I had a comprehensive eye examination. What is the next step?

Because Dr. Roth practices developmental optometry, even your comprehensive eye examination will include some eye and vision tests you have never done before. These tests are done to get a thorough picture of your visual system. Unless you have already had a comprehensive eye examination with a developmental optometrist, we will request to do that exam before further evaluations.

After the initial comprehensive eye exam, if the Doctor believes there are underlying visual functional and processing issues that may be contributing to your symptoms, she will recommend a visual functional or processing evaluation. This evaluation takes place on a separate day because it is a longer, often more visually tiring exam. You or your child will be tested with special lenses and standardized tests, and compared to people of your age or grade level, to see what percentile of the population your visual system falls in. Afterwards Dr. Roth will write a detailed report outlining the outcomes of your testing and the recommended treatment plan. If you or your child have had previous testing with a neuro-psychologist or other specialist, that information is always helpful in our testing and treatment plan, and we are happy to communicate with other specialists you are currently or have previously worked with.

Who needs vision therapy?

Children and adults may need vision therapy! Children with untreated visual problems turn into adults with untreated visual problems. If you are an adult who comes home from work extremely tired, has much difficulty focusing on the computer and other devices, get headaches from reading, don’t enjoy 3-D movies, or just feel that you have always had to work harder than your peers to understand things and get things done – you may benefit from vision therapy. Though vision therapy can be treated as an adult, if problems are detected and treated early, learning and sports become much easier and more enjoyable!

Vision therapy helps individuals to learn and relearn specific vision skills. Vision therapy is indicated in the following conditions:

• Lazy eye (amblyopia)
• Strabismus (eye turn)
• Accommodation disorders (focusing of the eyes)
• Eye teaming disorders (eye muscle difficulty, for example convergence insufficiency)
• Oculomotor dysfunction (Eye tracking disorders)
• Post concussion/brain injury syndromes
• Visual Information processing disorders

Some examples are:

• • letter reversals
  • difficulty with left and right
  • visual motor problems, such as difficulty catching the ball in sports
  • visual memory and comprehension issues when reading

My child has been diagnosed with ADD/ADHD. Isn’t that the cause of their learning issues?

Possibly, but not necessarily. There are symptoms that overlap across multiple conditions. Sometimes children may be treated for Attention Deficit Hyperactivity Disorder (ADD/ADHD), or even dyslexia, when they actually have a vision problem, or a combination of these conditions. One treatment may only deal with the symptoms, and not address the root cause of the problem. This may lead to disappointment, wasted time, and unnecessary expenses.

Infographic Source: covd.org

What is the connection between vision and learning?

Vision is one of the most important senses we all have and need, and often take for granted. Most of our world – learning, sports, reading, arts – inside and outside the classroom – are all based on how we see things. That means that having optimal vision is crucial to navigating the world. Vision is integral to learning (up to 80% of learning occurs through the eyes) and it has been found that children may struggle in school for reasons that may not be immediately clear. Your child may have 20/20 vision but still lack the skills they need for learning. These may include tracking, coordinating, focusing their eyes, and visual processing. 1 in 10 kids has a vision problem that affects their learning – that is 5 million alone in the USA.

We are already seeing an educational therapist and OT. Do we still need vision therapy?

If your child is diagnosed with a visual functional problem or visual processing problem, then vision therapy is the correct treatment. VT includes developmental and rehabilitative treatment individualized for the patient in order to improve visual perceptual, sensory, and motor dysfunctions. Vision therapy does not replace, but actually complements the services of pediatric neuro-psychologists, educational therapists, occupational therapists, and speech language pathologists. Vision therapy trains the visual system – a foundation skill for all of these other areas. Dr. Roth has spent years working with these different specialists, as well as parents and teachers, in order to help people with visual issues. Dr. Roth practices developmental and behavioral optometry, and can identify and diminish a number of possible road blocks to learning by building underdeveloped visual skills through vision therapy.

What are some signs my child or I might have an undetected vision problem?

Dr. Roth is happy to offer a free phone consultation to discuss your or your child’s vision and learning concerns and further recommendations for a comprehensive eye exam and functional and perceptual vision evaluation. This is a short list of some signs you might be noticing that warrant a call to our office:

• Print blurs after reading for a short time
• Headaches (forehead or temples)
• Double vision
• Losing place while reading
• Getting sleepy while reading
• Re-reading/skipping lines
• Difficulty tracking a moving object/hitting or catching a ball in sports
• Confusing or reversing letters, numbers, or words
• Confusing right and left
• Failing to visualize what is read silently or aloud
• Making errors when copying form board to paper
• Squint/close/cover one eye
• Dislike of 3-D movies
• Misaligning numbers in columns while doing math
• Words “swim” or blur on the page
• Eye turns in or out at any time
• Tilting head extremely while doing desk work
• Difficulty with crowded areas/clumsiness
• Need to use a finger to mark or keep place
• Head turns as read across the page
• Whispers to self for reinforcement while reading silently

What is lazy eye (amblyopia)?

This is a vision development disorder where one or both eyes fails to achieve normal visual acuity (ie 20/20 vision). Even with glasses or contact lenses the eye cannot attain 20/20. If amblyopia is not treated, there can be permanent reduction of vision in the affected eye, and a loss of depth perception – 3-D vision. Amblyopia can limit the occupational and fun activities you can do. Anything that requires good depth perception becomes impossible. Additionally, if the non-lazy eye ever gets injured or develops vision problems, you would have difficulty maintaining your normal activities with reduced vision in both eyes.

Amblyopia is an infant vision development problem and can be detected by an eye examination with your eye doctor. Amblyopia can occur with or without strabismus (an eye turn). Once diagnosed, amblyopia can be treated by using eyeglasses, patches, and vision therapy, to improve binocular vision ( the use of two eyes to see together). Amblyopia is best treated at a younger age, but studies now show that amblyopia can also be treated once older.

What is strabismus?

Strabismus, sometimes called “crossed-eyes” is a condition where the two eyes can’t continuously look at an object together due to misalignment. One eye looks at the target, and the other is pointing in a different direction (in, out, up, or down). Surgery is sometimes necessary or desired as a cosmetic fix for strabismus. However, surgery does not guarantee that the two eyes can work together as a team to have binocular vision and improved depth perception. Vision therapy is a non invasive treatment option for strabismus that promotes eye alignment and improved vision. Vision therapy is also often helpful after strabismus surgery, if you or your child have chosen to undergo surgery.

What is sports vision?

Improved sports vision helps amateur and professional athletes use their vision to enhance their competitive edge in their game. Strong visual skills are critical to success in sports. Visual acuity, ocular alignment, tracking, and binocular vision testing is all performed during a sports vision examination. Vision therapy can often help hand-eye coordination, visual motor skills, reaction time, and peripheral awareness – which all contribute to improved performance in athletics.

What is computer vision syndrome?

In today’s world, we are constantly staring at a screen – whether it’s a computer, tablet, or cell phone. Starting at a very young age, our eyes are constantly focused on our devices. Common symptoms include eyestrain, blurred vision, headaches, dry eyes, neck, and shoulder pain. Treatment for computer vision syndrome may include glasses, contacts, improved body and eye positioning, and vision therapy. Vision therapy may help in computer vision syndrome if glasses and contacts do not – and you have a focusing, tracking, or eye coordination problem that is exacerbating your computer vision syndrome problems.