Monday, September 7, 2009

The Etiology of Autism

Maino DM, Viola, SG, Donati R. The Etiology of Autism. Optom Vis Dev 2009:(40)3:150-156.

A single etiology for autism or for any of the disorders on the autistic spectrum has yet to be determined. In the past, suspected causes of these disorders included parentally induced autism, brain injury/anomalies, constitutional vulnerability, and developmental aphasia, as well as deficits in the reticular activating system, and an unfortunate interplay between psychogenic and neurodevelopmental factors. Other suspected etiologies are structural cerebellar changes, genetics, viral infections, and immunological abnormalities, with various teratogens, seizures and vaccines also being investigated. Until we know the multiple etiologies of those within the Autism Spectrum; as researchers, health care providers, educators and optometrists, we must offer all within the autistic continuum the very best, most current and accessible care available based upon the latest known science.

Comments: This paper is available on line by clicking the title above. DM

Brain Anatomy, Electrophysiology and Visual Function/Perception in Children within the Autism Spectrum Disorder

Viola SG, Maino DM. Brain anatomy, electrophysiology and visual function/perception in children within the autism spectrum disorder. Optom Vis Dev 2009;40(3):157-163.

Background: Autism Spectrum Disorders (ASD) affects as many as one in 150 children. These individuals experience significant impairments in social interaction, communication, cognition, and behavioral functioning. Neuroimaging technologies have been utilized during the past twenty years to examine brain anatomy and physiology in individuals with autism to obtain a better understanding of the disorder. Methods: More than seventy-five published articles and papers on the topics of brain anatomy, electrophysiology, and visual function/perception in children with ASD were reviewed. Neurobiological findings include structural abnormalities in the amygdale, hippocampus, corpus callosum, frontal, temporal, and parietal cortex, and the cerebellum. Neurochemistry findings include a wide array of transmitter systems that may contribute to ASD including serotonin, dopamine, acetylcholine, and brain-derived neurotropic factor. There have also been several empirical demonstrations of decreased and enhanced visual abilities of individuals with autism including abilities in visual acuity, refractive error,pursuits and saccades, and strabismus. Conclusions: Individuals with ASD have numerous neuro-anatomical, neurophysiological, neuropsychological, cognitive and other anomalies that can affect the oculomotor system, vision information processing/visual perception, and the development of refractive error that may require intervention. Optometrists with experience in applying the concepts of behavioral, functional and developmental optometry to patient care should be integral members of the diagnostic and treatment team for individuals with autism.

Comments: This paper is available on line by clicking the title above. DM

Insights into the Diagnosis and Treatment of Patients within the Autism Spectrum: A Patient’s Story

Torgerson NG. Insights into optometric evaluations of patients on the autism spectrum. Optom Vis Dev 2009;40(3):176-183.

The incidence of those being diagnosed within the autism spectrum disorder (ASD) appears to be soaring. Those on the spectrum have many sensory issues which include difficulty coping with visual information. With many signs and symptoms associated with ASD, it would be easy to assume that autism itself is the problem and to overlook vision information processing as an important component that produces some of these signs and symptoms. Comprehensive eye and vision evaluations can be challenging for the doctor because of the patient’s lack of ability to communicate in the traditional way of answering questions and giving verbal feedback. The individual with ASD may be fearful and display problematic behaviors. One must be attuned to how each individual communicates and discover what the behaviors may mean. Supplemental probes to traditional optometric clinical methods are needed to insure that visual needs are revealed. Lenses, yoked prisms and vision therapy can be helpful in addressing any vision information processing deficits. Treatment progress should be measured with quality of life changes as well as standard optometric assessment tools. Our patient, NT’s story highlights these challenges. This paper aids the optometrist in obtaining insights into
this disorder and seizing the opportunity to think creatively to help change lives for those within the autistic spectrum.

Comments: This paper is available on line by clicking the title above. DM

Understanding the Visual Symptoms of Individuals with Autism Spectrum Disorder (ASD)

Coulter RA. Understanding the visual symptoms of individuals with autism spectrum disorder (ASD). Optom Vis Dev 2009;40(3):164-175.

Background: Sensory integration problems are frequently found in individuals with Autism
Spectrum Disorders (ASD). In particular, vision is often affected with visual symptoms being pervasive and severe. These visual symptoms are due to an individual’s unique sensory-processing abilities and are biologically based in origin. Review: Ninety-six publications, including research studies, case reports, literature reviews and first-hand accounts were reviewed. Visual symptoms in individuals with ASD are linked to underlying differences in the central nervous system including the visual system. The concept of Individual-Differences
from the Developmental, Individual-Difference, Relationship-based (DIR) model is discussed with regard to vision. Visual differences for individuals with ASD include photosensitivity, hyper- and hyposensitivity, color perception processing, and differences in processing central and peripheral stimuli. Face processing, gaze shifts, visual integration with other senses, and visual closure are affected as well. It has also been noted that motion processing, visual-spatial and visual-motor processing and spatial awareness including visual neglect are also anomalous. Some visual symptoms such as gaze aversion, lateral vision and hand flapping are so intimately associated with ASD, that they are used to screen for and to assist in the diagnose of the condition. A symptom intake form summarizing symptoms associated with these visual differences is provided as a resource. Conclusions: Understanding the link between visual symptoms and their underlying visual differences is important so that the optometrist who cares for patients with ASD can accurately gather information, complete diagnostic testing, interpret results, choose treatments, educate the patient and his or her caregivers and make appropriate referrals when necessary.

Comments: This paper is available on line by clicking the title above. DM

The Role of Optometry in Early Identification of Autism Spectrum Disorders

Press LJ, Richman J. The role of optometry in early identification of autism spectrum disorders. Optom Vis Dev 2009;40(3):141-149.

Autism spectrum disorder (ASD) is a diverse, behaviorally identifiable neurodevelopmental disorder that occurs in 1 in 150 children. The absence of eye contact, unresponsiveness to facial gestures, and/or difficulty in sharing joint visual attention are signs of abnormal or atypical visual development. Optometric utilization of various targets used for diagnostic testing in infants and toddlers may be among the earliest probes of preferred visual looking patterns
conducted with this population. This potentially places Optometry in the vanguard of identifying
infants and young children at risk for developing ASD characteristics.

Comments: This paper is available on line by clicking the title above. DM

Serving the Needs of the Patient with Autism

Coulter RA. Serving the needs of the patient with autism. Optom Vis
Dev 2009;40(3):136-140.
Vision care provided by all members of the College of Optometrists in Vision Development (COVD) is based upon the principle that vision can be improved, enhanced, developed and changed. COVD, as an organization, supports its members by providing education and information to practitioners and by fostering research and scholarship related to vision development. As an organization, it has a responsibility to address an unmet public health need in providing comprehensive eye and vision care to individuals with autism. Many news stories have focused on the rise in the numbers of individuals who are diagnosed with autism. The Centers for Disease and Prevention in 2007 reported that one out of every 150 8-year-olds in multiple areas of the United States had an Autism Spectrum Disorder. What has not been reported as often is that these individuals frequently have severe, persistent visual signs and symptoms.2 Also unacknowledged is the fact that, many of these individuals have not received the same level of optometric vision care that we offer to our other patients. That is, comprehensive care with the goal of providing the patient with single, clear, comfortable, efficient, binocular and pathology free vision.....

Comments: This paper is available on line by clicking the title above. DM

Early brain activity sheds new light on the neural basis of reading


Early brain activity sheds new light on the neural basis of reading

Science Centric (27 Apr 2009 16:21 GMT) - Most people are expert readers, but it is something of an enigma that our brain can achieve expertise in such a recent cultural invention, which lies at the interface between vision and language. Given that the first alphabetic scripts are thought to have been invented only around four to five thousand years it is unlikely that enough time has elapsed to allow the evolution of specialised parts of the brain for reading. While neuroimaging techniques have made some progress in understanding the neural underpinning of this essentially cultural skill, the exact unfolding of brain activity has remained elusive... [full story]


Human brain contains neurones with a preference for whole real words

A new study provides direct experimental evidence that a brain region important for reading and word recognition contains neurones that are highly selective for individual real words. The research, ... provides important insight into brain mechanisms associated with reading and may lead to a better understanding of reading disabilities.

The ability to read is a complex cognitive skill that is thought to depend on neural representations built as a result of experience with written words. 'Although some theories of reading as well as some neuropsychological and experimental data have argued for the existence of a neural representation for whole real words, experimental evidence for such a representation has been elusive,...

Listening to pleasant music could help restore vision in stroke patients


Listening to pleasant music could help restore vision in stroke patients

Science Centric (24 Mar 2009 17:30 GMT) - Patients who have lost part of their visual awareness following a stroke can show an improved ability to see when they are listening to music they like, according to a new study published today in the journal Proceedings of the National Academy of Sciences... [full story]

Correcting poor vision can help preschoolers' performance


Correcting poor vision can help preschoolers' performance

Science Centric (11 Feb 2008 22:01 GMT) - Preschoolers with poor vision have lower scores in developmental testing indicative of success in school performance, but those scores improve significantly within six weeks when the children are given prescription glasses, according to a new study by the University of California, San Diego School of Medicine... [full story]


Comments: Even though I reported this in an earlier post....now that school is here it is important to post once again. Have you children's eyes examined. It is important. Vision screenings often miss the eye problems noted in this study. DM

She's going back to school but can she read?


She's going back to school but can she read?

Science Centric (6 Sep 2009 10:07 GMT) - Five million students will return to Canadian schools this month. If nothing changes at least a million will fail to graduate high school... [full story]

Eye exercises help patients work out vision problems


Eye exercises help patients work out vision problems, UH optometrist says

Science Centric (1 Apr 2009 13:26 GMT) - You've probably been there. In a doctor's office, being advised to do what you dread - exercise. You get that feeling in your gut, acknowledging that, indeed, you should exercise but probably won't. Now imagine that the doctor is your optometrist... [full story]

Brain Development


Researchers identify critical gene for brain development, mental retardation

Science Centric (6 Sep 2009 10:12 GMT) - In laying down the neural circuitry of the developing brain, billions of neurones must first migrate to their correct destinations and then form complex synaptic connections with their new neighbours... [full story]


Researchers restore missing protein in rare genetic brain disorder

UCSF researchers have successfully used protease inhibitors to restore to normal levels a key protein involved in early brain development. Reduced levels of that protein have been shown to cause the rare brain disorder lissencephaly, which is characterized by brain malformations, seizures, severe mental retardation and very early death in human infants.

The findings offer a proof-of-principle, at least in mice, that the genetic equivalent to human lissencephaly, also known as "smooth brain" disease, can be treated during pregnancy and effectively reversed to produce more normal offspring. Findings are reported in the September issue of "Nature Medicine" and found online at http://www.nature.com.

Myopia Control

In the study, children with myopia were randomly assigned to treatment with pirenzepine gel or an inactive placebo gel. After a year of treatment, the average increase in myopia was significantly less for children using pirenzepine. The new study presents the final results in 84 patients who continued treatment for a total of two years: 53 with pirenzepine and 31 with placebo.

Although myopia worsened in both groups of children, the rate of progression was slower with pirenzepine. At the end of two years, myopia increased by an average of 0.58 diopters in children using pirenzepine versus 0.99 diopters with placebo. (All children initially had “moderate” myopia, with an average refractive error of about -2.00 diopters.)

The Eyes Have It: Kids Need Exams Before School Starts

Previous studies have found that 60 percent of children labeled as “problem learners” may actually have undetected vision problems and are sometimes incorrectly diagnosed as having attention-deficit disorder or attention-deficit/hyperactivity disorder, the association noted. (American Optometric Association)

… Schedule an eye exam if you notice that your child:

* Loses their place while reading
* Avoids close work
* Has a tendency to rub their eyes
* Complains of frequent headaches
* Turns or tilts their head when looking at something
* Makes frequent reversals when reading or writing
* Uses a finger to keep their place when reading
* Confuses or omits simple words when reading
* Seems to consistently perform below potential
* Struggles to finish their homework
* Squints while reading or watching television
* Experiences behavioral problems
* Holds reading material too close to their face

Janet's Journal: A Vision First Blog

Ever write a check only to have it returned NSF, Non-Sufficient Funds?
Banks issue NSF charges when account balances don’t cover the amount written on the check.
Today I’m issuing the vision policy by the American Academy of Pediatrics (AAP) my spin on NSF: Non-Sufficient Facts.
August 2009, the AAP updated their 1998 policy on learning disabilities, dyslexia, and vision. The newly released policy statement made by top medical groups refutes vision therapy and the link between vision and learning for the fourth time in four decades. In other words, “Non-Sufficient Facts” abound here!
Here’s my list of the biggest “overdrawn” statements found in that AAP policy balanced by deposits:


Comments: Janet goes on to explain how the AAP policy is deficit in so many ways. Click on the title to read more: DM

Sunday, September 6, 2009

Opera Gala Benefit Concert

I don't normally post personal "stuff" here....but this is just too cool not to post. I will have an opportunity to sing with the very best in September. Those doing solos and duets have been featured at the Chicago Lyric Opera and other opera companies around the USA. I will be in the middle of the choir singing tenor....but heh, that's probably as close as I'll get to the Chicago Lyric Opera House while being on stage!! So if you are in the Chicago area...we'd love to see you at the concert!(DM)

Opera Gala Benefit Concert

Featuring favorite arias, duets and choruses from Rigoletto, The Magic Flute,
La Traviata, Carmen, Norma, Nabucco, Lucia di Lammermoor and Turandot

In a performance by:

Maire O'Brien, Soprano; Kirsten Leslie, Soprano; JeanMarie Garofolo, Soprano; Katherine Kahrmann, Soprano; Lauren Curnow, Mezzo-soprano; John Concepcion, Tenor;
Paul Radulescu, Baritone

The Romanian Madrigal Consort; Members of the Apollo Chorus; St. Benedict Chorale (and ME!!(

JULIA DAVIDS, Guest Conductor; LUCIANO LAURENTIU, Music Director


SEPTEMBER 25 at 8:00pm

ST. BENEDICT CHURCH
2215 W. Irving Park Rd.
Chicago, IL 60618

$15 in advance through September 23
$20 at the door
($12 Students and Seniors)
For TICKETS and Information
Call (773)775-8791
Email: bmazzone860@aol.com
All proceeds will benefit the music ministry at St. Benedict Church

Saturday, September 5, 2009

Sound Advice: Pediatricians Answer Vaccine Questions

...Parents can listen first-hand as experts address specific questions related to immunization:

1. Why is it important to vaccinate on time?
2. What vaccines do adolescents need?
3. Why should infants get the Hepatitis B vaccine?
4. Why do kids need the flu shot?
5. Are some children extra-sensitive to vaccines?
6. Why are vaccines required for school entry? ...

How Blast Waves May Cause Human Brain Injury Even Without Direct Head Impacts

...New research on the effects of blast waves could lead to an enhanced understanding of head injuries and improved military helmet design....Using numerical hydrodynamic computer simulations, ...have discovered that nonlethal blasts can induce enough skull flexure to generate potentially damaging loads in the brain, even without direct head impact. ...

The Same Neural Networks In The Brain Process Familiar And Newly Learned Words

...Our vocabulary continues to grow and expand even in adulthood. Just ten years ago, the word 'blog' did not yet exist - and now we no longer remember when we heard this word for the first time or when we learned its meaning. At some stage new words become just as familiar to us as words we have learned earlier....

The Brain Predicts What Eyes In Motion Will See

...When the eyes move, objects in the line of sight suddenly jump to a different place on the retina, but the mind perceives the scene as stable and continuous. A new study reports that the brain predicts the consequences of eye movement even before the eyes take in a new scene. ...

Avian Flu Survivors At Increased Risk For Neurological Disorders Later In Life

Experts say that there is at least one strain of the H5N1 virus that leaves avian flu survivors at increased risk for Parkinson's disease, and other neurological problems later in life.

Take the Next Step after an ADHD Diagnosis.

... Behavioral therapy can help reduce problems related to the child's ability to pay attention or sit still at school, how he interacts with family and how well he does in his classes.Therapy should be started as soon as a diagnosis is made. ....Children with ADHD may not respond to the usual parenting practices, so experts recommend parent education.....Medication is one option that may help better control some of the behavior problems that have led to trouble in the past with family, friends and at school....
* Stimulants are the best-known and most widely used treatments. Between 70-80 percent of children with ADHD respond positively to these medications.
* Nonstimulants were approved for treating ADHD in 2003. This medication seems to have fewer side effects than stimulants and can last up to 24 hours....


Comments: Of course what they forget to mention is that children with ADHD can have vision problems and vision problems can mimic ADHD. Please have your child evaluated by an optometrist. DM

Distribution Of Antibiotic For Eye Disease Linked To Low Death Risk Among Ethiopian Children

Children in Ethiopia who received the antibiotic azithromycin as a method for controlling the contagious eye disease trachoma had a lower odds of death compared to children who did not receive the antibiotic...

Football, Wrestling Top Severe-Injury Risk in HS Sports

...Football and wrestling carried the highest risk of severe injury to high school athletes, according to a review of sports-injury data....Football and wrestling were the only high school sports with severe-injury rates that exceeded the national average of 0.39 incidents per 1,000 athletic exposures. Girls' basketball came in third, exceeding the severe-injury risk of boys' basketball (0.34 versus 0.24 ) per 1,000 exposures....Almost 60% of severe injuries resulted in disqualification from a sport for at least a year, investigators reported online in the American Journal of Sports Medicine....

Novartis Says Swine Flu Vaccine Works Quickly

A vaccine against the H1N1 pandemic flu was safe and immunogenic within two weeks after a single dose...The vaccine, developed using a cell-culture method, is the second to show single dose immunogenicity, ...The Novartis vaccine, dubbed Celtura, was tested for safety and immunogenicity in a 100-volunteer study run by the University of Leicester and University Hospitals of Leicester in England...Serum antibody responses were highest among volunteers who got two doses but a single dose also yielded responses deemed to be protective against the flu....

Masks key flu protection for health workers

...Doctors, nurses and other healthcare workers taking care of people infected with the new swine flu should wear special masks known as respirators, but need to protect themselves in other ways, too, ....The Institute of Medicine stressed that scientists still do not know much about how influenza viruses are transmitted, and that healthcare workers in general are bad at protecting themselves and their patients against such infections....in the meantime workers should at least wear a special respirator in addition to washing hands ....A N95 respirator covers the nose and mouth tightly, filtering out tiny particles that can carry viruses and bacteria. ....

Comments: OK...If I start wearing a respirator...it's for everyone protection. Now where can I get one? DM

Design of a National Distributed Health Data Network

... A distributed health data network is a system that allows secure remote analysis of separate data sets, each comprising a different medical organization's or health plan's records. Distributed health data networks are currently being planned that could cover millions of people, permitting studies of comparative clinical effectiveness, best practices, diffusion of medical technologies, and quality of care. These networks could also support assessment of medical product safety and other public health needs. Distributed network technologies allow data holders to control all uses of their data, which overcomes many practical obstacles related to confidentiality, regulation, and proprietary interests. Some of the challenges and potential methods of operation of a multipurpose, multi-institutional distributed health data network are described....

Comments: Full text of article is available. Click on title. DM

Tips for Better Vision

Wednesday, September 2, 2009

Delleman Oorthuys syndrome: 'Oculocerebrocutaneous syndrome' Arora V, Kim UR, Khazei HM - Indian J Ophthalmol

Delleman Oorthuys syndrome: 'Oculocerebrocutaneous syndrome' Arora V, Kim UR, Khazei HM - Indian J Ophthalmol:

"Delleman Oorthuys syndrome (oculocerebrocutaneous syndrome) is a rare, congenital sporadic disorder affecting the skin and central nervous system. We present the case of a one-month-old male who presented with an orbital cyst in the left eye since birth along with other manifestations of this syndrome. The manifestations of this syndrome resemble other developmental disorders like Goldenhar and Goltz syndrome. Conservative management of the orbital cyst in these cases have been described. The need to diagnose this rare congenital anomaly with cerebral malformations as a separate entity is crucial in the management of these children."

Vision Screenings Unreliable

Wiley InterScience :: JOURNALS :: Journal of Nursing Scholarship: "Improvement in school vision-screening reliability is needed, especially among 6- and 7-year-old students. To this end, the determinants of fair reliability should be investigated and training programs planned. Reasons for differences in the reliability of nurses' recommendations detected among subdistricts must be further studied, together with careful supervision, to ensure better performance and adherence to PHS guidelines. Implications for nurses and nursing should be considered."

Comments: Vision screenings do not need improvement. They need to be discarded in favor of comprehensive eye and vision examinations for all children. DM