Thursday, December 24, 2009

Test Allows Early Detection Of Vision Problems In Infants With Hemangiomas Of Eyelids

...In children with vascular birthmarks around the eye, even partial blockage of vision can lead to visual loss due to amblyopia. Now a simple test can detect early evidence of amblyopia in infants too young for conventional vision testing,...

Drug and Placebo: Study Redefines Placebo Effect as Part of Effective Treatment

...Researchers used the placebo effect to successfully treat psoriasis patients with one quarter to one half of their usual dose of a widely used steroid medication, .... Early results in human patients suggest that the new technique could improve treatment for several chronic diseases that involve mental state or the immune system, including asthma, multiple sclerosis and chronic pain....

Comments: Doctors have been using placebo therapies for centuries for the good of their patients. Good doctors today still do so. Never discount the power of a patients' mind to help "cure" what needs to be cured. DM

Perinatal Systemic Inflammatory Response Syndrome and Retinopathy of Prematurity

...Fetal and neonatal inflammation is associated with several morbidities of prematurity. ..... We conclude that perinatal inflammation may be involved in the pathogenesis of ROP.

I Think Step To The Left, You Think Step To The East

....Even the way people remember dance moves depends on the culture they come from, ..... Whereas a German or other Westerner might think in terms of "step to the right, step to the left," a nomadic hunter-gatherer from Namibia might think something more like "step to the east, step to the west."...Those differences aren't just a matter of language; rather, they reflect differences in the way our minds encode and remember spatial relationships.

Bedside Skills Trump Medical Technology

...Sometimes, a simple bedside exam performed by a skilled physician is superior to a high-tech CT scan, a Loyola University Health System study has found....

Comments: All doctors should read this story immediately. It is the patient we serve. Listen to them. Share stories. Like them.....and the best possible outcome will always occur. DM

Topiramate in the prevention and treatment of migraine: efficacy, safety and patient preference

Migraine is a very common disorder characterized by the combination of typical headache with associated autonomic symptoms and/or the presence of aura. Considerable advances have been made in recent years to understand the pathophysiology of migraine, which has led to improved treatment options for the acute migraine attack as well as migraine prophylaxis. Unfortunately, preventive treatment is often insufficient to decrease migraine frequency substantially or is not well tolerated. Topiramate is an antipileptic drug with a complex mode of action which has proven its efficacy and safety in the prophylactic treatment of episodic migraine in a number of randomized controlled clinical trials. Topiramate is also effective in treating patients with chronic migraine. It has little pharmacological interaction with other drugs and is generally well tolerated by patients.

Comments: Topamax is now prescribed for many disorders. It can cause narrow angle GLC and other adverse affects. If you click on title a link to the full article is available. DM

When ADHD is really a Vision Problem

It is important for all children with ADHD to have a comprehensive eye AND vision evaluation that not only assesses visual acuity (clarity of vision)and eye health...but also how the eyes move, focus, and coordinate....a vision information processing assessment may need to be completed as well. Go to to find a doc that has been certified in these areas.

Wednesday, December 23, 2009

Squishing Squid....Tackling Octopi

In the Maino's been a tradition (forever) that on Christmas Eve we have all I make a seafood marinara sauce for linguine and homemade lasagna with my special ricotta mixture that includes egg, lemon and sugar. The marinara sauce includes squid, octopus, clams, mussels and anything else I can find to throw into the pot that swims.

My grandson (Dominic IV) and I are squishing the squid and tackling the octopi....just like my son and I used to do....more pics available on my Facebook page.....

Have a very Merry Christmas and most Joyous and Happy New Year.



A undergrad buddy of mine emailed these "tips"...since I do not want to be the only one following them...I invite you all to follow each and every one of these Golden Holiday Eating Requirements. DM

1. Avoid carrot sticks. Anyone who puts carrot sticks on a holiday buffet table knows nothing of the Holiday spirit. In fact, if you see carrot sticks, leave immediately. Go to the party next door, where they're serving rum balls.

2. Drink as much eggnog as you can - quickly - it's rare. You cannot find it any other time of year but now, so drink up! Who cares that it has 10,000 calories in every sip? It's not as if you're going to turn into an eggnog-alcoholic or something. It's a treat. Enjoy it. Have one for me. Have two for me. It's later than you think. It's Christmas!

3. If something comes with gravy, use it. That's the whole point of gravy. Gravy does not stand alone, and dishes do not have gravy as an OPTION. Pour on a large amount. Make a volcano out of your mashed potatoes. Fill it with gravy AND BUTTER. Eat the volcano. Savor the lava flow. Repeat.

4. As for the mashed potatoes, always ask if they were made with skim milk or whole milk. If it's skim milk, why bother? Would you buy a high performance Italian sports car with an automatic transmission?

5. Do not have a snack before going to a party in an effort to control your eating. The whole point of going to a Holiday party is to eat other people's food for free. Lots of it. Hello?

6. Under no circumstances should you exercise between now and New Year's Day. You can do that in January when you have nothing else to do. This is the time for long naps, which you'll need after circling the buffet table while carrying a 10-pound plate of food and a vat of eggnog.

7. If you come across something really good at a buffet table, like lobster croquettes or cheese stuffed jalapenos or really spicy buffalo wings, or even the really good frosted Christmas cookies in the shape and size of Santa, position yourself near them and don't budge. Have as many as you can before becoming the center of attention. They're like a beautiful pair of shoes. If you leave them behind, you're never going to see them again.

8. The same thing goes for the pies: Apple, Pumpkin, Mincemeat? Have a slice of each. Or, if you don't like mincemeat, have two apples and one pumpkin. Always have three. When else do you get to have more than one dessert? Labor Day?

9. Did someone mention fruitcake? OK, OK, it IS loaded with the mandatory celebration calories, but should be avoided at all costs. I mean, one must have some standards. Note: there is ONE EXCEPTION to the fruitcake rule. If you know for sure that it is loaded up with and soaked in real rum or cognac instead of those pathetic artificial flavors, toast a few slices and bury them in cream cheese and powdered sugar.

10. One final tip: If you don't feel terrible when you leave the party or get up from the table, you haven't been paying attention. Re-read the tips and start over, but hurry, January is just around the corner.

Tuesday, December 22, 2009

Identify Binocular Vision Disorders

>>>In comparison to glaucoma, cataract, age-related macular degeneration, diabetic retinopathy and dry eye syndrome; binocular vision (BV) disorders are even more frequently encountered than these diseases and have significant negative effects on one's quality of life. In fact, one study revealed that the prevalence of accommodative and BV (strabismic and non-strabismic) disorders is 9.7 times greater than the prevalence of ocular disease in children ages six months to five years old, and it's 8.5 times greater than the prevalence of ocular disease in children ages six to 18 years old.1 In addition, a study of 1,679 patients between the ages of 18 and 38 showed that 56.2% presented with symptoms associated with BV dysfunction.2 Although these are alarming statistics, a disconnect exists between the high prevalence of BV disorders in the general population and the BV patients reported being evaluated by primary care optometric practices.

To improve the lives of these often overlooked patients, while augmenting the financial health of your practice, follow these four steps......

Comments:This is an article I wrote and has been featured as the lead story for the December issue of Optometric Management. Please tell all to have a look. We should diagnose and treat these binocular vision disorders in all our patients. DM

Suppression and Reading

Detecting Suppression

Convergence Insufficiency..

....The Skill of Convergence

The ability to converge your eyes is a skill that develops in childhood. A baby can’t do it, but by age 2 or 3, most children can. What is it? It’s just the ability to bring both eyes together on a single point and hold them there. Ordinarily, when you relax the muscles in your eyes, you end up focusing at a distance. It takes muscle activity to pull your eyes together so that you can converge on a nearer point. Obviously, reading requires this skill, since most reading is done at a relatively close distance....

Conlon Survey and Academic Problems

....researchers at Western University of Health Sciences, College of Optometry, the Jules Stein Eye Institute, UCLA, and the Southern California College of Optometry, Drs. Chris Chase, Chinatsu Tosha, Eric Borsting, and William Ridder have noted that the Conlon survey is a useful tool to identify students with near work vision problems that negatively affect academic/school performance or are associated with eye focusing problems.

About Optometry & Vision Development

Optometry & Vision Development (OVD) is a peer-reviewed open access journal indexed in the online Directory of Open Access Journals. The full text of these articles is available free from OVD is an official publication of the College of Optometrists in Vision Development. Any questions may be addressed to the editor, Dominick M. Maino, OD, MEd, FAAO, FCOVD-A at

Dyslexia and Fixation Optometry & Vision Development, Drs. Burkhart Fischer and Klaus Hartnegg of the Centre of Neuroscience, Optomotor Laboratory, of the University of Freiburg, present their research on instability of fixation and children with dyslexia. They note that "Dyslexic subjects have higher incidence of fixation instabilities as compared with their corresponding age group. The percentage of affected subjects was 25% for the binocular instability independent of age. Daily practice improves binocular fixation by 55%, with simple stability improving by 19%. To the extent that the binocular vision instability causes dynamic problems of stereo-vision (3D vision), the trained subjects have less and shorter periods of double images arriving at cortical levels of visual processing. This in turn makes it easier for them to identify letters and short sequences of letters with the result of fewer problems in reading."...

Optometric Vision Therapy Helps Children With Math Problems

...The incidence of individuals with a mathematics learning disability is between 6 - 7% of the population." Since there are more than 300 million individuals in the United States, up to 21 million men, women, and children may be affected by this disorder. Sidney Groffman OD, MA, FCOVD, Professor Emeritus at SUNY College of Optometry, author of the article published in the December 2009 issue of Optometry & Vision Development, also says, "This is unfortunate because math skills are of prime importance in everyday life enabling us to understand number concepts and do calculations. Math ability is essential for many occupations and professions."...

Autism Numbers Are Rising. The Question is Why?

One in 110 American children are considered to fall somewhere along the autism spectrum, according to the latest report released by the federal government. The new figure, which was released initially in October, comes from the most comprehensive set of data yet on the developmental health of eight-year-olds.

Prevalence of Down Syndrome Among Children and Adolescents in 10 Regions of the United States

...From 1979 through 2003, the prevalence of DS at birth increased by 31.1%, from 9.0 to 11.8 per 10000 live births in 10 US regions. In 2002, the prevalence among children and adolescents (0–19 years old) was 10.3 per 10000. The prevalence of DS among children in a given age group consistently increased over time but decreased with age within a given birth cohort. The pooled prevalence of DS among children and adolescents was lower among non-Hispanic black individuals and other racial/ethnic groups compared with non-Hispanic white individuals; it was also lower among females than males....

Visual Outcome in 879 Children Treated for Strabismus: Insufficient Accommodation and Vision Deprivation, Deficient Emmetropisation and Anisometropia

...On the basis of these findings, severe residual amblyopia in children remaining after treatment could be explained by additional vision deprivation. It can be reduced by starting spectacle correction of hypermetropia before the age of 18 months. Anisometropia seemed the result of deficient emmetropisation. ...

Comments: Maybe before doing surgery you should: 1.) Rx glasses 2.) Consider optometric vision therapy even on little ones. 3.) Since we know surgery can be done at any time...why rush it. Make sure the child is seeing as clearly as possible, use prisms as is appropriate, and maximize all hand eye capabilties...before doing surgery. DM

Volunteering Keeps Older Minds Sharp...

Tutoring children as part of a volunteer service program helped older women delay or reverse declining brain function, according to a new study that suggests aging brains benefit from mentally stimulating social activities. ...

Autism disorders increased by 57% in four years.

From AOA FirstLook:

NBC Nightly News (12/18, story 5, 1:55, Williams) reported that "there are astounding new numbers out...on the extent of autism in the United States." NBC chief science correspondent Robert Bazell explained, "According to the latest CDC study," published in Morbidity and Mortality Weekly Report, "almost one percent of American children have autism," including "one in 70 boys and one in 315 girls."

The CBS Evening News (12/18, story 3, 3:00, Couric) reported that, according to the study, "one eight-year-old out of every 110 was diagnosed with autism or a related disorder" in 2006, "a 57 percent jump over just four years."

The New York Times (12/19, A16, Carey) reported that "the estimate is the highest to date of so-called autism spectrum disorders (ASDs)," which include "a range of disorders, from severe autism to milder forms like Asperger's, to 'pervasive developmental disorder,' a nonspecific diagnosis given to many children with social difficulties or some kinds of learning and sensory problems."

The CDC obtained its estimates from "an analysis of medical records from more than 307,000 eight-year-olds," the Washington Post (12/19, Stein) reported. This estimate is also "consistent with another estimate the agency released in October, based on a telephone survey that concluded the condition was diagnosed in about one out of every 100 children." According to study lead author Catherine Rice, of the CDC's National Center on Birth Defects and Developmental Disabilities, the "reason for the increase remains unclear," but may be partly due "to more children being diagnosed with one of the conditions, rather than an actual increase in how many children are developing the disability."

The AP (12/21, Stobbe), Bloomberg News (12/18, Randall, Gibson), CNN (12/19, Falco), Time (12/19, Park), the Wall Street Journal (12/19, A4, Dade), the Baltimore Sun (12/18, Brewington), the Tampa Tribune (12/18, Shedden), Reuters (12/18), the Los Angeles Times (12/18, Maugh) "Booster Shots" blog, HealthDay (12/18, Gardner), WebMD (12/18, DeNoon), and the Boston Globe (12/19, Smith) also covered the story.

Recurrent corneal metallic foreign bodies in children with autism spectrum disorders

Corneal metallic foreign body is a common condition in working-age adults due to occupational exposure, such as grinding, welding, and hammering. Ocular trauma is a leading cause of vision loss in children; however, corneal metallic foreign bodies are rare in the pediatric population. Here we describe 2 children suffering from autism spectrum disorders presenting with recurrent corneal metallic foreign bodies. Meticulous history revealed that both children extensively used a therapeutic home swing with metallic suspensions, suggesting the potential mechanism for the recurrent corneal metallic foreign bodies. Furthermore, the use of protective eyewear during swinging prevented further recurrences. Awareness of this potential danger is particularly important in children with disabilities, who may have difficulty communicating their concerns and cooperating during examination and treatment.

Pupillary light reflexes in premature infants prior to 30 weeks postmenstrual age

Data regarding the pupillary responses in very premature neonates is scarce; what data exist, moreover, is not recent. The purpose of this pilot study is to collect data on direct and consensual pupillary light responses before 30 weeks postmenstrual age. Six neonates were studied. Mean pupillary size at rest was 3.6 ± 0.4 mm. No direct or consensual responses to light were present in any of 12 eyes. Accurate information about pupillary reflexes in very premature neonates provides relevant information about the development of the visual and neurologic systems. Available information about the development of the Edinger-Westphal nucleus

Uncovering the Mystery of Anti-Psychotic Drugs in the Brain

...Delusions and hallucinations, along with difficulty paying attention and recalling information, are prevalent symptoms of schizophrenia, which can interfere with daily life. A class of drugs called atypical neuroleptics is most commonly prescribed to treat the disorder, but how they affect brain chemistry was never fully understood. ...

Dr. Geoffrey Goodfellow answers an Optics Questions

Why does a mirror only appear to invert things left to right and not up/down?

The short answer is that a mirror appears to only reverse horizontally and not vertically, but this is not really the case. A plano mirror reverses things perpendicularly only. Light coming towards the mirror is reflected outward from the mirror.

The confusion comes because directions like up and down are relative to space whereas directions like left and right are relative to the body position. For example, take two people, one facing north and another facing south to both point up, they will both point in the same direction in space. Ask them both to point to their right, and they will point in opposite directions in space. Ask the question using directions in space instead of body position (i.e. ask them both to point east) and they will both point in the same direction again since "east" is not relative to their body positions.

Back to the mirror, it only reverses in and out. Therefore if you put up, the image will point up. If you point east, the image will point east. However, if you point left, because left is defined relative to the front of the body, the image will appear to point right.

Sorry if I've confused you here. Optometry also has a similar confusion with BU/BD versus BO/BI which is why BU OD and BU OS is considered yoked whereas BO OD and BO OS is not.

Hope this helps!

Geoffrey Goodfellow
Associate Professor
Illinois College of Optometry

“Diaton tonometry”

“Diaton tonometry” is a unique approach to measuring intraocular pressure (IOP) through the Eyelid. Non-Contact (no contact with cornea), no anesthesia or sterilization required, pen like, hand-held, portable tonometer.

Comments: Anyone out there use this? DM

Sunday, December 20, 2009


It's that time of year....yes, Italian Blood Oranges are now available. (If you've never had an Italian Blood Orange, you must immediately go out and get a dozen or more right now...then come back to read the rest of this the "zest")

Since Italian Blood Oranges are now available you are obligated to make some Italian Orange Liqueur...

A college buddy of mine gave me these directions....follow them to bliss. BTW you must be 21 years of age to do this...


Snag a large (at least 2 quart, 1/2 gallon mason jars work great for this) jar with a lid you can close.

Add 1 quart 150 proof grain alcohol to the jar. Polish RYE alcohol (spirytus) works best for this, and that claim is based on empirical research rather than mere Polish favoritism. Everclear is corn based and not even remotely as good for the job. It is best for killing brain cells - .

Eat a lot of Italian Blood Oranges - good for you during cold / flu season - your family doctor will approve :-)

BEFORE eating the oranges, zest them. Place the zest in the jar with the alcohol and keep adding zest until you've basically filled the jar.

Once filled, let it sit for a month or so. Once a week you can swirl it around just to keep the essences blended.

Get another 1/2 gallon jar. Split the zest/alcohol mixture evenly between the two jars. Make a sugar syrup of desired sweetness - start with equal parts sugar & water - the so-called simple syrup - and add 1 pint of syrup to each jar so you now have TWO jars full about 3/4 full of stuff. Let them sit for a month, swirling around occasionally for the first two weeks or so. Hopefully you will notice that it gets less cloudy when you let it sit for the last two weeks and the sediments collect at the bottom of the jars.

CAREFULLY pour the final essence of all that is good through sufficient filtering media and into the storage containers of your preference. I personally find that double layered paper coffee filters are perfect for the task.

Make marmalade from the zest... If you are fool enough to throw it away, you don't deserve to drink the finished product.

The resulting nectar is about 80 proof so there's no concern about spoilage / storage. Store-bought Arancello is only about 40 to 60 proof and just ain't as good, especially since it is made commercially, without l'amore.

Comments: OK...let me know if you try this. Also, I will trade a bit of my batch for a bit of yours...say at the next COVD, AAO or AOA meeting. We can share zesting stories while we imbibe! DM

Skeffington Symposium

...The Symposium will be held on Saturday, Sunday, Monday, January 16, 17, 18, 2010. The Symposium will be held at the Hyatt Regency Bethesda in Bethesda, Maryland (in the Washington, DC area). The Symposium is sponsored by the Institute for Behavioral Optometry (IBO) and under the auspices of the Optometric Extension Program Foundation, Inc....