Category Archives: Specialty Clinics

Learning-Related Vision Problems

By: Carla D. Adams, OD, FCOVD

WHAT IS THE VISION TRIANGLE?
UntitledSome parents have received a notice that their child needs a complete eye examination.
Parents often take their child to an optometrist and anxiously watch as they are asked to distinguish between lenses. “Which is better -1 or 2?” While a routine exam is a good start it should not be the only test for many students. Since vision and learning are closely linked, problems with vision can often interfere with learning. A routine eye exam alone will not always detect all problems that could affect good vision and thus good learning. Parents should be aware of the vision triangle. There are three types of vision exams, two of which are beyond the routine exam performed by eye doctors. By understanding the vision triangle, it will help avoid frustrations. Parents are armed with options if their child should have academic problems related to how he or she interprets what is being taught, especially if the problems persists with eyeglass.

ROUTINE EYE EXAMS
The first part of the vision triangle is the routine eye exam (just like the example aimagebove). Routine eye exams can detect sight imperfections such as near-sighted, far-sighted and astigmatism. Routine exams can also detect more complex problems such as crossed-eyes and lazy eyes. These conditions are often diagnosed during routine eye exams and respond well to eyeglasses and contact lenses. However, if eyeglasses cured all learning related problems, then there would be an overabundance of “A” students. Clear vision or having 20/20 sight is only part of the vision triangle. Unfortunately, most optometrists and ophthalmologists do not proceed further.

FUNCTIONAL VISION
The second part of the vision triangle is centered on functional vision. To read smoothly, a child’s eyes must work well together. This is called binocularity. A depth perception test is one of several tests used to test this skill. Fine eye movements and focusing tests (accuracy, flexibility and stamina) should also be measured. There maybe deficits in this area if your child complains of readiUntitledng problems such as eye strain, fluctuating vision that will not stay clear, words that float off the page or even headaches. Maybe you even suspect that one of your child’s eyes do not look straight. These types of deficits do not always respond well to eyeglasses or contact lenses which is why some students continue to have problems after a routine exam. Vision therapy is often a good approach to treating such problems. Typically, only a few eye doctors offer therapy. More will be discussed about vision therapy later.

PERCEPTUAL VISION
Untitled1The third and final part of the vision triangle is perceptual visual testing. Visual perception involves not only the eyes but also the brain and how it interprets and organizes information. This type of disorder surfaces around the age of 6 when children first learn to read. You should consider perceptual problems if your child tends to avoid reading and writing. Children with perceptual problems may reverse letters, print poorly and have trouble learning. Eye glasses alone do not solve perceptual problems. A vision therapy consultation with a pediatric optometrist is advised when learning problems persist.

What is Vision Therapy (V.T.)?
Just as eyeglasses and contact lenses work well to treat sight imperfections (i.e., near sightedness, far sightedness, etc.), functional and perceptual problems are often best atreated with vision therapy. It is a type of physical therapy for the eyes. The purpose is to resolve visual problems that interfere with reading and learning. V.T. helps children develop or improve visual skills, read with efficiency and changes how a child processes or
interprets visual information.

Vision therapy is a progressive program of vision exercises or procedures performed under an optometrist’s supervision. The therapy sessions are individualized for each child. The meeting sessions are conducted in-office, once a week.

Following is a list of symptoms that often respond well to vision therapy:

• Blurred or double vision
• Headaches or eye strain
• Crossed eyes or strabismus
• Avoidance or dislike of reading
• Short attention span when reading
• Turning or tilting head to favor one eye
• Rubbing the eyes
• Slow reading speed
• Difficulty remembering what is read
• Omitting or repeating works or confusing letters
• Poor eye-hand coordination
• Losing one’s place while reading or using finger as a guide

For more information regarding vision visit our website:
http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/clinics.html

Editor’s Note:
Dr. Carla Adams is a Developmental Optometrist with a specialization in pediatrics and vision therapy.  Her training includes an emphasis on serving children with special needs.  Dr. Adams is successful in treating children struggling in the classroom as well as children with attention deficit, PDD and autism.  She is a partner of the Easter Seals DuPage & Fox Valley Jayne Shover Center in Elgin.  Learn more about her care via  www.optique-eyecare.com

Down Syndrome Enters a New Era

By: Dr. Peter Smith, Associate Professor of Pediatrics, University of Chicago

Editor’s Note: Through a partnership with the University of Chicago, developmental- behavioral pediatrician, Dr. Smith leads a new Neurodevelopmental Disability Clinic at Easter Seals DuPage & Fox Valley which provides support for children with Down Syndrome, ADHD or Autism, disabilities that may include complex medical and emotional issues.

Dr. Smith also leads Easter Seals DuPage & Fox Valley’s multi-disciplinary team including an occupational therapist, speech-language pathologist, developmental therapist, audiologist and parent liaison in the Medical Diagnostic Clinic. This clinic specializes in early diagnosis of young children.

Current Processes Are Not Working

Individuals with Down syndrome (DS) are living longer and healthier lives than ever.  There is consensus that complete information needs to be offered to all parents of children with Down syndrome (both pre- and postnatal) regarding the current experiences, health outcomes, lifespans, and quality of life for individuals with DS.  DS represents a dramatic “success story” and the lives of individuals with Down syndrome are improving in every way measurable.  Unfortunately, this good news is too often not being shared with new and expectant families.  Doctors are not prepared for this task and parents report frustration with the process.

Maggie_1.jpgOn the Cusp of Potentially “Game Changing” Therapies

In addition to the dramatic changes that have already occurred, DS as a clinical and research arena is on the cusp of developing even newer therapies that have the potential to improve cognitive outcomes.  Multiple research teams have protocols already enrolling study subjects.  For example, the team at the Jerome Lejeune Institute in Paris has an active study underway  that employs a combination of folic acid and thyroid hormone, targeting infants and primarily measuring cognitive performance during and after therapy.  Their preliminary work has shown significant promise and preliminary results might be released later this year.  Because of their early successes, there are ongoing efforts to mount a similar study here in the United States.  The NIH has recognized this new era and has launched an international registry (see https://dsconnect.nih.gov ).  However, this “breaking news” has not been widely disseminated.  Many worry that recruitment to these studies could be diminished due to the lack of awareness by primary care providers and the general public, which would slow the progress of the studies.

01_Lucas_Vasquez.jpgA Growing Number of States Have Addressed the Issue: Including Illinois

Because of the lack of general knowledge of both the dramatic improvements in the lives of individuals with DS and the emerging clinical trials in DS, a coalition lead (of course) by family support organizations has emerged.  They have initiated a new “information rights” movement that includes clinicians, policymakers, legislators, and researchers that has worked to enact new state laws addressing the problem of misinformation.  The first to successfully pass legislation was Massachusetts: in 2012, a coalition helped to pass a state law, mandating that clinicians provide accurate information and Referral to parent support organizations.  Most recently, Illinois, passed unanimous legislation in 2015, which proves that this is truly a bipartisan issue.

To learn more about our specialty clinics including the Medical Diagnostic Clinic, visit eastersealsdfvr.org.