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FAQs

General FAQs

What is a Behavioral or Developmental Optometrist?

What if another Doctor checked my eyes and said they were fine?

What do you do differently from other doctors?

What is a Visual Perceptual Motor Assessment (VPMA)?

What are the signs or symptoms that may indicate a vision problem?

Vision Therapy FAQs

What is Optometric Vision Therapy?

Is Vision Therapy a new treatment?

Why is Vision Therapy provided mostly by Optometrists rather than Ophthalmologists?

How long does Vision Therapy take to resolve vision disorders?

Learning and Vision FAQs

Can a vision problem affect my child’s self-esteem?

Do you diagnose learning problems, disabilities or dyslexia?

Can Vision Therapy help children with learning problems?

Is there an age limit for Vision Therapy to be effective?

What causes learning related vision problems?

What specific visual dysfunctions contribute to learning-related vision problems?

What are symptoms of learning-related vision disorders?

What is a Behavioral or Developmental Optometrist?

A behavioral or developmental optometrist is concerned with the prevention, remediation and enhancement of vision to achieve optimal function. In other words, the visual evaluation goes far beyond eye health and glasses to include how comfortably and efficiently you use your vision for the type of work, education, or sports activities you engage in. Recommendations for special types of lenses, prisms and vision therapy (ex: for learning, computer, sports, etc.) are considered. We do not treat eyes as separate, isolated entities, but as a part of the total eye-mind-body integrated function. Vision therapy involves specific activities designed to improve eye teaming, focusing, eye movements, peripheral vision, depth perception, visualization, vision perception and visual motor abilities, as well as visual auditory integration.

What if another Doctor checked my eyes and said they were fine?

Eyesight/visual acuity is the physical process of detecting patterns of light and contrast with the eyes. The accepted measurement of good eyesight/visual acuity is 20/20.

However, vision is not just 20/20 vision; it is the learned process which allows the brain to efficiently gather information about where we are, and what is around us. Vision also provides the brain with an efficient channel for monitoring our movement through space and activities in our environment.

Routine vision exams do not frequently include tests for many of the difficulties that can cause or complicate learning such as tracking (following a moving object), focus stability and flexibility, eye teaming, hand-eye coordination, visual perception, etc. The routine eye exam may be very thorough in checking eye health and eyesight/visual acuity, but while the visual acuity may be 20/20, this may give a false sense of security that all “visual processing” abilities, which were not checked, are adequate as well.

What do you do differently from other doctors?

The initial comprehensive exam thoroughly investigates eye health, need for eyeglasses, ability to track and move eyes accurately and efficiently, focusing, eye teaming and depth perception. Then, depending on what is found during the first exam, and the reasons for the evaluation, additional evaluations may be recommended. These evaluations include tests for visual perceptual abilities (what you understand from what you see), binocular coordination (eye teaming efficiency), saccadic eye movement control during reading, eye-hand coordination, visual memory, visual auditory integration and visual motor integration ability.

What is a Visual Perceptual Motor Assessment (VPMA)?

The VPMA is a series of tests that are designed to identify an individual’s strengths and weaknesses in the acquisition and processing of visual information. The tests measure accommodation (focusing), binocularity (eye teaming), and ocular motility (eye tracking movements). In addition, the tests determine the level of integration of vision with auditory input, and vision with motor skills. For children, the VPMA testing takes approximately two hours. The test performance is analyzed and results are presented to parents or guardians during a conference with Dr. Ruggiero or Dr. Hannigan at a later date.

What are the signs or symptoms that may indicate a vision problem?

Double vision, blurred vision, avoidance of sustained visual tasks, dizziness, motion sickness, headaches, eye strain, difficulty reading (loss of place, poor comprehension), eye “crossing or drifting,” closing or covering one eye, bumping into objects, head tilt or turn, balance and coordination problems, and poor judgment of depth.

What is Optometric Vision Therapy?

Optometric Vision Therapy is an individualized treatment program designed to teach the brain how to use the eyes effectively to gather information, understand it quickly and react to it appropriately. Vision Therapy typically will include the use of special lenses, prisms, or filters in association with procedures designed to enhance the brain’s ability to control eye alignment, eye movements, focusing ability and eye teamwork. Carefully monitored therapy sessions use specialized computer and optical devices to integrate vision with motor and cognitive skills. In most cases, Vision Therapy treatment sessions are once a week for forty-five minutes. The in-office sessions are supported with daily home vision therapy.

Is Vision Therapy a new treatment?

Vision Therapy has been a vital part of eye care since the early 20th century. Numerous scientific studies published in Optometry: Journal of the American Optometric Association, American Journal of Optometry and Physiological Optics, Documenta Ophthalmologica and American Journal of Ophthalmology show that Vision Therapy is an effective treatment for vision problems including eye focusing, eye coordination, amblyopia (lazy eye) and strabismus (crossed eyes). More recent neuroscientific studies on neuroplasticity have provided additional evidence regarding the benefits and efficacy of optometric vision therapy. We would be happy to provide information, efficacy studies, references, etc. on vision therapy. We are often invited to present lectures and workshops on vision therapy for other medical providers and educators. In addition, we have a list of patients and other professionals who are familiar with vision therapy and would gladly discuss any of your questions.

Why is Vision Therapy provided mostly by Optometrists rather than Ophthalmologists?

Traditionally, optometrists have emphasized the clinical treatment of the functional and cognitive processes involved in vision (eye tracking, eye teaming, binocular vision, visual-motor integration, visual perception). Ophthalmologists have concentrated on the physical nature of the eye and eye diseases.

How long does Vision Therapy take to resolve vision disorders?

Our Vision Therapy programs are individually prescribed for each patient based on the conditions being treated and the severity of the symptoms. In-office therapy sessions provide targeted opportunities for patients to learn new, more efficient abilities. Home practice (20-30 minutes, 6 days a week) allows the patient to develop accuracy, comfort and efficiency. How long a vision therapy program takes not only depends on the patient’s condition, but also on the number of sessions prescribed and on the consistency of home therapy.

Can a vision problem affect my child’s self-esteem?

YES! Children with vision problems often have a history of underachievement and frustration. Frequently, they conclude that the reason for their low achievement is that they are not as “smart” as other children. Low self-esteem and lack of confidence are often the result of that conclusion. Correcting the vision problems which interfere with achievement can have a dramatic impact on both performance and self-esteem.

Do you diagnose learning problems, disabilities or dyslexia?

Approximately 20% of school-aged children may be affected by some degree of learning related visual problems. This percentage increases dramatically in learning disabled and remedial reading populations, where as many as 70% of the students have a significant visual component to their learning difficulty. A recent study highlighted by the Harvard University Graduate School of Education showed that visual perception and eye movement abilities are strong predictors of academic scores.

Visual problems such as poor focusing, eye teaming and eye movement control can cause challenges that impact children’s academic, social and athletic performance. Problems that indicate a possible visual problem include loss of place, skipping words, blurriness, unsteady print, headaches, fatigue, tired eyes and difficulty with spacing and staying on the line while writing. Even if the patient can see clearly, there may be other significant visual perception and processing problems hindering one’s ability to learn. To thoroughly diagnose learning disabilities or dyslexia, a full psycho-educational battery of testing and consultation should be considered. Dr. Ruggiero is happy to coordinate care with other professionals, schools, hospitals and treatment centers as needed.

Can Vision Therapy help children with learning problems?

YES! Vision Therapy can be an important part of the overall treatment of a child’s learning difficulty. Vision deficits can cause eyestrain, headaches, blurred or double vision, loss of place while reading and difficulty maintaining attention to close work. Even intelligent, highly-motivated children can be severely handicapped by these problems in the academic environment. Correcting these deficits allows affected children to benefit from academic remediation and to achieve their full potential in the classroom.

Is there an age limit for vision therapy to be effective?

Vision Therapy is effective at any age. Vision is a brain process, and therefore the changes that take place as a result of vision therapy take place in the visual neuro-muscular pathways of our brains.

Recent neuro-scientific research has demonstrated that our brains are pliable at any age, though adults that receive vision therapy tend to require longer periods of treatment. Research supports that this is due to the fact that the adult brain changes more slowly and that part of the therapy involves eliminating or rewiring around whatever maladaptations have developed.

It is never too late to do vision therapy. We have had patients benefit from treatment well into their nineties.

What causes learning related vision problems?

Research indicates the problem can be due to difficulty in either acquiring or processing the information we receive through our eyes. The visual skills needed to see effectively may be lacking or the brain may not be sufficiently trained to interpret what the eyes see. Without these abilities, the child or adult spends so much energy just “looking at” and “decoding” the written word, there may be little mental energy left to comprehend and remember what is said.

What specific visual dysfunctions contribute to learning-related vision problems?

Inadequately developed visual abilities in the following areas can lead to learning-related vision disorders:

  • Eye tracking skills (eyes staying on target)
  • Eye teaming skills (eyes working together in a synchronized fashion)
  • Binocular vision (blending images from both eyes together at the same time)
  • Accommodation (eye focusing)
  • Visual-motor integration (eye-hand coordination)
  • Visual perception (visual memory, visual form perception, directionality)

What are symptoms of learning-related vision disorders?

  • Dislike or avoidance of reading and other close work
  • Loss of place while reading or copying
  • Trouble finishing assignments in the allotted time
  • Omitting or misreading words or letters
  • Slow, inaccurate copying
  • Distractibility, loses attention quickly
  • Blurred, double, or unstable vision
  • Headaches, eye strain, or visual fatigue associated with reading or other close work

If I were to describe the office to someone, I would tell them that the staff and doctors are not only professional, but caring individuals who make any worries or concerns about visual perception fade away. It is because of this office, and the services that are provided, that my son has a new view of the world.”

Maria Peterson

West Springfield, MA

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