[A Note From the Web Master: I'd like to add that in my own experience, the optical profession is made up of highly qualified, competent, caring individuals, some of whom I happen to disagree with. Regardless, I do not envy their positions, for they face quite a dilemma. The existing standard for treating nearsightedness is to let it run wild; traditional treatments do not help nearsightedness, and quite probably make it worse. On the other hand, in adopting newer treatments for nearsightedness the brave ones risk raising the eyebrows of parents, patients, and colleagues alike with unfamiliar treatments that most of us are not accustomed to. (A major goal of this site is to educate the public so that we can be better patients!) That there is a spirited debate between the two camps should not be taken as any sign of disrespect for the optical professionals we so depend on -- none is intended. ja]
THE TRUTH ABOUT SEEING: GUARDING YOUR CHILD'S VISION
By Vera F. Rollo, Ph.D., Stirling Colgate, Ph.D., and Otis Brown
It's not that eye specialists and optometrists in treating nearsightedness want to provide an incorrect method of treatment. The fact is, however, that many health care professionals feel forced to follow the tradition of the last 300 years. Actually there are two options in treating nearsightedness. The traditional one is to prescribe minus lenses (which gives a "quick fix"). This unfortunately results in progressive worsening and the requirement for stronger minus lenses at each subsequent eye examination. The other option is to provide a positive lens (essentially a magnifying or relaxing lens) for reading. This approach produces a long-term solution by gradually restoring clear distant vision to the naked eye. This lens is used only for close work.
You may say, "But that doesn't make sense. Isn't that contradictory?"
Well perhaps, on the face of it, yet we are familiar with quick fixes that only make the problem worse in the long run. The easy fix taps into the very strong human tendency to resist innovation and scientific knowledge, to do things the way one has always been taught. Yes, even in spite of the evidence!
The evidence, supported by studies done as early as 1961, is that the understanding of the normal (remember the word normal) eye is quite neglected, . Most researchers and medical professionals have focussed on the defective eye and the diseases of the eye. Only a few researchers have studied the normal eye and what a marvelous organism it is.
The eye develops its focal state in response to its environment. This is an essential behavioral characteristic of the normal eye. The eye does not develop nearsightedness (a negative focal state) until about the age of seven or eight when a child reaches second or third grade. When a youngster studies, reads, writes, he or she is looking near at hand. After years of this close work, the eye gradually adapts to this close focal environment. In a word, he or she becomes nearsighted.
Prescribing and using a minus lens enables the student to immediately see an eye chart, which is at a distance. This is because the negative lens makes the chart have the focal properties of an object much closer. The negative lens encourages the eye to adapt to all objects being closer, and so the eye becomes even more nearsighted.
But, you may ask next, what else can an optometrist or ophthalmologist do? After all, hasn't instant clarity of vision been provided for the child? Hasn't the child's long-term vision been preserved?
Not really. Not when studies have shown that, instead, the eye professionals should be discussing the alternative method, and encouraging youngsters to study wearing a plus lens. At the very least, eye doctors should advise the student and his parents that he must make a clear cut choice between these two major alternatives.
Many eye professionals do, in fact, make this recommendation. You see, the plus lens will make reading easier, too. It enlarges the type on the page and relaxes the eye. But most important of all, it helps your child avoid the problem of progressively worsening myopia.
But don't all health professionals know this? Some do, some don't. Many find it difficult to make the extra effort to discuss, educate and explain this preventive approach to their clients. Some even resist the facts demonstrated by many scientific studies.
Let's take a look at just three things: common misconceptions about nearsightedness; the studies that prove that the eye is dynamic; and some examples that show that plus lenses do work to prevent nearsightedness.
First, nearsightedness is not a disease. The medical term for the eye's long-term behavior is "myopia" -- which sounds like a disease, but it isn't -- in fact, it isn't even an eye defect. It's an adjustment, or accommodation, that the normal eye always makes to the reading environment.
The use of a minus lens began in the seventeenth century when Johann Kepler, astronomer and scientist, found that he was becoming nearsighted, . He applied a negative lens to his eyes and found that this lens instantly made distant objects clear. This same idea is routinely used today.
Secondly: A further misconception is that the eye is like a static box camera. It is and it isn't. It is a camera all right, but it is not static. Back in the 1860s Dr. H. Helmholtz and Dr. F. C. Donders came up with the box camera theory, , . But this theory simply ignores the fact that the normal eye is a dynamic structure which accommodates continuously in response to changes in its environment, or visual demands placed on it.
Thirdly: The evidence began to surface a long time ago about the problem of the reading environment. In a paper presented to the Royal Society of London, in 1813, the Honorable James Ware related his observations on nearsightedness, . He found that the educated officers of the Queen's Guard were frequently nearsighted while among the 10,000 foot guards a scant half-dozen were nearsighted! None of the foot guards had been educated enough to be able to read. Nearsightedness, myopia, was correctly attributed to the habit of looking at near objects.
In modern times, Dr. Frances Young studied the Eskimos of Point Barrow before and after the introduction of schools. You can guess the results of his study. There was found a sudden and dramatic increase in myopia where nearly none was present in the past. A very large percentage of the children in schools became myopic, . A reading environment can be hazardous for the health of your eyes!
How Was A Solution Achieved?
An early, successful prevention of myopia was accomplished by Dr. Jacob Raphaelson, . This result, occurring in 1904, had rather ironic consequence for him.
A mother mentioned to him that her son had difficulty in seeing in school. The doctor made an appointment to fit the boy with glasses. Raphaelson found that the boy's vision was poor, worse than 20/40. The mother promised to pay the doctor when her husband, a printer, returned in about six weeks. So Dr. Raphaelson provided positive lenses, rather than the conventional negative lenses, and agreed to wait for payment.
The boy used these lenses and in under six weeks his vision was tested and found to be excellent. His nearsighted eyes had been returned to 20/20. But when the father appeared, he refused to believe that the doctor had effected a cure, because the boy's eyes were fine! The mother returned the glasses to Dr. Raphaelson.
The point should not be lost that had Dr. Raphaelson fitted the boy with negative lenses, the boy would have immediately seen clearly at a distance. Both the boy and the mother would have been immediately happy and Dr. Raphaelson would have been paid for the prescription of glasses that provided this solution. As the years passed, Raphaelson would have been paid again and again for increasingly stronger negative lenses. This argument, that only a instant solution can be provided, and that recovery cannot be achieved with a plus lens, surfaces in various forms to this day.
For years, since 1879 in fact, studies of military cadets in the United States have shown that their vision changes over the years of their academic work. Records reveal that a large percentage of the cadets (39% of those at the U.S. Military Academy in 1956)  became nearsighted and needed negative lenses by graduation. Further, of those who developed 20/25 vision, only one percent recovered to 20/20 over the four years, . (They were not provided with plus-lenses, and for this reason had no chance to recover.) In early years their degraded vision was blamed on the fumes of gas lighting, and later, on any number of factors, but the upshot of the studies was that none of these circumstance were really behind the cadet's loss of visual acuity. The myopia (change of focal state) was caused by constantly looking close, studying, reading, looking at books, rather than at distant objects.
"Chickens Don't Lie", might well be an amusing title for the study done by Dr. Howard C. Howland of Cornell University in 1987. (The formal name of the no-nonsense study, however, was "Accommodation, Refractive Error and Eye Growth in Chickens"), . Dr. Howland wanted to find out the effects of positive lenses and negative lenses on normal eyes.
Dr. Howland took five chickens and put plus lenses on them. Another five chickens were equipped with minus lenses. Yet a third group had a plus lens on one eye and a minus lens on the other eye. A control group was maintained for standard scientific protocol. In every case the eyes of the chickens with plus lenses, upon examination, were found to have accommodated in a positive direction. Also, in every case the eyes of the chickens with minus lenses accommodated in a negative direction. This clearly showed that lenses do profoundly affect the focal state of the eye. Translated into human terms, the negative lens caused nearsightedness, and the positive lens restored clear distant vision.
DOES THE NORMAL HUMAN (PRIMATE) EYE BEHAVE THE SAME WAY?
Monkeys were used in another study to find out more about the normal eye. This study was conducted by Frank Young, Ph.D., Washington State University. Monkeys were used because they are, frankly, the closest animals to humans. 
Dr. Young confined adolescent monkeys in a box where they were looking very close, about 14 inches in most directions with 20 inches as a maximum, for eleven months. A control group of monkeys was maintained and kept in regular cages. No lenses at all were used on the animals. Here, the argument being tested was the expectation that environment would not cause a negative change of focus in the normal eye.
Young, checking the monkeys in the boxes, found that all their eyes accommodated in the direction of nearsightedness -- to varying degrees. The correlation to the changed visual environment was excellent. The correlation coefficient was in fact 0.97, where 1.00 would be perfect correlation, . The control group showed no meaningful change in their focal status, indicating that if you do not change your visual environment, the focal status of your eyes will not change. This experiment explicitly demonstrates that the normal eye always changes its focal state to match one's changed visual environment.
BUT WAIT, WHAT DOES ALL THIS PROVE?
It shows that the eye is not a rigid "box camera" as was previously thought, but is in fact a dynamic living organism that always adjusts its focus to its environment. It always changes, it always accommodates!
Frankly, and somewhat understandably, studies of the normal eye have been avoided with the thought that they are unnecessary. Medical researchers, instead, have concentrated on eye diseases and disorders. This in the face of much accumulated statistical data that clearly shows that the focal status of all military academy students moves toward nearsightedness -- from their plebe year to graduation, .
WHAT SHOULD YOU DO?
To protect the eyes of your children, you may wish to consult with your eye care professional. Ask him for a discussion concerning the effective use of a plus lenses for recovery and prevention. We are assuming that the child either has 20/20 eyesight and you want to prevent nearsightedness. Or, that your child has just failed to read the 20/20 line on the eye chart, and is therefore on the threshold of nearsightedness. You obviously want to work with the eye specialists to help your child clear and maintain his distant vision.
Further, you should obtain an eye chart so that you can check your child's eyesight yourself. (These charts cost about $8.00). Your eye doctor will sell you one, or will assist you in getting one if you ask for it.
WHAT WILL YOU ENCOUNTER?
You will meet some eye professionals who are willing to help you. You might, perhaps, ask for a "behavioral optometrist". Now some optometrists and ophthalmologists may resist innovation and oppose your efforts to help your child recover from nearsightedness, as a personal bias. It is also true that some ophthalmologists are supportive of the preventative approach since they have, for some time, recognized the bad effect that a negative lens has on the normal eye. With this recognition they have either declined to use the lens at all, or have under-prescribed the negative lens, .
If your selected doctor is unwilling to discuss the normal eye's behavior with you, as well as the bad effect the negative lens has on the eye, or is opposed to any use of a positive lens for recovery and/or prevention, it would be wise to seek another doctor with a more reasonable outlook.
Your decision is critical at this stage! While completely successful recovery may be obtained when your vision is 20/25, 20/30, and even 20/40, there is a limit to the eye's ability to respond properly to a positive lens. You should be knowledgeable of the long-term effect that a lens has on the eye -- before you finally chose to use the negative-lens approach. The negative lens will push your eyes rapidly towards 20/100, and worse. Tragically, it is also true that after this happens, a positive lens can no longer have the desired recovery effect, .
WHAT IS THE JUDGMENT OF EYE DOCTORS?
Members of the health profession have developed the alternative approach to the historical practice. Since 1949 they have pioneered a plus-lens (bifocal) approach, . In addition, individual members of the eye-care profession have strongly railed against the complacency that exists within the profession. In a paper presented to the ANZAAS Scientific Congress in Auckland, Maurice Brumer said, :
". . . The eye care professions of Optometry and Ophthalmology have resisted change irrationally and fearfully, unwilling to admit that what has gone on before [the use of the negative-lens] has been wrong and harmful, and by doing so they have unleashed on the public they serve a cataract of horror. This continued situation [of failing to inform the public adequately of the danger of minus-lens use] is a tragedy for the public and disgrace for optometry.
"While it is understandable that optometrists will not find it easy to admit that what they have been doing is wrong and harmful, especially for those academic university optometrists responsible for the education of our graduates, to preserve the current horrors to protect our professional prestige and privilege is an abdication of our responsibilities, ethics and morality.
"I can make no apology for causing embarrassment to my professional colleagues. The interests of the public are paramount and must be served. The purpose of this paper is to direct the future to end the disgrace of the past."
ALL THIS IS FINE, BUT DOES IT REALLY WORK?
One of the authors of this paper, Dr. Stirling Colgate, has used the above described technique to restore his own vision. When he was 14 years old he found that he had 20/80 vision. By persistently using the plus lens for all close work, he successfully returned his vision to 20/20. While overseas during WWII he twice lost his positive lens glasses and soon developed myopia. Each time, after roughly six months, he again obtained positive lenses for reading and returned his vision to 20/20. He is a physicist with the Los Alamos National Laboratory. Yes, both personal experience and scientific studies prove that it works. In Dr. Colgate’s judgment, anyone could accomplish the same result if he has similar motivation, commitment and understanding of the normal eye's behavior.
Note: The words emmetropia and ametropia were introduced by
Donders. Donders took the focal states of the normal eye to be DEFECTS of the
eye. Any non-zero focal state of the eye was, by definition, a defect
(ametropia). A focal state of EXACTLY zero was defined as "normal". Under this
definition, very few, if any, animals or humans have eyes that are normal!
The cause of myopia is further clearly indicated in a study of 1,200 Eskimos in Barrow, Alaska, published in the American Journal of Optometry in 1970, which showed that in one generation of the Eskimo population had moved from no myopia to approximately 65% myopia among the off-spring, and that neither the grandparents nor parents over 40 had any myopia. Thus the first generation between grandparents and parents was similar in that myopia was nonexistent, but in the second generation between the parents and their children, suddenly myopia occurs in a surprisingly high number of children. As a matter of fact, of 53 offspring who were in their early 20's, 88% had myopia. Such a sudden and great degree of change cannot readily be accounted for on the basis of heredity, especially when there has been no identifiable force which could have brought about this obviously considerable mutation in the genetic composition of the offspring. The obvious difference between the parents and the children is the amount of near work which is currently being done by the children. About the time of the second World War, the white man intruded into their lives, requiring the development of education among a population which was uneducated and illiterate. The Eskimo has become an avid reader because of his environment. While he spends a great deal of time out-of-doors in the warmer, daylight summer months, he spends relatively little time out-of-doors in the cold, dark winter months.".