High Myopia cures by rest methods

Just wanted to let you know that I am not dead or handcuffed in prison
but was working on several interesting projects and could not post as
usual.

Now I have met another friend with -17 D of myopic prescription.

Although he had abandoned glasses three months earlier and started
self-treatment according to Dr. Bates books, when I first met him and
the cellular phone rang, he neared it at about 7 cm from his eyes to
see who was calling.

I resented about this and we started a few games with the Snellen
chart.

The day after, after having worked for several hours continuously with
such a chart, the boy went home in Naples after having read 7/10 at 10
feet, under electric light.

Of course the vision was not continuous, but the feat was great for
him.

Then I have to report that my friend who is under self-treatment curing
her -23 D myopic prescription has had her first TRUE flash of PERFECT
SIGHT which lasted more than three seconds.

She was able to see license plates numbers at 15 meters, but since she
could see neatly the embossing of the letters, her vision was much more
than that.

How you learned men explain this without having to allow the eye to
return back in its normal shape by means of external muscles, I do not
know.

Intersting article for you:

I thought you might be interested in this article from eMedicine. You
may either click on the following link or copy and paste it into your
browser.http://www.emedicine.com/oph/topic723.htmeMedicine is the
leading provider of clinical medical information for medical
professionals and consumers. To explore eMedicine today visit
http://www.emedicine.com

 

Oh, God. It's back.

Same deal. I'm out. Though it may pain me, and test my resolve, I
shan't engage this troll.

Please join me in this effort. Please allow Rishi's (and Otis's)
words to echo in the cosmos, unanswered. Eventually, they /will/ go
away.

If /I/ can do it, . . . .

Neil

 

Dear Rishi,

Subject: Bates bucked the "system".

Good to hear you are still alive and
kicking.

The ODs on this site have determined
that they will make no comment on:

1. The dynamic behavior of the
natural eye.

2. The results of any and
all experiments that prove
that the natural eye "adapts" to
a minus lens.

3. Any statement by anyone,
"Bates supporter" or
Raphaelson supporter
who proposes that a negative
refractive state can be prevented
by ANY METHOD.

Medicine tends to "work" by
default. You "complain" about
something -- and get a resultant
quick-fix.

I truly understand the "power"
of this method -- and the difficulty
of "bucking" this system -- but
sometimes it is worth the effort.

In any event -- post what you
like, and enjoy the various responses.

Best,

Otis

 

Wow it's the legendary Rishi. I remember reading some of your stuff.
You're insane. But I am too. Your link doesn't work, idiot. Anyways,
welcome back. It's a pleasure to meet you.

 

Dear Rishi and fellow "objectors",

There is a strong scientific base for "objecting" to the
traditional minus lens -- put is place 400 years ago
because it works "instantly".

I am certainly respectful of that fact.

But eqully, there is a small group of people, scientists,
optometrists, ophthalmologists, and laymen (and Bates)
who "object".

In this "objection" we should respect each other
and the true difficulties of prevention.

Those difficulties suggest that we should share information,
and work towards a better "solution" -- and not
fight with each other as we attempt to accomplish
this preventive work.

Best,

Otis

 

But why do you bother?

People is getting cures.

Now another friend with CONICAL CORNEA uncorrected even by 6 dioptres
of convex lens has having flashes of NORMAL SIGHT at three meters with
that eye, reading the 10 line at 10 feet on the black chart. The other
eye has 20/10 vision.

This guy is very much intelligent, and after a little bit of
awkwardness at beginning of treatment, he started seriously to exercise
his own imagination and got great progress.

DO you know what is a conical cornea?

To the other super-idiot from China (a great country with many young
children, it is normal that some of them are idiots) I must tell that
the link works very well.

Here is the abstract

Presbyopia: Cause and Treatment
Last Updated: February 21, 2005
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Synonyms and related keywords: vision loss, visual deficit

AUTHOR INFORMATION Section 1 of 10 Click here to go to the next
section in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

Author: Ronald Schachar, MD, PhD, President and CEO, Presby Corporation

Ronald Schachar, MD, PhD, is a member of the following medical
societies: American Academy of Ophthalmology, American Association for
the Advancement of Science, American Medical Association, American
Society of Contemporary Ophthalmology, Phi Beta Kappa, Sigma Xi, and
Texas Medical Association

Editor(s): Stephen D Plager, MD, FACS, Chief, Department of
Ophthalmology, Dominican Hospital; Assistant Clinical Professor,
Department of Ophthalmology, Stanford University Hospital; Donald S
Fong, MD, MPH, Assistant Clinical Professor of Ophthalmology, Director,
Clinical Trials Research, Department of Ophthalmology, Southern
California Permanente Medical Group; J James Rowsey, MD, Consulting
Staff, Department of Corneal and Refractive Surgery, St Luke's
Hospital; Lance L Brown, OD, MD, Ophthalmologist, Regional Eye Center,
Affiliated With Freeman Hospital and St John's Hospital, Joplin,
Missouri; and Hampton Roy, Sr, MD, Clinical Associate Professor,
Department of Ophthalmology, University of Arkansas for Medical
Sciences

Disclosure
INTRODUCTION Section 2 of 10 Click here to go to the previous
section in this topic Click here to go to the top of this page Click
here to go to the next section in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

The scleral expansion band procedure for the surgical reversal of
presbyopia (SRP) is a new technique. The scleral expansion band
procedure has been developed for SRP. The effects of the scleral
expansion band are based on a recently developed theory by Schachar
that states that the crystalline lens is under increased equatorial
zonular tension during accommodation. An understanding of demonstrable
clinical effects of the scleral expansion band procedure, based upon
Schachar's theory, requires a revision of historically held views
concerning the mechanism of accommodation.
HELMHOLTZ'S THEORY OF ACCOMMODATION Section 3 of 10 Click here to
go to the previous section in this topic Click here to go to the top of
this page Click here to go to the next section in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

According to Helmholtz, during accommodation, when the optical power is
greatest, the zonules are relaxed and the crystalline lens can shift.
The lens would not be stable while reading or examining close objects.
The instability of the crystalline lens during near vision did not seem
physically correct. When viewing through an optical system, the higher
the magnification, the more stable the system needs to be.

According to Helmholtz's hypothesis, since the equatorial diameter
increases with age (ie, since the crystalline lens equator is getting
closer to the ciliary muscle), the zonules should relax. As one ages,
the power of the crystalline lens should increase while viewing distant
objects in the accommodated state. One should become more myopic and
the crystalline lens should become unstable, but in fact, one becomes
slightly hyperopic and the crystalline lens remains stable. Helmholtz's
theory also is not consistent with the decrease in spherical aberration
that occurs during accommodation.

Helmholtz attributes the universal linear decrease in the amplitude of
accommodation with age to hardening of the crystalline lens. No tissue
in the body uniformly hardens in a linear fashion with age. During
cataract extraction, it commonly is observed that crystalline lenses
have different degrees of hardness and no uniform loss of water content
of the crystalline lens with age has been demonstrated. Even in those
cataracts that have a hard nucleus, the cortex is soft.
SCHACHAR'S THEORY OF ACCOMMODATION Section 4 of 10 Click here to
go to the previous section in this topic Click here to go to the top of
this page Click here to go to the next section in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

An outward equatorial displacement of the crystalline lens produces
central steepening. This counterintuitive phenomenon is demonstrated
readily by pulling on the equator of a biconvex air-filled Mylar
balloon and observing that the reflections from the center of the
balloon become smaller, or minify, (see Picture 2), and the reflections
from its periphery enlarge (see Picture 3).

The equatorial displacement of the crystalline lens occurs as a result
of increased tension on the equatorial zonules (see Picture 4),
produced by contraction of the anterior radial muscle fibers of the
ciliary muscle (see Picture 5, Picture 6). Since an active force is
involved in accommodation, the amount of force that the ciliary muscle
can apply is dependent on how much the ciliary muscle is stretched.

The crystalline lens is of ectodermal origin and continues to grow
throughout life. Except for the progressive myope, the dimensions of
the scleral shell do not change significantly after 13 years. The
distance between the ciliary muscle and the equator of the lens
decreases throughout life. Therefore, the effective force that the
ciliary muscle can apply to the lens equator is reduced in a linear
fashion with age. The amplitude of accommodation decreases linearly
with age resulting in presbyopia and is a consequence of normal lens
growth.

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Author Information
Introduction
Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation
Augmentation Of Accommodative Function
Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation
Methods For Treating Presbyopia
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Bibliography

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AUGMENTATION OF ACCOMMODATIVE FUNCTION Section 5 of 10 Click here
to go to the previous section in this topic Click here to go to the top
of this page Click here to go to the next section in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

Any procedure that increases the distance between the lens equator and
the ciliary muscle should reverse presbyopia. In the mid 1980s, scleral
expansion was performed based on these concepts by making multiple
incisions in the sclera over the ciliary muscle. The scleral incisions
produced accommodative amplitude increases of only +1.25 diopters (D)
in young presbyopes and the effect regressed. Fukuska independently
confirmed these observations and predictions.

In 1992, the first scleral expansion band procedure was performed using
a plastic polymethyl methacrylate (PMMA) circular band sutured to the
sclera (see Picture 6). The results were dramatic. Presbyopic patients
had as much as 10 D of accommodation. Since that time, the scleral
expansion band procedure has been modified and improved, so that now a
separate PMMA segment is placed in each of the 4 oblique quadrants of
the eye (see Picture 8, Picture 9).

To date, the worldwide experience with the scleral expansion band
procedure for the SRP involves more than 500 eyes with a range of
accommodative recovery of 1.3-7 D with a mean of 3.25 D. In general,
the response has been favorable with no change in distance refraction,
best-corrected visual acuity, or axial length. Common adverse effects
that resolve in 6-8 weeks include subconjunctival hemorrhage, transient
astigmatism, fluctuating near vision, and dry eyes.
COMPARISON OF THE HELMHOLTZ THEORY AND THE SCHACHAR THEORY Section
6 of 10 Click here to go to the previous section in this topic Click
here to go to the top of this page Click here to go to the next section
in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

The Schachar theory of accommodation has met considerable reaction and
discussion, especially from those subscribing to the Helmholtz theory.
Many past experiments have been published that are in disagreement with
Schachar's conclusions that the crystalline lens diameter increases
during accommodation. A careful examination of these experiments
reveals that a systematic error exists. Movement occurs between the
imaging device and the eye. Measurement of the thickness of the cornea
in the accommodated and unaccommodated states of these experiments
reveals a change in corneal thickness. Since corneal curvature and
corneal thickness do not change during accommodation, these experiments
are flawed and cannot be used to reveal the mechanism of accommodation.

The recent experiments by Glasser and Kaufman are similarly flawed.
Although they placed sutures in the cornea as a reference point,
neither the sutures, nor the corneal Purkinje images, subtract out of
the overlain accommodated and unaccommodated images, demonstrating that
eye movement occurred between the imaging device and the eye. They
stated that the small amount of eye movement observed in their
experiments cannot account for the changes in the crystalline lens size
and configuration during Edinger Westphal or pharmacologic stimulation;
however, they offer no controls to prove that this statement is true.

Interestingly, when they fixated the lateral rectus, so that eye
movement was reduced, they observed that the crystalline lens equator
moved toward the sclera, with anterior and posterior zonular
relaxation. They state that the movement of the crystalline lens
equator toward the temporal sclera is caused by lateral translation of
the crystalline lens. This is mechanically impossible. Since the
crystalline lens is denser than water and vitreous, when the anterior
and posterior zonules are relaxed, the crystalline lens equator can
only move toward the temporal sclera by an active generated force (eg,
by the pull of the equatorial zonules).

The importance of eye movement relative to the imaging device is
exemplified by MRI studies performed on accommodating patients by
Strenk et al. An MRI image of the patient's eye during accommodation
revealed that the eye is turned nasally and that a change in the
configuration of the orbital bones occurred. Therefore, both the head
and eye moved during accommodation.

Measurement of the transverse diameter of the globe, the corneal
diameter, and the equatorial diameter of the crystalline lens in the
unaccommodated and accommodated states, demonstrate that all these
measurements decrease during accommodation. This means that the image
plane of the eye in the unaccommodated and accommodated states was not
the same. Their observations are due to artifact, and any conclusion
that they make concerning the mechanism of accommodation from this MRI
study is not valid. For example, they conclude that the equatorial
diameter of the crystalline lens does not increase with age. Their
conclusion is contrary to actual histologic measurements.

Linear and nonlinear finite element mathematical analyses have been
performed on the human crystalline lens. Nonlinear finite element
analysis is used routinely to reliably predict reality. The
mathematical analysis demonstrates that only equatorial stretching of
the equator of the crystalline lens by the equatorial zonules can
produce the clinically observed increase in central optical power
accompanied by a decrease in spherical aberration.

Scanning electron microscopy has shown the following 3 types of
zonules: anterior, posterior, and equatorial. The equatorial zonules
act similar to a skeletal muscle tendon and are the components that
transduce the force of the ciliary muscle to change the focal power of
the crystalline lens. The anterior and posterior zonules are tense
during distance vision and relax during accommodation. The anterior and
posterior zonules act similar to the ligaments of skeletal joints and
are stabilizing components, predominately for distance vision.

Since only the anterior and posterior zonules can be visualized with a
slit lamp in vivo during accommodation, it is understandable how
incorrect deductions have been made. Investigators have demonstrated
that the crystalline lens is stable and gravity does not affect the
amplitude of accommodation. The equatorial zonules have a separate and
distinct insertion into the ciliary body. The crystalline lens remains
stable because the anterior zonules maintain the same position on the
anterior crystalline lens surface even though the crystalline lens
equator is enlarging with increasing age.

In vivo measurements of the position of the crystalline lens equator of
young human research subjects during pharmacologically controlled
accommodation using high-frequency, high-resolution anterior segment
ultrasound revealed that the crystalline lens moves toward the sclera
during accommodation. The mean movement was 6.8±1 mm/D. This amount of
equatorial movement during accommodation was consistent with the
prediction of the nonlinear finite element mode and demonstrated that
accommodation is a small displacement phenomenon (ie, <5% change occurs
in the equatorial diameter of the crystalline lens during
accommodation).

The small amount of equatorial crystalline lens movement explains the
problems and the systemic errors that have occurred during previous
experiments that try to determine the position of the crystalline lens
equator during accommodation. Eye movements are much larger than the
movement of the crystalline lens equator; therefore, proper controls
are essential to interpret any measurements.

Table 1. Comparison of the Helmholtz Theory and the Schachar Theory
Test Helmholtz Schachar Observation
Small displacement equatorial stretching of the biconvex deformable
lens Decrease in central optical power Large increases in central
optical power Large increases in central optical power
Effect of gravity on the amplitude of accommodation Yes No No
Effect of accommodation on spherical aberration Increase Decrease
Decrease
Change in refraction following presbyopia Myopic Hyperopic Hyperopic
Anterior disinsertion of the ciliary muscle Myopic Hyperopic
Hyperopic
Change in the circular muscle fibers following presbyopia Atrophy
Hypertrophy Hypertrophy
Change in the anterior radial muscle fibers following presbyopia
Little or no effect Atrophy

Atrophy
Theory has widespread and new applications No Yes

1. Profile of the ocean tides
2. Effect of a magnetic field on a magnetic fluid
3. The shape of normal spiral galaxies
The effect of tight 12-o'clock position cataract wound sutures on the
central curvature of the cornea The cornea flattens in the vertical
meridian (against the rule astigmatism) The cornea steepens in the
vertical meridian (with the rule astigmatism) The cornea steepens in
the vertical meridian (with the rule astigmatism)

For the first time, the theory has predicted methods to surgically
reverse presbyopia, to produce a single element variable focus lens
that can have rapid large optical power changes from small equatorial
displacement, and to treat and to prevent ocular hypertension and
primary open-angle glaucoma. The continued challenge will be to perform
properly controlled experiments and to see how this theory will provide
new tools and better methods for improving the visual performance of
patients.
HISTORICAL PERSPECTIVE OF THE THEORIES OF THE MECHANISM OF
ACCOMMODATION Section 7 of 10 Click here to go to the previous
section in this topic Click here to go to the top of this page Click
here to go to the next section in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

The healthy, young human (<40 y) or young primate eye can rapidly focus
on near and distant objects (ie, it can change focus or accommodate).
The mechanism by which the eye can accomplish this amazing task has
been speculated upon for centuries. Initially, it was suggested that
the eye was divinely created; therefore, it did not follow known
physical laws of optics.

In 1619, Scheiner, a Jesuit priest, proved that accommodation occurred
as a result of a change in the optical power of the eye and that the
eye obeyed the laws of optics. His experiment easily is duplicated and
consists of making 2 vertical pinholes in a card, which are separated
by less than the diameter of the pupil of the eye. The observer looks
through both holes simultaneously and focuses on a needle held
perpendicular to the plane of the holes. When focusing on the needle,
it will appear single; however, if the observer focuses on a more
distant or near object, the needle will appear doubled. This simple
elegant experiment demonstrates that the eye functions as an optical
system.

The explanation of Scheiner's experiment is demonstrated in Picture 10.
Consider a point source of light as the object. A convex lens converges
the rays of light to a point. By placing a card containing 2 holes
between the point source and the convex lens, only 2 rays are brought
to a focus. If the power of the convex lens is changed, then the 2 rays
are brought to a focus at a different distance. The point source
appears doubled at all other distances. If the card has 3 or 4 holes,
the point source will triple or quadruple.

Some of the most famous philosophers and scientists were interested in
how the eye accommodates. In 1611, Kepler and others thought the
crystalline lens moved forward and backward. In 1677, Descartes
suggested that the shape of the crystalline lens changed. In 1742, Lobe
postulated that the shape of the cornea changed. Sturm and Listing
believed that the eye elongated.

In 1801, Thomas Young, using ingenious experiments, provided evidence
that accommodation occurs as a result of changes in shape of the
crystalline lens. He had very prominent eyes. Without anesthesia (which
had not been discovered yet) he placed a caliper, that had rings
attached to each side, around his eye. With his eye rotated nasally, he
placed 1 ring on his cornea and the other ring over his macula. He
could see a circular entopic ring induced by the ring on his macula. As
he changed his point of focus, the entopic ring did not change size.
This proved that the eye does not elongate during accommodation.

Next, he calculated the amount the cornea would have to move forward to
account for his accommodative amplitude. Using candles and a front
surface mirror engraved with a scale, he did not observe any corneal
movement as he changed his point of focus. He further proved that the
radius of curvature of the cornea does not play a role in
accommodation. He attached a convex lens possessing the optical power
of the cornea to the bottom of an eyecup. He filled the eyecup with
saline and placed it over his cornea (the forerunner of contact
lenses). The saline in contact with the cornea eliminated the
refractive power of the cornea; yet, he was still able to fully
accommodate.

Young demonstrated that accommodation did not occur in aphakes. He
realized that accommodation had to result from a change in position or
shape of the crystalline lens. He was convinced that accommodation
could not occur because of forward or backward movement of the
crystalline lens. He calculated that the crystalline lens would have to
move 10 mm to account for his amplitude of accommodation. This would be
impossible.

Young observed that spherical aberration decreased during
accommodation. He concluded that accommodation occurs as a result of a
change in shape of the crystalline lens. Since the ciliary body had not
been discovered yet, he postulated that the change in shape of the
crystalline lens is induced by a muscular mechanism within the
crystalline lens.

In 1823, Purkinje noted the reflected images of a candle from the
anterior and posterior crystalline lens surfaces. In 1849, Langenbeck
was able to observe in a patient that the Purkinje image from the
anterior surface of the crystalline lens became smaller during
accommodation by using a candle and a magnifying glass. He correctly
concluded that the anterior surface of the crystalline lens becomes
more convex during accommodation. He proposed that the ciliary muscle,
which had been discovered independently by Bruecke and Bowman in 1847,
squeezes the crystalline lens.

In 1851, Cramer followed up on Langenbeck's observation and improved on
it by making a device that incorporated a telescope to allow accurate
observations of the Purkinje images during accommodation. He observed
that the anterior surface of the crystalline lens became more convex,
but the posterior surface did not change shape.

In 1855, Helmholtz improved on the Cramer device by placing crossed
glass plates between the patient's eye and the telescope, so that the
Purkinje images were doubled and could be measured more accurately. In
addition to observing that the anterior and posterior surfaces of the
crystalline lens became more convex, he noted that the lens became
thicker during accommodation. He hypothesized that the ciliary muscle
relaxes during accommodation allowing the lens to become more spherical
under the influence of its own elasticity. According to his hypothesis,
the equatorial diameter of the lens should decrease as it becomes more
spherical during accommodation. He postulated that presbyopia, the loss
of accommodation with age, occurred as a result of lens sclerosis (ie,
loss of elasticity of the lens with age).

In 1864, Donders studied the change of the amplitude of accommodation
with age. He found that the amplitude of accommodation declined in a
linear fashion with age. This decline occurs universally and
predictably. If patients are corrected properly for distance vision,
their age can be determined within 1.5 years by measuring their
amplitude of accommodation. Donders also observed that patients become
slightly hyperopic when they become presbyopic.

In 1901, Tscherning examined the curvature changes of the anterior
crystalline lens surface by observing the changes in the Purkinje
images when 4 lights are used as objects. He placed the lights so that
2 formed reflected images from the central anterior surface and 2
formed reflected images from the peripheral anterior surface of the
crystalline lens. He observed that the central images moved closer
together during accommodation, while the peripheral images moved
further apart. He concluded that the crystalline lens was becoming more
convex centrally but was becoming flatter in the periphery during
accommodation. This was consistent with Young's observation that the
spherical aberration of the eye decreases during accommodation.

Helmholtz's theory did not explain the peripheral flattening of the
crystalline lens without additional assumptions. For example, the iris
constricts during accommodation and it was imputed to produce the
peripheral flattening of the crystalline lens. However, von Graefe had
demonstrated accommodation in a patient with a total iridectomy.

Tscherning postulated that during accommodation the ciliary muscle
exerted tension on the crystalline lens, pressing the crystalline lens
against the anterior vitreous. The resistance of the vitreous
transmitted sufficient force to effect central bulging of the anterior
surface of the crystalline lens. His theory predicts that the central
thickness should decrease during accommodation. He did not accept
Helmholtz's measurements of increasing crystalline lens thickness with
accommodation. Tscherning thought that presbyopia was the result of
enlargement of the crystalline lens nucleus. All subsequent theories
Gullstrand (1911), Fincham (1937) used Helmholtz's hypothesis that the
zonules are relaxed during accommodation. Helmholtz's hypothesis and
subsequent modifications attribute presbyopia to sclerosis of the
crystalline lens stroma or capsule, atrophy of the ciliary muscle, or
stiffening of the ciliary muscle attachments.

Based on these theories for the mechanism of accommodation, the
amplitude of accommodation could be increased only by softening the
lens stroma and/or capsule, rejuvenating the ciliary muscle by somehow
reversing ciliary muscle atrophy, or reversing ciliary body fibrosis.
Since none of these methods are clinically possible there has been no
surgical therapy for increasing the amplitude of accommodation and
reversing the symptoms of presbyopia.
METHODS FOR TREATING PRESBYOPIA Section 8 of 10 Click here to go
to the previous section in this topic Click here to go to the top of
this page Click here to go to the next section in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

Presbyopia initially was treated with near vision optical aids using
magnifying lenses, reading glasses, and monocles. Patients were
constantly removing reading glasses and losing them because the reading
glasses interfere with vision at all other distances. Benjamin Franklin
fused the distance lens with the near reading lens to give us bifocals
that were later modified to trifocals. The problem with these reading
aids is that they only allow sharp near vision at a given distance and
the near visual field is limited by the lens. Patients must learn to
rotate their eyes downward when reading with bifocals instead of
rotating their head. It usually takes 2-3 weeks for patients to get
used to wearing bifocals. Trifocals can even be more of a problem for
many patients.

To avoid the problems of bifocals and trifocals, bifocal contact lenses
have been developed. The bifocal contact lenses generally have been
unsuccessful because the distance and near powers of the contact lens
must be crowded into an area that can barely cover the pupil. The
patient must learn how to shift the contact lens and to ignore the
distant or near image according to the visual task.

Multifocal glasses and multifocal contact lenses also are generally not
satisfactory. Multifocal lenses produce multiple images at various
focal points. Light reflected or emitted by an object must be dispersed
by the multifocal lens over all the focal points. Therefore, the
intensity at any given focal point will be reduced and the contrast
sensitivity diminished. To avoid prismatic effects, the visual field of
a multifocal lens is reduced. In addition, the patient must learn to
select the appropriate image.

The problems with bifocal and multifocal contact lenses forecast the
problems that have, and will continue to occur, with attempts at making
a bifocal or multifocal cornea using LASIK, or using intracorneal
lenses, or phakic intraocular lenses.

Monovision as a treatment for presbyopia generally is accepted by fewer
than 30% of the population. The loss of stereopsis and learning to
ignore a blurry image from one half of the binocular visual field
easily accounts for the patient's distress with monovision.

Summary

Treatments for presbyopia have not been very good because the
physiological mechanism of the crystalline lens has not been restored.
The Schachar theory of accommodation states the following:

1. Increased equatorial zonular tension occurs during accommodation.

2. Presbyopia is due to a decrease in the effective working distance of
the ciliary muscle as a result of normal crystalline lens growth.

Based on this theory the accommodative amplitude of presbyopes can be
increased.

Any technique that increases the effective working distance of the
ciliary muscle, the distance between the ciliary muscle and the
crystalline lens equator, increases the amplitude of accommodation
physiologically.
Table 2. Comparison of Methods for Treating Presbyopia



Focus at Multiple Near Distances


Full Clear Visual Field


Reversible


Large Range of Correction


Effect Regresses


Normal Stereopsis


Negative Cosmetic Implications


Physiological


Involves a Surgical Technique


Halos at Night


Potential for Serious Complications

Reading glasses


No


No


Yes


Yes


N/A


Yes


Yes


No


No


No


None

Bifocals glasses


No


No


Yes


Yes


N/A


Yes


Yes


No


No


No


None

Trifocals glasses


No


No


Yes


Yes


N/A


Yes


Yes


No


No


No


None

Monovision


No


No


Yes


Yes


N/A


No


No


No


No


No


None

Multifocals glasses


Yes


No


Yes


Yes


N/A


Yes


No


No


No


No


None

Bifocal contacts


No


No


Yes


Yes


N/A


Yes


No


No


No


No


Minimal

Multifocal contacts


Yes


No


Yes


Yes


N/A


Yes


No


No


No


No


Minimal

Intracorneal lenses


No


No


Yes


Yes


No


Yes


No


No


Yes


No


Significant

Intracorneal multifocal lenses


Yes


No


Yes


Yes


No


Yes


No


No


Yes


Yes


Significant

Phakic intraocular lenses


No


No


Yes


Yes


No


Yes


No


No


Yes


Yes


Significant

Phakic multifocal intraocular Lenses


Yes


No


Yes


Yes


No


Yes


No


No


Yes


Yes


Significant

LASIK produced bifocal cornea


No


No


No


Yes


No


Yes


No


No


Yes


Yes


Significant

LASIK produced multifocal cornea


Yes


No


No


Yes


No


Yes


No


No


Yes


Yes


Significant

Scleral incisions


Yes


Yes


Yes


No


Yes


Yes


No


Yes


Yes


No


Minimal

Scleral expansion band


Yes


Yes


Yes


Yes


No


Yes


No


Yes


Yes


No


Minimal
PICTURES Section 9 of 10 Click here to go to the previous section
in this topic Click here to go to the top of this page Click here to go
to the next section in this topic
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

Caption: Picture 1. Keratoconjunctivitis, Atopic
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Picture Type: Image
Caption: Picture 2. Reflection in the center of the balloon
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Picture Type: Image
Caption: Picture 3. Reflection in the periphery of the balloon
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Picture Type: Image
Caption: Picture 4. In the unaccommodated state, all the zonules are
under tension (a). According to the Schachar theory, in the
accommodated state, the equatorial zonules are under increased tension,
and the anterior and posterior zonules are relaxed (b).
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Picture Type: Image
Caption: Picture 5. Schema of the configuration of the eye in the
unaccommodated state.
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Picture Type: Image
Caption: Picture 6. Schema of the configuration of the ciliary body in
the accommodated state according to the Schachar theory.
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Picture Type: Image
Caption: Picture 7. Polymethyl methacrylate band
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Picture Type: Image
Caption: Picture 8. Incisions for placement of the polymethyl
methacrylate band
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Caption: Picture 9. Placement of the polymethyl methacrylate band
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Caption: Picture 10. Scheiner's experiment
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Picture Type: Graph
BIBLIOGRAPHY Section 10 of 10 Click here to go to the previous
section in this topic Click here to go to the top of this page
Author Information Introduction Helmholtz's Theory Of Accommodation
Schachar's Theory Of Accommodation Augmentation Of Accommodative
Function Comparison Of The Helmholtz Theory And The Schachar Theory
Historical Perspective Of The Theories Of The Mechanism Of
Accommodation Methods For Treating Presbyopia Pictures Bibliography

* Atchison DA: Accommodation and presbyopia. Ophthalmic Physiol Opt
1995 Jul; 15(4): 255-72[Medline].
* Bowman: Lectures on the Parts concerned in the Operations of the
Eye. London: 1849:62.
* Brown N: The shape of the lens equator. Exp Eye Res 1974 Dec;
19(6): 571-6[Medline].
* Brucke: Arch Anat Physiol wiss Med. 1846:370.
* Coulombre JL, Coulombre AJ: Lens development. IV. Size, shape,
and orientation. Invest Ophthalmol 1969 Jun; 8(3): 251-7[Medline].
* Cramer N: Lancet. Vol 1. 1851:529.
* Descartes R: Traite de l'homme. Paris: 1677.
* Donders FC: Accommodation and refraction of the eye. The New
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Ma: 2000.
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Seattle, WA; April 1999.
* Glasser A, Kaufman PL: The mechanism of accommodation in
primates. Ophthalmology 1999 May; 106(5): 863-72[Medline].
* Glasser A, Kaufman PL: Letter to the editor. Ophthalmology 2000;
107: 626.
* Gordon AR, Siegman MJ: Mechanical properties of smooth muscle. I.
Length-tension and force- velocity relations. Am J Physiol 1971 Nov;
221(5): 1243-9[Medline].
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Menschen. Leipzig 1911.
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aberration in the human eye: an attempt to interpret night myopia. J
Opt Soc Am 1947; 37: 730-1.
* Kepler: Dioprice. Augsburg: 1611.
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Foundations of Clinical Ophthalmology. Vol 1. Philadelphia: 1994.
* Koomen M, Tousey R, Scolnik R: The spherical aberration of the
eye. J Opt Soc Am 1949; 39: 370-6.
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Ophthalmology 2000 Apr; 107(4): 625-6[Medline].
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Artifact. In: Invest Ophthalmol Vis Sci. 2000; Available at
http://www.iovs.org[Full Text].
* Lim SJ, Kang SJ, Kim HB: Analysis of zonular-free zone and lens
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1853; 4: 498.
* Lobe: Dissertatio de ocula humano. Vol 119. 1742.
* Marshall J, Beaconsfield M, Rothery S: The anatomy and
development of the human lens and zonules. Trans Ophthalmol Soc U K
1982; 102 Pt 3: 423-40[Medline].
* Neider MW, Crawford K, Kaufman PL: In vivo videography of the
rhesus monkey accommodative apparatus. Age- related loss of ciliary
muscle response to central stimulation. Arch Ophthalmol 1990 Jan;
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* Purkinge: Beobachtungen u. Versuche z. Physiologie d. Sinne.
Prague 1823; 2: 128.
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5,503,165; 5,529,076; 5,722,952 . European and other patents pending.
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Presbyopia: Cause and Treatment excerpt

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Institutional Subscribers

 

Hallo Otis,
see you later

 

Why does the best scientific evidence to date suggest that a promising
treatment for myopia prevention in human to be overcorrection with minus
lenses-- the opposite of what you propose, plus lenses (which by the way
have been proven to NOT be effective)

indeed. a very small group. apparently non of which are actually involved
in vision research.

no-- Rishi is a wacko. just like you and Asainmale.

please post you "unscientific unmedical" drivel in alt.med.vision.improve
and not here!

 

so it bothers you that noone wants to engage you in irrational
conversation?
you are a sick pathetic old man. what other psychological problems do
you have-- do you have a fetish for young children?

 

Why such hysterical ad hominem arguments when someone is posting a different
view point then your own, are you unable to use reason to counter these
viewpoints with which you disagree ??

 

New in town, huh?

 

And by that he means that you are unaware that the ridiculous notion put
forth by Otis has been carefully, scientifically, factually debunked
countless times during the two and half years the zealot has been
posting his trash (sometime daily!) It's not that we disagree, it's
that his theory is completely wrong and easily proven so. And,
conversely, he cannot prove his contention at all.

This discussion group is under the heading: sci. and med (science and
medicine) and as such we participate in science-based discussion. "The
Plus" is not science, is proven false and does not belong in this
newsgroup.

Enough said.

Welcome to SCI.MED.Vision. Feel free to participate under that charter.

LB, O.D.

 

like the others have already mentioned, otis has been engaged in
conversation over and over again for 21/2 years. we know all his
arguments (which relate to chickens) and we have given him the
references and links to the human studies. he refuses to discuss
relevant valid scientific data, he just reposts over and over again his
theory about plus lenses curing myopia.

you've just walked into the middle (really the end) of a long dialogue
where everyone is sick and tired of dealing with this troll.

feel free to post anything here that you want that relates to science,
or medicine, or vision, or vision research. the posters here like and
tolerate rational people with various questions and opinions very well.
and then there are "other" people like otis (and rishi, and asianmale)
that have deeper psychological issues.

 

Dear Michael,

It is obvious that they lack logical, scientific arguements
to support their "position" that the natural eye is
"dynamic".

A rational person can accept the premise -- an argue it
out by objective scientific testing.

A person protecting at "standard position" simply can
not do it -- and so must resort to "ad hominem" attacks.

Prevention is indeed difficult -- but possible. But to
deny it because the use of the minus lens is
so easy -- is hardly the basic for a scientific argument.

Best,

Otis