NEARSIGHTED CHILDREN CAN BE CURED
[FROM PREVENTION MAGAZINE, The December 1973 Issue]
Michael Clark -- (Pseudonym Cyril Maxton)
with some clarifying editing by Otis Brown
Researchers have discovered that myopia can be successfully
treated if special lenses are fitted before it gets too bad.
When Otis S. Brown was a young boy, he dreamed of someday
becoming an airline pilot. In fact, everything he did throughout
those early days in grade school was aimed at achieving that goal.
Then, disaster struck, and Otis Brown's dreams of becoming a
pilot faded as he was fitted with increasingly stronger minus
glasses to correct a worsening case of myopia, or nearsightedness,
a condition which causes distant objects to appear blurred.
Brown was born too soon. Today, there is good reason to
believe, if his parents could take that same 10 year old boy to an
optometrist, there is at least a 50-50 chance that Brown would
never have to wear a pair of glasses or contact lenses to see
distant objects. And, instead of being limited to flying his
home-built, Volkswagen powered cub plane, Otis Brown might have
the regular Pan Am route between Philadelphia and Paris.
It is only in the past few years that substantial numbers of
optometrists have begun using a radically new treatment, involving
"plus" lenses, that is said to keep myopic eyes of children from
deteriorating further, and even to cure or prevent myopia. It is
a direct contradiction to the more traditional forms of treating
nearsightedness which use "negative" lenses that bring distant
objects into sharp focus.
When rays of light enter the eye, they are bent by the eye's
lens so that they converge on a single point on the retina of the
eye. The retina, it should be noted, is the inside coating of the
eyeball. Although it is only the thickness of a newspaper page,
it contains 10 distinct layers and between 125 and 150 million
sensing rods which we use to see directly ahead and to all sides,
according to Dr. Harris Gruman (New Ways to Better Sight,
Hermitage House, 1950).
In the individual with myopia, the eye has adapted itself to
the reading environment. Therefore the light rays converge on a
single point in front of the retina, making distant objects appear
blurred. The traditional treatment for this problem has been to
fit the patient with negative (or minus) lenses which make an
adjustment to the light rays, resulting in their finally being
focused on the retina.
If some of the optometrists now doing research on myopia are
correct, then the child should be using a plus lens for
prevention, rather than the traditional minus lens. Although a
direct opposite treatment, the plus lens may be the right one to
actually prevent the eye from developing a negative focal state
Here's how it works.
The eye functions by "accommodation," which is the term used
to describe how the focusing apparatus of the eye adjusts to
objects at different distances. "Accommodation" takes place by
increasing the convex shape of the eye's lens through adjustment
of the ciliary muscles in response to blur sensed at the surface
of the retina.
In man, according to some of the researchers, the eye's
normal function is programmed to distant objects. But, by
starting children in school at an early age -- and keeping them
there -- as well as letting television baby sit them -- the eye's
"long-term focusing" adjusts to close-up work. To perform the
adjustment the eye alters its corneal curvature and length,
thereby blurring its distance vision.
TREATMENT STARTS WHEN SQUINTING BEGINS
The positive lens advocates believe that when a child starts
squinting in school -- one sign that may mean myopia is right
around the corner -- the child should be fitted with weak positive
lenses. The positive lens, which is a magnifying glass, minimizes
the need for large amounts of accommodation.
For example, when a child dons a pair of plus glasses,
(strong enough to neutralize the near enviroment) the reading
material will become clearer, since the plus lens is a magnifying
lens. This means that the eye's accommodation process does not
have to work at all for close work. When the child stops his
reading to look at something in the distance -- the distant
objects will be clearer.
And in order to minimize the number of times a child might
have to put on and take off his glasses, those who advocate the
use of positive lenses recommend either a full-face plus, or a
half-lens or "granny" glasses, so that the child can look over the
positive lenses when gazing at distant objects.
What happens, on the other hand, if the child who develops a
ease of myopia is fitted with a pair of negative lenses?
The negative lens corrects the blurred image and distant
objects literally leap into focus the minute the glasses are put
over the nose. But, the negative lenses do not correct the
overall problem of accommodation, and in fact move all objects
(optically) closer to the eyes.
The basic problem of adjustment to close-up work still
exists. And what's worse is that the eye will continue on the
same path, developing a worsening case of myopia. This means that
until the individual is about 25 or so, he will continue to need
stronger and stronger negative lenses until the myopia gradually
grinds to a halt.
Even then, there is no guarantee it will stop. And besides
having to wear glasses every waking minute, the individual winds
up spending anywhere from $600 on up to thousands of dollars for
new glasses during the course of his life.
On the other hand, there is a good chance that if a child is
fitted with positive lenses, he can slowly work his way out of a
myopic state to the point where he will never have to wear
negative glasses. By this theory, the use of plus lenses enables
the child to use his distance vision all the time, keeping the
myopia from developing further, and in many cases eliminating it.
Does the "positive lens" theory work?
"Yes, definitely," says Dr. William M. Ludlam, an
optometrist who formerly directed the Laboratory for Myopia
Research in New York and is now working on a year-long National
Institutes of Health grant at the University of the Pacific.
"I've used that method for the past 20 years and have had good
success with it."
Dr. Ludlam believes that myopia can be cured and, what's
more important, can actually be prevented through development of
good reading and other eyesight habits such as holding books
farther away from the eyes during reading and frequently looking
at distant objects during and after long periods of reading.
"But once they (optometrists or ophthalmologists) fit
negative lenses, that's it. The child has myopia," he said.
One time an accountant brought his young son to Dr. Ludlam
for treatment of headaches associated with long periods of
reading. After fitting the son with positive reading glasses and
prescribing a series of visual exercises, Dr. Ludlam was asked if
he could cure or at least help the accountant's myopia.
"The accountant had normal vision up until he was about 23 or
24. In fact he had served in the Air Force. But by the time he
came to me, he had 20/400," Dr. Ludlam said.
20/400 means that the accountant who was in his early 30's
could see at 20 feet what people with perfect vision could see at
400 feet. In practical terms, he could read only the largest
letter on an eye chart.
Dr. Ludlam treated the accountant with a series of exercises
and positive lenses which increased the eye's flexibility. "I
brought him down from 20/400 to 20/80 and 20/40 where he is now
and I've held him there," Dr. Ludlam said. "He-still wears
glasses to drive, for the theater and to watch television, but
other than that, he doesn't need them especially for his close-up
Dr. Ludlam has done the same for children, bringing them
from extremely poor distant vision right down to 20/40 through
exercises and positive lenses and "held them there for 10 years.
I reported on 30 cases that I treated for over a 10 year period of
time, so I know it can be done. They're still there today."
NOT ALL MYOPIA RESPONDS
There are two different kinds of myopia that Dr. Ludlam has
studied. One is caused by pressure of the eye growing too fast,
causing the eye to become elongated. "It literally grows right
out of focus."
Treatment calls for fitting the eye with contact lenses which
press the eye into focus, acting like a "pressure bandage." If a
10, 11 or 12 year-old child is fitted with contact lenses, there
is a good chance that the myopia will be caught and not progress
further, he noted.
But the other type of myopia can be reversed. It's caused by
a spasm of the ciliary muscles. For example, a person is reading
and then looks up. If the eye fails to focus on a distant object,
the ciliary muscles are believed to be undergoing spasms.
If a child comes in and tells me that he has trouble trying
to focus on a black-board or a clock until he blinks a couple of
times, he's accurately describing a ciliary spasm," Dr. Ludlam
This second type of myopia is controlled by use of positive
lenses which tend to take the close-up environment and push it
outwards, increasing the reading distance.
"The nearer you hold something like a book, the greater the
problem, because the more the ciliary muscles must contract," Dr.
Ludlam said. "Reading at 8 inches or less is murder on eyes and
someone who does this continually will become nearsighted very
Sometimes, a person will have both problems, said Dr.
Ludlam, citing the instance of a college student he treated.
In cases like that, Dr. Ludlam said he first fits the eye
with contact lenses to "pressure" the eyeball into place. Then,
the patient is fitted with positive lenses.
"I had one case of a college girl. During the summer time,
her eyes weren't too bad. So I attributed her problems to
reading. After fitting her with contact lenses and positive
lenses, her vision improved. Now, the only time she wears reading
glasses is during periods of heavy reading. But she wears her
Dr. Ludlam pointed out, however, that other factors might
play a role in myopia as well.
"There are indications that nearsightedness is caused by a
number of things such as the environment, nutrition and function
(i.e. reading)," Dr. Ludlam told PREVENTION. "There are cases
where one aspect of the problem is more important than the other.
For example, if a child eats a well-balanced diet and lives in a
good home, but all of a sudden becomes a book worm and develops
myopia, it's pretty obvious what the cause is."
Dr. Ludlam cited a study done on Eskimos in which it was
discovered that myopia had reached near-epidemic proportions among
the current school-age generation.
The study of 204 children in grades 3, 4, 5 and 6 in Alaska
showed that the proportion of myopes in grade 5 approximated that
found in grade 12 among Caucasians, or 26 per cent. However, the
proportion of myopes in grade 6 (59 per cent) usually is never
reached in any school population among Caucasians (American
Journal of Optometry and Archives of the American Academy of
Optometry, Young, et al., May, 1970).
Dr. Ludlam pointed out that the grandparents of these
children had no myopia while the parents of these school children
had less than a 5 per cent incidence.
"This near-epidemic of myopia may be a combination of many
different factors," he said. "This is the first generation to
read. It's the first to use electrical lights and it's the first
generation to eat a non-protein diet. They're eating everything
from popcorn to Coke. Who can say what is causing their
The optometrist is now in the process of analyzing data on
525 children with an NIH grant. While in New York he and his
associates followed these children for several years, taking down
all the information they could, ranging from the size of the
eyeball to total weight. Now, the information is being analyzed
"In a year, we should have most of the answers about what
affects what. We'll know exactly how one thing relates to
another. And then, we'll be able to make some kind of judgment,"
he said. "We'll know what factors relate to myopia and why there
is such an increase, even in the United States."
Dr. Ludlam also believes that heredity can pretty well be
discounted as a cause of myopia simply because of the fact that it
is growing much faster than if it were a genetic defect.
Although the "positive lens" theory works and can possibly
lead to a life free from the anchor of negative glasses, it is
extremely difficult to convince many patients that it will work
A lower Bucks County (Pa.) optometrist, Dr. Carl Cordova
told us that many patients are reluctant to try the preventive
approach because it doesn't work right away. "They believe in
making a distant picture clear and they'll go from doctor to
doctor in order to hear the answers they want."
But, the onset of myopia is a gradual one. It can happen
over a year or two and a person might first be conscious of it
after being examined. And, as Dr. Cordova pointed out, patients
want the blurred vision eliminated almost immediately. They will
not take the time to effect a cure but will settle for having
their distant vision cleared with a minus lens. A cure, however,
can take almost as long as the eye took to reach the point at
which correction started.
A variations of the positive lens cure, Dr. Cordova said, is
to fit the patient with bifocals containing a reading (positive)
lens on the bottom, and a negative lens of a lower power than
needed on top. He has had success with patients using that method
and was eventually able to almost completely corrected myopia in
patients who were willing to use the treatment.
Almost a universal problem of parents today revolves around
the question: "How can I prevent my child from becoming
There are several ways, the first of which begins in the
crib. Mothers, according to Dr. Amiel Franke, of Washington,
D.C., should keep a child out of the playpen as much as possible.
By stimulating the baby's eyes they are given more of a chance to
develop. "When a child's activities, even in infancy are limited,
his vision growth and development is limited too," he told a
recent meeting of the Southeastern Congress of Optometry.
Other things: Keep a dim light in the nursery so that a
child sees something if he awakens at night; his crib should be
placed in different spots in the room for variety; the baby's
position in his crib should be changed; and bright, moving objects
should be within his sight at all times.
This, believe some optometrists, will help the infant's eyes
develop strongly for later use.
Besides exercises in infancy, diet has been blamed for the
near epidemic incidence of myopia. Dr. Jin Otsuka, a leading
Japanese authority on nearsightedness and professor of the
Department of Ophthalmology, Tokyo Medical and Dental University,
believes that diet as well as the environment plays a major role
"If you give sugar to a rabbit, the rabbit becomes myopic,"
is the way the Japanese researcher describes it in a soon-to-be
published book, The Cause and Treatment of Myopia.
He pointed out that shortly before World War II, the Japanese
population was developing extensive myopia, a condition which
seemed to disappear during the war and, strangely enough,
reappeared more recently.
Dr. Otsuka attributes the rise in myopia to the extensive
use of sugar and refined foods in place of a more traditional
Japanese diet which was heavy on natural foods. During the war,
of course, most refined foods and sugars were unavailable.
In experiments conducted at the Columbia College of
Physicians and Surgeons by Dr. Arthur A. Knapp, animals were fed
diets deficient in vitamin D and calcium. The animals developed
an amazing variety of eye problems including myopia (Medical World
News, Sept. 17, 1965 ). Dr. Knapp then tried feeding vitamin D
and calcium to human patients suffering from the same eye diseases
as those produced in the animals.
The results were significant. In one group, 18 out of 52
vitamin supplemented patients showed a reduction in myopia while
only 8 remained unchanged.
Myopia, therefore, seems to be a disease which can often be
corrected, if the proper steps are taken. For many, who have gone
through several increases in minus lens strength, it's too late.
The die is cast. But it would be wise for parents to:
o Make sure their infants get plenty of eye exercise;
o Insure that their children eat a balanced menu including
plenty of vitamin D and calcium;
o Guard against excessive close eye work and long hours of
reading, especially at distances of less than 8 inches;
o Have the child use a plus lens for all reading, the strength
of the plus lens to be based on the child's habitual reading
o Watch for signs of squinting, headaches and tiredness;
o Train their children to take breaks in reading and look at
far-off objects over the tops of the plus lens.
Unfortunately, all of this "new" information comes much too
late for Otis Brown. His eyes are bad and they will remain that
way. But, despite his run of bad luck and being born 20 or 25
years too early, he hasn't lost his zest for evangelism and
constantly warns others against accepting negative lenses too
readily without examining the alternative.
"Parents should know that there is an alternative for their
children," Brown said. "But this alternative stops later on in
life. If they can stop myopia early, they should be able to take
advantage of it and use the preventive process.
"The biggest advantage to trying the positive lens approach
is that it is completely harmless. It can't hurt." But, Brown
continued, "it could help tremendously. If the child is 8, 9, 10
or 11, how important is it that he have 20/20 vision immediately?
If the condition has developed over a year or a year-and-a-half,
what's the matter with waiting a year or a year-and-a-half to
clear your distant vision with a plus lens -- if it means your