Vision & Learning

Vision problems can lead to difficulties in reading and learning, even with 20/20 vision

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Strabismus / Amblyopia

We provide a non-invasive, therapeutic approach to treating these conditions

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Neuro-Rehabilitation

From light sensitivity to poor memory, vision problems are very common after brain injury

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Vertigo / Balance (Vision & Vestibular)

Dizziness and imbalance may be signs of a visual problem

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Conditions We Treat

Southern Oregon Vision Treatment

Vision is much more than 20/20 eye sight. Good functional vision involves clarity of vision along with the following:

  • Focusing – changing focus near to far, or maintaining near focus for extended periods of time
  • Eye tracking - accurate movement of the eyes, which is essential in reading and sports
  • Binocular vision - eye-teaming: both eyes pointing together at the correct place in space
    • Double vision is a condition that is often overlooked, but can cause serious avoidance of near work (reading)!
    • Strabismus, or an eye turn, is a binocular vision problem which can be treated with vision therapy
    • Amblyopia, or lazy eye, is also a binocular vision problem which can be treated with vision therapy
  • Visual perception - a big category that includes the following:
    • Visual discrimination, or “just noticeable differences”
    • Visual memory
    • Visual sequential memory – remembering a series of objects, letters or numbers
    • Visual figure ground – such as hidden pictures, or finding an object in a busy room, or even attending to the teacher when the room is full of distractions
    • Visual closure – seeing part of the information and inferring the rest of it
  • Body knowledge – understanding where I am in space
  • Bilateral integration – coordinated movement of both sides of the body
  • Space awareness – understanding where things are in space
  • Eye-hand coordination – letting vision guide your movement, which is essential for proper handwriting and sports activities
  • Vestibular / balance – helping the visual system be the “top dog” of the vestibular triad, which helps with motion sickness, car sickness and head injury rehabilitation

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Vision & Learning

Southern Oregon Vision Treatment Medford OR Double Vision Doctor

Signs of a vision-related learning problem: Any deficiency in the items listed above can cause difficulties with learning, including reading and sustaining attention. For example, intermittent double vision can cause print to look smeary, or like it’s moving on the page. This is very distracting and uncomfortable!

Symptoms of a vision-related learning problem: There are many potential symptoms, depending on the area of challenge in eye-brain processing. These symptoms include:

  • Holds things very close
  • Complains of blurred vision
  • Poor reading comprehension
  • Says eyes are tired
  • Able to read for only a short time
  • Has headaches when reading
  • Moves head excessively when reading
  • Frequently loses place when reading
  • Uses finger to keep place
  • Short attention span
  • Can’t distinguish the main idea from insignificant details
  • Mistakes words with similar beginnings
  • Trouble visualizing what is read
  • Poor speller
  • Trouble with mathematical concepts
  • Poor recall of visually-presented material
  • Sloppy handwriting and drawing
  • Can't stay on lines
  • Poor copying skills
  • Can respond orally but not in writing
  • Trouble learning right and left
  • Reverses letters and words
  • Trouble writing and remembering letters and numbers
  • Trouble learning basic math concepts of size, magnitude and position
  • Difficulty recognizing letters, words or simple shapes and forms

Treatment of a vision-related learning problem:

  • A comprehensive vision-and-learning examination is needed to evaluate the patient’s visual abilities, beyond a glasses prescription and eye health evaluation. A Visual Information Processing evaluation will evaluate the patient’s visual processing abilities. This will give a full picture of the patient’s ability to use their eyes, brain and body together.
  • Glasses may be prescribed to help a patient sustain near focus. Additional therapy or nutritional treatments may be recommended, depending on the patient’s needs.
  • Vision therapy will treat the patient with a developmental approach: working on the patient’s visual function from the ground up. Our therapy is individualized to meet each patient’s specific needs, because each patient’s brain is different!
  • Mid-therapy evaluations will ensure we are making progress, to meet the goals of the doctor and the patient.


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Strabismus

Strabismus occurs when the eyes are not pointing in the same direction. Any of these alignment problems will cause a deficit in depth perception. Oftentimes, strabismus is interpreted as an eye muscle problem. However, it really is an eye-brain problem which affects the eye muscles.

Signs of strabismus:
• Exotropia – an eye points outward too far, out of alignment with the other eye
• Esotropia – an eye points inward too far
• Hypertropia – an eye points up or downward more than the other eye

Symptoms of strabismus: There are many potential symptoms, depending on the type and frequency of strabismus. These symptoms may include:

  • Covering or closing an eye
  • Rubbing eyes
  • Tired eyes
  • Avoiding near work
  • Poor depth perception
  • Fear of heights
  • Clumsy / poor motor control

Treatment for strabismus: Since there is no age limit to learning, we believe that strabismus therapy can be effective for patients of any age.

  • Glasses may be prescribed to help the brain use both eyes better together.
  • Vision therapy involves neuro-feedback, giving the brain the opportunity to learn to see with both eyes open. Patients with strabismus may also have difficulties with other areas of visual processing (see above), which also will be addressed with vision therapy.



Amblyopia

Amblyopia, often called "lazy eye", is poorer vision in one eye compared to the other.

Signs of amblyopia: Amblyopia may be present with the following conditions:

  • Strabismus – if an eye turn is present, the turned eye often has poorer vision
  • High glasses prescription – if one eye needs excessive focusing effort to see clearly and the other eye sees without effort, this often results in amblyopia.

Symptoms of amblyopia: There are many potential symptoms, depending on the underlying condition(s) and intensity of suppression. These symptoms may include:

  • Covering or closing an eye
  • Rubbing eyes
  • Tired eyes
  • Avoiding near work
  • Poor depth perception
  • Fear of heights
  • Clumsy / poor motor control

Treatment for amblyopia: Amblyopia does not mean a child has one “good” eye and one “bad” eye. Rather, both eyes typically have reduced visual function. Depth perception, focusing and eye movements are typically lacking in both eyes, not just the amblyopic eye. Amblyopia therapy aims at improving the vision while both eyes are open.

  • Special glasses may be prescribed to improve the patient’s ability to use both eyes together. For patients with a large prescription difference between the eyes, traditional glasses can create an image size difference, which is very confusing for the brain.
    • Our office prescribes Shaw Lenses (www.shawlens.com) which minimizes this image size difference, dramatically improving a patient’s ability to bring the images together in the brain.
    • Contact lenses also minimize this image size difference. Talk with Dr. Carter regarding these options.
  • Vision therapy give the patient neuro-feedback, which helps their ability to use both eyes together. We utilize interactive games and activities to improve the brain’s awareness and utilization of both eyes. Lenses, prisms and colored filters are utilized to improve the patient’s vision and eye-teaming while both eyes are open.

Prevention of amblyopia: Amblyopia is often not diagnosed until a child is in elementary school. Our doctor strongly suggests that children follow the American Optometric Association’s recommendations for eye exam frequency:

  • First exam at 6 to 12 months old
  • Next exam at 2 to 3 years old
  • Pre-school exam at 5 years old
  • Every year thereafter while in school


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Neuro-Rehabilitation

Traumatic brain injury (TBI) is damage to any area of the brain due to external force. The damage may be microscopic, as in the case of concussions, or it could be structure-altering in more severe TBI or stroke.

Signs and symptoms of Traumatic Brain Injury:

  • Accommodative Insufficiency – This condition is a reduction in eye focusing ability that results in blurry vision at near, even in young athletes. Near vision may be constantly blurry or may pulse in and out of clarity during near activities like reading.
  • Blurry Vision - Blurry vision following a concussion can occur at distance, near or both.
  • Convergence Insufficiency – This inability to use the eyes comfortably at near can result in a number of symptoms including: headaches, eyestrain, fatigue or even double vision during near activities.
  • Double Vision – There are several causes of double vision, which is why anyone who sees double (even intermittently) should be evaluated by an optometrist with advanced training in neuro-optometry, binocular vision and vision therapy.
  • Light Sensitivity – Photophobia, or light sensitivity, can result from various types of acquired brain injuries (including concussions).
  • Ocular-Motor Dysfunction – Deficiencies in eye movement abilities are quite common following concussions and other forms of mild traumatic brain injuries. These eye movement deficits can pose challenges with many activities of daily life, including reading and driving.
  • Reduced Cognitive Abilities with Visual Tasks - Visual perceptual deficits can be caused by concussions and have dramatic effects on academic, occupational and even athletic success.
    • Visual Discrimination – Seeing small detailed differences between objects
    • Visual Memory – Keeping a visual image in your head in order to retain information better
    • Visual Sequential Memory – Remembering a sequence of information, like a phone number, or several items on a to-do list
    • Visual Figure Ground – Finding objects in a crowded area, working with spreadsheets on a computer
  • Reduced Visual Processing Speed or Reaction Time – Prolonged visual processing speed can slow down an athlete both on and off the field. The speed with which an athlete processes visual information affects many aspects of athletic competition, including: reading the field of play, judging the speed of a moving ball or puck, and judging the speed of other players on the field.
  • Visual Field Defects – Stroke patients may experience a lack of vision in one section of their field of sight. In some cases, the entire right or left side of their vision may disappear following a stroke. Lenses, prisms, vision therapy and occupational therapy can all be helpful to patients who need to re-learn spatial judgment after experiencing visual field loss

Treatment for traumatic brain injury:

The advocated treatment is multidisciplinary approach: optometrists, physicians, physiotherapists, occupational therapists, psychologists, speech pathologists, chiropractors, craniosacral therapists, and other specialists depending on associated symptoms.

• During the initial assessment at our office, our doctor will evaluate visual acuity, eye-teaming, eye movements, balance and posture.

• Special glasses with prism lenses may be utilized to help a patient recover their center of balance or improve their eye-teaming. Binasal occlusion (frosting the inside-corners of the lenses) can significantly reduce “sensory information overload,” calming the visual system.

• Vision therapy involves working both sides of the body so that both hemispheres of the brain communicate together. Patients will learn techniques to improve their peripheral awareness and eye tracking, as well as near-far focusing and eye-teaming. The length of therapy varies depending on severity of injury. Dr. Carter will evaluate her patients after every 10-12 sessions to ensure that their visual function is improving.

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Vertigo / Balance (Vision & Vestibular)

Your sense of balance arises from the interaction between the visual system, inner ear function and head position. A disruption in any of these systems can cause a person to experience balance, dizziness and/or vertigo problems. A physical therapist or ENT can often help, but problems with the visual system can cause persistent symptoms. At our office, Dr. Carter diagnoses and treats visual-vestibular conditions.

Signs of a visual-vestibular problem: Dizziness or discomfort with eye movement, poor coordination of eye movement, or a visual-midline shift, meaning a patient’s awareness of “center” is off-center.

  • Symptoms of a visual-vestibular problem:
  • Vertigo
  • Car sickness or motion sickness
  • Balance problems: leaning, falling over, or running into objects on one side
  • Gait problems: toe walking, or favoring one side when walking
  • General discomfort moving through space
  • Dizziness
  • Swimming sensation with eye movement

Treatment for visual-vestibular problems:

  • Special glasses with prism may be prescribed to re-balance the visual system. For many patients, these specialized lenses can provide profound relief and improvement in their symptoms. (See link) for a patient’s report regarding her experience at InSight Vision Therapy.
  • Vision therapy may be recommended if the patient experiences additional symptoms. In therapy, the patient will work on eye movement control and eye-teaming in dynamic, real-life conditions.
Vertigo treatment southern oregon

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