VISION THERAPY

Vision Therapy is an individualized treatment plan consisting of activities aimed at improving visual function and comfort.  The use of therapeutic lenses, prisms, various visual activities using traditional therapy equipment as well as quantitative computerized programs, provide for a form of neurologic rehabilitation more efficiently coordinating the pathways between the eyes and the brain.  Some form of vision therapy may be recommended for children and adults with binocular vision deficits, pre- and post- strabismus surgery, or as post-concussion treatment.

COMMON CONDITIONS

​

REFRACTIVE ERRORS “BLURRED VISION”

• Myopia "Nearsightedness" – Causes blurred vision at distance; nearsightedness occurs if the eyeball is too long or the cornea (the clear front surface of the eye) is too curved, causing the light entering the eye to not focus correctly. Myopia is mostly genetically determined, though some environmental factors, such as excessive near work, may play a role.

​​

• Hyperopia "Farsightedness" – Causes blurred vision at near, with normal or blurred vision at far distances; farsightedness occurs if the eyeball is too short or the cornea has too little curvature to correctly focus the light that enters it. It is normal for children to have a small level of hyperopia, however higher amounts may lead to blurred vision, headaches with near work, amblyopia or strabismus.

​

• Astigmatism – Causes blurred vision at all distances; can vary in severity and symptoms; caused by an irregularly shaped cornea or occasionally by an irregularly shaped lens inside of the eye. Astigmatism is often present at birth and may occur in combination with nearsightedness or farsightedness.  Children may not realize their vision is blurry, so they need to be screened for eye disease and have their vision tested.  When symptomatic, the most common treatments include eyeglasses or contact lenses.

EYE CONDITIONS

• Strabismus “Crossed Eyes"– Strabismus is when there is an eye misalignment in at least one direction of gaze.  It usually occurs in people who have poor eye muscle control or are very farsighted.  Normally, the eyes work together so they both point at the same place. When problems develop with eye movement control, an eye may turn in, out, up or down.  The eye turning may occur all the time or may appear only when the person is tired, ill, or has done a lot of reading or close work. In some cases, the same eye may turn each time.  In other cases, the eyes may alternate turning. Proper eye alignment is important to avoid seeing double, for good depth perception, and to prevent the development of poor vision in the turned eye.  When the eyes are misaligned, the brain receives two different images. At first, this may create double vision and confusion. But over time the brain will learn to ignore the image from the turned eye.  Untreated eye turning can lead to permanently reduced vision in one eye. This condition is called amblyopia or lazy eye. Strabismus usually develops in infants and young children, most often by age 3. But older children and adults can also develop the condition.   People often believe that a child with strabismus will outgrow the condition. However, this is rarely true. In fact, strabismus may get worse without treatment. A child older than 4 months whose eyes do not appear to be straight all the time should be examined by a pediatric eye care specialist.  Treatment for strabismus may include eyeglasses, prisms, vision therapy, or eye muscle surgery. If detected and treated early, strabismus can often be corrected with excellent results.

​​

• Amblyopia “Lazy Eye” – Amblyopia is decreased vision in one or both eyes due to abnormal development of vision in infancy or childhood.  There may not be any obvious problem with the eye, sometimes making detection difficult. Vision loss occurs because nerve pathways between the brain and the eye are not properly stimulated during development.  When the brain learns to see only blurry images from one eye, it will favor the other eye, causing poor vision in the amblyopic eye. If the vision is equally poor in both eyes, bilateral amblyopia can develop, leading to a permanent decrease in vision unless treated with corrective lenses at an early age. Amblyopia often occurs in people who have strabismus or crossed eyes (misalignment) or a large difference in the degree of nearsightedness or farsightedness between the two eyes. It usually develops before age 6 and it does not affect side (peripheral) vision.  Amblyopia will not go away on its own. If not diagnosed until the preteen, teen or adult years, treatment takes longer and is often less effective. Amblyopia may be treated using corrective lenses, patching and/ or eye drop therapy. Amblyopia is the leading cause of vision loss amongst children.

​​

• Convergence Insufficiency – When we read or look at close objects, the eyes must cross (or converge) slightly towards the nose to allow single vision.  Convergence Insufficiency results from difficulty maintaining the eyes in this crossed posture. When convergence is reduced, the individual must exert excessive effort to maintain single vision.  This typically causes headaches, eye strain, blurred vision and double vision during sustained reading or close work. Convergence insufficiency is usually diagnosed in school-age children and adolescents. It can cause difficulty reading, for which parents or teachers might suspect the child has learning difficulties rather than an eye disorder. There is also some evidence suggesting that motion sickness may be related to convergence insufficiency.

MEDICAL CONDITIONS

• Hordeolum "Stye" – A red, painful lump at the edge of the eyelid caused by an infection of the oil glands in the eyelid.  Treatment is hot compresses and hygiene. If there is no improvement in 48 hours, consult your doctor.

​​

• Chalazion "Stye" – Similar to a stye except inside the eyelid and more centered.  Inflammation on the inside of the eyelid, causing a lump. It is usually not painful.  Treatment includes hot compresses and hygiene. If there is no improvement in 48 hours, consult your doctor.

​

• Various Types of "Red Eyes"

​

• Conjunctivitis “Pink Eye” –  General term for a red, irritated eye causing inflammation or swelling of the conjunctivita (the thin transparent tissue covering the white part of the eye).  There are many types of conjunctivitis, including allergic, infectious (bacterial or viral), chemical. There will also be symptoms of discharge, light sensitivity or pain in the eyes. Bacterial and allergic conjunctivitis require treatment with eye drops, whereas viral conjunctivitis does not have to be treated. This can be unilateral (involving one eye) or bilateral (involving both eyes). Vision is minimally affected unless the conjunctivitis is severe.

​​

• Blepharitis – Blepharitis is characterized by inflammation, scaling, reddening, and crusting of the eyelids. It can cause burning, itching, and/or redness in the eye(s) with a grainy sensation in the eyes. This is a chronic condition and although is not sight-threatening, can lead to permanent alterations of the eyelid margin. Proper eyelid hygiene is required to treat this condition. Sometimes drops are also necessary.

​​

• Corneal Abrasion – Corneal abrasions are often the result of some type of direct injury to the eye.  They are common in younger children and usually occur unilaterally (involving only one eye). The eye will be painful with lots of tearing from the eye accompanied by redness and light sensitivity. The eye is treated with some eye drops and sometimes a patch. Depending on where the abrasion is, centrally or peripherally, vision may or may not be affected.

​​

•  Subconjunctival Hemorrhage – When a small blood vessel breaks under the tissue that covers the white of the eye (sclera), a subconjunctival hemorrhage develops. Eye trauma and/or vigorous coughing/sneezing can cause the hemorrhage. In some cases, rare life-threatening diseases such as Vitamin K deficiency or blood clotting disorders can also cause the hemorrhages. Treatment usually includes cold compresses and lubricating drops. The condition is self-limiting and usually takes 2-3 weeks to go away.

​

• Contact Lens Induced Red Eye – One of the main culprits of eye redness in older children is over-wearing or improper care of contact lenses, which includes cleaning, storing and appropriately replacing the lenses. Failing to follow proper contact lens care guidelines can cause irritants to deposit on the lenses which can further develop into an infection. Any child who experiences red eyes with contact lens wear should immediately seek care from a skilled eye care professional to ensure there is no sight threatening infection.  The use of daily wear disposable contact lenses has greatly reduced the risk of infection related to contact lenses.

​​

• Uveitis – Uveitis is inflammation of the middle layer of the eye (uvea). In this condition, the eye(s) may become red, painful and/or light sensitive. Vision may also be affected.  Uveitis is most commonly seen with trauma or systemic conditions such as JIA (juvenile idiopathic arthritis), psoriasis and Crohn’s Disease. These children should be screened periodically to check for uveitis, as it sometimes presents with minimal symptoms. 

​​

• Ocular Herpes – Ocular herpes is a viral infection that is caused by type 1 herpes simplex virus. It presents with  vesicles around the eye(s) but may or may not be accompanied by cold sores. Signs and symptoms include: eye redness, light sensitivity, pain in the eye, and watery discharge. Treatment is crucial since it can cause scarring of the cornea which may cause a permanent decrease in vision.

Have a question?  Contact us.