Community

For many adults, reading and writing come so naturally that they seem almost effortless. However, reading and writing are actually complicated skills that take significant effort to learn. For example, reading involves recognizing letters, associating letter combinations with their corresponding sounds, blending sounds together, identifying words, and connecting words to their meanings. Vision problems can interfere with several portions of this process, resulting in significant reading or writing deficits that may be diagnosed as learning disabilities.

Symptoms of Reading and Writing Difficulty

There are many reasons that kids might experience difficulty with reading or writing, but it is important to rule out vision impairment. Common symptoms of vision-related reading and writing problems include:

• Reporting that words appear blurry or shimmer on the page

• Words “swimming” or switching locations

• Low attention span for reading and writing tasks

• Behavioral outbursts when asked to read or write

• Eye strain

• Headaches after short periods of reading or writing

• Poor grades in reading and English classes

• Making spelling errors

• Problems recalling the sequence of letters or numbers
   

Common Vision Problems Affecting Reading and Writing

Several vision disorders can negatively impact reading and writing, including the following:

• Refractive disorders. Farsightedness, nearsightedness, and astigmatism lead to poor visual acuity. This may make it difficult to clearly see written words.

• Convergence insufficiency. Convergence insufficiency is a function vision problem in which the two eyes do not stay aligned, particularly when doing close work.

• Eye movement disorders. Effective reading and writing require smooth, synchronized eye movements. Problems with the eye muscles or execution of these eye movements may significantly impair reading and writing abilities.

• Accommodative dysfunction. If the eyes do not focus accurately, words may appear blurred or may seem to move on the page. While children may be able to focus well when concentrating hard, this often leads to eye strain.
   

Vision Therapy for Reading and Writing Problems

Vision therapy offers an opportunity to teach the eyes to work more typically. Performed in an eye doctor’s office, vision therapy involves performing special tasks to correct vision disorders. This might include corrective lenses, prism lenses, computer tasks, focusing exercises, or eye movement tasks.

Over time, completing vision therapy exercises retrains the eyes and brain to work together more effectively. Vision therapy can correct many of the problems that lead to reading and writing difficulty, resulting in improved academic performance and better visual attention.

Dyslexia

When a child has difficulty reading due to problems recognizing speech sounds and learning how they connect to words and letters, the condition is known as dyslexia, a learning disorder caused by genetic traits that disturb how the brain works. It affects areas of the brain dealing with language and inhibits one’s ability to translate words and written letters into speech.

Dyslexia commonly occurs in children, although it may go undiagnosed for years and not recognized until adulthood. Symptoms may be hard to spot prior to the child attending school, but it is not impossible. Early warning signs include:

• Challenges playing rhyming games or learning nursery rhymes

• Talking later than what is considered normal

• Learning new words at a slow pace
   

How Dyslexia Can Affect Cognitive Processes

Once a child begins school, his or her teacher may be the first to recognize the signs of dyslexia, particularly when he or she begins to learn how to read. This may come in the form of the child:

• Having trouble comprehending instructions

• Struggling to process and grasp what is heard

• Having difficulty remembering sequences

• Reading well below the level expected for their age

• Having problems spelling and seeing likenesses/distinctions in words and letters

• Failing to sound out the pronunciation of a word he or she is unaccustomed to
   

If dyslexia is not recognized by the time the child has reached adolescence or adulthood, he or she may have:

• Challenges with time management

• Trouble reading, even aloud

• Problems summing up a story

• Difficulty understanding expressions or jokes with a meaning not easily understood from the idioms

• Obstacles with memorization and math problems
   

When diagnosing dyslexia, a doctor will request a variety of tests and look at a number of factors, including vision. Learning is achieved via intricate and interconnected processes, one of which is vision. Concluding the relationship between vision and learning requires assessing vision acuity (clarity of sight) and eye health, among other things. Having a vision test can assist with determining whether another disorder is the cause or adding to the child’s reading disability.
 

How Do You Treat Dyslexia?

If vision is the source or part of a learning-related vision problem, the optometrist’s goal will be to provide treatment necessary to improve visual function and reduce associated symptoms and signs. This may include prisms, eye drops, lenses, vision therapy or other visual aids.

It should be noted that while some proponents of vision therapy contend that it is an absolute treatment for dyslexia, professional optometric associations state that vision therapy does not directly treat dyslexia and other learning disabilities. Rather, vision therapy can be used to improve visual processing and visual competence, which then allows the child to be more receptive to education instruction. Therefore, vision therapy should be used in conjunction with other multidisciplinary approaches, such as tutoring and a specialized education program.

Vision therapy may include, but is not limited to, the following activities:

• Looking through prisms

• Donning an eye patch during a portion of the therapy session

• Performing letter-finding puzzles

• Putting tinted plastic over reading material, or wearing tinted glasses while reading material

• Eye exercises
   

Each session takes about an hour and is done up to twice a week. Depending on the condition and how the child progresses, this therapy may be needed for three months to a year.

Crossed eyes, also known as strabismus, refer to a condition in which both eyes do not look at the same place at the same time. Often times they both turn in, but may also turn out.

What Causes Crossed Eyes?

The six muscles attached to each eye, which control how it moves, receive signals from the brain. These signals direct the eye’s movements. In normal circumstances, the eyes work in an organized fashion so that both point in the same direction at the same time. With crossed eyes, however, the muscles around the eyes do not work together because some are weaker than others. This causes the eyes to turn inward or in the opposite direction of each other.

It is important to have proper eye alignment. Misalignment can cause:

• Double vision

• Poor depth perception

• Poor vision in the turned eye

• Confusion
   

When the eyes are askew, the brain receives mixed images from each eye. In the beginning, the person may suffer from double vision and misperception. Over time, the brain becomes trained to ignore the image it receives from the weaker eye. But, if left untreated, the person may permanently lose vision in the weaker eye.

Risk factors for crossed eyes include family history, a considerable amount of uncorrected farsightedness and medical conditions like stroke, head injury, Down syndrome and cerebral palsy.

Though crossed eyes can develop in older children and adults, it typically develops in infants and young children by the age of three. Though babies are commonly affected, some experience a condition called false strabismus or pseudostrabismus, in which their eyes may appear misaligned, but they in fact are aiming at the same direction. This appearance of crossed eyes can be due to having excess skin over the inner corner of the eyes, or a wide bridge of the nose. As the child'face grows, the appearance of crossed eyes diminishes.

Ways to Treat Crossed Eyes

If the child does truly have crossed eyes, it is vital that he or she get treated. While some believe that the condition can be outgrown, it cannot. Crossed eyes can worsen without treatment. If you are the parent of a child who is older than four months and notice that his or her eyes do not appear to be straight at all times, an examination is in order.

In order to diagnose crossed eyes, a comprehensive eye exam will be performed, and it will concentrate on how the eyes focus and move. This may consist of:

• Visual acuity – reading letters on near and distance reading charts in order to measure and evaluate the degree to which vision is impacted

• A review of the patient’s family history

• Refraction – an instrument known as a phoropter is used to conclude the right lens power needed to rectify refractive errors like astigmatism, nearsightedness and farsightedness. During the test, a series of lenses are placed in front of the patient’s eyes while a handheld lighted instrument (retinoscope) gauges how they focus light.

• Focusing and alignment testing to determine how well your eyes move, focus and work in unison.

• An eye health examination to observe the internal and external structures of the eyes.
   

The information rendered from these tests will allow your optometrist to develop a treatment plan, which can involve prisms, vision therapy, eyeglasses or eye muscle surgery. If the condition is found and treated early, it can often be corrected with excellent outcomes.

Convergence insufficiency is a relatively common eye condition that is typically diagnosed in childhood. A study of two large optometry clinics found that 17.6% of children who received vision exams had convergence insufficiency. As this disorder may cause difficulty focusing on written pages, some children with convergence insufficiency are actually diagnosed with learning disability rather than a vision problem. This highlights the necessity of receiving a comprehensive eye exam that tests for this vision problem.

What Is Convergence Insufficiency?

Convergence insufficiency is an eye disorder in which the eyes do not work together properly when focusing on a nearby object. In general, looking at a close object causes the eyes to turn inward, allowing them to focus. If the eyes drift outward, this prevents accurate focusing and is labeled convergence insufficiency.

Symptoms of convergence insufficiency typically manifest when reading, writing, or doing other work that requires focusing on a nearby object. Common symptoms include:

• Headaches

• Double vision

• Eyestrain

• Difficulty concentrating

• Difficulty reading. Many patients report that the words seem to swim on the page or blur.

• Squinting or closing one eye when doing close-up work.
   

Diagnosis of Convergence Insufficiency

Unfortunately, convergence insufficiency is commonly missed on basic eye exams such as those performed as screening tools at school. A child may seem to have 20/20 vision but still suffer from convergence insufficiency and its associated symptoms.

An optometrist can diagnose convergence insufficiency during a comprehensive vision exam. First, the eye doctor will take a history of signs and symptoms associated with this disorder. Next, the optometrist will conduct a thorough vision exam to detect nearsightedness or other vision problems. Finally, the eye doctor will test the ability of the eyes to focus on nearby objects. This may involve asking the patient to hold the eyes together to focus on a small object or to read through a prism.

Treatment Options

Unlike many other eye problems, convergence insufficiency is not easily treated by eyeglasses (although reading glasses with built-in prisms may be prescribed). Instead, vision therapy exercises teach the eyes how to converge to focus accurately on an object. Your eye doctor can recommend exercises to perform at home or in the office. This may include focusing on a small letter as you move it toward the bridge of your nose, improving the ability of the eyes to turn inward to focus.

Eye movement refers to the voluntary and involuntary movements of the eyes that assist with obtaining, fixating and following visual stimuli. The eyes are each connected to a system of six muscles. Light is sensed by the retina, which is a type of tissue that contains cells known as photoreceptors. These cells translate light into electrochemical signals that move along the optic nerve fibers to the brain. Once they reach the brain, the signals are interpreted as vision in the visual cortex and the brain applies meaning to what is being seen.

How Your Eyes Interpret Movement

And just as the eyes send signals to the brain, the brain sends signals to the eyes. Three cranial nerves transport signals from the brain to the muscles attached to each eye. This ultimately controls both voluntary and involuntary eye movements.

There are four types of eye movement:

• Saccades – rapid, flying movements of the eyes that suddenly change the point of fixation. These movements range in scale from the tiny movements made while reading to greater movements made while scanning a room

• Vergence movements – these movements bring into the line the area of the retina (fovea) designed for high perception

• Smooth pursuit movements – steady tracking movements that are meant to keep moving stimulus in focus

• Vestibulo-ocular movements – helps stabilize the eyes when the head’s position moves
   

Poor eye muscle control or injury/trauma can affect the eyes’ ability to move in harmony, leading to eye movement disorders like:

• Nystagmus – fast, uncontrollable movements of the eyes. This can sometimes be referred to as dancing eyes

• Strabismus – the eyes are misaligned and not aimed in the same direction. This may cause crossed eyes or other vision problems like lazy eye
   

Correcting Eye Movement Problems

If an individual has problems with eye movement, vision therapy is one treatment that can help by using vision exercises and specialized equipment to strengthen the eye muscles, leading to more fluid, cooperated eye movement.

Performed under the guidance of an optometrist, vision therapy is conducted in an office setting up to twice a week for an hour. The types of exercises and equipment will be tailored to meet the individual needs of the patient and are based on the severity of the eye movement problem, as well as any associated symptoms. These influences will also establish the number of sessions the patient requires. To accompany in-house visits, the optometrist may also instruct the patient on how to perform certain vision exercises at home.

Equipment that may be used during a vision therapy session includes:

• Therapeutic or corrective lenses

• Optical filters

• Prisms

• Occluders or eye patches

• Balance boards

• Computer software

• Vision-motor-sensory training equipment

• Electronic target with programmed apparatuses
   

When vision therapy is over, and all necessary sessions have concluded, the patient should be able to perform the four types of eye movement with greater ease and should be more efficient when it comes to processing and interpreting visual information.

The primary sufferers of technology-related eyestrain used to be adults whose work involved computers. Now, however, people of all ages use computers, smartphones, tablets and gaming devices, which can take their toll on the eyes. As people’s reliance on technology grows, so does the incidence of eyestrain. Keep reading to learn more about digital eyestrain and how you can protect your eyes in the digital age.

How Much Screen Time Is Too Much?

After two hours of screen time, the eyes typically begin to get tired and suffer from digital eyestrain. Additional contributing factors to developing eyestrain include small print, devices held at non-ergonomic angles too far from eyes and the blue light emitted from digital screens. People who wear glasses or contacts are even likelier to strain their eyes, as their prescriptions might not be ideal for mid-range viewing of electronics.

Screens and Blinking

When going about their day, the average person blinks approximately 18 times per minute. However, staring at a screen slows the blink rate. This can lead to itchy, dry and burning eyes. Office workers with computer-related jobs may even undergo physiological changes to their eyes that are similar to those experienced by people who suffer from dry eye disorder.

Age-Related Trends

People of different ages tend to use technology differently. The Vision Council, which represents optical industry suppliers and manufacturers, analyzed these differences in its 2015 report on digital eyestrain. The council determined that Millennials (individuals born between 1981 and 1996) and members of Generation X (individuals born between 1965 and 1980) are the most likely to strain their eyes due to screen overuse. Sixty percent of Millennials and nearly one-third of Gen Xers spent nine or more hours per day looking at a screen. Only 26 percent of Baby Boomers (individuals born between 1946 and1964) are as glued to digital technology as the aforementioned generations. About 63 percent of Gen Xers and 68 percent of Millennials reported symptoms of digital eyestrain.

Protect Your Eyes

• Tweak your lighting. Turn down your ambient lighting when looking at screens, and avoid fluorescent tube lighting. Windows should be to the side of your computer, rather than directly in front or behind it.

• Pick the right display. Liquid crystal displays (LCDs) with flat panels are better than cathode ray tube (CRT) monitors. If you are still using a flickering CRT display, it is time to upgrade. Go for a larger screen with high resolution.

• Adjust your computer’s display settings. Brightness should be about the same as that of your surrounding area. Use the “view” menu to zoom in and make text bigger without changing the font size. Reduce the color temperature to reduce blue light. Microsoft Windows users will find display settings in the control panel. Apple users should look in systems preferences.

• Take breaks. Blink. Look off into the distance. Better yet, get up and walk around.

• Get regular eye exams. Your eye doctor is your ally in avoiding digital eyestrain. Discuss your computer use, how far you sit from the screen and what other devices, such as tablets and smartphones, you typically use.
   

Call us today. We’ll set up your next comprehensive eye exam to help determine ways you can protect your eyes against digital eyestrain and other factors that may affect your eye health.

Visual perception refers to a set of skills used to collect and interpret visual information taken in from our environment. The visual information gathered is combined with our other senses, allowing us to derive meaning from what we see. Through the process of merging visual data with our other senses, we are also able to organize eye and physical movement. For this, visual perception is critical when it comes to our ability to learn, move with ease and understand the world around us.

How Your Eyes See

Seeing begins with the lens of the eye focusing an image onto the retina, a light-sensitive membrane located in the rear of the eye. The retina contains cells called photoreceptors, and they translate light into electrochemical signals that journey along the optic nerve fibers to the brain. When the signals reach the brain, they are read as vision in the visual cortex and the brain puts meaning to what is being seen.

Just as the eyes send signals to the brain, the brain also sends signals to the eyes, ultimately controlling their movement. And as we are aware, the brain additionally releases signals to other organs, muscles and nerves throughout the body, controlling their movement as well.

When our vision is not in sync with our brain and other senses, there is a dysfunction, and this can lead to:

• Being easily distracted or having a short attention span

• Lack of concentration

• Difficulty understanding and following instructions

• The inability to recall a sequence of letters, numbers or objects in the order they were initially presented

• The inability to recognize visual clues

• Clumsiness

• Trouble with rhythm

• Struggles with learning left and right

• Reordering numbers or letters when copying or writing

• Complications learning the alphabet or recognizing words
   

Correcting Your Vision With Therapy

Through the aid of visual therapy, this dysfunction can be corrected with a mix of vision exercises and specialized equipment that train the visual system to work in coordination with the brain and other senses.

Devices used to help achieve this may include:

• Therapeutic or corrective lenses

• Balance boards

• Computer software

• Vision-motor-sensory training equipment

• Electronic target with programmed apparatuses

• Optical filters

• Prisms

• Occluders or eye patches
   

Therapy is guided by an optometrist and is performed in an office once to twice a week for up to an hour. The types of exercises and equipment, as well as the number of sessions required, will depend on the individual needs of the patient. To supplement office visits, the optometrist will likely give the patient instruction on how to perform certain vision exercises at home.

Following the completion of vision therapy—meaning all necessary sessions have ended—the individual should be able to coordinate eye and physical movements, their visual capabilities should have improved and there should be greater efficiency when it comes to processing and interpreting visual information.

Few eye issues are as simultaneously subtle and annoying as a twitch that comes on suddenly and/or recurs frequently. A twitching eyelid may not appear visible to the people around you at all, but it can make you feel highly self-conscious and drive you to search for the cause and the cure. Unfortunately, there are so many possible reasons for the twitching that figuring out how to stop it can prove a most challenging task. The good news is that most of the reasons for eye twitching pose no serious threat to your ocular or neurological wellbeing.
 

Causes of Eye Twitching

Perhaps most common recognizable cause of eyelid twitching is dry eye syndrome. Dry eyes may afflict you if you spend lots of time staring at a computer screen, you are exposed to air conditioning or wind, or you have a medical condition that impairs tear production. Using eye drops and reducing your exposure to dryness triggers may not only help your eyes feel better but also eliminate the twitching. Other common causes include eyestrain, fatigue, caffeine abuse, and allergic reactions. Your twitching eyelid may also be an indicator of a condition known as blepharitis. Blepharitis is an irritation caused by inflamed oil glands next to the eyelashes. Your eye care professional can recommend several home remedies to help you get this problem -- and hopefully the twitch -- under control.

Neurological problems can cause eye twitches as well. Just as the nervous system's countless branches send motor signals to every part of the body, certain nerves send commands to the muscles in the face, including the eyes and eyelids. A variety of issues can interfere with optimal nerve signaling, causing the muscles attached to these nerves to go into spasm. Your twitching eye could therefore be part of a larger facial tic known as a hemifacial spasm, especially if the eye closes completely with each twitch. This condition is sometimes treated with Botox injections. Other neurological conditions can also affect the facial nerves to produce twitching motions.
 

Diagnosis and Treatment

Less commonly, eye twitching can be a sign of an ocular disorder that requires treatment by an eye doctor. These conditions include uveitis (an inflammation of the iris), conjunctivitis (the infamous "pinkeye"), and entropion (inwardly-turned eyelashes, mostly seen in older patients). Your eye care provider can discuss your symptoms and medical history with you to help you figure out how best to cope with that annoying twitch.

If you find yourself experiencing blurred or distorted vision that seems to get worse year after year, you may suffer from an irregularity of the cornea known as keratoconus. This condition is infamous for causing astigmatism and nearsightedness that can progress rapidly, calling for constant updates to your corrective lens prescription. Fortunately, several treatment options are available to help you cope with keratoconus.
 

Causes and Symptoms

While medical science has no clear explanation for the cause of keratoconus, the condition occurs more frequently in people who rub their eyes a lot, have worn contacts habitually for many years, or have certain genetic disorders such as Down syndrome. Pregnant women are also known to develop keratoconus, which might indicate that endocrine system imbalances are involved. The condition occurs when corneal tissue grows unusually weak or thin. This allows it to lose its perfectly spherical shape and take on more a cone-like outward bulge. A cornea deformed in this manner cannot refract incoming light in a way that creates an accurate image for the retina.

Keratoconus usually appears between late childhood and the mid-20s, at which point it may progress for many years. The progression is characteristically dramatic, with sufferers having to get new lens prescriptions practically every time they see their eye care provider. Blurred vision is the obvious primary symptom, but in some cases eyesight can also become hazy or cloudy if a rupture at the rear of the cornea occurs. Patients also find that their eyes grow increasingly sensitive to bright light.
 

Diagnosis and Treatment

The vision problems caused by mild to moderate keratoconus can usually be corrected through such conventional methods as eyeglasses and soft contacts. More stubborn cases may require gas-permeable rigid contacts, scleral lenses, or custom-made silicon hydrogel soft contacts. Some sufferers even "piggyback" a gas permeable lens on top of a hydrogel lens to achieve an optimal balance between vision accuracy and comfort.

Traditional laser surgeries such as LASIK are not usually recommended for keratoconus patients, but other types of structural correction may provide the desired vision correction. Intacs, tiny corneal inserts implanted just below the corneal surface to flatten out the cone-like curve, can be inserted in a minimally invasive surgery. Even the most extreme cases can be treated with a corneal transplant. However mild or severe your keratoconus, your eye care professional can help you understand your treatment options and devise an effective treatment plan.

Can I wear contact lenses?

Most people are able to wear contact lenses safely and comfortably. There are contact lenses that correct for nearsightedness, farsightedness, astigmatism, and other vision problems. An optometry exam can determine what lenses are appropriate for you.
 

Are contact lenses safe for my eyes?

Millions of people wear contact lenses without any difficulties. Following recommendations for inserting, removing, cleaning, storing, and replacing contacts typically keeps your eyes safe and healthy. However, you should talk to your eye doctor if you have specific concerns about contact lens safety.
 

What is the difference between hard and soft contact lenses?

Soft contact lenses are made of plastic combined with water. Soft lenses allow oxygen to pass through the material to your cornea, nourishing and soothing the surface of your eye. Rigid gas permeable contact lenses, sometimes called “hard lenses” are made from a stiffer, oxygen-permeable material. They are often used by individuals with astigmatism or higher-order aberrations.
 

How often should I change my contact lenses?

The frequency with which you should dispose of lenses depends on the contact lens type. Some lenses are made to be disposed of each night, while others may last several weeks. Talk to your eye doctor and read the instructions on your contact lens package to determine the replacement schedule for your lenses.
 

Is it possible to lose a contact behind my eye?

No. If you rub your eyes or swim underwater with contacts, it is possible to dislodge your contacts. Usually, they can be found under your upper eyelid and removed without difficulty.
 

How long does it take to adjust to wearing contacts?

If you’re not used to wearing contacts, you may notice them or feel slight discomfort for a day or two. As you become accustomed to the contact lenses, you will no longer even notice that they’re there.

There are a lot of variables to consider when choosing contact lenses. Think about your typical routine and consult with your eye care provider to find the perfect contact lenses for your lifestyle.