Saturday, October 31, 2009
Aim : To detect and treat visual impairment, if any, in hearing-impaired children.
Setting and Design : Observational, clinical case series of hearing-impaired children in schools providing special education.
Materials and Methods : Hearing-impaired children in selected schools underwent detailed visual acuity testing, refraction, external ocular examination and fundoscopy. Ocular motility testing was also performed. Teachers were sensitized and trained to help in the assessment of visual acuity using Snellen's E charts. Refractive errors and squint were treated as per standard practice.
Statistical Analysis : Excel software was used for data entry and SSPS for analysis.
Results : The study involved 901 hearing-impaired students between four and 21 years of age, from 14 special education schools. A quarter of them (216/901, 24%) had ocular problems. Refractive errors were the most common morbidity 167(18.5%), but only 10 children were using appropriate spectacle correction at presentation. Fifty children had visual acuity less than 20/80 at presentation; after providing refractive correction, this number reduced to three children, all of whom were provided low-vision aids. Other common conditions included strabismus in 12 (1.3%) children, and retinal pigmentary dystrophy in five (0.6%) children.
Conclusion : Ocular problems are common in hearing-impaired children. Screening for ocular problems should be made mandatory in hearing-impaired children, as they use their visual sense to compensate for the poor auditory sense.
Comments: For full text of the article click the title above. DM
Comments: Be careful. Very careful. Long term results of refractive surgery for adults are unknown yet alone for children who have decades ahead of them. DM
Thursday, October 29, 2009
Comments: I've used this method for many years....and as the research shows...it works pretty well. Click on title for full text article. DM
Looking But Not Seeing: Atypical Visual Scanning and Recognition of Faces in 2 and 4-Year-Old Children with Autism Spectrum Disorder.
Optometric vision therapy and rehabilitation have been used to successfully treat a wide range of visual disorders for over 80 years. However, it was not until the past few decades that the scientific basis supporting its efficacy was beginning to be understood. This review article discusses current neuroplasticity concepts, the supporting research, their therapeutic applications in other disciplines, and their implications to optometry. It can be hypothesized that vision therapy techniques strengthen synaptic connections through Hebbian learning and induce cortical reorganization to maximize visual efficiency. This can provide a theoretical basis for the efficacy of vision therapy, while neuroimaging can provide an objective basis.
Oculomotor Dysfunctions, Their Remediation, and Reading-Related Problems in Mild Traumatic Brain Injury
Reading is a complex task involving a wide range of functions and abilities that are both vision and non-vision-based. Accurate eye movements are essential for efficient reading. Hence, if oculomotor control is impaired by traumatic brain injury (TBI), reading will likely be adversely affected.
Traumatic Brain Injury: A New Challenge for Optometry, Neuro-Optometric Rehabilitation and Our Nation
Traumatic Brain Injury (TBI) may result in the need for life-long care. In times of combat TBI comprises at least 14-20% of surviving casualties, who need more acute and long-term healthcare resources. The Department of Defense and Department of Veterans Affairs have been meeting this challenge since 1992 with the Defense and Veterans Brain Injury Center (DVBIC). More recently, the Veterans Health Administration has developed a Polytrauma System of Care so that veterans receive the right care, in the right place, at the right time.
Military Optometry in the Care of Traumatic Brain Injury Patients
The medical care system for soldiers and Marines who incur traumatic brain injury in Iraq and Afghanistan is presented. After initial immediate care is provided, they are sent to a staging area for further treatment and then to a tertiary care hospital in Germany. Finally, they are assigned to an army or navy medical care facility in the United States. All suspected traumatic brain injured patients are screened to determine the level of severity of injury. They are then assigned to either an Army Hospital, or a Department of Veterans Affairs health care facility for further treatment and rehabilitation. The author notes his impressions that in terms of vision, there are often changes in refraction, impaired accommodation and binocular functioning.
Additional articles can be found at:
Relationship between accommodative and vergence dysfunctions and academic achievement for primary school children
Gene Therapy Can Restore Eyesight In People With A Genetically-Inherited Sight Disorder, Especially Children
They add: "The most noteworthy result was the ability of children to navigate an obstacle course independently and accurately, even in dim light...The visual recovery noted in the children confirms the hypothesis that efficacy will be improved if treatment is applied before retinal degeneration has progressed. Assessment of whether the treatment alters the natural progression of the retinal degeneration will be possible in follow-up studies."
They conclude: "The success of this gene therapy study in children provides the foundation for gene therapy approaches to the treatment of other forms of LCA and of additional early onset retinal diseases."...
Comments: So how long should we keep our kids at home? DM
Dr. Mary Beth Rhomberg, of the AOA’s Clinical Care Center helped put the finishing touches on the project. There will be a laminated insert accompanying background information on this in the October 26 issue of the AOA News.
You can preview this information at:
More information about the toolkit is available at: http://www.aoa.org/CI-Toolkit.xml
Sunday, October 25, 2009