2/8/2010. Remote treatment of intermittent central suppression improves quality of life measures

Transcription

1 Remte treatment f intermittent central suppressin imprves quality f life measures Eric S. Hussey, OD, FCOVD W. Nra, Suite 0 Spkane, WA spacegggle@cmcast.net

2 S O C Z N H R V D K D R K C V O Z H S N S Z H V D N R K C O R C O S V Z N D H K D S V N K H O C Z R S O C Z N H R V D K D R K C V O Z H S N S Z H V D N R K C O R C O S V Z N D H K D S V N K H O C Z R Z S VZNDH M R H O C Z S S O C Z N H R V D K D R K C V O Z H S N S Z H V D N R K C O R C O S V Z N D H K D S V N K H O C Z R N H D O K R V S C C O Z N H D R V R N H D C K S O Brish Near Card N H D O K R V S C C O Z N H D R V R N H D C K S O N H D O K R V S C C O Z N H D R V R N H D C K S O Enlarged Mdified Diamnd Target Plarid Overlays Seattle Canada ~ mi. Curlew Brewster Spkane Idah D Pacific Ocean Tri-Cities Seen by left eye Seen by right eye Mt. St. Helens Oregn OEP # Descriptin Distance Retinscpy Target is standard nn-plarized near card Mncular negative relative acmmdatin m blur/recvery Cylinder Pratt Near Cylinder Pratt/Haynes Nrms Calculated frm p.e. =/ +./+. Diagnsis Pint A A B B Unfused Crssed Cylinder Lateral Phria thrugh A Fused Crssed Cylinder Lateral Phria thrugh B +.. e e. Target is plarized (mdified) Brish Near Card d Vertical fiatin disparity/assciated phria Near fd Lateral fiatin disparity/asciated phria Bincular psitive relative acmmdatin blur/recvery rth -.0/ B Unfused Crssed Cylinder B Lateral Phria thrugh - e. A/B Base-in t Break / Recvery /./. A/B Vide Base-ut t Break / Recvery diagnsis with diamnd Bincular negative relative acmmdatin blur/recvery /./ N lsses +./+..0/. Mve t Distance with AO Vectgraphic Chart Best VA Distance Crrectin - Bincular A Use all distance targets N lsses Clckdial is great fr kids Distance Vectgraphic Chart Sterepsis Rings % (th Rw) Vertical fiatin disparity/assciated phria (&) fd rth Lateral fiatin disparity/asciated phria MEM Near retinscpy thrugh A +0.. Myrn - QOL Scres Pst Diagnsis D + m. D + m. D + m Pre- Length f Suppressin Perids, Secnds

3 0 Pst- 0 Pst Pre- Length f Bincular Perids During Cycle, Secnds Pre- COVD QOL Scre - Full Checklist Pst Blurred visin at near/reading Duble visin Headaches with near wrk Wrds run tgether reading Burning, itching, watering eyes Fall asleep reading See wrse end f day Skip/repeat lines when reading Dizziness/nausea with reading Head tilt/clse an eye reading Avid near wrk/reading Miss/mit small wrds reading Pre- COVD QOL Scre - Reading Questins Hld reading t clse Shrt attentin span reading Difficulty finishing assignments 0 Reading cmprehensin dwn Blur at near read cmprehensin dwn ver time Duble Visin pr sprts perfrmance Duble visin Headaches with near wrk Wrds run tgether reading Burning, itching, watering eyes Fall asleep reading See wrse end f day Skip/repeat lines when reading Dizziness/nausea with reading Head tilt/clse an eye reading Avid near wrk/reading Wrds run tgether reading Eyes burn/sting/water falls asleep reading Visin wrse end f day skip/repeat lines reading dizziness/nausea with near wrk 0 tilts head/clses eye reading difficulty cpying frm bard truble keeping attentin n reading difficulty cmpleting assignments n time says "I can't" avids sprts pr hand-eye/handwriting - difficulty with hand tls can't estimate distances clumsy/kncks things ver n desk/table difficulty with time management Blurred visin at near/reading Headaches with near wrk hlds reading t clse Miss/mit small wrds reading avids near wrk/reading difficulty with mney cncepts/make change Hld reading t clse Shrt attentin span reading Difficulty finishing assignments writes uphill/dwnhill misaligns digits/clumns car sickness, mtin sickness 0 pr memry Reading cmprehensin dwn mits wrds reading lses papers & belngings

4 p<0.00 Visin wrse end f day skip/repeat lines reading difficulty cmpleting assignments n time p<0.00 Visin wrse end f day skip/repeat lines reading difficulty cmpleting assignments n time p<0.0 Headaches with near wrk Wrds run tgether reading Eyes burn/sting/water falls asleep reading read cmprehensin dwn ver time 0 tilts head/clses eye reading mits wrds reading writes uphill/dwnhill Blur at near pr sprts perfrmance read cmprehensin dwn ver time hlds reading t clse truble keeping attentin n reading Duble Visin hlds reading t clse Headaches with near wrk truble keeping attentin n reading Wrds run tgether reading says "I can't" Eyes burn/sting/water avids sprts falls asleep reading pr hand-eye/handwriting - difficulty with hand tls Blur at near pr hand-eye/handwriting - difficulty with hand tls dizziness/nausea with near wrk can't estimate distances Duble Visin can't estimate distances 0 tilts head/clses eye reading clumsy/kncks things ver n desk/table dizziness/nausea with near wrk clumsy/kncks things ver n desk/table difficulty cpying frm bard difficulty with time management difficulty cpying frm bard difficulty with time management avids near wrk/reading difficulty with mney cncepts/make change avids near wrk/reading mits wrds reading lses papers & belngings misaligns digits/clumns difficulty with mney cncepts/make change writes uphill/dwnhill car sickness, mtin sickness pr sprts perfrmance lses papers & belngings misaligns digits/clumns 0 pr memry says "I can't" car sickness, mtin sickness avids sprts 0 pr memry p<0.00 Visin wrse end f day skip/repeat lines reading difficulty cmpleting assignments n time p<0.0 Headaches with near wrk Wrds run tgether reading Eyes burn/sting/water falls asleep reading 0 tilts head/clses eye reading mits wrds reading writes uphill/dwnhill TABE Reading Test Grade Level p << 0.00 read cmprehensin dwn ver time hlds reading t clse truble keeping attentin n reading JbCrps average age,. yrs 0 p<0.0 Blur at near Duble Visin misaligns digits/clumns avids near wrk/reading says "I can't" can't estimate distances All the rest imprved, but p>0.0 th grade level ~ yrs. ld dizziness/nausea with near wrk difficulty cpying frm bard pr sprts perfrmance clumsy/kncks things ver n desk/table difficulty with time management difficulty with mney cncepts/make change lses papers & belngings avids sprts car sickness, mtin sickness Diagnsis Re-Eaminatin pr hand-eye/handwriting - difficulty with hand tls 0 pr memry 0 Pst- 0 Pre- TABE Reading Scres

5 Bincular Perids, Secnds 0-0 Decrease in Suppressin Perids, Secnds Fig Cntrl is all in the ff prtin - active inhibitin Crtical Inhibitin Bincular Perids, Secnds 0-0 Decrease in Suppressin Perids, Secnds Fig Cntrl is all in the ff prtin - active inhibitin Bincular Perids, Secnds Crtical Inhibitin 0 Fig Cntrl is in sme internal timing, s n/ff is a cycle f pre-determined length Internal Gating - 0 Decrease in Suppressin Perids, Secnds decrease in ff = increase in n

6 Bincular Perids, Secnds 0 Fig Changes are in prtin f cycle - Increasing Bincular Perids - 0 Decrease in Suppressin Perids, Secnds Bincular Perids, Secnds 0 Makes sense - a mtin stimulus, applied t neurlgy, shuld make mtin synapses mre rbust, increasing bincular perids which will decrease suppressin perids - 0 Decrease in Suppressin Perids, Secnds