Bates method

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The Bates method for "better eyesight" is an educational method developed by ophthalmologist William Horatio Bates, M.D., which aims to undo what Bates claimed are "strained" vision habits. Bates described his approach to helping patients relax such strain (and thus, he claimed, improve their sight) in a 1920 book entitled Perfect Sight Without Glasses (or The Cure of Imperfect Sight by Treatment Without Glasses), and in his monthly magazine entitled Better Eyesight, published from 1919 to 1930[1] (see links below.)

Bates believed that various types of habitual strain originating in the mind are responsible not only for refractive errors which are usually compensated for with glasses (such as myopia, hyperopia, astigmatism, and presbyopia), but also for other abnormal eye conditions including strabismus, cataracts, glaucoma, amblyopia, conjunctivitis, blepharitis, and diseases of the optic nerve and retina.[2][3] He also claimed that "strain" was responsible for perfectly normal, and usually harmless, phenomena such as floaters.[4][5] To help one's self become aware of and thereby counteract this supposed habitual strain, Bates suggested repeatedly closing and opening the eyes in front of an eye chart, visualizing objects previously seen, regularly shifting one's gaze from point to point, exposing the eyes to sunlight, and other activities.

Although some people claim to have been helped by following Bates' principles, his ideas remain controversial. His main physiological theory, that the extraocular oblique muscles adjust the shape of the eyeball to maintain its focus, was rejected by mainstream ophthalmology and optometry of his day, and is still rejected today.[6][7][8][9] Although most of Bates' recommendations are harmless, there is some risk that those who follow his suggestions may overexpose their eyes to sunlight, avoid conventional treatment, or stop wearing their prescribed correction.

In Fads and Fallacies in the Name of Science, skeptic Martin Gardner characterizes Bates' book as "a fantastic compendium of wildly exaggerated case records, unwarranted inferences, and anatomical ignorance." Gardner suggests that Bates' techniques may seem to work, to a limited degree, by helping one become better able to interpret blurred images.[1]

Contents

[edit] Bates' theories

Bates developed many theories regarding vision during his career. Central to most of his theories was the thesis that "mental strain" caused poor vision. Many of his therapies rested on this assumption.

[edit] Accommodation

Accommodation is the process by which the eye increases optical power, while shifting to a closer object, to maintain focus on the retina.

Bates claimed that focus is maintained by varying elongation of the eyeball caused using the extraocular muscles, rejecting the orthodox view that accommodation is brought about by the action of the ciliary muscle on the eye's crystalline lens.[10] He contended that the lens plays no part in accommodation, and asserted that the extraocular muscles, and in particular the superior and inferior oblique muscles, which are wrapped around the eye somewhat like a belt, elongate the eyeball to obtain focus at the near point, and allow the eyeball to shorten again when it looks into the distance.[11][1]

Critics of Bates reject the theory that human eyes accommodate, or focus, due to elongation of the eyeball caused by “squeezing” of the extraocular muscles, and instead support the mainstream theory set forth by Hermann von Helmholtz that human eyes accommodate due to the actions of the ciliary muscle (an intraocular muscle) and zonules changing the shape of the crystalline lens. Various cycloplegic agents can temporarily prevent accommodation by paralyzing the ciliary muscle, but these leave the extraocular muscles unaffected.[1] Bates acknowledged that the effect of atropine fit the orthodox theory in "about nine cases out of ten", but argued that all "tenth cases" in which (he said) atropine failed to stop accommodation constituted strong evidence that the ciliary muscle is not actually responsible for accommodation.[10] Critics respond that it is incorrect to base a theory on rare occurrences rather than typical ones.[5]

To boost his theory that the extraocular muscles are responsible for accommodation, Bates cited the apparent ability of some aphakics to accommodate.[10] Critics note that these cases are extremely rare, and therefore contend that they should be considered exceptions to the rule rather than the rule,[6] and also cite research which indicates that there is no change in the refractive power of the eye in these cases.[12][13]

Photographic evidence has shown the lens changing shape when the eye accommodates.[1] Elwin Marg, writing in 1952 points out that "it would take about one millimeter change in axial length of the eyeball for each three diopters change of refractive power. Hence, a youth accommodating 15 D. would shorten his globe by five millimeters" if indeed the eyeball itself changed shape to accommodate. He continues: "to the writer's knowledge, no corresponding anterior-posterior corneal movement has ever been reported."[6]

Modern proponents of the Bates method usually concede that Bates was mistaken in believing that the lens had no role whatsoever in accommodation, but contend that the traditionally accepted explanation of such is flawed as well, and maintain that Bates was correct in his central thesis that refractive errors result from habitual strain of the eyes.[14][15]

[edit] Physiological cause of refractive errors

Bates regarded the refractive state of the eye as variable and disregarded the notion that irreversible changes in the shape of the eyeball caused refractive errors. Instead, he maintained that the eyeball's shape responded instantly to the action of the extraocular muscles upon it.[16][17]

Bates regarded refractive errors as directly resulting from visual habits. A strain to see, he asserted, would inhibit the eyeball from sufficiently changing shape (per his explanation of accommodation) when shifting its focus nearer or farther. He claimed that straining to see at the near-point instantly shortened the eyeball, producing hypermetropia (farsightedness) in an eye with previously normal vision, and that straining to see at the far-point instantly lengthened the eyeball, producing myopia (nearsightedness) in an eye with previously normal vision. He also stated that astigmatism would be produced if these changes occurred "unsymmetrically".[18]

The concept that relaxing the extraocular muscles can reliably or predictably reduce refractive error has not been substantiated by patients whose muscles are loosened during strabismus surgery. Although small refractive changes may occur following this type of muscle loosening surgery (recession), these alterations are generally small, clinically insignificant, transient, and occur in both directions (stronger and weaker).[19]

[edit] Psychological cause of refractive errors

Bates was of the opinion that chronic refractive errors were ultimately due to "strain of the mind" which brought about a "loss of mental control".[18] He asserted that hypermetropia was caused by "straining to see at the near-point",[6] by which he did not mean excessive close work, but rather a mental effort to see close objects. In a chapter entitled "Strain" he wrote: "mental strain of any kind always produces a conscious or unconscious eyestrain and if the strain takes the form of an effort to see, an error of refraction is always produced."[2]

Bates likewise believed that a mental effort to see distant objects was the underlying cause of myopia, or nearsightedness.[18][6] This is in discrepancy with more recent research which has implicated heavy amounts of near-work as a contributing factor to the development of myopia,[20][21] which was also commonly believed in Bates' day. But Bates emphasized his view that near-work and "overuse of the eyes" did not directly cause myopia, and wrote: "The remedy is not to avoid either near work or distant vision, but to get rid of the mental strain which underlies the imperfect functioning of the eye at both points."[18]

The concept that "mental strain" causes refractive errors is crucial to Bates' work, but is perhaps the most vague aspect of his theory. "Strain" can refer to fatigue, stress, concentration, or any other of a number of factors, making this a virtually untestable hypothesis. For example, Bates believed that the "strain" of lying could cause temporary myopia.[22][23][1]

[edit] Eyeglasses and contact lenses

Bates cited many disadvantages to eyeglasses made in his day, maintaining that they adversely affected color perception, contracted the field of vision, and caused dizziness and headaches when the wearer viewed objects off-axis. He wrote: "At their best it cannot be maintained that glasses are anything more than a very unsatisfactory substitute for normal vision."[24] Moreover, he maintained that the refractive condition of the eye is constantly changing, from day to day, hour to hour, and minute to minute; consequently, he reasoned, the prescribing of corrective lenses can only ever be right at the time they are fitted, after which, when they are too strong, the eye is encouraged to adjust to them (which in Bates' view meant straining more.) He thus advised against wearing glasses.[1][24]

Bates reported that those who had never worn glasses were generally cured of sight problems more easily than those who had, and recommended that bespectacled patients who sought a cure completely discard their glasses from the outset. He acknowledged that it might not always be practical to do so, but said that continuing to wear them would delay the cure.[18] For readers of his book wanting to cure themselves without the personal help of someone who had successfully used the method, however, he emphasized that completely discarding glasses was a non-negotiable. From the chapter entitled Home Treatment: "It is absolutely necessary that the glasses be discarded. No half-way measures can be tolerated, if a cure is desired. Do not attempt to wear weaker glasses, and do not wear glasses for emergencies. Persons who are unable to do without glasses for all purposes are not likely to be able to cure themselves."[25]

For children, following Bates' advice not to wear glasses could jeopardize visual development. In humans the eye and brain development continues throughout childhood and into the teens. Depending on the situation, it may be necessary to correct a child's refractive error promptly in order to prevent the development of amblyopia.[26][27]

Bates did not address the use of contact lenses, as they were not generally available in his day. But modern-day Bates method advocates point out that contacts are not normally removed when not needed, making them an even larger impediment to improvement than glasses, from a Bates perspective.[28]

[edit] Bates' treatments

Bates wrote that "The ways in which people strain to see are infinite, and the methods used to relieve the strain must be almost equally varied",[18] emphasizing that no single approach would work for everyone. His techniques are all methods designed to help dissociate strain from seeing (and are not, as is commonly misperceived, "exercises" in the sense of building ocular muscle strength.)

Bates' approach is centered around learning to control thoughts, as they relate to seeing. "We cannot by any amount of effort make ourselves see, but by learning to control our thoughts we can accomplish that end indirectly."[2] He explained that, in his view, "You can teach people how to produce any error of refraction, how to produce a squint, how to see two images of an object, one above another, or side by side, or at any desired angle from one another, simply by teaching them how to think in a particular way. When the disturbing thought is replaced by one that relaxes, the squint disappears, the double vision and the errors of refraction are corrected; and this is as true of abnormalities of long standing as of those produced voluntarily." "If the relaxation is only momentary, the correction is momentary. When it becomes permanent, the correction is permanent."[2][1]

[edit] Central fixation

Only a very small part of the retina, the fovea centralis, is capable of resolving high detail, and resolution falls off with distance from the fovea. Bates asserted that "The eye with normal vision, therefore, sees one part of everything it looks at best, and everything else worse, in proportion as it is removed from the point of maximum vision; and it is an invariable symptom of all abnormal conditions of the eyes, both functional and organic, that this central fixation is lost." When central fixation is lost, he claimed, at some distances the point directly regarded appears as blurry as parts of the periphery, or even blurrier, a phenomenon which he termed eccentric fixation. He wrote that "eccentric fixation is a symptom of strain, and is relieved by any method that relieves strain; but in some cases the patient is cured just as soon as he is able to demonstrate the facts of central fixation."[29] Bates believed that "eccentric fixation" occurs when one attempts simultaneously to fixate one point and to move to another. There is no evidence that this happens, and modern neuroscience has shown that the representation of visual space is updated moments before an eye movement is made, bringing the retinal image into correspondence with the position of the intended eye movement.[30]

Bates did not present central fixation as an exercise, or as a habit to be directly learned, as it is often portrayed. Rather, he viewed it as naturally occurring when one is not straining to see,[1] and suggested activities related to central fixation for the purpose of demonstrating something to one's self. He reported that some patients were benefited by deliberately increasing their eccentric fixation; that is, by attempting to see a large letter on an eye chart or a whole row of letters equally well at once, and observing that their vision was made momentarily worse, which he said made it easier for them to avoid doing the same thing subconsciously.[29] This phenomenon could be explained by crowding, a failure of visual attention that occurs when an observer is unable to resolve a feature (letter, object, etc), that is normally resolvable in isolation, when it is presented in the presence of other features.[31]

Beyond asserting that it was a "symptom of strain", Bates did not provide any empirical evidence that his theory of "eccentric fixation" was responsible for the blurriness reported by his patients, nor did he suggest any physiological mechanism by which it occurred. The mechanism of "central" and "eccentric" fixation was only discussed in vague psychological terms: "One part of an object is seen best only when the mind is content to see the greater part of it indistinctly, and as the degree of relaxation increases the area of the part seen worse increases, until that seen best becomes merely a point." Only when the mind is not attempting to see more than a very small point best, Bates maintained, is the sight naturally clear at the distance regarded. "Since central fixation is impossible without mental control, central fixation of the eye means central fixation of the mind."[29]

[edit] Flashing

Bates noted that most patients, though not all, found it easiest to relax with their eyes shut. He reported that some quickly obtained "flashes" of temporarily improved vision by alternately closing their eyes for a few minutes or longer and then opening them to a Snellen test card for a second or less.[32] In these cases, Bates believed, the eyes were rested by being closed for a while, and the patients were eventually able to open them without immediately reasserting the strain, and were further benefited by closing their eyes again before the strain resurfaced.[33] Skeptics acknowledge that such "clear flashes" do actually occur, but claim that they are not the result of any change in refractive power.[6] One explanation sometimes offered is that these flashes are a contact lens-like effect of moisture on the eye (such as from tears.)[34][35]

[edit] Palming

Although he did not believe that even very bright light is inherently bad for the eyes, Bates reported that most people with sight problems strain in response to light. Hence he suggested that, in addition to simply closing the eyes, an even greater degree of relaxation could be obtained in most cases by palming, or covering the closed eyes with the palms of the hands, without putting pressure on the eyeballs. If the eyes did not strain to see while palming, he said, they would see "a field so black that it is impossible to remember, imagine, or see anything blacker", since light was excluded by the palms. However, he reported that even while palming, many people continue to strain visually, and thus see "illusions of lights and colors ranging all the way from an imperfect black to kaleidoscopic appearances so vivid that they seem to be actually seen with the eyes." Some such patients, he reported, were helped by the memory of a black object (see the following subsection on memory and imagination.)[32]

The "illusions of lights and colors [and] kaleidoscopic appearances" reported by some of Bates' patients, and which he concluded were caused by his ubiquitous "strain", were almost certainly caused by eigengrau or "dark light". It is impossible to see absolutely "perfect" black, as the neurons of the retina and optic nerve have a "resting level" of activity, which, if the viewer succeeds in achieving total darkness, is interpreted by the brain as patterns of colour and light in the visual field.[5] Similar hallucinations can be invoked by visual deprivation using a Ganzfeld.[36]

Palming was of varying benefit to patients, Bates reported. "The longer some people palm the greater the relaxation they obtain and the darker the shade of black they are able both to remember and see. Others are able to palm successfully for short periods, but begin to strain if they keep it up too long." He also acknowledged that not everyone was helped by palming, and said that in some cases it is "better and more expeditious to drop the method until the sight has been improved by other means."[32]

[edit] Memory and Imagination

Bates reasoned that if a given object could be visualized without strain, it could likewise be seen without strain, if the strain was not reasserted as soon as the eyes were opened. He claimed that one's poise can be measured by the visual memory of black; that if black "is remembered perfectly, one is perfectly relaxed. If it is remembered almost perfectly, one's relaxation is almost perfect. If it cannot be remembered at all, one has very little or no relaxation." The memory of black is a better gauge of relaxation than that of other colors, Bates reasoned, because he believed that, unlike other colors, "black is just as black in a dim light as in a bright one" when seen with normal sight.[37] This is not strictly true, as the visual system recalibrates itself for different lighting situations, a technique called simultaneous contrast or colour constancy, which is caused by lateral inhibition within the visual system. The Moon, for example, varies from medium luminance grey to black as coal depending on the angle of the Sun, but due to the absence of a comparison stimulus in the sky, it appears white.[38]

Bates emphasized that the clear visual memory of black "cannot be attained by any sort of effort", explaining that "the memory is not the cause of the relaxation, but must be preceded by it." "The smaller the area of black which the patient is able to remember, the greater is the degree of relaxation indicated; but some patients find it easier, at first, to remember a somewhat larger area, such as one of the letters on the Snellen test card with one part blacker than the rest. They may begin with the big C, then proceed to the smaller letters, and finally get to a period."[37][1] The smaller the part of a black object which appears darker than the whole, the more clearly black is seen and remembered, Bates claimed.[39]

People who strain habitually, Bates explained, usually don't recognize most of their strain for what it is, because it feels normal to them. Thus, he suggested that patients who were sometimes able to remember a small area of black often check to see whether that memory came effortlessly, to help themselves "recognize and avoid the conditions that produce strain". The clear memory of a black period, he claimed, is "obtained only during moments of relaxation, and retained only as long as the causes of strain are avoided".[37]

Bates suggested palming to help bring about the poised state of mind in which (he claimed) black could be remembered clearly. If the strain to see was lessened by palming, he reported, patients were usually able to remember a black object for at least a few seconds. To prolong this "period of relaxation", Bates suggested either opening the eyes to a black object at the distance at which it could be seen best, or else, with the eyes still closed, shifting mentally "from one black object to another, or from one part of a black object to another."[37] He wrote that "it is impossible to see, remember, or imagine anything, even for as much as a second, without shifting from one part to another, or to some other object and back again".[32] He said that a black period "can be imagined perfectly and with benefit as forming part of a black letter on the test card, because this merely means imagining that one sees one part of the black letter best", but cautioned that to attempt to imagine a black period while looking at something of another color was a strain. "When a period is remembered perfectly while a letter on the Snellen test card is being regarded, the letter improves" until the strain is reasserted, Bates wrote.[37] Skeptics reason that, in addition to being the result of imagination, such "improvement" occurs entirely within the imagination as well, and point out that letters can be recognized even when they appear less than clear, especially if one is already familiar with the eye chart or text regarded.[5]

Bates cautioned that an attempt to "concentrate" on black is an effort, in other words, more strain. "As popularly understood, concentration means to do or think one thing only; but this is impossible, and an attempt to do the impossible is a strain which defeats its own end. The human mind is not capable of thinking of one thing only. It can think of one thing best, and is only at rest when it does so; but it cannot think of one thing only." He reported that a patient who tried, while palming, to see black only and ignore all other colors "which intruded themselves upon her field of vision, becoming worse and worse the more they were ignored", went into convulsions from the strain (this "seizure" anecdote suggests that the patient was perhaps already hysterical or suffered from other mental problems). When she was able to resume the treatment, Bates directed her to "stop palming, and, with her eyes open, to recall as many colors as possible, remembering each one as perfectly as possible." He explained that this was a way of "consciously making the mind wander more than it did unconsciously", and reported that she then became able to palm for short periods of time.[32]

While Bates claimed that "black is, as a rule, the best color to remember" for reasons discussed above, he also acknowledged that "some patients are bored or depressed by it, and prefer to remember white or some other color. A familiar object, or one with pleasant associations, is often easier to remember than one which has no particular interest. One patient was cured by the memory of a yellow buttercup, and another was able to remember the opal of her ring when she could not remember a period. Whatever the patient finds easiest to remember is the best to remember, because the memory can never be perfect unless it is easy."[37][1] It appears Bates believed that any relaxing visual memory will work, to some extent, which could be seen as weakening his argument that 'black' is important. Bates' recommendation to use imagination or memory to improve vision therefore sounds increasingly like simple meditation.

[edit] Shifting and Swinging

It is often said that Bates was opposed to staring,[5] but his meaning may be misunderstood. By staring, Bates meant locking one's attention somewhere, even for an extremely short time, in an attempt to accomplish something. "The eye with normal sight never tries to see. If for any reason, such as the dimness of the light, or the distance of the object, it cannot see a particular point, it shifts to another. It never tries to bring out the point by staring at it, as the eye with imperfect sight is constantly doing."[2] Bates reported that "in some cases remarkable results have been obtained simply by demonstrating to the patient that staring lowers the vision and shifting improves it."[40]

Relaxed eyes shift thousands of times per second, Bates claimed, and every time they do so, he explained, the previous point regarded becomes less distinct (since another point becomes more clear), and everything seen appears to move, or swing, in the direction opposite to which the eyes move (though he said that this is rarely noticed by those with normal sight unless it is demonstrated, since it is so natural for them.) But, he contended, these things often do not happen when one is straining to see, because, in "eccentric fixation", one attempts simultaneously to hold onto one point and to move to another (but see [30]). "One of the best methods of improving the sight, therefore, is to imitate consciously the unconscious shifting of normal vision and to realize the apparent motion produced by such shifting." Bates suggested at first shifting slowly, at the distance where the sight is most clear, over areas wide enough that one can easily let go of the previous point regarded, and allowing it to develop from there. He said that "it is usually impossible, however, to realize the swing if the shifting is more rapid than two or three times a second", and felt that an overt attempt to shift rapidly would just produce more strain. He also indicated that it is usually helpful to imagine something swinging. "A mental picture of a letter can, as a rule, be made to swing precisely as can a letter on the test card. Occasionally one meets a patient with whom the reverse is true; but for most patients the mental swing is easier at first than visual swinging; and when they become able to swing in this way, it becomes easier for them to swing the letters on the test card. By alternating mental with visual swinging and shifting, rapid progress is sometimes made. As relaxation becomes more perfect, the mental swing can be shortened, until it becomes possible to conceive and swing a letter the size of a period in a newspaper. This is easier, when it can be done, than swinging a larger letter, and many patients have derived great benefit from it."[40][1]

In his Better Eyesight magazine, Bates suggested several methods of experiencing either the "swing", or the strain which he claimed inhibits it. One such technique is the long swing.[17][41]

"LONG SWING: Stand with the feet about one foot apart. Turn the body to the right, at the same time lifting the heel of the left foot. The head and eyes move with the movement of the body. Do not pay any attention to the apparent movement of stationary objects. Now place the left heel on the floor, turn the body to the left, raising the heel of the right foot. Alternate. Pain and fatigue are relieved promptly while practicing this swing. When done correctly, relief is felt in a short time. The long swing, when done before retiring, lessens eyestrain during sleep."[42] Bates said that at first, the long swing is the "optimum swing" because it is wide, but indicated that it can be shortened down to "the normal swing of the normal eye."[43]

Bates' recommendations regarding the practice of "swinging" or "shifting" could be seen as implying that the subject can improve their vision simply by moving their eyes. This seems unlikely since the eyes are in constant, and sometimes unconscious, motion - even when we believe that we are "fixating." If the retinal image is genuinely stabilised, it fades to nothing within seconds.[44] Due to the oculomotor and nystagmus reflexes, which attempt to stabilise the image on the retina, it is likely that Bates' recommendation of swinging the upper body (or "the long swing"), would result in many small saccades punctuated by micro-fixations. It is not clear from Bates' writings what this practice is intended to achieve specifically.

[edit] Sunning

Because he believed that people who strain to see tend to strain in response to light, Bates suggested exposing the eyes to sunlight to help unlearn that strain. He claimed that "persons with normal sight can look directly at the sun, or at the strongest artificial light, without injury or discomfort",[45] and gave several examples of patients' vision allegedly improving after having done so,[46] which in some situations may be dangerous.[5] Bates cautioned that, just as one should not attempt to run a marathon without training, one should not immediately look directly at the sun, but he suggested that could be worked up to.[45] He acknowledged that looking at the sun could have ill effects, but claimed they were "always temporary" (at least in the sense of being reversible) and were actually the effects of strain in response to the sunlight. He claimed to have cured people who believed that the sun had caused them permanent eye damage.[46][6]

Of bright sunlight shining directly on open eyes, Bates remarked that "persons with imperfect sight usually find it impossible to accustom themselves to such a strong light until their vision has been improved by other means", though he also reported that in rare cases, sungazing alone had brought about complete cures of sight problems.[46] Although he never renounced the claim that open-eyed "sunning" was safe, Bates did temper his suggestions regarding this activity in later editions of his magazine, Better Eyesight. From the August 1924 edition:

Sunning: Let the sun shine on your closed eyelids for short intervals. Choose preferably the early morning sunlight. It is the light rays which benefit the eyes rather than the heat rays. The sun loses some of its effect when it comes through glass.[47]

[edit] Modern variants

Many "self-help" books and "programs" exist claiming to improve eyesight "naturally" by various means, most having some basis in the Bates method.[3][7][8][9][48] Modern approaches place more emphasis on breathing and posture than Bates did. Nutrition is also often mentioned as a factor in vision habits.[49]

[edit] "Natural Vision Improvement"

"Natural Vision Improvement" markets itself as a lifestyle method of improving eyesight by holistic means.[50] It uses aspects of the Bates method "merged" with modern theories of brain function, character, and responsibility for one’s self and state of being.[51] "Natural vision teachers" often claim that the "correct vision habits" must be "relearned", although Bates spoke of learning to control thoughts which relate to seeing.[2]

According to Janet Goodrich :

Improving vision naturally is an internal transformation, not a treatment, cure or makeover by external forces.[51]

"Natural vision teacher" Thomas R. Quackenbush defines the Bates method thus:

An educational program created by ophthalmologist William H. Bates, M.D., in which natural, correct vision habits—based on relaxation of the mind and body—are taught; optional self-healing activities and games are often included to accelerate integration and self-healing; commonly misunderstood as only "eye exercises"—even by many "Bates Method" teachers.[52]

[edit] The "See Clearly Method"

See also: Eye exercises

The commercial See Clearly Method, marketed by the "American Vision Institute", was shut down by a court order in November 2006.[53][54][3] While it included "palming" and "light therapy", the American Vision Institute doctors emphasized that they did not endorse the Bates method overall.[55] Likewise, Bates method proponents have distanced themselves from the See Clearly Method.[56]

[edit] Ophthalmological research

A review of research on visual training for refractive errors by the American Academy of Ophthalmology (AAO) concluded that there is "level I evidence" (from randomized controlled trials) "that visual training for control of accommodation has no effect on myopia." Other studies have shown weaker (level II/III) evidence of improvements in subjective visual acuity for patients with myopia who have undertaken visual training.[34] No corresponding physiological cause for the observed improvements has been demonstrated and one study[57] showed that 30% of patients showed "slight improvement" while 10% demonstrated a worsening of symptoms after visual training. Of the sub-population that showed an improvement, 2 patients maintained this improvement at a 5-month follow-up.

The AAO report states that "mainstream medicine is recognizing a need to learn more about alternative therapies and determine their true value." However, they also conclude that "the Academy believes that complementary therapies should be evaluated similarly to traditional medicine: evidence of safety, efficacy, and effectiveness should be demonstrated."[34]

[edit] Biofeedback training

In the 1980s and 1990s, interest in biofeedback stimulated some research into whether it could affect eyesight (as might be expected if "strain" were the cause of sight problems, as Bates believed.) It was found in one study that myopes could improve their visual acuity with biofeedback training, but that this improvement was "instrument-specific" and did not generalise to other measures or situations.[58] In another study an "improvement" in visual acuity was found but the authors concluded that this could be a result of observers learning the task.[59] Finally, in an evaluation of a training system designed to improve acuity, "no significant difference was found between the control and experimental subjects".[60] A 1997 review of this biofeedback research concluded that "controlled studies to validate such methods ... have been rare and contradictory."[61]

[edit] Claimed success

As their strongest evidence for the effectiveness of the Bates method, proponents point to the many stories of people claiming to have improved their eyesight. Skeptics generally do not accuse these people of lying, but rather suggest that they have wrongly interpreted the results, have made incorrect extrapolations, or are just fooling themselves. Skeptics do acknowledge that some apparent myopia can be reduced by relaxation, but claim it is only pseudomyopia.[62] Also, as noted above, the "clear flashes" often spoken of by Bates enthusiasts are sometimes explained by skeptics as a contact lens-like effect of moisture on the eye.[35] It is further suggested that one who stops wearing glasses will in time become better able to interpret the blur and recognize familiar objects, which could lead to the erroneous conclusion that the sight itself has improved.[34][63]

Perhaps the most famous individual to claim successful results with the Bates method was the British writer Aldous Huxley, who detailed his supposed improvement in his 1942 book entitled The Art of Seeing. Huxley was among the students of Margaret Corbett, a "Bates Practitioner", who trained with Dr. Bates in 1930 and was later tried and acquitted on a charge of practicing medicine without a license.[6][64]

However, in 1952 Bennett Cerf was reportedly present when Huxley spoke at a Hollywood banquet, wearing no glasses and apparently reading his paper from the lectern without difficulty. Martin Gardner quotes Cerf:

"Then suddenly he faltered—and the disturbing truth became obvious. He wasn't reading his address at all. He had learned it by heart. To refresh his memory he brought the paper closer and closer to his eyes. When it was only an inch or so away he still couldn't read it, and had to fish for a magnifying glass in his pocket to make the typing visible to him. It was an agonizing moment."[1]

[edit] General Criticisms

The purported benefits of Bates' techniques are generally anecdotal, and their claimed effectiveness in improving eyesight has not been substantiated by medical research. The medical community is often critical of the Bates method due to a lack of evidence-based support.[5]

[edit] Emotional consequences

Critics contend that many of Bates' claims and treatments blame the victim and may adversely affect the self-esteem of people who try Bates' method and fail to improve their vision. This is a criticism frequently leveled at other alternative medicines that recommend positive thinking as a cure, or suggest that a person can heal themselves without professional help if the appropriate actions are taken.[65] If a patient "fails" to fix their problem, it then reflects "their" failure, not the effects of the malady itself.

Lack of success with the Bates method may also foster resentment toward society, if one finds that daily life makes it difficult to relax or to discard corrective lenses.

[edit] Avoidance of conventional treatment

Critics warn that faith in the Bates method could deter people with eye conditions requiring prompt care from seeking conventional treatment.[1] Professional Bates Method teachers usually emphasize that they are not Ophthalmologists.

[edit] Further reading

[edit] See also

[edit] References

  1. ^ a b c d e f g h i j k l m n Gardner, Martin (1957). "Chapter 19: Throw Away Your Glasses", Fads and Fallacies in the Name of Science. Reprint: Courier Dover, 230-241. 
  2. ^ a b c d e f Bates, William H. (1920). "Chapter 10: Strain", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 106-113. 
  3. ^ a b c Russell S. Worrall OD, Jacob Nevyas PhD, Stephen Barrett MD (September 12, 2007). Eye-Related Quackery. Quackwatch. Retrieved on 2008-03-27.
  4. ^ William Bates (0ct 1919). "Floating Specks". Better Eyesight Magazine. 
  5. ^ a b c d e f g Pollack P. (1956). "Chapter 3: Fallacies of the Bates System", The Truth about Eye Exercises. Philadelphia: Chilton Co.. 
  6. ^ a b c d e f g h Marg, E. (1952). ""Flashes" of clear vision and negative accommodation with reference to the Bates Method of visual training." (PDF). Am J Opt Arch Am Ac Opt 29 (4): 167-84. 
  7. ^ a b Alan M. MacRobert (1979). HOCUS FOCUS: modern spiritualism.
  8. ^ a b Robyn E. Bradley. "Advocates see only benefits from eye exercises", The Boston Globe (MA), September 23, 2003. 
  9. ^ a b Leanna Skarnulis (February 5th, 2007). Natural Vision Correction: Does It Work?. WebMD.
  10. ^ a b c Bates, William H. (1920). "Chapter 6", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 69-74. 
  11. ^ Bates, William H. (1920). "Chapter 4", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 38-53. 
  12. ^ Bettman, J . W. (1950). "Apparent Accommodation in Aphakic Eyes.". Amer. Jour. Ophthal. 33: 921-928. 
  13. ^ Hirsch, Monroe J. (1950). "Apparent Accommodation in Aphakia.". Amer. Jour. Optom. and Arch. Amer. Acad. Optom. 27: 412-414. 
  14. ^ van der Werf, Esther. Visions of Joy FAQ. Retrieved on 2008-04-17.
  15. ^ Kiesling, David. A Response to Philip Pollack's "The Truth About Eye Exercises". Retrieved on 2008-04-17.
  16. ^ Bates, William H. (1920). "Chapter 7", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 75-80. 
  17. ^ a b "Exercise v. Eyeglasses" (March 1943). Time. 
  18. ^ a b c d e f Bates, William H. (1920). "Chapter 9", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 89-105. 
  19. ^ Preslan M, Cioffi G, Min Y (1992). "Refractive error changes following strabismus surgery.". J Pediatr Ophthalmol Strabismus 29 (5): 300-4. PMID 1432517. 
  20. ^ Lifestyle causes myopia, not genes (8th July 2004).
  21. ^ Jiang BC, Schatz S, Seger K. (2005). "Myopic progression and dark focus variation in optometric students during the first academic year.". Clin Exp Optom. 88 (3): 153-9. 
  22. ^ William Bates (1919). "Lying a cause of myopia.". Better Eyesight (September). 
  23. ^ William Bates (1930). "Lying as a cause of Myopia". Better Eyesight Magazine (March). 
  24. ^ a b Bates, William H. (1920). "Chapter 8", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 81-88. 
  25. ^ Bates, William H. (1920). "Chapter 24", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 242-245. 
  26. ^ Donahue, Sean P. (February 2007). "Prescribing Spectacles in Children: A Pediatric Ophthalmologist's Approach". Optometry and Vision Science 84(2): 110-114. 
  27. ^ Nigel W. Daw (1998). "Critical Periods and Amblyopia". Arch Ophthalmol. 116: 502-505. 
  28. ^ Keilman, Kate. Reduced Lenses for Eyesight Improvement. Retrieved on 2008-04-17.
  29. ^ a b c Bates, William H. (1920). "Chapter 11", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 114-122. 
  30. ^ a b "The Updating of the Representation of Visual Space in Parietal Cortex by Intended Eye Movements" . Science 255 (5040): 90-92. 
  31. ^ Various Authors. "Special Issue on Crowding". Journal of Vision 7 (2). 
  32. ^ a b c d e Bates, William H. (1920). "Chapter 12", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 123-135. 
  33. ^ William Bates (1922). "Fundamentals of Treatment". Better Eyesight Magazine (March). 
  34. ^ a b c d Complementary Therapy Assessments: Visual Training for Refractive Errors. American Academy of Ophthalmology. Retrieved on 2008-04-01.
  35. ^ a b Balliet R, Clay A, Blood K. (September 1982). "The training of visual acuity in myopia.". J Am Optom Assoc 53(9): 719-24. 
  36. ^ R.R. Holt (1964). "Imagery: the return of the ostracized". Am. Psychol. 19: 254–264. doi:10.1037/h0046316. 
  37. ^ a b c d e f Bates, William H. (1920). "Chapter 13", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 136-147. 
  38. ^ Mike Luciuk. How Bright is the Moon?. Retrieved on 2008-03-07.
  39. ^ William Bates (1926). "Memory". Better Eyesight Magazine (February). 
  40. ^ a b Bates, William H. (1920). "Chapter 15", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 159-171. 
  41. ^ (1947) The Proceedings of the Iowa Academy of Science, 264-267. 
  42. ^ William Bates (1926). "Swinging". Better Eyesight Magazine (January). 
  43. ^ William Bates (1930). "The Optimum Swing". Better Eyesight Magazine (March). 
  44. ^ Stevens, J. K. et al. "Paralysis of the awake human: visual perceptions" (PDF). Vision Research (1): 93-8. 
  45. ^ a b William Bates (1920). "Sun-gazing". Better Eyesight Magazine (June). 
  46. ^ a b c Bates, William H. (1920). "Chapter 17: Vision Under Adverse Conditions a Benefit to the Eye", Perfect Sight Without Glasses. New York: Central Fixation Publish Co., 183-197. 
  47. ^ Quackenbush, Thomas R. (2000). Better Eyesight: The Complete Magazines of William H. Bates. North Atlantic Books, page 299. ISBN 1-55643-351-4. 
  48. ^ Museum of Quackery
  49. ^ Quackenbush, Thomas R. (1997). Relearning to See. North Atlantic Books, page ix to 521. ISBN 1-55643-205-4. 
  50. ^ Jonel Aleccia. "Ditch those glasses", Mail Tribune. 
  51. ^ a b Goodrich, Janet. (1986). Natural vision improvement. Cellestialarts, 2. ISBN 0-89087-471-9. 
  52. ^ Quackenbush, Thomas R. (2000). Better Eyesight: The Complete Magazines of William H. Bates. North Atlantic Books, page 643. ISBN 1-55643-351-4. 
  53. ^ Court Pulls Blinds On See Clearly Method. consumeraffairs.com (November 4, 2006).
  54. ^ Annys Shin (November 6, 2006). Seeing the See Clearly Method for What It Is. washingtonpost.com.
  55. ^ Steven M. Beresford, David W. Muris, Mara Tableman, Francis A. Young. Clinical Evaluation of the See Clearly Method 13.
  56. ^ van der Werf, Esther. Visions of Joy FAQ with statement on SCM.
  57. ^ Woods AC. (1946). "Report from the Wilmer Institute on the results obtained in the treatment of myopia by visual training.". Am J Ophthalmol 29: 28-57. 
  58. ^ Randle RJ (1988). "Responses of myopes to volitional control training of accommodation.". Ophthalmic Physiol Opt 8: 333-340. 
  59. ^ Gallaway M, Pearls SM, Winkelstein AM, et al. (1987). "Biofeedback training of visual acuity and myopia: A pilot study.". Am J Optom Physiol Opt 64: 62-71. 
  60. ^ Koslowe KC, Spierer A, Rosner M, et al. (1991). "Evaluation of accommotrac biofeedback training for myopia control.". Optom Vis Sci 68: 252-4. 
  61. ^ G Rupolo, M Angi, E Sabbadin, S Caucci, E Pilotto, E Racano and C de Bertolini (1997). "Treating myopia with acoustic biofeedback: a prospective study on the evolution of visual acuity and psychological distress" (PDF). Psychosomatic Medicine 59 (3): 313-317. 
  62. ^ Klaus Schmid (2004). "Chapter 3: Myopia - Observations and Experimental Results", Myopia Manual. Pagefree Pub Inc, 34-35. 
  63. ^ MARK ROSENFIELD, SUSAN E. HONG and SINI GEORGE (2004). "Blur Adaptation in Myopes". OPTOMETRY AND VISION SCIENCE 81 (9): 657–662. 
  64. ^ Help Yourself to Better Sight, by Margaret Darst Corbett.
  65. ^ Linda Noble Topf (1996). New Age guilt: dealing with the unrealistic expectations of positive thinking. Retrieved on 2008-03-10.