Thursday, December 31, 2009

Oculomotor function in frontotemporal lobar degeneration, related disorders and Alzheimer’s disease

Frontotemporal lobar degeneration (FTLD) often overlaps clinically with corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP), both of which have prominent eyemovement abnormalities.To investigate
the ability of oculomotor performance to differentiate between FTLD, Alzheimer’s disease, CBS and PSP, saccades and smooth pursuit were measured in three FTLD subtypes, including 24 individuals with frontotemporal dementia (FTD), 19 with semantic dementia (SD) and six with progressive non-fluent aphasia (PA), as
compared to 28 individuals with Alzheimer’s disease, 15 with CBS, 10 with PSP and 27 control subjects. Different combinations of oculomotor abnormalities were identified in all clinical syndromes except for SD, which had oculomotor performance that was indistinguishable from age-matched controls.Only PSP patients displayed abnormalities in saccade velocity, whereas abnormalities in saccade gain were observed in PSP`CBS`Alzheimer’s disease subjects. All patient groups except those with SD were impaired on the anti-saccade task, however only the FTLD subjects and not Alzheimer’s disease, CBS or PSP groups, were able to spontaneously self-correct anti-saccade errors as well as controls. Receiver operating characteristic
statistics demonstrated that oculomotor findings were superior to neuropsychological tests in differentiating PSP from other disorders, and comparable to neuropsychological tests in differentiating the other patient groups.These data suggest that oculomotor assessmentmay aid in the diagnosis of FTLD and related disorders.

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

How parents choose to use CAM: a systematic review of theoretical models

Conclusion: The SBM modified for CAM use, which incorporates both psychological and pragmatic determinants, was identified as the best conceptual model of CAM use. This model provides a valuable framework for future research, and could be used to explain child CAM use. An understanding of the decision making process is crucial in promoting shared decision making between healthcare practitioners and parents and could inform service delivery, guidance and

Preserved motor learning after stroke is related to the degree of proprioceptive deficit

These results support the importance of central sensory processing for motor learning. The confirmation of central sensory processing dependent motor learning in humans is discussed in the context of our prior report of preserved motor learning when sensation is disrupted peripherally.

Developmental dyscalculia: compensatory mechanisms in left intraparietal regions in response to nonsymbolic magnitudes

Overall, findings are suggestive of (a) less consistent neural activity in right (intra)parietal regions upon processing nonsymbolic number magnitudes; and (b) compensatory neural activity in left (intra)parietal regions in developmental dyscalculia.

Attention Deficit Hyperactivity Disorder comorbid oppositional defiant disorder and its predominately inattentive type: evidence for an association wi

Background: There are three childhood disruptive behavior disorders (DBDs), attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). The most common comorbid disorder in ADHD is ODD. DSM-IV describes three ADHD subtypes: predominantly inattentive type
(ADHD-IA), predominantly hyperactive-impulsive type (ADHD-HI), and combined type (ADHD-C). Prior work suggests that specific candidate genes are associated with specific subtypes of ADHD in China. Our previous association studies between ADHD and functional polymorphisms of COMT and MAOA, consistently showed
the low transcriptional activity alleles were preferentially transmitted to ADHD-IA boys. Thus, the goal of the present study is to test the hypothesis that COMT Val158Met and MAOA-uVNTR jointly contribute to the ODD phenotype among Chinese ADHD boys.
Methods: 171 Chinese boys between 6 and 17.5 years old (mean = 10.3, SD = 2.6) with complete COMT val158met and MAOA-uVNTR genotyping information were studied. We used logistic regression with genotypes as independent variables and the binary phenotype as the dependent variable. We used p < 0.05 as the level of nominal statistical significance. Bonferroni correction procedures were used to adjust for multiple comparisons.
Results: Our results highlight the potential etiologic role of COMT in the ADHD with comorbid ODD and its predominately inattentive type in male Chinese subjects. ADHD with comorbid ODD was associated with homozygosity of the high-activity Val allele, while the predominantly inattentive ADHD subtype was associated with the low-activity Met allele. We found no evidence of association between the MAOA-uVNTR variant and ADHD with comorbid ODD or the ADHD-IA subtype.
Conclusion: Our study of attention deficit hyperactivity disorder comorbid oppositional defiant disorder and its predominately inattentive type highlights the potential etiologic role of COMT for ADHD children in China. But we failed to observe an interaction between COMT and MAOA, which suggests that epistasis between COMT and MAOA genes does not influence the phenotype of ADHD-IA with comorbid ODD in a clinical sample of Chinese male subjects. To confirm our findings further studies with a larger number of subjects and healthy controls are needed.

The relationship between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women

These results suggest that a higher dietary intake of n-3 fatty acids is associated with a decreased presence of DES in women. These findings are consistent with anecdotal clinical observations and postulated biological mechanisms.

The relationship between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women

These results suggest that a higher dietary intake of n-3 fatty acids is associated with a decreased presence of DES in women. These findings are consistent with anecdotal clinical observations and postulated biological mechanisms.

Lutein, zeaxanthin, macular pigment, and visual function in adult cystic fibrosis patients

Adults with CF have dramatically low serum and macular concentrations of carotenoids (lutein and zeaxanthin), but their ocular status and visual function are surprisingly good. The clinical implications of low plasma concentrations of carotenoids in CF are yet to be clarified.

Cognitive function and psychological well-being: findings from a population-based cohort

Background: depression is associated with poor cognitive function, though little is known about the relationship between psychological well-being and cognitive function.
Objective: to investigate whether psychological well-being is associated with levels of cognitive function.
Design: nationally representative population-based cohort study.
Setting and participants: 11,234 non-institutionalised adults aged 50 years and over of the English Longitudinal Study of Ageing in 2002.
Methods: psychological well-being was measured using the CASP-19, and cognitive function was assessed using neuropsychological tests of time orientation, immediate and delayed verbal memory, prospective memory, verbal fluency, numerical
ability, cognitive speed and attention. The relation of psychological well-being to cognitive function was modelled using linear regression.
Results: on a global cognitive score combining all cognitive tests, those in the fifth quintile of psychological well-being scored an average of 0.30 SD units higher than those in the lowest quintile (95% CI 0.24-0.35) after adjustment for depressive
symptoms and sociodemographics. This association remained after additional adjustment for physical health and health behaviours. The same pattern of association was observed for men and women, and across all cognitive domains.
Conclusions: in a large population of community living adults, higher levels of psychological well-being were associated with better cognitive function.

Myopia Progression in Children Wearing Spectacles vs. Switching to Contact Lenses

COMET children switching from glasses to CLs experienced a small, statistically significant but clinically inconsequential increase in myopia progression.

Detecting Alzheimer’s Through the eye?

According to recent data from the Alzheimer’s Association, every 71 seconds someone develops Alzheimer’s disease, the seventh leading cause of death in the United States; but a new laser eye scanning device is providing hope of diagnosing the degenerative condition early.

Engineers at Neuroptix Corporation in Acton, Mass., are developing a non-invasive laser eye scanning device to detect the presence of beta-amyloid (BA) plaque in the eye -- a protein widely associated with the disease. The device is based on the discovery that these plaques form on the lens of the eye, in addition to the brain.

Behind the Unproven H1N1 Flu Vaccine

Public health officials have been warning for some time that nothing about the flu is predictable. But here's something that is: When it comes to a new strain of the flu like H1N1, which has already stoked global fears of a massive pandemic, there's almost certain to be some overreaction. That's what happened this week when the public was hit with a double-play of scary news: A new estimate showed that that up to 90,000 Americans could die of H1N1 in the upcoming season; and a simultaneous report that the government was taking some unprecedented steps to get a vaccine ready in time. But the fatality numbers are more complicated — and less alarming — than they seem; and the vaccine report is less a reason for alarm than a sign of smart epidemiological planning. Read more:,8599,1918743,00.html#ixzz0bFbOrxSb

American Medical Association may investigate journal editors

The American Medical Association is seeking an investigation of claims that editors of its leading medical journal threatened a whistle-blower who pointed out a researcher's conflict of interest.

Editors of the Journal of the American Medical Association deny threatening a professor who raised concerns about a study author's undisclosed financial link to a drug company when JAMA published the study last year. JAMA, like most leading medical journals, has a policy of noting scientists' industry connections.

According to the Wall Street Journal, JAMA editors threatened to ban the professor from their journal and ruin his medical school's reputation if he didn't stop talking to reporters.

Odds of abuse associated with retinal hemorrhages in children suspected of child abuse

....Seventy-four percent of children were younger than 6 months old. Forty-five percent of cases were definite abuse and 37% were definite accident. The prevalence of retinal hemorrhages was 32%. Across all subjects, the presence of retinal hemorrhage was highly associated with definite or probable abuse versus definite or probable accident (age-adjusted odds ratio 5.4 [95% CI, 2.1-13.6]). The odds ratio in children younger than 6 months (n = 81) was 11.7 (95% CI, 2.9-66.8). Retinal hemorrhage severity was higher in abuse versus accident (p < 0.0001) and correlated positively with abuse (Spearman r = 0.406, p < 0.0001). Scores above 8 (n = 13) were only present in abused children....Retinal hemorrhages are highly associated with abusive head trauma, particularly in children younger than 6 months of age. Increasing retinal hemorrhage severity is correlated with increasing likelihood of abuse.....

Diplopia and Fluoroquinolones

...A total of 171 case reports of diplopia associated with fluoroquinolones were reported, including 76 men, 91 women, and 4 case reports in which the gender was not specified. The median age was 51.6 years. Dosage varied between the different fluoroquinolone drugs, with the median dosage within the range recommended in the package insert for each different fluoroquinolone. Median time from beginning of therapy to appearance of the ADR was 9.6 days (range 1 day to 5 months). Seventeen subjects also had concomitant tendinitis, 49 patients were 60 years or older, 1 patient had renal cysts, and 4 patients were taking systemic anti-inflammatory steroids. There were 53 positive dechallenge and 5 positive rechallenge case reports....

Top-Read Clinical Articles of 2009 in Ophthal/Pediatric Ophthalmology

1. Infantile Hemangiomas and Retinopathy of Prematurity Pediatrics 03/04/2009

2. Recognizing the signs of retinoblastoma Practice Nursing 09/02/2009

3. Osteopontin and 'melanoma inhibitory activity': comparison of 2 serological tumor markers in metastatic uveal melanoma patients Ophthalmologica 03/06/2009

4. Whole-body 18FDG PET-CT Imaging of Systemic Sarcoidosis: Ophthalmic Oncology and Uveitis Ocular Immunology and Inflammation 05/11/2009

5. Orbital sarcoma in HIV positive patient: A diagnostic dilemma Diagnostic Cytopathology 07/08/2009

6. Malignant Transformation of Congenital Hypertrophy of the Retinal Pigment Epithelium Ophthalmology 09/23/2009

7. Cerebral Arteriopathy in Children With Neurofibromatosis Type 1 Pediatrics 09/15/2009

8. Analysis of ototoxicity in young children receiving carboplatin in the context of conservative management of unilateral or bilateral retinoblastoma Pediatric Blood & Cancer 01/27/2009

9. Decreased Catalase Expression and Increased Susceptibility to Oxidative Stress in Primary Cultured Corneal Fibroblasts from Patients with Granular Corneal Dystrophy Type II American Journal of Pathology 06/05/2009

10. Natural history and outcome of optic pathway gliomas in children Pediatric Blood & Cancer 07/23/2009

11. Oncogenic GNAQ mutations are not correlated with disease-free survival in uveal melanoma British Journal of Cancer 08/05/2009

12. Ifosfamide or trofosfamide in patients with intraocular lymphoma Journal of Neuro-Oncology 12/30/2008

13. Relapses of optic pathway tumors after first-line chemotherapy Pediatric Blood & Cancer 01/22/2009

14. Spontaneous Subperiosteal Hematoma of the Orbit Journal of Pediatric Ophthalmology & Strabismus 06/01/2009

15. Peripheral Exudative Hemorrhagic Chorioretinopathy Simulating Choroidal Melanoma in 173 Eyes Ophthalmology 03/24/2009

16. How to Handle Benign Optic Glioma of Childhood: A Short Overview Neuro-Ophthalmology 06/18/2009

17. Pterygium and Associated Ocular Surface Squamous Neoplasia Archives of Ophthalmology 01/16/2009

18. Leucocoria in a boy with Kawasaki disease: a diagnostic challenge Singapore Medical Journal 08/17/2009

19. Episodic Src activation in uveal melanoma revealed by kinase activity profiling
British Journal of Cancer 07/01/2009

20. Cytomegalovirus retinitis mimicking intraocular lymphoma Clinical Ophthalmology 01/09/2009

21. Clinical Course and Prognosis of Trochlear Nerve Schwannomas Ophthalmology 08/26/2009

22. A Phase I Study of Periocular Topotecan in Children with Intraocular Retinoblastoma Investigative Ophthalmology and Visual Science 04/14/2009

23. Intravitreal Administration of the Anti-Tumor Necrosis Factor Agent Infliximab for Neovascular Age-related Macular Degeneration American Journal of Ophthalmology 05/07/2009

24. Is CT Still Useful in the Study Protocol of Retinoblastoma American Journal of Neuroradiology 07/20/2009

25. Darier Disease Mimicking Basal Cell Carcinoma of the Eyelid Ophthalmic Plastic and Reconstructive Surgery 04/10/2009

26. Orbital Metastasis: Clinical Features, Management and Outcome
Orbit - The International Journal on Orbital Disorders, Oculoplastic and Lacrimal Surgery 06/22/2009

27. Cryo-assisted anterior approach for surgery of retroocular orbital tumours avoids the need for lateral or transcranial orbitotomy in most cases
Acta Ophthalmologica 09/08/2009

28. Familial retinoblastoma in developing countries
Pediatric Blood & Cancer 05/15/2009

29. Eye-conserving treatment in massive congenital orbital teratoma
Clinical and Experimental Ophthalmology 05/12/2009

30. Invasive thymoma with intraorbital metastases
Journal of Cancer Research and Therapeutics 03/31/2009

31. Toxocariasis mimicking liver, lung, and spinal cord metastases from retinoblastoma
The Pediatric Infectious Disease Journal 03/10/2009

32. The skull beneath the skin: Cancer survival and awareness of death
Psycho-Oncology 03/10/2004

33. Orbital lymphoma: Role of radiation
Indian Journal of Ophthalmology 02/18/2009

34. Salvage external beam radiotherapy after failed primary chemotherapy for bilateral retinoblastoma: rate of eye and vision preservation
British Journal of Ophthalmology 04/17/2009

35. Eye Cancer Related Glaucoma: Current Concepts
Survey of Ophthalmology 02/17/2009

36. Nondiagnostic Conjunctival Map Biopsies for Sebaceous Carcinoma
Archives of Ophthalmology 08/12/2009

37. Expression of -Crystallin in Retinoblastoma
Archives of Ophthalmology 02/11/2009

38. Intralesional injection of OK-432 in pediatric orbital lymphangioma
Journal of American Association for Pediatric Ophthalmology and Strabismus 04/08/2009

39. Eyelid Contracture may Indicate Recurrent Basal Cell Carcinoma, even after Mohs Micrographic Surgery Orbit - The International Journal on Orbital Disorders, Oculoplastic and Lacrimal Surgery 02/23/2009

40. Inadvertent Evisceration of Eyes Containing Uveal Melanoma Archives of Ophthalmology 02/10/2009

41. Retinoblastoma and Hirschsprung Disease With a 13q14 to 22 Deletion Journal of Pediatric Ophthalmology & Strabismus 12/30/2008

42. Combined Hamartoma of the Retina and Retinal Pigment Epithelium in 77 Consecutive Patients: Visual Outcome Based on Macular versus Extramacular Tumor Location Ophthalmology 12/31/2008

43. Preceding orbital granulocytic sarcoma in an adult patient with acute myelogenous leukemia with t(8;21): a case study and review of the literature
Cancer Genetics and Cytogenetics 08/12/2008

44. Orbital solitary fibrous tumor. Another rare case from Africa
International Ophthalmology 09/09/2009

45. Benign Hamartoma Masquerading as a Deep Orbital Hemangioma Journal of Pediatric Ophthalmology & Strabismus 07/30/2009

46. Schwannoma of the Lower Eyelid in a 13-Year-Old Girl Ophthalmic Plastic and Reconstructive Surgery 03/18/2009

47. Topical Interferon Alpha 2b Eye Drops for Treatment of Ocular Surface Squamous Neoplasia: A Dose Comparison Study British Journal of Ophthalmology 06/08/2009

48. SPECT-CT Images of an Ocular Coralline Hydroxyapatite Implant Visible on Bone Scintigraphy Clinical Nuclear Medicine 02/05/2007

49. Recurrent melanotic neuroectodermal tumor in the orbit successfully treated with resection followed by pediculated periosteal flaps Pediatric Blood & Cancer 06/05/2008

50. Ectopic Meningioma Anterior to the Lacrimal Gland Fossa Ophthalmic Plastic and Reconstructive Surgery 03/18/2009

Monday, December 28, 2009


...Exodeviations or divergent squint occurs as a result of certain obstacles to development or maintenance of binocular vision and/ or due to defective action of the medial rectus muscles. Small exophorias are found in high frequency in the normal population and 60-70% of normal newborn infants have a transient exodeviation that resolves by 4-6 months of age (1-3). Intermittent exotropia is an exodeviation intermittently controlled by fusional mechanisms. Unlike a pure phoria, intermittent exotropia spontaneously breaks down into a manifest exotropia.............

Comments: This was written by a surgeon (which doesn't automatically make it bad) but it does explain why he has a misguided view of orthoptics/vision therapy. I know I am biased as an optometrist....but I would not try surgery first. I would recommend optometric vision therapy first....especially after the NEI supported clinical trials in the area of convergence insufficiency. You can do surgery at any time. DM

Impact of computer use on children's vision

Today, millions of children use computers on a daily basis. Extensive viewing of the computer screen can lead to eye discomfort, fatigue, blurred vision and headaches, dry eyes and other symptoms of eyestrain. These symptoms may be caused by poor lighting, glare, an improper work station set-up, vision problems of which the person was not previously aware, or a combination of these factors. Children can experience many of the same symptoms related to computer use as adults. However, some unique aspects of how children use computers may make them more susceptible than adults to the development of these problems. In this study, the most common eye symptoms related to computer use in childhood, the possible causes and ways to avoid them are reviewed.

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 [email protected]

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....

Saturday, December 19, 2009

Predictability of Strabismus Surgery in Children with Developmental Disorders and/or Psychomotor Retardation

...Re-surgery in children with developmental disorders and/or psychomotor delay has a larger effect per mm of surgery than in normal children. RcRs-surgery has a similar effect in delayed and normal children. ...

Comments:Just like in normal children....multiple strabismic surgeries are expected....except you need to do more in children with delays. DM

Awareness of Exodeviation in Children with Intermittent Exotropia

...In our study, most patients with IXT were aware of their eye condition, but patient experience varied. In individual interviews, children described awareness of their eye condition mainly due to comments from others. Awareness of ability to correct the exodeviation by blinking was common and may be related to mechanisms used to control IXT....

Blindness in Childhood in Developing Countries: Time for a Reassessment?

Summary Points

Childhood blindness is a priority area for VISION 2020, a global initiative to eliminate avoidable blindness, because blind and visually impaired children have a lifetime of blindness ahead of them.

Globally, vitamin A deficiency- and measles-related blindness in children has declined substantially although it persists in some focal settings.

With reductions in nutritional and infectious causes of blindness, intra-uterine and genetic causes of blindness (e.g., cataract and congenital anomalies) have assumed increased importance and need tertiary care-level interventions and long-term follow-up to achieve good visual rehabilitation.

Further research is needed to identify the underlying causes of congenital and developmental cataract and to determine the best strategies for recognition, referral, treatment, and rehabilitation.

Changing patterns of global childhood blindness suggest a reassessment of research, training, and programmatic needs.

Comments: They forgot to mention that the #1 cause of treatable visual impairment in the world is uncorrected refractive error: myopia, hyperopia, astigmatism and presbyopia. When are we going to simply give people a pair of spectacles? That would be money very well spent! DM

Nutrition Research and Practice

The following new journal from the Korean Society of Community Nutrition and the Korean Nutrition Society has been added to PubMed Central:

Nutrition Research and Practice
ISSN: 1976-1457 (print) 2005-6168 (electronic)


Archive includes vol. 2(4) [2008] to 3(2) [2009]
Note: There is no embargo delay for this journal; all articles are Open Access.

Active Video Games Can Break a Sweat

...People who play active video games such as Wii Sports or Wii Fit may actually be breaking a sweat: researchers here say some provide the equivalent of a moderate-intensity workout. ...

The Top 10 Medical Advances of the Decade

1. Human Genome Discoveries Reach the Bedside
2. Doctors and Patients Harness Information Technology
3. Anti-Smoking laws and Campaigns Reduce Public Smoking
4. Heart Disease Deaths Drop by 40 Percent
5. Stem Cell Research: Laboratory Breakthroughs and Some Clinical Advances
6.Targeted Therapies for Cancer Expand With New Drugs
7. Combination Drug Therapy Extends HIV Survival
8. Minimally Invasive and Robotic Techniques Revolutionize Surgery
9. Study Finds Heart, Cancer Risk with Hormone Replacement Therapy
10. Scientists Peer Into Mind With Functional MRI

Several clinical factors may predict length of hospital stay for extremely preterm infants.

From AOA FirstLook:

Medscape (12/17, Barclay) reported, "Clinical factors may predict length of hospital stay for extremely preterm infants," Stanford researchers found after looking at data on "2,254 infants younger than 27 weeks...who were born at a Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network site." According to the paper in Pediatrics, the team eventually found that a "very streamlined, five-factor model was as good as the much more complicated statistical model that [was] used to predict if a baby would be discharged early or late." In short, the "five key factors or groups of factors predicting later-than-usual hospital discharge were birth weight less than 750 g, the need for surgery during hospitalization, sepsis or gastrointestinal tract infections, chronic lung problems, and severe problems with retinal development."

Onset and Progression of With-the-Rule Astigmatism in Children with Infantile Nystagmus Syndrome

...Both our cross-sectional and longitudinal data showed that WTR astigmatism was common among children with INS and increased in magnitude with age during the first 8 years of life. Changes observed in meridional refractive error with age were consistent with meridional emmetropization in children with INS and WTR astigmatism....

Music and the Arts Fight Depression, Promote Health

If you paint, dance or play a musical instrument -- or just enjoy going to the theatre or to concerts -- it's likely that you feel healthier and are less depressed than people who don't, a survey of nearly 50,000 individuals from all socio-economic backgrounds from a county in mid-Norway shows.....

In Medical News Today: Optometric Vision Therapy Helps Children With Math Problems

AOA Secures New Federal Recognition and Funding for InfantSEE® Program

From AOANews Blog:

Resources Aimed at Expanding Scope and Impact of Key Public Health Program for Kids

President Barack Obama yesterday signed into law a measure that provides nearly $600,000 in new federal resources to help expand the scope and impact of InfantSEE® - the signature public health program of the American Optometric Association (AOA) and administered by Optometry’s Charity™ - The AOA Foundation.

On December 16, President Obama signed into law the FY 2010 Consolidated Appropriations Act of 2009, which was approved by the U.S. House and Senate and cleared the way for the White House earlier this month. The bill, which provides funding for the operations of many areas of the federal government, includes $590,000 in new direct appropriations for InfantSEE® and is designed to ensure that eye and vision care becomes an integral part of infant wellness.

The first direct appropriation, sponsored by Sen. Robert C. Byrd (D-W.Va.) totaled $500,000 and is aimed at supporting expansion and outreach of the program.

“Many parents of newborns do not know that the most dramatic development of a child’s visual system occurs within the first year of life,” said Sen. Byrd. “And it is through early detection and treatment of potential problems that parents can help ensure poor vision and eye health does not severely affect their child’s ability to learn and place them at a disadvantage in education and in life.”

The second direct appropriation totaling $90,000 was sponsored by Sen. Tom Harkin (D-IA) and will support program expansion through outreach in Iowa.

“InfantSEE® is doing much more than identifying and treating risk factors that may cause eye and vision problems later in the life,” said Sen. Harkin. “They are taking prevention to a new level to ensure healthier, thriving children and lower health care costs down the road.”

The InfantSEE® program previously received a direct appropriation sponsored by Sen. Byrd in the fall of 2008 and implemented in 2009. Data collected from the 2009 project display an overall prevalence rate of one in six infants exhibiting a cause for concern (in need of follow-up care or referral to an eye doctor). The data also identified two groups at greatest risk for abnormal vision status: premature and minority infants.

“The fact is that this is so much more than just another big win in Washington, D.C. for our patients and profession,” said Randolph E. Brooks, AOA President. “The expanded funding for InfantSEE® that the AOA has secured provides a new level of recognition from the President and Congress for the leadership role of optometry in delivering needed eye health and care to a critical population.”

InfantSEE® assessments are complementary to the routine well-care exams a baby receives from a pediatrician or family physician. Optometrists have the training to identify areas of risk that are critical to vision development and the skills to identify conditions that might not be detected in a routine pediatric wellness exam. In some cases, conditions may need to be monitored, immediately treated or referred to a pediatric eye specialist.

To learn more about InfantSEE® visit

ASCO Eye on Education Newsletter

Friday, December 18, 2009

Optometry and Vision Development Volume 40, No. 4, 2009

Optometry and Vision Development Volume 40, No. 4, 2009

One Time Around the Sun
by Dominick M. Maino, OD, MEd, FAAO, FCOVD-A, Editor

Mentoring: Giving Back to the Profession
by Marc B. Taub, OD, FAAO, FCOVD

Letter to the Editor

Instability of Fixation in Dyslexia: Development - Deficits - Training
by Burkhart Fischer, Dipl Phys; Klaus Hartnegg, Dipl Phys

Subitizing: Vision Therapy for Math Deficits
by Sidney Groffman OD, MA, FCOVD

Predicting Accommodative Insufficiency and Academic Problems using the Conlon Visual Discomfort Survey
by Chris Chase, PhD; Chinatsu Tosha, PhD; Eric Borsting, OD, MS, FAAO,FCOVD; William H. Ridder III, OD, PhD, FAAO

Papers and Posters

Literature Review
Current Eye & Vision Science Literature
Review by David A. Goss, OD, PhD, FAAO, FCOVD-A

Book Review
Clinical Management of Binocular Vision
Review by Christine L. Allison, OD

EnVISIONing a Bright Future
Review by Dr. Gary Williams

COVD 39th Annual Meeting
President’s Speech - COVD Continues Making a Difference
By Brad Habermehl, OD, FCOVD

Annual Membership Report
By Carol L. Scott, OD, FCOVD

Annual Meeting Photos


Optometric Vision Therapy Helps Children With Math Problems

Optometric Vision Therapy Helps Children With Math Problems

AURORA, Ohio, Dec. 18 /PRNewswire-USNewswire/ --"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."

Dr. Dominck Maino, editor of Optometry & Vision Development says that in this article, "Dr. Groffman goes on to review a particular ability called subitizing. This is a basic skill which has been known to be a precursor of math skills." Dr. Groffman has helped to develop a subitizing vision therapy computer program that has been designed and based upon theories and experimental data appropriate for improving math skills. It consists of a diagnostic test and four therapy programs. This paper reviews subitizing and how members of the College of Optometrists in Vision Development can use this computer program to help their patients.

In this same issue of 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."

And finally, 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 [email protected] or 312-949-7282.

About COVD

The College of Optometrists in Vision Development (COVD) is an international, non-profit optometric membership organization that provides education, evaluation, and board certification programs in behavioral and developmental vision care, optometric vision therapy, and visual rehabilitation. The organization is comprised of doctors of optometry, vision therapists and other vision specialists. For more information on learning-related vision problems, optometric vision therapy, and COVD, please visit or call 888.268.3770.

CONTACT: Pamela R. Happ, CAE
COVD Executive Director
Phone: 888.268.3770
Email: [email protected]

Thursday, December 17, 2009

Never, Never, Never, Never Do this!!!

Dr. Mike Cohen sent this to me in his newsletter....NEVER do this. DM

Center for Patient Insights

From Dr. Mike Cohen's Newsletter:

THE CPI: The Center for Patient Insights is now available to U.S. eye care professionals, developed specifically for eye care professionals and its purpose is to deliver up-to-date news on industry trends, and insights on patient attitudes and beliefs.

To this end, the Center has created a Web site

that will provide research and insights that are downloadable and printable for future use and reference, as well as video materials that eye care professionals can listen to or watch at their convenience. This site, which is just one component of the Center initiative, also includes a search function that allows users to easily locate specific information using keywords and categories.

The insights on consumer behavior that the

Center offers are not tied to specific brands and are derived from proprietary data or from research conducted by outside sources such as Gallup and Health Product Research. Some of the available topics include: patient health and vision conditions; patient preferences and behaviors; patient satisfaction and retention; time management; and market growth.



To all:

The Neuro Optometric Rehabilitation Association (NORA) and the International Congress of Behavioral Optometry (ICBO) have a very exciting opportunity to offer to full time students and residents interested in vision training and rehabilitative vision care. Most traditional curriculums offer very limited exposure to working with brain injured and stroke patients, however, there are many private practice doctors applying diverse and interesting approaches to rehabilitation. This opportunity will allow you to expand your knowledge in the area of neuro optometric rehabilitation and get a taste of the multidisciplinary approach necessary when working in the rehabilitation setting.

The Neuro Optometric Rehabilitation Association (NORA) is hosting its annual meeting in conjunction with the International Congress of Optometry on April 8-11 in Pomona, CA. The continuing education offered at this meeting will expose you to material and a way of thinking that you most likely have not yet encountered. The two days prior to the annual meeting, April 6-7, will be NORA’s Clinical Skills program. The Clinical Skills program is an opportunity to explore Neuro Optometric Rehabilitation through a comprehensive, multidisciplinary lecture sequence. Recipients of the grant will have the opportunity to attend Clinical Skills level 1. By attending this two day course you will learn a great deal about the nuts and bolts of Traumatic Brain Injury rehabilitation. Integrated into the course are tools that can be applied in providing rehabilitative care.

NORA and ICBO have come together to offer grants to students and residents to help with the costs of attending the meeting. If you are a full time student or resident willing to volunteer time at the meeting, as well as write a report on the conference to be distributed at your college, NORA and ICBO will provide full conference registration (including lunch both days), up to $200 travel grant, and dorm style hotel rooming at no cost to you. To be considered for one of these grants you must complete the attached application and email it to, [email protected] We have 10 of these opportunities to offer so get your applications in soon. The deadline for submission of an application is February 15, 2010, but the sooner the better!

Grant recipients will be assigned duties throughout the meeting. These duties will include things like stamping CE forms after lectures, assisting during the clinical skills lectures and assisting at the registration desk.

The dorm style hotel arrangements for students and residents will provide you with an opportunity to meet the other students in attendance and work together to make your experience at NORA/ ICBO the best it can be. Grant recipients will be matched up and assigned to rooms through this program.

We also offer a Dinner-with-a-doc night. If you are interested in participating in this you will be matched with a doctor who has expressed interest in hosting a student for dinner with a group of other docs. This is an opportunity for you as a student to get a sense of the “family” at the meetings.

If you are interested in attending the meeting please forward me a completed application by February 15, 2010. If you have any questions or concerns please feel free to contact me for additional information.

Additional information on these meetings can be found at and You will also have a chance to see Western University College of Optometry, a cosponsor of this conference. Looking forward to seeing you in Sunny California!

Sarah Lane, O.D.
[email protected]
215 284 4895

P.S. Please feel free to share this information with anyone you feel may be interested. Remember...this opportunity is not restricted to Optometry students and residents so share the information with other professions as well!!!

My Trip to the Eye Doctor

Illinois Eye Institute Video

Glasses for Amblyopia

Vision and Learning Video II

Vision and Learning Video

Optometric Care of the Patient with Acquired Brain Injury

From the AOA:

....Injury to the eye or the sensory, motor or associated areas of the visual system of the Brain Injury patient may result in the development of the following:

* Strabismus
* Reduced visual acuity at far
* Reduced visual acuity at near
* Visual field loss
* Ocular motility disorders
* Binocular vision dysfunctions
* Accommodative disorders
* Difficulties in visual perception
* Deficits in visual motor integration...

Comments: For additional info, click the title. DM

Vision, Learning and Dyslexia

From the AOA:


Many children and adults continue to struggle with learning in the classroom and the workplace. Advances in information technology, its expanding necessity, and its accessibility are placing greater demands on people for efficient learning and information processing.

Learning is accomplished through complex and interrelated processes, one of which is vision. Determining the relationships between vision and learning involves more than evaluating eye health and visual acuity (clarity of sight). Problems in identifying and treating people with learning-related vision problems arise when such a limited definition of vision is employed.

This position statement addresses these issues, which are important to individuals who have learning-related vision problems, their families, their teachers, the educational system, and society...

Comments: Click on title to read all. DM

The Need for Comprehensive Vision Examination of Preschool and School-age Children

From AOA:

Vision disorders are a common pediatric health problem in the United States. It is estimated that nearly 25% of school-age children have vision problems. Despite the economic, social and health care advances which have occurred in our society, many preschool and school-age children are not receiving adequate professional eye and vision care. Only about one third of all children have had an eye examination or vision screening prior to entering school. Also, a recent study found that 11.5% of teenagers have undetected or untreated vision problems. The early detection and treatment of eye and vision problems for children needs to be a major public health goal. This is made increasingly important by the enhanced understanding of critical periods in human visual development. The earlier a vision problem is diagnosed and treated, the less the potential negative impact it may have on the child's development.

Comments: Click on title to read more. DM

Vision: A Collaboration of Eyes and Brain

From AOA:

The fact that vision seems so effortless belies the complexity of the visual process. The term vision refers to the complex of eye and brain.1 It is this complex which guides a broad spectrum of human abilities.

We walk down a street, step up and down curbs, maneuver around objects and other pedestrians and adjust our pace, while visually monitoring our position. Moments later we get into our car, drive at highway speed through traffic and judge where we are relative to other vehicles while anticipating the flow of traffic. We arrive at baseball practice where we pick up a bat, walk to the plate, miss a curve ball, foul-off a fast ball and then hit a single, making numerous conscious and subconscious judgements with varying degrees of success. After practice, we stop by the mall, scan the crowd for our friend, and go to the bookstore to find the book we might want to purchase. Over a no-foam latte, we read the opening chapter, seeing if it captures our attention.

Our vision plays an essential role in each of these activities through the collaboration of eyes and brain.

Comments: Click on title to read more. DM

Wednesday, December 16, 2009

Get Ready for the Revolution in Pediatric Optometry

This is an awesome article by my friend and colleague Dr. Len Press. Read it! DM

Monocular and binocular distance cues: insights from visual form agnosia I (of III)

Abstract The human nervous system constructs a Euclidean
representation of near (personal) space by combining
multiple sources of information (cues). We investigated
the cues used for the representation of personal
space in a patient with visual form agnosia (DF). Our results
indicated that DF relies predominantly on binocular
vergence information when determining the distance of a
target despite the presence of other (retinal) cues. Notably,
DF was able to construct an Euclidean representation
of personal space from vergence alone. This finding
supports previous assertions that vergence provides the
nervous system with veridical information for the construction
of personal space. The results from the current
study, together with those of others, suggest that: (i) the
ventral stream is responsible for extracting depth and
distance information from “monocular” retinal cues (i.e.
from shading, texture, perspective) and (ii) the dorsal
stream has access to binocular information (from horizontal
image disparities and vergence). These results
also indicate that DF was not able to use size information
to gauge target distance, suggesting that intact temporal
cortex is necessary for “learned size” to influence
distance processing. Our findings further suggest that in
neurologically intact humans, object information extracted
in the ventral pathway is combined with the products
of dorsal stream processing for guiding prehension. Finally,
we studied the “size-distance paradox” in visual
form agnosia in order to explore the cognitive use of size
information. The results of this experiment were consistent
with a previous suggestion that the paradox is a cognitive

Binocular Depth Perception without Familiarity Cues

A classic paper. DM

COPE Standards for Commercial Support

In its November 2009 meeting, the ARBO Board of Directors approved the final timeline for the release and implementation of the new COPE Standards for Commercial Support. The Standards were released on December 15, 2009. January through June 2010 will be a six-month training period, followed by a six-month implementation phase. Oversight and enforcement during 2010 will consist of notification of non-compliance and assistance with compliance issues. Full compliance to the standards for all COPE accredited CE will be required as of January 1, 2011.

Old Math Reveals New Thinking In Children's Cognitive Development

Five-year-olds can reason about the world from multiple perspectives simultaneously, according to a new theory by researchers in Japan and Australia. ....

Ginkgo Biloba Extract Is Effective For Cognitive Decline

"Ginkgo biloba not only improves declining memory but offers specific benefits for other cognitive functions as well" that's how Dr. Reiner Kaschel, Clinical Neuropsychologist at the University of Osnabrueck, Germany, summarizes the results of a comprehensive new scientific publication.....

What Is A Coma (comatose)? What Is A Persistent Vegetative State?

A coma, or comatose is a deep state of unconsciousness - longer-term comatose patients may be reclassified as being in a permanent vegetative state. The patient cannot be awakened and does not respond to pain, light or sound in a normal way - the person in coma cannot react with the surrounding environment. A person in a coma does not take voluntary actions and does not have sleep-wake cycles....

No Best Approach To Education For All Children With Autism

There is no one best approach that can be used in educating all children and young people with autism, according to a new report by researchers from the University of Birmingham's Autism Centre for Education and Research and St. Patrick's College Dublin, published by the Republic of Ireland's National Council for Special Education (NCSE).

Study Reveals Differences In How The Autistic Brain Distinguishes Oneself From Others

Scientists at the University of Cambridge have discovered that the brains of individuals with autism are less active when engaged in self-reflective thought. The study published in the journal Brain provides new evidence for the neural correlates of self-awareness and a new window into understanding social difficulties in autism spectrum conditions

Special SECO Alert!

An announcement from my friend and colleague Dr. Walt Mayo:

I've personally worked with SECO since 1994. There simply is no other meeting in Optometry that compares. As in prior years, SECO 2010 represents the best of three worlds: Education, Exhibits, and Events. The upcoming SECO Congress to be held in Atlanta February 10-14, 2010 is a terrific opportunity to get the finest education. The Congress itself features hundreds of hours of CE, plus for SECO 2010 you can add six hours the day before through a partnership with the Optometric Nutrition Society, and an addition eleven hours of free Virtual CE for all full Congress registrants. Don't miss Early Bird registration! See SECO2010. com for all the information you need to make the most of your SECO experience. Here are few important things to know as we head into the Christmas rush:

SECO Early-Bird Registration Rate Ends December 17th
SECO Symposium Series - Free Meal WIth Each Symposium!
SECO Offers 11 Hours of Free Virtual CE with SECO Registration
Optometric Nutrition Society To Hold Spring Educational Conference Prior to SECO
Almost 350 Hours of Continuing Education
275 Leading Industry Companies
SECO Early-Bird Registration Rate Ends December 17th
You've got today and tomorrow to save at least $40 by registering for SECO 2010 at the Early Bird rate.

SECO Symposium Series - Free Meal WIth Each Symposium!
In keeping with the SECO tradition of providing Optometrists with the most innovative and new educational opportunities, SECO 2010 unveils a unique Symposium Series. SECO 2010 and its Diamond and Platinum level Partners are inviting attendees to enjoy a FREE meal while listening to reputable industry leaders at FREE Symposium Series presentations highlighting information on the latest developments in optometric products and services designed to give an edge in today's economy. The symposiums are not for COPE credit.

Thursday, February 11th
Clinical Partnerships: Understanding the Opportunities for Your Patients and Practice
Paul Karpecki, OD, FAAO; William Trattler, MD
Presented by Abbott Medical Optics
Course 300 8:15 AM - 9:15 AM

A Perfect Fit for Optometry
Marc Bloomenstein, OD
Presented by Allergan

Value for Your Patients, Profit for Your Practice
Mike Rothschild, OD; Dwight Akerman, OD, FAAO; Amir Khoshnevis, OD
Presented by CIBA VISION
Course 301 11:45 AM - 1:00 PM

Friday, February 12th

Insights to Grow in Today’s Environment
Presented by Bausch & Lomb

Combining Modality and Material for Short and Long-Term Ocular Health
Lyndon Jones, PhD, FAAO
Presented by Vistakon
Course 302 7:15 AM - 8:15 AM

Saturday, February 13th

Best Practices in Prescribing Vision Correction in 2010 - Part I
Paul Karpecki, OD, FAAO
Presented by Essilor

Best Practices in Prescribing Vision Correction in 2010 - Part II
Christine Sindt, OD, FAAO
Presented by Alcon
Course 303 7:15 AM - 8:15 AM

Don't miss this unique opportunity to learn the latest in the industry, have breakfast or lunch with colleagues and friends, and chances to win complimentary SECO 2011 OD registrations or $1,000 vouchers to be used in Optometry's Marketplace(tm) at SECO 2010.

SECO Offers 11 Hours of Free Virtual CE with SECO Registration
Register now, or at any time prior to SECO 2010 and receive free access to SECO's brand new collection of Virtual CE courses. Available right now, you can take up to eleven hours of excellent COPE-approved online CE just for SECO 2010 attendees. This makes your SECO 2010 registration an even better value. Presenters for these courses include Jeffrey Anshel, OD, Paul Harris, OD, Kelly Malloy, OD, Anastas Pass, OD, and Tammy Than, OD.

Optometric Nutrition Society To Hold Spring Educational Conference Prior to SECO
The New Spring Educational Conference for the Optometric Nutrition Society will be held at the Atlanta Marriott Marquis on February 10, 2010. This is one day prior to the annual meeting of SECO. Presenters include Ellen Troyer, A. Paul Chous, OD, Ben Lane, OD, Stuart Richer, OD, and Jeffrey Anshel, OD. Six hours of CE including lunch are available at a very good rate.

Almost 350 Hours of Continuing Education
SECO 2010 will offer almost 350 hours of continuing education for optometrists, opticians, paraoptometrics, ophthalmic technicians, and administrative staff. Education includes special sessions, hourly lectures, hands-on workshops, certification reviews and joint education for the entire office. Many of these courses will focus on generational patient care topics themed, “Embracing the Generations.”

275 Leading Industry Companies
SECO 2010 features Optometry's Marketplace at SECO™, one of the largest exhibit halls in optometry. With 70,000 square feet of exhibit hall space, Optometry’s Marketplace™ features 275 industry leading companies showcasing new trends, the most recent product introductions, as well as breakthrough technologies and services. Whether its frames, ophthalmic equipment, pharmaceuticals or office technology, the exhibitors within Optometry’s Marketplace™ have what every eye care professional is looking for.

= = is optometry's oldest and largest online community, serving optometrists since 1994. Over the years, thousands of doctors from nearly 40 countries around the world have participated in this dynamic, innovative group of optometric colleagues.

Tuesday, December 15, 2009

ICO Alumni Look at This and be Very Proud!

ICO Faculty & Program Achievements and Activities
December 16, 2009

Faculty Achievement. Congratulations to Maino DM, Viola, SG, Donati R. The Etiology of Autism. Optom Vis Dev 2009:(40)3:150-156.

Faculty Achievement. Congratulations to Viola SG, Maino DM. Brain anatomy, electrophysiology and visual function/perception in children within the autism spectrum disorder. Optom Vis Dev 2009;40(3):157-163.

Faculty Achievement. Congratulations to Maino D. Partly cloudy with a chance of meatballs. Optom Vis Dev 2009;40(3):134-135.

Faculty Achievement. Congratulations to: Pang Y, Trachimowicz R, Castells DD, Goodfellow GW, Maino DM. Optic Nerve Heads in Pediatric African Americans Using Retinal Tomography. Optom Vis Sci 2009;86:1-●●●

Faculty Achievement. Dr. Maino and Dr. Donati were cited in press releases concerning the Special Autism Issue Published by the College of Optometrists in Vision Development (Optometry & Vision Development, Volume 40, Number 3, 2009)

Faculty Achievement. Dr. Hodur attended an Essilor-sponsored Key Optometric Leaders meeting in Cancun, Mexico, December 2-5, 2009. Dr. Hodur’s group had preliminary discussions about the use of ophthalmic lenses in diseased eye conditions.

Faculty Activity. Drs. Allison, Block, Maino, L. Messner and Pang attended part or all of the 3-day National VHA/DoD Conference: Sensory Impairment Issues in Traumatic Brain Injury here in Chicago on December 8-10, 2009 sponsored by the Department of Veterans Affairs and Department of Defense. Dr. Joan Stelmack, also an ICO faculty, was one of the presenters. Tammy Duckworth, Assistant Secretary of Public and Intergovernmental Affairs for the US Department of Veteran Affairs was the keynote speaker.

Faculty Achievement. The editors at Optometric Management have selected Dr. Maino’s article, Identify Binocular Vision Disorders, to be the cover story for the December 2009 issue.

Faculty Achievement. Dr. Frantz organized the 12-hour continuing education program for the Fellowship of Christian Optometrists conference held in Brown County State Park, Nashville, IN in October 2009.

Faculty Activity. Drs. Pang, Scharre and L. Messner submitted a pre-proposal, Assessment of Eye Movements in Service Members as Risk for Mild TBI, to the Defense Medical Research and Development Program (DMRDP) Applied Research and Advanced Technology Development Award program.

Faculty Achievement. The Prevent Blindness America Annual meeting was Friday, December 4, 2009. At the banquet to present annual awards, Dr. Block was awarded the F. Park Lewis, MD Lifetime Achievement Award, Prevent Blindness America, 2009. This prestigious award recognized Dr. Block for work that she has been doing with Prevent Blindness America for many years. Dr. Block notes that the attached link shares some perspectives on this important work.

Faculty Achievement. Dr. Frantz and Dr. Cotter published a chapter in the prestigious Duane's Ophthalmology this year. Cotter SA, Frantz KA. Therapeutic uses of prism for binocular vision disorders. In: Tasman W, Jaeger EA, eds. Duane’s Clinical Ophthalmology. Philadelphia: Lippincott Williams and Wilkins, 2009.

Faculty Activity. Dr. Harthan is once again the chair of the AOA Faculty Liaison to Residency Programs and Optometry Students Committee. She and the committee have put together a list of awards for this year and are in process of involving as many students and residents involved as possible.

Program and Faculty Activity. COVD past President Dr. Fortenbacher hosted the Annual COVD Tour de Optometry event here at ICO. Dr. Fortenbacher met with interested faculty and later separately with students about COVD. His topic was Football to Neuroscience: VT Hits the Jackpot! Both faculty and students are strongly represented in the organization.

Faculty Activity. Dr. Mary Flynn-Roberts has announced the capacity and equipment to run Multifocal ERGs (mfERG) in the Visual Electrophysiology Service. The mfERG is used to evaluate the photopic cone function in an area of 20-30 degrees on either side of fixation. This test is useful for the monitoring for plaquenil toxicity and is also useful for investigating unexplained vision loss, unusual macular lesions and solar retinopathy.

Faculty Activity. Preliminary assessment suggests that up to 13 abstracts were submitted to ARVO 2010 from ICO faculty and students. ARVO is one of the most prestigious vision research meetings in the world.

Faculty Achievement. Drs. Wendy Stone, Janis Winters, and Kelly Frantz participated in the Correction of Hyperopia in Children Study (CHICS) study and the recent AAO poster presentation. The PCON report was presented at the AAO press conference in which the CHICS results were discussed ( ). CHICS is a multi-centered pilot study on correction of hyperopia in children. The pilot study, showed that children with hyperopia who wore vision correction showed improvement in attention and accommodative response, but had no significant effect on measures of visual function or reading. Marjean T. Kulp, OD, MS, FAAO is principal investigator.

Faculty Achievement. At the meeting of the ASCO SIG for International Optometric Educators, November 13, 2009, at the AAO Annual Meeting, Dr. Pang was elected as chair of the ASCO SIG IOE. Dr. Block also attended. Dr. Pang was also elected to chair a Planning Committee that includes Dr. Block.

Faculty Activity. Dr. Pang has administrated training for the College’s new Tracey Technologies iTrace Aberrometer for research projects and/or patient care. The sessions were on December 8-9, 2009 in room 3527. The aberrometer is a sophisticated device allowing the assessment of refractive error, accommodation and aberrations of the eye.

Faculty Activity. Dr. Klemencic attended the Optometric Glaucoma Society meeting in Orlando, FL in November 2009.

Faculty Activity. Drs. Jan Jurkus and Lewis Williams presented a workshop at the 2009 AOCLE Workshop, which was hosted by the University of Houston College of Optometry (UHCO) on Incorporating Interactive Case Reports in Teaching.

Faculty Achievement and Activity. Dr. Jurkus is also mentioned as a contributor to a textbook. At the end of the morning session of the AOCLE, attendees were treated to a book signing. Clinical Manual of Contact Lenses (3rd edition) editors Ed Bennett and Vinita Henry patiently signed copies for attendees, along with contributors Jan Jurkus, John Mark Jackson, Terry Scheid, Gina Sobora and Ron Watanabe. Dr. Jurkus is pictured with her collaborators on page 4 of the AOCLE Newsletter, November 2009. Dr. Jurkus also updated the group on her recent teaching trip to New Zealand (p. 7).

Faculty Achievement. Dr. Pang attended the International Conference of Education, Research and Innovation from Nov 16-18, 2009 in Madrid. She did an oral presentation of "Research Collaborations of US Optometry Schools/Colleges Internationally".

Faculty Activity. Dr. Daum has been appointed to the ASCO Committee on the Optometry Admission Test. The committee will review issues related to the OAT at the ADA headquarters in February 2010.

Dr. Mitch Scheiman the next ICO Dr. & Mrs. Dominick M. Maino Visiting Professor

Dr. Mitchell Scheiman's visit as the next Dr. and Mrs. Dominick M. Maino Visiting Professor starts June 22nd at ICO. His main responsibilities will be to interact with faculty, students, and administration. To lecture to faculty and students and to provide feedback on various research projects.

Besides activities with students and faculty, Dr. Scheiman will be providing a series of CE lectures on Sunday June 27th

• 9:00 -10:40 AM, 25180-FV - Should You Change the Way you Treat Amblyopia? Format: Live Category: Functional Vision/Pediatrics Total CE Hours: 2
Description: The results of recent studies of amblyopia treatment have important implications for clinical practice. Suggestions for changes in clinical practice are highlighted. Updated recommendations and options for the treatment of anisometropic and strabismic amblyopia are provided.

• 11:10-12:00PM, 25161-FV - Evidence Based Treatment of Convergence Insufficiency Format: Live Category: Functional Vision/Pediatrics Total CE Hours: 1
Description: In this course, data from recently completed clinical studies of convergence insufficiency are reviewed. Implications and suggestions for changes in clinical practice are highlighted and updated treatment approaches for convergence insufficiency are described.

• 1:00-2:40PM, 25162-FV - Pediatric Optometry: New Developments in Diagnosis and Treatment Format: Live Category: Functional Vision/Pediatrics Total CE Hours: 2
Description: Results from current or recently completed clinical studies in areas related to the pediatric population are reviewed. Areas of emphasis are myopia, the use of colored lenses and filters, new diagnostic tests and new technology appropriate for children.

Please contact ICO CE Director for additional information
Diane Gillette
Coordinator of Continuing Education
Illinois College of Optometry
[email protected]

Previous visiting professors included, Kenneth Ciuffreda, OD, PhD, FAAO, FCOVD-A and Leonard Press,OD, FAAO, FCOVD. The Dr. and Mrs. Dominick M. Maino Visiting Professor program is made possible by an endowed fund. Please contact ICO if you are interested in supporting this activity at the Illinois College of Optometry.

Scientific Peer Review

If you've ever sent in a paper to a scientific will love this YouTube video. (One of my colleagues sent this to me)DM

Free Medical E-books

I haven't tried this out yet....but if you do...let me know what you think. Dm

Optometrists more likely to stay married

...Optometry is among the professions most likely to lead to a happy and lasting marriage according to research to be published in the Journal of Police and Criminal Psychology.

Optometrists only have a 2-7 per cent chance of divorcing along with dentists, clergymen podiatrists and agricultural workers The Guardian newspaper reported. Conversely, dancers and choreographers have a 43.05 per cent chance of their marriages ending in divorce. Bartenders and massage therapists are also most at risk of experiencing family break-up.

The research, led by Dr Michael Aamodt of Radford University in Virginia, rated 449 occupations according to the likelihood of a successful marriage. Commenting on the research, Dai Williams, a charted occupational psychologist, told The Guardian: 'Opticians, who have a low divorce rate, meet lots of people but don't have time to chat them up.' ...

Half of Kids with Mental Illness Go Untreated

...Data from the National Health and Nutrition Examination Survey from 2001 to 2004 indicated that 13% of 8- to 15-year-olds had a recognized mental disorder, but only 51% of them had sought professional help...

Update on pediatric cataract surgery and intraocular lens implantation

...The just completed Infant Aphakia Treatment Study aims to answer questions regarding visual outcomes with primary IOL implantation versus contact lens use in children less than 7 months old with a unilateral congenital cataract. But correct IOL selection is controversial as recent studies highlight difficulties with biometry measurement and IOL calculations in the entire pediatric population. We also discuss the risk of late suture breakage and dislocation with sutured IOLs and the risks of aphakic glaucoma....

Randomized Evaluation of Spectacles Plus Alternate-Day Occlusion to Treat Amblyopia

...The magnitude of change in the BCVA 1 year after spectacles plus prescribed alternate-day patching was not significantly different than that after spectacles plus prescribed daily patching to treat amblyopia in children 4 to 5 years old. The effect of patching was not separate from that of optical correction with a period of refractive adaptation. Thus, the improvement in visual acuity is a combined effect of spectacle wear and occlusion therapy....

Rates of myopia increasing

The Los Angeles Times (12/15, Roan) reports that, according to a study published in the Dec. issue of the Archives of Ophthalmology, "17% more Americans aged 12 to 54 are afflicted with mild to severe distance vision problems than 30 years ago." In their study, "researchers at the National Eye Institute, part of the National Institutes of Health, found that rates of people ages 12 to 54 increased from 25% in 1971-72 to 41.6% in 1999-2004. The study included people with a range of myopia, from mild to severe."
Study lead author, Susan Vitale, PhD, MHS, explained that "the likely cause is less outdoor time and more activities requiring close-up viewing, such as text-messaging, playing hand-held video games, and Web surfing," Bloomberg News (12/15, Gibson) reports. Importantly, myopia "ends up costing a lot," Vitale said, pointing out that "it costs $3.8 billion a year to treat poor distance vision, a tab that rises by $1 billion for every 12 percent increase in the rate of nearsightedness."
MedPage Today (12/14, Fiore) reported, "The researchers noted that improved methodologies have pegged the actual prevalence of adult myopia at 33% in 2008. They said they used older formulas, which overestimated nearsightedness, on both old and new data to show the rate of growth." Noting specific trends, the authors found that "among blacks, estimates of myopia prevalence grew faster over the period than it did among whites, more than doubling -- from 13% to 33.5%." Meanwhile, "among whites, estimated prevalence increased from 26.3% to 43%," while overall "prevalence was...higher in 1999-2004 for all levels of myopia severity."

Comments: OK let's see if we can figure this one out. Functional optometry has been saying for years that myopia progression has something to do with near point activities ... and only now the researchers are getting it? Better late than never. Do you think they will credit optometry with this find? DM

Monday, December 14, 2009

Doctor's Orders: Practicing Evidence-Based Medicine Is a Challenge

...With the amount of research being published in medical journals and presented at meetings, it should not be surprising when a new finding slips by a busy physician.

Nor should it be surprising, then, that some decisions about patient care might be made without benefit of the most recent evidence....

Comments: Type in "parachute" in the search box above. DM

National Vision Screening Project in Australia

Children's Vision & School Work YouTube Video

Modified Bell Retinoscopy: Measuring Accommodative Lag in Children

...MBR estimates of accommodative lag correlate with traditional dynamic retinoscopy measures over a wide range of lags and show comparable repeatability. MBR may be a useful addition to the repertoire of clinical tools available for assessing accommodation in young children....

Variable Synergistic Divergence

...A patient with congenital fibrosis of the extraocular muscles may show alternatively either synergistic divergence or adduction, which has not been documented before....