Author Topic: Does the plus have ANY effect at all?  (Read 965 times)

Offline OtisBrown

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Does the plus have ANY effect at all?
« on: January 02, 2014, 11:21:14 AM »

Subject:  We might guess that the fundament eye (having refractive states, not failures) is dynamic - or maybe it is not.

Issue:  Has a plus-prevention study ever been attempted - and exactly what were the results.

Issue: How can you get a 10 year-old child to EVER wear a plus lens - so you could even ATTEMPT to conduct a "prevention only" study.

I will use the term "Core Refractive State", which means the individual is personally responsible for the measurement.

This is to avoid the intense medical bias that almost always over-prescribes a minus lens.

I will post the "prescribing details" shortly.

Offline OtisBrown

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Re: Does the plus have ANY effect at all?
« Reply #1 on: January 02, 2014, 11:43:55 AM »
Subject:  You simply can not "prescribe prevention", because the child can not be instructed to wear the preventive plus "correctly".

Issue: But you can use "existing practice" to get as close to that "ideal" as possible.

Issue:  For me, no OD has ANY interest in prevention, and I accept that ONLY prevention is possible.  Intense use of the plus - is out-of-scope for any medical person sitting in an office - prescribing a strong minus - for all who enter.

TITLE:  "Bifocal Control of Myopia"

Author:  Dr. Francis Young, Dr. Kenneth H. Oakley

1975 Issue of the, "American Journal of Optometry and Physiological Optics"

Let me clarify.  What we need to know, in a plus-group versus minus-group, what the effect was over a five year period - on the totally natural eye.  (A natural eye can and does have negative and positive refractive states.  With a positive state, you have 20/20 or better - if you measure it yourself.)

Since a child can not be trusted to wear "just the plus" alone, a "bifocal" was prescribed.  This is not a plus-prevention study as such, but with some intelligence and wisdom on the part of the person himself - it would be perceived that prevention would be possible at 20/40 and -1.0 diopters.

Here was the protocol for children:

Young>  ... the parents were offered a discussion about the fitting of a "reading lens" or bifocal which would provide 3/4 to 1 diopter (D), of plus lens magnification over the minus distance prescription which was usually under-corrected by 0.5 diopter.

Young>  For example if the chidren's refraction indicated -1.0 diopter, the prescription would be written for a -.5 diopter with a plus 1.5 diopter add.

What this study FAILED to do - was to EXPLAIN the need and wisdom of wearing the plus "correctly".  If you give a young man a plus - but do not tell him WHAT he is doing or WHY he is doing it, you will find that, when he puts the plus on (say a +2 for reading), and then he will LEAN FORWARD to about 13 inches. When he does this - he totally CANCELS OUT THE INTENDED, AND DESIRED EFFECT OF THE PLUS.

This would ruin the study - as a practical manner.  But still, even NOT TELLING the child to "push print" (the study DID have a highly significant effect.)

This does not mean "cure". It does not mean you can ever "prescribe it".  Further, I limit myself to those who understand these difficulties.

But this study did proven that a plus (used before you go below 20/40, and -1.0 diopters) could have a MILD "recovery effect".

That is the reason why, for a study with intelligent, motivated pilots, you could get recovery from 20/40.  But you would have to TRUST both the intelligence and motivation of each person in the study.

NOT ONE STUDY ever extended that type of trust to the person himself.

Until THAT is done, all plus-prevention studies will fail.

No OD wants to give you authority and competence to work on prevention (with you in control) because if you succeed, the entire "science" that he thinks SUPPORTS a prescription - will be proven wrong.

Think about it.
« Last Edit: January 02, 2014, 11:54:08 AM by OtisBrown »