The Wow Vision Therapy Blog

Early intervention critically important in children's vision problems

When is it OK to "wait and see" if the problem goes away on it's own?

What if your 6 year old child has been diagnosed with a binocular vision problem that appears to be interfering with her learning to read? You are seeing behaviors that look like she can't concentrate on books. Her teacher is spotting some signs of trouble but can't be sure that it is "her eyes". You take her to an eye doctor who makes the diagnosis of a binocular vision problem called convergence insufficiency but dismisses treatment "for now" and opts for monitoring the problem. But, is it really ok to just wait and see?

As strange as it may sound, an outdated approach often recommended by many eye doctors when faced with a young patient (often 4-7 years old) diagnosed with certain forms of eye coordination problems, such as convergence insufficiency, is to simply monitor the condition and see if it goes away it's own. In other words, no treatment is recommended.

In response to this and other vision problems in children, the University of Oregon Brain Development Lab has just produced this video on vision and the developing brain. See what the neuroscientists and the research is showing about the importance of early intervention.

Then check out the story of a mom (below) who wouldn't accept "NO" for an answer when told that her 6 year old daughter (with convergence insufficiency) was too young to be treated.

Find out how a persistent mom dealt with this problem with her own 6 year old daughter. Read the heartwarming and inspirational story from Paige Melendres in Albuquerque, who was not comfortable with the "wait and see" recommendation by her first doctor.  Her story can be found by clicking on  CI:The Private Eye Goes Public -Part 1 and scroll down to comment #8. Her story has a happy ending and good advice for parents who may have a child who is struggling.

CI: The Private Eye Goes Public is a  VisionHelp Blog investigational series written by Dr. Leonard Press and Dr. Dan Fortenbacher dedicated to uncovering the important public health and patient care issues surrounding convergence insufficiency.

Dan L. Fortenbacher, O.D., FCOVD

A Hidden Epidemic? Parent Back-to-School Oversights – by an MCO Intern

The summer is winding down, and back-to-school is on almost every parent’s thoughts.  As a “doctor in training”, I’ve been thinking about my amazing summer internship at The Michigan College of Optometry externship site, Wow Vision Therapy in St. Joseph, Michigan.  What especially amazed me was the number of children that we see in this clinic that have learning-related component to their vision problem.  At the beginning of each child’s treatment plan, we ask the parent what they expect vision therapy will do to help their child.  Almost every patient has school-related goals.  In optometry school, we talk about the fact that 1 in 4 children suffers from an undiagnosed vision problem and that 1 in 8 children suffers from a binocular vision problem known as Convergence Insufficiency, but until I came to this practice, I didn’t realize just how many families are affected by this.  When a child struggles in school, it’s not just a problem for them; the entire family is affected.

 

Seeing so many children with vision problems causing them to struggle in school  made me start thinking about how these children even began to realize that they had a vision problem.  I have had the opportunity to speak with a number of our patients’ parents.  It’s amazing how often I hear that the visual system was the last thing on their minds when their child started to have problems in school.  Vision-related learning problems can often manifest in ways that don’t always suggest that the visual system is at the root of the problem.  Common symptoms include problems with reading comprehension or fluency, avoidance of reading, headaches or eyestrain after near work, poor handwriting, or attention problems.  It’s easy to think that these problems could be academic or behavioral, but a visual dysfunction can be all-too-often to blame.  Imagine how hard it would be to pay attention or to be interested in reading if the words were doubled on the page or looked like they were moving around!  It would be hard to read efficiently or have neat hand writing if everything you see up close is blurry! 

 

Detecting vision-related learning problems can be a difficult task for parents.  I often hear that the child had a school vision screening, but they passed with 20/20 vision!  Now I’m starting to remind parents that 20/20 vision is only a small piece of the puzzle.  Most people think of 20/20 as “perfect vision,” but there are a whopping 17 skills that are necessary for efficient learning!  A list of these skills can be found at the COVD website on Children's Vision and Learning Month.  Children who struggle with these skills may not realize that they have a problem.  They don’t know how other people see, so they may not realize that they should not have to struggle to keep their vision clear, comfortable, and single. 

 

The best way to make sure that you child does not have a learning-related vision problem is to have a comprehensive eye exam from an optometrist who is trained to identify and recommend the necessary treatment for vision-related learning problems.  The American Optometric Association has outlined the best practices for this in a Clinical Practice Guideline (CPG) entitled Care of the Patient with Learning Related Vision Problems. In this CPG, under Early Detection (pg 8-9) it says, “because the evidence that learning related vision problems can be prevented to any substantial degree is inconclusive, the emphasis is on early detection. It is recommended that vision examinations be scheduled at 6 months, 3 years of age and at the entry into school…” Too often, parents rely on school vision screenings to tell them if their child has a vision problem.  These, however, may not be enough.  School screenings usually test for only distance visual acuity and possibly any overt eye muscle problem. This leaves out the vast majority of the 17 necessary skills.  Even with the screenings in place, 1 in 4 children suffer from undiagnosed vision problems!  A comprehensive vision examination with a focus on the vision problems that can affect learning will detect these problems before your child begins to struggle in school.  It is with these insights that I hope will lead to fewer parent oversights. For those parents who read this story, make sure your child is seen by an optometrist who knows how to recognize the 17 vision skills! Make a comprehensive vision exam a priority to your back-to-school checklist this year!

 

To find out if your optometrist will recognize a vision-related learning problem simply use the 17 skills checklist and ask before making your appointment. You can also contact the American Optometric Association at www.aoa.orgor  College of Optometrists in Vision Development at www.covd.org for assistance.

 

April A. Jones

4th Year Intern, Michigan College of Optometry

Help your child become a piano virtuoso with simple finger exercises!

What if your child is struggling to play the piano? Let say he is a bright 10 year-old boy who finds playing the piano difficult.  He just doesn’t get it! You ask yourself, why is he having this difficulty…he just seems to be unable to coordinate his fingers to play?   So, as any concerned parent, you seek professional help. But first,  you go on-line to research the possibilities for a solution to this problem and stumble across a website that says,   “Help your child become a piano virtuoso with simple finger exercises!”

Now wait a minute, that’s hard to believe right!? We all know that is illogical.  Doing simple finger exercises will not teach anyone how to become a skilled piano player! His fingers are strong enough to move the keys on the piano, his brain just does not know how to coordinate his fingers to play the music. The answer to his problem is found when you locate a good piano “coach” who can guide him along a process of learning the skills for playing the piano. Then with practice he will improve.  So, you dismiss the internet offer as another example of someone trying to promote an unproven and implausible self-help program.

Now let’s consider another scenario.  This time it is your 10-year-old son who is struggling to read and keep up in school. He  loses his  place easily when reading. He is  having trouble concentrating on a reading task and become very frustrated. He says his eyes hurt and sometimes he gets a headache when he reads. It sounds like he could be having a vision problem.

So you seek professional help and schedule him to have his eyes examined by your family optometrist, Dr. A.  Your son has his eye exam with Dr. A. and what you learn from the doctor is that his eyes are healthy and he has normal 20/20 eye sight. But,  he is having difficulty with coordinating his eyes together as a team when he tries to look at a book to read. Specifically he has trouble with his binocular vision (eye teaming). The doctor called it Convergence Insufficiency(CI). As it turns out, Convergence Insufficiency occurs in about 8-12% of children; affecting about 21.5 million people in the US (adults included).  Often times a person with CI (especially children) will experience symptoms involving  stress and strain around the eyes and have occasional double vision and avoidance behaviors. Often these symptoms look like ADD (Attention Deficit Disorder) too.

Doctor A. turns to you and says your child has a problem with proper eye coordination. His visual brain has not developed the correct neuromotor coordination abilities resulting in poor eye teaming when he attempts to do near vision work. This condition is treatable with 25-30 hours of office-based, doctor supervised, optometric vision therapy. While Dr. A.  does not provide this service in his office, he recommends another doctor whose practice is dedicated to treating patients with office-based optometric vision therapy and makes the referral.

Gosh, you were hoping for an easy fix like a new pair of glasses!  But what you are hearing is that it is much more complicated and will take several trips to another doctor over an extended period of time.

In the mean time, you think about it and decide to check around on your own and take your son to another doctor, Dr. B. for a second eye examination.  Dr. B. completes his eye exam of your son and agrees with the diagnosis…yes, he has CI. But this doctor’s approach is entirely different.  Dr. B. describes the problem with your son’s eyes is that he just has “weak eye muscles”  which need to be strengthened. He advises you that  your child’s problem can be solved  with some simple “eye exercises”! All you have to do is make his eye muscles stronger by asking him  to look at the tip of a  pencil as you move it closer to his nose.  In addition you are given some “work books” that have your son doing “tracking exercises”. You are puzzled by the lack of consistent treatment recommendations between the two doctors but since the recommendation is coming from a doctor, it must be true…right? Besides he accepts the minimal payment by your insurance and the treatment plan sounds a lot easier than what Dr. A was recommending. 

So…who do you believe? Why if both doctors agree on the diagnosis, don’t  they agree on the method of treatment? Who has got it right, Dr. A or Dr. B?

First, let’s remember the first example of the 10-year-old boy who was having trouble playing the piano. Is it logical to think that doing simple finger exercises will help him learn how to successfully play the piano? The answer seems pretty obvious right?

Surely the coordination of a person’s eyes is equally as complex as coordinating ones fingers to play a piano. So it would seem illogical that doing simple eye exercises would be effective at treating a problem with both eyes coordinating when attempting to read. However, over 50 years ago, many doctors were  taught that Convergence Insufficiency (CI) was a problem with eye muscle strength. While techniques in the area of visual rehabilitation were also beginning to emerge about that time, there were still some text books that the had the old-fashioned remedy for CI as just  a “series of simple eye exercises”. The problem was that the eye-exercise model of treatment was based on an assumption and not based on research.  Therefore, many doctors to this day still hang on to an old outdated model of treatment that was never based on proven research. 

 Therefore the answer to the question, “Who has got it right, Dr. A. or Dr. B”,  can only be answered based on double-blind multicenter research. What’s more, the research on the best methods to treat CI  was completed in 2008. It is a landmark study called the Convergence Insufficiency Treatment Trial (CITT). The CITT was funded with a $6.1 million grant  by the National Institute of Health and conducted through the National Eye Institute along with several sites around the country including Mayo Clinic and Bascom Palmer plus 6 Colleges of Optometry.

What this double-blind, multicenter research did was to compare office-based doctor supervised vision therapy (OBVT) to home based eye exercises called “pencil push-up therapy” as well as compared to a placebo, called “placebo therapy”

What did the research prove? It found that the “eye exercise therapy” had about the same effectiveness as the placebo. In fact the research proved that both the “eye exercise therapy” and the placebo therapy were found to be ineffective in treating Convergence Insufficiency.

However, office-based vision therapy was found to be effective and in subsequent research found to be the cure for convergence insufficiency. Dr A was correct!

The research is clear. So why do some doctors persist to advise patients about old-fashioned and ineffective treatment for Convergence Insufficiency? This can be difficult to answer in each case, but certainly when this condition, Convergence Insufficiency (CI) is accepted by the entire optometric and medical community as an important public health issue, then and only then will the majority of doctors get it right.

To address this fundamental public health problem and its realitive importance in the eye-care community, I wrote an article that was published in the Journal of Behavioral Optometry (Vol 21/2010/#2) entitled:  "Does Convergence Insufficiency Really Matter"(download)

Dan L. Fortenbacher, O.D.,FCOVD

Children Vision Problems and why some doctors don't tell you... Answers found with Cats who Succeed

In my practice that specializes in vision therapy, the majority (about 70%) of our patients find their way to my care from a direct referral from another doctor or rehabilitation professional. Yet there are a significant number of patients, (often children) who are referred by a parent of a past patient who recognizes behaviors in a child that looks like what their own child struggled with before coming to see us for vision therapy.

This represents about a third of our practice that come to us directly because of a parent, teacher or friend who saw behaviors or recognized the problems described by the other parent. That means many children somewhat serendipitously find their way to our care because of a thoughtful  "goodwill ambassador" past patient or friend.

This group of patients are typically the kids with vision related learning problems. There can be a variety of clinically presenting conditions but some of the more common diagnoses are convergence insufficiency, accommodative dysfunction or oculomotor dysfunction or a combination of all three.They may also have a visual processing problem resulting in letter reversals, difficulty with visual memory and/or hand-eye coordination.

When a child has a vision related learning problem, it is also interesting to note that the diagnosis is typically very obvious as I will demonstrate to the parent directly their child's trouble with the sample visual test  and then let the parent see for themselves usually how effortless the test is if they have normal abilities. Once we establish the diagnosis and determine that this child has a vision problem that can be effectively treated, there is typically a three part response by the child's parents.

First there is a sense of relief that finally  a visual explanation has been found that answers why their child has struggled and it is not because their child was "not smart enough" or "not trying hard enough" and they are not "bad parents".

Second  there is a feeling of hope for their child's future because the solution I present just makes sense. We provide the "best practice" delivery of care, doctor supervised office-based vision therapy that is a proven and effective treatment and I have a solid track record of 30 years experience in this specialty.

Thirdly the parents then experience a momentary feeling of regret and disappointment (sometimes anger) that their previous eye care professional who saw their child did not not recognize the problem in the first place. As a result of overlooking their child's vision problem their child had to deal with often years of frustration and emotional side effects. It is this group of parents who will ask me, "Dr. Fortenbacher, why did our child's previous eye doctor not tell us about this problem with our child's vision?" Often I can not honestly say why with certainty, but try to emphasize the positive, we can leave the past behind and move forward now to solve the problem.

However now I'm pleased to have a better response to this question. Thanks to my friend and colleague, Dr. Leonard Press who has written 3 wonderful articles on The VisionHelp Blog there is now an answer to  the proverbial question, "Why did our other eye doctor not tell us about this problem?" The answer can be found in CATS WHO SUCCEED.

CATS WHO SUCCEED – Part 1

CATS WHO SUCCEED – Part 2

CATS WHO SUCCEED – Part 3

Dan L. Fortenbacher, O.D., FCOVD

3-D Vision Syndrome...linked to "ADD-like" behaviors in children

{Authors note: Coincidently today,  just before I was about to publish this blog article, I examined a 5th grade (11 year old) girl who has been struggling to concentrate in school for the last 3 years.  Her teachers thought she had ADHD since she could not concentrate on reading or paper pencil activities for more than a couple minutes. When asked about her interest in the new 3-D movies her mother reported that they just give her a headache and she shuts her eyes! Until recently, her mother never suspect a vision problem since she had always passed the school vision screening with 20/20 eye sight. But, the frustration and headaches with reading prompted her to make an appointment for her daughter to see an optometrist. The primary care optometrist recognized this little girl's poor attention and concentration was due to a binocular vision problem called convergence insufficiency and referred her to see me for a specific diagnosis and treatment. This article was written for her and the millions of other children who continue to struggle with treatable binocular vision problems (like convergence insufficiency) that causes poor attention, concentration and reduced ability for near-centered visual tasks, such as reading and paper pencil activities. These kids also typically do not enjoy the new 3-D movies because of a condition known as 3-D Vision Syndrome... dizziness, discomfort and poor depth perception  while watching a 3-D movie.}

A link between 3-D Vision Syndrome and a treatable binocular vision problems associated with "ADD-like" behaviors in children is being recognized. Not only has the advent of 3-D technology hit the bit screen, but  soon will become common place in the home as the next wave of 3-D televisions. However, for children to enjoy the 3-D visual experience requires that they have developed an essential visual function called binocular vision. Binocular vision involves the ability to effectively coordinate, focus and move the eyes effortlessly. This eye coordination function develops normally in early childhood for most kids however, research shows that as many as 10-15% of children will have difficulty in binocular function. Some children (3-5%) will have a total lack of binocular ability due to a complete failure of binocular vision known as strabismus. These children will have no appreciation for 3-D movies or 3-D television because these children are completely stereo blind.

On the other hand, another more common form of binocular vision failure affects 7-10% of the population and has more serious symptoms. Stereo blindness is less severe in these cases because these children have the general ability to coordinate their two eyes, however they just do it very poorly! As a result, instead of having fun with the three dimensional entertainment experience, these children will often experience dizziness, visual discomfort and reduced depth perception while watching the 3-D movie; what is now being called the 3-D Vision Syndrome. A look into the cause of this "visual stress", optometrists will often find that the patient who complains of 3-D Vision Syndrome will have a diagnosis of a binocular vision problem called convergence insufficiency (CI).

It is no strange coincidence that convergence insufficiency (CI) which has been linked with 3-D Vision Syndrome is also associated  with "ADD-like" behaviors in children due to the inability for the CI individual to sustain binocular alignment and focus of the two eyes for near-centered visual tasks such as reading. As a result parents whose children experience dizziness or discomfort associated with a 3-D movie or TV should seek a Doctor of Optometry for a comprehensive vision examination. Don't forget to mention your child's symptoms to the doctor as routine eye health and eye sight testing will not identify a child with convergence insufficiency (CI). Rather a battery of specialized tests are necessary to properly diagnose problems with binocular vision such as convergence insufficiency.

When diagnosed with CI a patient can be effectively treated with office-based vision therapy which has been found, though double-blind research, as the only effective treatment yielding an effective "cure" in most individuals. While outcomes can vary, the usual result of office-based vision therapy for CI is complete remediation of the binocular vision dysfunction and improved ability to visually attend and participate in near centered visually demanding tasks. That translates to better concentration and ability to stay on task improving competency for completing reading and homework...and enjoyment of the 3-D movie or TV experience!

Dan L. Fortenbacher, O.D., FCOVD

 

 

 

 

Research shows link...eye movement predictor of academic success

"Eye movement is a predictor of academic success". This month marks the 10 year anniversary when the Harvard University Graduate School of Education made this announcement. The research clearly shows that there is important association between effective eye movement control and academic success.

Ever since this breaking news a decade ago, further evidence of the association between eye movement and academic success continues to be recognized. For example, in Volume 27 Issue 8 of the Journal of Brain Development in 2005 the titled research is, the Voluntary Control of Saccadic and Smooth-Pursuit Eye Movement in Children with Learning Disorders.

While the testing of eye movement is relatively easy, the clinical presentation of poor eye movement control can often be missed and misunderstood. For example the testing of smooth-pursuit  eye movement control can be easily performed with a bead on a stick or the tip of a pencil or pen. The examiner simply asks the child to look at the target (held about 10 inches from the nose) and follow it with their eyes as the target is slowly moved horizontally, vertically (on the midline) and in a rotation. The child should be able watch the moving target with minimal head movement. Furthermore, the child who is years and older, should be able to "visually track" the target with a minimal amount of distraction such as asking simple questions (cognitive loading).

With the advent of web-based professional networking sites, like Sovoto, a platform now exists to help doctors and other professionals who work with children to see an example of a child with oculomotor dysfunction. To see an example of a child with oculomotor difficulty that was associated with his reading difficulty click here.

The American Optometric Association has published the symptoms of eye movement disorders in the Optometric Clinical Practice Guideline (CPG) Care of the Patient with Learning Related Vision Problems. They are:

• Moving head excessively when reading
• Skipping lines when reading
• Omitting words and transposing when reading
• Losing place easily when reading
• Requiring a finger or marker to keep place when reading
• Experiencing confusion on return sweep phase when reading
• Experiencing illusionary text movement
• Having deficient ball playing skills

More importantly, once identified, the child who is diagnosed with a problem in eye movement, such as smooth-pursuits, can be treated with vision therapy. Specifically office-based optometric vision therapy provided by a vision therapist (supervised by the doctor), can effectively treat disorders of voluntary eye movement. The results can often be a dramatic improvement in the child's reading efficiency.

To see the same patient after 24 sessions of office-based vision therapy click here. His reading efficiency and fluency has improved and he is enjoying reading!

To learn more about optometric vision therapy  and find a doctor who provides office-based vision therapy visit the COVD website at www.covd.org

Dan L. Fortenbacher, O.D.,FCOVD

 

 

 

Signs and Symptoms of a vision-related learning problem...Teachers need to be on the look-out!

In Michigan, school officially begins the first day after Labor Day. Students are eagerly coming into the classroom and teachers are ready with their lesson plans. The parents have high hopes for their children.

However, some children will be entering the classroom with a hidden vision disability. These are bright children who are smart enough to catch on quickly particularly with verbal teaching presentation yet when given visually demanding reading or written tasks they will begin to have problems. Yes, studies show that about 5-15% of children in the classroom will have performance problems caused by an underlying vision-related learning problem. Teachers need to be on the look out for these signs and symptoms.

What does it mean when a child has a vision-related learning problem?

A vision-related learning problem describes the signs, symptoms and behaviors of a bright child who under-performs in reading and learning due to one or more deficiencies in vision development. These deficiencies in vision development have a medical diagnosis and are treatable with office-based vision therapy.

Even though a child may have normal eye sight (20/20 visual acuity), to be visually ready, a child must enter the classroom with over 15 visual skills essential for reading and learning. These visual skills encompass eye-coordination, visual perception and visual-motor integration (eye hand coordination).

Below are examples of the essential “eye-coordination” visual skills necessary for reading and learning:

Eye teaming skill – the ability to coordinate the two eyes together is called Binocular Vision. A child who lacks Binocular Vision skill will often experience eye strain, fatigue, poor attention and avoidance of reading activities. The child will often experience words over lapping with extended reading, yet will rarely tell their parents that they are seeing double. Imagine how strenuous is would be if while reading you were seeing double.

A common medical diagnosis is Convergence Insufficiency.

 

Eye focusing skill – the ability to focus our eyes for sustained reading as well as shift focus from near to far when copying from the chalkboard requires good eye focusing known as Accommodation. A child who lacks Accommodation skill will often miscall easy words, complain of headaches with reading, tire easily and have poor attention and concentration for reading. The child may complain of blurred vision while reading or will just give up quickly when reading.

A common medical diagnosis is Accommodative Dysfunction.

 

Eye tracking skill – the ability to “point” our eyes on the printed material as well as skillfully move our eyes from word to word and through rows of sentences is known as Oculomotor function. A child who lacks Oculomotor function will typically lose their place easily when reading. They often require the use of their finger to keep their place on the page. The child with poor eye tracking will be much slower in their reading and have poor fluency and comprehension. They will lose attention easily and have difficulty coping from book to paper. It is hard to pay attention what the meaning is when words seem to jump around on the page.

A common medical diagnosis is Oculomotor Dysfunction.

 

When a child has a medical diagnosis in one or more these essential "eye coordination" vision skills, your doctor may prescribe treatment involving office-based vision therapy which may also include prescription reading glasses. With treatment a child can acquire the necessary “eye coordination” visual skills essential for better performance in reading, learning and attention in the classroom.

 

It is important for teachers to be on the look-out for these signs and symptoms. It is equally important, however to be sure to recommend a doctor in your area who looks for these problems in children and will prescribe office-based vision therapy (if necessary) or refer to a doctor who provides office-based vision therapy. One good source to find a doctor is the College of Optometrists in Vision Development. Click on Doctor locator.

 

Dan L. Fortenbacher, O.D., FCOVD

 

Vision-related Learning Problems...parents be aware, 20/20 sight is not enough!

Your child may not be visually ready for school due to a vision-related learning problem even though they have excellent eye sight (20/20 or better). How can that be? Your child's visual "readiness" for learning involves over 15 visual skills. It is very important for parents to have their children's vision evaluated before school to make sure that they have good eye health, eye sight AND to see if they have the essential visual skills that are critical for reading, learning and attention and concentration.

Public awareness is growing for children's vision-related learning problems. August is the National Children's Vision and Learning Month.

Helping to spread the word about vision-related learning problems,  two of the nations top doctors in developmental vision and vision therapy have been interviewed by TV News stations. The following news segments provides vital information to parents.

First, lecturer, private practitioner and recipient of the prestigious the COVD 2008 GN Getman Award, Dr. Carl Hillier from San Diego: Click here to view Dr. Hillier.

Second, private practitioner and Vice President of the College of Optometrists in Vision Development Dr. Carole Hong from San Francisco: Click here to view Dr. Hong.

It is important that your child be tested prior to school by a primary care optometrist who is experienced with children's vision problems. An important question to ask your doctor is, "If my child has a vision related learning problem do you either provide or will you refer me to a doctor who provides office-based vision therapy?"

Dan L. Fortenbacher, O.D., FCOVD

Reading and Attention Problems Found with Common Eye Condition in Children ...A Proven Treatment for Convergence Insufficiency

Parents, teachers and health care professionals should see this video by the National Eye Institute. Too often children with reading and attention problems are overlooked in the healthcare delivery system, labeled with ADHD, learning disabilities and/or behavior problems when instead they have a common undiagnosed eye condition known as convergence insufficiency (CI).

Watch this video and see what the director of the National Eye Institute (NEI), researchers as well as a mother of a child who had CI, have to say. The results of the National Institute of Health (NIH) "double blind" multicenter research project completed in 2008 found that the only proven treatment for CI is office-based vision therapy. Other approaches such as home based remedies or prism glasses are not effective.

Children with CI often have symptoms that can impact reading, learning and attention. After treatment the patient will often show dramatic improvement in reading, learning and attention and concentration for near vision visual tasks.

At Wow Vision Therapy, office-based vision therapy is provided by a Doctor supervised Board Certified Vision Therapist along with vision therapy assistants.  Once successfully treated, the results are life long without the need for further maintenance treatment.

Dan L. Fortenbacher, O.D., FCOVD

David's Story...Binocular Vision Problems can Cause Reading and Learning Problems

When a child struggles in reading and learning it is critically important to have their vision evaluated for not only eye health and eye sight, but also binocular vision. A child who has a binocular vision problem, such as convergence insufficiency(CI) or intermittent exotropia will typically experience reading and learning problems. Study's show that approximately 5% of children in the classroom have CI.

 

Parents should rely only on the advise of  eye doctors who are experienced in working with children. Too often a child with a binocular vision problem will needlessly struggle because of misinformation or lack of a proper diagnosis.  David's story is a good example of a child who struggled for 4 years before his mother found help.

Dan L. Fortenbacher, O.D., FCOVD

 

               David's Story

David was identified with a vision problem by the county vision screening in kindergarten (he failed the depth perception or ball in the box test).  He was referred to see an eye doctor.  David was originally seen by an ophthalmologist and diagnosed with intermittent exotropia in his left eye.  He had 20/20 vision and seemed to have excellent control of his exotropia.  The doctors believed that David would compensate for his vision problems and these problems were believed not to have any effect on his tracking abilities or learning skills.

 

David seemed to be fine in his developing skill set, however, by the end of first grade, he began to struggle.  He started to have headaches and tummy aches before school, when doing homework, and while riding in the car.

 

 David’s struggle continued into second grade causing him to fall further behind in reading and develop a strong dislike for school.  Soon we attended and consulted another veteran ophthalmologist for a second opinion.  Tutoring seemed to help, but still did not seem to solve the problem completely.  The second ophthalmologist again stated that vision was not the cause of learning difficulty.

 

In third grade we were referred to Dr. Seim’s office at Mattawan Family Eye care who suggested that David’s vision was causing possible double & unclear vision affecting not only his reading, but all facets of learning.  She suggested that David see Dr. Fortenbacher at Wow Vision Therapy in St. Joseph for further testing and treatment.

 

THANK YOU … Debra (his vision therapist), Dr. Fortenbacher, and all vision therapy staff at Wow Vision Therapy.  David has now completed vision therapy. He has gained confidence in himself, and no longer dislikes school.  David no longer gets headaches when he reads, plays video games, does homework, or concentrates in the car.  ** David is now a successful 4th grade student currently pulling an "A" in Mathematics, a "B" in Language Arts, and an "A-" in Reading! (Not bad after the public school recommended he not move forward to 4th grade.)

-Terry Elenga, David's mother