Unfortunately some eye specialists, like those who offer "quick" exams, test only for "refractive error," also doing little more than the Snellen test. A pediatric optometrist or one trained in behavioral optometry can tell you if your child has problems in addition to clear distance and near sight, such as with focusing ability, eye coordination, depth perception, eye muscle action, side vision and understanding what is seen. Behavioral optometrists use specialized, age-specific tests to spot and remedy subtle, but serious vision problems before they can limit your child's learning.

Lastly, doctors other than optometrists (and ophthalmologists), rarely have the necessary, specialized equipment and experience to diagnose the more serious eye infections and conditions. Conditions that we see every day.

The most important thing to remember is:
If you have an eye emergency DO NOT DELAY CARE AND DO NOT RISK YOUR EYESIGHT! Seek medical attention immediately. You can always call your optometrist later if you have any questions.

It can result from a failure to use both eyes together. Lazy eye is often associated with crossed-eyes (strabismus) or a large difference in the degree of nearsightedness or farsightedness between the two eyes. It usually develops before age six and it does not affect side vision. Symptoms may include noticeably favoring one eye or a tendency to bump into objects on one side. Symptoms are not always obvious. Treatment for lazy eye may include a combination of prescription lenses, prisms, vision therapy and eye patching. Vision therapy teaches the two eyes how to work together, which helps prevent lazy eye from reoccurring.

Early diagnosis increases the chance for a complete recovery. This is one reason why the American Optometric Association recommends that children have a comprehensive optometric examination by the age of six months and again at age three. Lazy eye will not go away on it's own. If not diagnosed until the pre-teen, teen or adult years, treatment takes longer and is often less effective.

Strabismus, sometimes called "Crossed-eyes," occurs when one or both of your eyes turns in, out, up or down. Poor eye muscle control usually causes crossed-eyes. This misalignment often first appears before age 21 months but may develop as late as age six. This is one reason why the American Optometric Association recommends a comprehensive optometric examination before six months and again at age three.

There is a common misconception that a child will outgrow crossed-eyes. This is not true. In fact, the condition may get worse without treatment. Treatment for crossed-eyes may include single vision or bifocal eyeglasses, prisms, vision therapy, and in some cases, surgery. Vision therapy helps align your eyes and solves the underlying cause of crossed-eyes by teaching your two eyes to work together. Surgery alone may straighten your eyes, but unless your eye muscle control is improved, your eyes may not remain straight. If detected and treated early, crossed-eyes can often be corrected with excellent results

The American Optometric Association recommends that all children should receive a comprehensive eye and vision examination assessing and treating any deficiencies in ocular health, visual acuity, refractive status, oculomotility and binocular vision prior to entering school. Asymptomatic/risk free pediatric patients should have a comprehensive examination at age 3 followed by another examination before first grade. The asymptomatic/risk free child should continue to have comprehensive eye and vision examinations every 2 years thereafter. Symptomatic/at risk children may need to have examinations more frequently at the discretion of their doctor of optometry.

There are many aspects of vision which may affect an individual's abilities to attend and respond to teacher instruction. It is well known that nearsightedness, farsightedness, and astigmatism, all of which can result in blurred vision or eye strain, relate to performance in the classroom. However, individuals may also have focusing problems which do not allow them to rapidly change focus from book to blackboard and vice versa. They may have difficulty using both eyes together. This dysfunction can require excess effort to overcome and may interfere with visual information processing. Also, an individual may have difficulty controlling eye movements. This could result in loss of place when reading, frequent guessing of words, need for the use of the finger to maintain one's place, or other more subtle difficulties.

Visual information processing problems may result in children being overwhelmed the day they start school. The academic curriculum is designed on the assumption that children posses certain visual information processing abilities, as well as other skills, at certain chronological ages. In other words, is the child visually ready for school? The child who has not developed the required level of skill may have difficulty from "day one." These difficulties might manifest themselves as problems in reading, writing, mathematics, spelling, thinking, sports, endeavors, playground activities, and even the social relationships children have with their siblings and peers.

Individuals who manifest visual problems associated with learning problems may benefit from the use of lenses and prisms for both the prevention and remediation, of these visual problems. Other visual problems might best be remediated by optometric vision therapy. This includes the application of lenses and prisms in conjunction with procedures to provide the individual with strategies which will aid in the development of adequate visual performance.

Clinical evidence shows that academic achievement depends on visual abilities. Vision is basic to learning and your child's most dominant information getting system. Vision is a mental act involving determination of object placement in space, form, distance, color, control of speed and direction of movement. These abilities, once thought to be inherited, are also learned, developed and changed throughout life. Learning takes place more easily when using both eyes together efficiently and combining visual information with that received through other senses, such as hearing, touching and moving.

There are specific controlled studies in the literature demonstrating the effectiveness of optometric vision therapy for treating problems in the functioning of the visual system. There are also numerous case reports supporting specific diagnoses and treatment plans. Studies have also demonstrated visual deficiencies and visual information processing deficits in older individuals, supporting the fact that children do not simply outgrow these deficits.

In short, through visual training, people are able to develop more efficient visual performance. If you'd like more information about vision therapy, click on the very informative website www.visiontherapy.org found in the links section.

Behavioral optometrists spend years in post-graduate, continuing education to master the complex visual programs prescribed to prevent or eliminate visual problems and enhance visual performance. Not all optometrists practice behavioral optometry, which includes developmental and functional optometry. If you do not now have an optometrist who practices behavioral optometry, call or write the OEP Foundation. Or, make sure you receive a yes answer to each of the following questions before you make an appointment.

Visual Skills which all eye doctors should test and all behavioral optometrists routinely evaluate, include:

Fixation - The ability to quickly and accurately locate and inspect with both eyes a series of stationary objects, one after the other, such as moving from word to word while reading.

Focus Change - The ability to look quickly from far to near and vice versa without momentary blur, such as looking from the chalkboard to a book or from the dashboard to cars on the street.

Depth Perception - The ability to judge relative distances of objects and to see and move accurately in three dimensional space, such as when hitting a ball or parking a car.

Peripheral Vision - The ability to monitor and interpret what is happening around you while you are attending to a specific central visual task; the ability to use visual information perceived from over a large area.

Binocularity - The ability to use both eyes together, smoothly, equally, simultaneously and accurately.

Maintaining Attention - The ability to keep doing any particular skill or activity with ease and without interfering with the performance with other skills.

Visualization - The ability to form mental images in your "mind's eye," retain or store them for future recall, or for synthesis into new mental images beyond your current or past direct experiences.

Eye Coordination - the ability of both eyes to work together as a team. Each of your eyes sees a slightly different image and your brain, by a process called fusion, blends these two images into one three-dimensional picture. Good eye coordination keeps the eyes in proper alignment. Eye coordination is a skill that must be developed. Poor eye coordination results from a lack of adequate vision development or improperly developed eye muscle control. Although rare, an injury or disease can cause poor eye coordination.

If a person's visual skills are not adequately developed, or a person fails to coordinate vision with other senses, then vision problems may occur as well as headaches, double vision, reduced performance and fatigue, which is why visual skills evaluation should be a part of every eye examination and why a "vision screening" conducted at school, the DMV or in a pediatrician's office, is simply not enough.

- They avoid near visual work entirely, or as much as possible.
- They attempt to do the work anyway, but with lowered understanding.
- They often experience discomfort, fatigue and short attention span.
- They adapt by becoming nearsighted, or by suppressing the vision of one eye.

Visual stress reactions can help explain the discomfort, fatigue, changes in behavior, altered eyesight and declining academic performance that often indicate a learning-related vision problem.

(Vision problems do not "cause" learning disabilities. However, poor visual skills, by interfering with the process, can impede remedial efforts. It's like trying to build a house on sand. Good vision skills, on the other hand, can provide a solid foundation for learning.)

Behavioral optometrists, may help their patients deal with visual stress by prescribing "stress- relieving lenses." These make it much easier for a child or adult to benefit from near vision work. Another fundamental approach is visual training. This is a sequence of activities prescribed by an optometrist in which the child builds visual skills and the ability to efficiently take in, understand and use visual information.

Many have 20/20 eyesight
Behavioral optometrists find that many children with learning-related vision problems have 20/20 distance eyesight, but have great difficulty doing vision tasks less than arm's length away. Most school screenings test just the sharpness of distance eyesight, so many vision problems that affect learning go undetected. But parents and teachers can learn to spot learning-related visual problems. Please call if you have any further questions and we will gladly fax or mail to you a checklist of signs to look for in your child.