Vision Therapy

How is a Routine Eye Exam Different From a Developmental Vision Assessment?

A developmental vision assessment is different from a routine eye exam. A routine eye exam is approximately 15-20 minutes in length. The examination is spent ensuring the patient can see clearly, and that there are not any diseases that may affect the eyes. A developmental vision assessment is at least 90 minutes in length and is often conducted over more than one appointment. In addition to performing all of the tests that are done during a routine exam, a significant amount of time is spent to test the visual skills required for reading and learning. We use the information collected during our session to determine treatment options, guide our Vision Therapy programs, and to monitor for progress. Some of the testing that may be included in our assessment at Vision By Design Optometry are as follows:

Visual Motor Testing

Visual motor integration is the coordination of visual and fine motor control. A child with poor visual motor integration may have messy handwriting, have difficulty keeping their writing contained within a line, write with a tight pencil grip, or show poor fine motor control such as difficulty using scissors, rulers or stringing beads.

Visual Perceptual Evaluation

Visual information is gathered by the eyes however, the brain has to process this information. This evaluation assesses how the brain interprets visual information. A visual perceptual examination tests for skills such as Visual Discrimination, Visual Memory and Visual Closure among others.

A visual perceptual evaluation can be performed with patients starting at age 5.

Laterality and Directionality Testing

This testing provides insight to a child’s awareness of left and right. Patients with poor laterality or directionality often reverse letters, and may have difficulty understanding which way to turn, which hand to use or which direction to go.

Visual Motion Hypersensitivity Testing

Patients who have suffered a concussion often experience increased symptoms in busy visual environments such as driving, a busy shopping mall, or crowded events. We are able to test for visual hypersensitivities and provide treatment if they are found

What Visual Skills Can Be Improved From Vision Therapy?

Eye Tracking

When we read, our eyes must track along a row of text. This involves accurately moving our eyes from left to right across a row of text, followed by a large precise eye movement in order to get to the beginning of the next row.

Eye tracking is the ability to move both eyes together in a coordinated manner in order to do activities such as moving our eyes from one word to the next while reading. If a child has difficulty performing accurate movements they may end up skipping over small words when reading, or skipping to the wrong line at the end of a row of text.

When this happens children will end up reading the words on a page in the wrong order. This can affect reading comprehension since they often have to re-read text multiple times in order to retain the context of the paragraph. Patients will often also have reduced reading speed since they often slow down how quickly they read in order to reduce the frequency of mistakes. Parents may observe their children following with a finger or using head movement while reading.

Visual tracking issues in children present symptoms such as:

  • Using a finger to keep their place on a page
  • Skipping words or whole lines while reading
  • Swapping words
  • Reduced reading speed or comprehension
  • Avoidance of near work
  • Poor coordination with sports
  • Having to re-read text

If a patient has difficulty with Eye Teaming skills they can have multiple symptoms including:

  • Eyestrain
  • Headaches
  • Blurry Vision
  • Double Vision
  • Words moving on a page
  • Skipping words when reading
  • Tilting head/closing an eye when reading
  • Avoiding near work
  • Reduced reading comprehension
  • Poor attention when reading

Eye Teaming

We often forget that we see two separate images from our right and left eye. We have to maintain proper eye alignment in order to allow our brain to easily fuse these two images into one. Eye teaming is the ability to point both eyes together at the same target in order to see a single image. When we move our eyes from one target to another both eyes have to move in and out in order to point at the same spot in space.

Patients who have difficulty with eye alignment may experience double vision when performing visual tasks such as reading. Words on the page may also appear to be moving as the two images slide in and out of alignment.

This can be distracting resulting in reduced reading comprehension. This can also be uncomfortable to look at, causing children to avoid reading tasks or get frustrated when having to do prolonged periods of reading.

Parents may observe their child covering their eye or turning their head in an attempt to block out the second distracting image.

Eye Focusing

Eye focusing is the ability to change how much your eyes are focused when looking at objects at various distances.

Our eyes have to be able to relax together when looking far away, and they must focus accurately together when looking up close. If this skill is inadequate words may appear blurry or our vision may fluctuate.

Patients may experience eye strain or headaches, or may become tired or fall asleep when reading. It can reduce our reading speed as we have to wait for the images to clear, and can affect our reading comprehension since it can be distracting for the words to go in and out of focus.

Like the issues above children may end up avoiding near work or get frustrated when performing visual tasks such as reading.

If a patient has difficulty with Eye Focusing they will often experience symptoms such as:

  • Headaches
  • Eyestrain
  • Blurry Vision
  • Avoiding near work
  • Reduced reading comprehension
  • Abnormal working distance when reading
  • Reduced attention when reading
  • Blurry vision at distance after sustained near work