Thursday, May 28, 2009
Reviews Written by
David H. Peterzell "Ph.D., Ph.D." (San Diego, CA United States)
Fixing My Gaze: A Scientist's Journey Into Seeing in Three Dimensions
by Susan R. BarryEdition: Hardcover
Great Story, Great Science, Instills Hope, May 24, 2009
I ordered this new book just after meeting the inspirational Dr. Barry at this year's meeting of the Vision Sciences Society. The book arrived this last Friday and I spent the day reading it. I confess to be blown away by her story, as well as the scientific and clinical implications of her work. Add me to the list of people who loved the book! Sue Barry's astonishing development of stereopsis at age 48 changed - profoundly - the way that many scientists (me included) view visual development and plasticity. Somehow we had tuned out, en masse, one hundred years of successes using vision therapy (including the extensive the work of Frederick Brock). The stuff of vision therapy was ignored, relegated to the fringes of sensible vision care. Instead, several generations of us took the Nobel Prize winning research of Hubel and Wiesel as gospel truth, going beyond the data by wrongly concluding (perhaps unlike the Nobel laureates) that stereopsis could only develop during a critical period during infancy. It took Barry, a well-established neuroscientist and keen observer, to bring us to our senses. And yet now, having read her new book, I see that the story is much deeper and profound than I thought. First off, she's a very entertaining storyteller in her own right. The human drama escalated as she went through frightening surgeries as a child (including an encounter with a deceptive anesthesiologist); as she experienced shock and disappointment at being exposed as stereoblind; as she had her vision problems dismissed by one ophthalmologist as a psychiatric disorder; as she experienced steropsis bursting out at her for the first time; as she gained steam and knowledge, recognizing the scientific, clinical, and human implications of her story; as she brought celebrity neuroscientists on board. And so it is a story of empowerment for Barry the patient, Barry the scientist, Barry the teacher, and Barry the instiller of hope. I believe that Susan Barry has demonstrated for many of us that stereopsis is, indeed, important. I, for instance, was trained to believe that binocular vision and any advantage it afforded us wasn't that big a deal. Sure, I loved stereo viewers and all that... But as an undergrad at Berkeley in the early `80s, I recall a visit by Bela Julesz, of cyclopean vision fame. Two of my academic heroes, Russ and Karen De Valois rose to challenge Julesz, eventually (as I recall) suggesting that two eyes really aren't that much better than one. As I read Barry's book, as well as her descriptions of the consequences of her visual deficit, I realized that my early academic training (as a I had encoded it) was quite wrong. The book makes it clear that lack of stereopsis, and having two eyes that don't fuse images properly, has profound consequences for people like Barry (e.g., her driving, her energy level, and her sense of efficacy). Moreover, it is fair to say that Barry is an extraordinary observer of stereoscopic experience, and that she uses her newfound, developing perceptual ability to achieve scientific and clinical insights that are elusive to us who grew up with normal stereopsis. One of the epiphanies for me was when I read and grasped the following paragraph: "Just as I could not imagine a world in stereo depth, an individual with normal normal stereopsis cannot experience the worldview of a person who has always lacked steropsis. This may be surprising because you can eliminate clues from stereopsis simply by closing one eye. What's more, many people do not notice a great difference when viewing the world with one eye or two. When a normal binocular viewer closes one eye, however, he or she still uses a lifetime of past visual experiences to re-create the missing stereo information." People interested in stereopsis will find excellent coverage of the basic issues and the key scientific figures past and present (e.g., Wheatstone, Hering, Helmholtz, Eileen Birch, Shin Shimojo, Denis Levi, Uri Polat, Chris Tyler). It is nice, if not surprising, to learn that the already positive, cool Oliver Sacks played a positive, cool role in Susan Barry's story. If you have strabismus or some other disorder of binocular vision, you will find what you need here. You will find out how to find an appropriate vision therapist. You will find extensive, understandable information about the theory and science of binocular vision. More importantly, you will learn in marvelous detail about the experiences and practices that can in some instances lead to acquiring stereopsis late in life. My guess is that vision therapy patients will use this book as a guide for years to come. One last thing: I recommend listening to two NPR interviews (2006, 2009) featuring Sue Barry, as well as other key scientific figures in the story, including Sacks, Hubel, Levi, and, briefly, the heroic Theresa Ruggiero. The NPR programs are available online and go quite well with the book. Two thumbs up! (one with uncrossed disparity; one with crossed disparity).
Comments: Unfortunately, Sean P. Donahue MD PhD , still doesn't seem to get it...the earlier a COMPREHENSIVE eye examination is given, the better the outcomes for all children. Sean....full exams NOT VISION SCREENINGs are needed. The first full exam should be between 6-12 months (I've mentioned InfantSee a million times....check it out!) and then before Kindergarten and every 1-2 years after that. DM
Comments: Optometric vision therapy for adults works....see StereoSue and Fixing My Gaze: A Scientist's Journey Into Seeing in Three Dimensions . Let's help these individual overcome all these significatn associations thru optometric vision therapy! DM
Does Assessing Eye Alignment along with Refractive Error or Visual Acuity Increase Sensitivity for Detection of Strabismus in Preschool Vision Screen
Comments: How many children are still missed? Vision screenings are not adequate. Billions for banks....nothing for our children. Comprehensive eye exams for all kids are a smart investment in that child's future. Have a comprehensive eye exam at 6-12 months (see InfantSee), then Kindergarten, then as often as needed (once a year to every two years). DM
to vertical accommodative vergence are yet unknown....
Comments: Very interesting. The full text available by clicking on title. DM
Comment: PDF of article available by clicking on title above. DM
Wednesday, May 27, 2009
Researchers have found that higher levels of vitamin D -- acquired from the sun and also found in oily fish -- are associated with improved cognitive function in middle-aged and older men....
media have underlined the importance of unambiguous
diagnosis and appropriate action. Failure to recognize
abuse may have severe consequences. Abuse of infants
often leaves few external signs of injury and therefore merits
special diligence, especially in the case of non-accidental
head injury, which has high morbidity and mortality.
Methods: Selective literature review including an overview
over national and international recommendations.
Results: Shaken baby syndrome is a common manifestation
of non-accidental head injury in infancy. In Germany,
there are an estimated 100 to 200 cases annually. The
characteristic findings are diffuse encephalopathy and
subdural and retinal hemorrhage in the absence of an
adequate explanation. The mortality can be as high as 30%,
and up to 70% of survivors suffer long-term impairment.
Assessment of suspected child abuse requires meticulous
documentation in order to preserve evidence as well as
radiological, ophthalmological, laboratory, and forensic
Conclusions: The correct diagnosis of shaken baby syndrome
requires understanding of the underlying pathophysiology.
Assessment of suspected child abuse necessitates
painstaking clinical examination with careful documentation
of the findings. A multidisciplinary approach is indicated.
Continuation, expansion, and evaluation of existing preventive
measures in Germany is required.
Comments: Full text pdf available by clicking on title above. DM
Comment: VERY BAD IDEA! If you are a parent doing this...stop it immediately. These medicines have numerous unwanted side effects. DM
Comments: I haven't used the Peli lenses just yet....but have at least one patient I'm probably going to try them on...DM
Wear sunglasses --
Don't smoke --
Eat right --
Baseline eye exam --
Eye protection --
Family History --
Early intervention --
Know your eye care provider --
Contact lens care --
Be aware of eye fatigue --
Comments: This list was put together by an ophthalmology group....so as you might expect it's a bit slanted. I would also recommend all of the above, but unlike our OMD colleagues I believe that the baseline examination/early intervention should start somewhere between 6-12 months of age (See the AOA InfantSee Program) with children being seen once a year starting in Kindergarten and continuing until they graduate High School.
Knowing your eyecare practitioner is also a good idea. Did you know that optometrists are primary eye care providers who provide the majority of eye care for the people of the United States? Did you know that our ophthalmology colleagues are surgeons? You do realize that optometrists can provide the majority of eyecare services you need and are very cost effective? Would you go to a surgeon if you didn't need something cut?
Oh yes, eye fatigue...up until recently most of my ophthalmologist colleagues didn't really do much about "eye fatigue". Did you know that there are several binocular vision dysfunctions that result in eye fatigue and that National Institutes of Health National Eye Institute sponsored clinical trials have shown that optometric vision therapy is the most effective treatment for improving ones quality of life...including eye fatigue?
Bottom line? All of the above 10 tips make sense....see an optometrist. DM
Sunday, May 24, 2009
Comments: Learn more by clicking on the title above. DM
I had the pleasure of being present when, Dr. Peter Kehoe gave the Keynote address at the Illinois College of Optometry last week. I was a fairly new ICO faculty member at ICO and had an opportunity to "teach" the AOA President back then. Now I "learn" from every day.
He is a dedicated doctor who always puts his patients first. He is husband and father, who always puts his family first. He is a member of several organizations...he always puts his profession first.
Few of us can do this....Pete has done this successfully.
Here are some comments that Pete made on his blog:
Last weekend I had the honor of delivering the commencement address to the ICO Class of 2009. What an awesome experience and one that 25 years earlier at my graduation – was not a thought in my mind.
This years graduating class is the best educated in our profession and they can be proud of their education and training. Patients for years ahead will benefit from the care provided by these great doctors.
I delivered 5 points to them for consideration:
First and foremost, be an independent doctor of Optometry no matter what setting you choose to practice.
Second: Use the power of your exam room by becoming a doctor driven dispenser and educating your patients about a lifetime of healthy vision at EVERY opportunity.
#3 Get involved in your local society
#4: join your state and national associations whatever mode of practice you choose. This is where the deep roots of optometry are planted.
And fifth and last…include your personal and extended family in all you do …and MAKE IT FUN.
Thank you ICO for allowing me the opportunity to deliver my message and best of luck to ALL 2009 graduates. The Future of Optometry is in Your Hands……GRAB HOLD!