Dr. Curtis Baxstrom

Articles of Interest:

Calgary Vision Event 2015 – Dr. Curtis R. Baxstrom

Vision Therapy with a Vestibular Twist

Saturday, 1445-1645

Download: CVE – Baxstrom – VT with a Vestibular-Motor Twist

  1. Overview of Vision and Vestibular Processing
  2. Vestibular anatomy and physiology
    1. Central and Peripheral Processing
    2. Semi-circular canals-rotational stimulation, arousal
      1. Effects upon pairs of EOM
    3. Otoliths-linear stimulation, calming
      1. Effects upon all EOM
    4. Combined
  3. Vestibular development
    1. Development of VOR gain and motion processing
  4. Specific functions of vestibular processing-Herdman
  5. Evaluation of vestibular processing
    1. Case history
    2. Observations
    3. Dynamic visual acuity
    4. Disequilibrium Evaluation Form
    5. Visual examination
  6. Vestibular Dysfunction
    1. Disequilibrium/Dizziness
    2. Inner concussion syndrome
    3. Benign paroxysmal positional vertigo(bppv)
    4. Others
  7. Management of Vestibular Dysfunction
    1. Spontaneous recovery
    2. Vestibular adaptation
    3. Substitution
    4. Habituation
    5. Medication and surgery
    6. Optical considerations
  8. Vestibular treatment considerations in vision therapy
    1. Position of patient
    2. Support of patient, foundational surfaces
    3. Adjunct tools
    4. Visual input-eyes open or closed, lenses, prism, occlusion
    5. Linear stimulation
    6. Rotational stimulation
    7. Variables-head position, speed, range, fixations, repetition
    8. KEY-therapeutic value
  9. Vision therapy applications
    1. Can you separate visual and vestibular processing?
    2. Arousal, attention and modulation
      1. Processing speed
    3. Eye movements
      1. EOM control-DEM
      2. Range of movement for paresis
      3. Gaze palsy
    4. Binocular vision
      1. Suppression, Phorias, Ductions
      2. Strabismus
      3. Convergence spasm
    5. Unilateral Spatial Inattention
    6. Nystagmus
  10. Summary Overview

Looking at the Ends of the Strabismus Spectrum-Infantile Esotropia and Paresis/Palsy of EOM

Sunday, 10:30-12:30

Download: CVE – Baxstrom – Infantile Esotropia-Paresis EOM 2

  1. Overview
  2. Strabismus-overview
    1. Accommodative
    2. Non-Accommodative
    3. Others
      1. Infantile esotropia
      2. Strabismus from paresis/palsy of EOM
  3. Infantile Esotropia
    1. Origins of infantile esotropia
    2. Review of the literature
    3. Evaluation of infantile esotropia
      1. Abduction deficit
      2. Motion processing asymmetry
    4. Traditional medical treatment
      1. Surgical treatment
        1. Benefits and side effects of early surgery
      2. Nonsurgical treatment
        1. Monocular patching
        2. Prism
        3. Sector occlusion
    5. Developmental Aspects
      1. Spontaneous recovery
      2. Why 3-4 months of age are critical for early diagnosis
      3. Addressing causes vs. symptoms
        1. Abduction deficit and cross fixation pattern
    6. Optometric approach
      1. Binasal occlusion
        1. Disrupt cross fixation pattern
        2. Promote abduction
        3. Abducting eye should lead localization
        4. Promote motion processing
        5. Motor and sensory dysfunction
    7. Abduction therapy
      1. Pursuits
      2. Saccades
      3. OKN/Motion processing
      4. VOR
      5. Overview of Ron, et.al. studies on EOM
      6. Vergence therapy with release
      7. Cranial Osteopathy and Petrosphenoidal ligament(Gruber)
    8. Case Examples
    9. Summary overview
  4. Beyond Diagnosis-The Rehabilitation of Ocular Motor Paresis/Palsy
    1. Introduction
    2. Causes
    3. Effects of treatment or no treatment
      1. Atrophy
      2. Contracture
      3. Muscle loss
    4.  Testing
      1. Monocular ROM
      2. CT all 9 gazes
      3. Parks 3 Step
      4. Hess-Lancaster testing
      5. Spreading of commitance
    5. Special considerations for patient
      1. Patient needs
        1. Safety during mobility and ADL’s
        2. Recovery of function
      2. Patient vs. Rehab team vs. OD goals
      3. Rehabilitation vs. Compensatory vs. Combined approaches
    6. Medical treatment
      1. Unilateral patching-for diplopia management
      2. Wait and see
      3. Surgery
    7. Optometric considerations for treatment
      1. Selective vs. Full occlusion
      2. Guidance and rehabilitation
        1. Extend monocular ROM
        2. Extend binocular ROM
      3. Compensatory prism
      4. Combining approaches
    8. Case Presentations
    9. Summary Overview
      1. Start as early as possible
      2. Improve ROM, control diplopia with selective occlusion and/or prism
      3. Remove prism overtime
      4. Surgical considerations