Saturday, May 29, 2010

Focus On Vision Problems Before ADD Diagnosis

.........More and more studies are revealing children are often misdiagnosed as having attention deficit disorder when their struggles could actually stem from their vision.

Kids are often labeled as "lazy" and "unable to focus" when they may have correctable vision problems.

That includes some children who have 20- 20 vision on standard eye tests because visual skills like close- up and depth perception are often not tested.

The specialized vision care uses vision therapy that helps improve visual skills needed for improving reading and focus. ...........

Using the voice of the child who is blind as a tool for exploring spatial perception

.....This article gives an example of using the child’s voice to explore spatial understanding and involves a narrative account from a 13-year-old student who was blind from birth about the strategies he uses to overcome the challenges he faces in making sense of space. The results suggest that the child’s voice can provide insights into spatial understanding that can be used to help triangulate the findings and understandings achieved from the experimental approaches that dominate the literature....


By Dr. Len Press on SOVOTO.....A 2009 issue of the Journal of Optometric Vision Development, dedicated to an overview of Autism Spectrum Disorders (ASD), contained an article that Jack Richman and I co-authored, on the role of Optometry in the early detection of ASD. The entire issue is marvelous, and worth keeping as a reference:

I was reminded of this today when a good colleague in NJ, Charlie Fitzpatrick, asked me if I had heard about the potential use of pupillary function as an early sign of ASD. He forwarded a Medscape Medical News article dated yesterday on research presented at the 9th Annual Meeting for Autism Research (IMFAR) in Philadelphia last week.

Mom reports problems when child given colloidal multi mins liquid

A mom who reads my blog left this msg:

Gabes mom has left a new comment on your post "Manganese And Children's Brain Development": A homeopath prescribed this adult thing called colloidal multi mins liquid for my three year old son. I went to her because he had enlarged adenoids, and she told me to take this because every child should be on this colloidal liquid. Right after taking this, my lovely, calm, sweet 3 year old son started twitching, turned grey and had changed. The health store said that he had received a toxic dose of this product, and told me to phone poison control. Poison control had never heard of these ingredients, and sent me to emerg. The emerg staff said that they had never heard of these things. Can you check out the ingredients on that product, and tell me, if the manganese is too high for children, and if other things in there could have affected him. He is now 7, and it is so sad to see him, shrugging his shoulders, turning his head, twitching severely at night...signed sad mother

Comments: Dear Gabes Mom....I just conducted a PubMed and Google Scholar search on "colloidal multi mins liquid" and found no information what so ever...not a single article in the scientific literature....this is disturbing. One formulation I found showed that it can contain the following ingredients:

Each Tablespoon (15 ml) Contains: Vitamin C (Ascorbic Acid) 30 mg Calcium (Carbonate) 3 mg Iron (Aspartic Acid Chelate) 300 mcg Iodine (Kelp) 50 mcg Magnesium (Aspartic Acid Chelate) 1500 mcg Zinc (Aspartic Acid Chelate) 300 mcg Potassium (Chloride) 2 mg Selenium (Selenomethionine) 25 mcg Copper (Aspartic Acid Chelate) 100 mcg Manganese (Aspartic Acid Chelate) 300 mcg Chromium (Aspartic Acid Chelate) 50 mcg Molybdenum (Aspartic Acid Chelate) 25 mcg Vanadium (Aspartic Acid Chelate) 25 mcg Colloidal Minerals: Antimony, Barium, Beryllium, Bismuth, Bromine, Carbon, Cerium, Cesium, Chlorine, Cobalt, Dysprosium, Erbium, Europium, Fluorine, Gadolinium, Gallium, Germanium, Gold, Hafnium, Holmium, Lithium, Niobium, Nitrogen, Osmium, Oxygen, Palladium, Phosphorus, Platinum, Praseodymium, Rhenium, Ruthenium, Samarium, Scandium, Silicon, Silver, Sodium, Strontium, Sulfur, Tantalum, Tellurium, Terbium, Thallium, Thorium, Thulium, Tin, Titanium, Tungsten, Ytterbium, Yttrium, Zirconium Natural Orange Flavor and Fructose..

OMG! Half of this stuff I've never heard about....Did you know that: Dysprosium is a chemical element with the symbol Dy and atomic number 66. It is a rare earth element with a metallic silver luster. Dysprosium is never found in nature as a free element, though it is found in various minerals, such as xenotime. Naturally occurring dysprosium is composed of 7 isotopes, the most abundant of which is 164Dy.
...and it just gets worse.

Info on Manganese
This metal (not to be confused with magnesium) is important to central-nervous-system function, bone growth, and reproduction. It also helps the body metabolize cholesterol, carbohydrates, and amino acids.
Good sources of manganese include nuts, whole grains, tea, instant coffee, cocoa powder, and some fruits and vegetables notably legumes.
Manganese deficiency has never been observed in human beings.
Symptoms of an oversupply include involuntary laughing, hand tremors, slurred speech, and "poker face" immobile, deadpan expression.

Concerned about overdose, the Food and Nutrition Board (FNB). advises that "because manganese in drinking water and supplements may be more bioavailable than manganese from food, caution should be taken when using manganese supplements, especially among persons already consuming large amounts of manganese from diets high in plant products. In addition, individuals with liver disease may be distinctly susceptible to the adverse effects of excess manganese intake.

The bottom line on this is to take you child to your pediatrician....have him/her run all appropriate may be this strange concoction causing these problems .... it may not be.... have Gabe checked out head to toe! Do it now! DM

Friday, May 28, 2010

Mechanisms underlying perceptual learning of contrast detection in adults with anisometropic amblyopia

...What underlies contrast sensitivity improvements in adults with anisometropic amblyopia following perceptual learning in grating contrast detection? In this paper, we adopted the external noise approach to identify the mechanisms underlying perceptual learning in adults with anisometropic amblyopia. By measuring contrast thresholds in a range of external noise conditions at two performance levels (79.3% and 70.7%), we found that a mixture of internal additive noise reduction and external noise exclusion underlay training induced contrast sensitivity improvements in adults with anisometropic amblyopia. In comparison, normal adults exhibited only small amount of external noise exclusion under the same training conditions. The results suggest that neural plasticity may be more robust in amblyopia, lending further support of perceptual learning as a potential treatment for adult amblyopia....

Comments: This article is available free. Just click on the title above. DM

Optometry's Child On Broadway?

I received this email today from two of my former students....their son has a chance at singing at the Tony' the email...then go vote! Click on the title above. DM

Two days ago, we heard about a singing contest put on by CBS. The winner gets to sing at the Tony Awards in June. A video had to be uploaded to the site and approved before they would add it to the contest. Dylan's video was accepted. The deadline for submission is May 27 at noon PT, so we had to scramble.

Dylan is in Italy until the 29th. When he called yesterday, he asked me to post the video for him after he heard about the contest. There are only a few specific songs that they wanted to hear, one of which was..."Stars" from 'Les Miserable''. He had sung this one at an open mic last summer and I had a video.

Five semi-finalists win a trip to NYC to compete for the grandprize which is to sing at the Tony Awards with a red carpet walk and the whole thing.

Here's the deal. The public votes for the videos in phase one of the contest. Voting is from May 27th to June 1st to find the top five. On June 3 at noon Pacific time you can vote again for your favorite of the top 5 videos. I'm assuming there will be a place to vote next to the video during the voting period.

Not all videos were accepted. As of the close of video acceptance, there are nearly 500 videos in the contest. Will you please help Dylan out by voting for him?

Here's the link to his video to vote:;=yes

How cool would it be for a kid educated in Fergus Falls, MN to get a chance to sing on Broadway?

Article in the FF Daily Journal:


Mark D. Olmsted, O.D. (ICO 1986)
Christine A. Olmsted, O.D.(formerly Clark) (ICO 1989)

Optometrist: An Awesome Career

The life of an Optometry student video is above...

Optometrist: As one of the 50 best careers of 2010, this should have strong growth over the next decade....This US News & World Report article (click on title above) lets you know that optometry is an awesome career choice. Of course, I am biased since I am an optometrist...but if you are looking for a career where you can help people, make a good living and still have time for family and should consider optometry.

Go to the following for more information:

American Optometric Association

Association of Schools and Colleges of Optometry

Illinois College of Optometry Academic Program Information

Letter Reversals…Does my child have dyslexia or a vision problem?

...When a child confuses and reverses letters, such as “b’s” for “d’s” and “p’s” for “q’s”, parents often wonder, “does my child have dyslexia?”. This is largely due to the fact that the media has drawn public attention to a problem in visual perception where the person who reverses their letters or numbers usually has trouble reading effectively. However, dyslexia is a broad term that indicates an unexpected reading disability that exists in a person who otherwise has no cognitive impairment and has had adequate educational instruction. The causes can vary as outlined in Wikipedia’s review of dyslexia. A more general overview of “Vision and Dyslexia” has been written in a White Paper by the College of Optometrists in Vision Development....

Comment: Please read this wonderfully written blog article about reversals by my colleague, Dr. Dan Fortenbacher on the COVD Blog by clicking the title above. DM

Children at Risk for Vision Problems: Vision Health & Learning Center Video

Up to 85% of children at risk for behavioral problems have vision problems. Dr. Jennifer McDermed evaluates children's visual skills, including eye movement, perception and coordination, to diagnose the cause of children's problems in school. ...

When children needlessly suffer and the consequences.

I recently received this email from a follower of MainosMemos:

I enjoy your [blog], it is so informative. I screen children at various schools and I wanted to share something with you. I recently referred a 4y.o. girl to see an eye doctor. She was unable to see the 20/50 HOTV letters farther than 5 ft much less be able to see the 20/40 at 10ft. Her pupils were misaligned and both eyes were moving outwards. I realized that I had referred her the prior year. I checked my file and had noted that the parent had not replied to any letters I had sent last year requesting her completed exam report. I had noted the same description that I had referred her for this year. The mother called me in regards to the note I left her on the referral letter. I stated my concern as to why she had not been to see an eye doctor and the mother replied that indeed she took her daughter last year to her eye doctor and was told that she was too young. I was in total disbelief. I scheduled an appointment through the One Sight Program offered by Lenscrafters and within a couple of days she was seen. This child's eyes had deteriorated so much that they couldn't prepare her glasses on site. She was diagnosed with severe amblyopia and astigmatism. Her prescription will be ready in 10 days. I am saddened that this little girl was not seen by the doctor last year because she was three. If I had known, I would have found a doctor for her. Is this typical? I know that the earlier a child is treated for amblyopia, the better the outcome.I had written my observations on the referral. My concern is what the outcome will be for her because this doctor turned her away. My next step with this family is to find her an [eye doctor] who will take the All Kids Card as insurance once this family receives the card. I feel she will need to see a specialist to follow her ..... I would like your input on this if you have the time.

Thank You,

My response was:

Hello Laura...

It saddens me to think that there are doctors out there that do not realize we now have the tools to examine young children, even infants. In fact the American Optometric Association (AOA) has a special Public Health Service Program called InfantSee that is specifically aimed at providing no-cost vision assessments for children aged 6-12 months. If all parents went to they could find an AOA doctor who is participating in this marvelous program and receive the type of evaluation their little one deserves.

I would suggest that a great resource for the family you told me about is the College of Optometrists in Vision Development ( This is where they should seek out a doctor who should be able to help with the strabismus (eye turn) and amblyopia (lazy eye). This organization certifies doctors in the area of optometric vision therapy. Optometric vision therapy has been shown to be effective in helping to improve strabismus and amblyopia. Have your parents use the doctor locator link on the organization's webpage.

Please have the parents contact me directly ([email protected]), if they have any other questions or concerns. Thank you for giving me an opportunity to help!


Although I should have...I didn't tell Laura this in my email msg.... she is a most incredible individual who should be congratulated for taking that extra step in serving the families she works with...I wish all of us would do the same. If you work with children who need eye care services, but they are not getting them...take that extra step like Laura did....if you are an eye doctor who does not know how to examine little ones...refer to a colleague who does...or take the appropriate continuing education classes so you can get up to speed on how to diagnose and treat even the very young. Need more can also contact me anytime. DM

Thursday, May 27, 2010

Study Finds Racial, Ethnic Disparities In Family-Centered Care For Kids With Special Health Needs

...... African American and Latino children with special health care needs, and those who come from households in which the primary language is not English, are less likely to receive family-centered care than are white children and those from households where English is the primary language........ there were disparities in two critical components of care provided to African American and Latino children and those from households where English is not the primary language: having adequate time with the child's health care provider and receiving care that is sensitive to the family's values and customs. ....

Behavior Therapy Effective In Reducing Tics In Children With Tourette Syndrome

...Tourette syndrome, a neurological disorder characterized by tics like grimacing, blinking and vocalizations, is normally treated in children and teens with one of several antipsychotic medications. But such drugs usually don't eliminate all the tics, and worse, they can often have side effects, acting as sedatives, causing weight gain and impairing cognitive function. ...The study showed that CBIT resulted in a significantly greater reduction in tic severity and tic-related problems than the supportive counseling. ...

Medical News Today Spreads the Word about 3D Vision Syndrome

The American Optometric Association's campaign to get the word out about 3D Vision Syndrome is spreading far and wide...including Medical News Today. Although not truly recognized as a syndrome it has all the characteristics of one....a group of symptoms that collectively indicate or characterize a disease, psychological problem, other abnormal condition or, in this case, a functional vision disorder. 3DVS symptoms include headaches, blurred vision, eyestrain, diplopia, dizziness/nausea and motion sickness after watching a 3D movie.... and it appears to be caused by binocular vision dysfunction and vision induced motion sickness. If you "suffer" from 3DVS go to and for more information and for doctors who can help. DM

A Cautious Thumbs Up For Tai Chi

...Tai Chi, a low impact martial art, has been associated with reduced stress, anxiety and depression, and enhanced mood, in both healthy people and those with chronic conditions. A systematic review of the subject, published in the open access journal BMC Complementary and Alternative Medicine, found that although Tai Chi does appear to have positive psychological effects, more high quality, randomized trials are needed. ...

Comments: I always get a kick out of the phrase: "more high quality, randomized trials are needed" about stating the obvious! I should know, because I've used phrases like this in my own articles...I'm trying not to do so in the future.. Go to for the complete FREE article. DM

Is Lamarckian evolution relevant to medicine?

...Epigenetics allows the peaceful co-existence of Darwinian and Lamarckian evolution. Further efforts should be exerted on studying the mechanisms by which this occurs so that public health measures can be undertaken to reverse or prevent epigenetic changes important in disease susceptibility. Perhaps in 2059 we will be celebrating the anniversary of both Darwin and Lamarck....

Comments: If you are at all into genetics...this is most fascinating. Lamarckian theories have been laughed at for decades...except by the Russians. And now epigenetics may bring this back to the forefront of our thinking about genetics. The environment does affect our genes and how they are expressed in future generations. (This concept goes back to the amazing founders of the Optometric Extension Program Foundation organization.) Could the current myopia epidemic be caused by epigenetics and Lamarckian thinking on this topic? DM

Accommodating IOL shows good near vision results at 6 months

...Ultrasound biomicroscopy studies showed that accommodation in the true sense does not take place. There are forward movements of the ciliary process, but minimal changes in anterior chamber depth. The lens moves only slightly, too slightly to produce the focal changes that allow near vision.

"If patients can read, this is not due to focal changes, but to an increase in spherical aberration," Edoardo Ligabue, MD, said. "The minimal arching effect of the lens that follows ciliary muscle contraction is sufficient to produce these aberrometric changes." ...

Comments: So if we train the ciliary body to work more effectively we can induce accommodative like results? Wait...isn't that what we do with optometric vision therapy? I can now see OMDs doing OVT on their IOL patients. Cool! DM Speaks Out about Newsweek Article

..."Put harshly, we need more of a cancerlike sensibility around epilepsy. We cannot usually see our friends' cancer, but we do not hesitate to invest the search for a cure for different cancers with the utmost cultural and political importance. We must now do the same with epilepsy."

The article goes on to say that Up to 50,000 Americans die each year from seizures and related causes, including drownings and other accidents; one in 10 people will suffer a seizure in their lifetimes. By some estimates, the mortality rate for people with epilepsy is two to three times higher—and the risk of sudden death is 24 times greater—than that of the general population. There are 200,000 new cases each year, and a total of more than 3 million Americans are affected by it—more than multiple sclerosis, cerebral palsy, muscular dystrophy and Parkinson's disease combined. Between 1 and 3 percent of the population will develop some form of epilepsy before age 75. ....

Do 3-D Movies Cause Motion Sickness

Do 3-D Movies Cause Motion Sickness? Watch this video and learn. The 3D movie doesn't cause motion sickness...but if you have a binocular vision might!! Go to and to learn more. DM

Think About Your Eyes: Dancing Eye Balls

The Think About Your Eyes program featured Dancing Eyeballs in New York to call attention to the fact that all of us should protect our most precious assesst...our vision! DM

Think About Your Eyes: Macular Degerneration

Macular degeneration usually affects older adults....but is often due to Ultraviolet Light....have all you sons and daughters wear optical quality sunglasses no matter what age they are when they go outside! Toy sunglasses do not protect your little ones! DM

Tuesday, May 25, 2010

Refractive ocular conditions and reasons for spectacles renewal in a resource-limited economy

...Worldwide refractive error is the cause of blindness in 8 million persons (18% of all causes of blindness second only to cataract) and the cause of visual impairment in 145 million persons accounting for over 50% of all causes of visual impairment...Adequate correction of refractive errors reduces visual impairment and avoidable blindness and to achieve optimal control of refractive errors in the community, services should be targeted at individuals in the peri-adolescent and the middle age years....

Comments: For all of you who think a pair of glasses are just a cosmetic buy blue frames to go with your blue outfits...and red ones for red you should realize that glasses are a medical device! Glasses can cure 50% of all causes of visual impairment worldwide!! Amazing! See provisional PDF by clicking the title. DM

Ocular manifestations of branchio-oculo-facial syndrome: Report of a novel mutation and review of the literature

Purpose: To report unusual ocular manifestations of branchio-oculo-facial syndrome (BOFS) caused by a novel mutation in activating enhancer binding protein 2 alpha (TFAP2A).
Methods: Full ophthalmological evaluation and direct sequencing of TFAP2A.
Results: A 10-year-old girl with unusual ocular manifestations of BOFS such as elliptical shaped microcornea and a novel de novo TFAP2A mutation was identified.
Conclusions: This report expands the ocular phenotypic spectrum of BOFS and adds to the small number of reported TFAP2A mutations.

Comments: Read full article by clicking the title. DM

Cornea/Anterior Chamber Worms

Although this blog is usually more about childrens vision, optometric vision therapy and special populations....this was unique enough that I thought you'd get a kick out of seeing it. The cornea worms can be seem by clicking on the title above. The surgical removal of an anterior chamber worm can be seen by clicking here. DM

Monty Vickers: Songster & Doctor?

I am jealous of colleagues who can consistently write (especially "stuff" that is funny which is much harder than writing scientific articles), who give excellent patient care, and can write/sing/produce music albums. Well, Dr./Songster Monty Vickers (of the Review of Optometry Fame) does all of this. Want to see his artistic side...just click on the title above. (By the way, I found out about this in my latest issue of OD2OD newsletter by my friend Dr. Mike Cohen. Sign up for his newsletter by clicking here. DM

Monday, May 24, 2010

Senator Kwame Raoul Speaks at ICO's Commencement

Illinois College of Optometry The one hundred sixty-seventh commencement Confering of Honorary Degree of Doctor of Humane Letters. Dr. Arol Augsburger,OD, The President of Illinois College of Optometry addresses the crowd at Rockefeller Chapel on Unversity of Chicago before the hooding. The Honorable Kwame Raoul, Illiniois StateSenator, was hooded by Dr. Kattouf and assisted by Kent M. Daum,OD, Ph.D, Vice President and Dean for Academic Affairs.

John Streff Memorial Information

...John W. Streff, OD, DOS passed away on May 6, 2010 from cancer. He was 83. A 1951 graduate from the Chicago College of Optometry, John joined the staff of the Gesell Institute of Child Development in 1960 after practicing in Minnesota for several years during which time he served an externship at Gesell. While at the Institute he worked closely with Dr. Richard Apell, Associate Director of Gesell....

Intervention Fails to Reduce Autism Symptoms

....A social communication intervention for children with autism improved parent-child interactions but failed to reduce the severity of autism symptoms....
Children who received the intervention had a reduction in symptom severity of 3.9 points during 13 months, while those who had treatment as usual showed a reduction of 2.9 points, for a between-group effect size of −0.24 (95% CI −0.59 to 0.11...

3-D TV and Movies Look to Attract Viewers, But Not Everyone Can 'See' What All the Hype is About

Many websites have picked up on the AOA's latest news release regarding 3D movies and the vision problems associated with viewing this new technology...go to those sites listed below for a sample!

Vision and 3D movies

...Ganesh returned home, complaining of nausea and headache after watching a 3D movie, while his friends enjoyed every bit of the technologically brilliant film. Ganesh works on a computer, for over 12 hours a day, and enjoys regular movies, so he was baffled about his reaction to the 3D film. Maria, a young movie buff, said she had to remove the 3D glasses and rest, with her eyes closed, at regular intervals during the film. Supreeta, a call centre executive, reported that she did not enjoy the movie as she was unable to spot the 3D effect. The screen was all blurred and dim, she claimed. What could be their problem? ...

New problem emerges for 3D TV - not everyone can see it

...D TV is ramping up. ESPN just this week announced that its 3D network will debut next month, and, of course, lots of people in television were excited by the new 3D TV equipment displayed at the recent NAB Show in Las Vegas. The commercial potential of 3D TV is believed by many to be great, although not yet quantified.

RBR-TVBR Executive Editor Jack Messmer recently weighed in with an observation that 3D TV poses a problem for people (like him) who can’t see much of anything without prescription glasses, so they have to wear two sets of glasses at once to watch 3D TV. Now we learn that there is another vision problem associated with 3D TV and movies - some people simply can’t see the 3D images....


...1) Information from neuroimaging and insights from cognitive neuroscience demand a significant reformulation of the understanding of vision.

2) Vision occurs neither in the eyes nor in the brain, but emerges from the collaboration of the eyes and the rest of the brain.

3) Vision is a pervasive aspect of our existence which permeates all of our activities.

4) Vision develops and, due to neural plasticity, can be enhanced....

Safety of Infant Vaccine Schedule Affirmed

...Worries that cramming multiple vaccinations into the first months of life slows brain development have no basis in fact....There was no evidence of neurodevelopmental delays or deficits associated with on-time vaccination in an intensively studied cohort of more than 1,000 children....

Three Out Of Four Children On Medicaid Missed Required Medical, Vision, And Hearing Screenings.

...Modern Healthcare (5/21, Zigmond) reported that "three out of four children on Medicaid in nine states did not receive all required medical, vision, and hearing screenings, according to a new report (pdf) from the HHS' inspector general's office." The report, which "examined the extent to which children in...Arkansas, Florida, Idaho, Illinois, Missouri, North Carolina, North Dakota, Texas, Vermont, and West Virginia received required Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) screenings, a child health benefit for children under the age of 21," revealed "that 2.7 million children, about 76%, missed one or more of the required EPSDT medical, vision, or hearing screenings, and 41% of children did not receive any required medical screenings." ...

3-D TV And Movies Look To Attract Viewers But Not Everyone Can 'See' What All The Hype Is About

...As Hollywood prepares for a summer filled with 3-D blockbuster hopefuls and cable networks launch 3-D networks and programming for newly-released 3-D televisions, the trend towards this new technology is hard to miss-except for the millions of Americans who literally can't see it. ...

COVD Call for Abstracts

Call for Papers

The College of Optometrists in Vision Development is soliciting abstracts for papers and posters to be presented at the COVD 40th Annual Meeting in San Juan, Peurto Rico in 2010. Any person wishing to make a presentation is invited to submit a proposal.

All abstracts will be reviewed by the Research Committee and will be judged on the basis of overall quality, completion of required information, relevance to Pediatrics, binocular vision, optometric vision therapy,learning related vision problems, subject matter, innovation, and attention to key questions in the field. Proposals may include research results, case studies, or new and innovative diagnostic procedures or treatment techniques.

Abstract Submission Application

Abstract Submission Guidelines

Deadline for abstract submission is June 11, 2010.