The quality of "proof" -- the quality of support for prevention.

Discussion in 'Optometry Archives' started by Otis Brown, Nov 19, 2004.

  1. Otis Brown

    Otis Brown Guest

    Dear Prevention minded friends,

    Subject: Pure scientific proof versus pseudo-medical proof

    RM > I know better than all of you.

    When you run experiments yourself concerning the
    behavior of the natural eye, and verify that
    the refractive state of the natural eye "tracks"
    its average visual environment -- then you
    have SCIENTIFIC (but not medical) proof.

    When a young man, Shawn, starting with 20/60
    -1.5 diopters, clears his vision to 20/20, the
    it is Shawn who has used a preception of
    SCIENTIFIC proof -- to clear his distant vision.

    Final proof is that he verified the results
    himself -- as any excellent scientist
    or engineer would do.

    RW's attituted is such that, "if you don't like
    the minus lens quick-fix that I provide -- then
    you will have to do it youself -- under your
    own control. That is RW's real message -- that
    comes across loud-and-clear.

    Dear Shawn,

    Here is a example of:

    1. Total arrogance.

    2. Complete blindness created by the arrogance.

    3. An "in you face" attitude towards those who would
    like to honestly work to clear their distant vision
    with the plus from 20/60.

    After 30 years of seeing the effect of this "attitude", I just give up.

    Learning to clear your distant vision -- on your own -- is
    the only way that "nearsighedness" can be ever be prevented




    Dear Prevention Minded Friends,

    Subject: Profound "attitude" arrogance of RM and the long-term
    destructive effect it must have on the public's vision.

    I can deal with experimental data. I can run expermiments
    that demonstrate the true behavior of the natural eye (as a
    dynamic system).

    I can acknowledge that most people have scant interest in
    true-prevention at the threshold -- and lack to motivation to do
    the work "correctly". But I can not "take" RM who declares the

    RM > All myopes must be exactly like Mr. Doe. Plus lenses never
    help anyone with myopia. If you don't believe it then
    that's YOUR PROBLEM. I don't care what any of you say, or
    how cogent and reasonable your arguments are. No matter how
    many of you there are, or what level of training and
    experience you have, I know better than all of you. I will
    never listen and I will argue with you until you give up.
    Because it's YOUR PROBLEM.

    RM > Yours truly, RM, Scientist, Optometrist, Democrat

    [Tragically I have the sense that these OD-Boards are staffed
    by optometrists who explicitly hold or maintain RM's
    point-of-view. Or as a minimum, an OD of this nature on a board
    can "black ball" any OD who would seek to "change the system".

    I guess "our problem" is this man's total, self-imposed
    ignorance of the dynamic nature of the fundamental eye.

    I regret the consequences for everyone who enters his office
    and gets that "first" strong minus lens -- and NO DISCUSSION of
    the second-opinion. We all owe a person at least a "fighting
    chance" at prevention -- even if he turns it down.

    While I do not particularly support "Bates", at least he had
    the good-heart to discuss alternatives -- as the second opinion.

    Here are remarks to "Rishi" who is a Bates-supporter.


    Dear Rishi,

    While "Bates", may get "beat-up", at least you and I have the
    good grace to maintain a sense of humor about the issues.

    When a man is defending a "professional position" you can
    expect the type of response we are getting.

    Please remember -- there are ODs, MDs and scientists who are
    willing to take a major step towards effective PREVENTION.

    We can only work towards that "better world", even though it
    is difficult.

    It is hard to see how a "quick-fix" procedure -- put in place
    400 year ago -- could be based on much that is scientific. It can
    be based on the fact that is works immediately -- and the public
    will reject the preventive alternative at this time.

    But let us "calm down" our language, respect each other and
    work as democrats (small "d") to achieve a better "preventive"
    solution to this world-wide problem.


    Otis Brown, Nov 19, 2004
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  2. (Otis Brown) wrote in
    Except that those who know better have suggested a mechanism for the result
    (assuming the result is even real and verifiable) that blows away the
    methodology as an intervention for most forms of myopia. You haven't
    addressed this concern, and that is flawed science

    Scott Seidman, Nov 19, 2004
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  3. Otis Brown

    RM Guest

    In case you didn't understand me, I was trying to be sarcastic by making the
    below statements (however the case report I presented is true). If you will
    go back to your own remarks in your postings at the time that message
    appeared you will see that the phrase "YOUR PROBLEM" was what YOU said to
    me. I thought if I presented your types of arguments back to you that you
    might see the way you were coming off to everyone reading this newsgroup.
    Apparently it was lost on you.

    Your whole tone in replying to questions that others direct to you is to
    simply to avoid them and just blurt out your own rhetoric. For instance, go
    back to a post by the lay-person named Ann. She points out your problem of
    avoiding direct answers to questions, and in turn your reply to her was some
    oblique difficult-to-comprehend blabbing.


    RM, Nov 19, 2004
  4. Otis Brown

    RM Guest

    "> RW's attituted is such that, "if you don't like
    Tell me where is this message is stated, either directly or implied
    indirectly? Does this argument add more sympathetic drama to your point of
    view? Otis, you poor martyr!

    My point to you is simply that your plus-lens prevention fix can indeed work
    but only for a subgroup of younger people with accommodative dysfunction.
    When I tried over and over again to explain it to you, you avoided direct
    replying and kept giving me equations that you seem to believe apply to all
    myopes. You do not understand what I say because you do not know the
    structure and function of the eye. You quote a study where primates were
    vastly overcorrected and then draw conclusions to all human myopes.

    And finally I will restate what I said to you the bottom-line issue I have
    with this.
    What really irks me is that people who propose this kind of
    snake-oil fix for vision problems can mislead people. I have had patients
    who told me that they heard this kind of voodoo stuff on the radio from Paul
    Harvey or bought some cassette tapes after seeing television
    advertisements starring Marriet Hartley. I respect your right to think
    whatever you want to think. But by blurting out unproven theories
    (and in some cases even disproven theories) you are misleading people
    and possibly doing some harm to lay-persons reading this newsgroup.
    RM, Nov 20, 2004
  5. Otis Brown

    Otis Brown Guest

    Dear Scott,

    I did not suggest "intervention" in "myopia" -- except
    to state that a person should be informed of the
    "preventive" alternative -- before ANY minus lens
    was used.

    This places responsiblity for a decision on the
    pilot himself (assuming a complete tutorial)
    on the subject -- when the plus can be
    potentially effective. If the pilot
    (who is informed of the -1/3 diopter per
    year -- average "down" rate at college)
    chooses to REJECT the use of the plus -- there
    would be no further discussion of PREVENTION.

    Shawn is well-aware of this choice by now.
    He reports sustained 20/20. He knows that
    if he should stop using the plus -- his vision
    will start "down" as per these military-college

    Since he will be personally verifing his eye-chart
    20/20 -- the issue is no longer a medical issue.

    I think that is the best solution possible for hims,
    and other mature pilots who wish to "take over control"
    and clear their distant vision the way that Dr. Colgate

    This is a scientific issue involving the wise understaning
    of ojbective facts about the behavior of all primate
    eyes. It is also the "second opinion" if you wish
    to make a "medical" statement.

    But it does depend completely on the resolve and
    motivation of the person who does it successfully.

    The scientific facts do not "prevent" prevention -- if
    you "see" it that way.


    Otis Brown, Nov 20, 2004
  6. Otis Brown

    Dr. Leukoma Guest

    (Otis Brown) wrote in

    But, it's not really an alternative. It's a 'sham' of an alternative.

    Dr. Leukoma, Nov 20, 2004
  7. Otis Brown

    Ann Guest

    So are you saying that instead of him wearing a minus lens he now
    wears a plus lens? And with the consequent diminished vision at that.
    I can't see the point of that.

    Ann, Nov 20, 2004
  8. Otis Brown

    Otis Brown Guest

    Dear DrL,

    This depends on how the engineer judges objective
    science as it concerns the dynamic behavior
    of the primate eye (all eyes -- science -- not medicine).

    A person (pilot) has a right to examine this
    type of data, and decide for himself what
    course of action fits is own personal requirements.

    That means transfer of control to the person
    (in this case "Shawn") to do the work necessary
    to change his refractive state by +1.5 diopters.

    That is not a "sham". That is scientific honesty
    my friend.


    Otis Brown, Nov 20, 2004
  9. Otis Brown

    Otis Brown Guest

    Dear RM,

    I deeply regret that we can not communicate
    effectively about the dynamic nature of the
    natural eye FIRST.

    It is true that I believe that a person who
    previously had 20/20, andi recently reads
    the chart at 20/40 or 20/50, could gradually
    work his way out of it. This is because
    of objective facts concerning the behavior
    of the natural primate eye.

    This is established by direct "input" versus
    "output" testing. This establishes that a
    population of natural eyes will move "down"
    from the wearing of a minus lens. The same
    result is obtained from a step-change in
    visual enviroment. You deny this behavior
    of the natural eye. The above experiment
    could be repeated by a competent experimenter,
    thus the requirement for "repeatable consistent
    results" is achieved. There can be
    no doubt about this essential an fundamental
    characteristic of the natural eye.

    Since I would supply this information to
    an intelligent person with 20/50,
    (like a "entering" college student)
    and you would deny it -- whe do have
    an argument about what constitutes
    fundamental scientific truth about
    the natural eye's behavior.

    Shawn used these objective facts, and
    intense motivation with a strong plus
    lens to clear his vision.

    I believe that students who are older
    that he is, would have the "smarts" to
    examine the objective facts themselves
    and decide the issue. Their
    long-term visual future depends
    on their judgment -- and not on you.

    I they choose to reject the analysis,
    and the plus lens, then they can expect
    their vision to go down by -1.3 diopters
    per year. And indeed that is an
    honest choice -- and they should
    not complain about the consequence of
    their neglect.



    cc Shawn, and prevention minded pilots
    and students-of-science
    Otis Brown, Nov 20, 2004
  10. Otis Brown

    RM Guest

    We can do this
    OK, now that you are qualifying your statement some then we have some
    opportunity for agreement. A person who was 20/20 and very quickly becomes
    20/40 or 20/50 is likely not an anatomical myope. This type of person is
    likely an accommodative myope. The myopia is caused by inappropriate
    contraction of the ciliary muscle. Such a person might develop this
    increased muscle tone due to lots of recent near work (e.g. "student
    myopia"). Such a person is likely young. The diagnosis can be made by
    cycloplegic refraction which involves pharmaceutical agents that paralyze
    the ciliary muscle. Yes-- such a person could be treated with plus lenses
    and should try to avoid using their minus lenses. However, their distance
    blur is real and since they have to function (like drive, etc.) they may, on
    a practical basis, need to wear minus lenses to accomplish critical tasks
    like getting back and forth to work, see whats going on in school, etc.

    This group of people is the MINORITY of myopes that you encounter in the
    world. Your technique could work for this subgroup of people but not for
    the majority of myopes. You try to extrapolate your case reports and
    theories about these people to everybody.
    Here you go extrapolating this observation to the entire "population of
    natural eyes" again. This is an error in your reasoning that you keep
    No, this could happen in some patients but not all of them. For examply,
    some patients are inadvertently overminused in an eye exam and when you
    recheck them it's apparent they are overcorrected and they prefer the lower
    prescription (i.e. reduced minus). You are extrapolating your beliefs on
    the whole population of myopes again.
    I would not deny it. If I find an accommodative myope I inform them they
    should wear their minus correction sparingly and consider using plus at
    near. There's just not that many of these types of myopes.
    Are you saying that all myopes will "go down" (I assume you mean become more
    myopic) by -1.3 D per year. No way. Again you are extrapolating your
    theory to the whole population.

    Otis, get objective. Who has seen more myopes in their careers. The docs
    who post in this forum or you.

    Here is a question for you that does not involve an understanding of the
    anatomy/physiology of the eye- right down your alley. It's been posed
    before but you haven't responded---- Why does a young myope (-1.50
    to -2.00) who goes around totally uncorrected (meaning they never have used
    a minus lens) not revert to emmetropia (or at least less myopia)? These
    individuals essentially have a plus optical correction on their natural eye
    which they wear 24/7. They have a constant plus blur. This is equivalent
    to aggressive plus lens therapy. Why do they not improve and why is it that
    they oftentimes become more myopic?

    RM, Nov 20, 2004
  11. Otis Brown

    Dr. Leukoma Guest

    But, engineering is not the appropriate discipline to be giving advice on
    "prevention." As an engineer, you are free to make judgements concerning
    your own health, but you should not be diagnosing and prescribing for
    others. Otherwise you are practicing medicine without a license, and I
    think you are.


    (Otis Brown) wrote in
    Dr. Leukoma, Nov 21, 2004
  12. Otis Brown

    Dr. Leukoma Guest

    One can make a point without being so verbose. Do you like to read your
    own prose?


    (Otis Brown) wrote in
    Dr. Leukoma, Nov 21, 2004
  13. Otis Brown

    Otis Brown Guest

    Otis >Shawn is well-aware of this choice by now.
    Ann> So are you saying that instead of him wearing a minus lens he now
    wears a plus lens?

    Otis> What Shawn does is the following.
    He monitors his vision and confirms 20/20.
    When he sits down to read, or use the computer
    he uses a "correct strength" plus lens.
    His vision is clear all the time -- for distance,
    and clear for near through the plus. The plus
    "moves" the near objects out to "infinity", so
    it is as though he is living out-doors all the

    Ann > And with the consequent diminished vision at that.

    Otis> Absolutly NOT. His distant vision is clear -- now
    he does not "need" a minus lens. He near
    vision is clear through a correct-strength plus lens.
    There is no blur at all.

    Otis> Sorry you don't understand the issues. But
    Shawn does, and that is the only person
    concerned with it.


    Otis Brown, Nov 21, 2004
  14. Otis Brown

    Ann Guest

    So he doesn't have perfect vision. He is now long sighted and needs a
    plus for reading. Was he always long sighted or is it that he changed
    from short to long in the process? If he started out both short and
    long sighted I would think he is not at all typical of your everyday
    myope who is not long sighted.

    Ann, Nov 21, 2004
  15. OK, now that you are qualifying your statement some then we have some
    Dear sir,
    there is much hope even for real myopic people.

    When I see my clients who have perfect sight clear flashes, or more
    than flashes, there is no doubt that their eyes return in the normal
    emmetropic shape.

    There is no doubt at all.

    Mostly this happens in the beginning in the outdoor light of the sun.

    But lately it happens indoors, with the eyechart illumined by a good

    When you work with -9 or -11 myopic people, and they have discarded
    glasses and get well without them and then on the eyechart they read
    half the chart with no effort or trouble, what do you say?

    What is your comment of these cases?

    Simply saying that these do not exist or are just make-ups, is not a
    scientific answer.

    But you talking about accomodative myopia is fraudolent, because you
    DO NOT TREAT that kind of myopia by inducing a sense of rest from the
    accomodative strain: you SELL GLASSES, in the hope of inducing more
    strain and the inception of NON accomodative myopia, when the eye
    really starts to elongate definitely, and the poor patient starts to
    wear stronger glasses (and you SELL them).

    What to do?

    The world is such a dirty thing, as you professionals have devised it
    to be, that the sense of vomit is really very hard and painful.

    Intelligent readers may find useful my webpage on the true cure of
    imperfect sight:
    Rishi Giovanni Gatti, Nov 21, 2004
  16. Otis Brown

    Otis Brown Guest

    Dear RM,

    Subject: PREVENTION of a negative refractive
    state at the 20/40 (-1/2 diopter) level.

    As you probably know, most 5 year-olds have
    a positive refractive state -- of some degree,
    and 20/20.

    Most "myopes" enter nearsighedness by having
    their refractive state move from a positive
    value to a negative value.

    I stipulate that an a highly motivated
    pilot, who has just entered into nearsightedness
    could clear his vision bact to a positive

    I sounds like you are inclined to agree with
    me on that point. The only requirement I would
    have is that the PERSON be fully informed
    of the standard "down" rate of -1/3 diopter per year,
    or -1.3 dioters in four years. (Typo in
    my post below. The "down" rate for children
    is -1/2 diopter per year -- average of the
    bi-focal studies -- of the single-minus group)

    If it can not be "prevented" at the 20/40,
    with the pilot IN CONTROL, then it can not
    be preveted at all.

    If you would use a scientific (not medical) protocol
    then I believe a successful PREVENTIVE effort
    could be conducted with a highly educated
    engineer -- provided he gets the type of
    scientific support he needs -- and makes

    I believe that will work -- and will make
    a personal commitment to work with that type
    of person.

    I will reply in later and in greater detail in a separate


    Otis Brown, Nov 22, 2004
  17. Otis Brown

    RM Guest

    Actually, 20/40 is more in the range of -0.75 to -1.00 range
    No, usually 5 year olds are not 20/20. More likely in the range of 20/40 -

    Yes, as stated above most children are born farsighted and change from
    No Otis-- I am NOT inclined to agree to that. Only a highly motivated
    ACCOMMODATIVE MYOPE stands any chance of reverting to 20/20 without any kind
    of correction. The doctors keep stating this over and over to you.
    Accommodative myopes, whose myopia is due to increased ciliary muscle tone,
    can indeed revert if their ciliary muscle relaxes. And this can be done
    using plus lens treatment. However, most myopes are NOT accommodative
    myopes. As proof of this, when you paralyze their ciliary muscle forcing it
    to relax, then they still remain myopic.

    The majority of myopes are anatomical myopes who will not respond to
    therapies aimed at relaxing their ciliary muscle (like plus lenses).

    You keep trying to state that the entire population of myopes, or even
    "highly-motivated pilot" myopes are all the same and are all treatable with
    plus lenses. You are way overstating your point. Just because you have
    seen a few accommodative myopes and you know that they can respond does not
    mean that the whole population of them will. You are making the same
    mistakes that older optometrists did decades ago-- it was tried and it
    doesn't work!
    OK-- so you admit that some of your group of myopes cannot be reverted to
    emmetropia with plus lenses. I agree with you there. In fact most of them
    cannot. They will need minus lenses to be able to see 20/20.
    P.S.-- and when you reply please address this still unanswered questions
    that was originally put to you by MT and restated by me twice:

    Why does a young myope (-1.50 to -2.00) who goes around totally uncorrected
    (meaning they never have used
    a minus lens) not revert to emmetropia (or at least less myopia)? These
    individuals essentially have a plus optical correction on their natural eye
    which they wear 24/7. They have a constant plus blur. This is equivalent
    to aggressive plus lens therapy. Why do they not improve and why is it
    they oftentimes become more myopic?
    RM, Nov 22, 2004
  18. Otis Brown

    Otis Brown Guest

    Dear RM,

    Subject: Profound disagreement about the need for
    prevention -- and who can and should
    be in "control".

    Obviously we diagree in a profound an fundamental
    way about the inherent behavior of the natural

    It is clear that an "empowered" pilot, who
    PREVIOUSLY had 20/20, has a good chance
    of clearing his distant back to 20/20

    It is also clear that you do not wish
    to be involved in this type of
    engineering-scientific work -- and
    no power on earth can force you to
    be involved.

    That is why there is a "seond opinion" in
    your profession -- even though you ignore

    It is also why a "preventive" effor
    will have to be run under scientific
    (not medical) protocols).

    You have made this situation very
    clear to all of us.

    I will forward your commentary to
    those MOTIVATED pilot who are interested
    in keeping their distant vision clear -- through
    the school years.

    Thanks for your commentary.



    cc: Shawn and others interested in true-prevention.
    Otis Brown, Nov 22, 2004
  19. Otis Brown

    Otis Brown Guest

    Dear Mike,

    That fact that you teach yourself the method of the
    minus lens -- does not surprise me.

    Most people only "want" a quick fix anyway, and it
    is not your job to "discuss" alternatives -- why
    should you, the quick-fix works, and any one
    who says anything "different" must be "wrong"
    by your definition.

    Fortunately I have friends in optometry. They tell
    me a different story. That is called the SECOND OPINION,
    because medicine (if that is what you are doing)
    is never a "finished" business, and alternative
    judgments do exist concerning the dynamic behavior
    of the fundamental eye.

    But obviously, at this point, if a person wishes
    to avoid nearsighedness, he must learn to
    use the plus (under his own control) and actually
    review the safety of the minus lens.

    If he learns enough (as Shawn did), and works systematically
    with the plus, then he can clear his vision to the
    required legal standard -- and keep it there.

    But you -- by your definition -- can NEVER be part
    of that process.

    But some ODs (who will change this "system") do support
    a person's right-of-choice, as Steve Leung OD does.


    Otis Brown, Nov 23, 2004
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