Developmental Optometry

Developmental, or behavioral, optometry is an expanded area of optometric practice. Specialists in this field test for specific visual skills that are often related to learning.

Over the last century, our dependence on near-vision has increased tremendously as a result of the time spent with computers, television, and video games. It is estimated that students today read about three times as many textbooks as they did 50 years ago. This increased use of near-vision has placed additional strain on the eyes, and some experts suggest that vision difficulties have consequently increased.

Signs of Vision Problems

Teachers are in a good position to observe reading habits. Parents who suspect vision problems in their child should ask teachers if they notice signs of difficulty during class. These are just some of many possible indicators of eye problems that might respond to vision therapy:

Holds book too far
or too close

Squints eyes or opens
them wide

Places one hand over an eye

Blinks or rubs
eyes frequently

Loses place when
copying from paper

Has problems copying
from the board

Runs words together
when writing

Has difficulty keeping math columns straight

Skips words or lines; needs a marker when reading

Complains that text
is too bright

Complains that letters
blur or move on page

Schools often screen for vision with a Snellen chart or telebinocular instrument. The familiar Snellen eye chart does not diagnose focusing skills, depth perception, eye movement, or visual perception. Telebinocular screening does not provide information on visual perception, focusing skills or eye movements. Even a student with 20/20 vision can experience headaches, eyestrain, or fatigue as a result of a problem focusing both eyes. This can affect the student's comprehension, ability to pay attention in class, and overall school performance.

Recognizing the difference between acuity problems and vision problems is important. Underachievers often have average or better standard acuity yet are faced with unrecognized visual difficulties.

Vision therapy is a clinical approach to correcting eyemovement disorders, non-strabismic binocular dysfunction, focusing disorders, amblyopia, nystagmus, and certain visual perceptual disorders. A series of treatments is usually involved, based on the nature and severity of the problem. (A misconception exists that the only purpose of visual therapy is to strengthen the eye muscles.)

Treatment can range from a simple eye patch, as part of amblyopia therapy, to complex infrared sensory devices and computers that monitor eye position and provide feedback to the patient. Medical insurance, which sometimes does not cover eyeglasses, often covers visual training under the category of physical therapy. Vision therapists may prescribe stress-relieving and preventive lenses along with visual training. Not all optometrists practice behavioral optometry.

For More Information
Optometric Extension Program, 1921 E. Carnegie, Suite 3L, Santa Ana, CA 92635; phone: (714) 250-8070

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