Request for a citation for your single-minus "down" rate.

Discussion in 'Optometry Archives' started by otisbrown, May 1, 2005.

  1. otisbrown

    otisbrown Guest

    To: Mike Tyner OD
    William Stacy

    Dear Mike,


    Re: What if there are at least two other
    experiments with equally
    careful design that point exactly opposite? Care to see
    citations? No? You've seen them before and you didn't pay
    any attention then. Mike Tyner.

    Otis> Yes, I want to see the citations. I will publish and
    discuss them with interested parties -- concerning
    the "down" rate of -1/2 dioper per year.

    Otis> Willaim Stacy stated that very few children
    show a "progression"
    of -1/2 diopter per year. Willaim, of
    those people you prescribe a
    minus lens to -- what do you estimate to be the AVERAGE
    "down" rate for the students wearing a minus lens,
    on the basis of your practice?

    Otis> 0.0 diopters per year? -1/10 diopter per year? -1/4
    diopter per year? -1/2 diopter per year?

    Stacy> I see that kind of progression in maybe 1% of my patients.
    And I'm talking MANY THOUSANDS OF PATIENTS.

    Stacy> Come on, Otis. YOUR NUMBERS ARE WRONG. Sorry. Do some
    real research, and stick to facts, preferably verifiable
    facts.

    Stacy> w. stacy, o.d.

    Otis> I posted the following "down" rate of:

    Minus vision lenses: - 1.23 D increase (2 years) Progressive
    lenses with +1.50 add: - 0.76 D increase (2 years)
    Progressive lenses with +2.00 add: - 0.66 D increase (2
    years)

    Otis> I have also reviewed the "down" rate of a number of these
    studies, and the single-minus "down" rate has been
    consistently between -4/10 diopters per year and -6/10
    dipoter per year.

    Otis> Yes, I would like to see citations for rates for
    single-minus wear that are significantly different thatn
    the above.

    Otis> Please ignore the "bifocal" part -- just stick with the
    single-minus group, and their published "down" rate.

    ++++++++++++++++++++++++++++++

    Mike> Excellent design. Hard to argue with. I'm convinced... no
    wait...

    Mike> What if there are at least two other experiments with
    equally careful design that point exactly opposite? What
    do we do then?

    Mike> Care to see citations? No? You've seen them before and you
    didn't pay any attention then.

    -MT

    Otis> Source: Leung JT, Brown B. Progression of myopia in Hong
    Kong Chinese schoolchildren is slowed by wearing
    progressive lenses. Optom Vis Sci 1999; 76:346, 354.
    Published 10/07/00.
     
    otisbrown, May 1, 2005
    #1
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  2. otisbrown

    Dr. Leukoma Guest

    My dear man,

    What indeed is the down-rate of myopia without minus lenses?

    DrG
     
    Dr. Leukoma, May 1, 2005
    #2
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  3. otisbrown

    otisbrown Guest

    Dear DrG,

    The post was made by William Stacy and Mike Tyner.

    I will review their response -- since only they can provide
    their answer.

    Best,

    Otis
     
    otisbrown, May 1, 2005
    #3
  4. otisbrown

    otisbrown Guest

    Dear Mike,

    Your statement was to the effect that you do not
    see "down" rates (average) of -1/2 diopter per year.

    You the demanded that I DOCUMENT this "down" rate
    in children who have been put into a minus lens.

    THAT IS THE ONLY ISSUE. Not prevention, not
    the plus -- just your "challenge" to produce
    scientific facts on that specific issue.
    for the single-minus group is:

    - 1.87 in 3 years, therefore the "down" rate in one year is:

    - 6.25 diopters per year -- confirming what I said about this rate.

    You put a child into a minus lens -- and his parents can
    expect the child's eyes to go down at a rate exceeding
    -1/2 diopter per year.

    But you said your experience with children in your
    office differs from these scientific studies.

    What is your estimate for the children in your office?

    0.0 diopters per year? -1/10 diopter per year?
    - 1/3 diopter per year? -1/2 diopter per year.

    Best,

    Otis

    _________________


    but in the left eye the change in the distant use group was
    significantly higher (-1.87 D)
     
    otisbrown, May 1, 2005
    #4
  5. otisbrown

    otisbrown Guest

    Correction:

    The calculated down rate from -1.87 diopters in 3 years
    would be

    - 0.635 diopters

    which simply verifies even more strongly
    the rate of -1/2 dipoter per year for
    children wearng the single-minus.

    To "O'Leary" study is not to be trusted
    for a number of reasons.

    Further, no single-minus value was published in
    what you provided.

    Best,

    Otis
     
    otisbrown, May 1, 2005
    #5
  6. otisbrown

    otisbrown Guest

    Dear Mike,

    cc: William Stacy

    You are right, it was William Stacy who insisted that
    the young eye with a minus lens on it does not go
    down at an average rate of -1/2 diopter per year.

    But William challenged this statement by insisting
    that it was not scientifically true,

    Stacy> Come on, Otis. YOUR NUMBERS ARE WRONG. Sorry. Do some
    real research, and stick to facts, preferably verifiable
    facts.

    Forcing me to post the "verifiable facts", i.e., the "down" rate
    of -1/2 diopter per year for kids when they begin wearing
    a single-minus lens. I believe I am "sticking to the facts"
    concerning this issue -- far more than Stacy.
    He insists that my "numbers are wrong", but then
    fails to post any other numbers concerninig this
    "down" rate in scientific studies. Office "judgments"
    do not "count" under these circumstances.

    Best,

    Otis

    __________


    Otis>> It is obvious that the situation is only preventable
    (potentially) -- given the -1/2 dioter per year for children
    wearing a single-minus, as shown in a number of
    published scientific studies.

    Stacy> ok so according to this if the kid starts at -1.00 at age
    6:

    Stacy> he'd be -2 at age 8

    Stacy> -3 at age 10

    Stacy> -4 at age 12

    Stacy> -5 at age 14

    Stacy> -6 at age 16

    Stacy> I see that kind of progression in maybe 1% of my patients.
    And I'm talking MANY THOUSANDS OF PATIENTS.

    Stacy> Come on, Otis. YOUR NUMBERS ARE WRONG. Sorry. Do some
    real research, and stick to facts, preferably verifiable
    facts.

    Stacy> w. stacy, o.d.
     
    otisbrown, May 1, 2005
    #6
  7. otisbrown

    A Lieberman Guest

    If you are sticking to the facts Otis, please provide facts from medical
    websites OUTSIDE your website. I bet you won't / can't.

    Is it because your facts are made up????????

    Allen
     
    A Lieberman, May 1, 2005
    #7
  8. otisbrown

    otisbrown Guest

    Dear Mike,

    You asked for formal studies demonstrating the average
    "down" rate of -1/2 diopter per year. This is not just
    one study -- that might be suspect -- but a very large
    number of studies, with substantial numbers of
    young children wearing the single minus.

    If you wish to tell the people on sci.med.vision
    that your "down" rate is
    -1/10 diopter per year -- then go ahead. Is that
    your rate?


    Best,

    Otis
     
    otisbrown, May 2, 2005
    #8
  9. otisbrown

    Dr. Leukoma Guest

    Otis, my man.

    Well, of course the "down rate" of myopia in myopic children is about
    0.50 diopters/year, but not every year, and not every child. This
    "down rate" is the same whether the child is wearing minus lenses or
    not wearing minus lenses.

    Prove it otherwise, or please go to bed.

    DrG
     
    Dr. Leukoma, May 2, 2005
    #9
  10. otisbrown

    otisbrown Guest

    Dear DrG,
    The information is that the entire
    group in the minus lens when
    down by -6/10 diopters over
    a period of three years.

    This is the AVERAGE of the group.

    If a parent thinks his child will
    avoid this "down" rate -- then
    that is fine. I would be deeply
    concerned with this statistic
    before I put my child into
    an over-prescribed minus.

    It is a fact to be presented
    to a parent -- that might be
    interested in assistance
    in working with the plus -- before
    a minus lens is used.

    I think any parent would be
    interested in the plus-alternative,
    even if he should reject it.

    Then when his child's vision
    goes down at that rate -- he
    will have no reason to complain
    about the expected result.

    This issue is indeed the concern
    of Steve Leung OD, and "avoiding"
    this -1/2 diopter per year is the
    reason he has his own children
    wearing a strong plus -- when
    their refractive status is zero.

    This is the reason for a
    true "second opinion".

    Going into nearsighedness with
    the minus is indeed a one-way street,
    as these statistics show.

    This is the major reason why I
    "pushed" my sister's kids into
    using the plus -- to avoid this
    -1/2 diopter per year effect
    of wearing a minus 16 hours
    a day.

    Best,

    Otis
     
    otisbrown, May 2, 2005
    #10
  11. otisbrown

    Dr. Leukoma Guest

    You still avoid the issue. The issue is proving that myopic children
    who wear minus progress at a faster rate than those who do not. I
    answered this question myself in clinical practice, and I can say with
    utter confidence that children who wear minus lenses do not become more
    myopic than those who wear no lens.

    I can also state with confidence born out of 20 years of clinical
    experience that children who wear bifocals do not become less myopic
    than those who wear single vision minus lenses.

    DrG
     
    Dr. Leukoma, May 2, 2005
    #11
  12. otisbrown

    otisbrown Guest

    Dear DrG,
    No, that is not the issue. The issue is whether the child
    understands the consequences (to him) of wearing an
    over-prescribed minus all the time.

    Mike Tyner said quite frankly that he can not be
    involved with prevention (for pilots) because he
    judged it was "illegal" if he gave that advice,
    or the pilot "though" it was medical, rather
    than scientific advice.

    Mike is totally candid on that point -- as I am.

    Since Mike can't do it -- then who can. It leaves
    the person (pilot) himself to figure out what HE is
    going to do about -- because Mike can not.

    I accept Mikes challenge -- with my sister' kids,
    and explained the visual requirements that had to
    pass -- and the consequences TO THEM, of
    neglecting:

    1. Reading their own eye-charts to verify their distant
    vision met "standard".

    2. The fact that if they did not do this -- some one
    would put them into a minus -- when there vision
    when below 20/40 -- there would be no choice
    at that point.

    3. The responsibility rested with them to learn more,
    understand more, and act effectively for their own
    personal protection and interest.

    They are now about 40, and have kept their
    distant vision -- while many of their friends
    are seriously nearsighed.

    Obviously no one in "optometry" could "prescribe" this
    type of consistent effort, and I explained to them
    that the scientific facts showed that the natural
    eye is dyanamic, and controls its refractive
    state to its average-visual enviroment.

    But this issue separates how you deal with the
    great mass of people walking in off-the-stree, who
    probably have no interest in protecting their distant
    vision -- versus and "educated" person who is
    truly aware of the science behind the natural
    of the natural eye's proven behavior.

    This issue was of concern to them -- and so they
    took the "high road" of reason, logic and science.

    But equally, I know that you could NEVER implement
    this type of solution -- except with your own chidren.

    And that does become a personal choice indeed.

    Best,

    Otis
     
    otisbrown, May 2, 2005
    #12
  13. otisbrown

    Dr. Leukoma Guest

    But what ARE the consequences of wearing a minus lens, Otis? Better
    vision? Certainly. More myopia compared to wearing nothing, compared
    to wearing a bifocal, compared to wearing pluls? Certainly not. Thus
    far, you are unable to prove that any of your interventions are
    effective, bluster, verbosity, and obfuscation notwithstanding.


    DrG
     
    Dr. Leukoma, May 2, 2005
    #13
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