What is an Optometrist?

Optometrist: A health care professional who is licensed to provide primary and specialized eye and vision care services:

• to examine and diagnose eye diseases such as dry eye, conjunctivitis, glaucoma, cataracts, and retinal diseases and to treat or refer them as is appropriate;
• to diagnose related systemic (bodywide) conditions such as hypertension and diabetes that may affect the eyes;
• to examine, diagnose and treat refractive conditions such as nearsightedness, farsightedness, astigmatism and presbyopia;
  
• to examine, diagnose and treat disorders of the binocular vision system such as strabismus, amblyopia, convergence insufficiency, and oculomotor dysfunctions
  
• to provide optometric vision therapy for disorders of the binocular vision system and learning related vision disorders and
• to prescribe glasses, contact lenses, low vision rehabilitation and medications as well as perform appropriate surgical procedures such as the removal of foreign bodies.

An optometrist is a Doctor of Optometry, an O.D. (Doctors of Medicine, or MDs are NOT Optometrists.). To become an optometrist, one must complete pre-professional undergraduate college education followed by 4 years of professional education in a college of optometry. Many optometrists also do a residency.

Flu vaccines for all kids, federal panel advises

All children - not just those under 5 - should get vaccinated against the flu, a federal advisory panel said Wednesday.............

5 ways medical physics has changed health care

Many of the greatest inventions in modern medicine were developed by physicists who imported technologies such as X rays, nuclear magnetic resonance, ultrasound, particle accelerators and radioisotope tagging and detection techniques into the medical domain. There they became magnetic resonance imaging (MRI), computerized tomography (CT) scanning, nuclear medicine, positron emission tomography (PET) scanning, and various radiotherapy treatment methods. These contributions have revolutionized medical techniques for imaging the human body and treating disease.

photorefractive keratectomy and laser-assisted subepithelial keratectomy in children

Photorefractive keratectomy and LASEK were effective and stable surgical alternative treatments in children with refractive errors who were unable to tolerate or who failed conventional methods of treatment.

Comment: PRK and LASEK were done under general anesthesia. There is always risk involved when you place children as young as 12 months of age under general anesthesia. Also note that PRK and LASEK significantly affects the thickness of the cornea. As we age, the cornea thins. Since these children will probably have an opportunity to live well into their 70's and 80's, what will happen to these corneas over time? This procedure is NOT for most children...but may be appropriate in limitted cases. DM

Herbal Supplement May Protect Memory After Age 85

Among 118 people 85 or older, those who took the supplement (ginkgo extract ) reliably had a 70% lower risk of developing mild memory problems than those who took a placebo, Hiroko Dodge, Ph.D., of Oregon State University here, and colleagues reported online in Neurology.

Comment: I'm not 85 yet....but will need all the help I can get when I get there! (Actually, my wife says I could use some help in the memory department right now! DM

Google to launch electronic health records project.

Both the Wall Street Journal and Government Health IT have stories about how Google, Microsoft and others will host your personal medical records to share with whomever you think appropriate. Unfortunately, these business' are not held to the HIPPA standards that we are expected to uphold....would advertisers market allergy products to you if they found out you have allergies? Could cause many privacy problems.

Know Your Hymns

My most favorite Nun passed these along to me.

KNOW YOUR HYMNS

Dentist's Hymn............................Crown Him with Many Crowns
Weatherman's Hymn.....................There Shall Be Showers of Blessings
Contractor's Hymn.......................The Church's One Foundation
The Tailor's Hymn.........................Holy, Holy, Holy
The Golfer's Hymn........................There's a Green Hill Far Away
The Politician's Hymn.....................Standing on the Promises

Optometrist's Hymn......................Open My Eyes That I Might See

The IRS Agent's Hymn...................I Surrender All
The Gossip's Hymn........................Pass It On
The Electrician's Hymn...................Send The Light
The Shopper's Hymn.....................Sweet Bye and Bye
The Realtor's Hymn.......................I've Got a Mansion, Just Over the Hilltop
The Massage Therapists Hymn.........He Touched Me
The Doctor's Hymn.......................The Great Physician

And for those who speed on the highway - a few hymns:
45 mph........................................God Will Take Care of You
65 mph........................................Nearer My God To Thee
85 mph........................................This World Is Not My Home
95 mph........................................Lord, I'm Coming Home
100 mph......................................Precious Memories

Give me a sense of humor, Lord,
Give me the grace to see a joke,
To get some humor out of life,
And pass it on to other folk.

---

Brain Blogger

Since you’re pretty much on your own once they tell you you’re recovered, I’m dedicating this topic to everyone who is supposedly recovered, but who do not have functional lives yet. If this isn’t you, please keep reading, because it’s bound to be someone you know sooner or later.

Comment: All too often he missing peace is optometric vision therapy.
DM

Autism's origins: Mother's antibody production may affect fetal brain

The mothers of some autistic children may have made antibodies against their fetuses’ brain tissue during pregnancy that crossed the placenta and caused changes that led to autism, suggests research led by Johns Hopkins Children’s Center investigators and published in the February issue of the Journal of Neuroimmunology.

The causes of autism, a disorder manifesting itself with a range of brain problems and marked by impaired social interactions, communication disorders and repetitive behaviors, remain unknown for an estimated 90 percent of children diagnosed with it. Genetic, metabolic and environmental factors have been implicated in various studies of autism, a disorder affecting 1 in 150 U.S. children, according to estimates by the Centers for Disease Control and Prevention.

Comment: Autism's etiology continues to be a mystery. Click on the title to read the full story. DM

TV Could Be Disrupting Your Kid's Sleep

It may seem like a good idea: Use a bit of TV viewing to help your young child get to sleep.
But a growing body of research is finding that infants and children under the age of 3 who watch TV -- even too much TV during the day -- struggle with interrupted sleep and irregular bed and naptime schedules.

Comment: For more info click on the title above. DM

LASIK failure toll can be high

Comment: Besides the problems noted in this story, I've also seen patients develope binocular vision problems (strabismus, convergence excess, etc) as well. Please recommend that all LASIK patients have a comprehensive binocular vision assessment before surgery. DM

FDA to study effects of complications from eye surgery; some blame them for depression, suicide

Patients who undergo vision-correcting laser eye surgery sign a release form with an extensive list of risks, but some researchers and former patients say a potential complication is not mentioned: depression that can lead to suicide...."Frustration and sorrow can follow any unsuccessful surgery, but when the procedure leaves a patient with unremitting eye pain or permanently impaired vision, the emotional toll can be severe."

Retinopathy of Prematurity

Fleck BW et al. - Retinopathy of Prematurity (ROP) occurs when premature birth interrupts normal retinal vascular development. Postnatal tissue oxygen levels are significantly higher than those present in utero. Oxygen therapy further increases oxygen levels in the developing retina.

Prematurity and Amblyopia

O'Connor A et al. - There are numerous reports of an increase in refractive errors and amblyogenic factors in the low birth weight population relative to children born at full term. One key aspect of a screening programme is the age at testing as this dictates the possible tests used which impacts on the efficacy. However, although the prevalence of strabismus and refractive errors is well documented the development of these conditions is poorly understood so for this and other reasons it is difficult to devise the most effective screening programme.

Ametropia, Preschoolers' Cognitive Abilities, and Effects of Spectacle Correction

Comment: Have your young child's eye examined immediately. Wearing glasses improves visual motor function! DM

Ametropia, Preschoolers' Cognitive Abilities, and Effects of Spectacle Correction . nne-Catherine Roch-Levecq, PhD; Barbara L. Brody, MPH; Ronald G. Thomas, PhD; Stuart I. Brown, MD Arch Ophthalmol. 2008;126(2):252-258.

Objectives To examine cognitive abilities of low-income preschoolers with uncorrected ametropia and effects of spectacle correction.
Methods Baseline and 6-week data from a longitudinal controlled study were analyzed. Subjects were 70 preschoolers (mean age, 4.6 years; 60.0% were female; and 85.7% were Latino), including 35 children with previously uncorrected ametropia and 35 emmetropic control subjects. Ametropia was defined as bilateral hyperopia of 4.00 diopters (D) or more in children aged 3 to 5 years, astigmatism of 2.00 D or more in children aged 3 years and 1.50 D or more in children aged 4 and 5 years, or a combination of both. Emmetropia was defined as 2.00 sphere diopters or less and 1.00 cylinder diopter or less in both eyes. Ametropes were assessed before and 6 weeks after correction and compared with control subjects. Primary and secondary outcome measures were Beery-Buktenica Developmental Test of Visual-Motor Integration and Wechsler Preschool and Primary Scale of Intelligence-Revised scores, respectively.
Results At baseline, uncorrected ametropes scored significantly lower on the Beery-Buktenica Developmental Test of Visual-Motor Integration (P = .005) and the Wechsler Preschool and Primary Scale of Intelligence-Revised performance scale (P = .01). After 6 weeks of correction, the ametropic group significantly improved on the Beery-Buktenica Developmental Test of Visual-Motor Integration compared with emmetropic control subjects (P = .02).

Conclusions Preschoolers with uncorrected ametropia had significant reduction in visual-motor function. Wearing spectacles for 6 weeks improved Beery-Buktenica Developmental Test of Visual-Motor Integration scores to emmetropic levels.

Government Concedes Vaccine-Autism Case in Federal Court - Now What?

After years of insisting there is no evidence to link vaccines with the onset of autism spectrum disorder (ASD), the US government has quietly conceded a vaccine-autism case in the Court of Federal Claims.

Comment: I'm not convinced just yet. You can settle a legal case for many reasons. No research that I know of indicates mercury as a cause of autism. DM

Myopia Research

Myopia Research

Gwiazda J, Hyman L, Dong LM, Everett D, Norton T, Kurtz D, Manny R, Marsh-Tootle W, Scheiman M; Comet Group. Factors associated with high myopia after 7 years of follow-up in the Correction of Myopia Evaluation Trial (COMET) Cohort. Ophthalmic Epidemiol. 2007 Jul-Aug;14(4):230-7.

Mutti DO, Hayes JR, Mitchell GL, Jones LA, Moeschberger ML, Cotter SA, Kleinstein RN, Manny RE, Twelker JD, Zadnik K; CLEERE Study Group. Refractive error, axial length, and relative peripheral refractive error before and after the onset of myopia. Invest Ophthalmol Vis Sci. 2007 Jun;48(6):2510-9.

Subramaniam SV, Bennett ES, Lakshminarayanan V, Morgan BW.Gas permeable (GP) versus non-GP lens wearers: accuracy of orthokeratology in myopia reduction. Optom Vis Sci. 2007 May;84(5):417-21

Fan DS, Lam DS, Chan CK, Fan AH, Cheung EY, Rao SK. Topical atropine in retarding myopic progression and axial length growth in children with moderate to severe myopia: a pilot study.
Jpn J Ophthalmol. 2007 Jan-Feb;51(1):27-33. Epub 2007 Feb 9.

Adler D, Millodot M. The possible effect of undercorrection on myopic progression in children.
Clin Exp Optom. 2006 Sep;89(5):315-21.

Research on Convergence Insufficiency

Maples WC, Hoenes R. Near point of convergence norms measured in elementary school children. Optom Vis Sci. 2007 Mar;84(3):224-8.

Marran LF, De Land PN, Nguyen AL. Accommodative insufficiency is the primary source of symptoms in children diagnosed with convergence insufficiency. Optom Vis Sci. 2006 May;83(5):281-9.

Scheiman M, Cotter S, Rouse M, Mitchell GL, Kulp M, Cooper J, Borsting E; Convergence Insufficiency Treatment Trial Study Group. Randomised clinical trial of the effectiveness of base-in prism reading glasses versus placebo reading glasses for symptomatic convergence insufficiency in children. Br J Ophthalmol. 2005 Oct;89(10):1318-23.

Scheiman M, Mitchell GL, Cotter S, Kulp MT, Cooper J, Rouse M, Borsting E, London R, Wensveen J. A randomized clinical trial of vision therapy/orthoptics versus pencil pushups for the treatment of convergence insufficiency in young adults. Optom Vis Sci. 2005 Jul;82(7):583-95.

Scheiman M, Mitchell GL, Cotter S, Cooper J, Kulp M, Rouse M, Borsting E, London R, Wensveen J; Convergence Insufficiency Treatment Trial Study Group. A randomized clinical trial of treatments for convergence insufficiency in children. Arch Ophthalmol. 2005 Jan;123(1):14-24.

Rouse MW, Borsting E, Hyman L, Hussein M, Cotter SA, Flynn M, Scheiman M, Gallaway M, De Land PN. Frequency of convergence insufficiency among fifth and sixth graders. The Convergence Insufficiency and Reading Study (CIRS) group. Optom Vis Sci. 1999 Sep;76(9):643-9.

Birnbaum MH, Soden R, Cohen AH. Efficacy of vision therapy for convergence insufficiency in an adult male population. J Am Optom Assoc. 1999 Apr;70(4):225-32.

Rouse MW, Hyman L, Hussein M, Solan H. Frequency of convergence insufficiency in optometry clinic settings. Convergence Insufficiency and Reading Study (CIRS) Group.Optom Vis Sci. 1998 Feb;75(2):88-96.

Reading disability and oculomotor problems

Verbal and visual problems in reading disability.

These results provide further support for the hypothesis that reading disability may...result from dysfunction of the visual and oculomotor systems.

Colored filters do not improve reading

Failure of blue-tinted lenses to change reading scores of dyslexic individuals.

...Among this population of dyslexic students, tinted lenses appeared to provide no beneficial effect....

Improving reading with optometric vision therapy

Coherent motion threshold measurements for M-cell deficit differ for above- and below-average readers.

The outcome of this preliminary study provides an efficient procedure to identify sixth-grade students whose reading disability may be associated with an M-cell deficit. Our previous investigations involving visual processing, visual attention, and oculomotor therapy have resulted in significant improvements in reading comprehension, visual attention, and eye movements.

Vision therapy improves reading

M-cell deficit and reading disability: a preliminary study of the effects of temporal vision-processing therapy.

This study supports the vision therapy for children identified as moderately reading disabled.

The prevalence of specific reading disability in an amblyopic population. A preliminary report.

...strabismic amblyopia and presence of suppression may have an adverse effect on phonological skills....

Comment: Vision can affect performance. DM

Shining the light on mental fog

Clear away the brain fog.
It can feel like a mist shrouding a person’s consciousness, creating a feeling of not being quite all there. People who complain of “brain fog” have frequent bouts of feeling scattered, forgetful, unfocused and confused when faced with simple decisions. Productivity dips....

Comments: Most of us probably feel this way from time to time. Read this to find out why this may be.... DM

Six-minute nap 'may boost memory'

Even the shortest of catnaps may be enough to improve performance in memory tests, say German scientists.

Comment: Now my wife knows why I take a cat-nap in front of the TV every now and then. DM

25% of Disabled Readers have poor Visual Skills

ADHD Treatment Effective for Fragile X Syndrome

All About Down Syndrome

Down syndrome
The Chromosomal Basis of Down syndrome
The Occurrence of Down syndrome
Prenatal Screening and Diagnostic Testing
A Diagnosis of Down syndrome
Down syndrome and Associated Medical Disorders
NewbornsInfants and Preschool Children
Early Intervention and Education
Adolescence and Down syndrome
Adults with Down syndrome
Down syndrome in the Workplace
Future Research in Down syndrome
Questions and Answers about Down syndrome
Additional Resources for Information on Down syndrome

Antioxidants Do Not Help Children With Down's Syndrome

Giving children with Down’s syndrome antioxidants and nutrients does not help their condition improve at all, according to a study that was recently published.

Binocular photophobia after surgical treatment

Lew H, Kim CH, Yun YS, Han SH. Binocular photophobia after surgical treatment in intermittent exotropia. Optom Vis Sci. 2007 Dec;84(12):1101-3.

PURPOSE: This study examined the rate of binocular photophobia in intermittent exotropia patients before surgical correction, and the factors affecting this rate. The study also investigated the factors affecting postsurgical disappearance of binocular photophobia.

METHODS: The study involved 162 basic type intermittent exotropia patients who underwent surgical correction between March 2001 and January 2006. The study did not include patients with entropion, congenital cataract, or retinal abnormalities. Parents of the patients were questioned to determine which patients had monocular eye closure in bright light and which had disappeared after bilateral lateral rectus recession. Data was analyzed to determine the factors affecting monocular eye closure before surgery and disappearance after surgery.

RESULTS: Of 162 patients, 96 patients had binocular photophobia (60.2%). Photophobia was found to be associated with an angle of exodeviation at distance >25 Prism Diopter (Delta) (p 3D 0.02), and stereoacuity worse than 60 s (p 3D 0.02). We defined satisfactory surgical outcome as a deviation of <10>.

Comment: Surgical intervention can have unwanted side effects. Please ask your ophthalmic surgeon about these unwanted side effects before having any surgery. DM

Patching for Amblyopia

Objectively monitored patching regimens for treatment of amblyopia: randomised trial

Participants: 97 children with a confirmed diagnosis of amblyopia associated with strabismus, anisometropia, or both.

Conclusions Substantial (six hours a day) and maximal (12 hours a day) prescribed occlusion results in similar visual outcome. On average, the occlusion dose received in the maximal group was only 50% more than in the substantial group and in both groups was much less than that prescribed. Younger children required the least occlusion.

Comment: Recent studies suggest that as little as 2 hours of patching a day with active therapy is also very effective. DM

Computer Vision Syndrome

Though it will probably never lead to a world-wide ban of computers, an estimated 40 percent to 70 percent of computer users suffer from dry, irritated eyes associated with Computer Vision Syndrome. The good news is that it can be treated.

Focus on Lazy Eye

The bottom line with lazy eye is clear. ...If you get to it early enough you can almost always treat it...

Older Children More Likely to Develop Vision Disorders

In a study of more than 6,000 Los Angeles-area children - the largest study of its kind - researchers at the Keck School of Medicine of the University of Southern California (USC) found that both strabismus (commonly known as cross-eyed or wall-eyed) and amblyopia (often referred to as lazy eye) were more prevalent in older children than in younger children.

Vision is Critical for Child Development

...When it comes to early childhood development, vision is critical. Experts estimate the 80 to 90 per cent of early learning takes place through vision, placing visually impaired youngsters at risk of experiencing significant developmental delays.

That’s because a person’s visual system involves much more than the eyes; it interacts with the body’s muscles to develop reaching, crawling, grabbing and walking skills in infants and children. In fact, two-thirds of the functions of the brain are associated with vision....

TURN OFF THE TV TO SAVE CHILDREN’S EYES

CHILDREN’S reading and learning abilities are being damaged by computer games and television, eye specialists warned last night

Cortical Visual Impairment

Cortical visual impairment is a condition in which the eyes are functionally working, but the information isn't properly processed by the brain, interfering with the ability to interpret the image. The range of impairment can vary from severe to total blindness.

Maximizing BrainWare Safari

Maximizing Your BrainWare Experience

by Dominick Maino, OD, MEd, FAAO, FCOVD-A

In order to maximize the effects of BrainWare Safari software, you may need to ensure that your child’s visual system is working correctly. The areas that should be assessed by your pediatric optometrist include: Visual Acuity, Refractive Error, Binocularity and Eye Health. (Originally published in BrainWare Bulletin May 2007)

Visual Acuity
The measurement of Visual Acuity is used to determine how clear your vision is at all distances. If you are farsighted, nearsighted or have astigmatism1, your eye sight may not be clear enough to allow you to maximize the learning effects of BrainWare Safari. Your vision will not only be “fuzzy” but can also lead to visual discomfort, fatigue, and headaches, as well as an avoidance of many near tasks such as reading or using a computer.

Refractive Error
Refractive Error is the amount of myopia (nearsightedness), hyperopia (farsightedness) and astigmatism you may have. All three of these vision disorders can affect how well and comfortably you see. All three can be easily corrected by using appropriately prescribed eye glasses.

Binocularity
An assessment of Binocularity or eye teaming often includes an evaluation of the quality of eye movements (saccades2 and visual tracking/pursuits), eye coordination (convergence/divergence), focusing (the ability to maintain clear vision at near), depth perception (3D vision) and many other functional vision areas. If any of these visual skills are poor, you can experience double vision, headaches, blur at near and many other symptoms that would make using a computer difficult. Your optometrist may recommend special glasses, optometric vision therapy or other treatment options to correct many of these problems.

Eye Health
Although eye health problems in children are usually rare, the more frequently seen problems include “pink eye” (conjunctivitis) and ocular allergies. Conjunctivitis can be caused by viruses, bacteria and allergies. Allergies, for instance, typically result in itchy, watery eyes that make concentrating on any activity very difficult. Your pediatric optometrist can diagnosis and treat these problems so that your child can see clearly and comfortably.

School Vision Screenings
School Vision Screenings frequently miss many of the potential problems noted above. Only a comprehensive eye and vision examination will make sure your child is ready for everything
BrainWare Safari has to offer.

If you want to maximize the benefits of BrainWare Safari, you should make sure your children’s eyes see clearly, work together appropriately and are healthy. For additional information on this topic, use your Internet connection to go to the following websites:

Northwest Optometric Associates http://www.nw.optometry.net
Blogs http://www.mainosmemos.blogspot .com
College of Optometrists in Vision Development http://www.covd.org
Vision 3D http://www.vision3d.com
Parents Active for Vision Education http://www.pavevision.org
Children Special Needs Org http://www.children-special-needs.org
Finding a Pediatric Optometrist http://www.vision-therapy.com
Optometric Extension Program Foundation http://www.oep.org
American Optometric Association http://www.aoa.org
All About Vision http://www.allaboutvision.com


Dr. Dominick Maino is a Professor of Pediatrics at the Illinois College of Optometry/Illinois Eye Institute in Chicago. He is also in private practice (Northwest Optometric Associates) in Harwood Heights, Il. (www.nw.optometry.net). Dr. Maino has no financial interest in BrainWare

1 Astigmatism occurs when the front surface of the eye is not perfectly round.
2 Saccades are reading eye movements.