There is much more to vision than whether you see clearly or not. We must evaluate how the eyes align, focus, work together as a team, accuracy of eye movements, and how the brain processes visual information. Collecting all these data often requires more than one visit.
Start with the Basics
A developmental vision evaluation must begin with a standard eye exam. It is very important to first determine the health of the eyes and whether or not glasses are needed for basic conditions like astigmatism, hyperopia, etc. This will either be done by us or the eye doctor who referred you here.
Binocular Vision Evaluation (eye alignment and teaming)
Both eyes should work together as a team and to point to the same position in space. When looking from far to near, they must converge (turn inward.) Adjusting and maintaning eye alignment should be easy and comfortable. Eye alignment problems, such as convergence insufficiency can cause double vision, blurred vision, headaches, reduced interest in reading, etc. In some cases the brain may not the eyes well together as a team and may actually suppress visual input from one eye, which can lead to reduced depth perception or 3D vision. A visually evoked potential (VEP) is sometimes performed to get a better feel for how much either eye is contributing to the overall visual process.
Accommodation (eye focusing)
When looking back and forth between something up close and something far away, you must adjust your focus to make it clear. Difficulty with adjusting and maintaining focus can cause headaches, eye strain, blurred vision, difficulty copying from the board, etc.
Many of the tasks we do every day require highly accurate eye movements (known as pursuits and saccades.) If these eye movements are not accurate, these tasks become much more difficult. During reading, for example, poor tracking can cause you to lose your place frequently, skip lines and words, and reduce overall comprehension and speed. We will typically evaluate these eye movements in a few different ways including Visagraph testing.
Visual Information Processing.
This evaluates how visual information is processed by the brain and is more cognitive in nature. If deficits are found in the areas described above, it is more important to address those first. Visual perceptual problems like figure ground, closure, and memory can have a significant impact on performance and learning, but we typically don’t run these tests on everybody.
What if deficits are found?
The manner in which these deficits are addressed can vary depending on the type and severity of the diagnoses and each person’s unique circumstances. Typically this involves vision therapy and/or glasses. Vision therapy is often (but not always) the best choice. Glasses, which may include prism or a bifocal, can be quite helpful improving performance, aiding development, and reducing visual stress. We’re also happy to provide reports to schools or the workplace, which may include requests for appropriate accommodations.