Clinic is Closed on February 12, 2019 due to Snow

Sorry for the inconvenience, the we will be closed today, February 12, 2019 due to the snowy conditions.

Optometric Management of a Post-Concussion Patient: A Case Report

A case report on the optometric vision therapy treatment of the visual symptoms of a concussion patient was published in the December 2016 issue of the journal, Vision Development & Rehabilitation. We treat many concussion patients in our vision therapy and rehabilitation practice in Vancouver and the results of this case report are consistent with the results that we see in our clinic.

Concussions are a mild injury to the brain which have been known to cause visual problems such as blur, double vision, reading problems, sensitivity to light, visual memory problems and other visual deficits like reductions in contrast perception. It is estimated that 15% of concussion patients experience a visual problem as a result of their concussion.

The patient that was the subject of the case report suffered several sports-related concussions that caused a variety of problems with the patient's visual system. The patient was diagnosed with with low myopic astigmatism, convergence insufficiency, fusional instability, oculomotor dysfunction, and photosensitivity. Treatment included tinted spectacle correction for full-time wear and conventional oculomotor-based vision therapy. 

When vision therapy concluded, the patient was free of symptoms. And this effect was still present at a three-year follow-up appointment. The results demonstrate the efficacy of a comprehensive optometric approach in concussion treatment. The results also demonstrate the ability of the visual system to heal when the proper therapy is used for treatment. 

Concussion: Parents Speak Out about the Visual Link to Recovery

Will Smith’s new movie Concussion is likely to make parents think twice about having their children involved in contact sports like football and soccer. But what about kids who have already suffered a concussion and are struggling to get back to learning? Parents of these children are stepping forward to share their experiences with the hope of helping others.

“Research has shown that approximately 70% of young athletes who suffer a concussion have eye coordination, focusing, and eye movement problems1 . Yet most parents are left on their own choose a health care professional who can help their child correct these problems,” shares Dr. Kara Heying, OD, FCOVD, President of College of Optometrists in Vision Development.

Evyn of Tulsa, Oklahoma had struggled for two years after suffering a concussion at the age of 13, sustained while playing soccer. She saw twelve physicians and specialists, including her pediatrician, two ophthalmologists, a neuro-ophthalmologist, a neurologist, and a sports medicine doctor before an optometrist finally referred her to a developmental optometrist.

Read more.

Vision Problems May Be More Common In Children With An ASD

April is autism awareness month

Here is what you need to know about autism and vision in a nutshell.

Since autism spectrum disorders (ASDs) affect how we process and respond to sensory information, it’s important to evaluate exactly what visual sensory information is going in.

Recent studies have found that refractive errors, such as near-sightedness, far-sightedness, and/or astigmatism, may be more common in those with an ASD. The same goes for strabismus (often called cross-eye) and amblyopia (lazy eye). These problems can be treated, corrected, and sometimes even prevented. Especially if we can catch them early in life.

For more information on how optometrists like us can help treat vision disorders in people with ASD, click here: http://www.visiontherapy.ca/autism.html

Watch these videos for more information:

Alcohol and cataracts

A new study pubished in the journal Optometry & Vision Science found that heavy alcohol consumption significantly increased the risk of age-related cataract. There was some evidence, but not as strong, that moderate consumption may help prevent cataracts. 

Cataracts require surgery to treat. The surgery is fairly common and usually results in a good outcome. However it is not without risks and bad outcomes like double vision and other problems can occur. It is best to avoid contracts altogether. Avoiding heavy drinking appears to be one way to do that.

Source:

Optometry and Vision Science: Official Publication of the American Academy of Optometry
Different Amounts of Alcohol Consumption and Cataract: A Meta-Analysis
Optom Vis Sci 2015 Apr 01;92(4)471-479, Y Gong, K Feng, N Yan, Y Xu, CW Pan

ADHD Drugs and suicide risk

On this blog we often write about ADHD and the fact that ADHD symptoms often mimic the symptoms of common eye movement disorders such as convergence insufficiency. It is important for parents to be alive to the possibility that what was thought to be ADHD is actually a treatable eye movement disorder. Treatment of the eye  movement disorder may make the symptoms go away and avoid unnecessary medication.

A recent warning issued by health Canada about ADHD drugs underscore the importance of seeing in optometrist to test for eye  movement disorders such as convergence insufficiency before excepting a diagnosis of ADHD. 

Health Canada has warned that ADHD drugs may increase suicidal thoughts in patients. Here is a link to a news story that discuss the new warning:

http://www.cbc.ca/m/news/health/adhd-drugs-to-add-suicide-risk-warnings-1.3015562

To learn more about the connection between ADHD's type symptoms and convergence insufficiency click here:

http://www.visiontherapy.ca/adhd_convergence.html

Behavioural vision training for older adults improves contrast sensitivity and near accuity

Dr. Dominick Maino points out that  "it has taken science/medicine decades to catch up with an approach that functional/behavioral optometry has taken since the early 1900's. The brain can be changed for the better at ANY age!"

This is because the brain maintains significant neuroplacticity, even in older adults.  Neuroplacticity is the reason that the vision training approaches used for decades in vision therapy by behavioural and developmental optometrists help so many patients.

A new study published in Psychological Science supports the use of behavioral visual training to improve sight in older adults.  This has important implications for reducing falls and car accidents that are associated with loss of depth perception and contrast sensitivity.

The researchers used a perceptual-learning task  to improve age-related declines in contrast sensitivity. Older and younger adults were trained over 7 days using a forced-choice orientation-discrimination task with stimuli that varied in contrast with multiple levels of additive noise. The study's authors found that older adults performed as well after training as did college-age younger adults prior to training. In addition, the vision training therapy improved far acuity in younger adults and in near acuity in older adults. The researchers concluded that behavioral interventions can greatly improve visual performance for older adults.

Source:
Psychological Science March 6, 2015
Improving Vision Among Older Adults Behavioral Training to Improve Sight
Denton J. DeLoss, Takeo Watanabe, George J. Anderse

Combination therapy for dry eye disease

In dry eye disease, the cause is sometimes the malfunctioning of the meibomian glands, which make an essential component of healthy tear film.  And many dry eye treatments are focused on getting those glands working again.

A new study published in the journal Cornea suggests that a combination treatment consisting of daily lid wipes, artificial tears and the right nutritional supplements can improve meibomian gland function and dry eye symptoms after three months compared with a regimen of warm compresses applied to the eyes once a day. 

 Warm compresses is an old and standard treatment and often the first thing to try for dry eye. The study suggests that skipping warm compresses and going with a combination of treatments works much better. 

As with any treatment, check with your eye doctor before trying it.

Source:

Effect of Using a Combination of Lid Wipes, Eye Drops, and Omega-3 Supplements on Meibomian Gland Functionality in Patients With Lipid Deficient/Evaporative Dry Eye

Cornea 2015 Feb 03;[EPub Ahead of Print], DR Korb, CA Blackie, VM Finnemore, T Douglass

Glaucoma awareness month

Glaucoma is the second most common cause of blindness. January is glaucoma awareness month! Help us preserve people’s vision by spreading the prevention message this month!

The term “glaucoma” refers to a group of disorders that damage the ocular nerve, leading to vision loss and blindness. Glaucoma is most commonly caused by ocular hypertension, or high pressure inside of the eye.

Typically, There Are No Early Warning Signs

What makes glaucoma so frightening is that it often becomes a sudden problem. Most people don’t notice any of the warning signs or symptoms; however, with regular eye exams we can check the pressure of your eye and monitor your risk.

Who’s Most At Risk For Glaucoma?

Though certain factors put you at higher risk, it’s important for everyone to understand the risk factors. For example, glaucoma usually affects people in their middle age—and the elderly—but it can, and does, affect people all age groups. 

African Americans are at a much higher risk and that risk spikes as early as age 40. 

South Asians and East Asians are also at greater risk. 

You’re at a higher risk over age 60 and even more so over age 80. 

Some medical conditions, like diabetes, high blood pressure, and heart disease may increase risk.
If you have a family history of glaucoma, you are a much higher risk. 

Diagnosing Glaucoma Early Can Help Preserve Sight

There’s no cure for glaucoma; however, when caught early, we can take steps to slow or halt vision loss. Often treatments as simple as specialized eye drops that reduce the pressure building up inside of your eye can make a difference.

Everyone age 40 and over should get eye exams regularly. If you have any of the high risk factors listed above, you should get an eye exam even more often! Take the time to learn more about glaucoma.

Source:

http://www.visionsource.com/blog/january-is-glaucoma-awareness-month/

Vision and learning Ted Talk

Here is a new (and excellent) Ted Talk by Dr. Vicky Vandervort on how treatable vision problems can cause learning problems, including a great explanation and demonstration of the most common eye movement problem that interferes with learning: convergence insufficiency.

The video also includes a demonstration of a real patient's eyes as they move inefficiently across a page in an attempt to read.

As explained in the video, many well meaning professionals, including many eye doctors, are not aware of an do not test for eye movement disorders, leaving patients without any help. Developmental optometrists (like Dr. Randhawa) diagnose and treat eye movement problems that interfere with learning.  To find one near you visit www.covd.org.

Eye make-up and discomfort

Eye make-up is very popular and millions of women around the world use it.  Some eye cosmetics, like eyeliner, is applied very close to the surface of the eye where it can cause eye disease and ocular discomfort.  What impact does eye make-up on ocular discomfort?  That is the question investigated in a study published in the November 2012 issue of the journal Ophthalmic & Physiological Optics.  

The authors of the study took surveyed 1360 women aged 20-34 and found that over 80% of them used eye cosmetics regularly and over half used at least three different eye cosmetics regularly.  Mascara was the most common type used.

The survey results lead the authors to conclude that the use of multiple eye cosmetics is extensive and
associated with the perception of ocular discomfort. The results suggest that taking a break from eye make-up might make your eyes feel better.  However, the use of makeup could be the cause of diseases such as dry eye, tear gland dysfunction or blepharitis (inflammation of the eyelid where the eyelashes grow).

However, if you love your make-up and can't do without it, see your optometrist to determine if any of those other eye issues are the cause of your discomfort.  It may be possible to treat the other conditions while keeping you in your make-up.

Source:

Eye cosmetic usage and associated ocular comfort
Alison Ng, Katharine Evans, Rachel North and Christine Purslow
School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
Citation information: Ng A, Evans K, North R & Purslow C. Eye cosmetic usage and associated ocular comfort. Ophthalmic Physiol Opt 2012, 32,
501–507. doi: 10.1111/j.1475-1313.2012.00944.x

The reason for childhood eye exams

Childhood is the critical time to look after a child's health.  Untreated childhood vision problems are associated with poor social, economic and academic outcomes.  Most vision problems are treatable and are diagnosed during an eye exam with your optometrist. Don't let childhood vision problems grow up to be adult issues.

A 2011 study published in the journal,Pediatrics, found that in addition to refractive errors that can be corrected with glasses such as myopia and astigmatism, ocular disorders like strabismus (eye-turn, cross eyes) and amblyopia (lazy eye) that occur in infants, toddlers, and children may present lifelong problems for the child. Strabismus and amblyopia require more intense treatment such as vision therapy or surgery.

Children who become adults with these conditions must adapt and compensate for them. Moreover, vision problems that were present in childhood may continue to plague the patient into adulthood, affecting overall health, self-perception, educational attainment, job choices, and a number of other social factors.

Basically, people with these disorders find it very difficult to do things that people with healthy vision take for granted, like effortlessly understanding visual learning. The fact that 80% of classroom learning happens through our visual system means a child with lazy eye, for example, is at a significant disadvantage in school.

Here is a nice childhood vision infographic by Doctors of Optometry Canada.

Vision and Learning

In honour of Children's vision month, here is a nice infographic from Doctors of Optometry Canada .  To learn more about vision and learning click here.

Aeroplan promotion - September to October, 2014

We have a huge Aeroplan promotion that runs from September to October 2014.  Here are the highlights:

1. 1000 Bonus Miles for New patients!
2. 500 Bonus Miles with the purchase of premium personalized lenses
3. Up To 600 Bonus Miles on Select Contact Lenses!

1000 Bonus Miles for New patients!

New Patients! Earn 1000 Bonus Miles with a completed eye exam
Bonus mile offer only applies to Aeroplan Members who are NEW patients of FYidoctors (and participating Vision Source locations) and who have completed an eye examination.

One-time bonus offer per Aeroplan Member for NEW patients of FYidoctors (and participating Vision Source locations) only.

Members are considered NEW if they have never been to an FYidoctors (or participating Vision Source locations) location.

If you are not sure if you have been to an FYidoctors location (or participating Vision Source location) before, please visit www.fyidoctors.com/find-a-location and search by optometrist or city/province.

Aeroplan Members cannot receive 500 bonus miles for other members in the event the member pays for another member’s exam(s).

Aeroplan Card must be presented at time of payment to receive your Aeroplan Miles.
Bonus miles will be credited to Aeroplan Members’ accounts within one week of payment.

Some restrictions may apply. Please see our clinic for complete details.  Bonus Miles offer cannot be combined with the Free Eyeglasses promotion.

500 Bonus Miles with the purchase of premium personalized lenses

Qualifying lens products include TruClear SD and TruClear XD lenses. Patients can choose either single vision or progressive designs. For information on materials and prescription range availability, click here.

Please call or visit our clinic for more details.

Bonus Miles are awarded PER lens pair purchase. For example, one pair of lenses gets you 500 Bonus Miles; two pairs of lenses gets you 1000 Bonus Miles.

Aeroplan member may purchase as many pairs as they like.

Aeroplan Card must be presented at time of payment to receive your Aeroplan Miles.
Bonus miles will be credited to Aeroplan Members’ accounts within one week of payment.
Some restrictions may apply. Please visit our clinic for complete details.

Do You Wear Contact Lenses? Earn Up To 600 Bonus Miles on Select Contact Lenses!

Earn 250 Miles on any 4 box purchase of eligible Alcon products.
Earn 600 Miles on any 8 box purchase of eligible Alcon products.

Eligible Products:

-          DACP (Sphere, Multi Focal and Toric) – 90 packs
-          Dailies Total One – 90 packs
-          Air Optix Aqua (Sphere, Multi Focal and Toric)
-          Night and Day

Non eligible contact lens products:

-          All 30 pack purchases
-          All Freshlook products

Aeroplan Card must be presented at time of payment to receive your Aeroplan Miles.

Aeroplan Card must be presented at time of payment to receive your Aeroplan Miles.

Bonus miles will be credited to Aeroplan Members’ accounts within one week of payment.

Some restrictions may apply. Please visit this clinic for more information.

  

Aeroplan® and the Aeroplan® logo are registered trademarks of Aimia Canada Inc.

Eyewear trends for fall 2014

The website http://eyecessorizeblog.com, is an excellent source for info on eyewear trends.  They have a excellent post on trends for Fall 2014.  Click here to visit eyecessorizeblog.com.  Here is a taste of Fall 2014:

Vision therapy for saccades improves reading

Dr. Dominick Maino has an excellent post on the blog of the College of Optometrists in Vision Development about a new study published in the journal Clinical Pediatrics by a group of researchers including one from the Illinois College of Optometry that shows that vision training (vision therapy) for saccadic eye movements improves reading in children. Read more

Do clouds block UV rays?

According to the Doctors of Optometry Facebook page, UV rays are so strong, up to 90% of rays can penetrate through the clouds. They can also reflect off surfaces such as sand, snow and water. No matter the day, always protect your eyes from invisible UV rays.

A significant amount of UV rays can actually enter your eyes even you are wearing UV blocking eyeglasses.  That's because those glasses block the UV rays that come at them from the front but UV rays can reflect of the back of the lens (the side of the lens that is closest to your eye) and into your eyes.  To stop that, you should wear advanced UV protection lenses with an ESPF (eye-sun-protection factor) of 25 or higher.

Learn more here.

How to be visible at night to older drivers

A new study says that it takes longer for older drivers to notice pedestrians at night. And pedestrians are more visible to them if they wear reflective strips on their movable joints like such as shoulders, elbows, wrists, waist, knees and ankle. Eye doctors can test seniors to ensure that they are safe driving at night. Learn more.

Eye movement dysfunctions, their treatment and reading related problems in patients with mild traumatic brain injury (mTBI)

We have large vision therapy practice at our Vancouver vision and eye clinic where one category of patients that we treat come to us with traumatic brain injuries that have caused vision problems in the patients, including reading difficulties.  

Reading is a complex task involving a number of functions, abilities and visual skills.  Reading has oculomotor, sensory, cognitive, and attentional components, and all of these must be integrated. If any one of them is affected by a brain injury, they reading is likely to be negatively affected as well.   For example, accurate eye movements are essential for efficient reading. This means that if a traumatic brain injury (TBI) has affected the normal control of eye movements, then reading will likely be adversely impacted.

How can doctors fix these problems?  That was the issue investigated by the authors of a study published in 2007 in the Journal of Behavioral Optometry.  The researchers looked at three studies done by their research group which involved versional oculomotor dysfunctions, their related reading problems, and treatment in a group of patients with mild TBI whose injury affected their vision and reading ability.

Let's take a second to make sure we understand a few of those scientific terms.  A "version" is an eye movement involving both eyes moving together as a team in the same direction.  A "versional oculomotor dysfunction" is a problem in the way the eyes move together as a team.

The results have shown that in a large clinical sample (160 patients), approximately 90% had one or more oculomotor deficits, such as convergence insufficiency or abnormal saccadic tracking- a saccade is a fast movement of the eye like the moments the eye does when tracking words on a printed page.  Deficits in these areas have the potential to interfere with reading performance.  

Out of the 160 patients examined, thirty-three of them completed a program of vision therapy. Of the patients who received vision therapy, an impressive ninety percent of them experienced improvement in at least one related sign and one related symptom. 

The researchers also laboratory-tested 9 of the study subjects who had  eye-movement-related reading problems and found that all of them improved their overall reading performance and versional eye tracking ability after vision therapy.

There are a number of conclusions to draw from this study:

1. eye movement dysfunctions are common in individuals with mild TBI;
2. vision therapy can effectively treat eye movement dysfunctions;
3. the positive vision therapy findings demonstrate that the adult brain can be changed and molded (re-wired) with vision therapy and this shows the presence of considerable neuroplasticity in adults with mild traumatic brain injury;
4. optometric vision therapy should be used to treat  visually symptomatic patients with TBI who have eye-movement-based reading problems.

More information

To learn more about vision therapy and brain injuries, visit: www.braininjuries.org
Another excellent resource is the website of NORA, the Neuro-Optometric Rehabilitation Association.




Related Articles
Traumatic brain injury often results in convergence insufficiency 
Dec 11, 2012

Brain injuries and vision problems
Nov 04, 2012

Eye movement dysfunctions, their treatment and reading relateed problems in patients with traumatic brain injury
Dec 28, 2012

Vision problems after car accident are caused by brain injury 
Nov 07, 2012

- See more at: http://www.visiontherapy.ca/braininjury.html

Image courtesy of Victor Habbick / FreeDigitalPhotos.net

Binocular vision and older adults

Binocular vision, refers to the way that the two eyes work together as a team.  Deficiencies in this ability  is one of the major categories of vision disorder that is effectively treated with vision therapy. Recent research has sought to determine the prevalence of binocular vision disorders in adults aged 60 or over and has found that the prevalence of binocular vision disorders increases as we age.

The results of a study from researchers at Canada's University of Waterloo found that as many as 27% of adults in their sixties have a binocular vision or eye movement disorder and 38% of adults over the age of 80 have such a vision disorder. That's compared to the general population in which 20% of people have a binocular vision disorder.

Binocular vision disorders can cause problems in reading, driving, motion sickness and depth perception. The latter problem is of particular concern among the elderly, as people with reduced depth perception are at greater risk of falls.

According to the press release issued by the University of Waterloo to publicize the results of the study, vision therapy and eye-glasses are effective treatments for binocular vision disorders:

Although the study suggests that the rate of binocular vision disorders in older adults is higher than expected, there is good news. Many binocular vision disorders are treatable with glasses, vision therapy, or in some cases surgery. 

Related Articles

Eyes and ageing

January 23, 2014

When seniors loose depth perception and need to see a developmental optometrist
Thursday, June 28, 2012