Eye Exercises Help Patients Work Out Vision

Problems, Optometrist Says

A young patient undergoes vision therapy at the University Eye

Institute at the University of Houston. (Credit: University of
Houston)
Science Daily (Apr. 9, 2009) — You've probably been there. In a doctor's
office, being advised to do what you dread – exercise. You get that feeling in
your gut, acknowledging that, indeed, you should exercise but probably
won't. Now imagine that the doctor is your optometrist.
Don't clean your glasses. You read that right. Eye exercises are used to treat
a variety of vision disorders, according to Dr. Janice Wensveen, clinical
associate professor at the University of Houston's College of Optometry.
Patient reactions to this quite common prescription range between surprise
and relief, she said, but doing the therapy can improve their performance at
school and work.
"They're curious, especially when we tell them, instead of putting a Band-Aid
on it like we do with glasses or contact lenses, we're actually going to solve
your problem. You're going to be cured, and that's something we don't very
often do," she said.
The standard at-home prescription is known as "pencil push-up therapy,"
said Wensveen, who practices at the University Eye Institute's Vision Therapy
Clinic in the Family Practice Service.
"Patients visually follow a small letter on a pencil as they moved the pencil
closer to the nose. The goal is to be able to keep the letter clear and single
until it touches your nose."
Not surprisingly, she said, many patients don't follow through once they're
out the door.
"You can imagine that, in the doctor's office, it sounds great, and you can do
it. You think, 'Wow, this can help me?' But you get home, and you do it. You
think, 'This is really dumb.' You do it once, and you never do it again," she
said.
In fact, a study released in the fall by the National Eye Institute (NEI) found
that office-based treatment for patients with a common eye muscle
coordination disorder, along with at-home reinforcement, is more effective
than home-based programs in isolation. The research, reported in the
Archives of Ophthalmology, involved more than 200 young people with a
condition known as convergence insufficiency, which Wensveen said likely
affects between 5 percent and 20 percent of the population, depending on
the definition used and the age group studied.
"As the name implies, it's somebody who can't cross their eyes, and you
might think that's a weird thing to have to be able to do. But, if you just
consider the geometry of looking up close, your two eyes do have to turn in
so that they're both pointing at the thing that you want to see," Wensveen
said.
Left unattended, Wensveen said, convergence insufficiency can affect a
student's performance in school, because reading can become very
frustrating.
"These are the kids who would rather do anything but sit down and do their
work," she said. "And I think that's why kids especially who have
convergence insufficiency are sometimes mislabeled as having attention
deficit hyperactivity disorder, because they just don't want to sit down."
While most eye care professionals treat convergence insufficiency using only
home-based therapy, the NEI results indicated approximately 75 percent of
patients treated both in the office and at home reported fewer and less
severe symptoms related to reading and other close-up work. Symptoms of
convergence insufficiency include loss of place and concentration while
reading, reading slowly, eyestrain, headaches, blurry vision and double
vision.
"Studies would suggest there is a possible relationship between convergence
insufficiency and ADHD, in that about 10 percent of patients with
convergence insufficiency had a history of ADHD at initial presentation or in
follow-up exams," said Dr. Nick Holdeman, executive director of the
University Eye Institute. "While the research does not support a direct
relationship between the two diagnoses, it is recommended that evaluation
of convergence insufficiency should be undertaken in children diagnosed
with ADHD."
Wensveen said the research results underscore that patients, or the parents
of patients, advised to conduct eye exercises should seriously consider in-
office vision therapy to get the results they desire.
"It's like using a physical trainer or a physical therapist. We will work with you
to ensure that you do make progress toward being able to use your eyes
comfortably and efficiently," she said.
Adapted from materials provided by University of Houston, via EurekAlert!, a
service of AAAS.

Vaccine For Ear Infections

Pediatricians Reduce Ear Infections By Vaccinating
Children

September 1, 2007 — Infectious disease experts have completed clinical

trials on a vaccine designed to eliminate chronic ear infections. The
vaccine works on 7 pneumococcal bacterial strains that cause ear
infections. Tests with 177,000 kids show around a 20% reduction in the
number of children who experienced regular problems with ear infections.
Almost every child in America will have an ear infection by the age of two.
It's one of the most common infections in babies and today, a simple shot
may be the answer parents have been waiting for.
Pediatrician Katherine Poehling from Wake Forest University Medical
Center not only treats sick kids, but knows first-hand what it's like to have
a child suffering from an ear infection.
"You go home at night. They are just a little bit fussy, you put them down,
and they are screaming all night," Poehling said.
She sees the benefits of the PCV-7 vaccine every day. It protects against
seven strains of pneumococcal bacteria ... one of the most common
causes of ear infections.
"It's a routine shot in the arm or actually, more commonly in the leg."
Babies receive four doses of the vaccine at age two months, four months,
six months and again at 12 months. "The good news is we did find that
children who are prone to frequent ear infections, which we define as
three or four separate episodes in a year, are having a reduction,"
Poehling explains.
Since the vaccine got the okay by the FDA in 2000, ear infections in
children have decreased nationally by 20-percent.
"While I may not personally see that my children have missed an ear
infection, knowing that, in all likelihood, they had about one fewer ear
infection is a good thing to know," Poehling said.
The PCV-7 vaccine was first used to fight meningitis and serious blood
infections in children. Now it's helping elderly patients avoid these
infections as well.

BACKGROUND: A new vaccine has been developed that can help reduce the
number of infants and toddlers who develop frequent ear infections. It has been
available since 2000, but a new study demonstrates its effectiveness against seven
especially virulent strains of the bacteria that cause such infections.
WHAT THEY FOUND: A team of researchers at Wake Forest University Baptist
Medical Center tracked some 27,000 children in New York, and 150,000 children in
Tennessee from birth to age two -- all born after a vaccine was approved by the FDA
to help protect children from potentially deadly strains of meningitis and other
pneumococcal (a type of bacteria) diseases such as ear infections. The children
received four doses of the vaccine: at two months, four months, six months, and
between 12-15 months. The researchers found that number of children who
developed frequent ear infections declined by 16% in Tennessee and 25% in New
York after receiving the vaccine. They also found declines in the incidence of serious
cases of pneumococcal meningitis on both children and adults. Most children
develop at least one ear infection by their second birthday, and 25 to 30 percent
will experience frequent infections. Of those, one in every 15 to 25 will need to
have ear tubes implanted by age two. Before the vaccine was introduced, about
one-third of ear infections were caused by the pneumococcal bacteria. However,
there are 90 known strains of the bacteria; the vaccine only protects against seven
of them.
ABOUT EAR INFECTIONS: There are three main parts to the human ear: outer,
middle and inner ear. The outer ear is the part you can see and opens into the ear
canal leading to the middle ear. The middle ear is a closed, air-filled chamber,
separated from the outer ear by the ear drum, and ventilated by the Eustachian
tube. Sometimes the pressure in the middle ear becomes higher or lower than that
in the outer ear, causing hearing loss, severe pain, and the accumulation of fluid in
the middle ear. The inner ear contains the hearing nerve that leads to the brain. It
detects sound vibrations and turns them into electrical nerve impulses, which the
brain then interprets as sound. Chronic middle ear fluid is a condition known as
otitis media with effusion (OME).When this condition becomes persistent, and
antibiotics aren't effective, it is often treated with surgical insertion of ear
ventilation tubes. More than 700,000 children undergo this procedure each year.
But the tubes often fall out within four to seven months, and the patients have a
recurrence of the condition.
HOW VACCINES WORK: Whenever a disease-causing micro-organism enters the
body, the immune system mounts a defense, producing proteins to fight off the
foreign substance. Vaccines stimulate the body's immune system by introducing a
weakened form of a particular germ or virus, making the body think it is being
invaded by a foreign organism. If a person who has been vaccinated is exposed
later to the virus, he or she will be protected because the body already has the
necessary antibodies to ward off infection