NEI REJECTION LETTER COMMENTS
Dr. Sidney J. Heller
355 Fifth Avenue
Pittsburgh, Pa. 15222
Dear Dr. Heller:
I am pleased to provide you, upon your written request, with a summary of the evaluation of your above-referenced grant application by an NIH- appointed panel of non-governmental scientists.
Note how careful he is to mention that they use a panel of "non-governmental scientists", as if that makes these people impartial and working in the public interest. You can be sure that they are all under the control of financial interests, just as the NEI is.
The reviewers note that the objective of the proposed study is to prove that there exist effective means to prevent or improve acquired myopia in children, in particular by use of the Myopter, a viewing device to transform close work into distant work by eliminating accommodation, convergence and stereoscopic effect. The rationale of the study is the belief that acquired myopia is caused by excessive close work through a mechanism of increased vitreous pressure.
At least he got that right.
The consultants take cognizance of your claim that you have demonstrated consistent success in halting myopic progression and obtaining improvements in the refractive error of children. However, while you quote the work of others on the effects of bifocals you provide no evidence for such success. Close work does not always produce progressive myopia, and the study of identical twins has revealed the same degree of myopia even when one twin, or both, does little close work. Further, many bright emmetropic children perform close work.
No one claims that close work ALWAYS produces myopia. Some children may start out very farsighted and never move into myopia even though the eye lengthens due to close work. He next claims that identical twins always have the same amount of myopia, but he gives no proof of that statement. There is no proof, because the statement is nonsense. The fact that "many bright children perform close work" without becoming myopic also proves nothing. They may hold the book far away. They may read in very good light. They may take frequent breaks. They may start out very farsighted. He knows these things, but chooses to ignore them in his attempt to cast doubt on the possibility of preventing myopia.
The reviewers do feel that the hypotehsis that accommodative efforts in childhood produce myopia, a hypothesis that has neither been proven nor disproven, is worthy of scientific investigation. Such an investigation must, however, be carried out by a scientist sufficiently unbiased to include in his study a control group of patients which is not treated according to the hypothesis the investigator favors. To be sure, there is a way to obtain a control group from children treated differently by someone else. However, such a procedure does not constitute an optimal experimental design. What is needed, rather, is a researcher who has sufficient question in mind about the efficacy of the treatment to under- take a controlled study himself.
First of all, we refuse to put minus lenses on an unnecessary "control" group when we know the lenses will destroy their vision. Secondly, the eye care industry states firmly that myopia cannot be halted or reversed. Our tests prove them wrong. A control group is not needed to do this. We are not comparing our test group to a control group. We are comparing our test group to the claims of the industry that myopia is inherited and cannot be prevented or reversed!
The panel is of the opinion that you do not propose a scientific study, but simply wish to practice optometry. Under these conditions it would be more appropriate for you to carry out your preventive treatment supported by the usual sources of health care. You might thus gather data over a ten year period, and, retrospective material in hand, apply for research support for data analysis at that time.
He claims that no one can do meaningful myopia research and practice optometry at the same time. Who then would qualify to do the research? Someone in a school of optometry? Such people are under the control of the optical industry and have no interest in such studies. Furthermore, the Young/Oakley bifocal study that has been included on this web site proved that bifocals could slow the progression of myopia. Oakley, who collected the data, was a PRACTICING OPTOMETRIST. Does this make his data invalid?
Note the suggestion to, "gather data for 10 years." That can be translated to, "get lost and don't come back."
I hope that this survey of the reviewers' comments, which obviously center about the need for a scientifically acceptable research design, will prove informative. If you are interested in the guidelines that NEI currently favors as regards proper controls in clinical trials, please contact me again.
A discovery that myopia can be reversed is so important that the NEI should conduct a study itself to verify this, using its own personnel. But all it does is block such research in every way it can.
Michael F. Halasz, Ph.D.
Extramural Program Director
Sensory-Motor Disorders & Rehabilitation
National Eye Institute
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