EyeWorld and the Integrative Practice: Optometry + Ophthalmology

The American Society of Caract and Refractive Surgery's magazine, EyeWorld quoted Dr. Dominick Maino extensively on his views concerning the role optometry and ophthalmology should play in the integrated practice.

Eye World Quotes Dr. Maino Extensively

View more documents from Dominick Maino.

Critical Flicker Frequency (CFF) is Reduced in Children with Suspected Reading Disability

...Mean CFF threshold discriminated well between children with a chief complaint of reading problems and those with no history or report of reading problems. This agrees with earlier studies demonstrating reduced temporal processing reflecting visual magnocellular impairment in individuals with reading disability. We suggest that the CFF threshold test, which is both simple and rapid, be considered for inclusion in the clinical vision testing for children presenting with reading problems.....

Comments: This study was done by my colleagues Barry Tannen, Kenneth J. Ciuffreda, & Noah M. Tannen. Dr. Tannen noted that: "In this study, the critical flicker frequency threshold (CFF) of children who had a history of reading disability were compared to age matched normal readers. CFF threshold discriminated well between reading disabled and normal readers. CFF threshold is a test that measures visual magnocellular function and adds further evidence to the growing body of evidence that shows reduced temporal processing in individuals with reading disability. CFF threshold is a simple test to perform and hopefully will be commercially available within the next year as a clinical test for optometrists and other health professionals to perform. (NOTE: I have no financial interest in this device)."

 This research will be presented as a Poster Presentation at the Association for Research in Vision and Ophthalmology (ARVO) 2011 Annual Meeting DM

Review of Optometry Academy 2010 San Francisco Roundup

The Review of Optometry was kind enough to make note of the poster I presented at the recent American Academy of Optometry meeting in San Francisco this past fall. This was the first ever presentation describing a patient with 3 D Vision Syndrome and the post optometric vision therapy outcomes.

Review of Optometry Discusses Dr. Maino's AAO Poster 12/10

View more documents from Dominick Maino.

Optometry Students . Com!

....OptometryStudents.com is your #1 resource for pre-optometry and optometry student information! Our website is run entirely by motivated optometry students who are dedicated to learning and sharing knowledge. The website is a long term project and has big plans to improve the current state of optometry by making valuable information available to all optometry students. ....

Distracted Child? It Might Be His Eyes

...Not long ago Eva Phelps wouldn't focus on what was right in front of her. Teachers noticed the 5th grader looking out windows instead of her books. Some even wondered if she had attention deficit disorder. "It would just be normal but then it would start to blur, and I would see like two of the word or it would be like smudged." Turns out the problem was her eyes. ...

See video at http://www.digtriad.com/video/default.aspx?bctid=775162602001

Long-term results of the surgical management of intermittent exotropia

...Long-term surgical results in intermittent exotropia are less encouraging when sensory status is added to the evaluation. Patients with anisometropia, lateral incomitance, and immediate postoperative undercorrection are at increased risk for poor outcomes and to require reoperations....

Comments: Long term results of surgical correction of strabismus is not very good from most of the studies I've seen (type in strabismus outcomes in the search box upper left). Why is this all too often the first thing done? Optometric vision therapy should probably be attempted prior to surgery for most forms of strabismus...especially if the strabismus is intermittent. DM

Understanding Acupuncture

...Acupuncture is a traditional medicine that’s been practiced in China and other Asian countries for thousands of years. Its proponents say it can do everything from relieving pain to bringing a general sense of wellness. Others think the only benefits you get from acupuncture are in your head. Recent studies have found that both sides may have a point. Acupuncture can be effective for certain health problems, such as some types of chronic pain. But how it works is something of a mystery....

Adult ADHD Significantly Increases Risk of Common Form of Dementia

...Adults who suffer from attention-deficit and hyperactivity disorder (ADHD) are more than three times as likely to develop a common form of degenerative dementia than those without...

Should Your Kid Be on Statins or GERD Medicine?

...The patient was overweight and had Type 2 diabetes. He was on Crestor for cholesterol, Atacand for hypertension; the proton pump inhibitor Protonix for GERD (gastro-esophageal reflux disease), Axert for migraines and Singulair for asthma. The patient was eight years old....

Transcranial Magnetic Brain Stimulation

...What sounds like science fiction is actually possible: thanks to magnetic stimulation, the activity of certain brain nerve cells can be deliberately influenced. ... various stimulus patterns changed the activity of distinct neuronal cell types. ...certain stimulus patterns led to ... learning more easily. The knowledge obtained could contribute to cerebral stimulation being used more purposefully in future to treat functional disorders of the brain....

Learning Causes Structural Changes In Affected Neurons

Learning.....significantly alters the structure of the specific brain cells involved, which sprout a whopping 22 percent more dendritic spines connecting them to other motor neurons. ..... The finding.... underscores the brain's remarkable ability to physically change as it learns .... but also reveals that the effect is surprisingly restricted to the network of neurons actually involved in the learning.....

Importance Of Vision Screening For 3- To 5-Year-Olds Reaffirmed

....The importance of vision screening for children 3 to 5 years old was confirmed today with the publishing of the U.S. Preventative Services Task Force ... statement in Pediatrics. This new statement is an update to the 2004 statement on vision screening and says, "There is adequate evidence that early treatment of amblyopia in children ages 3 to 5 years leads to improved visual outcomes."....

Comments: This does not confirm the importance of vision screening....it does confirm the importance of having each and every child undergo a comprehensive eye and vision evaluation. Vision screenings miss too many children with vision problems.... DM

More Americans Turn To Lower-Cost Alternative Meds

....The use of complementary and alternative medicine (CAM) therapies experienced a significant growth in the United States in the last decade, and a new analysis finds that CAM use becomes more likely when access to conventional care has been restricted.....

How do children learn to follow gaze, share joint attention, imitate their teachers, and use tools during social interactions?

Grossberg S, Vladusich T.How do children learn to follow gaze, share joint attention, imitate their teachers, and use tools during social interactions?Neural Netw. 2010 Oct-Nov;23(8-9):940-65. Epub 2010 Aug 5.

...The article proposes how intra-personal circular reactions create a foundation for inter-personal circular reactions when infants and other learners interact with external teachers in space. Both types of circular reactions involve learned coordinate transformations between body-centered arm movement commands and retinotopic visual feedback, and coordination of processes within and between the What and Where cortical processing streams. ....

Comments: This is sounding very much like what a developmental optometrist would say. DM

Echan el ojo al 3D

I was recently quoted in a Spanish internet story:

..."Ver programas en 3D puede desenmascarar cuestiones tales como ojo perezoso, insuficiencia de convergencia, problemas de concentración y otros problemas visuales de los que los consumidores desconocían su existencia", dice el doctor Dominick Maino, del Instituto de Optometría de la Universidad de Illinois....

I want to thank my colleague, Dr. Angel Romero for bringing this to my attention! DM

American Optometric Association Optometry's Meeting Registration

Optometry's Meeting IPhone app http://itunes.apple.com/us/app/om-2011/id411946673?mt=8&ign-mpt=uo%3D4


For all other phone types (including Android and BlackBerry) point your mobile browser to http://m.core-apps.com/OM2011

Kids Like Their iPods. Their Parents? E-Readers

All will need the appropriate visual abilities to appreciate this technology. See your optometrist today...and bring that technology with you so we can help you use it to the best of your ability. DM

The Impact of Pediatric Vision Disorders in Adulthood

....In addition to refractive errors such as myopia and astigmatism, ocular disorders that occur in infants, toddlers, and children may present lifelong problems for the child. Conditions such as strabismus, amblyopia, and retinopathy of prematurity may require adaptations in adulthood. In addition, vision disorders that occur in childhood may manifest as problems well into adulthood. When visual impairment is present, there may be further effects on overall health, self-perception, educational attainment, job choices, and a number of other social factors.....

Comments: Yet another good reason that our ophthalmology colleagues should join with optometry to demand that all of our children receive comprehensive eye examinations and not just vision screenings. Vision screenings miss too much too often, cannot be supported by research, and results in problems well into adulthood. DM

Perceptual learning, aging, and improved visual performance in early stages of visual processing

....These results indicate that perceptual learning with near threshold training can be used to improve visual performance among older individuals....

Comments: See full PDF by clicking on title above. DM

Binocular Vision & Pediatrics Forum

The Ohio State University College of Optometry is proud to present the

Binocular Vision & Pediatrics Forum

Friday, March 18, 2011

Binocular Vision & Pediatrics Forum
Friday, March 18, 2011 at The OSU College of Optometry (room 33), Columbus, Ohio

Speaker: Michael Bartiss, O.D., M.D.
Session Topics:  The Pediatric Motility Examination  2 hours
Clinical Pediatric Eye Grand Rounds  2 hours
A Systematic Approach to the Evaluation and Treatment of Adults with Diplopia  2 hours
Neuro-Motility Disorders  1 hour

Please visit OSU's CE website at http://optometry.osu.edu/BVPF or email us at CE@optometry.osu.edu for more information and registration details.

AOA Says 3-D May Not Be Bad For Children After All

From AOA First Look:

AOA Says 3-D May Not Be Bad For Children After All.

In "In-Game," MSNBC  (1/6, Benedetti) reports, "Nintendo, Sony and Toshiba have all issued warnings telling parents to keep young children from playing 3-D games and watching movies shown in 3-D." Now, however, "an organization representing family eye doctors says 3-D may not be bad for kids after all. In fact, the American Optometric Association has issued a statement  saying that the 3-D in movies, TV and games is may 'help uncover subtle disorders that, left uncorrected, often result in learning difficulties.'"

3D TV & Movies May Reveal Hidden Vision Problems

....Allaboutvision.com thinks the company is likely being cautious because of a lack of research on the effects of long-term 3D viewing on young children’s vision development.  This may be a wise precautionary choice for parents, however the American Optometric Association (AOA) recently released a statement saying it is safe if the child’s visual system is developing normally.  The AOA went on to suggest 3D viewing of movies, TV and the Nintendo 3DS may actually help diagnose ...vision disorders, like convergence insufficiency, that should be corrected. ...

Beyond patching: Stella’s vision therapy now includes MFBF

...Ever since Stella’s vision therapy progress evaluation which showed great gains, we’ve been doing a bit of what Susan Barry discusses on page 150 of Fixing My Gaze: monocular fixation in a binocular field (MFBF). This means that instead of being completely excluded via the patch, the stronger eye is merely put at a disadvantage. Her dominant eye is still able to receive and contribute visual input, allowing the eyes to work together, but the amblyopic eye is forced to do the heavy lifting. Several doctors/researchers, over several decades, have endorsed the effectiveness of this approach (Brock, Cohen and Hess for starters)....

Vision Disorder Often Misdiagnosed as ADHD

....Kids who can't concentrate at school are often diagnosed with ADHD while others are said to have a learning disability and that can impact their entire education. We've uncovered many kids may be getting the wrong treatment -- from doctors and teachers. A number that we found is one million. One million American children may be misdiagnosed with ADHD, according to researchers at Michigan State University....Grant's mother is a teacher and heard from colleagues that Grant might have convergence insufficiency. That's a visual disorder where people -- even with 20/20 vision -- can't focus on the words they're reading...


Comments: See video on KAALtv by clicking on the title above. DM

Books About Living With Autism

...

The management of childhood esotropia with hyperopia.

....Treatment of esotropia in children with hyperopia includes wearing glasses, glasses combined with prism glasses and surgery. Prismatic correction in the treatment of small angle of residual esotropia in partial AE was feasible and efficacious. Since the follow-up lasted only a year, a long-term follow-up is needed in future studies to investigate the efficiency of the treatments....

Comments: It is unfortunate that they do not consider optometric vision therapy BEFORE invasive surgery. DM

3D is all the rage, but causes headaches for many

The AOA spokesperson on 3 D Vision Syndrome, Dr. Dominick Maino shown on WLBZ in Bangor, ME.

WRCB TV shows Dr. Maino's Comments on 3D Vision Syndrome

...CHATTANOOGA (WRCB)-- Three-dimensional TVs and movies may be all the rage in Hollywood, but for many people they can cause a raging headache.

It's a scene that producers probably didn't foresee.

Watching 3-D movies gives some viewers such nausea and headaches that they're forced to leave theaters long before the credits roll.

"There are some folks who also develop dizziness and vision-induced motion sickness," says Dr. Dominick Maino, American Optometric Association....

Reliability of Eye Tracking and Pupillometry Measures in Individuals with Fragile X Syndrome.

Farzin F, Scaggs F, Hervey C, Berry-Kravis E, Hessl D.Reliability of Eye Tracking and Pupillometry Measures in Individuals with Fragile X Syndrome.J Autism Dev Disord. 2011 Jan 26. [Epub ahead of print]

Department of Psychology, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA, ffarzin@stanford.edu.

Abstract

Recent insight into the underlying molecular and cellular mechanisms of fragile X syndrome (FXS) has led to the proposal and development of new pharmaceutical treatment strategies, and the initiation of clinical trials aimed at correcting core symptoms of the developmental disorder. Consequently, there is an urgent and critical need for outcome measures that are valid for quantifying specific symptoms of FXS and that are consistent across time. We used eye tracking to evaluate test-retest reliability of gaze and pupillometry measures in individuals with FXS and we demonstrate that these measures are viable options for assessing treatment-specific outcomes related to a core behavioral feature of the disorder.

New Open Access Journals Available

GMS Health Technology Assessment

    ISSN: 1861-8863 (electronic)

    http://www.ncbi.nlm.nih.gov/pmc/journals/1341

    Archive includes 1(2005) to the present

    Note: There is no embargo delay for this journal

American Public Health Association's first ever Midyear Meeting

Registration is now open for the American Public Health Association's first ever Midyear Meeting. Join APHA in Chicago, IL from June 23-25, 2011 to discuss Implementing Health Reform - A Public Health Approach. This meeting will equip attendees from federal, state, local and tribal agencies and organizations with the tools needed for implementing the provisions of the Affordable Care Act and improving health outcomes in communities across the country. For a full description of the meeting visit www.apha.org/midyear.

The use of distance stereoacuity assessment in determining the effectiveness of minus lenses in intermittent exotropia

....Distance stereoacuity (and binocular visual acuity) cannot reliably be used to determine the optimum minus lens strength that could be used in these patients to reduce the angle of deviation and regain binocularity in the distance. An additional observation was made that stronger lenses should perhaps be avoided to prevent binocular and visual discomfort.....

Comments: Although I use additional minus at distance when appropriate... there are several possible problems with using minus lenses for divergence excess...the common one I see is that the doctor doesn't bring the patient back for follow-up and the patient is looking thru this over correction for a very long time...and seldom do I see docs provide an add for near use so that the patient is at least emmetropic at near...and not being forced to use and excessive accommodative effort when reading or doing other near point tasks. Use all the tools available...but use them wisely...do not create a problem where there was none by over minusing and then not following this patient carefully. BTW...I didn't read in the abstract that the researchers used a cover test to see how successful they were in eliminating the strabismus...that's strange. DM

Complementary and alternative medicine for prevention and treatment of the common cold

... For prevention, vitamin C demonstrated benefit in a large metaanalysis, with possibly increased benefit in patients subjected to cold stress. There is inconsistent evidence for Asian ginseng (Panax ginseng) and North American ginseng (Panax quinquefolius). Allicin was highly effective in 1 small trial. For treatment, Echinacea purpurea is the most consistently useful variety; it was effective in 5 of 6 trials. Zinc lozenges were effective in 5 of 9 trials, likely owing to dose and formulation issues. Overall, the evidence suggests no benefit from probiotics for prevention or treatment of the common cold. .....

Comments: I wish they would have also studied chicken soup! OK go out and get the vit C.. Full article is available free by clicking title above. DM

Brain pacemakers to help fight depression

.... Brain pacemakers are already being used to treat Parkinson's disease patients. Now, a new study has suggested that this deep brain stimulation technique could effectively help in the fight against depression....

Traumatic Brain Injury Completed and Ongoing Research

 Here is a partial listing on ongoing research in the area of TBI. It's interesting to note that few studies are looking at functional vision problems...nor do they include optometrists on the research team. Considering the number of vision problems folks with TBI have...that's unfortunate. DM


Therapy for Reading Problems in Adults After Brain Injury 


Adults who sustain brain damage due to stroke, head injury, or traumatic surgery may develop difficulty reading. This study examines the effectiveness of behavior-based programs to improve reading ability in these individuals.

Effects of Prismatic Spectacle Lenses on Symptoms of Dizziness, Headache and Anxiety as Caused by Vertical Heterophoria

 The purpose of this study is to demonstrate whether, in patients diagnosed with Vertical Heterophoria, the symptoms of dizziness, headache and / or anxiety are reduced or eliminated when a kind of correction called vertical prism is added to the patient's normal eye glass prescription.

The experiment will involve giving the patient two pairs of glasses (one pair containing the baseline prescription with vertical prism (Standard Treatment Glasses) and the other pair containing the baseline prescription but without vertical prism (Placebo Glasses)) to demonstrate which pair of glasses is most effective in reducing the symptoms of dizziness, headache and / or anxiety in these patients.

Eye-Tracking Rapid Attention Computation 

The purpose of this study is to validate and refine a diagnostic device that can detect attention and memory deficits that result from mild traumatic brain injury (mTBI).

Multidisciplinary Treatment in Patients With Mild Traumatic Brain Injury 

he aim of the study is to compare a multidisciplinary examination and follow up by rehabilitation program with a multidisciplinary examination, good advice and follow up by the family doctor.

Deep Brain Stimulation for Traumatic Brain Injury

The study will evaluate the benefit of Deep Brain Stimulation for subjects with severe disability due to Traumatic Brain Injury

  

Eye Movement Recordings in the Diagnosis of Traumatic Brain Injury

The study investigates whether the use of eye movement recordings can provide a reliable diagnostic of previously undiagnosed mild traumatic brain injury (blast and impact) in Operations Enduring Freedom or Iraqi Freedom (OIF/OEF) veterans.

Improving New Learning and Memory in Traumatic Brain Injury 

 The current study is a double-blind, placebo-control randomized clinical trial examining the efficacy of memory retraining in Traumatic Brain Injury (TBI). Impairment in higher level cognitive processing, such as new learning and memory, is one of the most common deficits in individuals with TBI and such deficits have been shown to exert significant negative impact on multiple aspects of everyday life, including occupational and social functioning. Despite these findings, few studies have attempted to treat these cognitive deficits in order to improve the everyday functioning of individuals with TBI. The current proposal will evaluate (a)the efficacy of this treatment protocol within a TBI population,(b) the impact of the treatment on everyday functioning, (c) the long term efficacy of the treatment and (c) the utility of booster sessions in facilitating long-term treatment effects. The investigators will randomly assign individuals with TBI, with documented impairment in new learning abilities, to a memory retraining group or a placebo control group. Both groups will undergo baseline, immediate and long-term follow-up assessment consisting of: (1) a traditional neuropsychological battery and (2) an assessment of global functioning examining the impact of the treatment on daily activities. This design will allow us to evaluate the efficacy of this particular memory retraining technique in a TBI population through the assessment of cognitive function via a standard evaluation. In addition, the investigators will be able to draw conclusions regarding the impact of this particular memory remediation program on everyday life from questionnaires completed by the participant and a significant other.

Efficacy of Pharmacological Treatment of Working Memory Impairment After Traumatic Brain Injury: Evaluation With fMRI

This study is designed to examine the effects of a wake-promoting agent (Modafinil) on working memory (WM) in persons with moderate to severe TBI utilizing a double blinded placebo controlled methodology. Our approach is to evaluate participants with BOLD fMRI and a limited neuropsychological battery to examine WM performance before and after pharmacological intervention.

Hypotheses

1. Because increased cognitive effort (as a function of decreased efficiency after TBI) is presumed to underlie fMRI activation dispersion that is seen during central executive WM tasks, we anticipate an attenuation of cerebral activation in prefrontal cortex during pharmacological intervention with Modafinil when compared to placebo administration on the mPASAT and vigilance testing.
2. There will be a correlation between the decreased dispersion of the fMRI signal on scans and improvement in neuropsychological measures when individuals are on Modafinil that is not seen when they are taking placebo.
3.  

"Interactive Metronome Technology for Blast-Related Traumatic Brain Injury"

The purpose of this research is to see whether adding a new therapy helps people with brain injury focus better and think more clearly. You are being asked to participate in this research study because you have had a brain injury. If you decide to volunteer, you will be in the study for about six months.As a participant, you will be randomly assigned to one of 2 treatment plans. Randomization is a process like flipping a coin and means you will have a chance of being assigned to either of the plans. One group will be given an experimental therapy using a metronome one hour a day, three times a week. A metronome is a device that produces a steady beat. You will need to keep time with the metronome doing several different movements. On each beat, you will be given information both through sound and on a computer screen about whether you were early or late and how far off beat you were. The tempo of the beat will be at 54 beats per minute, so you will need to process the feedback information very quickly to adjust your speed up or down to match the beat. The various movements include things like clapping hands, tapping toes, or alternating between different similar movements. It is hoped that the metronome will help subjects to concentrate better

Treatment of Traumatic Brain Injury (TBI)-Related Attention Deficits

The purpose of this research study is to find out whether Vyvanse, a psychostimulant, can help with attention deficits due to traumatic brain injury (TBI). Vyvanse is currently approved for the treatment of Attention-Deficit/Hyperactivity (ADHD). The exact effects this drug may have on attention deficits caused by TBI are not known, but we expect that Vyvanse will be of some help in treating those types of problems as well. The study will utilize functional magnetic resonance imaging (fMRI) methods, as well as neural-behavioral measures, to elucidate neural mechanisms of response.

Functional MRI Study of Attention in Normal Controls and Traumatic Brain Injured Patients 

 The purpose of this study will be to assess the attentional ability of patients with mild to moderate traumatic brain injury (TBI) using the functional Magnetic Resonance Imaging (fMRI) technique. Methodology for specific aim 1: sagittal pilot scan, 3-D anatomical MRI, Whole brain echo-planar imaging (EPI), and functional MRI techniques with traumatic brain injured subjects doing a Continuous Performance Test (CPT) attention task and compare the pattern of activation with those of normal controls to see if there is a failure to activate frontal lobes in the traumatic brain injured subjects.

 Vestibular Consequences of Blast-related Mild Traumatic Brain Injury (TBI)

The purpose of this project is to determine the effects of mild traumatic brain injury and blast exposure on the inner ear balance and central nervous systems.

...and more...

Methylphenidate (Ritalin) and Memory/Attention in Traumatic Brain Injury (TBI) 

 Measurement of Optic Nerve Sheath in Traumatic Raised Intracranial Pressure 

The Effect of Transcranial Magnetic Stimulation on Learning With Reward in Healthy Humans

 

A Fascinating Discussion

The incredible discussion between David Granet, MD and Leonard Press, OD continues at VisionHelpBlog. Dr. Granet appears to be an almost one of a kind OMD who has at least a basic understanding of optometric vision therapy! There are some differences however as this discussion notes...

We should probably not blame him if his professional organizations continue to proclaim themselves as the Doctors of NO.

Optometry says YES...all children should have comprehensive eye and vision examinations starting at an early age so that we can stamp out amblyopia (lazy eye) in our lifetimes...and goes on to create the InfantSee program that provides eye assessments for children 6-12 months at no charge.

Optometry says YES to the basic public health idea that all children should have comprehensive eye and vision examinations while in school ... while our ophthalmology colleagues say "NO" to full eye examinations because, they say, vision screenings are "good enough" for our children. If you've been paying attention to this blog, you know that the studies done on vision screenings are so poor, that other studies evaluating these vision screening articles state that they can't determine if vision screenings are effective or not! You know that Janet Hughes of the Vision First Foundation (http://www.visionfirstfoundation.org/)  was so upset that her children had significant vision problems that were missed during a vision screening, that she (almost single-handedly) had the law changed in Illinois so that at least Kindergarten children had to have full eye examinations before they could get into school.

Optometry for decades has said YES to the fact that optometric vision therapy significantly improved the quality of life for our patients with binocular vision problems....and even after NIH NEI supported randomized, placebo controlled clinical trials show this to be true, ophthalmology says NO and denies the evidence in front of them ... even when they participated in the studies. Read: Maino D. An Open Letter to David K Wallace, MD, MPH (and other disbelievers and holders of outdated and biased opinions and beliefs). Optom Vis Dev 2008;39(4):178-180.

and...finally....optometry says YES ... vision problems affect learning...while ophthalmology says NO ...and re-publishes unsupported reasons to bolster yet another NO position (See: Retract the Joint Medical Statement trivializing vision problems in kids)

It is past time for all OD's and OMD's to work together for the benefit of our patients... someday we might just do that. Optometry says YES! What do you think ophthalmolgy says? DM