Tag Archives: functional vision care


Dyslexia or Learning Disability Diagnosis? Get a Second Opinion from a Developmental Optometrist

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

Has your child been diagnosed with dyslexia or a learning disability? You may want to get a second opinion from a developmental optometrist.

When a child has trouble with reading, learning, or test performance, teachers and parents often suspect a learning disability or dyslexia. However, what appears to be a learning disability might actually be an undiagnosed learning-related functional vision problem that can be treated successfully with vision therapy.

Although parents would rather their child not have to face the challenges of living with a learning disability, sometimes a diagnosis can come as a relief. Now that you’ve identified the problem, you can begin working with specialists who can help your child develop healthy and productive coping strategies.

But if your child’s diagnosis is not correct, they could be struggling unnecessarily with a condition that is treatable with vision therapy.

Here’s why so many children are misdiagnosed:

  • Standard eye exams and vision screenings will not detect learning-related vision problems. So, unfortunately, many children are misdiagnosed with learning challenges without ever undergoing a comprehensive vision exam by a developmental optometrist trained in functional vision care.

  • The signs and symptoms learning-related vision problems practically mimic dyslexia and other learning disabilities, sometimes with only subtle differences.

  • Most teachers, educational specialists, and occupational therapists have never been trained to recognize the symptoms of learning-related vision problems. They receive training in detecting possible learning disabilities and other special needs. However, the majority of education professionals are unaware of how common learning-related vision problems are.

A learning disability is a neurological disorder that indicates a person’s brain is “wired” differently. Children with learning disabilities are no less intelligent than their classmates, but they may have difficulty learning through conventional teaching methods. A child with a learning disability may struggle with reading, writing, math, organizing information, memory, or with reasoning skills.

Examples of learning disabilities include auditory processing disorders (difficulty understanding spoken language), dysgraphia (difficulty with writing), dyslexia (difficulty understanding written language), dyscalculia (difficulty with math problems and concepts), and nonverbal disabilities (difficulty with spatial and facial cues).

Learning-related vision problems may present almost identically to some learning disorders. But many vision deficiencies and disorders can be significantly improved or even eliminated permanently with vision therapy.

Both a child with a learning disability and a child with a vision deficiency may:

  • Transpose, omit, substitute, and reverse words and letters when reading and writing.
  • Appear restless, fidgety, or distracted in a classroom setting or while doing homework
  • Have difficulty staying on task, paying attention, zoning out, and daydreaming
  • Have poor coordination or fine motor skills
  • Struggle with reading, writing, spelling, comprehension, and memory
  • Seem bright, articulate, and may have a high IQ, but they are unable to read, write, spell, or perform as well as expected on exams and standardized tests 
  • Learn well through hands-on experiences; dyslexics tend to be helped by being able to observe and use visual aids, but those with visual deficiencies do better with oral coaching.
  • Have difficulty with time; dyslexics have trouble with sequences and time management; those with vision problems have trouble telling time on a clock dial.

But your child might not need to learn differently. Instead, your child may need to undergo a treatment program to train and reinforce vision skills, with lasting results.

To be clear, vision therapy does not cure dyslexia, 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.

Additionally, it is important to note that many children who have learning disabilities and developmental delays also struggle with vision problems. If your child has been diagnosed with developmental delays, and they are not making expected progress from working with an occupational therapist or in another type of learning developmental therapy, it could be due to an undetected vision problem that can be treated with vision therapy.

The only way to rule out a vision problem is with a comprehensive vision exam by a developmental optometrist who specializes in functional vision care.

For a comprehensive exam and vision therapy in Olney, Maryland or Silver Spring, schedule an appointment with Dr. Philip Nicholson’s Visual Learning Center.

Register for an upcoming webinar here.

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.

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.