Tag Archives: eye teaming

An Eye Teaming Problem Could Be The Reason Your Child Struggles to Read

The Visual Learning Center offers 
developmental optometry & vision therapy
in Olney, Maryland,  convenient to Silver Spring.

Have you noticed that your child or a child you work with tries to avoid reading? Do they look away from the text often, rub their eyes repeatedly, or claim that they are tired every time they sit down to read?

This observed behavior could be caused by an eye teaming problem that might be interfering with their ability to learn and read effectively.

When a child is doing close work, such as writing, reading, or using a tablet, mobile device or computer, they must be able to keep both eyes turned in to point at the same position long enough to complete the task. This vision function–the ability to move, turn, and point the eyes together–is called eye teaming or binocular vision skills.

To learn more how vision can affect learning, download our free guide here and watch our pre-recorded webinar here.

Signs that your child may have an eye teaming problem include:

  • covering or closing one eye while reading
  • rubbing eyes excessively
  • complaining that words are blurry even with “20/20 eyesight”
  • having double vision
  • attempting to avoid reading or homework
  • declining performance over prolonged spans of close work
  • seeming to have a short attention span
  • tiring quickly while reading or doing close work
  • losing place while reading
  • frequent headaches

When a visual deficiency prevents both eyes from moving precisely in the same direction at the same time, reading can be challenging and the extra effort required to perform basic tasks can cause fatigue quickly.

Reading requires our eyes to aim in together at the same point on the page. Our vision is only clear, single and comfortable as long as both of our eyes are aiming at the same point.

Children with poor convergence or divergence skills have difficulty with eye teaming. Their eyes move somewhat independently of one another, which causes double or blurry vision, distorted depth perception, and sometimes dizziness.

They find it difficult to maintain the inward eye aim that required for reading. As their eyes get tired, they move inward or outward, pointing at different places on the page. Even a slight variation that isn’t noticeable when casually observing can cause a significant problem. The result is blurred vision that looks like double print.


A typical eye exam by your family eye doctor or during a school vision screening does not test for eye teaming skills. If a child has an eye teaming disorder, he may be able to fixate on the vision chart in a typical eye exam and see it clearly long enough to see clearly for a moment. But maintaining proper eye turn for a sustained period of time can be a problem.

If you suspect that a child might have an eye teaming problem, it’s important that they undergo a comprehensive vision exam by a developmental optometrist who specializes in functional vision care and vision therapy. Studies have shown that as many as 78% of kids with reading and learning problems cannot track or team their eyes properly.

The good news is intensive vision therapy can improve binocular vision skills significantly and even eliminate eye teaming problems. See our vision therapy success stories.

For vision therapy in Olney or Silver Spring, Maryland contact Dr. Philip Nicholson’s Visual Learning Center today.

problems copying from the board

Why Copying From The Board is So Difficult for Some Children

Does your child complain that copying from the board at school is difficult? Does he or she come home with partial notes with a lot of errors or missed assignments? Perhaps your child’s teacher regularly states that the instructions, due dates, or lessons were written clearly on the board, and your child claims to have missed important information.

As a parent or teacher, it may be hard to believe that a child is truly having difficulty copying from the board, particularly if that child has 20/20 eyesight, wears corrective lenses, or has been moved closer to the board for a clear line of sight. You may attribute the child’s behavior to carelessness, laziness, or an excuse.  However, certain functional vision problems that often go undiagnosed can make copying from the board extremely challenging for some students.

Vision disorders that interfere with a child’s ability to easily copy from the board at school include:

Poor eye teaming:

Binocular vision skills include the ability for two eyes to work together as a team. When a visual deficiency prevents both eyes from moving precisely in the same direction at the same time, reading and copying from the board can pose a problem.

If a child has an eye teaming disorder, he may be able to fixate on the vision chart in a typical eye exam and see it clearly, but moving his eyes together from one point to another is difficult. Moving the eyes together to look up at the board, down at the desk, and then back up without getting lost should be easy. But children with eye teaming problems will experience visual fatigue and tire quickly when attempting to copy from the board.

Accommodative dysfunction:

Weak accommodative facility refers to difficulty with visual focus. In a typical vision exam, a child may have clear 20/20 eyesight, but the exam usually does not require the child to sustain focus for an extended period of time or to shift focus quickly from far to near and back to far again.

The student may see the board clearly and see his paper clearly, but looking up and down, back and forth, from the board to the paper could be where the difficulty comes into play. If the focus mechanism in a child’s visual system is weak or not fully developed, the adjustment period as he looks from one point of sight to another will be slower than average, which can be challenging and frustrating.

Oculomotor deficiency:

If a student has deficient oculomotor skills, also known as an eye tracking problem, he will strain to accurately and efficiently control eye movements. Whereas in people with healthy visual systems, eyes move somewhat smoothly, in people with poor oculomotor skills, the eyes will jump or skip around the text.

Copying from the board is difficult for students with eye tracking problems because each time they look up at the board or back down at the paper, they have to struggle to point the eyes in the intended direction again. They tend to lose their place often and fall behind or make errors.

Visual processing problems:

If a student has a visual memory problem, a deficiency in the visual system interferes with retaining information that was just learned; so recalling a line of text just read from the board long enough to write on paper is difficult. If a student has a problem with visual sequential memory, he will have trouble remembering the proper sequence of words or letters in the order just seen. A child who struggles with visual spatial skills and visual discrimination skills may process letters or words they see backwards as they copy text from the board, so you may notice letter reversals and suspect dyslexia.

Children with learning-related vision disorders struggle now more than ever, because today’s classrooms often require students to spend hours each day interacting with boards and screens. In a typical school, you might find whiteboards, large projected screens, Promethean Boards, and ActivBoards. A child may spend a significant portion of the day straining to look at boards and then back down to the paper on the desk in front of them, and then back up to the board. If that student has a functional vision problem, copying from the board will interfere with learning the lesson or keeping up with classmates.

Trouble copying from the board can contribute to slow progress, low grades, and frustration. When a child is not able to learn and participate efficiently alongside his classmates, self-esteem or behavioral problems may arise.

Many teachers, learning specialists, occupational therapists, and other education professionals are not trained to detect functional vision problems. Most learning-related vision problems even go undetected during school vision screenings or exams with your family eye doctor.

Click here to learn more about learning-related vision problems.

If you suspect a vision problem could be to blame for your child’s problems copying from the board, 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 and intensive vision therapy program can significantly improve functional vision problems in a relatively short period of time. Within a few months, copying from the board could become much easier quickly.

Does your child complain of dizziness while reading?

Has your child ever complained of feeling dizzy while reading? Dizziness can have many causes, and it’s a symptom that should be taken seriously. But if you’ve noticed that your child tends to complain of mild dizziness, queasiness, malaise, or nausea, specifically when reading or doing homework, it could be due to an undiagnosed functional vision problem that can be treated with vision therapy.

If your child says, “I don’t feel well,” too often at homework time, you may assume it’s an excuse to avoid work in favor of play time. However, most parents and teachers would not know to associate complaints of dizziness while reading with a vision disorder, particularly because learning-related vision deficiencies almost always go undetected in typical vision screenings or eye doctor exams.

Click here to read 9 signs that your child could have a learning-related vision problem that may cause headaches.

Click here to watch a pre-recorded webinar to learn more about vision problems in children.

We often think of dizziness as something that stems from an inner-ear problem. Many people are aware that the inner-ear and brain work together to control balance. So you probably wouldn’t be surprised to find that your child has fluid or an infection in his ear or a problem in the vestibular system when complaining of dizziness.

In a healthy visual system, our brain and eyes also work together to maintain a stable and even visual plane, which we need in order to read efficiently. When we point our eyes at text, we need to be able to fix and maintain our gaze so that the page and the text remains steady and still. If you have a properly functioning visual system, you can do this without extra effort. But for someone with a functional vision problem, the text may be misaligned or blurry, or it may seem to move, jump, go in and out of focus, appear wavy, or slide down the page. Experiencing any of these effects can cause dizziness while reading.

Children with poor convergence or divergence skills have difficulty with eye teaming. Their eyes move somewhat independently of one another, which causes double or blurry vision, distorted depth perception, and sometimes dizziness.

Children with an eye tracking problem strain to accurately control eye movements. Instead of their eyes moving smoothly across a line of text while reading, their eyes skip or jump, which makes it challenging to read without feeling disoriented and sometimes dizzy.

Children with accommodative dysfunction, or trouble focusing, have difficulty sustaining focus on text or maintaining a clear image for a reasonable length of time. Reading is challenging because the texts grows fuzzy or blurred, and straining to keep the text in focus can contribute to dizziness.

The only way to know if your child’s dizziness while reading is caused by an underlying vision problem is by scheduling a comprehensive vision exam by a developmental optometrist who specializes in functional vision care.

The good news is, learning-related vision problems that cause dizziness when reading can be treated effectively with vision therapy. Students often experience remarkable improvement in a short period of time.

If you are looking for vision therapy in Silver Spring or vision therapy in Olney, Maryland, and you suspect your child’s complaints of dizziness could be related to a functional vision problem, make an appointment with developmental optometrist Dr. Philip Nicholson at The Visual Learning Center today.

child in occupational therapy session

3 Vision Problems Occupational Therapists Can Recognize When Working with Patients

At the Visual Learning Center, we often receive referrals from Occupational Therapists who notice that a child in their care may be struggling with vision problems. OTs are trained to work with children to improve and strengthen specific skills and abilities, and deficiencies in the visual processing system can interfere with a child’s ability to make progress.

However, many skilled and experienced Occupational Therapists simply are not trained on how to detect vision problems. Further, many OTs are unaware that Vision Therapy can supplement or enhance the work they are doing with a child.

If you are an Occupational Therapist who works with children, here are 3 main types of functional vision problems you may notice during your assessments or sessions:

1. Accommodation Skills

If you work work with a child who often gets frontal headaches or eye aches, squints, blinks, or rubs his eyes excessively, or often complains that his eyes sting or itch, these may be signs of an eye focusing problem.

Children with poor accommodation skills, or trouble focusing, are unable to easily sustain focus on an object or text or maintain a clear image for a reasonable length of time. Reading and writing are difficult because objects become fuzzy or blurred, and the child will strain to perform well on assignments or tests, compared to his peers.

2. Convergence Skills

If you notice that a child tries to avoid reading, looks away from the text often, shows fatigue easily while reading, or indicates that the words are moving around on the page, this could be due to an eye teaming problem.

If a child has poor convergence or divergence skills, or an eye teaming problem, this means he has trouble using his eyes together as a team. His eyes move somewhat independently of one another, causing blurry or double vision, difficulty with depth perception, and fatigue. Performance and reading comprehension suffer because the child has to work harder than his classmates just to properly see and efficiently process the text.

3. Ocular Motor Skills

If you are working with a child who reads slowly, struggles with reading comprehension, has difficulty copying from the board at school, or loses his place or skips words while reading or writing, this could be due to an eye tracking problem.

If a child has poor ocular motor skills, or an eye tracking problem, he strains to accurately control the movements of his eyes. Instead of moving smoothly, his eyes will skip or jump, making it difficult to read, write, or look up at something in the distance and then back down to the page in front of him. What should be simple tasks prove challenging.

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.

If you suspect that a child may have a functional vision problem, the next step is to refer him or her to a developmental optometrist for a comprehensive functional vision exam.

For occupational therapists in Olney or Silver Spring, Maryland, contact Dr. Philip Nicholson at The Visual Learning Center to speak to our staff.


Functional vision problems: What happens if your child’s eyes fail to work as a team?

When your child is doing close work, such as reading, writing, or using a mobile device or computer, he or she needs to be able to keep both eyes turned in to point at the same position. The ability to move, turn, and point the eyes together, is called eye teaming.

Eye teaming is a function that people with normal healthy visual systems do naturally, without thinking about it. However, if your child has a functional vision problem known as Convergence Insufficiency, eye teaming is a challenge.

Convergence insufficiency  is a common two-eyed (binocular) disorder affecting a child’s near vision. It interferes with a person’s ability to see clearly at close distances, making it challenging to read, learn, and complete tasks. People with Convergence Insufficiency find it difficult to keep their eyes working together smoothly as a team, and their eyes tend to drift outwardly when attempting to focus on text or other items at a near distance.

Unfortunately, this problem often goes undetected in children because standard eye exams and school vision screenings do not test for convergence insufficiency. Your child could have passed a typical eye exam with 20/20 eyesight and still have convergence insufficiency.

Additionally, you may not readily notice your child’s uncoordinated or drifting eye movements. Even subtle differences in eye teaming, that are not easily observed by parents or teachers, can cause a significant hindrance to learning.

Symptoms of convergence insufficiency, or poor eye teaming skills, include:

  • double vision
  • blurred vision
  • headaches
  • eye fatigue

Here is an image that demonstrates how text appears to a child with convergence insufficiency:


Signs your child could be struggling with convergence insufficiency include:

  • covering or closing one eye while reading
  • rubbing eyes excessively
  • attempting to avoid reading or homework
  • seeming to have a short attention span
  • fatigue quickly while doing close work
  • losing place while reading

You may notice that while your child did not have trouble reading initially, he struggles with reading speed, fluency, and comprehension, which appears to get worse with prolonged attempts to read.

If you suspect your child may have a learning-related vision problem such as poor eye teaming skills, schedule a functional vision exam with a developmental optometrist right away.

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

How Vision Problems Interfere with Reading Comprehension

Reading comprehension refers to a child’s ability to not only read the text on a page, but also process it and understand its meaning.

For a child to develop reading comprehension, the entire visual processing system must work efficiently. Seeing the text clearly is only the first step in the process. Your child must know how to sound out a word or remember a word on sight, understand each word’s meaning, and then make sense of sentences and paragraphs.

Intelligence is one factor in reading comprehension, but there are many more factors that come into play in a child’s ability to both read and comprehend. Some bright children have difficulty with reading comprehension due to problems with their visual processing system.

In order to read, we take in visual information in the form of text and then decode it into mental images to which we assign meaning, and then retain and use those images to categorize and recall for future use.

Taking in visual information efficiently requires the coordination of hundreds of eye muscles and strong oculomotor control. If there is a weakness or deficiency, this can affect a child’s ability to focus both eyes on the same spot simultaneously or to move their eyes smoothly as a team across a line of text. Poor eye tracking,  eye teaming, or focus leads to difficulty and frustration for a child, and the extra effort to take in visual information may cause fatigue, headaches, or the inability to maintain attention.

Once the visual information is taken in through the eyes, the process of comprehension has only just begun.  Next up, a child’s brain will have to run the information through the process of visual perception, meaning they will have to be able to extract the information they see and use it appropriately.

Efficient visual perception is needed for a child to recognize and remember letters, words, and their meaning. If a child has a deficiency related to visual perception, he will struggle with minor differences in similar words or letters. This may lead to confusing p with q or d with b, for example; or it may also mean conflating words with similar beginnings, reading words backwards, or having difficulty distinguishing the main idea of a story from a minor detail. Recognizing, remembering, and applying information quickly and easily is critical for performance in reading comprehension, and student must have a healthy vision system to do so.

The following are specific ways visual perceptual processing may interfere with reading comprehension:

Visual Spatial Skills and Visual Discrimination are required to organize visual space and understand directional concepts and orientation. A child with poor visual spatial and discrimination skills may process a letter or word backwards.

Visualization is the ability to create a mental image in one’s mind, which is important for processing and remembering information for comprehension. When someone says, “I see what you mean,” we think of this a an idiom, but when it comes to reading and visual processing, we really are creating mental images that help us to comprehend. We’re essentially seeing something in our mind.

Visual Memory is the ability to retain information that you have learned. A child must be able to recognize and remember a word from one page, assignment, and day to the next. He must create an image of that word or set of words in his mind and recall it as needed.

Visual Sequential Memory refers to the ability to remember the proper sequence of words, letters, or story narrative, in the same order it was seen originally. Keeping the images of what they recall in order is of course critical to comprehension.

So, as you can see, the ability to comprehend is not simply a function of intelligence.

If a child is having difficulty moving and coordinating his eye muscles properly and then the child also has difficulty processing that information visually in his brain, he is going to perform poorly in the area of reading comprehension as a result.

If a student has a visual processing problem, reading comprehension can be improved significantly and relatively quickly with an individualized comprehensive vision therapy plan. If you suspect your child has a learning-related vision problem that interferes with reading comprehension, contact a developmental optometrist for a functional vision exam and vision therapy program.

If you are in the Olney. Maryland area, convenient to Silver Spring, schedule an appointment with Dr. Philip Nicholson’s Visual Learning Center today.

Philip Nicholson, O.D.

Q&A: How is your program different from other providers of vision therapy?

When a child struggles with vision problems, such as deficiencies in eye focusing, eye teaming, eye tracking, or visual processing, the first step to getting help is diagnosis.

Many Montgomery County families come to the Visual Learning Center in our Olney, Maryland office because their child has been having difficulty with reading, writing, or behavioral problems in school. Often, learning disabilities, dyslexia, and attention deficit disorders have been ruled out, or traditional attempts to help the child improve in school are not working.

After an initial assessment, we encourage parents to schedule an appointment for a comprehensive visual analysis, which takes up to two hours and includes a written report and follow-up consultation, and a unique treatment plan individualized for each child.

What sets our vision therapy treatment plan apart from other approaches is that it is 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.

Our vision therapy program is a highly targeted treatment program designed to correct visual-motor and perceptual-cognitive deficiencies. Vision therapy sessions include procedures designed to enhance the brain’s ability to properly control the whole vision system. At the Visual Learning Center, our vision therapy exercises target and train visual skills that are most likely to have a meaningful impact on learning performance and a child’s academic abilities.

Each child is treated individually, on a one-on-one basis, to achieve significant results quickly and allow for immediate feedback. Both positive reinforcement and gentle and direct error correction encourages the child to feel greater confidence early in the process and make progressive improvements throughout the vision therapy program. One of the first things you will notice, is that your child’s self-esteem will improve as he sees the difference in his performance.

The vision therapy exercises are designed with a discouraged young student’s needs in mind. Children work through sequenced procedures that aim to challenge–not bore or frustrate them–unlike their school work, which carries negative associations for them. Instead, the activities are designed to help your child practice and develop new skills in a non-academic way that does not remind them of their difficulty with schoolwork. Because of this approach, newly developed visual skills will become habitual in a fun and safe manner, and then your child will be able to apply his new skills to his academics automatically, and with a high level of retention.

Something else that sets our program apart is that we encourage parental involvement. The program requires practice outside of in-office sessions. Practicing at home provides an opportunity for cost-effective repetitious procedures and helps your child to transfer learned skills to everyday activities. But what parents tell us they enjoy most about their participation is that it often mends the parent-student relationship. We understand that homework wars and punishments for getting in trouble at school can strain your interactions with your child, so we are delighted to play a part in making a positive impact on your relationship.

Overall, vision therapy at the Visual Learning Center produces invaluable results when considering committed effort, time, and finances. I chose to become an optometrist who specializes in developmental and functional vision care because I struggled with vision problems as a child, and I can attribute my success as a student to the results of vision therapy. Click here to read some of the vision therapy results and success stories our patients have experienced.

To schedule an appointment for a comprehensive vision assessment and learn more about our vision therapy program in Olney, MD, call 301-570-4611, or complete this form.

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.