Therapy for poor vision can be real eye-opener

By Zenaida Mendez, Reprinted with permission from the Daily Record of Morris County, New Jersey

Exercises help some youngsters conquer sight, learning problems

Throughout elementary and middle school, Alaina Marks struggled with reading.

Barbara Marks said that just before Alaina entered fourth grade, an assessment revealed that her daughter has dyslexia, a learning disability that impairs the ability to read.

Persons diagnosed with dyslexia typically read at levels significantly lower than expected, despite having normal intelligence.

Then, during spring of 2005, Barbara Marks was told that her daughter couldn’t read blue and red writing on the class board. The Montville mother subsequently brought Alaina to Fair Lawn-based optometric physician Dr. Leonard J. Press, who performed a comprehensive eye exam and determined that the girl had an eye tracking problem. Essentially, her eyes didn’t stay on target.

An eye tracking problem is one of several visual problemsthat contribute to learning-related vision difficulties, according to the College of Optometrists in Vision Development, or COVD. Problems with eye teaming, binocular vision, visual-motor integration and visual perception also can lead to learning-related vision disorders.

Vision and learning

This month is National Children’s Vision & Learning Month. The goal of the observance is to help educate parents and educators about the link between vision and learning. Among signs of learning-related vision problems cited by the COVD are frequent loss of place when reading, poor reading comprehension, sloppy handwriting, avoidance of close work, or complaints of eyes hurting or headaches after reading.

According to the COVD, “children often are misdiagnosed as having attention deficit disorder/attention deficit hyperactivity disorder, labeled ‘dumb,’ or misplaced in a resource room when academic or behavior struggles actually stem from correctable vision problems.”

Dr. Christian Miller, a Hackettstown-based optometric physician, said learning-related vision problems usually show up after third grade, when a child is required to do more and more reading. Before that, he said, the main concern is “lazy eye,” or amblyopia.

Exam is key

The first step to any diagnosis, physicians advise, is a comprehensive eye exam.

“Everybody misconstrues a school screening as an eye exam,” optometric physician Dr. Joseph A. Viviano, who has offices in Morristown and Summit, said of many of the parents who visit his office.

“That school screening may or may not bring out some of the issues with learning,” he explained. “You definitely need a more comprehensive evaluation and it has to be geared toward a variety of aspects of visual processing.”

Livingston-based optometric physician Dr. Stuart M. Rothman said a comprehensive eye exam should include inquiries about the patient’s medical and academic history. It also should check how information is getting in and processing, or comprehension.

“I’d lose my place a lot, or I’d skip a line or a word by accident,” said Alaina Marks.

She underwent vision therapy for six months at Family Eyecare Associates’ Vision and Learning Center, where is director.

Nicole Astrella, an optometric vision therapist at Family Eyecare, said vision therapy is a behavioral therapy-like approach to address vision-related learning difficulties. Therapy is tailored to meet each patient’s needs and may include use of a variety of lens, prisms, filters, computer programs, eye patches, and binocular vision devices, such as stereoscopes. The goal is to condition eyes to focus accurately and work together efficiently, which patients should be able to do effortlessly at the end of the program. Occasional follow-up visits are required.

Alaina Marks, now 16, said her once-a-week office visits and 10-minute daily vision therapy “homework” exercises made a difference.

“It helped like strengthen my eyes a lot,” she explained. “Now I can just read without messing up or missing something.”

Just recently, Alaina asked her mother to purchase her a book from C.S. Lewis'”Chronicles of Narnia” series and has been so engrossed with the story that she will recapitulate it for her mom after reading.

“I can’t tell you what that means as a parent,” Barbara Marks said. “I couldn’t have dreamed of that a couple of years ago.”

Ghost images

Julie Mull’s son, Derek, also underwent vision therapy to help him with eye tracking and ghost images, or double vision.

Julie Mull, of Morristown, said she first noticed that her son, who now is 14, might have had a vision problem years ago. She said he kept moving closer to the television and, after he learned to read, he would cover one eye while doing so.

“I’d ask, ‘What hurts?’ and he’d say, ‘Nothing,'” she recalled. “I could never tell anything else was wrong.”

When Derek Mull’s vision was tested in kindergarten, Julie Mull learned that he had some trouble tracking but was told that it wouldn’t be a problem until later.

Around second grade, Mull had vision therapy with Viviano. His mom said she tried it despite protest from another eye care professional.

“Someone did say to me ‘You can do that for years and years and years and never get anywhere, never see any improvement,’ but I disagree,” she said.

She said such therapy has been beneficial, improving his eyes and his behavior.

“There have been periods of time when teachers ask, ‘What’s changed?’ and I don’t realize it until later on,” she said.

“There are gray times when he may not be behaving so well in school, he loses focus easier, he’s distracted by other kids more easily, but towards the end of the year it falls back into place for him,” she added.

Mull said her son still experiences difficulties, so he is continuing vision therapy. After a break from it during the summer, it resumes next month with a West Orange-based physician who specializes in sensory-motor vision therapy.

Though vision therapy is not covered by health insurance, she considers the expense worthwhile.

“I think it helped him maybe in ways we cannot measure,” Mull said. “It’s all worth it because it will improve his quality of life.”