Monthly Archives: August 2014

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What Vision Therapy Can and Cannot Treat

Vision therapy helps children with vision problems develop or improve visual skills, abilities, and efficiencies. If your child is diagnosed with a functional vision problem or visual processing disorder, an individualized vision therapy treatment program, under the supervision of an optometrist trained in developmental and functional vision care, can significantly improve or correct the visual deficiency.

Some visual conditions cannot be treated adequately with just glasses, contact lenses, patching, or surgery. When appropriate, these conditions are best resolved through a program of vision therapy.

Effective vision therapy is an individualized treatment program designed to correct visual-motor and/or perceptual-cognitive deficiencies. Sessions include procedures designed to enhance the brain’s ability to control eye focusing, eye teaming, eye tracking, or visual processing.

Click here for 9 Signs Your Child May Have an Undiagnosed Vision Problem

Here are are just a few examples of conditions that affect vision and interfere with learning, which can be treated successfully with vision therapy:

Accommodative (focusing) dysfunction

A child with an accommodative disorder has trouble using his eye muscles appropriately to bring an object into focus clearly or to maintaining focus for a sustained period of time. The muscles that focus the lenses in our eyes have to adjust quickly (and often) to see various points of visual interest clearly, or sustain that clear focus over a period of time, without vision becoming fuzzy or blurred. Vision therapy can treat accommodative disorders successfully.

Amblyopia (lazy eye)

A child with amblyopia has reduced vision in one eye because normal and healthy connections between the child’s eyes and brain did not form correctly during developmental stages. The deficiency causes the brain to favor one eye over the other and suppresses images from the affected eye. Vision therapy can treat amblyopia successfully.


Strabismus is a condition in which the eye is either constantly or intermittently turned – usually inward or outward (often the cause of amblyopia). In a child with strabismus or other similar alignment problems the eye that points straighter becomes dominant. In severe cases, surgery may be required, but vision therapy can treat strabismus successfully.

Convergence insufficiency

Convergence is the ability to aim one’s eyes at a near distance, and children with a healthy visual system are able to aim their eyes naturally and easily.Convergence insufficiency is a medical condition in which the brain has trouble accurately, efficiently, and comfortably coordinating the eye muscles to see properly for a prolonged period of time at reading distance. Vision therapy can treat convergence insufficiency successfully.

Visual Processing Deficiencies

Normal visual processing requires a complex system of neurological activity to be developed and functioning properly. Many children lack good visual processing skills. Because of a delay in development or disorder, their vision system has trouble computing visual input, leading to problems with visual-motor integration and speed, visualization, visual memory, and more. Vision therapy can treat visual processing problems successfully.

Unfortunately, a lot of children continue to struggle unnecessarily due to undetected vision problems that can be treated successfully with vision therapy. However, one reason so many vision problems go undiagnosed is that they often resemble similar problems that cannot be treated with vision therapy. As parents discover the remarkable results achieved in vision therapy programs, it’s important to understand that vision therapy is not a miracle cure for untreatable conditions.

Some examples of conditions that vision therapy does not treat include:

Myopia, Hyperopia, Astigmatism

Vision therapy does not treat nearsightedness (myopia), farsightedness (hyperopia), or astigmatism. Children with these common condition, which blur vision, are prescribed eyeglasses or contact lenses to optically correct the problem, by altering the way in which light enters the eyes. Myopia, hyperopia, and astigmatism are all caused by an irregularity in the length of the eyeball itself or curvature of the cornea, and therefore cannot be corrected by vision therapy. (Note: Vision therapy is sometimes confused with the Bates Method or the See Clearly Method which do not have the same scientific basis or reputation as vision therapy.)


Vision therapy does not cure dyslexia. the signs and symptoms of dyslexia and learning-related vision problems practically mimic each other, with subtle differences. Even a professional trained to recognize dyslexia may not suspect a vision deficiency without proper awareness. Dyslexia cannot be cured, though many learn to cope with it well and succeed; however, learning-related vision deficiencies that have symptoms similar to dyslexia can be treated and even eliminated by vision therapy. Click here to learn more.

Unrelated Learning Disabilities or Developmental Delays

Vision therapy does not eliminate developmental delays or learning disabilities unrelated to vision. A child with an undetected vision disorder may be misdiagnosed with a learning disability; but a learning disability such as an auditory or language processing disorder, cannot be treated with vision therapy. Many children diagnosed with learning disabilities and developmental delays also struggle with vision problems. If your child has been diagnosed with developmental delays, and he or she is not making expected progress from working with an occupational therapist or in another type of early learning developmental therapy, it could be due to an undetected vision problem that can be treated with vision therapy.

Attention Deficit Disorder or Attention Deficit Hyperactivity Disorder (ADD/ADHD)

Vision therapy is not an antidote for ADD/ADHD, as it does not directly treat impulsivity, hyperactivity, or inattentiveness. However, some children are misdiagnosed with attention deficit disorder when the symptoms they display are actually related to a vision disorder. Teachers might describe your child as distracted or antsy, report that your child daydreams in class, stares out the window, or looks around the room when he should be focusing on his paper or the board. You may have noticed that your child has a short attention span, difficulty staying on task, or following instructions. If the child has a vision problem, he may be diverting his eyes to avoid strain, “acting out” due to frustration, or coping by avoiding tasks; but if the problem is unrelated to vision, vision therapy will not help.

Test Performance in Children with Healthy Vision

In the competitive environment of an educational system that relies heavily on standardized testing, some parents look for creative methods to give their child an edge. You may have learned that vision therapy has helped a friend’s child improve test scores or grades and wonder if your child’s performance in school could be boosted by vision therapy too. Vision therapy does not improve performance in school or tests for children who do not have vision disorders. However, many children could benefit from following these tips to ease eye strain.

When your child is having trouble in school or difficulty learning, it can be confusing and troubling for you as a parent.

Learn more about how vision affects learning by watching this webinar for parents.

Fortunately, vision therapy addresses and treats learning-related vision problems that might be holding your child back. But the first step is always to determine if your child does indeed have a vision problem.

So check for these 9 signs; and if you suspect a problem, schedule a comprehensive vision exam by an optometrist who specializes in functional and developmental vision care right away.

If you are located in Olney or Silver Spring, Maryland, contact us for an appointment.

What Your Child’s Handwriting Could Reveal About Struggles With Reading

Many children struggle to read because of an undiagnosed vision problem. These children are often bright and may have passed a vision screening with 20/20 eyesight; so it is not always readily apparent that a vision deficiency is to blame for difficulty reading. Most parents and educators are simply unaware that vision is so critical to learning and that healthy vision is comprised of so much more than being able to pass a typical eye exam.

Sometimes parents and teachers attribute reading and learning difficulties to laziness, behavior problems, or attention deficits. You may notice that your child is skipping words or lines or seeming to bounce around the text; so you might assume that he or she is distracted, being careless, or not trying hard enough.

The truth is, a child with learning-related vision problems often becomes frustrated. Every effort to complete tasks, such as reading and writing that comes more naturally and easily to their classmates with healthy normal vision systems requires extra effort and strain. Because they are young and unaware that a problem exists, they are unable to articulate what they are experience and their self-esteem often suffers.

More often than not, your child will not be able to tell you that he’s experiencing a vision problem, because he has no way of knowing his experience isn’t normal. Your family eye doctor doesn’t usually detect a problem, because he is only trained to test for specific eye conditions. Teachers, occupational therapists, and other professionals are all-too-often simply uninformed about learning-related vision deficiencies.

So how can you know if a vision problem could be to blame for your child’s reading and learning difficulties and trouble in school?

Click here for 9 Signs Your Child May Have an Undiagnosed Vision Problem

Poor handwriting skills could be a sign that your child is struggling with a functional vision problem.

Exceptionally messy handwriting with crooked or poorly-spaced letters or words could indicate an undetected functional vision deficiency that is interfering with your child’s ability to read and learn.

Misaligned words or letters in your child’s handwriting could be a clue that your child is struggling with poor eye teaming or eye tracking — functions crucial to following text on a page without strain.

If your child’s letters are big and sloppy, this might be due to avoiding using the visual system as much as possible while writing. They may avoid looking directly at the paper and scribble words on the page while barely looking.

Conversely, a child with vision problem may have tiny handwriting. If they struggle with visual-motor function, they may make an extra-concentrated effort to control their hand using minimal movement, and the result is unusually small handwriting.

Another indication way handwriting may indicate a learning-related vision problem is that your child’s handwriting may become increasingly messy over time. She may start off her homework with relatively neat writing, but 15 minutes later, you can barely make out what she’s written. This is because a child with a functional vision deficiency is constantly struggling to keep the eyes turned, focused, and moving smoothly from left to right. So the strain quickly leads to fatigue that becomes apparent in declining handwriting.

You may also notice that your child reverses letters, such as ‘p’ and ‘q’ or ‘b’ and ‘d’ when writing. Often confused with dyslexia, a learning-related vision problem may be interfering with the visual processing system and cause affected children to reverse letters.

To be clear, messy handwriting or writing errors are not always a sign that a child has a vision problem. But if your bright child is struggling with reading and you’re not sure why, it’s time to start looking for some answers. If you’re aware and you look carefully enough, you may start to see some of the telltale signs, such as the handwriting clues we’ve outlined here.

Handwriting problems may arise if a child has a problem with visual dominance due to amblyopia (lazy eye), deficient eye movement skills, or poor visualization skills, among other possible problems — all of which affect reading and learning as well.

The good news is, vision therapy can help, and your child can experience a significant improvement in a relatively short period of time. A child can learn to strengthen eye movement skills, look ahead to where the pencil is going, point and focus eyes in the right place, incorporate peripheral vision, and more.  Vision therapy that improves handwriting will also improve learning. 

If you suspect your child has a learning-related vision problem, schedule a comprehensive vision exam with a developmental optometrist who specializes in functional vision care.

To learn more about how vision affects learning, download our free guide here, and watch our webinar for parents here.

If you live in Olney or Silver Spring, Maryland, contact Dr. Philip Nicholson’s Visual Learning Center to schedule a comprehensive vision exam today.

Click here to learn more about why your child loses his place while reading. To learn more about how vision problems interfere with reading comprehension, click here. To find more information about how vision therapy will help your child with reading, go here.

What Parents Need to Know About How Vision Problems Interfere with Learning (Even if a Child Has 20/20 Eyesight)

Did you know that your child could have 20/20 eyesight yet still have a vision problem that significantly interferes with his or her ability to learn? It’s true, and it’s more common than most parents, teachers, child-development professionals, or even family eye doctors are aware.

Vision is comprised of three main components — reception, processing, and output; and each of these main components of vision are complex.

  • Reception is the ability to see clearly, singularly, and comfortably. It’s the input function, similar to entering data into a computer.
  • Visual Processing is the brain’s ability to determine and compute the information our eyes receive. After the computer gets the data, it manipulates, categorizes, and runs it through various processes.
  • Output is the result of visual processing.

If any aspect of the complex vision system is not functioning in a normal and healthy way, the ability to learn can be impacted significantly.

Click here to read 9 Signs Your Child May Have an Undiagnosed Vision Problem


Your child’s vision exam typically only covers the ability to see letters on a chart clearly and singularly for a few seconds.

However, there is a third component of reception that is also important, but isn’t tested by many doctors— the ability to see comfortably. For example, if you hold a pen within inches of your nose, you may be able to see clearly and singularly. But for how long?

Seeing the pen singularly and clearly for just a few seconds does not mean that your eyes can work properly and without strain for longer periods. For instance, you may be able to lift a chair with one hand for a few seconds, but does that mean you can hold it at that height for thirty minutes? No.

Likewise, many children who can look at the tip of their nose cannot maintain clear, single vision at near for more than a few minutes. And those children who can’t, feel strained, tired, or fatigued when reading. They may rub their eyes, blink, or close or cover one eye to avoid using them both. And often, they will try to avoid the activities that make them feel uncomfortable.

Watch for signs of strain and discomfort in your child as he or she reads, works on a computer, or writes, because these problems can affect learning.

Visual Processing

Typical vision exams do not test for visual processing skills. Normal visual processing requires a complex system of neurological activity to be developed and functioning properly.

For example, visual processing speed and accuracy involves reading words, sentences, and numbers quickly and accurately. Selective concentration within visual processing requires a child to stay on a visual task, even with distractions present. Visual memory is an aspect of visual processing that refers to the ability to accurately remember what is only seen for a short period of time. Visualization is the process of creating a mental picture in the mind that is used to solve a problem.

Many children lack good visual processing skills. Because of a delay in development or disorder, their vision system has trouble computing visual input. They can’t make sense of what they see as easily as their peers who have a properly functioning vision system.

Consequently, visual processing problems may cause their performance of everyday tasks such as reading, memorizing, and studying tends to be slower than normal, and their abilities in these areas can fall below average.


Output is the ability to take the gathered and processed information, and make an appropriate response or action. For example, the output may be the creation of a mental image, an oral or written response, or a gesture.

A child who tends to make more errors than average to complete a task, and/or uses an excessive amount of energy to handle visual information, could be revealing deficient visual processing skills in their output. Often, but not always, the symptoms of a vision problem become apparent in the output.

A child who makes more reversal errors than average may have underlying visual processing problems in the areas of visual memory, discrimination, visualization, laterality, and association skills. Poor visual-motor integration could be the cause of messy handwriting.

Vision Therapy Can Help

At the Visual Learning Center in Olney, Maryland, our vision training program is concerned with all three components of vision (reception, processing and output). But we concentrate on visual processing skills most because they are so vital to effective learning.

No one knows the full reason why some children have a greater difficulty with visual processing skills — it’s part hereditary, part environment, and part education-based.

The important thing to note is that, though vision problems can interfere with learning, visual processing skills are learned skills that can be improved. Comprehensive functional vision exams and testing can pinpoint which visual processing skills are most deficient, so that an individualized vision therapy program can focus on specific areas.

By concentrating on and correcting specific problem areas in your child’s visual processing system, vision therapy can eliminate many of the underlying causes of learning difficulties. The symptoms a child with vision problems experience, such as discomfort, poor memory, poor concentration and comprehension, toiling over simple tasks, and avoiding complicated tasks, can improve significantly in a relatively short amount of time or even disappear altogether.

To learn more about how vision affects learning, download our free guide here, and watch our webinar for parents here.

If suspect that an undetected vision problem is interfering with your child’s ability to learn effectively, schedule an exam with a developmental optometrist who specializes in functional vision care right away.

If your family lives in Olney or Silver Spring, Maryland, contact us at Dr. Philip Nicholson’s Visual Learning Center to schedule an appointment.