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This article continues discussion of optometry faculty at Pacific University in the early 1970s. Part 1 profiled Charles Margach, O.D., M.S., Colin Pitblado, Ph.D., and Don West, O.D.; Part 2 presented notes on John Gerke, Ph.D., Margaret Gilbert, Ph.D., Mort Gollender, Ph.D., Leonard Levine, Ph.D., Jurgen Meyer-Arendt, M.D., Ph.D., Theodore Oakberg, Ph.D., Oscar Richards, Ph.D., and Frank Thorn, Ph.D.; and Part 3 provided brief bios of Bradford Wild, O.D., Ph.D., Earle Hunter, O.D., and Richard Septon, O.D., M.S.1-3 Considered first in this part will be some of the optometrists whose instructional duties were mostly in the classroom and laboratory. The latter part of this article will present notes on a few of the part-time faculty who worked in the clinic.

Background: Use of the flexor hallucis longus (FHL) tendon is well described for several tendon augmentation procedures. Harvesting the FHL through an open medial approach is commonly done, but is associated with anatomic risks. Recently, several authors have described a minimally invasive (MI) technique to harvest the FHL tendon utilizing a hamstring tendon stripper commonly used in ACL reconstruction. The purpose of this study was to evaluate the safety and effectiveness of harvesting the FHL tendon using this novel minimally invasive retrograde approach. Methods: The FHL tendon was harvested through a transverse plantar incision over the interphalangeal joint of the great toe in 10 fresh-frozen cadaver lower extremities. A lateral-based incision for peroneal tendon repair was made and the FHL was retrieved. Tendon length, complications, and interconnections between the FHL and flexor digitorum longus (FDL) were recorded and classified. The specimens were then dissected by a single surgeon in a standardized fashion, and damage to any surrounding structures was recorded. Results: The average length of the FHL tendon from the distal stump to the first intertendinous connection was 13.3 cm (range 8.8-16 cm, SD 2.3 cm). Eight cadavers demonstrated Plaass type 1 interconnections whereas 2 demonstrated type 3. There was no injury to the medial and lateral plantar arteries and nerves, plantar plate, or FDL tendons. One FHL tendon was amputated at the level of the sustentaculum during graft harvest. No injury of the medial neurovascular structures occurred with retrieval of the FHL tendon through the lateral incision. Conclusions: We found that care must be taken when approaching the sustentaculum with the tendon harvester in order to avoid amputation of the graft against a hard bony endpoint. Additionally, flexion and extension of the lesser toes could aid in successful tendon harvest when tendon interconnections were encountered. Clinical Relevance: Using this MI technique appears to be a safe and effective way to obtain a long FHL tendon graft for tissue augmentation.

Background. Treatment options after failed total ankle arthroplasty (TAA) are limited. This study reports midterm outcomes and radiographic results in a single-surgeon group of patients who have undergone ankle arthrodesis with intramedullary nail fixation and structural allograft augmentation following failed TAA. Methods. A retrospective review on patients who underwent failed TAA revision with structural femoral head allograft and intramedullary tibiotalocalcaneal (TTC) nail fixation was completed. Foot Function Index (FFI), American Orthopaedic Foot & Ankle Society (AOFAS) outcome scores, and radiographs were obtained at each visit with 5-year follow-up. Results. Five patients were followed to an average of 5.2 years (range 4.7-5.6). Enrollment FFI was 34.82 (range 8.82-75.88); at midterm follow-up it was 20.42 (range 0-35.38). Enrollment AOFAS scores averaged 66.6 (range 61-77); at midterm follow-up it was 70.33 (range 54-88). Radiographs showed union in 4 of 5 patients at enrollment and 2 of 3 patients at midterm. Conclusions. Utilization of TTC fusion with femoral head allograft is a salvage technique that can produce a functional limb salvage. Our results show continued improvement in patient-reported outcomes, with preservation of limb length and reasonable union rate. Levels of Evidence: Therapeutic, Level II: Prospective, comparative trial.

Background: Lesser toe metatarsophalangeal joint (MTPJ) instability, secondary to plantar plate tear, has been the focus of numerous recent publications, the majority reporting on repair through a dorsal approach. A plantar approach has been described with the advantage of direct ligamentous repair or repair to bone, which follows conventional techniques employed throughout the body. Previous clinical studies have shown success in deformity correction and the longevity of both approaches. The proponents of the dorsal approach advocate that indirect repair of the plantar plate avoids perceived risks of complications with a plantar incision without evidence of superior outcomes. The purpose of this study was to investigate the safety and efficacy of the direct plantar approach to plantar plate repairs (PPRs) by reporting the rate of specific complications in a large clinical series. Methods: This was the institutional review board (IRB) approved retrospective study of 204 PPRs in 185 patients (194 lesser MTP, 10 hallux MTP) with an average age of 56 and a mean body mass index (BMI) of 28. Surgical technique involved repair with absorbable braided suture (88%) versus suture anchor (12%) with or without MTPJ pinning (80%). Mean follow up was 53 weeks (range 5–170). Patients were screened for associated risk factors, including diabetes mellitus (8%), tobacco use (5%), neuropathy (1%), and additional concurrent procedures (96%). Complications were defined as superficial or deep infection, painful scars, and reoperation. Analysis was conducted using the Wilcoxon-Mann-Whitney test or Fisher’s exact tests for continuous and categorical variables, respectively. Risk factors were analyzed using univariate logistic analysis to produce odds ratios (OR) with a 95% confidence interval (CI) and an inclusion criterion of a P-value, P > .2 for multivariate analysis as determined by Wald tests (significance at P < .05 for final modeling). Results: Overall, there were 31 total complications (15%) demonstrated by 14 superficial infections (6.8%) and 17 painful scars (8.3%) along with three reoperations (1.4%). All reoperations were performed for deformity or instability, not scar revision. There were no deep infections. No increased odds of complications were found with suture anchor repair, MTPJ pinning, neuropathy, or diabetes. Patients that used tobacco had 7.5 (CI 1.66, 34.06) the odds of developing any wound complication compared with nonsmokers. Tobacco use was also found to significantly increase the odds of superficial infection by 9.8 (CI 2.08, 46.15). There was no increase in painful scars or reoperation in tobacco users. This study did not find an increased complication rate with additional ipsilateral procedures performed at the time of surgery. Conclusion: To our knowledge, this is the largest study evaluating the direct plantar approach to PPR as well as the evaluation of associated complications with the plantar incision. With low complication and minimal reoperation rates, the results of this study have demonstrated the clinical viability of plantar-based incisions. Previous studies have demonstrated the success of PPR and correction of deformity with a direct approach. This case series further demonstrates the safety and efficacy of plantar-based incisions, particularly for direct PPRs. Level of Evidence: IV Retrospective Case Series Category: Lesser Toes

This paper gives an account of the history of the Optometric Historical Society (OHS), based on material in its quarterly publication, variously named Newsletter of the Optometric Historical Society (1970-1991), Hindsight (1992-2006), and Hindsight: Journal of Optometry History (2007-present). Operated as an independent organization for many years from its founding in 1969, the OHS became a part of Optometry Cares – The AOA Foundation in 2012. In addition to its publication, now totaling more than 3,300 pages since its inception, the OHS has also held meetings referred to as Reminisce-ins or Blasts from the Past, in association with annual meetings of the American Optometric Association and the American Academy of Optometry. Officers and participants in the OHS have included many significant individuals in optometry.

Henry W Hofstetter, OD, PhD, had a long and distinguished career as an optometric educator, writer, researcher, administrator, and leader. This biographical sketch examines his life and career, and notes his role in fostering the study and understanding of optometry’s history, as exemplified by his work as co-founder of the Optometric Historical Society and long-time editor of its quarterly publication, Hindsight.

An online search for articles on the history of optometry and other healthcare fields is reported and is compared to a similar search conducted in 2007. A possible explanation for comparatively fewer articles on the history of optometry is explored. Brief comments are made on the significance of optometry history, along with suggestions on ways to enhance its study.

Background: Retrograde intramedullary fibular nail fixation is being utilized with increasing frequency, particularly in patients at higher risk of wound complications. The purpose of this anatomic study was to assess the relative risk to nearby anatomic structures when implanting a contemporary retrograde locked intramedullary fibular nail. Methods: Ten human cadaveric lower extremities were instrumented with a fibular nail. The cadavers were dissected. The shortest distance, in millimeters (mm), between the site of procedural steps and nearby named structures of interest (ie, sural nerve, superficial peroneal nerve, and the peroneal tendons) was measured and recorded. Levels of risk were assigned based on observed distances as high (0 to 5 mm), moderate (5.1-10 mm), and low (greater than 10 mm). Results: The peroneus brevis (PB) tendon was found to be less than 5.0 mm from the distal skin incision in all specimens. When reaming and inserting the nail through the distal fibula aperture, the PB was less than 5.0 mm in 6 specimens. The peroneus longus tendon was at moderate to high risk when inserting both the proximal and distal syndesmotic screws in 9 specimens. The superficial peroneal nerve was at high risk when inserting an anterior to posterior distal locking screw in 7 specimens. The sural nerve was at low risk for all procedural steps. No structures were violated or damaged during any portion of the fibular nail instrumentation. Conclusion: The peroneal tendons and superficial peroneal nerve were at the highest risk; however, no structures were injured during instrumentation. Clinical relevance: The current findings indicate that strict adherence to sound percutaneous technique is needed in order to minimize iatrogenic damage to neighboring structures when performing retrograde locked intramedullary fibular nail insertion. This includes making skin-only incisions, blunt dissection down to bone, and maintaining close approximation between tissue protection sleeves and bone at all times.

Dr. Goss introduces the articles in this issue and describes the steady increasing number of women entering the profession during the course of the last 50 years, providing statistics on women applying to and entering optometry schools between 1971 and 2018.

Introduction Isolated gastrocnemius equinus contracture has been associated with several foot and ankle pathologies within the literature. The Silfverskiold test is commonly used to identify isolated gastrocnemius contracture, however, the proper technique for performing the test has been scrutinized. The purpose of this study was to determine if there is a clinical significance in the ankle dorsiflexion that is obtained when the examination is performed incorrectly with a single hand versus the correct two-hand technique. Methods Thirty consecutive new patients with conditions associated with gastrocnemius equinus were included in the study. The Silfverskiold test was performed with a two-hand technique and a single-hand technique. The amount of dorsiflexion obtained with the knee in full extension was measured and recorded using an extendable goniometer for each technique, with the arms aligned with the fifth metatarsal and fibular head. Results The average amount of dorsiflexion that was obtained with the two-hand technique with the knee in full extension was 76.3°±4.2°. When the one-hand technique was utilized the average amount of dorsiflexion obtained with the knee in full extension was 88.4°±4.2°. This was found to be statistically significant (p

Darrell Boyd Harmon (1898-1975) was an educator who researched the impact of environment and vision on learning in school-aged children. Harmon published several works designed to help improve the ergonomic conditions in classrooms to improve handwriting, cognition and performance. While controversial to some, Harmon is considered by many as an innovator that has contributed to our knowledge of how to optimize learning particularly for children with vision problems.

Background:Recurrence of deformity remains a concern when fusing the first tarsometatarsal joint for correction of hallux valgus (HV). A recently described construct adds an additional point of fixation from the plantar medial first metatarsal to the intermediate cuneiform. The purpose of this study was to determine the maintenance of correction of the first and second intermetatarsal angle, hallux valgus angle, and tibial sesamoid position after undergoing a first tarsometatarsal joint arthrodesis using the proposed construct.Methods:A radiographic review was performed of patients with HV treated with a first tarsometatarsal joint arthrodesis with the addition of a cross-screw intermediate cuneiform construct. Three observers reviewed radiographic data, including preoperative weightbearing, first weightbearing, and final weightbearing plain-film radiographs. Initial improvement and maintenance of intermetatarsal angle, hallux valgus angle (HVA), and tibial sesamoid position were evaluated radiographically. A total of 62 patients met inclusion criteria and were included in the study. Mean follow-up time was 9.3 months (SD 6.7).Results:Bony union was achieved in 60 of 62 patients (96.7%). Two of 62 patients required revision surgery as a result of recurrence (3.3%). Final mean improvement of the intermetatarsal angle (IMA) was 6.8 degrees (±2.9 degrees), HVA was 14.8 degrees (±7.5 degrees), and tibial sesamoid position was 2.4 (±1.4) positions. Mean loss of IMA correction was 1.5 degrees (±1.6), HVA was 2.9 degrees (±4.8 degrees), and tibial sesamoid position was 0.8 (±0.8).Conclusion:This study showed that the cross-screw intermediate cuneiform construct for first tarsometatarsal joint arthrodesis had a good union rate, a low complication rate, and maintained radiographic correction.Level of Evidence:Level IV, retrospective case series.

Ankle fractures are becoming increasingly more common in the elderly population and present a significant burden to the United States health care system. Many factors have been associated with fragility ankle fractures including age, gender, body mass index, diabetes, tobacco use, and osteoporosis. However, the literature is inconsistent regarding the relationship between ankle fractures and osteoporosis. The primary aim of this meta-analysis was to quantify the relationship between bone mineral density (BMD) in elderly patients with ankle fractures compared with BMD in elderly patients without ankle fractures. A literature search was undertaken using relevant search terms. Articles were screened for suitability and data extracted where studies met inclusion criteria and were of sufficient quality. Data were combined using standard meta-analysis methods. Seven studies were used in the final analysis. A small-pooled effect size was found indicating the control group had increased BMD regardless of measurement used (95% confidence interval 0.09-0.58; I2 = 98.39%). Lower femoral neck BMD showed a small-pooled effect size (femoral neck 0.36; 95% confidence interval 0.00-0.73; I2 = 94.91%) with the ankle fracture cohort. This is the first meta-analysis to quantify the relationship between BMD and ankle fractures in the elderly population. Elderly ankle fractures showed a significant association with femoral neck BMD. The current data can be used in orthopedic clinics and Fracture Liaison Service programs to assign the appropriate subgroup of ankle fracture patients to investigative and treatment groups, assess fracture risk, and serve as an indication for secondary fracture prevention by stimulating an osteoporosis prevention workup. There may be a role for a team approach to fracture care including metabolic optimization.

Category: Bunion Introduction/Purpose: Fusion of the first tarsometatarsal joint is common for the treatment of moderate to severe hallux abductovalgus deformity. Despite arthrodesis of the first tarsometatarsal joint, recurrence of the deformity remains a concern. The addition of a screw from the 1st metatarsal base to the 2nd metatarsal base allows for increased stability and can help create a “spot weld” between the metatarsal bases to prevent loss of deformity correction. The additional screw construct is termed the intermetatarsal screw in this study. The purpose of the current study is to determine the long-term maintenance of angular correction of the 1st and 2nd intermetatarsal angle, hallux abductus angle, and tibial sesamoid position after undergoing a 1st tarsometatarsal joint arthrodesis with the addition of the intermetatarsal screw. Methods: A retrospective, single-center chart and radiographic review was performed of 17 consecutive patients who underwent primary hallux abductovalgus correction with a 1st tarsometatarsal joint arthrodesis using the intermetatarsal screw fixation by the senior author. The study period was from January 1, 2017 to May 14, 2018. Three observers independently reviewed radiographic data including preoperative weight bearing, 1st weight bearing, and final weight bearing plain film radiographs. Preoperative films were used if they were within 3 months of the surgery and the radiographic time line for the post-operative intervals were at 12 ± 2 weeks, 18 ± 4 weeks, 26 ± 4 weeks, 52 ± 12 weeks, and the final follow-up visit. Radiographic data evaluated were initial improvement and long-term maintenance of intermetatarsal angle, hallux abductus angle, and tibial sesamoid position. Results: 17 consecutive patients were identified for review that met inclusion criterea. Mean follow up time was 8.12 months (SD ± 3.68). Bony union was achieved in all patients. There was 1 symptomatic recurrent bunion, 1 case of symptomatic hardware, and 1 case of transient neuritis. Average preoperative IMA was 16.05º (±2.34), HAA was 33.05º (±6.24), and tibial sesamoid position was 5.77 (±0.9). Average IMA improvement was 8.38º (±2.21), HAA improvement was 17.25º (±8.21), and TSP improvement was 3.29 (±1.36) positions. Average loss of IMA was 1.03º (±1.24), HAA was 4.14º (±5.34), and tibial sesamoid position was 0.65 (±0.86) positions. Wilcoxon signed rank test showed statistical significance in all radiographic parameters; both in initial improvements and loss of correction (pConclusion: The current study shows the addition of an intermetatarsal screw for 1st tarsometatarsal joint arthrodesis has good union rates, a low complication rate, and maintains correction. Further clinical and comparative studies with a larger patient cohort may yield additional useful information.

Category: Trauma, Ankle, Ankle Arthritis Introduction/Purpose: Ankle fractures in complicated diabetic patients (i.e. presence of neuropathy, nephropathy, or peripheral vascular disease) have significantly increased rates of complications with markedly worse functional outcomes. Current management advocates for operative intervention due to high rates of fracture reduction loss and Charcot arthropathy in those treated nonoperatively. Tibiotalocalcaneal (TTC) nails have been reported in the literature as a salvage option when initial ankle stabilization has failed. We hypothesize that the minimally invasive, robust construct that primary TTC fixation with an intramedullary nail offers will result in high rates of limb salvage, acceptable rates of complications, and nominal loss of function. Thus, the purpose of this study was to evaluate the outcomes of primary TTC intramedullary nailing for definitive treatment of neuropathic ankle fractures. Methods: This was an IRB approved retrospective study of 27 complicated diabetic patients who underwent TTC nailing of their ankle fracture as a primary treatment without formal joint preparation. The study was undertaken at an urban Level 1 trauma center. Complicated diabetes was defined as having one or more of the following formal diagnoses: neuropathy (20 patients), nephropathy (4), PVD (3). Mean clinical follow up was 888 days (range 21-2843 days). Patients were screened for associated risk factors such as open fracture, neuropathy, nicotine and alcohol abuse, obesity and elevated Hba1c. Data was also collected on surgical complications such as superficial and deep infection, wound dehiscence, amputation, revision fixation, hardware failure, malunion, nonunion. Outcomes were measured in length of hospital stay, loss of ambulatory level, and time to death. Results: The mean age was 66 (32-92) years with an average BMI of 38 (21-68). Six of 27 fractures were open and 20 of 27 patients were neuropathic. Mean hemoglobin A1C was 7.4 (5.5-13). Average hospital stay was 6 days (0-22). The average patient was fully weight bearing at 6 weeks (1-17). Two patients underwent removal of hardware, due to pain and proximal screw failure respectively. One patient required formal arthrodesis. There were no malunions, symptomatic nonunions, or instances of Charcot arthropathy. Two patients underwent repeat debridement for infection, resulting in antibiotic nail placement and above knee amputation respectively. A total of eight patients had died by final follow up (mean 1048 days) from index procedure. Overall, mean ambulatory status was maintained. Conclusion: Primary tibiotalocalcaneal nailing is a viable alternative to previously described methods of fixation of complicated diabetic ankle fractures. With high limb salvage rates, early weight bearing, maintained ambulatory status and low rates of return to the operating room, our technique can be considered an applicable approach to increase overall survivability of threatened limbs and lives with acceptably low complications.

Category: Bunion Introduction/Purpose: The Lapidus procedure is common for the treatment of moderate to severe hallux abductovalgus deformity. Standard fixation consists of a combination of crossing screws and plates. Despite arthrodesis of the first tarsometatarsal joint, recurrence of the deformity remains a concern. A recently described construct adds an additional point of fixation from the plantar medial first metatarsal to the intermediate cuneiform. This construct is termed the cross screw intermediate cuneiform construct. The purpose of this study is to determine the long-term angular maintained correction of the 1st and 2nd intermetatarsal angle, hallux abductus angle, and tibial sesamoid position after undergoing a 1st tarsometatarsal joint arthrodesis utilizing the cross screw intermediate cuneiform construct to correct and maintain the hallux abductovalgus deformity. Methods: A retrospective, single-center chart and radiographic review was performed of all patients with HAV treated with a 1st tarsometatarsal joint arthrodesis with cross screw intermediate cuneiform construct fixation by the senior author. The study period was from June 1st, 2016 to June 1st, 2017. Patients who underwent 1st tarsometatarsal joint arthrodesis for a primary diagnosis of HAV were studied. Three observers independently reviewed radiographic data including preoperative weight bearing, 1st weight bearing, and final weight bearing plain films radiographs. Preoperative films were used if they were within 3 months of the surgery, and the radiographic time line for the post-operative intervals were at 12 ± 2 weeks, 18 ± 4 weeks, 26 ± 4 weeks, 52 ± 12 weeks, and the final follow-up visit. Radiographic data evaluated were initial improvement and long-term maintenance of intermetatarsal ankle, hallux abductus angle, and tibial sesamoid position. Results: Forty-five patients met inclusion criteria and were included in the study. Mean follow-up time was 9.76 months (SD ± 7.62). Bony union was achieved in 43 of 45 patients (95.6%). Two patients required revision bunionectomy as result of recurrence (4.4%). Other complications included symptomatic hardware in 2 patients requiring hardware removal and neuritis in 2 patients. Average preoperative IMA was 15.95º (±2.55), HAA was 31.14º (±6.19), and tibial sesamoid position was 4.36 (±1.07). Final average improvement of IMA was 6.26º (±2.9), HAA was 13.89º (±7.02), and tibial sesamoid position was 2.07 (±1.34) positions. Average loss of IMA correction was 1.70º (±1.64), HAA was 2.45º (±4.6), and tibial sesamoid position was 0.8 (±0.82) positions. Wilcoxon signed rank test showed statistical significance in all radiographic parameters both in initial improvements and loss of correction (pConclusion: The current study shows the cross screw intermediate cuneiform construct for 1st tarsometatarsal joint arthrodesis has good union rates, a low complication rate, and maintains correction. Further clinical and comparative studies may yield additional useful information.

Editorial from David Goss, OD, PhD about the second military optometry issue.

The editor introduces the topics covered in the themed issue and summarizes the history of the development and growth of the schools and colleges of optometry. This editorial includes a list of the 23 extant institutions.

CASE We report the successful use of arthroscopy for reduction and internal fixation of a posterior glenoid fracture in a 62-year-old man 5 days following a skiing accident. Additionally, we review the technique utilized for successful fixation of this rare fracture, and we report the postoperative return of function. CONCLUSION Arthroscopically facilitated fixation of glenoid fractures has been reported in the literature with excellent clinical outcomes. However, arthroscopic reduction and screw fixation of a posterior intra-articular glenoid fracture (Ideberg type Ib), to our knowledge, has not been previously published. The unique benefits of arthroscopic screw fixation are discussed.

CASE McArdle disease, a glycogen storage disorder, often manifests as exercise intolerance secondary to muscle ischemia. Few authors have reported on rhabdomyolysis or compartment syndrome following inciting events among patients with McArdle disease. We present the case of a 40-year-old woman who developed spontaneous compartment syndrome of the right forearm and subsequently underwent emergency fasciotomy. CONCLUSION On the basis of the present case and our review of the current literature, we advocate a high level of suspicion for compartment syndrome in patients with a history of McArdle disease.

To compare vergence facility with nonstereo and stereo targets in binocular symptomatic and asymptomatic subjects.Sixty-six students were divided into symptomatic and asymptomatic groups according to the Convergence Insufficiency Symptom Survey Questionnaire score. Vergence facility was tested at 40 cm by flipper prism 3Δ BI/12Δ BO (BI, base-in; BO, base-out). The targets used were a nonstereo target (a vertical column of small letter "E" of ~20/30 size), a stereo-local target (fifth set of circles of the Titmus test with stereoacuity of 100 arcsec), and a stereo-global target (page 6 of the TNO test with stereoacuity of 120 arcsec).Repeated-measures analysis of variance showed differences in the mean vergence facility with different targets in all subjects and separately in two symptom groups (p0.001). In all subjects and separately in the symptomatic subjects, this difference was statistically significant among the three different targets (p0.05). In the asymptomatic subjects, this difference was not significant between the measured values with nonstereo and stereo-local targets (p0.05) but significant for the comparison of stereo-global targets with the other two targets. The receiver operating characteristic curve analysis showed the cutoff points 10.5, 10.5, and 9.75 cycles per minute with nonstereo, stereo-local, and stereo-global targets, respectively. The sensitivity of the three targets used was the same (97%). Specificity was 0.93 or higher with all three targets, with the highest specificity obtained with the stereo-global target (100%).The highest vergence facility was obtained with a nonstereo target and the lowest was obtained with a stereo-global target. High sensitivity with all three targets means that there are few false-negative results with them, and the high specificity is indicative of low false-positive results. Hence, the vergence facility predictive value would be high in diagnosing binocular symptomatic patients using a 3Δ BI/12Δ BO prism flipper at near and a response cutoff of about 10 cycles per minute or less.

Historical narratives reflect the biases of their creators. In order to promote his own interests, sporting goods magnate A.G. Spalding created a "creation myth" that baseball was a uniquely American sport which evolved from the English game "rounders." While historians later debunked this assertion and established an earlier and more complicated origin story for baseball, Spalding's historical narrative persists in popular culture. Optometry has a similar "creation myth" which holds that the profession began at the turn-of-the 20th century in the United States with the founding members of the American Optometric Association (AOA) and the move to make optometry a legislated profession. However, optometry's origins are much older, beginning in the late 13th century and, therefore, can be divided into periods. The period beginning in 1890 and which saw the founding of the AOA should be viewed as the beginning of "modern optometry." Optometry historians should recognize the importance of all periods of optometry history.

The purpose of this study was to determine if non-thrust manual therapy (MT) attenuated side-to-side differences (asymmetry) of the erector spinae (ES) stretch reflex amplitude in nine patients with chronic LBP. We used electromechanical tapping to elicit short-latency stretch reflexes (SR) from the ES muscles before and after non-thrust MT. A large asymmetry in the SR was observed at baseline, with the higher of the paraspinal sides exhibiting a 100.2 ± 28.2% greater value than the lower side. Following the intervention, this SR asymmetry was reduced (100.2 ± 28.2% to 36.6 ± 23.1%; p = 0.03). This change was largely due to reduced amplitude on the side that was higher at baseline (35% reduction following treatment; p = 0.05), whereas no change over time was observed in the low side (p = 0.23). Additionally, there was no difference between the respective sides following the intervention (p = 0.38), indicating that the asymmetry was normalized following treatment. These findings provide insight into the mechanism(s) of action of non-thrust MT, and suggest that it acts to down regulate the gain of the muscle spindles and/or the various sites of the Ia reflex pathway. Ultimately, developing a better understanding of the physiologic effects of manual therapies will assist in optimizing treatment strategies for patients with LBP.

A list of founding members and presidents of the Optometric Historical Society

List of annual meetings of the Optometric Historical Society, including date, number in attendance, context and speaker.

List of award recipients from the Optometric Historical Society with dates of award.

Our understanding the neurophysiologic characteristics of the human paraspinal muscles has historically been hindered by the lack of experimental techniques to examine these muscles function in vivo. In this article we describe a paired-pulse transcranial magnetic stimulation (TMS) protocol to quantify intracortical facilitation (ICF) and short-interval intracortical inhibition (SICI) of the lumbar paraspinal muscles, and an electromechanical tapping protocol to measure the amplitude of the short-latency stretch reflex. Test-retest reliability of these protocols was examined across two sessions separated by 30-min in healthy adults. We assessed relative reliability by calculating the intraclass correlation coefficient (ICC), and absolute reliability was assessed via coefficient of variation (CV). ICF and SICI in the lumbar paraspinal muscles exhibited the classical facilitatory and inhibitory responses observed in appendicular skeletal muscles (∼30% facilitation and inhibition, respectively). The motor evoked potential amplitude (MEP), ICF, SICI, and stretch reflex amplitude measurements did not significantly differ between the two testing sessions (p>0.05). The MEP amplitude, ICF and stretch reflex amplitude exhibited the highest relative and absolute reliability (ICC=0.89-0.91, CV=10.6-11.1%); whereas the SICI measure exhibited somewhat lower reliability (ICC=0.75, CV=20.1%). The stretch reflex protocol performed in the first testing session did not influence the TMS outcome measures in the second testing session (p>0.05). These innovative methods may be useful in studying basic physiology, the pathology of low back pain, as well as the mechanisms of action of treatment interventions.

The explosion of information in vision care and vision science makes keeping up with the literature and information in the field challenging. This report examines the nature of literature and information in vision care and vision science. A variety of topics are discussed, including the general nature of scientific and clinical journals, journals in vision science and vision care, resources available for searches for literature and information, and issues involved in the evaluation of journals and other information sources. Aspects of the application of citation analysis to vision care and vision science are reviewed, and a new citation analysis of a leading textbook in vision care (Borish's Clinical Refraction) is presented. This report is directed toward anyone who wants to be more informed about the literature of vision care and vision science, whether they are students, clinicians, educators, or librarians.

Purpose The purpose of this study is to compare citation patterns in the clinical binocular vision literature of optometry and ophthalmology. Methods The author conducted citation analysis of two current clinical binocular vision textbooks from optometry and two from ophthalmology and of articles published in the years 2000 to 2004 in optometry and ophthalmology journals. Topical parameters for inclusion of sources were diagnosis and management of nonstrabismic binocular vision disorders, diagnosis and management of nonpresbyopic ocular accommodation disorders, and procedures for examining such conditions. These topical parameters were chosen because they are areas in which the diagnostic procedures and treatment options available to members of the two professions are not delineated by their respective scopes of practice. Results The most frequently cited journals in the optometric publications were optometry journals (63% of citations in the optometry textbooks and 58% in the optometry journal articles). The most frequently cited journals in the ophthalmology publications were ophthalmology journals (79% of citations in the ophthalmology textbooks and 49% in the ophthalmology journal articles). Each discipline also cited a greater variety of journals from within its own field than was cited by the other discipline. The journal with the highest total number of citations was Optometry and Vision Science (280) followed by Ophthalmic and Physiological Optics (73), American Journal of Ophthalmology (68), Investigative Ophthalmology and Visual Science (62), and Optometry (61). Conclusions Optometry and ophthalmology sources show more citations to materials from their own discipline than from their fellow discipline in the area of nonstrabismic binocular vision disorders and nonpresbyopic accommodative disorders. Reasons may include lack of awareness of the literature of the other discipline, bias toward the literature of one's own discipline, or bias against the literature of another discipline. It is also likely that the diagnostic and management strategies of the two professions are significantly different, although scope of practice would not constrain the range of strategies for the conditions chosen as the topical matter for consideration in this study. The journals found to be most frequently cited in this study should help to identify the core journals in this area of clinical binocular vision.

The Distinguished Service Foundation of Optometry was an organization which sought to encourage research and education to facilitate the conservation of vision through publications and the awarding of medals. It existed from 1927 to 1979, but was most active in the 1930s and 1940s. Its leaders and activities are discussed.

This paper describes books with content solely on myopia or with titles that imply that they were entirely on myopia. Thirty such books were found, published from 1912 to 2010. For the purpose of organization, they are classified as textbooks, treatises on treatment, treatises on etiology, and conference proceedings. Changing contents of the books through the years reflect increasing sophistication of myopia research and clinical care.

The first documented letter distance test charts appeared in the 19th century. The first electronic projectors for eye and vision examination arrived in the early 20th century. This paper comments on some of those and other developments in distance testing charts and projectors. Brief biographical information is given on some of the inventors of projector systems.

Supreme Court confirmation is an exhaustively studied phenomenon, but lower court confirmation is less well understood, in part because lower court nominees are very rarely rejected, and the Senate fails even to hold a recorded vote for most appointees. However, the length of time it takes to fill a judicial vacancy serves as alternate evidence of conflict between the president and the Senate. We present an empirical assessment of appellate vacancy conflict, based on a continuous time-proportional hazard model of vacancy duration. Our results demonstrate that female and minority candidates are confirmed only after unusually long vacancies, and this has nothing to do with the qualifications of the nominees. Our results also demonstrate that institutional and partisan conflict between the Senate and the White House drive the confirmation process for the federal appeals courts, but delay tactics employed by the Senate are only partially strategic.

When designing fasteners, engineers should choose materials and processes that provide the strength required for the application. And if the materials can be turned into a fastener using less manufacturing steps than traditional processes, then a company making these fasteners can save time and money. For instance, high strength bolts and screws are typically produced from annealed wire. The wire is cold formed into the fastener shape and threaded. A quench-and-temper heat treatment gives the fasteners the required mechanical properties. Now high-strength fasteners can be made from work (strain) hardening steel, which eliminates wire annealing and heat treatment. In addition, fasteners made from work hardening steel offer several fastener performance benefits. This paper will describe several work hardening steels and illustrate that the fastener manufacturer cannot always use traditional processes and tooling to produce acceptable parts. Cold formed part and F.E.A. simulation results using traditional and modified processes will be presented.