Vision problems linked to motion sickness…an important public health issue

Last week Stacy Lu, reporter for MSNBC.com, wrote an excellent article entitled Adult-onset motion sickness rare — but can happen. In doing her research,  Ms. Lu contacted me requesting my clinical insights into the types of vision problems that are associated with those individuals (both adults and children) who are  susceptible to motion sickness and vertigo.

It was a pleasure to provide Ms. Lu with an overview of these complex visual issues and she in turn contacted another medical expert, Timothy Hain, M.D., an otoneurologist and professor at Northwestern University Medical School for his medical insights.

Then to balance out the story with the patient’s perspective, she asked if I had recently completed treatment on an adult patient who wouldn’t mind speaking to her on the phone. Coincidently,  we had just completed the process of vision therapy treatment for an adult individual who  had struggled with dizziness secondary to a  binocular dysfunction combined with poor visual-vestibular integration, and she agreed to speak with Ms. Lu.  Our patient, LaReine Gretzky, was originally referred to me by her primary eye care optometrist, Dr. John Marohn of Great Lakes Eye Care in St. Joseph, Michigan, who had recognized LaReine’s visual problems. Dr. Marohn advised LaReine that she needed the help of vision rehabilitation/vision therapy, and referred her to my care for a diagnostic evaluation and treatment.  And to share her story, here she is…  LaReine Gretzky on the day of her “graduation” from Wow Vision Therapy.

For those who struggle with vision problems linked to motion sickness and/or dizziness it is important to find help by a doctor who is experienced in neuro-optometric vision rehabilitation and vision therapy. Look for a Board Certified Fellow (FCOVD)through the College of Optometrists in Vision Development (COVD) nearest you by going to the www.covd.org or the Neuro Optometric Vision Rehabilitation Association website at www.nora.cc

Additional information with related references,  including my PowerPoint lecture delivered in July 2011, can be found within the article I wrote for The VisionHelp Blog entitled: The See-Sick Syndrome…when visual dysfunction causes motion sickness.

Dan L. Fortenbacher, O.D., FCOVD

Convergence Insufficiency… a serious children’s vision problem that should not be trivialized

Convergence Insufficiency (CI) is a vision disorder that affects nearly 1 in 12 children and has consequences to a child’s quality of life.  CI is a serious vision problem and when left untreated, can have a significant impact…

A real live example of this is told by Aiden’s Success Story just submitted by his parents to our office yesterday at his Exit Examination from treatment. Aiden’s (CI) symptoms before treatment were a collective set  of behaviors that appeared like so many children with CI who are misdiagnosed and treated for ADD/ADHD.

As stated by Dr. Press in his latest VisionHelp Blog post, An Inconvenient Truth, one notably partisan membership association, The American Academy of Pediatric Ophthalmology and Strabismus (AAPOS) has  turned a blind eye to the current research on this serious vision problem by purveying unproven and ineffective treatments on their website. Incredibly, even after 10 years of gold standard research  by the Convergence Insufficiency Treatment Trial (CITT) Investigation Group, which has proven that prism glasses and home based vision activities alone are not effective treatment modalites for Convergence Insufficiency, these treatments are still recommended as possible remedies for this serious child’s vision disorder by the AAPOS. It is not only wrong for the AAPOS to mislead the public, doctors and third-party representatives on bogus CI treatment…it is shameful!

Three years ago this month, in its lead story Optometry Times published the evidenced-based research for Doctors of Optometry so that their clinical decisions would be guided by proven methods, thereby enabling their patient’s with Convergence Insufficiency to obtain the correct treatment.

Click here to see what Doctors are being taught about the most effective treatment for Convergence Insufficiency.

For additional factual information on Convergence Insufficiency, click here.

Dan L. Fortenbacher, O.D., FCOVD

Convergence insufficiency and “tracking problems”…How hard can it be to spot these kids?

Sometimes the vision problems that involve poor eye coordination seem to be missed or mistaken during a regular eye examination. Parents who have such a child with a previously undetected binocular or oculomotor problem  are often surprised and ask,  ”Why was this not spotted before?”  After many years of seeing hundreds if not thousands of these children and with the plethora of research and body of knowledge readily available, it is becoming more and more difficult for me to explain to a parent why the previous eye doctor, whether ophthalmologist or optometrist did not see this.  After all,  how can a child with complaints of words overlapping while reading and trouble concentrating on a reading tasks not raise a red flag to test for problems in  eye coordination??

To show how easy it is to test for this condition, take a look at the video below to see our patient Josh before and after his vision therapy treatment. While there are about 17 clinical tests typically performed by the doctors who specialize in Developmental Vision to make the correct diagnosis, there are 2 easy chair-side tests that nearly anyone can perform that will often show if a child has convergence insufficiency (CI) and/or oculomotor dysfunction (tracking problems).

• The first test is a simple “tracking” test where Josh is asked to follow a bead on a stick. Notice at first he starts out pretty good, but as I begin to ask him questions and he has to think, in less than a minute he begins to show signs of significant fatigue, loss of fixation and furrowed brow showing stress.
• In the second clip Josh is wearing red-green glasses (over his own glasses). He is then asked to look at a “penlight” as it is brought closer to his nose. This test is described and published by the American Optometric Association. Read more by clicking here. Notice that in this second clip that Josh reports double (two lights -one red, one green) at about 20 inches. What’s normal on this test? Double at 2-4 inches. To see the research and normative data …click here

Just as so many other children are affected (research shows 1 in 12) by this vision problem known as Convergence Insufficiency (CI), Josh also struggled. The impact on him was that he had double vision and loss of interest for reading. It also made it difficult for him to play baseball or most any ball sport. As a result Josh lacked confidence at school and on the playground. Now after successful completion of his office-based optometric vision therapy Josh no longer sees double when reading, his comprehension and reading speed has significantly improved and he is gaining skill and confidence in sports. Now that he has good binocular vision, Josh no longer struggles and is a happy kid!

Dan L. Fortenbacher, O.D., FCOVD

Vision therapy for the special needs patient…you be the judge

A few days ago a Dad of one our special patients raised a question of  concern  that centered around his son being able to have access to some of the new computer-based teaching applications being introduced into his school.  You see, his 10-year-old son Christopher has cerebral palsy and  like many children with cerebral palsy,  Christopher has developmental vision delays associated with his neurological condition. 

 The question posed by Christopher’s dad was, “Should my son be able to take advantage of the new high-tech computer-based, interactive technologies that are becoming available at Christopher’s school?”  This question stemmed from discussions at his school and assumptions about children  with neurological based conditions like CP. In this case a concern was voiced at the school that Christopher’s Individualized Education Program (IEP) might disallow him having access to the newly available interactive computer based education systems being utilized in the classroom.   Imagine this is your special child and while all the other kids are enjoying access to the “new educational gadgets”,  your child  is going to be relegated to “playing with blocks.” 

Yes,  prior to his vision therapy treatment Christopher would have  had trouble  with even the most basic visual demands in the classroom. Yet even though  Christopher has cerebral palsy,  there is still plasticity in his visual brain that has enabled him to positively respond to neuro-optometric vision rehabilitation. His treatment has targeted the plasticity of  his brain with office-based vision therapy through a variety of activities that incorporate awareness, feedback and sensory integration.

To help demonstrate the point, in this Movie Clip take a look at our patient Christopher. First you will see Christopher 10 months ago showing him struggle to visually track and follow a simple cube on a stick in a very basic chair-side assessment of his eye movement. Second in the clip you will see  an introduction by Dr. Fortenbacher and Dr. Tuan (MCO Extern) demonstrating an example of one the latest  advanced vision therapy applications using the Sanet Vision Integrator.  Then you will see Christopher in action (on the SVI) showing progress in his visual skill development with an interactive visually challenging high-tech vision therapy procedure. 

You be the judge…should Christopher be given the opportunity to try to work with the new computer-based educational applications as part of his IEP?

Dan L. Fortenbacher, O.D. FCOVD

Extreme vision problems a catalyst for teaching…20/20 is not good enough

In the study of disease, often it is useful to explore the extreme in order to understand the significance of a disorder and it’s impact on human potential even when it exists in a less recognizable form.

For example, while attending optometry school the modern-day optometry student,  early in their clinical training, will be presented with samples photos and video of eye conditions that depict an  ocular disease with  graphic exaggerations of what could be  seen in clinical practice.  Therefore, portraying the extreme condition helps to sensitize the future doctor  to the importance of recognizing these conditions early. In this way the quality of patient  care is greatly improved when the doctor is able to catch the problem early,  when there is a more subtle  and less obvious clinical presentation, provide the appropriate care before the problem becomes  “full-blown” and thus help to provide a better future for the patients vision and quality of life.

Let’s take for example an ocular disease known as a corneal ulcer. The student doctor in training will often see many samples of eyes with extreme variations of corneal ulcer. Yet it is understood that when the condition is recognized early and the correct treatment is prescribed, the condition will unlikely erode into this exaggerated condition.

Now, if you are a regular visitor to The VisionHelp Blog you already know that vision problems, known as binocular vision problems,  exist in children and adults, causing significant problems for the patient even though they may be quite capable of seeing 20/20.  A fairly common binocular vision problem, known as Convergence Insufficiency occurs in 1 in 12 and can be detected by doctors early in its clinical presentation in children when the eye examination findings are not so severe and the child has not had to struggle with the effects of the condition for that long.

In the case of Convergence Insufficiency one test that is fairly easy to administer is called a Near Point of Convergence Test. In this case the doctor holds a target like a pencil tip or pen light in front of the bridge of the patient’s nose (on their midline) and moves it closer to their eyes asking them to tell when they see the object go double. The norms for this test show the diagnosis of CI can be applied when the patient reports double at 5-7 centimeters from the bridge of the nose.

However, to convey this better…let’s show an example of an extreme condition of Convergence Insufficiency as a catalyst for teaching…

While this is an example of an extreme, it is not too late for Breanna. Within a short period of time and  the appropriate treatment involving office-based doctor supervised optometric vision therapy she begins to gain control and her binocular vision. Let’s  take a look at Breanna this time after having completed only a portion of her prescribed treatment plan but well on her way to successful conclusion.

While at age 15 Breanna had to endure her binocular vision problem for much longer than necessary, fortunately her primary care optometrist who saw her for the first time referred her immediately. However, prior to her doctor’s referral Breanna had to endure a vision problem in spite of the fact that she had 20/20 eye sight!

As we now enter August’s National Children’s Vision and Learning Month, it is critically important that doctors, teachers and parents recognize the developmental vision problems like the binocular vision dysfunction of Convergence Insufficiency before they become the extreme. This patient-video submitted into The Visions of Hope campaign, Mackenzie says it best -20/20 Is Not Good Enough…For Me!

Dan L. Fortenbacher, O.D., FCOVD

Vision Therapy Success Cultivating Inspiration and Awareness… Visions of Hope

As August begins the National Children’s Vision and Learning Month, the COVD Visions of Hope Campaign for patient video submissions is cultivating inspiration and fostering greater public awareness.  The impact of binocular (eye teaming), accommodative (eye focusing) and oculomotor (eye tracking) problems can disable a child and prevent them from reaching their potential. Through the Visions of Hope entries, all patients can tell their story of success through vision therapy…including the adult patients.

In this Visions of Hope video you will enjoy just that. Thirty eight year old adult patient, Toni, tells her Story of Success through vision therapy  in a way that is more like an MTV video. Through Toni’s artistic flare we can appreciate how challenging her world was before she found optometric vision therapy. We can feel how painfully difficult it must have been but happy for her new-found success.

As you watch this video, think of the children who struggle with these vision problems and realize that there is help. No child should have to struggle with an undetected and unaddressed binocular vision problem.  In Toni’s video you will witness the debilitating effects of her chronic double vision but in a way that is truly going to touch your heart and quite possibly make you laugh. And here’s Toni!

Dan L. Fortenbacher, O.D., FCOVD

Convergence Insufficiency a Patient Health Issue

When over 21 million people in the United States are affected by a vision problem that can have serious consequences especially to a child’s quality of life, it begs the question…”Why?”

Studies show that Convergence Insufficiency affects about  1 in 12 children often causing headaches, poor concentration for reading tasks and even double vision. Yet, even when finally diagnosed by an eye doctor, most patients say they have never heard of this condition prior to their diagnosis.  One cause could be that too many parents rely on a school vision screening to test their child’s eyes and school vision screenings routinely overlook vision problems involving proper eye coordination and binocular (eye teaming) control. Therefore, a child  may “pass” the eye sight test at school and still have a serious vision problem like Convergence Insufficiency.

Just as undetected Glaucoma or Diabetes is a serious patient health issue, so too is the problem of undetected cases of  Convergence Insufficiency. However, unlike Glaucoma or Diabetes, in the case of Convergence Insufficiency there is a cure.  Since the patient with Convergence Insufficiency is typically unaware that they have a disease that can have serious consequences, it is important for all health care providers who work with children to be informed about this condition…including Family Physicians and Pediatricians.

In January 2011, I was contacted by Scott Eshowsky, MD from  Main Street Medical in Granger, Indiana.  Dr. Eshowsky is a wonderfully caring doctor who is Board Certified in Family Practice and currently serves as the Medical Director for Main Street Medical Group.  As a concerned physician, who has experienced first hand the impact of vision problems on child development, Dr. Eshowsky asked me to come to Main Street Medical Group and provide more information about Convergence Insufficiency. I accepted the invitation and on January 18, 2011 presented to the doctors within their practice the following lecture. While  my lecture was 7 months ago and took about an hour to present, with new  PowerPoint to video technology, I have tweaked, polished and added some artistic flare so that this lecture on Convergence Insufficiency can be viewed in only a few minutes and nicely within the palm of your hand on your smart phone or iPad. If viewing on your PC, open to full screen by clicking in the lower right corner of the video.

I hope you find this presentation both informative and enjoyable!

CI…

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For further information and resources from this lecture, click here.

For a PDF copy of this lecture, click here.

Dan L. Fortenbacher, O.D., FCOVD

The See-Sick Syndrome…when visual dysfunction causes motion sickness

Recently I had the pleasure of presenting a  CE lecture to primary care ODs about a vision related problem that receives little attention from the media yet plagues the quality of life of millions of people. It affects children and adults with an increase in symptoms in adults.  But,  those who suffer from the condition rarely associate it to their vision and don’t think to mention it to their primary care eye doctor. Indeed for most of these patients, whether adults or children,  the malady they suffer is assumed to be just  ”their nature”.  So unless detected and properly treated, the individual with this condition is forced to cope with the problem…a problem that is just sickening. Yes,  the symptom that is fundamental to these patients is “motion sickness”.  You know, that “yucky” feeling that almost all of us have experienced at one time or another. But in these individuals the  malaise of motion sickness is a frequent, annoying (and can be severe) response to activities that are generally quite benign to the majority of people, such as:

• Riding in a car or a plane and trying to read
• Peripheral visual shadows or movement such as a rotating ceiling fan or the shadows of trees when driving down a country road or even looking at a striped shirt
• Rapid eye movement such as watching sporting event or viewing an action movie on a big screen
• Watching a 3-D movie
  

  Dr. Fortenbacher lectures on See-Sick Syndrome

• Walking down the aisle of a grocery store
• Walking within a crowd of people

The name of this condition that results in easy and frequent motion sickness is the Neuro-Ocular Vestibular Dysfunction (NOVD) or the See-Sick Syndrome (SSS).

To understand how motion sickness is related to visual dysfunction, one must look at the neurology of the brain that deals with providing stability and normalcy to our lives.  The part of the brain that allows us to have a sense of balance and calm even when the visual space world from our eyes plus the movement of our body, influenced by the forces of gravity and objects within our environment is called the Vestibular System. Just as the eyes are the sensory receptors for vision, within the middle ear are the “peripheral sensory receptors” including the semi circular canals (SCC) and the otolyth organs (utricle and saccule) which responds to our body’s vertical, horizontal and rotational movements.

The beauty of the vestibular system goes beyond the sensory receptor within the middle ear. The beauty is the central processing within the variety of other sensory systems within the brain that provides normalcy to our world so that we know up from down, our sense of  where we are in space and which way we are going.  One way to think about it is that the vestibular system is the neural software that helps us to keep us from “getting lost in space”.

Yes the vestibular system is closely integrated with tactile (touch), proprioception (sense of movement), auditory (hearing), kinesthesia (muscle awareness) and vision. Indeed in order for us to have a sense of balance and stability the “neural software” of the vestibular system must effectively integrate with of these sensory  systems and especially the dominant sensory system -VISION!

The problem with visual-vestibular integration typically begins in these patients with an associated binocular (eye teaming), accommodative (eye focussing), oculomotor (visual tracking) and/or visual perceptual problem. The visual condition alone may not be severe enough to result in overt visual symptoms but just enough to provide interference for the patient in their visual-vestibular connection. As a result they become symptomatic with the activities that have a visually stimulating central and peripheral vision component. Examples of reading while riding in a moving car, watching an action movie or especially 3-D movie on a big screen, moving through a big supermarket with attention on details but processing peripherally all the displayed items simultaneously. All are examples of how a fragile visual function coupled with ineffective integration with the ”neural-normalcy software” (vestibular system) results in the classic motion sickness symptoms for the patient even though they are not engaged in anything that would cause a problem to most people.

The good news for patients diagnosed with the See-Sick Syndrome is that there is an effective treatment solution. This usually involves a combination of properly prescribed ophthalmic lenses as well as office-based optometric vision therapy along with some home-oriented activities. The duration of treatment is dependent on a variety of factors but when the patient is consistent with their prescribed doctor supervised treatment plan it routinely takes less than 3 months. The end result is problem solved and the patient can enjoy life without coping strategies; a life long resolution of the condition and no more easy motion sickness!

For more in-depth information click on the icon below and you can download my Powerpoint presentation. Also I would like to give a special thanks to Dr. Michelle Brennan who helped in the development of my lecture.

Dan L. Fortenbacher, O.,D, FCOVD

Developmental Vision and Sensory Integration OT…A Co-Treatment Approach that Works

When it comes to helping children with developmental delays or those who have suffered a traumatic brain injury, one professional that has always impressed me for their empathy and advocacy for their patient is the occupational therapist. The year was  1988 when I was first contacted by an occupational therapist who was at the time the Director of Rehabilitation services for an acute care neuro-rehabiltation hospital in Southwest Michigan.  She was interested in adding neuro-optometric rehabilitative services to complement the existing repertoire of rehabilitative care offered by the facility then known as Visitors Hospital. I accepted her invitation and was brought on staff at the hospital where I provided neuro-optometric diagnostic and rehabilitative services. In addition to having the opportunity to serve a completely different patient population compared to private practice, it was at Visitors Hospital  that I had the special privilege to work side by side the occupational therapists which in turn gave me an inside look at one of the most caring and conscientious groups of professionals that I have ever known. In addition to the rehabilitative OT, I began to learn about and appreciate another special category of OT who works with the sensory development of children known as the Sensory Integration Occupational Therapist. (SI OT)

Now it has been over 25 years, and I have had the pleasure of serving along with SI OTs co-treating scores of patients who have had sensory modulation issues as well as developmental delays in their visual system. This professional relationship of co-treatment has many benefits to the patient because of the complementary function that each discipline brings to the improvements in the patient. 

First it is important to understand that a child with developmental delays will often be lagging behind in their visual system development as well as sensory modulation functions.  For instance, if a child has delays with sensory issues involving vestibular integration they will often have coexisting delays with binocular, accommodative and oculomotor development.  The fact that they have delays in one sensory system often seriously complicates their progress in treatment in another. Therefore,  delays in the patient visual system will interfere with the treatment provided by the sensory integration OT and the sensory integration delays can interfere with the office-based optometric vision therapy provided by the developmental optometrist.

 To gain a better understanding of the role of the sensory integration OT here is an informative video:

An excellent research article entitled, A Randomized Control Pilot Study of the Effectiveness of Occupational Therapy for Children with Sensory Modulation Disorder, shows that SI-OT is effective in treating children with sensory modulation disorders and was published in 2007 in The American Journal of Occupational Therapy.

Other excellent sources of information can be found at the Sensory Processing Disorder website as well as the Sensory Processing Disorder Foundation website.

What warms the heart is to see a parents expression of pride as they react to observing their child making steady progress in treatment. It is especially gratifying to witness that child’s expressions of  confidence as they begin to experience success in their personal goals.  These gains can be attributed to a model of care that produces results…SI-OT sensory integration therapy and office-based doctor supervised optometric vision therapy a co-treatment approach that works!

Dan L. Fortenbacher, O.D., FCOVD

New Scientific Evidence for Amblyopia Treatment…Two Eyes are Better than One!

Those of us who have had the privilege of years in practice, working with children in the optometric specialty of developmental vision, realize that few things surprise parents more than learning that their young child has subnormal vision in one eye.  The observation on a mother’s face when she learns that her happy-go-lucky  5-year-old little boy or girl has a form of reversible blindness known as Amblyopia (lazy eye) can be unsettling. More specifically, there exists a  relatively common form of  lazy eye known as Refractive  Amblyopia which typically has no observable signs or behaviors. It exists even without an eye crossing eye condition (strabismus) that would alert the parent that something is wrong.

 Sometimes a child is first identified by the Pre-Kindergarten School Screening and then referred to the primary care Optometrist. Other times it may be that the parent simply decided to have their child’s eyes tested at the time when their child started to recognize their letters.  What ever the reason for the child finally ending up in the eye doctor’s examination chair, there are simply too many children diagnosed with Amblyopia beyond the age when it could have been prevented if detected in infancy. Even in spite of  the good  intentions of public health initiatives such as AOA’s  InfantSEE Project,  a free infant vision assessment  program offered by participating AOA optometrists designed for early detection and prevention of vision problems in baby’s 1-12 months old, the incidence of Amblyopia is still at about 1:50 children. 

In terms of  Refractive Amblyopia,  a child with this condition will have a serious refractive error in one eye compared to the other. For example, if there exists a significant amount of  farsightedness and astigmatism  in one eye while the other eye has no  significant refractive error, then the large difference in focus exists between the two eyes.  This in turn triggers an active response to suppress (turn off) the blurred visual signal from the eye with the large refractive error which in turn arrests the natural visual development that is needed  in the baby’s visual brain.

Therefore the cause of the subnormal vision (amblyopia) is due to a baby’s brain shutting off the distorted signal from the “out of focus eye” which leads to the inhibition of neural development in the infant’s visual brain. Plain and simple the child grows up and remains unable to see…even when diagnosed and the proper corrective lenses prescribed.  Thus,  Amblyopia, one of the most common forms of reversible blindness in children, is caused by a problem in binocular vision that happens during infant/toddler development.

Now when this occurs, not only is the mother surprised to hear that her child has a diagnosis of  Amblyopia, she is even more surprised when she hears the prescribed treatment; that is when the treatment begins with a regimen of daily patching (occlusion therapy) of the child’s good eye.  The latest attempts to make the process of occlusion therapy more palatable involve things like cute looking decorator eye patches. Another approach is to reduce the patching time to only a few hours a day. And another creative approach to “patch without a patch” is with doctor prescribed Atropine eye drops instilled into the “good eye” thus cause blurring of  the “good eye”  and inducing a temporary form of pharmaceutical patching. Yes even though these are more creative approaches, the thought of having to put a child through the distress of forcing them see with a “bad eye” can be very stressful  indeed for both the child and the parent.

After all, occlusion therapy is stressful to the child because, as far as the child is concerned, when they came in to the eye doctor they could see fine. They were a happy-go-lucky normal child. But when they leave the eye doctor, they find themselves  forced to deal with the world, “one-eyed”  and with  blurry vision.  This is also very stressful to the parents because they must now do their best, for the sake of their child’s visual welfare, use their powers of parental influence to coherse their previously happy-go-lucky child to comply with a regimen of treatment that makes them face the world,  ”one-eyed” and with blurry vision. And yes, while Occlusion Therapy is evidence based treatment and the standard used by many eye doctors  for patients with Amblyopia for nearly 100 years,  universally kids hate the treatment and compliance becomes a family battle.

However, now there is good news!  We are beginning to see the emergence of a new body of  research in visual science that sheds light on an improved way to treat Amblyopia…and it does not rely completely on occlusion therapy. Just like modern science has found new and better methods to treat cataracts, modern science is now helping doctors to understand that it is better to treat the amblyopic patient with binocular vision therapy in conjunction with a more limited amount of occlusion (patching) therapy.

 The new scientific evidence is showing for treatment of Amblyopia,  two eyes are better than one !

What this means for patient care is that a child who is diagnosed with Amblyopia can still function as a normal “happy-go-lucky” child even with treatment. The new best practice treatment, that involves office-based doctor supervised optometric binocular vision therapy, will not only help the child “see”, thus curing the amblyopia, but it gives the child the opportunity to develop normal 3-D vision (depth perception), eye hand coordination and many other visual skills. This leads to a more productive and happy life for the child.

So now, when a parent is faced with the realization that their child has subnormal vision in one eye due to Amblyopia, thanks to the new research and improved treatment options including binocular vision therapy…there is a happy ending!

To see some of  the research into this exciting area of treatment for patients with Amblyopia check out the following:

Eye-Hand Coordination Skills in Children with and without Amblyopia- Dr. Barry Tannen Reviews in The VisionHelp Blog an important research article published in Investigative Ophthalmology and Visual Science in March 2011.

A list of 105 scientific papers published and accessable in Pub Med.gov, the US National Library of Medicine National Institute of Health, showing the evidence-based research on the topic of binocular vision in the treatment of Amblyopia.

Dan L. Fortenbacher, O.D., FCOVD