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July 14, 1989

To Best Was Always to Worst, but Worse Is Better, if Good and Bad Are Relevant

JAMA. 1989;262(2):210. doi:10.1001/jama.1989.03430020052023

To the Editor.—  In the March 24/31 issue of JAMA, there is an article entitled "Cryotherapy in Infants With Retinopathy of Prematurity" and subtitled "A Decision Model for Treating One or Both Eyes [italics added]."1 I gather that the only newborns studied were those who had two eyes, the normal situation. The article goes on to explain that "this study includes four possible choices: treat no eyes, treat the worst eye [italics added], treat the best eye [italics added], or treat both eyes." The decision tree on page 1752 includes the following treatment possibilities: "Treat Worst Eye" and "Treat Best Eye."I believe that a newborn with two eyes can have a worse eye (as opposed to a worst eye), and a better eye (as opposed to a best eye). One would need three or more eyes to have a "worst eye" or a "best eye."