Behavioral Medicine Associates, Inc.

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Good Vision Isn't Just About Good Glasses

Most people think that if their vision, or that of their child's is "20/20" everything is fine with the visual system. At worst, you wear glasses, or if you feel vain, contact lenses. Then everything is fine. This is very far from the truth.

A variety of fairly common, correctible conditions may be stopping you or your child from having the success that is possible for you. Many people do not possess adequate binocular coordination. That is, their eyes are not very happy to aim together smoothly and progressively as an object moves closer to them. The eyes may have poor "fusional reserves"- the eyes don't have the staying power to hold a constant angle of convergence as you read. This results in distractibility, eye strain, tiredness, headaches and poor comprehension.

Developmental and Traumatic Visual Disorders

Neuro-ophthalmologists and behavioral/developmental optometrists are very familiar with binocular vision disorders. These problems may be inherited, or they may be acquired, usually as a result of a mild brain injury from whiplash or a blow to the head. Too many psychologists and physicians miss the problem entirely. Too frequently, assessment of children’s and adult’s vision is limited to measurement and correction of acuity, or clarity of vision. Further, in typical school vision assessments, only distance vision, not close visual acuity is assessed. Binocular coordination, speed of accommodation and other important functions are not measured at all. Acuity is only one of many elements of good vision. The inability to create easy, rapid and clear binocular vision can dramatically interfere with reading, attention and comprehension. Normal acuity near and far, binocular coordination, eye movement skills, peripheral awareness and eye/hand coordination are all critical visual skills needed for success in school. In adult life many people suffer needless headaches and confusion stemming from poor visual processing. This is not uncommon after whiplash injuries or concussions, both of which can create mild traumatic brain injury (mTBI). A common symptom of mTBI is "convergence insufficiency" - the relative inability of the brain to control the aiming of both eyes toward a foreground focal point.
    1. Delayed or incomplete visual development;
    2. Two eyed (binocular) coordination and focusing problems;
    3. Eye movement and tracking problems; and
    4. Amblyopia and/or strabismus.
Sixty to eighty percent of children with reading disabilities have measurable, correctable problems in accurate aiming of both eyes at the line of print. Many children have limited depth perception due to failures of proper binocular vision. These deficits lead to poor eye-hand coordination, clumsiness, and performance problems. Vision therapy corrects these problems through a training process in which the patient learns to control the convergence and divergence of the eyes. We use both stationary and moving “3-D” visual targets to develop these skills. A computer program also is used to improve visual processing accuracy and speed. For example, patients with difficulties confusing similar letters like “b” and “d” can be trained to make more rapid and accurate discrimination between these confusing letters.

Checklist for Visual Problems

Look at the objects in the box below. Make sure you have your glasses on for this if you need them for close work. Can you cross your eyes comfortably until you create a third object in the middle? Here is some "real" Virtual Reality!

You should be able to cross your eyes slightly and see a total of three objects. The middle one should look cool. It should consist of a background "starburst," a smaller burst standing out in "3-D" in front of it, then a small item closest to you. If you have trouble doing this, hold your finger about a foot away from your computer screen, with your fingertip right below the white box. Focus on your fingertip. You should see the third object now, right above your fingertip. If you're really good you can "uncross" your eyes and again see three objects. The middle one will again be in "3-D," but this time it should look like there's a hole in your screen with objects behind it. This can be harder to do than the first (eyes crossing) exercise. Can you see the "Magic Eye" type pictures? Can your children do this? If not, you may want to learn more about Vision Training, available now at our Edina, MN office. Look up a behavioral optometrist in your local Yellow Pages. Search "Vision Therapy" or "Sports Vision Training" on the internet. Professionals with training in optometric vision therapy can get vision therapy supplies from Bernell Corporation .

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