Chiropractic Healthiness

Question:

> You assume the efficacy of VT without a shred of objective scientific > support for that position.  At the same time you condemn surgery for > strabismus, which has volumes of documentation about outcomes.  No > ophthalmologist claims functional VISUAL improvement for patients operated > after about age 2.  What is wrong with a COSMETIC cure in a growing child? >  Strabismus surgery in appropriate cases is a life-changing experience. We > can do in a few minutes far more for the child than a VT optometrist does > in months or years of voodoo eye exercises. > R. Whitten, MD > Rick Whitten > Fresno, CA

Dear Dr Whitten, I object to the term "voodoo" used to describe eye exercises.  I am sorry that you have obviously never seen them work. Perhaps if you would take the time to visit a behavioural optometrist’s practice (and at least put aside your obvious predjudices for a while) you might learn something to your benefit. (if you do want to learn, that is.) — Richard Allen  BSc FBCO FAAO DCLP Optometrist & Contact Lens Practitioner Colchester Vision Therapy Centre

Response:

– Hide quoted text — Show quoted text ->You assume the efficacy of VT without a shred of objective scientific >support for that position.  At the same time you condemn surgery for >strabismus, which has volumes of documentation about outcomes.  No >ophthalmologist claims functional VISUAL improvement for patients operated >after about age 2.  What is wrong with a COSMETIC cure in a growing child? > Strabismus surgery in appropriate cases is a life-changing experience. We >can do in a few minutes far more for the child than a VT optometrist does >in months or years of voodoo eye exercises. >R. Whitten, MD >Rick Whitten >Fresno, CA

Dear Rick, Balony, perhaps the valley heat has affected you. There is a huge amount of information supporting vision therapy and reading. I have never found however an ophthalmologist who had the training in VT stuff and knew what it really was to have an intelligent conversation. Short and sweet VT improves reading abilities- I never assummed anything about it -this comes from my own moderate experience with it. There is not any great deal of literature to say VT does not work.For an ophthalmologist to say or quote someone else who said "VT does not work" when they don’t even really understand what it is is ludicrous. It is not the same as saying for example yes I have studied this issue and know what works and what does not and why- I did not hear you saying this- I know you never learned the stuff in residency. About strab surgery, I am pleased to hear you are improving so many lives by doing cosmetic eye surgery. My comment really had to do with whether you are informing patients that there will most often be no sensory improvement in their binocular vision- that what you are doing is cosmetic usually, and that the success rate is X% or whatever it is- I would suggest that strab surgery has a low- lets say 25-50 % success rate.Do yu tell people that it often needs to be repeated, or that,after a time it will need to be done again, and that it is cosmetic usually ownly. I do not think the success rate for esotropia or divergence excess exo would be over 50% and much less than that if you are looking for any binocular vision improvement. Do you know what effect EOM surgery has on the development of reading skills? You are talking about cosmetic stuff. Were you an expert in either VT or voodoo perhaps you would be qualified to speak about it but Ill bet you could not prove from your background that you are qualified to discuss VT on anything more than introductory levels. I have seen of course many people who have had multiple eye surgeries and I can tell you these are tramatic experiences for them. I think there are appropriate situations for strabismus surgery, once again I wonder if you inform people that it will not "fix" their eyes or improve their vision for the most part, and that it is cosmetic and often needs to be repeated and success may be 25-75% depending on when and what for- you see what I am getting at you incredibly ignorant pompous ass.You should talk about voodoo- you probably do not know what that is either. Hollis Stavn hlstavn#wco.com

Response:

: You assume the efficacy of VT without a shred of objective scientific : support for that position.  At the same time you condemn surgery for : strabismus, which has volumes of documentation about outcomes.  No : ophthalmologist claims functional VISUAL improvement for patients operated : after about age 2.  What is wrong with a COSMETIC cure in a growing child? :  Strabismus surgery in appropriate cases is a life-changing experience. We : can do in a few minutes far more for the child than a VT optometrist does : in months or years of voodoo eye exercises. the arrogance of some doctors never ceases to amaze me. seems if its not a quick fix with megabuck price tag they are not interested. sad sad sad. Vic Natural Vision FAQ: http://www.usyd.edu.au/~vicc "Civilization does not mean electric lights being installed.  It does not mean poducing atomic bombs either.  Civilization means not killing people." Nichidatsu Fujii

Response:

>>>lots snipped>>> > I look forward to working with opticians in the future when they gain the > right in all states to refract. > David > — > David B. Granet, M.D. > Director > Pediatric Ophthalmology & Ocular Motility Services > University of California, San Diego > *Keeping an Eye on our future  ;-) *

I hope that, in the same spirit of inter-professional cooperation, you are looking forward to working with optometrists who carry out ophthalmic surgery and therapeutic management. Why on earth are so many people trying to do different jobs. It’s happening in many different walks of life: Banks want to be estate agents (=real estate specialists), Building societies want to be banks,  Mechanics want to be engineers, Typists want to be secretarys or P.A.s,  etc…. Many optometrists want to get involved in therapeutics, (dispensing) opticians and ophthalmologists want to refract… Let’s all concentrate and get really good at our own specialised areas, and leave other areas to other people who have been trained "from first base" to do the job.   (.)          <>  |         (.)    / — Richard Allen  BSc FBCO FAAO DCLP Optometrist & Contact Lens Practitioner Colchester Vision Therapy Centre

Response:

>David >– >David B. Granet, M.D.

David, I have noticed a definite improvement in the ability of ophthalmologists to refract since autorefractors have been invented. I retain the opinion that an ophthalmologists lack of training in VT and perceptual skills stuff is a direct cause of reading difficulties.You do not exhibit a depth of knowledge about this stuff, you do have a clear non academic level bias, and I am also certain you have a sincere interest in the welfare of your patients. I would be quite happy with VT being done in the schools if it could be competently done-there is already a speech and language perception specialty profession- why not a vision too. True dyslexia is relatively uncommon-reading difficulties are not. There is a large amount of resources available through optometrists that can help with reading skills. But in the future we will be too busy treating eye diseases to have time for it.Actually I think it is time the OD schools address the issue also of overproduction vs need. I do not think this is being done but it should be.Some of us think it is not a good idea to produce more practitioners that the world requires. Being a pediatric eye doc, before you stump about VT not working I wonder if you give in your informed consent to surgical patients that the "success rate " may be only 25-50% depending on whether you are talking about functional vs cosmetic only improvement, or that the procedures may be temporary. I am all for strabismus surgery when it needs to be done but I am not sure the surgeons here are too good at giving informed consent about there possibly being no sensory change or improvement or that cosmetic surgery is just that will need to be repeated perhaps. If there is anything about vision care that is often done inappropriately it is surgery for strabismus. I am not talking about the superspecialists who know what they are doing but you know the occassional or the fanatical strabismus surgepons. Sincerely, Hollis Stavn OD

Response:

You assume the efficacy of VT without a shred of objective scientific support for that position.  At the same time you condemn surgery for strabismus, which has volumes of documentation about outcomes.  No ophthalmologist claims functional VISUAL improvement for patients operated after about age 2.  What is wrong with a COSMETIC cure in a growing child?  Strabismus surgery in appropriate cases is a life-changing experience. We can do in a few minutes far more for the child than a VT optometrist does in months or years of voodoo eye exercises. R. Whitten, MD Rick Whitten Fresno, CA

Response:

Keng leck writes: >A couple of years ago I came across an ariticle on one  eyesight improving >machine call Accomotrac Vision Training or something similar invented by >someone in New York. Is it still avaliable ? and hasanyone ever benefited >from using it ? It claimed  to train the focusing muscle of the eye.

Here are a couple of articles by the developers of this biofeedback system, which produces a tone whose pitch varies as you change the refractive status of your eye. The idea is, you can learn to see farther by imagining a high-pitched tone. The optometrist who invented the device J. N. Trachtman, who still has a practice in New York. His telephone number is 718 852 7856, fax 718 237 1454, address 26 Schermehorn St. Brooklyn, NY 11201. Here are a couple of scientific articles on the device, written by people who use it and promote it: Randle, RJ.  1988. Responses of myopes to volitional control training of accommodation. Ophthalmic Physiol Opt: 8 (3): 333-40. Roscoe, Stanley N. & Donald H. Couchman. 1987. Improving visual performance through volitional focus control. Human Factors 29(3), 311-325. There is more recent work on the subject, not all of it positive. It seems that the device works for some and not for others. One experiment by outside researchers showed that people improved even in the control group, where the biofeedback was incorrect. Maybe it’s actually the state of relaxation that comes during the training which produces the improvement. I think the machine also shines a soft white light in one’s eyes, which also may be therapeutic (some people have associated light deprivation with myopia). –Alex

Response:

David, I agree with you about the Alex posts, but not about your last comments on optometric vision therapy for reading difficulties. I guess you left off the optometric experts when you talked about excellent educational experts and expert psychologits etc. I think that when ophthalmology says vision therapy " has not been proven effective" in reading difficulties ( I disagree by the way) that that is not the same thing as ophthalmology saying it has studied this issue and knows what the issues are and knows what is important and what is not in terms of the connections between visual skills and perceptual skills and development and reading etc. So an opinion that is not an expert opinion seems to me to be less valid. As far as I can tell ophthalmologists are clueless about the entire issue. I cannot for the life of me figure out why an ophthalmologist would really even want to get deeply into this arena of reading difficulties.You probably are also overwhelmimgly pleased about OD’s obtaining therepeutic priveleges throughout the nation and I suspect soon even in California. Hollis Stavn O.D.

Response:

- Hide quoted text — Show quoted text – > David, I agree with you about the Alex posts, but not about your last > comments on optometric vision therapy for reading difficulties. > I guess you left off the optometric experts when you talked about > excellent educational experts and expert psychologits etc. > I think that when ophthalmology says vision therapy " has not been proven > effective" in reading difficulties ( I disagree by the way) that that is > not the same thing as ophthalmology saying it has studied this issue and > knows what the issues are and knows what is important and what is not in > terms of the connections between visual skills and perceptual skills and > development and reading etc. So an opinion that is not an expert opinion > seems to me to be less valid. As far as I can tell ophthalmologists are > clueless about the entire issue. I cannot for the life of me figure out > why an ophthalmologist would really even want to get deeply into this > arena of reading difficulties.You probably are also overwhelmimgly > pleased about OD’s obtaining therepeutic priveleges throughout the nation > and I suspect soon even in California. Hollis Stavn O.D.

Please see my post re reading disorders.  I am comfortable in my knowledge re this topic.   I look forward to working with opticians in the future when they gain the right in all states to refract. David — David B. Granet, M.D. Director Pediatric Ophthalmology & Ocular Motility Services University of California, San Diego *Keeping an Eye on our future  ;-) *

Response:

>   I givvy, you takey, Trust this reading doesn’t contribute to more > myopia. By the way I knew Elwin Marg back in the old days. DIdn’t know he > was against Bates.

Please – I’m not going to read all of these, especially alphabetically. Why don’t you pick the three strongest papers that you feel substantiate your treatment methods. sdb —

Response:

William Bates wasn’t the only proponent of the cause of naked-eye vision. Here are some modern books on achieving better vision by people who have no connection with the Bates school. Here are a couple of popular by optometrists on the subject that have some good case studies and bibliographies:    * Kavner, Richard S. Total Vision. New York : A & W Publishers,        1978.    * Seiderman, Arthur. 20/20 is not enough : the new world of vision.        New York : Knopf : Distributed by Random House, 1989. Here is a fascinating series by an optometrist who investigated the healing properties of plus lenses, especially in connection with preventing and treating myopia. He also gives some good references.  * Raphaelson, Jacob. A preventive and remedy for school-myopia. An        optical discovery based on 55 years of individual and independent        optical research. Cincinnati: Research Foundation for Prevention        of Myopia: 1958.  * Raphaelson, Jacob. Stretch your eyes; an optical discovery based        on fifty-eight years of optical research. Cincinnati, Research        Foundation for Prevention of Myopia: 1959.  * Raphaelson, Jacob.: Spectacle hobby; a story with a purpose. The following books are more on the negative side — critiques of the standard method of treating eye problems. They emphasize prevention rather than treatment.  * Kennebeck, Joseph (OD). Why Eyeglasses are Harmful for Children and        Young People. New York: Vantage, 1969.  * Rehm, Donald S. The myopia myth: the truth about nearsightedness        and how to prevent it. Ligonier, PA International Myopia        Prevention Assn., 1981. The following books deal with the effect of eye-use on the health of the nervous system and on the eyes themselves. They also include case studies of eye problems and their treatment with therapy glasses. Prentice goes into great anatomical detail on the subject of visual demand in the modern world, the cause of refractive error by eyestrain, and the use of plus lenses to prevent and treat myopia. Check your library!  * Brumer, V. (Victor). Eye-Strain: Its Cause, Consequences and        Treatment. St. Helens, England: Victor Optical Company, 1953.  * Prentice, Chalmers. The eye in its relation to health. Chicago:        A.C. McClurg and company, 1895.  * Prentice, Chalmers. The eye, mind, energy and matter, Chicago,        1905. –Alex

Response:

> –Alex

I guess final exams are over and summer break has started.   David David B. Granet, M.D. Director Pediatric Ophthalmology & Ocular Motility Services University of California, San Diego *Keeping an Eye on Our Future   *

Response:

>>I’ve been told by someone that this group once discussed the use of eye >exercises to produce mild improvemnt in unaided sight.  Could anyone point >to a references to such exercises?

A couple of years ago I came across an ariticle on one  eyesight improving machine call Accomotrac Vision Training or something similar invented by someone in New York. Is it still avaliable ? and hasanyone ever benefited from using it ? It claimed  to train the focusing muscle of the eye. Keng Leck

Response:

> > > Focusing problems can be caused by muscular difficulties – > > particularly as you get older the fibers become thicker, but exercise > > won’t prevent that either. > "Exercises", or more accurately vision therapy, changes the innervation to > these muscles thus increasing the vision functionality. > Sorry. I’ve never seen any published research that substantiates your > claims. Gimme.

  I givvy, you takey, Trust this reading doesn’t contribute to more myopia. By the way I knew Elwin Marg back in the old days. DIdn’t know he was against Bates. REFERENCES Baker, R.S., and Steed, M.M.  1990.  Restoration of function in paralytic strabismus: Alternative Methods of Therapy.  Bin Vis Quarterly   5(4), 203-211 Bracewell, R.M. and Stein, H.M. 1990.  Specialization of the right hemisphere for visuomotor control. Neurology  40, 284-292. Collins, F.L. Ricci, J.A., and Burkett, J.A.  1981.  Behavioral training for myopia: long term maintenance of improved acuity.  Behaviour Research and Therapy 19(3), 265-268. Cool, S.J.  1993.  Clinicians should be open-minded and explore the clinical value of new therapies or myth and metaphor, fact and datum in the art and science of clinical care.  Journal of Behavioral Optometry 4, 119-121. Goss, D.A., and Winkler, R.L.  1983.  Progression of myopia in youth: age of cessation. Am. J. Optom. Physiol. Opt. 60, 651-658. Greene, P.R.  1980.  Mechanical considerations in myopia: relative effects of accommodation, accommodative convergence, intraocular pressure and extra-ocular muscles.  Am. J. Optom. Physiol. Opt. 47, 902-914. Hall, P.S., and Wick, B.C.  1991.  The relationship betwen ocular functions and reading achievement. Journal of Pediatric Ophthalmology and Strabismus 28, 17-19. Kane, M.  1992.  Vision Therapy:  It’s Impact on Intelligence Tests. Journal of Optometric Vision Development 23, 39-41. Kaplan, R.M.  1983.  Changes in form visual fields in reading disabled children, produced by syntonic (colored light) stimulation. The International Journal of Biosocial Research  5(1), 20-33. Kaplan, R.M.  1977.  A Comparison of left and right eye speed of recognition values in average and below readers.  Optometric Extension Program Papers 30(2). Kaplan, R.M.  1977.  Orthoptics or Surgery? A Case Report.  Optometric Weekly  68(39), 33-66. Lane, B.C.  1982.  Myopia prevention and reversal: new data confirms the interaction of accommodative stress and deficit-inducing nutrition. Journal of the International Academy of Preventive Medicine 7(3), 17-30. Ogle, K.N., Martens, T.G., and Dyer, J.A.  1967.  Oculomotor imbalance in binocular vision and fixation disparity. Philadelphia: Lea and Febiger, 39-73. Roscoe, S.N., and Couchman, D.H.  1987.  Improving visual performance through volitional focus control.  Human Factors 29(3), 311-325. Rosen, R.C.,  Schiffman, H.R., and Cohen, A.S.  1984.  Behavior modification and the treatment of myopia.  Behavior Modification 8(2), 131-154. Rosenfield, M. and Gilmartin, B.  1987.  Effect of a near vision task on the response AC/A of a myopic population.  Ophthal. Physiol. Opt. 7, 225-233. Siderov, J., and DiGuglielmo, L.  1991.  Binocular accommodative facility in prepresbyopic adults and its relation to symptoms.  Optometry and Vision Science  68, 49-53. Sherman, A.  1993.  Myopia can often be prevented, controlled or eliminated.  Journal of Behavioral Optometry 4, 16. Shotwell, A.J.  1981.  Plus lenses, prisms and bifocal effects on myopia progression in military students.  Am. J. Optom. Physiol. Opt. 58, 349-354. Shotwell, A.J.  1984.  Plus lenses, prism and bifocal effects on myopia progression in military students. Part II. Am. J. Optom. Physiol. Opt. 61, 112-117. Trachtman, J.N.  1987.  Biofeedback of accommodation to reduce myopia – A review.  Am-J-Optom-Physiol-Opt. 64(8), 639-643. Trachtman, J.,Giambalvo, V., and Feldman, V.  1981.  Biofeedback of accommodation to reduce functional myopia.  Biofeedback-Self-Regul. 6(4), 547-62. Trachtman, J. and Giambalvo, V.  1991.  The Baltimore myopia study 40 years later. Journal of Behavioral Optometry  2, 47-50. Velasco e Cruz, A.A.  1990.  Historical roots of 20/20 as a (wrong) standard value of normal visual acuity. Optometric and Vision Science 67(8), 661. Wiggins, N., and Daum, K.  1991.  Visual discomfort and astigmatic refractive errors in VDT use.  Journal of the American Optometric Association  68, 680-684. Wilson, M.E.J.  1992.  Adult amblyopia reversed by contralateral cataract formation.  Pediatr. Ophthalmol. Strabismus 29(2), 100-102. Young, F.A.  1963.  The effect of restricted visual space on the refractive error of the young monkey eye. Invest. Ophthalmol. 2, 571-577. Young, F.A., Leary, G.A., Baldwin, W.R., West, D.C., Bos, R.A., Harrie, E., and Johnson, C.  1969.  The transmission of refractive errors within Eskimo families.  Am. J. Optom. Arch. am. Acad. Optom. 49, 676-685. Zeki, S.  1992.  The visual image in mind and brain.  Scientific American 267(3), 69-76.

Response:

> >The bates exercises *do* *not* *work*. Period. Glasses *are* *not* >*harmful*. Period. >Keep repeating that to yourself like a good lad. > Thanks for the brainwashing session, Scott. Now then, please see > my sci.med.vision article "Glasses can be poison!", where I quote several > doctors of optometry who argue that glasses make your vision worse, and > explain how.

That’s not brainwashing Alex – that’s deprogramming.  Don’t get me wrong – I actually think you Bates-oids are cute – but I have always been attracted to people who squint a lot (it makes you look scholarly). > Then pick up a copy of "Better Eyesight Without Glasses" and actually read > what Bates had to say.

I actually own several copies of that book, including a fairly rare first edition.  Each year they decrease in value – I paid $3.00 for the first edition, I suspect it’s worth about $0.75 now – but I digress. >The majority of vision problems are caused by the eye ball being ‘out >of round’ – there is nothing that you can do with exercise to make the >eye ball ’round’ if the genetics are not there to do it for you, >sorry. > "Exercise" is not what the Bates method is about. It’s about lessening > strain on the eyes. You don’t have to believe the Bates’s physiology to > prove to yourself that relaxed eyes see better. A simple face and neck > massage can do wonders. Most refractive errors start during school, when > children are forced to strain their eyes. Genetic time-bomb? Hardly.

Sorry. It’s perfectly clear that there is a genetic component. The actual shape of the eye is key in most cases, although it’s true the refractive properties of the lens do affect some vision but none of this are affected by the Bates eye exercises. > Myopic eyes are no more genetic than beer bellies. A study by Francis > Young in Alaska showed that while less than 2% of the non-schooled Eskimo > parents were nearsighted, over half of their children, who went to school, > were nearsighted — and the incidence and severity of the nearsightedness > increased with years of schooling. What’s more, there was no way to tell, > on the basis of the parents’ vision, how well the children would see.

Yawn. Instead of this crap, why don’t you read Elwin Marg’s study of the Bates technique. He wrote that back in 1952 and it’s been known ever since that this stuff is worthless. sdb —

Response:

> > Focusing problems can be caused by muscular difficulties – > particularly as you get older the fibers become thicker, but exercise > won’t prevent that either. > "Exercises", or more accurately vision therapy, changes the innervation to > these muscles thus increasing the vision functionality.

Sorry. I’ve never seen any published research that substantiates your claims. Gimme. sdb —

Response:

>   Robert-Michael Kaplan. O.D., M.Ed, FCOVD: >   >The majority of vision problems are recorded in the eye and and are >   >revealed as muscular difficulties. Developmental optometry has for years >   >been measuring the ongoing changes in structure mediated by stress on >   >the functional components of vision. > Yeuch…a chiropractor of the eyeball. Do you also press on the eye > to treat tachycardia via the oculocardiac reflex? >   >"Exercises", or more accurately vision therapy, changes the innervation >   >to these muscles thus increasing the vision functionality.

Vision therapy is a process that is being utilized by approximately  2000 vision specialists nation wide. Your naive and simplistic interpretation of this science ignores the many applications of vision therapy in the U.S., namely a whole array of vision difficulties including, vision related learning problems, perceptual dysfunction in juvenile delinquents, enhancing concentration and flow in olympic athletes, reducing eyestrain in the workplace, and helping individuals who have suffered from head trauma .Did you know that many of the national football leagues and the U.S. Olympic teams have vision therapy consultants? I assure you they are not doing a kindergarten version of chiropractic. Vision Therapy stimulates the nerve and muscle innervation from the brain to relearn the nativistic sense we all have to look easily and efficiently with the minimum amount of effort. The outcome of this process is sharper acuity.   – Hide quoted text — Show quoted text -> You mean the ciliary muscle is no longer innervated by cranial nerve > III, for example?  Now you really _do_ sound like a chiropractor ;’) > Tell me that ‘those opthalmologists’ and ‘medically oriented’ optometrists > are against all this VT stuff and everything else will be in place. > Seriously, what could you ever mean by "vision therapy" beyond the very > plausible and sane recommendations to focus away from your work at > frequent intervals and perhaps adding a few periorbital acupressure > massage points to ‘give yourself a rest?’ > The addition of ‘vision therapy’ "services" offered by OD’s has the > conspicuous economic look of the D.D.S ‘moving into’ TMJ therapy, the > podiatrist manipulating naviculars to ‘restore’ arches, and the > chiropractor getting into _anything_ they can get their hands on to > provide more "Service"…*including* vision, TMJ, orthotic, vitamin, > homeopathic, etc. therapies.  But what does it actually have to do > with improving visual acuity?  What’s the rap, at least?

FYI, Vision Therapy has been around for sixty years and hasn