Academic Progress Report - Comparative Literature: Fill & Download for Free

There’s an old academic joke about a wealthy racehorse owner who hired a biologist, an engineer, and a physicist to advise him. After a year the biologist reported “I have some promising data on the bloodline descended from the Darley Arabian of 1704, and its gene complex for protein phosphatase 2.” The engineer said “These appear to be the optimum ratios of length and mass for femur, tibia, and third metatarsus.” The physicist said: “I’m making progress on the spherical homogeneous frictionless horse.”Balance that against the old meme that social scientists suffer from “physics envy” — i.e., that they yearn for laws and principles with the breadth, predictive power and precision of natural sciences, with physics as the “hardest” exemplar.As a chemistry student who ended up in mythology and comparative literature by graduation, I found some truth in both. But based on experience over the years of places such as the Institute for Advanced Study, where scholars from many disciplines interact, I learned that thoughtful natural scientists rarely look down on psychology and social sciences as “squishy.” They’re more likely to shake their heads sympathetically at how hard it is to extract even tentative generalizations, let alone mathematical models, from such complex systems.

I am an optical physicist. I have had myopia since junior high school. I have researched this subject and people on Quora have sent me papers. I will try to present all the data from this research, but it is a little long and gets a little technical. I am not selling anything. I am just trying to give an honest answer to the best of our ability to know today. Tomorrow the cause of myopia might be discovered. But until then, this is the result of my research of the published papers. Note: this answer includes material from my previous answers on this subject on Quora.First let me say that your kid is normal. His eyes are healthy. They are most likely just growing a bit too long. Children’s eyesight on average starts out as hyperopic (eyeballs too short). As the children grow, the eyeballs grow also. At about age six, they are often the correct length. By age 9, they are starting to be too long. This continues slowly until sometime in the twenties. Why are eyeballs suddenly growing too long? I will try to answer as we go along. I include paragraph topic sentences to help you choose if you want to read a particular paragraph.Can you cure myopia naturally?The short answer is: No “natural”cure has been shown to be effective. The only known treatment to stop myopia is atropine eye drops.At the present level of medical knowledge, other than atropine eye drops, there is no way to stabilize myopia. Myopia on average progresses at about -0.25D per year until the early to mid 20s. By the age of 30, it is pretty much stabilized. Myopia is caused by the eyeball growing too long. We do not yet know what causes it. We do note that there are places where the prevalence is high (urban China and North America, for example) and low (Australia and rural Nepal, for example.) There is much misinformation and disinformation about myopia around. In certain societies there is a large stigma associated with it and glasses, so naturally there is a desire for a natural magical cure.By the way, after the first year or so of atropine eye drops, it appears that the myopia that had been halted shows up at the same level that it would have been without the atropine eye drops. So it now looks as though it only delays the development of myopia.What causes myopia?Is it reading? Using computers? Staying indoors while young? Is it a chemical or hormone in our environment or in our food supply? Is it a side effect of a childhood disease? Is it a side effect of an antibiotic or other drug? We don’t know. A lot of research has been done to see if glasses, exercise, reading, using computers, smartphones, diet, sunshine or a few other things make any difference. Apparently they don’t, because the researchers expected to find a correlation, but they did not.In a 5-year follow-up longitudinal study on 1318 children aged 6–14 years, hours per week spent reading or using a computer did not differ between the groups before myopia onset. Studying and TV watching were also not significantly different before myopia onset. This study failed to show evidence of a relationship between near visual activities and the development of myopia. (Ref. 44)Eye Exercises and Eye-Friendly DietsAlthough there is no evidence that they work, I am including links to free eye exercises and green smoothie recipes because scam artists out there are charging a lot of money for the same information.PLEASE NOTE: “Palming” or rubbing of the eyes to flatten the cornea is dangerous and can result in uncorrectable vision. Please see the comments after this answer.5 Free Eye Exercises to Improve Your Vision5 Green Smoothies For Vision & Eye Health - DavyandTracy.comPeople have been known to vigorously rub their eyes to flatten their corneas a little and reduce their myopia. Unfortunately some people who have tried this ended up with vision that could not be corrected with eyeglasses or contact lenses. This is a very dangerous thing to try and not recommended.A few people have been able to train their minds to see even though the image on their retinas is blurry. Think of this like the algorithm used to sharpen the Hubble Space Telescope images when it was first discovered to have spherical aberration. Most people can never succeed at this.When will there be a cure?Until research discovers the cause of myopia, there will be no cure. It is easily mitigated with corrective lenses or refractive surgery. There is one thing I only briefly mentioned: atropine eye drops have been shown by research to halt the progression of myopia, but apparently, only temporarily.The evidence that reading causes myopia is bunkIn 1969, Francis Young published a paper on the transmission of refractive errors in Eskimo families. He showed some correlations within families that seemed to indicate a genetic component to myopia. However, his sample sizes were so small that the data is too full of random chance to be very indicative. In the same paper he published the following data:You can see that the standard deviations and ranges are fairly large due to the small sample sizes. However, there does seem to be a correlation with age and something seems to have happened to people born 21-25 years earlier. There is a marked increase in myopia (on average) starting in 1944–1948 (the paper is from 1969.) [Edit: On reflection, this data seems to have been manipulated. With the error bars, the clear correlation with age is unrealistically consistent. ]Now what caused it? The bombs on Japan? The change of diet? The coming of electricity to Barrow, Alaska? The DEW line with the hugely powerful early warning radars? Well, without any research at all, Young confidently says it must be due to 40 watt light bulbs in Eskimo houses and the ability to read indoors. I am sorry, all of you who suggest that this paper proves that reading causes myopia, you are all incorrect.Six years later the same Francis Young tried again to prove that reading causes myopia. He collaborated with Ken Oakley, who prescribed bifocals for children in the test group, but for the “control” group he under-prescribed glasses. That’s right, he gave them less refractive power by 0.50 diopters than they needed. This gave support to the misguided attempt to under-correct myopia in order to slow it down.So a year later, guess what. The control group needed stronger glasses. The peer review process called out this paper for internal biases, lack of randomized data, and a number of other problems. Young weakly admits that it was then too late to correct for these biases. But they published this flawed study anyway.What resulted was this data:Guess what. On average, the control group needed a stronger prescription by roughly a half diopter. Do you see the problem with this data? This is supposed to be proof that reading is the problem and bifocals for children is the solution. Just awful science. These papers should never have been published. Myopia dot org should be embarrassed and ostracized for using this data.Recent Research ResultsDistributions of Refractive Errors by amountFrequency of occurrence of refractive errors by diopter. Positive diopters are lumped with zero for these studies.[1] [2]The method is inaccurate for -0.5 diopters because they only counted people who were wearing glasses for it. A lot of people with -0.5 will not wear glasses.Distributions of Refractive Errors by group[3]Research into causes of myopiaBy 2002, a lot of research into bifocals and other treatments to prevent, slow down or reverse myopia had been done, much inspired by the Young papers. A review was made of many studies, but emphasis was made on scientific approaches, unbiased studies, and large enough sample sizes to be relevant. Using only data that passed the test of scientific method, the following charts were produced.Differences between control group and test group are shown. In most cases there is no significant difference between the control group and the test group.Atropine Eye DropsHere we see that three separate studies of sufficient sample sizes showed a very clear difference between the control groups and the test group receiving atropine eye drops. Side effects included stinging, photophobia, headaches and other vision issues.Thanks to Ed Averbukh, ophthalmologist[4] , for pointing me to the ATOM study. Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2, Myopia Control with 0.01% Atropine Eyedrops, American Academy of Ophthalmology, Chia, Lu & Tan, 2015[5]Let’s look at the normal untreated average progression of myopia compared to 1% Atropine Eyedrops.You see on average that untreated myopia progresses at about -0.4 diopters per year according to the control group in the study. 1% atropine actually initially reverses some of the refractive error for the first 18 months, on average. However, when treatment ended, there was a rebound effect, in which the myopia rapidly increased. These subjects were then removed from the study (called a wash-out) and they were put under treatment with 0.01% atropine.Here you see that 0.5% atropine eye drops had less of a slowing effect, but after treatment ceased, there was still a rebound effect. After 60 months, there was no net improvement over no treatment at all.We can say about the same for 0.1% atropine eye drops. Let’s look at 0.01% atropine.Although 0.01% Atropine takes a while to work, it seems to have long-lasting effects. In the 5 year study, on average, it decreased the progression of myopia by about 1 diopter.Bifocals to reduce “eye strain” from readingWe also see that four separate studies with sufficient sample sizes saw almost zero benefit to bifocals. The average was a small fraction of a diopter, but notice that zero is included in the error bars for every single study. As a result of this, they concluded The latest evidence from randomized clinical trials does not provide sufficient information to support interventions to prevent the progression of myopia.Soft contact lenses and timolol eye dropsTwo additional studies found no benefit from timolol eye drops or using soft contact lenses in place of glasses. Typically people who push the idea of eye strain causing myopia ignore all of the studies referenced in the figure above and stick with the obviously flawed studies by Francis Young.Ortho K Hard contact LensesSpecial hard contact lenses are sometimes used to push the eyes (corneas) of the myope into a flatter shape to compensate for the eyeball being too long. Unfortunately, this effect is short-lived. The patients must wear the contact lenses every night.Interocular LensesAs to surgical interventions, interocular lenses can be inserted, with the disadvantage of causing immediate and absolute presbyopia. Multi-focal interocular lenses try to address this issue, but they cause a loss of sharpness and contrast at all distances. I should mention here that one company, Ocumetrics, is developing what they call a “bionic lens” which is a flexible IOL (interocular lens) that is supposed to refocus under control of the ciliary muscle just like the natural crystalline lens does in a young person.Refractive SurgeryVarious kinds of refractive surgeries have been devised to change the shape of the cornea. A bunch of different names come up like PRK, LASIK, LASEK, SMILE, wave-guided LASIK, epiLASIK, and conductive keratoplasty.Eyeball shrinking surgeryIt is difficult to find results of experimental surgeries to reduce the length of the eyeball. This seems to be the most difficult way to correct myopia possible. To reduce the eyeball length, you have to also shrink the retina somehow. Surgery seems especially problematic in this direction.ConclusionsThe cause of myopia has not yet been shown.In the category of non-refractive correction, only 0.01% atropine eye drops showed long term effectiveness. Atropine eye drops had some undesired side effects at concentrations of 0.5% and above.The other interventions simply apply a refractive correction to the error that is caused by a long eyeball.Reading, staying indoors, lack of sunshine, using smartphones and computers have not been shown to cause or be correlated with myopia.There is no evidence that eye exercises or special diets prevent myopia. You will find testimonials and emotional slick videos to promote these “discoveries” but you can get the same information for free using my links above. I do not endorse or represent that these have any medical benefit. I have included them to save you from sending money to people trying to make a buck from the same information.Let me closeThere is a short webpage called “Myths and Facts About Vision” by the Mayo Clinic.[6] Here are some myths:Myth 1. Reading in poor light will hurt the eyesMyth 2. Holding a book too close or sitting too close to the television set is harmful to the eyes.Myth 3. Using the eyes too much can "wear them out"Myth 4. Wearing eyeglasses will weaken the eyesMyth 5. Crossing the eyes can make them permanently crossedMyth 6. Having 20/20 vision means that the eyes are perfectI almost want to add here the myth that self-sexual-gratification will make you go blind.ReferencesInterventions to retard myopia progression in children: an evidence-based update. (2002)BIFOCAL CONTROL OF MYOPIA (1975): Optometry and Vision Science: http://www.mediafire.com/file/42j150328xwtpqc/Bifocal+Control+of+Myopia.pdfTHE TRANSMISSION OF REFRACTIVE ERRORS WITHIN ESKIMO... (1969): Optometry and Vision Science: https://www.mediafire.com/file/ikzq63jiatne0pg/Eskimo+Families.pdfThe following references are given in reference 1 above:Tan NWH, Saw SM, Lam DSC, et al. Temporal variations in myopia progression in Singaporean children within an academic year. Optom Vis Sci 2000;77:465–72.Lin LLK, Shih YF, Tsai CB, et al. Epidemiologic study of ocular refraction among schoolchildren in Taiwan in 1995. Optom Vis Sci 1999;76:275–81.Mutti DO, Bullimore MA. Myopia: an epidemic of possibilities? [editorial]. Optom Vis Sci 1999;76:257–8.Katz J, Tielsch JM, Sommer A. Prevalence and risk factors for refractive errors in an adult inner city population. Invest Ophthalmol Vis Sci 1997;38:334–40.Saw SM, Katz J, Schein OD, et al. Epidemiology of myopia. Epidemiol Rev 1996;18:175–87.Wu SY, Nemesure B, Leske MC. Refractive errors in a black adult population: the Barbados Eye Study. Invest Ophthalmol Vis Sci 1999;40:2179–84.Mitchell P, Hourihan F, Sandbach J, Wang JJ. The relationship between glaucoma and myopia: the Blue Mountains Eye Study. Ophthalmology 1999;106:2010–5.Pierro L, Camesasca FI, Mischi M, Brancato R. Peripheral retinal changes and axial myopia. Retina 1992;12:12–7.Rose K, Harper R, Tromans C, et al. Quality of life in myopia. Br J Ophthalmol 2000;84:1031–4.Wallman J. Nature and nurture of myopia. Nature 1994;371:201–2.Hung LF, Wallman J, Smith EL III. Vision-dependent changes in the choroidal thickness of macaque monkeys. Invest Ophthalmol Vis Sci 2000;41:1259–69.Grosvenor T, Goss DA. The role of bifocal and contact lenses in myopia control. Acta Ophthalmol Suppl 1988; 185:162– 6.Goss DA. Attempts to reduce the rate of increase of myopia in young people - a critical literature review. Am J Optom Physiol Opt 1982;59:828–41.Hosaka A. Myopia prevention and therapy. The role of pharmaceutical agents. Japanese studies. Acta Ophthalmol Suppl 1988;185:130–1.Jensen H. Myopia progression in young school children. A prospective study of myopia progression and the effect of a trial with bifocal lenses and beta blocker eye drops. Acta Ophthalmol Suppl 1991;200:1–79.Grosvenor T, Goss DA. Role of the cornea in emmetropia and myopia. Optom Vis Sci 1998;75:132–45.Angi MR, Caucci S, Pilotto E, Racano E. Changes in myopia, visual acuity, and psychological distress after biofeedback visual training. Optom Vis Sci 1996;73:35–42.Polse KA, Brand RJ, Vastine DW, Schwalbe JS. Corneal change accompanying orthokeratology. Plastic or elastic? Results of a randomized controlled clinical trial. Arch Ophthalmol 1983;101:1873–8.Dumbleton KA, Chalmers RL, Richter DB, Fonn D. Changes in myopic refractive error with nine months’ extended wear of hydrogel lenses with high and low oxygen permeability. Optom Vis Sci 1999;76:845–9.Daubs J, Shotwell AJ. Optical prophylaxis for environmental myopia: an epidemiological assessment of short-term effects. Am J Optom Physiol Opt 1983;60:316–20.Shotwell AJ. Plus lens, prism, and bifocal effects on myopia progression in military students. Part II. Am J Optom Physiol Opt 1984;61:112–7.Scottish Intercollegiate Guidelines Network. Grading System for Recommendations in Evidence-based Clinical Guidelines. Edinburgh, Scotland: SIGN, 2000;8.Minckler D. Acknowledging the importance of study design in the organization and quality of manuscripts [editorial]. Ophthalmology 1999;106:11–2.Yen MY, Liu JH, Kao SC, Shiao CH. Comparison of the effect of atropine and cyclopentolate on myopia. Ann Ophthalmol 1989;21:180–7.Pa¨rssinen O, Hemminki E, Klemetti A. Effect of spectacle use and accommodation on myopic progression: final results of a three-year randomised clinical trial among schoolchildren. Br J Ophthalmol 1989;73:547–51.Shih YF, Chen CH, Chou AC, et al. Effects of different concentrations of atropine on controlling myopia in myopic children. J Ocul Pharmacol Ther 1999;15:85–90.Schwartz JT. Results of a monozygotic cotwin control study on a treatment for myopia. Prog Clin Biol Res 1981;69:249–58.Grosvenor T, Perrigin D, Perrigin J, Quintero S. Rigid gas-permeable contact lenses for myopia control: effects of discontinuation of lens wear. Optom Vis Sci 1991;68:385–9.Fulk GW, Cyert LA. Can bifocals slow myopia progression? J Am Optom Assoc 1996;67:749–54.Fulk GW, Cyert LA, Parker DE. A randomized trial of the effect of single-vision vs. bifocal lenses on myopia progression in children with esophoria. Optom Vis Sci 2000;77:395–401.Horner DG, Soni PS, Salmon TO, Swartz TS. Myopia progression in adolescent wearers of soft contact lenses and spectacles. Optom Vis Sci 1999;76:474–9.Jensen H. Timolol maleate in the control of myopia. A preliminary report. Acta Ophthalmol Suppl 1988;185:128 –9.Hemminki E, Pa¨rssinen O. Prevention of myopic progress by glasses. Study design and the first-year results of a randomized trial among schoolchildren. Am J Optom Physiol Opt 1987; 64:611–6.Grosvenor T, Perrigin DM, Perrigin J, Maslovitz B. Houston Myopia Control Study: a randomized clinical trial. Part II. Final report by the patient care team. Am J Optom Physiol Opt 1987;64:482–98.Bedrossian RH. The effect of atropine on myopia. Ophthalmology 1979;86:713–7.Chou AC, Shih YF, Ho TC, Lin LLK. The effectiveness of 0.5% atropine in controlling high myopia in children. J Ocul Pharmacol Ther 1997;13:61–7.Tigges M, Iuvone PM, Fernandes A, et al. Effects of muscarinic cholinergic receptor antagonists on postnatal eye growth of rhesus monkeys. Optom Vis Sci 1999;76: 397– 407.Lind GJ, Chew SJ, Marzani D, Wallman J. Muscarinic acetylcholine receptor antagonists inhibit chick scleral chondrocytes. Invest Ophthalmol Vis Sci 1998;39:2217–31.Ong E, Grice K, Held R, et al. Effects of spectacle intervention on the progression of myopia in children. Optom Vis Sci 1999;76:363–9.Leung JTM, Brown B. Progression of myopia in Hong Kong Chinese schoolchildren is slowed by wearing progressive lenses. Optom Vis Sci 1999;76:346–54.Jones-Jordan LA, Mitchell GL, Cotter SA et al. Visual activity before and after the onset of juvenile myopia. Invest Ophthalmol Vis Sci 2011; 52: 1841–1850.Leo, Seo Wei, Current approaches to myopia control, Wolters Kluwer Health, 2017.Effects of orthokeratology on the progression of low to moderate myopia in Chinese children.Myopia Control with Bifocal Contact Lenses: A Randomized Clinical Trial.Five-Year Clinical Trial on Atropine for the Treatment of Myopia 2: Myopia Control with Atropine 0.01% Eyedrops.Multifocal versus single vision lenses intervention to slow progression of myopia in school-age children: a meta-analysis.Peter Polack's answer to Can a nearsighted person get 20/20 vision naturally (i.e., without glasses, contacts, or LASIK)? If so, how?If the Bates method and similar eye exercises and devices are actually effective alternatives or adjuncts to prescription glasses, why didn't the 'natural methods' ever really catch on?Footnotes[1] Worldwide prevalence and risk factors for myopia.[2] Increased prevalence of myopia in the United States between 1971-1972 and 1999-2004.[3] Worldwide prevalence and risk factors for myopia.[4] Ed Averbukh[5] https://www.aao.org/Assets/28fe020e-5f93-4d06-aac1-889cecb15fb2/635835505202800000/atropine-for-myopia-5-yr-clinical-trial-ophthalmology-2015-pdf?[6] Myths and Facts - Mayo Clinic Health System

This is one of the most important questions in science today. The consequences of this answer are profound as they influence how science progresses and the hidden biases of scientific progress.The question was, "Why don't more scientists publish failed experiments?" and let's start by looking at this question from the point of view of a scientist who has just completed an extensive series of experiments where the results were negative. Remember, results are to test a hypothesis and negative results say that the null hypothesis has not been ruled out. Let's give an example. The hypothesis might be that high myopia (nearsightedness) comes from a gene that not only makes the eye larger (which is what causes near sightedness), but also makes the brain larger (the eye and brain are largely controlled by the same genes). This might have enormous clinical significance. Maybe bigger brains are associated with higher intelligence. Maybe nearsighted people are more intelligent. But you start with the narrowest test of the narrowest hypothesis, so the experiment should be to compare the brain MRIs of patients with severe nearsightedness and compare that to normals with the same ages and gender distribution. By the way, this is not a bad experiment and I don't think it's been done.In our hypothetical example, to the disappointment of the early career experimenters, it turns out that there is no association. Technically, that means that the p value (probability of an effect) was not < 0.05 (the line in the sand in science is that the null hypothesis of random chance association is less than 5% likely. If that happens, then you imply a 95% chance that your hypothesis was right and you move on to significance). But that didn't happen. Too bad, since if it were the opposite, the paper could be sent to a great journal and such a publication would help the scientists involved get promoted (publish or perish) and famous. And such a finding would surely lead to a good NIH grant and get the scientist a lot more time as an investigator (NIH funding pays for and hence buys your time from teaching or clinical duties). And they would surely be asked to present these findings to an important symposia. All of this would fast track them to great academic careers.But it didn't turn out that way. The negative results don't say why some people have myopia. It certainly doesn't help answer the question of whether big brains help with intelligence. In fact, it gives a really boring answer of "we don't know anything more". Except for one thing, we've learned that big eyes are not associated with big brains. And that is something and deserving of publication.Now the scientists have to spend a lot of time and a modicum of money preparing these negative results for publication. And though the scientific program still wants the lead scientist to present these negative findings at the symposium, they don't give him the prime time and the big room. No one will show up anyway, so he's given a tiny classroom on the afternoon of the symposium when most people are already heading to the airport. No one wants to hear a negative story that doesn't intrigue them or empower them to understand mechanisms better.But, in the interest of good science, our intrepid scientist still submits the data to a journal for peer review and, hopefully, publication. The submitted paper is sent out to two world famous reviewers who like what they see. The methodology is sound and the experiments well done. But as they fill out their favorable reviews, they come across a box that asks them, "will this be of great interest to our readership?" I've ticked off that box hundreds of times. The journals like to sell journals. So the reviewers have to check "no". The good journal has lots of good science that is sexy and important and with greater clinical implications. So it does not accept the article for publication (a good journal usually rejects > 75% of submissions), but points out to the author that the reviewers liked the study, and he should submit it elsewhere. So he does and works himself down from excellent, high impact factor journals, to good ones, to average ones and finally gets the article accepted in a lousy journal. This process might take a couple of years.But it gets published! Now what? The title of the article, that appears in pubmed for internet access, says that the results did NOT support the conclusion that eye size reflected brain size. No one wants to read the details. They've learned enough just from the title. Similarly, no review journal or newspaper wants to hear anything more either. No one comments on it in their presentations. The average scientific peer reviewed study written in English gets cited about 0.7 times. If you publish an article that gets 10 citations it is great and 100 citations is a home run. This paper, will never get cited. The poor lead scientist never gets a boost from this work. The next time, he's learned his lesson. Publishing negative studies is much more work than positive ones, and does not get rewarded. He lets the next one go, and the next few after that.Which is a shame. A negative study in the literature lets us know what doesn't work and that's important too. At least others don't have to repeat the published negative work.But here comes the profound part. The lack of published negative studies is a huge ascertainment bias. Only seeing the positive ones gives us a slanted view of reality. Every study has a chance of randomly showing or not showing an association. Let's say our guy got a p = .1 and didn't publish it. The next 10 guys redo the experiments and get p values of between .2 and .05. These are random shifts. But the 12th guy gets a p = .049. Bingo! That's a positive result. And he runs off for fame and glory. But wait a minute! If you included all the unpublished p values with the .049 you would average about 0.1 which is what the first guy got. There is still good a good likelihood that eye size and brain size are not associated. But the last guy doesn't know this. He is sitting on p < .049 and that is gold. Science thinks he's right because science doesn't know about all the unpublished negative results. And science makes a mistake. And this happens all the time and takes a lot of time and money to straighten out (eventually). No one messed up. No one planned this. No one should take the blame. Except maybe a system that discourages the publication of negative results. Most well seasoned scientists know and worry about this phenomenon. But no one has the answer that will correct for all the market forces I've mentioned that suppress the publication of negative results.BTW, thanks for the A2A.