Hey, Elevator Boy! Couldn't help but notice...

Discussion in 'Optometry Archives' started by Neil Brooks, Mar 8, 2007.

  1. Neil Brooks

    Neil Brooks Guest

    I know how reluctant you are to engage in a true dialog, Otis. That's
    why you--like a little squirrel--take these little acorns and run away
    to another site where only you get to decide what's posted and what's

    As always, to help balance things out, I'll publish to a public forum
    and let others decide on the merits of your monologue.



    Dear Friends,

    Subject: "Catching" a negative refractive STATE at -1/2 to -1
    diopters. (20/40 to 20/60)

    Regards: After the "fact" type of arguments.

    Judy is a majority-opinion OD. Typically, she prescribes
    "Best Visual Acuity -- correction", i.e., put a minus that will
    create 20/20, 20/18 and even 20/15.

    This results in from -3/4 to -1.5 diopter "correction" on an
    eye that is good enough for most purposes. (i.e., read the board
    in school, etc.) For a child under 16 years, this is reasonable.

    ===I'm sorry, Uncle Otie, but ... how did you determine the strength
    of lens that Dr. Judy uses to achieve that Snellen result? Did she
    tell you, or are you just pulling these numbers out -- er ... excuse
    me -- making assumptions again?

    But my argument is that the "Parent-child" must "wake up", by
    monitoring the Snellen, and make a strong effort to clear with
    this plus -- AT THAT POINT.

    ===Do you have any evidence that this would result in outcomes that
    differ from untreated groups?? I mean ... your niece, Joy, did this,
    and she's now a myope with a restricted driver's license. Doesn't
    seem very effective. Also, YOU stated that you had helped, perhaps,
    TEN people. Based solely on the numbers that I AM aware have
    endeavored your method, it would seem that the TREATMENT group, with
    the plus, fares WORSE than the untreated group. Why, I wonder??

    If the parents "manage" their child, and the child clears to
    20/40 or better (as you did), then no minus is ever used, and no
    stair-case myopia ever develops.

    ===Ah, that brings up an interesting question. See question #4 in

    But Judy does not believe that is even POSSIBLE.

    ===And you haven't given her any evidence that it is. In fact, Joy's
    myopia seems to indicate it isn't.

    Here are Judy's arguments -- with Alex as the "presenter".

    Judy> I think you are misunderstanding his (Dr. Wallman's - OSB)
    comments about brain boosting high frequency amplification
    following distance blur. Whether wearing myopic correction,
    no correction or plus lenses at near, accommodation will be
    inaccurate and lag the stimulus so that hyperopic blur will
    be present in all situations.

    Alex> The only justification for full distance correction in the
    "alternative" theory would be to keep myopic children from
    getting good at seeing through blur

    Judy> Actually, I think the best justification is to provide good
    distance vision so that the children can function, myopia
    progression or prevention is secondary.

    [Comment: Well I guess that is it. Judy does not care what
    happens to the child's long-term vision.

    ===But if YOU cared, then why did you turn your niece into a myope?
    Why do you hate Joy so, Uncle Otie?

    The real issue is
    this --DO YOU CARE? While I agree that plus-prevention is
    difficult, it is far better to use the plus at the threshold
    -- keeping your distant vision clear for life

    ===got any evidence that it works? Your myopic niece seems like
    evidence that it doesn't.

    -- rather than
    being RUSHED into a strong minus

    ===What's a "strong minus," Uncle Otie (other than the ones that YOU
    wear), and what's your evidence that it's being prescribed

    as Judy deems as essential
    -- with no choice. I hate being patronized,

    ===Get used to it. With the idiocy that you exhibit on a constant
    basis, it's to be expected.

    and further
    hate a third party making a choice of this nature for me.
    The consequences are too serious -- and can not be reversed,
    except for the threshold.

    ===And even then ... apparently nothing can be done ... or perhaps
    you'd have provided some evidence that it could be done. Your myopic
    niece, Joy, would seem to be proof that it doesn't work ... or do you
    simply not CARE about her?

    ===Why do you hate your niece, Uncle Otie?

    Maybe you wish to through your
    child's visual future on Judy's mercy, but it seems that her
    "convenience" will produce permanent loss of naked-eye
    vision for the child that is started in the minus at an
    early age.

    ===I know a lot of people who'd trade all your bloviating and baseless
    scare tactics for even a SHRED of valid evidence ... that you have
    never come up with.

    As always I take this issue as a second-opinion
    choice. Take care you fully understand these two "paths".

    Judy> When a child can't see the board, can't see the spin of a
    baseball, can't recognize faces across the room, can't
    follow the puck in a hockey game, can't see the music when
    playing in band, can't see the cellular details in the
    overhead slides in biology class, can't see the Mona Lisa
    smile illusion in art class, can't see the stars at night,
    can't identify birds on a field trip, what solution can you

    ===This is where you say, "None," Uncle Otie. You haven't offered any
    solution that's shown to vary the outcomes from those of untreated
    emmetropes or myopes. Nada. Zip. Never.

    The issue is this. We induce a negative refractive STATE in
    our eyes by:

    1. Our own "bad habits", and the simple fact of 12 to 16 years in

    2. Our refractive STATE moves from "plus" to "minus" and we see
    some blur.

    3. Judy "jumps" on this slight blur in a "panic", and
    over-prescribes -- not understanding the natural eye as the
    sophisticated system -- that it has always been.

    4. The child continues with his bad habits, and further
    "adaptation" develops at -1/2 diopter per year. Worse, the
    child wears the -1.5 diopter ALL THE TIME -- because no one
    told him NOT TO DO SO.

    ===Let's just get back to basics here: do you have ANY EVIDENCE
    WHATSOEVER that either a minus lens accelerates myopic progression or
    that a plus lens slows or reverses it? If so, then why do you still
    have a myopic niece??

    ===Didn't you care about Joy, Uncle Otie?

    5. This preempts ANY POSSIBLE DISCUSSION of plus-prevention. It
    also kills plus-prevention when it could have been

    ===You, of course, mean ... in your dreams.
    ===Evidence, Dear Boy. It's more compelling than threats, scare
    tactics, obfuscation, evasion, and bloviating.
    ===Evidence. Look it up. There WILL be a test.
    Neil Brooks, Mar 8, 2007
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