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Interactive Metronome

Description: Learn how the Interactive Metronome program works, its benefits and why it’s considered a crucial element in cognitive therapy.

Interactive Metronome (IM) is a training program that assists children and adults cope with coordination, memory and attention difficulties. IM is backed by solid scientific research and can be used by people of all age groups who suffer from a number of different conditions which hinder their physical abilities and cognitive functions.

How IM Works

To understand how it works, consider that your brain has a “clock” inside that keeps track of time in intervals of hours, minutes, seconds, milliseconds and microseconds. Brain timing, or what researchers call temporal processing, is the reason why you can determine where sound is coming from when it strikes your ears microseconds prior to striking the other ear.

The timing in your brain is also the reason for waking up, putting us to sleep, motor coordination, processing speech, remembering facts and figures, reading and other essential human functions. Conditions like Parkinson’s, Auditory Processing Disorder, reading disorders, autism, dyslexia and ADHD result in neural timing problems, as will a stroke or brain injury.
This is the problem that IM addresses. Combined with functional therapy interventions, you will be focusing not just on the aspects of your brain that affect independence and achievements, but also deficient neural timing in the regions of your brain which is responsible for many of the problems you’re trying to fix during therapy. With IM you can expect better overall results.

With IM you get an auditory-visual platform that keeps you engaged and generates constant feedback at the deepest level, stimulating the synchronized timing in your brain. All the exercises may be customized and consists of complex and accurately timed motor movements combined with cognitive processing, decision making and attention. IM is also a tool that can be utilized with individuals from different therapy spectrums, including those that need assistance because of physical or cognitive impairments.

IM is different from other therapies because unlike other programs that have you do repetitive movements or activities, IM therapists allow their patients to become more engaged, aware and perform more functional reps and patterns, and they do so in a more precise manner. This ultimately leads to quicker progress in terms of achieving their physical, communicative and cognitive goals.

The Scientific Explanation

IM works by improving the efficiency and resolution of the individual’s temporal processing and brain clock. When this takes place, your brain connectivity improves and enhances synchronization, and this is done by increasing the integrity of the white matter tract communication system. What this means is your brain will be able to communicate more efficiently.

Research has indicated that IM training stimulates the parietal-frontal brain network, the component of your brain that is linked to executive functions, controlled attention, working memory and general intellectual functioning. Based on the scientific studies, IM improves function of neurocognitive mechanisms in the brain.

To be more specific, IM provides millisecond feedback on the temporal processing resolution of your brain’s internal clock. When this happens, the neural efficiency is enhanced and leads to better, more improved processing. What IM does is produce greater synchronization and efficiency between the major structures in your brain that make up the functional networks involved in motor and cognitive demands.

IM also improves brain network communication, particularly the P-FIT. The bottom line is with IM you can expect improvements in cognitive functions. Of all the benefits, probably the most important is enhancing of the attentional control system (ACS) as it helps you retain information and prevents your mind from wandering.

Pediatric IM Benefits

The individualized approach of IM makes it ideal for a pediatric client. Unlike other therapies, IM is more entertaining, and the interface is easier to understand so your pediatric patient is going to be looking at their goals following each exercise and help them attain higher goals.

IM also lets you enhance the challenge involved in each task while they concentrate on the IM interface. The bottom line is that with IM, treatments become easier because it provides the appropriate setting, group dynamics, developmental level and more.

Adult IM Benefits

IM makes it easy to individualize IM applications from 18 to the geriatric level. Those who participate in this will understand the skills required to adapt to ever changing clinical presentations with individualized treatment methods that will motivate and engage the patient.

Reducing Fall Risks

One of the reasons why patients tend to fall is their failure to manage postural control while performing various cognitive tasks. What they need to learn is how to steer clear of obstacles, walk symmetrically and remain upright. As researchers will tell you, patients fall for many reasons, so what IM does is provide recommendations to prevent this.

In addition, IM also provides you with an interdisciplinary approach for greater fall prevention. The exercises and therapeutic activities in the platform will address various issues involving the cognitive/communicative, vestibular, oculomotor, proprioceptive and musculoskeletal systems. At the same time, the activities put emphasis on rhythm and timing.

In effect what IM does is target the patient as a whole, so you aim for the timing deficit and ensuring falls are prevented. Research indicates that rhythm and timing integration in therapies provide benefits when it comes to remediating hemiplegia and gait. At the same time, IM enhances rhythm and timing with unique real-time feedback so timing is down to the millisecond.

This is maintained all through the program, and that leads to greater gait symmetry, reciprocal movement and better timing. For changes to be permanent after constant repetition, several components are required such as emphasis on cognitive effort, progressing from predictable and stable to more varied activities and exercises that will force the individual to adapt.
The IM program also provides repetitive practice apart from the ones used in standard therapeutic exercise. Finally, IM provides extrinsic and intrinsic feedback, something other therapy modalities cannot offer you, making it an efficient program.

What makes Interactive Metronome more attractive from the rest is the fact that you will be able to see improvements quickly and naturally, so this is good news for patients as this will encourage them to keep moving forward.


Description: This guide reveals the various lenses available and how to read an eyeglass prescription.


How to Choose the Right Lens for Your Glasses

The lens you choose for your glasses will determine how comfortable and helpful your eyeglasses are going to be. Today there are as many lenses as there are frame designs so choosing one can be difficult. The following information will explain the different types of lens available, and knowing what’s out there is going to help you make the right decision. The Benefits of Choosing the Right Lens Your choice should depend on these factors: safety, vision, comfort and appearance. Design, coatings and materials have to be considered as well. Bear in mind there are many different types of prescription glasses, with single vision lenses for astigmatism, farsightedness or nearsightedness. There are also progressive lenses, multifocal lenses for presbyopia and bifocals.

Materials for eyeglass lens consult your eye doctor for other options and what’s best for you.

  • Glass lenses: the earliest lenses were made of glass, and these are still available. They offer superior optics but break easily and therefore can pose a serious threat to your eyes.
  • Plastic lenses: lightweight plastic eyeglass lenses first came out during the late 1940s and were constructed from CR-39 plastic polymer. CR-39 weighs only half as much as glass, cheap and offers good optical qualities so it’s still popular today.
  • Polycarbonate lenses: during the 1970s, the Gentex Corporation began offering polycarbonate lenses for use on glasses. These glasses found wide acceptance and by the 1980s had become widely used, and still used today. These glasses were originally designed for use on helmet visors for the United States Air Force, for bulletproof glass and other applications. However, its reliability, safety and dependability made it ideal for use as eyewear, especially for children. It is lighter than CR-39 and has greater impact resistance, making it ideal not just for children’s eyewear but also for sports eyewear and safety glasses.
  • Trivex: introduced by PPG Industries in 2001, this is being touted as an alternative to polycarbonate as it is lightweight and with impact resistant features.
  • High-index plastic lenses: the past two decades has seen an increase in the demand for lighter and thinner eyeglasses, and this has led to the development of several high index lenses. Many of them are lighter, stronger and thinner than CR-39 because of their higher refraction index, which makes them attractive to many people.

What is the Index Refraction?

The refraction index, or refractive index of your lens material is a measure of how effective material bends, or refracts light, which is dependent on how fast light can travel in the material. To be more specific, the lens material’s refractive index is the speed of light’s ratio in a vacuum, divided by speed of light in the lens. For example, if the CR-39 plastic has an index refraction of 1.498, it would mean that light moves 50% slower in the CR-39 plastic compared to that of a vacuum.

The higher the refractive index of a material is, the slower light travels and leads to more bending / refracting of the light. The higher the refractive index, the less lens material is necessary to refract the light. The refractive index for lens materials today are from 1.498 (CR-39 plastic) to 1.74 (high index plastic). What this means is that lens constructed from CR-39 plastic is going to be the thickest available while the 1.74 lens will be the thinnest.

How to Read an Eyeglass Prescription

When you get an eyeglass prescription you’re going to see the words OS and OD with numbers under them. OS stands for oculus sinister, which is Latin for your left eye, and oculus dextrus for your right eye. Sometimes you will see OU instead, which means both eyes. To make it simple, the further the numbers are from zero, the more severe your eyesight condition is and the more correction is necessary. If there’s a plus sign on the number, it signifies that you are farsighted, and if there is a minus sign it means you are nearsighted. The numbers on your prescription are indicative of diopters, which is the unit used for measuring the focusing power or correction of the lens needed by your eyes. In prescriptions, diopter is usually shown as “D”.

Suppose your prescription reads -1.00: it means nearsightedness of 1 diopter, and it’s just mild. If the prescription says -4.25, that signifies your nearsightedness level is 4 and 1/4 diopters. This also means your nearsightedness is greater compared to -1.00 and therefore requires thicker lenses. The same is true if your prescription says +1.00, as that is just a bit of farsightedness whereas +5 is greater. If you are astigmatic, there will be three numbers and they will usually be written as S x C x Axis. The S here is in reference to the “spherical” part of your prescription, and is the degree of your farsightedness or nearsightedness as indicated above. The C on the other hand, refers to the astigmatism or “cylinder”. This can be negative or positive and is used to measure your astigmatism, also in diopters. The higher the number, the more astigmatic you are.

The axis mentioned in your prescription is going to be a number from 0 to 180 degrees and tells you the astigmatism’s orientation. A typical prescription for astigmatism will look like this:

  • -2.00 +1.50 x 180
  • +3.50 +3.00 x 45

In the first prescription, you have a nearsightedness of 2 diopters 1.5 diopters of astigmatism and 180 axis degrees. In the second prescription, you have .5 diopters of farsightedness, 45 degree axis and 3 diopters of astigmatism. These are just examples of course, but you should get a general idea of what they are and how they work.

Keep in mind that prescription for eyeglasses and contact lens are not the same, and if you’ve been given prescription for eyeglasses, you can only use that for glasses and not for contact lenses.. If you want those, a separate prescription and consultation will be necessary. This is very important and must not be confused.

Eye Testing

An eye exam doesn’t have to be daunting if you know what to expect. Learn what happens during eye testing and the options available for you. Optometrists perform different types of eye testing procedures, and these range from basic ones like reading from an eye chart to more intricate tests that involve the use of powerful lens for visualizing structures in the eyes. A simple eye test only takes a few minutes but a complex one can take up to an hour or longer, depending on what your optometrist feels is necessary.


What are Visual Acuity Tests?

These are usually the first test used to determine the sharpness of your vision. They are usually performed using an eye chart and a handheld acuity chart to gauge your distance and near vision respectively.

Color Blindness Test

This is a screening exam that assesses your color vision, and it’s usually done early during an eye examination to check for color blindness. Apart from sensing color vision problems, these tests also inform your doctor of potential eye health issues that could affect color vision.

The Cover Test

Optometrists use many tests to evaluate how well your eyes work together, but the cover test is the simplest and in many cases the most effective. During the test, your optometrist will ask you to concentrate your eyes on an object in the room. You will be asked to cover one of your eyes alternately while looking at the object. As you do this, your doctor will check if the eye that’s uncovered needs to move to look at the object. If that’s the case it could be indicative of lazy eye.


Retinoscopy is a test used for obtaining an eyeglass prescription. During the examination, the lights will be dimmed and you’ll be presented a target (most likely the letter E on a chart). As you look at the letter E, light will be shone in your eyes and lenses will be flipped in front of you. The doctor will assess the way light reflects on your eyes and from there give you an estimation of the prescription required. Retinoscopy is particularly helpful for kids or patients that cannot answer a doctor’s questions clearly.

Refraction Test

The refraction test is the method used by your doctor to determine the exact eyeglass prescription you need. During the test a phoropter will be used to figure out the prescription for your contact lenses or eyeglasses. When you undergo this test your optometrist will place the phoropter in front of you and give you several lens options, and you’ll be asked which of the lens pair looks clearest. Your answers helps your eye doctor fine tune the lens until the appropriate prescription is reached. Refraction is also used to assess your level of presbyopia, astigmatism, myopia (nearsightedness) or hyperopia (farsightedness).

Aberrometers and Autorefractors

Your optometrist may also use an aberrometer or an autorefractor to automatically assess your prescription. With both devices, your chin rest is used to keep your head stable while your eyes are focused on an image or light. An autorefractor is a device that determines how much lens power is necessary for light to center on your retina. These autorefractors also come in handy if young children are involved since they aren’t likely to keep still or interact with the optometrist to get a proper assessment.

Autorefractors are becoming more popular due to their accuracy and because they save a lot of time. Unlike other methods, an autorefractor only takes a few seconds, and the results minimizes the time necessary for your optometrist to evaluate and determine the prescription. An aberrometer on the other hand, utilizes sophisticated wavefront technology to sense even the smallest vision errors by assessing the way light moves in your eyes. The majority of aberrometers are used for wavefront or custom LASIK vision correction processes, but a growing number of optometrists use this device in their eye exams as it’s quite effective.

Slit-Lamp Examination

The slit lamp is a device your eye doctor will use to determine the general health status of your eyes. With this device, your doctor can see the structures in your eyes. The slit lamp, also known as a biomicroscope, offers a magnified and detailed look at your eye so your doctor can check for signs of disease, infection or injury.

During the examination your optometrist will put your chin on the slit lamp’s chin rest. The lamp’s light will be shone on your eyes while the doctor peers through a pair of oculars to examine your eyes. The eye doctor starts by checking the structures in front of your eye like the iris, conjunctiva, cornea, lids and so on. Using a powerful set of lens, your doctor will then examine the interior of your eye including the macula, optic nerve, retina and more. The slit lamp examination is useful for examining a wide array of eye diseases and conditions such as diabetic retinopathy, corneal ulcers, macular degeneration and cataracts.

The Glaucoma Test

There are several ways to test for glaucoma, but they all have the same purpose, and that is to gauge the pressure within the eyes. A tonometer is used to measure this pressure and determine if you have glaucoma or not. One of the more common tests is called “puff-of-air”, or non-contact tonometry (NCT). For the NCT, the exam begins with your chin being placed on the chin rest. You then look in the light in the machine, while the eye doctor or an assistant will puff air in front of your eyes. This isn’t going to hurt and neither will the tonometer make contact with your eye. Your eye’s resistance to the air will be used by the machine to calculate your intraocular pressure (IOP), and the higher the figure the more likely you are susceptible to glaucoma, or already have one.

If you think you have glaucoma and need to undergo eye testing, another option would be the applanation tonometer. This is an instrument usually set on the slit lamp, and for this exam, eye drops will be applied to your eyes. Your eyes will then feel heavy, and you’ll be asked to look into the slit so your IOP can be measured.


Sportsvision training offers athletes a way to improve their eyesight and performance. Uncover the methods used and benefits here. Sportsvision training and tests are designed to help athletes assess their eye’s performance but unlike a typical eye chart, the tests are more focused on enhancing athletic abilities. While athletes undergo intense physical training to prepare for a competition, these vision tests are just as important.


What are the Benefits?

These vision skill training programs are focused on several areas including the following:

  • Eye tracking ability: these tests include tracking and trying to anticipate the movement of a ball
  • Improving depth perception: this helps athletes that have to deal with obstacles and make turns like downhill skiers
  • Hand and eye coordination: this is especially useful for baseball players who have to hit fastballs

The different types of vision tests are used to determine how clearly an athlete sees and if necessary, improve their vision. Various types of vision tests exist and are determined by the needs of the athlete. Some of the tests might consist of the following.

The Snellen Eye Chart

The Snellen Eye Chart is a common eye test that involves reading letters from a distance of 20 feet. You will be required to read the letters that get smaller until you can no longer identify the symbols. Typically the 20/20 section are the letters fourth from the bottom. If you can read the next smallest, you have 20/15 vision, and if the letter before that, 20/25.

If you cannot read most of the letters you’ll need to wear contact lenses or eyeglasses, and in the cases of most athletes they usually undergo LASIK procedure to improve their vision. Problems with eyesight is far more common in athletes than is commonly believed and this can affect their performance. Even if you are a sports fan you can tell that athletes will benefit from improved eyesight.

Eye Tracking Devices

Today there are several methods that can assess and improve the way your eyes track objects that move. There are specially designed computer systems that will have your eyes following the movement onscreen. There are also mechanical devices that look like record players where targets move in specific patterns. These and other devices are all built for the same purpose, and that’s to improve your eyes’ ability to follow movement.

Contrast Sensitivity Tests

Athletes can also be tested to assess their contrast sensitivity. There are many ways this can be done, and one of the most common will have you identifying parallel gray stripes set on backdrops that slowly match the stripes’ shade. If you’re wearing eyeglasses or lenses these need to be cleaned regularly because dirty glasses affects contrast sensitivity.

Eye Dominance Tests

This method is used to determine which eye is dominant. Also known as the Miles test, it’s simple enough to do on your own. Make a triangular frame with your fingers and frame an area, and look into it. Close one of your eyes and repeat with the other eye. The eye that provides a clear view of the frame is your stable eye.

Knowing which eye is dominant can provide a lot of benefits. If you’re a photographer for instance, you always use your dominant eye when looking through the viewfinder. If you’re into sharpshooting competition, you do the same thing, to say nothing of other sports.

The Miles test isn’t the only one as there are other techniques that may be used such as the Doman method, whereby both eyes are required to focus on an object as it comes closer to you. When one of your eyes loses focus or diverges, the remaining eye is the dominant one. But if your non-dominant eye diverges too quickly, it could be a sign of binocularity or stereopsis and require medical attention.

Ocular Alignment Tests

These tests are used to determine how well aligned your eyes are and how effective they work together. During the test your doctor will use different methods such as covering one of your eyes to see how both react to visual stimulation. Afterwards, both of your eyes will be uncovered to determine how they react to the same stimulation.

Another method used to determine ocular alignment is the Hirschberg test, which determines how light is reflected at the cornea. By assessing the spots in the cornea where reflections take place, alignment problems can be diagnosed.

Depth Perception Measurements

Tests like the Howard-Dolman Apparatus are used to determine your ability to view objects in three dimensions. The device is shaped like a box with interior lighting, and during the test is positioned before you at eye level. You will be asked to look at a couple of black, vertical rods that you’ll have to manipulate using pulleys and strings.

These strings are connected to the rods, and you have to move them in various positions as directed by the examiner. What is being tested here is your ability to see where the rods are placed relative to one another. This exercise, along with the varying distances, determines your depth perception.

Other Eye Tests

There are also tests that determine how fast your eyes react upon seeing an object, and this visual input provides the stimulus for your brain to react (i.e., swinging the bat when a ball is pitched). There are also tests that determine how quickly you react when an object is dropped, and in these experiments your reaction time is determined by how far the object falls before you react and attempt to catch it.

As you can see these and other tests are very useful in training for various sports and improving hand-eye coordination. Another helpful test is the Saladin Near Point Balance Card, which is used to determine how well your eyes work together. The device checks how accurately each eye attains fixation on an object as well as how your eyes work together to gain accommodation (near vision focus).

Sportsvision training provides several benefits for athletes and can make a huge different in terms of performance. If you’re into sports, this is something you should look into.

Paediatric Optometry

Description: Does your child have eye problems that require treatment? This article explains what paediatric optometry is and which vision disorders can be treated.


An Overview of Paediatric Optometry

Paediatric optometry is a branch of optometry that focuses on methods for evaluating and executing tests to determine eye problems and pathological visual defects in children. To avoid confusion, the difference between optometrists and ophthalmologists will be explained below.

What is an Ophthalmologist?

An ophthalmologist is concerned with the study of visual perception illnesses and functional disorders, especially the seeing organ. Generally speaking, visual activity extends from the eye lid’s skin to the visual cortex in the brain. Ophthalmologists however, also do a lot of optometric measurements including those used for correcting astigmatism, farsightedness and shortsightedness. Children’s ophthalmology includes the use of measurements for assessing eye movement, eye parallax errors and near focus.

Every measurement used to determine what contact lenses to use are also those used in optometry. However, their primary purpose is medicinal treatment concerning pathological changes in the eye such as injuries, infection, cornea and glaucoma. What is an Optometrist? Optometry for children involves the measurement of the eyes and possible defects. Optometry is also concerned with the study of psychological optics, or the effects of optical corrections. To keep it simple, all the steps used in taking measurements in adults are also used in children.

There are several measurements that may be used on children such as sight acuity, subjective and objective evaluation concerning refraction or dioptric sight defect. If necessary, the refraction can be performed with the help of cyclopledic eye drops to turn near focus off. In several instances the “dropping in” is not required to determine  the cause of the visual defect.

An ophthalmologist relies on eye drops more frequently because they widen the pupil which is required for retina examination. An optometrist also does the same measurements to assess binocular sight and also determine other binocular ideal sight defects such as amblyopia, aniserkonia, heterophoria and squinting errors. Particularly important paediatric optometric measurements are accommodation and convergence. Paediatric optometrists provide several specialties, including writing and reading defects. During the measurements, the visual acuity of each eye is examined, and other aspects are covered. Among these are colormetry, pupil reaction, positive and negative relative convergence positioning speed and positive and negative relative accommodation positioning speed.

Optometry also covers accommodative, absolute and relative convergence, associated and dissociated phoria, eye mobility, color vision, contrast vision as well as stereopsis. Also included are objective and subjective dioptric deviances and binocular sight acuity. All the measuring results are performed to ensure the proper corrective measures can be taken. The process usually lasts from 45 to 60 minutes, though it can vary depending on the case.

When to Take a Child to an Optometrist

Your child should have an eye checkup regularly, but if the child complains of headaches, blurred vision, red eyes or sore eyes, it’s time to take him / her to an optometrist. To put it simply, any time your child feels there is something affecting their vision should require a visit to an optometrist. This is especially true if the child complains of continuous headaches or headaches brought about by activities. Finding an optometrist doesn’t have to be difficult especially if you know what you’re looking for. The first thing you should check is board certification. A board certified optometrist is someone who has completed an oral and written examination confirming their expertise in the field as required by the state where they practice.

Another way to verify this information is to consult your state optometrist association and check if that optometrist is part of the association. Because these state groups subject members to periodic checks, it provides assurance they meet all the state requirements.

Ask Your Doctor

Another option is to simply ask your doctor if they can recommend someone. Your doctor can also help clear up any confusion you may have concerning optometry and ophthalmology so you don’t make a mistake during the consultation.

Common Eye Disorders in Children

  • Amblyopia: also known as lazy eye, this condition results in reduced vision in one of the eyes due to pediatric cataract, refractive error or strabismus (misalignment of the eyes). If the condition is recognized during the preschool years, the disorder will respond to treatment. If amblyopia is recognize when the child is 9 or 10 years old, treatment will be more difficult. Symptoms include squinting in one eye, double vision, head tilting and poor depth perception.
  • Astigmatism: astigmatism results in objects appearing blurred, both near and far.  This is due to an uneven curvature in the cornea or lens, and this keeps light from getting into the child’s eyes, causing the blurring of vision. Astigmatism usually affects those with hyperopia (farsightedness) or myopia (nearsightedness).
  • Childhood Tearing: this is often noticed during infancy and is the result of tear drainage system blocking. Usually the tearing improves without treatment when the infant reaches 6 to 12 months, but if the symptoms persist, eye drops or surgery may be required.
  • Hyperopia (farsightedness): children afflicted with this disorder see objects far away more clearly compared to those nearby. Usually the farsighted eye is smaller compared to regular eyes, and this makes it hard for light rays to focus on the retina. Hyperopia may be inherited, and while most children are usually farsighted, this condition disappears as they grow, but in some cases it doesn’t.
  • Myopia (nearsightedness): this is the opposite of farsightedness in that the child can see objects nearby clearly but those far away appear blurred. Myopic eyes forces light from distance objects to focus before it can get to the retina, and this can result in the blurring.
  • Nystagmus: Nystagmus is a condition that leads to a rhythmic oscillation of the child’s eyes. These involuntary movements can cause the eyes to move rotary, up and down or side to side. This condition may be apparent at birth or it could be acquired later on.

The field of paediatric optometry is a broad one, and under the guidance of a skilled optometrist, your child’s eye problems can be treated properly and prevent the condition from deteriorating.