Women at Higher-Risk than Men for Sight-Threatening Eye Diseases and Conditions

CHICAGO (March26, 2013) – Among the many differences between men and women’s health, women are more susceptible to vision impairment. Of the 4.1 million Americans age 40 and older who are visually impaired or blind, 2.6 million are women. And,according to a recent study by Prevent Blindness America, more women than men have age-related macular degeneration, cataracts, glaucoma and diabetic retinopathy, the four leading eye diseases in the country.

According to the National Eye Institute, the causes are primarily due to longevity as well as hormonal factors.  Prevent Blindness America has designated April as Women’s Eye Health and Safety Month in an effort to educate women about the steps they can take today to help preserve vision in the future.

“The first thing every woman should do, especially those ages 40 and older, is get a dilated eye exam," said Hugh R. Parry, president and CEO of Prevent Blindness America.  "Through early detection and treatment, vision loss can be lessened.”

Prevent Blindness America also recommends a healthy diet, quitting smoking, taking supplements (as approved by a medical professional), consistently wearing UV-blocking sunglasses with a brimmed hat outdoors and learning of any family history of eye disease.

If anyone is experiencing any of the following symptoms, an appointment with an eyecare professional should be made immediately:

• Unusual trouble adjusting to dark rooms;
• Difficulty focusing on near or distant objects;
• Squinting or blinking due to unusual sensitivity to light or glare;
• Change in color of iris;
• Red-rimmed, encrusted or swollen lids;
• Recurrent pain in or around eyes;
• Double vision;
• Dark spot at the center of viewing;
• Lines and edges appear distorted or wavy;
• Excess tearing or "watery eyes";
• Dry eyes with itching or burning; and
• Seeing spots, ghost-like images.

Vision and 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

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 Sjögren’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;

To learn more about eye allergies in kids, click here.

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:

What MDs say about vision therapy

As a member of the College of Optometrists in Vision Development, I read the COVD blog which often has excellent and up to date information of developmental vision disorders and vision therapy.  Today, there was an excellent post on that blog on what MDs say about optometric vision therapy.  

That is an interesting topic because vision therapy is not taught in medical schools but is taught in every optometry school on the continent.  This fact is often at the root of a misunderstanding between some MDs and optometrists about what vision therapy is, what diseases it treats and why it works.  

The topic is a timely one for COVD to discuss because one of the most famous (and one of the only) developmental vision MDs - developmental ophthalmologist, Dr. Lea Hyvarinen, addressed the COVD at last weekend's annual meeting.  We wrote about her and her new book in a previous post.

Here is the COVD's collection of statements from MDs about vision therapy:

Pediatrician and Parent Advocate for the National Center for Learning Disabilities

Dr. Debra Walhof is a Pediatrician who specializes in Integrative Medicine.  During the past 20 years, she has practiced in hospital, academic and community-based clinical settings.  Her work has focused primarily on multi-cultural and under served populations who present as "at risk" across many developmental and behavioral domains.  According to Dr. Walhof:

“It is important to remember that normal sight may not necessarily be synonymous with normal vision... That being said, if there is a vision problem, it could be preventing the best tutoring and learning methods from working. Now that certainly doesn't mean every dyslexic child needs vision therapy, however in my opinion, skills such as focusing, tracking and others are essential foundational tools for reading. In general, if your child has trouble with reading or learning to read, getting a vision evaluation to assess these skills from a qualified Developmental Optometrist would be a smart move.”

Psychiatrist & Physician

Dr. Katherine Donovan, a Psychiatrist from Charleston, S.C., was one of those parents who didn’t give up, “It wasn’t until my own child had problems with reading that I discovered that my medical training was missing a very valuable piece of information which turned out to be the key to helping my daughter, Lily. While I had taken Lily to many ophthalmologists and learning specialists, desperate to understand why this very bright child still could not read well, or write legibly at age 12, I always got the same answers:  ‘her vision’s fine’ and ‘she’s dyslexic.’”

“As a physician, I had been taught that vision therapy was controversial and could not treat learning disabilities. However, my personal experience with my daughter proved to me that vision therapy worked, when nothing else did,” Dr. Donovan shares. “While vision therapy cannot treat learning disabilities, per se, it absolutely corrected a vision problem which was blocking Lily from being able to learn. After a visit with a developmental optometrist who tested over 15 visual skills critical to reading and learning, I was shocked to learn that Lily was seeing double out to three FEET—which meant that when she tried to read, the words were double. No wonder she hated to read!” Following optometric vision therapy, “Lily now reads 300 pages a day, in her free time; she puts down ‘reading’ as her favorite hobby; and she has a 95-average at Buist Academy with NO help from me on her homework! Prior to this, I’d been spending three to four hours each night, for many years, tutoring Lily,” Dr. Donovan shares with delight. 

 Physician and Medical Expert Witness for Medico-Legal Cases

Even though there is a wealth of optometric research which proves vision therapy works, as Dr. Donovan mentioned, there is false information in the medical community about vision therapy.  This can be confusing for parents, especially when it comes from their child’s pediatrician.  

Dr. Joseph Manley, a physician and medical expert witness for medico-legal cases, states, “The conclusions (particularly the failure to recommend vision therapy for children likely to benefit from it) of the American Academy of Pediatrics report on Learning Disabilities, Dyslexia and Vision are based on exclusion of the most relevant data and inconsistent application of the Academy's stated criteria for selecting evidence.  They fail to acknowledge abundant published and anecdotal evidence supporting the use of vision therapy.  This overlooked evidence includes controlled trials, observational studies, case reports and consensus of experts - the same kinds of data that underpin the daily practice of medical professionals.”

Neurologists & Leading Clinicians on Learning Disabilities

Brock Eide, M.D., M.A. and Fernette Eide, M.D., leading clinicians and writers on learning disabilities, state, “In spite of the very positive research findings validating the role vision plays in learning, some are still claiming visual dysfunction plays little or no role in the reading challenges that dyslexics face. This is a shame. When we look specifically at the results of studies performed to address specific visual issues, the evidence supporting visual therapy is quite strong.”

The Eides run the Eide Neurolearning Clinic in Edmonds, Washington, are authors of the popular book, The Mislabeled Child:  How Understanding Your Child’s Unique Learning Style Can Open the Door to Success, and lecture throughout the U.S. and Canada to parents, educators, therapists, and doctors. Drs.  Eides have published extensively in the fields of gifted education, learning disabilities, and twice exceptionalities such as giftedness and dyslexia, and served as consultants to the President's Council on Bioethics.

 “While not all children or adults with dyslexia have visual processing problems, many --at least two-thirds in some studies-- do. This makes sense from a neurological standpoint, because several of the structural neurological features associated with dyslexia appear to predispose to visual difficulties,” Dr. Brock Eide adds.

“Not surprisingly, several types of visual difficulties are more common in dyslexic than non-dyslexic children. In one study of dyslexic children, just one type of visual problem, near-point convergence insufficiency, was present in 30-40% of the dyslexic children, compared to just 20% of controls. As can be seen from this control figure, visual processing problems are also quite common in non-dyslexic school-age children,” Eide continues.

Dr. Fernette Eide explains, “The bottom line is that visual problems are common, though not universal, in children who struggle to read; and optometric vision therapy can help address visual problems in children with significant visual dysfunction. A good visual examination is an important part of the workup of every struggling reader.” 

Ophthalmologists

Ophthalmologist, Dr. Bruce Sumlin, writes, “Optometric vision therapy makes sense.  It is very similar to other kinds of treatment and therapies we provide in the medical disciplines which help to develop neural connections in the brain.”John B. Ferguson III, MD, an ophthalmologist who has been in practice for over 34 years, was not always a strong believer in vision therapy.  When asked what made him change his mind, Dr. Ferguson shared, "Among ophthalmologists, vision therapy has been thought to be reserved for certain eye muscle disorders. I was unaware, and I believe many other ophthalmologists are also unaware, of the significant effects that these eye muscle disorders have on the attitude and behavior of some children. I thought that at the most these children, if left untreated, might experience headaches or read less efficiently. However, I had the opportunity to speak with children and the parents of children who went through vision therapy and I was very impressed by the dramatic and positive academic and behavioral changes they experienced."

According to ophthalmologist, Robert Abel, in his book The Eyecare Revolution: 
“Vision therapy is taught at optometry schools; ophthalmologists know very little about it … It can change people’s lives, as it has for President Lyndon Baines Johnson’s daughter, Lucy, whose dyslexia was helped greatly by vision therapy.”
In an editorial responding to an article, “Optometric Vision Therapy &Training for Learning Disabilities and Dyslexia,” Dr. Paul Romano, ophthalmologist and editor of the Binocular Vision & Strabismus Quarterly states:

“…why should I think that my fellow ophthalmologists are correct about dyslexia and learning disabilities virtually never being a real eye problem and amenable to some eye directed therapy? I must trust my own 30 years of personal experience.”
“There is no doubt in my mind that the exams most orthoptists, ophthalmic technicians and ophthalmologists, including pediatric ophthalmologists, perform for the learning disabled or the dyslexic child are too often inadequate or incomplete and are unable to find these ‘subtle abnormalities of monocular and binocular vision which may give rise to these problems...”

“Also I simply do not believe the current organized ophthalmology-pediatric ophthalmology mantra that virtually nothing with regard to binocular vision (except maybe convergence insufficiency) can be affected, altered or improved by anything other than surgery. There are too many other areas in medicine where change is achieved without drugs or surgery.”

How to Identify a Vision Problem

Children should be referred for a comprehensive eye exam whenever visual symptoms are noticed or if they are not achieving their potential. Many of these vision problems will not be detected during a school vision screening or limited vision assessment as part of a school physical or routine pediatric health evaluation. 

Locate a Doctor in your area who is experienced and knowledgeable in diagnosing and treating learning-related vision problems.

Related article:

What teachers say about vision therapy

Eye nutrition basics

Here is some clear and concise information on nutrition and eye health from the
American Optometric Association (www.aoa.org):

• Lutein & Zeaxanthin

  Lutein and zeaxanthin are important nutrients found in green leafy vegetables, as well as other foods, such as eggs. Many studies have shown that lutein and zeaxanthin reduce the risk of chronic eye diseases, including age-related macular degeneration and cataracts.

• Vitamin C

  Vitamin C (ascorbic acid) is an antioxidant found in fruits and vegetables. Scientific evidence suggests vitamin C lowers the risk of developing cataracts, and when taken in combination with other essential nutrients, can slow the progression of age-related macular degeneration and visual acuity loss.

• Vitamin E

  Vitamin E in its most biologically active form is a powerful antioxidant found in nuts, fortified cereals and sweet potatoes. It is thought to protect cells of the eyes from damage caused by unstable molecules called free radicals which break down healthy tissue.

• Essential Fatty Acids

  Fats are a necessary part of the human diet. They maintain the integrity of the nervous system, fuel cells and boost the immune system. Two omega-3 fatty acids have been shown to be important for proper visual development and retinal function.

• Zinc

  Zinc is an essential trace mineral or ‘helper molecule.’ It plays a vital role in bringing vitamin A from the liver to the retina in order to produce melanin, a protective pigment in the eyes. Zinc is highly concentrated in the eye, mostly in the retina and choroid, the vascular tissue layer lying under the retina.

• Emerging Research

  In the last 20 years, eye health research has linked diet and nutrition with a decreased risk of age-related macular degeneration (AMD).

Written in partnership with AOA members Stuart Richer, O.D., Ph.D., and Steven Newman, O.D.

To learn more about eye nutrition visit www.eyenutrition.ca.

Related articles:

Vitamin C lowers cataract risk

The miracle vitamin - vitamin D - gets more miraculous

Vegetarians and vegans have a lower risk of cataracts 

April is women's eye health and safety month - women must focus on eye nutrition

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