VISION THERAPY CONFERENCE
Interesting Facts:
The goal of vision therapy: clear (20/20) vision, comfortable, single binocular (no double and both eyes seeing the same thing)
Ways to fix lazy eye: patching, surgery, vision therapy and atrophy therapy which doesn’t help encourage binocular vision
Ocular Alignment:
- Exophoria - eye goes out at resting point
- Esophoria - eye goes in at resting point
Infant C = 6-12 month sensorimotor exam for free; 9 months is the best
7 out of 10 juvenile delinquents have vision problems which are affecting performance in the classroom - California Department of Youth Authority
American Optometric Association:
- 1 out of 4 children have an undiagnosed vision problem that interferes with their ability to read and learn
60% of children with learning disabilities have undiagnosed vision problems
Components of Vision:
- Oculomotor
- Pursuits = smooth eye movements
- Saccades = eyes are jumping while moving
- Function = reading, sports (tracking a ball)
- Treatment = word finds, mazes, dot-to-dots, tracing, hidden pictures, letter cancellation, Mardsen Ball
- Binocularity
- Eye teaming
- Supression (shutting 1 eye down)
- Double vision (both eyes working and moving differently)
- Function = navigating unlevel ground or stairs; scanning the environment; writing; pouring
- Treatment = Near/Far GTVT Charts, Red/Green Bar Readers, Red/Green TV Filters, Marsden Ball
- Accommodation
- The automatic adjustment of the eye seeing at different distances
- Amplitude - getting it clear (a problem for farsighted individuals who usually pass the Snellen chart)
- Sustenance - keeping it clear (print comes into & out of focus, especially with fatigue
- Facility - changing focus from one distance to another
- Function: ability to take notes in school shifting from whiteboard to notebook; shifting focus from speedometer in the car to traffic signs; ability to read directions on recipe and then setting the time/temperature on oven
- Treatment = Near/Far Hart Charts
- Vergence Skills
- Convergence
- Required for near work; common to have difficulty with both accommodation and near work
- Function - sewing; reading a pill bottle; dialing a phone
- Divergence
- More strenuous/harder than convergence
- Changing alignment at change in distance; affects how quickly we can change our viewing distance
- Function - playing board games; measuring ingredients; reading labels at the grocery store
- Treatment = Flashlight Mazes, Brock String, Aperture Rule
- Depth Perception
- Binocular
- Stereopsis or 3rd degree function
- Requires 2 eyes working together
- Brain uses retinal disparity to compare information from 2 different points of view
- Lack of stereopsis leads to difficulty with coordination
- Function - driving; stairs; getting into bathtub; pouring liquids
- Peripheral vision
- Important in moving about, speeds performance
- Many times amblyopic (lazy) eye maybe better at peripheral awareness
- Visual fields overlap
- Symptoms
- May look like an eye movement disorder (doesn’t track in certain quadrants)
- Bumping into things
- Decreased night vision
- Spatial insecurity
- Decreased body image
- Dry eye & low blink rate
- Function - riding a bike; sports (balance, awareness of other player while playing sports)
- Visual Fields
- Visual field deficit - a partial or complete loss of vision in the central or peripheral range of vision
- Homonymous hemianopsia
- Homonymous quadratanopsia
- Visual neglect - a more severe form of visual inattention, often paired with a visual field deficit
- Function - walking, driving, riding bike, cooking, shopping, writing
- Treatment = putting items in the ignored/lost visual field (including people that are talking to them, use activities with a wide field of view
- Visual Midline Shift Syndrome
- A neurological event that often corresponds with hemiplegia & hemiparesis
- The ambient visual process attempts to create a balance by expanding a concept of space of the unaffected side and compressing the concept of space on the other side
- The individual will lean or tilt their head away from the neurologically affected side
- Yoked prisms can move the image to midline
- Visual Perception and Processing
- Visual information and processing speed
- Figure ground perception
- Visual closure
- Form constancy
- Size and shape discrimination
- Visual memory
- Treatment = beading tasks, pick up sticks, yard games, interactive video games, pattern play, hidden pictures, mazes, dot-to-dots, word searches, cutting tasks
- Things to look for when there maybe a vision issue:
- Headaches
- Dizziness
- Double vision
- Fatigue
- Difficulty reading (errors, decreased speed, loss of place)
- Red, sore, itchy eyes
- Jerky eye movement, one eye moves in or out more than the other
- Head tilt or covering one eye when reading
- Avoiding near work
- Low self esteem
- Temper flare ups/aggression/irritability
- Vertigo
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