What's New
OUR OFFICE HAS BEEN CURRENTLY USING THE FOLLOWING METHODS TO TRY AND CONTROL THE PROGRESSIVE RATE OF MYOPIA (NEARSIGHTEDNESS) IN CHILDREN:
Low dose atropine: This is an eye drop that is used before bedtime and has been found to reduce the rate of myopia progression. In the low doses we are using this drop, there have been almost no side effects. This can be used with current eyeglasses or with patient's who wear contact lenses. This compounded eye drop can only be obtained from pharmacies that do compounding of medications. It is generally not covered by insurance and the cost is about $50-60 per bottle.
Soft multifocal contact lenses: These are specially designed lenses that focus for distance through the center of the lens and for near through the peripheral part of the lens. There are daily wear and monthly wear options for these lenses. The lenses need to be worn regularly to have the desired ability to reduce the progressive rate of nearsightedness increases.
Orthokeratology (AOK): These are rigid contact lenses that are worn during sleep to reshape the front surface of the eye (cornea). They have been shown to reduce the rate of nearsightedness increases by up to 50% in recent studies. They have the added benefit of allowing for clear daytime vision without the use of any eyeglasses or contact lenses during the day because of the corneal reshaping that occurs overnight.
BIFOCALS ARE EFFECTIVE IN SLOWING NEARSIGHTEDNESS IN CHILDREN Bifocals worked better than single-vision glasses to slow nearsightedness in children whose sight was deteriorating most rapidly, according to a study in the Archives of Ophthalmology. Researchers randomly assigned 153 of these children, ages 8 to 13, to wear either single-vision glasses, standard bifocals or so-called prismatic bifocals for two years. Though the eyesight of children in each group worsened throughout the study, children who wore standard bifocals required one-third less subsequent correction than children who wore single-vision glasses. Children who wore the prismatic bifocals, which permit the wearer to adjust the focus of the near-viewing lens, fared even better, requiring about one-half as much subsequent correction as children who wore single-vision lenses. Though the precise reason why bifocals slow the progress of myopia is unclear, they may work by reducing eyestrain, which contributes to nearsightedness.
STUDY AFFIRMS THE BENEFITS OF OFFICE VISION THERAPY Convergence Insufficiency (CI) is a common condition that effects people of all ages. It results in the eyes having difficulty converging (turning inward) when looking at a near target. A minimum of 1 in 20 children have this condition which can cause symptoms like difficulty reading, headaches, blurred vision, double vision, eye strain, loss of place when reading, covering one eye, rubbing the eyes, poor attention span, avoidance of reading, taking a long time to complete assignments, and poor comprehension.
A recent report from the convergence insufficiency treatment trial (CITT) found that office based vision therapy plus at home treatment was significantly more effective than either home based computer vision therapy or home based pencil pushups for treating convergence insufficiency.
Specifically, about 75% of children in the study had normal or improved symptoms after receiving office based vision therapy. Only 43% of children achieved this success doing pencil pushups and 33% achieved this level with only home based computer therapy.
Mitchell Scheiman, O.D., the lead author of the study says "we now have quality evidence showing that office based vision therapy with a trained therapist, plus at home reinforcement, can effectively treat convergence insufficiency in children 9 to 17 years old and is significantly more effective than home based therapy. This treatment can improve symptoms and physical measurements of the condition. Based on the results of this clinical trial, office based vision therapy should be recommended as the first line treatment for children with symptomatic CI".
Our office provides this type of vision therapy treatment for patients with convergence insufficiency as well as for patients with various other visual conditions that effect visual performance, efficiency, and comfort. Dr. Rothman is certified by the College of Optometrists in Vision Development to provide vision therapy.
NEW OFFICE TECHNOLOGY:
Visual Evoked Potential (VEP) and Electroretinogram (ERG) testing: This allow us to measure the nerve connections on the eye and from the eye though the brain. It is a non invasive test that allows us to detect the reasons behind vision loss, visual field (peripheral vision) problems, and monitor progression of glaucoma. It also helps to determine the possibility of improving lazy eye or an eye turn. It has been recently studied for helping to diagnose concussion and traumatic brain injury.
Right Eye Visual tracking system: This device monitors eye position and eye movements as well as evaluating visual reaction time. We are using it to diagnose, measure and monitor patients who have visual tracking problems, reading problems, concussions, brain injury, letter or number reversals, and need visual evaluation before returning to driving.
Ultrasound: A scan ultrasound allow us to measure the length of the eyeball. This is an important measurement in determining the change in the eye that can contribute to increases in nearsightedness. In nearsightedness the eye elongates causing distance objects to focus in front of the retina and be out of focus on the retina. B scan ultrasound is used to evaluate the internal eye when the back of the eye is not visible (in cataracts for instance). It also allows us to determine the position of floaters in the eye and to make sure that the retina is free of areas of detachment.
Optos wide field retinal imaging: This has eliminated the need for routine dilation of the eyes when the patient is assymptomatic. The Optos image is an almost full image of the entire retina. By seeing the whole retina at once it helps us to get a better perspective on where abnormalities are present and allows us to compare what we are seeing from year to year. Patient's with abnormalities seen on the Optos image may need to be dilated for further testing at another visit.
OCT: The optical coherence tomographer is an essential instrument in eye care. It allows us to monitor and follow diseases like glaucoma, macula degeneration, corneal problems, other retinal abnormalities, visual field defects etc. It is a non invasive test.
Low dose atropine: This is an eye drop that is used before bedtime and has been found to reduce the rate of myopia progression. In the low doses we are using this drop, there have been almost no side effects. This can be used with current eyeglasses or with patient's who wear contact lenses. This compounded eye drop can only be obtained from pharmacies that do compounding of medications. It is generally not covered by insurance and the cost is about $50-60 per bottle.
Soft multifocal contact lenses: These are specially designed lenses that focus for distance through the center of the lens and for near through the peripheral part of the lens. There are daily wear and monthly wear options for these lenses. The lenses need to be worn regularly to have the desired ability to reduce the progressive rate of nearsightedness increases.
Orthokeratology (AOK): These are rigid contact lenses that are worn during sleep to reshape the front surface of the eye (cornea). They have been shown to reduce the rate of nearsightedness increases by up to 50% in recent studies. They have the added benefit of allowing for clear daytime vision without the use of any eyeglasses or contact lenses during the day because of the corneal reshaping that occurs overnight.
BIFOCALS ARE EFFECTIVE IN SLOWING NEARSIGHTEDNESS IN CHILDREN Bifocals worked better than single-vision glasses to slow nearsightedness in children whose sight was deteriorating most rapidly, according to a study in the Archives of Ophthalmology. Researchers randomly assigned 153 of these children, ages 8 to 13, to wear either single-vision glasses, standard bifocals or so-called prismatic bifocals for two years. Though the eyesight of children in each group worsened throughout the study, children who wore standard bifocals required one-third less subsequent correction than children who wore single-vision glasses. Children who wore the prismatic bifocals, which permit the wearer to adjust the focus of the near-viewing lens, fared even better, requiring about one-half as much subsequent correction as children who wore single-vision lenses. Though the precise reason why bifocals slow the progress of myopia is unclear, they may work by reducing eyestrain, which contributes to nearsightedness.
STUDY AFFIRMS THE BENEFITS OF OFFICE VISION THERAPY Convergence Insufficiency (CI) is a common condition that effects people of all ages. It results in the eyes having difficulty converging (turning inward) when looking at a near target. A minimum of 1 in 20 children have this condition which can cause symptoms like difficulty reading, headaches, blurred vision, double vision, eye strain, loss of place when reading, covering one eye, rubbing the eyes, poor attention span, avoidance of reading, taking a long time to complete assignments, and poor comprehension.
A recent report from the convergence insufficiency treatment trial (CITT) found that office based vision therapy plus at home treatment was significantly more effective than either home based computer vision therapy or home based pencil pushups for treating convergence insufficiency.
Specifically, about 75% of children in the study had normal or improved symptoms after receiving office based vision therapy. Only 43% of children achieved this success doing pencil pushups and 33% achieved this level with only home based computer therapy.
Mitchell Scheiman, O.D., the lead author of the study says "we now have quality evidence showing that office based vision therapy with a trained therapist, plus at home reinforcement, can effectively treat convergence insufficiency in children 9 to 17 years old and is significantly more effective than home based therapy. This treatment can improve symptoms and physical measurements of the condition. Based on the results of this clinical trial, office based vision therapy should be recommended as the first line treatment for children with symptomatic CI".
Our office provides this type of vision therapy treatment for patients with convergence insufficiency as well as for patients with various other visual conditions that effect visual performance, efficiency, and comfort. Dr. Rothman is certified by the College of Optometrists in Vision Development to provide vision therapy.
NEW OFFICE TECHNOLOGY:
Visual Evoked Potential (VEP) and Electroretinogram (ERG) testing: This allow us to measure the nerve connections on the eye and from the eye though the brain. It is a non invasive test that allows us to detect the reasons behind vision loss, visual field (peripheral vision) problems, and monitor progression of glaucoma. It also helps to determine the possibility of improving lazy eye or an eye turn. It has been recently studied for helping to diagnose concussion and traumatic brain injury.
Right Eye Visual tracking system: This device monitors eye position and eye movements as well as evaluating visual reaction time. We are using it to diagnose, measure and monitor patients who have visual tracking problems, reading problems, concussions, brain injury, letter or number reversals, and need visual evaluation before returning to driving.
Ultrasound: A scan ultrasound allow us to measure the length of the eyeball. This is an important measurement in determining the change in the eye that can contribute to increases in nearsightedness. In nearsightedness the eye elongates causing distance objects to focus in front of the retina and be out of focus on the retina. B scan ultrasound is used to evaluate the internal eye when the back of the eye is not visible (in cataracts for instance). It also allows us to determine the position of floaters in the eye and to make sure that the retina is free of areas of detachment.
Optos wide field retinal imaging: This has eliminated the need for routine dilation of the eyes when the patient is assymptomatic. The Optos image is an almost full image of the entire retina. By seeing the whole retina at once it helps us to get a better perspective on where abnormalities are present and allows us to compare what we are seeing from year to year. Patient's with abnormalities seen on the Optos image may need to be dilated for further testing at another visit.
OCT: The optical coherence tomographer is an essential instrument in eye care. It allows us to monitor and follow diseases like glaucoma, macula degeneration, corneal problems, other retinal abnormalities, visual field defects etc. It is a non invasive test.
View this video on the benefits of vision therapy that appears on WebMD: