The "Mad Parent" problem 
Author Message
 The "Mad Parent" problem

Dear Mike Tyner,

Re:  So you really don't think parents would mind if I used that
      to justify $250 progressive bifocals instead of $100 SV
      minus lenses.  Hmmm...  -- Mike

Otis> I have never advocated that a bifocal be used.  The idea is
      to stop it before a minus lens is required.  Thus the parent
      would be sufficiently informed about the effect of the
      minus lens on the eye so he could make an intelligent
      choice between these two alternatives.

Otis> The lens I advocate for use is a basic plus single-vision
      lens.  But since you are totally opposed to even the
      mentions of the word "reasoning" with the person at the 20/40
      level, then they  will not find anything out from you about the
      subject.  The result is that they must obtain a plus from
      some other source.  Dr.  Stirling Colgate found the plus in
      a drug store for much less that $250, and used it
      successfully.  I would have no problem paying you for
      professional advice concerning the use of a strong plus at
      the 20/50 level -- if you would provide the advice.  This
      would avoid the "mad parent" syndrome -- since the parent
      would have made the choice to reject the use of a strong
      plus -- when it could have been effective.

Mike> I can promise you some Dad will come storming in mad and
      slam a piece of paper down and it'll have this article sent
      by his physician friend with the last couple of lines
      highlighted HOT PINK:  ..progression cannot be reduced by
      diminishing accommodation with bifocals or by reading
      without spectacles."

Otis> He should read the various "plus lens" advocacy sites BEFORE
      any lens were used.  The fact that he is badly informed will
      produce the result as you have described it.

Mike> He'll be wanting $150 back and another pair of glasses.

Otis> Since he would have rejected the use of the plus at the
      20/40 level -- this specific issue would not come up.

Mike> You gonna split it with me?

Otis> In fact the use of the a proper-strength plus, when
      conducted under control of a "motivated pilot" is effective.
      Since the plus lens is sold in drug stores for $15, it
      follows that there is no argument.  The person can simply
      discard the plus lens with out any involvement by either one
      of us if he decides that the "preventive-plus" is not for
      him.  There is no money to "split".  Just a choice between
      two mutually exclusive alternatives.

Best,

Otis

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

Quote:
> Dear Mike,

Otis > As per our symposium on reviewing "thinking" of dinner
      guests, here is an opinion by a person who is not happy with
      the minus lens.  Food for thought.

Mike OD> He isn't offering proof.  At chinamyopia.org, that's not
      considered a problem.  Best I can tell he's describing
      several longitudinal anecdotes without any comparison
between groups that are wearing minus versus groups who are not.
      Bates used "proof by anecdote" extensively.  It's common
      among those who believe that minus "just has to be" harmful.

Otis> I believe in proof by direct testing.  Take a population of
      primates.  Measure their focal states.  Place a minus lens
      on 1/2 of them.  Determine if a difference in focal states
      develops between them.  If no difference develops than the
      "box-camera" theory is confirmed, and you will get no
      arguments from me beyond that point.  If the eye is
      controlling its focal state to the applied lens or visual
      environment, then you must use a completely different
      concept to represent the behavior of all natural eyes.

     We learn by many methods.  Alfred's method was to present his
history of his vision.

     Obviously prevention requires a lot of motivation when your
vision is at -1/2 diopter.  But a decision between two mutually
exclusive alternatives is a wise thing to review.

     No on can make your choice for you, or tell you what
course-of-action will best suit your needs as a professional
pilot.

     I am sorry you feel the way you do.  It is not helpful.

     I will send your commentary to Steve Leung since he knows of
your hostility to change.  A lot of choice in resolving this issue
must reside in the mind of the parent who chooses to use the plus
lens at the 20/40 level for his child.

     Best,

     Otis

                                 *******

From Mike Tyner OD:

     If you or Bates or your oriental friends took the trouble to
measure two groups, wearing minus and not wearing, he'd see there
isn't much difference.  Chinamyopia.org doesn't know that yet but
it's been accepted by vision scientists for some time.  There have
been consistent studies in Singapore.

     On your side of the argument, there _is_ a more recent study
from the optometry school in Talequah that says bifocals DO help,
but only during the first two years.  The results weren't dramatic
and they probably only apply to a minority and they don't apply to
{*filter*}s.  To that degree, the Talequah paper directly contradicts
the one below.

     So you really don't think parents would mind if I used that
to justify $250 progressive bifocals instead of $100 SV minus
lenses.  Hmmm...

     I can promise you some Dad will come storming in mad and slam
a piece of paper down and it'll have this article sent by his
physician friend with the last couple of lines highlighted HOT
PINK:  ..progression cannot be reduced by diminishing
accommodation with bifocals or by reading without spectacles."

     He'll be wanting $150 back and another pair of glasses.  You
gonna split it with me?



Sun, 13 Nov 2005 03:23:11 GMT
 The "Mad Parent" problem


Quote:
>       him.  There is no money to "split".  Just a choice between
>       two mutually exclusive alternatives.

The myope who removes glasses is wearing plus.

-MT



Sun, 13 Nov 2005 04:15:05 GMT
 The "Mad Parent" problem
Dear Mike Tyner,

Subject:  The Mad Parent problem

Re:>  There is no money to "split".  Just a choice between
two mutually exclusive alternatives. Otis

You are correct.  

A poorly informed parent is going to
reject the use of a strong plus at the 20/40 level,
since he only wants 20/15 vision, and no BS about prevention.
If that is his choice -- then that statment ends the discussion -- for
him.

Only if the parent understands the nature of choice
offered is "change" possible.  As I suggested previously,
we must change together.  But since you are not going
to change, it follows that the pilot has no choice
but to look at objective experimental data himself
(that shows that all eyes MOVE IN A NEGATIVE DIRECTION
when you place a minus lens on them).

Let the person concerned with this issue look at the
PROOF HIMSELF.  Let him decide.  Do you think his
is stupid or someting.  

However I do agree that you cannot institute the
change unless:

1.  You have the motivation for the effort.
2.  The parents young person understand some of
    the motivation for prevention, and the
    need to do it at the 20/40 level.

I think we all need to understand why an optometrist can not "do it
for us" -- and why we get silence from ODs on the subject.

Here is Dr. Raphaelson's story about the "mad parent" for
your reading pleasure.

Food for thought.

THE PRINTER'S SON

"It was the year 1904 that I met a mother at a social lodge meeting.
She told me about her son's trouble with his eyes in school. I gave
her my card and told her to bring him to my office and I would fit him
with a pair of spectacles.

"She said that she had no money at the time and that her husband was a
printer working in another city. She did not expect him home for the
next six weeks. I told her all this would not matter, that she should
bring the boy over and I would fit him with a pair of spectacles. I
told her that she could pay for them when her husband returned home.

"She brought the boy in and I examined his eyes. I found that his
vision for distance was poor. It was less than 20/40. I made him a
pair of plus 1.00 diopter spectacles. She was to pay me when her
husband came back home.

"In about six weeks she came back and returned the glasses to me. She
stated that her husband was provoked with her for getting the glasses.
He had tried the boy's eyes with different prints, far and near, and
had found him to have perfect vision with his {*filter*} eyes. In fact, she
said, the boy could see even better without the glasses than with
them.

"I was surprised that the plus lens could produce recovery that
quickly. I could hardly believe this story. I persuaded the mother to
bring the boy back to let me check to see if he could really see well
with his {*filter*} eyes. She again brought the boy in and I checked his
vision. I found that the father was indeed right. The boy had good
eyes, with 20/20 vision and better.

"I was in a dilemma. I did not have the nerve to say anything to the
mother. I just let her go. How was I to prove that the boy had poor
vision before he received his glasses? And who would believe that
vision could be restored by just wearing a pair of plus 1.00 glasses
for a few weeks?

"My experience with the printer's son aroused my inborn tendency for
exploration. It gave me an incentive to try to do special work on
children's eyes and on vision restoration. It also enticed me to
investigate myopic (nearsighted) eyes because I was myself
nearsighted.

"On the other hand, this experience was a warning to be cautious in
doing such work. For selling spectacles to persons who, supposedly,
did not need them was almost a crime. And the fitting of glasses
without the advice or consent of a medical doctor to unhealthy or
diseased eyes, or even to an unhealthy person who might need or be
under medical attention, was, and is now, and encroachment on the
medical profession.

"To shield myself against possible enmity and involvement, I took the
following precautions: First, I quit using the title 'doctor' in any
form, in print or verbally. I was to be known as a spectacle fitter
and nothing more. Second, I charged a reasonable price for the
spectacles I sold but nothing extra for any special work or relief I
gave. I did not advertise about this special work. I just did it as a
matter of routine whenever or wherever I was given the opportunity.

"Thus in 1904 I became an independent researcher on the relationship
of the eye's behavior to spectacles, vision, and health. I have kept
it up, and will continue to do this work as long as I continue to have
the incentive and capability.

"Who would believe it? Who would believe that by just wearing a pair
of plus one (+1.00) glasses for a few weeks, that normal vision to the
{*filter*} eye could be restored to children whose eyes have a negative
focal state? This was true in 1904, and it is also true now, in this
decade of 1950." (It continues to be true in this decade of 1990 --
Otis Brown)



Sun, 13 Nov 2005 23:02:27 GMT
 The "Mad Parent" problem

Quote:
> but to look at objective experimental data himself
> (that shows that all eyes MOVE IN A NEGATIVE DIRECTION
> when you place a minus lens on them).

Where is that objective data?

Objective data would compare two groups over a period of years, and you have not
done that. Nor have you quoted anyone who did.

WHAT EXPERIMENTAL DATA SHOWS THAT?

-MT


Quote:
> Dear Mike Tyner,

> Subject:  The Mad Parent problem

> Re:>  There is no money to "split".  Just a choice between
> two mutually exclusive alternatives. Otis

> You are correct.

> A poorly informed parent is going to
> reject the use of a strong plus at the 20/40 level,
> since he only wants 20/15 vision, and no BS about prevention.
> If that is his choice -- then that statment ends the discussion -- for
> him.

> Only if the parent understands the nature of choice
> offered is "change" possible.  As I suggested previously,
> we must change together.  But since you are not going
> to change, it follows that the pilot has no choice

> Let the person concerned with this issue look at the
> PROOF HIMSELF.  Let him decide.  Do you think his
> is stupid or someting.

> However I do agree that you cannot institute the
> change unless:

> 1.  You have the motivation for the effort.
> 2.  The parents young person understand some of
>     the motivation for prevention, and the
>     need to do it at the 20/40 level.

> I think we all need to understand why an optometrist can not "do it
> for us" -- and why we get silence from ODs on the subject.

> Here is Dr. Raphaelson's story about the "mad parent" for
> your reading pleasure.

> cooking.net">food for thought.

> THE PRINTER'S SON

> "It was the year 1904 that I met a mother at a social lodge meeting.
> She told me about her son's trouble with his eyes in school. I gave
> her my card and told her to bring him to my office and I would fit him
> with a pair of spectacles.

> "She said that she had no money at the time and that her husband was a
> printer working in another city. She did not expect him home for the
> next six weeks. I told her all this would not matter, that she should
> bring the boy over and I would fit him with a pair of spectacles. I
> told her that she could pay for them when her husband returned home.

> "She brought the boy in and I examined his eyes. I found that his
> vision for distance was poor. It was less than 20/40. I made him a
> pair of plus 1.00 diopter spectacles. She was to pay me when her
> husband came back home.

> "In about six weeks she came back and returned the glasses to me. She
> stated that her husband was provoked with her for getting the glasses.
> He had tried the boy's eyes with different prints, far and near, and
> had found him to have perfect vision with his {*filter*} eyes. In fact, she
> said, the boy could see even better without the glasses than with
> them.

> "I was surprised that the plus lens could produce recovery that
> quickly. I could hardly believe this story. I persuaded the mother to
> bring the boy back to let me check to see if he could really see well
> with his {*filter*} eyes. She again brought the boy in and I checked his
> vision. I found that the father was indeed right. The boy had good
> eyes, with 20/20 vision and better.

> "I was in a dilemma. I did not have the nerve to say anything to the
> mother. I just let her go. How was I to prove that the boy had poor
> vision before he received his glasses? And who would believe that
> vision could be restored by just wearing a pair of plus 1.00 glasses
> for a few weeks?

> "My experience with the printer's son aroused my inborn tendency for
> exploration. It gave me an incentive to try to do special work on
> children's eyes and on vision restoration. It also enticed me to
> investigate myopic (nearsighted) eyes because I was myself
> nearsighted.

> "On the other hand, this experience was a warning to be cautious in
> doing such work. For selling spectacles to persons who, supposedly,
> did not need them was almost a crime. And the fitting of glasses
> without the advice or consent of a medical doctor to unhealthy or
> diseased eyes, or even to an unhealthy person who might need or be
> under medical attention, was, and is now, and encroachment on the
> medical profession.

> "To shield myself against possible enmity and involvement, I took the
> following precautions: First, I quit using the title 'doctor' in any
> form, in print or verbally. I was to be known as a spectacle fitter
> and nothing more. Second, I charged a reasonable price for the
> spectacles I sold but nothing extra for any special work or relief I
> gave. I did not advertise about this special work. I just did it as a
> matter of routine whenever or wherever I was given the opportunity.

> "Thus in 1904 I became an independent researcher on the relationship
> of the eye's behavior to spectacles, vision, and health. I have kept
> it up, and will continue to do this work as long as I continue to have
> the incentive and capability.

> "Who would believe it? Who would believe that by just wearing a pair
> of plus one (+1.00) glasses for a few weeks, that normal vision to the
> {*filter*} eye could be restored to children whose eyes have a negative
> focal state? This was true in 1904, and it is also true now, in this
> decade of 1950." (It continues to be true in this decade of 1990 --
> Otis Brown)



Mon, 14 Nov 2005 07:08:52 GMT
 The "Mad Parent" problem
Dear Mike,

Mike> Were is that objective data?

It depends on who is "objective"?  The pilot who
wishes to clear his distant vision from 20/50 to 20/20,
or YOU.  I think the pilot is more interested and more
motivated than you are.   In any event, the actions
taken, and the judgments made will be the pilots actions,
and not yours.  I site DIRECT CHANGES in the visual
enviroment, and CHANGES IN FOCAL STATE of the entire
population of eyes, whether positive or negative.
I depend on the intelligence of the person to understand
this difference in preception.

Mike> Objective data would compare two groups over a period of years,
and you have not done that. Nor have you quoted anyone who did.

Yes I have.  You just totally igonored the factual data -- since
is apparently goes right over your head.  The objective
experimental data is on my site discussed in chapters 4, 5, 6
and 7.

Mike> WHAT EXPERIMENTAL DATA SHOWS THAT?

Otis>  It dependes on what you mean by "shows that".  What the
experimental data shows is that the natural eye changes its
focal state as the visual enviroment is changed.  It shows
nothing concerning "defect", only the dynamic behavior of
all natural eyes.

Best,

Otis

*********

Quote:

> -MT

You keep on totally ignoring objective experimental data.

In an engineering sense, you ask the question (before there
is nny "defective" eyes, whether the natural eye
CHANGES ITS FOCAL STATE as THE VISUAL ENVIROMENT IS CHANGED.

This is an engineering question -- AND NOT A MEDICAL QUESTION.

Thus:

You can do this experiment with primates.  No need to
inflict this measurement work on humans.

Quote:

> > but to look at objective experimental data himself
> > (that shows that all eyes MOVE IN A NEGATIVE DIRECTION
> > when you place a minus lens on them).

> Where is that objective data?

> Objective data would compare two groups over a period of years, and you have not
> done that. Nor have you quoted anyone who did.

> WHAT EXPERIMENTAL DATA SHOWS THAT?

> -MT



> > Dear Mike Tyner,

> > Subject:  The Mad Parent problem

> > Re:>  There is no money to "split".  Just a choice between
> > two mutually exclusive alternatives. Otis

> > You are correct.

> > A poorly informed parent is going to
> > reject the use of a strong plus at the 20/40 level,
> > since he only wants 20/15 vision, and no BS about prevention.
> > If that is his choice -- then that statment ends the discussion -- for
> > him.

> > Only if the parent understands the nature of choice
> > offered is "change" possible.  As I suggested previously,
> > we must change together.  But since you are not going
> > to change, it follows that the pilot has no choice

> > Let the person concerned with this issue look at the
> > PROOF HIMSELF.  Let him decide.  Do you think his
> > is stupid or someting.

> > However I do agree that you cannot institute the
> > change unless:

> > 1.  You have the motivation for the effort.
> > 2.  The parents young person understand some of
> >     the motivation for prevention, and the
> >     need to do it at the 20/40 level.

> > I think we all need to understand why an optometrist can not "do it
> > for us" -- and why we get silence from ODs on the subject.

> > Here is Dr. Raphaelson's story about the "mad parent" for
> > your reading pleasure.

> > cooking.net">food for thought.

> > THE PRINTER'S SON

> > "It was the year 1904 that I met a mother at a social lodge meeting.
> > She told me about her son's trouble with his eyes in school. I gave
> > her my card and told her to bring him to my office and I would fit him
> > with a pair of spectacles.

> > "She said that she had no money at the time and that her husband was a
> > printer working in another city. She did not expect him home for the
> > next six weeks. I told her all this would not matter, that she should
> > bring the boy over and I would fit him with a pair of spectacles. I
> > told her that she could pay for them when her husband returned home.

> > "She brought the boy in and I examined his eyes. I found that his
> > vision for distance was poor. It was less than 20/40. I made him a
> > pair of plus 1.00 diopter spectacles. She was to pay me when her
> > husband came back home.

> > "In about six weeks she came back and returned the glasses to me. She
> > stated that her husband was provoked with her for getting the glasses.
> > He had tried the boy's eyes with different prints, far and near, and
> > had found him to have perfect vision with his {*filter*} eyes. In fact, she
> > said, the boy could see even better without the glasses than with
> > them.

> > "I was surprised that the plus lens could produce recovery that
> > quickly. I could hardly believe this story. I persuaded the mother to
> > bring the boy back to let me check to see if he could really see well
> > with his {*filter*} eyes. She again brought the boy in and I checked his
> > vision. I found that the father was indeed right. The boy had good
> > eyes, with 20/20 vision and better.

> > "I was in a dilemma. I did not have the nerve to say anything to the
> > mother. I just let her go. How was I to prove that the boy had poor
> > vision before he received his glasses? And who would believe that
> > vision could be restored by just wearing a pair of plus 1.00 glasses
> > for a few weeks?

> > "My experience with the printer's son aroused my inborn tendency for
> > exploration. It gave me an incentive to try to do special work on
> > children's eyes and on vision restoration. It also enticed me to
> > investigate myopic (nearsighted) eyes because I was myself
> > nearsighted.

> > "On the other hand, this experience was a warning to be cautious in
> > doing such work. For selling spectacles to persons who, supposedly,
> > did not need them was almost a crime. And the fitting of glasses
> > without the advice or consent of a medical doctor to unhealthy or
> > diseased eyes, or even to an unhealthy person who might need or be
> > under medical attention, was, and is now, and encroachment on the
> > medical profession.

> > "To shield myself against possible enmity and involvement, I took the
> > following precautions: First, I quit using the title 'doctor' in any
> > form, in print or verbally. I was to be known as a spectacle fitter
> > and nothing more. Second, I charged a reasonable price for the
> > spectacles I sold but nothing extra for any special work or relief I
> > gave. I did not advertise about this special work. I just did it as a
> > matter of routine whenever or wherever I was given the opportunity.

> > "Thus in 1904 I became an independent researcher on the relationship
> > of the eye's behavior to spectacles, vision, and health. I have kept
> > it up, and will continue to do this work as long as I continue to have
> > the incentive and capability.

> > "Who would believe it? Who would believe that by just wearing a pair
> > of plus one (+1.00) glasses for a few weeks, that normal vision to the
> > {*filter*} eye could be restored to children whose eyes have a negative
> > focal state? This was true in 1904, and it is also true now, in this
> > decade of 1950." (It continues to be true in this decade of 1990 --
> > Otis Brown)



Mon, 14 Nov 2005 21:56:15 GMT
 The "Mad Parent" problem

Quote:
> It depends on who is "objective"?  The pilot who
> wishes to clear his distant vision from 20/50 to 20/20,
> or YOU.
> I depend on the intelligence of the person to understand
> this difference in preception.

In the math department they taught me that studies of "preception" are prone to
bias, and so are "interested" and "motivated" subjects.

But even so, show me a group of your enthusiastic pilots before and after
training, and another group with the same demographics and myopia who did NOT
train, and their average refraction just won't vary much. Not for big groups.
Where is your evidence otherwise?

Bias is expected in myopia experiments. If you don't control for it, conclusions
are unreliable.

Hearsay and intuition aren't proof. Minus lenses don't cause myopia.

When the myopia is yours, it makes sense to try anything safe that might help.
It doesn't make sense to chase faery-tales. Your pilots have better things to
do.

-MT



Tue, 15 Nov 2005 02:36:20 GMT
 The "Mad Parent" problem

Quote:

> Bias is expected in myopia experiments. If you don't control for it, conclusions
> are unreliable.

Because the experiment is wrong. Of course is biased.

Quote:
> Hearsay and intuition aren't proof. Minus lenses don't cause myopia.

In fact they aggravate it and prevent any cure.

Quote:
> When the myopia is yours, it makes sense to try anything safe that might help.
> It doesn't make sense to chase faery-tales. Your pilots have better things to
> do.

Good said.

Now please cure your own patient if you can with minus or plus or
everything else. You will see you won't succeed.



Tue, 15 Nov 2005 04:05:04 GMT
 
 [ 7 post ] 

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