
stress and strain that makes their vision worse, said Maybury.

      Maybury says he is not suggesting that kids spend less time
reading or doing other activities close to the eyes.  Instead,
parents should ask eye doctors to take a look at how their
children's eyes are focusing on those close-up activities, so they
can get the proper eyewear if needed.

      While many optometrists believe the use of bifocals or
reading glasses for kids can help preserve their long distance
vision, some local ophthamologists have told 9NEWS, in most cases,
they disagree.

      They believe there are few kids who would indeed benefit from
reading glasses and say there aren't enough studies to prove they
can truly slow the progression of myopia (near-sightedness) in
many kids.  They say parents should not feel pressured to pay for
reading glasses for their kids, especially if their kids are not
already wearing glasses to help with distance vision.

      The development and growth of a child's eye will not be
impacted by whether or not that child wears glasses.  His or her
need for glasses is significantly more connected to genetics than
any day-to-day behavior, such as video game playing or reading,
said Ophthalmologist Richard Davidson at the Rocky Mountain Lions
Eye Institute, University of Colorado School of Medicine

Dear Chris,

Subject:  Two answers.

In asking these questions I will always say
that you will get exactly OPPOSITE answers -- from
the EXPERTS.

Thus my use of the term "second-opinion".  It
depends not on the facts, but the opinion
of the person providing the "facts".

Please understand this.  Normal astigmatism
will not prevent 20/20 vision (if you have
a positve refractive STATE.)

In primates, about 10 percent have astigmatism,
of up to 1 diopters.  It does not cause
any problem since they have a positive
STATE and excellent vision.

To further respond:


--- In Myopiafree2@yahoogroups.com, "armistice1112" <armistice1112@...>
wrote:
>
> Alrighty, from what I have been reading, I can conclude that my
> ghosting is caused by astigmatism which I have noticed because of two
> things: not wearing my minus lenses anymore and maybe my vision
> getting better.

Otis> Let me put it this way.  If I quit wearing the
minus, and got my Snellen to 20/60 or better -- I would
not "care" about astigmatism.

Otis> Further, it is stated that when you do a lot
of close work, you develop either a minus refractive
STATE OR astigmatism -- or both.

Otis> The implication would be that if you quit
with that wretched "near" environment, your
refractive STATE would move positive, and the
astigmatism would reduce.  But this is indee
the second-opinion.  I am certain you will
find "experts" who will say the dead opposite.


Anyways, I have been reading that astigmatism can be
> treated with glasses, and my ghosting disappears when I put on my
> glasses, which probably means my glasses were prescribed for both
> myopia and astigmatism.

Otis> It is indeed true that a minus, with an astigmatism
"cut" will further sharpen vision.  No doubt about it.
The real issue is this -- is it worth it?

Otis> If the astigmatism "cut" cleared from 20/30 to 20/20,
(but I passed the DMV) -- I personally would not wear
the astigmatic glasses.


So my question is: can my astigmatism progress
> if I don't wear my minus glasses?

Otis>  I think the majority-opinion, versus second-opinion
concept must apply to your question.

Otis



Thanks
>

Alrighty, from what I have been reading, I can conclude that my
ghosting is caused by astigmatism which I have noticed because of two
things: not wearing my minus lenses anymore and maybe my vision
getting better. Anyways, I have been reading that astigmatism can be
treated with glasses, and my ghosting disappears when I put on my
glasses, which probably means my glasses were prescribed for both
myopia and astigmatism. So my question is: can my astigmatism progress
if I don't wear my minus glasses? Thanks

Dear Chris,

Subject: The NATURAL eye's refractive STATE moving negative.

This "answer" must be in two parts.

1.  The natural eye with postive refractive STATES
at Annapolis in 1941.

At that time a positive refractive STATE meant 20/20,
Therefore NO LENS OF ANY KIND WAS USED -- plus or minus.

But the mishipman who had a refractive STATE of zero
would go minus in 1 to 3 years, and have 20/25 to 20/30 vision.

That was sufficient cause to reject the student,
automatically.  Thus no preventive actions were
taken at all.

When the West Point study was run, they had
changed their policy.  They would accept
students with a negative refractive STATE.

Thus, the personal files showed a DOWN rate
for all negative-state students of -1.3 diopters
per year, with the spread of -1.1 to -1.6 diopters.

To further respond:


--- In Myopiafree2@yahoogroups.com, "armistice1112"
<armistice1112@...> wrote:
>
> YOu said that the eye will go down by -1/3 diopters by year in
> college.

Otis> As defined in Annapolis and West Point.

I am just curious; does this mean the naked eye not wearing
> any plus lens or minus lens, or does this mean wearing a minus lens
> all the time.

Otis> There is no attempt to define or state "wearing
all the time".  No one attempts to "control", measure
or judge this.

Otis> But the person at 20/40 will typically avoid
the minus (if he has any smarts about it), and use
the minus only when driving.  Others, believing that
the "minus" will "help" their eyes, will wear
the minus all the time.

Best,

Otis



Thanks
>

YOu said that the eye will go down by -1/3 diopters by year in
college. I am just curious; does this mean the naked eye not wearing
any plus lens or minus lens, or does this mean wearing a minus lens
all the time. Thanks

Dear Prevention-minded friends,

It is necessary to understand the majority-opinion
OD.

Otis


Subject: Majority-opinion Logic for a strong minus for a 5 year-old.

Some of this comes down the the sense of "family".

One OD will insist that his 5 year old wear a plus.  The
next OD will put is kid in a minus.

This is a judgment of EXPERTS.  But because experts
disagree, I use the term "second-opinion" which
I believe is ethically correct.

Here is Dr G.

Otis

+++++++=


On Feb 14, 10:02 pm, "otisbr...@..." <otisbr...@...> wrote:


> Dear DrG,

> Subject:  Dealing with your own children.


> I do respect you in this way.


> You only "know" to put your own children in a minus.



I "know" that my son loved to play baseball.  Therefore, I had a
choice to make: either give him eyeglasses so he could see the ball,
or do nothing and have him be hit in the head by a baseball he
couldn't see, or not play baseball at all.


> Further, I do agree that plus-prevention is difficult,
> and must be STARTED before the refractive STATE
> goes below -1/2 diopter.


So THAT'S the problem.  I started him in bifocals when he was -0.75
instead of -0.50.


> That is indeed difficult.  But some optometrists
> recognize the problems, and START their
> own childern in the plus (at a refractive STATE
> of zero) because they recognize the consequences
> of the Eskimo data provided by Frank Young.


SInce the cause of myopia is genetic, it certainly is difficult to
imagine doctors doing this on their own children.


> But, I agree, once you START with the
> minus, your distant vision becomes so much
> spilt milk, so much water over the dam.


With minus lenses, my son was able to play baseball every year since
he was 5 years/old, become an accomplished pianist, and go on to a
prestigious university.  Instead of going over the dam, he crossed
the
bridge.

DrG



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

Otis> Added later:

This "son" at age five with a negative refractive STATE of
-1/2 diopter (20/40) could FUNCTION with no minus lens.
If you (in you zeal) over-prescribe him (which is often the case)
and he wears that minus lens all the time (recommended),
then his refractive STATE will go down at a rate of -1/2 diotper
per year from that point onward.  Thus, 10 years later,
the child will be at -5.5 diopters.  And if college, and masters,
then another 3 diopter to 8.5 diopters.  I do appreciate this -- if
the OD puts his own children into a minus -- he can not help
anyone with plus-prevention.  Further, I said "PLUS" not bifocal.
I must rely on the child to function at 20/40 with no minus.  You
can fly a plane legally with 20/40 vision.  There is a period
of "grace",
where the plus can be used WITH NO MINUS.  The bifocal (with its
minus) prevents vision-clearing -- in my opinion.
Where as, if he had been offered support with the plus (very difficult
admitedly), and use the plus as a habit, his refractive STATE could
have moved positve to zero, and 16 years later, his refractive STATE
would be some positive value and he would not become totally
dependent on that wretched minus lens.

"The fault, dear Brutus, is not in our stars, but in ourselves."

Otis

NeilTry.txt

Dear Chris,

Subject:  The reason why no OD will ever help you with
	   plus-prevention.

      People are not stupid.

      But they are often driven, not by science, and not by facts,
but the "social" world around them.

      People have asked me, "Otis, why don't you become and
optometrist -- THEN you could help people see better".

      Now, Neil has supplied the correct answer.

      Neil Brooks, a "parrot" of medical literature, could sue me,
or turn me into an "optometry board", made of Catman Grant, and
others -- and THEY would take Brook's charges SERIOUSLY.

      I would lose my license -- or worse.

      That is WHY I am not an optometrist.

      The issues is HOW you deal with a person -- including your
own children.

      When I sat with Raphaelson, I began to "wonder" about that
issue.

      And now Brooks has answered the question.

      It is not that ODs don't want to help us.  It is that we
don't understand the necessity of plus-prevention, until it is too
late.  Spilt milk -- water over the dam.

      We (I) try to develop a coherent picture of the natural eye's
behavior that is "different" than the conventional.

      That relies on an "insight" to all of this provided by
Raphaelson.

      That no OD can ever provide prevention -- because it must be
stopped at the zero diopter level.  And that required more
motivation than most parents and children will ever have.

      There is an element of "medicine", where you try to find:

      1.  A quick fix and

      2.  A preventive.

      Except that the only thing the public "understands" is the
quick fix.

      The public is HOSTILE to plus prevention and is suspicious of
any OD who would even suggest it.

      For those reasons I "give up" -- not on the concept of
plus-prevention, but on attempting to deal with the public an its
"medical" thinking.

      It is true that we should have medical checks.  But after
that, with a refractive STATE of -1/2 diopter -- we should
consider "doing it ourselves".

      And the "driver" for that realization is the limiting effect
of Brook's machinations.

      That would be my proof for the powerful effect Brooks has on
any OD.  I know I would not stand for it -- but then I would
resign from optometry.

      Best,

      Otis


      ----- Original Message -----

> Hey Otis, just because I think Neil is to be pitied does not
        mean that we should excuse him for his slanders, or that we
        should tolerate his fictions presented as fact. In this
        area, I show him no pity.

> For your enjoyment.

      > -------- Original Message --------

> Neil Brooks wrote:

> >>> Really, the issue is that--even in the monkey studies--when
        the lenses that were forced on the monkeys (who did not
        NEED lenses in the first place) were removed for even 20
        minutes or so per 24hr period, then there was no long-term
        effect from them wearing inappropriate, unnecessary lenses.

> Alex:

> >> I've shown this factoid, brought up by both you and Judy, to
        be wrong several times. First time around it's kind of
        fun.  After a while it gets tiring.  Perhaps there's a new
        study, in which case I apologize.  Got a reference to it?

> Neil:

> > Well, here's an extreme case, but it makes my statement far
        more plausible than yours/Otis's:

http://www.iovs.org/cgi/content/full/45/10/3361

Alex> That paper shows monkeys with round-the-clock unrestricted
        vision taking months to recover from diffuser (not minus
        lens)-induced myopia.  There is nothing in that paper to
        substantiate your claim that monkeys who wore minus
        long-term for all but 20 minutes a day avoided a myopic
        shift.  When Otis gives an "extreme" example from
        laboratory experiments or population surveys, one might
        dispute the example's applicability, but at least it has
        SOME basis in published research.  Your example has NO
        basis.

Alex> Once, again, I appreciate your efforts to back up your
        unsubstantiated assertion with a reference to published
        studies.  Nice try, in any case.

> --Alex

Shao.txt

      Dear Dr.  Shao,

      Subject:  Myopia Prevention Questions

      Questions for BENNY P.  SHAO, O.D. by Sean.

      I found your website today and have a few questions regarding
myopia prevention and myopia control.

      Is it possible to prevent myopia in children?  If so, how?

      Besides orthokeratology, are there any other methods for the
reduction of near-sightedness?

      Besides orthokeratology, are there any other methods for
myopia control?

      Is it possible to cure low myopia, say, -1.00 D in children
and teenagers?

      I look forward to hearing from you.  Thank you.

      Sincerely,

      Sean

      *********************************

      Dear Sean,

      Thanks for your inquiry.  Well to answer your questions, it
IS in fact possible to prevent myopia and to control it if it does
develop.

      The question is...  what KIND of myopia?

      Myopia has many different causes. Generally speaking, we are
all born with a little bit of far-sightedness, and as our visual
system develops, we learn to focus our eyes properly, and as we
practice focusing our eyes between near and far our
far-sightedness is supposed to decrease until the power is around
+0.50 in both eyes, with no astigmatism.

      If our ability to use the two eyes do not develop properly,
or if our ability to change our focus between near and far does
not develop well, then we are at risk for developing myopia.

      Sometimes this also has to do with our ability to process
central vs.  peripheral detail.  A child who has trouble paying
attention to periphery and is very detail-oriented might feel a
tendency to pull things closer to himself to analyze--such a child
is at risk for developing myopia.

      In any case, it is necessary to figure out which of these
problems is at the cause of the myopia.

      Unfortunately, oftentimes the cause is a mixture of several
things so it's difficult to say what is at cause.

      If you can find the cause just before the myopia starts and
intervene by the use of vision therapy or the use of reading
glasses, you may be able to prevent its onset.

      For someone who is mildly myopic, sometimes it is possible to
reverse the myopia IF there are signs that it is caused by a
focusing spasm of the ciliary muscle within the eyes that controls
ones focusing ability.

      Typically, at the early onset of myopia a doctor can usually
find the presence of some focusing problems.  If these problems
are addressed and treated then you can control the myopia.

      As far as orthokeratology is concerned, it is a technique
which TEMPORARILY changes the shape of the eyes, allowing the eyes
to see clearly without correction for a limited amount of time.

      The literature DOES show that orthokeratology DOES control
the progression of myopica better than glasses or conventional
contact lenses.

      My personal approach is that I look for problems relating to
the focusing skills or the binocular alignment of the eyes first
in an attempt to find root cause of visual strain, and if none are
found, then I consider using orthokeratology to stabilize the
myopia.

      I treat the binocular alignment problems or focusing problems
through office and home vision therapy in which I work with the
patient to teach them "eye exercises" that improve their ability
to use their eyes.

      Most offices that offer vision therapy are geared towards
helping children whose vision problems impair their ability to do
well academically, but I find that myopic kids with these problems
typically DO NOT have reading problems...in fact they read TOO
MUCH and their vision problems are causing their myopia to
increase.  So, I'm one of the few doctors around who spends more
time looking for myopic children to treat.

      If you need more info on vision therapy, feel free to look at
www.covd.org or www.pave-vision.org.  Again, these sites will most
likely discuss learning-related vision problems more than myopia
control though.  I hope this answers your questions.

      Regards,

      Dr.  Shao

      ^^^^^^^^^^^

      Dear Dr.  Shao,

      Thank you for your response.  I am so glad to have found an
eye doctor who likes to treat myopic children and who believes
that reading too much causes myopia to increase.

      Just to get a rough idea of what the public likes, among
young myopes (children, teenagers, etc.) in your office, what
would be the percentage (roughly) of them who use orthokeratology
to control their myopia?

      What would be the percentage (roughly) of them who use vision
therapy to control, reduce or cure their myopia?

      What would be the percentage (roughly) of them who use
reading glasses to control, reduce, or cure their myopia?

      What would be the percentage (roughly) of them who choose not
to use any of the above and just want to wear minus lens to
correct the myopia?

      Thanks again.

      Sincerely,

      Sean

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

      Replies from BENNY P.  SHAO, O.D.

His website is:

http://www.doctorshao.com

      Subject:  Re:  Myopia Prevention Questions

      Hi Sean,

      Let's see...it's a little difficult to say just how many
people actually do vision therapy in my office.  I only have about
a dozen patient visits per week for vision therapy so the
percentage of people doing vision therapy is kind of low.

      Not everyone is that hardcore about trying to keep their
eyesight from getting worse.  Also, a little myopia isn't such a
bad thing.  Having a prescription of -1.50 to -2.60 is actually
great for reading--it actually reduces strain when reading.

      The problem is that we don't know at what stage it'll stop,
so I start to SERIOUSLY recommend therapy if the patient's
prescription is increasing very rapidly, or if their vision
problem is very OBVIOUSLY linked with their prescription increase.

      It's not always easy to convince people that they should do
vision therapy because I can't guarantee any results--you don't
really know that it has worked until a year later and you realize
that your vision hasn't gotten worse.

      As far as orthokeratology is concerned, I only have a handful
of patients doing that right now--fewer than 10.  I haven't really
pushed orthokeratology in my practice because I wanted to set
myself apart.

      There are many practitioners in this area who offer
orthokeratology as a service.  Of my children patients, those who
use reading glasses are probably around 30-40%.

      This includes children who wear bifocals or progressive
lenses (no line bifocals).  Probably around 5-10% of the kids that
I've seen have signed up for vision therapy.  This number could
certainly be higher, but like I said, not every myopic patient is
a good candidate for vision therapy.  The rest just wear glasses
or contact lenses.

      Sincerely,

      Dr. Shao

MayVideo.txt

      Dear Vision-clearing friends,

      Subject:  Listen to Dr.  Maybury's video.

      Dr.  Maybury got it right!

http://www.9news.com/news/article.aspx?storyid=64338

      The real issue is whether the kid will keep it up.

      If he does, then he can keep his distant vision clear.

      But it does required understanding and commitment -- and that
is a rare quality in most people

      The remarks by Brooks clearly spell out why most ODs will not
make any attempt at plus-prevention.

      To risky, some idiot like Neil Brooks might file charges that
the "reading glasses" CAUSED double vision.

      Then, after the charge is filed in Denver, all the other
majority-opinion ODs will testify against Dr.  Maybury.

      Then they will convince the kid that he developed dilopia,
and that will scare the poop out of everyone.

      What I suggest to ANY second-opinion OD is that they inform
the parents of this issue, and obtain an "informed consent" about
the use of the plus for near.

      That way they will have some protection from the likes of
Brooks.

      I hate to think that "practice" is determined, not by
science, but by the need to protect your "practice" from idiots
like Brooks.  But that does seem to be the case.

      Issues like this one MUST be understood by the parents.

      And if you start with the minus -- at all -- your distant
vision becomes so much "spilt milk" or "water over the dam".

      That is indeed a tough lesson to learn.

      Best,

      Otis

After some careful but thorough study, I was able to find out what
ghosting is. It is monocular diplopia most of the time. This is
usually cause by the refractive error astigmatism. I know I have this
because looking through a pinhole or squinting fixes the condition.
Also, wearing my glasses fixes the condition. I realize my glasses
must have been prescribed to my level of astigmatism. I'm still wary
of the plus though. It is odd that the blur appeared so suddenly.
Well, whatever, sorry for that comment before. You were right.
Good luck,
Chris

Respons.txt

Dear Plus-prevention friends,

Subject:  Decisions that have permanent life-time
           consequences.

      Re:  Displacement of "Responsibility"

      I know that "we the public" believe that there is no limit
to the way we use our NATURAL, or FUNDAMENTAL eyes.

      As a child -- I had not a "clue" -- because of the pretense
that you can do ANYTHING YOU WANT WITH YOUR EYES -- with NO CHANGE
IN REFRACTIVE STATE.

      That false belief about our natural eyes must change!

      I think that any and all ODs have an obligation to INFORM us
of this second-opinion.

      All they need to do is to SUGGEST the use of the plus (as per
Maybury), and then say, "there is sincere disagreement about
plus-prevention.  No one has been able to resolve the disputes.
But there is a tradition in medicine to respect your right to an
informed, competent second-opinion.  Here are a list of sites,
starting with i-see where you can get this crucial information and
insights.  Your child is at 20/40.  He can function with no
glasses at this time.  But the records show that his vision will
go down at a rate of -1/2 diopter per year is no preventive action
is takes.  Why not take a few weeks and do your own research.
When you return, I will DO WHAT YOU WISH FOR EITHER PREVENTION OR
A FULL-STRENGTH MINUS. My fees are the same either way.  You pay
me for my professional services.  And this is my professional
responsibility to inform you in this manner".

      Now, exactly what is wrong with that level of professional
honesty?

      The real issue is that responsibly is "given back" to the
parents and child.

      That way if a "wrong" choice is made, the parent and child
must be considered the "responsible party".

      Best,

      Otis

Dear Prevention-minded freinds,

Here's the link to the vision article on 9 News last night:

http://www.9news.com/news/article.aspx?storyid=64338

It is very clear that if a second-opinion OD recommends
plus-prevention to you -- and you engage him
in endless hostile argument -- then there
is NO POSSIBILITY OF PLUS PREVENTION.

It seems that the person himself (like Striling
Colgate at age 14) must figure it out
HIMSELF, and then DO IT.

You simply can not "prescribe" personal
insight about this issue.

So enjoy!

Best,

Otis

JoyState.txt

Dear prevention minded friends,

      When I visited Raphaelson (about 1967) I truly wondered why
an OD couuld NOT offer plus-prevention.

      The answer is clear.  The public is afraid of the plus, and
any OD who would offer it.  In that sense we truly shoot ourselves
in the foot with our ignorance.  The story of the "Printer's Son"
totally convinced me that Joy would have to "do it herself", and
there was to be no OD support at all.  That would be impossible as
we have seen.

      My niece was one year old.  I thought -- I would hate to see
her develop stair case myopia from the over-prescribed minus --
the way I did.

      I consider her a success, with moderate motivation.  The
result was that she kept her vision in a range that passes most of
the DMV level tests -- which is consistent with her motivational
level.

      What most people fail to realize is that the "plus" must be
maintained.

      It is truly a trade-off.  The person complains, "...gee whiz,
I don't like wearing a plus when I sit down to read.  I don't like
glasses."

      So they quit with the plus.  Then, as a result their
refractive STATE SLOWLY goes down at about -1/2 diopter per year.
Thus, after 3 years, they are -1.5 diopters, and can not read the
20/70 line.  They have problems reading the board.  But still,
they will not use the plus, so another two years go by, and they
are at -2.5 diopters, or 20/180 or so.

      Now, their distant vision is permanently lost, and there is
no getting it back.  Now, they are wearing minus glasses 16 hours
a day, 7 days a week -- forever.

      Her are Joy's remarks for your interest.

      I truly admire her and figure that this is the real truth of
plus-prevention.

      Best,

      Otis

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

      ( A note from Joy)

      Steve,

      Here is some more commentary from my niece on her use of the
plus lens.

      Best,

      Otis

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

      Note from Joy:

      Dear Uncle,

      Subject:  An old, but informative e-mail

      The e-mail message that I wrote below is evidence of how
behind I am.  It was an answer to the e-mail Alison Dall had
written to me almost three years ago.  It's embarrassing that I
never responded to her.  I wrote the e-mail below but never sent
it!  Her e-mail address is at the end of the message.

      Have you kept in touch with her?  I could send it now.  I
hope she didn't give up on having her son use the glasses.

      In any case, this information might be helpful to Steve Leung
and perhaps for your records.

      One thing I would add in the way of advice is that it has
been very helpful for me to have several pairs of glasses so I
have them handy in places where I usually read.  I also sometimes
can use different diopters that way.  I should get a pair with
less diopters to use at the computer.  I would think that for
children it would be especially important to make sure that the
diopters fit the work, without making it too hard or easy for the
child to see and to make sure the glasses don't interfere with
their work or play.

      The other thing I didn't mention in my unfinished e-mail was
that the first time I started using a computer for several hours
on a daily basis (while doing an internship without using plus
lenses), I noticed my vision got worse very quickly, probably
within a couple weeks.

      Here's the e-mail I was going to send 2-3 years ago!  (I only
corrected typos, so my job and age information are not
up-to-date.)

      Joy


==========

      Remarks by Joy:

      Subject:  RE:  Plus Lenses for Myopia

      Dear Alison:

      I'm sorry I didn't get back to you sooner.  I realize this is
an important decision for you and your son.

      I am Otis Brown's niece.  Thanks to him, I have been wearing
the plus lenses since fifth grade.  I am now 32 and was very happy
to pass my driver's license eye exam once again this July (though
because the vision in my left eye is not so good, I just got a
restriction -- I must have a rearview mirror on the left side,
which is standard for most cars, anyway).

      As I know my uncle has expressed to you, finding the
motivation to wear plus lenses while reading is not so easy, and
I think it might be especially hard for a younger person.  Even
after more than 20 years of wearing the plus lenses, I struggle to
do so consistently.  But I'm happy that I have the choice of
whether to wear glasses or not.  There's no doubt in my mind that
I would have to wear glasses or contacts all the time if I had
started wearing negative lenses more frequently.

      Perhaps knowing some of my history will help you to guide
your son:

      When I started wearing the plus lenses in fifth grade, I was
a little bit shy.  The glasses, as a new item, called attention to
me.  The fact that they were different than regular glasses meant
that I might have to explain why I was wearing them.  At the same
time, I think some of my friends thought they were kind of cool.
I can't remember how often I wore the glasses.

      In junior high and high school, I continued to wear the
glasses on and off.  My memory is a bit vague, but I assume, as
has been my trend, I wore the plus lenses more at home than at
school.  Perhaps participation in sports helped me to maintain far
vision, but because my studies were very important to me, I always
read a lot.  (I also had the advantage of not growing up using a
computer; I believe computers can ruin your eyes very quickly.)

      In college, I continued with tennis, but I had trouble seeing
the chalkboard, so I got negative lenses.  (Again, my studies were
important to me and my mother wears glasses and doesn't mind it a
bit, so she did not pressure me to wear the plus lenses.)
Nevertheless, I rarely wore the negative lenses, and I continued
to wear the positive lenses (in part due to the encouragement from
my uncle).  Even my memory of plus-lens use in high school and
college is a bit vague, probably because I've never been very
strict about wearing the lenses every single time I sit down to
read.

      Partly it's hard because it's easier for me to read without
the lenses.  (In order to improve my vision, I try to read at a
distance that will slightly blur the text, but without glasses I
see the text clearly.) Also, my glasses always have to be at hand.
Even at home, I don't always read in the same place, so it's an
extra step to get my glasses before I read something (and often I'm
just reading short items--letters, articles, etc.  -- so it's easy
to think that a little reading without glasses won't hurt).

      After I finished college, I continued to do work that
required plenty of reading.  (I did a master's in Spanish
literature and a certificate program for translation, among other
things.) Currently I work as an editor and it is a big challenge
for me to wear the plus lenses, but all the more crucial.  I sit
in front of texts and the computer eight hours a day.  Because I
can't afford to slow down my work, and because the many texts
(including the screen) that I look at are at all different
distances, I am not able to wear the plus lenses much of the time.
I still have my negative lenses from college, but I only wear them
when I feel it's absolutely necessary--mainly if I'm driving in an
unfamiliar place or if I'm at a workshop and need to see at a
distance.  I haven't tested my eyes since before I took my
driver's exam, but I know my vision is not as good as it could be.
I still need to work on wearing the plus lenses every time I
possibly can.

      Joy

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

      Question by Alison:

      Subject:  Plus Lenses for Myopia

      I got your e-mail number from Otis Brown's mailing list.  Do
you have an interest in using plus lenses to help myopia?  I would
like to try to help my son but would like to speak to anyone who
has already tried or is considering using this method.

      Regards,

      Alison Dall

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

      Remarks by Otis:

      Dear Joy,

      Thanks for your review of your use of the plus lens.

      I think you did exactly what was necessary.

      What you have avoided is about -5 to -7 diopters of myopia or
(20/350 to 20/490) vision.  If you want to know how your vision
would have looked, get a +3 to +4 diopter plus lens and look
through it at distant objects. That is how your vision would have
become -- only worse.

      I know you might not believe it, but it is the truth.

      We always have problems with prevention -- but you managed to
overcome them.

      The use of a mild minus lens for night driving is reasonable
-- because the eye will take on a more negative focal state at
night But you are also wise to remove them as soon as you do not
need them.

      I do not know what happened to Alison Dall.  People will
"flash" enthusiastic, and then will quit after one or two weeks.

      It takes strong judgment to continue the process to be
effective for the long-run, as you have done.

      I sent your email to Steve Leung -- for his reference.  I
wish him well with the effort, but success depends on the quality
and insight of the person who is able to use the plus lens for the
long-term.  He has a daughter, and perhaps she will be able to
learn from her father.

      Again, thanks for your effort with the plus lens. I wish I
had had the intelligence, motivation and insight to make the plus
lens approach effective for myself at very young age.

      Otis

Dear Myopia AVOIDANCE friends,

I certainly recognize the difficulties of plus-prevention.

I truly "wondered" if anyone would "get the
idea".

After my vision with Raphaelson, and his statment
of the plublic's REJECTION of the preventive
plus, I began to realize the full scope of
the problem.  See:

"Why even a second-opinion OD can not help you."

It is very clear from that statement that we
are "left on our own".

As I freely admit -- we are the "victims" of
our own civilization.  We REFUSE to believe
that there are "limits" to the use of
our eyes.  I truly had a "problem" with
that concept for many years.

Yet the primate data (pure science) leaves
me with no choice but to recognize the
problem we create for ourselves with
our 12 years in school.

It always seems that we should go through
an educational "process" before we attempt
to do ANYTHING of this nature.

But even that seems impossible.

Some of you will become parents.  And maybe
you will "wake up" to these issues for
your own children, and overcome you
"fear" about plus-prevention.

I truly don't know.

Best,

Otis