Viikari Plus


Subject:  Two professionals who advocate successful prevention, Dr. Viikari by wearing a “preventive” plus lens and Dr. Orfield by a combination of exercise and wise wearing of a plus. 


Otis>  There are those (in medicine) who argue that all prevention (at 20/40 and self-measured -1 diopter), is totally impossible.  The reality, in medicine, is that a few ODs and MDs have managed to slowly work their way back to 20/20.  Thus we must ask, is prevention possible?  These two professionals answer that question.



8 responses to “Viikari Plus

  1. Dr. Kaisu Viikari.

    Thirty years of success with prescribing a plus for prevention.

    There are many who consider medicine, and “open and shut” scientific business. Nothing could be further from the truth. In fact, there is a strong scientific basis, that prevention, for the highly motivated is possible. Dr. Viikari has advocated the wearing of a plus for “just prevention” for the last 50 years. Here are her statements about the need for the person to make the choice to begin wearing a plus, when the person’s Snellen is in the range of 20/40 to 20/70 (about -1 to -2 diopters, self-measured.)

    Here is a review – to clarify theses issues, of Dr. Viikari’s struggle, to prevent with the plus.

    Dr. Kaisu is “put down” by the medical community. We need insightful people to conduct prevention, not people “protecting the status-quo”.

    Dr. Kaisu’s book:

    Dr. Viikar had 50 year struggle with the Finnish Medical Society – to get them to accept the concept – will go down in history and one of the longest fight to institute needed change in medicine.

    This struggle, is like the arguments against, “bleeding” a patient, to make them feel better. But few in the Finnish Medical Society, want to admit that truth.

  2. Dr. Orfield’s Success

    There is a tendency to insist that even prevention is impossible. It is necessary to listen to ODs who, with dedication and effort, have managed to get their refractive STATE to change from a negative value of -3 diotpers (about 20/200) to normal (Zero Diopters) under THEIR dedicated control. Here are some comments by Dr. Orfield on the subject:

    Note: The author underwent myopia reduction from a spectacle prescription of -3.87 and -3.37 Diopters, to -0.50 and -.025 Diopters, over a period of seven years. For all practical purposes, this is 20/20 on a normal Snellen chart.


    By Dr. Orfield:

    Whenever I am considering a minus lens increase for a progressing myope I think of Ray Bradbury’s story, “The Man in the Rorschach Shirt,” about the psychologist who got new glasses and suddenly saw only “pores.” Losing his more holistic insights, he said:

    “Have you ever thought, did you know, that people are for the most part pores..Pores. A million, ten billion .. pores. Everywhere and everyone. People crowding buses, theaters, telephone booths, all pore and little substance. Small pores on tiny women. Big pores on monster men ..”?

    The experience of giving up myopia has made me very conservative in lens prescribing, especially in new myopes.

    I see that our instruments and darkened rooms and the myope’s tendency to accommodative spasm lead us to frequent over-dosing with minus. This then unfortunately determines forever after that person’s brain program for seeing space.

    Arnold Sherman describes myopic progression as the process of the patient’s visual system transforming itself so that it is suited for near, if flexibility is not possible. Then:

    “When an adaptation is decompensated (by stronger minus lenses), a re-adaptation will occur in order to achieve steady state performance at near tasks, resulting in a further increase of myopia.”

    He calls the continual prescribing of more minus without any intervention the “iatrogenic” cause of myopia.

    I would add to what Sherman has said that the adaptation to stronger and stronger minus lenses is a brain program and that reducing myopia is necessarily brain re-programming. It is the restructuring of one’s entire perception of space, of where things are, and what size they are, and of how one’s eyes respond to that motorically.

    It is my experience that minus lenses cause both the ambient and focal visual processes to be re-patterned so that the resulting world is no longer the “space world” that one sees and the translation between the two is a constant effort that wastes brain energy.

    But I did not know this when I was a child.

    I didn’t know it when I was grown up, either, until I had reduced enough of my myopia to see it.

    Now, I explain to patients that when we prescribe maximum minus for central acuity we sacrifice more of their ambient vision, more of the periphery.

    We also take away the comfort at near they have unconsciously achieved be becoming more myopic.

    If we increase minus we have to cancel it off at near with reading lenses in order to hold the line on further deterioration.

    If I must increase minus, I give separate lenses for the classroom with as little extra power as possible.

    Patients are instructed to sit in front where they “won’t need binoculars.”

    I tell law students that I am giving them just enough minus “to take the edge off their panic” in class, so they don’t accommodate and make things worse.

    They are to wear it only in class in a bifocal prescription.

    Outside, they go back to their habitual Rx. If there is any plus acceptance, they get computer glasses as well. While there are those who will not budge from their need for more and more dioptric power for full-time wear, most people, I find, are eager to stop the process if someone will show them how.

    Others, though they are few, even want to attempt a reduction program. I warn them it is very long and very slow and involves many shifts in lenses.

    We can do it more easily now, though, with disposable contacts than when I was going through it in the ’70s and early ’80s.

    ”You train a patient whenever you put a lens on him,” Francke told me. That means you change programs in the brain.

    Why not train patients into weaker instead of stronger lenses?

    Even if it takes seven years, that person can be changed for life.

    In some cases, as Dr. John Thomas has suggested, strong lenses may even cause tissues changes. We know from research with chickens and monkeys that a blurry image on the fovea causes increased axial length and stretching in the posterior pole like that in some hereditary myopes.

    It also may be true of humans, as observed in identical twins.

    Thomas speculates that it may be the blurry image created by the high minus lens distortion at the periphery that causes myopic degeneration and eyeball stretching.

    Indeed, in chickens “only peripheral field occlusion is necessary to induce a myopia shift, while the central retina is receiving sharp images,” Crewther, Crewther, Nathan and Kiely reported.

    Elio Raviola and Torsten Wiesel speculated years ago that “the retina exerts a control on eye growth by releasing regulatory molecules whose production is influenced by the pattern of light stimulation.”

    Overall eye enlargement and increased axial length does exist in high myopia.

    We automatically assume, though, that it is the elongation of the eye that occurs first, in some spontaneous manner, causing the myopia, causing the light to fall short.

    We think of this enlargement or elongation as the definition of myopia. We need to entertain the thought that myopic changes in the eyeball could develop secondarily from chemical signals put out by a retina responding to central blur caused by other factors such as accommodative spasm. This could then be compounded by blur in the periphery caused by the very compensatory minus lenses that are supposed to correct the problem.

    We need to examine our model of vision again in the light of retinal research, successful myopia reduction, and a great many cases of multiple personality where, depending on the personality in charge, the glasses can vary in prescription quite significantly.

    Luckily, I never did develop major retinal changes that we see in high myopes. I never wore my lenses full time because I could not read through them and I read a large part of every day. That also may be why it was relatively easy for me to train out of them.

    Because of my own personal experience that myopia can be reduced, and because of the fact that many of my patients also reduce their prescriptions during or at the end of therapy, and because others report similar results, I had to evolve a model of vision that included traditional optometry as well as the new insights.

    Vision, I now see, is an intensely adaptive process, in which unconscious choices are made, depending on what solution is most useful for meeting an individual’s visual demands, within the specific life, health and stress conditions he faces. Myopia is a good solution at near for the person who can’t avoid close work and doesn’t have the energy to stay flexible.

    Unfortunately, the same plasticity that allowed the myopia to develop in the first place remains after the minus lens is introduced to recover distance sight. Minimal prescriptions, therefore, are probably a better idea than a lens that recovers crystal clear distance again at the expense of comfort at near. I use plus at near as a counterforce to substitute for the adaptation so it need not occur.

    I am happier when my lenses can be tools for change or prevention rather than compensatory crutches.

    When we use lenses only to compensate for problems, we have thrown away our healing power, which is great, because we have at our command precision modifiers that shape, direct, and give controlled doses of the very stuff of the universe, which is light.

    They are awesomely powerful and optometry is the only field that has sufficient understanding of their use to apply them in a truly healing manner.

    John Streff reminds us of the power of our tools.

    Lenses interact with the body motorically and affect timing. They are light transformers that amplify or dampen selectivity, size, distance, distribution of light to the eyes, and affect the ambient/focal balance of system.

    The optical bench model distracts us.

    It makes us think that distance vision is a passive process of light falling on the fovea. It isn’t.

    As I learned during my training, “vision is a motor act,” and if patients realize this they are empowered to work on their vision. I never tell them they have long eyeballs. That is so fatalistic, so permanent, so mechanical, and so often wrong.

    The lenses we prescribe, if we believe that, are likely to be too strong to stabilize the system because we are going for precision in foveal focus instead of overall balance in a total system. We may even be creating tissue changes, just by blurring peripheral light, relative to the sharp focus we are delivering to the fovea.

    Full minus also takes away an individual’s ability to refocus at distance so that far vision does, indeed, become the passive process we have believed it to be. In addition, we recalibrate the whole accommodative and convergence system around that lens.

    How one perceives space, where one thinks objects are, has a large impact on how one’s vision operates, I learned. The deep three-dimensional reality of good vision becomes, in subtle ways, a two-dimensional image of reality in minus lenses. Even in contacts, the spaces between objects are visually compressed, but only patients who get weaker lenses ever realize it. the virtual images have created a new brain program for spatial relations.

    Distance is brought in as if it were at near. The brain adjusts. If one wants to get out of minus lenses, one has to intervene at the level of the brain program.

    This is my fundamental assumption based on experience. There are ways to do this, but they must all be done at once, together. A single factor, such as a bifocal, does not cut it. Lenses for different purposes, though, are a key part of any brain changing program.

    In an article under preparation for the JBO, I discuss the brain and vision research which explains for me how it is possible to give up minus and learn to see space again. There is ample evidence that this kind of change is probably due to enhancement of the ambient visual system through peripheral awareness training, simultaneous movement training of eyes and body, stress management, and mental processing changes.

    Many other professionals do myopia reduction-body workers of all types, yoga teachers, naturopathic doctors, and psychologists.

    Since lenses and prisms, combined with movement, are the most efficient tools for the space world expansion that reduces myopia, optometrists should be involved. We need to demonstrate the use of our tools for the healing of vision. Otherwise therapy will be taken away from us in the marketplace of health by healers who do.

    Dr. Orfield

  3. Remarks about the plus for prevention (at 20/40) by Jake of EndMyopia.

    Prevention is an educated choice. It is limited to professionals who verify 20/40, on their own Snellen, and need a refractive change of +3/4 diopers, to get to FAA required 20/20. It is not a short-term solution.

  4. The depressing nature of going into an OD’s shop.

    Blake> Yet – we know that some ODs know the partial truth – that the minus lens is a tragic choice – even though it works instantly.
    My most recent optometrist visit was an interesting one. I walked in feeling as if I had to be on the verge of defense at every question. I looked around at all the fancy posters, companies, glasses, etc. This time around was much much different, I was conscious of everything happening in that present moment. The old man being prescribed his first pair of glasses, the young teenaged boy staring at his phone while the doctor informs the parent that his prescription went up a quarter diopter and that when he receives his new glasses he must wear them as much as he can. All of it a lie, deceitfulness, trickery, ugh.. the disgust I had. (I wanted to tell everyone there about endmyopia.) The receptionist took me back, used all of the ‘fancy’ expensive equipment on me, set up the optical chair, failed a couple times, and then finally left and returned with the doctor, who sat in the chair as the receptionist literally does my whole entire eye exam, the doctor was just there to oversee. I denied the drops to test for glaucoma, as I should, and with my new prescription and 30$ less in my pocket, I left. On the brighter side of things, my RX decreased, not bad, not bad.

  5. ENDMOPIA – Additional comments:

    1) Daily Blog from Endmyopia:

    There are forces that have the goal of prevention. I post these remarks for your own judgment and education.

    Sadly, the ODs and MDs just give up on you – and put you in a strong minus lens.

    Prevention is never going to be easy, when quick-fixing with a minus is so easy.

    But I always say, that you have a right of an informed choice, about prevention, while you can still read the 20/30 to 20/40 line. My eye’s belong to me, and I would like the right to make this life changing choice for my benefit.

    The best place to start – is with a professional who admits that, “we did not know what else to do – even for our own children. ”

    That is indeed a big step in the right direction, and I feel that we should be better informed of the preventive choice – when we can still read the 20/40 line, with a mild prescription.

    Here is the woman who discusses this issue – including putting her own children into a minus lens at a young age. (Click on this Link. )

    2) An Optometrist’s View

    Prevention means self-measurement, and a resolve to work on prevention, until you are successful.

    ISSUE: The pot calling the kettle BLACK. The Kettle calling the pot black. (Click on this Link.)

    3) Optometrists Calling Us Names (Again)

    This issue is about money. I suggest that prevention is indeed possible. There is an explosion against prevention by the optometrist community (in many cases). I would encourage you to become educated about this issue. Yet some “deep thinking” ODs know this situation must begin to change – for the better.

  6. Sent: Monday, May 09, 2016 11:19 PM
    To: Otisbrown
    Subject: Prevention (Though high school, college and grad school – and after).

    Dear Uncle,

    Do you think most of the people you correspond to have a true understanding of the concept of prevention? I don’t really think many people understand prevention in the sense that you use it and I too attempt to describe it at work. I think most people assume there either is or will soon be a shortcut to their difficulties in life therefore hard work and determination are not thought of as accomplishing fundamental necessities. In other words, people tend to think of hard work and determination as accomplishing Ironman triathlon or a PhD or some other lofty goal. They tend not to think of hard work and determination as brushing teeth to prevent cavities, pushing print to prevent affects of reading at close distances or walking every day to stay healthy. I try to look at what I can do the easiest first and with the most pay off. Ironman took a lot of work but so does push ups and sit ups EVERY day. As they say, the hardest distance in training for a marathon is the couch to the front door.

    “People nowadays blame everything on their parents – add that to the differences – but Pop lived in an era when character alone was expected to accomplish miracles, and so many times did.”

    – W.D. Wetherell, North of Now, A Celebration Of Country And The Soon To Be Gone



    Dear K____,

    It is VERY HARD, to give intelligent pure-preventive advice. This is because the person must learn to anticipate – what is certain to happen – if you do not take “brushing your teeth” seriously. No one “in an office” will ever supply this type of advice. I known that, but I always expect “better” of myself.

    I just need a ‘clean’ presentation of science and facts – so THAT I CAN UNDERSTAND THESE ISSUES. If that is done for me (at 20/40, and self-measured –1 diopter), then I will make a choice with truly LIFE TIME CONSEQUENCES.

    No OD will give you this advice, because they know (almost universally) that you will REFUSE TO TAKE ANY OF THIS – SERIOUSLY. So – they deny the science that does truly support – personal prevention, and you, “doing it yourself”.

    I learned this from Dr. Raphaelson (Christmas 1966), when I thought I, “knew everything.” Raphaelson forced his own three kids to wear the plus. That works – they never become nearsighted. But it ONLY WORKS for your own children.

    What he said about the, “ignorant, general public”, was that, “… they will not STAND FOR IT…”. (That is NOT an insult … it is just that it takes great scientific wisdom to “commit” to wearing a plus for the long-term.)

    What he should have said is this. The most arrogant of people – are often the ignorant, or those who think they “know everything”. I had the good luck to publish with Dr Young, about the dynamic behavior of all natural eyes. That data showed that the kids (at 20/40), (and wearing the plus all the time) never became nearsighted. (I should say never became more nearsighted. But you can deduce for this fact, that if a wise person “commits” to wearing a strong plus, at 20/40, he can SLOWLY clear his own Snellen, from 20/40 to 20/20, or a refractive change of +3/4 diopters.)

    This is where that –1/2 diopter per year comes from, Dr. Young’s plus study.

    This is where that, 0.0 diopters per year comes from – if the plus is worn for all close work.

    Since you were old enough to understand this science, and could wear the plus with the fortitude that is required – you could go from 20/40 to 20/20. (A change of +3/4 diopters.) But equally – in true science – a wise person must understand that when you see your Snellen at 20/30, you can not expect ANY HELP FROM AN OD – as even Raphaelson explained it. You just must have the gumption to do it yourself.

    The “method “ of the plus does not fail. Rather, our ignorance and dis-like of objective science causes us to refuse to wear the plus correctly when we can still read the 20/30 line. This is the normal eye’s response to long-term near – and must be understood that way.

    In our modern society – we can not avoid that long-term near. But a correctly understood and worn plus, has the optical-effect of moving that near work – out to infinity. Thus, when you wear the plus, you are living “out doors” for the 8 hours of close work, when you wear a strong plus for all close work. But – as we learn – most people are totally confused, and will never understand it.

    This issue will, come up, with the (whining) statement, “… you mean I have to wear glasses …. to avoid wearing glasses…?” That is exactly why it will always take a deeper intelligence than most people can ever develop.

    I know that I am not good at explaining this – but you did it successfully. This is the only thing that matters to me – and to you.


  7. Remarks by an ophthalmologist, Kaisu Viikari — about protecting her own grand children, from entering into nearsightedness.
    Kaisu> My daughters daughter Tea’s (two “clever” physicians not understanding my insight – BUT THE HUSBAND, just 2 weeks in Amerika because of the huge project of Helsinki and its surrounds big hospitals computer care) ad they children, L__, nearly 5 years and W___, 2½ years, both have eyglasses +4.0 which they want immediately in the morning!!!
    They have noticed how reliewing it is to live with them!
    So should the 7 billions inhabitants of the globe do!!
    Peter> You *have prescribed +4.00 diopter lenses to your grand-children,*
    *ages 2.5 and 5, yes ? ( I say prescribed, because here, in the *
    *US, **the strongest available pharmacy power is +3.25 D. )*
    * surely, this is the sort of thing that should be properly*
    *reported in an Ophthal or Optom journal, yes ?
    This is indeed a “hot” issue. Dr Viikari, has advocated true prevention for the last 50 years – by wise wearing of a plus – before you become nearsighted.

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