Saturday, December 22, 2012

Can candy canes cure dry eye disease? Researchers say yes. And yum!


Can an candy cane cure dry eye disease?

Can candy cure dry eye disease?
This holiday season, try sucking on a candy cane to cure your dry eye disease.  A study by researchers at the Department of Physiology of Nepal Medical College in Kathmandu set out to determine enjoyment of a mouth-watering candy can increase tear production in your eyes.  Read more at DryEyeDoctor. ca...

Image courtesy of scottchan / FreeDigitalPhotos.net

Tuesday, December 11, 2012

Traumatic brain injury often results in convergence insufficiency. But could there be more vision problems?

Brain injuries and vision problems.
Traumatic brain injury often results in convergence insufficiency.  But could there be more vision problems?  That is the question that researchers investigated in a recent study published in Optometry & Vision Science.

The researchers looked at the medical records of 557 brain injury patients and assessed the visual acuity, oculomotor function, binocular vision function, accommodation, visual fields, ocular health, and vestibular function for each patient.

Only 9% of the TBI brain injury patients had convergence insufficiency without the following simultaneous diagnoses: saccade or pursuit dysfunction; third, fourth, or sixth cranial nerve palsy; visual field deficit; visual spatial inattention/neglect; vestibular dysfunction; or nystagmus.

It was far more common for the brain injury patients to have convergence insufficiency with other vision problems.  Here are some examples:

  • Photophobia (light sensitivity) together with convergence insufficiency was observed in 16.3% (21 of 130), 
  • vestibular dysfunction together with convergence insufficiency was observed in 18.5% (24 of 130) 
  • Convergence insufficiency and cranial nerve palsies were present in 23.3% (130 of 557) and 26.9% (150 of 557), respectively

Other vision disorders were also present.   Accommodative dysfunction was common, as were visual field deficits or unilateral visual spatial inattention/neglect.

The study findings support the idea that patients who have suffered a traumatic brain injury need a comprehensive eye exam that tests for a wide variety of vision problems.  Where visual problems are found to result from a brain injury, vision therapy is an effective treatment. 


Image courtesy of Victor Habbick / FreeDigitalPhotos.net

Sunday, December 2, 2012

Dry eye syndrome after cataract surgery



At our Vancouver eye clinic, we see and treat lots of patients who have dry eyes following cataract surgery.  Cataract surgery results in dry eye syndrome because the surgery cuts the nerves in the cornea of the eye, which impairs the ability of the eye to create a proper tear film. The result is dry eye.   Dry eye can cause pain, irritation and  decreased vision.  Here's what everyone contemplating cataract surgery should know about what to do about dry eye.  Read more...





Wednesday, November 21, 2012

The eye nutrients that prevent blindness and also make you smarter

The connection between vision and cognition
Science has shown that increased lutein and zeaxanthin in the diet lowers the risk of cataracts and age related macular degeneration (AMD) two eye diseases that cause permanent vision loss. Catracts can be treated by removing the damaged lens of the eye and transplanting a new artificial lens but AMD has no treatment and the only way to fight it is through prevention.  New research suggests that these same nutrients improve cognitive function in the elderly.  Read more...

Related articles:

Sharp vision sharp mind

The miracle vitamin gets even more miraculous

Lutein and zeaxanthin - nutrients for eye health


For more information on eye nutrition, visit EyeNutrition.ca.

Monday, November 19, 2012

Retinal tear - what does it mean?

Having a retinal tear does not necessarily mean that your eye is generally unhealthy or compromised.  However, people who are highly myopic have a higher risk of developing a retinal tear because their eye is elongated which puts a strain on the retina. Note that the risk of retinal tears remains even after laser vision correction because laser vision correction does not correct the elongation of the eye.

A retinal tear is usually treated by a surgeon who will use a laser to seal the tear.  Sometimes the tear cannot be sealed completely which will result in a permanent loss of vision in a small part of the visual field of the affected eye.  However, patients usually never notice this because the healthy eye will compensate for the eye with the small tear.

A common sign of a retinal tear is to have flashes or floaters in your vision.  If this happens, see your optometrist right way.  If a retinal tear is found, you will be immediately referred to an eye surgeon for treatment.

After three unsuccessful strabismus surgeries, patient says no more.

Vision Therapy is an effective alternative to strabismus surgery
Here is a recent comment by a reader from Australia on the College of Optometrists in Vision Development blog that nicely illustrates the risks, problems and in inadequacies of strabismus surgery:

I’m from Coogee Beach which is a seaside suburb of Sydney, Australia.

I am the father of Terry who has had two operations in his right eye to correct a squint. When those two operations failed, an unsuccessful operation on the good left eye to try to get binocular vision also failed. The surgeon proposed a 4th operation to which my wife and I hesitated. Terry still tilts his head to one side to avoid double vision since his eyes work separately. He failed the 3D vision test.

Somehow I found the COVD blog and receive regular emails alerting me to new content. The blog has allowed me to consult with doctors who are members of it who have led me to a specialist vision optometrist at Maroubra Junction in Sydney very near to my home. Terry has been having regular vision therapy devised by Dr Liz Jackson and she has measured improvements from this therapy.

I still follow the blog because of the interesting guest articles and because, from it, I found out about Dr Sue Barry who regained 3D vision in adulthood. So that gives me hope for Terry’s vision therapy being successful. The COVD blog has also alerted me to research which indicates that vision problems in young children is grossly overlooked (pardon the pun). As a result, we’ve had our youngest son Julian screened – so far so good but we will check his vision annually. Please keep this blog going for parents and practitioners for the good of patients like my son Terry!
For more informaiton on strabismus, treatment for strabismus and vision therapy for strabismus, visit www.strabismus.ca

Vision and learning

At Vision Source Vancouver, optometrists help children learn by treating vision problems that interfere wit learning.

At our Vancouver optometry clinic one of the most professionally and personally rewarding things we do is to help children reach their full academic and intellectual potential by treating vision problems that interfere with learning.  There are a number of vision problems that interfere with learning beyond the obvious one that can be fixed with glasses or contact lenses and need to be treated by a developmental optometrist using vision therapy.  These include visual information processing and binocular vision disorders, convergence insufficiency and accomodative insufficiency. These disorders are sometimes the result of traumatic brain injury.

That's because these are not problems with visual accuity,which means that even if a child has 20-20 vision as measured with the eye chart, the child's vision could be substantially deficient if she has one of these visual problems.


For who want to learn more about vision and learning, here are some informative articles:

More visual symptoms means lower academic performance
Feb 29, 2012

Vision therapy for convergence insufficiency improves academic performance ...
Jan 16, 2012

82% of teachers report an improvement in students after vision therapy
Jun 16, 2012

Binocular vision dysfunctions ate my homework
Mar 31, 2012


Study proves that vision problems interfere with learning and cause dyslexia
Apr 25, 2012


60% of students labled "learning disabled" students failed two or more binocular vision tests
Oct 20, 2012

Symptoms of some vision problems are a lot like ADHD - make sure your child is not misdiagnosed and unnecessarily medicated.

To find a doctor visit www.covd.org

Wednesday, November 14, 2012

Fixing my gaze - how vision therapy worked where strabismus surgery failed

Fixing My Gaze is and inspirational book by neuroscientist, Susan Barry, who was born with strabismus (an eye turn) and had lived all her life without stereo vision, meaning that she could not see in three dimensions.

She had three surgeries to "correct" the eye turn cosmetically but she still could not see properly and the eye was still turned, although less than before. She had lived this way for over 40 years until she met optometrist Dr.Theresa Ruggiero.

Dr. Ruggiero treated Susan with vision therapy which corrected the eye turn and allowed her see in three dimensions for the first time in her life. Can you imagine how her world was transformed?

Here is what Susan Barry said in an interview with Scientific American about how the world looked different after vision therapy:

"For the first time, I could see the volumes of space between different tree branches, and I liked immersing myself in those inviting pockets of space. As I walk about, leaves, pine needles, and flowers, - even light fixtures and ceiling pipes - seem to float on a medium more substantial than air. Snow no longer appears to fall in one plane slightly in front of me. Now, the snowflakes envelope me, floating by in layers and layers of depth. It's been seven years since I gained stereovision, but ordinary views like these still fill me with a deep sense of wonder and joy."

Our vision therapy practice includes many patients with strabismus but all of them are very young (obviously it is better to fix the problem when a patient is young to save her from living years with the condition).

Susan Barry's story is remarkable in that she was in midlife when she received vision therapy. The conventional wisdom, now being disproved by new studies, was that after a "critical period" around the age of 7 or 8 , the brain could not be trained (or "rewired") to see in new ways. The old scientific thinking was that after early childhood, the brain became fixed. In fact, Susan Barry herself and other scientists thought that it was impossible for her to ever see in 3D.

Now, we know that the brain exhibits neuroplacticity and that given the proper behavioural therapy, even adults can rewire their brains. This has given hope to many people who did not receive treatment for visual processing disorders at a young age. Now it seems possible that even older patients with amblyopia or strabismus and other binocular vision disorders can benefit from treatments like vision therapy.

You can hear interviews with Susan Barry and read more about her story at her website: http://www.fixingmygaze.com/.

Related Articles:

Strabismus Treatment

Vision therapy for strabismus

Alternatives to strabismus surgery

Risks and complications of strabismus surgery

Eye allergy, dry eye disease, virus or bacteria - which one is bothering my eyes?


It is a scene that happens every day at our Vancouver eye clinic.  A child comes in with dry eyes.  Simple, right?  Not at all! Here is a window on how doctors distinguish between dry eye disease, bacterial infections, viral infections and eye allergies.

If a child has dry eyes, doctors have to find the cause.  Dry eyes in kids can be caused by allergies, viruses, bacteria or systemic diseases.  A good doctor will correctly determine the cause of the dryness in order to treat the problem effectively.

Doctors distinguish between bacterial and viral infections on the one hand and allergies on the other using many techniques.  One of them is by noting the duration of the episode.   Viral and bacterial infections are usually not chronic.  By contrast, a chronic problem can point to an eye allergy.

Only about 1.5% of healthy children have dry eye disease symptoms and for most children dry eye is the symptom of an eye allergy.  However, parents of children with dry eyes need to take them to the optometrist for evaluation because some symptoms point to potentially serious problems. 

For example, dry eyes with the presence of a symptom such as burning is an indication of possible systemic disease.  In certain children with dry eyes, certain things point to dry eye syndrome such as a history of systemic disease like rheumatoid juvenile arthritis or Sj√∂gren’s syndrome.  Conversely, other things point to allergies such as a history of asthma or atopic dermatitis. Bacteria or a virus may be the cause of dry eyes if the child has a history of recent upper respiratory infection,  or a recent eye infection in a sibling.

Doctors pay close attention to patient symptoms because these help to distinguish between dry eye disease (aka dry eye syndrome) and eye allergy.  Here are some symptoms and the cause that they point to:

  • itching is strongly associated with eye allergy; 
  • burning and foreign body sensation are associated with dry eye disease;
  • complaints of lids matted together, along with irritation and soreness suggest a bacterial infection
  • irritation and pain suggest a virus;
  • sensitivity to light is also usually associated with a virus;
  • tearing eyes are usually a sign of dry eye;





Tuesday, November 13, 2012

What is the best eyewear for kids? It's what eye doctors choose for their own kids.

Kids eye-wear in Vancouver BC.  Children's optometrist.
Our sister blog, KidsVision.ca asks, "What is the best eyewear for kids?"  The eye wear that eye doctors choose for their own children  reflects a doctor's concern for health, safety and effective vision correction.  Find out what eye doctors choose for their own kids. Read more...

What can go wrong if you don't get treatment for your dry eye?

Here is a post on DryEyeDoctor.ca about all of the rotten, horrible, no good, very bad things that can happen if people with dry eye syndrome ignore it and don't get any treatment.  And that list is beside the obvious that untreated dry eye give you a poor quality of life, with uncomfortable eyes and vision for your waking life.  Read more...

Saturday, November 10, 2012

Does Restasis work?

One of the most well known dry eye medications is Restasis which was created by and sold by the company Allergan.  The active ingredient in Restasis is Cyclosporine. 

Many patients have seen television commercials on Restasis featuring Dr. Alison Tendler (see the photo to the left) and they come to our Vancouver eye clinic asking our doctors whether Restasis really works or is it all hype and marketing.  The answer is yes, it does work.  It requires the doctor to take enough time to educate the patient on how Restasis works and when the patient can expect results.  If the patient follows the doctor's instructions, relief from dry eye syndrome is likely.  Read more...

Related dry eye articles:


Dry eye syndrome hurts work productivity
Oct 31, 2012

Digital eye strain - who's at risk? - See For Life
Oct 13, 2012

The basic facts about dry eye syndrome - See For Life
Apr 05, 2012

Caffeine improves dry eye syndrome
Apr 18, 2012

Depressed? Anxious? Maybe your eyes are too dry ... - See For Life
Apr 20, 2012

Thursday, November 8, 2012

How eye glasses totally change your look, enhance your vision and prevent cancer

Eye-wear can totally change our entire look in addition to enhancing your vision, protecting your eyes from harmful UV radiation, preventing wrinkles and getting rid of visual fatigue and headaches and preventing skin cancer.  What a great invention!



Visit www.freeglasses.ca to find out you you can get free eyeglasses from our Vancouver Optometry clinic.


Wednesday, November 7, 2012

Vision problems after car accident are caused by brain injury - effective treatment available even 11 years later


A case study on the effects of vision therapy even 11 years after a car accident that caused a brain injury and resulting vision problems was presented in the journal Optometry and Vision Science. The study shows that accident victims that have suffered brain injuries experience a decreased quality of life when vision problems result and persist for years and, in this case, over a decade.  It also shows that treatment with vision therapy is probably never too late and can be a great benefit to the patient.

The subject of the case study is a 28-year-old Caucasian male who was evaluated for vision problems that started after he acquired a traumatic brain injury (TBI) during a car accident 11 years previously. According to the study the patient  had "numerous symptoms including reading difficulties, ocular pain, headaches, and difficulties with depth perception. The evaluation revealed binocular vision, accommodative, and oculomotor dysfunctions, as well as reduced peripheral visual awareness and visualization anomalies."  The patient was treated with weekly office-based optometric vision therapy (OVT), home-based syntonics, primitive reflex integration, and single vision lenses with base-in prism.  

At both a 1-month post OVT progress evaluation and by a telephone follow up 15 months post-OVT,
the patient reported significant improvement in symptoms.

To find a doctor near you who can can treat the vision problems that result form brain injuries visit the website of the College of Optometrists in Vision Development here.


Here is some information from the case study on brain injuries and the vision problems that can result:











Sunday, November 4, 2012

Brain injuries and vision problems - vision therapy and developmental optometry

Brain injuries Brain injuries can result from impacts during sports, car accidents or falls and they can also result from events like a stroke, aneurysm or due to degenerative diseases that affect the brain. A brain injury caused by an external trauma to the head is called a “traumatic brain injury” or “TBI”.

Brain injuries and vision


It is estimated that 20%-40% of people with brain injuries suffer vision related disorders.  

At our Vancouver developmental optometry clinic, we have treated patients with brain injuries resulting from car accidents, viral brain infections, sports related injuries such as concussions and more with vision therapy.

In many brain injury cases, eye muscles or the nerves controlling the eye muscles are damaged, resulting in problems with teaming, movement and focusing of the eyes. These disorders include binocular vision problems, visual information processing disorders, convergence insufficiency and accomodative insufficiency.
A number of published research studies support vision therapy as a and effective treatment for vision disorders caused by brain injuries.  One study presented  4 cases of pediatric brain injury patients aged 6-18 years who were examined at an optometry clinic of a local hospital.  The author found that the children suffered from a variety of ocular and visual disorders and three of them were having difficulties academically. Academic problems are no surprise since 80% of our learning happens through our visual system.  The patients benefited from vision therapy.

Symptoms of brain injury caused vision disorders


The most common vision related symptoms of brain injuries include the following:
  • Double vision
  • Poor eye tracking ability
  • Difficulties with shifting gaze quickly from one point to another
  • Focusing
  • Loss of binocular vision (eye alignment)
  • Eye strain
  • Fatigue
  • Glare, or light sensitivity
  • Inability to maintain visual contact
  • Headaches
  • Blurred near vision
  • The extent of the injury can also impact a person’s visual information processing ability.  This can cause the following symptoms:
  • Spatial disorientation
  • Shifts in ability to judge location of objects
  • Difficulties with balance and posture
  • Poor depth perception
  • Memory loss
  • Poor handwriting

Studies on the treatment of vision problems caused by brain injury

For more information on the treatment of vision problems caused by brain injuries, check out the following published scientific studies on the topic:

Brodak, M.I. Pediatric acquired brain injury. Optometry 2010 81: 516-527. DOWNLOAD.

Green, W., Ciuffreda, K.L., et al. Accomodation in mild traumatic brain injury. Journal of Rehabilitation Research & Development. 2010. 47: 183-200. DOWNLOAD.

Ciuffreda KJ, Ludlam DP, Kapoor N. Clinical oculomotor training in traumatic brain injury. Optom Vis Dev 2009;40(1):16-23. DOWNLOAD.

Cockerham, G.C., Goodrich, G.L., et al. Eye and visual function in traumatic brain injury. Journal of Rehabilitation Research & Development. 2009. 46: 811-818. DOWNLOAD.

Julie L., Julie, B-T, et al. Deficits in complex visual information processing after mild TBI: Electrophysiological markers and vocational outcome prognosis Brain Injury.March 2008; 22(3): 265–274. DOWNLOAD.

Stanley, Paul. Effects of computer assisted visual scanning training on visual neglect: three case studies. Physical & Occupational Therapy in Geriatrics,1996 Vol. 14(2) 33-44. DOWNLOAD.

Sharieff K. From braille to quilting: a neuro-optometric rehabilitation case report. Optom Vis Dev 2010;41(2):81-91. DOWNLOAD.

Schlageter, K. Gray, B. Incidence and treatment of visual dysfunctoin in traumatic brin injury. Brain Injury. 1993, 7:439-448. Download.

Brosseau-Lachaine, O. Gagnon, I. et al. Mild traumatic brain injury induces prolonged visual processing deficits in children. Brain Injury.August 2008; 22(9): 657–668. DOWNLOAD.

Leslie S. Myopia and accommodative insufficiency associated with moderate head trauma. Opt Vis Dev 2009;40(1):25-31.DOWNLOAD.

Gottlieb, D.D., Fuhr, A., et al. Neuro-optometric facilitation of vision recovery after acquired brain injury. NeuroRehabilitation. 1998. 11: 175-199. DOWNLOAD.

Mandese M. Oculo-visual evaluation of the patient with traumatic brain injury. Optom Vis Dev. 2009;40(1):37-44. DOWNLOAD.

Raymond, M.J., et al. Rehabilitation of visual processing deficits following brain injury. NeuroRehabilitation. 1996. 6: 229-240. DOWNLOAD.

Proctor A. Traumatic brain injury and binasal occlusion. Optom Vis Dev 2009;40(1):45-50.DOWNLOAD.

Tong D, Zink C. Vision dysfunctions secondary to motor vehicle accident: a case report. Optom Vis Dev 2010;41(3)158-168. DOWNLOAD.

Tassinari JT. Vision Therapy for sensory fusion disruption syndrome: two case reports. Optom Vis Dev 2010;41(4):215-221.DOWNLOAD.

Hellerstein L.F., Freed S., Maples, W.C., Vision profile of patients with mild brain injury. J Am Optom Assoc. 1995; 66: 634-39. DOWNLOAD.

Freed, S. Hellerstein, LF, Visual electrodiagnostic findings in mild traumatic brain injury, Brain Injury. 1997, VOL. 11, NO. 1, 25-36. DOWNLOAD.

Rowe, F. Visual perceptual consequences of stroke. Strabismus. 2009 Jan-Mar;17(1):24-8. DOWNLOAD.

Han, E., The role of the neuro-rehabilitation optometrist. DOWNLOAD.

Suchoff, I., Gianutosos, R., Rehabilitative optometric interventions for the adult with acquired brain injury. DOWNLOAD.

Wednesday, October 31, 2012

Dry eye syndrome hurts work productivity


Study of dry eye disease and work productivity


A study published in the October 2012 issue of ClinicoEconomics and Outcomes Research found that dry eye disease causes workers to loose productivity and costs their employers big bucks.

The study, by Japanese researchers, looked at a total of 396 individuals aged 20 years or older (258 men and 138 women).  Study subjects were classified into the  following four groups according to the diagnostic status and subjective symptoms of dry eye: a definite dry eye group; a marginal dry eye group; a self-reported dry eye group; and a control group. The impact of dry eye on work productivity was evaluated using the Japanese version of the Work Limitations Questionnaire. The cost of work productivity loss associated with dry eye and the economic benefits of providing treatment for dry eye were also assessed.

The study found that degree of work performance loss was 5.65% in the definite dry eye group, 4.37% in the marginal dry eye group, 6.06% in the self-reported dry eye group, and 4.27% in the control group. Productivity in the self-reported dry eye group was significantly lower than that in the control group. The researchers estimated that employers loose $741 per year for every dry eye sufferer that they employ.

The study shows that dry eye impairs work performance among office workers, which may lead to a substantial loss to industry. Management of symptoms of dry eye by providing treatment may contribute to improvement in work productivity.

Dry eye and quality of life


The prevalence of dry eye varies among the reports with some studies putting the number as high as 30% of the population.  Dry eye disease is a chronic eye disorder in North America. The risk of going blind or suffering permanent vision loss due to dry eye is low.  Nevertheless, it has a significant impact on the daily and social lives of affected patients.  In our Vancouver dry ey clinic, we have seen patients whose dry eye disease was so debilitating that they could not hold down a job and were permanently disabled.   One study foudn that patients with dry eye syndrome had more difficulty reading, carrying out professional work, using a computer, watching television, and driving compared with those without dry eye.  (see Miljanovic B, Dana R, Sullivan DA, Schaumberg DA. Impact of dry eye syndrome on vision-related quality of life. Am J Ophthalmol. 2007; 143(3):409–415.). 

For more information on dry eye disease and visit www.dryeyedoctor.ca
For the basic facts about dry eye disease and for dry eye downloads, visit our Vancouver clinic website here.

Related articles:




Sunday, October 28, 2012

Alternatives to strabismus surgery - vision therapy is 87% effective


Vancouver's children's optometrist -Vision therapy for strabismus is an alternative to surgery

Under optimal clinical conditions the success rate for vision therapy treatment of strabismus is 87%


Vision therapy/orthoptics has been used to successfully treat the various forms of strabismus for over 100 years. Numerous studies have found it to have a 75% success rate in achieving normal cosmetic alignment of the eyes as well as functional binocular vision.  Under optimal clinical conditions such as those in a private practice optometric clinic where each patients receives individualized, one-on-one care, the success rate can be as high as 87%.

The Ludlam Study on Vision therapy for strabismus

Dr. William Ludlam conducted a landmark study, but not the first such study, of 149 strabismus patients who came for treatment at the Optometric Centre of New York.  Ludlam summarized the results as follows: 

"combining the functional and almost cured groups and adding four patients whose eyes ware straight ... but are listed as 'moderately improved' because of the the technical requirements of the 'cured' categories (2 subnormal ranges of motor fusion, 1 with a 7" N.P.C. rather than the required 4", and 1 with frequent asthenopia, headaches and accomodative spasm), we may state that a total of 113 (76%) of the patients in the sample had binocular vision with straight eyes 95% of the time or more at dismissal from teh regular clinic training sessions. The other 36 patients had residual deviations occurring more often than 5% of the time, and were classified as orthoptic failures. Of these, 8 of the "moderate improvement" group dropped out when quite near the "almost cured" category, i.e. with their eyes straight well over half the time and possessing all of the technical factors necessary for a cure with several moths of additional stabilization work."

Even though the Ludlam study produced outstanding results, Ludlam pointed out that the patients treated at the Optometric Centre were treated in poor clinical conditions. For example, they received group therapy, control and management of each case was relatively poor, and they were treated by different clinicians who had diferent personalities and treatment approaches.  He expected that under the optimal conditions of a private practice optometric office, the results would be even better.  Indeed, subsequent studies shown this to be the case.   Click here to read more about the Ludlam study.

The Hoffman & Allen Study on vision therapy for strabismus


Another significant study addressed Ludlam's expectation that optimal clinical conditions would produce better results.  The study, by Hoffman, Cohen, et al., found that the vision therapy treatment fo strabismus had an 87% success rate in clinical circumstances that were "near optimal" such as those conditions that obtain at a private practice optometric clinic.  The researchers also found that younger patients were easier to treat than older ones and that exotropes (patients whose eye turns outwards towards the wall) were easier to treat than esotropes (patients whose eye turns inwards towards to nose) .  Even so, the vision therapy treatment of esotropes achieved a very impressive success rate of 74.5%.  Moreover, the maximum success rate of 100% was obtained in treating intermittent and periodic eye turns whereas constant eye turns were treated at a still-impressive success rate of 76%.

Case Reports on vision therapy for strabismus


Numerous case reports have been published documenting the treatment of strabismus patients with vision therapy.  The most recent was published in August 2011 in the journal Optometry by Peddle and Steiner who discussed two cases of adults with moderate sized intermittent exotropia (eyes turned outward to the wall). Both patients also had asthenopia (eye fatigue and discomfort), headaches, and/or diplopia (double vision). Twenty to 30 in-office VT sessions were recommended to reduce the magnitude and frequency of the deviation as well as improve their binocularity and decrease their symptoms. After completing VT, both patients became phoric for all distances, had normal vergence ability, and had normal near points of convergence.

The most famous case of vision therapy treatment for strabismus


In an inspirational book called Fixing My Gaze, neuroscientist, Susan Barry, who was born with strabismus and had lived all her life without depth perception as a consequence, meaning that she could not see in three dimensions.  The book was Amazon.com's number 4 science book of 2009.

She had three surgeries to "correct" the eye turn cosmetically but she still could not see properly and the eye was still turned, although less than before. She had lived this way for over 40 years until she met optometrist Dr. Theresa Ruggiero.

Dr. Ruggiero treated Susan with vision therapy and corrected the eye turn and allowed her see in three dimensions for the first time in her life. Can you imaging how her world was transformed? I've heard rumors of a "Fixing My Gaze" movie but have not been able to confirm them.


Doctor Barry has received much attention for her book and her experience with vision therapy.  She has been interviewed for numerous publications and her story was the subject of a feature article in the New Yorker.  

You can visit Susan Barry's website here.  Here are some videos of Susan Barry talking about vision therapy and strabismus:












Related articles:


Saturday, October 27, 2012

Poison in eye drops puts some kids in a coma - FDA issues a safety warning

The United States Food and Drug Administration (FDA) has issued a warning about over-the-counter eye drops.

The danger is that children may accidentally swallow the eye drops.  The drops in question are used to relieve redness in the eyes and they include the popular Visine brand of drops.  

Keep in mind that there are safer and more effective alternatives available on the advice of your optometrist.  In fact, at our Vancouver clinic, we almost never recommend these drops because of their danger and because they only "get the red out" of your eyes by narrowing blood vessels, which does not treat the cause of the redness and ignores the fact that there is a biological reason why  blood vessels are so visible in your eyes in the first place and it is that reason that needs to be addressed if the condition is to be properly treated.  

The eye drops can be dangerous because they contain the active ingredients tetrahydrozoline, oxymetazoline, or naphazoline. These same ingredients are also found in some nasal sprays.  These products are sold under various brand names, as generics, and as store brands (see List of Products created by the FDA below).

The FDA reviewed 96 cases of accidental swallowing in  children 5 years of age and younger. There were no deaths but swallowing had serious consequences requiring hospitalization such as:
  • coma,
  • decreased heart rate, 
  • decreased breathing, and 
  • sedation (sleepiness) 

These serious conditions have occurred on the swallowing of  only a small amount (1-2 mL; for reference, there are 5 mL in a teaspoon) of the eye drops. Most of these redness-relief eye drops  do not currently come packaged with child-resistant closures, so children can accidentally ingest the drug if the bottles are within easy reach.


Consumers should store these products out of reach of children at all times. If a child accidentally swallows these eye drops  and seek emergency medical care immediately.

List of Products*
Products containing tetrahydrozoline
Products containing naphazoline
Products containing oxymetazoline
Visine Original
Visine A
Visine L.R.
Visine A.C.
Ak-Con Ophthalmic Solution
12 Hour Nasal Decongestant Nasal Spray
Visine Advanced Relief
Napha Forte Ophthalmic Solution
Afrin Extra Moisturizing Nasal Spray
Visine Totality
Naphazoline HCl Ophthalmic Solution
Afrin No Drip Severe Congestion Nasal Spray
Visine Maximum Redness Relief Formula
All Clear Ophthalmic Solution
Afrin No Drip Sinus Nasal Spray
Walgreens Redness Reliever Advanced Eye Ophthalmic Solution
All Clear AR Maximum Strength Ophthalmic Solution
Afrin No Drip Sinus Extra Moisturizing Nasal Spray
Tyzine Nasal Spray
Opcon-A Ophthalmic Solution
Afrin Original Nasal Spray
GNP Original Eye Drops
Naphcon A Ophthalmic Solution
Afrin Severe Congestion Nasal Spray
Opti-clear Ophthalmic Solution
Walgreens Eye Allergy Relief Drops
Dristan 12 Hour Nasal Spray
Tetrahydrozoline HCl Ophthalmic Solution

Equaline 12 Hour Nasal Spray
Today’s Health Original Eye Drops

Equaline 12 Hour Extra Moisturizing Nasal Spray
Leader Eye Drops Regular Formula Ophthalmic Solution

Equate Nasal Spray


GNP 12 Hour Nasal Spray


GNP 12 Hour No Drip Nasal Spray


GoodSense 12 Hour Nasal Spray


Leader 12 Hour Nasal Spray


Maximum Strength Nasal Decongestant Nasal Spray


Mucinex Full Force Nasal Spray


Mucinex Moisture Nasal Spray


Nasal Relief Spray


Neo-Synephrine 12 Hour Nasal Spray


Publix Nasal Spray


Select Brand Nasal Spray


Sinex Nasal Spray


Sudafed OM Nasal Spray


Today’s Health Nasal Relief Nasal Spray


Tope Care 12 Hour Nasal Spray


Walgreens Anefrin Nasal Spray
*List may not be all-inclusive. Check the Drug Facts label on the package to determine the active ingredients of any over-the-counter product.
References
  1. Spiller HA, Rogers J, Sawyer TS. Drug facilitated sexual assault using an over-the-counter ocular solution containing tetrahydrozoline (Visine®). Legal Medicine 2007;9:192-5.
  2. Katar S, Taskesen M, Okur N. Naloxone use in a newborn with apnea due to tetrahydrozoline intoxication. Pediatr Int 2010;52:488-9.
  3. Tobias JD. Central nervous system depression following accidental ingestion of Visine eye drops. Clin Pediatr (Phila). 1996;35:539-40.