(AboutUs.txt) Dear Fellow Pilot, This is Dr. Stirling Colgate's book on nearsightedness prevention. I think it is important for you to establish the fact that a scientist has successfully defeated the problem of nearsightedness by his own understanding of optics -- and because of his own forceful effort in the proper use of a plus lens. The ultimate result was that Dr. Colgate cleared his distant vision to 20/20, i.e., his eyes changed their focal status from -1.0 diopters (20/70) to +1/2 diopter (20/20) by use of a +2.5 dioter plus lens. http://en.wikipedia.org/wiki/Stirling_Colgate Otis Brown ********************** A SCIENTIFIC UNDERSTANDING OF EYESIGHT AND THE EYE'S DYNAMIC BEHAVIOR by Stirling A. Colgate, Ph.D.. Theoretical Physics Division MS-210 Los Alamos Scientific Laboratory Los Alamos, New Mexico 87545 [Previous Title: "A Physicist's Understanding of Eyesight, or, How to Manage Advantageously Your Mean Relaxed Eyesight Focus", dated 5/22/79] Edited by Otis S. Brown C & O Research 11286 Weatherstone Dr. Waynesboro, PA 17268 717-749-7895 otisbrown@pa.net _______________________________ Table of Contents Acknowledgment Personal Note by Stirling Colgate Why Stirling's Experience is Important to You Prologue How to Maintain Clear Distance Vision for Life: Introduction Lenses, Plus and Minus The Artificial Correction Mechanisms How to Maintain Distance Vision in a Civilized Environment How to Select Glasses What to do for Early Myopia Bifocals Other Caveats Why Do So Few People Know About This? Conclusion Letter to the National Institute of Medicine Dr. Stirling Colgate's Vita ******************************************** GENERAL DISCUSSION Acknowledgment I am deeply grateful to the very many people who have read, criticized, and encouraged this work. Foremost among these are my wife, Rosie, who helped start the project. Dr. Francis Young has insisted on technical accuracy and strongly encouraged the project. By his concern, Dr. Dick Garwin has added significantly to the final completion. A Personal Note by Dr. Colgate Since I am a physicist I am not dependent upon optometry or ophthalmology for my professional peer group. I have managed my own eyesight all my life. I have undertaken to try to explain this because I believe that the condition of myopia (and then having to wear nearsighted glasses for life) is totally unnecessary for the majority of the human race. I believe that the condition of progressive myopia is a grotesque and needless distortion of human physiology, created by our intellectual environment of reading and continued because of our collective denial of that very intellect. Fortunately, I understood most of how to manage eyesight for myself when I was studying biology and physics when I was 14. I first started to become nearsighted (again fortunately -- at a relatively late age) -- at 13 to 14. As soon as I noticed it, I immediately acted upon it by buying a pair of reading (farsighted) glasses, positive lenses, at the dime store. I used these for reading. A positive lens substitutes for further contraction of the ciliary muscle thereby allowing the eye focus to remain at infinity when reading a book up close. Within several weeks my eyesight had returned to normal -- focal state at infinity. Stirling Colgate Why Stirling's Experience is Important to You I had prepared eight papers on the dynamic behavior of the eye, from 1979 to 1985. My co-authors were long-established scientists and researchers. These papers presented the eye as a sophisticated feedback-controlled device, where the eye continually adjusts its focal state to the average visual environment. Towards the end of this effort, I received Dr. Stirling Colgate's manuscript from Dr. David Guyton, which further confirmed the scientific opinion that the eye is dynamic. I then organized my papers into a book called, "How to Avoid Nearsightedness". This book is dedicated to the welfare or pilots, and other self-motivated students of science who desire to return their distant vision to 20/40 or better. Since I had such a difficult time obtaining Stirling's manuscript, I think that it is important that we make an effort to formally publish Stirling's judgment about nearsightedness prevention. I have edited his original manuscript somewhat, to update it and make it consistent with current experimental data and knowledge. There is no doubt that Stirling accomplished precisely what he says he achieved, and that his statements are reinforced by the most direct and objective scientific measurements that are possible. To assist pilots and other highly motivated individuals in their understanding of the eye's behavior, Stirling wrote a letter to the NIH, to get their assistance in informing both the health profession and the general public about the experimental data, and the scientific opinion that the eye is dynamic, and that an alternative method does exist to prevent nearsightedness. Other than a courtesy receipt acknowledgment of Stirling's letter, no effort was mounted by the NIH, and NEI to assist with this important scientific work. (The letter is at the end of this article.) While the prevention of nearsightedness is not easy, it is possible. The traditional method (negative-lens) does work, and creates impressive clarity of vision. It is this initial success of the minus lens that blinds us to the deeper truth concerning the eye's behavior. The minus lens is a trap for the unwary, but most of us will step into it. I hope you enjoy Stirling's review and recognize his successful effort with a difficult scientific and practical problem. Otis Brown PROLOGUE "A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it." Max Planck The following book is a description of what we think should be done. The study of the development of the dynamic eye should be a well-funded scientific research effort. With accurate knowledge of the normal eye's behavior, we can then expect that the preventive care of the eye can be an important part of science and medicine. We acknowledge that the person who is on the threshold of nearsightedness must play a fundamental and insightful role in the this process. If he is willing to do so, the maintenance of clear distant vision can be an entirely successful process. Offering a discussion of the preventative process to all individuals who are at 20/30 to 20/50 level is an engineering and medical responsibility. The preventative technique has been developed as the "second opinion" over the past fifty years. This manuscript has been prepared by two authors, Stirling Colgate and Otis Brown. We are both committed to a scientific understanding of facts. Stirling was able to defeat the situation by developing a clear understanding of the eye's fundamental behavior. It must be preceived that this book regards nearsightedness as a negative focal state of the eye -- with no necessary suggestion of defect. Since an accurate representation of the eye's behavior does not require the concept of "defect", we judge that research into this question of the eye's behavior is of prime importance for the solution of this difficult problem. If you, apriori, decide that myopia is an organic defect, or refractive error, then it will be difficult for you to form a coherent picture of the experimental data, as well as judging the success of the preventive approach. OSB & SAC HOW TO MAINATION CLEAR DISTANT VISION FOR LIFE INTRODUCTION It is not necessary for young people to become myopic. Progressive myopia is "iatrogenic" (a professionally induced condition). Myopia can be prevented by the use of far-sighted glasses for reading instead of the use of near-sighted glasses for distance. This book argues that myopia is completely preventable, and therefore need not be progressive. Young people should not use negative-lens glasses for distance vision -- unless they accurately understand the long-term consequences of such use. There is a trade-off; either use positive lens glasses for the unnatural act of reading or use negative-lens glasses to compensate a distorted eyeball for distance vision. The scientific investigations on which this factual assessment is made is based extensive scientific work by Dr. Francis A. Young, as well a many other gifted researchers. "Normal vision" means seeing mountains, birds and stars at a far distance -- "infinity" -- with sharp detail, as great a detail as is allowed by the spacing of receptors (rods and cones) of the retina of the eye. This spacing of receptors has biologically evolved in mammals, birds and some reptiles to corresponds to a resolution of about one in ten thousand (l in 10,000), or a resolution of 1 minute-of-angle. To make use of the resolution of the optical receptors requires a focal system that is also good to 1 in 10,000. We can't be born with physiological parts that are made that precisely; instead, there is a natural process in growth and development that corrects for the wide dispersion of the physical dimensions of the new born eye. Essentially all eyes at birth are far-sighted with a positive focal state. Continual close-work causes the normal eye to change from a positive to a negative focal state -- which is described as "nearsightedness". This process of adaptation is supposed to stop when the eye's focal status is zero. (All normal eyes have a zero or positive focal status.) The eye behaves in this manner for people and animals in a natural environment, outdoors -- i.e., people without books, TV, or sewing kits. Instead we learn to read, and then our focal status becomes as close as the book we read. We lose the ability to see clearly at a distance because our eyes have adapted to the close-up focus of the book. We call this condition "near-sighted" or myopic. Our response to this condition is disastrous, because we attempt to correct this condition by actions that exacerbate the original condition, namely by wearing near-sighted glasses. After we have changed our focus to a negative value, and we want to see a mountain, we must use a lens that moves the mountain (optically) closer. The mountain will have the same focal property as an object close up. Such a lens is called a negative lens or "near-sighted glasses". The focal property of a close-by object is that the rays of light diverge; for distant objects the light rays arrive parallel. A negative lens, or "near-sighted glasses", causes light rays to diverge; hence endowing the distant object with the focal properties of one close-by. When we start wearing such glasses they indeed bring the mountain closer, and of course in better (sharper) focus. But then with such glasses (when we read using these glasses) we bring the near object up still closer. Because of the wondrous adaptability of the eye, the eye continues to adapt to the still closer environment (caused by the negative lens) and you become still more nearsighted. That is, your normal eyes take on an ever increasing negative focal state, caused directly by your use of a negative lens. Fortunately, nature sometimes puts an end to this farce at the age of about 18 to 22 -- by refusing to adapt further. After that you are stuck with a negative focal state for life because the eyeball loses its ability to change in response to the close work you are doing. Of course, after the age of 40 to 50 you also lose the elasticity of the lens. This however, is an entirely different matter, just as glaucoma, blindness, etc., are entirely different eye problems. The elementary and obvious thing to do in order to maintain clear distant vision -- i.e., seeing mountains and stars clearly without glasses -- is to catch your focal adaptation when your eye-sight is on the threshold of the situation, i.e., your focal state is zero or slightly negative. When you first notice a slight blur at distance, begin using positive-lens glasses for reading. A positive lens endows the close object with the focal properties of a distant one by making near-by light rays parallel. When you use a plus-lens for a close-by object, the rays become parallel as rays are from a distant object. Remember, prolonged reading is the "unnatural" thing you are doing. Then the focal properties of the book you are reading are like those of the mountains, i.e. infinity, and the further adaptation of your eyes stops at this point. You then have, and can maintain normal vision. (A positive focal state of the eye.) Because this period of normal vision occurs early, 5 to 10 years old, you are usually too young to know when you are at "normal" vision. Your parents don't know either because until recently it has not been understood. Further, there has been no consistent effort to accurately explain the eye's behavior to you, so that you could not intelligently make this "either-or" decision, between recovery and successful prevention, or progressive worsening of vision. Every professional who deals with you owes it to you to broach the subject of this alternative when you are on the threshold of the situation. Your eyes, after all, belong to you. Since the nearsightedness produced by the negative lens cannot be undone by a positive lens, it is imperative that you understand and choose to use either one or the other of these two mutually exclusive techniques. Science has progressed to an accurate understanding this mechanism of slow change of the normal eye to its average environment. A significant number (several dozen) of professional people in ophthalmology and related disciplines have empirically and intuitively come to the same conclusion and unsuccessfully attempted, even with the dedication of a lifetime, to reverse the orthodox view of solely genetically determined eye focus. The "majority opinion" of those in the ophthalmology profession has been a refusal to recognize a mechanism of slow adaptation of the focal state of the eye to its mean focal environment -- for various reasons. Among these reasons are: 1. There is a long-standing orthodox view that all focal states of the normal eye are hereditary and therefore nothing affects focus after conception. 2. The public demands instantaneous sharp vision, i.e., "Johnny can't read the blackboard and I won't stand for any nonsense about getting positive glasses that make it still fuzzier -- even temporarily!" 3. The scientific understanding of the early development of the normal eye is new and not yet complete so there is always an excuse to ignore it. 4. There have been many non-scientific books about sight without glasses that have not logically argued the reasons, not giving the physics background, nor have they discussed the biological mechanism. For example, eye exercises involve contracting the ciliary muscle causing a shorter, more myopic focus and therefore tending to change the eyeball and produce a still more myopic state. 5. Ophthalmologists in general are not required to study the physics of the normal eye, which includes optics and information theory necessary to understanding a logical scientific argument for a physiological mechanism. 6. If reading glasses were used at the onset of myopia up to 90% of all myopia would be prevented, and then a significant fraction of the optometry profession would be eliminated. Furthermore, reading glasses cost no more than $6.00 to $9.00 to manufacture and sell for $12.00 to $19.00 without a prescription. 7. Many optometrists and even some ophthalmologists believe that myopia and wearing glasses is not such a bad thing; after all, many people want to buy glasses in order to look chic. The very many that undergo the discomfort and expense of wearing contact lenses is an overwhelming vote to the contrary. People would rather not be nearsighted. 8. Finally social pressure of intellectual achievement is forcing the age of first reading to an earlier, even preschool age, hence causing earlier myopia and a eventually, further progression. Note: Ophthalmologists who practice ophthalmology are trained as medical doctors specializing in the diseases of the eye. They have minimum training in optics, measuring human refractive states, physics, etc. Optometry on the other hand, came out of physics dealing with the physical optics approach and the application of physical optics to correction of human refractive errors. (This idea, of course, assumes that a negative focal state of the normal eye is a "refractive error".) Although optometry came from physics, little if any physics is retained in the curriculum of the training of optometrists. Optometrists, however, are somewhat more sympathetic to the concept that myopia can be prevented with a plus lens, than are ophthalmologists -- although opinions vary widely! LENSES There are two types of lenses in use today -- positive and negative. You can find a sketch of the basic optics and physics of these lenses in any standard physics book. A NEGATIVE LENS: This lens creates diverging rays of light from parallel rays. This lens is the standard prescription lens for persons who have a slight a negative focal status for their eyes. A POSITIVE LENS: This lens takes diverging rays of light and makes them parallel. If you read with this lens on, the lens creates the effect as though you are looking at distant objects all the time. THE ARTIFICIAL CORRECTION MECHANISMS Professor Young has shown that older monkeys can be made nearsighted in a matter of weeks. He has done this by enclosing the monkeys' heads in hood-like devices that allows only near point focus of 14 inches or less. A relief of their near point environment -- soon enough -- within 6 months permits a return to normal vision. Longer than this seems to have a more permanent effect -- indicating that a severe negative focal state of the eyeball is irreversible. It is also common experience with both people and Young's monkeys that the process of focal state compensation, i.e.,, changes eyeball in response to ciliary muscle change, apparently terminates by the age of early twenties so that by the time you are interested enough to read this you probably have long since elongated your eyeball, compensating for the focal stress of reading, (and the negative lens) and probably are nearsighted. Of course, as you age beyond 20, there is a progressive loss of elasticity to the lens (as well as growth in the lens diameter and thickness) and the focus tends to settle down to (somewhat beyond) the relaxed focal position of your late twenties. If the lens cannot thicken in response to ciliary muscle contraction, then of course we cannot focus up close. This happens for "normal" vision when we are older -- 40 to 50 years old -- and we then need "reading" glasses permanently in order to read. This is a completely different situation than nearsightedness which is a matter of the normal eye's responsiveness to a confined environment. "Reading" glasses are quite rightfully for reading, or close work. They are positive curvature lenses so that our own eyeball lens doesn't have to thicken so much for good focus. It means that we make the book, or close-up object have the focal properties of an object further away -- say, 10 feet to infinity. It doesn't "appear" further away; just the focal properties of the book are those of an object further away. To say that it appears further away, as some say, is misleading. The fact is that the object's light rays as seen through a positive lens are less divergent as would be the case for a more distant object. On the other hand, when we were very young and were of course very studious (or at least kept our eyes close to the book to avoid the teacher) and furthermore some of us were genetically endowed with a more adaptive focal compensation mechanism, then at a young age -- 6 to 15 years -- we became adapted to our own near point -- close up environment of reading, block-building, TV, etc.; then we were nearsighted. We could not see at a distance what normal people do, but we could sure focus up close. We could see detail in a flower or an insect that was lost to the rest of the world (unless they went around with a magnifying glass.) But then along came school and competition -- "My God! You can't see the blackboard!" -- Which implies you may be dumb or retarded! -- So it is absolutely necessary that you see the blackboard no matter how many encyclopedias you have read and understood. This pressure of society forces you and your mother to go to an ophthalmologist or to get a pair of glasses. Since the purpose of these glasses is so that you can see the blackboard, i.e., distance vision, they must perform the function of transforming the light rays of distant objects to the light rays of an object up close. It has also brought the close world of reading up still closer; but such is the wondrous adaptive nature of the eye compensation mechanism that even though you wear these negative lens glasses for reading -- (and you read almost all the time, otherwise you wouldn't have the problem in the first place) you eyes again compensate for the average focal environment. Thus, after a while, a year or so, you need still stronger lenses and your eyes adapt and compensate again. Nature is trying to give you normal vision such that the eye's focus is (positive) where you "see" for more than 50% of the time, but you keep fooling Nature by bringing the "near" still nearer -- by increasing the strength of your negative lens every six months or so. Nature is compensating and presuming that you were born very, very farsighted. The compensating mechanism is so marvelous that the eye can be distorted by almost 40% from a normal shape by such grotesque measures. This is called progressive myopia. It reminds one of the extended lips and earlobes of the Ubangi tribe in Africa. But it is more tragic because it is more pervasive; and it is far more dangerous -- such a high degree of myopia increases the probability of a detached retina which may result in blindness. It also leaves the individual almost operationally blind without glasses. What to do about this natural compensation mechanism that seems to work against our own best interests? Those of us who are affected really do want to study and read and be intellectual even more than we want to be an athlete or racing car driver or play tennis without glasses. It is a degeneration of life, however, when we must wear glasses (all the time) for this reason. A large percentage of the ophthalmology profession has so far just said, "That is the way it is -- and the way it is entirely hereditary." There is a bit of truth in this -- we would not even have eyes without heredity, to say nothing of a compensating mechanism. But to assert that heredity equals progressive myopia, and that myopia is absolutely not preventable is to stretch scientific truth to the breaking point. In fact, most ophthalmologists use a lens as a convenient fix, and the ophthalmologist does not think further about the situation. But it is inconceivable that heredity can reproduce an eye to a fractional accuracy of one part in 10,000. Instead, as we will discuss, there is a natural mechanism to readjust the focal properties of the eye to meet your average focal condition. Young has discussed, in depth, the problem of heredity versus environment and there is no question but that the data are puzzling -- until one understands the simplifying concept of the normal eye's compensation ability. Granted such a mechanism, then heredity can and does account for all the wide diversity of occurrence of nearsightedness. This demonstrated characteristic of the normal eye also accounts for the family-oriented association of myopia. HOW TO MAINTAIN DISTANCE VISION IN A CIVILIZED ENVIRONMENT We want to lead a normal life, of reading, watching TV, enjoying the outdoor views without wearing glasses -- for distance vision. There are two obvious and simple recourses: (1) Give up reading and all close work (2) Change the near focal environment to a distant environment. One could of course give up reading and/or become an illiterate cowboy/cowgirl, which is not what said girl or boy wants to be. The other obvious thing is to wear glasses when reading that transform the light rays from the book to an angle the same as from a distance -- i.e., infinity. The second alternative is to reestablish an average focal environment that has more than 50% distant vision and rely on the natural compensation mechanism of the eye to establish normal vision. How to do this? In order for a normal eye to focus up close, the eye-lens must thicken which is done by the contraction of the lens muscle. If one uses a reading lens (which is thick in the center), then it means that the eye-lens doesn't have to be so thick. Any lens (eye or glass) that is thicker at the center is called a positive lens; such positive glass lenses are called "reading glasses." Positive lens "reading glasses" transforms the nearby up-close object to a distant one allowing your focus to be at infinity when reading. This relieves the constant stress of the focal muscle and prevents the muscle spasm that leads to myopia. (For old people, reading glasses perform the function of permitting the rigid eye-lens that focuses ONLY at infinity to see or focus at a closer distance. But this isn't the problem for old people especially if they are nearsighted; they can focus up close just fine. But in today's world they don't look at a distance often enough to maintain their distance vision.) A positive lens or reading glasses transforms the close object -- a book or comic strip or TV at 4 feet -- to a distant (focal) object. You must understand that a positive lens glasses won't help you see the book any better; instead, the positive lens will make everything except the book seem fuzzier (especially if you are already slightly myopic). Distant objects will be badly out of focus. This is a completely normal situation. If you went to the optometrist and said that you couldn't see things at a distance but could read O.K., and you wanted glasses to see better -- and if he were to give you positive lens reading glasses, you would think he was nuts. But reading glasses would best help your eyes to develop correctly -- and advantageously in today's environment. Positive lens reading glasses on a myopic person makes distant objects totally out of focus -- of course. Close by objects are just in focus and this relieves the near point focal stress. With such glasses you could clearly see the book -- and the horse and the car would disappear into a blurry fuzz. The plus-lens would have made distant objects worse! The use of positive-lens reading glasses to prevent nearsightedness is using a lens that is the complete, total, absolute diametrical opposite from what is usually done. It takes a smarter, or more reasonable person to understand this approach. The approach that accurately recognizes and understands the normal eye's behavior is not yet orthodox. The lack of orthodoxy has a very serious consequences; you can sue your optometrist -- perhaps successfully -- for anything he or she prescribes that is not orthodox, that is, for any procedure that is not taught in optometry school and is approved. Therefore you probably (not always) won't be able to have such positive lens glasses prescribed by your eye doctor. However, fortunately, there is a simple and direct way around this. In most states, reading glasses are considered to be used only by old people. (Massachusetts, Minnesota, New York, and Rhode Island do not permit over the counter sale of reading glasses.) In deference to the fact that the eye shape of old people is set for life, the legislators have permitted such glasses to be sold over the counter, i.e., in dime stores or department stores. So, before it is against the law, go to the dime store and buy a pair, or even several pair of positive lens reading glasses (also sold as "magnifiers"). They should be of a strength of 1.5 to 2.5 diopters or of a focal length of about 27 to 18 inches. One diopter is the strength of a lens whose focal length is one meter (39 inches). With a lens (or glasses) of 1 diopter positive, a book held at one meter would have the focal properties of infinity. But who holds a book at one meter distance? A lens of +2 diopters has the focal length of 50 cm, about 20 inches, and completely "corrects," i.e., transforms, the average reading focal point to an "infinite distance" -- the vision people use in a natural environment. HOW TO SELECT GLASSES You can buy reading glasses over the counter in a department store, a discount store or even in some dime stores (except in Massachusetts, Minnesota, New York, and Rhode Island). If the Store's rack of reading glasses does not have intelligent markings, this is how you can tell a pair that is a positive lens, 18 to 27 inches focal length -- about 2 to 1.5 diopters: Identify a bright, distant light -- 30 to 50 feet away is enough -- the ceiling lights are sometimes far enough away -- the sun is best of all. Hold the glasses such that the image of the light falls on a blank surface, the lighter the better. Move the glasses towards or away from the surface until an image of the light appears. If the light is at "infinity," then the distance from the glasses to the image is the focal length. Thirty feet is almost infinity so that the distance of the glasses to the single plane (the floor) should be about 18 to 27 inches when the image is in focus. If you pick up a pair of negative lens glasses (your own glasses if you are nearsighted), then you won't form an image of the light no matter where you hold them relative to the floor or image plane. All light rays from an object diverge. A negative lens causes light rays reaching it to diverge more -- hence no image. It takes a positive lens like your eye to form a real image -- that is the only kind your retina and brain can use. WHAT TO DO FOR EARLY MYOPIA Now I assume you are young, 8 to 20 years old; have recently (within months) started or gone nearsighted and don't want to go on with thicker and thicker negative lenses for distant vision. You buy and wear positive lens reading glasses for (all) your reading -- or anything up close, and even for some of the rest of the time. You might get a bit of a headache at first; if so, decide which comes first -- the headache or myopia and adjust the use of the positive lenses accordingly. There is enough known to give you definitive advice to monitor your mean relaxed focus, i.e., distance vision at least once a day. If you see better at a distance, O.K.; if after a time, several weeks, your distance vision gets worse, naturally give it up and find out why. I may or may not be average but it took me only 2 weeks when I was 14 years old to return my initial myopia (about 20/80) to normal vision, i.e., (20/20) eyesight. Of course I had only just become myopic, probably in the accommodative spasm stage so that relief of the near point stress had an immediate beneficial effect. (20/20 vision means that you can see at 20 feet what a "normal" person sees at 20 feet.) Twenty feet is almost as distant as infinity; (20/80) vision is the start of myopia. I could see at 20 feet what good eyes could see at 80 feet. I was a studious, slightly shy, introverted type -- which also included, fortunately for me, a course in physics at that age. That is when I first understood the simple facts about lenses and optics and the absurdity of using a negative lens when I was becoming nearsighted. I bought my own reading glasses in the dime store. They were plus 2.5 diopters and stronger than I needed, but they did the trick in a hurry. If you catch the start of myopia before the lens muscle spasm leads to irreversible lengthening of the eyeball, then it seems that the eyesight returns to 20/20 rapidly. (20/40 is legal for driving, but why stop at 20/40? As your distant vision improves by +1/2 diopter you should increase the strength of your reading glasses by +1/2 diopter.) If you make up your mind what value of the mean relaxed focal distance you want in life, you can manage or lead your eye to that condition. When several times I lost my reading glasses during the war (World War II), I could not get them replaced by military optometrists because my glasses were not orthodox. I rapidly became myopic again; at 17 I read a lot in the Merchant Marine. I restored my vision to 20/20 as soon as I could purchase positive lens reading glasses when I returned to the States. During that war there was much social pressure to get into the officers' college training programs but 20/20 vision was required. A few optometrists recognized the need and they prescribed positive lens glasses for myopic young people who desperately wanted to get into the Navy V-12 training program. This technique worked for many who were modestly myopic. An optometrist at Cornell was surprised that I had been doing this successfully since the age of 14. Actually, I have not had any trouble getting positive lens glasses from an optometrist -- better style and quality -- but they cost more, $50 to $80 rather than the $12 to $20 in the dime store. The better quality glasses are fitted to your facial eyeball dimensions so that there is significantly less distortion of the field of view when looking sideways. This is a significant advantage and reduces a tendency towards tunnel vision. It is suspected that the process of severe progressive myopia may lead also to a partial lack of symmetry of the eyeball, i.e., astigmatism. BIFOCALS For over 50 years approximately 20 percent of optometrists have recognized the necessity of using a plus 2 diopter lens at the 20/40 level. They have found themselves powerless to persuade a child to use a lens correctly at that critical stage. As a result, they begin using the plus lens when vision gets down to -3 diopters. This is a very important preliminary step and testifies to the changing opinion that exist in the health profession about the need for a stronger preventive approach. Normally if you kept your eyes in an "open" environment, your eyes would stop at an approximate focal state of zero. If you continue the near point stress of reading, your eye continues into a negative focal state. If you read at all, a positive lens should be worn just before at time when your focal state goes just below zero. By adjusting the fraction of the time that you use reading glasses, you can effectively control the focal status of your eyes. This is an advantage -- especially as you get older and lose the elastic dynamic range of focus. When you are older, about 50, you would like to have the final limited range of focus overlap the ability to read without glasses -- if necessary at arms length -- and if necessary, give up a little detail at infinity -- i.e., a mean relaxed focal length just on the short side of zero. The advantage of this technique is that you don't need glasses then for distance vision like driving a car or flying an airplane, and you can just manage to read if you lose your glasses. (The range of accommodation changes from birth to maturity. At birth the range of travel is about 10 diopters. At 60 the range is about 1 to 2 diopters.) Several researchers in visual focal management have tried with significant success to manage the average focal environment of children by using two strengths of positive lenses combined in bifocals. Dr. K. H. Oakley and Dr. F. A. Young in Pullman, Washington, claim 75% to 80% success in using bifocals. No one has made a comparable study using a single cheaper plus lens. Bifocals are glasses with two lenses -- one comes into use when you are looking downwards -- and for older people the lower lens is stronger in order to bring the near point into focus. Then when you look up, your eyes will be looking through a weaker positive lens. The same logic would apply to children, except the weaker lens when you look up should be zero -- no correction is needed or required. The problem with bifocals is that they are usually made for the person who needs the more positive down-viewing lens. The young potential myope does not "need" this lens (in a direct, obvious way) and so may not look through the down-viewing positive lens for much of his or her reading. To remedy this the focal division line of the bifocals can be placed much higher than usual. The preferred, or simpler technique is to use a separate more positive glasses for all reading. I personally believe, probably because I was adequately motivated, that bifocals (with the negative lens) are unnecessary. After all, the child -- or anyone -- should have the advantage and motivation of not wearing glasses as the end result of his work with the positive lens. Not wearing glasses for distance vision is the primary advantage of normal eyesight anyhow. With only modest dedication and self-interest, the use of reading glasses for close-work can easily be great enough to relieve the major fraction of lens muscle spasm and restore 20/20 vision to an eye that previously had 20/70 vision. Therefore, as a first step, the individual can use ordinary single lens reading glasses. If there is still a progression into myopia, then more "heroic" measures can be tried -- like atropine drops. Surgeons use the word "heroic" as an euphemism when referring to a particular drastic surgical procedure. Using atropine drops every day is a more dramatic procedure than using reading glasses. However, atropine is extremely useful to paralyze the ciliary muscle if an "accommodation spasm" has already started. Then after several months of drops, positive lens reading glasses will suffice. Reading glasses are available in most states in the dime store -- no prescription needed. The other thing you could find useful is an eye chart. You can buy these at a medical supply house, but it is just as good to paste some random letters cut from a magazine headline on a card. Distance vision is well tested at 15 to 20 feet. Typical 3/8 inch letters, say from TIME magazine headlines, can be read at this distance (for 20/20), but it is necessary to have some larger ones (like 3/4 inch letters for 20/40) so that there is a "fall-back" reinforcement. For reasonable success you need to establish an awareness of visual acuity in the home with several eye chart equivalents and distances marked off. If you keep constantly aware of your eyesight -- distant vision (focus state), then it is much easier to maintain the continuity in the use of reading glasses. If you demonstrate your own recovery, it is unlikely that you will ever again be persuaded to use the negative lens. OTHER CAVEATS There is, of course, a continuing need to see an ophthalmologists to check for all the other actual malfunctions of the eye. Fortunately, most of these are rare but they do happen. One that is not quite so rare is astigmatism, perhaps 10% or greater of the population. Since, in the case of astigmatism, there is no unique focus, the ciliary muscle is constantly hunting for something that cannot be satisfied with the result that myopia occurs even without a near point stress. In this case you need to correct the astigmatism, but also make sure that you have a positive astigmatic correcting lens for near point work. WHY DO FEW PEOPLE KNOW ABOUT THIS? It is perhaps worth speculating why there has not been any prior recognition by the medical and optometry professions of this preventative approach to the management of the normal eye's behavior. I believe there are many additional "reasons" but I have heard of these: 1. Nearsightedness is not a very severe handicap and mostly those affected are studious anyhow and don't need distance vision. 2. Ophthalmologists are not usually taught physics in sufficient depth and so cannot be expected to understand optics. 3. It is not a problem for medicine and so medical doctors are not concerned. 4. If you don't want to be nearsighted, give up reading. 5. Negative lenses that correct nearsightedness are relatively cheap and easy to wear so why bother with another approach. 6. Glasses are a status symbol of the intellectual. 7. Contact lenses make nearsightedness even less of a problem. 8. Only recently has nearsightedness become a severe problem -- it is both more prevalent and, because of earlier onset, leads to progressive myopia. 9. Traditionally medicine treats or cures the symptom and only recently is preventive medicine respected. 10. Only very recently is there a rational scientific explanation for the scientific observation of the development mechanism of the relaxed mean focus. Only the last statement is acceptable to us. So now that there is a scientific basis, lets get on with the remedy. Stirling Colgate CONCLUSION Those who make science or mathematics their career must learn not only facts and theories but also methods of solving problems. Those who make political affairs their business must acquire another sort of ability; how to NOT solve problems. When a dispute shows signs of approaching resolution, a participant who fears being on the losing side shows great ingenuity in getting the issue off the track. A motion is offered to refer the issue back to committee, or to table the issue. Such a motion has the appearance of preserving the question for more study with a view to eventual solution, but the appearance is often a fiction. "Refer back to committee," like as not, means to kill the measure; but it sounds nicer. This world of contentious human beings needs a large repertoire of techniques for not solving issues (while giving the appearance of trying to do so). Garrett Hardin CLARITY OF THINKING AND ANALYSIS Dr. Stirling Colgate defeated the problem of nearsightedness by assuming control of his distant vision through his understanding of optics, experimental data, and an intuitive understanding of how all eyes behave under direct experimental test. Dr. Colgate's practical demonstration of the eye's behavior is in agreement with the fact that all eyes track/follow the average visual environment. By analysis it has been demonstrated that the fundamental eye is a sophisticated control system. For this reason the focal state of the eye is related to the visual environment, with 0.97 as the correlation coefficient. It is extremely difficult for an optometrist to inspire this degree of understanding in a person who casually enters his office and expects instant clarity of vision. The optometrist cannot sort out the individuals who have the qualities of insight and personal commitment that Stirling has. For this reason the optometrist is forced to use a minus lens on the average person who walks into his office and wants to see clearly immediately. Otis Brown * * * * * * * * LETTER TO THE NATIONAL INSTITUTE OF MEDICINE November 9, 1977 Dr. Elena Nightingale Director, Preventive Medicine National Institute of Medicine 2101 Constitution Avenue Washington, DC 20418 Dear Dr. Nightingale: The enclosed two reports are a statement concerning the prevention of myopia -- the one within the profession by Francis Young * and the other a discussion at an elementary level by myself, a physicist. * Francis Young, "The Development and Control of Myopia in Human and Subhuman Primates", Contacto 19, p. 16) The point is that myopia can be prevented in essentially all cases by appropriate management of the focal environment. It requires measuring each year the mean relaxed-state focal length of the eye during child development. When this refractive error is zero, one then uses any of the proven methods of preventing or inhibiting the progression of myopia. If the child does not progress beyond refractive error of zero, the child retains a refractive error of zero. This is called 20-20 vision. The simplest, easiest and least drastic means of inhibiting further progression of myopia is the use of positive lens glasses, +1.5 to +2 diopters for (all) reading and protracted close work. The eye progressively adapts to its mean focal environment starting from the focal properties of all new-born babies, +4 to +6 diopters, to progressively more near-sighted each year, usually -1/2 to -1 diopters per year. Then at ttthe age of 6 to 10 years the mean relaxed state focus, refractive error, passes through zero. The normal environment of distance and no reading means that when the refractive error becomes zero, the time average contraction of the ciliary muscle becomes small and further adaptation to the focal environment ceases. This way the normal development leads to and maintains zero refractive error. The unnatural environment of reading causes myopia by extending the progressive adaptation to the unnatural near point focal environment of the book. The logical and least disruptive action is to change the effective focal properties of the book to infinity. Elementary optics indicates the use of a positive lens to accomplish this. Conventional ophthalmology has traditionally treated the symptoms not the cause. We wait until the individual has adapted to the near-point focal environment. This adaptation is called myopia. We then fit the person with a negative lens which endows the distant object with the focal properties of a close-by one. If the individual then uses the negative lens glasses for reading, a further adaptation to a still closer point focus is made and the grotesque result is called progressive myopia. The optometry profession has traditionally defended itself on the basis that all focal properties of the eye are predetermined genetically. One can equally well explain the observed very large genetic correlation function and myopia with a variable genetic endowment affecting the focal adaptation mechanism. Dr. Francis Young has, in my opinion, demonstrated conclusive scientific evidence for the existence and for the mechanism of this adaptive mechanism -- namely the small, progressive and irreversible lengthening of the eyeball in response to the fluid pressure increase caused by a contraction of the ciliary muscle. On very general grounds (information theory) one can argue that there has to exist some such mechanism: Genetic endowment generally encompasses a physiological dispersion of roughly 10 percent limited by cellular growth dispersion, i.e., cell growth is a noisy system. 20-20 vision on the other hand requires an accuracy of the composite structure of the normal eye of 1 in 5000, i.e., 2 x 10(-4). The progression from a genetic noise figure of 10% to a functional accuracy of less than 1/10% requires a developmental feed-back mechanism. This mechanism is well documented by the work of Francis Young. The alleviation of myopia is a worthwhile goal. At the very least, an open choice and recognized knowledge of the causes and prevention would seem to me to be an outstanding objective in preventive medicine. Sincerely yours, Stirling A. Colgate ************** VITA Sept. 21, 1989 STIRLING A. COLGATE DEGREES: B.A. (Physics), Cornell University, Ithaca, NY 1948 Ph.D. (Physics), Cornell University, Ithaca, NY 1952 PROFESSIONAL CAREER 1951 Lawrence Radiation Laboratory, Berkeley, CA (electron physics and accelerator physics). 1952 - 1964 Lawrence Radiation Laboratory, Livermore, CA (nuclear weapons diagnostics, controlled fusion, lasers). 1956-64 Group Leader, controlled fusion project. 1959 Technical Advisor to the U.S. State Dept. Conference on the Discontinuance of Nuclear Weapons Tests, Geneva, Switz. 1960-64 Lecturer, Univ. of Calif., Berkeley, Elect. Engr. Dept. (plasma physics). 1965 -1974 President of New Mexico Institute of Mining and Technology, Socorro, NM. Director of Research. Professor of Physics. 1975 - Adjunct Professor (Physics and Astrophysics) NMIMT. 1976 Los Alamos National Laboratory, Theoretical Division. 1980 Los Alamos National Laboratory, Group Leader, Theoretical Astrophysics . 1981 Los Alamos National Laboratory, Senior Fellow. 1984 Member National Academy of Science Research Interests: Nuclear physics (diagnostics and fusion plasma confinement), astrophysics (supernovae, quasars, cosmic rays, solar physics), atmospheric physics (tornadoes, thunderstorms), geotectonic engineering, epidemiology. Memberships and Boards: Present: Member National Academy of Sciences; Fellow of the American Physical Society; Fellow of the American Association for the Advancement of Science; Member of: American Astronomical Society, American Meteorological Society; American Geophysical Society, Cosmic Physics Division of APS, International Astronmy Union, American Academy of Arts and Sciences; Founding Board, Board Member, Santa Fe Institute. Past: Member of Space Science Board; Director-at-Large of Association of Universities for Research in Astronomy (AURA): Member of the Aspen Center for Physics Board; Trustee of Associated Universities, Inc. (AUI); National Science Foundation Ad Hoc Panel for Large Radius Astronomy Facilities; National Research Council Panel on Optical Facilities; National Research Associate ship Evaluation Panel; National Academy of Sciences Sub-Field Survey of Plasma Physics and Physics of Fluid Panel; National Science Foundation Advisory Committee on Environmental Science; Consultant, AEC Gas Centrifuge Flow Study Group; Nuclear Panel, Scientific Advisory Board NASA Research Advisory Committee on Fluid Mechanics; Consultant, Conference on the Discontinuance of Nuclear Weapons Tests; Sigma Xi; Chairman of Study Committee on Space Plasma Physics of the National Research Council; Chairman of Panel on Solar Physics of National Research Council, Space Science Board, National Academy of Sciences, NASA Space and Earth Science Advisory Committee.