Article Date: 10/1/2013

Leading Off
Leading Off

personal reflections

My Encounter With a Teen in Trouble

Looking back through my long career as an optometrist, I remember many patients fondly and one, in particular, who broke my heart.

Early on, I worked in a Medicaid office on Chicago’s West Side. One day in my waiting room, I found a police officer accompanied by a young male in handcuffs. The officer told me the young man needed an eye exam.

At the beginning of the exam, I handed the 15-year-old prisoner a reading card, and asked him to read it. At first, he read fluently. But, as he got closer to the card’s bottom, his reading slowed and halted between words. Eventually, he just stared at the card, saying nothing.

I placed two lenses in front of his eyes. The young man began reading again and quickly with increasing emotion with each sentence. Watching him was like seeing someone learning to walk again. He then looked up at me with wonder.

When I explained to the 15 year-old that he had needed reading glasses, he started crying. And it wasn’t just a whimper. He cried like a child, gasping for breath, with tears streaking his black leather jacket. At that moment, the officer placed his arm on the young man’s shoulder to console him.

“I tried to tell my teachers, I tried to tell my Mama,” was all the young man could say. The officer assured me the young man would receive glasses. Then they left. I have often thought of that young man. He would be 50 years old this year.

— Julie Kos, O.D., St. Lemont, Ill.


But, do patients know the difference between screenings and exams?

The U.S. Preventive Services Task Force recently released a statement that it “is unable to determine the balance of benefits and harms of screening for glaucoma in asymptomatic adults.” There is concern, however, the statement did not advise the public to get a comprehensive eye exam if they were concerned or had a family history of glaucoma.

“[The statement] recommended the general public talk to their family doctor or nurse to decide whether ‘screening’ is appropriate,” explains Optometric Glaucoma Society member Elizabeth Muckley, O.D. “Unfortunately, many don’t know the difference between a screening and a comprehensive exam, the latter of which takes into account family history and the findings of specialized testing,” says Dr. Muckley.


Ohio State University Engineers have created a lens that combines the wide-angle view of insects’ eyes with the human eye’s focusing ability, making it ideal for smart phones and laparoscopic surgeries, as both cameras used currently lack depth. (Visit html for more information.)

Patient Tips:

According to the Harvard Health Newsletter, senior citizen drivers can take the following steps to keep driving safely:

✓ Regular hearing and vision tests.

✓ Minimizing noise inside the car.

✓ Curbing night driving.

✓ Exercising and stretching for the flexibility and strength required to drive.

✓ Avoiding driving during busy times to maintain mental sharpness.

✓ Avoiding high-traffic areas.

✓ Ceasing driving when emotionally distressed or when using medications that induce drowsiness, dizziness and confusion.

✓ Pulling over when feeling sick to avoid accidents.

Read the full article “Stay driving to stay independent” at

Study Casts Doubt on Strabismic Rembrandt Claim


▪ Look at many of Rembrandt Harmenszoon van Rijn’s selfportraits, and you’ll notice one of his eyes deviates. This has lead researchers to postulate that the painter of The Night Watch, among other lauded works, had unilateral strabismus. However, a study in September’s Optometry & Vision Science questions this claim.

Specifically, the study’s researchers say the appearance of strabismus is actually due to gaze overshoot caused by head turn, using a mirror to paint himself, angle kappas and personal artistic style, as portraits that Rembrandt and his students created, of theoretically nonstrabismic persons, often appear to have the condition as well.


The researchers arrived at this conclusion after studying 10 self-portraits — five that contained the largest difference in centration between the irises, and five that contained the smallest — and occluding each image with Photoshop to create two more images that revealed monocular gaze. Judgments were then made as to where Rembrandt was looking within the plane of his face.


• While researchers have hypothesized statins’ antioxidant effects may slow the lens’ aging process, a Sept. 19 JAMA Ophthalmology study reveals they increase cataracts risk.

• Depression was linked with dry eye disease (DED) and, specifically, with DED symptoms in patients age 40 and older, says a study published online Sept. 13 in the British Journal of Ophthalmology.

• Cataract surgery is linked with significantly improved long-term survival in patients age 49 and older, regardless of other health factors, says Sept.’s Ophthalmology.

• Six-month use of supplemental GLA and n-3 PUFAs improved ocular irritation symptoms, maintained corneal surface smoothness and curbed conjunctival dendritic cell maturation in postmenopausal keratoconjunctivitis sicca patients, says October’s Cornea.

Optometric Management, Volume: 48 , Issue: October 2013, page(s): 10 13