Most visual/perceptual skills are learned, and can generally be improved with practice under supervision. Many visual problems can’t be corrected by glasses or contact lenses alone – visual training may be prescribed to treat some conditions, and to help patients learn or re-learn specific visual skills. There is no “typical” program, since each patient will have individual needs. Patients may receive in-office treatment once a week, and could be given exercises to practice at home. They may be prescribed a set of lenses to support the visual training management. Those patients who are motivated, willing to practice and follow instructions usually achieve significant improvements.
Some of the important visual skills that need to be monitored are:
Visual Problem Solving Style
- Does your child have trouble with visual detail, needing to touch things instead of just visually expecting them?
- Right/left awareness, the position of objects in relation to themselves, also known as spatial awareness
Visual Analysis Skills
- The ability to make judgments on size, shape, position and distance of objects. The ability to copy forms and visualise them in different contexts
- Can your child visually plan and perform a task in a defined spatial area?
Eye Movement Control
- Can the child follow moving objects, focus from far to near to far, and do so without undue effort or strain?
Eye Focus Skills
- Can the child shift focus from near to far & back again, while maintaining clear vision?
Eye Teaming Skills
- Do the two eyes work well together for both near and far tasks, without undue stress or fatigue?
Good vision habits
Developing the following good habits can protect and improve your vision:
- Take breaks every 20 Minutes or so when reading, studying or doing close work. Look up, focus on other objects around you, close your eyes and roll them widely a few times. Then you can resume your work
- Work distance is important – don’t hold your book or work too close! Knuckle to elbow distance between your eyes and the book is ideal
- Good lighting – make sure your work is adequately lit. Room lighting is fine so long as it also illuminates the reading matter
- Good posture is vital - Don't read in bed or whilst reclining. Knuckle to elbow distance is recommended, and eyes should be used equally
- Angle of work surface – Slope-topped desks are recommended because they encourage a balanced body posture
- Watching TV – Don’t sit closer than you have to, and ensure the room is well lit. Limit children’s time in front of the TV, as vision develops better during activities such as reading and active play
- Alternate close work with activities – Intensive use of eyes (ie. when studying) should be alternated with periods of outdoor play or sport, which requires distance vision.
- Don’t overdo it when you’re sick – Your body’s energy reserves are lowered and visual skills will be reduced. High fever can damage the visual system.
- Don’t read in the car – The movement of the vehicle puts too much strain on your eyes when focussing and teaming
- Glasses – Make sure you understand their purpose (for near or far vision, or constant wear). Make sure they are kept clean, well adjusted and worn straight on the face
- Good writing grip – Should be between thumb and next two fingers, and allow you to see the tip of the pencil while writing. Ensure the work angle & posture is correct. A rubber pencil grip can help encourage good grip (available from the ACBO Shop)
Vision therapy activities
Optometric vision therapy can include many activities, some of which are shown below. A Behavioural Optometrist will design a program of activities in the appropriate sequence to meet each patient's individual needs and goals.
Timing Swing Ball
Attach a ball with a string to the ceiling, get a friend to hold the ball and release it towards you. Use your hand to gently bat the ball, whilst simultaneously stamping your foot on the floor. Your assistant must tell you which hand & foot to use each time.
Cover one eye, then hold your thumb in front of the open eye. Move your thumb up & down, left & right, diagonally, and in circles. Try to follow your thumb without straining your eyes or moving your head. Try to achieve smooth, fluent eye movements.
Move your focus from a book held in front of you, to an object in the distance, then back again. Try it with the left eye, then the right, then both together.
- Hold the circles 40cm away from your eyes, and a pencil 15cm away from your eyes
- Look carefully at the top of the pencil and notice how the circles look
- Adjust the circles and the pencil until you can achieve a fusion, a three-target effect
- Hold the central target fused and notice how the inner circle appears closer than the outer circle, with a cat in the centre
- Keep the target fused, and clear and move the circles slowly in and out
With practice, you should get in to 25cm and out to 50cm
- Hold the circles 10cm away from your eyes, and look 'through' them
- Move the circles until you can achieve fusion and three targets
- The centre fused target will appear to have the inner circle behind the outer circle, with a cat in the centre
With practice, you should be able to keep the fusion target clear and single, and be able to move the circles in to 25cm and out to 50cm
- Repeat with the previous instructions using the circles below and discover the relationships
- Get two metres of string and two buttons
- Thread the buttons onto the string
- Tie one end onto a door-knob or the back of a chair
- Hold the other end to your nose
Look carefully from button to button, and notice the appearance of the string and also the buttons. The string should appear as an "X", crossing where your eyes are focused.
Efficient visual function is important - don't leave it to chance
Have your child examined at the ages of 6 months and 2 1/2 years, before starting school, and yearly thereafter. A school vision test is not enough - you should consult a Behavioural Optometrist regularly.
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