Summer Safety Tips To Keep Your Kids Safe

Doctors and other experts at Cincinnati Children's Hospital Medical Center are providing tips on how to keep your child safe this summer. Safety topics that they focus on include:

Visual field defects after stroke – a practical guide for GPs

Background
Visual field defect after stroke can result in significant disability and reduction in quality of life. Visual rehabilitation aims to maximise the residual vision and decrease functional disability. Understanding the rehabilitation options available, and where to refer patients with visual defects after a stroke, can help patients, and their families, in the rehabilitation process.
Objective
This article provides a review of the functional disability from visual field loss and discusses the various forms of visual rehabilitation.
Discussion
Optical therapy, eye movement therapy and visual field restitution are the rehabilitation therapies currently available. Rehabilitation needs to cater to each patient’s specific needs. Any patient recognized as having a visual field defect after stroke needs prompt referral for further assessment and consideration for visual rehabilitation.

Comments: This FREE PDF is reprinted from Australian Family Physicia n Vol. 39, No. 7, JULY 2010, but is also appropriate as a review of visual fields associated with stroke for the primary care optometrist. Besides discussing visual fields they also briefly talk about saccadic therapy and the use of glasses/prisms and the use of computer Visual restorative therapy. No where do they note that optometrists should be involved in the care of the patient. Considering the growing body of evidence that optometric vision therapy can make a significant change in the life of these individuals (acquired/traumatic brain injury. DM

ICO Faculty Publications 2009-10

Once again being proud of my ICO colleagues is real easy. Here is a listing of publications over the last year.

Peer Reviewed Publications

• Donati, R.J., Maino, D.M., Bartell, H., and Kieffer, M.Polypharmacy and the Lack of Oculo-Visual Complaints from those with Mental Illness and Dual Diagnosis (MI/ID). 2009: Optometry, 80(5):249-254.
• Maino DM., Viola, SG, Donati R. The Etiology of Autism. Opt Vis Dev 2009:(40)3:150-156.
• Viola SG, Maino DM. Brain anatomy, electrophysiology and visual function/perception in children within the autism spectrum disorder. Opt Vis Dev 2009;40(3):157-163.
Allen, M. Skew deviation: report of a case treated with prismatic spectacles. Optometry and Vision Development, Vol 40 #2: 2009, 94-99
• Dave, R.H., Saengsawang, W., Yu, J-Z., Donati, R. and Rasenick, M.M. (2009). Heterotrimeric G-proteins interact directly with cytoskeletal components to modify microtubule-dependent cellular processes. NeuroSignals, 17:100-108
• Pang Y, Trachimowicz R, Castells DD, Good fellow GW, Maino DM. Optic nerve heads in African American children using retinal tomography. Optom Vis Sci 2009 Dec; 86(12):1346-51.
• Roberts DK, Lukic A, Yang Y, Moroi SE, Wilensky JT, Wernick M. Novel observations and potential applications using digital infrared iris imaging. Ophthalmic Surgery, Lasers & Imaging 2009;40:207-16.
• Stephanie Klemencic, O.D. Cotton wool spots as an indicator of methotrexate induced blood dyscrasia. Optometry, 2010;81, 177-180
• Pang, Y., Gabriel, H., Franz, KA, Saeed, F. A Prospective Study of Different Test Targets for the Nearpoint of Convergence. Ophthal. Physiol. Opt. 2010 30: 298–303.
• Allison, Christine L. Proportion of Refractive Errors in a Polish Immigrant Population in Chicago. Optometry & Vision Science, 3 June 2010.

Book Chapters and Non-Peer Reviewed Publications
• Maino DM. Identify Binocular Vision Disorders. Optometric Management. 2009;(12) available at http://www.optometric.com/article.aspx?article=103756 (accessed 1/10)
• Maino DM, Good fellow G. Digital Social Networking and Health Care Education. J Optom Ed. 2009 35(1):19-21 available at http://www.opted.org/files/public/JOE_FALL_2009_final.pdf accessed 10/09
• Maino DM. Partly cloudy with a chance of Meatballs. Opt Vis Dev 2009:(40)3:134-135.
• Maino DM. Borg Certification: Resistance is Futile. Optom Vis Dev 2009;40(2):70-71.
• Maino DM. Experiment. Optom Vis Dev 2009;40(1):6-10.
• Maino DM. Neuroplasticity: Teaching an Old Brain New Tricks. Rev Optom 2009. 46(1):62-64,66-70. (Tested Continuing Education Course)
• Cotter SA, Frantz KA. Therapeutic uses of prism for binocular vision disorders. In: Tasman W, Jaeger EA, eds. Duane’s Clinical Ophthalmology. Philadelphia: Lippincott Williams and Wilkins, 2009
• Goodfellow GW, Maino DM. ASCOTech: Make way, old dog. Optom Educ 2009 Win;34(2):52-53.

ICO Faculty Professional Presentations

I'm biased of course, but I think the faculty of the Illinois College of Optometry are awesome...noted below are presentations made by faculty at the College of Optometrists in Vision Development meeting, The 6th International Congress of Behavioral Optometry/Neuro-Optometric Rehabilitation Association meeting, American Public Health Association meeting, American Academy of Optometry, International Conference of Education, Research and Innovation meeting, The Association for Research in Vision and Ophthalmology Meeting. If you see a topic area of interest please feel free to contact the faculty involved in the research...perhaps a joint project could occur in the future.


• Condie J, Johnson J, Allison C. “Does performance on the Test of Visual Perceptional Skills 3rd Edition Vary Between Occupations?” The College of Optometrists in Vision Development meeting, October 2009.
• Allison C, Beatty R. “Unilateral optic nerve hypoplasia and vision loss in childhood.” The 6th International Congress of Behavioral Optometry meeting, April 2010.
• Maino D, Schlange D, Donati R. Bakouris C, Nikoniuk M. A Gun Shot to the Head: Oculo-visual & Perceptual Anomalies. International Congress of Behavioral Optometry/Neuro-Optometric Rehabilitation Association 2010. Ontario, CA 4/10
• Winters J. Primary care physician report and blood pressure in a low income uninsured population. American Public Health Association meeting, Philadelphia, PA, November 2009.
• Dominick Opitz, Mirijana Dordevic, Eric Conley. Clear Lens Phacomorphic Glaucoma Demonstrated With Ultrasonography And Anterior Segment Optical Coherence Tomography. American Academy of Optometry 2009 Annual Meeting.
• Dominick Opitz, Sherman Gin Yung Tung, Jenny Joo-Won Park , Unsun Sarah Jang Silicone Punctal Plugs As An Adjunctive Therapy To Travoprost 0.004% Ophthalmic Solution in Primary Open Angle Glaucoma And Ocular Hypertension. American Academy of Optometry 2009 Annual Meeting.
• Ashley Firby, Eric Conley. A Rare Bilateral Presentation Of Posner-Schlossman Syndrome. American Academy of Optometry 2009 Annual Meeting.
• Daniel K. Roberts. Long Anterior Lens Zonule Trait in African-American First-Degree Relatives. American Academy of Optometry 2009 Annual Meeting.
• Shana Brafman, Jennifer S. Harthan. Lens Adherence Related To Contact Lens Overwear. American Academy of Optometry 2009 Annual Meeting.
• Renee E. Reeder, Jacqueline Haro, Jennifer S. Harthan. Improving Comfort For First Time Gp Wearers With The So2clear Lens. American Academy of Optometry 2009 Annual Meeting.
• Mindy C. Nguyen. Utilization of Digital Imaging in The Assessment Of Students'' Performance On Direct Ophthalmoscopy. American Academy of Optometry 2009 Annual Meeting.
• Sandra S. Block, Erik Ranta, Daniel Hermanson, Colin Connors. Comparison Of Icare® Tonometer To The Tono-Pen® in Children. American Academy of Optometry 2009 Annual Meeting.
• Yi Pang, Kelly A. Frantz. A Prospective Study On Diagnosing Optic Nerve Hypoplasia Using Heidelberg Retina Tomograph And Fundus Photographs. American Academy of Optometry 2009 Annual Meeting.
• Marjean T. Kulp, G. Lynn Mitchell, Ida Chung, Amelia G. Bartolone, Janis E. Winters. Correction Of Hyperopia in Children Study (CHICS) Pilot. American Academy of Optometry 2009 Annual Meeting.
• Janice M. McMahon, Rebecca Nichols. Eyelid Edema as Presenting Sign Of Nephrotic Syndrome. American Academy of Optometry 2009 Annual Meeting.
• Kelly A. Frantz, Yi Pang. Unilateral Optic Nerve Hypoplasia in The Dominant Eye Of a Patient With Anisometropic/Strabismic Amblyopia. American Academy of Optometry 2009 Annual Meeting.
• Megan S. Allen, Benjamin Ticho. Cyclic Accomm ative Esotropia in a Child With Associated Hippocampus Abnormality. American Academy of Optometry 2009 Annual Meeting.
• Kent M. Daum, Kimberly Betton, Daman Gupta. Does The Use Of Colored Overlays Affect Reading Rate? American Academy of Optometry 2009 Annual Meeting.
• David Y. Lee, Anne Eng, Lenna Go. Color Differences Between The 2005 And 2006 Editions Of The Ishihara Color Vision Test. American Academy of Optometry 2009 Annual Meeting.
• Kaori Asano, Sanjay Rao. Topical Cyclosporine For The Prevention Of Dry Eye Disease: Second Year Of Two-Year Study. American Academy of Optometry 2009 Annual Meeting.
• Renee E. Reeder, Jeff Horst, Jennifer S. Harthan, Jacqueline Haro. Managing Patients With Ocular Surface Disease And Hepatitis C. American Academy of Optometry 2009 Annual Meeting.
• Jennifer S. Harthan, Renee E. Reeder. Peripheral Ulcerative Keratitis in Association With Sarcoid. American Academy of Optometry 2009 Annual Meeting.
• Mindy C. Nguyen. Visualization Of Iriociliary Cyst Using Various Imaging Techniques,American Academy of Optometry 2009 Annual Meeting.
• Ellen S Shorter, Keith Tyler. Venous Stenosis Causing Loss Of Consciousness And Intracranial Hypertension. American Academy of Optometry 2009 Annual Meeting.
• Stephanie A. Klemencic. Atypical Maculopathy Associated With Syphilitic Chorioretinitis in The Presence Of Human Immun eficiency Virus. American Academy of Optometry 2009 Annual Meeting.
• David Castells. Optical Coherence Tomography in a Case Of North Carolina Macular Dystrophy. American Academy of Optometry 2009 Annual Meeting.
• Ashley Firby, Mary Flynn Roberts. Atypical Stargardt Disease. American Academy of Optometry 2009 Annual Meeting.
• Anne Rozwat, Optical Coherence Tomography Of Type 1 Retinal Hamartomas in Tuberous Sclerosis. American Academy of Optometry 2009 Annual Meeting.
• Elizabeth Wyles, Leonard V. Messner, Nicholas Lillie. Inner Retinal Cystic Degeneration Following a Central Retinal Artery Occlusion. American Academy of Optometry 2009 Annual Meeting.
• Bruce A. Teitelbaum. Retinopathy After Myocardial Infarction: Microembolic Retinopathy Revisited. American Academy of Optometry 2009 Annual Meeting.
• Gary G. Gunderson, Dominick Opitz, Jennifer Lin, Kevin Trieu, Katherine Tran, Susan Kelly. The Relationship Of Macular Pigment Density To Foveal Architecture. American Academy of Optometry 2009 Annual Meeting.
• Michelle Crist , Sarah Boulais Klein. Multiple Retinal Pigment Epithelial Detachments and Oral Bisphosphonate Use. American Academy of Optometry 2009 Annual Meeting.
• Ren, Z, Clinical Connected Care Project-Clinical Communication System for Eye care. International Conference of Education, Research and Innovation 2009 meeting.
• G.W. Goodfellow, B.L. Seiller. A Pilot Observational Study to Determine the Prevalence of Usual-Corrected Binocular Distance Visual Acuity among Illinois Lifeguards. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• R.K. Zoltoski, E. Wyles, J.R. Kuszak. Correlation Lens Anterior Star Suture Changes to an Accommodative Response. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• F.T. Collison, M. Huynh, S. Kelly. The Effect of Pupil Size on Perceived Brightness With Yellow Tinted Lenses. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• L.A. Sicks, S.S. Block, A. Keller. Effect of Test Distance on Visual Acuity With Induced Myopic Refractive Error. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• S. Kelly, K. Goodman, T. Makoni, C. Misener, A. Yeh, Y. Pang. Geometric Variables May Cause Errors in Distance Perception. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• R.J. Mack, I. Shaikh, S.J. Farley, C. Caldwell, E. Chaglasian. Myopia and Sun Exposure: Patients With Pingueculum and Pterygium Are Significantly Less Myopic. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• C.L. Allison, D. Schlange. Eye Movements and Their Relationship to Birth Order. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• V. yevseyenkov, L. Gerlach, W.M. Jay. Comparison of Stand-Mounted to Free Space Closed Circuit Television Devices for the Visually Impaired. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• N.A. Manastersky, W.M. Jay. Effect of Peer Pressure on the Use of Low Vision Devices in Visually Impaired Children and Adolescents. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• C.B. Nau, M. Malihi, J.W. McLaren, A.J. Sit. Circadian Variation of Aqueous Humor Dynamics in Older Healthy Subjects. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• J.E. Winters, K.M. Daum. History vs. Clinical Findings Relating to Hypertension and Glaucoma Diagnosis Among African Americans in Rural and Urban Settings. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• Y. Pang, C. Allison, G. Goodfellow, S. Block, K. Frantz. A Prospective Pilot Study of Treatment Outcomes for Amblyopia Associated With Myopic Anisometropia. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• E.A. Knighton, R.K. Zoltoski, D.K. Roberts, J.T. Wilensky, J.R. Kuszak. Increase in Lens Thickness as Measured by A-Scan Ultrasonography in an Older African-American Population. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• M.T. Kulp, D.K. Wallac, E. Lazar, M. Melia, Y Pang. Stereoacuity in Children With Anisometropic Amblyopia. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• J. Ho, M. Luu, Y. Pang. Efficacy of Treatment Options for Anisometropic Amblyopia. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• K.M. Daum, J.E. Winters. Optometry, Illinois College of Optometry, Chicago, IL. Comparison of Systemic and Visual Findings in African Americans in Rural and Urban Settings. The Association for Research in Vision and Ophthalmology 2010 Annual Meeting.
• Pang, Y., Patel, B. Research Collaborations of US Optometry Schools/Colleges Internationally. International Conference of Education, Research and Innovation 2009 meeting.

Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review

...To date there is insufficient evidence to evaluate the efficacy of chiropractic care for paediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by
low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of
chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardized measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for paediatric and adolescent AD/HD.....

Comments:This article is open access and if you click the title above you should be able to read it immediately. I do not know much about Chiropractic care...but this article is a nice review and has a good discussion about Levels of Evidence. DM

For a few, 3-D effects are not so special: Projection technique uncovers vision problems, even makes some people sick

Rachel Saslow a Washington Post Staff Writer in this article tells the story of how I helped my patient with 3 D Vision Syndrome.....she didn't always quote me accurately...but came pretty close most of the time.

The story noted that my patient.. "tested her eyes this spring after three months of therapy by going to see "Shrek Forever After" in 3-D. She felt nervous, but Maino insisted that she try; it was her vision therapy "homework." She didn't get sick at all and was so excited by her progress that she text-messaged Maino right away.

"I used to frown a lot when I was talking to people because I couldn't hold them still; they were spinning in a way," she says. "I don't frown as much anymore, and when I'm reading my eyes don't strain as much."

Although the optometric vision therapy was over a 3 month period of time, we actually only had 9 therapy sessions before prescribing home vision therapy to ensure she kept all the fine results she achieved from therapy. She is much better now...no headaches, dizziness, nausea, blurred vision, double vision and eye strain.

One of my ophthalmologic colleagues interviewed for this story said "If you get a headache, it doesn't mean you need to rush to the eye doctor because something is horribly wrong with your eyes. It just means that, for whatever reason, your brain isn't comfortable seeing 3-D and you shouldn't do it."

I couldn't disagree with him more....even if even if nothing "is horribly wrong" while watching 3 D movies, TV or video games...you do not have to suffer and deny yourself the 3 D experience. If you experience any symptoms while watching 3 D movies or...if you "just don't get it"...no 3 D effect...go to the College of Optometrists in Vision Development webpage http://www.covd.org and/or to the American Optometric Association webpage http://www.aoa.org doctor locator tab to find a doctor who can help.

I should also mention that a patient of Baltimore optometrist, Dr. Paul Harris (who is my friend and colleague), was also quoted in this story.

For more information go to

3-D: Healthbeat Report - The 3-D Dilemma

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

3 D Movie Vision Syndrome

and

Want to see examples of optometric vision therapy? Just click the URLs below

Split Vectogram Biocular Handeye/Accommodation

Computer Vergence Paddle Ball


http://www.youtube.com/watch?v=EGlCVTdNqfw

http://www.youtube.com/watch?v=MWKWNPdxpyk&feature=player_embedded

http://www.youtube.com/watch?v=D6adPKchQm4&feature=player_embedded

DM

Vision Therapy/Orthoptics for Symptomatic Convergence Insufficiency in Children: Treatment Kinetics.

...The rate of improvement is more rapid for clinical signs (near point of convergence and positive fusional vergence ) than for symptoms in children undergoing treatment for Convergence Insufficiency. OBVAT results in a more rapid improvement in symptoms, NPC and PFV, and a greater percentage of patients reaching pre-determined criteria of success when compared with home-based pencil push-ups , home-based computer vergence/accommodative therapy and pencil push-ups, or office-based vergence/accommodative therapy with home reinforcement....

Comments: In this CITT study the clinical signs improve before the symptoms which makes sense to me except for the fact that most of my patients seem to have improved symptoms before the clinical findings improve. I'm going to need to take a closer look at what my patients tell me and when they tell it to me in regards to symptoms. Will keep you posted! DM

Attention Problems Traced to Time Spent Gaming

...A large study found that children who spent more than three hours in front of a computer or television screen -- whether playing video games or watching TV -- were significantly more likely to have attention problems...

Visual demands in elementary school.

....Average visual acuity demands in these classrooms at distance ranged from 20/100 to 20/300 for children in grades kindergarten to 2 and from 20/60 to 20/100 for grades 3 to 5. The average near demand ranged from 20/100 to 20/500 for all grades at 16 inches....

Comments: This is one of those good news/bad news situations. It is good that we know what the visual acuity demands are....it is unfortunate that some may interpret this so that visual acuity is all we need to be concerned about. Students in elementary school have ever increasing vision demands...but not only on visual acuity. Today they need sustained vergence, appropriate accommodative responses to the stimulus, and the ability to visually track and move the eyes in an appropriate fashion. They also require vision information processing skills that can adapt/adjust to the learning environment and new technology. I suggest that all of these areas be accessed when the child comes to us for vision care. If not you, who? DM

The effect of recent amblyopia research on current practice in the UK.

...The uptake of recent evidence into clinical practice is sporadic and incomplete with one-third of respondents indicating that following the studies, they had made no changes whatsoever to their practice. This is similar to other areas of medicine; the reasons are likely to be varied, and is an area that would benefit from greater attention....

Comments: All of us who practice the healing arts should be ashamed about this...but we should also be eager to get the word out that our patients no longer need to suffer the quality of life threatening outcomes of untreated amblyopia. The research clearly shows that amblyopia is treatable....at any age. (Of course the younger the better). Go to PubMed and search PEDIG and amblyopia...and let's bring our practices into the 21st century. I heard it said that the only way to bring new ideas into clinical practice is thru education...or you have to wait until all the old guys die off! As I become more chronologically enhance....I promise my patients that I will try to keep my practice as up to date as possible...will you make that same promise? DM

Treatment of accommodative insufficiency with plus lens reading addition: is +1.00 D better than +2.00 D

Wahlberg M, Abdi S, Brautaset R.Treatment of accommodative insufficiency with plus lens reading addition: is +1.00 D better than +2.00 D?Strabismus. 2010 Jun;18(2):67-71.

...The results indicate that +2.00 D reading addition does not exercise the accommodative system in the same amount as +1.00 D reading addition to improve the accommodative amplitude. We therefore recommend that +2.00 D reading addition is not used for treatment of AI....

Comments: This article is amazing on several counts. As far as I can tell this is one of the few times I've seen an article in the ophthalmology literature that acknowledges the existence of accommodative insufficiency (AI) that is not presbyopia or due to a neurological disorder. It is also unusual that an OMD would prescribe a child with bifocals that doesn't have accommodative esotropia.

So far I have only read the abstract but am getting the article so I can read the full text. The abstract did not say how they diagnosed the AI. Most OMDs are not familiar with the various ways AI can be assessed (MEM, NRA, PRA, Facility, Amplitudes,etc....if you do not believe AI is possible in children...well, you typically do not test for it.

I am also thrilled by the phrase "The results indicate that +2.00 D reading addition does not exercise the accommodative system... ..." because this acknowledges that accommodative function can be treated and its function improved.

This sounds like functional optometry to me! DM

Grant-Tech.net

I just had my house and all it's digital gadgets WiFied...a hard drive "fixed" and more. Being somewhat tech savvy I usually do this kind of stuff by myself, but since there were other "issues" beyond my knowledge base, I called upon Mr. Kevin Grant VP of Grant-Tech.net to help out. The end result is that everything is working nicely or because of Kevin's advice, I know how to get those %^$@&* blasted devices working myself saving a couple of $$$.

So if you are in the Chicago-land area contact Kevin or Chris and tell 'em Dominick sent ya! (BTW I have no financial interest in this company.) DM

MIT Develops Android Optometry App

...What a patient does is to continue to adjust the image things comes into focus, and viola, you have a prescription...

Comments: If you think a prescription for glasses is only measuring your "refractive error" you are probably in for a disappointment with this device. On the other hand...if used in 3rd World countries it could be spectacular! DM

No autism epidemic - Part One

...You are out for a drive, when a policeman waves you over. He looks at your dashboard, and declares "I see that you have a full tank of gas. I'm giving you a ticket for speeding!" Sounds ridiculous, doesn't it? Yet, lots of otherwise sensible people make a similar error when they equate the increase in the percent of children with an ASD diagnosis (prevalence) with an increase the rate at which new cases of ASD are occurring (incidence). You have both a gas gauge and a speedometer on your dashboard, but you cannot equate one with the other; the same is true for prevalence and incidence of ASD....

Comments: This pediatrician takes the hype out of autism....read this now by clicking on the title above. DM

No vaccine-autism link: Get kids shots

...What nobody knew was that the British doctor who claimed vaccines caused autism, Andrew Wakefield, had his own secrets. Among them, that he had performed some very risky, invasive experiments on children without approval from the hospital he worked at; that he had accepted nearly a million dollars from legal firms suing vaccine manufacturers; and that he had applied for a patent for a replacement vaccine to the one he claimed caused autism, which would have made him a very rich man....

Love that chocolate!

From Medical Break Throughs by Invanhoe:

A Chocolate a Day Keeps the Doctor Away:

Chocolate is loaded with antioxidants, calcium, potassium and vitamins B-2 and E.

The darker you go the better. The darker it is means it has more cocoa – an ingredient shown to trigger the release of neurotransmitters that help alleviate depression.

Chocolate can also help relieve stress. In a recent study those who ate about an ounce and a half of dark chocolate every day for two weeks, reduced their stress hormones.

Theobromine, an ingredient in chocolate, is more effective at stopping persistent coughs than codeine.

Chocolate is also good for your heart, it contains oleic acid – a monounsaturated fat that helps boost good cholesterol levels.

Flavanols in chocolate MAY help prevent arteries from hardening.

Sources: Journal of Proteome Research, November 2009; Federation of American Societies for Experimental Biology Journal, November 2004, and California Academy of Sciences

Comments:

Childhood malnutrition could weaken brain function in elderly

.....Malnutrition early in life appears to diminish brain function in older adulthood, according to a study led by a Michigan State University researcher that has implications for many poor, developing nations.....

The study of more than 15,000 elderly people in China suggests that fighting hunger throughout childhood not only saves lives and improves health but also may enhance cognitive well-being in late life. The study appears in the journal Social Science & Medicine....

Commentary on "How Does This Happen?"

Comments: My friend and colleague made this comment regarding children not getting appropriate eye and vision care in a timely manner:

Hi Dominick,
I agree 100%. I find this more of an issue with Convergence Insufficiency and uncorrected cyls [astigmatism] mostly (yeah, -2.00DS beats me though). I had a 45 year old the other day who was in for his FIRST eye examination and he 6/60 acuity in one eye and never realized it - come on. Sent him for VFs etc just to be on the safe side, but there was a history of learning issues at school in his youth. Should eye examinations be mandated - hell yes. This is definite no brainer. In Canada, only 15-30% (tops) of children have their eyes examined prior to entering high school (yes...HIGH SCHOOL). This is just nuts in a so called developed country. Keep up the blog Dominick, glad to see someone cares!
Dr. Pat Quaid

Comments 2: Pat...it is indeed a sad reflection upon our countries that we cannot (actually will not) provide or mandate the basics for our children. Sure they must have a physical and dental evaluation before going to school....these children do not use their teeth to learn....they use their visual system.... Shame on the politicians, shame on organized medicine which does not recognize the need for vision care and then fights optometry on this at every opportunity. Parents tell me of many children suffering needlessly. Go to the Vision First Foundation website to see how one parent wouldn't accept the status quo and fought to bring mandatory eye exams for children entering Kindergarten.

If we were to examine all infants between 6-12 months of age we could stamp out amblyopia (go to the American Optometric Association's InfantSee website.) The AOA member doctors who participate in the InfantSee program provide no-cost evaluations for these children.

If we were to examine all children while they are in school once a year, we could diagnose and treat all learning related vision problems. Imagine how many children would be helped. Imagine these children (and their families) not suffering the immediate and long term after affects of school failure. Imagine our leaders finally getting their act together to ensure our children succeed. DM

How does this happen?

OK...so explain this one to me. I was in my Harwood Heights office (Northwest Optometric Associates) and I saw this soon to be High School freshman. He came in with minimal complaints...but with unaided visual acuities of 20/100-20/200. He wore glasses in 5th grade...then they were broken, dog ate 'em, etc. He has been going around legally blind since then.

I do the examination and he is a 2 diopter myope! Mom kind of shrugs her shoulders and says that he's been doing "OK".....passed school screenings....

Well, of course he is not doing OK... Tell me again why ophthalmology still fights us on getting comprehensive eye examinations mandated for children?

Bottom line...have your children's eyes examined once a year while they are in school!! DM

MainosMemos in the Top 11 Blogs in Pediatrics!

MainosMemos has been listed as one of the top eleven blogs in Pediatrics by Networked Blogs. They have given this blog ***** .. that's FIVE STARS (out of 5)!

Looking you in the mouth: abnormal gaze in autism resulting from impaired top-down modulation of visual attention

...People with autism are impaired in their social behavior, including their eye contact with others, but the processes that underlie this impairment remain elusive. We combined high-resolution eye tracking with computational modeling in a group of
10 high-functioning individuals with autism to address this issue. The group fixated the location of the mouth in facial expressions more than did matched controls, even when the mouth was not shown, even in faces that were inverted and most noticeably
at latencies of 200–400 ms. Comparisons with a computational model of visual saliency argue that the abnormal bias for fixating the mouth in autism is not driven by an exaggerated sensitivity to the bottom-up saliency of the features, but rather by an abnormal top-down strategy for allocating visual attention....

Comments: Full article available by clicking the title. DM

Wii Fit And Brain Damage Rehab

...Wii Fit, combined with sophisticated new software, is giving people their lives back, not just brain-injured soldiers but also thousands of others who suffer brain injuries in car, motorcycle and other accidents....

Comments: I won't even try to be unbiased on this one. My friend, Rod Bortel of Home Therapy Solutions, developed and markets this unique combination of software and hard ware to help those with brain injury. Go to http://www.visiontherapysolutions.net/ to find out more...

FYI I have no financial interest in any of the programs produced by Rod. DM

Illinois College of Optometry Students score High on NBEO

Congratulations to the ICO class of 2011. You have performed very well on the NBEO ABS exam. The ICO class of 2011 pass rate was 97.2%. This compares with the national average for first time takers of 92.1% and all takers of the exam at 85.1%. You have done ICO proud.

We not only graduate the best clinicians....but some of the greatest scholars!

(OK, OK so I'm a bit biased!!)

How to solve the Board Certification Problem: Ophthalmology

Illinois College of Optometry July 25-26 Continuing Education

Illinois College of Optometry July 25-26 Continuing Education

Sunday, July 25, 2010
7:00-8:00 A.M. – Continental Breakfast

8:00-10:00 A.M.
Anterior Segment Disease Grand Rounds (2 TQ)
Gary Oliver, OD

10:00-11:00 A.M.
Current Concepts in Management of Dry Eye and Ocular Surface Disease
Ron Carr, OD
11:00 A.M. – 12:00 P.M.

Current Treatment Strategies for Ocular Pain Management
Gary Oliver, OD

12:00-1:15 P.M. -- Lunch

1:15 – 2:15 P.M.
Nutraceuticals, Supplements and Vitamins in Eye Care
Gary Oliver, OD

2:15-3:15 P.M.
Glaucoma Diagnosis Made Simple
Eric Conley, OD

3:15-5:15 P.M.
Glaucoma Grand Rounds (2 TQ)
Gary Oliver, OD

Monday, July 26, 2010
7:00-8:00 A.M. – Continental Breakfast

8:00-10:00 A.M.
Common Oral Meds in Eye Care (2 TQ)
Stephanie Klemencic, OD

10:00 A.M.-12:00 P.M.
Spectacle Rxs for the Pediatric Patient: How to Make Confident Prescribing Decisions (2 TQ)
Valerie Kattouf, OD

12:00-1:00 P.M. -- Lunch

1:00-3:00 P.M.
Red Eye Revelations: Case Based Diagnosis and Management (2 TQ)
David Castells, OD

3:00-4:00 P.M.
How to Make Staff Members Income Producers
Richard Kattouf, OD

4:00-5:00 P.M.
Practice Separation
Richard Kattouf, OD

Long-term Changes in Refractive Error in Patients with Accommodative Esotropia

....Patients with accommodative esotropia showed a continuous decrease in Spherical Equivalent refractive error over time. Changes in refractive error in patients with accommodative esotropia may be influenced by both spectacle wearing and amblyopia....

Comments: I often tell my patients that as we treat various binocular vision disorders not to be surprised if their prescriptions change...this is true for those with ET as well. DM

Do bifocals reduce accommodative amplitude in convergence excess esotropia?

....In several patients, excessive convergence is secondary to the extra accommodative effort required due to the presence of a primitive Near Point of Accommodation deficit. In these subjects, the prognosis can be made on the basis of NPA measurement, and treatment with bifocal lenses will always be required to compensate. Furthermore, the parents of these small patients should be informed, even before the prescription of bifocals, that prospective surgery of medial rectus muscles will not eliminate the need for bifocals....


Comments; This article in Graefe's Archive for Clinical and Experimental Ophthalmology tells OMDs to use bifocals and that surgery would eliminate the need for this multi-focal prescription. Before the OMDs take credit for this...it should be noted that optometrists have been using bifocals for decades to treat this disorder. It's good to see my OMDs are catching up with the innovative thinking of optometrists! Now I can't wait for them to discover optometric vision therapy! DM

Schools Still Failing To Promote Positive Attitudes Toward Disabled People

..."Some of the reasons for the lack of positive promotion of disability in primary schools are; uncertainty about how to fit disability equality into the curriculum or a reluctance to talk about disability for fear of highlighting 'difference' " says the study....

Comments: The easiest way to teach another about individuals with disability is thru interaction. You know longer fear what you know....DM

Babies Receive Drugs And Medicines Through Breast Milk

...The breast milk of smoking mothers contains between 2 and 240 nanograms of nicotine per millilitre, which means their babies receive a dose equivalent to 0.3 to 36 micrograms/kg/day. These infants tend to suffer more from colic and are more prone to respiratory infections. ...
Caffeine - found in coffee, tea, cola drinks and medicines - can cause irritability and insomnia. Although the level of caffeine absorption varies greatly from one person to another, this substance has a lengthy half-life in newborns. For this reason, it is recommended to reduce consumption during breastfeeding to a maximum of 300 mg/day, equivalent to around three cups of coffee per day. ...For alcohol, the exact risk is still ill-defined, and no studies have been carried out to correlate the dose, although some research suggests it can harm the infant's motor development, as well as causing changes to their sleep patterns, reduce the amount they eat, and increase the risk of hypoglycaemia....

Some Blinding Diseases May Be Prevented By Ingredient In Red Wine

...Resveratrol - found in red wine, grapes, blueberries, peanuts and other plants - stops out-of-control blood vessel growth in the eye, according to vision researchers at Washington University School of Medicine in St. Louis....

Comments: Love that red wine! DM

Is Scientific American Right About Autism?

...A Scientific American article asks, "What if Vitamin D Deficiency is a Cause of Autism?" (1) How could vitamin D deficiency during pregnancy cause autism, a genetic disease? Indeed, five researchers at Harvard, led by Dr. Dennis Kinney, recently endorsed and then modified the vitamin D theory of autism.(2)...

3 D Vision Syndrome Patient #2

More comments from patients with 3 D Vision Syndrome:

I am 41 years of age.. not only did I not understand why I never saw anything in 3D, I never understood why I could not see a baseball coming at me, why I could not see anything in a telescope or microscope, and why I could not see a volley ball come at me. I just avoided these things.. Come to find out, I have been legally blind my whole life, and living off a small area in my left eye. I have never heard of anyone with my story. I am sure there are other people like me out there that exist. How can no one notice in my life that I can't see. I would never know differently... crazy stuff! Nice to know I am not the only one that went through life not seeing 3D.. sounds like others are in that boat with me. Thanks for this post! Always nice to know you are somewhat not alone... I am having a hard time getting a diagnosis after slipping through the cracks my whole life. Is my story that "unbelievable?"

Comments: Unfortunately your story is all too believable! You need a doc who can diagnose and treat this condition. Go to http://www.covd.org to find one right now! Even those of us who are somewhat chronologically enhanced can be helped! Go to the search box on the upper left and thype in "optometric vision theapy".....and you will see that treatment is possible. DM

3 D Vision Syndrome

Comments: One of my readers left this message:

The last time i watched a 3d movie i just about passed out. The guy
sitting next to me had to grab my arm before i hit the floor. I wear
glasses already and i can't see with out them. If i take them off for
the 3d glasses i can't see anything. if i where the 3d glasses over my
glasses then i get severe headaches and tend to pass out. To make a
long story short i hate 3d movies. They should give the moviegoer
options.

Comments2: You do not have to suffer. Go to http://www.covd.org to find a doc who can help. I'm in the final therapy stages with a patient who was VERY adversely affected by 3 D movies....she just went ot Shrek 3D...and loved it...no problems!

Memory problems not the only predictor of later mild cognitive impairment

...Researchers at Rush University Medical Center have found that lower, though not necessarily impaired, performance on tests measuring story learning or retention and processing speed in motor tasks dependent on visual control, as well as symptoms of depression, predicted subsequent cognitive decline in a normal population....

Study Finds Signs of Schizophrenia in Babies' Brains

...The scientists used ultrasound and MRI to examine brain development in 26 babies born to mothers with schizophrenia. Having a first-degree relative with the disease raises a person’s risk of schizophrenia to one in 10. Among boys, the high-risk babies had larger brains and larger lateral ventricles — fluid-filled spaces in the brain — than babies of mothers with no psychiatric illness. The researchers found no difference in brain size among girls in the study. This fits the overall pattern of schizophrenia, which is more common, and often more severe, in males....

Handwashing, masks, may limit transmission of pandemic flu

...Nonpharmaceutical interventions are measures other than vaccines and antiviral treatments that can reduce the harm and spread of disease, including frequent handwashing with soap and water, using alcohol-based hand sanitizers, covering sneezes and coughs, wearing face masks, closing schools, working from home and restricting public gatherings....

Comments: Although more research is needed in this area....wash your hands.....wash your hands....wash your hands. It's amazing how often patients comment how wonderful it is to see their doc was his hands before he does anything. BTW I went to my doc today...and guess what...he washed his hands before he started working on me! DM

Ocular axial length and corneal refraction in children with mucopolysaccharidosis (MPS I-Hurler)

... Reduced axial length together with reduced corneal refraction is suggested to be causative to the hyperopia in patients with MPS I-Hurler. Detection of refractive errors and prescription of eye glasses are important to avoid amblyopia....

Concussion significantly affects quality of life in young athletes

...Young athletes who sustain concussions are likely to suffer deficits in health-related quality of life, but most experience significant improvement within 30 days...

Comments: As far as I know this study did not ask any vision related questions. Sad since many of the problems encountered after most have been addressed are visual in nature. DM