Dr. Hollis Stavn, 2200 Range Avenue, Santa Rosa Ca 95403 (707)-527-9137
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More About Vision Therapy


Vision Therapy Background

Optometrists have taken the lead in investigating the important links between reading and vision.Over the last century people have come to Doctors of Optometry for difficulty with reading or comprehension. Many have been labelled and more often mislabelled as dyslexic. Today they are often mislabelled with ADD or attention deficit disorder. The word optometry virtually means " to measure the eyes."Optometrists began to measure what we now call "visual skills" to see if they could define differences in these "visual skills" between good readers and poor readers.By improving these skills can you also improve reading ability? It turns out that this is the case. It is possible to determine why a child has trouble reading and to eliminate reading difficulties in most cases. Many different skill areas have been defined, and hundreds of activities are available to work on improving them. Most of these activities differ from the academic level instruction taught in the schools, rather they are perceptual level or pre-reading level skills which are not taught in the schools. This explains why tutoring alone is often ineffective- it is usually academically based and not perceptually based! Modern vision therapy is the culmination of decades worth of work by a few dedicated individuals and only one profession- Optometry. Vision Therapy is taught only at Schools of Optometry in the United States.

Vision and Reading - Developmental Skills

The visual system is dependent on developmental experiences. We are not born with good vision, but rather with the ability to develop good vision. If this development is interfered with then amblyopia may result- or poor vision due to a lack of proper developmental stimulation. The lack of a clear image in the eye early in life can lead to a lack of nerve connections with the eye in the brain. There is a critical period for this proper development to take place- usually the first several years of life. This is an example of development requiring proper stimulation at certain critical ages.This can serve as a model system for the development of other visual attributes as well. Visual and perceptual development is hierarchically based. The perceptual mechanisms of vision develop in a sequential way. A child who is 4 may be able to draw a circle but not the more complex square. A child of 5 may be able to draw the square but not the more complex diamond. A child in second grade may be able to read and track large print short second grade words but not the longer smaller words a third grader can read. How does a child acquire these visual skills from one level to the next? Does it happen automatically or is it dependent on interaction with his environment?

Some of the important visual and reading skills are:

  1. Binocular Vision- The ability of the eyes to work together well. Common problems that can affect reading are over and under convergence of the eyes.This is also referred to as eye muscle balance.
  2. Refractive - undiagnosed farsightedness can contribute to reading difficulty.
  3. Accommodative ability to easily and quickly change focus without fatigue. This is a common contributor to reading difficulty.
  4. Visual Tracking- the ability to read without skipping lines and losing ones place.
  5. Visual Perception.
  6. Auditory Perception.
  7. Visual Memory.
In the model system these skills are related to each other. For example good binocular vision and tracking skills are needed for the development of visual memory which is needed for reading.

The Vision Therapy Eye Exam

If you want to have a developmental eye exam to test for reading or learning difficulties, you need to make an appointment with a Doctor of Optometry who has received training in vision therapy. Only about one in twenty optometrists do such testing. This testing cannot be done by ophthalmologists. Despite their medical training ophthalmologists receive no education in reading difficulties. In addition to a standard eye exam additional tests should include:

  1. A developmental,academic, and behavioral history.
  2. A dilated eye exam.
  3. Binocular Vision tests.
  4. Focussing facility tests.
  5. A tracking test.
  6. Visual Perception tests.
  7. Reading tests.
Unless these tests are done your doctor will not be able to help you find the cause of or help you correct a reading difficulty. Many times people expect a standard eye exam to tell them these things but in fact a standard eye exam will determine if you need glasses and if your eyes are healthy but additional testing is required when evaluating reading problems. Every child with a reading difficulty should be examined by an optometrist.

Parents Comment on Vision Therapy

Following are the results of questionnaires that parents have filled out after their children completed a three month program of Vision Therapy.

1. How valuable was Vision Therapy?

(Ranked from 1 to 5 where 1 is not helpful and 5 is extremely helpful!))

2. How valuable was vision therapy compared to other things that you did before vision therapy such as special education or tutoring?

( Ranked from 1 to 5 where 1 is less effective and 5 is more effective.)


3. After Vision Therapy, did reading ability and school performance improve?

( Ranked from 1 to 5 where 1 is no improvement and 5 is much improvement.)

4. Did vision therapy lead to any improvements in behavior and self esteem?

Additional Comments

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