Comprehensive Vision Examination

Young kid being examinedAt InSight Vision Therapy, we take our time to understand the history of each patient related to their development, total-body health, and visual function. The examination will focus predominantly on how the eyes work together. So often, people with 20/20 vision believe they could not have a vision problem. This is simply not true. During the examination, you will play with toys, follow interesting targets with your eyes, grab 3-D objects (hopefully!), see double on purpose, and much more. In other words, the examination will be fun, interactive, and educational for everyone involved.

The following components are evaluated during a typical new patient evaluation:

  • Visual acuity – how clearly can each eye see, and both eyes together
    • Eye tracking – the ability to move the eyes accurately independent of head movement
    • Fixations – the ability to hold eyes steady
    • Pursuits – the ability to slowly track an object
  • Saccades – the ability to quickly jump the eyes between objects, used in reading
  • Focusing – the ability to make objects clear near and far
  • Eye teaming – the ability to point the eyes together at the correct place in space
  • Depth perception – the ability to see objects in 3-D
  • Glasses prescription evaluation – looking specifically at improving the brain’s ability to use both eyes together
  • Pupil assessment – evaluating the neurological system through the pupils
  • Eye health evaluation – may include dilation, as needed
  • Eye pressure testing – without the air puff!

Strabismus / Amblyopia Assessment

Young girl with StrabismusStrabismus (eye turn) and Amblyopia (poor vision in one eye) are disorders of binocular vision, resulting in reduced depth perception. To see properly in 3-D, our eyes need to be aiming at the same place at the same time. In addition, the vision in both eyes needs to be approximately the same for proper depth perception.

A strabismus/amblyopia evaluation may include the following components, in addition to the comprehensive eye examination elements listed above:

  • Eye alignment – measuring eye tracking and turn of the eyes in different positions of gaze, near and far.
  • Binocular vision – in-depth assessment of eye teaming utilizing red-green and polarized 3-D glasses.
  • Glasses prescription – determination of the prescription that gives the brain the best opportunity to use both eyes together.

The results from these testing will help to determine the best treatment options, whether it is prescription glasses or contact lenses, prism lenses, vision therapy and/or eye-muscle surgery.

Read Dr. Carter’s article about current therapy options for amblyopia, which do NOT involve patching!

Neuro-Optometric Evaluation

Dr. Carter using handheld equipmentMany patients experience visual problems following neurological trauma such as concussion, brain injury, stroke, etc. Symptoms such as difficulty focusing, light sensitivity, balance problems, dizziness, and difficulty reading may be tied to visual system deficits.

A neuro-evaluation starts with a thorough history of the trauma, including previous testing and treatments, and a visual symptoms survey. Take your survey here.

A neuro-evaluation may include the following components, in addition to the comprehensive eye examination elements listed above. This may be scheduled as a separate appointment, depending on the patient’s fatigue level following the basic testing.

  • Visual motion sensitivity testing – patients feel dizzy if the eyes move at a different speed than the head. Lenses or partial occlusion may be utilized to improve this communication.
  • Balance assessment – an eye-brain misconnection may cause the patient to lean or fall over to one side. Lenses and prisms may be utilized to restore the patient’s balance.
  • Lens assessment – this may include distance, near and computer testing. Distance evaluation may involve walking in the hallway or observing traffic outdoors.
  • Functional visual field evaluation – after a trauma, the brain often reduces the amount of visual information it processes, causing tunnel vision. A functional visual field checks for these (temporary, stress-related) field changes.
  • Syntonics (optometric phototherapy) – following trauma, the fight-or-flight system tends to become overly active. Phototherapy is aimed at restoring balance to the autonomic nervous system.

Visual Information Processing Evaluation

Young girl looking through special equipmentVisual perception occurs throughout the brain. In order to better understand a patient’s visual system, a set of standardized tests is used to evaluate his or her ability to process visual information. Below are the various aspects of vision that may be evaluated. Since vision is a learned process, these areas can be improved through vision therapy. Learn more about the conditions we treat.

This evaluation takes up to two hours and is scheduled as a separate appointment. The following areas may be assessed:

  • Visualization – the ability to form a mental image and manipulate details in one’s mind. This is important in reading comprehension and math.
  • Visual–Motor Integration – evaluates the ability to match motor output with visual input. It is crucial for handwriting accuracy and efficiency as well as eye-hand coordination in sports.
  • Visual Sequential Memory – the ability to remember objects or words in the sequence they appear. A deficit in this area may result in misreading words such as ‘saw’ and ‘was.’
  • Visual Discrimination – the ability to differentiate between two similar looking objects, shapes, or words such as ‘horse’ and ‘house.’
  • Visual Closure – the ability to have part of the information and infer the rest. This is an important skill in reading speed and math.
  • Spatial Relations – the ability to perceive the position of two or more objects in relation to each other and in relation to oneself. This is an important skill in problem-solving, high-level math, and proper spacing between words when writing a sentence.
  • Spatial Orientation – required in understanding and recognizing the direction of objects. A deficit in this area lead to letter (b, d, p, q) and number (6 vs. 9) reversals.
  • Laterality – the understanding of rights and lefts on the patient and in space.
  • Directionality – understanding the proper orientation of letters and numbers.

A consultation appointment will be scheduled following this evaluation to discuss the results and treatment options.

InfantSEE Evaluations

Smiling infantOur office participates in this free public health program, offering no-charge visual assessments as part of a baby’s wellness visits. This is available for infants age 6-12 months old to ensure proper visual development.