Myopia should not exceed 3.0 D
Stefan Stefanov
Therapy centre in Colchester, UK. His post is no longer available so I
can't truly reference it.
Richard's main theory was that ultimately myopia is caused by behavioral
factors and that correction of low levels of myopia are probably
accelerating its progression.
I couldn't agree more. If the eye is never corrected for myopia, the
refractive error should not generally exceed -3.0 D - the adaptation the
eye makes to alleviate the stress of prolonged near work (reading,
computing, etc.).
By correcting for low levels such as 0.75 - 2.0 D and reading with the
glasses or contacts on the eye is simply strained again and tries to
readaptate by increasing its myopic error. This is especially true in
the years 10 - 18. I am appalled when I hear optometrists telling
patients that they must wear their glasses all the time.
Mechanically thinking (and profit-minded?) optometrists are the primary
cause for a sizable proportion of the myopia above 3-4 diopters. This
excludes myopic cases where the genetic factor may have a significant
role.
William Stacy
writes:
>(...)
>In other words, the optometrists are at fault except when they are not
>at fault. Such tautological statements convey no information.
>
Ben:
Good. Reason is finally taking back this group.
Bill
aeulenbe
>Stefan Stefanov <stef...@ctrvax.vanderbilt.edu> writes:
>>Mechanically thinking (and profit-minded?) optometrists are the primary
>>cause for a sizable proportion of the myopia above 3-4 diopters. This
>>excludes myopic cases where the genetic factor may have a significant
>>role.
Ben Carter:
>In other words, the optometrists are at fault except when they are not
>at fault. Such tautological statements convey no information.
Well, Ben, what YOU said is indeed a tautology; however, it is not what
STEFAN said. He said that optometrists are at fault for prescribing
corrective lenses for children who have less than a diopter of myopia.
He is saying that if mildly myopic children were not encouraged to read
through minus lenses, high myopia would be confined to those for whom
the cause is genetic. Evidently you think all myopia over 3 diopters is
genetic.
In general I agree with Stefan, although I would add that there are
other, non-genetic factors besides close work with negative lenses on
that can lead to high myopia. Rickets (Vitamin A deficiency) and measles
are two examples that come to mind. However even in these cases, I
believe treatment is possible.
For anyone interested in this topic, I highly recommend the books:
/Why Eyeglasses are Harmful for Children and Young People/
by Joseph Kennebeck, OD.
and
/Myopia Control/
by O.D. Rasmussen, OD.
--Alex
David B. Granet
<stef...@ctrvax.vanderbilt.edu> wrote:
>
> I couldn't agree more. If the eye is never corrected for myopia, the
> refractive error should not generally exceed -3.0 D - the adaptation the
> eye makes to alleviate the stress of prolonged near work (reading,
> computing, etc.).
Saw three kids yesterday alone who came for eye exams and were all between
-3.50 and -4.50. Never wore glasses. Hate to throw facts around but...
David
--
==================================================
David B. Granet, M.D.
Director
Pediatric Ophthalmology & Ocular Motility Services
University of California, San Diego
*Keeping an Eye on our future ;-) *
Benjamin P. Carter
> ... If the eye is never corrected for myopia, the
>refractive error should not generally exceed -3.0 D - the adaptation the
>eye makes to alleviate the stress of prolonged near work (reading,
>computing, etc.).
What does "should" mean here?
>By correcting for low levels such as 0.75 - 2.0 D and reading with the
>glasses or contacts on the eye is simply strained again and tries to
>readaptate by increasing its myopic error. This is especially true in
>the years 10 - 18.
Where is the evidence for this statement?
>
>Mechanically thinking (and profit-minded?) optometrists are the primary
>cause for a sizable proportion of the myopia above 3-4 diopters. This
>excludes myopic cases where the genetic factor may have a significant
>role.
In other words, the optometrists are at fault except when they are not
at fault. Such tautological statements convey no information.
--
Ben Carter internet address: b...@netcom.com
Lea McAndrews
>In article <488c21$t...@news.vanderbilt.edu>, Stefan Stefanov
><stef...@ctrvax.vanderbilt.edu> wrote:
>
>
>>
>> eye makes to alleviate the stress of prolonged near work (reading,
>> computing, etc.).
>
>
>-3.50 and -4.50. Never wore glasses. Hate to throw facts around but...
As a child (in the 50's when wearing glasses was definately uncool) I did
my level best to NOT wear glasses and hid my myopia until I was eleven
and my parents tricked me. Till that time I had been in a blissful fog
of nearsightedness - so I doubt you could say I was suddenly -3.25 at
eleven. My prescription remained stable from that time on, even through
my high school years when a boy made a comment about my geek-girl look
and I stopped wearing my glasses during school.
If the logic of the original poster prevailed, my sight should not have
progressed to -3.25 (+/-) and would have changed somewhat due to the
periods that I went without my glasses. No changes whatsoever.....
Regards
-Lea
Lea McAndrews
>Can you tell us more about these kids, Dr. Granet? How old were they?
As I said, I was eleven when fitted for glasses, but recall being myopic
from as early as four or five.
>Did they have normal births? (Were they triplets?) Did they have any
I had a normal birth, not a multiple birth.
>neurological or physical problems? Or were they otherwise perfectly
>healthy?
I have my "moments" now, but my neurological and physical health at the
time of my birth were quite normal. I was a perfectly healthy baby.
>When someone says X is generally the case, a vague anecdote does not
>refute it.
I doubt the children described by Dr. Granet were the FIRST cases he'd
ever seen... and I doubt we would be happy to listen to a long list of
all of the cases he's run across. I believe he'd said something like
"why, just the other day..." one anecdotal incident, probably of many.
-Lea
--
aeulenbe
Lea McAndrews <lov...@cybergate.com> wrote:
> My prescription remained stable from that time on, even through
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>my high school years when a boy made a comment about my geek-girl look
^^^^
>and I stopped wearing my glasses during school.
^^^^^^^^^^^^^^^^^^^^^^^^^^^^
>If the logic of the original poster prevailed, my sight should not have
>progressed to -3.25 (+/-) and would have changed somewhat due to the
>periods that I went without my glasses. No changes whatsoever.....
No, according to Stefan your myopia probably would have progressed
beyond -3.25 if you had constantly worn your glasses during your
developing years.
As for why your prescription didn't increase at all, there's always the
possibility you were given stronger-than-necessary prescription to begin
with (due to incomplete relaxation of the focusing muscles during
examination), which you "grew into."
On the other hand, Lea, you may be an exceptional case. What we do need
is some hard data on what happens to kids with LOW MYOPIA, ON AVERAGE
when they are given glasses, as opposed to let alone. Stefan's point was
that LOW MYOPES (in the < -1.00 range) should not be given glasses. In
general, these are people with 20/40 vision. He was talking primarily
about the people who are first become noticeably myopic between the ages
of 9-14, and then, after wearing glasses, eventually progress to -3.00
or more. He specifically wanted to exclude cases that were myopic at
birth, which appears to be your case.
--Alex
aeulenbe
>>cause for a sizable proportion of the myopia above 3-4 diopters. This
>>excludes myopic cases where the genetic factor may have a significant
>>role.
Ben Carter:
>In other words, the optometrists are at fault except when they are not
>at fault. Such tautological statements convey no information.
Well, Ben, what YOU said is indeed a tautology; however, it is not what
STEFAN said. He said that optometrists are at fault for prescribing
corrective lenses for children who have less than a diopter of myopia.
He is saying that if mildly myopic children were not encouraged to read
through minus lenses, high myopia would be confined to those for whom
the cause is genetic. Evidently you think all myopia over 3 diopters is
genetic.
In general I agree with Stefan, although I would add that there are
other, non-genetic factors besides close work with negative lenses on
that can lead to high myopia. Rickets and measles are two examples that
BillyFish
*********
Saw three kids yesterday alone who came for eye exams and were all between
-3.50 and -4.50. Never wore glasses. Hate to throw facts around but...
*********
Your facts are incomplete. There is no indication what these kids did.
Did they read comic books in the dark six inches from their faces like
many of kids in my generation did. Were they book worms.
How many kids have that level of myopia who have to be practically abused
to get them to read a book or other close work. Without such information,
the anecdote is incomplete.
William Buchman
David B. Granet
aeul...@ezinfo.ucs.indiana.edu (aeulenbe) wrote:
>
> In general I agree with Stefan, although I would add that there are
> other, non-genetic factors besides close work with negative lenses on
> that can lead to high myopia. Rickets (Vitamin A deficiency) and measles
> are two examples that come to mind. However even in these cases, I
> believe treatment is possible.
Alex its great to hear your opinions as a non-expert in anything remotely
related to vision science. We are all glad to hear your belifs that
treatment is possible. I just continue to shake my head at the continued
insistence on your part to write under the guise of expertise when you
aint.
David
Feel free to correct the english in my final sentence. In that you are at
least training.
==========================
David B. Granet, M.D.
Director
Pediatric Ophthalmology & Ocular Motility Services
University of California, San Diego
*Keeping an Eye on Our Future ;-) *
Al Neustadter
opthalmologists that kept giving me a stronger prescription every year
when I was a kid - and ordering me to wear the glasses full time, even
when reading. Of course it's anecdotal, but looking back at all my old
RXs, my biggest increases in myopia directly followed the
biggest increases in minus power. (My dad, whom I resemble in every way,
and who didn't have the benefit of medical services when he was young is
about a -5:00) Even if I was genetically destined to be myopic, it could
have been minimized if any doctor would have cared. Its so intuitive you
almost don't need studies to back this up. Now those doctors are retired
and nowhere to be found, and I'm left with oversized eyes, coke bottle
glasses, floaters up the wazoo, and at high risk for vertually everything
that can go wrong with an eye.
aeulenbe
>Feel free to correct the english in my final sentence.
OK. Correction time.
>I just continue to shake my head at the continued
>insistence on your part to write under the guise of expertise when you
>aint.
Yes, you're right. That last sentence is complete jibberish. When you
are shaking your head, EITHER I am writing under the guise of expertise
OR I ain't. You can't have it both ways.
--Alex
David B. Granet
aeul...@ezinfo.ucs.indiana.edu (aeulenbe) wrote:
> Can you tell us more about these kids, Dr. Granet? How old were they?
> Did they have normal births? (Were they triplets?) Did they have any
> neurological or physical problems? Or were they otherwise perfectly
> healthy?
>
> When someone says X is generally the case, a vague anecdote does not
> refute it.
Alex I see kids almost EVERY time I see patients who violate the "general"
case. The point is that the *original* comment had no basis in fact. As
a non-expert in this field I would not expect you to recognize this.
David
--
==================================================
David B. Granet, M.D.
Director
Pediatric Ophthalmology & Ocular Motility Services
University of California, San Diego
*Keeping an Eye on our future ;-) *
Lea McAndrews
>aeul...@ezinfo.ucs.indiana.edu (aeulenbe) wrote:
>
>>>In article <48bpj1$m...@opal.CyberGate.COM>,
>>>Lea McAndrews <lov...@cybergate.com> wrote:
>
>>>> My prescription remained stable from that time on, even through
>>> ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
my point was that even though I spent a good deal of time during the day
sans spectacles, my prescription never varied from the day I was given my
EYESIGHT (and the wonder of seeing clearly!!!!) till I was in my
thirties.
>>>No, according to Stefan your myopia probably would have progressed
>>>beyond -3.25 if you had constantly worn your glasses during your
>>>developing years.
Yea... and I feel certain that it would not have. I wore my glasses the
rest of the time, when I got home from school, rode my horse for hours,
did homework, watched tv. I have to agree with:
>Or it could be that wearing your myopic correction does not cause you
>to become more myopic.
>>>As for why your prescription didn't increase at all, there's always the
>>>possibility you were given stronger-than-necessary prescription to begin
>>>with (due to incomplete relaxation of the focusing muscles during
>>>examination), which you "grew into."
All I recall is the excitement and wonder I felt at seeing clearly. It
was wonderful and I would think if it had been too strong, wouldn't I
more than likely have had headaches or felt eye strain? It seems to me
what you propose would cause symptoms/reactions that could not be
overlooked.
When I was in my early 20's and had hard contact lenses, I'd forgotten
which one had the "idiot dot" and inadvertantly switched them. This
eventually caused me to have excruciating pain in one of my eyes since
that eye was not as strong as the other rx... and the pain was resolved
by switching them back to the proper sides... Yes, I believe children
everywhere would be feeling the adverse effects of wearing too-strong of
a prescription.
>>>On the other hand, Lea, you may be an exceptional case. What we do need
Well, thank you! Yes I AM exceptional!
>>>is some hard data on what happens to kids with LOW MYOPIA, ON AVERAGE
>>>when they are given glasses, as opposed to let alone.
I understand I am NOT a "high" myope, so I presume that would make me a
"low myope" or am I relegated to the bermuda triangle of vision middle
myopehood?
>>>Stefan's point was
>>>that LOW MYOPES (in the < -1.00 range) should not be given glasses. In
>>>general, these are people with 20/40 vision. He was talking primarily
>>>about the people who are first become noticeably myopic between the ages
>>>of 9-14, and then, after wearing glasses, eventually progress to -3.00
>>>or more. He specifically wanted to exclude cases that were myopic at
>>>birth, which appears to be your case.
>
>Again making an incredible leap, what makes you think she was myopic
>at birth?
I am willing to bet I wasn't THAT myopic when I first realized I couldn't
see well. There had to be a reason my parents trapped me at the age of
eleven, meaning there was something noticeable about my actions that made
them suspicious. When I think about it, with my vision as "near-sighted"
as it now is, it WOULD have been very apparent early on since I would
have been bumping into things, falling into holes, etc. I doubt I was
THAT myopic at birth. I think it progressed gradually, perhaps
accelerated when I started accelerating...
-Lea
--
aeulenbe
> The point is that the *original* comment had no basis in fact.
The original comment was that uncorrected myopes seldom progress beyond
-3.00, and that glasses are responsible for the fact that there are so
many high myopes walking around to day. No basis in fact? Since we see
so few uncorrected -3.00 + myopes, it's hard to tell.
But support for this contention, incidentally, is given in /Myopia
Control/, by O.D. Rasmussen, who went to China in the 30s and surveyed
the people who did not have access to spectacles. As I recall, he said
that in the "land of the myopes" where glasses were not prescribed,
myopia rarely went beyond 3 - 4 diopters. Compare this to the statistics
on myopia in China today. I don't have this book with me now, so I can't
quote him exactly. But I know the author was very much against
prescribing myopic glasses for the very young, due to the very high
myopia that he believed would ensue.
--Alex
Benjamin P. Carter
> ... Of course it's anecdotal, but
> ... Even if I was genetically destined to be myopic, it could
>have been minimized if any doctor would have cared.
The variety of opinions expressed in this group shows that there is still
no consensus about whether wearing glasses agravates myopia. Since there
is and was no consensus, it seems likely that the doctors who prescribed
glasses for Al Neustadter thought they were helping him. And maybe they
were. His conclusion that they didn't care is unwarranted.
> Its so intuitive you almost don't need studies to back this up.
Without controlled studies, there is no way to convince people whose
intuition doesn't agree with yours. The history of science is full of
examples of widely held views that proved to be wrong. Intuition is not
enough. You need hard, empirical evidence--and not just anecdotes.
William Stacy
(aeulenbe) writes:
> As I recall, he said
>that in the "land of the myopes" where glasses were not prescribed,
>myopia rarely went beyond 3 - 4 diopters. Compare this to the
statistics
>on myopia in China today.
What's 'rarely' in this context. And what ARE those statistics?
One man's rare is another's occasional.
Bill
Al Neustadter
>Without controlled studies, there is no way to convince people whose
>intuition doesn't agree with yours. The history of science is full of
>examples of widely held views that proved to be wrong. Intuition is not
>enough. You need hard, empirical evidence--and not just anecdotes.
..and of course you're right. But I and many other high myopes with
otherwise healthy eyes need no convincing.
aeulenbe
Alex:
>>>What we do need
>>>is some hard data on what happens to kids with LOW MYOPIA, ON AVERAGE
>>>when they are given glasses, as opposed to let alone.
John Warren, OD <war...@execpc.com> wrote:
>As stated previously, such studies might prove you right, or wrong.
>The problem is finding someone who sees their child as a lab animal
>and is willing to withhold accepted treatment "in the name of
>science." Design and implement a study if you really feel that you
>have a valid hypothesis.
Design I can do. Implement is another thing. For that I would need the
help of an OD or Ophthalmologist.
All you'd have to do is each time there comes to your office a 9
to 14-year-old with a 1.0 diopters of myopia, and 20/40 vision, but who
is doing fine in school, and who does not think they need glasses, and
whose parents do not care one way or another whether the child gets
glasses, flip a coin and do one of two things:
1) Tell them that their vision is poor now, but that if they are to get
glasses at such a young age, there is a possibility that their vision
will get worse than it would without the glasses. Tell them that this
puts them at higher risk for retinal detachment. Tell them to sit closer
to the chalkboard if it's hard to read, and use a pair of +1.00 D
reading glasses for all close work, especially late night studing and
written tests during school. Give them an eye chart so that they can
monitor their own vision. Tell them to spend more time outside, and less
time watching TV or playing video games. See them in a year.
2) Tell them that they need glasses. Tell them that by wearing the
glasses they will be keeping their eyes healthy, and tell them to wear
the glasses as much as possible, including when reading. Tell them that
if they feel any discomfort, this is only a sign of adjustment and their
vision is not getting worse. Tell them that they may think their vision
is getting worse, but this is just an illusion. See them in a year.
Since such children are below the driving age, and their vision is
20/40, you cannot argue that they need glasses for driving. Since they
are doing well in school, you cannot argue that they need glasses to
read the chalkboard. Since such children do not particularly want to or
feel the need to wear glasses, they will not consider themselves "guinea
pigs". I know quite a few people who as children would have been more
than willing to have had "accepted treatment[sic]" withheld from them --
that is, to go for a year continuing to not wear glasses -- if they had
been presented with the arguments for and against minus glasses for low
myopia. Probably far more than would ever willingly wear bifocals. And
bifocal experiments are legion.
--Alex
bill b. rainey
>bra...@silver.ucs.indiana.edu (bill b. rainey) writes:
>
>>You are absolutely correct, Maurice, about these results. However, if
>>the data are reanalyzed by comparing subjects with nearpoint esophoria
>>to those with nearpoint exophoria, there is a significant difference
>>in myopia progression rates between the SV group and the BF group in
>>those with esophoria. This difference does not exist in those
>>subjects with nearpoint exophoria. By no means conclusive, I know,
>>and "more study is needed"; however it does give one something to
>>think about. Dr. Dave Goss, one of my faculty colleagues here at IU,
>>is "hot on the trail" of this phenomenon, so stay tuned.
>>
>Bill:
>
>Which way, por favor? Not having read the study, I'd love to know
>whether esos or exos fared better/worse with which therapy.
>
>Bill
Sorry. Those individuals with nearpoint esophoria who were corrected
with bifocals showed a slower progression of myopia than those
individuals with nearpoint esophoria who were corrected with SV
lenses. The individuals with nearpoint exophoria had no such difference in
myopia progression.
Again, this observation is from a reanalysis of data in a previously
published study. This information can be found in:
Goss DA, Grosvenor T. Rates of childhood myopia progression with
bifocals as a function of nearpoint phoria: Consistency of Three
Studies. Optom Vis Sci 1990;67(8), 637-40.
Goss found similar results in another *retro*spective study of a
"wholelotta" clinical data from several private optometric practices:
Goss DA, Uyesugi EF. Effectiveness of bifocal control of childhood
myopia progression as a function of near point phoria and binocular
cross-cylinder. J Optom Vis Dev 1995;26, 12-7.
Again (again), *pro*spective, longitudinal controlled studies are
needed.
BRainey
--
Bill B. Rainey, O.D. ******************************
Chief, Binocular Vision/Pediatrics Services * Through a child's eyes... *
Indiana University School of Optometry ******************************
bra...@indiana.edu (812)855-8241 http://silver.ucs.indiana.edu/~brainey
Steve Machol
: What they are trying is to enable children to see so they can get on with
: life. Learning is no picnic when you can't see the blackboard and I
: shudder to think of the disability underprescription would foist upon
: children at the time of their lives when they're laying the foundation of
: their studies.
This, for me, is the crux of the matter - and one of the most intelligent
statements I've read in this whole debate over myopia progression.
Steve
--
___ ____ ____ _ _ ____
/ __)(_ _)( ___)( \/ )( ___) Steve Machol
\__ \ )( )__) \ / )__) sma...@crl.com
(___/ (__) (____) \/ (____) http://www.crl.com/~smachol/
Dennis Yelle
I really don't understand how you can beleave that.
It really upsets me when people use phrases like,
"can't see the blackboard".
I am about -6.00 and -4.00 and I can certainly "see the blackboard"
even from the back of the room. What I cannot do is read most of what
is written on the blackboard. If it is written large enough, I can read it.
If not, I cannot. I suppose that you will object by saying that
everybody knows what you mean when you say, "can't see the blackboard".
I am not so sure about that. I think that if they really understood, they
would speek and write more clearly.
I got my first pair of glasses when I was 11 years old.
I thought they were great, I could see a lot better, and I discovered that
the world really was 3 dimensional. But almost every time I went
back to have my eyes tested again, the doctor told me I needed new
glasses, and when I got the new glasses, I knew they were stronger
than I needed. But I didn't say anything, because the doctor was
a doctor, and I was just a kid.
I don't REALLY understand EXACTLY what is going on here, but I
know I am much more comfortable wearing glasses that give me
20/25 or 20/30 vision than ones that give me 20/20 vision.
And I also know that 20/30 vision is good enough vision for
everything I have ever wanted to do.
Where is the research that shows people are better off with
20/20 glasses than with 20/30 glasses?
Where is the research that shows that people are better off
with glasses that have as much cylinder correction as they
"ask for" during the cross cylinder test even when it is
0.75 D more cylinder than they need to read the 20/20 line?
--
den...@netcom.com (Dennis Yelle)
"You must do the thing you think you cannot do." -- Eleanor Roosevelt
Lea McAndrews
>And Stefan's theory says BECAUSE you spent a good deal of time during
>the day sans spectacles, your vision did not get worse than about 3
>diopters of myopia.
I also had vision improvement in college after a night of partying and
drinking beer. But the effect was only temporary. Should I drink beer
all the time now?
>>When I was in my early 20's and had hard contact lenses, I'd forgotten
>>which one had the "idiot dot" and inadvertantly switched them. This
>>eventually caused me to have excruciating pain in one of my eyes since
>>that eye was not as strong as the other rx... and the pain was resolved
>>by switching them back to the proper sides... Yes, I believe children
>>everywhere would be feeling the adverse effects of wearing too-strong of
>>a prescription.
>
>Not necessarily. In one experiment, they intentionally prescribed
>glasses 0.75D too strong (to find out if that had an effect on the
>progression of myopia) and none of the kids complained, even when
>specifically asked.
I was referring to my own case, where a fairly slight difference (.25)
caused excruciating pain. I WOULD have noticed it if the doctor had
overprescribed.
>Why didn't they react, while you did with your contact lens? Children
>have a greater amplitude of accommodation than adults; that is, they can
>focus nearer more easily. The gradual loss of this ability begins long
>before "presbyopia" is diagnosed.
Well, I WAS nineteen when the contact switch occurred. I used to take
them off and stick them in a place that had a right and a left side, but
I got THEM mixed up one night...
I still think your method is more wishful thinking than good science, and
I'll opt for and trust (proven) science any day.
>What is your prescription, exactly, for each eye? And what was it for
>most of your life?
-3.00 in one eye and -3.25 in the other starting from the age of eleven
and has continued till my current age of almost 45.
>Wouldn't it have been nice if you knew that you could stop myopia, and
>not have to wear glasses?
I fooled them for nearly five or six years. I think that would have
proven to cure my eyes in your books.
>Then you wouldn't have tricked your parents,
>and you would have been happy to go to the doctor as soon as you
>realized you didn't see well.
This was the 50's and I would not have been happy under any circumstances
to see the doctor for eyewear. Although I appreciated it greatly when I
GOT them, I just didn't know what I had been missing.
>I'm not saying I know the answer now, but
>it looks like nobody is trying to find it!
What they are trying is to enable children to see so they can get on with
life. Learning is no picnic when you can't see the blackboard and I
shudder to think of the disability underprescription would foist upon
children at the time of their lives when they're laying the foundation of
their studies.
Lea
--
John Warren, OD
>>I don't REALLY understand EXACTLY what is going on here, but I
>>know I am much more comfortable wearing glasses that give me
>>20/25 or 20/30 vision than ones that give me 20/20 vision.
>>And I also know that 20/30 vision is good enough vision for
>>everything I have ever wanted to do.
Good for you, but you are in the minority. The VAST majority of
people are not happy with less than the best distance vision they can
achieve along with normal near vision. Sorry to burst your bubble,
but that is the way it is. At least in Racine, WI, Bloomington, IN,
Indianapolis, IN and Danville, IL (the only places where I have
sampled the public!)
>>Where is the research that shows people are better off with
>>20/20 glasses than with 20/30 glasses?
No research needed, just ask any OD or MD how happy patients have been
with less than optimal distance vision. See reply above.
>>Where is the research that shows that people are better off
>>with glasses that have as much cylinder correction as they
>>"ask for" during the cross cylinder test even when it is
>>0.75 D more cylinder than they need to read the 20/20 line?
See above.
Keep in mind that there are no universals when considering a
refraction. However as mentioned, the vast majority of patients want
their best corrected distance and near vision at the same time. That
has been the case since the time of Ben Franklin (hence the invention
of a lens to deliver both!)
Stefan Stefanov
that there is someone else who thinks this way.
Since conceptually the study is clear, the focus has to be on the
implementation.
We need an O.D. or M.D. help and dedication. If funding cannot be secured
through a medical institution, the National Institutes of Health or a
vision foundation I hope that in the future I shall be able to donate
some of my own money to this purpose.
If the study proves us wrong the only thing possibly lost is some of our
reputation. On the contrary, if the study proves the hypothesis right,
the implications are profound.
However, even if the hypothesis is proven valid, there are some hitches
that may prevent a radical change in spectacles prescription practices.
First, in today's fast world most people want to be completely functional
which usually includes being able to see clearly all the time. And
second, if laser refractive surgery proves to be successful long term,
people wouldn't care that much about "non-traditional" vision
preservation methods knowing that at 25 they can always have the surgery.
Ironically, although we are talking supposedly an exact science, it looks
like trying to reconcile the style of two artists, each having its own
merits and followers. In discussions like this the outcome is very
infrequently a consesus. But to the extent that logic binds us all, I
shall continue to try to prove the validity of my ideas.
Stefan Stefanov
Stefan Stefanov
>>refractive error should not generally exceed -3.0 D
>What does "should" mean here?
"Should" is an attempt to balance between Einstein's determinism and
Heisenberg's indeterminism. The whole "magic" of existence and
non-existence is that it happens with logical alternatives simultaneously
valid. Down to earth, "should" means z=1.282 when you standardize the
distribution of refractive errors of myopes who have never worn
corrective lenses, have good reading habits, and are not genetically
predisposed to developing myopia. This translates into a
cummulative probability of 0.9 (assuming normal distribution. In the
likely case of negatively skewed distribution the probability alone still
holds). If you feel uneasy with this constant, consider how many other
professional issues have some "subjectivity" about them.
>>By correcting for low levels such as 0.75 - 2.0 D and reading with the
>>glasses or contacts on the eye is simply strained again and tries to
>>readaptate by increasing its myopic error. This is especially true in
>>the years 10 - 18.
>
>Where is the evidence for this statement?
All mathematics is, is common sense reduced to numbers. Where is the
evidence that the Sun will rise again tomorrow? Do you reject school
myopia? I have posted exact citations (AJO, Arch Ophthalmol, Invest
Ophthalmol Vis Sci, Ophthalmology) previously in this group but since
hardly anybody else is doing this I have redefined the purpose of this
newsgroup for myself as anything but rigorous scientific research.
If you are interested you may search your medical library catalogue or
Medline for the topic in question. I'll give just two references here: 1)
Greene, P.R. (1980). Mechanical considerations in myopia: Relative
effects of accomodation, convergence, intraocular pressure, and the
extraocular musles. Am J Optom Physiol Opt, 57, 902-914. and 2) Trachtman
JN, Giambalvo V, and Feldman J (1981) Biofeedback of accomodation to
reduce functional myopia, Biofeedback and Self-Regulation, 6, 547-564.
>>Mechanically thinking (and profit-minded?) optometrists are the primary
>>cause for a sizable proportion of the myopia above 3-4 diopters. This
>>excludes myopic cases where the genetic factor may have a significant
>>role.
>
>In other words, the optometrists are at fault except when they are not
>at fault. Such tautological statements convey no information.
I don't see the logic behind this remark. To paraphrase what I am saying,
if somebody is not genetically predisposed to myopia and does not have
any other systemic conditions that may have an adverse effect on their
vision, (i.e. environment is the sole factor), then prescribing
corrective lenses, especially when the patient is young, will likely
cause him/her more harm than good.
As to the three myopic kids described by Dr. Granet - two questions in
addition to Alex's:
What were their reading habits?
Were their parents or grandparents significantly (>1.0 D) myopic?
Stefan Stefanov
Lea McAndrews
What I meant by saying I could not see the blackboard (without glasses)
was just that. It is my experience, not yours - and without glasses,
from a distance of anything beyond a few feet I am unable to see anything
except a blur of color which I do not consider "seeing."
I value what doctors have been able to do for me, what I consider to be
the gift of clear sight. It is my opinion that your vision will pretty
much reach a point that it is meant to, and then stabilize. Doctors are
far too easy a target when it comes to blame, and that is a shame.
Particularly when the issue is one of a physical abnormality to which
they have little "control" over, and are simply try to help us adapt. I
could go on (and will) - and say they do have your best interests at
heart and base decisions upon extensive education and experience, they do
not pull their knowledge out of a magician's hat.
-Lea
--
William Stacy
writes:
>(...)
>Where is the research that shows people are better off with
>20/20 glasses than with 20/30 glasses?
>
>Where is the research that shows that people are better off
>with glasses that have as much cylinder correction as they
>"ask for" during the cross cylinder test even when it is
>0.75 D more cylinder than they need to read the 20/20 line?
>
Probably doesn't exist, but being a lifelong astigmatic myope myself, I
can give you this feeble testimonial:
Crisp 20/20 is better than marginal 20/30, any day, any time...
Bill
Stefan Stefanov
throwing it in for the mere sake of argument. I want to call on your
common sense. Look at all the experiments with confined animals where
myopia occured almost in every case. Look at the trends in human myopia
prevalence and magnitude across the years. Unless you are making a case
that mankind mutates to a more myopic refractive state as a way to adapt
to changes in the working environment, I can't understand you.
Prolonged accomodative stress is the leading cause for environmental
myopia. Pure and simple. Why would you want your children to wear minus
glasses when their eyes are still developing thus putting an additional
burden on their accomodative mechanism? If the eye turns myopic it
adjusts to the functions it most often performs. If this is undesirable
you can make your child change his or her lifestyle (read less, be out
more often). But you can only worsen the situation if you "correct" the
eye.
The study I have here is a classic from the family of atropine studies
investigating how blocking accomodation through atropine affects myopic
progression.
Brodstein RS, Brodstein DE, Olson RJ, Hunt RJ, Williams RR, The treatment
of myopia with atropine and bifocals. A long-term prospective study.,
Ophthalmology, 91(11):1373-9, 1984 Nov.
Two hundred fifty-three patients on atropine regimen followed up to nine
years exhibited a marked reduction in the rate of myopia progression than
controls. When atropine administration was discontinued the two groups
had similar rates of myopia progression.
I would try to explain to my children the risks of wearing glasses when
they are young. However, if shortsightedness makes them feel insecure,
shy, and unconfident I would get them glasses, but not the full
correction.
Stefan Stefanov
adrian
> >>By correcting for low levels such as 0.75 - 2.0 D and reading with the
> >>glasses or contacts on the eye is simply strained again and tries to
> >>readaptate by increasing its myopic error. This is especially true in
> >>the years 10 - 18.
> >
> >Where is the evidence for this statement?
>
> All mathematics is, is common sense reduced to numbers. Where is the
> evidence that the Sun will rise again tomorrow? Do you reject school
> myopia? I have posted exact citations (AJO, Arch Ophthalmol, Invest
> Ophthalmol Vis Sci, Ophthalmology) previously in this group but since
> hardly anybody else is doing this I ha
> >>Mechanically thinking (and profit-minded?) optometrists are the primary
> >>cause for a sizable proportion of the myopia above 3-4 diopters. This
> >>excludes myopic cases where the genetic factor may have a significant
> >>role.
Forgive me if this is a silly question, but if I might...
The above discussion seems to be saying that: certain 'extreme' levels of
myopia are caused by correcting a myopia problem (using glass lenses), and
then subjecting the 'corrected state' to the same environmental pressures
which may have led\contributed to the myopia in the first place. Is this what
is being said here?
If I am understanding properly, is it then fair to extrapolate this to mean
that my myopic eyes only get worse when I read with my glasses on?...and that
prescriptive lenses needn't be updated so often? I'm reasonably young (ie
25), and will be going back to school in the next few years for another
degree. I'm hoping you will have some suggestions on how I can minimize the
damage\strain that this much reading is going to place on my eyes. As it is,
my father is in his mid-forties, and can no longer really focus on small
objects without taking his glasses OFF and squinting like the dickens...(ie it
IS in my genes too)....I was hoping to avoid the same situation. Any
suggestions?
shu...@aspen.uml.edu
> Prolonged accomodative stress is the leading cause for environmental
> myopia. Pure and simple. Why would you want your children to wear minus
> glasses when their eyes are still developing thus putting an additional
Functioning. Learning. Living.
> burden on their accomodative mechanism? If the eye turns myopic it
> adjusts to the functions it most often performs. If this is undesirable
> you can make your child change his or her lifestyle (read less, be out
> more often). But you can only worsen the situation if you "correct" the
> eye. ...> I would try to explain to my children the risks of wearing glasses
> when they are young. However, if shortsightedness makes them feel insecure,
> shy, and unconfident I would get them glasses, but not the full
> correction.
I appreciate the intentions expressed here, but I must offer a
contradictory opinion here. I am not an expert in any relevant topic - in fact
I am about as far from a scientist as you can get, but I have some subjective
experience I would like to share.
I got my first pair of glasses (for myopia) at age 15 - almost nine
years ago. I can tell you that I "needed" them at least two or three years
prior to that - and very likely even earlier. I have had an opthamologist ever
since I can remember - to do possible vision issues which could have I guess
become a factor due to some other medical situation I won't go into here.
Anyway, I learned very quickly how to "fake it".
I can say that it was not worth the price to preserve my sense of image
or vanity or what have you. I know that my learning was effected. I am very
definitely an auditory learner (to the point that I have what is inaccurately
called "perfect pitch") - with kinesthetic second, and visual a distant third.
My point is that no one should force a particular lifestyle upon you.
This will only create internal conflict, distress, confusion, depression, and a
very low sense of identity and self-esteem. Let children be who they are
"naturally" inclined to be. There is nothing unhealthy about being a "book
worm" nor preferable about being a jock.
This makes me very fearful for any myopic would-be pianists. I was not
meant to play ball. I was meant to play music.
-stan
P.S. - On a(n almost) completely unrelated topic: didn't Wade Boggs (ex-first
baseman for the Red Sox) get glasses to increase his acuity to 20/15 from
20/20 so as to improve his performance at-bat?
William Stacy
>
>In article <dennisDI...@netcom.com>,
>Dennis Yelle <den...@netcom.com> wrote:
>>I don't REALLY understand EXACTLY what is going on here, but I
>>know I am much more comfortable wearing glasses that give me
>>20/25 or 20/30 vision than ones that give me 20/20 vision.
>
>I cannot rapidly focus closer than 13 inches (used to be 10 or 11 in.,
>but presbyopia is setting in), on the other hand far distant vision
>is relentlessly sharp. Excellent trade-off for me in my opinion.
>YMMV
>
Most people agree with Greg, myself included, for most situations. I find very few
patients who are happy with 20/30, any time, any where.
>>And I also know that 20/30 vision is good enough vision for
>>everything I have ever wanted to do.
>
>20/5 would be nice. :-)
>Ideally, I could dispense with binoculars for far distant vision.
>There's a wonderful world there to be seen.
Touche!
>
>>Where is the research that shows people are better off with
>>20/20 glasses than with 20/30 glasses?
Res ipsa loquitur. (The thing speaks for itself)
>>
>>Where is the research that shows that people are better off
>>with glasses that have as much cylinder correction as they
>>"ask for"
>
>I suppose it's a subjective thing. I expect that when I look at a
>circle drawn with a uniform thin black line it will be in focus all
>the way around and it will appear to be uniformly dark (uniform width
>of line). I don't put up with any alternative.
Exactly so, oh acute one! You epitomize the majority of the people I
see day in, day out. There may be room for fuzziness in this world, but
most of them like you and I like our details well defined.
Bill
(So maybe we get a little more myopic. There are worse things in life,
like missing out on the beauty of clarity itself. And myopia DOES
eventually stop progressing, in ALL cases).
Karen Brazier
: I would try to explain to my children the risks of wearing glasses when
: they are young. However, if shortsightedness makes them feel insecure,
: shy, and unconfident I would get them glasses, but not the full
: correction.
I wish someone had done that for me instead of making me wear glasses
all the time. No one calls you names, picks on you or assumes you're
hopeless at sport when you are 8 and can't see perfectly - unless you
wear glasses. I don't know any myopes who wore glasses from an early
age and whose experience as a child was different. Why is this so
underestimated as a psychological effect?
For the specialists who deal with highly myopic children, don't
flame. Those are perhaps the 5-sigma end of the myopic population
and not representative of the majority.
Sorry, seem to have deviated from the thread a bit!
Al Neustadter
>I got my first pair of glasses when I was 11 years old.
>I thought they were great, I could see a lot better, and I discovered that
>the world really was 3 dimensional. But almost every time I went
>back to have my eyes tested again, the doctor told me I needed new
>glasses, and when I got the new glasses, I knew they were stronger
>than I needed. But I didn't say anything, because the doctor was
>a doctor, and I was just a kid.
Yep, I remember that feeling oh so well. I would tell the optician
"everything is so much sharper and brighter; it feels like it's too
much," --and he'd say, "oh you'll get used to it in a few days."
He was right. Every year.
Raymond A. Chamberlin
as well as I can. I've always found that optometrists,
optometric residents and ophthalmologists don't give a damn about
reasonably accurate refractions for astigmatism. With 1.5 to 2.0
cylindrical correction needed, the angle has to be accurate
within about 2 deg. Out of about a dozen times with about half a
dozen practitioners, this never happened. I always had to yank
on the cylindrical angle myself. Two very basic problems exist:
1) to make refracting look like an expensive job, a
nineteenth-century lash-up of trial-and-error lens holders is
used, and 2) ambiguous incantations are used with the subject, so
that he/she can't tell which kind of distortion you're talking
about. Of course, it also doesn't help when it's done (as most
of the time) by someone who loves Snellen charts but never
learned Snell's law. (Learning geometric and physical optics is
too much like work and not enough like dicking around with people
and pocketing money.) Using a Latin-letter chart, rather than a
starburst chart, to ascertain the correctness of an astigmatic
correction is just plain stupid, unless you charge for callbacks.
Dr. Joseph Gil
>This whole discussion is really moot. There is empirical data to refute
>the original argument.
>Back in the mid 80's a study was concluded at UHCO led by Ted Grosvenor,O.
>D.. This study helped answer the question of near point stress and the
>effect of it on advancement of myopia. The exact details escape my
>memory as does the exact title of the study, but here are the basics.
>School age children (under 10?) were randomly selected into two groups.
>One group wore there regular myopic single vision correction full time
>and the other wore full time executive bifocals splitting the pupil to
>reduce near point stress. The outcome after many years was that the two
>groups did not show any statistical differences in the rate of
>advancement or level of thir myopia.
>Isn't it better knowing children are corrected to their far point and
>allowed to develop normally in our technical society (as compared to
>rural China). This study should show that glasses do not change genetics.
>Maurice J. Wilson, O.D.
Not too long ago, another researcher reported in this newsgroup on
a mainstream journal published paper of his which suggests a radically
different conclusion. He found a significant difference in the level
of myopia between Yeshiva boys and their sisters. The yeshiva boys who
spend a lot of time doing close work tended to be more myopic then the
control group of their sisters.
--
Joseph (Yossi) Gil yo...@CS.Technion.AC.IL
The Faculty of Computer Science yo...@NeXT.CS.Technion.AC.IL
Technion -- Israel Institute of Technology Tel: +972-4-29-4333
Technion City, Haifa 32000, Israel Fax: +972-4-29-4353
Kevin Goldstein
>From: yo...@tx.technion.ac.il (Dr. Joseph Gil)
>Subject: Re: Myopia should not exceed 3.0 D
>Date: Mon, 27 Nov 1995 20:05:55 GMT
>XLG...@prodigy.com (Maurice Wilson) writes:
>>Maurice J. Wilson, O.D.
That's hardly a controlled study. And without knowing what the natural rate of
myopia is in women versus men (most particularly, in the group studied), the
paper might provide gist for further study, but is in itself useless to draw
firm conclusions from.
-Kevin Goldstein
ke...@kg.com
Avi & Stacy
William Stacy
writes:
>
>GET A LIFE
>
Just want to make it clear that I am not related in any way to the 'Avi
and Stacy' who posted the above orphan of a message.
William Stacy
O:BASE Ophthalmic Systems
w...@ix.netcom.com
http://www.cybergate.com/~lovelea/obase.htm
Paul Harris
writes:
>
>
>Dr. Harris,
>
>You seem to be one of the few doctors who post here that
>believe in vision therapy.
>
I have a lot more than belief, I have seen the benefits of VT.
However, I am, and have always been VERY uncomfortable when the
discussion of VT is limited to myopia only. This is such a small
portion of that which we do. It seems that this is the main thrust of
this newsgroup. At any rate, I have 16 years experience having helped
thousands and I teach this specialty regularly through the Baltimore
Academy for Behavioral Optometry.
The body of literature that supports the behavioral concept is HUGE
with most of it coming from neurology, congnitive neuroscience, AI,
Etc...
>Please give us your comments on the likely success of a male
>who started wearing glasses at age 11 and is now 44 and has
>a current 20/20 Rx of:
> -6.25
> -3.75
>add +1.25
>
First off not enough information...... We talk about the difference
between a "Visual Problem" and a "data problem".
A "Visual Problem" is an unmet need that the person has that can be
served by improving their "vision". "Vision" is the deriving of
meaning and direction of action as triggered by light. Vision is much
more that sight or visual acuity. An optometric "data Problem" is a
set of numbers that that may not measure up to some expected.
I am in the business of helping patients with their visual problems
which may or may not always be reflected in the data. Also, data
problems may exist for which the person is content and has no unmet
needs and does not wish to make any changes.
what I am saying is the above numbers tell me nothing about the person
with the numbers and this is critical in answering your question! We
learned in the Baltimore Myopia study in the late 1940's that we cannot
make anyone better. We only provide the patient with the means whereby
they can help themselves. I do nothing to a person. The machines and
the procedures of VT by themselves are only tools to facilitate a
person with needs and wants to make changes.
Two articles in a recent (within the past year) Journal of Behavioral
Optometry were written by OD's are their personal stories of myopia and
myopia control. One woman went through a long term 8-10 years worth,
of work, (mostly on her own with infrequent periodic visits to OD's)
and made a 5 diopter shift. The man made about a 4 diopter shift.
Usually I have been able to help highly motivated individuals to reduce
2 diopters of myopia and keep it off. Now I can hear Granett and
others asking about wet and dry refractions and that maybe they were
just over minused, etc..... I can tell you that done any way they were
what I measured and they made long term changes which held as a result
of VT.
Myopia is so multifactorial that we all have had patients who, in spite
of providing them the opportunity to change for the better continue to
get worse also. This is not the norm, but I want to let people know
that this is not 100% a guarantee of anything.
Other factors include nutrition, amount of close work, attitude brought
to the workplace and the close work done, ergonimics, etc.....
>Is there any likelyhood of him improving his unaided vision
>to, say 20/40? If so, how long would this process be likely to take?
>Would we be talking months, or decades?
I hope that the above answers this. I'll be glad to comment further if
you would like.
Paul Harris, O.D., F.C.O.V.D., F.A.C.B.O.
Director, Baltimore Academy for Behavioral Optometry
Dennis Yelle
[...]
>I would agree with the statement when limited discussion to the group
>of progressive myopes who start between second and fourth grade, who
>progress until age 16-19 and who are the goal oriented successful
>students who do lots of concentrated close work.
>
>The statement I would make about this group of people only (also
>assuming normal to good nutrition because these factors can act as
>modifiers of the amount of change.) is:
>
>Most myopia greater than -3.00 is a secondary iatrogenic illness caused
>by overzealous prescribing of minus lenses at distance which are
>misused for near. Meaning: if there were no such thing as glasses at
>all, these people should not get more nearsighted than -3.00.
>
>I welcome dialogue on this, unless this has already been talked to
>death.
>
>Paul Harris, O.D., F.C.O.V.D., F.A.C.B.O.
>Director, Baltimore Academy for Behavioral Optometry
Dr. Harris,
You seem to be one of the few doctors who post here that
believe in vision therapy.
Please give us your comments on the likely success of a male
who started wearing glasses at age 11 and is now 44 and has
a current 20/20 Rx of:
-6.25
-3.75
add +1.25
Is there any likelyhood of him improving his unaided vision
to, say 20/40? If so, how long would this process be likely to take?
Would we be talking months, or decades?
Dennis
Dennis Yelle
>In <dennisDJ...@netcom.com> den...@netcom.com (Dennis Yelle)
>writes:
>>who started wearing glasses at age 11 and is now 44 and has
>>a current 20/20 Rx of:
>> -6.25
>> -3.75
>>add +1.25
>>
>
>between a "Visual Problem" and a "data problem".
[...]
>Two articles in a recent (within the past year) Journal of Behavioral
>Optometry were written by OD's are their personal stories of myopia and
>myopia control. One woman went through a long term 8-10 years worth,
>of work, (mostly on her own with infrequent periodic visits to OD's)
>and made a 5 diopter shift. The man made about a 4 diopter shift.
Did these people get to 20/40 or better?
>Usually I have been able to help highly motivated individuals to reduce
>2 diopters of myopia and keep it off.
[...]
>>Is there any likelyhood of him improving his unaided vision
>>to, say 20/40? If so, how long would this process be likely to take?
>>Would we be talking months, or decades?
>
>I hope that the above answers this. I'll be glad to comment further if
>you would like.
>
>Paul Harris, O.D., F.C.O.V.D., F.A.C.B.O.
>Director, Baltimore Academy for Behavioral Optometry
My understanding of what you wrote above (including the part I removed)
is that what I asked for is unlikely to happen, and if it did
happen, it is unlikely to happen in less than 8 years.
If I misunderstood, please correct me.
Thanks for the honest answer, even if is is somewhat
discouraging. It is less discouraging then the answer most
doctors give. Yes, if you have other comments to make about this,
I would like to see them.
Paul Harris
snip snip
>[...]
>
>>Two articles in a recent (within the past year) Journal of Behavioral
>>Optometry were written by OD's are their personal stories of myopia
and
>>myopia control. One woman went through a long term 8-10 years worth,
>>of work, (mostly on her own with infrequent periodic visits to OD's)
>>and made a 5 diopter shift. The man made about a 4 diopter shift.
>
>Did these people get to 20/40 or better?
>
I believe that the woman in the article did but not the man. A part me
is wondering what the 20/40 number has that is so magical???? I have
some patients that function for "most" things with 20/70 or 20/100 just
fine (not driving) and others with 20/25 who will not take a step in
their house without putting on their lenses. This benchmark number
does not tell the whole story of how one can use the light from the
environment and this is the key to me and to my patients.
>>Usually I have been able to help highly motivated individuals to
reduce
>>2 diopters of myopia and keep it off.
>
>[...]
>
>>>Is there any likelyhood of him improving his unaided vision
>>>to, say 20/40? If so, how long would this process be likely to
take?
>>>Would we be talking months, or decades?
>>
>My understanding of what you wrote above (including the part I
>removed)
>is that what I asked for is unlikely to happen, and if it did
>happen, it is unlikely to happen in less than 8 years.
>
>If I misunderstood, please correct me.
>
You do not misunderstand.
>Thanks for the honest answer, even if is is somewhat
>discouraging. It is less discouraging then the answer most
>doctors give. Yes, if you have other comments to make about this,
>I would like to see them.
>
I am sorry. I never what to discourage but at the same time I feel
strongly that a sprinkling of reality is important. There is always a
difference between possible and probable. What you want is possible.
Dennis Yelle
[...]
>>
>>>Two articles in a recent (within the past year) Journal of Behavioral
>>>Optometry were written by OD's are their personal stories of myopia
>and
>>>myopia control. One woman went through a long term 8-10 years worth,
>>>of work, (mostly on her own with infrequent periodic visits to OD's)
>>>and made a 5 diopter shift. The man made about a 4 diopter shift.
>>
>>Did these people get to 20/40 or better?
>>
>
>I believe that the woman in the article did but not the man. A part me
>is wondering what the 20/40 number has that is so magical???? I have
>some patients that function for "most" things with 20/70 or 20/100 just
>fine (not driving) and others with 20/25 who will not take a step in
>their house without putting on their lenses. This benchmark number
>does not tell the whole story of how one can use the light from the
>environment and this is the key to me and to my patients.
Yes, it is the driving number.
Also, I know what 20/40 is like, I got a pair of 20/40
glasses a while back, they are my 20/20 glasses now and
I wear a pair that is .50 R .25 L weaker when I leave
my home now. If I ever convince myself that I am 20/25 with
them all day long, I will ask for a weaker pair.
I am sometimes 20/25 with them when I get up in the morning,
but it doesn't last.
If I could see well enough to
drive legally, I would not wear minus lenses for anything.
In fact, I remember many years ago a friend of mine who kept a
pair of glasses in his car and only put them on when he was driving.
I thought it was odd, at the time, and didn't think to ask him what
his Rx was, or how well he could see without them. He was a
computer programmer, like I was.
[...]
>>Thanks for the honest answer, even if is is somewhat
>>discouraging. It is less discouraging then the answer most
>>doctors give. Yes, if you have other comments to make about this,
>>I would like to see them.
>>
>I am sorry. I never what to discourage but at the same time I feel
>strongly that a sprinkling of reality is important. There is always a
>difference between possible and probable. What you want is possible.
Yes, reality is important. Otherwise you get people
giving up after a few months because the progress is so slow.
William Stacy
(aeulenbe) writes:
>
>On sci.med.vision, In article <4a1sj0$g...@ixnews5.ix.netcom.com>,
>Paul Harris <ba...@ix.netcom.com> wrote:
>
>>Two articles in a recent (within the past year) Journal of Behavioral
>>Optometry were written by OD's are their personal stories of myopia
and
I think that the only way you'll ever convince us skeptics of these
things is to have one or two of us skeptics measure the subjects before
and after therapy. I hereby offer my services for such a validation at
no charge. The only catch is that the subjects would have to come to
the Sacramento, California area for validation by me.
Bill
Dennis Yelle
But Bill, if you measured a 4 diopter improvement yourself, you would
no longer be a skeptic, and the other skeptics wouldn't believe you.
Dennis "I bet it was her twin sister he saw 5 years ago" Yelle
aeulenbe
Paul Harris <ba...@ix.netcom.com> wrote:
>Two articles in a recent (within the past year) Journal of Behavioral
>Optometry were written by OD's are their personal stories of myopia and
>myopia control. One woman went through a long term 8-10 years worth,
>of work, (mostly on her own with infrequent periodic visits to OD's)
>and made a 5 diopter shift. The man made about a 4 diopter shift.
Just filling in the facts here...
I don't know which man Dr. Harris is talking about, but one woman,
Antonia Orfield (OD) wrote an article in the 1994 Journal of Behavioral
Optometry entitled "Seeing Space: Undergoing Brain re-programming to
Reduce Myopia" (pp. 123-131). It was not a five diopter
shift, but still significant. From the abstract:
* * *
:The author underwent myopia reduction from a spectacle prescription of
:-3.87 DS and -3.37 DS to -.50 DS and -.25 DS over a period of seven
:years. The essence of the program was passive adaptation to a series of
:weaker glasses and better vision in a reverse of the process of adaptation
:to stronger and stronger glasses and a more and more warped
:space world...
* * *
From the article:
* * *
:My training consisted of three phases.
:First Phase, 1975-1981: Lens reduction without any specific training
:techniques until I wore a -1.50 DS [diopters] and -1.25 DS spherical
:prescription. Prior to '75 I wore a -3.87 DS and -3.37 DS with a small
:amount of against the rule cylinder. That Rx was based on a cycloplegic
:refraction in 1973 that had already cut me from my old -4.25 DS with
:cylinder OU [both eyes] prescription.
:Second Phase, 1981-82: Office training with [Dr. Amiel] Francke [in
:Washington, DC] for two three-month blocks of two one-hour sessions per
:week, with one month free between, and two months of a home program
:after. This took me down to what I now wear for good distance vision
:(-.50 DS and -.25 DS in spin-case soft contact lenses). These lens
:powers were determined by retinoscopy, as well as the subjective
:refraction. When I left Washington, I was also wearing a +.25 DS pair of
:training spectacles over my contacts for walks, and getting excellent
:vision most days. During that year every lens cut was first practiced
:with plus spectacles cancelling out minus before I actually received new
:contacts. Even with no lensess at all, I was comforrtable at the beach
:that summer, seeing numbers on the sailboats, addresses on the houses
:across the street, white caps on the bay.
:Third Phase, 1983-89: Further Rx reduction with [Dr. James] Blumenthal
:[of the Illinois College of Optometry] in Chicago to a -.25 DS and a
:Plano, and then a struggle to hold my gains. For six months I wore
:nothing on either eye except to read. There followed a private tutorial
:with Blumenthal on myopia control during two years of pre-optometry
:classes and four years at ICO. My vision held up fairly well throug the
:first year and a half of optometry studies. Then there was some slippage
:in spite of our efforts, but now I am back to where I was when I left
:Washington. This phase involved no actual vision training, just lens control.
[...]
:Since I have learned to SEE SPACE, a -2.00 flipper reveals a visibly
:flat and warped distance view. A -3.50 DS or a -4.00 DS is a swimming
:blur, the way my father's glasses seemed to me when I was a child. It is
:hard to believe I spent years looking through them. How was it possible?
:By gradual, stealthy adaptation.
:How did I get out of them, then?
:By gradual de-adaptation.
* * *
--Alex
William Stacy
Stacy ) writes:
>>In <4a4eb6$o...@usenet.ucs.indiana.edu>
aeul...@ezinfo.ucs.indiana.edu
>>(aeulenbe) writes:
>>>
>>>Paul Harris <ba...@ix.netcom.com> wrote:
>>>
>>>>Two articles in a recent (within the past year) Journal of
Behavioral
>>>>Optometry were written by OD's are their personal stories of myopia
>>and
>>
>>I think that the only way you'll ever convince us skeptics of these
>>things is to have one or two of us skeptics measure the subjects
before
>>and after therapy. I hereby offer my services for such a validation
at
>>no charge. The only catch is that the subjects would have to come to
>>the Sacramento, California area for validation by me.
>>
>>Bill
>
>But Bill, if you measured a 4 diopter improvement yourself, you would
>no longer be a skeptic, and the other skeptics wouldn't believe you.
I would certainly document my pre and post therapy degrees of
skepticism, publicly on sci.med.vision. If I were transformed, believe
me, that *would* be news.
I don't think anyone will take me up on it. If it really worked, I
would think they'd clamor for the publicity.
How about if we make it financially attractive both ways?
Take a -4.00 myope and put him/her through therapy (no contacts, no
surgery) and the payoff according to the following schedule:
ENDING REFRACTION
0.00 or any + amount I pay $1,000 and become a total convert
-0.25 to -1.00 I pay $ 750 and become a convert
-1.25 to -2.00 I pay $ 500 and become somewhat converted
-2.25 to -3.00 I pay $ 250 and retain some skepticism
-3.25 to -3.50 We break even and remain skeptical
-3.75 or more The therapy provider pays me $1,000
and I rest my case once and for all
The therapy period would be 1 year maximum. I would want an immediate
$10,000 penalty, agreed to in advance, for any rigid contact lens wear,
surgical intervention, or blood glucose manipulation that occurs within
the 3 year period beginning 1 year before the start of therapy and
ending 1 year after the end of therapy, regardless of the outcome. The
discovery of such violation could occur any time within 7 years of the
end of therapy.
In the event of patient or therapist drop out, I receive $500 as a
default penalty, unless it is for good cause (medical emergency, death,
etc.), in which case the trial is terminated and nobody pays anything
(and we try again with someone else, if agreed to).
Any takers?
Bill
William Stacy
myopia:
Stefan Stefanov
Harris ) writes:
>Most myopia greater than -3.00 is a secondary iatrogenic illness caused
>by overzealous prescribing of minus lenses at distance which are
>misused for near. Meaning: if there were no such thing as glasses at
>all, these people should not get more nearsighted than -3.00.
>
>I welcome dialogue on this, unless this has already been talked to
>death.
>
>Paul Harris, O.D., F.C.O.V.D., F.A.C.B.O.
>Director, Baltimore Academy for Behavioral Optometry
Dr Harris,
I cannot help expressing my satisfaction that finally in this discussion
a professional has taken the side that many of us, the optometric
non-professionals support. The experience, intuition, and knowledge of
many short-sighted people I know favor this idea.
I want to join Dennis Yelle in asking you about the likelihood that, say,
a 5.0 D myope can improve his or her unaided vision through behavioral
methods to 20/40. And what would be a realistic time frame?
Best regards,
Stefan Stefanov
William Stacy
>>But Bill, if you measured a 4 diopter improvement yourself, you would
>>no longer be a skeptic, and the other skeptics wouldn't believe you.
>
And I offered the following 'bet', which got buried by some 'burybot'
out of Australia, which I'm reposting now:
>I would certainly document my pre and post therapy degrees of
>skepticism, publicly on sci.med.vision. If I were transformed,
believe
>me, that *would* be news.
>
>I don't think anyone will take me up on it. If it really worked, I
>would think they'd clamor for the publicity.
>
Dennis Yelle
>And I offered the following 'bet', which got buried by some 'burybot'
>out of Australia, which I'm reposting now:
[...]
>>The therapy period would be 1 year maximum. I would want an immediate
>>$10,000 penalty, agreed to in advance, for any rigid contact lens
>wear,
>>surgical intervention, or blood glucose manipulation that occurs within
>>the 3 year period beginning 1 year before the start of therapy and
>>ending 1 year after the end of therapy, regardless of the outcome. The
>>discovery of such violation could occur any time within 7 years of the
>>end of therapy.
Your "bet" is an interresting idea, but...
1. What is this "blood glucose manipulation"?
"Can I have a candy bar?"
"No, that would manipulate your blood glucose."
"Than I can't have any candy for 3 years?"
"Well, I suppose that if you didn't, then THAT would manipulate..."
2. I don't think anyone, who posts to this newsgroup, ever claimed
to be able to cure a -4.00 D patient in a single year.
3. I don't think anyone would want to live under this $10,000 cloud for
7 years. You have to understand that we don't really know you, and some
people would do crazy things if they thought they could get $10,000
for it, like manufacturing evidence, paying someone to lie, etc.
I am not suggesting that you, Bill Stacy, would ever do such a thing.
Only that there are some people in this country that would, and have.
And therefore, it would not be reasonable to accept such a condition.
Dennis
William Stacy
>(...)
>1. What is this "blood glucose manipulation"?
> "Can I have a candy bar?"
> "No, that would manipulate your blood glucose."
> "Than I can't have any candy for 3 years?"
> "Well, I suppose that if you didn't, then THAT would
manipulate..."
>
Well, in thinking out the possible cheating that could be used in such
a trial, blood glucose levels are one that came to mind, since we know
that high sugar level can induce myopia through lenticular swelling.
Your candy bar example would indeed be a violation, if for example, the
subject were diabetic and had a couple of Snicker Bars just before the
baseline evaluation. I was thinking more along the lines of
artificially jacking it up e.g. by I.V. loading...
>2. I don't think anyone, who posts to this newsgroup, ever claimed
> to be able to cure a -4.00 D patient in a single year.
>
OK, then how many years do you want this to go? Besides, I offered
money for even a partial cure.
>3. I don't think anyone would want to live under this $10,000 cloud
for
> 7 years. You have to understand that we don't really know you, and
some
> people would do crazy things if they thought they could get $10,000
> for it, like manufacturing evidence, paying someone to lie, etc.
Hey, Dennis, you and I both know that a lot of people would use any
method they could to get that $1,000 reward. I've got to have some
leverage against the riff-raff.
> I am not suggesting that you, Bill Stacy, would ever do such a
thing.
Thank you for your obviously sincere trust, my friend.
> Only that there are some people in this country that would, and
have.
> And therefore, it would not be reasonable to accept such a
condition.
>
I'd only bet with the ones that would submit to that penalty for fraud.
Dennis Yelle
>In <dennisDJ...@netcom.com> den...@netcom.com (Dennis Yelle)
>writes:
>
>> people would do crazy things if they thought they could get $10,000
>> for it, like manufacturing evidence, paying someone to lie, etc.
>thing.
>have.
>> And therefore, it would not be reasonable to accept such a
>condition.
>
>fraud on my part. Obviously such fraud would have to be proven in a
>court of law to be enforced. 'Beyond reasonable doubt' would be good
>enough for me.
>
>Bill
The 'Beyond reasonable doubt' standard is only used for criminal trials.
What you are talking about is a civil case where the standard
is just 'preponderance of the evidence' which some judges say means
'51% chance that you are right'. What scares me about this is that
it seems that if only one side is willing to hire expensive lawyers and
cheat and lie, they have the advantage.
William Stacy
Alex Eulenberg
Stefan Stefanov brought up the idea that if the environmental hypothesis
of myopia is true, then uncorrected myopes should rarely progress beyond
3 diopters, since only 3 diopters of accommodation is neccessary for
most close work (reading). I had said that one researcher, O.D.
Rassmusen, who had done extensive work in China, had supported this
contention. Actually what he found was that 3 diopters of myopia was
the universal _average_ for mature myopia, that the vast majority of
uncorrected myopes fall within a diopter of this average.
And now, some excerpts from his book, /Myopia Control/, Tonbridge, Kent:
Crystalgate (1956).
From the preface:
:[The author's] researches and clinic experience [in China] with large
:numbers of patients, sixty-five per cent of whom were myopic, produced
:evidence on a scale previously unequalled. It included all types, from
:artisans and farmers to the more sheltered and wealthy classes --
:magistrates, civil and military officials. The author was commanded, in
:fact, almost abducted, to refract the former Emperor, sometimes known as
:Pu Yi, the 'Boy Emperor'.
[...]
:All myopia was found to be progressive under the orthodox full
:corrections; or full neutralisation where corneal scar tissue
:interfered; and most uncorrected myopia was close to three diopters.
[...]
:The myopic factors in this work are not assembled from one national
:group or system only. They are drawn from many sources and from actual
:personal contacts with forty or fifty nationalities in international
:communities, including all types and classes. It was in these now almost
:vanished 'laboratories' that the author and a colleague investigated the
:question of orthodox practices, or what are regarded as such.
pp. 14-15 (from the introduction):
:The greatest number of uncorrected myopes obtaining first-time
:prescriptions in various parts of the world is in the range 2.D. to
:4.D., an actual average of about 3.D. Most of these are in countries
:where state-aided clinics do not exist. Out of 120,000 in general
:practice refractions in China (including small percentages of second-
:and third- time cases) 83 per cent. were under 4.D.; while in a separate
:inquiry, ten years previously in the same country by medical
:refractionists, dealing with a mixed nationality group, there were 84
:per cent. under 4.D. Natives only under the same inquiry revealed 78.7
:per cent. under 6.D., and 63 per cent. under 4.D.
:This proximity of majorities to 3.D. in the uncorrected leads naturally
:to the assumption, without other evidence, that the problem is connected
:with the close-visual holding-viewing distance -- 13 to 15 cm, where the
:energy involved is about 3.D. of convergence and accommodation.
[...]
p. 49 (from the chapter "The 'Heredity Principle'"):
:The majority of the world's myopes -- largely uncorrected cases in
:countries where ophthalmic services have been difficult to obtain --
:possess identical errors. Over 80 per cent. of them manifest about three
:diopters in both eyes.... [M]illions of racially segregated groups in
:different races and civilizations -- Chinese, Japanese, Russian, French,
:Indians, Slavs -- Aryans and non-Aryans -- could all wear a pair of
:spectacles glazed with O.U. -3.00 -0.50 x 180 lenses.
I'm not sure what this all PROVES, but in any case, it's food for
thought and discussion.
As for Rasmussen, never in his book does he compare these figures with
the figures for myopia among predominantly fully-corrected populations.
He just implies that for such groups, the proportion of higher myopia is
significantly greater. In any case, Ramsussen argues that to prevent
myopia, both accommodation and convergence (because of its indirect
influence on accommodation) must be carefully controlled. His
conclusions are guardedly optimistic. He seems to think there is hope
only in very precisely prescribed reading glasses with prisms for the
incipient myope.
--Alex
Stefan Stefanov
[...]
>Also, I know what 20/40 is like, I got a pair of 20/40
>glasses a while back, they are my 20/20 glasses now [...]
Dennis,
Will you, please, define *a while back*?
Thank you.
Stefan Stefanov
David B. Granet
aeul...@ezinfo.ucs.indiana.edu (Alex Eulenberg) wrote:
> And now, some excerpts from his book, /Myopia Control/, Tonbridge, Kent:
> Crystalgate (1956).
>
Now please can someone remind me, was this before or after Sputnick and
the discovery of DNA ?
David
==========================
David B. Granet, M.D.
Director
Pediatric Ophthalmology & Ocular Motility Services
University of California, San Diego
*Keeping an Eye on Our Future ;-) *
Raymond A. Chamberlin
>In <dennisDJ...@netcom.com> den...@netcom.com (Dennis Yelle)
>writes:
>
>>(...)
You have to understand that we don't really know you, and
>some
>> people would do crazy things if they thought they could get $10,000
>> for it, like manufacturing evidence, paying someone to lie, etc.
>
>method they could to get that $1,000 reward. I've got to have some
>leverage against the riff-raff.
>
>thing.
>
>
>have.
>> And therefore, it would not be reasonable to accept such a
>condition.
>>
Hey, for $100 I could design you an eyechart that would tell
whether an optometrist was honest or not. At that rate, you
could still make a profit.
Ray Chamberlin
William Stacy
<ra...@sirius.com> writes:
>Hey, for $100 I could design you an eyechart that would tell
>whether an optometrist was honest or not. At that rate, you
>could still make a profit.
OK, Ray, if there's a joke in there, clue me in. I hate it when I
don't 'get' jokes...
Bill