Saturday, September 13, 2008

Why Should Your Child Have A Comprehensive Eye and Vision Examination

Why should you have your child examined by a member of the College of Optometrists in Vision Development? ... So you can be sure that the academic problem isn't due to a learning related vision disorder.... DM

The United States Department of Education, Nation’s Report Card says that nearly 70% of our nation’s schoolchildren are below grade level in our four most important subjects:

Reading: Grade 4: 68% are below grade level

Reading: Grade 8: 70% are below grade level

Writing: Grade 8: 70% are below grade level

Math: Grade 4: 62% are below grade level

Math: Grade 8: 69% are below grade level

Science: Grades 4 and 8: 73% are below grade level


Sarah Palin's Glasses

Many of my patients have asked about the Republican's VP Candidate glasses.

Sarah Palin's frame is the Kawasaki 704 series, and the color is 34 gray. Costs will vary....but are at the upper end of frames. Ask your optometrist if he/she can obtain a pair for you if you are interested....I hear they are next to impossible to get however!! USA Today Story DM

Children With TVs In Their Room Sleep Less

...Middle school children who have a television or computer in their room sleep less during the school year, watch more TV, play more computer games and surf the net more than their peers who don't -...

Comments: Well, duh. Every child should have an understanding of when they can and cannot use the devices noted above. DM

More Evidence That BPA Found In Clear Plastics Impairs Brain Function

...Yale School of Medicine researchers reported that the chemical bisphenol-A (BPA), a building block for polycarbonate plastics found in common household items, causes the loss of connections between brain cells. This synaptic loss may cause memory/learning impairments and depression, according to study results published in the Proceedings of the National Academy of Sciences (PNAS)....

VSP Vision Care Study: Nearly 8 Out Of 10 American Kids Under Five Have Never Had An Eye Exam

...A recent nationwide survey of nearly 4,000 Americans by VSP® Vision Care revealed that more than three-quarters (76 percent) of children under the age of five have never had a comprehensive eye exam....

Comments: When the return on investment, cost benefit ratio, and risk benefit ratio are considered...a comprehensive eye and vision examination for our nation's children is an important health care and public health issue that really must be met. Those ophthalmologists, pediatricians, optometrists. politicians and others who believe vision screenings are the answer are just plain wrong. Wrong! Have your child examined today. If you review the research just on this blog alone, you know it is the right thing to do. DM

'The Transporters' - Unique Government-Backed DVD To Help Children With Autism Recognise Emotions To Go On Sale World-Wide

...A groundbreaking teaching resource to help children with autism make sense of the world around them is to be marketed internationally... The Transporters, a DVD that uses a combination of real actors' faces and 3D computer-generated settings...The DVD pack, together with information about the underlying research is available from a special website launched this week:

Autism Not Linked To Measles Vaccine

...After a decade of controversy that has seen surges in measles outbreaks because of many parents' mistrust of the vaccine, a new US-led study concluded there is no link between the MMR vaccine and the onset of autism or gastrointestinal symptoms in children who develop both...

Comments: I've said for some time now that there is no evidence to link MMR with least not at this time....get those kids vaccinated! DM

Vitamin 'may prevent memory loss'

...Older people with lower than average vitamin B12 levels were more than six times more likely to experience brain shrinkage, researchers concluded....

Comments: The more "chronologically enhanced" I become ... the interest I pay to these studies....I may have to invest in some B12! DM

Knowledge and Beliefs Associated with Refractive Errors and Undercorrection: The Singapore Malay Eye Study

...The lack of knowledge and awareness of refractive errors are important risk factors for undercorrected refractive error in an urban Singapore population....

Comments: It is not only those who live in Asia that lack a great deal of knowledge about refractive error.....every day I have to educate my patients on how profoundly uncorrected refractive error can affect ones life. Every day the AOA, IOA, PAVE, COVD, OEP , the good staff in my office and at the Illinois Eye Institute and other organizations try to educate the public about the devastating affects of uncorrected refractive error. Every day we try to educate all we meet about the importance of a comprehensive eye examination .... and NOT a what is needed. If you are a lay individual and if you and/or your family have not had a comprehensive vision examination call an optometrist's office today. Do it!

Brain Injury Patients Cope by Using More of Their Brains

...Patients with diffuse axonal injury who returned to a pre-injury level of school or work recruited more regions of the brain to perform tasks related to executive control of working memory than did healthy controls, Gary Turner, Ph.D., and Brian Levine, Ph.D., of the Rotman Research Institute of the Baycrest Center for Geriatric Care, reported in the Sept. 9 issue of Neurology....

AOA President Pete Kehoe, O.D., launches blog

For all AOA Members:

The AOA officially launched AOA's inaugural AOA Blog at the State Legislative Conference in Indianapolis last weekend, at .

"We hope that this blog will allow you, the members of the AOA to have a way to share your thoughts and ideas with the leaders of the AOA and for me as President, to share my personal thoughts and directions of the AOA to the membership in a timely and efficient manner," notes Dr. Kehoe in a posting last week.

Metabolic Syndrome Adds Little to Prediction of Diabetes and CVD

I've wondered if "metabolic syndrome" was created just to start selling meds to folks who don't need them earlier than they otherwise might....and now metabolic syndrome does appear "iffy" as a p[re-diagnostic tool. DM

The metabolic syndrome was defined to aid in predicting and preventing vascular events and diabetes, but other readily available data are more powerful predictors.

An editorialist calls this study "another nail in the coffin of the metabolic syndrome." Fasting hyperglycemia alone was a much stronger predictor of incident diabetes than were the combined metabolic-syndrome components. Similarly, the Framingham risk score, which includes important nonmetabolic factors such as smoking, was a strong independent predictor of cardiovascular disease, whereas the metabolic syndrome was not. The concept of the metabolic syndrome has been useful in suggesting common pathophysiological pathways, but little evidence shows that diagnosing the syndrome adds value in clinical decision making.

Bruce Soloway, MD

Published in Journal Watch General Medicine July 29, 2008

Sattar N et al. Can metabolic syndrome usefully predict cardiovascular disease and diabetes? Outcome data from two prospective studies. Lancet 2008 Jun 7; 371:1927. [Medline® abstract]

Kahn R. Metabolic syndrome — What is the clinical usefulness? Lancet 2008 Jun 7; 371:1892. [Medline® abstract]

Black Board Gets Bad Reviews

If you a an instructor at an optometry school you probably use a LMS (learning management system). The biggest one out there is Black Board. A recent article in The Chronicle of Higher Education suggests that Black Board is having significant problems with customer support. Click on the title above to see the article. DM

Friday, September 12, 2008

California Optometric Association advocates state legislation mandating eye examinations for kindergartners.

From AOA First Looks:

KGO-TV San Francisco (9/11, 7:31 p.m. PT, Johnson), an ABC affiliate, reported that the "California Optometric Association (COA) is now advocating state legislation requiring students to receive a comprehensive eye exam before starting kindergarten." The COA pointed "to a recent study out of" the University of California-San Diego that "found that three-to-five year olds with vision problems scored lower on a standardized developmental test, but those scores returned nearly to normal after six weeks with the students' vision corrected." Children's vision-related problems, such as strabismus or amblyopia, can affect "performance in school, while going undetected or even misdiagnosed." KGO-TV noted that "a comprehensive vision exam costs about $130 to $150 at a typical optometrist's office. Health plans very in their coverage."

AOA's Daum advises against wearing specialty line of eyeglasses purporting to prevent computer vision syndrome.

From AOAs First Look:

Popular Mechanics (9/11, Porges) reviewed Gunnar Optiks Digital Performance Eyewear, reporting that the specialty line of eyeglasses "purports to prevent" computer vision syndrome (CVS) with "an antiglare coating, a yellow tint that is easy on the eyes, and magnification that allows you to type without sitting quite as close to your monitor." But, Kent Daum, O.D., Ph.D., of the American Optometric Association (AOA), stated, "They are unnecessary, and I would advise against wearing them." Dr. Daum explained further: "Traditionally, if we're thinking about eliminating glare, a polarizing filter does that most significantly and best." In fact, "it's much more helpful to get rid of glare by closing blinds or adjusting your monitor." Popular Mechanics concluded that the "stylish and comfortable" glasses were not "without merit," and were "nice to wear out on sunny days (the coating did a decent job of shielding some of the sun's glare.) But, as for solving CVS, these glasses may work best as a placebo."

More YouTube Optometric Vision Therapy Videos

Optometric Vision Therapy Videos

These offer a wide variety of therapy techniques designed to remediate or improve visual, visual motor, and vision function problems.

Vision Therapy 1

Vision Therapy 2

Vision Therapy 3

Vision Therapy 4 (with 101 y/o patient)

Eccentric Circles

Explanation of Vision Therapy by Dr. Kaplan

Television News Cast

Television News Cast 2

Television News Cast 3 Olympic Vision Therapy

Brock String & Eccentric Circle Vision Therapy Video on YouTube

This is a very well done explanation of how to do the Brock String optometric vision therapy technique. There is also another well done video on how to do Eccentric Circles.

I will be directing my patients to this video from my office website. DM

Improvements With Different Amblyopia Treatments Are Similar and Sustained

.... Atropine and patching are comparable for the treatment of moderate amblyopia in young children, a study indicates, and the improvement of the amblyopic eye is maintained at age 10 years.Dr. Michael X. Repka, of Jaeb Center for Health Research, Tampa, Florida, and colleagues report the findings in the August issue of the Archives of Ophthalmology.In a multicenter clinical trial, the researchers examined the visual acuity outcome at 10 years of age for children who were younger than 7 years at enrollment in a treatment trial for moderate amblyopia. A total of 419 children were randomly assigned to patching or atropine eyedrops for 6 months, after which treatment was at the discretion of the investigator.A subgroup of 188 children entered long-term follow-up 2 years after enrollment, and 176 of them completed the examination at age 10 years.At entry into the randomized trial, the mean visual acuity of the amblyopic eyes was approximately 20/63. At age 10 years, it was approximately 20/32. Overall, 46% of amblyopic eyes had an acuity of 20/25 or better.The mean amblyopic and sound eye visual acuities at 10 years of age were similar in the original treatment groups."Younger age at entry into the randomized trial was associated with a better amblyopic eye visual acuity at age 10 years," Dr. Repka and colleagues note."In summary," they write, "the visual acuity improvement achieved in amblyopic eyes is maintained, although residual amblyopia is common, after treatment for amblyopia initiated at age 3 years to younger than 7 years. The outcome is similar regardless of whether initial treatment was with atropine or patching."The team plans a follow-up of all the children in the long-term study at age 15 years. Arch Ophthalmol 2008;126:1039-1044.

Monday, September 8, 2008

Practices test potential of online vision therapy

...Essilor has begun commercial trials in 11 UK practices of NeuroVision, a non-surgical internet-based treatment developed in Singapore that purports to improve visual performance in patients with low myopia (up to around -1.50D)....

Antioxidant-Rich Diet May Protect Against Eye Disease

...Eating plenty of antioxidant-rich food such as blueberries, artichokes and pecans may help protect against macular degeneration, the leading cause of age-related blindness in the United States and other developed countries. ...U.S. researchers found that antioxidants disrupt a link between two processes in the retina that, in combination, contribute to macular degeneration. Antioxidants also extend the lifetime of irreplaceable photoreceptors and other retinal cells.

Accommodative function in school children with reading difficulties

...Our findings suggest a reduced monocular accommodative amplitude and binocular accommodative facility, such that this function should be assessed by an optometric clinician in children whose reading level is below average. ...

Comments: Optometry has for decades shown that many vision function areas affect reading and have been conducting optometric vision therapy to help those patients so's nice to see this article in an Ophthalmology journal....DM

Sarah Palin: Vice presidential nominee's rimless designer glasses garner attention.

From AOA's First Look:

USA Today (9/4, Horovitz) reports that the "nation's eyes aren't just on Gov. Sarah Palin (R-Alaska) -- they're on her glasses." Should Gov. Palin become Vice President, "it could rock the vision-care market, which totals $26.6 billion a year, says tracker Jobson Optical Research." According to Amy Hahn, vice president at Italee, the American distributor of the frames designed by Japanese industrial designer Kazuo Kawasaki, "We keep getting calls from dealers who want to stock the exact shape and style that she's wearing." Gloria Nicola, senior editor at the eyewear trade magazine 20/20, advises optometrists to carry the line, or "at least sell similar-looking brands." Still, "matching the look won't be easy." Even though Gov. Palin's eyeglass frame (Kawasaki's 704 series in 34 gray) is readily available, "the shape of the strongly rectangular lenses was custom-made for Palin by Home Optics, an upscale retailer in Chugiak, Alaska." The frames, which "are made from titanium," are "mounted via a screwless, tension system."

Study indicates 75 percent of children under age five have never had eye exams.

From AOA's First Look:

The Sacramento Business Journal (9/4) reports that "three-quarters of children under the age of five have never had an eye exam," according to a study released Wednesday by VSP. In fact, the "Vision Care Study of 4,000 people found that most parents rely on eye screenings from pediatricians and school nurses, rather than comprehensive eye exams from optometrists and ophthalmologists." James Short, chair of VSP Vision Care's board of directors, stated, "Before children enter school, an eye doctor should examine the eyes for signs of astigmatism, nearsightedness, farsightedness, and also examine the structure of the eye for tell-tale signs of serious diseases affecting more American kids each year, including diabetes, hypertension, and high cholesterol."
AOA, optometrist emphasize importance of children's eye exams. The
Des Moines Register (9/3, Villanueva-Whitman) featured an interview with Iowa optometrist Beth Triebel, O.D., who answered questions about the importance of children's eye exams. Dr. Triebel pointed out, "The American Optometric Association (AOA) recommends the first vision exam be in the first year of life. To help promote that," the AOA "has come up with a no-cost public-health program called Infant See. That's a program for any child between six months to one year to have a free eye-health assessment." Dr. Triebel also explained that "one in four school-age children has a vision problem that can get in the way of learning." Currently, "only 14 percent of children have received an eye exam before they enter school." Although some schools perform eye screenings, those "screenings are not as good as a comprehensive eye exam." They will not check how well "the eyes work together as a team," how well they focus, see colors, or "track and follow." Checking children for those things will " done in a comprehensive eye exam," Dr. Triebel said.
Virginia mother would like state to require eye exams for schoolchildren. Both on the air and on its website, Virginia NBC affiliate
WSLS-TV (9/3, McNew) featured a segment on a local boy, Parker Waters, whose amblyopia was detected during an eye exam that took place two weeks before he started kindergarten. After Parker's mother, Kim Waters, discovered that "some states require a formal eye exam for kids" about to enter school, "but not Virginia," she wrote "a letter to lawmakers to try to get that changed." Meanwhile, Parker is currently wearing a patch to cover his "good eye, in order to strengthen the bad one." The WSLS-TV website provided links to amblyopia resources offered by Prevent Blindness America, the National Eye Institute, and Medlineplus. The website also provided a link to the Virginia General Assembly, so people can contact their state "legislator about requiring eye exams for Virginia's children."

No link between measles vaccine and autism

...The Measles-Mumps-Rubella (MMR) vaccine causes neither autism nor gastrointestinal disorders, a study reported Wednesday, disputing a theory that has persisted for a decade....

Quantitative Pediatric Vision Screening in Primary Care Settings in Alabama.

...National efforts to reduce preventable vision loss from amblyopia are hampered because children are not available for screening and because providers miss many opportunities to screen vision at pre-school age. Efforts to improve vision screening should target pediatrician-led practices, because these serve greater numbers of children....

Comments: This article has it all wrong! Screening is not the answer. Comprehensive examinations are what these children require. Join the AOA's InfantSee program today. Examine these children now! DM

Is anyone looking at me? Direct gaze detection in children with and without autism

Senju A, Kikuchi Y, Hasegawa T, Tojo Y, Osanai H Is anyone looking at me? Direct gaze detection in children with and without autis Is anyone looking at me? Direct gaze detection in children with and without autismBrain Cogn. 2008 Jul;67(2):127-39. Epub 2008 Jan 28.

...atypical processing of eye contact is one of the significant characteristics of individuals with autism, but the mechanism underlying atypical direct gaze processing is still unclear. This study used a visual search paradigm to examine whether the facial context would affect direct gaze detection in children with autism. Participants were asked to detect target gazes presented among distracters with different gaze directions. The target gazes were either direct gaze or averted gaze, which were either presented alone (Experiment 1) or within facial context (Experiment 2). As with the typically developing children, the children with autism, were faster and more efficient to detect direct gaze than averted gaze, whether or not the eyes were presented alone or within faces. In addition, face inversion distorted efficient direct gaze detection in typically developing children, but not in children with autism. These results suggest that children with autism use featural information to detect direct gaze, whereas typically developing children use configural information to detect direct gaze.

Eyes and Autism

Jones W, Carr K, Klin A. Absence of preferential looking to the eyes of approaching adults predicts level of social disability in 2-year-old toddlers with autism spectrum disorder.Arch Gen Psychiatry. 2008 Aug;65(8):946-54.

CONCLUSIONS: Looking at the eyes of others is important in early social development and in social adaptation throughout one's life span. Our results indicate that in 2-year-old children with autism, this behavior is already derailed, suggesting critical consequences for development but also offering a potential biomarker for quantifying syndrome manifestation at this early age.

Eye doctor emphasizes exams at age 6 months

...When should a child first be seen by an eye professional?

The American Optometric Association recommends the first vision exam be in the first year of life. To help promote that, the American Optometric Association has come up with a no-cost public health program called Infant See. That's a program for any child between 6 months to 1 year to have a free eye health assessment. There are volunteer doctors all across the country who participate in the program. Most of the doctors in my office volunteer. I think more than 50 percent, maybe closer to 60 percent, of all the optometrists in Iowa volunteer for the program....

Eye doctor emphasizes exams at age 6 months

...When should a child first be seen by an eye professional?

The American Optometric Association recommends the first vision exam be in the first year of life. To help promote that, the American Optometric Association has come up with a no-cost public health program called Infant See. That's a program for any child between 6 months to 1 year to have a free eye health assessment. There are volunteer doctors all across the country who participate in the program. Most of the doctors in my office volunteer. I think more than 50 percent, maybe closer to 60 percent, of all the optometrists in Iowa volunteer for the program....

About 60 percent of students identified as problem learners have undetected vision problems

...Around 60 percent of students identified as problem learners have undetected vision problems, the AOA states. Some common problems in children include nearsightedness (myopia), farsightedness (hyperopia) and imperfection of the eye's curvature (astigmatism).
Children with vision trouble may rub their eyes, tilt their head to one side, bump into objects, avoid close work, hold reading material close to their face, get frequent headaches and constantly perform below their potential. They may also display behavioral problems, such as short attention span, and in some cases, be diagnosed as having Attention Deficit Hyperactivity Disorder (ADHD). ...

Palin has created quite a stir ... with her designer glasses

...The Kawasaki frames are made from titanium and mounted via a screwless, tension system....

Eye disorders major problem among pupils

...Disorders of the eye constitute the major health problem among students who reported at school health clinics during 2007.
Of a total of 11,657 cases recorded, 5,410 accounted for eye diseases, data from Hamad Medical Corporation’s Department of Epidemiology and Medical Statistics has revealed...

FDA posts list of drugs under investigation

...The first list is a bare-bones compilation naming 20 medications and the potential issue for each. It provides no indication of how widespread or serious the problems might be, leading some consumer advocates to question its usefulness, and prompting industry worries that skittish patients might stop taking a useful medication if they see it listed...


Here's the list of drugs and the "adverse events" -- side effects -- reported to the AERS database:
Product Name: Active Ingredient (Trade)or Product Class
Potential Signal of Serious Risk/New Safety Information

Arginine Hydrochloride Injection (R-Gene 10)
Pediatric overdose due to labeling / packaging confusion
Desflurane (Suprane)
Cardiac arrest (heart stops working)
Duloxetine (Cymbalta)
Urinary retention
Etravirine (Intelence)
Hemarthrosis (blood in a joint)
Fluorouracil Cream (Carac) and Ketoconazole Cream (Kuric)
Adverse events due to name confusion
Anaphylactic-type (life-threatening allergic) reactions
Icodextrin (Extraneal)
Hypoglycemia (low blood sugar)
Insulin U-500 (Humulin R)
Dosing confusion
Ivermectin (Stromectol) and Warfarin
Drug interaction
Lapatinib (Tykerb)
Hepatotoxicity (liver toxicity)
Lenalidomide (Revlimid)
Stevens-Johnson syndrome (a deadly drug reaction)
Natalizumab (Tysabri)
Skin melanomas (deadly skin cancer)
Nitroglycerin (Nitrostat)
Overdose due to labeling confusion
Octreotide Acetate Depot (Sandostatin LAR)
Ileus (bowels not moving)
Oxycodone Hydrochloride Controlled-Release (OxyContin)
Drug misuse, abuse, and overdose
Perflutren Lipid Microsphere (Definity)
Cardiopulmonary reactions (lung/heart problems)
Phenytoin Injection (Dilantin)
Purple glove syndrome (discoloration, pain, and swelling of the hand that may lead to amputation)
Quetiapine (Seroquel)
Overdose due to sample pack labeling confusion
Tebivudine (Tyzeka)
Peripheral neuropathy (tingling or numbness in the extremities)
Tumor Necrosis Factor (TNF) Blockers
Cancers in children and young adults

Sunday, September 7, 2008

COVD 38th Annual Meeting Registration

COVD 38th Annual Meeting
Palm Springs, California
Rancho Las Palmas Resort & Spa
October 14-18, 2008.

Early Registration Ends 9/11/08

Meeting At A Glance
Meeting Schedule
Exhibitor Information
Hotel Reservations

Deadline for Early Registration is September 11, 2008. Don't miss out on everything we have planned.

Wednesday, October 15
Joint COVD/OEP Practice Management Symposium
Coding Strategies for Effective Third Party Billing of Vision Therapy

Thursday - Saturday, October 16-18Featured Speakers
Dr. Mitchell Scheiman: Update on Convergence Insufficiency Treatment Trial (CITT)
Dr. Mitchell Scheiman: Update on Treatment of Amblyopia
Dr. Barry Tannen: Gems and Caveats of Treating Adult Patients with Strabismus
Patricia S. Lemer, MEd: EnVISIONing a Bright Future: Using a Trans-Disciplinary Approach with Patients on the Autism Spectrum
Drs. Steve Ingersoll, Leonard Press, and Eric Borsting: The Optometric Evaluation and Management of Children with Reading Difficulties

Applied Concepts Courses are Almost Full!The Applied Concepts Courses have limited availability, and our two-day VT101 course is already full.

Tuesday - Wednesday, October 14-15
Applied Concepts & VT Courses
Dr. Robert Sanet: Visual Information Acquisition
Dr. Carl Hillier: Visual Information Processing
Dr. Allen Cohen: Acquired Brain Injury
Dr. Barry Tannen: Strabismus and Amblyopia
Drs. Brenda Heinke Montecalvo & Kellye Knueppel: Therapeutic Lens Prescribing
SOLD OUT Linda Sanet, COVT: VT 101 - Expanded to a two-day course (course for vision therapists only)

Don't miss out this year. Register now!

We look forward to seeing you there!

Upcoming Meetings

68th Northeast Congress of OptometryVisual Learning: Visual Attention, Visual Memory, and VisualizationSeptember 7-8, 2008
Westford, Massachusetts
Contact: Kathleen Prucnal, O.D.C

OVD 38th Annual MeetingCollege of Optometrists in Vision Development
October 14-18, 2008
Rancho Las Palmas Resort & Spa
Palm Springs, California
For information:

Southern California Vision Therapist Forum
April 17-18, 2009Handlery Hotel
San Diego, CaliforniaContact: [email protected]
Robert Wold, Southern California Behavioral Vision SeminarPresenting: Carl G. Hillier, O.D., FCOVD
April 19-20, 2009
Handlery HotelSan Diego, California
Contact: [email protected]

77th International Conference on Light and Vision
College of Syntonic Optometry
April 30-May 2, 2009Fallsview Marriott
Niagara Falls, Ontario, Canada
Contact: Ron Wahlmeier

COVD 39th Annual Meeting
College of Optometrists in Vision Development
October 13-17, 2009
Denver Marriott Tech CenterDenver, Colorado

COVD 40th Annual Meeting
College of Optometrists in Vision Development
October 12-14, 2010
Rio Mar Beach ResortRio Grande, Puerto Rico