Friday, November 27, 2009

Nonveridical Visual Perception in Human Amblyopia

...Amblyopia is a developmental disorder of spatial
vision. There is evidence to suggest that some amblyopes misperceive spatial structure when viewing with the affected eye. However, there are few examples of these perceptual
errors in the literature. This study was an investigation of the prevalence and nature of misperceptions in human amblyopia....

Comments: PDF available by clicking on title. DM

Perceptual learning as a potential treatment for amblyopia: A mini-review

...A review of the extant studies makes it clear that practicing a visual task results in a long-lasting improvement in performance in an amblyopic eye. The improvement is generally strongest for the trained eye, task, stimulus and orientation, but appears to have a broader spatial frequency bandwidth than in normal vision. Importantly, practicing on a variety of different tasks and stimuli seems to transfer to improved visual acuity. Perceptual learning operates via a reduction of internal neural noise and/or through more efficient use of the stimulus information by retuning the weighting of the information. The success of PL raises the question of whether it should become a standard part of the armamentarium for the clinical treatment of amblyopia, and suggests several important principles for effective perceptual learning in amblyopia....

Comment: Amblyopia is treatable. Amblyopia is treatable at any age. Go to to find a doc to help you. DM

Action-Video-Game Experience Alters the Spatial Resolution of Vision

Playing action video games enhances several
different aspects of visual processing; however, the mechanisms underlying this improvement remain unclear. Here we show that playing action video games can alter fundamental characteristics of the visual system, such as the spatial resolution of visual processing across the visual field. To determine the spatial resolution of visual processing, we measured the smallest distance a distractor could be from a target without compromising target identification. This approach exploits the fact that visual processing is hindered as distractors are brought close to the target, a phenomenon known as crowding. Compared with nonplayers, action-video-game players could tolerate smaller target-distractor distances. Thus, the spatialresolution of visual processing is enhanced in this population. Critically, similar effects were observed in non-video- game players who were trained on an action video game; this result verifies a causative relationship between video-game play and augmented spatial resolution.

Comments: PDF available by clicking on title. DM

Carrot sticks or joysticks: video games improve vision

...Playing action-based video games has been shown to improve attentional processing. A study now finds that it also induces long-lasting improvements in contrast sensitivity, a basic visual function that commonly deteriorates with age. These improvements do not happen for an equivalent group who played a non-action video game....

Comments: PDF available by clicking on title. DM

Enhancing the contrast sensitivity function through action video game training

...The contrast sensitivity function (CSF) is routinely assessed in clinical evaluation of vision and is the primary limiting factor in how well one sees. CSF improvements are typically brought about by correction of the optics of the eye with eyeglasses, contact lenses or surgery. We found that the very act of action video game playing also enhanced contrast sensitivity, providing a complementary route to eyesight improvement....

Prolonged Perceptual Learning of Positional Acuity in Adult Amblyopia: Perceptual Template Retuning Dynamics

...Amblyopia is a developmental abnormality that results in physiological alterations in the visual cortex and impairs form vision. It is often successfully treated by patching the sound eye in infants and young children, but is generally considered to be untreatable in adults. However, a number of recent studies suggest that repetitive practice of a visual task using the amblyopic eye results in improved performance in both children and adults with amblyopia. These perceptual learning studies have used relatively brief periods of practice; however, clinical studies have shown that the time-constant for successful patching is long. The time-constant for perceptual learning in amblyopia is still unknown. Here we show that the time-constant for perceptual learning depends on the degree of amblyopia. Severe amblyopia requires 50 h (35,000 trials) to reach plateau, yielding as much as a five-fold improvement in performance at a rate of
1.5%/h. There is significant transfer of learning from the amblyopic to the dominant eye, suggesting that the learning reflects alterations in higher decision stages of processing. Using a reverse correlation technique, we document, for the first time, a dynamic retuning of the amblyopic perceptual decision template and a substantial reduction in internal spatial distortion. These results show that the
mature amblyopic brain is surprisingly malleable, and point to more intensive treatment methods for amblyopia.....

Comments: Click on title for pdf. DM

Experience-dependent recovery of vision following chronic deprivation amblyopia

...The shift in ocular dominance induced by brief monocular deprivation is greatest during a postnatal critical period and is thought to decline irreversibly thereafter. However, here we demonstrate that complete visual deprivation through dark exposure restores rapid ocular dominance plasticity in adult rats. In addition, the loss of visual acuity resulting from chronic monocular deprivation is reversed if dark exposure precedes removal of the occlusion in adulthood, suggesting a potential use for dark exposure in the treatment of adult amblyopia...

Environmental enrichment in adulthood promotes amblyopia recovery through a reduction of intracortical inhibition

...Loss of visual acuity caused by abnormal visual experience during development (amblyopia) is an untreatable pathology in adults [This is NOT true]. 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....

Prevalence and causes of amblyopia in an adult population

...Amblyopia was diagnosed in 118 participants, or 3.2% of the population using a visual acuity criterion of 20/30 or less and 2.9% using a visual acuity criterion of 20/40 or less. Using a two-line visual acuity difference between the eyes, the amblyopia prevalence was 2.6% and 2.5%, respectively, for the above criteria. The underlying amblyogenic causes assessed were anisometropia (50%), strabismus (19%), mixed strabismus and anisometropia (27%), and visual deprivation (4%). The visual acuity of the amblyopic eye was 20/200 or worse (19%), 20/80 to 20/160 (19%), 20/40 to 20/63 (52%), and 20/30 (11%). .... The most frequent pattern of strabismus was esotropia, whereas hypermetropia was the most frequent refractive error in amblyopic eyes. The mean age at diagnosis was earlier for strabismic and mixed amblyopia (7.4 years) than for anisometropic amblyopia (12.7 years)....

Thursday, November 26, 2009

The Intersection of Online Social Networking with Medical Professionalism

...While social networking in medical trainees
is common in the current culture of emerging professionals, a majority of users allow anyone to view their profile. With a significant proportion having subjectively inappropriate content, ACGME competencies in professionalism must include instruction on the intersection of personal and professional identities....

Comment: Full text available by clicking on title: DM

A Scientific Collaboration Tool Built on the Facebook Platform

We describe an application (“Medline Publications”)
written for the Facebook platform that allows users to maintain and publish a list of their own Medlineindexed publications, as well as easily access their contacts’ lists. The system is semi-automatic in that itinterfaces directly with the National Library of
Medicine’s PubMed database to find and retrieve citation data. Furthermore, the system has the capability to present the user with sets of other users with similar publication profiles. As of July 2008, Medline Publications has attracted approximately
759 users, 624 of which have listed a total of 5,193 unique publications.

Comment: Full text available by clicking on title. DM

Neural Basis of Self and Other Representation in Autism: An fMRI Study of Self-Face Recognition

...This functional dissociation between the representation of self versus others points to a potential neural substrate for the characteristic self-focus and decreased social understanding exhibited by these individuals, and suggests that individuals with ASD lack the shared neural representations for self and others that TD children and adults possess and may use to understand others.....

Oculomotor Control in Children Who Were Born Very Prematurely

...the preterm children had difficulties with the voluntary control of saccades, particularly in the area of inhibition, which may be indicative of a deficit in the region of the dorsolateral prefrontal cortex. This finding is consistent with other reports in preterm children in whom executive function has been found to be compromised, and both these aspects of behavior are likely to share similar areas of cortical control....

Comments: Full text available by clicking on title.

Visual Processing of Faces in Individuals with Fragile X Syndrome: An Eye Tracking Study

...Gaze avoidance is a hallmark behavioral feature of fragile X syndrome (FXS), but little is known about whether abnormalities in the visual processing of faces, including disrupted autonomic reactivity, may underlie this behavior. Eye tracking was used to record fixations and pupil diameter
while adolescents and young adults with FXS and sex- and age-matched typically developing controls passively viewed photographs of faces containing either a calm, happy, or fearful expression, preceded by a scrambled face matched on luminance. Results provide quantitative evidence for significant differences in gaze patterns and increased pupillary reactivity when individuals with FXS passively view static faces. Such abnormalities have significant implications in terms of understanding causes of gaze avoidance observed in individuals with FXS.

Comments: Full text available by clicking title. DM

The impact of optical factors on resolution acuity in children with Down syndrome.

...Grating resolution and interferometric thresholds are reduced in children with DS. However the discrepancy between developmentally healthy children and those with DS is greater for grating resolution acuity, suggesting that degradation in optical quality is a major contributor to poor visual performance in children with DS....

Physiological and behavioral differences in sensory processing: a comparison of children with Autism Spectrum Disorder and Sensory Modulation Disorder

...high incidence of sensory processing diffi culties exists in children with Autism Spectrum Disorder (ASD) and children with Sensory Modulation Disorder (SMD). This is the fi rst study to directly compare and contrast these clinical disorders. Sympathetic nervous system markers of arousal and reactivity were utilized in a laboratory paradigm that administered a series of
sensory challenges across fi ve sensory domains. The Short Sensory Profi le, a standardized parent-report measure, provided a measure of sensory-related behaviors. Physiological arousal and sensory reactivity were lower in children with ASD whereas reactivity after each sensory stimulus was higher in SMD, particularly to the fi rst stimulus in each sensory domain. Both clinical groups had signifi cantly more sensory-related behaviors than typically developing children, with contrasting profi les. The ASD group had more taste/smell sensitivity and sensory under-responsivity while the SMD group had more atypical sensory seeking behavior. This study provides preliminary evidence distinguishing sympathetic nervous system functions and sensory-related behaviors in Autism Spectrum Disorder and Sensory Modulation Disorder.
Differentiating the physiology and sensory symptoms in clinical groups is essential to the provision of appropriate interventions....

Comments: Free full text of article available by clicking title. DM

Traumatic Brain Injury in Young Children: Post-Acute Effects on Cognitive and School Readiness Skills

..Previous studies have documented weaknesses in cognitive ability and early academic readiness in young children with traumatic brain injury (TBI). However, few of these studies have rigorously controlled for demographic characteristics, examined the effects of TBI severity on a wide range of
skills, or explored moderating influences of environmental factors on outcomes. To meet these objectives, each of three groups of children with TBI (20 with severe, 64 with moderate, and 15 with mild) were compared with a group of 117 children with orthopedic injuries (OI group). The childrenwere hospitalized for their injuries between 3 and 6 years of age and were assessed an average of 1½ months post injury. Analysis revealed generalized weaknesses in cognitive and school readiness
skills in the severe TBI group and suggested less pervasive effects of moderate and mild TBI. Indices of TBI severity predicted outcomes within the TBI sample and environmental factors moderated the effects of TBI on some measures. The findings document adverse effects of TBI in early childhood on post-acute cognitive and school readiness skills and indicate that residual deficits are related to
both injury severity and the family environment....

Comments: Full text of article available by clicking title. DM

The magnocellular theory of developmental dyslexia

...In dyslexics, the development of the visual magnocellular system is impaired: development of the magnocellular layers of the dyslexic lateral geniculate nucleus (LGN) is abnormal; their motion sensitivity is reduced; many dyslexics show unsteady binocular fixation; hence poor visual localization, particularly on the left side (left neglect). Dyslexics' binocular instability and visual perceptual instability, therefore, can cause the letters they are trying to read to appear to move around and cross over each other. Hence, blanking one eye (monocular occlusion) can improve reading. Thus, good magnocellular function is essential for high motion sensitivity and stable binocular fixation, hence proper development of orthographic skills. ...

Visual control in children with developmental dyslexia.

...The results support the hypothesis that developmental dyslexia might present deficits which involve the magnocellular pathway and a part of the posterior cortical attentional network....

Picture perception in Chinese dyslexic children: an eye-movement study

...The characteristics of the pictures can significantly influence the visuospatial cognitive processing capability of the Chinese children. There is a detectable disability for the Chinese dyslexic children in the visuospatial cognitive processing: their saccade amplitude and mean saccade distance are shorter, which may be interpreted as specific for their reading disability....

Comments: Full text of this article is available by clicking the title. DM

Executive dysfunction in poor readers born prematurely at high risk

...This study examined the relation between a preterm birth and reading ability and whether children born preterm with poorer reading were more likely to show lower cognitive and executive functioning
skills compared to children born term with poor reading ability. Participants born at term (n=97) and preterm (n=156) were studied using the Woodcock-Johnson Test of Achievement Word Attack subtest (WJWA), Stanford-Binet Intelligence Scale, Comprehensive Evaluation of Language Fundamentals, and executive function tasks during the 3rd, 5th and 7th grades. Children born prematurely were divided into low (n=94) and high (n=62) risk groups based on severity of neonatal
complications. Growth in WJWA scores was used to cluster the sample into three reading ability groups. Contrary to predictions, children born preterm were not more likely to be in the poor reading group. Poorer reading ability was associated with lower language and cognitive scores. The effect of premature birth demonstrated fewer and weaker associations with such scores. A significant interaction between reading ability and birth status indicated that high risk prematurely born children
with poor reading ability were more likely than the other groups to perform poorly on executive function tasks. These data suggest that better reading ability is associated with better neuropsychological function independent of prematurity....

Comments: Full text of article is available by clicking the title above. DM

The Functional Significance of Stereopsis.

...Performance on motor skills tasks was related to stereoacuity, subjects with normal stereoacuity performing best on all tests. This quantifiable degradation in performance on some motor skill tasks supports the need to implement management strategies to maximise development of high grade stereoacuity....

Comments: So have single, clear, comfortable, binocular vision IS important afterall!! DM

Consecutive exotropia after surgical treatment of childhood esotropia: a 40-year follow-up study.

...The incidence of consecutive XT in this cohort was 21%.... Patients who had undergone multiple surgeries had a higher risk of developing consecutive XT compared to those successfully aligned with one surgery. Restriction of adduction and convergence postoperatively was associated with a high risk of consecutive XT. The incidence of consecutive XT did not vary with the level of visual acuity in the operated eye. Age of onset, age at surgery and amount of surgery did not appear to influence the risk for developing consecutive XT....

Comments: Coming on heals of the positive long term research regarding optometric vision therapy, this study suggests that we caution our patients on the long term out comes of strabismus surgery. DM

Susan Berry, PhD & COVD

...Many of us have wished that we had said thank you at just the right moment but then the opportunity passed us by. This happened to me very recently. I had attended the meeting of the College of Optometrists in Vision Development (COVD) which is made up of a small subset of optometrists who are experts in optometric vision therapy. It was an optometrist from this group who had given me an enormous gift: she had taught me that I could rehabilitate my own vision and, with her guidance, I leaned to straighten my crossed eyes and to see in 3D. I wrote all about these experiences in my book Fixing My Gaze....

Wednesday, November 25, 2009

New Open Access Journal in Pubmed

The following journal has been added to PubMed Central:

Open Medicine
ISSN: 1911-2092 (electronic)
Archive: v. 3 (2009). Current and back content is forthcoming. There is no
embargo delay for this journal.

The chain of communication in health science: from researcher to health worker through open access

GLOBALLY, THE PUBLIC AND PRIVATE SECTORS spend billions of dollars each year on biomedical and health related research. Yet in many parts of the world, health care systems are far from achieving the health outcomes targeted by the UN Millennium Development Goals The reasons for this disparity are complex, but one key factor that has been consistently identified is the failure to translate research into effective policy and practices. Not surprisingly, then, health agencies and funding bodies around the world are paying closer attention to what is now generally described as “knowledge translation,” developing mechanisms that “strengthen communication between health researchers and users of health knowledge, enhance capacity for knowledge uptake, and accelerate the flow of knowledge into beneficial health applications.

Comments: Full text available. Click on title. DM

Recent Advances in the Pathogenesis of Syndromic Autisms

Background. Current advances in genetic technology continue to expand the list of medical conditions associated with autism. Clinicians have to identify specific autistic-related syndromes, and to provide tailored counseling. The aim of this study is to elucidate recent advances in autism research that offer important clues into pathogenetic mechanisms of syndromic autism and relevant implications for clinical practice. Data Sources. The PubMed database was searched with the keywords “autism” and “chromosomal abnormalities,” “metabolic diseases,” “susceptibility loci.” Results. Defined mutations, genetic syndromes, and metabolic diseases account for up to 20% of autistic patients. Metabolic and mitochondrial defects may have toxic effects on the brain cells, causing neuronal loss and altered modulation of neurotransmission systems. Alterations of the neocortical excitatory/inhibitory balance and perturbations of interneurons' development represent the most probable pathogenetic mechanisms underlying the autistic phenotype in Fragile X-Syndrome and Tuberous Sclerosis Complex. Chromosomal abnormalities and potential candidate genes are strongly implicated in the disruption of neural connections, brain growth, and synaptic/dendritic morphology. Conclusion. Metabolic testing may be appropriate if specific symptoms are present. High-resolution chromosome analysis may be recommended if a specific diagnosis is suspected because of obvious dysmorphisms. Identifying cryptic chromosomal abnormalities by whole genome microarray analysis can increase the understanding of the neurobiological pathways to autism.

Comments: Full text of article available by clicking on title above. DM

New Journals in Pubmed

The following new journals from Hindawi have been added to PubMed Central:

International Journal of Pediatric Endocrinology
ISSN: 1687-9848 (print) 1687-9856 (electronic)
Archive includes: v. 2009(2009).
Note: There is no embargo delay for this title.

Advances in Hematology
ISSN: 1687-9104 (print) 1687-9112 (electronic)
Archive includes: v. 2009(2009).
Note: There is no embargo delay for this title.

International Journal of Endocrinology
ISSN: 1687-8337 (print) 1687-8345 (electronic)
Archive includes: v. 2009(2009).
Note: There is no embargo delay for this title.

International Journal of Pediatrics
ISSN: 1687-9740 (print) 1687-9759 (electronic)
Archive includes: v. 2009(2009).
Note: There is no embargo delay for this title.

Curbing Mom's Smoking, Childhood Lead Exposure May Be Key to Preventing ADHD

Attention deficit hyperactivity disorder takes a huge toll on children, with about 9 percent of kids ages 8 to 15 displaying diagnosable symptoms of inattention, hyperactivity, and impulsive behavior that can make schoolwork an ordeal and friendships trying. Maternal smoking and lead exposure in early childhood might be behind nearly 40 percent of ADHD cases, according to new research. If that turns out to be true, it may be possible to prevent many cases of ADHD and reduce the huge social, financial, and personal toll of the disorder.

Refractive Errors and Strabismus in Children With Tuberous Sclerosis: A Controlled Study

...A high prevalence of hypermetropia seems to be an additional feature of tuberous sclerosis. Early screening for this amblyogenic factor is indicated in patients with tuberous sclerosis.

Effect of different anesthetic agents on oculocardiac reflex in pediatric strabismus surgery

...Propofol or remifentanil anesthesia was associated with a higher incidence of OCR during pediatric strabismus surgery than sevoflurane and desflurane anesthesia, when either ketamine or midazolam was used as an induction agent.

Comments: Strabismus surgery all though relatively common, does have risks. parents should know what they are. D<

Childhood Abuse may Speed up Aging

...Researchers from Butler Hospital and Brown University found a direct connection between childhood trauma and accelerated reduction in the size of telomeres, the caps on the end of chromosomes that promote cellular stability. Telomeres typically shorten with age. After measuring DNA extracted from blood samples of 31 adults, researchers found accelerated shortening of telomeres in those who reported suffering abuse as kids, compared to those who did not report abuse. ...

Day Care May Double TV Time For Young Children

...the amount of television viewed by many young children in child care settings doubles the previous estimates of early childhood screen time, with those in home-based settings watching significantly more on average than those in center-based daycares. This study is the first to examine screen time in child care settings in more than 20 years. The study looked at television use in 168 child care programs in four states,...

Drug Studied As Possible Treatment For Spinal Injuries

...Researchers have shown how an experimental drug might restore the function of nerves damaged in spinal cord injuries by preventing short circuits caused when tiny "potassium channels" in the fibers are exposed.

The chemical compound also might be developed as a treatment for multiple sclerosis. ...

Phthalates, Common Plastics Chemicals, Linked To ADHD Symptoms

...A new report by Korean scientists, published by Elsevier in the November 15th issue of Biological Psychiatry, adds to the potentially alarming findings about phthalates. They measured urine phthalate concentrations and evaluated symptoms of attention-deficit/hyperactivity disorder (ADHD) using teacher-reported symptoms and computerized tests that measured attention and impulsivity.

They found a significant positive association between phthalate exposure and ADHD, meaning that the higher the concentration of phthalate metabolites in the urine, the worse the ADHD symptoms and/or test scores. ...

Central Corneal Thickness in Children With Diabetes

Diabetic patients have a significantly increased (~55 µm) central corneal thickness compared with healthy controls. Current HbA1C value, which is the marker of metabolic control of the disease, is the only disease-related variable that predicts a higher central corneal thickness. [J Refract Surg. 2009;25:1041-1044.]

Tuesday, November 24, 2009

The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders

Comment: This paper is so important that it should be mandatory reading for all interested in optometric vision therapy. Click on the title for the full text. DM

Background: For nearly 75 years, optometric vision therapy has been an important mode of therapy for both children and adults who manifested a range of nonstrabismic accommodative and vergence disorders.

Methods: In this article, the scientific basis for, and efficacy of,optometric vision therapy in such patients will be discussed. Using bio-engineering models of the oculomotor system as the conceptual framework, emphasis will be focused on studies that used objective recording techniques to directly assess therapeutically related changes in oculomotor responsivity.

Results and Conclusions: The findings clearly support the
validity of optometric vision therapy. Furthermore, the results
are consistent with the tenets of general motor learning.

Computer Gaming for Vision Therapy

...Abstract—Convergence insufficiency is characterized by an inability to maintain effortless alignment of the two eyes (binocular convergence) while performing near tasks. Conventional rehabilitative vision therapy for the condition is monotonous and dull, leading to low levels of compliance. If the therapy is not performed then improvements in the condition are unlikely. This paper examines the use of computer games as a new delivery paradigm for vision therapy, specifically at how they can be used in the treatment of convergence insufficiency while at home. A game was created and tested in a small scale clinical trial. Results show clinical improvements, as well as high levels of compliance and motivation. Additionally, the game was able to objectively track patient progress and compliance.

Comments: Full text of the article is available by clicking on the title. DM

Visual and Perceptual Problems after a Brain Injury

...Although vision problems may not be the most noticeable barrier after a brain injury, they do affect your ability to move and complete your daily tasks. For example, our eyes notice that we are about to step on ice in the parking lot. Our visual system processes this information. We change the speed and direction of our feet to avoid the ice. Or, if we want to pick up a glass of water, our eyes move to locate the glass and focus on it. The brain processes this information. It moves your open hand to the glass. It grasps it and picks it up so you can take a drink....

Improvements in performance following optometric vision therapy in a child with dyspraxia

SS, an 8-year-old boy with dyspraxia, presented for behavioural optometry assessment. He had been diagnosed with a subtle form of dyspraxia by his paediatric occupational therapist, based on poor proprioception, delayed bilateral integration and poor visual perception. A full visual assessment was carried out. SS was given a programme of reflex inhibition exercises for 3 months. Then, a programme of optometric vision therapy (OVT) exercises was prescribed at home and in practice for
a period of 8 months. SS was assessed using a battery of occupational therapy Sensory Integration and Praxis Tests (SIPT) before optometric intervention, and after OVT. There were significant improvements in fusional reserves, accommodative facility and oculomotor control of pursuit and saccadic eye movements. His reading level had changed by 4 years in 11 months. The SIPT results showed improvements in the visual and motor/visual perception subtests, confirming the significant
changes in visual perceptual performance. Consideration is given to treatment modalities for dyspraxia, and the studies confirming their effectivity of approach. This case study provides evidence supporting the use of OVT eye exercises in dyspraxia, ocular motility, accommodative dysfunction, learning difficulties and sports performance. The need for further research and inter-professional
working is discussed.

Comments: Full text of article is available by clicking on the title. DM

Efficacy of Vision Therapy

...Negative feedback control theory analysis of the accommodative and vergence systems provides the basis of today’s optometric vision therapy. These models have a strong physiological and anatomical basis, and have been described in numerous articles and textbooks.5-7 Computer simulations using control theory demonstrates the predictability of both the accommodative and vergence systems. Defects in any component of the system may result in asthenopia, diplopia, and/or strabismus.8 The most common cause of asthenopia is related to inadequate slow vergence. Vision therapy differs from orthoptic models in that control theory analysis acknowledges the dynamic interaction of accommodation and vergence, and its respective feedback mechanisms....

Vision Therapy Fact Sheet

..Vision therapy is a program that aims to improve a person’s visual abilities. It uses a variety of means - such as eye therapy procedures, testing, occlusion (patching) lenses and prisms - to treat a range of visual problems. Vision therapy may be used to treat problems such as amblyopia (lazy eye), eye alignment and coordination problems (including turned eyes or squints), poor focus or inadequate eye-hand coordination. Each program is designed to suit the specific needs of the individual...


Vision therapy is a sequence of neurosensory and neuromuscular activities individually prescribed and monitored by the doctor to develop, rehabilitate and enhance visual skills and processing. The vision therapy program is based on the results of a comprehensive eye examination or consultation, and takes into consideration the results of standardized tests, the needs of the patient, and the patient’s signs and symptoms. The use of lenses, prisms, filters, occluders, specialized instruments, and computer programs is an integral part of vision therapy. The length of the therapy program varies depending on the severity of
the diagnosed conditions, typically ranging from several months to longer periods
of time. Activities paralleling in-office techniques are typically taught to the
patient to be practiced at home, thereby reinforcing the developing visual skills.
Research has demonstrated vision therapy can be an effective treatment option
• Ocular motility dysfunctions (eye movement disorders)
• Non-strabismic binocular disorders (inefficient eye teaming)
• Strabismus (misalignment of the eyes)
• Amblyopia (poorly developed vision)
• Accommodative disorders (focusing problems)
• Visual information processing disorders, including visual-motor integration
and integration with other sensory modalities
• Visual sequelae of acquired brain injury

Approved by the American Optometric Association Board of Trustees, April 2009

VISION THERAPY Information for Health Care and Other Allied Professionals

...Society places a premium on efficient vision. Schools and most occupations require increasing amounts of printed and computer information to be handled accurately and in shorter periods of time. Vision is also a major factor in sports, crafts, and other pastimes. The efficiency of our visual system influences how we collect and process information. Repetitive demands on the visual system tend to create problems in susceptible individuals. Inefficient vision may cause an individual to slow down, be less accurate, experience excessive fatigue, or make errors. When these types of signs and symptoms appear, the individual’s conscious attention to the visual process is required. This, in turn, may interfere with speed, accuracy, and comprehension of visual tasks. Many of these visual dysfunctions are effectively treated with vision therapy....

Vision issues and children…

... * 80 percent of all learning during a child’s first 12 years is obtained through vision. Journal of Behavior Optometry, Visual Screening of Adjudicated Adolescents, Vol. 10, No. 1, 1999.
* Vision disorders are the fourth most common disability in the United States and the most prevalent handicapping condition in children. Current Ophthalmology Vol. 43, No. 5 March-April 1999, A Survey
of Vision Screening Policy of Preschool Children in the United States. 
* The Journal of the American Public Health Association reports that 10% of pre-schoolers have vision deficiencies. This figure increases in grades K through 6 to 25% or one-in-four Pennsylvania children. The prevalence of vision disorders is even higher in children at risk or special needs children, Journal of the American
Public Health Association.
* The National Parent Teacher Association reports that more than ten million children suffer from
visual problems, yet vision exams still are not a part of a child’s school readiness package. American
Foundation for Vision Awareness, Children’s Vision and Literacy Campaign.
* Vision problems are also associated with the inability to master higher math concepts, reading comprehension and spelling. This is a very important part of vision in that approximately 75% of every school day is spent reading and writing. American Optometric Association, Pediatric Eye and Vision Examination, Optometric Clinical Practice Guideline, 1994.
* Research indicates that among the 20 percent of school age children who have a learning disability in reading, 70 percent of them have some form of visual impairment, such as ocular motor,perception or binocular dysfunction, which may be interfering with their reading skills. Optometry,The Journal of the American Optometric Association, Practice Strategies: Back to School, Vol 71, No. 8 August
* Children with vision-related learning problems revealed that they were experiencing feelings such as a lack of direction, a sense of not belonging, an inadequate sense of self-assurance and a feeling of insecurity, inadequacy and inferiority. Joel N. Zaba, Vision’s relationship to delinquency, illiteracy and learning problems, 2001....

Are We Making Ourselves Stupider?

...Today we absorb much of our knowledge through the internet, an act which requires little more than the click of a mouse. Schools have little money for classes that require thinking and moving, such as classes in the visual arts, acting, or music. Laboratories courses, emphasizing hands-on activities, are cut from our science curriculum. If we divorce our learning from our actions, will we lose important ways of thinking? After all, we were built to move, not for the mouse click....

Autism treatments: Risky alternative therapies have little basis in science

...Studies have shown that up to three-quarters of families with children with autism try alternative treatments, which insurance does not usually cover. Doctors, many linked to the influential group Defeat Autism Now!, promote the therapies online, in books and at conferences....

Omnibus autism decision: ‘Good science wins out in the end

...On Feb. 12, 2009, a court of special masters ruled that the combination of measles-mumps-rubella and thimerosol-containing vaccine does not cause autism. The ruling involved three test families who have children with autism. The families contended their children’s autism was triggered by a combination of the measles, mumps, rubella vaccines and the preservative thimerosal and were seeking to be compensated through the Vaccine Injury Compensation Program. ...

3 Most Common Mistakes: Children’s Vision

1. Confusing those school screenings with eye exams.

2. Relying on your child's opinion of their eyesight.

3. Leaving the sunglasses behind.

Stunning Stereoviews: Historical Photos Show Past in 3D

...The opportunity to catch a glimpse at life in a long-ago era in 3D is rare indeed, but thanks to the stereoviews taken by photographer T. Enami, Meiji Japan in the early 1900s momentarily appears vivid and immediate. Enami was Japan’s most prolific stereo-photographer...

Comment: This is absolutely amazing! No special glasses need. You will enjoy this very much! DM

NIMH Study Finds Anti-Psychotic Medication Useful in Treating Serious Behavioral Problems among Children with Autism

..."Although this study did not attempt to treat the core symptoms of autism, our findings suggest that risperidone can be useful in treating moderate to severe behavior problems that are associated with autism in children," said Lawrence Scahill, Ph.D., principal investigator at the Yale Child Study Center site....

Comments: Many of my patients who have both intellectual disability and a psychiatric diagnosis are taking risperidone. Potential side effects include tardive dyskinesia, stroke, and various visual disturbances. This is not a drug to be taken lightly. DM

Autism Spectrum Disorders (Pervasive Developmental Disorders)

Autism Spectrum Disorders (Pervasive Developmental Disorders)

What are Autism Spectrum Disorders?
Autism Spectrum Disorders (ASD), also known as Pervasive Developmental Disorders (PDDs), cause severe and pervasive impairment in thinking, feeling, language, and the ability to relate to others. These disorders are usually first diagnosed in early childhood and range from a severe form, called autistic disorder, through pervasive development disorder not otherwise specified (PDD-NOS), to a much milder form, Asperger syndrome. They also include two rare disorders, Rett syndrome and childhood disintegrative disorder.

Comments: Click on the title for a great deal of info on Autism from the National Institute of Mental Health. DM

Lead, Tobacco Linked to ADHD

...Prenatal tobacco and childhood lead exposures are associated with increased risks of attention deficit hyperactivity disorder (ADHD), researchers said.

Moreover, the two exposures were are synergistic: together they yield an ADHD risk increase that is greater than the product of the risk factors for lead and tobacco individually, according to Tanya Froehlich, MD, of the Cincinnati Children's Hospital Medical Center, and colleagues....