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How common are traumatic brain injuries

How common are TBIs? I’m Dr. Moshe Roth. I’m a neuro optometrist. I practice in Old Bridge, New Jersey.

According to the Centers for Disease Control, the CDC, an estimated 13 and a half million individuals live with a disability that’s caused by a traumatic brain injury in the US alone. Approximately half of all traumatic brain injuries are caused by a fall.

How does the TBI affect vision?

Well, there are more areas of the brain that process vision than any other system. The brain is essentially a vision machine. Most of the information we take in from the world around us is through our visual system. And in turn, our brain then directs our eyes to point where we want to look so we can take in more visual information.

That’s why a traumatic brain injury can often cause visual symptoms. A traumatic brain injury can disrupt the communication between the brain and the visual system, and interfere with the processing or making sense of that visual information that leads to blurred vision, reading difficulties, sensitivity to light and double vision among other symptoms.

Visual problems tend to be overlooked during the initial treatment of brain injury, especially with a mild TBI, such as a concussion or a whiplash.

A regular eye exam rarely identifies the extent that the visual process has been affected since the visual complication that developed are not related to visual acuity like 20/20, but rather due to eye teaming problems or eye focusing problems or tracking across the page.

If you’re experiencing post-concussion visual symptoms, there’s always the risk that they will become worse over time. Some patients notice visual problems, only when experiencing additional stress like illness or family or work stress, or when there’s a disruption to their normal routine.

A neuro optometric evaluation can determine both the severity of the impact of the TBI on your visual system and the treatment that’s required for your recovery. What treatment can a neuro optometrist offer? If you sustained a TBI, we at family eyecare and Old Bridge offer neuro optometric, vision rehabilitation, neuro optometric rehabilitation, or NOR is an individualized treatment regimen to rehabilitate the connection between the brain and the eyes and the visual system.

This therapy can minimize or even eliminate TVI related visual symptoms, weeks, months, or even years after the injury.

If you’ve had a traumatic brain injury or concussion, or have the symptoms that we’ve discussed, call our office, Family Eyecare in old bridge, New Jersey, we’re happy to answer any questions where to schedule for a neuro optometric assessment. You can reach us at (732) 679-2020. There are many pages that I’ve written on our website, We look forward to helping you.

Do you have to lose consciousness to have a brain injury

Do you have to lose consciousness to have a brain injury?

I’m Dr. Moshe Roth, I practice at Family Eye Care in Old Bridge, New Jersey.

A brain injury can be caused by even a mild hit to the head. A traumatic brain injury is a disruption and the normal function of the brain most are caused by a blow, a bump or a jolt to the head. You can have a TBI, even if you haven’t lost consciousness.

A concussion may seem trivial, but it’s actually a brain injury. Even if it didn’t cause a loss of consciousness, any brain injury can interfere with the brains visual pathways. It can cause a disruption in the brain and the eyes communicate properly. It can bring on many visual dysfunctions.

Studies have shown that 90% of TBI patients experienced some sort of visual disruption. These can bring on long-term and life altering consequences, including blurred vision, visual field loss and reading problems.

A very common symptom of traumatic brain injury is sensitivity to light. It can cause symptoms that are similar to dyslexia or to add or ADHD.

It can cause difficulties and knowing where somebody is in space and that can cause dizziness changes in posture and difficulty with balance.

Some individuals that have to tilt their head or turn their head in order to avoid seeing double.

Some brain injuries called traumatic brain injuries are caused by a motor vehicle accident, a blast due to an explosion, a fall, physical abuse or a sports related injury.

At times, what may seem to be a mild hit to the head can bring about changes that seem to be disproportionate to the injury.

Some injuries may bring on a brain bleed while others may not bleed at all.

It may not cause me symptoms may not appear for days or weeks TBIs and related visual symptoms must be taken seriously if you sustain even a mild head injury, but feel that you have a reason for concern, call us.

We can help determine the right course of treatment. Then we can prevent potential long-term damage. We can often offer help to get you back to being the person that you were before the injury.

How can we manage and control myopia (nearsightedness)

I’d like to explain how we can help to treat myopia. I’m Dr. Moshe Roth, I practice in old bridge, New Jersey.

Number one, if your child exhibits the symptoms of myopia like squinting, getting close to the TV, tilting, or turning their head, headaches after doing a lot of near work, all of those are symptoms of myopia then schedule an eye exam as soon as possible.

Undetected myopia can cause many complications, whether they’re academic or social or emotional.

Early diagnosis of myopia and other eye problems can improve your child’s performance at school or in sports.

And they can prevent serious sight threatening eye diseases that may occur later on in life.

If your child is diagnosed with myopia, we can help slow down the progression with myopia management and sometimes even reverse the process. We work closely with each family and customized treatment programs for each child based on their unique needs.

If you’re concerned about your child’s myopia, schedule an assessment for myopia management to see if they can benefit from these life-changing treatments.

Answers to myopia include orthokeratology, which is reshaping the front part of the eye while sleeping. It’s kind of like braces for the eyes.

Vision therapy helps retrain the focusing mechanism and the eye convergence mechanism.

There are special therapeutic eyeglasses and special myopia controlling soft contact lenses. Like MiSight and natural view.

Syntonic phototherapy is yet another natural way of therapy using light to stem the progression of myopia. Atrophy is a drug that we’ve used for a long time, but in certain concentrations it’s been shown to be effective in reducing the progression of myopia in our office.

We offer all of those. Some offices may offer some of those options. They may offer eyeglasses or soft contact lenses because that’s what they’re familiar with doing. Some offices offer atrophying because they’re used to, um, managing diseases with eye drops and different drugs.

But to learn about myopia management, where to schedule an eye exam, call us, you can reach us at (732) 679-2020.

Could a Low-Carb Diet Reduce Your Risk of Glaucoma?

A recent eye care study points to a possible connection between carbs and preventing glaucoma.

Recently, an eye doctor at the New York Eye and Ear Infirmary of Mount Sinai (NYEE) conducted a unique research study exploring the potential link between long-term dietary changes and preventing primary open-angle glaucoma (POAG). The study’s results indicated that if people at a high risk of developing glaucoma eat a diet that’s low in carbohydrates and high in fat and vegetable protein, they may lower their risk of this sight-threatening ocular disease by 20 percent. These results were published in Eye-Nature (July 22 issue).

Why are these results so significant?

Currently, glaucoma is the #1 cause of blindness in the United States, and primary open angle glaucoma is the most common type of this dangerous eye disease. Due mainly to elevated pressure levels inside the eye, POAG leads to optic nerve degeneration – causing vision loss.

Usually, patients experience no symptoms of POAG until the disease progresses, and visual problems motivate them to visit a nearby eye clinic for an eye exam. Regular eye exams by a qualified optometrist can detect the early signs of POAG way before vision loss occurs, but unfortunately, many people don’t visit an eye care provider until they notice a problem. In addition to routine eye exams, following a low carb diet may fortify people with another way to help prevent devastating vision loss.

How does the low carb diet affect eye health?

Eating foods that are low in carbohydrates and higher in fats and proteins causes the production of metabolites that are favorable for the optic nerve head, which is the specific site of damage in primary open angle glaucoma. Previous scientific studies have already linked this type of diet with positive effects on epilepsy, along with some promising results for Alzheimer’s and Parkinson’s disease.

While the low-carb diet cannot stop glaucoma progression in a patient who already has the disease, it may be a helpful way to prevent glaucoma in high-risk groups, such as people with a family history. Subsequently, the rate of vision loss due to glaucoma would be reduced.

Does a low-carb diet have the same effects as a ketogenic diet?

In the past, studies have demonstrated the protective effects that a ketogenic diet can have against neurologic disorders. (Ketogenic diets = extremely low-carb and higher-fat.). That’s because ketone bodies (energy compounds made by the body as it metabolizes fats) are used by the brain as a major energy source instead of glucose, and using more of these may enhance neurologic function and slow down neuronal degeneration. However, additional studies have shown that following a low-carb diet, not specifically ketogenic, may have similar properties for protecting against neurologic problems. And because a moderately low-carb diet is easier for most people to follow and doesn’t cause the same possible side effects of a ketogenic diet (e.g. headaches, abdominal issues, weakness, and irritability), it has been lauded as a more practical alternative.

How was the study on low-carb diets conducted?

The goal of the research study was to determine if following a low-carbohydrate diet for the long-term could have a positive impact on the optic nerve.

Your optic nerve transfers visual information from the retina to your brain, and it is located at the back of the eye. There is a large concentration of mitochondria (the major source of a cell’s energy supply) in the optic nerve. Because glaucoma is associated with dysfunctional mitochondria, researchers aimed to discover if substituting fat and proteins for carbohydrates would improve mitochondrial activity, preserve the function of the optic nerve, and prevent optic nerve degeneration in POAG (specifically, in a subtype of POAG with paracentral vision loss).

A large-scale study was formulated, involving 185,000 adults – female nurses and male health professionals between the ages of 40 – 75, between 1976 – 2017. Every two to four years, participants filled out questionnaires about what they ate and drank, as well as supplied information about their health condition. If they said they had glaucoma, the researchers followed up with their eye doctors to determine if they had POAG.

Data about the study’s participants was classified into three groups, based on how they achieved a low-carb diet:

  • Group 1 – Substituting animal-based fats and proteins instead of carbs
  • Group 2 – Substituting plant-based fats and proteins instead of carbs
  • Group 3 – Replacing carbs with high fats and proteins, regardless of the source

In the end, the results showed that people in Group 2 (increased plant-based fat and protein) were linked to a 20% lower risk of developing POAG compared to people who followed a high-carb diet. These findings suggest that vegetable sources may be beneficial than animal sources for a low-carb diet, with respect to lowering the risk of this subtype of open-angle glaucoma with paracentral vision loss.

What’s the take-home from this study?

First of all, eye doctors caution to remember that this was an observational study and not a clinical trial – so additional studies are needed to investigate the connection between dietary patterns and preventing POAG. Other issues, such as genetics, may also play a significant role. While it’s too early for optometrists to hang signs banning carbohydrates in their eye clinics, early findings do point to the eye care benefits of following a low-carb, plant-based diet. It’s time to stock up on legumes, avocados, nuts and tofu!

Many eye diseases can be quickly and easily diagnosed during a Comprehensive eye exam, Pediatric eye exam and Contact lens eye exam. If you were diagnosed with an eye disease, such as Cataracts, Astigmatism, Pink Eye or conjunctivitis Myopia or Nearsightedness , Glaucoma, Macular degeneration, Diabetic retinopathy, or Dry eye, you may be overwhelmed by the diagnosis and confused about what happens next. Will you need medications or surgery – now or in the future? Do I need Blue light lenses? Is LASIK eye and vision surgery an option for you ? Our Old Bridge eye doctor is always ready to answer your questions about eye disease and Contact lenses.

Book an eye exam at Family Eye Care eye clinic near you in Old Bridge, New Jersey to learn more about your candidacy for contact lenses and which type is right for you. Call 732-393-8636

Family Eye Care, your Old Bridge eye doctor for eye exams and eye care

Alternatively, book an appointment online here CLICK FOR AN APPOINTMENT


  • What exactly is glaucoma?

    Glaucoma is a condition in which the eye’s intraocular pressure (IOP) is too high. This means that your eye has too much aqueous humor in it, either because it produced too much, or because it’s not draining properly. Other symptoms are optic nerve damage and vision loss. Glaucoma is a silent disease that robs the patient of their peripheral vision. Early detection is very important.

  • How do I tell that I am developing glaucoma?

    The real tragedy behind vision-stealing glaucoma is that most people afflicted with this eye disease do not even realize they have it. As a result, the condition goes undiagnosed and untreated, which too often leads to unnecessary blindness. Of the 2.7 million people in the United States with glaucoma, half are undiagnosed. Most are lulled into a false sense of confidence because glaucoma often displays no symptoms in its early stages. By the time it begins to affect vision, any lost sight is impossible to regain. The risk of developing glaucoma begins to increase dramatically at midlife, which is why everyone should have a baseline exam by age 40. The most important concern is protecting your sight. Doctors look at many factors before making decisions about your treatment. If your condition is particularly difficult to diagnose or treat, you may be referred to a glaucoma specialist. While glaucoma is most common in middle-aged individuals, the disease can strike at any age, with those having a family history of the disease is especially vulnerable.

  • If one of my parents has glaucoma, does that mean I will develop it as well at some point?

    Having a parent with glaucoma does not mean that the child will automatically develop the condition too. However, those people with an immediate family history (parents, siblings) of glaucoma are at more risk to develop this disease. Patients should have a comprehensive eye examination each year to evaluate the health of the eyes and to look for signs of glaucoma. Some of these signs can be an increase in the pressure of the eyes as well as changes to the appearance of the optic nerve. Many times there are no symptoms noticed by the patient. If there is suspicion of glaucoma, more frequent visits to the eye doctor along with additional nerve testing are often required.

  • How often should I have my glasses prescription checked?

    Glaucoma is a condition in which the eye’s intraocular pressure (IOP) is too high. This means that your eye has too much aqueous humor in it, either because it produced too much, or because it’s not draining properly. Other symptoms are optic nerve damage and vision loss. Glaucoma is a silent disease that robs the patient of their peripheral vision. Early detection is very important.

How can a neuro optometrist help someone who has suffered a brain injury

How could a Neuro Optometrist help somebody who suffered a brain injury?

Whether it’s acquired like a stroke or a traumatic brain injury, like a car accident or a concussion, it could be discouraging to hear from other health professionals that there’s nothing to be done for lingering TBI symptoms.

Many professional professionals say, well, just sit in a darkened room.

The good news is that neuro optometrists can help people who’ve suffered a traumatic brain injury that few other healthcare providers can. Neuro optometry deals with the visual system and how it impacts daily function. Neuro means brain. So here we’re working on the brain. The eyes are the most direct way to get information from the outside into the brain. The brain then sends signals to the eyes where they should be pointing or how they should be moving. When we work on the brain through the visual system, so to communicate more effectively symptoms like dizziness and headache and nausea are significantly reduced.

We get our patients regain abilities by retraining the eye-brain communication.

Neuro optometric rehabilitation is like putting the tools back into the toolbox. After all the tools have been spilled out from the toolbox. Once that’s done, the individual can return to doing the things that they want to be able to do, and it could be life changing.

Children can then return to being able to play with their friends on the soccer field, or the basketball court.

Adults can then return to being the person that they once were and can be more productive at work. They could then return to being able to exercise and socialize. Returning to these activities can boost self-esteem and feelings of self-worth.

We understand the challenges that accompany a traumatic brain injury and how it can affect self-esteem call us schedule and neuro optometric evaluation so we can help you solve the visual problems that you have after you’ve suffered a brain injury. You can reach us at (732) 679-2020 or through our website..

A traumatic brain injury breaks a visual system

A traumatic brain injury breaks the visual system and self-esteem.

I’m Dr. Moshe Roth here practice Family Eye Care in Old Bridge, New Jersey.

Traumatic brain injury, or TBI often breaks the vital connections between the brain and the visual system and this brings on disabling symptoms.

People often have symptoms of blurred vision, double vision, difficulty reading, and dizziness. They may feel anxious and depressed and have low self esteem.

When somebody suffered some brain injury due to a car crash or a concussion or a stroke, they may no longer be able to do the things that they were able to do before. They may have recurring headings that require the individuals at the breaks frequently working or studying may be able to read only for five minutes or so. They may have chronic dizziness and this can lead to difficulty driving and making the individual dependent on others.

A child that’s suffered a TBI or concussion may not be able to play group sports for activities. They may then feel alone or different. That’s where we come. If you or a loved one suffered even a mild TBI, we can often help. We begin with a comprehensive eye examination and then a functional vision evaluation to determine what specific course of neuropathy metric rehabilitation will help you. A brain injury can cause double vision or eye tracking problems. Reading a book or catching a ball can then become a struggle and extremely frustrating. And then that can lead to someone who has suffered a brain injury to be upset or have lowered self-esteem or even being depressed and be alert to these signs, social withdrawal, persistent feeling of sadness and lack of interest in personal hygiene or appearance negative. Self-talk like I can’t, I can’t lack of motivation being irritable and moody, reduced appetite or lack of appetite, being very sensitive to light in the next video, I’m going to discuss how a neuro optometrist can help.

What are the risks of having a child wear contact lenses

In this video I’d like to address what are the risks of having a child wear contact lenses?

Hi, I’m Dr. Moshe Roth. I practice at Family Eyecare in Old Bridge, New Jersey.

A study published in the January 2021 issue of the journal of Ophthalmic and Physiological Optics found that kids aren’t at higher risk of experience, contact lens complications.

The study followed nearly as thousand children that were aged eight through 16, over a course of a year and a half to three years, to determine how contact lenses affected their eye health. The results indicate that age doesn’t have an effect on contact lens safety.

In fact, the researcher found that the risk of developing infections or other adverse reactions was less than 1% per year of wear, which is comparable to contact lens wearers of other ages.

But before you decide that contact lenses are the right thing for your child, you may want to consider whether your child is ready to wear them.

We’re going to ask questions like:

  • tell us about your child’s level of maturity
  • their responsibility
  • personal hygiene.

Since many children are highly motivated to wear contact lenses, they tend to display real maturity in caring for their lenses. But even with that at the starting point, parents may need to play an active role as their children, as a child gets used to inserting and removing the new contact lenses.

And it’s very common that after a few weeks and child asks to be able to do those things on their own. It’s important to note that just like with any other medical devices, contact lenses are not risk-free. Anyone who wears contact lenses has a chance of developing infections or other complications with contact lenses.

However, when warrants and cared for reporting to our instruction, contact lenses are low risk and perfectly safe for children and teenagers. So go ahead and schedule your child for a contact lens. Consultation will help to determine if your child is ready for contact lenses and we’ll answer any questions that you or your child may have just schedule. Call our office at (732) 679-2020. You can look at videos on our website as well. Thanks for listening.

Adult Testimonial of Using Multifocal Orthokeratology for Presbyopia

We’re here with EA who’s had her multifocal Ortho K lenses for a number of weeks. Now, a multifocal simply means that we’ve changed her cornea, the front part of the eye, so that she’s able to see a body at a distance and up close. We’re going to be making a slight modification in her left. Oh, she’s a pink, phenomenal sight. And her corneas are beautiful in a right eye. And we’re going to be doing this equally in her left. What I’d like you to do please is put into your own words how has this changed your life?

Before I had the orthok. I’ve worn glasses since I was in fourth grade. I couldn’t see distance at all. So I went, I started wearing contacts in high school, so I would go get you to my glasses and my contacts. I turned 40 last year and when I turned 40, I couldn’t see a plus anymore. So I would have to either wear reading glasses with my contacts, which then it became depended on or out of the were make lists and see them off to be able to read. So having the ortho K where I seek them out in the morning and I could read and see far with nothing has been life-changing because I was going around the house with my glasses, my reading glasses, and my contacts and lose everything and give myself headaches with their reading glasses. So it was not working. So definitely changed my life.

So this kind of has given you a lot of freedom, so you can, you can drive and you can work on your computer or read or do anything that you want to be able to do at both of those distances.


How have you worked this in? How easy was it for you to learn how to insert and remove and clean and disinfect?

It was very easy. They showed me at the office, like took them in and out a couple of times I went home that night and I have my setup at home with my towel on my dining room table with my mirror. And it’s, it’s very, very, very easy to recommend this for other people. Yes. I have actually told people about it because they can’t believe that they’ve never heard about it. Just like myself, where I came in. I never heard about it. I would absolutely recommend

This. Great. Thank you so much for sharing. Is there anything else you’d like to add?

I would just add, cause I have two children and I have genetic, I guess, eye problems in my family. For those with younger children to look into it because for myself, I had gotten Sylvia at risk for a retinal detachment, first of all. So you can get your children to wear them at a younger age. It’ll help stop that.

You’re absolutely right. And we have children as young as six that are in orthok. We’ve got patients that are in their seventies and everywhere in between. And yes, when we find a child that’s early on and starting to become more and more near-sighted ortho K is one of the best ways as a first step in starting to reshape the front part of the eye and to prevent that myopia or that nearsightedness from continuing. We call that myopia management, you can manage it. And, and most of our patients do phenomenally well and they don’t progress. They don’t get worse and yes, we can prevent things like retinal detachment and glaucoma and cataracts and myopic maculopathy. And those are changes that become more prevalent as somebody gets older. So if we can stem this as if it’s kind of like changing the washer instead of having to change the entire philosophy. Right. Great. Thanks so much for sharing.

Patient displays the benefits of yoked prisms

This patient shows how effective command can be on the same day.

While vision therapy can help bring a patient to develop the proper visual skills they need to cope with their underlying visual problem, yoked prisms are an amazing tool to get a person back to feeling normal again.

What is myopia and how can we prevent it from getting worse

In this video, I’d like to answer the question.

What exactly is myopia? Hi, I’m Dr. Moshe Roth. I practice at Family Eye Care in Old bridge, New Jersey.

Myopia is the medical term for near-sightedness. Near-sightedness simply means that somebody can see better at near than often a distance. Just think about this as two separate words: Near. Sighted. Somebody can see better at near.

How can you prevent myopia or slow down your child’s myopia?

Well, identifying myopia early can help slow progression and prevent serious eye disease later on in life. As a parent, here’s what you can do to help prevent your child from developing this eye condition. Bring your child in early for an assessment. We’re developmental optometrists. We have special training and expertise to identify the underlying reason for the myopia.

What’s the fire that’s producing that smoke?

Some suggest limiting the amount of time that your child spends at close work such as reading or homework or screen time, but realistically, that’s not going to happen. That’s just not practical.

Good computer work hygiene is important. Making sure that the computers properly positioned and take frequent screen breaks, addressing the over focusing problem is really important.

It’s important to remember the 20-20-20 rule; for every 20 minutes that you’re on computer. Take a 20 second break and look at something through a window that’s 20 feet or beyond a way, and that will relax your focusing mechanism. It is also good idea to encourage outdoor time released 90 minutes or an hour and a half a day. Preferably in the sunshine. Some doctors propose that as a way to prevent myopia. That’s a good idea because it gets kids to be physically active, but the doctors that propose that usually don’t understand that it’s not the outdoors that’s preventing the myopia, rather it’s limiting the amount of indoor use of the computer and other doing other near work.

Thank you for listening.