The Bates method for "better eyesight" was developed by eye-care physician William Horatio Bates, M.D. (1860–1931) with the goal of undoing what he described as "strained" vision habits. Bates detailed 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 Magazine, published from 1919 to 1930. The Bates method is not considered by optometrists and ophthalmologists to be an effective form of vision correction.
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, amblyopia, diplopia, conjunctivitis, blepharitis, cataracts, glaucoma, and diseases of the optic nerve and retina. He also claimed that "strain" was responsible for perfectly normal, and usually harmless, phenomena such as floaters. 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 closed eyes to sunlight, and other activities.
Although some people claim to have been helped by following Bates' principles, his techniques have not been shown to objectively improve eyesight, and his main physiological proposition, that the extraocular oblique muscles adjust the shape of the eyeball to maintain its focus, was rejected by ophthalmology and optometry of his day, and is still rejected today. In Fads and Fallacies in the Name of Science, mathematical journalist Martin Gardner characterized Bates' book as "a fantastic compendium of wildly exaggerated case records, unwarranted inferences, and anatomical ignorance." Gardner suggested that Bates' techniques may seem to work, to a limited extent, due to the eyes adjusting to seeing without glasses when they are put aside.
Adherence to Bates' ideas is not entirely without risk, as it is possible that those who attempt to follow his suggestions might overexpose their eyes to sunlight or neglect conventional eye-care when it is needed. Additionally if they stop wearing glasses, as Bates recommended, this might compromise safety or performance in contexts where clear vision is essential, such as driving.
Bates claimed that focus is maintained by varying elongation of the eyeball caused by the extraocular muscles, rejecting the orthodox explanation set forth by Hermann von Helmholtz, which is still accepted by ophthalmology and optometry today, that accommodation is brought about by action of the ciliary muscle (an intraocular muscle) which changes the shape of the eye's crystalline lens. Bates 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. However, various cycloplegic agents such as atropine can temporarily prevent accommodation by paralyzing the ciliary muscle. Bates acknowledged that this stopped accommodation in "about nine cases out of ten", but argued that the "tenth cases" in which applying atropine to the ciliary muscle failed to stop accommodation constituted strong evidence that that muscle is not actually responsible for accommodation. However, it is recognized that a single dose of atropine is not always enough to induce paralysis.
To boost his assertion that the extraocular muscles are responsible for accommodation, Bates cited the apparent ability of some aphakics to accommodate. These instances, however, are extremely rare, and as such are best considered exceptions to the rule; moreover, examination of such cases has found no change in the refractive power of the eye.
Photographic evidence has shown the lens changing shape when the eye accommodates. Moreover, Berkeley optometry professor Elwin Marg, writing in 1952, pointed 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 focus. He continued: "to the writer's knowledge, no corresponding anterior-posterior corneal movement has ever been reported."
Many subsequent proponents of Bates' method have expressed the view that it is unimportant whether Bates was right or wrong regarding the mechanism of eye-focusing, arguing that this is separate from his treatments, and that the proof of their effectiveness is in the results they claim to have obtained.
Bates regarded refractive errors as directly resulting from visual habits, and emphasized that he did not view excessive near-work as the cause of nearsightedness. Rather, he asserted that a "mental strain" to see would inhibit the eyeball from sufficiently changing shape (per his explanation of accommodation) when shifting its focus nearer or farther. He claimed that effort to see close objects instantly causes the extraocular muscles to shorten the eyeball, producing hypermetropia (farsightedness) in an eye with previously normal vision, and that effort to see distant objects instantly lengthens the eyeball, producing myopia (nearsightedness) in an eye with previously normal vision. He also stated that astigmatism is produced when these changes occur "unsymmetrically". When such "strain" becomes habitual, Bates believed, the eyes are prevented from shortening or lengthening past a certain point, and consequently the refractive error becomes constant.
Bates also linked disturbances in the circulation of blood, which he characterized as being "very largely influenced by thought", not only to refractive errors but also to diplopia, strabismus, amblyopia, and to more serious eye conditions such as cataracts and glaucoma.
The proposition that "mental strain" causes sight problems is crucial to Bates' work, but is perhaps the most vague aspect of his writings. "strain#Verb" 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.
For children, following Bates' advice not to wear glasses could jeopardize visual development, as their eye-brain pathways are still forming, and this process is dependent on visual images. In some situations, it is necessary to correct a child's refractive error promptly in order to prevent the development of amblyopia.
Regarding contact lenses, some Bates method advocates point out that unlike glasses, contacts are not normally removed during moments when they are not needed, and thus characterize contacts as an even larger impediment to improvement than glasses.
Bates 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 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 which he attributed to his ubiquitous "strain" and which he claimed disappeared when one truly relaxed. This phenomena, however, was almost certainly caused by eigengrau or "dark light". In fact, it is impossible to see entirely "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 color and light in the visual field. Similar hallucinations can be invoked by visual deprivation using a Ganzfeld.
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.
Bates felt that the manner of eye movement is key to how well one sees. 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 shorter the area over which the "swing" is experienced, the greater the benefit to sight. He also indicated that it is usually helpful to close the eyes and imagine something swinging. By alternating actual and mental shifting over an image, Bates reported, 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 masters this will attain the "universal swing", Bates believed.
In his Better Eyesight magazine, Bates set forth several techniques designed to help realize and then shorten the "swing". One such method was the "long swing", which consisted of standing with the feet a foot apart, slowly turning the body alternately from left to right and right to left while raising the opposite heel off the ground, allowing the head and eyes to move with the body, without paying attention to the apparent movement of stationary objects. 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."
Perhaps finding Bates' concepts of "shifting" and "swinging" too complicated, some proponents of vision improvement have suggested simply moving the eyes up and down, left and right, and shifting focus between a near-point and a far-point.
The terms "shift" and "swing" are not used in this fashion outside of a Bates context. Bates provided no evidence of any correlation between visual acuity and eye movement, beyond his own clinical experience, which is effectively anecdotal.
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. 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. However, Bates did temper his suggestions regarding this activity in later editions of his magazine, recommending instead that direct sunlight be allowed to shine on closed eyelids. He also clarified that he regarded the benefit as being in the solar light rays rather than the heat rays, and thus suggested "sunning" in the early morning, moving the head from side to side.
In late 1940 Mrs. 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 witnesses testified on her behalf. They described in detail how she had improved their sight and had enabled them to discard their glasses. One witness testified that he had been almost blind from cataracts, but that, after receiving treatment, his vision had improved to such an extent that for the first time he could read for eight hours at a stretch without glasses. Mrs. Corbett explained in court that she was practising 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 which would have then made such vision education illegal without an optometric or medical licence. After a lively campaign in the media, the bill was defeated.
In 1939, at the age of 45 and with eyesight which 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".
His case attracted wide publicity. Ophthalmologist Walter B. Lancaster commented:
"It is often pointed out that Huxley’s visual acuity has not improved in any extraordinary way. He admits that. The point is that he has learned how to use what he has to better advantage. It is not the primary retinal sensation that is improved; it is the neglected, but vitally important, cerebral part of seeing that has been trained."If his ability to see had actually improved, it remained imperfect and variable. Ten years later, in 1952, 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 pointed out that he had "never claimed to be able to read except under very good conditions", and explained that he often did "use magnifying glasses where conditions of light are bad". He had previously written in Chapter 4 of The Art of Seeing:
"The most characteristic fact about the functioning of the total organism, or any part of the organism, is that it is not constant, but highly variable. ... People with unimpaired eyes and good habits of using them possess, so to speak, a wide margin of visual safety. Even when their seeing organs are functioning badly, they still see well enough for most practical purposes. Consequently they are not so acutely conscious of variations in visual functioning as are those with bad seeing habits and impaired eyes. These last have little or no margin of safety; consequently any diminution in seeing power produces noticeable and often distressing results.”
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."
The other factor which applies here is the potential for selection bias, the effect whereby spurious relationships can appear to exist due to selective reporting. In this case, many people have tried the Bates method. For some, their eyesight may have seemingly improved; for some no noticeable change occurred; in some cases, perhaps, their eyesight has deteriorated. If only the first of these groups publicize what has happened, and the other two groups keep silent or are ignored, it will appear that the Bates method has been very effective, whereas in actuality it may not have been.