The effect of a +2.0 diopter lens on refractive status of natural eye

Discussion in 'Eye-Care' started by otisbrown, Feb 18, 2005.

  1. otisbrown

    otisbrown Guest

    Dear Friends,

    Since RM posts "blasts" against vision scientists
    like Dr. Francis Young, I hardly judge
    it is worth it to respond -- since
    RM referred to Dr. Francis Young and other Blah
    Blah. Apperently RM has NO RESPECT for this
    gifted vision scientist.

    RM > OTIS, PLEASE EXPLAIN WHY STUDIES ON HUMAN SUBJECTS SHOW NO EFFECT
    ON MYOPIA PROGRESSION USING PLUS LENSES.

    The Oakley-Young study demonstrated that a "high plus"
    where the child actually looked THROUGH THE PLUS
    had the effect of stopping the "downward" change
    of refractive status for these young children.

    The over-all result was that the test-group
    show a rate of (approximagely) zero diopters,
    where the control-group (single-vision minus)
    showed a "downward" rate of -1/2 diopter per year.

    This suggests that the use of the plus AT THE THRESHOLD
    would stop the deveopment of nearsighedness
    AT THE THRESHOLD -- if used logically and
    agressively.

    The practical problems (lack of motivation of the person)
    are well-understood by me. That does become
    a question of how "motivated" a person can,
    and must be at the threshold.

    Further it is clear that the "judgment faculity" must
    be a matter of THAT PERSON's scientific (and engineering)
    training.

    The plus simply can not "casually" be prescribed for
    prevention -- and NOT as a "medical" device.

    Best,

    Otis
    Engineer
     
    otisbrown, Feb 18, 2005
    #1
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  2. otisbrown

    g.gatti Guest


    Now the truth is in the hands of a majority?

    This is your science: the dominance of the gullible mass.
     
    g.gatti, Feb 18, 2005
    #2
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  3. otisbrown

    otisbrown Guest

    Dear Friends,

    Subject: Asking for information concerning
    scientific research -- and then TOTALLY INGNORING IT.

    As ususal -- Mike asks for infromation -- and then
    thinks up endless excuses and "rationalizations"
    to totally ignore scientific research.

    The next thing Mike will do it post "blasts"
    against all researches who do not do things
    that HE approves of.

    Talk about intellectual blindness of a
    closed mind.

    But, as always, you decide.

    Best,

    Otis
    Engineer


    _________________
     
    otisbrown, Feb 18, 2005
    #3
  4. otisbrown

    Neil Brooks Guest

    So, Otis . . .

    Despite my best efforts at adding you and your pet topic to my
    killfile in every conceivable permutation, here you are again.

    A couple quick things:

    1) I suppose the bar for "proof" should be lower for you than for
    the rest of the scientific community because you want it to be? Seems
    a little narcissistic and self-serving;

    2) In the wake of recent events (Aleve, Vioxx, Celebrex, etc.) I'm
    reminded that scientific hypotheses should be held to the /highest/ of
    scrutiny before introduced as "safe," "accurate," "state-of-the-art,"
    or "conventional wisdom." Reach for it, Mister. It's up there for
    you to surmount.

    Time and time again, you eagerly and blithely foist your theories on
    unsuspecting folks who stop by S.M.V. looking for help. The general
    public must rely on the kindly doctors to alert them to your lack of
    credentials, potential for harm, and untested hypotheses.

    Look, Otis, I'll allow for the possibility that /all/ of the eye
    doctors on this NG /could possibly be/ avaricious, self-serving
    monsters who have a lock on a huge chunk of change that comes from
    doing things "their" way. They may be a member of the vast ocular
    conspiracy that defends its wealth by maintaining the status quo. All
    of this /may/ be true, though I don't think so.

    But you still come across as a petulant, Napoleonic idiot.

    The bar for proving your theories is the same as it is for all others.
    Go prove your theories (yes, the old fashioned way: proper testing,
    accurate data, peer-review) and -- if there's a kernel of truth in
    what you spout -- you'll be rich and you'll be right up there with
    Bagolini, Heimholz, Donders, Schirmer, Robert A. Strabismus, and all
    the other paragons whose names are memorialized in
    ophthalmology/optometry.

    Until then, you're a troll . . . who creates risk for unsuspecting,
    often desperate, people seeking help. "Engineer" in your signature
    expiates some of your guilt. It does nothing to ameliorate the risk.
    Perhaps if your signature said, "I am not a doctor. My theories are
    my own and are not shared by most in the medical community. Consult
    your doctor."

    Neil
     
    Neil Brooks, Feb 19, 2005
    #4
  5. otisbrown

    RM Guest

    Foolish Otis,

    Valid scientific studies have failed to show a preventative effect on myopia
    progression using plus lens treatment on the human eye. You have been
    informed of this over and over again by people who hold advanced degrees in
    vision science. Why do you pretend to know better.

    It is YOU who TOTALLY IGNORS our request to produce proof of your claims.

    I direct you to the following two articles. Now you tell me what data YOU
    have. Skip the anecdotal reports of pseudomyopes. Skip the old non-blinded
    studies without controls. Skip your reminescent stories about "The Printers
    Son". I'm talking about real valid controlled scientific studies. And
    since you can't find them, then spend your energy producing them. We would
    love nothing more than to offer an effective form of treatment to our
    patients. Quit pontificating and prove it to the medical community.

    But until then, all you offer is false hopes and snake-oil.

    Saw et al. British Journal Ophthalm. 2002 86: 1306
    Saw et al. Ophthalmology 2002 109: 415.

    RM PhD OD
     
    RM, Feb 19, 2005
    #5
  6. otisbrown

    Neil Brooks Guest

    And again, your anecdotal evidence is more credible than the National
    Eye Institute's multicenter, randomized, double-masked clinical trial .
    .. . WHY?

    Note the conclusion: "Use of PALs compared with SVLs slowed the
    progression of myopia in COMET children by a small, statistically
    significant amount only during the first year. The size of the
    treatment effect remained similar and significant for the next 2 years.
    The results provide some support for the COMET rationale-that is, a
    role for defocus in progression of myopia.

    The small magnitude of the effect does not warrant a change in clinical
    practice."

    Now, would you kindly set up a better study that controverts this one?
    Or, at least, go find out whether ANY of the participants in this study
    has changed his or her clinical practice in ANY way as a result.

    ========================================================
    Correction of Myopia Evaluation Trial (COMET)

    Purpose
    To evaluate whether progressive addition lenses (PALs) slow the rate of
    progression of juvenile-onset myopia (nearsightedness) when compared
    with single vision lenses, as measured by cycloplegic autorefraction.
    An additional outcome measure is axial length, as measured by A-scan
    ultrasonography.
    To describe the natural history of juvenile-onset myopia in a group of
    children receiving conventional treatment (single vision lenses).
    Background
    Myopia (nearsightedness) is an important public health problem, which
    entails substantial societal and personal costs. It is highly prevalent
    in our society and even more frequent in Asian countries; furthermore,
    its prevalence may be increasing over time. High myopia contributes to
    significant loss of vision and blindness. At present, the mechanisms
    involved in the etiology of myopia are unclear, and there is no way to
    prevent the condition. Current methods of correction require lifelong
    use of lenses or surgical treatment, which is expensive and may lead to
    complications. The rationale for this trial, the Correction of Myopia
    Evaluation Trial (COMET), arises from the convergence of research
    involving (1) the link between accommodation and myopia in children and
    (2) animal models of myopia showing the important role of the visual
    environment in eye growth. A contribution of this research is that blur
    is a critical component in the development of myopia. The primary aim
    of COMET, to evaluate the efficacy of progressive addition lenses, a
    noninvasive intervention, in slowing the progression of myopia, follows
    from this line of reasoning. These lenses should provide clear visual
    input over a range of viewing distances without focusing effort by the
    child. The comparison of myopia progression in children treated with
    PALs versus single vision lenses will allow the quantification of the
    effect of PALs on myopia progression during the followup period.

    Description
    The COMET is a multicenter, randomized, double-masked clinical trial to
    evaluate whether PALs slow the progression of juvenile-onset myopia as
    compared with single vision lenses. The study is a collaborative effort
    that involves a Study Chair at the New England College of Optometry;
    four clinical centers at colleges of optometry in Boston, Birmingham,
    Philadelphia, and Houston; and a Coordinating Center at the State
    University of New York at Stony Brook.

    The sample size goal, 450 children with myopia in both eyes who met
    specific inclusion and exclusion criteria, was attained with the
    enrollment of 469 children in one year. Children were identified from
    school screenings, clinic records, and referrals from local
    practitioners. Eligible children were randomly assigned to receive
    progressive addition or single vision lenses. Participating children
    are being examined at 6-month intervals following baseline, for at
    least 3 years, to measure changes in refractive error and to update
    prescriptions, according to a specified protocol. A dilated examination
    to evaluate the study outcome measures is performed at the annual study
    visits. A standardized, common protocol is used at all centers.

    The primary outcome of the study is progression of myopia, defined as
    the magnitude of the change relative to baseline in spherical
    equivalent refraction, determined by cycloplegic autorefraction. The
    secondary outcome of the study is axial length measured by A-scan
    ultrasonography.

    Patient Eligibility
    Children between the ages of 6 and 12 years with myopia in both eyes
    (defined as spherical equivalent between -1.25 D and -4.50 D in each
    eye as measured by cycloplegic autorefraction), astigmatism less than
    or equal to 1.50 D, and no anisometropia (defined as a difference in
    spherical equivalent between the two eyes greater than 1.0 D) were
    eligible for inclusion. Exclusion criteria included visual acuity
    greater than 20/25, strabismus, use of contact lenses, birth weight
    less than 1,250 grams, use of bifocal or progressive addition lenses,
    or any conditions precluding adherence to the protocol.

    Patient Recruitment Status
    Completed. Child recruitment began in September 1997 and was completed
    in September 1998.

    Current Status of Study
    Ongoing

    Results
    The mean age of the 469 COMET children at baseline is 9.3 years (range
    6-11 years); 52 percent are female. This group of children is
    ethnically diverse, according to a self-report, with 46 percent white,
    26 percent African-American, 14 percent Hispanic, and 8 percent Asian.
    Mean residual accommodation measured twenty minutes after instillation
    of two drops of tropicamide (1 percent) was found to be small (0.38D in
    the right eye and 0.30D in the left eye). Thus, tropicamide (1 percent)
    is an effective cycloplegic agent in myopic children. Baseline mean (±
    sd) cycloplegic refractive correction in COMET children is -2.38 D (±
    0.81) in the right eye and -2.40 D (± 0.82) in the left eye. Young
    children have significantly less myopia than older children, but the
    amount of myopia does not differ by gender or ethnicity. Mean axial
    dimensions are: 4.0 ± 0.2 mm (anterior chamber), 3.4 ± 0.2 mm (lens),
    16.8 ± 0.7 mm (vitreous chamber), and 24.1 ± 0.7 mm (axial length).
    Girls have significantly shorter eyes than boys. Mean corneal radii are
    7.73 mm (horizontal) and 7.59 mm (vertical). Ninety-five percent of the
    children have a ratio of axial length to corneal radius greater than
    3.0. These baseline measures provide cross-sectional data on a large
    group of ethnically diverse myopic children and will serve as a basis
    for examining changes that occur over a minimum of three years of
    follow-up.

    Use of PALs compared with SVLs slowed the progression of myopia in
    COMET children by a small, statistically significant amount only during
    the first year. The size of the treatment effect remained similar and
    significant for the next 2 years. The results provide some support for
    the COMET rationale-that is, a role for defocus in progression of
    myopia.

    The small magnitude of the effect does not warrant a change in clinical
    practice.

    Publications
    Gwiazda J, Marsh-Tootle W, Hyman L, Norton T, and the COMET group:
    Baseline refractive and ocular component measures of children enrolled
    in the Correction of Myopia Evaluation Trial (COMET). Invest Ophthalmol
    Vis Sci, in press.

    Gwiazda J, Hyman L, Hussein M, Everett D, Norton TT, Kurtz D, Leske MC,
    Manny R, Marsh-Tootle W, Scheiman M, and the COMET Group: A randomized
    clinical trial of progressive addition lenses versus single vision
    lenses on the progression of myopia in children. Invest Ophthalmol Vis
    Sci 44: 1492-1500, 2003.

    Hyman L, Gwiazda J, Marsh-Tootle W, Norton T, and the COMET Group: The
    Correction of Myopia Evaluation Trial (COMET): Design and baseline
    characteristics. Controlled Clinical Trials 22: 573-592, 2001.

    Manny R, Hussein M, Scheiman M, Kurtz D, Nieman K, Zinzer K, and the
    COMET Study Group: Tropicamide (1%): An effective cycloplegic agent for
    myopic children. Invest Ophthalmol Vis Sci 42: 1728-1735, 2001.



    Clinical Centers

    Alabama
    Wendy Marsh-Tootle, O.D.
    University of Alabama-Birmingham
    School of Optometry
    1716 University Boulevard
    Birmingham, AL 35294-0010
    Telephone: (205) 934-5702
    Fax: (205) 934-6758

    Massachusetts
    Daniel Kurtz, O.D., Ph.D.
    New England College of Optometry
    424 Beacon Street
    Boston, MA 02115
    Telephone: (617) 236-6251
    Fax: (617) 369-0168

    Pennnsylvania
    Mitchell Scheiman, O.D.
    Pennsylvania College of Optometry
    1200 West Godfrey Avenue
    Philadelphia, PA 19141-3399
    Telephone: (215) 276-6057
    Fax: (215) 276-6108

    Texas
    Ruth Manny, O.D., Ph.D.
    University of Houston, College of Optometry
    4901 Calhoun
    Houston, TX 77204-6052
    Telephone: (713) 743-1944
    Fax: (713) 743-2053


    Resource Centers

    Chairman's Office
    Jane Gwiazda, Ph.D.
    New England College of Optometry
    424 Beacon Street
    Boston, MA 02115
    Telephone: (617) 236-6234
    Fax: (617) 369-0188
    E-mail:

    Coordinating Center
    Leslie Hyman, Ph.D.
    M. Cristina Leske, M.D., M.P.H.
    Division of Epidemiology
    Department of Preventive Medicine
    University Medical Center
    Stony Brook, NY 11794-8036
    Telephone: (516) 444-7525
    E-mail:


    NEI Representative

    Donald Everett, M.A.
    National Eye Institute
    National Institutes of Health
    Executive Plaza South, Suite 350
    6120 Executive Boulevard MSC 7164
    Bethesda, MD 20892-7164
    Telephone: (301) 496-5983
    Fax: (301) 402-0528

    Data and Safety Monitoring Committee


    Ex Officio Members


    M. Cristina Leske, M.D., M.P.H.
    Division of Epidemiology
    Department of Preventive Medicine
    University Medical Center
    Stony Brook, NY 11794-8036
    Telephone: (516) 444-7525
    Fax: (516) 444-7525

    Robert J Hardy, Ph.D. (Chair)
    University of Texas
    Health Science Center at Houston
    School of Public Health
    Coordinating Center, Suite E827
    1200 Herman Pressler
    Houston, TX 77031
    Telephone: (713) 500-9550
    Fax: (713) 500-9530

    Argye Hillis, Ph.D.
    Director of Clinical Epidemiology and Biostatistics
    Scott and White Memorial Hospital/Foundation
    Texas A&M Health Science Center
    2401 South 31st Street
    Temple, TX 76706
    Telephone: (817) 724-3307
    Fax: (817) 662-3867

    Don Mutti, O.D., Ph.D.
    College of Optometry
    Ohio State University
    338 W. 10th Avenue
    Columbus, OH 43210
    Telephone: (614) 247-7057
    Fax: (614) 247-7058

    Richard Stone, M.D.
    Department of Ophthalmology
    University of Pennsylvania Medical School
    D603 Richards Building
    3700 Hamilton Walk
    Philadelphia, PA 19104-6075
    Telephone: (215) 898-6950
    Fax: (215) 898-0528

    Sr Carol Taylor, R.N., Ph.D.
    Georgetown University
    School of Nursing
    3700 Reservoir Road, NW
    Washington, DC 20007


    Ex Officio Members


    Donald Everett, M.A.
    National Eye Institute
    National Institutes of Health
    Executive Plaza South, Suite 350
    6120 Executive Boulevard
    Bethesda, MD 20892
    Telephone: (301) 496-5983
    Fax: (301) 402-0528

    Jane Gwiazda, Ph.D.
    Department of Vision Science
    Assistant Professor
    New England College of Optometry
    424 Beacon Street
    Boston, MA 02115
    Telephone: (617) 236-6234
    Fax: (617) 424-9202

    Mohamed Hussein, Ph.D.
    Department of Preventive Medicine
    University Medical Center at Stony Brook
    Stony Brook, NY 11794-8036
    Telephone: (516) 444-2140
    Fax: (516) 444-7525

    Leslie Hyman, Ph.D.
    Division of Epidemiology
    Department of Preventive Medicine
    University Medical Center
    Stony Brook, NY 11794-8036
    Telephone: (516) 444-7525
    Fax: (516) 444-7525


    Last Updated: 3/25/2003

    This page was last modified in November 2004
     
    Neil Brooks, Feb 19, 2005
    #6
  7. otisbrown

    A Lieberman Guest

    Otis,

    Please "entertain" me!!!!

    Where on the web OUTSIDE your website is this Oakley - Young study on the
    web???? NOT ON YOUR WEBSITE, but a website that is unbiased.

    Allen
     
    A Lieberman, Feb 20, 2005
    #7
  8. otisbrown

    RM Guest

    Dear Prevention minded friends,

    I am a practicing optometrist. Today I had an adolescent male patient who I
    had seen previously 3 years ago. At that time his refraction was
    approximately -3.00-1.00 X 180 in both eyes. He bought a pair of glasses
    and wore them for about 6 months but then lost them. He has been going
    around for the last 2.5 years without any spectacle correction at all. This
    condition is optically equivalent to wearing +3.00-1.00 x 180 lenses in
    both eyes all the time. His refraction again today was the same as what it
    was 3 years ago. If Otis' theory of plus lens prevention is correct, then
    why didn't this patient's refraction improve?

    I have asked this question of Otis many times before and he never answers.
    Otis-- please answer this time. Why not ask your good friends Dr. Young,
    Dr. Cheung, etc. to reply since you obviously are at a loss.


    PS-- for anyone really interested in the REAL TRUTH about the status of
    scientific research regarding myopia prevention, I offer the following
    unbiased medical references:

    1. http://annals.edu.sg/pdf200401/V33N1p4.pdf
    2.
    http://www.revoptom.com/index.asp?ArticleType=SiteSpec&page=osc/apr01/lesson_0401.htm
    3. http://dels.nas.edu/ilar/jour_online/40_2/V40_2NortonAnimalModels.asp
    4. http://www.optometrists.asn.au/gui/files/ceo865276.pdf

    Regards,

    RM PhD OD
     
    RM, Feb 20, 2005
    #8
  9. otisbrown

    Guest Guest

    Mistype RM?

    Refraction error S+3,00=C+1,00 180?


    --
    Free to Marcus Porcius Cato: ''Ceterum censeo Carthaginem esse delendam"

    In conclusion, I think that the "Otis therapy" should be destroyed

    Jan (normally Dutch spoken)
     
    Guest, Feb 20, 2005
    #9
  10. otisbrown

    RM Guest

    Sorry ;)
     
    RM, Feb 20, 2005
    #10
  11. otisbrown

    RM Guest

    Quit trying to misquote and misrepresent me Otis. I post warnings (you like
    to call them "blasts") only against YOU -- not others. YOU have no
    training or understanding of the functioning of the human eye. You are just
    a single-minded zealot. You never listen to reason or scientific facts.

    Dr. Young was one of a group of optometrists who believed some time ago that
    myopia progression might be arrested or reduced by using plus lenses. Since
    those early days a number of human studies have shown NO EFFICACY for that
    form of treatment. Only die-hard zealots like yourself continue to argue
    the point.

    Do not misquote and lie any more Otis. I have kept a long listing of the
    examples of your lying and I will be happy to post it to everyone.

    For those that are truly interested in the topic of myopia prevention, I am
    happy to provide the following current medical references for your personal
    evaluation.

    http://annals.edu.sg/pdf200401/V33N1p4.pdf
    http://www.revoptom.com/index.asp?ArticleType=SiteSpec&page=osc/apr01/lesson_0401.htm
    http://dels.nas.edu/ilar/jour_online/40_2/V40_2NortonAnimalModels.asp
    http://www.optometrists.asn.au/gui/files/ceo865276.pdf
     
    RM, Feb 20, 2005
    #11
  12. otisbrown

    otisbrown Guest

    Dear RM,

    Professor Theodore Grosvenor -- YES PH.D. Optometrist
    stated that it would be WISE to begin the
    use of a PLUS PREVENTIVE lens BEFORE
    the nearsighedness even starts.

    This is EXACTLY MY POSITION -- no more -- no less

    Francis Young is a vision scientists -- world famous
    He stated the same concept concerning the
    dynamic behavior of the natural eye.
    Dr. Grosvenor -- said exactly the same thing,

    Prevention is indeed difficult -- and depends on
    the person (not you and your "blasts" against
    these other people.

    The plus is indeed the "second opinion" but
    the person should be informed of this
    choice BEFORE ANY LENS IS USED.

    The choice shouild belong to the individual
    since even starting with the minus lens
    will have life-time consequences.

    It is not up to me to make that choice.

    You "blasts" are in fact against
    the second opinion -- so you can
    spin the dials on your phoropter
    and not take any responsibility
    for the consequences.

    Fortunately, some ODs are recognizing this
    basic professional responsibility -- even
    if you do not.

    So, but "unknown" freind (are you Robin Parsons, morphed
    into "RM") post another "blast" to keep you position.

    You can fool all the people some of the time.

    You can fool some of the people all the time.

    But eventually you can not fool all the people all the time.

    Best,

    Otis
    Engineer

    [RM's "Blast" will be posted below for those people
    who wish to be denied access to the
    "second opinion" at the threshold -- when
    it must be used to be effective. ]

    Neither "medicine" nor science is ever
    "set in stone" and I would keep this in
    mind as we review the proven behavior
    of the dynamic eye.
     
    otisbrown, Feb 21, 2005
    #12
  13. otisbrown

    otisbrown Guest

    Dear MT,

    Given the "blasts" the RM posts,
    (and you repeat), followed by
    Jan's statement that the concept
    of the plus-preventive "second opinion"
    MUST BE DESTROYED, and I would
    suggest you are a hypocrite.

    Fruther -- I do not advocate that a
    BI-FOCAL be used. If you
    are gong to do something -- do it
    right. That means, while the
    person still PASSES the
    DMV, he makes a decision
    to BEGIN using the plus.
    He has nothing to lose.

    But that type of decision, would
    turn responsibility can CONTROL
    over to him -- and that
    is not MEDICAL in concept
    or execution.

    You asked for INDICATIONS of
    the result of a PREVENTIVE study.

    The Oakley-Young intimates
    the result of a well-ruen ENGINEERING
    (NOT MEDICAL) study run for
    prevention -- with engineers
    IN CONTROL.

    It would make all the difference -- where
    the person knows the "score"
    and will "intellectually" participate
    and actually use the plus "correctly".

    This would REQUIRE that detailed
    instructions be provided, and that
    would absolutly PREVENT a
    "blind" study.

    An engineering-scientific study
    had no "blind" requirement.

    Best,

    Otis
    Engineer
     
    otisbrown, Feb 21, 2005
    #13
  14. otisbrown

    Guest Guest

    And this is what I (Jan) realy said and keep saying until you deliver proof
    that forces me to draw back my conclusion.
    --
    Free to Marcus Porcius Cato: ''Ceterum censeo Carthaginem esse delendam"

    In conclusion, I think that the "Otis therapy" should be destroyed

    Jan (normally Dutch spoken)

    Snip.......
    Okay Otis, than show us results wich can be verified instead of anectodes
    of your famous pilots, nephews, nieces, grandchilds etc... for a start.
    O, and do not forget to cc this posting to uncle Arnie and aunt Edith.

    --
    Free to Marcus Porcius Cato: ''Ceterum censeo Carthaginem esse delendam"

    In conclusion, I think that the "Otis therapy" should be destroyed

    Jan (normally Dutch spoken)
     
    Guest, Feb 21, 2005
    #14
  15. otisbrown

    A Lieberman Guest

    Otis,

    I asked this in another post and I will ask again!!!

    Please "entertain" me!!!!

    Where on the web OUTSIDE your website is this Oakley - Young study on the
    web???? NOT ON YOUR WEBSITE, but a website that is unbiased.

    Or is this another imaginary thing like your subjects....

    Allen
     
    A Lieberman, Feb 21, 2005
    #15
  16. otisbrown

    RM Guest

    (not you and your "blasts" against
    Please post a link to the "blasts" that I have made against other people.

    I only make them against YOU Otis because you give unlicensed medical advice
    to people, which is illegal, and you should be stopped!

    Oh. So if the dynamic natural eye uses a minus lens only for a short time,
    it is irrevocably changed. It changes from dynamic to static? Is that what
    you are saying? That wretched minus!
    So now you are trying to redefine my remarks again! Read my lips -- my
    warnings (you like to call them "blasts") are only against YOU. Because you
    are an unlearned fool who by your own admission doesn't understand anything
    about the anatomy and physiology of the human eye.

    Readers beware. Avoid Otis the Engineer!

    Yes. You figured it out. My goal is to deny people access to plus lenses.
    Soon our legions will disperse to all the drug stores around the world and
    collect all the plus reading glasses and burn them!

    Our next conspiracy meeting in Jamaica in March will discuss this plan along
    with our other strategies to take over the world and force everyone to wear
    eyeglasses for eternity!

    All we have ever asked you is to show us the proof that you keep speaking of
    Otis.

    Go take another thorazine!
     
    RM, Feb 21, 2005
    #16
  17. otisbrown

    RM Guest

    I noticed that. The other references also discuss plus lenses and bifocal
    therapy in a neutral light. I said these papers were objective and unbiased
    as they should be.

    I think there IS value for some patients with plus lens therapy. The
    question is which ones. A problem is someone needs to prove it and define
    it a little better. A large in-depth longitudinal study using A-scans, Orb
    scans, careful consistent refractions etc. of different age groups might
    show a benefit for a subpopulation of patients. You would have to wonder
    whether, since muscarinic antagonists, and bifocal corrections, seem to
    sporadically show some positive influence, accommodation being controlled
    via plus lenses might not work for some people too.

    I can see Otis' next post-- "Even the unknown RM (aka Robin Parsons) who
    slams the "second opinion" admits that he recommends +3 glasses to all his
    patients".

    Otis-- when you read this be sure you get the message. Your "model" is weak
    and insufficient. You need to prove what subgroup of patients might benefit
    from plus lens (if any at all). Prove it, and no one will argue with you.
    Go around giving unfounded advice is practicing medicine without a license
    and you will be continuously opposed.

    PS: Hint-- the eye is most "dynamic" in young people (ages 0-18). Your
    chance of showing that plus lenses influence the anatomy of the eye most
    likely lies within that group. Once the anatomy is set, then the only group
    where plus lenses will help will be accommodative myopes.
    ======================
     
    RM, Feb 23, 2005
    #17
  18. otisbrown

    yanding Guest

    I have read the report, and clearly the study indicates the most
    efficient time period for myopia prevention is before the human stop
    growing, such as before 12-15 years age. According to the study, human
    constantly adjust the growth of the eye based on the stimuli: "stop" or
    "growth", which are based on the kind of blur the eye received. By
    this theory, letting a myopic child wear a plus lens before the child
    finish growing should help generating the "stop" signal the eye needed
    to stop the eyeball from further elongation. Furthermore, the study
    suggests, even after the eyeball has already elongated, if the child
    has not finished his/her growth, there is still chance for the eyeball
    to become round again since the overall eyeball size will be larger.
    Anyway, that is my understanding about the study, and in my opinion a
    very good one. Otis has always suggested to use plus lens on myopic
    children when onset, so he is right along with this study. Anyway, I
    do not have the intention to debate on this issue. Sometimes people
    get lost when they just want to prove they were right at first place.

    Yan
     
    yanding, Feb 23, 2005
    #18
  19. otisbrown

    RM Guest

    The paper is a review paper. The section where this is discussed is in the
    "discussion" part of the paper. You understand correctly what the author
    speculates about. Unfortunately none of it is proven. It is only theory at
    this point. While it seems logical, scientific studies need to be
    performed. And I speculate that this approach would not work for all
    adolescents. I believe studies using plus lenses have been tried before
    without success.

    Otis proposes much more that treating 12-15 year olds with plus lenses.
     
    RM, Feb 24, 2005
    #19
  20. otisbrown

    otisbrown Guest

    Dear Yan,
    You are correct when you preceive tha the natural eye
    is "dynamic" and that is true-prevention is to be
    achieved, that process must START before a
    minus lens is applied. This concept, while difficult,
    is in fact the second-opinion. Further it is reflected
    in the fact that some ODs are getting their own
    children to wear the plus, when the child still
    has 20/20, but a refractive status of zero.

    Further, the recognition, by professor Theodore Grosvenor
    U. o f Houston was that this is an either-or decision
    the parents and child must make -- BEFORE the minus lens
    is applied.

    If you child is on the THRESHOLD of nearsighedness,
    i.e., passes the legal 20/40 line, but is slightly nearsighed,
    then it would be good to be aware of this
    advocacy for fundamental "change". You have
    nothing to lose. You might enjoy reading
    Steve Leung's opinion on the subject.

    www.chinamyopia.org

    There is no "right" or "wrong" here -- only your
    right to an "informed" choice.

    Keep an open mind. Understanding new ideas and
    concepts can not hurt you.

    Enjoy,

    Otis
    Engineer
     
    otisbrown, Feb 24, 2005
    #20
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