Frequently Asked Questions about Vision Therapy and All Ages Vision Care

Below is a compilation of the most frequently asked questions about vision therapy that our patients have on their minds when conducting research and when meeting in our office. We hope this will help answer some of your more basic questions. As always, we stand ready to assist you with any eye health or vision therapy concern!

What conditions do you treat at All Ages Vision care?

All Ages Vision Care provides a full range of vision care services, with specialties in pediatric developmental optometry and vision therapy. We specialize in therapy for treatment of visual based learning problems, visual spatial disorders, convergence insufficiency,lazy eye, crossed eyes, tracking, sports vision enhancement and neuro-optometric rehabilitation for head injury and cerebral palsy.

HOW DO YOU DETERMINE THE PROBLEM AND TREATMENT?

Dr. Beasley conducts a thorough examination of every patient’s eyes and vision health. The following tests are included in a comprehensive vision exam:

A thorough patient history, including general health and developmental history.
A measurement of how clearly the patient can see in the distance and up close (visual acuity, e.g. 20/20)
A measurement of the presence of any refractive errors (nearsightedness, farsightedness, or astigmatism)
An assessment of eye focusing, eye teaming, and eye movement abilities (accommodation, binocular vision, ocular motility)
An examination of the health of the eyes.

Depending on the results of these evaluations, additional tests of visual development and visual perceptual abilities may be needed to effectively assess a patient’s total visual status.

Testing with eye drops is sometimes used to evaluate the refractive status or health of the eyes; however, these eye drops can alter test results and mask significant visual problems. Therefore, testing with eye drops should be deferred until after the first comprehensive vision examination.

A complete functional evaluation of all visual abilities should be conducted first.

When is Learning difficulty due to a vision problem?

While learning occurs through a number of complex and interrelated processes, vision plays a key role. Many signs, symptoms, and behaviors associated with learning disabilities are similar to those caused by vision problems. This is why it is so important that a comprehensive vision examination be part of the interdisciplinary evaluation of all children who are failing to succeed in school.

What are some of the signs or symptoms of a vision problem?

Frequent headaches or eye strain
Blurring of distance or near vision, particularly after reading or other close work
Avoidance of close work or other visually demanding tasks
Poor judgment of depth
Turning of an eye in or out, up or down
Tendency to cover or close one eye, or favor the vision in one eye
Double vision
Poor hand-eye coordination
Difficulty following a moving target
Dizziness or motion sickness

What performance problems in children indicate a vision problem?

Poor reading comprehension
Difficulty copying from one place to another
Loss of place, repetition, and/or omission of words while reading
Difficulty changing focus from distance to near and back
Poor posture when reading or writing
Poor handwriting
Can respond orally but can’t get the same information down on paper
Letter and word reversals
Difficulty judging sizes and shapes

What are the symptoms of nearsightedness, farsightedness or astigmatism?

Inability to see clearly in the distance or up close
Complains of blurred vision
Rubs eyes frequently
Squints

What are the symptoms of eye coordination problems?

Inability to coordinate the eyes together effectively
Closes or covers one eye
Occasionally sees double
Rubs eyes frequently
Able to read for only a short time
Poor reading comprehension

What are the symptoms of eye focusing problems?

Inability to easily refocus eyes or maintain clear focus
Holds things very close
Complains of blurred vision
Poor reading comprehension
Says eyes are tired
Able to read for only a short time
Has headaches when reading

What are the symptoms of eye tracking problems?

Inadequate ability to smoothly and accurately move the eyes from one point to another
Moves head excessively when reading
Frequently loses place, skips lines when reading
Uses finger to keep place
Poor reading comprehension
Short attention span

What are the symptoms of faulty visual form perception?

Inability to discriminate differences in size, shape or form
Mistakes words with similar beginnings
Difficulty recognizing letters, words, or simple shapes and forms
Can’t distinguish the main idea from insignificant details
Trouble learning basic math concepts of size, magnitude, and position

What are the symptoms of faulty visual memory?

Inability to remember and understand what is seen
Trouble visualizing what is read
Poor reading comprehension
Poor speller
Trouble with mathematical concepts
Poor recall of visually presented material

what are the symptoms of difficulty with laterality and directionality?

Poor development of left/right awareness
Trouble learning right and left
Reverses letters and words
Trouble writing and remembering letters and numbers

What IS A Visual spatial disorder?

Having a visual spatial disorder means that someone has difficulty organizing visual information into meaningful patterns. They have problems understanding how objects might change as they rotate and move through space. They may also have difficulty with visual memory, which is the ability to retrieve a mental image of original objects, places, animals or people from our memory.

What is convergence insufficiency?

Convergence Insufficiency (CI) is a common eye muscle coordination problem. where a person’s eyes must turn in (converge) in order for the words they are reading to be clear. The convergence isn’t easy, therefore the extra effort may cause eyestrain, headaches, double vision, blurred vision, difficulty concentrating, loss of place and concentration, and slow reading. CI can only be detected through a thorough eye examination.

What is Myopia?

This is often referred to as “short-sightedness” or “near-sighted”. An eye is myopic when the “far point”; a point at which light from an object is focused on the retina, is located at a finite distance in front of the eye. Myopia can be due to either an eye which is too long relative to the optical power of the eye (axial myopia), or because the optical power of the eye is too high relative to the length of the standard eye (refractive myopia). The focus is correctly adjusted with a “minus” power lens, or concave lens. (More information on myopia)

What is Hyperopia?

Hyperopia is often referred to as “long-sightedness” or “far-sighted”. An eye is hyperopic when the far point is at a virtual point behind the eye. Generally the hyperopic eye is too short with respect to the refractive state of the standard eye (i.e., an emmetropic eye or eye requiring no optical correction) or because the optical power of the eye is too low relative to the length of the standard eye. The focus is correctly adjusted using a “plus” lens power or convex lens.
(More information on hyperopia)

What is astigmatic eye?

This generally has two different meridians, at 90 degrees to each other, which cause images to focus in different planes for each meridian. The meridians can each be either myopic, hyperopic or emmetropic. The correction for astigmatism is a lens power at a particular direction of orientation. Astigmatism causes images to be out of focus no matter what the distance. It is possible for an astigmatic eye to minimize the blur by accommodating, or focusing to bring the “circle of least confusion” onto the retina. More information on astigmatism)

What is Visual acuity?

This refers to the measure of the sensitivity of the visual system. It is expressed in Snellen notation, expressed as a fraction, where the numerator indicates the test distance and the denominator denotes the distance at which the letter read by the patient subtends 5 minutes of arc. Normal vision is expressed as 20/20 (or 6/6 in countries where metric measurements are used). An acuity of 20/60 means that the patient was tested at 20 feet but could only see letters that a person with normal vision could read at 60 feet. (More information on visual acuity)

What is a squint or strabismus?

This is a failure of the two eyes to look at the same object thereby preventing binocular vision. Human binocular vision develops during the first few years of life. Interruption to the motor, sensory or central components, for example nerve or muscle defect, can lead to sensory or central defect. Causes of many squints are not fully understood although the majority are either a hereditary factor or a responsible defect. Such factors causing squints include:

ocular abnormalities that prevent good central vision, i.e., congenital cataract.
paresis of one of the eye’s muscle
brain damage, i.e., cerebral palsy
large refractive errors, i.e., accommodative esotropia

Refractive errors are an important causative factor to strabismus since it can prevent clear vision – impeding development of the sensory mechanism, and affecting the normal relationship between accommodation and convergence.

When the eye’s require vision at a near distance there is both a movement of the two eyes (convergence) and change in focus (accommodation). A child that is hypermetropic (long sighted) has to accommodate more than is normally required for distance and near vision. Because of the linkage between accommodation and convergence the excess accommodation causes an excess convergence of the two eyes. The result, in a young child whose visual system is still developing is what is called a convergent squint.When binocular vision is disturbed double vision results.

Young infants are able to suppress one of the images to one eye to remove the double vision that occurs at the onset of strabismus. The effect of the suppression of the image causes the vision in the “squinting” eye to fail to develop normally. This is called amblyopia. There are other visual abnormalities that can develop as a result of squint.

The treatment for squint depends on the cause. Some essential treatments include:

search for ocular defects
refraction and glasses to remove any refractive errors
vpatching or occlusion of the eyes to prevent amblyopia
surgical adjustments to the muscles of the eye

These treatments aim to remove amblyopia, restore binocular vision and if necessary cosmetic corrections to the appearance of the turned eye. (More information on strabismus)

What is Amblyopia?

Amblyopia is defined as the condition of reduced visual acuity which cannot be corrected by refractive means and is not attributed to structural or pathological ocular anomalies. Acuities of worse than 20/30 (6/9) are considered to meet the criteria of amblyopia according to Griffins reference on Binocular Anomalies. There are a variety of classifications of amblyopia, in general the categories are organic or functional.

Examples of organic amblyopia include:

nutritional – poor diet in the case of alcoholism
toxic – methyl alcohol poisoning or salicylate poisoning
congenital – bilateral or unilateral central scotoma at birth

Functional amblyopiz also has three classifications:

hysterical – psychogenic causes giving central visual field defect
refractive – uncorrected isometropia resulting in poor visual acuity developments
strabismic – long standing suppression in cases of strabismus

Commonly used therapy for amblyopia is occlusion or lens therapy in the case of refractive. The patching is associated with general to increasing eye-hand coordinated tasks to stimulate development of the amblyopic eye. More information on amblyopia

FAQs