Friday, July 3, 2009

What's New in Autism Research from Pubmed

Here's what's new. Go to PubMed to get the full abstract.

Itier RJ, Batty M Neural bases of eye and gaze processing: the core of social cognition.Neurosci Biobehav Rev. 2009 Jun;33(6):843-63. Epub 2009 Feb 24.

Eyes and gaze are very important stimuli for human social interactions. Recent studies suggest that impairments in recognizing face identity, facial emotions or in inferring attention and intentions of others could be linked to difficulties in extracting the relevant information from the eye region including gaze direction. ......We suggest impairments in processing eyes and gaze may represent a core deficiency in several other brain pathologies and may be central to abnormal social cognition.

Allen MLBrief report: decoding representations: how children with autism understand drawingsJ Autism Dev Disord. 2009 Mar;39(3):539-43. Epub 2008 Sep 23.

Young typically developing children can reason about abstract depictions if they know the intention of the artist. Children with autism spectrum disorder (ASD), who are notably impaired in social, 'intention monitoring' domains, may have great difficulty in decoding vague representations. ..... Results are discussed in terms of intention and understanding of visual representation in autism.

Riby DM, Hancock PJ.Do faces capture the attention of individuals with Williams syndrome or autism? Evidence from tracking eye movements. J Autism Dev Disord. 2009 Mar;39(3):421-31. Epub 2008 Sep 12.

The neuro-developmental disorders of Williams syndrome (WS) and autism can reveal key components of social cognition. Eye-tracking techniques were applied in two tasks exploring attention to pictures containing faces. ...... The findings are interpreted in terms of wider issues regarding socio-cognition and attention mechanisms.

Faja S, Webb SJ, Merkle K, Aylward E, Dawson G. Brief report: face configuration accuracy and processing speed among adults with high-functioning autism spectrum disorders.J Autism Dev Disord. 2009 Mar;39(3):532-8. Epub 2008 Aug 27.

The present study investigates the accuracy and speed of face processing employed by high-functioning adults with autism spectrum disorders (ASDs). ..... Results suggest adults with ASD were less accurate, but responded as quickly as controls for both tasks. ....

Ageing Brains Show Great Promise For Rejuvenation

...In research published in Stem Cells, Dr Daniel Blackmore and his colleagues at the Queensland Brain Institute (QBI) have shown that moderate exercise directly increases the number of stem cells in the ageing brain. ...

Comments: REALLY is time for me to get away from this dang computer and start moving about!! DM

Changes In Brain Architecture May Be Driven By Different Cognitive Challenges

...Scientists trying to understand how the brains of animals evolve have found that evolutionary changes in brain structure reflect the types of social interactions and environmental stimuli different species face...

Comments: Environment plays a role in brain development and evolution. I thinnk optometry has known this for some time. DM

Brain Plasticity: Changes And Resets In Homeostasis

...In an article published in the June 25th edition of the journal Neuron, researchers at the Hotchkiss Brain Institute, University of Calgary, have found that synaptic plasticity, long implicated as a device for 'change' in the brain, may also be essential for stability. ...

Could Estrogen Improve Outcomes After Traumatic Brain Injury, Shock?

...UT Southwestern Medical Center researchers are conducting two pilot clinical trials to determine whether a single, early dose of estrogen can improve survival and neurological outcomes after severe traumatic brain injury or traumatic hemorrhagic shock...

American Optometric Association Approves Optometric Board Certification At Annual Meeting

..."Our members' actions Friday suggest that optometrists see the need for a mechanism to clearly demonstrate continued competency to patients, legislators and payers," said Randy Brooks, O.D., president of the AOA. "The creation of the American Board of Optometry will provide a unified national platform to establish and demonstrate competency and value and will position our profession solidly for the future." ...

Neurological Differences Support Dyslexia Subtypes

...Parts of the right hemisphere of the brains of people with dyslexia have been shown to differ from those of normal readers. Researchers writing in the open access journal BMC Neuroscience used magnetic resonance imaging (MRI) to compare the two groups, and were able to associate the neurological differences found with different language difficulties within the dyslexic group. ...

Further Gene Mutations Linked To Autism Risk

...Pieces in the complex autism inheritance puzzle are emerging in the latest study from a research team including geneticists from the University of Pennsylvania School of Medicine and The Children's Hospital of Philadelphia (CHOP). The study identified 27 different genetic regions where rare copy number variations - missing or extra copies of DNA segments - were found in the genes of children with autism spectrum disorders, but not in the healthy controls. The findings are published June 26 in the open-access journal PLoS Genetics....

UC Davis Researchers Develop New Test For Fragile X Syndrome

...Researchers at UC Davis have developed a new test that will measure the protein deficit responsible for fragile X syndrome - the single-most common cause of intellectual impairment and the most-commonly inherited cause of autism...

ADHD Genes Found; Known To Play Roles In Neurodevelopment

...Pediatric researchers have identified hundreds of gene variations that occur more frequently in children with attention-deficit hyperactivity disorder (ADHD) than in children without ADHD. Many of those genes were already known to be important for learning, behavior, brain function and neurodevelopment, but had not been previously associated with ADHD....

Comments: Just a reminder....all things start in the they end up often is determined by the environment. If we arrange the environment correctly, we can change, alter, improve the life of kids and adults with ADHD. DM

More success stories for my former students!

I've been a member of the Northwest Optometric Associates professional staff for decades now. I've always practiced in a private practice setting through out my career to make sure I kept at least one foot in the real world of optometry while spending most of my time in academia researching, writing, lecturing and teaching in our Illinois Eye Institute's various clinics. I've always had an ICO student working besides me as well. I figured I must have done a pretty good job of teaching because now one of those former students, Dr. Denice Rice-Kelly is my boss on Wednesdays when I'm in the office.

My congratulations to Dr. Rice for being recognized in Women in Optometry (scroll down for story). She is not only an awesome individual who manages the demand of a full time office and family, but also conducts research for major contact lens and spectacle lens companies around the world. If there is any out there who would like a role model to emulate, Dr. Denice Rice-Kelly is an individual of note. DM

My students' Success!

When my students succeed in life, I like to think that I might have had a small part to play in that success. Drs. Patricia and Angelica Perez are doubly great optometrists and twins! Both were featured as the cover story in Women in Optometry , a supplement to the Review of Optometry this past June. Patricia and I also serve on ICO's Alumni Council. My congratulations to both!

Many of you know this, but I am also a very proud optometric twin. My brother Joseph is Chief of Optometry at the Kansas City, VA Hosptial. He is a low vision specialist so even though we deal with different aged populations...we both strive to increase vision function in our patients. If there are any other optometric twins out there, let me hear from you. DM

Thursday, July 2, 2009

Characteristics of associated craniofacial trauma in

...Adult males are the most common victims in craniofacial trauma, and road traffic accidents were responsible for the majority. Most of the patients sustained mild head injuries and were managed conservatively. Open reduction and internal fixation with miniplates was used for displaced facial bone fractures....

Comments: Click on title for full text article. DM

Fixing My Gaze Reviewed in New England Journal of Medicine

My good friend and colleague, Dr. Len Press sent this to me:

From today's issue of the New England Journal of Medicine (7-2-09), an unqualified and ringing endorsement of Sue Barry's book, and of specially trained and imaginative optometrists which reads, in part:

"Capitalizing probably more on latent neuronal connections than on the creation of new ones, Barry benefited from orthoptics — a hidden corner of restorative medicine. With contrived ocular exercises, specially trained and imaginative optometrists treat patients whose eyes are cosmetically aligned but imperfectly foveated. The simplicity of the exercises and of the apparatus (such as beads on a string, papers taped to walls, and strips of film) is bracing for a profession enamored with technology.

The book’s main contribution, however, is exposing the wrong-headed dogma that acuity and binocular vision can be restored only during a critical developmental period. Surgical correction of strabismus is dominated by this notion, first posited by Claud Worth in his landmark 1903 book, Squint: Its Causes, Pathology, and Treatment, and set at a hard stop at 2 years of age by his student Francis Chavasse. The experiments of Hubel and Wiesel are often cited as confirming the lost malleability of the adult brain, but Barry points out that they did no such thing because there was no attempt at restoration of fusion. Her experiences and those she recounts from others belie the “nothing else can be done” message that ophthalmologists gave to her and to her mother throughout her childhood.

Several visual scientists have now demonstrated the reversibility of infantile loss of vision and stereopsis, but blindness to these findings and underappreciation of the solutions offered by orthoptics still persist."

Comments: I have to least a little. Optometric vision therapy has never been hidden from our Ophthalmology colleagues....but they (OMDs) have deliberately and continually closed their eyes (and minds) to the possibility that what we have been doing for decades is therapeutically sound and can change how we see.

I also have to laugh at "With contrived ocular exercises, specially trained and imaginative optometrists treat patients whose eyes are cosmetically aligned but imperfectly foveated. The simplicity of the exercises and of the apparatus (such as beads on a string, papers taped to walls, and strips of film) is bracing for a profession enamored with technology. " Our therapeutic programs (definitely not ocular exercises) are not contrived but well thought out. We also straighten out turned eyes.....and it is the simplicity of some of our therapeutic procedures that make them so effective. Although we often use computers as a part of our therapy program....we also use what has been shown to work from our past.

Also research in neuroplasticity has shown that new neuro-pathways are often created...not just the re-activation of old ones...( see Maino D. Neuroplasticity: Teaching an Old Brain New Tricks. Rev Optom 2009. 46(1):62-64,66-70. (Tested Continuing Education Course))

It is about time for our Ophthalmological colleagues to stop their dedicated ill will towards the profession of Optometry. We are not going anywhere. We examine and take very good care of our patients. We are the primary eye care providers to the United States and its people. Get over it. Move on. Let's work together for the benefit of our patients. You do the surgery. We do everything else...including optometric vision therapy. DM

Wednesday, July 1, 2009


Thriller by MJ. Good song. Strange fellow.

Corneal Power and Astigmatism in Down Syndrome.

... The majority of the DS group have significant refractive errors including an increased prevalence of oblique astigmatism. Corneal curvature in DS is not related to spherical (M) or astigmatic (J0, J45) refractive error. Further research is required to better understand the association between the ocular structures of the DS eye and their impact on functional vision....

Brief report: visual processing of faces in individuals with fragile X syndrome: an eye tracking study.

...Results provide quantitative evidence for significant differences in gaze patterns and increased pupillary reactivity when individuals with FXS passively view static faces....

Atypical eye contact in autism: Models, mechanisms and development.

....we propose that atypical eye contact processing in ASD originates in the lack of influence from a subcortical face and eye contact detection route....

Asperger syndrome associated with idiopathic infantile nystagmus--a report of 2 cases.

...There are no reports in the literature of association between idiopathic infantile nystagmus (IIN) and AS. We report 2 cases of Asperger syndrome associated with idiopathic infantile nystagmus....

Amblyopia reduces temporal, not just spatial resolution.

...We conclude that amblyopia not only decreases spatial resolution, but also temporal factors such as time-based figure-ground segregation even at high stimulus contrasts. This finding requires to extend the realm of neuronal processes that may be disturbed in amblyopia...

Macular and Nerve Fiber Layer Thickness in Amblyopia The Sydney Childhood Eye Study.

.....In children aged predominantly 6 and 12 years, central macular thickness may be increased in eyes with amblyopia, although it is uncertain if this precedes or follows the development of amblyopia. No differences in peripapillary RNFL thickness were found when compared with normal eyes.....

Tuesday, June 30, 2009

Monday, June 29, 2009

Journal of Neurotrauma

Comments: Get full text/pdfs of all articles from Journal of Neurotrauma for free. Click on title above. DM

Lack Of Spectacles Costs $427 Billion

...Over 158 million people in the world are effectively blind because they do not have the spectacles they need to correct their vision. The cost of this disability is enormous. A recent study published in the Bull World Health Organ claims that uncorrected refractive error results in a loss of economic productivity globally worth $427 billion...

Comments: Finally spectacles are getting their due. When we prescribe a pair of spectacles....this is VERY important...we stop people from being blind. We save sight. We are awesome! (At this point my wife ususally says something like..."If you don't quit patting yourself on the back you are going to break your arm!!). DM

Do ADHD Drugs Cause Sudden Death?

...A new study in The American Journal of Psychiatry suggests that children and teens who take stimulants like Ritalin for ADHD have an increased risk for sudden cardiac death. ...

Paradoxical robust visual evoked potentials in young patients with cortical blindness

...The objective of this study was to review retrospectively cases of clinically blind children in whom robust pattern visual evoked potentials (VEPs) were recorded. ...We searched for charts of children who were clinically cortically blind, but in whom assessment of visual acuity, using visual evoked potentials (VEPs), was normal or close to normal. ... The commonality among the cases was the presence of suspected cortical visual impairment with seizures and developmental delay. VEP acuity cannot be correlated unequivocally with visually guided behaviour. In specific cases, particularly cases with developmental delay and neuroradiographic abnormalities, a child who is behaviorally blind with no clinical evidence of vision may show robust VEPs even to small patterns. This finding might be consistent with a defect of the visual association cortex. ...

Comments: Children labeled cotically blind often are not blind at all. Something else is going on. DM

Turning Your Abstract into a Paper:

Academic writing is a critical skill distinct from creative writing. While brevity is vital, clarity in writing reflects clarity of thought. This paper is a primer for novice academic writers.....

Comments: Although this tells how to write for a medical journal....writing is this, do it....if what you write is on pediatrics, binocular vision, strabismus, amblyopia, optometric vision therapy, it to me and we'll put it into the peer review process for Optometry & Vision Development...if it's on other topics send it to the AOA, AAO and other find organizations with journals...see it, do it, write it! It's that easy (and that hard). DM

Epigenetics in congenital diseases and pervasive developmental disorders

Epigenetics is an intrinsic mechanism that alters gene function – not by altering DNA sequences, but by chemically modifying the DNA and chromosomal histone proteins. Epigenetics is involved in genomic imprinting and X-chromosome inactivation in humans, and the failure of this mechanism causes a subset of congenital syndromes and cancers. Until recently, it has been believed that epigenetic modification is stable and that the pattern is faithfully preserved following DNA replication during cell division, leading to stable epigenomic patterns during one’s life-time. However, more recent reports of environmental stress altering the epigenomic patterns within a short time frame after birth, followed by alterations in gene expression and phenotype, indicate that epigenetics is not only involved in congenital neurodevelopmental diseases but also in acquired diseases, including pervasive developmental disorders, through gene–environmental interaction. In this review, I introduce the subject of congenital diseases with abnormalities in known epigenetic mechanisms and discuss possible epigenetic abnormalities in pervasive developmental disorders.

Comments: For full text of article, click on title above. DM

Questions remain about use of refractive surgery in pediatric patients

...The idea of offering surgical refractive correction to some pediatric patients has received increased attention in the ophthalmic community, but serious questions remain regarding its implementation.
The use of refractive surgery – LASIK, PRK and even lens exchange – in pediatric patients is relatively new. While some investigators suggest theoretical benefits, others contend that either there is insufficient data to date to support its widespread adoption or the studies to date have been improperly constructed to decipher feasibility. ...

Comments: What are they thinking? Refractive surgery for children? For the vast majority...maybe all...we should not allow this to happen. In my most cases this should be considered a form of child abuse. What is going to happen to that child after 20, 30, or 50 years? What very serious eye problems will develop over time. Don't do it. As is noted above...there is insufficient data to date to support its widespread adoption or the studies to date have been improperly constructed to decipher feasibility... DM

ADHD medication linked with improved academic achievement

...Children with attention-deficit/hyperactivity disorder who received prescription medications had higher standardized mathematics and reading test scores compared with unmedicated peers. ...

Comments: Can you imagine what you could achieve if you linked medication with optometric vision therapy? DM

Visuospatial skills, ocular alignment, and magnetic resonance imaging findings in very low birth weight adolescents

...The Very Low Birth Weight adolescents had more visuospatial problems, lower stereoacuity, and more ocular misalignment than the control subjects. Ocular misalignment was associated with visuospatial deficiencies and/or WMDI (white matter damage of immaturity ) in the VLBW group and was a better predictor for visuospatial deficits than WMDI....

Comment: Get these children in to see a functional/behavioral/developmental optometrist as soon as possible. Active optometric visioin therapy and a bit of brain neuroplasticity should help improve vision function! DM

Treatment of severe amblyopia with weekend atropine: Results from 2 randomized clinical trials

...Weekend atropine can improve visual acuity in children 3 to 12 years of age with severe amblyopia. Improvement may be greater in younger children...

Comments: Amblyopia (mild to severe) can be improved at practically any age....with atropine, with active optometric vision therapy, with it or refer to someone who will! DM

Many people treated with antidepressants stop taking them because of side effects

Many of our patients take antidepressants...they can cause many side effects. See this WebMD video. DM

Playing a Bassoon Protects Against Sleep Apnea

...Compared with other members of an orchestra, musicians who played a high-resistance woodwind instrument were less likely to develop obstructive sleep apnea, researchers found...In a study of 901 professional musicians, the woodwind players also had a lower risk of apnea than did singers or conductors, ...

Comments: Since I play the trumpet I found this interesting. Hmmm, perhaps it's time to learn a new instrument? DM

Researchers: minor genetic flaws may combine to cause autism

...A new study has used a large number of families with multiple autistic children to explore the role of genes in the disorder. The results reinforce other findings that suggest the disorder may be the result of the cumulative impact of many minor genetic problems....

Why Can't My Child Read?

Susan Barry, PhD says....When I was in second grade, I did miserably on a standardized achievement test. The school principal told my parents that I was, "a dim bulb," and I was placed in a class with other "problem" children. But the principal was unaware of the connection between vision and reading. I was cross-eyed and, in the previous five years, my eyes had been surgically rearranged in their sockets three times. I had 20/20 eyesight with each eye, but even after the operations, my two eyes still did not point to the same place at the same time. In fact, when trying to read, I saw letters with my right eye that were to the left of those I saw with my left eye. No wonder I had trouble pinpointing the letters on the page and did not like to read....

Comments: Read her book, "Fixing My Gaze" today. A most wonderful story. DM

Grab a Tool and Change Your Brain

.....Pick up a golf club and your brain may do more than look for an easy par three. New research suggests that the brain considers tools to be extensions of the body. The mere act of holding a mechanical grasping tool "temporarily modifies the cerebral representation of a subject's arm," said Lucilla Cardinali, a graduate student in France and lead author of the study. In other words, people think their arm is longer, at least for a moment. It's not immediately clear what this new knowledge about the "schema" -- people's internal representation of themselves in the world -- could mean in terms of treatment of illness. ...

Comments: Functional/Developmental/Behavioral Optometry has known this for decades. MOTOR including motor activities using tools (optometric vision therapy procedures0 changes the brain which changes vision function. DM

Call for Paper and Poster Presentations

Call for Paper and Poster Presentations

6th International Congress of Behavioral Optometry (ICBO)

The International Congress of Behavioral Optometry is soliciting proposals for papers and posters to be presented at its April, 2010 meeting. Proposals are requested in three general areas:

! Manifestations of Visual Dysfunction in ABI/TBI
! Vision Therapy - Habilitation and Rehabilitation
! Vision Science - Applications and Advances

Proposals may include research results, case studies, clinical techniques or observations related to diagnostic/treatment procedures. Any person wishing to make a presentation is invited to submit a proposal as outlined below.

Presentations must be original and must not have been published or presented at any other meeting prior to the ICBO 2010 meeting.

Each proposal will be reviewed for the following elements:
(1) scientific and clinical quality
(2) general appeal to the interests of the Congress attendees
(3) multidisciplinary nature
(4) timeliness of the topic

Proposals will be chosen for their suitability as either paper or poster presentations. Presenting authors must be registered delegates and attend the meeting. Each complete submission received by September 1, 2009 will be independently peer-reviewed by a committee and rated on a blind evaluation basis.

Primary authors will be notified of acceptance or rejection by October 1, 2009.


! Visual Fields – testing, treatment, management.
! Visual/Vestibular issues – balance, orientation and dizziness - diagnosis and treatments.
! Spatial transformations and perceptions post trauma - orientation shifts, neglect - testing, treatment, management.
! Post-Brain injury driving – driver evaluation and rehabilitation.
! Visual Learning/Development - theory and application.
! Service delivery models for Vision Therapy.
o Individual or group
o Office or home based therapy
o Addressing functions as isolated or integrated

! Proposals must be submitted in English.
! Proposals must be submitted electronically.

o Proposals submitted by fax will not be accepted.

! Presentation title is limited to 20 words.
! Proposal text is limited to 350 words.

! Proposed reports of research projects should clearly state:
o Background and aims
o Methods
o Results
o Conclusions

(All studies must follow accepted ethical standards for experimental and human investigations.)

! Proposed case reports should clearly state:
o Patient symptoms
o Findings, diagnosis
o Treatments
o Outcomes

! Proposals regarding of diagnostic or therapeutic techniques should clearly describe:
o Equipment and procedure
o Applications
o Unique or innovative characteristics

! Use only standard abbreviations. Place special or unusual abbreviations in parentheses after the full word when it appears the first time.
! Submit proposals electronically in a Microsoft Word compatible format (.doc or .docx files) to:
Email subject line should read:

! Deadline for submission of proposals: September 1, 2009

! Work submitted for presentation must include an acknowledgement of funding sources of commercial nature and/or consulting or equity holdings of an author in a company that could be affected by the results of the study.
! Presentations that primarily promote or advertise a specific product will not be accepted.
Pervasive and inappropriate use of logos in a presentation is prohibited.
! Advertising material of any description may not be distributed as part of a presentation. Material that in any way directly promotes the commercial interest of any particular company or enterprise or of an author/presenter may not be displayed as part of a presentation.
! If costs of a presentation have been underwritten to any extent, a clear acknowledgment stating support and identifying the particular source should be included (e.g., "The support of [name of corporation/institute] for this project is gratefully acknowledged").

! Paper and poster presentations must be made in person and presenters must be registered delegates to the conference. Presenters are responsible for their personal expenses (e.g., registration, airfare, hotel, meals).
! The Congress will provide typical audio/visual equipment and support for paper presentations.
Time for paper presentations will be strictly controlled.
! The Congress will supply a template and support for poster presentations. Space for poster presentations will be strictly limited.