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Our parental instinct naturally wants to find the fastest solution & often the first options for a child who struggles in the classroom are either a tutor or a learning center. However, some learning problems are vision-related, which is a problem in development and not necessarily due to learning capability.

When patients come to us for a vision therapy evaluation, we strive to educate parents how to recognize that when their child has a tantrum, gets easily frustrated, and can’t continue with homework, the child can show he or she is very bright and intelligent in other areas. Therefore, the issue of learning to read might not have anything to do with the child’s intelligence but a visual one.

Vision is such a basic tool that many parents may have already enrolled their child in other programs because they never questioned the child’s ability to see. When learning programs can’t solve the child’s struggles, parents discover vision therapy as an alternative, either from a referral or after online research.

Why aren’t parents brought to vision therapy from the beginning?

There are various reasons why vision therapy may not have been recommended to you initially or perhaps have never heard about it until now.

1. Vision therapy is a unique program that only some optometrists specialize in and offer at their clinics.
2. In vision screenings at school, vision is only tested for seeing at a distance. A child with a problem with another visual skill can go undiagnosed.
3. Since there are children with learning problems, some with vision problems, diagnosing the exact issue becomes more difficult as the child may be juggling more than one condition.
4. The child does not have regular eye exams with an optometrist or local eye doctor.

Fortunately, vision therapy is growing in popularity because of the effectiveness and immediate benefits in children with problems. Previousl children would continue their years at school without ever treating their vision problem. Even today, some adult patients come to us for therapy & discover they had a lingering vision problem holding them back the entire time.

Is there a time that’s too early to treat a vision problem?

When a child is starting to read & pronounce the words in 1st or 2nd grade, if they have a vision problem, their learning will be slower than other children & unfortunately, the issue generally won’t go away on its own. In scenarios like this, a child with a vision problem who reaches 3rd, 4th, or even 5th grade without treating their vision, will end up falling behind the class at a more noticeable rate. A child may lose confidence or face peer pressure unless their situation is handled with care. However, if the vision problem is addressed early, the child can enjoy their early school years with fully developed visual skills and not have to face these challenges at an older age.

Signs of a child with a vision problem may be able to pronounce words & run through sentences, but they will lack comprehension. Children may end up learning to read but never reading to learn. For a person who grew up with normal vision, it’s difficult to comprehend how someone can read through a page & not remember what they read.

Why Vision Therapy Should Be Your 1st Priority

Fortunately, vision therapy is well researched & supported with multitudes of success stories over the years. Plus, a developmental optometrist who specializes in vision therapy has ways to accurately test your child’s various visual skills & identify whether vision therapy is needed. There’s no guesswork involved. This means that your child will achieve normal, functional vision at the end of therapy, and in many cases, they become amazing readers, sports players, and happy to learn.

Lyme disease is a very prevalent concern across the United States and particularly in our neck of the woods. Without prompt attention, the Lyme spirochetes spread throughout the body through the bloodstream, affecting the joints, heart, brain and eyes. Individuals may experience a wide range of symptoms, including headaches, joint pain, muscle pain, back and neck stiffness, facial paralysis, blurred or double vision, and ringing in the ears. Other symptoms can include chest pains, palpitations, tremors, chronic fatigue, numbness, dizziness, burning sensations, mood swings, irritability, sleep disturbances, mental instability, panic attacks, speech difficulties, disorientation, confusion and memory loss.

There are some challenges to the LD diagnosis. Even when LD is suspected, blood tests are inaccurate and miss specific markers for the disease. In addition, LD often comes with co-infections that make diagnosis and treatment trickier. Understanding that LD and its co-infections can have effects throughout the body can make a key difference in getting the right answers to move forward with treatment. Seemingly unrelated symptoms can be pieced together to come up with a better understanding of what is happening in the body.

For example, certain vision conditions accompany LD and co-infections. People are becoming much more aware of vision involvement and its effects. Vision concerns can be as mild as light sensitivity to the serious Bell’s palsy. This palsy, a common nerve-related problem, is a drooping of the muscles on one side of the face; it leaves the person with the inability to blink or close their eye, drying the cornea and endangering sight.

Being aware of the diverse symptoms that accompany LD and its co-infections, including the visual conditions, can help to connect the dots on this disease and get the appropriate treatment needed. Typical treatment is a course of antibiotics. Naturopathic and integrative practitioners recognize that LD and its co-infections must be viewed as part of a larger picture and addressed at the immune-function level. Supporting the immune system and the body’s natural way of fighting infection is an important part of the treatment process as well as addressing the subsequent effects throughout the body. The vision concerns can be addressed and alleviated concurrent to the overall health of the body.

The most common vision symptoms include:

• light sensitivity that requires sunglasses on a cloudy day and prevents night driving;
• flashes, floaters and phantom images with dots, lines or streaks that range in color and are seen out of the corner of the eye;
• cloudy or “foggy” vision where objects go in and out of focus;
• faulty depth perception resulting in poor judgment of space and a feeling of instability;
• double vision where there is a “ghosting” of another image or a print becomes double; and
• reading confusion consisting of difficulty focusing on words, words jumping, and an inability to recall what has been read.

Eye involvement seems to be related to the stage of the disease. In the early stages, many people develop conjunctivitis or pink eye. The eyes are red, uncomfortable and discharge pus. Typically contagious, in this LD-related form, the pink eye is not and usually resolves on its own. Keratitis, an inflammation of the cornea, is also seen in early stages of LD and can cause pain in the eye, light sensitivity, tearing and blurred vision. The eye may appear opacified, or covered with a white haze. Prednisone, a steroid, may be given as eye drops, or by mouth for up to six months.

Later stages result in more serious inflammation of the eye including uveitis (inflammation of the uvea), pars planitis (inflammation of the midsection of the eye) and optic neuritis (inflammation of the optic nerve). Symptoms of eye inflammation include significant photophobia or light sensitivity, flashes and floaters, or lights and spots seen in front of the eyes. More concerning inflammatory symptoms are a loss of color vision and/or vision loss as seen in retinal vasculitis (an inflammation of the blood vessels of the retina) or papillitis (inflammation of the optic nerve).

The main treatment used for uveitis is steroid eye drops, which reduce inflammation. Treatment can take several months as steroids need to be slowly reduced or a rebound effect will occur. Drops that dilate the pupil may also be used to keep the iris from sticking to the lens, which can happen if the iris becomes scarred and can cause permanent vision loss. Steroids are typically given both intravenously and as eye drops and/or intraocular injections to treat the more serious retinal vasculitis and optic nerve neuritis.

In addition to specific, more allopathic methods of treatment for such conditions as keratitis and uveitis, there are natural methods for supporting the health of the eyes and combating some of the more frustrating symptoms of blurred vision, double vision and light sensitivity. Syntonic light therapy, nutritional support and lenses and/or prisms can help treat and alleviate vision symptoms associated with LD.

Consulting with an optometrist or ophthalmologist is important if any concerning visual symptoms are occurring.

More information about doctors who are able to treat the visual conditions accompanying LD with minimal medication can be found at COVD.org, OEPF.org and CollegeofSyntonicOptometry.org.

Randy Schulman, MS, OD, FCOVD, specializes in behavioral optometry and vision therapy, pediatrics, learning disabilities, and preventative and integrative vision care for all ages. EyeCare Associates has locations in Trumbull, Southport and Norwalk. Connect at cteyecareassociates.com.

September Is Sports Eye Safety Month!

Ocular sports trauma is among the leading causes of permanent vision loss in North America. Tens of thousands of people get treated for sports-related eye injuries a year, with the most common injuries occurring during water sports and basketball. Infections, corneal abrasions, eye socket fractures, and detached retinas are just a few of the typical cases eye doctors encounter on a regular basis.

Sports Eye Safety Month is sponsored by Prevent Blindness America (PBA) to remind people to protect their eyes when playing sports. Though young children are usually the most vulnerable to eye injuries, it should be noted that professional athletes can also suffer eye injuries while on the job.

Eye accidents can happen in a split second – the effects can last a lifetime…

By wearing protective eyewear, you can safeguard your eyesight without compromising on your favorite sports activities. Athletes who wear contact lenses still need additional eye protection for relevant sports.

At EyeCare Associates, our eye doctor is experienced and trained to treat sports-induced eye injuries sustained by our active patients. Dr. Randy Schulman and our dedicated staff are committed to providing the most comprehensive eye care to help get you back on the field again. Furthermore, we provide consultations on a wide array of protective eyewear for all your sporting needs.

What Eye Injuries Can Be Caused by Sports?

Corneal Abrasion

A corneal abrasion, also known as a scratched cornea, is the most common sports-related eye injury. When someone gets poked in the eye, the eye’s surface can get scratched. Symptoms may include acute pain and a gritty or foreign body sensation in the eyes, as well as redness, tearing, light sensitivity, headaches, blurry or decreased vision. Medical care includes prevention or treatment of infection, and pain management. If you suspect that you have suffered a corneal abrasion, make sure to see an eye doctor right away.

Traumatic Iritis

Iritis is an inflammation of the iris, the colored part of the eye. The condition rapidly develops and typically affects only one eye. Symptoms include pain in the eye or brow region, blurred vision, a small or oddly-shaped pupil, and sensitivity to bright lights.

Hyphema

Hyphema is among the more common sports-related eye injuries, with racquet sports, baseball and softball accounting for more than 50% of all hyphema injuries in athletics.

A hyphema is a broken blood vessel inside the eye which causes blood to collect in the space between the cornea and iris, also known as the “anterior chamber”. Although the main symptom is blood in the eye, it can be accompanied by blurry or distorted vision, light sensitivity or eye pain.

If you recognize the signs and symptoms of hyphema, make sure to seek immediate medical attention in order to avoid secondary complications.

Angle recession

Angle recession can develop from an eye injury or bruising of the eye, caused by getting punched, elbowed, or hit with a ball. The trauma damages the fluid drainage system of the eye, which causes it to back up, increasing the pressure in the eye. In 20% of people with angle recession, this pressure can become so severe that it damages the optic nerve, and causes glaucoma (known as “angle-recession glaucoma”).

You may not notice any symptoms at first, and it may take years before you experience any signs of vision loss. Therefore, it’s critical to visit the eye doctor as soon as possible for a complete eye exam and make sure that you follow-up with routine screenings.

Retinal tear or detachment

Retinal detachment is a condition in which the retina gets lifted or pulled away from its normal position at the back of the eye. If not treated immediately, retinal detachment can develop permanent vision loss.

Symptoms include seeing flashing lights, floaters or little black spots in your vision. A retinal detachment is a medical emergency and requires an eye doctor’s immediate attention – surgical intervention may be necessary.

Subconjunctival Hemorrhage

This happens when a blood vessel breaks on the white part of the eye. In addition to a sport-related injury, it can be induced by rubbing the eye, heavy lifting, sneezing or coughing. For those with subconjunctival hemorrhage, the eye appears intensely red – though this minor condition will often clear up within a couple weeks on its own without treatment.

Orbital Fracture

This occurs when one or more of the bones around the eyeball break, often caused by a hard blow to the face – such as by a baseball or a fist. This is a major injury and should be assessed by an eye doctor, like Dr. Randy Schulman, along with X-Rays or CT scan imaging to help confirm the diagnosis.

Black Eye or Periorbital Hematoma

A “shiner” can occur when a blunt object such as a fist or ball strikes the eye-area of the face and causes bruising. Typically, this kind of injury affects the face more than the eye. Blurry vision may be a temporary symptom, but it’s a good idea to get a black eye checked out by an optometrist in any case, because sometimes there is accompanying damage to the eye which could impact vision.

How Does One Prevent Sports-Related Eye Injuries?

One of the most important things one can do in order to prevent eye injuries is to wear protective eyewear. In fact, wearing eye protection should be part of any athlete’s routine, and should be prioritized just like wearing shin guards or a helmet.

Below are a few tips to prevent sports-related eye injuries:

• Wear safety goggles (with polycarbonate lenses) for racquet sports or basketball. For the best possible protection, the eye guard or sports protective eyewear should be labeled “ASTM F803 approved” – which means it is performance tested.
• Use batting helmets with polycarbonate face shields for baseball.
• If you wear prescription eyewear, speak with Dr. Randy Schulman about fitting you for prescription protective eyewear.
• Sports eye protection should be comfortably padded along the brow and bridge of the nose, to prevent the eye guards from cutting into the skin.
• Try on protective eyewear to assess whether it’s the right fit and size for you and adjust the straps as needed. For athletic children who are still growing, make sure that last-year’s pair still fits before the new sports season begins. Consult Dr. Randy Schulman to determine whether the comfort and safety levels are adequate.
• Keep in mind that regular glasses don’t provide nearly enough eye protection when playing sports.

For athletes, whether amateur or pro, there is so much more at stake than just losing the game. Fortunately, by wearing high-quality protective eyewear, you can prevent 90% of all sports-related eye injuries.

Speak with Dr. Randy Schulman at EyeCare Associates about getting the right sports-related protective eyewear to ensure healthy eyes and clear vision. Our eye care clinic serves patients from Trumbull and the surrounding areas.

Over the centuries there have been a lot of old-wives tales circulating about eyes and vision. You know, like the one that if someone hits you on the back while your eyes are crossed they will stay that way. Unlike this example, some of these myths do have roots in truth, yet filtering out those truths isn’t an easy task.

Here are a few of the most common myths and truths about the eyes and vision.

1. Myth: Eating a lot of carrots will help you see in the dark.Truth: Carrots have a lot of Vitamin A, a vitamin that is essential for good eyesight, but eating a lot of carrots isn’t going to give you 20/20 vision or help you see in the dark. Likely, the basis of this over-exaggeration is that night-blindness and vision loss found in underdeveloped countries can be a sign of malnutrition due to Vitamin A deficiency. However, you only need a relatively small amount of Vitamin A for vision, and it is easily obtainable in a normal balanced diet from a lot of sources, not limited to carrots.

   Higher-than-normal doses of Vitamin A might be useful in treating certain eye conditions and as part of a combination of vitamins used to slow the progression of early-stage macular degeneration. However, in any of these cases, do not take Vitamin A supplements without instructions from your eye doctor.

2. Myth: Wearing glasses makes your vision worse.
   
   Truth: People think this is true because often once we start wearing glasses our vision continues to deteriorate and we have to keep going back for a higher prescription. The notion that wearing glasses causes your vision to get worse is simply not true. Distance vision or myopia typically gets worse over time, especially during childhood and adolescence, and does depend on whether the child wears glasses. Additionally, most people begin to experience vision deterioration as they enter their 40’s and 50’s with or without the use of vision correction devices.
3. Myth: Sitting too close to the TV is bad for your eyes.
   
   Truth: While it may cause your eyes to feel tired, there is no evidence that sitting too close to the TV will harm your eyes or vision. Children in fact have a heightened ability to focus on close objects so often it is natural and relatively comfortable for them to sit close to a screen.
4. Myth: Reading in dim light can damage your eyes.
   
   Truth: This one also has no good evidence. While yes, your eyes are working harder and may feel tired when reading in dim light, there is no evidence of permanent or long-term damage to your eyes.
5. Myth: As you get older there is nothing you can do to prevent vision loss.
   
   Truth: While most older adults will eventually develop some degree of presbyopia which is near-vision loss, and eventually cataracts, no sign of vision loss should be ignored. Vision problems like these can be treated, allowing you to see clearly again. Moreover, there are many serious eye diseases such as glaucoma and macular degeneration that can threaten your vision and eyes with permanent and severe vision loss if not diagnosed and treated early. If you are 40 or older, you should have your eyes checked with a comprehensive eye exam on a yearly basis. In many cases, early treatment can save your eyesight.
6. Myth: Squinting causes vision loss.
   
   Truth: Squinting is a natural reaction of your eyes to let less light into the pupil in order to sharpen your focus. Rather than impairing your vision, squinting is usually a sign that someone can’t see clearly which often suggests that their vision is impaired and that they need glasses to see better in the first place.

Got any other eye myths that you are curious about? Just ask at your next visit to our office. We are happy to help weed out the fact from the fiction.

Diabetes is becoming much more prevalent around the globe. According to the International Diabetes Federation, approximately 425 million adults were living with diabetes in the year 2017 and 352 million more people were at risk of developing type 2 diabetes. By 2045 the number of people diagnosed is expected to rise to 629 million.

Diabetes is a leading cause of blindness as well as heart attacks, stroke, kidney failure, neuropathy (nerve damage) and lower limb amputation. In fact, in 2017, diabetes was implicated in 4 million deaths worldwide. Nevertheless preventing these complications from diabetes is possible with proper treatment, medication and regular medical screenings as well as improving your diet, physical activity and adopting a healthy lifestyle.

What is Diabetes?

Diabetes is a chronic disease in which the hormone insulin is either underproduced or ineffective in its ability to regulate blood sugar. Uncontrolled diabetes leads to hyperglycemia, or high blood sugar, which damages many systems in the body such as the blood vessels and the nervous system.

How Does Diabetes Affect The Eyes?

Diabetic eye disease is a group of conditions which are caused, or worsened, by diabetes; including: diabetic retinopathy, diabetic macular edema, glaucoma and cataracts. Diabetes increases the risk of cataracts by four times, and can increase dryness and reduce cornea sensation.

In diabetic retinopathy, over time, the tiny blood vessels within the eyes become damaged, causing leakage, poor oxygen circulation, then scarring of the sensitive tissue within the retina, which can result in further cell damage and scarring.

The longer you have diabetes, and the longer your blood sugar levels remain uncontrolled, the higher the chances of developing diabetic eye disease. Unlike many other vision-threatening conditions which are more prevalent in older individuals, diabetic eye disease is one of the main causes of vision loss in the younger, working-age population. Unfortunately, these eye conditions can lead to blindness if not caught early and treated. In fact, 2.6% of blindness worldwide is due to diabetes.

Diabetic Retinopathy

As mentioned above, diabetes can result in cumulative damage to the blood vessels in the retina, the light-sensitive tissue located at the back of the eye. This is called diabetic retinopathy.

The retina is responsible for converting the light it receives into visual signals to the optic nerve in the brain. High blood sugar levels can cause the blood vessels in the retina to leak or hemorrhage, causing bleeding and distorting vision. In advanced stages, new blood vessels may begin to grow on the retinal surface causing scarring and further damaging cells in the retina. Diabetic retinopathy can eventually lead to blindness.

Signs and Symptoms of Diabetic Retinopathy

The early stages of diabetic retinopathy often have no symptoms, which is why it’s vitally important to have frequent diabetic eye exams. As it progresses you may start to notice the following symptoms:

• Blurred or fluctuating vision or vision loss
• Floaters (dark spots or strings that appear to float in your visual field)
• Blind spots
• Color vision loss

There is no pain associated with diabetic retinopathy to signal any issues. If not controlled, as retinopathy continues it can cause retinal detachment and macular edema, two other serious conditions that threaten vision. Again, there are often NO signs or symptoms until more advanced stages.

A person with diabetes can do their part to control their blood sugar level. Following the physician’s medication plan, as well as diet and exercise recommendations can help slow the progression of diabetic retinopathy.

Retinal Detachment

Scar tissues caused by the breaking and forming of blood vessels in advanced retinopathy can lead to a retinal detachment in which the retina pulls away from the underlying tissue. This condition is a medical emergency and must be treated immediately as it can lead to permanent vision loss. Signs of a retinal detachment include a sudden onset of floaters or flashes in the vision.

Diabetic Macular Edema (DME)

Diabetic macular edema occurs when the macula, a part of the retina responsible for clear central vision, becomes full of fluid (edema). It is a complication of diabetic retinopathy that occurs in about half of patients, and causes vision loss.

Treatment for Diabetic Retinopathy and Diabetic Macular Edema

While vision loss from diabetic retinopathy and DME often can’t be restored, with early detection there are some preventative treatments available. Proliferative diabetic retinopathy (when the blood vessels begin to grow abnormally) can be treated by laser surgery, injections or a procedure called vitrectomy in which the vitreous gel in the center of the eye is removed and replaced. This will treat bleeding caused by ruptured blood vessels. DME can be treated with injection therapy, laser surgery or corticosteroids.

Prevent Vision Loss from Diabetes

The best way to prevent vision loss from diabetic eye disease is early detection and treatment. Since there may be no symptoms in the early stages, regular diabetic eye exams are critical for early diagnosis. In fact diabetics are now sometimes monitored by their health insurance to see if they are getting regular eye exams and premium rates can be affected by how regularly the patients get their eyes checked. Keeping diabetes under control through exercise, diet, medication and regular screenings will help to reduce the chances of vision loss and blindness from diabetes.