Ginger Saenz knew right away to check for a visual problem when her granddaughter began having trouble in school.
As a child, Saenz underwent vision therapy to correct an eye defect. Four of her children also benefitted from the therapy. So she quickly arranged an eye exam for her granddaughter, Tori Foronato, and it showed that Tori's eyes drifted up and down a line when reading text.
Tori, 12, has since benefitted from doing special eye exercises at home, in addition to periodic visits to Des Moines Eye Care, 2600 Grand Ave., one of the few optometry practices in the area offering vision therapy.
Vision therapy is a treatment process used to improve vision function. It can be used to help such conditions as amblyopia, or lazy eye, which is caused by strabismus, or crossed eyes; ocular motor dysfunctions and perceptual disorders.
Lenses, prisms, filters and a variety of special instruments, such as a balance beam and flashing-light board, work both fine and gross motor skills to improve binocular skills, or eye teaming. They also can be used in conjunction with other therapy, such as eye patching, and if needed, prior to surgery, says Dr. John Kruger of Des Moines Eye Care.
"These are life-changing treatments," he says.
Saenz advises parents to watch their children's eye growth carefully. "I see nothing but a positive experience when you can take a child's eyes and make them see better," she says.
All ages can benefit
Kruger's practice has many success stories, including helping a patient who was unable to climb a ladder due to poor depth perception, and an older woman diagnosed with amblyopia as a child who was unaware that therapy was an option.
Parents often realize a child has vision problems when he or she has difficulty with schoolwork. Kruger's son, Michael, also an optometrist at Des Moines Eye Care, explains that reading is a complex process requiring that we fixate, track, go line by line and then remember what was read. Any problems reduce comprehension, he says.
"Kids who struggle that much to read are going to get frustrated, quickly get distracted or avoid because they don't like to feel that way. They can be mislabeled," he says.
Some children with visual disorders are misdiagnosed with attention deficit hyperactivity disorder, says Mary Kay Barker, vision therapist at Des Moines Eye Care.
John Kruger says some patients compensate with other skills, such as skimming or scanning passages, to avoid reading.
"They get to a point where they have so many difficulties with headaches, fatigue and comprehension skills that they have to do something," he says.
John Kruger left law school because he had trouble retaining what he read in textbooks. A behavioral optometrist helped him overcome that and inspired him to pursue that interest in his practice.
Therapy may involve office visits a few times a week, in addition to work at home. How long therapy lasts depends on the problem and the patient's effort, Michael Kruger says.
The process begins by developing equal skills in each eye separately. Repetition is key, and Barker advises patients to do exercises at home for 45 minutes throughout the day.
Some exercises are simple, such as tossing a bean bag back and forth between the hands to function in space visually.
Other vision therapy exercises
- Flipper lenses. Many children have trouble reading directions off a board and writing them down on a notebook in front of them. Wearing flipper lenses, they can work on this skill by viewing an item larger, then smaller, in a process known as accommodation.
- "Pursuits." In this game, patients smoothly follow a small pen light as it moves clockwise, counterclockwise, vertically, horizontally and diagonally. This can be done with and without lenses or an eye patch, with both eyes and then one eye at a time.
- Pencil work. Wearing an eye patch, patients alternate their focus between the tips of two pencils in front of them. They must look smoothly without stopping short, or overshooting and coming back.
- Rotator. Wearing an eye patch, patients follow a spinning wheel three times around, then place golf tees into holes labeled with letters and numbers. The technique works eye-hand coordination and gross motor skills.
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