AC:C Ratio - The Presumed Risks of Wearing a Plus.

[OtisBrown]

Dear Peter and Proh,

Here is the MEDICAL opinion.  Even PREVENTION - will ALWAYS BE IMPOSSIBLE. It is just your 'bad heredity". NOTHING CAN BE DONE.

Just "give it up".  If you wish to get "medical help' with prevention - here is what you will get -  ALWAYS.  I simply will not argue with this man - he thinks he is totally RIGHT. 

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

But, I also agree with this man - about THRESHOLD prevention - by the person himself - but ONLY if the person's Snellen is no worse than 20/40 to 20/50.

http://myopiafree.i-see.org/prent.txt

So I acknowledge that ONLY prevention is possible - and NEVER under ANY KIND OF MEDICAL CONTROL. 

Make your choice accordingly.  I am not a "hard ass" about this - but I know a "losing situation" when I see one.

Otis

[OtisBrown]

Hi Peter and Proh,

It always amazes me.  The OD will talk about "slowing myopia down" when you are at -1.5 diotpers.  But they will never talk about Preventing (getting out of it) under YOUR control. (i.e., no minus lens, and accept 20/50 - until you get your Snellen better-than 20/25).  There is an intellectual blindness that says that ONLY a OD in his office can "prescribe prevention" - so do not do this under your control.

Here they also confirm that a MINUS on the natural eye CAUSES MYOPIA.  Thus that "minus lens" can only exacerbate the original "adaptation" of our natural eyes to long-term near.  I hope you enjoy this video.


http://www.youtube.com/watch?v=xH_H4BRJMLk&feature=related

Otis

[PROH]

Thanks Otis for Video


I still raise the question . If someone is having a vision at 20/60 obviously he cannot see clearly board & has to use minus.

Also If you are below 20/60 about 20/200 what should he do .
You provide very good guidance for prevention but I want to know what to do once you are below 20/200 .

May be other members  can also add

Proh

[OtisBrown]

Hi Proh,

It should become clear that if *I*, verified that 1) I was reading 20/50 to 20/60, and 2) A -1.25 would clear the 20/30 line, I would 3) NOT WEAR A MINUS LENS. 

For children - it is possible to do that.  The ENTIRE PURPOSE OF WEARING A +2.5 DIOPTER FOR ALL CLOSE WORK, IS TO VERIFY THAT YOUR SNELLEN IMPROVES TO 20/40.  That would take about six months of WEARING THE +2.5 FOR ALL CLOSE WORK.

That takes total commitment.  Perhaps beyond the ability of most people.  I truly don't know who has that ability.  But the ENTIRE PURPOSE OF THE PLUS IS TO GET TO 20/40. If you verify this, you can avoid the minus - and if you verify this, you are likely to CONTINUE TO WEAR THE PLUS 2.5 THROUGH THE SCHOOL YEARS.

Thus the question of "going down" below 20/60 - is academic - once you verify you can get your Snellen to 20/40 or better.  If you can't do that - then that is the end of this story.

That is my judgment about this issue.

Todd managed to get his vision clear.  You can choose to believe him - or not.

No one can guarantee results - not me - no one.

Otis

Thanks Otis for Video


I still raise the question . If someone is having a vision at 20/60 obviously he cannot see clearly board & has to use minus.

Also If you are below 20/60 about 20/200 what should he do .
You provide very good guidance for prevention but I want to know what to do once you are below 20/200 .

May be other members  can also add

Proh

[peterg]

Hi Proh,

It should become clear that if *I*, verified that 1) I was reading 20/50 to 20/60, and 2) A -1.25 would clear the 20/30 line, I would 3) NOT WEAR A MINUS LENS. 

Hi Otis,

The confusion lies in your lack of clarity and not whether we doubt Todd cleared his vision.   We do not doubt the latter at all.

Where we need clarification is prevention under these two scenarios:

Scenario 1:  Person has mild myopia, with an error of -1.25 and no perscription but able to see the 20/60 line. This person has never practiced any form of prevention.  Under this scenario, we know that this person can successfully practice prevention.  This is the scenario our children are in.

Scenario 2:  Person has slightly stronger myopia, with a perscription of -3.00 (as Todd had) and is barely able to clear the 20/200 line when he begins prevention.  Due to prevention and use of the plus, this person clears the 20/20 line with -1.25 perscription and naked eye can clear the 20/60 line. 

Both candidates are now at 20/60 and you chime in on them both being possible candidates for prevention.  Do we consider them equal?  That is where our confusion lies as clearly candidate in Scenario 2 started out beyond the boundaries of being a prevention candidate.

Further, both Proh and I would be candidates in Scenario 2.

[OtisBrown]

Dear Proh and Peter,

As you know, I refuse to get into a "fight" with an OD.  They simply get angry, and no rational discussion can develop when they do that.

When I talk about prevention - you must keep in mind that I don't want to make "false claims", or encourage a person to ATTEMPT to do somthing - when success is out of the question.  Let me state the problem with item #2:

Yes, Todd has a prescription for a -3.0 diopter.  But what I have found is that an OD - in an office - never bothers to even CHECK what you read on a Snellen chart.  What they do is to crank your OLD PRESCRIPTION into their Phoropter, and start increasing the strength of the minus FROM THAT POINT ON.  This means that, while you MIGHT have 20/60 vision (if you ACTUALLY CHECKED) you wind up with a minus stronger than -3.0  diopters.  This is why I ask a person to ACTUALLY CHECK - which MOST REFUSE TO DO IT.

I have seen SO MANY TRULY BAD PRESCRIPTION, that I truly don't believe them - nor trust them.  Further, Peter, even you discovered some interesting facts.  1) You have "Variable Snellen" - which NO OD COULD FIND OUT OR CHECK.  You can read the 20/25 line at time, but also make your Snellen very sharp with a -1.25 lens. (I congratulate you for your self-checking).  You also found out you can read your 20/25 line THROUGH a +1 lens.  This gives you the ability to CONTROL YOUR DISTANT VISION - if you choose to do so.

I am not going to "conflict" with a prescription - or get between a "patient" and a "doctor".  If you consider yourself a "patient" - then I should not be talking to you.  If you consider yourself a wise person, and are willing to start prevention under YOUR TOTAL CONTROL - then  I think you could always verify you always pass the 20/40 line - by wearing a strong plus for all close work.

But for the three of us - I don't know where you will be in ten years.  We will be long-gone.  But for Proh's child (if she does not wear a strong plus now), I can predict that, in 10 years she will be a -6 diopter myope.  (That is just an objective fact - which I am certain he does not believe.)  So it will make no difference to me - what he might do.  I have no control over Proh or his child.

I only suggest the wise use of the plus - while there is still time....

But it is all up to you.

Otis

Hi Proh,

It should become clear that if *I*, verified that 1) I was reading 20/50 to 20/60, and 2) A -1.25 would clear the 20/30 line, I would 3) NOT WEAR A MINUS LENS. 

Hi Otis,

The confusion lies in your lack of clarity and not whether we doubt Todd cleared his vision.   We do not doubt the latter at all.

Where we need clarification is prevention under these two scenarios:

Scenario 1:  Person has mild myopia, with an error of -1.25 and no perscription but able to see the 20/60 line. This person has never practiced any form of prevention.  Under this scenario, we know that this person can successfully practice prevention.  This is the scenario our children are in.

Scenario 2:  Person has slightly stronger myopia, with a perscription of -3.00 (as Todd had) and is barely able to clear the 20/200 line when he begins prevention.  Due to prevention and use of the plus, this person clears the 20/20 line with -1.25 perscription and naked eye can clear the 20/60 line. 

Both candidates are now at 20/60 and you chime in on them both being possible candidates for prevention.  Do we consider them equal?  That is where our confusion lies as clearly candidate in Scenario 2 started out beyond the boundaries of being a prevention candidate.

Further, both Proh and I would be candidates in Scenario 2.

[peterg]

I have seen SO MANY TRULY BAD PRESCRIPTION, that I truly don't believe them - nor trust them.  Further, Peter, even you discovered some interesting facts.  1) You have "Variable Snellen" - which NO OD COULD FIND OUT OR CHECK.  You can read the 20/25 line at time, but also make your Snellen very sharp with a -1.25 lens. (I congratulate you for your self-checking).  You also found out you can read your 20/25 line THROUGH a +1 lens.  This gives you the ability to CONTROL YOUR DISTANT VISION - if you choose to do so.

Thank you Otis.  I am pretty confident, that my first many attempts to read my snellon gave at most 20/150 vision.  So, my variable vision was not all that crash hot for the first several days after I got my snellon.  Afterwards, as I started to do the equivalent of using plus lenses, that is pushing print with no glasses at all, I recovered from 20/150 to about 20/50 or 20/60 with flashes of better vision.  I must be clear, they were only flashes of better vision, and nothing I could hold steady.

Also, the first thing the OD had me do in Dec. 2011 was have me look at a regular snellon and tell me what I see, and I told him barely the big E.  Again, consistent with my own findings a few weeks later when I got my own snellon and before I started learning.

I think it is fair to say, I did not in any sense of the word begin with variable vision that allowed me at times to see 20/60.  This was at a time when I wore -2L & -2.5R.

So, given this scenario, and based what you have stated, I think you rightfully don't make claims of recovery.  I think that is sensible.

At 13, when I got my first glasses and the OD told me I was 20/30 L and 20/50 R, I was definately in the situation where I could have applied prevention with a strong plus lens and gotten out of it.   Right now, I can apply the same plus principle, as I did in January 2012 but this time with plus glasses, and over 6-9 months I may potentially begin to more consistently see the 20/40 line and have less variability in my vision.  But when I get to that level, I don't think I reset physiologically to where I was when I was 13.

As I've read from Don Rehm's site, your info, info from Alex Freinfeld, and other like minded sites, I fall outside the prevention sweet spot, and likely am attempting to recover from physiological changes.  No matter how forcefully I apply the plus lens, I may not recover.  We never know from each individual, whether they end up successful like Todd or Brian Severson.  I am sure others have applied themselves just as forcefully as those two gentlemen, and failed to get out of it.  As I've heard from most prevention minded practitioners, everyone is different.

I do hope to attain consistent 20/30 or better accuity, understanding completely that if I get there, it will likely not give me the same visual experience as a person who has never worn glasses but also has 20/30 accuity.  I am thankful for Shadowfoot who has achieved 20/15 accuity, for helping me understand this.  He stated it was frustrating to have 20/15 self-measured accuity, but also experiencing that a person with "perfect" uncorrected vision is still able to outsee him in real life scenarios.  I would gladly be in that situation.

[PROH]

Hi Otis

I carry a more point apart from your below commwnt

"It should become clear that if *I*, verified that 1) I was reading 20/50 to 20/60, and 2) A -1.25 would clear the 20/30 line, I would 3) NOT WEAR A MINUS LENS. 

For children - it is possible to do that.  The ENTIRE PURPOSE OF WEARING A +2.5 DIOPTER FOR ALL CLOSE WORK, IS TO VERIFY THAT YOUR SNELLEN IMPROVES TO 20/40.  That would take about six months of WEARING THE +2.5 FOR ALL CLOSE WORK.

"
The use of +2.5D will not provide much reduction in diopters unless the person do slight defocus reading .

The correct use of plus a child will never learn unless he attains a particular age. So what is the alternative

Proh

[OtisBrown]

Dear Peter,

What you now state - is IDENTICAL to the "thinking" I arrived at - after 10 years of exhaustive review.  I know that no OD or MD "intends harm".  Indeed - far from it.  They simply DON'T KNOW WHAT TO DO ABOUT IT.  That would be an admission of "tragic ignorance".  Yet the even "deeper" ignorance is in the person himself.  (I truly do NOT know how to break this cycle.)

Let me relate this - as conversation with my parents.  I began to realize that a negative STATE of the natural eye - is always "self-induced".  

I found out that our medical doctor - told my parents that I would going to be "myopic" - when I had 20/20!!!

I wondered - how the hell did he know that.  Its easy.  If my refractive state was +3/4 diopters - I would have been safe.

But even the slightest "plus" would blur the 20/20 line. That simple test will confirm that a child WILL BECOME MYOPIC.

This is confirmed by Dr. Young's study.  But how do you tell  a parent, that because he has a refractive STATE of zero - that he MUST BEGIN WEARING A STRONG PLUS FOR ALL CLOSE WORK.  That is the "tough lesson" we must indeed "learn".

But who the hell is going to teach us that lesson?  Futher, what parent will ever LISTEN to and OD or MD who TELLS YOU THAT EXACT TRUTH??

That is what *I* see as the ONLY POSSIBILITY.

Since the OD or MD will NOT VOLUNTEER THIS TYPE OF INFORMATION (about pure prevention) this I will volunteer it to you - AND I EXPECT YOU ALL WILL IGNORE ALL THAT I TELL YOU.

Peter - I profoundly appreciate you honesty and experience.  I think you are at a point (or will be) where you pass the 20/40 line - and can avoid the minus.  I hope you can convince yourself to always wear a plus for all close work.  If it were *ME* - I would be doing it.

Best,

Otis

I have seen SO MANY TRULY BAD PRESCRIPTION, that I truly don't believe them - nor trust them.  Further, Peter, even you discovered some interesting facts.  1) You have "Variable Snellen" - which NO OD COULD FIND OUT OR CHECK.  You can read the 20/25 line at time, but also make your Snellen very sharp with a -1.25 lens. (I congratulate you for your self-checking).  You also found out you can read your 20/25 line THROUGH a +1 lens.  This gives you the ability to CONTROL YOUR DISTANT VISION - if you choose to do so.

Thank you Otis.  I am pretty confident, that my first many attempts to read my snellon gave at most 20/150 vision.  So, my variable vision was not all that crash hot for the first several days after I got my snellon.  Afterwards, as I started to do the equivalent of using plus lenses, that is pushing print with no glasses at all, I recovered from 20/150 to about 20/50 or 20/60 with flashes of better vision.  I must be clear, they were only flashes of better vision, and nothing I could hold steady.

Also, the first thing the OD had me do in Dec. 2011 was have me look at a regular snellon and tell me what I see, and I told him barely the big E.  Again, consistent with my own findings a few weeks later when I got my own snellon and before I started learning.

I think it is fair to say, I did not in any sense of the word begin with variable vision that allowed me at times to see 20/60.  This was at a time when I wore -2L & -2.5R.

So, given this scenario, and based what you have stated, I think you rightfully don't make claims of recovery.  I think that is sensible.

At 13, when I got my first glasses and the OD told me I was 20/30 L and 20/50 R, I was definately in the situation where I could have applied prevention with a strong plus lens and gotten out of it.   Right now, I can apply the same plus principle, as I did in January 2012 but this time with plus glasses, and over 6-9 months I may potentially begin to more consistently see the 20/40 line and have less variability in my vision.  But when I get to that level, I don't think I reset physiologically to where I was when I was 13.

As I've read from Don Rehm's site, your info, info from Alex Freinfeld, and other like minded sites, I fall outside the prevention sweet spot, and likely am attempting to recover from physiological changes.  No matter how forcefully I apply the plus lens, I may not recover.  We never know from each individual, whether they end up successful like Todd or Brian Severson.  I am sure others have applied themselves just as forcefully as those two gentlemen, and failed to get out of it.  As I've heard from most prevention minded practitioners, everyone is different.

I do hope to attain consistent 20/30 or better accuity, understanding completely that if I get there, it will likely not give me the same visual experience as a person who has never worn glasses but also has 20/30 accuity.  I am thankful for Shadowfoot who has achieved 20/15 accuity, for helping me understand this.  He stated it was frustrating to have 20/15 self-measured accuity, but also experiencing that a person with "perfect" uncorrected vision is still able to outsee him in real life scenarios.  I would gladly be in that situation.

[OtisBrown]

HI Proh,

In my judgment - your child has been 'reading' from a young age - with all due respect.  Children simply don't get "down" to about -1 diopter - unless they have been doing that type of work.  (I am not a critic - but I an certain - for myself - that is how I started to "go down").

I don't know how to address this issue to a four year-old child - and it would be presumptuous of me to even attempt to do so.

Otis

Hi Otis

I carry a more point apart from your below commwnt

"It should become clear that if *I*, verified that 1) I was reading 20/50 to 20/60, and 2) A -1.25 would clear the 20/30 line, I would 3) NOT WEAR A MINUS LENS. 

For children - it is possible to do that.  The ENTIRE PURPOSE OF WEARING A +2.5 DIOPTER FOR ALL CLOSE WORK, IS TO VERIFY THAT YOUR SNELLEN IMPROVES TO 20/40.  That would take about six months of WEARING THE +2.5 FOR ALL CLOSE WORK.

"
The use of +2.5D will not provide much reduction in diopters unless the person do slight defocus reading .

The correct use of plus a child will never learn unless he attains a particular age. So what is the alternative

Proh

[peterg]

 

I think you are at a point (or will be) where you pass the 20/40 line - and can avoid the minus.  I hope you can convince yourself to always wear a plus for all close work.  If it were *ME* - I would be doing it.

And I think you understand my question, and Proh's question.  Essentially, both he and I are in the "rehabilitiation" scenario and so you know neither he or I are prevention candidates physiologically.

It seems that from what I have heard from others, that first .5 to 1 diopters is fairly easy to drop.  The net balance remaining is the problem.

[PROH]

Otis It's true that she has started reading at the age of 2 & writing at the age of 3.

May be this is the reason. We were not even aware at that time of any impact on eyes due to this work.

But since last 6 months we are taking care of good vision habits & ensuring to use plus of 1.5D for near work

[OtisBrown]

Hi Proh,

I know how hard parents want there children to "develop".  I never stand in there way.  But this "galloping' myopia must be called a 21 th Century problem.

As you know, I feel I can only promote a "pure prevention" study at a four year engineering college (where no student is below 20/50).  You can EXPLAIN to them that they can expect their eyes to go down by -1.5 diopoters in four year - IF THEY REFUSE TO WEAR A +2 FOR ALL CLOSE WORK.

But you never know what any person might decide to do.  I am a pilot. If some one told me (when I was at 20/40, and -1 diopter) that by steady wearing of a plus, that I could get back to 20/20 (as Shadowfoot did it) believe me - I would do it - for the four years I was in college.

But you see the problem here.  Eveyone wants a quick-fix in a month.  So they QUIT with the plus in that time frame. Or they "fear" that wearing the plus - will CAUSE THEM TO GO BLIND - OR SOME OTHER FALSE BELIEF.

I had guessed your child was a "reader" at a young age. 

I do not know what you plan to  do - but, however difficult, I would say NO MINUS LENS.  Then, get a +2.5 diopter, and see that she always puts this on for all reading.  (She can use a "half glass" so she can look over the tops for distant vision.) Yes, I know this will look "strange" - but it is indeed, "now or never".

If you could do this - for the next six months, then there is a reasonable chance she could begin to read the 20/40 line. This is truly tough - but I do not have anything else to suggest.

Otis

Otis It's true that she has started reading at the age of 2 & writing at the age of 3.

May be this is the reason. We were not even aware at that time of any impact on eyes due to this work.

But since last 6 months we are taking care of good vision habits & ensuring to use plus of 1.5D for near work

[peterg]

Otis It's true that she has started reading at the age of 2 & writing at the age of 3.

May be this is the reason. We were not even aware at that time of any impact on eyes due to this work.

But since last 6 months we are taking care of good vision habits & ensuring to use plus of 1.5D for near work

Hi Proh,

I think the key is trying to teach your daughter to read just inside the blur point, which takes a lot of discipline from adults.  Perhaps you will be able to slowly coach your daughter on that over the next 2 years.

It may be likely that you will succeed in slowing down her myopia development if you continue with plus lenses but can't get her to read at just before blur.

The OD I visited in Dec. 2011 who believes in myopia reduction via plus lenses, indicated that the main problem with giving children plus lenses of any strength is that they will just pull their eyes closer to what they are looking at.  Therefore it is implied, they are still exerting as much accomodation as they were before the lenses.   Otis knows the ballpark numbers a little better and what they mean, but if your daughter was reading at 8 inches, and then put on plus 1.5 but reads at 4 inches some of the benefit of the plus is negated as far as strain reduction.