To Mike Tyner -- Request for your statement.

Discussion in 'Optometry Archives' started by Otis Brown, Feb 8, 2004.

  1. Otis Brown

    Otis Brown Guest


    To: Mike Tyner OD

    Dear Mike,

    I am concerned with your statement.

    It is important to an engineering study that both sides of a
    technical argument be presented.

    Re: Mike> You respect a person's right to informed choice, but
    only if you do the informing.

    Re: Otis> ABSOLUTLY NOT! You have every right to present your
    judgment that a minus lens had no effect on the
    refractive status of the natural eye -- and the reasons
    you believe in that idea.

    Please write up you consideration of "informed choice" as you
    see it under the (**) provided below.

    I am certain the pilots will be interested in hearing what
    you have to say on the subject.





    I start with the premise that the function of leadership is
    to produce more leaders, not more followers.

    Ralph Nader


    THE FIRST YEAR -- See the over-all syllabus on this web page.


    1. What this study is:

    This study is an Engineering-Scientific study of the dynamic
    nature of the fundamental eye. You personal expertise and
    motivation is crucial for the success of this program. The more
    you know, the more you understand, the greater the probability of
    success. In concept, you will be taking complete control of this

    2. What this study it is not. **

    This is not a study of the defective eye. It is not a
    medical study. That is a medical function. This issue will be
    clarified by later discussion an analysis.


    ** There is a profound disagreement in ophthalmology as to
    whether nearsightedness (a negative refractive status) is
    preventable or not. That issues has never been resolved.

    Mike Tyner (as well a percentage of ODs) state that a lens
    has no effect on the refractive status of the eye. Since he
    insists on that truth, it is his judgment that use of a plus will
    produce no change in the refractive status between the control
    group and the test group in this proposed study.

    I have invited Mike Tyner to discuss the reasons why:

    1. He believes that nearsightedness is not preventable.

    2. Why you should not be offered a discussion an analysis about
    the potential for you to do the work of effective





    This is an Engineering-Scientific study of the dynamic nature
    of the fundamental eye.

    As such you have every right to review the experimental data
    concerning the design, behavior and control of this device.

    Your will be in "control" of this study from start to finish.
    In entering Embry-Riddle you will receive an excellent
    technical-engineering education. It is expected that four year
    from now you will look back on this engineering analysis and
    support and state that this approach made a great deal of sense --
    from and engineering point-of-view.


    A study of this nature will depend completely on your
    intellectual judgment. While certain leadership functions and
    guidance will be supplied now and next year, you are expected to
    "get the idea" and proceed with the preventive work for the Junior
    and Senior. The statistical verification is also listed
    on this page. If your background it engineering-technical
    then you should understand the nature of this type of testing.

    We can not guarantee any results -- since everything will
    depend on your knowledge, actions and motivation. We will say
    that we will answer your questions to the best of our ability.


    We need 100 engineers to lead this study. The statistics are
    crucial and must be understood in detail by you. You will receive
    detailed statistical analysis courses during your years at
    Embry-Riddle, but we will need 100 pilots to participate. As an
    engineering study, requiring that you understand detailed
    instruction, and make the measurements.

    At the end of the six months we will review the results and
    submit them for publication in the IEEE/EMBS Magazine.


    Certain attitudes are destructive. Some develop from the
    general-public against prevention, and some attitudes develop
    internal to optometry that are hostile to preventive work. It
    will be your responsibility to evaluate these attitudes as they
    affect your personal visual welfare. This should be part of your
    review-process in your Freshman year.

    The "general public" is ignorant, and lacks
    the motivation it takes to achieve effective prevention.
    This is not the fault of anyone. (Read "The Printer's Son"
    by Jacob Raphaelson to understand this attitude.)


    This has been a very brief description of what is becoming
    the "second opinion", that a negative refractive state of the eye
    (nearsightedness) can be prevented.

    You have one year to review this discussion. Nothing is
    required of you during this year.

    If you wish be part of and lead with the preventive effort we
    invite you to join a six-month effort by strong use of a plus lens
    -- at the beginning of the Sophomore year.

    The details of that use will be supplied at next year.

    Further steps will depend on your judgment of your results.

    It is intended that this discussion will become a "standing"
    program at Embry-Riddle. Therefore, this pitch will be made to
    the next two incoming class.

    There is no cost to you in money. The "cost" to you is in your
    understanding, personal effort, logic, and scientific consistency.

    Thank You!

    Otis Brown
    Otis Brown, Feb 8, 2004
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  2. Otis Brown

    Otis Brown Guest

    Dear Mike,

    Thanks for your statement.

    I believe in fair play, and honest discussion of
    objective facts in a academic environment.

    I will post your statement as part of the
    introductory statment to the entering pilots
    at Embry Riddle.



    Otis Brown, Feb 8, 2004
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  3. Otis Brown

    Dr Judy Guest

    I too would congratulate Mike on his well written response.

    I think Otis simply chooses to ignore control group, single or double
    blinding and placebo issues because he doen't agree with the results from
    well controlled human studies using plus lenses. One or two poorly
    controlled studies done decades ago had results he likes. He calls well
    controlled studies "medical" and he calls his proposed, no control study a
    "science" or "engineering" or "thought" experiment. He has stated that
    engineers don't need control groups, though other engineers have refuted
    that claim.

    Over the years, this issue of control and placebo effect has been discussed
    with Otis. As recently as January 28, 2004 I posted a discussion of control
    which Otis did not reply to.

    Here it is again:

    "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, Feb 8, 2004
  4. Otis Brown

    Otis Brown Guest

    Dear Mike,

    Thanks for your offer of support.

    I have learned that the real "linch pin" of this
    effort will be in the minds and resolution
    of the pilots who are going to be controlling
    the study.

    As far at "understanding" accommodation I have
    published an analytical study of accommodation
    for purpose of analysis and discussion.

    It is essential that accommodation be understood
    as a sophisticated physiological system that
    reproduces the visual enviroment (in diopters)
    if the preventive study is to be effective.

    [The paper is available on my site for review.]

    It is part of the analytical process of engineering.


    Otis Brown, Feb 9, 2004
  5. Otis Brown

    Otis Brown Guest

    Don't be concerned. You will not receive any
    tests on the subject, since you are not an
    engineer. The pilots should receive the test,
    however. The mathematical model follow
    Dr. George Hung and Dr. John Semmlow's model
    for the most part.

    The analytic tool defines "visual blur" as the "stop point"
    of the "lens travel".

    This is determined by using a trial-lens kit to determine
    the refractive state of the native, or natural eye.

    Hope this clarifies.


    Otis Brown, Feb 10, 2004
  6. Otis Brown

    Otis Brown Guest

    Dear Mike,

    Dr. John Semmlow joined Dr. Peter Green and others at Johns Hopins
    to talk about various issues.

    It was obvious that he felt a lot of political pressure.


    Otis Brown, Feb 10, 2004
  7. Otis Brown

    Otis Brown Guest

    Dear Mike,

    John realized there was no money in prevention.

    He made a wise decision.


    Measuring a signal in noise is what engineers

    Given the correct approach, an engineer can determine
    the dynamic nature of the fundamental eye (by not
    using the word "defect" all the time).

    A single-point measurement simply can not be accurate.

    Repeated measurements will provide a much higher level
    of accuracy and confidence in the "true" value.

    Basic statistics my friend.


    Otis Brown, Feb 11, 2004
  8. (Otis Brown) wrote in
    Tell that to the vision therapists, who seem to get a ton of money out of
    their clients annually.

    I chuckle when people use financial arguments as an excuse for why
    prevention isn't promoted. Vision therapy is TONS more expensive than a
    yearly optometrist visit and new spectacles every few years.

    Scott Seidman, Feb 11, 2004
  9. Otis Brown

    Otis Brown Guest

    Dear Scott and Mike,

    One of the deepest "wake up" was when I found out
    that the "public" would reject prevention with a plus lens
    if it were to be ever offered.

    You simply can not offer prevention in the sense of "medicine" -- but
    we keep on insisting that some one medical offer "prevention".

    As far as "costs" go, I have no problem paying an
    OD or MD for a review of the general situation concerning
    the effect the minus lens has on the refractive state
    of the native eye, and who would encourage me to
    learn more, and understand that prevention is a
    process that MUST involve my personal review of this
    type of choice.

    Could this be done in the normal 20 minutes you have
    with an OD or MD? Of couse not. Even the discussion
    would be very expensive. But what could be done
    (with a pilot) is to send him to web sites that
    advocate prevention with the plus.

    In a sense though, this exceeds the boundaries of
    "medicine" because you are virtually empowering the
    pilot to "take control" and do it himself. Obviously
    difficult, but possible.

    If he does it himself, and clears his distant vision
    through intense effort with the plus, and achieves
    20/20 -- and sustains it through four years of college,
    then the subject matter was not medical at all.

    But most people just want the minus lens -- and no
    discussion. Prevention is indeed very low cost -- but
    VERY HIGH COST in terms of the man taking very forceful
    control, and clearing his vision from 20/40 to 20/20 through
    this arduous process.


    Otis Brown, Feb 12, 2004
  10. Otis Brown

    Dr Judy Guest

    I don't believe this is true. If good evidence existed that myopia could be
    prevented, I'm sure that the public and doctorw would embrace it. Look at
    what has happened with smoking, exercise, seat belts etc, once the public
    was informed that death and disease could be prevented, smoking rated
    dropped, seat belt use increased etc.

    Otis, if you really believe your system works, why are you so opposed to a
    proper scientific, clinical trial. Right now, only a few pilots who happen
    upon your web site find out about your method. If they do any research or
    ask any eye doctors or eye researchers, they will be told the truth: that no
    science based evidence exists that your method works to reduce or prevent
    myopia in human adults. Only a few of the few will bother to try it out and
    so almost no myopia is prevented.

    On the other hand, if you worked toward a proper study with cycloplegic
    refractions, control group and at least single blind design that showed
    myopia reversing, it would be published and other researchers would
    replicate the results. At that point, with evidence in hand, every eye
    doctor in the world would promote the method and millions of people would

    You can post all the anecdotal evidence you want here and on your web site;
    you can keep on ranting about engineering studies and your bizarre
    definitions, but no one will take a word of it seriously until you produce
    the science.

    Why are you denying millions of myopes the benefit of wide publication and
    application of your method by insisting on a non scientific study?

    Dr Judy
    Dr Judy, Feb 12, 2004
  11. Otis Brown

    Otis Brown Guest

    Dear Judy,

    You ask some interesting and honest questions.

    The best answers came from Dr. Raphaelson.

    When he used a strong plus on a child, (and successfully)
    both parent and child rejected this success.

    Under that circumstance, it makes prevention impossible
    in a "medical" context.

    The only other option is to have the person
    "highly motivated pilots", do the work himself
    and verify the result -- himself.

    And that indeed is difficult -- because most
    people totally lack the motivation and interest.

    The difference is in finding a pilot who
    will learn to "accept" the transfer of control
    to him. And, as far as I am concerned, it makes
    the issue one for the pilot to resolve.

    I beleve this can be done in a engineer-controlled
    enviroment. Given the opportunity to do so,
    I think certain pilots could understand the
    type of control they must exert, and the
    type of result they could expect.


    Otis Brown, Feb 19, 2004
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