Why true prevention can not be offered by an OD

Dear Friends,

We have had pleasant arguments about the eye's
natural behavior.

But the real problem is the publics rejection
of the plus.

I accept this argument as the "real reason".

I do not "twist arms" -- once this
decision has been made.

Best,

Otis



Dear Lucia,

Otis> To answer your questions:

Dear Otis,

Lucia> I have been crying victory too early!.

Lucia> The day i bought the + 1.25 lenses for my daughter she wore
them for most afternoon, but after that she practically
refused to wear them for more than a few minutes on the
grounds that their use triggers headache on her and she
can't do math with a headache!

Otis > Your daughter is in "control" of her eyes. You and I are
not in control. It is her decision. I would not "fight"
with her anymore. While clear distant vision is very
important to a pilot -- it is obviously not THAT important
to most of the "public" at this time.

Lucia> I really don't know what to tell her!

Otis > You have done your best. She "knows" -- but has made her
decision.

Lucia> I tried to insist but was hushed by my husband (he agrees
with me on having her try the plus lenses but thinks that
insisting if she gets headache is not sensible)

Otis > I would like to have your daughter "get the idea", but your
husband is "right". We can only "protect" our
blood-relatives, but only to a certain point. Your
daughter has reached that point. Accept the fact that your
daughter is going to be permanently nearsighted. This is
not "heredity", but our collective refusal to use the plus
lens properly. I accept this as the real "cause" of
nearsightedness.

Lucia> Is it normal that she gets headaches?

Otis > Yes. Some do -- some do not. It is a price we pay for
prevention. The plus moves the object out to "infinity"
while the eyes are "converged". In some people this
produces a headache. Don Rehm invented a Myopter to also
eliminate this problem. But this is just an additional
detail. You daughter simply does not want to do any of
this work.

Lucia> ... and is there a pattern of increasing usage to get used
to the plus lenses ,, i mean 5 minutes , then 10, then
etc...???

Otis > Yes, she COULD get comfortable with the plus in this
manner. But I think she will fight you in every way
possible on this issue. I do advocate prevention -- but
only IF THE PERSON (pilot) can have the motivation to do it
correctly.

Lucia> ... any tips on this?

Otis > I am a total loss in "fighting" with children. Perhaps it
is because I am a engineer. If a person points a gun at
his foot, we will say, "if you pull the trigger, you will
have a big hole in you foot". As sure enough, the person
will pull the trigger. What can I say about this? I have
no arguments but the facts themselves.

Lucia> Thanks a lot i won't give up the nagging and the hope to be
able to do something for my daughter's myopia.

Otis > You have done all you can. Your daughter "knows". Show
her these statements. If she does not value her distant
vision, then in a few short years she will become
completely dependant on that minus lens. She will be
wearing the minus 16 hours a day -- and 7 days a week.

Otis > Since she eventually must wear a minus lens, then I would
suggest that she keep it off her face as much as possible,
and only use it when absolutely necessary. Since she does
not like "wearing glasses" then she should like that idea
concerning the use of a minus lens.

Otis > Your daughter has had her "fighting chance". You have
helped as much as possible. Life is short -- enjoy it.
Your daughter has made her decision -- let it go.



ciao

lucia


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


Dear lucia,

I appreciate your interest!

A slight "headache" is normal. If you will read Dr.
Colgate's commentary he says the same thing.

MOTIVATING A CHILD TO USE THE PLUS:

Your daughter has made her decision.

This is all that I would expect of an OD, and of myself.

I would not "push it" beyond this point. Your daughter can
expect to be about -3 diopters in about 6 years -- if she goes to
college.

This is the major reason why I have no argument with the ODs
-- except for this issue of providing the information.

As long as we reject or refuse the use of the plus at the
-1/2 to -1.0 diopter level, then we shall pay the price.

She, far more than most, knows the price she will pay. Later
on, she can get Ortho-K, Lasik, Inter-ocular lens implant, and
other methods like that produce instant results.

I am sorry that you and I can be of no further help to your
daughter.

For some reason, my niece got the idea correctly and
consistently used the plus through college and graduate school.

I must run now!


Best,


Otis

 

Otis,

Long boring stories.
You better provide us with proof or evidence your ideas about true
preventing are working.
We have not seen a tiny little bit of such.
Get real man, you are wrong until shown otherwise by proof instead of those
boring anecdotes.
More and more I get the idea you are hearing deaf and seeing blind.
Every time it is getting hot under your feet you are starting another tread
and leave the hot one, not exactly fair if I may say so.

EVIDENCE, PROOF or whatever we can check please Otis instead of anecdotes.
Show us we could help people in a better way.
I have an open mind but this mind has to be convinced your ideas are useful,
so far you did not succeed nor did your people with a professional
background

Jan (normally Dutch spoken)

 

I understand that you can cure up to 10 dB of hearing loss by wearing 10dB
earplugs.

Scott

 

This post has quite angered me.

Not only are you busy encouraging the abuse of the child when you have
No Idea whether she will end up shortsighted, you are also making the
mother and parents feel guilty and that it is their fault, that they
could have 'fixed' their daughter's vision, when it's not and the rest
of the world happily accepts this

How do you sleep at night?!?

 

Thanks to the good work of Dr. Raphaelson,
and other doctors who support the concept of
the "second opinion", I sleep well.

The fact that my sister's children had
this opportunity -- and took it seriously,
enabled them to keep clear distant vision
through high school, college and
graduate school.

I do not know if you understand any
statistics, but the "downward" rate
at college is about -1/3 diopters per year.

The young woman has every right to look
at these statistics, and as a informed
decision reject the use of the plus.
No harm done.

In fact, now that the daughter has
made her decision -- I ask her to
worry about it no more.

Some of us appreciate a "fighting chance",
some do not. The decision is
up to the person concerned with it.

Best,

Otis

 

(Otis Brown) wrote in

Oh, uh-huh.

Everybody progresses at that rate? Does this mean that 100% of college
students are more than one diopter myopic after four years?

Some people waste time on the internet, others may choose to wear plus
lenses in an attempt to prevent myopia I guess.

DrG

 

I am pleased your children have good vision.

That choice, that decision, is a matter of their
judgment. The choice, thanks to pioneering optometrists
and ophthalmologists and a professor at the
Houston College of optometry, is that
the plus lens constitutes a choice at
the thereshold.

Given the statistics at the military academys
of -1/3 diopters per year, I think that a
person should be informed of them
(at the 20/30 level) and make is own
decision -- with the understanding
that this approach constitutes the
"second opinion".

Best,

Otis
Engineer

 

People who sincerely believe what they are saying usually sleep well.

Of course. I'm glad to see that you do have a good understanding of
statistics. Not everybody does.

/sarcasm mode off

:-(

 

(Dan Abel) wrote in 64en129.sonoma.edu:

I was a statistician in a previous life. I have had many incarnations.

DrG

 

Excellent, Dr. G.

Incidentally, since I talked with Dr. Raphaelson
and learned of his frustration with "The Printer's
Son", and many other things, it became
clear to me that prevention was indeed very
difficult, and could not be offered in
the 10 minutes -- no make that 8 minutes -- you
spend with a person.

Indeed, about 99 percent of the population
wants their vision sharpened immediately -- as
we discussed.

However, I could not "sleep well", if I did
not make the effort to help my sister's kids.
(They now have children of their own.)

In fact we had a friend who was is an
optometrist -- who acknowledged the
primary role the individual had
to play in effective prevention.

Because of their wisdom, they used the
plus correctly -- as advocated by Professor
Grosvenor at the Houston College of Optometry.

Yes, the professor is correct. Pevention
is indeed difficult -- but they worked
the issues correctly.

Anectdotal you say? For you perhaps yes.
For them -- since they saw the results
themselves then no. But do not worry
about this.

By the way -- we do not use the
word "anectdotal" in engineering.
We make measurements and report
facts.

People who do not like the facts
"spin" the facts by calling them
all "anectdotal".

Enjoy my friend. Other optometrists
have been of great help in this
process -- even though these
"kids" had to do almost
all the work themselves.

Let us learn together.

Best,

Otis
Engineer

 

So you can show us with ease that people who don't do this all end up
myopic?

Let me do a quick survey in the office... right, 9 people, two
shortsighted, the others all just fine - NONE OF THEM USED A PLUS, and
both the shortsighted people got no worse during university - I should
know I'm one of them.

So out of our sample size of 9 we find 0 people have demonstrated what
you claim happens to everyone and claim as sufficient reason to piss
around with children.

Just which college, because it doesn't appear true here.

You have taken a flimsy statistic and bend it into an excuse to abuse
parent's concerns for their children so that they hand over money and
abuse their children to salve their own consciences

What next? A claim that children are getting too short therefore we
should strap them to a rack and stretch them for an hour a day?

We have that without giving you or yours money mate. Sorry.

 

(Otis Brown) wrote in @posting.google.com:

Yes, we do. While we make measurements and report facts, we make repeated
measurements to verify our facts, and we do statistics to ascertain the
quality and meaning of the data we collect.

This is why ABET, the accreditation body for engineering programs, requires
statistics as a program criteria for any curriculum seeking accreditation
in Biomedical Engineering. No statistics, no accreditation.

Engineers in the life sciences must exercise scientific rigor. No two ways
about it.

Scott

 

major snip

I doubt if Prof Grosvenor agrees with you saying that he still advocates
plus for prevention. Could you e-mail him and have him confirm this? I
have seen his recent published works with the use of plus on humans and he
has found it to have little effect in preventing or slowing the progression
of myopia.

So if someone built a bridge out of rotten wood and rusty metal and one or
two cars drove over it without breaking through, engineers would accept that
it is a "fact" that bridges can safely be built of rotten wood and rusty
metal? I think not.

When you provide stories about select individuals whose vision improved
while ignoring the controlled studies that show groups of people using plus
do not improve any more than groups of people not using plus, you are
providing the same quality "proof" as the rusty bridge example.

Rather the reverse. People who do not like the facts contained in
controlled scientific studies, ignore those facts in favour of isolated,
anecdotal, reports contrary to the scienfically derived facts.

Dr Judy

 

(Frostypaw) wrote in message
Dear FrostyPaw,

Yes -- you are an optometrst!

There are both ODs and MDs who do not agree with
you, ergo -- the second opinion.

But, to respond:

Science and engineering are not "easy". I have no
obligation to show you that which you do not
want to understand.

But it was necessary to explain most of this
to these intelligent and motivated adults.

It is to their credit that they worked
very hard at it, and always verified
they passed the Snellen-DMV test.

You have an unusual way of "doing statistics".
Takes much more time to evaluate the
natural eyes behavior with a engineering student -- like
a year for instance.

You are very biased my friend with the fractured
statistics.

Both the U. S. Naval Academy, and West Point -- but
I know you do not read papers you do not like.
West Point paper was by Gemlin I believe.
and the AVERAGE rate for the entire
population was -1/3 diopters per years.

I am certain an engineering student would have
greater scientific and engineering of the
nature of these statistics that you do.
But that judgment will be up to them -- and
not you.

You have obviously jumped to your own preferred
conclusion.

I have no idea what you are talking about her.
No money is involved with my statements. Only
and informed choice, or "fighting chance" if
you want to put it that way.

Certainly the minus lens is 100 times easier
than prevention with a plus lens. But
some times the "easy" way is not the best way.

Stick with the subject. I acknowledge that
you can do nothing for true prevention,
and you would never be the man
to lead such a effort.

I NEVER asked you for money. I do not
know what you are taking about.

Best,

Otis
Engineer

 

Mike,

They are not "wrong" as you like to
say.

They are profoundly conflicted -- and you
read what you want to read into them --
as I am well aware.

The Oakley-Young study suggested in strongest
terms that PREVENTION would work if the
plus were used BEFORE the minus were used.

This is the same suggestion made by Dr.
Grosvenor of the Houston college of
optometry. The real difficulty
(as we all agree) is to get the parents
to understand the necessity or
using a strong plus at the THRESHOLD
of "nearsighedness", i.e., 20/20 but
a refractive state of zero.

Rather than attempting to do anything furhter
with children, I would be wise to
consult with pilots entering a
four year college and present them
with the statistics at West Point
and Annapolis.

That way they can make an intelligent
choice in the matter -- given
a year to think it over.

But that would be an issue for
the future.

Best,

Otis
Engineer