Author Topic: Honesty in medicine - about who tells the truth?  (Read 3085 times)

Offline OtisBrown

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Honesty in medicine - about who tells the truth?
« on: February 27, 2014, 10:34:25 AM »
You start with a "preventive" program, say, 20/50, and -1.0 diopter.  You see no results.  Why is that true?

Are "commercial interests" so powerful, that you will never find the truth about prevention?  Were these "office interests" so great, that they shut down Dr. Bates successful study?  Or was his study just self-promotion, that did not produce successful results.  Are the people promoting Bates - fraudulent? 

I obviously have my own opinion, but here are some remarks about this troubling issue by Dr. Alex. 

http://frauenfeldclinic.com/troubling-facts-commercial-interests-driving-medical-science/

I spent a great deal of time trying to determine what the truth is about these issues.  I would be curious about your commentary.

It the statement, "prevention is possible - on the 20/40 threshold" or is it all a lie?  Is it fraud?  Or have the truly self-motivated pilots been successful - because of their persistence?

What is your judgment?

Offline CapitalPrince

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Re: Honesty in medicine - about who tells the truth?
« Reply #1 on: February 27, 2014, 12:34:06 PM »
20/40 is actually very poor and comfortable vision. Most people would not be willing to live with 20/40 or even 20/30 vision for months. driving really should be 20/25+. It is really not safe to drive with 20/40. This is why its very very very difficult for anyone who is at 20/40 to attempt prevention because they "need" a minus (for job, school, driving, etc)

also just wearing the plus only reverses ciliary myopia. It takes active use of the plus, active print pushing, or distance focus pulling for long periods of time to reverse any myopia. LONG periods of time. Getting a change of +0.5D really is not as simple as wearing a plus for a year.

The industry HIDES prevention so almost all people who get into it NEVER get out.

Offline Ydgrunite

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Re: Honesty in medicine - about who tells the truth?
« Reply #2 on: February 27, 2014, 07:48:33 PM »
also just wearing the plus only reverses ciliary myopia. It takes active use of the plus, active print pushing, or distance focus pulling for long periods of time to reverse any myopia. LONG periods of time. Getting a change of +0.5D really is not as simple as wearing a plus for a year.

How does this explain animal studies where plus lenses were used to reduce axial length?  Were the animals actively print pushing and focus pulling?

In similar studies where the optic nerve was cut, the animals' brains had no idea what image appeared on the retina and yet axial length was also reduced.

Offline CapitalPrince

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Re: Honesty in medicine - about who tells the truth?
« Reply #3 on: February 27, 2014, 08:20:19 PM »
it's difficult to get a accurate measurement of length when you think about it. Your axial length changes even when you blink.
but you can test wearing plus lens while watching tv. It really is not that ea]sy. if all it takes it wearing a plus and looking at a defocused image, then everyone would be "cured". Also Alex Frauenfeld would not be emphasizing the importance of active focus in reversing myopia.

Offline OtisBrown

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Re: Honesty in medicine - about who tells the truth?
« Reply #4 on: February 28, 2014, 03:23:40 AM »
Hi Ydgrunite,

It would be a mistake to think that anyone can measure a "length" with much accuracy.  What is done in the "Lab" is to measure a refractive STATE (objectively), and then "infer" that the "length", or "lens", or "something", must  have changed to produce an objective REFRATIVE change.  This is just "an artificial" assumption. It is a matter of "jumping" to mistaken  conclusion - based on a bad assumption that an eye is a "frozen camera".

Has any optometrist "removed your eye" and said it was "too long".  Of course not. They measure your normal refractive STATE, and if it is negative -1, then they tell you that your eye is "too long".  If they measure your eye at +1 diopter, then they tell you your eye is, "too short".

But if you experiment on the natural primate eye, it becomes very clear that a minus has a profound effect on the refractive STATE of all natural eyes.  But, again, it is refractive STATE.  It is then inferred that the eye "changed its length".  I do not think the second step is necessary.  I just need to know what always happens when you put a minus lens on the eye.

also just wearing the plus only reverses ciliary myopia. It takes active use of the plus, active print pushing, or distance focus pulling for long periods of time to reverse any myopia. LONG periods of time. Getting a change of +0.5D really is not as simple as wearing a plus for a year.

How does this explain animal studies where plus lenses were used to reduce axial length?  Were the animals actively print pushing and focus pulling?

In similar studies where the optic nerve was cut, the animals' brains had no idea what image appeared on the retina and yet axial length was also reduced.
« Last Edit: February 28, 2014, 04:21:34 PM by OtisBrown »

Offline CapitalPrince

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Re: Honesty in medicine - about who tells the truth?
« Reply #5 on: February 28, 2014, 05:37:25 AM »
axial myopia and eye elongation does happen and if a person is moderately myopic there is most likely eye elongation (like in micrometers/millimeters). This is why high myopes are riskier for retinal tears, retinal detachment. But it's difficult to establish a relationship between axial length and refractive state. the myopia can be in the muscles, lens, cornea, etc. But unfortunately i can tell i do have some axial myopia.

Offline Ydgrunite

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Re: Honesty in medicine - about who tells the truth?
« Reply #6 on: February 28, 2014, 02:35:16 PM »
It would be a mistake to think that anyone can measure a "length" with much accuracy.  What is done in the "Lab" is to measure a refractive STATE (objectively), and then "infer" that the "length", or "lens", or "something", must  have changed to produce an objective REFRATIVE change.  This is just "an artificial" assumption. It is a matter of "jumping" to mistaken  conclusion - based on a bad assumption that an eye is a "frozen camera".

Most studies that I read about myopia include measurements of axial length and they always explicitly state their methods, such as in "Hammond DS, Wallman J & Wildsoet CF. Dynamics of active emmetropisation in young chicks - influence of sign and magnitude of imposed defocus. Ophthalmic Physiol Opt 2013, 33, 215–226)":
"Axial ocular dimensions were measured by high frequency A-scan ultrasonography (35 MHz transducer, 100 MHz sampling), which allows the thickness of the retina, choroid and sclera to be measured in addition to the principal ocular components (anterior chamber depth, lens thickness, vitreous chamber depth)."

Lengths were reported in increments of 0.1 um, which seems pretty accurate to me.

This study says that axial length is readily measured "Fledelius H. Ophthalmic Changes from Ages 10 to 18 Years. Acta Ophthalmologica, v60 n3 (June 1982): 403-411":
"The refractive power of the eye is made up mainly of corneal power (about 44 D) and lens power (about 20 D), while axial eye length may be considered the main parameter to determine the resulting refractive value of the eye. Of these 3, corneal power and axial length are readily measured, while it is difficult directly to assess lens power.  Most lens power analyses are therefore based on indirect estimates, as calculated from cycloplegic retinoscopy value and axial length (by subtracting corneal power from total refractive power, examples being given by Delmarcelle et al. 1976)."


axial myopia and eye elongation does happen and if a person is moderately myopic there is most likely eye elongation (like in micrometers/millimeters). This is why high myopes are riskier for retinal tears, retinal detachment. But it's difficult to establish a relationship between axial length and refractive state. the myopia can be in the muscles, lens, cornea, etc. But unfortunately i can tell i do have some axial myopia.

The relationship between axial length and refactive state that I often see is 1 mm = 3D, but I found this rule of thumb discussed ialso n the Fledelius paper:
"The strongest correlation found is that between refraction and axial (or vitreous) length. The rather high values of r (or better r^2) signify that about half of the variations in the dependent variable is explained by variations in the other (independent) variable, while the remaining half must relate to other factors."

"Consequently, we have to modify a tenacious classical textbook concept: that 1 mm axial change leads to a 3 diopter refractive change. As discussed previously in more detail (Fledelius 1976), empirical results show a considerable scatter. Table 3 thus gives a ratio about 1.4 D refractive change per mm change in axial length, with the former parameter as dependent variable, but after reversal of dependency (A AL on y-axis) a quite different ratio can be calculated, even from the same set of data. A very absolute figure is, however, without meaning. The point of the discussion is to emphasize the wide- biological variation of the parameters under study and the, all things considered, rater poor co-variation of most refractive components. For this reason it is stated, that the classical 3 D/mm change ratio does not deserve its consistency in ophthalmic literature. Empirically, a somewhat lower ratio (2-2.5 D/mm) is in better keeping with biological data."


I agree that axial length, along with many elements of the eye that affect refractive state, can vary during the day.  But these variations are small and will always be there.  Reduction or elimination of myopia for many will involve a reduction in axial length beyond the daily variation.

Offline CapitalPrince

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Re: Honesty in medicine - about who tells the truth?
« Reply #7 on: February 28, 2014, 03:43:04 PM »
i seen the 1mm = 3D figure in alot of places (i am assuming  its 3D to max visual acuity not 20/20)...
Yes if a person has been myopic for a while (the myopia is "locked in"), then eye elongation has happened, and to regain 20/20+ the eye has to shorten

I recently asked Alex Frauenfeld if he reversed his myopia and he said he recovered from -4D (impressive, if it is actually true). In his website he states that active focus will reverse axial myopia.

I believe i have eye elongation since when i blink i can see a lot clearly (and sometimes weird things like i described inn my earlier thread). My father also had this experienced, but this did not happen anymore when he returned his vision from 20/40-20/50 to 20/20+. So yes his eyes probably shortened.

I remember when i played soccer before high school (doing alot of active focus in soccer), I could "feel" a pull on my eyes. soccer always gave my eyes a good workout.

Simply put: eye elongation is real, but there is a "cure" (altough very difficult and slow)

Offline OtisBrown

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Re: Honesty in medicine - about who tells the truth?
« Reply #8 on: March 01, 2014, 10:50:48 AM »
Hi Sam,

Here are some results that are incredible.  From -5 diopters to 20/20.

http://frauenfeldclinic.com/another-myopia-success-story/

This is better than Dr. Bates.

Offline CapitalPrince

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Re: Honesty in medicine - about who tells the truth?
« Reply #9 on: March 01, 2014, 11:56:50 AM »
hi otis thanks for the link

I personally do not like these stories. I don't mean to undermine Liam's success (he obviously improved greatly if he can function without glasses), but saying -5D to 20/20 is not accurate.

First his -5D prescription was corrected to infinity (max visual acuity) (also note eye tests are done in a DARK ROOM, which kills vision). his -5D are excessively overprescribed in bright lightinging/outdoors

he reports about 20/26 (13 at 10 ft) vision with -2.5D. so how much has he really improved?
Also 20/40 (stable) visual acuity was done OUTDOORS. So in a room with artificial lightning it is probably 20/60-20/50.

This is why i do not like when someone reports his vision is 20/20 and the definition of 20/20= 0D. There is also the "functionality of vision" issue and the "depth of field" and lightning conditions.

Nevertheless to recover from -5D to a point where he can function without glasses is an amazing accomplishment

Offline OtisBrown

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Re: Honesty in medicine - about who tells the truth?
« Reply #10 on: March 01, 2014, 08:20:58 PM »
Hi Sam,

I think Liam is telling us the truth about his objective vision.  Why should we doubt him?

This is why I teach a person to actually read his own Snellen, and measure his refractive state - himself.  After all, if he does not truth his own objective measurements - then who can he truth.

We are all required to exceed the 20/40 line if we drive a car.  If we wish to qualify as a pilot, we must objectively read and pass the 20/20 line.

Those are the real objective measurements we should be concerned with.



hi otis thanks for the link

I personally do not like these stories. I don't mean to undermine Liam's success (he obviously improved greatly if he can function without glasses), but saying -5D to 20/20 is not accurate.

First his -5D prescription was corrected to infinity (max visual acuity) (also note eye tests are done in a DARK ROOM, which kills vision). his -5D are excessively overprescribed in bright lightinging/outdoors

he reports about 20/26 (13 at 10 ft) vision with -2.5D. so how much has he really improved?
Also 20/40 (stable) visual acuity was done OUTDOORS. So in a room with artificial lightning it is probably 20/60-20/50.

This is why i do not like when someone reports his vision is 20/20 and the definition of 20/20= 0D. There is also the "functionality of vision" issue and the "depth of field" and lightning conditions.

Nevertheless to recover from -5D to a point where he can function without glasses is an amazing accomplishment

Offline CapitalPrince

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Re: Honesty in medicine - about who tells the truth?
« Reply #11 on: March 01, 2014, 08:50:26 PM »
hi otis,

I do not doubt his success. but for alex to say liam got from -5D to 20/20 (or even 20/40) is grossly exaggerrated. -5D to 20/20 sounds MIRACULOUS, but upon closer inspections its not so.
bright sunlight GREATLY increased the depth of field and visual acuity.

his edge of blur is a better estimate of his actual vision and to have a edge of blur of 60cm to 90cm is probably borderline functional. he may pass the DMV, but i do not think hat driving with this kind of vision is safe.

I do not like these stories, because it gives people a false sense of "20/20".

when people exceed the 20/40, the snellen v/a is not really important, but the overall comfortable and functionality of vision
 

Offline Myoctim

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Re: Honesty in medicine - about who tells the truth?
« Reply #12 on: March 02, 2014, 04:31:17 AM »
his edge of blur is a better estimate of his actual vision and to have a edge of blur of 60cm to 90cm is probably borderline functional. he may pass the DMV, but i do not think hat driving with this kind of vision is safe.

probably that's the reason while some other countries require up to 20/25 vision and/or reading at least 2/3 of the required line.
Also when using Landolf rings the guess chance is much lower.

when people exceed the 20/40, the snellen v/a is not really important, but the overall comfortable and functionality of vision

if there's no need to strain for seeing clearly it also means everything being more relaxed resulting in a better concentration on your main task.