Eye Didn't Know!

The Amazing Eye

Richard Dawkins elegantly shows how the eye, a complex organ, evolved through gradual steps, each small step conferring a small additional benefit to the organism.

In this video, the ophthalmologist explains the function of the eye in the same manner as I do with patients.

Free To Choose?

Most Americans today are clueless as to why our country is prosperous and many other countries are poor. Most in government today think that more and more government control of our medical system and our economy is a good thing.

Milton Friedman (1912-2006) understood before most of us that a free society was the route to a prosperity. I read his book, Free to Choose: A Personal Statement, during college, and it has influenced my thought ever since. 

Mart Laars, however, read his book as Estonia was achieving its freedom from the Soviet Union. At 32 years of age, Laars became Estonia's prime minister and instituted Friedman's ideas (for example, a flat tax, and privatizing industries). Estonia's prosperity has been a resounding success, while other former soviet states are mired in poverty, governed by statist thugs.

John Stossel, as always, introduces these ideas of freedom with clarity on his network television show. If you want intellectual ammunition to argue against the government takeover of medicine and of the economy, the ideas of Milton Friedman (and John Stossel!) are a good place to start.

Chiropractic Pseudoscience

What's the rationale behind the chiropractic field?

It's easy to trace the hierarchy and progression of scientific ideas behind most medical science (just as it's easy to show that medicine was pretty primitive 100 years ago). 

Medical students learn the biology, physiology, biochemistry, anatomy, pharmacology, pathology, and so on, of human diseases. Treatment of these diseases is mostly based on evidence, the gold standard being the double-blind, controlled clinical trial.

Most physicians and most of the public have no idea what chiropractic treatment is based on, beyond a vague notion of spinal manipulation. Evidently chiropractors themselves split themselves into a wide number of camps, depending on their belief systems regarding how much spinal manipulation can affect physical conditions, and how widely they wish to wander into other areas of alternative (non-evidence based) care, such as acupuncture, herbs, homeopathy, etc.

Here is an excellent video designed to educate the public of the philosophy behind chiropractic care. What intrigues me is that it most resembles a pre-scientific, faith-based belief system, rather than a science. 

The video was made in response to the incredible lawsuit by the British Chiropractic Association against the free-speech rights of a British scientist, Simon Singh, who publicly criticized chiropractic. 

It is important that science be able to advance without being stifled by the legal intimidation of lawsuits such as this. It is also important that the public be made aware of the lack of a rational foundation behind practices such as homeopathy and chiropractic. (I'm not sure, though, if what most people believe is really guided by reason).

Luckily, few chiropractors, that I am aware of, make claims that spinal manipulation is effective in treating disorders of the eye. This may be, in my opinion, because most eye diseases have fairly objective measurements, such as visual acuity, refractive error, or intraocular pressure, which are measurable and less susceptible to the placebo effect, which is the only likely benefit of many non-scientific treatments.

There are many ways to treat physical conditions, but not all of them are based on reason or evidence. Caveat emptor.

Sunglasses For The Masses

Did you know? Various excellent charities exist for collecting used prescription eyeglasses and donating them to the poor in other countries, who otherwise might not be able to afford them.

Sara Schairer, however, had the brilliant idea of collecting and donating used sunglasses. She visited the Flying Samaritans eye clinic in Tecate, Mexico, and was impressed that the diseases we treat surgically, cataracts and pterygia, were caused, at least in part, by sun exposure. She noticed that none of our patients were wearing sunglasses! 

The clinic distributes dozens of prescription eyeglasses each month, but no one had thought of distributing sunglasses.

Sara singlehanded started an organization, Sunglasses For The Masses, to coordinate collection and distribution of "gently used" sunglasses.

Last weekend Sara came to Tecate and distributed 40 pairs of sunglasses. What a great start!

Did you also know? Visit Sara's website, Sunglasses For The Masses, to learn how you can donate your old sunglasses, and how you can help spread this wonderful idea. And if you ever think that one person cannot make a difference, think again!

 

20/20!

Did you know?  Two patients today asked me what 20/20 vision means. I suspect that every day other patients wonder as well, but don't ask.

The easiest way to think about 20/20 is that it means that the eye can see at 20 feet what the average, healthy eye can see at 20 feet. It would follow that 20/200 (poor) vision means that the eye can see at 20 feet what an average, healthy eye can see at 200 feet, or that an eye that sees 20/10 (exceptionally well) sees at 20 feet what an average, healthy eye can see at 10 feet.

Having 20/20 vision does not necessarily mean that your eyes are healthy. The presence of glaucoma or many other eye conditions may not affect central visual acuity until late in the disease. Healthy eyes, though, usually do see 20/20 or better.

If an eye does not see 20/20, it is up to the ophthalmologist to determine the cause. It is also important to test each eye individually.

Did you also know?  The standard eye chart used by most doctors today is known as the Snellen Eye Chart, developed by Dutch ophthalmologist Herman Snellen in 1862.

image: wikimedia commons 

Vitamin C and Cataracts

There is a much higher concentration of vitamin C in the aqueous humor (the fluid in the front of the eye which bathes the cornea, iris, and lens) than in the bloodstream. For many years, some researchers have speculated that taking vitamin C could lessen the incidence of cataracts.

A new study from Sweden refutes that claim. Over the course of ten years, women who took vitamin C supplements had a higher incidence of cataracts than those that did not. Those on birth control pills and vitamin C had an even higher rate. The increase was not huge, but was significant.

This study and others show that until properly controlled studies are done, speculating on the benefit of vitamin supplementation often is fraught with errors, (and in the case of many purveyors of supplements, wishful thinking, misrepresentation, and fraud).

Medicare. Why Not Foodcare?

Here's a thought experiment. Which is more important, food, or medical care?

Why does food continue to improve in quality, yet decline in price?

Since government forces us into Medicare at age 65, shouldn't we all be forced into Foodcare? Why not?

Economist Mark Skousen elaborates on these ideas here.

What would real health reform look like?

For the answer, read this excellent article in January's issue of Reason Magazine.

Hint: it looks nothing like Congress's or our president's idea of "reform." 

The Singapore Alternative

Many people claim that health savings accounts, such as those used successfully at Whole Foods Market, cannot work on a large scale. John Stossel reports that Singapore uses health savings accounts as the model for their national health care. Almost 2/3 of medical expenditures are controlled by the individual. As a result, healthcare costs are less than half those of France, where the state controls almost all expenditures.

Read more about here.

Health Care Reform?

John Stossel interviews John Mackey, of Whole Foods Market, who provides a tested alternative to the  health care "reform" making its way through Congress. 

Unlike Congress's "reform", which, of course, will do nothing of the sort, John Mackey's Health Savings Accounts have been enthusiastically endorsed by his employees, have provided them with control over their health care spending, and have lowered costs.

The following video is part one of seven, which are all available by clicking on the You Tube logo in the corner of the screen.