Vision Therapy Center at EYEcenter Optometric In Sacramento, California
Vision is all about the way our brains and eyes interact. Whether we’re reading words on the board, catching a ball, or tying our shoelaces, we depend on our visual system to work properly in order to succeed so many tasks.
That’s because vision isn’t just what we see, it’s how we interpret and interact with that information. In fact, you can have perfect visual acuity―able to rattle off all the symbols on the reading chart―but still struggle with dyslexia, poor focus, hand-eye coordination, or vision conditions like strabismus, amblyopia, or convergence insufficiency.
What Is Vision Therapy?
Vision Therapy helps patients improve their foundation for reading, learning and playing sports. It’s a series of custom and individualized activities and exercises which function as a form of neuro-optometric rehabilitation.
In other words, Vision Therapy retrains the brain to more effectively interact with the eyes and therefore improve vision functioning. The goal is to enhance eye tracking, focusing and eye teaming abilities as well as eye-hand coordination and visual processing speed. The program is not only for children. Vision Therapy is effective for adults, especially if they are motivated to improve their visual abilities.
Common Conditions That Vision Therapy Helps
Your Sacramento Developmental Optometrist can help with lazy eye (amblyopia), eye turns (strabismus), traumatic brain injury (concussion, whiplash) and special needs populations. Research has shown that 20% of children have a vision issue that affects their learning.
What Is Amblyopia?
Amblyopia, commonly referred to as “lazy eye," is when there is a significant difference in power between the eyes. This is often, but not always, caused by an alignment or eye-teaming problem such as strabismus.
Some common symptoms and problems associated with lazy eye are:
- Poor depth perception
- Head tilting
- Social stigma
- Slow reading*
*According to a study published on November 2015 by the Journal of the American Association for Pediatric Ophthalmology and Strabismus, children with amblyopia read slower 42 words per minute than children without amblyopia that read 81 words per minute.
Treatment For Amblyopia
It’s not about the “bad” eye! Amblyopia or “lazy eye” is best treated by Vision Therapy.
First, the source of the amblyopia must be identified. When indicated, eyeglasses are prescribed. Many eye doctors, particularly pediatric ophthalmologists, begin treatment by patching the "good" eye. However, numerous studies have indicated that patching has been proven to be ineffective! Likewise, some doctors recommend atropine eye drops. However, atropine eye drops merely address the symptoms and not the neuro-optometric cause itself.
The common approach treats the problem as a problem in that one eye. Treating one eye may improve the acuity (being able to see letters on a chart) for a while, but often reverts and regresses.
The developmental approach taken by Vision Therapists realizes that amblyopia is really not an eye problem, but rather a problem of not being able to use the two eyes together as a team (eye-teaming). This approach is therefore often much more successful. In the same way that it was difficult for a parent to identify if someone had the problem to begin with, it is often difficult for them to know if an eye doctor's recommendation to patch the eye is really working. They, therefore, may be losing time with an ineffective and outdated treatment plan.
Amblyopia does not go always away on its own, and it can significantly affect a child’s ability to learn and thrive socially in school. Untreated amblyopia can lead to permanent visual problems and poor depth perception. To prevent this and to give your child the best vision possible, amblyopia should be treated early by vision therapy.
At What Age Can Vision Therapy Treat Amblyopia?
An old axiom that is still believed by many eye doctors is that amblyopia must be detected and aggressively treated before the age of 8 or 9. In reality, treatment for amblyopia or lazy eye is effective for adults too. A child’s visual system is more malleable at a younger age, potentially making treatment quicker or easier. However, adults with amblyopia or “lazy eye” tend to be more motivated patients. Improved eye teaming is nearly always achievable.
What Is Strabismus?
Strabismus, often referred to as “Crossed Eyes”, “Wandering Eyes”, or “Wall Eye” is a condition where the eyes fail to align properly. Beyond the social stigma, strabismus often results in other vision and visual processing problems such as diplopia (double-vision), amblyopia ("lazy eye") and problems with depth perception. A major concern for developmental optometrists is that strabismus is not as simple to diagnose as a visual check. In fact, you can have strabismus without any obvious crossing or eye turn.
What Kind Of Strabismus Are There?
There are four kinds of strabismus, two horizontal and two vertical:
- Esotropia: one or both eyes turn in, relative to the other
- Exotropia: one or both eyes turn out, relative to the other
- Hypertropia: one eye turns up relative to the fixating eye
- Hypotropia: one eye turns up relative to the fixating eye
Treatment For Strabismus And The Causes
All too often, parents are told not to worry about their child's strabismus symptoms, reassured that their child will 'grow out of it'. Unfortunately, in many cases, the symptoms of the problem do not improve as the child grows, and meanwhile, strabismus causes significant difficulties with reading and learning. Treatment varies depending on the cause of the eye-turn, and may include:
- Vision Therapy
- Prism Therapy
- Eye muscle surgery
Eye muscle surgery can sometimes make the eyes appear to others as if it is straight, but it rarely aligns with the other eye, and, despite undergoing the surgery, the visual challenges associated with strabismus may persist without additional therapy. A program of Vision Therapy for children or adults is usually required in order to improve visual function and the ability to properly use the two eyes together as a team.
What Is Convergence Insufficiency?
Convergence Insufficiency is a neuro-visual condition where the eyes fail to come together (to converge) enough to achieve proper visual perception. The condition is particularly related to near-vision or near-center and visually demanding activities. This can result in:
- Poor school performance and behavioral problems
- Blurred vision
- Diplopia (double-vision)
- Asthenopia (eye strain and fatigue)
- Difficulty making eye contact
- Headaches and migraines
- Difficulty reading and concentrating
- Avoidance of “near” work
- Poor sports performance
- Dizziness or motion sickness
A study of almost 700 5th and 6th graders indicated that convergence insufficiency is much more common than many assumed, with 13% of students having convergence insufficiency, as well as demonstrating that, of the children who showed three signs of convergence insufficiency, 79% were classified as having accommodative insufficiency as well.
Treatment For Convergence Insufficiency
Eye coordination problems such as convergence insufficiency and convergence excess generally cannot be improved with eyeglasses or surgery. Likewise, research demonstrates that the traditional focus exercise often called "pencil push-ups" are ineffective. The only consistently effective treatment for convergence insufficiency is office-based Vision Therapy, which will improve eye coordination abilities and reduce symptoms and discomfort when doing close work.
Other Vision Therapy Subjects
Dyslexia, ADD/ADHD, & Learning Disabilities
Most people are familiar with vision problems that eyeglasses address; nearsightedness, farsightedness and astigmatism. These are called refractive conditions.
A learning-related visual problem directly affects how we learn, read, or sustain close work. Because difficulties with reading and learning affect the child's ability to focus, vision related learning problems are often misdiagnosed as ADHD or other behavioral issues.
Visual problems in any of the following areas can have a significant impact on learning:
- eye tracking skills - eyes following a line of print
- eye teaming skills - two eyes working together as a synchronized team
- binocular vision - simultaneously blending the images from both eyes into one image
- accommodation - eye focusing
- visual-motor integration - eye-hand coordination
- visual perception - visual memory, visual form perception, and visualization
Vision and learning are intimately connected. Someone may have a learning problem that is caused by an underlying vision problem. A child with a vision problem can be misdiagnosed as having Learning Disabilities, ADHD, or Dyslexia. There are various reasons for this misdiagnosis. For example, children who have learning-related visual problems cannot sustain their close work at school or home and often show signs of Inattention or Hyperactivity. A child may be misdiagnosed with ADD or ADHD because children with ADHD also can't sustain attention on their work, and inattention and hyperactivity are the two of the three main symptoms for the diagnosis. Same behaviors with vastly different diagnoses.
It is common for children who have Learning Disabilities to have vision problems that contribute to these learning problems. Vision Therapy does not correct learning disabilities, but correcting the underlying vision problems through Vision Therapy often solves many of the obstacles that make learning more difficult than it need be. Call our Vision Therapy Clinic in City1 for more information.
Traumatic Brain Injury, Stroke, MS And Concussions
Acquired Brain Injuries
A brain injury such as a concussion will often disrupt the visual process that interfere with how information is taken in and processed.
Vision can be also be compromised as a result of a neurological disorder such as a stroke, a brain tumor or Multiple Sclerosis. These are termed Acquired Brain Injuries.
When someone has a Traumatic Brain Injury (for example a car crash or a bad fall) or an Acquired Brain Injury (stroke or brain tumor), it is common to then develop problems associated with vision. Making sense of what you see is one of the most basic and important brain functions. Your City1 Neuro-Optometrists help individuals solve the vision problems brought about by that brain injury. Addressing the vision problem often facilitates improvement with other therapies. Neuro-Optometrists diagnose and treat the vision problems in order to maximize the patient's outcome, with the ultimate goal of these services to improve the patient's quality of life.
Neuro-Optometric Rehabilitation at our vision therapy center serving City1,City2,City3,City4 treats patients with a specialized Vision Therapy program for those who have suffered a brain injury, that effectively treats visual problems including:
- Diplopia (double vision)
- Eye-tracking problems
- Binocular Vision Dysfunctions (the ability to coordinate the two eyes to work together)
- Reduced visual acuity at far (how clear the letters are at distance)
- Reduced visual acuity at near (how clear the letters are at reading distance)
- Accommodative Disorders (physically focusing the eyes)
- Difficulties in visual perception (are objects where I think they are?)
- Visual Field loss (not being able to see on the right side of the right eye, for example)
- Deficits in visual motor (eye movement problems)
- Ocular Motility disorders integration (putting together eye movement with body movement)
- Visual Information Processing (making sense of what you see)
- Strabismus (eye turns)
- Mental visual focus
- Physical eye focus
These Visual Issues..
These visual issues affect how someone is able to function on a daily basis. Addressing these vision conditions to the recovery process. In fact, patients typically gain more from neuro-developmental vision therapy than they do from other therapies, such as occupational therapy, physical therapy, or cognitive therapy, etc.
Vision issues such as the ones listed above are all too often the main obstacle in achieving a full recovery.
Vision Therapy For The Special Needs Community
Autism And Developmental Disabilities
Vision problems are very common in individuals with developmental disabilities such as autism. These problems or stims include:
- lack of eye contact
- staring at spinning objects or light
- fleeting peripheral glances
- side viewing
- difficulty at maintaining visual attention
People with autism and other developmental disabilities often have trouble efficiently and accurately processing visual information, often combined with difficulty coordinating between peripheral and central vision. Following an object (eye-tracking) is also a typical problem. There is usually a preference to scan or glance at objects from the side instead of looking at it straight on. Eye movement disorders and crossed eyes are common in the autistic spectrum.
Vision Therapy is effective at in stimulating and improving proper visual responses, eye movements, and the central visual system. Vision Therapy is also effective in helping patients to better organize visual space and gain peripheral stability so that he or she can better attend to and appreciate central vision and gain more efficient eye coordination and visual information processing. Dr. is certified as a Fellow of the College of Optometrists in Vision Development (COVD) and is experienced in examining and treating individuals with developmental disabilities and autism, even those who are non-verbal.
Vision Therapy And Down Syndrome
Patients with Down Syndrome overwhelmingly require eye care, with 70% requiring glasses and 45% of people with down syndrome have strabismus, which is usually best treated by a Vision Therapy Optometrist. Furthermore, there are a variety of ocular diseases associated with Down Syndrome patients such as tear duct abnormalities that can lead to severe discomfort, keratoconus (misshapen cornea) and congenital cataracts. A patient with down syndrome will also require specialized glasses made for their unique facial features.
Vision Therapy And Cerebral Palsy
Patients with Cerebral Palsy will most likely have visual conditions that require correction with glasses and in many cases Vision Therapy. Recent research on Vision Therapy for Cerebral Palsy is showing that it is extremely effective. Many patients with Cerebral Palsy will have Strabismus, or, “crossed eyes”, which is most effectively treated with a Vision Therapy program that is personalized to the patient.
Links to further research
What Is Sport Vision Therapy?
20/20 eyesight and good hand-eye coordination are not enough to maintain peak performance for sports. We tend to underestimate the complexity and challenge posed to our visual system when we try to hit a ball moving at 65-80 miles per hour. Sports Vision Training uses the principals of Vision Therapy in research-backed therapy that improves sports performance through improving skills such as:
- Better hand-eye coordination
- Improved depth perception and estimation
- Faster reaction times
- Vision and balance
- Precise eye movement and tracking
Our optometrist, Dr. Randy Fuerst & Dr. Hannah Mikes provides cutting-edge sports vision training to athletes from Sacramento, Folsom, Roseville, Elk Grove.