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Saturday, December 5, 2009

Private Practice Pediatric/Binocular Vision Residency Programs

EyeCare Professionals, P.C.
www.eyecareprofessionals.com
www.visiontherapyresidency.com

1777 Kuser Road
Hamilton Square, NJ 08690
609-581-5755

Program Supervisor: Dr. Barry Tannen Email: btannenod@aol.com

Description of Program: The goals of this program are two-fold:
1. To teach the resident through extensive clinical experience, didactic coursework, and guided self study, the art and science of the practice of Vision Therapy and Rehabilitation. The resident will gain extensive experience in working with patients with binocular/accommodative and eye movement disorders, vision processing and perceptual deficits, traumatic brain injury, and special needs and other developmental disorders. Additionally, the resident will participate in primary care, specialty contact lenses, ocular disease and special testing, as the practice is a large full scope practice that encompasses all areas of optometric care.
2. The resident will learn the nuts and bolts of running a successful optometric practice. S/he will complete specific modules in all relevant areas of optometric practice administration including (but not limited to) staff hiring and management, insurance coding, billing and submission, team building, report writing, patient care and professional seminar, and many other topics.


Family Eyecare Associates, P.C.
The Vision & Learning Center

www.pressvision.com
www.visionhelp.com

17-10 Fair Lawn Avenue
Fair Lawn, NJ 07410
Phone: (201) 794-7977

Program Supervisor: Dr. Leonard J. Press E-mail: pressvision@aol.com

Description of Program: The Resident in our facility will have the opportunity to work in a unique environment that positions the candidate to be highly successful in key areas of Optometry. While the principal emphasis is on acquiring skills necessary for advanced competency and financial management in vision therapy and rehabilitation, interaction with externs rotating through our practice from ICO and PCO enable the Resident to model clinical teaching skills as well. The Resident will also interact with our Optometric Vision Therapists who are Board Certified or Board Eligible members of COVD. At year’s end the Resident will feel comfortable implementing a broad array of skills in any environment, be it clinical research, institutional practice, or private practice.

The learning objectives of the Residency stem from the textbook Applied Concepts in Vision Therapy authored by Dr. Press, who is a Past President of COVD, former Chief of Vision Therapy Services at SUNY, current Chair of the Pediatrics and Binocular Vision Committee of the AOA, and a consultant on visual disabilities for the NBME (National Board of Medical Examiners).


Appelbaum Eye Care Associates, PC
www.visionhelp.com

6509 Democracy Blvd.
133 Defense Highway, Suite 113
Bethesda, Maryland 20817
Annapolis, Maryland 21401
301-897-8484 301-897-8484

Program Supervisor: Dr. Stanley A. Appelbaum E-mail: stan@visionhelp.com

Description of Program: The program emphasizes the diagnosis and treatment of binocular vision and visual perceptual disorders. The resident will gain extensive experience in Vision Therapy for Adults and Children, Vision Improvement Programs, Pediatrics, Primary Care, Special Testing, Infants Vision, Head Trauma/Rehabilitation, Children with Special Needs, Therapeutic Lenses, Contact Lenses and Low Vision.

As an employee of Appelbaum Eye Care Associates, PC, the resident will gain experience working with visual perceptual deficits, developmental vision anomalies, general binocular and eye movement skill deficiencies, complex Strabismus and Amblyopia as well as patients with visual/vestibular disorders including sensory integration dysfunction, sensory processing disorder, tactile defensiveness, apraxia, vertigo, dizziness, balance, movement, attention, and coordination disorders.


Child and Family Optometry

www.childrensvision.com

746 N. Maize Rd., Suite 100
Wichita, KS 67212
Phone: (316) 721-8877

Program Supervisor: Dr. Pat Pirotte E-mail: pirotte@childrensvision.com

Description of Program: The mission of the residency at Child and Family Optometry is to give the graduate all the tools necessary to start and succeed privately practicing in the specialty realm of pediatrics and vision therapy and integrating it into a primary care setting. The resident will obtain advanced competence in clinical, social, and business aspects of successfully practicing in this area of optometry. Graduates of the residency will be uniquely suited to successful private practice.
Our unique position is to try and teach clinical care in the management of strabismus, amblyopia, visually related learning problems, stroke, head trauma, and rehabilitation, while also developing skills in communication, marketing, and business.

Vision Therapy Group and Sensory Learning Center
www.visiontherapygroup.com

4091 Richfield Road
Flint, MI 48506
Phone: (810) 736-6673

Program Supervisor: Dr. Bradley Habermehl E-mail: dr.habermehl@prodigy.net


Description of Program: Dr. Bradley Habermehl and the Vision Therapy Group have been in practice in Southeast Michigan for over 21 years. This dynamic practice is split into three separate, but interconnected businesses. A resident who is selected to serve at this location will have the opportunity to experience a full scale optical practice as well as the added benefits of participating in Dr. Habermehl’s thriving vision therapy and sensory learning programs. Specific experiences in general optometry include the following: fitting for glasses and contacts, care for pre and post cataract and lasik surgery, and children’s vision care including vision therapy for vision-related learning problems and working with children on the autism spectrum. The resident will also be assigned vision therapy cases and will learn first hand practice management of running a vision therapy practice. Dr. Habermehl currently serves as president-elect of the College of Optometrist for Vision Development.

Friday, December 4, 2009

Green tea chemical combined with another may hold promise for treatment of brain disorders

...Scientists at Boston Biomedical Research Institute (BBRI) and the University of Pennsylvania have found that combining two chemicals, one of which is the green tea component EGCG, can prevent and destroy a variety of protein structures known as amyloids. Amyloids are the primary culprits in fatal brain disorders such as Alzheimer's, Huntington's, and Parkinson's diseases. Their study, published in the current issue of Nature Chemical Biology (December 2009), may ultimately contribute to future therapies for these diseases. ...

New Brain Connections Form Rapidly During Motor Learning

...The researchers studied mice as they were trained to reach through a slot to get a seed. They observed rapid growth of structures that form connections (called synapses) between nerve cells in the motor cortex, the brain layer that controls muscle movements. ...

Childhood Lead Exposure Damages the Brain

...New research indicates that early childhood exposure to lead may cause permanent brain damage.

The new Cincinnati Children’s Hospital study revealed a connection between higher lead levels and decreased activation in areas of the brain, including the parietal region. Researchers say white matter, part of the brain that matures early in life, adapts to the lead exposure. The last part of the brain to develop, the frontal lobe, is damaged by the lead exposure as it matures....

Number of kids in daycare may affect asthma risk

...For every additional other child in his or her primary care setting, a child's risk of asthma decreased, up until age 9. Asthma risk began to increase again for toddlers in day care with 10 or more other kids, suggesting that there may be a "threshold for this protective effect."...

Down syndrome increases among U.S. children

...Older average maternal age may have contributed to a 31.1% increase in the number of babies born with Down syndrome from 1979 to 2003, researchers believe.

During this time period, the prevalence of Down syndrome at birth increased from 9.0% to 11.8% per 10,000 live births, data pooled from 10 U.S. regions indicated, with prevalence rates five times higher among babies born to mothers who were aged 35 or older compared with younger mothers (38.6 per 10,000 vs. 7.8 per 10,000). ...

Wednesday, December 2, 2009

Cover Story December Issue of Optometric Management

The editors at Optometric Management liked my article, Identify Binocular Vision Disorders, so much, that it will be the cover story for the December 2009 issue. Watch for more news about this article here!

"Millions of children and adults suffer unnecessarily from binocular vision disorders because they’re underdiagnosed. Rectify this by following these four steps."

DM

Tuesday, December 1, 2009

For the first time researchers show reversal of earliest sign of retinal aging, using a resveratrol-based nutriceutical matrix (Longevinex(R))

Just thought you'd be interested. Stuart Richer OD, PhD, Chief, Optometry Section at the Veterans Medical Center in North Chicago is a colleague and friend. DM

For the first time researchers show reversal of earliest sign of retinal aging, using a resveratrol-based nutriceutical matrix (Longevinex(R))

Parachutes, Optometric Vision Therapy and Randomized, Clinical Trials

Martínez PC, Muñoz AG, Ruiz-Cantero MT.Treatment of accommodative and nonstrabismic binocular dysfunctions: A systematic review.Optometry. 2009 Dec;80(12):702-16.

CONCLUSION: Scientific evidence exists for the efficacy of vision therapy for convergence insufficiency. Insufficient scientific evidence exists on the best therapeutic options for treatment of the other nonstrabismic binocular anomalies and accommodative disorders.


Comments: Are these authors really this naive? Do they really think you cannot treat patients' problems unless the treatment has had randomized, clinical trials conducted? Do they practice in an ivory-tower bubble? Medicine has NEVER waited for the clinical trials before treating. Should optometry be held to a different standard? There is enough research at various levels (Observational Studies, Case-control Study, Cross-sectional Studies, Integrative Studies and Case Series studies) to support optometric vision therapy as a viable treatment. If these authors bothered to look at this research they would have known better than to come up with this erroneous conclusion! Go to http://www.covd.org for a listing of these papers. '

Please see the paper below. It illustrates just how "obsessed" some folks can become with "evidence based medicine". We need good science to support clinical care. Good clinical care usually occurs while the science tries to catch up. DM

Smith GCS, Pell JP. (2003). Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials. BMJ, 327(7429), 1459-1461. DOI: 10.1136/bmj.327.7429.1459

Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials

Gordon C S Smith, professor1, Jill P Pell, consultant2
1 Department of Obstetrics and Gynaecology, Cambridge University, Cambridge CB2 2QQ, 2 Department of Public Health, Greater Glasgow NHS Board, Glasgow G3 8YU

Correspondence to: G C S Smith gcss2@cam.ac.uk

Abstract

Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.

Design Systematic review of randomised controlled trials.

Data sources: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.

Study selection: Studies showing the effects of using a parachute during free fall.

Main outcome measure Death or major trauma, defined as an injury severity score > 15.

Results We were unable to identify any randomised controlled trials of parachute intervention.

Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a doub
le blind, randomised, placebo controlled, crossover trial of the parachute

Comment: Get PDF by clicking on title. DM

Fragile X Syndrome

‘‘It’s Something I Need to Consider’’: Decisions About Carrier Screening for Fragile X Syndrome in a Population of Non-Pregnant Women

One of my MD colleagues from down under...just sent me this email....so I thought I'd share it...

Hi,

Just a brief note to let you know about two exciting developments in the Fragile X world in Australia. We have just had a paper published in the AJMG (click link).

http://www.docstoc.com/docs/18237062/?key=MTEyNjMyNTUt&pass=NzM4Ny00NmVl

We have also had our NHRMC funding confirmed for a 3 year multicentre trial offering FXS carrier testing to women both before and in early pregnancy.

Two small but important steps towards offering all women screening for Fragile X Syndrome.

Sincerely
Jonathan

Dr Jonathan Cohen
Medical Director, Fragile X Alliance Clinic
263 Glen Eira Rd, Nth Caulfield 3161
t: +613 9528 1910 | f: +613 9532 9555
e: jcohen@travelclinic.com.au| w: www.fragilex.com.au

New Journal

The following new journal from The Korean Society of Cardiology has been added to PubMed Central:

Korean Circulation Journal

ISSN: 1738-5520 (print) 1738-5555 (electronic)

URL: http://www.ncbi.nlm.nih.gov/pmc/journals/977/

Archive includes vol. 39(3-10) (2009)

Note: There is no embargo delay for this journal; all articles are Open Access.

Early Intervention for Toddlers With Autism Highly Effective

..The study, published online in the journal Pediatrics, examined an intervention called the Early Start Denver Model, which combines applied behavioral analysis teaching methods with developmental relationship-based approaches. This approach was novel because it blended the rigor of applied behavioral analysis with play-based routines that focused on building a relationship with the child. While the youngest children in the study were 18 months old, the intervention is designed to be appropriate for children as young as 12 months of age with autism. Although previous studies have found that early intervention can be helpful for preschool-aged children, interventions for children who are toddlers are just now being tested. Autism is a lifelong neurodevelopmental disorder characterized by repetitive behaviors and impairment in verbal communication and social interaction. It is reported to affect one in 100 children in the United States....

Attention All ICO Alumni

Illinois College of Optometry Shines

Faculty & Program Achievements and Activities

Drs. Keith Tyler, Wendy Stone, Danielle Poole and Karen Squier successfully achieved Fellowship in the American Academy of Optometry at the 2009 Annual meeting in Orlando, FL, on November 14, 2009.

College faculty made twenty-eight presentations of scholarly work at the Annual Meeting of the American Academy of Optometry in Orlando, FL, November 11-14, 2009. Dr. Maino has kindly made available photos of the events (http://picasaweb.google.com/dmaino/2009AmericanAcdemyOfOptometry# ).

Faculty made the following presentations of their original, peer-reviewed research:

Clear Lens Phacomorphic Glaucoma Demonstrated With Ultrasonography And Anterior Segment Optical Coherence Tomography, Dominick Opitz, OD, FAAO, Mirijana Dordevic, OD, Eric Conley, OD, Illinois College of Optometry

Silicone Punctal Plugs As An Adjunctive Therapy To Travoprost 0.004% Ophthalmic Solution in Primary Open Angle Glaucoma And Ocular Hypertension, Dominick Opitz, OD, FAAO, Sherman Gin Yung Tung, OD, FAAO, Jenny Joo-Won Park, Illinois College of Optometry, Unsun Sarah Jang, Illinois College of Optometry

A Rare Bilateral Presentation Of Posner-Schlossman Syndrome, Ashley Firby, OD, Eric Conley, OD, Illinois College of Optometry

Long Anterior Lens Zonule Trait in African-American First-Degree Relatives, Daniel K. Roberts, OD, MS, FAAO, Illinois College of Optometry

Lens Adherence Related To Contact Lens Overwear, Shana Brafman, Jennifer S. Harthan, OD, FAAO, Illinois College of Optometry

Improving Comfort For First Time Gp Wearers With The So2clear Lens, Renee E. Reeder, OD, FAAO, Illinois College of Optometry, Jacqueline Haro, OD, Private Practitioner, Jennifer S. Harthan, OD, FAAO, Illinois College of Optometry

Utilization Of Digital Imaging in The Assessment Of Students'' Performance On Direct Ophthalmoscopy, Mindy C. Nguyen, OD, FAAO, Illinois College of Optometry

Comparison Of Icare® Tonometer To The Tono-Pen® in Children, Sandra S. Block, OD, MEd, FAAO, FCOVD, Erik Ranta, OD, Daniel Hermanson, OD, Colin Connors, OD, Illinois College of Optometry

A Prospective Study On Diagnosing Optic Nerve Hypoplasia Using Heidelberg Retina Tomograph And Fundus Photographs, Yi Pang, PhD, OD, FAAO, Kelly A. Frantz, OD, FAAO, FCOVD, Illinois College of Optometry

Correction Of Hyperopia in Children Study (CHICS) Pilot, Marjean T. Kulp, OD, MS, FAAO, Ohio State University, G. Lynn Mitchell, BS, MAS, FAAO, Ohio State University, Ida Chung, OD, FCOVD, FAAO, State University of New York, Amelia G. Bartolone, OD, FAAO, State University of New York, Wendy Stone, OD, Illinois College of Optometry, Janis E. Winters, OD, FAAO, Illinois College of Optometry

Eyelid Edema As Presenting Sign Of Nephrotic Syndrome, Janice M. McMahon, OD, Illinois College of Optometry, Rebecca Nichols, OD

Unilateral Optic Nerve Hypoplasia in The Dominant Eye Of a Patient With Anisometropic/Strabismic Amblyopia, Kelly A. Frantz, OD, FAAO, FCOVD, Illinois College of Optometry, Yi Pang, PhD, OD, FAAO

Cyclic Accommodative Esotropia in a Child With Associated Hippocampus Abnormality, Megan S. Allen, OD, Illinois College of Optometry, Benjamin Ticho, MD, University of Illinois Chicago

Does The Use Of Colored Overlays Affect Reading Rate?, Kent M. Daum, OD, MS, PhD, FAAO, Illinois College of Optometry, Kimberly Betton, BS, Illinois College of Optometry, Daman Gupta, BS, Illinois College of Optometry

Color Differences Between The 2005 And 2006 Editions Of The Ishihara Color Vision Test, David Y. Lee, OD, PhD, FAAO, Anne Eng, BSc, Lenna Go, BA, Illinois College of Optometry

Topical Cyclosporine For The Prevention Of Dry Eye Disease: Second Year Of Two-Year Study, Kaori Asano, OD, Illinois College of Optometry, Sanjay Rao, MD, Private Practitioner

Managing Patients With Ocular Surface Disease And Hepatitis C, Renee E. Reeder, OD, FAAO, Illinois College of Optometry, Jeff Horst, OD, Boston VA Healthcare System, Jennifer S. Harthan, OD, FAAO, Illinois College of Optometry, Jacqueline Haro, OD, Private Practitioner

Peripheral Ulcerative Keratitis in Association With Sarcoid, Jennifer S. Harthan, OD, FAAO, Illinois College of Optometry, Renee E. Reeder, OD, FAAO, Illinois College of Optometry

Visualization Of Iriociliary Cyst Using Various Imaging Techniques, Mindy C. Nguyen, OD, FAAO, Illinois College of Optometry

Venous Stenosis Causing Loss Of Consciousness And Intracranial Hypertension, Ellen S Shorter, OD, Illinois College of Optometry, Keith Tyler, OD, Illinois College of Optometry

Atypical Maculopathy Associated With Syphilitic Chorioretinitis in The Presence Of Human Immunodeficiency Virus, Stephanie A. Klemencic, OD, FAAO, Illinois College of Optometry

Optical Coherence Tomography in a Case Of North Carolina Macular Dystrophy, David Castells, OD, FAAO, Illinois College of Optometry

Atypical Stargardt Disease, Ashley Firby, OD, Illinois College of Optometry, Mary Flynn Roberts, OD, Illinois College of Optometry

Optical Coherence Tomography Of Type 1 Retinal Hamartomas in Tuberous Sclerosis, Anne Rozwat, OD, Illinois College of Optometry

Inner Retinal Cystic Degeneration Following a Central Retinal Artery Occlusion, Elizabeth Wyles, OD, FAAO, Leonard V. Messner, OD, FAAO, Illinois College of Optometry, Nicholas Lillie, Illinois College of Optometry

Retinopathy After Myocardial Infarction: Microembolic Retinopathy Revisited, Bruce A. Teitelbaum, OD, FAAO, Illinois College of Optometry

The Relationship Of Macular Pigment Density To Foveal Architecture, Gary G. Gunderson, OD, FAAO, Illinois College of Optometry, Dominick Opitz, OD, FAAO, Jennifer Lin, BS, Kevin Trieu, BS, Katherine Tran, BS, Susan Kelly, PhD,

Multiple Retinal Pigment Epithelial Detachments And Oral Bisphosphonate Use, Michelle Crist, Illinois College of Optometry, Sarah Boulais Klein, OD, FAAO, Illinois College of Optometry.

Dr. Dominick Maino presented a lecture, Neuroplasticity – A Paradigm Sea Change, as part of the Ellerbrock Program at the Annual Meeting of the AAO in Orlando, FL. http://www.slideshare.net/DMAINO/neuroplasticity-a-paradigm-sea-change-latest-updated-file

Drs. Melissa Siglar and Christine Allison presented a workshop, Management of Patients with Vertical Deviations, as part of the Ellerbrock Program at the Annual Meeting of the AAO in Orlando, FL.

Dr. Kelly Frantz presented a lecture, Binocular Vision Case Management Using Prism, as part of the Ellerbrock Program at the Annual Meeting of the AAO in Orlando, FL.

Dr. Janis Winters presented a lecture, Barriers: What Keeps Someone from Seeking Healthcare? What Can I Do About It?, as part of the Ellerbrock Program at the Annual Meeting of the AAO in Orlando, FL.

Dr. Tom Stelmack presented a lecture, Ocular Immunology: Clinical Applications, as part of the Ellerbrock Program at the Annual Meeting of the AAO in Orlando, FL.

Dr.Christine Allison is a member of the Education Committee of the AAO which administrated the educational program at the AAO Annual Meeting.

Dr. Kelly Frantz participated in administering the Binocular Vision, Perception, & Pediatric Optometry Diplomate practical examination to one candidate during the 2009 AAO meeting.

The College convened the 1st Research Symposium on November 6, 2009. A total of 28 posters were presented. IM specialist Mr. Waldo Duran for designed and printed the posters. Dr. Robert Donati, Kathryn Johnston, Waldo Duran, Teresa Siupinski, Margaret Rhodes, the Research Resource Committee (Drs. Robert Donati, Renee Reeder, Christine Allison, Dominick Opitz, Pang) for organized the symposium. Mr. Opie Nimon and his staff for set up the Gym and Ms. Jennifer Sopko and Jonathan McIntire for listed the information on ICO website. Faculty, residents and students provided much hard work to produce the excellent presentations.

The following ICO faculty are appointed in the AOA Volunteer structure: Drs. Augsburger, M. Chaglasian, Federal Relations Committee; Dr. Block, Pediatrics and Binocular Vision Committee; Dr. Colip, Research and Information Center Executive Committee; Dr. Conrad, Insurance Committee; Dr. Goodfellow, Student and New Graduate Committee; Dr. Maino, Poster Session Sub-committee; Dr. McMahon, Faculty Relations Committee; and, Dr. Scharre, Accreditation Council on Optometric Education.

Drs. Beckerman, Goodfellow, Harthan and Scharre as well as the Illinois College of Optometry were cited as participants in the 2009 CDC InfantSEE Week Pilot Program in the AOA News, 48(6):11, October 26, 2009.

Dr. Daum completed an interview with Ms. Lori Johnston, free lance journalist, Atlanta Constitution's Q & A on the News, about television viewing distance with reference to newer types of monitors. (http://www.ajc.com/news/q-how-did-georgia-200680.html )

Dr. Goodfellow completed the 20-hour certification program and has been appointed as a member of the Consultant-Evaluator Corps of the Higher Learning Commission. The meeting reaffirmed that ICO is on the right track for its current endeavors regarding assessment and student learning outcomes. Assessment has been a large focus of HLC for the past ten years. The future HLC initiatives appear focused on benchmarking, transparency, and active-learning

Photos of Dr. Roberts’ research have been submitted to Ms. Rosemary Janiszewski (NIH/NEI). The NEI is gathering a collection of images and video from grantees to feature in various outlets, including the NEI image catalog (www.nei.nih.gov/photo), Eye on NEI monthly newsmagazine (www.nei.nih.gov/EYEonNEI/snapshot), and other internal purposes, including a television slideshow in the NEI offices.

Drs. Block and Winters made presentations of scholarly work at the Annual Meeting of the American Public Health Association in Philadelphia, PA, November 7-11, 2009.

Dr. Sandra Block is the Chair of the Vision Care section of the APHA. The APHA noted her election: “The VCS membership elected Sandra Block of the Illinois College of Optometry as the incoming chair-elect. Sandy is also in a leadership role with Special Olympics Lions Clubs International Opening Eyes program, which is working to develop sustainable vision care worldwide for persons with intellectual disability.” Dr. Block authored a column about the activities of the section (http://www.apha.org/membergroups/newsletters/sectionnewsletters/vision/winter09/Chair+Column.htm ).

Dr. Block was elected to the prestigious steering council at the APHA.

Winters JE. Primary care physician report and blood pressure in a low income uninsured population, Annual Meeting of the APHA, November 9, 2009

Ms. Karen Lee (Illinois College of Optometry 2011
National Liaison to ASCO Diversity Task Force, US Students' Liaison to CAO, ICO Liaison to CAO, Chinese American Service League Board Member) has traveled to Salinas, Ecuador with OneSight Foundation (onesight.org) and sends a video link of the trip (Karen appears at the 6:54 mark of the video.)

Monday, November 30, 2009

New Journals from PubMed

New Journals from PubMed

Journal of Medical Physics / Association of Medical Physicists of India
ISSN: 0971-6203 (print); 1998-3913 (electronic)
URL: http://www.ncbi.nlm.nih.gov/pmc/journals/976/
Archive: v. 33 (2008). Current and back content is forthcoming.
There is no embargo delay for this journal.

Indian Journal of Community Medicine: Official Publication of Indian
Association of Preventive & Social Medicine
ISSN: 0970-0218 (print); 1998-3581 (electronic)
URL: http://www.ncbi.nlm.nih.gov/pmc/journals/962/
Archive: v. 33 (2008).
There is no embargo delay for this journal.

Indian Journal of Dermatology
ISSN: 0019-5154 (print); 1998-3611 (electronic)
URL: http://www.ncbi.nlm.nih.gov/pmc/journals/963/
Archive: v. 53 (2008).
There is no embargo delay for this journal.

Annals of Indian Academy of Neurology
ISSN: 0972-2327 (print); 1998-3549 (electronic)
URL: http://www.ncbi.nlm.nih.gov/pmc/journals/974/
Archive: v. 11 (2008).
There is no embargo delay for this journal.

International Journal of Diabetes in Developing Countries
ISSN: 0973-3930 (print); 1998-3832 (electronic)
URL: http://www.ncbi.nlm.nih.gov/pmc/journals/975/
Archive: v. 28 (2008).
There is no embargo delay for this journal.

What is Amblyopia?

What is Amblyopia? A presentation by Dominick M. Maino, OD, MEd, FAAO, FCOVD-A
video

CE in Vegas

ICO Continuing Education is going to Las Vegas this March! Come warm up with us and get 12 hours of Continuing Education. All 12 hours are COPE pending and 10 of the hours will be offered as TQ for doctors who need TQ CE.

Registration: Register online here or download a registration form to fax or mail in. You may also call 312-949-7426 to register over the phone. Space is limited so register soon!

We look forward to seeing you in Las Vegas!

Diane D. Gillette
Continuing Education and Assessment Coordinator
Illinois College of Optometry
Phone: 312-949-7429
Fax: 312-949-7729
Email: dgillette@ico.edu

Advances in neuroimaging of traumatic brain injury and posttraumatic stress disorder PDF

Veterans with history of mild traumatic brain injury and posttraumatic stress disorder: Challenges from provider perspective PDF

Pathology of blast-related brain injury PDF

Clinical practice guideline: Management of Concussion/Mild Traumatic Brain Injury PDF

Computer Vision Syndrome: what is it and what can you do to prevent it?

...Have you wondered why your eyes may feel tired after a long day of staring at the computer at work? Or why you can get headaches and eye strain after looking at the computer for just a few hours at work while you can surf the web the entire weekend at home and your eyes will feel perfectly fine? If you are experiencing these symptoms, you may have Computer Vision Syndrome....

Vision Intervention Program

This is a Program from Learning Insights, a not for profit organization in Missouri, striving to screen children for vision problems, provide tutoring for them in schools, and refer the more severe cases to optometrist that look at vision from a broad perspective.

AOA survey indicates Americans practicing poor eye care.

From AOA First Look:

In his column in California's Times-Standard (11/29), Dave Stancliff observed that "in a new Harris Interactive survey conducted for Lighthouse International, 62 percent of America's baby boomers reported they are not concerned about becoming visually impaired or experiencing a loss of vision that can't be corrected by surgery, medicine, or eye wear." In fact, "Americans practice poor eye care, according to a new survey from the American Optometric Association (AOA). Despite the fact that they view their eyesight as their most valued sense, they admit engaging in behavior that could be harmful to their eyes, including poor contact-lens hygiene and avoiding eye exams."

Ocular component growth curves among Singapore children with different refractive error status

...In young Asian children, the axial length and vitreous chamber elongated with time and the elongation slowed with age. There was a U-shaped growth curve for lens thickness and inverted U-shaped curve for anterior chamber depth. Our findings of early lens thinning followed by thickening, suggests a two-phase growth in the lens....

Tobacco, Lead Could Increase ADHD Risk

...Environmental factors may increase a child's risk for attention-deficit hyperactivity disorder (ADHD). New research suggests exposure to both tobacco and lead may increase his or her risk by eight-fold. ...

Parent training key to improved treatment of behavior problems in children with autism

...The serious behavior problems that can occur in children with autism and related conditions can be reduced with a treatment plan that includes medication combined with a structured training program for parents, according to Yale University researchers and their colleagues...

Sunday, November 29, 2009

Heroin and strabismus

...Acute esotropia with double vision is a disturbing side effect of heroin withdrawal, and, similarly, acute exotropia may be related to
heroin intake. In the absence of focal neurologicalsigns, further work-up is not mandatory. Referral to a specialised orthoptic service is beneficial in offering the patient symptomatic treatment andreassurance, thus supporting successful withdrawal
therapy....


Comments: Click on title for pdf. DM

Learning disabilities, dyslexia, and vision: a subject review A rebuttal, literature review, and commentary

..The AAP/AAO/AAPOS paper contains errors and
i n t e rnal inconsistencies. Through highly selective re f e re n c e choices, it misre p resents the great body of evidence from the l i t e r a t u re that supports a relationship between visual and perceptual problems as they contribute to classroom diff i c u l t i e s . The 1998 paper should be retracted because of the errors, bias,
and disinformation it presents. The public assigns great tru s t to authorities for accurate, intellectually honest guidance, which is lacking in this AAP/AAO/AAPOS position paper....


Comments: PDF available by clicking on title. DM

MMR vaccine does not cause autism

In February 1998, The Lancet published an article titled “Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis, and Pervasive Developmental Disorder in Children,” which suggested that MMR vaccine could contribute to the development of autism. Intense media coverage of the article followed its publication, and many parents, particularly in the UK, refused MMR vaccination of their children. In 2004, The Lancet published a retraction submitted by 10 of the 13 original authors. The authors stated that there was no connection between the MMR vaccine and the boweldisease/autism syndrome. In 2008, the number of articles published in peer-reviewed medical journals that refute a connection between MMR vaccine and autism totals more than 20; whereas the number of articles that suggest a connection between the vaccine and autism stands at 3. The following list of studies published in peer-reviewed journals is provided so that parents and practitioners can
themselves compare the balance of evidence about MMR and autism.
\

Comments: Click title for the pdf. DM

Broken Mirrors: A THEORY OF AUTISM

..CHILDREN WITH AUTISM may struggle with social interaction because their mirror neuron systems are not functioning properly....

Three Reasons Not to Believe in an Autism Epidemic

...According to some lay groups, the nation is
experiencing an autism epidemic—a rapid escalation in the prevalence of autism for unknown reasons. However, no sound scientific evidence indicates that the increasing
number of diagnosed cases of autism arises from anything other than purposely broadened diagnostic criteria, coupled with deliberately greater public awareness and intentionally improved case finding. Why is the public perception so disconnected from the scientific evidence? In this article we review three primary sources of misunderstanding: lack of awareness about the changing diagnostic criteria, uncritical acceptance of a conclusion illogically drawn in a California-based study, and inattention to a crucial feature of the ‘‘child count’’ data reported annually by the U.S. Department of Education....

Bifocals in Down Syndrome Study (BiDS): Design and Baseline Visual Function

...This study confirms previous findings of a high prevalence of reduced accommodation and shows that near VA is reduced compared to distance VA. The present results indicate that all subjects might benefit from bifocals....

Comments: It should now be obvious that just about all folks with Down Syndrome should have a multi-focal lens design...give them bifocals (children and adults with cerebral palsy can usually use a bit of help at near too!) DM

Corneal Power and Astigmatism in Down Syndrome

...The study is the first to explicitly investigate the association between corneal power and refractive error in children with DS. The majority of the DS group have significant refractive errors including an increased prevalence of oblique astigmatism. Corneal curvature in DS is not related to spherical (M) or astigmatic (J0, J45) refractive error. Further research is required to better understand the association between the ocular structures of the DS eye and their impact on functional vision...

Vision in autism spectrum disorders

...Autism spectrum disorders (ASDs) are developmental disorders which are thought primarily to affect social functioning. However, there is now a growing body of evidence that unusual sensory processing is at least a concomitant and possibly the cause of many of the behavioural signs and symptoms of ASD. A comprehensive and critical review of the phenomenological, empirical, neuroscientific and theoretical literature pertaining to visual processing in ASD is presented, along with a brief justification of a new theory which may help to explain some of the data, and link it with other current hypotheses about the genetic and neural aetiologies of this enigmatic condition....

Does Nonsurgical Treatment of Exodeviations Work?

...There are proven successful nonsurgical treatments for exodeviations, and, very specifically, convergence insufficiency. Clinicians have sought nonsurgical treatments for a variety of reasons both their own and their patient’s personal preference. The basic principals of treatment are to correct vision and to remove any obstacles to fusion. The main categories of nonsurgical treatment are: occlusion, glasses (base-in/over-minus), and exercises (fusional convergence, antisuppression, and increasing the near point of convergence). The recently published randomized clinical trial studying which exercise modality is best for treating convergence insufficiency is reviewed....

Vision in Children and Adolescents with Autistic Spectrum Disorder: Evidence for Reduced Convergence

...Evidence of atypical perception in individuals
with ASD is mainly based on self report, parental questionnaires or psychophysical/cognitive paradigms. There have been relatively few attempts to establish whether binocular vision is enhanced, intact or abnormal in those
with ASD. To address this, we screened visual function in 51 individuals with autistic spectrum disorder and 44 typically developing individuals by measuring visual acuity,
stereoacuity, convergence, divergence, ocular motility,incidence of strabismus and integrity of the optokinetic response. The data suggest that many aspects of vision,
including visual acuity, are unaffected in ASD, but that convergence is an aspect of visual function that merits further research in those with ASD.

Reduction of symptoms in binocular anomalies using computerized home therapy—HTS™

...Automated vision therapy delivered by the HTS system improved convergence and divergence amplitudes with a concomitant reduction in symptoms. The HTS system should be used on those patients with symptoms associated with an accommodative/vergence anomaly when in-office vision therapy supplemented with home therapy is not practical....

Visual Impairment and Dysfunction in Combat-Injured Servicemembers With Traumatic Brain Injury

..Eighty-four percent of Polytrauma Rehabilitation Center (PRC) -inpatients and 90% of Polytrauma Network Site (PNS)-outpatients had TBIs associated with a blast event. The majority of patients in both the PRC and PNS populations had visual acuities of 20/60 or better (77.8% PRC, 98.4% PNS). Visual dysfunctions (e.g., convergence, accommodative, and oculomotor dysfunction) were common in both PRC and PNS populations. In the PRC-inpatient population, acuity loss of 20/100 to no light perception (13%) and visual field defects (32.3%) were found. In the PNS-outpatient population, acuity loss of 20/100 to no light perception (1.6%) and visual field defects (3.2%) were infrequently found. In both the PRC and PNS populations, visual field defects were more often associated with blast than non-blast events.

Friday, November 27, 2009

Nonveridical Visual Perception in Human Amblyopia

...Amblyopia is a developmental disorder of spatial
vision. There is evidence to suggest that some amblyopes misperceive spatial structure when viewing with the affected eye. However, there are few examples of these perceptual
errors in the literature. This study was an investigation of the prevalence and nature of misperceptions in human amblyopia....


Comments: PDF available by clicking on title. DM

Perceptual learning as a potential treatment for amblyopia: A mini-review

...A review of the extant studies makes it clear that practicing a visual task results in a long-lasting improvement in performance in an amblyopic eye. The improvement is generally strongest for the trained eye, task, stimulus and orientation, but appears to have a broader spatial frequency bandwidth than in normal vision. Importantly, practicing on a variety of different tasks and stimuli seems to transfer to improved visual acuity. Perceptual learning operates via a reduction of internal neural noise and/or through more efficient use of the stimulus information by retuning the weighting of the information. The success of PL raises the question of whether it should become a standard part of the armamentarium for the clinical treatment of amblyopia, and suggests several important principles for effective perceptual learning in amblyopia....

Comment: Amblyopia is treatable. Amblyopia is treatable at any age. Go to http://www.covd.org to find a doc to help you. DM

Action-Video-Game Experience Alters the Spatial Resolution of Vision

Playing action video games enhances several
different aspects of visual processing; however, the mechanisms underlying this improvement remain unclear. Here we show that playing action video games can alter fundamental characteristics of the visual system, such as the spatial resolution of visual processing across the visual field. To determine the spatial resolution of visual processing, we measured the smallest distance a distractor could be from a target without compromising target identification. This approach exploits the fact that visual processing is hindered as distractors are brought close to the target, a phenomenon known as crowding. Compared with nonplayers, action-video-game players could tolerate smaller target-distractor distances. Thus, the spatialresolution of visual processing is enhanced in this population. Critically, similar effects were observed in non-video- game players who were trained on an action video game; this result verifies a causative relationship between video-game play and augmented spatial resolution.


Comments: PDF available by clicking on title. DM

Carrot sticks or joysticks: video games improve vision

...Playing action-based video games has been shown to improve attentional processing. A study now finds that it also induces long-lasting improvements in contrast sensitivity, a basic visual function that commonly deteriorates with age. These improvements do not happen for an equivalent group who played a non-action video game....

Comments: PDF available by clicking on title. DM

Enhancing the contrast sensitivity function through action video game training

...The contrast sensitivity function (CSF) is routinely assessed in clinical evaluation of vision and is the primary limiting factor in how well one sees. CSF improvements are typically brought about by correction of the optics of the eye with eyeglasses, contact lenses or surgery. We found that the very act of action video game playing also enhanced contrast sensitivity, providing a complementary route to eyesight improvement....

Prolonged Perceptual Learning of Positional Acuity in Adult Amblyopia: Perceptual Template Retuning Dynamics

...Amblyopia is a developmental abnormality that results in physiological alterations in the visual cortex and impairs form vision. It is often successfully treated by patching the sound eye in infants and young children, but is generally considered to be untreatable in adults. However, a number of recent studies suggest that repetitive practice of a visual task using the amblyopic eye results in improved performance in both children and adults with amblyopia. These perceptual learning studies have used relatively brief periods of practice; however, clinical studies have shown that the time-constant for successful patching is long. The time-constant for perceptual learning in amblyopia is still unknown. Here we show that the time-constant for perceptual learning depends on the degree of amblyopia. Severe amblyopia requires 50 h (35,000 trials) to reach plateau, yielding as much as a five-fold improvement in performance at a rate of
1.5%/h. There is significant transfer of learning from the amblyopic to the dominant eye, suggesting that the learning reflects alterations in higher decision stages of processing. Using a reverse correlation technique, we document, for the first time, a dynamic retuning of the amblyopic perceptual decision template and a substantial reduction in internal spatial distortion. These results show that the
mature amblyopic brain is surprisingly malleable, and point to more intensive treatment methods for amblyopia.....


Comments: Click on title for pdf. DM

Experience-dependent recovery of vision following chronic deprivation amblyopia

...The shift in ocular dominance induced by brief monocular deprivation is greatest during a postnatal critical period and is thought to decline irreversibly thereafter. However, here we demonstrate that complete visual deprivation through dark exposure restores rapid ocular dominance plasticity in adult rats. In addition, the loss of visual acuity resulting from chronic monocular deprivation is reversed if dark exposure precedes removal of the occlusion in adulthood, suggesting a potential use for dark exposure in the treatment of adult amblyopia...

Environmental enrichment in adulthood promotes amblyopia recovery through a reduction of intracortical inhibition

...Loss of visual acuity caused by abnormal visual experience during development (amblyopia) is an untreatable pathology in adults [This is NOT true]. We report that environmental enrichment in adult amblyopic rats restored normal visual acuity and ocular dominance. These effects were due to reduced GABAergic inhibition in the visual cortex, accompanied by increased expression of BDNF and reduced density of extracellular-matrix perineuronal nets, and were prevented by enhancement of inhibition through benzodiazepine cortical infusion....

Prevalence and causes of amblyopia in an adult population

...Amblyopia was diagnosed in 118 participants, or 3.2% of the population using a visual acuity criterion of 20/30 or less and 2.9% using a visual acuity criterion of 20/40 or less. Using a two-line visual acuity difference between the eyes, the amblyopia prevalence was 2.6% and 2.5%, respectively, for the above criteria. The underlying amblyogenic causes assessed were anisometropia (50%), strabismus (19%), mixed strabismus and anisometropia (27%), and visual deprivation (4%). The visual acuity of the amblyopic eye was 20/200 or worse (19%), 20/80 to 20/160 (19%), 20/40 to 20/63 (52%), and 20/30 (11%). .... The most frequent pattern of strabismus was esotropia, whereas hypermetropia was the most frequent refractive error in amblyopic eyes. The mean age at diagnosis was earlier for strabismic and mixed amblyopia (7.4 years) than for anisometropic amblyopia (12.7 years)....

Thursday, November 26, 2009

The Intersection of Online Social Networking with Medical Professionalism

...While social networking in medical trainees
is common in the current culture of emerging professionals, a majority of users allow anyone to view their profile. With a significant proportion having subjectively inappropriate content, ACGME competencies in professionalism must include instruction on the intersection of personal and professional identities....


Comment: Full text available by clicking on title: DM

A Scientific Collaboration Tool Built on the Facebook Platform

We describe an application (“Medline Publications”)
written for the Facebook platform that allows users to maintain and publish a list of their own Medlineindexed publications, as well as easily access their contacts’ lists. The system is semi-automatic in that itinterfaces directly with the National Library of
Medicine’s PubMed database to find and retrieve citation data. Furthermore, the system has the capability to present the user with sets of other users with similar publication profiles. As of July 2008, Medline Publications has attracted approximately
759 users, 624 of which have listed a total of 5,193 unique publications.


Comment: Full text available by clicking on title. DM

Neural Basis of Self and Other Representation in Autism: An fMRI Study of Self-Face Recognition

...This functional dissociation between the representation of self versus others points to a potential neural substrate for the characteristic self-focus and decreased social understanding exhibited by these individuals, and suggests that individuals with ASD lack the shared neural representations for self and others that TD children and adults possess and may use to understand others.....

Oculomotor Control in Children Who Were Born Very Prematurely

...the preterm children had difficulties with the voluntary control of saccades, particularly in the area of inhibition, which may be indicative of a deficit in the region of the dorsolateral prefrontal cortex. This finding is consistent with other reports in preterm children in whom executive function has been found to be compromised, and both these aspects of behavior are likely to share similar areas of cortical control....

Comments: Full text available by clicking on title.

Visual Processing of Faces in Individuals with Fragile X Syndrome: An Eye Tracking Study

...Gaze avoidance is a hallmark behavioral feature of fragile X syndrome (FXS), but little is known about whether abnormalities in the visual processing of faces, including disrupted autonomic reactivity, may underlie this behavior. Eye tracking was used to record fixations and pupil diameter
while adolescents and young adults with FXS and sex- and age-matched typically developing controls passively viewed photographs of faces containing either a calm, happy, or fearful expression, preceded by a scrambled face matched on luminance. Results provide quantitative evidence for significant differences in gaze patterns and increased pupillary reactivity when individuals with FXS passively view static faces. Such abnormalities have significant implications in terms of understanding causes of gaze avoidance observed in individuals with FXS.


Comments: Full text available by clicking title. DM

The impact of optical factors on resolution acuity in children with Down syndrome.

...Grating resolution and interferometric thresholds are reduced in children with DS. However the discrepancy between developmentally healthy children and those with DS is greater for grating resolution acuity, suggesting that degradation in optical quality is a major contributor to poor visual performance in children with DS....

Physiological and behavioral differences in sensory processing: a comparison of children with Autism Spectrum Disorder and Sensory Modulation Disorder

...high incidence of sensory processing diffi culties exists in children with Autism Spectrum Disorder (ASD) and children with Sensory Modulation Disorder (SMD). This is the fi rst study to directly compare and contrast these clinical disorders. Sympathetic nervous system markers of arousal and reactivity were utilized in a laboratory paradigm that administered a series of
sensory challenges across fi ve sensory domains. The Short Sensory Profi le, a standardized parent-report measure, provided a measure of sensory-related behaviors. Physiological arousal and sensory reactivity were lower in children with ASD whereas reactivity after each sensory stimulus was higher in SMD, particularly to the fi rst stimulus in each sensory domain. Both clinical groups had signifi cantly more sensory-related behaviors than typically developing children, with contrasting profi les. The ASD group had more taste/smell sensitivity and sensory under-responsivity while the SMD group had more atypical sensory seeking behavior. This study provides preliminary evidence distinguishing sympathetic nervous system functions and sensory-related behaviors in Autism Spectrum Disorder and Sensory Modulation Disorder.
Differentiating the physiology and sensory symptoms in clinical groups is essential to the provision of appropriate interventions....


Comments: Free full text of article available by clicking title. DM

Traumatic Brain Injury in Young Children: Post-Acute Effects on Cognitive and School Readiness Skills

..Previous studies have documented weaknesses in cognitive ability and early academic readiness in young children with traumatic brain injury (TBI). However, few of these studies have rigorously controlled for demographic characteristics, examined the effects of TBI severity on a wide range of
skills, or explored moderating influences of environmental factors on outcomes. To meet these objectives, each of three groups of children with TBI (20 with severe, 64 with moderate, and 15 with mild) were compared with a group of 117 children with orthopedic injuries (OI group). The childrenwere hospitalized for their injuries between 3 and 6 years of age and were assessed an average of 1½ months post injury. Analysis revealed generalized weaknesses in cognitive and school readiness
skills in the severe TBI group and suggested less pervasive effects of moderate and mild TBI. Indices of TBI severity predicted outcomes within the TBI sample and environmental factors moderated the effects of TBI on some measures. The findings document adverse effects of TBI in early childhood on post-acute cognitive and school readiness skills and indicate that residual deficits are related to
both injury severity and the family environment....


Comments: Full text of article available by clicking title. DM

The magnocellular theory of developmental dyslexia

...In dyslexics, the development of the visual magnocellular system is impaired: development of the magnocellular layers of the dyslexic lateral geniculate nucleus (LGN) is abnormal; their motion sensitivity is reduced; many dyslexics show unsteady binocular fixation; hence poor visual localization, particularly on the left side (left neglect). Dyslexics' binocular instability and visual perceptual instability, therefore, can cause the letters they are trying to read to appear to move around and cross over each other. Hence, blanking one eye (monocular occlusion) can improve reading. Thus, good magnocellular function is essential for high motion sensitivity and stable binocular fixation, hence proper development of orthographic skills. ...

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....

Picture perception in Chinese dyslexic children: an eye-movement study

...The characteristics of the pictures can significantly influence the visuospatial cognitive processing capability of the Chinese children. There is a detectable disability for the Chinese dyslexic children in the visuospatial cognitive processing: their saccade amplitude and mean saccade distance are shorter, which may be interpreted as specific for their reading disability....

Comments: Full text of this article is available by clicking the title. DM

Executive dysfunction in poor readers born prematurely at high risk

...This study examined the relation between a preterm birth and reading ability and whether children born preterm with poorer reading were more likely to show lower cognitive and executive functioning
skills compared to children born term with poor reading ability. Participants born at term (n=97) and preterm (n=156) were studied using the Woodcock-Johnson Test of Achievement Word Attack subtest (WJWA), Stanford-Binet Intelligence Scale, Comprehensive Evaluation of Language Fundamentals, and executive function tasks during the 3rd, 5th and 7th grades. Children born prematurely were divided into low (n=94) and high (n=62) risk groups based on severity of neonatal
complications. Growth in WJWA scores was used to cluster the sample into three reading ability groups. Contrary to predictions, children born preterm were not more likely to be in the poor reading group. Poorer reading ability was associated with lower language and cognitive scores. The effect of premature birth demonstrated fewer and weaker associations with such scores. A significant interaction between reading ability and birth status indicated that high risk prematurely born children
with poor reading ability were more likely than the other groups to perform poorly on executive function tasks. These data suggest that better reading ability is associated with better neuropsychological function independent of prematurity....


Comments: Full text of article is available by clicking the title above. DM

The Functional Significance of Stereopsis.

...Performance on motor skills tasks was related to stereoacuity, subjects with normal stereoacuity performing best on all tests. This quantifiable degradation in performance on some motor skill tasks supports the need to implement management strategies to maximise development of high grade stereoacuity....

Comments: So have single, clear, comfortable, binocular vision IS important afterall!! DM

Consecutive exotropia after surgical treatment of childhood esotropia: a 40-year follow-up study.

...The incidence of consecutive XT in this cohort was 21%.... Patients who had undergone multiple surgeries had a higher risk of developing consecutive XT compared to those successfully aligned with one surgery. Restriction of adduction and convergence postoperatively was associated with a high risk of consecutive XT. The incidence of consecutive XT did not vary with the level of visual acuity in the operated eye. Age of onset, age at surgery and amount of surgery did not appear to influence the risk for developing consecutive XT....

Comments: Coming on heals of the positive long term research regarding optometric vision therapy, this study suggests that we caution our patients on the long term out comes of strabismus surgery. DM

Susan Berry, PhD & COVD

...Many of us have wished that we had said thank you at just the right moment but then the opportunity passed us by. This happened to me very recently. I had attended the meeting of the College of Optometrists in Vision Development (COVD) which is made up of a small subset of optometrists who are experts in optometric vision therapy. It was an optometrist from this group who had given me an enormous gift: she had taught me that I could rehabilitate my own vision and, with her guidance, I leaned to straighten my crossed eyes and to see in 3D. I wrote all about these experiences in my book Fixing My Gaze....

Wednesday, November 25, 2009

New Open Access Journal in Pubmed

The following journal has been added to PubMed Central:

Open Medicine
ISSN: 1911-2092 (electronic)
URL: http://www.ncbi.nlm.nih.gov/pmc/journals/896/
Archive: v. 3 (2009). Current and back content is forthcoming. There is no
embargo delay for this journal.

The chain of communication in health science: from researcher to health worker through open access

GLOBALLY, THE PUBLIC AND PRIVATE SECTORS spend billions of dollars each year on biomedical and health related research. Yet in many parts of the world, health care systems are far from achieving the health outcomes targeted by the UN Millennium Development Goals The reasons for this disparity are complex, but one key factor that has been consistently identified is the failure to translate research into effective policy and practices. Not surprisingly, then, health agencies and funding bodies around the world are paying closer attention to what is now generally described as “knowledge translation,” developing mechanisms that “strengthen communication between health researchers and users of health knowledge, enhance capacity for knowledge uptake, and accelerate the flow of knowledge into beneficial health applications.

Comments: Full text available. Click on title. DM

Recent Advances in the Pathogenesis of Syndromic Autisms

Background. Current advances in genetic technology continue to expand the list of medical conditions associated with autism. Clinicians have to identify specific autistic-related syndromes, and to provide tailored counseling. The aim of this study is to elucidate recent advances in autism research that offer important clues into pathogenetic mechanisms of syndromic autism and relevant implications for clinical practice. Data Sources. The PubMed database was searched with the keywords “autism” and “chromosomal abnormalities,” “metabolic diseases,” “susceptibility loci.” Results. Defined mutations, genetic syndromes, and metabolic diseases account for up to 20% of autistic patients. Metabolic and mitochondrial defects may have toxic effects on the brain cells, causing neuronal loss and altered modulation of neurotransmission systems. Alterations of the neocortical excitatory/inhibitory balance and perturbations of interneurons' development represent the most probable pathogenetic mechanisms underlying the autistic phenotype in Fragile X-Syndrome and Tuberous Sclerosis Complex. Chromosomal abnormalities and potential candidate genes are strongly implicated in the disruption of neural connections, brain growth, and synaptic/dendritic morphology. Conclusion. Metabolic testing may be appropriate if specific symptoms are present. High-resolution chromosome analysis may be recommended if a specific diagnosis is suspected because of obvious dysmorphisms. Identifying cryptic chromosomal abnormalities by whole genome microarray analysis can increase the understanding of the neurobiological pathways to autism.

Comments: Full text of article available by clicking on title above. DM

New Journals in Pubmed

The following new journals from Hindawi have been added to PubMed Central:

International Journal of Pediatric Endocrinology
ISSN: 1687-9848 (print) 1687-9856 (electronic)
http://www.ncbi.nlm.nih.gov/pmc/journals/987/
Archive includes: v. 2009(2009).
Note: There is no embargo delay for this title.

Advances in Hematology
ISSN: 1687-9104 (print) 1687-9112 (electronic)
http://www.ncbi.nlm.nih.gov/pmc/journals/993/
Archive includes: v. 2009(2009).
Note: There is no embargo delay for this title.

International Journal of Endocrinology
ISSN: 1687-8337 (print) 1687-8345 (electronic)
http://www.ncbi.nlm.nih.gov/pmc/journals/995/
Archive includes: v. 2009(2009).
Note: There is no embargo delay for this title.

International Journal of Pediatrics
ISSN: 1687-9740 (print) 1687-9759 (electronic)
http://www.ncbi.nlm.nih.gov/pmc/journals/996/
Archive includes: v. 2009(2009).
Note: There is no embargo delay for this title.

Curbing Mom's Smoking, Childhood Lead Exposure May Be Key to Preventing ADHD

Attention deficit hyperactivity disorder takes a huge toll on children, with about 9 percent of kids ages 8 to 15 displaying diagnosable symptoms of inattention, hyperactivity, and impulsive behavior that can make schoolwork an ordeal and friendships trying. Maternal smoking and lead exposure in early childhood might be behind nearly 40 percent of ADHD cases, according to new research. If that turns out to be true, it may be possible to prevent many cases of ADHD and reduce the huge social, financial, and personal toll of the disorder.

Refractive Errors and Strabismus in Children With Tuberous Sclerosis: A Controlled Study

...A high prevalence of hypermetropia seems to be an additional feature of tuberous sclerosis. Early screening for this amblyogenic factor is indicated in patients with tuberous sclerosis.

Effect of different anesthetic agents on oculocardiac reflex in pediatric strabismus surgery

...Propofol or remifentanil anesthesia was associated with a higher incidence of OCR during pediatric strabismus surgery than sevoflurane and desflurane anesthesia, when either ketamine or midazolam was used as an induction agent.

Comments: Strabismus surgery all though relatively common, does have risks. parents should know what they are. D<

Childhood Abuse may Speed up Aging

...Researchers from Butler Hospital and Brown University found a direct connection between childhood trauma and accelerated reduction in the size of telomeres, the caps on the end of chromosomes that promote cellular stability. Telomeres typically shorten with age. After measuring DNA extracted from blood samples of 31 adults, researchers found accelerated shortening of telomeres in those who reported suffering abuse as kids, compared to those who did not report abuse. ...

Day Care May Double TV Time For Young Children

...the amount of television viewed by many young children in child care settings doubles the previous estimates of early childhood screen time, with those in home-based settings watching significantly more on average than those in center-based daycares. This study is the first to examine screen time in child care settings in more than 20 years. The study looked at television use in 168 child care programs in four states,...

Drug Studied As Possible Treatment For Spinal Injuries

...Researchers have shown how an experimental drug might restore the function of nerves damaged in spinal cord injuries by preventing short circuits caused when tiny "potassium channels" in the fibers are exposed.

The chemical compound also might be developed as a treatment for multiple sclerosis. ...

Phthalates, Common Plastics Chemicals, Linked To ADHD Symptoms

...A new report by Korean scientists, published by Elsevier in the November 15th issue of Biological Psychiatry, adds to the potentially alarming findings about phthalates. They measured urine phthalate concentrations and evaluated symptoms of attention-deficit/hyperactivity disorder (ADHD) using teacher-reported symptoms and computerized tests that measured attention and impulsivity.

They found a significant positive association between phthalate exposure and ADHD, meaning that the higher the concentration of phthalate metabolites in the urine, the worse the ADHD symptoms and/or test scores. ...

Central Corneal Thickness in Children With Diabetes

Diabetic patients have a significantly increased (~55 µm) central corneal thickness compared with healthy controls. Current HbA1C value, which is the marker of metabolic control of the disease, is the only disease-related variable that predicts a higher central corneal thickness. [J Refract Surg. 2009;25:1041-1044.]

Tuesday, November 24, 2009

The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorders

Comment: This paper is so important that it should be mandatory reading for all interested in optometric vision therapy. Click on the title for the full text. DM

Background: For nearly 75 years, optometric vision therapy has been an important mode of therapy for both children and adults who manifested a range of nonstrabismic accommodative and vergence disorders.

Methods: In this article, the scientific basis for, and efficacy of,optometric vision therapy in such patients will be discussed. Using bio-engineering models of the oculomotor system as the conceptual framework, emphasis will be focused on studies that used objective recording techniques to directly assess therapeutically related changes in oculomotor responsivity.

Results and Conclusions: The findings clearly support the
validity of optometric vision therapy. Furthermore, the results
are consistent with the tenets of general motor learning.

Computer Gaming for Vision Therapy

...Abstract—Convergence insufficiency is characterized by an inability to maintain effortless alignment of the two eyes (binocular convergence) while performing near tasks. Conventional rehabilitative vision therapy for the condition is monotonous and dull, leading to low levels of compliance. If the therapy is not performed then improvements in the condition are unlikely. This paper examines the use of computer games as a new delivery paradigm for vision therapy, specifically at how they can be used in the treatment of convergence insufficiency while at home. A game was created and tested in a small scale clinical trial. Results show clinical improvements, as well as high levels of compliance and motivation. Additionally, the game was able to objectively track patient progress and compliance.

Comments: Full text of the article is available by clicking on the title. DM

Visual and Perceptual Problems after a Brain Injury

...Although vision problems may not be the most noticeable barrier after a brain injury, they do affect your ability to move and complete your daily tasks. For example, our eyes notice that we are about to step on ice in the parking lot. Our visual system processes this information. We change the speed and direction of our feet to avoid the ice. Or, if we want to pick up a glass of water, our eyes move to locate the glass and focus on it. The brain processes this information. It moves your open hand to the glass. It grasps it and picks it up so you can take a drink....

Improvements in performance following optometric vision therapy in a child with dyspraxia

Abstract
SS, an 8-year-old boy with dyspraxia, presented for behavioural optometry assessment. He had been diagnosed with a subtle form of dyspraxia by his paediatric occupational therapist, based on poor proprioception, delayed bilateral integration and poor visual perception. A full visual assessment was carried out. SS was given a programme of reflex inhibition exercises for 3 months. Then, a programme of optometric vision therapy (OVT) exercises was prescribed at home and in practice for
a period of 8 months. SS was assessed using a battery of occupational therapy Sensory Integration and Praxis Tests (SIPT) before optometric intervention, and after OVT. There were significant improvements in fusional reserves, accommodative facility and oculomotor control of pursuit and saccadic eye movements. His reading level had changed by 4 years in 11 months. The SIPT results showed improvements in the visual and motor/visual perception subtests, confirming the significant
changes in visual perceptual performance. Consideration is given to treatment modalities for dyspraxia, and the studies confirming their effectivity of approach. This case study provides evidence supporting the use of OVT eye exercises in dyspraxia, ocular motility, accommodative dysfunction, learning difficulties and sports performance. The need for further research and inter-professional
working is discussed.

Comments: Full text of article is available by clicking on the title. DM

Efficacy of Vision Therapy

...Negative feedback control theory analysis of the accommodative and vergence systems provides the basis of today’s optometric vision therapy. These models have a strong physiological and anatomical basis, and have been described in numerous articles and textbooks.5-7 Computer simulations using control theory demonstrates the predictability of both the accommodative and vergence systems. Defects in any component of the system may result in asthenopia, diplopia, and/or strabismus.8 The most common cause of asthenopia is related to inadequate slow vergence. Vision therapy differs from orthoptic models in that control theory analysis acknowledges the dynamic interaction of accommodation and vergence, and its respective feedback mechanisms....

Vision Therapy Fact Sheet

..Vision therapy is a program that aims to improve a person’s visual abilities. It uses a variety of means - such as eye therapy procedures, testing, occlusion (patching) lenses and prisms - to treat a range of visual problems. Vision therapy may be used to treat problems such as amblyopia (lazy eye), eye alignment and coordination problems (including turned eyes or squints), poor focus or inadequate eye-hand coordination. Each program is designed to suit the specific needs of the individual...

DEFINITION OF OPTOMETRIC VISION THERAPY

Vision therapy is a sequence of neurosensory and neuromuscular activities individually prescribed and monitored by the doctor to develop, rehabilitate and enhance visual skills and processing. The vision therapy program is based on the results of a comprehensive eye examination or consultation, and takes into consideration the results of standardized tests, the needs of the patient, and the patient’s signs and symptoms. The use of lenses, prisms, filters, occluders, specialized instruments, and computer programs is an integral part of vision therapy. The length of the therapy program varies depending on the severity of
the diagnosed conditions, typically ranging from several months to longer periods
of time. Activities paralleling in-office techniques are typically taught to the
patient to be practiced at home, thereby reinforcing the developing visual skills.
Research has demonstrated vision therapy can be an effective treatment option
for:
• Ocular motility dysfunctions (eye movement disorders)
• Non-strabismic binocular disorders (inefficient eye teaming)
• Strabismus (misalignment of the eyes)
• Amblyopia (poorly developed vision)
• Accommodative disorders (focusing problems)
• Visual information processing disorders, including visual-motor integration
and integration with other sensory modalities
• Visual sequelae of acquired brain injury

Approved by the American Optometric Association Board of Trustees, April 2009

VISION THERAPY Information for Health Care and Other Allied Professionals

...Society places a premium on efficient vision. Schools and most occupations require increasing amounts of printed and computer information to be handled accurately and in shorter periods of time. Vision is also a major factor in sports, crafts, and other pastimes. The efficiency of our visual system influences how we collect and process information. Repetitive demands on the visual system tend to create problems in susceptible individuals. Inefficient vision may cause an individual to slow down, be less accurate, experience excessive fatigue, or make errors. When these types of signs and symptoms appear, the individual’s conscious attention to the visual process is required. This, in turn, may interfere with speed, accuracy, and comprehension of visual tasks. Many of these visual dysfunctions are effectively treated with vision therapy....

Vision issues and children…

... * 80 percent of all learning during a child’s first 12 years is obtained through vision. Journal of Behavior Optometry, Visual Screening of Adjudicated Adolescents, Vol. 10, No. 1, 1999.
* Vision disorders are the fourth most common disability in the United States and the most prevalent handicapping condition in children. Current Ophthalmology Vol. 43, No. 5 March-April 1999, A Survey
of Vision Screening Policy of Preschool Children in the United States. 
* The Journal of the American Public Health Association reports that 10% of pre-schoolers have vision deficiencies. This figure increases in grades K through 6 to 25% or one-in-four Pennsylvania children. The prevalence of vision disorders is even higher in children at risk or special needs children, Journal of the American
Public Health Association.
* The National Parent Teacher Association reports that more than ten million children suffer from
visual problems, yet vision exams still are not a part of a child’s school readiness package. American
Foundation for Vision Awareness, Children’s Vision and Literacy Campaign.
* Vision problems are also associated with the inability to master higher math concepts, reading comprehension and spelling. This is a very important part of vision in that approximately 75% of every school day is spent reading and writing. American Optometric Association, Pediatric Eye and Vision Examination, Optometric Clinical Practice Guideline, 1994.
* Research indicates that among the 20 percent of school age children who have a learning disability in reading, 70 percent of them have some form of visual impairment, such as ocular motor,perception or binocular dysfunction, which may be interfering with their reading skills. Optometry,The Journal of the American Optometric Association, Practice Strategies: Back to School, Vol 71, No. 8 August
2000.
* Children with vision-related learning problems revealed that they were experiencing feelings such as a lack of direction, a sense of not belonging, an inadequate sense of self-assurance and a feeling of insecurity, inadequacy and inferiority. Joel N. Zaba, Vision’s relationship to delinquency, illiteracy and learning problems, 2001....

Are We Making Ourselves Stupider?

...Today we absorb much of our knowledge through the internet, an act which requires little more than the click of a mouse. Schools have little money for classes that require thinking and moving, such as classes in the visual arts, acting, or music. Laboratories courses, emphasizing hands-on activities, are cut from our science curriculum. If we divorce our learning from our actions, will we lose important ways of thinking? After all, we were built to move, not for the mouse click....

Autism treatments: Risky alternative therapies have little basis in science

...Studies have shown that up to three-quarters of families with children with autism try alternative treatments, which insurance does not usually cover. Doctors, many linked to the influential group Defeat Autism Now!, promote the therapies online, in books and at conferences....

Omnibus autism decision: ‘Good science wins out in the end

...On Feb. 12, 2009, a court of special masters ruled that the combination of measles-mumps-rubella and thimerosol-containing vaccine does not cause autism. The ruling involved three test families who have children with autism. The families contended their children’s autism was triggered by a combination of the measles, mumps, rubella vaccines and the preservative thimerosal and were seeking to be compensated through the Vaccine Injury Compensation Program. ...

3 Most Common Mistakes: Children’s Vision

1. Confusing those school screenings with eye exams.

2. Relying on your child's opinion of their eyesight.

3. Leaving the sunglasses behind.

Stunning Stereoviews: Historical Photos Show Past in 3D

...The opportunity to catch a glimpse at life in a long-ago era in 3D is rare indeed, but thanks to the stereoviews taken by photographer T. Enami, Meiji Japan in the early 1900s momentarily appears vivid and immediate. Enami was Japan’s most prolific stereo-photographer...

Comment: This is absolutely amazing! No special glasses need. You will enjoy this very much! DM

NIMH Study Finds Anti-Psychotic Medication Useful in Treating Serious Behavioral Problems among Children with Autism

..."Although this study did not attempt to treat the core symptoms of autism, our findings suggest that risperidone can be useful in treating moderate to severe behavior problems that are associated with autism in children," said Lawrence Scahill, Ph.D., principal investigator at the Yale Child Study Center site....

Comments: Many of my patients who have both intellectual disability and a psychiatric diagnosis are taking risperidone. Potential side effects include tardive dyskinesia, stroke, and various visual disturbances. This is not a drug to be taken lightly. DM

Autism Spectrum Disorders (Pervasive Developmental Disorders)

Autism Spectrum Disorders (Pervasive Developmental Disorders)

What are Autism Spectrum Disorders?
Autism Spectrum Disorders (ASD), also known as Pervasive Developmental Disorders (PDDs), cause severe and pervasive impairment in thinking, feeling, language, and the ability to relate to others. These disorders are usually first diagnosed in early childhood and range from a severe form, called autistic disorder, through pervasive development disorder not otherwise specified (PDD-NOS), to a much milder form, Asperger syndrome. They also include two rare disorders, Rett syndrome and childhood disintegrative disorder.


Comments: Click on the title for a great deal of info on Autism from the National Institute of Mental Health. DM

Lead, Tobacco Linked to ADHD

...Prenatal tobacco and childhood lead exposures are associated with increased risks of attention deficit hyperactivity disorder (ADHD), researchers said.

Moreover, the two exposures were are synergistic: together they yield an ADHD risk increase that is greater than the product of the risk factors for lead and tobacco individually, according to Tanya Froehlich, MD, of the Cincinnati Children's Hospital Medical Center, and colleagues....

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