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Vision Therapy

4 Causes of Lazy Eye in Children

3 Causes of Lazy Eye in Children 640

Amblyopia, commonly known as ‘lazy eye,’ is a neuro-developmental vision condition that begins in early childhood.

One kind of lazy eye develops when one eye is unable to achieve normal visual acuity, causing the affected eye not to see clearly, even when wearing glasses. When this is left untreated, amblyopia leads to permanent vision loss in one eye.

It’s important to understand that a lazy eye isn’t actually lazy. Usually it occurs because there is a large difference in prescription between the two eyes, so the brain ignores the visual signals from that side and doesn’t process that information. The communication on that side then deteriorates further, and this usually leads to permanently reduced vision in that eye. Fortunately, Vision Therapy can improve the condition by training the brain to work with both eyes equally.

What Causes Lazy Eye?

When the neural connections between the eyes and the brain are healthy, each eye sends a visual signal to the brain. The brain combines these two signals into one clear image, enabling us to see what we are looking at.

When someone has amblyopia, the brain doesn’t recognize the weaker eye’s signals. Instead, it relies only on the visual input from just the other eye. The child assumes this is normal and is not aware of this, so they don’t complain.

The two most common reasons for Amblyopia are: Strabismus (when an eye turns in or out), and Anisometropia (when there is a large difference between the two eyes).

Strabismus

Strabismus means that the eyes don’t line up with one another. One might point in or out relative to the other. This can occur some of the time or all of the time. We use the terms “constant” or “intermittent”. The child may alternate; meaning that at some time, the child uses one to fixate and then the other eyes to fixate.

When the eyes don’t line up, and they point in different directions, then the brain receives two images and it can’t combine the two into one single, clear image. So when the two eyes don’t line up properly, the brain cannot process the two images, so it ‘turns off’ one of the images. That side gets ignored and the wiring between the eye and the brain does not develop. The eye is healthy, but the information from the eye to the brain gets shut off. This protects the child from getting 2 confusing pictures which would cause double vision.

As the brain ‘turns off’ the weaker eye, this eye will eventually become ‘lazy’—unless we treat the problem.

Anisometropia – one form of Refractive Amblyopia

Anisometropia is when the refractive powers (visual acuity) of the two eyes are very different from one another. This causes a conflict for the brain. It causes the visual signal from one eye to be much clearer than the other. The brain then can’t make the two images work together. The brain uses only the visual signal from the eye that is sending the clearer image and begins to ignore the information from the eye with the blurrier image. This further weakens the eye-brain connection from that side. If not treated, this results in permanent poor vision in that eye.

Bilateral Amblyopia – another form of Refractive Amblyopia

Bilateral Amblyopia is when the refractive power of BOTH eyes are very high, usually when someone is very FARsighted in BOTH eyes, but it can occur in people that are highly NEARsighted in both eyes. In this case, BOTH eyes do not develop a good connection to the brain.

Deprivation

If something doesn’t allow light to reach the back part of the eye, the retina, then the wiring between the eye and the brain doesn’t develop. We actually don’t see in the eye; rather, we see in the brain. Can you “picture” yourself at home? Can you “see” yourself at the beach or on your vacation? Those are examples of how we Visualize, and actually see in the brain, not in the eye.

Deprivation Amblyopia means that light was blocked from reaching the retina the back of the eye. That can be caused by a cataract, a cloudy cornea, or a tumor of the eyelid. Each of these can affect a child’s vision, resulting in amblyopia. Sometimes these are hard to notice and that is why a child should have a full examination and not just a screening at school or at the pediatrician’s office. When identified, we can treat the problem swiftly.

How To Treat Amblyopia

The goal of most amblyopia treatments is to 1st strengthen the signal to the eye that has been neglected, and then 2ndl, to learn how to use the two together as a team. Once we do that, amblyopia is cured. Patching does not cure this long term, although many doctors practice this “old thinking”. You see, amblyopia is more of a brain issue than an eye issue.

Common ways we treat amblypia are:

  • Special Eyeglasses
  • Vision Therapy
  • Special Contact Lenses
  • Special Foils or Prisms placed on eyeglasses
  • Special Eye Drop Therapy
  • Patching- often recommended by some eye doctors, but this does not treat or cure amblyopia long term

Vision Therapy

Vision Therapy is the most effective treatment for amblyopia. It is often used along with other treatments.

A Vision Therapy program is customized to the specific needs of the patient. It may include the use of lenses, prisms, filters, occluders, and other specialized equipment designed to actively make the lazy eye work to develop stronger communication between the eye and the brain. Ultimately, the goal is not only for the eye to see better, but for the patient to be able to use their two eyes together as a team. Once the patient achieves that, the problem is cured and does not return. Some eye doctors still recommend patching alone, but this often does not resolve the problem and the problem then returns.

Vision Therapy is extremely effective and successful to achieve the ability to use the two eyes together as a team. That is called binocular vision. This improves visual acuity, visual processing abilities, depth perception and reading fluency.

Vision Therapy programs for amblyopia include procedures that improve the following visual skills:

  • Accommodation (focusing)
  • Binocular vision (the eyes working together)
  • Fixation (visual gaze)
  • Pursuits (eye-tracking)
  • Saccades (eye jumps)
  • Spatial skills (eye-hand coordination)
  • Stereopsis (3-D vision)

Call our office and schedule an appointment. Discover how Vision Therapy can help improve your child’s vision. Our doctors will ask about your child’s vision history, conduct a thorough evaluation, and take your child on the path to effective and lasting treatment.

Frequently Asked Questions with Dr. Moshe Roth

Q: How do I know if my child has lazy eye?

  • A: It’s difficult to identify lazy eye (Amblyopia) on your own. Even patient that have strabismus is not obvious to parents. Children generally learn how to ignore the side that is not working as well and that side does not develop the connection between the eye and the brain. Some symptoms of lazy eye include:
  • Closing one eye or squinting
  • Difficulty with fine eye movements
  • Poor depth perception
  • Poor eye-hand coordination
  • Reduced reading speed and comprehension
  • Rubbing eyes often

Q: How is lazy eye diagnosed?

  • A: Our doctors will conduct specific tests during your child’s eye examination to assess the visual acuity, depth perception and visual skills of each eye.

 

 

Amblyopia, commonly known as ‘lazy eye,’ is a neuro-developmental vision condition that begins in early childhood, usually before the age of 8.

One form of lazy eye develops when one eye is unable to achieve normal visual acuity, causing blurry vision in the affected eye, even when wearing glasses. Left untreated, amblyopia leads to permanent vision loss in one eye.

It’s important to understand that a lazy eye isn’t actually lazy. Usually it is because there is a large difference in prescription between the two eyes, so the brain ignores the visual signals from that side and doesn’t process that information. Eventually, the communication on that side deteriorates further, and this usually leads to permanently reduced vision in that eye. Fortunately, Vision Therapy can improve the condition by training the brain to work with both eyes equally.

What Causes Lazy Eye?

When the neural connections between the eyes and the brain are healthy, each eye sends a visual signal to the brain. The brain combines these two signals into one clear image, enabling us to see what we are looking at.

In the case of amblyopia, the brain doesn’t recognize the weaker eye’s signals. Instead, it relies only on the visual input from the stronger eye.

Amblyopia can be caused by strabismus, anisometropia and deprivation.

Strabismus

Strabismus occurs when the eyes are misaligned and point in different directions. The most common cause of amblyopia is eye misalignment, which causes the brain to receive two images that cannot be combined into one single, clear image.

A child’s developing brain cannot process images when both eyes are not aligned in the same direction, so it ‘turns off’ the images sent by the weaker eye. This is the brain’s defense mechanism against confusion and double vision.

As the brain ‘turns off’ the weaker eye, this eye will eventually become ‘lazy’—unless treatment is provided.

Anisometropia – one form of Refractive Amblyopia

Anisometropia is when the refractive powers (visual acuity) of your eyes differ markedly, causing your eyes to focus unevenly – rendering the visual signal from one eye to be much clearer than the other. The brain is unable to reconcile the different images each eye sends and chooses to process the visual signal from the eye sending the clearer image. The brain begins to overlook the eye sending the blurrier image, further weakening the eye-brain connection of the weaker eye. If not treated, this results in permanent poor vision in that eye.

Bilateral Amblyopia – another form of Refractive Amblyopia

Bilateral Amblyopia is when the refractive power of BOTH eyes are very high, usually when someone is very FARsighted, but it can occur in people that are highly NEARsighted in both eyes. In this case, BOTH eyes do not develop a good connection to the brain.

Deprivation

Deprivation refers to a blockage or cloudiness of the eye. When an eye becomes cloudy, it directly impacts the eyes’ ability to send a clear image to the retina, harming the child’s ability to see images clearly from that eye. When clear images can’t reach the retina, it causes poor vision in that eye, resulting in amblyopia. Deprivation is by far the most serious kind of amblyopia, but it is also incredibly rare.

There are several types of deprivation: cataracts, cloudy corneas, cloudy lenses and eyelid tumors. Each of these can affect a child’s vision, resulting in amblyopia. Because these are also difficult to notice from a child’s behavior, it’s crucial to have your child tested for eye-related problems so that treatment can begin right away.

How To Treat Amblyopia

The goal of most amblyopia treatments is to naturally strengthen the weaker eye so that your child’s eyes can work and team with the brain more effectively. Amblyopia treatment will be determined by the cause and severity of their condition.

Common types of treatment include:

  • Special Eyeglasses
  • Vision Therapy
  • Special Contact Lenses
  • Special Filters and Prisms
  • Special Eye Drop Therapy
  • Patching- often recommended by some eye doctors, but does not treat or cure amblyopia long term

Vision Therapy

Vision Therapy is the most effective treatment for amblyopia, and is often combined with other treatments.

A Vision Therapy program is customized to the specific needs of the patient. It may include the use of lenses, prisms, filters, occluders, and other specialized equipment designed to actively make the lazy eye work to develop stronger communication between the eye and the brain.

Vision Therapy is highly successful for the improvement of binocular vision, visual acuity, visual processing abilities, depth perception and reading fluency.

Vision therapy programs for amblyopia may include eye exercises to improve these visual skills:

  • Accommodation (focusing)
  • Binocular vision (the eyes working together)
  • Fixation (visual gaze)
  • Pursuits (eye-tracking)
  • Saccades (eye jumps)
  • Spatial skills (eye-hand coordination)
  • Stereopsis (3-D vision)

Contact Family Eye Care to make an appointment and discover how vision therapy can help improve your child’s vision. Our eye doctor will ask about your child’s vision history, conduct a thorough evaluation, and take your child on the path to effective and lasting treatment.

Frequently Asked Questions with Dr. Moshe Roth

Q: How do I know if my child has lazy eye?

  • A: It’s difficult to recognize lazy eye because the condition usually develops in one eye, and may not present with a noticeable eye turn. As such, children generally learn how to ignore the lazy eye and compensate by mainly relying on the sight from the ‘good’ eye. Some symptoms of lazy eye include:
  • – Closing one eye or squinting
    – Difficulty with fine eye movements
    – Poor depth perception
    – Poor eye-hand coordination
    – Reduced reading speed and comprehension
    – Rubbing eyes often

Q: How is lazy eye diagnosed?

  • A: Your child’s eye doctor will conduct specific tests during their eye exam, to assess the visual acuity, depth perception and visual skills of each eye.

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Closing one eye or squinting
Difficulty with fine eye movements
Poor depth perception
Poor eye-hand coordination
Reduced reading speed and comprehension
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Family Eye Care serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, all throughout New Jersey.

Book An Appointment
Call Us 732-993-3420

Vision Therapy: Facts and Myths

5 Vision Therapy Myths 640Vision Therapy is a customized program to train the brain and the eyes to work together more effectively and efficiently. We would like to explain the facts and address some of the myths about Vision Therapy.

5 Myths and Facts about Vision Therapy

1. Myth: Vision Therapy is just for children

Fact: People of all ages benefit from Vision Therapy.

Vision Therapy is often prescribed for younger patients, but many adults benefit as well. The basis of vision therapy is neuroplasticity, meaning, the brain’s ability to change and learn new habits.

Your brain is capable of forming new neural pathways throughout your entire life, so Vision Therapy is effective at any age; whether someone has amblyopia (lazy eye), strabismus (an eye that turns in or out), sports vision. Neuro-Optometric Rehabilitation is a special form of Vision Therapy to help individuals who have suffered a stroke, brain injury, or concussion.

2. Myth: Vision Therapy isn’t based on scientific research

Fact: Many scientific studies that have been funded and published by the National Eye Institute (NEI), prove the effectiveness of Vision Therapy. Vision Therapy has been available and effective for nearly 100 years !

One study, funded by the National Eye Institute, states that Vision Therapy is the most effective treatment for a common binocular vision problem, Convergence Insufficiency. Vision Therapy is also effective to treat Amblyopia (lazy eye), Strabismus (eye turn), and difficulties related to reading and learning.

3. Myth: All Vision Therapy is the same

Fact: Vision Therapy is directed to the specific problem that someone has. A Developmental or Behavioral Optometrist is the expert in the diagnosis and treatment of Vision problems. At times Occupational Therapists and Physical Therapists say they offer Vision Therapy. Vision is complex and to be the most effective, it should be addressed by someone who understands the visuals system.

Our Vision Therapists have been trained in our office to use the specific technique and the specific time it is needed within the Vision Therapy program. The various techniques in a Vision Therapy program must be done in a specific sequence for it to be most effective. There are various awareness procedures so the individuals learns the skill so they own it and apply it to their schoolwork, driving a car, or playing a sport. Within the program, we use computer programs, lenses, prisms, and other equipment for treatment.

4. Myth: Eye surgery is the only option for treating eye misalignment

Fact: Eye surgery to “correct” strabismus (misaligned eyes) usually does not yield the intended outcome and it is common for an eye surgeon to then recommend more and more eye surgery. At best, it gives the appearance as though the eyes look straight to others, but it is rare for the individual to then develop the ability to use the two eyes together as a team.

The best way to obtain eye alignment is to improve binocular function.

In other words, surgery attempts to correct the mis-alignment but doesn’t teach the eyes and brain to work together. Vision Therapy is recommended for patients who have had strabismus surgery or those that are considering it.

5. Myth: I don’t need Vision Therapy, I have 20/20 eyesight

Fact: The notation 20/20 tells us how each eye sees individually. It is not a measure of how the individual uses the two eyes together as a team. The 20/20 notation is a measure of eyesight and not a measure of Vision. Vision includes the ability to use peripheral vision, color vision, integrate the central and peripheral vison, tracking, saccades ( jumping from one word to the next), making sense of what we are seeing, etc.

Therapy has little to do with eyesight, and everything to do with how your eyes function.

Even a person with 20/20 eyesight can have poor tracking skills, eye movement skills, depth perception, and other visual deficits.

In fact, you may have poor visual skills and not even know it. If you experience symptoms like headaches, dizziness, nausea, eyestrain, or difficulty with concentrating and reading, it may be time to have your vision evaluated by a doctor who is expert in this are.

To schedule a Vision Evaluation for these issues, for you or your child, call Family Eye Care today! You can reach us at 1-732-679-2020.

Family Eye Care serves patients from Old Bridge, East Brunswick, Woodbridge, Edison, and throughout New Jersey.

Frequently Asked Questions with Dr. Moshe Roth

Q: #1: What is Vision Therapy?

  • A: Vision Therapy is a customized program of eye and brain exercises and procedures. The initial therapy is done in-office and home activities are encouraged. Vision Therapy enables the visual system to develop and trains the eyes and brain to work in unison. Duration of treatment varies from patient to patient, and is dependent on the problem that someone has. Each person responds differently. Speak to us to learn more about what we offer and how we can help.

Q:#2: Is Vision Therapy covered by insurance?

  • A: Vision Therapy may be covered in part under major medical insurance plans. Medical Insurance is very selective on what types of problems they will cover. Vision Therapy is most often applied to a medical policy rather than a Vision Plan. Medical insurance companies may deny or place severe limits on coverage for Vision Therapy to limit their financial exposure. It is important to ask the right questions, and know the diagnosis and procedures. We find that often medical insurance representatives may say one thing, but ultimately when the claims are submitted, the medical insurance may not necessarily parallel what was told.

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Book An Appointment
Call Us 732-993-3420

Does Vision Therapy Aid in Controlling Myopia?

Can Vision Therapy Help Myopia 640

Vision Therapy is certainly effective in helping adults and children with a lazy eye (amblyopia), eye turn (strabismus), and learning difficulties, but did you know that Vision Therapy is effective in preventing, reducing, or slowing myopia (nearsightedness)?

The fact of the matter is that rate of myopia is increasing in children. In the US, it has increased from about 25% to 40% over the past few decades. In Asia, some countries have a rte of myopia in children that approaches 90%.

Many have attributed it to the amount of screen time on digital devices. The concept is: “how you use your body, changes your body”. Someone who lifts weights or plays sports certainly changes their body. How we use our visual system, changes our visual system. It is not that the digital device “does it to us”, rather, it is how we use our visual system when working at near, computer, cell phone, text books, that changes our system and causes us to become more nearsighted. Many have sought a “cure”, and some have even proposed “outdoor time” as a cure. It is not the out-door time, but rather the less digital screen time, that helps curb the myopia. Obviously eyeglasses alone, that compensate and enable someone see more clearly at distance, does not correct the problem. The individual continues to use their visual system the same way, and that is the reason the myopia increases, and the prescription becomes higher each year. Vision Therapy addresses the root cause.

Other options have included special eyeglasses, special molding lenses at night (orthokeratology). There are special soft lenses; MiSight and Natural Vue, that are designed to stem the progression of myopia. Atropine is an eye drop medication that has been found to reduce the rate of progression. Vision Therapy addresses the core, the reason that someone is becoming more nearsighted. It puts out the “fire” rather than addressing the smoke. It teaches the individual how to use their visual system in a more effective way to prevent the progression, and at times reverse myopia.

If your child is becoming more nearsighted, it is best to evaluate what is causing the myopia. Not all eye doctors look for the same things. Some are eye surgeons and look primarily for eye disease. Some are prescribing regular eyeglasses as we have done for decades. But what if there was a way to address the underlying reason for the myopia? In our office, Family Eye Care in Old Bridge that is exactly what we do. We offer all of the options above, including a program that is specific to address myopia progression.

How Does Vision Therapy Work?

What is Vision Therapy and how does it work? Vision Therapy is a set of visual procedures tailored to your specific needs. Therapists specifically trained to provide Vision Therapy instruct using a specifically programed sequence, with the aid of specialized prisms or filters, computer programs, and other therapeutic tools. Vision Therapy works on the brain so that the brain and eyes work as a team. It enables the individuals to develop visual skills that include eye tracking, teaming, accommodation, convergence, visual processing, visual memory, focusing, and depth perception. There is usually an at-home component, to reinforce what is learned in the office.

Can’t I Just Do This At Home?

Similar to school-based teaching, that is directed by a teacher, Vision Therapy is most effective when directed by a Vision Therapist. It is not effective as a do-it-yourself program because it requires guidance and oversight by a skilled professional. It is evidence-based. Published data has shown that it is effective in helping the individual gain the visual skills that are needed and are precursors to reading, learning, overall school and sports performance.

How Does Vision Therapy Relate To Myopia?

As stated above, how you use your visual system, changes our visual system. Myopia occurs when the individual uses their visual system in a less than optimal way.

In Vision Therapy the individual learns how to use the visual system so the underlying problem no longer exists. We work on accommodation—the eyes’ ability to maintain clear focus on objects. Poor focusing skills have been linked to myopia. Fusion is the ability to use the two eyes together as a team. Fixation is the ability to “lock on” to what you are looking at, for example locking onto a word on a page. Saccades are a visual skill of being able to “jump” your eye accurately from one word or phrase to the next. Pursuits are the skill of being able to track across a line of print. These are SOME of the visual skills that we work on to improve.

Can an Occupational Therapist provide Vision Therapy?

Occupational Therapists are excellent at what they do. Physical Therapists are excellent as well. These are 2 different discipline and each brings benefit, but they don’t do the same thing. There is obviously some overlap between the two.

Vision Therapist are specifically trained to help individuals improve the visual system. It is a separate field, much as Occupational Therapy is separate from Physical Therapy.

What is the Bottom line?

If you or your child has myopia and is becoming more and more nearsighted each year, then schedule a functional visual assessment for your child.

To schedule your appointment with Dr. Moshe Roth and Dr. Steffani Tiomno, call Family Eye Care today.

Frequently Asked Questions with Dr. Moshe Roth

Q: #1: Who can benefit from Vision Therapy?

  • A: Children and adults with various visual dysfunctions can benefit from a personalized program of Vision Therapy. Visual dysfunction can manifest in many ways, including—but not limited to—behavioral and learning problems, coordination difficulties, headaches, dizziness, nausea, anxiety, and attention deficits. These problems cannot be addressed with eyeglasses, contact lenses, or surgery.

Q: #2: Do All Optometrists Offer Vision Therapy?

  • A: No. This is a subspecialty area within Optometry. Behavioral Optometrist also known as Developmental Optometrists are men and women who have a special interest and have taken additional work to know how to provide Vision Therapy. Some have attained the level of Fellowship in the College of Optometrist in Vision Development. As stated above, there are other types of therapists that claim to offer Vision Therapy, but only an eye doctor who understands how the visual system works, rather than how the eye works, can prescribe the necessary visual treatments for optimal results.

Family Eye Care serves patients from Old Bridge, East Brunswick, Woodbridge, Edison, and throughout New Jersey.

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Book An Appointment
Call Us 732-993-3420

Common Visual Symptoms to Watch for in Children

kid playing outside 640

People often believe that if a child has 20/20 vision, they have perfect eyesight. This isn’t always the case. Having 20/20 eyesight refers to the ability to see clearly from 20 feet away. This doesn’t guarantee that a child has the visual skills needed to read properly, pay attention in class, writing, and other tasks required for academic success.

It may surprise you to know that many students who show signs of a learning difficulty actually have an underlying vision problem. According to the National PTA, approximately 10 million school-age children suffer from vision problems that make it more difficult for them to learn in a classroom setting.

If your child is struggling in school, Dr. Moshe Roth and Dr. Steffani Tiomno can determine whether the problem is related to their vision and provide a vision therapy program to help them succeed.

Vision Screenings vs Comprehensive Eye Exam

While school vision screenings might detect significant lazy eye or myopia, they miss many other vision problems, such as issues with focusing, depth perception, or eye tracking.

A comprehensive eye exam, on the other hand, checks for farsightedness, nearsightedness, astigmatism, eye focusing abilities, eye tracking, eye focusing, visual skills, binocular eye coordination, and visual processing.

What Signs Should Parents and Teachers Look For?

Below is a list of signs and symptoms indicating that a child may be experiencing vision difficulties:

  • Difficulty paying attention
  • Complains of frequent headaches
  • Difficulty with comprehension
  • Complains of double or blurry vision
  • Makes errors when copying from the board
  • Reads below grade level
  • Holds reading material close to the face
  • Reverses words or letters while reading or writing
  • Loses place or skips words when reading
  • Confuses or omits small words while reading
  • Rubs eyes
  • Slow to finish written assignments
  • Frequently squints
  • Tilts head or covers one eye
  • Spelling difficulties
  • Uses finger pointing when reading

How Does Vision Therapy Help Solve These Problems?

Vision therapy is a personalized treatment program designed to strengthen and improve your child’s visual skills.

Each vision therapy program is customized to your child’s needs and may include specialized lenses, filters, or prisms, alongside personalized eye exercises to help retrain the brain-eye connection and improve your child’s school performance.

If you think a vision problem may be affecting your child’s academic performance, vision therapy may provide them with the necessary visual skills to succeed in school.

Frequently Asked Questions with Our Vision Therapist in Old Bridge, New Jersey

Q: How do vision problems impact learning?

  • A: A child’s vision problem can impact all aspects of learning. Often, children with vision problems are told they have a learning difficulty, when in fact, their brain isn’t properly processing what their eyes see. Vision problems can affect a child’s reading skills and comprehension, handwriting, spelling, classroom performance, concentration and attention, and visual skills.

Q: Does my child have a vision problem?

  • A: It is often difficult for a parent to determine if their child has vision problem that is affecting learning. A child would not realize that they have a vision problem because they have no point of comparison to know what correct vision is. They assume that everyone sees the way that they do. These types of problems are not obvious by a parent just looking at the child. A child rarely has the verbal skills to describe what they are experiencing.

Common indicators that your child may have a vision problem include:- Covering one eye- Behavioral problems- Reading avoidance- Difficulties with reading comprehension- Frequent blinking- Excessive fidgeting- Limited attention span- Reading below school grade level- Tilting head to one side

Developmental Optometrists are specifically trained to identify and treat these problems. They have taken additional coursework and study. Some have attained the level of becoming Fellows of the College of Optometrists in Vision Development, which means that they have demonstrated expertise in this area.

If your child displays any of these signs, make sure you set up an appointment with our eye doctors at Family Eye Care to evaluate their visual skills, and find out whether your child could benefit from Vision Therapy.

Family Eye Care serves patients from Old Bridge, East Brunswick, Woodbridge, and Edison, all throughout New Jersey.

Book An Appointment
Call Us 732-993-3420

Should My Child See an Occupational Therapist or a Developmental Optometrist that provides Vision Therapy?

vision therapy 640When a child struggles in school, parents naturally want to help. At times it is difficult to know what kind of help a child needs and who is best to provide that service.

Occupational Therapists (OT) are employed by schools and that may be a good place to start. School systems, and their OT’s, are often stretched thin and can offer only a limited therapy program. It also draws the child out of the classroom, and may take them away from learning. Many private OT’s offer pediatric care and provide OT care outside the school system.

When a vision problem interferes with learning, the best place to turn is a Developmental or Behavioral Developmental Optometrists. This is a subspecialty within Optometry. Optometrists obviously understand the vision system, provide eye examinations, eye medications, and eye glasses. Developmental Optometry is the subspecialty that understands how vision impacts learning and helps individuals to solve vision problems that affect learning. These doctors provide Vision Therapy (VT).

How are OT and VT similar? How are they different? Perhaps we can offer some guidance for parents and educators.

Most people are aware that there is an overlap between OT and PT, physical therapy. There is also an overlap with SLP; speech and language pathologists. Some OT’s and some PT’s say they provide Vision Therapy. Vision Therapy is an entity onto itself, much as Occupational Therapy is not Physical Therapy. It is specific to visual problems that affect learning and for other visual problems that eyeglasses and contact lenses can’t treat.

Developmental Optometrist offer Vision Therapy. Problems with the visual system are often best treated by someone who understand the visual system. There are parts within a Vision Therapy program that are similar to OT and PT, but in Vision Therapy, as the name implies, the main ‘focus” is vision. Vision is the sense that supplies our brain with the most information.

What is the Difference Between OT and VT?

diagramThere is some overlap between OT and VT, but there are considerable differences as well.

Occupational Therapists help people gain or regain the ability to perform various daily tasks through the use of sensory-motor exercises and interventions. OT aims to improve gross and fine motor coordination, balance, tactile awareness, bilateral awareness, and hand-eye coordination.

Eye Doctors that provide Vision Therapy, and the Vision Therapists in those practices help children and adults who have not yet developed the visual skills needed to succeed in school. Behavioral and Developmental Optometrists help patients improve how the vision system works and strengthens the eye-brain connection. This then helps solve vision problems that affect learning and schoolwork. It is often these vision problems that causes a child to struggle with poor reading and then produces anxiety. Children then procrastinate completing assignments and become frustrated. The reasons for these problems are not always apparent to a parent. A child assumes that the way they see is normal, and is the same as how their classmates see. They may not realize that they see blurry or double. They may not realize that they have eye strain or headaches that are due to a vision problem.

Some of the important visual skills for reading and school success are eye teaming, tracking, focusing, depth perception, visual processing, and visual-motor skills. These are eye movement and higher visual function skills.

How does a visual deficit look in a real world situation?

A child may have 20/20 eyesight, but that only means how someone can see at a distance of 20 feet. Yes, that’s where the “20” of 20/20 comes from. It does not tell us how someone functions at near, for example reading or computer use, that is so critical now, when so much of learning is computer-based. It doesn’t tell us how the two eyes work together, as a team. A child may need to read a sentence several times in order to understand its meaning, or tilt their head to read the whiteboard. They may ultimately avoid doing activities that are visually demanding. Poor performance in school and on the playing field can often be attributed to visual skill deficits.

Which Therapy Is Right For Your Child?

If the child’s visual system is the underlying cause of behavioral or learning problems, then a personalized Vision Therapy program is usually the best answer to help the child gain the visual skills needed to succeed.

So, when is best to consider Vision Therapy for your child? The answer is simple and straightforward. If your child is struggling in school it is important to first be evaluated by a doctor who specializes in vision problems that affect learning. If a child has trouble with visually demanding tasks, like homework, reading, spelling, or complain of headaches, then a doctor skilled in this area is able to evaluate and determine if Vision Therapy is indicated. This also applies to children who avoid sports. There may be an issue in judging space and how fast a ball is coming toward them. Developmental optometrists also work on sports vision.

The point is that a Doctor of Optometry, and specifically a Developmental Optometrist, is the doctor that provides the expertise needed to address the visual system, and how someone is able to read and learn.

This is not to lessen the benefits that Occupational Therapists provide. OT’s and PT’s often refer patients to our office. OT’s sometimes perform visual exercises with children, but only an eye doctor experienced in Vision Therapy can prescribe therapeutic lenses, prisms, and filters that enable the child to develop visual skills needed for school success.

Not all optometrist are trained in Vision Therapy. Dr. Roth is a Fellow of the College of Optometrist in Vision Development. This means taht he is certified in this subspecialty. Dr. Tiomno, Dr. Roth’s associate, completed her residency with Dr. Roth. Our doctors are experienced in diagnosing and treating people of all ages with all types of visual dysfunction.

Often children who have passed a school’s vision screening, or “passed the eye test” at the pediatrician’s office, may still have a significant problem with visual processing and other skills. A screening “test” usually measures how each eye sees individually and does not test how the two eyes work together as a team. A school vision-screening tests only for visual acuity (eyesight) and do not test for the other visual skills that are so important for a child to be able to succeed.

The visual system is highly integrated with other systems, and therefore, an interdisciplinary approach is often the most effective approach. OT and VT overlap, but don’t always have to be undertaken simultaneously. Some children may benefit from both of these therapies

If your child is struggling with learning or behavioral problems, their vision could be an underlying cause or contributing factor. To schedule your child’s functional visual evaluation, contact Family Eye Care in Old Bridge today.

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Why vision therapy comes before tutoring or a learning center

Teacher eyeglasses 1280 x 853Our parental instinct naturally wants to find the fastest solution & often the first options for a child who struggles in the classroom are either a tutor or a learning center. However, some learning problems are vision-related, which is a problem in development and not necessarily due to learning capability.

When patients come to us for a vision therapy evaluation, we strive to educate parents how to recognize that when their child has a tantrum, gets easily frustrated, and can’t continue with homework, the child can show he or she is very bright and intelligent in other areas. Therefore, the issue of learning to read might not have anything to do with the child’s intelligence but a visual one.

Vision is such a basic tool that many parents may have already enrolled their child in other programs because they never questioned the child’s ability to see. When learning programs can’t solve the child’s struggles, parents discover vision therapy as an alternative, either from a referral or after online research.

Why aren’t parents brought to vision therapy from the beginning?

There are various reasons why vision therapy may not have been recommended to you initially or perhaps have never heard about it until now.

  1. Vision therapy is a unique program that only some optometrists specialize in and offer at their clinics.
  2. In vision screenings at school, vision is only tested for seeing at a distance. A child with a problem with another visual skill can go undiagnosed.
  3. Since there are children with learning problems, some with vision problems, diagnosing the exact issue becomes more difficult as the child may be juggling more than one condition.
  4. The child does not have regular eye exams with an optometrist or local eye doctor.

Fortunately, vision therapy is growing in popularity because of the effectiveness and immediate benefits in children with problems. Previousl children would continue their years at school without ever treating their vision problem. Even today, some adult patients come to us for therapy & discover they had a lingering vision problem holding them back the entire time.

Is there a time that’s too early to treat a vision problem?

When a child is starting to read & pronounce the words in 1st or 2nd grade, if they have a vision problem, their learning will be slower than other children & unfortunately, the issue generally won’t go away on its own. In scenarios like this, a child with a vision problem who reaches 3rd, 4th, or even 5th grade without treating their vision, will end up falling behind the class at a more noticeable rate. A child may lose confidence or face peer pressure unless their situation is handled with care. However, if the vision problem is addressed early, the child can enjoy their early school years with fully developed visual skills and not have to face these challenges at an older age.

Signs of a child with a vision problem may be able to pronounce words & run through sentences, but they will lack comprehension. Children may end up learning to read but never reading to learn. For a person who grew up with normal vision, it’s difficult to comprehend how someone can read through a page & not remember what they read.

Why Vision Therapy Should Be Your 1st Priority

Fortunately, vision therapy is well researched & supported with multitudes of success stories over the years. Plus, a developmental optometrist who specializes in vision therapy has ways to accurately test your child’s various visual skills & identify whether vision therapy is needed. There’s no guesswork involved. This means that your child will achieve normal, functional vision at the end of therapy, and in many cases, they become amazing readers, sports players, and happy to learn.

Struggling with Reading & Overall Learning Problems

learning at home 640×350During COVID-19, parents are challenged with the task of supporting their children’s studies as they contend with online classrooms and homework. We can certainly acknowledge our teachers have done a phenomenal job at adapting their classroom setting to a virtual one, but a struggling reader or learning problem is hard for a teacher in a remote setting to solve. So, the burden is placed on the parent’s shoulders to bear.

Fortunately, there are multiple avenues to take to help your child feel empowered and gain a better foothold with their online learning. By now, most parents have equipped their child with a fast internet connection, new computer, and quiet learning environment. What else is there left to do?

Encouragement & Support

As much as we’re all under a lot of stress, your child depends on your never-ending support & love. You don’t need to turn to gifts or money to make a child feel appreciated. A personal touch like their favorite snack, quality time, and compliments can go far with anyone.

Digital Eye Strain

Eye fatigue from excessive smartphone/computer usage isn’t unique to children — it affects everyone. Not only do our eyes need a rest from the computer, but digital devices reduce our blinking rate, which also results in dry eye symptoms. Take frequent breaks & stretch your eye muscles by looking out a window once in a while.

Did your child ever have a functional vision evaluation?

While a child who is really struggling at learning can require the help of an educational therapist or tutor, a key step to identifying what’s holding your child back in their studies is addressing their vision — 80 of learning is visual!

We often find children who have struggled in the classroom as “C” students because their vision was never evaluated by an optometrist who specializes in vision therapy.

If your child has an underlying vision problem, no amount of tutoring or work with other specialists will address or treat the problem effectively or at all.

We encourage you to contact Family Eye Care today for a vision therapy evaluation to assess if their vision is what has held them back from their studies.

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How Vision Therapy Impacts Confidence & Success

Mom Daughter Child Eye HealthBuilding confidence in children is critical to their success. Children who have visual skills that have not yet developed, tend to lack confidence in their abilities. They may struggle to keep up in school, finding it difficult to concentrate in the classroom. They may have difficulty when trying to catch a ball when playing on the sports field.

The good news is that Vision Therapy can help children (and adults) develop the specific visual skills they lack, offering them the best opportunities to have better reading comprehension, increase their reading level and attention span, and improve their sports performance.

We usually expect eyeglasses to solve all vision problems, but they don’t and they can’t. Much as eyeglasses don’t solve an eye allergy and they can’t solve glaucoma (an eye disease), eyeglasses don’t solve all vision problems. Vision Therapy solves eye problems that eyeglasses and contact lenses can’t treat.

Once the vision problems are addressed, the child is able to function and learn better. This then directly impacts their confidence level.

How Does Vision Therapy Work?

The primary goal of Vision Therapy is to improve the child’s visual skills. A child can have 20/20 acuity, which means they can see clearly at 20 feet and beyond, but they may still have visual skills that have not yet developed. Think about it. Most of child’s learning is at near, on the computer, or reading a book. Is measuring distance acuity really a good gauge for how someone functions are NEAR?

Poor visual skills makes it hard for the eyes and brain (and body) to work together. Vision Therapy helps the child or adult to develop that communication. That enables people who have Binocular Vision Dysfunction to process and react to visual information faster, more accurately, and more efficiently.

Vision Therapy Process

A Vision Therapy program helps the person learn the visual skills that they need so they can succeed. It is a personalized program tailored to what that person’s needs.

The Therapy program is specific for that individual’s particular type and level of visual dysfunction. Its purpose is to develop communication between the brain and the visual system. The instruments we use to do that include specialized optical lenses, eye patches, prisms, balance boards, and digital technology in order to develop the brain-eye connection.

Visual Skills

There are several visual skills that vision therapy helps to improve. These include:

  • Saccades – the eyes’ ability to move quickly or “jump” between two or more focus points. This skill is crucial for reading, as children need to be able to move their eyes along a straight line without straying to other lines.
  • Pursuits or Tracking – the eyes’ ability to smoothly track a moving target. This skill allows a child’s eyes to glide along with a page and also to catch, hit, or kick a moving ball.
  • Convergence – the eyes’ ability to work together as a team in order to focus on a nearby object like a book or computer screen..
  • Accommodation Flexibility – the eyes’ ability to continuously change focus between near and distant objects. This is the skill required when a child looks at the blackboard and then copies the writing into a notebook.
  • Accommodation – The eyes’ ability to maintain focus on close-up activities. This skill is needed for homework and for using a computer for many hours.
  • Central and Peripheral Vision – the ability to integrate those two different important parts so they are seamless and have flow.
  • Visual Memory – The ability to remember words and information. Good visual memory is essential for spelling.
  • Color Perception – The ability to distinguish between various colors. This skill is essential for the accurate interpretation of color-coded materials, such as graphs and charts.
  • Fine Visual-Motor – The ability to engage in close-up activities with accuracy and comfort. This skill is needed for reading, writing, cutting with scissors, and assembling a puzzle.
  • Visual Integration – The ability to combine your vision with your other senses to perform complex tasks. This skill is required to process various forms of visual information accurately and quickly. Visual integration is crucial for a student copying from the board and analyzing the information.

Confidence And Success Building

Developing visual skills is critical to a child’s ability to succeed and meet the demands of school, especially now, when so much learning is done on computer. This will then help a child improve their grades, and allow them to gain confidence in the classroom. Vision Therapy can also lead to improved hand-eye coordination and allow them to have more fun on the sports field. In fact, Vision Therapy can be a key component in preparing children for higher education. As they master new skills, they feel more confident in their abilities.

IT is important to understand that a school eye screening by the school nurse or with a pediatrician, is not an eye examination. Most regular eye exams evaluate eyesight, but do not assess the essential visual skills required for sports, reading, and learning. Only a comprehensive vision exam by a Developmental Optometrist can determine whether a child has the visual skills they need to succeed in school. Contact Family Eye Care to schedule a Comprehensive vision exam to assess your child’s visual skills. We have Vision Therapy Programs that are individualized to help each child develop visual skills so your child can succeed and reach their full potential.

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4 Ways To Help Your Child who has a Vision-Related Learning Difficulties

sad child 640An estimated 1.25 million children in North America are affected by some form of visual problem that affects studying, reading, and daily living. These include: nearsightedness, farsightedness, lazy eye, or crossed-eye.

Please consider visiting our website to learn the difference between these two. We have explained that in words and with videos.

These visual problems usually have a huge impact on school performance and can cause a child to lag behind their peers.

The good news is that there are steps you can take to help your child succeed. First, let’s explain the link between vision and learning.

Why are Visual Skills Necessary For Learning?

Most of what we learn is through our visual system. Up to 80% of classroom learning is vision-based. Is it any wonder then, that children who have problems with certain visual skills lag behind their peers academically?

This goes way beyond the ability to see letters on the eye chart at the pediatrition’s office or the school nurse. It goes way beyond the pediatric eye surgeon’s test for eye health. What we are dealing with is how the 2 eyes function together as a team.

The Acuity chart tells us how we see at distance, such as looking at the blackboard, but more of learning, and reading, is NOT done at distance; it is done at near, such as reading a book or working on a computer.

The visual skills needed for school success go far beyond just visual acuity, such as myopia (nearsightedness) or hyperopia (farsightedness). The visual skills needed rely on brain-eye communication. These types of visual skills problems can only be detected with a doctor who is looking for these types of problems. These vision skills include eye teaming, tracking, accommodation, and focusing, all of which are critical for proficient reading, writing, and reading comprehension.

How Educators Can Help Students With Vision-Related Learning Challenges

Firstly, teachers are experts in teaching, but may not be experts in identifying what is holding a child back from being able to learn effectively.

1. Consider Where Your Students Should Be Seated

It is a good idea to have children seated facing the whiteboard rather than having to look over their shoulder or turn around to see what the teacher is writing on the board. Some classrooms have students seated at round tables, which puts some children into the position of having to turn around to see the front of the classroom. There are some positive reasons for this type of seating arrangement, but it makes it difficult to quickly shift gaze from distance to near in order to copy from the board.

2. Pay Attention to a Child’s Visual Needs

If eyeglasses were prescribed, it is important to know how and when they should be used. Sometimes children are bullied and that is why they don’t wear the eyeglasses that were prescribed.

3. Classroom Lighting

It is important that a child’s seat is not in direct sunlight or under a shadow. Natural lighting is preferred, but when that isn’t possible, tungsten light bulbs are generally favored by the eye over fluorescent lighting. Flickering light bulb should be changed without delay.

4. Choose a Teaching Method That Promotes good Vision and Sight

  • Use black or dark-colored markers on the whiteboard.
  • Avoid bright colored markers like orange, red, and yellow.
  • When writing on the board, say the words/numbers aloud to assist those who may have difficulty reading or seeing the text.
  • Avoid using language that relies heavily on vision, such as “like this one” or “over there.”
  • Be patient when a student stares off into space or daydreams. This is often a symptom of visual dysfunction, rather than a lack of attention.

How We Can Help

At Family Eye Care, our goal is to help each child reach their full potential by strengthening any visual skill deficiencies.

We treat children who have visual problems that affect learning. Most often, a child is not awaare that they have a problem and assuemthat everyone sees the same way that they do. Vision Therapy may be indicated to help the child to be able to use the two eyes together as a team, and to physically focus so the child can then mentally focus. Vision Therapy enables the individual to build a strong eye-brain connection.

To learn more or to ask any questions, contact Family Eye Care today.

Family Eye Care serves patients from Old Bridge, East Brunswick, Woodbridge, Edison, and throughout New Jersey.

REFERENCES

 

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Choose Holiday Gifts That Support Your Child’s Vision

child looking at toys 640Gift giving season is fast approaching. If you plan on purchasing a gift for a child, you may want to consider choosing one that supports healthy visual functioning.

Here’s our list of children’s gifts that benefit their visual health in a fun and enjoyable way.

Building Toys

Building toys help children develop hand-eye coordination and visualization skills. They also help enhance visual-spatial skills — an essential component of reading readiness. Understanding how to create a structure refines children’s spatial-organization skills.

Playing with building toys perfects skills like problem-solving, patience, and focus.

Some popular building toys are Legos, Duplos, Mega-Bloks, Clics, and Magnatiles. Many building toys are appropriate for children aged 1-9, but follow the age recommendation and warning labels listed on the packaging.

Visual Thinking Games and Toys

Jigsaw puzzles, memory games, dominoes, checkers, Rush Hour, and Bingo all help children to build visual thinking and processing skills. Visual thinking, also known as visual/spatial learning or picture thinking, is the ability to think and analyze what you have seen. This skill is needed for math and reading comprehension.

Visual thinking games are a great way to cultivate abilities like visual memory, form perception, eye tracking, sequencing, and pattern recognition.

Space Perception Toys

What better way to develop a child’s hand-eye coordination than with a lively game of catch or ping pong? Space perception toys also promote a child’s awareness of the space around them, as well as three-dimensional depth perception, eye tracking, and accommodation flexibility (the eyes’ ability to continuously change their focus between near and distant objects).

Other examples of space perception toys include marbles, pick-up-sticks, Jenga, and any game or sport that involves a ball.

Let’s Support Your Child’s Vision Together

A child’s vision enables them to succeed academically, building self esteem. When a child has a problem with one or several visual skills, it can cause them to struggle in school or develop attention and behavioral issues.

That’s why it’s important to provide children with toys, games, and opportunities that support and refine their visual skills.

If you suspect that your child may be struggling with their vision, bring them to Family Eye Care for a functional visual evaluation, where will test their visual skills and processing abilities.

Even a child with 20/20 vision can have visual dysfunction that will likely go undetected in standard eye exams or school screenings.

If a problem with their visual functioning is found, we may recommend a personalized program of vision therapy. Vision therapy is an evidence-based treatment method that has been proven effective for a wide variety of visual dysfunctions. This form of therapy can be thought of as a “gym” for the brain, as it helps to retrain the eye-brain connection and speed up a child’s visual information superhighway.


For more information or to schedule a functional visual evaluation, call Family Eye Care today.

Family Eye Care serves patients in Old Bridge, East Brunswick, Woodbridge, Edison, and throughout New Jersey.

 

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