The check-up which a regular optometrist performs relates to
only one aspect of vision. It can be compared to the work of
a dentist who wants to help someone with a nutrition problem.
Healthy teeth are desirable for healthy eating, but that is
only one aspect of proper nutrition.
A person can have two eyes blessed with perfect vision, yet
he might still be suffering from crippling vision
deficiencies.
The following checklists highlight symptoms which can
indicate that the reader is suffering from stress while he is
trying to see.
I. APPEARANCE OF EYES
1. One eye turns in or out independently of the other eye, at
any time.
2. Reddened eyes or lids.
3. Eyes tear excessively.
4. Encrusted eyelids.
5. Frequent styes on eyes.
II. COMPLAINTS WHEN USING EYES AT DESK
1. Headaches in forehead or temples.
2. Burning or itchy eyes after reading or doing desk work.
3. Print blurs after reading a short time.
4. Complains of seeing double (diplopia).
5. Words move or `swim' on the page.
III. BEHAVIORAL SIGNS OF VISUAL PROBLEMS
1. Eye Movement Abilities (Ocular Motility):
Field of vision is the area over which vision is
possible. Vision skills related to the field of vision
include relating correctly to relative position of objects in
space, contrast and movement sensitivity in side vision
(reading from line to line without getting lost on the
page).
The eye does not move completely smoothly from point to
point, like a machine, but moves in little jumps.
Fixation is the ability of the eye to control those
little jumps so that the eyes shift rapidly and accurately
from one object to another, such as when moving along a line
of writing, reading letters and words in their correct
sequence.
Tracking is the ability of the eye to follow moving
objects smoothly and accurately, such as when catching a ball
and keeping your place when you or the book moves.
Checklist for Problems with Ocular Motility:
a. Head turns as he reads across page.
b. Loses place frequently during reading.
c. Needs finger or marker to keep place.
d. Short attention span in reading or copying.
e. Frequently omits words.
f. Reads what he thinks should be there instead of what is
actually written.
g. Writes up- or downhill on paper.
h. Rereads or skips lines unknowingly.
i. Orients drawings poorly on page.
2. Eye Teaming Abilities (Binocularity)
BINOCULAR VISION is the ability of the eyes to work
together and combine information received through each eye to
make one mental picture.
Using one eye and mentally shutting off the other is called
SUPPRESSION.
CONVERGENCE is muscular ability of the eyes to turn
toward each other to look at near objects (words at reading
distance) and maintaining eye alignment comfortably and
efficiently over time (attention span).
STEREOPSIS is the ability of the brain to use the
information coming simultaneously from the eyes to determine
relative distances between objects [depth vision] because
each eye looks at the target from a slightly different
position to that of the other eye.
Checklist for Problems with Binocularity:
a. Repeats letters within words.
b. Omits letters, numbers or phrases.
c. Misaligns digits in number columns.
d. Squints, closes or covers one eye.
e. Tilts head extremely while working at desk.
f. Odd working posture at desk activities.
3. Eye-Hand Coordination Abilities
a. Must feel things to `get the idea.'
b. Eyes not used to `steer' hand movements (extreme lack of
orientation, placement of words or drawings on page).
c. Writes crookedly, poorly spaced, cannot stay on ruled
lines.
d. Misaligns both horizontal and vertical series of
numbers.
e. Uses hand as `spacer' to control spacing and alignment on
page.
f. Repeatedly confuses left-right directions.
g. The child is well coordinated, yet has trouble with ball
games (softball, tennis, kickball).
4. Visual Form Perception (Visual Comparison, Visual
Imagery, Visualization)
FORM PERCEPTION is essential for organizing and
recognizing visual sensations as shapes, noticing
similarities and differences (the difference between `was'
and `saw,' `that' and `what,' 21 and 12, a circle and a
square, `e' and `o').
Checklist for Problems with Visual Form Perception:
a. Fails to recognize same word in next sentence.
b. Reverses letters and/or words in writing and copying.
c. Difficulty recognizing minor difficulties.
d. Repeatedly confuses words with similar beginnings and
endings.
e. Fails to visualize what is read silently or aloud.
f. Whispers to self for reinforcement while reading
silently.
g. Uses `drawing with fingers' to discriminate similarities
and differences.
5. Refractive Status (Nearsightedness, Farsightedness,
Focus Problems etc.)
Even though this aspect of vision is usually checked
efficiently by a regular optometrist, he might not understand
the significance of some problems.
For example, if someone is long-sighted in one eye and short-
sighted in the other eye, the optometrist might say that the
situation is okay because the person can use the long-sighted
eye for distance vision and the short-sighted eye for
reading.
In fact, such an opinion is mistaken because both eyes are
active. In both situations, the eye which is not focusing
correctly will interfere with the other eye!
Furthermore, if the optometrist gives glasses with one lens
being very different from the other lens, that will cause the
image in one eye to be a different size than the image in the
other eye, making it impossible for the brain to fuse both
images together to enable normal vision.
In such a situation, the person might need contact lenses,
which enable the images in both eyes to be the same.
Another commonly ignored problem is when a person finds it
difficult to change focus from near to far, and back.
Checklist for Problems with Refractive Status:
a. Quickly loses interest in reading.
b. Blinks excessively at desk tasks or reading.
c. Holds book too closely; face too close to desk.
d. Makes errors in copying from chalkboard to paper.
e. Makes errors in copying from page to paper.
f. Squints to see chalkboard, or requests to move nearer.
g. Takes a long time to copy from chalkboard.
h. When copying from the chalkboard, needs to look back
frequently because he has forgotten what was written
there.
i. Rubs eyes during and after short periods of visual
activity.
j. Covers one eye when reading.
k. Blinks to `clear' view of chalkboard after reading or
writing.
This information and checklist is based on information given
out by the Optometric Extension Program.
I know of hundreds of people: children, teenagers and adults,
who have been saved from misery and failure, through using
the services of optometrists who have been trained under that
program.
