Recent studies show that 3% of COVID-19 patients have ocular complications. 

However, the true number actually varies between studies when calculated by a meta-analysis of six studies comprising 854 COVID-19 patients.

An article on the topic of Covid-19 and the eyes was published in the Clinical and Experimental Ophthalmology journal in June, 2020. 

According to this article, scientists in Turkey examined 93 patients that had been hospitalized with Covid-19. Out of the 93 patients, 20 of these patients (21.5%) presented with at least one of the following ocular symptoms:

• Hyperemia (red eye): 20 patients (21.5%)
• Photophobia (light intolerance): 15 patients (16.1%)
• Itchiness: 13 patients (15.7%)
• Epiphora (watery eyes): 9 patients (9.7%)
• Follicular conjunctivitis (severe conjunctiva swelling): 8 patients (8.6%)
• Burning sensation: 7 patients (8.4%)
• Increased discharge (green or yellow): 6 patients (6.5%)
• Gritty feeling (feels like sand in the eye): 5 patients (6.0%)
• Blurred vision: 4 patients (4.8%)
• Chemosis (swelling of conjunctiva): 3 patients (3.2%)
• Episcleritis (inflammation of eye sclera): 2 patients (2.2%)

The article noted that the primary risk factors for Covid-19 ocular problems included high fever (which served as a biomarker of systemic inflammation) and older age.

If you have experienced any of these symptoms contact an eye doctor near you.

Another study cited in the article noted ocular symptoms in 12 (31.6%) out of 38 patients with COVID-19.

A third study conducted in Mexico, found that none of 114 COVID-19 patients that participated in the study had any ocular symptoms.

The retina and optic nerve connection

In the May edition of the Ocular Immunology and Inflammation journal, an article stated that researchers in Germany detected COVID-19 genetic material in the retina of three out of 12 deceased patients. Moreover, prior research has also found the expression of ACE2 (the main receptor SARS-CoV-2 uses to infect cells) in the human retina.

The retina is the back part of the eye where the optic nerve sits. Any information the retina receives from the eyes is relayed to the brain via the optic nerve.

In the May edition of The Lancet, a published research study also shed light on this topic. Using a noninvasive, eye imaging technique called optical coherence tomography (OCT), researchers at the Paulista Institute of Studies and Research in Ophthalmology in Brazil detected damage to the retina and optic nerve in all 12 COVID-19 patients tested.

However, interestingly, these patients experienced no visual impairments.

Later in July, another study was published in the Journal of Medical Virology in which Ophthalmologists at the Hospital Clinico Universitario in San Carlos,Spain performed an OCT scan for five patients with COVID-19. According to the results, increased optic nerve inflammation was noted in all five patients, as compared to the state of their optic nerves prior to COVID-19 exposure.

Similar to the previous study, none of these patients experienced visual impairments. This seems to imply that the optic nerve inflammation they experienced may not have been severe enough to damage the nerve completely.

Important note: The most common early signs of COVID-19 are fever, cough, and shortness of breath — none of which are ocular symptoms.

If you notice any COVID-19 symptoms, seek appropriate medical attention as soon as possible.

The post COVID-19 and the Eyes: What Do the Numbers Say? appeared first on Optometrists.org.

Fragile X syndrome (FXS) is the second most common chromosomal-based developmental condition after Down Syndrome and is estimated to occur in:

• 1.4 in 10,000 males (0.014%)
• 0.9 in 10,000 females (0.009%)

Fragile X syndrome is a genetic disorder characterized by mild-to-moderate intellectual disability.

Physical features of FXS may include a long and narrow face, large ears and flexible fingers. About a third of those affected have features of autism such as problems with social interactions and delayed speech. Hyperactivity is common and seizures occur in about 10 percent of the FXS population.

Fragile X syndrome has an X-linked dominant inheritance, typically caused by an expansion of the CGG triplet repeat within the FMR1 (fragile X mental retardation 1) gene on the X chromosome.

Signs of FXS

Most young children do not show any physical signs of FXS— physical features usually begin to develop around the time puberty begins.  Aside from intellectual disability, prominent characteristics of the syndrome may include:

• Large, protruding ears
• Long face (vertical maxillary excess)
• High-arched palate (related to the above)
• Hyper-extensible finger joints
• Hyper-extensible (‘double-jointed’) thumbs
• Post pubescent macro-orchidism
• Hypotonia (low muscle tone)
• Flat feet
• Soft skin

Behavioral characteristics may include stereotypic movements, such as hand-flapping and atypical social development, particularly:

• Shyness
• Limited eye contact
• Memory problems
• Difficulty with face recognition

Some individuals with FXS also meet the diagnostic criteria for autism.

If your child suffers with any of the signs above contact a vision therapy eye doctor near you.

SEE RELATED: Vision and Special Needs

Vision and FXS 

Over half of the FXS population suffer from visual problems— most commonly eye turns, lazy eye and poor eye muscle control.

According to a review of ophthalmic findings of 55 patients with FXS, most of the vision problems included:

• Strabismus (eye turns)
• Amblyopia (lazy eye)
• Convergence insufficiency
• Poor stereopsis (3D vision)
• Refractive errors
• Nystagmus

Management of FXS

Medications may be used to treat associated seizures, mood problems, aggressive behavior or ADHD.

Early intervention is highly recommended for children with FXS as it provides the best opportunities for developing a variety of skills and abilities.

These interventions may include:

• Vision therapy
• Speech therapy
• Behavioral therapy
• Sensory integration therapy
• Occupational therapy
• Special education

LEARN MORE: Vision for Special Needs

If your child has been diagnosed with FXS, contact an eye doctor who is experienced in vision therapy to be able to offer you solutions and strategies to manage any vision problems.

The post Fragile X Syndrome appeared first on Optometrists.org.

Any interference in the visual pathways can inhibit a child from performing to his maximum potential.

According to the American Optometric Association (AOA), 25 percent of all children, or 1 in 4 students, have a vision problem significant enough to impact their learning.

A child may pass a visual acuity eye exam and still have an undetected vision problem— mainly because 20/20 eyesight does not indicate “perfect” functioning of the visual skills.  In other words, visual problems do not only stem from blurry vision, but can be caused by reduced visual skills as well.

Schedule an eye exam with an eye doctor near you who has experience diagnosing and managing vision problems.

SEE RELATED: The Power of Visualization

How can vision problems impact learning?

Strong visual skills are essential for all aspects of learning.

Vision problems do not go away on their own and will persist into adulthood if not treated.  In many cases, adults are not even aware that their difficulties are caused by a vision problem— leading to years of avoidance of difficult activities.

Therefore, it is essential to obtain an accurate diagnosis of a vision problem, and appropriate treatment as early as possible.

Vision problems can impact:

• Reading
• Spelling
• Handwriting
• Reading comprehension
• Homework completion
• Classroom performance
• Concentration and attention
• Visual arts

If your child’s vision is affecting any of these areas contact an eye doctor near you.

Visual skills are essential for learning 

This page is a guide to facilitate understanding of the visual skills, and how they are needed for each of the fundamental components of learning. Visual skills can be improved with a personalized program of vision therapy.

Reading

Why is reading important?

Not only is reading fun, but reading can help build a child’s language skills which further helps to develop vocabulary. Additionally, the ability to read is essential for communication, and truly opens up the world to a child.  Reading books teaches children about the past, present, and future— different cultures, histories, and societies. It allows a child to use their imagination, and is a great tool for relaxation!

Visual skills necessary for reading:

• Saccades and Visual integration

Saccades is a skill that allows you to read sentences in a fluid manner, with the two eyes moving smoothly across the line, in coordination.

Without saccades, a child may omit words in a sentence, or make assumptions, filling in words that may not actually appear on the page.

Visual integration is a skill that allows you to read words correctly— seeing the shapes and order of the letters accurately.

Without visual integration, a child may confuse letters that are similar in shape, such as b and d, or p and q; or confuse words such as ‘saw’ and ‘was’.  Additionally, without laterality — a skill that falls under visual integration, a child will struggle with reading from left to right, or from the top of the page to the bottom.

Spelling

Why is spelling important?

Spelling is important because it facilitates reading ability — cementing the connection between sounds and letters, and enabling language proficiency.  In addition, proper spelling facilitates written communication— poor spelling distracts the reader because it is difficult to read a text when it’s full of spelling errors.

Visual skills necessary for spelling:

• Pursuits and Focusing

Pursuits allow you to read a word, one letter at a time, with slow, smooth binocular movements.  Pursuits enable your eyes to scan across a word in order to read it accurately, sounding out each letter in the word.

Without this visual skill, a child may omit sounds, reading the word ‘through’ as ‘though’— or may assume that the ‘r’ is there, pronouncing the word correctly, even though it was not seen. These omissions and assumptions often lead to spelling mistakes.

Focusing skills allow you to see a word clearly and comfortably. Just as a camera needs to be in focus to capture a clear picture of an image, the same is true with your eyes when it comes to seeing a word with absolute clarity.

Without this visual skill the child will experience difficulties seeing words clearly and comfortably

Handwriting

Why is handwriting important?

Legible handwriting is still an essential educational requirement for optimal performance on exams and assignments. Legible handwriting is also important for taking notes by hand, which is crucial for students of all ages because it facilitates improved attention and comprehension.

Legible handwriting can have a positive impact on grades, while illegible handwriting can lead to difficulties in proofreading and detecting mistakes. Moreover, illegible handwriting can result in poor self expression, or avoidance of writing tasks altogether.

Visual skills necessary for handwriting:

• Fine visual motor and Visual perception

Fine visual motor skills allows you to write appropriately sized letters, in a neat fashion. Reduced fine visual motor skills can cause a child to press too hard onto the page when writing, which can lead to muscle fatigue, or strain injuries to the muscles in the hand and wrist.

Visual perception allows you to process visual information such as the shape and sound of a letter, or a complete word. This cognitive process is required to trigger a subconscious motor response, by initially seeing the word in your head then actually writing the letters and words.

A combination of these skills ensures that the sequence of letters are written within the lines, correctly oriented, consistently sized, and appropriately spaced.

Reading comprehension

Why is reading comprehension important?

Reading comprehension is essential for understanding, processing, and recalling what was read.  Reading comprehension difficulties will impact a child’s ability to answer questions based on text.  Additionally, a child may become frustrated as a result of not fully understanding what is being read— many times, resulting in avoidance of reading altogether.

Visual skills necessary for reading comprehension:

• Visual Memory and Convergence

Visual memory allows you to visualize, or imagine, the scene of a book in your mind. Visualization enables increased comprehension of text, and consequently enhances your ability to recall what was read.

Convergence allows you to focus both of your eyes inward, in order to see an image clearly.  Convergence is an essential skill for reading, as well as looking at a computer screen comfortably, for an extended period of time.

Convergence Insufficiency is one of the most common visual problems experienced by up to 15% of all children.

Homework

Why is homework important?

There is a positive correlation between homework completion and academic achievement. Homework completion encourages children to work independently, and enables a deeper understanding of subjects. Homework is also essential in improving memory and critical thinking, and increases test grades. 

Visual skills necessary for homework:

• Accommodation endurance and Binocular coordination

Accommodation endurance allows you to maintain focus for reading and other close vision tasks, for an extended period of time. Many children can focus clearly at the beginning of the day, but after a few hours, fatigue sets in—making it difficult for them to focus on their homework assignments.

Binocular coordination allows you to use both eyes at the same time, in coordination, for clear and comfortable vision. Poor binocular vision can result in fatigue and avoidance of homework. In some cases poor binocular vision can result in blurry or even double vision.

Concentration and attention 

Why are concentration and  attention important?

Children who are able to concentrate and pay attention during class become successful students.  If a child is unable to concentrate during class, his academic performance will be affected significantly.

Concentration is necessary for following instructions, completing assignments and exams, and understanding the material being taught.

Visual skills necessary for concentration and attention:

• Peripheral vision and Gross visual motor control 

Peripheral vision allows you to see what is going on around you, without having to turn your head. This skill enables a child to attend to a task without being easily distracted by noises or movement in their environment.

Gross visual motor allows you to sit at a desk, with correct upright posture— enabling increased attention to school work and the teacher’s lesson. A child with reduced gross visual motor skills will typically display poor posture while sitting behind a desk, resulting in an inability to concentrate properly.

Classroom vision

Why is classroom vision important?

Classroom vision is needed for seeing what is written on the whiteboard, taking notes off the whiteboard, following directions, and more!

Visual skills necessary for optimal classroom performance: 

• Central vision acuity and Accommodation flexibility 

Central vision acuity allows you to see distant images with clarity.  This skill is needed in the classroom for many different reasons, one of them being the ability to clearly see what is written on the whiteboard.

Accommodation flexibility allows you to switch focus from near to distant images. This skill is necessary for taking notes from the whiteboard— looking from the whiteboard to your book, and then back to the whiteboard, continually.

Visual arts

Why are visual arts important?

Participating in visual art activities facilitates physical, emotional, cognitive, and social development. Visual arts help to build a child’s imagination, as they invent new ways to create art. Moreover, visual arts strengthen a child’s decision making and problem solving skills — color, size, and placement are important factors in the creation of artwork.

Visual skills necessary for visual arts:  

• Visual thinking and Color perception

Visual thinking or processing allows you to analyze and form a mental image in your mind. Visual thinking is essential for painting, drawing, and all forms of visual arts —as it enables a child to visualize the artwork they plan to create, before beginning the project.

Color perception allows you to distinguish between different colors. This skill is necessary for appreciating the detail, depth and complexity of what is seen.

Treatment of vision problems

Strong visual skills are essential for academic success.

All of the fundamental components of learning rely heavily on the strength of the visual skills. It is important to treat vision problems as early as possible in order to enable a child to reach their full potential— and to facilitate optimal outcomes.

If your child is struggling academically, take this quiz to find out if they may be suffering from a vision problem, and be sure to schedule a comprehensive vision evaluation.

LEARN MORE: Vision Therapy for Children

Schedule an appointment with a vision therapy eye doctor. They will be able to detect the presence of a vision problem, and discuss the benefits of vision therapy— an effective treatment method for the improvement of visual skills.

Your child’s visual skills are essential for their optimal learning performance, and overall academic success.

The post Vision and Learning Difficulties appeared first on Optometrists.org.

Down syndrome (DS) is caused by a duplication of all, or part, of chromosome 21— making three copies of the chromosome rather than the usual two copies. The extra genetic material leads to certain physical changes in individuals with DS.

Down syndrome is one of the most common chromosomal abnormalities in children.

The frequency of DS is approximately 1 in every 800 births, with an increased frequency among older mothers.

With the specialized improvements in the quality of medical care and educational resources, individuals with DS can live a more productive, longer life.

How do vision problems affect children with DS?

According to the National Institute of Child Health and Human Development, more than 60 percent of children with DS have vision problems.

Furthermore, the optical prescriptions for children with DS are often in the higher range of far-sighted, near-sighted and astigmatism, often requiring them to use specialty lenses and frames.

Therefore, even with corrective eyeglasses for near or distant vision, the quality of their vision may be affected as a result of reduced visual skills.

When is an eye exam necessary?

Down syndrome affects the development of the eyes, which can impact the proper development of vision. According to research, ocular disease is prevalent in over 50 percent of patients with DS— from milder conditions such as tear duct abnormalities to severe diagnoses such as cataracts, that can cause significant vision loss.

Frequent comprehensive eye exams, beginning from 6 months of age, are essential for individuals with DS.

It is important to note that an eye exam can be challenging for both the child and the doctor, it is therefore recommended to choose an eye doctor skilled in evaluating children with developmental delays.

Common vision conditions that affect individuals with DS

Refractive errors – Children with DS are more likely to need glasses than other children as a result of myopia (near-sightedness), hyperopia (far-sightedness), and/or astigmatism. A refractive error may develop early in life or later on.

Strabismus and amblyopia – Between 20 and 60 percent of individuals with DS have amblyopia (lazy eye) or strabismus (crossed-eyes). Esotropia (inward eye turn) is most common, while exotropia (outward eye turn) occurs less frequently. Strabismus often goes unnoticed or it may be hidden by the folds of skin between the eyes and the nose.

It is important to diagnose strabismus as early as possible, as crossed eyes can result in amblyopia, loss of stereopsis (the use of the two eyes together), or loss of depth perception. Amblyopia and strabismus may be treated with eyeglasses or vision therapy (with or without patching), and/or eye muscle surgery (usually involving multiple procedures).

Keratoconus – Approximately 30 percent of individuals with DS suffer from this condition that causes thinning of the cornea (front layer of the eye) and blurred vision. Keratoconus is usually diagnosed around puberty and regular monitoring is essential.

Cataracts – There is an increased incidence of congenital cataracts (present at birth) as well as acquired cataracts among the DS population. Cataracts cause a clouding of the lens inside the eye. The condition may progress slowly and should therefore be monitored regularly for proper management.

If cataracts are present early in childhood, they will prevent a clear image from being delivered to the brain, and the brain may therefore never “learn” to see. This can cause a severe form of amblyopia known as deprivational amblyopia. Surgical treatment for cataracts is performed when necessary.

Glaucoma– There is an increased incidence of infantile glaucoma among the DS population.  Glaucoma results from elevated pressure within the eye and can lead to a significant loss of vision. Appropriate treatment depends on the severity of the condition, and may include medication, laser treatments, or surgery.

Blepharitis – Inflammation of the eyelids with redness at the edge of the lids and crusting around the lashes may cause dryness or burning. Eyelid hygiene and topical antibiotics are typically used to treat this condition.

Tearing – Excessive tears or watering of the eyes may occur as a result of a blocked or narrow drainage channel (nasolacrimal duct obstruction). This may require surgery for treatment.

Nystagmus – An involuntary “back-and-forth” movement or shaking of the eyes that can affect vision clarity on a mild to a severe degree. While surgery may improve appearance, and botox injections are sometimes able to reduce the amount of visible movements, the outcomes are generally only temporary.

Signs of a vision problem

Unfortunately, children with DS often do not complain about their eye problems, either because they are unable to communicate that there is a problem, or because they simply don’t notice a problem.

It is therefore essential that parents and caregivers be on the lookout for the following signs that may indicate a vision problem:

• Blurry vision
• Sits close to the TV
• Reading difficulties
• Squinting
• Closing one eye
• Unusual head tilt
• Poor hand-eye coordination
• Light sensitivity
• Crossing or wandering of one or both eyes
• Ptosis (eyelid droop)
• Tearing or discharge (blocked tear duct)

If your child has experienced any of these symptoms contact an eye doctor near you.

SEE RELATED: Vision and Special Needs

Special eyeglasses designed for patients with DS

More than 50 percent of all individuals with DS have a refractive error, including high levels of hyperopia (farsightedness), myopia (nearsightedness), or astigmatism— requiring full time use of eyeglasses. 

Typical eyeglasses are not usually appropriate for individuals with DS because of their unique facial features. However, a wide variety of optical frames have been designed specifically for individuals with DS— allowing the bridge of the frame to be adjusted appropriately on the nose, and the temples to be modified to keep the glasses from constantly slipping down.

Additionally, optical lenses for patients with DS often include transition, hi-index and bifocal designs.

Vision therapy for patients with DS

Vision therapy, with or without eyeglasses, is highly effective in treating amblyopia, strabismus, and other functional vision difficulties that are common among the DS population. 

Each vision therapy program is personalized to the needs of the individual patient, and includes therapeutic activities to retrain the eye-brain connection and improve the visual skills necessary for clear binocular vision.

Vision therapy aims to enhance the following visual skills:

• Eye alignment
• Eye teaming
• Eye focusing
• Eye movements
• Visual processing

Enhancement of the visual skills can improve your child’s quality of life

Improvement of visual skills through a program of vision therapy will facilitate achievement of developmental milestones and significantly influence the development of important life skills for children with DS. 

Wearing appropriate eyeglasses and participating in a program of vision therapy may enhance your child’s skills and significantly improve their overall quality of life.

LEARN MORE: Vision for Special Needs

Schedule an appointment with a vision therapy eye doctor to improve your child’s vision.

The post Vision and Down Syndrome  appeared first on Optometrists.org.

Vision problems are common in children with ASD, but unfortunately these often go undiagnosed.

A recent study conducted in April 2018, called the Autism Prevalence Study, determined that 1 in 59 children are affected by Autism Spectrum Disorder (ASD)— a higher prevalence reported among boys, with 1 in 37 as compared to 1 in 92 girls.

Autism Spectrum Disorder is a range of childhood developmental conditions characterized by social, behavioral, and communication deficits.

• Many individuals with ASD have problems with sensory integration.
• ASD can affect the child’s visual skills as well as other sensory-processing abilities.

Eye exams for children with autism

It is crucial for parents to understand that children with ASD need to have regular eye exams in order to assess their ocular health, as well as their vision acuity. A standard 20/20 vision screening is insufficient.

Doctors also recommend that children with ASD have a functional visual evaluation in order to assess many other important aspects of the visual system, namely: eye movements, eye teaming, eye tracking, visual processing, visual-spatial judgment, and central/peripheral vision.

According to research, children with ASD present with a higher incidence of strabismus (eye turn) ranging from 21-50 percent prevalence, as compared to children without ASD. 

Autistic behaviors and vision problems

Common autistic behaviors may seem unrelated to vision problems — though truthfully, many of the following behaviors actually present as a result of reduced vision or visual skills.

• Poor eye contact
• Looking beyond/through objects
• Absence of reciprocal play
• Extreme fear of heights or absence of appropriate fear of heights
• Tracking moving objects accurately
• Maintaining eye contact with people
• Eye alignment (eye turns)
• Keeping their eyes from wandering (amblyopia/lazy eye)
• Light sensitivity
• Head turning (looking at objects from the side of the eyes)
• Fleeting views or rolling eyes
• Visual stimming (flapping fingers in front of eyes)

If your child displays any of these vision problems contact an eye doctor near you who has experience with vision therapy.

SEE RELATED: Outsmarting Autism

Vision therapy for children with autism

Vision therapy is a highly effective treatment method, designed to enhance visual skills and the neurological connections between the eyes and brain. 

A vision therapy program for a child with ASD will facilitate improved visual processing, enabling them to understand their surroundings with greater certainty— and consequently improve associated behaviors such as anxiety, social skills, and verbal skills.

Each therapy program is personalized to the needs of the child, and includes age-appropriate exercises and activities.

Common vision therapy goals for children with ASD include the improvement of:

• Visual-spatial organization
• Peripheral stability
• Central vision
• Efficient eye coordination
• Visual information processing

Prism lenses (yoked prisms or ambient prisms)

Many times, vision problems, specifically visual-spatial misperceptions such as body/objects/people moving in space, can cause a child with ASD to feel anxious, confused, or distressed— resulting in certain behavioral responses, discussed above.

Prism lenses have been created to help children with ASD to use their vision in a more effective and positive way. For example, prisms can create immediate improvements in posture, balance, and attention— significantly increasing the child’s feelings of physical safety and comfort, while decreasing anxiety and sensory overload.

The prism lenses can be worn daily or just for the duration of a vision therapy program, and typically facilitate significant improvements.

The goal of vision therapy for your child

The goal of optometric care for children with ASD is to facilitate the performance of everyday tasks, and minimize the challenges that both you as the parent, and your child, face on a daily basis.

LEARN MORE: Vision for Special Needs

If your child has autism, schedule a comprehensive eye exam to enable a proper diagnosis of any visual difficulties.

The post Vision and Autism (ASD) appeared first on Optometrists.org.