Saturday, April 3, 2010

Statement on vision therapy outdated, flawed

...“This publication pretends to be a review of the literature, but instead is a straw man argument,” noted Leonard Press, O.D., chair of the AOA’s Pediatrics and Binocular Vision Committee and prominent member of the College of Optometrists in Vision Development (COVD). “The references at the end, for example, include outdated research literature, and are padded with 23 references to the Irlen lens concept. None of the positive studies on vision therapy from optometric literature is included.”...

Other prominent optometrists and educators also took issue with the “joint policy paper.”

“It should also be noted that every school and college of optometry teach courses in and provides clinical experiences for students in the area of vision therapy and that the procedures used in vision therapy have been codified within text books published by major publishers throughout the United States and the international community,” said Dominick M. Maino, O.D., M.Ed., professor of Pediatrics/Binocular Vision at the Illinois College of Optometry and editor of Optometry & Vision Development.

“Optometric vision therapy is a scientifically sound series of therapeutic procedures used successfully for a number of vision disorders from amblyopia to learning-related vision problems,” Dr. Maino said.....

llinois OD helps those with 3-D vision problems

From the AOA News:

March 24, 2010

Dominick Maino, O.D., M.Ed., with ABC WLS-TV Healthbeat Segment Producer Christina Tressel. Dr. Maino was featured on the program discussing undiagnosed vision problems discovered in the wake of recent 3-D movie releases.

In addition to serving as a Professor of Pediatrics and Binocular Vision at the Illinois College of Optometry’s Illinois Eye Institute and as the editor of Optometry & Vision Development, Dominick Maino, O.D., M.Ed., is considered an expert on the subject of 3-D vision syndrome and its treatment.

Dr. Maino is also in private practice with Denice Rice-Kelly, O.D., and Cheryl Adams, O.D., at Northwest Optometric Associates in Harwood Heights, Ill.

The Chicago affiliate of ABC News recently interviewed Dr. Maino in wake of the wave of 3-D movies now hitting theaters.

Movies such as “Avatar,” “Alice in Wonderland” and “How to Train Your Dragon” have left many viewers experiencing headaches, nausea, dizziness, diplopia and eyestrain.

These could be signs of undiagnosed vision problems, according to Dr. Maino.

“Anywhere from 3 million to 9 million or more individuals will have binocular vision dysfunction that will stop them from enjoying 3-D movies,” said Dr. Maino. “Watching 3-D movies can unmask issues such as lazy eye or convergence insufficiency.”

Patients may present with asthenopia, in which they cannot specifically describe the problem but know that something is just not right.

Dr. Maino stressed that optometric vision therapy can help with these problems and that it’s quite effective even for adults.

“The goal is to improve eye coordination, focusing and eye movement to help with the appreciation of the 3-D experience,” he said. “We need to re-educate the brain to achieve single, clear, comfortable, two-eyed vision so that everyone can appreciate these new technologies.”

Dr. Maino points out that the human organism was not designed to act in a virtual 3-D environment. This can cause a cognitive dissonance in which what someone knows to be true (the image is at the distance of the movie screen) and sees to be true (the distance they actually perceive the image to be) are in conflict.

“After optometric vision therapy they can start trusting what they see,” said Dr. Maino.

The Illinois Eye Institute provides binocular vision services to thousands of patients each year.

Since the segment aired on ABC News, Dr. Maino said he has received e-mails from all over inquiring about optometric vision therapy. He has directed these patients to the Dr. Locators on the AOA and the College of Optometry in Vision Development Web sites ( and

Dr. Maino suggests that optometrists who are not familiar with the techniques of diagnosing binocular vision disorders review the AOA Optometric Clinical Practice Guidelines on Pediatric Eye and Vision Examination (available at

The procedures for screening for convergence insufficiency are available at

Dr. Maino has recently published two articles that may be helpful for other practitioners.

A Review of Optometry article on neuroplasticity speaks to working with adults who have binocular vision dysfunction (

The second one, from Optometric Management, is on binocular vision dysfunction and is available at

“We have an epidemic of undiagnosed and untreated binocular vision problems that optometrists should diagnose, treat or refer out for treatment.” said Dr. Maino.

Dr. Maino also notes the best way for a primary eye care practice to provide state-of-the-art care for those with binocular dysfunction is to hire someone who specializes in pediatrics and binocular vision problems, such as those who have completed a residency in this area.

He also suggests visiting his blog,, for the latest information on children’s vision.

Friday, April 2, 2010

Deregulation puts patients at risk for undetected eye diseases: optometrists

...The provincial government is putting patients at risk for serious health complications by deregulating optometry and allowing opticians to prescribe eyewear without testing for eye disease, the B.C. Association of Optometrists warned Thursday.

The association says one-seventh of people who visit optometrists for regular eye exams have asymptomatic eye disease -- a disease with no noticeable symptoms. The health problems can range from cataracts to retinal detachment and, in some rare cases, brain tumours, said Dr. Antoinette Dumalo, president of the B.C. Association of Optometrists....

Comments: This is the absolutely dumbest thing government has ever done! I know I am biased, but who could possibly think that not having a comprehensive eye health coupled with a refractive exam as being unnecessary? What bureaucrat thought this was a good idea? There is no screening that is appropriate for this. How many people will loose their eye sight...or even life because of this? All of us optometrists have saved lives....and sight because we do a comprehensive examination....this is a sad day for those living in BC. DM

New Test May Allow Screening For Fragile X Syndrome

....Quick Test May Overcome Barriers to Fragile X Screening

Fragile X syndrome, which causes intellectual disability and other abnormalities, affects about 1 in 4,000 males in the United States (Fragile X syndrome also occurs in females, but causes less severe impairment). Fragile X syndrome is caused by mutations of a gene called FMR1. The mutations are relatively common in the population-although estimates vary, 1 in 300 to 400 U.S. couples may be carriers of the abnormal genes....

Artist/Neurocientist Collaboration To Examine The Way We See Things

...By bringing together an artist and a neuroscientist, both disciplines seek to learn from each other principles of visual perception. In the process of the research, both artist and scientist are gaining new insights into what truly lies in the eye of the beholder....

San Diego measles outbreak highlights consequences of intentional undervaccination

...High vaccine exemption rates at charter and private schools in a San Diego community contributed to the largest measles outbreak in the area since 1991, study findings suggested.The outbreak ensued when an intentionally unvaccinated 7-year-old boy returned from Switzerland and unknowingly imported the disease. From Jan. 11 to Feb. 29, 2008, an additional 839 people were exposed and 11 additional measles cases were identified, all in unvaccinated children, the researchers reported. One measles-related hospitalization occurred in an infant too young to be vaccinated, and an additional 48 children too young to be vaccinated were quarantined....

Comments: Talk to your doctor. Get those kids vaccinated. We have not conquered disease. It is just waiting on the sidelines....waiting to hurt those you love. DM

A drug that extends life span prevents Alzheimer's deficits

.....If research results continue to be repeated and are turned into clinical trials, a drug already approved for some uses could be marshaled — sooner than we expect — to prevent Alzheimer's disease in humans and improve health to the end of life.

A few weeks after a report that rapamycin, a drug that extends lifespan in mice and that is currently used in transplant patients, curbed the effects of Alzheimer's disease in mice, a second group is announcing similar results in an entirely different mouse model of early Alzheimer's....

The second report, released April 1 by the journal PLoS ONE, published by the Public Library of Science, , showed that administration of rapamycin improved learning and memory in a strain of mice engineered to develop Alzheimer's. The improvements in learning and memory were detected in a water maze activity test that is designed to measure learning and spatial memory. The improvements in learning and memory correlated with lower damage in brain tissue....

Comment: Read full article by clicking here. DM

3D Google Maps

Google Maps has a 3D view available. Go to Google Maps. Click on "street view". On the upper left hand side you will see a fella with a pair of on this...

You will need red/green glasses to see this in 3D.

Usually the red lens is on the right side....flip the glasses...or take out the red lens and put it on the left....with the green one on the right to get the full affect!

My thanks for my optometric colleagues for bringing this to my attention. DM

Thursday, April 1, 2010

How 3-D TV Works

....The 3-D thrill that swept movie theaters last year is now headed for your living room. In the wake of a new Blu-ray standard for high-definition 3-D, Panasonic, Sony and Samsung are all releasing home-theater setups that can display 3-D movies in full high-def glory. Using a combo of 3-D-capable Blu-ray players, TVs and, yes, glasses, the systems are able to deliver separate, full-screen, 1080p pictures to each eye. The technique they use creates a picture as vivid as in a movie theater without requiring a major overhaul of TV technology. And within a few years, a new cable television standard could even bring live events like the Super Bowl right to your TV in high-def 3-D.....

New Lenses for Myopia Control

Scientists from the Vision Cooperative Research Centre (Vision CRC) in Australia today announced that myopia, or short-sightedness, can be controlled with new technology. This ground breaking discovery was based on research conducted by Vision CRC partners - the University of Houston College of Optometry and the Brien Holden Vision Institute, located at the University of New South Wales.

Myopia affects over 1.6 billion people globally, with two thirds of those affected living in the Asia region. If unchecked, the number is expected to reach 2.5 billion by 2020.

There are 128 million people affected in the United States, which equates to 42% of the population.

Successful basic research on the nature and cause of myopia has led to the discovery that the peripheral retinal image plays a major part in stimulating eye growth and myopia. Large scale clinical trials testing both spectacles and contact lenses designed to control the position of the peripheral image and involving over 500 children in China and Australia, have produced promising results.

With myopia, instead of a distant image being focused on the retina, as it needs to be for clear vision, it is focused in front of the retina. Myopia often occurs when children commence school (ages six to seven), and if left undetected the condition progresses and can adversely impact the child's education and social development.

Professor Brien Holden, CEO of the Vision CRC, explained further, "For hundreds of years focusing defects of the eye have been corrected by simply moving the visual image backwards and forwards with spectacle lenses. Professor Earl Smith from the University of Houston College of Optometry, has demonstrated that if we move the central image onto the retina but leave the peripheral image behind the retina, the peripheral image can drive the eye to elongate, causing myopia to increase."

"The beauty of this new technology is that it addresses this problem by bringing the peripheral image forward, onto or even in front of the retina, and at the same time independently positioning the central image on the retina giving clear vision.

"The commercialisation of this technology is a most important outcome for the CRC program because of the potential vision and eye health benefits," Professor Holden said.

Professor Holden announced that the breakthrough technology has been licensed to Carl Zeiss Vision (CZV) and developed into the first spectacle lens of its kind through a joint project with CZV lens designers. This new spectacle lens will be launched under the ZEISS brand name throughout Asia from April of this year.

The Vision CRC has also licensed its myopia control technology to CIBA VISION for contact lens applications.

Professor Holden added, "Myopia can be a serious eye condition. High myopia significantly increases the risk of
cataract, glaucoma, and retinal detachment, all potentially blinding conditions and the public health risk is significant."

Dr Padmaja Sankaridurg, Head of the Myopia Program at Vision CRC, emphasised the nature of the new technology's appeal. "Our unique lens designs act to curve or shift the peripheral image forward, thereby removing the stimulus to axial elongation and myopia progression," she said. "We are continuing testing in Chinese and Australian children and young adults. So far, the trials have found that the first spectacle lens prototypes based on this new technology slow the rate of progress of myopia by 30% in children six to 12 years of age, where the child has a history of parental myopia," she said.

Professor Smith, from the University of Houston, commented, "Evidence shows that the number of individuals with myopia will dramatically escalate with increasing urbanisation and less outdoor activity".

"As urbanisation has increased in China, the prevalence and average amount of myopia has also increased. Recent evidence indicates that similar trends are occurring in the US and Australia. This ongoing epidemic of vision loss is associated with spiralling health and social costs, especially in many developing countries where over 80% of children have no correcting spectacles or contact lenses," he said.

"This new technology is not just for children either. Over 25% of myopes in the Western world are adult-onset myopes, which often begins at University. We believe that this technology has potential benefits for all myopes," Professor Smith said.

Comments: Did not see any research on PubMed about this....does anyone know about research support? DM

Screens And Eyestrain

...The launch of Apple Inc.'s iPad is fueling an ocular debate: What type of e-reader is easiest on the eyes: the gray-scale screens that simulate ink on a printed page or the back-lit color screens used by computers and the iPad...

A Systematic Review of the Diagnostic Accuracy of Ocular Signs in Pediatric Abusive Head Trauma

....Prospective, consecutive studies confirm that IOH in infants—particularly bilateral, extensive, and multilayered—are highly specific for AHT. Optic nerve sheath hemorrhages are significantly more common in AHT than in other conditions, in autopsy studies. Traumatic retinoschisis and perimacular folds are present in a minority of AHT, but rarely seen in other conditions. ....

Wednesday, March 31, 2010

COVD Members in the News

Many College of Optometrists in Vision Development members are receiving media attention. Here are some of the news stories that feature COVD members:

Dominick Maino,OD, MEd, FAAO, FCOVD-A
ABC Chicago

Carole L. Hong, OD, FCOVD (page 19)
Parenting on the Peninsula, San Francisco

Lynn F. Hellerstein, OD, FCOVD, FAAO
The Denver Post
ABC Denver

Stanley A. Appelbaum, OD, FCOVD
The New York Times

Several COVD members in March 2010 issue (pages 9-12)
Women in Optometry

Sara R. Williams, OD
The Suburban Times, Washington

Vision Therapy Games for Kids

........Vision therapy is diagnosed for students with eye problems. This therapy helps to develop visual skills to help students succeed at school when using the computer, reading or focusing on the classroom board. Vision therapy games are one way to help develop these visual skills for kids. ...

Comments: Although each of the vision perception games listed are vision therapy program should be started without your optometrist doing an evaluation...this webpage does note that you may need to wear glasses for these activies....but does not recommend a full evaluation by an optometrist trained in this area. For such information about a doctor certified in this area, please go to DM

Tuesday, March 30, 2010

ADHD Symptoms Often Subside Within a Year

Children identified with an attention-deficit problem should be re-evaluated annually because symptoms often subside from one year to the next..... The study authors looked at three groups of elementary school-age children: 27 first-graders and 24 fourth-graders who appeared to have trouble paying attention but weren't diagnosed as having attention deficit hyperactivity disorder (ADHD), and 28 kids in grades one through four who had been diagnosed with ADHD. ..

Comments: Could this be because the children didn't have ADHD but rather undiagnosed and untreated vision problems? When the visual demands you see a change in the behavior? Did anyone in this study bother to ask this question? DM

The Case for Comanaging with Other O.D.s

If you are an optometrist or ophthalmologist, occupational therapist, physical therapist, developmental specialist or just might want to read how your primary eye care doctor should co-manage patients so that all can benefit! DM

From Review of Optometry's The Case for Comanaging with Other O.D.s...

....isn’t it time to recognize these valuable resources within an intra-optometric referral model? A pair of optometrists, Mary Van Hoy, O.D., and Mary Beth Woehrle, O.D., answered this question when they developed the Indiana Vision Improvement Center 10 years ago with an emphasis in visual rehabilitation. (The comanagement of vision care patients was first proposed more than 15 years ago by a special committee of the College of Optometrists in Vision Development, formed to develop a program to facilitate referral of primary care patients to vision therapy practices.) Over the years, the Indiana Vision Improvement Center has evolved into the Eyes for Wellness Center, in Carmel, Ind., and provides only secondary eye care through visual rehabilitation.

“It’s a win-win-win situation,” Dr. Van Hoy says. “The patients get the necessary care. .... The referring practitioner has another service to offer and enjoys an enhanced reputation as a practitioner who can handle any vision problem.”

Comment: Read the whole article by clicking on the title above. DM

College of Optometrists in Vision Development on the Web

Follow COVD on Twitter

Become a Fan on Facebook

Join the discussion on SOVOTO

Read the latest articles in Optometry & Vision Development


Visit COVD on our homepage

Monday, March 29, 2010

Eye Resources on the WWW

Eye Resources on the WWW

The Association of Vision Science Librarians has created a website listing all the best resources on the Internet about the eye and vision at:

One website profiled is the Eye Simulator, which provides an eye motion and pupil response simulator, animations to demonstrate neurological testing, and quizzes to test comprehension. Eye Resources on the WWW also lists organizations, image databases, blogs related to eyecare, institutes, university programs, fulltext journals and electronic versions of books like

Ocular Syndromes and Systemic Diseases

, and many other helpful resources.

Sunday, March 28, 2010

Atomoxetine for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in children with ADHD and dyslexia.

...Atomoxetine (Strattera ) reduced ADHD symptoms and improved reading scores in both groups. Conversely, different patterns and magnitude of improvement in working memory component scores existed between ADHD and ADHD+D patients. Though limited by small sample size, group differences in relation to the comparable changes in improvement in ADHD symptoms could suggest that brain systems related to the therapeutic benefit of atomoxetine in reducing ADHD symptoms may be different in individuals with ADHD+D and ADHD without dyslexia...

Poor binocular coordination of saccades in dyslexic children.

...Poor quality of binocular coordination of saccades and drift of the eyes after the saccade, regardless of the task, indicates an intrinsic ocular motor deficiency. Such a deficiency could be related to immaturity of the normal ocular motor learning mechanisms via which ocular motor coordination and stable fixation are achieved. Learning could be based on the interaction between the saccade and vergence subsystems. The cerebellum, but also cortical areas of the magnocellular stream such as the parietal cortex, could be the sites of ocular motor learning....

Visual control in children with developmental dyslexia.

...The results support the hypothesis that developmental dyslexia might present deficits which involve the magnocellular pathway and a part of the posterior cortical attentional network.....

Comments: Vision plays a role in learning! DM

Comparison of Irlen scotopic sensitivity syndrome test results to academic and visual performance data.

..Many questions about the use of colored filters for the treatment of reading problems remain unanswered. Among these are questions dealing with whether the M-pathway anomalies found in some dyslexics are also present to a lesser degree in other cases of reading disabilities, and how colored filters could re-balance the M- and P-pathways. Is it the color of the filter itself that is critical, or is it the change in luminance or contrast produced by the filter that seems to make it easier for some subjects to read? More research will be needed to answer these questions....

Spatiotemporal Visual Function in Tinted Lens Wearers

...Under thorough psychophysical investigation, these results revealed no significant difference in visual function between subject group, and this finding is consistent with the absence of any effect of the tinted lenses in the group with Meares-Irlen syndrome....

Comments: This past weekend I was talking to a researcher who told me Meares-Irlen may actually be a real syndrome...and not a binocular vision problem in disguise....I'm not convinced just yet. Full text of this article is available by clicking on the title above. DM

Complications of botulinum toxin a and their adverse effects.

...A low incidence of complications per injection (12.4%) was found particularly for induced vertical deviations (2%) and hemorrhages (1%). Incidence for ptosis was the highest (8.4%). Notably, 10 additional cases of ptosis had resolved before follow-up. Two children were given occlusion therapy to prevent the possibility of stimulus deprivation occlusion until ptosis resolution....

Comments: OK...let me get this straight. They conclude that having more than 12 children out of 100 having an adverse affect as a low incidence of complication? What planet do these folks live on? As with all medical procedures, know the to a doc who understands these risks! DM

Visual outcome in 879 children treated for strabismus: insufficient accommodation and vision deprivation, deficient emmetropisation and anisometropia.

...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....

A case report on the use of a novel optokinetic chart stimulation intervention for the restoration of voluntary movement and mobility in a patient wit

...Optokinetic chart stimulation led to restoration of voluntary movement on the affected side as well as restoration of independent mobility. Further research on the use of the optokinetic chart to enhance neural plasticity for restoration of voluntary movement and mobility is recommended...

Saccadic eye movements while reading music.

...These observations suggest a new model of the oculomotor and perceptual processes involved, in which an central, iconic representation of the fixated image is internally scanned and interpreted to a given criterion of accuracy, the scan ending when this criterion cannot be reached, and this end-point determining the position of the next fixation. It is proposed that the fullness of the buffer between the perceptual and motor processes determines the strictness of the criterion which is adopted, and hence the amplitude and timing of the eye movements....

A neurocognitive approach to music reading.

...Specific learning-related changes were seen in the superior parietal cortex and fusiform gyrus, for melody reading and rhythm reading, respectively. These changes are suggested to correspond to the acquisition of processes that deal with the extraction of spatial and featural properties of notation, respectively....

Sight-reading of violinists: eye movements anticipate the musical flow.

...the piece with higher complexity was associated with lower anticipation in notes, longer fixation duration and a tendency for more regressive fixations....

Advanced Sight Reading Piano Music

Check out this blog if you are into music:

...The ability to retain visual sequences in the short-term memory long enough to recall them is crucial for sight-readers. A person with problems retaining visual sequences because of a lack of the left/right directional tracking is not able to perceive the order of stimuli in which they appear and switch the order of letters in a word or notes in a music....

3 D Television; A Review

Comments: Those who hate "flicker" or have binocular vision problems need to think carefully about purchasing this in the future: DM

3-D Movies, TV Can Cause Eye Strain, Headaches

Comments: Always have a comprehensive eye and vision examination by your optometrist that includes an assessment of how your eyes work together. DM

Reducing eye strain in the office

Comments: More good suggestions on reducing eye strain. DM

How to prevent compute eye strain

Comment: Nicely done video. I would only add that if you suffer from eyestrain, the very first thing you should do is to have a comprehensive eye and vision evaluation including testing for binocular vision dysfunction. DM