Bates Method

The Bates Method is a method created at the beginning of 20 th century by Dr. William Horatio Bates, M.D. (1860-1931). The aim of the Bates Method is to improve vision and restore the natural habits of seeing, which according to Bates have been lost through strain, tension and the resulting misuse of the eyes. Despite the more than 80 years that the Bates Method has been available, it is still a controversial system. Nevertheless, many people claim to have been helped by the method.

The Bates Method was first published in 1920 by William Horatio Bates in a book entitled Perfect Sight Without Glasses, then subsequently in his monthly magazine entitled Better Eyesight.

Bates claimed to have discovered that people with abnormal vision use their eyes differently than people with normal vision, and then created a system designed to help people to relearn the right vision habits. Advocates of the Bates Method claim that these vision habits are inseparably connected to normal vision. They assert that the Bates Method is a natural method that improves movement, relaxation, and circulation of the whole visual system.

The core of the Bates Method consists of a set of practices which Bates advocates term "exercises in relaxation" and "movement exercises" [1]. They state that the term "exercise" is used in the same sense as "memory exercise" and does not imply muscle strengthening. Advocates state that the Bates Method emphasizes the practice of deliberate movements of the body ("swinging") with relaxed awareness of vision; cupping or palming the eyes with the hands; attempting to see or visualize "perfect black"; and exposing the eye to indirect sunlight. Fundamentally, the Bates Method is said to require a holistic change in the way the body is used rather than any consciously applied eye exercises.

Techniques

Palming is one technique that advocates claim achieves relaxation of the mind and the eyes. Palming requires a person to gently cup the palms of the hands over the closed eyelids in order give the mind and the visual system as much rest as possible. Then the person sits for five to fifteen minutes (or as long he or she wants) breathing deeply and easy with a good posture.

Eye exercises

In recent years, the growing interest in alternative medicine has led to an increase in the popularity of the Bates Method and other methods claim success via visual training through eye exercises. One particularly controversial area is the efficacy of eye exercises in the treatment of myopia(near-sightedness) and whether the use of eyeglasses makes myopia progressively worse.

Several points-of-view exist about the use of eye exercises to treat vision problems:

• Traditional mainstream ophthalmologistsand optometristsuse eye exercises to treat a limited range of problems, particularly problems involving muscular imbalances and problems with coordination of eye movement between the two eyes. (See orthoptics.)
• Functional optometrists and optometric vision therapists are licensed, credentialed doctors of optometry, who specialize in treatment that involves eye exercises. They hold that such exercises are useful in improving a wide range of visual conditions, including focusing problems. The methods used are said to be backed by clinical studies and publications in peer-reviewed journals.
• The Bates method differs from other health systems that use eye exercises in a way that can be categorized as alternative medicine. Like homeopathic medicine, the treatments used and the explanations of how they are said to work are rejected by mainstream medicine, despite personal testimony by people who claim to have been helped by such methods.

The Bates Method

Theory of accommodation/focusing

Accommodation is the process by which the eye changes focus between objects that are far and objects that are near. Bates maintained that the eye focuses, not by the action of the ciliary muscles on the crystalline lens, but by varying elongation of the eyeball caused by the extraocular muscles.

Theory regarding the pathogenesis of refractive errors

Bates concluded that myopia was related to apprehension or what some may call "anxiety." He reportedly felt that good vision was nature's way and that any other way was a strained way of seeing. Bates believed that it was impossible to consciously relieve the eyes of this tensing and instead developed his method as means of effecting subconscious relaxation.

Advocates of the Bates Method believe that excessive tension of the extraocular muscles changes the shape of the eyeball to cause decreased vision, and that by understanding this cause of decreased vision is essential to understanding how it may be improved. They claim that excessive tension of the oblique muscles make the eyeball too long (leading to myopia), that excessive tension of the recti muscles make the eyeball too short (leading to hyperopia, and that excessive tension of the oblique and recti muscles make them astigmatic. They claim that Bates Method techniques can elleviate this excessive muscle tension to allow the shape of the entire eyeball to return to normal.

Advocates of the Bates Method claim that viewing books, computer monitors, and other near vision activities are harmless as long as a person maintains the right vision habits. The Bates Method is about taking away the excessive tension of the external eyemuscles. Eyeglasses are an unnecessary crutch. Bates advocates also claim that the Tibetan eye charthas long been used for the purpose of helping to keep eye muscles toned and that acupressuretechniques can be used to improve vision and increase circulation to the eyes.

Some advocates of the Bates Method propose that the myopic eye condition is not caused by weakened muscles, but by muscles that are being used improperly. It is suggested that when a myopic person focuses on distant objects, they are no longer relaxing the muscles used in accommodation. Instead, they are "straining" to see the distant objects with the same musuclar tension exhibited when viewing at the nearpoint.

Efficacy

Advocates believe the Bates Method to be effective. The British writer Aldous Huxley(author of Brave New World) was one such advocate. Huxley claimed achieving successful results in his book entitled The Art of Seeing. Huxley was among the students of Margaret Corbett, who trained with Dr. Bates in 1930and later authored Help Yourself to Better Sight.

Safety

Advocates believe the Bates Method to be safe.

Criticisms of the Bates Method

Theory of accommodation/focusing

Critics of the Bates Method reject the theory that human eyes accommodate, or focus, due to elongation of the eyeball caused by ?squeezing? of the extraocular muscles, as has been claimed to happen in some animals. Critics of the Bates Method instead support the mainstream theory set forth by Hermann von Helmholtzthat human eyes accommodate, or focus, due to the actions of the ciliary muscle (an intraocular muscle) and zonules changing the shape of the crystalline lens. To support this theory, critics of the Bates Method point to the action of various cycloplegic agents which temporarily paralyze accommodation by relaxing the ciliary muscle but leave the extraocular muscles, which control eye movements, unaffected. They also note that modern equipment, not available to Bates, has made possible the observation of the eye in great detail; such observations show the lens changing shape when the eye accommodates. [2]

Theory regarding the pathogenesis of refractive errors

Critics of the Bates Method contend that if the cause of myopia is continuous tensing of the muscles, either ciliary or extraocular, the Bates Method theory is that it should be possible to cure (or noticeably improve) it by causing intentional relaxation of the muscles; a process most commonly done using injections or topical administration of atropine. The mainstream consensus on this, however, is that no significant improvement of the vision is obtained when muscles are relaxed in this manner.

Efficacy

The vast majority of optometrists and ophthalmologists do not recommend the Bates Method. Martin Gardner, in Fads and Fallacies in the Name of Science, characterized Bates' book as "a fantastic compendium of wildly exaggerated case records, unwarranted inferences and anatomical ignorance." He suggested that the Bates method may however work, to a limited degree, by increasing the trainee's ability to interpret and extract information from blurred images.

Safety

Critics of the Bates Method concede that most of the Bates techniques are harmless, apart from the possibility that faith in the Bates system could deter people with eye conditions requiring prompt care from seeking conventional treatment. (One of his original exercises, however, involved looking directly at the sun, which in some situations may be dangerous; a 1940 revision of his book modified this by suggesting that the sun shine on closed eyes.)

The modern debate - myopia is not as irreversible as was thought

Though modern research refutes Bates' claims regarding the role of the extraocular muscles in focussing, many studies are confirming that reading and close-work play a part in the development of myopia in children. It is hard to find any other reason for the epidemic of myopia that afflicts our children, with the percentages of children reported as myopic in different countries appearing to be highly correlated with the amount of early study [3].

A study of students with myopia showed that while their refractive error progressively worsened over the period of a year, it actually reduced during periods of vacation in which they reported doing less close-work[4]. While this in no way supports Bate's main ideas, it does support his basic tenet that refractive error is not just something that has to be accepted, and that it can to some extent be reversed by change of habit.

Whatever the mechanism, more and more research is supporting the idea that prolongued straining of the ciliary muscle does probably play a part, along with herditary predisposition, in the development of myopia (a theory actually opposed by Bates), and there have been recent suggestions that relieving this strain by the use of reading glasses with positive lenses might stave off the development of myopia, while corrective (negative) lenses for far vision might hasten its development [5]. This does make sense according to our current understanding, suggesting that many children may have been damaged by the prescribing of corrective lenses to be worn all the time, and that in children in particular, anything that relaxes the eyes is likely to be beneficial.

An area of great relevance concerns the mechanism by which our brain focuses our eyes and converges our binocular vision for near-sight. Basic optical principles suggest that there is no way in which the eye can tell whether a blurred image is being brought to focus in front of or behind the retina, and hence which way to change focus. This is supported by the fact that modern digital cameras with passive autofocus use a trial and error approach, shifting focus first one way and then the other while attemting to maximise contrast in areas of fine detail. If the brain uses this trial and error method, then it must remember what stage it is at and decide when to stop, a difficult task for a neural network, and one that does not always work reliably or quickly in cameras.

This suggests that the brain might use other cues like binocular convergence, or perceived object size and distance to direct focussing, perhaps with trial and error for fine trimming. In principle, convergence on near objects to avoid double vision need not be trial and error, but can use negative feedback from the two apparent image positions to adjust the extraocular muscles rapidly for coincident images. Convergence could therefore be the driver for accommodation. The whole issue of convergence and accommodation is discussed in detail in the 'Myopia Manual' by Klaus Schmid [6], which attempts to review the entire published literature. In section 3.4 of the Myopia Manual, Phoria is described as a defect in which convergence and accomodation do not track together properly. Too much convergence is called esophoria, and too little convergence exophoria. The manual refers to evidence that the progression of myopia is in fact linked with the degree of phoria, and refers to more technical details involving the AC/A and CA/C ratios.

If such cues are indeed used, then it follows that the wearing of glasses is likely to confuse the brain, and weaken its aquired algorithms, by changing the relationship between convergence and apparent focus distance, requiring the wearer to develop two or more separate programs in the brain for aquiring focus with and without glasses. The Myopia manual goes on to describe the use of prisms for correcting phoria, indicating that prisms added to prescription lenses might slow the progression of myopia.

Phoria could be part of the reason myopia progresses in young people wearing corrective glasses. It could also be relevant when presbyopia sets in and we start to focus through multiple lenses or varifocals. It may be that there was a grain of truth in what Bates was doing in so far as training excercises might help the brain to improve its focus strategy, or to ignore a false strategy.

See also

• Myopia
• Alternative medicine
• Eye
• Matthew Luckiesh
• Quackery

External links

Free books and articles by W. H. Bates

• Perfect Sight Without Glasses (unabridged book)
• Better Eyesight magazine (from 1919 to 1930)

Supportive of the Bates Method

• Imagination Blindness
• Central-Fixation.com
• Natural Vision Improvement FAQ
• List of Natural Vision Improvement websites
• Effective Eye Exercises for Better Vision

Critical of the Bates Method

• Quackwatch
• "Fallacies of the Bates System" by Philip Pollack, O.D.de:Augentraining

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This article is licensed under the GNU Free Documentation License.
It uses material from the http://en.wikipedia.org/wiki/Bates+Method Wikipedia article Bates Method.