Saturday, November 19, 2011

Cognitive and Behavioral Outcomes After Early Exposure to Anesthesia and Surgery

Cognitive and Behavioral Outcomes After Early Exposure to Anesthesia and Surgery

...these researchers noted that repeated exposure to anesthesia and surgery before the age of 2 was a significant independent risk factor for the later development of learning disabilities .... ... multiple exposures to anesthesia/surgery at an early age may adversely affect human neurodevelopment with lasting consequences. ...
Coments: Perhaps this is an excellent reason NOT to have STRABISMUS SURGERY early or at least before the age of 2 years. It is well documented that approximately one out of three of those who have strabismus surgery require another surgery and of those having that second surgery...again about 1/3 need a third surgery. Free full PDF available by clicking here. DM

To Err is Human - And We Keep Doing It

To Err is Human - And We Keep Doing It

....As many as one million Americans may have died from adverse events in U.S. hospitals over the past decade, the IOM (Institute of Medicine) estimates. Electronic Health Records may hold the key to patient-safety,,,,,rates of injury due to medical error had remained essentially unchanged between 2000 and 2008.....

Comments: Why do we keep on making the same mistakes over and over again....besides having a poor
mistake tracking system? To find out read:
Mistakes Were Made (But Not by Me) DM

Friday, November 18, 2011

Captain Lazy Eye

Captain Lazy Eye

 Does Captain Lazy Eye really help treat amblyopia? We do not know since no research has been completed using this product.

It appears as if this was created by a video game company with the assistance of a Chinese ophthalmologist. So far it seems as if only press releases have been available that mostly hype the product. Some of these PR releases have additional information. As far as I can tell the therapy activities used may be beneficial for the treatment of amblyopia. This company could definitely use a native English speaker to help edit this for an English speaking market.

It is unfortunate that this product continues to use outdated and wrong terminology. "Lazy eye", although frequently used as a word in place of the term amblyopia, gives the impression that amblyopia is an "eye" problem when it is really a "brain" problem. Using terminology such as  "eye exercisers" or "exercise" instead of  "therapy" gives the impression this is a problem better suited for the gym than the doctor's office.

I do not know if this iPad app will be successful in treating amblyopia....I do know that a great deal of work needs to be done to make this app acceptable for use by a medical savy consumer. DM

The Latest in Neuro-plasticity Research: Adults can Learn and Amblyopia CAN be treated at ANY AGE!

One of my colleagues at the Illinois College of Optometry (Barclay Bakkum, DC, PhD) brought these abstracts from the Society of Neuroscience to my attention. Please take a moment to review and give me any appropriate feedback. I edited the abstracts presented here, so if there are any mistakes in interpretation of the study....they are mine alone! Thanks. DM

Super normal vision: The eye limits the brain's potential

The authors note that the concept of a critical period for visual development early in life is important to normal neural development. They go on to state that it is now recognized that neuro-plasticity remains after this period well into adulthood and that multiple studies using perceptual learning have shown that the adult brain is plastic enough to show sensitivity improvements as a result of therapeutic intervention.. Since it appears that there may be some limiting factors to outcomes of therapy they compared the effectiveness of perceptual learning for contrast sensitivity and visual acuity with and without correction of the eye's higher order aberrations. They found that greater therapy improvements in contrast sensitivity and visual acuity were achieved when these higher order aberrations were corrected using adaptive optics compared with those without such optical correction. These improvements were not due to an immediate improvement caused by the correction of higher order aberrations (HOAs), a delayed improvement as a result of a longer-term adaptation, or reductions in internal neural noise, but were due to improved transduction efficiencies as a direct result of training. They concluded that after the critical period, the  brain still has a great deal of plasticity but how much improvement that can be obtained may be limited by uncorrected higher order optical aberrations of the eye. If the higher order aberrations are corrected, the full amount of brain plasticity can result in supernormal vision. 

Comments: This research supports the concept that adults can "learn" at any age and that many visual deficits, such as amblyopia, are treatable even in the adult. We need to correct any and all opical problems....even the higher order ones....of course!

J. ZHOU, Y. ZHANG, Y. DAI, et al. Super normal vision: The eye limits the brain's potential . Program No. 193.19/VV26 . 2011 Neuroscience Meeting Planner. Washington, DC: Society for Neuroscience, 2011. Online.

Video game training improves vision in adults with bilateral deprivation amblyopia

This presenation notes that approximately 3% of the adult population has amblyopia which the authors defined as reduced acuity caused by abnormal visual input during a critical period beginning shortly after birth. The state that, "...we provide the first demonstration that video game training can improve the vision of adults who are amblyopic in both eyes because of a history of bilateral pattern deprivation during early infancy...." Six adults with amblyopia were treated using the video game Medal of Honor for 40 hours over a ten week period. The researchers assessed visual acuity, stereopsis, crowding, spatial and temporal contrast sensitivity, sensitivity to global motion, face perception, peripheral vision, and contrast threshold prior to and after treatment. They found that their subjects showed improvement in one or both eyes on seven out of the nine areas assessed. The also stated that "...there was some improvement on every task tested except stereopsis and peripheral vision...." Their conclusion was that "....long after the end of the critical period ... there is enough residual plasticity in the adult visual system to effect improvements, even in cases of deep amblyopia caused by early bilateral deprivation...."

T. L. LEWIS, D. MAURER, S. T. JEON. Video game training improves vision in adults with bilateral deprivation amblyopia.  Program No. 488.12/QQ2 . 2011 Neuroscience Meeting Planner. Washington, DC: Society for Neuroscience, 2011. Online.

Comments: Even though they state that "Amblyopia is usually considered to be irreversible after childhood." those of us who have been treating amblyopia in adults for decades have noted that through appropriate clinical therapeutic intervention that this statement is wrong, wrong, wrong! This has been documented time and again with case studies and clinical research, but virutually ignored ...that is unitl recently. Now...almost "all of a sudden" research has caught up to the clinician in the diagnosis and treatment of amblyopia in individuals of all ages.

I am curious that with all the research that shows that amblyopia affects not only what they chose to evaluate here, but also various other visual spatial relationships, accommodation (focusing), convergence/divergence, and oculomotor (pursuit/saccadic/fixation) ability...why they limited what they evaluated pre/post intervention in this study?

Is it suprising to any clinician with expertise in this area that minimal to no improvement was noted in stereopsis...since no intervention to improve stereopsis was instituted? It appears that watching a video game has its limitations....and since amblyopia is a BINOCULAR vision problem that if you do not include an intervention with a BINOCULAR component that your outcomes are not as good as you would have liked?

The bottonline on this is.....

1.) Anyone at any age can be treated for amblyopia.

2.) To achieve maximum improvement you will need to incoorporate binocular vision therapy into the program of treatment.

and, infinally...

3.) STOP this nonsense about amblyopia not being treatable after age _____ .... (well pick an age). It is always treatable. It is best to treat any disorder arguement from me....but amblyopia can be treated at any age, any time with not only video games...but optometric vision therapy that includes a "binocular" component! DM

The NECO Challenge

The NECO Challenge: College of Optometrists in Vision Development Scholarship Programs

This September, thanks to the efforts of Dr. Richard Laudon, a NECO Scholarship program was established at COVD which supports NECO students’ travel to the COVD Annual Meeting.

This year, $750.00 was contributed to the fund by Drs. Jack Richman, Celia Hinrichs, and Richard Laudon. Their generosity allowed two NECO students to receive a $375 grant to attend the COVD 41st Annual Meeting October 24-29, 2011 in Las Vegas, Nevada.

COVD thanks the NECO alumni for their support of NECO students in pursuing behavioral and developmental optometry. Dr. Laudon is challenging other colleges’ faculty and alumni to set up a similar fund with COVD. ....

Another unique NECO initiative has been giving a cash award to the recipient of the COVD VT Student of the Year Award. ..... The original award was $500.00 and has grown to $615.00. ....
 A similar program has been in existence at Uniersity California Berkely School of Optometry which was initiated by Dr. Pia Hoenig. Dr. Hoenig and her colleagues award the recipient with a plaque and binocular vision equipment. The value of the award varies from year to year. .....

To find out more about these innovative programs contact Ms. Pam Happ, COVD Executive Director at 1-888-268-3770.

Thursday, November 17, 2011

Silvers Summit CES 2012:Inventor of the Cell Phone and Leading Advocate for Americans Age 50+

Inventor of the Cell Phone and Leading Advocate for Americans Age 50+
Headline Morning & Afternoon Keynote Sessions
at 4th Annual Silvers Summit at 2012 International CES

....What does it take to create change in today's world? This is the main question veteran news correspondent and MSNBC host and news anchor Alex Witt will ask two leading change agents, Emilio Pardo, executive vice president and chief brand officer at AARP, and Martin Cooper, chairman and co-founder of DYNA, LLC, during the morning and afternoon keynote sessions at the fourth annualSilvers Summit at the 2012 International CES to be held on January 10, 2012. Both embrace change and meld their wisdom and experience with a vision for tackling 21st century issues.....

Comments: I had a chance to speak at last year's CES....and had a ball! If you get a chance to it! t There is something there for all ages. DM

Tuesday, November 15, 2011

CALL FOR POSTERS 115th Annual AOA Congress & 42nd Annual AOSA

 CALL FOR POSTERS 115th Annual AOA Congress & 42nd Annual AOSA 

Submit your Poster Abstract Today!

Time's Running Out!!


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EYE on Concussions


EYE on Concussions Inaugural Fundraising Event
To benefit the Illinois Eye Institute Foundation, Sports Legacy Institute and the Chicago Concussion Coalition
Friday November 18, 2011 ~ Illinois Eye Institute
3241 South Michigan Avenue  Chicago, IL 60616
With over 90,000 patient visits each year, the Illinois Eye Institute is a leading provider of vision and eye care services in the state, as well as the nation. The Illinois Eye Institute Foundation provides funding for comprehensive multi-specialty eye care for patients of all ages from the Chicago metropolitan region and beyond, giving superior care for those patients who are unable to pay.
The Illinois Eye Institute provides diagnostic and therapeutic eye and vision care for all who have have experienced an acquired or a traumatic brain injury.

Click here for information on the Sports Legacy Institute.

The mission of the Sports Legacy Institute is to advance the study, treatment and prevention of the effects of brain trauma in athletes and other at-risk groups. SLI was founded in 2007 in Boston, Massachusetts by Christopher Nowinski and Dr. Robert Cantu in reaction to new medical research indicating brain trauma in sports had become a public health crisis. In 2008, SLI partnered with Boston University School of Medicine to form the Center for the Study of Traumatic Encephalopathy, which quickly has become the world leader in the study of the long term effects of brain trauma in sports.

Chicago Concussion Coalition

The CCC was formed on August 22, 2011 to offer Chicago’s coaches, athletic directors and trainers,
student athletes, parents, and citizens with the best resources to protect student athletes from concussions.

If you have suffered an acquired/traumatic brain injury or a repetitive sports induced brain injury....even a mild one...long after acute care has been given, long after routine rehabilitative therapy has been completed...numerous eye and vision problems continue to interfere with your quality of life. These eye and vision problems frequently include but are not limited to exotropia, convergence insufficiency, pursuit/saccadic dysfunctions (eye movement), accommodative (focusing) problems, reading problems, perceptual/visual mid-line shifts, visual attention/memory/perceptual/information processing issues, vertigo/balance/vestibular problems and other anomalies that disrupt what you want to do.

For more information on brain injury and vision go to Optometry &Vision Development Volume 40, No. 1, 2009

I you live in the Chicago-land area please feel free to contact me at the Illinois College of Optometry/Illinois Eye Institute at 312-949-7280 for additional information concerning the diagnosis and therapy of vision problems associated with brain injury. 

To find practitioners in your area go to The College of Optometrists in Vision Development and/or the Neuro-Optometric Rehabilitation Association.