Friday, January 2, 2015

2015 American Conference on Pediatric Cortical Visual Impairment

2015 American Conference on Pediatric Cortical Visual Impairment

Sara M. Olsen, M.Ed.
Continuing Medical Education Coordinator
Medical Staff Services

Children’s Hospital & Medical Center
8200 Dodge Street  Omaha, NE 68114-4113
402.955.6070 • 402.955.4162 FAX

Vision Problems and the Struggling Student: AAO Position Paper

 Vision Problems and the Struggling Student

"Recent studies have provided new insights into disorders of eye focusing (accommodation) and eye teaming (vergence) that reinforce the need for comprehensive eye examinations and follow-up care for students who are struggling in school. These disorders may occur even when individuals have 20/20 eyesight, and can impact students when reading and studying. The typical student with an eye focusing or eye teaming disorder will often experience fatigue, loss of place when reading, and difficulty completing assignments.

Other common symptoms include skipping small words, rereading sentences, inserting words that do not exist in the text, and experiencing decreasing comprehension the longer that he or she reads. Teachers and parents are often at a loss to explain the source of a student’s problems. The difficulties that they observe may not fit exclusively into the currently accepted categories of problems that adversely impact a student’s 
school performance such as a specific learning disability, attention deficit hyperactivity disorder (ADHD), or language-based dyslexia. Parents, teachers and other professionals often have several common questions when seeking information about disorders of eye focusing and eye teaming....."

Comment: I find it somewhat contradictory that the AAO can publish a paper recommending vision screenings as being adequate for our children when all the research strongly suggests only full eye examinations will do. This position paper by the AAO also supports full, comprehensive eye and vision examinations as well. DM

Read the complete paper here:

Impact of Simulated Hyperopia on Academic-Related Performance in Children.

Impact of Simulated Hyperopia on Academic-Related Performance in Children.

"...A relatively low level of simulated bilateral hyperopia impaired children's performance on a range of academic-related outcome measures, with sustained near work further exacerbating this effect. ..."

Comments: Ever since I was in optometry school (dinosaurs still roamed the earth at that time), optometrists have clinically known that even low amounts of hyperopia could adversely effect academic performance because of its neurological interactions with accommodation and vergence. The evidence continues to accumulate that hyperopia and vision function effects school performance. 

Vision screening often misses these vision related learning problems. ONLY a full, comprehensive eye and vision examination will diagnose these problems. Our children deserve full examinations and not just vision screenings. 

Read more about it here:

Other articles:

Association between reading speed, cycloplegic refractive error, and oculomotor function in reading disabled children versus controls

Hyperopia and educational attainment in a primary school cohort

Comparison of visual characteristics in children with and without learning difficulties.

The Role of Vision in Learning Disorders

Articles about vision screening:

Research and comments from past MainosMemos blog posts:

Effectiveness of screening systematic review

Population based preschool vision screening programmes cannot be sufficiently assessed by the literature currently available. However, it is most likely that the present systematic review contains the most detailed description of the main limitations in current available literature evaluating these programmes. Therefore, future research work should be guided by the findings of this publication.

Comments: I don't get it...this paper says there is NO evidence that consistently supports vision screening....why isn't optometry and InfantSee shouting this from the roof tops?DM (Looks like they are!!!)

Evidence-based medicine: the value of vision screening.

This paper answers a couple of questions about the value of vision screening. The questions were:

(1) Is vision valuable (an inherent good)?; (1) yes 
(2) Is screening effective (finding amblyopia)?; (2) no
(3) Is amblyopia detection beneficial? (3) economic productive values are likely very high, with returns of investment on the order of 10:1,

The Impact of Pediatric Vision Disorders in Adulthood

The Economic Value Added (EVA) Resulting from Medical Care of Functional Amblyopia, Strabismus, (Pathologies of Binocular Vision) and Asthma

Teen Eye Chart Screening Misses Some Problems 

Thursday, January 1, 2015

Guidelines for spectacle prescribing in infants and children

Comment: Always remember these are guidelines. Prescribing glasses, when done right, remains as much an art as it does a science. How you prescribe will also depend upon if you are using the spectacles as a therapeutic device or as a compensatory intervention.

Read full article here:

Wednesday, December 31, 2014

Mydriatic Spray: Is it effective with the eyes closed?

Tropicamide 1% mydriatic effect: comparison between spray in closed eyes and eye drops in open eyes.

The vaporized tropicamide 1% mydriatic effect in closed eyes was clinically equivalent to the instillation effect of eye drop in open eyes.


Comment: use the spray with the eyes closed. Patients tolerate this better AND it works!!