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Common
Conditions/Symptoms Associated with Vision




See our page on
ADD/ADHD for more information specific to how these
conditions relate to vision.
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Amblyopia also know as Lazy Eye is a
condition in which one eye sees worse (blurry) than the
other despite the best correction with glasses or
contact lenses. This means that one eye may be 20/20
while the other eye is not. Because vision in the weaker
eye has not properly developed, the brain ignores a
significant proportion of the visual information coming
from the weaker eye. Since the brain doesn't have the
opportunity to use both eyes together, the person with
this condition never develops normal
3-D vision.
Amblyopia can occur because of a
congenital cataract (cloudiness of the lens inside the
eye), unequal refractive conditions (meaning the eyes
have a significant difference in glasses prescription
that was untreated at a young age), or
strabismus (an eye turn that
causes one eye to see off to the side while the other
looks straight ahead).
Common treatments for amblyopia
include patching of the stronger eye, fine visual tasks
done with the weaker eye, or vision training/therapy.
Because amblyopia is more than just a problem with sight
(the 20/20 part of vision), we recommend an active
course in therapy to train the brain how to use the two
eyes together, because this is something that it has
never done before even if the weaker eye improves in
sight secondary to patching. Even adults can benefit
from treatment of this condition.
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Vision and balance are highly integrated
in the brain. The two systems work together to keep you
upright and steady. When balance centers in the brain
are damaged or underdeveloped, the visual system is most
likely affected. On the flip side, when vision is not
highly tuned in certain processing loci of the brain,
balance and a sense of groundedness can be out of synch.
Balance plays a vital role in
eye movements and eye movements play an equally
important role in how well you feel balanced. Feelings
of nausea and vertigo can occur because the two systems
are miscommunicating or have stopped talking to each
other almost completely. Not all vertigo cases are
directly or indirectly linked to vision; however, if
vision is ignored the problem may persist despite
treatment of the balance system alone. To find out if
you have or know someone who you think might have vision
problems that relate to balance take our
Online Vision Quiz to see
if the symptoms match.
Treatment for balance or vertigo
problems are centered around reintegrating the visual
system and the balance or vestibular system so the two
work together in the most efficient way. Vision
training/therapy is a good way to accomplish this.
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According to the American Optometric
Association (AOA)
visual dysfunctions are among the most common aftermath
associated with acquired brain injuries. Over 50% of the
brain is dedicated to processing vision in some way or
another and any injury such as strokes (cerebral
vascular accidents-CVA), lack of oxygen to the brain
(hypoxia or suffocation), blunt or penetrating trauma
can disrupt the intricate balance of the visual
pathways. Even a low velocity car accident can cause
nerve damage in the brain or brain stem and affect
vision.
Those who have significant brain
injuries may not realize they have a vision problem at
first because of other physical concerns. However,
vision should not be overlooked in the rehabilitation
process because it has a significant role to play in
balance, motor coordination like standing and walking,
and fine motor control (all of which are things worked
on in rehabilitation).
People with minor brain injuries like
those who have whip lash or minor concussions may not
even realize that the symptoms they have are related to
vision. To see if you have symptoms that relate to
vision take our Online Vision
Quiz.
Treatment for patients with brain
injuries is a collaborative effort that rehabilitation
specialists and optometrists can play a part in.
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Double vision results from a misalignment
in the two eyes causing the brain to see such different
images that it cannot combine the two images in order to
see the world as single.
Double vision may come and go from a
slight mismatch between the eyes caused by conditions
such as convergence insufficiency or convergence excess.
Convergence insufficiency is the inability of the eyes
to maintain a turned in posture at close-up distances.
This condition has many symptoms that are similar to
ADD/ADHD and can cause
symptoms like words moving around on the page, inability
to sustain attention on reading, or fatigue at the end
of the day. Convergence excess occurs when the eyes turn
in too much when looking up close and can cause symptoms
like headaches, eyestrain, or fatigue.
Severe double vision can occur because
of strabismus (eye turn);
however, if strabismus occurs early in life the brain
can eliminate the double vision problem by suppressing
the vision from the turned eye causing
amblyopia. If strabismus occurs
because of a brain injury
then double vision is the most likely outcome because
the brain has less ability to adapt to the double vision
later in life and therefore cannot suppress the second
image.
The treatment for double vision can be
accomplished with special lenses called prisms, through
an active program of vision training/therapy, or a
combination of both.
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Dyslexia is often misunderstood as only a
problem with letter/word reversals; rather, there are
multiple factors in this phenomenon. Dyslexia is also
know as "congenital word blindness" as coined by Morgan
in 1896. Their are several types of dyslexia, two main
ones of which we will cover here-dyseidesia and
dysphonesia and a third one we will cover under
Letter/Word Reversals.
Dyseidesia is characterized by an
inability or a decreased ability to recognize words by
sight or sight-words. The brain has limited capability
to recognize a word because it is not stored in or
accessible from a "vocabulary bank." The child or adult
with this type of dyslexia has to rely on the more
laborsome task of individually attacking each word
phonetically when reading. Decoding phonetically may
work for some words, but in the English language there
are multitudes of phonetically irregular words.
Dysphonesia is a poor word attack
skill. People who have this type of dyslexia may or may
not have dyseidesia, but do have a difficult time
decoding unknown words by means of phonetics. Even
phonetically regular words (ones that sound like they
are spelled) are difficult to process for these people.
Reading errors can be substitution errors such as home
for house and spelling errors are often frequent.
Dyslexia is not always solely a
language processing difficulty. In order for the
information one reads to travel to the areas of the
brain that process language it must first pass through a
complex system of visual interpretation. Since vision
makes up the first stop on the journey to processing
language, it stands to reason that a visual problem can
cause a translation error that ends up skewing language
analysis.
Treatment for dyslexia depends on the
origin of the problem-whether it be language or vision.
Sometimes it can be a combination of both. We recommend
having a visual evaluation to see if vision is affecting
the language center and proceeding from there.
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Eye movements are controlled by 6 small
muscles in each eye. These 6 muscles are controlled by 3
different cranial nerves. There are two main types of
eye movements, one is called saccades (eye movement
jumps) and the other is called pursuits (smooth,
tracking eye movements). Saccades are important for
reading because the eyes have to jump from word to word
and line to line. These are extremely small movements
and therefore they have to be extremely precise in order
to land the eye on the correct target. If saccades are
not working in the most efficient manner possible, the
eyes may seem to dart all over the place, words may jump
around on the page, or a reader may skip lines. Pursuits
are important for following moving targets such as in
sports or when watching your hand when writing. When
pursuits lack efficiency, eye/hand coordination tasks
become difficult if not seemingly impossible.
Treatment for eye movement disorders
includes an active course of vision training/therapy.
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If you have two eyes, then eye teaming is
a big deal! Eye teaming is the brain's way of combining
information from one eye with the information from the
other eye to create a solid perception of the world.
Since each eye is separated by a certain distance, the
right eye sees a slightly different picture than the
left eye. So how does the brain deal with these two
slightly different pictures? If everything is working
together properly, the brain interprets the difference
(also know as disparity) between the two eyes as
3-dimensional information and the result is seeing the
world in 3-D. If information from the two eyes is not
combined because of a visual condition then the brain
may see two separate images
(double vision) or suppress central vision (the part
that allows you to read find print) from one eye causing
reduced 3-D vision.
The treatment for eye teaming
difficulties is the use of special lenses used to relax
the focusing of the eyes or an active course of vision
training/therapy.
To read more about the latest research
in convergence insufficiency (one type of eye teaming
problem) please click this link to view the PDF file of
this journal article

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Focusing is an important visual skill for
school age children. It allows for them to maintain
clear vision up close for extended periods of time (such
as in reading). Good focusing also allows them to be
able to change focus from the board to their papers and
back again. The brain must tell the eyes to change focus
rapidly for large shifts in distances (like from board
to paper) or it must tell the eyes to maintain an
enormous amount of focus for prolonged near tasks like
studying. If the brain doesn't understand where to aim
the focusing system, visual stress can creep in and
cause structural or physiological changes to the visual
system. Structural changes occur to the eye by means of
elongation of the eyeball in order to reduce the amount
of focusing that has to occur at near distances-this
change causes distance vision to become blurry and the
child becomes nearsighted. Physiological changes can be
things like headaches, eye fatigue, or sleepiness at the
end of the school day.
Treatment for this type of condition
can include special lenses that relax the focusing
system or an active program of vision training/therapy
that retrains the brain to determine where to aim
focusing better. A combination of the two may also be
the best means of treatment.
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Letter or word reversals are frequent and
common among young children in grade school. Reversals
are normal for children up to the age of 8 but should
significantly decrease after the 1st grade. Some may be
present in second grade, but none should appear in the
3rd grade. Letter and word reversals are a form of
dyslexia called dysnemkinesia
and are a result of poor motor planning as it relates to
language. Children with reversals may also exhibit
confusion between their left and their right or left and
right on other people. This results from a poor
understanding of the body map the brain develops in
order to relate to the outside world. The brain maps
where the arms and legs are in order to move them
accurately through space. The map also contains the left
and right labels to further refine those movements
through space. A shaky map of the body and left/right
awareness can spill over to the language and motor
centers that are important for reading and writing.
Treatment for this condition may
include a program that reorganizes the brain to have an
accurate map of the body and where left and right are
located. This can be done through the visual system and
vision therapy/training is an excellent way to achieve
this.
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According to the American Optometric
Association (AOA), 80%
of learning is visually acquired. This is extremely
important as a child progresses from grade school to
high school to college and beyond. Anywhere along the
visual pathway, problems can occur to impede the process
of learning. Anything from blurry vision (eye) to poor
visual processing skills (which occur in higher brain
centers) can slow one's ability to learn and/or function
in daily life.
In order to avoid the frustrations of
learning difficulties related to vision, have your child
examined by an optometrist to see if visual skills are
capable of standing up to the demands of school work.
Check out our Online Vision
Quiz to see if your child has symptoms that relate
to learning and vision.
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Strabismus is a large
misalignment of the eyes usually due to an underlying
neurological problem and NOT muscle weakness. Strabismus
can occur early in life or later after an event like
head trauma or brain injury.
Because poor neurological input in the major cause of
strabismus, surgery on the muscles is not as effective
as rehabilitation of the nerves. Some types of eye turns
can be due to structural problems within the eye socket
(or orbit). This type of eye misalignment is more likely
to benefit from surgery than the majority of strabismus
cases.
If strabismus is constant
in one eye it can lead to a condition known as
amblyopia and have an affect on
the clarity of sight. Both conditions need treatment in
order to restore the visual system back to a normal or
near normal state. Even adults with this type of
condition have been know to be treated with good
success.
Treatment for eye turns
consists of several options depending on diagnosis. One
option is surgery; however, we highly recommend several
opinions concerning this method, with at least one
opinion coming from an optometrist who specializes in
treating eye turns with therapy rather than surgery. The
other treatment options for eye turns consist of
specialized lenses called prisms to help decrease visual
discomfort, lenses to relax the visual system and
reduced the eye turn, or an active program of vision
therapy/training to retrain the neurology that is the
source of the eye turn (in certain cases).
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