58 Optometry & Vision Development

Editorial

An American Optometrist in EdinburghDominick M. Maino, OD, MEd, FAAO, FCOVD-A Editor, Optometry & Vision Development; Professor of Pediatrics/Binocular Vision, Illinois College of Optometry

Do ya hear it laddie? Do ya? C’mon lassie, do ya hear it? The pipes. The pipes be playin’. They be playin’ faint, but lissen careful….the pipes be playin!

As I write this editorial I’m in Edinburgh, Scotland for a wee bit of vacation, as well as the 9th World Congress on Brain Injury1 presented by the International Brain Injury Association.2 I noticed while here, that there was never a moment I couldn’t hear pipes. There was never a moment I didn’t see a lassie or a laddie in a kilt. There was never a moment that the Scottish aqua vitae (in the Scottish Gaelic “uisge beatha”) wasn’t prominently displayed in small whisky shops throughout the city. Edinburgh is Scottish from its Balmoral and Glengarry hats to its Ghillie Brogues and from its Glencairn crystal whiskey tasting glasses to its many monuments celebrating great Scotsmen and Scotswomen. And then there is always the overpowering Edinburgh Castle with its steep approach, towering walls and impressive cannons. (The photograph on the right shows a view of Edinburgh from the castle walls.)

As you could probably tell from my last editorial (Single Malt Scotch and Developmental Optometry3), I’ve been very diligent in my studies regarding all things Scottish. [Ask me sometime about the first part of my trip that included seeing much of the Highlands, Speyside (Glenfiddich in Dufftown for instance), Loch Ness (but no monster sightings) and even the north-west coast and the Atlantic Ocean with

double rainbows thrown in for special effects!]. Once the sight-seeing was over however, the real work began.

Two COVDers invaded Scotland at this time. These friendly invaders included myself, Dominick “The Bruce” MacMaino, the Lord of Scotchland, Duke of Haggis and 9th Earl of the MacMaino Clan and Steen “The Dane” Aalberg, the Baron of Deuchars IPA and Viscount of Valhalla Bruery. We came to Scotland to conquer the lack of knowledge of how optometry (and specifically behavioral optometry) can help individuals with brain injury. As you can imagine those in attendance (more than 1300 international attendees) were usually surprised to hear of our role in serving those with acquired and traumatic brain injury. The good news was that not all of those we encountered were lacking in the knowledge of the benefits of what we could offer their patients, but these individuals were very small in number.

I always bring handouts to my poster presentations and this time was no exception. All of the handouts I had (about 30), which included a copy of my poster, a sheet with references and resources and my professional card were gone even before my scheduled presentation time. During my poster presentation I talked to numerous therapists who told me that they knew something was missing from what they should be able to do for their patients. A few even mentioned

Correspondence regarding this article should be emailed to dmaino@ico.edu or sent to Dominick M. Maino, OD, MEd, Illinois College of Optometry, 3241 S. Michigan Ave., Chicago, IL 60616. All statements are the author’s personal opinion and may not reflect the opinions of the College of Optometrists in Vision Development, Optometry & Vision Development or any institution or organization to which the author may be affiliated. Permission to use reprints of this article must be obtained from the editor. Copyright 2012 College of Optometrists in Vision Development. OVD is indexed in the Directory of Open Access Journals. Online access is available at http://www.covd.org.

Maino D. An American optometist in Edinburgh. Optom Vis Dev 2012;43(2):58-59

Volume 43/Number 2/2012 59

that they had reached out to behavioral optometrists, but that the availability of these practitioners was quite limited.

My poster (co-written with my colleague, Dr. Darrel Schlange), Improving Vision Function in the Patient With Traumatic Brain Injury, reviewed how with only twenty-seven, 45 minute in-office optometric vision therapy sessions (combined with at home vision therapy), we not only resolved issues with binocularity, accommodation and oculomotor dys functions, and relieved all symp-tomology but also im-proved attention (as noted by an improved Test of Variables Attention score that went from -4.00 to +4.00) and reading ability from significantly below expected levels to at expected levels (as noted with the Visagraph). She even could now parallel park her car without scratching its passenger side!

My friend and colleague, Steen Aalberg, FCOVD-I, also presented a poster. His poster was entitled: Neuro-Optometric Rehabilitation of ABI/TBI Induced Vision impairment where he noted that the “Educational goal [of the poster] is to make the participant aware of the presence … of the vision problems occurring from ABI/TBI, their potential impact on the rehabilitation process, and to provide a few simple tools to verify their presence. … He goes on to state that … Vision is developed through and for movement … responsible for the planning of movement and guiding of our motor system, as well, as playing the main role in perceiving and understanding of the visual world we live in. Vision impairments in various forms exist with high frequency occurrence in

brain injured patients. …… vision problems may go undetected throughout rehabilitation, thus potentially impairing the outcome. Binocular problems of almost any kind will influence the ability to read, orient oneself in space and maintain concentration. Fixation problems and eye motor problems due to neural damage can cause … diplopia, loss of 3D-vision, create major perceptional disturbances and impair balance and cognition. … Steen also says that without the proper vision assessment completed by a functional optometrist many of these problems go undetected, undiagnosed and untreated.

Finally, a non-COVD group presented the poster, A Retrospective Analysis of Vertical Heterophoria Treatment and Amelioration of Post-concussive Disorder Symptoms Via a Multifaceted Assessment Battery by Drs. Mark Rosner, Debby Feinberg, Jennifer Doble, and Arthur Rosner, which discussed the problems associated with vertical heterophoria and brain injury (for more information about this see the NewsMakers column in this issue or go to http://goo.gl/AyFpb to read the complete abstract). Also of interest is that Dr. Debbie Feinberg is a former ICO student of mine, while Dr. Mark Rosner (Dr. Feinberg’s husband) is an emergency room physician and his brother, Arthur is an ENT specialist.

Sadly, these three posters pretty much summed up the total number of present-ations specifically concerned about the eye and vision problems associated with acquired or traumatic brain injury. We have much to do,

not only within the United States but internationally as well. The world needs our help, our skills and our knowledge. COVD, NORA, ACBO and OEPF should continue to work together to bring the benefits of functional optometry to those who need it most. This should include not only reaching out to our international optometric brethren, but also to the many physicians, therapists, teachers, parents and all who should be aware of what we do and the potential benefits our unique skill set offer those with disability. Go out to the world. Tell all how they can benefit from optometric vision therapy. Do it.

ReferencesNote: URLs are functional hyperlinks to internet addresses.1. 9th World Conference on Brain Injury. Informationa available from: http://goo.gl/yc5G5

2. International Brain Injury Association. Information available from http://goo.gl/oSLao

3. Maino D. Single Malt Scotch and Developmetal Optometry. Optom Vis Dev 2012;43(1):6-9

Go out to the world. Tell all how they can benefit from optometric vision therapy. Do it.

Pictured in full Scottish Optometric Dress is Dr. Dominick “The Bruce” MacMaino; the Lord of Scotchland, Duke of Haggis and 9th Earl of the MacMaino Clan and editor of Optometry & Vision Development