AutoBio2.txt December 28, 2005 Dear Friends, Subject: My History PART I - Personal engineering and scientific interest. PART II - Separating pure scientific facts from "medicine". PART I Purpose: To Provide intellectual and scientific support to Steve Leung in his work to prevent the development of nearsightedness in children. When I was young, I was told that I would learn scientific truth -- only after the truth no longer mattered. But knowing the truth about the dynamic nature of the eye was, and is, very important to me. Since we have been working on "nearsightedness prevention" for the last 30 years, we might look "inward" in the sense that we analyze our own motivations. Obviously I realized that we understand the natural eye "differently". I believe that that natural eye MUST be dynamic, and some people have accepted the "traditional" picture that the eye is a "frozen" box camera, and does not control its refractive state to its visual environment. MY PERSONAL CURIOSITY When I was 16 years old I went through a personal "crisis" and felt my life was "over". [Most people would have regarded it as a normal "bump" on the road of life!] But that personal disaster spurred my interest in "nearsightedness". The standard (i.e., box-camera) explanations did not "ring true", and I had to wonder if the pressure to prescribe an immediate solution was "driving" this process - and I sought to determine if that were the case. THE OPHTHALMOLOGIST Since my interest had become clear to my family, my father asked our ophthalmologist about this issue. The ophthalmologist said, "Oh, God, don't let Otis get involved with that issue". To me he said, "Once you become an Ophthalmologist -- then you will understand". I have not become an Ophthalmologist - but I certainly understand why he made the statements he did! But my curiosity was such that I could not "let it go". Equally, however, I knew he was a fine man who was doing the best that he could do - and I respected him for that reason. I did understand how my questions might be construed as insulting, although that is not, and has never been intention. The fact that he had to imply that I didn't "understand" worried me. I resolved to ask a different type of question to avoid this type of conflict. WORKING FOR A LIVING I worked a few years for the telephone company. This was good "outside work". I had some time the study the design of the V2 rocket in a book written by Dr. Walter Dorenberger. The result of this engineering book caused me to respect for the design of a "control systems". The rocket flies straight up -- with the flame straight down. To thhe casual observer it appears that the rocket-motor is "fixed". To the rocket-engineer it is clear that this is a false belief - - of the general public. The entire system is absolutely "unstable". Only continuous strong motions of the motor, monitoring a gyroscope creates this apparent "stability". Later this idea of "active" stability became the core of a technical analysis of the eye's fundamental behavior. COLLEGE AND TECHNICAL ANALYSIS In college I had the opportunity to study the history of science. (This was different from most "science" books, since it defined how ideas in science develop. The concept was profoundly "different" than the conventional notion of science that most people have of the subject. The book was "The Foundations of Modern Science" by Gerald Holton and Duane Roller. The specific idea that caught my imagination was the struggle between the Ptolemaic concept (earth-centered) universe, versus the Copernicus (sun-centered) universe. These were two "world-view" concepts. A study of these concepts and how "observed facts" interact with scientific theory were essential for me. The "world view" and the "fact" seemed to totally support the Ptolmaic concept -- and the fact that the concept had been use for the last 1200 years seemed to make the Ptolmaic concept "perfect". Further, the concept had been accepted by the Catholic church. The "objections" by Galileo was then translated as a DIRECT ATTACK on the entire Catholic church. It was for this reason that Galileo was forced to "recant" his belief that the earth (and planets) moved around the sun as the center - and not the earth. He was placed under "house arrest" until his death. Later I changed my "interest" to engineering and spent four years obtaining a BS degree from Capitol College. As part of this study I learned to design "control systems" -- as well as many issues regarding engineering and design in science. A deep appreciation the truth that the natural eye must be a sophisticated system (for stability) became part of this evaluation. RADIO STATION WORK - FREE TIME TO THINK During this time (for curiosity) I continued my interest in nearsightedness. One "popular" publication, about 1965 was by Dr. William Ludlam. He stated that "Submariners developed nearsightedness proportional to the time they spent in a submarine". Since this make a great deal of sense to me, I wrote up a thirty page paper, describing the concept of the plus to be used for prevention -- since I had NEVER EVEN HEARD of any proposed or suggested use of the plus as a preventive to nearsightedness. Dr. Ludlam wrote back and said that the concept of "the plus" was not new, and that Dr. Raphaelson had developed the concept to a certain extent. I then went to Cincinnati about 1967 to see him. Jacob was 92 years old -- and I felt very lucky that I could visit and talk with him. He gave me his publications, and they provided a great insight into the difficulties of introducing prevention - from the perspective of an optometrist. These insights were valuable to me - and changed by "world view" about the natural eye's behavior in a fundamental way. PREVENTION AS SEEN FROM THE OPTOMETRIST'S POINT-OF-VIEW While Jacob covered many subject, there were two items that DEFINED the nature of the "problem" and caused me to forcefully separate the matter of dealing with people "off the street" as different from pure-science, or "engineering-science". I will describe why this is necessary in "Part II" of this review. FURTHER CLARIFICATION There is a tendency to state that the minus lens method, put is place 400 years ago is "based on science", or call such use, "science". I object in strong terms to that type of "thinking". I could understand the OD who would say, ".but I have no choice". To avoid conflict, I would describe this as "medical-science", or the matter of dealing as best you can with a great mass of people who expect an "instant solution" from some one who is "medical". Dr. Raphaelson was successful in, "The Printer's Son", only to have the parents and child totally REJECT both Raphaelson and the plus lens. It is now very clear, that the child (in this statement) would simply have gotten back into nearsightedness because his habits had not changed. I simply can not tolerate this type of situation. If the person I talk to demands that "instant solution", then I will not "fight" with him or the OD about the issue. CLEARING THE MIND -- AND WORK WITH FRANCIS YOUNG In fact, I have no "objection" to the use of the minus, and consider that an OD (like Jacob Raphaelson) has only an obligation to SUGGEST the possibility of using the plus (providing the child's vision is "workable", i.e., 20/40 to 20/70). If the parents can not accept the plus at that point -- then they should sign a statement that they had been informed of the "preventive" method, and that they prefer the immediate solution of the minus lens. For me that would "clear the air", and make the parent responsible for the long-term consequence of that choice. Given the one-way street nature of myopia development, the parents must understand that when the minus lens is started - the plus can not be used. FINDING MORE INFORMATION -- BY BEING PROVACATIVE Many people are "passive" -- meaning that they do not "push" their knowledge. It has always been my habit to ask questions. If I receive "put offs" and "put downs" then I must find out why my questions are being deflected. Is it because I am "insulting" the person with my questions. If my questions are honest, then I expect an honest answer. If my questions are still considered "insulting" then I must find out why. Part of this goal is to "stand up" and publish your assessment. In a formal scientific review process. I have published papers in the IEEE/EMBS with co-authors who are leaders in their field. It takes a considerable amount of time to prepare these papers and get them accepted for publication. This was a "learning" process for me. But at least I had the "guts" to stand up and make this type of pitch. Ultimately, I assembled these papers into my book, "How to Avoid Nearsightedness". I did this in part to help the "next curious person" to avoid the labor I when through to reach my conclusion about nearsightedness-prevention. [I was very upset that it took me ten years to "find" Jacob Raphaelson. An engineering text and review would have saved me an immense amount of labor. And I am always in favor of "labor saving" publications. Straight answers about the proven behavior of the natural eye would have saved me an immense amount of physical work on this project.] DAVID GUYTON, KAREL MONTOR, PETER GREENE, AND DONALD REHM During this time I had the pleasure of meeting the above people. The goal was to initiate a "preventive" effort at the Naval Academy -- among pilots -- who MIGHT have the motivation for the effort. The result was pleasant conversations and discussions -- but "red tape" prevented ANYTHING frrom being attempted. I must also add that the time I spent with these people was wonderful. PUBLICATION OF MY BOOK, "HOW TO AVOID NEARSIGHTEDNESS" Up to this point, I only knew that Dr. Colgate had cleared his vision with the plus. But I never heard of anyone else doing it under their own control. With the book published, I sold it through a "Professional Flying" magazine, and attempted to restrict the sale to ONLY pilots whose vision was 20/40 to 20/70 who (with intense motivation) could clear their vision back to 20/20. I sold the book to a Brian Severson, who "cleared" to 20/20 - from 20/70. At least I knew that prevention was possible -- when done with great intensity. RETIREMENT FROM GSFC In 2002 (age 62) I retired from "contractor work" at the Goddard Space Flight Center in Greenbelt, Maryland -- after 35 years of very interesting and enjoyable work. Since I now have more time to pursue my "hobby", I developed the Internet page, www.myopiafree.com, to further develop the concept and help people like, "The Printer's Son", to "wake up" and understand the necessity of prevention - or understand the "direct consequence" of rejecting the use of the plus at the threshold. This is far more an educational process for the individual himself, rather than a "medical" process. I know that most people simply do not understand this issue. It is very important however, since failure to learn to use the plus "correctly" leads to life-time consequences that (almost) can not be reversed. [Obviously this now depends on the "qualities" of the person himself -- to decide this issue. Since no one can "predict" that a person has a "quality mind" for this work, I make myself completely dependent on the person himself to have these qualities.] THE FUTURE -- SAME AS THE PAST? The past "predicts" the future. One hundred years ago, no one could make a statement about the dynamic behavior of the natural eye -- because no one "thought" to run the correct experiment. Today, in "engineering science" we can predict -- with good accuracy -- the behavior of the fundamental eye, providing we test the natural eye under "input" versus "output" conditions. We must use absolutely neutral testing (to avoid bias) I suggest we use the term "refractive state" where the natural eye can (and does) have positive and negative refractive states -- depending on the "input" average-visual environment. This type of study proves that the fundamental eye is dynamic. [Dynamic in the sense of rocket-guidance. There is no doubt that on a pure-scientific level that the natural eye is proven to behave as a dynamic system.] However NONE of this accurate information is ever discussed with a person on the threshold of nearsightedness. I am very pleased that a few men have been able to "figure out" how to intensively use the plus "correctly". It seems to take a person of considerable intelligence to realize that you must understand the eye's behavior "correctly" -- and can not, in a knee-jerk fashion use the quick fix method. The real answer is to understand the facts as stated above, and CHANGE the near environment with the plus. PART II SEPARATING PURE SCIENCE FROM MEDICAL ISSUES AND PROBLEMS There are may people who confuse "medical" considerations and actions From "pure science" issues. To avoid the antagonisms involved, I suggest using the word engineering- science when discussing the dynamic nature of the fundamental eye, versus "medical-science", when discussing MEDICAL issues concerning the eye. Failure to separate this issue in this manner will ALWAYS create confusion and anger - and emotional, self-protective response from an OD or MD. I have see way too much of the "self-protective" reaction on the part of may Ods. I regret it - but it must be faced as a "fact" of this discussion. MEDICAL-SCIENCE CONSIDERATIONS A very dedicated optometrist (Raphaelson) spelled out the real problem of prevention - in the "Printer's Son". As long a parents REJECT the use of the plus when it must be used - there is no future for "true-prevention", or the optometrist can not administrate it effectively. This issue did not reflect on Raphaelson - it reflects on the ignorance and lack of MOTIVATION of the public for prevention. There was NOTHING Raphaelson could do about this issue - and NOTHING I can do about it either. Classify this as a "medical-science" issue. ENGINEERING-SCIENCE ISSUES As long as the "Printer's Son" scenario exists, then "prevention" will always be impossible. Thus the issue becomes the "education" of the "Printer's son" about prevention - on an "either-or" basis. I quite frankly was shocked about this question when I discussed the story with Dr. Raphaelson. But it became clear that nothing could be done. No amount of scientific research, or technical analysis can change this issue. But in the last 100 years scientific truth is finally confirming the behavior of the natural eye. OBJECTIVE MEASUREMENTS In working with Francis Young, I had access to his data. Thus, the issue of the natural eye could be resolved by DIRECT testing. In order to do this correctly it is necessary to use very basic words to describe a measurement. We should not "read" meaning into a measurement - because this becomes a biased way of interpreting the data. Thus, if we wish to determine the dynamic nature of the fundamental eye, we ask simple and basic questions about whether a population of nature eyes are dynamic on an input versus output basis. Further, we use the neutral term refractive-state. In the case of Francis Young's study, the measurement was made by induced paralysis, since you could not get the monkeys to read an eye chart. Thus the test is simple - and there can be only two possible results. Either the natural eye is dynamic - or it is not. Further, this type of test is repeatable, if the result is disputed. This is "pure-science", since it takes the person himself to "accept" the conclusions you will reach if you take this type of testing seriously. Francis Young published these results, and I did further analysis which demonstrated that the natural eye controlled its refractive status to its average value of accommodation. There is no scientific doubt about this result - but there are may who do not like "abstract" analysis and scientific truth about this result. I have no power to "argue" with a person who rejects this type of scientific analysis --- but it does lead to the conclusion that nearsightedness could be prevented - by the person himself - if he had the fortitude to take this type of pure-scientific research seriously. My book, "How to Avoid Nearsightedness" is designed to assist a person who has a strong motivation to "protect" his distant vision through the school years. But equally I do acknowledge that most people can not "get motivated" in the correct-use of the plus. The person who criticizes an optometrist like Jacob Raphaelson or Steve Leung should write up an "essay" explaining how Steve should overcome the resistance of "The Printer's Son" to correct-use of the plus. Since was the parents who rejected the use of the plus - then they, in their ignorance, accepted full responsibility for the consequences. We know now that when the plus is rejected in this manner, the child's vision will start down again, and that the "down" rate is about -1/2 diopter per year. (Although for some children, it can be 3.5 diopters per year.). Thus the OD must deal with this type of "ignorance", and this ignorance will continue to compel this situation. Worse, some Ods insist that "prevention" with the plus ". must be destroyed". This makes the situation of "The Printer's Son" even worse - since any OD attempting to offer the use of the plus on the threshold will encounter of "buzz saw" of opposition FROM HIS FELLOW Ods! THE DIS-INCENTIVE TO SUPPORT PREVENTION FOR AN OD This is a tremendous dis-incentive to do ANYTHING for prevention. These are very serious issues - and must be discussed with the parents before any minus lens is used. AN INFORMED-CONSENT CONTRACT AS THE FIRST STEP TO PRACTICAL PREVENTION The issue is serious enough to call for a "technical agreement" or "contract" with the parents about the use of a straight-plus for the child. I believe that this will prevent "abuse" OF THE OD who OFFERS true-prevention with the plus. This document is prepared to help BOTH the parents and the OD with this subject. Obviously the parents can not understand all these issues - but their intelligence should be respected, and their child's right to a "second opinion" could be respected and supported under this "signed contract" method of prevention. HOW TO SEPARATE PURE SCIENTIFIC ISSUES FROM "MEDICAL" ISSUES. Subject: the Second-opinion on preventing negative refractive states. I suggest that there is a profound difference concerning "pure science" and "pure medicine". And I suggest the difference is this: Medicine: Must deal with a great mass of people walking in off the street. There might be some "intelligent" people but that can never be the assumption of the medical doctor. The result is that we get "canned" procedures that "work" instantly. I consider that people in this profession have no choice but to conduct that kind of work -- and I would do the same thing IN THEIR PROFESSION. That would not make it "right" but I do understand them -- and what they are doing. Science: Must "step back" from that situation, and think about the behavior of the natural eye as a dynamic system. Engineers and scientists simply do not deal with children, nor with others that do not understand the need to work on prevention with the plus. But when you ask very fundament questions about whether a population of eyes (primates) are dynamic, you get the "second-opinion" answer, that POTENTIALLY a negative refractive status could be prevented -- before the minus lens is applied. I believe that pure science (i.e., the SCIENTIFIC -- not medical -- experiments proves that point.) But that is the nature of our arguments. Many concepts in science simply can never be reduced to "medicine" and we should understand that truth. I enjoyed your write-up about pure science, and the "habit" of tossing science out the window when a concept (like the dynamic eye) can never produce a quick-fix in 15 minutes. But that is how I separate "medical issues" from scientific concepts and experimental and objective testing. But that is why it took a scientist like Dr. Stirling Colgate to do the "work" correctly and clear his vision from 20/70 to 20/20. His statements are confirmed by direct experiments with the primate eye, again on a pure-scientific (not medical) level. Use the term "refractive state" where the natural eye can have positive and negative refractive status (as a dynamic device) and this situation becomes much clearer. Best, Otis