Vision therapy can improve lots of skills that you might not even realize are related to vision. Vision therapy can work with integrating reflexes, motion sickness, balance, multi-tasking, pencil grip, formation of letters and numbers, etc. Vision therapy can help improve the simplicity of your working circumstances and make your life ultimately easier.

About five months ago, an eight year old boy came to vision therapy who needed some help. His eyes were reluctant to work together, so it was challenging for him to ride his bike. It was hard to rely on his eyes rather than his body to watch a moving object. He also needed improvement with the formation of his letters and his ability to know his left from right.

When speaking to him before he started vision therapy, his main goal was to be able to ride his bike. And after only about three months of vision therapy, he achieved that goal. He no longer has letter or number reversals and he can now rely on his eyes instead of his body to follow a moving object.

On top of these tasks becoming easier for him, his reading has improved; he is above his age level and both of his eyes now work well together. He is excelling in so much that he does. He is so happy with his progress and he has noticed his improvements along with his parents, teachers and myself.

One of the big things in vision therapy that was never hard for him was to have a positive attitude and mindset. He always comes to vision therapy with a big smile on his face. He knew what was hard for him and knew that he wanted to do better. He did not want to have these struggles anymore and after that short period of time, he did it.

I would recommend vision therapy to anyone who believes they aren’t at their full potential, but wish to achieve it. Be aware of your struggles and be open to being pushed to achieve your best self. Vision therapy is truly life changing for all ages.

Understanding a patient’s vision is the first step in deciding if vision therapy is the right path. To begin vision therapy at Focus Eyecare, there are two required evaluations – the binocular vision evaluation with Dr. Robyn Dragoo, OD and the visual perceptual evaluation with Melissa Hoyer, the lead vision therapist of our clinic.

When I see a patient for an evaluation, I am an observer of many things. My overall goal is to get a complete picture of vision skills and how this person uses vision on a daily basis. The following will outline the specifics of this evaluation.

The following skills are assessed in a variety of methods:

Infantile Reflexes – These reflexes are present at birth and should become integrated to be replaced with higher level skills. It is common for our vision therapy clients to have reflexes that have not been integrated.

Gross & Fine Motor Skills – These skills form the foundation for vision development and delays can be roadblocks in development. We complete a brief assessment of gross and fine motor skills that relate to vision.

Awareness Skills – This is a collection of skills that are vital in daily life – Body Awareness, Spatial Awareness, Perception of Time, Laterality & Directionality.

Visual Skills – In addition to the binocular vision evaluation, additional data is collected regarding vision skills. These include: Fixation, Saccades, Pursuits/Tracking, Convergence & Divergence, Accommodation, Central Peripheral Integration, and Visual Fields.

Visagraph – When appropriate, clients complete a visagraph to gain visual data relating to reading including speed and comprehension. The visagraph is a specialized pair of goggles that uses infrared sensors to study eye movements.

Visual Perceptual Skills – Depending on the client, we have many ways to assess visual perceptual skills. We use observation and assessment to gain information about the following skills: Visual Discrimination, Figure Ground, Visual Closure, Form Constancy, and Visual Motor Integration.

Behavior & Making Choices Assessment – Many of our younger clients struggle with focus, attention and making good decisions. Part of our evaluation assesses the ability of the client to remember the past and visualize the future.

Visual Thinking – Visual thinking skills include visual memory & visualization, the highest level of visual skills. These skills make daily life easier and more efficient for all our clients.

Academics – An assessment of spelling, reading, writing, letter formation, basic math skills and more is completed during the evaluation to determine the impact of vision skills on life and learning.

This evaluation is unique – in fact, it is so unique that it is not covered by insurance*. It is the one portion of our program that is always an out of pocket cost. As a compromise, we complete re-evaluations to assess progress throughout the program with the patient’s vision therapist at no cost. Following the initial evaluation, a detailed report is provided along with complete supporting documentation as necessary for schools, other professionals, etc. In fact, we will support you both during and after the evaluation and vision therapy in any way possible. The facts gained from both evaluations form the basis and goals for a completely customized vision therapy program.

*There is no insurance procedure code that is an accurate description of the visual perceptual evaluation – the scope of assessments is too broad and also includes assessments relating to academics, attention, focus and other skills that are not covered by medical insurance.

Are you actually a visual learner?

We hear this phrase a lot. People will describe themselves as visual learners. Here I’d like to explore what a person means and what it means to me as a behavioral optometrist.

When someone identifies themselves as visual, they mean to say that they like a picture to reference, or like someone to show them how to do a task as in on the job training. As a behavioral optometrist this clue tells me something else about the way the person thinks, or how they learn and possibly their binocular vision function.

If you prefer a picture or need a picture made for you instead of readily making pictures in your head say from words read from a page, then you may not in fact be a visual learner. On the contrary, you likely use auditory or verbal stimuli as your primary source of information in the brain. When you learn something with auditory or verbal skills there are a few factors that make it less effective, less efficient, more difficult to recall, and further more difficult to manipulate once remembered.

Here’s an example, taught to me by a colleague. If I were to ask you “ what is the number, 3 before 97?” What might your answer be? Furthermore, how did you get your answer? Ponder this question and how many ways you can get to the answer. You are being asked a math question. To solve it, you did not have to begin at 1, nor 90, and there were several ways to do this “in your head” as you visualized a math problem, or you simply counted down the 3 digits, or maybe you pictured a number line, or maybe you are so efficient at this visual task, you don’t even know the way in which you arrived at your accurate answer, you simply just got there. That is because math is visual and spatial. We learn math visually, with graphs, shapes, and symbols. We memorize facts, and are able to manipulate those pictures easily.

Now let’s compare to another proposed question: What is the letter 3 before J in the alphabet? How do you get to this answer? Is it easier or more difficult than the math question? Did you find yourself singing to yourself? Did you get the correct answer? How much more time did it take you to get to the answer and how confident are you that it is correct? The difference here is that we have all learned the alphabet the same way and it is stored as auditory/verbal information. It is a song. Yes, we can remember songs and we do not need a picture of them to recall the song. Yet, when we try to manipulate the information, it is much more difficult. Most of us find ourselves starting at the beginning and trying to intuitively feel if we are 3 characters away from J.

My point here is that visual learners, we are. We ALL are. At least, that is the most efficient way to learn and learn long term. Memories of visual pictures stay with us long after we have studied them, and long after the test. Auditory memories are more difficult to manipulate and many times are literally in one ear and out the other. They do not stick with us like a picture does. In this way, if you can easily make your own pictures from symbols on a page, rather than needing someone to show you how, or show you the way, one might say you would be able to learn many complex tasks independently and with less time.

Many of our students in Vision Therapy at Focus Eyecare, have difficulty with this type of task. The good news is that we have well established treatment plans to train this behavior and improve visualization skills.

As a parent, very few things are as painful as watching your children struggle through the early years of academic life. At times, my daughter was unable to self-regulate her emotions, which led to generally not fitting in very well with her peers. Listening to various doctors and friends’ advice, I did a variety of different things to try to break the pattern for her, including changing her diet, getting her a tutor, modifying her curriculum, therapy, medication, visits to neurologists and psychologists to formulate behavioral modification plans, social workers, me volunteering more time at her school, etc. While many of these steps improved her overall standing, it still didn’t address some of the root causes, and I was made to feel like I failed my child in the end.

Several years ago, I discovered vision therapy and became aware of the benefits of it. My eye doctor, who was also a developmental optometrist, often shared stories about her successes with practicing it, and how it truly benefited her patients. I had no idea this even existed, of course, but I soon began to wonder if this was the missing piece to what my daughter may have needed earlier in her life.

In the years since then, I had an ear surgery that left me with some very nauseating motion sickness. The ear surgery exacerbated a condition I had already had since childhood, and while it generally got better, it never truly “went away” fully. My eye doctor recommended I do some vision therapy exercises to help with the lingering motion sickness, and once I did, I was surprised at how big an impact it had for me. The experience intrigued me and it led to me wanting to learn more about it.

Not only did I learn more about the amazing benefits of vision therapy, but I also decided that I wanted to have an impact on others’ lives as well, so I became a vision therapist. I no longer carry the guilt of letting my daughter down, because I see her in so many of my students and it drives me to help them. Taking that energy and passion, I help my students feel confident, cared for, and I help them understand that they’re not alone. It has been a joy to watch so many kids develop that passion for reading that they didn’t have before vision therapy, seeing how excited they get to check their next book out at the library. It’s extremely heartwarming to me when someone shares with me that they’re now testing at grade level for reading, when prior to vision therapy they had never done so before.

It’s such a relief, too, when a student shares with me how they’ve used our techniques to conquer their motion sickness. And it’s a privilege to sit next to a parent and witness their relief and joy when they’re told that their child’s visual skills have reached the normal range and they’ve achieved the goals we set for them, because I know how hard those kids have worked and I know how much it will benefit them the rest of their lives.

Being a Vision Therapist has been a rewarding job that has taught me so much about compassion, kindness, perseverance, relationships, and patience. I’m thankful for this opportunity that I’ve been given and I’m looking forward to continuing to change lives, two eyes at a time.

Years ago, when I first became a vision therapist, there was a commonality between the majority of my clients. They were all young children, usually male and struggling to maintain attention in the classroom. Even today, it is a common misconception that vision therapy is only appropriate for children. In reality, adults can benefit greatly from vision therapy and our practice works with many adult clients; many of whom are still kids at heart.

Our adult clients tend to have big issues that impact daily life – a stroke has left them unable to drive; they’ve suffered from migraines for years and reached a breaking point; reading to their children has become impossible due to eye fatigue; spending all day working remotely has caused debilitating symptoms; and the list goes on.

Recently, two standout moments occurred with two of my adult clients. One mentioned that her friends asked her what vision therapy is all about. She replied that it is like hanging out with a friend, doing some cool exercises and games, while developing great vision skills. Her vision is improving by leaps and bounds as she puts in the work and has fun doing it. And this is the truth of it, vision therapy is fun with a purpose.

The second came in after experiencing the onset of double vision and she just recently mentioned to me how scared she was on the first visit. She feared she would never be able to drive again or be able to do many of the things she loved in life. Her comment was “look at me now”! She’s driving with comfort, no longer experiences double vision and continues to make great strides in developing strong, accurate binocular vision skills.

Our vision therapy team is skilled in working with clients of all ages and getting excellent results. Each program begins with two evaluations – a binocular vision evaluation with Dr. Robyn Dragoo and a visual perceptual evaluation with myself. These assessments give a comprehensive picture of the client’s vision skills, deficiencies and more.

We all deserve quality of life and visual dysfunctions often interfere with the most important areas of our lives. Our clients at Focus Eyecare range in age from infancy to 90 years young! Because our program is completely customized to each individual, we can work successfully with clients of all ages to achieve their goals.

Melissa Hoyer
Vision Therapy Clinic Manager
Lead Vision Therapist

By Robyn Dragoo, OD

Ever looked at someone and their two eyes are not looking at the same thing at the same time? Do you have two eyes that don’t always seem to “play” together? Well, you make up about 5% of our total population and contrary to popular belief, your eye is not LAZY it’s NICE.

In development, your two eyes learn to play or coordinate with one another through life experiences, and a series of developing steps occur from infantile reflex integration to gross motor development, all leading to fine motor development. The finest motor development we have is ocular motor development. This is the two eyes working together well and also leading your body through space and time.

When the two eyes cannot coordinate in such a way that they give your brain good data, the brain has choices as to how to differentiate the two conflicting sources of information.

You might know, your two eyes are each giving the brain a “picture” of what you see. One image comes in from the right eye and one from the left. When your two eyes are aligned, the two eyes give the brain a similar image and due to their relative positioning, they give a slightly different perspective, but nonetheless the same image, so the brain sees one object. When this alignment does not occur, the brain could see two images of the same object. You can see how this may not be advantageous unless of course, we were looking at two happy golden retrievers, two steak dinners, or two banana splits. (just kidding)

One of the ways the brain can dissociate the two conflicting pictures is by turning an eye to the blind spot. Yes, both of your eyes have a significant blind spot that corresponds directly to the anatomical connection where your optic nerve sits within your retinal tissue. No photoreceptors reside there. Therefore, no information to the brain is gathered there creating a blind spot.

Your brain is then eliminating one of the images so as to be able to function in your environment by turning the center of the eye to it. The brain does not want to see double.

Whether the brain is turning the eye in or out, it is achieving this.

That is when a person is considered to have a “lazy” eye by layman’s standards when truly, the eye that turns is not lazy, but just nice. Telling the dominant eye, the lead eye, or the “bully” eye, “you go first. You show the brain what we see, and I will go out of the sandbox because we cannot play well together at this time. “ This turned eye says, “ I will recede.“

The dominant eye is chosen by the brain to keep their relationship open. The non-dominant eye is then sent out of the “sandbox” per se. It’s put into a “time out.” That way, it does not send conflicting messages to the brain and life can be carried out without double vision. Clever move, genius move, and I can’t make this stuff up. Truly, this is what is happening in the brain.

When the object you are viewing is in the field corresponding to the turned eye, that eye is expected to lead. Many times this eye will then come to attention, lead and send the dominant eye out of the sandbox and to its blind spot. That would be considered alternating to the other eye.

In the same way, if we just use our hand and cover the dominant eye, the non-dominant eye will rise to the occasion and will be able to track, converge and perform functional eye movements without difficulty. There is seemingly nothing “wrong” with the eye that turns. It is not lazy at all. Therefore, there is no nerve that is innervating improperly nor a muscle that is too weak or too strong. It is the relationship between the two eyes, that is not coordinating or playing well together that causes the eye to turn. Lucky for us, there is a way to train this coordination through a series of vision exercises, much like teaching a person how to ride a bicycle. We need not strengthen muscles or have surgery to ride the bike, we simply need to teach the brain and the two eyes to play together in that sandbox and when we do, a glorious occurrence called BINOCULAR VISION is achieved. And that my friend is the best occurrence of all. It is what was intended for our visual system to provide the brain for optimal movement through space and time.

April is Parkinson’s Awareness Month in the USA and Canada, a time when those living with the disorder, their family members, friends, and community come together to raise awareness and share helpful information. People with Parkinson’s Disease (PD) and their loved ones are encouraged to share their stories, struggles, and successes in order to educate and support others.

The Parkinson’s Foundation has announced this year’s theme: #KeyToPD and Parkinson Canada advocates the same involvement. What is the key to living a high quality of life while living with Parkinson’s? Patients, doctors, caregivers, and families are encouraged to use this hashtag on social media to give of their knowledge and experience.

In order to successfully manage the disorder, it’s essential to understand the disease, symptoms, and treatments. After all, knowledge is power.

What is Parkinson’s Disease?

Parkinson’s Disease is a neurological disorder that affects the brain’s ability to control physical movement. It typically affects middle aged people and the elderly. Parkinson’s causes a decrease in the brain’s natural levels of dopamine, which normally aids nerve cells in passing messages within the brain. According to The Parkinson’s Foundation and Statistics Canada, the disorder affects an estimated 1 million people in the United States, 55 000 Canadians, and 10 million globally.

What Causes Parkinson’s Disease?

Although much research has been done on the subject, the exact cause of the disease isn’t really known. What doctors and scientists do know is that certain nerve cells located in the brain somehow break down. This damage interferes with both motor and non-motor functions.

How Does Parkinson’s Affect Vision?

Parkinson’s can have a significant impact on vision and ocular health. Patients with PD often find themselves unable to control blinking. Blinking is good for the eyes as it moisturizes the surface and clears it from foreign substances. Less blinking can cause Dry Eye Syndrome, resulting in itchy, red, or gritty-feeling eyes. Other people blink too much or can’t keep their eyes open. 

In more serious cases, Parkinson’s affects the nerves that help us see. Someone with PD may experience blurry vision, double vision, difficulty seeing color and contrast, problems with focus, and other visual symptoms. 

In addition to the inherent impact of the disease, some of the medications used to treat Parkinson’s symptoms have known side effects including dry eyes, blurred eyesight and even hallucinations in advanced PD.

Common Visual Symptoms of Parkinson’s

Although the most recognized physical symptom is uncontrollable tremors, patients can experience other symptoms that affect their vision. These typically include:

• Apraxia (inability to open the eyelids) 
• Blurry or double vision
• Difficulty with balance
• Dry eyes
• Eye twitching
• Focusing problems

Parkinson’s Patients and Eye Exams

Eye exams can be particularly challenging for a PD patient, so choosing the right doctor is essential. Make sure your eye doctor regularly treats patients with PD. They’ll understand your or your loved ones’ unique needs and will take the time needed.

Common Non-Visual Symptoms of Parkinson’s

PD affects other areas of the body that may or may not – depending on each patient – be related to their eye health and visual needs. 

Some of the most common non-visual symptoms are:

• Depression
• Excessive saliva
• Loss of smell
• Moodiness
• Muscle cramps
• Sleep disturbance
• Slow movement (bradykinesia)
• Stiff limbs
• Tremors

Coping With Vision Problems From Parkinson’s

Despite the struggles caused by this degenerative disease, there is hope. Talk to your eye doctor. He or she may recommend medicated ointments or drops, injections, therapeutic lenses, visual aids, vision therapy, or a combination thereof. Additionally, a Neuro-Optometric Rehabilitation doctor can provide comprehensive eye care specifically designed for neurological disorders like PD.

Treatment for Parkinson’s Disease

There is currently no cure for the disease itself, but there are options to treat the symptoms of PD. A combination of medications, physical and/or occupational therapy, support groups, and of course, top-quality vision care can give a PD patient relief for some of their symptoms and tools to help cope with the condition.

Research and clinical trials are continuing as doctors and others in the medical community work towards the goal of finding a cure for PD.

No two patients are alike, and each can experience PD differently from the other, so finding what works for you or your loved one is key. During this Parkinson’s Awareness Month, share your #KeyToPD and give your loved ones hope for a healthy and high quality of life.

March 8th is International Women’s Day, a day when women are honored and their accomplishments celebrated worldwide. From medicine to law, entrepreneurship to corporate leadership, education to the military, women are achieving great strides in areas of business like never before.

In addition to professional achievements, International Women’s Day is a time for women to focus inwards on their personal goals, relationships, and health. From the adolescent years to pregnancy, childbirth, and menopause, women’s bodies go through some major changes that can affect many areas of their health, especially their vision.

Age Is Just a Number, But Not For Your Vision

They say that ‘age is just a number’, but when it comes to women’s health, it’s essential to pay close attention to any signs of changing vision as we get older.

Women over 40 have a higher risk of developing eye disease, impaired vision, and blindness than men. They are more likely to develop eye conditions such as Cataracts, Diabetic Retinopathy, and Dry Eye Syndrome. In fact, 61% of Glaucoma patients and 65% of Age-Related Macular Degeneration patients are female, so it’s crucial that women know the risk factors and signs of developing these conditions.

Put Your Needs First

Women are typically the family caretakers, running a spouse, children, or elderly parents to the doctor, putting their own healthcare needs last. It’s time to put your eye care needs first. Don’t ignore symptoms or push them off for another day. Take care of yourself, and you’ll be able to continue being there for others.

Signs and Risk Factors of Vision Problems

Knowing what to look out for is a crucial step in keeping your eyes healthy and enjoying great vision.

Genetics often play a key role in many health issues. Just like people inherit eye color and shape, hair color and texture, and facial features from parents, vision difficulties or diseases can also be hereditary. If something runs in the family, you may be more susceptible to developing it and passing it on to your children, as well.

Pregnancy can temporarily affect a woman’s vision. This is due to the hormonal changes in the body, which typically stabilize after breastfeeding has stopped. A pregnant woman with diabetes must be closely monitored, since diabetic retinopathy (swelling or leaking of blood vessels in the retina) can progress more quickly during the pregnancy.

Climate and environment are also important factors when it comes to eye health. Extremely cold or hot climates can cause dry eye symptoms. A healthy amount of sun exposure is good for the skin, but an excessive amount can harm your eyes and even lead to vision loss. Smoking dehydrates the skin and can lead to eye bags and dark circles, not to mention a whole slew of serious eye diseases like cataracts, macular degeneration, glaucoma, and diabetic eye disease. 

Symptoms of Declining Vision and Eye Conditions

Some of the most common signs of declining vision or eye disease include:

• Blind spots
• Blurry or distorted vision
• Burning sensation
• Gritty feeling
• Itchy eyes
• Redness
• Shadows or dark spots on an image
• Stinging
• Swelling or soreness in the eye
• Watery eyes

If you or a loved one experiences any of these symptoms, or if you feel like something just isn’t right with your eyes, speak with your eye doctor right away. Mention any other conditions or medications you may be taking, including birth control pills (a known contributor to Dry Eye Syndrome), and even natural supplements or vitamins. Other factors such as an irregular menstrual cycle, fertility treatments, or cosmetic procedures may impact your vision in ways you may be unaware of, so disclosing this to your doctor is important.

What Can You Do to Improve Your Eye Health?

There are some preventative measures that women can take to ensure their eye health and overall vision are at their best.

1. Keep that body hydrated! Mothers always say it, doctors remind us too, and they’re right. Drinking 8 glasses of water daily is great for your skin and can prevent dry eye symptoms from forming.
2. Quit smoking. Not only is it bad for your lungs, but it can cause eye problems, like dryness, itchiness, and swelling, as well as more serious eye diseases associated with vision loss.
3. Love the outdoors? Wear UV-blocking sunglasses when you’re at the beach or even hanging out in your backyard, to protect against harmful sun rays. Polarized lenses are a great way to shield your eyes from strong glare.
4. Eat healthy. A balanced diet including a variety of vitamin-rich fruits and vegetables may help protect you from several eye conditions including dry eyes, macular degeneration, and even diabetic retinopathy.
5. Try to get more shut-eye. A healthy amount of sleep ensures your eyes are rested and clear the next day.

On this International Women’s Day, let’s work together to keep the women in our lives healthy for many years to come.