Don’t Trick Kids into Entering a Dangerous Yard

Trick-or-treaters will be taking it to the streets in their finest Halloween garb this coming Hollow’s Eve.

And while parents should be sure to debrief them with safety tips for their night of goody-collecting, it’s equally important that those manning the candy bowl back home do some safety checks of their own.

“There are plenty of easy ways to make sure your house is safe for the night’s special visitors,” said Dr. Anne Brayer, who directs Injury Free Coalition for Kids at Golisano Children’s Hospital.

Fire Safety: Candle-lit Pumpkins

Halloween is one of the top five days for home candle fires, along with four other holidays that come in the following two months: Christmas, Christmas Eve, New Year’s Day, and New Year’s Eve, according to research from the National Fire Protection Association (NFPA).

NFPA also reports that December is the peak time home candle fires, so r says its smart to start to teach kids candle fire safety around Oct. 31.

“Having working smoke alarms is one of the best ways to protect families against fires in the home,” she says. “This is a great time to buy fresh batteries for your home smoke alarms, and to remind kids of your family’s fire action plan.”

Of course, a battery-powered jack o’ lantern is always preferable to a real flame — but if families do decide to use candles to light up decorative pumpkins, they should be kept far away from decorations, drapes, other flammable materials and areas where children and pets will be standing or walking.

“More than half of all candle fires start when something that could burn, such as furniture, mattresses or bedding, curtains, or decorations, gets too close to the candle,” according to NFPA. So play if smart and keep a safe distance.

Clear the Yard of Leaves, Lawn Decor

Make sure trick-or-treaters avoid slips and related injuries by cleaning up hoses, toys, bikes, lawn decorations, or anything else they might trip over when walking to your house. Be sure to clear out wet leaves and any snow or ice that might be on the driveway or sidewalk near your house (just don’t leave the rakes or shovels in the way!).

Walkways and the door should be well-lit, too, so make sure any burned-out bulbs are replaced in advance.

“Drivers should also be especially careful on Halloween, too,” Brayer adds, “Especially when entering or exiting a driveway, since over-excited and often-distracted trick-or-treaters might be nearby.

Keep Pets Away From the Action

Even the friendliest pets can act out of the ordinary on Halloween. Unknown visitors and unfamiliar sights and sounds on Halloween can frighten dogs and cats, so it’s best to keep them inside and away from doors when trick-or-treaters approach homes.

In addition to directing the Injury Free Coalition for Kids of Rochester,

Dr. Brayer is an associate professor in the Emergency Department at URMC.

The Coalition is a child injury prevention program centered at the Golisano Children’s Hospital at Strong, and funded by the Robert Wood Johnson Foundation. The program’s main goal is to reduce the incidence and severity of childhood injury in the greater Rochester metropolitan area.

Runny-Nosed Kids: Is the Whole Family Doomed?

Aaaaaaaaachoooo!

If you’re living with a sniffly, sneezy tot, new research out of URMC bears some unpleasant news: You and fellow housemates are probably doomed to suffer through the same cold, too.

In fact, infectious disease expert Dr. Ann Falsey, who helped with the study, says that mere exposure to school-age children ups your odds of experiencing unpleasant cold symptoms (in the study, persons with lung disease who caught colds were more likely to suffer from runny noses, sore throats and coughs if they’d had contact with kids).

The study, which drew upon a databank of 1,000 samples of sputum and nasal secretions from people with chronic obstructive pulmonary disease, or COPD, recently published in the Journal of Clinical Virology. We spoke to Falsey to learn more.

Scripts: In your research, you point out that not everyone who catches a cold exhibits classic symptoms.

Falsey: That’s true. In everyday life, a good number of people have no symptoms, and are oblivious to the fact they’ve come down with a cold. In our study, more than one-third of the folks infected with a rhinovirus (the bug that causes most colds) showed had no noticeable symptoms. That might be because the particular virus is less severe (some are wimpier than others), or it might have to do with the host – that is, the person catching the cold. Maybe they’ve already developed immunity against the virus, so they’re more or less unaffected. Or maybe they have underlying health complications, like heart or lung disease, that make them more susceptible to more severe bouts of illness.

The real interesting piece, for us, was what happened when kids came into the mix.  Even when we controlled every other factor, having contact with kids singlehandedly predicted symptomatic colds.  In fact, folks with symptoms were about twice as likely to have had contact with school-age children as people whose infections didn’t become symptomatic. Maybe this is because kids, when sick, produce a much bigger “viral load” (they’re better breeding grounds for the bug). It may also be because their hand hygiene is less sophisticated. They put everything, including their fingers, in their mouths. They use their sleeves in place of tissues. Things like that.

Scripts: Indeed, kids are germ-factories. If one family member’s sick with a cold, what can you do to keep sickness from spreading to your whole house?

Falsey: It’s a challenge, for sure. Kids, like you said, are masters at propagating illness. The average infant will suffer eight to 10 colds before their first birthday (think about that as they blow out the candle!)

The best thing you can do is to wash your hands frequently, and be generous in applying alcohol-based hand sanitizer. Cold viruses love to hang out on door knobs, toys, and high-contact surfaces, so clean them often.

All this said, parenting is a full-contact sport. Kids will nuzzle runny noses into your shoulder.  They’ll cough without shame (and without covering). So you do the best you can.

Scripts: Understandable. If someone does fall ill, is there anything that will speed recovery?

Falsey: Only time, unfortunately. But you can make kids (or yourself) feel better as you heal. Hydration helps keep mucous runny, so drink plenty of water. Over the counter medicines can help adults with decongestion. Some studies even suggest a hot bowl of chicken soup – thanks the salty steam it releases – can sooth sore nasal passages.

The bottom-line: If you’re a parent, or spend lots of time with others’ tots, take heart – by the time the kids are ready for college, you’ll have built up immunity to just about everything!

Ann Falsey, M.D., is a professor of Medicine at the University of Rochester and an infectious disease expert at Rochester General Hospital. Falsey is a senior author of the aforementioned study, which was led by first author Anurag Gandhi, M.D., an infectious disease fellow at URMC.

Want more ways to shield your family from wintertime illness? Check out this recent interview with infectious disease specialist John Treanor, M.D. In int, he explains the power of flu shots — and squashes some common misconceptions surrounding them.

Banning Big Soft-Drinks: Expert Says It Could Work

New York City Mayor Michael Bloomberg’s ban on soft drinks bigger than 16 ounces found more solid scientific footing last week, thanks to number of newly published clinical studies linking sugar-sweetened drinks to thicker waistlines.

The plan to can too-large soft drinks (passed by the city’s Board of Health in September) cracks down on the sale of super-sized sodas, sports and energy drinks, sweetened teas, coffees and fruit drinks containing less than 70 percent juice.

But will the move ultimately make for a healthier city? Or will it just disgruntle thirsty Americans? For some insight, we spoke to pediatric cardiologist Rae Ellen Kavey. Daily, she and her team help obese kids make the lifestyle changes needed to wrangle run-away blood pressure, unhealthy lipid levels, and more.

Scripts: The city’s ban demonizes soft drinks bigger than 16 ounces. Why are we quick to point a finger at soda?

Kavey: For starters, because there’s a huge amount of sugar in it. 16-ounce soft drinks can pack more than 50 grams – that’s about 13 cubes, if you’ve ever tossed one or two in a cup of tea. Somehow, because we’re drinking them, the calories tend to be under-appreciated. To make matters worse, they’re “empty” – they offer no nutritional merit to offset all that sugar.

What’s more, there’s a considerable amount of evidence – including three new articles out just last week in the New England Journal of Medicine – suggesting that by limiting sugary drinks, we can help individuals lose weight (or avoid becoming obese in the first place). And in clinical practice, among families we work with, we’ve absolutely witnessed this firsthand.  Limiting your primary beverages to fat-free milk, water, and – if you must – diet sodas, is a powerful starting point.

Scripts: Do you think the ban, if left in place, will make New Yorkers healthier?

Kavey: It just might. Whether or not it’s within the mayor’s purview to be making such decisions is certainly up for debate – but there is science behind this kind of approach. We have research showing that limiting access (say, removing soda vending machines from schools) can be an effective way of shaping healthier habits. It doesn’t have to be a perfect roadblock to work. It just has to deter folks.

In that sense, as a physician, I’m thrilled that the ban – and the flood of news surrounding it – is creating such a powerful educational moment. It’s opening our eyes to soda’s excessive sugar content. It’s spurring conversations around the issue of portion size. But it can’t stop there.

Scripts: What more needs to happen?

Kavey: I think that we need to make clear that this isn’t just about soda. It’s about a whole class of drinks that are, for all intents and purposes, flavored sugar-water.

Take sports drinks. High school athletes and weekend warriors have no need for electrolyte-charged drinks in their duffel bags. A water bottle is more than sufficient, unless you’re a high-performance athlete training several hours a day. And fruit juice? Many people feel almost virtuous sipping a glass of orange juice with breakfast, or giving their kids “100 percent” juice. But at the end of the day, juice is essentially just sugar-water too. It’s a way to consume far more sugar than you would if you enjoyed fruit in its natural state. Case in point, a cup of orange juice packs the calories of three to four medium oranges. Can you imagine consuming that many in one sitting? If you want to have your fruit, eat it in its whole form, the way it comes on the vine, the bush, or the tree. You’ll get some satiating fiber, that way.

Dr. Kavey was a member of both the NIH Obesity Task Force and the American Heart Association’s Pediatric Obesity Working Group, and is past Chair of the AHA’s Committee on Atherosclerosis, Hypertension and Obesity in Childhood. She divides her time between clinical pursuits, mainly in preventive cardiology and the Children’s Heart Center’s exercise lab, and expanding the division’s clinical research program.

To learn more about the Children’s Heart Center at URMC’s Golisano Children’s Hospital, click here.

More Blame for BPA? Plastics Chemical Found in Heavier Kids

When we think of the drivers behind America’s obesity epidemic, sugar-laden beverages, such as soda and sports drinks, and too little exercise might come to mind. Efforts like First Lady Michelle Obama’s “Let’s Move” campaign are being implemented nationwide to help rein in the childhood obesity rate, which has tripled over the past three decades.

But parents beware – a recent study in the Journal of the American Medical Association adds another potential offender to the list: the chemical Bisphenol A, or BPA, commonly found in canned food, bottled liquids, and other consumer products. Researchers found that children and teens with higher concentrations of BPA in their body were more likely to be obese.

We asked Dr. Emily Barrett, a scientist (and parent!) who studies the influence of various chemicals on development, to shed some light on BPA and what the findings mean for moms and dads trying to raise healthy kids.

Scripts: Studies show that most of kids’ exposure to BPA is through food. Are we exposed mainly through canned goods and other packaged foods?  What about fresh fruits and vegetables?

Barrett: Food does appear to be a main source of exposure to BPA, and several studies have now shown that BPA levels drop when individuals avoid processed foods.  Many studies suggest that cans are a major source; the linings are often made with an epoxy resin containing BPA.

But BPA is probably lurking in a lot of other foods as well, since the food can be exposed to the chemical during processing. And unfortunately, environmental chemicals like BPA might even be found in foods that we typically think of as unprocessed, like fresh meats and dairy. That said, fresh fruits and vegetables are unlikely to be a major source of BPA and remain a smart choice.

Scripts: Why might higher levels of BPA be tied to obesity in kids and teens? And why was a link only found among whites – not blacks or Hispanics?

Barrett: At this point, we don’t understand much about the mechanisms by which current BPA levels might be connected with obesity, as most of the research so far has focused on prenatal exposures. One possibility, though, is that kids who are obese eat greater quantities of foods that are high in BPA, such as fast food, than slimmer kids.

Another possibility is that higher consumption of BPA might actually change metabolism in some way that promotes obesity.

Still, another possibility is that BPA is stored in and released from fat tissue, and since obese kids have more fat, the levels they excrete will be higher.  Further study is needed to better understand these possibilities.

As far as racial differences in the relationship, it may simply be due to different eating patterns and behaviors across cultures. It could also be due to genetic or metabolic differences, but again, more research is needed.

Scripts: What is your advice for parents raising kids and teens? Should they work hard to avoid foods containing BPA? Or should they focus more on common sense recommendations, like eating more fruits and vegetables and getting more exercise?

Barrett: The good news is that by following already tried-and-true recommendations, you’ll likely avoid foods that contain high levels of BPA. We know that highly processed foods tend to be bad for you nutritionally, and those foods are also more likely to have high levels of BPA. So, if you’re encouraging your kids to eat fresh, minimally processed foods, you’re already doing the right thing.

Parents who want to go a step further may think about reducing their use of canned goods – fresh and frozen alternatives are likely to be better for you, plus they taste better, too. They may also want to check their food packaging, plastic food storage containers, and water bottles; those marked with 1, 2, 4, 5, and 6 recycling codes are unlikely to contain BPA. Those marked with 3 and 7 might.  One final tip: Avoid putting plastics in the microwave, as they might release toxins under high heat.

Up to 80 percent of children who are obese remain overweight as adults, according to the National Institutes of Health (NIH). Learn more about child obesity in URMC’s health encyclopedia, linked here.

Emily Barrett, Ph.D., is an assistant professor in the Department of Obstetrics and Gynecology at URMC.

Back-to-School Checklist: Don’t Forget Eye Exam

Pens and pencils, notebooks and glue sticks are always on the back-to-school supply list; however, parents shouldn’t overlook one of the most important tools for classroom success – your child’s eyes.

The Centers for Disease Control and Prevention reports about 7 percent of all children have a diagnosed vision condition. Sadly, though, some children slip under the radar with undiagnosed disorders, leading to frustration in school, trouble with reading and paying attention. Only one in three children in America receives eye-care services before their sixth birthday.

The relationship between vision and learning is crucial, says Dr. Matthew Gearinger, pediatric ophthalmologist at the Flaum Eye Institute at URMC. We asked him to discuss proper eye health and share some tips to help parents spot warning signs.

Scripts:  How often should children have their eyes examined?

Gearinger:  A vision screening is usually included in the annual well-child checkup.  This is important for children of all ages.  If a pediatrician identifies a problem, he or she will recommend the child sees an eye doctor, or ophthalmologist.

Scripts: We’ve heard that a few seemingly innocuous behaviors might signal that a child’s vision is changing. What are the common, early signs that a child may need glasses?

Gearinger: Squinting, tilting the head, and sitting too close to the television are very common. Let me explain the trouble with each of these behaviors. Squinting is much like looking through a pinhole. Peeking through a hole reduces the size of a blurred image on the back of the retina and temporarily improves vision. So, squinting is a way of compensating for poor vision.

Tilting the head to one side can be a sign of an eye muscle imbalance or strabismus. Some children experience double vision when they look down or in a certain direction, and tilting the head minimizes the double vision. Sitting too close to the TV or lowering the head while reading is often a sign of nearsightedness. This is when people have clear vision at a close range but poor vision at a distance.

Scripts: Should parents be concerned if children frequently rub or cover their eyes?

Gearinger: Yes, because this is a sign of eye fatigue, which is related to many types of vision problems. Common complaints such as allergic conjunctivitis – usually a reaction to pollen that causes itchy and swollen eyes – can lead to vision impairment and should not be ignored.

In addition, when you see a child covering one eye to look at something – this could be a sign of something more serious. A child who covers one eye to read is simply shutting off the eye with the poorer vision so that it doesn’t interfere with sight. But an uncorrected vision problem in one eye can increase a child’s risk of developing amblyopia. Covering one eye can also be a sign of double vision caused by strabismus or a more serious but common medical problem, such as a cataract, which can be fixed.

Scripts: Once a child begins to read, are there more symptoms that teachers and parents should discuss?

Gearinger: Absolutely. The three most common things to watch for are headaches, losing their place while reading, and finger-pointing while reading. A child with uncorrected farsightedness will often get frontal headaches or brow aches. The pain is a result of exerting extra effort to clear blurry vision.

Skipping lines or losing your place while reading can indicate astigmatism or an eye muscle problem. Finger pointing while reading isn’t always a bad sign – we often see it as children learn to read independently. However, it can indicate an uncorrected problem such as amblyopia, where the eyes exhibit a crowding phenomenon. Letters or words seem very close together, making them difficult to recognize.

And one final thought: At the end of a long day, some children’s eyelids don’t completely close while sleeping. This is a condition called lag ophthalmus, which causes the eyes to dry out at night and excessive tearing during the daytime. The extra tears can interfere with good vision.

For more information about eye health, go the Flaum Eye Institute or call (585) 273-EYES (3937) to make an appointment.

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Sugar Tipping Your Scales? Try a Sweet Substitute

Americans consume far too much sugar in their daily diets. That may be old news – but recently the American Heart Association and American Diabetes Association suggested that artificial sweeteners might be part of the solution for those of us with a wicked sweet tooth.

Non-nutritive sweeteners are products such as stevia, aspartame, acesulfame-K, neotame, saccharin or sucralose. Although no one is saying they’re a perfect alternative, artificial sweeteners do cut calories by curbing a high intake of regular table sugar.

In light of the obesity epidemic (and tempting seasonal treats like snow cones and ice cream) we asked Dr. Steven Cook, a childhood obesity expert at Golisano Children’s Hospital and member of the American Heart Association, to explain how to swap alternative sweeteners with the real thing.

Scripts: When should we consider using alternative sweeteners?

Cook: People can consider using products containing non-nutritive sweeteners in place of full-calorie products. For instance, grab a yogurt with low- or no-calorie sweetener instead of a full-calorie one. Be careful not to compensate for those saved calories, though. It’s a trick a lot of us play on ourselves far too often — drinking a diet soda now and then using that as an excuse to get a candy bar later.

Scripts: Should I give my children alternative sweeteners?

Cook: Actually, I recommend steering clear of very sweet foods, regardless of what kind of sweetener is used, as often as possible. We develop our eating habits and palate in childhood. When children eat more healthy whole foods, they’ll most likely turn to healthier foods as adults. Instead of sweetened foods, try to give kids naturally sweet foods, like apples and carrots. But some sweetened foods are OK. The key is everything in moderation.

Scripts: How much sugar in a day is OK?

Cook: The AHA recommends that women eat no more than 100 calories a day in sugar, and men, no more than 150. Take a look at your food labels and you’ll see what a challenge that can be — and why the AHA and the ADA are recommending non-nutritive sweeteners to get those sugar-calories down to an acceptable level.

Scripts: Is cutting down on sugar really going to make a difference in my weight and health?

Cook: Yes, especially if you’re significantly above the recommended 100 or 150 calories from sugar. Sugar is essentially empty calories. Your body isn’t likely to need sugar, and it’s been shown to contribute to cardiovascular disease in addition to obesity. We’ve seen incredible results from families who cut down or cut out sugar-sweetened beverages and switch to water and skim milk. It takes time to see the results on a scale, but if you stick to it, the benefits are life-long. But be careful: Just because a product has low sugar content, doesn’t mean it’s healthy. Read labels and aim to meet the daily recommendations of vegetables, fruits, whole grains, dairy and protein. For more information on a healthy diet, visit www.choosemyplate.gov.

Dr. Cook is an associate professor of ediatrics. To contact him, call the Strong Pediatric Practice at 275-2821 or visit http://www.urmc.rochester.edu/childrens-hospital/general-peds/index.cfm.

 

Children and CT Scans: What Parents Need to Know

Kids end up in emergency rooms more than 17 million times a year and chances are doctors will order a diagnostic CT scan. But is the imaging test safe?

A recent, headline-grabbing study suggests that more imaging tests in younger years (and therefore greater, cumulative exposure to radiation) results in a higher risk of cancer later in life.

CT (computed tomography) scans use ionizing radiation to allow doctors to quickly see details inside the body – internal injuries, tumors, appendicitis, for example. The British medical journal The Lancet reviewed the records of nearly 180,000 people younger than age 22 who received scans between 1985 and 2002.  Later, 74 developed leukemia and 135 developed brain cancer — numbers that were higher than what would be expected in the general population.

Dr. Hans Blickman, radiologist-in-chief at Golisano Children’s Hospital, often helps worried parents sort through the scientific data and balance the pros and cons of tests involving radiation.

We asked him to share his insights on this complex issue.

Scripts:  The Lancet study, published earlier this month, generated a buzz. What are the most important things to understand about that research?

Blickman: There are two major issues. First, the data comes from CT machines that did not use dose-reduction software, which only became available in 2001. Newer technology allows us to use the safest level of radiation possible. And second, we already knew that excess ionizing radiation might lead to an increased risk of cancer – and yet this hasn’t been proven conclusively.

Scripts: Aside from that particular study, are there other concerns you are aware of?

Yes, as the use of imaging scans has climbed in recent years, so have the questions of possible harm. It’s important to understand the factors leading to more scans, though. They include, but are not limited to, fear of malpractice lawsuits and the need to avoid delays in diagnoses.

Complicating the issue is other news from studies suggesting that a third of all scans are unnecessary or could be replaced by safer tests, like ultrasound or magnetic resonance imaging (MRI), which do not use radiation.

Scripts: It makes sense that newer technology and greater awareness of diagnostic tests have come into play. Tell us more about what evidence to consider when faced with a quick decision to have a CT.

Blickman: First and foremost, parents need to know that in the past 10 years we’ve made huge progress in reducing radiation exposure for both children and adults. As I mentioned earlier, the British study was based on estimates of what radiation levels used to be before industry changes took place. 

URMC and many academic medical centers across the country have invested in upgrades to imaging equipment during the past five years, to comply with goals established by an “Image Gently” initiative from the Society for Pediatric Radiology.

The acronym ALARA is another guiding principle for our industry. It stands for As Low As Reasonably Achievable. It’s not only a sound philosophy, but it’s a regulatory requirement for all radiation safety programs.

When we open the new Golisano Children’s Hospital in 2015 the imaging suite will offer even more improvements, with the highest quality scans at the lowest dosing possible.

I’d like to add that most people don’t realize the radiation exposure from three to five chest x-rays is less than the exposure to naturally occurring radiation on a plane ride to Denver.

Scripts: That’s reassuring but some parents might still wonder: Can children safely avoid imaging tests altogether?

Blickman: Probably not. I recommend that parents have faith in their physicians while continuing to ask good questions about imaging tests and whether they are actually needed.  CT scans are very useful, but the circumstances will vary. If you have a child with a serious chronic illness, like lymphoma or another cancer, the number of imaging tests required will be greater than for a healthy child with an accidental injury.

Parents also should remind all doctors and radiologists involved in their child’s care about the frequency and history of imaging tests. Ask if the exposure is too much. With electronic medical records, calculating the cumulative exposure will be easier and more readily available. When doctors are ordering tests, this will help them decide if alternative tests might be a better idea.

Expertise in pediatric imaging is the key, and we are very fortunate to have a strong group at URMC.

For more information about pediatric radiology services, call (585) 273-1971 or visit: www.urmc.rochester.edu/radiology/procedures/procDetails.cfm?procid=8&id=8=

 

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A Weighty Matter: Heavy Kids

Despite the inescapable buzz around America’s “obesity epidemic,” research has shown that too few parents accurately appreciate extra pounds on their own kids.

What’s more, our “screen society” – rife with iPads, Nintendo, HDTVs – has made it all too easy for youngsters to live their lives sitting down.

And to add one more ingredient to this toxic mix, consider kids’ media. TV and web commercials have found a surefire formula from promoting “junk food” – just show cool kids and cartoon characters happily noshing on the questionable eats. (Don’t believe it? Name the last time you saw a cartoon character – besides Bugs Bunny – happily munching on a vegetable.)

As these forces collide, what does it mean for the nation’s youth? For one thing, a growing burden on their developing hearts. Last week, the White House Community Leaders Briefing on Cardiovascular Health drew dozens of experts from the national health care community – including pediatric obesity expert Dr. Stephen Cook – to discuss legislation, regulations and initiatives that the Administration  is implementing to help improve our nation’s heart health.

Since you, our blog readers couldn’t attend, we want to loop you into the conversation by sharing some of our work with the Greater Rochester Obesity Collaborative (which has been selected as a national model for obesity prevention and treatment), plus results from two studies Dr. Cook recently was involved in (which point out why many parents don’t realize their children are obese, as well as how obesity rates have mushroomed over the past three decades).

In the clip below, you also can hear Dr. Cook discuss how modern media messaging is shaping our kids’ food preferences.

Does 3D Gaming, Movie-Going Damage Young Eyes?

As 3D video games and films continue to dazzle young fans, some moms and dads worry if the technology poses risk for kids’ still-developing eyes and brains.

Fortunately, pediatric ophthalmologist Matthew Gearinger offers these parents peace of mind.

“I hardly believe that experiencing artificial 3D environments will prove problematic,” Dr. Gearinger said. “Children’s brains and eyes will have plenty of opportunity to mature normally, as they’ll be walking around in a real 3D environment for the lion’s share of their lives.”

To learn more about how our brains interpret 3D technologies – and if and how parents should limit 3D screen time – we spoke with Dr. Gearinger further.

Scripts: How do our brains interact with the 3D technology on screen to fake depth and dimension?

Dr. Gearinger

Gearinger: In the natural world, each of our eyes perceives a separate “picture” based on the angle between each eye and the given object (naturally, that angle is greater for nearby objects, and smaller for distant objects). This discrepancy – between the images that our left and right eyes register – is the secret behind what we commonly refer to as “depth perception.”

Typically, when traditional movies, video games and paintings inhabit a flat surface, there is no real depth to the objects – so our brain creates it, based on the relative sizes of the overlapping objects. Today’s 3-D technology, however, does one better – recreating the illusion of depth even more realistically by allowing each eye to view separate images – each taken at slightly different angles – through polarized glasses. The moment you slip off your glasses, though, the screen looks blurry – after all, you’re viewing two different pictures at the same time.

Sometimes, people will experience visual unease (fuzzy vision, headaches) because of the mismatch between perceived depth and actual depth. Let me explain. Typically, as a natural object approaches us, our eyes turn in (converge or cross). At the same time, as a reflex, we unconsciously shift our degree of “optical power” to better focus in on the object. In an artificial 3D experience, however, our eyes still turn in – but there’s no need for the real-life reflex of changing “optical power,” as the object never moves from the screen.  Decoupling this “converging” and “optical power shifting” can be exhausting; the brain has a hard time resisting its normally programmed behavior.

Scripts: How much 3D TV or gaming is too much, in general? And is it important to take breaks while playing or watching 3D programs – and if so, how often?

Gearinger:  Honestly, the real evils attributed to “too much” 3D television or gaming are probably linked more to the resulting lack of physical activity – and the lack of varied intellectual stimulation – than any problem or potential threat to the eyes.

That said, I do see some kids who qualify as heavy screen-users, and they can suffer from dry eye. They concentrate so hard on the visual task at hand that they actually forget to blink! Taking breaks can certainly help.

Scripts: So, bottom line – do you think 3D is here to stay?

Gearinger: 3D technology definitely seems to be a trendy add-on for movies, TV, and games, and it can really enhance the viewing experience (one caveat, though: It does tend to dim the brightness of the images, as each eye is only getting half of the light). Overall, though, it shouldn’t cause visual problems in the majority of consumers.

More about Dr. Gearinger

Dr. Gearinger’s passion for improving the vision of children is the driving force behind his daily research and clinical practice. In the Flaum Eye Institute’s pediatric wing, he treats patients suffering from a variety of conditions ranging from pink eye, blocked tear ducts and blurred vision, to  pediatric glaucoma and congenital cataracts. He has treated adults with misaligned eyes, and even performed surgery on one-week-old infants.

To learn more about pediatric ophthalmology care at URMC, click here.

To Grandmother’s (Dangerous?) House We Go

Later this week, holiday travels will draw families together for sumptuous feasts, giggles, gift exchanges and more.

And with so many loved ones milling about – crowding kitchens, sipping wine and getting caught up in the holiday cheer – it’s not uncommon the littlest guests to sneak off and find their way into trouble.

“We see too many toddlers suffer injuries while visiting grandparents, or while at holiday gatherings where their parents are otherwise distracted,” says Dr. Anne Brayer, an emergency department pediatrician at the University of Rochester Medical Center, who also co-directs the local Injury Free Coalition for Kids chapter.

So, how do you keep curious little fingers from finding danger – especially in a non-child-proofed home? Brayer offers the following tips:

• Before settling into the fun with friends and family, quickly scan the room that youngsters are in. Don’t let the munchkins toddle off without having made sure there are no open outlets, electric cords, or easy-to-swallow items in reach. Also pay special attention to pointy-edged coffee tables, wall corners that jut out, or any other sharp objects an infant could bump her head on – and watch out for kitchens, bathrooms, and other cabinets that might hold cleaning supplies.
• Don’t leave children without an adult. Well-meaning cousins or other grade-school-aged friends might not recognize potentially risky situations. What’s more, they often get so carried away in amusing one another, they forget to make babies’ and toddlers’ safety their first priority.
• Monitor a child’s interaction with pets. Little ones might be tempted to grab Fluffy’s tail, or even try to climb Fido, causing some pets to lash out. “Dog bites are especially problematic this time of year, since many dogs who aren’t used to toddlers horsing around the house,” Dr. Brayer warns. Even subdued pets can easily knock over little ones.

Remember, no one wants to spoil a holiday with a trip to the emergency room (or worse, carry the guilt of having a little guest injured at their house!) – so while it may seem cumbersome to pay extra attention to youngsters and prepare the house for their arrival, make the effort! It’s time well-spent.

Wishing you a most safe and happy holiday season!

Scripts will not publish next week, but returns Wednesday, Jan. 4. Happy New Year!