Frequently Asked Questions

Vision and Learning

Vision is a complex process which involves more than twenty visual abilities and about two-thirds of the pathways into the brain. Visual skills are usually acquired as we grow and mature, but a variety of factors can interfere with this development. Prolonged repetitive tasks such as computer use, as well as developmental delays and brain injury, can lead to imbalances and deficits in visual skills.

Most learning – nearly 80% of what we perceive, remember, and comprehend – is visual. Effective processing and retention of information requires the ability to quickly gather information and to accurately transmit it to the brain.

Most learning-related tasks are done at the close range of a desk or computer, not at the 20 foot distance used to measure visual acuity on a standard eye chart test. Even with “20/20” vision, a child or adult may lack the visual skills necessary for close work.

When individuals struggle with school, are slow or reluctant to complete assignments, have difficulty deriving meaning from what they read, or achieve at a level below their capabilities, there may be an underlying visual system disorder which makes learning difficult and stressful.

Glasses, while a solution for some vision problems, cannot compensate for a lack of visual skills. Invasive and inexpensive solutions such as surgery can generally be avoided. Remedial tutoring is often ineffective because it does not address the real issue: a need for improved visual skills to facilitate learning.

Vision therapy works by developing the visual skills that provide a solid foundation for learning.

What is vision therapy? 

Vision therapy is a carefully programmed series of visual exercises which are designed to enhance and develop visual skills. A patient works with a vision therapist in 45-minute weekly sessions, learns and practices the appropriate exercises for his or her specific case, and does about 20 minutes of daily “homework” exercises designed to assist in the development of the visual system and to reinforce the newly acquired skills. The process typically extends over a period of months, depending on the specifics of the individual case.

What are the benefits of vision therapy? 

When visual skills are underdeveloped, damaged, or imbalanced, a program of vision therapy works to improve these abilities. When a person has difficulty with activities such as driving, reading, or catching a ball, there may be an underlying visual system disorder which can be addressed with vision therapy.

Humans are born with eyesight, and that is what is measured by an eye chart test. As we grow and mature, however, we must develop the skills to use our entire visual system – the complex array of skills we use to transmit information from the eyes to the brain.

Experts have noted an increase in visual system deficiencies in the last thirty years, as games such as hopscotch, baseball, and jacks have been replaced by more passive visual activities like television and computer games. Such activity provides less opportunity to practice visual skills, and the result is an inefficient visual system.

What are some symptoms I should look for? 

An inadequately developed visual system can be the root cause of an inability to achieve in school, work, and sports. Nearly 80% of the information we perceive, comprehend, and remember enters our brain through the visual system, so you or your child might experience a lack of concentration, poor recall or comprehension of texts, headaches, and fatigue.

Current research indicates that about 1 out of 4 school-aged children have vision problems which interfere with their ability to succeed in school. Some signs you might watch for in your child include: squinting, eye rubbing, blinking, or moving the head while reading, and head tilting or closing one eye. A child might frequently lose his or her place while reading, reverse letters when copying, misalign numbers or omit words.

A screening by a developmental optometrist can uncover and treat problems before they lead to failure!

Many times visual system disorders are overlooked or misdiagnosed. Children are labeled lazy or hyperactive, and adults lack self-esteem and report that they are irritable, tired or unable to achieve their goals.

Watch for these symptoms:

  • Headaches

  • Blurred vision/focus goes in and out

  • Double vision

  • Sensitive to light

  • Eyes hurt

  • Eyes tired

  • Words move around on the page

  • Motion sickness/car sickness

  • Dizziness

  • Redness of the eyes

  • Frequent eye rubbing

  • Frequent sties

  • Frowning

  • Frequent blinking

  • Closing or covering one eye

  • Difficulty seeing distant objects

  • Head close to paper when reading/writing

  • Avoids reading or other near tasks

  • Prefers being read to

  • Tilts head when reading

  • Moves head when reading

  • Confuses letters or words

  • Reverses letters or words

  • Confuses right and left

  • Skips, rereads or omits words

  • Loses place while reading

  • Vocalizes when reading silently

  • Reads slowly

  • Uses finger as a marker

  • Poor reading comprehension

  • Comprehension decreases over time

  • Writes or prints poorly

  • Writes neatly but slowly

  • Does not support paper when writing

  • Awkward or immature pencil grip

  • Frequent erasures

  • Tires easily

  • Difficulty copying from chalkboard

  • Poor word attack skills

  • Difficulty with memory

  • Remembers better orally than by writing

  • Knows material, but does poorly on tests

  • Dislikes/avoids near tasks

  • Short attention span/loses interest

  • Poor large motor coordination

  • Poor fine motor coordination

  • Difficulty with scissors/small hand tools

  • Dislikes/avoids sports

  • Difficulty catching/hitting a ball

  • Remembers better what hears than sees

  • Difficulty recognizing same word on different page

Who provides the therapy? 

Our vision therapy programs are overseen by Dr. Kelly de Simone, a developmental optometrist and Fellow of the College of Optometrists in Vision Development. Dr. de Simone has completed hundreds of hours of post-doctoral continuing education in vision development.

Weekly therapy sessions are conducted by Angela Barnes, B.S., currently pursuing board certification. Periodic progress assessments are conducted by Dr. de Simone throughout the course of therapy.

What is the success rate? 

Optometric vision therapy is a specialized area of optometric care, and has been shown to be an effective and permanent treatment for many types of visual performance deficits. Complete information on clinical research can be found at the websites of the following:

College of Optometrists in Vision Development
Optometric Extension Program Foundation

We are proud of the success of our patients, and we have a large file of their success stories displayed in our office. We will gladly provide references on request.

Why can’t I just get glasses? Does vision therapy make it so I won’t need glasses?

Glasses generally correct problems involving acuity, the ability to see clearly at near and far distance, and acuity is only one part of vision. Corrective lenses may be part of your treatment plan, and occasionally mild visual system issues can be treated through the use of glasses alone.

A treatment plan can include the use of glasses in combination with vision therapy, or vision therapy alone, depending on the individual diagnosis. Vision therapy, however, is not intended to be a substitute for corrective lenses.

What is the cost? 

Due to the fact that our program lengths are tailored to the individual needs of our patients, we cannot give pricing information until after testing has been completed.

Will vision therapy work for an adult or is it better for children? 

It is never too late to correct inadequacies in the visual system, and many of our patients are adults. Vision therapy can alleviate the physical and emotional stress which may result in irritability, lack of concentration, poor performance in work or sports, or difficulty with driving or other tasks.

Essential visual skills

Tracking: This is the ability to follow a moving object with your eyes. This skill allows us to follow a line of print when reading and to catch a ball.

Fixation: Vital to reading, this skill enables us to find and look at stationary objects in a series such as words on a page.

Focus Change: We use this skill constantly, whether while looking first at the road, then at our speedometer while driving, or looking up and across the room while we are at our computer.

Visual Discrimination: This skill allows us to quickly detect small differences in what we see. Accurate reading and spelling require excellent visual discrimination.

Binocularity: This is the ability of both eyes to point to the same place and move together accurately and smoothly – another skill vital to comfortable and efficient reading.

Depth Perception: This critical skill tells us exactly where things are, and is important for driving and sports performance.

Peripheral Pision: We use this ability to visually take in objects that are not in our direct line of sight. This skill helps us to successfully navigate through our surroundings, and is also used to direct us through lines when reading.

Visual Memory: This important skill enables us to picture in our minds what we have seen. When we give directions, locate an object we have put away, or tell a story, we are using visual memory.

Visual skills can be taught, practiced, and improved with vision therapy.

Lazy Eye

What is Lazy Eye? 

Amblyopia, also known as “lazy eye,” is the loss or lack of development of central vision in one eye. This condition affects about four million people in the U. S. and is not correctable with glasses or contacts.

Regrettably, eye muscle surgery is often performed to realign the eyes. Surgery produces a cosmetic straightening of the eye, but results are superficial and often temporary. Even in cases where surgery has already been performed, vision therapy can be used to improve functional visual skills.

Vision therapy works by retraining the brain and eyes to work together. Effective for both children and adults, vision therapy provides proven results that are permanent.

Sports Vision

What part does vision play in your sport? 

Most athletes have not considered the impact of visual skill on their sports performance, but a growing number of coaches and athletes are integrating vision training into their regimens. Improving sport-specific visual skills can give a player the competitive edge.

The public doesn’t realize that you need over fifteen visual skills to succeed in reading, learning, sports, and in life. Seeing 20/20 is just one of those skills.
— Larry Fitzgerald, Arizona Cardinals 2008 Champions' Wide-Receiver and 2008 Pro-Bowl MVP

Brain Injury Rehabilitation

What is Brain Injury Rehabilitation? 

Visual problems resulting from Acquired Brain Injury can have a significant impact on an individual’s ability to process information. Such problems are not always readily apparent, and are often overlooked during the initial phases of rehabilitation.

Symptoms of disruption to the visual system may include:

  • Blurred or double vision

  • Sensitivity to light

  • Fatigue, headaches or aching around eyes

  • Loss of visual field

  • Reading difficulty, words appearing to move

  • Difficulty with attention and concentration

  • Difficulty with comprehension and memory

Vision therapy can effectively improve the flow and processing of information between the eyes and the brain, improve control of the visual system, and help support activities of daily living.

It is surprising to realize that memory, learning, comprehending, doing multiple things in sequence are just a few of the activities related to vision. Vision therapy has given me back a big portion of myself.
— Gail G., Phoenix