Friday, October 17, 2008

Sutured protective occluder for severe amblyopia.

Comments: Some of our ophthalmology colleagues have criticized those of us who do optometric vision therapy....during today's presentation by Dr. Mitch Schiemann, while disscussing the current clinical trials supporting optometric vision therapy...mentioned an article where the researcher SUTURED a PATCH onto a child's EYE to treat amblyopia!!! Yes, you read that correctly!! Ah...it is definitely time for us to strongly recommend to our OMD colleages that they DO NOT do this....there are other approaches that work better!! Shame on you...and shame on the journal that printed this article! You should be tried in the world court of REAL STUPID treatments for amblyopia and sentenced to have a sign sutured on your forehead that says..."I'm the researcher who did something really stupid, dangerous, and...did I mention, really stupid, to my patients." Is there a personal injury lawyer in the hourse? (See below) DM

Their conclusion was, Sew-on occluder shields are an alternative when adherence to the use of other types of patching (often referred to as compliance with patching) is not satisfactory.

Senate Passes Prenatally and Postnatally Diagnosed Conditions Awareness Act

Senate Passes Prenatally and Postnatally Diagnosed Conditions Awareness Act
Yesterday, the Senate passed the Prenatally and Postnatally Diagnosed Conditions Awareness Act (S. 1810) by unanimous consent. The bill seeks to increase provision of scientifically sound information and support services to patients receiving a positive test results for Down syndrome and/or other diagnosed conditions, whether prenatally or postnatally. The bill would also set up a registry of parents who are willing to adopt babies with disabilities.
The Senate bill enjoyed the joint-backing of Senators Kennedy (D-MA) and Brownback (R-KS), who take stand on opposite sides of the abortion debate. Senator John McCain was also a co-sponsor of the Senate bill, having joined as a co-sponsor shortly after announcing Governor Sarah Palin, whose son has Down syndrome, as his vice presidential running mate.
The Senate bill now heads to the House for consideration. Although Congress was scheduled to recess at the end of the week, many suspect an announcement may soon be made that Congress will remain in session past this weekend.

Memory Improves If Neurons Are New

...The birth of new neurons (neurogenesis) does not end completely during development but continues throughout all life in two areas of the adult nervous system, i.e. subventricular zone and hippocampus. Recent research has shown that hippocampal neurogenesis is crucial for memory formation. These studies, however, have not yet clarified how the newborn neurons are integrated in the existing circuits and thus contribute to new memories formation and to the maintenance of old ones....

Thursday, October 16, 2008

Gene Hunt In Dyslexia

...Scool? Skuul? Or perhaps shcool? The beginning is a delicate time especially in reading and writing. Twisted letters or other beginner´s mistakes disappear quite fast as learning progresses. Nevertheless about four percent of German schoolchildren struggle very hard with written words. What is the cause for such a reading and writing disorder called dyslexia? "Dyslexia is not a matter of low intelligence. It is mainly caused genetically, as twin-studies have shown," explains Arndt Wilcke, scientist at the Fraunhofer Institute for Cell Therapy and Immunology (IZI) in Leipzig. Relief could be rendered by a special support for affected children: the German free state of Saxony, for example, maintains classes for dyslexics, beginning with third grade of elementary education. Usually, the disorder is not noticed before the children learn to read and to write at the age of six to eight, but the largest part of speech development is already completed by this time. An accepted thesis is: the earlier a disposition to dyslexia is detected, the better are chances of success for remedial therapy. Supported at kindergarten age, most predisposed children learn reading and writing quite successfully....

Blindsight: How brain sees what you do not see

Blindsight is a phenomenon in which patients with damage in the primary visual cortex of the brain can tell where an object is although they claim they cannot see it. A research team led by Prof. Tadashi Isa and Dr. Masatoshi Yoshida of the National Institute for Physiological Sciences, Japan, provides compelling evidence that blindsight occurs because visual information is conveyed bypassing the primary visual cortex. Japan Science and Technology Agency supported this study. The team reports their finding in the Journal of Neuroscience on Oct 15, 2008.

Research shows a walk in the park improves attention in children with ADHD

...For children with Attention Deficit Hyperactivity Disorder (ADHD) tasks that require concentration such as doing homework or taking a test can be very difficult. A simple, inexpensive remedy may be a "dose of nature." A study conducted at the University of Illinois shows that children with ADHD demonstrate greater attention after a 20-minute walk in a park than after a similar walk in a downtown area or a residential neighborhood....

New Research Gives Hope to Children with Common Reading-Related Vision Disorder

On Monday, the National Institute of Health released a study showing that there is a more
effective treatment for children who have a common reading-related vision disorder.
Convergence insufficiency (CI) is an eye condition which leads to some or all of the following:
loss of concentration, slow reading, eye strain, headaches, blurred or double vision and
ultimately impacts learning.


CI, a common childhood eye muscle coordination problem, is often missed in many routine
vision screenings because these screenings test distance vision, not the visual skills required for reading. For this reason many children can be misdiagnosed with learning disabilities when, in fact, they have a treatable eye condition.


The NIH study was a collaborative study with both optometrists and ophthalmologists involved in 9 sites throughout the United States. The study included 221 children ages 9 to 17 and compared different forms of treatment, including the most commonly prescribed “pencil pushups” in addition to a placebo therapy activity. After 12 weeks of treatment, nearly 75 percent of the children that were given office-based Vision Therapy along with at-home reinforcement exercises achieved normal vision or had significantly fewer symptoms of CI. While there have been hundreds of optometric studies over the years, this is the first scientific study to look at these treatment protocols.

It also found that two commonly prescribed home-based therapy programs were no more
effective than placebo treatment. Office-based Vision Therapy is provided by trained Vision
Therapists who traditionally work in optometric offices under the direction of an optometrist.
“This study shows that, once diagnosed, CI can be successfully treated with office-based vision therapy by a trained therapist along with at-home reinforcement. This is very encouraging news for parents, educators, and anyone who may know a child with CI,” said principle investigator Mitchell Scheiman, O.D., of Pennsylvania College of Optometry at Salus University.


Pamela Happ, Executive Director of the College of Optometrists in Vision Development (an
international non-profit membership association of eye care professionals devoted to
developmental vision care and vision therapy), is elated with the study results. “Many eye care professionals, as well as parents, doubted which treatment options for convergence insufficiency were effective. Now this definitive, double blind, masked, placebo-controlled study demonstrates conclusively that in-office vision therapy by trained professionals is the most effective solution.”
She now hopes many more eye doctors will either refer patients who have CI to optometrists who provide vision therapy or get the education necessary to provide vision therapy in their offices.

Vision therapy is an advanced optometric specialty service that has been in existence for over 70 years. All optometrists learn about vision therapy in optometry school, but most optometrists who provide vision therapy receive post graduate education in the subject.

This study is particularly important because it showed that treatment can significantly
reduce symptoms when a child reads which may impact on reading performance.
“We found decreases in the frequency and severity of symptoms that might make
schoolwork more difficult. Parents reported that they saw a significant decrease in their
child having difficulty completing schoolwork at school or at home, appearing inattentive
or easily distracted when completing schoolwork, and avoiding schoolwork. In addition,
parents reported that they worried less about their child’s school performance,” added
Scheiman.


When a child struggles with reading and learning it costs their parents dearly in terms of time,
money and frustration. In addition, there are significant costs to the schools that inadvertently misdiagnose this problem.


When a vision problem is at the root of a child’s difficulties, the symptoms can be easily
detected, if you know what to look for. For an in-depth symptom checklist, more information on vision problems that block learning, or to find a doctor who provides vision therapy, go to:
www.visionforlearning.org.

Or if you are in the Chicagolandland area contact http://www.nw.optometry.net/ for additional information from Dr. Dominick Maino...

About COVD
The College of Optometrists in Vision Development (COVD) is an international, non-profit
optometric membership organization that provides education, evaluation and board certification programs in behavioral and developmental vision care, optometric vision therapy and vision rehabilitation. The organization is comprised of doctors of optometry, vision therapists and other vision specialists. For more information on convergence insufficiency, learning-related vision problems, vision therapy, COVD and our open access journal, Optometry & Vision Development,
Edited by Dr. Dominick M. Maino....please visit www.covd.org.

Monday, October 13, 2008

More Effective Treatment Identified for Common Childhood Vision Disorder

The first scientific study to show that office based Optometric Vision Therapy coupled with home OVT has a clearly superior outcome to "home only" OVT

The first scientific study to show that office based Optometric Vision Therapy coupled with home OVT has a clearly superior outcome to "home alone" OVT.Scientists have found a more effective treatment for a common childhood eye muscle coordination problem called convergence insufficiency (CI). For words on a page to appear in focus a child's eyes must turn inward, or converge. In CI, the eyes do not converge easily, and as a result, additional muscular effort must be used to make the eyes turn in.While the majority of eye care professionals treat children diagnosed with CI using some form of home-based therapy, a new study concludes that office-based treatment by a trained therapist along with at-home reinforcement is more effective. The research, reported in the Oct.13 issue of Archives of Ophthalmology, was funded by the National Eye Institute (NEI), part of the National Institutes of Health.The 12-week study, known as the Convergence Insufficiency Treatment Trial (CITT), found that approximately 75 percent of those who received in-office therapy by a trained therapist plus at-home treatment reported fewer and less severe symptoms related to reading and other near work. Symptoms of CI include loss of place, loss of concentration, reading slowly, eyestrain, headaches, blurry vision, and double vision."This NEI-funded study compared the effectiveness of treatment options for convergence insufficiency," said Paul A. Sieving, M.D., Ph.D., director of the NEI. "The CITT will provide eye care professionals with the research they need to assist children with this condition."The CITT, which included 221 children age 9 to 17, is the first to compare three forms of vision therapy and a placebo therapy option. The first therapy was the current treatment standard known as home-based pencil push-up therapy, an exercise in which patients visually followed a small letter on a pencil as they moved the pencil closer to the bridge of their nose. The goal was to keep the letter clear and single, and to stop if it appeared double. The second group used home-based pencil push-ups with additional computer vision therapy. The third attended weekly hour-long sessions of office-based vision therapy with a trained therapist and performed at-home reinforcement exercises. The last group was given placebo vision activities designed to simulate office-based therapy.After 12 weeks of treatment, nearly 75 percent of children who were given the office-based vision therapy along with at-home reinforcement achieved normal vision or had significantly fewer symptoms of CI. Only 43 percent of patients who completed home-based therapy alone showed similar results, as did 33 percent of patients who used home-based pencil push-ups plus computer therapy and 35 percent of patients given a placebo office-based therapy."There are no visible signs of this condition; it can only be detected and diagnosed during an eye examination," said principal investigator Mitchell Scheiman, O.D., of Pennsylvania College of Optometry at Salus University near Philadelphia, Pa. "However, as this study shows, once diagnosed, CI can be successfully treated with office-based vision therapy by a trained therapist along with at-home reinforcement. This is very encouraging news for parents, educators, and anyone who may know a child diagnosed with CI."A 12-month follow-up study is being conducted to examine the long-term effects of these CI treatments. Further information about the reported trial, NCT 00338611, can be found at http://www.clinicaltrials.gov/The National Eye Institute (NEI) a component of the National Institutes of Health is the federal government's lead agency for vision research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness. For more information, visit the NEI Web site at http://www.nei.nih.gov/The National Institutes of Health (NIH)-The Nation's Medical Research Agency-includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov/

Comments: I will be rubbing elbows with one or more of the researchers who made the above publication possible while attending the College of Optometrists in Vision Development annual meeting. I predict that research will continue to support optometric vision therapy in the months and years to come. If you do not support this research with $$$ (make donations to the COVD research fund or fund research at your optometric alma mater) you should do so immediately. As I type this the stock market is WAY UP....use some of your earnings to support what we do..... You can also support your optometric community by sending in your case reports, clinical research, etc. to me. As editor of Optometry & Vision Development, I need your papers as well to support what we do in the office every day. If you don't write it....I can't published it. Email me....we'll talk. DM

BBC notes obstacles to diagnosis, treatment of binocular instability.

From AOA First Look..

The BBC (10/13, Hargreaves) reports that, for "the 15 percent of the [U.K.] population who suffer from a condition called binocular instability," reading can cause headaches and it can be difficult to hold someone's gaze, "because you are seeing two faces and four eyes." The condition is caused by our eyes drifting too much, which causes a "delayed processing of information at the most basic level." While "it can be cured simply and cheaply with eye exercises and spectacles," the "condition isn't easily spotted in a routine eye test," causing many to suffer unknowingly. The BBC notes that "only 1,500 specially trained orthoptists...can spot the subtleties of binocular instability" in the U.K., and "funding is another key issue." Professor Bruce Evans, director of research at the Institute of Optometry, "has been campaigning for proper funding for the detailed eye test required to diagnose binocular instability." He said, "We have had sympathy from politicians, but so far no promises of proper funding for this. It has been a very frustrating process."

Physicians' group recommends doubling daily vitamin D intake for children.

From AOA First Look...

The New York Times /AP (10/13, A14) reports, "The country's leading group of pediatricians is recommending that children receive double the usually suggested amount of vitamin D because of evidence that it might help prevent serious diseases." The American Academy of Pediatrics is now recommending that children take 400 units daily in response to "mounting research about potential benefits from vitamin D besides keeping bones strong." The group's advice "replaces a 2003 academy recommendation for 200 units daily." In addition, the government advisory group responsible for setting "dietary standards is discussing with federal agencies whether the recommendations should be changed based on the new research." Still, although some research has shown that vitamin D "might reduce the risk for cancer, diabetes, and heart disease," the AP notes that "the evidence is not conclusive, and there is no consensus on how much of the vitamin would be needed for disease prevention."
Researcher urges government agencies to revise vitamin D recommendations.
UPI (10/11) reported that researcher Anthony Norman, of the University of California-Riverside, "is calling for a sea change in how governmental agencies advise people to take vitamin D," because he insists that nearly "half of the elderly in North America are not getting enough vitamin D to maintain healthy bone density, lower their fracture risk, and improve tooth attachment." He also said that the "deficiency is associated with...increased risk for colorectal, prostate, and breast and other major cancers," according to a statement published in the American Journal of Clinical Nutrition.