Why Bi-focal Studies Fail

Dear I-SEE Members,

Subject: Why prevention (recovery) is so difficult.
Why ODs can not offer "prevention".


I have been told consistently for the last 50 years by both
MDs and ODs that even prevention was absolutely impossible.

I do respect these ODs and MDs, and I am not willing to
directly challenge that statement. I will agree to the words
{extremely difficult". I think that it is our responsibility to
prove that "absolute impossible", is not quite right.

I need the help of these ODs and MDs and I do not want to
appear to be practicing medicine. The only way I can secure that
agreement is to agree with them about these difficulties.

When the would-be pilot recognizes these difficulties and
that there own resolve MIGHT help them with prevention they MIGHT
work harder on there efforts in using the plus properly.

While I do work with "conceptualizations", I also face hard
experimental data realistically.

I have reviewed numerous bi-focal studies. The BEST of these
studies show that the downward movement of -1/2 diopter per year
can be stopped -- but not reversed.

I must face these types of results. The WORST of these
studies show that the two groups go down at -1/2 diopter per years
-- same rate for both groups.

It is better that a pilot at 20/30 understand these
statistics BEFORE he chooses to wear a minus lens. These facts
might steel him in is resolve to work the "plus" when the method
has some chance of success. He is not going to "worry" about
those people who are too deep into it to get out of it. He should
only worry about getting out if it himself.

Here is a discussion with "Jon" who asks why I concentrate
on the issue of prevention -- for your thoughtful intererst.

I strongly suggest that any parent who has
a child staggering on the threshold of nearsightdness
consider the consequences of a decision to
wear the minus lens all the time.

[This is RECOMMENDED by a large percentage of ODs.
I consider it to be a grave risk -- eventually
producing "galloping myopia".]

I blieve that the an issue that will affect you
the rest of your life must be understood by
you.

That is the purpose of this discussion.

**************

Jon > Dear Otis:


Jon > The only reason I began wearing a minus lens is that I was
told that this is what I had to do to continue in the US Air
Force, or be court martial for disobeying a direct order.

Otis> I have seen this attitude at the U. S. Naval Academy. I
was told by Dr. Karl Montor that the kids could not even
take an aspirin with out a medical order! We were
attempting to help one man in his use of the plus lens.

Jon > They will throw you in a military jail until your four years
is up if you do not do what they say.

Otis> I was forced into the military. I know how they think.

Jon > After that it was a continuation of more minus lenses and
those in the visual care industry that lied, and
misrepresented reality.

Otis> Welcome to the true facts concerning prevention. I agree
that the world is not "fair" and that is a rare thing that
we even receive a "fighting chance". We are attempting to
help with that issue.

Jon > They knew better, and they knew what they were doing was
wrong, yet they continued to do it since they could do it
and make money at it.

Otis> I only ask that we attempt to work together for the pilots
who begin to understand these destructive attitudes.

Jon > Not too far from what happened with the tobacco industry.

Otis> Yes. As long at they print the warning on the pack -- I
have no further problem with the sale of tobacco. I would
like to see a standard "discussion" about the effect
supplied to people about to receive that first minus lens.

Otis> I am also a "dreamer" about these issues.

Jon > Still the question as to why should it be "almost
impossible'?

Otis> The bifocal studies convince me. As an engineer I try to
invest my time in projects that have at least some chance of
being successful. In is these bifocal studies that I agree
with.

Otis> I have extremely meager resources. I can only use these
resources (our motivation) where there might possibility of
success among engineers and scientists who think like we do.

Jon > I would be curious to know how you come to this conclusion
from an engineering foundation.

Otis> Maybe not so much from "engineering" or physical science
foundation, but from the reality of dealing with the
stubbornness and intense resistance I get from most people
about instituting a prevention program.

Otis> Many ODs and MDs tell me I am not realistic, and don't "face
facts". Believe me I do, I don't like them but I do.

Otis> Let us work together to attempt to start a preventive study
at Embry-Riddle. We might be able to accomplish effective
prevention it a type of study that has never even been
attempted.

Otis> I always hope to merge engineering strength with
OD assistance. After Tom K's statements I am
beginning to believe that would be impossible.

 

Absolutly -- that is what engineers do.

A wise understanding of the dynamic behavior of the
eye under experimental control is crucial for
the purposes of science and engineering.

I am certain that pilots who wish to avoid nearsightedness
will pay very close attention to direct-exeprimental data.

Why toture children with this?

The issue is demonstrating that the natural eye is dynamic,
and will change its focal state in a negative direction
when you place a minus lens on it.

Since the engineers can understand the nature of this
kind of experiment -- there is no need to
do the same thing to young children.


It'd save time if you simply take my word ...

You have already given me your "word" that the evolution-designed
eye does not move negative when I place a minus lens on
it.

You give me no choice. Trust your "word", or basic
science and engineering on this subject. I
will trust the experimental data itself if the
subject matter is pure science.

You do or say and/or believe anything you wish
to. Any review of the "dynamic model" should
juxtapose your predictions about the outcome
of this type of experiment -- with the predictions
of a dynamic model. But that is science, not medicine ...


that the big effect ain't there.

1. I don't know what you mean by "big effect".
Not necessarily your call -- since you are not
making the jugement.

2. The issues is whether the eye is behaving as
designed, and as expected.


If there are times when eye growth responds _dramatically_

I do not think it is "over" ... just your opinion. To be
taken into account in due course. Certainly I agree that
once you begin wearing the minus lens you will not
be able to get out of it. I guess that is
why you say the eye "stops growing".


and get included in studies. According to Parnissen, kids who take off

And this is the dead opposite conclusion reached by other
scientific researchers, optometrists, and scientists.

But that is why there is a "second opinion" about the
natural eye's dynamic behavior. It makes life interesting.

We do have one important agreement. If anything is
to be done for prevention, a decision must be
made before the pilot-engineer begins wearing the
minus lens.

That is his choice ... and will have major life-time
consequences for him.

He should make that decision in full view of the
objective scientific data ... and not your
opinion about the data.

Just my opinion.

Best,

Otis
Engineer