Developmental Eye Care: What Is It? What Can We Do?
What Is It?
Vision is a critical part of learning in every stage of life. And vision is more than seeing a distant image clearly or being able to recognize words or letters. The descriptor of visual acuity, 20/20, describes the ability to detect a small black letter on a white background twenty feet away. This is dramatically different from the visual skill required for development of reading skills.
Reading and life require multiple skills including
- Fast and efficient focusing
- Eye coordination
- Visual perceptual skills
Accurate visual skills create a stable, predictable visual world. The more stable the visual world; the less effort required maintaining that stability, the more efficient, comfortable and accurate a child’s visual performance becomes. In simple terms, that leaves more brainpower left over for the cognitive tasks at hand.
A developmental eye exam looks at six areas of visual function. These include:
- Visual acuity (sharpness of vision and the need for distant glasses)
- Eye health
- Focusing (ability to make a near target clear)
- Eye coordination and visual motor
- Visual perceptual skills.
The first two areas are covered in any eye exam. The remaining four areas require significantly more time and expertise to perform and are ignored by most eye doctors.
Each of these areas can be tested through a variety of different methods, corroborating and complementing each other. Instead of asking the question “can you see?” we are asking the question “how well do you see?”
Who Needs Developmental Eye Care
There are a variety of behaviors that suggest the need for developmental eye care. Generally we are looking at children, however anyone struggling with the following, including skipping words, rereading lines, misreading small familiar words, headache, unusual postures, difficulty sustaining effort or an excessive number of seemingly careless errors. In other words, the amount of effort put into the task doesn’t quite correlate with the quality of the output.
In addition, people who have known associated disorders, including attentional issues and or other developmental difficulties, often benefit from an evaluation.
Concussions are a growing issue in our society and anyone struggling with persistent visual issues after a concussion should have a developmental eye exam.
What Can We Do?
If a problem is diagnosed, there are a number of possible treatment options. Sometimes it is best to do nothing and simply wait until the weak area of visual function matures. If it is a developmental delay, it is often just a matter of time until things improve. However, sometimes there is much to be lost by waiting and some sort of intervention is appropriate. These treatments consist of eye exercises, glasses or visual perceptual activities.
Eye exercises consist of activities designed to train weak or uncoordinated eye muscles to improve focusing and eye alignment and tracking skills. These are physical exercises that can be performed in free space or on a computer. Just like doing pushups or running, the more you do it, the better you get at it. There are age-related norms established in each of these areas, so the exercises are performed until these norms are met or exceeded.
A specific version of eye exercises offered here is RightEye. This is a focused therapy working on tracking issues including pursuits, saccades and fixations. This program is done remotely from home with periodic visits back to the office. We monitor all work and progress. RightEye can help with reading, concussions and sports performance.
Glasses can be an extremely useful, cost-effective method of compensating for a weak visual system. They work by compensating for weak focusing skills and by playing on the interrelationship that exists between focusing and eye coordination. Sometimes a prism is used to enhance alignment of the eyes or make it easier for the child’s eyes to work together. A prism bends light without focusing it, allowing the eyes to see as if they are aligned properly, without the distracting excessive effort that would normally be required.
Visual perceptual exercises come in a variety of forms, many of which are available in any toy store. These are generally activities that require some level of copying, manipulation or visualization, such as jig-saw puzzles or crafts. Additionally, there are some useful computer programs that allow children to practice and improve their visual perceptual skills with the advantage of keeping records of the child’s performance in the activity. Each activity builds on the previously performed sessions, becoming slowly more difficult. These often include activities that build visual attention, visual memory and visual spatial skills