Why true prevention can not be offered by an OD

Discussion in 'Optometry Archives' started by Otis Brown, Apr 5, 2004.

  1. Otis Brown

    Otis Brown Guest

    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 Brown, Apr 5, 2004
    #1
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  2. Otis Brown

    Jan Guest

    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)
     
    Jan, Apr 5, 2004
    #2
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  3. I understand that you can cure up to 10 dB of hearing loss by wearing 10dB
    earplugs. ;)

    Scott
     
    Scott Seidman, Apr 5, 2004
    #3
  4. Otis Brown

    Frostypaw Guest

    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?!?
     
    Frostypaw, Apr 6, 2004
    #4
  5. Otis Brown

    Otis Brown Guest

    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, Apr 7, 2004
    #5
  6. Otis Brown

    Dr. Leukoma Guest

    (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
     
    Dr. Leukoma, Apr 7, 2004
    #6
  7. Otis Brown

    Otis Brown Guest

    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
     
    Otis Brown, Apr 7, 2004
    #7
  8. Otis Brown

    Dan Abel Guest


    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, Apr 7, 2004
    #8
  9. Otis Brown

    Dr. Leukoma Guest

    (Dan Abel) wrote in 64en129.sonoma.edu:
    I was a statistician in a previous life. I have had many incarnations.

    DrG
     
    Dr. Leukoma, Apr 7, 2004
    #9
  10. Otis Brown

    Otis Brown Guest

    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
     
    Otis Brown, Apr 8, 2004
    #10
  11. Otis Brown

    Frostypaw Guest

    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.
     
    Frostypaw, Apr 8, 2004
    #11
  12. (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
     
    Scott Seidman, Apr 8, 2004
    #12
  13. Otis Brown

    Dr Judy Guest

    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
     
    Dr Judy, Apr 8, 2004
    #13
  14. Otis Brown

    Otis Brown Guest

    (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
     
    Otis Brown, Apr 8, 2004
    #14
  15. Otis Brown

    Otis Brown Guest

    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
     
    Otis Brown, Apr 9, 2004
    #15
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