New Collaboration Between Optometry & Ophthalmology


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As most of you reading this will know, Optometry and Ophthalmology potentially have much in common when it comes to areas of mutual interest in helping patients.  During my professional career it hasn’t always seemed that way, and Lord knows if you read this blog you’ll find examples where it appears that our two professions are in different boats, oft times rowing in different directions if not on collision courses.

Paul FreemanThat’s why my ears perked up about six months ago when I received a call from our colleague and good friend, Paul Freeman, O.D., former editor of Optometry, the former journal of the American Optometric Association.  Paul had been contacted by Elsevier about a new venture in the ophthalmic field, which would entail putting together weekly updates based on journal publications, together with interviews of experts in various topics in eye and vision care..  That in and of itself wasn’t quite so revolutionary as was the idea of making this a joint Optometry/Ophthalmology venture.  Who would be the Ophthalmology editor?  It turned out to be Myron Yanoff, M.D.

Yanoff_MyronFor those of you who aren’t familiar with Dr. Yanoff, he was chairman of the Department of Ophthalmology of the University of Pennsylvania and director of the Scheie Eye Institute, both in Philadelphia. He has published over 160 scientific articles and authored or co-authored over 30 textbooks in the field of ophthalmology and ocular pathology, including six editions ofOcular Pathology and three editions of the standard medical textbook, Ophthalmology.

Yanoff Book Cover

The opportunity to do something collaboratively with Dr, Yanoff was intriguing, so I asked Paul what the ground rules would be.  The concept was have two teams working in parallel, with the Opthalmology Editor (Dr. Yanoff) and Optometry Editor (Dr. Freeman)  each working closely with an Associate Editor to arrive at a weekly cross section of articles reviewed and recommended to a readership of optometrists and ophthalmologists who would register for this free service.  Elsevier would coordinate and host this service, and we would have weekly conference calls to agree on the articles selected for review and chosen to be featured.  We agreed that were to be no airs, so to speak, and that in order for this to work we would have to respect one another’s interests and areas of expertise.  There have been working models of collaboration between our two groups in recent years, most notably through the CITT and PEDIG studies.  But no joint ventures like this in publishing.

Well I’m pleased to relate that we’ve gotten along swimmingly, and the facilitation and support staff at Elsevier have been wonderful to work with.  The new Eye Care component of the Elsevier Expert PracticeUpdater Service is now ready for you to register.  Both the registration and service are free.

To register, go to www.practiceupdate.com.  After clicking on “Register for free” you’ll get an email verification to complete the process and select your content channel.  While most of you will opt for Eye Care, you can register for any content (current content is Primary Care, Eye Care, Cardiology, Dermatology, Oncology, and Urology) and in the future you will be able to filter content by speciality topic.  You can view our editorial team here.

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My expert opinion on Amblyopia was published today.  Hope to see you online soon!

11 thoughts on “New Collaboration Between Optometry & Ophthalmology

    • Thanks for signing on, Dan. You make an interesting point, though the style is different from something that would be published in a journal. It’s more a chance for various experts to survey the field and comment on trends.

  1. Len, that’s great. A great idea, and sounds like a strong team. I look forward to seeing many more behavioural components to complement the medical.

    Of interest, from one of the articles features with yours ‘ARFs Were Found to Be Much More Prevalent in Preschool Children Than Previously Thought’ (The title in itself seems a long time coming from the medical community.) “For children >49 months of age original criteria should be used: astigmatism >1.5 D, anisometropia>1.5 D, and hyperopia >3.5 D.” These are referral criteria for amblyopia risk factors; much lower than often posted in research. These numbers matter in the classroom. Optometrists should take note when it comes to prescribing.

  2. Sir i signed on and also gone through your expert opinion on Amblyopia, It was very nice and the explanation you gave that Amblyopia is a devlopemental disorder of spatial vision justifies the disorder more clearly so i also like that new defination.Sir as we know that clinicians grades amblyopia depending on visual acuity but as you said visual acuity is not the only factor. so sir is there any guideline which grades the amblyopia according to assesment of other factors?

  3. Multidisciplinary is the way to go with all things brain these days. Hope you will continue with collaborations in other fields. Obviously motor coordination would be one of them. But I wonder about any linkages with audiological disorders such as auditory processing disorder? There are audiological correlates to visual problems such as contrast sensitivity. when you fix one area of sensory processing you can get a bump in other areas.

    Also, I wonder if anyone has ever collaborated with a neuropsychologist and looked at the relationship between visual disorders and higher order executive functioning. For example, integrating optometric theories and therapies regarding visual memory with that of global memory function. Or intelligence. When are performance IQ problems or processing speed problems really just visual efficiency problems and when are they really more global problems? When is a nonverbal learning disorder a global problem and when is it just a visual problem?

    I think it would be very interesting if work was done with Luria’s theories and elhonon goldberg’s gradient theory to see how visual processing is linked to other areas of the brain.

  4. Regarding ABI and TBI, deficits in attention and memory are the most common cognitive dysfunctions i.e. Agnosia, Alexia and Aghasia (Sohlberg, 2001). Treatment with low levels of prism and binasal occlusion re-established spatial organization and saccades and pursuits improved working memory showing that training-induced plasticity in the neural systems affect higher order executive functioning and intelligence in IQ testing. So whether a nonverbal LD is a visual problem or a global problem the O.T. and O.D. is positioned to do V.T., since Area 8, Area 19 and other areas can be assisted with Smooth Pursuit, Saccade, Convergence and other visual perceptual skills of closure, figure-ground, visual memory and as Dr. Press pointed out with a stroke patient, visuospatial attention disorder ( left neglect). (Sohlberg, 2001).
    Training areas of the brain by doing activities that require shifting of eye movements (a parietal activity) is critical in development of attention. In addition Healy, 1999 points out that fine motor and large motor synapses are next door neighbors to neurons that manage mental behaviors. Since the parietal lobe is smaller in for example AD/HD’s, abnormal information processing responsible for emotions and control over impulses and movements can be trained by oculomotor, convergence and accommodation and attention V.T. These activities affect the M pathway Dorsal Stream leading to less mental health issues (my opinion). Of course a supportive parent-child and school-child situation along with less single parent homes can possibly keep a latent tendency into a full blown disorder (Rotenberger, 2007). This is why I stated that executive function including planning, decision making up to and including evil behavior can’t be controlled by passing gun laws and other laws which create bias, one group against the other.
    Visual attention V.T. works in my practice helping kids do better in school even if I just take the time to show them how to hold a pencil correctly without thumb wrap.
    I got in trouble with politics when I opened my mouth but I still believe evil up to and including what we saw in CT might be preventing with V.T.
    August

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