Pub Date : 2021-12-23DOI: 10.31707/vdr2021.7.4.p270
Background: To evaluate improvements in clinical measures and symptoms in children and young adults with accommodative insufficiency in an open trial of office-based vergence and accommodative therapy. Methods: Major eligibility requirements included ages 9 to 30 years and amplitude of accommodation (AA) ≥2 diopters (D) below Hoffstetter’s minimum. Participants completed 8 weekly, 1-hour sessions of office-based vergence and accommodative therapy. Therapy procedures followed the Convergence Insufficiency Treatment Trial (CITT) therapy protocol with emphasis on accommodative procedures. Clinical measures of accommodation and symptoms (Convergence Insufficiency Symptom Survey [CISS]) were assessed at baseline and after therapy. Results were evaluated using the Student’s t test and Kruskal-Wallis test. Repeatability of CISS scores at baseline was assessed using Bland Altman 95% Limits of Agreement (LoA) and Interclass Correlation Coefficient (ICC). Results: Eighteen participants (mean age 17.4 ± 8.0 years) were enrolled; sixteen completed the study. The mean AA improved significantly from 5.5D OD and OS at baseline to 12.4D OD and 12.8D OS at outcome (p<0.001). Mean monocular accommodative facility (AF) also increased significantly in both eyes from 6.6 cycles per min (cpm) OD and 7.4cpm OS at baseline to 14.2cpm OD and OS at outcome (p≤0.0009). Amplitude-scaled monocular AF also showed significant improvements (p≤0.034 for both). Mean CISS score improved 10.50 points (p=0.0003). Significantly greater improvements in AA were observed in children (9.0D) than in adults (4.3D) in the right eye (p=0.007 for both comparisons). Conversely mean improvement in CISS score was significantly greater in adults than in children (p=0.039). Repeated CISS scores differed by, on average,1.47 points (95% limits of agreement:-5.19, 8.13; p=0.12). The ICC was 0.95 with a 95% confidence interval of 0.87 to 0.98. Conclusion: Eight weekly sessions of office-based accommodative vergence therapy combined with homebased- reinforcement therapy resulted in improvements of symptoms and clinical measures of accommodation in children and young adults with accommodative insufficiency.
{"title":"Effectiveness of Therapy for the Treatment of Accommodative Insufficiency: An Open Pilot Study","authors":"","doi":"10.31707/vdr2021.7.4.p270","DOIUrl":"https://doi.org/10.31707/vdr2021.7.4.p270","url":null,"abstract":"Background: To evaluate improvements in clinical measures and symptoms in children and young adults with accommodative insufficiency in an open trial of office-based vergence and accommodative therapy.\u0000Methods: Major eligibility requirements included ages 9 to 30 years and amplitude of accommodation (AA) ≥2 diopters (D) below Hoffstetter’s minimum. Participants completed 8 weekly, 1-hour sessions of office-based vergence and accommodative\u0000therapy. Therapy procedures followed the Convergence Insufficiency Treatment Trial\u0000(CITT) therapy protocol with emphasis on accommodative procedures. Clinical measures\u0000of accommodation and symptoms (Convergence Insufficiency Symptom Survey [CISS]) were assessed at baseline and after therapy. Results were evaluated using the Student’s t test and Kruskal-Wallis test. Repeatability of CISS scores at baseline was assessed using Bland Altman 95% Limits of Agreement (LoA) and Interclass Correlation Coefficient (ICC).\u0000Results: Eighteen participants (mean age 17.4 ± 8.0 years) were enrolled; sixteen completed the study. The mean AA improved significantly from 5.5D OD and OS at baseline to 12.4D OD and 12.8D OS at outcome (p<0.001). Mean monocular accommodative facility (AF) also increased significantly in both eyes from 6.6 cycles per min (cpm) OD and 7.4cpm OS at baseline to 14.2cpm OD and OS at outcome (p≤0.0009). Amplitude-scaled monocular AF also showed significant improvements (p≤0.034 for\u0000both). Mean CISS score improved 10.50 points (p=0.0003). Significantly greater improvements in AA were observed in children (9.0D) than in adults (4.3D) in the right eye (p=0.007 for both comparisons). Conversely mean improvement in CISS score was significantly greater in adults than in children (p=0.039). Repeated CISS scores differed by, on average,1.47 points (95% limits of agreement:-5.19, 8.13; p=0.12). The ICC was 0.95 with a 95% confidence interval of 0.87 to 0.98.\u0000Conclusion: Eight weekly sessions of office-based accommodative vergence therapy combined with homebased- reinforcement therapy resulted in improvements of symptoms and clinical measures of accommodation in children and young adults with accommodative insufficiency.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"78 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72488751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-23DOI: 10.31707/vdr2021.7.4.p233
Diana was one of the most incredible individuals I have ever met: smart, insightful, clever, master clinician, social hostess, politically savvy, an adventurer/world traveler, abstract painter, poet, and so much more.
{"title":"Diana Patricia Eastburn-Ludlam (1942-2021): Reflection on a Modern Wonder Woman","authors":"","doi":"10.31707/vdr2021.7.4.p233","DOIUrl":"https://doi.org/10.31707/vdr2021.7.4.p233","url":null,"abstract":"Diana was one of the most incredible individuals I have ever met: smart, insightful, clever, master clinician, social hostess, politically savvy, an adventurer/world traveler, abstract painter, poet, and so much more.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73717606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.31707/vdr2021.7.2.p128
Mild Traumatic Brain Injury (mTBI) affects a large proportion of the population and the chronic nature of symptoms present a significant socioeconomic challenge to the patient, their families, and to society. Given the multitude of ocular sequelae that may persist in this cohort of patients, eye care professionals play a crucial role in their management. Although further research is warranted, several nutrients and dietary considerations show promising results for mTBI recovery. These include, but are not limited to, omega 3 fatty acids, various dietary antioxidants, creatine, lutein, and zeaxanthin. Many of the nutrients that show beneficial results are prevalent in the Mediterranean Diet. Additionally, current literature shows improvements in cognitive impairment; therefore, this should act as the preferred dietary template for post-TBI patients. Optometric practitioners should strongly consider incorporating nutritional therapies in conjunction with conventional interventions to best improve visual outcomes associated with mTBI.
{"title":"Nutritional Considerations in the Optometric Management of Mild Traumatic Brain Injury","authors":"","doi":"10.31707/vdr2021.7.2.p128","DOIUrl":"https://doi.org/10.31707/vdr2021.7.2.p128","url":null,"abstract":"Mild Traumatic Brain Injury (mTBI) affects a large proportion of the population and the chronic nature of symptoms present a significant socioeconomic challenge to the patient, their families, and to society. Given the multitude of ocular sequelae that may persist in this cohort of patients, eye care professionals play a crucial role in their management. Although further research is warranted, several nutrients and dietary considerations show promising results for mTBI recovery. These include, but are not limited to, omega 3 fatty acids, various dietary antioxidants, creatine, lutein, and zeaxanthin. Many of the nutrients that show beneficial results are prevalent in the Mediterranean Diet. Additionally, current literature shows improvements in cognitive impairment; therefore, this should act as the\u0000preferred dietary template for post-TBI patients. Optometric practitioners should strongly consider incorporating nutritional therapies in conjunction with conventional interventions to best improve visual outcomes associated with mTBI.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"431 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74390173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.31707/vdr2021.7.2.p137
Background: Vertical yoked prisms for treatment for binocular, accommodative, refractive, gait, posture, and behavioral conditions has been recommended by various authors. Few clinical trials have assessed the safety and efficacy of this practice. The purpose of this study is to estimate the frequency of vertical yoked prism use in vision therapy and spectacle prescriptions in a sample of College of Optometrists in Vision Development (COVD) membership. Methods: Multiple invitations to participate in a prospective anonymous survey were sent to all COVD members by email in October 2019. Results: One hundred twenty-three COVD members participated. Eighty percent use vertical yoked prisms in vision therapy and 83% prescribe vertical yoked prisms in habitual spectacle prescriptions. Base down and base up across a range of powers are used about equally in therapy. Base down is prescribed more commonly for esophoria and myopia. Base up is prescribed more commonly for exophoria. Base down and base up are prescribed about equally for oculomotility, perceptual conditions, posture and behavioral conditions such as autism. Sixty three percent of respondents plan to wean patients off the prism prescriptions. Conclusions: Vertical yoked prisms are commonly used in vision therapy and prescribed in habitual spectacle prescriptions in this sample of COVD members. Given the high frequency reported, larger controlled studies on safety and efficacy are in order.
{"title":"The Use of Vertical Yoked Prisms in College of Optometrists in Vision Development Members","authors":"","doi":"10.31707/vdr2021.7.2.p137","DOIUrl":"https://doi.org/10.31707/vdr2021.7.2.p137","url":null,"abstract":"Background: Vertical yoked prisms for treatment for binocular, accommodative, refractive, gait, posture, and behavioral conditions has been recommended by various authors. Few clinical trials have assessed the safety and efficacy of this practice. The\u0000purpose of this study is to estimate the frequency of vertical yoked prism use in vision therapy and spectacle prescriptions in a sample of College of Optometrists in Vision Development (COVD) membership.\u0000Methods: Multiple invitations to participate in a prospective anonymous survey were sent to all COVD members by email in October 2019. \u0000Results: One hundred twenty-three COVD members participated. Eighty percent use vertical yoked prisms in vision therapy and 83% prescribe vertical yoked prisms in habitual spectacle prescriptions. Base down and base up across a range of powers are used about equally in therapy. Base down is prescribed more commonly for esophoria and myopia. Base up is prescribed more commonly for exophoria. Base down and base up are prescribed about equally for oculomotility, perceptual conditions, posture and\u0000behavioral conditions such as autism. Sixty three percent of respondents plan to wean patients off the prism prescriptions.\u0000Conclusions: Vertical yoked prisms are commonly used in vision therapy and prescribed in habitual spectacle prescriptions in this sample of COVD members. Given the high frequency reported, larger controlled studies on safety and efficacy are in order.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86730295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.31707/vdr2021.7.2.p84
Ariel Pscheidl
Background: As the deaf and hard of hearing population has increased over the last few decades, the prevalence of American Sign Language as a person’s primary language has increased with it. However, many optometrists are unsure as to how to approach an exam, and what the law requires to accommodate these patients. This literature review explores the legal and ethical considerations of examining and communicating with patients who are deaf or hard of hearing. Methods: Through literature review, information was gathered and summarized from many high quality publications and legal cases as to how to properly care for and communicate with a patient who is deaf or hard of hearing, with special attention to the legal and ethical requirements of an optometrist. Results: To optimize the health care environment for patients who are deaf or hard of hearing, the most important step is for optometrists to understand local resources, such as sign language interpreters, legal support, and community agencies, that can benefit both the patients and their chair time. This varies depending on what the deaf/hard of hearing patient needs and should be adjusted accordingly. The supplemental use of pictures or diagrams to illustrate tests or procedures may also help solidify communication between patient and doctor but may not be a substitute for “effective communication” as outlined in the Americans with Disabilities Act. Above all, it is important to meet these legal requirements, as well as address the specific needs of the patient, preferably with preparation before the exam. In addition, this information in this literature review is summarized in pamphlet format for distribution to the optometric community. Conclusion: The Americans with Disabilities Act lays out legal guidelines that physicians must follow when it comes to patients who are deaf or hard of hearing, including optometrists. It is important for optometrists to study these requirements and be aware of them, should the situation arise when a patient who is deaf or hard of hearing schedules or presents in a clinical setting.
{"title":"The Legal and Ethical Care of Patients Who are Deaf or Hard of Hearing with an Emphasis on Communication Methods","authors":"Ariel Pscheidl","doi":"10.31707/vdr2021.7.2.p84","DOIUrl":"https://doi.org/10.31707/vdr2021.7.2.p84","url":null,"abstract":"Background: As the deaf and hard of hearing population has increased over the last few decades, the prevalence of American Sign Language as a person’s primary language has increased with it. However, many optometrists are unsure as to how to approach an exam, and what the law requires to accommodate these patients. This literature review explores the legal and ethical considerations of examining and communicating with patients who are deaf or hard of hearing.\u0000Methods: Through literature review, information was gathered and summarized from many high quality publications and legal cases as to how to properly care for and communicate with a patient who is deaf or hard of hearing, with special attention to the legal and ethical requirements of an optometrist.\u0000Results: To optimize the health care environment for patients who are deaf or hard of hearing, the most important step is for optometrists to understand local resources, such as sign language interpreters, legal support, and community agencies, that can benefit both the patients and their chair time. This varies depending on what the deaf/hard of hearing patient needs and should be adjusted accordingly. The supplemental use of pictures or diagrams to illustrate tests or procedures may also help solidify communication between patient and doctor but may not be a substitute for “effective communication” as outlined in the Americans with Disabilities Act. Above all, it is important to meet these legal requirements, as well as address the specific needs of the patient, preferably with preparation before the exam. In addition, this information in this literature review is summarized in pamphlet format for distribution to the optometric community. \u0000Conclusion: The Americans with Disabilities Act lays out legal guidelines that physicians must follow when it comes to patients who are deaf or hard of hearing, including optometrists. It is important for optometrists to study these requirements and be aware of them, should the situation arise when a patient who is deaf or hard of hearing schedules or presents in a clinical setting.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74506733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.31707/vdr2021.7.2.p107
Background: Screen time continues to increase among children and youth, yet little is known about its potential effects on oculomotor development and function. The aims of the current study were to (a) compare oculomotor function in children today to those tested before smartphone use and (b) explore correlations between screen time use and oculomotor function among children today. Method: A retrospective comparison was conducted comparing normative data published in the Developmental Eye Movement (DEM) Test manual in 1990, prior to the invention of smart devices, to data collected in 2020. Correlations between screen time and DEM variables were also explored within the current sample. Results: Sixty middle school students reported spending on average 45.5 hours/week on screens with approximately 18.5 hours/week on iPhones, 14.5 hours/week on television and 10.5 hours/week on computers. Surprisingly, DEM performance was not significantly improved in the current sample compared to the historical sample. There were also no significant correlations between any screen time variables and oculomotor metrics within the current sample. Conclusion: Despite the significant increase in screen time usage since 1990, DEM performance was replicable among 6th, 7th, and 8th grader students tested 30 years later. A statistically significant difference was found among 7th graders on DEM Vertical, where the 2020 students performed slower however, this difference may not be clinically significant. Importantly, DEM Ratio, a key variable for identifying ocular motility dysfunction (OMD), was also not significantly different between 1990 and 2020. Moreover, screen time in the current sample did not correlate with any DEM variables. This study provides preliminary evidence indicating that as measured by the DEM Test, increased screen time may not affect ocular motility. Further research is warranted using more finite methods for measuring saccade and smooth pursuit eye movements during the use of screened devices.
{"title":"Screen Time and Developmental Eye Movement Testing in Middle School Students","authors":"","doi":"10.31707/vdr2021.7.2.p107","DOIUrl":"https://doi.org/10.31707/vdr2021.7.2.p107","url":null,"abstract":"Background: Screen time continues to increase among children and youth, yet little is known about its potential effects on oculomotor development and function. The aims of the current study were to (a) compare oculomotor function in children today to those tested before smartphone use and (b) explore correlations between screen time use and oculomotor function among children today.\u0000Method: A retrospective comparison was conducted comparing normative data published in the Developmental Eye Movement (DEM) Test manual in 1990, prior to the invention of smart devices, to data collected in 2020. Correlations between screen time and DEM variables were also explored within the current sample.\u0000Results: Sixty middle school students reported spending on average 45.5 hours/week on screens with approximately 18.5 hours/week on iPhones, 14.5 hours/week on television and 10.5 hours/week on computers. Surprisingly, DEM performance was not significantly improved in the current sample compared to the historical sample. There were also no significant correlations between any screen time variables and oculomotor metrics within the current sample.\u0000Conclusion: Despite the significant increase in screen time usage since 1990, DEM performance was replicable among 6th, 7th, and 8th grader students tested 30 years later. A statistically significant difference was found among 7th graders on DEM Vertical, where the 2020 students performed slower however, this difference may not be clinically significant. Importantly, DEM Ratio, a key variable for identifying ocular motility dysfunction (OMD), was also not significantly different between 1990 and 2020. Moreover, screen time in the current sample did not correlate with any DEM variables. This study provides preliminary evidence indicating that as measured by the DEM Test, increased screen time may not affect ocular motility. Further research is warranted using more finite methods for measuring saccade and smooth pursuit eye movements during the use of screened devices.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81515131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-01DOI: 10.31707/vdr2021.7.2.p95
Kierstyn Napier-Dovorany, V. Graham
Gait is an important human function, and vision is the dominant sensory input used during gait. Vision aids pathfinding decisions and provide ongoing sensory feedback to maintain appropriate balance and prevent falls. Eye care providers who wish to effectively address the impact of vision impairment on the risk of falling will customize their management plan based on specific impairments. This article provides an overview of normal sensory integration as it applies to gait, with an emphasis on vision. It also presents an evidence-based review of visual dysfunctions that cause falls, as well as strategies to reduce falls in adults with visual impairment, with emphasis on patients over age 65.
{"title":"Topical Review: Vision and Gait in Older Adults: A Clinician’s Perspective","authors":"Kierstyn Napier-Dovorany, V. Graham","doi":"10.31707/vdr2021.7.2.p95","DOIUrl":"https://doi.org/10.31707/vdr2021.7.2.p95","url":null,"abstract":"Gait is an important human function, and vision is the dominant sensory input used during gait. Vision aids pathfinding decisions and provide ongoing sensory feedback to maintain appropriate balance and prevent falls. Eye care providers who wish to effectively address the impact of vision impairment on the risk of falling will customize their management plan based on specific impairments. This article provides an overview of normal sensory integration as it applies to gait, with an emphasis on vision. It also presents an evidence-based review of visual dysfunctions that cause falls, as well as strategies to reduce falls in adults with visual impairment, with emphasis on patients over age 65.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77224149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.31707/vdr2021.7.1.p50
R. Pandey, M. Optm, Priya Pandey
Background: Amblyopia is characterised by visual impairment along with compromised binocular visual function. Form deprivation amblyopia is a result of opaque media which results in obstruction of light. This obstruction of light prevents visual development. It is has traditionally been managed at early stage of life through occlusion therapy. Case Summary: A 29-year old male presented to us, diagnosed with form deprivation adult strabismic amblyopia and nystagmus. Anterior segment evaluation showed pseudophakia in both eyes, and posterior segment was within normal limits. Stereopsis was absent. In-office vision therapy and homebased vision therapy was undertaken, which included optometric syntonic phototherapy, biofeedback mechanisms to improve nystagmus along with oculomotor skills, monocular fixation in a binocular field (MFBF) and binocular therapies in-office, and Amb-iNet at home. Conclusion: A multi-modality treatment approach in vision therapy is presented, which resulted in improvement of visual acuity, stereopsis and other components of vision for an adult with form deprivation strabismic amblyopia and nystagmus.
{"title":"A Multi-Modality Treatment Approach in Vision Therapy for a Patient with Form Deprivation Adult Strabismic Amblyopia and Nystagmus: A Case Report","authors":"R. Pandey, M. Optm, Priya Pandey","doi":"10.31707/vdr2021.7.1.p50","DOIUrl":"https://doi.org/10.31707/vdr2021.7.1.p50","url":null,"abstract":"Background: Amblyopia is characterised by visual impairment along with compromised binocular visual function. Form deprivation amblyopia is a result of opaque media which results in obstruction of light. This obstruction of light prevents visual development. It is has traditionally been managed at early stage of life through occlusion therapy. Case Summary: A 29-year old male presented to us, diagnosed with form deprivation adult strabismic amblyopia and nystagmus. Anterior segment evaluation showed pseudophakia in both eyes, and posterior segment was within normal limits. Stereopsis was absent. In-office vision therapy and homebased vision therapy was undertaken, which included optometric syntonic phototherapy, biofeedback mechanisms to improve nystagmus along with oculomotor skills, monocular fixation in a binocular field (MFBF) and binocular therapies in-office, and Amb-iNet at home. Conclusion: A multi-modality treatment approach in vision therapy is presented, which resulted in improvement of visual acuity, stereopsis and other components of vision for an adult with form deprivation strabismic amblyopia and nystagmus.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84347011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-23DOI: 10.31707/vdr2020.6.4.p304
Andrew J. Bodwell
Background: Insult to the brain, whether from trauma or other etiologies, can have a devastating effect on an individual. Symptoms can be many and varied, depending on the location and extent of damage. This presentation can be a challenge to the optometrist charged with treating the sequelae of this event as multiple functional components of the visual system can be affected. Case Report: This paper describes the diagnosis and subsequent ophthalmic management of an acquired brain injury in a 22 year old male on active duty in the US Army. After developing acute neurological symptoms, the patient was diagnosed with a pilocytic astrocytoma of the cerebellum. Emergent neurosurgery to treat the neoplasm resulted in iatrogenic cranial nerve palsies and a hemispheric syndrome. Over the next 18 months, he was managed by a series of providers, including a strabismus surgeon, until presenting to our clinic. Lenses, prism, and in-office and out-of-office neurooptometric rehabilitation therapy were utilized to improve his functioning and make progress towards his goals. Conclusions: Pilocytic astrocytomas are the most common primary brain tumors, and the vast majority are benign with excellent surgical prognosis. Although the most common site is the cerebellum, the visual pathway is also frequently affected. If the eye or visual system is affected, optometrists have the ability to drastically improve quality of life with neuro-optometric rehabilitation.
{"title":"Neuro-Optometric Treatment of Complications from a Cerebellar Astrocytoma","authors":"Andrew J. Bodwell","doi":"10.31707/vdr2020.6.4.p304","DOIUrl":"https://doi.org/10.31707/vdr2020.6.4.p304","url":null,"abstract":"Background: Insult to the brain, whether from trauma or other etiologies, can have a devastating effect on an individual. Symptoms can be many and varied, depending on the location and extent of damage. This presentation can be a challenge to the optometrist charged with treating the sequelae of this event as multiple functional\u0000components of the visual system can be affected.\u0000Case Report: This paper describes the diagnosis and subsequent ophthalmic management of an acquired brain injury in a 22 year old male on active duty in the US Army. After developing acute neurological symptoms, the patient was diagnosed with a pilocytic astrocytoma of the cerebellum. Emergent neurosurgery to treat the neoplasm resulted in iatrogenic cranial nerve palsies and a hemispheric syndrome. Over the next 18 months, he was managed by a series of providers, including a strabismus surgeon, until presenting to our clinic. Lenses, prism, and in-office and out-of-office neurooptometric rehabilitation therapy were utilized to improve his functioning and make progress towards his goals.\u0000Conclusions: Pilocytic astrocytomas are the most common primary brain tumors, and the vast majority are benign with excellent surgical prognosis. Although the most common site is the cerebellum, the visual pathway is also frequently affected. If the eye or visual system is affected, optometrists have the ability to drastically improve quality of life with neuro-optometric rehabilitation.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90224562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-23DOI: 10.31707/vdr2019.6.4.p295
R. Pandey, M. Optom
Introduction: Children with Global Developmental Delay (GDD) fail to achieve developmental milestones expected for their age range as compared to their peers. They typically have visual problems in addition to poor gross and fine motor skills. Developmental delays extend to speech, language, cognition, and personal-social domains, and impact activities of daily living. Case Summary: A 4-year-old child presented with chief concerns from his parents that he had difficulty making eye contact was unable to stand and walk. He was not making adequate progress in physiotherapy. Neuro-developmental assessment resulted in a diagnosis of GDD. Visual Evoked Potential showed decreased visual acuity, and nystagmus. Comprehensive examination showed that the patient had a face tilt and head turn. Spectacle lenses with prism was prescribed. A therapy treatment plan was recommended and it was divided into three phases, with the primary goal of improving visual functions through vision therapy. At the end of the therapy, the child developed the confidence to stand and walk without any support. Conclusion: This case report demonstrates the importance of vision therapy in improving the patient’s overall visual performance. In particular, it demonstrates the role of visual intervention in aiding motor skills to the extent that standing and walking was enabled without the need for additional support.
{"title":"A Journey Towards 1st Step of Life – A Case Report on Vision Therapy for A Patient with Global Developmental Delay and Nystagmus","authors":"R. Pandey, M. Optom","doi":"10.31707/vdr2019.6.4.p295","DOIUrl":"https://doi.org/10.31707/vdr2019.6.4.p295","url":null,"abstract":"Introduction: Children with Global Developmental Delay (GDD) fail to achieve developmental milestones expected for their age range as compared to their peers. They typically have visual problems in addition to poor gross and fine motor skills. Developmental delays extend to speech, language, cognition, and personal-social domains, and impact activities of daily living. \u0000Case Summary: A 4-year-old child presented with chief concerns from his parents that he had difficulty making eye contact was unable to stand and walk. He was not making adequate progress in physiotherapy. Neuro-developmental assessment resulted in\u0000a diagnosis of GDD. Visual Evoked Potential showed decreased visual acuity, and nystagmus. Comprehensive examination showed that the patient had a face tilt and head turn. Spectacle lenses with prism was prescribed. A therapy treatment plan was recommended and it was divided into three phases, with the primary goal of improving visual functions through vision therapy. At the end of the therapy, the child developed the confidence to stand and walk without any support.\u0000Conclusion: This case report demonstrates the importance of vision therapy in improving the patient’s overall visual performance. In particular, it demonstrates the role of visual intervention in aiding motor skills to the extent that standing and walking was enabled without the need for additional support.","PeriodicalId":91423,"journal":{"name":"Vision development and rehabilitation","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83375779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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