Friday, May 22, 2009

Visual Acuity and Visually-evoked Responses in Children with Cerebral Palsy: Gross Motor Function Classification Scale

...Quantitative visual acuities can be obtained in the majority of CP children, including those with severe motor dysfunction. Difficulties in testing CP children lead often to the misconception that the children have immeasurably low vision....

Susan Barry's Book Update

From COVD NewsBlast:

Susan Barry, PhD; from the "Stereo Sue" article by Oliver Sacks, articles in OVD, and lecturer at the COVD Annual Meeting, is in the news again. She releases her book, Fixing My Gaze: A Scientist's Journey Into Seeing in Three Dimensions on May 25.....

...The back jacket of the book contains endorsements from two Nobel Prize Winners in Physiology and Medicine, Eric Kandel and David Hubel. Dr. Kandel is co-author of the highly acclaimed textbook, Principles of Neural Science, and Dr. Hubel is known for his work on vision with co-Nobel recipient Torsten Wiesel. Oliver Sacks, who popularized Sue's story in his New Yorker article, wrote the forward.

Published by Basic Books, Fixing My Gaze can be ordered directly through Amazon or Barnes and Noble, and will be available through OEP's website.

Plans are being made for Sue to sign copies of her book at the OEP booth at the COVD 39th Annual Meeting in Denver. Read Sue's blog, which discusses the book and Sue's story.

Thursday, May 21, 2009

Cost-effectiveness dependent on glaucoma diagnostic costs, treatment efficacy

...Routine glaucoma treatment proved cost-effective when diagnostic assessment costs were omitted and optimistic treatment efficacy was assumed, a study showed....

Comments:OK...let me see if I got this right....if you EXCLUDE the actually costs involved in GLC diagnosis and treatment...and ignore actual treatment efficacy, GLC treatment was cost effective? You cannot treat something if it has not been diagnosed. Very strange. Oh wait. These are the same folks who think it's not cost effective to have children receive at least ONE comprehensive eye examination in their lifetimes. I get it!! Well, maybe I don't. Very strange. DM

How To Build A Bigger Brain

...Push-ups, crunches, gyms, personal trainers people have many strategies for building bigger muscles and stronger bones. But what can one do to build a bigger brain?...

Outcomes Similar for Kids of Fresh or Frozen Embryos

....In a meta-analysis, researchers found no difference in rates of preterm birth, low birthweight, or malformations between kids born from frozen or fresh embryos,...

Proteins Underlying Devastating Brain Diseases Uncovered

...Scientists ...have discovered a set of brain proteins responsible for some of the most common and devastating brain diseases. The proteins underlie epilepsy, depression, schizophrenia, bipolar disease, mental retardation and neurodegenerative diseases including Alzheimer's and Huntington's diseases....

Face protection effective in preventing the spread of influenza

...A new article in the journal Risk Analysis assessed various ways in which aerosol transmission of the flu, a central mode of diffusion which involves breathing droplets in the air, can be reduced. Results show that face protection is a key infection control measure for influenza and can thus affect how people should try to protect themselves from the swine flu. ...

Pseudotumor cerebri associated with lithium use in an 11-year-old boy

...Pseudotumor cerebri, ... idiopathic intracranial hypertension, is ... increased intracranial pressure in the setting of normal brain imaging and cerebrospinal fluid analysis. It can often be associated with optic nerve head edema. Several medications have been associated with pseudotumor cerebri, including the use of lithium carbonate in the adult population as well as in adolescents. Signs and symptoms of increased intracranial pressure typically resolve after cessation of lithium carbonate usage. We report a case of the onset of pseudotumor cerebri associated with lithium treatment in a child who sustained long-term optic atrophy and vision loss and required acetazolamide treatment for approximately 1 year after cessation of lithium....

Wednesday, May 20, 2009

ROP severity may be predicted by birth weight, ventilation duration, sepsis, patent ductus arteriosus

...A study ... showed birth weight, ventilation duration, sepsis and patent ductus arteriosus are factors associated with severity of retinopathy of prematurity, and a physician recommended that infants younger than 28 weeks gestational age be examined for ROP at no later than 31 weeks....

SECO Podcast Series

I didn't see much here pertaining to children....but lots on disease, practice management and nutrition. SECO always does a good job! DM

The Demise of Primary Care: A Diatribe From the Trenches

Medical school graduates are avoiding primary care. The very aspects that once attracted students have been subverted. The breadth of practice that was once appealing has become the breadth of heavy-handed scrutiny, as politicians and business leaders have demanded quality—simplistically defined as dogmatic adherence to a standard. Individualized clinical judgment has been devalued; thinking has been replaced by algorithms. Practice guidelines have been usurped by pay-for-performance police, on patrol for deviations—not understanding that knowing and allowing for exceptions is the heart and soul of primary care. The coercive surveillance of "Quality Improvement" has become oppressive, making single organ–system specialties increasingly attractive (or at least more tolerable). Generalists are spending so much time proving they are good doctors, they don't have time to be good doctors. A remedy is suggested: a pilot project of volunteer salaried internists (more trusted, less audited) commissioned to our expandable national health care program, Medicare.

Comments: Optometry is still a primary care profession....but if our government keeps going the way it is going....then you will see optometry having many of the same problems now seen in medicine. Tell our government to get out of the way...we do not need you in between the doc and patient. DM

Tuesday, May 19, 2009

Are you okay to kiss?

....Tel Aviv University researchers have come up with the ultimate solution –– a pocket-size breath test which lets you know if malodorous bacteria are brewing in your mouth. A blue result suggests you need a toothbrush. But if it's clear, you're "okay to kiss." ...

Comments: I would think our scientific colleagues in Israel would have more important things to do...but hey, I'm Italian and I like garlic!! DM

Indiana University Dean Search for the School of Optometry

I just received this information. If you, or others you know are interested, please pass this along. DM

Indiana University has announced a national search for the position of Dean of the School of Optometry. On behalf of the Search Committee, I respectfully request your assistance in identifying outstanding individuals who might meet the leadership needs of the University.

The School combines academic education and clinical practice in optometry with research in a comprehensive program that takes advantage of opportunities for interdisciplinary studies with other academic programs at the University. The candidate will have a record of administrative success, as well as distinction in research, teaching, and service sufficient to merit the rank of professor in a major academic and professional program. He or she must have an O.D. or its equivalent.

Additional information about this position is available through the following link:

Information on the School of Optometry is available at
Information about Indiana University is available at

If you know of individuals who might be competitive candidates for this position, kindly forward their name(s) to me at Please be assured that any information that you provide will be held in strictest confidence.

Thank you in advance for your thoughtful consideration of candidates for this position. I look forward to hearing from you and would be pleased to answer any questions that you may have regarding this position search.


Dr. John DiBiaggio
Senior Consultant
Academic Search, Inc.
1825 K St. NW Suite 705
Washington, DC 20006

Monday, May 18, 2009

Pediatric vision screening remains hot topic for clinicians, lawmakers

The Baltimore Pediatric Eye Disease Study examined the prevalence of refractive error among preschool children. ...The population-based study, one of the largest of its kind, delineated clinical findings based on race and ethnicity. It is the first in the United States to stratify the refractive status of preschool children by race and ethnicity,...The study included 1,268 African-American children and 1,030 white children who were between 6 months old and 71 months old. Hyperopia was found to be the most common refractive error among both groups of children. However, black children were an average of 0.75 D less hyperopic than white children.
... Based on the American Academy of Ophthalmology’s Preferred Practice Patterns, 5.1% of the children would have benefited from spectacle correction, but only 1.3% of children had been prescribed corrective lenses...

Comments: Shame on our colleagues who do not prescribe glasses for children who need them....and even MORE shame on my ophthalmology colleagues who still believe that children are not worth a comprehensive eye examination at least once in their lives! Vision screenings are NOT enough....and if money is the reason why comprehensive eye examinations should not be done....than I say our Pediatrician colleagues should stop well baby visits because return on our health care dollar investment is even worse! So do you think the Pediatricians will stop doing well baby exams because of the expense? Of course's get all states to mandate mandatory eye exams for our children....they are worth it! DM

Progressive esotropia

...The patient stated that the condition began approximately 3 years prior to presentation and that she had never had any problems with eye misalignment earlier in her life. The patient denied any pain or ocular swelling at any time during the course of the progression. She denied any diplopia but has had poor vision for years secondary to very high myopia in both eyes. ...

Comments: Sudden onset strabismus can indicate many problems...most not good! Take a look at this case (and great photos) and tell me what you think. (Note that even after surgery, the eye still turned in.) DM

Are 3-D movies bad for your eyes?

...Three-dimensional effects are predicted to be popular box-office attractions this summer.No fewer than 15 mainstream films -- including Disney/Pixar's animated "Up" and director James Cameron's motion-capture "Avatar" -- will be available in 3-D this year. But will movies that seem to pop out of the screen hurt your eyes?

Some vision researchers say yes. They argue that repeatedly asking our eyes and brains to go against their normal function has short-term effects. And they worry about the long-term effect on small children whose vision systems are still in development....

Comment: The only major problem will be those kids who have strabismus or amblyopia and can't appreciate the 3D effect.....and whose parents are out "big bucks" for a movie that they can't see the way they are supposed to see it. On the other hand, this could motivate parents to bring their kids in for an eye exam....this could be the largest vision screening on earth....if we can only get the word out!! Take your kid to the 3D movie....if they don't see 3D....get 'em in for comprehensive eye exams with your friendly pediatric optometrist....aka COVD doc! DM

Childhood Brain Injury Can Delay Development

......traumatic brain injury can have a range of severity and neurocognitive and developmental consequences for children....

Paralysis of the near-vision triad in a child

...Paralysis of the near-vision complex is rare and appears to be of supranuclear origin. Detailed neuropsychiatric examination and neuroimaging may be inconclusive in such cases. Once organic causes are ruled out, treatment should focus on improving function using a combination of base-in prism and a near add....

Comments: This JAAPOS article actually recommends prism and an add! Unfortunately if doesn't give a very good rationale for the +3.00 add and the prism given....Let me know what you think. DM

Sunday, May 17, 2009

Recovery from amblyopia in adults via decreased visual cortical inhibition caused by experience in an enriched environment

...A remarkable report by Sale and colleagues (2007), published in Nature Neuroscience, highlights potential interventions that may rescue mal-adaptive plasticity in adults, as in the case of amblyopia, where changes in visual performance are detrimental. [Sale's abstract: Loss of visual acuity caused by abnormal visual experience during development (amblyopia) is an untreatable pathology in adults. We report that environmental enrichment in adult amblyopic rats restored normal visual acuity and ocular dominance. These effects were due to reduced GABAergic inhibition in the visual cortex, accompanied by increased expression of BDNF and reduced density of extracellular-matrix perineuronal nets, and were prevented by enhancement of inhibition through benzodiazepine cortical infusion.] Furthermore, in this article the authors have discovered and described a central role for intra-cortical inhibition in the regulation of plasticity states in the visual cortex. Authors exposed adult rats to an enriched environment (EE), a protocol that provides subjects with greater variability in sensory and motor experiences relative to standard home cages, and known to drive robust anatomical and functional plasticity in most sensory cortices (for reviews, see van Praag et al 2000; Pinaud 2004). Enhanced visual experience in the EE recovered amblyopia induced by monocular deprivation followed by reverse-suture. The recovery of visual acuity was evidenced both by electrophysiological recordings of visual evoked potentials and by a standard visual acuity behavioural test (visual water-box task). Interestingly, this EE-induced recuperation of visual acuity paralleled a recovery in binocularity and appeared to be long-lasting, persisting for a minimum of two weeks. Thus, compared to controls housed in standard conditions, adult rats exposed to environmental enrichment display signifi cant functional plasticity of V1 circuitry that impacts visual acuity behaviour. ...

Comments: This brief review article nicely tells us how neuroplasticity plays a role in recovering vision even for amblyopic adults! Amblyopia CAN be treated at any age....repeat after me...amblyopia can be treated AT ANY AGE!! For the full text article click on the title. DM