Disagreement between the Bearded Guru and the Optometrist

This was kind of hard for me to post, but please bear with me to the end…I think it’ll be worth it. I’ve always had a bit of a knack for uniting people who disagree on things, so here goes!

@jakey, You’ve stated recently that you no longer automatically recommend parents immediately bring kids to a behavioral optometrist for myopia management due to what seems to be rampant overdiagnosis of other vision conditions. That’s a valid issue.

And at the same time, someone in that profession (Dr. Steve Gallop) has claimed that he can no longer recommend Endmyopia due to “limited understanding of the visual process” and “elusive” program details. Also a valid concern.

Both comments are out in the open online; one in a video by Jake and the other in a blog post by Dr. Steve on his website. I have had no private dialog with either of you guys about this topic, and don’t plan to!

That said, I think I know what is going on here…please bear with me, and do not take any of this personally…I’m only offering what I think is a likely large source of the inherent difference in methods, and thus, disagreement over how worthwhile each other’s methods are.

I think both parties very well may be missing analagous key parts of the other’s methods. This may sound a bit far-out, but I think it may have to do with active focus, believe it or not. Rather than lack of understanding, I think the communication is the issue.

I think active focus is actually a key point here in the communication issue, but not in the way people might think at first glance. When Gallop claims Steiner’s method misses out on the process and how to use lenses effectively, I think he may have an issue with the active focus part. Jake himself admits active focus may be elusive at the beginning.

I have an idea. I think there’s a reason the optometrists don’t chase active focus, but it’s actually not that they don’t utilize it; rather, I think, instead of trying to create willful change in the focusing, I think they are doing it through their vision therapy and possibly lens selection too. In other words, creating the prerequisite visual conditions under which “clear flashes” (automatic active focus) would occur on their own. They use lenses and therapy to modify behavior, which then modifies vision (e.g. produces active focus).

But at the same time, the issue with the optometrists’ methods is likely that creating those conditions that encourage the visual system to function as well as possible, requires that they diagnose every sub-optimal visual performance issue. Even though they are pro myopia reduction, these people are still optometrists, and are taught to diagnose and fix whatever they find and deem suboptimal…and thus are likely biased to believe that process is necessary for improving myopia to substantial degree.

I think the solution is for us to figure out exactly why active focus and clear flashes occur, and what conditions encourage them with the least effort, and for the behavioral optometrists to realize that Endmyopia, while by no means perfect, does work, and contains many open-minded, scientific DIY practitioners interested in always learning more and adding to their knowledge!

I really think both sides mostly agree on the mechanics of the process, but don’t always realize it!

Whew! Tough to write and tough to read, but I think this is an important discussion. We need to celebrate each others’ similarities, and in doing so will find we agree on more than we thought, and can learn from each other (DIYers and professionals).

No dog in this fight, on a personal level.

If I were to have thoughts on this topic, one might be the question which of the two parties wears glasses. Do you pick the out-of-shape personal trainer, or the one who looks the way you want to? I don’t have myopia and I talk about how I reversed it. If somebody prefers to take myopia management advice from a myope, hey by all means. :yum:

And one may consider the volume of clinical science and studies posted on the site. While for sure I have a limited understanding of just about everything in life, vision biology isn’t really particularly complex when it comes to myopia - and we sure talk about it quite a bit more on endmyopia.org than Steve (or really anybody else I can think of).

Or perhaps more randomly, the general success rate of reducing / eliminating diopter dependence. Elusive perhaps, but if we’re going to throw stones, let’s put numbers on them first. If you really want results, which destination looks like they can deliver?

I have nothing against Steve or any of the countless others in the profession who chose to cast aspersions rather than showing off results. At some point years ago I remember vaguely some disagreement with El Steve in particular, but my focus is whatever is most productive for the most amount of people - which is already more work than I can manage most days.

(also turns out, arguing with people is a massive waste of time and I’d rather agree to disagree than fan flames that really don’t need fanning)

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You know, I thought the same thing…Steve still wears glasses, and so do the patients he writes about for the most part (I bought his book on myopia a few years ago and really liked it.) That was a bit unsettling for me, but I tried to keep an open mind.

Neither method is perfect…I hope to meet both of you guys one day, and have already learned tons from both of you. (In case Steve is a member here and reading this).

I can’t help but point out the similarities though, and this is not about Steiner vs. Gallop, but rather the bigger picture…DIY compared to professional.

All I know is, I’m going to help bridge the gap between the groups over my career. That’s what I’m all about. That is my niche, what I love doing.

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Yup. If it one day boils down to Steve vs. Jake, we all are winning. :wink:

(I also feel fortunate to not have to call any of our darling friends “patients”, since my lack of knowledge or otherwise, we’re not sick or broken.)

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That’d be cool. Maybe a prelude of things to come?

I like the healthy debate, and you guys are civil to one another, which is important.

Not easy being a symbol for entire groups…leaders.

Which is/ will be what, if I may ask?

@ jake: Oh yeah, the ‘then why do they still wear glasses?’ - question is what made my parents so skeptical about lasik - and that made so much sense to me that I didn’t want to go after lasik later on.

Don’t know much about SG, but skipped through his articles after you, jim, posted one. What I read on the dangerous sun made me leave the page pretty soon.

So what is EM missing from SG method, in your opinion, @FMR? Just curious :slight_smile:

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Hi Tii!

So, I thought about this a lot before before posting my original topic. It seems to me that the optometrists using the method he uses don’t chase active focus, but rather check the person’s convergence and accommodation abilities with a bunch of different measures, and then prescribe the lenses that they feel fit that particular visual system in its current state the best, in other words the lenses with best compromise between between function and vision. It’s often a co-effort between the person and optometrist to figure out what powers. Problem is, are those enough stimulus to provide a 4 month reduction? What if they’re too weak? That was the impression I got sometimes. See where I’m going? Having been through every lens power on my way to an optimal normalized during my blur adaptation reduction, I feel I’m in a unique position to know what different powers do to my system. Yes, some are more comfortable. But sometimes those aren’t the ones that reduce the most progress.

Long story short, not all optometrists use similar methods, but I believe he learned from a couple of first generation myopia savvy optometrists who used a certain approach. The late Dr. Orfield on the other hand, used very different methods, very gradual lens changes like this site uses. She was a DIYer (under guidance from an optometrist) first before she was inspired to become one. She ended up at Plano eventually, just like Jake and others here. What does that say about those methods?

She also mentioned finding active focus, which is rare for optometrists to mention because it’s not a defined “thing” in Endmyopia with a recipe on how to get it.

I feel like I will be in a position in the future to do some research on active focus and really understand the ins and outs of it so it’s no longer as “elusive”. But I can’t be the only one. We need lots of research and anecdotal feedback about accommodation and vergence to understand how it works.

Like I said, my feeling is that there may be smoother, more reliable ways to help produce it. Sort of like how athletes use various training methods to achieve certain results in performance gains.

For example, you know how some people do better with a 0.25D cut and others with a 0.50D cut? It’s probably due to differences in accommodative amplitude, vergence (and their relationship), past lens history, blur adaptation, current lens power, etc.

You know how some people have great progress (like @Laurens for example) and go from like -3.75 to -0.75 really quickly? It’s probably due to optimal visual system performance and/or optimal lens use. Then you have people like me who went no glasses and differentials for ten years, and did not improve.

Wrote this on my phone. :frowning:

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FMR = future myopia researcher, an online nickname I came up with during college to describe what I wanted to do someday, inspired by my own vision quest. I’m really going to do this.

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Thanks for your replies!
How cool you made up your mind to this! After reading that orfiel article, I’ll look into this, too - at least check what I’d need to do to become an opto.
Not sure where you’ll go, but be prepared of what jake keeps posting: a massive shit storm from big lense producers, trying to ruin your reputation. As long as you expect them to use James Bond like methods against you, you should be fine :wink:

Still don’t get your point totally, I think.
You say, most optos are missing af, might give comfortable prescriptions instead of slightly below. Right?
What’s em missing, then?

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@Tii_Chen, I never said exactly what type of career I plan to go into, but if you’d like, you can message me to discuss potential career paths further; I think your idea is a good one!

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I was referring to the point of this topic here, but I still might! :wink:
Once I’ve gathered my info, I will!

I’m sending you a message now about career paths to start us off. No need to feel you have to contribute a lot to it right away if you’re not ready though.

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Great post, and best of luck with your goals. I’m not personally interested in the research end of it, but I love being a spokesperson / marketer / salesperson for the endmyopia concepts. We need both!

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Thanks Matt. Keep up the great work!

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One of my friends is already embarrassed by me asking people if they want to get rid of their glasses… :joy::joy::joy:
He can guess now and just leaves the scene when I start :joy:
I never thought I’d be a good marketer - but if I believe in the message, it’s really fun!

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I should sponsor fully paid vacations including kitesurfing lessons to darlings who successfully make it back to 20/20 (or close enough to play on the beach without glasses).

Seems being glasses free is a great goal, if there’s a reason for it.

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@jakey, there is still a disconnect between those who stay at, say -1.5 (or whatever) forever, for whatever reason, and people who end up between -0.50 and 0 and get rid of glasses forever in most cases. I believe that there is enough evidence to show that any person with lens-induced myopia, given enough time and proper course of action, can get back to emmetropia.

My own current thoughts (which might change over time!) are that 20/20 in the emmetropic range is good enough, because it means never needing glasses again.

I’d also like to see some information in the future on maintaining those gains. We all know people who slipped back into myopia again due to improper vision use (some of whom got rid of it again after that).

And I am going to figure out this active focus puzzle someday. How it works, what its limits are, what it can do, how to create it without even trying, etc.

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I know you always point this out - but I don’t get why anyone needs an extra reason, I just don’t!
Just not needing anything when I wake up will be such a huge piece of freedom on its own… :two_hearts:

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I never got that either. I’ve wanted clear vision every second since I noticed it was first blurry. I think, though, that Jake is just emphasizing we need hobbies and interests that ensure we get plenty of distance vision.

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Mmmmm… interesting offer!! Will you keep it for 10 more years? I can play on the sand without glasses. I can build castles with my children, or… well, dig tunnels, haha.

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