Myths and Misconceptions

Vision Therapy Only Involves the Eyes

This is one of the biggest misconceptions and comes as a surprise to most patients and parents alike. But vision is not an isolated system. It is inseparable from the brain which is inseparable from the body. The Vestibular Disorders Association talks about how important the integration of the vestibular, visual, and proprioceptive (information perceived through our muscles and joints) systems are in order to successfully navigate the physical world. The importance of integrating these systems shows how vision affects and is affected by more than just the eyes! Studies show that there is more neurological activity when young children are engaged in multi-sensory activities compared to predominantly visual motor activities. Some of the ways we incorporate this concept include: primitive reflexes, balance boards, metronome, perceptual activities, walking rail, hand eye coordination, trampoline, virtual reality, and more!


There Is No Evidence to Back It Up

Vision therapy is no stranger to skepticism. Because it is fairly new to the general public, it often falls victim to the dissemination of flawed information. We understand this and not only expect your concerns, but welcome them! In addition to the vast number of personal success stories, vision therapy has the scientific research to back it up! Check out these links from Optometrists Network and The College of Optometrists in Vision Development which cite a number of different scientific articles:  




I’m Too Old for Vision Therapy

Age is not a factor when it comes to benefitting from vision therapy! Many people think that our brains stop developing at a certain age, but that is simply not true. Since vision therapy is based around the concept of neuroplasticity, our brains always have the capacity to change based on new external stimuli, making our visual systems entirely trainable even later in life. A great testament to this is neuroscientist and author of “Fixing My Gaze”, Dr. Sue Barry. In her book, Dr. Barry raves about how vision therapy treated her strabismus that she was diagnosed with as an infant, and even helped her see depth for the first time at age 47!


My Child Has Dyslexia, Can You Help?

Many parents come to us thinking their child is dyslexic because of symptoms such as reversing letters (such as b, d, p, and q). Actually, dyslexia is a language-based learning disability and so cannot be treated with vision therapy. This is a fairly common misconception because functional vision disorders are often misidentified as dyslexia because they share many similar symptoms. In both cases, their difficulty with reading seems inconsistent with their cognitive skills in other areas of learning. In reality, this could actually be a visual processing disorder in which they struggle with laterality/ directionality, which means they have trouble distinguishing right from left. This is decently common in children in first grade and younger, but if the problem persists past the second grade, they may have a visual processing disorder or dyslexia. To determine which it is, it is important to first rule out a visual processing disorder by getting evaluated by a developmental optometrist. 

Of course this does not cover every myth and misconception surrounding vision therapy, but they are some of the most widespread! If you have any questions or think you or your child may benefit from vision therapy, do not hesitate to call and set up a comprehensive vision evaluation with us or another developmental optometrist!

Vision Therapy and Autism

As many now know, autism is on a spectrum and can look differently in different people. It is a neurobiological disorder that can have a range of conditions which include challenges with social skills, communication, forming relationships, speech, processing, and responding to information from their senses. Those with autism can also possess very unique strengths and differences too. The Center for Disease Control and Prevention states that 1 in 68 children in the United States have autism; 1 in 42 boys and 1 in 189 girls.

Vision is a neurological process that is directly affected by autism, and so vision problems are extremely common with those with ASD. Whenever there is any kind of developmental delay in a child, vision can also be underdeveloped. However, these visual problems are often overlooked because they coincide with other autistic behaviors such as:

·         Poor eye contact

·         Light sensitivity

·         Looking through or beyond objects

·         Poor understanding of one’s physical place within an area

·         Staring at light or spinning objects

·         Fleeting peripheral glances

·         Side viewing

·         Poor motor skills (gross and fine)

·         Poor eye- hand and eye-body coordination

·         Poor impulse control

·         Poor depth perception

According to the College of Optometrists in Vision Development, those with ASD will often have problems coordinating their central and side vision.  Instead of looking at an object directly when asked to follow it, they look off to the side at the object. And once they do fixate on an object, they tend to then ignore their peripheral vision. COVD also explains how those with autism are oftentimes visually defensive, meaning they avoid contact with specific visual input and can have hypersensitive vision. This difficulty in integrating the two visual systems makes it more challenging to process visual information. Any deficit or disruption in the visual system consequently affects other necessary abilities such as motor, cognitive, speech and perceptual skills.

A vision therapy program would be designed based on the individual’s needs in relation to ASD. The program’s objective would not just be the integration of the central and peripheral systems, but would work to advance the development in several areas including:

·         Sensory issues

·         Initiating and sustaining eye contact

·         Eye teaming

·         Gross and fine motor skills

·         Spatial awareness

·         Visual processing

·         Reduction of repetitive behaviors in response to specific visual input

·         And more!

If you feel like your child with ASD could benefit from a program of vision therapy, do not hesitate to call and set up a comprehensive vision evaluation! The exam may consist of your child wearing certain lenses and performing gross motor activities while we observe their visual responses to both moving and fixated stimuli of various kinds. Your child does not have to be verbal to participate in a vision evaluation!

-Emily Thompson, Vision Therapist

Visual Motor Integration

Visual motor integration fits in seamlessly with the overarching theme of this blog, which is that vision affects and is affected by more than just the eyes. It bears repeating that your eyes, brain, and body exist not as isolated parts, but interconnected functions of a whole you.

Our motor skills are what allow us to move. We have fine motor skills, which are small movements using our smaller muscles such as fingers and wrists. Fine motor skills include eye hand coordination, hand writing, coloring, typing, tying shoes, and more of the like. Then we have our gross motor skills which allow us to make big movements with our larger muscles such as our arms and legs. These skills include eye body coordination, sports, and basically any activity that involves physical activity.

Issues with any of these skills could indicate a visual motor dysfunction, but not necessarily. There does not have to be a deficit in your motor skills or vision to still suffer from a visual motor dysfunction. That is because visual motor integration consists of how well the two systems communicate and work together as a team. According to the Visual Learning Center, “Visual-motor integration is comprised of the ability to correctly perceive visual information, process it, and move your hands or body accordingly.” VMI requires strong motor skills in conjunction with strong visual perception and visual-motor speed. This is more than just being able to catch or throw a ball, which is simply your vision guiding movement. You have to have the ability to correctly perceive a form in order to accurately replicate it as well.

You can spot a visual motor dysfunction early on by recognizing missed milestones such as crawling, walking, or even being able to easily grasp small objects. Other signs of visual motor dysfunction include:

·         Poor spatial awareness

o   Misaligning of numbers

o   Sloppy handwriting

o   Difficulty coloring inside the lines

o   Difficulty writing within lines

·         Poor grip

o   Pencils, crayons, scissors, building blocks, puzzles

·         Poor coordination

o   Clumsiness

o   Difficulty in sports

At The Center for Vision Development, we test for visual motor integration at the initial evaluation, and if found deficient, we incorporate activities designed to help integrate the two systems.

Attached below is a great link from an occupational therapist mother of three, outlining basic visual motor activities. Check it out and try the activities listed if you think your child may have a visual motor dysfunction!

The Connection between the Vestibular System and Vision

               The effects of the visual system are farther reaching than most realize. Vision is not an isolated system, it is inseparable from the brain and the brain is inseparable from the body. This concept is essential to the understanding of how the vestibular system and vision are related. The vestibular system is what gives you your sense of balance and an awareness of your spatial orientation. It is a sensory system located in your inner ear that coordinates movement with balance. According to the Vestibular Disorders Association, we are able to successfully navigate our physical world because of the integration of the vestibular, visual, and proprioceptive (information perceived through our muscles and joints) systems. Our vestibular system develops before our visual system, causing our movement to guide our vision in the first few years of life. But when the necessary visual skills are developed, vision guides movement.

                The College of Optometrists in Vision Development states, “One way the visual and vestibular systems work together is via the vestibular-ocular reflex (VOR). When motion of the head is sensed by the vestibular sensors in the inner ear, the information is processed by the central nervous system. Signals are sent to the eye muscles which cause our eyes to move in the opposite direction. The result is a stable image on the retina.” A brain injury could result in a vestibular- ocular reflex dysfunction which can cause dizziness, imbalance, and an unstable binocular system. When this happens, there is a lack of integration between the vestibular and vision systems. Vision therapy can effectively integrate the two systems.

                One way vision therapy works to integrate the two systems is through strengthening awareness of your peripheral vision. Most go through their daily routines without thinking twice about their peripheral vision. In fact, most children have no idea what it is. By becoming aware of and processing what you are seeing in your periphery, your spatial awareness increases. Not only does there need to be a balance between the visual and vestibular systems but also between the visual systems: the central processing system and the peripheral processing system. It is just as important to be able to clearly see what your eyes are pointed at as it is to be aware of your surroundings (think driving). In vision therapy, we work to balance out the two visual systems first, and once those are sufficient, we begin to incorporate vestibular work. We do this by including head movement, body movement, balance, filters, and prisms. By simultaneously working on movement and vision, the two systems become neurologically reconnected.

The Dynamic Vision Therapy Center has a great list of possible visual symptoms when the vestibular-ocular reflex is impaired:

•             Uncontrolled, repetitive movement of eyes

•             Issues with balance, coordination, depth perception, and visual acuity

•             Objects appear to bounce

•             Light sensitivity

•             Difficulty looking at moving objects, rows of similar objects, lines of text, etc.

•             Visual dependence:

o                             Additionally, with the lack of integration between the vestibular and visual system, the movement of objects near the individual can be mistaken for one’s own movement in space.

If any of the above sounds like you or your child, schedule a comprehensive vision evaluation with us today!

Is it Dyslexia?

October is Dyslexia Awareness Month!

                I think it is important for me to start by outright saying that vision therapy does not treat dyslexia. According to the International Dyslexia Association, dyslexia is a “language-based learning disability and refers to a cluster of symptoms that result in people having difficulties with specific language skills, particularly reading.” Because dyslexia is a problem with language, not vision, vision therapy is not a beneficial treatment option. It is very common to think otherwise for several reasons.  A functional vision disorder can be misidentified as dyslexia because they share many similar symptoms. Those with dyslexia struggle to read despite generally having normal to high intelligence. The same is also true of those with functional vision disorders. In both cases, their struggle with reading does not seem consistent with their cognitive skills in other areas.

                Many parents come to us saying they think their child is dyslexic because they consistently reverse letters (such as b,d,p,q). In reality, this could actually be a visual processing disorder in which they struggle with laterality/ directionality, which means they have trouble distinguishing right from left. It manifests itself in reversing their letters and/or numbers. This is decently common in children in first grade and younger. But if the problem persists past the second grade, they may have a visual processing disorder or dyslexia. The only way to know for sure is to get them evaluated by a developmental optometrist in order to first rule out a vision problem.

                Functional vision disorders such as strabismus, convergence insufficiency, and accommodation insufficiency can cause slow, choppy reading. This happens because the attempt to compensate for these orders can cause major visual fatigue. An oculomotor dysfunction, which is the inability to accurately control eye movements, can cause one to skip words, lines, and words to appear jumbled and floating around on the page. These setbacks can often lead to poor reading comprehension as well. Dyslexia shares these same symptoms, making it increasingly difficult to determine what the exact issue is.

According to the International Dyslexia Association, other symptoms of dyslexia include difficulty with:

·         Learning to speak

·         Sounding out letters and words

·         Recognizing commonly seen words

·         Organizing written and spoken language

·         Spelling

·         Learning a foreign language

·         Correctly doing math operations

·         Remember certain facts

              If your child is struggling with reading and learning and you are unsure what the cause is, it is important to first rule out a vision problem! You can do this by visiting a developmental optometrist for an evaluation. There is no one solution to dyslexia, but there are recommended treatment options such as multisensory reading programs that focus on using all the senses to learn.  If you believe dyslexia may be the problem, have your child evaluated by a reading specialist and/ or doctor as soon as possible!

-Emily Thompson, Vision Therapist


Jack's Success Story

Patient Success Story- Jack, Age 11, Length of Treatment: 8 months

Jack’s Success Story:

       “Before vision therapy I was having problems with focusing on the words while I was reading and the words were blurry at first and they would go in to two words. But now since I’ve done eye therapy it’s all gone. It’s helped in school, sports, reading, focusing, and everything else. It’s made my life better.”

Jack’s mom’s success story:

       “Before vision therapy, Jack was having problems with comprehension, reading out loud, writing and staying engaged in the classroom. He is an outgoing, very athletic young man with lots of friends but was challenged with long hours of homework. ‘I can’t’ was the first words out of his mouth when doing homework. After 3 months in therapy, his willingness began to improve and grades increased 10 points. Since then he went from a D student to an A/B student, completing his homework and studying on his own. His confidence in himself has been the best outcome ever.”

       When I first started seeing Jack, he complained of words “flipping or looking backwards”, moving around on the page, and seeing double. When initially evaluated, he was diagnosed with accommodation insufficiency, difficulty with saccades, intermittent alternating exotropia, and convergence insufficiency. This basically means his eyes did not turn in enough to focus on near work. His eyes had a tendency to drift outward. He had difficulty rapidly moving his eyes between fixation points, and he had trouble switching his focus from near to far and vice versa. It is no wonder he was fidgety and easily distractable when reading!

       Jack’s success with vision therapy is mainly due to his dedication to completing home therapy 5-6 times a week. It is not enough to do vision therapy in office for 45 minutes a week. 20 minutes a day makes all the difference. It is best to get into a routine so that you don’t forget or put it off. Resistance to home therapy at first is completely normal and even expected. At first, Jack’s mom had to make him do the home therapy each day, but by the end of therapy, he was the one reminding his mom! School work and reading gradually shifted from being a frustrating task to a fun activity that boosted his confidence when he started receiving higher grades. He was ecstatic that vision therapy not only helped him in school, but sports as well! Jack loves baseball and was so excited when his skills improved. He also mentioned having difficulty rock climbing before, but now he can make it to the very top!

       When doing vision therapy, it is very easy for a child to become discouraged due to the challenging nature of the activities. But if they know what they are working for, why they are doing each activity, and begin to see the progress, then they can fully dedicate themselves to the program. That dedication is vital in order to see full results. Vision is learned! We cannot learn for you; we can only guide you in the proper direction of learning. YOU must do the learning. Jack is a prime example of how hard work in vision therapy can change your life! We are so proud of him and all of our patients for their hard work and determination.

-Emily Thompson, Vision Therapist

Functional Vision Disorders Misdiagnosed as ADHD

      I’ve mentioned this topic in several of my previous writings, but I feel its importance renders its own post.  The past couple decades have seen the rise of the diagnosis of ADHD, especially in school-aged children. According to the Center for Disease Control and Prevention, the American Psychiatric Association states that approximately 5% of children have ADHD. They also give statistics on children ages 4-17. Approximately 11% (6.4 million) of children in this age range have ever been diagnosed with ADHD. The percentage of children continues to increase from 7.8% in 2003 to 9.5% in 2007 to 11% in 2011-2012. While experts are still disputing exactly how often it is being misdiagnosed, there is no question that it is happening.

      The symptoms of ADHD can look strikingly similar to several disorders, but one of the most common includes functional vision disorders. The College of Optometrists in Vision Development state that, “Some children with learning difficulties exhibit specific behaviors of impulsivity, hyperactivity, and distractibility.”

      Accommodation insufficiency (difficulty changing focus from near to far) is a common functional vision disorder which can cause poor attention in the classroom. A child copying notes from the board can easily fall behind due to his eyes’ inability to change focus fast enough. This can lead to confusion, frustration, and oftentimes giving up. Their attention then goes elsewhere to relieve their suffering. When their attention is no longer on their work, they can become fidgety and easily distractible.  A teacher who has no idea of the child’s vision issues can understandably label them as having discipline or attention issues due to ADHD.

      Another vision issue that shares the same symptoms as an attention disorder is the inability or difficulty to move both eyes in a precise, coordinated way, known as eye teaming. Issues with eye teaming, especially convergence insufficiency (the reduced ability of the eyes to turn toward each other), can cause blurred vision, double vision, eye strain, headaches, and so on.  According to Dr. Granet of the Children’s Eye Center, children with convergence insufficiency are three times more likely to be misdiagnosed with ADHD than children without the disorder. If a child cannot even see the words clearly, and is having to exert much effort just to see normally, then their ability to process what they are reading is greatly reduced.  It is hard to imagine trying to understand what you are reading, remember what you read, and then answer questions about it if you are spending the majority of the time trying to decode each individual word. Between visual discomfort and low reading comprehension, it is no wonder they cannot stay on task with reading and schoolwork.

      Almost any functional vision disorder results in a reduced ability to complete any kind of near work, such as reading or writing, for a long duration. The visual demands are too great to comfortably endure for hours on end while in school. This results in difficulty completing assignments on time, especially on tasks like timed tests. In an effort to keep up, they are also prone to make careless mistakes.

      Other functional vision disorder symptoms that manifest themselves as behaviors and habits which look like an attention disorder on the surface include: losing place when reading, skipping or repeating words, poor visual memory, poor reading comprehension, inability to verbalize visual information, and so on. Each of these has the ability to create an aversion to reading and learning in the child experiencing them. This, not surprisingly, can oftentimes lead to poor self-esteem, anxiety, and depression which can continue well into adulthood.

      If you are unsure whether your child’s symptoms are due to a functional vision disorder or an attention disorder, the only way to know for certain is to have a comprehensive eye exam by a developmental optometrist. Once examined, if a visual issue is identified, a program of vision therapy is the best course of action to treat both the disorder and its symptoms. Once complete we can then determine if an attention issue is also present or if it was purely visual. Vision therapy is a much healthier and beneficial treatment option in the long run versus immediately resorting to medication to fix the issue, especially if you are unsure exactly what the issue may be.

Emily Thompson, Vision Therapist

How Concussions Affect Vision

       More and more people in our society are becoming aware of the severity of concussions and the effects they can have on one’s life. But not everyone realizes that these effects oftentimes manifest as functional vision disorders. According to The Concussion Project, over 50% of patients with a concussion or post-concussion syndrome have visual problems. Up to 1/3 of concussion symptoms are visual, proving just how intimately related the brain and visual system are. A concussion can occur from a direct or indirect blow to the head, causing the brain to hit the inside of the skull. The Concussion Project claims that nearly 4 million concussions occur every year in the US alone.

Common symptoms of a concussion can include:

·         Dizziness

·         Double vision

·         Eye strain

·         Headaches during visual tasks

·         Poor reading comprehension

·         Head tilting

·         Problems with balance

·         Poor depth perception

·         Sensitivity to light

·         Aching eyes

·         Loss of visual field

·         Blurred vision

·         Ocular motor dysfunction

·         Motion sensitivity

·         Reduced cognitive abilities

·         Reduced visual processing speed

·         Convergence insufficiency

·         Accommodative insufficiency

       Contrary to popular belief, most concussions actually do not include a loss of consciousness. The Advanced Vision Therapy Center states that fewer than 10% of sports-related concussions have associated loss of consciousness. Not surprisingly, sports are the most common cause of concussions in children. Since loss of consciousness is not a required component, oftentimes people (children especially) do not even know that they have one. This makes it increasingly difficult to recognize and diagnose.  Another challenging aspect to diagnosing and treating concussions is that the subsequent vision problems are not always immediately obvious. Visual symptoms can take up to several weeks to surface.

       The Advanced Vision Therapy Center states that 67% of the neural connections within the brain are involved with some aspect of vision, including visual input, visual perception, and visual integration. Some visual symptoms following a concussion can be simply treated by lenses or prisms. But vision therapy is a form of neuro-optometric rehabilitation and thus the best choice of action following a head injury. Vision therapy is sometimes most effective after the brain has had a little time to heal.

        The most common visual disorders that are associated with concussions mentioned in the symptoms above include convergence insufficiency, which is the inability of the eyes to turn inward enough to focus on a close target. This contributes to double vision, eye strain, headaches, and so on. Another common disorder is accomodative insufficiency, which is the inability to successfully change your focus from near to far and vice versa. This contributes to blurred vision, aching eyes, and more. Reduced visual processing speed and ability is also possible, which is difficulty in your brain’s ability to quickly make sense of visual information. Poor reading comprehension is often a result of a reduced visual processing ability. Ocular motor dysfunction is also possible following a concussion, which is a defect in the ability to have purposeful eye movement. This can be exhibited in a variety of symptoms, all which are easily treatable by vision therapy!

       If you are experiencing vision problems due to a concussion, head injury, or seemingly out of the blue, then schedule an appointment with a developmental optometrist to receive a comprehensive vision evaluation.

-Emily Thompson, Vision Therapist

"The eyes look, but the brain sees": Visual Processing Disorders

       Vision therapy does not only treat functional vision disorders, but perceptual ones as well. A visual processing disorder is not a physical disability of the eye, it is a deficit in the brain’s ability to identify, organize, and process visual information. One can have 20/20 vision and still have a visual processing disorder. The eyes are purely a vessel to transmit what the brain sees. Having this disorder does not entail that one has an attention disorder, intellectual disability, or learning deficit. It is not clear how many people are affected by this because it is not easily diagnosed or recognized by teachers. Read through the symptoms below, and if you believe your child is experiencing a visual processing disorder, do not hesitate to make an appointment with a developmental optometrist!


·         Difficulty discriminating between certain letters/ numbers

·         Omit, substitute, repeat, or confuse similar words

·         Confuse left/ right directions

·         Difficulty with sizing, spacing, or copying written words.

·         Reversing numbers/ letters

·         Easily distracted by too much visual information

·         Difficulty writing within lines or margins

·         Difficulty completing puzzles

·         Trouble spelling or recognizing familiar words with irregular spelling patterns

·         Eye strain


There are several different types of visual processing skills needed for both academic and daily success. Those skills include:


Visual discrimination: the ability to identify similarities and differences in visual images such as shapes, sizes, colors, objects, and patterns

o   Ability to quickly see the small details in things

o   A child might have difficulty distinguishing between similar letters such as b, d, p, and q.

o   Treatment Example Activity: Attribute blocks: We have blocks of differing shapes, sizes, thickness, and color. We work with the patient on being able to quickly recognize all of the differences and similarities.


Visual memory: the ability to recognize information about what one has seen (short or long term)

o   Treatment Example Activity: We use blocks of differing shapes and colors and arrange them to form a design. The patient has as much time as they need to memorize this design. It is then covered up and they have to recreate it from memory.

§  In order to ensure they are using their visual memory as opposed to auditory, we sometimes have them listen to music or sing the alphabet while they are memorizing.


Spatial Relations: the ability to be aware of oneself in space. An organized knowledge of objects in relation to oneself in that given space (even when there is a change of position).

o   Issues with this can manifest in being clumsy, bumping into things, and knocking things over.

o   This can affect handwriting as well as they may have difficulty with the spacing of letters and words.

o   Treatment Example Activity: Estimating Distances: The patient must use their spatial reasoning and visualization skills to guess how many of their feet (heel to toe) it will take to get to a certain point. Their errors show them the difference between their perceived judgment of distance and the actual distance.


Form Constancy: the ability to identify or sort objects, shapes, symbols, letters, and/or words despite differences in size or position (or when viewed from a different angle or in a different environment).

o   This can cause difficulty recognizing words they know that are presented in a different manner.

o   Treatment Example Activity: Mirror rotations: We have them practice writing letters, shapes, etc. as a mirror image. We use an x and y axis so that they have to flip the image both horizontally and vertically.


Sequential Memory: the ability to remember a series of forms/ numbers/ letters/ objects in order

o   Treatment Example Activity: Visual Presidents: The patient is presented with a series of images each representing a president (ex.: a picture of a mad sun is Madison). After learning what each picture represents, they practice recalling the presidents in order simply by looking at the pictures. This also practices visual memory.


Figure ground: ability to identify a figure from its background.

o   You see words on a printed paper as the “figure” and the white sheet as the “background”

o   This affects the ability to easily complete things such as crossword puzzles and word searches.

o   Treatment Example Activity: Magic Eraser: Letters and words are hidden within a combination of shapes, the patient must guess find the word/ letter within the shapes and then create their own.


Visual Closure: the ability to recognize an object, letter, or number without seeing all of the object (visualizing a complete whole).

o   Treatment Example Activity: Multi Matrix: They complete a puzzle in which they move blocks around in the order they are presented on a card. The card has incomplete images on it, but the blocks have the complete images.


Visualization: forming a mental image

o   The inability to visualize makes it difficult to process texts as a whole and see the story in their head as they are reading.

o   Treatment Example Activities: We give the patient an image to picture in their head, and they must manipulate that image how we tell them to (turning a yellow pencil blue).

o   Another activity we like to use is called word movies. They are given a series of words which they must create a story out of.


A visual processing disorder cannot only negatively affect a child’s academic success but their self-esteem as well. Understanding what to look for is the first step on the road to increasing your child’s confidence in reading and learning!

-Emily Thompson, Vision Therapist

Learning-Related Vision Problems

       Every child should have every opportunity to reach their full potential, especially in school! As adults we should do everything possible to make sure a child’s love for learning is not stifled by any means. But 1 out of every 10 children struggle with reading and learning due to undiagnosed vision problems, that is 5 million children in the US alone. Most of these vision problems go undetected if a child has only had a basic vision screening. The College of Optometrists in Vision Development says that these typical vision screenings can miss up to 50% of vision problems. These statistics might be shocking but that is all the more reason to advocate for required comprehensive eye exams by a developmental optometrist for all school aged children.               

        Learning and vision are so intimately related that approximately 80% of learning is visual. By vision, I do not mean just seeing clearly. Seeing clearly is just one out of 17 visual skills needed for academic success. In fact, oftentimes kids who have a learning-related vision disorder have 20/20 vision. There are 3 types of learning-related vision disorders: refractive (acuity, sharpness of vision as measured by an eye chart), functional (neurological control of eye movements), and perceptual (understanding and identifying what you see). The visual skills needed for successful learning according to COVD include: 

·         Eye movement control

·         Simultaneous focus at far

·         Sustaining focus at far

·         Simultaneous focus at near

·         Sustaining focus at near

·         Simultaneous alignment at far

·         Sustaining alignment at far

·         Simultaneous alignment at near

·         Sustaining alignment at near

·         Central vision (visual acuity)

·         Peripheral vision

·         Depth awareness

·         Color perception

·         Gross visual-motor

·         Fine visual-motor

·         Visual perception

·         Visual integration

       You might start suspecting your child has a learning-related vision disorder if they are very intelligent yet are still struggling in school. A learning-related vision disorder can look like attention disorders, learning disorders, laziness and an aversion to reading and learning. Children are too often misdiagnosed as having one of these because the symptoms are so similar to a vision problem. Symptoms include but are not limited to:

·         Skips or rereads lines

·         Loses place when reading

·         Doesn’t like to read

·         Prefers to be read to

·         Cannot write notes from the board fast enough

·         Headaches

·         Eye strain

·         Difficulty remembering what has been read

·         Difficulty paying attention

·         Number/ letter reversals such as b, d, p, and q.

·         Homework takes longer than it should

       It is hard to imagine trying to understand what you are reading, remember what you read, and then answer questions about it if you are spending the majority of the time trying to decode each individual word. Those with vision problems thus cannot visualize the words, see a story in their head, or quickly process the text as a whole. If your child is experiencing this, you might notice that they tend to verbalize most things instead of using visualization skills. Vision not only affects the processing of words and numbers but also handwriting. The visual system guides handwriting through an understanding of spatial concepts, laterality/ directionality, and gross motor skills.

       Any one of these symptoms is enough to hold a child back from reaching their full potential, especially as they get older and the print gets smaller and the reading demands increase. But a learning-related vision problem does not only affect academic success but also acts as a ripple effect throughout their entire life. These issues may cause children emotional problems such as anxiety, depression, and low self-esteem. The American Optometric Association Clinical Practice Guidelines mentions that, “Vision disorders that occur in childhood may manifest as problems well into adulthood, affecting an individual’s level of education, employment opportunities, and social interactions.”

       At The Center for Vision Development, we strongly encourage getting help as soon as a problem is noticed! We go to great lengths to ensure that a child does not go through their life hating school and learning. We write accommodation letters to teachers so that they have a better understanding of how their student’s vision is impacting academic performance. Based on the doctor’s assessment of their visual abilities and anticipated classroom demands, we offer recommendations to assist in the classroom. If asked to, we make phone calls or email back and forth with teachers and tutors. We can send copies of home therapy activities to whoever is assisting in addition to the parents. We even encourage bringing in homework and incorporating it into the therapy plan!

       If you suspect you or your child may be experiencing these symptoms, take our symptoms quiz and/ or request an appointment before the new school year!

-Emily Thompson, Vision Therapist

Convergence Insufficiency

       The first visual disorder I want to go into more detail about is convergence insufficiency. It is among the most (if not the most) common binocular vision disorder we treat at CVD. Optometrists Network states that it is the leading cause of eyestrain, blurred vision, double vision, and/or headaches.  Convergence means to come together and meet at a point. So, convergence insufficiency is the inability of the eyes to turn inward enough to focus on a close target. It entails the inability of the eyes to work together in a simultaneous, coordinated manner. This affects one’s capability to do near work such as reading, writing, and computer use. The tendency of the eyes to drift outward means they are essentially looking past the focal point. Many who experience this, work extra hard to turn their eyes inward to eliminate double or blurred vision, which can not only cause eyestrain and headaches but also: poor concentration, poor comprehension, tendency to lose place, and words seemingly float or jump around.

       The negative impact these symptoms can have on a person’s daily life, especially a child in school, are obvious. So how is this visual disorder not more widely known? According to the Optometrists Network, “A person can pass the 20/20 eye chart test and still have convergence insufficiency”. Also, if a child has convergence insufficiency, they might not know that what they see is abnormal because it is all they know. Concurrently, they might not know how to communicate what they are experiencing either. It is challenging for anyone to communicate exactly what their eyes are doing, especially a young child. This barrier often manifests itself in behaviors and habits that look very similar to those of attention disorders, learning disorders, laziness, and aversion to reading and learning.

       Aside from the unhealthy behaviors and habits which stem from the symptoms, a person can have convergence insufficiency yet not complain of any of the aforementioned symptoms. This happens when a person’s brain has essentially found a way to cope with double vision by halting communication with one eye. The eye can still be perfectly healthy, yet it is not taking in any information. This is called suppression and it is the subconscious effort of the brain to eliminate the symptoms of disorders of binocular vision. This is essentially equivalent to someone covering or closing one of their eyes when doing close work, which can also be a coping mechanism for someone with convergence insufficiency.

       Through weekly vision therapy sessions and at home therapy, we are able to train the eyes to turn inward. This process takes time and numerous methods, but I’ll delve deeper into one of those methods in order to give you a glimpse into effective treatment. After patching, and after each eye has proven successful on its own, we begin binocular work. One of the first things we do to begin treating convergence insufficiency is called physiological diplopia. This practice is essentially teaching what normal double vision is supposed to look like. To do this, we’ll have them put an object such as a writing utensil or their finger about 6 inches away from their face and then choose a distant object across the room. When looking at the object/finger closest to your face, you should see two of the objects in the distance and vice versa. Those with CI will initially struggle to see only one of the close objects because their eyes constantly want to look further in the distance. Those with suppression will not see double at all. This is an important beginning step for those with a binocular vision disorder to understand what “normal” vision is supposed to look like. From there, we can begin training the brain to have total control over the eyes.

       If you think your or your child has convergence insufficiency or any other binocular vision disorder, do not hesitate to call and set up an evaluation with Dr. Taddese. We want every child to have every chance to succeed in school and live up to their potential!


Scientific Articles: 

  • Convergence Insufficiency Treatment Trial:

-Emily Thompson, Vision Therapist


More Than 20/20: Vision Therapy Concepts You Need to Know

I cannot reiterate enough that vision is much more than 20/20. Visual acuity (sharpness of vision) is only one minute aspect of vision. Vision therapy is not intended to make you see more clearly, but rather to train your brain to better communicate with your visual system.  If you don’t completely understand what that statement means, do not worry! In order to gain a more comprehensive understanding of what your or your child is going through due to a vision disorder and thus experiencing in vision therapy, then it is very important that you are familiar with certain terms and concepts. The list below is a good place to get started!

·         Fixation: maintaining gaze on a single location

·         Accommodation: the ability to change your focus from near to far and vice versa.

·         Eye tracking: the motion of the eye

o   Saccades: rapid movement of the eye between fixation points

o   Pursuits: smoothly follow a moving object

·         Eye teaming: both eyes working together           

o   The basis for single vision and depth perception

·         Binocular: using both eyes with overlapping fields of view

·         Monocular: both eyes are used separately

·         Diplopia: double vision (seeing double)

·         Vergence:  the movement of both eyes at the same time to turn opposite directions in order to have single vision when looking at a point.

o   When looking near: eyes need to converge (turn in)

o    When looking far, eyes need to diverge (turn out)

o   Convergence insufficiency: An eye teaming problem in which the eyes have a strong tendency to drift outward when reading or doing close work

·         Strabismus: abnormal alignment of the eyes

o   Esotropia: one or both eyes turns inward

o   Exotropia: one or both eyes is turned outward

o   Hypertropia: one or both eyes turn upward

o   Hypotropia: one or both eyes turn downward

·         Amblyopia: lazy eye, impaired vision without obvious defect in appearance of eye.

·         Suppression: the brain ignoring all or some of the image of one eye in order to subconsciously eliminate the symptoms of disorders of binocular vision

·         Vestibular: sense of balance

·         MotorSkills:

o   Gross motor skills: movement and coordination of the arms, legs, and other large body parts

o   Fine motor skills: involved in smaller movements that occur in the wrists, hands, fingers, feet, and toes.

·         Visual perceptual: the ability to see and interpret the visual information around us

If any of these definitions sound like you or your child, do not hesitate to try out vision therapy! Treatment of these visual deficits does not only benefit sight, but is paramount to success in so many aspects of daily life. Knowledge of these terms gives you the tools to spot the problem before you or your child falls behind in school or work due to an undiagnosed vision disorder.

-Emily Thompson, Vision Therapist

Primitive Reflexes Part 1

       After the first week of syntonics, patients are typically given a primitive reflex exercise as their second home therapy activity. When explaining primitive reflexes, one of our most frequently asked questions is, “How does this have anything to do with vision?” That is a completely understandable and expected question. It may seem odd that one of the first activities you or your child is doing at vision therapy resembles physical therapy. But it actually is not so odd when you fully understand how vision works! Vision is inseparable from the brain which is inseparable from the body. Your brain has to communicate with your eyes and body to facilitate normative functionality in everyday life.

       So, what are primitive reflexes exactly? Essentially, they are reflexes which help infants survive and adapt to the sensory stimuli around them in their first year of life.  They are automatic responses to their new environment and are even vital to the birthing process. They create the basis for cognitive and motor skills. By the first year of age, as their central nervous system develops, these reflexes should typically be inhibited and evolve into more mature responses called postural reflexes. They should begin using their processing skills in place of their survival techniques. According to the Brain Balance Achievement Center, “Retained primitive reflexes can lead to developmental delays related to disorders like ADHD, sensory processing disorder, autism, and learning disabilities. The persistence of primitive reflexes contributes to issues such as coordination, balance, sensory perceptions, fine motor skills, sleep, immunity, energy levels, impulse control, concentration and all levels of social, emotional, and intellectual learning.” Our brain serves as the control center for these reflexes, and our brain is completely trainable! By training our bodies to integrate out of these reflexes, we are creating new neural pathways which can effectively treat the above symptoms and create strong functional visual skills.

       There are numerous causes for retention, some which are unknown, but most have to do with the birthing process. Various studies have shown that factors such as C sections, low birth weight, traumatic births, lack of tummy time, a skipped crawling phase, and much more can contribute. I often find patient’s parents are slightly embarrassed that their child still has “baby reflexes”. But almost all of our patients have more than one retained reflex. There were even some still present in me when I was tested! Their ability to hinder adults is not significant if the adult has lived a successful life. But if your child is exhibiting some of the above symptoms, there is no reason not to give them every chance possible to reach their full potential, especially when it is so easy. There are specific exercises we distribute at certain periods during each patient’s vision therapy process based on which reflex they have retained. They are one of the first things we test for during the initial evaluation. Read my next blog post to learn in detail how we test for them and what we do to treat them!

-Emily Thompson, Vision Therapist

Syntonics: Optometric Phototherapy

          If you’ve never experienced vision therapy, then chances are slim that you’ve heard of syntonics. But I chose it as the subject of my second blog post because its significance should not be overlooked or misunderstood. Syntonics, which is a form of light therapy, serves as the starting point for nearly all vision therapy patients! Also referred to as optometric phototherapy, the practice of syntonics consists of sending frequencies of light to the brain through the eyes. According to Dr. Ray Gottlieb and Dr. Larry Wallace in the Journal of Behavioral Optometry, “Energy medicine, which also includes different forms of light therapy, is rapidly becoming a global phenomenon used by a variety of health professionals from medical physicians to chiropractors, acupuncturists, physical therapists and psychologists. In our view, there lies the future of medicine,” (Syntonic Photherapy, 31).

            A patient’s first session usually entails them staring into different frequencies of light depending on their particular visual dysfunction. Syntonics has been proven successful in the treatment of numerous visual dysfunctions such as eye turns, lazy eyes, focusing, vergence issues, and even emotional disorders and brain injuries! It proves most effective for those who suffer from headaches, head injures, or various visual dysfunctions simultaneously. Aside from treating particular issues, syntonics broadens the visual field, which is not only how much we are able to see in our periphery but how much information our brain is actually processing. Those with a functional visual field problem may be physically seeing their surroundings, but their brain is essentially ignoring it. I recently had an adult patient who suffered from migraines and double vision. After only one week of syntonics, her headaches were less frequent and she commented, “I’ve never noticed all the buildings I pass on my drive to work until now!” For her and many others, syntonics is an effective alternative when medicine does not work.

            In addition to changing how your brain and eyes interact, syntonics also balances out your sympathetic and parasympathetic nervous system. Dr. H.R. Spitler founded syntonics in the early 1900s and named it so because “syntony” means to bring into balance. In 1933, Spitler published The Syntonic Principle, which included clinical results from syntonic practitioners and showed that 90.7% of individuals taking the treatments responded positively. We have now been using this field of science clinically for over 70 years! (Syntonic Phototherapy, 31).

            So, what does it entail exactly? During a patient’s initial consultation, the optometrist will test their pupil. They do this by shining a pen light in their eye and observing how fast the pupil returns to normal or dilates, which is called pupillary release. If the pupil does not constrict and stay small for at least ten seconds, then that is usually a sign of a reduced functional visual field or a nervous system imbalance. (Syntonic Phototherapy, 31). The doctor will then prescribe them certain colors of light based on these results along with history and symptoms as well. Typically, those starting vision therapy will do syntonics for a minimum of three weeks, at least six days a week. They come in once a week for an in-office session in which they sit in a darkened room and stare into a unit which emits two different frequencies of light, each for 10 minutes at a time. At home, they are either given their own light unit and do the same or are given glasses in which they sit in a very bright room or outside on a sunny day. Immediately after the 10 minutes is up, they close their eyes and report what they see. It is usually a mix of various colors. This feedback, as well as performing weekly visual fields on the patient, shows us how much information they are taking in from their periphery, and essentially how effective the syntonics is on them. Other indicators include behavior changes and reduction in symptoms.

           To learn more about syntonics, read the scientific article which I have previously mentioned by clicking the link below. To find out if you can benefit from syntonics, schedule an appointment with Dr. Taddese through our website!

-Emily Thompson, Vision Therapist

Vision Therapy: The Basics

   Hi all, The Center for Vision Development is starting a bi-weekly blog in order for anyone who is interested in vision therapy to learn more about it in a detailed, yet simplified way! Although vision therapy is not a new practice, it is still relatively unknown to the general public. We, along with numerous other practices and developmental optometrists, are striving to spread the word about this amazing field that has transformed so many lives.

   What is vision therapy exactly? Well, one of the most common misconceptions is that it strengthens the muscles in your eyes. Actually, our eye muscles are already extremely strong and do not need to be strengthened! What VT actually does is train the brain to better communicate with the visual system. As vision therapists, we create individualized plans in order to help your eyes and brain make those connections, which eventually become automatic habits! Our visual systems are entirely trainable because our brains have the capacity to change based on new external stimuli.

   What if your eyesight is 20/20? Your visual acuity, which is sharpness of vision, measured by the ability to discern letters or numbers at a given distance, is no indication of whether you need vision therapy or not. Routine eye exams merely test for whether you need glasses and/ or surgery. They do not cover essential visual skills such as eye movements, focusing, eye teaming, hand-eye coordination, visual memory, and so many more which are necessary for basic tasks in your daily life.

   We not only teach visual exercises that progress in difficulty over time, but what makes us unique from other kinds of therapies, is that we utilize corrective and therapeutic lenses, prisms, filters, and numerous other specialized medical equipment.

   Who and what kinds of visual deficiencies do we treat the most? While most of our patients are children, it is very important to know that it is never too late to treat your visual deficiencies! That is a myth that needs to be dispelled. We treat patients of all ages, from toddlers to seniors. The most common types of visual issues we see and treat are convergence insufficiency, learning-related vision problems, poor binocular vision, amblyopia (lazy eye), diplopia (double vision), strabismus (crossed-eyes, eye turns), stress related vision problems, visual rehabilitation for special needs, and sports vision improvement.

   Many of these terms and concepts are not familiar to the general public, so I will be covering these along with activities we do to treat them in more depth in blog posts to come! I will also attach scientific articles, success stories, informative videos, and more!

-Emily Thompson, Vision Therapist