Another reason why he's way off base?

Discussion in 'Optometry Archives' started by Neil Brooks, Feb 28, 2007.

  1. Neil Brooks

    Neil Brooks Guest

    Was thinking about this while quaffing my coffee this a.m. If you
    could get "Mr. All Data Ignored Since 1895" outta' the way, there
    really could be an interesting dialog around this subject, but....

    Instrument myopia and margin of error are two variables that,
    combined, clearly mean that some percentage of people deemed to have,
    say, 0.25 of myopia .... simply aren't myopes; they're emmetropic (or
    very slightly hyperopic), no? [you could certainly cycloplege, but
    that's not always indicated, I presume].

    It's highly likely, then, that--given NO refractive intervention--
    their refractive progression will simply follow the standard
    distribution (some shift myopic. Some shift hyperopic. Some don't
    shift). Especially with kids--a group that some could term "at the
    threshold," in whom instrument myopia--primarily with dry refractions--
    is a more significant factor. Haven't done the research, but would
    guess it could easily account for 1/2 a diopter or so, no?

    So ... if one were really confused ... really dishonest ... or some
    combination of the two ... then the group in whom that person could
    express the "greatest success rate" WOULD BE these young "incipient
    myopes," precisely BECAUSE they are statistically quite likely not to
    be myopes at all AND even a sizeable percentage OF these myopes remain
    stable OR shift hyperopic over time [USAF study, et al].

    Am I getting my point across, or is it muddled?

    Yet another rationale for NOT prescribing (there simply IS NO "over-
    prescribed minus") at very low levels of refractive error (absent
    binocular/accommodative dysfunction issues, etc.): in young mild
    hyperopes, accommodative reserve handily absorbs it; in young mild
    myopes, there's little to no functional impact, no evidence of
    significant lifestyle impact, and a statistical likelihood that they
    aren't myopic at all.

    Besides the whole "nothing's been seen to alter the normal
    progression, anyway" thing.....
    Neil Brooks, Feb 28, 2007
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