Monthly Archives: August 2014

How Vision Therapy Helps Children With Amblyopia (Lazy Eye)

If a child has amblyopia (sometimes referred to as “lazy eye”), it means he or she struggles with reduced vision in one eye because the brain and the eye are not working together and functioning as they should.

Amblyopia occurs because something blocked or blurred vision during the child’s developmental stages, so as a result, normal and healthy connections between the child’s eyes and brain did not form correctly. The deficiency causes the brain to favor one eye over the other and suppresses images from the affected eye.

In a patient with amblyopia, the suppressed eye itself tends to be healthy; but because the brain is favoring the other eye, the affected eye is not being used.

As a parent, teacher, or occupational therapist, it is important to note that many children who have amblyopia do not actually complain of vision problems. They have adapted or grown accustomed to favoring one dominant eye.

If you notice your child tilting his head or closing one eye in order to see, this is often a tell tale sign of amblyopia. You may also be able to observe that your child’s eyes are not aligned, that they are not moving together as a team, or that one eye is turning inward, wandering outward, upward, or downward.

Other common symptoms include poor depth perception, clumsiness, and squinting. Your child may complain of eyestrain or headaches. Amblyopia can make it difficult for a child to catch a ball or perform well in sports. At school, he may have trouble with near work or struggle to copy from the board.

Most commonly, amblyopia is caused by strabismus, which is a misalignment of the eyes. With strabismus, the eye is either constantly or intermittently turned–usually inward or outward. Rather than strain to adjust the misaligned images, the eye that points straighter becomes dominant.

If misalignment is not the cause, amblyopia may also occur if there is a significant difference between the two eyes. For example, one eye may not be able to focus as well as the other eye, the affected eye may be more farsighted or nearsighted than the other, there may be an anatomic block such as a droopy eyelid, or one eye may have more astigmatism than the other eye. Rather than strain to compensate for the less competent eye, again, the brain begins to favor one eye over the other.

Early detection of amblyopia is important. If left untreated, the brain will eventually ignore vision in the eye that is affected. Without proper attention by a trained optometrist who specializes in developmental and functional vision care, amblyopia will cause persistent vision problems.

If your child’s amblyopia is caused by a severe eye turn, surgery may be suggested; however this is uncommon and it’s usually an outpatient procedure. If one eye sees significantly more clearly than the other, eyeglasses are prescribed. Usually, a combination of eye patching, eye drops, and vision therapy exercises lead to significant improvement in patients with amblyopia, particularly if the condition is caught early.

If you suspect that your child has amblyopia, schedule a functional vision exam with a developmental optometrist today.

The purpose of vision therapy exercises in amblyopic children is to strengthen overall vision by correcting the way the brain processes visual images. Vision therapy exercises are designed to force the brain to pay attention to the suppressed images seen by the weaker or amblyopic eye.

At the Visual Learning Center, our vision therapy programs for amblyopia are based in the best scientific research available in the field of vision and learning, and our methods are continually modified to incorporate new scientific data to achieve the best results. Each individualized session includes procedures designed to enhance the brain’s ability to properly control the whole vision system and targets your child’s specific deficiency.

If your family is local to Olney or Silver Spring, Maryland, contact us to schedule a functional vision exam with developmental optometrist, Dr. Philip Nicholson here


Vision Therapy: How to Improve Vision Skills at Home

Vision Therapy helps children with functional vision problems, often resulting in dramatic improvement in their ability to overcome the visual deficiencies and the special challenges they face. With the help of vision therapy, children with vision disorders experience significant improvements in reading, writing, spelling, math, classroom behavior, sports, social skills, and more.  

To learn more about functional vision problems and vision therapy watch this webinar for parents.

Effective vision therapy includes an individualized and intensive program, in which patients work closely with trained therapists under the supervision of an optometrist who specializes in developmental and functional vision care.

One-on-one attention allows for immediate feedback that enables your child to actually recognize the difference in his or her performance, quickly improve self-esteem, and make significant progress in a relatively short period of time.

Your child’s vision therapy program should target and train skills that are most likely to have an impact on the unique learning and academic difficulties he or she is facing. The immediate goal should be to develop meaningful skills that will be used in daily activities, so that they will retain skills over the longterm.

Once you notice the improvement your child makes in vision therapy, you may wonder what you can do to enhance their progress at home.

At the Visual Learning Center, we encourage parental involvement and we require practice outside of office visits. Practicing at home is a cost-effective way to reinforce repetitious procedures and help transfer learned skills to everyday use.

We believe practicing at home contributes to the results our families are able to enjoy together, and parents report that it helps to mend and strengthen the relationship with a child that has been strained due to “homework wars” and getting into trouble at school (for “acting out” due to vision-related frustrations).

Click HERE to download our list of fun, age-appropriate activities that you can do at home with your child. This guide also includes a list of games, online resources, and apps.

Download (3-pages)

Download (3-pages)

Remember that these activities are intended to enhance a vision therapy program, not replace it. If you suspect your child has a learning-related vision problem, first contact a developmental optometrist to schedule a comprehensive functional vision exam. Only a trained professional can develop an appropriate course of treatment.

For even more activities, visit our resource center here.

If you you are located in Olney or Silver Spring, Maryland, contact Dr. Philip Nicholson’s office to schedule a functional vision exam today.

girl with motion sickness due to vision problem

Motion sickness could be a sign of an undiagnosed vision problem

Learning-related vision problems are not always immediately evident in a classroom setting. Sometimes the first signs that your child could have a vision problem become noticeable far from a school environment.

On your next family road trip or as you travel across town, your child may experience an often-overlooked tell-tale sign of a functional vision deficiency — visually-induced motion sickness.

Symptoms of visually-induced motion sickness include headaches, nausea, dizziness, eye strain, and photophobia (extreme sensitivity to light). These signs may become more readily recognizable when a child is trying to read in a moving vehicle. Your child may complain of these symptoms on family road trips, so pay attention.

When scenery moves by fast, a conflict occurs between central vision and peripheral vision and balance. What’s happening is the child’s brain receives information that conflicts with his senses. We all do; but if he has an associated vision problem, he could be particularly motion sensitive. The problem is neurological, but treatable. It could be Neuro-Ocular Vestibular Dysfunction (NOVD) or See-Sick Syndrome.

The vestibular system in our brains serves to create balance and calm from the stimuli we take in. It integrates information received from the visual system with information received from what we hear and touch and from our muscle movement and awareness.

A normal functioning system integrates a lot of information quickly and without extra conscious concentrated effort. However, an underlying visual system problem makes the vestibular system’s job more challenging; so if your child already struggles with visual processing, focusing (accomodative dysfunction), eye tracking (ocularmotor dysfunction), or eye teaming (binocular dysfunction), their symptoms may become exacerbated by added or conflicting stimulation.

To learn more about signs and symptoms of functional vision problems, download our free guide “10 Things You Need to Know About Vision” here and watch our recorded webinar on vision here.

In other words, if your child is already struggling to focus his eyes, get his eyes to work together as a team or move smoothly across the page, or to process visual information, the problem might not be evident in a typical classroom setting. But if a peripheral component is added to compete with his attention, such as scenery whirring by on your family road trip when he’s trying to read a comic book, his system will be strained. Information will not be integrated efficiently enough and visually-induced motion sickness will occur.

Simply putting down the book while riding in the car isn’t the answer, because you may be ignoring a possible underlying vision problem. In cases of visually-induced motion sickness, vision therapy can relieve symptoms and decrease instances of motion sickness. And, perhaps more importantly, vision therapy can significantly improve functional vision problems that interfere with learning. If your child was struggling in the classroom, but not enough to cause concern yet, tasks that were challenging will become easier and performance will improve.

So if your child complains of motion sickness while trying to read in the car, train, or airplane, or even while watching action-packed movies, be sure to schedule a functional vision exam with a developmental optometrist right away.

If you are located in Olney or Silver Spring, Maryland, contact us at Dr. Philip Nicholson’s Visual Learning Center today.

child with accommodative dysfunction

Functional Vision Problems: What Happens if Your Child’s Eyes Do Not Focus Like They Should?

Sometimes we need to see things far away, and sometimes we need to see things that are nearby. From moment to moment, those needs change. A child at school, may need to see the worksheet on her desk, the equation the teacher is writing on the board, a book on her lap, a list on the bulletin board, a digital tablet, or a big screen video in the front of the classroom.

Eye muscles function one way to see close items clearly and they function a different way to see items clearly at a distance. The muscles that focus the lenses in our eyes have to adjust quickly and often to focus on various points of visual interest or sustain that focus over an extended period of time. Otherwise, our vision becomes fuzzy or blurred.

If a child has “normal” healthy vision, he or she will have the ability to bring objects of visual interest into sharp focus rapidly and sustain focus as needed. This function is automatic, subconscious, and occurs without extra concentrated effort or strain on the vision system.

However, children with poor focusing skills have a functional vision problem we refer to as accommodative dysfunction. A child with an accommodative disorder has to put forth extra effort and concentration to bring a blurry object into focus or to maintain focus for a sustained period of time. The child will struggle to bring the text on the page in front of her into focus, and then look up to see blurry text on the board, and struggle all over again to bring it into focus.

Her classmates without a focusing problem, will look up at the board and down again at their paper, seeing text clearly each time with no extra concerted effort.

Research has shown that elementary students spend as much as 75% of their day looking back and forth from near to far. So it comes as no surprise that a child who has trouble focusing will grow weary, stressed, and frustrated throughout the day. As a result, these children often lag behind in progress and performance, and sometimes they are misdiagnosed with learning disabilities, dyslexia, behavioral disorders, or attention problems.

Signs your child may have accommodative dysfunction include:

  • Missing more questions at the end of a test
  • Copying from the board slowly or with lots of mistakes
  • Complaining of blurred or fuzzy vision, especially towards the end of the day
  • Rubbing and squinting eyes
  • Poor attention span, fidgeting, and behaviors often mistaken for ADD/ADHD
  • Bending close or bobbing and tilting head while reading
  • Headaches or aching eyes
  • Avoiding reading or near work, especially with small print

A typical eye exam by your family eye doctor or school vision screening generally only tests clear vision at a distance. Most eye doctors do not test accommodative facility, so it’s possible to have 20/20 eyesight yet still have poor focusing skills.

If you suspect your child might have trouble focusing, schedule a functional vision exam with an optometrist trained in developmental vision care right away. If diagnosed, vision therapy treatment can result in significant improvement in a relatively short amount of time.

Click here to read Vision Therapy success stories.

If your family is located in Olney or Silver Spring, Maryland, contact the Visual Learning Center today to schedule a functional vision exam with our developmental optometrist, Dr. Philip Nicholson.