Thursday, February 25, 2010

Healthbeat Report: The 3-D Dilemma

Chicago-lands ABC WLS TV news just finished showing a HealthBeat segment where I was interviewed on the "Avatar 3D Vision Syndrome" during the 10 PM time slot. Here is a bit of the on the title above for the full transcript and video....(Photo by Waldo Duran...thanks Waldo!)

February 25, 2010 (CHICAGO) -- Digital technology is making the 3-D experience like nothing before. But many people still say trying to see in stereo leaves them with a headache, stomach ache or both. That could be a sign of an undiagnosed vision problem. And there may be a way to fix it.

For decades, 3-D was seen as more of a gimmick than an art form. Today's three-dimensional experience is challenging that perception. And by spring you could have a 3D TV in your home.

But even in this advanced form3-D is leaving some viewers feeling sick. Angela Brusnman is one of them.

"Throughout the experience it's definitely an ocular headache. You can tell it's definitely coming from right behind the eyes," said Brunsman.

Complaints include headache, nausea, dizziness and fatigue. There are no hard numbers but its estimated anywhere from 4 to 10 percent of the population can't watch or tolerate 3-D.

"Anywhere from 3 million to 9 million or more will have binocular vision dysfunctions that will stop them from enjoying 3-D movies," said Dominick Maino, O.D., optometrist, Illinois Eye Institute.".....

I went on to discuss how we can treat those binocular vision disorders that stop my patients from enjoying 3D movies....

The newscast also interviewed an Ophthalmologist, who did not think optometric vision therapy would help's too bad he has not stayed up to date on all the new neuroplasticity research that clearly shows even adult brains can change in a positive fashion with the right therapy!! I'll post the link to the video as soon as it becomes available.

If you have any questions about the 3D Vision Syndrome, please feel free to email me at or even call me at the Illinois Eye Institute 312-949-7282 or at Northwest Optometric Associates (my private office)708-867-7838. DM

Wednesday, February 24, 2010

This Blogger on TV Thursday WLS 10 PM News

Just a quick reminder, I will be on the HealthBeat segment of ABC WLS TV News (channel 7) in the Chicago-land area tomorrow on Thursday Feb 25th at 10 PM. I will be interviewed on why some people become ill after watching 3D movies.

WLS 10 PM news is the #1 most watched news program in Chicago. Hundred's of thousands of viewers tune in each night. I hope I don't blow it!

Please watch and let me know what you think.

Feel free to post comments to my Facebook Page at!/home.php?sk=lf or just email me at

Tell your friends....thanks.

Are special glasses needed for regular computer users?

...The use of computers has made us all aware of how well our eyes work -- or don't. Add to that the stress of looking at the tiny type on iPhones or BlackBerrys, and suddenly we're all afraid we need glasses....

Untreated Vision Problems In Elderly Associated With Increased Risk Of Cognitive Decline.

From AOA News:

MedPage Today (2/23, Bankhead) reported that, according to a study published online in the American Journal of Epidemiology, "untreated vision problems in older age are associated with an increased risk of decline in cognitive function and Alzheimer's disease." In a study of "625 participants followed for an average of 10 years," researchers found that "uncorrected poor vision was associated with a five- to 10-fold greater risk of Alzheimer's disease and a five-fold greater risk of cognitive decline without dementia, compared with older people who had very good or excellent vision."

Reuters (2/24, Norton) reports that while it remains unclear why untreated vision problems contribute to dementia, one study author theorized that poor vision may prevent some seniors from fully taking part in a social life, exercising, reading, and performing activities to keep their minds active, all of which could help stave off dementia.

Help with IEP and 504 Plans

I just had a parent write me saying:

Are you aware of a comprehensive list that suggests possible 504 plan/IEP accommodations for each separate visual processing diagnosis area? I am part of a parent networking group and many of our families have children with visual processing diagnoses. However, when they approach the school for a 504 plan, they find themselves needing to 'educate the educators'! As such, it would seem beneficial to have a list of specific accommodations that might be applicable to each diagnosis, rather than walking in with a three page list of possible accommodations and overwhelming the school team. Many standard accommodations most likely apply to most/all of the diagnoses, but perhaps there are some that apply to only certain diagnoses.

Thank you for your time and for your many valuable contributions to 'education & awareness' regarding visual processing. Our daughter's world changed dramatically when we finally got her diagnosed and treated appropriately for convergence insufficiency/binocular dysfunction. The world is a MUCH less frustrating place for her now!

So here's the list we use at the Illinois Eye Institute. This may be a good starting point.

Area Adjustments

Gross Motor Encourage individual motor activities
Select games/activities that ensure success

Laterality / Directionality Label directions on paper
Point to the direction when giving instructions
Highlight letters or words reversed frequently
Label paper with up/down and right/left

Visual Discrimination Allow tracing of forms with finger prior to copying
Allow verbal reinforcement to aid discrimination
Use tracing and matching activities
Avoid poor quality or reduced size copies of paperwork

Eye Tracking / Figure Ground Move to the front of the classroom
Allow use of templates or windows to reduce amount of visual information
Allow use of finger, pointer, or highlighter
Point out / highlight important features
(See suggestions under visual discrimination)

Visual Closure Point out significant features
Allow tracing of forms with finger prior to copying

Visual Memory / Allow use of aids (i.e. mnemonics)
Visual Sequential Memory Reinforce visual information with other sensory aids
Reduce the number of steps in visual tasks

Visual Motor Integration Reduce time on written work
Allow oral or taped responses
Use large diameter pencils
Allow boundaries for printing
Color code materials
Allow tracing of forms prior to copying

Auditory-Visual Integration Stress single modality (auditory or visual – not both at the same time)

Tuesday, February 23, 2010

Amazing 3D Photography by Almont Green

I just received an email from a wonderful photographer who specializes in 3D photography. He has developed a keen interest in binocularity and stereopsis because of this. His FAQ notes that....

Almont Green uses lenticular lens technology to create a real three-dimensional photograph. His multi-perspective images come from reality, a true photographic image – not from inside a computer. To date, lenticular has been used primarily for winking-eye-type animations and cut-up, stacked images created with computer software. Years ago, there were multi-lens film cameras but their fixed (and low quality) lenses limited the quality and precise alignment required for accurate “what you see in real life” recreation. Some people are experimenting with a single camera solution that moves along a rail, but this process is limited to objects that don’t move and is analogous to closing one eye and moving your head from side to side. Almont’s process is unique and his photos go beyond “museum quality”. Their limited-run availability makes them appropriate for collectors. As you move one of Almont’s photos,the images stay stable and the level of depth is so palpable,people often turn them over to see if the object is sticking out the other side.

Click on the title above to check out his website and click here to go to his blog. I am also going to list his blog here under "Blogs of Interest" on the right hand side of this blog. DM

Is There a “Language of theEyes”?

Is There a “Language of theEyes”? Evidence from Normal Adults, and Adults with
Autism or Asperger Syndrome

Previous work suggests that a range of mental states can be read from facial
expressions, beyond the “basic emotions”. Experiment 1 tested this in more
detail.... Results indicated that:
(1) Subjects show remarkable agreement in ascribing a wide range of mental
states to facial expressions, (2) for the basic emotions, the whole face is more
informative than either the eyes or the mouth, (3) for the complex mental states,
seeing the eyes alone produced significantly better performance than seeing the
mouth alone, and was as informative as the whole face. In Experiment 2, the
eye-region effect was re-tested,... Results were broadly similar
to those found inExperiment 1. InExperiment 3, adults with autism orAsperger
Syndrome were tested using the same procedure as Experiment 1. Results showed
a significant impairment relative to normal adults on the complex mental states,
and this was mostmarked on the eyes-alone condition. The results fromall three
experiments are discussed in relation to the role or perception in the use of our
everyday “theory of mind”, and the role of eye-contact in this.

Comments: Although this was published in 1997...this article (available for download by clicking on the title) is a good place to start in your study of autism. DM

Antidepressants May Slow Fetal Development

...At age 6 months, babies who were exposed to antidepressants in utero were twice as likely to be unable to sit without support as those whose mothers had untreated depression during pregnancy...

Online Program Helps Manage Pain

...A personalized, online self-management program helped patients with pain syndromes improve coping skills and reduce stress and depression...The online program, demonstrated at, employs patient-specific information to generate individualized self-management strategies.

Eyeing gene therapy

...A new gene therapy regimen offers hope to patients with a form of Leber’s congenital amaurosis, including some children who were able to subsequently attend sighted classes, ...In the study involving 12 subjects ages 8 to 44, all were given one subretinal injection of a vector of adeno-associated virus (AAV) containing an intact copy of a gene that was defective in these Leber’s congenital amaurosis patients. ...

Differential development of visual attention skills in school-age children

...Children aged 7–17 years and adults aged 18–22 years were tested on three aspects of visual attention: the ability to distribute visual attention across the field to search for a target, the time required for attention to recover from being directed towards a target, and the number of objects to which attention can be simultaneously allocated. The data suggested different developmental trajectories for these components of visual attention within the same set of participants. This suggests that, to some extent, spatial, temporal and object-based attentional processes are subserved by different neural resources which develop at different rate. In addition, participants who played action games showed enhanced performance on all aspects of attention tested as compared to non-gamers. These findings reveal a potential facilitation of development of attentional skills in children who are avid players of action video games. As these games are predominantly drawing a male audience, young girls are at risk of under-performing on such tests, calling for a careful control of video game usage when assessing gender differences in attentional tasks.

International Congress of Behavioral Optometry

ICBO will feature many well known clinicians and scientists presenting the latest in research and clinical care. These presenters include but are not limited to: Susan Barry, PhD (StereoSue); Ken Ciufredda, PhD, OD (well known researcher); Nate Flax, OD (well known researcher/clinician); Dominick Maino, OD, MEd (well known educator/researcher/clinician, editor Optometry & Vision Development); WC Maples, OD (well known educator/researcher/clinician and Editor, Journal of Behavioral Optometry) and many, many more! Click on the title above to register for this meeting today!

ICBO Education Program (alphabetic order by presenter)


Aalberg, Steen
ABI/TBI Induced Vision Impairments Addressed in a Multidisciplinary Rehabilitation Setting

Abbondanza, John
A Model of Visual Imagery

Barry, Dan

Barry, Susan
Fixing my Gaze: Vision Therapy for Strabismus

Baxstrom, Curt
Optometric Considerations in the Diagnosis and Treatment of Paresis and Paralysis of Cranial Nerves III, IV, and VI

Berthiaume, Janet
Vision, Posture, Balance, Spatial Orientation and It's Relationship to Function

Bleything, Willard
The Effectiveness of a Group Delivered Vision Therapy Program

Chase, Chris
Predicting Reading Speed in Above Average Readers with Clinical Measures of Accommodation

Chen, Ai Hong
Short and Long-Term Effects of a Vision Intervention Program on Academic Performance Among Primary School Children in Malaysia

Christian, Michael
Quantum Optics - Visuo-Somatic Realignment - QO-VSR

Ciuffreda, Kenneth
Egocentric Localization: Basic Aspects, Interpretations, and Clinical Implications

Collier, Stefan
Logistic support for the Behavioral optometrist, Group vs. One-on-One VT, Both Types of VT can be Successful?

Coulter, S., Mandese, M., Green, M.
Vision Therapy for Individuals with Autism Spectrum Disorder

Flax, Nathan
Kraskin Memorial Lecture: Paths to Managing Strabismus and Amblyopia

Galaviz, José de Jesús Espinosa
Effects of Refractive Surgery on Binocular Vision: Pre- and Post- LASIK Values

Gallop, Steven
Astigmatism...with a Twist

Getz, Donald
Successful Strabismus Therapy

Gooden-Lewis, Martha
Traveling Zero to One Thousand Within a School Zone - Visual Learning/Development in a Group Setting within an Inner City School

Gottlieb, Raymond
ELECTIVE: Attention and Memory Training in an Optometric Neuro-Rehabilitation Practice: Introduction to Stress-Point Training

Graham, Victoria
Differential Diagnosis and Treatment of Balance Disorders: The interaction of visual, vestibular and somatosensory systems

Grbevski, Simon
When we Diagnose an Eye Problem, is the Cause Really in the Eyes?

Hadden, Denise
Determination of Cognitive Processing Styles Using Colour Visual Field Analysis and Perceptual Scores

Hellerstein, Lynn
Create Your Successful Vision Therapy Practice

Hirsch, Lee
Driver Rehabilitation Following Brain Injury: A Collaborative Effort

Hohendorf, Robert
So, What has Vision Done for me Lately?

Holland, Keith
A Review of Past and Current Concepts in Visual Processing - The Behavioural Legacy Discovered Anew

Howell, Edwin
Where is the "Magic" in Vision Therapy

Hurst, Caroline
Primary Variabilities of Movement and Optometric Vision Therapy

Hussey, Eric
Remote Treatment of Intermittent Central Suppression Improves Quality of Life Measures

Kappel, Garry
ELECTIVE: Myopia and Nutrition

Lemer, Patricia
Optometry's Role: Using a Trans-Disciplinary Approach for Patients with Autism Spectrum Disorders

Leslie, Steve
Visual Field Defects in Neuro-Optometric Practice: Assessment and Management

Ludlam, Diana
Dynamic Aspects of Accommodation and Vergence in Mild Traumatic Brain Injury

Maino, Dominick
Neuroplasticity - A Paradigm Sea Change

Maples, WC
The COVD-QOL - A Tool for Behavioral Optometry

Padula, William
Consequences of Neuro-Visual Processing Dysfunction Affecting Balance, Posture & Spatial Orientation (Visual Midline Shift Syndrome)

Peachey, Graham
Turn-Key System for Developmental Assessment of Oculomotor and Perceptual Factors

Politzer, Thomas
Benefits, Rewards and Inventions from Working in an Acute Care Rehabilitation Hospital

Quinlan, Elizabeth
Enhancing Synaptic Plasticity and Visual Acuity in a Rodent Model of Amblyopia

Ramachandran, VS
KEYNOTE PRESENTATION & Getman Memorial Lecture

Roberts, Beverley
Who Fails Vision Therapy - the Patient or the Therapist?

Sanet, Robert
Unilateral Spatial Inattention

Sheedy, James
The Fundamental Role of Vision in Cognition, Behavior, and Social Organization

Steele, Glen
The Link between Retinoscopy, Vision and Social, Emotional and Cognitive Milestones

Steele, G., Holland, K., Aalberg, S
ELECTIVE: The Clinical Use of the Retinoscope - A Hands-on Workshop

Stumbo, Janet
Brain Injuries Change Lives

Suter, Penelope
Dizziness, Disorientation, and Imbalance - Optometric Roots in ABI - Acquired Vertical Phorias

Timple, Cathelyn
Gait Assessment of Neurologically Challenged Patients

Torgerson, Nancy
The Diary of an Expert Witness

Warshowsky, Joel
Lens Application for Clinical Management of Cyclovertical Deviation Associated with Vestibular Function, Proprioception, Oculomotor Skills and Emotion

Wenberg, Sue
Using the Balance Board in Therapy

Zelinsky, Deborah
A Novel Contribution to the Optometric Rehabilitation of Amblyopia

Monday, February 22, 2010

AOA Journal, Optometry Fan

Become a fan of Optometry, the journal of the American Optometric Association at!/pages/Optometry-Journal-of-the-American-Optometric-Association/325588922550?v=wall&ref=nf

A Vision Therapy Story – From a Mother’s Point of View

A Vision Therapy Story – From a Mother’s Point of View

This is an Guest Post by Stephanie Leary, who is training to be a Vision Therapist. Although her story is long, I encourage you to read it because it is not written by a doctor or by a newspaper reporter, but from a mother how has experienced how vision therapy can change lives. – Dr. Nate

Comments: This was written on a colleague's site. Read it. You'll be glad you did! DM

Helping people see in 3-D

From the Herald Citizen.... "Your peripheral vision is connected very intimately with your balancing system," said Dr. Jason Clopton, developmental optometrist and director of the Center of Vision Development in Cookeville. "When you get a lot of information in your peripheral vision -- like on a big screen -- and a lot of movement, it may give you this sensation that you're physically moving when you're not. If the two systems are working together, you shouldn't have any difficulties at all." A movie in 3-D works by projecting two images on the screen, with each image seen by one eye. The images are then merged into one by your brain. If the images aren't perceived correctly, it will be difficult to merge or fuse them into 3-D....

The Early Course of Autism

...There has been much debate about the early course of autism, specifically the earliest age at which autism may be detected. At present scientific evidence suggests that autism is dominantly genetic, and so researchers expect that there may be early signs of autism even in infancy. Traditionally, however, autism is not diagnosed until age 2-3, when parents bring their children to medical attention, or when signs are detected on routine well-child visits or in day-care....

Oxytocin Touted As Autism Treatment the study, adults with autism or Asperger's disorder received an intravenous infusion of pitocin (synthetic oxytocin) or placebo (saline solution) over a four-hour period. During that time, participants were monitored for repetitive behaviors that are hallmarks of autism spectrum disorders including need to tell/ask, touching, and repeating. These behaviors were assessed at a baseline and throughout the course of the infusion. "Repetitive behaviors are often overlooked as symptoms of autism in favor of more dramatic symptoms like disrupted social functioning," explained Hollander. "However, early repetitive behavior is often the best predictor of a later autism diagnosis."

The study found that the infusion produced results that were both clinically and statistically significant. Hollander noted a rapid reduction of repetitive behaviors over the course of the oxytocin infusion, whereas no such reduction occurred following the placebo infusion. ...

Hormone-infused nasal spray found to help people with autism

...The study, involving 13 adults with either a high-functioning form of autism or Asperger syndrome, a mild form of the disorder, found that when the subjects inhaled the hormone oxytocin, they scored significantly better on a test that involved recognizing faces and performed much better in a game that involved tossing a ball with others. ....

Placebos Advocated as Active Treatments

...The placebo effect is a real and therapeutic psychological phenomenon that, with more research, could be exploited more systematically in medical practice, said Australian researchers....

Comments:Finally the placebo effect gets its due! DM

Food seeking in spite of harmful consequences is under prefrontal cortical noradrenergic control

Chocolate craving: Previously food-deprived mice, unlike well-fed mice, continue to seek chocolate despite a foot-shock-paired conditioned stimulus, but desist from this maladaptive behavior on inactivation of noradrenaline in the prefrontal cortex.

Comments: Bottomline? We seek out and eat chocolate no matter what! DM

Sports Vision Magazine now Online

Sports Vision Magazine is now online. There is a subscription fee. DM

Consider Vision

Please check out the Consider Vision website. It tells the story of a mom with kids whose vision problems were missed during a routine eye examination. DM

Eye exercises to help reading

...Ten-year-old Gracy Barber of Baldwyn can see 20-20. But as Barber’s parents began exploring why their daughter was struggling in school, they discovered that her vision had other problems.

Two nearby doctors who study developmental vision disorders both determined that Gracy’s eyes had difficulty working together, focusing and tracking letters across a line....

Comments: Please note optometrist do not teach children how to read better. We do remediate the learning related vision problems that may be holding them back! DM

Panasonic’s Response To Concern Over Binocular Dysphoria

Panasonic responds to a blogger's concerns about 3D Television and binocular visiion dysfunction. DM

Trouble with 3-D - eye fatigue

The San Francisco Chronical says...Regardless of whether "Avatar" wins the best picture Oscar next month, 3-D technology seems to be here to stay - and the people who produce that technology should be taking steps now to make it comfortable to watch, doctors say....

Comments: Please have your eyes examined for binocular vision dysfunction so you can enjoy these great movies. Also don't forget to hear what I have to say on this topic on Thursday Feb 25th on ABC WLS TV Chicago channel 7 News 10pm broadcast! DM

3d Movies made Enjoyable!

The MetroWest Daily News notes that, Celia Hinrichs is a doctor of optometry and a fellow in the College of Optometrists in Vision Development, an international, nonprofit organization which supports behavioral optometry and accredits optometrists in that specialty. We asked the Sudbury practitioner about behavioral optometry, how she got her start in the field and how her work helps patients enjoy 3-D movies such as "Avatar."..... Click on the link to read the full story. DM

Parent Writes about Child with IAXT

I recently received a comment on one of my posts where a parent writes about her infant with an intermittent alternating exotropia (eye turn out). The ophthalmologist says surgery is the only cure. The optometrists wants to do patching and other non-surgical intervention. The parents do not want surgery and asks me for advice. This blog does not give medical advice and all who read this should consult their own doctors about what to do. Since I have not examined this little one I really do not want to make any specific suggestions.

Here's what I would suggest for a hypothetical patient however, if the following were true and varified by my examination results:

The eye turn is relatively infrequent.
No neurological or pathological (disease) etiology has been found.
No major refractive error is found (no large amounts of nearsightedness, farsightedness, astigmatism)

I would suggest to these hypothetical parents to:
1.) Watch the child closely and keep a log where you would write down how often the eye turns during the day, which eye, and for how long. This would give us a better idea of the frequency of the eye turn.
2.) If the eye turn in infrequent, I would monitor the child closely or prescribe prism to allow the visual system to develop binocularity (two eyed fusion) as much as possible.
3.) If one eye turns in more frequently than the other, I would have the parents patch the eye used most often while engaging the child in handeye activities. I would monitor this very closely so I do not make the better seeing eye amblyopic.
4.) If both eyes alternate fixation equally, again I would monitor and give the child prism glasses to help fusion develop.
5.) If one eye turned in all the time, I would patch the other eye while engaging in active therapy. I would monitor this closely and again use prism glasses.

Although strabismus surgery usually results in good outcomes if the surgery is done early, these outcomes seem to occur even if done when the child is older. Please remember surgery is not the cure some ophthalmologists may tell you it is. If you've been reading this blog, you know surgical outcomes vary greatly for each patient and over time.

I am concerned that no cause has been found for the eye turn. I would definitely look deeper in the XTs etiology.

Remember this blog and I do not give medical advice. Talk to your doctor. Get a second opinion. Visit for doctors who have expertise in this area. Good Luck. DM