Holistic Eyecare

Before I get too far down writing about my model of vision, I need to make a clear statement about holistic eye care as AI is trying to describe my ideas as “holistic”. When I received my board certification, it was made clear to me that my model of vision will be (and should be) ever evolving…and boy has it!

I do not practice alternative “holistic” eye care. I practice Optometry with a focus on neuro-optometric habilitation and rehabilitation—vision therapy. This is a mainstream field of optometry with all schools of optometry in North America being required to teach this field. I practice with a minimum standard. If a patient needs an antibiotic, I’ll prescribe it. I hate drugs, but if they are needed, they are needed. If a patient has glaucoma, meds is a must.

The same is my concern with myopia. “Holistic“ eyecare is not going to work for myopia. The reason is as follows: I do not believe one can simply holistically recover from a disease that was either caused by or exacerbated by an unholistic practice. Myopia, for instance, is higher because of an unholistic multi-factorial cause of artificially climate controlled indoor electronic use under LED lights. Schools are unholistic in nature going against the natural tendency for children to stay with their parents throughout the day, being made to sit still and only having 30 minutes of an unstructured play break from a stressful meeting—there is nothing holistic about school. To think myopia can be holistically prevented, treated, or behaved while under a myriad of unholistic assaults is plain fallacious.

If a parent wishes to have their children in these unholistic environments, then they should be prepared to have unholistic preventative measures. These measures have been extensively studied and influenced ortho-K lenses, MiSight and other studied myopia control lenses, multifocal contacts lenses, Stellest lens. Red light therapy is emerging, but that is something I am personally not comfortable with yet I myself practice with optometric phototherapy—another subject that I don’t deem as holistic.

The only holistic measures I truly promote is dietary interventions such as whole grains per observational studies and outside time: lifestyle suggestions that are quite universal among the numerous medical specialties. I do not promote yoga or other types of meditative systems often deemed as “holistic”.

Why then my fascination with Dr. Bates? Ha! If I only looked at the works of William Horatio Bates, I would not have developed my visuospatial methods. The “Bates Method,” as called by his proponents after his death, is very lacking in neuro-scientific modelling just as much as the current state myopia control is lacking in optometry because is there is very little focus on the neurovision component. An assumption in the conclusion from the Trolio et al study regarding the locality of myopia progression was made. Other than that, there is a big gaping hole in the mechanistic principle of hyperopic defocus and axial elongation—something my modeling is attempting to close.

Even Dr. Bates himself would have scoffed at this idea of holisticism which is evident from his own publication:

That the results of the present method of treating defects of vision are far from satisfactory is something which no one would attempt to deny. It is well known that many patients wander from one specialist to another, seeking vainly for relief, while others give up in despair and either bear their visual ills as best they may without assistance, or else resort to Christian Science, mental science, osteopathy, physical culture, or some of the other healing cults to which th incompetence of orthodox medicine has given birth. —Better Eyesight, August 1919—

Dr. Bates here expressed his frustration with his colleagues and the practice of medicine in general because patients were not getting better. It is 1919, and still yet many ophthalmologists of the day have yet to pick up the regular use of the retinoscope—something we eye doctors couldn’t imagine practicing without today. Dr. Bates was mainstream and allopathic to the core and definitely not “holistic.” He was most certainly annoyed that medicine at the time was failing to listen to and investigate the sufferings of the patients and them leaving medicine looking for answers where they ought not.

Dr. Bates also understood his methods were not perfect and knew they needed refinement when he wrote regarding why some people grasp the concept quickly and others do not:

I believe the time is coming when it will be possible to cure everyone quickly. It is only a question of accumulating more facts and presenting them in such a way that the patient can grasp them quickly. —Better Eyesight, September 1919—

This method evidently works for some, otherwise the method would have died out at least 50 years ago, but it doesn’t work for all, and many times it doesn’t work for high myopes. Prior to Esther Joy van der Werf’s passing, I asked her how often do those above -5.00 D make progress. She sadly admitted to me that it isn’t very often. I was a -5.00 at the time. The question is “WHY?” It’s the same question I have with atropine, ortho-K, MiSights, Multifocal, and Stellest. Some patients still fall off the myopia cliff. Why should we be satisfied with a mere slowing of myopia? I’ll take what we can get. But if it works for some, what is preventing it from working in others.

When I discovered the “seeing spaces” technique, it would work well for some, and not others. In-time, I found a repeatable reason as to why and am able to make a prediction as to the visual behavior in other optometric testing and visual probings. This is where the Bates Method people have failed as a whole. Unfortunately, the Bates Method has turned into the very thing that Dr. Bates himself despised—it has become a healing cult, or as he put it, “a house built on sand.”

The value I take from Dr. Bates is hope. Hope is the driving force of discovery. If shifting, swinging, palming, breathing, all of which is used by many vision therapy practitioners, can provide even a random change clarity for the better confirmed by a snellen, then there’s hope. The Bates Method is never something I could in good conscience practice with patients. Yes, I had random clear flashes of clarity, but I cannot charge for service and promise some random flash of clarity. I cannot practice in some undetermined model of Hope. However, it can fuel my personal driver of the exploratory process just like many other doctors in the field of optometry have done. However, if I discover a form of visuospatial therapy, developed off the material of multiple well respected individuals and keynote speakers in my Field, and can provide, at least a skeleton of a neurophysiological model to the mechanism with predictable and repeatable results, just like a vectogram, a Sanet Vision Integrator, a Syntonizer, an MFBF, yoked prisms and the more(none of which are “holistic” btw), which I have done, then I can in good conscious use it just like many other tools and techniques that my colleagues have done. Though I am not going to call it what it is not—holistic.

We know peripheral plus works per evidence based studies and I am going to use it. We also know, according to my own model I’ve adopted from Elliot Forest’s Stress and Vision, that blur (sensory deprivation) can indeed be a stressor, and if my model is based upon the idea of neuro-driven chemical cascade of scleral remodeling to elongation from the deprivation of peripheral response due to some stressor, I know that recommending what Bates recommended, ie abstaining from all glasses, can actually do more harm than good. My job as a treating doctor is to find that balance and room to work with the person’s threshold just as our own optometric literature states, and blur at all times as Bates would recommend just won’t cut it. This is also why the “under-correction” of myopia debate still persists and why the data on the benefits/harm of myopia under-correction is, like many other subjects, mixed in results. I am so glad for these new tested products as they can help manage that threshold. They fit into my model so well, and they keep the peripheral engine on fire. Yes, there may be times I recommend performing certain therapy activities without their habitual Rx on, but that is nothing new in the VT world. It all depends!

So do I practice holistic eye care? The answer is ABSOLUTELY NOT!