Tag Archives: developmental optometrist

A child that sees like this can pass a vision screening [infographic]

As a parent, you’re dedicated to ensuring your children are healthy, thriving, and have access to the best available learning opportunities. So when your child undergoes an eye exam at school or with your family eye doctor and passes with “20/20 eyesight” or a prescription for corrective lenses, you’re probably confident that his or her vision is fine.

As far as common knowledge goes, you’ve done everything necessary to make sure your child is able to see clearly enough to perform well in school. If your child continues to struggle in school, it must be due to something else, right?

Unfortunately, most eye exams do not test for functional vision problems that often interfere with learning and performance. A typical eye exam with your family optometrist or ophthalmologist generally only tests to determine if your child can see clearly at a distance for a period long enough to complete the exam. It doesn’t test for eye movement and visual processing problems that may affect your child’s ability to see, learn, and complete tasks for a sustained period of time in a learning environment.

The general exam doesn’t check into how well the eyes work together as a team, how quickly the eyes focus when moving from one visual plane to another, how smoothly the eyes move across the page when reading, how efficiently the brain processes information taken in by the eyes, or a number of other areas of functional vision.

Only a functional vision exam by an optometrist trained in developmental vision care can diagnose learning-related vision problems such as convergence insufficiency, amblyopia, strabismus, blurred vision, double vision, and more.

Children who see like the illustrations below can still pass a typical vision test:

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As you can now see, if your child sees like any of the above illustrations, learning can be challenging. Children with functional vision problems struggle more than their peers to learn, not because they are not bright and capable of learning, but because their visual system is not functioning in a healthy manner.

The good news is, once he or she receives an appropriate diagnosis, a personalized and intensive vision therapy program can lead to significant lasting improvements in a relatively short period of time.

Click here to read “9 Signs Your Child May Have an Undiagnosed Vision Problem,” to learn more about signs and symptoms of functional vision problems that interfere with learning.

After reviewing the signs and symptoms, if you suspect your child may have a learning-related vision problem, schedule a functional vision exam with a developmental optometrist today.

If you are located in Olney or Silver Spring, MD, contact Dr. Philip Nicholson’s Visual Learning Center to schedule an appointment today.

5 Tips to Help Your Child Ease Eye Strain

We all experience eye strain from time to time. Whether we’re avid readers or our work keeps us glued to a computer screen all day, modern work and play taxes our eyes and our entire visual system now more than ever before in history.

Think about the number of images, emails, text messages, television shows, social media updates, books, and more that we consume each day of our lives today compared to our own childhood, or consider stark difference between the way we use our eyes each day and the way our great grandparents used their visual systems. It should come as no surprise that modern work, school, and entertainment can cause our eyes can become overworked if we are not careful.

For a child who is still in developmental stages of growth, eye strain can be particularly taxing. If that child has an functional vision problem, the effects of eye strain can severely interfere with learning. Even when well-rested, children with learning-related vision problems struggle more than their classmates to read, write, and perform in the classroom; so additional stress to the visual system can be particularly detrimental.

We suggest that all parents work with children to help them avoid and alleviate eye strain whenever possible. If your child has a vision problem, this is especially important.

Here are 5 tips to help your child ease eye strain:

1. Limit Screen Time

While there is nothing wrong with allowing your child to use smartphones, video games, computers, or tablets for fun and to develop comfort with technology, it’s important that you limit their screen time to protect their eyes. We understand that kids love their devices and this can cause fits or tantrums, so we suggest gradually replacing their screen time with other enjoyable activities.

2. Use Adequate Lighting

If you were the kid who tried to read under the covers with a flashlight despite your parents saying you’ll “ruin your eyes,” this tip might ring a bell. Keep in mind that if what you’re reading is brighter than the rest of the room, it will cause a strain on your eyes. This goes for back-lit screens or working in a dark room with a small desk lamp. So remember that your child will incur less eye strain if he works in a well-lit room, with preferably natural or full-spectrum lighting.

3. Work at a Proper Distance

Does your child sometimes try to write with his head down on his desk or read with his chin propped up on a book? It’s best to sit up straight and work with slightly more than a foot or an arm’s length distance away from the text. Your child may mistakenly believe reading closer is helping to ease the strain, but it is only making matters worse.

4. Take Breaks

Our eyes need an occasional break in order to avoid strain. Encourage your child to take a short break every 15 to 20 minutes.  Put the book or pencil down and step away from the screen every so often. Ask her to get up and stretch, close her eyes tightly for a few moments, or focus on objects in the distance for awhile. Pushing a child to keep working, especially if she is already struggling with a vision problem, will only cause more eye strain and greater difficulty learning and performing.

5. Get Active

Children with functional vision problems sometimes not only struggle with learning, but they have difficulty with coordination, sports, and social interaction as well. For this reason, they may avoid outdoor and physical activities in favor of video games and television. Encourage your child to play outside when possible — go for walks and look around at the environment, play in the yard with the dog — activities that will give the eyes a break from working and stimulate the visual system in a different way.

If  you suspect your child has a functional vision problem that is exacerbated by eye strain, help him or her to follow these tips. Then schedule a comprehensive vision exam with a developmental optometrist immediately. In addition to properly resting the eyes, an intensive vision therapy program will provide relief of unnecessary strain and improvement to vision.

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

Does homework in your household drag on for hours? Convergence insufficiency could be the cause

If your child spends hours completing homework each evening, your initial frustration might be with his teacher. You may complain that too much homework is being assigned and worry that the school is to blame for interfering with family time, play time, or outdoor and extracurricular activities; but over time, you eventually realize that your child is taking much longer to complete his homework than his peers.

You know that your child is bright, so why is he struggling to complete homework in a timely manner? You could suspect a learning disability or attention deficit disorder, but your child could actually have a vision disorder, even if he was found to have “20/20” eyesight during a vision screening at school or an exam by your family’s eye doctor.

Vision disorders and poor visual processing skills are sometimes to blame for “homework wars” and poor performance in the classroom.

As a parent, it is important to pay close attention to your child’s symptoms. You might be tempted to dismiss complaints as excuses and urge your child to push forward and try harder. However, if your child has a vision problem such as convergence insufficiency, his symptoms could be presenting significant challenges to performing well on school assignments.

Convergence–the ability to aim ones eyes at a near distance–is a required skill for reading and other schoolwork. 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.

If your child often complains of headaches or claims that his eyes hurt, feel like they are pulling, tired, or uncomfortable, this could be a sign of convergence insufficiency. Difficulty concentrating or remembering what he has read could be symptoms as well. A child may also complain of double vision, or say that that words float, swim, or move in and out of focus. He may read slowly, lose his place, or read the same line more than once.

If your child is having difficulty in school or completing homework, and you notice any of these red flags, schedule an evaluation with a functional or developmental optometrist, trained to detect and treat learning-related vision problems, as soon as possible. If diagnosed with a vision problem such as convergence insufficiency, the good news is vision therapy can treat and improve your child’s convergence problem significantly and quickly.

If you are in the Olney, MD or Silver Spring, MD area, contact the Visual Learning Center today to schedule a comprehensive evaluation with Dr. Philip Nicholson and his staff.

My child has “20/20” eyesight but still has trouble copying off the board at school. What could cause that?

You probably remember struggling from time to time to see the blackboard in school when you were a child. Maybe you sat in the back of the classroom, behind the tall kid, or someone with big hair sat in front of you. Perhaps you needed your first pair of glasses before you could easily make out the letters and numbers on the board without squinting.

If you remember those brief periods of frustration, you understand how some children with certain vision problems feel throughout the day while struggling to copy from the board, even with 20/20 eyesight.

Modern classrooms include whiteboards, ActivBoards, and Promethean Boards. Students spend a lot of time looking at boards, and then back at their desks, during a school day. If a child has a vision problem, it may be difficult for the child to copy off the board and follow the lesson.

A child may have “20/20” clear eyesight but may also lack the ability to refocus from near to far and from far to near. As the child looks down at his paper to read or write, he may see clearly. After he is looking at the board for some time, he can see clearly too. However, looking up and down, back and forth, from the board to the paper might be where the difficulty comes into play.

The focus mechanism in the child’s eyes might be weak, slowing down the adjustment period as he looks from one point of site to the other. In functional optometry, focusing is called “accommodation.” A full functional vision exam tests “accommodative facility,” which is the ability to sustain clear vision and to shift focus.

Weak accomodative facility (focusing) is not detected during most normal vision screenings.

Another vision problem that would make it difficult for your child to copy from the board at school is poor eye teaming. Eye teaming, known in functional optometry as “binocular vision skills,” refers to the ability for the two eyes to work together as a team. If both eyes are not moving at the same time in the same direction, a child will struggle to look up at the board, down at her paper, and back again without experiencing visual fatigue and tiring quickly.

Your child could also have poor eye movements, such as tracking and pursuits. Tracking eye movement skills help the child “locate” the words on the board and then locate the space on the paper where they are to place their print. A child with poor tracking skills loses her place often, and getting lost frequently is frustrating and tiring.

Poor teaming and tracking skills are not detected during most normal vision screenings.

If your child has been complaining that he is having trouble copying from the board, or your child’s teacher complains that he is not copying down the lessons or assignments as instructed, a vision problem could be to blame.

Even if a school vision screening or visit to your family vision care clinic indicated that your child has 20/20 eyesight, problems with focus, eye teaming, or eye tracking might be interfering with his or her ability to copy from the board and learn efficiently alongside his classmates.

Find an optometrist in your area who specializes in developmental or functional vision care. If you live near Olney or Silver Spring, Maryland, schedule an appointment with Dr. Nicholson’s Visual Learning Center for a full visual analysis.

The good news is intensive vision therapy can improve eye teaming, eye tracking, and focusing skills. Within the next few months, your child could experience significant improvement, and copying from the board can become easier.

Philip Nicholson, O.D.

Q&A: Why did the other eye doctor we took our child to say he didn’t see anything wrong with his eyes?

Parents often contact us at the Visual Learning Center confused, wondering how their child could possibly have a vision problem when their family eye doctor did not indicate that anything was wrong with the child’s eyes.

We understand that, as a parent, you only want the best for your child and you rely on professionals to detect problems and advise you on the best course of action to care for your child.

Sometimes families express frustration with their eye doctor, wondering how the visual processing problem that — as it turns out — is causing so much disruption in their child’s ability to learn, could have been missed. They question whether earlier intervention and vision therapy at a younger age could have set the child up for better success at school.

The simple answer is that the particular eye doctor who examined your child is probably not a developmental optometrist. Though he or she is an O.D., just like I am, that doctor has not been trained in developmental diagnosis and vision therapy.

Routine eye or vision exams check the health of the eyes and the need for glasses. Eye doctors that specialize in surgery or disease treatment will likely not be able to diagnose functional problems, related to learning. This is simply not their area of expertise.

If you are a parent who suspects that your child might be struggling with a learning-related vision problem, have a conversation with your eye doctor to make sure your provider will look beyond ‘20/20 vision.’ If your eye doctor does not test using specific methods, vision-related learning problems will not be diagnosed and your child may continue to have functional vision problems.

Here is a helpful list of questions to ask your eye doctor:

  • Do you test for and correct accommodation (focusing) facility with +2 and –2 diopter flippers? Do you test for and correct lateral vergence facility (lateral eye alignment and speed) using prism flippers with 3 diopters base in and 12 diopters base out?
  • Do you test for and correct vertical vergence ranges (vertical eye alignment) using single prisms base up and down?
  • Do you test for and correct eye movement while the child is reading or answering questions that require comprehension? (using Visigraph infrared monitoring devices or similar equipment)? Eye movement analysis while simply following a moving target is not an accurate measurement of eye movement skills used while reading as this measures pursuit movements and not saccadic movements used while reading.
  • Do you test for visual perceptual or visual processing skills like visual discrimination, visualization or visual memory?

Feel free to print this off and take it with you to your appointment.

And if your family lives in the Olney, MD or Silver Spring, MD area, and you are interested in having your child tested for vision problems that may be interfering with their learning, contact our office and schedule an appointment to determine if your child might significantly benefit from treatment of learning related vision problems.

Philip Nicholson, O.D.

eye with earth reflection

How are “Visual Skills” related to learning?

Discovering that your child is struggling to learn, not because of a learning disability or lack of classroom skills, but instead a problem with their “visual skills” can be confusing for parents.

If a school screening or an eye doctor’s exam indicates that your child has no trouble with her eyesight, it can be even more confusing. You might ask yourself, “If my child can see just fine, how can there be something wrong with her vision?”

You might wonder how a child with 20/20 eyesight can also have a vision problem that is so significant that her learning is delayed or disrupted.

Most people think that vision is the same as sight. So if that’s what you thought too, you’re not alone.

However, sight simply provides the input for a child’s learning, while vision represents a complex system. When a child’s vision system is working efficiently, that child can process, understand, and relate new information to knowledge he or she already has.

On the other hand, when a child’s visual system is not working as it should, visual skills deficiencies can contribute to learning problems. If children experience a lag in their ability to recognize what they see, and relate it to what they already know, and then use this information as a basis for future understanding, the learning process can become frustrating.

For the learning process to work as it should, your child must first be able to see, then use what he sees to understand. The ability to see letters on a chart for an eye exam is not enough — 20/20 vision is not enough.

What developmental optometrists know is that there is a very important relationship between vision and the brain. The two work together so closely that vision and intelligence and understanding are almost synonymous

Sound complicated? It is. But the good news is, many children with low visual skills are often quite bright, or they may have little enduring learning problems with proper vision therapy. Also known as vision training, vision therapy can improve visual skills significantly and quickly.

A child’s ability to perform visual tasks (such as reading and studying) depends on the ability to synchronize thinking and seeing. The processes of thinking and seeing work together to give a perceptual and conceptual understanding of the material. The full spectrum of seeing and thinking needs to run smoothly for a child to gain meaning from what is taught.

Vision therapy exercises improve the integration of seeing and thinking.

Visual skills such as focusing, following moving objects, aiming, turning the eyes together as a team, visual processing and other abilities can be inefficient or poorly integrated, which can put great strain on a child.

Vision training allows a child to practice and strengthen vision skills, lessening the strain and effort they will have to put forth.

Experts have found that when anyone’s attention is spread between a number of tasks, it reduces the efficiency of the tasks. Think of the last time you tried to do two things at once. Was it easy? Did you do both as well as you wanted to? Or did one (or both) tasks suffer

When a child’s attention and efforts are spread between trying to make the visual system work physically and understanding the material, attempting to learn anything new that requires visual skills can be discouraging. A child who does not have deficiencies in visual processing can simply focus on understanding the material, without the interference of trying to get their system to function as it should.

Vision therapy serves to help children strengthen the link between vision and intelligence. Once visual skills are improved through vision therapy, it frees up energy and focus for actual learning. The less stressed mind is freed to focus on the task at hand.

Vision therapy in Olney, MD, and convenient to Silver Spring, MD, is provided by Dr. Philip Nicholson, O.D. and his staff at the Visual Learning Center. Call 301-570-4611 for a comprehensive assessment and to see if your child might significantly benefit from vision training.