Friday, May 16, 2008

Effectiveness of optometric vision therapy.

One hundred consecutive optometric vision therapy patients' records were evaluated to determine what changes occurred in the visual processing system. An ordinal visual performance scale was utilized to rate visual functioning on a one hundred point scale. The scale divides the visual processing system into 10 functions of 10 points each. Each of the 10 functions improved at the .001 level of significance as a consequence of the binocular vision therapy treatment program...

Comments: I know that this blog is dedicated to the latest research...but it is important to recognize that vision therapy has had research to support it for some time. Even in 1978 we knew vision therapy could change visual performance. DM

http://www.ncbi.nlm.nih.gov/pubmed/17186259?ordinalpos=17&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

...We conclude that vergence deficits are frequently present in dyslexics, and that dyslexics should be re-educated; training should address distinctively convergence and divergence subsystems.

Rehabilitation and management of pseudophakic amblyopia in cases of unilateral congenital cataract by active vision therapy.

We studied the benefit of active vision therapy in 910 pseudophakic amblyopic children and young adults suffering from unilateral congenital cataract. It was concluded that noninvasive active vision therapy helps improve visual acuity in the majority of subjects.....

Poor binocular coordination of saccades in dyslexic children.

...Poor quality of binocular coordination of saccades and drift of the eyes after the saccade.... indicates an intrinsic ocular motor deficiency. Such a deficiency could be related to immaturity of the normal ocular motor learning mechanisms via which ocular motor coordination and stable fixation are achieved. Learning could be based on the interaction between the saccade and vergence subsystems. The cerebellum, but also cortical areas of the magnocellular stream such as the parietal cortex, could be the sites of ocular motor learning.

Vision therapy for oculomotor dysfunctions in acquired brain injury: a retrospective analysis.

...Nearly all patients ...exhibited either complete or marked reduction in their oculomotor-based symptoms and improvement in related clinical signs, with maintenance of the symptom reduction and sign improvements at the 2- to 3-month follow-up. These findings show the efficacy of optometric vision therapy for a range of oculomotor abnormalities in the primarily adult, mild brain-injured population. Furthermore, it shows considerable residual neural plasticity despite the presence of documented brain injury.

Refractive errors and binocular dysfunctions in a population of university students.

...High near visual demand could be the most important factor for higher incidence of myopia, worse convergence and fusion amplitude, higher degree of exophoria, and worse results in Titmus test in the student population....

Ophthalmological examination and VEPs in preterm children with perinatal CNS involvement

...These observations suggest that the magnocellular system/dorsal stream of the visual pathway (which is particularly activated in response to motion stimuli) may be more frequently affected in preterm children than the parvocellular system/ventral stream (tested mostly by the standard pattern-reversal VEPs). ...

Few physicians communicate with patients via email.

From AOA First Look...

Forbes (5/16, Van Dusen) reports that a "new Deloitte Center for Health Solutions online survey of more than 3,000 adults shows that nearly 80 percent of healthcare consumers would like to be able to email with their physicians." Moreover, "23 percent said they'd be willing to pay for it." But, physicians, "for a variety of reasons, have been slow to embrace use of the Web and email in their practices." Just "one-third of the more than 1,300 physicians surveyed by healthcare market research firm Manhattan Research said they used email to communicate with patients in the first quarter of 2007." Some cite financial and privacy concerns. For instance, "setting up and maintaining a secure email system can cost thousands of dollars, and costs of most email between physicians and patients...[are] still not reimbursed by insurance providers." Nevertheless, for patients who can communication with their physicians via email, it is worth noting that "some doctors...use free Gmail or Yahoo! Accounts," which may not be secure.

Comments: I give most of my patients my email address. Very few abuse this great communication tool and it allows me to email reports and answer questions when I'm available to do so. Of course a phone call or face to face visit is sometimes required as well. DM

Newborn Hearing Screening Important for Development

...Each year in the United States, as many as 12,000 babies are born with a hearing loss. The cause of hearing loss for many babies is not known, and hearing loss can go unnoticed for years. It is important to identify hearing loss early. Early identification allows families to make decisions about their child's care that can affect speech, language, and social develollpment...

Comments: All babies should have a complete assessment of hearing, vision, etc. That is why it so important that if you are not signed up for the AOA's InfantSee program you do so today....and when you see that little one in our office...mention a hearing screening may not be a bad idea either! DM

Green tea may benefit those suffering from sleep apnea

...the drop in oxygen levels and inflammation associated with apnea can lead to the death of brain cells over time. He said the study showed that drinking six to 10 cups of green tea a day can help combat this decline....

Comments: The only problem with this is that you'd be waking up every 2 hours in the middle of the night to go to the bathroom! So much for getting a good nights sleep!! DM

Memory loss: When to seek help

...With kids, work, bills and other obligations, it's hard to stay focused. If you feel like you're forgetting a lot of things experts say you are not alone. ....

Brain Food

...studies suggest that eating Mediterranean lowers blood pressure, reduces inflammation in the body, and protects against chronic conditions ranging from cancer to stroke...

Thursday, May 15, 2008

FAQ: Vaccine Court Hears Autism Cases

What's Really Going On in the Autism-Vaccines Lawsuits
Contrary to media reports, a U.S. court has not yet issued any decisions on whether vaccines cause autism.

Lower Stress Responses After Newborn Individualized Developmental Care and Assessment Program Care During Eye Screening Examinations for Retinopathy o

A Newborn Individualized Developmental Care and Assessment Program-based intervention during eye examination does not decrease pain responses but results in faster recovery, as measured by lower salivary cortisol 60 minutes after the examination. The differences were seen despite the influence from the Newborn Individualized Developmental Care and Assessment Program intervention on the standard care treatment that occurred during the study period.

Reduction of Congenital Nystagmus in a Patient after Smoking Cannabis

Cannabis may be beneficial in the treatment of congenital idiopathic nystagmus (CIN). Further research to clarify the safety and efficacy of cannabis in patients with CIN, administered for example by capsules or spray, would be important.

Teens reach linguistic peak in online chat

LOL, OMG and TTYL: parents and teachers worry that teenagers’ use of these and other forms of online shorthand is harming their language skills. Perhaps they will take comfort from a study suggesting that instant messaging (IM) actually represents “an expansive new linguistic renaissance”.

Comments: The "new English"? Idon't think so....before you can master a new language, you should master your current one. Open minded....but VERY skeptical! DM

Wednesday, May 14, 2008

Increasing number of athletes now undergo LASIK.

From AOA First Look...

The Washington Times (5/13, Cohn) reported that "[a]mid the constant quest to achieve an edge, often by any means necessary,...a growing number of athletes" now undergo laser-assisted in situ keratomileusis (LASIK) "surgery, which usually takes 10 to 15 minutes, and involves the reshaping of the inner corneal layer." Golfer Tiger Woods, "who became the foremost pitchman for LASIK after his surgery...in 1999, is the most famous," but "there are many others in all sports." Even though LASIK "surgeries have declined from 1.4 million in 2000 to 800,000 last year," because of the faltering economy, the "association with sports keeps growing." Now, some LASIK "clinics not only proudly advertise their work with athletes," but they also "have become affiliated with professional sports teams." Indeed, "[s]ome team vision specialists urge their players to have LASIK surgery, usually when contacts are not the answer." Still, "[w]hen assessing the effect of LASIK surgery, the athlete's age, skill level, and the sport they play must be considered." And, LASIK "has its limits." The surgery will not replace practice, technique, talent, or athletic aptitude.

Comments: Refractive surgery can cause binocular vision dysfunction. I've worked with XTs & ETs....those having surgery done should have a complete BV evaluation as well. Also...watch out for that dry eye!

Study indicates multifaceted rehabilitation program may improve visual reading ability for patients with macular disease.

From AOA First Look..

MedPage Today (5/13, Bankhead) reported that "[l]ow-vision troubles for patients with macular disease can be eased significantly by a 10-hour multifaceted rehabilitation program," according to a study published in the May issue of the journal Archives of Ophthalmology. In a "four-month controlled...trial," Joan A. Stelmack, O.D., of the Hines VA Hospital, and colleagues, followed "126 patients with low vision, defined as worse than 20/100, but better than 20/500 in the better eye." The participants, "whose mean age was almost 80, were randomized to five weekly sessions at low-vision clinics to learn strategies for effective use of remaining vision, and how to use assistive devices." Each participant "in the treatment group was assigned five hours of homework between sessions to practice use of assistive devices," such as "reading glasses, a monocular telescope, pocket magnifiers, and filters for glare control," in "perform[ing] routine daily activities." The researchers found that for the outcomes of visual "reading ability, mobility, information processing, and motor behavior," the "treatment group demonstrated improvement, and the control group had vision loss."

Comments: Dr. Joan Stelmack is an ICO grad and an awesome doc! Congrats to Joan and all her VA colleagues.

New MRI Technique Detects Subtle Brain Injuries

A new way of analyzing MRI data can detect a subtle but serious kind of brain injury and help determine how a patient may recover, ... This kind of injury, called diffuse axonal injury (DAI), occurs when the head suddenly stops moving, such as during a motor vehicle crash, and axons are damaged or deformed. Axons are long, thin extensions that reach from one area to another....

Tuesday, May 13, 2008

Vision Screening vs Comprehensive Eye Examination

This video tells us why all children should have a comprehensive eye examination. Check out the Vision First Foundation for more information as well. Click the title above to see the video. DM

BTW Illinois recently passed a mandatory eye examination law so that all Kindergarteners must have an eye examination!

Got a baby.....turn off the *%&*& TV!

Parent-Infant Verbal Interactions Adversely Affected By TV...Infants who are exposed to television and video in low socio-economic households tend to have limited verbal interactions with their mothers...

Comments: Children need the real world so that they can interact with it in an appropriate manner....mom....turn off the TV....pay attention to your child. It will do you both good! DM

Falls A Leading Cause Of Injury-Related Emergency Department Visits For Infants Each Year

...Half of the estimated 328,500 infants 12 months of age or younger who were treated for injuries in hospital emergency departments each year from 2001 to 2004 were injured as a result of a fall...

Comments: Many of these children should have a comprehensive eye examination to rule out any resultant ocular problems because of the fall. DM

Preemies Need Protein In First Days Of Life

...Researchers at Nationwide Children's Hospital studied hundreds of preemies for more than three years, and found that giving them an IV of amino acids, the building blocks of protein, dramatically improved their weight. The problem is, with all the other issues facing these babies, some doctors put nutrition on the back burner, giving them only sugar water in the first hours after they're born. ...

Manganese And Children's Brain Development

...Evidence is slowly building that manganese in air, water and even soy-based formula can sometimes accumulate to toxic levels in children. There are no federal health standards for manganese exposure, in part because data are only beginning to emerge on its effects. Occupational exposure has long been known to be neurotoxic, producing behavior changes, memory loss and a Parkinson-like syndrome. ...

Groundbreaking International Effort Begins Search For Causes Of Autism

...The Simons Simplex Collection (SSC) is a coordinated effort to create a database of genetic and behavioral information about cases where there is only one family member with autism. This group, which represents the great majority of autism spectrum disorders, Is expected to lead to the discovery of new genetic factors that increase the risk of autism. ...

New Analysis In Boys And Girls Shows The ADHD Patch, DAYTRANA(TM) Improved Attention

....On the CGI-I scale, clinicians rated 83 percent of boys and girls "improved" or "very much improved" at the end of the study compared to week one. Additionally, the PGA rating scale showed that 78 percent of boys and girls "improved" or "very much improved" at the end of the study compared to week one. The results in both the CGI-I and PGA scale were comparable between boys and girls.....

FDA Approves Strattera(R) For Maintenance Of ADHD In Children And Adolescents

Eli Lilly and Company (NYSE: LLY) announced that the United States Food and Drug Administration (FDA) has approved Strattera(R) (atomoxetine HCI) for maintenance treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. Strattera, a selective norepinephrine reuptake inhibitor, is the first FDA-approved non-stimulant to treat ADHD in children, adolescents and adults.

Pfizer Programs that help Families Pay for Medicines

You may have to register on their website before you can find out more about these programs.

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Pfizer Pfriends® view details
Savings on branded Pfizer medicines at the pharmacy
88 branded Pfizer medicines
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MRI Innovation Allows Detection of Subtle Traumatic Brain Injuries

...Tracking progress and predicting outcomes after severe traumatic brain injury may be possible with an innovative MRI-based technique,....Called diffusion tensor tractography, the method offers an improved way to measure multifocal nerve damage within the brain after severe head trauma, ....

Comments: Tracking progress of therapy programs and offering some predictive ability as to outcomes is welcome when it comes to working with those with traumatic brain injury. I'm curious to see who will take advantage of this technology and the costs involved. DM

Survey indicates young people may consider children with glasses more intelligent.

From AOA First Look...

ScienceDaily (5/12) reported that "[y]oung children tend to think that other kids with glasses look smarter than kids who don't wear glasses," according to a new survey. Lead author Jeffrey Walline, O.D., assistant professor of optometry at Ohio State University, and colleagues, "assembled a series of 24 pairs of pictures of children for comparison." The participants "in each pair differed by gender and ethnicity, and each pair included one child with glasses, and one child without glasses." In all, "42 girls and 38 boys were surveyed." The subjects "were asked which of the two children pictured: would you rather play with; looks smarter; looks better at playing sports; do you think is better looking; looks more shy; and looks more honest?" The researchers found that "two thirds of the participating children said they thought that kids wearing glasses looked smarter than kids not wearing glasses." In addition, "57 percent of the participants said they thought kids with glasses appeared to be more honest. Both kids with and without glasses thought other kids wearing glasses looked smarter."

Comment: I knew it! I've worn glasses for most of my life...and always thought I at least somewhat smart! DM

Study suggests prism glasses may improve vision for patients with hemianopia.

From AOA First Look...

PhysOrg.com (5/12) reported that "[i]nnovative prism glasses can significantly improve the vision and the daily lives of patients with hemianopia, a condition that blinds half the visual field in both eyes," according to a study published in the May issue of the Archives of Ophthalmology. In order to "expand the visual field," Eli Peli, M.D., a Senior Scientist at Schepens Eye Research Institute, and colleagues, "attach[ed] small, specially designed high power prisms on the top and bottom of one spectacle lens." For the study, which "evaluated the glasses' ability to improve a patient's walking mobility," the researchers fitted 43 patients "with prism glasses in 15 community-based clinics around the country." Participants were interviewed "at six weeks and after 12 months." The authors found that "32 participants (74 percent) continued wearing the glasses at week six," and after 12 months, 20 (47 percent) were still donning the spectacles eight hours a day, and rating them as 'very helpful' for obstacle avoidance."

Functional presbyopia in a rural Kenyan population: the unmet presbyopic need

...In low-income regions, there is a high prevalence of uncorrected presbyopia, which is associated with near-vision functional impairment. Provision of spectacles for near vision remains a priority in low-income regions....

Comments: Only recently has the world paid attention to the refractive needs of its population. We tend to forget that a pair of glasses are a medical device that works wonders. DM

APPLIED CONCEPTS IN VISION THERAPY

I just found out that Dr. Len Press' text, Applied Concepts in Vision Therapy is now available from OEP. This is a great book....with a CD! If you do not own a copy....get a copy by clicking the title above. (BTW I have no $$$ interest in the text....it's just a wonderful book!) DM

APPLIED CONCEPTS IN VISION THERAPY with accompanying CD - The OEP Edition by Leonard J. PressAPPLIED CONCEPTS IN VISION THERAPY is a valuable resource that will enhance your practice!• Covers a comprehensive array of topics on vision therapy, all in one place!• Written and edited by 10 experts who have extensive experience incorporating vision therapy concepts successfully into their practices.• Includes an entire section on practice management!• Addresses key issues on reimbursement documentation.• Covers HOT topics such as sports vision and vision rehabilitation!• Includes key terms, clinical pearls and review questions in each chapter--case examples appear throughout the book.• Contains 93 illustrations and photos, 17 in full color!• Unique blend of behavioral optometric care and classical optometric theory.• Clinical approach helps you learn how to apply theoretical concepts to practice.Plus . . . a FREE computer disk is enclosed! Rich Text Format (RTF) files are compatible with most popular IBM and Macintosh word processing systems!Packed full of invaluable techniques and practice management communications, this CD:• Is a great learning tool for both students and practitioners!• Contains letters and forms that typify a cross section of encounters in the practice of vision therapy, including how to handle difficult patients or third parties, and sample letters to referring optometrists.• Lets you modify and print all items for your own use!• Includes an introduction to home vision therapy.• Contains a compendium of vision therapy techniques and sports vision therapy activities, referenced to the material in Section III of the text, and listed alphabetically for easy access.• Includes many therapy techniques that are original and updated! Softbound, 404 pages.
Price: $95.00

Monday, May 12, 2008

Early detection key to correcting amblyopia in children

...Joanna Klee of Appleton never imagined her daughter would be diagnosed with amblyopia, a vision problem commonly known as lazy eye....And yet, she is thankful her doctor caught it early enough so that Kristen, 5, could be treated before the condition got worse....Dr. Amy Lahay, an optometrist ....."The best chance of correcting amblyopia is well before the age of 6," she said, noting that if parents prolong testing and treatment, "it usually takes a lot longer to get the improvement, and we might not get as much improvement as if we would have found it at a younger age."...

Comments: Dr. Lahay is certainly correct about catching amblyopia early. But as we've stated repeatedly on this blog...you CAN treat amblyopia at any age!! Nice job Dr. Lahay. (BTW I'm only a bit biased since Dr. Lahay is an ICO graduate!!)

Allergery Season

Over the past couple of weeks I've seen many children and adults with allergies. I should own stock in Pataday....alas I do not (well, maybe in one of my mutual funds!).

Note the links below for information your patients might be able to use this time of year!

National Institute of Environmental Sciences NIH
http://www.niehs.nih.gov/health/topics/conditions/asthma/pollen.cfm

American Academy of Allergy
http://www.aaaai.org/nab/index.cfm?p=pollen

American Lung Association
http://www.lungusa.org/site/apps/s/content.asp?c=dvLUK9O0E&b=4061173&ct=67446

No jabs, no school

...Public confidence in vaccination, and in MMR particularly, fell after research raised the possibility that the jab may be linked to an increased risk of autism. The research has since been debunked, and a string of studies have concluded that the triple vaccine - which protects against rubella and mumps as well as measles - is perfectly safe. Public confidence in vaccination, and in MMR particularly, fell after research raised the possibility that the jab may be linked to an increased risk of autism. ...The research has since been debunked, and a string of studies have concluded that the triple vaccine - which protects against rubella and mumps as well as measles - is perfectly safe. ....

Comments: This is an article about problems they are having getting children in for their vaccinations. Protect your child. Have them vaccinated appropriately. DM

About 40,000 Americans suffer sports-related eye injuries each year.

From AOA First Look...

HealthDay (5/10, Preidt) reported that in the U.S. each year, approximately "40,000 people suffer sports-related eye injuries," including "corneal abrasions, eyelid bruising, retinal detachment, and internal bleeding," which can lead to loss of vision, infection, and even "an increased risk of developing glaucoma." Therefore, doctors "recommend that all athletes wear appropriate, sports-specific eye protection properly fitted by an eye-care professional." The "highest level of impact protection" is offered by "[l]enses made from polycarbonate materials," which "can withstand the force of a ball or other projectile traveling at 90 miles per hour." Eye protection is particularly important for children. Parents should ensure that "their children wear eye protection," because "eye protection isn't mandatory in most children's sports leagues." Finally, if the worst should happen, and a "person does suffer an eye injury, it's important to seek immediate medical help. Even a seemingly minor impact can cause serious injury." People who experience "a black eye, pain, or visual problem occur[ring] after an eye has been hit, [should] contact an eye doctor, or seek emergency medical help" as soon as possible.