Eighth-grader Rosie H. had always been a hardworking student. But as she got older, schoolwork got more difficult, and the main issue seemed to be reading.
Yes, she could read, but she didn’t seem to be understanding what she was reading. And the advice from teachers — slow down, ask more questions — didn’t seem to help her comprehend the material.
She also was beginning to experience headaches while doing homework, along with intermittent double vision, though at the time she didn’t quite know how to describe that to others.
Naturally, she began to dislike reading. Rosie’s parents knew they had to find help for her.
A Functional Vision Exam Identifies Rosie’s Problems
At the suggestion of a family therapist, Rosie came to The Vision Therapy Center for a Functional Vision Exam.
This exam goes beyond a conventional eye exam, which primarily measures visual acuity, or 20/20 eyesight. Functional vision is how your entire visual system – the eyes, the brain, the visual pathways – works together to help you interact with your environment.
That’s why a Functional Vision Exam also includes a comprehensive assessment of visual information processing, binocular (i.e., two-eyed) function, and other visual skills.
Note that not all optometrists have the advanced training or equipment required to perform this type of exam.
Rosie’s exam results revealed several functional vision problems. Let’s take a closer look to better understand why she struggled not only with understanding what she read but also other activities typical for a middle-schooler.
The Reading Itself was Physically Taxing for Rosie
The biggest takeaway from her exam was that Rosie had to devote 75 to 80 percent of her effort to the physical act of reading, leaving only 20 to 25 percent for memory and comprehension. In other words, her eyes were working so hard just to focus on the words themselves that it left little room for her to understand them.
More specifically, the exam revealed functional vision problems like the following.
Convergence insufficiency. Convergence insufficiency is a problem with keeping both eyes working together, especially when focusing on things like words on a page.
When the eyes don’t converge efficiently, it can adversely affect the ability to concentrate on otherwise simple near tasks. This can also result in visual discomfort, headaches, and even double vision – things Rosie sometimes experienced – when performing near-point activities like reading.
Irregular saccades. Saccades is a visual skill that enables a person to make quick eye movements from one object to another (imagine watching a tennis match). Irregular saccades make that more challenging. This is also the type of eye movement used to move from word to word when reading.
For Rosie, irregular saccades likely made it more difficult to keep her place when reading.
Poor depth perception. Normal depth perception allows people to see in three dimensions and, more specifically, helps them judge how close (or far) an object is from them.
For Rosie, this problem affected her ability to perform certain athletic activities like softball. In fact, she earned the nickname “Two-Strikes Rosie,” recalls her dad, because she so often would have two strikes before ultimately hitting the ball. “We later realized it took her a couple of pitches to figure out where the ball was,” he says.
Accommodative insufficiency. The technical term for the eyes’ ability to focus is called accommodation. Tiny muscles inside your eyes contract or relax to change the shape of your eyes’ lenses and allow you to bring objects at different distances into focus.
When you focus on something close, the muscles contract, and when you focus on something in the distance, they relax. In Rosie’s case, she had difficulty sustaining focus on objects up close, such as reading material.
Optometric Vision Therapy Puts Rosie on a Path of Hope (and Progress)
Rosie’s mom and dad were surprised by the results, especially the double vision. But they were also relieved because now Rosie could get help. She began 36 weeks of weekly in-office optometric vision therapy, along with daily at-home vision exercises to support her progress.
“Many of the visual exercises were timed,” recalls her dad, “and each week Rosie was able to complete them faster, which was a key sign of progress.”
And her mom remembers how Rosie would gravitate toward very simplistic graphic novels. But that began to change. “We ‘caught’ her reading chapter books,” she says.
‘So Worth It’: Better Homework Habits AND No More Headaches or Double Vision
Today, Rosie is throwing, catching, and hitting the softball better than ever. “I can see the ball coming now,” she says. And her mom happily reports that her reading speed and comprehension “just skyrocketed from when she was first tested.”
Perhaps even more important, Rosie can do her homework much more efficiently. “She’s better able to read information on her own and comprehend it because her eyes now do what they’re supposed to do,” says her dad.
And on top of all those improvements, her headaches and double vision have vanished.
Rosie’s parents are obviously happy with the results. But they can’t help but wonder about other children who may have issues similar to Rosie’s. “We had no idea that vision therapy was out there,” says her mom. “I just wish more people knew about it, because vision therapy was so worth it for Rosie.”
A Vision Quiz Can Be the First Step Toward Detecting a Problem
Functional vision problems can manifest in school-aged kids as academic work gets more visually challenging.
If you think your child may be suffering from vision problems similar to Rosie’s, the first step toward diagnosis is to take the Vision Quiz. It can help identify if your child is suffering from any of the symptoms associated with functional vision problems.
Click here to take the Vision Quiz.
About the author: Dr. Kellye Knueppel is a developmental optometrist specializing in vision related learning problems, sports vision, and rehabilitative optometry. She is board certified in vision development as a Fellow of the College of Optometrists in Vision Development. Since opening The Vision Therapy Center in 1995, she has dedicated herself to helping people overcome their visual problems.
