Incredible Optical Knowldge Incompetence of an OD.

[OtisBrown]

Subject: I am an engineer, and have good knowledge of "ray trace" analysis and image formation.

I expect the same skills in an OD.  Here an OD "explains" why "squint" will clear your Snellen by about  one diopter.

It will, but not by the type of drawing presented by this OD.  Parallel rays of light pass through an optical serface, (in this case the cornea), and an image is formed at the point of convergence.  (Any competent engineer can confirm this analysis, and the essential physics of optics).

Now in this drawing, he shows the "convergence" point to be in the lens of the eye!!  That, in optics is where the image will form.

I truly wonder how a man can go through four years of "optometry college" -- and not get this right!!


http://www.youtube.com/watch?v=yux69ryP67Y&NR=1

You can not have a "technical argument" -- unless the person has optical competence.  Tragically, this man does not have it.

Now, I just check my refractive status myself, and if necessary, I would get a plus or minus lens based on my judgment (consistent with passing the DMV), and never deal with these people ever again.

Otis

[OtisBrown]

Subject:  Why I don't "bash" ODs -- and thank the second-opinion ODs for their courage.
What I regret -- and resent -- are then endless attacks on me personally, because I advocate a "new approach" towards prevention.
There are some ODs who have been able to look THROUGH THE PROBLEM, and see that prevention (at 20/50, and 1.0 diopter) would be possible, if the person himself could "get the idea", and teach himself (preventive optometry).  I would be glad to work WITH an OD on this issue, and WITH an OD like Soon See.

But this would have to be started with my great force-of-will, and before my Snellen went below 20/50 to 20/60.  To prove that this concept does exist in optometrists -- and in pure science -- here is the statement I totally support.

http://myopiafree.i-see.org/soonicansee/index.html

Let us plan to build a better scientific future with such professionals.

Otis

[OtisBrown]

Subject: The Optometrist with the correct answer -- for his own children.
Was Jake Raphaelson "intuitive" understanding of the dynamic NATURAL EYE correct -- as "pure science".  Since no OD could ever "prescribe" prevention -- then who would make the obvious intellectual and physical commitment to use the plus, before his Snellen went below 20/50???  (And his refractive state below -1.0 diopters.)
Rather obviously, no OD will ever 'volunteer' this type of information -- about the public's rejection of the plus -- when it must be used.
But, for me, my estimate that a pilot, at 20/60 with intense professional motivation (Brian Severson) would be able to overcome his fear about using the plus -- even though he would see NO RESULTS for about two or three months.  But that is normal.  It takes that kind of "resolve" to keep on going, to finally succeed in about nine to 12 months.  Most people simply don't take the time to understand prevention in that manner (in my opinion).  But, with the above restriction clearly understood, then 1) Prevention is something you do for yourself 2) No OD is going to be in a position to help you. 3) It truly takes strong personal resolve to do it.  4) If you do it yourself, and our successful, then you have truly accomplished what most people believe can never be accomplished.  But I think anyone (at 20/50) who has the motivation COULD SUCCEED, but he must have the motivation to persist -- when most will quit after a month or two.  What truly got to me was the correct statement by Raphaelson, when he stated that, "... the parents WILL NOT STAND FOR IT".  So who then has the responsibility to initiate prevention before you go below 20/40??  Otis

[OtisBrown]

Subject: Prevention is known to be effective -- for the last 100 years!
The tragedy is that we ASSUME that a medical doctor will "help us".  I don't disparage medical people, because what this ophthalmologists states is true.  Unless the person is prepared to take FULL PERSONAL RESPONSIBILITY to commit to the use of the plus (at -1 diopters) IT IS ALL MOST IMPOSSIBLE TO GET HIM TO WEAR IT.
This issue speaks to both the intelligence and motivation of the person (at the 20/50 level).  Frankly, the data over the last 50 years (bi-focal studies) simply prove the necessity to "self-teach" yourself to wear the plus (at 20/50), for long-term use.  This is why I don't use "medical terms" to discuss what YOU MUST PERSONALLY MEASURE.  But the same "medical mind" has blocked studies dedicated to people who (at 20/40) could do this work correctly.  I am pleased that Shadow has done so well (to 20/15) with Todd's nurturing attitude, but real credit must be in Shadows wisdom about wearing the plus, and getting to his desired goal.  No one had to FORCE Shadow to wear the plus.

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

     EXAMPLE CASES

     Age forty-three; myopia; had been wearing over the right eye
-1.25 D, left eye -1 D, with little or no cchange for the space of
two years; eyes in use more or less at the near point.   I
recommended the removal of the concave glasses for distant vision
and prescribed +3.50 D for reading, writing and other office work.

     After reading in these glasses for several days, the patient
was able to read print twelve inches from the eyes.  This patient
was of more than ordinary intelligence and understood the aim of
the effort.  In six months I changed the glasses for reading and
writing to a +4 D without seeing the patient.  After using the +4
D glasses for several months he again came under my care for an
examination, when the left eye gave twenty-twentieths of vision,
while the right eye was very nearly the same, but the acuity was
just perceptibly less.


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

     Similar results have been attained in 34 like cases;

     ...but the process is very tedious for the patients, and
unless their understanding is clear on the subject, it is almost
impossible to induce them to undergo the trial.

+++++++++++++++++++
This is why I don't call Todd or Shadow a "patient".  Just some very smart people who figured out that they had to wear the plus to pass the DMV requirement under THEIR control.  I would also point out that is did not cost them ANYTHING TO DO IT.

[OtisBrown]

Subject: Am "I" responsible?  Who is going to "teach" me prevention responsibility?

It took me YEARS to find this statement!!

If we restrict our attention to our vision (at 20/40 to 20/50, or about -1 diopters), then Chalmer is correct in the sense of science.  But, just suggesting prevention (at 20/40) for the most part is not effective -- unless the person himself gets the "idea" and can make a very strong commitment to wearing the plus, and monitoring his brightly-lit Snellen.

I would also add, obtain your own "check" minus lenses and plan on CONDUCTING ALL PREVENTION WORK YOURSELF. 

A massive body of science shows that our long-term near (required through 12 years of school) slowly induces this negative state in our natural eyes.  This makes prevention an educational effort, and avoiding the minus (i.e., passing the 20/30 at all times) a PERSONAL RESPONSIBILITY.

I know how hard it is to both "conceptualize" both the problem (self induced), but the solution, and must always depend on, not a medical person, but on your own insight and skill.

After 100 years, Chalmer was correct about this issue of the "public" rejecting the plus -- when it must be used as he states.  The minus is indeed "impressive", but simply does not solve any problem -- other that to impress the person who is at 20/40.  It take real insights to recognize that you must reject the minus (when at 20/40) and make the truly strong systematic use of the plus to clear the 20/30 and 20/25 line under YOUR PERSONAL CONTROL.

Thanks for your review.  Otis

[OtisBrown]

Why I do not go into an OD's office and ARGUE with him about fundamental science.

But still, what are the true facts about the natural and dynamic eye?  You have to ignore the OD who tells you, that a "minus" has NO EFFECT, or that long-term "near" has no effect on the eye's refractive state (as carefully measured). 

There are three graphs:

The first shows primates in the wild, versus students in "long term near".  (This same effect develops for primates kept in cages for seven years.

The second graph shows the effect of a plus on the young eye (with a positive refractive state). The "state" follows the applied lens in a "symmetrical" manner.

The last graph shows the refractive STATE of the natural eye 1) Living out-doors with no reading and 2) A negative state of this natural eye, when kept "near" as in 12 years in school.


http://myopiafree.i-see.org/DynamicEye.html

There is no "perfect science", but this suggests that the optometrist in his office, is disconnected with pure science, and is just telling you things that are not science related, or have no basis in pure science.

But as always, Dr. Prentice sill remains correct -- unless the person himself and understand these issues, and take prevention seriously (when his Snellen is still at 20/40 to 20/50) the issue is still difficult.  It is just that no OD in his office will ever help you with prevention -- when you must understand, and do it yourself -- in my opinion.  This is the scientific basis of prevention at the threshold. 

[OtisBrown]

Subject: My opinion.

There is no way that this science and these facts can ever be "compressed" in to an "office prescription".  It is tragic that anyone would think that could be possible.  There is a "widow" of opportunity for prevention, when the person himself realizes exactly why this situation exists.  In my way, I teach "optometry" to a person, that he might both 1) Read his Snellen, and I hope at 20/40  2) Realize that an OD has no motivation to tell you anything  3) Prevention (up to 20/40 and -1 diopter) is possible.  4) The minus is the worst possible solution, but it is the only "solution" that will ever be provided in an office. 5)  If you truly wish to avoid the minus, it is necessary to start with the plus, and, at 20/40 be prepared to make heavy use of the plus for about six months, until you begin to pass the 20/25 line.

I consider this to be very difficult for most people to "commit" to, but I do believe that for a person who will use his own "test" minus lenses, and as "sustaining" motivation, then he can get out of it on his own.  After all, if you pass the 20/25 line at home, you will pass all the DMV tests with flying colors, and should and OD attempt to "prescribe" for you -- you can ignore that attempt.  In fact when I was reading the Snellen at 20/20 IN AN OFFICE, they still attempted to use a Phoropter to PRESCRIBE A LENS.  That is why checking yourself is so important.  Otis

[OtisBrown]

Subject:  Why you would be wise to CHECK YOURSELF.
Here is the standard visual acuity test.  Note that the person truly did not know what line she read. 
As an engineer (helping other engineers recover from -1 diopter) I would insist that 1) The engineer establish WHICH line he could read and 2) Use a minus to determine if it would clear the 20/20 line -- from 20/40. and 3) Note the amount of minus needed to clear (normally about -3/4 diopters.

Since I "gave up" on ODs, I realize I have no choice but to become "smart" about this issue, and, from 20/40 -- conduct prevention myself.  I am sad to say this, but realistic also.


http://www.youtube.com/watch?v=kRgsqlH6cr4&feature=related

I don't like to "fight" with a person about my need to protect my vision myself.  But I truly don't see how a person with a medical "title" can ever help me.  But then, I don't agree that prevention is "medical" in the first place, so that it part of the issue.  Otis

[OtisBrown]

Subject: Having the courage to get a -1/2 and -1 diopter (spherical) and check your retina yourself.
Re: I got to admit, that I WANT TO DO PREVENTION MYSELF -- and check with my own low-cost minus lens.

When a "smart" person has his own "minus" in his hand, and in fact shows (to himself) that a minus 3/4 will clear the 20/20 line, then he has proven to himself, that he has a mild negative state.  That empowerment is a large part of prevention.  It is the difference between YOU being responsible and "acting" in a wise way, versus being "acted upon", as in this video.  What is used here is a "trial lens frame", and the lenses are inserted into the frame.


http://www.youtube.com/watch?v=prrh3a_iW1g&feature=fvwrel

This is how it has been done for the last 150 years.  But this is only how to "make it sharp" with a minus.  I don't object to that, but it is better that YOU know how to do it, and take responsiblity to DO IT YOURSELF.  Otis

[OtisBrown]

Subject: A competent study of the "plus" and the ability of an OD to "trash" it and its implications.
Re: Quoted from sci.med.vision -- I will review this study, because it suggests that very forceful use of the plus, by an intelligent, MOTIVATED person could be effective in clearing his Snellen from 20/40 to 20/20.  (But don't ask an OD to tell you this --they hate the idea of it.)

Dan>  Otis was quoting from the Oakley/Young bifocal study.  However, his cite  is from:

http://www.myopia.org/bifocals.htm

I believe that the study has been criticized here on this group, but I
don't remember the details.

Dan
++++++
Hi Dan,

Otis> For those who wish to believe that a minus has NO EFFECT on the natural eye's refractive state -- and wish to continue "quick fixing" with a minus, then no study will ever be reviewed by them as fundamental science.

If ever an intelligent study were proposed, where EACH PERSON WOULD REVIEW THE OBJECTIVE FACTS CONCERNING THE NATURAL EYE'S PROVEN BEHAVIOR (All primate eyes), then an element in the planning for a study would be a complete evaluation of Dr. Young study of the eye's behavior.   

But since these majority opinion ODs love to trash all science and facts concerning the proven behavior of the natural eye -- it would be difficult to see how they could be involved in an intelligent (preventive) study, where each person would received the education he needs when his refractive state is no less than -1 diopter, and his Snellen no less than 20/40.

But that would be an engineering/scientific study, not a optometry study -- because of the implications it would have for optometry.   

Otis

[OtisBrown]

Subject: There has been no "pure plus" study -- because that would be "not medical".

The primate data, that shows that the totally normal eye can be made myopic with the forced wearing of a minus lens -- is the real scientific truth of this difficult situation.  But that is pure engineering/science, not medical.

But how do you run a pure-plus study -- with children?  The answer is that you can not, because the child is not old enough to take and follow instructions. This is why a "plus -- or bifocal" is used.  You can FORCE the child to wear the "plus" by putting a minus 'on top'.  Even here the child can defeat the purpose of the plus, if he "leans forward" and cancels out the desired effect of the plus.  Thus if a person can be taught HOW to use the plus, (i.e., sit up, and read at the just-blur point), then the plus can be effective.  But that assumes that the person is going to monitor his Snellen and use the plus for all close work.  This puts all responsibility on the person himself --to learn these issues, and make the commitment to wear the plus for the six to nine months to clear his Snellen from 20/40 to 20/25 or better.

But the only "plus" study is the one conducted by Francis Young on children.  The child would be given no "minus" on top, if the child was at 20/40, and requested to wear a "plus" on bottom.  Where the child could not read the 20/40 line, he would get a minus lens with a plus on bottom.  (If these were pilots, and understood this issue -- I think they could make the required commitment to wear the plus, and get out of it in about one year.)

So what were the results of Frank Young's study?  First the results were highly significant (0.01 level).  These results showed that the plus could stop entry into serious myopia.  The plus group did not go down, and the pure-minus went down at a rate of -1/2 diopter EACH YEAR. 

This is the reason I accept a "limit" on getting out-of-it.  This is why I suggest avoiding the minus, consistent with passing the 20/40 to 20/50 line (for starters).  What truly "comes through" on this, and so many other studies, is the fact that we induce this situation in our natural eyes because of our 'reading habit'.  In other bi-focal studies, the control-group ALWAYS WENT DOWN AT AN AVERAGE OF -1/2 DIOPTER PER YEAR -- through high school and into college.  Any SERIOUS REVIEW with an intelligent person entering a four year college, would know the implication of that fact -- and should be  understood that way.  Otis

[Anima]

Not all optometrists are idiots.  I had terrible vision problems as a child.  My mother has always worn glasses, my father is legally blind and my brother also has bad vision, so I think it is hereditary.  Anyway, the optometrist I was taken to said that he would not prescribe corrective lenses to a small child except for the most extreme circumstances.  He told me to make sure to keep an arm's length away from my coloring books (not so easy when you can't see) and had my parents bring me back in a year.  My vision corrected itself to 20/20, where it's been until recently.  I will always appreciate what that optometrist did for me.  I could have been wearing glasses since age five and would probably have really bad vision now if I had gone to a different doctor.