Syllabus for Nearsightedness Prevention for Pilots

Discussion in 'Optometry Archives' started by Otis Brown, Jan 27, 2004.

  1. Otis Brown

    Otis Brown Guest

    Dear Friends,

    Apparently we will get no assistance from
    retired optometrist who would get sued if
    they offered to help us with prevention.

    Here is a suggested study, where the
    pilots have no choice but to do it
    themselves. Maybe there is no other way.





    "He who can take advice is sometimes superior to him who can
    give it."

    Karel von Knebel

    Subject: Proto-type Syllabus for Nearsightedness Prevention at a
    four-year aeronautical college.


    1. One Hour Introductory Statement for the Entering Student Body
    about the general concept of prevention.

    2. All pilots accepted into this program must have previously had
    20/20 (in high school). All will have had a medical
    examination of their retinas. The only issue will be a
    slight negative refractive status.

    3. The publish statistics concerning the U. S. Naval Academy
    will be completely reviewed.

    If the pilot is interested in this study, he should identify
    himself to us. His vision must be such so that he can function
    with out wearing a minus lens. (Pilots with refractive states
    from zero to +1/2 diopters would be encouraged to review the
    concept for possibly joining the study in the Sophomore year.

    Method of measurement would be taught using a Snellen chart
    and a simple trial-lens kit. The measurements made by the pilots
    would be confirmed by the volunteer optometrist.

    A team of two pilots would exchange places if a phoropter
    (trial-lens) measurement is made.

    Nothing further would be done in the freshman year. The
    pilot should think very carefully about his visual future to
    determine if he wishes to enter into the SCIENTIFC part of the

    During this year they would be taught scientific concepts
    (The Structure of Scientific Revolutions - Kuhn) as part of the
    under-pinning for this study.

    They would also be taught control-system concepts as they
    apply to the dynamic behavior of the fundamental eye.


    Having review all information appropriate to the study, he
    would be part of a team of 100 pilots who would intelligently use
    the plus lens for the next six months.

    The group all measure their focal status (see original
    measurement in the freshman year). By now they would be
    experienced with this process.

    The would be randomly divide themselves into two groups.

    Both groups would continue to measure their focal status at
    periodic intervals.

    The group using the plus lens would be given precise
    instructions about the proper use of the plus.

    The other group would simply record their average

    The statistics of this type of work would be accepted by the
    group of 100 pilots. We would be looking for a difference in
    refractive status of greater-than 0.25 diopters to develop
    between these two groups.

    At the end of six months final measurements by the pilots
    will be made, and the results will be discussed.

    If the refractive status of the test group and the control
    group is identical, i.e., both groups go "down" by 0.2 diopters,
    then the study will be terminated, and the pilots thanked for
    their scientific effort.

    If a difference of greater-than 0.25 diopters is achieved,
    then the effort will be continued. This judgment will exclusively
    be made by the pilots themselves.

    If these results are excellent, then the pilots in the
    program will recommended that the next group of incoming freshman
    pilots be offered the same opportunity to go through this
    educational process -- for their own personal visual welfare.

    A wine-and-cheese reception will be held for the volunteer and
    altruistic optometrist who has been helping us with this preventive


    The individual pilots can elect to continue with the
    preventive process if they judge that it is effective in helping
    them maintain 20/20 through their remaining two years at


    The results of this study will be written up by the
    pilot-engineers and submitted to the IEEE/EMBS for potential
    publication as a scientific study of the eye's dynamic behavior as
    a sophisticated control-system.

    The results will be publish whether the results are positive
    or negative.

    A special award will be provided to the volunteer optometrist
    for his devotion and altruistic spirit for assisting with this
    engineering-scientific project.


    I think the reason why previous attempts at large scale nearsightedness
    prevention studies have failed is described by Mr. Garrett
    Hardin. What do you think? There is no vested interest
    in running this type of scientific study. Just my opinion.


    Those who make science or mathematics their career must learn
    not only facts and theories but also methods of solving problems.
    Those who make political affairs their business must acquire
    another sort of ability: How to NOT solve problems.

    When a dispute shows signs of approaching resolution, a
    participant who fears being on the losing side shows great
    ingenuity in getting the issue off the track. A motion is offered
    to refer the issue back to committee, or to table the issue. Such
    a motion has the appearance of preserving the question for more
    study with a view to eventual solution, but the appearance is
    often a fiction. "Refer back to committee," like as not, means to
    kill the measure; but it sounds nicer.

    This world of contentious human beings needs a large
    repertoire of techniques FOR NOT SOLVING ISSUES (while giving the
    appearance of trying to do so).
    Otis Brown, Jan 27, 2004
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  2. (Otis Brown) wrote in
    Without review and consent forms approved by an Institutional Review Board
    for Human Subjects that follows the terms of the Helsinki declaration, you
    won't be able to publish in an IEEE/EMBS journal.

    Scott Seidman, Jan 27, 2004
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  3. Otis Brown

    Dr Judy Guest

    Or maybe no retired optometrists from Florida read this newsgroup. Did you
    approach any directly? Did you approach School of Optometry in Florida to
    see if a masters student might be interested in helping?

    The study you propose is similar to the one you proposed a few months ago.
    Scott and I provided suggestions to improve the design to make it acceptable
    to qualify as science and you have not addressed the problems eg not single,
    let alone double blind control, non cycloplegic refraction check.

    I remember Scott suggesting that the study might qualify for funding if
    properly designed. I think you need to approach a researcher for assistance
    in design and funding, if you are serious about doing this study.

    Dr Judy
    Dr Judy, Jan 27, 2004
  4. Otis Brown

    Otis Brown Guest

    Excellent suggestion. I will look into it!
    As I suggest we distinguish between "medicine" and "science".

    Science is accurage measurement. I believe these
    engineers can make accurate measurements of
    the refractive state of their normal eyes.
    That subject will be part of the syllabus.

    .... and you have not addressed the problems eg not single,
    Another issue to be discussed. This would be
    an engineering study -- not dictated by medicine.
    Needs to be evaluated by the pilots themselves.

    I would never ask for funding to do this. We either do this
    as friends, for free, or we do not do it at all.

    I think you need to approach a researcher for assistance
    If you mean that some OD or MD is going to take over
    and RUN the study -- then that is not what
    I asked for. We must find a better way, but
    thanks for your commentary.
    Otis Brown, Jan 27, 2004
  5. Otis Brown

    Dr. Leukoma Guest

    (Otis Brown) wrote in

    IF you truly believe this, then you must agree that optometry is
    scientific, as it is about proper measurement of the eye and its refractive

    Dr. Leukoma, Jan 28, 2004
  6. Otis Brown

    Otis Brown Guest

    (Otis Brown) wrote in message
    Dear Judy,

    Now that I think about it, your post would be an
    excellent "agenda" item.

    The issue would be how much the pilots themselves
    would wish to be in "control" and how much
    they wish to transfer control to you.

    I believe that an intelligent, motivated
    person should make his own measurements -- otherwise
    he simply will not believe the results.

    When flying an airplane with an instructor you let him
    fly the airplane -- initially.

    But normally there is a moment where he says, "you got it".

    This is to prevent BOTH of you attempting to CONTROL
    the airplane at the same time.

    The issue is how and when is control transferred
    to them.


    Otis Brown, Jan 28, 2004
  7. (Otis Brown) wrote in
    Scientifically, you make the measurement as accurately as you can. You
    don't care whether the subject believes the results or not. Ideally, the
    subject shouldn't even know the result.

    Scott Seidman, Jan 28, 2004
  8. Otis Brown

    Otis Brown Guest

    Dear Dr Leukoma,

    Yes, a well trained engineer can make as accurate
    a measurement as an OD or MD of the
    refrfactive state of the natural eye.

    More important is to have the pilot repeat the
    measurement at periodic intervals (like once
    a day).

    It does not take an optometrist for you to look
    at your own eye chart and record the result.

    Nor does is it necessary to have an OD involved
    if the trained pilot uses a trial-lens kit and
    establishes the refractive status of his eyes
    (when they are at 20/20).

    It just takes the traing to do so.


    Otis Brown, Jan 28, 2004
  9. Otis Brown

    Dr Judy Guest

    I don't think you understand what is meant by "control" in a science
    experiment. It is not about who controls the experiment.

    In any research involving a living organisms, there is natural variation
    between the subjects. Molecular biologists have lately been surprised at
    the amount of variation there can be in the amino acid sequences of proteins
    and the genetic material that codes them from one individual to another, yet
    the proteins appear the same and seem to work the same. For example,
    hemoglobin in humans has hundreds of subtle differences from person to

    In an experiment to test if a procedure or therapy works, you need to use it
    on one group of subjects and not use it on another group and study the
    difference. You need to ensure that the groups are as similar as possible,
    so as to avoid having a preexisting difference influence the results. With
    human research, we also know that if either the experimentor or the
    subjects know which subjects are getting the therapy and which are not, it
    will influence the results.

    So we need to introduce "control" into the experiment to make sure the two
    groups are as similar as possible and to make sure that during the
    experiment, nobody knows who is getting the therapy and who is not. This
    "control" is part of the experimental design and does not depend on who is
    doing the measuring.

    The proven best way to control is to start with a relatively homogenous
    group of subjects then randomly assign them to the therapy group and the non
    therapy (called control) group. After random assignment, you should test
    the similarity of the groups with regard to known factors that may affect
    the results. The non therapy group must be given a sham therapy, so that
    they do not know they are in the non therapy group. The code that reveals
    which subject is in which group should be held by a person not directly
    involved in the experiment and should not be broken until after the

    If measurements are made a number of times during the experiment,
    measurement of results should be done in such a way that neither the
    experimentor nor the subject knows the trend of measurements. Measurements
    should be as objective as possible and things measured should have good
    reliablity and repeatablility.

    Your experimental design violates almost all of the above.

    Dr Judy
    Dr Judy, Jan 29, 2004
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