| Identifier |
Aspergers_Syndrome_1080p_Lee |
| Title |
Asperger's Syndrome |
| Creator |
Andrew G. Lee, MD; Hannah Hanania |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (HH) Baylor College of Medicine, Houston, Texas |
| Subject |
Asperger's; Autism; Photosensitivity; Prosopagnosia |
| Description |
Dr. Lee lectures medical students on the subject of Asperger's syndrome. |
| Transcript |
I want to tell you a little bit about what a neuro-ophthalmologist needs to know about the Asperger-Autism spectrum disorder. And it's really a spectrum because there are people on the Autism spectrum who really are not functional. So the autism people often have low IQ and they have both mental and physical disfunction, and they're at the low end of the function spectrum. And then you've got people on the Asperger side of the equation who are very high functioning. These people might have a job and have gone to school. They might even be highly intelligent, so you've got a spectrum of function from low functioning to high functioning individuals. Obviously the two overlap to some degree in terms of their symptoms and signs, and so you really kind of have to be amenable to have a blended diagnosis here. However, the ones that come to me are the Asperger patients because they're ambulatory, they're high functioning, and they can complain. The autism kids they're brought to us. Usually, they have normal eye exams because it's not really an eye thing. So really the exam's going to be normal. In fact, probably the exam should be normal. The major complaints of these spectrum disorder people results from their problems with gain. So they, gain as you recall is the input side of the equation, and volume is the output side. So on a gain, their gain is set at the wrong number and that means they're very sensitive to stimuli. So they're overly sensitive to stimuli, and that stimuli can be the light. And so they often complain that they're photosensitive. And they might even be wearing sunglasses and normally that's a sign of nonorganic disease, but in these people I think it really is true. The lighting might be fluorescent lighting or just going outside in general or devices. It can also be overly sensitive to sounds and crowds and that's why they tend to be viewed as like antisocial because they just don't want to interact. In addition, the other thing that's interesting from a visual standpoint with these people is they're not really good at faces. And as you recall from the other lectures, prosopagnosia means you can't see or recognize faces, that's agnosia of face. In these people they can recognize faces, but their problem is in determining what the emotional content of the facial expression is. And so, they have problems with empathetic reading of facial features and many Asperger-autism patients actually don't like to make eye contact because they can't get any feedback from that information. And patients might have very, very strange complaints. One of the features in the DSM4 and 5 for Asperger is the patients often have stereotyped countermeasure behaviors that they use to kind of build a routine around. And so, a patient might say they have to do some obsessive behavior to get started in the day. In addition, they're going to have problems establishing emotional content and empathy with pictures or they might not understand why people are crying at a funeral for example. They might not get jokes if someone is telling a joke. They just don't get it. And so, they have problems with social interactions, and they'll tend to avoid those social interactions. And then the rest of the Asperger criteria are actually exclusionary criteria. You're not allowed to be schizophrenic. You're not allowed to be depressed. You can't have any organic psychoses. So it is the combination of the stereotypic routine behaviors plus the failures on the social interaction scale and the lack of empathy especially for facial features combined with an overly sensitive gain especially for sounds and noises that form the core of Asperger. And then you have to rule out the other things. So for an ophthalmologist you need to be aware of this because if the patient comes to you on this spectrum you need to look at their eye, but it's going to be normal. And then be empathetic to this person about their photosensitivity and their lack of recognition of facial features. |
| Date |
2021-06 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6j44s8g |
| Setname |
ehsl_novel_lee |
| ID |
1701556 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6j44s8g |
