​​​​​​​​​​​​​Effects of Ambient Prism Lenses and Visual-Motor Training on Heart Rate Variability

and Behavioral Outcomes in Autism

​Dombroski B, Kaplan M, Kotsamanidis B, Edelson S, et al. (2014)

We rely on our sense of vision to gather information about our surroundings, read directions, recognize familiar faces, and numerous other activities. Vision can be classified into two main types. The first, focal, is conscious and allows us to see objects in high-resolution color. At the doctor's office it is focal vision that is tested and given a score, sometimes resulting in the prescription of corrective lenses for near- or - farsightedness. The other type of vision is known an ambient vision, which is largely non-conscious and us used in spatial orientation and depth perception. Unlike focal vision, which is restricted to two degrees of visual field, ambient vision involves the entire visual field and integrates with other sensory systems to determine one's position in space. Deficits in this ambient vision system could clearly cause confusion, disorientation, and stress. In fact, such deficits have been linked to autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and other developmental disorders by previous studies.


​​Applied Psychophysiology and Biofeedback 39(3-4):306-306. November 2014


Behavioral Changes in Autistic Individuals as a Result

of Wearing Ambient Transitional Prism Lenses

​Kaplan M, Edelson, SM, Seip JA (1998) Child Psychiatry and Human Development, 29 (1): 65-76.

Abstract: A double-blind crossover design was used to assess the efficacy of wearing ambient lenses to reduce the behavioral symptoms of autism. Eighteen autistic individuals, ranging in age from 7 to 18 years, participated in the study. Behavior, attention, and orientation were evaluated at 1 1/2 months, 2 months, 3 months, and 4 months. Compared to the placebo condition, the results showed a decrease in behavior problems at the 1 1/2 and 2 month assessment periods and a slight loss of these benefits at the 3 and 4 month assessment periods. These findings support the prediction that ambient lenses, worn without engaging in visual-motor exercises, have positive effects on autistic individuals.


​      Postural Orientation Modifications in Autism in Response to Ambient Lenses
Kaplan M, Carmody DP, Gaydos A (1996). Child Psychiatry and

                                                                       Human Development, 27 (2),  81-91.

Abstract: Autistic children often display abnormal postures, head tilts, and other spatial management dysfunctions. Methods were introduced to measure spatial orientation in tasks in a group of fourteen autistic children in Montreal, Canada. Ambient lenses were found to improve posture, correct head tilts, and improve ball catching abilities. A model of spatial orientation is described and recommendations are made to incorporate ambient lenses in treatment programs.


Strabismus in Autism Spectrum Disorder
            Kaplan M, Edelson SM, Rimland B (1999). Focus on Autism and Other Developmental Disabilities, 14(2): 101-105

Abstract: Two studies of strabismus ("crossed eyes") in children with autism are reported. A clinical optometric evaluation of 34 individuals with autism, ages 7 to 19 years, found a strabismus rate of 50% and a parent survey of 7,640 families of children with autism found an incidence of 18% (compared to 2-4% in the general population).


Abnormal Saccadic Eye Movements in Psychiatric Patients as

Part of a Spatial Management Disorder
            Carmody D, Flach F, Kaplan M, et al (1994). Studies in Visual Information Processing, 5: 243-253.

Abstract: Abnormal saccadic intrusions for psychiatric patients during smooth pursuit tasks have been frequently reported in the literature. In this study, 26 schizophrenic, 23 affective, and 8 miscellaneous psychiatric inpatients were compared to 60 controls for smooth pursuit and convergence tracking abilities. Saccadic intrusions occurred far more frequently for psychiatric patients than for controls in both tracking tasks. The findings are consistent with a model proposed by Flach and Kaplan (1983) that psychiatric patients have a spatial management disorder which adapts poorly to motion and interferes with the accurate appraisal of distances and locations.


                             Visual Perceptual Dysfunction in Patients with Schizophrenic and Affective

                                                                   Disorders Versus Control Subjects
                             Flach F, Kaplan M, Bengelsdorff H (1992). Journal of Neuropsychiatry and

                                                                 Clinical Neurosciences, 4 (4): 422-427

Abstract: Visual perception was evaluated with standard tests for 26 hospitalized patients with schizophrenia, 23 hospitalized patients with affective disorders, and 60 control subjects. Both patient groups differed significantly from the control group on low amplitude of accommodation, esophoria or exophoria, vergence duction suppression, and convergence and divergence recovery ductions. Only the affective group showed significantly reduced fusion at near distance, and only the schizophrenic group differed significantly from control subjects on disorganized left apex formation. These findings appear to confirm the presence of visual perceptual disorders that can cause disability in psychiatric patients, with important research and rehabilitation implications.


An Optometric Approach to Motion Sickness
           Kaplan M (1975). Optometric Journal of Revised Optometry, 112, (9), .

                                                                                                    READ MORE>

                                                    Visual Perceptual Dysfunction in Psychiatric Patients
                                       Flach F, Kaplan M (1983). Comprehensive Psychiatry, 24 (4) 304-311.

Abstract: Subjectively experienced alterations in visual perception are commonly seen in various psychopathologic condition- visual hallucinations in schizophrenic disorders and organic brain disease, concentration impairment accompanying anxiety states and states of depression, and reactions to spatial relationships in phobic states such as claustrophobia. Nonetheless, direct investigation of perceptual capacity as it may relate to psychiatric disturbance has not been extensively carried out. Mialet and Pichot did suspect that a central nervous system imbalance might be present in schizophrenic patients, reflected in abnormalities in eye tracking movements. Two kind of eye movements are normally made in the foveal tracking of targets: saccades and smooth pursuit eye movements. The former are fast, ballistic movements that bring the fovea to the target. In one study they demonstrated that of twenty-seven schizophrenic patients, three failed to track all together; of the remaining twenty-four they noted a significant increase in saccades during tracking in contrast to non-schizophrenic subjects.


                                                                           Recognition and Rehabilitation
                            Kaplan M (1984). The Role of Optometry in Psychiatric Rehabilitation, 1 (1).

Abstract: For many years, traditional psychologists, educators and vision specialists viewed visual perception as a passive process, mainly depended upon the stimuli reaching the sense organs. Today we believe that visual perception is not passive, but rather is a group of active processes coordinated by the cerebral cortex.

                                                                                                Gaze Control

 Abstract: Autistic children often display abnormal posture such as toe-walking, arching of the back, and hyper-extension of the neck, as well as abnormal use of face to face gaze in social and affective relationships, head tilts, and looking from the corners of eyes. Such dysfunctions often interfere with the child’s ability to attend to social stimuli, including attempts made by therapists, teachers, and caretakers. Play, school, and family interactions are compromised by the visual dysfunctions which prevents the child from experiencing an integrated visual percept of events and objects in their environment. When severe enough, children lose track of their own position in space, compromising their posture, as well as recognition of the consequences of their own actions.


​To test the benefits of ambient prism lenses and visual management, our institute has conducted several scientific studies over the last three decades. We feel strongly in providing not just exceptional clinical care, but objective clinical research allowing us to provide optimal solutions for our patients needs.

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