2nd Annual Conference on Pediatric Cortical Visual Impairment feature four keynote speakers. I was fortunate to be one of them. This is the PowerPoint of my presentation.
This Module will help the learners to understand the best about Low vision in General.This will also help and guide Educators to make up more things regarding Low Vision and its introduction.
This Module will help the learners to understand the best about Low vision in General.This will also help and guide Educators to make up more things regarding Low Vision and its introduction.
It extends from the etiology to the management measures. A little effort to make people understand LOW VISION. Vivek Chaudhary, Christian College BSc Optometry, Bangalore. Frm NEPAL, LAHAN
Low Vision Near Systems-Microscopes,Magnifiers & Electronic systemsHarsh Jain
Different Optical devices used in Low vision patients.
Its very important to take proper assessment and calculations for giving Optical devices like Microscopes,Magnifier etc.
The references are given.
A,B,V's of School Performance: Academics, Behavior and VisionDominick Maino
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.
It extends from the etiology to the management measures. A little effort to make people understand LOW VISION. Vivek Chaudhary, Christian College BSc Optometry, Bangalore. Frm NEPAL, LAHAN
Low Vision Near Systems-Microscopes,Magnifiers & Electronic systemsHarsh Jain
Different Optical devices used in Low vision patients.
Its very important to take proper assessment and calculations for giving Optical devices like Microscopes,Magnifier etc.
The references are given.
A,B,V's of School Performance: Academics, Behavior and VisionDominick Maino
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.
Designing With Visually Impaired People: NetSquared CambridgeNetSquared
Downloaded from http://www.meetup.com/Net2Camb/events/203431952/comments/421549912
People with little or no sight, like most other people with varied abilities, are typically treated as passive recipients of assistive technologies. This month we present an inspiring story from Nikiforos, Warren and Jerry, who have used the process of participatory design to let visually impaired people to take the driving seat and design their own technologies.
Nikiforos will talk about how he got together with Warren Wilson and Jerry Gilbert from Cam Sight to organise and run a hands-on prototyping Bootcamp aimed to inspire visually impaired young people to become active imaginers of how technology can shape their experience of the world.
Both Jerry and Warren will also be there to share their experiences of working with Nikiforos and of living incredible lives with visual impairments.
Come to this event if you want to challenge your assumptions about what people with little or no sight can and cannot do and human ability in general!
About our speakers:
Nikiforos Karamanis enjoys spending time with visually impaired people and learning from them. He volunteers for the RNIB and Cam Sight and is a champion of participatory design for people with little or no sight. Nikiforos recently joined the User Experience team at the European Bioinformatics Institute. Before that he worked as an independent consultant and as the UX Lead of SwiftKey. He has a background in Language Engineering and did research at Cambridge University and Trinity College Dublin on user-centered design and evaluation of novel technologies in a variety of settings.
Twitter @technorasis
Healthy eyes and vision are a critical part of kid's development. Their eyes should be examined regularly, as many vision problems and eye diseases can be detected and treated early.
The eye is a mirror which reflect the health of other systems in the human body.
The human eye, as an organ, can offer critical clues to the diagnosis of various systemic illnesses.
Ocular changes are common in various endocrine disorders such as diabetes mellitus and Graves’ disease.
Awareness of the associations between the ocular manifestations and endocrine disorders is the first step in the diagnosis and management of these complex patients.
What are the Common Eye Problems in Children ShroffEyeMumbai
This is presentation given by Dr Rahul Shroff from Shroff Eye Hospital Mumbai about Growing eye, the common eye problems in children and how to protect your child's eyesight
Pediatric Cortical Visual Impairment: Congenital or acquired brain-based visual impairment with onset in childhood, unexplained by an ocular disorder, and associated with unique visual and behavioral characteristics. (PCVI Society). Presentation made to Illinois College of Optometry NORA and COVD students, faculty and residents.
Low vision rehabilitation in patients with retinal dystrophyAmrit Pokharel
The presentation I have made and uploaded provides you with an in-depth insight into the rehabilitation of patients with retinal dystrophy on the part of LOW VSION. It also details the features the patients present with and specific tests that are launched.
The author does not assume responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.
No copyright infringement, or plagiarism intended.
Amrit Pokharel
Lazy Eye, Eye Turns and Other Functional Vision DisordersDominick Maino
This is a presentation that will be given to the GreenParent Network conference attendees of Chicago's Green Family Festival, April 17 & 18, at the Irish American Heritage Center.
Biology Investigatory Project on Eye Diseases (class 12th) MohitBhuraney
Biology Investigatory peoject on Eye Diseases 2021-22
Email : mohitbhuraney@gmail.com
Mail me if you're unable to download or if you want any changes. I'll handle that.
My students and I wrote several translations of how to conduct an eye examination (mostly my students since my language skills are not very good!). I know there are many ways, and perhaps better ways to ask these questions, but this could be a starting point. Feel free to adapt this to your needs and to make this even better. Please share when you do.
My students and I wrote several translations of how to conduct an eye examination (mostly my students since my language skills are not very good!). I know there are many ways, and perhaps better ways to ask these questions, but this could be a starting point. Feel free to adapt this to your needs and to make this even better. Please share when you do.
Let me know what you think. (dmaino@ico.edu).
Neuroplasticity and Vision Therapy for Adults; A Case SeriesDominick Maino
This poster was presented at the American Optometric Association's Annual meeting in Boston, MA 06/2016
The bottom line:
The visual cortex has the capacity for experience dependent change (neuroplasticity) throughout life. Unfortunately, when it comes to the adult with binocular vision problems, this is not always recognized as being true even though there is strong clinical evidence to suggest a high level of adult neuroplasticity. Current research shows that adults tend to have numerous anomalies associated with the binocular vision system especially within certain populations. This case series demonstrates how those even approaching 70 years of age can benefit from optometric vision therapy.
Current Clinical Case Reorts & Research You Should Incorporate into Your Mode...Dominick Maino
Dominick Maino, OD, MEd, FAAO, FCOVD-A
Moderator
Featuring the Best of AOA's 2016 Poster Presentations
Saturday, July 2nd 8-10AM
Five of the very best, clinically relevant posters were chosen to be given during the American Optometric Association meeting in Boston in 2016. These posters were chosen by the AOA Poster Committee (Dr. Dominick M. Maino, Chair).
PDF Handout: D Maino: Visual Diagnosis and Care of the Patient with Special N...Dominick Maino
This is a copy of my handout of the lecture given in class today. (Copyright 2016). You may download and use this for any non-commercial educational purpose.
Writing the Perfect Poster Abstract in 20 Minutes or LessDominick Maino
One of the easiest ways to begin your publishing career is to present a poster during one of the many annual meetings held by professional optometry. These meetings include but are not limited to the College of Optometrists in Vision Development, American Academy of Optometry and the American Optometric Association. This presentation reviews the step by step process involved in writing an abstract that will be accepted for presentation by these and other organizations most of the time. Once the abstract is written, you are one third of the way to making a significant contribution to the optometric literature. The other two thirds include, creating the poster and writing the final paper to be submitted to an appropriate journal for publication (the last two topics will be addressed at other meetings and/or within future VDR articles). You are encouraged to bring information for a case report and/or case series that you wish to use for a poster in the future.
This course presents the latest information concerning cortical visual impairment, its etiology, diagnosis and treatment. Various topics reviewed include cortical vs cerebral visual impairment, ventral/dorsal visual streams, visual acuity, and contrast sensitivity. Also discussed are various retinoscopy techniques, overlapping functional vision disorders, and visual stimulation/therapy for these disorders.
Course Objectives
At the end of this course, the participant will:
Be able to identify cortical vs cerebral visual impairment
Be able to access various vision functions such as visual acuity, contrast sensitivity, oculomotor and accommodative disorders
Be able to treat the diagnosed vision problems with all the tools available to the optometrist (spectacles, low vision devices, vision rehabilitative techniques)
Be aware of and use outside resources to supplement and add to any therapeutic interventions recommended
AOA "There's More to 3D than Meets the Eye"Dominick Maino
The American Optometric Association did an awesome job in making a potentially hard to understand topic...easier to understand. If you have problems with viewing 3D, please review this PowerPoint presentation.
060915 current research that you should incorporate into yourDominick Maino
Current Research that You Should Incorporate into Your Mode of Practice Now!
Dominick Maino, OD, MEd, FAAO, FCOVD‐A
Moderator
Featuring the Best of AOA's 2015 Poster Presentations
Jun‐27‐2015 8:00AM ‐ 10:00AM
Optic Nerve Head Drusen: A Myriad of Presentations
Jennifer L. Jones, Sylvia E. Sparrow, Christina Grosshans
Validation Study of New LCD‐Based Contrast Sensitivity Testing Method
Sarah Henderson, Jeung H Kim, Paul Harris
Bilateral Cystoid Macular Edema in Retinitis Pigmentosa and its Management
Lindsay T. Gibney
An ODE to Optic Disc Edema
Kelli Theisen
Is Binocular Balancing with Subjective Refraction a thing of the Past?
David Geffen
Optometry's Meeting 2015
Seattle, Washington
Maino D. Agenda Driven Research. Vis Dev Rehab 2015; 1(1):7-11.
Read the editorial.....
Conclusion
It is time for all to put aside our agendas,
our biases, our preconceived notions. It is time
to work together to determine best practices
even if it is contrary to prevailing opinion. The
world is not flat. Amblyopia can be treated at
any age. And optometric vision therapy is an
appropriate treatment modality for disorders of
he binocular vision system.
Dr. Dominick Maino Quoted in AOAFocus Article: Wearable WonderDominick Maino
".....Dominick M Maino, O.D., M.Ed., FAAO, FCOVD-A, professor of pediatrics and binocular vision at the Illinois College of Optometry and private practitioner at Lyons Family Eye Care in Chicago, imagines a world in which people with dementia wear unobtrusive GPS devices that allow family members to easily track them if they leave the safety of their homes. Or, he imagines Google Contacts, which are being designed to monitor blood glucose levels, working seamlessly with insulin pumps, so one's blood sugar never veers out of healthy range. The possibilities are endless. Already, engineers are developing bracelets for the hearing impaired that can translate hand movements into words. For optometrists such as Dr. Maino, who see a great number of patients with disabilities, such technology could be quite useful.
"In the not-too-distant future—probably in my lifetime—both in terms of prevention and monitoring of health, we will probably all be wearing one or more devices that talk to each other," Dr. Maino says. "But right now, much of this is in the development stage or just vaporware."...."
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
2. Dominick M. Maino, OD, MEd, FAAO, FCOVD-A
Professor of Pediatrics/Binocular Vision
Illinois Eye Institute/Illinois College of Optometry
Lyons Family Eye Care
Chicago, Il
dmaino@ico.edu
ICO.edu
LyonsFamilyEyeCare.com
MainosMemos.com
3. Presenter Disclosures
Consultant/ Expert Witness/Legal Consultant-Gilbert & Tobin, Sydney, Australia
American Optometric Association Spokes Person, Lecturer
Speakers bureaus American Academy of Optometry, Lecturer
College of Optometrists in Vision Development, Lecturer
Pacific University College of Optometry, Lecturer
Research funding “No Disclosures.”
Stock “No Disclosures.”
ownership/Corporate
boards-employment
Off-label uses “No Disclosures.”
Editor/Author Visual Diagnosis and Care of the Patient with Special
Needs, Lippincott, 2012; American Optometric Association News
4. Vision Function and Functional Vision Anomalies in PCV
The American Conference on Pediatric Cortical Visual Impairment
brings together professionals in
optometry, ophthalmology, occupational therapy and visual
educational psychology to increase the understanding of the
definition, diagnosis and management of cortical vision loss in
children.
5. Vision Function and Functional Vision Anomalies in PCV
1. Define pediatric cortical visual impairment (PCVI).
2. Describe the diagnostic criteria utilized in occupational therapy,
teachers of the visually impaired, optometry and ophthalmology.
3. Discuss the management and treatment techniques utilized in
occupational therapy, teachers of the visually impaired, optometry
and ophthalmology.
6. Vision Function and Functional Vision Anomalies in PCV
4. Demonstrate problem-solving strategies when evaluating the new
PCVI patient.
5. Develop a multidisciplinary approach to the newly diagnosed
PCVI patient.
6. Network with professionals in related medical and educational
disciplines who can serve as resources for improved vision care for
PCVI patients.
7. Vision Function and Functional Vision Anomalies in PCV
7. Identify the causes of PCVI.
8. Discuss research topics which further the knowledge base of PCVI.
9. The use of social media and the internet to disseminate
information about PCVI.
8.
9. Vision Function and Functional Vision Anomalies in PCV
An
Introduction
1. Define pediatric cortical visual impairment (PCVI)
Definition confusing, misunderstood and imprecise.
Pediatric Cerebral Visual Impairment (PCVI).
Pediatric Cortical Visual Impairment
Delayed Visual Development
10. Vision Function and Functional Vision Anomalies in PCV
Pediatric Cerebral Visual Impairment (PCVI)
Pediatric Cortical Visual Impairment
North America: Cortical Visual Impairment
Elsewhere: Cerebral Visual Impairment
Cerebral visual impairment: inclusive term
Ocular visual impairment: Refractive state, Optics, Eye health
Cerebral visual impairment: Neuro-pathway problems,
cortical problems, oculomotor dysfunction, vision information
processing (dorsal and ventral streaming processing mechanisms)
For more in depth information please see: Maino D. Pediatric Cerebral Visual Impairment. Optom Vis Dev 2012:43(3):115-120 (available
from http://www.slideshare.net/DMAINO/maino-cortical-visual-impairment)
11. Diagnosis and Therapeutic Intervention of Vision Function and
Functional Vision Anomalies in PCV
Describe the diagnostic criteria utilized in ……
optometry and ophthalmology.
12. Vision Function and Functional Vision Anomalies in PCV
Diagnostic Approaches & Strategies
1.Case History
2.Visual Acuity
3.Refractive Error
4.Vision Function Assessment
5.Ocular Health
6.Special Tools
13. Vision Function and Functional Vision Anomalies in PCV
Vision Function
Clarity of vision (visual acuity, contrast
sensitivity, refractive error)
Oculomotor ability (pursuits and
saccades; convergence and divergence)
Accommodation (focusing)
Depth perception (3D vision)
14. Vision Function and Functional Vision Anomalies in PCV
Vision Function:Eye health
Biomicroscopy, Tonometry
Dilated Fundus Evaluation
Special diagnostic tools
EOG (electrooculogram)
ERG (electroretinogram)
VER/VEP (visually evoked response
visual evoked potential)
15. Vision Function and Functional Vision Anomalies in PCV
Functional Vision
Functionally induced disability that overlays
pathologically induced disability
Uncorrected refractive error : Amblyopia
Constant Strabismus: Amblyopia
Oculomotor dysfunction, Binocular vision
dysfunction, Accommodative dysfunction:
Attention
16. Vision Function and Functional Vision Anomalies in PCV
Functional vision
Vision information processing (VIP)/
Visual perceptual skills
laterality/directionality
visual motor integration
non-motor perceptual skills
auditory perceptual/processing
17. Vision Function and Functional Vision Anomalies in PCV
History
All the usual questions AND
General/Motor/Visual/Auditory
Development
Daily Living Skills
Skills needed for Learning
18. Vision Function and Functional Vision Anomalies in PCV
Vision Function
Clarity of vision
What is visual acuity?
What is contrast sensitivity?
What is refractive error?
19. Vision Function and Functional Vision Anomalies in PCV
Vision Function: Clarity of vision
What is visual acuity?
The ability to see a certain
size object at a certain
distance . .
20. Vision Function and Functional Vision Anomalies in PCV
Tests
of
Visual
Acuity
21. Vision Function and Functional Vision Anomalies in PCV
Vision Function:
Clarity of vision
What is contrast sensitivity?
22. Vision Function and Functional Vision Anomalies in PCV
Contrast sensitivity measures the ability to
see details at low contrast levels. Visual
information at low contrast levels is
particularly important:
1. in communication, since the faint
shadows on our faces carry the visual
information related to facial
expressions.
23. Vision Function and Functional Vision Anomalies in PCV
2. in orientation and mobility, where
we need to see such critical low-contrast
forms as the curb, faint shadows, and
stairs when walking down. In traffic, the
demanding situations are at low
contrast levels, for example, seeing in
dusk, rain, fog, snow fall, and at night.
24. Vision Function and Functional Vision Anomalies in PCV
3. in every day tasks, where there
are numerous visual tasks at low
contrast, like cutting an onion on a
light colored surface, pouring coffee
into a dark mug, checking the
quality of ironing, etc.
25. Vision Function and Functional Vision Anomalies in PCV
4. in near vision tasks like reading
and writing, if the information is at
low contrast, as in poor quality copies
or in a fancy, barely readable
invitation, etc.
from http://www.lea-
test.fi/en/vistests/instruct/contrast/csensiti/csensiti.html
26. Vision Function and Functional Vision Anomalies in PCV
Regular Low
Contrast Contrast
27. Vision Function and Functional Vision Anomalies in PCV
Regular Contrast Low Contrast
30. Vision Function and Functional Vision Anomalies in PCV
Refractive Error
Myopia (Nearsightedness)
Hyperopia (Farsightedness)
Astigmatism
31. Vision Function and Functional Vision Anomalies in PCV
Refractive Error
Myopia (Nearsightedness)
32. Vision Function and Functional Vision Anomalies in PCV
Refractive Error: Myopia (Nearsightedness)
33. Vision Function and Functional Vision Anomalies in PCV
Refractive Error: Hyperopia (Farsightedness)
34. Vision Function and Functional Vision Anomalies in PCV
Refractive Error: Astigmatism
35. Vision Function and Functional Vision Anomalies in PCV
Refractive Error: Astigmatism
36. Vision Function and Functional Vision Anomalies in PCV
Refractive Error: Assessment
Objective
Dry Retinoscopy
Cycloplegic Retinoscopy
Mohindra Dynamic Retinoscopy
Auto-refraction
37. Vision Function and Functional Vision Anomalies in PCV
Refractive Error: Assessment
Objective
Dry Retinoscopy
Mohindra Dynamic Retinoscopy
Cycloplegic Retinoscopy
38. Vision Function and Functional Vision Anomalies in PCV
Refractive Error: Assessment
Objective
Mohindra Dynamic Retinoscopy
Dark room
50 cm
Neutralize main meridians
Algebraically add -1.25 to sph
45. Accommodation (focusing)
Monocular Estimate Method (MEM): you neutralize the
reflex while the patient accommodates to a target at
near (usually at 40cm)
With motion: Lag of accommodation --- Add PLUS
Against motion: Lead of accommodation - Add MINUS
Use patient’s correction for distance or near
TRUE measurement of lag/lead if measured
with BVA
Place the target at their working distance
Adults: usually 40 cm Children: use Harmon’s
distance
46. Accommodation (focusing)
MEM
Room illumination should be dim but with
target illuminated
Briefly insert lens into line of sight
Measurements should be made within
1 second per lens used to minimize the
dazzle of light and the effect of lens on
accommodation system
The lens that creates neutrality is the value
47. Accommodation (focusing)
Nott Method: clinician moves toward and
away from the patient until neutrality is
seen (Dioptric difference between neutral and your
beginning distance is the lead/lag)
Against motion: move closer to the
patient
With motion: move further away
from patient
48. Accommodation (focusing)
Book Retinoscopy
Technique developed at the Gesell Institute
by Gerry Getman, OD working with Arnold
Gesell, MD.
49. Accommodation (focusing)
Book
1. Free and Easy reading level, reflex varied
from neutral to with motion with
bright, sharp edges and had a pinkish color.
2. Instructional reading level (maintaining
the reading task with comprehension in spite
of being stressed) the reflex was a varying
fast against motion while the color was
bright, sharp, and very pink.
50. Accommodation (focusing)
Book
3. Frustration reading level (reading with
minimal comprehension) the reflex showed a
slow against motion with a dull brick red
color.
51. Accommodation (focusing)
Bell Retinoscopy
A small shiny bell dangling from a string is used
as a fixation target (now use a silver ball on the
top of a stick). The ball is moved closer to and
farther from the patient along this midline.
The retinoscope is positioned slightly above
this line at a fixed distance of 50 cm. (20
inches) from the patient. Watch what happens
to the reflex as you move the ball.
62. Functional Vision Anomalies in PCV
Amblyopia, Strabismus, Oculomotility Disorder, Accommodative
Disorders, Binocular Vision Disorders
Down Syndrome Review (see Woodhouse M. Maino D. Down
Syndrome. In Taub M, Bartuccio M, Maino D. (Eds) Visual Diagnosis
and Care of the Patient with Special Needs; Lippincott Williams &
Wilkins. New York, NY;2012:31-40.)
Cerebral Palsy Review (see Taub MB, Reddell AS. Cerebral Palsy. In
Taub M, Bartuccio M, Maino D. (Eds) Visual Diagnosis and Care of
the Patient with Special Needs; Lippincott Williams & Wilkins. New
York, NY;2012:21-30.)
63. Treatment of Functional Vision Anomalies in PCV
Treatment begins with the basics
Vision function
Refractive error & quality of life
Spectacles therapeutic
Eye health
64. Treatment of Functional Vision Anomalies in PCV
Treatment with spectacles
multi-focal prescription/bifocal
prism
occlusion
task specific glasses
high “+” adds (magnification)
Low Vision Aids
65. Treatment of Functional Vision Anomalies in PCV
Treatment with spectacles
“The medicine in my
glasses has run out!”
66. Treatment of Functional Vision Anomalies in PCV
Vision Therapy/Vision Rehabilitation/
Vision Stimulation
Use Principles of Neuroplasticity
Use it or lose it
Use it and improve it
Specificity
Repetition matters
Intensity matters
67. Treatment of Functional Vision Anomalies in PCV
Vision Therapy/Vision Rehabilitation/
Vision Stimulation Maino D, Donati R, Pange Y, Viola
S, Barry S. Neuroplasticity. In Taub
M, Bartuccio M, Maino DM. (eds)
Use Principles of Visual Diagnosis and Care of the
Patient with Special Needs.
Neuroplasticity Lippincott 2012.
Time matters Kleim JA, Jones TA. Principles of
experience-dependent neural
Salience matters plascitity: implications for
rehabilitation after brain damage. J
Age matters Speech Lang Hear Res. 2008;51;S225-
39.
Transference
Interference
68. Treatment of Functional Vision Anomalies in PCV
Vision Therapy/Vision Rehabilitation/
Vision Stimulation
Use Principles of Neuroplasticity
Oculomotor/hand-eye, Biocular, Binocular
Integration/Stabilization, Visual stimulation,
Vision information
processing, Vestibular/Vision Computer
applications
70. Treatment of Functional Vision Anomalies in PCV
How To Modify your Home for Visual Stimulation
Rationale-
Environment- directly impacts visual development and
brain cells
Lighting- to increase stimulation of brain cells
Open drapes- position child’s back to windows/doors
Use In-direct lighting – floor or desks lamps are best and
reduce glare (direct light may damage retinal tissues);
compact fluorescent bulbs -16 or 22 Watt with warm color
71. Treatment of Functional Vision Anomalies in PCV
Increase contrast-
Use electrical colored tape, stickers, decals to add to
objects(bottles, cups) walls, cribs
Use plain colored sheets, poster board to hang on
walls/corners to then attach objects, fabrics to make
playspaces or rooms around the home more stimulating
Use patterned fabrics, carpet squares, cellophane, clear
plastic- to add to walls, windows, play spaces
Make a “stained glass” window or mobile- use
cellophanes, CD’s, mylar wrapping papers
Use carpet squares on floor to mark areas; paint/tape on
floor moldings or door jams
72. Treatment of Functional Vision Anomalies in PCV
Suggested Materials and Activities to try-
Mobiles- suspend colorful Mylar, CD’s, strings- provides movement
and shiny objects
Screen savers- computer backgrounds are very stimulating and can
become a cause and effect activity
Household items- use soup cans, quacker oats
containers, spoons, metal bowls, colorful cups
Adhesives- wall decals, stickers; add to lower places on walls
**Be aware of what you wear or what other sounds are in the environment; competing
stimuli make it harder to visually attend and focus
Barbara Halton-Bailey, Education Coordinator Virginia Dept. f/t Blind
73. Treatment of Functional Vision Anomalies in PCV
Show, Tell & Reach-
Develops understanding of objects and immediate
world through hands on experience
Helps understand daily routines
Develops better visual and/or motor responses
Builds sound localization
Increases active involvement
Lays the groundwork for crawling and walking
74. Treatment of Functional Vision Anomalies in PCV
Show, Tell & Reach-
How to do-
Slow down the pace during activities
Routinely take 5 minutes or so; tell what object is and what is
happening, allow extra time for baby to “study” with hands, ears,
eyes and body
Provide assistance with reaching
Babies may need to hold and “get to know” it by touching it before
understanding and reaching for it away from the body
Gradually put familiar toys a few inches away (after initially touching)
and make a sound for baby to reach for the object
Barbara Halton-Bailey, Education Coordinator Virginia Dept. f/t Blind
75. Treatment of Functional Vision Anomalies in PCV
Defined Spaces or Play spaces-
Provides incentive for movement, exploration, and independent
interaction
A life-long organizational strategy to enhance efficiency of
movement, independence and self-esteem-the use of defined spaces
expands and grows with the child
Use walls and furniture as reference points in each room of the
house
First place toys touching body as baby plays on tummy, back, side or
seated on the play space.
Move objects further away and make sounds with the object for
baby to reach for
76. Treatment of Functional Vision Anomalies in PCV
Defined Spaces or Play spaces-
Keep objects predictable and highly meaningful to the child in each
area
Be sure objects are easily accessible with the child’s current abilities
Return child to the play space frequently showing where 2 or 3 toys
are, throughout the day and allow the child to play independently
Examples:
Floor space- pallet with a border on 2-3 sides created by
walls, furniture
Pull-up space- arranged beside sofa, chairs, shelves, tables
Crib- use only if child enjoys waking periods in the crib
77. Treatment of Functional Vision Anomalies in PCV
Defined Spaces or Play spaces-
Sittin’ Center- adapted seating with toys secured within reach
beside, in front, and above
Eatin’ place- High chair, tray table-arrange cup and bowl
Kitchen space- special cabinet designated and marked, containing
child-safe pots. Lids containers, spoons
Outer space- area in backyard defined by play
equipment, furniture, garden fencing, wind chimes. Have predictable
storage of outdoor toys, wheeled vehicles, push carts, radio or music
used as a sound source to return to the door.
Barbara Halton-Bailey, TVI, NBCT
Education Coordinator, DBVI
78. Treatment of Functional Vision Anomalies in PCV
I love … the use of shiny emergency blankets. They are like
large sheets of reflective Mylar material that kids love to
wrap themselves in and look at the reflection of the light
off of the wrinkles created in the sheets. ….reflective
Christmas gift bags, water bottles filled with glitter, snap
and light up neon bracelets or necklaces, pompoms, shiny
reflective beaded necklaces, feather boas and the list goes
on and on. Sometimes just using neon coloured duct tape
over a baby bottle or favorite toy works wonders.
Jody Whelan, Specialist, Early Intervention Early Childhood Vision
Consultant Northeast Blind Low Vision Early Intervention Program
80. Medications and Alternative Therapies
Medications: Prescribed many more
medications
Higher affinity for adverse effects due to
systemic/environmental factors
Seldom complain of symptoms related
to their disability, systemic anomalies,
or medication side effects
81. Medications and Alternative Therapies
Alternative and complementary
medical therapies
Traditional allopathic approaches
Mental illnesses in children
Pediatric Bipolar disorder
Pediatric depression
82. Medications and Alternative Therapies
Major environmental hazard:
People do not know how to
respond, make assumptions
true for lay
individuals, teachers, health care
professionals
83. Other Topics
4. Demonstrate problem-solving strategies
when evaluating the new PCVI patient
5. Develop a multidisciplinary approach to
the newly diagnosed PCVI patient
6. Network with professionals in related
medical and educational disciplines who can
serve as resources for improved vision care
for PCVI patients
84. Case Reviews
Case Guided Workshop: The role of the Optometrist in the
Management of the PCVI Patient
Acknowledgements:
Dr. Tracy Matchinski: The Chicago Lighthouse for People who are
Blind or Visually Impaired
Dr. Mary Flynn-Roberts: Illinois Eye Institute/Illinois College of
Optometry Electrodiagnostic Service
85. Case Reviews
Case #1
Hx: 2 year 4 mo old, ischemic changes in the cortex
with both white and deep grey matter diffuse
abnormalities, CP spastic quad, DD, seizures since
birth (infantile spasms)
Dx: CVI, Delayed visual maturation, exotropia.
Placental umbilical cord problems, lower heart rate,
meconium aspiration, profound hearing loss
bilateral cochlear implants, encephalopathy
86. Case Reviews
Case #1
Medications: Multiple medications
Participates in vision therapy, developmental tx,
speech/OT/PT, PT pool,
VA 20/300 PL Teller Cards, 38 cm test dist. OU
Horizontal tracking fine, vertical much more
difficult
Binocularity inadequate most of the time, IAXT 30-
35PD
87. Case Reviews
Case #1
VF using toys/OKN drum. Responded well in
all visual fields.
Contrast sensitivity at 10% level, moderately
reduced for his age
Refraction hyperopia/astigmatism.
Tolerates glasses well. No change from last
prescription.
88. Case Reviews
Case #1
OD +2.50-2.00X005 OS +2.50-2.50X177
Old Rx Mohindra Ret +3.75-2.50X180 OD
+3.50-2,50X180
Near VA good, accommodation/interested in
near objects appears to function well.
Health of eyes: normal
size, shape, clarity, structure, pupils. DFE
previously done
89. Case Reviews
Case #1
Recommendations
High degree of vision function.
Continue to work with
developmental therapist. Visual
search, scan, tracking vertically and
hand-eye coordination therapy
90. Case Reviews
Case #2
Hx: 2 y 5 mo female, picks up toys more,
increased facial expressions, still using g-tube.
No change in mobility, feeding improving. Eye
health unremarkable
XT onset after head trauma, all milestones
delayed shaken baby syndrome, retinal signs
resolved, seizures, Prevacid, Topamax,
91. Case Reviews
Case #2
phenobarbital, ROS unremarkable except for
what is noted above. Strong tracking all
quadrants, + convergence, +OKN, pupil acc
response, Teller 20/200 50cm, Cardif 20/253
at 20 cm, IET, IXT, nystagmus, cyclo +.50-
4.00X170 OD +.50-4.00X010 OS
Dx CVI, strabismus, nystagmus
OT/PT/speech/developmental tx
92. Case Reviews
Case #3
11 yr 6 m F. vision problems noted at 8mos of
age, optic nerve hypoplasia, nystagmus
VEP all results delayed. Peak poorly formed
but consistent with optic nerve
hypoplasia, nystagmus
intermittent, gtube, seizures, poor
handeye, Mobility rolls over
93. Case Reviews
Case #3
OD +.75-3.00X170 OS +1.00-4.00X010 cyclo
OKN/Teller UTT, can separate head from eye
movement, IAXT 10 with 5 R hyper, VF
UTT, contrast sensitivity UTT, ref +.50-
3.25X180 OD, +.75-3.75X015 OS, pupils OD
2mm OS 3mm RRL, ocular allergies
Pataday Rx’d
Light stimulus therapy
94. Case Reviews
Case #4
2 y/o HM, genetic mutation L1CAM that lead
to hydrocephalus and developmental delays,
had VP shunt, in early intervention program,
no self feeding, hearing ok, Lissencephaly,
ROS unremarkable, born c-section because of
large head, APGAR 9 and 9, no meds
95. Case Reviews
Case #4
Teller 20/180, Cardif 20/80, +tracking,
+OKN, + eyehand, FROM, Ta 26, 26 lids
held, +2.25 OD/OS IRET 10PD, PERRL –
apd
Dx: CVI, IAET, Hordeolum, hyperopia, eye
health unremarkable
96. 8. Discuss research topics which
further the knowledge base of
PCVI.
Little research on pure PCVI
97. Rehabilitation of cortical visual impairment in children. Denise E Malkowicz,
Ginette Myers, Gerry Leisman in The International journal of neuroscience
(2006)
….Criteria were set to extract a fairly homogeneous group of
21 children with CVI due to perinatal HIE or postnatal anoxia
who had extensive gray and white matter injury and multiple
neurological deficits; 20 of 21 (95%) had symptomatic
epilepsy as well. Subjects entered the study with responses
ranging from just a pupillary light reflex to rudimentary
perception of outline. Each subject underwent an at-home
treatment program. Twenty of 21 children (95%) manifested
significant improvement after 4 to 13 months on the
program. Results indicate that even in this challenging
group, there may be considerable neuroplasticity in visual
systems leading to reintegration and visual recovery.
98. Optom Vis Sci. 2005 Sep;82(9):807-16. Retrospective analysis of refractive errors
in children with vision impairment. Du JW, Schmid KL, Bevan JD, Frater KM,
Ollett R, Hein B.
….We found that cortical or cerebral vision impairment (CVI) was the most
common condition causing vision impairment, accounting for 27.6% of cases.
This was followed by albinism (10.6%), retinopathy of prematurity (ROP; 7.0%),
optic atrophy (6.2%), and optic nerve hypoplasia (5.3%). Vision impairment was
associated with ametropia; fewer than 25% of the children had refractive errors
< or = +/-1 D. The refractive error frequency plots (for 0 to 2-, 6 to 8-, and 12 to
14-year age bands) had a Gaussian distribution indicating that the
emmetropization process was abnormal. The mean spherical equivalent
refractive error of the children (n = 813) was +0.78 +/- 6.00 D with 0.94 +/- 1.24
D of astigmatism and 0.92 +/- 2.15 D of anisometropia. Most conditions causing
vision impairment such as albinism were associated with low amounts of
hyperopia. Moderate myopia was observed in children with ROP.
The relative frequency of ocular conditions causing vision impairment in
children has changed since the 1970s. Children with vision impairment often
have an associated ametropia suggesting that the
emmetropization system is also impaired.
99. 9. The use of social media and
the internet to disseminate
information about PCVI.
Websites for information
101. Social Media
Pinterest
http://pinterest.com/pediastaff/visual-
impairment/
Facebook
Present Blindness American
https://www.facebook.com/preventblindness?fre
f=ts
Thinking Outside the Lightbox
https://www.facebook.com/Thinkingoutsidetheligh
tbox?ref=ts&fref=ts
102. Social Media
Blogs
http://adayinourshoes.com/tag/cortical-visual-
impairment/
103. Resources:
Dutton GN, Bax M (eds). Visual Impairment in Children due to Damage to the
Brain. Clinics in Developmental Medcine No. 186. Mac Keith Press, London, UK.
2010
Taub M, Bartuccio M, Maino D. (Eds) Visual Diagnosis and Care of the Patient
with Special Needs; Lippincott Williams & Wilkins. New York, NY. 2012
Lantzy C. Cortical Visual Impairment: An Approach to Assessment and
Intervention. AFB Press, NY, NY. 2007
Hyvarinen L, Jacob N. What and How does this Child See? Vistest, Ltd.
Helsinki, Finland. 2011
Brown, C. (2004). A guide for teachers and therapists working with my child.
Chapel Hill, NC: Early Intervention Training Center for Infants and Toddlers With
Visual Impairments, FPG Child Development Institute, UNC-CH.
105. Dominick M. Maino, OD, MEd, FAAO, FCOVD-A
Professor of Pediatrics/Binocular Vision
Illinois Eye Institute/Illinois College of Optometry
Lyons Family Eye Care
Chicago, Il
dmaino@ico.edu
ICO.edu
LyonsFamilyEyeCare.com
MainosMemos.com