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A,B,V's of School Performance: Academics, Behavior and Vision

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This presentation is geared towards teachers and professional teaching staff, but can also be adapted for parents and others. It reviews the three O's of eye care (Optometry, Ophthalmology, Optician), the optometric examination, learning related vision problems and more.

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A,B,V's of School Performance: Academics, Behavior and Vision

  1. 1. The A, B, V’s of School Performance: Academics, Behavior and Vision Dominick M. Maino, OD, MEd, FAAO, FCOVD-A Professor, Pediatrics/Binocular Vision Illinois Eye Institute/Illinois College of Optometry Michelle O’Brien Vision Therapy Coordinator Lyons Family Eye Care Chicago, Il
  2. 2. The 3 O’s of Vision Care •Optometrist •Ophthalmologist •Optician
  3. 3. Optometrist • 4 Years of College • 4 Years at an accredited College of Optometry • Residency (Optional) • Pass National and State Boards • Practice
  4. 4. Optometrist Dx & Tx • Eye Diseases • Refractive errors • Binocular vision problems • Vision information anomalies
  5. 5. Ophthalmologist • 4 yrs college • 4 yrs medical school • Residency • Boards • Practice • Eye disease & surgery
  6. 6. Optician • Variable education (on the job) • Makes glasses • Assists in eyewear selection • Fits/adjusts glasses
  7. 7. The Optometric Examination • Case History –Medical –Vision –Vocational –Educational –Recreational
  8. 8. The Optometric Examination • Visual Acuity – Snellen – Lea Symbols – Broken Wheel – Teller Acuity Cards – Fix and Follow
  9. 9. The Optometric Examination • Visual Acuity – Snellen – Lea Symbols – Broken Wheel – Teller Acuity Cards – Fix and Follow
  10. 10. The Optometric Examination • Visual Acuity – Snellen – Lea Symbols – Broken Wheel – Teller Acuity Cards – Fix and Follow
  11. 11. The Optometric Examination • Visual Acuity – Snellen – Lea Symbols – Broken Wheel – Teller Acuity Cards – Fix and Follow
  12. 12. The Optometric Examination • Visual Acuity – Snellen – Lea Symbols – Broken Wheel – Teller Acuity Cards – Fix and Follow
  13. 13. The Optometric Examination Muscle Function Tests • Cover test • EOM’s • NPC • Hirschberg • Kappa
  14. 14. The Optometric Examination Refractive Error • Myopia • Hyperopia • Astigmatism • Presbyopia
  15. 15. The Optometric Examination Refractive Error Tests • Subjective refraction (which is better one or two?) • Objective refraction (retinoscopy: static, dynamic, cycloplegic,k autorefraction)
  16. 16. The Optometric Examination Tests of Binocularity • Heterophoria • Fusional vergence • Stereopsis
  17. 17. The Optometric Examination • Stereopsis/3D
  18. 18. The Optometric Examination Tests of Accommodation • Positive Relative Accommodation • Negative Relative Accommodation • Amplitudes • Facility • Lag of Accommodation
  19. 19. The Optometric Examination Eye Health • Eye drops • Biomicroscopy • Tonometry • Binocular indirect ophthalmoscopy • Visual fields
  20. 20. The Optometric Examination • Assessment or Diagnosis • Plan or Treatment • Patient Education
  21. 21. The Optometric Examination Assesses Vision
  22. 22. Pursuits/Saccades • Oculomotor Dysfunction – Looses place while reading – Skips words – Confuses words – Reversals – Must re-read often – Words run together – Slow reader – Avoidance of reading – Uses finger as a guide while reading
  23. 23. Accommodative Excess/Insufficiency • Accommodation – Blur – Headaches – Avoidance of near work – Eyestrain
  24. 24. Convergence/Divergence Insufficiency/Excess • Binocular Vision Dysfunction –Diplopia –Eyestrain –Avoidance of near work
  25. 25. Amblyopia/Stabismus • Amblyopia: reduced vision do to refractive error and/or strabismus • Strabismus: an eye turn in/out/up/down Intermittent, constant, monocular, alternating
  26. 26. Vision Information Processing • Vision perception or Vision development – Laterality & Directionality • Reversals • Up/down/left/ right – Non-motor Visual information Processing • Visual discrimination • Visual memory • Visual spatial relations • Visual form constancy
  27. 27. Vision Information Processing – Non-motor Visual information Processing • Visual sequential memory • Visual figure ground • Visual closure • Motor VIP – Visual motor integration – Eye-hand coordination – Motor speed/precision
  28. 28. Auditory Information Processing • Auditory discrimination • Auditory memory • Auditory visual integration
  29. 29. Other Tests • Dyslexia Determination Test • Slossen Intelligence Test • Peabody Picture Vocabulary Test
  30. 30. Optometric Vision Therapy/Orthoptics • Visual motor integration problems • Oculomotor dysfunction • Focusing problems • Binocular vision problems • Learning Related Vision Problems
  31. 31. Optometric Vision Therapy/Orthoptics The Relationship between Convergence Insufficiency and ADHD “The symptoms of convergence insufficiency (CI) can make it difficult for a student to concentrate on extended reading and overlap with those of ADHD.” “Some of the symptoms of ADHD overlap those of convergence insufficiency (CI). Comparing the Convergence Insufficiency Symptom Survey... with the DSM-IV criteria for ADHD, we noted that 5 of the 9 symptoms of inattention could also be applied for CI (symptoms 1, 2, 4, 6 and 8 as follows).
  32. 32. Optometric Vision Therapy/Orthoptics The Relationship between Convergence Insufficiency and ADHD DSM-IV Criteria for ADHD: 1. Often does not give close attention to details or makes careless mistakes in schoolwork, work or other activities. 2. Often has trouble keeping attention on tasks or play activities ... 4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
  33. 33. Optometric Vision Therapy/Orthoptics The Relationship between Convergence Insufficiency and ADHD ... 6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework). ... 8. Is often easily distracted.” “For the diagnosis [of ADHD], a complete medical, optometric and psycho-educational evaluation should be performed and vision or hearing deficits should be ruled out. Underlying visual or hearing problems may cause the child's academic underperformance and/or lack of concentration.”
  34. 34. Optometric Vision Therapy/Orthoptics The Relationship between Convergence Insufficiency and ADHD “Since the symptoms [of ADHD and convergence insufficiency] can be similar, it is not hard to imagine a diagnostic confusion.” “We observed in our clinic that an unusual number of children with or suspected to have ADHD also had convergence insufficiency.” Medication Issues: “...it is possible that the medications used to treat ADHD are aggravating CI. For some of these drugs, difficulties with accommodation and blurring have been reported.”
  35. 35. Optometric Vision Therapy/Orthoptics The Relationship between Convergence Insufficiency and ADHD “No matter what the true cause or cause and effect relationship, it is unavoidable that the presence of CI may cause (1) misdiagnosis, (2) diagnostic confusion or (3) exacerbation of the symptoms of ADHD.” “In view of these findings, we believe it reasonable that CI be evaluated in patients with or suspected to have ADHD.” CI is a condition that responds well to optometric vision therapy treatment...
  36. 36. Optometric Vision Therapy/Orthoptics These statements were from: The Relationship between Convergence Insufficiency and ADHD Strabismus 2005 Dec;13(4):163-8. David B. Granet, MD FACS FAAO FAAP, Cintia F. Gomi MD, Ricardo Ventura, MD, Andrea Miller-Scholte, CO
  37. 37. Optometric Vision Therapy/Orthoptics Vision Therapy Phases of Therapy Monocular, Biocular, Binocular, Integration/Stabilization
  38. 38. Websites • http://www.MainosMemos.blogspot.com – Latest research in children’s vision • http://www.covd.org/ – College of Optometrists in Vision Development • http://www.ico.edu/ – Illinois College of Optometry • http://www.oep.org/ – Optometric Extension Program
  39. 39. Websites • http://www.opt.indiana.edu/vtlit/vtlit.html – Research articles on vision therapy • http://www.indiana.edu/~v755/Amblyopia/ambss/sld001. htm – University course on lazy eye (amblyopia) • http://www.children-special- needs.org/vision_therapy/what_is_vision_therapy.html – What is vision therapy?
  40. 40. Websites • http://www.aoanet.org/ia-op-vis-ther.html – AOA POSITION STATEMENT ON OPTOMETRIC VISION THERAPY • http://www.optcom2.com/covd/covd7/page 144.html – Article from The Montgomery Journal, Montgomery County, Maryland on Attention Deficit Disorder (ADD) and Dyslexia • http://www.vision3d.com/optical/index.sht ml#stereogram – 3D Pictures
  41. 41. Websites • Online Vision Therapy/iPad Therapy http://www.centerforvisionandlearning.com/in dex.php/resources/apps-and-games.html
  42. 42. Websites • http://www.LyonsFamilyEyeCare.com –Office website • Illinois Eye Institute –http://www.illinoiseyeinstitute.org/
  43. 43. Lyons Family Eye Care Dr. Stephanie Lyons Dr. Kelsey Frederick Dr. Rachel Barker Dr. Dominick Maino Ms. Michelle O’Brien Mr. John Lyons
  44. 44. Lyons Family Eye Care
  45. 45. Websites Not Vision Therapy Related Filament Theatre http://www.filamenttheatre.org/
  46. 46. Questions? Dominick M. Maino, OD, MEd, FAAO, FCOVD-A Lyons Family Eye Care 3250 N. Lincoln Ave Chicago, Il 60657 773-935-2020 Michelle O’Brien Illinois College of Optometry/Illinois Eye Institute 3241 S. Michigan Ave. Chicago, Il. 60616 312-949-7280 dmaino@ico.edu

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