# Optical Forums > General Optics and Eyecare Discussion Forum >  Zeiss MyoVision reduces myopia by 30%

## allanon

http://www.youtube.com/watch?v=vX8_eQZWDjI

We'll see.  Retail US$265

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## finefocus

OK, I don't get it. The "Explain Myovision" video (for which I don't get audio) seems to be about matters chiropractic, not optical. Does anyone know what this is about? How does a spectacle lens limit axial growth, or corneal steepening? I'm lost here.

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## uncut

It seems that this lens is probably a multifocal design like the Anti-fatigue Lens by Essilor...which I tongue-in-cheek refer to as the "training bra" for multifocal wearers.  It is probably the same old bifocals for kids trend that we see popping up and studied here in North America ad nauseam...........I am only speculating of course.
No mention of it in Canadian pricelists from Zeiss.

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## LENNY

Probably the replacement for XL!

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## finefocus

> It seems that this lens is probably a multifocal design like the Anti-fatigue Lens by Essilor...which I tongue-in-cheek refer to as the "training bra" for multifocal wearers. It is probably the same old bifocals for kids trend that we see popping up and studied here in North America ad nauseam...........I am only speculating of course.
> No mention of it in Canadian pricelists from Zeiss.


So we're back to the question of whether or not reading/accomodating causes myopia. I've heard that question answered both ways. What's the current wisdom? Do Ophthalmology and Optometry agree on this?

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## uncut

I hope our resident ZEISS expert will join in........maybe on Monday?

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## finefocus

And another question: Everybody has 30% less myopia, or 30% fewer people develop myopia? If you are among the 70%, do you have no myopia? Or only 70% of what we thought you'd have? You Zeiss marketers, please explain the phrase.

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## Yeap

As i understand Myovision is to slow down progression by 30% not reduce the Rx by 30%. it using a 'peripheral vision management technology' on that purpose.. is not a 'new' children progressive lens. Myopic control study shows that the eyeball will get elongated to 'find' the focus if the image shell projected behind the retina. so myovision projected the image shell in front of the retinal on the peripheral so the eyeball will not elongated and hence achieve the myopia control..

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## uncut

> As i understand Myovision is to slow down progression by 30% not reduce the Rx by 30%. it using a 'peripheral vision management technology' on that purpose.. is not a 'new' children progressive lens. Myopic control study shows that the eyeball will get elongated to 'find' the focus if the image shell projected behind the retina. so myovision projected the image shell in front of the retinal on the peripheral so the eyeball will not elongated and hence achieve the myopia control..


So...control study? by whom.  Source please!

What is the uniqueness of this lens design?

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## fjpod

This is not about accomodation at near causing myopia. It is about peripheral retinal blur...not central. Peripheral blur behind the retina has been shown to induce myopia, hence the aspheric nature of the lens. Yeap has it right. This is not a progressive lens to reduce accomodation.

I don't have the exact reference, but I recently attended a CE class on the topic given by this fellow. http://www.sunyopt.edu/research/troilo/index.shtml

These studies help to explain why controlling accomodation does not always control myopia.  There is much more to it.

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## Yeap

the study invoilved Prof Brien Holden conducted in Sun Yat-Sen University China from Oct 2009-Jan 2009.sorry that i don't have much source to provide you. maybe you can try to serach this in some journal. but before this lots study and research on animal done show positive results that when the peripheral image projected in front of retinal it able to slow down or even stop the eye globe gowth.  other than that i think fjpod has explain it well.

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## icare

I can't find any links directly attributed to Zeiss on the net.  Is this a spoof?

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## uncut

So....this is an aspheric lens design?  2-drop, 4-drop?

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## Darryl Meister

As FJPOD pointed out, MyoVision slows the progression of myopia by manipulating the peripheral retinal image. Conventional lenses are generally designed to focus light on the central retina for different angles of view. Recent research suggests that the quality of the peripheral retinal image may contribute to the stimulation of continued eye growth or "emmetropization."

The MyoVision lens design is a highly aspheric and asymmetric single vision lens design. Essentially, the lens attempts to improve the focus of the retinal image not only at the fovea but also away from the fovea, at least through the central region of the spectacle lens. In theory, this should reduce the stimulus to continued emmetropization.

The 30% reduction in myopia progression, or the rate of increase in myopia, refers to children in the clinical study with at least one myopic parent.

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## uncut

> As FJPOD pointed out, MyoVision reduces myopia by manipulating the peripheral retinal image. Conventional lenses are generally designed to focus of light on the central retina for different angles of view. Recent research suggests that the quality of the peripheral retinal image may contribute to the stimulation of continued eye growth or "emmetropization."
> 
> The MyoVision lens design is a highly aspheric and asymmetric single vision lens design. Essentially, the lens attempts to improve the focus of the retinal image not only at the fovea but also away from the fovea, at least through the central region of the spectacle lens. In theory, this should reduce the stimulus to continued emmetropization.
> 
> The 30% reduction in myopia progression, or the rate of increase in myopia, refers to children in the clinical study with at least one myopic parent.


And this lens is available in Canada/U.S.A. and is known as...........?????

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## Darryl Meister

It is not currently available in Canada or the USA. We have not confirmed a launch date for this region yet.

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## LandLord

Interesting.  If I were a parent interested in the amount of my child's myopia, would I not prefer Ortho K, which has also been said to control myopic progression, while temporarily correcting it?

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## Darryl Meister

> Interesting. If I were a parent interested in the amount of my child's myopia, would I not prefer Ortho K, which has also been said to control myopic progression, while temporarily correcting it?


I suspect that the spectacle lens market for 6- to 12-year-olds is at least as large as the market for rigid contact lenses for that age group. I suspect that the question, which is probably fairly easy for a parent to answer, becomes: "Why use a regular spectacle lens for your child when you could buy a spectacle that will reduce your child's potential visual impairment?"

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## drk

If it is true, this lens is all that anyone will want, until age 40. Not that it will be scientifically valid--but patients aren't scientific but emotional, and prescribers won't be in any position to say "no".

Heck, we may get the argument that we were negligent in not recommending them, if someone progresses 1/2 D.

Some good science would be nice.

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## Darryl Meister

> If it is true, this lens is all that anyone will want, until age 40. Not that it will be scientifically valid--but patients aren't scientific but emotional, and prescribers won't be in any position to say "no".


Just keep in mind that the progression of myopia typically stabilizes by age 16 or 17 years. The positive results obtained in the clinical study was for children between the ages of 6 and 12 years with at least one myopic parent (so some genetic component). More studies are underway in collaboration with Vision CRC though.

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## uncut

> the study invoilved Prof Brien Holden conducted in Sun Yat-Sen University China from Oct 2009-Jan 2009.sorry that i don't have much source to provide you. maybe you can try to serach this in some journal. but before this lots study and research on animal done show positive results that when the peripheral image projected in front of retinal it able to slow down or even stop the eye globe gowth. other than that i think fjpod has explain it well.


I'm a bit confused by the timeline you use on this study Oct 2009 to Jan 2009 ????????

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## uncut

> As FJPOD pointed out, MyoVision slows the progression of myopia by manipulating the peripheral retinal image. Conventional lenses are generally designed to focus of light on the central retina for different angles of view. Recent research suggests that the quality of the peripheral retinal image may contribute to the stimulation of continued eye growth or "emmetropization."
> 
> The MyoVision lens design is a highly aspheric and asymmetric single vision lens design. Essentially, the lens attempts to improve the focus of the retinal image not only at the fovea but also away from the fovea, at least through the central region of the spectacle lens. In theory, this should reduce the stimulus to continued emmetropization.
> 
> The 30% reduction in myopia progression, or the rate of increase in myopia, refers to children in the clinical study with at least one myopic parent.


As my little myopic friend, wearing the WW2 helmet, parting the long tall reeds would say...VELLLLY INTERRRRRESTHHHING!!!!!

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## drk

I think you're generally correct on when myopia stabilizes, but I'm specifically talking about consumer demand.  In the clinic, you'd be suprised how many people fret over myopic progression.

(FWIW, I'm officially a doubter of this entire theory of myop-i-genesis.)

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## fjpod

> I think you're generally correct on when myopia stabilizes, but I'm specifically talking about consumer demand. In the clinic, you'd be suprised how many people fret over myopic progression.
> 
> (FWIW, I'm officially a doubter of this entire theory of myop-i-genesis.)


mmm... do some serious reading on this.  It opened my eyes (no pun intended).  This is not the "accomodation at near causing myopia" theory.  This has to do with whether the shape of the eye (as determined by genes) is prolate or oblate.  I forget which is more prone to myopia, but if you are the "wrong" one, you will progress due to the fact that the peripheral retinal image is falling in the wrong place.  The aspheric nature of the lens is not for the purpose of adding plus at near.  It is to put the peripheral retinal image in the right place, thereby reducing the stimulus to myopia.

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## fjpod

> Interesting. If I were a parent interested in the amount of my child's myopia, would I not prefer Ortho K, which has also been said to control myopic progression, while temporarily correcting it?


Many times, myopia will start in children at age 7 or 8.  Most parents would freak out at a doctors recommendation to use CLs at this age...let alone a HARD lens.

Also, in my mind, OrthoK does not get at the root cause of the myopic progression.  And while it may seem to work well while the patient is in lenses, they usually lose most of the effect if wear is stopped.  So, it's not a panacea.

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## Yeap

@ uncut: the time line is Oct 2007-jan 2009..sorry my mistake.

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## Yeap

If not compare either ortho k or Myovision can achieve a better result. i will think that now we have another option for our patient that concern about their myope progression. as Darryl mentioned it has been study through 6-12 years old kids but i really curious how the outcome if i fit it to some 15 -18 years old teens, as in Asia the myope progression is at the level that worries the practitioner.

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## Darryl Meister

Children through 16 years of age were included in the study but they experienced less of a benefit than the younger children. As did children with no myopic parents.

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## rbaker

Just wondering if anyone can cite any peer reviewed articles on this interesting topic?

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## Darryl Meister

I have a few that I can dig up tomorrow.

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## uncut

> I'm a bit confused by the timeline you use on this study Oct 2009 to Jan 2009 ????????


A *grand conclusion* for such a short timeline in a developing child's life, don't you think?

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## snotbagel

Depending on the OD's perspective, parents these days can be very receptive to passive fixes to their kids problems. WE know that moderate myopia is much more prevalent than in pre-industrial populations. The average amount is just about our regular reading distance..does anyone see smoke yet?
Tearing the kids away from their Ipods, etc, is too much trouble, however..lets just fix em up after with expensive eyewear!..Yeah..big bucks for me!

I know, I'm being sarcastic,..but also a bit truthful..

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## fjpod

I found this related to the topic
http://vimeo.com/10917445

If it works, I think this will be almost as big as progressive lenses are to the industry.

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## rdcoach5

Darryl, do you have links to any studies on this?

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## icare

> Just wondering if anyone can cite any peer reviewed articles on this interesting topic?


Ditto

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## Darryl Meister

I'll see if I can post something later this weekend.

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## manoj_verma

INTERESTING !
requisitng to mr DARRYL......would it be possible to get this lens in MIDDLE EAST ?

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## Chris Ryser

*Vision Therapy*
Like Bates, "Vision therapists" claim to strengthen eyesight through a series of exercises. In contrast to Bates' use of relaxation, vision therapists promote active exercises. They emphasize exercising focusing, eye pointing and eye movement skills. Exercises may include eye-hand coordination drills, watching a series of blinking lights, staring at colored lights (Syntonics), bouncing on a trampoline and even sleeping in a certain position. Often they prescribe bifocal and prism glasses to prevent or cure nearsightedness. In addition to promising to eliminate glasses, they claim that these methods can also improve school and athletic performance, increase I.Q., help overcome learning problems and attention disorders and even prevent juvenile delinquency. However, no scientific evidence supports such claims [2-4].
In 2009, the United Kingdom's College of Optometrists evaluated ten types of controversial eye-related programs claimed to improve visual, mental, neurological, and behavioral problems: (a) vision therapy for accommodation/convergence disorders; (b) vision therapy for dyslexia and other forms of academic underachievement; (c) prisms for near binocular disorders and for producing postural change; (d) near point stress and low-plus prescriptions; (e) use of low-plus lenses for close work to slow the progression of myopia; (f) exercises to reduce myopia; (g) behavioral approaches to treating strabismus and amblyopia; (h) training central and peripheral awareness and syntonics; (i) sports vision therapy; and (j) neurorehabilitation after trauma/stroke. The reviewers concluded:
There is a continued paucity of controlled trials in the literature to support behavioural optometry approaches. Although there are areas where the available evidence is consistent with claims made by behavioural optometrists (most notably in relation to the treatment of convergence insufficiency, the use of yoked prisms in neurological patients, and in vision rehabilitation after brain disease/injury), a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated [5].There is a proven segment of vision therapy known as orthoptics which can help with symptoms of visual strain or fatigue in individuals with mild eye coordination or focus problems (including conversion insufficienty), double vision, or even strabismus ("crossed" or turned eyes) and amblyopia ("lazy eye") [6-9]. Many optometrists, ophthalmologists, and Certified Orthoptists offer orthoptic diagnostic and treatment services.

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## rdcoach5

We are still waiting on a peer reviewed study on Myovision. Maybe there isn't one. Just you Tube?

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## icare

> *Vision Therapy*
> Like Bates, "Vision therapists" claim to strengthen eyesight through a series of exercises. In contrast to Bates' use of relaxation, vision therapists promote active exercises. They emphasize exercising focusing, eye pointing and eye movement skills. Exercises may include eye-hand coordination drills, watching a series of blinking lights, staring at colored lights (Syntonics), bouncing on a trampoline and even sleeping in a certain position. Often they prescribe bifocal and prism glasses to prevent or cure nearsightedness. In addition to promising to eliminate glasses, they claim that these methods can also improve school and athletic performance, increase I.Q., help overcome learning problems and attention disorders and even prevent juvenile delinquency. However, no scientific evidence supports such claims [2-4].
> In 2009, the United Kingdom's College of Optometrists evaluated ten types of controversial eye-related programs claimed to improve visual, mental, neurological, and behavioral problems: (a) vision therapy for accommodation/convergence disorders; (b) vision therapy for dyslexia and other forms of academic underachievement; (c) prisms for near binocular disorders and for producing postural change; (d) near point stress and low-plus prescriptions; (e) use of low-plus lenses for close work to slow the progression of myopia; (f) exercises to reduce myopia; (g) behavioral approaches to treating strabismus and amblyopia; (h) training central and peripheral awareness and syntonics; (i) sports vision therapy; and (j) neurorehabilitation after trauma/stroke. The reviewers concluded:There is a continued paucity of controlled trials in the literature to support behavioural optometry approaches. Although there are areas where the available evidence is consistent with claims made by behavioural optometrists (most notably in relation to the treatment of convergence insufficiency, the use of yoked prisms in neurological patients, and in vision rehabilitation after brain disease/injury), a large majority of behavioural management approaches are not evidence-based, and thus cannot be advocated [5].There is a proven segment of vision therapy known as orthoptics which can help with symptoms of visual strain or fatigue in individuals with mild eye coordination or focus problems (including conversion insufficienty), double vision, or even strabismus ("crossed" or turned eyes) and amblyopia ("lazy eye") [6-9]. Many optometrists, ophthalmologists, and Certified Orthoptists offer orthoptic diagnostic and treatment services.


Not sure if this thread has just been hijacked or not......:hammer:

To clarify, it might be best to include that vision therapy and orthoptics are terms that are often used interchangeably.  There is a wide body of literature supporting the benefits of vision therapy, but many readers conclude that those techniques are similar if not identical to those used in orthoptic training.

OMD's like the term orthoptics.  ODs like the term vision therapy.  Tomayto/Tomahto.  I hope the readers don't get the sense that vision therapy is voodoo eye care.  That would be unfair to those that have proven gains from visual training.

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## uncut

> We are still waiting on a peer reviewed study on Myovision. Maybe there isn't one. Just you Tube?


It it highly likely that some "palm grease" is required in order to obtain such a study?

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## Win C

> I'll see if I can post something later this weekend.


Brien Holden and Co has done a study on 200+ children in China using Myovision. How come they did not publish their findings in scientific publications?

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## rdcoach5

Maybe it was not a good scientific study that would hold up to review?

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## allanon

Speaking of Zeiss... I understand they're going to cause a bit of a stir tomorrow

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## rdcoach5

OK what's the news with Zeiss?

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## finefocus

OK, this thread now has been hijacked.
Back to the original topic: Isn't it true that the progression of myopia is due to changes in corneal curvature and/or globe size, both related to growth? Is the conformation of the eye finalized before puberty? Doesn't the eye continue to change until adulthood? Am I wrong, or do kids' eyes seem to change most dramatically during growth spurts, like when they grow 15 inches over a summer? How can eyeglasses deal with that?  I'm confused; possibly simply incorrect, but confused.

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## Darryl Meister

> Just wondering if anyone can cite any peer reviewed articles on this interesting topic?


The abstract of the Vision CRC study for MyoVision lenses has been published online on ARVO's website at *Progression of Myopia With Spectacle Lenses Designed to Reduce Relative Peripheral Hyperopia: 12 Months Results*. A paper has also been submitted to and accepted by Optometry and Vision Science, although it has not been published yet, so keep an eye out for it.

The study included 210 Chinese children aged 6 to 16 years, and ran from 2007 to 2008.

Another interesting article on the subject of the shape of the myopic eye and the potential mechanisms behind the development of myopia is *Homeostasis of Eye Growth and the Question of Myopia*.

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## uncut

> The abstract of the Vision CRC study for MyoVision lenses has been published online on ARVO's website at *Progression of Myopia With Spectacle Lenses Designed to Reduce Relative Peripheral Hyperopia: 12 Months Results*. A paper has also been submitted to and accepted by Optometry and Vision Science, although it has not been published yet, so keep an eye out for it.
> 
> The study included 210 Chinese children aged 6 to 16 years, and ran from 2007 to 2008.
> 
> Another interesting article on the subject of the shape of the myopic eye and the potential mechanisms behind the development of myopia is *Homeostasis of Eye Growth and the Question of Myopia*.


O.K. So now we have at least a link to "an abstract".   Thank you Darryl!.........................now.........................  how about a little teensyweensy hint about this glorious lens design?????   Since it is from Zeiss, I assume you have some information about what makes this lens so special.

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## uncut

Is anybody else finding this a painful process of information extraction?    Something like a root canal?   :bbg

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## Darryl Meister

> how about a little teensyweensy hint about this glorious lens design?????


I actually explained the lens design back in *Post #14*. It is essentially a highly aspheric lens single vision lens that corrects the relative hyperopia in the peripheral retinal of the myopic eye.

The lens design is a bit more complex than that, with some degree of asymmetry, but this is probably the easiest way to think of it.




> Is anybody else finding this a painful process of information extraction? Something like a root canal?


Keep in mind that that the product was only recently launched in Asia-Pacific. The product hasn't actually launched in the US, and will not be launching here anytime soon, so I, personally, wouldn't normally have as much information regarding the product readily available.

Also, much of the information regarding the clinical study that you are requesting has only recently been submitted for publication. Until it has been published, there isn't a lot to share with you regarding the actual study, beyond the abstracts.

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## braheem24

> O.K. So now we have at least a link to "an abstract". Thank you Darryl!.........................now.........................  how about a little teensyweensy hint about this glorious lens design????? Since it is from Zeiss, I assume you have some information about what makes this lens so special.


 8:14 est




> Is anybody else finding this a painful process of information extraction? Something like a root canal? :bbg


 8:50 est

Considering Darryl is arguably the biggest contributor on the board, I personaly would have given him at least 40 minutes.

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## Darryl Meister

> Considering Darryl is arguably the biggest contributor on the board, I personaly would have given him at least 40 minutes.


It _is_ a Sunday, after all. ;)

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## uncut

> 8:14 est
> 
> 8:50 est
> 
> Considering Darryl is arguably the biggest contributor on the board, I personaly would have given him at least 40 minutes.


Reread post # 30 and 36.

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## Darryl Meister

> Reread post # 30 and 36


Unfortunately, I learned since then that the OVS paper hadn't actually been published yet, just submitted and accepted. Everything else that is already in the public domain, you have just as much access to as I do. I use Google, myself.

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## allanon

> OK, this thread now has been hijacked.


Hijacked my own thread.. ouch.

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