Bates method

The Bates method is an alternative
therapy aimed at improving eyesight. Eye-care physician William Horatio
Bates, M.D. attributed nearly all sight problems to habitual strain of the eyes,
and felt that glasses were harmful and never necessary. Bates self-published a
book, Perfect Sight Without Glasses, as well as a magazine, Better Eyesight
Magazine, detailing his approach to helping people relax such “strain”, and
thus, he claimed, improve their sight. His techniques centered on visualization
and movement. He placed particular emphasis on imagining black letters and
marks, and the movement of such. He also felt that exposing the eyes to sunlight
would help alleviate the “strain”. Despite continued anecdotal reports of
successful results, including well-publicised support by Aldous
Huxley, Bates’ techniques have not been objectively shown to improve eyesight.
His main physiological proposition—that the eyeball changes shape to maintain
focus—has consistently been contradicted by observation. In 1952, optometry
professor Elwin Marg wrote of Bates, “Most of his claims and almost all of
his theories have been considered false by practically all visual scientists.”
Marg concluded that the Bates method owed its popularity largely to “flashes
of clear vision” experienced by many who followed it. Such occurrences have since
been explained as a contact lens-like effect of moisture on the eye, or a
flattening of the lens by the ciliary muscles.
The Bates method has been criticized not only because there is no good evidence
it works, but also because it can have negative consequences for those who
attempt to follow it: they might damage their eyes through overexposure of their
eyes to sunlight, put themselves and others at risk by not wearing their
corrective lenses while driving, or neglect conventional eye care, possibly
allowing serious conditions to develop. Underlying concepts
=Accommodation=Accommodation is the process by which
the eye increases optical power to maintain focus on the retina while
shifting its gaze to a closer point. The long-standing medical consensus is that
this is accomplished by action of the ciliary muscle, a muscle within the eye,
which adjusts the curvature of the eye’s crystalline lens. This explanation is
based in the observed effect of atropine temporarily preventing accommodation
when applied to the ciliary muscle, as well as images reflected on the
crystalline lens becoming smaller as the eye shifts focus to a closer point,
indicating a change in the lens’ shape. Bates rejected this explanation, and in
his 1920 book presented photographs that he said showed that the image remained
the same size even as the eye shifted focus, concluding from this that the
lens was not a factor in accommodation. However, optometrist Philip Pollack in a
1956 work characterized these photographs as “so blurred that it is
impossible to tell whether one image is larger than the other”, in contrast to
later photographs that clearly showed a change in the size of the reflected
images, just as had been observed since the late nineteenth century.
Bates adhered to a different explanation of accommodation that had already been
generally disregarded by the medical community of his time. Bates’ model had
the muscles surrounding the eyeball controlling its focus. In addition to
their known function of turning the eye, Bates maintained, they also affect its
shape, elongating the eyeball to focus at the near-point or shortening it to
focus at a distance. Commenting on this hypothesis in an interview with WebMD,
ophthalmologist Richard E. Bensinger stated “When we put drops in the eye to
dilate the pupil, they paralyze the focusing muscles. The evidence of the
anatomical fallacy is that you can’t focus, but your eye can move up and
down, left and right. The notion that external muscles affect focusing is
totally wrong.” Science author John Grant writes that many animals, such as
fishes, accommodate by elongation of the eyeball, “it’s just that humans aren’t
one of those animals.” Laboratory tests have shown that the
human eyeball is far too rigid to spontaneously change shape to a degree
that would be necessary to accomplish what Bates described. Exceedingly small
changes in axial length of the eyeball are caused by the action of the ciliary
muscle during accommodation. However, these changes are far too small to
account for the necessary changes in focus, producing changes of only −0.036
dioptres.=Causes of sight problems=
Medical professionals characterize refractive errors such as
nearsightedness, farsightedness, astigmatism, and presbyopia as
consequences of the eye’s shape and other basic anatomy, which there is no
evidence that any exercise can alter. Bates, however, believed that these
conditions are caused by tension of the muscles surrounding the eyeball, which
he believed prevents the eyeball from sufficiently changing shape when gaze is
shifted nearer or farther. Bates characterized this supposed muscular
tension as the consequence of a “mental strain” to see, the relief of which he
claimed would instantly improve sight. He also linked disturbances in the
circulation of blood, which he said is “very largely influenced by thought”,
not only to refractive errors but also to double vision, crossed-eye, lazy eye,
and to more serious eye conditions such as cataracts and glaucoma. His therapies
were based on these assumptions. Bates felt that corrective lenses, which
he characterized as “eye crutches”, are an impediment to curing poor vision. In
his view, “strain” would increase as the eyes adjust to the correction in front
of them. He thus recommended that glasses be discarded by anyone applying
his method. Treatments
In his writings, Bates discussed several techniques that he claimed helped
patients to improve their sight. He wrote “The ways in which people strain
to see are infinite, and the methods used to relieve the strain must be
almost equally varied,” emphasizing that no single approach would work for
everyone. His techniques were all designed to help disassociate this
“strain” from seeing and thereby achieve “central fixation”, or seeing what is in
the central point of vision without staring. He asserted that “all errors of
refraction and all functional disturbances of the eye disappear when
it sees by central fixation” and that other conditions were often relieved as
Bates suggested closing the eyes for minutes at a time to help bring about
relaxation. He asserted that the relaxation could be deepened in most
cases by “palming”, or covering the closed eyes with the palms of the hands,
without putting pressure on the eyeballs. If the covered eyes did not
strain, 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 some of his patients experienced
“illusions of lights and colors” sometimes amounting to “kaleidoscopic
appearances” as they “palmed”, occurrences he attributed to his
ubiquitous “strain” and that he claimed disappeared when one truly relaxed. This
phenomenon, however, was almost certainly caused by Eigengrau or “dark
light”. In fact, even in conditions of perfect darkness, as inside a cave,
neurons at every level of the visual system produce random background
activity that is interpreted by the brain as patterns of light and color.
=Visualization=Bates placed importance on mental
images, as he felt relaxation was the key to clarity of imagination as well as
of actual sight. He claimed that one’s poise could be gauged by the visual
memory of black; that the darker it appeared in the mind, and the smaller
the area of black that could be imagined, the more relaxed one was at
the moment. He recommended that patients think of the top letter from an eye
chart and then visualize progressively smaller black letters, and eventually a
period or comma. But he emphasized his view that the clear visual memory of
black “cannot be attained by any sort of effort”, stating that “the memory is not
the cause of the relaxation, but must be preceded by it,” and cautioned against
“concentrating” on black, as he regarded an attempt to “think of one thing only”
as a strain. While Bates preferred to have patients
imagine something black, he also reported that some found objects of
other colors easiest to visualize, and thus were benefited most by remembering
those, because, he asserted, “the memory can never be perfect unless it is easy.”
Skeptics reason that the only benefit to eyesight gained from such techniques is
itself imagined, and point out that familiar objects, including letters on
an eye chart, can be recognized even when they appear less than clear.
=Movement=He thought that the manner of eye
movement affected the sight. He suggested “shifting”, or moving the eyes
back and forth to get an illusion of objects “swinging” in the opposite
direction. He believed that the smaller the area over which the “swing” was
experienced, the greater was the benefit to sight. He also indicated that it was
usually helpful to close the eyes and imagine something “swinging”. By
alternating actual and mental shifting over an image, Bates wrote, many
patients were quickly able to shorten the “shift” to a point where they could
“conceive and swing a letter the size of a period in a newspaper”. One who
mastered this would attain the “universal swing”, Bates believed.
Perhaps finding Bates’ concepts of “shifting” and “swinging” too
complicated, some proponents of vision improvement, such as Bernarr Macfadden,
suggested simply moving the eyes up and down, from side to side, and shifting
one’s gaze between a near-point and a far-point.
=Sunning=Bates believed that the eyes were
benefited by exposure to sunlight. He stated that “persons with normal sight
can look directly at the sun, or at the strongest artificial light, without
injury or discomfort,” and gave several examples of patients’ vision purportedly
improving after sungazing – this is at variance with the well-known risk of eye
damage that can result from direct sunlight observation.
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 it could be worked up to. He acknowledged that looking at the sun
could have ill effects, but characterized them as being “always
temporary” and in fact the effects of strain in response to sunlight. He wrote
that he had cured people who believed that the sun had caused them permanent
eye damage. In his magazine, Bates later suggested exposing only the white part
of the eyeball to direct sunlight, and only for seconds at a time, after
allowing the sun to shine on closed eyelids for a longer period.
Posthumous publications of Bates’ book omitted mention of the supposed benefits
from direct sunlight shining on open eyes.
Results and criticism Bates’ techniques have never been
scientifically established to improve eyesight. Several of Bates’ techniques,
including “sunning”, “swinging”, and “palming”, were combined with healthy
changes to diet and exercise in a 1983 randomized controlled trial of myopic
children in India. After 6 months, the experimental groups “did not show any
statistically significant difference in refractive status”, though the children
in the treatment group “subjectively … felt relieved of eye strain and other
symptoms”. In 1967 the British Medical Journal
observed that “Bates […] advocated prolonged sun-gazing as the treatment of
myopia, with disastrous results.” The philosopher Frank J. Leavitt has
argued that the method Bates described would be difficult to test
scientifically due to his emphasis on relaxation and visualization. Leavitt
asked “How can we tell whether someone has relaxed or imagined something, or
just thinks that he or she has imagined it?” In regards to the possibility of a
placebo trial, Leavitt commented “I cannot conceive of how we could put
someone in a situation where he thinks he has imagined something while we know
that he has not.” After Bates
After Bates died in 1931, his methods of treatment were continued by his widow
Emily and other associates, some of whom incorporated exercises and dietary
recommendations. Most subsequent proponents did not stand by Bates’
explanation of how the eye focuses mechanically, but nonetheless maintained
that relieving a habitual “strain” was the key to improving sight.
=Margaret Darst Corbett=Margaret Darst Corbett first met Bates
when she consulted him about her husband’s eyesight. She became his
pupil, and eventually taught his method at her School of Eye Education in Los
Angeles. She was of the stated belief that “the optic nerve is really part of
the brain, and vision is nine-tenths mental and one-tenth only physical.”
In late 1940, Corbett and her assistant were charged with violations of the
Medical Practice Act of California for treating eyes without a licence. At the
trial, many of her students testified on her behalf, describing in detail how she
had enabled them to discard their glasses. One witness testified that he
had been almost blind from cataracts, but that, after working with Corbett,
his vision had improved to such an extent that for the first time he could
read for eight hours at a stretch without glasses. Corbett explained in
court that she was practicing neither optometry nor ophthalmology and
represented herself not as a doctor but only as an “instructor of eye training”.
Describing her method she said “We turn vision on by teaching the eyes to shift.
We want the sense of motion to relieve staring, to end the fixed look. We use
light to relax the eyes and to accustom them to the sun.”
The trial attracted widespread interest, as did the “not guilty” verdict. The
case spurred a bill in the Californian State Legislature that would have then
made such vision education illegal without an optometric or medical
licence. After a lively campaign in the media, the bill was rejected.
=Aldous Huxley=Perhaps the most famous proponent of the
Bates method was the British writer Aldous Huxley. At the age of sixteen
Huxley had an attack of keratitis, which, after an 18-month period of
near-blindness, left him with one eye just capable of light perception and the
other with an unaided Snellen fraction of 10/200. This was mainly due to
opacities in both corneas, complicated by hyperopia and astigmatism. He was
able to read only if he wore thick glasses and dilated his better pupil
with atropine, to allow that eye to see around an opacity in the center of the
cornea. In 1939, at the age of 45 and with
eyesight that continued to deteriorate, he happened to hear of the Bates method
and sought the help of Margaret Corbett, who gave him regular lessons. Three
years later he wrote The Art of Seeing, in which he related: “Within a couple of
months I was reading without spectacles and, what was better still, without
strain and fatigue…. At the present time, my vision, though very far from
normal, is about twice as good as it used to be when I wore spectacles.”
Describing the process, Huxley wrote that “Vision is not won by making an
effort to get it: it comes to those who have learned to put their minds and eyes
into a state of alert passivity, of dynamic relaxation.” He expressed
indifference regarding the veracity of Bates’ explanation of how the eye
focuses, stating that “my concern is not with the anatomical mechanism of
accommodation, but with the art of seeing.”
His case generated wide publicity as well as scrutiny. Ophthalmologist Walter
B. Lancaster, for example, suggested in 1944 that Huxley had “learned how to use
what he has to better advantage” by training the “cerebral part of seeing”,
rather than actually improving the quality of the image on the retina.
In 1952, ten years after writing The Art of Seeing, Huxley spoke at a Hollywood
banquet, wearing no glasses and, according to Bennett Cerf, apparently
reading his paper from the lectern without difficulty. In Cerf’s words:
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. In response to this, Huxley wrote “I
often do use magnifying glasses where conditions of light are bad, and have
never claimed to be able to read except under very good conditions.” This
underscored that he had not regained anything close to normal vision, and in
fact never claimed that he had.=Modern variants=
“Natural vision correction” or “natural vision improvement” continues to be
marketed by practitioners offering individual instruction, many of who have
no medical or optometric credentials. Most base their approach in the Bates
method, though some also integrate vision therapy techniques. There are
also many self-help books and programs, which have not been subjected to
randomized controlled trials, aimed at improving eyesight naturally. Purveyors
of such approaches argue that they lack the funds to formally test them.
The heavily advertised “See Clearly Method” included “palming” and “light
therapy”, both adapted from Bates. The creators of the program, however,
emphasized that they did not endorse Bates’ approach overall.
In his 1992 book The Bates Method, A Complete Guide to Improving
Eyesight—Naturally, “Bates method teacher” Peter Mansfield was very
critical of eye care professionals for prescribing corrective lenses,
recommending most of Bates’ techniques to improve vision. The book included
accounts of twelve “real cases”, but did not report any information about
refractive error. Czech native John Slavicek claims to
have created an “eye cure” that improves eyesight in three days, borrowing from
ancient yogic eye exercises, visualizations from the Seth Material,
and the Bates method. Although he has testimonials from his neighbor and
others, several of his students indicate that he has greatly exaggerated their
cases. Slavicek’s self-published manual, Yoga for the Eyes, was rejected by an
ophthalmologist who evaluated it, and evinced no interest from the World
Health Organization and St. Erik’s Eye Foundation in Sweden as he had not
conducted double-blind tests. Anecdotal support
In support of the effectiveness of the Bates method, proponents point to the
many accounts of people allegedly having improved their eyesight by applying it.
While these anecdotes may be told and passed on in good faith, several
potential explanations exist for the phenomena reported other than a genuine
reversal of a refractive error due to the techniques practiced:
Some cases of nearsightedness are recognized as due to a transient spasm
of the ciliary muscle, rather than a misshapen eyeball. These are classed as
pseudomyopia, of which spontaneous reversal may account for some reports of
improvement. Research has confirmed that when
nearsighted subjects remove their corrective lenses, over time there is a
limited improvement in their unaided visual resolution, even though
refraction indicates no corresponding change in refractive error. This is
believed to occur due to adjustments made in the visual system. One who has
been practicing Bates’ techniques and notices such improvement may not realize
that simply leaving the glasses off would have had the same effect, which
may be especially pronounced if the prescription was too strong to begin
with. Visual acuity is affected by the size of
the pupil. When it constricts, the quality of focus will improve
significantly, at the cost of a reduced ability to see in dim light. This is
known as the “pinhole effect”. This concept is also used in photography when
changing the aperture size. Some eye defects may naturally change
for the better with age or in cycles. A cataract when first setting in sometimes
results in much improved eyesight for a short time. One who happens to have been
practicing the Bates method will likely credit it for any improvement
experienced regardless of the actual cause.
Some studies have suggested that a learned ability to interpret blurred
images may account for perceived improvements in eyesight.
Ophthalmologist Walter B. Lancaster had this to say: “Since seeing is only
partly a matter of the image on the retina and the sensation it produces,
but is in still larger part a matter of the cerebral processes of synthesis, in
which memories play a principal role, it follows that by repetition, by practice,
by exercises, one builds up a substratum of memories useful for the
interpretation of sensations and facilitates the syntheses which are the
major part of seeing.” Lancaster faulted ophthalmologists in general for
neglecting the role of the brain in the process of seeing, “leaving to
irregular, half-trained workers the cultivation of that field”.
=Flashes of clear vision=Bates method enthusiasts often report
experiencing “flashes” of clear vision, in which eyesight momentarily becomes
much sharper, but then reverts to its previous state. Such flashes are not the
result of squinting, and can occur in one eye at a time or in both eyes at
once. Observation has suggested that both the quality and duration of such
flashes can be increased with practice, with some subjects holding a substantial
improvement for several minutes. Tests of such subjects have found that the
temporary improvement in visual acuity is real, but per retinoscopy is not due
to any change in refractive error. A 1982 study concluded that such
occurrences are best explained as a contact lens-like effect of moisture on
the eye, based on increased tear action exhibited by 15 out of 17 subjects who
experienced such improvement. A more recent series of studies have proposed
that such flashes may be caused by “negative accommodation”.
General research In 2004 the American Academy of
Ophthalmology published a review of various research regarding “visual
training”, which consisted of “eye exercises, muscle relaxation techniques,
biofeedback, eye patches, or eye massages”, “alone or in combinations”.
No evidence was found that such techniques could objectively benefit
eyesight, though some studies noted changes, both positive and negative, in
the visual acuity of nearsighted subjects as measured by a Snellen chart.
In some cases noted improvements were maintained at subsequent follow-ups.
However, these results were not seen as actual reversals of nearsightedness, and
were attributed instead to factors such as “improvements in interpreting blurred
images, changes in mood or motivation, creation of an artificial contact lens
by tear film changes, or a pinhole effect from miosis of the pupil.”
In 2005 the Ophthalmology Department of New Zealand’s Christchurch Hospital
published a review of forty-three studies regarding the use of eye
exercises. They found that “As yet there is no clear scientific evidence
published in the mainstream literature supporting the use of eye exercises” to
improve visual acuity, and concluded that “their use therefore remains
controversial.” General criticisms
=Dead-end=A frequent criticism of the Bates method
is that it has remained relatively obscure, which is seen as proof that it
is not truly effective. Writer Alan M. MacRobert concluded in a 1979 article
that the “most telling argument against the Bates system” and other alternative
therapies was that they “bore no fruit”. In regards to the Bates method, he
reasoned that “If palming, shifting, and swinging could really cure poor
eyesight, glasses would be as obsolete by now as horse-drawn carriages.”
=Corrective lenses and safety=Discarding one’s corrective lenses, as
Bates recommended, or wearing lenses weaker than one’s prescribed correction,
as some Bates method advocates suggest, poses a potential safety hazard in
certain situations, especially when one is operating a motor vehicle. James
Randi related that his father, shortly after discarding glasses on the advice
of Bates’ book, wrecked his car. Bates method teachers often caution that when
driving, one should wear the correction legally required.
=Avoidance of conventional treatment=One of the greatest potential dangers of
faith in the Bates method is that a believer may be disinclined to seek
medical advice regarding what could be a sight-threatening condition requiring
prompt treatment, such as glaucoma. Also, children with vision problems may
require early attention by a professional in order to successfully
prevent lazy eye. Such treatment may include exercises, but which are
different from those associated with the Bates method, and parents who subscribe
to Bates’ ideas may delay seeking conventional care until it is too late.
It may further be necessary for a child at risk of developing lazy eye to wear
the proper correction. See also
Behavioral optometry Iridology
Pinhole glasses Tibetan eye chart
List of topics characterized as pseudoscience
References Further reading
Grosvenor, TP. Nonsurgical Methods of Myopia Control or Reduction. Primary
Care Optometry. p. 370. ISBN 0-7506-7575-6. There has never been any
clinical or scientific evidence that these procedures are of any help in
controlling myopia. External links
“The Unending Search for ‘Normal’ Vision”. Life. 27 May 1957.
Orfield, M.A., O.D., Antonia. “Seeing Space: Undergoing Brain Re-Programming
to Reduce Myopia”. Journal of Behavioral Optometry 5: 123–131.
“To See or Not to See–Natural Vision Correction”. BBC. 27 September 2004.
Robertson, Kate. “Seeing eye to eye”. The Sydney Morning Herald.

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