Tag Archives: diagnose vision functional problems

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.

Going to See a 3D Movie Could Reveal a Vision Problem

The Peanuts Movie is set to hit theaters next week, and some of your favorite childhood characters will be making their big screen debut. Charlie Brown, Snoopy, and the gang will be coming to you in state-of-the art 3D animation in a brand new adventure that has parents and kids alike buzzing in anticipation.

But what’s sure to be an entertaining afternoon at the theater for some could be far less fun for your child if he or she has a vision problem. Unfortunately, 3D effects affect people with certain vision deficiencies, causing dizzy spells, queasiness, and nausea.

People with a healthy visual  system see 3D effects as they are meant to be seen — popping from the screen, almost as if you can reach out and touch the characters. These effects are created by projecting two moving images simultaneously, but with different colors or polarization of colors for each image. The 3D glasses we wear allow most people to see these two overlaid moving flat images as one three dimensional moving image.

When we look at a movie screen (or anything else) each of our eyes sees the object from a particular perspective. The image is processed through our visual system, and our brain does the work of taking the two separate images and combining them into one image that we see. This process is enabled by binocular vision skills.

Binocular vision skills – How well your child’s eyes can blend visual images from both eyes into a single, three-dimensional image.

To properly see 3D effects in movies, strong binocular vision is necessary. If your child has poor binocular vision with amblyopia or lazy eye, the brain and eye are not working together in a healthy correctly functioning manner. One eye may be favored by the brain while the other is suppressed. The problem encountered is that 3D glasses and the special effects may cause the brain to favor the suppressed eye, which causes a lot of strain. Your child might not see the 3D effects at all, or he may complain of headaches, dizziness, or nausea.

If your child has complained during Minions or another 3D movie in past or if the complaints arise while watching the upcoming release of The Peanuts Movie, this is a sign of a possible vision problem. In fact, in many cases, uneasiness during a 3D movie is the first obvious sign that something is wrong.

The same vision problem that causes headaches, dizziness, or nausea during a 3D movie will affect your child’s ability to learn as well.

If you suspect your child has a vision problem, based on his or her experience while watching a 3D movie, schedule a functional vision exam with a developmental optometrist right away. Vision therapy can improve the problem significantly.

If you are in Olney or Silver Spring, Maryland, contact The Visual Learning Center to make an appointment today.

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.