How ODs respond to the idea of plus-prevention (at 20/40).

[OtisBrown]

Dear Friends,

Subject: Incredible blindness towards "abstract science".

People DO learn how to use the plus on themselves -- with wisdom, knowledge and persistence.  I advocated my nephew, Keith do it, from age 14.  Here are my remarks to him.

Keith, here is the "type of argument" I get against YOUR wise use of the plus (that was totally necessary).

I post this because YOUR long-term visual welfare is far more important than MY
visual welfare. I truly had no choice but to "fight" on a scientific level for
you.

[ But always make scientific, logical sense of this tragic situation. You can
avoid having your eyes "go down" – but below 20/40 – you can't get out of it –
in my opinion. ]


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

Here are my comments on a "social media" site -- that should provoke a THOUGHTFUL SUPPORTIVE DISCUSSION -- not "organized name calling and insults".


Otis> If you study the primate eye -- it is clear that this child's
"bad habit" (reading at 4 inches -- stress equivalent of -10 diopters) has a
profound long-term effect on the refractive state of all natural eye. But
recognizing that issue as science, is not what most people will do.

Here is the "standard" OD you go to, for presumed information regarding "plus prevention" when you are at 20/40.

Blue OD> No. Vision researchers HAVE recognized the need for science in
studying the development of myopia. Thats why controlled studies have
been done in humans that show using plus lenses has NO EFFECT on
myopia development. Thats why you so delicately choose your words by
stating "natural eye" because you like to invoke the work on monkey
eyes. Only problem is, the data also proves that monkey eyes develop
differently than human eyes. There is no such thing, in real life, as
the unified concept of the "Natural Eye" in the way you wished it
were. Doesn't it suck when the data shows that you're wrong Otis?
Again!

Blue OD> Stick to the facts Otis. Anyone here can search back in old archives
of this newsgroup and see how the facts have been shoved up your butt
time after time without any apparent impact on your ranting. I
realize that some types of dementias can cause people to revert to
older primitive thinking patterns. Well, I'm sorry Otis.

+++++

Otis> Wrong!

Otis> Studies that have been "Cherry Picked" by very biased ODs show WHAT
YOU CHOOSE TO BELIEVE against what science shows it the behavior of
the fundamental eye.

Otis> But I know that no scientific truth (about the dynamic natural eye)
will ever penetrate you incredible office "blindness" towards an
accurate understanding (and representation) of a the natural eye as
said dynamic system.

Otis> You should get out of your office more often, into the sunlight of
objective science and fact. But I know for you -- that can never
happen.

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

Yes, I truly "gave up" attempting a rational review of science and fact with these majority-opinion ODs.

They, and their FIRST minus lens -- simply destroy your vision -- in my opinion.

[OtisBrown]

Summary:

Blue the OD> Only problem is, the data also proves that monkey eyes develop
differently than human eyes. There is no such thing.

Otis> This is how these ODs convince themselves that they can TOTALLY IGNORE ALL SCIENCE AND FACT -- when it "intrudes" on their business.

Otis> Over the last 100 years there were some WISE ODs who intuitively understood that "long-term" near creates negative status (i.e., 20/40 on your Snellen), and at that point, 1) Sitting up and 2) Disciplined wearing of the plus (reading at the just-blur point) CAN PREVENT ENTRY.

Otis> It is to those dedicated ODs and MDs that I dedicate this thread.  For this reason described "Blue OD" as a "majority opinion" person, and these few, who would have us begin the wise wearing of the plus at 20/40) as the "second-opinion".

Otis> In other areas, I have shown (as science) that if the plus is used (Frank Young plus study) the  "plus group" does not go down over 12 years, while the "pure minus" group goes down at a rate of -1/2 diopter FOR EACH YEAR IN SCHOOL.

Otis> This again, is totally ignored and DENIED BY PEOPLE LIKE "BLUE OD".

Otis> There is a need for "Engineer/Scientists" who will speak scientific truth with us.

[OtisBrown]

The issue of "Plus Prevention" always brings up the issue of "How much PERSONAL RESPONSIBLITY do you want to give to the person".

I would turn this around, and say that, with education, the person himself must take total responsibility to slowly clear their Snellen from 20/50 to 20/25 to 20/20.  We know, thanks to a "Plus" study, that the natural eye simply "adapts" when a child puts his nose in, or on the book.  The younger a child is, who starts doing this, the sooner his refractive status goes below 20/40.  That is the real implication of this "Plus" (bifocal) chart.

http://myopiafree.i-see.org/bifig1.gif

As previously posted.  But, equally, I must add the FINAL PROVEN EFFECT of a strong minus on the natural eye.  Again, simplified, but very clear:

http://www.ocf.berkeley.edu/~wildsoet/images/neg_lens_induce_myopia.swf

The minus lens is VERY IMPRESSIVE IN AN OFFICE FOR CHILD AND PARENT. Why should anyone "object" to it, and work with the plus?

Because, the minus (however easy) simply does NOT SOLVE ANY PROBLEM.

The even DEEPER truth, is that our natural eyes are simply "adapting" to long-term near, by moving to 20/40, and the minus lens while superfically "fixing" our distant vision -- ignore how a child "induces" this negative status in his natural eyes.

This is why we should not "fix" with a minus, and expect the person to be very intelligent about this issue.  They will always say, or ask, why should I wear a plus for near, WHEN I CAN'T SEE IN THE DISTANCE"?

I hope this helps with science and fact show the reason why we should avoid the minus, and use the plus (read at just-blur point), and personally verify we pass the 20/40 line -- to avoid the minus.

I am absolutely convinced that a highly motivated, mature person, who has the strongest reason possible, and change his refractive state by +3/4 diopters, and clear from 20/40 to 20/20 -- if he will take this process VERY SERIOUSLY.

Otis

[OtisBrown]

Subject: Yes, plus prevention has been successful for Todd and others. But don't bother "arguing" with this Blue_OD.

I have taught myself how to 1) Read my own Snellen. 2) Respect the requirement that I PASS the 20/40 line -- and do better than I can 3) Measure my refractive state MYSELF -- because I don't trust this type of OD any more.

I consider plus-prevention to be difficult, because it requires so much
intelligence and SELF-MOTIVATION to keep up the effort. I further, put a
restriction, in that the person MUST START before his Snellen goes much below
20/40. Here is the reason why there is no choice but to be wise, intelligent
and self-motivated -- because these ODs tell you (despite Todd's success) that
PREVENTION, EVEN AT 20/40 IS ALWAYS IMPOSSIBLE.

+++++

Otis > Subject: Why is there "medical silence" on the subject of successful prevention?

BlueOD> The is no "silence". However, there has been "science" and those
studies (done in HUMANS, done with untreated control subjects) shows that plus
prevention doesn't work. You can claim conspiracy, or whatever you want but the
data is the data. Sorry Otis Brown, Engineer.

Otis> When we put our kids in our "modern" world, they put their NOSE ON THE
BOOK. That is not 20 inches (or -2 diopters stress). No, it is more like 4
inches (or -10 diopters stress). Yet no one SAYS ANYTHING ABOUT THE FACT THAT
THIS ACTION INDUCES NEGATIVE STATUS FOR THE NATURAL EYE. Why not? I think the
reason is LEGAL — and the fact that "correct use" of the plus when, you are at
20/40, does not produce "instant results".

BllueOD> Nor any results at all apparently. Why do all the control subjects, in
all the studies, develop myopia at the same rate as the plus
prevention subjects if plus lenses really do work? I supposed the
subjects just aren't trying hard enough, right Otis?
What about the possibility that plus lenses have no beneficial
effect? If there is a simple prevention scheme as you claim Otis,
what is it? What's certain is it has nothing to do with plus lenses
or using minus lenses on real myopia. Hell, in one of the studies,
the only truly proven preventative treatment was actually OVERminusing
children a little bit.


Otis> fact to DO IT YOURSELF — accepting full legal responsibility, because no
OD wants to deal with you on this issue.

BlueOD> For sure. Because it doesn't work.

++++++

Otis> I certainly do not excessively claim for "prevention" -- and I do not
consider that it will ever be "easy".

Otis> But the issues of WISE use of the plus (as I describe it) and SCIENCE, and
the effect of a plus when (push print) is used CORRECTLY is show here:

http://www.ocf.berkeley.edu/~wildsoet/images/pos_lens_induce_hyperopia.swf

Otis> This to me is "pure science" that I respect. This does confirm (on a pure scientific level) Todd's success.

Otis> Blue_OD makes one false statement.  He states that, "... the plus has not been effective".  That is truly an "office lie".  A true plus study would require an "informed, intelligent person", to wear the plus in a logical manner, when he was at 20/40, and about -1/2 diopter.  YOU CAN NOT GIVE A CHILD THAT KIND OF INSTRUCTION AND EXPECT HIM TO DO IT. So this is why the Francis Young study -- must be used.  It is a close as you can get to a pure plus study -- with children.

Otis> The motivation factor would be a pilot at 20/40 who MUST get to 20/20. While we know that most people don't have that kind of fortitude, when it comes to PERSONAL SELF INTEREST -- then the entire picture can change.

[OtisBrown]

SCIENCE and Francis Young> Why the minus lens should be avoided (consistent with YOU passing the 20/40 line.)

Francis has 44+ papers published. Kids have worn the plus for 50 years -- which makes it safe to a REASONABLE person.

But what Young's seminal study showed was that the eye with a minus GOES DOWN at -1/2 diopter/per year.

The plus DID NOT GO DOWN. (Simplified -- for your understanding). Thus the "plus" must start early -- or the "cause" of
prevention is ALMOST LOST -- in my opinion.

I am just pleased when some people "catch" this issue when reasonable recovery is possible.  That is Todd's great strength.

[OtisBrown]

For Proh, Peter and Todd,

Subject: When I had my "Oh My God" moment. Why should "I" or anyone attempt to help YOU with prevention - if you are not interested.

Regards:  The ODs who helped me understand what would be possible (for prevention).

It was with Jacob Raphaelson OD that convinced me about his advocacy. It was
then that I realized that if you desire prevention (when you are at 20/50, and
-3/4 diopters) it would require LONG-TERM WEARING OF THE PLUS.

It was truly difficult for me to accept that idea. I remember my own "fighting"
of these exercise "routines", and realized that unless the parents (and child)
truly got the idea, there would be not much "future" for prevention.

Again, as an engineer, I accept the need for REASONABLE requirements. For me
that "make or break" line is the 20/40 line. But also, as an engineer, I say
that if I want something done RIGHT, I MUST DO IT MYSELF. Perhaps that
"declaration of independence" makes some people angry at me. If it does - I
regret it.

My "curiosity" was to fully investigate Rapahelson's claims, not to persecute
him - but to vindicate his truly accurate sense of the eye as a dynamic system.
But obviously I personally "limit" prevention (for me) to stop it before it
truly gets bad. This is why you will find that I don't post "claims" and issues
like that.

[OtisBrown]

Subject: Measurements that are highly complex, and confusing - AND YOU DON'T UNDERSTAND - almost always lead to bad measurements, excessive prescriptions, excessive "Cyl" (astigmatism) measurements.

If I hold the lens, know what I am doing, I will MAKE AN ACCURATE MEASUREMENT.  The first video shows an optometrist using a "Trial Lens" frame, and making very complex measurements.  The second video, shows how to make an accurate measurement using two (spherical) lenses.  I believe in the concept - KISS.  That is "Keep it Simple, Stupid". I hope no one is insulted.  The word "subjective" means that an OD put the lens in a frame. If I make the measurement then I AM OBJECTIVE, and the result is an accurate, objective measurement of my refractive status - that I AM OBVIOUSLY GOING TO TRUST. This is the reason why I would insist that an engineer - make his own measurement using  intelligence and simplified tools.  The first video by ODs:


http://www.youtube.com/watch?v=ae8YgQrVMB0&feature=related

Video of an engineer measuring his refractive status. If there were ever to be a scientific study by engineers - I would insist that each engineer make his own refractive measurements - in this manner.  The difference is personal knowledge and being in control of this process:

http://www.youtube.com/watch?v=CrfuLuibclY&feature=g-upl

Accurate measurements require long-term repeated measurements.  There is no way an OD can do this. This is why you would be very wise to do it yourself.

Thanks!

[OtisBrown]

Subject: To make this even FAR MORE COMPLICATED - most ODs use a "Phoropter", as shown in this video.

Notice how totally complicated this is for the OD - and for the person - totally mysterious. Also note that they START with you CURRENT PRESCRIPTION. They never check the person's naked eye visual acuity. THIS IS WHY YOU FIND PEOPLE WITH A -3 DIOPTER PRESCRIPTION - WHO CAN READ THE 20/40 LINE - AND CAN AVOID WEARING THE MINUS - IF THEY KNEW THIS.  This is why I ask (plead) with a person to put up a Snellen and READ IT.

http://www.youtube.com/watch?feature=fvwp&NR=1&v=Vj5mhd12SWs

I am not a critic of ODs. But this totally complicated process - is not necessary.

Thanks!

[OtisBrown]

Hi
Subject: The OD exam. This man is a really NICE GUY. 

But if I am going to work on prevention - I MUST UNDERSTAND THIS "EXAM". Here is the 10 minutes of it.


http://www.youtube.com/watch?v=ziXX6fP00-U&feature=related

Remember -  the "habit" is to give you the strongest minus possible.  They do NOT see any "bad" in the minus lens - so they will not volunteer any information, to the effect that you should keep the minus OFF YOUR FACE, unless driving the car.  It is that "missing" information that bothers me the most.  Why not just be HONEST??

This is why I have a Snellen set-up - and AFTER this type of exam - I go home, read my Snellen and get any lens I might need from Zennioptical for $7.

It is not the OD who is ever going to "change". No, only "I" must change.

[OtisBrown]

I am asked, why do you 1) Read your own Snellen 2) Measure your refractive state - yourself.  This is the reason - I can no longer "trust" an OD in his office.

A persona actually checking his Snellen - knows his visual acuity. ODs simply
don't bother checking. Typically the over-prescribe by -1 or -2 diopters. I
truly doubt that this person has 20/400 vision. But here is his statement:

+++++

From "Friend"

Subject: Very biased statement by an OD:



Thanks for the response. My prescription is as follows:

RX O.D. -2.25 -1.00 X 163

RX O.S. -1.75 -1.25 X 020

I understand that it's not possible to figure out visual acuity with a prescription alone, so I called my optometrist and they said that it is 20/400.

At this point, do you think it's even possible for me to improve my vision?

+++++

I work on the basis of TRUST. But I can not trust the 20/400 statement. This is why I PERSONALLY CHECK MY OWN SNELLEN - BECAUSE OF THIS LACK OF CANDOR ON THE PART OF THE OD.

I have the choice of being personally competent - in which case, by my own efforts I must eventually pass the 20/40 line - or lose my vision to an over-prescribed minus lens.

In this case, the Spherical-Equivalent would be:

OD -2.75

OS -2.25

[OtisBrown]

Subject: Some ODs are REASONABLE and will discuss prevention - but others are angry and hostile.

But don't take my word for it. Here one OD "explains" his anger:
++++++
Otis > Hi Blue,

Otis> Please explain why you believe that a minus has no effect on the refractive STATE of the natural eye.


Blue>  I don't know what you are talking about when you say "natural eye".  That terminology is an Otisism and is not in use by anyone but you.
With regard to the use of minus lenses on HUMAN eyes, there are lots and lots of studies that show they have no detrimental effect, and lots and lots of evidence that they help myopes see better.  Furthermore, there is even one study that shows overminusing humans slightly reduces the progression of myopia.
In short Otis, there is no harm in using plus lenses on humans.  Don't make me post all the scientific references AGAIN Otis.  Everyone here is tired of hearing about it but you.

Otis> When objective science says that it does.

You have no such objective science to prove your point in humans Otis.  I however know of a mountain of evidence that shows you are wrong.  And don't pull out the IOVS abstract that shows human choroids get thicker using minus lenses.  While that finding is very interesting, they only get thicker by 10 microns which has virtually zero implications for myopia development.  Do the math Otis.  And besides, that study shows its completely reversible.  If you actually read the authors remarks, they clearly state that their findings on changes in choroidal thickness does not prove any relationship with myopia progression as you wish it had.

Otis> Also, please describe the issue of prevention.  Or do you judge that you personally have no responsibility for prevention - at all.

Blue OD> I wish there was a prevention scheme that works.  Plus lenses clearly don't.  Apparently the amount of time spent outdoors DOES seem to have some influence.  Haven't you read the links that myself and Dr. Tyner posted here recently?  If you really cared about prevention you would do that, even though it has nothing to do with "the plus".  Perhaps its your propensity for denial that keeps you from really trying to find something that actually might work instead of trying to scream loudly over and over again about the benefits of plus when there are none.

Blue OD> Goodbye moron.  Stew in your own idiocy. Unlike you, I get tired of repeating the same thing over and over again.
++++
Otis> This is just tragic.  Here what science says about the eye's response to a lens:

[OtisBrown]

Otis>  Blue-OD has attempted to "trash" science.  He hates proof that this  dynamic system responds to a minus lens.

Here is the proven science of the fundamental eye.

http://frauenfeldclinic.com/eye-recovery-city-university-of-new-york/

As we should expect, the fundamental eye is a dynamic system, and long-
term near produces a negative status for the eye.  Here is a animation
of this natural process as proven by this report.

http://www.ocf.berkeley.edu/~wildsoet/images/neg_lens_induce_myopia.swf

Blue, not understanding this issue in science, calls people "names".
It would be better to just state that this concept of the fundamental
eye is science, and this is the second-opinion of the fundamental eyes
proven behavior.