In the last 100 years we have seen a huge shift in the demands on our near sight. Close vision tasks now form a major proportion of the work our eyes do. Whilst we have evolved to cope with this, the demand can cause varying degrees of stress on our vision. Untreated visual issues can cause headaches, blurry vision and sore eyes, you may experience print moving or jumping around the page, missing or skipping, of words and avoidance of reading. If using your vision is difficult, it can lead to poor visual memory and long term memory, difficulties copying from board or book, short attention span, messy handwriting and poor hand eye coordination.
Vision is so much more than what you see. Vision is about the brain processing what the eyes see and then acting accordingly. This is an incredibly complex process requiring many parts of the visual system, body and brain to perform a role.
For example, catching a ball requires the person to firstly see the ball, process how far away the ball is, how quickly it is travelling and consequently, when it will reach their hands, the brain then tells the hands when they need to clasp the ball. So much of this relies on quick and accurate visual processing. Similarly, reading requires the eyes to see the letters clearly, group them correctly, tell the brain what they have seen, then the brain has to process these letters in a recognised sequence. As such, we are relying on many processes to take place for each word to be read correctly.
Optometric vision therapy is designed to improve the efficiency and performance of the visual system and enhance visual skills, retraining and strengthening the brain’s connection with the eyes.
Vision therapy can help with; focusing, attention, concentration, reading, writing and spelling. Ideally, any issues with visual processing should be identified and treated as early as possible, usually when a child is in primary school. However, it might only be that a person notices an issue at a later stage especially if your vision is changing with age. Professional and amateur sports people have been known to benefit hugely from vision therapy to maximise and optimise their vision and visual performance.
Vision therapy can help reduce the visual issues experienced with specific learning related disorders such as those found in dyslexia and dyspraxia, and develop the visual skills in children and adults with Asperger’s and autism. It can also help with specific eye conditions such as strabismus, amblyopia, decompensating muscle issues and poor ocular motor skills.
An optometrist will be able to diagnose many visual issues faced by children from a young age, even before a child can read, such as an eye turn, astigmatism or long sightedness. Our vision therapy assessments go further, examining the development of the visual system and investigating the efficiency and accuracy of ocular motor skills. You can have ‘perfect’ 20/20 vision but struggle to visually process which can lead to visual memory and long term memory issues due to delayed visual development and poor ocular motor ability.
A behavioural optometrist looks at how all the senses work together, vision, hearing, balance and the brain all need to communicate, for example for good hand eye coordination when catching a ball, you need your brain and vision to work efficiently together to move quickly. If a child struggles to read, there may be processing issues being exacerbated by poor visual development and delayed visual skills, they may greatly benefit from vision therapy.
We are born with the potential for vision but just as our bodies need to grow so that we can move in an efficient and coordinated way, we need to develop our vision and visual skills. Approximately 80% of all information we receive is visual, therefore efficient visual skills are vital in learning, working and sport. Vision therapy is about developing and enhancing vision, and visual skills, it is not just about good visual acuity. An eye examination might conclude that you don’t need any correction but that does not mean your visual skills don’t need help. These skills might include:
Children: In many cases, the patient will be referred to us from another optometrist, teacher, support for learning departments, occupational therapists, as well as concerned parents.
Adults: Many children with poor visual skills will reach adulthood without having their visual issues addressed and still struggle with their visual skills. Vision problems can also occur at any time in life. Vision therapy can have a huge impact on adults and improve their visual performance in many areas including work and when playing sport, especially in professional sport when you rely on accurate and efficient vision.
Our behavioural optometrist will conduct a full vision therapy assessment, looking at many elements of vision, including functional vision, tracking, reading speed, and accuracy of fixation, focusing flexibility, depth perception, binocularity and distance and near refraction. The treatment plans are as unique as the patient and vary depending on the complexity of the eye issues, also on the quality and quantity of the effort put in doing the exercises given.
This examination takes around an hour. A follow up appointment is often recommended, usually around a month after the initial appointment.
Included in the process is a colorimetry test where we will examine how your vision is affected by coloured spectacle lenses. During the test, using our colorimeter technology, we are able to change the three parameters of colour – hue, saturation and brightness. The colour that suits the individual best will be different for each patient, with over 100,000 colour combinations available.
We will also recommend an eye examination for any patients who are new to the practice or haven’t had their eyes examined recently. Our examinations provide extra detail you probably wouldn’t have from another optometrist so will be the final part of the holistic process. In this we are able to examine how well you see, as well as the health of your eye, giving us a rounded picture of your vision.
Children:All three stages (behavioural optometrist + colorimetry + eye examination) are included in the £160 fee. In some cases, a follow up appointment with the behavioural optometrist is required which would cost £75.
Adults: Your appointment with the behavioural optometrist and colorimetry appointment are charged at £160. If you require a comprehensive eye examination as well, the cost is an additional £60. In some cases, a follow up appointment with the behavioural optometrist is required which would cost £75.
Every vision therapy treatment programme is entirely based on the individual visual issues, the way your vision has developed and how you use your vision is as unique as you are. However vision training and Intuitive Colorimetry can both assist to reduce and relieve visual problems and signs of visual stress.
Think of vision training like visiting a physiotherapist, where they will work with you regularly to build your strength and overcome weaknesses, sending you away with exercises to do at home between each session to retrain the brain. It is a step-by-step process to, which slowly but surely, builds up to improvement. By creating solid ocular motor ability, binocular stability and being able to use your vision without effort and fatigue you can enjoy the benefits of vision therapy for a lifetime.
Following the specialist vision assessment you will receive a summary of observations and also recommendations on what should happen next which may include a spectacle prescription or therapeutic lenses, colorimetry assessment or vision therapy exercises that will require equipment. The majority of this equipment will often be provided, however for some equipment, the patient would be required to purchase the item.
Often when there are signs of visual stress a tinted lens or coloured overlay can be given to make vision more comfortable, especially for near tasks such as reading and screen work. Although the tint in the lens or overlay does not solve the reason for the visual issues in the first place, it can immediately help make using vision easier and less stressful, often improving visual performance at school and work straight away.
We have the very latest in colorimetry technology, the Cerium Curve. If a tint is found to be beneficial, your precision tinted lens can be individually designed for you using sophisticated computer screening and then glazed into your chosen frame within a few weeks. It is essential to have a specialist vision assessment and eye health examination before using the colorimeter. If the optometrist feels a tinted lens may help, they will suggest an Intuitive Colorimetry coloured overlay screening. This will establish whether a tinted lens may be helpful, and if a specific spectacle prescription is required. Tinted lenses are often combined with vision training as from the specialist vision assessment the reasons for the visual stress or visual issues will be investigated and vision therapy will give long term benefits and solutions.
Emma Drewery is an experienced optometrist specialising in behavioural optometry and practicing optometric vision therapy. She is one of only two optometrists in Scotland who are accredited to the British Association of Behavioural Optometrists (BABO), and she is also a member of the American Optometric Extension Program Foundation. She holds a diploma in Sports Vision and is a facilitator on courses held by BABO as well as a member of the BABO education committee. Emma regularly receives referrals and is called upon to provide behavioural optometry expertise and opinion to other professionals including teachers, occupational therapists and fellow optometrists.