Vision is the ability to identify, interpret and understand what we see, and this is learnt in
various stages from childhood, like learning to walk and crawl and keep our balance.
87% of the information received by the brain is from the eyes, so good visual skills are vital in
learning, working and sport.
As we grow one visual skills builds upon another step by step. Many people miss out one of
these steps or do not complete a step, which reduces visual efficiency and causes difficulty
with eye co-ordination, focusing, tracking and “finding” objects in space.
Vision Therapy exercises and lenses can be used to:
Prevent vision and eye problems
Develop visual skills needed to:
Achieve more effectively at school, work or in sport
Enable greater concentration and “staying power” on difficult visual tasks such as computer
Assist with visual problems which have already developed, or which occur due to stroke or
other brain injury.
What are the Visual Skills?
Visual Acuity (eyesight):
This is the number “20/20” or “6/6”. This is the ability to see and identify
an object either at distance or at near. People with “20/20” vision may
still have problems with their vision.
This is the ability to adjust and maintain focus smoothly and accurately.
This is the ability to turn both eyes inwards to keep the eyes accurately positioned on a target, and avoid double vision. This is closely linked to accommodation so that the eyes are pointing and focused at the same point. The ability to comfortably maintain convergence over a period of time is essential to maintain attention, particularly for reading. The eyes also have to be able to “let go” and diverge again once the task is complete or when we change focus (for example looking up at the board after reading or writing on the desk at school.
This is the ability to smoothly and accurately follow a moving object with both eyes, e.g. a ball moving through the air, or reading without moving the head or keeping place by following each word with a finger underneath it.
This is the ability to quickly locate an object in space, with both eyes, for example moving from one word to the next when reading, or changing focus to the board and back to the desk.
Depth Perception (stereo/3D vision):
This gives us the ability to be aware of distance and time movements when playing ball sports and when driving.
The ability to be aware and monitor what is going on around you while you are paying attention to something else (such as being able to work without being distracted) and the ability to take in visual information from a large area (for example being able to read quickly, recognising groups of words and phrases as a group) rather than slowly one word at a time).
Vision and Learning
Children who are performing below average at school may have difficulties,
not due to lack of intelligence, but to problems with visual function
and visual processing. A child may have difficulty focusing when
looking from a book to the board and back when at school, or difficulty
using both eyes together so that words become double or appear to move
about. If eye movements are poorly controlled the child may frequently
loose their place when reading, guess words or see and therefore read either
the words themselves or the letters in the wrong order. To overcome these
difficulties the child has to make more and more effort to “keep up” in school,
and therefore they will have less and less mental energy left to understand
what they are seeing. If it all gets too much effort the child may just stop
reading wherever possible saying “I don’t like reading”, or become disruptive
in class as a way of avoiding the problem.
These visual difficulties stay with us, we do not grow out of them, so that a
child with reading and writing problems at school grows up into an adult
with exactly the same problems. In most situations it is the message the
brain sends to the eye muscles which is inefficient rather than the muscles
being “weak”. Once the brain is “reprogrammed” with the aid of vision therapy, and sending clear messages to the eye muscles, visual performance will improve.
Once the child can “focus” he or she will be less distracted and possibly less disruptive in class.
Glasses, either for reading or bifocal/varifocal, are often used in together with vision therapy to relieve visual stress and improve performance at school.
Common Visual conditions and Vision Therapy:
Lazy Eye or Amblyopia
A “lazy eye” somehow does not “match up” with the “good eye” and
does not connect up so well in the brain. We need two “matching”
eyes to develop good 3D vision and eye-hand co-ordination, and
to judge speed and movement accurately.
Treatment for this may involve glasses or contact lenses, patching of
the “good eye” and vision therapy to encourage the brain to use both
eyes “as a team” as much as possible. Success depends on motivation,
as therapy can take 6 to 12 months or more, depending on how
difficult it is to “reprogramme” the visual system.
Squint or Strabismus
This is where one eye does not line up with the other (usually one or
either eye turns in or out, occasionally or all the time); often the vision
in one eye is reduced as well (lazy eye). Treatment involves glasses or
contact lenses to improve the vision as much as possible in both eyes,
and vision therapy as before.
Sadly if the lazy eye or squint is discovered fairly late or the difference
in vision between the two eyes is very great then treatment may not
produce significant improvement.
This very common condition occurs when close objects are clear and distant objects appear blurred.
In some cases this is related to visual stress (eyestrain) associated with close work; the first symptom is blurred distance vision lasting only a few seconds after a period of close work (for example a child sees the board as blurred for a few seconds after looking up from their work, and then the board looks clear again).
This can be caused by poor co-ordination of the eye muscles, and may result in permanent short-sightedness as the eyes try to adapt to make continued near work easier.
This type of short-sightedness may need glasses to reduce the “visual stress”, vision therapy, and changes in posture and work pattern where possible; glasses are used to reduce the need to focus by letting the lenses do it instead, and Vision Therapy aims to improve focusing and eye teaming skills.
There are many things about short-sightedness we do not understand, but in some cases the “progression” of needing stronger and stronger lenses can be reduced, or even stopped, but unfortunately never reversed.
Checklist for common visual problems seen at school, home or at work
Have you noticed any of these with your child, or yourself?
Skips or has to reread lines when reading
Tilts head to one side when reading
Closes or covers one eye when reading
Problems copying from the board or from a book
Leaves out small words when reading
Writes up or downhill, cannot keep to the line
Written work starts in the middle of the page and not at the left hand margin
Tires easily when reading or looses concentration with time
Holding head too close to reading material
Problems lining up numbers properly
Extreme fatigue or falls asleep when reading
Blurred vision for close up tasks
Words run together when reading, appear shadowed or move about
Headaches especially on close work
Reverses letters or numbers (after 7 to 8 years old)
Avoids reading or close work
Poor eye-hand co-ordination, including poor handwriting
Clumsy or awkward, frequently tripping or stumbling
Poor judgement of distances
Short attention span, easily distracted
Problems completing work in the time allowed
Forgetful, or poor memory
Poor time management
Car sick or motion-sick
Dizziness or nausea with near tasks
Vision worse at the end of the day
Eyes burn, sting or water
What does Vision Therapy Involve?
The Vision Therapy programme is designed for each person, as in physiotherapy, following an initial assessment, and is modified depending on how we progress. Therapy sessions are usually every two weeks in the Practice, with home activities every day, usually lasting 15 to 20 minutes. Reviews are carried every three months, and most therapy programmes will cover three to twelve months. An estimate of the time involved will be given after the initial assessment, which will take approximately 1 and a half hours.
For further information contact the practice or go to:
Visual Perceptual skills:
These include the ability to identify recognise shapes when presented in different ways (for recognising upper and lower case letters, reading upside down), visual memory, visualisation (the ability to retain and create visual images “in your mind’s eye” and recall them later).
As visual skills develop we learn to use both eyes together efficiently as a team, so that visual information is understood and processed with minimum effort.
People with poor visual skills may still be high achievers, but they have to use excessive amounts of effort to achieve their goals, and endure unnecessary stress in the process. If a person is less motivated and determined to succeed, even one or two poor visual skills will cause them enough stress and frustration to make them give up.