October 9, 2008

Reported by the American Optometric Association

Too many Americans are not paying enough attention to their eyesight and overall eye health, according to a new survey by the American Optometric Association (AOA).

The AOA’s 2008 American Eye-Q® survey, which assesses public knowledge and understanding of a wide range of issues related to eye and visual health, showed that most Americans – 81 percent of respondents – wear contact lenses, eyeglasses or both. At the same time, however, 26 percent have not visited an eye doctor or eye care specialist within the past two years, as recommended by the AOA.

Since many eye and vision problems have no obvious signs or symptoms, people often are unaware that a problem exists. Early diagnosis and treatment of eye and vision problems are important to maintain good vision and eye health and, when possible, prevent vision loss.

“Every adult should have a comprehensive eye exam at least every two years, but it’s even more important for people who already use corrective lenses,” said Dr. James Kirchner, optometrist and AOA’s Eye Health Expert. “Too often we see people who have put off eye exams because they assume they just need a different lens prescription, when they really have a more serious problem. With eye diseases and disorders, as with most health issues, early detection and treatment are often the keys to avoiding permanent problems.”

Comprehensive eye exams are designed to:

• Evaluate the functional status of the eyes, taking into account special vision demands and needs
• Assess vision health and related systemic health conditions
• Determine a diagnosis (or diagnoses)
• Formulate a treatment and management plan
• Counsel and educate patients about their visual, ocular and related systemic health care status, including recommendations for treatment, management and future care

Most Americans are unaware that comprehensive eye exams can detect more than just vision problems. Sixty-two percent didn’t know that signs of diabetes can be detected by an optometrist. Other diseases and conditions that respondents did not realize can be detected through a comprehensive eye exam include hypertension (not recognized by 71 percent), brain tumors (75 percent), cancer (78 percent), cardiovascular diseases (80 percent) and multiple sclerosis (90 percent).

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CONVERGENCE INSUFFICIENCY(CI) is a common binocular vision disorder that is often associated with a variety of symptoms, including eyestrain, headaches, blurred vision, diplopia, sleepiness, difficulty concentrating, movement of print while reading, and loss of comprehension after short periods of reading or performing close activities.  Various treatments are commonly prescribed, including passive treatment with base-in prism reading glasses and active treatment, such as home-based therapy using pencil pushups (HBPP) alone, home-based therapy using pencil push-ups plus other therapy techniques, office-based vision therapy, and orthoptics. Consensus regarding the most effective treatment is lacking and there are considerable differences among treatments in time and cost. Recent studies that surveyed the ophthalmic community suggest that HBPP is the most commonly prescribed treatment by both ophthalmologists and optometrists for young patients with symptomatic CI. 

Active therapies for the treatment of symptomatic CI typically involve the purposeful, controlled manipulation of target blur, vergence demand, and/or target proximity with the aim of normalizing the accommodative and vergence systems and their mutual interactions.  The various active treatment approaches for CI differ in their (1) ability to control and manipulate stimulus parameters (eg, vergence and accommodative demand), (2) dosage, (3) mode of administration, and (4) use of motor learning theory and patient feedback. It is unknown, however, whether these differences affect the outcome of treatment.