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Dr. Taylor & Associates
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April 2015
 
Vision Examinations Vs. Vision Screenings in Children
 
Vision screenings conducted by pediatricians and in schools are often mistakenly viewed by many as a sufficient and sole means of determining ocular and visual health.  While screenings can play an important role in the detection of some visual abnormalities, they can miss the signs of many other visual conditions that affect a child’s performance in school, and therefore should not be used as a substitute for a comprehensive eye exam.
 
Vision screenings traditionally put more emphasis on detecting abnormalities in distance vision, even though a large majority of classroom demands are at near. An additional pitfall to vision screenings is that parents may be given a false sense of security if their child passes the testing, and therefore as a result may delay or forgo having their child get a full eye exam.  Studies have shown that even for those children who fail a vision screening, only about 50% will proceed to follow up with a comprehensive eye examination for further assessment.  This illustrates the very important reality that many children are not receiving proper evaluation and management of visual conditions that can profoundly impact their learning and development.
 
Under the Affordable Care Act, all children under the age of 18 now have access to vision care with no referral necessary.  With this new law and with increased community education, it is our hope that the practice and awareness of the importance of comprehensive eye examinations for all children will significantly increase.

For more information on this topic, please visit the Practice Update article by clicking here!

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1/28/15
King-Devick Test Approved for Sideline Concussion Screening
Earlier this week, it was reported that the Mayo Clinic has entered into an agreement with King-Devick Test Inc in an effort to increase the awareness and incorporation of concussion screenings for athletes.  The King-Devick Test was developed over 30 years ago and involves reading aloud a list of written numbers while being timed and monitored for accuracy.  The test requires the use of accurate eye movements, speech, language, and concentration.  All of these elements have been shown to have potential impairments following concussion.  The King-Devick Test has been proven to be an accurate, objective, and reliable detector of head trauma, even in more subtle or “silent” concussion cases.  The test is easy, fast, and able to be applied by both medical and non-medical personnel such as coaches and parents.  With the new backing by the Mayo Clinic, the hope is that the test will be used on the sidelines as a quick screening to help assess whether or not it is safe for an athlete to return to play after a head trauma.
Here at Dr. Taylor and Associates we are able to perform the King-Devick Test on our patient athletes in the office.  A baseline test should be done annually and, should a head trauma occur, the test is then repeated and the new results compared to the most recent baseline.  If any significant difference in the results are found, or if there are any other signs of difficulty during the testing, the athlete should not be allowed to return to play until further medical assessment.  With the incorporation of these screening techniques, we hope to raise awareness and detection of concussive events as well as prevent further unnecessary injury.
For more information on this topic, please visit the Mayo Clinc website at the link below:
http://newsnetwork.mayoclinic.org/discussion/mayo-clinic-and-king-devick-test-announce-licensing-agreement-to-sideline-concussion-testing/

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Optical News!
We are excited to announce the arrival of two new frame lines, Plein Les Mirettes and Face & Cie by Zenka. Both of these unique lines are designed, manufactured and imported from France. As one of only three offices in the U.S. to carry these frames, we are proud to feature them as the first lines in our exclusive international collection.
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CDC: Eye infections linked to improper contact lens use

 
It is estimated that about 38 million Americans are contact lens wearers.  The most common ocular irritation that occurs in contact lens wearers is an inflammation of the cornea called keratitis.  This inflammation can cause symptoms of pain, redness, blurred vision, and light sensitivity.  In severe cases, untreated keratitis can lead to corneal scarring and even blindness.
 
A new report released by the Centers for Disease Control and Prevention estimates that about one million cases of eye infection in the U.S. annually are specifically a result of contact lens misuse.
 
Contact lenses, when cared for properly, can be a convenient and safe alternative to glasses for many people.  However, many contact lens wearers engage in improper care and hygiene habits which greatly increase their risk of infection.  Risk factors for contact lens related keratitis include sleeping in contacts, inadequate cleaning of lenses, failing to replace lens solution and case frequently, exposing lenses to water, and not disposing of contacts according to their approved replacement schedule.    
 
“People who wear contact lenses overnight are more than 20 times more likely to get keratitis,” said Jennifer Cope, a medical epidemiologist at the CDC.
 
It is difficult to convey to patients the harm that they may be doing to their eyes by not taking proper care of their contact lenses, especially if they have never had any problems in the past.  Practitioners point out that it may only take one serious infection to potentially cause permanent vision changes.  Why gamble with something as important as your sight?
 
Here are examples of good contact lens care techniques that should be followed to prevent infection:
1)   Always wash your hands with soap and water before handling contact lenses.
2)   Always remove contact lenses before sleeping, showering, or swimming.
3)   After removing contact lenses, rub and rinse them with disinfectant solution.
4)   Rinse out contact lens case with disinfectant solution daily, never use water.
5)   Fill contact lens case with fresh solution each night. Never re-use old solution.
6)   Replace contact lens case at least once every 3 months.
7)   Do not wear the same pair of contact lenses longer than their approved disposal schedule.
8)   Be sure to have a back up pair of eyeglasses in case contact lenses cannot be worn.
 
If your eyes ever become red, painful, or irritated, you should remove your contact lenses immediately.  If the symptoms do not resolve, see your eye doctor to rule out possible infection.  Timely diagnosis and treatment is very important in cases of contact lens related keratitis.
 
Please click on the link below for more information on the article published by the CDC:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6345a3.htm?s_cid=mm6345a3_w

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This week, we're looking at how an "eye turn" can effect an individual's, particularly an older individual's, risk of falling.

A new study out in JAMA Ophthalmology has found evidence to support that older adults with strabismus are more likely to be injured by a fall.

Strabismus is an ocular condition in which there is a misalignment of the eyes, and is more commonly known as an “eye turn.”  Because the two eyes do not point in the same direction they may be unable to focus on the same point or object together.  This can lead to symptoms of double vision (diplopia), and reduced or absent depth perception. Strabismus symptoms can often be improved by certain treatments, including the use of vision therapy and prism glasses.

As the aging population increases so too does the prevalence of older adults with strabismus, and this study was conducted in an effort to examine the impact that strabismus might have on these patients’ quality of life.  Specifically, the study authors wanted to see whether there was an association between strabismus and increased musculoskeletal injuries and falls.   They did this by researching a random sample of Medicare claims from 2002 to 2011.  Of that sample they found about 100,000 diagnoses of binocular vision problems such as strabismus and diplopia, and about 75 percent of that group had also reported a musculoskeletal injury during that time span.

After eliminating other possible contributing factors, the researchers determined that there was about a 27 percent higher risk of falls and musculoskeletal injuries in those with binocular vision disorders compared to those without.

Specialists note that eye problems often do not take priority for elderly patients when compared to other illnesses that may be more pressing.  The results of this study are just one example of how ocular conditions can play a significant role in patients’ daily life and safety, and illustrate how important it is that these conditions are well managed.

For more information on the study, please visit the link below:
http://www.reuters.com/article/2014/10/30/us-health-elderly-vision-falls-idUSKBN0IJ2JT20141030

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Check out this awesome write up on Convergence Insufficiency from Dr. Baran.

Researchers from the New Jersey Institute of Technology (NJIT) and the Pennsylvania College of Optometry are conducting a 5 year study to investigate the neural processes underlying convergence insufficiency and its treatment.
Convergence insufficiency (CI) is an ocular condition in which the two eyes have difficulty working together to converge and focus on near objects and text.  This condition can lead to symptoms such as headaches, double vision, and eye strain with near work.  CI is more frequently seen in children but is also a common finding in adults who have experienced a traumatic brain injury.  

The most effective treatment for CI is vision therapy— systematic, prescribed training sessions in which a patient performs techniques to enhance the eyes’ ability to work together.  Though studies have consistently shown an improvement in CI symptoms as a result of vision therapy, the neurologic mechanisms by which these adaptations occur is still not known.   In their study, the researchers at NJIT will use functional magnetic resonance imaging scans to observe brain function as subjects complete different ocular tasks and movements.  In doing this, they will be able to see what parts of the brain are active during such tasks and gain a deeper understanding of what is occurring at the neural level.  This can lead to the development of new therapies as well as improvements on current treatments, and has the potential to revolutionize the way we manage convergence insufficiency.
http://www.optometry.co.uk/news-and-features/news/?article=6068

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According to Optometry Times, it could! Researchers from GCU are working in collaboration with the University of California, Berkeley, to develop a video game to help with the treatment of amblyopia. Amblyopia or “lazy eye” effects visual acuity, depth perception and may be present with or without a turned eye (strabismus).   Vision therapy is the most successful treatment for amblyopia and patching may be part of the treatment plan. According to the study, this video game would stimulate both eyes at the same time and improve visual acuity as well as depth perception, or stereo vision. Researchers believe the video game will stimulate children more than other methods. This would increase the child’s engagement and motivation while participating in vision therapy activities. There are many different techniques used in vision therapy and the earlier a child with amblyopia starts treatment, the better!
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