As always, you ask wise questions. As always - I never say "cure". It should be clear that I agree that ODs can not CHARGE MONEY FOR PREVENTION. Further, the word "cure" remains a problem. But then that is indeed an honest disagreement. This opinion comes from my conversation with Raphaelson and HIS prescription of the plus. (But parent a child had NO CLUE AS TO WHY WEARING THE PLUS WOULD BE WISE - AND HAVE TO BE CONTINUED AS LONG AS THE CHILD WAS IN SCHOOL.) This statement convinced me that PREVENTION (versus cure) had to be in the mind and by the wisdom of the person himself. I regret that I can never put that kind of "wisdom" in a person's brain. I do not consider prevention (at 20/40 and -3/4 diopters) to be medical in any sense of the word. It will always be PERSONAL. We will consider COSTS and TIME to do this also.
Peter> Patients who go to see a behavioral optometrist in order to try to prevent myopia end up getting advice that has been shown in scientific studies to be ineffective at treating myopia.
Otis> AFTER they are severly myopic. I has stipulated that is TOTALLY TRUE. We are not talking about "treating myopia", but rather PREVENTING ENTRY before a negative status goes below -1 diopters. Only in that range do I judge that "recovery" is possible. BUT only if the person has considerable force-of-character to make continous use of the plus. Given this severe nature of "wearing the plus" - it is clear that the public will have NO PART OF IT.
Peter> I've read industry advice, which essentially says, if you are considering vision traiinig ask the OD to show you the scientific studies that show the outcome will be favorable as well as how much it will cost.
Otis> If you have the wisdom to relize that UNDER OD CONTROL - the COST WILL BE HUGE. By if you figure out how to INTENTIONALLY DO IS YOURSELF - the COST IN 1) Price of your own test lenses 2) Snellen chart 3) VERY STRONG, CONTINUED RESOLVE. As far as I am concerned, no OD will be ever able to do this - tragic but so, so true.
Peter> I have no doubt a behavioral optometrist would perscribe a strong plus if they believed in its effectiveness as well.
Otis> I have said, it is only POTENTIALLY effective if used by the wisdom of the PILOT himself - WHO TRULY REALIZES THAT THIS TYPE OF TOTAL COMMITMENT CAN NEVER BE PRESCRIBED.
Peter - I will post the remarks by Raphaelson (who had the greatest interest in THRESHOLD PREVENTION WITH PLUS) and the parents reaction - AFTER THE PLUS WAS SUCCESSFUL.
The main issue most of us have Otis, is that it doesn't make sense with all the national jurisdictions all over the world that not one jurisdiction has second-opinion eye doctors who will offer their patients to consider the treatment plan of wearing a strong plus. A medical doctor gives an overweight person or even others who are not overweight advice on how to eat, excercise, and rest in order to prevent obesity and remain healthy. That is why I find it very challenging to understand the reason ODs that believe in the power of the strong plus do not offer that advice except to their children for fear of losing their licence or being sued. Especially in the US, where such a pool of ODs could I am sure sue in some sort of federal class-action lawsuit allowing them to offer their medical advice as far as vision correction is concerned.
Patients who go to see a behavioral optometrist in order to try to prevent myopia end up getting advice that has been shown in scientific studies to be ineffective at treating myopia. I've read industry advice, which essentially says, if you are considering vision traiinig ask the OD to show you the scientific studies that show the outcome will be favorable as well as how much it will cost. I have no doubt a behavioral optometrist would perscribe a strong plus if they believed in its effectiveness as well. So, it doesn't make sense to me. You would figure somewhere there is a national jurisdiction with a group of eye doctors who band together and decide to do the right thing. But we can not find them the world over.
By the way, my behavioral optometrist does use the strong plus in certain situations, just doesn't perscriibe it. For example, sometimes I will wear a +2 for certain excercises at the office. Then there are the flippers that I use for tiring out my accomodative response. Usually +2/-2, but was told when it gets too easy perhaps I will need to go larger - either +2.5/-2.5, +3/-3 etc.
Hi Proh and Peter,
Subject: Talking to a "tough-minded" engineer - who is passionate about prevention-only.
I would like to have a person talk to me when I was at 20/50, and about -1 diopters - AND EXPLAIN MY CHOICE TO ME. Like Peter, I would like to be shown that my Snellen is 20/50, and have it explained to me (assuming age 16) that, the natural eye goes down by -1/2 diopter per each year in school. Then I would want to MEASURE MY REFRACTIVE STATE MYSELF.
Then I would want to be told how VERY easy it is to "fix" a person - and send him away, "happy". Then, I would want to understand that - THAT IT THE LAST CHANCE I HAVE TO "WORK" TRUE-PREVENTION - under *my* control.
I might ask - why do you want me to "fix" my eye by wearing a "plus" for near - when my "problem" is in the distance!! (That does require a very intelligent, wise man.) If the reason is clear as to WHY I should NOT WEAR THE MINUS (with passing the 20/50), and I had a STRONG REASON to get to naked eye 20/20 (with the plus) *I* would do it myself.
But that "strong persistent drive" to keep up wearing the plus - and understand this "subtle logic" (of not fixing the obvious) is totally missing in most people.
It is not there intelligence (so much) - it is just that they have no interest. I accept that truth as the reason few people will "commit" to wearing the plus when it could be effective for them.