Regular vision evaluations are the best and easiest way to maintain ocular health and ensure optimal visual function. The first vision evaluation should be before kindergarten and preferably long before that. As members of the highly regarded American Optometric Association (AOA) InfantSEE™ program, our office provides free examinations for infants between the ages of six and twelve months. During the school years, demands on one's visual system change dramatically from year to year and so annual evaluations are advisable. In adulthood, there is less variation in demand on the eyes, so examinations are recommended at one to two year intervals.

Optometric vision therapy is devoted to developing, rehabilitating and/or enhancing visual performance. The most common problems include lazy eyes (amblyopia), turned eyes (strabismus), ocular movement disorders (tracking), ocular teaming disorders (eyestrain, headaches, double vision), and focusing disorders (blur, discomfort). Depending on the specific vision problems that a person has, one of several types of therapy may be administered. (See article where vision therapy allowed an adult patient to achieve 3-D vision.)

Basic Vision Therapy
We possess basic viewing skills that include visual acuity, ocular movements, form perception, focusing, and binocular fusion. Basic vision therapy addresses each area and ensures that the individual can make use of what is seen. Basic vision therapy includes the following:

Fixation: Fixations describe the act of aligning the eyes directly onto an object of regard. We determine what to fixate upon with a combination of peripheral awareness (knowing what is available within our entire field of view) and a mental determination of what is of value to view more closely.

Following: Moving targets are followed by ocular movements called pursuits. The eyes are supposed to lock onto a target, accurately follow their path, and help the person to determine where a target will land.

Form: In order to determine what an object is, we perform a series of very small scanning movements known as microsaccades. By scanning the parts of a given object we can transform the small pieces of information into a whole picture. The consistency of the movement pattern gives rise to visual memory, with which we can recall a previous visual experience.

Focus: We learn to focus our eyes accurately for far away viewing, for close in viewing, and at all distances in between. Immediate focusing allows us to adjust effortlessly from one distance to another (i.e., chalkboard viewing to copying on paper). Accurate focusing increases the efficiency with which we obtain and utilize information through our visual system.

Fusing: Since we have two eyes, we must learn to point and focus them at the same time and in the same place. When this occurs we can view the world consistently, and seeing things the same way each time makes understanding that which we see much easier. When the two eyes have difficulty fusing properly, there is initial confusion (blurry or double) between the image of one eye and the image of the other. We adapt to confusion by discontinuing the use of one eye (suppression), turning one eye with respect to the other (strabismus), or avoiding those tasks that result in visual confusion (reading, writing or ball play).

Vision therapy is an individualized program in which conditions are arranged so that a person can develop a greater degree of facility in one or more of these areas, depending on the needs of the individual.

Specialized Vision Therapy
Certain populations have severe difficulty developing and utilizing some basic visual abilities and some populations have lost the abilities that they once utilized successfully. Examples of those that have difficulty developing visual capacities include those with some forms of autism, Down’s Syndrome, neurological disorders and neuromuscular disorders. Most often these are children who have difficulty early on performing the following activities:

• maintaining eye contact
• attending to visual materials
• executing actions requiring eye-hand coordination (grasping, catching)
• developing movement sequentially (rolling over, sitting up, crawling, walking, climbing up and down stairs, running, hopping, skipping)
• executing actions that require eye-body coordination (walking without bumping into walls or objects)
• modulating speaking voice and force of their own strength

Examples of those that lost previous abilities include victims of traumatic brain injuries, head-injury patients, stroke patients, individuals with drug addictions, and in some cases the elderly. Most often these are adults who exhibit difficulty performing the following:

• organizing themselves for problem-solving
• maintaining binocular fusion
• concentrating on near-centered activities
• coping with a loss within their visual field
• coping with reduced movement capacity, including walking
• maintaining the ability to drive safely
• tracking words and keeping one’s place while reading
• remembering that which they have recently seen

Patients who have lost or not developed normal vision capacities often require intensive, one-on-one therapy sessions with a need for specific equipment and knowledge and thus qualify for specialized vision therapy services.

Developmental Vision Therapy
Basic vision capacities such as those described above are normally observed quite early, often by the age of six months and certainly before the age of two to three years. Developmental vision therapy refers to higher-order vision capacities that are developed after the age of two. They include visual imagery, visual recall, visualization, and visual thinking. Cumulatively they are used for success in academics, problem-solving, receptive and expressive communication, and graphic capacities that include writing and drawing.

Children who have gaps in their vision development often have difficulty with spelling, reading comprehension, memorizing lists and tables, following multiple instructions, and solving problems with visual cues. Adults with vision development gaps have often compensated by learning through alternative means, but they still can have difficulty following driving directions, judging distances, and studying.

Developmental vision therapy is designed to help people develop higher order vision capacities, to fill in gaps in vision development where they have occurred, and to ensure utilization along with our other capacities for leaning and understanding. This is accomplished by creating developmentally appropriate conditions, for each individual, in which the only way to achieve a given objective is to explore one or more of these visual capacities.

The fast pace of our society for adults at work and children in school requires that we have fully developed our capacity to understand that which we see. Children should develop the ability to create, maintain, and utilize mental pictorial images throughout childhood, but this does not always happen. Gaps in development can occur, at which time children often choose alternative, less efficient methods of learning. A child can have perfect eyesight but be unable to match patterns, recall letters or words, or visualize the main ideas or details of a story. If a child is struggling in reading, writing, spelling, or math, it is possible that his/her vision is not fully developed. Whenever a parent or a teacher believes that a child is unable to perform to the level that they expect, a vision development evaluation should be considered. Such an examination determines whether or not a child is able to use vision for learning. Treatment for vision-related learning disorders may include basic vision therapy and/or developmental vision therapy, and provides the opportunity for the child to use all (rather than some) of his/her visuo-cognitive capacity in the pursuit of academic achievement.

Athletic performance is dependent upon many factors, not the least of which are raw talent and motivation. Vision is often ignored once good visual acuity and/or protective eyewear is obtained. Our 21 years of experience with professional football and hockey players has shown us, however, that for maximum performance three vision factors should be optimized:

Visual Judgments: This area deals with the question of “Where is the ball in space?” Examples include judging the speed and direction of baseballs or footballs, the spin of a tennis ball, or the flight of a golf ball.

Vision-Directed Movement: The athlete must position oneself in the correct location to reach or hit a ball. Vision directs the decision in baseball whether to charge a ball in the outfield or to back up to catch it on the bounce, in basketball when to jump for a rebound off the rim or backboard, and in tennis to coordinate the toss of the ball with the movement and extension of the arm in serving.

Visuospatial Knowledge: Coaches covet players who are continuously in the right place at the right time, even if they are not the fastest or strongest athlete on the team. Anticipation, being able to “know” where the ball or the opponent is going to be, is enhanced with visuospatial knowledge. Those who have developed this to a high degree understand the angle at which a baseball will carom off a wall, judge the angle of attack when trying to make a tackle, determine the roll of a ball on the green in golf, choose the best part of the net in which to shoot a hockey puck, or determine the most likely shot from a tennis opponent during a particular part of a match.

Sports vision therapy makes use of basic and developmental vision therapy to improve one’s speed and accuracy of visual judgments, better understand one’s movement capacity and direct one’s movement accordingly, and develop visualspatial knowledge to a high degree. Enhancements in these areas provides one with the best opportunity to make the most of one’s talent and achieve a higher level of success in sports.

We offer a solution for whichever vision correction treatment you prefer.

Glasses – With over 50 years of combined experience, our trained and helpful lab technicians are happy to assist you in selecting a pair of glasses that are comfortable, attractive, and appropriate for your vision needs. Our adult eyewear collections include frames by: Dior, Kate Spade, Ralph Lauren, Gucci, Bolle´, Coach, Valentino, Juicy Couture, and Calvin Klein. We also carry an exclusive international eyewear collection from Denmark called ProDesign. More information can be found at www.prodesigndenmark.com. Our youth eyewear collections include frames by: Nickelodeon, Disney, Stride Rite, and Nine West.

Lenses - We offer the most technologically advanced lenses by such makers as Varilux and Carl Zeiss. The lenses can be crafted with features such as: transitions, Crizal anti-reflective coating, progressive addition lenses, and bifocals. Visit the Varilux website at www.Varilux.com for more information.

Contact Lenses - Following an examination with the doctor you will be fitted with the appropriate prescription for your vision needs. We use a variety of lens designs for different conditions including bifocals, keratoconus, gas permeables, daily disposables, toric, and the most advanced contact lens materials (silicone hydrogel) available.