Friday, November 28, 2008

Wedding Photographer

Hi All....well this is a bit different. I am in Marion, Il (a shout out to all my colleagues in southern Illinois)...I am here to be the wedding photographer for my friend's daughter wedding. It was a 6 hr drive from Chicago...not too bad...but there were State Troopers every couple of miles with teams of copper bikers all over the place...I felt real safe and went the speed limit...mostly.

Have any of you shot a wedding? This is my 3rd....and it is always a very special challenge...will keep you posted!

Thursday, November 27, 2008

FAQ: Melamine in U.S. Baby Formula

...American-made infant formula is not made with milk products from China. The trace amounts of melamine detected in U.S. infant formula apparently came from routine contact with melamine-containing substances during the manufacturing process. There is no reason to suspect the melamine was added deliberately....

Wednesday, November 26, 2008

AOA on FaceBook

The American Optometric Association is now on the title above to become a "fan" of the AOA!! DM

Principles of Experience-Dependent Neural Plasticity: Implications for Rehabilitation after Brain Damage and how it relates to Vision Therapy

While writing a paper for the Review of Optometry on neuroplasticity I found this gem by Kleim & Jones: Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res. 2008 Feb;51(1):S225-39

In their paper, Principles of Experience-Dependent Neural Plasticity: Implications for Rehabilitation after Brain Damage, they lists 10 key principles that should be followed to take advantage of any neuroplasticity present and to improve function. These principles include:

1. Use it or lose it (if you do not drive specific brain functions, functional loss will occur)
2. Use it and Improve it (therapy that drives cortical function, enhances that function)
3. Specificity (the therapy you choose determines the resultant plasticity and function)
4. Repetition matters (plasticity that results in functional change requires repetition)
5. Intensity matters (induction of plasticity requires the appropriate amount of intensity)
6. Time matters (different forms of plasticity take place at different times during therapy)
7. Salience matters (it has to be important to the individual)
8. Age matters (plasticity is easier in the younger brain, but possible in the adult)
9. Transference (neuroplasticity and the change in function that results from one therapy, can augment the attainment of similar behaviors)
10. Interference (plasticity in response to one experience can interfere with the acquisition of other behaviors)

These principles are pefect for those of us doing optometric vision therapy. Use this as a guide for all our patients and you will put neuroplasticity to work for you!! BTW my paper should appear in the January issue of the Review of Optometry....or soon after. DM

Vision Therapy IS NOT Eye Exercises

My friend and colleague Dan L. Fortenbacher, O.D., FCOVD wrote on his blog:

For the patient who suffers from the symptoms of double vision, headaches, fatigue and poor reading performance due to a binocular vision problem like convergence insufficiency, now there is scientific proof that office-based vision therapy is the only viable and effective treatment. When compared to all of the other commonly prescribed treatments recommended by doctors in the past, research has now proven that office-based therapy is effective but, pencil push-up eye exercises or computer based home therapy (used alone) are no better than a placebo.

Yes, office-based vision therapy is effective because IT IS NOT eye exercises. Why?

To understand the difference, one must understand that vision problems such as poor binocular control (like convergence insufficiency), accommodation problems (poor eye focusing), oculomotor dysfunction (poor eye tracking), problems in visual processing or visual motor integration (eye-hand coordination) are not typically problems with muscle weakness.
A child that has double vision when reading is not having that problem because their eye muscles are too weak to turn their eyes in the orbit. If you think of any person with double vision like a "computer", the problem is not with the "hardware" (eye muscles), the problem exists in the "software" (the brain). The visual problem is a "brain coordination problem" not an eye muscle weakness problem.

Thus exercising eyes or eye muscles is no more effective in learning binocular "two-eyed" vision skill than exercising ones fingers in an attempt to learn how to play the piano. Doing finger exercises will not result in becoming a piano virtuoso. The same is true with eye exercises and vision.

Office-based vision therapy is effective because it IS NOT eye exercises. Office-based vision therapy is a process of helping the patient to develop the "brain skills" for proper binocular vision (and much more). This brain skill is a learned ability that, once learned, is like riding a is not forgotten.

The results of a successful office-based vision therapy treatment program is that the patient will learn proper vision skills and enjoy the lifelong benefit of good binocular vision, symptom free and more productive and competent in the rigorous visual demands of school and work

Comments: Dan, I couldn't agree with you therapy is brain is taking neuroplasticity to its highest peak and allowing our patients to develop new and improved visual abilities so they can do the best they can in all they attempt. Nicely done.

BTW if you want to go to Dan's blog...just click on the title above. DM

Screening catches girl's eye ailment early

Amblyopia and vision therapy in the news (this is good)....take a look at the comments (this is not so good) and note that...

Dr. Julia Stevens, a pediatric ophthalmologist, said there is no scientific evidence to suggest that vision therapy works. It is also fairly expensive, costing $100 a session and very rarely covered by insurance. LuAnn Epperson, chief executive officer of Prevent Blindness Kentucky..

..these two individuals need to keep up to date with the current research and should be ashamed of themselves for giving out such false statements....DM

HealthFirst-Convergence Insufficiency

If your child is having trouble in school, it may not be due to a learning disability. The problem could be with their eyes, and your kids may not even be aware of it.
HealthFirst reporter Leslie Toldo tells us how easy it can be to fix without drugs.
The condition is called convergence insufficiency, or CI, and it's not something that will be picked

Comments: Convergence insufficiency continues to be newsworthy. COVD President elect is featured in this story... DM

Testing for eye-convergence insufficiency

...Sometimes stumbling blocks to reading development can't be attributed to a learning disability or concentration issues. A recent government report found that one in 20 students may suffer from a childhood eye-muscle coordination problem called convergence insufficiency, or CI. This disorder may be the reason reading activities are problematic for some children. Children with CI find it difficult to make their eyes focus inward or converge -- which is necessary for reading and other close-up activities....The results of a 12-week study released last month by the National Eye Institute concluded that a combination of office-based vision-therapy treatment coupled with at-home reinforcement is more effective than home-based methods most commonly used....

Comments: Convergence insufficiency continues to be in the news! Do you offer diagnostic and therapeutic services for your patients? DM

More Down's syndrome babies are being born

...The UK saw 749 Down's births in 2006, up from 717 in 1989 when tests came in.
The Down's Syndrome Association surveyed 1,000 parents to find out why they had pressed ahead with a pregnancy despite a positive test result. ...A fifth said they had known somebody with Down's, a third cited religious or anti-abortion beliefs and 30% felt life had improved for people with Down's.

Hepatitis B triple series vaccine and developmental disability in US children aged 1-9 years

...This study investigated the association between vaccination with the Hepatitis B triple series vaccine prior to 2000 and developmental disability in children aged 1-9 years (n = 1824), proxied by parental report that their child receives early intervention or special education services (EIS). National Health and Nutrition Examination Survey 1999-2000 data were analyzed and adjusted for survey design by Taylor Linearization using SAS version 9.1 software, with SAS callable SUDAAN version 9.0.1. The odds of receiving EIS were approximately nine times as great for vaccinated boys (n = 46) as for unvaccinated boys (n = 7), after adjustment for confounders. This study found statistically significant evidence to suggest that boys in United States who were vaccinated with the triple series Hepatitis B vaccine, during the time period in which vaccines were manufactured with thimerosal, were more susceptible to developmental disability than were unvaccinated boys. ..

Comments: As you know I have been ver sceptical of folks saying vaccines cause autism...this study may push me to look closer at this controversey. Remember 1 study does not make it necessarrily so...I need to take a closer look at this one..will get a full copy of the paper and after I read it let you know what I think....DM

Study indicates office-based vision therapy plus at-home reinforcement may benefit children with convergence insufficiency.

From AOA First Look:

New Jersey's Courier Post (11/24, Callahan) reports that "convergence insufficiency" is "a condition that prevents the eyes from focusing on a subject...without difficulty and strain," and may affect "about five percent of the nation's children." The National Eye Institute recently "launched a study to compare two commonly prescribed approaches" to treat the condition. That four-year study, which was "conducted in part" by Michael Gallaway, O.D., FCOVD, associate professor of optometry at Pennsylvania College of Optometry, found that children "fared better when given office-based vision therapy along with at-home reinforcement." Specifically, "nearly 75 percent of" the 221 "youngsters who had office-based vision therapy with at-home reinforcement achieved normal vision or had significantly fewer symptoms" after "12 weeks of treatment." Dr. Gallaway explained that vision-therapy programs "employ various devices, including prescription lenses, prisms, optical filters, and eye patches," and are tailored to individual patients' needs.

Are you an Academic Optometrist Looking for a pay raise?

South African universities are haemorrhaging lecturers and are forced to pay professors in some departments over R1-million a year to get them to stay.

University of Limpopo, which needs 182 academic staff, including a professor and

five lecturers in optometry,

12 in dentistry, 19 in pharmacy and five chartered accounting lecturers

Comments: Learn more byy clicking title DM

New research tool to enhance athlete's abilities

Interesting...looks like virtual reality and sports vision have met. DM

ICO Grad in New Story

I always like to keep an eye out for ICO grads who do well....ICO grad, Tara Van De Wyngaerde is featured in this story.... Congrats Tara!! DM

Talking Turkey: Get the Best From Your Bird

Experts offer tips for buying and cooking a tasty turkey. Read this to help make sure your Thanksgiving dinner is safe, nutritious, and delicious, we asked the experts for some timely turkey tips.

Comments: While it is the holidays you know! Have a great Thanksgiving. Be safe. DM

Wiring in Brain Influences Choices

If you like to try new things and seek new experiences, you can thank your brain for being wired that way.

Comments: Thanks brain! Maybe that's why I'm always trying something new!! BTW while writing a paper on neuroplasticity, I discovered that one of the ways to "grow neurons and created synapses" was to try new things....accept new challeges....learn new skills.... So don't give in to the familar and comfortable...get out there and do new 'stuff!' DM

Complementary and alternative medicine approaches to blood pressure reduction

...MEDLINE and EMBASE were searched from January 1966 to May 2008 combining the key words hypertension or blood pressure with acupuncture, chocolate, cocoa, coenzyme Q10, ubiquinone, melatonin, vitamin D, meditation, and stress reduction. Human clinical trials and prospective studies were selected, along with relevant references. The interventions were selected by the author based on a familiarity with the CAM literature and popular use by patients and CAM practitioners. ... Level I evidence was available for most of the interventions (Table 1), although some studies had methodologic limitations inherent to nondrug clinical trials. This was most relevant to acupuncture and mind-body trials. ...

Comments: This seems to be a very good review of CAM as it is applied to various health issues. DM

Half of primary-care doctors in survey would leave medicine

Nearly half the respondents in a survey of U.S. primary care physicians said that they would seriously consider getting out of the medical business within the next three years if they had an alternative....The survey, released this week by the Physicians' Foundation, ...In the survey, the foundation sent questionnaires to more than 270,000 primary care doctors and more than 50,000 specialists nationwide. Of the 12,000 respondents, 49 percent said they'd consider leaving medicine.

Comments: I get around the country quite a bit....and I can't recall the last time I heard an optometrist say they wanted to get out of optometry. Maybe these PC folks should become optometrists? DM

Practice Costs for ICD-10 conversion

...According to Baltimore-based Nachimson Advisors, the ICD-10 upgrade will cost $83,290 for an average small physician practice, $285,195 for an average medium practice, and $2.7 million for an average large practice. Nachimson defines a small practice as 3 physicians and 2 administrative assistants; a medium practice as 10 physicians and midlevels, a coder, and 6 administrative staff; and a large practice as 100 physicians and midlevels, 10 full-time coders, and 54 medical-records staff. ...

Comments: So we have to pay BIG so that 3rd party payors can pay us small? DM

Two Antidepressants Taken During Pregnancy Linked To Heart Anomalies In Babies

...Women who took the antidepressant fluoxetine during the first three months of pregnancy gave birth to four times as many babies with heart problems as women who did not and the levels were three times higher in women taking paroxetine....

Tuesday, November 25, 2008

Study backs vision therapy route

...Stephanie Bocek, 11, receives vision therapy from Dr. Michael Gallaway of Marlton....a news story about my colleague Dr. Gallaway. Mike is on the Optometry & Vision Development Journal Review Board.....nice going Mike! DM

Panel Of Experts Warns FDA Of Frequent Use Of Antipsychotics In Children

...Certain antipsychotic medicines are being prescribed too frequently to children, and FDA should take action to discourage the drugs' growing use, a panel of federal drug experts told agency officials Tuesday, the New York Times reports. FDA officials had proposed that the panel approve the agency's routine monitoring of the safety of the antipsychotics Risperdal and Zyprexa -- made by Johnson & Johnson and Eli Lilly, respectively -- in children and support its previous efforts to highlight the risks of the drugs. Children are especially susceptible to the drugs' side effects, according to the Times. Panel members did not approve the agency's proposals....

Discovery Of Differences In Synaptic Connections Of The Learning Center Of The Brain

...Since the historical discovery of the speech center in the left cortex in 150 years ago, functional differences between left and right hemisphere have been well known; language is mainly handled by left hemisphere, while spatial recognition is more specialized to the right hemisphere. However, the structural differences of synapses underlying left-right difference of the brain remained unknown. Japanese research team, led by Prof Ryuichi Shigemoto in National Institute for Physiological Sciences, Dr Yoshiaki Shinohara and his colleagues found that synaptic size and shape in the center of the spatial memory (i.e. hippocampus) were asymmetrical between synapses receiving input from the left and right hemisphere. Hajime Hirase in Brain Science Institute in RIKEN helped this study, and it was done under Japan Science Technorogy Agency support. This report is published in Proceedings of National Academy of Sciences in the week of Nov 17, 2008. ...

Visual Illusions: Barrow Scientists Solve 200-Year-Old Scientific Debate

Neuroscientists at Barrow Neurological Institute at St. Joseph's Hospital and Medical Center have discovered a direct link between eye motions [microsacades] and the perception of illusory motion that solves a 200-year-old debate.

Training Brain-Injured Enables Recovery of Emotional Perception Skills

,,,People who have lost the ability to interpret emotion after a severe brain injury can regain this vital social skill by being re-educated to read body language, facial expressions and voice tone in others, according to a new study. ...

Link Between Nicotine Addiction And Autism

...Scientists have identified a relationship between two proteins in the brain that has links to both nicotine addiction and autism. The finding has led to speculation that existing drugs used to curb nicotine addiction might serve as the basis for potential therapies to alleviate the symptoms of autism. ...

Brain Abnormalities That May Play Key Role In ADHD Revealed By Novel Imaging Technique

...Researchers from the Kennedy Krieger Institute in Baltimore, Md. and the Johns Hopkins Center for Imaging Science used a new analysis tool, large deformation diffeomorphic mapping (LDDMM), which allowed them to examine the precise shape of the basal ganglia. The study found boys with ADHD had significant shape differences and decreases in overall volume of the basal ganglia compared to their typically developing peers. Girls with ADHD did not have volume or shape differences, suggesting sex strongly influences the disorder's expression. ...

ADHD Medications Do Not Cause Genetic Damage In Children

...In contrast to recent findings, two of the most common medications used to treat attention deficit hyperactivity disorder (ADHD) do not appear to cause genetic damage in children who take them as prescribed, according to a new study by researchers at the National Institutes of Health (NIH) and Duke University Medical Center...

Wikipedia often omits important drug information

...NEW YORK (Reuters Health) - Consumers who rely on the user-edited Web resource Wikipedia for information on medications are putting themselves at risk of potentially harmful drug interactions and adverse effects, new research shows.

Dr. Kevin A. Clauson of Nova Southeastern University in Palm Beach Gardens, Florida and his colleagues found few factual errors in their evaluation of Wikipedia entries on 80 drugs. But these entries were often missing important information, for example the fact that the anti-inflammatory drug Arthrotec (diclofenac and misoprostol) can cause pregnant women to miscarry, or that St. John's wort can interfere with the action of the HIV drug Prezista (darunavir)....

Comments: All of should use information from the internet with caution. (Except my blog of course!) DM

A Randomized Trial of Near Versus Distance Activities While Patching for Amblyopia in Children Aged 3 to Less Than 7 Years

...Performing common near activities does not improve visual acuity outcome when treating anisometropic, strabismic, or combined amblyopia with 2 hours of daily patching. Children with severe amblyopia may respond to 2 hours of daily patching....

Comments: The Rx'd near activities were not active optometric vision therapy, but non-therapeutic activities from "doing chores" to playing with dolls.

Monday, November 24, 2008

Changes in Gray Matter Induced by Learning—Revisited

Background: Recently, activation-dependant structural brain plasticity in humans has been demonstrated in adults after three months of training a visio-motor skill. Learning three-ball cascade juggling was associated with a transient and highly selective increase in brain gray matter in the occipito-temporal cortex comprising the motion sensitive area hMT/V5
bilaterally. However, the exact time-scale of usage-dependant structural changes occur is still unknown. A better understanding of the temporal parameters may help to elucidate to what extent this type of cortical plasticity contributes to fast adapting cortical processes that may be relevant to learning. Principal Findings: Using a 3 Tesla scanner and monitoring whole brain structure we repeated and extended our original study in 20 healthy adult volunteers, focussing on the temporal aspects of the structural changes and investigated whether these changes are performance or exercise dependant. The data confirmed our earlier observation using a mean effects analysis and in addition showed that learning to juggle can alter gray matter in the occipito-temporal cortex as early as after 7 days of training. Neither performance nor exercise alone could explain these changes. Conclusion: We suggest that the qualitative change (i.e. learning of a new task) is more critical for the brain to change its structure than continued training of an already-learned task.

Comments: You better not ever get "too old to learn new things" because when you do neuroplasticity do not grow...literally! Seek out the new. See the wondrous. Be amazed. Try new things. This (at least) is one of the things I've gotten right during my life. DM

Adult visual experience promotes recovery of primary visual cortex from long-term monocular deprivation

Prolonged visual deprivation from early childhood to maturity is believed to cause permanent visual impairment. However, there have been case reports of substantial improvement of binocular vision in human adults following lifelong visual impairment or deprivation. These observations, together with recent findings of adult ocular dominance plasticity in rodents, led us to re-examine whether adult primary visual cortex (V1) is capable of any recovery following long-term monocular deprivation starting in development. Using mice as a model, we find that monocular deprivation from early development to mature ages (well past the critical period) severely impaired binocular vision by reducing the amplitude of responses elicited by stimulation of the deprived eye. Surprisingly, we find little effect on nondeprived eye responses. Restoration of binocular vision in mature adults yields modest but significant improvement of visual responses in V1. Remarkably, we find that when binocular vision is followed by occlusion of the nondeprived eye, visual responses in V1 recover almost fully, as measured by visual evoked potential amplitude, spatial frequency threshold, and single-unit activity. We conclude that adult V1 can recover from long-term deprivation when provided with an optimal regimen of visual experience.

Read the complete article by clicking on

Comments: I wonder if Stereo Sue has read this? DM

Gluten Free Bread & More

If you live in the Chicago-land area and have patients that are sensitive to gluten and would like to help them find "Goodies" they can eat...I just discovered a bakery (I haven't eaten there yet) that offers..."great tasting fresh breads, cookies, cakes, pizzas, pies and assorted pastries to the Chicago area, all of which are GLUTEN FREE." Check out Roses' in Evanston and let me know what you think! DM

Art and Vision

One of my friends of the VTOD list brought this to my attention and I thought I'd pass it along! DM

ScienceDaily (Nov. 22, 2008) — Famous works of abstract art achieve popularity by using shapes that resonate with the neural mechanisms in the brain linked to visual information, a psychologist at the University of Liverpool has discovered.
Humans make aesthetic judgments about shapes and forms quickly and easily, preferring certain shapes to others, even in the absence of any narrative. Dr Richard Latto, from the University’s Psychology department, has discovered that these shapes resonate with the processing properties of the human visual system, which is responsible for analyzing what we have seen.
Dr Latto said: “Humans inherit a basic visual system through genetics. That system provides very selective information about the world around us. It has evolved to provide only the information that we need to survive - for example, we cannot see most electromagnetic radiation or follow the leg movement of a galloping horse.
“Of course our visual systems can be influenced by social factors, like fashion and the number of abstract images that we expose ourselves to, but evolution had given us some genetically determined responses to certain shapes and forms. In popular abstract works such as Matisse’s The Snail (1953), Mondrian’s Composition with Red, Blue and Yellow (1921), and Malevich’s Supremus No. 50 (1915), the artists start with a blank canvas and arrange shapes and colours in a way that is aesthetically pleasing, using their own brain to monitor the effect.
“We like to look at the human body or parts of the body like the face and hands, stylized representations like stick figures and organic forms of the kind incorporated into the work of Salvador Dali and Francis Bacon. Certain landscapes and horizontal and vertical lines are also popular because they resonate with our visual systems, which have been tuned by evolution and experience to respond particularly to these biologically and socially important stimuli.
“We know that neurons in the brain need to be kept active to flourish and develop, so it is important for the visual system to be stimulated and sometimes pushed to the limit to function effectively. As with other adaptive behaviors, we have evolved a mechanism for encouraging this by rewarding ourselves with good feelings. Perhaps we enjoy looking at faces, landscapes and Mondrian’s work because it is good for us and good for our brains.”
enlargeDr Latto added: “Artists were experimenting with abstract shapes long before scientists began analyzing our nature of perception. Through observation or trial-and-error, artists have been identifying these aesthetic primitives - critical shapes and arrangements - and have indirectly defined the nature of our visual processes. In purely abstract painting, as with much music, form is all we have. Popular works have shown that essentially we like looking at what we are good at seeing.”