Vision Therapy

Tom Headline is a certified optometric vision therapist through the College of Optometrists in Vision Development (www.covd.org). He has over 30 years of experience in the field of vision development and has worked with a variety of cases, ranging from acquired brain injuries to athletes attempting to get that extra edge to children with visual processing and reading difficulties. He currently works with Dr. Benjamin Popilsky in Aptos, California and can be reached at 831-688-2020.

Tom is a vision therapy instructor as well and teaches the VT 101, 102 and 103 courses. He teaches through the College of Optometrists in Vision Development (COVD) and has taught for the Vision Science Institute (VSI) in the Philippines. He has also co-authored a vision therapist training manual, The Vision Therapist’s Toolkit.

WHAT IS VISION THERAPY?

In order to better understand vision therapy, it is important to understand our understanding about what vision is itself.

There’s much more to it than just “20/20”.

VISION requires many skills working together in an integrated manner to help us derive meaning and take action upon the information coming to us through our eyes. The clarity of our sight (or 20/20 ability) is only ONE of these skills.

Research demonstrates that over 20 visual skills are required in order to have effective reading & learning abilities. Some of these visual skills include:

• VISUAL TRACKING: The ability to move our eyes accurately, smoothly and efficiently. Visual Tracking skills allow us to accurately move from word-to-word and line-to-line while reading. Also, visual tracking skills are important in athletics because they allow us to keep our “eyes on the ball”.

• VISUAL FOCUSING: This refers to our ability to maintain clarity at a specified distance as needed, and the ability to quickly shift that clarity from one distance to another. This is important for many daily activities, such as reading, copying from the board and in athletics. If our visual system fatigues quickly, we may find the print on the page blurring out, or finding ourselves adjusting our body posture to compensate.

• EYE TEAMING: Also, known as Binocular Vision, refers to the ability to aim both eyes at an object (or text) of interest. Here’s a FUN EXPERIMENT to help you understand how both eyes aim.

1) Hold a Pencil, Pen or even your finger so it points to the ceiling.

2) Position the Pencil at your Eye Level and about 12 inches from your nose (so it is on the body’s midline)

3) Look past (or beyond) the Pencil at an object directly across the room in your line of sight.

4) Notice what has happened to the Pencil…you should see 2!

5) Now, look directly at the Pencil.

6) Notice what has happened to the object across the room…you should see 2!

In the above experiment, we had you purposefully alter your gaze. However, some individuals have difficulty aiming their eyes properly, which results in double vision (see VISUAL SYMPTOMS). Double

Vision can be very stressful during activities like reading, sports and even driving.

Some individuals learn how to ignore the vision from one eye (referred to as suppression). This can result in other visual conditions such as Amblyopia (lazy-eye) or Strabismus (eye turn). Efficient Eye Teaming promotes more accurate Depth Perception (knowing how far something is from us). Depth Perception is important for sports, flying aircraft and even parking our cars!

• VISUAL PERCEPTION: This refers to the process by which the brain interprets and understands the visual information received by the eyes. Many components influence Visual Perception.

• Visual Figure-Ground: The ability to perceive a visual form and find it amid a distracting background. Such as Word Searches.

• Visual Form Constancy: The ability to recognize an object or abstract representation which has been manipulated in space. To see a form as the same, even though it may appear smaller, larger, rotated, reversed and/or hidden.

• Visual Closure: The ability to visually create a “whole” picture from appropriate “parts”.

• Visual Matching: making, providing or selecting one object or abstract representation that is the same as another.

• Visual Memory: The mental function or capacity of recalling an image created through visualization or a previous visual experience.

• Visual Sequencing: The ability to perceive the logical progression of visual images, space, time or thought.

• Visual Manipulation: The ability to visually transfer objects or abstract representations to another dimension in space.

• Visual Spatial Relationships: The knowledge of “whereness”. This is the ability to perceive the position of two or more objects in relation to oneself as well as in relation to each other. Laterality/Directionality are important components here.

Poor visual perception skills can lead to copying errors, letter & number reversal issues and difficulties with problem-solving tasks

• VISUAL-MOTOR INTEGRATION: This refers to the process by which the visual system guides the overall body movements through space. This is further broken down into the Gross Motor (or large muscle movements) and the Fine Motor (smaller muscle movements). Poor Visual-Motor Integration skills can affect overall coordination, sports and writing skills. Individuals who have difficulty with Visual-Motor Integration skills may appear clumsy and possibly may develop awkward pencil grips.

• VISUALIZATION: The highest level of visual perceptual processing which is free from verbalization, and tactile-kinesthetic-proprioceptive input. Visualization is important for being able to translate the text of a story into a mental experience for better comprehension. Visualization is also important for athletes for ‘mental’ rehearsal of sport’s performance skills.

Visualization is a critical skill which allows us to combine the knowledge previous sensory experiences and project future possibilities in new ways.

Now that we have an understanding about all of the visual skills involved with vision, we can answer the question, What is Vision Therapy?

VISION THERAPY is a progressive program of vision procedures which are designed to rehabilitate and to build the visual skills which are deficient. The vision procedures are performed under doctor supervision and individualized to fit the visual needs of each patient. Generally, vision therapy is conducted in our office with our vision therapist for 45 minute sessions. Selected procedures are then sent home which are to be performed between office visits.

WHO NEEDS VISION THERAPY?

We work with anyone who would like to improve their visual skills no matter their age. Scientific research demonstrates the plasticity of the brain well into adulthood, so you’re never too old to improve your visual skills. However, here are some areas in which we specialize:

Learning-related vision problems (such as losing place while reading, poor copying skills)
Acquired Brain Injury (such as stroke or car accident victims)
Athletes (to improve hitting & catching skills)
Computer Users (to help with computer related visual fatigue)

POSSIBLE INDICATIONS OF A VISION PROBLEM (if you find yourself checking quite a few (5 or more), you may want to schedule a Visual Efficiency Examination with Dr. Popilsky)

Inability to follow objects smoothly
Reading Problems
Skipping words
Rereading words
Reversals of letters/numbers
Nystagmus-regular, rapid, involuntary movement or rotation of the eyes
Headaches
Pain/Ocular Discomfort
Squinting
Blur
Slow transition of clarity from near to far distances after sustained near work/computer work
Double Vision
Closing/Covering one eye
Tilting or Turning the of the head
Headaches
Pain/Ocular Discomfort
A “wandering” eye (eye-turn)
Difficulty judging depth (possibly accidentally knocking object over, bumping into things)
Inaccurate judgment of sizes
Inaccurate judgment of distances/spacing
Left-Right confusions of self/others
Poor awareness of similarities/differences
Coordination problems
Appearing clumsy/awkward
Poor imitative movement
Shaky replication of shapes/letters/numbers
Tight-fisted pencil grip

For more information about vision therapy, please visit: