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.

1. Lazy Eye, Eye Turns and other Functional Vision Disorders By Dominick M. Maino, OD, MEd, FAAO, FCOVD-A

2. Dominick M. Maino, OD, MEd, FAAO, FCOVD-A Professor of Pediatrics/Binocular Vision Illinois Eye Institute/Illinois College of Optometry in Chicago, Il Private Practice Northwest Optometric Associates Harwood Heights, Il

3. The Binocular Vision Dysfunction Pandemic It is estimated that: In 2010, almost 170 million individuals will be wearing glasses.

4. The Binocular Vision Dysfunction Pandemic There will also be up to 9 million amblyopes and 18 million strabismics.

5. The Binocular Vision Dysfunction Pandemic Research suggests that for those18 to 38 years of age up to 56% or 173 million of them will have symptoms associated with a binocular vision dysfunction, 189 million (61%) with focusing problems and 118 million (38%) will show various eye teaming problems

6. Symptoms -Complains of blurred vision-Rubs eyes frequently-Squints - Closes or covers one eye- Occasionally sees double- Rubs eyes frequently- Able to read for only a short time- Poor reading comprehension - Holds things very close- Complains of blurred vision- Poor reading comprehension- Says eyes are tired- Able to read for only a short time- Has headaches when reading

11. Performance problems Poor reading comprehension Difficulty copying from one place to another Loss of place, repetition, and/or omission of words while reading Difficulty changing focus from distance to near and back Poor posture when reading or writing Poor handwriting Can respond orally but can't get the same information down on paper Letter and word reversals Difficulty judging sizes and shapes

12. Avatar 3D Syndrome Functional vision problems even decrease our ability to enjoy being entertained. Did you feel ill after seeing Avatar in 3D? Headaches? Double vision? Blurred vision? Eye strain? Dizziness? Nausea?

13. The Binocular Vision Dysfunction Pandemic Why doesn’t the health care community stridently rise as one to denounce this situation?

14. The Binocular Vision Dysfunction Pandemic In part because as primary eye care professionals we do not ask the right case history questions;

15. The Binocular Vision Dysfunction Pandemic we do not evaluated patients using the right tests;

16. The Binocular Vision Dysfunction Pandemic … we do not make the diagnosis;

17. The Binocular Vision Dysfunction Pandemic … and we do not treat or refer out for treatment these frequently encountered but often ignored disorders.

18. What should you do? Ask your doctor if he tests for these problems, if he treats these problems, and if he is a Fellow in the College of Optometrists in Vision Development or comparable organization.

19. Optometric Vision Therapy is… … a sequence of therapeutic activities individually prescribed and monitored by the optometrist to develop efficient visual skills and vision information processing..

20. Optometric Vision Therapy is… … prescribed after a comprehensive eye examination and any specialized assessments have been performed and has indicated that vision therapy is an appropriate treatment option.

21. Optometric Vision Therapy is… …based on the results of standardized tests, the needs of the patient, and the patient's signs and symptoms....

22. Optometric Vision Therapy … uses lenses, prisms, filters, occluders, eye drops, specialized instruments, and computer programs as an integral part of your optometric vision therapy program....

23. Optometric Vision Therapy’s … … end result should be single, clear, comfortable, pathology free, two-eyed (binocular) vision with excellent vision information processing skills.

24. Research has demonstrated vision therapy is an effective treatment option for … Ocular motility dysfunctions (eye movement disorders) Non-strabismic binocular disorders (inefficient eye teaming) Strabismus (misalignment of the eyes)

25. Research has demonstrated vision therapy can be an effective treatment option for … Amblyopia (lazy eye) Accommodative disorders (focusing problems) Visual information processing disorders, including visual-motor integration and integration with other sensory modalities

26. Vision Problems Ocular motility dysfunctions (eye movement disorders) Pursuits: visual tracking Saccades: looking from one object to another (reading eye movements)

27. Vision Problems Non-strabismic binocular disorders (inefficient eye teaming) Convergence Insufficiency/Excess Divergence Insufficiency/Excess

28. Vision Problems Accommodative disorders (focusing problems) Insufficiency Excess Infacility Instability Paresis

29. Vision Problems Amblyopia (lazy eye) Refractive Amblyopia Anisometropic Isometropic

30. Vision Problems Amblyopia (lazy eye) Constant Strabismus Esotropia (in-ward turn) Exotropia (out-ward) Hypertropia (up/down)

31. Vision Problems Learning Related Vision Problems All those already noted and Visual information processing disorders

32. Who should consider vision therapy? In the past it was mostly prescribed for children. Now, due to the recent research in neuroplasticity, we know it is for individuals of all ages.

33. Who should considervision therapy? Children with school problems, College aged adults, Even seniors….

34. Who should considervision therapy? Those with acquired and traumatic brain injury, autism, and other developmental disorders.

35. How long is a typical optometric vision therapy program? If there are no complicating factors like eye turns, lazy eye, or vision information processing problems. It should take approximately 12-24 therapy visits.

36. How long is a typical optometric vision therapy program? If eye turns, lazy eye, or vision information processing problems exist it can take 6 months to a year.

37. Will I be asked to do homework? Yes. It has been shown that the combination of in-office and out-of-office optometric vision therapy works best.

38. What does a typical OVT program include? Four Phases for BV Problems Monocular Biocular Binocular Integration/Stabilization

39. The next step…. If you or someone you know has any of these problems you should find a doctor who specializes in optometric vision therapy.

40. Finding a Doctor… You can find the doctors you need at: College of Optometrists in Vision Development COVD.org

41. Finding a Doctor… You can find the doctors you need at: American Optometric Association AOA.org

42. Finding a Doctor… You can find the doctors you need at: Optometric Extension Program Foundation OEPF.org

43. Finding a Doctor… You can find the doctors you need at: American Academy of Optometry AAOPT.org

44. Optometric Vision Therapy Information Resources MainosMemos Blog MainosMemos.blogspot.com The latest in vision research in pediatrics, binocular vision and special populations (developmental disabilities, acquired brain injury, etc)

45. Optometric Vision Therapy Information Resources College of Optometrists in Vision Development COVD.org OEPF OEPF.org Susan Barry, PhD Blog psychologytoday.com/blog/bloggers/susan-r-barry-phd

46. Optometric Vision Therapy Information Resources The scientific basis for and efficacy of optometric vision therapy in nonstrabismic accommodative and vergence disorder oepf.org/ReferenceArticles.php

47. Questions? Contact: Dominick M. Maino, OD, MEd, FAAO, FCOVD-A Professor of Pediatrics/Binocular Vision Illinois Eye Institute/Illinois College of Optometry 3241 S. Michigan Ave. Chicago, Il 60616 1-312-949-7280 ICO.edu dmaino@ico.edu Northwest Optometric Associates 4970 N. Harlem Ave Harwood Heights, Il 60706 1-708-867-7838 NW.Optometry.net

48. MEDICAL DISCLAIMER This information and advice published or made available through various venues is not intended to replace the services of an optometric physician, nor does it constitute a doctor-patient relationship. Information in this program is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information in this program for diagnosing or treating a medical or health condition. You should consult an optometric physician in all matters relating to your eyes and vision and particularly in respect to any symptoms that may require diagnosis or medical attention. Any action on your part in response to the information provided in presentation is at the individual’s discretion. Readers should consult their own optometric physicians concerning the information in this presentation. Dr. Dominick Maino, nor any institution and/or organization with which he may be associated makes no representations or warranties with respect to any information offered or provided on or through this presentation regarding treatment, action, or application of medication. Dr. Dominick Maino, and any institution and organization with which he may be associated are not liable for any direct or indirect claim, loss or damage resulting from use of this presentation.