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A Tribute to Melvin Kaplan, OD, FCOVD 向Melvin Kaplan致敬,OD, FCOVD
Pub Date : 2023-01-01 DOI: 10.31707/vdr2023.9.3.p160
which, in turn, affects behavior and influences how one performs in social, academic, and vocational surroundings.” 4 Other clinicians using yoked prism procedures, such as Robert Kraskin, preferred a disruptive approach. Mel taught that yoked prisms might improve function such that a patient’s performance improved immediately. His technique engaged patients who were nonverbal and/or multiply chal­ lenged, improving their overall function. Mel taught that optometrists needed to look at the patient in front of them from a functional performance approach and emphasized the importance of objective findings for all of us. “I do not view people with various disabilities as different. I look at them as having different levels of visual performance … the question is not of labels, but of levels of performance.” 4
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引用次数: 0
Alva Noë, Art and Vision Therapy Alva Noë,艺术与视觉治疗
Pub Date : 2023-01-01 DOI: 10.31707/vdr2023.9.3.p151
What a delight to read philosopher Alva Noë’s latest book, THE ENTANGLEMENT: How Art and Philosophy Make Us What We Are.1 We first met Alva Noë as a speaker at our 2012, Ft. Worth, COVD meeting. Since what we do is an art thoroughly entangled with philosophy and life, Noë’s insights are especially valuable. Many of us imagine that behavior and vision share an intimate relationship. As for the nature of the relationship, there are probably as many perspectives as there are practitioners who have thought about vision for a professional lifetime. Our disagreements are a testament to the elusiveness of the visual process. Our persistent diversity of thought, however, agrees with Noë’s observation that philosophers aim at “not agreement, but persuasion, that is to say, conversion. They seek to see the world anew. And this is an aesthetic project.”
阅读哲学家Alva Noë的最新著作《纠缠:艺术和哲学如何塑造我们》是一件多么愉快的事情。我们第一次见到Alva Noë是在2012年沃斯堡COVD会议上作为演讲者。因为我们所做的是一门与哲学和生活彻底纠缠在一起的艺术,Noë的真知灼见尤为可贵。我们很多人都认为行为和视觉有着亲密的关系。至于这种关系的本质,可能有多少从业者在职业生涯中思考过视力问题,就有多少观点。我们的分歧证明了视觉过程的难以捉摸。然而,我们思想的持续多样性与Noë的观察一致,即哲学家的目标“不是达成一致,而是说服,也就是说,转变。”他们试图以全新的眼光看待世界。这是一个美学项目。”
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引用次数: 0
The Effects of Increased Near Point Stress on the Visual System of Pediatric Patients with Strabismus 近点应力增加对儿童斜视患者视觉系统的影响
Pub Date : 2023-01-01 DOI: 10.31707/vdr2023.9.3.p173
Due to the COVID-19 pandemic, school closures resulted in children participating in remote learning and a subsequent increase in near demand associated with increased computer work. Prolonged near work has been shown to impact the visual system and possibly myopia progression. This case series shows the functional visual effects near point stress may have on pediatric patients with strabismus.
由于2019冠状病毒病大流行,学校关闭导致儿童参与远程学习,随后由于计算机作业增加,近距离需求增加。长期近距离工作已被证明会影响视觉系统,并可能导致近视的发展。本病例系列显示了近点应力可能对斜视儿童患者产生的功能性视觉影响。
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引用次数: 0
Vision Therapy for Convergence and Accommodative Insufficiency in Post-Concussion Syndrome 脑震荡后综合征会聚和调节功能不全的视力治疗
Pub Date : 2023-01-01 DOI: 10.31707/vdr2023.9.3.p181
Accommodative and convergence insufficiencies are commonly found in post-concussion syndrome. Retrospective studies have determined the prevalence of these conditions as well as the effectiveness of neuro-optometric rehabilitative therapy (NORT).
适应性和收敛性不足常见于脑震荡后综合征。回顾性研究已经确定了这些疾病的患病率以及神经验光康复治疗(NORT)的有效性。
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引用次数: 0
Using Principles of Neuroplasticity and Visual-Vestibular Function in the Treatment of 6th Cranial Nerve Palsy or Paresis 运用神经可塑性和视前庭功能原理治疗第6脑神经麻痹或神经麻痹
Pub Date : 2023-01-01 DOI: 10.31707/vdr2023.9.3.p163
Sixth cranial nerve (abducens) palsy is a common manifestation of acquired brain injury. Abducens nerve damage results in esotropia and horizontal diplopia. The current standard of care appears to be no treatment initially other than monocular occlusion or limited use of Fresnel prism, followed by Botox or strabismus surgery at 6-12 months post injury.
第六颅神经(外展神经)麻痹是后天性脑损伤的常见表现。外展神经损伤导致内斜视和水平复视。目前的治疗标准似乎是除了单眼遮挡或有限使用菲涅耳棱镜外不进行任何治疗,然后在损伤后6-12个月进行肉毒杆菌注射或斜视手术。
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引用次数: 0
An Interdisciplinary Approach to Improve Head Tilt in Pediatric Torticollis Patients with the Use of Prism Glasses 使用棱镜镜改善小儿斜颈患者头部倾斜的跨学科方法
Pub Date : 2021-12-24 DOI: 10.31707/vdr2021.7.4.p235
Background: Infants with head tilts are most often diagnosed with torticollis and are referred to a pediatric physical therapist for evaluation and treatment. Determining if the head position is muscular or non-muscular when assessing these infants is key in making the appropriate referrals to other specialists and determining the best treatmentapproach. Most pediatric physical therapists treat patients with head tilts with manual therapy (i.e. massage, myofascial release, and passive/active range of motion). Many physical therapists only consider a visual etiology as a possibility after other treatment options have been exhausted and the head tilt persists. Although the incidence of torticollis has increased, based on the author’s experience, the number of cases of non-muscular etiology has also increased. There is a lack of current research on the use of prism glasses for treating head tilts in young children and infants carrying a diagnosis of torticollis, especially those presenting without any active/passive motion limitations. Traditionally, these patients undergo years of treatment without resolution of the head tilt.Case Report: A two-year-old patient initially presented with a diagnosis of torticollis with an intermittent and alternating head tilt for physical therapy. After several months of manual therapy, with little improvement in her head posture, the patient’s physical therapist referred her to a behavioral optometrist for a comprehensive vision examination and to pursue alternative treatment options. The optometric evaluation revealed ocular misalignment causing poor depth perception skills and prism glasses were prescribed full-time with the recommendation of continuing physical therapy for gross motor development.Conclusion: Prism glasses are an appropriate treatment consideration for some pediatric patients with persistent head tilts because they can provide immediate improvement in head position and depth perception. It is important to include optometrists in the multi-disciplinary team when working with patients with head tilts. Pediatric physical therapists would benefit from training on how to properly screen visual skills when evaluating children with head tilts. With such training, an appropriate optometric referral could be initiated early on in treatment.
背景:头部倾斜的婴儿最常被诊断为斜颈,并被转到儿科物理治疗师进行评估和治疗。在评估这些婴儿时,确定头部位置是肌肉性还是非肌肉性是向其他专家进行适当转诊和确定最佳治疗方法的关键。大多数儿科物理治疗师用手工疗法(即按摩、肌筋膜释放和被动/主动活动范围)治疗头倾斜患者。许多物理治疗师只考虑视觉病因的可能性后,其他治疗方案已经用尽,头部倾斜仍然存在。虽然斜颈的发病率有所增加,但根据作者的经验,非肌肉病因的病例数量也有所增加。目前缺乏关于使用棱镜眼镜治疗患有斜颈的幼儿和婴儿头部倾斜的研究,特别是那些没有任何主动/被动运动限制的儿童和婴儿。传统上,这些患者经过多年的治疗,头部倾斜没有得到解决。病例报告:一个两岁的病人最初提出诊断为斜颈与间歇性和交替的头部倾斜物理治疗。经过几个月的手工治疗,她的头部姿势几乎没有改善,病人的物理治疗师将她转到行为验光师那里进行全面的视力检查,并寻求其他治疗方案。验光评估显示眼睛错位导致深度感知能力差,并建议继续进行大运动发展的物理治疗。结论:对于一些持续性头部倾斜的儿童患者,棱镜眼镜是一种合适的治疗方案,因为它可以立即改善头部位置和深度感知。在治疗头部倾斜患者时,将验光师纳入多学科团队是很重要的。儿科物理治疗师在评估头部倾斜儿童时,将从如何正确筛选视觉技能的培训中受益。有了这样的培训,适当的验光转诊可以在治疗的早期开始。
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引用次数: 0
Age-Related Vestibular Dysfunction; Vestibulo-Ocular Reflex, Dynamic Visual Acuity, Dizziness and Falls: A Review 年龄相关性前庭功能障碍;前庭-眼反射,动态视力,头晕和跌倒:综述
Pub Date : 2021-12-23 DOI: 10.31707/vdr2021.7.4.p279
Background: Vestibular and vision functions are important contributors to posture control and fall avoidance. This review examines how the vestibulo-ocular reflex can be rehabilitated to help restore postural control.Methods: PubMed searches (7th April 2021) using the terms ‘vestibulo-ocular reflex’, ‘imbalance and vestibular dysfunction’, ‘vestibular dysfunction and dizziness’, ‘dynamic visual acuity’, ‘vestibular dysfunction rehabilitation’, and ‘gaze stabilization exercises’ yielded 4986, 495, 3576,1830, 3312, and 137 potentially useful publications respectively.Selections of those which were found to be the most relevant and representative of a balanced and current account of these topics, as well as selections from the most relevant reports referenced in those publications, were included in this review.Results: Just as there are age-related losses of static visual acuity even when there are no specific visual pathologies diagnosed, patients may also present with age-related loss of vestibular functions in the absence of specific vestibular pathologies. For example, cases of dizziness which are diagnosed as idiopathic might be usefully classified as age-related as the basis for the initiation of rehabilitation exercises.Conclusions: Apart from age-related loss of vestibular functions, cases diagnosed as having a particular form of vestibular pathology may have that condition exacerbated by age-related losses of vestibular functions. The effects of vestibular rehabilitation gaze stability exercises in patients with vestibular dysfunction are well established and include both improved dynamic acuity and postural stability. Improvements in posture control following rehabilitation of the vestibulo-ocular reflex are apparently due to improved peripheral and/or central vestibular balance control which has occurred in conjunction with enhanced gaze stability. The complex nature of increased fall risk suggests that an interdisciplinary approach to rehabilitation that includes vestibulo-ocular reflex rehabilitation appears likely to be associated with optimum outcomes for both pathological and age-related cases.
背景:前庭和视觉功能是姿势控制和避免跌倒的重要因素。这篇综述探讨了如何恢复前庭眼反射来帮助恢复姿势控制。方法:PubMed检索(2021年4月7日),检索词为“前庭眼反射”、“不平衡和前庭功能障碍”、“前庭功能障碍和头晕”、“动态视力”、“前庭功能障碍康复”和“凝视稳定练习”,检索结果分别为4986、4995、3576、1830、3312和137篇潜在有用的出版物。从被认为最相关和最能反映这些主题的平衡和最新情况的报告中选出的报告,以及从这些出版物中引用的最相关的报告中选出的报告,都列入了本次审查。结果:正如即使没有诊断出特定的视觉病变,也存在与年龄相关的静态视力丧失一样,在没有特定的前庭病变的情况下,患者也可能出现与年龄相关的前庭功能丧失。例如,被诊断为特发性的头晕病例可能被归类为与年龄有关的,作为开始康复锻炼的基础。结论:除了与年龄相关的前庭功能丧失外,被诊断为具有特定形式的前庭病理的病例可能会因与年龄相关的前庭功能丧失而加重病情。前庭康复凝视稳定练习对前庭功能障碍患者的影响已经得到了很好的证实,包括改善动态敏锐度和姿势稳定性。前庭眼反射康复后姿势控制的改善显然是由于外周和/或中央前庭平衡控制的改善,这与增强的凝视稳定性有关。跌倒风险增加的复杂性表明,包括前庭-眼反射康复在内的跨学科康复方法可能与病理性和年龄相关病例的最佳结果相关。
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引用次数: 0
A Combined Approach of Syntonic Phototherapy along with Vision Therapy in Treatment of Rod-Cone Dystrophy: A Ray of Hope - Case Series Report 综合光疗法与视觉疗法联合治疗杆状锥体营养不良:一线希望-病例系列报告
Pub Date : 2021-12-23 DOI: 10.31707/vdr2021.7.4.p254
Background: Rod-Cone Dystrophies (RCDs) are characterized by the dominant clinical features of rods manifestation predominantly over the cones such as night blindness and peripheral vision worsening that leads to restricted activities of daily living. There are no medical or surgical treatments available for this disease. A combined approach of syntonic phototherapy along with the vision therapy may be a viable treatment optionfor the improvement in visual efficiency skills and visual function of RCD patients.Case Reports: Case 1: A female, aged 47 years old, diagnosed with severe RCD and complained of poor sight and difficulty in seeing at night in both eyes along with progressive diminution of vision for the past ten years. Case 2: A boy, 11 years of age, diagnosed with severe RCD and presented with major complaints of progressive vision loss, photophobia and falling short in school performance. Both patients were recommended for a combined treatment approach of syntonic phototherapy combined with vision therapy to be completed in our centre.Conclusion: These two patients showed significant improvement in visual acuity, oculomotor motility and visual field. Further research is recommended to enrich our understanding on the use of syntonic phototherapy along with vision therapy in managing patients with RCD which otherwise lacks in specific medical or surgical treatment.
背景:视杆锥体营养不良症(rcd)的临床特征主要是视杆细胞而非视锥细胞,如夜盲症和周边视力恶化,导致日常生活活动受限。这种疾病没有药物或手术治疗方法。联合光疗法与视觉疗法可能是改善RCD患者视觉效率、技能和视觉功能的可行治疗方法。病例报告:病例1:女性,47岁,诊断为严重RCD,主诉视力差,夜间双眼视力困难,视力进行性下降近十年。病例2:一名男孩,11岁,诊断为严重RCD,主要表现为进行性视力丧失、畏光和学习成绩不佳。建议两例患者在我中心接受联合光疗结合视力治疗的治疗方法。结论:两例患者的视力、动眼力和视野均有明显改善。建议进一步的研究,以丰富我们对使用联合光疗结合视力治疗RCD患者的认识,否则缺乏具体的药物或手术治疗。
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引用次数: 0
Automated Functional Color Field Tester (FCFTester) Trends and Reproducibility – A Multicenter Pilot Study 自动化功能色场测试仪(FCFTester)趋势和可重复性-一项多中心试点研究
Pub Date : 2021-12-23 DOI: 10.31707/vdr2021.7.4.p293
Background: The present study was designed to assess a protocol for investigating normative trends of kinetic color visual field sizes and reproducibility of such utilizing the Automated Functional Color Field Tester (FCFTester).Methods: The participants were recruited at three clinical sites. The participants were screened for the study based on a questionnaire designed by the authors to help assess the inclusion and exclusion criteria. There were 116 adult-only participants, however, only those reporting White race (n = 106) were used for statistical analysis. The mean age was 35.8 (std = 14) and nearly 70% of the sample was female.Results: This study demonstrated that kinetic visual field sizes across all four color isopters are not influenced by gender (p = 0.96) nor eye tested (p = 0.46). Only a slight difference in mean visual field sizes was found between the three clinical sites ranging from less than 2.5 degrees when the target was blue or green to less than 1.5 degrees for white or red targets. Overall, age had limited, yet significant, influence on kinetic field sizes likely related to the relatively young age of our participants. A significant difference in mean field size existed when comparing the four color isopters with an ascending order of green, red, blue, and white. This pattern was consistent across the three testing sites. Variability in field size for each color isopter was slight across thethree clinical sites. Conclusion: The present pilot study shows promise that a protocol can be established to provide reproducible data and normative trends in kinetic color visual field testing. The authors recognize that this should be achievable with further refinement of the current testing protocol.
背景:本研究旨在评估一种利用自动功能色场测试仪(FCFTester)调查动态色视野大小的规范趋势和再现性的方案。方法:在三个临床地点招募受试者。参与者根据作者设计的问卷进行筛选,以帮助评估纳入和排除标准。有116名成人参与者,然而,只有那些报告白人种族(n = 106)被用于统计分析。平均年龄35.8岁(std = 14),近70%的样本为女性。结果:本研究表明,所有四种色差的动态视野大小不受性别(p = 0.96)和眼睛测试(p = 0.46)的影响。在三个临床位置之间,平均视野大小只有轻微的差异,从目标为蓝色或绿色时小于2.5度到目标为白色或红色时小于1.5度。总的来说,年龄对动力学场大小的影响有限,但很重要,这可能与我们的参与者相对年轻有关。以绿、红、蓝、白四种颜色等分线进行比较,平均视场大小存在显著差异。这种模式在三个测试点之间是一致的。在三个临床部位,每个颜色等色器的视场大小变化很小。结论:目前的初步研究表明,可以建立一个协议,提供可重复的数据和规范的动态颜色视野测试趋势。作者认识到,这应该是可以实现的进一步完善当前的测试方案。
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引用次数: 0
Making Modifications in Vision Therapy for a Child with Cerebral Visual Impairment and Developmental Delay 脑性视力障碍和发育迟缓儿童视力治疗的改进
Pub Date : 2021-12-23 DOI: 10.31707/vdr2021.7.4.p245
Background: Children with cerebral visual impairment (CVI) and/or developmental delay(DD) have a higher incidence of oculomotor dysfunction and visual perceptual challenges, in addition to challenges with motor control and body awareness. Such disorders could negatively impact one’s quality of life.Case Summary: This case demonstrates the efficacy of modified vision therapy (VT) activities in a 5-year-old child with CVI and DD. She completes roughly 50 sessions of VT and shows significant improvements in visual tracking and visual perceptual (VP) skills.Conclusions: This case emphasizes that children with CVI and/ or DD can benefit from VT. The progress of therapy may be affected by other motor and cognitive challenges; therefore, visual modifications to standard VT procedures can improve therapy success in these patients.
背景:患有脑视觉障碍(CVI)和/或发育迟缓(DD)的儿童除了运动控制和身体意识方面的挑战外,还具有较高的动眼肌功能障碍和视觉感知挑战的发生率。这些疾病可能会对一个人的生活质量产生负面影响。病例总结:本病例展示了改良视力治疗(VT)活动对一名5岁CVI和DD儿童的疗效。她完成了大约50次VT治疗,并在视觉跟踪和视觉感知(VP)技能方面显示出显着改善。结论:本病例强调CVI和/或DD患儿可以从VT中获益。治疗进展可能受到其他运动和认知障碍的影响;因此,对标准VT程序进行视觉修改可以提高这些患者的治疗成功率。
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引用次数: 0
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Vision development and rehabilitation
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