Sunday, August 7, 2011

Vision & Special Needs Kids

Kids with special needs can have a myriad of vision problems.  We are proud to have the capability, equipment and expertise to diagnose and treat these difficulties.

Developmental disorders arise in some stage of a child's development.  They are often grouped into:
  • Pervasive Developmental Disorders (PDD)
    Autism Spectrum Disorder (ASD)
              Autism (39% of ASD)
              Asperger Syndrome (14% of ASD)
    PDD-Not Otherwise Specified, NOS (32% of ASD)
         Rett Syndrome
         Childhood Disintegrative Disorder (CDD)
  • Specific Developmental Disorders (SDD)
    Specific Learning Disabilities
         Developmental Coordination Disorders
I came across a very nice blog today written by Pat Wyman (  She wrote an excellent piece on how optometric vision therapy can help reading problems in autism.  I believe you will find her article very informative.  Access it by clicking HERE. 

Saturday, August 6, 2011

Visual Difficulties after Brain Injury (Video)

Vision problems are among the most common problems associated with acquired brain injuries.   Causes of brain injury can include trauma, auto accidents, suffocation, drug reaction and strokes.  Initially symptoms may be subtle but often become more of a concern with time. Specific problems can include poor memory, disorientation, loss of reading skills or poor word recall.

Common visual symptoms after brain injury include:
  • Double vision
  • Headaches
  • Blurry vision
  • Dizziness or nausea
  • Attention or concentration difficulties
  • Staring behavior (low blink rate)
  • Spatial disorientation
  • Lose place when reading
  • Can't find beginning of next line when reading
  • Comprehension problems when reading
  • Visual memory problems
  • Pulling away from objects when they are brought close
Unfortunately conventional ophthalmological treatment for these difficulties is many times limited.  I have seen a number of patients told to cover one eye with a patch if they have double vision!!  Others with slow reading speed have been told to get books on tape!!  Some with attention and concentration difficulties are told to just accept it.

These difficulties can often be helped through the use of specialized lenses/prisms and/or optometric vision therapy.  If you have concerns for yourself or a relative, give me a call so we can discuss it further.

--James B. Mayer, OD, FCOVD
     Agape Learning & Optometry Center
     Thousand Oaks, CA

Friday, August 5, 2011

Vision Exams For Kids!! (Video)

Betsy Cowand, a kindergarten teacher from West Shore Elementary in Tampa, Florida & Dr. Larry Lampert, a developmental optometrist from Boca Raton, Florida are interviewed  by Danielle Knox (Lifetime TV) about children's vision & eye exams.

Over 80% of learning comes through the visual system.  Almost 25% of children have a undetected vision problem that affects learning.  Vision screenings at school and the pediatrician's office are missing visual skill checks with areas of processing that are crucial for learning.

--James B. Mayer, OD, FCOVD
     Agape Learning & Optometry Center
     Thousand Oaks, CA

Thursday, August 4, 2011

Optometric Sports Vision Therapy & Ice Hockey

This is a very nice interview from WBFO-FM 88.7 NPR radio in Buffalo, New York.  A developmental optometrist (Dr. Mark Gordon) is credited with helping extend the career of a goalie with the Tampa Bay Lightning.  His name is Dwayne Roloson and he feels optometric sports vision therapy is one of the main reasons he has been able to play into his 40's.

"I've been with him 12, 13 years, working with him," says Roloson. "We've tried to keep it quiet because we were going to write a book about it and bring it out later once I retired, but I keep on - because of a lot of his eye stuff that we're doing - I've been able to keep playing. So I think now, I think it's great for him to be able to get some recognition and knowledge for the success that I've had."

"If you're doing well as an athlete, and you find the goose that laid the golden egg, if you find your Holy Grail, if you find the thing that gives you the winning edge, you might not want to share that with your competition," says Dr. Gordon. "And that's what we see going on in offices like mine who do a lot of work with athletes, especially at such a high level."

The interview can be found by clicking HERE.

I have found that optometric sports vision therapy can be very effective for not only hockey goalies but also soccer, field hockey and lacrosse goalies.

--James B. Mayer, OD, FCOVD
     Agape Learning & Optometry Center
     Thousand Oaks, CA 

Wednesday, August 3, 2011

Letter & Number Reversals - Dyslexia? (COVD White Paper)

Problems of letter and number reversals in children have concerned parents and educators for many years.  Some have considered reversals as a symptom of dyslexia.  More commonly reversals reflect a lag in spatial development. Most research has shown there is no structural or medical basis for these reversals. Although reversals are common and expected in five to six year old children, they may persist through childhood.  Some adults may even continue to manifest these problems.

For many years, scientists have studied children with reversal problems, particularly regarding orientation to right and left as related to their own bodies (laterality), and to objects around them (directionality). At three, or even younger, the child should have grasped the concept of top and bottom, and right side up or upside down (even though still looking at books upside down). The four year old is grappling with front and back, and may still put a shirt on backward.  Many four year olds show reversals as they put on shoes by themselves.  Some four to five year olds may start printing numbers and letters from right to left.  At these ages, this is a normal stage of developing orientation in children.

Although most children master this concept of directionality by age seven, this confusion in orientation may continue, in some people, all their life.  Reversals are a manifestation of a developmental lag in the process of orientation.  They are indicative of an underlying problem in the integration of the vestibular and visual systems in the brain.  Rote repetition of learning to write letters and numbers correctly or rotely learning right and left hands may help us pass a test, but it does not solve the problem of the underlying causative factor of delayed orientation development.

The development of orientation starts in the prenatal period with the attitudinal reflexes which help the fetus orient in utero.  This development continues through varied learned experiences in our lives.  Interferences in movement activities involving vision and neuromotor relationships limit the development of orientation. According to the neuroscientist J.D. French, orientation contributes in an important way to the highest mental processes--the focusing of attention, and the ability to think, to learn, and to act.

Specific optometric vision therapy, including the unique application of lenses and prisms during visual-neuromotor activities (movement with awareness and feedback), provides learning experiences to improve the development of laterality, directionality and orientation, and the related problems of reversals.  When a child learns to orient easily, the evidence points to a well integrated and effectively operating person.

Members of the College of Optometrists in Vision Development (COVD) are optometrists who have demonstrated interest in the problems and remediation of reversals. Fellows of the College are certified in the diagnosis and treatment of learning related vision problems. For further information, contact COVD or consult with a COVD member optometrist.

This informational paper was produced by the College of Optometrists in Vision Development, which board certifies qualified optometric physicians in vision therapy. For further information, see our website, WP5 Rev 1/2/08 ©2008

--James B. Mayer, OD, FCOVD
     Agape Learning & Optometry Center
     Thousand Oaks, CA 

Tuesday, August 2, 2011

Cataract Symptoms

Cloudy/milky vision with a cataract
Cataracts are the leading cause of blindness in people 55 and older.  You should be aware of the symptoms of cataracts, for the sake of your vision or a relative/friend.

A cataract is a clouding of the lens of the eye and they tend to ‘grow’ gradually, so changes in vision may not be noticeable at first.

Symptoms of cataracts may include:
• “Cloudy” vision
• Sensitivity to bright sunlight
• “Halos” appear around headlights at night
• Colors appear faded

The most common cataracts are age-related.  By age 80, almost half the population either has a cataract or has had a cataract surgically removed.

Cataract surgery is one of the most common forms of surgery, but surgery is not the first option for anyone with a cataract.

Some of the symptoms of cataracts can be managed in the early stages with Polaroid sunglasses or iZon eyeglasses with anti-reflective lenses.  Others can be helped with homeopathic eye drops.  When the cataract interferes with daily activities such as reading or driving, it’s time to consider surgery.

As with any eye disease, early detection and treatment are the keys to successful management of cataracts.  The first step is a comprehensive eye examination annually, especially for persons over 60 years of age.

Monday, August 1, 2011

Infant, Toddler & Preschool Vision Testing - Part 2

Children typically do not receive a comprehensive vision exam before entering school.  The brief pediatrician exam does NOT count.  It is estimated (Indiana University) that only 14% of children under age 6 are likely to have a comprehensive vision exam and only 31% of kids between 6 and 16 are likely to have an exam.

A recent retrospective study of comprehensive pediatric eye examinations reported the following as the most common disorders in children between 6 months and 18 years:
  • Farsightedness (hyperopia - eyestrain at near): 24.8%
  • Astigmatism (eyestrain at distance & near):  22.5%
  • Nearsightedness (myopia - distance blur):  18.2%
  • Subtle binocular disorders (ie: convergence insufficiency):  14.3%
  • Overt binocular disorders (ie: strabismus - crossed eye):  12.1%
  • Lazy eye (amblyopia - reduced sight in one eye):  7.1%
Photoscreening a young patient
Due to these problems it is imperative that children have a comprehensive vision exam.  These exams are often much different than those for adults.  Technology has enabled exams to occur with all ages.  Photoscreening is done in our office to provide objective results by the use of digital ocular images.  It is supported by recommendations of the American Academy of Pediatrics.  Preferential looking utilizes automatic brain reflexes in looking at closely spaced lined targets versus blank screens.  The brain will always look at targets if they can be seen.  Optokinetic nystagmus (OKN) testing gives information about how well a moving target is seen.  Differences between the eyes can also be indicative of strabismus.

--James B. Mayer, OD, FCOVD
     Agape Learning & Optometry Center
     Thousand Oaks, CA