1 IN 4 SCHOOL-AGED CHILDREN HAS AN UNDETECTED VISION PROBLEM THAT IS AFFECTING THEIR LEARNING
THE MYTH OF 20/20
"It is estimated that 80% of children with a learning disability have an undiagnosed vision problem" - Vision Council of America
Very often the first question I get asked by parents is "Does my child see 20/20?". The ability to see 20/20 is based on the length of our eyeball and is only a measure of whether our distance vision is clear without glasses, or requires corrective lenses to be clear. Unfortunately having 20/20 vision does not indicate that our visual system is set up to allow us to succeed in school. This means that your child may see 20/20 but can still have significant problems with reading, writing, spelling and learning due to other visual skills being deficient. There are many different vision skills that are required for a successful learning experience. If your child is struggling in school please ensure you get a comprehensive eye exam with a Doctor of Optometry skilled in Binocular Vision Testing. Binocular vision is the ability to team our eyes together, focus them, move them in a coordinated fashion, decode the information they relay to the brain, and allow them to guide a correct and precise motor movement. When one or more of these skills are lacking there can be large impacts on learning, causing significant delays in school. I hope you can now see that seeing 20/20 is not a measure of your child's ability to succeed in school, and a comprehensive eye exam that includes testing for the skills below is necessary to ensure success in school.
5 common signs that your child has a vision disorder that could interfere with your child's learning
1. skipping words of lines, rereading words or lines
2. reversing "b" and "d", "q" and "P"
3. taking a long time to complete homework
4. poor reading comprehension
5. short attention span while doing homework
FOCUSSING IS OUR ABILITY TO MAKE OUR NEAR VISION CLEAR AND MAINTAIN CLEAR FOCUS. DEFICIENCIES IN THIS SKILL WILL CAUSE BLURRY VISION, POOR READING COMPREHENSION, HOLDING THINGS VERY CLOSE, TIRED EYES, HEADACHES AND ONLY ABLE TO READ FOR SHORT PERIODS OF TIME.
EYE TEAMING IS THE ABILITY TO POINT BOTH EYES AT THE SAME SPOT IN SPACE. THIS INVOLVES CROSSING AND UNCROSSING OUT EYES. DEFICIENCIES IN THIS SKILL WILL CAUSE DOUBLE VISION, HEADACHES, CLOSING ONE EYE, EYE RUBBING, AND READING ONLY FOR SHORT PERIODS OF TIME.
TRACKING INVOLVES SMALL AND LARGE EYE MOVEMENTS. THESE MOVEMENTS MUST BE PRECISE TO GUIDE THE EYES TO RELAY INFORMATION IN THE CORRECT SEQUENCE TO THE BRAIN. DEFICIENCIES IN THIS SKILL CAUSES POOR READING COMPREHENSION, SKIPPING WORDS OR LINES, MOVING HEAD WHILE READING, USING FINGER TO KEEP YOUR PLACE, AND FREQUENT LOSS OF PLACE WHILE READING.
VISUAL INFORMATION PROCESSING
VISUAL INFORMATION PROCESSING ENCOMPASSES MANY DIFFERENT SKILLS THAT ALLOW US TO DECODE VISUAL INFORMATION. DEFICIENCIES IN THIS SKILL CAUSES POOR READING COMPREHENSION, POOR SPELLING, DIFFICULTY WITH MATH, POOR RECALL OF VISUAL INFORMATION, AND POOR COPYING SKILLS.
VISUAL MOTOR INTEGRATION
THIS SKILL PERTAINS TO OUR ABILITY TO RECREATE A PIECE OF VISUAL INFORMATION THROUGH WRITING OR DRAWING. DEFICIENCIES IN THIS SKILL WILL CAUSE SLOPPY WRITING, POOR COPYING SKILLS, AND CAN'T STAY ON THE LINE.
LATERALITY AND DIRECTIONALITY IS OUR ABILITY TO BE AWARE OF LEFT AND RIGHT. DEFICIENCIES IN THIS SKILL WILL CAUSE REVERSALS OF LETTERS, TROUBLE REMEMBERING RIGHT AND LEFT, AND TROUBLE WRITING AND REMEMBERING LETTERS AND NUMBERS.
WHAT IS VISION THERAPY?
Vision therapy is a customized program of exercises supported by evidence-based scientific research, with the goal of remediating any visual skills that are not functioning optimally. Therapy involves in-office therapy with adjunct at home exercises. Repetition of the exercises allow the visual system to integrate the proper skills for clear, comfortable vision for successful learning. Depending on the condition therapy can take a few weeks or may require a few months. Vision is the basic building block of learning, and when visual skills are poor or deficient learning becomes very difficult and frustrating for the individual. Therapy allows vision to work efficiently to allow for improved reading skills, writing skills, and overall learning. Therapy works on rewiring the way the brain moves or engages the eyes, so if therapy is done properly regression of the skills acquired is unlikely.
WHAT CAN WE TREAT WITH VISION THERAPY
Vision therapy is recommended for a variety of conditions such as:
Binocular vision disorders (such as Convergence Insufficiency)
Oculomotor Dysfuction (Tracking Disorders)
Visual Processing Disorder
Post Trauma Vision Syndrome (Concussion related vision disorders)
Strabismus is a condition in which the eyes do not coordinate to team together for distance or near, causing one eye to turn. The eye can turn towards the nose (esotropia), out towards the ear (exotropia), or can turn up (hypertropia) or down (hypotropia). The turn can be there all the time (constant) or some of the time (intermittent). Strabismus can cause amblyopia, double vision, a head turn, a face turn or a head tilt, and poor depth perception. Vision therapy helps teach the eyes how to coordinate, and work together at all distance so that the eye turn is no longer visible, there is no double vision, and depth perception is developed. In some cases the best course of treatment for strabismus is a combination of vision therapy and surgery, however, in many causes vision therapy can be very successful in providing treatment for the strabismus without the need for surgery. We work with adult and children as patients. At times in our childhood years we are able to compensate for an eye turn on our own, and as we get older our compensation methods decrease and the eye turn becomes visible. There is no age limit with regards to vision therapy for strabismus.
Amblyopia is reduced vision, even with glasses, contact lenses, or surgery to correct any prescription. Amblyopia happens during development of vision when a child is young. If an eye turn is present, a high prescription in one eye or both, or a cataract or corneal disease in one or both eyes the vision will not develop in that eye. Vision continues to develop after birth and if one or both eyes is not provided with clear vision, the ability to see 20/20 becomes compromised. Most recent research has indicated that treating amblyopia with modified patching and vision therapy can render better and faster results than patching alone to improve visual acuity. Vision therapy has the benefit of also improve accommodation, eye teaming and tracking in the affected eye.
CONCUSSIONS & BRAIN INJURIES
We often think that we "see" with our eyes, but in reality it is our brain that does all the orchestrating. It is easy to take for granted everything that our brain does minute by minute to ensure we "see", and have single, clear and comfortable vision. When a brain injury occurs, such as a concussion or a stroke, the pathways and infrastructure that we use to "see" are interupted. Those same systems that were automatic before, are now not. This can cause double vision, blurry vision, poor memory skills, challenges with reading, writing, and computer work, confusion, dizziness, light sensitivity and headaches. The areas that are now deficient can be remediated with vision therapy to improve symptoms and improve quality of life. Concussion and stroke patients generally require a circle of care, where multiple specialities including physiotherapist, occupational therapist, osteopaths, optometrists, nutritionist and more are involved in their rehabilitation.
HOW TO GET ASSESSED
If you suspect that you or your child has a vision disorder start by booking a comprehensive eye exam.
COMPREHENSIVE EYE EXAM
A comprehensive eye exam is a critical first step. Here we check if all of the anatomy of the eye is healthy. In addition we check if a prescription is needed to provide clear vision. We also do screening tests for binocular vision disorders and strabismus.
BINOCULAR VISION EXAM
A binocular vision examationation is a more in-depth examination of the eye focussing, eye teaming, and eye tracking system. Specialized prescriptions are tested that may include prism, reading prescriptions, or modified patching techniques. This examination allows us to assess if vision therapy may be helpful.
VISUAL PROCESSING & VISUAL MOTOR INTEGRATION EXAM
Should further testing in the area of visual processing and visual-motor integration be required, we generally do it on a separate day as the testing can be long and tiring. This allows us to better customize our treatment and therapy plan for each individual patient.