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The 19th European Kraskin Invitational Skeffington Symposium on Vision

9/29/2014

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Susanne Stenbo Sonne

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The 19th European Kraskin Invitational Skeffington Symposium on Vision was held in Denmark the 23rd- 25th of May 2014. The twelve participants (a large turnout for this meeting) were mostly Danes, but also included clinicians from Andorra  and Sweden. This year Steve Gallop, OD was invited to be the keynote speaker. His first paper was titled “Narrow Binasal Occlusion and Instant Gratification” and revealed the use of very narrow binasal occlusion for other kinds of patients than strabismics, including those with a brain injury. He uses the technique to make the patient more comfortable right away before offering visual therapy in some cases. It seems that even very narrow binasal occlusion often produces good results. This  type of occlusion inhibits only a small portion of the visual stimuli, letting binocularity rule in most of the visual field without the patient actually seeing the occlusion. It seems to be enough for many patients just to remove this small area of binocularity to have instant gratification, like going from a major headache and discomfort to calmness and relief in seconds. The technique seems to expand peripheral awareness and reduce visual stress.

Steve Gallop spoke in an easy and understandable language for us foreigners, with lots of humour and not claiming that it was the one and only way. He just presented the technique to be yet another tool in our toolbox for helping our patients in the best possible way.

Other papers given at the E-KISS dealt with mindfulness and VT, the visual pathways and reading, ADHD, the connection between vision and motor and the importance of gross motor activities in VT, measurements, activities and questions to communicate out of office to reveal vision impairment and visual improvement, and discussions about patients kept out of the kind of VT (charged combination of in office and home VT) offered in Denmark.

The day before the E-KISS meeting, Steve Gallop was invited to give several lectures for the participants of the meeting. He talked about the connection between vision, posture, and movement, and he also discussed the difference between compensating and therapeutic lenses. He covered the importance of doing some kind of lens therapy for almost every patient with or without visual therapy. Changing their compensating prescription as soon as possible by really thinking of whether the necessity of cylinder and acuity should be above efficiency and comfort. Furthermore, Steve Gallop presented the way he was offering therapy in his office. The omission of home therapy was a rather new idea for most of the participants, and it left some thoughts for perhaps changing some daily routines ourselves to be able to embrace a larger group of patients, who for the moment have difficulty in fitting into our therapy.

Beside Steve Gallop's enlightening presentations, Steen Aalberg, OD, gave lectures on the importance of optometrists taking care of the binocular problems in the population. In Denmark about 70-80% of VT is performed by physiotherapists or occupational therapists, only thinking about vision in one eye and sometimes doing more harm than good – building up more compensations than doing rehabilitation.


Ramon Porqueres 

In the era of technology in which technology is annihilating the clinical sense of the clinicians, clinicians submit their clinical thinking to the machines without questioning the results. Dr Steve Gallop brought a new fresh air. He will not be the doctor that get finger arthritis because of pushing the button of refractometer. He sees the patient was a hyperope but an entire human. He understands the importance of posture and movement in the development of the child's vision. Dr Steve taught how to arrange conditions in order to make the organism move in the right direction, making a more balance use of vision. He gave three presentations at the meeting. The presentation on prescribing astigmatism was full of consideration about space perception and distortion. We got tremendous insights and a vaccination against pushing the button of the automatic refractometer and prescribe the result. In his third presentation we got details and considerations about binasal occlusion.  A part from his presentations, his comments where very enlightening and very good food for thought. We would like have him again in this wonderful room with natural light viewing the seaside.

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Chronic visual dysfunction after blast-induced mild traumatic brain injury

9/8/2014

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M. Teresa Magone Ellen Kwon, Soo Y. Shin                                                          
Journal of Rehabilitation Research and Development 
2014: 51; 71 80           
                                                       
http://www.ncbi.nlm.nih.gov/pubmed/24805895

Reviewed by: Tina Esposito, OD
Midwestern University Arizona College of Optometry

Traumatic Brain Injuries (TBI) are defined as an “alteration in brain function, or other evidence of brain pathology, caused by an external force”. The Department of Defense reports that over 250,000 service members have been diagnosed with traumatic brain injury since the conflicts in Afghanistan and Iraq. That equates to roughly 542 cases of newly diagnosed TBI per month over the last 5 years. Some of the most common symptoms reported by patients are blurred vision, diplopia, headaches, dizziness, poor concentration, an inability to sustain visual attention, photophobia, movement of print, and difficulty when reading. Some of the more common findings with TBI patients are convergence insufficiency and eye movement disorders. This purpose of this retrospective study was to investigate the long-term visual dysfunction in patients after blast-induced mild traumatic brain injury (mbTBI).

Out of the 192 patients with the diagnosis of TBI that presented to the VA for an evaluation, 31 were identified with mbTBI without eye injuries. The inclusion criteria included all servicemen diagnosed with mbTBI longer than 12 months prior to the eye examination and no history of eye injury. The date of the injury, mechanism of injury (mounted vs. dismounted, LOC), age of injury, time since injury, medications, visual symptoms, visual acuity, employment status, and documented eye examination results were all reviewed and analyzed.

After reviewing the data, 94% of patients were male and the mean age at the time of the injury was 30.5 +/-8.3 yrs. Fifty-eight percent occurred while they were dismounted and 42% were inside a vehicle during the injury. The mean interval between the mbTBI and the eye examination was 50.5 +/- 19.9 months. Medications were taken by 14 of the patients in the study. It was noted that patients who did not take any medications had fewer visual symptoms than patients who were on medications; however, this was not found to be statistically significant. Overall, 68% of patients had visual complaints. The most common symptoms were photophobia (55%) and difficulty with reading (32%). Of all patients, 25% were diagnosed with convergence insufficiency and 23% had accommodative insufficiency. Patients with more than one mbTBI had a higher rate of visual complaints (87.5%).

In summary, chronic visual dysfunction and symptoms are present in veteran’s even years after a mild blast traumatic brain injury despite having 20/20 distance visual acuity. It is believed that it takes roughly 5-6 years for the symptoms to improve following an injury. Assessment of symptoms and binocular vision testing should be done routinely during eye examinations to recognize visual problems in this population. 

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How Badges and Points Will Make Connecting at ICBO 2014 More Fun Than Ever Before

9/3/2014

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By now you’ve probably heard that ICBO 2014 has gone mobile with our ICBO Social conference app sponsored by HOYA (http://www.hoyavision.com/) - download here (please embed this link over ‘download here’ text http://ddut.ch/icbosocial).

We’ve added a number of game elements to ICBO Social that promise to make connecting and participating at the conference more fun than ever before. One way we’re doing so is by rewarding you with badges and points for the things you do in the app.

How? It’s simple. For all the things you do in the app, you can earn unique in-app badges or points (which go towards the leaderboard, discussed below).

And did we mention badges and points will be tied to real prizes at the event?

Here’s how it works:

Badges

Every time you earn points or badges you’ll get notified in the app. And you can see what badges you and your friends have earned via attendee profiles.

Here are all the badge types you can earn:

ICBO Social Exhibitor Badge Game

We’re really excited about these! To earn these badges, each participating booth will have a fun, easy task for you to perform. Instructions will be provided at the booth. For example, you may have to post a photo with a booth staff.  The participating exhibitors include: HOYA, Good-Lite, SHAMIR, CRSurfacing, OEP, and ICBO Social.

To get them all, look for instruction signs at participating booths or stop by the ICBO Social booth for a map.

Other Badges:

In addition, earn badges when you check into certain events - like speaker sessions and other events at the conference. There are numerous such badges you can earn. To make it a bit of a scavenger hunt, we aren’t telling what all of the possible places are that you can earn a badge for checking in. Hint: You may need to check into more than one event to earn certain badges.

Status Updates

You can also earn badges when you post status updates in the app. You’ll get your first badge, the Newbie badge, for your first update and will level up your status when you reach certain benchmarks for the number of status updates you’ve made. If you reach Voyager badge status you’ve been a top contributor!

Photo Badges

Just like status updates, you earn badges for posting photos to the app. You’ll get the Polaroid badge for the first photo you post. But don’t stop there. As you post more photos, you’ll earn more badges when you reach certain benchmarks. Fifteen photos will earn you the Shutterbug badge. Want to become a or a History Maker or even a Director? Share lots of photos and you may just earn these hard to achieve badges!


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Points and the Leaderboard

While just as fun, points are different than badges. You earn points for all sorts of activities in the app like posting photo, status updates, liking and commenting on someone else’s status updates, checking in and more. Different activities in the app will earn you different point amounts. But you don’t earn points for earning badges.

Feeling competitive? The leaderboard in the app (available via the main app menu) displays a real-time list of the top 20 point earners in the app. And as we said above, we’ll be giving away prizes for points earned. More details on prizes to be announced at the conference.

We want you to know that at ICBO, you are part of a welcoming international optometric family that encourages your contribution and participation. We’ve designed the ICBO Social app to facilitate that participation, and we hope, make it a fun and rewarding experience!










Trouble with the app or questions? Email profkushin@gmail.com or stop by the ICBO Social booth in the exhibit hall at the event.


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